02-32503. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2003 and Inclusion of Registered Nurses in the Personnel Provision of the Critical Access Hospital Emergency Services Requirement for ...  

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    AGENCY:

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

    ACTION:

    Final rule with comment period.

    SUMMARY:

    This final rule with comment period refines the resource-based practice expense relative value units (RVUs) and makes other changes to Medicare Part B payment policy. In addition, as required by statute, we are announcing the physician fee schedule update for CY 2003.

    The update to the physician fee schedule occurs as a result of a calculation methodology specified by law. That law required the Department to set annual updates based in part on estimates of several factors. Although subsequent after-the-fact data indicate that actual increases were different to some degree from earlier estimates, the law does not permit those estimates to be revised. A subsequent law required estimates to be revised for FY 2000 and beyond.

    Although we have exhaustively examined opportunities for a different interpretation of law that would allow us to correct the flaw in the formula administratively, current law does not permit such an interpretation. Accordingly, without Congressional action to address the current legal framework, the Department is compelled to announce herein a physician fee schedule update for CY 2003 of −4.4 percent.

    Because the Department would adopt a change in the formula that determines the physician update if the law permitted it, we have examined how proper adjustments to past data could result in a positive update. The Department believes that revisions of estimates used to establish the sustainable growth rates (SGR) for fiscal years (FY) 1998 and 1999 and Medicare volume performance standards (MVPS) for 1990-1996 would, under present calculations, result in a positive update.

    The Department intends to work closely with Congress to develop legislation that could permit a positive update, and hopes that such legislation can be passed before the negative update takes effect. Because the Department wishes to change the update promptly in the event that Congress provides the Department legal authority to do so, we are requesting comments regarding how physician fee schedule rates could and should be recalculated prospectively in the event that Congress provides the Department with legal authority to revise estimates used to establish the sustainable growth rates (SGR) and for 1998 and 1999 and the NVPS for 1990-1996.

    The other policy changes concern: the pricing of the technical component for positron emission tomography (PET) scans, Medicare qualifications for clinical nurse specialists, a process to add or delete services to the definition of telehealth, the definition for ZZZ global periods, global period for surface radiation, and an endoscopic base for urology codes. In addition, this rule updates the codes subject to physician self-referral prohibitions. We are expanding the definition of a screening fecal-occult blood test and are modifying our regulations to expand coverage for additional colorectal cancer screening tests through our national coverage determination process. We also make revisions to the sustainable growth rate, the anesthesia conversion factor, and the work values for some gastroenterologic services.

    We are making these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.

    This final rule also clarifies the enrollment of physical and occupational therapists as therapists in private practice and clarifies the policy regarding services and supplies incident to a physician's professional services. In addition, this final rule discusses physical and occupational therapy payment caps and makes technical changes to the definition of outpatient rehabilitation services.

    In addition, we are finalizing the calendar year (CY) 2002 interim RVUs and are issuing interim RVUs for new and revised procedure codes for calendar year (CY) 2003.

    As required by the statute, we are announcing that the physician fee schedule update for CY 2003 is −4.4 percent, the initial estimate of the sustainable growth rate for CY 2003 is 7.6 percent, and the conversion factor for CY 2003 is $34.5920.

    This final rule will also allow registered nurses (RNs) to provide emergency care in certain critical access hospitals (CAHs) in frontier areas (an area with fewer than six residents per square mile) or remote locations (locations designated in a State's rural health plan that we have approved.) This policy applies if the State, following consultation with the State Boards of Medicine and Nursing, and in accordance with State law, requests that RNs be included, along with a doctor of medicine or osteopathy, a physician's assistant, or a nurse practitioner with training or experience in emergency care, as personnel authorized to provide emergency services in CAHs in frontier areas or remote locations.

    DATES:

    Effective date: This rule is effective on March 1, 2003.

    Comment date: We will consider comments on the definition of a screening fecal-occult blood test, the critical access hospital emergency services requirement, the physician self-referral designated health services identified in Table 10, the interim work RVUs for selected procedure codes identified in Addendum C, the practice expense direct cost inputs, and on how physician fee schedule rates could and should be recalculated prospectively in the event that Congress provides the Department with legal authority to revise estimates used to establish SGRs for 1998 and 1999 and the MVPS for 1990-1996, if we receive them at the appropriate address, as provided in the addresses section, no later than 5 p.m. on March 3, 2003.

    ADDRESSES:

    In commenting, please refer to file code CMS-1204-FC. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. Mail written comments (one original and two copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1204-FC, P.O. Box 8013, Baltimore, MD 21244-8013.

    Please allow sufficient time for us to receive mailed comments on time in the event of delivery delays.

    If you prefer, you may deliver (by hand or courier) your written comments (one original and two copies) to one of the following addresses: Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013.

    (Because access to the interior of the HHH Building is not readily available to persons without Federal Government identification, commenters are Start Printed Page 79967encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available if you wish to retain proof of filing by stamping in and retaining an extra copy of the comments being filed.)

    Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and could be considered late.

    For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section.

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    FOR FURTHER INFORMATION CONTACT:

    Marc Hartstein, (410) 786-4539, or Stephanie Monroe (410) 786-6864 (for issues related to resource-based practice expense relative value units).

    Jim Menas, (410) 786-4507 (for issues related to anesthesia).

    Marc Hartstein, (410) 786-4539 (for issues related to the sustainable growth rate).

    Gail Addis, (410) 786-4522 (for issues related to PET scans).

    Craig Dobyski, (410) 786-4584 (for issues related to telehealth).

    Terri Harris, (410) 786-6830 or Pam West, (410) 786-2302 (for issues related to physical and occupational therapy).

    William Larson, (410) 786-4639 (for issues related to fecal-occult blood test).

    Regina Walker-Wren, (410) 786-9160 (for issues related to clinical nurse specialists).

    Dorothy Shannon, (410) 786-3396 (for issues related to services and supplies incident to a physician's professional services).

    Joanne Sinsheimer, (410) 786-4620 (for issues related to updates to the list of certain services subject to the physician self-referral prohibitions).

    Mary Collins, (410) 786-3189 (for issues related to the critical access hospital emergency services requirement).

    Diane Milstead, (410) 786-1101 (for all other issues).

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    SUPPLEMENTARY INFORMATION:

    Inspection of Public Comments: Comments received timely will be available for public inspection as they are recorded and processed, generally beginning approximately 4 weeks after the publication of the document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone (410) 786-7197.

    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 toll-free at 1-888-293-6498) or by faxing to (202) 512-2250. The cost for each copy is $10. 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 physician fee schedule can be found on our homepage. You can access this data by using the following directions:

    1. Go to the CMS homepage (http://www.cms.hhs.gov).

    2. Click on “Medicare.”

    3. Select Medicare Payment Systems.

    4. Select Physician Fee Schedule.

    To assist readers in referencing sections contained in this preamble, we are providing the following table of contents. Some of the issues discussed in this preamble affect the payment policies but do not require changes to the regulations in the Code of Federal Regulations. Information on the regulation's impact appears throughout the preamble and is not exclusively in section XIII.

    Table of Contents

    I. Background

    A. Legislative History

    B. Published Changes to the Fee Schedule

    C. Components of the Fee Schedule Payment Amounts

    D. Development of the Relative Value Units

    E. Delay in the Effective Date

    II. Specific Provisions for Calendar Year 2003

    A. Resource-Based Practice Expense Relative Value Units

    B. Anesthesia Issues

    C. Pricing of Technical Components (TC) for Positron Emissions Tomography (PET) Scans

    D. Enrollment of Physical and Occupational Therapists as Therapists in Private Practice

    E. Clinical Social Worker Services

    F. Medicare Qualifications for Clinical Nurse Specialists

    G. Process to Add or Delete Services to the Definition of Telehealth

    H. Definition for ZZZ Global Periods

    I. Change in Global Period for CPT Code 77789 (Surface Application of Radiation Source)

    J. Technical Change for § 410.61(d)(1)(iii) Outpatient Rehabilitation Services

    K. New HCPCS G-Codes From June 28, 2002 Proposed Rule

    L. Endoscopic Base for Urology Codes

    M. Physical Therapy and Occupational Therapy Caps

    III. Other Issues

    A. Definition of a Screening Fecal-Occult Blood Test

    B. Clarification of Services and Supplies Incident To a Physician's Professional Services: Conditions

    C. Five-Year Review of Gastroenterology Codes

    D. Critical Access Hospital Emergency Services Requirements

    IV. Refinement of Relative Value Units for Calendar Year 2003 and Response to Public Comments on Interim Relative Value Units for 2002

    V. Update to the Codes for Physician Self-Referral Prohibition

    VI. Physician Fee Schedule Update for Calendar Year 2003

    VII. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate

    A. Medicare Sustainable Growth Rate

    B. Physicians' Services

    C. Provisions Related to the Sustainable Growth Rate

    D. Preliminary Estimate of the Sustainable Growth Rate for 2003

    E. Sustainable Growth Rate for 2002

    F. Sustainable Growth Rate for 2001

    G. Calculation of 2003, 2002, and 2001 Sustainable Growth Rates

    VIII. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2003

    IX. Provisions of the Final Rule

    X. Waiver of Proposed Rulemaking for Definition of a Screening Fecal-Occult Blood Test and Critical Access Hospital Emergency Services Requirement

    XI. Collection of Information Requirements

    XII. Response to Comments

    XIII. Regulatory Impact Analysis

    Addendum A—Explanation and Use of Addendum B

    Addendum B—2003 Relative Value Units and Related Information Used in Determining Medicare Payments for 2003

    Addendum C—Codes with Interim RVUs

    Addendum D—2003 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Addendum E—Updated List of CPT/HCPCS Codes Used to Describe Certain Designated Health Services Under the Physician Self-Referral Provision

    Addendum F—Codes Refined by the PEAC for 2003

    In addition, because of the many organizations and terms to which we refer by acronym in this proposed rule, we are listing these acronyms and their corresponding terms in alphabetical order below:

    AMAAmerican Medical Association
    BBABalanced Budget Act of 1997
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    BBRABalanced Budget Refinement Act of 1999
    CAHCritical Access Hospitals
    CFConversion factor
    CFRCode of Federal Regulations
    CMSCenters for Medicare & Medicaid Services
    CNSClinical Nurse Specialist
    CPT[Physicians'] Current Procedural Terminology [4th Edition, 2002, copyrighted by the American Medical Association]
    CPEPClinical Practice Expert Panel
    CRNACertified Registered Nurse Anesthetist
    E/MEvaluation and management
    GPCIGeographic practice cost index
    HCPCSHealthcare Common Procedure Coding System
    HHAHome health agency
    HHS[Department of] Health and Human Services
    IDTFsIndependent Diagnostic Testing Facilities
    MCMMedicare Carrier Manual
    MedPACMedicare Payment Advisory Commission
    MEIMedicare Economic Index
    MSAMetropolitan Statistical Area
    NCDNational Coverage Decision
    PCProfessional Component
    PEACPractice Expense Advisory Committee
    PETPositron Emission Tomography
    PPSProspective payment system
    RUC[AMA's Specialty Society] Relative [Value] Update Committee
    RVURelative value unit
    SGRSustainable growth rate
    SMS[AMA's] Socioeconomic Monitoring System
    SNFSkilled Nursing Facility
    TCTechnical Component

    I. Background

    A. Legislative History

    Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), “Payment for Physicians” Services.” This section provides for three major elements—(1) A fee schedule for the payment of physicians' services; (2) limits on the amounts that nonparticipating physicians can charge beneficiaries; and (3) a sustainable growth rate for the rates of increase in Medicare expenditures for physicians' services. The Act requires that payments under the fee schedule be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense, and malpractice expense. Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may not cause total physician fee schedule payments to differ by more than $20 million from what they would have been had the adjustments not been made. If adjustments to RVUs cause expenditures to change by more than $20 million, we must make adjustments to preserve budget neutrality.

    B. Published Changes to the Fee Schedule

    In the July 2000 proposed rule, (65 FR 44177), we listed all of the final rules published through November 1999. In the August 2001 proposed rule (66 FR 40372) we discussed the November 2000 final rule relating to the updates to the RVUs and revisions to payment policies under the physician fee schedule.

    In the November 2001 final rule with comment period (66 FR 55246), we revised the policy for—resource-based practice expense RVUs; services and supplies incident to a physician's professional service; anesthesia base unit variations; recognition of CPT tracking codes; and nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies. We also addressed comments received on the June 8, 2001 proposed notice (66 FR 31028) for the 5-year review of work RVUs and finalized these work RVUs. In addition, we acknowledged comments received in response to a discussion of modifier-62, which is used to report the work of co-surgeons. The November 2001 final rule also updated the list of services that are subject to the physician self-referral prohibitions in order to reflect CPT and Healthcare Common Procedure Coding System (HCPCS) code changes that were effective January 1, 2002. These revisions ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.

    The Medicare, Medicaid, and State Child Health Insurance Program (SCHIP) Benefits Improvement and Protection Act of 2000 (Pub. L. 106-554) (BIPA) modernized the mammography screening benefit and authorized payment under the physician fee schedule effective January 1, 2002. It provided for biennial screening pelvic examinations for certain beneficiaries and expanded coverage for screening colonoscopies to all beneficiaries effective July 1, 2001. It provided for annual glaucoma screenings for high-risk beneficiaries and established coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002. It expanded payment for telehealth services effective October 1, 2001; required certain Indian Health Service providers to be paid for some services under the physician fee schedule effective July 1, 2001; and revised the payment for certain physician pathology services effective January 1, 2001. This final rule conformed our regulations to reflect these statutory provisions.

    The final rule also announced the calendar year 2002 physician fee schedule conversion factor (CF) of $36.1992.

    C. Components of the Fee Schedule Payment Amounts

    Under the formula set forth in section 1848(b)(1) of the Act, the payment amount for each service paid under the physician fee schedule is the product of three factors—(1) A nationally uniform relative value for the service; (2) a geographic adjustment factor (GAF) for each physician fee schedule area; and (3) a nationally uniform conversion factor (CF) for the service. The CF converts the relative values into payment amounts.

    For each physician fee schedule service, there are three relative values—(1) An RVU for physician work; (2) an RVU for practice expense; and (3) an RVU for malpractice expense. For each of these components of the fee schedule, there is a geographic practice cost index (GPCI) for each fee schedule area. The GPCIs reflect the relative costs of practice expenses, malpractice insurance, and physician work in an area compared to the national average for each component.

    The general formula for calculating the Medicare fee schedule amount for a given service in a given fee schedule area can be expressed as:

    Payment = [(RVU work × GPCI work) + (RVU practice expense × GPCI practice expense) + (RVU malpractice × GPCI malpractice)] × CF

    The CF for calendar year (CY) 2003 appears in section VIII. The RVUs for CY 2003 are in Addendum B. The GPCIs for CY 2003 can be found in Addendum D.

    Section 1848(e) of the Act requires us to develop GAFs for all physician fee schedule areas. The total GAF for a fee schedule area is equal to a weighted average of the individual GPCIs for each of the three components of the service. In accordance with the statute, however, Start Printed Page 79969the GAF for the physician's work reflects one-quarter of the relative cost of physician's work compared to the national average.

    D. Development of the Relative Value System

    1. Work Relative Value Units

    Approximately 7,500 codes represent services included in the physician fee schedule. The work RVUs established for the implementation of the fee schedule in January 1992 were developed with extensive input from the physician community. A research team at the Harvard School of Public Health developed the original work RVUs for most codes in a cooperative agreement with us. In constructing the vignettes for the original RVUs, Harvard worked with expert panels of physicians and obtained input from physicians from numerous specialties.

    The RVUs for radiology services were based on the American College of Radiology (ACR) relative value scale, which we integrated into the overall physician fee schedule. The RVUs for anesthesia services were based on RVUs from a uniform relative value guide. We established a separate CF for anesthesia services, and we continue to recognize time as a factor in determining payment for these services. As a result, there is a separate payment system for anesthesia services.

    2. Practice Expense and Malpractice Expense Relative Value Units

    Section 1848(c)(2)(C) of the Act required that the practice expense and malpractice expense RVUs equal the product of the base allowed charges and the practice expense and malpractice percentages for the service. Base allowed charges are defined as the national average allowed charges for the service furnished during 1991, as estimated using the most recent data available. For most services, we used 1989 charge data aged to reflect the 1991 payment rules, since those were the most recent data available for the 1992 fee schedule.

    Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 103-432), enacted on October 31, 1994, required us to develop a methodology for a resource-based system for determining practice expense RVUs for each physician service. As amended by the BBA, section 1848(c) required the new payment methodology to be phased in over 4 years, effective for services furnished in 1999, with resource-based practice expense RVUs becoming fully effective in 2002. The BBA also required us to implement resource-based malpractice RVUs for services furnished beginning in 2000.

    E. Delay in the Effective Date

    On November 5, 2002 we published a notice (67 FR 67319), delaying the publication of this final rule due to concerns about the data used to establish the physician fees and the need to further assess the accuracy of the data. We have concluded our review and are moving forward with our proposals unless otherwise indicated in this preamble. This rule is effective on March 3, 2003.

    II. Specific Provisions for Calendar Year 2003

    In response to the publication of the June 28, 2002 proposed rule, (67 FR 43846), and the interim final rule, (67 FR 43555), we received approximately 236 comments. We received comments from individual physicians, health care workers, and professional associations and societies. The majority of comments addressed the proposals related to the enrollment of therapists, anesthesia services and the SGR.

    The proposed rule discussed policies that affected the number of RVUs on which payment for certain services would be based. Certain changes implemented through this final rule are subject to the $20 million limitation on annual adjustments contained in section 1848(c)(2)(B)(ii)(II) of the Act.

    After reviewing the comments and determining the policies we would implement, we have estimated the costs and savings of these policies and added those costs and savings to the estimated costs associated with any other changes in RVUs for 2003. We discuss in detail the effects of these changes in the Regulatory Impact Analysis in section XIII.

    For the convenience of the reader, the headings for the policy issues correspond to the headings used in the June 28, 2002 proposed rule. More detailed background information for each issue can be found in the June 2002 interim final rule with comment period and the June 2002 proposed rule.

    A. Resource-Based Practice Expense Relative Value Units

    1. Resource-Based Practice Expense Legislation

    Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 103-432), enacted on October 31, 1994, required us to develop a methodology for a resource-based system for determining practice expense RVUs for each physician's service beginning in 1998. In developing the methodology, we were to consider the staff, equipment, and supplies used in providing medical and surgical services in various settings. The legislation specifically required that, in implementing the new system of practice expense RVUs, we apply the same budget-neutrality provisions that we apply to other adjustments under the physician fee schedule.

    Section 4505(a) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 105-33), enacted on August 5, 1997, amended section 1848(c)(2)(ii) of the Act and delayed the effective date of the resource-based practice expense RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based practice expense RVUs to resource-based RVUs. Further legislation affecting resource-based practice expense RVUs was included in the Medicare, Medicaid and State Child Health Insurance Program (SCHIP) Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106-113), enacted on November 29, 1999. Section 212 of the BBRA amended section 1848(c)(2)(ii) of the Act by directing us to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations. These data would supplement the data we normally collect in determining the practice expense component of the physician fee schedule for payments in CY 2001 and CY 2002. (In the 1999 final rule (64 FR 59380), we extended, for an additional 2 years, the period during which we would accept supplementary data.)

    2. Current Methodology for Computing the Practice Expense Relative Value Unit System

    Effective with services furnished on or after January 1, 1999, we established a new methodology for computing resource-based practice expense RVUs that used the two significant sources of actual practice expense data we have available—the Clinical Practice Expert Panel (CPEP) data and the American Medical Association's (AMA) Socioeconomic Monitoring System (SMS) data. The methodology was based on an assumption that current aggregate specialty practice costs are a reasonable way to establish initial estimates of relative resource costs for physicians' services across specialties. The methodology allocated these aggregate specialty practice costs to specific procedures and, thus, is commonly called a “top-down” approach.Start Printed Page 79970

    a. Major Steps

    A brief discussion of the major steps involved in the determination of the practice expense RVUs follows. (Please see the November 1, 2001 final rule (66 FR 55249) for a more detailed explanation of the top-down methodology.)

    Step 1—Determine the specialty specific practice expense per hour of physician direct patient care. We used the AMA's SMS survey of actual aggregate cost data by specialty to determine the practice expenses per hour for each specialty. We calculated the practice expenses per hour for the specialty by dividing the aggregate practice expenses for the specialty by the total number of hours spent in patient care activities. For the CY 2000 physician fee schedule, we also used data from a survey submitted by the Society of Thoracic Surgeons (STS) in calculating thoracic and cardiac surgeons' practice expenses per hour. (Please see the November 1999 final rule (64 FR 59391) for additional information concerning acceptance of these data.) For 2001, we used these STS data, as well as survey data submitted by the American Society of Vascular Surgery and the Society of Vascular Surgery. (Please see the November 2000 final rule (65 FR 65385) for additional information on the acceptance of these data.)

    Step 2—Create a specialty specific practice expense pool of practice expense costs for treating Medicare patients. To calculate the total number of hours spent treating Medicare patients for each specialty, we used the physician time assigned to each procedure code and the Medicare utilization data. We then calculated the specialty specific practice expense pools by multiplying the specialty practice expenses per hour by the total physician hours.

    Step 3—Allocate the specialty specific practice expense pool to the specific services performed by each specialty. For each specialty, we divided the practice expense pool into two groups based on whether direct or indirect costs were involved and used a different allocation basis for each group.

    (i) Direct costs—For direct costs (which include clinical labor, medical supplies, and medical equipment), we used the procedure specific CPEP data on the staff time, supplies, and equipment as the allocation basis.

    (ii) Indirect costs—To allocate the cost pools for indirect costs, including administrative labor, office expenses, and all other expenses, we used the total direct costs combined with the physician fee schedule work RVUs. We converted the work RVUs to dollars using the Medicare CF (expressed in 1995 dollars for consistency with the SMS survey years).

    Step 4—For procedures performed by more than one specialty, the final procedure code allocation was a weighted average of allocations for the specialties that perform the procedure, with the weights being the frequency with which each specialty performs the procedure on Medicare patients.

    b. Other Methodological Issues

    (i) Non-Physician Work Pool—For services with physician work RVUs equal to zero (including those services with a technical and professional component), we created a separate practice expense pool using the average clinical staff time from the CPEP data and the “all physicians” practice expense per hour.

    We then used the adjusted 1998 practice expense RVUs to allocate this pool to each service. Also, for all radiology services that are assigned physician work RVUs, we used the adjusted 1998 practice expense RVUs for radiology services as an interim measure to allocate the direct practice expense cost pool for radiology.

    (ii) Crosswalks for Specialties Without Practice Expense Survey Data—Since many specialties identified in our claims data did not correspond exactly to the specialties included in the SMS survey data, it was necessary to crosswalk these specialties to the most appropriate SMS specialty.

    Because we believe that most physical therapy services furnished in physicians' offices are performed by physical therapists, we cross-walked all utilization for therapy services in the CPT 97000 series to the physical and occupational therapy practice expense pool.

    Comment: We received several comments objecting to our policy of cross-walking all utilization for therapy services in the CPT 97000 series to the physical and occupational therapy practice expense pool. One commenter stated that we are currently employing an arbitrary utilization crosswalk methodology to determine the resource-based practice expense RVUs for physical and occupational therapy. Commenters also indicated that this departure from the standard methodology has not been previously published for review and comment. In addition, one commenter challenged our assumption that most therapy services billed by physicians are furnished by therapists and stated that it is neither supported by explanatory text nor accompanying data. The commenter indicates that if we did not employ this assumption to change the resource-based practice expense methodology only for therapy services, payments for these services would be as much as 18 percent higher. Other commenters stated that use of the “altered methodology” has resulted in inappropriate reductions in payments for physical and occupational therapy services. One commenter expressed concern that the adjustment affects SNFs, home health agencies, outpatient hospital departments and CORFs in addition to therapists in private practice. Other commenters also objected to use of a crosswalk for physical and occupational therapy services stating that the policy is inconsistent with the “top-down” methodology that bases the final RVUs for a service on a weighted average of the practice expenses of the specialties that bill Medicare. Another commenter indicated that there is no evidence to suggest that practice expenses for therapy services provided by physicians are any different from the practice expenses of all other services they provide. This commenter indicated that physician specialties were also disadvantaged because all therapy services that a specialty billed were not included in calculating the practice expense pool for that specialty, thus decreasing the dollars that could be allocated to the services performed by that specialty. The commenters strongly recommended that we discontinue use of the crosswalk and employ the standard top down methodology for computing the 2003 PERVUs for the 97000 CPT code series.

    Response: We carefully reviewed comments on this issue. As indicated in our proposed rule, we do not believe that physicians provide most therapy services that are billed by physicians. We believe that the practice expenses for therapy services provided in physicians' offices by therapists are more likely to be comparable to those of therapists than physicians. For this reason, we crosswalked utilization for the therapy codes (CPT codes 97010 through 97750) to the physical and occupational therapy practice cost pools. We used the physician utilization data for the therapy evaluation codes (CPT codes 97001 through 97004) since we believe these services would be much more likely to be performed by the billing physician. In the meantime, we welcome further public comments on this issue. We note that physical therapy was the only specialty for which we used their supplemental survey data (as noted below). Use of Start Printed Page 79971such survey data increases payments for physical therapy by 2 percent.

    3. Practice Expense Provisions for Calendar Year 2003

    a. Supplemental Practice Expense Surveys Criteria for Acceptance of Supplemental Practice Expense Surveys From the June 28, 2002 Interim Final Rule with Comment Period

    On June 28, 2002 we published an interim final rule with comment period (67 FR 43555) in the Federal Register, which made revisions to the criteria that we apply to supplemental survey information supplied by physician, non-physician, and supplier groups for use in determining practice expense RVUs under the physician fee schedule. While this rule was effective upon publication, we provided a comment period on the revision to the criteria and are responding to the comments received in this final rule.

    The following criteria had been in effect:

    • Physician groups must draw their sample from the AMA Physician Masterfile to ensure a nationally representative sample that includes both members and non-members of a physician specialty group. Physician groups must arrange for the AMA to send the sample directly to their survey contractor to ensure confidentiality of the sample; that is, to ensure comparability in the methods and data collected, specialties must not know the names of the specific individuals in the sample.
    • Non-physician specialties not included in the AMA's SMS must develop a method to draw a nationally representative sample of members and non-members. At a minimum, these groups must include former members in their survey sample. The sample must be drawn by the non-physician group's survey contractor, or another independent party, in a way that ensures the confidentiality of the sample; that is, to ensure comparability in the methods and data collected, specialties must not know the names of the specific individuals in the sample.
    • A group (or its contractors) must conduct the survey based on the SMS survey instruments and protocols, including administration and follow-up efforts and definitions of practice expense and hours of direct patient care. In addition, any cover letters or other information furnished to survey sample participants must be comparable to the information previously supplied by the SMS contractor to its sample participants.
    • Physician groups must use a contractor that has experience with the SMS or a survey firm with experience successfully conducting national multi-specialty surveys of physicians using nationally representative random samples.
    • Physician groups or their contractors must submit raw survey data to us, including all complete and incomplete survey responses as well as any cover letters and instructions that accompanied the survey, by August 1, 2002 for data analysis and editing to ensure consistency. All personal identifiers in the raw data must be eliminated.
    • The physician practice expense data from surveys that we use in our code-level practice expense calculations are the practice expenses per physician hour in the six practice expense categories—clinical labor, medical supplies, medical equipment, administrative labor, office overhead, and other. Supplemental survey data must include data for these categories.

    In addition to the above survey criteria, we required a 90-percent confidence interval with a range of plus or minus 10 percent of the mean (that is, 1.645 times the standard error of the mean, divided by the mean should be equal to or less than 10 percent of the mean).

    Based on a review of these criteria and concern that the this language had created confusion, in the June 2002 interim final rule we revised this language to indicate that we will accept surveys that achieve a sampling error of 0.15 or less at a confidence level of 90 percent. We noted that this change refines both the measurement of precision and the level of precision we will accept and could result in our acceptance of more surveys than the past criteria. In addition, we stated that we would allow specialties that have submitted surveys previously rejected under the present criteria to resubmit these surveys to be evaluated under the revised criterion.

    We also amended § 414.22(b)(6) to reflect the 2-year extension in the deadline for submitting supplemental data. Specifically, we will accept supplemental data that meet the established criteria that we received by August 1, 2002 to determine CY 2003 practice expense RVUs and by August 1, 2003 to determine CY 2004 practice expense RVUs.

    Comment: We received comments from several specialty organizations on the change in the precision criteria for supplemental surveys. Specialty organizations representing audiologists, physical therapists and radiologists expressed support for the revised precision criterion. The American Academy of Audiology indicated that the revised rule makes it easier for specialty groups to submit information for our consideration. The American College of Radiology (ACR) supported the proposed change by suggesting that the previous requirements were not reasonable. The ACR indicated that radiology and radiation oncology did not conduct surveys previously because of concerns about the strictness of the original criteria. The ACR also indicated concerns about averaging the supplemental survey data with existing SMS survey data and the requirement that the survey sample would have to be selected from the AMA Masterfile. According to the ACR, the AMA Masterfile does not adequately represent radiologists and radiation oncologists that own and operate their own centers and equipment. The American Physical Therapy Association (APTA) supported the new criterion and our decision to allow previously completed surveys to be resubmitted and considered using the new precision standard. The American Society Clinical Oncology (ASCO) objected to the use of any precision criteria and outlined a number of reasons why they opposed the use of this test. The ASCO indicated that there may be wide variation in oncology practice patterns (for example, hospital based versus non-hospital based, or differentials in provision of chemotherapy) that could lead to wide variation in practice expenses among surveyed practices. They suggested that “at least in the case of oncologists, a survey that is conducted in accordance with the CMS rules should not be excluded from consideration because of failure to meet the precision criteria.”

    Response: If the data from physician and practitioner surveys is to be used as the basis for physician payment, it is necessary that we have assurance that the survey is both representative and reliable. Applying numerical criteria for the statistical concepts of confidence and precision give some basis for believing that the data accurately represent practice costs for the specialty nationwide. We set the criteria for precision and confidence after lengthy consultation with our contractor, the Lewin Group, and agency experts on statistical surveys. We believe the levels set are both fair and reasonable. In addition, as indicated in the proposed rule, we are attempting to be as flexible as possible consistent with our goal of obtaining new surveys of practice expense that are scientifically sound and methodologically consistent with Start Printed Page 79972our existing estimates. We indicated that a specialty may include different types of physician practices that exhibit different patterns of practice expenses. We welcome stratified sampling of these different types of practices and, would, as appropriate, apply the precision criteria to subgroups of surveyed practices.

    We considered the comment that suggests the AMA Masterfile may not adequately represent radiologists and radiation oncologists that own and operate their own equipment. However, since the AMA Masterfile is the most comprehensive listing of physicians that practice in the United States, we still believe it should be the best source of information for selecting a representative sample of physicians. We do acknowledge that there may be special issues related to diagnostic and radiation oncology services. For instance, radiologists and radiation oncologists that predominantly practice in hospitals may have fundamentally different practice expenses than those providing services in free-standing clinics and private offices where they likely incur far higher costs for staff, supplies, equipment and indirect costs. In addition, office-based radiologists and radiation oncologists may have substantial but irregular expenses associated with medical equipment. That is, they may purchase equipment one year and amortize the costs over several years. It is possible that modification to the survey instrument may be necessary to accurately identify annual equipment costs for some specialties. Further, independent diagnostic testing facilities also bill Medicare for diagnostic services affected by the non-physician work pool calculations. A sample of physicians selected from the AMA Masterfile is unlikely to include independent diagnostic testing facilities. We believe that all of these issues can be addressed in a supplemental survey with stratified sampling, relevant modifications to the survey instrument and augmentation of the AMA Masterfile with a listing of independent diagnostic testing facilities. As we indicated in our supplemental survey interim final rule, we are attempting to be flexible to achieve our goal of incorporating the best possible practice expense survey information into our methodology. We believe all of these issues should be considered carefully. We advise any party interested in conducting a supplemental survey to consult the Lewin Group and us before proceeding with a survey.

    Comment: We also received comments from two organizations representing emergency medicine. The Emergency Department Practice Management Association (EDPMA) is concerned that the requirement that supplemental surveys be based on the SMS survey instrument will preclude us from obtaining data on uncompensated care and emergency physician practice expenses. The EDPMA suggests that we extend the criteria to include data regarding indirect emergency medicine practice expense or uncompensated care cost. The American College of Emergency Physicians (ACEP) stated that we have failed to recognize the legitimate practice costs associated with uncompensated care pursuant to requirements imposed by the Emergency Medical Treatment and Active Labor Act (EMTALA) and that these costs should be recognized by us. Despite our acknowledgement of these costs, the commenter argues that we have not made any movement in making payment for EMTALA's uncompensated care costs.

    Response: As we indicated in the November 2, 1998 final rule (63 FR 58821), we made an adjustment in the practice expense per hour for emergency medicine because of our concern that emergency medicine physicians could spend a significantly higher proportion of time than other physicians providing uncompensated care to patients. We are currently using a practice expense per hour of $33.00 for emergency medicine. If we had not made the adjustment for uncompensated care, the practice expense per hour for emergency medicine would be $14.90. Our adjustment assumes that 55 percent ($14.9/(1−0.55)=$33.00) of emergency physicians' time spent treating patients is uncompensated. This has the effect of raising the practice expense per hour to reflect only the physician's time spent in revenue-generating activities. If emergency physicians believe that they spend more than 55 percent of their time treating patients for which they are not compensated, we would welcome specific data on this subject from a supplemental survey.

    Comment: The American College of Cardiology (ACC) and the AMA, who wrote in support of the ACC, indicated they are aware that we would like data on practice expenses that shows the six categories of practice expenses used in the practice expense methodology. However, the ACC indicated that the AMA no longer collects data in this disaggregated fashion and suggested that this data limitation can be overcome by simply apportioning practice expense reported in the most recent survey to the separate pools based on historical distribution patterns.

    Response: We will continue to require disaggregated data from supplemental surveys because apportionment based on historical distribution patterns might not reflect actual or current cost patterns. Further, to accept this data would be inconsistent with our clearly stated rule. In both the original interim final rule published on May 3, 2000 (65 FR 25666) and in the interim final rule published on June 28, 2002 (67 FR 43556), we indicated that “* * * code-level practice expense calculations are the practice expense per physician hour in the six practice expense categories-clinical labor, medical supplies, medical equipment, administrative labor, office overhead and other. Supplemental survey data must include data for these categories.”

    Result of Evaluation of Comments

    We are retaining the change to the precision and confidence levels for supplemental surveys to reflect a confidence level of 90 percent and a precision level of 0.15, as stated in our interim final rule.

    (ii) Submission of Supplemental Surveys—We received surveys from the American Physical Therapy Association (APTA), the American Society of Clinical Oncology (ASCO), the American College of Cardiology (ACC), and the American Academy of Pediatrics (AAP). The National Association of Portable X-Ray Providers (NAPXP) also provided us with cost data for their industry. Our contractor, the Lewin Group, has evaluated the data submitted by each organization and recommends that we use the survey information from APTA. We reviewed and agree with their analysis; therefore, we are using the APTA survey to determine practice expense RVUs for CY 2003 and subsequent years. The data supplied to the Lewin Group reflects a 1999 cost year. As indicated in our June 2002 interim final rule (67 FR 43556), we are deflating the figures by the MEI to reflect a 1995 cost year. The revised practice expense per hour figures that we are using for physical therapy (specialty code 65) and occupational therapy (specialty code 67) are as follows: Start Printed Page 79973

    Table 1

    Clinical staffAdmin. staffOffice expenseSuppliesEquipmentOtherTotal
    10.46.513.42.42.27.742.5

    The Lewin Group raised significant concerns about the data received from ASCO. Specifically, the Lewin Group is concerned about extraordinarily high expenses associated with clinical and clerical staff and a more than 300 percent increase in “other” practice expenses compared to the SMS value for oncology. As a result, the Lewin Group carefully examined the underlying data. They report that compensation (including salaries and fringe benefits) would average out to $71,014 for clinical staff and $87,253 for clerical staff. They believe it is unlikely that the average annual salary for clerical staff would be higher than for clinical staff. Further, the Lewin Group indicates that the average clerical compensation from the ASCO survey is approximately 400 percent higher than the figure reported by the Bureau of Labor Statistics for “Office Clerks, General.” While the Lewin Group indicates that the high payroll expense for clinical staff may be explained, in part, by recent changes in labor markets, we remain concerned that the compensation reported in the survey is far higher than independent information on oncology nursing salaries provided to us by the Oncology Nursing Society. The Lewin Group also indicated that “other professional expenses” increased more than 349 percent from the SMS to the supplemental survey and the contribution of this category to total practice expenses increased from 9.4 percent to 22.3 percent. They believe that such a large increase in practice expense per hour needs further examination. The Lewin Group believes that we should confer with ASCO and request a rationale for the high values found in the survey results or validate the data in some other fashion. Therefore, at this time, we are not using the supplemental survey received from ASCO. However, we would like to further examine the data with the Lewin Group and discuss the survey results with ASCO and will consider using the data in the future if our concerns are addressed.

    In the June 2002 proposed rule (67 FR 43850), we discussed an adjustment made to the medical supplies practice expense per hour for oncology. We made this adjustment because of a concern that the inordinately high practice expense per hour includes expenses associated with separately billable drugs. We expressed an interest in reconsidering the adjustment consistent with a recommendation made by the GAO in their October 2001 report. If we resolve concerns about the oncology survey data, the adjustment for medical supplies will no longer be necessary since the supplemental survey collects information on medical supplies practice expenses net of separately billable drugs.

    The Lewin Group indicated that the surveys from the ACC and the AAP do not meet requirements established in regulations for supplemental surveys. As a result, we will not be incorporating data from the ACC or the AAP into the practice expense methodology. We will be making the Lewin Group's full recommendations available on our website. The National Association of Portable X-ray Providers (NAPXP) did not provide us with data as part of the supplemental survey process. However, they requested that we use their data to develop practice expense RVUs for the physician fee schedule services they provide. Since we were provided with survey information, we asked the Lewin Group to evaluate the data using the same standards of review applied to other specialty survey data. The Lewin Group evaluated whether the cost information supplied by NAPXP meets our criteria for acceptance of supplemental surveys. The Lewin Group found that (1) More information is required to determine if the data are broadly representative of the portable x-ray industry and (2) the data as presented are not adequately detailed to support a practice expense per hour based on the current practice expense methodology.

    Comment: Health Trac, a supplier of portable x-rays and other imaging services, commented that the practice costs associated with set-up of portable x-ray equipment are not included in the SMS and there are sufficient differences among geographic regions in the performance of this procedure that warrant reclassifying this service as carrier-priced.

    Response: At this time, we are not making portable x-ray set-up (Q0092) a carrier-priced service. However, we will continue to work with the suppliers of portable x-ray services to find the best ways of developing payment rates for these services.

    b. CPEP Data

    (i) 2001 PEAC/RUC Recommendations on CPEP inputs

    In the November 2001 final rule (66 FR 55256), we responded to the PEAC/RUC recommendations for the refinement to all or part of the CPEP inputs for over 1,100 codes. These included refinements of large numbers of orthopedic, dermatology, pathology, physical medicine, and ophthalmology services. In addition, these recommendations confirmed that there were no inputs for over 150 ZZZ-global procedures that are performed only in a facility and no supply or equipment inputs for almost 700 facility-only services with an XXX or 0-day global period.

    We accepted almost all of the recommendations with only minor revisions. We received the following comments on our responses and modifications to the RUC recommendations on the CPEP inputs.

    Comment: Specialty societies representing radiology and orthopedic surgery both expressed appreciation about our willingness to work with the RUC and PEAC on practice expense refinement, as well as for our implementation of the refinements already submitted by the PEAC. Both societies agreed with our establishment of revised practice expense values as “interim” until the refinement process is complete.

    Response: We are also pleased with the progress of the refinement of the CPEP inputs and thank the PEAC, RUC and all the involved specialty societies for the hard work and dedicated commitment that has led to a successful refinement process.

    Comment: A specialty society representing surgeons expressed support for our decisions on CPEP revisions in general and commended our staff for our efforts to develop appropriate and acceptable inputs for a large number of codes. The commenter also agreed with the use of the refined evaluation and management (E/M) inputs to refine post-surgical visits, but recommended that the process should allow for exceptions.

    Response: We understand that the PEAC has developed a standard Start Printed Page 79974approach to estimating the clinical staff time involved in post-surgical visits in which the times associated with the assigned E/M visits are applied to the post-surgical clinical staff times. It is also our understanding that, as with all the standards and packages that the PEAC has developed, a specialty would be free to argue that something other than the standard should be applied to a given service.

    Comment: One commenter representing family physicians noted that we had accepted most of the practice expense recommendations submitted by the PEAC/RUC and commended us for our willingness to accept these recommendations. The commenter also suggested that the PEAC recommendations for the fine needle aspiration CPT codes 88170 and 88171, which were deleted CPT codes for 2002, should be applied to CPT codes 10021 and 10022 that replace these deleted codes.

    Response: We agree with this suggestion. When CPT codes 10021 and 10022 were originally valued by the RUC, the practice expense inputs were crosswalked from the then unrefined inputs for CPT codes 88170 and 88171. Now that these inputs have been refined, it is appropriate for us to crosswalk the inputs for CPT codes 10021 and 10022 from this updated CPEP data.

    Comment: A commenter representing dermatologists was pleased with our acceptance of PEAC revisions for the phototherapy codes. However, the commenter expressed concern about the decrease in the practice expense RVUs for the code for the application of an Unna boot, CPT code 29580, and for the cryotherapy code, CPT code 17340 and requested that we explain the decrease. A specialty society representing podiatrists agreed with decision to retain the Unna boot in the list of supplies for CPT code 29580.

    Response: Both CPT codes 29580 and 17340 were refined by the PEAC in October 2001 and were included in the PEAC/RUC recommendations for 2002. We accepted these recommendations without change, except that we retained an Unna boot in the supply list for CPT code 29580. The recommendations contained lower direct cost inputs than the original CPEP panel data, which explains the decrease in payment for these services.

    Comment: A specialty society representing urologists requested an explanation of why the bougie a boule was deleted from the equipment list for the cystourethroscopy code, CPT code 52281 and requested that it be added as a supply.

    Response: Since the inception of resource-based practice expense, the supply list has been used for disposable items and we have only included as equipment those items that are more than $500. The bougie a boule is not a disposable item, and at a cost of $105 it does not meet the definition of equipment. These definitions have applied across the spectrum of physician fee schedule services and, therefore, we do not believe that any specialty has been disadvantaged. If we did include a $100 item in our equipment list with a five-year expected life, it would add only $0.0004 per minute of use to the input costs of any associated procedure and, thus, would have no effect on the practice expense RVUs for that service.

    Comment: Two organizations representing physical and occupational therapists argued strongly that the revisions we made to the PEAC recommendations on the practice expense inputs for the physical medicine and rehabilitation (PM&R) codes were inappropriate. The physical therapy comment commended the specialty societies participating in the PEAC, as well as AMA and our staff, for their time and assistance as the clinical inputs for the therapy codes were developed. However, the commenter also expressed concern that we did not accept the PEAC's recommendations in their entirety despite the fact that we state in the rule that the PEAC refinement process is working. The comment from the occupational therapists shared this concern and both commenters urged us to revisit our decision and accept the PEAC recommendations for the CPT codes in the 97000 series without revisions.

    Specifically, both commenters objected to the deletion of the PEAC approved clinical staff time for obtaining vital signs and measurements, patient education and phone calls. One commenter contended that our decision is contrary to the standardized times that we have allowed for physicians' clinical staff and to the survey data presented which demonstrated that clinical staff do perform these services in therapy practices. The other commenter argued that, because we have allowed such clinical staff time for other specialties, our revisions disrupt the resource-based relative value scale on which the physician fee schedule is based. Further, the occupational therapy comment states that the addition of 7 minutes only in the evaluation and reevaluation codes for aide services is insufficient to counteract the deletion of the physical therapy assistant time, and that this has created anomalies in the practice expense RVUs within the PM&R family of services.

    Response: We deleted the times assigned to the physical therapy assistant for taking vital signs, and for phone calls and patient education because we were concerned that there could be an overlap between the work of the physical therapist, which is reflected in the work RVUs, and the work of the assistant, which is considered as practice expense. However, the commenters are correct that we have allowed such tasks to be considered as practice expense for other services, even though there could also be some potential overlap between practitioner and clinical staff work. We still believe that this can be more problematic with therapy services because of the broad range of clinical activities that the physical therapy assistant can share with the therapist, but also believe that this issue might be better addressed as a general issue across all specialties. Therefore, we are revising the clinical staff times for all codes in the CPT 97000 series to reflect the 2001 PEAC recommendations for these services.

    Comment: The specialty society representing physical therapy commented that the relatively high practice expense of 0.45 RVUs for CPT code 97530, therapeutic activities, cause a rank order anomaly with other codes in the CPT 97000 series. For example, therapeutic exercise (CPT code 97110) only has a PE value of 0.25. The commenter speculated that this might be due to inclusion of the environmental module in the equipment list for this code.

    Response: On analyzing the differences in CPEP inputs between these two codes, it became apparent that the major contributor to the possible anomalous practice expense values lies not with the equipment for CPT code 97530, but with the supplies. For the timed codes that are billed in 15-minute increments, the PEAC recommendations generally assumed that two 15-minute sessions would be performed during one visit. Therefore, for all of these codes, including CPT code 97110, the PEAC recommendations divided the supplies by half because they would not have to be replaced for the second 15-minute session. However, inadvertently, the recommendation for the therapeutic activities code, CPT code 97530, did not make this adjustment, and the full cost of the relatively expensive woodworking kit was assigned to the code. In addition, it seems unlikely that a supply like a $13 woodworking kit would necessarily be discarded after one visit. Therefore, we are Start Printed Page 79975apportioning the cost of this kit over four sessions, and are assigning one-fourth of a kit to CPT code 97530.

    Comment: The comment from the physical therapy specialty society raised the concern that there may be an inadvertent error in the printing of the values of physical therapy and occupational therapy evaluation and reevaluation CPT codes in the final rule. First, the values for the occupational therapy codes are significantly higher than values for the physical therapy codes, which did not change from the 2001 values, despite the refinement of these codes. Second, the practice expense RVUs for the occupational therapy evaluation and re-evaluation codes are the same, which appears inappropriate.

    Response: The practice expense RVUs for the occupational therapy evaluation and re-evaluation codes are higher than those for physical therapy because the PEAC recommendations, which were based on the specialty societies' presentation and which we later accepted, assigned higher cost supplies and equipment to the occupational therapy codes than to the physical therapy evaluation and re-evaluation services. In addition, although the occupational therapy evaluation code had higher cost equipment than the re-evaluation code, the opposite was true for supplies. We would certainly consider information that might point to specific problems in any inputs assigned to these codes, but, at this point, have no basis for making any changes in the direct cost inputs.

    Comment: A medical electronics manufacturer commented that the practice expense RVUs assigned to short wave diathermy treatment (CPT code 97024) may not take into account all of the resources required to provide the service, because the cost of the equipment alone is not covered by the practice expense reimbursement. The commenter suggested that the cost of the diathermy machine has increased greatly since 1995, when the equipment was last priced, and stated that the current price is between $18,000 and $30,000. The commenter urged us to reevaluate and increase the 2002 fee schedule reimbursement to ensure that diathermy continues to be available for beneficiaries.

    Response: We accepted the PEAC recommendations for the direct cost inputs for CPT code 97024, except for the deletion of one minute of physical therapy assistant time. The PEAC recommendation was based on a presentation that was made by the physical therapy specialty society. The current CPEP inputs consist of 2 minutes for a physical therapy aide and 3 minutes of physical therapy assistant time and 15 minutes of a low mat table and diathermy machine. There were no supplies assigned because the supplies are included in the procedures that are typically delivered with this modality. We have seen no evidence that would indicate that any of these inputs are incorrect. Therefore, we will make no revisions to the inputs at this time. However, we have two diathermy machines in our CPEP input database. We currently have assigned the machine priced at $2850 to the diathermy code, but will substitute the higher priced machine, which we have priced at $3120, until we have more definitive information regarding the typical cost of the equipment. We have a contractor who is currently updating the prices of all the supplies and equipment listed in the CPEP database, and will soon be proposing updated prices for all the CPEP inputs, including the diathermy equipment.

    (ii) PEAC/RUC Recommendations on CPEP Inputs for 2003

    We have received recommendations from the PEAC on the refinement to the CPEP direct practice expense inputs for over 1200 codes. (A list of these codes can be found in Addendum F.) These include refinements to codes from almost every major specialty. In addition, the PEAC has continued to standardize inputs to streamline the refinement process. Previously, the PEAC created standardized inputs for 90-day global services as well as supply packages for evaluation and management, neurosurgery, gynecology services, ophthalmology and postoperative services. The PEAC has also established standard times for certain clinical staff tasks, such as greeting and gowning the patient, the taking of vital signs and post-service phone calls. These current recommendations include standardized times for office-based clinical staff for services provided during a patient's hospitalization and for discharge day management services, as well as pre-service clinical staff time data for 323 neurosurgery procedures. At an early PEAC meeting a list was drawn up of the codes most in need of refining. Of the 122 codes on this list, only seven have not yet been refined, which is one important measure of the success of the PEAC's efforts.

    As stated above, we are very pleased with the progress that the PEAC has made so far and appreciate greatly the contributions that have been made to our refinement effort by the PEAC members, as well as by the staff from the AMA and the specialty societies. We have reviewed the submitted PEAC recommendations and are also pleased that, because of the expertise gained by the PEAC in evaluating the practice expense inputs, we are able to accept all of the recommendations without any revision. The complete PEAC recommendations and the revised CPEP database can be found on our Web site. (See the SUPPLEMENTARY INFORMATION section of this rule for directions on accessing our Web site.)

    (iii) Other Comments on the Refinement of the CPEP Inputs

    Comment: We received comments from specialty societies representing vascular surgery, radiation oncology, rheumatology, physical therapy and internal medicine agreeing with the update we made to the clinical staff categories and to the revised salary data. Several of these commenters also thanked us for our analysis and use of the additional data that was supplied by the specialty societies.

    Response: We appreciate the positive response to our repricing of clinical staff salaries.

    Comment: The specialty society representing radiology expressed appreciation for the establishment of new clinical wage rates for CT technologist, MRI technologist, medical physicist, and dosimetrist. However, the comment expressed disagreement with our decision to merge the x-ray technician and radiation technologist staff types under the title of “radiologic technologist,” because the education and scope of practice for these staff types are different and merging them will reduce the radiation technologists wage rate. The specialty society also opposed the decision to blend the staff types of RN and sonographers because they are trained to provide different services and are not interchangeable.

    Response: The original CPEP data listed both “x-ray technician” and “radiation technologist” and seemingly made no distinction between these two staff types because the same wage rate was assigned to both. We used the Bureau of Labor Statistics' salary data to determine the wage rate for the “radiologic technologist.” Therefore, we do not believe that the salary assigned has been reduced in any way. If some of the radiology procedures typically use staff that are paid at a lower rate than the radiologic technologist, this information should be provided by the specialty society when the practice expense inputs for the services are refined. Regarding the second concern, we did not make a decision to blend the staff types, “RN” and “diagnostic Start Printed Page 79976medical sonographer.” This blend currently exists in the original CPEP data and has also been contained in several PEAC recommendations. Both staff types are priced separately and we were merely listing what the pricing would be when such a blend was applied to any service.

    Comment: Three specialty societies, representing surgeons, thoracic surgeons and ophthalmologists, commented on the issue of our previous exclusion from the CPEP data of all claimed time associated with staff brought to the hospital by the physician. The commenters from the surgical and the thoracic surgery specialty societies claimed that a recent report by the Office of the Inspector General (OIG) confirms that over 70 percent of cardiac surgeons bring staff to the hospital, but that only 19 percent are being reimbursed by the hospital. The commenters further argued that this is an inequitable arrangement that requires corrective action by us. The commenter from the ophthalmology society claimed that ophthalmologists bring their staff to the facility setting 50 percent of the time and some cost for this should be built into their practice expense.

    Response: In the November 2, 1999 final rule (64 FR 59399), we adopted a policy to exclude all clinical staff time in the facility setting from the input data used to develop practice expense RVUs. Among other arguments, we indicated that Medicare should not pay twice for the same service. That is, Medicare's payment to the hospital includes payment for clinical staff and we should not also compensate a physician for using their own staff in the hospital. In addition, we argued that we also pay for physician-extender staff used in the facility setting, such as physician assistants and nurse practitioners, through the physician work RVUs, and we pay physician assistants directly when performing as an assistant-at-surgery. In response to this argument, thoracic surgeons contended that hospitals are no longer providing the staff to furnish adequate care. While we did not change our policy, we asked the Office of Inspector General (OIG) to conduct an independent assessment of staffing arrangements between hospitals and thoracic surgeons (see November 1, 2000 final rule 65 FR 65395). In April, 2002 (OEI-09-01-00130, page ii), OIG concluded:

    Medicare pays for non-physician staff even though surgeons do not receive additional payment for some of the staff they bring to the hospital. Instead, services of these staff are paid to either physicians through the work relative value units, to the mid-level practitioners directly, or to the hospital through Part A or the Ambulatory Payment Classification system for outpatient services. Recognizing this, some hospitals and cardiothoracic surgeons have entered into arrangements whereby hospitals provide some compensation to surgeons who bring their own staff.

    We believe the OIG report clearly supports our position to exclude the costs of clinical staff brought to the hospital from the practice expense calculations. While it may be common for thoracic surgeons to bring staff to hospitals, the OIG report makes clear that Medicare pays for these costs either directly to physicians or the hospital. Since the OIG report supports our position, we are not making any revisions to our policy to exclude practice expense inputs associated with bringing clinical staff to hospitals.

    Comment: One commenter representing an independent diagnostic testing facility commented that a review of the practice expense inputs for the 24-hour cardiac monitoring HCPCS codes G0005, G0006 and G0007 and the corresponding CPT codes 93270, 93271, and 93272 revealed the CPEP input lists contain items that are not needed to perform these services. The commenter suggested the following deletions: G0005 and CPT code 93270 (for the hookup of the equipment)—delete the ECG electrodes, laser paper, king of hearts-20, computer, life receiving center; G0006 and CPT code 93721 (for the monitoring and transmission of data)-delete the razor, gloves, alcohol swab, and tape and exam table; G0007 (interpretation and report)-delete all the supplies (G0007 currently has no equipment and CPT code 93272 currently has no equipment or supplies assigned.

    Response: We agree that the changes to the practice expense inputs suggested above divide the inputs more appropriately between the two TC codes and the PC code for this cardiac monitoring service. However, as discussed in section IV, we are deleting the referenced G-codes for CY 2003 and these services will be reported using the CPT codes. On an interim basis, until these codes are refined, we will make the recommended revisions to the CPEP data for the CPT codes for these services. It should be noted, however, that the TC codes are currently in the non-physician work pool and that the CPEP data is not currently used to calculate their practice expense RVUs. In addition, we do not assign direct cost inputs to PC codes. Therefore, these changes will not at this time have any effect on the payment for these codes.

    Comment: A specialty society representing radiology commented that the review cycle for pricing “high tech” equipment and supplies may need to be reviewed more frequently than every 5 years and suggested a 3-year cycle.

    Response: We plan to propose current pricing for all the supplies and equipment in our CPEP database in next year's proposed rule. We have made no final decision on how often this pricing update should be done and will consult with the medical community on how best to ensure that we have appropriate pricing for all of our direct cost inputs.

    (iv) Proposed Changes from June 28, 2002 Proposed Rule

    (A) Ophthalmology Services—Rank Order Anomalies

    Based on a request from the American Academy of Ophthalmology we proposed revisions to the CPEP data for five ophthalmology services: For CPT code 67820, Revise eyelashes, we proposed to remove ophthane from the supply list. For CPT code 67825, Revise eyelashes, we proposed to remove the bipolar handpiece from the supply list. For CPT code 65220, Removal foreign body from eye, we proposed using the supply list and clinical staff time assigned to CPT code 65222. The exam lane is the only equipment assigned. For CPT codes 92081 and 92083, Visual field examination(s), we proposed to assign the same supplies and equipment as CPT code 92082 and to assign 35 minutes of clinical staff time to 92081 and 70 minutes to 92083.

    Comment and Response: Commenters were supportive of the proposed revision to the CPEP inputs for the ophthalmology codes and we are finalizing the revisions as proposed.

    (B) Practice Expense Inputs for Thermotherapy Procedures

    There are three CPT codes for transurethral destruction of prostate tissue: CPT 53850, by microwave therapy, CPT 53852, by radiofrequency thermotherapy, and CPT 53853, by water-induced thermotherapy (WIT). Based on concerns expressed by a manufacturer of WIT equipment that practice expense inputs were underestimated for CPT code 53853 relative to the other two codes, we made a comparison and agreed that the WIT procedure had not been assigned many of the basic supply and equipment inputs that were included in the CPEP inputs for the other two procedures. Therefore, we proposed to add, on an interim basis, the following inputs: Power table, ultrasound unit, mayo stand, endoscopy stretcher, light source, Start Printed Page 79977chux, sani-wipe, patient education book, sterile towel, sterile gloves, specimen cup, alcohol swab, gauze, tape, lidocaine, betadine, 10 cc syringe, 30 cc syringe, sterile water, leg bag.

    We also proposed to change on an interim basis the staff type for CPT code 53853 from the RN/LPN/MTA blend to RN in order to make the staff type consistent among these three similar procedures. In addition, we corrected, for all three procedures, the minutes assigned to each piece of equipment to reflect the intra- and post-clinical staff times only, rather than the total clinical staff times.

    We have also requested that these three procedures be reexamined by the PEAC at the same time in order to ensure that there is a consistent approach to the assignment of direct cost inputs.

    Based on questions we received regarding the large disparity in prices used for the three different thermotherapy machines and indications that the prices have decreased dramatically since these were initially priced in 1999, we proposed to set the price for thermotherapy equipment at $60,000 for CPT code 53850 and $30,000 for CPT code 53852. We also requested any additional available price documentation that would assist us in ensuring assigned prices accurately reflect actual costs.

    Comment: Commenters were generally supportive of the proposed revisions and in agreement that the PEAC should review the CPEP inputs for these procedures. A specialty society representing urology agreed that the best way to handle the CPEP inputs for these services is to have the PEAC review the direct cost inputs for all the heat therapy procedures concurrently and the comment from the RUC stated that it plans to review these codes in time for inclusion in the physician fee schedule for 2004. However, a few commenters also suggested that the review be extended to other codes for treatment for benign prostatic hypertrophy, such as the code for transurethral resection of the prostate, CPT code 52612, and for laser coagulation of the prostate, CPT code 52647.

    Response: We agree that it would be advantageous to have the PEAC review the CPEP inputs for all codes pertaining to the treatment of benign prostatic hypertrophy at the same time. This would help ensure that the same standards are applied to developing the direct cost inputs for these codes so that the resulting practice expense RVUs appropriately reflect the relative costs of each service. We will request that the PEAC include for review all the codes suggested by the commenters.

    Comment: One commenter, representing a manufacturer, also indicated that, as part of any review, it is imperative that cost data for all medical devices that fall within the CPT code should be evaluated. The commenter suggested that we work with the specialty groups to obtain pricing information rather than using invoices for pricing. The comment from the specialty society argued that we should maintain all the proposed input changes unless we receive compelling data from urologists or manufacturers that varies from the proposed inputs. Another commenter stated that, while there has been a reduction in the price of the thermotherapy control unit over the past few years, the proposed price of $60,000 for thermotherapy equipment for CPT code 53850 was not representative. The commenter included an invoice that indicated that the current price is closer to $80,000, after the application of discounts.

    Response: We will finalize the revisions to the CPEP inputs as proposed with the exception of the price for the thermotherapy equipment that we will increase to $80,000 on an interim basis. As part of the practice expense refinement process we have awarded a contract to update the pricing for both the supplies and equipment represented in the CPEP inputs and we anticipate that the proposed pricing revisions to the inputs will be included in next year's proposed rule. Pricing of the thermotherapy equipment will be included in these proposed changes and we will be seeking input from the specialty society to help us in this endeavor.

    (C) Revision to Inputs for Iontophoresis

    It had been brought to our attention that the electrodes assigned to the supply list for CPT code 97033, Iontophoresis, were not the type required for this procedure. We proposed to substitute two electrodes with a medication vesicle as the appropriate supply for iontophoresis.

    (D) Correction to Price for Sterile Water

    We proposed to change the price for 1000 ml of sterile water from $40.00 to $3.00.

    Comments and Responses: No comments were received on our proposals to substitute two electrodes with a medication vesicle as the appropriate supply for iontophoresis or to correct the price of sterile water. Therefore, we are finalizing these as proposed.

    b. Non-Physician Work Pool For Practice Expense

    Comment: We received a comment objecting to use of the phrase “zero work pool.” The comment acknowledges that our preamble refers to “zero physician work pool” but stated that the vernacular used by the agency, Congressional staff and other stakeholders is “zero work pool.” While acknowledging that we do not intend to connote a zero value for oncology nurses' contributions, oncology nurses, social workers, radiology technicians and others take offense to the use of “zero work pool” because it suggests that the work done by oncology nurses and other clinical staff is without value. The comment suggested four appropriate alternative titles: Non-physician clinical staff time, Non-physician work components, Non-physician work pool or Non-physician health professional pool.

    Response: We did not intend to devalue the contribution of clinical staff involved in providing physician fee schedule services. In fact, we created the special methodology to value services that are provided by clinical staff without a physician because of our concern that these services could be valued inappropriately low under the top down methodology. Nevertheless, it is clear that there are objections to the nomenclature we have used. We appreciate the suggestions for alternative nomenclature and will refer to the special methodology as the “Non-physician work pool.”

    (i) Discussion of Alternatives to the Non-Physician Work Pool

    In our June 2002 proposed rule (67 FR 43850) we summarized alternatives to the non-physician work pool that have been included in reports prepared by our contractor, the Lewin Group. Included in the alternatives were: elimination of the non-physician work pool; development of specialty specific non-physician work pools; making the TC equal to the global less the PC RVUs; and, development of proxy physician work RVUs for physician fee schedule services provided by clinical staff without physicians. While we included a discussion of each alternative and their feasibility, we did not propose eliminating or replacing the non-physician work pool. We indicated that specialties whose services are affected by the non-physician work pool may conduct supplemental practice expense surveys if they believe there are shortcomings in the practice expense per hour information that we use as part of the basic methodology. We referenced Start Printed Page 79978the interim final rule also published June 28, 2002 in the Federal Register. The interim final rule modified the criteria for acceptance of supplemental data. (See section II.A.3.(a) of this rule for a summary of the interim final rule, the public comments, and our responses.) We also noted that while the non-physician work pool is of benefit to many of the services that were originally included, we have allowed specialties to request that their services be removed.

    As part of our analysis of alternatives to the non-physician work pool, we proposed a change in the computation of practice expense RVUs for some PC and TC services. Since it is far more common to receive a global bill than a TC only bill, we believe that using the global to value the TC service will result in a payment that is more typical of the relative actual practice expense associated with the service. Therefore, we proposed to make the TC value equal the difference between the global and the PC for procedure codes that are not included in the non-physician work pool. That is, we used the practice expense value produced by the methodology for the global and subtracted the PC to derive the TC practice expense RVU. As a result of concerns that we had about the impact of this change on services that are affected by the non-physician work pool calculations, we proposed continuing to make the global value equal to the sum of the professional and the TC values for non-physician work pool services.

    Comment: One commenter, representing oncologists, argued that the “normal top-down methodology discriminates against [non-physician work pool] services * * * by assuming, without any basis, that indirect costs are lower than comparable services that do involve physician work.” The commenter stated that both the GAO and Lewin reports provide support for the conclusion that the indirect cost allocation is biased against non-physician work services. According to the commenter, our assertion that “the indirect cost allocation must be correct because not all of the services without a physician work component are disadvantaged by its use is not a sound basis for maintaining the current methodology.” The commenter argues that estimates of practice expense per hour and physician time may be overstated for some non-physician work services resulting in an advantage outside of the non-physician work pool. Furthermore, the comment argues that an increase in payment resulting from services being “withdrawn from the [non-physician work pool] does not demonstrate that the normal top-down methodology results in an appropriate payment amount for services that do not have physician work components.” The commenter also objected to our rejection of the Lewin Group's idea to develop specialty-specific non-physician work pools on the basis that a single methodology must apply to all services. According to the commenter, our refusal would only be appropriate if the methodology was not biased against non-physician work pool services. Another comment suggested that we allocated indirect costs by deeming direct costs as 33.2 percent of total costs. Indirect costs would then be added to direct costs to determine a total practice expense RVU.

    Response: We do not believe the practice expense methodology is biased against non-physician work services. The methodology allocates indirect costs based on physician work and direct costs. While the comment suggests the use of physician work in the indirect cost allocation is biased against services that do not have physician work, it ignores that direct costs are also used. Most services that do not have physician work have significant direct expenses. Thus, any bias against non-physician work services in the indirect cost allocation is offset by the use of direct costs. Similarly, the use of physician work in the indirect cost allocation will offset any bias against services predominantly performed in facilities where the physician will have few, if any, direct costs associated with the services. For example, surgical services furnished in a hospital have few direct expenses, thus the allocation of indirect expenses according to both work and direct expenses helps offset any bias against surgical services.

    We also disagree with the comment that suggests “deeming” direct costs to be 33.2 percent of total costs for purposes of developing practice expense RVUs. The proportion of costs attributable to direct and indirect costs will be different for each service. Such a proposal would be inherently unfair to services that have few direct costs (and impossible to use for services that have no direct costs) and would create a significant bias in favor of services that have high direct expenses.

    We further examined the assertion in the comment and in the Lewin Group and GAO reports that the indirect cost allocation is a possible explanation for the adverse payment impact that would occur under the top-down methodology for some non-physician work pool services. It is important to distinguish between the different types of services that are affected by the non-physician work pool calculations. Professional/TC services are the largest category of services included in the non-physician work pool. While many professional/TC services were not adversely affected by the adoption of the top-down methodology, the ones remaining in the pool are the services that would be most adversely affected by its elimination. Some “Incident to” services are also included in the non-physician work pool. Elimination of the non-physician work pool may cause payments for these services to go up or down depending on the specialty that provides them.

    Based on 2000 utilization data, the specialties with the largest amount of Medicare allowed charges affected by the non-physician work pool calculations are: radiology ($2.8 billion), cardiology ($2.1 billion), internal medicine ($568 million), radiation oncology ($465 million), multi-specialty clinics ($313 million), independent diagnostic testing facilities ($309 million) and oncology ($226 million). Radiology receives 87 percent of its Medicare revenues from services that are affected by the non-physician work pool calculations. The figures are 47 percent for cardiology, 9 percent for internal medicine, 65 percent for radiation oncology, 17 percent for multi-specialty clinics, 86 percent for independent diagnostic testing facilities and 26 percent for oncology. There are other smaller specialties that also receive a significant proportion of their revenues from services in the non-physician work pool (portable x-ray suppliers, 100 percent, interventional radiology, 63 percent, allergy/immunology 35 percent). The specialties that receive the highest proportion of their revenues from professional/TC services remaining in the non-physician work pool would be most adversely affected by its elimination (independent diagnostic testing facilities, portable x-ray suppliers, radiology, radiation oncology and interventional radiology). Cardiology also receives substantial Medicare revenues from professional/TC services remaining in the non-physician work pool but would be less adversely affected by its elimination. Allergy/immunology receives substantial revenues from “incident to” services in the non-physician work pool and would experience a more modest decline in payment under the top-down methodology. Payments to oncology for “incident to” services would increase if the non-physician work pool were eliminated.

    Radiology, radiation oncology and certain other diagnostic services with professional and technical components Start Printed Page 79979are likely to be the services most adversely affected by elimination of the non-physician work pool. We do not believe the allocation of either direct or indirect costs explains the effect of the top-down methodology on these services. We examined this issue further by modifying the indirect cost allocation using an idea suggested by the Lewin Group that would retain work and direct expenses to allocate indirect costs but create proxy physician work values for services that do not have physician work (the Lewin Group, pages 22-23). As indicated earlier, we proposed to modify the practice expense methodology to calculate the TC practice expense RVU as the difference between the global and the PC RVU for services unaffected by the non-physician work pool. To analyze the Lewin idea, we followed this same approach for all services. However, we further modified the methodology to use proxy work RVUs for the TC (or non-physician work portion) of the global service for the allocation of indirect costs. (We did this for TC services as well, but it makes no difference whether a proxy physician work RVU is used for the indirect cost allocation since the RVU produced by the practice expense methodology for the TC is not used). By developing a proxy work RVU for the global, in effect, we imputed physician work RVUs for the technical portion of the global service and added it to the existing work RVUs for the physician interpretation. If such an approach were adopted, the indirect cost allocation would favor the global service at the expense of professional component. That is, the practice expense RVUs would increase for the global and decrease for the PC but the overall impact for the specialty would be about the same. Modifying the indirect cost allocation in this way would not offset large decreases in payment for radiology, radiation oncology and other specialties most adversely affected by elimination of the non-physician work pool. In fact, such a methodological change would not even raise payments to these specialties.

    As we indicated in the June 2002 proposed rule, we believe a relatively low practice expense per hour, and not the indirect cost allocation, explains the adverse impact on diagnostic services that would occur from eliminating the non-physician work pool. We encourage radiology, radiology oncology and other diagnostic service providers affected by the non-physician work pool to undertake a survey of the practice expenses. Since practice expense methodology uses a weighted average of the practice expenses of the specialties that bill Medicare, we believe there are significant advantages to the survey being undertaken with collaboration among the different providers of diagnostic services. As indicated earlier, we advise any party interested in conducting a supplemental survey to consult the Lewin Group and us before proceeding.

    Comment: Most comments we received supported making the TC practice expense RVUs equal to the difference between the global and PC practice expense RVUs. We received a number of comments from pathologists and organizations representing independent laboratories, pathologists, dermatologists, and others expressing concern about the effect of the proposal on payment for pathology services. Some of the commenters indicated that we did not provide an explanation of the necessity for the change or indicate why a simple arithmetic change should result in such a large difference in the proposed fee for TC services. Several of these commenters stated that practice expenses for physician pathology services are increasing, not decreasing. According to some of these commenters, it is inequitable to apply the methodology to certain specialties or groups of services that would experience significant reductions while sparing other specialties or services that would experience reductions under the same change. There were also comments indicating that the reduction in payment for pathology services was related to the mix of specialties that bill for global services; specifically, there is concern that independent laboratories bill for a higher proportion of global than TC services. The commenters noted that we do not have a practice expense per hour for independent laboratories and use a crosswalk practice expense per hour from “all physicians.” While this comment acknowledges our need to use a crosswalk when we do not have a practice expense per hour, the comment indicated that there is no reason to conclude that independent laboratories that provide pathology services have practice expenses per hour similar to the all physician average. The comments expressing concern about the impact of the proposal on pathology services requested a one-year moratorium on its implementation to allow for a survey of independent laboratory practice expenses under the supplemental survey process. There were a number of comments indicating that organizations representing pathologists would undertake a survey of practice expenses for independent laboratories that could be used to develop 2004 physician fee schedule rates.

    Response: We agree with the comments that suggest a one-year moratorium on implementation of the proposed change for pathology services paid under the physician fee schedule. Based on a consultation with the College of American Pathologists, we will continue to determine the global practice expense RVUs as the sum of the professional plus TC for all of the global codes in the CPT 80000 series that are paid using the physician fee schedule, as well as the following HCPCS and CPT codes:

    Table 2

    CPT/HCPCSDescription
    G0141Screening c/v, autosys, interp
    P3001Screening c/v, interp
    10021FNA w/o image
    10022FNA w/image
    36430Blood transfusion service
    36440Blood transfusion service
    36450Blood transfusion service
    36455Exchange transfusion service
    36460Transfusion service, fetal
    36520Plasma and/or cell exchange
    38220Bone marrow aspiration
    38221Bone marrow biopsy
    38230Bone marrow collection
    38231Stem cell collection

    CPT codes and descriptions only are copyright 2002 American Medical Association.

    As we indicate in the background part of this preamble, the practice expense methodology essentially takes a weighted average of different specialty practice expenses to determine a practice expense RVU. The methodology will independently produce a value for the global, professional and technical components. For instance, CPT code 88305 (Tissue exam by pathologist) is a commonly provided pathology service. The methodology produces a value of 1.60 for the global, 0.34 for the PC and 1.39 for the technical component. The sum of the professional and TC RVUs (0.34 + 1.39 = 1.73) is not equal to the global RVU (1.60). The values are not equal because the mix of specialties that provide the global and the TC are different and each specialty has a different practice expense per hour. The specialties that bill CPT code 88305 to Medicare for the global service most frequently have the following practice expense per hour: Start Printed Page 79980

    Table 3

    SpecialtyPractice expense per hourPercent of total volume
    Independent Lab$69.0056
    Pathology66.3029
    Dermatology119.4013

    The specialties that bill Medicare most frequently for the TC are:

    Table 4

    SpecialtyPractice expense per hourPercent of total volume
    Independent Lab$69.0047
    Dermatology119.4033
    Pathology66.3016

    As shown in the tables above, dermatology has a very high practice expense per hour relative to independent laboratories and pathology. However, dermatologists bill Medicare for a smaller portion of the global services. As a result, dermatology contributes less weight to the global value than the TC value. Our practice has been to make the global RVUs equal the sum of the PC and TC values. If the methodology results in PC and TC values that do not sum to the global value, we must change either the global or TC value. To date, we have used the PC (0.34) and the TC value (1.39) to determine the global value (1.74). However, in the proposed rule, we used the global value (1.60) minus the PC (0.34) to obtain the TC (1.26). Using the TC to value the global component for this code (88305) produces a higher RVU for both the technical and the global components than using the global component to value the TC.

    As we have previously indicated, it is far more common for Medicare to receive a global than technical-component-only bill. For this reason, we believe it is valid to rely on the global to produce a value for the technical rather than use the technical to value the global. Nevertheless, since independent laboratories predominantly bill the global for pathology services and we are using a crosswalk for the practice expense per hour, we believe it makes sense to allow for a one-year moratorium on implementation of this provision for pathology services to allow for use of a supplemental survey that provides us with specific data on practice expenses for independent laboratories.

    Final Decision: We are not adopting the proposed change for pathology services paid using the physician fee schedule at this time. For all professional/TC services not included in the non-physician work pool, excluding pathology services, we will make the TC value equal the difference between the global and the professional component. We will continue with the current practice for pathology services and non-physician work pool services and sum the professional and TC values to determine the global.

    (ii) Other Proposals for Changes to the Non-Physician Work Pool

    (A). Change to Staff Time Used To Create the Pool

    In the November 2, 1998 final rule (63 FR 58841), we indicated that average clinical staff time was used in the creation of the non-physician work pool. Since the cost pools are created using physician time and, by definition, services provided by clinical staff have no physician time, we need staff time to create the non-physician cost pool. If our database indicates that multiple staff types are typically involved in the service, we have used an average of the different clinical staff times. We proposed to create the non-physician cost pool using the highest staff time in place of average staff time.

    Comment: We received many comments that supported using the highest staff time to create the non-physician work pool. Some comments suggested that we should consider using “total” staff time especially if we will use the clinical staff times being provided by the Practice Expense Advisory Committee (PEAC). The comment indicates that the PEAC has been particularly careful to avoid duplications of time. If the PEAC has limited or eliminates concurrent staff time, the comment suggests that “total” rather “maximum” staff time should be use to determine the non-physician work pool. A number of comments expressed concern about PEAC refinements of clinical staff times associated with codes included in the non-physician work pool. These comments requested that we not incorporate any PEAC revised clinical staff times for non-physician work services until there has been an opportunity for public notice and comment. There were two comments objecting to this proposal. One comment indicated that the maximum staff time is not the “typical” time associated with provision of the service and urged us not to implement the proposal. We received another comment that noted that physician times used to establish practice expense cost pools for physician work services use average or median times from RUC or Harvard surveys. The comment indicates that the proposal to use maximum staff time represents a step away from the stated goal of developing a consistent method for all services. According to this commenter, the proposal will penalize specialties that do not perform a large volume of services in the non-physician work pool.

    Response: We disagree with the comment that suggests we are not using a time that is typical of the service and the one that implies our staff time proposal is inconsistent with how we determine physician time. For a physician's service, we develop time based on surveys. While the comment is correct that we generally use average or median time estimates from surveys to determine the typical time, the time reflects the service of a single physician. Start Printed Page 79981For non-physician work pool services, we are also using estimated average staff times to represent the typical service. However, multiple clinical staff are frequently involved in performing non-physician work pool services. The staff may be working concurrently, consecutively or overlapping time. Given the special circumstances associated with non-physician work pool services that do not apply to physicians' services, it was necessary for us to select among multiple time estimates to develop the pool. We are currently using an average of the estimated staff times but proposed to use the maximum. Once we address issues related to the non-physician work pool, this will no longer be an issue since we will use a single methodology for all physician fee schedule services and staff time will not be used to create cost pools.

    In response to the comment that refined clinical staff times not be used at this time for non-physician work pool services, we agree that there are special circumstances that apply to these services. Because the clinical staff times are used to create the pool and can result in RVU changes across all services, even those where no refinements have been made, we are not using the revised clinical staff time to create the non-physician work pool at this time. However, as indicated above, this will no longer be an issue once we address other issues related to the non-physician work pool.

    (B). Removal of Non-Invasive Vascular Diagnostic Study Codes From the Non-Physician Work Pool

    We proposed to remove the non-invasive vascular diagnostic study codes (CPT codes 93875-93990) from the non-physician work pool based on a request from the American Association for Vascular Surgery (AAVS) and the Society for Vascular Surgery (SVS).

    Comment: We received support from vascular surgeons and others for removing the non-invasive vascular diagnostic studies from the non-physician work pool. These comments requested that AAVS/SVS should be able to modify the request if CMS does not finalize its proposal to calculate the TC practice expense RVU as the difference between the global and professional components. We also received a number of comments requesting that we remove other codes from the non-physician work pool. The Society of Vascular Technology and Society of Diagnostic Medical Sonography) requested that we remove 26 ultrasound codes in the CPT code range 76506 through 76977. The American Society of Neuroimaging also requested that some of these codes be removed. The American Urological Association (AUA) also requested that we remove CPT codes 76857, 76872, 76942 and 96400 from the non-physician work pool. While there were no objections to removing the non-invasive vascular diagnostic study codes, we received many comments that suggested limiting the financial impact that removing codes from the non-physician work pool have on the remaining codes. In particular, many of these commenters expressed concern about the impact of removing chemotherapy administration codes from the non-physician work pool. Some comments provided suggestions for modifications to the non-physician work pool (for example, using a different practice expense per hour) that could be used if adverse impacts result from codes being removed. One commenter suggested that we maintain the existing RVUs and provide a downward adjustment to the CF to ensure no increase in aggregate payment results from removing chemotherapy administration services from the non-physician work pool.

    Response: At this time, we have not received any requests to remove chemotherapy administration from the non-physician work pool. Nevertheless, if there are sound suggestions that could be adopted consistent with changes in the composition of the non-physician work pool that will improve the practice expense methodology, we may consider adopting them in the future. Of course, as stated elsewhere, our goal is to eliminate the non-physician work pool and apply a single methodology to all physician fee schedule services so further adjustments will be unnecessary. We expect this to be a top priority in CY 2003 for determining CY 2004 physician fee schedule rates.

    We have reviewed the comments to remove specific services from the non-physician work pool. While our general policy has been that “families” of procedure codes should be removed from the non-physician work pool (see the July 22, 1999 proposed rule (64 FR 39620)), we will allow individual codes to be removed if the requesting specialty predominantly performs the requested code and other specialties predominantly perform the other codes in the family. We have reviewed 2001 utilization for the codes requested by the AUA. Since urologists predominantly perform the requested codes and other codes in the family are predominantly performed by other specialties, we are removing the following codes from the non-physician work pool: CPT codes 76857, 76872, 76942 and 96400. We are not removing other codes requested in the comments because they are predominantly performed by radiology, neurology or obstetrics-gynecology and the specialty societies representing these physicians have not requested that the codes be removed from the non-physician work pool.

    Comment: The American College of Rheumatology (ACR) acknowledged that the current average wholesale price (AWP) methodology provides for a “healthy margin overall” in the provision of these services [infusion agents and infusion therapy] through “cross-subsidization.” However, they indicated that payments for infusion therapy services are “woefully insufficient.” The comments from ACR and many rheumatologists expressed concern about reductions in payment for infusion agents in combination with maintaining the current payment amounts for infusion therapy (CPT codes 90780 and 90781). The comments indicated that a reduction in payment for infusion agents without an increase in the payment for infusion therapy services will likely result in Medicare beneficiaries being unable to receive infusion services in physicians' offices. One commenter from a society representing gastroenterologists indicated that we should consider increasing the payment for non-chemotherapy infusion services. Other comments suggested that we should use the rulemaking process to establish HCPCS G codes to increase payment for non-chemotherapy drug administration to a more appropriate level.

    Response: We currently determine the practice expense RVUs for CPT codes 90780 and 90781 using the non-physician work pool methodology. One commenter suggested establishing a G code for non-chemotherapy infusion services. While this option would allow infusion therapy to be valued outside of the non-physician work pool, we want to avoid establishment of G codes for services that are already described by existing CPT codes. Another option for addressing these comments would be to remove infusion therapy from the non-physician work pool and allow for resource-based pricing under the top-down methodology. However, oncologists predominantly perform these services and have not requested removing the codes from the non-physician work pool. We are reluctant to remove infusion therapy services from the non-physician work pool without a request from the specialty that predominates the data. As we previously noted, oncologists provided Start Printed Page 79982us with a supplemental practice expense survey. At this time, we are not incorporating the survey into the practice expense methodology because of concerns raised by our contractor, the Lewin Group, about the validity of some of the data. However, we hope to work with the Lewin Group and ASCO to either get an explanation of the survey results or use alternative data to validate the results. As we work to resolve issues related to the ASCO survey, we will consider removing the infusion therapy codes from the non-physician work pool.

    In the interim, we note that Medicare pays for drugs based on 95 percent of AWP. This system has been widely criticized for paying physicians for drugs at far higher rates than prices paid to obtain them. Oncologists receive more than 70 percent of their Medicare revenues from drugs. While we would prefer a statutory change to address Medicare's drug pricing methodology, we are contemplating administrative actions that may be taken under current law to address this issue. As we consider options for changing Medicare's drug payment methodology, we will continue examining the ASCO survey to determine whether the data can be used to calculate the practice expense per hour for oncology.

    (C). Removal of Immunization CPT Codes 90471 and 90472 From the Non-Physician Work Pool

    We proposed to remove immunization administration services from the non-physician work pool. We indicated this change would nearly double payment for CPT code 90471 and slightly reduce payment for CPT code 90472. Procedure CPT code 90471 is used for immunization administration of one vaccine and CPT code 90472 is used for the administration of each additional vaccine. Since CPT code 90472 must be billed in conjunction with CPT code 90471, the total payment for these procedures would increase when billed together.

    We also explained that we have not assigned immunization administration physician work RVUs because this service does not typically involve a physician. The nurse that administers the vaccine typically provides the necessary counseling to the patient and this time is accounted for in the practice expense RVU.

    In addition, we noted that not all services represented by CPT codes 90471 and 90472 are covered by Medicare. For example, medically necessary administrations of tetanus toxoid (such as following a severe injury) would be covered whereas preventive administration of this vaccine would not be covered. We also indicated we would consider whether coding changes might be appropriate to reflect the differences in counseling of the patient and/or family for childhood immunizations.

    Comment: Commenters supported our proposal to remove CPT codes 90471 and 90472 from the non-physician work pool. However, commenters indicated elderly patients are at higher risk to acquire pathogens and viruses and are in greater need of vaccinations. Medicare must recognize that as part of their practice of medicine, physicians take the time and responsibility to explain to their patients the benefits of vaccination and the potential side effects. Physicians question the patient about previous reactions to the vaccine and provide information material. These comments indicated that we should assign work RVUs of 0.17 for the administration of vaccines as recommended by the RUC.

    Response: The RUC has recommended that we both establish a work RVU for CPT code 90471 and include 13 minutes of clinical staff time to value the practice expense RVU. Further, our understanding from the RUC is that these immunization services are also provided in conjunction with a separately billable visit. We believe the clinical staff time for these services is intended to account for patient counseling and some of the activities described in the comment. Other activities attributed to the physicians are likely being provided as part of a separately billable office visit. For these reasons, we continue to believe that these codes should not be assigned physician work RVUs.

    Comment: Several commenters expressed concern that we did not propose any change in the payment rate for the administration of influenza (G0008), pneumonia (G0009), and hepatitis B (G0010) vaccines. The commenters are concerned that we continue to link payment for the administration of Medicare covered vaccines to a therapeutic injection CPT code (90782) that pays at half of the proposed rate for CPT code 90471. Other commenters recommended that Medicare use the CPT codes 90471 and 90472 in place of the Medicare-only alphanumeric codes (G0008, G0009, G0010). These comments indicated that if we are to retain the G codes, we should publish RVUs for them that match CPT code 90471.

    Response: We considered the comment to eliminate use of the G codes and allow use of the CPT codes for the administration of Medicare covered vaccines. However, we have decided that we will maintain these G codes at this time. It is important that we be able to closely monitor patient access to these important preventive services. However, since CPT has established similar codes for immunization administration that can be covered by Medicare, we will consider this issue further in 2003.

    With respect to payment, we agree with the commenters. Rather than link payment for procedures codes G0008, G0009, and G0010 to a service paid under the physician fee schedule, we will develop practice expense RVUs for these codes. Using the top-down methodology to develop practice expense RVUs will nearly double payment for these codes and make Medicare's payment for vaccine administration using the G codes more consistent with the rates paid for the CPT codes. Since the statute does not include the administration of pneumonia, influenza, and hepatitis B vaccines within the definition of physicians' services in section 1848(j) of the Act, the increased payment for these services will not result in reductions to the practice expense RVUs associated with physician fee schedule services. That is, there is no budget-neutrality adjustment to be made for revisions in payments for the administration of pneumonia, influenza, and hepatitis B vaccines.

    Comment: One commenter indicated that Medicare does not pay for the administration of influenza and pneumonia vaccines provided on the same day as another physician's service.

    Response: The commenter is incorrect. Medicare will pay separately for the administration of these vaccines and other physicians' services on the same day.

    (D) Utilization Data

    Medicare utilization is an important data source used in determining the practice expense RVUs. Our current policy has been to use the latest utilization data to develop each successive year's fully implemented practice expense RVUs during each year of the transition. While substituting the latest year's utilization data into the practice expense methodology generally made little difference on total Medicare payments per specialty, there has been a larger impact on services affected by the non-physician work pool. Based on suggestions made by specialty organizations, we proposed to use the CYs 1997 through 2000 utilization data to develop the CY 2003 practice expense RVUs and not to update further the utilization data in this year's final rule Start Printed Page 79983to incorporate the CY 2001 utilization data. Further, we proposed to continue using the CYs 1997 through 2000 utilization data in the practice expense methodology until we undertake the 5-year review of practice expense RVUs.

    Comment: We received comments both supporting and opposing use of multi-year utilization data in the practice expense methodology. The comments that “applauded CMS's efforts to ensure the stability” of the practice expense RVUs largely came from organizations affected by the non-physician work pool methodology. We also received support from specialties that are largely unaffected by the proposal because of its potential to provide more year-to-year stability in the practice expense RVUs. Other commenters indicated that use of new utilization data with a different “mix” of services produces unpredictable changes in RVUs even though resource costs have not changed. There were comments that indicated use of multi-year utilization data will restore the unanticipated and extraordinary reductions experienced by diagnostic imaging centers in CY 2002. These commenters urged that we adopt our proposal in the final rule. One comment stated that “utilization data adjustments should not change annually until the [non-physician work pool] is eliminated and/or CMS undertakes the 5-year review of practice expense RVUs.”

    One commenter stated that it is unclear whether the multi-year utilization will be used to develop practice expense RVUs for all services or only those in the non-physician work pool. Another commenter stated it is difficult to assess the impact of the proposal and urged the agency “not to make such a change, at least until it has conducted extensive impact comparisons” that can be evaluated by physicians and other stakeholders. Other commenters suggested that we should not update the practice expense methodology with new utilization data without giving an opportunity for public notice and comment. A number of commenters argued that application of a 10-percent payment reduction in CY 1998 and the per beneficiary per facility payment cap of $1500 cap in CY 1999 (in settings other than outpatient hospital departments) make utilization data unreliable for therapy services during the CYs 1997 through 2000 period. Commenters also noted that outpatient physical and occupational therapy services provided in facility settings were paid under cost-based reimbursement before CY 1999. The commenters questioned the accuracy of the utilization data for Part B therapy services from CYs 1997 through 2000 and suggested that the utilization data during this period would be biased by the implementation of policy changes. One commenter recommended that we use the most current available data as the base for examining therapy utilization and should commit to an annual review of the data until it can be established that a longer time horizon accurately reflects utilization. Other comments requested clarification of how we use data from this period for physical and occupational therapy.

    Response: With respect to therapy services, we do not use claims of institutional providers (rehabilitation agencies and comprehensive outpatient rehabilitation facilities) in developing payment rates for therapy services paid using the physician fee schedule. We only use the claims for therapy services from physical and occupational therapists in private practice. The proposal was intended to apply to all physician fee schedule services, not just those in the non-physician work pool. We are finalizing our proposal to use the CYs 1997 through 2000 utilization data to develop the practice expense RVUs for all services. However, we believe the comments raise important issues about policy changes that were occurring from CYs 1997 through 2000 that could lead to changes in utilization patterns during this time. We may analyze this issue further. In the interim, we welcome public comment about using the latest utilization data in the practice expense methodology.

    (E) Site of Service

    As part of our resource-based practice expense methodology, we make a distinction between the practice expense RVUs for the non-facility and the facility setting. This distinction is needed because of the higher resource costs to the physician in the non-facility setting where the practitioner typically bears the cost of the resources associated with the service. In addition, the distinction ensures that we do not make a duplicate payment for any of the practice expenses incurred in performing a service for a Medicare beneficiary. Currently, we have designated only hospitals, skilled nursing facilities (SNFs), and community mental health centers (CMHCs) as facilities for purposes of calculating practice expense. An ambulatory surgical center (ASC) is designated as a facility if it is the place of service for a procedure on the ASC list. All other places of service are currently considered non-facility.

    We proposed site-of-service designations for several new places of service as well as revisions to the site-of-service designation for several existing places of service. We proposed to assign a facility site-of-service when a facility or other payment will be made, in addition to the physician fee schedule payment to the practitioner, to reflect the practice expenses incurred in providing a service to a Medicare patient. We proposed to designate all other places of service as non-facilities.

    The following lists the place of service numerical code, the place of service and the proposed site of service designations:

    04 Homeless Shelter—Non-facility

    15 Mobile Unit—Non-facility, however, if a mobile unit provides a service to a facility patient, the appropriate place-of-service code for the facility should be used.)

    20 Urgent Care Facility—Non-facility

    26 Military Treatment Facility—Facility

    41 Ambulance-Land—Facility

    42 Ambulance Air or Water—Facility

    52 Psychiatric Facility Partial Hospitalization—Facility

    56 Psychiatric Residential Treatment Facility—Facility (NOTE: the chart included in the June 28, 2002 proposed rule at 67 FR 43854 incorrectly listed this as “NF”—nonfacility)

    We would also clarify two items in the chart published at 67 FR 43854:

    61 Comprehensive Inpatient Rehabilitation Facility was listed as a non-facility. This is currently considered a facility setting and we did not propose changing this designation. The reference to non-facility was in error.

    We also made reference to four place of service codes for Indian Health Service and Tribal 638 facilities and clinics. We were considering these place of service codes to implement section 432 of the BIPA that authorizes physician fee schedule payments to Indian Health Service and Tribal 638 facilities and clinics. At this time, we do not believe these place of service codes will be needed for implementation of these provisions and do not expect them to be in use. We are implementing section 432 of BIPA by using specialty codes, not place of service codes to identify HIS providers.

    Comment: One organization expressed appreciation for our efforts to update the list and had no comments. Others commented requesting clarification of site-of-service designations for the provision of Part B therapy services in nursing facilities. One commenter expressed particular concern about the use of place of service Start Printed Page 79984code 32 (Nursing facility) in conjunction with outpatient therapy services in nursing facilities. This commenter suggested we reiterate in the final rule the current policy that fee schedule payments for Part B therapy services delivered in a nursing home are classified as “non-facility.” They also suggested we redefine “site-of-service” for physicians services to non-Part A patients in nursing centers as “non-facility,” thereby applying the higher PERVUs to those services. We received one comment from a carrier medical director that indicated that physician practice costs for treating patients in skilled nursing facilities (POS 31) and nursing facilities (POS 32) are the same and that both should be designated as either facility or non-facility. This comment also suggested deleting the POS 32 designation (NH), or changing its meaning to a “SNF or NF stay not covered by Medicare.” A physician who practices in nursing facilities also argued that our current policy makes no sense because physician practice costs are the same regardless of whether Medicare makes a payment to the SNF for institutional services. This physician would like us to pay at the higher non-facility rate for physicians' services in both entities, but acknowledged that using the lower facility rate would be more consistent with the practice expense methodology.

    Response: We regret any ambiguity or concern that we may have created in our proposed rule. In general, for purposes of the physician fee schedule, we will consider a site to be a facility if the site also receives a Medicare payment for institutional services (that is, a payment under the inpatient prospective payment system (PPS), outpatient PPS, and SNF PPS). Thus, since there is a payment for institutional services to a hospital when a beneficiary receives care in an inpatient or outpatient setting, we consider the site to be a facility site and make a payment under the physician fee schedule using the facility rate. For entities other than those that receive a payment for institutional services, we consider the site a non-facility site and pay under the physician fee schedule using the higher non-facility rate. However, there are special provisions with respect to outpatient physical and occupational therapy services. These services are paid under the physician fee schedule even when provided in institutional sites like skilled nursing facilities. For this reason, for these services we calculate only a non-facility rate. Since there is no facility payment under Medicare, we use a non-facility rate to determine payment.

    Place of service code 32—Nursing facility—was designated as non-facility in our June 2002 proposed rule. Place of service code 31—Skilled nursing facility—is designated as facility. We have instructed physicians to use place of service code 31 for patients who are in an inpatient stay in a skilled nursing facility. Since Medicare is making a payment for institutional services that includes compensation for staff, supplies, and equipment, we are paying physicians using the lower facility rate when place of service code 31 is used. If the patient exhausts eligibility for SNF benefits and Medicare is no longer making payment to the SNF for institutional services, we have instructed physicians to use place of service code 32—Nursing facility, to allow Medicare to provide compensation to the physician for the costs of staff, supplies and equipment that would otherwise not be included in our payment. However, since it may be burdensome to the physician to determine when a patient is entitled to SNF Part A benefits, we always allow the physician to use place of service 31 and receive the lower facility payment for physicians' services.

    While we acknowledge the arguments of those who have written and contacted us both prior to and as part of the rulemaking process, we are reluctant to make any further changes in our policy at this time. We believe existing policy is equitable in that it does not overly burden physicians to have to determine whether a patient is in a Part A SNF inpatient stay. Physicians can always bill using place of service code 31 and be paid at the facility rate. Further, we allow use of place of service code 32 and our payment will be at the higher non-facility rate that includes compensation for staff, equipment, and supplies that would not otherwise be paid since there is no payment for the institutional services. In response to the request that we change the nomenclature describing place of service code 32, we will consider this further as updates are made to place of service coding. However, we note that Medicaid uses the place of service codes as well and the needs of this program will also need to be considered.

    Comment: One commenter suggested the descriptor for place of service code 23, “emergency room-hospital,” should be changed to “emergency department.”

    Response: We will consider this comment when further updates are made to place of service codes.

    Comment: One commenter expressed concern about the proposed designation change of site of service from non-facility to facility for both psychiatric facility partial hospitalization and psychiatric residential treatment facility. The commenter felt this would negatively impact physician reimbursement and could provide disincentive for psychiatrists to treat patients in these settings.

    Response: By developing practice expense RVUs that differ by site, we intend to reflect the relativity of resource costs incurred by physicians between sites. Our policies are not intended to provide financial incentives for a physician to select one site over another. Physicians should make these decisions based on the clinical needs of the patient. We believe that both psychiatric residential treatment facilities and psychiatric partial hospitalization programs are institutional sites that provide staff, equipment and supplies used in providing medical services and physicians will not incur these resource costs when providing services in these settings.

    (F). Other Practice Expense Issues

    (1) Budget Neutrality

    We received several comments suggesting that budget neutrality for changes in practice expense RVUs be applied to the physician fee schedule conversion factor. The comments indicated that payment for CPT codes with significant practice expense RVUs are reduced when there are aggregate increases in work RVUs but services that are predominantly composed of work RVUs are not significantly affected by aggregate increases in practice expense RVUs. According to the comments, such a modification would “help assure more year-to-year stability in the practice expense RVUs.” Since affected professional groups have not had an opportunity to consider and comment on this important issue, one comment suggests that we include this issue in the proposed notice for the CY 2004 physician fee schedule.

    Response: We will consider this idea for the future.

    (2) Computerized Tomographic Angiography

    Comment: We received a number of comments about Computed Tomographic Angiography (CTA). The comments indicated that, before CY 2001, CTA services were billed as a CT scan of an anatomical region plus an add-on code for 3-D image reconstruction. New codes specifically for CTA that incorporated the image reconstruction were developed for use Start Printed Page 79985in 2001. The comments indicated that the TC RVUs for CTA established in the November 1, 2000 final rule appear as though they were calculated by cross-walking the RVUs from the anatomically analogous existing CT procedure codes without accounting for the 3-D image reconstruction.

    Response: Based on this comment, we have adjusted the current CTA codes to incorporate image reconstruction.

    (3) TC for Cardiac Catheterization

    Comment: We received several comments that noted the TC RVU for cardiac catheterization declined in the notice of proposed rulemaking even though the codes are included in the non-physician work pool. These comments noted that the practice expense RVUs for all other non-physician work pool services increased in the proposed rule. One comment expressed concern over our proposal to derive the TC RVU from the global RVU service. The comment indicated that we currently have no direct cost inputs for these services and it is unlikely that the PEAC will be able to provide them since cardiac catheterization is generally provided in hospital settings. According to the commenter, there are only 80-100 non-hospital facilities that provide cardiac catheterization services. It is unlikely that we will have physician survey information that reflects the costs of these providers since they normally bill for the TC service and not the global service. The comment stated the cardiologist normally bills independently for professional services.

    Response: We have addressed the comment regarding the TC for the cardiac catheterization. The TC RVUs for these services are changing by the same percentage as all other non-physician work pool services. We understand that the PEAC may consider providing inputs for cardiac catheterization services. This will address one aspect of the commenter's concern. With respect to valid SMS data for cardiac catheterization services, we will consider this issue along with others as we address issues related to the non-physician work pool in CY 2003.

    B. Anesthesia Issues

    1. Five-Year Review of Anesthesia Work

    Section 1848(b)(2)(B) of the Act indicates that, to the extent practicable, we will use the anesthesia relative value guide with appropriate adjustment of the anesthesia conversion factor (CF) in a manner to assure that the fee schedule amounts for anesthesia services are consistent with the fee schedule amounts for other services. The statute also requires us to adjust the CF by geographic adjustment factors in the same manner as for other physician fee schedule services. Unlike other physician fee schedule services, anesthesia services are paid using a system of base and time units. The base and time units are summed and multiplied by a CF. The base unit is fixed depending on the type of anesthesia procedure performed, and the time units vary based on the length of the anesthesia time associated with the surgical procedure. Thus, our payment will increase as anesthesia time lengthens. The same anesthesia service provided in two different surgeries will be paid different amounts if the associated anesthesia time is different. This system differs from other physician fee schedule services for which RVUs for physician work, practice expense, and malpractice are summed and multiplied by a CF to determine payment. Payment for these non-anesthesia procedures will not vary based on the length of time it takes to perform the procedure in a specific instance.

    In the June 2002 proposed rule (67 FR 43855) we explained that the law requires that we review RVUs no less often than every 5 years. There is a fundamental difference in how the 5-year review applies to anesthesia services versus medical and surgical services. In general, for medical and surgical services, the relevant physician specialty society and the AMA's RUC review the current and proposed work RVUs on a code-by-code basis. The RUC will make recommendations to us on work values for specific codes and, if we accept or modify them, the new physician work RVUs will be used to determine payment. However, each anesthesia service does not have a work RVU. Therefore, adjustments for anesthesia work (and practice expense) are made to the anesthesia CF and payment for all anesthesia services is affected.

    The second 5-year review (with the exception of anesthesia services) was completed and revised work RVUs were implemented in 2002. For the second 5-year review, the American Society of Anesthesiologists (ASA) contended that the work of anesthesia services remained undervalued by almost 31 percent. They subsequently argued for a 26 percent increase in work RVUs based on additional discussions with the RUC. More recently, based on their further analysis and discussion with the RUC, the ASA asked for a 13.6 percent increase in work.

    The ASA derived a work value for an anesthesia code by dividing the anesthesia service into five uniform components. The five components are preoperative evaluation, equipment and supply preparation, induction period, postinduction period, and postoperative care and visits. These components were assigned work RVUs based on a comparison to non-anesthesia services paid under the physician fee schedule. The work of these components is then summed. Using this method, the ASA proposed new work values for 19 high volume anesthesia codes. These work values can be compared to imputed work values derived from current anesthesia payments for these services.

    Under the CPT coding system, anesthesia for various common surgical procedures is reported under a single anesthesia code. For example, CPT code 00790 is used to report anesthesia for over 250 intraperitoneal procedures in the upper abdomen.

    The ASA studied one surgical procedure for each of the anesthesia codes. The 19 codes represent a range of surgical procedure types, including general surgery, vascular surgery, neurosurgery, urology, orthopedics, cardiac surgery, and ophthalmology. The 19 procedures reviewed account for about 35 percent of Medicare allowed charges for anesthesia services.

    During the second 5-year review of work, several RUC workgroups reviewed the ASA comments and received supplemental information from them through presentations. Most of these workgroups expressed concerns about some of the work intensity values the ASA assigned to the individual anesthesia components, most notably, the induction and post induction time periods. For about 50 percent of the codes, the RUC was confident that the anesthesia work value of the surveyed service was similar to the anesthesia work values for all of the other surgical services assigned to the given anesthesia code. For the remaining codes, the RUC was not confident that the work values of the surveyed code could be applied to other anesthesia services that would be reported under that anesthesia code.

    The workgroups also expressed concern about extrapolating the results from the 19 surveyed codes to all anesthesia services. At its April 2002 meeting, the final meeting addressing anesthesia work values for the second 5-year review, the RUC concluded it was unable to make a recommendation regarding modification to the physician work values for anesthesia services. Specifically, the RUC stated:

    The RUC, having carefully considered the information presented, and having a Start Printed Page 79986reasonable level of confidence in the data, which was presented and developed by the ASA, is unable to make a recommendation to CMS regarding modification to the physician work valuation of anesthesia services.

    While the RUC did not make a recommendation to us regarding extrapolation, it forwarded its analysis to us for review.

    In the June 2002 proposed rule (67 FR 43856), we indicated our intent to review the information forwarded by the RUC and all comments we received during the comment period.

    Comment: The ASA commented that, based on work values accepted by the RUC anesthesia workgroup, the final RUC data show that anesthesia services are undervalued by a weighted average of 13.57 percent. The ASA urged us to adjust the anesthesia CF accordingly. The American Association of Nurse Anesthetists (AANA) endorsed the ASA's comments and provided similar comments. Several certified registered nurse anesthetists and anesthesiologists also wrote in support of an increase in the anesthesia CF. We also received several comments alleging that the ratio of Medicare payment to private payer payments for anesthesia services is considerably less than the analogous ratio for medical and surgical services.

    Response: The ASA and the AANA have requested that we apply the RUC's analysis of the 19 codes to all anesthesia codes. They believe that the weighted average increase in anesthesia work values that results from the RUC's analysis is representative of work values for all other anesthesia codes.

    For some codes, the RUC seemed confident that the anesthesia work value of the surveyed code was similar to the anesthesia work values for all of the other surgical services assigned to the given anesthesia code. However, for almost half of the surveyed codes, the RUC did not have confidence that the work values of the surveyed code could be applied to any other anesthesia services that would be reported under that anesthesia code.

    Due to the uncertainty of the RUC with regard to extrapolation, even within the family of surgical procedures assigned to a single anesthesia code, we have weighted each of the 19 anesthesia codes only by the anesthesia allowed charges associated with the single surveyed surgical procedure. Using this methodology, anesthesia for the surveyed surgical codes account for approximately 23 percent of all anesthesia allowed charges. This results in an increase in anesthesia work for the 19 codes of 9.13 percent. However, because we will apply a payment increase only to these codes, we are increasing the physician work portion of the anesthesia conversion factor by 2.10 percent which reflects a 9.13 percent increase in payment applied to the 23 percent of total anesthesia charges represented by the 19 codes. We provide more detail on how this increase is applied to the anesthesia conversion factor in the section VIII of this final rule.

    Final Decision

    We are increasing the physician work component of the anesthesia conversion factor by 2.10 percent to reflect a 9.13 percent increase in payment applied to 23 percent of anesthesia allowed charges. This as an interim adjustment that is subject to comment.

    2. Add-On Anesthesia Codes

    Payment for anesthesia services is based on the sum of an anesthesia code-specific base unit value plus anesthesia time units multiplied by an anesthesia CF. Under our current policy at § 414.46(g), if the physician is involved in multiple anesthesia services for the same patient during the same operative session, payment is based on the base unit assigned to the anesthesia service having the highest base unit value and anesthesia time that encompasses the multiple services.

    Claims processing manuals instruct the carrier on the method for handling anesthesia associated with multiple or bilateral surgical procedures. Under the Medicare Carrier Manual (MCM) 4830 D, the physician reports the anesthesia procedure with the highest base unit value with the multiple procedures modifier-51 and total time of anesthesia for all surgical procedures. Thus, the carrier is recognizing payment for one anesthesia code.

    In CYs 2001 and 2002, the CPT included new add-on anesthesia codes. The objective is that the add-on code would be billed with a primary code, each code having base units. We believe that anesthesia add-on codes should be priced differently from other multiple anesthesia codes. We proposed to revise the regulations at § 414.46(g) to include an exception to the usual multiple anesthesia services policy for add-on codes.

    Comment: The ASA, AANA and the AMA expressed support for our adopting a payment policy for add-on anesthesia codes. The ASA asked that we clarify the policy for recognition of base or time units or both for add-on anesthesia codes.

    Response: Of the 259 anesthesia codes, there are two codes, called primary codes that may have add on codes, under certain circumstances. These are:

    Primary code: CPT code 01967

    Add-on code: CPT code 01968 or 01969

    Primary code: CPT code 01952

    Add-on code: CPT code 01953

    Based on comments received, we understand that the ASA is seeking to bill only the base unit of the add-on code (01953) when it is billed with the primary code 01952. The time of the add-on code is to be included in the time of the primary code. Thus, all anesthesia time is attributable to the primary code.

    The ASA is seeking to bill both the base and time of the add-on code, 01968 or 01969, when either is billed with the primary code 01967. Thus, the anesthesia provider would report the base and time units of both the primary and the add-on code.

    We recognize that the general policy for add-on codes is that the carrier should allow only the base unit of the add-on code. As with multiple anesthesia services, the anesthesia time of the add-on code would be reported with the time of the primary code. In other words, anesthesia time is reported for all the underlying surgical services.

    However, in discussions with the ASA, we have learned that many third party payors have more restrictive time units policies for obstetrical anesthesia codes than for other anesthesia codes. If the time of the add-on code, such as 01968 or 01969, were reported with the primary code, the time units of the add-on code might be undervalued. To prevent this result, we are requiring that (for the two obstetrical anesthesia add-on codes) the anesthesia time be separately reported with each of the primary and the add-on code based on the amount of time appropriately associated with either code.

    Further, we think the policy on multiple procedure codes as well as add-on codes is an operational policy and should be addressed only in program operating instructions. As a result, we are revising the regulation text at § 414.46(g) accordingly.

    Final Decision

    We are allowing the carriers to recognize the base unit of the add-on codes. However, for the obstetrical add-on codes, the carrier may recognize both the base unit and the anesthesia time associated with the add-on code.

    C. Pricing of Technical Components (TC) for Positron Emission Tomography (PET) Scans

    Currently, all components of HCPCS code G0125, Lung image PET scan, are Start Printed Page 79987nationally priced. However, the TC and the global value for all other PET scans are carrier-priced. To keep pricing consistent with other PET scans, we proposed to have carriers price the TC and global values of HCPCS code G0125.

    Comment: We received comments from one specialty organization in support of carrier pricing. We received comments from another specialty organization and a few providers stating that they were concerned that, contrary to our stated purpose, this change would lead to inconsistent payment by carriers. The commenters believe that some carriers use the nationally-established TC RVUs for G0125 as a reference for payment for the other PET scans.

    Response: While we understand the commenter's concerns, we believe the RVUs assigned before CY 2003 for the TC of G0125 do not accurately reflect the resources used for furnishing this service, which is why we proposed carrier pricing. Thus, using G0125 as a reference code for pricing could lead to inappropriate pricing for all services. We believe that adopting carrier-pricing, instead of a national fee schedule amount, for the TC of G0125 will result in more appropriate pricing for the TC of all PET scans. Carriers have a variety of methods that they use to establish payment for codes. We believe using some of these alternative methods will lead to more accurate pricing for this service.

    Final Decision

    We will finalize our proposal to allow carriers to price the TC and global values of code G0125.

    D. Enrollment of Physical and Occupational Therapists as Therapists in Private Practice

    In the November 2, 1998 final rule (63 FR 58814), we defined private practice for physical therapists (PTs) or occupational therapists (OTs) to include a therapist whose practice is in an—

    • Unincorporated solo practice;
    • Unincorporated partnership; or
    • Unincorporated group practice.

    The term “private practice” also includes an individual who is furnishing therapy services as an employee of one of the above, a professional corporation, or other incorporated therapy practice. Some carriers and fiscal intermediaries have interpreted the regulation to mean that OTs and PTs employed by physicians cannot be enrolled as therapists in private practice. In these carrier areas, therapy services provided in a physician's office must instead be billed as incident to a physician's service.

    A specialty society representing OTs has requested that carriers be able to enroll OTs in physician-directed groups as OTs in private practice. A group representing PTs believes that provider numbers should be issued only to PTs working as employees in practices owned and operated by therapists.

    We proposed to clarify national policy and revise §§ 410.59 and 410.60 to state we would allow enrollment of therapists as PTs or OTs in private practice when employed by physician groups. We believe that this reflects actual practice patterns, will permit more flexible employment opportunities for therapists and will also increase beneficiaries' access to therapy services, particularly in rural areas.

    Comments: We received many comments from associations, specialty groups, therapists, and the public that strongly support the proposed clarification that would allow carriers and fiscal intermediaries to enroll therapists as PTs or OTs in private practice when they are employed by physician groups. However, one association urged us to confirm that this policy extends to therapists employed by a non-professional corporation.

    Response: We agree and will change the regulation to reflect that carriers and fiscal intermediaries can enroll therapists as PTs or OTs in private practice when the therapist is employed by physician groups or groups that are not professional corporations, if allowed by State law.

    Comments: Several commenters suggested that we state clearly that carriers and fiscal intermediaries are required to enroll physician-employed therapists, who are otherwise qualified, and that carriers and fiscal intermediaries may not refuse to enroll therapists simply on the basis of employment. They requested that the regulation state specifically that Medicare contractors must enroll therapists as PTs or OTs in private practice when they are employed or under contractual relationships with physician groups or groups that are not professional corporations.

    Response: We agree and will change the Medicare Carriers and Fiscal Intermediaries Manuals' to reflect that carriers and fiscal intermediaries “will” enroll Medicare therapists as PTs or OTs in private practice for purposes of Medicare when the therapists are employed by physician groups or groups that are not professional corporations. However, we do not believe that we need to specify further employee-employer relationships, which are detailed in the Medicare Carriers Manual, Part 3, Chapter III.

    Comment: One commenter believed that we should not enroll PTs who are employees of physicians' offices as PTs or OTs in private practice but, instead, should establish a separate section of the regulations that would govern the issuance of provider numbers to PTs who are employees in physicians' offices, and give these therapists a different designation. The commenter suggested we also include protections that currently exist when a non-physician practitioner provides services in a physician's office and the physician bills for these services under the physician's Medicare provider number.

    Response: We disagree with this comment. We have established procedures for issuing provider numbers that we believe are adequate. The proposed changes to the regulations reflect actual practice patterns, will permit more flexible employment opportunities for all therapists, and also increase beneficiary access to therapy services, particularly in rural areas. Therapists still have the flexibility of providing outpatient therapy services incident to a physicians service if they so choose. However, the services must meet the incident to requirements at § 410.26.

    Final Decision

    We will finalize our proposal to revise §§ 410.59 and 410.60 with the modifications noted above.

    E. Clinical Social Worker Services

    In the June 28, 2002 proposed rule, (67 FR 43846), we indicated we would be addressing comments received on the October 19, 2000 proposed rule entitled, “Clinical Social Worker Services,” (65 FR 62681), in this final rule. Upon further review, we have determined that we will not include this issue in this final rule, but will address it in future rulemaking.

    F. Medicare Qualifications For Clinical Nurse Specialists

    Currently, the qualifications for a clinical nurse specialist (CNS) include a requirement that a CNS must be certified by the American Nurses Credentialing Center (ANCC). We proposed to revise this particular requirement under the CNS qualifications because of concerns expressed that the ANCC does not provide certification for CNSs who specialize in fields such as oncology, critical care, and rehabilitation. Additionally, we noted that the proposed revision of the certification requirement for CNSs is consistent with Start Printed Page 79988the certification requirement under the nurse practitioner (NP) qualifications. Accordingly, we proposed specifically to revise section § 410.76(b)(3) to read as follows:

    “Be certified as a clinical nurse specialist by a national certifying body that has established standards for clinical nurse specialists and that is approved by the Secretary.”

    Comments and Responses

    We received comments on the proposed revision to the CNS certification requirement from professional nursing societies, a specialty nursing certification corporation, a college of radiology, a major nurses association, a provider of health care and elder care and, several independent clinical nurse specialists.

    Comment: We received comments indicating that the current CNS certification requirement poses a serious threat to ensuring Medicare beneficiary access to quality care because it restricts CNSs who are not certified by the ANCC from qualifying for Medicare payment. The ANCC does not certify CNSs in oncology, rehabilitation, acute care or critical care. Since the current CNS certification requirement inherently precludes CNSs who are certified in oncology from Medicare payment, the number of nurses available to care for Medicare beneficiaries with cancer is limited. The proposed change to the CNS qualifications is more inclusive, and it will enable the 415 oncology CNSs who hold Advanced Oncology Nursing Certification (AOCN) provided by the Oncology Nursing Certification Corporation (ONCC) to meet the certification criteria for CNSs and therefore, qualify for Medicare payment. An independent CNS stated that as a palliative care CNS, her institution required advanced certification that is not offered by the ANCC in many specialty areas of practice. However, the American Board of Nursing Specialties is the credentialing board for the ONCC, which is the only national certification that an advanced practice nurse can obtain specific to his or her field of expertise. All of the commenters support the proposed revision to the CNS certification requirement because they stated that overall, the certification criteria for CNSs will be consistent with the certification criteria for NPs and the requirement will ensure that Medicare beneficiaries receive services from advanced practice nurses who are certified by a national certifying body.

    Response: It has not been our intention to be overly restrictive in our program requirements and consequently prevent qualified CNSs who specialize in areas of medicine other than those certified by the ANCC from participating under the Medicare program's CNS benefit and rendering care to patients in need of specialized services. The intent of the revised CNS certification requirement is to recognize all appropriate national certifying bodies for CNSs as the program does for NPs.

    Result of Evaluation of Comments

    We are implementing the proposed revision to the CNS certification requirement under the CNS qualifications at § 410.76.

    G. Process To Add or Delete Services to the Definition of Telehealth

    In the June 2002 proposed rule (67 FR 43862), we proposed to establish a process for adding or deleting services from the list of telehealth services, and to add specific services to the list of telehealth services for CY 2003.

    We stated that we would accept proposals from any interested individuals or organizations from either the public or the private sectors, for example, from medical specialty societies, individual physicians or practitioners, hospitals, and State or Federal agencies. We also mentioned that we might internally generate proposals for additions or deletions of services.

    We stated that we would post instructions on our website outlining the steps necessary to submit a proposal. Please see the June 2002 proposed rule for the items that were to be addressed, the assignment of categories, and the outcomes.

    We proposed to remove a service from the telehealth list of services if, upon review of the available evidence, we determine that a telehealth service is not safe, effective, or medically beneficial when performed as a telehealth service.

    We proposed to make additions or deletions to the list of telehealth services effective on a CY basis. We proposed to use the annual physician fee schedule proposed rule published in the summer and the final rule published by November 1 each year as the vehicle for making these changes. Requests must be received no later than December 31 of each CY to be considered for the next proposed rule.

    Based upon further review of the comments submitted in response to the proposed rule for CY 2002, we believe that the psychiatric diagnostic interview is similar to the telehealth services listed in the statute. Specifically, we believe this service would meet the criteria set forth in Category 1 of the proposed process for adding services. Therefore, we proposed to add psychiatric diagnostic interview examination as represented by CPT code 90801 to the list of telehealth services and proposed to revise §§ 410.78 and 414.65 to reflect the proposed addition to the list of telehealth services.

    Comment: We received many comments expressing support for our proposed process for adding and deleting telehealth services. The commenters indicated that our proposed criteria for reviewing submitted requests are reasonable and provide a viable mechanism for adding existing services to the list of telehealth services. However, as part of our review, one specialty college suggested that the CPT editorial panel be an integral part of our process. The commenter stressed that reviewing codes and determining how these services can be furnished is the CPT editorial panel's area of expertise. With regard to deletion of services, one association urged us to consult with the appropriate medical society members to obtain clinical evidence based on peer-reviewed information and medical journal articles before deleting services from the list of telehealth services.

    Response: Section 1834(m) of the Act requires us to develop a process specifically for adding or deleting telehealth services on an annual basis. The mandate for this statutory provision is separate and distinct from the role of the AMA CPT editorial panels in developing new codes and/or defining services for the CPT compendia. It would not be appropriate to make the CPT editorial panel an integral part of the process to add or delete services from the list of telehealth services. We will review submitted requests for addition and deletion based on the criteria discussed in this final rule and welcome input from medical professionals with expertise in the service being reviewed as part of the rulemaking process.

    We are clarifying from the proposed rule that a decision to remove a service from the list of telehealth services would be made using evidence-based, peer-reviewed data which indicate that a specific telehealth service is not safe, effective, or medically beneficial. Such determination would not be made under section 1862(a)(1)(A) of the Act. Therefore, a decision to delete a service under this process would only apply to the list of Medicare telehealth services.

    Comment: One commenter suggested that we publish a summary of any requests that are rejected.

    Response: As stated in the proposed rule, we will use the annual physician fee schedule as a vehicle to make changes to the list of telehealth services. Start Printed Page 79989As part of the rulemaking process, we will publish a summary in the proposed rule of the requests that we receive with an explanation as to why a service is added, deleted, or a request is rejected.

    Comment: One commenter requested that, if possible, we look for ways to shorten the time frame between the submittal of a request and the actual implementation. The commenter stated that actual implementation of an additional telehealth service could take a year or more from the date of the request.

    Response: The statute requires us to establish a process that provides for the addition or deletion of telehealth services on an annual basis. We understand that in some cases our review and subsequent implementation of a decision to accept a request may take up to and possibly more than a full year. However, we believe that using the annual physician fee schedule rulemaking schedule would be the most efficient and time sensitive mechanism for publishing changes to the list of telehealth services.

    A national coverage determination (NCD) is a possible alternative to the rulemaking process for adding or deleting telehealth services. In formulating the proposed process to add services to the list of telehealth services, we considered using the NCD process. For instance, under this option, all requests for addition, whether the request is considered an existing or new service, would be required to complete the requirements for an NCD. We rejected this option because we believe that many telehealth applications are existing services provided through a different delivery mechanism. We believe that subjecting all requests for addition to the evidence-based requirements of an NCD would be unnecessary, and would be contrary to the public interest.

    Comment: A large number of commenters applauded the addition of the psychiatric diagnostic interview examination to the list of telehealth services. Commenters generally agreed that the psychiatric diagnostic interview includes components that are comparable to an initial office visit or consultation, which are currently telehealth services.

    Response: We agree with the comment.

    Comment: We received two comments regarding general telehealth policy. One commenter urged us to expand the definition of an originating site. For example, the commenter believes that hospitals with inadequate physician ratios relative to the treatment of acute ischemic stroke patients should be considered as an originating site, regardless of geographic location or whether the hospital is located in a designated health professional shortage area. The other comment pertained to the physician or practitioner who provides the telehealth service at the distant site. In this regard, one association encouraged us to support the addition of speech language pathologists and audiologists to the list of practitioners that may provide and receive payment for telehealth services.

    Response: The statute permits hospitals to serve as originating sites for any Medicare telehealth service as long as the hospital is located in a rural HPSA or in a non-MSA county. Thus, the commenter would be able to serve as an originating site for the treatment of acute ischemic stroke patients if the hospital is located in these geographic areas. The statute is explicit regarding the types of practitioners who can provide and receive payment for telehealth services. Speech language pathologists and audiologists are not included within the list of medical professionals that may provide and or receive payment for telehealth services at the distant site. We are reviewing these issues as part of a report to the Congress as required by the BIPA.

    Result of Evaluation of Comments

    We are adopting the process to add or delete telehealth services and adding the psychiatric diagnostic interview examination to the list of telehealth services as stated in the proposed rule. Additionally, we are referencing the process to add or delete services at new § 410.78(f).

    H. Definition for ZZZ Global Periods

    Services with ZZZ global periods are add-on services that can be billed only with another service. Before CY 2003, we paid only the incremental intraservice work and practice expense RVUs associated with the add-on service for a code with a global indicator of ZZZ. Any pre-service or post-service work associated with a service with a global indicator of ZZZ is considered accounted for in the base procedure with which these add-on services must be billed. However, based on comments from the RUC and specialty societies that some add-on services contain separately identifiable post-service work and practice expense RVUs, we proposed to revise the current definition of a ZZZ global period as follows:

    “ZZZ = Code related to another service and is always included in the global period of the other service (Note: Physician work is associated with intra-service time and in some instances the post-service time).”

    Comments: The commenters supported this change. However, several specialty organizations, as well as the RUC, stated that there are instances when pre-service time should be considered, and they recommended that we amend the definition to include pre- and post-service time.

    Response: We agree with the commenters and will revise the definition to consider pre-service time as well post-service time. However, when a code with a ZZZ global indicator is considered by the RUC or PEAC, we will require that all base codes with which the ZZZ codes are billed are also considered by the RUC and PEAC to assure that both physician work and practice expense RVUs are appropriate for the base and add-on codes and to assure that no duplicate payment is made.

    Result of Evaluation of Comments

    The definition of a ZZZ global period will be revised as follows:

    “ZZZ = Code related to another service and is always included in the global period of the other service (Note: Physician work is associated with intra-service time and in some instances the pre- and post-service time).”

    I. Change in Global Period for CPT Code 77789 (Surface Application of Radiation Source)

    Based on a suggestion from the RUC, we proposed to change the global period for CPT code 77789 (surface application of radiation source) from a 90-day global period to a 000-day global period. We stated that we did not need to adjust the current work values or the practice expense inputs for supplies and equipment, but we would adjust the clinical staff practice expense inputs to reflect that there is no post-procedure visit.

    Comment: The commenters supported this change and noted that the PEAC attributed clinical times for this CPT code of 34 minutes for the registered nurse and 6 minutes for the physicist. The commenters did not believe the practice expense RVUs should change significantly, if at all, as a result of this adjustment in the global period.

    Response: We had not received the PEAC recommendations at the time the proposed rule was written, and we proposed a change to the original CPEP inputs that included time for a post-procedure visit. We have reviewed and accepted the above PEAC recommended clinical staff times. Start Printed Page 79990

    Result of Evaluation of Comments

    We are changing the global period for CPT code 77789 (surface application of radiation source) from a 90-day global period to a 000-day global period as proposed.

    J. Technical Change for § 410.61(d)(1)(iii) Outpatient Rehabilitation Services

    Based on comments received that § 410.61(d)(1)(iii) incorrectly references “physical” therapy when it should reference “occupational” therapy, we proposed to revise § 410.61(d)(1)(iii) to correct this error.

    Final Decision

    No comments were received on this proposed technical correction. We will correct § 410.61(d)(1)(iii) by replacing the word “physical” with “occupational” as proposed.

    K. HCPCS G-Codes From June 28, 2002 Proposed Rule

    In the June 28, 2002 rule we proposed the following new HCPCS G codes.

    1. Codes for Treatment of Peripheral Neuropathy

    Effective for services furnished on or after July 1, 2002, Medicare will cover an evaluation (examination and treatment) of the feet every six months for individuals with a documented diagnosis. This policy is a national coverage determination.

    G0245: Initial physician evaluation of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) which must include the procedure used to diagnose LOPS; a patient history; and a physical examination that consists of at least the following elements

    (a) Visual inspection of the forefoot, hindfoot and toe-web spaces;

    (b) Evaluation of protective sensation;

    (c) Evaluation of foot structure and biomechanics;

    (d) Evaluation of vascular status and skin integrity;

    (e) Evaluation and recommendation of footwear; and

    (f) Patient education.

    We proposed to crosswalk work and malpractice RVUs and the practice expense inputs from CPT code 99202, a level two, new patient office visit code. We proposed to revalue the practice expense RVUs using the practice expense methodology once we have utilization data for these codes.

    G0246: Follow-up evaluation of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include at least the following, a patient history and physical examination that includes—

    (a) Visual inspection of the forefoot, hindfoot and toe-web spaces;

    (b) Evaluation of protective sensation;

    (c) Evaluation of foot structure and biomechanics;

    (d) Evaluation of vascular status and skin integrity;

    (e) Evaluation and recommendation of footwear; and

    (f) Patient education.

    We proposed to crosswalk the work and malpractice RVUs from CPT code 99212, a level two, established-patient office visit code. We also proposed to crosswalk the practice expense inputs from CPT code 99212 and to revalue the practice expense RVUs using the practice expense methodology once we have utilization data for these codes.

    G0247: Routine foot care of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (LOPS) to include if present, at least the following

    (a) Local care of superficial wounds;

    (b) Debridement of corns and calluses; and

    (c) Trimming and debridement of nails.

    We proposed to crosswalk the work and malpractice RVUs and the practice expense inputs from CPT code 11040, Debridement; skin; partial thickness. We would revalue the practice expense RVUs using the practice expense methodology once we have utilization data for this code.

    Comment: The American Podiatric Medical Association (APMA) believes that the RVUs assigned to HCPCS codes G0245 and G0246 are too low. They do not believe that the assigned RVUs account for the physician work and practice expense required to perform those services. They recommended that we crosswalk the RVUs from CPT codes 99203 and 99213 to these codes instead of the crosswalk we actually used, from CPT codes 99202 and 99212. They also commented that the RVUs assigned for G0247 were too low and should be increased as the assigned RVUs did not account for the required physician work. Alternatively, they recommended that we delete G0247 and allow a physician to report CPT codes that described similar services. A large medical clinic commented that they were not sure why CMS had implemented these codes. They believe that if the only reason for creating codes was to permit us to track the services, this reason is insufficient because the codes cause significant administrative burden to physician practices. They believe that providers could use other CPT codes to report these services instead of the G codes. A carrier medical director familiar with these services commented that G0247 is overvalued because the most common service provided using this code will be toe nail trimming and debridement and that the CPT code for toe nail trimming and debridement is valued much lower then G0247.

    Response: These G codes were created to implement a national coverage determination (NCD). The coverage determination was very specific with regard to the required components of each service. Furthermore, the NCD specifically allowed these services to be performed no more than every six months and allowed the initial visit to be performed only once per physician for the lifetime of a beneficiary. Creation of these G codes allows us to implement the coverage decision, especially with regard to the required frequency limitation and to track the utilization of these services while minimizing provider burden. Reporting these services with CPT evaluation and management (E/M) codes and procedure codes would have resulted in numerous post-pay audits while creation of a modifier to be used in conjunction with such CPT codes would have been quite burdensome and resulted in just as many post pay audits. Therefore, we plan to continue requiring these G codes for reporting of these services.

    With regard to the valuation of these services we will finalize the proposed RVUs. This service is provided to those diabetic beneficiaries who are “at risk” for foot-care problems but who do not have an injury or illness of the foot. Any service provided to a diabetic beneficiary with an illness or injury to the foot (for example, foot pain, foot ulcer, foot infection) should be reported using the appropriate CPT codes (for example, E/M service, debridement service). Furthermore, the requirements for provision of care to LOPS patients are clearly set forth in the NCD. Nothing beyond those requirements need be performed in order to report a LOPS HCPCS code. Careful scrutiny of the requirements for provision of initial LOPS services shows that they are most similar to the requirements of a level 2 E/M service. The lack of illness, injury, or deformity in these patients and the requirements that the practitioners need only to take a history and to examine the foot are quite similar to the requirements of CPT code 99202: an expanded problem focused history, an expanded problem focused examination, and straightforward medical decision making. For follow-up patients who do not have an illness, injury, or deformity, the requirements of Start Printed Page 79991the NCD are quite similar to the requirements of CPT code 99212: a problem focused history, a problem focused examination, and straightforward medical decision making. With regard to G0247, we agree with the carrier medical director who stated that the most commonly performed procedure would be toenail trimming and or debridement. However, review of the work RVUs for CPT codes 11719 (0.17), 11720 (0.32), 11721 (0.54), 11055 (0.43), 11056 (0.61), 11057 (0.79), and 11040 (0.50) shows that we have properly valued this service. We believe that a work value of 0.50 RVUs appropriately accounts for what is likely to be the typical combination of services provided to eligible beneficiaries.

    Result of Evaluation of Comments

    We will continue requiring these G codes for reporting of these services and are finalizing the RVUs as proposed.

    2. Current Perception Sensory Nerve Conduction Threshold Test (SNCT)

    G0255: Current Perception Threshold/Sensory Nerve Conduction Test, (SNCT) per limb, any nerve

    We proposed a G-code that represents SNCT as a diagnostic test used to diagnose sensory neuropathies. This test is noninvasive and uses a transcutaeous electrical stimulus to evoke a sensation. However, we determined that there is insufficient scientific or clinical evidence to consider the use of this device as reasonable and necessary within the meaning of section 1862(a)(1)(A) of the Act and indicated Medicare will not pay for this type of test.

    Comment: One commenter requested that the descriptor for this code be revised, as the current descriptor “Current Perception Threshold/Sensory Nerve Conduction Test” is very similar to other codes for example, the short descriptor for CPT code 95904 is “Sense Nerve Conduction Test”. The commenter recommended changing the descriptor for this G code to “Current Perception Threshold Test”.

    Response: We appreciate the commenters bringing this to our attention and have revised the short descriptor for this G code to address the concern they raised. The short descriptor for this G code will be “Current perception threshold test”.

    Result of Evaluation of Comments: We will finalize our proposal for G0255 but will revise the short descriptor as discussed above.

    3. Positron Emission Tomography (PET) Codes for Breast Imaging

    Medicare has expanded the coverage indications for PET scanning to include imaging for breast cancer, and we have created codes that describe staging and restaging after or prior to the course of treatment of breast cancer. We also created a PET scan code to evaluate the response to treatment of breast cancer.

    PET imaging for initial diagnosis of breast cancer and/or surgical planning for breast cancer are described by a CPT code, but Medicare will not cover the procedure for this diagnosis.

    G0252: PET imaging for initial diagnosis of breast cancer and /or surgical planning for breast cancer (for example, initial staging of axillary lymph nodes), not covered by Medicare.

    We stated that this code is not covered by Medicare because there is a national non-coverage determination for the use of PET imagery for the initial diagnosis of breast cancer and initial staging of axillary lymph nodes.

    G0253: PET imaging for breast cancer, full and partial-ring PET scanners only, staging/restaging after or prior to course of treatment.

    G0254: PET imaging for breast cancer, full and partial-ring PET scanners only, evaluation of response to treatment, performed during course of treatment.

    We proposed that the TC and global for both of these codes be carrier-priced. For the PC for codes G0253 and G0254, we proposed to make the PC work RVU equal to 1.87 and use practice expense RVUs of 0.58 and malpractice RVUs of 0.07 since there are no direct inputs for PC services.

    Comments: Commenters expressed appreciation for creation of these G codes; however, one commenter was concerned that the TC and global component of these codes will be carrier-priced which, the commenter contended, could lead to widely varying and unjustifiably low payment rates, particularly if there is no national benchmark.

    Response: Carriers use a variety of methods and resources when developing payment rates for services that they are responsible for pricing. We do not believe that having the carriers price these codes will lead to unjustifiably low payment rates.

    Result of Evaluation of Comments: We are adopting the proposals for these G codes; however, we have made editorial revisions to the descriptors for G0252 and G0253 to more accurately describe the service provided. The revised descriptors are as follows:

    G0252: PET imaging, full and partial-ring PET scanners only, for initial diagnosis of breast cancer and /or surgical planning for breast cancer (for example, initial staging of axillary lymph nodes).

    G0253: PET imaging for breast cancer, full and partial-ring PET scanners only, staging/restaging of local regional recurrence or distant metastases (that is, staging/restaging after or prior to course of treatment).

    4. Home Prothrombin Time International Normalized Ratio (INR) Monitoring for Anticoagulation Management

    For services furnished on or after July 1, 2002, Medicare will cover the use of home prothrombin time or INR monitoring in a patient's home for anticoagulation management for patients with mechanical heart valves. A physician must prescribe the testing. The patient must have been anticoagulated for at least three months prior to use of the home INR device, and the patient must undergo an education program. The testing with the device is limited to a frequency of once per week.

    G0248: Demonstration, at initial use, of home INR monitoring for a patient with mechanical heart valve(s) who meets Medicare coverage criteria, under the direction of a physician; includes: demonstration use and care of the INR monitor, obtaining at least one blood sample provision of instructions for reporting home INR test results and documentation of a patient's ability to perform testing.

    We proposed that this code be assigned no work RVUs and .01 malpractice RVUs. For the practice expense inputs, we proposed 75 minutes of RN/LPN/MTA staff time; a supply list including four test strips, lancets and alcohol pads, a patient education booklet, and batteries for the monitor; and equipment consisting of a home INR monitor. These proposed inputs result in an estimated practice expense RVU of 2.92.

    G0249: Provision of test materials and equipment for home INR monitoring to patient with mechanical heart valve(s) who meets Medicare coverage criteria. Includes provision of materials for use in the home and reporting of test results to physician; per 4 tests.

    We proposed this code be assigned no work RVUs and .01 malpractice RVUs. For the practice expense inputs, we proposed 13 minutes of RN/LPN/MTA staff time; a supply list including four test strips, lancets and alcohol pads, and equipment consisting of a home INR monitor. These resulted in an estimated practice expense RVU of 2.08.

    G0250: Physician review/interpretation and patient management of home INR test for a patient with mechanical heart valve(s) who meets other coverage criteria; per 4 tests (does not require face-to face service) Start Printed Page 79992

    We proposed this code be assigned 0.18 work RVUs and .01 malpractice RVUs. We stated that there would be no direct practice expense inputs for this code, and the use of the practice expense methodology to develop the indirect practice expense of the physician performing this service resulted in an estimated practice expense RVU of 0.07. Note: Subsequent to the publication of the proposed rule, we updated the payment rates for home PT/INR monitoring via Program Memorandum AB-02-112 (July 31, 2002). Based on a correction in the practice expense methodology used to calculate the practice expense RVUs issued in the Program Memorandum AB-02-064 on May 2, 2002 and included in the June 28, 2002 proposed rule there was an increase in practice expense RVUS for G0248 to 3.06 and to 3.28 for G0249 effective for services performed after October 1, 2002.

    Comment: A manufacturer of equipment used to perform INR monitoring at home was concerned that the proposed RVUs for the HCPCS codes used to report Home INR monitoring services were inconsistent with the RVUs published in Program Memorandum AB-02-112 issued on July 31, 2002. (This program memorandum was issued to correct an error that had resulted in the original RVUs for these codes being too low.) The commenter also requested that we clarify the descriptor for the HCPCS code used to report provision of Home INR materials to assure that Medicare only paid for properly controlled INR tests that were consistent with FDA labeling.

    Response: The aforementioned program memorandum was issued after the Proposed Rule (NPRM) was published. We agree with the commenter that the physician fee schedule for 2003 should reflect the RVUs as published in the July 31, 2002 program memorandum and will make this change.

    With regard to changing the descriptors for the HCPCS code used to report provision of home INR test materials, we will review this issue and, if appropriate, clarify the descriptor as requested for CY 2004.

    Comment: Several commenters asked CMS to expand the covered indications for home INR monitoring.

    Response: We direct these commenters to the published process for requesting a national coverage determination. In order for the covered indications to be expanded on a national level this process must be followed.

    Comment: A manufacturer of equipment used for home INR monitoring pointed out that there were several companies who manufacture test strips. Producing a test result may require one or three test strips depending on the manufacturer. Additionally, the cost of test strips from each manufacturer is different and Medicare based its payment on the cost of a test strip from only one manufacturer.

    Response: We agree that there are several types of test strips available. However, we also understand that not all manufacturers are currently providing new home INR monitoring equipment and that the market share for each product is in flux. We will review the appropriate payment for this service, including the appropriate amount to include for test strips, after we have sufficient experience paying for this service. The earliest time that we could consider proposing a change in payment rate would be for the 2005 physician fee schedule; at that time, we would have 18 months worth of payment data upon which we could base a proposal.

    Result of Evaluation of Comments

    As indicated above, payment for CY 2003 for these services will reflect the corrections made in the Program Memorandum AB-02-112 issued on July 31, 2002.

    5. Bone Marrow Aspiration and Biopsy on the Same Date of Service

    We proposed a new G code (GXXXX) that reflects a bone marrow biopsy and aspiration procedure that is performed on the same date, at the same encounter, through the same incision, based on our understanding that the typical case involves an aspiration and biopsy through the same incision.

    We proposed physician work RVUs of 1.56 and malpractice RVUs of 0.04. We also proposed to crosswalk the practice expense inputs from CPT code 38220, Bone marrow aspiration, with the assignment of an additional five minutes of clinical staff time. These proposed inputs in the practice expense methodology resulted in an estimated practice expense RVU of 3.32 in the nonfacility setting and 0.60 in the facility setting.

    We also noted that if the two procedures, aspiration and biopsy, are performed at different sites (for example, contralateral illiac crests, sternum/illiac crest, two separate incisions on the same iliac crest or two patient encounters on the same date of service), the CPT codes for aspiration and biopsy would each be used along with the -59 modifier.

    Comment: Two commenters, one representing a provider and the other a specialty organization, agreed with the proposal to create a G code for bone marrow aspiration and biopsy on the same date of service. However, another specialty organization and the AMA did not agree with the creation of this new G code and felt its creation was unnecessary. These commenters indicated that CPT currently has sufficient and accurate coding for these services that is, CPT codes 38220 and 38221 which when performed through the same incision could both be reported with the modifier 51 (used in reporting of multiple procedures performed in the same incision) appended. In addition, the commenters stated that the descriptor for this code does not adequately describe the procedure for which it is intended as it does not specifically state “through the same incision.” This could lead to a denial of services of all bone marrow aspiration and biopsies performed on the same date of service.

    Response: After review of the comments, we agree that this code should go through the CPT process. Therefore, we are withdrawing our proposal to create this code. We will submit a code for “Bone Marrow Biopsy and Aspiration performed in the same bone” to CPT in time for the 2004 CPT cycle.

    Result of Evaluation of Comments

    We will not proceed with a separate G code for bone marrow biopsy and aspiration procedure that is performed on the same date, at the same encounter.

    Creation of G Codes

    Comment: Several commenters expressed concern about the increasing frequency of G codes being issued by us. Commenters believed that, in the interest of coding standardization, accuracy, and clarity, G codes should only be developed as a last resort and should be temporary. Commenters believed that an annual meeting with us to discuss codes that may be necessary to accommodate new payment and coverage policies would help reduce the number of G codes. Some commenters also asked for greater physician involvement in the HCPCS editorial process (for example, direct representation of the physician community on the panel).

    Response: We agree that, where appropriate, G codes should be temporary. Unfortunately, it is sometimes necessary to develop G codes to accommodate changes in legislation, regulation, coverage, and payment policy. The timetable for such changes Start Printed Page 79993is not necessarily consistent with the timetable for CPT publication and frequently these changes must be made on a quarterly basis.

    In 2002 CMS and CPT staff, working together, reviewed all existing G codes and agreed to transition over 20 of them to CPT codes. Therefore, for 2003 many G codes are being deleted in favor of newly created CPT codes. (See section IV for a discussion of deleted G codes). We believe that an annual review of G codes by CMS and CPT staff is the best way to determine which G codes should be transitioned to CPT codes and the process to use for such a transition. Therefore, we plan to continue working with CPT staff on an annual basis to continue transitioning existing G codes to CPT codes. We believe such an annual comprehensive review will address the commenters' concerns. However, we do wish to emphasize that we, when appropriate, does consult with interested providers prior to the creation of G codes in order to facilitate coding clarity and minimize physician burden.

    L. Endoscopic Base For Urology Codes

    Cystoscopy and treatment CPT codes 52234, 52235, and 52240 were inadvertently identified in the Medicare Physician Fee Schedule Database as services subject to the reductions for multiple procedures as opposed to the procedural reduction rules specific to endoscopic services. This has resulted in our overpaying for these services. We proposed applying the endoscopic reduction rules to these services and identified CPT code 52000 as the endoscopic base code for these services.

    Comment: The American Urological Association was in agreement with our proposal to apply the endoscopic reduction rules to CPT codes 52234, 52235, and 52240.

    Final Decision: The endoscopic reduction rules will be applied to these three codes as proposed.

    M. Physical Therapy and Occupational Therapy Caps

    Section 4541(c) of the Balanced Budget Act of 1997 required application of a payment limitation to all rehabilitation services provided on or after January 1, 1999. The limitation was an annual per beneficiary limit of $1500 on all outpatient physical therapy (PT) services (including speech-language pathology services). A separate $1500 limit was applied to all occupational therapy (OT) services. (The limitation amounts were to be increased to reflect medical inflation.) The annual limitation did not apply to services furnished directly or under arrangement by a hospital to an outpatient or to an inpatient who is not in a covered Part A stay.

    Section 221 of the Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106-113, enacted on November 29, 1999) placed a moratorium on the application of the payment limitation for two years from January 1, 2000 through December 31, 2001. Section 421 of the Medicare, Medicaid, and SCHIP Beneficiary Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-554, enacted on December 21, 2000), extended the moratorium on application of the limitation to claims for outpatient rehabilitation services with dates of service January 1, 2002 through December 31, 2002. As we explained in the June 28, 2002 proposed rule, outpatient rehabilitation claims for services rendered on or after January 1, 2003 will be subject to the payment limitation unless the Congress acts to extend the moratorium.

    Comments: We received comments from associations and societies urging us to support the permanent repeal of the $1500 financial limitation on PT, including speech language pathology, and a separate $1500 financial limitation on OT. All commenters stated that this financial limitation would adversely affect nursing home beneficiaries who receive Part B therapy services.

    Response: As stated before, we will implement the outpatient rehabilitation therapy financial limitation via a Program Memorandum to Carriers and Fiscal Intermediaries, unless the Congress acts to extend the moratorium or repeals the legislation.

    III. Other Issues

    A. Definition of a Screening Fecal-Occult Blood Test

    One commenter suggested that the current definition of a screening fecal-occult blood test at § 410.37(a)(2) that limits coverage to guaiac-based tests should be expanded to permit coverage of another test. The commenter suggested that this change be made in the final rule because the June 2002 proposed rule added a variety of new HCPCS G codes similar to the G code for which the commenter has requested for its new fecal-occult blood test.

    Based on our analysis of the preliminary information we have on the new test, we believe that it may have the potential for effective screening for colorectal cancer, and thus, we have agreed with the commenter to broaden the definition in § 410.37(a)(2) to permit coverage of non-guaiac based tests. However, in order to establish national coverage of the new test under the Medicare colorectal cancer screening benefit we must first compare the clinical utility of the test to the existing guaiac-based test. If, for instance, the test is not as effective as the currently covered test, it would not make sense to authorize coverage as permitted by section 1861(pp)(1)(D) of the Act.

    To facilitate our consideration of future coverage of other new types of fecal-occult blood tests, we have decided to amend § 410.37(a)(2) to provide that in addition to the guaiac-based screening test, other types of fecal-occult blood tests may be covered under the screening benefit, if we determine that this is appropriate through a national coverage determination (NCD). This change will allow us to conduct a more timely assessment of other new types of fecal-occult blood tests that may have been approved or cleared for marketing by the Food and Drug Administration (FDA) than is possible under the standard rulemaking process. We intend to use the NCD process, which includes an opportunity for public comments, for evaluating the medical and scientific issues relating to the coverage of additional tests that may be brought to our attention in the future. Use of an NCD to establish a change in the scope of benefits is authorized by section 1871(a)(2) of the Act.

    In accordance with section 1861(pp)(1)(D) of the Act, we have discretion to determine that additional tests or procedures are appropriate and can be used for the early detection of colorectal cancer. This authority is currently reflected in § 410.37(a)(1)(v). We are amending that section to announce that approval of any new tests or procedures for use in early detection of colorectal cancer will be made through an NCD. The use of an NCD, authorized by section 1871(a)(2) of the Act, will permit public participation. The NCD process, however will allow Medicare to expand coverage for additional tests or procedures when warranted more rapidly than the notice and comment procedures of the Administrative Procedure Act would normally permit.

    B. Clarification of Services and Supplies Incident to a Physician's Professional Services: Conditions

    In the November 2001 final rule (66 FR 55238) we revised regulations on services and supplies furnished incident to a physician's professional services. In the revised regulations at § 410.26(a)(7) we defined such services and supplies as “ * * * any services and supplies * * * that are included in section Start Printed Page 799941861(s)(2)(A) of the Act and are not specifically listed in the Act as a separate benefit included in the Medicare program.”

    We are clarifying that services having their own statutory benefit category are covered under that category rather than as incident to services. This means that they are subject to manual and other program operating instructions pertaining to their specific statutory benefit category. In addition, they are not required to meet incident to implementing instructions such as those in section 2050 of Part III of the Medicare Carriers Manual (MCM). For example, diagnostic tests are covered under section 1861(s)(3) of the Act and are subject to the requirements for diagnostic tests in MCM section 2070. Depending on the particular test, the supervision requirement in section 2070 may be more or less stringent than that in section 2050 for incident to services. When diagnostic tests are furnished, the requirements for diagnostic tests apply, and not those for incident to services. Likewise, pneumococcal, influenza, and hepatitis B vaccines are covered under section 1861(s)(10) of the Act and do not need to meet incident to requirements.

    While we believe our regulations are clear on this point, one of the comments and responses published in our November 2001 final rule has caused some confusion on this issue. The comment and response were as follows:

    Comment: “Many commenters wanted us to re-emphasize that incident to services set forth in section 1861(s)(2)(A) of the Act do not include Medicare benefits separately and independently listed in the Act, such as diagnostic services set forth in section 1861(s)(3). Some requested that we not permit these separately and independently listed services to be furnished as incident to services.”

    Response: “We realize, as did the Congress with the enactment of section 4541(b) of the BBA, that many services—even those that are separately and independently listed—can be furnished as incident to services. However, this fact of medical practice is not inconsistent with our policy. We maintain that a separately and independently listed service can be furnished as an incident to service but is not required to be furnished as an incident to service. Furthermore, even if a separately and independently listed services is provided as an incident to service, the specific requirements of that separately and independently listed service must be met. For instance, a diagnostic test under section 1861(s)(3) of the Act may be furnished as an incident to service. Nevertheless, it must also meet the requirements of the diagnostic test benefit set forth in § 410.32. Specifically, the test must be ordered by the treating practitioner, and it must be supervised by a physician. Thus, if a test requires a higher level of physician supervision than direct supervision, then that higher level of supervision must exist even if the test is furnished as an incident to service. Accordingly, we decline to prohibit a separately and independently listed service from being furnished as an incident to service. Instead, we reiterate that a separately and independently listed service need not meet the requirements of an incident to service.”

    The intent of the above response was to state that for a service having its own separately and independently listed statutory benefit category, Medicare carriers should apply the requirements of that separately listed benefit category and not also apply the incident to requirements. We interpret § 410.26(a)(7) literally. That is, incident to services and supplies covered under 1861(s)(2)(A) of the Act means services and supplies not having their own independent and separately listed statutory benefit category.

    Perhaps it could be argued that any service provided under the direct supervision of a physician could be considered an incident to service. However, the Congress specifically provided for the many separate benefit categories of medical and health services in the Act. We believe that the Congress intended for incident to services to be a catch-all category to allow payment for certain services and supplies commonly furnished in a physician's office and not having their own separate benefit category. The billing of services with their own separate and independent coverage benefit categories as incident to may circumvent the coverage and payment rules applicable to those other categories. Therefore, only services that do not have their own benefit category are appropriately billed as incident to a physician service. Examples of benefit categories are diagnostic X-ray tests (section 1861(s)(3) of the Act) and influenza vaccine and its administration (section 1861(s)(10)(A) of the Act).

    However, since section 4541(b) of the BBA allows certain services with their own benefit category (that is, outpatient physical therapy services (including speech-language pathology services) and outpatient occupational therapy) to also be provided as incident to services, we cannot prohibit physicians and practitioners from billing these services as incident to. However, when these services are billed incident to, requirements in Medicare Carriers Manual section 2050 must also be met. Note that the personal (in-the-room) supervision requirements for physical and occupational therapy assistants apply only to the private practice setting. The services of nurse practitioners, clinical nurse specialists and physician's assistants may be billed as incident to a physician's service if the incident to requirements are met, or those practitioners may bill their services separately under their own benefit.

    C. Five-Year Review of Gastroenterology Codes

    In the November 2001 final rule, (66 FR 55246), we finalized work RVUs for several gastrointestinal endoscopy codes that were reviewed by the RUC during the five-year review of physician work. However, we asked the RUC to review several families of gastrointestinal endoscopy codes to ensure that no rank order anomalies existed within those families. The procedures for gastrointestinal stent placement were among those families. Although we have not received further RUC recommendations for any gastrointestinal endoscopy codes, several specialty societies have submitted further information regarding the physician work required to perform gastrointestinal stent placement services. We have reviewed this information and are making several adjustments to the RVUs for these services. These adjustments are interim and we will respond to comments concerning these adjustments in next year's final rule.

    CPT code 43219 Esophagoscopy, rigid or flexible; with insertion of plastic tube or stent

    Based on the information we have reviewed (including physician intraservice time data), there is no compelling evidence that the physician work of this procedure is inappropriate. The work increment (1.21 work RVUs) beyond the base procedure CPT code 43200, Esophagoscopy, rigid or flexible; with or without collection of specimen(s) by brushing or washing (separate procedure) is appropriate. Therefore we are maintaining 2.8 work RVUs for CPT code 43219.

    CPT code 43256 Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic stent placement (includes predilation)

    This code currently has 4.60 work RVUs. We reviewed physician time data for this service and believe that it is overvalued compared to the value of Start Printed Page 79995other stent placement procedures. Therefore, to place it in the proper rank order to other stent placement codes, we are assigning it 4.35 work RVUs. This makes the incremental work (1.96 work RVUs) above the base procedure CPT code 43235, Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/ or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure), in line with other stent placement codes.

    CPT code 44383 Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation)

    This code currently has 3.26 work RVUs. We reviewed physician time data for this code and compared it to other stent placement codes. The incremental work value (2.21 work RVUs) above the base procedure CPT code 44380, Ileoscopy, through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure), is high. Therefore, we are reducing the work RVUs to 2.94. This gives it an incremental work value of 1.89 work RVUs which is similar to the incremental work value of CPT code 44397, Colonoscopy through stoma; with transendoscopic stent placement (includes predilation), and places it in the proper rank order with other stent placement codes.

    D. Critical Access Hospital Emergency Services Requirements

    Section 1820 of the Act provides for a nationwide Medicare Rural Hospital Flexibility Program (MRHF). The Act also provides that certain rural providers may be designated as critical access hospitals (CAHs) under the MRHF program if they meet qualifying criteria and the conditions for designation specified in the statute. Implementing regulations for section 1820 of the Act are located at 42 CFR part 485, subpart F.

    Section 1820(c)(2)(B) of the Act implements specific conditions of participation (CoPs) that a facility must meet to be designated a CAH. The statutory criteria for State designation as a CAH require, in part, that the facility makes available 24-hour emergency care services that a State determines are necessary for ensuring access to emergency care services in each area served by a CAH. To help protect the health and safety of Medicare patients who seek emergency medical care at a CAH, our regulations at § 485.618 require CAHs to provide emergency care necessary to meet the needs of its patients.

    In 2002, we received letters requesting a special waiver from the current emergency services personnel requirement (specified in § 485.618(d)) for CAHs in frontier areas and remote locations. The requests included the following comments; (1) A number of remote CAHs have been struggling to comply with the current CAH requirement; (2) the personnel requirement places a hardship on isolated frontier communities that have only one medical practitioner; and (3) often these remote facilities have a very low volume of patients which makes it difficult to recover all of their costs and to recruit other practitioners.

    As of September 2002, the Cecil G. Sheps Center for Health Services Research at Chapel Hill, North Carolina has identified approximately 173 CAHs that are located in frontier areas (identified as having six individuals per square mile). The average population for a frontier CAH community is 7,024. We have no empirical data to indicate which of these 173 CAHs are currently experiencing workforce issues that create a hardship for the facility or any sole provider. However, the University of Washington conducted a survey of CAHs in May 2001 and learned that, of the 388 CAHs that responded to the survey, 146 facilities are in an isolated small rural census tract. Of these facilities, 10 have no physicians, 24 have only 1 physician, 39 have 2 physicians, and 26 have 3 physicians. Of the CAHs with no doctors, 6 have only 1 mid-level provider (4 of these are in Montana), and 3 have 2 mid-level providers (1 apparently had no physician or mid-level provider at the time of the survey). Of the 39 CAHs that had 2 physicians, 3 had no mid-level providers, and 12 had only 1 mid-level provider.

    The Rural Health Research Center at the University of Washington, through its CAH National Tracking Project, reported that CAHs frequently cite problems with recruitment and retention of emergency medical personnel. Based on 2002 data, more than half of the designated CAHs are serving counties dually designated as both a Medically Underserved Area (MUA) and a Health Professional Shortage Area (HPSA). Less than 1 in 10 CAHs are located in counties without a HPSA or an MUA designation.

    The delicate balance of providing access to care in very rural and remote areas without jeopardizing quality of care continues to be challenging. We believe that if a small CAH is forced to close because of the lack of qualified personnel, adding RNs to the list of approved personnel would greatly help CAHs with nogreater than 10 beds, in frontier areas or remote locations to serve the emergency health care needs of residents of these areas. Often CAHs in frontier or remote areas are located 50 miles or farther from the nearest health care facility. We believe that allowing RNs, as needed on a temporary basis, to work in CAHs with no greater than 10 beds, with training or experience in emergency care to be included in the list of personnel to be on call and immediately available within 60 minutes is the best means of ensuring that patients in frontier or remote areas will continue to have access to high-quality emergency health care services. However, we are requesting comments on other viable alternatives on how CAHs that are currently experiencing workforce issues can provide emergency care in frontier and remote areas.

    Our regulations at § 485.618(d) require a doctor of medicine or osteopathy, a physician's assistant, or a nurse practitioner with training or experience in emergency care to be on call and immediately available by telephone or radio and to be available on site within 30 minutes, or 60 minutes if the CAH is located in a designated frontier area or a remote location designated by the State in its rural health plan. In addition, § 485.618(e) requires that the CAH must coordinate with the emergency response system in the area and ensure the 24-hour telephone or radio availability of a doctor of medicine or osteopathy to receive emergency calls, provide information on treatment of patients, and refer patients to the CAH or other appropriate locations for treatment.

    We understand that it may be difficult for small CAHs in frontier areas or remote locations to meet the personnel requirements set forth in § 485.618(d). However, section 1820(c)(2)(B)(ii) of the Act requires a qualifying CAH to make available the 24-hour emergency care services that a State determines are necessary for ensuring access to emergency care services in each area served by a CAH. Although the statute does not provide authority to waive the requirement for continuous emergency care services, we believe that the statute provides the flexibility for States to assess their emergency care service needs and permit small CAHs that experience the absence of emergency personnel required by § 485.618(d) to nonetheless provide emergency services. Accordingly, this final rule with comment provides a mechanism for States with CAHs with no greater than 10 beds, in frontier areas and remote locations to include registered nurses (RNs), with training or Start Printed Page 79996experience in emergency care, as authorized emergency services personnel under our current general emergency service personnel requirements at § 485.618(d). Therefore, in this final rule with comment we are revising § 485.618(d) to add the possibility for States to include RNs among authorized personnel, at § 485.618(d)(3). This will permit State Governors, following consultation on the issue of using RNs on a temporary basis as part of their State rural healthcare plan with the State Boards of Medicine and Nursing, and in accordance with State laws, to request in writing the inclusion of RNs to our current personnel requirements, so that RNs may fulfill the emergency personnel requirements of § 485.618 for frontier area or remote location CAHs with no greater than 10 beds. The letter from the Governor must attest that he or she has consulted with State Boards of Medicine and Nursing about issues related to access to and the quality of emergency services in the State. The letter from the Governor must also describe the circumstances and duration of the temporary request to include the RN on a list of emergency personnel specified in § 485.618(d)(1). The request for such inclusion, and any withdrawal of a request for this inclusion, may be submitted at any time, and will be effective on the date we receive the request. In addition, once a State submits a letter to us signed by the Governor requesting that an RN be included in the list of specified personnel for CAHs with no greater than 10 beds, a CAH must submit documentation to the State survey agency demonstrating that it has not been able, despite reasonable attempts, to hire a sufficient number of physicians, physician assistants, or nurse practitioners to provide 24-hour emergency services on-call coverage. In a frontier or remote area when a CAH has only one physician or mid-level provider, we would expect the facility to provide relief to the sole provider by using an RN with training or experience in emergency services to provide emergency on-call services.

    IV. Refinement of Relative Value Units for Calendar Year 2003 and Response to Public Comments on Interim Relative Value Units for 2002

    A. Summary of Issues Discussed Related to the Adjustment of Relative Value Units

    Section IV.B of this final rule describes the methodology used to review the comments received on the RVUs for physician work and the process used to establish RVUs for new and revised CPT codes. Changes to codes on the physician fee schedule reflected in Addendum B are effective for services furnished beginning January 1, 2003.

    B. Process for Establishing Work Relative Value Units for the 2003 Physician Fee Schedule

    Our November 1, 2001 final rule (66 FR 55294) announced the final work RVUs for Medicare payment for existing procedure codes under the physician fee schedule and interim RVUs for new and revised codes. The RVUs contained in the final rule applied to physician services furnished beginning January 1, 2002. We announced that we considered the RVUs for the interim codes to be subject to public comment under the annual refinement process. In this section, we summarize the refinements to the interim work RVUs published in the November 2001 final rule and our establishment of the work RVUs for new and revised codes for the 2003 physician fee schedule.

    Work Relative Value Unit Refinements of Interim and Related Relative Value Units

    1. Methodology (Includes Table titled “Work Relative Value Unit Refinements of the 2002 Interim and Related Relative Value Units”)

    Although the RVUs in the November 2001 final rule were used to calculate 2002 payment amounts, we considered the RVUs for the new or revised codes to be interim. We accepted comments for a period of 60 days. We received substantive comments from many individual physicians and several specialty societies on approximately 19 CPT codes with interim work RVUs. Only comments on codes listed in Addendum C of the November 2001 final rule were considered.

    To evaluate these comments we used a process similar to the process used in 1997. (See the October 31, 1997 final rule (62 FR 59084) for the discussion of refinement of CPT codes with interim work RVUs.) We convened a multispecialty panel of physicians to assist us in the review of the comments. The comments that we did not submit to panel review are discussed at the end of this section, as well as those that were reviewed by the panel. We invited representatives from the organization from which we received substantive comments to attend a panel for discussion of the code on which they had commented. The panel was moderated by our medical staff, and consisted of the following voting members:

    • One or two clinicians representing the commenting organization.
    • Two primary care clinicians nominated by the American Academy of Family Physicians and the American College of Physicians/American Society of Internal Medicine.
    • Four carrier medical directors.
    • Four clinicians with practices in related specialties, who were expected to have knowledge of the service under review.

    The panel discussed the work involved in the procedure under review in comparison to the work associated with other services under the physician fee schedule. We assembled a set of reference services and asked the panel members to compare the clinical aspects of the work of the service a commenter believed was incorrectly valued to one or more of the reference services. In compiling the set, we attempted to include—(1) Services that are commonly performed whose work RVUs are not controversial; (2) services that span the entire spectrum from the easiest to the most difficult; and (3) at least three services performed by each of the major specialties so that each specialty would be represented. The set listed approximately 300 services. Group members were encouraged to make comparisons to reference services. The intent of the panel process was to capture each participant's independent judgement based on the discussion and his or her clinical experience. Following the discussion, each participant rated the work for the procedure. Ratings were individual and confidential, and there was no attempt to achieve consensus among the panel members.

    We then analyzed the ratings based on a presumption that the interim RVUs were correct. To overcome this presumption, the inaccuracy of the interim RVUs had to be apparent to the broad range of physicians participating in each panel.

    Ratings of work were analyzed for consistency among the groups represented on each panel. In general, we used statistical tests to determine whether there was enough agreement among the groups of the panel and whether the agreed-upon RVUs were significantly different from the interim RVUs published in Addendum C of the November 2001 final rule. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings Start Printed Page 79997that we first used in the refinement process for the 1993 physician fee schedule. The statistical tests were described in detail in the November 25, 1992 final rule (57 FR 55938).

    Our decision to convene multispecialty panels of physicians and to apply the statistical tests described above was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties.

    We also received comments on RVUs that were interim for 2002, but which we did not submit to the panel for review for a variety of reasons. These comments and our decisions on those comments are discussed in further detail below.

    The table below lists the interim code reviewed during the refinement process described in this section. This table includes the following information:

    • CPT Code. This is the CPT code for a service.
    • Description. This is an abbreviated version of the narrative description of the code.
    • 2002 Work RVU. The work RVUs that appeared in the November 2001 rule are shown for each reviewed code.
    • Requested Work RVU. This column identifies the work RVUs requested by commenters.
    • 2003 Work RVU. This column contains the final RVUs for physician work.

    Table 5.—Work RVU Refinement of 2002 Interim Codes and Related RVUs

    CPT code 1Description2002 Work RVURequested work RVU2003 Work RVU
    53853Transurethral destruction of prostate tissue; by water-induced thermotherapy4.148.755.24
    1 All CPT codes and descriptions copyright 2003 American Medical Association.

    2. Interim 2002 Codes

    CPT Code 00797 Anesthesia for Intraperitoneal Procedures in Upper Abdomen Including Laparoscopy; Gastric Restrictive Procedure for Morbid Obesity CPT Code 01968 Cesarean Delivery Following Neuraxial Labor Analgesia/Anesthesia (List Separately in Addition to Code for Primary Procedure

    The RUC recommended that 9 base units be assigned to CPT code 00797 and 3 base units be assigned to the add-on code CPT code 01968. We did not accept the RUC recommended values for these two anesthesia services and assigned 8 base units to CPT code 00797 and 2 base units to the add-on code CPT code 01968.

    The AMA and the RUC disagreed with the reductions we made to the base units and the reasoning as stated in the November 1, 2001 final rule behind these reductions. No other comments were received on these codes.

    Final Decision: Given that the only comments received were from the AMA and RUC and these provided no additional information, we are maintaining the base units of 8 for CPT code 00797 and 2 base units for the CPT code 01968.

    CPT code 47382 Ablation, one or more liver tumor(s), percutaneous, radiofrequency

    We had not received recommendations from the RUC for this procedure and assigned work RVUs of 12.00 to this service.

    Specialty organizations indicated that the value assigned was inappropriately low and that this would be revisited by the RUC in February 2002. They recommended that we take the RUC values into consideration for the 2003 Medicare fee schedule.

    Final Decision: We did receive a RUC recommendation of 15.19 for CPT code 47382 and are in agreement with the recommended work RVU.

    CPT code 52001 Cystourethroscopy with irrigation and evacuation of clots.

    The RUC recommended 5.45 work RVUs based on a comparison to certain reference procedures. We had concerns about the descriptor associated with this code and based on the descriptor of this CPT code for 2002 assigned 2.37 RVUs to this procedure. We felt the time and intensity of the physician work for this procedure as described was comparable to CPT Code 52005. Commenters acknowledged that the descriptor was being revised and felt that this would enable us to accept the original RUC recommendation of 5.45.

    Final decision: The descriptor for CPT code 52001 has been revised for 2003 and the RUC provided a new recommended work RVU of 5.45. We agree with the RUC recommended work RVU of 5.45 for CPT code 52001.

    CPT code 53853 Transurethral destruction of prostatic tissue; by water induced thermotherapy).

    The RUC recommended 6.41 work RVUs for this procedure. We did not agree with the RUC recommendation and based on an analysis of intraservice activities, we believed it more appropriate to compare CPT code 53853 to 90-day global procedures with less than 30 minutes of intraservice time. Based on this we assigned a work RVU of 4.14 to this code.

    Commenters disagreed with the RVUs assigned. One commenter provided detailed information in support of an increase in work RVUs. Based on these comments we referred this code to the multispecialty validation panel for review.

    Final decision: As a result of the statistical analysis of the 2002 multispecialty validation panel ratings, we have assigned 5.24 work RVUs to CPT code 53853.

    CPT code 76490 Ultrasound guidance for, and monitoring of, tissue ablation

    We did not receive a recommendation from the RUC for this procedure. We compared the time and intensity of this procedure to other radiologic guidance codes and to radiologic supervision and interpretation codes and assigned work RVUs of 2.00 to this code. Two specialty groups expressed concern that the assigned RVUs were not appropriate and indicated the RUC would be revisiting work RVUs for this service in February 2002. They recommended that we take the RUC values into consideration for the 2003 Medicare fee schedule.

    Final Decision: We did receive a RUC work RVU recommendation of 4.00 for this service and are in agreement with this recommendation.

    CPT code 90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections); one vaccine (single or combination vaccine/toxoid) and CPT code 90472 Immunization administration (includes percutaneous, intradermal, subcutaneous, intramuscular and jet injections); each additional vaccine/toxoid (List separately in addition to code for primary procedure) one vaccine

    We disagreed with the RUC recommended work RVU of .17 for CPT code 90471 and .15 work RVUs for CPT code 90472. To the extent the physician Start Printed Page 79998performs any counseling related to this service, it is considered part of the work of the preventive medicine visit during which the immunization was administered. If the vaccine is administered during a visit other than a preventive medicine service, any physician counseling should be billed separately as an E/M service. Commenters disagreed that there is no physician work associated with this service particularly in light of the required counseling that must be provided by the physician concerning possible reactions to vaccines. Commenters also continue to be concerned that Medicaid and private payors will base their payment amounts on the “incomplete” RVUs established under the physician fee schedule, which do not include physician work for these services.

    Final Decision: We have addressed the issue of immunization administration in a separate section of this rule. We continue to believe that there is no physician work associated with this service. Please see Section A.(3)(c) (Practice Expense provisions for CY 2003) for discussion of this issue.

    CPT code 90473 Immunization administration by intranasal or oral route; one vaccine (single or combination vaccine/toxoid); and, CPT code 90474 Immunization administration by intranasal or oral route each additional vaccine/toxoid (List separately in addition to code for primary procedure)

    The RUC recommended a work RVU of .17 for CPT code 90473 and .15 work RVUs for CPT code 90474. Medicare does not cover self-administered vaccines. We did not assign work RVUs to these services as these are noncovered services. Commenters disagreed with our assessment that there is no physician work associated with these codes.

    Final Decision: As we had previously indicated, Medicare does not cover self-administered vaccines. Since these services are not covered under Medicare, RVUs are not listed under the physician fee schedule.

    CPT code 93609 Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia

    We did not receive a recommendation from the RUC for this service. The descriptor for this service did not change, but the AMA CPT editorial panel changed the global period for this service from a zero day global to a ZZZ global. This means that this is now an “add-on” code and the physician work RVUs no longer include any pre- or postservice work. (It previously had a work RVU of 10.07.) To appropriately value this add-on service, we compared it to several other electrophysiology services and assigned a work RVU of 4.81 to CPT code 93609. Commenters disagreed with the assigned work RVUs and stated that this code would be presented at the February 2002 RUC meeting. Commenters encouraged us to reconsider the work RVUs for this code based on the forthcoming RUC recommendation.

    Final Decision: We have received a RUC recommendation of 5.00 for CPT code 93609 for 2003 and are in agreement with this recommendation.

    CPT code 93613 Intracardiac electrophysiologic 3-dimensional mapping

    This was a new add-on code for 2002 for which we did not receive a recommendation from the RUC. This is a service that does not include any pre-or postservice work. Based on a comparison to similar services, we believed the intraservice time and intensity of 93613 was slightly less than that of CPT code 93619 and therefore assigned 7.00 work RVUs to CPT code 93613. Commenters disagreed with our rationale and stated that this code would be presented at the February 2002 RUC meeting. Commenters encouraged us to reconsider the work RVUs for this code.

    Final Decision: We have received a RUC recommendation of 7.00 for CPT code 93613 for 2003 and are in agreement with this recommendation.

    CPT code 93701 Bioimpedence, thoracic, electrical

    We did not accept the RUC recommendation of 0.00 work RVUS but assigned this service 0.17 work RVUs based on the value assigned to HCPCS code M0302 which is the code used to pay for this service in 2001. We did indicate that we would consider the RUC recommendation but that, if we considered revising the work RVUs, we would discuss any proposed change in a future proposed rule. Commenters expressed concern that we would revisit this issue as we had addressed valuing of this service through rulemaking in 2000. While we retained the work RVUs that had been assigned based on rulemaking in 2000 for this service, we did want to indicate that, in consideration of the RUC recommendation, should we determine that any revisions to the RVUs are necessary, we would address revisions in future rulemaking.

    Final Decision: We are retaining the work RVU of 0.17.

    CPT code 95250 Glucose monitoring for up to 72 hours by continuous recording and storage of glucose values from interstitial tissue fluid via a subcutaneous sensor (includes hook-up, calibration, patient initiation and training, recording, disconnection, downloading with printout of data)

    We agreed with the RUC recommendation that the physician work value for this service was 0.00. Though the physician can bill an E/M code for the physician review and interpretation associated with this service, commenters believe that use of the E/M code to reflect the physician work is not adequate and that the present reimbursement for this code will discourage its use.

    Final Decision: The CPT descriptor for this code indicates that it is for the “TC” only and that, to report the physician review, interpretation and written report associated with this code, the practitioner should use the E/M service codes. Based on this, we believe that the assignment of 0.00 work RVUs is appropriate.

    CPT code 97602 Removal of devitalized tissue from wound(s); non-selective debridement, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion), including topical applications(s), wound assessment and instruction(s) for ongoing care, per session

    The HCPAC recommended a work RVU of 0.32 for this service. We disagreed with this recommendation and stated that the services of this code are bundled into CPT code 97601 and did not establish work RVUs for this service. Commenters disagreed with our determination that this service should be bundled. Commenters felt that, despite the fact that there may be some elements of the service that are common to both codes, these codes describe distinct services that are not used simultaneously. We have re-examined our determination but have not changed our decision. As we explained in last year's final rule, CPT code 97602 describes services that typically involve placement of a wound covering, for example, wet-to-dry gauze or enzyme-treated dressing. It also includes nonspecific removal of devitalized tissue that is an inherent part of changing a dressing. This service is already included in the work and practice expenses of CPT code 97601. In the typical service described by CPT code 97601, the patient has a dressing placed over the wound. We would add that the services described by CPT code 97602 are also included in the work and practice expenses of the whirlpool code, CPT code 97022. For this reason, we consider this a bundled service that is not paid separately. Start Printed Page 79999

    Final Decision: As discussed above we will continue to consider this a bundled service that is not paid separately.

    CPT code 99091 Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, requiring a minimum of 30 minutes of time

    The RUC recommended work RVUs of 1.10 for this code. We disagreed since this work is considered part of the pre- and post-service work of an E/M service and payment for this code is bundled into payment for the E/M service. Commenters objected to our bundling of this code and believed that the work associated with this service is not captured in other services, as this is not a face-to-face service. Some commenters felt that the work involved in this code was similar to care plan oversight codes, for which we provide separate payment.

    Final Decision: Some portion of both the pre- and post-service work of an evaluation and management visit will not be face-to-face. We still conclude, as discussed above, that this a bundled service that is not paid separately.

    CPT codes 99289 Physician constant attention of the critically ill or injured patient during an interfacility transport; first 30-74 minutes, and 99290, each additional 30 minutes (List separately in addition to code for primary service)

    We did not agree with the RUC recommended values of 4.8 work RVUs for CPT code 99289 and 2.4 work RVUs for CPT code 99290. We also had concerns as to whether the code descriptors for these two new codes, as written, met the requirements for critical care. Based on the concerns outlined in the November 1, 2001 rule, we decided not to recognize these codes for Medicare purposes and created two HCPCS Level II codes for use in CY 2002 to describe critical care services provided to patients during inter-facility transport. These codes (G0240—Critical Care Service delivered by a physician; face-to-face, during inter-facility transport of a critically ill or critically injured patient: first 30-74 minutes of active transport and G0241—each additional 30 minutes (list separately in addition to G0240) were valued at 4.00 work RVUs and 2.00 work RVUs, respectively. Commenters indicated that the descriptors for the CPT codes were being revised and requested that we reconsider the work relative values for these codes in light of the changes that CPT will be making to these codes.

    Final Decision: Based on the changes the CPT Editorial Panel has made to the descriptors for CPT codes 99289 and 99290, we are in agreement with the RUC recommended work RVUs of 4.80 for 99289 and 2.40 for 99290 and will use these CPT codes for Medicare purposes. We are also eliminating HCPCS codes G0240 and G0241 that had previously been used to report these services.

    RUC Recommendations on Practice Expense Inputs for 2002 New and Revised Codes

    In the November 2001 final rule (66 FR 55310), we responded to the RUC recommendations on the practice expense inputs for the new and revised CPT codes for CY 2002. We have received two comments on this issue.

    Comment: The AMA commented that it was pleased that we accepted nearly all of the RUC's recommendations for direct practice expense inputs for new and revised codes for CPT 2002.

    Response: We are also pleased that we are receiving recommendations on the practice expense inputs that need no modification and thank the RUC for the time and effort expended on developing appropriate recommendations.

    Comment: Two organizations representing radiation oncologists were opposed to the reduction of the recommended clinical staff time for a radiation therapist from 123 to 60 minutes for CPT code 77418, intensity modulated treatment delivery. One of the comments argued that there is no overlap of clinical staff time with other services and that the typical time is over 60 minutes for this procedure. Both comments contend that for quality of care purposes two therapists are required.

    Response: In the November 2001 final rule (66 FR 55310), we accepted, as interim, the RUC's recommendations for practice expense inputs for CPT code 77418, except that we reduced the staff time from 120 minutes (60 minutes for each of two radiation technologists) to 60 minutes (for one radiation technologist). We still believe that this reduction in staff time is appropriate. IMRT is currently delivered in multiple fractions on a daily basis and is usually administered to patients with prostate cancer or tumors of the head and neck. Most of the treatments take considerably less than 60 minutes and only one technologist is required to actually deliver the treatment, as the parameters are preprogrammed into a computer. Further, any time spent adjusting the radiation fields using ultrasound or computed tomography is separately payable. We believe that 60 minutes of staff time adequately accounts for the pre-, intra-, and post-service staff resources used to provide this service.

    We received the following comments on HCPCS codes established in the November 1, 2001 final rule.

    • Respiratory Therapy Codes

    G0237 Therapeutic Procedures To Increase Strength or Endurance of Respiratory Muscles, Face-to-Face, One-on-One, Each 15 Minutes (Includes Monitoring); G0238 Therapeutic Procedures To Improve Respiratory Function, Other Than Described by G0237, One-on-One, Face-to-Face, per 15 Minutes (Includes Monitoring); and G0239 Therapeutic Procedures To Improve Respiratory Function, Two or More Patients Treated During the Same Period, Face-to-Face (Includes Monitoring).

    Note that we have revised the descriptor for G0239 for clarity, and discussed this in section IV(C).

    While several organizations expressed appreciation for the establishment of these codes, they requested clarification on the following points:

    Comment: Commenters asked whether nurses could also use these codes.

    Response: Physicians can use these codes if nurses are providing services “incident to” a physician's service, with the physician in the suite in his or her office, and the codes may be used in a comprehensive outpatient rehabilitation facility (CORF) or a hospital outpatient department. Since there is no respiratory therapy or pulmonary rehabilitation benefit, respiratory therapists can provide these services only in a CORF or under the “incident to” provision in a physician's office or in the hospital outpatient setting.

    Comment: Commers requested clarification of the term “monitoring” used in all three of these code descriptions.

    Response: Monitoring provides physiologic or other data about the patient during the period before, during, and after the activities. It can represent, for example, pulse oximetry readings, electrocardiography data, pulmonary testing measurements, or measurements of strength or endurance performed to assess the status of the patient before, during, and after the activities. An example would be pursed-lip breathing which involves nasal inspiration followed by slow exhalations through partially closed pursed lips to create positive pressure in upper respiratory tract, and improve respiratory muscles action. If, after this training, the practitioner were to check the patient's oxygen saturation level (via pulse oximetry), peak respiratory flow, or Start Printed Page 80000other respiratory parameters, then this would be considered “monitoring.” Payment for this monitoring is bundled into G0237 and not paid separately as a diagnostic test.

    Comment: Another asked about the differences between the G codes.

    Response: G0237 involves therapeutic procedures specifically targeted at improving the strength and endurance of respiratory muscles. Examples include pursed-lip breathing, diaphragmatic breathing, and paced breathing (strengthening the diaphragm by breathing through tubes of progressively increasing resistance to flow). G0238 involves a variety of activities including teaching patients strategies for performing tasks with less respiratory effort and the performance of graded activity programs to increase endurance and strength of upper and lower extremities. G0238 does not include demonstration of the use of nebulizer or inhaler or chest percussions because these services are described by other CPT codes (94664 and 94667, respectively). G0239 represents situations in which two or more patients are receiving services simultaneously (such as those described above in G0237 or G0238) during the same time period. The practitioners must be in constant attendance but need not be providing one-on-one contact. For example, a therapist provides medically necessary therapeutic procedures to two patients (A and B) in the same gym, for a 30-minute period. Both are performing different graded activities (described by G0238) to increase endurance of their upper and lower extremities while the therapist divides his/her time—in intermittent, brief episodes—between patients A and B. In this scenario the therapist would bill each patient for group therapy (G0239) because the treatment was provided simultaneously to two patients, and not one-on-one, as required by G0238.

    Comment: Commers requested clarification concerning use of G0237, G0238, and G0239 codes and whether these codes can be billed more than once a day.

    Response: G0237 and G0238 are timed codes, reported for each 15 minutes of one-on-one face-to-face treatment. They can be reported with more than one unit per patient per day, depending upon the duration of treatment. G0239 is not a timed code and thus should be reported only once a day for each patient in the group.

    Comment: Clarification was also requested about whether the physician must certify the services every 30 days.

    Response: The 30-day certification and recertification of the plan of care requirement applies to the services of physical therapists, occupational therapists, and speech language pathologists as described in section 1861(p) of the Act. Since we expected G0237, G0238, and G0239 typically to be provided by respiratory therapists, the 30-day certification and recertification of the plan of care requirement does not generally apply. If the services are performed by either a physical or occupational therapist (or by a therapy assistant under his or her direction), the requirement for the 30-day certification and recertification applies. Additionally, all services provided in the CORF setting including G0237, G0238, and G0239 require 60-day certification and recertification of the plan of care.

    Comment: One commenter asked whether the “NA” in the facility total column indicated that these codes are not for use in the hospital outpatient setting.

    Response: As stated above, these codes are appropriate for use in the hospital outpatient setting. The “NA” refers to the fact that in the hospital outpatient setting, these codes are paid under the hospital outpatient prospective payment system and are assigned to an APC, rather than being paid on the physician fee schedule.

    Comment: Commenters also asked for the specific clinical situations in which the use of these codes is appropriate.

    Response: All services must meet the test of being “reasonable and necessary” pursuant to section 1862(a)(1)(A) of the Act. Determinations of medical necessity have been made by carriers and intermediaries on a claim-by-claim basis in their local medical review policies. We believe that this is the appropriate manner to address these questions, and many of our contractors have already developed these policies. We note however, there is no explicit pulmonary rehabilitation benefit.

    Comment: Commenters asked whether respiratory therapists would be precluded from using additional CPT codes to bill for their pulmonary-rehabilitation related services.

    Response: We reiterate that codes G0237, G0238, and G0239 were developed to provide more specificity about the services being delivered. Thus, CPT codes 97000 to 97799 are not to be billed by professionals involved in treating respiratory conditions, unless these services are delivered by physical or occupational therapists and meet the other requirements for physical and occupational therapy services. Also CPT code 99211, (office or other outpatient visit for evaluation and management), should not be used by practitioners providing outpatient respiratory or pulmonary therapy services.

    Revisions to Malpractice RVUs for New and Revised CPT Codes for 2002

    Malpractice RVUs are calculated using the methodology described in detail at Addendum G of our November 1, 2000 final rule (65 FR 65589). Because of the timing of the release of new and revised CPT codes each year, the malpractice RVUs for the first year of these codes are extrapolated from existing similar codes based on the advice of our medical consultants and are considered interim subject to public comment and our revision. The following year, these codes are given values based on our malpractice RVU methodology and a review of any comments received.

    The malpractice RVUs for new and revised codes for CY 2002 published in Addendum B of the November 2001 final rule, were extrapolated from existing similar codes. The malpractice RVUs for these codes in this year's Addendum B were calculated by our consultant, KPMG, using the same methodology used for all other codes. Likewise, the malpractice RVUs for new and revised codes for CY 2003 are being extrapolated from existing similar codes and will be calculated using the malpractice RVU methodology next year.

    Comment: The American College of Radiology continues to be concerned about the increasing liability costs for radiology and radiation oncology. They would like us to explore and ultimately implement a change in the malpractice methodology. They stated that radiologists and radiation oncologists bear the majority of costs for liability insurance; therefore, the larger proportion of malpractice value should be included in the PC and the smaller portion in the TC.

    Response: While we can understand the concern about rising liability costs, we do not believe that radiology and radiation oncology are the only specialties facing such increases. We also do not agree that the larger proportion of malpractice values should be associated with the PC component of the service. As we have explained in previous physician fee schedule rules, the total TC RVUs (practice expense and malpractice) for the TC of radiology diagnostic tests represent the expenses required to perform the test—equipment, supplies, and technicians plus malpractice insurance. The total PC RVUs (work, practice expense and malpractice insurance) represent only Start Printed Page 80001the interpretation of the test by the physician. Generally, the TC RVUs for radiology services are significantly higher than the PC RVUs because of the very expensive equipment and supplies. The malpractice RVUs are generally split in similar proportion between PC and TC as are the practice expense RVUs. In cases when the physician or group provides both the TC and PC and bills for both components, the split is not a significant issue since the physician or group would receive the total payment. In many cases, the TC is provided by an entity—hospital or free standing imaging center—other than the physician providing the interpretation. The entity providing the TC, which includes a supervising physician who is most likely a radiologist, assumes the risk, such as excessive irradiation of the patient, of providing the TC. We can think of no reason to transfer any portion of malpractice RVUs from the entity (which would include a supervising physician) providing the majority of the service, the TC, to a physician who is providing only the interpretation. The malpractice liability associated with interpreting the test is reflected in the PC malpractice RVUs.

    Comment: The American Occupational Therapy Association indicated that for computing malpractice RVUs, occupational therapy was incorrectly crosswalked to occupational medicine (Insurance Service Office (ISO) code 80233). They suggested the appropriate crosswalk is to physical medicine and rehabilitation (ISO 80235).

    Response: We agree with the commenter that a more appropriate crosswalk for occupational therapy is to physical medicine and rehabilitation as opposed to occupational medicine. The original data that were used to calculate malpractice RVUs were based upon 1993 to 1995 malpractice premium data. These data were replaced with more recent premium data (1996 to 1998). The resulting risk factors are published in the November 2000 final rule (65 FR 65594). These more recent premium data place occupation medicine, occupational therapy, and physical medicine and rehabilitation into the same risk classification. Due to this update to the risk classifications, revising the crosswalk for occupational therapy will have no effect; nonetheless, for purposes of accuracy, we will change the occupational therapy crosswalk at the next scheduled update to malpractice premium data in CY 2005.

    Establishment of Interim Work Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2003 (Includes Table titled American Medical Association Specialty Relative Value Update Committee and Health Care Professionals Advisory Committee Recommendations and CMS's Decisions for New and Revised 2003 CPT Codes)

    One aspect of establishing RVUs for 2003 was related to the assignment of interim work RVUs for all new and revised CPT codes. As described in our November 25, 1992 notice on the 1993 physician fee schedule (57 FR 55983) and in section III.B. of the November 22, 1996 final rule (61 FR 59505 through 59506), we established a process, based on recommendations received from the AMA's RUC, for establishing interim work RVUs for new and revised codes.

    This year we received work RVU recommendations for approximately 249 new and revised CPT codes from the RUC. Our staff and medical officers reviewed the RUC recommendations by comparing them to our reference set or to other comparable services for which work RVUs had previously been established, or to both of these criteria. We also considered the relationships among the new and revised codes for which we received RUC recommendations. We agreed with the majority of the relative relationships reflected in the RUC values. In some instances, when we agreed with the relationships, we nonetheless revised the work RVUs to achieve work neutrality within families of codes, that is, the work RVUs have been adjusted so that the sum of the new or revised work RVUs (weighted by projected frequency of use) for a family will be the same as the sum of the current work RVUs (weighted by projected frequency of use). For approximately 96 percent of the RUC recommendations, proposed work RVUs were reviewed and accepted, and, for approximately 4 percent, we disagreed with the RUC recommended values. In the majority of these instances, we agreed with the relativity established by the RUC, but needed to adjust work RVUs to retain budget neutrality.

    There were also 22 CPT codes for which we did not receive a RUC recommendation. After a review of these CPT codes by our staff and medical officers, we established interim work RVUs for the majority of these services. For those services for which we could not arrive at interim work RVUs, we have assigned a carrier-priced status until such time as the RUC provides work RVU recommendations.

    We received 22 recommendations from the Health Care Professionals Advisory Committee (HCPAC). We agreed with approximately 86 percent of the HCPAC recommendations and disagreed with approximately 14 percent of the HCPAC recommendations.

    We have also included, in Table 6, 34 codes for which the RUC has submitted revisions to their original 2002 recommendations. These CPT codes are identified with an “L” in Table 6.

    Table 6, titled “AMA RUC and HCPAC Recommendations and CMS Decisions for New and Revised 2003 CPT Codes”, lists the new or revised CPT codes, and their associated work RVUs, that will be interim in 2003. This table includes the following information:

    • A “#” identifies a new code for 2003.
    • CPT code. This is the CPT code for a service.
    • Modifier. A “26” in this column indicates that the work RVUs are for the professional component of the code.
    • Description. This is an abbreviated version of the narrative description of the code.
    • RUC recommendations. This column identifies the work RVUs recommended by the RUC.
    • HCPAC recommendations. This column identifies the work RVUs recommended by the HCPAC.
    • CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table. An “(a)” indicates that no RUC recommendation was provided.
    • 2003 Work RVUs. This column establishes the 2003 work RVUs for physician work. Start Printed Page 80002

    Table 6

    *CPT codeModDescriptionRUC recommendationHCPAC recommendationCMS decision2003 Work RVU
    11400Exc tr-ext b9+marg 0.5 < cm0.85Agree0.85
    11401Exc tr-ext b9+marg 0.6-1 cm1.23Agree1.23
    11402Exc tr-ext b9+marg 1.1-2 cm1.51Agree1.51
    11403Exc tr-ext b9+marg 2.1-3 cm1.79Agree1.79
    11404Exc tr-ext b9+marg 3.1-4cm2.06Agree2.06
    11406Exc tr-ext b9+marg > 4.0 cm2.76Agree2.76
    11420Exc h-f-nk-sp b9+marg 0.5 <0.98Agree0.98
    11421Exc h-f-nk-sp b9+marg 0.6-11.42Agree1.42
    11422Exc h-f-nk-sp b9+marg 1.1-21.63Agree1.63
    11423Exc h-f-nk-sp b9+marg 2.1-32.01Agree2.01
    11424Exc h-f-nk-sp b9+marg 3.1-42.43Agree2.43
    11426Exc h-f-nk-sp b9+marg > 4 cm3.78Agree3.78
    11440Exc face-mm b9+marg 0.5 < cm1.06Agree1.06
    11441Exc face-mm b9+marg 0.6-1 cm1.48Agree1.48
    11442Exc face-mm b9+marg 1.1-2 cm1.72Agree1.72
    11443Exc face-mm b9+marg 2.1-3 cm2.29Agree2.29
    11444Exc face-mm b9+marg 3.1-4 cm3.14Agree3.14
    11446Exc face-mm b9+marg > 4 cm4.49Agree4.49
    11600Exc tr-ext mlg+marg 0.5 < cm1.31Agree1.31
    11601Exc tr-ext mlg+marg 0.6-1 cm1.80Agree1.80
    11602Exc tr-ext mlg+marg 1.1-2 cm1.95Agree1.95
    11603Exc tr-ext mlg+marg 2.1-3 cm2.19Agree2.19
    11604Exc tr-ext mlg+marg 3.1-4 cm2.40Agree2.40
    11606Exc tr-ext mlg+marg > 4 cm3.43Agree3.43
    11620Exc h-f-nk-sp mlg+marg 0.5 <1.19Agree1.19
    11621Exc h-f-nk-sp mlg+marg 0.6-11.76Agree1.76
    11622Exc h-f-nk-sp mlg+marg 1.1-22.09Agree2.09
    11623Exc h-f-nk-sp mlg+marg 2.1-32.61Agree2.61
    11624Exc h-f-nk-sp mlg+marg 3.1-43.06Agree3.06
    11626Exc h-f-nk-sp mlg+mar > 4 cm4.30Agree4.30
    11640Exc face-mm malig+marg 0.5 <1.35Agree1.35
    11641Exc face-mm malig+marg 0.6-12.16Agree2.16
    11642Exc face-mm malig+marg 1.1-22.59Agree2.59
    11643Exc face-mm malig+marg 2.1-33.10Agree3.10
    11644Exc face-mm malig+marg 3.1-44.03Agree4.03
    11646Exc face-mm mlg+marg > 4 cm5.95Agree5.95
    L 11981Insert drug implant device1.48Agree1.48
    L 11982Remove drug implant device1.78Agree1.78
    L 11983Remove/insert drug implant3.30Agree3.30
    173041 stage mohs, up to 5 spec7.60Agree7.60
    173052 stage mohs, up to 5 spec2.85Agree2.85
    173063 stage mohs, up to 5 spec2.85Agree2.85
    17307Mohs addl stage up to 5 spec2.85Agree2.85
    17310Mohs any stage > 5 spec each0.95Disagree0.62
    L 20526Ther injection, carp tunnel0.94Agree0.94
    L 20550Inj tendon sheath/ligament0.75Agree0.75
    L 20551Inject tendon origin/insert0.75Agree0.75
    L 20552Inject trigger point, 1 or 20.66Agree0.66
    L 20553Inject trigger points, =/> 30.75Agree0.75
    L 20600Drain/inject, joint/bursa0.66Agree0.66
    L 20605Drain/inject, joint/bursa0.68Agree0.68
    # 20612Aspirate/inj ganglion cyst0.70Agree0.70
    21030Excise max/zygoma b9 tumor(a)(a)3.89
    21034Excise max/zygoma mlg tumor16.17Agree16.17
    21040Removal of jaw bone lesion(a)(a)3.89
    # 21046Remove mandible cyst complex13.00Agree13.00
    # 21047Excise lwr jaw cyst w/repair18.75Agree18.75
    # 21048Remove maxilla cyst complex13.50Agree13.50
    # 21049Excise uppr jaw cyst w/repair18.00Agree18.00
    21740Reconstruction of sternum16.50Agree16.50
    # 21742Repair sternum/nuss w/o scope(a)(a)carrier
    # 21743Repair sternum/nuss w/scope(a)(a)carrier
    23410Repair rotator cuff, acute12.45Agree12.45
    23412Repair rotator cuff, chronic13.31Agree13.31
    L 24344Reconstruct elbow lat ligmnt14.00Agree14.00
    L 24346Reconstruct elbow med ligmnt14.00Agree14.00
    25320Repair/revise wrist joint10.77Agree10.77
    27425Lat retinacular release open5.22Agree5.22
    27730Repair of tibia epiphysis7.41Agree7.41
    27732Repair of fibula epiphysis5.32Agree5.32
    27734Repair of lower leg epiphysis8.48Agree8.48
    Start Printed Page 80003
    27870Fusion of ankle joint, open13.91Agree13.91
    29806Shoulder arthroscopy/surgery14.37Agree14.37
    # 29827Arthroscop rotator cuff repr15.36Agree15.36
    # 29873Knee arthroscopy/surgery6.00Agree6.00
    # 29899Ankle arthroscopy/surgery13.91Agree13.91
    # 33215Reposition pacing-defib lead4.44Disagree4.76
    33216Insert lead pace-defib, one5.39Disagree5.78
    33217Insert lead pace-defib, dual5.75Agree5.75
    # 33224Insert pacing lead & connect9.05Agree9.05
    # 33225L ventric pacing lead add-on8.34Agree8.34
    # 33226Reposition L ventric lead8.69Agree8.69
    # 33508Endoscopic vein harvest0.31Agree0.31
    L 33979Insert intracorporeal device46.00Agree46.00
    L 33980Remove intracorporeal device56.25Agree56.25
    34812Xpose for endoprosth, femorl6.75Agree6.75
    34825Endovasc extend prosth, init12.00Agree12.00
    34826Endovasc extend prosth, addl4.13Agree4.13
    # 34833Xpose for endoprosth, iliac12.00Agree12.00
    # 34834Xpose, endoprosth, brachial5.35Agree5.35
    # 34900Endovasc iliac repr w/graft16.38Agree16.38
    # 35572Harvest femoropopliteal vein6.82Agree6.82
    36415Routine venipuncture0.00Agree0.00
    # 36416Capillary blood draw0.00Agree0.00
    # 36511Apheresis wbc(a)(a)1.74
    # 36512Apheresis rbc(a)(a)1.74
    # 36513Apheresis platelets(a)(a)1.74
    # 36514Apheresis plasma(a)(a)1.74
    # 36515Apheresis, adsorp/reinfuse(a)(a)1.74
    # 36516Apheresis, selective(a)(a)1.74
    # 36536Remove cva device obstruct3.60Agree3.60
    # 36537Remove cva lumen obstruct0.75Agree0.75
    36540Collect blood venous device0.00Agree0.00
    # 37182Insert hepatic shunt (tips)17.00Agree17.00
    # 37183Remove hepatic shunt (tips)8.00Agree8.00
    # 37500Endoscopy ligate perf veins11.00Agree11.00
    37760Ligation, leg veins, open10.47Agree10.47
    # 38204Bl donor search management2.00Disagree0.00
    # 38205Harvest allogenic stem cells1.50Agree1.50
    # 38206Harvest auto stem cells1.50Agree1.50
    # 38207Cryopreserve stem cells(a)(a)0.00
    # 38208Thaw preserved stem cells(a)(a)0.00
    # 38209Wash harvest stem cells(a)(a)0.00
    # 38210T-cell depletion of harvest(a)(a)0.00
    # 38211Tumor cell deplete of harvest(a)(a)0.00
    # 38212Rbc depletion of harvest(a)(a)0.00
    # 38213Platelet deplete of harvest(a)(a)0.00
    # 38214Volume deplete of harvest(a)(a)0.00
    # 38215Harvest stem cell concentrte(a)(a)0.00
    # 38242Lymphocyte infuse transplant1.71Agree1.71
    # 43201Esoph scope w/submucous inj2.09Agree2.09
    # 43236Uppr gi scope w/submuc inj2.92Agree2.92
    43245Uppr gi scope dilate strictr3.18Agree3.18
    # 44206Lap part colectomy w/stoma27.00Agree27.00
    # 44207L colectomy/coloproctostomy30.00Agree30.00
    # 44208L colectomy/coloproctostomy32.00Agree32.00
    # 44210Laparo total proctocolectomy28.00Agree28.00
    # 44211Laparo total proctocolectomy35.00Agree35.00
    # 44212Laparo total proctocolectomy32.50Agree32.50
    # 44701Intraop colon lavage add-on3.10Agree3.10
    # 45335Sigmoidoscope w/submuc inj1.46Disagree1.36
    # 45340Sig w/balloon dilation1.96Disagree1.66
    # 45381Colonoscope, submucous inj4.30Disagree4.20
    # 45386Colonoscope dilate stricture4.58Agree4.58
    # 46706Repr of anal fistula w/glue2.95Disagree2.39
    L 47370Laparo ablate liver tumor rf19.69Agree19.69
    L 47371Laparo ablate liver cryosurg19.69Agree19.69
    L 47380Open ablate liver tumor rf23.00Agree23.00
    L 47381Open ablate liver tumor cryo23.27Agree23.27
    L 47382Percut ablate liver rf15.19Agree15.19
    # 49419Insrt abdom cath for chemotx6.65Agree6.65
    # 49904Omental flap, extra-abdom20.00Agree20.00
    Start Printed Page 80004
    49905Omental flap, intra-abdom6.55Agree6.55
    # 50542Laparo ablate renal mass20.00Agree20.00
    # 50543Laparo partial nephrectomy25.50Agree25.50
    # 50562Renal scope w/tumor resect10.90Agree10.90
    # 55866Laparo radical prostatectomy30.74Agree30.74
    # 51701Insert bladder catheter0.50Agree0.50
    # 51702Insert temp bladder cath0.50Agree0.50
    # 51703Insert bladder cath, complex1.47Agree1.47
    # 51798Us urine capacity measure0.38Disagree0.11
    53440Male sling procedure13.62Agree13.62
    53442Remove/revise male sling11.57Agree11.57
    # 56820Exam of vulva w/scope1.50Agree1.50
    # 56821Exam/biopsy of vulva w/scope2.05Agree2.05
    # 57420Exam of vagina w/scope1.60Agree1.60
    # 57421Exam/biopsy of vag w/scope2.20Agree2.20
    # 57452Exam of cervix w/scope1.50Agree1.50
    # 57454Bx/curett of cervix w/scope2.33Agree2.33
    # 57455Biopsy of cervix w/scope1.99Agree1.99
    # 57456Endocerv curettage w/scope1.85Agree1.85
    # 57460Bx of cervix w/scope, leep2.83Agree2.83
    # 57461Conz of cervix w/scope, leep3.44Agree3.44
    58140Myomectomy abdom method14.60Agree14.60
    58145Myomectomy vag method8.04Agree8.04
    # 58146Myomectomy abdom complex19.00Agree19.00
    58260Vaginal hysterectomy12.98Agree12.98
    58262Vag hyst including t/o14.77Agree14.77
    58263Vag hyst w/t/o & vag repair16.06Agree16.06
    58267Vag hyst w/urinary repair17.04Agree17.04
    58270Vag hyst w/enterocele repair14.26Agree14.26
    # 58290Vag hyst complex19.00Agree19.00
    # 58291Vag hyst incl t/o, complex20.79Agree20.79
    # 58292Vag hyst t/o & repair, compl22.08Agree22.08
    # 58293Vag hyst w/uro repair, compl23.06Agree23.06
    # 58294Vag hyst w/enterocele, compl20.28Agree20.28
    # 58545Laparoscopic myomectomy14.60Agree14.60
    # 58546Laparo-myomectomy, complex19.00Agree19.00
    58550Laparo-asst vag hysterectomy14.19Agree14.19
    # 58552Laparo-vag hyst incl t/o14.19Agree14.19
    # 58553Laparo-vag hyst, complex19.00Agree19.00
    # 58554Laparo-vag hyst w/t/o, compl19.00Agree19.00
    # 61316Implt cran bone flap to abdo1.39Agree1.39
    # 61322Decompressive craniotomy29.50Agree29.50
    # 61323Decompressive lobectomy31.00Agree31.00
    61340Subtemporal decompression18.66Agree18.66
    # 61517Implt brain chemotx add-on1.38Agree1.38
    # 61623Endovasc tempory vessel occl9.96Agree9.96
    61624Transcath occlusion, cns20.15Agree20.15
    # 62148Retr bone flap to fix skull2.00Agree2.00
    # 62160Neuroendoscopy add-on3.00Agree3.00
    # 62161Dissect brain w/scope20.00Agree20.00
    # 62162Remove colloid cyst w/scope25.25Agree25.25
    # 62163Neuroendoscopy w/fb removal15.50Agree15.50
    # 62164Remove brain tumor w/scope27.50Agree27.50
    # 62165Remove pituit tumor w/scope22.00Agree22.00
    62201Brain cavity shunt w/scope14.86Agree14.86
    62263Epidural lysis mult sessions6.14Agree6.14
    # 62264Epidural lysis on single day4.43Agree4.43
    64415N block inj, brachial plexus1.48Agree1.48
    # 64416N block cont infuse, b plex3.50Agree3.50
    64445N block inj, sciatic, sng1.48Agree1.48
    # 64446N blk inj, sciatic, cont inf3.25Agree3.25
    # 64447N block inj fem, single1.50Agree1.50
    # 64448N block inj fem, cont inf3.00Agree3.00
    64450N block, other peripheral1.27Agree1.27
    # 66990Ophthalmic endoscope add-on1.51Agree1.51
    # 7590126Remove cva device obstruct0.49Agree0.49
    # 7590226Remove cva lumen obstruct0.39Agree0.39
    7595326Abdom aneurysm endovas rpr1.36Agree1.36
    # 7595426Iliac aneurysm endovas rpr2.93Disagree1.36
    7607026Ct bone density, axial0.25Agree0.25
    # 7607126Ct bone density, peripheral0.22Agree0.22
    Start Printed Page 80005
    L 7608526Computer mammogram add-on0.06Agree0.06
    L 76362E26CAT scan for tissue ablation4.00Agree4.00
    L 7639426MRI for tissue ablation4.25Agree4.25
    L 7649026US for tissue ablation4.00Agree4.00
    # 76801Ob us < 14 wks, single fetus0.99Agree0.99
    # 76802Ob us < 14 wks, addl fetus0.83Agree0.83
    76805Ob us ≥ 14 wks, sngl fetus0.99Agree0.99
    76810Ob us ≥ 14 wks, addl fetus0.98Agree0.98
    # 76811Ob us, detailed, sngl fetus1.90Agree1.90
    # 76812Ob us, detailed, addl fetus1.78Agree1.78
    76815Ob us, limited, fetus(s)0.65Agree0.65
    76816Ob us, follow-up, per fetus0.85Agree0.85
    # 76817Transvaginal us, obstetric0.75Agree0.75
    # 92601Cochlear implt f/up exam < 70.00Agree0.00
    # 92602Reprogram cochlear implt < 70.00Agree0.00
    # 92603Cochlear implt f/up exam 7 >0.00Agree0.00
    # 92604Reprogram cochlear implt 7 >0.00Agree0.00
    # 92605Eval for nonspeech device rx0.00Agree0.00
    # 92606Non-speech device service0.00Agree0.00
    # 92607Ex for speech device rx, 1hr0.00Agree0.00
    # 92608Ex for speech device rx addl0.00Agree0.00
    # 92609Use of speech device service0.00Agree0.00
    # 92610Evaluate swallowing function0.00Agree0.00
    # 92611Motion fluoroscopy/swallow0.00Agree0.00
    # 92612Endoscopy swallow tst (fees)1.27Agree1.27
    # 92613Endoscopy swallow tst (fees)0.99Disagree0.00
    # 92614Laryngoscopic sensory test1.27Agree1.27
    # 92615Eval laryngoscopy sense tst0.88Disagree0.00
    # 92616Fees w/laryngeal sense test1.88Agree1.88
    # 92617Interprt fees/laryngeal test1.10Disagree0.00
    # 93580Transcath closure of asd18.00Agree18.00
    # 93581Transcath closure of vsd24.43Agree24.43
    L 9360926Map tachycardia, add-on5.00Agree5.00
    L 93613Electrophys map 3d, add-on7.00Agree7.00
    L 9361926Electrophysiology evaluation7.32Agree7.32
    L 9362026Electrophysiology evaluation11.59Agree11.59
    L 9362126Electrophysiology evaluation2.10Agree2.10
    L 9362226Electrophysiology evaluation3.10Agree3.10
    # 95990Spin/brain pump refil & main(a)(a)0.00
    L 96000Motion analysis, video/3d1.80Agree1.80
    L 96001Motion test w/ft press meas2.15Agree2.15
    L 96002Dynamic surface emg0.41Agree0.41
    L 96003Dynamic fine wire emg0.37Agree0.37
    L 96004Phys review of motion tests2.14Agree2.14
    96530Syst pump refill & main0.00Agree0.00
    # 96920Laser tx, skin < 250 sq cm1.15Agree1.15
    # 96921Laser tx, skin 250-500 sq cm1.17Agree1.17
    # 96922Laser tx, skin > 500 sq cm2.10Agree2.10
    # 99026In-hospital on call service(a)(a)0.00
    # 99027Out-of-hosp on call service(a)(a)0.00
    99289Ped crit care transport4.80Agree4.80
    99290Ped crit care transport addl2.40Agree2.40
    # 99293Ped critical care, initial16.00Agree16.00
    # 99294Ped critical care, subseq8.00Agree8.00
    99295Neonate crit care, initial18.49Agree18.49
    99296Neonate critical care subseq8.00Agree8.00
    99298Neonatal critical care2.75Agree2.75
    # 99299Ic, lbw infant 1500-2500 gm2.50Agree2.50
    (a) No Final RUC recommendation provided.
    # New CPT codes.
    *All CPT codes copyright 2002 American Medical Association.
    L Revised 2002 RUC recommendations.

    Table 7, which is titled “AMA RUC ANESTHESIA RECOMMENDATIONS AND CMS DECISIONS FOR NEW AND REVISED 2003 CPT CODES”, lists the new or revised CPT codes for anesthesia and their base units that will be interim in 2003. This table includes the following information:

    • CPT code. This is the CPT code for a service.
    • Description. This is an abbreviated version of the narrative description of the code. Start Printed Page 80006
    • RUC recommendations. This column identifies the base units recommended by the RUC.
    • CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table.
    • 2003 Base Units. This column establishes the 2003 base units for these services.

    Table 7

    *CPT codeDescriptionRUC recommendationCMS decision2003 base units
    # 00326 Anesth, larynx/trach, < 1 yr7Agree7
    # 00539 Anesth, trach-bronch reconst18Agree18
    # 00540 Anesth, chest surgery12Agree12
    # 00541 Anesth, one lung ventiliation15Agree15
    # 00640 Anesth, spine manipulation3Agree3
    # 00834 Anesth, hernia repair < 1 yr5Agree5
    # 00836 Anesth hernia repair, preemie6Agree6
    # 00921 Anesth, vasectomy3Agree3
    # 01829 Anesth, dx wrist arthroscopy3Agree3
    # 01991 Anesth, nerve block/inj3Agree3
    # 01992 Anesth, nerve block/inj, prone5Agree5
    *All CPT codes copyright 2003 American Medical Association.# New CPT codes.

    Discussion of Codes for Which There Were No RUC Recommendations or for Which the RUC Recommendations Were Not Accepted

    The following is a summary of our rationale for not accepting particular RUC work RVU or base unit recommendations. It is arranged by type of service in CPT order. Additionally, we also discuss those CPT codes for which we received no RUC recommendations for physician work RVUs. This summary refers only to work RVUs or base units.

    New and Revised Codes for 2003

    CPT code 17310 Chemosurgery (Mohs micrographic technique) including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and complete histopathological preparation including the first routine stain (e.g., hematoxylin and eosin, toluidine blue); each additional specimen after the first 5 specimens, fixed or fresh tissue, any stage (List separately in addition to code for primary procedure).

    This add-on code is used to report specimens generated during Mohs surgery. Prior to the changes made for 2003, the code was reported once for all specimens over five, generated during a particular stage of Mohs surgery. In 2003, the code will be used to report each specimen over five during a particular stage of Mohs surgery. The RUC recommended maintaining 0.95 work RVUs for this code as an interim value. We disagree. We share the concerns of the RUC that the specialty society recommendation was based on a survey that did not take into account the ZZZ global period of this code. Additionally, in order to determine whether the current work RVU for 17310 was appropriate, we analyzed the current work RVU for 17310 in the context of the work RVUs for other Mohs surgery CPT codes. Mohs surgery work RVUs are based on Harvard data which is depicted in Table 8 below (all codes have 000 global periods for 2002):

    Table 8

    CPT code2002 Work RVUsTotal time (minutes)Intra-service time (minutes)Work intensity (work RVU/total time)RN Time (minutes) (CPEP data)Histotechnician Time (minutes) (CPEP data)
    173047.68950.08520250
    173052.8562.04610125
    173062.8562.04610125
    173072.8562.04610125
    173100.9531.031328

    These data clearly show that the Harvard data appropriately rank these services in terms of intensity. We note that, because intra-service times are not given for all codes, it is impossible to calculate intra-service work intensity. The RUC recommendation of 0.95 work RVUs which is based on a median time of 20 minutes yields a work intensity of 0.047 which is higher than the work intensities for CPT codes 17305-17307. This would create a rank order anomaly in this family of codes.

    We also note that the 2002 descriptor for CPT code 17310 says that this code should be reported only once for all specimens more than five for a given stage of Mohs. Therefore, we believe that the current work RVU represents the total work required for the typical number of specimens obtained (beyond five) per stage of Mohs.

    We compared CPT code 17310 with CPT codes 88331 Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen, and 88332 Pathology consultation during surgery; each additional tissue block with frozen section(s). CPT code 88332 has a work RVU of 0.59 and total physician time of 15 minutes. We note that if the RUC survey time (20 minutes) for CPT code 17310 is multiplied by the Harvard Start Printed Page 80007intensity (.031) that a work value of 0.62 is obtained.

    Therefore, we are assigning a work value of 0.62 work RVUs to CPT code 17310 pending further recommendations from the RUC. We believe this value is appropriate for the new descriptor, which allows reporting of CPT code 17310 for each specimen rather than once for all specimens. We also believe this work value places this code in correct rank order with CPT codes 17304-17307 and with CPT codes 88331 and 88332.

    We also note that a work value of 0.62 RVUs will not require any work neutrality adjustment because it already takes our claims data for CPT code 17310 into account.

    CPT Codes 21030, Excision of benign tumor or cyst of maxilla or zygoma, by enucleation and curettage, and 21040, Excision of benign tumor or cyst of mandible, by enucleation or curettage.

    CPT changed the descriptors for these codes to make the procedure more specific, and we have not yet received RUC recommendations for these codes. We compared these services to CPT Codes 21555, Excision tumor, soft tissue of neck or thorax; subcutaneous (work RVU of 4.35), 28043, Excision, tumor, foot; subcutaneous tissue (work RVU 3.54), 28108, Excision or curettage of bone cyst or benign tumor, phalanges of foot (work RVU 4.16), 21501, Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax (work RVU 3.81), 26115 Excision, tumor or vascular malformation, soft tissue of hand or finger; subcutaneous (work RVU 3.86), and 24075 Excision, tumor, soft tissue of upper arm or elbow area; subcutaneous (work RVU 3.92). We believe that 21030 and 21040 are most similar to 24075 and 26115 in terms of physician work and are assigning interim RVUs of 3.89 for both of these procedures. We are crosswalking the malpractice RVUs from current CPT Code 21030 (0.60 RVUs) to these procedures.

    CPT Codes 21740 Reconstructive repair of pectus excavatum or carinatum; open and 21742 Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure) with thoracoscopy

    We have not received the final recommendation from the RUC on these services and carriers will price these services in 2003.

    CPT codes 33215 Repositioning of previously implanted transvenous pacemaker or pacing cardioverter-defibrillator (right atrial or right ventricular) electrode and 33216 Insertion of transvenous electrode; single chamber (one electrode) permanent pacemaker or single chamber pacing cardioverter-defibrillator

    We received a RUC recommendation of 4.44 work RVUs for CPT code 33215 and a RUC recommendation of 5.39 work RVUs for CPT code 33216. Previously, both the insertion and repositioning of the electrodes were billed under CPT code 33216. Effective January 1, 2003, CPT code 33215 will be used to report the repositioning of a previously implanted transvenous pacemaker or pacing cardioverter-defibrillator electrode, while CPT 33216 will be used to report the insertion of a transvenous electrode. Although we agree with the relativity established by the RUC, in order to retain work neutrality between these two services, we have scaled the total relative values that will be paid in 2003 to what would have been paid in 2003 if CPT code 33215 had not been established. This results in work RVUs of 4.76 for CPT code 33215 and 5.78 work RVUs for CPT code 33216.

    CPT Codes 36511 Therapeutic apheresis; for white blood cells, 36512 Therapeutic apheresis; for red blood cells, 36513 Therapeutic apheresis; for platelets, 36514 Therapeutic apheresis; for plasma pheresis, 36515 Therapeutic apheresis; with extracorporeal immunoadsorption and plasma reinfusion, and 36516 Therapeutic apheresis; with extracorporeal adsorption or selective filtration and plasma reinfusion

    We have not yet received the RUC recommendations for these CPT codes. We are assigning 1.74 work RVUs to all these procedures. This is the work RVU for both CPT codes 36520 and 36521 (deleted for CPT 2003) which are currently being used to report these procedures. We are also crosswalking the malpractice RVUs for CPT code 36520 to these procedures (0.06 RVU).

    CPT Codes 38204 Management of recipient hematopoietic progenitor cell donor search and cell acquisition, 38205 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogenic, 38206 Blood-derived hematopoietic cell harvesting for transplantation, per collection; autologous, 38207 Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage, 38208 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, 38209 Transplant preparation of hematopoietic progenitor cells; washing of harvest, 38210 Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, T-cell depletion, 38211 Transplant preparation of hematopoietic progenitor cells; tumor cell depletion, 38212 Transplant preparation of hematopoietic progenitor cells; red blood cell removal, 38213 Transplant preparation of hematopoietic progenitor cells; platelet depletion, 38214 Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion, 38215 Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer, 38242 Bone marrow or blood-derived peripheral stem cell transplantation; allogeneic donor lymphocyte infusions

    We agree with the RUC work recommendations for CPT codes 38205, 38206, and 38242. We disagree with the RUC recommendations for the CPT code 38204. CPT codes 38207 through 38215 were reviewed at the April RUC meeting but final work RVUs were not established. We did not receive final recommendations on work RVUs for these services in time for publication in this final rule, but will review any RUC recommendations for next year.

    CPT code 38204 is reported by the physician managing a search for potential hematopoietic progenitor cell donors. We are giving this code a status indicator “B,” meaning that we will not make separate payment for this service. We believe we are already making payment for any physician work associated with this service as part of our payment for other bone marrow transplant codes (that is, CPT codes 38205, 38206, 38240, 38241, and 38242). Furthermore, we have significant concerns about how this code would be used in actual practice. Would beneficiaries be billed for failed donor searches, and, if so, how many? How would beneficiaries be able to determine whether one or more searches had actually been conducted? This problem is compounded by the fact that the beneficiary would probably never meet the physician conducting the search. Additionally, it is unclear from the specialty society vignette what is actually physician work and what is the work of clinical and administrative staff. It would seem most appropriate that any payment would be made to the physician who is performing the cell harvesting or bone marrow transplant services (that is, CPT codes 38205, 38206, 38240, 38241, and 38242). We welcome RUC's further review of these codes to determine whether any physician work associated with a cell donor search is already included. If the RUC determines that such work is not included, we would review Start Printed Page 80008recommendation for changing the RUC values of these codes to include such work.

    CPT codes 38207, 38208, 38209. These codes represent an unbundling of CPT codes 88240 Cryopreservation, freezing and storage of cells, each cell line, and 88241 Thawing and expansion of frozen cells, each aliquot. Both codes 88240 and 88241 are paid under the laboratory fee schedule. We also note that CPT 2003 has added a parenthetical note under 88240 and 88241, which implies that, starting in January 2003, they should be used only for diagnostic services, and codes 38207, 38208, and 38209 should be used for therapeutic services.

    • It is unclear from the specialty vignettes whether any physician work is typically required to perform these services. The descriptions of typical physician involvement in these procedures indicate that the only physician services are laboratory oversight or quality management services for which we do not make separate payment to physicians.
    • We also believe these services will be reported on a “per aliquot” basis. However, even though blood-derived stem cells are usually stored in aliquots, the processes of freezing, thawing, and washing are done in batches. This means that the physician oversight of these processes does not occur on a “per aliquot” basis and therefore, it does not seem appropriate to pay for physician services on a “per aliquot” basis.
    • We believe that the analysis the RUC was using to arrive at its interim recommendation for assigning physician work to CPT codes 38207, 38208, and 38209 was flawed. The RUC discussed assigning physician work to these services based on its review of 38210 which it compared to CPT code 86077 Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report (work RVU 0.94). The RUC then used the specialty societies' relative ranking of services 38207-38215 as the basis for recommending work values for CPT codes 38207-38209 and 38211-38215. With regard to this analysis, we note: (1) the descriptor for CPT code 86077 requires a physician service and an “interpretation and written report,” while CPT code 38210 is not described as a physician service, nor does it require an “interpretation and written report.” Therefore, we believe it is inappropriate to compare 38210 with 86077, (2) 38210 is currently reported as CPT code 86915, Bone Marrow or peripheral stem cell harvest, modification or treatment to eliminate cell types (e.g., T cells, metastatic carcinoma) which is paid under the laboratory fee schedule, and (3) 38207, 38208, and 38209 describe entirely different services from 38210, 86077, and 86915, thus making it difficult to understand how a work value for 38210 could be extrapolated to 38207-38209.

    At this time we are assigning status indicator “I” to 38207-38209 making them not valid for Medicare purposes. We are creating two G codes, G0265 Cryopreservation, freezing and storage of cells for therapeutic use, each cell line, and G0266 Thawing and expansion of frozen cells for therapeutic use, each aliquot. These codes will be paid under the laboratory fee schedule at the same rate as CPT codes 88240 and 88241 respectively. The descriptors will allow us to continue to recognize CPT codes 88140 and 88141 as described in CPT 2003 for diagnostic use, thus making it unnecessary for us to change the status indicators for these services. The G codes will also enable us to track the utilization of these services. We believe that continuing the status quo with regard to these procedures will not affect beneficiary access to transplantation services and will give us more time to analyze the services and recommendations.

    CPT codes 38210-38215. Currently CPT codes 38210-38213 are described by CPT code 86915, Bone Marrow or peripheral stem cell harvest, modification or treatment to eliminate cell types (for example, T cells, metastatic carcinoma). Currently, CPT code 86915 is paid under the laboratory fee schedule. With regard to CPT codes 38210-38215, we have many of the same concerns as we have for CPT codes 38207-38209.

    • It is unclear from the specialty vignettes whether any physician work is typically required to perform these services. The descriptions of typical physician involvement in these procedures indicate that a significant portion of the physician work is procedure oversight or quality management services for which we do not make separate payment to physicians. In fact, the only references in the specialty society vignettes for these procedures to services paid under the physician fee schedule are references to performance of flow cytometry. Therefore, if there is any physician work associated with these services it is currently payable under the CPT code 88180 Flow cytometry; each cell surface, cytoplasmic or nuclear marker.
    • We do not believe that unbundling of these services is warranted because CPT codes 38210, 38212, 38213, 38214, and 38215 may be performed together on a single harvest of stem cells during an allogeneic transplant. Further, when these services are performed together, if there is any physician work associated with these activities, it must be allocated to each service and it is not clear that this can be accomplished.
    • As discussed above, we have concerns about the RUC's preliminary discussions for work RVUs for these codes. CPT code 86077 to which 38210 was compared requires physician services, an interpretation and report, and has forty minutes of intra-service time associated with it. In contrast 38210 has no requirement for physician work, and it is stated that the physician will only perform this service in an emergency. Further, there is no requirement for interpretation of data or a written report, and the intra-service time is 23 minutes. We do not believe the stress involved with these procedures is any greater than the stress involved with 86077 or other pathology services that require correct interpretation of clinical laboratory data or surgical specimens to make a correct diagnosis essential in determining appropriate treatment. Furthermore, we know the RUC is continuing to review these codes and we also require further time to review them.

    Therefore, we are assigning status indicator “I” to CPT codes 38210-38215, making them invalid for Medicare purposes. We are creating G0267, Bone marrow or peripheral stem cell harvest, modification or treatment to eliminate cell type(s) (for example, T-cells, metastic carcinoma). This G code will replace deleted code CPT code 86915, and it will be paid under the laboratory fee schedule.

    We welcome any comments from the RUC or other interested parties concerning these codes and ask that such comments specifically address the concerns discussed above. We will continue to review these codes internally, obtain payment and utilization data for CPT code 86915, and track utilization of all three G codes.

    CPT code 45335 Sigmoidoscopy, flexible; with directed submucosal injection(s) any substance and 45381 Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal injection(s) any substance

    The RUC recommended work RVUs of 1.46 for CPT code 45335 and 4.30 for CPT code 45381. For CPT code 45335, the RUC used CPT code 45330 as the base code (0.96 work RVUs) and added an increment of 0.50 work RVUs based upon the increased pre-, intra-, and post-service work associated with CPT code 45335 as compared to CPT code 45330. For CPT code 45381, the RUC Start Printed Page 80009used CPT code 45378 (3.70 work RVUs) as the base code and added an increment of 0.60 work RVUs based upon the increased pre-, intra-, and post-service work associated with CPT code 45381 as compared to CPT code 45378.

    In order to review the RUC recommended values for CPT code 45335 and 45381, we compared these services to the analysis and recommendations provided by the RUC for CPT codes 43201 and 43236. We agree with the RUC recommendations for CPT codes 43201 and 43236, which are also new submucosal injection codes. We further note that the intra-service intensities of CPT codes 43201 and 43236 should be higher than the intra-service intensities of CPT codes 45335 and 45381 because of the increased risk of complications, and the fact that several sites are being injected instead of one.

    In reviewing the pre-, intra-, and post-service times for CPT codes 43201, 43236, 45335, and 45381, we are unsure why these times vary so much. The pre-service time for CPT code 45381 is 25 minutes longer than the pre-service time for CPT code 45378 and there is nothing in the RUC vignette to indicate the reason for the increased pre-service time. Moreover, it is unclear why the post-service time for CPT code 45381 is 9 minutes less than the post-service time for CPT code 45378. Interestingly, less than 10 minutes of extra pre- and post-service time (beyond the base codes) was allotted for the incremental work of CPT codes 43201 and 43236 that we believe are more intensive procedures than CPT codes 45335 and 45381. Therefore, we believe that the pre- and post-service time increment for CPT codes 45335 and 45381 should be less than for CPT codes 43201 and 43236. In short, we had a great deal of difficulty interpreting the RUC time data.

    In assigning work values to CPT codes 45335 and 45381, we compared them to the incremental work values and times for CPT codes 43201 and 43236 because we agreed with the RUC recommendations and times for those codes. The intra-service intensities for CPT codes 43201 and 43236 are 0.05 RVU per minute and 0.035 RVU per minute, respectively. We believe the intra-service intensity of CPT code 45335 is less than the intensity of CPT code 43201. After accounting for a few minutes of extra post-service time and an intra-service intensity of 0.04 RVU per minute, we are left with an incremental work value of 0.4 work RVUs for CPT code 43201, which is what we will apply to CPT code 45335. We also believe the intensity of CPT code 45381 is less than the intensity of CPT code 43201. Therefore, accounting for approximately 10 minutes of extra pre- and post-service time, and assigning an intra-service intensity of 0.04 RVU per minute leaves an incremental work value of 0.5 work RVUs, which is what we will apply to CPT code 45381. Therefore, we are assigning work RVUs of 1.36 and 4.20 to CPT codes 45335 and 45381, respectively.

    CPT code 45340 Sigmoidoscopy, flexible; with dilation by balloon, each stricture

    The RUC recommended a work RVU of 1.96 for this CPT code. This includes 1.00 for the incremental work based on the need for conscious sedation to perform this procedure (other flexible sigmoidoscopies do not require conscious sedation). This means the incremental work for CPT code 45340 is greater than the incremental work for other endoscopic dilation codes (CPT codes 43245 and 45386) because those codes have base procedures that include use of conscious sedation. The RUC has been considering the issue of conscious sedation in general for some time and has not been able to conclude that there is any incremental physician work associated with conscious sedation. In the absence of a specific RUC recommendation affirmatively stating that specific physician work is associated with conscious sedation, we do not believe it is appropriate to assign a work RVU for CPT code 45340 that is based on the presumption that a portion of the work value is for using conscious sedation. Therefore, we compared the RUC recommendations for work and physician time for CPT code 45386 to the incremental times for CPT code 45340. We believe that the intra-service intensity of CPT code 45340 should be no greater than the intra-service intensity for CPT code 45386. Therefore, we calculated the increment in pre- and post-service work (.341 work RVUs) and the intra-service intensity (0.036 RVU per minute) of CPT code 45386. We multiplied this intensity by 10 minutes to arrive at an intra-service work of .36 RVU for CPT code 45340 and added .341 RVUs for pre- and post-service work to arrive at an RVU of 0.7 for the total incremental work of CPT code 45340. Therefore, we are assigning an interim work RVU of 1.66 to CPT code 45340.

    CPT code 46706 Repair of Anal Fistula with fibrin glue. The RUC recommended 2.95 work RVUs for this service based on a comparison to CPT codes 46020, Placement of Seton (work RVU 2.90) and 46940, Curettage or Cautery of Anal Fissure, including dilation of anal sphincter (separate procedure); initial (work RVU 2.32). The intra-service time for CPT code 46706 is less than the intra-service time for CPT code 46940 and requires similar physician work to CPT code 46612, Anoscopy with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique (work RVU 2.34). The post-service work for CPT code 46706 is comparable to that of CPT code 46940. Therefore, we are assigning a work RVU of 2.39 to CPT code 46706. Malpractice RVUs are crosswalked from CPT code 46940 at 0.17 RVUs.

    CPT code 51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, nonimaging. The RUC recommended 0.38 work RVUs based on a comparison of this procedure to CPT code 76857, Ultrasound, pelvic (nonobstetric), B-scan and/or real time with image documentation; complete. The RUC recommended 0.38 work RVUs based on a urology survey that reported that this procedure is performed 75 percent of the time by the physician and based on a comparison of this procedure to CPT code 76857, Ultrasound, pelvic (nonobstetric, B-scan and/or real time with image documentation; complete. We disagree. This code has been a HCPCS level two code that was assigned 0.00 work RVUs because we believe that it is typically performed by a nurse or other clinical staff. We continue to believe that this is a non-physician service and are assigning 0.00 work RVUs to this service. We will accept the practice expense inputs recommended by the RUC and will crosswalk the malpractice RVUs from G0050. It is not appropriate to bill CPT code 51798 in a SNF, hospital, or other setting in which nursing care is provided by the facility, since it is a routine nursing service, not really a diagnostic test.

    CPT code 75954 Endovascular graft placement for repair of iliac artery (for example, aneurysm, pseudoaneurysm, ateriovenous malformation, trauma) radiological supervision and interpretation.

    The RUC agreed with the specialty societies and recommended a value of 2.93 work RVUs based on comparing this code to CPT code 75952, Endovascular repair of infrarenal abdominal aortic anuerysm or dissection, radiological supervision and interpretation (work RVU of 4.5) and CPT code 75953, Placement of proximal or distal extension prosthesis for endovascular repair of infra renal abdominal aortic aneurysm, radiological supervision and Start Printed Page 80010interpretation (work RVU or 1.36). The recommended RVUs are midway between the RVUs of the reference procedures. The specialty societies presented the following to the RUC: “Unlike many of the other radiological supervision and interpretation (S&I) codes, 75954 includes all routine supervision and interpretation of the endovascular iliac graft placement procedure with the only exception being that 75953 is added if an extension prosthesis is required. This more inclusive approach makes 75954 very similar in concept to the inclusive S&I for endovascular aortic aneurysm repair CPT 75952.” The specialties go on to say that survey respondents believed that the code should be valued less than CPT code 75952 but more than CPT code 75953. We disagree. First, we note that CPT code 75953, which was reviewed by the RUC in February of 2001, is not an “add-on” code. It is a stand-alone code that is billed with a stand-alone surgical procedure. Furthermore, total procedure time for CPT code 75954 (85 minutes) is less than the total procedure time for CPT code 75953 (95 minutes), and the intra-service times of CPT codes 75954 and 75953 are identical (45 minutes). This is consistent with the specialty societies' description of the work of CPT code 75954, which is virtually identical to the description of the work for CPT code 75953. Therefore, in order to maintain correct rank order in this family of codes we are assigning a work RVU of 1.36 to CPT code 75954.

    CPT codes 92605 Evaluation for prescription of non-speech generating augmentative and alternative communication device and 92606 Therapeutic service(s) for the use of non-speech generating device, including programming and modification

    We will consider CPT codes 92605 and 92606 bundled for Medicare payment purposes. The RUC's evaluation of these services implied that they are similar to the new CPT codes for speech generating devices. We believe that CPT codes 92605 and 92606 typically do not involve the same type of highly specialized equipment as the codes for speech generating devices. We believe that the work associated with these services is already contained in CPT codes 92506 Evaluation of speech, language, voice communication, auditory processing, and/or aural rehabilitation status and 92507 Treatment of speech, language, voice communication, auditory processing disorder (includes aural rehabilitation); individual, and will consider CPT codes 92605 and 92606 bundled.

    We note that CPT also created new codes to describe programming and analysis of cochlear implants. These CPT codes are 92601 Diagnostic analysis of cochlear implant, patient under 7 years of age; with programming; 92602 Diagnostic analysis of cochlear implant, patient under 7 years of age; subsequent reprogramming; 92603 Diagnostic analysis of cochlear implant, age 7 years or older, with programming; and 92604 Diagnostic analysis of cochlear implant, age 7 years or older, subsequent reprogramming. Codes 92601 and 92603 describe post-operative analysis and fitting of previously placed external devices, connection to the cochlear implant, and programming of the stimulator. CPT Codes 92602 and 92604 describe subsequent sessions for measurements and adjustment of the external transmitter and re-programming of the internal stimulator.

    An existing CPT code, 92510 Aural rehabilitation following cochlear implant (includes evaluation of aural rehabilitation status and hearing, therapeutic services) with or without speech processor programming, will no longer be used for Medicare services since it represents services which have considerable overlap with the services described by the new CPT codes, 92601, 92602, 93603, and 92604. For the remaining services that do not involve reprogramming of the cochlear implant, CPT code 92507 Treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation); individual describes the services, so a code specific to cochlear implant patients is no longer needed. The use of CPT code 92507 for this service is consistent with the note in the CPT manual under CPT code 92602.

    CPT codes 92613 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording; physician interpretation and report only, 92615 Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or video recording; physician interpretation and report only, and 92617 Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; physician interpretation and report only.

    Effective January 1, 2003, CPT created several codes to describe fiberoptic endoscopic evaluation services that are currently described by temporary G-codes. For specific information related to both the former G-codes and the new CPT codes that will replace the deleted G-codes, refer to the end of this section. We agreed with the RUC recommended values for all of the fiberoptic endoscopic evaluation services (CPT codes 92612, 92614, and 92616) with the exception of CPT codes 92613, 92615, and 92617. For these three services that refer only to a separately identified physician review and interpretation of the fiberoptic endoscopic evaluation, we consider the physician interpretation and report bundled into an evaluation and management service. We believe the physician who does not perform the testing should only bill the patient when performing an evaluation and management service, not as the supervisor of another professional performing and reviewing the initial fiberoptic endoscopic evaluation. The interpretation of this test is an integral part of the testing itself. If a nonphysician professional has the credentials and experience to perform this testing, then that professional should also provide the interpretation of the findings.

    CPT codes 93784 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report, 93786 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; recording only, 93788 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; scanning analysis with report, and 93790 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; physician review with interpretation and report.

    We have not yet received RUC recommendations for these codes. We established RVUs for these services during this past year in response to a national coverage determination. We will maintain these RVUs until we receive a RUC recommendation.

    CPT code 95990 Refilling and maintenance of implantable pump or reservoir for drug delivery; spinal (intrathecal, epidural) or brain (intraventricular).

    We understand that performance of CPT code 95990 requires the use of an expensive kit, the cost of which may not be reflected in the RVUs for CPT code 96530, the code under which it was previously reported. CPT code 96530 has practice expense RVUs of 1.01 and malpractice RVUs of 0.05. We are assigning 1.50 practice expense RVUs because we estimate that the practice expense for CPT code 95990 is 50 percent higher than it is for CPT code Start Printed Page 8001196530. We are crosswalking the malpractice RVUs from CPT code 96530 to CPT code 95990.

    We are not assigning work RVUs to CPT code 95990 for 2003 since we believe that this procedure is typically (greater than 50 percent of the time) performed by a nurse. We understand that there has been discussion with the CPT Editorial Committee about revising this code so that it would be billed only when performed in the presence of a physician. If the code were to be so revised, we would consider any RUC recommendations regarding work RVUs for this service.

    These values are interim for 2003 and we will address comments about the RVUs for this code in next year's final rule.

    CPT codes 99026 Mandated On-call service; in hospital and 99027 Mandated physician on call services

    No RUC recommendation was received for these codes. Note that stand-by and on-call services are not covered by Medicare and we would not pay for these services billed using these codes.

    Establishment of Interim Practice Expense RVUs for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System (HCPCS) Codes for 2003

    We have developed a process for establishing interim practice expense RVUs for new and revised codes that is similar to that used for work RVUs. Under this process, the RUC recommends the practice expense direct inputs, that is, the staff time, supplies and equipment, associated with each new code. We then review the recommendations in a manner similar to our evaluation of the recommended work RVUs.

    The RUC recommendations on the practice expense inputs for the new and revised 2003 codes were submitted to us as interim recommendations. We, therefore, consider that these recommendations are still subject to further refinement by the PEAC, or by us, if it is determined that such future review is needed. We may also revisit these inputs in light of future decisions of the PEAC regarding supply and equipment packages and standardized approaches to pre- and post-service clinical staff times.

    We have accepted, in the interim, all of the practice expense recommendations submitted by the RUC for the codes listed in the following table titled “AMA RUC and HCPAC RVU Recommendations and CMS Decisions for New and Revised 2003 CPT Codes.”

    C. Other Changes to the 2003 Physician Fee Schedule

    We are establishing the following HCPCS codes for CY 2003.

    GO262 Small intestinal imaging; intraluminal, from ligament of Treitz to the ileo cecal valve, includes physician interpretation and report

    We are creating this code to describe a new diagnostic test for which we will make separate payment under the physician fee schedule and the Hospital Outpatient Prospective Payment System (OPPS). The procedure involves ingesting a small camera through the mouth. As the camera traverses the gastrointestinal tract, it produces two images per second and transmits those images to a receiver worn by the patient. After eight hours (the battery life of the camera) the belt containing the receiver is removed from the patient. The images are then developed and reviewed by a physician who interprets them and makes a written report. The capsule is excreted in the patient's stool and discarded. Images taken in the esophagus, stomach and large intestine (colon) are hard to interpret; therefore, current use of this imaging modality is limited to evaluation of the small intestine. The G-code descriptor is designed to ensure accurate reporting of this diagnostic test. Although this test has been referred to as “capsule endoscopy”, the term “endoscopy” is a misnomer because “endoscopy” refers to physician-controlled viewing the gastrointestinal tract through an endoscope.

    Physician Work

    We understand from recently published clinical studies that the average small intestine transit time was 257 minutes and the transit time from ingestion to the cecum was 302 minutes. Review of the images includes a first pass overview to mark areas of special interest, a review of the entire video recording, and a focused review of abnormalities, if any are found. The average time to review the capsule images in two recently published studies was 50 and 56 minutes. Therefore, we believe that, typically, 53 minutes of physician time will be spent reviewing the video. To assign a work value, we compared the work of this code to the work of other diagnostic tests and procedures that require review of significant amounts of data. Specifically, we reviewed the work RVUs and intra-service times for electroencephalography (EEG) reading and interpretation, magnetic resonance angiography (MRA), computed tomographic angiography (CTA), Holter monitor reading and interpretation, prolonged esophageal acid reflux testing, echocardiography, duplex scanning of the carotid arteries, and anorectal manometry. Based on these comparisons, we are assigning a work value of 2.12 RVUs. This results in an intensity of .04 RVU per minute and places it in correct rank order with the procedures to which it was compared. We note that this assumes that a complete study from the ligament of Treitz to the ileocecal valve was performed and that the camera functioned normally throughout the procedure and produced two images per second. If an incomplete evaluation of the small intestine is accomplished, this code should be billed with a CPT code 52-modifier indicating reduced services, and the payment amount would also be reduced. The amount of reduction is determined by the carrier. Until such time as we make a NCD for this service, coverage is at the discretion of carriers and intermediaries.

    Malpractice

    We are crosswalking the value from CPT code 74230 with the same PC/TC split because they have similar physician times and intensities.

    Practice Expense

    For the physician fee schedule we are assigning the following inputs for practice expense:

    • Staff Time—RN/LPN/MA mix—90 minutes—includes pre-service education, attachment of the receiver, administration of the camera, removal of the receiver, and processing of the images
    • Supplies—Single use camera; Razor
    • Equipment—Workstation

    GO268 Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing

    This code was created in order to allow payment to a physician who removes impacted cerumen on the same date as his or her employed audiologist performs audiologic function testing. We will assign the same physician work RVUs, practice expense inputs, and malpractice RVUs to this code as are assigned to CPT code 69210, Removal impacted cerumen (separate procedure), one or both ears.

    First, we emphasize that routine removal of cerumen is not paid separately. It is considered to be part of the procedure with which it is billed (for example, audiologic function testing). To assure the appropriate reporting of this code, we note that it Start Printed Page 80012should only be used in those unusual circumstances when an employed audiologist who bills under a physician UPIN number performs audiologic function testing on the same day as removal of impacted cerumen requiring physician expertise for removal. This code should not be used when the audiologist removes cerumen, because removal of cerumen is considered to be part of the diagnostic testing and is not paid separately.

    GO269 Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (for example, angioseal plug, vascular plug)

    We are creating this G code to assure proper reporting of this service. It has come to our attention that this service is being inappropriately reported with codes for such procedures as “blood vessel repair” and “repair of arterial pseudoaneurysm.” We are assigning a status indicator of “B” (payment bundled into payment for other services) to this service, as the work, practice expense, and malpractice risk of closing an arteriotomy or venotomy site at the conclusion of an invasive percutaneous procedure, whether by manual compression, suture, or use of a closure device, is included in the main invasive procedure. Therefore, there is no separate payment for this procedure.

    GO270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), individual, face-to-face with the patient, each 15 minutes and

    GO271 Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease) group (2 or more individuals), each 30 minutes

    In our NCD dated May 1, 2002, we established basic coverage for medical nutrition therapy billed under CPT codes 97802 through 97804 as 3 hours per year for beneficiaries with either diabetes or renal disease. However, we also pay for additional hours if a physician makes a second referral in the same year based on a change in the beneficiary's medical condition, diagnosis, or treatment regimen. These new codes allow us to edit for basic coverage and reimburse for additional coverage when appropriate.

    We are crosswalking the RVUs from CPT code 97803 to G0270 and CPT code 97804 to G0271 because these are the corresponding CPT medical nutrition codes.

    GO272 Naso/oro gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)

    We are creating this code for one year until an identical CPT code becomes effective.

    Physician Work

    We compared this code to other gastroenterology and radiologic procedures including CPT codes 91105 Gastric intubation, and aspiration or lavage for treatment (e.g, for ingested poisons) (work RVU of 0.37); 44500 Introduction of long gastrointestinal tube (e.g., Miller-Abbott) (separate procedure) (work RVU of 0.49); 74340 Introduction of long gastrointestinal tube (e.g., Miller-Abbott), including multiple fluoroscopies and films, radiological supervision and interpretation (work RVU of 0.54), and 76000 Fluoroscopy (separate procedure), up to one hour physician time, other than 71023 or 71034 (e.g., cardiac fluoroscopy) (work RVU of 0.17).

    This procedure is most similar to CPT code 91105 (16 minutes of physician time), but requires less work because it is done in a controlled setting with fluoroscopy to aid in placement. It is not similar to CPT codes 44500 and 74340 because placement of Miller-Abbott tubes is a more lengthy and involved procedure than placement of naso/oro gastric tubes. In fact, the physician time for placement of Miller-Abbott tubes is over 30 minutes, while placement of a naso/oro gastric tube takes about 15 minutes. We are assigning this G code a work RVU of 0.32, which is the sum of the work RVU for CPT code 76000 and the work intensity of CPT code 44500 times 15 minutes.

    Malpractice

    We are assigning 0.02 malpractice RVUs to this procedure.

    Practice Expense

    We believe this procedure will only be performed in facilities, so we are not assigning any practice expense inputs to this code.

    GO273 Radiopharmaceutical biodistribution, single or multiple scans on one or more days, pre-treatment planning for radiopharmaceutical therapy of non-Hodgkin's lymphoma, includes administration of radiopharmaceutical (e.g., radiolabeled antibodies).

    We are creating this code to describe radionuclide scanning to determine the biodistribution of Zevalin. The procedure encompasses administration of Indium labeled Zevalin followed by whole body radionucliide scanning 2-24 hours and 48-72 hours after the administration of Zevalin. Rarely, a third scan is necessary. The purpose of the scanning is to ensure that the biodistribution of Zevalin is normal, thus decreasing the risk of toxic effects from the administration of a therapeutic dose. The published criteria for determining appropriate biodistribution involve making a qualitative comparison of isotope uptake in several organ systems between the two scans. Therefore, these scans cannot be read in isolation, and this code should only be reported once, no matter how many scans are performed.

    Physician Work

    We are assigning 0.86 work RVUs to this code which is equivalent to the work for CPT code 78802, Radiopharmaceutical localization of tumor; whole body. We believe the total physician time of 41 minutes for CPT code 78802, and the intensity are similar to the time and intensity required for this service.

    Malpractice

    We are assigning 0.28 RVU to the global procedure, 0.25 RVU to the technical component, and 0.03 RVU to the professional component. These are identical values to CPT code 78802.

    Practice Expense

    The TC of this code is being priced in the nonphysician work pool, where we crosswalked it to the charge-based practice expense RVUs for CPT code 78802, taking into account that the radiopharmaceutical is administered once, but that there are two scans obtained.

    We wish to emphasize that this code is only reported once and includes the administration of the radiopharmaceutical and performance and interpretation of all scans. We also note that the infusion of rituxumab prior to the administration of Zevalin is separately payable.

    GO274 Radiopharmaceutical therapy, non-Hodgkin's lymphoma, includes administration of radiopharmaceutical (e.g., radiolabeled antibodies)

    We are establishing this code to allow appropriate reporting of this new service. Radiopharmaceutical therapy using radiolabeled monoclonal antibodies is a new form of treatment for non-Hodgkins lymphoma and is not currently described by any existing HCPCS code. Start Printed Page 80013

    After review of information regarding this service, we are assigning the following RVUs:

    Physician Work

    We believe that physicians typically take 60 minutes to perform this service on the day of the procedure. Of this time, 45 minutes is spent counseling the patient and family, while 15 minutes are spent setting up and infusing the radiopharmaceutical. Additionally, there is post-procedure time spent reviewing platelet counts, which requires calling the patient or another physician 25 percent of the time. We compared this procedure to the physician work RVUs, physician times, and intensity (RVU per minute) of other nuclear medicine and radiation oncology procedures CPT codes 79400, 77790, 79030, 79035, and 79100; infusion procedures CPT codes 36520, 36521, 37201, and 37202; hemodialysis CPT codes 90935, and 90937; evaluation and management CPT codes 99214 and 99215.

    Based on this comparison we are assigning a work RVU of 2.07 to this code. This represents the work of CPT code 99214 (counseling a complex patient), 15 minutes for infusion at an intensity of 0.05 RVU per minute (similar to the intensity of CPT code 77790), and 10 minutes of post service work (at an intensity of 0.022 RVU per minute). This also places the code in the correct rank order with all of the above procedures.

    Malpractice

    We are assigning malpractice RVUs of 0.20 to this procedure, with 0.12 assigned to the technical component and 0.08 assigned to the professional component. These are identical to the RVUs for CPT code 79400.

    Practice Expense

    The TC of this code is being priced in the nonphysician workpool where we crosswalked it to the charge-based practice expense RVUs for CPT code 79400.

    GO275 Renal angiography (unilateral or bilateral) performed at the time of cardiac catheterization, includes catheter placement in the renal artery, injection of dye, flush aortogram and radiologic supervision and interpretation and production of images (List separately in addition to primary procedure) and

    GO278 Iliac artery angiography performed at the same time of cardiac catheterization, includes catheter placement in the iliac artery, injection of dye, radiologic supervision and interpretation and production of images (List separately in addition to primary procedure)

    We are creating these add-on codes to assure proper reporting of and payment for renal and iliac angiography performed at the time of cardiac angiography. These procedures are performed frequently on Medicare patients and are currently reported using codes that describe placement of a catheter in the renal and/or iliac artery(s) (CPT codes 36245 and 36246) and radiological supervision and interpretation of renal and/or iliac angiography (CPT codes 75710, 75716, 75722, and 75724).

    Physician Work

    Based on the information we reviewed, the typical performance of these procedures involves the use of a pigtail catheter positioned in the aorta (not the renal or iliac artery(s)), injection of a minimal dye load (because of the heavy dye load already used for cardiac angiography), and viewing the dye run off into the proximal main renal or iliac arteries under fluoroscopy. We determined work values for these procedures by using the work values for CPT codes 75625, Aortography, abdominal, by serialography, radiological supervision and interpretation (1.14 work RVUs with 22 minutes of physician time) and 93544, Injection procedure during cardiac catheterization; for aortography (0.25 work RVUs and 5 minutes of physician time) and adjusting for a procedure time of approximately two and one half minutes. This process yields a value of 0.25 work RVUs, which is what we are assigning to these two add-on procedures.

    Malpractice

    We are crosswalking the 0.01 malpractice RVUs for CPT code 93544 to these procedures.

    Practice Expense

    We are not assigning any practice expense inputs to these procedures because the incremental increase in staff and room time to perform these procedures is negligible.

    GO279 Extracorporeal shock wave therapy; involving elbow epicondylitis.

    GO280 Extracorporeal shock wave therapy; involving other than elbow epicondylitis or plantar fascitis.

    CPT code 0020T Extracorporeal Shock Wave Therapy; involving plantar fascia

    We are creating and establishing a national payment amount for two G-codes describing extracorporeal shock wave therapy for the musculoskeletal system and establishing a national payment amount for CPT code 0020T. We are doing this in response to multiple requests from our contractors to establish a national payment amount, though creation of these codes does not imply that services will be covered by Medicare. We also note that this form of therapy was recently approved by the Food and Drug Administration for treatment of lateral epicondylitis. Our staff has reviewed the method of treatment and we are establishing work, practice expense, and malpractice RVUs for these codes.

    We believe these services are similar to other physical therapy modalities and are designating it to be paid on the therapy fee schedule. Based on the information we reviewed, these services are typically performed by a technician similar to a physical therapy aide and take about 20 minutes to perform.

    Physician Work

    We compared these services to other physical therapy services and believe they are most similar to unattended physical therapy modalities such as diathermy. We are assigning a work RVU of 0.06 for these procedures in order to place them in proper rank order with other unattended physical therapy services.

    Malpractice

    We are crosswalking the malpractice RVUs (0.01) from CPT code 97024, Application of a modality to one or more areas; diathermy, to these procedures.

    Practice Expense

    We are assigning the following practice expense inputs:

    • Staff/Time: Physical therapy aide; 30 minutes.
    • Supplies: Ultrasound Gel.
    • Equipment: Shock wave machine.

    We note that, for lateral epicondylitis, the typical treatment regimen is up to 3 total treatments at weekly intervals.

    Electrical Stimulation for Wound Care

    GO281 Electrical stimulation, (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care; and

    GO282 Electrical stimulation, (unattended), to one or more areas, for wound care other than described in G0281 and

    GO283 Electrical stimulation, (unattended), to one or more areas, for indication(s) other than wound care, as part of a therapy plan of care. Start Printed Page 80014

    These three new G codes have been created to implement the coverage determination on use of electrical stimulation for wound care.

    The work, practice expense, and malpractice values for CPT code 97014 Application of a modality to one or more areas; electrical stimulation (unattended) will be crosswalked to these new G codes, but G0282 will not be covered by Medicare. In addition, CPT code 97032, Application of a modality to one or more areas: electrical stimulation (manual), each 15 minutes, should not be utilized for any wound care.

    The coverage determination that allowed coverage for the use of electrical stimulation for certain types of wound care also stated that another similar modality, electromagnetic stimulation, would not be covered. A G code, “G0295: Electromagnetic stimulation, to one or more areas” will be created to describe this service, since this service would otherwise have been coded using CPT code 97039 and would have required manual claims review. The new code, G0295, will be listed as non-covered by Medicare.

    GO288 Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery.

    We are creating this code to assure accurate reporting of this service by independent diagnostic testing facilities (IDTFs) that perform this service. Facilities that perform this service (either at the facility or under arrangement) report this service through the use of a “C” code specific to hospital reporting.

    This code is a technical component code only since the service provided by the IDTF includes receipt of a Computed Tomographic Angiogram (CTA), post CTA processing using specialized software, and burning the 3D model onto a CD and returning it to the operating surgeon. This 3D model is used to assist vascular surgeons in planning for, or monitoring the results of, endovascular aneurysm repair. The service is a technical service provided under the general supervision of a physician according to the supervision requirements for IDTFs. We compared this procedure to CPT codes 74175, Computed tomagraphic angiography, abdomen, without contrast material(s), followed by contrast material(s) and further sections, including image post-processing and 76375, Coronal, sagital, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computerized axial tomography, magnetic resonance imaging, or other tomographic modality. Based on this review, we developed practice expense RVUs using the nonphysician workpool methodolgy. The malpractice RVUs will be crosswalked from CPT code 76375 directly and will be set at 0.15 RVUs.

    GO289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chrondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee.

    We are creating this code to permit appropriate reporting of arthroscopic procedures performed in different compartments of the same knee during the same operative session. This is an add-on code and should be added to the knee arthroscopy code for the major procedure being performed. This code is only to be reported once per extra compartment, even if both chondroplasty, loose body removal, and foreign body removal are performed. The code may be reported twice (or with a unit of two) if the physician performs these procedures in two compartments in addition to the compartment where the main procedure was performed.

    This code should only be reported if the physician spends at least 15 minutes in the additional compartment performing the procedure. It should not be reported if the reason for performing the procedure is due to a problem caused by the arthroscopic procedure itself. This code is to be used when a procedure is performed in the lateral, medial, or patellar compartments in addition to the main procedure. However, CPT codes 29874, Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochrondritis dissecans fragmentation, chondral fragmentation) and 29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chrondroplasty) may not be billed with other arthroscopic procedures on the same knee.

    Physician Work

    We examined the work RVUs, the intra-operative work intensity, and the intra-operative times for CPT codes 29874 and 29877. We also compared these intensities and times to those for CPT code 29870, the base procedure for this family. We determined a work value using the intra-operative intensity for CPT code 29874 (which is higher than for CPT code 29877) and the mean intra-operative times (for CPT codes 29874 and 29877) beyond the time required for CPT code 29870 (14 minutes for CPT code 29874 and 27 minutes for CPT code 29877). This code represents approximately 20 minutes of extra work at a high level of intensity. Therefore, the work value we are assigning to this code is 1.48 RVUs.

    Malpractice

    We are assigning 0.27 malpractice RVUs to this procedure. This is the sum of the malpractice RVUs for CPT codes 29874 and 29877 beyond the malpractice RVUs for CPT code 29870, divided by two.

    Practice Expense

    We are not assigning any practice expense inputs to this code because it is an add-on code that will only be performed in the facility setting.

    Revisions to G Codes

    We are also revising the descriptors for the following existing G codes as follows:

    G0179 Physician recertification services for Medicare-covered services provided by a participating home health agency (patient not present) including review of subsequent reports of patient status, review of patient's responses to the OASIS assessment instrument, contact with the home health agency to ascertain the follow-up implementation plan of care, and documentation in the patient's office record, per certification period and

    G0180 Physician certification services for Medicare-covered services provided by a participating home health agency (patient not present), including review of initial or subsequent reports of patient status, review of patient's responses to the OASIS assessment instrument, contact with the home health agency to ascertain the initial implementation plan of care, and documentation in the patient's office record, per certification period

    Comment: Individuals have requested clarification as to whether a review of OASIS data is required when a physician bills for the certification and re-certification of home health plans of care.

    Response: The review of OASIS data, although not required for the performance of either a certification or re-certification of a home health plan of care, is considered a valuable tool to be utilized in the performance of both a certification or re-certification of a home health plan of care. We agree that the current HCPCS code(s) descriptors are unclear and will revise the descriptors to identify the review of OASIS as an option as opposed to a requirement. The descriptors are being revised as follows:

    G0179 Physician re-certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial Start Printed Page 80015implementation of the plan of care that meets patient's needs, per re-certification period.

    G0180: Physician certification for Medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implementation of the plan of care that meets patient's needs, per certification period.

    G0236 Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, diagnostic mammography (list separately in addition to code for primary procedure)

    Comment: Individuals have requested that we establish additional G-codes that would specify the use of computer-aided detection with direct digital image mammograms. Currently, the descriptors associated with HCPCS code G0236 (diagnostic) and CPT code 76085 (screening) refer not only to the application of computer-aided detection but also to the conversion of film images to digital images.

    Response: When the computer-aided detection codes were originally assigned, we intended that they would be used for the application of computer-aided detection to both direct digital images and to standard film images that were converted to digital images. The current descriptors of both HCPCS code G0236 and CPT code 76085 do not explicitly state that the code can be billed in conjunction with either direct digital images or standard film images converted to digital images. We have revised the descriptor associated with the application of computer-aided detection to diagnostic images (HCPCS code G0236) to incorporate both direct digital images and standard film images converted to digital images. Additionally, we will request that the CPT editorial panel review the current definition associated with the screening computer-aided detection code (CPT code 76085) for future revision. Until such time as a revision is made to CPT code 76085, physicians should use CPT code 76085 for both direct digital screening images as well as for standard film screening images that are converted to digital images.

    G0236 is revised to read as follows: Digitization of film radiographic images with computer analysis for lesion detection, or computer analysis of digital mammogram for lesion detection, and further physician review for interpretation, diagnostic mammography (List separately in addition to code for primary procedure).

    G0239 Therapeutic procedures to improve respiratory function, other than services described by G0237, two or more (includes monitoring).

    For clarity, and to address concerns expressed by individuals about how to code group treatment of patients with procedures described in G0237, we are revising the descriptor for G0239 to read as follows:

    G0239 Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more (includes monitoring).

    Deletion of G Codes

    We will be deleting the following G codes for CY 2003: G0002 Office procedure, insertion of temporary indwelling catheter, foley type (separate procedure)

    Services formerly billed under G0002 will be billed under CPT codes 51702 Insertion of temporary indwelling bladder catheter; simple (e.g., Foley) or 51703 Insertion of temporary indwelling bladder catheter; complicated (e.g., altered anatomy, fractured catheter/balloon).

    G0004 Patient demand single or multiple event recording with pre-symptom memory loop and 24 hour attended monitoring, per 30 day period; includes transmission, physician review and interpretation; G0005 Patient demand single or multiple event recording with pre-symptom memory loop and 24 hour attended monitoring, per 30 day period; recording (includes hook-up, recording and disconnection); G0006 Patient demand single or multiple event recording with pre-symptom memory loop and 24 hour attended monitoring, per 30 day period; 24 hour attended monitoring, receipt of transmissions, and analysis; and G0007 Patient demand single or multiple event recording with pre-symptom memory loop and 24 hour attended monitoring, per 30 day period; physician review and interpretation only.

    Services formerly billed under G0004 will be billed using CPT code 93268, Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; includes transmission, physician review and interpretation; services billed using G0005 will be billed using CPT code 93270, Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; recording (includes hook-up, recording and disconnection); services billed using G0006 will be billed using CPT code 93271, Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; monitoring, receipt of transmissions and analysis; services billed using G0007 will be billed using CPT code 93272 Patient demand single or multiple event recording with presymptom memory loop, 24-hour attended monitoring, per 30 day period of time; physician review and interpretation only, and services billed using G0015 will be billed using CPT code 93012 Telephonic transmission of post-symptom electrocardiogram rhythm strip(s), per 30 day period of time, tracing only. Unattended monitoring of patient demand single or multiple event recording with presymptom memory loop, per 30 day period of time and unattended telephonic transmission of post symptom electrocardiogram rhythm strip(s), per 30 day period of time should be billed using CPT code 93799, Unlisted cardiovascular service or procedure.

    G0050 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound

    Services formerly billed under G0050 will be billed using CPT code 51798.

    G0131 Computerized tomography bone mineral density study, one or more sites; axial skeleton (e.g., hips, pelvis, spine) and G0132 Computerized tomography bone mineral density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel).

    Services formerly billed under G0131 will be billed using CPT code 76070, and those billed under G0132 will be billed using CPT code 76071.

    G0185 Destruction of localized lesion of choroids for example, choroidal neovascularization; transpupillary thermotherapy (one or more sessions) and G0186 Destruction of localized lesion of choroids for example, choroidal neovascularization; photocoagulation, feeder vessel technique (one or more sessions).

    Services formerly billed under G0185 will be billed using CPT code 0016T, Destruction of localized lesion of choroids (e.g., choroidal revascularization), transpupillary thermotherapy, and G0186 will be billed using CPT code 0017T, Destruction of macular drusen, photocoagulation.

    G0193 Endoscopic study of swallowing function (also fiberoptic endoscopic evaluation of swallowing (FEEST)), G0194 Sensory testing during endoscopic study of (add-on code) referred to as fiberoptic endoscopic evaluation of swallowing Start Printed Page 80016with sensory (FEEST), G0195 Clinical evaluation of swallowing function (not involving interpretation of dynamic radiological studies or endoscopic study of swallowing), and G0196 Evaluation of swallowing involving swallowing of radio-opaque materials.

    Services formerly billed under G0193 will be billed using new CPT code 92612; services billed using G0194 will be billed using new CPT code 92614; services billed using G0195 will be billed using new CPT code 92610; and G0196 should be billed using new CPT code 92611.

    G0197 Evaluation of patient for prescription of speech generating devices, G0198 Patient adaptation and training for use of speech generating devices, G0199 Re-evaluation of patient using speech generating devices, G0200 Evaluation of patient for prescription of voice prosthetic, and G0201 Modification or training in use of voice prosthetic.

    Services formerly billed under G0197 will be billed using CPT code 92607 Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour, and, if appropriate, CPT code 92608, Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes; services billed using G0198 will be billed using CPT code 92609 Therapeutic services for the use of speech-generating device, including programming and modification; services billed using G0199 will be billed using CPT code 92607, using the -52 modifier if the service is less than 1 hour; services billed using G0200 will be billed using revised CPT code 92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech; and services billed using G0201 will be billed using CPT code 92507.

    G0240 Critical Care Service delivered by a physician; face-to-face, during inter-facility transport of a critically ill or critically injured patient: first 30-74 minutes of active transport, and G0241—each additional 30 minutes (list separately in addition to G0240)

    Services formerly billed under G0240 and G0241 will be billed using CPT codes 99289 and 99290.

    V. Update to the Codes for Physician Self-Referral Prohibition

    A. Background

    On January 4, 2001 we published in the Federal Register a final rule with comment period, “Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships” (66 FR 856). That final rule incorporated into regulations the provisions in paragraphs (a), (b) and (h) of section 1877 of the Act. Section 1877 of the Act prohibits a physician from referring a Medicare beneficiary for certain “designated health services” to a health care entity with which the physician (or a member of the physician's immediate family) has a financial relationship, unless an exception applies. In the final rule, we published an attachment listing all of the CPT and HCPCS codes that defined the entire scope of the following designated health services for purposes of section 1877 of the Act: clinical laboratory services; physical therapy services (including speech-language pathology services); occupational therapy services; radiology and certain other imaging services; and radiation therapy services and supplies.

    In the January 2001 final rule, we stated that we would update the list of codes used to define these designated health services in an addendum to the annual physician fee schedule final rule. The purpose of the update is to conform the code list to the most recent publications of CPT and HCPCS codes. An updated all-inclusive list of codes was included in the November 1, 2001 physician fee schedule final rule in Addendum E and was subsequently corrected in a notice that was published in the Federal Register (66 FR 20681) on April 26, 2002.

    The updated all-inclusive list of codes effective for January 1, 2003 is presented in Addendum E in this final rule. It is our intent to always use Addendum E of the annual physician fee schedule final rule for the physician self-referral update. The updated all-inclusive list of codes will also be available on our Web site at http://cms.hhs.gov/​medlearn/​refphys.asp.

    B. Response to Comments

    We received three comments regarding the code list. The comments and our responses are stated below.

    Comment: One commenter agreed with the additions and deletions to the list of designated health services as published in the November 1, 2001 physician fee schedule final rule (66 FR 55312). The commenter expressed the understanding that we would address the comments regarding the original list of designated health services (published in the January 4, 2001 final rule) in a second final rule on the physician self-referral prohibition. A second commenter raised concerns about our decision (announced in the January 4, 2001 final rule) to exclude nuclear medicine from the definition of “radiology and certain other imaging services.”

    Response: The first commenter is correct in understanding that we intend to address substantive comments on the designated health services that are defined by reference to HCPCS and CPT codes in a second final rule concerning the physician self-referral prohibition. We will also address the second commenter's concerns regarding nuclear medicine in that final rule. As noted above, this update to the code list merely reflects changes to the most recent publications of HCPCS and CPT codes.

    Comment: One commenter noted that we post on our Web site (http://www.hcfa.gov/​stats/​cpt/​rvudown.htm) an Excel spreadsheet file containing all of the CPT/HCPCS codes with accompanying RVUs. The commenter suggested that we add a column indicating whether a code is considered a designated health service for purposes of the physician self-referral law, as well as in which category of designated health services it would be included. The commenter stated that, as changes are made, they would be scattered throughout several physician fee schedules.

    Response: We believe that the commenter was concerned that updates to the list of designated health services under the physician self-referral law would be published in various fee schedules throughout the course of a year. This is not the case. We publish the annual update and the entire list of CPT/HCPCS codes in the physician fee schedule final rule. (Addendum E contains the updated all-inclusive list of codes.) We have no plans to publish an updated list of codes for physician self-referral purposes in any other fee schedule. We chose the physician fee schedule, as opposed to one of the other fee schedules, because we believe that physicians would be more likely to see it. We maintain a current list of codes used to define certain designated health services for purposes of the physician self-referral law on our Web site at http://cms.hhs.gov/​medlearn/​refphys.asp. We have decided not to make any changes to the RVU website at this time because we believe the updated all-inclusive list of codes used for purposes of physician self-referral is readily available to all physicians.

    C. Revisions Effective for 2003

    Table 9, below, identifies the additions and deletions to the comprehensive list of physician self-referral codes published in Addendum Start Printed Page 80017E of the November 2001 physician fee schedule final rule and subsequently corrected in the April 26, 2002 correction notice (66 FR 20681). Table 9 also identifies the additions, deletions and revisions to the lists of codes used to identify the items and services that may qualify for the exceptions in § 411.355(g) (regarding EPO and other dialysis-related outpatient prescription drugs furnished in or by an end-stage renal dialysis (ESRD) facility) and in § 411.355(h) (regarding preventive screening tests, immunizations and vaccines).

    We will consider comments with respect to the codes listed in Table 9 below, if we receive them by the date specified in the DATES section of this final rule.

    Table 9.—Additions and Deletions to the Physician Self-Referral Codes

    HCPCSCPT 1/Descriptor
    Additions:
    51798Us urine capacity measure
    76070Ct bone density, axial
    76071Ct bone density, peripheral
    76801Ob us < 14 wks, single fetus
    76802Ob us < 14 wks, addl fetus
    76811Ob us, detailed, sngl fetus
    76812Ob us, detailed, addl fetus
    92601Cochlear implt f/up exam < 7
    92602Reprogram cochlear implt < 7
    92603Cochlear implt f/up exam 7 >
    92604Reprogram cochlear implt 7 >
    92607Ex for speech device rx, 1hr
    92608Ex for speech device rx addl
    92609Use of speech device service
    92610Evaluate swallowing function
    92611Motion fluoroscopy/swallow
    92612Endoscopy swallow tst (fees)
    92614Laryngoscopic sensory test
    92616Fees w/laryngeal sense test
    0010TTB test, gamma interferon
    0019TExtracorp shock wave tx, ms
    0020TExtracorp shock wave tx, ft
    0023TPhenotype drug test, HIV 1
    0026TMeasure remnant lipoproteins
    0028TDexa body composition study
    0029TMagnetic tx for incontinence
    0030TAnitprothrombotin antibody
    0041TDetect UR infect agnt w/cpas
    0042TCt perfusion w/contrast, cbf
    0043TCo expired gas analysis
    G0256Prostate brachy w palladium
    G0261Prostate brachytherapy w/rad
    G0262Sm intestinal image capsule
    G0274Radiopharm tx, non-Hodgkins
    G0279Excorp shock tx, elbow epi
    G0280Excorp shock tx other than
    G0281Elec stim unattend for press
    G0283Elec stim other than wound
    G0288Recon, CTA for surg plan
    J0636Inj calcitriol per 0.1 mcg
    J1756Iron sucrose injection
    J2501Paricalcitol
    J2916Na ferric gluconate complex
    Q3021Ped hepatitis b vaccine inj
    Q3022Hepatitis b vaccine adult ds
    Q3023Injection hepatitis Bvaccine
    Deletions:
    76830Us, exam transvaginal
    76872Echo exam, transrectal
    76873Echograp trans r, pros study
    86915Bone marrow/stem cell prep
    90744Hepb vacc ped/adol 3 dose im
    90746Hep b vaccine, adult, im
    90747Hepb vacc, ill pat 4 dose im
    92510Rehab for ear implant
    97014Electric stimulation therapy
    G0026Fecal leukocyte examination
    G0027Semen analysis
    G0050Residual urine by ultrasound
    G0131CT scan, bone density study
    G0132CT scan, bone density study
    G0193Endoscopicstudyswallowfunctn
    Start Printed Page 80018
    G0194Sensorytestingendoscopicstud
    G0195Clinicalevalswallowingfunct
    G0196Evalofswallowingwithradioopa
    G0197Evalofptforprescipspeechdevi
    G0198Patientadapation&trainforspe
    G0199Reevaluationofpatientusespec
    G0200Evalofpatientprescipofvoicep
    G0201Modifortraininginusevoicepro
    J0635Calcitriol injection
    J1755Iron sucrose injection
    J2915NA Ferric Gluconate Complex
    Revisions:
    76085Computer mammogram add-on [when used in conjunction with 76092]
    1 CPT codes and descriptions only are copyrighted in the 2002 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.

    The “Additions” section of Table 9 generally reflects new CPT and HCPCS codes that become effective January 1, 2003. The one exception is the addition of the following emerging technology codes, referred to as Category III codes, which the AMA first included in the CPT effective January 1, 2002: 0010T, 0019T, 0020T, 0023T, and 0026T. CPT codes 0010T, 0023T, and 0026T represent clinical laboratory services while CPT codes 0019T and 0020T are therapy codes. These codes were addressed in the November 2001 physician fee schedule final rule with the clarification that coverage and payment of these services is generally at the discretion of the carrier. However, the portion of the November 2001 final rule that concerned the list of codes for physician self-referral purposes failed to address these new codes. Thus, we are adding the Category III codes that should have been included in last year's update. We also are adding the following new Category III codes issued for 2003 to which the physician self-referral prohibition applies: 0028T, 0029T, 0030T, 0041T, 0042T, and 0043T. CPT codes 0028T and 0042T are radiology services; CPT code 0029T is a physical therapy service; and, CPT codes 0030T, 0041T and 0043T are clinical laboratory services.

    Table 9 also reflects the addition of 4 new codes (J0636, J1756, J2501 and J2916) to the list of dialysis-related outpatient prescription drugs that may qualify for the exception described in § 411.355(g) regarding those items. The physician self-referral prohibition will not apply to these drugs if they meet the conditions set forth in § 411.355(g). Table 9 also reflects the addition of 3 vaccine codes (Q3021, Q3022 and Q3023) to the list that identifies preventive screening tests, immunizations and vaccines that may qualify for the exception described in § 411.355(h) for such items and services. The physician self-referral prohibition will not apply to these vaccines if they meet the conditions set forth in § 411.355(h) concerning the exception for preventive screening tests, immunizations, and vaccines.

    With the exception of CPT codes 76830, 76872 and 76873 for ultrasounds, the “Deletions” section of Table 9 reflects changes necessary to conform the code list to the most recent publications of CPT and HCPCS codes. We are deleting CPT code 76830 for transvaginal ultrasound and CPT codes 76872 and 76873 for transrectal ultrasounds because these codes should never have appeared on the list of designated health services. Our definition of “radiology and certain other imaging services” published in the January 2001 final rule (66 FR 956) specifically excludes any ultrasonic procedure that requires “the insertion of a needle, catheter, tube, or probe”. Thus, although the deletion of these codes is not a change to conform to an annual change in CPT or HCPCS codes, we are making the change at this time so that the list of codes will accurately reflect the regulatory definition for “radiology and certain other imaging services.”

    Table 9 includes one revised CPT code. That is CPT code 76085, “Computer mammogram add-on.” In the CPT publication effective January 1, 2003, the CPT long descriptor was changed to delete the word “screening” so that the digitization no longer refers only to screening mammography. Because our exception under § 411.355(h) applies to preventive screening tests, we have revised the list of codes that may qualify for that exception to indicate that CPT code 76085 may qualify for the exception only when it is used in conjunction with CPT code 76092, “Mammogram screening.”

    VI. Physician Fee Schedule Update for Calendar Year 2003

    A. Physician Fee Schedule Update

    The physician fee schedule update is determined under a calculation methodology that is specified by statute. Under section 1848(d)(4) of the Act, the update is equal to the product of 1 plus the percentage increase in the Medicare Economic Index (MEI) (divided by 100) and 1 plus the update adjustment factor. For CY 2002, the MEI is equal to 3.0 percent (1.030). The update adjustment factor is equal to -7.0 percent (0.930). Section 1848(d)(4)(F) of the Act requires an additional -0.2 percent (0.998) reduction to the update for 2003. Thus, the product of the MEI (1.030), the update adjustment factor (0.930), and the statutory adjustment factor (0.998) equals the CY 2003 update of -4.4 percent (0.956).

    The Department believes that the negative update is inappropriate because the current update system does not reflect actual, after the fact, data from earlier years. Instead, the Act requires the Department to rely upon estimates made in past years, even though the Department now has actual data for these particular years. Even though after-the-fact data show that for certain years actual increases differed to some degree from earlier estimates, the Department is unable to revise estimates without congressional action. We have exhaustively searched for a different interpretation of law that would allow us to revise estimates for earlier years administratively, but unfortunately, we had to conclude that current law does not permit such an interpretation.

    Without congressional action to address the current legal framework, the Department is compelled to announce a Start Printed Page 80019physician fee schedule update for CY 2003 of -4.4 percent. The Department's calculations are explained below.

    We have, however, also identified reasonable adjustments that could result in a positive update in physician fee schedule rates if the Department were permitted by law to make those adjustments. Revisions of estimates used to establish the sustainable growth rates (SGR) for fiscal years (FY) 1998 and 1999 and Medicare volume performance standards (MVPS) for 1990 through 1996 could, under present estimations, result in an increase in the update.

    The Department intends to work closely with the Congress to develop legislation that could permit a positive update, and hopes that such legislation can be passed before the negative update takes effect. Because the Department wishes to take action immediately in the event that Congress provides the Department legal authority to make the corrections, we are requesting comments regarding how physician fee schedule rates could and should be recalculated prospectively in the event that Congress provides the Department with legal authority to revise estimates used to establish the sustainable growth rates (SGR) for FYs 1998 and 1999 and the MVPS for 1990-1996.

    B. The Percentage Change in the Medicare Economic Index

    1. Medicare Economic Index (MEI) Productivity Adjustment

    In the June 28, 2002 proposed rule, we reviewed the history of the MEI productivity adjustment, described the current MEI productivity adjustment, identified and evaluated possible alternative MEI productivity adjustments based on the individual contributions we solicited from experts on this topic, and proposed changing the MEI productivity adjustment to reflect an economy-wide multifactor productivity adjustment. In this final rule, we repeat this research information, respond to public comments on the MEI, and determine the CY 2003 MEI using the proposed methodological change.

    a. History of MEI Productivity Adjustment

    The MEI is required by section 1842(b)(3)(L) of the Act which states that prevailing charge levels beginning after June 30, 1973 may not exceed the level from the previous year except to the extent that the Secretary finds, on the basis of appropriate economic index data, that such higher level is justified by year-to-year economic changes. S. Rep. No. 92-1230, at 191 (1972) provides slightly more detail on that index, stating that:

    Initially, the Secretary would be expected to base the proposed economic indexes on presently available information on changes in expenses of practice and general earnings levels combined in a manner consistent with available data on the ratio of the expenses of practice to income from practice occurring among self-employed physicians as a group.

    Consistent with section 1842(b)(3)(L) and legislative intent, in 1975, we determined that the MEI would be based on a broad wage measure reflecting overall earnings growth, rather than direct inclusion of physicians' net income. We used average weekly earnings of nonagricultural production (non-supervisory) workers, net of worker's productivity, as the wage proxy in the initial MEI. We included the productivity adjustment because it avoided double counting of gains in earnings resulting from growth in productivity and produced an MEI that approximated an economy-wide output price index similar to the Consumer Price Index (CPI). The productivity adjustment we used was the annual change in economy-wide private non-farm business labor productivity, applied only to the physicians' earnings portion of the MEI (then 60 percent).

    As noted, the productivity adjustment in the MEI serves to avoid the double counting of productivity gains. Absent the adjustment, productivity gains from producing additional outputs (procedures) with a given amount of inputs would be included in both the earnings component of the MEI (reflecting growth in overall economy-wide wages) and in the additional procedures that are billed (reflecting physicians' own productivity gains). Therefore, general economic labor productivity growth is removed from the labor portion of the MEI.

    Although the basic structure of the MEI remained relatively unchanged from its effective date (July 1, 1975) until 1992, its weights were updated periodically and a component was added for professional liability insurance. Section 9331 of the Omnibus Budget Reconciliation Act of 1986 (Pub. L. 99-509) (OBRA 86) mandated that we conduct a study of the structure of the MEI and prepare a notice and offer the public an opportunity to comment before we revise the methodology for calculating the MEI. Based on this requirement, we held a workshop with experts on the MEI in March 1987 to discuss topics ranging from the specific type of index to use (Laspeyres versus Paasche) to revising the method of reflecting productivity changes. Participants included the Federal government, the Physician Payment Review Commission (PPRC), the Congressional Budget Office, the AMA, and several private consulting firms. The meeting participants concluded that a productivity adjustment in the MEI was appropriate and that an acceptable measure of physician-specific productivity did not currently exist. Many alternative approaches were discussed, including the use of a policy-based “target” measure and several existing economic productivity measures.

    Using recommendations from the meeting participants, we revised the MEI and the productivity adjustment with the implementation of the physician fee schedule as discussed in the November 1992 final rule (57 FR 55896). While we retained an adjustment for economy-wide labor productivity, this adjustment was applied to all of the direct labor categories of the MEI (70.448 percent), not just physicians' earnings, and was based on the 10-year moving average percent change (instead of annual percent changes). This form of the index has been used since that time, and was most recently discussed in the November 1998 final rule (63 FR 58845) when the MEI weights were rebased to a 1996 base year.

    The BBA replaced the Medicare Volume Performance Standard (MVPS) with a Sustainable Growth Rate (SGR). The SGR is an annual growth rate that applies to physicians' services paid for by Medicare. The use of the SGR is intended to control growth in aggregate Medicare expenditures for physicians' services. Payments for services are not withheld if the percentage increase in actual expenditures exceeds the SGR. Rather, the physician fee schedule update, as specified in section 1848(d)(4) of the Act, is adjusted based on a comparison of allowed expenditures (determined using the SGR) and actual expenditures. If actual expenditures exceed allowed expenditures, the update is reduced. If actual expenditures are less than allowed expenditures, the update is increased. Specifically, the SGR is calculated on the basis of the weighted average percentage increase in fees for physicians' services, growth in fee-for-service Medicare enrollment, growth in real per capita Gross Domestic Product (GDP), and the change in expenditures on physicians' services resulting from changes in law or regulations. Start Printed Page 80020

    When the SGR was enacted, the Congress specified continued use of the MEI. By 1997, the MEI, including its productivity adjustment, had been used in updating Medicare payments to physicians for over twenty years. We did not propose any changes to the productivity adjustment used in the MEI when the SGR system was enacted because its continued use was consistent with the newly mandated formula. If we did not make a productivity adjustment in the MEI, general economic productivity gains would be reflected in two of the SGR factors, the MEI and real per-capita GDP (which reflects real GDP per hour worked, or labor productivity, and hours worked per person). We believe it is reasonable to remove the effect of general economic productivity from one of these factors (the MEI) to avoid double counting.

    As noted previously, since its original development, the MEI productivity adjustment has been based on economy-wide productivity changes. This practice arose from the fact that the physicians' compensation portion of the MEI is proxied to grow at the same rate as general earnings in the overall economy, which reflect growth in overall economy-wide productivity. Removing labor productivity growth reflected in general earnings from the labor portion of the MEI produces an index that is consistent with other economy-wide output price indexes, like the CPI.

    b. Research on Alternative MEI Productivity Adjustments

    In the June 2002 proposed rule we presented the research we completed on evaluating the most appropriate productivity adjustment for the MEI. This research included evaluating the currently available productivity estimates produced by the BLS to develop a better understanding of the strengths and weaknesses of these measures and reviewing the theoretical foundation of the MEI to understand how labor and multifactor productivity relate to the current physician payment system. We also studied the limited publicly available data to begin to develop preliminary estimates of trends in physician-specific productivity to better understand the current market conditions facing physicians. Finally, we solicited the individual contributions of academic and other professional economic experts on prices and productivity. These experts included individuals from the MedPAC, the AMA, the Office of Management and Budget (OMB), Dr. Uwe Reinhardt from Princeton University, Dr. Joe Newhouse from Harvard University, Dr. Ernst Berndt from MIT, and Dr. Joel Popkin from Joel Popkin and Company. Below we repeat the findings on each of the six options we investigated and detailed in the proposed rule:

    • Option 1—Using a physician-specific productivity adjustment.

    This option would entail using an estimate of physician-specific productivity to adjust the MEI. This option may have some theoretical attractiveness, but there are major problems in obtaining accurate measures of physician-specific productivity. First, no published measure of physician-specific productivity is available. The Federal agency that produces the official government statistics on productivity, BLS, does not calculate or publish productivity measures for any health sector. Nor are there alternative measures of physician-specific productivity that would conform to the BLS methodology for measuring productivity. Second, it is not clear that using physician-specific productivity within the current structure of the MEI would be appropriate. Because we believe the MEI appropriately uses an economy-wide wage measure as the proxy for physician wages, using physician specific productivity could overstate or understate the appropriate wage increases in the MEI.

    We do believe, however, that it is important to understand the rate of change in physician-specific productivity. Toward this end, we have performed our own preliminary analysis of physician-specific productivity, using the limited available data on physician outputs and inputs. Our analysis attempted to simulate the methodology the BLS would use to measure productivity. To help achieve this we have been in contact with experts at the BLS to obtain their feedback on our methodology. While this information cannot be interpreted as an official measure of physician productivity, we do believe it provides a rough indication of the current market conditions facing physicians. We used this information to aid in forming our determination of the most appropriate productivity adjustment to incorporate in the MEI, fully recognizing its preliminary nature and other limitations of our analysis. The results of our preliminary analysis suggest that long-run physician-specific productivity growth is currently near the level of economy-wide multifactor productivity growth. Prior to the recent period, however, our preliminary estimates suggested that physician productivity gains were generally significantly greater than general economy-wide multifactor productivity gains and more in line with economy-wide labor productivity.

    As we have emphasized, our rough estimates are inadequate for establishing a formal basis for the productivity adjustment to the MEI. In addition, the underlying economic theory is not sufficiently compelling, at this time, to adopt a physician-specific productivity measure, even if a suitable one were available. We conclude, however, that economy-wide multifactor productivity growth appears to be roughly comparable to our estimates of current physician-specific productivity growth.

    Comment: A few commenters urged us to develop a measure of productivity that more accurately reflects the conditions facing physicians. The commenters suggested that we consider issues like increased regulatory burden on physicians and the service-oriented nature of physician services.

    Response: As we stated in the June 2002 proposed rule and repeated above, no publicly available measure of physician productivity exists. In addition, no publicly available measure of service-sector productivity exists. Because of this it is not possible at this time to incorporate a productivity adjustment in the MEI that explicitly reflects physician marketplace characteristics.

    However, we do believe that it is important that the productivity adjustment included in the MEI be consistent with the market conditions facing physicians. As we have discussed in this final rule, we attempted to understand the trends in physician productivity by researching and making the most optimal use of the sparse data available. We will continue to refine this research, including soliciting contributions both from experts at BLS and outside experts on measuring productivity. In addition, we encourage the commenters to work with BLS to pursue the development of official measures of physician and health sector productivity.

    • Option 2—Using economy-wide labor productivity applied to the labor portion of the MEI.

    We have applied economy-wide labor productivity growth to a portion of the MEI in some form since the inception of the index in 1975. For the 2002 update, we applied the 10-year moving average percent change in economy-wide labor productivity to the labor portion of the MEI. This adjustment was developed based on the contributions of a 1987 expert panel. That panel concluded that applying labor productivity data to the labor portion of the index was a technically sound way to account for Start Printed Page 80021productivity in the physician update. This method made optimal use of the available data because labor productivity data were, and are, available on a more-timely basis than economy-wide multifactor productivity. By applying this measure to the labor portion of the index, the mix of physician-specific labor and non-labor inputs is reflected. Also, the use of a 10-year moving average percentage change reduces the volatility of annual labor productivity changes.

    Our research, however, has indicated that using multifactor productivity applied to the entire index is a superior method to using an economy-wide labor productivity measure applied only to the labor portion of the index. The experts with whom we consulted believed it was more appropriate to reflect the explicit contribution to output from all inputs. The current measure explicitly reflects the changes in economy-wide labor inputs but does not reflect the actual change in non-labor inputs. Instead, it implicitly assumes that non-labor inputs would grow at a rate necessary to produce an economy-wide multifactor measure that is equivalent to the current MEI productivity adjustment. That implicit assumption is less precise than a direct, explicit calculation.

    In addition, while the implicit approach produced an MEI productivity adjustment in most years that was reasonably consistent with overall multifactor productivity growth, it now appears less consistent with the actual change in non-labor inputs in the economy. In recent years, economy-wide labor productivity has grown very rapidly. This acceleration is partly the result of major investments in non-labor inputs that have helped to create a more productive work force. Also, the Bureau of Economic Analysis (BEA) adopted methodological changes in accounting for computer software purchases in measuring GDP. These changes have significantly increased the measured historical growth rates in real GDP and labor productivity. As a result of these developments, the current MEI productivity adjustment, applying labor productivity only to the labor portion of the MEI, has increased very rapidly. Because the multifactor definition is an explicit calculation of the change in economic output relative to the change in both labor and non-labor inputs, it better reflects the overall productivity trend changes.

    Finally, as noted previously, our preliminary estimates of physician-specific productivity suggest a current growth pattern that is similar to growth in multifactor productivity in the economy overall. In consideration of the economic theory underlying productivity measurement, especially in view of the recent developments in labor versus non-labor economic input growth trends, we concluded that using a multifactor productivity adjustment is superior to the current methodology for adjusting for productivity in the MEI.

    • Option 3—Change to using economy-wide multifactor productivity.

    The option we proposed in the June 2002 proposed rule was to adjust for productivity gains in the MEI using economy-wide multifactor productivity applied to the entire index, instead of labor productivity applied to the labor portion of the MEI. This option would better satisfy the theoretical requirements of an output price, in this case the MEI, by explicitly reflecting the productivity gains from all inputs. In addition, the use of economy-wide multifactor productivity would still be consistent with the MEI's use of economy-wide wages as a proxy for physician earnings. While annual multifactor productivity can fluctuate considerably, though usually less than labor productivity, using a moving-average would produce a relatively stable and predictable adjustment.

    Each expert with whom we consulted believed that using a multifactor productivity measure was theoretically superior to the previous methods used to adjust the MEI because it reflects the actual changes in non-labor inputs instead of reflecting an implicit assumption about those changes. These experts also believed that the lack of timely data on multifactor productivity was not as important as would have appeared initially. Instead, they believed it was more appropriate that the adjustment be based on a long-run average that was stable and predictable rather than on annual changes in productivity. Thus, if a long-run average were used, the increased lag time associated with the availability of published data on multifactor productivity becomes less significant. Finally, one expert believed that changing to economy-wide multifactor productivity applied to the entire MEI would make it easier to understand the magnitude of the productivity adjustment.

    However, use of multifactor productivity to adjust the MEI poses two concerns. First, multifactor productivity is much harder to measure than labor productivity. Economic inputs other than labor hours can be very difficult to identify and calculate properly. The experts at BLS, however, have adequately overcome these difficulties, and we are satisfied that their official published measurements are sound for the purpose at hand. Moreover, use of a 10-year moving average increase helps to mitigate any remaining measurement variation from year to year.

    The second concern relates to the timeliness of the data. BLS publishes multifactor productivity levels and changes annually (as opposed to the quarterly release of labor productivity data) and with an extended time lag (about 11/2 years). These timeframes arise unavoidably from the difficulties of measuring non-labor input as mentioned above, but would result in a misalignment of the data periods for the data used to adjust the MEI and of the historical data on wages and prices underlying the MEI. For the CY 2003 physician payment update, for example, we would use data on wages and prices through the second quarter of CY 2002, but would have to use multifactor productivity data through CY 2000. Although the misalignment of data periods is a concern, we believe it is a reasonable trade-off in view of the improvement offered by an explicit measurement of non-labor inputs. Also, because use of a 10-year moving average is intended to reduce fluctuations and provide a more stable level of the productivity adjustment, availability of the most recent data is of less importance.

    The 10-year moving average percent change in economy-wide multifactor productivity that would be used for the CY 2003 update (historical data through CY 2000) is estimated at 0.8 percent. Our preliminary internal analysis of physician-specific productivity gains suggests that these economy-wide multifactor measures are consistent with those trends. Thus, using economy-wide multifactor productivity for MEI productivity adjustment theoretically would be superior to using labor productivity growth applied to the labor portion of the MEI.

    • Option 4—Change to using economy-wide multifactor productivity with physician-specific input weights

    Another option we explored was using economy-wide labor and capital productivity measures (which, when weighted together, produce multifactor productivity), but with physician-specific input weights. This method would better reflect the proportion of labor and capital inputs used by physicians, and reflect the explicit contribution to productivity of labor and non-labor inputs. The experts with whom we discussed this option thought it was theoretically consistent with a measure of multifactor productivity, even though different productivity Start Printed Page 80022measures would be applied to different components of the MEI.

    A weakness of this method is that the BLS capital productivity series is not widely used or cited; therefore, we are unsure of the accuracy and reliability of this measure. This method also adds another layer of complexity to the formula, making it more difficult to understand the adjustment. We would prefer that any method we choose be straightforward so that it can be readily understood. Moreover, the labor and capital shares for the overall economy do not appear to vary enough from the physician-specific shares in the MEI to result in a significantly different measure. Overall, we believe that this method does not provide enough of a technical improvement to justify the added complexity that would be required to implement it.

    • Option 5—Adjusting productivity using a “Policy Standard”.

    In its March 2002 Report to the Congress, MedPAC suggested establishing a policy target for the productivity adjustment. Under this methodology, the level of the policy target would be based on the productivity gains that physicians could reasonably be expected to attain. This level would be set through policy and would likely be based on a long-run average of either economy-wide labor or multifactor productivity (but could reflect other, possibly judgmental, factors). Generally, the level of the policy standard would remain constant for several years, and periodically would be reviewed and adjusted as needed.

    Some of the experts we consulted believed that a policy target would lessen the volatility of the adjustment because the target would not be changed often. Conversely, others noted the large, abrupt changes that could result if actual economic performance deviated from the policy standard requiring subsequent adjustments to the standard. Some believed that this method adjusts for the problem of precisely measuring productivity. If we used a policy standard we could avoid having to develop an exact measure. Using a policy target, however, may appear arbitrary without a theoretical basis to support its use.

    The policy target recommended by the MedPAC was 0.5 percentage points per year. The MedPAC's justification for this number was that the long-run average of economy-wide multifactor productivity was close to 0.5 percent (the most recent 10-year average is now 0.8 percent). We do not believe this is a preferred option for adjusting the MEI for productivity improvements. Our preference is to use a data based approach that automatically reflects changes in actual economic performance over time, and not through abrupt periodic, possibly large adjustments. Thus, we conclude that a policy target does not provide an improvement over any of the data based methodologies.

    Comment: One commenter recommended the productivity adjustment be removed from the MEI to make the index more consistent with our other market baskets.

    Response: Since its inception in 1975 the MEI has included a productivity adjustment. By including the productivity adjustment in the MEI and using a general earnings proxy for physician wages, the index approximated an economy-wide output price index like the CPI. This original intent was different from that for the other market baskets, which are defined to reflect pure price changes in inputs associated with providing care. Thus, the MEI appropriately includes an adjustment for productivity changes.

    As we described earlier, practically it makes no difference whether productivity is adjusted for within or outside the MEI, as long as an adjustment is present. However, given the historical precedent regarding the definition of the MEI, the apparent legislative intent behind recent legislation that did not prescribe a change to the MEI definition, and the specific update formula that must be used under the SGR, we do not believe it would be appropriate for the productivity adjustment to be made outside the MEI.

    • Option 6—Eliminate Productivity Adjustment from the MEI.

    Questions are raised occasionally as to the possibility of eliminating the productivity adjustment from the MEI. We did not consider this to be a viable option. Our research concluded that adjusting for productivity in the MEI is necessary in order to have a technically correct measure of an output price increase, free from double-counting of the impact of productivity. Every expert with whom we consulted agreed that a productivity adjustment is appropriate. They believed that the important question is which measure is the most appropriate for the adjustment.

    c. Use of a Forecasted MEI and Productivity Adjustment

    In a March 2002 Report to the Congress, the MedPAC recommended the use of a forecasted MEI value, rather than the current historical increase. However, implementation of this option raises several legal as well as practical issues. The 1972 Senate Finance Committee report language reflects the intent of the Congress that the MEI should “follow rather than lead” overall inflation. As a result, updates to the physician fee schedule have always been based on historical, rather than forecasted, MEI data. In this way, increases in the MEI do not lead the current measures of inflation but follow them based on historical trends. Furthermore, at the time of implementation of the SGR system, the Congress specified that the SGR system should use the MEI that existed at the time, which was based on historical data measures. The law did not recommend or specify a change in the MEI methodology. Thus, the assumption is that the Congress was satisfied that the MEI was functioning as designed. If we were to use a forecasted MEI and productivity adjustment, there are several practical issues that would need to be addressed. One issue is that a change from a historical-based MEI to a projected MEI would cause transitional problems because there would be a period of data that would not be accounted for in the year of implementation. For example, the CY 2002 MEI update was based on historical data through the second quarter of 2001. If we were to use a forecasted MEI in the update for CY 2003, any changes between the second quarter of 2001 and the first quarter of 2003 would not be accounted for in the update. Additionally, changing to a forecasted MEI and productivity adjustment raises additional questions about correcting for forecast errors. Based on these problems, we will continue to use historical data to make updates under the physician fee schedule.

    Comment: One commenter urged us to use a forecast of the MEI change for the update in the upcoming year. The commenter believed that we had the legal authority to make such a change and that the transition issues cited in the proposed rule were not relevant.

    Response: We do not believe that it would be appropriate to use a forecast of the MEI for the 2003 update. Since the inception of the MEI, and more recently the implementation of the physician fee schedule, the MEI increase for the upcoming year's update has been based on as much historical data as is available when the update is determined. For the 2003 update this means using data that is available through June 2002.

    Our interpretation of the legislative intent is for the MEI update to be based on historical data, and does not contemplate a MEI based on projections. Start Printed Page 80023As we stated above, the MEI update has always been based on historical data and we believe that the legislative intent when the SGR system was implemented was to continue using this methodology. In addition, we believe that the transition and forecast error issues described above are legitimate concerns that, at this time, would outweigh the benefits of making such a change. Therefore, we will continue to use historical data in developing the MEI used for the 2003 fee schedule update.

    d. Productivity Adjustment to the MEI

    Based on the research we conducted on this issue, we are changing the methodology for adjusting for productivity in the MEI. The MEI used for the CY 2003 physician payment update will reflect changes in the 10-year moving average of private non-farm business (economy-wide) multifactor productivity applied to the entire index. Several commenters agreed with this methodological change.

    We made this change because—(1) It is theoretically more appropriate to explicitly reflect the productivity gains associated with all inputs (both labor and nonlabor); (2) the recent growth rate in economy-wide multifactor productivity appears more consistent with the current market conditions facing physicians, and (3) the MEI still uses economy-wide wage changes as a proxy for physician wage changes. We believe that using a 10-year moving average change in economy-wide multifactor productivity produces a stable and predictable adjustment and is consistent with the moving-average methodology used in the existing MEI. Thus, the productivity adjustment will be based on the latest available actual historical economy-wide multifactor productivity data, as measured by the BLS.

    We currently estimate the MEI to increase 3.0 percent for CY 2003. This is the result of a 3.8 percent increase in the price portion of the MEI, adjusted downward by a 0.8 percent increase in the 10-year moving average change in economy-wide multifactor productivity. Table 10 shows the detailed cost categories of the MEI update for CY 2003.

    Table 10.—Increase in the Medicare Economic Index Update for Calendar Year 2003 1

    Cost categories and price measures1996 Weights 2CY 2003 percent changes
    Medicare Economic Index Total, productivity adjustedn/a3.0
    Productivity: 10-year moving average of multifactor productivity, private nonfarm business sectorn/a0.8
    Medicare Economic Index Total, without productivity adjustment100.03.8
    1. Physician's own time 354.53.9
    a. Wages and Salaries: Average hourly earnings private nonfarm44.23.7
    b. Fringe Benefits: Employment Cost Index, benefits, private nonfarm10.35.0
    2. Physician's practice expense 345.53.6
    a. Nonphysician employee compensation16.84.2
    1. Wages and Salaries: Employment Cost—Index, wages and salaries, weighted by occupation12.43.7
    2. Fringe Benefits: Employment Cost—Index, fringe benefits, white collar4.45.5
    b. Office Expense: Consumer Price Index for urban consumers (CPI-U), housing11.62.8
    c. Medical Materials and Supplies: Producer Price Index (PPI), ethical drugs/PPI, surgical appliances and supplies/CPI-U, medical equipment and supplies (equally weighted)4.52.0
    d. Professional Liability Insurance: CMS professional liability insurance survey 43.211.3
    e. Medical Equipment: PPI, medical instruments and equipment1.91.5
    f. Other professional expense7.61.8
    1. Professional Car: CPI-U, private transportation1.32.3
    2. Other: CPI-U, all items less food and energy6.32.6
    1 The rates of historical change are estimated for the 12-month period ending June 30, 2002, which is the period used for computing the calendar year 2003 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of September 19, 2002.
    2 The weights shown for the MEI components are the 1996 base-year weights, which may not sum to subtotals or totals because of rounding. The MEI is a fixed-weight, Laspeyres-type input price index whose category weights indicate the distribution of expenditures among the inputs to physicians' services for calendar year 1996. To determine the MEI level for a given year, the price proxy level for each component is multiplied by its 1996 weight. The sum of these products (weights multiplied by the price index levels) over all cost categories yields the composite MEI level for a given year. The annual percent change in the MEI levels is an estimate of price change over time for a fixed market basket of inputs to physicians' services.
    3 The measures of productivity, average hourly earnings, Employment Cost Indexes, as well as the various Producer and Consumer Price Indexes can be found on the Bureau of Labor Statistics Web site http://stats.bls.gov.
    4 Derived from a CMS survey of several major insurers (the latest available historical percent change data are for the period ending second quarter of 2002).
    n/a Productivity is factored into the MEI compensation categories as an adjustment to the price variables; therefore, no explicit weight exists for productivity in the MEI.

    Comment: Several commenters requested that we ensure that the costs of medical liability insurance are adequately reflected in the MEI by making available all information that is the basis for measuring medical liability costs in the MEI.

    Response: We agree with the commenters that it is vital that the MEI accurately reflect the price changes associated with professional liability costs. Accordingly, we continue to incorporate into the MEI a price proxy that accomplishes this goal by making the maximum use of available data on professional liability premiums. Below we describe in more detail the annual CMS data collection from commercial insurance carriers, which are designed to maximize the use of publicly available data.

    Each year, we solicit professional liability premium data for physicians from a small sample of commercial carriers. This information is not collected through a survey form, but instead is requested from a few national commercial carriers via letter. The carriers provide information on a voluntary basis, and generally between 5 and 8 carriers volunteer this information.

    As we require for our other price proxies, the professional liability price proxy must reflect the pure price change associated with this particular cost category. Thus, it should not capture changes in the mix or level of liability coverage. To accomplish this result, weStart Printed Page 80024 obtain premium information from commercial carriers for a fixed level of coverage, currently $1 million per occurrence and a $3 million annual limit. This information is collected for every state by physician specialty and risk class. Finally, the state-level, physician-specialty data is aggregated by effective premium date to compute a national total using counts of physicians by state and specialty as provided in the AMA publication “Physician Characteristics and Distribution in the U.S.”

    The resulting data provides a quarterly time series, indexed to a base year consistent with the MEI, which reflects the national trend in the average professional liability premium for a given level of coverage. From this series, quarterly and annual percent changes in professional liability insurance are estimated for inclusion in the MEI. This data produced an 11.3 percent increase for professional liability insurance in the MEI for the 2003 update. We believe that, given the limited timely data available on professional liability premiums, this methodology adequately reflects the price trends facing physicians.

    Comment: One commenter urged CMS to use the most current professional liability insurance data available when developing the MEI update.

    Response: The professional liability data used to develop the 2003 MEI update was based on premium rates effective as of June 2002. We believe our methodology ensures that the MEI update includes the most recent data available. In the spring of 2002 we collected professional liability insurance premiums from commercial insurers as described in the previous comment. These data included both the premium amount and effective date, which we use to create a quarterly time series. Thus, the professional liability insurance component of the 2003 MEI update includes effective premium rates through the 2nd quarter of 2002, which is consistent with the timeliness of other data used in determining this update.

    The most comprehensive data on professional liability costs exist with the state insurance commissioners. However, these data are available only with a substantial lag. For instance, when we developed this final rule the most recent professional liability data available from the state insurance commissioners were for 2000. Hence, the data currently incorporated into the MEI are much more timely.

    Comment: Several commenters requested that we make an ad hoc adjustment to the MEI to account for recent increases in medical liability insurance.

    Response: We disagree with the commenters that an ad hoc adjustment should be made to the MEI to account for recent increases in professional liability insurance. As detailed above, the current methodology reflects recent data collected directly from commercial insurance carriers and specifically reflects the conditions facing physicians. Thus, the MEI adequately accounts for the recent increases in professional liability insurance prices, much the same way it reflects the price changes associated with other inputs, such as office expenses, wages or benefits. Thus, we believe the MEI appropriately reflects the price changes as measured by reliable and relevant data sources, and should not be adjusted through an ad hoc mechanism.

    Comment: Several commenters suggested that physicians' earnings more closely follow the wage changes faced by professional and technical occupations. The commenters suggested that we use the employment cost index (ECI) for professional and technical workers as the physicians' wage proxy in the MEI.

    Response: As we stated in the November 2, 1998 final rule (63 FR 58848), we believe that the current price proxy for physicians' earnings, average hourly earnings (AHE) in the non-farm business economy, is the most appropriate proxy to use in the MEI. The AHE for the non-farm business economy reflects the impacts of supply, demand and economy-wide productivity for the average worker in the economy. Using the AHE as the proxy for physician earnings captures the parity in the rate of change in wages for the average worker and for physicians. In addition, use of this proxy is consistent with the original legislative intent that the change in the physicians' earnings portion of the MEI parallel the change in general earnings for the economy.

    The suggestion to use the ECI for professional and technical workers has a major shortcoming in that, in many instances, occupations, such as engineers, computer scientists, nurses, etc., have unique characteristics that are not reflective of the overall economy or the physician market. Specifically, wage changes for these types of occupations can be influenced by excess supply or demand for these types of workers. We do not believe it would be appropriate to proxy the physician earnings portion of the MEI with a wage proxy that reflects these unique characteristics.

    C. The Update Adjustment Factor

    Section 1848(d) of the Act provides that the physician fee schedule update is equal to the product of the MEI and an “update adjustment factor.” The update adjustment factor is applied to make actual and target expenditures (referred to in the law as “allowed expenditures”) equal. Allowed expenditures are equal to actual expenditures in a base period updated each year by the SGR. The SGR sets the annual rate of growth in allowed expenditures and is determined by a formula specified in section 1848(f) of the Act.

    Since the inception of the physician fee schedule in 1992, physician payment rates have been updated using two different systems. From 1992 to 1998, physician fee schedule rates were updated using the Medicare Volume Performance Standard (MVPS). From 1999 to the present, physician fee schedule rates have been updated using the sustainable growth rate (SGR). While there are significant and important differences between the MVPS and SGR, both use the same general concept that expenditures for physicians' services should grow by a limited percentage amount of allowed expenditures each year. If expenditures exceed the amount in a year, the physician fee schedule update is reduced. If expenditures are less than the amount of allowed expenditures in a year, the physician fee schedule update is increased.

    We determined the annual percentage increase in expenditures using the formulas specified in the statute. One important feature of both the MVPS and the SGRs for fiscal years (FYs) 1998 and 1999 was that the percentage increase was based on estimates of the four factors specified in the law, made before the beginning of the year. Under the MVPS and the SGRs for FYs 1998 and 1999, the statute did not permit us to revise the estimates used to set the annual percentage increase. Beginning with the FY 2000 SGR, the statute specifically requires us to use actual, after the fact, data to revise the estimates used to set the SGR.

    For some of the component factors of both the MVPS and the SGR, there have been differences between the estimates used to set the annual MVPS and SGR and the actual increase based on actual, after the fact, data. For instance, under both the MVPS and the SGR, we are required to account for increases in Medicare beneficiary fee-for-service enrollment. There have been differences between our estimates of the increase in fee-for-service enrollment and the actual, after the fact increase because it Start Printed Page 80025is difficult to predict, before the beginning of the year, beneficiary enrollment in Medicare + Choice plans (or Medicare managed care plans as they were known under the MVPS). Under the MVPS, we generally estimated higher growth in beneficiary fee-for-service enrollment than actually occurred. For the FY 1998 and FY 1999 SGRs, we estimated lower growth in beneficiary fee-for-service enrollment than actually occurred. (For subsequent years, the statute has required us to revise our estimates.)

    Under the SGR, the statute also requires us to account for the increase in real per capita gross domestic product (GDP) to determine the annual percentage increase in expenditures for physicians' services. In both FY 1998 and FY 1999, we estimated lower real per capita GDP growth than actually occurred. Because the statute did not permit us to revise estimates for these years, the SGRs for FYs 1998 and 1999 are lower than if we were authorized to revise estimates as required under current law for the FY 2000 SGR and all subsequent SGRs.

    Because the physician fee schedule CF has been affected by a comparison of the actual increase in expenditures to the level of allowed expenditures calculated using the MVPS and the SGRs for FYs 1998-1999, revision of our estimates would have resulted in different CFs than those we actually determined. Revision of the estimates used to set the MVPS would have made the physician fee schedule CFs established under the MVPS lower than those we have actually determined. As a result, higher expenditures in 1997 were higher than if we had revised estimates with actual after the fact data. The actual amount of expenditures in 1997 forms the basis for the calculation of allowed expenditures under the SGR.

    In contrast, revision of the estimates used to set the SGRs for FYs 1998 and 1999 would have resulted in higher physician fee schedule CFs for CY 2000 and all subsequent years than those we have actually determined. If the statute authorized revisions of the estimates used to establish both the MVPS and the SGRs for FYs 1998 and 1999, the physician fee schedule CF would be higher than it is currently.

    We have analyzed the effect that revision of the estimates used to set the MVPS from FY 1990 through 1996 and the SGRs for FYs 1998 and 1999 would have on the physician fee schedule update for CY 2003 and subsequent years. The Department believes that a positive update could result if the statute authorized revisions of the estimates used to establish both the SGR for FYs 1998 and 1999 and MVPS for 1990 to 1996.

    As noted above, however, current law does not permit the Department to adopt the positive update for 2003. In the event that Congress enacts legislation permitting the Department to make such an adjustment, the Department wishes to make the adjustment as promptly as possible. We therefore are soliciting public comments regarding the proper adjustments in the event that Congress authorizes the Department to make such an adjustment.

    1. Calculation Under Current Law

    Under section 1848(d)(4)(A) of the Act, the physician fee schedule update for a year is equal to the product of— (1) 1 plus the Secretary's estimate of the percentage increase in the MEI for the year, divided by 100 and (2) 1 plus the Secretary's estimate of the update adjustment factor for the year. Under section 1848(d)(4)(B) of the Act, the update adjustment factor for a year beginning with 2001 is equal to the sum of the following—

    • Prior Year Adjustment Component. An amount determined by—

    —Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services for the prior year (the year prior to the year for which the update is being determined) and the amount of the actual expenditures for such services for that year;

    —Dividing that difference by the amount of the actual expenditures for such services for that year; and

    —Multiplying that quotient by 0.75.

    • Cumulative Adjustment Component. An amount determined by—

    —Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services from April 1, 1996, through the end of the prior year and the amount of the actual expenditures for such services during that period;

    —Dividing that difference by actual expenditures for such services for the prior year as increased by the sustainable growth rate for the year for which the update adjustment factor is to be determined; and

    —Multiplying that quotient by 0.33.

    Section 1848(d)(4)(E) of the Act requires the Secretary to recalculate allowed expenditures consistent with section 1848(f)(3) of the Act. Section 1848(f)(3) specifies that the SGR (and, in turn, allowed expenditures) for the upcoming calendar year (2003 in this case), the current calendar year (2002) and the preceding calendar year (2001) are to be determined on the basis of the best data available as of September 1 of the current year. Allowed expenditures are initially estimated and subsequently revised twice. The second revision occurs after the calendar year has ended (that is, we are making the final revision to 2001 allowed expenditures in this final rule). Once the SGR and allowed expenditures for a year have been revised twice, they are final.

    Table 11 shows annual and cumulative allowed expenditures for physicians' services from April 1, 1996 through the end of the current calendar year, including the transition period to a calendar year system that occurred in 1999.

    Table 11

    PeriodAnnual allowed expenditures (Dollars)Cumulative allowed expenditures (Dollars)FY or CY SGR
    4/1/96-3/31/9748.9 billion48.9 billionN/A
    4/1/97-3/31/9849.6 billion98.5 billionFY 1998=1.5%
    4/1/98-3/31/9949.4 billion147.9 billionFY 1999=−0.3%
    1/1/99-3/31/9912.5 billionIncluded in 147.9 aboveFY 1999=−0.3%
    4/1/99-12/31/9939.6 billionIncluded in 187.6 belowFY 2000=6.9%
    1/1/99-12/31/9952.1 billion187.6 billionFY 1999/FY 2000 (see note)
    1/1/00-12/31/0055.9 billion243.5 billionCY 2000=7.3%
    1/1/01-12/31/0158.4 billion301.9 billionCY 2001=4.5%
    1/1/02-12/31/0263.5 billion365.4 billionCY 2002=8.8%
    1/1/03-12/31/0368.3 billion433.8 billionCY 2003=7.6%
    Start Printed Page 80026

    *Note:

    Allowed expenditures for the first quarter of 1999 are based on the FY 1999 SGR and allowed expenditures for the last three quarters of 1999 are based on the FY 2000 SGR. Allowed expenditures in the first year (April 1, 1996-March 31, 1997) are equal to actual expenditures. All subsequent figures are equal to quarterly allowed expenditure figures increased by the applicable SGR. Cumulative allowed expenditures are equal to the sum of annual allowed expenditures. We provide more detailed quarterly allowed and actual expenditure data on our Web site under the Medicare Actuary's publications at the following address: http://www.cms.hhs.gov/​statistics/​actuary/​. We expect to update the web site with the most current information later this month.

    Consistent with section 1848(d)(4)(E) of the Act, table 12 includes our final revision of allowed expenditures for 2001, a recalculation of allowed expenditures for 2002, and our initial estimate of allowed expenditures for 2003. To determine the update adjustment factor for 2003, the statute requires that we use cumulative allowed expenditures from April 1, 1996 through December 31, 2002, actual expenditures through December 31, 2002, and the SGR for 2003, as well as annual allowed and actual expenditures for 2002. We are using estimates of allowed expenditures for 2002 and 2003 that will subsequently be revised consistent with section 1848(d)(4)(E) of the Act. Because we have incomplete expenditure data for 2002, we are using an estimate for this period. Any difference between current estimates and final figures will be taken into account in determining the update adjustment factor for future years.

    We are using figures from table 12 in the statutory formula illustrated below:

    UAF = Update Adjustment Factor.

    Target02 = Allowed Expenditures for 2002 or $63.5 billion.

    Actual02 = Estimated Actual Expenditures for 2002 = $69.1 billion.

    Target4/96-12/02 = Allowed Expenditures from 4/1/1996-12/31/2002 = $365.4 billion.

    Actual4/96-12/02 = Estimated Actual Expenditures from 4/1/1996-12/31/2002 = $381.9 billion.

    SGR03 = 7.6 percent (1.076).

    Section 1848(d)(4)(D) of the Act indicates that the update adjustment factor determined under section 1848(d)(4)(B) of the Act for a year may not be less than −0.07 or greater than 0.03. Because the calculated update adjustment factor of −0.134 is less than the statutory limit of −0.07, the update adjustment factor for 2003 will be −0.07.

    Section 1848(d)(4)(A)(ii) of the Act indicates that 1 should be added to the update adjustment factor determined under section 1848(d)(4)(B) of the Act. Thus, adding 1 to −0.070 makes the update adjustment factor equal to 0.930.

    VII. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate

    A. Medicare Sustainable Growth Rate

    The SGR is an annual growth rate that applies to physicians' services paid for by Medicare. The use of the SGR is intended to control growth in aggregate Medicare expenditures for physicians' services. Payments for services are not withheld if the percentage increase in actual expenditures exceeds the SGR. Rather, the physician fee schedule update, as specified in section 1848(d)(4) of the Act, is adjusted based on a comparison of allowed expenditures (determined using the SGR) and actual expenditures. If actual expenditures exceed allowed expenditures, the update is reduced. If actual expenditures are less than allowed expenditures, the update is increased.

    Section 1848(f)(2) of the Act specifies that the SGR for a year (beginning with 2001) is equal to the product of the following four factors:

    (1) The estimated change in fees for physicians' services.

    (2) The estimated change in the average number of Medicare fee-for-service beneficiaries.

    (3) The estimated projected growth in real GDP per capita.

    (4) The estimated change in expenditures due to changes in law or regulations.

    In general, section 1848(f)(3) of the Act requires us to publish SGRs for 3 different time periods, no later than November 1 of each year, using the best data available as of September 1 of each year. Under section 1848(f)(3)(C)(i) of the Act, the SGR is estimated and subsequently revised twice (beginning with the FY and CY 2000 SGRs) based on later data. Under section 1848(f)(3)(C)(ii) of the Act, there are no further revisions to the SGR once it has been estimated and subsequently revised in each of the 2 years following the preliminary estimate. In this final rule, we are making our preliminary estimate of the 2003 SGR, a revision to the 2002 SGR, and our final revision to the 2001 SGR.

    B. Physicians' Services

    Section 1848(f)(4)(A) of the Act defines the scope of physicians' services covered by the SGR. The statute indicates that the term “physicians' services” includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office, but does not include services furnished to a Medicare+Choice plan enrollee. We published a definition of physicians' services for use in the SGR in the Federal Register (66 FR 55316) on November 1, 2001. We defined “physicians' services” to include many of the medical and other health services listed in section 1861(s) of the Act. For purposes of determining allowed expenditures, actual expenditures, and SGRs through December 31, 2002, we have specified that “physicians' services” include the following medical and other health services if bills for the items and services are processed and paid by Medicare carriers:

    • Physicians' services. Start Printed Page 80027
    • Services and supplies furnished incident to physicians' services.
    • Outpatient physical therapy services and outpatient occupational therapy services.
    • Antigens prepared by or under the direct supervision of a physician.
    • Services of physician assistants, certified registered nurse anesthetists, certified nurse midwives, clinical psychologists, clinical social workers, nurse practitioners, and clinical nurse specialists.
    • Screening tests for prostate cancer, colorectal cancer, and glaucoma.
    • Screening mammography, screening pap smears, and screening pelvic exams.
    • Diabetes outpatient self-management training services.
    • Medical nutrition therapy services.
    • Diagnostic x-ray tests, diagnostic laboratory tests, and other diagnostic tests.
    • X-ray, radium, and radioactive isotope therapy.
    • Surgical dressings, splints, casts, and other devices used for the reduction of fractures and dislocations.
    • Bone mass measurements.

    In the June 2002 proposed rule (67 FR 43861), we announced a change to our methodology for determining the “weighted average percentage increase in fees for all physicians' services” for the 2001 and subsequent year SGRs. We use a weighted average of the price indices that are used to increase payment for services included in the SGR to determine the percentage increase in fees for physicians' services. Physicians' services are updated using the MEI. Clinical diagnostic laboratory services are updated using the CPI. Drugs furnished “incident to” a physician's service under section 1861(s)(2)(A) of the Act, are also included in the calculation of the SGR. Under section 1842(o) of the Act, payments for drugs are based on 95 percent of average wholesale prices. We are currently using the MEI as a proxy for growth in drug prices. In the proposed rule, we indicated that, rather than using the MEI as proxy for growth in drug prices, we would use growth in actual drug prices to determine the weighted average percentage increase in fees for all physicians' services. In response, we received many comments suggesting that “incident to” drugs should not be included in the definition of physicians' services.

    Comment: Comments indicated that the administration of a drug is a physician's service that, by statute, must be included in the definition of physicians' services. The drug itself, however, argued the comments, is not a physician service and should not be included in the SGR. A number of comments indicated that rising Medicare expenditures for drugs are due in large part to the introduction of costly new cancer drugs and not to the failure of physicians to control their use. Many of these comments stated that the increase in drug spending is due to government policies that encourage the rapid development of new drugs, as well as government efforts to urge Americans to be tested and seek early treatment for cancer and other diseases. Some comments indicated that physicians should not be forced to pay for the rising cost of drugs covered by Medicare through reduced fees. Other comments stated that including drugs in the SGR has not led to controls on drug spending and, as a result, removing them would not lead to increased spending. Other comments indicated that the SGR has not been increased to reflect the growing cost of drugs. These comments indicated that the SGR should either account for the growing cost of drugs or exclude them completely. One comment indicated that the SGR should account for the cost of new drugs approved by the FDA and covered by Medicare during the prior year and the cost of covered drugs that have the same biologic effect as non-covered drugs. Several comments indicated that the Secretary does not have the legal authority to include “incident to” drugs in the SGR because the section 1848(f) of the Act refers to physicians' services and not “medical and other health services.” Others provided copies of a detailed legal opinion arguing that drugs may be included in the SGR under section 1848(f) of the Act but cannot be included in the definition of physicians' services for purposes of determining the update adjustment factor under section 1848(d) of the Act.

    Response: The statute provides the Secretary with clear authority to specify the services that are included in the SGR. Section 1848(f)(4)(A) of the Act indicates “the term ‘physicians’ services' includes other items and services (such as clinical diagnostic laboratory tests and radiology services) specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office”. We disagree with the comments suggesting that the Secretary does not have the authority to include drugs in the definition of physicians' services for purposes of determining allowed expenditures, actual expenditures and the SGR. In reviewing section 1861(s) of the Act, we decided to include items and services in the SGR that are commonly furnished by physicians or in physicians' offices. Since “incident to” drugs covered under section 1861(s) of the Act are commonly furnished in physicians' offices, we are including these items in the SGR.

    C. Provisions Related to the Sustainable Growth Rate

    Section 211(b)(1) of the BBRA amended section 1848(f)(1) of the Act to require that three SGR estimates be published in the Federal Register not later than November 1 of every year. In this final rule, we are publishing our preliminary estimate of the SGR for 2003, a revised estimate of the SGR for 2002, and our final determination of the SGR for 2001. Consistent with section 1848(f)(3)(C) of the Act, we are using the best data available to us as of September 1, 2002 for all of the figures.

    D. Preliminary Estimate of the Sustainable Growth Rate for 2003

    Our preliminary estimate of the 2003 SGR is 7.6 percent. We first estimated the 2003 SGR in March and made the estimate available to the Medicare Payment Advisory Commission and on our website. Table 12 shows our March estimates and our current estimates of the factors included in the SGR:

    Table 12

    Statutory factorsMarch estimateCurrent estimate
    Fees1.7% (1.017)2.9% (1.029)
    Enrollment1.3% (1.013)1.2% (1.012)
    Real per capita GDP2.9% (1.029)3.3% (1.033)
    Law and regulation0.0% (1.000)0.0% (1.000)
    Total6.0% (1.060)7.6% (1.076)
    Start Printed Page 80028

    Note:

    Consistent with section 1848(f)(2) of the Act, the statutory factors are multiplied, not added, to produce the total (that is, 1.029 × 1.012 × 1.033 × 1.000 = 1.076.) A more detailed explanation of each figure is provided below in section H.1.

    E. Revised Sustainable Growth Rate for 2002

    Our current estimate of the 2002 SGR is 8.8 percent. Table 13 shows our preliminary estimate of the 2002 SGR that was published in the Federal Register on November 1, 2001 (66 FR 55317) and our current estimate:

    Table 13

    Statutory factors11/1/01 estimateCurrent estimate
    Fees2.3 (1.023)2.5% (1.025)
    Enrollment0.7 (1.007)2.8% (1.028)
    Real per capita GDP1.7 (1.017)2.3% (1.023)
    Law and regulation0.8 (1.008)0.9% (1.009)
    Total5.6 (1.056)8.8% (1.088)

    A more detailed explanation of each figure is provided below in section H.2.

    F. Final Sustainable Growth Rate for 2001

    The SGR for 2001 is 4.5 percent. Table 14 shows our preliminary estimate of the SGR published in the Federal Register on November 1, 2000 (65 FR 65433), our revised estimate published in the Federal Register on November 1, 2001 (66 FR 55317) and the final figures determined using the latest available data:

    Table 14

    Statutory factors11/1/00 estimate11/1/01 estimateCurrent estimate
    Fees1.9 (1.019)1.9 (1.019)2.1% (1.021)
    Enrollment0.9 (1.009)3.0 (1.030)3.0% (1.030)
    Real per capita GDP2.7 (1.027)0.7 (1.007)−0.7% (0.993)
    Law and regulation0.0 (1.000)0.4 (1.004)0.1% (1.001)
    Total5.6 (1.056)6.1 (1.061)4.5% (1.045)

    A more detailed explanation of each figure is provided below in section H.2.

    G. Calculation of 2003, 2002, and 2001 Sustainable Growth Rates

    1. Detail on the 2003 SGR

    A more detailed discussion of our preliminary estimates of the four elements of the 2003 SGR follows. We note that all of the figures used to determine the 2003 SGR are estimates that will be revised based on subsequent data. Any differences between these estimates and the actual measurement of these figures will be included in future revisions of the SGR and incorporated into subsequent physician fee schedule updates.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2003

    This factor was calculated as a weighted average of the 2002 fee increases for the different types of services included in the definition of physicians' services for the SGR. Medical and other health services paid using the physician fee schedule account for approximately 83.5 percent of total allowed charges included in the SGR and are updated using the MEI. The MEI for 2003 is 3.0 percent. Diagnostic laboratory tests represent approximately 8.0 percent of Medicare allowed charges included in the SGR and the costs of these tests are typically updated by the CPI-U. The CPI-U for 2003 that will be used to update clinical diagnostic laboratory tests is 1.1 percent. Drugs represent 8.5 percent of Medicare allowed charges included in the SGR. Medicare pays for drugs based on 95 percent of AWP under section 1842(o) of the Act. We calculated the weighted average fee increase for drugs to be included in the SGR, we estimate a weighted average fee increase for drugs of 3.3 percent in 2002. Table 15 shows the weighted average of the MEI, laboratory and drug price increases for 2003:

    Table 15

    WeightUpdate
    Physician0.8353.0
    Laboratory0.0801.1
    Drugs0.0853.3
    Weighted Average1.0002.9

    After taking into account the elements described in table 16, we estimate that the weighted-average increase in fees for physicians' services in 2002 under the SGR (before applying any legislative adjustments) will be 2.9 percent.

    Factor 2—The Percentage Change in the Average Number of Part B Enrollees From 2002 to 2003

    This factor is our estimate of the percent change in the average number of Start Printed Page 80029fee-for-service enrollees from 2002 to 2003. Services provided to Medicare+Choice (M+C) plan enrollees are outside the scope of the SGR and are excluded from this estimate. Our actuaries estimate that the average number of Medicare Part B fee-for-service enrollees will increase by 1.2 percent from 2002 to 2003. Table 16 illustrates how this figure was determined:

    Table 16

    20022003
    Overall37.986 million38.321 million
    Medicare+Choice5.070 million5.012 million
    Net32.916 million33.309 million
    Percent Increase1.2 percent

    An important factor affecting fee-for-service enrollment is beneficiary enrollment in Medicare+Choice plans. Because it is difficult to estimate the size of the Medicare+Choice enrollee population before the start of a calendar year, at this time, we do not know how actual enrollment in Medicare+Choice plans will compare to current estimates. For this reason, there may be substantial changes to this estimate as actual Medicare fee-for-service enrollment for 2003 becomes known.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2003

    We estimate that the growth in real per capita GDP from 2002 to 2003 will be 3.3 percent. Our past experience indicates that there have also been large changes in estimates of real per capita GDP growth made before the year begins and the actual change in GDP computed after the year is complete. Thus, it is likely that this figure will change as actual information on economic performance becomes available to us in 2003.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2003 Compared With CY 2002

    As indicated below, section 101-104 of the BIPA added Medicare coverage for a variety of new services. We estimate no additional costs for these services in 2003 relative to 2002. We will continue to monitor utilization of all of the new benefits provided in BIPA and modify our estimates (up or down) and the SGRs accordingly.

    Comment: We received many comments indicating that we should adjust the SGR to account for the addition of the psychiatric diagnostic interview to the list of covered telehealth services.

    Response: We agree that the addition of the psychiatric diagnostic interview is a change in regulation that should be accounted for in the SGR. However, since there is such low utilization of the telehealth benefit, we believe the addition of the psychiatric diagnostic interview to the list of covered telehealth services will have no impact on the SGR.

    Comment: Several comments noted that section 112 of BIPA changed Medicare's drug payment policy. Prior to the enactment of the BIPA, section 1861(s)(2) of the Act allowed Medicare to pay for “drugs and biologicals, which cannot, as determined in accordance with regulations, be self-administered.” The BIPA amended the Act to allow Medicare to pay for drugs which “are not usually administered by the patient.” The commenters believe that this new drug payment policy will result in an increase in expenditures that should be accounted for in the SGR.

    Response: The amendments to Medicare's drug payment policy contained in section 112 of the BIPA constitute a change in law or regulation that is taken into account in determining the SGR. We estimate a 2002 cost for this policy change that will be accounted for in the 2002 SGR described below. At this time, we are not estimating additional Medicare costs in 2003 relative to 2002 for drugs not usually self-administered by patients.

    Comment: We received many public comments that argued for adjusting the SGR for changes in expenditures resulting from NCDs. According to these comments, any changes in national Medicare coverage policy that are adopted by us pursuant to a formal or informal rulemaking, such as a Program Memorandum or a national Medicare coverage determination, constitute a regulatory change for purposes of computing factor 4 of the SGR. The comments indicate that our authority to make any regulatory change is derived from law—whether it is a law specifically authorizing Medicare coverage of a new service or a law that provides general rulemaking authority. According to these comments, any new coverage initiative is a direct implementation, by regulation, of a law that should be taken into account in determining the SGR. One commenter indicated that we effectively compare actual expenditure data that include additional utilization resulting from NCDs with a spending target that does not include this additional utilization, making it more likely that the target will be exceeded.

    Response: We carefully considered this comment. If the Congress adds a new statutory benefit (for example, medical nutrition therapy), we are required by law to increase the target. Medicare does not have authority to pay for a service lacking a defined statutory benefit listed in section 1861(s) of the Act (for example, prior to January 1, 2002, there was no authority for Medicare to pay for medical nutrition therapy). However, we do have the authority to establish national coverage policies for items and services that are included in a benefit category listed in section 1861(s) of the Act. Further, we contract with Medicare carriers who may establish local coverage policies for items and services that have a statutory benefit category.

    The statute requires that real GDP per capita be used in setting the SGR target. We believe that use of real GDP per capita was intended as a proxy for a number of factors that may increase the volume and intensity of physicians' services (other than beneficiary enrollment and statutory changes that increase expenditures, which are separately accounted for by the statute), such as those associated with coverage of new items or services and other miscellaneous factors that cannot be specifically identified, such as any spending associated with NCDs.

    The large majority of Medicare spending is for services that are covered at local carrier discretion. While we may establish national coverage (or non-coverage) for a new item or service with a defined statutory benefit category, this NCD does not necessarily increase Medicare spending to the extent that the service has or would have been covered at local carrier discretion in the absence Start Printed Page 80030of a NCD. For instance, there was widespread publicity in 2000 about ocular photodynamic therapy (OPT), a new treatment for macular degeneration, a common cause of blindness in the elderly. Prior to our NCD, Medicare carriers had the authority to cover OPT at local carrier discretion as a physician's service under section 1861(s)(1) of the Act. Given the widespread publicity about the effectiveness of this new treatment, it is likely that, in the absence of a NCD, OPT would have been covered at local carrier discretion. That is, application of existing Medicare law and regulations would have allowed Medicare coverage for OPT at local carrier discretion. Because it seems likely that Medicare would covered this procedure in any event, it is unclear whether there are any additional costs associated with the NCD. Indeed the NCD limited the coverage of OPT to a defined subpopulation of Medicare beneficiaries. The local contractor determinations may not have done so, and therefore, the NCD may actually have resulted in a net savings to Medicare. Moreover, we did not change the law or regulations by making a national coverage decision for OPT. Rather, we applied existing law and regulations to a new service to make a national statement about coverage where one did not previously exist.

    We may also issue a NCD to clarify Medicare coverage for existing items or services. Such a decision may establish national policy that replaces differing local practices. In such a case, there may not have been consistency among Medicare carriers as to whether an item or service qualified for coverage based on existing law or regulation. Thus, our NCD would not change law or regulation, but replaces differing local practices with a national determination that, based on existing law and regulations, clarifies Medicare coverage for an item or service. Spending may increase or decrease depending upon the degree to which the particular item or service is currently being covered by Medicare carriers and whether the decision is to establish coverage or non-coverage of the item or service.

    For the reasons previously discussed, it would be very difficult to estimate any costs or savings associated with specific coverage decisions. Further, we believe any adjustment to the target would likely be of such a small magnitude that it would have little effect on future projected updates.

    1. Detail on the 2002 SGR

    A more detailed discussion of our revised estimates of the four elements of the 2002 SGR follows.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for 2002

    This factor was calculated as a weighted average of the 2002 fee increases that apply for the different types of services included in the definition of physicians' services for the SGR.

    Services paid using the physician fee schedule account for approximately 84.5 percent of total allowed charges included in the SGR, and are updated using the MEI. The MEI for 2002 is 2.6 percent. Diagnostic laboratory tests represent approximately 7.5, and the costs of these tests are typically updated by the CPI-U. However, the BBA required a 0.0 percent update in 2002 for laboratory services. Drugs represent 8.0 percent of Medicare allowed charges included in the SGR. Pursuant to section 1842(o) of the Act, Medicare pays for drugs based on 95 percent of AWP. Using wholesale pricing information and Medicare utilization for drugs included in the SGR, we estimate a weighted average fee increase for drugs of 3.3 percent in 2002. Table 17 shows the weighted average of the MEI, laboratory and drug price increases for 2002:

    Table 17

    WeightUpdate
    Physician0.8452.6
    Laboratory0.0750.0
    Drugs0.0803.3
    Weighted Average1.0002.5

    After taking into account the elements described in table 18, we estimate that the weighted-average increase in fees for physicians' services in 2002 under the SGR (before applying any legislative adjustments) will be 2.5 percent.

    Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2001 to 2002

    Our actuaries estimate that the average number of Medicare Part B fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) increased by 2.8 percent in 2002. Table 18 illustrates how we determined this figure:

    Table 18

    20012002
    Overall37.633 million37.986 million
    Medicare+Choice5.608 million5.070 million
    Net32.025 million32.916 million
    Percent Increase2.8 percent

    Our actuaries' estimate of the 2.8 percent change in the average number of fee-for-service enrollees, net of Medicare+Choice enrollment for 2002, compared to 2001 is different from our preliminary estimate (0.7 percent for 2002 from the November 1, 2001 final rule (66 FR 55318)) because the historical base from which our actuarial estimate is made has changed. We now have complete information on Medicare fee-for-service enrollment for 2001 that is different than the figure we used one year ago. Further, we now have information on actual fee-for-service Start Printed Page 80031enrollment for the first 8 months of 2002. We would caution that our estimate of fee-for-service enrollment for 2002 may change again once we have complete information for the entire year.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2002

    We estimate that the growth in real per capita GDP will be 2.3 percent in 2002. Our past experience indicates that there have also been large differences between our preliminary estimates of real per capita GDP growth and the actual change in this factor. Thus, it is likely that this figure will change further as actual information on economic performance becomes available to us in 2003.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in 2002 Compared With 2001

    As indicated earlier, sections 101 through 104 of the BIPA added Medicare coverage for a variety of new services that will affect the 2002 SGR. We included an adjustment in the 2002 SGR based on previous estimates of the costs of these new benefits, but are reducing our estimate of the costs of the new telehealth and medical nutrition therapy benefits based on lower utilization of these services than we had originally anticipated. This change will have little effect on this factor and we are not changing our estimate of the costs of any of the other provisions described earlier. In addition, as explained above, section 112 of BIPA made changes that will result in additional Medicare coverage for certain drugs. Prior to the enactment of the BIPA, Medicare only paid for drugs that cannot be self-administered by the patient. BIPA allows Medicare to pay for drugs that can be but are not usually self-administered. Accordingly, we are accounting for the increased Medicare drug expenditures that will result from implementation of section 112 of the BIPA. After taking these provisions into account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.9 percent for 2002.

    3. Detail on the 2001 SGR

    A more detailed discussion of our current estimates of the four elements of the 2001 SGR follows. Pursuant to section 1848(f)(3)(C) of the Act, we will be making no further revisions to these figures.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for 2001

    We are using a weighted average of the fee increases that apply to the different services included in the SGR for 2001. Services that are updated by the MEI represent 85.7 percent of allowed charges included in the SGR. The 2001 MEI was 2.1 percent. Pursuant to the BBA, laboratory services were updated by 0.0 percent in 2001 and represent 7.0 percent of allowed charges included in the SGR. The weighted average percentage increase in average wholesale prices for drugs included in the SGR in 2001 was 3.4 percent. Drugs represent 7.3 percent of allowed charges included in the SGR. Using these figures, the weighted average percentage increase in fees for physicians' services is illustrated in table 19:

    Table 19

    WeightUpdate
    Physician0.8572.1
    Laboratory0.0700.0
    Drugs0.0733.4
    Weighted Average1.0002.1

    Factor 2—The Percentage Change in the Average Number of Fee-for-Service Part B Enrollees From 2000 to 2001

    We estimate the increase in the average number of fee-for-service enrollees (excluding Medicare+Choice enrollees) from 2000 to 2001 was 3.0 percent. Table 20 illustrates the calculation of this factor:

    Table 20

    20002001
    Overall37.330 million37.633 million
    Medicare+Choice6.233 million5.608 million
    Net31.098 million32.205 million
    Percent Increase3.0 percent

    Our calculation of this factor is based on complete data from 2001.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2001

    We estimate that the growth in real per capita GDP was −0.7 percent in 2001. This is a final figure based on complete data for 2001.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2001 Compared With CY 2000

    As described above, the BIPA makes changes to the Act that affect Medicare expenditures for services included in the SGR. Some of these provisions had no effect on Medicare expenditures in 2001 because they did not go into effect until 2002. Other provisions became effective at some time during 2001. These provisions relate to coverage of new technology mammography, coverage changes for screening pap smears, screening pelvic exams, screening colonoscopy, expanded access to telehealth services, and Medicare payment for services provided in Indian Health Service hospitals and clinics. After taking these provisions into Start Printed Page 80032account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.1 percent for 2001.

    VIII. Anesthesia and Physician Fee Schedule Conversion Factors

    The 2003 physician fee schedule CF will be $34.5920. The 2003 national average anesthesia conversion factor is $16.0353.

    The specific calculations to determine the physician fee schedule and anesthesia CFs for 2003 are explained below.

    Detail on Calculation of the 2003 Physician Fee Schedule Conversion Factor

    • Physician Fee Schedule Conversion Factor

    Under section 1848(d)(1)(A) of the Act, the physician fee schedule CF is equal to the CF for the previous year multiplied by the update determined under section 1848(d)(4) of the Act. In addition, section 1848(c)(2)(B)(ii)(II) of the Act requires that changes to RVUs cannot cause the amount of expenditures to increase or decrease by more than $20 million from the amount of expenditures that would have been made if such adjustments had not been made. We implement this requirement through a uniform budget neutrality adjustment to the CF. There is one change that will require us to make an adjustment to the conversion factor to comply with the budget neutrality requirement in section 1848(c)(2)(B)(ii)(II) of the Act. We are making a 0.04 percent reduction (0.9996) in the CF to account for the increase in anesthesia work resulting from the 5-year review.

    We are illustrating the calculation for the 2003 physician fee schedule CF in table 21:

    Table 21

    2002 Conversion Factor$36.1992
    2003 Update0.9560
    Budget-Neutrality Adjustment: Increase in Anesthesia Work0.9996
    2003 Conversion Factor34.5920
    • Anesthesia Fee Schedule Conversion Factor

    Because anesthesia services do not have RVUs like other physician fee schedule services, we are accounting for the increase in anesthesia work through an adjustment to the anesthesia fee schedule conversion factor. As indicated earlier, we are increasing the physician work component of the anesthesia conversion factor by 2.10 percent to reflect a 9.13 percent increase in payment applied to 23 percent of anesthesia allowed charges. The 2002 anesthesia CF is $16.60. The physician work portion of the anesthesia conversion factor is 78 percent. We applied a 1.6 percent (1.016) increase to this part of the anesthesia conversion factor. Similarly, we also simulated the effect of practice expense refinements on the practice expense portion of the anesthesia conversion factor. The refinements reduced this portion of the anesthesia conversion factor by 4.04 percent (0.9596). In addition, we are also applying the physician fee schedule update and the budget neutrality adjustment for the increase in anesthesia work that that also apply to the physician fee schedule CF. To determine the anesthesia fee schedule CF for 2003, we used the following figures:

    Table 22

    2002 Anesthesia Conversion Factor$16.6055
    Adjustments for work and practice expense1.0106
    2003 Update0.9560
    Budget-Neutrality Adjustment: Increase in Anesthesia Work0.9996
    2003 Conversion Factor16.0353

    IX. Provisions of the Final Rule

    This final rule adopts the provisions of the June 2002 proposed rule, except as noted elsewhere in the preamble. The following is a highlight of the changes made from the proposed rule.

    For immunization administration, we are developing practice expense RVUs for influenza, pneumonia, and hepatitis B vaccine G codes. This will increase the payment for these codes and make Medicare's payment for vaccine administration more consistent with the rates paid for the CPT codes.

    For anesthesia, we are revising the regulations text at § 414.46(g) to incorporate that the policy on multiple procedure codes as well as add-on codes.

    For enrollment of PTs and OTs as therapists in private practice, we are revising our regulations text at § 410.59 and § 410.60 to reflect that carriers and fiscal intermediaries can enroll therapists as PTs or OTs in private practice when the therapist is employed by physician groups or groups that are not professional corporations.

    We are adopting the process to add or delete telehealth services and adding the psychiatric diagnostic interview examination to the list of telehealth services. In addition, we are referencing the process to add or delete services at new § 410.78(f).

    For the definition of a ZZZ global period, we are revising the definition to show that physician work is associated with intraservice time and, in some instances, the pre- and postservice time.

    For the definition of a screening fecal-occult blood test, we are revising the definition at § 410.37(a)(2) to permit coverage of non-guaiac based tests.

    For the critical access hospital emergency services requirement we are modifying § 485.618(d) to include RNs.

    X. Waiver of Proposed Rulemaking for Definition of a Screening Fecal-Occult Blood Test and Critical Access Hospital Emergency Services Requirement

    We ordinarily publish a notice of proposed rulemaking in the Federal Register and invite public comment on proposed rules. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed and the terms and substances of the proposed rule or a description of the subjects and issues involved. This procedure can be waived, however, if an agency finds good cause that notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule issued.

    In our proposed rule, we did not propose to modify § 410.37. Still, we received a comment seeking to modify coverage for one particular type of colorectal cancer test, a fecal-occult blood test. As explained earlier in this preamble, we have agreed to modify this regulation in a manner that would permit broader Medicare coverage if that is determined to be appropriate. Consistent with this change, we are modifying § 410.37(a)(1)(v) to announce that we will consider approving new tests or procedures for use in the early detection of colorectal cancer through our process for making national coverage determinations.

    The Congress has authorized the Secretary to cover additional tests or procedures that can be used for the early detection of colorectal cancer under the Colorectal Cancer Screening Test benefit in under part B in section 1861(pp)(1)(D) of the Act. The Secretary may determine that coverage of other tests or procedures are appropriate, in consultation with appropriate organizations. We are aware that new colorectal cancer screening tests are Start Printed Page 80033being developed. To determine whether it is appropriate to expand coverage to provide Medicare payment for additional tests or procedures, it will be necessary to compare the new tests to tests that are already covered. We are modifying § 410.37(a)(1)(v) to permit determinations on whether to cover (or not cover) additional tests or procedures to be made through NCDs.

    Expanding Medicare coverage of additional, effective, and appropriate screening tests would be in the public interest because the tests may discover patients with cancer at an earlier stage, increasing the chances that the patient will obtain proper medical treatment. An NCD, authorized by section 1869(a)(2) of the Act, can be used to develop a national policy regarding the scope of benefits. Moreover, the process for making an NCD will permit public participation, as well as the participation of appropriate groups, as the agency determines whether or not expanded coverage for additional tests or procedures is appropriate. This process offers advantages to the public because it could permit an expansion in the scope of the colorectal cancer screening benefit more rapidly than the notice and comment procedures of the Administrative Procedure Act would normally permit.

    In addition, we did not propose to modify § 485.618(d). A delay in implementation of this provision would hinder the ability of small CAHs (with no greater than 10 beds) in some frontier areas or remote locations to provide the necessary critical access hospital emergency services. It was brought to our attention that, in recent months, a number of small CAHs in very remote frontier areas have been struggling to comply with the CAH standard in § 485.618(d) that requires CAHs to have either a doctor of medicine or osteopathy, a physician's assistant, or a nurse practitioner, with training or experience in emergency care to ensure emergency coverage 24-hours-a-day, seven-days-a-week. These CAHs have 10 or less beds. In order to provide additional flexibility for other CAHs of virtually the same size, we believe 10 beds is an appropriate size limit for facilities that may be in the same situation and require potential relief from the existing staffing requirements. These facilities, located in isolated frontier communities, have only one medical practitioner and see a low volume of patients. For these providers the requirement referenced above results in a significant personal hardship to the sole practitioner who must be on call 24-hours-a-day, 52-weeks-a-year. In addition, it is a financial hardship for the facility to find a replacement for the currently required emergency services personnel because frequently the replacement costs far exceed what is recovered through the services provided. We believe that by allowing States to include RNs in the current critical access hospital emergency services personnel requirement, so that RNs may be on call for small CAHs in frontier areas or remote locations, we will help ensure that frontier communities will have continued access to CAH services. In addition, if small CAHs in frontier areas or remote locations close their doors there would be no access to care in these communities.

    Accordingly, we find good cause for waiving the prior notice-and-comment procedures as unnecessary and contrary to the public interest. In addition, we note that rules of agency procedure are exempt from the notice and comment requirements of 5 U.S.C. 553.

    XI. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995, we are required to provide 60-days notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues:

    • The need for the information collection and its usefulness in carrying out the proper functions of our agency.
    • The accuracy of our estimate of the information collection burden.
    • The quality, utility, and clarity of the information to be collected.
    • Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.

    We are soliciting public comment on each of these issues for the following sections of this document that contain information collection requirements:

    Section 485.618 permits a CAH located in an area designated as a frontier area or remote location described in paragraph (d)(1)(i) to include in the personnel requirement in paragraph (d) a RN, if the State in which the small CAH is located submits a letter to us, signed by the Governor, following consultation with the State Boards of Medicine and Nursing, and in accordance with State law, requesting that a RN be included temporarily in the list of personnel that must be on call and available on site within 60 minutes.

    Since we anticipate that we will receive approximately five requests for an inclusion of RNs on an annual basis, this collection requirement is not subject to the PRA as stipulated under 5 CFR 1320.3(c).

    If you comment on these information collection and recordkeeping requirements, please mail copies directly to the following:

    Centers for Medicare & Medicaid Services, Office of Strategic Operations & Regulatory Affairs, RDIG, Attn.: John Burke, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850.

    Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Brenda Aguilar, CMS Desk Officer.

    XII. Response to Comments

    Because of the large number of items of correspondence we normally receive on Federal Register documents published for comment, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, if we proceed with a subsequent document, we will respond to the major comments in the preamble to that document.

    XIII. Regulatory Impact Analysis

    We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 16, 1980 Pub. L. 96-354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive order 13132.

    Executive Order 12866 (as amended by Executive Order 13258, which reassigns responsibility of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared for final rules with economically significant effects (that is, a final rule that would have an annual effect on the economy of $100 million or more in any 1 year, or would adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or Start Printed Page 80034communities). We have simulated the effect of increases in payment for anesthesia work and the changes to practice expense RVUs described earlier. The net effect of the changes will not materially increase or decrease Medicare expenditures for physicians' services because the statute requires that these changes cannot increase or decrease expenditures more than $20 million. Since increases in payments resulting from the 5-year review anesthesia work and practice expense RVU changes cannot increase or decreases expenditures by more than $20 million, any increases or decreases in payment will result in a redistribution of payments among physician specialties. The proposed changes to the MEI would result in increases in Medicare expenditures for physicians' services of $150 million in fiscal year (FY) 2003, $340 million in FY 2004, and $550 million in FY 2005. Therefore, this rule is considered to be a major rule because it is economically significant, and, thus, we have prepared a regulatory impact analysis.

    The RFA requires that we analyze regulatory options for small businesses and other entities. We prepare a Regulatory Flexibility Analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives with less significant adverse economic impact on the small entities.

    Section 1102(b) of the Act requires us to prepare a regulatory impact analysis for any proposed rule that may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside a Metropolitan Statistical Area and has fewer than 100 beds.

    For purposes of the RFA, physicians, non-physician practitioners, and suppliers, are considered small businesses if they generate revenues of $8.5 million or less. Approximately 96 percent of physicians are considered to be small entities. There are about 700,000 physicians, other practitioners and medical suppliers that receive Medicare payment under the physician fee schedule. In addition, CAHs are considered small entities, either by nonprofit status or by having revenues of $6 to $29 million in any one year.

    Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. We have determined that this proposed rule will have no consequential effect on State, local, or tribal governments.

    We have examined this final rule in accordance with Executive Order 13132 and have determined that this regulation would not have any negative impact on the rights, roles, or responsibilities of State, local, or tribal governments.

    We have prepared the following analysis, which together with the rest of this preamble, meets all assessment requirements. It explains the rationale for, and purposes of, the rule, details the costs and benefits of the rule, analyzes alternatives, and presents the measures we are using to minimize the burden on small entities. As indicated elsewhere, we are making changes to the Medicare Economic Index, refining resource-based practice based practice expense RVUs, and making a variety of other changes to our regulations, payments, or payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We provide information for each of the policy changes in the relevant sections in this rule. In large part, the provisions of this rule are changing only Medicare payment rates for physician fee schedule services. While this rule allows physical and occupational therapists that are employed by physicians to separately enroll in the Medicare program, it does not impose reporting, recordkeeping, and other compliance requirements. We are unaware of any relevant Federal rules that duplicate, overlap, or conflict with this rule. The relevant sections of this contain a description of significant alternatives.

    A. Resource-Based Practice Expense Relative Value Units

    Under section 1848(c)(2) of the Act, adjustments to RVUs may not cause the amount of expenditures to differ by more than $20 million from the amount of expenditures that would have resulted without such adjustments. We are proposing several changes that would result in a change of expenditures that would exceed $20 million if we made no offsetting adjustments to either the CF or RVUs.

    With respect to practice expense, our policy has been to meet the budget-neutrality requirements in the statute by incorporating a rescaling adjustment in the practice expense methodology. That is, we estimate the aggregate number of practice expense RVUs that would be paid under current policies and under the policies we will be using in 2003. We apply a uniform adjustment factor to make the aggregate number of proposed practice expense relative values equal the number estimated that would have been paid under current policy. Consistent with section 1848(c)(2)(B)(ii)(II) of the Act, we ensure that changes to practice expense RVUs do not increase or decrease payments more than $20 million. We are also applying a 0.49 percent (0.9951) reduction to the practice expense RVUs to account for an anticipated increase in the volume and intensity of services in response to payment reductions from refinement of practice expense RVUs.

    Table 23 shows the specialty level impact of RVU changes on payment in 2003. As indicated in the June 2002 proposed rule (67 FR 43869), we are showing more specialty categories in our impact tables in this final rule than we have in the past. This change was well-received by the public, and we will continue to show impacts for the more detailed list of physician specialties, non-physician practitioners and medical suppliers. As indicated in the proposed rule, it is important to note that the payment impacts reflect averages for each specialty based on Medicare utilization. The payment impact for an individual physician would be different from the average, based on the mix of services the physician provides. The average change in total revenues would be less than the impact displayed here since physicians furnish services to both Medicare and non-Medicare patients and certain specialties may receive substantial Medicare revenues for services that are not paid under the physician fee schedule. For instance, independent laboratories receive more than 80 percent of their Medicare revenues from clinical laboratory services that are not paid under the physician fee schedule. Table 23 shows only the payment impact on physician fee schedule services.

    We modeled the impact of several changes that will affect payment for physician fee schedule services in CY 2003. The column labeled “NPRM” shows the impacts of our proposed rule policies and reflects the figures shown in the June 28, 2002 proposed rule (67 FR 43867). The remaining columns show additional impacts that will result from changes made in this final rule in response to comments. The column labeled practice expense refinements Start Printed Page 80035shows the impact on payment resulting from changes to practice expense inputs that are described in section II.A. As indicated earlier, we are making refinements to over 1,100 procedure codes. These changes result in little or no impact for most specialties. Dermatology, nephrology, and audiology will experience an approximate reduction in payment of 3 percent as a result of these changes. Payment will decline by an estimated 2 percent for others (clinical social workers, independent diagnostic testing facilities) while reductions in payments will be more modest for a few other specialties (cardiac surgery, neurosurgery, clinical psychology, orthopedic surgery and physician assistants). Payment will increase by an estimated 4 percent for independent laboratories as a result of these changes and by 2 percent for plastic surgery. Other specialties will experience smaller increases in payments from the practice expense refinements (endocrinology, family practice, general practice, obstetrics, gynecology, pediatrics, physical medicine, rhematology, urology, chiropractor, and optometry).

    The column labeled “5-Year Review” shows the impact revisions to payments for anesthesia services resulting from the 5-year review of physician work. As expected, the increase in anesthesia work results in a 1-percent increase in payment to anesthesiologists and a 2-percent increase to certified registered nurse anesthetists (CRNAs) that bill Medicare for anesthesia services. CRNAs bill Medicare almost exclusively for anesthesia services. Anesthesiologists bill Medicare for anesthesia services and other physician fee schedule services. The net increase in payment is slightly less for anesthesia services because it reflects the average increase in payment for anesthesia services and other physician fee schedule services that are not increasing as a result of the 5-year review

    The column labeled “All Other Changes” reflects all changes that affect practice expense RVUs described in section II. A. These changes include: (1) As requested by the American Urology Association (AUA), removing several codes From the non-physician work pool; (2) incorporating supplemental data from the American Physical Therapy Association (APTA) and; (3) continuing to determine the global practice expense RVUs as the sum of the PC and TC practice expense RVUs for pathology services. While removing the codes requested by the AUA will increase payments to urologists, it will result in a somewhat smaller increase in payment than proposed for the services remaining in the non-physician work pool. As expected, incorporating supplemental survey data will increase payment to physical and occupational therapists. Payment reductions to pathology and independent laboratories resulting from determining the TC value as the difference between the global and PC will not occur in CY 2003 since we are not making this change for 1 year for pathology services paid using the physician fee schedule.

    The column labeled “Total” shows the combined effect of all RVU changes on average Medicare payments for the specialties shown. The net effect of our final rule will continue to benefit several types of suppliers that provide services that are affected by the non-physician work pool methodology. Payments to Independent Diagnostic Testing Facilities will increase by approximately 4 percent. Portable x-ray suppliers will also receive an approximate increase of 4 percent in payments for services paid under the physician fee schedule. However, we note that only about 47 percent of Medicare revenues received by portable x-ray suppliers are attributable to physician fee schedule services. The other Medicare revenues received by portable x-ray suppliers are attributed to the transportation of x-ray equipment paid at rates determined by the Medicare carrier. Any change to the rates for carrier-priced services would be made at local carrier discretion. We recently asked our Medicare carriers to analyze payment for portable x-ray transportation since it has been a number of years since payment for this service has been reviewed.

    Table 23.—Impact of Work and Practice Expense Changes on Total Medicare Allowed Charges by Physician, Practitioner and Supplier Subcategory

    CategoryMedicare allowed charges ($ in billions)NPRM (percent)Practice expense refinements (percent)5-year review (percent)All other changes (percent)Total (percent)
    Physicians:
    ALLERGY/IMMUNOLOGY0.1420001
    ANESTHESIOLOGY1.24−10101
    CARDIAC SURGERY0.280−100−1
    CARDIOLOGY4.75100−11
    CLINICS2.5700000
    DERMATOLOGY1.55−2−301−4
    EMERGENCY MEDICINE1.1700000
    ENDOCRINOLOGY0.21010−10
    FAMILY PRACTICE3.4301000
    GASTROENTEROLOGY1.34−1000−1
    GENERAL PRACTICE0.8401000
    GENERAL SURGERY1.98−1000−1
    GERIATRICS0.0800000
    HEMATOLOGY/ONCOLOGY0.9510001
    INFECTIOUS DISEASE0.28−1000−1
    INTERNAL MEDICINE6.7700000
    INTERVENTIONAL RADIOLOGY0.14100−2−1
    NEPHROLOGY1.09−1−300−4
    NEUROLOGY0.9120002
    NEUROSURGERY0.38−1−100−1
    OBSTETRICS/GYNECOLOGY0.4801001
    OPHTHALMOLOGY3.86−1000−1
    ORTHOPEDIC SURGERY2.400−100−2
    OTOLARNGOLOGY0.66000−1−1
    Start Printed Page 80036
    PATHOLOGY0.69−20020
    PEDIATRICS0.0501001
    PHYSICAL MEDICINE0.4911002
    PLASTIC SURGERY0.25−12000
    PSYCHIATRY1.000000−1
    PULMONARY DISEASE1.1200000
    RADIATION ONCOLOGY0.81300−21
    RADIOLOGY3.47200−11
    RHEUMATOLOGY0.30010−10
    THORACIC SURGERY0.430000−1
    UROLOGY1.36−11022
    VASCULAR SURGERY0.3720001
    Other Practitioners:
    AUDIOLOGIST0.028−30−22
    CHIROPRACTOR0.50−1100−1
    CLINICAL PSYCHOLOGIST0.401−1000
    CLINICAL SOCIAL WORKER0.230−200−1
    NURSE ANESTHETIST0.38−10201
    NURSE PRACTITIONER0.3000000
    OPTOMETRY0.54−210−1−1
    PHYSICAL/OCCUPATIONAL THERAPY0.6100032
    PHYSICIANS ASSISTANT0.230−100−1
    PODIATRY1.17−10000
    Suppliers:
    DIAGNOSTIC TESTING FACILITY0.519−20−43
    INDEPENDENT LABORATORY0.43−84083
    PORTABLE X-RAY SUPPLIER0.07800−34
    ALL OTHER0.290−100−1
    ALL PHYSICIAN FEE SCHEDULE53.5300000

    Table 24 shows the combined impact of changes in payment due to RVUs and the physician fee schedule update. As described in section V, section 1848(d)(4) of the Act requires the physician fee schedule update to be −4.4 percent. We do not have the authority to change the physician fee schedule update formula specified in the statute. Table 24 shows the estimated change in average payments by specialty based on the provisions of this final rule and the physician fee schedule update.

    Table 24.—Estimated Impact of All Changes on Total Medicare Allowed Charges by Specialty

    CategoryMedicare allowed charges ($ in billions)5 Year review/RVU changes percentPhysician fee schedule update percentTotal percent
    Physicians:
    ALLERGY/IMMUNOLOGY0.141−4.4−3
    ANESTHESIOLOGY1.241−4.4−3
    CARDIAC SURGERY0.28−1−4.4−6
    CARDIOLOGY4.751−4.4−4
    CLINICS2.570−4.4−5
    DERMATOLOGY1.55−4−4.4−8
    EMERGENCY MEDICINE1.170−4.4−5
    ENDOCRINOLOGY0.210−4.4−5
    FAMILY PRACTICE3.430−4.4−5
    GASTROENTEROLOGY1.34−1−4.4−5
    GENERAL PRACTICE0.840−4.4−4
    GENERAL SURGERY1.98−1−4.4−5
    GERIATRICS0.080−4.4−5
    HEMATOLOGY/ONCOLOGY0.951−4.4−3
    INFECTIOUS DISEASE0.28−1−4.4−5
    INTERNAL MEDICINE6.770−4.4−5
    INTERVENTIONAL RADIOLOGY0.14−1−4.4−5
    NEPHROLOGY1.09−4−4.4−8
    NEUROLOGY0.912−4.4−2
    NEUROSURGERY0.38−1−4.4−6
    Start Printed Page 80037
    OBSTETRICS/GYNECOLOGY0.481−4.4−3
    OPHTHALMOLOGY3.86−1−4.4−5
    ORTHOPEDIC SURGERY2.40−2−4.4−7
    OTOLARNGOLOGY0.66−1−4.4−5
    PATHOLOGY0.690−4.4−5
    PEDIATRICS0.051−4.4−4
    PHYSICAL MEDICINE0.492−4.4−3
    PLASTIC SURGERY0.250−4.4−4
    PSYCHIATRY1.00−1−4.4−5
    PULMONARY DISEASE1.120−4.4−4
    RADIATION ONCOLOGY0.811−4.4−3
    RADIOLOGY3.471−4.4−4
    RHEUMATOLOGY0.300−4.4−4
    THORACIC SURGERY0.43−1−4.4−5
    UROLOGY1.362−4.4−3
    VASCULAR SURGERY0.371−4.4−3
    Other Practitioners:
    AUDIOLOGIST0.022−4.4−2
    CHIROPRACTOR0.50−1−4.4−5
    CLINICAL PSYCHOLOGIST0.400−4.4−4
    CLINICAL SOCIAL WORKER0.23−1−4.4−5
    NURSE ANESTHETIST0.381−4.4−4
    NURSE PRACTITIONER0.300−4.4−5
    OPTOMETRY0.54−1−4.4−5
    PHYSICAL/OCCUPATIONAL THERAPY0.612−4.4−3
    PHYSICIANS ASSISTANT0.23−1−4.4−6
    PODIATRY1.170−4.4−5
    Suppliers:
    DIAGNOSTIC TESTING FACILITY0.513−4.4−1
    INDEPENDENT LABORATORY0.433−4.4−1
    PORTABLE X−RAY SUPPLIER0.074−4.40
    ALL OTHER0.29−1−4.4−6
    ALL PHYSICIAN FEE SCHEDULE53.530−4.4−5

    Table 25 shows the impact of all of the changes previously discussed on payments for selected high volume procedures. This table shows the combined impact of changes in RVUs and the physician fee schedule update on total payment for the procedure. There are separate columns that show the change in the facility rates and the nonfacility rates. For an explanation of facility and non−facility practice expense refer to § 414.22(b)(5)(i).

     Table 25.—Impact of Proposed Rule and Physician Fee Schedule Update on Medicare Payment for Selected Procedures

    HCPCSMODDESCNon-FacilityFacility
    OldNew% ChangeOldNew% Change
    11721Debride nail, 6 or more$36.92$35.28^4$28.96$27.33^6
    17000Destroy benign/premlg lesion62.6257.77^832.9431.13^5
    27130Total hip arthroplastyN/AN/AN/A1,452.311,263.30^13
    27236Treat thigh fractureN/AN/AN/A1,113.851,005.24^10
    27244Treat thigh fractureN/AN/AN/A1,137.381,086.53^4
    27447Total knee arthroplastyN/AN/AN/A1,514.211,359.47^10
    33533CABG, arterial, singleN/AN/AN/A1,827.341,691.89^7
    35301Rechanneling of arteryN/AN/AN/A1,061.361,009.74^5
    43239Upper GI endoscopy, biopsy354.75317.55^10154.93146.67^5
    45385Lesion removal colonoscopy571.22513.00^10287.78273.28^5
    66821After cataract laser surgery229.50215.51^6213.94200.29^6
    66984Cataract surg w/iol, 1 stageN/AN/AN/A669.32630.61^6
    67210Treatment of retinal lesion603.08568.35^6546.61515.77^6
    7101026Chest x-ray9.058.65^49.058.65^4
    7102026Chest x-ray11.2210.38^711.2210.38^7
    76091Mammogram, both breasts90.5088.21^3N/AN/AN/A
    7609126Mammogram, both breasts43.4441.51^443.4441.51^4
    76092Mammogram, screening81.8177.83^5N/AN/AN/A
    7609226Mammogram, screening35.4833.90^435.4833.90^4
    77427Radiation tx management, 5167.96158.09^6167.96158.09^6
    7846526Heart image (3d), multiple74.9370.91^574.9370.91^5
    8830526Tissue exam by pathologist40.5438.40^540.5438.40^5
    90801Psy dx interview144.80140.10^3137.19132.14^4
    90806Psytx, off, 45-50 min95.9390.63^691.2287.17^4
    Start Printed Page 80038
    90807Psytx, off, 45-50 min w/e&m103.5396.51^798.8294.09^5
    90862Medication management51.0447.74^646.3344.97^3
    90921ESRD related services, month273.30246.64^10273.30246.64^10
    90935Hemodialysis, one evaluationN/AN/AN/A76.3867.11^12
    92004Eye exam, new patient123.44116.23^687.9683.02^6
    92012Eye exam established pat61.1857.77^635.8433.90^5
    92014Eye exam & treatment91.2285.44^658.6455.35^6
    92980Insert intracoronary stentN/AN/AN/A788.06752.72^4
    92982Coronary artery dilationN/AN/AN/A582.45559.01^4
    93000Electrocardiogram, complete25.3424.91^2N/AN/AN/A
    93010Electrocardiogram report9.058.30^89.058.30^8
    93015Cardiovascular stress test99.9197.55^2N/AN/AN/A
    9330726Echo exam of heart48.1445.32^648.1445.32^6
    9351026Left heart catheterization230.59217.58^6230.59217.58^6
    98941Chiropractic manipulation35.4833.55^531.1329.40^6
    99202Office/outpatient visit, new61.5458.81^445.6143.24^5
    99203Office/outpatient visit, new91.9587.17^569.5066.07^5
    99204Office/outpatient visit, new130.68124.19^5102.8197.55^5
    99205Office/outpatient visit, new166.15158.43^5136.47129.37^5
    99211Office/outpatient visit, est20.2719.37^48.698.30^4
    99212Office/outpatient visit, est36.2034.25^523.1721.79^6
    99213Office/outpatient visit, est50.3248.08^434.0332.52^4
    99214Office/outpatient visit, est78.9175.06^556.1153.27^5
    99215Office/outpatient visit, est115.84110.00^590.5085.79^5
    99221Initial hospital careN/AN/AN/A65.1661.92^5
    99222Initial hospital careN/AN/AN/A108.24102.74^5
    99223Initial hospital careN/AN/AN/A150.95142.86^5
    99231Subsequent hospital careN/AN/AN/A32.5830.79^5
    99232Subsequent hospital careN/AN/AN/A53.5750.85^5
    99233Subsequent hospital careN/AN/AN/A76.3872.30^5
    99236Observ/hosp same dateN/AN/AN/A214.66203.75^5
    99238Hospital discharge dayN/AN/AN/A66.2465.03^2
    99239Hospital discharge dayN/AN/AN/A90.8688.21^3
    99241Office consultation47.0644.62^533.3031.13^7
    99242Office consultation87.2483.02^568.0564.00^6
    99243Office consultation115.84109.66^590.1485.10^6
    99244Office consultation164.34156.01^5133.58126.26^5
    99245Office consultation212.85202.36^5177.01167.08^6
    99251Initial inpatient consultN/AN/AN/A34.7532.86^5
    99252Initial inpatient consultN/AN/AN/A69.8666.07^5
    99253Initial inpatient consultN/AN/AN/A95.2090.29^5
    99254Initial inpatient consultN/AN/AN/A136.83129.72^5
    99255Initial inpatient consultN/AN/AN/A188.60178.49^5
    99261Follow^up inpatient consultN/AN/AN/A21.7220.76^4
    99262Follow^up inpatient consultN/AN/AN/A43.4441.16^5
    99263Follow^up inpatient consultN/AN/AN/A64.8061.23^6
    99282Emergency dept visitN/AN/AN/A26.4325.25^4
    99283Emergency dept visitN/AN/AN/A59.3756.73^4
    99284Emergency dept visitN/AN/AN/A92.6788.56^4
    99285Emergency dept visitN/AN/AN/A144.80138.02^5
    99291Critical care, first hour208.87197.52^5198.37188.18^5
    99292Critical care, addl 30 min108.24101.35^698.8294.09^5
    99301Nursing facility care70.2366.76^560.0957.42^4
    99302Nursing facility care95.5790.98^580.7276.45^5
    99303Nursing facility care118.73112.77^5100.2795.13^5
    99311Nursing fac care, subseq40.1838.40^430.0528.71^4
    99312Nursing fac care, subseq61.9058.81^549.9547.39^5
    99313Nursing fac care, subseq84.3480.60^470.9567.45^5
    99348Home visit, est patient73.8569.88^5N/AN/AN/A
    99350Home visit, est patient166.52157.74^5N/AN/AN/A
    G0008Admin influenza virus vac3.987.2682N/AN/AN/A
    G0009Admin pneumococcal vaccine3.987.2682N/AN/AN/A
    G0010Admin hepatitis b vaccine3.987.2682N/AN/AN/A

    B. Proposed Productivity Adjustment to the MEI

    As indicated in section VI.B. of this final rule, we are adopting the proposed change to the methodology for adjusting for productivity in the MEI. We will use the 10-year moving average of private nonfarm business (economy-wide) multifactor productivity applied to the entire index to calculate the MEI beginning in CY 2003. The prior method accounted for productivity by adjusting the labor portion of the MEI by the 10-year moving average change in private nonfarm business (economy-wide) labor productivity. Our reasons for proposing this change and the alternatives we considered are discussed in detail in section VI.

    We believe that we have developed a revised MEI methodology that is technically superior to the current MEI and more adequately reflects annual changes in the cost of furnishing services in efficient physicians' practices. The change to the MEI will Start Printed Page 80039raise the index by 0.7 percentage points from 2.3 percent to 3.0 percent for 2003. We estimate that this change will increase Federal expenditures by $150 million in FY 2003. The outyear impact is a function of numerous economic variables that fluctuate unpredictably. Our estimate of the impact beyond FY 2003 is based on projections of both the current and revised index. We estimate the change would increase Federal expenditures by $340 million in FY 2004 and $550 million in FY 2005.

    C. Site of Service

    Relative values for practice expense are determined for both “facility” and “non-facility” settings. (See Addendum B.) We are clarifying whether a given place of service is either a facility or non-facility site for purposes of determining Medicare payment. This clarification should benefit physicians, providers, and Medicare contractors by making the payment rules clearer. We are updating the facility and non-facility designations for several new place-of-service codes and changing the designations for several already in existence. The update for the new place-of-service codes will have no effect on Medicare spending. The place-of-service codes in which we are changing the designation are infrequently used for physician fee schedule services. This rule could result in a minor redistribution in payment among physician fee schedule services through the practice expense budget-neutrality adjustments.

    D. Pricing of Technical Components (TC) for Positron Emission Tomography (PET) Scans

    As stated earlier, to keep pricing consistent with the manner in which other PET scan services are paid, we are changing from national pricing to carrier pricing for the TC and global value for HCPCS code G0125 Lung Image PET scans. The budgetary impact on the Medicare program and providers would be uncertain since we do not know the payment amounts that carriers would use for this service.

    E. Medicare Qualifications for Clinical Nurse Specialists (CNSs)

    As previously stated, we are revising regulations regarding qualifications for CNSs by allowing flexibility as to certifying bodies. We believe this change will make the Medicare requirements more consistent with criteria for nurse practitioners. We also believe there will be additional enrollment of CNSs that will qualify for Medicare enrollment. We expect that this policy will have little effect on Medicare expenditures.

    F. Process To Add or Delete Services to the Definition of Telehealth

    We are finalizing a process for adding or deleting services from the list of telehealth services. In addition, we are adding psychiatric diagnostic interview examinations, CPT code 90801, to the list of Medicare telehealth services. We believe this will have little effect on Medicare expenditures.

    G. Change in Global Period for CPT code 77789 (Surface Application of Radiation Source

    We are changing the global period for CPT code 77789 (surface application of radiation source) from a 90-day global period to a 000-day global period. We believe physicians that furnish these services will benefit from this change because it will simplify their billing processes. We do not expect it will have a significant impact on the Medicare program because the change will reflect current practices.

    H. New HCPCS G-Codes

    In section K we discuss new G-codes for—treatment of peripheral neuropathy; current perception sensory nerve conduction threshold tests; PET codes for breast imaging; and home prothrombin time INR monitoring for anticoagulation management. We have withdrawn our proposal for a new G code for bone marrow aspiration and biopsy on the same date of service. All G codes except for the G code for bone marrow aspiration and biopsy on the same date of service have been implemented during CY 2002 through Program Memoranda as a result of national coverage decisions or the need to clarify payment policy. As stated, we are not proceeding with a G code for bone marrow aspiration and biopsy on the same date of service.

    I. Endoscopic Base For Urology Codes

    We are correcting the pricing of certain endoscopic services. As we previously indicated, we will use CPT procedure code 52000 as the endoscopic base code for CPT procedure codes 52234, 52235, and 52240. This will result in a reduction in payment in instances when these codes are billed in conjunction with either CPT procedure code 52000 or other codes that have CPT procedure code 52000 as the endscopic base code. We expect the savings will be negligible.

    J. Physical Therapy and Occupational Therapy Caps

    There were no proposals made in this area. The imposition of the physical and occupational therapy caps will occur as a result of application of section 4541(c) of the BBA. While section 221 of the BBRA and section 421 of BIPA placed a moratorium on application of these caps, the moratorium expires for physical and occupational therapy services furnished after December 31, 2002. We estimate that application of the caps will reduce Medicare expenditures for physical and occupational therapy services by $240 million in CY 2003.

    K. Enrollment of Physical and Occupational Therapists as Therapists in Private Practice

    This change will provide flexibility for therapists by allowing therapists that meet the enrollment criteria to enroll in Medicare without regard to how they are organized to provide services. We do not expect this will have a significant effect on Medicare expenditures because Medicare pays the same amount for these therapy services whether they are billed directly by a therapist or by a physician as an incident to service.

    L. Screening Fecal Occult Blood Tests

    As discussed in section II.N (1) of the preamble, we are modifying our regulations to allow us to expand coverage when appropriate for (1) screening fecal-occult blood tests for the early detection of colorectal cancer, and (2) additional colorectal cancer screening tests through our national coverage determination process. These changes will allow us to conduct more timely assessments of new types of colon cancer screening tests than is normally possible under the standard rulemaking process. There are no costs or savings to the Medicare program associated with this regulation change.

    M. Add-on Anesthesia Codes

    The add-on codes, two for obstetrical anesthesia (CPT codes 01968 and 01969) and one for burn excisions (CPT code 01953), represent low volume codes for the Medicare population. We believe the new policy for add-on codes will have a negligible impact on total anesthesia payments.

    N. Physician Self-Referral Prohibitions

    As discussed in section IV of this preamble, we are updating the list of codes used to define certain designated health services for the purposes of section 1877 of the Act. We are not making any substantive change to the description of any designated health Start Printed Page 80040service as set forth in the January 4, 2001 physician self-referral final rule (66 FR 856). Instead, we are merely updating our list of codes to conform to coding changes in the most recent publication of CPT and HCPCS codes.

    For this reason, we certify that the changes we are making will not have a significant economic effect on a substantial number of small entities or on the operations of a substantial number of small rural hospitals.

    O. Critical Access Hospital Emergency Services Requirement

    We anticipate that this rule will reduce cost for small CAHs. Frontier area and remote location CAHs will no longer be limited to hiring only a physician, nurse practitioner or physician assistant to provide emergency coverage in the absence of the sole practitioner. This rule will provide relief to small CAHs in meeting the current emergency staffing requirement by allowing them to utilize a registered nurse to provide emergency care services once the State submits a letter to us, signed by the Governor, following consultation with the State Boards of Medicine and Nursing, and in accordance with State law, requesting that RNs be included as emergency personnel in § 485.618(d).

    P. Alternatives Considered

    This final rule contains a range of policies. The preamble identifies those policies when discretion has been exercised and presents rationale for our decisions, including a presentation of nonselected options (except for the critical access hospital emergency services requirement which is provided separately).

    Critical Access Hospitals Emergency Services Personnel Requirement

    We considered allowing each CAH in a frontier area or remote location to individually request a waiver of the requirements at § 485.618(a) and (d). The statute does not provide authority to waive the requirement for continuous emergency room coverage. Section 1820(c)(B)(ii) requires a qualifying CAH to make available the 24-hour emergency care services that a State determines are necessary for ensuring access to emergency care services in each area served by a CAH. However, we believe States may interpret emergency care services to allow CAHs to use a RN in order to comply with the emergency services personnel requirement stated in the regulations at § 485.618. This change is consistent with our policy of respecting State oversight of health care professions by deferring to State law to regulate professional practice.

    Q. Impact on Beneficiaries

    Although changes in physicians' payments were large when the physician fee schedule was implemented in 1992, we detected no problems with beneficiary access to care. We do not believe that there would be any problem with access to care as a result of the changes in this rule. While it has been suggested that the negative update for CY 2003 may affect beneficiary access to care, we note that the formula to determine this update is set by statute and this regulation cannot, and does not, change it.

    As indicated above, the imposition of the physical and occupational therapy caps will occur as a result of application of section 4541(c) of the BBA. It is possible that application of physical and occupational therapy caps will have an impact on Medicare beneficiaries either through increased liability for services exceeding the cap or fewer services being provided. We contracted with the Urban Institute to perform analyses related to the implementation of the therapy caps, based on an analysis of a sample of therapy services provided from CYs 1998 through 2000. The draft reports are available on the CMS website. The contractor report indicated that in CY 2000, about 12 percent of patients who received therapy services would have exceeded the caps. The caps are more likely to be exceeded in skilled nursing facilities, comprehensive outpatient rehabilitation facilities, and other rehabilitation facility settings. The caps do not apply to outpatient therapy services provided in an outpatient hospital. The report does not make assumptions about changes in behavior in response to the caps. Without more experience with the caps, it is difficult to predict the precise impact on beneficiaries.

    In addition, CAHs in frontier areas and remote locations will be able to satisfy the CAH emergency services personnel requirement, through the addition of RNs to our personnel requirements and beneficiaries will have greater access to care through the utilization of RNs providing emergency care services to patients.

    In accordance with the provisions of Executive Order 12866, the Office of Management and Budget reviewed this regulation.

    Start List of Subjects

    List of Subjects

    42 CFR Part 410

    • Health facilities
    • Health professions
    • Kidney diseases
    • Laboratories
    • Medicare
    • Rural areas
    • X-rays

    42 CFR Part 414

    • Administrative practice and procedure
    • Health facilities
    • Health professions
    • Kidney diseases
    • Medicare
    • Reporting and recordkeeping requirements
    • Rural areas
    • X-rays

    42 CFR Part 485

    • Grant programs-health
    • Health facilities
    • Medicaid
    • Medicare
    • Reporting and recordkeeping requirements
    End List of Subjects

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

    Start Part

    PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

    End Part Start Amendment Part

    1. The authority citation for part 410 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 Start Amendment Part

    2. In § 410.37, paragraphs (a)(1)(v) and (a)(2) are revised to read as follows:

    End Amendment Part
    Colorectal cancer screening tests: Conditions for and limitations on coverage.

    (a) * * *

    (1) * * *

    (v) Other tests or procedures established by a national coverage determination, and modifications to tests under this paragraph, with such frequency and payment limits as CMS determines appropriate, in consultation with appropriate organizations

    (2) Screening fecal-occult blood test means—

    (i) A guaiac-based test for peroxidase activity, testing two samples from each of three consecutive stools, or,

    (ii) Other tests as determined by the Secretary through a national coverage determination.

    * * * * *
    Start Amendment Part

    3. Section 410.59 is amended as follows:

    End Amendment Part

    A. Paragraph (c)(1)(ii)(C) is revised.

    B. A new paragraph (c)(1)(ii)(D) is added.

    C. A new paragraph (c)(1)(ii)(E) is added.

    The revision and additions read as follows:

    Outpatient occupational therapy services: Conditions.
    * * * * *
    Start Printed Page 80041

    (c) * * *

    (1) * * *

    (ii) * * *

    (C) An unincorporated solo practice, partnership, or group practice, or a professional corporation or other incorporated occupational therapy practice.

    (D) An employee of a physician group.

    (E) An employee of a group that is not a professional corporation.

    * * * * *
    Start Amendment Part

    4. Section 410.60 is amended as follows:

    End Amendment Part

    A. Paragraph (c)(1)(ii)(C) is revised.

    B. A new paragraph (c)(1)(ii)(D) is added.

    C. A new paragraph (c)(1)(ii)(E) is added

    The revision and additions read as follows:

    Outpatient physical therapy services: Conditions
    * * * * *

    (c) * * *

    (1) * * *

    (ii) * * *

    (C) An unincorporated solo practice, partnership, or group practice, or a professional corporation or other incorporated physical therapy practice.

    (D) An employee of a physician group.

    (E) An employee of a group that is not a professional corporation.

    * * * * *
    Start Amendment Part

    5. Section 410.61 is amended by revising paragraph (d)(1)(iii) to read as follows:

    End Amendment Part
    Plan of treatment requirements for outpatient rehabilitation services.

    (d) * * *

    (1) * * *

    (iii) The occupational therapist that furnishes the occupational therapy services.

    * * * * *
    Start Amendment Part

    6. Section 410.76 is amended by revising paragraph (b)(3) to read as follows:

    End Amendment Part
    Clinical nurse specialists' services.
    * * * * *

    (b) * * *

    (3) Be certified as a clinical nurse specialist by a national certifying body that has established standards for clinical nurse specialists and that is approved by the Secretary.

    * * * * *
    Start Amendment Part

    7. Section 410.78 is amended as follows:

    End Amendment Part Start Amendment Part

    a. Revise the heading of the section.

    End Amendment Part Start Amendment Part

    b. Revise the introductory text of paragraph (b).

    End Amendment Part Start Amendment Part

    c. Revise paragraph (b)(1).

    End Amendment Part Start Amendment Part

    d. Add a new paragraph (f).

    End Amendment Part

    The revisions and additions read as follows:

    Telehealth services.
    * * * * *

    (b) General rule. Medicare Part B pays for office and other outpatient visits, professional consultation, psychiatric diagnostic interview examination, individual psychotherapy, and pharmacologic management furnished by an interactive telecommunications system if the following conditions are met:

    (1) The physician or practitioner at the distant site must be licensed to furnish the service under State law. The physician or practitioner at the distant site who is licensed under State law to furnish a covered telehealth service described in this section may bill, and receive payment for, the service when it is delivered via a telecommunications system.

    * * * * *

    (f) Process for adding or deleting services. Changes to the list of Medicare telehealth services are made through the annual physician fee schedule rulemaking process.

    Start Part

    PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES

    End Part Start Amendment Part

    1. The authority citation for part 414 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).

    End Authority Start Amendment Part

    2. Section 414.46 is amended by revising paragraph (g) to read as follows:

    End Amendment Part
    Additional rules for payment of anesthesia services.
    * * * * *

    (g) Physician involved in multiple anesthesia services. If the physician is involved in multiple anesthesia services for the same patient during the same operative session, the carrier makes payment according to the base unit associated with the anesthesia service having the highest base unit value and anesthesia time that encompasses the multiple services. The carrier makes payment for add-on anesthesia codes according to program operating instructions.

    Start Amendment Part

    3. Section 414.65, is amended as follows:

    End Amendment Part Start Amendment Part

    a. Revise the heading of the section.

    End Amendment Part Start Amendment Part

    b. Revise paragraph (a)(1).

    End Amendment Part Start Amendment Part

    c. Revise paragraph (b) introductory text.

    End Amendment Part

    The revisions read as follows:

    Payment for telehealth services.

    (a) * * *

    (1) The Medicare payment amount for office or other outpatient visits, consultation, individual psychotherapy, psychiatric diagnostic interview examination, and pharmacologic management furnished via an interactive telecommunications system is equal to the current fee schedule amount applicable for the service of the physician or practitioner.

    * * * * *

    (b) Originating site facility fee. For telehealth services furnished on or after October 1, 2001:

    * * * * *
    Start Part

    PART 485—CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS

    End Part Start Amendment Part

    Part 485 is amended as set forth below:

    End Amendment Part Start Amendment Part

    1. The authority citation for 485 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102 and 1871 of the Act (42 U.S.C. 1302 and 1396hh).

    End Authority Start Amendment Part

    2. Section 485.618 is amended by revising paragraph (d) to read as follows:

    End Amendment Part
    Condition of participation: Emergency services.
    * * * * *

    (d) Standard: Personnel. (1) Except as specified in paragraph (d)(2) of this section, there must be a doctor of medicine or osteopathy, a physician assistant, or a nurse practitioner, with training or experience in emergency care on call and immediately available by telephone or radio contact, and available on site within the following timeframes:

    (i) Within 30 minutes, on a 24-hour a day basis, if the CAH is located in an area other than an area described in paragraph (d)(1)(ii) of this section; or

    (ii) Within 60 minutes, on a 24-hour a day basis, if all of the following requirements are met:

    (A) The CAH is located in an area designated as a frontier area (that is, an area with fewer than six residents per square mile based on the latest population data published by the Bureau of the Census) or in an area that meets the criteria for a remote location adopted by the State in its rural health care plan, and approved by CMS, under section 1820(b) of the Act.

    (B) The State has determined, under criteria in its rural health care plan, that allowing an emergency response time longer than 30 minutes is the only feasible method of providing emergency care to residents of the area served by the CAH. Start Printed Page 80042

    (C) The State maintains documentation showing that the response time of up to 60 minutes at a particular CAH it designates is justified because other available alternatives would increase the time needed to stabilize a patient in an emergency.

    (2) A registered nurse satisfies the personnel requirement specified in paragraph (d)(1) of this section for a temporary period if—

    (i) The CAH has no greater than 10 beds;

    (ii) The CAH is located in an area designated as a frontier area or remote location as described in paragraph (d)(1)(ii)(A) of this section;

    (iii) The State in which the CAH is located submits a letter to CMS signed by the Governor, following consultation on the issue of using RNs on a temporary basis as part of their State rural healthcare plan with the State Boards of Medicine and Nursing, and in accordance with State law, requesting that a registered nurse with training and experience in emergency care be included in the list of personnel specified in paragraph (d)(1) of this section. The letter from the Governor must attest that he or she has consulted with State Boards of Medicine and Nursing about issues related to access to and the quality of emergency services in the States. The letter from the Governor must also describe the circumstances and duration of the temporary request to include the registered nurses on the list of personnel specified in paragraph (d)(1) of this section;

    (iv) Once a Governor submits a letter, as specified in paragraph (d)(2)(ii) of this section, a CAH must submit documentation to the State survey agency demonstrating that it has been unable, due to the shortage of such personnel in the area, to provide adequate coverage as specified in this paragraph (d).

    (3) The request, as specified in paragraph(d)(2)(ii) of this section, and the withdrawal of the request, may be submitted to us at any time, and are effective upon submission.

    * * * * *
    Start Signature

    (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

    Dated: November 26, 2002.

    Thomas A. Scully,

    Administrator, Centers for Medicare & Medicaid Services.

    End Signature Start Signature
    Approved: December 12, 2002.

    Tommy G. Thompson,

    Secretary.

    End Signature

    Note:

    These addenda will not appear in the Code of Federal Regulations.

    Addendum A—Explanation and Use of Addenda B

    The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians' services furnished in 2003. Addendum B contains the RVUs for work, non-facility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.

    In previous years, we have listed many services in Addendum B that are not paid under the physician fee schedule. To avoid publishing as many pages of codes for these services, we are not including clinical laboratory codes and most alpha-numeric codes (Healthcare Common Procedure Coding System (HCPCS) codes not included in CPT) in Addendum B.

    Addendum B—2003 Relative Value Units and Related Information Used in Determining Medicare Payments for 2003

    This addendum contains the following information for each CPT code and alphanumeric HCPCS code for services that may be paid under the physician fee schedule as well as all G codes

    1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum.

    2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier -26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code: One for the global values (both professional and technical); one for modifier -26 (PC); and one for modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service.

    Modifier -53 is shown for a discontinued procedure. There will be RVUs for the code (CPT code 45378) with this modifier.

    3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the physician fee schedule and whether it is separately payable if the service is covered.

    A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an “A” indicator does not mean that Medicare has made a national decision regarding the coverage of the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.

    B = Bundled code. Payment for covered services is always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient.)

    C = Carrier-priced code. Carriers will establish RVUs and payment amounts for these services, generally on a case-by-case basis following review of documentation, such as an operative report.

    D = Deleted code. These codes are deleted effective with the beginning of the calendar year.

    E = Excluded from physician fee schedule by regulation. These codes are for items or services that we chose to exclude from the physician fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the physician fee schedule for these codes. Payment for them, if they are covered, continues under reasonable charge or other payment procedures.

    F = Deleted/discontinued codes. Code not subject to a 90-day grace period.

    G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services.

    H = Deleted modifier. Either the TC or PC component shown for the code has been deleted, and the deleted component is shown in the data base with the H status indicator. (Code subject to a 90-day grace period.)

    I = Not valid for Medicare purposes. Medicare uses another code for the reporting of, and the payment for these services. (Code NOT subject to a 90-day grace period.)

    N = Noncovered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.

    P = Bundled or excluded code. There are no RVUs for these services. No separate payment should be made for them under the physician fee schedule.

    —If the item or service is covered as incident to a physician's service and is furnished on the same day as a physician's service, payment for it is bundled into the payment for the physician's service to which it is incident (an example is an elastic bandage furnished by a physician incident to a physician's service).

    —If the item or service is covered as other than incident to a physician's Start Printed Page 80043service, it is excluded from the physician fee schedule (for example, colostomy supplies) and is paid under the other payment provisions of the Act.

    R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced.

    T = Injections. There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the service(s) for which payment is made.

    X = Exclusion by law. These codes represent an item or service that is not within the definition of “physicians' services” for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)

    4. Description of code. This is an abbreviated version of the narrative description of the code.

    5. Physician work RVUs. These are the RVUs for the physician work for this

    service in 2003. Codes that are not used for Medicare payment are identified with a “+.”

    6. Facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for facility settings. An “NA” in the facility column means that we do not pay for the service in a facility setting. For instance, we do not pay using the physician fee schedule for the global or technical component of a radiology service or other diagnostic test in a facility setting. Also, there is no payment in a facility setting for “incident to” services (services that do not have physician work RVUs). Payment is included in our payment for institutional services.

    7. Non-facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for non-facility settings. An “NA” in the nonfacility column means that the service is generally not provided outside of hospitals and we do not have information upon which to determine a price. In most cases, these are major surgical services.

    8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2003.

    9. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.

    10. Non-facility total. This is the sum of the work, fully implemented non-facility practice expense, and malpractice expense RVUs.

    11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows:

    MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians' Current Procedural Terminology for specific definitions.

    XXX = The global concept does not apply.

    YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).

    ZZZ = Code related to another service and is always included in the global period of the other service. (Note: Physician work is associated with intra service time and in some instances the pre- and post-service time.)

    Start Printed Page 80044

    —————————— 1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 2002 American Dental Association. All rights reserved. 3 + Indicates RVUs are not used for Medicare payment. Start Printed Page 80044

    Addendum B.—Relative Value Units (RVUS) and Related Information

    CPT 1/ HCPCS 2MODStatusDescriptionPhysician Work RVUs3Non- Facility PE RVUsFacility PE RVUsMal- Practice RVUsNon- Facility TotalFacility TotalGlobal
    0001TCEndovas repr abdo ao aneurys0.000.000.000.000.000.00XXX
    0002TCEndovas repr abdo ao aneurys0.000.000.000.000.000.00XXX
    0003TCCervicography0.000.000.000.000.000.00XXX
    0005TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0006TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0007TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0008TCUpper gi endoscopy w/suture0.000.000.000.000.000.00XXX
    0009TCEndometrial cryoablation0.000.000.000.000.000.00XXX
    0010TCTb test, gamma interferon0.000.000.000.000.000.00XXX
    0012TCOsteochondral knee autograft0.000.000.000.000.000.00XXX
    0013TCOsteochondral knee allograft0.000.000.000.000.000.00XXX
    0014TCMeniscal transplant, knee0.000.000.000.000.000.00XXX
    0016TCThermotx choroid vasc lesion0.000.000.000.000.000.00XXX
    0017TCPhotocoagulat macular drusen0.000.000.000.000.000.00XXX
    0018TCTranscranial magnetic stimul0.000.000.000.000.000.00XXX
    0019TCExtracorp shock wave tx, ms0.000.000.000.000.000.00XXX
    0020TAExtracorp shock wave tx, ft0.061.460.020.011.530.09XXX
    0021TCFetal oximetry, trnsvag/cerv0.000.000.000.000.000.00XXX
    0023TCPhenotype drug test, hiv 10.000.000.000.000.000.00XXX
    0024TCTranscath cardiac reduction0.000.000.000.000.000.00XXX
    0025TCUltrasonic pachymetry0.000.000.000.000.000.00XXX
    0026TCMeasure remnant lipoproteins0.000.000.000.000.000.00XXX
    0027TCEndoscopic epidural lysis0.000.000.000.000.000.00XXX
    0028TCDexa body composition study0.000.000.000.000.000.00XXX
    0029TCMagnetic tx for incontinence0.000.000.000.000.000.00XXX
    0030TCAntiprothrombin antibody0.000.000.000.000.000.00XXX
    0031TCSpeculoscopy0.000.000.000.000.000.00XXX
    0032TCSpeculoscopy w/direct sample0.000.000.000.000.000.00XXX
    0033TCEndovasc taa repr incl subcl0.000.000.000.000.000.00XXX
    0034TCEndovasc taa repr w/o subcl0.000.000.000.000.000.00XXX
    0035TCInsert endovasc prosth, taa0.000.000.000.000.000.00XXX
    0036TCEndovasc prosth, taa, add-on0.000.000.000.000.000.00XXX
    0037TCArtery transpose/endovas taa0.000.000.000.000.000.00XXX
    0038TCRad endovasc taa rpr w/cover0.000.000.000.000.000.00XXX
    0039TCRad s/i, endovasc taa repair0.000.000.000.000.000.00XXX
    0040TCRad s/i, endovasc taa prosth0.000.000.000.000.000.00XXX
    0041TCDetect ur infect agnt w/cpas0.000.000.000.000.000.00XXX
    0042TCCt perfusion w/contrast, cbf0.000.000.000.000.000.00XXX
    0043TCCo expired gas analysis0.000.000.000.000.000.00XXX
    0044TCWhole body photography0.000.000.000.000.000.00XXX
    10021AFna w/o image1.272.37NA0.073.71NAXXX
    10022AFna w/image1.272.66NA0.053.98NAXXX
    10040AAcne surgery1.181.100.710.052.331.94010
    10060ADrainage of skin abscess1.171.490.670.082.741.92010
    10061ADrainage of skin abscess2.401.881.410.174.453.98010
    10080ADrainage of pilonidal cyst1.172.130.730.093.391.99010
    10081ADrainage of pilonidal cyst2.452.901.550.195.544.19010
    10120ARemove foreign body1.221.540.360.102.861.68010
    10121ARemove foreign body2.692.961.790.255.904.73010
    10140ADrainage of hematoma/fluid1.531.490.870.153.172.55010
    10160APuncture drainage of lesion1.200.770.420.112.081.73010
    10180AComplex drainage, wound2.251.481.270.253.983.77010
    11000ADebride infected skin0.600.640.240.051.290.89000
    11001ADebride infected skin add-on0.300.380.110.020.700.43ZZZ
    11010ADebride skin, fx4.202.401.960.457.056.61010
    11011ADebride skin/muscle, fx4.953.832.600.539.318.08000
    11012ADebride skin/muscle/bone, fx6.885.514.230.8913.2812.00000
    11040ADebride skin, partial0.500.520.210.051.070.76000
    11041ADebride skin, full0.820.660.330.061.541.21000
    11042ADebride skin/tissue1.120.970.470.092.181.68000
    11043ADebride tissue/muscle2.383.572.640.246.195.26010
    11044ADebride tissue/muscle/bone3.064.733.910.348.137.31010
    11055RTrim skin lesion0.430.510.180.020.960.63000
    11056RTrim skin lesions, 2 to 40.610.580.260.031.220.90000
    11057RTrim skin lesions, over 40.790.650.330.041.481.16000
    11100ABiopsy of skin lesion0.811.240.380.042.091.23000
    11101ABiopsy, skin add-on0.410.380.200.020.810.63ZZZ
    11200ARemoval of skin tags0.771.230.310.042.041.12010
    11201ARemove skin tags add-on0.290.560.120.020.870.43ZZZ
    11300AShave skin lesion0.510.990.220.031.530.76000
    11301AShave skin lesion0.851.100.390.041.991.28000
    Start Printed Page 80045
    11302AShave skin lesion1.051.300.480.052.401.58000
    11303AShave skin lesion1.241.590.540.062.891.84000
    11305AShave skin lesion0.670.840.270.041.550.98000
    11306AShave skin lesion0.991.100.430.052.141.47000
    11307AShave skin lesion1.141.290.500.052.481.69000
    11308AShave skin lesion1.411.450.610.072.932.09000
    11310AShave skin lesion0.731.110.330.041.881.10000
    11311AShave skin lesion1.051.230.500.052.331.60000
    11312AShave skin lesion1.201.430.570.062.691.83000
    11313AShave skin lesion1.621.810.740.093.522.45000
    11400AExc tr-ext b9+marg 0.5 < cm0.852.080.960.062.991.87010
    11401AExc tr-ext b9+marg 0.6-1 cm1.232.121.080.093.442.40010
    11402AExc tr-ext b9+marg 1.1-2 cm1.512.281.140.123.912.77010
    11403AExc tr-ext b9+marg 2.1-3 cm1.792.501.350.164.453.30010
    11404AExc tr-ext b9+marg 3.1-4 cm2.062.841.420.185.083.66010
    11406AExc tr-ext b9+marg > 4.0 cm2.763.241.680.256.254.69010
    11420AExc h-f-nk-sp b9+marg 0.5 <0.981.811.000.082.872.06010
    11421AExc h-f-nk-sp b9+marg 0.6-11.422.121.180.113.652.71010
    11422AExc h-f-nk-sp b9+marg 1.1-21.632.301.380.144.073.15010
    11423AExc h-f-nk-sp b9+marg 2.1-32.012.661.490.174.843.67010
    11424AExc h-f-nk-sp b9+marg 3.1-42.432.931.640.215.574.28010
    11426AExc h-f-nk-sp b9+marg > 4 cm3.783.752.150.347.876.27010
    11440AExc face-mm b9+marg 0.5 < cm1.062.271.410.083.412.55010
    11441AExc face-mm b9+marg 0.6-1 cm1.482.401.590.113.993.18010
    11442AExc face-mm b9+marg 1.1-2 cm1.722.661.660.144.523.52010
    11443AExc face-mm b9+marg 2.1-3 cm2.293.041.900.185.514.37010
    11444AExc face-mm b9+marg 3.1-4 cm3.143.642.280.257.035.67010
    11446AExc face-mm b9+marg > 4 cm4.494.262.880.309.057.67010
    11450ARemoval, sweat gland lesion2.734.120.980.267.113.97090
    11451ARemoval, sweat gland lesion3.954.981.430.399.325.77090
    11462ARemoval, sweat gland lesion2.514.100.950.236.843.69090
    11463ARemoval, sweat gland lesion3.955.601.570.409.955.92090
    11470ARemoval, sweat gland lesion3.254.541.230.308.094.78090
    11471ARemoval, sweat gland lesion4.415.691.720.4010.506.53090
    11600AExc tr-ext mlg+marg 0.5 < cm1.312.530.990.093.932.39010
    11601AExc tr-ext mlg+marg 0.6-1 cm1.802.601.240.124.523.16010
    11602AExc tr-ext mlg+marg 1.1-2 cm1.952.731.290.134.813.37010
    11603AExc tr-ext mlg+marg 2.1-3 cm2.192.961.350.165.313.70010
    11604AExc tr-ext mlg+marg 3.1-4 cm2.403.271.410.185.853.99010
    11606AExc tr-ext mlg+marg > 4 cm3.433.961.760.287.675.47010
    11620AExc h-f-nk-sp mlg+marg 0.5 <1.192.490.970.093.772.25010
    11621AExc h-f-nk-sp mlg+marg 0.6-11.762.601.270.124.483.15010
    11622AExc h-f-nk-sp mlg+marg 1.1-22.092.871.420.155.113.66010
    11623AExc h-f-nk-sp mlg+marg 2.1-32.613.221.620.206.034.43010
    11624AExc h-f-nk-sp mlg+marg 3.1-43.063.611.810.256.925.12010
    11626AExc h-f-nk-sp mlg+mar > 4 cm4.304.562.440.359.217.09010
    11640AExc face-mm malig+marg 0.5 <1.352.541.140.103.992.59010
    11641AExc face-mm malig+marg 0.6-12.162.921.570.155.233.88010
    11642AExc face-mm malig+marg 1.1-22.593.301.770.186.074.54010
    11643AExc face-mm malig+marg 2.1-33.103.702.010.247.045.35010
    11644AExc face-mm malig+marg 3.1-44.034.632.560.338.996.92010
    11646AExc face-mm mlg+marg > 4 cm5.955.733.600.4612.1410.01010
    11719RTrim nail(s)0.170.250.070.010.430.25000
    11720ADebride nail, 1-50.320.340.130.020.680.47000
    11721ADebride nail, 6 or more0.540.440.210.041.020.79000
    11730ARemoval of nail plate1.130.810.440.092.031.66000
    11732ARemove nail plate, add-on0.570.300.230.050.920.85ZZZ
    11740ADrain blood from under nail0.370.820.140.031.220.54000
    11750ARemoval of nail bed1.861.720.770.163.742.79010
    11752ARemove nail bed/finger tip2.672.111.760.335.114.76010
    11755ABiopsy, nail unit1.311.110.560.062.481.93000
    11760ARepair of nail bed1.581.801.250.173.553.00010
    11762AReconstruction of nail bed2.892.241.880.325.455.09010
    11765AExcision of nail fold, toe0.691.130.490.051.871.23010
    11770ARemoval of pilonidal lesion2.612.981.230.245.834.08010
    11771ARemoval of pilonidal lesion5.745.503.910.5611.8010.21090
    11772ARemoval of pilonidal lesion6.986.414.360.6814.0712.02090
    11900AInjection into skin lesions0.520.750.220.021.290.76000
    11901AAdded skin lesions injection0.800.720.360.031.551.19000
    11920RCorrect skin color defects1.612.160.800.173.942.58000
    11921RCorrect skin color defects1.932.521.000.214.663.14000
    11922RCorrect skin color defects0.490.380.260.050.920.80ZZZ
    11950RTherapy for contour defects0.841.220.420.062.121.32000
    11951RTherapy for contour defects1.191.610.520.102.901.81000
    11952RTherapy for contour defects1.691.970.700.173.832.56000
    Start Printed Page 80046
    11954RTherapy for contour defects1.852.590.930.194.632.97000
    11960AInsert tissue expander(s)9.08NA10.940.88NA20.90090
    11970AReplace tissue expander7.06NA4.980.77NA12.81090
    11971ARemove tissue expander(s)2.136.333.860.218.676.20090
    11975NInsert contraceptive cap+1.481.440.580.143.062.20XXX
    11976RRemoval of contraceptive cap1.781.620.700.173.572.65000
    11977NRemoval/reinsert contra cap+3.302.301.280.315.914.89XXX
    11980AImplant hormone pellet(s)1.481.070.560.102.652.14000
    11981AInsert drug implant device1.481.590.580.143.212.20XXX
    11982ARemove drug implant device1.781.710.700.173.662.65XXX
    11983ARemove/insert drug implant3.302.301.280.315.914.89XXX
    12001ARepair superficial wound(s)1.702.160.440.133.992.27010
    12002ARepair superficial wound(s)1.862.230.920.154.242.93010
    12004ARepair superficial wound(s)2.242.511.030.174.923.44010
    12005ARepair superficial wound(s)2.863.071.220.236.164.31010
    12006ARepair superficial wound(s)3.673.691.530.317.675.51010
    12007ARepair superficial wound(s)4.124.161.830.378.656.32010
    12011ARepair superficial wound(s)1.762.340.440.144.242.34010
    12013ARepair superficial wound(s)1.992.490.960.164.643.11010
    12014ARepair superficial wound(s)2.462.771.080.185.413.72010
    12015ARepair superficial wound(s)3.193.381.270.246.814.70010
    12016ARepair superficial wound(s)3.933.811.550.328.065.80010
    12017ARepair superficial wound(s)4.71NA1.900.39NA7.00010
    12018ARepair superficial wound(s)5.53NA2.270.46NA8.26010
    12020AClosure of split wound2.622.551.420.245.414.28010
    12021AClosure of split wound1.841.701.020.193.733.05010
    12031ALayer closure of wound(s)2.152.290.770.154.593.07010
    12032ALayer closure of wound(s)2.472.981.280.155.603.90010
    12034ALayer closure of wound(s)2.923.211.440.216.344.57010
    12035ALayer closure of wound(s)3.433.151.670.306.885.40010
    12036ALayer closure of wound(s)4.055.262.460.419.726.92010
    12037ALayer closure of wound(s)4.675.622.800.4910.787.96010
    12041ALayer closure of wound(s)2.372.480.830.175.023.37010
    12042ALayer closure of wound(s)2.743.171.410.176.084.32010
    12044ALayer closure of wound(s)3.143.261.600.246.644.98010
    12045ALayer closure of wound(s)3.643.581.870.347.565.85010
    12046ALayer closure of wound(s)4.255.532.550.4010.187.20010
    12047ALayer closure of wound(s)4.656.152.890.4111.217.95010
    12051ALayer closure of wound(s)2.473.161.410.165.794.04010
    12052ALayer closure of wound(s)2.773.121.380.176.064.32010
    12053ALayer closure of wound(s)3.123.261.540.206.584.86010
    12054ALayer closure of wound(s)3.463.601.640.257.315.35010
    12055ALayer closure of wound(s)4.434.602.190.359.386.97010
    12056ALayer closure of wound(s)5.246.623.050.4312.298.72010
    12057ALayer closure of wound(s)5.966.143.730.5012.6010.19010
    13100ARepair of wound or lesion3.123.501.840.216.835.17010
    13101ARepair of wound or lesion3.923.762.290.227.906.43010
    13102ARepair wound/lesion add-on1.240.760.580.102.101.92ZZZ
    13120ARepair of wound or lesion3.303.601.880.237.135.41010
    13121ARepair of wound or lesion4.333.992.390.258.576.97010
    13122ARepair wound/lesion add-on1.440.890.650.122.452.21ZZZ
    13131ARepair of wound or lesion3.793.882.210.257.926.25010
    13132ARepair of wound or lesion5.954.723.250.3210.999.52010
    13133ARepair wound/lesion add-on2.191.221.050.173.583.41ZZZ
    13150ARepair of wound or lesion3.815.292.640.299.396.74010
    13151ARepair of wound or lesion4.455.273.080.2810.007.81010
    13152ARepair of wound or lesion6.336.013.980.3812.7210.69010
    13153ARepair wound/lesion add-on2.381.371.160.183.933.72ZZZ
    13160ALate closure of wound10.48NA6.331.19NA18.00090
    14000ASkin tissue rearrangement5.897.604.650.4613.9511.00090
    14001ASkin tissue rearrangement8.478.945.960.6518.0615.08090
    14020ASkin tissue rearrangement6.598.105.350.5015.1912.44090
    14021ASkin tissue rearrangement10.069.537.120.6920.2817.87090
    14040ASkin tissue rearrangement7.878.777.050.5517.1915.47090
    14041ASkin tissue rearrangement11.4911.018.910.7123.2121.11090
    14060ASkin tissue rearrangement8.509.487.840.5918.5716.93090
    14061ASkin tissue rearrangement12.2912.059.770.7525.0922.81090
    14300ASkin tissue rearrangement11.7611.449.360.8824.0822.00090
    14350ASkin tissue rearrangement9.61NA6.361.09NA17.06090
    15000ASkin graft4.003.662.220.378.036.59000
    15001ASkin graft add-on1.001.260.420.112.371.53ZZZ
    15050ASkin pinch graft4.305.123.990.469.888.75090
    15100ASkin split graft9.0511.708.090.9421.6918.08090
    15101ASkin split graft add-on1.723.271.480.185.173.38ZZZ
    15120ASkin split graft9.8310.238.030.9020.9618.76090
    Start Printed Page 80047
    15121ASkin split graft add-on2.674.191.850.277.134.79ZZZ
    15200ASkin full graft8.039.605.540.7318.3614.30090
    15201ASkin full graft add-on1.321.050.640.142.512.10ZZZ
    15220ASkin full graft7.879.746.180.6818.2914.73090
    15221ASkin full graft add-on1.190.930.580.122.241.89ZZZ
    15240ASkin full graft9.049.257.010.8019.0916.85090
    15241ASkin full graft add-on1.861.470.940.173.502.97ZZZ
    15260ASkin full graft10.069.918.900.6320.6019.59090
    15261ASkin full graft add-on2.232.911.600.175.314.00ZZZ
    15342ACultured skin graft, 25 cm1.002.060.750.093.151.84010
    15343ACulture skn graft addl 25 cm0.250.260.100.020.530.37ZZZ
    15350ASkin homograft4.008.444.340.4212.868.76090
    15351ASkin homograft add-on1.000.950.410.112.061.52ZZZ
    15400ASkin heterograft4.004.844.840.409.249.24090
    15401ASkin heterograft add-on1.001.250.460.112.361.57ZZZ
    15570AForm skin pedicle flap9.218.166.070.9618.3316.24090
    15572AForm skin pedicle flap9.277.755.800.9317.9516.00090
    15574AForm skin pedicle flap9.888.326.840.9219.1217.64090
    15576AForm skin pedicle flap8.698.916.290.7218.3215.70090
    15600ASkin graft1.916.132.340.198.234.44090
    15610ASkin graft2.423.392.620.256.065.29090
    15620ASkin graft2.946.743.390.289.966.61090
    15630ASkin graft3.276.193.660.289.747.21090
    15650ATransfer skin pedicle flap3.976.173.730.3610.508.06090
    15732AMuscle-skin graft, head/neck17.84NA12.701.50NA32.04090
    15734AMuscle-skin graft, trunk17.79NA12.731.91NA32.43090
    15736AMuscle-skin graft, arm16.27NA11.811.78NA29.86090
    15738AMuscle-skin graft, leg17.92NA12.251.95NA32.12090
    15740AIsland pedicle flap graft10.259.007.050.6219.8717.92090
    15750ANeurovascular pedicle graft11.41NA8.201.16NA20.77090
    15756AFree myo/skin flap microvasc35.23NA20.853.11NA59.19090
    15757AFree skin flap, microvasc35.23NA21.963.37NA60.56090
    15758AFree fascial flap, microvasc35.10NA22.003.52NA60.62090
    15760AComposite skin graft8.749.106.620.7218.5616.08090
    15770ADerma-fat-fascia graft7.52NA6.080.78NA14.38090
    15775RHair transplant punch grafts3.962.871.350.437.265.74000
    15776RHair transplant punch grafts5.545.752.890.6011.899.03000
    15780AAbrasion treatment of skin7.296.616.580.4114.3114.28090
    15781AAbrasion treatment of skin4.855.074.800.2710.199.92090
    15782AAbrasion treatment of skin4.324.304.150.218.838.68090
    15783AAbrasion treatment of skin4.294.723.570.269.278.12090
    15786AAbrasion, lesion, single2.031.771.290.113.913.43010
    15787AAbrasion, lesions, add-on0.330.320.160.020.670.51ZZZ
    15788RChemical peel, face, epiderm2.093.141.030.115.343.23090
    15789RChemical peel, face, dermal4.926.173.510.2711.368.70090
    15792RChemical peel, nonfacial1.862.962.170.104.924.13090
    15793AChemical peel, nonfacial3.74NA3.500.17NA7.41090
    15810ASalabrasion4.743.733.730.428.898.89090
    15811ASalabrasion5.396.094.730.5212.0010.64090
    15819APlastic surgery, neck9.38NA6.670.77NA16.82090
    15820ARevision of lower eyelid5.157.125.250.3012.5710.70090
    15821ARevision of lower eyelid5.727.475.410.3113.5011.44090
    15822ARevision of upper eyelid4.456.064.230.2210.738.90090
    15823ARevision of upper eyelid7.058.066.130.3215.4313.50090
    15824RRemoval of forehead wrinkles0.000.000.000.000.000.00000
    15825RRemoval of neck wrinkles0.000.000.000.000.000.00000
    15826RRemoval of brow wrinkles0.000.000.000.000.000.00000
    15828RRemoval of face wrinkles0.000.000.000.000.000.00000
    15829RRemoval of skin wrinkles0.000.000.000.000.000.00000
    15831AExcise excessive skin tissue12.40NA7.691.30NA21.39090
    15832AExcise excessive skin tissue11.59NA7.681.21NA20.48090
    15833AExcise excessive skin tissue10.64NA7.061.17NA18.87090
    15834AExcise excessive skin tissue10.85NA6.951.18NA18.98090
    15835AExcise excessive skin tissue11.67NA6.931.13NA19.73090
    15836AExcise excessive skin tissue9.34NA6.180.95NA16.47090
    15837AExcise excessive skin tissue8.437.406.420.7816.6115.63090
    15838AExcise excessive skin tissue7.13NA5.680.58NA13.39090
    15839AExcise excessive skin tissue9.387.215.750.8817.4716.01090
    15840AGraft for face nerve palsy13.26NA9.751.15NA24.16090
    15841AGraft for face nerve palsy23.26NA14.512.65NA40.42090
    15842AFlap for face nerve palsy37.96NA22.783.99NA64.73090
    15845ASkin and muscle repair, face12.57NA8.470.80NA21.84090
    15850BRemoval of sutures+0.781.440.300.042.261.12XXX
    15851ARemoval of sutures0.861.640.340.052.551.25000
    15852ADressing change,not for burn0.861.750.360.072.681.29000
    Start Printed Page 80048
    15860ATest for blood flow in graft1.951.300.810.133.382.89000
    15876RSuction assisted lipectomy0.000.000.000.000.000.00000
    15877RSuction assisted lipectomy0.000.000.000.000.000.00000
    15878RSuction assisted lipectomy0.000.000.000.000.000.00000
    15879RSuction assisted lipectomy0.000.000.000.000.000.00000
    15920ARemoval of tail bone ulcer7.95NA5.490.83NA14.27090
    15922ARemoval of tail bone ulcer9.90NA7.311.06NA18.27090
    15931ARemove sacrum pressure sore9.24NA5.560.95NA15.75090
    15933ARemove sacrum pressure sore10.85NA7.981.14NA19.97090
    15934ARemove sacrum pressure sore12.69NA8.291.35NA22.33090
    15935ARemove sacrum pressure sore14.57NA9.961.56NA26.09090
    15936ARemove sacrum pressure sore12.38NA8.791.32NA22.49090
    15937ARemove sacrum pressure sore14.21NA10.251.51NA25.97090
    15940ARemove hip pressure sore9.34NA5.920.98NA16.24090
    15941ARemove hip pressure sore11.43NA9.801.23NA22.46090
    15944ARemove hip pressure sore11.46NA8.591.21NA21.26090
    15945ARemove hip pressure sore12.69NA9.511.38NA23.58090
    15946ARemove hip pressure sore21.57NA13.952.32NA37.84090
    15950ARemove thigh pressure sore7.54NA5.150.80NA13.49090
    15951ARemove thigh pressure sore10.72NA7.991.14NA19.85090
    15952ARemove thigh pressure sore11.39NA7.391.19NA19.97090
    15953ARemove thigh pressure sore12.63NA8.791.38NA22.80090
    15956ARemove thigh pressure sore15.52NA10.401.64NA27.56090
    15958ARemove thigh pressure sore15.48NA10.721.66NA27.86090
    15999CRemoval of pressure sore0.000.000.000.000.000.00YYY
    16000AInitial treatment of burn(s)0.891.070.270.062.021.22000
    16010ATreatment of burn(s)0.871.190.360.072.131.30000
    16015ATreatment of burn(s)2.351.890.940.224.463.51000
    16020ATreatment of burn(s)0.801.130.260.061.991.12000
    16025ATreatment of burn(s)1.851.880.670.163.892.68000
    16030ATreatment of burn(s)2.083.050.910.185.313.17000
    16035AIncision of burn scab, initi3.75NA1.500.36NA5.61090
    16036AIncise burn scab, addl incis1.50NA0.620.11NA2.23ZZZ
    17000ADestroy benign/premlg lesion0.601.040.270.031.670.90010
    17003ADestroy lesions, 2-140.150.120.070.010.280.23ZZZ
    17004ADestroy lesions, 15 or more2.792.451.270.125.364.18010
    17106ADestruction of skin lesions4.594.773.210.289.648.08090
    17107ADestruction of skin lesions9.167.305.370.5316.9915.06090
    17108ADestruction of skin lesions13.209.357.660.8923.4421.75090
    17110ADestruct lesion, 1-140.651.710.450.042.401.14010
    17111ADestruct lesion, 15 or more0.921.750.560.042.711.52010
    17250AChemical cautery, tissue0.501.230.340.041.770.88000
    17260ADestruction of skin lesions0.911.370.410.042.321.36010
    17261ADestruction of skin lesions1.171.620.550.052.841.77010
    17262ADestruction of skin lesions1.581.890.750.073.542.40010
    17263ADestruction of skin lesions1.792.070.820.083.942.69010
    17264ADestruction of skin lesions1.942.250.860.084.272.88010
    17266ADestruction of skin lesions2.342.570.960.115.023.41010
    17270ADestruction of skin lesions1.321.700.600.063.081.98010
    17271ADestruction of skin lesions1.491.790.710.063.342.26010
    17272ADestruction of skin lesions1.772.000.850.073.842.69010
    17273ADestruction of skin lesions2.052.230.960.094.373.10010
    17274ADestruction of skin lesions2.592.611.180.115.313.88010
    17276ADestruction of skin lesions3.203.031.420.156.384.77010
    17280ADestruction of skin lesions1.171.610.530.052.831.75010
    17281ADestruction of skin lesions1.721.920.820.073.712.61010
    17282ADestruction of skin lesions2.042.170.980.094.303.11010
    17283ADestruction of skin lesions2.642.581.230.115.333.98010
    17284ADestruction of skin lesions3.212.991.490.146.344.84010
    17286ADestruction of skin lesions4.443.782.180.228.446.84010
    17304A1 stage mohs, up to 5 spec7.608.093.660.3116.0011.57000
    17305A2 stage mohs, up to 5 spec2.853.811.370.126.784.34000
    17306A3 stage mohs, up to 5 spec2.853.811.380.126.784.35000
    17307AMohs addl stage up to 5 spec2.853.821.400.126.794.37000
    17310AMohs any stage > 5 spec each0.621.480.310.052.150.98ZZZ
    17340ACryotherapy of skin0.760.380.260.041.181.06010
    17360ASkin peel therapy1.431.590.720.063.082.21010
    17380RHair removal by electrolysis0.000.000.000.000.000.00000
    17999CSkin tissue procedure0.000.000.000.000.000.00YYY
    19000ADrainage of breast lesion0.841.200.290.072.111.20000
    19001ADrain breast lesion add-on0.420.820.140.031.270.59ZZZ
    19020AIncision of breast lesion3.576.813.390.3510.737.31090
    19030AInjection for breast x-ray1.533.560.520.075.162.12000
    19100ABx breast percut w/o image1.271.430.440.102.801.81000
    19101ABiopsy of breast, open3.185.021.890.208.405.27010
    Start Printed Page 80049
    19102ABx breast percut w/image2.004.860.680.136.992.81000
    19103ABx breast percut w/device3.7012.311.270.1616.175.13000
    19110ANipple exploration4.308.624.430.4413.369.17090
    19112AExcise breast duct fistula3.679.153.080.3813.207.13090
    19120ARemoval of breast lesion5.564.923.090.5611.049.21090
    19125AExcision, breast lesion6.065.053.260.6111.729.93090
    19126AExcision, addl breast lesion2.93NA1.020.30NA4.25ZZZ
    19140ARemoval of breast tissue5.149.353.650.5215.019.31090
    19160ARemoval of breast tissue5.99NA4.520.61NA11.12090
    19162ARemove breast tissue, nodes13.53NA7.881.38NA22.79090
    19180ARemoval of breast8.80NA5.930.88NA15.61090
    19182ARemoval of breast7.73NA4.980.79NA13.50090
    19200ARemoval of breast15.49NA9.071.51NA26.07090
    19220ARemoval of breast15.72NA9.121.56NA26.40090
    19240ARemoval of breast16.00NA8.741.62NA26.36090
    19260ARemoval of chest wall lesion15.44NA9.131.64NA26.21090
    19271ARevision of chest wall18.90NA11.312.27NA32.48090
    19272AExtensive chest wall surgery21.55NA12.242.54NA36.33090
    19290APlace needle wire, breast1.272.890.430.064.221.76000
    19291APlace needle wire, breast0.631.690.210.032.350.87ZZZ
    19295APlace breast clip, percut0.002.65NA0.012.66NAZZZ
    19316ASuspension of breast10.69NA7.571.15NA19.41090
    19318AReduction of large breast15.62NA11.721.69NA29.03090
    19324AEnlarge breast5.85NA4.250.63NA10.73090
    19325AEnlarge breast with implant8.45NA6.250.90NA15.60090
    19328ARemoval of breast implant5.68NA4.540.61NA10.83090
    19330ARemoval of implant material7.59NA5.200.81NA13.60090
    19340AImmediate breast prosthesis6.33NA3.190.68NA10.20ZZZ
    19342ADelayed breast prosthesis11.20NA7.831.21NA20.24090
    19350ABreast reconstruction8.9213.456.800.9523.3216.67090
    19355ACorrect inverted nipple(s)7.5713.635.410.8022.0013.78090
    19357ABreast reconstruction18.16NA9.821.96NA29.94090
    19361ABreast reconstruction19.26NA10.272.08NA31.61090
    19364ABreast reconstruction41.00NA25.223.91NA70.13090
    19366ABreast reconstruction21.28NA10.272.27NA33.82090
    19367ABreast reconstruction25.73NA17.472.78NA45.98090
    19368ABreast reconstruction32.42NA21.083.51NA57.01090
    19369ABreast reconstruction29.82NA20.653.24NA53.71090
    19370ASurgery of breast capsule8.05NA6.080.86NA14.99090
    19371ARemoval of breast capsule9.35NA7.151.01NA17.51090
    19380ARevise breast reconstruction9.14NA7.050.98NA17.17090
    19396ADesign custom breast implant2.176.251.020.238.653.42000
    19499CBreast surgery procedure0.000.000.000.000.000.00YYY
    20000AIncision of abscess2.122.161.180.174.453.47010
    20005AIncision of deep abscess3.423.032.210.346.795.97010
    20100AExplore wound, neck10.085.824.370.9916.8915.44010
    20101AExplore wound, chest3.222.901.500.246.364.96010
    20102AExplore wound, abdomen3.943.391.750.357.686.04010
    20103AExplore wound, extremity5.304.263.020.5710.138.89010
    20150AExcise epiphyseal bar13.69NA8.960.96NA23.61090
    20200AMuscle biopsy1.461.700.610.173.332.24000
    20205ADeep muscle biopsy2.353.870.960.236.453.54000
    20206ANeedle biopsy, muscle0.993.150.350.064.201.40000
    20220ABone biopsy, trocar/needle1.274.872.930.066.204.26000
    20225ABone biopsy, trocar/needle1.874.373.020.116.355.00000
    20240ABone biopsy, excisional3.23NA4.220.33NA7.78010
    20245ABone biopsy, excisional7.78NA6.910.44NA15.13010
    20250AOpen bone biopsy5.03NA4.370.50NA9.90010
    20251AOpen bone biopsy5.56NA4.920.79NA11.27010
    20500AInjection of sinus tract1.235.893.820.107.225.15010
    20501AInject sinus tract for x-ray0.763.140.260.033.931.05000
    20520ARemoval of foreign body1.855.603.590.177.625.61010
    20525ARemoval of foreign body3.506.844.380.4010.748.28010
    20526ATher injection, carp tunnel0.940.770.410.061.771.41000
    20550AInj tendon sheath/ligament0.750.760.240.061.571.05000
    20551AInject tendon origin/insert0.750.700.340.061.511.15000
    20552AInject trigger point, 1 or 20.660.660.300.061.381.02000
    20553AInject trigger points, =/> 30.750.750.340.061.561.15000
    20600ADrain/inject, joint/bursa0.660.660.360.061.381.08000
    20605ADrain/inject, joint/bursa0.680.780.370.061.521.11000
    20610ADrain/inject, joint/bursa0.790.970.420.081.841.29000
    20612AAspirate/inj ganglion cyst0.700.770.280.061.531.04000
    20615ATreatment of bone cyst2.284.872.690.197.345.16010
    20650AInsert and remove bone pin2.235.083.290.287.595.80010
    20660AApply, rem fixation device2.51NA2.280.48NA5.27000
    Start Printed Page 80050
    20661AApplication of head brace4.89NA6.910.92NA12.72090
    20662AApplication of pelvis brace6.07NA6.270.81NA13.15090
    20663AApplication of thigh brace5.43NA5.580.77NA11.78090
    20664AHalo brace application8.06NA8.621.49NA18.17090
    20665ARemoval of fixation device1.312.141.300.173.622.78010
    20670ARemoval of support implant1.746.093.550.238.065.52010
    20680ARemoval of support implant3.355.375.370.469.189.18090
    20690AApply bone fixation device3.52NA1.820.47NA5.81090
    20692AApply bone fixation device6.41NA3.050.60NA10.06090
    20693AAdjust bone fixation device5.86NA13.200.85NA19.91090
    20694ARemove bone fixation device4.169.456.560.5714.1811.29090
    20802AReplantation, arm, complete41.15NA27.575.81NA74.53090
    20805AReplant forearm, complete50.00NA43.163.95NA97.11090
    20808AReplantation hand, complete61.65NA49.606.49NA117.74090
    20816AReplantation digit, complete30.94NA46.543.01NA80.49090
    20822AReplantation digit, complete25.59NA42.543.07NA71.20090
    20824AReplantation thumb, complete30.94NA45.413.48NA79.83090
    20827AReplantation thumb, complete26.41NA45.083.21NA74.70090
    20838AReplantation foot, complete41.41NA28.585.85NA75.84090
    20900ARemoval of bone for graft5.586.606.390.7712.9512.74090
    20902ARemoval of bone for graft7.55NA9.171.06NA17.78090
    20910ARemove cartilage for graft5.348.856.690.5014.6912.53090
    20912ARemove cartilage for graft6.35NA7.490.55NA14.39090
    20920ARemoval of fascia for graft5.31NA5.570.54NA11.42090
    20922ARemoval of fascia for graft6.618.976.400.8816.4613.89090
    20924ARemoval of tendon for graft6.48NA7.160.82NA14.46090
    20926ARemoval of tissue for graft5.53NA6.420.73NA12.68090
    20930BSpinal bone allograft0.000.000.000.000.000.00XXX
    20931ASpinal bone allograft1.81NA0.960.34NA3.11ZZZ
    20936BSpinal bone autograft0.000.000.000.000.000.00XXX
    20937ASpinal bone autograft2.79NA1.490.43NA4.71ZZZ
    20938ASpinal bone autograft3.02NA1.590.52NA5.13ZZZ
    20950AFluid pressure, muscle1.26NA2.240.16NA3.66000
    20955AFibula bone graft, microvasc39.21NA29.764.35NA73.32090
    20956AIliac bone graft, microvasc39.27NA28.795.77NA73.83090
    20957AMt bone graft, microvasc40.65NA21.195.74NA67.58090
    20962AOther bone graft, microvasc39.27NA28.285.19NA72.74090
    20969ABone/skin graft, microvasc43.92NA32.144.34NA80.40090
    20970ABone/skin graft, iliac crest43.06NA30.054.64NA77.75090
    20972ABone/skin graft, metatarsal42.99NA18.396.07NA67.45090
    20973ABone/skin graft, great toe45.76NA28.244.65NA78.65090
    20974AElectrical bone stimulation0.620.420.330.091.131.04000
    20975AElectrical bone stimulation2.60NA1.380.42NA4.40000
    20979AUs bone stimulation0.620.730.350.041.391.01000
    20999CMusculoskeletal surgery0.000.000.000.000.000.00YYY
    21010AIncision of jaw joint10.14NA7.160.54NA17.84090
    21015AResection of facial tumor5.29NA7.090.52NA12.90090
    21025AExcision of bone, lower jaw10.067.356.870.7918.2017.72090
    21026AExcision of facial bone(s)4.855.395.080.4010.6410.33090
    21029AContour of face bone lesion7.716.966.150.7415.4114.60090
    21030AExcise max/zygoma b9 tumor3.894.363.640.608.858.13090
    21031ARemove exostosis, mandible3.243.352.170.286.875.69090
    21032ARemove exostosis, maxilla3.243.322.290.276.835.80090
    21034AExcise max/zygoma mlg tumor16.1710.6710.641.3728.2128.18090
    21040AExcise mandible lesion3.893.762.580.197.846.66090
    21041DRemoval of jaw bone lesion0.000.000.000.000.000.00090
    21044ARemoval of jaw bone lesion11.86NA7.960.87NA20.69090
    21045AExtensive jaw surgery16.17NA10.291.20NA27.66090
    21046ARemove mandible cyst complex13.00NA10.421.01NA24.43090
    21047AExcise lwr jaw cyst w/repair18.75NA9.871.53NA30.15090
    21048ARemove maxilla cyst complex13.50NA10.631.01NA25.14090
    21049AExcis uppr jaw cyst w/repair18.00NA9.551.01NA28.56090
    21050ARemoval of jaw joint10.77NA11.630.84NA23.24090
    21060ARemove jaw joint cartilage10.23NA10.091.16NA21.48090
    21070ARemove coronoid process8.20NA5.980.67NA14.85090
    21076APrepare face/oral prosthesis13.429.497.131.3624.2721.91010
    21077APrepare face/oral prosthesis33.7523.8817.943.4361.0655.12090
    21079APrepare face/oral prosthesis22.3416.8812.411.5940.8136.34090
    21080APrepare face/oral prosthesis25.1018.9713.942.5546.6241.59090
    21081APrepare face/oral prosthesis22.8817.2812.711.8742.0337.46090
    21082APrepare face/oral prosthesis20.8714.7711.101.4637.1033.43090
    21083APrepare face/oral prosthesis19.3014.5810.721.9635.8431.98090
    21084APrepare face/oral prosthesis22.5117.0112.511.5741.0936.59090
    21085APrepare face/oral prosthesis9.006.374.790.6516.0214.44010
    21086APrepare face/oral prosthesis24.9218.8313.841.8645.6140.62090
    Start Printed Page 80051
    21087APrepare face/oral prosthesis24.9217.6313.242.2244.7740.38090
    21088CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21089CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21100AMaxillofacial fixation4.225.934.050.1810.338.45090
    21110AInterdental fixation5.215.314.320.2810.809.81090
    21116AInjection, jaw joint x-ray0.817.710.290.058.571.15000
    21120AReconstruction of chin4.939.806.080.2915.0211.30090
    21121AReconstruction of chin7.647.946.210.5616.1414.41090
    21122AReconstruction of chin8.52NA7.630.59NA16.74090
    21123AReconstruction of chin11.16NA8.081.16NA20.40090
    21125AAugmentation, lower jaw bone10.629.538.070.7220.8719.41090
    21127AAugmentation, lower jaw bone11.129.807.500.7621.6819.38090
    21137AReduction of forehead9.82NA8.030.53NA18.38090
    21138AReduction of forehead12.19NA9.401.47NA23.06090
    21139AReduction of forehead14.61NA9.781.02NA25.41090
    21141AReconstruct midface, lefort18.10NA10.791.63NA30.52090
    21142AReconstruct midface, lefort18.81NA12.161.16NA32.13090
    21143AReconstruct midface, lefort19.58NA11.100.90NA31.58090
    21145AReconstruct midface, lefort19.94NA11.252.09NA33.28090
    21146AReconstruct midface, lefort20.71NA11.922.13NA34.76090
    21147AReconstruct midface, lefort21.77NA12.151.52NA35.44090
    21150AReconstruct midface, lefort25.24NA16.331.09NA42.66090
    21151AReconstruct midface, lefort28.30NA19.931.98NA50.21090
    21154AReconstruct midface, lefort30.52NA19.844.86NA55.22090
    21155AReconstruct midface, lefort34.45NA20.755.48NA60.68090
    21159AReconstruct midface, lefort42.38NA25.586.74NA74.70090
    21160AReconstruct midface, lefort46.44NA26.694.39NA77.52090
    21172AReconstruct orbit/forehead27.80NA15.821.91NA45.53090
    21175AReconstruct orbit/forehead33.17NA20.065.16NA58.39090
    21179AReconstruct entire forehead22.25NA17.842.48NA42.57090
    21180AReconstruct entire forehead25.19NA18.592.15NA45.93090
    21181AContour cranial bone lesion9.90NA8.340.97NA19.21090
    21182AReconstruct cranial bone32.19NA21.892.53NA56.61090
    21183AReconstruct cranial bone35.31NA23.872.75NA61.93090
    21184AReconstruct cranial bone38.24NA24.304.12NA66.66090
    21188AReconstruction of midface22.46NA15.621.85NA39.93090
    21193AReconst lwr jaw w/o graft17.15NA10.781.53NA29.46090
    21194AReconst lwr jaw w/graft19.84NA12.721.39NA33.95090
    21195AReconst lwr jaw w/o fixation17.24NA12.351.20NA30.79090
    21196AReconst lwr jaw w/fixation18.91NA12.911.62NA33.44090
    21198AReconstr lwr jaw segment14.16NA11.661.05NA26.87090
    21199AReconstr lwr jaw w/advance16.00NA9.291.26NA26.55090
    21206AReconstruct upper jaw bone14.10NA9.721.01NA24.83090
    21208AAugmentation of facial bones10.239.698.360.9220.8419.51090
    21209AReduction of facial bones6.727.975.790.6015.2913.11090
    21210AFace bone graft10.238.998.140.8820.1019.25090
    21215ALower jaw bone graft10.778.907.081.0420.7118.89090
    21230ARib cartilage graft10.77NA10.060.96NA21.79090
    21235AEar cartilage graft6.7212.218.030.5219.4515.27090
    21240AReconstruction of jaw joint14.05NA11.301.15NA26.50090
    21242AReconstruction of jaw joint12.95NA11.071.40NA25.42090
    21243AReconstruction of jaw joint20.79NA13.761.85NA36.40090
    21244AReconstruction of lower jaw11.86NA9.170.95NA21.98090
    21245AReconstruction of jaw11.8612.1810.180.8824.9222.92090
    21246AReconstruction of jaw12.4710.3310.331.2124.0124.01090
    21247AReconstruct lower jaw bone22.63NA16.392.21NA41.23090
    21248AReconstruction of jaw11.488.997.761.0121.4820.25090
    21249AReconstruction of jaw17.5211.5110.201.3930.4229.11090
    21255AReconstruct lower jaw bone16.72NA11.441.13NA29.29090
    21256AReconstruction of orbit16.19NA13.271.04NA30.50090
    21260ARevise eye sockets16.52NA10.711.25NA28.48090
    21261ARevise eye sockets31.49NA20.592.20NA54.28090
    21263ARevise eye sockets28.42NA12.982.16NA43.56090
    21267ARevise eye sockets18.90NA14.481.35NA34.73090
    21268ARevise eye sockets24.48NA16.120.79NA41.39090
    21270AAugmentation, cheek bone10.239.549.540.7320.5020.50090
    21275ARevision, orbitofacial bones11.24NA10.781.03NA23.05090
    21280ARevision of eyelid6.03NA6.070.27NA12.37090
    21282ARevision of eyelid3.49NA5.150.21NA8.85090
    21295ARevision of jaw muscle/bone1.53NA4.350.13NA6.01090
    21296ARevision of jaw muscle/bone4.25NA4.550.30NA9.10090
    21299CCranio/maxillofacial surgery0.000.000.000.000.000.00YYY
    21300ATreatment of skull fracture0.722.730.260.093.541.07000
    21310ATreatment of nose fracture0.582.680.150.053.310.78000
    21315ATreatment of nose fracture1.513.431.270.125.062.90010
    Start Printed Page 80052
    21320ATreatment of nose fracture1.854.832.030.156.834.03010
    21325ATreatment of nose fracture3.77NA3.670.31NA7.75090
    21330ATreatment of nose fracture5.38NA5.510.48NA11.37090
    21335ATreatment of nose fracture8.61NA7.160.64NA16.41090
    21336ATreat nasal septal fracture5.72NA5.550.45NA11.72090
    21337ATreat nasal septal fracture2.705.233.250.228.156.17090
    21338ATreat nasoethmoid fracture6.46NA5.960.53NA12.95090
    21339ATreat nasoethmoid fracture8.09NA6.700.76NA15.55090
    21340ATreatment of nose fracture10.77NA9.090.85NA20.71090
    21343ATreatment of sinus fracture12.95NA9.771.06NA23.78090
    21344ATreatment of sinus fracture19.72NA13.441.72NA34.88090
    21345ATreat nose/jaw fracture8.169.737.910.6018.4916.67090
    21346ATreat nose/jaw fracture10.61NA10.050.85NA21.51090
    21347ATreat nose/jaw fracture12.69NA9.501.14NA23.33090
    21348ATreat nose/jaw fracture16.69NA10.931.50NA29.12090
    21355ATreat cheek bone fracture3.774.402.280.298.466.34010
    21356ATreat cheek bone fracture4.15NA3.230.36NA7.74010
    21360ATreat cheek bone fracture6.46NA5.630.52NA12.61090
    21365ATreat cheek bone fracture14.95NA11.311.30NA27.56090
    21366ATreat cheek bone fracture17.77NA11.901.41NA31.08090
    21385ATreat eye socket fracture9.16NA7.530.64NA17.33090
    21386ATreat eye socket fracture9.16NA7.970.76NA17.89090
    21387ATreat eye socket fracture9.70NA8.220.78NA18.70090
    21390ATreat eye socket fracture10.13NA8.470.70NA19.30090
    21395ATreat eye socket fracture12.68NA9.791.09NA23.56090
    21400ATreat eye socket fracture1.403.121.050.124.642.57090
    21401ATreat eye socket fracture3.264.833.110.348.436.71090
    21406ATreat eye socket fracture7.01NA6.750.59NA14.35090
    21407ATreat eye socket fracture8.61NA7.750.67NA17.03090
    21408ATreat eye socket fracture12.38NA10.011.24NA23.63090
    21421ATreat mouth roof fracture5.147.446.090.4213.0011.65090
    21422ATreat mouth roof fracture8.32NA7.490.69NA16.50090
    21423ATreat mouth roof fracture10.40NA8.020.95NA19.37090
    21431ATreat craniofacial fracture7.05NA6.680.58NA14.31090
    21432ATreat craniofacial fracture8.61NA7.740.55NA16.90090
    21433ATreat craniofacial fracture25.35NA17.102.46NA44.91090
    21435ATreat craniofacial fracture17.25NA12.561.66NA31.47090
    21436ATreat craniofacial fracture28.04NA17.162.32NA47.52090
    21440ATreat dental ridge fracture2.705.683.640.228.606.56090
    21445ATreat dental ridge fracture5.387.045.170.5512.9711.10090
    21450ATreat lower jaw fracture2.976.872.740.2310.075.94090
    21451ATreat lower jaw fracture4.876.635.650.3911.8910.91090
    21452ATreat lower jaw fracture1.989.394.200.1411.516.32090
    21453ATreat lower jaw fracture5.547.526.400.4913.5512.43090
    21454ATreat lower jaw fracture6.46NA5.780.55NA12.79090
    21461ATreat lower jaw fracture8.099.267.940.7318.0816.76090
    21462ATreat lower jaw fracture9.7910.568.080.8021.1518.67090
    21465ATreat lower jaw fracture11.91NA7.870.84NA20.62090
    21470ATreat lower jaw fracture15.34NA9.931.36NA26.63090
    21480AReset dislocated jaw0.611.580.180.052.240.84000
    21485AReset dislocated jaw3.993.853.390.318.157.69090
    21490ARepair dislocated jaw11.86NA7.571.31NA20.74090
    21493ATreat hyoid bone fracture1.27NA3.380.10NA4.75090
    21494ATreat hyoid bone fracture6.28NA5.060.44NA11.78090
    21495ATreat hyoid bone fracture5.69NA5.000.41NA11.10090
    21497AInterdental wiring3.864.753.970.318.928.14090
    21499CHead surgery procedure0.000.000.000.000.000.00YYY
    21501ADrain neck/chest lesion3.814.393.590.368.567.76090
    21502ADrain chest lesion7.12NA7.440.79NA15.35090
    21510ADrainage of bone lesion5.74NA7.160.67NA13.57090
    21550ABiopsy of neck/chest2.062.331.220.134.523.41010
    21555ARemove lesion, neck/chest4.354.262.440.419.027.20090
    21556ARemove lesion, neck/chest5.57NA3.210.51NA9.29090
    21557ARemove tumor, neck/chest8.88NA7.680.85NA17.41090
    21600APartial removal of rib6.89NA7.570.81NA15.27090
    21610APartial removal of rib14.61NA11.241.85NA27.70090
    21615ARemoval of rib9.87NA8.071.20NA19.14090
    21616ARemoval of rib and nerves12.04NA9.271.31NA22.62090
    21620APartial removal of sternum6.79NA8.040.77NA15.60090
    21627ASternal debridement6.81NA12.580.82NA20.21090
    21630AExtensive sternum surgery17.38NA13.521.95NA32.85090
    21632AExtensive sternum surgery18.14NA12.172.16NA32.47090
    21700ARevision of neck muscle6.199.227.250.3115.7213.75090
    21705ARevision of neck muscle/rib9.60NA7.620.92NA18.14090
    21720ARevision of neck muscle5.687.957.010.8014.4313.49090
    Start Printed Page 80053
    21725ARevision of neck muscle6.99NA7.450.90NA15.34090
    21740AReconstruction of sternum16.50NA12.482.03NA31.01090
    21742CRepair stern/nuss w/o scope0.000.000.000.000.000.00090
    21743CRepair sternum/nuss w/scope0.000.000.000.000.000.00090
    21750ARepair of sternum separation10.77NA9.851.35NA21.97090
    21800ATreatment of rib fracture0.962.381.080.093.432.13090
    21805ATreatment of rib fracture2.75NA4.710.29NA7.75090
    21810ATreatment of rib fracture(s)6.86NA7.060.60NA14.52090
    21820ATreat sternum fracture1.282.921.560.154.352.99090
    21825ATreat sternum fracture7.41NA10.260.84NA18.51090
    21899CNeck/chest surgery procedure0.000.000.000.000.000.00YYY
    21920ABiopsy soft tissue of back2.062.450.750.124.632.93010
    21925ABiopsy soft tissue of back4.4911.934.680.4416.869.61090
    21930ARemove lesion, back or flank5.004.602.620.4910.098.11090
    21935ARemove tumor, back17.96NA13.011.87NA32.84090
    22100ARemove part of neck vertebra9.73NA8.381.55NA19.66090
    22101ARemove part, thorax vertebra9.81NA8.571.51NA19.89090
    22102ARemove part, lumbar vertebra9.81NA8.771.46NA20.04090
    22103ARemove extra spine segment2.34NA1.240.37NA3.95ZZZ
    22110ARemove part of neck vertebra12.74NA10.662.20NA25.60090
    22112ARemove part, thorax vertebra12.81NA10.541.96NA25.31090
    22114ARemove part, lumbar vertebra12.81NA10.451.98NA25.24090
    22116ARemove extra spine segment2.32NA1.190.40NA3.91ZZZ
    22210ARevision of neck spine23.82NA17.104.23NA45.15090
    22212ARevision of thorax spine19.42NA14.612.78NA36.81090
    22214ARevision of lumbar spine19.45NA15.092.78NA37.32090
    22216ARevise, extra spine segment6.04NA3.210.98NA10.23ZZZ
    22220ARevision of neck spine21.37NA15.503.65NA40.52090
    22222ARevision of thorax spine21.52NA13.083.08NA37.68090
    22224ARevision of lumbar spine21.52NA15.723.20NA40.44090
    22226ARevise, extra spine segment6.04NA3.171.01NA10.22ZZZ
    22305ATreat spine process fracture2.053.402.820.295.745.16090
    22310ATreat spine fracture2.615.044.440.378.027.42090
    22315ATreat spine fracture8.84NA8.641.37NA18.85090
    22318ATreat odontoid fx w/o graft21.50NA14.634.26NA40.39090
    22319ATreat odontoid fx w/graft24.00NA17.144.76NA45.90090
    22325ATreat spine fracture18.30NA13.882.61NA34.79090
    22326ATreat neck spine fracture19.59NA15.003.54NA38.13090
    22327ATreat thorax spine fracture19.20NA14.242.75NA36.19090
    22328ATreat each add spine fx4.61NA2.330.66NA7.60ZZZ
    22505AManipulation of spine1.874.803.190.276.945.33010
    22520APercut vertebroplasty thor8.91NA3.980.99NA13.88010
    22521APercut vertebroplasty lumb8.34NA3.810.93NA13.08010
    22522APercut vertebroplasty addl4.31NA1.730.33NA6.37ZZZ
    22548ANeck spine fusion25.82NA16.224.98NA47.02090
    22554ANeck spine fusion18.62NA12.633.51NA34.76090
    22556AThorax spine fusion23.46NA14.893.78NA42.13090
    22558ALumbar spine fusion22.28NA13.403.18NA38.86090
    22585AAdditional spinal fusion5.53NA2.870.98NA9.38ZZZ
    22590ASpine & skull spinal fusion20.51NA13.623.81NA37.94090
    22595ANeck spinal fusion19.39NA13.123.62NA36.13090
    22600ANeck spine fusion16.14NA11.402.89NA30.43090
    22610AThorax spine fusion16.02NA11.562.66NA30.24090
    22612ALumbar spine fusion21.00NA14.363.28NA38.64090
    22614ASpine fusion, extra segment6.44NA3.441.04NA10.92ZZZ
    22630ALumbar spine fusion20.84NA14.013.79NA38.64090
    22632ASpine fusion, extra segment5.23NA2.740.90NA8.87ZZZ
    22800AFusion of spine18.25NA13.022.71NA33.98090
    22802AFusion of spine30.88NA19.994.42NA55.29090
    22804AFusion of spine36.27NA23.155.23NA64.65090
    22808AFusion of spine26.27NA16.724.36NA47.35090
    22810AFusion of spine30.27NA18.754.49NA53.51090
    22812AFusion of spine32.70NA20.274.67NA57.64090
    22818AKyphectomy, 1-2 segments31.83NA19.495.01NA56.33090
    22819AKyphectomy, 3 or more36.44NA20.585.20NA62.22090
    22830AExploration of spinal fusion10.85NA8.321.73NA20.90090
    22840AInsert spine fixation device12.54NA6.672.03NA21.24ZZZ
    22841BInsert spine fixation device0.000.000.000.000.000.00XXX
    22842AInsert spine fixation device12.58NA6.692.04NA21.31ZZZ
    22843AInsert spine fixation device13.46NA6.782.10NA22.34ZZZ
    22844AInsert spine fixation device16.44NA8.992.42NA27.85ZZZ
    22845AInsert spine fixation device11.96NA6.242.22NA20.42ZZZ
    22846AInsert spine fixation device12.42NA6.512.26NA21.19ZZZ
    22847AInsert spine fixation device13.80NA7.212.36NA23.37ZZZ
    22848AInsert pelv fixation device6.00NA3.270.88NA10.15ZZZ
    Start Printed Page 80054
    22849AReinsert spinal fixation18.51NA13.752.87NA35.13090
    22850ARemove spine fixation device9.52NA8.501.51NA19.53090
    22851AApply spine prosth device6.71NA3.451.11NA11.27ZZZ
    22852ARemove spine fixation device9.01NA8.261.40NA18.67090
    22855ARemove spine fixation device15.13NA11.242.74NA29.11090
    22899CSpine surgery procedure0.000.000.000.000.000.00YYY
    22900ARemove abdominal wall lesion5.80NA4.290.58NA10.67090
    22999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    23000ARemoval of calcium deposits4.368.977.380.5013.8312.24090
    23020ARelease shoulder joint8.93NA10.951.23NA21.11090
    23030ADrain shoulder lesion3.436.244.540.4210.098.39010
    23031ADrain shoulder bursa2.746.004.340.339.077.41010
    23035ADrain shoulder bone lesion8.61NA15.811.19NA25.61090
    23040AExploratory shoulder surgery9.20NA12.151.28NA22.63090
    23044AExploratory shoulder surgery7.12NA11.010.97NA19.10090
    23065ABiopsy shoulder tissues2.272.711.330.145.123.74010
    23066ABiopsy shoulder tissues4.167.966.490.5012.6211.15090
    23075ARemoval of shoulder lesion2.395.363.210.258.005.85010
    23076ARemoval of shoulder lesion7.63NA8.420.87NA16.92090
    23077ARemove tumor of shoulder16.09NA14.261.81NA32.16090
    23100ABiopsy of shoulder joint6.03NA9.130.81NA15.97090
    23101AShoulder joint surgery5.58NA9.140.77NA15.49090
    23105ARemove shoulder joint lining8.23NA10.551.13NA19.91090
    23106AIncision of collarbone joint5.96NA9.250.82NA16.03090
    23107AExplore treat shoulder joint8.62NA10.741.19NA20.55090
    23120APartial removal, collar bone7.11NA9.970.99NA18.07090
    23125ARemoval of collar bone9.39NA11.081.27NA21.74090
    23130ARemove shoulder bone, part7.55NA10.201.06NA18.81090
    23140ARemoval of bone lesion6.89NA8.640.82NA16.35090
    23145ARemoval of bone lesion9.09NA12.051.24NA22.38090
    23146ARemoval of bone lesion7.83NA11.371.11NA20.31090
    23150ARemoval of humerus lesion8.48NA10.371.14NA19.99090
    23155ARemoval of humerus lesion10.35NA12.621.20NA24.17090
    23156ARemoval of humerus lesion8.68NA10.741.18NA20.60090
    23170ARemove collar bone lesion6.86NA11.170.84NA18.87090
    23172ARemove shoulder blade lesion6.90NA10.700.95NA18.55090
    23174ARemove humerus lesion9.51NA12.191.30NA23.00090
    23180ARemove collar bone lesion8.53NA16.821.18NA26.53090
    23182ARemove shoulder blade lesion8.15NA16.901.08NA26.13090
    23184ARemove humerus lesion9.38NA17.081.24NA27.70090
    23190APartial removal of scapula7.24NA8.720.97NA16.93090
    23195ARemoval of head of humerus9.81NA11.111.38NA22.30090
    23200ARemoval of collar bone12.08NA14.521.48NA28.08090
    23210ARemoval of shoulder blade12.49NA14.471.61NA28.57090
    23220APartial removal of humerus14.56NA15.732.03NA32.32090
    23221APartial removal of humerus17.74NA17.132.51NA37.38090
    23222APartial removal of humerus23.92NA21.023.37NA48.31090
    23330ARemove shoulder foreign body1.855.753.770.187.785.80010
    23331ARemove shoulder foreign body7.38NA10.061.02NA18.46090
    23332ARemove shoulder foreign body11.62NA12.401.62NA25.64090
    23350AInjection for shoulder x-ray1.007.300.340.058.351.39000
    23395AMuscle transfer,shoulder/arm16.85NA14.272.29NA33.41090
    23397AMuscle transfers16.13NA14.612.24NA32.98090
    23400AFixation of shoulder blade13.54NA14.581.91NA30.03090
    23405AIncision of tendon & muscle8.37NA9.691.12NA19.18090
    23406AIncise tendon(s) & muscle(s)10.79NA11.891.48NA24.16090
    23410ARepair rotator cuff, acute12.45NA12.811.72NA26.98090
    23412ARepair rotator cuff, chronic13.31NA13.321.86NA28.49090
    23415ARelease of shoulder ligament9.97NA10.451.39NA21.81090
    23420ARepair of shoulder13.30NA14.311.86NA29.47090
    23430ARepair biceps tendon9.98NA11.501.40NA22.88090
    23440ARemove/transplant tendon10.48NA11.821.47NA23.77090
    23450ARepair shoulder capsule13.40NA13.301.86NA28.56090
    23455ARepair shoulder capsule14.37NA13.882.01NA30.26090
    23460ARepair shoulder capsule15.37NA14.462.17NA32.00090
    23462ARepair shoulder capsule15.30NA14.132.16NA31.59090
    23465ARepair shoulder capsule15.85NA14.311.61NA31.77090
    23466ARepair shoulder capsule14.22NA13.842.00NA30.06090
    23470AReconstruct shoulder joint17.15NA12.422.40NA31.97090
    23472AReconstruct shoulder joint21.10NA14.642.37NA38.11090
    23480ARevision of collar bone11.18NA12.161.56NA24.90090
    23485ARevision of collar bone13.43NA13.351.84NA28.62090
    23490AReinforce clavicle11.86NA12.241.11NA25.21090
    23491AReinforce shoulder bones14.21NA13.762.00NA29.97090
    23500ATreat clavicle fracture2.084.082.600.266.424.94090
    Start Printed Page 80055
    23505ATreat clavicle fracture3.696.204.120.5010.398.31090
    23515ATreat clavicle fracture7.41NA8.431.03NA16.87090
    23520ATreat clavicle dislocation2.164.122.680.266.545.10090
    23525ATreat clavicle dislocation3.606.003.980.4410.048.02090
    23530ATreat clavicle dislocation7.31NA8.200.85NA16.36090
    23532ATreat clavicle dislocation8.01NA8.601.13NA17.74090
    23540ATreat clavicle dislocation2.234.682.570.247.155.04090
    23545ATreat clavicle dislocation3.255.263.690.398.907.33090
    23550ATreat clavicle dislocation7.24NA8.370.94NA16.55090
    23552ATreat clavicle dislocation8.45NA9.031.18NA18.66090
    23570ATreat shoulder blade fx2.234.062.770.296.585.29090
    23575ATreat shoulder blade fx4.066.414.370.5311.008.96090
    23585ATreat scapula fracture8.96NA9.581.25NA19.79090
    23600ATreat humerus fracture2.935.913.740.399.237.06090
    23605ATreat humerus fracture4.878.796.830.6714.3312.37090
    23615ATreat humerus fracture9.35NA10.471.31NA21.13090
    23616ATreat humerus fracture21.27NA16.242.98NA40.49090
    23620ATreat humerus fracture2.405.623.470.328.346.19090
    23625ATreat humerus fracture3.937.755.750.5312.2110.21090
    23630ATreat humerus fracture7.35NA8.441.03NA16.82090
    23650ATreat shoulder dislocation3.395.743.580.319.447.28090
    23655ATreat shoulder dislocation4.57NA4.380.52NA9.47090
    23660ATreat shoulder dislocation7.49NA8.241.01NA16.74090
    23665ATreat dislocation/fracture4.477.935.990.6013.0011.06090
    23670ATreat dislocation/fracture7.90NA8.931.10NA17.93090
    23675ATreat dislocation/fracture6.058.666.870.8315.5413.75090
    23680ATreat dislocation/fracture10.06NA10.061.39NA21.51090
    23700AFixation of shoulder2.52NA3.650.35NA6.52010
    23800AFusion of shoulder joint14.16NA14.661.97NA30.79090
    23802AFusion of shoulder joint16.60NA13.912.34NA32.85090
    23900AAmputation of arm & girdle19.72NA15.692.47NA37.88090
    23920AAmputation at shoulder joint14.61NA14.021.92NA30.55090
    23921AAmputation follow-up surgery5.49NA6.900.78NA13.17090
    23929CShoulder surgery procedure0.000.000.000.000.000.00YYY
    23930ADrainage of arm lesion2.946.194.050.329.457.31010
    23931ADrainage of arm bursa1.795.973.880.217.975.88010
    23935ADrain arm/elbow bone lesion6.09NA13.610.84NA20.54090
    24000AExploratory elbow surgery5.82NA6.170.77NA12.76090
    24006ARelease elbow joint9.31NA8.701.27NA19.28090
    24065ABiopsy arm/elbow soft tissue2.085.873.350.148.095.57010
    24066ABiopsy arm/elbow soft tissue5.218.946.820.6114.7612.64090
    24075ARemove arm/elbow lesion3.928.206.140.4312.5510.49090
    24076ARemove arm/elbow lesion6.30NA7.340.70NA14.34090
    24077ARemove tumor of arm/elbow11.76NA13.781.32NA26.86090
    24100ABiopsy elbow joint lining4.93NA5.790.62NA11.34090
    24101AExplore/treat elbow joint6.13NA6.960.84NA13.93090
    24102ARemove elbow joint lining8.03NA7.951.09NA17.07090
    24105ARemoval of elbow bursa3.61NA5.380.49NA9.48090
    24110ARemove humerus lesion7.39NA10.130.99NA18.51090
    24115ARemove/graft bone lesion9.63NA10.521.15NA21.30090
    24116ARemove/graft bone lesion11.81NA12.571.66NA26.04090
    24120ARemove elbow lesion6.65NA6.950.87NA14.47090
    24125ARemove/graft bone lesion7.89NA7.280.88NA16.05090
    24126ARemove/graft bone lesion8.31NA8.030.90NA17.24090
    24130ARemoval of head of radius6.25NA7.050.87NA14.17090
    24134ARemoval of arm bone lesion9.73NA16.461.31NA27.50090
    24136ARemove radius bone lesion7.99NA6.550.85NA15.39090
    24138ARemove elbow bone lesion8.05NA8.031.12NA17.20090
    24140APartial removal of arm bone9.18NA17.561.23NA27.97090
    24145APartial removal of radius7.58NA11.641.01NA20.23090
    24147APartial removal of elbow7.54NA11.641.04NA20.22090
    24149ARadical resection of elbow14.20NA11.191.90NA27.29090
    24150AExtensive humerus surgery13.27NA15.231.81NA30.31090
    24151AExtensive humerus surgery15.58NA16.962.19NA34.73090
    24152AExtensive radius surgery10.06NA9.831.19NA21.08090
    24153AExtensive radius surgery11.54NA7.060.64NA19.24090
    24155ARemoval of elbow joint11.73NA9.421.42NA22.57090
    24160ARemove elbow joint implant7.83NA6.951.07NA15.85090
    24164ARemove radius head implant6.23NA5.950.84NA13.02090
    24200ARemoval of arm foreign body1.765.733.350.157.645.26010
    24201ARemoval of arm foreign body4.568.917.060.5614.0312.18090
    24220AInjection for elbow x-ray1.3111.020.460.0712.401.84000
    24300AManipulate elbow w/anesth3.75NA5.530.49NA9.77090
    24301AMuscle/tendon transfer10.20NA9.221.30NA20.72090
    24305AArm tendon lengthening7.45NA7.790.98NA16.22090
    Start Printed Page 80056
    24310ARevision of arm tendon5.98NA8.530.74NA15.25090
    24320ARepair of arm tendon10.56NA11.051.00NA22.61090
    24330ARevision of arm muscles9.60NA8.871.21NA19.68090
    24331ARevision of arm muscles10.65NA9.481.41NA21.54090
    24332ATenolysis, triceps7.45NA5.210.77NA13.43090
    24340ARepair of biceps tendon7.89NA7.861.08NA16.83090
    24341ARepair arm tendon/muscle7.90NA7.861.08NA16.84090
    24342ARepair of ruptured tendon10.62NA9.441.48NA21.54090
    24343ARepr elbow lat ligmnt w/tiss8.65NA7.891.13NA17.67090
    24344AReconstruct elbow lat ligmnt14.00NA11.181.83NA27.01090
    24345ARepr elbw med ligmnt w/tissu8.65NA7.891.13NA17.67090
    24346AReconstruct elbow med ligmnt14.00NA11.181.83NA27.01090
    24350ARepair of tennis elbow5.25NA6.440.72NA12.41090
    24351ARepair of tennis elbow5.91NA6.930.82NA13.66090
    24352ARepair of tennis elbow6.43NA7.190.90NA14.52090
    24354ARepair of tennis elbow6.48NA7.150.88NA14.51090
    24356ARevision of tennis elbow6.68NA7.330.90NA14.91090
    24360AReconstruct elbow joint12.34NA9.651.69NA23.68090
    24361AReconstruct elbow joint14.08NA10.641.95NA26.67090
    24362AReconstruct elbow joint14.99NA12.411.92NA29.32090
    24363AReplace elbow joint18.49NA11.532.52NA32.54090
    24365AReconstruct head of radius8.39NA7.311.11NA16.81090
    24366AReconstruct head of radius9.13NA7.691.28NA18.10090
    24400ARevision of humerus11.06NA12.991.53NA25.58090
    24410ARevision of humerus14.82NA14.111.89NA30.82090
    24420ARevision of humerus13.44NA17.271.82NA32.53090
    24430ARepair of humerus12.81NA13.181.80NA27.79090
    24435ARepair humerus with graft13.17NA14.371.84NA29.38090
    24470ARevision of elbow joint8.74NA8.501.23NA18.47090
    24495ADecompression of forearm8.12NA10.280.92NA19.32090
    24498AReinforce humerus11.92NA12.681.67NA26.27090
    24500ATreat humerus fracture3.215.313.380.418.937.00090
    24505ATreat humerus fracture5.179.317.100.7215.2012.99090
    24515ATreat humerus fracture11.65NA11.581.63NA24.86090
    24516ATreat humerus fracture11.65NA12.141.63NA25.42090
    24530ATreat humerus fracture3.506.524.970.4710.498.94090
    24535ATreat humerus fracture6.879.146.890.9616.9714.72090
    24538ATreat humerus fracture9.43NA10.851.25NA21.53090
    24545ATreat humerus fracture10.46NA10.371.47NA22.30090
    24546ATreat humerus fracture15.69NA13.832.18NA31.70090
    24560ATreat humerus fracture2.805.103.160.358.256.31090
    24565ATreat humerus fracture5.568.246.050.7414.5412.35090
    24566ATreat humerus fracture7.79NA10.341.10NA19.23090
    24575ATreat humerus fracture10.66NA8.431.44NA20.53090
    24576ATreat humerus fracture2.864.853.310.388.096.55090
    24577ATreat humerus fracture5.798.476.320.8115.0712.92090
    24579ATreat humerus fracture11.60NA11.311.62NA24.53090
    24582ATreat humerus fracture8.55NA10.771.20NA20.52090
    24586ATreat elbow fracture15.21NA11.052.12NA28.38090
    24587ATreat elbow fracture15.16NA10.882.14NA28.18090
    24600ATreat elbow dislocation4.237.125.110.4911.849.83090
    24605ATreat elbow dislocation5.42NA5.090.72NA11.23090
    24615ATreat elbow dislocation9.42NA7.971.31NA18.70090
    24620ATreat elbow fracture6.98NA6.710.90NA14.59090
    24635ATreat elbow fracture13.19NA16.641.84NA31.67090
    24640ATreat elbow dislocation1.203.541.840.114.853.15010
    24650ATreat radius fracture2.164.812.920.287.255.36090
    24655ATreat radius fracture4.407.665.410.5812.6410.39090
    24665ATreat radius fracture8.14NA9.721.13NA18.99090
    24666ATreat radius fracture9.49NA10.481.32NA21.29090
    24670ATreat ulnar fracture2.544.713.130.337.586.00090
    24675ATreat ulnar fracture4.727.865.680.6513.2311.05090
    24685ATreat ulnar fracture8.80NA10.081.23NA20.11090
    24800AFusion of elbow joint11.20NA9.941.41NA22.55090
    24802AFusion/graft of elbow joint13.69NA11.561.89NA27.14090
    24900AAmputation of upper arm9.60NA11.211.18NA21.99090
    24920AAmputation of upper arm9.54NA12.821.22NA23.58090
    24925AAmputation follow-up surgery7.07NA9.680.95NA17.70090
    24930AAmputation follow-up surgery10.25NA11.781.23NA23.26090
    24931AAmputate upper arm & implant12.72NA9.231.56NA23.51090
    24935ARevision of amputation15.56NA12.631.58NA29.77090
    24940CRevision of upper arm0.000.000.000.000.000.00090
    24999CUpper arm/elbow surgery0.000.000.000.000.000.00YYY
    25000AIncision of tendon sheath3.38NA7.590.45NA11.42090
    25001AIncise flexor carpi radialis3.38NA4.370.45NA8.20090
    Start Printed Page 80057
    25020ADecompress forearm 1 space5.92NA11.380.76NA18.06090
    25023ADecompress forearm 1 space12.96NA17.361.52NA31.84090
    25024ADecompress forearm 2 spaces9.50NA8.081.24NA18.82090
    25025ADecompress forarm 2 spaces16.54NA11.752.18NA30.47090
    25028ADrainage of forearm lesion5.25NA10.170.61NA16.03090
    25031ADrainage of forearm bursa4.14NA10.140.50NA14.78090
    25035ATreat forearm bone lesion7.36NA16.870.98NA25.21090
    25040AExplore/treat wrist joint7.18NA9.480.96NA17.62090
    25065ABiopsy forearm soft tissues1.992.582.580.124.694.69010
    25066ABiopsy forearm soft tissues4.13NA8.420.49NA13.04090
    25075ARemovel forearm lesion subcu3.74NA7.390.40NA11.53090
    25076ARemovel forearm lesion deep4.92NA12.880.59NA18.39090
    25077ARemove tumor, forearm/wrist9.76NA15.511.10NA26.37090
    25085AIncision of wrist capsule5.50NA11.290.71NA17.50090
    25100ABiopsy of wrist joint3.90NA7.660.50NA12.06090
    25101AExplore/treat wrist joint4.69NA8.020.60NA13.31090
    25105ARemove wrist joint lining5.85NA11.250.77NA17.87090
    25107ARemove wrist joint cartilage6.43NA11.620.82NA18.87090
    25110ARemove wrist tendon lesion3.92NA8.620.48NA13.02090
    25111ARemove wrist tendon lesion3.39NA6.670.42NA10.48090
    25112AReremove wrist tendon lesion4.53NA7.490.54NA12.56090
    25115ARemove wrist/forearm lesion8.82NA17.361.11NA27.29090
    25116ARemove wrist/forearm lesion7.11NA16.360.90NA24.37090
    25118AExcise wrist tendon sheath4.37NA8.090.55NA13.01090
    25119APartial removal of ulna6.04NA11.540.80NA18.38090
    25120ARemoval of forearm lesion6.10NA15.310.81NA22.22090
    25125ARemove/graft forearm lesion7.48NA16.391.02NA24.89090
    25126ARemove/graft forearm lesion7.55NA15.931.00NA24.48090
    25130ARemoval of wrist lesion5.26NA8.440.66NA14.36090
    25135ARemove & graft wrist lesion6.89NA9.270.89NA17.05090
    25136ARemove & graft wrist lesion5.97NA8.500.58NA15.05090
    25145ARemove forearm bone lesion6.37NA15.730.82NA22.92090
    25150APartial removal of ulna7.09NA12.280.96NA20.33090
    25151APartial removal of radius7.39NA16.280.93NA24.60090
    25170AExtensive forearm surgery11.09NA17.761.52NA30.37090
    25210ARemoval of wrist bone5.95NA8.840.73NA15.52090
    25215ARemoval of wrist bones7.89NA12.521.02NA21.43090
    25230APartial removal of radius5.23NA8.350.66NA14.24090
    25240APartial removal of ulna5.17NA11.070.69NA16.93090
    25246AInjection for wrist x-ray1.4510.270.500.0711.792.02000
    25248ARemove forearm foreign body5.14NA10.230.54NA15.91090
    25250ARemoval of wrist prosthesis6.60NA6.190.84NA13.63090
    25251ARemoval of wrist prosthesis9.57NA8.081.15NA18.80090
    25259AManipulate wrist w/anesthes3.75NA5.460.50NA9.71090
    25260ARepair forearm tendon/muscle7.80NA17.120.97NA25.89090
    25263ARepair forearm tendon/muscle7.82NA16.990.94NA25.75090
    25265ARepair forearm tendon/muscle9.88NA17.711.19NA28.78090
    25270ARepair forearm tendon/muscle6.00NA16.170.76NA22.93090
    25272ARepair forearm tendon/muscle7.04NA16.740.89NA24.67090
    25274ARepair forearm tendon/muscle8.75NA17.171.14NA27.06090
    25275ARepair forearm tendon sheath8.50NA7.441.13NA17.07090
    25280ARevise wrist/forearm tendon7.22NA16.290.91NA24.42090
    25290AIncise wrist/forearm tendon5.29NA18.620.66NA24.57090
    25295ARelease wrist/forearm tendon6.55NA15.930.86NA23.34090
    25300AFusion of tendons at wrist8.80NA10.061.07NA19.93090
    25301AFusion of tendons at wrist8.40NA9.981.08NA19.46090
    25310ATransplant forearm tendon8.14NA16.741.01NA25.89090
    25312ATransplant forearm tendon9.57NA17.491.22NA28.28090
    25315ARevise palsy hand tendon(s)10.20NA18.311.26NA29.77090
    25316ARevise palsy hand tendon(s)12.33NA19.711.74NA33.78090
    25320ARepair/revise wrist joint10.77NA11.501.32NA23.59090
    25332ARevise wrist joint11.41NA9.341.46NA22.21090
    25335ARealignment of hand12.88NA14.951.66NA29.49090
    25337AReconstruct ulna/radioulnar10.17NA13.851.31NA25.33090
    25350ARevision of radius8.78NA16.981.17NA26.93090
    25355ARevision of radius10.17NA17.601.44NA29.21090
    25360ARevision of ulna8.43NA16.891.17NA26.49090
    25365ARevise radius & ulna12.40NA18.511.67NA32.58090
    25370ARevise radius or ulna13.36NA18.421.88NA33.66090
    25375ARevise radius & ulna13.04NA19.421.84NA34.30090
    25390AShorten radius or ulna10.40NA17.691.38NA29.47090
    25391ALengthen radius or ulna13.65NA19.371.73NA34.75090
    25392AShorten radius & ulna13.95NA18.371.73NA34.05090
    25393ALengthen radius & ulna15.87NA20.631.87NA38.37090
    25394ARepair carpal bone, shorten10.40NA8.291.40NA20.09090
    Start Printed Page 80058
    25400ARepair radius or ulna10.92NA18.221.50NA30.64090
    25405ARepair/graft radius or ulna14.38NA20.481.95NA36.81090
    25415ARepair radius & ulna13.35NA19.391.87NA34.61090
    25420ARepair/graft radius & ulna16.33NA21.342.20NA39.87090
    25425ARepair/graft radius or ulna13.21NA26.801.61NA41.62090
    25426ARepair/graft radius & ulna15.82NA20.122.23NA38.17090
    25430AVasc graft into carpal bone9.25NA7.621.07NA17.94090
    25431ARepair nonunion carpal bone10.44NA6.380.56NA17.38090
    25440ARepair/graft wrist bone10.44NA11.251.41NA23.10090
    25441AReconstruct wrist joint12.90NA10.141.83NA24.87090
    25442AReconstruct wrist joint10.85NA9.001.24NA21.09090
    25443AReconstruct wrist joint10.39NA8.891.30NA20.58090
    25444AReconstruct wrist joint11.15NA9.171.43NA21.75090
    25445AReconstruct wrist joint9.69NA8.181.26NA19.13090
    25446AWrist replacement16.55NA12.172.20NA30.92090
    25447ARepair wrist joint(s)10.37NA8.761.34NA20.47090
    25449ARemove wrist joint implant14.49NA10.891.77NA27.15090
    25450ARevision of wrist joint7.87NA13.090.88NA21.84090
    25455ARevision of wrist joint9.49NA14.281.07NA24.84090
    25490AReinforce radius9.54NA16.711.19NA27.44090
    25491AReinforce ulna9.96NA17.581.41NA28.95090
    25492AReinforce radius and ulna12.33NA18.061.62NA32.01090
    25500ATreat fracture of radius2.454.372.930.287.105.66090
    25505ATreat fracture of radius5.218.045.810.6913.9411.71090
    25515ATreat fracture of radius9.18NA10.001.22NA20.40090
    25520ATreat fracture of radius6.268.236.430.8515.3413.54090
    25525ATreat fracture of radius12.24NA11.921.68NA25.84090
    25526ATreat fracture of radius12.98NA15.401.80NA30.18090
    25530ATreat fracture of ulna2.094.422.920.276.785.28090
    25535ATreat fracture of ulna5.147.815.860.6813.6311.68090
    25545ATreat fracture of ulna8.90NA10.141.23NA20.27090
    25560ATreat fracture radius & ulna2.444.412.900.277.125.61090
    25565ATreat fracture radius & ulna5.638.286.020.7614.6712.41090
    25574ATreat fracture radius & ulna7.01NA9.050.96NA17.02090
    25575ATreat fracture radius/ulna10.45NA10.981.46NA22.89090
    25600ATreat fracture radius/ulna2.634.753.110.347.726.08090
    25605ATreat fracture radius/ulna5.818.516.270.8115.1312.89090
    25611ATreat fracture radius/ulna7.77NA10.371.08NA19.22090
    25620ATreat fracture radius/ulna8.55NA9.911.17NA19.63090
    25622ATreat wrist bone fracture2.614.703.080.337.646.02090
    25624ATreat wrist bone fracture4.537.735.490.6112.8710.63090
    25628ATreat wrist bone fracture8.43NA9.951.14NA19.52090
    25630ATreat wrist bone fracture2.884.863.140.378.116.39090
    25635ATreat wrist bone fracture4.397.684.750.3912.469.53090
    25645ATreat wrist bone fracture7.25NA9.470.93NA17.65090
    25650ATreat wrist bone fracture3.054.913.210.378.336.63090
    25651APin ulnar styloid fracture5.36NA5.690.72NA11.77090
    25652ATreat fracture ulnar styloid7.60NA6.851.02NA15.47090
    25660ATreat wrist dislocation4.76NA5.490.59NA10.84090
    25670ATreat wrist dislocation7.92NA9.731.07NA18.72090
    25671APin radioulnar dislocation6.00NA6.020.81NA12.83090
    25675ATreat wrist dislocation4.677.525.430.5712.7610.67090
    25676ATreat wrist dislocation8.04NA9.781.10NA18.92090
    25680ATreat wrist fracture5.99NA6.480.61NA13.08090
    25685ATreat wrist fracture9.78NA10.441.25NA21.47090
    25690ATreat wrist dislocation5.50NA7.210.78NA13.49090
    25695ATreat wrist dislocation8.34NA9.861.07NA19.27090
    25800AFusion of wrist joint9.76NA10.921.30NA21.98090
    25805AFusion/graft of wrist joint11.28NA11.811.51NA24.60090
    25810AFusion/graft of wrist joint10.57NA11.341.37NA23.28090
    25820AFusion of hand bones7.45NA9.680.96NA18.09090
    25825AFuse hand bones with graft9.27NA10.661.20NA21.13090
    25830AFusion, radioulnar jnt/ulna10.06NA17.121.27NA28.45090
    25900AAmputation of forearm9.01NA14.481.08NA24.57090
    25905AAmputation of forearm9.12NA15.751.06NA25.93090
    25907AAmputation follow-up surgery7.80NA15.191.01NA24.00090
    25909AAmputation follow-up surgery8.96NA15.621.07NA25.65090
    25915AAmputation of forearm17.08NA23.142.41NA42.63090
    25920AAmputate hand at wrist8.68NA9.911.06NA19.65090
    25922AAmputate hand at wrist7.42NA9.060.93NA17.41090
    25924AAmputation follow-up surgery8.46NA10.251.07NA19.78090
    25927AAmputation of hand8.80NA14.181.02NA24.00090
    25929AAmputation follow-up surgery7.59NA7.830.89NA16.31090
    25931AAmputation follow-up surgery7.81NA15.090.88NA23.78090
    25999CForearm or wrist surgery0.000.000.000.000.000.00YYY
    Start Printed Page 80059
    26010ADrainage of finger abscess1.545.971.780.147.653.46010
    26011ADrainage of finger abscess2.1912.482.480.2514.924.92010
    26020ADrain hand tendon sheath4.67NA5.310.59NA10.57090
    26025ADrainage of palm bursa4.82NA5.180.60NA10.60090
    26030ADrainage of palm bursa(s)5.93NA5.850.72NA12.50090
    26034ATreat hand bone lesion6.23NA6.040.79NA13.06090
    26035ADecompress fingers/hand9.51NA7.991.12NA18.62090
    26037ADecompress fingers/hand7.25NA6.480.87NA14.60090
    26040ARelease palm contracture3.33NA3.750.45NA7.53090
    26045ARelease palm contracture5.56NA5.300.74NA11.60090
    26055AIncise finger tendon sheath2.6915.463.590.3618.516.64090
    26060AIncision of finger tendon2.81NA3.280.35NA6.44090
    26070AExplore/treat hand joint3.69NA3.320.35NA7.36090
    26075AExplore/treat finger joint3.79NA3.670.40NA7.86090
    26080AExplore/treat finger joint4.24NA4.580.52NA9.34090
    26100ABiopsy hand joint lining3.67NA3.900.45NA8.02090
    26105ABiopsy finger joint lining3.71NA3.930.45NA8.09090
    26110ABiopsy finger joint lining3.53NA3.800.44NA7.77090
    26115ARemovel hand lesion subcut3.8614.424.430.4818.768.77090
    26116ARemovel hand lesion, deep5.53NA5.660.69NA11.88090
    26117ARemove tumor, hand/finger8.55NA6.941.01NA16.50090
    26121ARelease palm contracture7.54NA6.720.94NA15.20090
    26123ARelease palm contracture9.29NA8.651.17NA19.11090
    26125ARelease palm contracture4.61NA2.510.57NA7.69ZZZ
    26130ARemove wrist joint lining5.42NA5.120.65NA11.19090
    26135ARevise finger joint, each6.96NA6.200.87NA14.03090
    26140ARevise finger joint, each6.17NA5.750.76NA12.68090
    26145ATendon excision, palm/finger6.32NA5.780.77NA12.87090
    26160ARemove tendon sheath lesion3.1518.943.860.3922.487.40090
    26170ARemoval of palm tendon, each4.77NA4.720.60NA10.09090
    26180ARemoval of finger tendon5.18NA5.100.64NA10.92090
    26185ARemove finger bone5.25NA5.620.67NA11.54090
    26200ARemove hand bone lesion5.51NA5.140.71NA11.36090
    26205ARemove/graft bone lesion7.70NA6.690.95NA15.34090
    26210ARemoval of finger lesion5.15NA5.120.64NA10.91090
    26215ARemove/graft finger lesion7.10NA6.070.77NA13.94090
    26230APartial removal of hand bone6.33NA5.680.84NA12.85090
    26235APartial removal, finger bone6.19NA5.620.78NA12.59090
    26236APartial removal, finger bone5.32NA5.170.66NA11.15090
    26250AExtensive hand surgery7.55NA6.230.92NA14.70090
    26255AExtensive hand surgery12.43NA9.261.05NA22.74090
    26260AExtensive finger surgery7.03NA5.980.83NA13.84090
    26261AExtensive finger surgery9.09NA6.220.84NA16.15090
    26262APartial removal of finger5.67NA5.180.70NA11.55090
    26320ARemoval of implant from hand3.98NA4.500.49NA8.97090
    26340AManipulate finger w/anesth2.50NA4.640.30NA7.44090
    26350ARepair finger/hand tendon5.99NA20.030.73NA26.75090
    26352ARepair/graft hand tendon7.68NA20.500.93NA29.11090
    26356ARepair finger/hand tendon8.07NA21.490.99NA30.55090
    26357ARepair finger/hand tendon8.58NA21.191.02NA30.79090
    26358ARepair/graft hand tendon9.14NA21.741.07NA31.95090
    26370ARepair finger/hand tendon7.11NA20.670.90NA28.68090
    26372ARepair/graft hand tendon8.76NA22.001.06NA31.82090
    26373ARepair finger/hand tendon8.16NA21.560.98NA30.70090
    26390ARevise hand/finger tendon9.19NA16.751.09NA27.03090
    26392ARepair/graft hand tendon10.26NA22.551.26NA34.07090
    26410ARepair hand tendon4.63NA16.300.57NA21.50090
    26412ARepair/graft hand tendon6.31NA17.390.80NA24.50090
    26415AExcision, hand/finger tendon8.34NA15.900.77NA25.01090
    26416AGraft hand or finger tendon9.37NA18.561.20NA29.13090
    26418ARepair finger tendon4.25NA16.130.50NA20.88090
    26420ARepair/graft finger tendon6.77NA17.690.83NA25.29090
    26426ARepair finger/hand tendon6.15NA17.160.77NA24.08090
    26428ARepair/graft finger tendon7.21NA18.240.84NA26.29090
    26432ARepair finger tendon4.02NA13.360.48NA17.86090
    26433ARepair finger tendon4.56NA14.270.56NA19.39090
    26434ARepair/graft finger tendon6.09NA14.670.71NA21.47090
    26437ARealignment of tendons5.82NA14.400.74NA20.96090
    26440ARelease palm/finger tendon5.02NA18.870.62NA24.51090
    26442ARelease palm & finger tendon8.16NA20.310.94NA29.41090
    26445ARelease hand/finger tendon4.31NA18.710.54NA23.56090
    26449ARelease forearm/hand tendon7.00NA20.020.84NA27.86090
    26450AIncision of palm tendon3.67NA8.570.46NA12.70090
    26455AIncision of finger tendon3.64NA8.450.47NA12.56090
    26460AIncise hand/finger tendon3.46NA8.200.44NA12.10090
    Start Printed Page 80060
    26471AFusion of finger tendons5.73NA14.060.73NA20.52090
    26474AFusion of finger tendons5.32NA14.310.69NA20.32090
    26476ATendon lengthening5.18NA13.800.62NA19.60090
    26477ATendon shortening5.15NA14.010.60NA19.76090
    26478ALengthening of hand tendon5.80NA14.650.77NA21.22090
    26479AShortening of hand tendon5.74NA14.650.76NA21.15090
    26480ATransplant hand tendon6.69NA19.940.84NA27.47090
    26483ATransplant/graft hand tendon8.29NA20.431.03NA29.75090
    26485ATransplant palm tendon7.70NA20.340.94NA28.98090
    26489ATransplant/graft palm tendon9.55NA17.040.98NA27.57090
    26490ARevise thumb tendon8.41NA15.541.05NA25.00090
    26492ATendon transfer with graft9.62NA16.151.19NA26.96090
    26494AHand tendon/muscle transfer8.47NA16.141.13NA25.74090
    26496ARevise thumb tendon9.59NA15.871.17NA26.63090
    26497AFinger tendon transfer9.57NA16.321.17NA27.06090
    26498AFinger tendon transfer14.00NA18.711.74NA34.45090
    26499ARevision of finger8.98NA17.020.94NA26.94090
    26500AHand tendon reconstruction5.96NA14.980.66NA21.60090
    26502AHand tendon reconstruction7.14NA15.270.87NA23.28090
    26504AHand tendon reconstruction7.47NA15.080.84NA23.39090
    26508ARelease thumb contracture6.01NA14.590.76NA21.36090
    26510AThumb tendon transfer5.43NA14.300.71NA20.44090
    26516AFusion of knuckle joint7.15NA15.070.90NA23.12090
    26517AFusion of knuckle joints8.83NA16.410.96NA26.20090
    26518AFusion of knuckle joints9.02NA16.121.13NA26.27090
    26520ARelease knuckle contracture5.30NA18.850.65NA24.80090
    26525ARelease finger contracture5.33NA19.020.66NA25.01090
    26530ARevise knuckle joint6.69NA6.040.86NA13.59090
    26531ARevise knuckle with implant7.91NA6.951.01NA15.87090
    26535ARevise finger joint5.24NA3.690.66NA9.59090
    26536ARevise/implant finger joint6.37NA10.320.80NA17.49090
    26540ARepair hand joint6.43NA14.890.81NA22.13090
    26541ARepair hand joint with graft8.62NA16.251.12NA25.99090
    26542ARepair hand joint with graft6.78NA14.780.87NA22.43090
    26545AReconstruct finger joint6.92NA15.520.79NA23.23090
    26546ARepair nonunion hand8.92NA16.151.14NA26.21090
    26548AReconstruct finger joint8.03NA16.020.98NA25.03090
    26550AConstruct thumb replacement21.24NA23.471.80NA46.51090
    26551AGreat toe-hand transfer46.58NA36.906.57NA90.05090
    26553ASingle transfer, toe-hand46.27NA28.161.99NA76.42090
    26554ADouble transfer, toe-hand54.95NA38.797.76NA101.50090
    26555APositional change of finger16.63NA22.512.13NA41.27090
    26556AToe joint transfer47.26NA34.276.67NA88.20090
    26560ARepair of web finger5.38NA12.990.60NA18.97090
    26561ARepair of web finger10.92NA16.120.69NA27.73090
    26562ARepair of web finger15.00NA19.370.98NA35.35090
    26565ACorrect metacarpal flaw6.74NA14.950.84NA22.53090
    26567ACorrect finger deformity6.82NA14.880.84NA22.54090
    26568ALengthen metacarpal/finger9.08NA20.411.10NA30.59090
    26580ARepair hand deformity18.18NA15.871.46NA35.51090
    26587AReconstruct extra finger14.056.36NA1.1221.53NA090
    26590ARepair finger deformity17.96NA17.461.32NA36.74090
    26591ARepair muscles of hand3.25NA13.800.37NA17.42090
    26593ARelease muscles of hand5.31NA13.780.64NA19.73090
    26596AExcision constricting tissue8.95NA9.860.87NA19.68090
    26600ATreat metacarpal fracture1.964.362.830.256.575.04090
    26605ATreat metacarpal fracture2.856.334.450.389.567.68090
    26607ATreat metacarpal fracture5.36NA8.460.70NA14.52090
    26608ATreat metacarpal fracture5.36NA9.070.73NA15.16090
    26615ATreat metacarpal fracture5.33NA8.490.70NA14.52090
    26641ATreat thumb dislocation3.946.704.860.4211.069.22090
    26645ATreat thumb fracture4.417.515.350.5412.4610.30090
    26650ATreat thumb fracture5.72NA9.240.77NA15.73090
    26665ATreat thumb fracture7.60NA9.520.97NA18.09090
    26670ATreat hand dislocation3.696.534.750.3610.588.80090
    26675ATreat hand dislocation4.646.664.570.5611.869.77090
    26676APin hand dislocation5.52NA9.300.76NA15.58090
    26685ATreat hand dislocation6.98NA9.140.95NA17.07090
    26686ATreat hand dislocation7.94NA9.731.05NA18.72090
    26700ATreat knuckle dislocation3.695.132.960.359.177.00090
    26705ATreat knuckle dislocation4.196.474.410.5011.169.10090
    26706APin knuckle dislocation5.12NA5.980.64NA11.74090
    26715ATreat knuckle dislocation5.74NA8.650.75NA15.14090
    26720ATreat finger fracture, each1.663.221.690.205.083.55090
    26725ATreat finger fracture, each3.335.473.280.439.237.04090
    Start Printed Page 80061
    26727ATreat finger fracture, each5.23NA9.180.69NA15.10090
    26735ATreat finger fracture, each5.98NA8.910.77NA15.66090
    26740ATreat finger fracture, each1.944.012.670.246.194.85090
    26742ATreat finger fracture, each3.857.415.280.4911.759.62090
    26746ATreat finger fracture, each5.81NA8.980.74NA15.53090
    26750ATreat finger fracture, each1.703.822.410.195.714.30090
    26755ATreat finger fracture, each3.105.253.100.378.726.57090
    26756APin finger fracture, each4.39NA8.890.56NA13.84090
    26765ATreat finger fracture, each4.17NA7.970.51NA12.65090
    26770ATreat finger dislocation3.024.982.710.278.276.00090
    26775ATreat finger dislocation3.716.254.060.4310.398.20090
    26776APin finger dislocation4.80NA9.010.63NA14.44090
    26785ATreat finger dislocation4.21NA7.940.54NA12.69090
    26820AThumb fusion with graft8.26NA16.221.11NA25.59090
    26841AFusion of thumb7.13NA15.460.97NA23.56090
    26842AThumb fusion with graft8.24NA16.241.10NA25.58090
    26843AFusion of hand joint7.61NA14.930.99NA23.53090
    26844AFusion/graft of hand joint8.73NA16.201.12NA26.05090
    26850AFusion of knuckle6.97NA14.890.89NA22.75090
    26852AFusion of knuckle with graft8.46NA15.841.05NA25.35090
    26860AFusion of finger joint4.69NA13.750.60NA19.04090
    26861AFusion of finger jnt, add-on1.74NA0.960.22NA2.92ZZZ
    26862AFusion/graft of finger joint7.37NA15.380.92NA23.67090
    26863AFuse/graft added joint3.90NA2.170.51NA6.58ZZZ
    26910AAmputate metacarpal bone7.60NA14.070.90NA22.57090
    26951AAmputation of finger/thumb4.59NA13.060.56NA18.21090
    26952AAmputation of finger/thumb6.31NA14.250.74NA21.30090
    26989CHand/finger surgery0.000.000.000.000.000.00YYY
    26990ADrainage of pelvis lesion7.48NA16.350.92NA24.75090
    26991ADrainage of pelvis bursa6.6811.949.870.8519.4717.40090
    26992ADrainage of bone lesion13.02NA20.251.75NA35.02090
    27000AIncision of hip tendon5.62NA7.780.76NA14.16090
    27001AIncision of hip tendon6.94NA8.520.95NA16.41090
    27003AIncision of hip tendon7.34NA9.520.93NA17.79090
    27005AIncision of hip tendon9.66NA10.841.36NA21.86090
    27006AIncision of hip tendons9.68NA10.841.33NA21.85090
    27025AIncision of hip/thigh fascia11.16NA10.701.38NA23.24090
    27030ADrainage of hip joint13.01NA12.691.81NA27.51090
    27033AExploration of hip joint13.39NA12.811.87NA28.07090
    27035ADenervation of hip joint16.69NA17.511.70NA35.90090
    27036AExcision of hip joint/muscle12.88NA14.251.80NA28.93090
    27040ABiopsy of soft tissues2.876.163.970.219.247.05010
    27041ABiopsy of soft tissues9.89NA8.601.01NA19.50090
    27047ARemove hip/pelvis lesion7.459.547.150.7917.7815.39090
    27048ARemove hip/pelvis lesion6.25NA8.060.73NA15.04090
    27049ARemove tumor, hip/pelvis13.66NA13.541.60NA28.80090
    27050ABiopsy of sacroiliac joint4.36NA7.420.53NA12.31090
    27052ABiopsy of hip joint6.23NA8.710.85NA15.79090
    27054ARemoval of hip joint lining8.54NA11.051.17NA20.76090
    27060ARemoval of ischial bursa5.43NA7.630.60NA13.66090
    27062ARemove femur lesion/bursa5.37NA7.590.74NA13.70090
    27065ARemoval of hip bone lesion5.90NA9.090.76NA15.75090
    27066ARemoval of hip bone lesion10.33NA12.881.42NA24.63090
    27067ARemove/graft hip bone lesion13.83NA14.911.95NA30.69090
    27070APartial removal of hip bone10.72NA18.361.36NA30.44090
    27071APartial removal of hip bone11.46NA19.321.51NA32.29090
    27075AExtensive hip surgery35.00NA25.822.22NA63.04090
    27076AExtensive hip surgery22.12NA20.292.86NA45.27090
    27077AExtensive hip surgery40.00NA29.143.18NA72.32090
    27078AExtensive hip surgery13.44NA15.811.67NA30.92090
    27079AExtensive hip surgery13.75NA15.341.86NA30.95090
    27080ARemoval of tail bone6.39NA7.660.80NA14.85090
    27086ARemove hip foreign body1.875.133.970.177.176.01010
    27087ARemove hip foreign body8.54NA9.191.09NA18.82090
    27090ARemoval of hip prosthesis11.15NA8.951.55NA21.65090
    27091ARemoval of hip prosthesis22.14NA14.223.11NA39.47090
    27093AInjection for hip x-ray1.3012.500.500.0913.891.89000
    27095AInjection for hip x-ray1.5011.470.540.1013.072.14000
    27096AInject sacroiliac joint1.4010.280.340.0811.761.82000
    27097ARevision of hip tendon8.80NA9.441.22NA19.46090
    27098ATransfer tendon to pelvis8.83NA9.881.24NA19.95090
    27100ATransfer of abdominal muscle11.08NA13.031.57NA25.68090
    27105ATransfer of spinal muscle11.77NA12.721.66NA26.15090
    27110ATransfer of iliopsoas muscle13.26NA13.591.38NA28.23090
    27111ATransfer of iliopsoas muscle12.15NA12.431.48NA26.06090
    Start Printed Page 80062
    27120AReconstruction of hip socket18.01NA12.052.45NA32.51090
    27122AReconstruction of hip socket14.98NA11.192.08NA28.25090
    27125APartial hip replacement14.69NA10.752.05NA27.49090
    27130ATotal hip arthroplasty20.12NA13.582.82NA36.52090
    27132ATotal hip arthroplasty23.30NA15.873.26NA42.43090
    27134ARevise hip joint replacement28.52NA18.203.97NA50.69090
    27137ARevise hip joint replacement21.17NA14.242.97NA38.38090
    27138ARevise hip joint replacement22.17NA14.723.11NA40.00090
    27140ATransplant femur ridge12.24NA12.271.67NA26.18090
    27146AIncision of hip bone17.43NA16.512.27NA36.21090
    27147ARevision of hip bone20.58NA17.712.61NA40.90090
    27151AIncision of hip bones22.51NA12.833.12NA38.46090
    27156ARevision of hip bones24.63NA20.373.48NA48.48090
    27158ARevision of pelvis19.74NA16.002.60NA38.34090
    27161AIncision of neck of femur16.71NA14.572.32NA33.60090
    27165AIncision/fixation of femur17.91NA15.112.51NA35.53090
    27170ARepair/graft femur head/neck16.07NA14.302.20NA32.57090
    27175ATreat slipped epiphysis8.46NA7.391.19NA17.04090
    27176ATreat slipped epiphysis12.05NA10.201.68NA23.93090
    27177ATreat slipped epiphysis15.08NA11.882.11NA29.07090
    27178ATreat slipped epiphysis11.99NA9.631.68NA23.30090
    27179ARevise head/neck of femur12.98NA11.011.84NA25.83090
    27181ATreat slipped epiphysis14.68NA11.171.74NA27.59090
    27185ARevision of femur epiphysis9.18NA10.511.29NA20.98090
    27187AReinforce hip bones13.54NA13.811.89NA29.24090
    27193ATreat pelvic ring fracture5.567.395.470.7713.7211.80090
    27194ATreat pelvic ring fracture9.659.407.711.3220.3718.68090
    27200ATreat tail bone fracture1.843.251.830.225.313.89090
    27202ATreat tail bone fracture7.04NA22.210.69NA29.94090
    27215ATreat pelvic fracture(s)10.05NA10.591.37NA22.01090
    27216ATreat pelvic ring fracture15.19NA14.822.15NA32.16090
    27217ATreat pelvic ring fracture14.11NA13.071.95NA29.13090
    27218ATreat pelvic ring fracture20.15NA14.412.85NA37.41090
    27220ATreat hip socket fracture6.187.735.820.8514.7612.85090
    27222ATreat hip socket fracture12.70NA10.441.77NA24.91090
    27226ATreat hip wall fracture14.91NA10.982.07NA27.96090
    27227ATreat hip fracture(s)23.45NA17.403.24NA44.09090
    27228ATreat hip fracture(s)27.16NA19.683.77NA50.61090
    27230ATreat thigh fracture5.508.016.440.7314.2412.67090
    27232ATreat thigh fracture10.68NA9.481.45NA21.61090
    27235ATreat thigh fracture12.16NA11.341.71NA25.21090
    27236ATreat thigh fracture15.60NA11.282.18NA29.06090
    27238ATreat thigh fracture5.52NA6.550.76NA12.83090
    27240ATreat thigh fracture12.50NA10.521.69NA24.71090
    27244ATreat thigh fracture15.94NA13.242.23NA31.41090
    27245ATreat thigh fracture20.31NA15.642.85NA38.80090
    27246ATreat thigh fracture4.717.736.190.6613.1011.56090
    27248ATreat thigh fracture10.45NA10.251.45NA22.15090
    27250ATreat hip dislocation6.95NA6.490.68NA14.12090
    27252ATreat hip dislocation10.39NA8.431.37NA20.19090
    27253ATreat hip dislocation12.92NA11.141.81NA25.87090
    27254ATreat hip dislocation18.26NA14.042.52NA34.82090
    27256ATreat hip dislocation4.12NA4.450.49NA9.06010
    27257ATreat hip dislocation5.22NA4.770.56NA10.55010
    27258ATreat hip dislocation15.43NA14.262.06NA31.75090
    27259ATreat hip dislocation21.55NA17.512.99NA42.05090
    27265ATreat hip dislocation5.05NA6.250.65NA11.95090
    27266ATreat hip dislocation7.49NA7.691.04NA16.22090
    27275AManipulation of hip joint2.27NA3.750.31NA6.33010
    27280AFusion of sacroiliac joint13.39NA14.601.98NA29.97090
    27282AFusion of pubic bones11.34NA12.541.14NA25.02090
    27284AFusion of hip joint23.45NA18.802.36NA44.61090
    27286AFusion of hip joint23.45NA19.332.37NA45.15090
    27290AAmputation of leg at hip23.28NA17.032.94NA43.25090
    27295AAmputation of leg at hip18.65NA14.462.35NA35.46090
    27299CPelvis/hip joint surgery0.000.000.000.000.000.00YYY
    27301ADrain thigh/knee lesion6.4916.4314.490.8023.7221.78090
    27303ADrainage of bone lesion8.28NA15.571.14NA24.99090
    27305AIncise thigh tendon & fascia5.92NA9.500.77NA16.19090
    27306AIncision of thigh tendon4.62NA7.930.62NA13.17090
    27307AIncision of thigh tendons5.80NA8.530.78NA15.11090
    27310AExploration of knee joint9.27NA10.401.29NA20.96090
    27315APartial removal, thigh nerve6.97NA4.450.79NA12.21090
    27320APartial removal, thigh nerve6.30NA4.680.78NA11.76090
    27323ABiopsy, thigh soft tissues2.286.013.570.178.466.02010
    Start Printed Page 80063
    27324ABiopsy, thigh soft tissues4.90NA7.140.59NA12.63090
    27327ARemoval of thigh lesion4.478.596.510.5013.5611.48090
    27328ARemoval of thigh lesion5.57NA7.280.66NA13.51090
    27329ARemove tumor, thigh/knee14.14NA14.741.68NA30.56090
    27330ABiopsy, knee joint lining4.97NA6.610.66NA12.24090
    27331AExplore/treat knee joint5.88NA7.830.81NA14.52090
    27332ARemoval of knee cartilage8.27NA9.061.15NA18.48090
    27333ARemoval of knee cartilage7.30NA8.591.03NA16.92090
    27334ARemove knee joint lining8.70NA9.971.21NA19.88090
    27335ARemove knee joint lining10.00NA10.831.41NA22.24090
    27340ARemoval of kneecap bursa4.18NA6.260.58NA11.02090
    27345ARemoval of knee cyst5.92NA7.700.81NA14.43090
    27347ARemove knee cyst5.78NA7.450.76NA13.99090
    27350ARemoval of kneecap8.17NA9.171.15NA18.49090
    27355ARemove femur lesion7.65NA10.741.07NA19.46090
    27356ARemove femur lesion/graft9.48NA11.741.29NA22.51090
    27357ARemove femur lesion/graft10.53NA12.241.48NA24.25090
    27358ARemove femur lesion/fixation4.74NA2.590.67NA8.00ZZZ
    27360APartial removal, leg bone(s)10.50NA18.971.42NA30.89090
    27365AExtensive leg surgery16.27NA14.682.26NA33.21090
    27370AInjection for knee x-ray0.9611.980.330.0613.001.35000
    27372ARemoval of foreign body5.078.646.690.6214.3312.38090
    27380ARepair of kneecap tendon7.16NA8.671.00NA16.83090
    27381ARepair/graft kneecap tendon10.34NA10.371.44NA22.15090
    27385ARepair of thigh muscle7.76NA9.021.09NA17.87090
    27386ARepair/graft of thigh muscle10.56NA11.171.49NA23.22090
    27390AIncision of thigh tendon5.33NA8.200.69NA14.22090
    27391AIncision of thigh tendons7.20NA9.330.99NA17.52090
    27392AIncision of thigh tendons9.20NA11.431.23NA21.86090
    27393ALengthening of thigh tendon6.39NA8.740.90NA16.03090
    27394ALengthening of thigh tendons8.50NA11.131.17NA20.80090
    27395ALengthening of thigh tendons11.73NA14.021.63NA27.38090
    27396ATransplant of thigh tendon7.86NA11.021.11NA19.99090
    27397ATransplants of thigh tendons11.28NA12.481.58NA25.34090
    27400ARevise thigh muscles/tendons9.02NA11.201.18NA21.40090
    27403ARepair of knee cartilage8.33NA9.191.16NA18.68090
    27405ARepair of knee ligament8.65NA10.041.21NA19.90090
    27407ARepair of knee ligament10.28NA10.741.38NA22.40090
    27409ARepair of knee ligaments12.90NA12.291.75NA26.94090
    27418ARepair degenerated kneecap10.85NA11.281.51NA23.64090
    27420ARevision of unstable kneecap9.83NA10.021.38NA21.23090
    27422ARevision of unstable kneecap9.78NA10.041.37NA21.19090
    27424ARevision/removal of kneecap9.81NA10.001.38NA21.19090
    27425ALat retinacular release open5.22NA7.580.73NA13.53090
    27427AReconstruction, knee9.36NA9.641.29NA20.29090
    27428AReconstruction, knee14.00NA12.861.95NA28.81090
    27429AReconstruction, knee15.52NA13.682.18NA31.38090
    27430ARevision of thigh muscles9.67NA10.081.35NA21.10090
    27435AIncision of knee joint9.49NA9.911.33NA20.73090
    27437ARevise kneecap8.46NA7.311.18NA16.95090
    27438ARevise kneecap with implant11.23NA8.711.56NA21.50090
    27440ARevision of knee joint10.43NA6.231.42NA18.08090
    27441ARevision of knee joint10.82NA6.901.49NA19.21090
    27442ARevision of knee joint11.89NA9.091.68NA22.66090
    27443ARevision of knee joint10.93NA8.851.52NA21.30090
    27445ARevision of knee joint17.68NA12.522.49NA32.69090
    27446ARevision of knee joint15.84NA11.502.22NA29.56090
    27447ATotal knee arthroplasty21.48NA14.823.00NA39.30090
    27448AIncision of thigh11.06NA12.411.51NA24.98090
    27450AIncision of thigh13.98NA14.201.96NA30.14090
    27454ARealignment of thigh bone17.56NA16.022.46NA36.04090
    27455ARealignment of knee12.82NA12.701.78NA27.30090
    27457ARealignment of knee13.45NA11.871.88NA27.20090
    27465AShortening of thigh bone13.87NA14.061.86NA29.79090
    27466ALengthening of thigh bone16.33NA16.391.92NA34.64090
    27468AShorten/lengthen thighs18.97NA16.562.68NA38.21090
    27470ARepair of thigh16.07NA16.452.24NA34.76090
    27472ARepair/graft of thigh17.72NA17.332.49NA37.54090
    27475ASurgery to stop leg growth8.64NA9.621.13NA19.39090
    27477ASurgery to stop leg growth9.85NA10.081.31NA21.24090
    27479ASurgery to stop leg growth12.80NA12.351.81NA26.96090
    27485ASurgery to stop leg growth8.84NA9.791.24NA19.87090
    27486ARevise/replace knee joint19.27NA13.672.70NA35.64090
    27487ARevise/replace knee joint25.27NA16.833.54NA45.64090
    27488ARemoval of knee prosthesis15.74NA11.832.21NA29.78090
    Start Printed Page 80064
    27495AReinforce thigh15.55NA16.192.18NA33.92090
    27496ADecompression of thigh/knee6.11NA8.250.77NA15.13090
    27497ADecompression of thigh/knee7.17NA8.280.84NA16.29090
    27498ADecompression of thigh/knee7.99NA8.670.97NA17.63090
    27499ADecompression of thigh/knee9.00NA9.281.18NA19.46090
    27500ATreatment of thigh fracture5.9210.407.840.8017.1214.56090
    27501ATreatment of thigh fracture5.9211.659.090.8318.4015.84090
    27502ATreatment of thigh fracture10.58NA11.601.49NA23.67090
    27503ATreatment of thigh fracture10.58NA11.641.49NA23.71090
    27506ATreatment of thigh fracture17.45NA14.572.33NA34.35090
    27507ATreatment of thigh fracture13.99NA12.741.95NA28.68090
    27508ATreatment of thigh fracture5.837.425.520.8014.0512.15090
    27509ATreatment of thigh fracture7.71NA9.501.08NA18.29090
    27510ATreatment of thigh fracture9.13NA7.391.26NA17.78090
    27511ATreatment of thigh fracture13.64NA13.341.91NA28.89090
    27513ATreatment of thigh fracture17.92NA15.662.51NA36.09090
    27514ATreatment of thigh fracture17.30NA14.782.41NA34.49090
    27516ATreat thigh fx growth plate5.378.206.000.7414.3112.11090
    27517ATreat thigh fx growth plate8.789.867.971.2219.8617.97090
    27519ATreat thigh fx growth plate15.02NA13.832.09NA30.94090
    27520ATreat kneecap fracture2.865.793.900.389.037.14090
    27524ATreat kneecap fracture10.00NA9.051.40NA20.45090
    27530ATreat knee fracture3.786.314.450.5110.608.74090
    27532ATreat knee fracture7.307.795.871.0216.1114.19090
    27535ATreat knee fracture11.50NA12.231.61NA25.34090
    27536ATreat knee fracture15.65NA12.092.19NA29.93090
    27538ATreat knee fracture(s)4.877.975.730.6713.5111.27090
    27540ATreat knee fracture13.10NA10.551.80NA25.45090
    27550ATreat knee dislocation5.767.575.830.6814.0112.27090
    27552ATreat knee dislocation7.90NA8.231.10NA17.23090
    27556ATreat knee dislocation14.41NA14.692.01NA31.11090
    27557ATreat knee dislocation16.77NA15.932.37NA35.07090
    27558ATreat knee dislocation17.72NA16.132.51NA36.36090
    27560ATreat kneecap dislocation3.826.203.990.4010.428.21090
    27562ATreat kneecap dislocation5.79NA5.850.69NA12.33090
    27566ATreat kneecap dislocation12.23NA10.201.73NA24.16090
    27570AFixation of knee joint1.74NA3.450.24NA5.43010
    27580AFusion of knee19.37NA16.572.70NA38.64090
    27590AAmputate leg at thigh12.03NA12.591.35NA25.97090
    27591AAmputate leg at thigh12.68NA14.631.63NA28.94090
    27592AAmputate leg at thigh10.02NA12.181.17NA23.37090
    27594AAmputation follow-up surgery6.92NA9.100.82NA16.84090
    27596AAmputation follow-up surgery10.60NA12.651.24NA24.49090
    27598AAmputate lower leg at knee10.53NA11.611.24NA23.38090
    27599CLeg surgery procedure0.000.000.000.000.000.00YYY
    27600ADecompression of lower leg5.65NA7.850.68NA14.18090
    27601ADecompression of lower leg5.64NA7.790.69NA14.12090
    27602ADecompression of lower leg7.35NA8.130.85NA16.33090
    27603ADrain lower leg lesion4.9416.0310.710.5621.5316.21090
    27604ADrain lower leg bursa4.4711.748.690.5416.7513.70090
    27605AIncision of achilles tendon2.8710.884.010.3814.137.26010
    27606AIncision of achilles tendon4.1413.175.240.5717.889.95010
    27607ATreat lower leg bone lesion7.97NA14.851.08NA23.90090
    27610AExplore/treat ankle joint8.34NA10.901.15NA20.39090
    27612AExploration of ankle joint7.33NA8.611.01NA16.95090
    27613ABiopsy lower leg soft tissue2.175.933.160.168.265.49010
    27614ABiopsy lower leg soft tissue5.6611.557.390.6217.8313.67090
    27615ARemove tumor, lower leg12.56NA16.851.39NA30.80090
    27618ARemove lower leg lesion5.0911.866.860.5417.4912.49090
    27619ARemove lower leg lesion8.4013.369.461.0122.7718.87090
    27620AExplore/treat ankle joint5.98NA8.480.83NA15.29090
    27625ARemove ankle joint lining8.30NA10.101.16NA19.56090
    27626ARemove ankle joint lining8.91NA10.791.23NA20.93090
    27630ARemoval of tendon lesion4.8011.527.240.6016.9212.64090
    27635ARemove lower leg bone lesion7.78NA11.581.06NA20.42090
    27637ARemove/graft leg bone lesion9.85NA12.911.38NA24.14090
    27638ARemove/graft leg bone lesion10.57NA13.241.47NA25.28090
    27640APartial removal of tibia11.37NA18.941.54NA31.85090
    27641APartial removal of fibula9.24NA16.891.22NA27.35090
    27645AExtensive lower leg surgery14.17NA18.701.98NA34.85090
    27646AExtensive lower leg surgery12.66NA17.641.55NA31.85090
    27647AExtensive ankle/heel surgery12.24NA11.521.64NA25.40090
    27648AInjection for ankle x-ray0.969.750.340.0510.761.35000
    27650ARepair achilles tendon9.69NA9.791.35NA20.83090
    27652ARepair/graft achilles tendon10.33NA10.021.45NA21.80090
    Start Printed Page 80065
    27654ARepair of achilles tendon10.02NA10.511.41NA21.94090
    27656ARepair leg fascia defect4.5712.846.760.4817.8911.81090
    27658ARepair of leg tendon, each4.9813.209.520.6818.8615.18090
    27659ARepair of leg tendon, each6.8114.8910.270.9622.6618.04090
    27664ARepair of leg tendon, each4.5915.009.660.6320.2214.88090
    27665ARepair of leg tendon, each5.4014.639.790.7520.7815.94090
    27675ARepair lower leg tendons7.18NA8.631.01NA16.82090
    27676ARepair lower leg tendons8.42NA9.681.15NA19.25090
    27680ARelease of lower leg tendon5.74NA8.480.80NA15.02090
    27681ARelease of lower leg tendons6.82NA8.980.92NA16.72090
    27685ARevision of lower leg tendon6.5010.508.740.9117.9116.15090
    27686ARevise lower leg tendons7.4615.1110.391.0523.6218.90090
    27687ARevision of calf tendon6.24NA8.900.88NA16.02090
    27690ARevise lower leg tendon8.71NA9.751.22NA19.68090
    27691ARevise lower leg tendon9.96NA11.371.40NA22.73090
    27692ARevise additional leg tendon1.87NA0.950.26NA3.08ZZZ
    27695ARepair of ankle ligament6.51NA9.630.90NA17.04090
    27696ARepair of ankle ligaments8.27NA9.971.16NA19.40090
    27698ARepair of ankle ligament9.36NA9.721.31NA20.39090
    27700ARevision of ankle joint9.29NA5.811.24NA16.34090
    27702AReconstruct ankle joint13.67NA10.571.92NA26.16090
    27703AReconstruction, ankle joint15.87NA11.362.24NA29.47090
    27704ARemoval of ankle implant7.62NA5.750.61NA13.98090
    27705AIncision of tibia10.38NA11.941.44NA23.76090
    27707AIncision of fibula4.37NA8.830.60NA13.80090
    27709AIncision of tibia & fibula9.95NA11.931.39NA23.27090
    27712ARealignment of lower leg14.25NA14.102.00NA30.35090
    27715ARevision of lower leg14.39NA15.502.00NA31.89090
    27720ARepair of tibia11.79NA14.121.66NA27.57090
    27722ARepair/graft of tibia11.82NA13.881.65NA27.35090
    27724ARepair/graft of tibia18.20NA17.612.10NA37.91090
    27725ARepair of lower leg15.59NA16.062.20NA33.85090
    27727ARepair of lower leg14.01NA14.961.84NA30.81090
    27730ARepair of tibia epiphysis7.4121.2210.170.7529.3818.33090
    27732ARepair of fibula epiphysis5.3214.218.710.6320.1614.66090
    27734ARepair lower leg epiphyses8.48NA9.910.85NA19.24090
    27740ARepair of leg epiphyses9.3023.9011.761.3134.5122.37090
    27742ARepair of leg epiphyses10.3016.6910.971.5528.5422.82090
    27745AReinforce tibia10.07NA12.051.38NA23.50090
    27750ATreatment of tibia fracture3.195.934.100.439.557.72090
    27752ATreatment of tibia fracture5.848.536.340.8215.1913.00090
    27756ATreatment of tibia fracture6.78NA11.380.94NA19.10090
    27758ATreatment of tibia fracture11.67NA12.421.52NA25.61090
    27759ATreatment of tibia fracture13.76NA13.741.93NA29.43090
    27760ATreatment of ankle fracture3.015.693.910.399.097.31090
    27762ATreatment of ankle fracture5.257.995.870.7113.9511.83090
    27766ATreatment of ankle fracture8.36NA8.681.17NA18.21090
    27780ATreatment of fibula fracture2.655.613.710.338.596.69090
    27781ATreatment of fibula fracture4.406.844.690.5711.819.66090
    27784ATreatment of fibula fracture7.11NA8.920.98NA17.01090
    27786ATreatment of ankle fracture2.845.663.830.378.877.04090
    27788ATreatment of ankle fracture4.456.924.750.6111.989.81090
    27792ATreatment of ankle fracture7.66NA8.401.07NA17.13090
    27808ATreatment of ankle fracture2.836.814.620.3810.027.83090
    27810ATreatment of ankle fracture5.138.085.880.7113.9211.72090
    27814ATreatment of ankle fracture10.68NA11.191.50NA23.37090
    27816ATreatment of ankle fracture2.896.274.630.379.537.89090
    27818ATreatment of ankle fracture5.508.226.020.7414.4612.26090
    27822ATreatment of ankle fracture11.00NA13.501.29NA25.79090
    27823ATreatment of ankle fracture13.00NA14.561.65NA29.21090
    27824ATreat lower leg fracture2.896.734.630.3910.017.91090
    27825ATreat lower leg fracture6.198.706.500.8515.7413.54090
    27826ATreat lower leg fracture8.54NA12.171.19NA21.90090
    27827ATreat lower leg fracture14.06NA15.231.96NA31.25090
    27828ATreat lower leg fracture16.23NA15.932.27NA34.43090
    27829ATreat lower leg joint5.49NA8.940.77NA15.20090
    27830ATreat lower leg dislocation3.795.774.310.4410.008.54090
    27831ATreat lower leg dislocation4.56NA5.530.61NA10.70090
    27832ATreat lower leg dislocation6.49NA8.610.91NA16.01090
    27840ATreat ankle dislocation4.58NA6.110.47NA11.16090
    27842ATreat ankle dislocation6.21NA5.250.76NA12.22090
    27846ATreat ankle dislocation9.79NA10.581.36NA21.73090
    27848ATreat ankle dislocation11.20NA11.921.55NA24.67090
    27860AFixation of ankle joint2.34NA3.760.31NA6.41010
    27870AFusion of ankle joint, open13.91NA14.081.95NA29.94090
    Start Printed Page 80066
    27871AFusion of tibiofibular joint9.17NA11.361.29NA21.82090
    27880AAmputation of lower leg11.85NA11.881.38NA25.11090
    27881AAmputation of lower leg12.34NA13.551.59NA27.48090
    27882AAmputation of lower leg8.94NA12.971.03NA22.94090
    27884AAmputation follow-up surgery8.21NA10.830.95NA19.99090
    27886AAmputation follow-up surgery9.32NA11.371.13NA21.82090
    27888AAmputation of foot at ankle9.67NA11.231.26NA22.16090
    27889AAmputation of foot at ankle9.98NA10.581.19NA21.75090
    27892ADecompression of leg7.39NA8.260.86NA16.51090
    27893ADecompression of leg7.35NA8.110.90NA16.36090
    27894ADecompression of leg10.49NA9.561.25NA21.30090
    27899CLeg/ankle surgery procedure0.000.000.000.000.000.00YYY
    28001ADrainage of bursa of foot2.735.633.230.318.676.27010
    28002ATreatment of foot infection4.626.934.330.5612.119.51010
    28003ATreatment of foot infection8.4111.2910.811.0320.7320.25090
    28005ATreat foot bone lesion8.68NA10.681.14NA20.50090
    28008AIncision of foot fascia4.458.116.330.5613.1211.34090
    28010AIncision of toe tendon2.847.565.290.3910.798.52090
    28011AIncision of toe tendons4.149.377.070.5814.0911.79090
    28020AExploration of foot joint5.019.326.740.6414.9712.39090
    28022AExploration of foot joint4.678.136.330.6213.4211.62090
    28024AExploration of toe joint4.388.306.560.5013.1811.44090
    28030ARemoval of foot nerve6.15NA3.460.85NA10.46090
    28035ADecompression of tibia nerve5.099.325.500.7115.1211.30090
    28043AExcision of foot lesion3.547.535.210.4511.529.20090
    28045AExcision of foot lesion4.728.145.910.6213.4811.25090
    28046AResection of tumor, foot10.1812.3510.951.1323.6622.26090
    28050ABiopsy of foot joint lining4.257.786.030.5512.5810.83090
    28052ABiopsy of foot joint lining3.948.106.140.5112.5510.59090
    28054ABiopsy of toe joint lining3.458.015.960.4511.919.86090
    28060APartial removal, foot fascia5.238.766.630.6914.6812.55090
    28062ARemoval of foot fascia6.529.626.520.8516.9913.89090
    28070ARemoval of foot joint lining5.107.956.120.6813.7311.90090
    28072ARemoval of foot joint lining4.588.507.070.6413.7212.29090
    28080ARemoval of foot lesion3.587.895.680.5011.979.76090
    28086AExcise foot tendon sheath4.7811.427.640.6616.8613.08090
    28088AExcise foot tendon sheath3.869.486.950.5213.8611.33090
    28090ARemoval of foot lesion4.418.055.730.5713.0310.71090
    28092ARemoval of toe lesions3.648.486.170.4612.5810.27090
    28100ARemoval of ankle/heel lesion5.6611.907.910.7618.3214.33090
    28102ARemove/graft foot lesion7.73NA9.270.97NA17.97090
    28103ARemove/graft foot lesion6.5010.077.460.8917.4614.85090
    28104ARemoval of foot lesion5.128.796.990.6914.6012.80090
    28106ARemove/graft foot lesion7.16NA6.841.01NA15.01090
    28107ARemove/graft foot lesion5.5610.017.090.7416.3113.39090
    28108ARemoval of toe lesions4.167.425.440.5212.1010.12090
    28110APart removal of metatarsal4.088.957.080.4913.5211.65090
    28111APart removal of metatarsal5.0110.657.860.6316.2913.50090
    28112APart removal of metatarsal4.499.667.660.6014.7512.75090
    28113APart removal of metatarsal4.799.247.320.6314.6612.74090
    28114ARemoval of metatarsal heads9.7914.0711.121.3625.2222.27090
    28116ARevision of foot7.758.886.831.0317.6615.61090
    28118ARemoval of heel bone5.969.527.260.7916.2714.01090
    28119ARemoval of heel spur5.398.546.230.7414.6712.36090
    28120APart removal of ankle/heel5.4012.7210.020.6918.8116.11090
    28122APartial removal of foot bone7.2911.289.680.9619.5317.93090
    28124APartial removal of toe4.819.527.870.6514.9813.33090
    28126APartial removal of toe3.528.277.110.4912.2811.12090
    28130ARemoval of ankle bone8.11NA9.031.11NA18.25090
    28140ARemoval of metatarsal6.9110.807.990.8418.5515.74090
    28150ARemoval of toe4.098.947.330.5213.5511.94090
    28153APartial removal of toe3.668.275.960.4912.4210.11090
    28160APartial removal of toe3.748.587.500.5112.8311.75090
    28171AExtensive foot surgery9.60NA8.481.13NA19.21090
    28173AExtensive foot surgery8.8011.138.871.0420.9718.71090
    28175AExtensive foot surgery6.059.586.900.7516.3813.70090
    28190ARemoval of foot foreign body1.966.413.420.168.535.54010
    28192ARemoval of foot foreign body4.648.205.590.5213.3610.75090
    28193ARemoval of foot foreign body5.738.776.700.6315.1313.06090
    28200ARepair of foot tendon4.608.416.530.5913.6011.72090
    28202ARepair/graft of foot tendon6.8411.557.110.8619.2514.81090
    28208ARepair of foot tendon4.378.156.100.5913.1111.06090
    28210ARepair/graft of foot tendon6.359.606.560.7716.7213.68090
    28220ARelease of foot tendon4.537.946.290.6313.1011.45090
    28222ARelease of foot tendons5.628.347.120.7714.7313.51090
    Start Printed Page 80067
    28225ARelease of foot tendon3.667.725.830.5011.889.99090
    28226ARelease of foot tendons4.537.996.800.6213.1411.95090
    28230AIncision of foot tendon(s)4.248.107.090.5912.9311.92090
    28232AIncision of toe tendon3.398.146.780.4812.0110.65090
    28234AIncision of foot tendon3.378.226.250.4612.0510.08090
    28238ARevision of foot tendon7.7310.317.611.0819.1216.42090
    28240ARelease of big toe4.368.056.670.6113.0211.64090
    28250ARevision of foot fascia5.929.007.080.8115.7313.81090
    28260ARelease of midfoot joint7.969.477.731.0818.5116.77090
    28261ARevision of foot tendon11.7311.029.661.6624.4123.05090
    28262ARevision of foot and ankle15.8317.3115.442.2235.3633.49090
    28264ARelease of midfoot joint10.3511.2811.281.4623.0923.09090
    28270ARelease of foot contracture4.768.707.460.6714.1312.89090
    28272ARelease of toe joint, each3.807.595.630.5211.919.95090
    28280AFusion of toes5.199.257.160.7215.1613.07090
    28285ARepair of hammertoe4.598.766.850.6413.9912.08090
    28286ARepair of hammertoe4.568.626.800.6413.8212.00090
    28288APartial removal of foot bone4.749.148.500.6514.5313.89090
    28289ARepair hallux rigidus7.0411.619.630.9619.6117.63090
    28290ACorrection of bunion5.669.899.250.7916.3415.70090
    28292ACorrection of bunion7.049.867.770.9817.8815.79090
    28293ACorrection of bunion9.158.285.991.2818.7116.42090
    28294ACorrection of bunion8.5610.477.961.1620.1917.68090
    28296ACorrection of bunion9.1810.948.741.2821.4019.20090
    28297ACorrection of bunion9.1811.9610.511.3122.4521.00090
    28298ACorrection of bunion7.9410.078.401.1219.1317.46090
    28299ACorrection of bunion10.5811.369.111.2423.1820.93090
    28300AIncision of heel bone9.5415.049.591.3125.8920.44090
    28302AIncision of ankle bone9.5514.769.531.1525.4620.23090
    28304AIncision of midfoot bones9.1610.317.891.0020.4718.05090
    28305AIncise/graft midfoot bones10.5014.769.730.5525.8120.78090
    28306AIncision of metatarsal5.869.216.480.8115.8813.15090
    28307AIncision of metatarsal6.3313.368.200.7120.4015.24090
    28308AIncision of metatarsal5.297.885.450.7413.9111.48090
    28309AIncision of metatarsals12.78NA10.661.64NA25.08090
    28310ARevision of big toe5.439.146.990.7615.3313.18090
    28312ARevision of toe4.558.877.700.6214.0412.87090
    28313ARepair deformity of toe5.019.369.360.6815.0515.05090
    28315ARemoval of sesamoid bone4.867.915.750.6613.4311.27090
    28320ARepair of foot bones9.18NA9.141.27NA19.59090
    28322ARepair of metatarsals8.3411.918.671.1721.4218.18090
    28340AResect enlarged toe tissue6.989.406.860.9817.3614.82090
    28341AResect enlarged toe8.419.507.141.1819.0916.73090
    28344ARepair extra toe(s)4.268.825.990.6013.6810.85090
    28345ARepair webbed toe(s)5.929.337.700.8416.0914.46090
    28360AReconstruct cleft foot13.34NA13.961.88NA29.18090
    28400ATreatment of heel fracture2.166.164.900.298.617.35090
    28405ATreatment of heel fracture4.577.066.090.6312.2611.29090
    28406ATreatment of heel fracture6.31NA9.130.87NA16.31090
    28415ATreat heel fracture15.97NA15.682.24NA33.89090
    28420ATreat/graft heel fracture16.64NA16.032.29NA34.96090
    28430ATreatment of ankle fracture2.095.584.270.277.946.63090
    28435ATreatment of ankle fracture3.405.824.890.479.698.76090
    28436ATreatment of ankle fracture4.71NA8.170.66NA13.54090
    28445ATreat ankle fracture15.62NA14.081.29NA30.99090
    28450ATreat midfoot fracture, each1.905.534.160.257.686.31090
    28455ATreat midfoot fracture, each3.095.465.080.438.988.60090
    28456ATreat midfoot fracture2.68NA6.500.36NA9.54090
    28465ATreat midfoot fracture, each7.01NA8.480.87NA16.36090
    28470ATreat metatarsal fracture1.994.773.440.267.025.69090
    28475ATreat metatarsal fracture2.975.374.590.418.757.97090
    28476ATreat metatarsal fracture3.38NA7.010.46NA10.85090
    28485ATreat metatarsal fracture5.71NA8.180.80NA14.69090
    28490ATreat big toe fracture1.092.862.180.134.083.40090
    28495ATreat big toe fracture1.582.962.310.194.734.08090
    28496ATreat big toe fracture2.3310.945.260.3213.597.91090
    28505ATreat big toe fracture3.8111.496.990.5015.8011.30090
    28510ATreatment of toe fracture1.092.552.170.133.773.39090
    28515ATreatment of toe fracture1.462.802.260.174.433.89090
    28525ATreat toe fracture3.3211.146.620.4414.9010.38090
    28530ATreat sesamoid bone fracture1.063.072.810.134.264.00090
    28531ATreat sesamoid bone fracture2.3511.174.200.3313.856.88090
    28540ATreat foot dislocation2.043.823.820.246.106.10090
    28545ATreat foot dislocation2.454.114.110.336.896.89090
    28546ATreat foot dislocation3.209.176.250.4612.839.91090
    Start Printed Page 80068
    28555ARepair foot dislocation6.3013.388.670.8820.5615.85090
    28570ATreat foot dislocation1.664.234.000.226.115.88090
    28575ATreat foot dislocation3.316.025.690.459.789.45090
    28576ATreat foot dislocation4.1711.896.880.5616.6211.61090
    28585ARepair foot dislocation7.999.708.461.1318.8217.58090
    28600ATreat foot dislocation1.894.584.150.246.716.28090
    28605ATreat foot dislocation2.715.245.200.358.308.26090
    28606ATreat foot dislocation4.9016.537.410.6822.1112.99090
    28615ARepair foot dislocation7.77NA9.711.09NA18.57090
    28630ATreat toe dislocation1.702.392.390.174.264.26010
    28635ATreat toe dislocation1.912.602.600.244.754.75010
    28636ATreat toe dislocation2.777.153.210.3910.316.37010
    28645ARepair toe dislocation4.226.724.420.5811.529.22090
    28660ATreat toe dislocation1.233.152.470.114.493.81010
    28665ATreat toe dislocation1.922.632.630.244.794.79010
    28666ATreat toe dislocation2.667.782.940.3810.825.98010
    28675ARepair of toe dislocation2.929.645.130.4112.978.46090
    28705AFusion of foot bones18.80NA15.422.13NA36.35090
    28715AFusion of foot bones13.10NA12.851.84NA27.79090
    28725AFusion of foot bones11.61NA11.671.63NA24.91090
    28730AFusion of foot bones10.76NA11.031.51NA23.30090
    28735AFusion of foot bones10.85NA10.811.51NA23.17090
    28737ARevision of foot bones9.64NA9.451.36NA20.45090
    28740AFusion of foot bones8.0213.739.191.1322.8818.34090
    28750AFusion of big toe joint7.3014.999.591.0323.3217.92090
    28755AFusion of big toe joint4.749.246.760.6614.6412.16090
    28760AFusion of big toe joint7.7510.177.891.0718.9916.71090
    28800AAmputation of midfoot8.21NA9.110.98NA18.30090
    28805AAmputation thru metatarsal8.39NA9.050.97NA18.41090
    28810AAmputation toe & metatarsal6.21NA7.960.70NA14.87090
    28820AAmputation of toe4.4111.197.260.5116.1112.18090
    28825APartial amputation of toe3.5910.587.110.4314.6011.13090
    28899CFoot/toes surgery procedure0.000.000.000.000.000.00YYY
    29000AApplication of body cast2.253.081.740.305.634.29000
    29010AApplication of body cast2.063.071.720.275.404.05000
    29015AApplication of body cast2.412.971.600.215.594.22000
    29020AApplication of body cast2.113.271.440.165.543.71000
    29025AApplication of body cast2.403.161.860.265.824.52000
    29035AApplication of body cast1.773.101.530.245.113.54000
    29040AApplication of body cast2.222.481.540.355.054.11000
    29044AApplication of body cast2.123.421.830.295.834.24000
    29046AApplication of body cast2.413.122.010.345.874.76000
    29049AApplication of figure eight0.891.100.570.122.111.58000
    29055AApplication of shoulder cast1.782.541.440.244.563.46000
    29058AApplication of shoulder cast1.311.360.760.142.812.21000
    29065AApplication of long arm cast0.871.150.700.122.141.69000
    29075AApplication of forearm cast0.771.090.640.111.971.52000
    29085AApply hand/wrist cast0.871.130.620.112.111.60000
    29086AApply finger cast0.620.720.550.061.401.23000
    29105AApply long arm splint0.871.080.510.112.061.49000
    29125AApply forearm splint0.590.910.400.061.561.05000
    29126AApply forearm splint0.771.130.470.061.961.30000
    29130AApplication of finger splint0.500.440.170.050.990.72000
    29131AApplication of finger splint0.550.710.240.031.290.82000
    29200AStrapping of chest0.650.800.360.041.491.05000
    29220AStrapping of low back0.640.750.400.071.461.11000
    29240AStrapping of shoulder0.710.880.390.051.641.15000
    29260AStrapping of elbow or wrist0.550.770.340.041.360.93000
    29280AStrapping of hand or finger0.510.810.340.041.360.89000
    29305AApplication of hip cast2.032.911.650.295.233.97000
    29325AApplication of hip casts2.323.091.830.315.724.46000
    29345AApplication of long leg cast1.401.551.020.193.142.61000
    29355AApplication of long leg cast1.531.531.070.203.262.80000
    29358AApply long leg cast brace1.431.801.040.193.422.66000
    29365AApplication of long leg cast1.181.440.900.172.792.25000
    29405AApply short leg cast0.861.070.670.122.051.65000
    29425AApply short leg cast1.011.080.700.142.231.85000
    29435AApply short leg cast1.181.370.890.172.722.24000
    29440AAddition of walker to cast0.570.630.270.071.270.91000
    29445AApply rigid leg cast1.781.640.950.243.662.97000
    29450AApplication of leg cast2.081.391.080.133.603.29000
    29505AApplication, long leg splint0.691.060.470.061.811.22000
    29515AApplication lower leg splint0.730.800.470.071.601.27000
    29520AStrapping of hip0.540.880.440.021.441.00000
    29530AStrapping of knee0.570.820.350.041.430.96000
    Start Printed Page 80069
    29540AStrapping of ankle and/or ft0.510.390.320.040.940.87000
    29550AStrapping of toes0.470.400.270.050.920.79000
    29580AApplication of paste boot0.570.600.350.051.220.97000
    29590AApplication of foot splint0.760.490.300.061.311.12000
    29700ARemoval/revision of cast0.570.810.290.071.450.93000
    29705ARemoval/revision of cast0.760.740.390.101.601.25000
    29710ARemoval/revision of cast1.341.410.710.172.922.22000
    29715ARemoval/revision of cast0.941.080.410.082.101.43000
    29720ARepair of body cast0.681.000.390.101.781.17000
    29730AWindowing of cast0.750.730.350.101.581.20000
    29740AWedging of cast1.121.040.500.152.311.77000
    29750AWedging of clubfoot cast1.261.000.590.162.422.01000
    29799CCasting/strapping procedure0.000.000.000.000.000.00YYY
    29800AJaw arthroscopy/surgery6.43NA9.060.84NA16.33090
    29804AJaw arthroscopy/surgery8.14NA8.530.66NA17.33090
    29805AShoulder arthroscopy, dx5.89NA7.850.84NA14.58090
    29806AShoulder arthroscopy/surgery14.37NA11.172.00NA27.54090
    29807AShoulder arthroscopy/surgery13.90NA10.931.94NA26.77090
    29819AShoulder arthroscopy/surgery7.62NA6.871.07NA15.56090
    29820AShoulder arthroscopy/surgery7.07NA6.390.99NA14.45090
    29821AShoulder arthroscopy/surgery7.72NA6.891.08NA15.69090
    29822AShoulder arthroscopy/surgery7.43NA6.771.04NA15.24090
    29823AShoulder arthroscopy/surgery8.17NA7.321.15NA16.64090
    29824AShoulder arthroscopy/surgery8.25NA7.461.15NA16.86090
    29825AShoulder arthroscopy/surgery7.62NA6.861.06NA15.54090
    29826AShoulder arthroscopy/surgery8.99NA7.631.26NA17.88090
    29827AArthroscop rotator cuff repr15.36NA11.551.86NA28.77090
    29830AElbow arthroscopy5.76NA5.470.79NA12.02090
    29834AElbow arthroscopy/surgery6.28NA5.960.86NA13.10090
    29835AElbow arthroscopy/surgery6.48NA6.020.88NA13.38090
    29836AElbow arthroscopy/surgery7.55NA6.831.06NA15.44090
    29837AElbow arthroscopy/surgery6.87NA6.270.96NA14.10090
    29838AElbow arthroscopy/surgery7.71NA6.981.07NA15.76090
    29840AWrist arthroscopy5.54NA5.490.69NA11.72090
    29843AWrist arthroscopy/surgery6.01NA5.740.82NA12.57090
    29844AWrist arthroscopy/surgery6.37NA5.960.86NA13.19090
    29845AWrist arthroscopy/surgery7.52NA6.610.84NA14.97090
    29846AWrist arthroscopy/surgery6.75NA6.190.89NA13.83090
    29847AWrist arthroscopy/surgery7.08NA6.330.91NA14.32090
    29848AWrist endoscopy/surgery5.44NA5.690.72NA11.85090
    29850AKnee arthroscopy/surgery8.19NA5.270.74NA14.20090
    29851AKnee arthroscopy/surgery13.10NA9.941.81NA24.85090
    29855ATibial arthroscopy/surgery10.62NA8.791.50NA20.91090
    29856ATibial arthroscopy/surgery14.14NA10.742.00NA26.88090
    29860AHip arthroscopy, dx8.05NA7.061.14NA16.25090
    29861AHip arthroscopy/surgery9.15NA7.481.29NA17.92090
    29862AHip arthroscopy/surgery9.90NA8.581.39NA19.87090
    29863AHip arthroscopy/surgery9.90NA8.531.40NA19.83090
    29870AKnee arthroscopy, dx5.07NA5.000.67NA10.74090
    29871AKnee arthroscopy/drainage6.55NA5.980.88NA13.41090
    29873AKnee arthroscopy/surgery6.00NA6.560.73NA13.29090
    29874AKnee arthroscopy/surgery7.05NA6.270.87NA14.19090
    29875AKnee arthroscopy/surgery6.31NA5.980.88NA13.17090
    29876AKnee arthroscopy/surgery7.92NA7.121.11NA16.15090
    29877AKnee arthroscopy/surgery7.35NA6.811.03NA15.19090
    29879AKnee arthroscopy/surgery8.04NA7.211.13NA16.38090
    29880AKnee arthroscopy/surgery8.50NA7.461.19NA17.15090
    29881AKnee arthroscopy/surgery7.76NA7.041.09NA15.89090
    29882AKnee arthroscopy/surgery8.65NA7.341.09NA17.08090
    29883AKnee arthroscopy/surgery11.05NA9.161.33NA21.54090
    29884AKnee arthroscopy/surgery7.33NA6.761.03NA15.12090
    29885AKnee arthroscopy/surgery9.09NA7.981.27NA18.34090
    29886AKnee arthroscopy/surgery7.54NA6.941.06NA15.54090
    29887AKnee arthroscopy/surgery9.04NA7.951.27NA18.26090
    29888AKnee arthroscopy/surgery13.90NA10.421.95NA26.27090
    29889AKnee arthroscopy/surgery16.00NA12.482.11NA30.59090
    29891AAnkle arthroscopy/surgery8.40NA7.501.17NA17.07090
    29892AAnkle arthroscopy/surgery9.00NA7.771.26NA18.03090
    29893AScope, plantar fasciotomy5.22NA3.880.74NA9.84090
    29894AAnkle arthroscopy/surgery7.21NA5.611.01NA13.83090
    29895AAnkle arthroscopy/surgery6.99NA5.600.97NA13.56090
    29897AAnkle arthroscopy/surgery7.18NA6.041.01NA14.23090
    29898AAnkle arthroscopy/surgery8.32NA6.281.14NA15.74090
    29899AAnkle arthroscopy/surgery13.91NA10.581.95NA26.44090
    29900AMcp joint arthroscopy, dx5.42NA5.920.75NA12.09090
    Start Printed Page 80070
    29901AMcp joint arthroscopy, surg6.13NA6.300.85NA13.28090
    29902AMcp joint arthroscopy, surg6.70NA6.610.93NA14.24090
    29999CArthroscopy of joint0.000.000.000.000.000.00YYY
    30000ADrainage of nose lesion1.432.521.470.104.053.00010
    30020ADrainage of nose lesion1.432.711.560.084.223.07010
    30100AIntranasal biopsy0.941.330.520.062.331.52000
    30110ARemoval of nose polyp(s)1.632.800.870.124.552.62010
    30115ARemoval of nose polyp(s)4.35NA4.490.31NA9.15090
    30117ARemoval of intranasal lesion3.164.973.150.228.356.53090
    30118ARemoval of intranasal lesion9.69NA8.170.66NA18.52090
    30120ARevision of nose5.275.975.970.4111.6511.65090
    30124ARemoval of nose lesion3.10NA3.310.20NA6.61090
    30125ARemoval of nose lesion7.16NA6.420.54NA14.12090
    30130ARemoval of turbinate bones3.38NA3.940.22NA7.54090
    30140ARemoval of turbinate bones3.43NA4.580.24NA8.25090
    30150APartial removal of nose9.14NA8.560.76NA18.46090
    30160ARemoval of nose9.58NA8.470.78NA18.83090
    30200AInjection treatment of nose0.781.210.440.062.051.28000
    30210ANasal sinus therapy1.082.150.590.083.311.75010
    30220AInsert nasal septal button1.542.510.840.114.162.49010
    30300ARemove nasal foreign body1.042.600.380.073.711.49010
    30310ARemove nasal foreign body1.96NA1.880.14NA3.98010
    30320ARemove nasal foreign body4.52NA5.240.36NA10.12090
    30400RReconstruction of nose9.83NA8.810.80NA19.44090
    30410RReconstruction of nose12.98NA10.501.08NA24.56090
    30420RReconstruction of nose15.88NA12.201.24NA29.32090
    30430RRevision of nose7.21NA7.140.62NA14.97090
    30435RRevision of nose11.71NA10.221.10NA23.03090
    30450RRevision of nose18.65NA13.821.53NA34.00090
    30460ARevision of nose9.96NA9.120.85NA19.93090
    30462ARevision of nose19.57NA14.401.92NA35.89090
    30465ARepair nasal stenosis11.64NA8.640.97NA21.25090
    30520ARepair of nasal septum5.70NA5.850.41NA11.96090
    30540ARepair nasal defect7.75NA6.430.53NA14.71090
    30545ARepair nasal defect11.38NA9.580.80NA21.76090
    30560ARelease of nasal adhesions1.262.331.500.093.682.85010
    30580ARepair upper jaw fistula6.694.974.970.5012.1612.16090
    30600ARepair mouth/nose fistula6.024.934.930.7011.6511.65090
    30620AIntranasal reconstruction5.97NA6.540.45NA12.96090
    30630ARepair nasal septum defect7.12NA7.080.51NA14.71090
    30801ACauterization, inner nose1.092.552.300.083.723.47010
    30802ACauterization, inner nose2.033.102.840.155.285.02010
    30901AControl of nosebleed1.211.400.330.092.701.63000
    30903AControl of nosebleed1.543.140.510.124.802.17000
    30905AControl of nosebleed1.973.790.780.155.912.90000
    30906ARepeat control of nosebleed2.454.191.230.176.813.85000
    30915ALigation, nasal sinus artery7.20NA7.030.50NA14.73090
    30920ALigation, upper jaw artery9.83NA8.480.69NA19.00090
    30930ATherapy, fracture of nose1.26NA2.160.09NA3.51010
    30999CNasal surgery procedure0.000.000.000.000.000.00YYY
    31000AIrrigation, maxillary sinus1.152.430.640.083.661.87010
    31002AIrrigation, sphenoid sinus1.91NA2.030.14NA4.08010
    31020AExploration, maxillary sinus2.944.303.640.207.446.78090
    31030AExploration, maxillary sinus5.924.774.600.4211.1110.94090
    31032AExplore sinus, remove polyps6.57NA6.060.47NA13.10090
    31040AExploration behind upper jaw9.42NA6.970.71NA17.10090
    31050AExploration, sphenoid sinus5.28NA5.040.39NA10.71090
    31051ASphenoid sinus surgery7.11NA6.510.55NA14.17090
    31070AExploration of frontal sinus4.28NA5.000.30NA9.58090
    31075AExploration of frontal sinus9.16NA8.160.64NA17.96090
    31080ARemoval of frontal sinus11.42NA8.780.78NA20.98090
    31081ARemoval of frontal sinus12.75NA9.731.84NA24.32090
    31084ARemoval of frontal sinus13.51NA10.490.96NA24.96090
    31085ARemoval of frontal sinus14.20NA10.731.18NA26.11090
    31086ARemoval of frontal sinus12.86NA10.420.90NA24.18090
    31087ARemoval of frontal sinus13.10NA10.431.15NA24.68090
    31090AExploration of sinuses9.53NA8.890.66NA19.08090
    31200ARemoval of ethmoid sinus4.97NA5.700.25NA10.92090
    31201ARemoval of ethmoid sinus8.37NA7.760.58NA16.71090
    31205ARemoval of ethmoid sinus10.24NA8.390.58NA19.21090
    31225ARemoval of upper jaw19.23NA15.011.38NA35.62090
    31230ARemoval of upper jaw21.94NA16.661.57NA40.17090
    31231ANasal endoscopy, dx1.101.990.590.083.171.77000
    31233ANasal/sinus endoscopy, dx2.182.631.190.164.973.53000
    31235ANasal/sinus endoscopy, dx2.642.901.450.185.724.27000
    Start Printed Page 80071
    31237ANasal/sinus endoscopy, surg2.983.171.610.216.364.80000
    31238ANasal/sinus endoscopy, surg3.263.711.820.237.205.31000
    31239ANasal/sinus endoscopy, surg8.70NA6.510.46NA15.67010
    31240ANasal/sinus endoscopy, surg2.61NA1.550.18NA4.34000
    31254ARevision of ethmoid sinus4.65NA2.710.32NA7.68000
    31255ARemoval of ethmoid sinus6.96NA4.010.49NA11.46000
    31256AExploration maxillary sinus3.29NA1.950.23NA5.47000
    31267AEndoscopy, maxillary sinus5.46NA3.160.38NA9.00000
    31276ASinus endoscopy, surgical8.85NA5.050.62NA14.52000
    31287ANasal/sinus endoscopy, surg3.92NA2.300.27NA6.49000
    31288ANasal/sinus endoscopy, surg4.58NA2.670.32NA7.57000
    31290ANasal/sinus endoscopy, surg17.24NA11.561.20NA30.00010
    31291ANasal/sinus endoscopy, surg18.19NA11.871.73NA31.79010
    31292ANasal/sinus endoscopy, surg14.76NA10.050.99NA25.80010
    31293ANasal/sinus endoscopy, surg16.21NA10.760.97NA27.94010
    31294ANasal/sinus endoscopy, surg19.06NA12.321.04NA32.42010
    31299CSinus surgery procedure0.000.000.000.000.000.00YYY
    31300ARemoval of larynx lesion14.29NA17.260.99NA32.54090
    31320ADiagnostic incision, larynx5.26NA12.980.40NA18.64090
    31360ARemoval of larynx17.08NA19.031.20NA37.31090
    31365ARemoval of larynx24.16NA22.761.72NA48.64090
    31367APartial removal of larynx21.86NA23.631.57NA47.06090
    31368APartial removal of larynx27.09NA28.251.90NA57.24090
    31370APartial removal of larynx21.38NA23.281.51NA46.17090
    31375APartial removal of larynx20.21NA20.861.43NA42.50090
    31380APartial removal of larynx20.21NA20.881.40NA42.49090
    31382APartial removal of larynx20.52NA22.861.44NA44.82090
    31390ARemoval of larynx & pharynx27.53NA28.421.95NA57.90090
    31395AReconstruct larynx & pharynx31.09NA34.272.27NA67.63090
    31400ARevision of larynx10.31NA15.660.72NA26.69090
    31420ARemoval of epiglottis10.22NA15.350.71NA26.28090
    31500AInsert emergency airway2.33NA0.670.15NA3.15000
    31502AChange of windpipe airway0.651.980.260.042.670.95000
    31505ADiagnostic laryngoscopy0.610.670.230.041.320.88000
    31510ALaryngoscopy with biopsy1.922.830.980.154.903.05000
    31511ARemove foreign body, larynx2.163.120.750.165.443.07000
    31512ARemoval of larynx lesion2.073.071.070.165.303.30000
    31513AInjection into vocal cord2.10NA1.280.15NA3.53000
    31515ALaryngoscopy for aspiration1.802.390.850.124.312.77000
    31520ADiagnostic laryngoscopy2.56NA1.380.17NA4.11000
    31525ADiagnostic laryngoscopy2.632.911.480.185.724.29000
    31526ADiagnostic laryngoscopy2.57NA1.540.18NA4.29000
    31527ALaryngoscopy for treatment3.27NA1.710.21NA5.19000
    31528ALaryngoscopy and dilation2.37NA1.260.16NA3.79000
    31529ALaryngoscopy and dilation2.68NA1.550.18NA4.41000
    31530AOperative laryngoscopy3.39NA1.750.24NA5.38000
    31531AOperative laryngoscopy3.59NA2.120.25NA5.96000
    31535AOperative laryngoscopy3.16NA1.820.22NA5.20000
    31536AOperative laryngoscopy3.56NA2.090.25NA5.90000
    31540AOperative laryngoscopy4.13NA2.400.29NA6.82000
    31541AOperative laryngoscopy4.53NA2.640.32NA7.49000
    31560AOperative laryngoscopy5.46NA3.050.38NA8.89000
    31561AOperative laryngoscopy6.00NA3.260.42NA9.68000
    31570ALaryngoscopy with injection3.874.162.230.248.276.34000
    31571ALaryngoscopy with injection4.27NA2.450.30NA7.02000
    31575ADiagnostic laryngoscopy1.102.070.570.083.251.75000
    31576ALaryngoscopy with biopsy1.972.451.020.134.553.12000
    31577ARemove foreign body, larynx2.472.931.250.175.573.89000
    31578ARemoval of larynx lesion2.843.191.240.206.234.28000
    31579ADiagnostic laryngoscopy2.262.941.200.165.363.62000
    31580ARevision of larynx12.38NA16.180.87NA29.43090
    31582ARevision of larynx21.62NA21.691.52NA44.83090
    31584ATreat larynx fracture19.64NA18.641.42NA39.70090
    31585ATreat larynx fracture4.64NA8.940.30NA13.88090
    31586ATreat larynx fracture8.03NA12.770.56NA21.36090
    31587ARevision of larynx11.99NA14.230.88NA27.10090
    31588ARevision of larynx13.11NA17.110.92NA31.14090
    31590AReinnervate larynx6.97NA12.520.50NA19.99090
    31595ALarynx nerve surgery8.34NA11.320.62NA20.28090
    31599CLarynx surgery procedure0.000.000.000.000.000.00YYY
    31600AIncision of windpipe7.18NA3.050.34NA10.57000
    31601AIncision of windpipe4.45NA2.150.39NA6.99000
    31603AIncision of windpipe4.15NA1.750.35NA6.25000
    31605AIncision of windpipe3.58NA1.210.33NA5.12000
    31610AIncision of windpipe8.76NA10.790.69NA20.24090
    Start Printed Page 80072
    31611ASurgery/speech prosthesis5.64NA10.190.40NA16.23090
    31612APuncture/clear windpipe0.911.490.420.062.461.39000
    31613ARepair windpipe opening4.59NA8.880.37NA13.84090
    31614ARepair windpipe opening7.12NA12.240.51NA19.87090
    31615AVisualization of windpipe2.093.741.170.145.973.40000
    31622ADx bronchoscope/wash2.783.441.150.146.364.07000
    31623ADx bronchoscope/brush2.883.181.140.146.204.16000
    31624ADx bronchoscope/lavage2.882.891.140.135.904.15000
    31625ABronchoscopy w/biopsy(s)3.37NA1.300.16NA4.83000
    31628ABronchoscopy/lung bx, each3.813.361.400.147.315.35000
    31629ABronchoscopy/needle bx, each3.37NA1.270.13NA4.77000
    31630ABronchoscopy dilate/fx repr3.82NA1.970.30NA6.09000
    31631ABronchoscopy, dilate w/stent4.37NA2.010.31NA6.69000
    31635ABronchoscopy w/fb removal3.68NA1.670.21NA5.56000
    31640ABronchoscopy w/tumor excise4.94NA2.340.37NA7.65000
    31641ABronchoscopy, treat blockage5.03NA2.130.30NA7.46000
    31643ADiag bronchoscope/catheter3.50NA1.320.15NA4.97000
    31645ABronchoscopy, clear airways3.16NA1.220.13NA4.51000
    31646ABronchoscopy, reclear airway2.72NA1.090.12NA3.93000
    31656ABronchoscopy, inj for x-ray2.17NA0.930.10NA3.20000
    31700AInsertion of airway catheter1.342.340.690.073.752.10000
    31708AInstill airway contrast dye1.41NA0.600.06NA2.07000
    31710AInsertion of airway catheter1.30NA0.710.06NA2.07000
    31715AInjection for bronchus x-ray1.11NA0.610.06NA1.78000
    31717ABronchial brush biopsy2.123.400.880.095.613.09000
    31720AClearance of airways1.061.860.330.062.981.45000
    31725AClearance of airways1.96NA0.600.10NA2.66000
    31730AIntro, windpipe wire/tube2.852.421.100.155.424.10000
    31750ARepair of windpipe13.02NA16.001.02NA30.04090
    31755ARepair of windpipe15.93NA19.111.15NA36.19090
    31760ARepair of windpipe22.35NA12.341.48NA36.17090
    31766AReconstruction of windpipe30.43NA16.113.16NA49.70090
    31770ARepair/graft of bronchus22.51NA14.252.27NA39.03090
    31775AReconstruct bronchus23.54NA15.352.91NA41.80090
    31780AReconstruct windpipe17.72NA12.851.55NA32.12090
    31781AReconstruct windpipe23.53NA14.742.04NA40.31090
    31785ARemove windpipe lesion17.23NA12.681.36NA31.27090
    31786ARemove windpipe lesion23.98NA15.622.20NA41.80090
    31800ARepair of windpipe injury7.43NA6.790.67NA14.89090
    31805ARepair of windpipe injury13.13NA10.711.45NA25.29090
    31820AClosure of windpipe lesion4.498.087.960.3512.9212.80090
    31825ARepair of windpipe defect6.8111.1611.160.5018.4718.47090
    31830ARevise windpipe scar4.507.977.970.3612.8312.83090
    31899CAirways surgical procedure0.000.000.000.000.000.00YYY
    32000ADrainage of chest1.543.110.500.074.722.11000
    32002ATreatment of collapsed lung2.19NA0.850.11NA3.15000
    32005ATreat lung lining chemically2.19NA0.870.17NA3.23000
    32020AInsertion of chest tube3.98NA1.440.36NA5.78000
    32035AExploration of chest8.67NA7.971.02NA17.66090
    32036AExploration of chest9.68NA8.691.20NA19.57090
    32095ABiopsy through chest wall8.36NA8.130.99NA17.48090
    32100AExploration/biopsy of chest15.24NA10.391.45NA27.08090
    32110AExplore/repair chest23.00NA12.891.63NA37.52090
    32120ARe-exploration of chest11.54NA9.491.42NA22.45090
    32124AExplore chest free adhesions12.72NA9.421.51NA23.65090
    32140ARemoval of lung lesion(s)13.93NA9.971.68NA25.58090
    32141ARemove/treat lung lesions14.00NA9.871.72NA25.59090
    32150ARemoval of lung lesion(s)14.15NA9.841.60NA25.59090
    32151ARemove lung foreign body14.21NA10.501.49NA26.20090
    32160AOpen chest heart massage9.30NA6.311.01NA16.62090
    32200ADrain, open, lung lesion15.29NA10.041.46NA26.79090
    32201ADrain, percut, lung lesion4.00NA5.540.18NA9.72000
    32215ATreat chest lining11.33NA9.441.34NA22.11090
    32220ARelease of lung24.00NA13.452.39NA39.84090
    32225APartial release of lung13.96NA10.111.70NA25.77090
    32310ARemoval of chest lining13.44NA9.751.65NA24.84090
    32320AFree/remove chest lining24.00NA13.182.50NA39.68090
    32400ANeedle biopsy chest lining1.761.860.570.073.692.40000
    32402AOpen biopsy chest lining7.56NA8.060.91NA16.53090
    32405ABiopsy, lung or mediastinum1.932.380.650.094.402.67000
    32420APuncture/clear lung2.18NA0.850.11NA3.14000
    32440ARemoval of lung25.00NA12.432.56NA39.99090
    32442ASleeve pneumonectomy26.24NA14.043.12NA43.40090
    32445ARemoval of lung25.09NA13.483.11NA41.68090
    32480APartial removal of lung23.75NA12.472.24NA38.46090
    Start Printed Page 80073
    32482ABilobectomy25.00NA12.502.35NA39.85090
    32484ASegmentectomy20.69NA10.932.54NA34.16090
    32486ASleeve lobectomy23.92NA12.633.00NA39.55090
    32488ACompletion pneumonectomy25.71NA13.203.18NA42.09090
    32491RLung volume reduction21.25NA11.972.66NA35.88090
    32500APartial removal of lung22.00NA11.791.77NA35.56090
    32501ARepair bronchus add-on4.69NA1.540.56NA6.79ZZZ
    32520ARemove lung & revise chest21.68NA10.872.71NA35.26090
    32522ARemove lung & revise chest24.20NA11.712.84NA38.75090
    32525ARemove lung & revise chest26.50NA12.423.25NA42.17090
    32540ARemoval of lung lesion14.64NA9.121.84NA25.60090
    32601AThoracoscopy, diagnostic5.46NA3.610.63NA9.70000
    32602AThoracoscopy, diagnostic5.96NA3.760.70NA10.42000
    32603AThoracoscopy, diagnostic7.81NA4.190.76NA12.76000
    32604AThoracoscopy, diagnostic8.78NA4.740.97NA14.49000
    32605AThoracoscopy, diagnostic6.93NA4.260.86NA12.05000
    32606AThoracoscopy, diagnostic8.40NA4.570.99NA13.96000
    32650AThoracoscopy, surgical10.75NA6.501.25NA18.50090
    32651AThoracoscopy, surgical12.91NA7.051.50NA21.46090
    32652AThoracoscopy, surgical18.66NA9.742.30NA30.70090
    32653AThoracoscopy, surgical12.87NA6.781.55NA21.20090
    32654AThoracoscopy, surgical12.44NA7.201.51NA21.15090
    32655AThoracoscopy, surgical13.10NA7.071.53NA21.70090
    32656AThoracoscopy, surgical12.91NA7.531.61NA22.05090
    32657AThoracoscopy, surgical13.65NA7.421.64NA22.71090
    32658AThoracoscopy, surgical11.63NA7.011.47NA20.11090
    32659AThoracoscopy, surgical11.59NA7.121.39NA20.10090
    32660AThoracoscopy, surgical17.43NA9.052.09NA28.57090
    32661AThoracoscopy, surgical13.25NA7.471.66NA22.38090
    32662AThoracoscopy, surgical16.44NA8.512.01NA26.96090
    32663AThoracoscopy, surgical18.47NA10.222.28NA30.97090
    32664AThoracoscopy, surgical14.20NA7.481.70NA23.38090
    32665AThoracoscopy, surgical15.54NA8.021.79NA25.35090
    32800ARepair lung hernia13.69NA9.821.51NA25.02090
    32810AClose chest after drainage13.05NA10.081.55NA24.68090
    32815AClose bronchial fistula23.15NA13.562.84NA39.55090
    32820AReconstruct injured chest21.48NA13.982.31NA37.77090
    32850XDonor pneumonectomy0.000.000.000.000.000.00XXX
    32851ALung transplant, single38.63NA20.194.90NA63.72090
    32852ALung transplant with bypass41.80NA21.705.17NA68.67090
    32853ALung transplant, double47.81NA23.606.13NA77.54090
    32854ALung transplant with bypass50.98NA24.256.41NA81.64090
    32900ARemoval of rib(s)20.27NA12.202.42NA34.89090
    32905ARevise & repair chest wall20.75NA12.572.54NA35.86090
    32906ARevise & repair chest wall26.77NA14.613.30NA44.68090
    32940ARevision of lung19.43NA11.852.47NA33.75090
    32960ATherapeutic pneumothorax1.842.150.570.124.112.53000
    32997ATotal lung lavage6.00NA1.930.55NA8.48000
    32999CChest surgery procedure0.000.000.000.000.000.00YYY
    33010ADrainage of heart sac2.24NA0.980.13NA3.35000
    33011ARepeat drainage of heart sac2.24NA1.020.13NA3.39000
    33015AIncision of heart sac6.80NA4.520.64NA11.96090
    33020AIncision of heart sac12.61NA8.011.50NA22.12090
    33025AIncision of heart sac12.09NA7.881.50NA21.47090
    33030APartial removal of heart sac18.71NA12.302.40NA33.41090
    33031APartial removal of heart sac21.79NA13.572.78NA38.14090
    33050ARemoval of heart sac lesion14.36NA10.311.73NA26.40090
    33120ARemoval of heart lesion24.56NA16.053.06NA43.67090
    33130ARemoval of heart lesion21.39NA12.742.51NA36.64090
    33140AHeart revascularize (tmr)20.00NA10.672.27NA32.94090
    33141AHeart tmr w/other procedure4.84NA1.570.55NA6.96ZZZ
    33200AInsertion of heart pacemaker12.48NA9.721.17NA23.37090
    33201AInsertion of heart pacemaker10.18NA9.711.21NA21.10090
    33206AInsertion of heart pacemaker6.67NA5.690.50NA12.86090
    33207AInsertion of heart pacemaker8.04NA6.230.57NA14.84090
    33208AInsertion of heart pacemaker8.13NA6.430.54NA15.10090
    33210AInsertion of heart electrode3.30NA1.280.17NA4.75000
    33211AInsertion of heart electrode3.40NA1.340.17NA4.91000
    33212AInsertion of pulse generator5.52NA4.620.44NA10.58090
    33213AInsertion of pulse generator6.37NA5.060.46NA11.89090
    33214AUpgrade of pacemaker system7.75NA6.190.52NA14.46090
    33215AReposition pacing-defib lead4.76NA3.150.36NA8.27090
    33216AInsert lead pace-defib, one5.78NA5.320.36NA11.46090
    33217AInsert lead pace-defib, dual5.75NA5.580.36NA11.69090
    33218ARepair lead pace-defib, one5.44NA4.680.40NA10.52090
    Start Printed Page 80074
    33220ARepair lead pace-defib, dual5.52NA4.690.39NA10.60090
    33222ARevise pocket, pacemaker4.96NA4.080.39NA9.43090
    33223ARevise pocket, pacing-defib6.46NA5.410.44NA12.31090
    33224AInsert pacing lead & connect9.05NA3.920.36NA13.33090
    33225AL ventric pacing lead add-on8.34NA3.110.36NA11.81ZZZ
    33226AReposition l ventric lead8.69NA3.790.36NA12.84000
    33233ARemoval of pacemaker system3.29NA4.120.22NA7.63090
    33234ARemoval of pacemaker system7.82NA5.660.56NA14.04090
    33235ARemoval pacemaker electrode9.40NA6.500.68NA16.58090
    33236ARemove electrode/thoracotomy12.60NA9.381.49NA23.47090
    33237ARemove electrode/thoracotomy13.71NA9.781.57NA25.06090
    33238ARemove electrode/thoracotomy15.22NA9.271.56NA26.05090
    33240AInsert pulse generator7.60NA5.770.53NA13.90090
    33241ARemove pulse generator3.24NA3.710.21NA7.16090
    33243ARemove eltrd/thoracotomy22.64NA10.902.53NA36.07090
    33244ARemove eltrd, transven13.76NA8.431.05NA23.24090
    33245AInsert epic eltrd pace-defib14.30NA11.021.28NA26.60090
    33246AInsert epic eltrd/generator20.71NA14.362.22NA37.29090
    33249AEltrd/insert pace-defib14.23NA9.270.80NA24.30090
    33250AAblate heart dysrhythm focus21.85NA14.421.01NA37.28090
    33251AAblate heart dysrhythm focus24.88NA14.532.41NA41.82090
    33253AReconstruct atria31.06NA16.793.68NA51.53090
    33261AAblate heart dysrhythm focus24.88NA14.792.82NA42.49090
    33282AImplant pat-active ht record4.17NA4.910.39NA9.47090
    33284ARemove pat-active ht record2.50NA4.390.23NA7.12090
    33300ARepair of heart wound17.92NA12.081.91NA31.91090
    33305ARepair of heart wound21.44NA13.532.68NA37.65090
    33310AExploratory heart surgery18.51NA12.432.26NA33.20090
    33315AExploratory heart surgery22.37NA13.742.90NA39.01090
    33320ARepair major blood vessel(s)16.79NA11.441.66NA29.89090
    33321ARepair major vessel20.20NA12.722.70NA35.62090
    33322ARepair major blood vessel(s)20.62NA13.322.51NA36.45090
    33330AInsert major vessel graft21.43NA12.932.49NA36.85090
    33332AInsert major vessel graft23.96NA13.182.45NA39.59090
    33335AInsert major vessel graft30.01NA16.233.79NA50.03090
    33400ARepair of aortic valve28.50NA15.003.09NA46.59090
    33401AValvuloplasty, open23.91NA13.332.71NA39.95090
    33403AValvuloplasty, w/cp bypass24.89NA13.712.48NA41.08090
    33404APrepare heart-aorta conduit28.54NA13.943.31NA45.79090
    33405AReplacement of aortic valve35.00NA17.523.86NA56.38090
    33406AReplacement of aortic valve37.50NA18.314.07NA59.88090
    33410AReplacement of aortic valve32.46NA16.004.11NA52.57090
    33411AReplacement of aortic valve36.25NA17.974.16NA58.38090
    33412AReplacement of aortic valve42.00NA19.774.66NA66.43090
    33413AReplacement of aortic valve43.50NA20.104.26NA67.86090
    33414ARepair of aortic valve30.35NA17.983.79NA52.12090
    33415ARevision, subvalvular tissue27.15NA16.053.25NA46.45090
    33416ARevise ventricle muscle30.35NA16.413.85NA50.61090
    33417ARepair of aortic valve28.53NA17.513.58NA49.62090
    33420ARevision of mitral valve22.70NA10.121.48NA34.30090
    33422ARevision of mitral valve25.94NA13.033.30NA42.27090
    33425ARepair of mitral valve27.00NA12.583.00NA42.58090
    33426ARepair of mitral valve33.00NA16.423.87NA53.29090
    33427ARepair of mitral valve40.00NA18.594.30NA62.89090
    33430AReplacement of mitral valve33.50NA16.543.95NA53.99090
    33460ARevision of tricuspid valve23.60NA14.133.02NA40.75090
    33463AValvuloplasty, tricuspid25.62NA14.873.17NA43.66090
    33464AValvuloplasty, tricuspid27.33NA15.473.47NA46.27090
    33465AReplace tricuspid valve28.79NA15.803.61NA48.20090
    33468ARevision of tricuspid valve30.12NA20.104.00NA54.22090
    33470ARevision of pulmonary valve20.81NA13.672.81NA37.29090
    33471AValvotomy, pulmonary valve22.25NA12.723.00NA37.97090
    33472ARevision of pulmonary valve22.25NA15.252.92NA40.42090
    33474ARevision of pulmonary valve23.04NA13.422.84NA39.30090
    33475AReplacement, pulmonary valve33.00NA18.872.64NA54.51090
    33476ARevision of heart chamber25.77NA14.072.40NA42.24090
    33478ARevision of heart chamber26.74NA15.153.56NA45.45090
    33496ARepair, prosth valve clot27.25NA17.183.44NA47.87090
    33500ARepair heart vessel fistula25.55NA13.862.80NA42.21090
    33501ARepair heart vessel fistula17.78NA10.552.05NA30.38090
    33502ACoronary artery correction21.04NA17.042.51NA40.59090
    33503ACoronary artery graft21.78NA14.051.42NA37.25090
    33504ACoronary artery graft24.66NA16.923.04NA44.62090
    33505ARepair artery w/tunnel26.84NA18.361.52NA46.72090
    33506ARepair artery, translocation35.50NA19.693.19NA58.38090
    Start Printed Page 80075
    33508AEndoscopic vein harvest0.31NA0.110.03NA0.45ZZZ
    33510ACABG, vein, single29.00NA15.523.13NA47.65090
    33511ACABG, vein, two30.00NA16.213.34NA49.55090
    33512ACABG, vein, three31.80NA16.753.70NA52.25090
    33513ACABG, vein, four32.00NA16.913.99NA52.90090
    33514ACABG, vein, five32.75NA17.164.37NA54.28090
    33516ACabg, vein, six or more35.00NA17.914.62NA57.53090
    33517ACABG, artery-vein, single2.57NA0.840.32NA3.73ZZZ
    33518ACABG, artery-vein, two4.85NA1.580.61NA7.04ZZZ
    33519ACABG, artery-vein, three7.12NA2.310.89NA10.32ZZZ
    33521ACABG, artery-vein, four9.40NA3.051.18NA13.63ZZZ
    33522ACABG, artery-vein, five11.67NA3.791.48NA16.94ZZZ
    33523ACabg, art-vein, six or more13.95NA4.501.78NA20.23ZZZ
    33530ACoronary artery, bypass/reop5.86NA1.900.73NA8.49ZZZ
    33533ACABG, arterial, single30.00NA15.673.24NA48.91090
    33534ACABG, arterial, two32.20NA16.813.63NA52.64090
    33535ACABG, arterial, three34.50NA17.303.97NA55.77090
    33536ACabg, arterial, four or more37.50NA17.633.29NA58.42090
    33542ARemoval of heart lesion28.85NA17.433.61NA49.89090
    33545ARepair of heart damage36.78NA20.014.40NA61.19090
    33572AOpen coronary endarterectomy4.45NA1.440.55NA6.44ZZZ
    33600AClosure of valve29.51NA16.892.30NA48.70090
    33602AClosure of valve28.54NA16.432.90NA47.87090
    33606AAnastomosis/artery-aorta30.74NA18.233.59NA52.56090
    33608ARepair anomaly w/conduit31.09NA17.624.17NA52.88090
    33610ARepair by enlargement30.61NA18.664.02NA53.29090
    33611ARepair double ventricle34.00NA19.213.28NA56.49090
    33612ARepair double ventricle35.00NA19.974.44NA59.41090
    33615ARepair, modified fontan34.00NA18.803.15NA55.95090
    33617ARepair single ventricle37.00NA21.914.09NA63.00090
    33619ARepair single ventricle45.00NA27.244.71NA76.95090
    33641ARepair heart septum defect21.39NA11.952.67NA36.01090
    33645ARevision of heart veins24.82NA14.273.27NA42.36090
    33647ARepair heart septum defects28.73NA17.653.37NA49.75090
    33660ARepair of heart defects30.00NA17.372.82NA50.19090
    33665ARepair of heart defects28.60NA17.673.81NA50.08090
    33670ARepair of heart chambers35.00NA16.192.18NA53.37090
    33681ARepair heart septum defect30.61NA18.073.53NA52.21090
    33684ARepair heart septum defect29.65NA16.933.77NA50.35090
    33688ARepair heart septum defect30.62NA14.403.89NA48.91090
    33690AReinforce pulmonary artery19.55NA13.652.56NA35.76090
    33692ARepair of heart defects30.75NA17.473.77NA51.99090
    33694ARepair of heart defects34.00NA18.414.27NA56.68090
    33697ARepair of heart defects36.00NA19.614.54NA60.15090
    33702ARepair of heart defects26.54NA16.853.45NA46.84090
    33710ARepair of heart defects29.71NA18.233.85NA51.79090
    33720ARepair of heart defect26.56NA16.343.21NA46.11090
    33722ARepair of heart defect28.41NA17.913.80NA50.12090
    33730ARepair heart-vein defect(s)34.25NA18.022.85NA55.12090
    33732ARepair heart-vein defect28.16NA17.202.78NA48.14090
    33735ARevision of heart chamber21.39NA12.251.12NA34.76090
    33736ARevision of heart chamber23.52NA15.562.70NA41.78090
    33737ARevision of heart chamber21.76NA14.862.93NA39.55090
    33750AMajor vessel shunt21.41NA13.381.74NA36.53090
    33755AMajor vessel shunt21.79NA12.252.93NA36.97090
    33762AMajor vessel shunt21.79NA13.401.59NA36.78090
    33764AMajor vessel shunt & graft21.79NA13.151.93NA36.87090
    33766AMajor vessel shunt22.76NA15.333.04NA41.13090
    33767AMajor vessel shunt24.50NA15.193.14NA42.83090
    33770ARepair great vessels defect37.00NA17.974.49NA59.46090
    33771ARepair great vessels defect34.65NA14.954.67NA54.27090
    33774ARepair great vessels defect30.98NA16.584.18NA51.74090
    33775ARepair great vessels defect32.20NA16.924.34NA53.46090
    33776ARepair great vessels defect34.04NA18.414.58NA57.03090
    33777ARepair great vessels defect33.46NA17.414.51NA55.38090
    33778ARepair great vessels defect40.00NA20.724.83NA65.55090
    33779ARepair great vessels defect36.21NA18.162.40NA56.77090
    33780ARepair great vessels defect41.75NA22.405.21NA69.36090
    33781ARepair great vessels defect36.45NA15.414.91NA56.77090
    33786ARepair arterial trunk39.00NA20.174.69NA63.86090
    33788ARevision of pulmonary artery26.62NA15.383.32NA45.32090
    33800AAortic suspension16.24NA12.451.11NA29.80090
    33802ARepair vessel defect17.66NA13.021.56NA32.24090
    33803ARepair vessel defect19.60NA13.512.63NA35.74090
    33813ARepair septal defect20.65NA14.942.78NA38.37090
    Start Printed Page 80076
    33814ARepair septal defect25.77NA16.472.52NA44.76090
    33820ARevise major vessel16.29NA11.452.10NA29.84090
    33822ARevise major vessel17.32NA13.842.33NA33.49090
    33824ARevise major vessel19.52NA12.632.61NA34.76090
    33840ARemove aorta constriction20.63NA13.952.36NA36.94090
    33845ARemove aorta constriction22.12NA15.132.90NA40.15090
    33851ARemove aorta constriction21.27NA14.802.86NA38.93090
    33852ARepair septal defect23.71NA15.343.19NA42.24090
    33853ARepair septal defect31.72NA18.904.23NA54.85090
    33860AAscending aortic graft38.00NA18.904.30NA61.20090
    33861AAscending aortic graft42.00NA20.184.24NA66.42090
    33863AAscending aortic graft45.00NA21.144.60NA70.74090
    33870ATransverse aortic arch graft44.00NA20.835.09NA69.92090
    33875AThoracic aortic graft33.06NA17.104.08NA54.24090
    33877AThoracoabdominal graft42.60NA21.755.07NA69.42090
    33910ARemove lung artery emboli24.59NA14.283.06NA41.93090
    33915ARemove lung artery emboli21.02NA12.371.20NA34.59090
    33916ASurgery of great vessel25.83NA14.943.04NA43.81090
    33917ARepair pulmonary artery24.50NA15.943.17NA43.61090
    33918ARepair pulmonary atresia26.45NA15.593.42NA45.46090
    33919ARepair pulmonary atresia40.00NA21.683.48NA65.16090
    33920ARepair pulmonary atresia31.95NA16.903.61NA52.46090
    33922ATransect pulmonary artery23.52NA14.382.30NA40.20090
    33924ARemove pulmonary shunt5.50NA1.820.74NA8.06ZZZ
    33930XRemoval of donor heart/lung0.000.000.000.000.000.00XXX
    33935RTransplantation, heart/lung60.96NA27.898.15NA97.00090
    33940XRemoval of donor heart0.000.000.000.000.000.00XXX
    33945RTransplantation of heart42.10NA21.795.42NA69.31090
    33960AExternal circulation assist19.36NA4.962.14NA26.46000
    33961AExternal circulation assist10.93NA3.651.47NA16.05ZZZ
    33967AInsert ia percut device4.851.901.870.287.037.00000
    33968ARemove aortic assist device0.64NA0.230.07NA0.94000
    33970AAortic circulation assist6.75NA2.290.70NA9.74000
    33971AAortic circulation assist9.69NA8.180.97NA18.84090
    33973AInsert balloon device9.76NA3.311.01NA14.08000
    33974ARemove intra-aortic balloon14.41NA10.981.48NA26.87090
    33975AImplant ventricular device21.00NA6.281.72NA29.00XXX
    33976AImplant ventricular device23.00NA7.522.82NA33.34XXX
    33977ARemove ventricular device19.29NA10.502.44NA32.23090
    33978ARemove ventricular device21.73NA11.372.66NA35.76090
    33979AInsert intracorporeal device46.0017.8817.883.9867.8667.86XXX
    33980ARemove intracorporeal device56.25NA26.474.60NA87.32090
    33999CCardiac surgery procedure0.000.000.000.000.000.00YYY
    34001ARemoval of artery clot12.91NA5.851.46NA20.22090
    34051ARemoval of artery clot15.21NA6.911.90NA24.02090
    34101ARemoval of artery clot10.00NA4.711.11NA15.82090
    34111ARemoval of arm artery clot10.00NA4.770.85NA15.62090
    34151ARemoval of artery clot25.00NA10.241.84NA37.08090
    34201ARemoval of artery clot10.03NA5.031.02NA16.08090
    34203ARemoval of leg artery clot16.50NA7.461.37NA25.33090
    34401ARemoval of vein clot25.00NA10.051.20NA36.25090
    34421ARemoval of vein clot12.00NA5.880.95NA18.83090
    34451ARemoval of vein clot27.00NA10.761.59NA39.35090
    34471ARemoval of vein clot10.18NA4.930.90NA16.01090
    34490ARemoval of vein clot9.86NA6.120.73NA16.71090
    34501ARepair valve, femoral vein16.00NA9.251.37NA26.62090
    34502AReconstruct vena cava26.95NA10.982.99NA40.92090
    34510ATransposition of vein valve18.95NA10.271.60NA30.82090
    34520ACross-over vein graft17.95NA9.301.41NA28.66090
    34530ALeg vein fusion16.64NA8.742.06NA27.44090
    34800AEndovasc abdo repair w/tube20.75NA8.941.49NA31.18090
    34802AEndovasc abdo repr w/device23.00NA9.691.65NA34.34090
    34804AEndovasc abdo repr w/device23.00NA9.691.65NA34.34090
    34808AEndovasc abdo occlud device4.13NA1.400.29NA5.82ZZZ
    34812AXpose for endoprosth, femorl6.75NA2.290.49NA9.53000
    34813AFemoral endovas graft add-on4.80NA1.600.34NA6.74ZZZ
    34820AXpose for endoprosth, iliac9.75NA3.300.70NA13.75000
    34825AEndovasc extend prosth, init12.00NA5.950.86NA18.81090
    34826AEndovasc exten prosth, addl4.13NA1.410.29NA5.83ZZZ
    34830AOpen aortic tube prosth repr32.59NA13.312.34NA48.24090
    34831AOpen aortoiliac prosth repr35.34NA11.682.53NA49.55090
    34832AOpen aortofemor prosth repr35.34NA14.382.53NA52.25090
    34833AXpose for endoprosth, iliac12.00NA4.980.70NA17.68000
    34834AXpose, endoprosth, brachial5.35NA2.480.49NA8.32000
    34900AEndovasc iliac repr w/graft16.38NA8.241.49NA26.11090
    Start Printed Page 80077
    35001ARepair defect of artery19.64NA8.392.44NA30.47090
    35002ARepair artery rupture, neck21.00NA9.071.82NA31.89090
    35005ARepair defect of artery18.12NA7.791.35NA27.26090
    35011ARepair defect of artery18.00NA7.401.30NA26.70090
    35013ARepair artery rupture, arm22.00NA8.741.91NA32.65090
    35021ARepair defect of artery19.65NA8.611.93NA30.19090
    35022ARepair artery rupture, chest23.18NA9.431.99NA34.60090
    35045ARepair defect of arm artery17.57NA8.611.25NA27.43090
    35081ARepair defect of artery28.01NA11.653.20NA42.86090
    35082ARepair artery rupture, aorta38.50NA14.604.07NA57.17090
    35091ARepair defect of artery35.40NA13.914.09NA53.40090
    35092ARepair artery rupture, aorta45.00NA16.934.31NA66.24090
    35102ARepair defect of artery30.76NA12.333.44NA46.53090
    35103ARepair artery rupture, groin40.50NA15.393.79NA59.68090
    35111ARepair defect of artery25.00NA10.181.81NA36.99090
    35112ARepair artery rupture,spleen30.00NA11.651.95NA43.60090
    35121ARepair defect of artery30.00NA12.072.93NA45.00090
    35122ARepair artery rupture, belly35.00NA13.463.54NA52.00090
    35131ARepair defect of artery25.00NA10.382.11NA37.49090
    35132ARepair artery rupture, groin30.00NA11.822.48NA44.30090
    35141ARepair defect of artery20.00NA8.501.65NA30.15090
    35142ARepair artery rupture, thigh23.30NA9.561.75NA34.61090
    35151ARepair defect of artery22.64NA9.541.93NA34.11090
    35152ARepair artery rupture, knee25.62NA10.421.93NA37.97090
    35161ARepair defect of artery18.76NA8.702.21NA29.67090
    35162ARepair artery rupture19.78NA8.862.21NA30.85090
    35180ARepair blood vessel lesion13.62NA6.351.44NA21.41090
    35182ARepair blood vessel lesion30.00NA12.301.88NA44.18090
    35184ARepair blood vessel lesion18.00NA7.791.34NA27.13090
    35188ARepair blood vessel lesion14.28NA6.581.53NA22.39090
    35189ARepair blood vessel lesion28.00NA11.462.12NA41.58090
    35190ARepair blood vessel lesion12.75NA5.881.33NA19.96090
    35201ARepair blood vessel lesion16.14NA7.021.17NA24.33090
    35206ARepair blood vessel lesion13.25NA7.511.04NA21.80090
    35207ARepair blood vessel lesion10.15NA9.761.15NA21.06090
    35211ARepair blood vessel lesion22.12NA13.772.83NA38.72090
    35216ARepair blood vessel lesion18.75NA11.672.17NA32.59090
    35221ARepair blood vessel lesion24.39NA10.091.79NA36.27090
    35226ARepair blood vessel lesion14.50NA8.950.84NA24.29090
    35231ARepair blood vessel lesion20.00NA9.241.32NA30.56090
    35236ARepair blood vessel lesion17.11NA8.891.19NA27.19090
    35241ARepair blood vessel lesion23.12NA14.422.90NA40.44090
    35246ARepair blood vessel lesion26.45NA14.232.22NA42.90090
    35251ARepair blood vessel lesion30.20NA12.031.87NA44.10090
    35256ARepair blood vessel lesion18.36NA9.431.32NA29.11090
    35261ARepair blood vessel lesion17.80NA7.431.34NA26.57090
    35266ARepair blood vessel lesion14.91NA7.981.16NA24.05090
    35271ARepair blood vessel lesion22.12NA13.572.77NA38.46090
    35276ARepair blood vessel lesion24.25NA13.842.37NA40.46090
    35281ARepair blood vessel lesion28.00NA11.411.82NA41.23090
    35286ARepair blood vessel lesion16.16NA8.731.36NA26.25090
    35301ARechanneling of artery18.70NA8.262.23NA29.19090
    35311ARechanneling of artery27.00NA10.922.75NA40.67090
    35321ARechanneling of artery16.00NA6.721.36NA24.08090
    35331ARechanneling of artery26.20NA10.822.71NA39.73090
    35341ARechanneling of artery25.11NA10.412.87NA38.39090
    35351ARechanneling of artery23.00NA9.632.29NA34.92090
    35355ARechanneling of artery18.50NA8.121.80NA28.42090
    35361ARechanneling of artery28.20NA11.372.66NA42.23090
    35363ARechanneling of artery30.20NA12.122.77NA45.09090
    35371ARechanneling of artery14.72NA6.581.32NA22.62090
    35372ARechanneling of artery18.00NA7.731.53NA27.26090
    35381ARechanneling of artery15.81NA7.211.80NA24.82090
    35390AReoperation, carotid add-on3.19NA1.070.38NA4.64ZZZ
    35400AAngioscopy3.00NA1.050.34NA4.39ZZZ
    35450ARepair arterial blockage10.07NA4.020.84NA14.93000
    35452ARepair arterial blockage6.91NA3.090.76NA10.76000
    35454ARepair arterial blockage6.04NA2.770.67NA9.48000
    35456ARepair arterial blockage7.35NA3.210.82NA11.38000
    35458ARepair arterial blockage9.49NA3.921.09NA14.50000
    35459ARepair arterial blockage8.63NA3.590.96NA13.18000
    35460ARepair venous blockage6.04NA2.630.66NA9.33000
    35470ARepair arterial blockage8.63NA3.890.50NA13.02000
    35471ARepair arterial blockage10.07NA4.530.50NA15.10000
    35472ARepair arterial blockage6.91NA3.260.39NA10.56000
    Start Printed Page 80078
    35473ARepair arterial blockage6.04NA2.950.34NA9.33000
    35474ARepair arterial blockage7.36NA2.940.40NA10.70000
    35475RRepair arterial blockage9.49NA4.120.47NA14.08000
    35476ARepair venous blockage6.04NA2.880.27NA9.19000
    35480AAtherectomy, open11.08NA4.501.13NA16.71000
    35481AAtherectomy, open7.61NA3.380.84NA11.83000
    35482AAtherectomy, open6.65NA3.040.75NA10.44000
    35483AAtherectomy, open8.10NA3.470.81NA12.38000
    35484AAtherectomy, open10.44NA4.191.13NA15.76000
    35485AAtherectomy, open9.49NA4.021.06NA14.57000
    35490AAtherectomy, percutaneous11.08NA4.800.55NA16.43000
    35491AAtherectomy, percutaneous7.61NA3.320.49NA11.42000
    35492AAtherectomy, percutaneous6.65NA3.200.43NA10.28000
    35493AAtherectomy, percutaneous8.10NA3.860.47NA12.43000
    35494AAtherectomy, percutaneous10.44NA4.460.48NA15.38000
    35495AAtherectomy, percutaneous9.49NA4.460.51NA14.46000
    35500AHarvest vein for bypass6.45NA2.070.63NA9.15ZZZ
    35501AArtery bypass graft19.19NA7.432.33NA28.95090
    35506AArtery bypass graft19.67NA8.132.33NA30.13090
    35507AArtery bypass graft19.67NA8.092.27NA30.03090
    35508AArtery bypass graft18.65NA7.852.34NA28.84090
    35509AArtery bypass graft18.07NA7.542.12NA27.73090
    35511AArtery bypass graft21.20NA8.691.74NA31.63090
    35515AArtery bypass graft18.65NA7.932.26NA28.84090
    35516AArtery bypass graft16.32NA5.801.88NA24.00090
    35518AArtery bypass graft21.20NA8.491.78NA31.47090
    35521AArtery bypass graft22.20NA9.331.82NA33.35090
    35526AArtery bypass graft29.95NA12.002.18NA44.13090
    35531AArtery bypass graft36.20NA14.132.91NA53.24090
    35533AArtery bypass graft28.00NA11.362.35NA41.71090
    35536AArtery bypass graft31.70NA12.582.62NA46.90090
    35541AArtery bypass graft25.80NA10.722.74NA39.26090
    35546AArtery bypass graft25.54NA10.482.84NA38.86090
    35548AArtery bypass graft21.57NA9.062.45NA33.08090
    35549AArtery bypass graft23.35NA9.812.77NA35.93090
    35551AArtery bypass graft26.67NA10.893.19NA40.75090
    35556AArtery bypass graft21.76NA9.242.48NA33.48090
    35558AArtery bypass graft21.20NA8.991.58NA31.77090
    35560AArtery bypass graft32.00NA12.782.73NA47.51090
    35563AArtery bypass graft24.20NA10.091.68NA35.97090
    35565AArtery bypass graft23.20NA9.711.71NA34.62090
    35566AArtery bypass graft26.92NA11.673.02NA41.61090
    35571AArtery bypass graft24.06NA11.902.14NA38.10090
    35572AHarvest femoropopliteal vein6.82NA2.570.63NA10.02ZZZ
    35582AVein bypass graft27.13NA11.093.11NA41.33090
    35583AVein bypass graft22.37NA10.392.53NA35.29090
    35585AVein bypass graft28.39NA14.293.21NA45.89090
    35587AVein bypass graft24.75NA12.582.17NA39.50090
    35600AHarvest artery for cabg4.95NA1.620.60NA7.17ZZZ
    35601AArtery bypass graft17.50NA7.332.08NA26.91090
    35606AArtery bypass graft18.71NA7.752.17NA28.63090
    35612AArtery bypass graft15.76NA6.721.72NA24.20090
    35616AArtery bypass graft15.70NA6.781.84NA24.32090
    35621AArtery bypass graft20.00NA8.671.68NA30.35090
    35623ABypass graft, not vein24.00NA9.981.91NA35.89090
    35626AArtery bypass graft27.75NA10.932.89NA41.57090
    35631AArtery bypass graft34.00NA13.412.83NA50.24090
    35636AArtery bypass graft29.50NA12.112.37NA43.98090
    35641AArtery bypass graft24.57NA10.272.83NA37.67090
    35642AArtery bypass graft17.98NA7.861.84NA27.68090
    35645AArtery bypass graft17.47NA7.691.91NA27.07090
    35646AArtery bypass graft31.00NA13.003.63NA47.63090
    35647AArtery bypass graft28.00NA11.763.28NA43.04090
    35650AArtery bypass graft19.00NA7.771.64NA28.41090
    35651AArtery bypass graft25.04NA10.502.53NA38.07090
    35654AArtery bypass graft25.00NA10.342.10NA37.44090
    35656AArtery bypass graft19.53NA8.222.21NA29.96090
    35661AArtery bypass graft19.00NA8.091.50NA28.59090
    35663AArtery bypass graft22.00NA9.441.55NA32.99090
    35665AArtery bypass graft21.00NA8.981.76NA31.74090
    35666AArtery bypass graft22.19NA11.722.19NA36.10090
    35671AArtery bypass graft19.33NA10.391.68NA31.40090
    35681AComposite bypass graft1.60NA0.550.18NA2.33ZZZ
    35682AComposite bypass graft7.20NA2.440.83NA10.47ZZZ
    35683AComposite bypass graft8.50NA2.880.98NA12.36ZZZ
    Start Printed Page 80079
    35685ABypass graft patency/patch4.05NA1.520.25NA5.82ZZZ
    35686ABypass graft/av fist patency3.35NA1.260.21NA4.82ZZZ
    35691AArterial transposition18.05NA7.542.06NA27.65090
    35693AArterial transposition15.36NA6.591.80NA23.75090
    35694AArterial transposition19.16NA7.832.13NA29.12090
    35695AArterial transposition19.16NA7.782.19NA29.13090
    35700AReoperation, bypass graft3.08NA1.030.36NA4.47ZZZ
    35701AExploration, carotid artery8.50NA4.590.64NA13.73090
    35721AExploration, femoral artery7.18NA5.130.59NA12.90090
    35741AExploration popliteal artery8.00NA5.340.60NA13.94090
    35761AExploration of artery/vein5.37NA4.420.60NA10.39090
    35800AExplore neck vessels7.02NA3.900.79NA11.71090
    35820AExplore chest vessels12.88NA4.191.61NA18.68090
    35840AExplore abdominal vessels9.77NA5.101.06NA15.93090
    35860AExplore limb vessels5.55NA3.540.63NA9.72090
    35870ARepair vessel graft defect22.17NA9.952.47NA34.59090
    35875ARemoval of clot in graft10.13NA6.300.97NA17.40090
    35876ARemoval of clot in graft17.00NA8.801.88NA27.68090
    35879ARevise graft w/vein16.00NA7.611.35NA24.96090
    35881ARevise graft w/vein18.00NA8.461.44NA27.90090
    35901AExcision, graft, neck8.19NA5.820.90NA14.91090
    35903AExcision, graft, extremity9.39NA8.081.03NA18.50090
    35905AExcision, graft, thorax31.25NA15.122.15NA48.52090
    35907AExcision, graft, abdomen35.00NA14.572.17NA51.74090
    36000APlace needle in vein0.180.660.050.010.850.24XXX
    36002APseudoaneurysm injection trt1.962.451.000.104.513.06000
    36005AInjection ext venography0.958.510.320.049.501.31000
    36010APlace catheter in vein2.43NA0.810.16NA3.40XXX
    36011APlace catheter in vein3.14NA1.050.17NA4.36XXX
    36012APlace catheter in vein3.52NA1.180.17NA4.87XXX
    36013APlace catheter in artery2.52NA0.670.17NA3.36XXX
    36014APlace catheter in artery3.02NA1.020.14NA4.18XXX
    36015APlace catheter in artery3.52NA1.180.16NA4.86XXX
    36100AEstablish access to artery3.02NA1.120.18NA4.32XXX
    36120AEstablish access to artery2.01NA0.670.11NA2.79XXX
    36140AEstablish access to artery2.01NA0.660.12NA2.79XXX
    36145AArtery to vein shunt2.01NA0.680.10NA2.79XXX
    36160AEstablish access to aorta2.52NA0.860.20NA3.58XXX
    36200APlace catheter in aorta3.02NA1.040.15NA4.21XXX
    36215APlace catheter in artery4.68NA1.620.22NA6.52XXX
    36216APlace catheter in artery5.28NA1.810.24NA7.33XXX
    36217APlace catheter in artery6.30NA2.210.32NA8.83XXX
    36218APlace catheter in artery1.01NA0.350.05NA1.41ZZZ
    36245APlace catheter in artery4.68NA1.690.23NA6.60XXX
    36246APlace catheter in artery5.28NA1.830.26NA7.37XXX
    36247APlace catheter in artery6.30NA2.170.32NA8.79XXX
    36248APlace catheter in artery1.01NA0.360.06NA1.43ZZZ
    36260AInsertion of infusion pump9.71NA5.501.00NA16.21090
    36261ARevision of infusion pump5.45NA3.330.50NA9.28090
    36262ARemoval of infusion pump4.02NA2.480.43NA6.93090
    36299CVessel injection procedure0.000.000.000.000.000.00YYY
    36400ABl draw < 3 yrs fem/jugular0.380.890.100.011.280.49XXX
    36405ABl draw < 3 yrs scalp vein0.310.330.080.010.650.40XXX
    36406ABl draw < 3 yrs other vein0.180.370.050.010.560.24XXX
    36410ANon-routine bl draw > 3 yrs0.180.390.050.010.580.24XXX
    36415IRoutine venipuncture0.000.000.000.000.000.00XXX
    36416ICapillary blood draw0.000.000.000.000.000.00XXX
    36420AVein access cutdown < 1 yr1.01NA0.310.09NA1.41XXX
    36425AVein access cutdown > 1 yr0.76NA0.220.05NA1.03XXX
    36430ABlood transfusion service0.001.01NA0.051.06NAXXX
    36440ABl push transfuse, 2 yr or <1.03NA0.290.08NA1.40XXX
    36450ABl exchange/transfuse, nb2.23NA0.720.16NA3.11XXX
    36455ABl exchange/transfuse non-nb2.43NA0.850.10NA3.38XXX
    36460ATransfusion service, fetal6.59NA2.270.56NA9.42XXX
    36468RInjection(s), spider veins0.000.000.000.000.000.00000
    36469RInjection(s), spider veins0.000.000.000.000.000.00000
    36470AInjection therapy of vein1.092.330.390.103.521.58010
    36471AInjection therapy of veins1.572.680.550.154.402.27010
    36481AInsertion of catheter, vein6.99NA2.800.40NA10.19000
    36488AInsertion of catheter, vein1.35NA0.740.09NA2.18000
    36489AInsertion of catheter, vein2.504.111.040.086.693.62000
    36490AInsertion of catheter, vein1.67NA0.830.17NA2.67000
    36491AInsertion of catheter, vein1.43NA0.760.13NA2.32000
    36493ARepositioning of cvc1.21NA0.860.06NA2.13000
    36500AInsertion of catheter, vein3.52NA1.260.14NA4.92000
    Start Printed Page 80080
    36510AInsertion of catheter, vein1.09NA0.720.06NA1.87000
    36511AApheresis wbc1.74NA0.700.06NA2.50000
    36512AApheresis rbc1.74NA0.700.06NA2.50000
    36513AApheresis platelets1.74NA0.700.06NA2.50000
    36514AApheresis plasma1.74NA0.700.06NA2.50000
    36515AApheresis, adsorp/reinfuse1.74NA0.700.06NA2.50000
    36516AApheresis, selective1.74NA0.700.06NA2.50000
    36520DPlasma and/or cell exchange0.000.000.000.000.000.00000
    36521DApheresis w/ adsorp/reinfuse0.000.000.000.000.000.00000
    36522APhotopheresis1.676.771.150.078.512.89000
    36530RInsertion of infusion pump6.20NA3.700.56NA10.46010
    36531RRevision of infusion pump4.87NA3.250.44NA8.56010
    36532RRemoval of infusion pump3.30NA1.520.34NA5.16010
    36533AInsertion of access device5.3213.553.380.4919.369.19010
    36534ARevision of access device2.80NA1.460.19NA4.45010
    36535ARemoval of access device2.272.811.820.215.294.30010
    36536ARemove cva device obstruct3.6033.541.470.2337.375.30000
    36537ARemove cva lumen obstruct0.757.690.490.048.481.28000
    36540BCollect blood venous device0.000.000.000.000.000.00XXX
    36550ADeclot vascular device0.000.38NA0.310.69NAXXX
    36600AWithdrawal of arterial blood0.320.410.090.020.750.43XXX
    36620AInsertion catheter, artery1.15NA0.240.06NA1.45000
    36625AInsertion catheter, artery2.11NA0.530.16NA2.80000
    36640AInsertion catheter, artery2.10NA0.720.18NA3.00000
    36660AInsertion catheter, artery1.40NA0.450.08NA1.93000
    36680AInsert needle, bone cavity1.20NA0.620.08NA1.90000
    36800AInsertion of cannula2.43NA1.760.17NA4.36000
    36810AInsertion of cannula3.97NA2.240.40NA6.61000
    36815AInsertion of cannula2.62NA1.260.26NA4.14000
    36819AAv fusion/uppr arm vein14.00NA6.411.56NA21.97090
    36820AAv fusion/forearm vein14.00NA6.431.56NA21.99090
    36821AAv fusion direct any site8.93NA4.940.97NA14.84090
    36822AInsertion of cannula(s)5.42NA7.140.63NA13.19090
    36823AInsertion of cannula(s)21.00NA10.382.18NA33.56090
    36825AArtery-vein autograft9.84NA5.481.09NA16.41090
    36830AArtery-vein nonautograft12.00NA6.041.32NA19.36090
    36831AOpen thrombect av fistula8.00NA3.930.79NA12.72090
    36832AAv fistula revision, open10.50NA5.531.13NA17.16090
    36833AAv fistula revision11.95NA6.001.29NA19.24090
    36834ARepair A-V aneurysm9.93NA3.791.06NA14.78090
    36835AArtery to vein shunt7.15NA4.520.80NA12.47090
    36860AExternal cannula declotting2.012.621.340.104.733.45000
    36861ACannula declotting2.52NA1.460.14NA4.12000
    36870APercut thrombect av fistula5.1642.322.390.2347.717.78090
    37140ARevision of circulation23.60NA10.311.21NA35.12090
    37145ARevision of circulation24.61NA10.932.48NA38.02090
    37160ARevision of circulation21.60NA9.142.16NA32.90090
    37180ARevision of circulation24.61NA10.272.63NA37.51090
    37181ASplice spleen/kidney veins26.68NA10.862.67NA40.21090
    37182AInsert hepatic shunt (tips)17.00NA6.371.49NA24.86000
    37183ARemove hepatic shunt (tips)8.00NA3.120.43NA11.55000
    37195AThrombolytic therapy, stroke0.008.02NA0.388.40NAXXX
    37200ATranscatheter biopsy4.56NA1.550.19NA6.30000
    37201ATranscatheter therapy infuse5.00NA2.530.24NA7.77000
    37202ATranscatheter therapy infuse5.68NA3.100.38NA9.16000
    37203ATranscatheter retrieval5.03NA2.550.23NA7.81000
    37204ATranscatheter occlusion18.14NA6.110.91NA25.16000
    37205ATranscatheter stent8.28NA3.790.43NA12.50000
    37206ATranscatheter stent add-on4.13NA1.480.22NA5.83ZZZ
    37207ATranscatheter stent8.28NA3.530.89NA12.70000
    37208ATranscatheter stent add-on4.13NA1.410.44NA5.98ZZZ
    37209AExchange arterial catheter2.27NA0.770.11NA3.15000
    37250AIv us first vessel add-on2.10NA0.770.17NA3.04ZZZ
    37251AIv us each add vessel add-on1.60NA0.570.14NA2.31ZZZ
    37500AEndoscopy ligate perf veins11.00NA8.700.40NA20.10090
    37501CVascular endoscopy procedure0.000.000.000.000.000.00YYY
    37565ALigation of neck vein10.88NA5.080.45NA16.41090
    37600ALigation of neck artery11.25NA6.300.40NA17.95090
    37605ALigation of neck artery13.11NA6.480.77NA20.36090
    37606ALigation of neck artery6.28NA3.980.79NA11.05090
    37607ALigation of a-v fistula6.16NA3.650.67NA10.48090
    37609ATemporal artery procedure3.007.022.520.2110.235.73010
    37615ALigation of neck artery5.73NA3.640.57NA9.94090
    37616ALigation of chest artery16.49NA10.581.93NA29.00090
    37617ALigation of abdomen artery22.06NA9.421.69NA33.17090
    Start Printed Page 80081
    37618ALigation of extremity artery4.84NA3.490.54NA8.87090
    37620ARevision of major vein10.56NA5.400.75NA16.71090
    37650ARevision of major vein7.80NA4.650.56NA13.01090
    37660ARevision of major vein21.00NA9.321.17NA31.49090
    37700ARevise leg vein3.73NA3.140.40NA7.27090
    37720ARemoval of leg vein5.66NA3.630.61NA9.90090
    37730ARemoval of leg veins7.33NA4.510.77NA12.61090
    37735ARemoval of leg veins/lesion10.53NA5.771.17NA17.47090
    37760ALigation, leg veins, open10.47NA5.631.11NA17.21090
    37780ARevision of leg vein3.84NA2.960.41NA7.21090
    37785ARevise secondary varicosity3.846.982.850.4111.237.10090
    37788ARevascularization, penis22.01NA11.501.35NA34.86090
    37790APenile venous occlusion8.34NA6.110.63NA15.08090
    37799CVascular surgery procedure0.000.000.000.000.000.00YYY
    38100ARemoval of spleen, total14.50NA6.561.30NA22.36090
    38101ARemoval of spleen, partial15.31NA6.941.38NA23.63090
    38102ARemoval of spleen, total4.80NA1.680.49NA6.97ZZZ
    38115ARepair of ruptured spleen15.82NA7.041.40NA24.26090
    38120ALaparoscopy, splenectomy17.00NA7.371.73NA26.10090
    38129CLaparoscope proc, spleen0.000.000.000.000.000.00YYY
    38200AInjection for spleen x-ray2.64NA0.920.12NA3.68000
    38204BBl donor search management0.000.000.000.000.000.00XXX
    38205RHarvest allogenic stem cells1.50NA0.610.05NA2.16000
    38206RHarvest auto stem cells1.50NA0.610.05NA2.16000
    38207ICryopreserve stem cells0.000.000.000.000.000.00XXX
    38208IThaw preserved stem cells0.000.000.000.000.000.00XXX
    38209IWash harvest stem cells0.000.000.000.000.000.00XXX
    38210IT-cell depletion of harvest0.000.000.000.000.000.00XXX
    38211ITumor cell deplete of harvst0.000.000.000.000.000.00XXX
    38212IRbc depletion of harvest0.000.000.000.000.000.00XXX
    38213IPlatelet deplete of harvest0.000.000.000.000.000.00XXX
    38214IVolume deplete of harvest0.000.000.000.000.000.00XXX
    38215IHarvest stem cell concentrte0.000.000.000.000.000.00XXX
    38220ABone marrow aspiration1.084.640.430.035.751.54XXX
    38221ABone marrow biopsy1.374.790.540.046.201.95XXX
    38230RBone marrow collection4.54NA2.420.25NA7.21010
    38231DStem cell collection0.000.000.000.000.000.00000
    38240RBone marrow/stem transplant2.24NA0.840.08NA3.16XXX
    38241RBone marrow/stem transplant2.24NA0.840.08NA3.16XXX
    38242ALymphocyte infuse transplant1.71NA0.700.05NA2.46000
    38300ADrainage, lymph node lesion1.994.512.590.156.654.73010
    38305ADrainage, lymph node lesion6.008.726.290.3615.0812.65090
    38308AIncision of lymph channels6.45NA5.700.51NA12.66090
    38380AThoracic duct procedure7.46NA7.550.68NA15.69090
    38381AThoracic duct procedure12.88NA9.831.58NA24.29090
    38382AThoracic duct procedure10.08NA9.181.08NA20.34090
    38500ABiopsy/removal, lymph nodes3.753.042.560.287.076.59010
    38505ANeedle biopsy, lymph nodes1.143.131.090.094.362.32000
    38510ABiopsy/removal, lymph nodes6.43NA5.410.38NA12.22010
    38520ABiopsy/removal, lymph nodes6.67NA5.550.52NA12.74090
    38525ABiopsy/removal, lymph nodes6.07NA4.400.48NA10.95090
    38530ABiopsy/removal, lymph nodes7.98NA5.840.63NA14.45090
    38542AExplore deep node(s), neck5.91NA6.000.50NA12.41090
    38550ARemoval, neck/armpit lesion6.92NA4.900.69NA12.51090
    38555ARemoval, neck/armpit lesion14.14NA10.281.46NA25.88090
    38562ARemoval, pelvic lymph nodes10.49NA6.530.97NA17.99090
    38564ARemoval, abdomen lymph nodes10.83NA6.271.06NA18.16090
    38570ALaparoscopy, lymph node biop9.25NA4.470.89NA14.61010
    38571ALaparoscopy, lymphadenectomy14.68NA6.100.80NA21.58010
    38572ALaparoscopy, lymphadenectomy16.59NA7.401.32NA25.31010
    38589CLaparoscope proc, lymphatic0.000.000.000.000.000.00YYY
    38700ARemoval of lymph nodes, neck8.24NA13.430.60NA22.27090
    38720ARemoval of lymph nodes, neck13.61NA15.951.03NA30.59090
    38724ARemoval of lymph nodes, neck14.54NA16.511.10NA32.15090
    38740ARemove armpit lymph nodes10.03NA5.790.69NA16.51090
    38745ARemove armpit lymph nodes13.10NA8.250.90NA22.25090
    38746ARemove thoracic lymph nodes4.89NA1.600.55NA7.04ZZZ
    38747ARemove abdominal lymph nodes4.89NA1.700.50NA7.09ZZZ
    38760ARemove groin lymph nodes12.95NA7.140.88NA20.97090
    38765ARemove groin lymph nodes19.98NA11.221.50NA32.70090
    38770ARemove pelvis lymph nodes13.23NA6.790.99NA21.01090
    38780ARemove abdomen lymph nodes16.59NA9.281.60NA27.47090
    38790AInject for lymphatic x-ray1.2931.590.450.0932.971.83000
    38792AIdentify sentinel node0.52NA0.180.04NA0.74000
    38794AAccess thoracic lymph duct4.45NA1.540.17NA6.16090
    Start Printed Page 80082
    38999CBlood/lymph system procedure0.000.000.000.000.000.00YYY
    39000AExploration of chest6.10NA7.580.73NA14.41090
    39010AExploration of chest11.79NA7.191.46NA20.44090
    39200ARemoval chest lesion13.62NA7.301.65NA22.57090
    39220ARemoval chest lesion17.42NA9.052.10NA28.57090
    39400AVisualization of chest5.61NA4.590.69NA10.89010
    39499CChest procedure0.000.000.000.000.000.00YYY
    39501ARepair diaphragm laceration13.19NA7.731.38NA22.30090
    39502ARepair paraesophageal hernia16.33NA8.221.68NA26.23090
    39503ARepair of diaphragm hernia95.00NA34.453.52NA132.97090
    39520ARepair of diaphragm hernia16.10NA9.681.83NA27.61090
    39530ARepair of diaphragm hernia15.41NA8.561.66NA25.63090
    39531ARepair of diaphragm hernia16.42NA8.751.83NA27.00090
    39540ARepair of diaphragm hernia13.32NA7.771.38NA22.47090
    39541ARepair of diaphragm hernia14.41NA7.861.52NA23.79090
    39545ARevision of diaphragm13.37NA9.291.55NA24.21090
    39560AResect diaphragm, simple12.00NA7.531.35NA20.88090
    39561AResect diaphragm, complex17.50NA9.761.97NA29.23090
    39599CDiaphragm surgery procedure0.000.000.000.000.000.00YYY
    40490ABiopsy of lip1.221.730.620.063.011.90000
    40500APartial excision of lip4.285.895.690.3110.4810.28090
    40510APartial excision of lip4.706.766.510.3811.8411.59090
    40520APartial excision of lip4.677.776.870.4212.8611.96090
    40525AReconstruct lip with flap7.55NA8.360.68NA16.59090
    40527AReconstruct lip with flap9.13NA9.240.82NA19.19090
    40530APartial removal of lip5.406.606.240.4712.4712.11090
    40650ARepair lip3.645.444.810.319.398.76090
    40652ARepair lip4.266.836.800.3911.4811.45090
    40654ARepair lip5.317.717.500.4813.5013.29090
    40700ARepair cleft lip/nasal12.79NA10.320.93NA24.04090
    40701ARepair cleft lip/nasal15.85NA12.701.36NA29.91090
    40702ARepair cleft lip/nasal13.04NA9.541.01NA23.59090
    40720ARepair cleft lip/nasal13.55NA11.931.31NA26.79090
    40761ARepair cleft lip/nasal14.72NA12.391.41NA28.52090
    40799CLip surgery procedure0.000.000.000.000.000.00YYY
    40800ADrainage of mouth lesion1.171.820.870.093.082.13010
    40801ADrainage of mouth lesion2.532.421.550.185.134.26010
    40804ARemoval, foreign body, mouth1.242.311.030.093.642.36010
    40805ARemoval, foreign body, mouth2.692.751.750.175.614.61010
    40806AIncision of lip fold0.310.960.860.021.291.19000
    40808ABiopsy of mouth lesion0.961.941.020.072.972.05010
    40810AExcision of mouth lesion1.312.071.160.093.472.56010
    40812AExcise/repair mouth lesion2.312.431.720.174.914.20010
    40814AExcise/repair mouth lesion3.423.342.980.267.026.66090
    40816AExcision of mouth lesion3.673.463.170.277.407.11090
    40818AExcise oral mucosa for graft2.414.114.110.146.666.66090
    40819AExcise lip or cheek fold2.413.573.550.176.156.13090
    40820ATreatment of mouth lesion1.282.472.300.083.833.66010
    40830ARepair mouth laceration1.762.532.500.144.434.40010
    40831ARepair mouth laceration2.462.782.780.215.455.45010
    40840RReconstruction of mouth8.736.146.140.7915.6615.66090
    40842RReconstruction of mouth8.736.006.000.6515.3815.38090
    40843RReconstruction of mouth12.107.317.310.8420.2520.25090
    40844RReconstruction of mouth16.018.988.951.6326.6226.59090
    40845RReconstruction of mouth18.5810.9410.941.4730.9930.99090
    40899CMouth surgery procedure0.000.000.000.000.000.00YYY
    41000ADrainage of mouth lesion1.302.381.500.093.772.89010
    41005ADrainage of mouth lesion1.262.261.470.093.612.82010
    41006ADrainage of mouth lesion3.243.753.400.257.246.89090
    41007ADrainage of mouth lesion3.103.873.190.227.196.51090
    41008ADrainage of mouth lesion3.373.603.280.247.216.89090
    41009ADrainage of mouth lesion3.593.673.270.257.517.11090
    41010AIncision of tongue fold1.063.263.260.064.384.38010
    41015ADrainage of mouth lesion3.964.223.230.298.477.48090
    41016ADrainage of mouth lesion4.074.153.380.288.507.73090
    41017ADrainage of mouth lesion4.074.163.320.328.557.71090
    41018ADrainage of mouth lesion5.104.553.790.3510.009.24090
    41100ABiopsy of tongue1.632.361.400.124.113.15010
    41105ABiopsy of tongue1.422.181.320.103.702.84010
    41108ABiopsy of floor of mouth1.052.041.100.083.172.23010
    41110AExcision of tongue lesion1.512.441.310.114.062.93010
    41112AExcision of tongue lesion2.733.382.710.206.315.64090
    41113AExcision of tongue lesion3.193.402.940.236.826.36090
    41114AExcision of tongue lesion8.47NA5.440.64NA14.55090
    41115AExcision of tongue fold1.742.612.540.134.484.41010
    Start Printed Page 80083
    41116AExcision of mouth lesion2.443.403.400.176.016.01090
    41120APartial removal of tongue9.77NA8.880.70NA19.35090
    41130APartial removal of tongue11.15NA9.660.81NA21.62090
    41135ATongue and neck surgery23.09NA15.991.66NA40.74090
    41140ARemoval of tongue25.50NA17.321.85NA44.67090
    41145ATongue removal, neck surgery30.06NA21.302.11NA53.47090
    41150ATongue, mouth, jaw surgery23.04NA17.161.67NA41.87090
    41153ATongue, mouth, neck surgery23.77NA17.771.71NA43.25090
    41155ATongue, jaw, & neck surgery27.72NA19.972.02NA49.71090
    41250ARepair tongue laceration1.912.881.710.154.943.77010
    41251ARepair tongue laceration2.272.722.000.185.174.45010
    41252ARepair tongue laceration2.973.502.340.236.705.54010
    41500AFixation of tongue3.71NA4.330.26NA8.30090
    41510ATongue to lip surgery3.42NA4.800.24NA8.46090
    41520AReconstruction, tongue fold2.733.033.030.195.955.95090
    41599CTongue and mouth surgery0.000.000.000.000.000.00YYY
    41800ADrainage of gum lesion1.171.971.370.093.232.63010
    41805ARemoval foreign body, gum1.241.951.950.093.283.28010
    41806ARemoval foreign body,jawbone2.692.572.450.225.485.36010
    41820RExcision, gum, each quadrant0.000.000.000.000.000.00000
    41821RExcision of gum flap0.000.000.000.000.000.00000
    41822RExcision of gum lesion2.312.830.960.245.383.51010
    41823RExcision of gum lesion3.303.583.000.297.176.59090
    41825AExcision of gum lesion1.312.402.360.103.813.77010
    41826AExcision of gum lesion2.312.642.640.175.125.12010
    41827AExcision of gum lesion3.423.583.580.257.257.25090
    41828RExcision of gum lesion3.093.012.400.226.325.71010
    41830RRemoval of gum tissue3.353.302.940.236.886.52010
    41850RTreatment of gum lesion0.000.000.000.000.000.00000
    41870RGum graft0.000.000.000.000.000.00000
    41872RRepair gum2.592.882.880.185.655.65090
    41874RRepair tooth socket3.092.882.400.236.205.72090
    41899CDental surgery procedure0.000.000.000.000.000.00YYY
    42000ADrainage mouth roof lesion1.232.531.530.103.862.86010
    42100ABiopsy roof of mouth1.312.512.500.103.923.91010
    42104AExcision lesion, mouth roof1.642.572.570.124.334.33010
    42106AExcision lesion, mouth roof2.102.642.640.164.904.90010
    42107AExcision lesion, mouth roof4.444.114.110.328.878.87090
    42120ARemove palate/lesion6.17NA6.110.44NA12.72090
    42140AExcision of uvula1.623.913.370.125.655.11090
    42145ARepair palate, pharynx/uvula8.05NA7.500.56NA16.11090
    42160ATreatment mouth roof lesion1.803.282.700.135.214.63010
    42180ARepair palate2.502.992.110.195.684.80010
    42182ARepair palate3.833.473.060.277.577.16010
    42200AReconstruct cleft palate12.00NA10.140.97NA23.11090
    42205AReconstruct cleft palate13.29NA9.230.82NA23.34090
    42210AReconstruct cleft palate14.50NA9.511.24NA25.25090
    42215AReconstruct cleft palate8.82NA8.690.96NA18.47090
    42220AReconstruct cleft palate7.02NA6.730.41NA14.16090
    42225AReconstruct cleft palate9.54NA9.150.75NA19.44090
    42226ALengthening of palate10.01NA9.520.73NA20.26090
    42227ALengthening of palate9.52NA8.090.70NA18.31090
    42235ARepair palate7.87NA6.180.49NA14.54090
    42260ARepair nose to lip fistula9.806.996.990.8517.6417.64090
    42280APreparation, palate mold1.541.430.750.123.092.41010
    42281AInsertion, palate prosthesis1.931.810.970.143.883.04010
    42299CPalate/uvula surgery0.000.000.000.000.000.00YYY
    42300ADrainage of salivary gland1.932.651.890.154.733.97010
    42305ADrainage of salivary gland6.07NA5.290.46NA11.82090
    42310ADrainage of salivary gland1.562.321.650.113.993.32010
    42320ADrainage of salivary gland2.352.772.130.175.294.65010
    42325ACreate salivary cyst drain2.753.361.150.176.284.07090
    42326ACreate salivary cyst drain3.783.341.760.347.465.88090
    42330ARemoval of salivary stone2.212.781.050.165.153.42010
    42335ARemoval of salivary stone3.313.663.660.237.207.20090
    42340ARemoval of salivary stone4.604.804.800.349.749.74090
    42400ABiopsy of salivary gland0.782.490.390.063.331.23000
    42405ABiopsy of salivary gland3.293.403.340.246.936.87010
    42408AExcision of salivary cyst4.544.544.540.349.429.42090
    42409ADrainage of salivary cyst2.813.393.390.206.406.40090
    42410AExcise parotid gland/lesion9.34NA7.870.77NA17.98090
    42415AExcise parotid gland/lesion16.89NA12.471.26NA30.62090
    42420AExcise parotid gland/lesion19.59NA14.031.45NA35.07090
    42425AExcise parotid gland/lesion13.02NA10.460.98NA24.46090
    42426AExcise parotid gland/lesion21.26NA14.831.57NA37.66090
    Start Printed Page 80084
    42440AExcise submaxillary gland6.97NA5.980.51NA13.46090
    42450AExcise sublingual gland4.624.784.780.349.749.74090
    42500ARepair salivary duct4.304.844.840.309.449.44090
    42505ARepair salivary duct6.185.465.460.4412.0812.08090
    42507AParotid duct diversion6.11NA5.980.66NA12.75090
    42508AParotid duct diversion9.10NA8.120.64NA17.86090
    42509AParotid duct diversion11.54NA9.651.24NA22.43090
    42510AParotid duct diversion8.15NA7.090.57NA15.81090
    42550AInjection for salivary x-ray1.2512.740.430.0614.051.74000
    42600AClosure of salivary fistula4.826.305.670.3411.4610.83090
    42650ADilation of salivary duct0.771.090.400.061.921.23000
    42660ADilation of salivary duct1.131.181.180.072.382.38000
    42665ALigation of salivary duct2.533.513.510.176.216.21090
    42699CSalivary surgery procedure0.000.000.000.000.000.00YYY
    42700ADrainage of tonsil abscess1.623.271.880.125.013.62010
    42720ADrainage of throat abscess5.424.884.760.3910.6910.57010
    42725ADrainage of throat abscess10.72NA8.520.80NA20.04090
    42800ABiopsy of throat1.393.092.620.104.584.11010
    42802ABiopsy of throat1.543.182.700.114.834.35010
    42804ABiopsy of upper nose/throat1.243.052.570.094.383.90010
    42806ABiopsy of upper nose/throat1.583.522.760.125.224.46010
    42808AExcise pharynx lesion2.305.063.150.177.535.62010
    42809ARemove pharynx foreign body1.813.501.740.135.443.68010
    42810AExcision of neck cyst3.255.524.500.259.028.00090
    42815AExcision of neck cyst7.07NA6.580.53NA14.18090
    42820ARemove tonsils and adenoids3.91NA3.350.28NA7.54090
    42821ARemove tonsils and adenoids4.29NA4.230.30NA8.82090
    42825ARemoval of tonsils3.42NA3.690.24NA7.35090
    42826ARemoval of tonsils3.38NA3.750.23NA7.36090
    42830ARemoval of adenoids2.57NA2.420.18NA5.17090
    42831ARemoval of adenoids2.71NA2.550.19NA5.45090
    42835ARemoval of adenoids2.30NA3.150.17NA5.62090
    42836ARemoval of adenoids3.18NA3.680.22NA7.08090
    42842AExtensive surgery of throat8.76NA7.820.61NA17.19090
    42844AExtensive surgery of throat14.31NA11.361.04NA26.71090
    42845AExtensive surgery of throat24.29NA17.441.76NA43.49090
    42860AExcision of tonsil tags2.22NA3.080.16NA5.46090
    42870AExcision of lingual tonsil5.40NA6.100.38NA11.88090
    42890APartial removal of pharynx12.94NA10.820.91NA24.67090
    42892ARevision of pharyngeal walls15.83NA12.341.14NA29.31090
    42894ARevision of pharyngeal walls22.88NA16.971.64NA41.49090
    42900ARepair throat wound5.25NA3.760.39NA9.40010
    42950AReconstruction of throat8.10NA7.520.58NA16.20090
    42953ARepair throat, esophagus8.96NA8.990.73NA18.68090
    42955ASurgical opening of throat7.39NA6.530.63NA14.55090
    42960AControl throat bleeding2.33NA2.110.17NA4.61010
    42961AControl throat bleeding5.59NA5.270.40NA11.26090
    42962AControl throat bleeding7.14NA6.180.51NA13.83090
    42970AControl nose/throat bleeding5.43NA3.770.37NA9.57090
    42971AControl nose/throat bleeding6.21NA5.810.45NA12.47090
    42972AControl nose/throat bleeding7.20NA5.540.54NA13.28090
    42999CThroat surgery procedure0.000.000.000.000.000.00YYY
    43020AIncision of esophagus8.09NA6.460.70NA15.25090
    43030AThroat muscle surgery7.69NA6.930.60NA15.22090
    43045AIncision of esophagus20.12NA11.082.15NA33.35090
    43100AExcision of esophagus lesion9.19NA7.200.79NA17.18090
    43101AExcision of esophagus lesion16.24NA8.621.81NA26.67090
    43107ARemoval of esophagus40.00NA18.023.29NA61.31090
    43108ARemoval of esophagus34.19NA15.853.78NA53.82090
    43112ARemoval of esophagus43.50NA19.493.67NA66.66090
    43113ARemoval of esophagus35.27NA16.484.33NA56.08090
    43116APartial removal of esophagus31.22NA18.822.62NA52.66090
    43117APartial removal of esophagus40.00NA17.093.51NA60.60090
    43118APartial removal of esophagus33.20NA15.403.56NA52.16090
    43121APartial removal of esophagus29.19NA13.363.44NA45.99090
    43122APartial removal of esophagus40.00NA17.293.27NA60.56090
    43123APartial removal of esophagus33.20NA15.823.96NA52.98090
    43124ARemoval of esophagus27.32NA14.942.95NA45.21090
    43130ARemoval of esophagus pouch11.75NA8.861.06NA21.67090
    43135ARemoval of esophagus pouch16.10NA9.911.85NA27.86090
    43200AEsophagus endoscopy1.597.971.180.119.672.88000
    43201AEsoph scope w/submucous inj2.094.441.270.126.653.48000
    43202AEsophagus endoscopy, biopsy1.896.251.130.128.263.14000
    43204AEsoph scope w/sclerosis inj3.77NA1.670.18NA5.62000
    43205AEsophagus endoscopy/ligation3.79NA1.680.17NA5.64000
    Start Printed Page 80085
    43215AEsophagus endoscopy2.60NA1.230.17NA4.00000
    43216AEsophagus endoscopy/lesion2.40NA1.180.15NA3.73000
    43217AEsophagus endoscopy2.90NA1.330.17NA4.40000
    43219AEsophagus endoscopy2.80NA1.400.16NA4.36000
    43220AEsoph endoscopy, dilation2.10NA1.100.12NA3.32000
    43226AEsoph endoscopy, dilation2.34NA1.170.12NA3.63000
    43227AEsoph endoscopy, repair3.60NA1.600.18NA5.38000
    43228AEsoph endoscopy, ablation3.77NA1.720.25NA5.74000
    43231AEsoph endoscopy w/us exam3.19NA1.570.20NA4.96000
    43232AEsoph endoscopy w/us fn bx4.48NA2.100.26NA6.84000
    43234AUpper GI endoscopy, exam2.014.281.040.136.423.18000
    43235AUppr gi endoscopy, diagnosis2.395.851.060.138.373.58000
    43236AUppr gi scope w/submuc inj2.924.701.260.147.764.32000
    43239AUpper GI endoscopy, biopsy2.876.171.230.149.184.24000
    43240AEsoph endoscope w/drain cyst6.86NA2.700.36NA9.92000
    43241AUpper GI endoscopy with tube2.59NA1.140.14NA3.87000
    43242AUppr gi endoscopy w/us fn bx7.31NA2.830.29NA10.43000
    43243AUpper gi endoscopy & inject4.57NA1.860.21NA6.64000
    43244AUpper GI endoscopy/ligation5.05NA2.030.21NA7.29000
    43245AUppr gi scope dilate strictr3.1813.871.340.1817.234.70000
    43246APlace gastrostomy tube4.33NA1.750.24NA6.32000
    43247AOperative upper GI endoscopy3.39NA1.420.17NA4.98000
    43248AUppr gi endoscopy/guide wire3.15NA1.350.15NA4.65000
    43249AEsoph endoscopy, dilation2.90NA1.260.15NA4.31000
    43250AUpper GI endoscopy/tumor3.20NA1.350.17NA4.72000
    43251AOperative upper GI endoscopy3.70NA1.530.19NA5.42000
    43255AOperative upper GI endoscopy4.82NA1.950.20NA6.97000
    43256AUppr gi endoscopy w stent4.35NA1.770.23NA6.35000
    43258AOperative upper GI endoscopy4.55NA1.850.22NA6.62000
    43259AEndoscopic ultrasound exam4.89NA1.950.22NA7.06000
    43260AEndo cholangiopancreatograph5.96NA2.440.27NA8.67000
    43261AEndo cholangiopancreatograph6.27NA2.550.29NA9.11000
    43262AEndo cholangiopancreatograph7.39NA2.960.34NA10.69000
    43263AEndo cholangiopancreatograph7.29NA2.930.28NA10.50000
    43264AEndo cholangiopancreatograph8.90NA3.490.41NA12.80000
    43265AEndo cholangiopancreatograph10.02NA3.890.42NA14.33000
    43267AEndo cholangiopancreatograph7.39NA2.960.34NA10.69000
    43268AEndo cholangiopancreatograph7.39NA2.960.34NA10.69000
    43269AEndo cholangiopancreatograph8.21NA3.240.28NA11.73000
    43271AEndo cholangiopancreatograph7.39NA2.950.34NA10.68000
    43272AEndo cholangiopancreatograph7.39NA2.960.34NA10.69000
    43280ALaparoscopy, fundoplasty17.25NA8.201.76NA27.21090
    43289CLaparoscope proc, esoph0.000.000.000.000.000.00YYY
    43300ARepair of esophagus9.14NA7.250.85NA17.24090
    43305ARepair esophagus and fistula17.39NA12.701.36NA31.45090
    43310ARepair of esophagus25.39NA14.663.18NA43.23090
    43312ARepair esophagus and fistula28.42NA18.203.38NA50.00090
    43313AEsophagoplasty congenital45.28NA21.665.43NA72.37090
    43314ATracheo-esophagoplasty cong50.27NA23.685.53NA79.48090
    43320AFuse esophagus & stomach19.93NA10.451.59NA31.97090
    43324ARevise esophagus & stomach20.57NA9.481.72NA31.77090
    43325ARevise esophagus & stomach20.06NA9.851.65NA31.56090
    43326ARevise esophagus & stomach19.74NA10.491.84NA32.07090
    43330ARepair of esophagus19.77NA9.561.52NA30.85090
    43331ARepair of esophagus20.13NA11.131.93NA33.19090
    43340AFuse esophagus & intestine19.61NA10.611.53NA31.75090
    43341AFuse esophagus & intestine20.85NA12.082.14NA35.07090
    43350ASurgical opening, esophagus15.78NA10.171.15NA27.10090
    43351ASurgical opening, esophagus18.35NA10.611.51NA30.47090
    43352ASurgical opening, esophagus15.26NA9.721.28NA26.26090
    43360AGastrointestinal repair35.70NA16.543.00NA55.24090
    43361AGastrointestinal repair40.50NA18.383.52NA62.40090
    43400ALigate esophagus veins21.20NA10.340.99NA32.53090
    43401AEsophagus surgery for veins22.09NA10.351.73NA34.17090
    43405ALigate/staple esophagus20.01NA9.511.63NA31.15090
    43410ARepair esophagus wound13.47NA8.931.15NA23.55090
    43415ARepair esophagus wound25.00NA12.261.92NA39.18090
    43420ARepair esophagus opening14.35NA8.920.86NA24.13090
    43425ARepair esophagus opening21.03NA11.222.03NA34.28090
    43450ADilate esophagus1.381.380.620.072.832.07000
    43453ADilate esophagus1.51NA0.670.08NA2.26000
    43456ADilate esophagus2.57NA1.040.14NA3.75000
    43458ADilate esophagus3.06NA1.230.17NA4.46000
    43460APressure treatment esophagus3.80NA1.500.21NA5.51000
    43496CFree jejunum flap, microvasc0.000.000.000.000.000.00090
    Start Printed Page 80086
    43499CEsophagus surgery procedure0.000.000.000.000.000.00YYY
    43500ASurgical opening of stomach11.05NA5.080.84NA16.97090
    43501ASurgical repair of stomach20.04NA8.601.55NA30.19090
    43502ASurgical repair of stomach23.13NA9.771.83NA34.73090
    43510ASurgical opening of stomach13.08NA7.530.90NA21.51090
    43520AIncision of pyloric muscle9.99NA5.810.84NA16.64090
    43600ABiopsy of stomach1.91NA1.020.11NA3.04000
    43605ABiopsy of stomach11.98NA5.390.93NA18.30090
    43610AExcision of stomach lesion14.60NA6.691.14NA22.43090
    43611AExcision of stomach lesion17.84NA7.931.38NA27.15090
    43620ARemoval of stomach30.04NA12.692.29NA45.02090
    43621ARemoval of stomach30.73NA12.882.36NA45.97090
    43622ARemoval of stomach32.53NA13.482.48NA48.49090
    43631ARemoval of stomach, partial22.59NA9.451.99NA34.03090
    43632ARemoval of stomach, partial22.59NA9.462.00NA34.05090
    43633ARemoval of stomach, partial23.10NA9.642.05NA34.79090
    43634ARemoval of stomach, partial25.12NA10.412.18NA37.71090
    43635ARemoval of stomach, partial2.06NA0.720.21NA2.99ZZZ
    43638ARemoval of stomach, partial29.00NA11.772.24NA43.01090
    43639ARemoval of stomach, partial29.65NA12.012.31NA43.97090
    43640AVagotomy & pylorus repair17.02NA7.521.51NA26.05090
    43641AVagotomy & pylorus repair17.27NA7.631.53NA26.43090
    43651ALaparoscopy, vagus nerve10.15NA4.591.03NA15.77090
    43652ALaparoscopy, vagus nerve12.15NA5.371.25NA18.77090
    43653ALaparoscopy, gastrostomy7.73NA4.230.78NA12.74090
    43659CLaparoscope proc, stom0.000.000.000.000.000.00YYY
    43750APlace gastrostomy tube4.49NA2.620.33NA7.44010
    43752BNasal/orogastric w/stent0.000.000.000.000.000.00XXX
    43760AChange gastrostomy tube1.101.420.460.072.591.63000
    43761AReposition gastrostomy tube2.01NA0.800.10NA2.91000
    43800AReconstruction of pylorus13.69NA6.441.07NA21.20090
    43810AFusion of stomach and bowel14.65NA6.741.10NA22.49090
    43820AFusion of stomach and bowel15.37NA6.961.18NA23.51090
    43825AFusion of stomach and bowel19.22NA8.301.50NA29.02090
    43830APlace gastrostomy tube9.53NA4.910.69NA15.13090
    43831APlace gastrostomy tube7.84NA4.280.81NA12.93090
    43832APlace gastrostomy tube15.60NA7.461.13NA24.19090
    43840ARepair of stomach lesion15.56NA7.021.20NA23.78090
    43842AGastroplasty for obesity18.47NA11.211.51NA31.19090
    43843AGastroplasty for obesity18.65NA10.811.53NA30.99090
    43846AGastric bypass for obesity24.05NA13.231.96NA39.24090
    43847AGastric bypass for obesity26.92NA14.862.14NA43.92090
    43848ARevision gastroplasty29.39NA15.912.39NA47.69090
    43850ARevise stomach-bowel fusion24.72NA10.141.97NA36.83090
    43855ARevise stomach-bowel fusion26.16NA10.732.01NA38.90090
    43860ARevise stomach-bowel fusion25.00NA10.302.03NA37.33090
    43865ARevise stomach-bowel fusion26.52NA10.852.15NA39.52090
    43870ARepair stomach opening9.69NA5.050.71NA15.45090
    43880ARepair stomach-bowel fistula24.65NA10.671.94NA37.26090
    43999CStomach surgery procedure0.000.000.000.000.000.00YYY
    44005AFreeing of bowel adhesion16.23NA7.201.39NA24.82090
    44010AIncision of small bowel12.52NA6.321.05NA19.89090
    44015AInsert needle cath bowel2.62NA0.910.25NA3.78ZZZ
    44020AExplore small intestine13.99NA6.401.20NA21.59090
    44021ADecompress small bowel14.08NA6.841.18NA22.10090
    44025AIncision of large bowel14.28NA6.491.21NA21.98090
    44050AReduce bowel obstruction14.03NA6.421.15NA21.60090
    44055ACorrect malrotation of bowel22.00NA9.201.32NA32.52090
    44100ABiopsy of bowel2.01NA1.060.12NA3.19000
    44110AExcise intestine lesion(s)11.81NA5.691.00NA18.50090
    44111AExcision of bowel lesion(s)14.29NA7.051.22NA22.56090
    44120ARemoval of small intestine17.00NA7.451.46NA25.91090
    44121ARemoval of small intestine4.45NA1.560.46NA6.47ZZZ
    44125ARemoval of small intestine17.54NA7.641.49NA26.67090
    44126AEnterectomy w/o taper, cong35.50NA17.790.36NA53.65090
    44127AEnterectomy w/taper, cong41.00NA20.280.41NA61.69090
    44128AEnterectomy cong, add-on4.45NA1.730.45NA6.63ZZZ
    44130ABowel to bowel fusion14.49NA6.571.23NA22.29090
    44132REnterectomy, cadaver donor0.000.000.000.000.000.00XXX
    44133REnterectomy, live donor0.000.000.000.000.000.00XXX
    44135RIntestine transplnt, cadaver0.000.000.000.000.000.00XXX
    44136RIntestine transplant, live0.000.000.000.000.000.00XXX
    44139AMobilization of colon2.23NA0.780.21NA3.22ZZZ
    44140APartial removal of colon21.00NA8.862.14NA32.00090
    44141APartial removal of colon19.51NA10.201.95NA31.66090
    Start Printed Page 80087
    44143APartial removal of colon22.99NA10.892.02NA35.90090
    44144APartial removal of colon21.53NA9.701.89NA33.12090
    44145APartial removal of colon26.42NA11.042.22NA39.68090
    44146APartial removal of colon27.54NA13.122.20NA42.86090
    44147APartial removal of colon20.71NA8.851.74NA31.30090
    44150ARemoval of colon23.95NA12.202.05NA38.20090
    44151ARemoval of colon/ileostomy26.88NA13.551.97NA42.40090
    44152ARemoval of colon/ileostomy27.83NA11.942.36NA42.13090
    44153ARemoval of colon/ileostomy30.59NA14.742.33NA47.66090
    44155ARemoval of colon/ileostomy27.86NA13.562.26NA43.68090
    44156ARemoval of colon/ileostomy30.79NA15.192.19NA48.17090
    44160ARemoval of colon18.62NA7.931.86NA28.41090
    44200ALaparoscopy, enterolysis14.44NA6.381.46NA22.28090
    44201ALaparoscopy, jejunostomy9.78NA4.630.97NA15.38090
    44202ALap resect s/intestine singl22.04NA9.142.16NA33.34090
    44203ALap resect s/intestine, addl4.45NA1.560.46NA6.47ZZZ
    44204ALaparo partial colectomy25.08NA10.212.55NA37.84090
    44205ALap colectomy part w/ileum22.23NA9.072.23NA33.53090
    44206ALap part colectomy w/stoma27.00NA11.222.02NA40.24090
    44207AL colectomy/coloproctostomy30.00NA11.822.22NA44.04090
    44208AL colectomy/coloproctostomy32.00NA13.422.20NA47.62090
    44209DLaparoscope proc, intestine0.000.000.000.000.000.00YYY
    44210ALaparo total proctocolectomy28.00NA12.112.05NA42.16090
    44211ALaparo total proctocolectomy35.00NA15.022.33NA52.35090
    44212ALaparo total proctocolectomy32.50NA14.162.26NA48.92090
    44238CLaparoscope proc, intestine0.000.000.000.000.000.00YYY
    44239CLaparoscope proc, rectum0.000.000.000.000.000.00YYY
    44300AOpen bowel to skin12.11NA5.630.88NA18.62090
    44310AIleostomy/jejunostomy15.95NA6.881.13NA23.96090
    44312ARevision of ileostomy8.02NA4.090.54NA12.65090
    44314ARevision of ileostomy15.05NA6.710.99NA22.75090
    44316ADevise bowel pouch21.09NA8.711.41NA31.21090
    44320AColostomy17.64NA7.831.28NA26.75090
    44322AColostomy with biopsies11.98NA8.751.18NA21.91090
    44340ARevision of colostomy7.72NA4.350.56NA12.63090
    44345ARevision of colostomy15.43NA7.031.11NA23.57090
    44346ARevision of colostomy16.99NA7.541.20NA25.73090
    44360ASmall bowel endoscopy2.59NA1.360.14NA4.09000
    44361ASmall bowel endoscopy/biopsy2.87NA1.450.15NA4.47000
    44363ASmall bowel endoscopy3.50NA1.640.19NA5.33000
    44364ASmall bowel endoscopy3.74NA1.760.21NA5.71000
    44365ASmall bowel endoscopy3.31NA1.630.18NA5.12000
    44366ASmall bowel endoscopy4.41NA2.010.22NA6.64000
    44369ASmall bowel endoscopy4.52NA2.010.23NA6.76000
    44370ASmall bowel endoscopy/stent4.80NA2.150.21NA7.16000
    44372ASmall bowel endoscopy4.41NA2.000.27NA6.68000
    44373ASmall bowel endoscopy3.50NA1.720.19NA5.41000
    44376ASmall bowel endoscopy5.26NA2.300.29NA7.85000
    44377ASmall bowel endoscopy/biopsy5.53NA2.430.28NA8.24000
    44378ASmall bowel endoscopy7.13NA2.990.37NA10.49000
    44379AS bowel endoscope w/stent7.47NA3.110.38NA10.96000
    44380ASmall bowel endoscopy1.05NA0.780.08NA1.91000
    44382ASmall bowel endoscopy1.27NA0.870.09NA2.23000
    44383AIleoscopy w/stent2.94NA1.420.13NA4.49000
    44385AEndoscopy of bowel pouch1.824.530.960.126.472.90000
    44386AEndoscopy, bowel pouch/biop2.125.991.090.158.263.36000
    44388AColon endoscopy2.826.491.380.189.494.38000
    44389AColonoscopy with biopsy3.137.241.510.1810.554.82000
    44390AColonoscopy for foreign body3.836.961.730.2211.015.78000
    44391AColonoscopy for bleeding4.326.011.730.2310.566.28000
    44392AColonoscopy & polypectomy3.827.441.740.2311.495.79000
    44393AColonoscopy, lesion removal4.847.762.120.2712.877.23000
    44394AColonoscopy w/snare4.437.961.980.2612.656.67000
    44397AColonoscopy w/stent4.71NA2.060.28NA7.05000
    44500AIntro, gastrointestinal tube0.49NA0.360.02NA0.87000
    44602ASuture, small intestine16.03NA6.631.07NA23.73090
    44603ASuture, small intestine18.66NA7.521.39NA27.57090
    44604ASuture, large intestine16.03NA6.691.42NA24.14090
    44605ARepair of bowel lesion19.53NA8.661.54NA29.73090
    44615AIntestinal stricturoplasty15.93NA6.891.39NA24.21090
    44620ARepair bowel opening12.20NA5.481.05NA18.73090
    44625ARepair bowel opening15.05NA6.491.30NA22.84090
    44626ARepair bowel opening25.36NA10.092.53NA37.98090
    44640ARepair bowel-skin fistula21.65NA8.821.46NA31.93090
    44650ARepair bowel fistula22.57NA9.131.49NA33.19090
    Start Printed Page 80088
    44660ARepair bowel-bladder fistula21.36NA8.561.14NA31.06090
    44661ARepair bowel-bladder fistula24.81NA9.801.53NA36.14090
    44680ASurgical revision, intestine15.40NA6.641.37NA23.41090
    44700ASuspend bowel w/prosthesis16.11NA6.881.21NA24.20090
    44701AIntraop colon lavage add-on3.10NA1.070.21NA4.38ZZZ
    44799CIntestine surgery procedure0.000.000.000.000.000.00YYY
    44800AExcision of bowel pouch11.23NA5.501.11NA17.84090
    44820AExcision of mesentery lesion12.09NA5.631.03NA18.75090
    44850ARepair of mesentery10.74NA5.130.99NA16.86090
    44899CBowel surgery procedure0.000.000.000.000.000.00YYY
    44900ADrain app abscess, open10.14NA4.870.84NA15.85090
    44901ADrain app abscess, percut3.38NA4.510.17NA8.06000
    44950AAppendectomy10.00NA4.500.88NA15.38090
    44955AAppendectomy add-on1.53NA0.550.16NA2.24ZZZ
    44960AAppendectomy12.34NA5.521.09NA18.95090
    44970ALaparoscopy, appendectomy8.70NA4.220.88NA13.80090
    44979CLaparoscope proc, app0.000.000.000.000.000.00YYY
    45000ADrainage of pelvic abscess4.52NA3.080.37NA7.97090
    45005ADrainage of rectal abscess1.994.511.570.186.683.74010
    45020ADrainage of rectal abscess4.72NA3.380.41NA8.51090
    45100ABiopsy of rectum3.68NA2.490.33NA6.50090
    45108ARemoval of anorectal lesion4.76NA3.020.46NA8.24090
    45110ARemoval of rectum28.00NA12.512.26NA42.77090
    45111APartial removal of rectum16.48NA7.351.60NA25.43090
    45112ARemoval of rectum30.54NA12.072.35NA44.96090
    45113APartial proctectomy30.58NA12.982.13NA45.69090
    45114APartial removal of rectum27.32NA11.192.28NA40.79090
    45116APartial removal of rectum24.58NA10.222.00NA36.80090
    45119ARemove rectum w/reservoir30.84NA12.852.13NA45.82090
    45120ARemoval of rectum24.60NA10.312.28NA37.19090
    45121ARemoval of rectum and colon27.04NA11.342.66NA41.04090
    45123APartial proctectomy16.71NA7.021.04NA24.77090
    45126APelvic exenteration45.16NA19.413.23NA67.80090
    45130AExcision of rectal prolapse16.44NA6.931.12NA24.49090
    45135AExcision of rectal prolapse19.28NA8.541.52NA29.34090
    45136AExcise ileoanal reservior27.30NA12.312.72NA42.33090
    45150AExcision of rectal stricture5.67NA3.080.46NA9.21090
    45160AExcision of rectal lesion15.32NA6.781.07NA23.17090
    45170AExcision of rectal lesion11.49NA5.390.89NA17.77090
    45190ADestruction, rectal tumor9.74NA5.120.76NA15.62090
    45300AProctosigmoidoscopy dx0.381.330.230.051.760.66000
    45303AProctosigmoidoscopy dilate0.441.580.260.062.080.76000
    45305AProctosigmoidoscopy w/bx1.011.580.450.092.681.55000
    45307AProctosigmoidoscopy fb0.942.520.420.153.611.51000
    45308AProctosigmoidoscopy removal0.831.520.390.132.481.35000
    45309AProctosigmoidoscopy removal2.012.390.790.174.572.97000
    45315AProctosigmoidoscopy removal1.402.550.590.204.152.19000
    45317AProctosigmoidoscopy bleed1.501.840.620.203.542.32000
    45320AProctosigmoidoscopy ablate1.581.800.660.203.582.44000
    45321AProctosigmoidoscopy volvul1.17NA0.510.17NA1.85000
    45327AProctosigmoidoscopy w/stent1.65NA0.860.10NA2.61000
    45330ADiagnostic sigmoidoscopy0.961.820.520.052.831.53000
    45331ASigmoidoscopy and biopsy1.152.240.530.073.461.75000
    45332ASigmoidoscopy w/fb removal1.793.960.750.115.862.65000
    45333ASigmoidoscopy & polypectomy1.793.570.750.125.482.66000
    45334ASigmoidoscopy for bleeding2.73NA1.080.16NA3.97000
    45335ASigmoidoscope w/submuc inj1.362.480.650.073.912.08000
    45337ASigmoidoscopy & decompress2.36NA0.950.15NA3.46000
    45338ASigmoidoscpy w/tumr remove2.344.290.950.156.783.44000
    45339ASigmoidoscopy w/ablate tumr3.143.261.230.176.574.54000
    45340ASig w/balloon dilation1.667.190.760.078.922.49000
    45341ASigmoidoscopy w/ultrasound2.60NA1.370.20NA4.17000
    45342ASigmoidoscopy w/us guide bx4.06NA1.810.23NA6.10000
    45345ASigmoidoscopy w/stent2.92NA1.400.15NA4.47000
    45355ASurgical colonoscopy3.52NA1.240.26NA5.02000
    45378ADiagnostic colonoscopy3.708.031.720.2011.935.62000
    4537853ADiagnostic colonoscopy0.961.820.520.052.831.53000
    45379AColonoscopy w/fb removal4.698.342.080.2513.287.02000
    45380AColonoscopy and biopsy4.448.462.000.2113.116.65000
    45381AColonoscope, submucous inj4.206.151.700.2110.566.11000
    45382AColonoscopy/control bleeding5.699.732.230.2715.698.19000
    45383ALesion removal colonoscopy5.879.342.500.3215.538.69000
    45384ALesion remove colonoscopy4.709.072.090.2414.017.03000
    45385ALesion removal colonoscopy5.319.242.310.2814.837.90000
    45386AColonoscope dilate stricture4.5815.291.840.2120.086.63000
    Start Printed Page 80089
    45387AColonoscopy w/stent5.91NA2.520.33NA8.76000
    45500ARepair of rectum7.29NA4.140.56NA11.99090
    45505ARepair of rectum7.58NA3.700.50NA11.78090
    45520ATreatment of rectal prolapse0.550.770.190.041.360.78000
    45540ACorrect rectal prolapse16.27NA7.901.17NA25.34090
    45541ACorrect rectal prolapse13.40NA6.780.88NA21.06090
    45550ARepair rectum/remove sigmoid23.00NA10.151.58NA34.73090
    45560ARepair of rectocele10.58NA5.890.73NA17.20090
    45562AExploration/repair of rectum15.38NA7.301.15NA23.83090
    45563AExploration/repair of rectum23.47NA10.901.84NA36.21090
    45800ARepair rect/bladder fistula17.77NA7.911.14NA26.82090
    45805ARepair fistula w/colostomy20.78NA9.911.47NA32.16090
    45820ARepair rectourethral fistula18.48NA8.151.17NA27.80090
    45825ARepair fistula w/colostomy21.25NA10.130.97NA32.35090
    45900AReduction of rectal prolapse2.61NA1.020.17NA3.80010
    45905ADilation of anal sphincter2.3011.460.940.1413.903.38010
    45910ADilation of rectal narrowing2.8015.871.120.1418.814.06010
    45915ARemove rectal obstruction3.144.651.100.177.964.41010
    45999CRectum surgery procedure0.000.000.000.000.000.00YYY
    46020APlacement of seton2.903.122.380.226.245.50010
    46030ARemoval of rectal marker1.233.001.190.114.342.53010
    46040AIncision of rectal abscess4.965.343.050.4810.788.49090
    46045AIncision of rectal abscess4.32NA2.770.40NA7.49090
    46050AIncision of anal abscess1.193.521.320.114.822.62010
    46060AIncision of rectal abscess5.69NA3.710.52NA9.92090
    46070AIncision of anal septum2.71NA2.400.27NA5.38090
    46080AIncision of anal sphincter2.493.611.600.236.334.32010
    46083AIncise external hemorrhoid1.404.661.530.126.183.05010
    46200ARemoval of anal fissure3.423.842.350.307.566.07090
    46210ARemoval of anal crypt2.675.082.170.268.015.10090
    46211ARemoval of anal crypts4.255.202.880.379.827.50090
    46220ARemoval of anal tag1.561.260.550.142.962.25010
    46221ALigation of hemorrhoid(s)2.041.711.070.123.873.23010
    46230ARemoval of anal tags2.574.261.650.227.054.44010
    46250AHemorrhoidectomy3.895.322.650.439.646.97090
    46255AHemorrhoidectomy4.606.002.870.5111.117.98090
    46257ARemove hemorrhoids & fissure5.40NA3.050.59NA9.04090
    46258ARemove hemorrhoids & fistula5.73NA3.190.64NA9.56090
    46260AHemorrhoidectomy6.37NA3.920.68NA10.97090
    46261ARemove hemorrhoids & fissure7.08NA4.040.70NA11.82090
    46262ARemove hemorrhoids & fistula7.50NA4.260.76NA12.52090
    46270ARemoval of anal fistula3.725.012.560.369.096.64090
    46275ARemoval of anal fistula4.564.662.760.409.627.72090
    46280ARemoval of anal fistula5.98NA3.690.50NA10.17090
    46285ARemoval of anal fistula4.094.072.600.348.507.03090
    46288ARepair anal fistula7.13NA4.190.60NA11.92090
    46320ARemoval of hemorrhoid clot1.613.861.540.145.613.29010
    46500AInjection into hemorrhoid(s)1.612.710.570.124.442.30010
    46600ADiagnostic anoscopy0.500.800.150.041.340.69000
    46604AAnoscopy and dilation1.310.960.460.092.361.86000
    46606AAnoscopy and biopsy0.810.870.280.071.751.16000
    46608AAnoscopy, remove for body1.511.830.470.133.472.11000
    46610AAnoscopy, remove lesion1.321.420.470.122.861.91000
    46611AAnoscopy1.812.000.640.153.962.60000
    46612AAnoscopy, remove lesions2.342.450.840.184.973.36000
    46614AAnoscopy, control bleeding2.011.790.690.143.942.84000
    46615AAnoscopy2.681.730.940.234.643.85000
    46700ARepair of anal stricture9.13NA4.640.56NA14.33090
    46705ARepair of anal stricture6.90NA4.060.73NA11.69090
    46706ARepr of anal fistula w/glue2.39NA1.240.17NA3.80010
    46715ARepair of anovaginal fistula7.20NA4.230.76NA12.19090
    46716ARepair of anovaginal fistula15.07NA7.381.30NA23.75090
    46730AConstruction of absent anus26.75NA12.232.03NA41.01090
    46735AConstruction of absent anus32.17NA14.082.64NA48.89090
    46740AConstruction of absent anus30.00NA12.541.99NA44.53090
    46742ARepair of imperforated anus35.80NA18.002.63NA56.43090
    46744ARepair of cloacal anomaly52.63NA21.432.27NA76.33090
    46746ARepair of cloacal anomaly58.22NA25.902.51NA86.63090
    46748ARepair of cloacal anomaly64.21NA25.752.77NA92.73090
    46750ARepair of anal sphincter10.25NA5.630.69NA16.57090
    46751ARepair of anal sphincter8.77NA6.380.78NA15.93090
    46753AReconstruction of anus8.29NA4.010.58NA12.88090
    46754ARemoval of suture from anus2.205.441.360.127.763.68010
    46760ARepair of anal sphincter14.43NA7.070.86NA22.36090
    46761ARepair of anal sphincter13.84NA6.570.84NA21.25090
    Start Printed Page 80090
    46762AImplant artificial sphincter12.71NA5.720.71NA19.14090
    46900ADestruction, anal lesion(s)1.913.440.750.135.482.79010
    46910ADestruction, anal lesion(s)1.863.741.460.145.743.46010
    46916ACryosurgery, anal lesion(s)1.863.361.670.095.313.62010
    46917ALaser surgery, anal lesions1.864.721.520.166.743.54010
    46922AExcision of anal lesion(s)1.863.861.430.175.893.46010
    46924ADestruction, anal lesion(s)2.765.091.690.208.054.65010
    46934ADestruction of hemorrhoids3.516.233.580.2610.007.35090
    46935ADestruction of hemorrhoids2.434.230.860.176.833.46010
    46936ADestruction of hemorrhoids3.695.913.430.309.907.42090
    46937ACryotherapy of rectal lesion2.694.411.770.127.224.58010
    46938ACryotherapy of rectal lesion4.665.033.250.4010.098.31090
    46940ATreatment of anal fissure2.323.140.810.175.633.30010
    46942ATreatment of anal fissure2.042.860.690.145.042.87010
    46945ALigation of hemorrhoids1.843.932.150.175.944.16090
    46946ALigation of hemorrhoids2.584.992.450.227.795.25090
    46999CAnus surgery procedure0.000.000.000.000.000.00YYY
    47000ANeedle biopsy of liver1.908.240.650.0910.232.64000
    47001ANeedle biopsy, liver add-on1.90NA0.670.18NA2.75ZZZ
    47010AOpen drainage, liver lesion16.01NA9.660.65NA26.32090
    47011APercut drain, liver lesion3.70NA4.380.17NA8.25000
    47015AInject/aspirate liver cyst15.11NA7.840.86NA23.81090
    47100AWedge biopsy of liver11.67NA6.300.75NA18.72090
    47120APartial removal of liver35.50NA16.552.29NA54.34090
    47122AExtensive removal of liver55.13NA23.433.60NA82.16090
    47125APartial removal of liver49.19NA21.423.18NA73.79090
    47130APartial removal of liver53.35NA22.883.47NA79.70090
    47133XRemoval of donor liver0.000.000.000.000.000.00XXX
    47134RPartial removal, donor liver39.15NA13.563.98NA56.69XXX
    47135RTransplantation of liver81.52NA42.528.13NA132.17090
    47136RTransplantation of liver68.60NA41.836.93NA117.36090
    47300ASurgery for liver lesion15.08NA7.530.97NA23.58090
    47350ARepair liver wound19.56NA9.211.25NA30.02090
    47360ARepair liver wound26.92NA12.511.71NA41.14090
    47361ARepair liver wound47.12NA19.573.11NA69.80090
    47362ARepair liver wound18.51NA9.541.22NA29.27090
    47370ALaparo ablate liver tumor rf19.69NA9.720.85NA30.26090
    47371ALaparo ablate liver cryosurg19.69NA9.720.85NA30.26090
    47379CLaparoscope procedure, liver0.000.000.000.000.000.00YYY
    47380AOpen ablate liver tumor rf23.00NA11.010.85NA34.86090
    47381AOpen ablate liver tumor cryo23.27NA11.120.85NA35.24090
    47382APercut ablate liver rf15.19NA6.251.14NA22.58010
    47399CLiver surgery procedure0.000.000.000.000.000.00YYY
    47400AIncision of liver duct32.49NA14.441.82NA48.75090
    47420AIncision of bile duct19.88NA9.151.70NA30.73090
    47425AIncision of bile duct19.83NA9.221.60NA30.65090
    47460AIncise bile duct sphincter18.04NA8.961.24NA28.24090
    47480AIncision of gallbladder10.82NA6.580.85NA18.25090
    47490AIncision of gallbladder7.23NA7.490.33NA15.05090
    47500AInjection for liver x-rays1.96NA0.660.09NA2.71000
    47505AInjection for liver x-rays0.762.650.260.033.441.05000
    47510AInsert catheter, bile duct7.83NA4.690.36NA12.88090
    47511AInsert bile duct drain10.50NA10.370.47NA21.34090
    47525AChange bile duct catheter5.55NA3.250.24NA9.04010
    47530ARevise/reinsert bile tube5.85NA4.930.29NA11.07090
    47550ABile duct endoscopy add-on3.02NA1.040.30NA4.36ZZZ
    47552ABiliary endoscopy thru skin6.04NA2.440.42NA8.90000
    47553ABiliary endoscopy thru skin6.35NA2.640.30NA9.29000
    47554ABiliary endoscopy thru skin9.06NA3.440.74NA13.24000
    47555ABiliary endoscopy thru skin7.56NA3.050.35NA10.96000
    47556ABiliary endoscopy thru skin8.56NA3.390.38NA12.33000
    47560ALaparoscopy w/cholangio4.89NA1.840.49NA7.22000
    47561ALaparo w/cholangio/biopsy5.18NA2.130.49NA7.80000
    47562ALaparoscopic cholecystectomy11.09NA5.011.13NA17.23090
    47563ALaparo cholecystectomy/graph11.94NA5.271.21NA18.42090
    47564ALaparo cholecystectomy/explr14.23NA6.081.44NA21.75090
    47570ALaparo cholecystoenterostomy12.58NA5.501.28NA19.36090
    47579CLaparoscope proc, biliary0.000.000.000.000.000.00YYY
    47600ARemoval of gallbladder13.58NA6.671.16NA21.41090
    47605ARemoval of gallbladder14.69NA7.031.25NA22.97090
    47610ARemoval of gallbladder18.82NA8.591.61NA29.02090
    47612ARemoval of gallbladder18.78NA8.451.60NA28.83090
    47620ARemoval of gallbladder20.64NA9.121.77NA31.53090
    47630ARemove bile duct stone9.11NA3.080.46NA12.65090
    47700AExploration of bile ducts15.62NA8.511.40NA25.53090
    Start Printed Page 80091
    47701ABile duct revision27.81NA13.063.00NA43.87090
    47711AExcision of bile duct tumor23.03NA11.021.98NA36.03090
    47712AExcision of bile duct tumor30.24NA13.632.67NA46.54090
    47715AExcision of bile duct cyst18.80NA8.751.59NA29.14090
    47716AFusion of bile duct cyst16.44NA8.201.41NA26.05090
    47720AFuse gallbladder & bowel15.91NA8.481.37NA25.76090
    47721AFuse upper gi structures19.12NA9.601.63NA30.35090
    47740AFuse gallbladder & bowel18.48NA9.401.59NA29.47090
    47741AFuse gallbladder & bowel21.34NA10.331.82NA33.49090
    47760AFuse bile ducts and bowel25.85NA11.932.21NA39.99090
    47765AFuse liver ducts & bowel24.88NA12.372.18NA39.43090
    47780AFuse bile ducts and bowel26.50NA12.172.27NA40.94090
    47785AFuse bile ducts and bowel31.18NA14.492.69NA48.36090
    47800AReconstruction of bile ducts23.30NA11.151.95NA36.40090
    47801APlacement, bile duct support15.17NA10.030.69NA25.89090
    47802AFuse liver duct & intestine21.55NA11.131.84NA34.52090
    47900ASuture bile duct injury19.90NA9.911.65NA31.46090
    47999CBile tract surgery procedure0.000.000.000.000.000.00YYY
    48000ADrainage of abdomen28.07NA12.401.32NA41.79090
    48001APlacement of drain, pancreas35.45NA14.701.90NA52.05090
    48005AResect/debride pancreas42.17NA16.992.26NA61.42090
    48020ARemoval of pancreatic stone15.70NA7.381.36NA24.44090
    48100ABiopsy of pancreas, open12.23NA6.831.08NA20.14090
    48102ANeedle biopsy, pancreas4.688.842.380.2013.727.26010
    48120ARemoval of pancreas lesion15.85NA7.361.35NA24.56090
    48140APartial removal of pancreas22.94NA10.512.12NA35.57090
    48145APartial removal of pancreas24.02NA11.182.25NA37.45090
    48146APancreatectomy26.40NA13.292.43NA42.12090
    48148ARemoval of pancreatic duct17.34NA8.981.61NA27.93090
    48150APartial removal of pancreas48.00NA21.384.43NA73.81090
    48152APancreatectomy43.75NA20.254.07NA68.07090
    48153APancreatectomy47.89NA21.584.40NA73.87090
    48154APancreatectomy44.10NA20.134.10NA68.33090
    48155ARemoval of pancreas24.64NA13.482.30NA40.42090
    48160NPancreas removal/transplant0.000.000.000.000.000.00XXX
    48180AFuse pancreas and bowel24.72NA10.852.24NA37.81090
    48400AInjection, intraop add-on1.95NA0.670.10NA2.72ZZZ
    48500ASurgery of pancreatic cyst15.28NA7.241.35NA23.87090
    48510ADrain pancreatic pseudocyst14.31NA7.491.07NA22.87090
    48511ADrain pancreatic pseudocyst4.00NA3.720.17NA7.89000
    48520AFuse pancreas cyst and bowel15.59NA7.211.41NA24.21090
    48540AFuse pancreas cyst and bowel19.72NA8.621.82NA30.16090
    48545APancreatorrhaphy18.18NA8.681.61NA28.47090
    48547ADuodenal exclusion25.83NA10.792.30NA38.92090
    48550XDonor pancreatectomy0.000.000.000.000.000.00XXX
    48554RTranspl allograft pancreas34.17NA11.943.30NA49.41090
    48556ARemoval, allograft pancreas15.71NA8.461.52NA25.69090
    48999CPancreas surgery procedure0.000.000.000.000.000.00YYY
    49000AExploration of abdomen11.68NA6.061.17NA18.91090
    49002AReopening of abdomen10.49NA5.961.06NA17.51090
    49010AExploration behind abdomen12.28NA6.931.22NA20.43090
    49020ADrain abdominal abscess22.84NA11.411.31NA35.56090
    49021ADrain abdominal abscess3.38NA5.280.16NA8.82000
    49040ADrain, open, abdom abscess13.52NA8.190.84NA22.55090
    49041ADrain, percut, abdom abscess4.00NA5.610.18NA9.79000
    49060ADrain, open, retrop abscess15.86NA9.580.77NA26.21090
    49061ADrain, percut, retroper absc3.70NA5.620.17NA9.49000
    49062ADrain to peritoneal cavity11.36NA7.071.08NA19.51090
    49080APuncture, peritoneal cavity1.354.390.470.075.811.89000
    49081ARemoval of abdominal fluid1.263.070.580.064.391.90000
    49085ARemove abdomen foreign body12.14NA6.560.88NA19.58090
    49180ABiopsy, abdominal mass1.738.220.590.0810.032.40000
    49200ARemoval of abdominal lesion10.25NA6.270.92NA17.44090
    49201ARemove abdom lesion, complex14.84NA8.561.47NA24.87090
    49215AExcise sacral spine tumor33.50NA14.742.48NA50.72090
    49220AMultiple surgery, abdomen14.88NA7.631.51NA24.02090
    49250AExcision of umbilicus8.35NA5.080.84NA14.27090
    49255ARemoval of omentum11.14NA6.491.12NA18.75090
    49320ADiag laparo separate proc5.10NA3.010.50NA8.61010
    49321ALaparoscopy, biopsy5.40NA2.990.53NA8.92010
    49322ALaparoscopy, aspiration5.70NA3.420.57NA9.69010
    49323ALaparo drain lymphocele9.48NA4.030.88NA14.39090
    49329CLaparo proc, abdm/per/oment0.000.000.000.000.000.00YYY
    49400AAir injection into abdomen1.88NA0.800.11NA2.79000
    49419AInsrt abdom cath for chemotx6.65NA3.810.55NA11.01090
    Start Printed Page 80092
    49420AInsert abdom drain, temp2.22NA0.970.13NA3.32000
    49421AInsert abdom drain, perm5.54NA4.060.55NA10.15090
    49422ARemove perm cannula/catheter6.25NA2.930.63NA9.81010
    49423AExchange drainage catheter1.46NA0.680.07NA2.21000
    49424AAssess cyst, contrast inject0.76NA0.440.03NA1.23000
    49425AInsert abdomen-venous drain11.37NA6.691.21NA19.27090
    49426ARevise abdomen-venous shunt9.63NA6.070.93NA16.63090
    49427AInjection, abdominal shunt0.89NA0.480.05NA1.42000
    49428ALigation of shunt6.06NA3.160.31NA9.53010
    49429ARemoval of shunt7.40NA3.440.81NA11.65010
    49491ARpr hern preemie reduc11.13NA5.511.10NA17.74090
    49492ARpr ing hern premie, blocked14.03NA6.281.47NA21.78090
    49495ARpr ing hernia baby, reduc5.89NA3.480.58NA9.95090
    49496ARpr ing hernia baby, blocked8.79NA6.110.92NA15.82090
    49500ARpr ing hernia, init, reduce5.48NA3.340.46NA9.28090
    49501ARpr ing hernia, init blocked8.88NA4.430.76NA14.07090
    49505APrp i/hern init reduc>5 yr7.604.484.010.6512.7312.26090
    49507APrp i/hern init block>5 yr9.57NA6.010.83NA16.41090
    49520ARerepair ing hernia, reduce9.63NA5.340.84NA15.81090
    49521ARerepair ing hernia, blocked11.97NA5.681.04NA18.69090
    49525ARepair ing hernia, sliding8.57NA4.830.74NA14.14090
    49540ARepair lumbar hernia10.39NA5.510.90NA16.80090
    49550ARpr rem hernia, init, reduce8.63NA4.420.75NA13.80090
    49553ARpr fem hernia, init blocked9.44NA4.840.83NA15.11090
    49555ARerepair fem hernia, reduce9.03NA5.170.79NA14.99090
    49557ARerepair fem hernia, blocked11.15NA5.420.97NA17.54090
    49560ARpr ventral hern init, reduc11.57NA5.951.00NA18.52090
    49561ARpr ventral hern init, block14.25NA6.531.23NA22.01090
    49565ARerepair ventrl hern, reduce11.57NA6.111.00NA18.68090
    49566ARerepair ventrl hern, block14.40NA6.601.24NA22.24090
    49568AHernia repair w/mesh4.89NA1.710.50NA7.10ZZZ
    49570ARpr epigastric hern, reduce5.69NA3.430.50NA9.62090
    49572ARpr epigastric hern, blocked6.73NA3.910.58NA11.22090
    49580ARpr umbil hern, reduc < 5 yr4.11NA2.920.34NA7.37090
    49582ARpr umbil hern, block < 5 yr6.65NA4.860.57NA12.08090
    49585ARpr umbil hern, reduc > 5 yr6.23NA4.040.53NA10.80090
    49587ARpr umbil hern, block > 5 yr7.56NA4.150.65NA12.36090
    49590ARepair spigilian hernia8.54NA4.850.74NA14.13090
    49600ARepair umbilical lesion10.96NA6.071.13NA18.16090
    49605ARepair umbilical lesion76.00NA29.892.57NA108.46090
    49606ARepair umbilical lesion18.60NA9.062.22NA29.88090
    49610ARepair umbilical lesion10.50NA6.770.77NA18.04090
    49611ARepair umbilical lesion8.92NA9.640.65NA19.21090
    49650ALaparo hernia repair initial6.27NA3.230.64NA10.14090
    49651ALaparo hernia repair recur8.24NA4.280.84NA13.36090
    49659CLaparo proc, hernia repair0.000.000.000.000.000.00YYY
    49900ARepair of abdominal wall12.28NA6.651.23NA20.16090
    49904AOmental flap, extra-abdom20.00NA15.981.91NA37.89090
    49905AOmental flap, intra-abdom6.55NA2.340.61NA9.50ZZZ
    49906CFree omental flap, microvasc0.000.000.000.000.000.00090
    49999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    50010AExploration of kidney10.98NA6.480.79NA18.25090
    50020ARenal abscess, open drain14.66NA13.740.80NA29.20090
    50021ARenal abscess, percut drain3.38NA9.980.15NA13.51000
    50040ADrainage of kidney14.94NA10.830.82NA26.59090
    50045AExploration of kidney15.46NA7.881.06NA24.40090
    50060ARemoval of kidney stone19.30NA9.131.14NA29.57090
    50065AIncision of kidney20.79NA8.011.13NA29.93090
    50070AIncision of kidney20.32NA9.531.20NA31.05090
    50075ARemoval of kidney stone25.34NA11.611.51NA38.46090
    50080ARemoval of kidney stone14.71NA9.630.86NA25.20090
    50081ARemoval of kidney stone21.80NA11.661.30NA34.76090
    50100ARevise kidney blood vessels16.09NA9.661.64NA27.39090
    50120AExploration of kidney15.91NA8.081.04NA25.03090
    50125AExplore and drain kidney16.52NA8.361.07NA25.95090
    50130ARemoval of kidney stone17.29NA8.411.04NA26.74090
    50135AExploration of kidney19.18NA9.051.18NA29.41090
    50200ABiopsy of kidney2.63NA0.930.12NA3.68000
    50205ABiopsy of kidney11.31NA6.200.94NA18.45090
    50220ARemove kidney, open17.15NA8.571.16NA26.88090
    50225ARemoval kidney open, complex20.23NA9.461.26NA30.95090
    50230ARemoval kidney open, radical22.07NA10.041.35NA33.46090
    50234ARemoval of kidney & ureter22.40NA10.141.37NA33.91090
    50236ARemoval of kidney & ureter24.86NA12.691.50NA39.05090
    50240APartial removal of kidney22.00NA11.821.36NA35.18090
    Start Printed Page 80093
    50280ARemoval of kidney lesion15.67NA7.950.99NA24.61090
    50290ARemoval of kidney lesion14.73NA7.801.11NA23.64090
    50300XRemoval of donor kidney0.000.000.000.000.000.00XXX
    50320ARemoval of donor kidney22.21NA10.241.78NA34.23090
    50340ARemoval of kidney12.15NA9.071.15NA22.37090
    50360ATransplantation of kidney31.53NA17.432.97NA51.93090
    50365ATransplantation of kidney36.81NA21.073.51NA61.39090
    50370ARemove transplanted kidney13.72NA9.471.26NA24.45090
    50380AReimplantation of kidney20.76NA13.491.80NA36.05090
    50390ADrainage of kidney lesion1.96NA0.660.09NA2.71000
    50392AInsert kidney drain3.38NA1.130.15NA4.66000
    50393AInsert ureteral tube4.16NA1.390.18NA5.73000
    50394AInjection for kidney x-ray0.762.440.260.043.241.06000
    50395ACreate passage to kidney3.38NA1.130.16NA4.67000
    50396AMeasure kidney pressure2.09NA0.870.10NA3.06000
    50398AChange kidney tube1.461.190.490.072.722.02000
    50400ARevision of kidney/ureter19.50NA9.191.21NA29.90090
    50405ARevision of kidney/ureter23.93NA11.441.45NA36.82090
    50500ARepair of kidney wound19.57NA10.591.45NA31.61090
    50520AClose kidney-skin fistula17.23NA10.041.26NA28.53090
    50525ARepair renal-abdomen fistula22.27NA11.991.51NA35.77090
    50526ARepair renal-abdomen fistula24.02NA13.431.62NA39.07090
    50540ARevision of horseshoe kidney19.93NA9.971.28NA31.18090
    50541ALaparo ablate renal cyst16.00NA6.370.99NA23.36090
    50542ALaparo ablate renal mass20.00NA8.341.36NA29.70090
    50543ALaparo partial nephrectomy25.50NA10.481.36NA37.34090
    50544ALaparoscopy, pyeloplasty22.40NA8.561.41NA32.37090
    50545ALaparo radical nephrectomy24.00NA9.141.53NA34.67090
    50546ALaparoscopic nephrectomy20.48NA7.951.37NA29.80090
    50547ALaparo removal donor kidney25.50NA10.792.04NA38.33090
    50548ALaparo remove k/ureter24.40NA9.181.49NA35.07090
    50549CLaparoscope proc, renal0.000.000.000.000.000.00YYY
    50551AKidney endoscopy5.604.061.840.339.997.77000
    50553AKidney endoscopy5.9911.312.000.3517.658.34000
    50555AKidney endoscopy & biopsy6.5313.902.170.3820.819.08000
    50557AKidney endoscopy & treatment6.6211.672.180.3918.689.19000
    50559ARenal endoscopy/radiotracer6.78NA2.310.27NA9.36000
    50561AKidney endoscopy & treatment7.5911.942.510.4419.9710.54000
    50562ARenal scope w/tumor resect10.92NA4.020.84NA15.78090
    50570AKidney endoscopy9.54NA3.130.56NA13.23000
    50572AKidney endoscopy10.35NA3.410.64NA14.40000
    50574AKidney endoscopy & biopsy11.02NA3.640.65NA15.31000
    50575AKidney endoscopy13.98NA4.600.84NA19.42000
    50576AKidney endoscopy & treatment10.99NA3.600.66NA15.25000
    50578ARenal endoscopy/radiotracer11.35NA3.730.67NA15.75000
    50580AKidney endoscopy & treatment11.86NA3.900.70NA16.46000
    50590AFragmenting of kidney stone9.0910.734.940.5420.3614.57090
    50600AExploration of ureter15.84NA8.110.99NA24.94090
    50605AInsert ureteral support15.46NA8.261.13NA24.85090
    50610ARemoval of ureter stone15.92NA8.441.08NA25.44090
    50620ARemoval of ureter stone15.16NA7.640.91NA23.71090
    50630ARemoval of ureter stone14.94NA7.600.90NA23.44090
    50650ARemoval of ureter17.41NA8.831.07NA27.31090
    50660ARemoval of ureter19.55NA9.571.19NA30.31090
    50684AInjection for ureter x-ray0.7611.210.250.0412.011.05000
    50686AMeasure ureter pressure1.512.450.670.094.052.27000
    50688AChange of ureter tube1.17NA1.690.06NA2.92010
    50690AInjection for ureter x-ray1.1611.170.390.0612.391.61000
    50700ARevision of ureter15.21NA8.750.86NA24.82090
    50715ARelease of ureter18.90NA11.711.68NA32.29090
    50722ARelease of ureter16.35NA9.561.41NA27.32090
    50725ARelease/revise ureter18.49NA9.861.44NA29.79090
    50727ARevise ureter8.18NA5.790.51NA14.48090
    50728ARevise ureter12.02NA7.550.88NA20.45090
    50740AFusion of ureter & kidney18.42NA9.091.49NA29.00090
    50750AFusion of ureter & kidney19.51NA9.631.24NA30.38090
    50760AFusion of ureters18.42NA9.371.25NA29.04090
    50770ASplicing of ureters19.51NA9.551.25NA30.31090
    50780AReimplant ureter in bladder18.36NA9.221.20NA28.78090
    50782AReimplant ureter in bladder19.54NA11.061.13NA31.73090
    50783AReimplant ureter in bladder20.55NA10.181.35NA32.08090
    50785AReimplant ureter in bladder20.52NA9.961.30NA31.78090
    50800AImplant ureter in bowel14.52NA8.990.92NA24.43090
    50810AFusion of ureter & bowel20.05NA12.281.78NA34.11090
    50815AUrine shunt to intestine19.93NA10.981.31NA32.22090
    Start Printed Page 80094
    50820AConstruct bowel bladder21.89NA11.331.38NA34.60090
    50825AConstruct bowel bladder28.18NA14.121.81NA44.11090
    50830ARevise urine flow31.28NA14.802.20NA48.28090
    50840AReplace ureter by bowel20.00NA10.921.26NA32.18090
    50845AAppendico-vesicostomy20.89NA9.621.26NA31.77090
    50860ATransplant ureter to skin15.36NA8.231.01NA24.60090
    50900ARepair of ureter13.62NA7.400.98NA22.00090
    50920AClosure ureter/skin fistula14.33NA7.950.84NA23.12090
    50930AClosure ureter/bowel fistula18.72NA9.481.57NA29.77090
    50940ARelease of ureter14.51NA7.651.04NA23.20090
    50945ALaparoscopy ureterolithotomy17.00NA6.991.15NA25.14090
    50947ALaparo new ureter/bladder24.50NA9.901.99NA36.39090
    50948ALaparo new ureter/bladder22.50NA8.851.83NA33.18090
    50949CLaparoscope proc, ureter0.000.000.000.000.000.00YYY
    50951AEndoscopy of ureter5.844.501.920.3510.698.11000
    50953AEndoscopy of ureter6.2411.222.060.3717.838.67000
    50955AUreter endoscopy & biopsy6.7516.742.260.3823.879.39000
    50957AUreter endoscopy & treatment6.7911.232.240.4018.429.43000
    50959AUreter endoscopy & tracer4.40NA1.450.18NA6.03000
    50961AUreter endoscopy & treatment6.0513.851.990.3520.258.39000
    50970AUreter endoscopy7.14NA2.360.43NA9.93000
    50972AUreter endoscopy & catheter6.89NA2.320.39NA9.60000
    50974AUreter endoscopy & biopsy9.17NA3.010.53NA12.71000
    50976AUreter endoscopy & treatment9.04NA2.990.53NA12.56000
    50978AUreter endoscopy & tracer5.10NA1.740.30NA7.14000
    50980AUreter endoscopy & treatment6.85NA2.260.41NA9.52000
    51000ADrainage of bladder0.781.870.250.052.701.08000
    51005ADrainage of bladder1.023.050.350.084.151.45000
    51010ADrainage of bladder3.534.871.930.238.635.69010
    51020AIncise & treat bladder6.71NA5.080.42NA12.21090
    51030AIncise & treat bladder6.77NA5.360.42NA12.55090
    51040AIncise & drain bladder4.40NA3.800.27NA8.47090
    51045AIncise bladder/drain ureter6.77NA5.460.47NA12.70090
    51050ARemoval of bladder stone6.92NA4.530.42NA11.87090
    51060ARemoval of ureter stone8.85NA5.650.54NA15.04090
    51065ARemove ureter calculus8.85NA5.500.53NA14.88090
    51080ADrainage of bladder abscess5.96NA5.140.35NA11.45090
    51500ARemoval of bladder cyst10.14NA5.850.88NA16.87090
    51520ARemoval of bladder lesion9.29NA5.870.58NA15.74090
    51525ARemoval of bladder lesion13.97NA7.280.85NA22.10090
    51530ARemoval of bladder lesion12.38NA7.080.82NA20.28090
    51535ARepair of ureter lesion12.57NA7.630.90NA21.10090
    51550APartial removal of bladder15.66NA7.971.05NA24.68090
    51555APartial removal of bladder21.23NA10.191.37NA32.79090
    51565ARevise bladder & ureter(s)21.62NA10.661.40NA33.68090
    51570ARemoval of bladder24.24NA11.711.59NA37.54090
    51575ARemoval of bladder & nodes30.45NA14.331.88NA46.66090
    51580ARemove bladder/revise tract31.08NA14.971.94NA47.99090
    51585ARemoval of bladder & nodes35.23NA16.072.18NA53.48090
    51590ARemove bladder/revise tract32.66NA14.902.01NA49.57090
    51595ARemove bladder/revise tract37.14NA16.332.23NA55.70090
    51596ARemove bladder/create pouch39.52NA17.602.39NA59.51090
    51597ARemoval of pelvic structures38.35NA17.282.49NA58.12090
    51600AInjection for bladder x-ray0.884.760.300.045.681.22000
    51605APreparation for bladder xray0.6412.010.220.0412.690.90000
    51610AInjection for bladder x-ray1.0512.170.350.0513.271.45000
    51700AIrrigation of bladder0.881.160.290.052.091.22000
    51701AInsert bladder catheter0.501.060.200.031.590.73000
    51702AInsert temp bladder cath0.501.970.270.032.500.80000
    51703AInsert bladder cath, complex1.471.910.590.093.472.15000
    51705AChange of bladder tube1.021.400.540.062.481.62010
    51710AChange of bladder tube1.493.241.210.094.822.79010
    51715AEndoscopic injection/implant3.743.641.240.247.625.22000
    51720ATreatment of bladder lesion1.961.410.730.123.492.81000
    51725ASimple cystometrogram1.517.29NA0.138.93NA000
    5172526ASimple cystometrogram1.510.510.510.102.122.12000
    51725TCASimple cystometrogram0.006.78NA0.036.81NA000
    51726AComplex cystometrogram1.719.35NA0.1511.21NA000
    5172626AComplex cystometrogram1.710.580.580.112.402.40000
    51726TCAComplex cystometrogram0.008.77NA0.048.81NA000
    51736AUrine flow measurement0.610.55NA0.051.21NA000
    5173626AUrine flow measurement0.610.210.210.040.860.86000
    51736TCAUrine flow measurement0.000.34NA0.010.35NA000
    51741AElectro-uroflowmetry, first1.140.79NA0.092.02NA000
    5174126AElectro-uroflowmetry, first1.140.380.380.071.591.59000
    Start Printed Page 80095
    51741TCAElectro-uroflowmetry, first0.000.41NA0.020.43NA000
    51772AUrethra pressure profile1.618.81NA0.1610.58NA000
    5177226AUrethra pressure profile1.610.570.570.122.302.30000
    51772TCAUrethra pressure profile0.008.24NA0.048.28NA000
    51784AAnal/urinary muscle study1.534.56NA0.136.22NA000
    5178426AAnal/urinary muscle study1.530.520.520.102.152.15000
    51784TCAAnal/urinary muscle study0.004.04NA0.034.07NA000
    51785AAnal/urinary muscle study1.534.68NA0.126.33NA000
    5178526AAnal/urinary muscle study1.530.520.520.092.142.14000
    51785TCAAnal/urinary muscle study0.004.16NA0.034.19NA000
    51792AUrinary reflex study1.1023.28NA0.2024.58NA000
    5179226AUrinary reflex study1.100.430.430.091.621.62000
    51792TCAUrinary reflex study0.0022.85NA0.1122.96NA000
    51795AUrine voiding pressure study1.538.93NA0.1810.64NA000
    5179526AUrine voiding pressure study1.530.520.520.102.152.15000
    51795TCAUrine voiding pressure study0.008.41NA0.088.49NA000
    51797AIntraabdominal pressure test1.604.31NA0.146.05NA000
    5179726AIntraabdominal pressure test1.600.540.540.102.242.24000
    51797TCAIntraabdominal pressure test0.003.77NA0.043.81NA000
    51798AUs urine capacity measure0.000.48NA0.070.55NAXXX
    51800ARevision of bladder/urethra17.42NA8.791.17NA27.38090
    51820ARevision of urinary tract17.89NA10.561.45NA29.90090
    51840AAttach bladder/urethra10.71NA6.310.87NA17.89090
    51841AAttach bladder/urethra13.03NA7.981.04NA22.05090
    51845ARepair bladder neck9.73NA6.130.62NA16.48090
    51860ARepair of bladder wound12.02NA7.340.89NA20.25090
    51865ARepair of bladder wound15.04NA8.181.01NA24.23090
    51880ARepair of bladder opening7.66NA5.300.54NA13.50090
    51900ARepair bladder/vagina lesion12.97NA7.620.87NA21.46090
    51920AClose bladder-uterus fistula11.81NA6.820.86NA19.49090
    51925AHysterectomy/bladder repair15.58NA9.311.48NA26.37090
    51940ACorrection of bladder defect28.43NA15.431.97NA45.83090
    51960ARevision of bladder & bowel23.01NA12.191.41NA36.61090
    51980AConstruct bladder opening11.36NA6.560.74NA18.66090
    51990ALaparo urethral suspension12.50NA6.531.02NA20.05090
    51992ALaparo sling operation14.01NA6.440.93NA21.38090
    52000ACystoscopy2.015.220.780.127.352.91000
    52001ACystoscopy, removal of clots5.457.892.330.3213.668.10000
    52005ACystoscopy & ureter catheter2.379.910.920.1512.433.44000
    52007ACystoscopy and biopsy3.02NA1.170.18NA4.37000
    52010ACystoscopy & duct catheter3.0211.791.140.1814.994.34000
    52204ACystoscopy2.3715.850.930.1518.373.45000
    52214ACystoscopy and treatment3.7146.641.360.2250.575.29000
    52224ACystoscopy and treatment3.1446.251.180.1849.574.50000
    52234ACystoscopy and treatment4.63NA1.670.27NA6.57000
    52235ACystoscopy and treatment5.45NA1.950.32NA7.72000
    52240ACystoscopy and treatment9.72NA3.370.58NA13.67000
    52250ACystoscopy and radiotracer4.50NA1.700.27NA6.47000
    52260ACystoscopy and treatment3.92NA1.460.23NA5.61000
    52265ACystoscopy and treatment2.9416.041.140.1819.164.26000
    52270ACystoscopy & revise urethra3.3723.021.320.2026.594.89000
    52275ACystoscopy & revise urethra4.7017.121.760.2822.106.74000
    52276ACystoscopy and treatment5.0023.831.880.3029.137.18000
    52277ACystoscopy and treatment6.17NA2.310.38NA8.86000
    52281ACystoscopy and treatment2.808.591.100.1711.564.07000
    52282ACystoscopy, implant stent6.4081.322.290.3888.109.07000
    52283ACystoscopy and treatment3.7413.841.410.2217.805.37000
    52285ACystoscopy and treatment3.619.791.370.2213.625.20000
    52290ACystoscopy and treatment4.59NA1.690.27NA6.55000
    52300ACystoscopy and treatment5.31NA1.950.32NA7.58000
    52301ACystoscopy and treatment5.51NA2.040.39NA7.94000
    52305ACystoscopy and treatment5.31NA1.900.31NA7.52000
    52310ACystoscopy and treatment2.815.381.050.178.364.03000
    52315ACystoscopy and treatment5.217.671.880.3113.197.40000
    52317ARemove bladder stone6.7237.822.340.4044.949.46000
    52318ARemove bladder stone9.19NA3.170.54NA12.90000
    52320ACystoscopy and treatment4.70NA1.680.28NA6.66000
    52325ACystoscopy, stone removal6.16NA2.170.37NA8.70000
    52327ACystoscopy, inject material5.19NA1.870.32NA7.38000
    52330ACystoscopy and treatment5.0418.511.790.3023.857.13000
    52332ACystoscopy and treatment2.8314.971.070.1717.974.07000
    52334ACreate passage to kidney4.83NA1.800.28NA6.91000
    52341ACysto w/ureter stricture tx6.00NA2.260.37NA8.63000
    52342ACysto w/up stricture tx6.50NA2.410.40NA9.31000
    52343ACysto w/renal stricture tx7.20NA2.690.44NA10.33000
    Start Printed Page 80096
    52344ACysto/uretero, stone remove7.70NA2.870.47NA11.04000
    52345ACysto/uretero w/up stricture8.20NA3.030.50NA11.73000
    52346ACystouretero w/renal strict9.23NA3.380.57NA13.18000
    52347ACystoscopy, resect ducts5.28NA2.090.33NA7.70000
    52351ACystouretero & or pyeloscope5.86NA2.190.36NA8.41000
    52352ACystouretero w/stone remove6.88NA2.570.42NA9.87000
    52353ACystouretero w/lithotripsy7.97NA2.930.49NA11.39000
    52354ACystouretero w/biopsy7.34NA2.740.45NA10.53000
    52355ACystouretero w/excise tumor8.82NA3.220.55NA12.59000
    52400ACystouretero w/congen repr9.68NA4.310.60NA14.59090
    52450AIncision of prostate7.64NA3.650.46NA11.75090
    52500ARevision of bladder neck8.47NA3.910.50NA12.88090
    52510ADilation prostatic urethra6.72NA3.240.40NA10.36090
    52601AProstatectomy (TURP)12.37NA5.230.74NA18.34090
    52606AControl postop bleeding8.13NA3.560.49NA12.18090
    52612AProstatectomy, first stage7.98NA3.830.48NA12.29090
    52614AProstatectomy, second stage6.84NA3.420.41NA10.67090
    52620ARemove residual prostate6.61NA3.080.39NA10.08090
    52630ARemove prostate regrowth7.26NA3.200.43NA10.89090
    52640ARelieve bladder contracture6.62NA3.100.39NA10.11090
    52647ALaser surgery of prostate10.3633.414.660.6144.3815.63090
    52648ALaser surgery of prostate11.21NA4.780.66NA16.65090
    52700ADrainage of prostate abscess6.80NA3.240.41NA10.45090
    53000AIncision of urethra2.287.312.230.139.724.64010
    53010AIncision of urethra3.64NA4.080.20NA7.92090
    53020AIncision of urethra1.773.050.660.114.932.54000
    53025AIncision of urethra1.133.040.450.074.241.65000
    53040ADrainage of urethra abscess6.4010.666.470.4117.4713.28090
    53060ADrainage of urethra abscess2.635.912.670.238.775.53010
    53080ADrainage of urinary leakage6.29NA6.480.42NA13.19090
    53085ADrainage of urinary leakage10.27NA7.860.67NA18.80090
    53200ABiopsy of urethra2.594.180.950.176.943.71000
    53210ARemoval of urethra12.57NA7.490.81NA20.87090
    53215ARemoval of urethra15.58NA8.080.93NA24.59090
    53220ATreatment of urethra lesion7.00NA5.080.44NA12.52090
    53230ARemoval of urethra lesion9.58NA5.800.60NA15.98090
    53235ARemoval of urethra lesion10.14NA6.000.60NA16.74090
    53240ASurgery for urethra pouch6.45NA4.850.42NA11.72090
    53250ARemoval of urethra gland5.89NA4.240.35NA10.48090
    53260ATreatment of urethra lesion2.985.302.240.238.515.45010
    53265ATreatment of urethra lesion3.125.132.190.208.455.51010
    53270ARemoval of urethra gland3.095.052.450.218.355.75010
    53275ARepair of urethra defect4.53NA3.040.28NA7.85010
    53400ARevise urethra, stage 112.77NA7.420.85NA21.04090
    53405ARevise urethra, stage 214.48NA7.700.91NA23.09090
    53410AReconstruction of urethra16.44NA8.430.99NA25.86090
    53415AReconstruction of urethra19.41NA8.991.16NA29.56090
    53420AReconstruct urethra, stage 114.08NA8.530.90NA23.51090
    53425AReconstruct urethra, stage 215.98NA8.490.97NA25.44090
    53430AReconstruction of urethra16.34NA8.621.01NA25.97090
    53431AReconstruct urethra/bladder19.89NA9.041.30NA30.23090
    53440AMale sling procedure13.62NA6.330.73NA20.68090
    53442ARemove/revise male sling11.57NA5.930.55NA18.05090
    53444AInsert tandem cuff13.40NA6.140.88NA20.42090
    53445AInsert uro/ves nck sphincter14.06NA7.760.84NA22.66090
    53446ARemove uro sphincter10.23NA5.820.67NA16.72090
    53447ARemove/replace ur sphincter13.49NA6.550.79NA20.83090
    53448ARemov/replc ur sphinctr comp21.15NA9.851.39NA32.39090
    53449ARepair uro sphincter9.70NA5.900.57NA16.17090
    53450ARevision of urethra6.14NA4.530.37NA11.04090
    53460ARevision of urethra7.12NA4.900.43NA12.45090
    53502ARepair of urethra injury7.63NA5.320.50NA13.45090
    53505ARepair of urethra injury7.63NA5.040.46NA13.13090
    53510ARepair of urethra injury10.11NA6.430.60NA17.14090
    53515ARepair of urethra injury13.31NA7.050.83NA21.19090
    53520ARepair of urethra defect8.68NA5.500.53NA14.71090
    53600ADilate urethra stricture1.210.870.450.072.151.73000
    53601ADilate urethra stricture0.980.950.390.061.991.43000
    53605ADilate urethra stricture1.28NA0.420.08NA1.78000
    53620ADilate urethra stricture1.621.300.620.103.022.34000
    53621ADilate urethra stricture1.351.330.510.082.761.94000
    53660ADilation of urethra0.711.010.330.041.761.08000
    53661ADilation of urethra0.720.970.310.041.731.07000
    53665ADilation of urethra0.76NA0.260.05NA1.07000
    53670DInsert urinary catheter0.000.000.000.000.000.00000
    Start Printed Page 80097
    53675DInsert urinary catheter0.000.000.000.000.000.00000
    53850AProstatic microwave thermotx9.4552.024.160.5662.0314.17090
    53852AProstatic rf thermotx9.8840.464.320.5850.9214.78090
    53853AProstatic water thermother4.1429.013.220.2733.427.63090
    53899CUrology surgery procedure0.000.000.000.000.000.00YYY
    54000ASlitting of prepuce1.544.111.340.105.752.98010
    54001ASlitting of prepuce2.194.671.920.147.004.25010
    54015ADrain penis lesion5.325.912.970.3311.568.62010
    54050ADestruction, penis lesion(s)1.242.780.500.074.091.81010
    54055ADestruction, penis lesion(s)1.224.911.340.076.202.63010
    54056ACryosurgery, penis lesion(s)1.243.120.540.064.421.84010
    54057ALaser surg, penis lesion(s)1.243.091.240.084.412.56010
    54060AExcision of penis lesion(s)1.934.381.490.126.433.54010
    54065ADestruction, penis lesion(s)2.425.242.020.137.794.57010
    54100ABiopsy of penis1.903.320.760.105.322.76000
    54105ABiopsy of penis3.504.862.000.218.575.71010
    54110ATreatment of penis lesion10.13NA6.860.60NA17.59090
    54111ATreat penis lesion, graft13.57NA7.860.79NA22.22090
    54112ATreat penis lesion, graft15.86NA8.860.94NA25.66090
    54115ATreatment of penis lesion6.158.405.580.3914.9412.12090
    54120APartial removal of penis9.97NA6.730.60NA17.30090
    54125ARemoval of penis13.53NA7.920.81NA22.26090
    54130ARemove penis & nodes20.14NA10.421.19NA31.75090
    54135ARemove penis & nodes26.36NA12.501.58NA40.44090
    54150ACircumcision1.815.451.880.177.433.86010
    54152ACircumcision2.31NA1.650.16NA4.12010
    54160ACircumcision2.484.401.700.167.044.34010
    54161ACircumcision3.27NA1.920.20NA5.39010
    54162ALysis penil circumic lesion3.00NA2.300.20NA5.50010
    54163ARepair of circumcision3.00NA2.070.20NA5.27010
    54164AFrenulotomy of penis2.50NA1.900.16NA4.56010
    54200ATreatment of penis lesion1.062.400.370.063.521.49010
    54205ATreatment of penis lesion7.93NA5.950.47NA14.35090
    54220ATreatment of penis lesion2.421.891.020.154.463.59000
    54230APrepare penis study1.34NA0.440.08NA1.86000
    54231ADynamic cavernosometry2.042.140.810.144.322.99000
    54235APenile injection1.191.120.400.072.381.66000
    54240APenis study1.311.85NA0.133.29NA000
    5424026APenis study1.310.440.440.081.831.83000
    54240TCAPenis study0.001.41NA0.051.46NA000
    54250APenis study2.222.85NA0.165.23NA000
    5425026APenis study2.220.730.730.143.093.09000
    54250TCAPenis study0.002.12NA0.022.14NA000
    54300ARevision of penis10.41NA7.530.64NA18.58090
    54304ARevision of penis12.49NA8.720.74NA21.95090
    54308AReconstruction of urethra11.83NA8.290.70NA20.82090
    54312AReconstruction of urethra13.57NA9.350.81NA23.73090
    54316AReconstruction of urethra16.82NA10.831.00NA28.65090
    54318AReconstruction of urethra11.25NA8.641.15NA21.04090
    54322AReconstruction of urethra13.01NA8.060.77NA21.84090
    54324AReconstruction of urethra16.31NA10.561.03NA27.90090
    54326AReconstruction of urethra15.72NA10.150.93NA26.80090
    54328ARevise penis/urethra15.65NA9.530.92NA26.10090
    54332ARevise penis/urethra17.08NA10.061.01NA28.15090
    54336ARevise penis/urethra20.04NA14.121.90NA36.06090
    54340ASecondary urethral surgery8.91NA7.340.72NA16.97090
    54344ASecondary urethral surgery15.94NA9.831.10NA26.87090
    54348ASecondary urethral surgery17.15NA11.251.02NA29.42090
    54352AReconstruct urethra/penis24.74NA14.531.62NA40.89090
    54360APenis plastic surgery11.93NA7.330.72NA19.98090
    54380ARepair penis13.18NA9.501.16NA23.84090
    54385ARepair penis15.39NA12.190.71NA28.29090
    54390ARepair penis and bladder21.61NA13.021.28NA35.91090
    54400AInsert semi-rigid prosthesis8.99NA5.680.53NA15.20090
    54401AInsert self-contd prosthesis10.28NA6.460.61NA17.35090
    54405AInsert multi-comp penis pros13.43NA7.530.80NA21.76090
    54406ARemove muti-comp penis pros12.10NA5.500.75NA18.35090
    54408ARepair multi-comp penis pros12.75NA5.860.79NA19.40090
    54410ARemove/replace penis prosth15.50NA6.770.96NA23.23090
    54411ARemov/replc penis pros, comp16.00NA8.900.80NA25.70090
    54415ARemove self-contd penis pros8.20NA4.610.54NA13.35090
    54416ARemv/repl penis contain pros10.87NA6.910.55NA18.33090
    54417ARemv/replc penis pros, compl14.19NA7.810.55NA22.55090
    54420ARevision of penis11.42NA7.470.72NA19.61090
    54430ARevision of penis10.15NA6.770.60NA17.52090
    Start Printed Page 80098
    54435ARevision of penis6.12NA5.010.36NA11.49090
    54440CRepair of penis0.000.000.000.000.000.00090
    54450APreputial stretching1.121.000.480.072.191.67000
    54500ABiopsy of testis1.314.860.440.086.251.83000
    54505ABiopsy of testis3.46NA2.280.21NA5.95010
    54512AExcise lesion testis8.58NA4.500.56NA13.64090
    54520ARemoval of testis5.23NA3.240.33NA8.80090
    54522AOrchiectomy, partial9.50NA5.120.62NA15.24090
    54530ARemoval of testis8.58NA4.860.53NA13.97090
    54535AExtensive testis surgery12.16NA6.720.83NA19.71090
    54550AExploration for testis7.78NA4.380.49NA12.65090
    54560AExploration for testis11.13NA6.340.79NA18.26090
    54600AReduce testis torsion7.01NA3.880.45NA11.34090
    54620ASuspension of testis4.90NA2.770.31NA7.98010
    54640ASuspension of testis6.90NA3.940.49NA11.33090
    54650AOrchiopexy (Fowler-Stephens)11.45NA6.590.81NA18.85090
    54660ARevision of testis5.11NA3.110.35NA8.57090
    54670ARepair testis injury6.41NA3.830.41NA10.65090
    54680ARelocation of testis(es)12.65NA7.060.94NA20.65090
    54690ALaparoscopy, orchiectomy10.96NA6.320.99NA18.27090
    54692ALaparoscopy, orchiopexy12.88NA5.470.87NA19.22090
    54699CLaparoscope proc, testis0.000.000.000.000.000.00YYY
    54700ADrainage of scrotum3.436.062.820.239.726.48010
    54800ABiopsy of epididymis2.334.980.790.147.453.26000
    54820AExploration of epididymis5.14NA3.260.33NA8.73090
    54830ARemove epididymis lesion5.38NA3.330.34NA9.05090
    54840ARemove epididymis lesion5.20NA3.240.31NA8.75090
    54860ARemoval of epididymis6.32NA3.800.38NA10.50090
    54861ARemoval of epididymis8.90NA4.640.52NA14.06090
    54900AFusion of spermatic ducts13.20NA6.221.34NA20.76090
    54901AFusion of spermatic ducts17.94NA8.491.83NA28.26090
    55000ADrainage of hydrocele1.432.170.480.103.702.01000
    55040ARemoval of hydrocele5.36NA3.100.35NA8.81090
    55041ARemoval of hydroceles7.74NA4.110.50NA12.35090
    55060ARepair of hydrocele5.52NA3.190.37NA9.08090
    55100ADrainage of scrotum abscess2.136.592.910.158.875.19010
    55110AExplore scrotum5.70NA3.220.36NA9.28090
    55120ARemoval of scrotum lesion5.09NA3.050.33NA8.47090
    55150ARemoval of scrotum7.22NA4.220.47NA11.91090
    55175ARevision of scrotum5.24NA3.310.33NA8.88090
    55180ARevision of scrotum10.72NA5.990.72NA17.43090
    55200AIncision of sperm duct4.24NA2.790.25NA7.28090
    55250ARemoval of sperm duct(s)3.296.562.740.2110.066.24090
    55300APrepare, sperm duct x-ray3.51NA1.540.20NA5.25000
    55400ARepair of sperm duct8.49NA4.800.50NA13.79090
    55450ALigation of sperm duct4.125.092.360.249.456.72010
    55500ARemoval of hydrocele5.59NA3.440.43NA9.46090
    55520ARemoval of sperm cord lesion6.03NA3.640.56NA10.23090
    55530ARevise spermatic cord veins5.66NA3.430.36NA9.45090
    55535ARevise spermatic cord veins6.56NA3.710.42NA10.69090
    55540ARevise hernia & sperm veins7.67NA4.200.74NA12.61090
    55550ALaparo ligate spermatic vein6.57NA3.500.47NA10.54090
    55559CLaparo proc, spermatic cord0.000.000.000.000.000.00YYY
    55600AIncise sperm duct pouch6.38NA3.820.38NA10.58090
    55605AIncise sperm duct pouch7.96NA4.900.54NA13.40090
    55650ARemove sperm duct pouch11.80NA5.810.72NA18.33090
    55680ARemove sperm pouch lesion5.19NA3.480.31NA8.98090
    55700ABiopsy of prostate1.572.830.730.104.502.40000
    55705ABiopsy of prostate4.57NA3.300.26NA8.13010
    55720ADrainage of prostate abscess7.64NA5.300.44NA13.38090
    55725ADrainage of prostate abscess8.68NA5.850.51NA15.04090
    55801ARemoval of prostate17.80NA8.821.08NA27.70090
    55810AExtensive prostate surgery22.58NA10.791.35NA34.72090
    55812AExtensive prostate surgery27.51NA12.971.69NA42.17090
    55815AExtensive prostate surgery30.46NA13.851.84NA46.15090
    55821ARemoval of prostate14.25NA7.330.85NA22.43090
    55831ARemoval of prostate15.62NA7.810.94NA24.37090
    55840AExtensive prostate surgery22.69NA11.271.37NA35.33090
    55842AExtensive prostate surgery24.38NA11.851.48NA37.71090
    55845AExtensive prostate surgery28.55NA13.141.71NA43.40090
    55859APercut/needle insert, pros12.52NA6.860.74NA20.12090
    55860ASurgical exposure, prostate14.45NA7.580.82NA22.85090
    55862AExtensive prostate surgery18.39NA9.191.14NA28.72090
    55865AExtensive prostate surgery22.87NA10.501.37NA34.74090
    55866ALaparo radical prostatectomy30.74NA11.791.37NA43.90090
    Start Printed Page 80099
    55870AVag hyst w/enterocele repair2.581.941.040.144.663.76000
    55873ACryoablate prostate19.47NA8.911.02NA29.40090
    55899CGenital surgery procedure0.000.000.000.000.000.00YYY
    55970NSex transformation, M to F0.000.000.000.000.000.00XXX
    55980NSex transformation, F to M0.000.000.000.000.000.00XXX
    56405AI & D of vulva/perineum1.442.291.230.143.872.81010
    56420ADrainage of gland abscess1.392.291.240.133.812.76010
    56440ASurgery for vulva lesion2.843.452.220.286.575.34010
    56441ALysis of labial lesion(s)1.972.331.810.174.473.95010
    56501ADestroy, vulva lesions, sim1.532.241.290.153.922.97010
    56515ADestroy vulva lesion/s compl2.763.012.240.185.955.18010
    56605ABiopsy of vulva/perineum1.101.090.470.112.301.68000
    56606ABiopsy of vulva/perineum0.550.510.220.061.120.83ZZZ
    56620APartial removal of vulva7.47NA4.850.76NA13.08090
    56625AComplete removal of vulva8.40NA5.780.84NA15.02090
    56630AExtensive vulva surgery12.36NA7.601.23NA21.19090
    56631AExtensive vulva surgery16.20NA10.271.63NA28.10090
    56632AExtensive vulva surgery20.29NA10.232.03NA32.55090
    56633AExtensive vulva surgery16.47NA9.271.66NA27.40090
    56634AExtensive vulva surgery17.88NA10.951.78NA30.61090
    56637AExtensive vulva surgery21.97NA12.642.18NA36.79090
    56640AExtensive vulva surgery22.17NA12.242.26NA36.67090
    56700APartial removal of hymen2.52NA1.700.24NA4.46010
    56720AIncision of hymen0.68NA0.410.07NA1.16000
    56740ARemove vagina gland lesion4.57NA2.580.37NA7.52010
    56800ARepair of vagina3.89NA2.610.37NA6.87010
    56805ARepair clitoris18.86NA9.121.82NA29.80090
    56810ARepair of perineum4.13NA2.720.41NA7.26010
    56820AExam of vulva w/scope1.501.640.650.103.242.25000
    56821AExam/biopsy of vulva w/scope2.052.020.920.134.203.10000
    57000AExploration of vagina2.97NA2.190.28NA5.44010
    57010ADrainage of pelvic abscess6.03NA3.790.57NA10.39090
    57020ADrainage of pelvic fluid1.501.560.630.153.212.28000
    57022AI & d vaginal hematoma, pp2.56NA2.030.24NA4.83010
    57023AI & d vag hematoma, non-ob4.75NA2.890.24NA7.88010
    57061ADestroy vag lesions, simple1.252.161.160.133.542.54010
    57065ADestroy vag lesions, complex2.612.882.230.265.755.10010
    57100ABiopsy of vagina1.201.110.500.102.411.80000
    57105ABiopsy of vagina1.692.001.310.173.863.17010
    57106ARemove vagina wall, partial6.36NA3.870.58NA10.81090
    57107ARemove vagina tissue, part23.00NA10.282.17NA35.45090
    57109AVaginectomy partial w/nodes27.00NA11.531.97NA40.50090
    57110ARemove vagina wall, complete14.29NA7.211.43NA22.93090
    57111ARemove vagina tissue, compl27.00NA12.302.71NA42.01090
    57112AVaginectomy w/nodes, compl29.00NA12.392.19NA43.58090
    57120AClosure of vagina7.41NA4.590.75NA12.75090
    57130ARemove vagina lesion2.43NA2.030.23NA4.69010
    57135ARemove vagina lesion2.672.872.130.265.805.06010
    57150ATreat vagina infection0.550.990.220.061.600.83000
    57155AInsert uteri tandems/ovoids6.27NA3.680.59NA10.54090
    57160AInsert pessary/other device0.891.100.400.092.081.38000
    57170AFitting of diaphragm/cap0.911.380.340.092.381.34000
    57180ATreat vaginal bleeding1.582.221.410.163.963.15010
    57200ARepair of vagina3.94NA3.110.38NA7.43090
    57210ARepair vagina/perineum5.17NA3.670.50NA9.34090
    57220ARevision of urethra4.31NA3.340.42NA8.07090
    57230ARepair of urethral lesion5.64NA3.540.50NA9.68090
    57240ARepair bladder & vagina6.07NA3.900.53NA10.50090
    57250ARepair rectum & vagina5.53NA3.810.54NA9.88090
    57260ARepair of vagina8.27NA5.140.83NA14.24090
    57265AExtensive repair of vagina11.34NA6.381.14NA18.86090
    57268ARepair of bowel bulge6.76NA4.480.66NA11.90090
    57270ARepair of bowel pouch12.11NA6.601.17NA19.88090
    57280ASuspension of vagina15.04NA7.731.44NA24.21090
    57282ARepair of vaginal prolapse8.86NA5.580.86NA15.30090
    57284ARepair paravaginal defect12.70NA7.121.17NA20.99090
    57287ARevise/remove sling repair10.71NA5.600.74NA17.05090
    57288ARepair bladder defect13.02NA6.050.86NA19.93090
    57289ARepair bladder & vagina11.58NA6.260.95NA18.79090
    57291AConstruction of vagina7.95NA5.290.78NA14.02090
    57292AConstruct vagina with graft13.09NA7.381.29NA21.76090
    57300ARepair rectum-vagina fistula7.61NA4.850.70NA13.16090
    57305ARepair rectum-vagina fistula13.77NA6.491.33NA21.59090
    57307AFistula repair & colostomy15.93NA7.551.59NA25.07090
    57308AFistula repair, transperine9.94NA5.890.91NA16.74090
    Start Printed Page 80100
    57310ARepair urethrovaginal lesion6.78NA4.290.45NA11.52090
    57311ARepair urethrovaginal lesion7.98NA4.850.51NA13.34090
    57320ARepair bladder-vagina lesion8.01NA4.950.60NA13.56090
    57330ARepair bladder-vagina lesion12.35NA6.290.86NA19.50090
    57335ARepair vagina18.73NA8.971.66NA29.36090
    57400ADilation of vagina2.27NA1.140.22NA3.63000
    57410APelvic examination1.752.551.030.144.442.92000
    57415ARemove vaginal foreign body2.173.211.870.195.574.23010
    57420AExam of vagina w/scope1.601.680.690.103.382.39000
    57421AExam/biopsy of vag w/scope2.202.080.980.134.413.31000
    57452AExam of cervix w/scope1.501.700.650.103.302.25000
    57454ABx/curett of cervix w/scope2.332.051.020.134.513.48000
    57455ABiopsy of cervix w/scope1.991.940.890.134.063.01000
    57456AEndocerv curettage w/scope1.851.860.840.133.842.82000
    57460ABx of cervix w/scope, leep2.835.011.250.288.124.36000
    57461AConz of cervix w/scope, leep3.445.321.500.289.045.22000
    57500ABiopsy of cervix0.972.020.490.103.091.56000
    57505AEndocervical curettage1.141.901.210.123.162.47010
    57510ACauterization of cervix1.903.011.510.185.093.59010
    57511ACryocautery of cervix1.902.360.750.184.442.83010
    57513ALaser surgery of cervix1.902.571.500.194.663.59010
    57520AConization of cervix4.044.132.760.418.587.21090
    57522AConization of cervix3.363.662.490.347.366.19090
    57530ARemoval of cervix4.79NA3.530.48NA8.80090
    57531ARemoval of cervix, radical28.00NA13.532.46NA43.99090
    57540ARemoval of residual cervix12.22NA6.141.21NA19.57090
    57545ARemove cervix/repair pelvis13.03NA6.591.30NA20.92090
    57550ARemoval of residual cervix5.53NA3.780.55NA9.86090
    57555ARemove cervix/repair vagina8.95NA5.600.89NA15.44090
    57556ARemove cervix, repair bowel8.37NA4.830.80NA14.00090
    57700ARevision of cervix3.55NA2.440.33NA6.32090
    57720ARevision of cervix4.13NA3.200.41NA7.74090
    57800ADilation of cervical canal0.770.770.480.081.621.33000
    57820AD & c of residual cervix1.671.511.110.173.352.95010
    58100ABiopsy of uterus lining1.531.450.750.073.052.35000
    58120ADilation and curettage3.272.351.970.335.955.57010
    58140AMyomectomy abdom method14.60NA7.011.46NA23.07090
    58145AMyomectomy vag method8.04NA4.840.80NA13.68090
    58146AMyomectomy abdom complex19.00NA9.151.46NA29.61090
    58150ATotal hysterectomy15.24NA7.891.57NA24.70090
    58152ATotal hysterectomy20.60NA10.281.52NA32.40090
    58180APartial hysterectomy15.29NA7.851.54NA24.68090
    58200AExtensive hysterectomy21.59NA10.602.15NA34.34090
    58210AExtensive hysterectomy28.85NA13.962.91NA45.72090
    58240ARemoval of pelvis contents38.39NA18.483.76NA60.63090
    58260AVaginal hysterectomy12.98NA6.681.23NA20.89090
    58262AVag hyst including t/o14.77NA7.431.42NA23.62090
    58263AVag hyst w/t/o & vag repair16.06NA7.951.55NA25.56090
    58267AVag hyst w/urinary repair17.04NA8.521.51NA27.07090
    58270AVag hyst w/enterocele repair14.26NA7.191.37NA22.82090
    58275AHysterectomy/revise vagina15.76NA7.721.51NA24.99090
    58280AHysterectomy/revise vagina17.01NA8.211.54NA26.76090
    58285AExtensive hysterectomy22.26NA10.851.88NA34.99090
    58290AVag hyst complex19.00NA9.371.23NA29.60090
    58291AVag hyst incl t/o, complex20.79NA10.341.42NA32.55090
    58292AVag hyst t/o & repair, compl22.08NA10.851.55NA34.48090
    58293AVag hyst w/uro repair, compl23.06NA11.251.51NA35.82090
    58294AVag hyst w/enterocele, compl20.28NA10.101.37NA31.75090
    58300NInsert intrauterine device+1.011.440.390.102.551.50XXX
    58301ARemove intrauterine device1.271.540.500.132.941.90000
    58321AArtificial insemination0.920.940.380.101.961.40000
    58322AArtificial insemination1.101.000.430.112.211.64000
    58323ASperm washing0.230.540.100.020.790.35000
    58340ACatheter for hysterography0.8812.100.330.0813.061.29000
    58345AReopen fallopian tube4.66NA1.730.36NA6.75010
    58346AInsert heyman uteri capsule6.75NA3.870.64NA11.26090
    58350AReopen fallopian tube1.011.931.050.103.042.16010
    58353AEndometr ablate, thermal3.56NA2.230.37NA6.16010
    58400ASuspension of uterus6.36NA3.930.62NA10.91090
    58410ASuspension of uterus12.73NA6.551.09NA20.37090
    58520ARepair of ruptured uterus11.92NA5.931.17NA19.02090
    58540ARevision of uterus14.64NA6.901.28NA22.82090
    58545ALaparoscopic myomectomy14.60NA7.761.45NA23.81090
    58546ALaparo-myomectomy, complex19.00NA9.551.45NA30.00090
    58550ALaparo-asst vag hysterectomy14.19NA7.211.44NA22.84010
    Start Printed Page 80101
    58551DLaparoscopy, remove myoma0.000.000.000.000.000.00010
    58552ALaparo-vag hyst incl t/o14.19NA7.561.44NA23.19090
    58553ALaparo-vag hyst, complex19.00NA9.571.23NA29.80090
    58554ALaparo-vag hyst w/t/o, compl19.00NA9.261.23NA29.49090
    58555AHysteroscopy, dx, sep proc3.332.101.490.345.775.16000
    58558AHysteroscopy, biopsy4.75NA2.120.49NA7.36000
    58559AHysteroscopy, lysis6.17NA2.690.62NA9.48000
    58560AHysteroscopy, resect septum7.00NA3.050.71NA10.76000
    58561AHysteroscopy, remove myoma10.00NA4.281.02NA15.30000
    58562AHysteroscopy, remove fb5.21NA2.270.52NA8.00000
    58563AHysteroscopy, ablation6.17NA2.710.62NA9.50000
    58578CLaparo proc, uterus0.000.000.000.000.000.00YYY
    58579CHysteroscope procedure0.000.000.000.000.000.00YYY
    58600ADivision of fallopian tube5.60NA3.280.39NA9.27090
    58605ADivision of fallopian tube5.00NA3.120.33NA8.45090
    58611ALigate oviduct(s) add-on1.45NA0.590.07NA2.11ZZZ
    58615AOcclude fallopian tube(s)3.90NA3.110.40NA7.41010
    58660ALaparoscopy, lysis11.29NA5.601.14NA18.03090
    58661ALaparoscopy, remove adnexa11.05NA5.271.12NA17.44010
    58662ALaparoscopy, excise lesions11.79NA5.541.18NA18.51090
    58670ALaparoscopy, tubal cautery5.60NA3.620.55NA9.77090
    58671ALaparoscopy, tubal block5.60NA3.630.56NA9.79090
    58672ALaparoscopy, fimbrioplasty12.88NA6.521.22NA20.62090
    58673ALaparoscopy, salpingostomy13.74NA6.861.40NA22.00090
    58679CLaparo proc, oviduct-ovary0.000.000.000.000.000.00YYY
    58700ARemoval of fallopian tube12.05NA5.800.64NA18.49090
    58720ARemoval of ovary/tube(s)11.36NA5.751.14NA18.25090
    58740ARevise fallopian tube(s)14.00NA6.990.59NA21.58090
    58750ARepair oviduct14.84NA7.371.52NA23.73090
    58752ARevise ovarian tube(s)14.84NA7.061.51NA23.41090
    58760ARemove tubal obstruction13.13NA6.671.34NA21.14090
    58770ACreate new tubal opening13.97NA6.971.42NA22.36090
    58800ADrainage of ovarian cyst(s)4.144.394.360.368.898.86090
    58805ADrainage of ovarian cyst(s)5.88NA3.470.56NA9.91090
    58820ADrain ovary abscess, open4.22NA3.340.29NA7.85090
    58822ADrain ovary abscess, percut10.13NA5.040.92NA16.09090
    58823ADrain pelvic abscess, percut3.38NA2.320.18NA5.88000
    58825ATransposition, ovary(s)10.98NA5.740.62NA17.34090
    58900ABiopsy of ovary(s)5.99NA3.530.56NA10.08090
    58920APartial removal of ovary(s)11.36NA5.580.68NA17.62090
    58925ARemoval of ovarian cyst(s)11.36NA5.541.14NA18.04090
    58940ARemoval of ovary(s)7.29NA3.940.73NA11.96090
    58943ARemoval of ovary(s)18.43NA9.441.86NA29.73090
    58950AResect ovarian malignancy16.93NA9.001.55NA27.48090
    58951AResect ovarian malignancy22.38NA11.322.20NA35.90090
    58952AResect ovarian malignancy25.01NA12.412.57NA39.99090
    58953ATah, rad dissect for debulk32.00NA15.083.30NA50.38090
    58954ATah rad debulk/lymph remove35.00NA16.153.56NA54.71090
    58960AExploration of abdomen14.65NA8.121.47NA24.24090
    58970ARetrieval of oocyte3.538.361.670.3612.255.56000
    58974CTransfer of embryo0.000.000.000.000.000.00000
    58976ATransfer of embryo3.832.291.590.396.515.81000
    58999CGenital surgery procedure0.000.000.000.000.000.00YYY
    59000AAmniocentesis, diagnostic1.301.880.710.233.412.24000
    59001AAmniocentesis, therapeutic3.00NA1.350.23NA4.58000
    59012AFetal cord puncture,prenatal3.45NA1.600.62NA5.67000
    59015AChorion biopsy2.201.591.080.404.193.68000
    59020AFetal contract stress test0.660.79NA0.201.65NA000
    5902026AFetal contract stress test0.660.270.270.121.051.05000
    59020TCAFetal contract stress test0.000.52NA0.080.60NA000
    59025AFetal non-stress test0.530.45NA0.121.10NA000
    5902526AFetal non-stress test0.530.220.220.100.850.85000
    59025TCAFetal non-stress test0.000.23NA0.020.25NA000
    59030AFetal scalp blood sample1.99NA1.060.36NA3.41000
    59050AFetal monitor w/report0.89NA0.360.16NA1.41XXX
    59051AFetal monitor/interpret only0.74NA0.300.14NA1.18XXX
    59100ARemove uterus lesion12.35NA6.292.21NA20.85090
    59120ATreat ectopic pregnancy11.49NA6.062.06NA19.61090
    59121ATreat ectopic pregnancy11.67NA6.192.09NA19.95090
    59130ATreat ectopic pregnancy14.22NA5.812.54NA22.57090
    59135ATreat ectopic pregnancy13.88NA7.042.49NA23.41090
    59136ATreat ectopic pregnancy13.18NA6.612.36NA22.15090
    59140ATreat ectopic pregnancy5.46NA3.360.98NA9.80090
    59150ATreat ectopic pregnancy11.67NA6.401.23NA19.30090
    59151ATreat ectopic pregnancy11.49NA5.841.41NA18.74090
    Start Printed Page 80102
    59160AD & c after delivery2.713.482.150.496.685.35010
    59200AInsert cervical dilator0.791.320.310.152.261.25000
    59300AEpisiotomy or vaginal repair2.412.080.990.434.923.83000
    59320ARevision of cervix2.48NA1.290.45NA4.22000
    59325ARevision of cervix4.07NA1.960.73NA6.76000
    59350ARepair of uterus4.95NA2.000.88NA7.83000
    59400AObstetrical care23.06NA16.094.14NA43.29MMM
    59409AObstetrical care13.50NA5.442.42NA21.36MMM
    59410AObstetrical care14.78NA6.482.65NA23.91MMM
    59412AAntepartum manipulation1.71NA0.840.31NA2.86MMM
    59414ADeliver placenta1.61NA0.650.29NA2.55MMM
    59425AAntepartum care only4.814.461.900.8610.137.57MMM
    59426AAntepartum care only8.288.043.301.4917.8113.07MMM
    59430ACare after delivery2.13NA0.980.38NA3.49MMM
    59510ACesarean delivery26.22NA18.214.70NA49.13MMM
    59514ACesarean delivery only15.97NA6.382.86NA25.21MMM
    59515ACesarean delivery17.37NA8.053.12NA28.54MMM
    59525ARemove uterus after cesarean8.54NA3.391.53NA13.46ZZZ
    59610AVbac delivery24.62NA16.664.41NA45.69MMM
    59612AVbac delivery only15.06NA6.212.70NA23.97MMM
    59614AVbac care after delivery16.34NA7.122.93NA26.39MMM
    59618AAttempted vbac delivery27.78NA19.524.98NA52.28MMM
    59620AAttempted vbac delivery only17.53NA6.943.15NA27.62MMM
    59622AAttempted vbac after care18.93NA8.873.39NA31.19MMM
    59812ATreatment of miscarriage4.013.602.530.588.197.12090
    59820ACare of miscarriage4.013.622.660.728.357.39090
    59821ATreatment of miscarriage4.473.792.850.809.068.12090
    59830ATreat uterus infection6.11NA3.941.10NA11.15090
    59840RAbortion3.013.982.240.547.535.79010
    59841RAbortion5.245.603.550.9411.789.73010
    59850RAbortion5.91NA2.731.06NA9.70090
    59851RAbortion5.93NA3.131.06NA10.12090
    59852RAbortion8.24NA4.571.48NA14.29090
    59855RAbortion6.12NA3.241.10NA10.46090
    59856RAbortion7.48NA3.831.34NA12.65090
    59857RAbortion9.29NA4.391.66NA15.34090
    59866RAbortion (mpr)4.00NA1.550.72NA6.27000
    59870AEvacuate mole of uterus6.01NA3.780.77NA10.56090
    59871ARemove cerclage suture2.132.000.900.384.513.41000
    59898CLaparo proc, ob care/deliver0.000.000.000.000.000.00YYY
    59899CMaternity care procedure0.000.000.000.000.000.00YYY
    60000ADrain thyroid/tongue cyst1.762.362.150.144.264.05010
    60001AAspirate/inject thyriod cyst0.971.640.350.062.671.38000
    60100ABiopsy of thyroid1.561.860.550.053.472.16000
    60200ARemove thyroid lesion9.55NA6.570.84NA16.96090
    60210APartial thyroid excision10.88NA6.451.01NA18.34090
    60212APartial thyroid excision16.03NA8.231.51NA25.77090
    60220APartial removal of thyroid11.90NA6.990.97NA19.86090
    60225APartial removal of thyroid14.19NA7.821.31NA23.32090
    60240ARemoval of thyroid16.06NA9.051.50NA26.61090
    60252ARemoval of thyroid20.57NA11.391.63NA33.59090
    60254AExtensive thyroid surgery26.99NA15.791.96NA44.74090
    60260ARepeat thyroid surgery17.47NA10.301.39NA29.16090
    60270ARemoval of thyroid20.27NA11.501.78NA33.55090
    60271ARemoval of thyroid16.83NA9.821.35NA28.00090
    60280ARemove thyroid duct lesion5.87NA5.160.45NA11.48090
    60281ARemove thyroid duct lesion8.53NA6.350.67NA15.55090
    60500AExplore parathyroid glands16.23NA7.751.61NA25.59090
    60502ARe-explore parathyroids20.35NA9.592.00NA31.94090
    60505AExplore parathyroid glands21.49NA11.422.14NA35.05090
    60512AAutotransplant parathyroid4.45NA1.660.44NA6.55ZZZ
    60520ARemoval of thymus gland16.81NA9.841.84NA28.49090
    60521ARemoval of thymus gland18.87NA11.772.34NA32.98090
    60522ARemoval of thymus gland23.09NA13.012.83NA38.93090
    60540AExplore adrenal gland17.03NA7.641.42NA26.09090
    60545AExplore adrenal gland19.88NA9.331.75NA30.96090
    60600ARemove carotid body lesion17.93NA13.241.87NA33.04090
    60605ARemove carotid body lesion20.24NA18.112.28NA40.63090
    60650ALaparoscopy adrenalectomy20.00NA8.061.98NA30.04090
    60659CLaparo proc, endocrine0.000.000.000.000.000.00YYY
    60699CEndocrine surgery procedure0.000.000.000.000.000.00YYY
    61000ARemove cranial cavity fluid1.58NA0.980.13NA2.69000
    61001ARemove cranial cavity fluid1.49NA1.080.15NA2.72000
    61020ARemove brain cavity fluid1.51NA1.380.26NA3.15000
    61026AInjection into brain canal1.69NA1.450.21NA3.35000
    Start Printed Page 80103
    61050ARemove brain canal fluid1.51NA1.270.13NA2.91000
    61055AInjection into brain canal2.10NA1.420.13NA3.65000
    61070ABrain canal shunt procedure0.89NA1.040.09NA2.02000
    61105ATwist drill hole5.14NA4.041.05NA10.23090
    61107ADrill skull for implantation5.00NA3.381.02NA9.40000
    61108ADrill skull for drainage10.19NA7.292.04NA19.52090
    61120ABurr hole for puncture8.76NA6.121.81NA16.69090
    61140APierce skull for biopsy15.90NA10.113.15NA29.16090
    61150APierce skull for drainage17.57NA10.663.52NA31.75090
    61151APierce skull for drainage12.42NA8.012.45NA22.88090
    61154APierce skull & remove clot14.99NA9.703.05NA27.74090
    61156APierce skull for drainage16.32NA10.073.42NA29.81090
    61210APierce skull, implant device5.84NA3.781.16NA10.78000
    61215AInsert brain-fluid device4.89NA4.090.99NA9.97090
    61250APierce skull & explore10.42NA7.012.02NA19.45090
    61253APierce skull & explore12.36NA7.872.26NA22.49090
    61304AOpen skull for exploration21.96NA13.184.33NA39.47090
    61305AOpen skull for exploration26.61NA15.705.25NA47.56090
    61312AOpen skull for drainage24.57NA15.424.99NA44.98090
    61313AOpen skull for drainage24.93NA15.205.07NA45.20090
    61314AOpen skull for drainage24.23NA13.344.00NA41.57090
    61315AOpen skull for drainage27.68NA16.425.62NA49.72090
    61316AImplt cran bone flap to abdo1.39NA0.570.43NA2.39ZZZ
    61320AOpen skull for drainage25.62NA15.165.20NA45.98090
    61321AOpen skull for drainage28.50NA16.555.35NA50.40090
    61322ADecompressive craniotomy29.50NA13.884.99NA48.37090
    61323ADecompressive lobectomy31.00NA14.084.99NA50.07090
    61330ADecompress eye socket23.32NA14.102.58NA40.00090
    61332AExplore/biopsy eye socket27.28NA15.974.15NA47.40090
    61333AExplore orbit/remove lesion27.95NA16.022.24NA46.21090
    61334AExplore orbit/remove object18.27NA10.933.02NA32.22090
    61340ASubtemporal decompression18.66NA11.413.66NA33.73090
    61343AIncise skull (press relief)29.77NA17.976.04NA53.78090
    61345ARelieve cranial pressure27.20NA16.515.23NA48.94090
    61440AIncise skull for surgery26.63NA15.305.57NA47.50090
    61450AIncise skull for surgery25.95NA15.535.11NA46.59090
    61458AIncise skull for brain wound27.29NA16.595.28NA49.16090
    61460AIncise skull for surgery28.39NA17.535.13NA51.05090
    61470AIncise skull for surgery26.06NA15.064.65NA45.77090
    61480AIncise skull for surgery26.49NA15.995.54NA48.02090
    61490AIncise skull for surgery25.66NA15.565.37NA46.59090
    61500ARemoval of skull lesion17.92NA11.763.26NA32.94090
    61501ARemove infected skull bone14.84NA9.972.63NA27.44090
    61510ARemoval of brain lesion28.45NA17.225.77NA51.44090
    61512ARemove brain lining lesion35.09NA20.727.14NA62.95090
    61514ARemoval of brain abscess25.26NA15.475.12NA45.85090
    61516ARemoval of brain lesion24.61NA14.924.94NA44.47090
    61517AImplt brain chemotx add-on1.38NA0.560.08NA2.02ZZZ
    61518ARemoval of brain lesion37.32NA22.227.53NA67.07090
    61519ARemove brain lining lesion41.39NA24.218.15NA73.75090
    61520ARemoval of brain lesion54.84NA31.7310.10NA96.67090
    61521ARemoval of brain lesion44.48NA25.768.85NA79.09090
    61522ARemoval of brain abscess29.45NA17.565.30NA52.31090
    61524ARemoval of brain lesion27.86NA16.795.01NA49.66090
    61526ARemoval of brain lesion52.17NA30.716.72NA89.60090
    61530ARemoval of brain lesion43.86NA26.946.17NA76.97090
    61531AImplant brain electrodes14.63NA9.662.84NA27.13090
    61533AImplant brain electrodes19.71NA12.323.80NA35.83090
    61534ARemoval of brain lesion20.97NA13.134.15NA38.25090
    61535ARemove brain electrodes11.63NA8.102.29NA22.02090
    61536ARemoval of brain lesion35.52NA21.026.68NA63.22090
    61538ARemoval of brain tissue26.81NA16.325.38NA48.51090
    61539ARemoval of brain tissue32.08NA18.976.62NA57.67090
    61541AIncision of brain tissue28.85NA16.915.50NA51.26090
    61542ARemoval of brain tissue31.02NA19.076.49NA56.58090
    61543ARemoval of brain tissue29.22NA17.526.11NA52.85090
    61544ARemove & treat brain lesion25.50NA14.524.91NA44.93090
    61545AExcision of brain tumor43.80NA25.028.88NA77.70090
    61546ARemoval of pituitary gland31.30NA18.686.06NA56.04090
    61548ARemoval of pituitary gland21.53NA13.643.63NA38.80090
    61550ARelease of skull seams14.65NA7.341.14NA23.13090
    61552ARelease of skull seams19.56NA9.840.88NA30.28090
    61556AIncise skull/sutures22.26NA12.013.57NA37.84090
    61557AIncise skull/sutures22.38NA13.864.68NA40.92090
    61558AExcision of skull/sutures25.58NA15.132.61NA43.32090
    Start Printed Page 80104
    61559AExcision of skull/sutures32.79NA19.676.86NA59.32090
    61563AExcision of skull tumor26.83NA16.074.46NA47.36090
    61564AExcision of skull tumor33.83NA18.727.08NA59.63090
    61570ARemove foreign body, brain24.60NA14.374.60NA43.57090
    61571AIncise skull for brain wound26.39NA15.705.23NA47.32090
    61575ASkull base/brainstem surgery34.36NA21.205.02NA60.58090
    61576ASkull base/brainstem surgery52.43NA30.804.68NA87.91090
    61580ACraniofacial approach, skull30.35NA19.152.75NA52.25090
    61581ACraniofacial approach, skull34.60NA15.393.37NA53.36090
    61582ACraniofacial approach, skull31.66NA19.266.30NA57.22090
    61583ACraniofacial approach, skull36.21NA22.626.94NA65.77090
    61584AOrbitocranial approach/skull34.65NA20.926.53NA62.10090
    61585AOrbitocranial approach/skull38.61NA22.586.19NA67.38090
    61586AResect nasopharynx, skull25.10NA16.223.52NA44.84090
    61590AInfratemporal approach/skull41.78NA25.534.28NA71.59090
    61591AInfratemporal approach/skull43.68NA26.345.26NA75.28090
    61592AOrbitocranial approach/skull39.64NA23.617.55NA70.80090
    61595ATranstemporal approach/skull29.57NA19.323.05NA51.94090
    61596ATranscochlear approach/skull35.63NA22.014.25NA61.89090
    61597ATranscondylar approach/skull37.96NA21.206.65NA65.81090
    61598ATranspetrosal approach/skull33.41NA20.654.60NA58.66090
    61600AResect/excise cranial lesion25.85NA15.963.12NA44.93090
    61601AResect/excise cranial lesion27.89NA17.325.29NA50.50090
    61605AResect/excise cranial lesion29.33NA18.502.51NA50.34090
    61606AResect/excise cranial lesion38.83NA23.376.81NA69.01090
    61607AResect/excise cranial lesion36.27NA22.055.69NA64.01090
    61608AResect/excise cranial lesion42.10NA24.778.31NA75.18090
    61609ATransect artery, sinus9.89NA4.912.07NA16.87ZZZ
    61610ATransect artery, sinus29.67NA13.483.52NA46.67ZZZ
    61611ATransect artery, sinus7.42NA3.401.55NA12.37ZZZ
    61612ATransect artery, sinus27.88NA13.673.55NA45.10ZZZ
    61613ARemove aneurysm, sinus40.86NA23.958.32NA73.13090
    61615AResect/excise lesion, skull32.07NA20.584.64NA57.29090
    61616AResect/excise lesion, skull43.33NA26.877.02NA77.22090
    61618ARepair dura16.99NA11.452.92NA31.36090
    61619ARepair dura20.71NA13.383.42NA37.51090
    61623AEndovasc tempory vessel occl9.96NA4.230.50NA14.69000
    61624ATranscath occlusion, cns20.15NA7.131.15NA28.43000
    61626ATranscath occlusion, non-cns16.62NA5.700.84NA23.16000
    61680AIntracranial vessel surgery30.71NA18.446.04NA55.19090
    61682AIntracranial vessel surgery61.57NA34.0112.69NA108.27090
    61684AIntracranial vessel surgery39.81NA23.127.87NA70.80090
    61686AIntracranial vessel surgery64.49NA36.0213.20NA113.71090
    61690AIntracranial vessel surgery29.31NA17.765.51NA52.58090
    61692AIntracranial vessel surgery51.87NA28.8410.17NA90.88090
    61697ABrain aneurysm repr, complx50.52NA28.7310.31NA89.56090
    61698ABrain aneurysm repr, complx48.41NA27.369.99NA85.76090
    61700ABrain aneurysm repr, simple50.52NA28.6810.18NA89.38090
    61702AInner skull vessel surgery48.41NA27.669.75NA85.82090
    61703AClamp neck artery17.47NA11.243.62NA32.33090
    61705ARevise circulation to head36.20NA20.056.67NA62.92090
    61708ARevise circulation to head35.30NA15.872.18NA53.35090
    61710ARevise circulation to head29.67NA14.532.42NA46.62090
    61711AFusion of skull arteries36.33NA20.637.39NA64.35090
    61720AIncise skull/brain surgery16.77NA10.743.51NA31.02090
    61735AIncise skull/brain surgery20.43NA12.764.16NA37.35090
    61750AIncise skull/brain biopsy18.20NA10.963.71NA32.87090
    61751ABrain biopsy w/ct/mr guide17.62NA10.773.57NA31.96090
    61760AImplant brain electrodes22.27NA8.834.59NA35.69090
    61770AIncise skull for treatment21.44NA13.054.09NA38.58090
    61790ATreat trigeminal nerve10.86NA6.021.82NA18.70090
    61791ATreat trigeminal tract14.61NA9.263.03NA26.90090
    61793AFocus radiation beam17.24NA10.933.51NA31.68090
    61795ABrain surgery using computer4.04NA2.090.81NA6.94ZZZ
    61850AImplant neuroelectrodes12.39NA8.082.23NA22.70090
    61860AImplant neuroelectrodes20.87NA12.884.04NA37.79090
    61862AImplant neurostimul, subcort19.34NA12.083.97NA35.39090
    61870AImplant neuroelectrodes14.94NA10.851.70NA27.49090
    61875AImplant neuroelectrodes15.06NA9.282.42NA26.76090
    61880ARevise/remove neuroelectrode6.29NA5.341.31NA12.94090
    61885AImplant neurostim one array5.85NA5.091.22NA12.16090
    61886AImplant neurostim arrays8.00NA6.151.64NA15.79090
    61888ARevise/remove neuroreceiver5.07NA3.901.04NA10.01010
    62000ATreat skull fracture12.53NA5.650.87NA19.05090
    62005ATreat skull fracture16.17NA9.462.33NA27.96090
    Start Printed Page 80105
    62010ATreatment of head injury19.81NA12.284.05NA36.14090
    62100ARepair brain fluid leakage22.03NA13.854.07NA39.95090
    62115AReduction of skull defect21.66NA11.694.53NA37.88090
    62116AReduction of skull defect23.59NA13.794.85NA42.23090
    62117AReduction of skull defect26.60NA15.875.56NA48.03090
    62120ARepair skull cavity lesion23.35NA14.383.07NA40.80090
    62121AIncise skull repair21.58NA13.552.47NA37.60090
    62140ARepair of skull defect13.51NA8.612.60NA24.72090
    62141ARepair of skull defect14.91NA9.782.85NA27.54090
    62142ARemove skull plate/flap10.79NA7.242.10NA20.13090
    62143AReplace skull plate/flap13.05NA8.752.55NA24.35090
    62145ARepair of skull & brain18.82NA11.693.81NA34.32090
    62146ARepair of skull with graft16.12NA10.402.94NA29.46090
    62147ARepair of skull with graft19.34NA12.143.64NA35.12090
    62148ARetr bone flap to fix skull2.00NA0.820.43NA3.25ZZZ
    62160ANeuroendoscopy add-on3.00NA1.160.52NA4.68ZZZ
    62161ADissect brain w/scope20.00NA9.713.70NA33.41090
    62162ARemove colloid cyst w/scope25.25NA11.895.77NA42.91090
    62163ANeuroendoscopy w/fb removal15.50NA7.973.70NA27.17090
    62164ARemove brain tumor w/scope27.50NA13.125.77NA46.39090
    62165ARemove pituit tumor w/scope22.00NA10.683.63NA36.31090
    62180AEstablish brain cavity shunt21.06NA12.904.32NA38.28090
    62190AEstablish brain cavity shunt11.07NA7.732.18NA20.98090
    62192AEstablish brain cavity shunt12.25NA8.272.46NA22.98090
    62194AReplace/irrigate catheter5.03NA2.770.50NA8.30010
    62200AEstablish brain cavity shunt18.32NA11.593.70NA33.61090
    62201ABrain cavity shunt w/scope14.86NA9.772.52NA27.15090
    62220AEstablish brain cavity shunt13.00NA8.652.53NA24.18090
    62223AEstablish brain cavity shunt12.87NA8.512.58NA23.96090
    62225AReplace/irrigate catheter5.41NA4.811.09NA11.31090
    62230AReplace/revise brain shunt10.54NA7.232.10NA19.87090
    62252ACsf shunt reprogram0.741.47NA0.182.39NAXXX
    6225226ACsf shunt reprogram0.740.380.380.161.281.28XXX
    62252TCACsf shunt reprogram0.001.09NA0.021.11NAXXX
    62256ARemove brain cavity shunt6.60NA5.451.34NA13.39090
    62258AReplace brain cavity shunt14.54NA9.342.91NA26.79090
    62263AEpidural lysis mult sessions6.1413.452.430.4220.018.99010
    62264AEpidural lysis on single day4.4311.381.320.3016.116.05010
    62268ADrain spinal cord cyst4.74NA2.710.29NA7.74000
    62269ANeedle biopsy, spinal cord5.02NA2.370.29NA7.68000
    62270ASpinal fluid tap, diagnostic1.133.780.500.064.971.69000
    62272ADrain cerebro spinal fluid1.354.850.650.136.332.13000
    62273ATreat epidural spine lesion2.152.790.580.145.082.87000
    62280ATreat spinal cord lesion2.639.340.820.1712.143.62010
    62281ATreat spinal cord lesion2.667.920.720.1610.743.54010
    62282ATreat spinal canal lesion2.3311.430.730.1413.903.20010
    62284AInjection for myelogram1.545.070.610.106.712.25000
    62287APercutaneous diskectomy8.08NA5.040.66NA13.78090
    62290AInject for spine disk x-ray3.008.541.290.2011.744.49000
    62291AInject for spine disk x-ray2.917.281.150.1710.364.23000
    62292AInjection into disk lesion7.86NA5.040.65NA13.55090
    62294AInjection into spinal artery11.83NA6.680.85NA19.36090
    62310AInject spine c/t1.914.910.510.116.932.53000
    62311AInject spine l/s (cd)1.545.020.450.096.652.08000
    62318AInject spine w/cath, c/t2.045.530.520.127.692.68000
    62319AInject spine w/cath l/s (cd)1.874.900.480.116.882.46000
    62350AImplant spinal canal cath6.87NA3.640.64NA11.15090
    62351AImplant spinal canal cath10.00NA6.721.79NA18.51090
    62355ARemove spinal canal catheter5.45NA2.820.47NA8.74090
    62360AInsert spine infusion device2.62NA2.280.21NA5.11090
    62361AImplant spine infusion pump5.42NA3.500.50NA9.42090
    62362AImplant spine infusion pump7.04NA4.060.86NA11.96090
    62365ARemove spine infusion device5.42NA4.090.58NA10.09090
    62367CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236726AAnalyze spine infusion pump0.480.130.130.030.640.64XXX
    62367TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    62368CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236826AAnalyze spine infusion pump0.750.190.190.050.990.99XXX
    62368TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    63001ARemoval of spinal lamina15.82NA9.933.03NA28.78090
    63003ARemoval of spinal lamina15.95NA10.282.98NA29.21090
    63005ARemoval of spinal lamina14.92NA10.312.62NA27.85090
    63011ARemoval of spinal lamina14.52NA8.601.43NA24.55090
    63012ARemoval of spinal lamina15.40NA10.452.71NA28.56090
    63015ARemoval of spinal lamina19.35NA12.363.84NA35.55090
    Start Printed Page 80106
    63016ARemoval of spinal lamina19.20NA12.223.62NA35.04090
    63017ARemoval of spinal lamina15.94NA10.772.91NA29.62090
    63020ANeck spine disk surgery14.81NA10.082.89NA27.78090
    63030ALow back disk surgery12.00NA8.752.21NA22.96090
    63035ASpinal disk surgery add-on3.15NA1.630.57NA5.35ZZZ
    63040ALaminotomy, single cervical18.81NA11.913.36NA34.08090
    63042ALaminotomy, single lumbar17.47NA11.713.11NA32.29090
    63043CLaminotomy, addl cervical0.000.000.000.000.000.00ZZZ
    63044CLaminotomy, addl lumbar0.000.000.000.000.000.00ZZZ
    63045ARemoval of spinal lamina16.50NA10.763.19NA30.45090
    63046ARemoval of spinal lamina15.80NA10.542.89NA29.23090
    63047ARemoval of spinal lamina14.61NA10.232.61NA27.45090
    63048ARemove spinal lamina add-on3.26NA1.710.58NA5.55ZZZ
    63055ADecompress spinal cord21.99NA13.604.09NA39.68090
    63056ADecompress spinal cord20.36NA12.983.34NA36.68090
    63057ADecompress spine cord add-on5.26NA2.710.81NA8.78ZZZ
    63064ADecompress spinal cord24.61NA14.934.72NA44.26090
    63066ADecompress spine cord add-on3.26NA1.710.63NA5.60ZZZ
    63075ANeck spine disk surgery19.41NA12.533.73NA35.67090
    63076ANeck spine disk surgery4.05NA2.110.78NA6.94ZZZ
    63077ASpine disk surgery, thorax21.44NA13.083.44NA37.96090
    63078ASpine disk surgery, thorax3.28NA1.670.50NA5.45ZZZ
    63081ARemoval of vertebral body23.73NA14.804.46NA42.99090
    63082ARemove vertebral body add-on4.37NA2.290.82NA7.48ZZZ
    63085ARemoval of vertebral body26.92NA15.834.70NA47.45090
    63086ARemove vertebral body add-on3.19NA1.630.55NA5.37ZZZ
    63087ARemoval of vertebral body35.57NA19.935.87NA61.37090
    63088ARemove vertebral body add-on4.33NA2.230.77NA7.33ZZZ
    63090ARemoval of vertebral body28.16NA16.404.27NA48.83090
    63091ARemove vertebral body add-on3.03NA1.490.45NA4.97ZZZ
    63170AIncise spinal cord tract(s)19.83NA13.693.89NA37.41090
    63172ADrainage of spinal cyst17.66NA13.213.46NA34.33090
    63173ADrainage of spinal cyst21.99NA15.224.14NA41.35090
    63180ARevise spinal cord ligaments18.27NA13.273.83NA35.37090
    63182ARevise spinal cord ligaments20.50NA12.933.48NA36.91090
    63185AIncise spinal column/nerves15.04NA9.822.08NA26.94090
    63190AIncise spinal column/nerves17.45NA11.922.88NA32.25090
    63191AIncise spinal column/nerves17.54NA12.313.50NA33.35090
    63194AIncise spinal column & cord19.19NA13.354.01NA36.55090
    63195AIncise spinal column & cord18.84NA12.973.44NA35.25090
    63196AIncise spinal column & cord22.30NA13.654.66NA40.61090
    63197AIncise spinal column & cord21.11NA13.854.42NA39.38090
    63198AIncise spinal column & cord25.38NA10.805.31NA41.49090
    63199AIncise spinal column & cord26.89NA16.295.62NA48.80090
    63200ARelease of spinal cord19.18NA13.103.61NA35.89090
    63250ARevise spinal cord vessels40.76NA20.697.65NA69.10090
    63251ARevise spinal cord vessels41.20NA23.267.98NA72.44090
    63252ARevise spinal cord vessels41.19NA22.907.75NA71.84090
    63265AExcise intraspinal lesion21.56NA13.304.29NA39.15090
    63266AExcise intraspinal lesion22.30NA13.734.47NA40.50090
    63267AExcise intraspinal lesion17.95NA11.533.50NA32.98090
    63268AExcise intraspinal lesion18.52NA10.863.18NA32.56090
    63270AExcise intraspinal lesion26.80NA16.105.41NA48.31090
    63271AExcise intraspinal lesion26.92NA16.205.56NA48.68090
    63272AExcise intraspinal lesion25.32NA15.275.07NA45.66090
    63273AExcise intraspinal lesion24.29NA14.895.08NA44.26090
    63275ABiopsy/excise spinal tumor23.68NA14.354.68NA42.71090
    63276ABiopsy/excise spinal tumor23.45NA14.234.63NA42.31090
    63277ABiopsy/excise spinal tumor20.83NA13.014.03NA37.87090
    63278ABiopsy/excise spinal tumor20.56NA12.844.02NA37.42090
    63280ABiopsy/excise spinal tumor28.35NA16.805.80NA50.95090
    63281ABiopsy/excise spinal tumor28.05NA16.645.67NA50.36090
    63282ABiopsy/excise spinal tumor26.39NA15.775.33NA47.49090
    63283ABiopsy/excise spinal tumor25.00NA15.095.12NA45.21090
    63285ABiopsy/excise spinal tumor36.00NA20.537.31NA63.84090
    63286ABiopsy/excise spinal tumor35.63NA20.477.07NA63.17090
    63287ABiopsy/excise spinal tumor36.70NA21.047.48NA65.22090
    63290ABiopsy/excise spinal tumor37.38NA21.187.65NA66.21090
    63300ARemoval of vertebral body24.43NA14.844.78NA44.05090
    63301ARemoval of vertebral body27.60NA15.845.03NA48.47090
    63302ARemoval of vertebral body27.81NA16.165.25NA49.22090
    63303ARemoval of vertebral body30.50NA17.395.21NA53.10090
    63304ARemoval of vertebral body30.33NA17.774.72NA52.82090
    63305ARemoval of vertebral body32.03NA18.305.39NA55.72090
    63306ARemoval of vertebral body32.22NA18.042.39NA52.65090
    Start Printed Page 80107
    63307ARemoval of vertebral body31.63NA17.334.23NA53.19090
    63308ARemove vertebral body add-on5.25NA2.671.01NA8.93ZZZ
    63600ARemove spinal cord lesion14.02NA6.031.22NA21.27090
    63610AStimulation of spinal cord8.73NA3.790.43NA12.95000
    63615ARemove lesion of spinal cord16.28NA9.992.85NA29.12090
    63650AImplant neuroelectrodes6.74NA2.960.48NA10.18090
    63655AImplant neuroelectrodes10.29NA7.231.85NA19.37090
    63660ARevise/remove neuroelectrode6.16NA3.740.65NA10.55090
    63685AImplant neuroreceiver7.04NA4.280.96NA12.28090
    63688ARevise/remove neuroreceiver5.39NA3.680.70NA9.77090
    63700ARepair of spinal herniation16.53NA10.452.69NA29.67090
    63702ARepair of spinal herniation18.48NA10.711.36NA30.55090
    63704ARepair of spinal herniation21.18NA12.613.84NA37.63090
    63706ARepair of spinal herniation24.11NA13.524.73NA42.36090
    63707ARepair spinal fluid leakage11.26NA8.011.96NA21.23090
    63709ARepair spinal fluid leakage14.32NA9.702.49NA26.51090
    63710AGraft repair of spine defect14.07NA9.432.61NA26.11090
    63740AInstall spinal shunt11.36NA7.762.15NA21.27090
    63741AInstall spinal shunt8.25NA4.861.05NA14.16090
    63744ARevision of spinal shunt8.10NA5.581.51NA15.19090
    63746ARemoval of spinal shunt6.43NA4.041.15NA11.62090
    64400AN block inj, trigeminal1.111.960.360.063.131.53000
    64402AN block inj, facial1.251.570.540.072.891.86000
    64405AN block inj, occipital1.321.700.400.083.101.80000
    64408AN block inj, vagus1.412.600.670.094.102.17000
    64410AN block inj, phrenic1.432.480.400.083.991.91000
    64412AN block inj, spinal accessor1.182.620.370.083.881.63000
    64413AN block inj, cervical plexus1.401.990.440.093.481.93000
    64415AN block inj, brachial plexus1.483.050.390.084.611.95000
    64416AN block cont infuse, b plex3.50NA0.750.08NA4.33010
    64417AN block inj, axillary1.443.250.430.094.781.96000
    64418AN block inj, suprascapular1.322.670.370.074.061.76000
    64420AN block inj, intercost, sng1.183.560.350.074.811.60000
    64421AN block inj, intercost, mlt1.685.300.460.107.082.24000
    64425AN block inj ilio-ing/hypogi1.751.600.480.113.462.34000
    64430AN block inj, pudendal1.462.090.500.113.662.07000
    64435AN block inj, paracervical1.452.240.650.153.842.25000
    64445AN block inj, sciatic, sng1.482.780.380.084.341.94000
    64446AN blk inj, sciatic, cont inf3.25NA1.150.08NA4.48010
    64447AN block inj fem, single1.50NA0.520.08NA2.10000
    64448AN block inj fem, cont inf3.00NA1.040.08NA4.12010
    64450AN block, other peripheral1.271.300.420.082.651.77000
    64470AInj paravertebral c/t1.854.990.570.126.962.54000
    64472AInj paravertebral c/t add-on1.291.990.320.093.371.70ZZZ
    64475AInj paravertebral l/s1.414.650.480.096.151.98000
    64476AInj paravertebral l/s add-on0.981.860.250.062.901.29ZZZ
    64479AInj foramen epidural c/t2.207.320.730.149.663.07000
    64480AInj foramen epidural add-on1.542.360.480.093.992.11ZZZ
    64483AInj foramen epidural l/s1.907.750.670.129.772.69000
    64484AInj foramen epidural add-on1.332.700.380.084.111.79ZZZ
    64505AN block, spenopalatine gangl1.361.890.490.083.331.93000
    64508AN block, carotid sinus s/p1.124.790.520.065.971.70000
    64510AN block, stellate ganglion1.223.190.380.074.481.67000
    64520AN block, lumbar/thoracic1.354.540.420.085.971.85000
    64530AN block inj, celiac pelus1.585.830.480.097.502.15000
    64550AApply neurostimulator0.180.560.050.010.750.24000
    64553AImplant neuroelectrodes2.311.891.270.174.373.75010
    64555AImplant neuroelectrodes2.272.470.640.114.853.02010
    64560AImplant neuroelectrodes2.362.430.710.174.963.24010
    64561AImplant neuroelectrodes6.7415.243.780.1122.0910.63010
    64565AImplant neuroelectrodes1.763.260.660.085.102.50010
    64573AImplant neuroelectrodes7.50NA5.401.48NA14.38090
    64575AImplant neuroelectrodes4.35NA3.010.37NA7.73090
    64577AImplant neuroelectrodes4.62NA3.630.50NA8.75090
    64580AImplant neuroelectrodes4.12NA4.010.21NA8.34090
    64581AImplant neuroelectrodes13.50NA6.610.37NA20.48090
    64585ARevise/remove neuroelectrode2.063.382.090.295.734.44010
    64590AImplant neuroreceiver2.40NA2.240.40NA5.04010
    64595ARevise/remove neuroreceiver1.73NA1.910.22NA3.86010
    64600AInjection treatment of nerve3.459.191.500.2812.925.23010
    64605AInjection treatment of nerve5.6110.602.010.5316.748.15010
    64610AInjection treatment of nerve7.16NA3.581.12NA11.86010
    64612ADestroy nerve, face muscle1.962.291.030.094.343.08010
    64613ADestroy nerve, spine muscle1.962.960.960.105.023.02010
    64614ADestroy nerve, extrem musc2.204.401.040.096.693.33010
    Start Printed Page 80108
    64620AInjection treatment of nerve2.846.131.100.179.144.11010
    64622ADestr paravertebrl nerve l/s3.008.531.170.1711.704.34010
    64623ADestr paravertebral n add-on0.992.490.230.063.541.28ZZZ
    64626ADestr paravertebrl nerve c/t3.288.461.840.2211.965.34010
    64627ADestr paravertebral n add-on1.162.700.270.083.941.51ZZZ
    64630AInjection treatment of nerve3.004.461.220.167.624.38010
    64640AInjection treatment of nerve2.766.721.700.119.594.57010
    64680AInjection treatment of nerve2.627.281.210.1510.053.98010
    64702ARevise finger/toe nerve4.23NA3.990.51NA8.73090
    64704ARevise hand/foot nerve4.57NA3.220.59NA8.38090
    64708ARevise arm/leg nerve6.12NA5.120.82NA12.06090
    64712ARevision of sciatic nerve7.75NA5.270.54NA13.56090
    64713ARevision of arm nerve(s)11.00NA5.801.01NA17.81090
    64714ARevise low back nerve(s)10.33NA4.220.64NA15.19090
    64716ARevision of cranial nerve6.31NA4.970.59NA11.87090
    64718ARevise ulnar nerve at elbow5.99NA5.300.87NA12.16090
    64719ARevise ulnar nerve at wrist4.85NA4.770.63NA10.25090
    64721ACarpal tunnel surgery4.295.975.640.5910.8510.52090
    64722ARelieve pressure on nerve(s)4.70NA3.330.32NA8.35090
    64726ARelease foot/toe nerve4.18NA3.090.57NA7.84090
    64727AInternal nerve revision3.10NA1.540.40NA5.04ZZZ
    64732AIncision of brow nerve4.41NA3.640.77NA8.82090
    64734AIncision of cheek nerve4.92NA3.650.83NA9.40090
    64736AIncision of chin nerve4.60NA2.950.71NA8.26090
    64738AIncision of jaw nerve5.73NA3.650.84NA10.22090
    64740AIncision of tongue nerve5.59NA3.820.43NA9.84090
    64742AIncision of facial nerve6.22NA4.710.69NA11.62090
    64744AIncise nerve, back of head5.24NA4.000.98NA10.22090
    64746AIncise diaphragm nerve5.93NA4.490.75NA11.17090
    64752AIncision of vagus nerve7.06NA4.700.83NA12.59090
    64755AIncision of stomach nerves13.52NA6.171.16NA20.85090
    64760AIncision of vagus nerve6.96NA4.020.51NA11.49090
    64761AIncision of pelvis nerve6.41NA3.630.26NA10.30090
    64763AIncise hip/thigh nerve6.93NA6.070.77NA13.77090
    64766AIncise hip/thigh nerve8.67NA5.680.99NA15.34090
    64771ASever cranial nerve7.35NA5.621.32NA14.29090
    64772AIncision of spinal nerve7.21NA4.891.20NA13.30090
    64774ARemove skin nerve lesion5.17NA3.780.60NA9.55090
    64776ARemove digit nerve lesion5.12NA3.840.63NA9.59090
    64778ADigit nerve surgery add-on3.11NA1.540.38NA5.03ZZZ
    64782ARemove limb nerve lesion6.23NA3.720.79NA10.74090
    64783ALimb nerve surgery add-on3.72NA1.890.48NA6.09ZZZ
    64784ARemove nerve lesion9.82NA6.681.17NA17.67090
    64786ARemove sciatic nerve lesion15.46NA10.132.22NA27.81090
    64787AImplant nerve end4.30NA2.180.56NA7.04ZZZ
    64788ARemove skin nerve lesion4.61NA3.480.54NA8.63090
    64790ARemoval of nerve lesion11.31NA7.291.68NA20.28090
    64792ARemoval of nerve lesion14.92NA8.851.88NA25.65090
    64795ABiopsy of nerve3.01NA1.800.40NA5.21000
    64802ARemove sympathetic nerves9.15NA5.430.87NA15.45090
    64804ARemove sympathetic nerves14.64NA7.421.79NA23.85090
    64809ARemove sympathetic nerves13.67NA6.310.96NA20.94090
    64818ARemove sympathetic nerves10.30NA5.771.08NA17.15090
    64820ARemove sympathetic nerves10.37NA7.441.17NA18.98090
    64821ARemove sympathestic nerves8.75NA9.230.99NA18.97090
    64822ARemove sympathetic nerves8.75NA9.230.99NA18.97090
    64823ARemove sympathetic nerves10.37NA10.031.17NA21.57090
    64831ARepair of digit nerve9.44NA7.241.14NA17.82090
    64832ARepair nerve add-on5.66NA3.020.68NA9.36ZZZ
    64834ARepair of hand or foot nerve10.19NA7.181.23NA18.60090
    64835ARepair of hand or foot nerve10.94NA7.861.36NA20.16090
    64836ARepair of hand or foot nerve10.94NA7.831.32NA20.09090
    64837ARepair nerve add-on6.26NA3.310.80NA10.37ZZZ
    64840ARepair of leg nerve13.02NA8.340.86NA22.22090
    64856ARepair/transpose nerve13.80NA9.401.71NA24.91090
    64857ARepair arm/leg nerve14.49NA9.871.76NA26.12090
    64858ARepair sciatic nerve16.49NA10.822.78NA30.09090
    64859ANerve surgery4.26NA2.250.50NA7.01ZZZ
    64861ARepair of arm nerves19.24NA12.642.45NA34.33090
    64862ARepair of low back nerves19.44NA12.262.47NA34.17090
    64864ARepair of facial nerve12.55NA8.521.13NA22.20090
    64865ARepair of facial nerve15.24NA10.091.37NA26.70090
    64866AFusion of facial/other nerve15.74NA9.991.06NA26.79090
    64868AFusion of facial/other nerve14.04NA9.321.40NA24.76090
    64870AFusion of facial/other nerve15.99NA9.091.08NA26.16090
    Start Printed Page 80109
    64872ASubsequent repair of nerve1.99NA1.080.24NA3.31ZZZ
    64874ARepair & revise nerve add-on2.98NA1.540.34NA4.86ZZZ
    64876ARepair nerve/shorten bone3.38NA1.310.39NA5.08ZZZ
    64885ANerve graft, head or neck17.53NA11.161.51NA30.20090
    64886ANerve graft, head or neck20.75NA13.071.73NA35.55090
    64890ANerve graft, hand or foot15.15NA10.251.74NA27.14090
    64891ANerve graft, hand or foot16.14NA7.751.38NA25.27090
    64892ANerve graft, arm or leg14.65NA9.101.65NA25.40090
    64893ANerve graft, arm or leg15.60NA10.051.77NA27.42090
    64895ANerve graft, hand or foot19.25NA9.822.04NA31.11090
    64896ANerve graft, hand or foot20.49NA11.111.85NA33.45090
    64897ANerve graft, arm or leg18.24NA10.912.64NA31.79090
    64898ANerve graft, arm or leg19.50NA11.882.71NA34.09090
    64901ANerve graft add-on10.22NA5.410.99NA16.62ZZZ
    64902ANerve graft add-on11.83NA6.131.10NA19.06ZZZ
    64905ANerve pedicle transfer14.02NA8.941.52NA24.48090
    64907ANerve pedicle transfer18.83NA12.381.79NA33.00090
    64999CNervous system surgery0.000.000.000.000.000.00YYY
    65091ARevise eye6.46NA11.280.26NA18.00090
    65093ARevise eye with implant6.87NA11.500.28NA18.65090
    65101ARemoval of eye7.03NA11.590.28NA18.90090
    65103ARemove eye/insert implant7.57NA11.740.30NA19.61090
    65105ARemove eye/attach implant8.49NA12.240.34NA21.07090
    65110ARemoval of eye13.95NA15.290.68NA29.92090
    65112ARemove eye/revise socket16.38NA17.540.96NA34.88090
    65114ARemove eye/revise socket17.53NA17.500.94NA35.97090
    65125ARevise ocular implant3.125.961.450.159.234.72090
    65130AInsert ocular implant7.15NA11.220.28NA18.65090
    65135AInsert ocular implant7.33NA11.430.29NA19.05090
    65140AAttach ocular implant8.02NA11.710.31NA20.04090
    65150ARevise ocular implant6.26NA10.750.25NA17.26090
    65155AReinsert ocular implant8.66NA12.540.40NA21.60090
    65175ARemoval of ocular implant6.28NA10.820.26NA17.36090
    65205ARemove foreign body from eye0.710.620.190.031.360.93000
    65210ARemove foreign body from eye0.840.770.300.031.641.17000
    65220ARemove foreign body from eye0.718.060.180.058.820.94000
    65222ARemove foreign body from eye0.930.780.280.041.751.25000
    65235ARemove foreign body from eye7.57NA6.840.30NA14.71090
    65260ARemove foreign body from eye10.96NA12.380.43NA23.77090
    65265ARemove foreign body from eye12.59NA13.880.50NA26.97090
    65270ARepair of eye wound1.903.972.310.085.954.29010
    65272ARepair of eye wound3.825.594.640.169.578.62090
    65273ARepair of eye wound4.36NA4.980.17NA9.51090
    65275ARepair of eye wound5.345.565.080.2711.1710.69090
    65280ARepair of eye wound7.66NA7.640.30NA15.60090
    65285ARepair of eye wound12.90NA13.460.51NA26.87090
    65286ARepair of eye wound5.518.827.610.2114.5413.33090
    65290ARepair of eye socket wound5.41NA6.270.26NA11.94090
    65400ARemoval of eye lesion6.068.386.910.2414.6813.21090
    65410ABiopsy of cornea1.471.710.670.063.242.20000
    65420ARemoval of eye lesion4.178.086.970.1712.4211.31090
    65426ARemoval of eye lesion5.257.806.540.2013.2511.99090
    65430ACorneal smear1.478.340.680.069.872.21000
    65435ACurette/treat cornea0.921.330.400.042.291.36000
    65436ACurette/treat cornea4.195.814.860.1710.179.22090
    65450ATreatment of corneal lesion3.277.766.570.1311.169.97090
    65600ARevision of cornea3.405.391.430.148.934.97090
    65710ACorneal transplant12.35NA12.720.49NA25.56090
    65730ACorneal transplant14.25NA11.770.56NA26.58090
    65750ACorneal transplant15.00NA14.130.59NA29.72090
    65755ACorneal transplant14.89NA14.040.58NA29.51090
    65760NRevision of cornea0.000.000.000.000.000.00XXX
    65765NRevision of cornea0.000.000.000.000.000.00XXX
    65767NCorneal tissue transplant0.000.000.000.000.000.00XXX
    65770ARevise cornea with implant17.56NA15.060.69NA33.31090
    65771NRadial keratotomy0.000.000.000.000.000.00XXX
    65772ACorrection of astigmatism4.297.246.240.1711.7010.70090
    65775ACorrection of astigmatism5.79NA8.380.22NA14.39090
    65800ADrainage of eye1.912.261.400.084.253.39000
    65805ADrainage of eye1.912.261.410.084.253.40000
    65810ADrainage of eye4.87NA8.650.19NA13.71090
    65815ADrainage of eye5.059.087.880.2014.3313.13090
    65820ARelieve inner eye pressure8.13NA10.640.32NA19.09090
    65850AIncision of eye10.52NA9.990.41NA20.92090
    65855ALaser surgery of eye3.855.013.560.179.037.58010
    Start Printed Page 80110
    65860AIncise inner eye adhesions3.554.013.070.147.706.76090
    65865AIncise inner eye adhesions5.60NA6.690.22NA12.51090
    65870AIncise inner eye adhesions6.27NA7.020.24NA13.53090
    65875AIncise inner eye adhesions6.54NA7.120.25NA13.91090
    65880AIncise inner eye adhesions7.09NA7.380.28NA14.75090
    65900ARemove eye lesion10.93NA12.480.46NA23.87090
    65920ARemove implant of eye8.40NA7.990.33NA16.72090
    65930ARemove blood clot from eye7.44NA8.560.29NA16.29090
    66020AInjection treatment of eye1.592.361.520.074.023.18010
    66030AInjection treatment of eye1.252.201.350.053.502.65010
    66130ARemove eye lesion7.697.396.480.3115.3914.48090
    66150AGlaucoma surgery8.30NA10.610.33NA19.24090
    66155AGlaucoma surgery8.29NA10.580.32NA19.19090
    66160AGlaucoma surgery10.17NA11.440.41NA22.02090
    66165AGlaucoma surgery8.01NA10.440.31NA18.76090
    66170AGlaucoma surgery12.16NA16.520.48NA29.16090
    66172AIncision of eye15.04NA15.120.59NA30.75090
    66180AImplant eye shunt14.55NA12.040.57NA27.16090
    66185ARevise eye shunt8.14NA8.230.32NA16.69090
    66220ARepair eye lesion7.77NA9.930.32NA18.02090
    66225ARepair/graft eye lesion11.05NA9.310.44NA20.80090
    66250AFollow-up surgery of eye5.987.796.330.2314.0012.54090
    66500AIncision of iris3.71NA4.650.15NA8.51090
    66505AIncision of iris4.08NA4.800.17NA9.05090
    66600ARemove iris and lesion8.68NA8.620.34NA17.64090
    66605ARemoval of iris12.79NA12.140.61NA25.54090
    66625ARemoval of iris5.137.626.590.2012.9511.92090
    66630ARemoval of iris6.16NA7.500.24NA13.90090
    66635ARemoval of iris6.25NA6.460.24NA12.95090
    66680ARepair iris & ciliary body5.44NA6.060.21NA11.71090
    66682ARepair iris & ciliary body6.21NA7.510.24NA13.96090
    66700ADestruction, ciliary body4.785.444.270.1910.419.24090
    66710ADestruction, ciliary body4.785.143.810.1810.118.76090
    66720ADestruction, ciliary body4.785.454.490.1910.429.34090
    66740ADestruction, ciliary body4.78NA4.840.18NA10.76090
    66761ARevision of iris4.075.253.980.1610.489.18090
    66762ARevision of iris4.585.333.970.189.999.70090
    66770ARemoval of inner eye lesion5.185.764.480.2012.1410.84090
    66820AIncision, secondary cataract3.89NA8.190.16NA12.24090
    66821AAfter cataract laser surgery2.353.783.340.106.235.79090
    66825AReposition intraocular lens8.23NA10.190.32NA18.74090
    66830ARemoval of lens lesion8.20NA6.830.32NA15.35090
    66840ARemoval of lens material7.91NA6.740.31NA14.96090
    66850ARemoval of lens material9.11NA7.260.36NA16.73090
    66852ARemoval of lens material9.97NA7.720.39NA18.08090
    66920AExtraction of lens8.86NA7.190.35NA16.40090
    66930AExtraction of lens10.18NA8.680.41NA19.27090
    66940AExtraction of lens8.93NA8.120.35NA17.40090
    66982ACataract surgery, complex13.50NA9.090.56NA23.15090
    66983ACataract surg w/iol, 1 stage8.99NA5.880.37NA15.24090
    66984ACataract surg w/iol, 1 stage10.23NA7.590.41NA18.23090
    66985AInsert lens prosthesis8.39NA6.820.33NA15.54090
    66986AExchange lens prosthesis12.28NA8.570.49NA21.34090
    66990AOphthalmic endoscope add-on1.51NA0.700.06NA2.27ZZZ
    66999CEye surgery procedure0.000.000.000.000.000.00YYY
    67005APartial removal of eye fluid5.70NA2.650.22NA8.57090
    67010APartial removal of eye fluid6.87NA3.200.27NA10.34090
    67015ARelease of eye fluid6.92NA8.120.27NA15.31090
    67025AReplace eye fluid6.8416.767.510.2723.8714.62090
    67027AImplant eye drug system10.8514.108.710.4625.4120.02090
    67028AInjection eye drug2.5210.431.160.1113.063.79000
    67030AIncise inner eye strands4.84NA6.720.19NA11.75090
    67031ALaser surgery, eye strands3.674.083.130.157.906.95090
    67036ARemoval of inner eye fluid11.89NA8.990.47NA21.35090
    67038AStrip retinal membrane21.24NA15.450.84NA37.53090
    67039ALaser treatment of retina14.52NA12.330.57NA27.42090
    67040ALaser treatment of retina17.23NA13.590.68NA31.50090
    67101ARepair detached retina7.5310.948.870.2918.7616.69090
    67105ARepair detached retina7.417.565.540.2915.2613.24090
    67107ARepair detached retina14.84NA13.180.58NA28.60090
    67108ARepair detached retina20.82NA17.690.82NA39.33090
    67110ARepair detached retina8.8120.1810.290.3529.3419.45090
    67112ARerepair detached retina16.86NA15.690.66NA33.21090
    67115ARelease encircling material4.99NA6.810.19NA11.99090
    67120ARemove eye implant material5.9816.077.120.2322.2813.33090
    Start Printed Page 80111
    67121ARemove eye implant material10.67NA12.100.42NA23.19090
    67141ATreatment of retina5.208.036.950.2013.4312.35090
    67145ATreatment of retina5.375.274.160.2110.859.74090
    67208ATreatment of retinal lesion6.708.367.130.2615.3214.09090
    67210ATreatment of retinal lesion8.827.265.740.3516.4314.91090
    67218ATreatment of retinal lesion18.53NA15.790.53NA34.85090
    67220ATreatment of choroid lesion13.1310.819.620.5124.4523.26090
    67221AOcular photodynamic ther4.014.631.880.168.806.05000
    67225AEye photodynamic ther add-on0.470.280.210.010.760.69ZZZ
    67227ATreatment of retinal lesion6.589.107.150.2615.9413.99090
    67228ATreatment of retinal lesion12.749.847.210.5023.0820.45090
    67250AReinforce eye wall8.66NA11.670.36NA20.69090
    67255AReinforce/graft eye wall8.90NA11.840.35NA21.09090
    67299CEye surgery procedure0.000.000.000.000.000.00YYY
    67311ARevise eye muscle6.65NA6.150.27NA13.07090
    67312ARevise two eye muscles8.54NA7.200.35NA16.09090
    67314ARevise eye muscle7.52NA6.720.30NA14.54090
    67316ARevise two eye muscles9.66NA7.700.40NA17.76090
    67318ARevise eye muscle(s)7.85NA7.110.31NA15.27090
    67320ARevise eye muscle(s) add-on4.33NA2.010.17NA6.51ZZZ
    67331AEye surgery follow-up add-on4.06NA1.940.17NA6.17ZZZ
    67332ARerevise eye muscles add-on4.49NA2.080.18NA6.75ZZZ
    67334ARevise eye muscle w/suture3.98NA1.840.16NA5.98ZZZ
    67335AEye suture during surgery2.49NA1.150.10NA3.74ZZZ
    67340ARevise eye muscle add-on4.93NA2.280.19NA7.40ZZZ
    67343ARelease eye tissue7.35NA7.000.30NA14.65090
    67345ADestroy nerve of eye muscle2.964.331.340.137.424.43010
    67350ABiopsy eye muscle2.87NA1.930.13NA4.93000
    67399CEye muscle surgery procedure0.000.000.000.000.000.00YYY
    67400AExplore/biopsy eye socket9.76NA13.390.43NA23.58090
    67405AExplore/drain eye socket7.93NA12.300.36NA20.59090
    67412AExplore/treat eye socket9.50NA15.450.41NA25.36090
    67413AExplore/treat eye socket10.00NA13.350.43NA23.78090
    67414AExplr/decompress eye socket11.13NA16.370.48NA27.98090
    67415AAspiration, orbital contents1.76NA0.790.09NA2.64000
    67420AExplore/treat eye socket20.06NA20.100.84NA41.00090
    67430AExplore/treat eye socket13.39NA17.120.97NA31.48090
    67440AExplore/drain eye socket13.09NA16.530.58NA30.20090
    67445AExplr/decompress eye socket14.42NA17.650.63NA32.70090
    67450AExplore/biopsy eye socket13.51NA16.680.56NA30.75090
    67500AInject/treat eye socket0.790.840.190.041.671.02000
    67505AInject/treat eye socket0.820.930.210.041.791.07000
    67515AInject/treat eye socket0.610.840.280.021.470.91000
    67550AInsert eye socket implant10.19NA13.190.50NA23.88090
    67560ARevise eye socket implant10.60NA13.050.47NA24.12090
    67570ADecompress optic nerve13.58NA17.130.69NA31.40090
    67599COrbit surgery procedure0.000.000.000.000.000.00YYY
    67700ADrainage of eyelid abscess1.357.460.580.068.871.99010
    67710AIncision of eyelid1.027.610.480.048.671.54010
    67715AIncision of eyelid fold1.22NA0.570.05NA1.84010
    67800ARemove eyelid lesion1.382.580.640.064.022.08010
    67801ARemove eyelid lesions1.887.910.880.089.872.84010
    67805ARemove eyelid lesions2.228.081.030.0910.393.34010
    67808ARemove eyelid lesion(s)3.80NA4.160.17NA8.13090
    67810ABiopsy of eyelid1.485.520.700.067.062.24000
    67820ARevise eyelashes0.891.960.380.042.891.31000
    67825ARevise eyelashes1.385.491.030.066.932.47010
    67830ARevise eyelashes1.7011.062.110.0712.833.88010
    67835ARevise eyelashes5.56NA4.650.22NA10.43090
    67840ARemove eyelid lesion2.047.870.960.089.993.08010
    67850ATreat eyelid lesion1.699.042.060.0710.803.82010
    67875AClosure of eyelid by suture1.3511.202.080.0612.613.49000
    67880ARevision of eyelid3.8012.263.130.1616.227.09090
    67882ARevision of eyelid5.0714.084.620.2119.369.90090
    67900ARepair brow defect6.1410.966.460.3017.4012.90090
    67901ARepair eyelid defect6.97NA6.800.32NA14.09090
    67902ARepair eyelid defect7.03NA6.880.34NA14.25090
    67903ARepair eyelid defect6.3712.117.180.3918.8713.94090
    67904ARepair eyelid defect6.2614.388.100.2620.9014.62090
    67906ARepair eyelid defect6.799.576.370.4216.7813.58090
    67908ARepair eyelid defect5.139.326.100.2014.6511.43090
    67909ARevise eyelid defect5.409.946.580.2515.5912.23090
    67911ARevise eyelid defect5.27NA6.680.23NA12.18090
    67914ARepair eyelid defect3.6812.713.560.1616.557.40090
    67915ARepair eyelid defect3.1811.261.480.1314.574.79090
    Start Printed Page 80112
    67916ARepair eyelid defect5.3115.805.330.2221.3310.86090
    67917ARepair eyelid defect6.0210.266.600.2516.5312.87090
    67921ARepair eyelid defect3.4012.443.350.1415.986.89090
    67922ARepair eyelid defect3.0611.233.160.1314.426.35090
    67923ARepair eyelid defect5.8814.925.420.2421.0411.54090
    67924ARepair eyelid defect5.799.605.960.2315.6211.98090
    67930ARepair eyelid wound3.6112.283.050.1716.066.83010
    67935ARepair eyelid wound6.2215.025.400.2921.5311.91090
    67938ARemove eyelid foreign body1.339.400.510.0610.791.90010
    67950ARevision of eyelid5.828.757.270.3014.8713.39090
    67961ARevision of eyelid5.699.125.750.2615.0711.70090
    67966ARevision of eyelid6.578.805.890.3315.7012.79090
    67971AReconstruction of eyelid9.79NA7.530.42NA17.74090
    67973AReconstruction of eyelid12.87NA9.540.59NA23.00090
    67974AReconstruction of eyelid12.84NA9.450.54NA22.83090
    67975AReconstruction of eyelid9.13NA7.200.38NA16.71090
    67999CRevision of eyelid0.000.000.000.000.000.00YYY
    68020AIncise/drain eyelid lining1.377.520.630.068.952.06010
    68040ATreatment of eyelid lesions0.857.380.390.038.261.27000
    68100ABiopsy of eyelid lining1.357.590.620.069.002.03000
    68110ARemove eyelid lining lesion1.778.641.350.0710.483.19010
    68115ARemove eyelid lining lesion2.368.141.090.1010.603.55010
    68130ARemove eyelid lining lesion4.93NA2.300.19NA7.42090
    68135ARemove eyelid lining lesion1.847.890.860.079.802.77010
    68200ATreat eyelid by injection0.490.740.230.021.250.74000
    68320ARevise/graft eyelid lining5.375.565.140.2111.1410.72090
    68325ARevise/graft eyelid lining7.36NA6.160.30NA13.82090
    68326ARevise/graft eyelid lining7.15NA6.030.30NA13.48090
    68328ARevise/graft eyelid lining8.18NA6.790.40NA15.37090
    68330ARevise eyelid lining4.837.045.530.1912.0610.55090
    68335ARevise/graft eyelid lining7.19NA5.480.29NA12.96090
    68340ASeparate eyelid adhesions4.1714.494.170.1718.838.51090
    68360ARevise eyelid lining4.376.585.230.1711.129.77090
    68362ARevise eyelid lining7.34NA7.820.29NA15.45090
    68399CEyelid lining surgery0.000.000.000.000.000.00YYY
    68400AIncise/drain tear gland1.6911.172.130.0712.933.89010
    68420AIncise/drain tear sac2.3011.502.440.1013.904.84010
    68440AIncise tear duct opening0.947.520.440.048.501.42010
    68500ARemoval of tear gland11.02NA9.590.60NA21.21090
    68505APartial removal, tear gland10.94NA10.690.57NA22.20090
    68510ABiopsy of tear gland4.6112.312.150.1917.116.95000
    68520ARemoval of tear sac7.51NA7.170.33NA15.01090
    68525ABiopsy of tear sac4.43NA2.070.18NA6.68000
    68530AClearance of tear duct3.6613.813.000.1617.636.82010
    68540ARemove tear gland lesion10.60NA9.170.46NA20.23090
    68550ARemove tear gland lesion13.26NA11.190.66NA25.11090
    68700ARepair tear ducts6.60NA6.640.27NA13.51090
    68705ARevise tear duct opening2.068.070.970.0810.213.11010
    68720ACreate tear sac drain8.96NA7.780.38NA17.12090
    68745ACreate tear duct drain8.63NA7.660.38NA16.67090
    68750ACreate tear duct drain8.66NA8.170.37NA17.20090
    68760AClose tear duct opening1.736.491.190.078.292.99010
    68761AClose tear duct opening1.363.000.950.064.422.37010
    68770AClose tear system fistula7.0216.245.980.2823.5413.28090
    68801ADilate tear duct opening0.940.850.560.041.831.54010
    68810AProbe nasolacrimal duct1.902.400.880.084.382.86010
    68811AProbe nasolacrimal duct2.35NA2.390.10NA4.84010
    68815AProbe nasolacrimal duct3.2012.252.830.1415.596.17010
    68840AExplore/irrigate tear ducts1.251.560.930.052.862.23010
    68850AInjection for tear sac x-ray0.8014.940.310.0315.771.14000
    68899CTear duct system surgery0.000.000.000.000.000.00YYY
    69000ADrain external ear lesion1.452.100.550.103.652.10010
    69005ADrain external ear lesion2.112.532.010.164.804.28010
    69020ADrain outer ear canal lesion1.482.220.710.113.812.30010
    69090NPierce earlobes0.000.000.000.000.000.00XXX
    69100ABiopsy of external ear0.811.590.410.042.441.26000
    69105ABiopsy of external ear canal0.851.511.020.062.421.93000
    69110ARemove external ear, partial3.443.532.780.247.216.46090
    69120ARemoval of external ear4.05NA4.450.31NA8.81090
    69140ARemove ear canal lesion(s)7.97NA8.070.56NA16.60090
    69145ARemove ear canal lesion(s)2.623.372.520.186.175.32090
    69150AExtensive ear canal surgery13.43NA11.171.07NA25.67090
    69155AExtensive ear/neck surgery20.80NA15.261.51NA37.57090
    69200AClear outer ear canal0.771.440.760.052.261.58000
    69205AClear outer ear canal1.20NA1.560.09NA2.85010
    Start Printed Page 80113
    69210ARemove impacted ear wax0.610.580.240.041.230.89000
    69220AClean out mastoid cavity0.831.520.430.062.411.32000
    69222AClean out mastoid cavity1.402.231.700.103.733.20010
    69300RRevise external ear6.36NA4.370.43NA11.16YYY
    69310ARebuild outer ear canal10.79NA9.710.77NA21.27090
    69320ARebuild outer ear canal16.96NA13.791.17NA31.92090
    69399COuter ear surgery procedure0.000.000.000.000.000.00YYY
    69400AInflate middle ear canal0.831.510.400.062.401.29000
    69401AInflate middle ear canal0.631.410.350.042.081.02000
    69405ACatheterize middle ear canal2.633.091.460.185.904.27010
    69410AInset middle ear (baffle)0.331.420.160.021.770.51000
    69420AIncision of eardrum1.332.360.710.103.792.14010
    69421AIncision of eardrum1.732.581.900.134.443.76010
    69424ARemove ventilating tube0.851.690.900.062.601.81000
    69433ACreate eardrum opening1.522.310.850.113.942.48010
    69436ACreate eardrum opening1.96NA2.040.14NA4.14010
    69440AExploration of middle ear7.57NA7.300.53NA15.40090
    69450AEardrum revision5.57NA6.110.39NA12.07090
    69501AMastoidectomy9.07NA8.070.65NA17.79090
    69502AMastoidectomy12.38NA10.640.86NA23.88090
    69505ARemove mastoid structures12.99NA10.890.92NA24.80090
    69511AExtensive mastoid surgery13.52NA11.230.96NA25.71090
    69530AExtensive mastoid surgery19.19NA14.751.32NA35.26090
    69535ARemove part of temporal bone36.14NA24.172.59NA62.90090
    69540ARemove ear lesion1.202.271.590.093.562.88010
    69550ARemove ear lesion10.99NA9.750.80NA21.54090
    69552ARemove ear lesion19.46NA14.321.36NA35.14090
    69554ARemove ear lesion33.16NA21.822.32NA57.30090
    69601AMastoid surgery revision13.24NA11.820.92NA25.98090
    69602AMastoid surgery revision13.58NA11.360.94NA25.88090
    69603AMastoid surgery revision14.02NA11.551.00NA26.57090
    69604AMastoid surgery revision14.02NA11.480.98NA26.48090
    69605AMastoid surgery revision18.49NA14.481.29NA34.26090
    69610ARepair of eardrum4.434.223.400.318.968.14010
    69620ARepair of eardrum5.896.873.190.4013.169.48090
    69631ARepair eardrum structures9.86NA9.190.69NA19.74090
    69632ARebuild eardrum structures12.75NA11.540.89NA25.18090
    69633ARebuild eardrum structures12.10NA11.190.84NA24.13090
    69635ARepair eardrum structures13.33NA10.740.87NA24.94090
    69636ARebuild eardrum structures15.22NA13.011.07NA29.30090
    69637ARebuild eardrum structures15.11NA12.921.06NA29.09090
    69641ARevise middle ear & mastoid12.71NA10.870.89NA24.47090
    69642ARevise middle ear & mastoid16.84NA13.861.18NA31.88090
    69643ARevise middle ear & mastoid15.32NA13.011.08NA29.41090
    69644ARevise middle ear & mastoid16.97NA13.941.19NA32.10090
    69645ARevise middle ear & mastoid16.38NA13.571.16NA31.11090
    69646ARevise middle ear & mastoid17.99NA14.531.26NA33.78090
    69650ARelease middle ear bone9.66NA8.430.68NA18.77090
    69660ARevise middle ear bone11.90NA9.650.84NA22.39090
    69661ARevise middle ear bone15.74NA12.441.10NA29.28090
    69662ARevise middle ear bone15.44NA12.311.08NA28.83090
    69666ARepair middle ear structures9.75NA8.510.68NA18.94090
    69667ARepair middle ear structures9.76NA8.490.72NA18.97090
    69670ARemove mastoid air cells11.51NA10.110.78NA22.40090
    69676ARemove middle ear nerve9.52NA9.030.69NA19.24090
    69700AClose mastoid fistula8.23NA5.530.55NA14.31090
    69710NImplant/replace hearing aid0.000.000.000.000.000.00XXX
    69711ARemove/repair hearing aid10.44NA9.350.62NA20.41090
    69714AImplant temple bone w/stimul14.00NA11.171.01NA26.18090
    69715ATemple bne implnt w/stimulat18.25NA13.731.32NA33.30090
    69717ATemple bone implant revision14.98NA10.551.08NA26.61090
    69718ARevise temple bone implant18.50NA13.611.34NA33.45090
    69720ARelease facial nerve14.38NA12.471.03NA27.88090
    69725ARelease facial nerve25.38NA18.041.78NA45.20090
    69740ARepair facial nerve15.96NA11.271.13NA28.36090
    69745ARepair facial nerve16.69NA12.771.00NA30.46090
    69799CMiddle ear surgery procedure0.000.000.000.000.000.00YYY
    69801AIncise inner ear8.56NA7.840.60NA17.00090
    69802AIncise inner ear13.10NA11.130.91NA25.14090
    69805AExplore inner ear13.82NA10.800.97NA25.59090
    69806AExplore inner ear12.35NA10.680.86NA23.89090
    69820AEstablish inner ear window10.34NA8.970.66NA19.97090
    69840ARevise inner ear window10.26NA7.640.64NA18.54090
    69905ARemove inner ear11.10NA9.730.77NA21.60090
    69910ARemove inner ear & mastoid13.63NA11.190.94NA25.76090
    Start Printed Page 80114
    69915AIncise inner ear nerve21.23NA15.651.54NA38.42090
    69930AImplant cochlear device16.81NA12.701.19NA30.70090
    69949CInner ear surgery procedure0.000.000.000.000.000.00YYY
    69950AIncise inner ear nerve25.64NA16.462.90NA45.00090
    69955ARelease facial nerve27.04NA18.641.89NA47.57090
    69960ARelease inner ear canal27.04NA18.132.43NA47.60090
    69970ARemove inner ear lesion30.04NA18.912.34NA51.29090
    69979CTemporal bone surgery0.000.000.000.000.000.00YYY
    69990RMicrosurgery add-on3.47NA1.840.56NA5.87ZZZ
    70010AContrast x-ray of brain1.194.72NA0.246.15NAXXX
    7001026AContrast x-ray of brain1.190.410.410.061.661.66XXX
    70010TCAContrast x-ray of brain0.004.31NA0.184.49NAXXX
    70015AContrast x-ray of brain1.191.75NA0.123.06NAXXX
    7001526AContrast x-ray of brain1.190.410.410.051.651.65XXX
    70015TCAContrast x-ray of brain0.001.34NA0.071.41NAXXX
    70030AX-ray eye for foreign body0.170.48NA0.030.68NAXXX
    7003026AX-ray eye for foreign body0.170.060.060.010.240.24XXX
    70030TCAX-ray eye for foreign body0.000.42NA0.020.44NAXXX
    70100AX-ray exam of jaw0.180.58NA0.030.79NAXXX
    7010026AX-ray exam of jaw0.180.060.060.010.250.25XXX
    70100TCAX-ray exam of jaw0.000.52NA0.020.54NAXXX
    70110AX-ray exam of jaw0.250.70NA0.040.99NAXXX
    7011026AX-ray exam of jaw0.250.080.080.010.340.34XXX
    70110TCAX-ray exam of jaw0.000.62NA0.030.65NAXXX
    70120AX-ray exam of mastoids0.180.68NA0.040.90NAXXX
    7012026AX-ray exam of mastoids0.180.060.060.010.250.25XXX
    70120TCAX-ray exam of mastoids0.000.62NA0.030.65NAXXX
    70130AX-ray exam of mastoids0.340.90NA0.051.29NAXXX
    7013026AX-ray exam of mastoids0.340.120.120.010.470.47XXX
    70130TCAX-ray exam of mastoids0.000.78NA0.040.82NAXXX
    70134AX-ray exam of middle ear0.340.86NA0.051.25NAXXX
    7013426AX-ray exam of middle ear0.340.120.120.010.470.47XXX
    70134TCAX-ray exam of middle ear0.000.74NA0.040.78NAXXX
    70140AX-ray exam of facial bones0.190.68NA0.040.91NAXXX
    7014026AX-ray exam of facial bones0.190.060.060.010.260.26XXX
    70140TCAX-ray exam of facial bones0.000.62NA0.030.65NAXXX
    70150AX-ray exam of facial bones0.260.87NA0.051.18NAXXX
    7015026AX-ray exam of facial bones0.260.090.090.010.360.36XXX
    70150TCAX-ray exam of facial bones0.000.78NA0.040.82NAXXX
    70160AX-ray exam of nasal bones0.170.58NA0.030.78NAXXX
    7016026AX-ray exam of nasal bones0.170.060.060.010.240.24XXX
    70160TCAX-ray exam of nasal bones0.000.52NA0.020.54NAXXX
    70170AX-ray exam of tear duct0.301.05NA0.061.41NAXXX
    7017026AX-ray exam of tear duct0.300.100.100.010.410.41XXX
    70170TCAX-ray exam of tear duct0.000.95NA0.051.00NAXXX
    70190AX-ray exam of eye sockets0.210.69NA0.040.94NAXXX
    7019026AX-ray exam of eye sockets0.210.070.070.010.290.29XXX
    70190TCAX-ray exam of eye sockets0.000.62NA0.030.65NAXXX
    70200AX-ray exam of eye sockets0.280.88NA0.051.21NAXXX
    7020026AX-ray exam of eye sockets0.280.100.100.010.390.39XXX
    70200TCAX-ray exam of eye sockets0.000.78NA0.040.82NAXXX
    70210AX-ray exam of sinuses0.170.68NA0.040.89NAXXX
    7021026AX-ray exam of sinuses0.170.060.060.010.240.24XXX
    70210TCAX-ray exam of sinuses0.000.62NA0.030.65NAXXX
    70220AX-ray exam of sinuses0.250.87NA0.051.17NAXXX
    7022026AX-ray exam of sinuses0.250.090.090.010.350.35XXX
    70220TCAX-ray exam of sinuses0.000.78NA0.040.82NAXXX
    70240AX-ray exam, pituitary saddle0.190.48NA0.030.70NAXXX
    7024026AX-ray exam, pituitary saddle0.190.060.060.010.260.26XXX
    70240TCAX-ray exam, pituitary saddle0.000.42NA0.020.44NAXXX
    70250AX-ray exam of skull0.240.70NA0.040.98NAXXX
    7025026AX-ray exam of skull0.240.080.080.010.330.33XXX
    70250TCAX-ray exam of skull0.000.62NA0.030.65NAXXX
    70260AX-ray exam of skull0.341.01NA0.061.41NAXXX
    7026026AX-ray exam of skull0.340.120.120.010.470.47XXX
    70260TCAX-ray exam of skull0.000.89NA0.050.94NAXXX
    70300AX-ray exam of teeth0.100.30NA0.030.43NAXXX
    7030026AX-ray exam of teeth0.100.040.040.010.150.15XXX
    70300TCAX-ray exam of teeth0.000.26NA0.020.28NAXXX
    70310AX-ray exam of teeth0.160.48NA0.030.67NAXXX
    7031026AX-ray exam of teeth0.160.060.060.010.230.23XXX
    70310TCAX-ray exam of teeth0.000.42NA0.020.44NAXXX
    70320AFull mouth x-ray of teeth0.220.86NA0.051.13NAXXX
    7032026AFull mouth x-ray of teeth0.220.080.080.010.310.31XXX
    70320TCAFull mouth x-ray of teeth0.000.78NA0.040.82NAXXX
    Start Printed Page 80115
    70328AX-ray exam of jaw joint0.180.55NA0.030.76NAXXX
    7032826AX-ray exam of jaw joint0.180.060.060.010.250.25XXX
    70328TCAX-ray exam of jaw joint0.000.49NA0.020.51NAXXX
    70330AX-ray exam of jaw joints0.240.92NA0.051.21NAXXX
    7033026AX-ray exam of jaw joints0.240.080.080.010.330.33XXX
    70330TCAX-ray exam of jaw joints0.000.84NA0.040.88NAXXX
    70332AX-ray exam of jaw joint0.542.28NA0.122.94NAXXX
    7033226AX-ray exam of jaw joint0.540.190.190.020.750.75XXX
    70332TCAX-ray exam of jaw joint0.002.09NA0.102.19NAXXX
    70336AMagnetic image, jaw joint1.4811.67NA0.5613.71NAXXX
    7033626AMagnetic image, jaw joint1.480.510.510.072.062.06XXX
    70336TCAMagnetic image, jaw joint0.0011.16NA0.4911.65NAXXX
    70350AX-ray head for orthodontia0.170.44NA0.030.64NAXXX
    7035026AX-ray head for orthodontia0.170.060.060.010.240.24XXX
    70350TCAX-ray head for orthodontia0.000.38NA0.020.40NAXXX
    70355APanoramic x-ray of jaws0.200.64NA0.040.88NAXXX
    7035526APanoramic x-ray of jaws0.200.070.070.010.280.28XXX
    70355TCAPanoramic x-ray of jaws0.000.57NA0.030.60NAXXX
    70360AX-ray exam of neck0.170.48NA0.030.68NAXXX
    7036026AX-ray exam of neck0.170.060.060.010.240.24XXX
    70360TCAX-ray exam of neck0.000.42NA0.020.44NAXXX
    70370AThroat x-ray & fluoroscopy0.321.41NA0.071.80NAXXX
    7037026AThroat x-ray & fluoroscopy0.320.110.110.010.440.44XXX
    70370TCAThroat x-ray & fluoroscopy0.001.30NA0.061.36NAXXX
    70371ASpeech evaluation, complex0.842.38NA0.143.36NAXXX
    7037126ASpeech evaluation, complex0.840.290.290.041.171.17XXX
    70371TCASpeech evaluation, complex0.002.09NA0.102.19NAXXX
    70373AContrast x-ray of larynx0.441.92NA0.112.47NAXXX
    7037326AContrast x-ray of larynx0.440.150.150.020.610.61XXX
    70373TCAContrast x-ray of larynx0.001.77NA0.091.86NAXXX
    70380AX-ray exam of salivary gland0.170.73NA0.040.94NAXXX
    7038026AX-ray exam of salivary gland0.170.060.060.010.240.24XXX
    70380TCAX-ray exam of salivary gland0.000.67NA0.030.70NAXXX
    70390AX-ray exam of salivary duct0.381.90NA0.112.39NAXXX
    7039026AX-ray exam of salivary duct0.380.130.130.020.530.53XXX
    70390TCAX-ray exam of salivary duct0.001.77NA0.091.86NAXXX
    70450ACt head/brain w/o dye0.854.99NA0.256.09NAXXX
    7045026ACt head/brain w/o dye0.850.290.290.041.181.18XXX
    70450TCACt head/brain w/o dye0.004.70NA0.214.91NAXXX
    70460ACt head/brain w/dye1.136.02NA0.307.45NAXXX
    7046026ACt head/brain w/dye1.130.390.390.051.571.57XXX
    70460TCACt head/brain w/dye0.005.63NA0.255.88NAXXX
    70470ACt head/brain w/o&w dye1.277.47NA0.379.11NAXXX
    7047026ACt head/brain w/o&w dye1.270.430.430.061.761.76XXX
    70470TCACt head/brain w/o&w dye0.007.04NA0.317.35NAXXX
    70480ACt orbit/ear/fossa w/o dye1.285.14NA0.276.69NAXXX
    7048026ACt orbit/ear/fossa w/o dye1.280.440.440.061.781.78XXX
    70480TCACt orbit/ear/fossa w/o dye0.004.70NA0.214.91NAXXX
    70481ACt orbit/ear/fossa w/dye1.386.10NA0.317.79NAXXX
    7048126ACt orbit/ear/fossa w/dye1.380.470.470.061.911.91XXX
    70481TCACt orbit/ear/fossa w/dye0.005.63NA0.255.88NAXXX
    70482ACt orbit/ear/fossa w/o&w dye1.457.53NA0.379.35NAXXX
    7048226ACt orbit/ear/fossa w/o&w dye1.450.490.490.062.002.00XXX
    70482TCACt orbit/ear/fossa w/o&w dye0.007.04NA0.317.35NAXXX
    70486ACt maxillofacial w/o dye1.145.09NA0.266.49NAXXX
    7048626ACt maxillofacial w/o dye1.140.390.390.051.581.58XXX
    70486TCACt maxillofacial w/o dye0.004.70NA0.214.91NAXXX
    70487ACt maxillofacial w/dye1.306.07NA0.317.68NAXXX
    7048726ACt maxillofacial w/dye1.300.440.440.061.801.80XXX
    70487TCACt maxillofacial w/dye0.005.63NA0.255.88NAXXX
    70488ACt maxillofacial w/o&w dye1.427.52NA0.379.31NAXXX
    7048826ACt maxillofacial w/o&w dye1.420.480.480.061.961.96XXX
    70488TCACt maxillofacial w/o&w dye0.007.04NA0.317.35NAXXX
    70490ACt soft tissue neck w/o dye1.285.13NA0.276.68NAXXX
    7049026ACt soft tissue neck w/o dye1.280.430.430.061.771.77XXX
    70490TCACt soft tissue neck w/o dye0.004.70NA0.214.91NAXXX
    70491ACt soft tissue neck w/dye1.386.10NA0.317.79NAXXX
    7049126ACt soft tissue neck w/dye1.380.470.470.061.911.91XXX
    70491TCACt soft tissue neck w/dye0.005.63NA0.255.88NAXXX
    70492ACt sft tsue nck w/o & w/dye1.457.53NA0.379.35NAXXX
    7049226ACt sft tsue nck w/o & w/dye1.450.490.490.062.002.00XXX
    70492TCACt sft tsue nck w/o & w/dye0.007.04NA0.317.35NAXXX
    70496ACt angiography, head1.7511.15NA0.5613.46NAXXX
    7049626ACt angiography, head1.750.590.590.082.422.42XXX
    70496TCACt angiography, head0.0010.56NA0.4811.04NAXXX
    Start Printed Page 80116
    70498ACt angiography, neck1.7511.16NA0.5613.47NAXXX
    7049826ACt angiography, neck1.750.600.600.082.432.43XXX
    70498TCACt angiography, neck0.0010.56NA0.4811.04NAXXX
    70540AMri orbit/face/neck w/o dye1.3511.62NA0.3613.33NAXXX
    7054026AMri orbit/face/neck w/o dye1.350.460.460.041.851.85XXX
    70540TCAMri orbit/face/neck w/o dye0.0011.16NA0.3211.48NAXXX
    70542AMri orbit/face/neck w/dye1.6213.94NA0.4416.00NAXXX
    7054226AMri orbit/face/neck w/dye1.620.560.560.052.232.23XXX
    70542TCAMri orbit/face/neck w/dye0.0013.38NA0.3913.77NAXXX
    70543AMri orbt/fac/nck w/o&w dye2.1525.51NA0.7728.43NAXXX
    7054326AMri orbt/fac/nck w/o&w dye2.150.730.730.072.952.95XXX
    70543TCAMri orbt/fac/nck w/o&w dye0.0024.78NA0.7025.48NAXXX
    70544AMr angiography head w/o dye1.2011.57NA0.5413.31NAXXX
    7054426AMr angiography head w/o dye1.200.410.410.051.661.66XXX
    70544TCAMr angiography head w/o dye0.0011.16NA0.4911.65NAXXX
    70545AMr angiography head w/dye1.2011.57NA0.5413.31NAXXX
    7054526AMr angiography head w/dye1.200.410.410.051.661.66XXX
    70545TCAMr angiography head w/dye0.0011.16NA0.4911.65NAXXX
    70546AMr angiograph head w/o&w dye1.8022.93NA0.5725.30NAXXX
    7054626AMr angiograph head w/o&w dye1.800.620.620.082.502.50XXX
    70546TCAMr angiograph head w/o&w dye0.0022.31NA0.4922.80NAXXX
    70547AMr angiography neck w/o dye1.2011.57NA0.5413.31NAXXX
    7054726AMr angiography neck w/o dye1.200.410.410.051.661.66XXX
    70547TCAMr angiography neck w/o dye0.0011.16NA0.4911.65NAXXX
    70548AMr angiography neck w/dye1.2011.57NA0.5413.31NAXXX
    7054826AMr angiography neck w/dye1.200.410.410.051.661.66XXX
    70548TCAMr angiography neck w/dye0.0011.16NA0.4911.65NAXXX
    70549AMr angiograph neck w/o&w dye1.8022.93NA0.5725.30NAXXX
    7054926AMr angiograph neck w/o&w dye1.800.620.620.082.502.50XXX
    70549TCAMr angiograph neck w/o&w dye0.0022.31NA0.4922.80NAXXX
    70551AMri brain w/o dye1.4811.67NA0.5613.71NAXXX
    7055126AMri brain w/o dye1.480.510.510.072.062.06XXX
    70551TCAMri brain w/o dye0.0011.16NA0.4911.65NAXXX
    70552AMri brain w/dye1.7814.00NA0.6616.44NAXXX
    7055226AMri brain w/dye1.780.620.620.082.482.48XXX
    70552TCAMri brain w/dye0.0013.38NA0.5813.96NAXXX
    70553AMri brain w/o&w dye2.3625.59NA1.1929.14NAXXX
    7055326AMri brain w/o&w dye2.360.810.810.103.273.27XXX
    70553TCAMri brain w/o&w dye0.0024.78NA1.0925.87NAXXX
    71010AChest x-ray0.180.53NA0.030.74NAXXX
    7101026AChest x-ray0.180.060.060.010.250.25XXX
    71010TCAChest x-ray0.000.47NA0.020.49NAXXX
    71015AChest x-ray0.210.59NA0.030.83NAXXX
    7101526AChest x-ray0.210.070.070.010.290.29XXX
    71015TCAChest x-ray0.000.52NA0.020.54NAXXX
    71020AChest x-ray0.220.69NA0.040.95NAXXX
    7102026AChest x-ray0.220.070.070.010.300.30XXX
    71020TCAChest x-ray0.000.62NA0.030.65NAXXX
    71021AChest x-ray0.270.83NA0.051.15NAXXX
    7102126AChest x-ray0.270.090.090.010.370.37XXX
    71021TCAChest x-ray0.000.74NA0.040.78NAXXX
    71022AChest x-ray0.310.85NA0.061.22NAXXX
    7102226AChest x-ray0.310.110.110.020.440.44XXX
    71022TCAChest x-ray0.000.74NA0.040.78NAXXX
    71023AChest x-ray and fluoroscopy0.380.92NA0.061.36NAXXX
    7102326AChest x-ray and fluoroscopy0.380.140.140.020.540.54XXX
    71023TCAChest x-ray and fluoroscopy0.000.78NA0.040.82NAXXX
    71030AChest x-ray0.310.88NA0.051.24NAXXX
    7103026AChest x-ray0.310.100.100.010.420.42XXX
    71030TCAChest x-ray0.000.78NA0.040.82NAXXX
    71034AChest x-ray and fluoroscopy0.461.60NA0.092.15NAXXX
    7103426AChest x-ray and fluoroscopy0.460.170.170.020.650.65XXX
    71034TCAChest x-ray and fluoroscopy0.001.43NA0.071.50NAXXX
    71035AChest x-ray0.180.58NA0.030.79NAXXX
    7103526AChest x-ray0.180.060.060.010.250.25XXX
    71035TCAChest x-ray0.000.52NA0.020.54NAXXX
    71040AContrast x-ray of bronchi0.581.65NA0.102.33NAXXX
    7104026AContrast x-ray of bronchi0.580.200.200.030.810.81XXX
    71040TCAContrast x-ray of bronchi0.001.45NA0.071.52NAXXX
    71060AContrast x-ray of bronchi0.742.45NA0.143.33NAXXX
    7106026AContrast x-ray of bronchi0.740.250.250.031.021.02XXX
    71060TCAContrast x-ray of bronchi0.002.20NA0.112.31NAXXX
    71090AX-ray & pacemaker insertion0.541.88NA0.112.53NAXXX
    7109026AX-ray & pacemaker insertion0.540.210.210.020.770.77XXX
    71090TCAX-ray & pacemaker insertion0.001.67NA0.091.76NAXXX
    Start Printed Page 80117
    71100AX-ray exam of ribs0.220.64NA0.040.90NAXXX
    7110026AX-ray exam of ribs0.220.070.070.010.300.30XXX
    71100TCAX-ray exam of ribs0.000.57NA0.030.60NAXXX
    71101AX-ray exam of ribs/chest0.270.76NA0.041.07NAXXX
    7110126AX-ray exam of ribs/chest0.270.090.090.010.370.37XXX
    71101TCAX-ray exam of ribs/chest0.000.67NA0.030.70NAXXX
    71110AX-ray exam of ribs0.270.87NA0.051.19NAXXX
    7111026AX-ray exam of ribs0.270.090.090.010.370.37XXX
    71110TCAX-ray exam of ribs0.000.78NA0.040.82NAXXX
    71111AX-ray exam of ribs/ chest0.321.00NA0.061.38NAXXX
    7111126AX-ray exam of ribs/ chest0.320.110.110.010.440.44XXX
    71111TCAX-ray exam of ribs/ chest0.000.89NA0.050.94NAXXX
    71120AX-ray exam of breastbone0.200.72NA0.040.96NAXXX
    7112026AX-ray exam of breastbone0.200.070.070.010.280.28XXX
    71120TCAX-ray exam of breastbone0.000.65NA0.030.68NAXXX
    71130AX-ray exam of breastbone0.220.78NA0.041.04NAXXX
    7113026AX-ray exam of breastbone0.220.070.070.010.300.30XXX
    71130TCAX-ray exam of breastbone0.000.71NA0.030.74NAXXX
    71250ACt thorax w/o dye1.166.27NA0.317.74NAXXX
    7125026ACt thorax w/o dye1.160.390.390.051.601.60XXX
    71250TCACt thorax w/o dye0.005.88NA0.266.14NAXXX
    71260ACt thorax w/dye1.247.46NA0.369.06NAXXX
    7126026ACt thorax w/dye1.240.420.420.051.711.71XXX
    71260TCACt thorax w/dye0.007.04NA0.317.35NAXXX
    71270ACt thorax w/o&w dye1.389.28NA0.4411.10NAXXX
    7127026ACt thorax w/o&w dye1.380.470.470.061.911.91XXX
    71270TCACt thorax w/o&w dye0.008.81NA0.389.19NAXXX
    71275ACt angiography, chest1.929.46NA0.3811.76NAXXX
    7127526ACt angiography, chest1.920.650.650.062.632.63XXX
    71275TCACt angiography, chest0.008.81NA0.329.13NAXXX
    71550AMri chest w/o dye1.4611.66NA0.4113.53NAXXX
    7155026AMri chest w/o dye1.460.500.500.042.002.00XXX
    71550TCAMri chest w/o dye0.0011.16NA0.3711.53NAXXX
    71551AMri chest w/dye1.7313.97NA0.4916.19NAXXX
    7155126AMri chest w/dye1.730.590.590.062.382.38XXX
    71551TCAMri chest w/dye0.0013.38NA0.4313.81NAXXX
    71552AMri chest w/o&w/dye2.2625.55NA0.6428.45NAXXX
    7155226AMri chest w/o&w/dye2.260.770.770.083.113.11XXX
    71552TCAMri chest w/o&w/dye0.0024.78NA0.5625.34NAXXX
    71555RMri angio chest w or w/o dye1.8111.78NA0.5714.16NAXXX
    7155526RMri angio chest w or w/o dye1.810.620.620.082.512.51XXX
    71555TCRMri angio chest w or w/o dye0.0011.16NA0.4911.65NAXXX
    72010AX-ray exam of spine0.451.17NA0.081.70NAXXX
    7201026AX-ray exam of spine0.450.150.150.030.630.63XXX
    72010TCAX-ray exam of spine0.001.02NA0.051.07NAXXX
    72020AX-ray exam of spine0.150.47NA0.030.65NAXXX
    7202026AX-ray exam of spine0.150.050.050.010.210.21XXX
    72020TCAX-ray exam of spine0.000.42NA0.020.44NAXXX
    72040AX-ray exam of neck spine0.220.67NA0.040.93NAXXX
    7204026AX-ray exam of neck spine0.220.070.070.010.300.30XXX
    72040TCAX-ray exam of neck spine0.000.60NA0.030.63NAXXX
    72050AX-ray exam of neck spine0.311.00NA0.071.38NAXXX
    7205026AX-ray exam of neck spine0.310.110.110.020.440.44XXX
    72050TCAX-ray exam of neck spine0.000.89NA0.050.94NAXXX
    72052AX-ray exam of neck spine0.361.24NA0.071.67NAXXX
    7205226AX-ray exam of neck spine0.360.120.120.020.500.50XXX
    72052TCAX-ray exam of neck spine0.001.12NA0.051.17NAXXX
    72069AX-ray exam of trunk spine0.220.57NA0.040.83NAXXX
    7206926AX-ray exam of trunk spine0.220.080.080.020.320.32XXX
    72069TCAX-ray exam of trunk spine0.000.49NA0.020.51NAXXX
    72070AX-ray exam of thoracic spine0.220.72NA0.040.98NAXXX
    7207026AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72070TCAX-ray exam of thoracic spine0.000.65NA0.030.68NAXXX
    72072AX-ray exam of thoracic spine0.220.81NA0.051.08NAXXX
    7207226AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72072TCAX-ray exam of thoracic spine0.000.74NA0.040.78NAXXX
    72074AX-ray exam of thoracic spine0.220.98NA0.061.26NAXXX
    7207426AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72074TCAX-ray exam of thoracic spine0.000.91NA0.050.96NAXXX
    72080AX-ray exam of trunk spine0.220.75NA0.051.02NAXXX
    7208026AX-ray exam of trunk spine0.220.080.080.020.320.32XXX
    72080TCAX-ray exam of trunk spine0.000.67NA0.030.70NAXXX
    72090AX-ray exam of trunk spine0.280.77NA0.051.10NAXXX
    7209026AX-ray exam of trunk spine0.280.100.100.020.400.40XXX
    72090TCAX-ray exam of trunk spine0.000.67NA0.030.70NAXXX
    Start Printed Page 80118
    72100AX-ray exam of lower spine0.220.75NA0.051.02NAXXX
    7210026AX-ray exam of lower spine0.220.080.080.020.320.32XXX
    72100TCAX-ray exam of lower spine0.000.67NA0.030.70NAXXX
    72110AX-ray exam of lower spine0.311.02NA0.071.40NAXXX
    7211026AX-ray exam of lower spine0.310.110.110.020.440.44XXX
    72110TCAX-ray exam of lower spine0.000.91NA0.050.96NAXXX
    72114AX-ray exam of lower spine0.361.30NA0.081.74NAXXX
    7211426AX-ray exam of lower spine0.360.120.120.030.510.51XXX
    72114TCAX-ray exam of lower spine0.001.18NA0.051.23NAXXX
    72120AX-ray exam of lower spine0.220.97NA0.071.26NAXXX
    7212026AX-ray exam of lower spine0.220.080.080.020.320.32XXX
    72120TCAX-ray exam of lower spine0.000.89NA0.050.94NAXXX
    72125ACt neck spine w/o dye1.166.27NA0.317.74NAXXX
    7212526ACt neck spine w/o dye1.160.390.390.051.601.60XXX
    72125TCACt neck spine w/o dye0.005.88NA0.266.14NAXXX
    72126ACt neck spine w/dye1.227.45NA0.369.03NAXXX
    7212626ACt neck spine w/dye1.220.410.410.051.681.68XXX
    72126TCACt neck spine w/dye0.007.04NA0.317.35NAXXX
    72127ACt neck spine w/o&w/dye1.279.24NA0.4410.95NAXXX
    7212726ACt neck spine w/o&w/dye1.270.430.430.061.761.76XXX
    72127TCACt neck spine w/o&w/dye0.008.81NA0.389.19NAXXX
    72128ACt chest spine w/o dye1.166.27NA0.317.74NAXXX
    7212826ACt chest spine w/o dye1.160.390.390.051.601.60XXX
    72128TCACt chest spine w/o dye0.005.88NA0.266.14NAXXX
    72129ACt chest spine w/dye1.227.45NA0.369.03NAXXX
    7212926ACt chest spine w/dye1.220.410.410.051.681.68XXX
    72129TCACt chest spine w/dye0.007.04NA0.317.35NAXXX
    72130ACt chest spine w/o&w/dye1.279.24NA0.4410.95NAXXX
    7213026ACt chest spine w/o&w/dye1.270.430.430.061.761.76XXX
    72130TCACt chest spine w/o&w/dye0.008.81NA0.389.19NAXXX
    72131ACt lumbar spine w/o dye1.166.28NA0.317.75NAXXX
    7213126ACt lumbar spine w/o dye1.160.400.400.051.611.61XXX
    72131TCACt lumbar spine w/o dye0.005.88NA0.266.14NAXXX
    72132ACt lumbar spine w/dye1.227.45NA0.379.04NAXXX
    7213226ACt lumbar spine w/dye1.220.410.410.061.691.69XXX
    72132TCACt lumbar spine w/dye0.007.04NA0.317.35NAXXX
    72133ACt lumbar spine w/o&w/dye1.279.25NA0.4410.96NAXXX
    7213326ACt lumbar spine w/o&w/dye1.270.440.440.061.771.77XXX
    72133TCACt lumbar spine w/o&w/dye0.008.81NA0.389.19NAXXX
    72141AMri neck spine w/o dye1.6011.71NA0.5613.87NAXXX
    7214126AMri neck spine w/o dye1.600.550.550.072.222.22XXX
    72141TCAMri neck spine w/o dye0.0011.16NA0.4911.65NAXXX
    72142AMri neck spine w/dye1.9214.05NA0.6716.64NAXXX
    7214226AMri neck spine w/dye1.920.670.670.092.682.68XXX
    72142TCAMri neck spine w/dye0.0013.38NA0.5813.96NAXXX
    72146AMri chest spine w/o dye1.6012.94NA0.6015.14NAXXX
    7214626AMri chest spine w/o dye1.600.550.550.072.222.22XXX
    72146TCAMri chest spine w/o dye0.0012.39NA0.5312.92NAXXX
    72147AMri chest spine w/dye1.9214.04NA0.6716.63NAXXX
    7214726AMri chest spine w/dye1.920.660.660.092.672.67XXX
    72147TCAMri chest spine w/dye0.0013.38NA0.5813.96NAXXX
    72148AMri lumbar spine w/o dye1.4812.90NA0.6014.98NAXXX
    7214826AMri lumbar spine w/o dye1.480.510.510.072.062.06XXX
    72148TCAMri lumbar spine w/o dye0.0012.39NA0.5312.92NAXXX
    72149AMri lumbar spine w/dye1.7814.00NA0.6716.45NAXXX
    7214926AMri lumbar spine w/dye1.780.620.620.092.492.49XXX
    72149TCAMri lumbar spine w/dye0.0013.38NA0.5813.96NAXXX
    72156AMri neck spine w/o&w/dye2.5725.66NA1.2029.43NAXXX
    7215626AMri neck spine w/o&w/dye2.570.880.880.113.563.56XXX
    72156TCAMri neck spine w/o&w/dye0.0024.78NA1.0925.87NAXXX
    72157AMri chest spine w/o&w/dye2.5725.66NA1.2029.43NAXXX
    7215726AMri chest spine w/o&w/dye2.570.880.880.113.563.56XXX
    72157TCAMri chest spine w/o&w/dye0.0024.78NA1.0925.87NAXXX
    72158AMri lumbar spine w/o&w/dye2.3625.59NA1.2029.15NAXXX
    7215826AMri lumbar spine w/o&w/dye2.360.810.810.113.283.28XXX
    72158TCAMri lumbar spine w/o&w/dye0.0024.78NA1.0925.87NAXXX
    72159NMr angio spine w/o&w/dye+1.8013.09NA0.6115.50NAXXX
    7215926NMr angio spine w/o&w/dye+1.800.700.700.082.582.58XXX
    72159TCNMr angio spine w/o&w/dye+0.0012.39NA0.5312.92NAXXX
    72170AX-ray exam of pelvis0.170.58NA0.030.78NAXXX
    7217026AX-ray exam of pelvis0.170.060.060.010.240.24XXX
    72170TCAX-ray exam of pelvis0.000.52NA0.020.54NAXXX
    72190AX-ray exam of pelvis0.210.74NA0.040.99NAXXX
    7219026AX-ray exam of pelvis0.210.070.070.010.290.29XXX
    72190TCAX-ray exam of pelvis0.000.67NA0.030.70NAXXX
    Start Printed Page 80119
    72191ACt angiograph pelv w/o&w/dye1.819.07NA0.3811.26NAXXX
    7219126ACt angiograph pelv w/o&w/dye1.810.620.620.062.492.49XXX
    72191TCACt angiograph pelv w/o&w/dye0.008.45NA0.328.77NAXXX
    72192ACt pelvis w/o dye1.096.25NA0.317.65NAXXX
    7219226ACt pelvis w/o dye1.090.370.370.051.511.51XXX
    72192TCACt pelvis w/o dye0.005.88NA0.266.14NAXXX
    72193ACt pelvis w/dye1.167.21NA0.358.72NAXXX
    7219326ACt pelvis w/dye1.160.390.390.051.601.60XXX
    72193TCACt pelvis w/dye0.006.82NA0.307.12NAXXX
    72194ACt pelvis w/o&w/dye1.228.86NA0.4110.49NAXXX
    7219426ACt pelvis w/o&w/dye1.220.410.410.051.681.68XXX
    72194TCACt pelvis w/o&w/dye0.008.45NA0.368.81NAXXX
    72195AMri pelvis w/o dye1.4611.66NA0.4213.54NAXXX
    7219526AMri pelvis w/o dye1.460.500.500.052.012.01XXX
    72195TCAMri pelvis w/o dye0.0011.16NA0.3711.53NAXXX
    72196AMri pelvis w/dye1.7313.97NA0.4816.18NAXXX
    7219626AMri pelvis w/dye1.730.590.590.052.372.37XXX
    72196TCAMri pelvis w/dye0.0013.38NA0.4313.81NAXXX
    72197AMri pelvis w/o & w/dye2.2625.55NA0.8428.65NAXXX
    7219726AMri pelvis w/o & w/dye2.260.770.770.083.113.11XXX
    72197TCAMri pelvis w/o & w/dye0.0024.78NA0.7625.54NAXXX
    72198NMr angio pelvis w/o&w/dye+1.8011.86NA0.5714.23NAXXX
    7219826NMr angio pelvis w/o&w/dye+1.800.700.700.082.582.58XXX
    72198TCNMr angio pelvis w/o&w/dye+0.0011.16NA0.4911.65NAXXX
    72200AX-ray exam sacroiliac joints0.170.58NA0.030.78NAXXX
    7220026AX-ray exam sacroiliac joints0.170.060.060.010.240.24XXX
    72200TCAX-ray exam sacroiliac joints0.000.52NA0.020.54NAXXX
    72202AX-ray exam sacroiliac joints0.190.68NA0.040.91NAXXX
    7220226AX-ray exam sacroiliac joints0.190.060.060.010.260.26XXX
    72202TCAX-ray exam sacroiliac joints0.000.62NA0.030.65NAXXX
    72220AX-ray exam of tailbone0.170.63NA0.040.84NAXXX
    7222026AX-ray exam of tailbone0.170.060.060.010.240.24XXX
    72220TCAX-ray exam of tailbone0.000.57NA0.030.60NAXXX
    72240AContrast x-ray of neck spine0.915.03NA0.256.19NAXXX
    7224026AContrast x-ray of neck spine0.910.300.300.041.251.25XXX
    72240TCAContrast x-ray of neck spine0.004.73NA0.214.94NAXXX
    72255AContrast x-ray, thorax spine0.914.59NA0.225.72NAXXX
    7225526AContrast x-ray, thorax spine0.910.280.280.041.231.23XXX
    72255TCAContrast x-ray, thorax spine0.004.31NA0.184.49NAXXX
    72265AContrast x-ray, lower spine0.834.31NA0.225.36NAXXX
    7226526AContrast x-ray, lower spine0.830.260.260.041.131.13XXX
    72265TCAContrast x-ray, lower spine0.004.05NA0.184.23NAXXX
    72270AContrast x-ray of spine1.336.50NA0.348.17NAXXX
    7227026AContrast x-ray of spine1.330.430.430.071.831.83XXX
    72270TCAContrast x-ray of spine0.006.07NA0.276.34NAXXX
    72275AEpidurography0.762.29NA0.213.26NAXXX
    7227526AEpidurography0.760.200.200.030.990.99XXX
    72275TCAEpidurography0.002.09NA0.182.27NAXXX
    72285AX-ray c/t spine disk1.168.72NA0.4210.30NAXXX
    7228526AX-ray c/t spine disk1.160.370.370.061.591.59XXX
    72285TCAX-ray c/t spine disk0.008.35NA0.368.71NAXXX
    72295AX-ray of lower spine disk0.838.10NA0.379.30NAXXX
    7229526AX-ray of lower spine disk0.830.280.280.041.151.15XXX
    72295TCAX-ray of lower spine disk0.007.82NA0.338.15NAXXX
    73000AX-ray exam of collar bone0.160.57NA0.030.76NAXXX
    7300026AX-ray exam of collar bone0.160.050.050.010.220.22XXX
    73000TCAX-ray exam of collar bone0.000.52NA0.020.54NAXXX
    73010AX-ray exam of shoulder blade0.170.58NA0.030.78NAXXX
    7301026AX-ray exam of shoulder blade0.170.060.060.010.240.24XXX
    73010TCAX-ray exam of shoulder blade0.000.52NA0.020.54NAXXX
    73020AX-ray exam of shoulder0.150.52NA0.030.70NAXXX
    7302026AX-ray exam of shoulder0.150.050.050.010.210.21XXX
    73020TCAX-ray exam of shoulder0.000.47NA0.020.49NAXXX
    73030AX-ray exam of shoulder0.180.63NA0.040.85NAXXX
    7303026AX-ray exam of shoulder0.180.060.060.010.250.25XXX
    73030TCAX-ray exam of shoulder0.000.57NA0.030.60NAXXX
    73040AContrast x-ray of shoulder0.542.27NA0.132.94NAXXX
    7304026AContrast x-ray of shoulder0.540.180.180.030.750.75XXX
    73040TCAContrast x-ray of shoulder0.002.09NA0.102.19NAXXX
    73050AX-ray exam of shoulders0.200.74NA0.050.99NAXXX
    7305026AX-ray exam of shoulders0.200.070.070.020.290.29XXX
    73050TCAX-ray exam of shoulders0.000.67NA0.030.70NAXXX
    73060AX-ray exam of humerus0.170.63NA0.040.84NAXXX
    7306026AX-ray exam of humerus0.170.060.060.010.240.24XXX
    73060TCAX-ray exam of humerus0.000.57NA0.030.60NAXXX
    Start Printed Page 80120
    73070AX-ray exam of elbow0.150.57NA0.030.75NAXXX
    7307026AX-ray exam of elbow0.150.050.050.010.210.21XXX
    73070TCAX-ray exam of elbow0.000.52NA0.020.54NAXXX
    73080AX-ray exam of elbow0.170.63NA0.040.84NAXXX
    7308026AX-ray exam of elbow0.170.060.060.010.240.24XXX
    73080TCAX-ray exam of elbow0.000.57NA0.030.60NAXXX
    73085AContrast x-ray of elbow0.542.28NA0.132.95NAXXX
    7308526AContrast x-ray of elbow0.540.190.190.030.760.76XXX
    73085TCAContrast x-ray of elbow0.002.09NA0.102.19NAXXX
    73090AX-ray exam of forearm0.160.57NA0.030.76NAXXX
    7309026AX-ray exam of forearm0.160.050.050.010.220.22XXX
    73090TCAX-ray exam of forearm0.000.52NA0.020.54NAXXX
    73092AX-ray exam of arm, infant0.160.54NA0.030.73NAXXX
    7309226AX-ray exam of arm, infant0.160.050.050.010.220.22XXX
    73092TCAX-ray exam of arm, infant0.000.49NA0.020.51NAXXX
    73100AX-ray exam of wrist0.160.55NA0.040.75NAXXX
    7310026AX-ray exam of wrist0.160.060.060.020.240.24XXX
    73100TCAX-ray exam of wrist0.000.49NA0.020.51NAXXX
    73110AX-ray exam of wrist0.170.59NA0.030.79NAXXX
    7311026AX-ray exam of wrist0.170.060.060.010.240.24XXX
    73110TCAX-ray exam of wrist0.000.53NA0.020.55NAXXX
    73115AContrast x-ray of wrist0.541.76NA0.112.41NAXXX
    7311526AContrast x-ray of wrist0.540.190.190.030.760.76XXX
    73115TCAContrast x-ray of wrist0.001.57NA0.081.65NAXXX
    73120AX-ray exam of hand0.160.55NA0.030.74NAXXX
    7312026AX-ray exam of hand0.160.060.060.010.230.23XXX
    73120TCAX-ray exam of hand0.000.49NA0.020.51NAXXX
    73130AX-ray exam of hand0.170.59NA0.030.79NAXXX
    7313026AX-ray exam of hand0.170.060.060.010.240.24XXX
    73130TCAX-ray exam of hand0.000.53NA0.020.55NAXXX
    73140AX-ray exam of finger(s)0.130.46NA0.030.62NAXXX
    7314026AX-ray exam of finger(s)0.130.040.040.010.180.18XXX
    73140TCAX-ray exam of finger(s)0.000.42NA0.020.44NAXXX
    73200ACt upper extremity w/o dye1.095.31NA0.266.66NAXXX
    7320026ACt upper extremity w/o dye1.090.370.370.051.511.51XXX
    73200TCACt upper extremity w/o dye0.004.94NA0.215.15NAXXX
    73201ACt upper extremity w/dye1.166.28NA0.317.75NAXXX
    7320126ACt upper extremity w/dye1.160.400.400.051.611.61XXX
    73201TCACt upper extremity w/dye0.005.88NA0.266.14NAXXX
    73202ACt uppr extremity w/o&w/dye1.227.81NA0.389.41NAXXX
    7320226ACt uppr extremity w/o&w/dye1.220.420.420.061.701.70XXX
    73202TCACt uppr extremity w/o&w/dye0.007.39NA0.327.71NAXXX
    73206ACt angio upr extrm w/o&w/dye1.818.01NA0.3810.20NAXXX
    7320626ACt angio upr extrm w/o&w/dye1.810.620.620.062.492.49XXX
    73206TCACt angio upr extrm w/o&w/dye0.007.39NA0.327.71NAXXX
    73218AMri upper extremity w/o dye1.3511.62NA0.3613.33NAXXX
    7321826AMri upper extremity w/o dye1.350.460.460.041.851.85XXX
    73218TCAMri upper extremity w/o dye0.0011.16NA0.3211.48NAXXX
    73219AMri upper extremity w/dye1.6213.94NA0.4416.00NAXXX
    7321926AMri upper extremity w/dye1.620.560.560.052.232.23XXX
    73219TCAMri upper extremity w/dye0.0013.38NA0.3913.77NAXXX
    73220AMri uppr extremity w/o&w/dye2.1525.52NA0.7828.45NAXXX
    7322026AMri uppr extremity w/o&w/dye2.150.740.740.082.972.97XXX
    73220TCAMri uppr extremity w/o&w/dye0.0024.78NA0.7025.48NAXXX
    73221AMri joint upr extrem w/o dye1.3511.62NA0.3613.33NAXXX
    7322126AMri joint upr extrem w/o dye1.350.460.460.041.851.85XXX
    73221TCAMri joint upr extrem w/o dye0.0011.16NA0.3211.48NAXXX
    73222AMri joint upr extrem w/dye1.6213.93NA0.4415.99NAXXX
    7322226AMri joint upr extrem w/dye1.620.550.550.052.222.22XXX
    73222TCAMri joint upr extrem w/dye0.0013.38NA0.3913.77NAXXX
    73223AMri joint upr extr w/o&w/dye2.1525.52NA0.7728.44NAXXX
    7322326AMri joint upr extr w/o&w/dye2.150.740.740.072.962.96XXX
    73223TCAMri joint upr extr w/o&w/dye0.0024.78NA0.7025.48NAXXX
    73225NMr angio upr extr w/o&w/dye+1.7311.84NA0.5714.14NAXXX
    7322526NMr angio upr extr w/o&w/dye+1.730.680.680.082.492.49XXX
    73225TCNMr angio upr extr w/o&w/dye+0.0011.16NA0.4911.65NAXXX
    73500AX-ray exam of hip0.170.53NA0.030.73NAXXX
    7350026AX-ray exam of hip0.170.060.060.010.240.24XXX
    73500TCAX-ray exam of hip0.000.47NA0.020.49NAXXX
    73510AX-ray exam of hip0.210.64NA0.050.90NAXXX
    7351026AX-ray exam of hip0.210.070.070.020.300.30XXX
    73510TCAX-ray exam of hip0.000.57NA0.030.60NAXXX
    73520AX-ray exam of hips0.260.76NA0.051.07NAXXX
    7352026AX-ray exam of hips0.260.090.090.020.370.37XXX
    73520TCAX-ray exam of hips0.000.67NA0.030.70NAXXX
    Start Printed Page 80121
    73525AContrast x-ray of hip0.542.27NA0.132.94NAXXX
    7352526AContrast x-ray of hip0.540.180.180.030.750.75XXX
    73525TCAContrast x-ray of hip0.002.09NA0.102.19NAXXX
    73530AX-ray exam of hip0.290.62NA0.030.94NAXXX
    7353026AX-ray exam of hip0.290.100.100.010.400.40XXX
    73530TCAX-ray exam of hip0.000.52NA0.020.54NAXXX
    73540AX-ray exam of pelvis & hips0.200.64NA0.050.89NAXXX
    7354026AX-ray exam of pelvis & hips0.200.070.070.020.290.29XXX
    73540TCAX-ray exam of pelvis & hips0.000.57NA0.030.60NAXXX
    73542AX-ray exam, sacroiliac joint0.592.26NA0.132.98NAXXX
    7354226AX-ray exam, sacroiliac joint0.590.170.170.030.790.79XXX
    73542TCAX-ray exam, sacroiliac joint0.002.09NA0.102.19NAXXX
    73550AX-ray exam of thigh0.170.63NA0.040.84NAXXX
    7355026AX-ray exam of thigh0.170.060.060.010.240.24XXX
    73550TCAX-ray exam of thigh0.000.57NA0.030.60NAXXX
    73560AX-ray exam of knee, 1 or 20.170.58NA0.040.79NAXXX
    7356026AX-ray exam of knee, 1 or 20.170.060.060.020.250.25XXX
    73560TCAX-ray exam of knee, 1 or 20.000.52NA0.020.54NAXXX
    73562AX-ray exam of knee, 30.180.63NA0.050.86NAXXX
    7356226AX-ray exam of knee, 30.180.060.060.020.260.26XXX
    73562TCAX-ray exam of knee, 30.000.57NA0.030.60NAXXX
    73564AX-ray exam, knee, 4 or more0.220.70NA0.050.97NAXXX
    7356426AX-ray exam, knee, 4 or more0.220.080.080.020.320.32XXX
    73564TCAX-ray exam, knee, 4 or more0.000.62NA0.030.65NAXXX
    73565AX-ray exam of knees0.170.55NA0.040.76NAXXX
    7356526AX-ray exam of knees0.170.060.060.020.250.25XXX
    73565TCAX-ray exam of knees0.000.49NA0.020.51NAXXX
    73580AContrast x-ray of knee joint0.542.79NA0.153.48NAXXX
    7358026AContrast x-ray of knee joint0.540.180.180.030.750.75XXX
    73580TCAContrast x-ray of knee joint0.002.61NA0.122.73NAXXX
    73590AX-ray exam of lower leg0.170.58NA0.030.78NAXXX
    7359026AX-ray exam of lower leg0.170.060.060.010.240.24XXX
    73590TCAX-ray exam of lower leg0.000.52NA0.020.54NAXXX
    73592AX-ray exam of leg, infant0.160.55NA0.030.74NAXXX
    7359226AX-ray exam of leg, infant0.160.060.060.010.230.23XXX
    73592TCAX-ray exam of leg, infant0.000.49NA0.020.51NAXXX
    73600AX-ray exam of ankle0.160.55NA0.030.74NAXXX
    7360026AX-ray exam of ankle0.160.060.060.010.230.23XXX
    73600TCAX-ray exam of ankle0.000.49NA0.020.51NAXXX
    73610AX-ray exam of ankle0.170.59NA0.030.79NAXXX
    7361026AX-ray exam of ankle0.170.060.060.010.240.24XXX
    73610TCAX-ray exam of ankle0.000.53NA0.020.55NAXXX
    73615AContrast x-ray of ankle0.542.28NA0.132.95NAXXX
    7361526AContrast x-ray of ankle0.540.190.190.030.760.76XXX
    73615TCAContrast x-ray of ankle0.002.09NA0.102.19NAXXX
    73620AX-ray exam of foot0.160.55NA0.030.74NAXXX
    7362026AX-ray exam of foot0.160.060.060.010.230.23XXX
    73620TCAX-ray exam of foot0.000.49NA0.020.51NAXXX
    73630AX-ray exam of foot0.170.59NA0.030.79NAXXX
    7363026AX-ray exam of foot0.170.060.060.010.240.24XXX
    73630TCAX-ray exam of foot0.000.53NA0.020.55NAXXX
    73650AX-ray exam of heel0.160.53NA0.030.72NAXXX
    7365026AX-ray exam of heel0.160.060.060.010.230.23XXX
    73650TCAX-ray exam of heel0.000.47NA0.020.49NAXXX
    73660AX-ray exam of toe(s)0.130.46NA0.030.62NAXXX
    7366026AX-ray exam of toe(s)0.130.040.040.010.180.18XXX
    73660TCAX-ray exam of toe(s)0.000.42NA0.020.44NAXXX
    73700ACt lower extremity w/o dye1.095.31NA0.266.66NAXXX
    7370026ACt lower extremity w/o dye1.090.370.370.051.511.51XXX
    73700TCACt lower extremity w/o dye0.004.94NA0.215.15NAXXX
    73701ACt lower extremity w/dye1.166.27NA0.317.74NAXXX
    7370126ACt lower extremity w/dye1.160.390.390.051.601.60XXX
    73701TCACt lower extremity w/dye0.005.88NA0.266.14NAXXX
    73702ACt lwr extremity w/o&w/dye1.227.80NA0.379.39NAXXX
    7370226ACt lwr extremity w/o&w/dye1.220.410.410.051.681.68XXX
    73702TCACt lwr extremity w/o&w/dye0.007.39NA0.327.71NAXXX
    73706ACt angio lwr extr w/o&w/dye1.908.04NA0.3810.32NAXXX
    7370626ACt angio lwr extr w/o&w/dye1.900.650.650.062.612.61XXX
    73706TCACt angio lwr extr w/o&w/dye0.007.39NA0.327.71NAXXX
    73718AMri lower extremity w/o dye1.3511.62NA0.3613.33NAXXX
    7371826AMri lower extremity w/o dye1.350.460.460.041.851.85XXX
    73718TCAMri lower extremity w/o dye0.0011.16NA0.3211.48NAXXX
    73719AMri lower extremity w/dye1.6213.93NA0.4415.99NAXXX
    7371926AMri lower extremity w/dye1.620.550.550.052.222.22XXX
    73719TCAMri lower extremity w/dye0.0013.38NA0.3913.77NAXXX
    Start Printed Page 80122
    73720AMri lwr extremity w/o&w/dye2.1525.51NA0.7828.44NAXXX
    7372026AMri lwr extremity w/o&w/dye2.150.730.730.082.962.96XXX
    73720TCAMri lwr extremity w/o&w/dye0.0024.78NA0.7025.48NAXXX
    73721AMri jnt of lwr extre w/o dye1.3511.62NA0.3613.33NAXXX
    7372126AMri jnt of lwr extre w/o dye1.350.460.460.041.851.85XXX
    73721TCAMri jnt of lwr extre w/o dye0.0011.16NA0.3211.48NAXXX
    73722AMri joint of lwr extr w/dye1.6213.94NA0.4516.01NAXXX
    7372226AMri joint of lwr extr w/dye1.620.560.560.062.242.24XXX
    73722TCAMri joint of lwr extr w/dye0.0013.38NA0.3913.77NAXXX
    73723AMri joint lwr extr w/o&w/dye2.1525.52NA0.7728.44NAXXX
    7372326AMri joint lwr extr w/o&w/dye2.150.740.740.072.962.96XXX
    73723TCAMri joint lwr extr w/o&w/dye0.0024.78NA0.7025.48NAXXX
    73725RMr ang lwr ext w or w/o dye1.8211.78NA0.5714.17NAXXX
    7372526RMr ang lwr ext w or w/o dye1.820.620.620.082.522.52XXX
    73725TCRMr ang lwr ext w or w/o dye0.0011.16NA0.4911.65NAXXX
    74000AX-ray exam of abdomen0.180.58NA0.030.79NAXXX
    7400026AX-ray exam of abdomen0.180.060.060.010.250.25XXX
    74000TCAX-ray exam of abdomen0.000.52NA0.020.54NAXXX
    74010AX-ray exam of abdomen0.230.65NA0.040.92NAXXX
    7401026AX-ray exam of abdomen0.230.080.080.010.320.32XXX
    74010TCAX-ray exam of abdomen0.000.57NA0.030.60NAXXX
    74020AX-ray exam of abdomen0.270.71NA0.041.02NAXXX
    7402026AX-ray exam of abdomen0.270.090.090.010.370.37XXX
    74020TCAX-ray exam of abdomen0.000.62NA0.030.65NAXXX
    74022AX-ray exam series, abdomen0.320.85NA0.051.22NAXXX
    7402226AX-ray exam series, abdomen0.320.110.110.010.440.44XXX
    74022TCAX-ray exam series, abdomen0.000.74NA0.040.78NAXXX
    74150ACt abdomen w/o dye1.196.03NA0.307.52NAXXX
    7415026ACt abdomen w/o dye1.190.400.400.051.641.64XXX
    74150TCACt abdomen w/o dye0.005.63NA0.255.88NAXXX
    74160ACt abdomen w/dye1.277.25NA0.368.88NAXXX
    7416026ACt abdomen w/dye1.270.430.430.061.761.76XXX
    74160TCACt abdomen w/dye0.006.82NA0.307.12NAXXX
    74170ACt abdomen w/o&w/dye1.408.93NA0.4210.75NAXXX
    7417026ACt abdomen w/o&w/dye1.400.480.480.061.941.94XXX
    74170TCACt abdomen w/o&w/dye0.008.45NA0.368.81NAXXX
    74175ACt angio abdom w/o&w/dye1.909.10NA0.3811.38NAXXX
    7417526ACt angio abdom w/o&w/dye1.900.650.650.062.612.61XXX
    74175TCACt angio abdom w/o&w/dye0.008.45NA0.328.77NAXXX
    74181AMri abdomen w/o dye1.4611.66NA0.4313.55NAXXX
    7418126AMri abdomen w/o dye1.460.500.500.062.022.02XXX
    74181TCAMri abdomen w/o dye0.0011.16NA0.3711.53NAXXX
    74182AMri abdomen w/dye1.7313.97NA0.4916.19NAXXX
    7418226AMri abdomen w/dye1.730.590.590.062.382.38XXX
    74182TCAMri abdomen w/dye0.0013.38NA0.4313.81NAXXX
    74183AMri abdomen w/o&w/dye2.2625.55NA0.8428.65NAXXX
    7418326AMri abdomen w/o&w/dye2.260.770.770.083.113.11XXX
    74183TCAMri abdomen w/o&w/dye0.0024.78NA0.7625.54NAXXX
    74185RMri angio, abdom w or w/o dy1.8011.77NA0.5714.14NAXXX
    7418526RMri angio, abdom w or w/o dy1.800.610.610.082.492.49XXX
    74185TCRMri angio, abdom w or w/o dy0.0011.16NA0.4911.65NAXXX
    74190AX-ray exam of peritoneum0.481.46NA0.082.02NAXXX
    7419026AX-ray exam of peritoneum0.480.160.160.020.660.66XXX
    74190TCAX-ray exam of peritoneum0.001.30NA0.061.36NAXXX
    74210AContrst x-ray exam of throat0.361.30NA0.071.73NAXXX
    7421026AContrst x-ray exam of throat0.360.120.120.020.500.50XXX
    74210TCAContrst x-ray exam of throat0.001.18NA0.051.23NAXXX
    74220AContrast x-ray, esophagus0.461.34NA0.071.87NAXXX
    7422026AContrast x-ray, esophagus0.460.160.160.020.640.64XXX
    74220TCAContrast x-ray, esophagus0.001.18NA0.051.23NAXXX
    74230ACine/vid x-ray, throat/esoph0.531.48NA0.082.09NAXXX
    7423026ACine/vid x-ray, throat/esoph0.530.180.180.020.730.73XXX
    74230TCACine/vid x-ray, throat/esoph0.001.30NA0.061.36NAXXX
    74235ARemove esophagus obstruction1.193.02NA0.174.38NAXXX
    7423526ARemove esophagus obstruction1.190.410.410.051.651.65XXX
    74235TCARemove esophagus obstruction0.002.61NA0.122.73NAXXX
    74240AX-ray exam, upper gi tract0.691.68NA0.102.47NAXXX
    7424026AX-ray exam, upper gi tract0.690.230.230.030.950.95XXX
    74240TCAX-ray exam, upper gi tract0.001.45NA0.071.52NAXXX
    74241AX-ray exam, upper gi tract0.691.71NA0.102.50NAXXX
    7424126AX-ray exam, upper gi tract0.690.230.230.030.950.95XXX
    74241TCAX-ray exam, upper gi tract0.001.48NA0.071.55NAXXX
    74245AX-ray exam, upper gi tract0.912.68NA0.153.74NAXXX
    7424526AX-ray exam, upper gi tract0.910.310.310.041.261.26XXX
    74245TCAX-ray exam, upper gi tract0.002.37NA0.112.48NAXXX
    Start Printed Page 80123
    74246AContrst x-ray uppr gi tract0.691.86NA0.112.66NAXXX
    7424626AContrst x-ray uppr gi tract0.690.230.230.030.950.95XXX
    74246TCAContrst x-ray uppr gi tract0.001.63NA0.081.71NAXXX
    74247AContrst x-ray uppr gi tract0.691.90NA0.122.71NAXXX
    7424726AContrst x-ray uppr gi tract0.690.230.230.030.950.95XXX
    74247TCAContrst x-ray uppr gi tract0.001.67NA0.091.76NAXXX
    74249AContrst x-ray uppr gi tract0.912.87NA0.163.94NAXXX
    7424926AContrst x-ray uppr gi tract0.910.310.310.041.261.26XXX
    74249TCAContrst x-ray uppr gi tract0.002.56NA0.122.68NAXXX
    74250AX-ray exam of small bowel0.471.46NA0.082.01NAXXX
    7425026AX-ray exam of small bowel0.470.160.160.020.650.65XXX
    74250TCAX-ray exam of small bowel0.001.30NA0.061.36NAXXX
    74251AX-ray exam of small bowel0.691.53NA0.092.31NAXXX
    7425126AX-ray exam of small bowel0.690.230.230.030.950.95XXX
    74251TCAX-ray exam of small bowel0.001.30NA0.061.36NAXXX
    74260AX-ray exam of small bowel0.501.65NA0.092.24NAXXX
    7426026AX-ray exam of small bowel0.500.170.170.020.690.69XXX
    74260TCAX-ray exam of small bowel0.001.48NA0.071.55NAXXX
    74270AContrast x-ray exam of colon0.691.92NA0.122.73NAXXX
    7427026AContrast x-ray exam of colon0.690.230.230.030.950.95XXX
    74270TCAContrast x-ray exam of colon0.001.69NA0.091.78NAXXX
    74280AContrast x-ray exam of colon0.992.56NA0.153.70NAXXX
    7428026AContrast x-ray exam of colon0.990.340.340.041.371.37XXX
    74280TCAContrast x-ray exam of colon0.002.22NA0.112.33NAXXX
    74283AContrast x-ray exam of colon2.023.24NA0.215.47NAXXX
    7428326AContrast x-ray exam of colon2.020.690.690.092.802.80XXX
    74283TCAContrast x-ray exam of colon0.002.55NA0.122.67NAXXX
    74290AContrast x-ray, gallbladder0.320.85NA0.051.22NAXXX
    7429026AContrast x-ray, gallbladder0.320.110.110.010.440.44XXX
    74290TCAContrast x-ray, gallbladder0.000.74NA0.040.78NAXXX
    74291AContrast x-rays, gallbladder0.200.49NA0.030.72NAXXX
    7429126AContrast x-rays, gallbladder0.200.070.070.010.280.28XXX
    74291TCAContrast x-rays, gallbladder0.000.42NA0.020.44NAXXX
    74300CX-ray bile ducts/pancreas0.000.000.000.000.000.00XXX
    7430026AX-ray bile ducts/pancreas0.360.120.120.020.500.50XXX
    74300TCCX-ray bile ducts/pancreas0.000.000.000.000.000.00XXX
    74301CX-rays at surgery add-on0.000.000.000.000.000.00ZZZ
    7430126AX-rays at surgery add-on0.210.070.070.010.290.29ZZZ
    74301TCCX-rays at surgery add-on0.000.000.000.000.000.00ZZZ
    74305AX-ray bile ducts/pancreas0.420.92NA0.061.40NAXXX
    7430526AX-ray bile ducts/pancreas0.420.140.140.020.580.58XXX
    74305TCAX-ray bile ducts/pancreas0.000.78NA0.040.82NAXXX
    74320AContrast x-ray of bile ducts0.543.31NA0.164.01NAXXX
    7432026AContrast x-ray of bile ducts0.540.180.180.020.740.74XXX
    74320TCAContrast x-ray of bile ducts0.003.13NA0.143.27NAXXX
    74327AX-ray bile stone removal0.701.99NA0.122.81NAXXX
    7432726AX-ray bile stone removal0.700.240.240.030.970.97XXX
    74327TCAX-ray bile stone removal0.001.75NA0.091.84NAXXX
    74328AX-ray bile duct endoscopy0.703.37NA0.174.24NAXXX
    7432826AX-ray bile duct endoscopy0.700.240.240.030.970.97XXX
    74328TCAX-ray bile duct endoscopy0.003.13NA0.143.27NAXXX
    74329AX-ray for pancreas endoscopy0.703.37NA0.174.24NAXXX
    7432926AX-ray for pancreas endoscopy0.700.240.240.030.970.97XXX
    74329TCAX-ray for pancreas endoscopy0.003.13NA0.143.27NAXXX
    74330AX-ray bile/panc endoscopy0.903.44NA0.184.52NAXXX
    7433026AX-ray bile/panc endoscopy0.900.310.310.041.251.25XXX
    74330TCAX-ray bile/panc endoscopy0.003.13NA0.143.27NAXXX
    74340AX-ray guide for GI tube0.542.79NA0.143.47NAXXX
    7434026AX-ray guide for GI tube0.540.180.180.020.740.74XXX
    74340TCAX-ray guide for GI tube0.002.61NA0.122.73NAXXX
    74350AX-ray guide, stomach tube0.763.39NA0.174.32NAXXX
    7435026AX-ray guide, stomach tube0.760.260.260.031.051.05XXX
    74350TCAX-ray guide, stomach tube0.003.13NA0.143.27NAXXX
    74355AX-ray guide, intestinal tube0.762.87NA0.153.78NAXXX
    7435526AX-ray guide, intestinal tube0.760.260.260.031.051.05XXX
    74355TCAX-ray guide, intestinal tube0.002.61NA0.122.73NAXXX
    74360AX-ray guide, GI dilation0.543.32NA0.164.02NAXXX
    7436026AX-ray guide, GI dilation0.540.190.190.020.750.75XXX
    74360TCAX-ray guide, GI dilation0.003.13NA0.143.27NAXXX
    74363AX-ray, bile duct dilation0.886.37NA0.317.56NAXXX
    7436326AX-ray, bile duct dilation0.880.300.300.041.221.22XXX
    74363TCAX-ray, bile duct dilation0.006.07NA0.276.34NAXXX
    74400AContrst x-ray, urinary tract0.491.84NA0.112.44NAXXX
    7440026AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    74400TCAContrst x-ray, urinary tract0.001.67NA0.091.76NAXXX
    Start Printed Page 80124
    74410AContrst x-ray, urinary tract0.492.11NA0.112.71NAXXX
    7441026AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    74410TCAContrst x-ray, urinary tract0.001.94NA0.092.03NAXXX
    74415AContrst x-ray, urinary tract0.492.28NA0.122.89NAXXX
    7441526AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    74415TCAContrst x-ray, urinary tract0.002.11NA0.102.21NAXXX
    74420AContrst x-ray, urinary tract0.362.73NA0.143.23NAXXX
    7442026AContrst x-ray, urinary tract0.360.120.120.020.500.50XXX
    74420TCAContrst x-ray, urinary tract0.002.61NA0.122.73NAXXX
    74425AContrst x-ray, urinary tract0.361.42NA0.081.86NAXXX
    7442526AContrst x-ray, urinary tract0.360.120.120.020.500.50XXX
    74425TCAContrst x-ray, urinary tract0.001.30NA0.061.36NAXXX
    74430AContrast x-ray, bladder0.321.15NA0.071.54NAXXX
    7443026AContrast x-ray, bladder0.320.110.110.020.450.45XXX
    74430TCAContrast x-ray, bladder0.001.04NA0.051.09NAXXX
    74440AX-ray, male genital tract0.381.25NA0.071.70NAXXX
    7444026AX-ray, male genital tract0.380.130.130.020.530.53XXX
    74440TCAX-ray, male genital tract0.001.12NA0.051.17NAXXX
    74445AX-ray exam of penis1.141.50NA0.102.74NAXXX
    7444526AX-ray exam of penis1.140.380.380.051.571.57XXX
    74445TCAX-ray exam of penis0.001.12NA0.051.17NAXXX
    74450AX-ray, urethra/bladder0.331.56NA0.091.98NAXXX
    7445026AX-ray, urethra/bladder0.330.110.110.020.460.46XXX
    74450TCAX-ray, urethra/bladder0.001.45NA0.071.52NAXXX
    74455AX-ray, urethra/bladder0.331.68NA0.102.11NAXXX
    7445526AX-ray, urethra/bladder0.330.110.110.020.460.46XXX
    74455TCAX-ray, urethra/bladder0.001.57NA0.081.65NAXXX
    74470AX-ray exam of kidney lesion0.541.42NA0.082.04NAXXX
    7447026AX-ray exam of kidney lesion0.540.180.180.020.740.74XXX
    74470TCAX-ray exam of kidney lesion0.001.24NA0.061.30NAXXX
    74475AX-ray control, cath insert0.544.23NA0.204.97NAXXX
    7447526AX-ray control, cath insert0.540.180.180.020.740.74XXX
    74475TCAX-ray control, cath insert0.004.05NA0.184.23NAXXX
    74480AX-ray control, cath insert0.544.23NA0.204.97NAXXX
    7448026AX-ray control, cath insert0.540.180.180.020.740.74XXX
    74480TCAX-ray control, cath insert0.004.05NA0.184.23NAXXX
    74485AX-ray guide, GU dilation0.543.31NA0.174.02NAXXX
    7448526AX-ray guide, GU dilation0.540.180.180.030.750.75XXX
    74485TCAX-ray guide, GU dilation0.003.13NA0.143.27NAXXX
    74710AX-ray measurement of pelvis0.341.16NA0.071.57NAXXX
    7471026AX-ray measurement of pelvis0.340.120.120.020.480.48XXX
    74710TCAX-ray measurement of pelvis0.001.04NA0.051.09NAXXX
    74740AX-ray, female genital tract0.381.43NA0.081.89NAXXX
    7474026AX-ray, female genital tract0.380.130.130.020.530.53XXX
    74740TCAX-ray, female genital tract0.001.30NA0.061.36NAXXX
    74742AX-ray, fallopian tube0.613.34NA0.164.11NAXXX
    7474226AX-ray, fallopian tube0.610.210.210.020.840.84XXX
    74742TCAX-ray, fallopian tube0.003.13NA0.143.27NAXXX
    74775AX-ray exam of perineum0.621.67NA0.102.39NAXXX
    7477526AX-ray exam of perineum0.620.220.220.030.870.87XXX
    74775TCAX-ray exam of perineum0.001.45NA0.071.52NAXXX
    75552AHeart mri for morph w/o dye1.6011.71NA0.5613.87NAXXX
    7555226AHeart mri for morph w/o dye1.600.550.550.072.222.22XXX
    75552TCAHeart mri for morph w/o dye0.0011.16NA0.4911.65NAXXX
    75553AHeart mri for morph w/dye2.0011.84NA0.5814.42NAXXX
    7555326AHeart mri for morph w/dye2.000.680.680.092.772.77XXX
    75553TCAHeart mri for morph w/dye0.0011.16NA0.4911.65NAXXX
    75554ACardiac MRI/function1.8311.83NA0.5614.22NAXXX
    7555426ACardiac MRI/function1.830.670.670.072.572.57XXX
    75554TCACardiac MRI/function0.0011.16NA0.4911.65NAXXX
    75555ACardiac MRI/limited study1.7411.82NA0.5614.12NAXXX
    7555526ACardiac MRI/limited study1.740.660.660.072.472.47XXX
    75555TCACardiac MRI/limited study0.0011.16NA0.4911.65NAXXX
    75556NCardiac MRI/flow mapping0.000.000.000.000.000.00XXX
    75600AContrast x-ray exam of aorta0.4912.74NA0.5613.79NAXXX
    7560026AContrast x-ray exam of aorta0.490.190.190.020.700.70XXX
    75600TCAContrast x-ray exam of aorta0.0012.55NA0.5413.09NAXXX
    75605AContrast x-ray exam of aorta1.1412.96NA0.5914.69NAXXX
    7560526AContrast x-ray exam of aorta1.140.410.410.051.601.60XXX
    75605TCAContrast x-ray exam of aorta0.0012.55NA0.5413.09NAXXX
    75625AContrast x-ray exam of aorta1.1412.94NA0.5914.67NAXXX
    7562526AContrast x-ray exam of aorta1.140.390.390.051.581.58XXX
    75625TCAContrast x-ray exam of aorta0.0012.55NA0.5413.09NAXXX
    75630AX-ray aorta, leg arteries1.7913.72NA0.6516.16NAXXX
    7563026AX-ray aorta, leg arteries1.790.640.640.082.512.51XXX
    Start Printed Page 80125
    75630TCAX-ray aorta, leg arteries0.0013.08NA0.5713.65NAXXX
    75635ACt angio abdominal arteries2.4016.66NA0.4119.47NAXXX
    7563526ACt angio abdominal arteries2.400.820.820.093.313.31XXX
    75635TCACt angio abdominal arteries0.0015.84NA0.3216.16NAXXX
    75650AArtery x-rays, head & neck1.4913.06NA0.6115.16NAXXX
    7565026AArtery x-rays, head & neck1.490.510.510.072.072.07XXX
    75650TCAArtery x-rays, head & neck0.0012.55NA0.5413.09NAXXX
    75658AArtery x-rays, arm1.3113.04NA0.6014.95NAXXX
    7565826AArtery x-rays, arm1.310.490.490.061.861.86XXX
    75658TCAArtery x-rays, arm0.0012.55NA0.5413.09NAXXX
    75660AArtery x-rays, head & neck1.3113.01NA0.6014.92NAXXX
    7566026AArtery x-rays, head & neck1.310.460.460.061.831.83XXX
    75660TCAArtery x-rays, head & neck0.0012.55NA0.5413.09NAXXX
    75662AArtery x-rays, head & neck1.6613.16NA0.6215.44NAXXX
    7566226AArtery x-rays, head & neck1.660.610.610.082.352.35XXX
    75662TCAArtery x-rays, head & neck0.0012.55NA0.5413.09NAXXX
    75665AArtery x-rays, head & neck1.3113.00NA0.6114.92NAXXX
    7566526AArtery x-rays, head & neck1.310.450.450.071.831.83XXX
    75665TCAArtery x-rays, head & neck0.0012.55NA0.5413.09NAXXX
    75671AArtery x-rays, head & neck1.6613.12NA0.6215.40NAXXX
    7567126AArtery x-rays, head & neck1.660.570.570.082.312.31XXX
    75671TCAArtery x-rays, head & neck0.0012.55NA0.5413.09NAXXX
    75676AArtery x-rays, neck1.3113.01NA0.6114.93NAXXX
    7567626AArtery x-rays, neck1.310.460.460.071.841.84XXX
    75676TCAArtery x-rays, neck0.0012.55NA0.5413.09NAXXX
    75680AArtery x-rays, neck1.6613.12NA0.6215.40NAXXX
    7568026AArtery x-rays, neck1.660.570.570.082.312.31XXX
    75680TCAArtery x-rays, neck0.0012.55NA0.5413.09NAXXX
    75685AArtery x-rays, spine1.3113.00NA0.6014.91NAXXX
    7568526AArtery x-rays, spine1.310.450.450.061.821.82XXX
    75685TCAArtery x-rays, spine0.0012.55NA0.5413.09NAXXX
    75705AArtery x-rays, spine2.1813.31NA0.6516.14NAXXX
    7570526AArtery x-rays, spine2.180.760.760.113.053.05XXX
    75705TCAArtery x-rays, spine0.0012.55NA0.5413.09NAXXX
    75710AArtery x-rays, arm/leg1.1412.95NA0.6014.69NAXXX
    7571026AArtery x-rays, arm/leg1.140.400.400.061.601.60XXX
    75710TCAArtery x-rays, arm/leg0.0012.55NA0.5413.09NAXXX
    75716AArtery x-rays, arms/legs1.3113.00NA0.6014.91NAXXX
    7571626AArtery x-rays, arms/legs1.310.450.450.061.821.82XXX
    75716TCAArtery x-rays, arms/legs0.0012.55NA0.5413.09NAXXX
    75722AArtery x-rays, kidney1.1412.96NA0.5914.69NAXXX
    7572226AArtery x-rays, kidney1.140.410.410.051.601.60XXX
    75722TCAArtery x-rays, kidney0.0012.55NA0.5413.09NAXXX
    75724AArtery x-rays, kidneys1.4913.13NA0.5915.21NAXXX
    7572426AArtery x-rays, kidneys1.490.580.580.052.122.12XXX
    75724TCAArtery x-rays, kidneys0.0012.55NA0.5413.09NAXXX
    75726AArtery x-rays, abdomen1.1412.94NA0.5914.67NAXXX
    7572626AArtery x-rays, abdomen1.140.390.390.051.581.58XXX
    75726TCAArtery x-rays, abdomen0.0012.55NA0.5413.09NAXXX
    75731AArtery x-rays, adrenal gland1.1412.94NA0.5914.67NAXXX
    7573126AArtery x-rays, adrenal gland1.140.390.390.051.581.58XXX
    75731TCAArtery x-rays, adrenal gland0.0012.55NA0.5413.09NAXXX
    75733AArtery x-rays, adrenals1.3113.00NA0.6014.91NAXXX
    7573326AArtery x-rays, adrenals1.310.450.450.061.821.82XXX
    75733TCAArtery x-rays, adrenals0.0012.55NA0.5413.09NAXXX
    75736AArtery x-rays, pelvis1.1412.94NA0.5914.67NAXXX
    7573626AArtery x-rays, pelvis1.140.390.390.051.581.58XXX
    75736TCAArtery x-rays, pelvis0.0012.55NA0.5413.09NAXXX
    75741AArtery x-rays, lung1.3113.00NA0.6014.91NAXXX
    7574126AArtery x-rays, lung1.310.450.450.061.821.82XXX
    75741TCAArtery x-rays, lung0.0012.55NA0.5413.09NAXXX
    75743AArtery x-rays, lungs1.6613.11NA0.6115.38NAXXX
    7574326AArtery x-rays, lungs1.660.560.560.072.292.29XXX
    75743TCAArtery x-rays, lungs0.0012.55NA0.5413.09NAXXX
    75746AArtery x-rays, lung1.1412.94NA0.5914.67NAXXX
    7574626AArtery x-rays, lung1.140.390.390.051.581.58XXX
    75746TCAArtery x-rays, lung0.0012.55NA0.5413.09NAXXX
    75756AArtery x-rays, chest1.1413.01NA0.5814.73NAXXX
    7575626AArtery x-rays, chest1.140.460.460.041.641.64XXX
    75756TCAArtery x-rays, chest0.0012.55NA0.5413.09NAXXX
    75774AArtery x-ray, each vessel0.3612.68NA0.5613.60NAZZZ
    7577426AArtery x-ray, each vessel0.360.130.130.020.510.51ZZZ
    75774TCAArtery x-ray, each vessel0.0012.55NA0.5413.09NAZZZ
    75790AVisualize A-V shunt1.841.96NA0.163.96NAXXX
    7579026AVisualize A-V shunt1.840.620.620.092.552.55XXX
    Start Printed Page 80126
    75790TCAVisualize A-V shunt0.001.34NA0.071.41NAXXX
    75801ALymph vessel x-ray, arm/leg0.815.67NA0.296.77NAXXX
    7580126ALymph vessel x-ray, arm/leg0.810.280.280.051.141.14XXX
    75801TCALymph vessel x-ray, arm/leg0.005.39NA0.245.63NAXXX
    75803ALymph vessel x-ray,arms/legs1.175.79NA0.297.25NAXXX
    7580326ALymph vessel x-ray,arms/legs1.170.400.400.051.621.62XXX
    75803TCALymph vessel x-ray,arms/legs0.005.39NA0.245.63NAXXX
    75805ALymph vessel x-ray, trunk0.816.35NA0.317.47NAXXX
    7580526ALymph vessel x-ray, trunk0.810.280.280.041.131.13XXX
    75805TCALymph vessel x-ray, trunk0.006.07NA0.276.34NAXXX
    75807ALymph vessel x-ray, trunk1.176.47NA0.327.96NAXXX
    7580726ALymph vessel x-ray, trunk1.170.400.400.051.621.62XXX
    75807TCALymph vessel x-ray, trunk0.006.07NA0.276.34NAXXX
    75809ANonvascular shunt, x-ray0.470.94NA0.061.47NAXXX
    7580926ANonvascular shunt, x-ray0.470.160.160.020.650.65XXX
    75809TCANonvascular shunt, x-ray0.000.78NA0.040.82NAXXX
    75810AVein x-ray, spleen/liver1.1412.94NA0.6014.68NAXXX
    7581026AVein x-ray, spleen/liver1.140.390.390.061.591.59XXX
    75810TCAVein x-ray, spleen/liver0.0012.55NA0.5413.09NAXXX
    75820AVein x-ray, arm/leg0.701.19NA0.081.97NAXXX
    7582026AVein x-ray, arm/leg0.700.240.240.030.970.97XXX
    75820TCAVein x-ray, arm/leg0.000.95NA0.051.00NAXXX
    75822AVein x-ray, arms/legs1.061.83NA0.123.01NAXXX
    7582226AVein x-ray, arms/legs1.060.360.360.051.471.47XXX
    75822TCAVein x-ray, arms/legs0.001.47NA0.071.54NAXXX
    75825AVein x-ray, trunk1.1412.94NA0.6014.68NAXXX
    7582526AVein x-ray, trunk1.140.390.390.061.591.59XXX
    75825TCAVein x-ray, trunk0.0012.55NA0.5413.09NAXXX
    75827AVein x-ray, chest1.1412.93NA0.5914.66NAXXX
    7582726AVein x-ray, chest1.140.380.380.051.571.57XXX
    75827TCAVein x-ray, chest0.0012.55NA0.5413.09NAXXX
    75831AVein x-ray, kidney1.1412.93NA0.5914.66NAXXX
    7583126AVein x-ray, kidney1.140.380.380.051.571.57XXX
    75831TCAVein x-ray, kidney0.0012.55NA0.5413.09NAXXX
    75833AVein x-ray, kidneys1.4913.06NA0.6115.16NAXXX
    7583326AVein x-ray, kidneys1.490.510.510.072.072.07XXX
    75833TCAVein x-ray, kidneys0.0012.55NA0.5413.09NAXXX
    75840AVein x-ray, adrenal gland1.1412.94NA0.6114.69NAXXX
    7584026AVein x-ray, adrenal gland1.140.390.390.071.601.60XXX
    75840TCAVein x-ray, adrenal gland0.0012.55NA0.5413.09NAXXX
    75842AVein x-ray, adrenal glands1.4913.05NA0.6115.15NAXXX
    7584226AVein x-ray, adrenal glands1.490.500.500.072.062.06XXX
    75842TCAVein x-ray, adrenal glands0.0012.55NA0.5413.09NAXXX
    75860AVein x-ray, neck1.1412.95NA0.6014.69NAXXX
    7586026AVein x-ray, neck1.140.400.400.061.601.60XXX
    75860TCAVein x-ray, neck0.0012.55NA0.5413.09NAXXX
    75870AVein x-ray, skull1.1412.95NA0.6014.69NAXXX
    7587026AVein x-ray, skull1.140.400.400.061.601.60XXX
    75870TCAVein x-ray, skull0.0012.55NA0.5413.09NAXXX
    75872AVein x-ray, skull1.1412.94NA0.5914.67NAXXX
    7587226AVein x-ray, skull1.140.390.390.051.581.58XXX
    75872TCAVein x-ray, skull0.0012.55NA0.5413.09NAXXX
    75880AVein x-ray, eye socket0.701.19NA0.081.97NAXXX
    7588026AVein x-ray, eye socket0.700.240.240.030.970.97XXX
    75880TCAVein x-ray, eye socket0.000.95NA0.051.00NAXXX
    75885AVein x-ray, liver1.4413.04NA0.6015.08NAXXX
    7588526AVein x-ray, liver1.440.490.490.061.991.99XXX
    75885TCAVein x-ray, liver0.0012.55NA0.5413.09NAXXX
    75887AVein x-ray, liver1.4413.04NA0.6015.08NAXXX
    7588726AVein x-ray, liver1.440.490.490.061.991.99XXX
    75887TCAVein x-ray, liver0.0012.55NA0.5413.09NAXXX
    75889AVein x-ray, liver1.1412.93NA0.5914.66NAXXX
    7588926AVein x-ray, liver1.140.380.380.051.571.57XXX
    75889TCAVein x-ray, liver0.0012.55NA0.5413.09NAXXX
    75891AVein x-ray, liver1.1412.93NA0.5914.66NAXXX
    7589126AVein x-ray, liver1.140.380.380.051.571.57XXX
    75891TCAVein x-ray, liver0.0012.55NA0.5413.09NAXXX
    75893AVenous sampling by catheter0.5412.74NA0.5613.84NAXXX
    7589326AVenous sampling by catheter0.540.190.190.020.750.75XXX
    75893TCAVenous sampling by catheter0.0012.55NA0.5413.09NAXXX
    75894AX-rays, transcath therapy1.3124.48NA1.1226.91NAXXX
    7589426AX-rays, transcath therapy1.310.450.450.071.831.83XXX
    75894TCAX-rays, transcath therapy0.0024.03NA1.0525.08NAXXX
    75896AX-rays, transcath therapy1.3121.37NA0.9723.65NAXXX
    7589626AX-rays, transcath therapy1.310.470.470.061.841.84XXX
    Start Printed Page 80127
    75896TCAX-rays, transcath therapy0.0020.90NA0.9121.81NAXXX
    75898AFollow-up angiography1.651.61NA0.123.38NAXXX
    7589826AFollow-up angiography1.650.570.570.072.292.29XXX
    75898TCAFollow-up angiography0.001.04NA0.051.09NAXXX
    75900AArterial catheter exchange0.4921.05NA0.9422.48NAXXX
    7590026AArterial catheter exchange0.490.170.170.020.680.68XXX
    75900TCAArterial catheter exchange0.0020.88NA0.9221.80NAXXX
    75901ARemove cva device obstruct0.491.47NA0.712.67NAXXX
    7590126ARemove cva device obstruct0.490.170.170.020.680.68XXX
    75901TCARemove cva device obstruct0.001.30NA0.691.99NAXXX
    75902ARemove cva lumen obstruct0.391.43NA0.712.53NAXXX
    7590226ARemove cva lumen obstruct0.390.130.130.020.540.54XXX
    75902TCARemove cva lumen obstruct0.001.30NA0.691.99NAXXX
    75940AX-ray placement, vein filter0.5412.73NA0.5713.84NAXXX
    7594026AX-ray placement, vein filter0.540.180.180.030.750.75XXX
    75940TCAX-ray placement, vein filter0.0012.55NA0.5413.09NAXXX
    75945AIntravascular us0.404.70NA0.235.33NAXXX
    7594526AIntravascular us0.400.150.150.030.580.58XXX
    75945TCAIntravascular us0.004.55NA0.204.75NAXXX
    75946AIntravascular us add-on0.402.42NA0.142.96NAZZZ
    7594626AIntravascular us add-on0.400.140.140.030.570.57ZZZ
    75946TCAIntravascular us add-on0.002.28NA0.112.39NAZZZ
    75952CEndovasc repair abdom aorta0.000.000.000.000.000.00XXX
    7595226AEndovasc repair abdom aorta4.501.751.750.686.936.93XXX
    75952TCCEndovasc repair abdom aorta0.000.000.000.000.000.00XXX
    75953CAbdom aneurysm endovas rpr0.000.000.000.000.000.00XXX
    7595326AAbdom aneurysm endovas rpr1.360.530.530.682.572.57XXX
    75953TCCAbdom aneurysm endovas rpr0.000.000.000.000.000.00XXX
    75954CIliac aneurysm endovas rpr0.000.000.000.000.000.00XXX
    7595426AIliac aneurysm endovas rpr1.360.480.480.682.522.52XXX
    75954TCCIliac aneurysm endovas rpr0.000.000.000.000.000.00XXX
    75960ATranscatheter intro, stent0.8215.13NA0.6816.63NAXXX
    7596026ATranscatheter intro, stent0.820.290.290.041.151.15XXX
    75960TCATranscatheter intro, stent0.0014.84NA0.6415.48NAXXX
    75961ARetrieval, broken catheter4.2511.90NA0.6416.79NAXXX
    7596126ARetrieval, broken catheter4.251.441.440.185.875.87XXX
    75961TCARetrieval, broken catheter0.0010.46NA0.4610.92NAXXX
    75962ARepair arterial blockage0.5415.86NA0.7217.12NAXXX
    7596226ARepair arterial blockage0.540.190.190.030.760.76XXX
    75962TCARepair arterial blockage0.0015.67NA0.6916.36NAXXX
    75964ARepair artery blockage, each0.368.49NA0.389.23NAZZZ
    7596426ARepair artery blockage, each0.360.130.130.020.510.51ZZZ
    75964TCARepair artery blockage, each0.008.36NA0.368.72NAZZZ
    75966ARepair arterial blockage1.3116.15NA0.7518.21NAXXX
    7596626ARepair arterial blockage1.310.480.480.061.851.85XXX
    75966TCARepair arterial blockage0.0015.67NA0.6916.36NAXXX
    75968ARepair artery blockage, each0.368.49NA0.379.22NAZZZ
    7596826ARepair artery blockage, each0.360.130.130.010.500.50ZZZ
    75968TCARepair artery blockage, each0.008.36NA0.368.72NAZZZ
    75970AVascular biopsy0.8311.78NA0.5413.15NAXXX
    7597026AVascular biopsy0.830.290.290.041.161.16XXX
    75970TCAVascular biopsy0.0011.49NA0.5011.99NAXXX
    75978ARepair venous blockage0.5415.85NA0.7117.10NAXXX
    7597826ARepair venous blockage0.540.180.180.020.740.74XXX
    75978TCARepair venous blockage0.0015.67NA0.6916.36NAXXX
    75980AContrast xray exam bile duct1.445.88NA0.307.62NAXXX
    7598026AContrast xray exam bile duct1.440.490.490.061.991.99XXX
    75980TCAContrast xray exam bile duct0.005.39NA0.245.63NAXXX
    75982AContrast xray exam bile duct1.446.55NA0.338.32NAXXX
    7598226AContrast xray exam bile duct1.440.480.480.061.981.98XXX
    75982TCAContrast xray exam bile duct0.006.07NA0.276.34NAXXX
    75984AXray control catheter change0.722.18NA0.123.02NAXXX
    7598426AXray control catheter change0.720.240.240.030.990.99XXX
    75984TCAXray control catheter change0.001.94NA0.092.03NAXXX
    75989AAbscess drainage under x-ray1.193.53NA0.194.91NAXXX
    7598926AAbscess drainage under x-ray1.190.400.400.051.641.64XXX
    75989TCAAbscess drainage under x-ray0.003.13NA0.143.27NAXXX
    75992AAtherectomy, x-ray exam0.5415.87NA0.7117.12NAXXX
    7599226AAtherectomy, x-ray exam0.540.200.200.020.760.76XXX
    75992TCAAtherectomy, x-ray exam0.0015.67NA0.6916.36NAXXX
    75993AAtherectomy, x-ray exam0.368.50NA0.379.23NAZZZ
    7599326AAtherectomy, x-ray exam0.360.140.140.010.510.51ZZZ
    75993TCAAtherectomy, x-ray exam0.008.36NA0.368.72NAZZZ
    75994AAtherectomy, x-ray exam1.3116.15NA0.7518.21NAXXX
    7599426AAtherectomy, x-ray exam1.310.480.480.061.851.85XXX
    Start Printed Page 80128
    75994TCAAtherectomy, x-ray exam0.0015.67NA0.6916.36NAXXX
    75995AAtherectomy, x-ray exam1.3116.16NA0.7518.22NAXXX
    7599526AAtherectomy, x-ray exam1.310.490.490.061.861.86XXX
    75995TCAAtherectomy, x-ray exam0.0015.67NA0.6916.36NAXXX
    75996AAtherectomy, x-ray exam0.368.48NA0.379.21NAZZZ
    7599626AAtherectomy, x-ray exam0.360.120.120.010.490.49ZZZ
    75996TCAAtherectomy, x-ray exam0.008.36NA0.368.72NAZZZ
    76000AFluoroscope examination0.171.35NA0.071.59NAXXX
    7600026AFluoroscope examination0.170.050.050.010.230.23XXX
    76000TCAFluoroscope examination0.001.30NA0.061.36NAXXX
    76001AFluoroscope exam, extensive0.672.84NA0.153.66NAXXX
    7600126AFluoroscope exam, extensive0.670.230.230.030.930.93XXX
    76001TCAFluoroscope exam, extensive0.002.61NA0.122.73NAXXX
    76003ANeedle localization by x-ray0.541.48NA0.092.11NAXXX
    7600326ANeedle localization by x-ray0.540.180.180.030.750.75XXX
    76003TCANeedle localization by x-ray0.001.30NA0.061.36NAXXX
    76005AFluoroguide for spine inject0.601.46NA0.092.15NAXXX
    7600526AFluoroguide for spine inject0.600.160.160.030.790.79XXX
    76005TCAFluoroguide for spine inject0.001.30NA0.061.36NAXXX
    76006AX-ray stress view0.410.190.190.040.640.64XXX
    76010AX-ray, nose to rectum0.180.58NA0.030.79NAXXX
    7601026AX-ray, nose to rectum0.180.060.060.010.250.25XXX
    76010TCAX-ray, nose to rectum0.000.52NA0.020.54NAXXX
    76012CPercut vertebroplasty fluor0.000.000.000.000.000.00XXX
    7601226APercut vertebroplasty fluor1.310.510.510.232.052.05XXX
    76012TCCPercut vertebroplasty fluor0.000.000.000.000.000.00XXX
    76013CPercut vertebroplasty, ct0.000.000.000.000.000.00XXX
    7601326APercut vertebroplasty, ct1.380.540.540.482.402.40XXX
    76013TCCPercut vertebroplasty, ct0.000.000.000.000.000.00XXX
    76020AX-rays for bone age0.190.58NA0.030.80NAXXX
    7602026AX-rays for bone age0.190.060.060.010.260.26XXX
    76020TCAX-rays for bone age0.000.52NA0.020.54NAXXX
    76040AX-rays, bone evaluation0.270.87NA0.071.21NAXXX
    7604026AX-rays, bone evaluation0.270.090.090.030.390.39XXX
    76040TCAX-rays, bone evaluation0.000.78NA0.040.82NAXXX
    76061AX-rays, bone survey0.451.15NA0.071.67NAXXX
    7606126AX-rays, bone survey0.450.150.150.020.620.62XXX
    76061TCAX-rays, bone survey0.001.00NA0.051.05NAXXX
    76062AX-rays, bone survey0.541.61NA0.092.24NAXXX
    7606226AX-rays, bone survey0.540.180.180.020.740.74XXX
    76062TCAX-rays, bone survey0.001.43NA0.071.50NAXXX
    76065AX-rays, bone evaluation0.700.98NA0.051.73NAXXX
    7606526AX-rays, bone evaluation0.700.240.240.010.950.95XXX
    76065TCAX-rays, bone evaluation0.000.74NA0.040.78NAXXX
    76066AJoint survey, single view0.311.21NA0.071.59NAXXX
    7606626AJoint survey, single view0.310.110.110.020.440.44XXX
    76066TCAJoint survey, single view0.001.10NA0.051.15NAXXX
    76070ACt bone density, axial0.253.02NA0.143.41NAXXX
    7607026ACt bone density, axial0.250.080.080.010.340.34XXX
    76070TCACt bone density, axial0.002.94NA0.133.07NAXXX
    76071ACt bone density, peripheral0.223.01NA0.053.28NAXXX
    7607126ACt bone density, peripheral0.220.070.070.010.300.30XXX
    76071TCACt bone density, peripheral0.002.94NA0.042.98NAXXX
    76075ADexa, axial skeleton study0.303.19NA0.153.64NAXXX
    7607526ADexa, axial skeleton study0.300.110.110.010.420.42XXX
    76075TCADexa, axial skeleton study0.003.08NA0.143.22NAXXX
    76076ADexa, peripheral study0.220.83NA0.051.10NAXXX
    7607626ADexa, peripheral study0.220.080.080.010.310.31XXX
    76076TCADexa, peripheral study0.000.75NA0.040.79NAXXX
    76078ARadiographic absorptiometry0.200.82NA0.051.07NAXXX
    7607826ARadiographic absorptiometry0.200.070.070.010.280.28XXX
    76078TCARadiographic absorptiometry0.000.75NA0.040.79NAXXX
    76080AX-ray exam of fistula0.541.22NA0.071.83NAXXX
    7608026AX-ray exam of fistula0.540.180.180.020.740.74XXX
    76080TCAX-ray exam of fistula0.001.04NA0.051.09NAXXX
    76085AComputer mammogram add-on0.060.44NA0.020.52NAZZZ
    7608526AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    76085TCAComputer mammogram add-on0.000.42NA0.010.43NAZZZ
    76086AX-ray of mammary duct0.362.73NA0.143.23NAXXX
    7608626AX-ray of mammary duct0.360.120.120.020.500.50XXX
    76086TCAX-ray of mammary duct0.002.61NA0.122.73NAXXX
    76088AX-ray of mammary ducts0.453.80NA0.184.43NAXXX
    7608826AX-ray of mammary ducts0.450.150.150.020.620.62XXX
    76088TCAX-ray of mammary ducts0.003.65NA0.163.81NAXXX
    76090AMammogram, one breast0.701.28NA0.082.06NAXXX
    Start Printed Page 80129
    7609026AMammogram, one breast0.700.240.240.030.970.97XXX
    76090TCAMammogram, one breast0.001.04NA0.051.09NAXXX
    76091AMammogram, both breasts0.871.60NA0.092.56NAXXX
    7609126AMammogram, both breasts0.870.300.300.031.201.20XXX
    76091TCAMammogram, both breasts0.001.30NA0.061.36NAXXX
    76092AMammogram, screening0.701.46NA0.092.25NAXXX
    7609226AMammogram, screening0.700.250.250.030.980.98XXX
    76092TCAMammogram, screening0.001.21NA0.061.27NAXXX
    76093AMagnetic image, breast1.6318.11NA0.8320.57NAXXX
    7609326AMagnetic image, breast1.630.560.560.072.262.26XXX
    76093TCAMagnetic image, breast0.0017.55NA0.7618.31NAXXX
    76094AMagnetic image, both breasts1.6324.35NA1.1027.08NAXXX
    7609426AMagnetic image, both breasts1.630.550.550.072.252.25XXX
    76094TCAMagnetic image, both breasts0.0023.80NA1.0324.83NAXXX
    76095AStereotactic breast biopsy1.597.67NA0.409.66NAXXX
    7609526AStereotactic breast biopsy1.590.540.540.092.222.22XXX
    76095TCAStereotactic breast biopsy0.007.13NA0.317.44NAXXX
    76096AX-ray of needle wire, breast0.561.49NA0.092.14NAXXX
    7609626AX-ray of needle wire, breast0.560.190.190.030.780.78XXX
    76096TCAX-ray of needle wire, breast0.001.30NA0.061.36NAXXX
    76098AX-ray exam, breast specimen0.160.48NA0.030.67NAXXX
    7609826AX-ray exam, breast specimen0.160.060.060.010.230.23XXX
    76098TCAX-ray exam, breast specimen0.000.42NA0.020.44NAXXX
    76100AX-ray exam of body section0.581.44NA0.092.11NAXXX
    7610026AX-ray exam of body section0.580.200.200.030.810.81XXX
    76100TCAX-ray exam of body section0.001.24NA0.061.30NAXXX
    76101AComplex body section x-ray0.581.61NA0.102.29NAXXX
    7610126AComplex body section x-ray0.580.200.200.030.810.81XXX
    76101TCAComplex body section x-ray0.001.41NA0.071.48NAXXX
    76102AComplex body section x-rays0.581.92NA0.122.62NAXXX
    7610226AComplex body section x-rays0.580.200.200.030.810.81XXX
    76102TCAComplex body section x-rays0.001.72NA0.091.81NAXXX
    76120ACine/video x-rays0.381.17NA0.071.62NAXXX
    7612026ACine/video x-rays0.380.130.130.020.530.53XXX
    76120TCACine/video x-rays0.001.04NA0.051.09NAXXX
    76125ACine/video x-rays add-on0.270.88NA0.051.20NAZZZ
    7612526ACine/video x-rays add-on0.270.100.100.010.380.38ZZZ
    76125TCACine/video x-rays add-on0.000.78NA0.040.82NAZZZ
    76140IX-ray consultation0.000.000.000.000.000.00XXX
    76150AX-ray exam, dry process0.000.42NA0.020.44NAXXX
    76350CSpecial x-ray contrast study0.000.000.000.000.000.00XXX
    76355ACAT scan for localization1.218.64NA0.4110.26NAXXX
    7635526ACAT scan for localization1.210.420.420.061.691.69XXX
    76355TCACAT scan for localization0.008.22NA0.358.57NAXXX
    76360ACAT scan for needle biopsy1.168.61NA0.4010.17NAXXX
    7636026ACAT scan for needle biopsy1.160.390.390.051.601.60XXX
    76360TCACAT scan for needle biopsy0.008.22NA0.358.57NAXXX
    76362ACat scan for tissue ablation4.009.57NA1.3914.96NAXXX
    7636226ACat scan for tissue ablation4.001.351.350.185.535.53XXX
    76362TCACat scan for tissue ablation0.008.22NA1.219.43NAXXX
    76370ACAT scan for therapy guide0.853.23NA0.174.25NAXXX
    7637026ACAT scan for therapy guide0.850.290.290.041.181.18XXX
    76370TCACAT scan for therapy guide0.002.94NA0.133.07NAXXX
    76375A3d/holograph reconstr add-on0.163.57NA0.163.89NAXXX
    7637526A3d/holograph reconstr add-on0.160.050.050.010.220.22XXX
    76375TCA3d/holograph reconstr add-on0.003.52NA0.153.67NAXXX
    76380ACAT scan follow-up study0.983.81NA0.194.98NAXXX
    7638026ACAT scan follow-up study0.980.330.330.041.351.35XXX
    76380TCACAT scan follow-up study0.003.48NA0.153.63NAXXX
    76390NMr spectroscopy+1.4011.64NA0.5513.59NAXXX
    7639026NMr spectroscopy+1.400.480.480.061.941.94XXX
    76390TCNMr spectroscopy+0.0011.16NA0.4911.65NAXXX
    76393AMr guidance for needle place1.5011.68NA0.5313.71NAXXX
    7639326AMr guidance for needle place1.500.520.520.072.092.09XXX
    76393TCAMr guidance for needle place0.0011.16NA0.4611.62NAXXX
    76394AMri for tissue ablation4.2512.60NA1.4818.33NAXXX
    7639426AMri for tissue ablation4.251.441.440.195.885.88XXX
    76394TCAMri for tissue ablation0.0011.16NA1.2912.45NAXXX
    76400AMagnetic image, bone marrow1.6011.70NA0.5613.86NAXXX
    7640026AMagnetic image, bone marrow1.600.540.540.072.212.21XXX
    76400TCAMagnetic image, bone marrow0.0011.16NA0.4911.65NAXXX
    76490AUs for tissue ablation4.002.85NA0.357.20NAXXX
    7649026AUs for tissue ablation4.001.341.340.115.455.45XXX
    76490TCAUs for tissue ablation0.001.51NA0.241.75NAXXX
    76496CFluoroscopic procedure0.000.000.000.000.000.00XXX
    Start Printed Page 80130
    7649626CFluoroscopic procedure0.000.000.000.000.000.00XXX
    76496TCCFluoroscopic procedure0.000.000.000.000.000.00XXX
    76497CCt procedure0.000.000.000.000.000.00XXX
    7649726CCt procedure0.000.000.000.000.000.00XXX
    76497TCCCt procedure0.000.000.000.000.000.00XXX
    76498CMri procedure0.000.000.000.000.000.00XXX
    7649826CMri procedure0.000.000.000.000.000.00XXX
    76498TCCMri procedure0.000.000.000.000.000.00XXX
    76499CRadiographic procedure0.000.000.000.000.000.00XXX
    7649926CRadiographic procedure0.000.000.000.000.000.00XXX
    76499TCCRadiographic procedure0.000.000.000.000.000.00XXX
    76506AEcho exam of head0.631.66NA0.102.39NAXXX
    7650626AEcho exam of head0.630.250.250.030.910.91XXX
    76506TCAEcho exam of head0.001.41NA0.071.48NAXXX
    76511AEcho exam of eye0.942.59NA0.083.61NAXXX
    7651126AEcho exam of eye0.940.410.410.021.371.37XXX
    76511TCAEcho exam of eye0.002.18NA0.062.24NAXXX
    76512AEcho exam of eye0.662.54NA0.093.29NAXXX
    7651226AEcho exam of eye0.660.300.300.010.970.97XXX
    76512TCAEcho exam of eye0.002.24NA0.082.32NAXXX
    76513AEcho exam of eye, water bath0.662.80NA0.093.55NAXXX
    7651326AEcho exam of eye, water bath0.660.300.300.010.970.97XXX
    76513TCAEcho exam of eye, water bath0.002.50NA0.082.58NAXXX
    76516AEcho exam of eye0.542.13NA0.072.74NAXXX
    7651626AEcho exam of eye0.540.250.250.010.800.80XXX
    76516TCAEcho exam of eye0.001.88NA0.061.94NAXXX
    76519AEcho exam of eye0.541.86NA0.072.47NAXXX
    7651926AEcho exam of eye0.540.250.250.010.800.80XXX
    76519TCAEcho exam of eye0.001.61NA0.061.67NAXXX
    76529AEcho exam of eye0.572.42NA0.083.07NAXXX
    7652926AEcho exam of eye0.570.250.250.010.830.83XXX
    76529TCAEcho exam of eye0.002.17NA0.072.24NAXXX
    76536AUs exam of head and neck0.561.60NA0.092.25NAXXX
    7653626AUs exam of head and neck0.560.190.190.020.770.77XXX
    76536TCAUs exam of head and neck0.001.41NA0.071.48NAXXX
    76604AUs exam, chest, b-scan0.551.49NA0.082.12NAXXX
    7660426AUs exam, chest, b-scan0.550.190.190.020.760.76XXX
    76604TCAUs exam, chest, b-scan0.001.30NA0.061.36NAXXX
    76645AUs exam, breast(s)0.541.22NA0.081.84NAXXX
    7664526AUs exam, breast(s)0.540.180.180.030.750.75XXX
    76645TCAUs exam, breast(s)0.001.04NA0.051.09NAXXX
    76700AUs exam, abdom, complete0.812.24NA0.133.18NAXXX
    7670026AUs exam, abdom, complete0.810.280.280.041.131.13XXX
    76700TCAUs exam, abdom, complete0.001.96NA0.092.05NAXXX
    76705AEcho exam of abdomen0.591.61NA0.102.30NAXXX
    7670526AEcho exam of abdomen0.590.200.200.030.820.82XXX
    76705TCAEcho exam of abdomen0.001.41NA0.071.48NAXXX
    76770AUs exam abdo back wall, comp0.742.21NA0.123.07NAXXX
    7677026AUs exam abdo back wall, comp0.740.250.250.031.021.02XXX
    76770TCAUs exam abdo back wall, comp0.001.96NA0.092.05NAXXX
    76775AUs eam abdo back wall, lim0.581.61NA0.102.29NAXXX
    7677526AUs eam abdo back wall, lim0.580.200.200.030.810.81XXX
    76775TCAUs eam abdo back wall, lim0.001.41NA0.071.48NAXXX
    76778AUs exam kidney transplant0.742.21NA0.123.07NAXXX
    7677826AUs exam kidney transplant0.740.250.250.031.021.02XXX
    76778TCAUs exam kidney transplant0.001.96NA0.092.05NAXXX
    76800AUs exam, spinal canal1.131.76NA0.113.00NAXXX
    7680026AUs exam, spinal canal1.130.350.350.041.521.52XXX
    76800TCAUs exam, spinal canal0.001.41NA0.071.48NAXXX
    76801AOb us < 14 wks, single fetus0.991.40NA0.142.53NAXXX
    7680126AOb us < 14 wks, single fetus0.990.360.360.041.391.39XXX
    76801TCAOb us < 14 wks, single fetus0.001.04NA0.101.14NAXXX
    76802AOb us < 14 wks, addl fetus0.831.01NA0.141.98NAZZZ
    7680226AOb us < 14 wks, addl fetus0.830.300.300.041.171.17ZZZ
    76802TCAOb us < 14 wks, addl fetus0.000.71NA0.100.81NAZZZ
    76805AOb us >/= 14 wks, sngl fetus0.992.44NA0.143.57NAXXX
    7680526AOb us >/= 14 wks, sngl fetus0.990.350.350.041.381.38XXX
    76805TCAOb us >/= 14 wks, sngl fetus0.002.09NA0.102.19NAXXX
    76810AOb us >/= 14 wks, addl fetus0.981.40NA0.252.63NAZZZ
    7681026AOb us >/= 14 wks, addl fetus0.980.360.360.071.411.41ZZZ
    76810TCAOb us >/= 14 wks, addl fetus0.001.04NA0.181.22NAZZZ
    76811AOb us, detailed, sngl fetus1.904.19NA0.516.60NAXXX
    7681126AOb us, detailed, sngl fetus1.900.680.680.152.732.73XXX
    76811TCAOb us, detailed, sngl fetus0.003.51NA0.363.87NAXXX
    76812AOb us, detailed, addl fetus1.781.69NA0.463.93NAZZZ
    Start Printed Page 80131
    7681226AOb us, detailed, addl fetus1.780.650.650.122.552.55ZZZ
    76812TCAOb us, detailed, addl fetus0.001.04NA0.341.38NAZZZ
    76815AOb us, limited, fetus(s)0.651.65NA0.092.39NAXXX
    7681526AOb us, limited, fetus(s)0.650.240.240.020.910.91XXX
    76815TCAOb us, limited, fetus(s)0.001.41NA0.071.48NAXXX
    76816AOb us, follow-up, per fetus0.851.43NA0.072.35NAXXX
    7681626AOb us, follow-up, per fetus0.850.330.330.021.201.20XXX
    76816TCAOb us, follow-up, per fetus0.001.10NA0.051.15NAXXX
    76817ATransvaginal us, obstetric0.751.79NA0.072.61NAXXX
    7681726ATransvaginal us, obstetric0.750.280.280.021.051.05XXX
    76817TCATransvaginal us, obstetric0.001.51NA0.051.56NAXXX
    76818AFetal biophys profile w/nst1.052.01NA0.123.18NAXXX
    7681826AFetal biophys profile w/nst1.050.400.400.041.491.49XXX
    76818TCAFetal biophys profile w/nst0.001.61NA0.081.69NAXXX
    76819AFetal biophys profil w/o nst0.771.90NA0.102.77NAXXX
    7681926AFetal biophys profil w/o nst0.770.290.290.021.081.08XXX
    76819TCAFetal biophys profil w/o nst0.001.61NA0.081.69NAXXX
    76825AEcho exam of fetal heart1.672.58NA0.154.40NAXXX
    7682526AEcho exam of fetal heart1.670.620.620.062.352.35XXX
    76825TCAEcho exam of fetal heart0.001.96NA0.092.05NAXXX
    76826AEcho exam of fetal heart0.831.01NA0.071.91NAXXX
    7682626AEcho exam of fetal heart0.830.300.300.031.161.16XXX
    76826TCAEcho exam of fetal heart0.000.71NA0.040.75NAXXX
    76827AEcho exam of fetal heart0.581.93NA0.122.63NAXXX
    7682726AEcho exam of fetal heart0.580.220.220.020.820.82XXX
    76827TCAEcho exam of fetal heart0.001.71NA0.101.81NAXXX
    76828AEcho exam of fetal heart0.561.32NA0.091.97NAXXX
    7682826AEcho exam of fetal heart0.560.220.220.020.800.80XXX
    76828TCAEcho exam of fetal heart0.001.10NA0.071.17NAXXX
    76830ATransvaginal us, non-ob0.691.75NA0.112.55NAXXX
    7683026ATransvaginal us, non-ob0.690.240.240.030.960.96XXX
    76830TCATransvaginal us, non-ob0.001.51NA0.081.59NAXXX
    76831AEcho exam, uterus0.721.77NA0.102.59NAXXX
    7683126AEcho exam, uterus0.720.260.260.021.001.00XXX
    76831TCAEcho exam, uterus0.001.51NA0.081.59NAXXX
    76856AUs exam, pelvic, complete0.691.75NA0.112.55NAXXX
    7685626AUs exam, pelvic, complete0.690.240.240.030.960.96XXX
    76856TCAUs exam, pelvic, complete0.001.51NA0.081.59NAXXX
    76857AUs exam, pelvic, limited0.382.09NA0.072.54NAXXX
    7685726AUs exam, pelvic, limited0.380.130.130.020.530.53XXX
    76857TCAUs exam, pelvic, limited0.001.96NA0.052.01NAXXX
    76870AUs exam, scrotum0.641.73NA0.112.48NAXXX
    7687026AUs exam, scrotum0.640.220.220.030.890.89XXX
    76870TCAUs exam, scrotum0.001.51NA0.081.59NAXXX
    76872AEcho exam, transrectal0.691.81NA0.122.62NAXXX
    7687226AEcho exam, transrectal0.690.230.230.040.960.96XXX
    76872TCAEcho exam, transrectal0.001.58NA0.081.66NAXXX
    76873AEchograp trans r, pros study1.552.61NA0.214.37NAXXX
    7687326AEchograp trans r, pros study1.550.520.520.082.152.15XXX
    76873TCAEchograp trans r, pros study0.002.09NA0.132.22NAXXX
    76880AUs exam, extremity0.591.61NA0.102.30NAXXX
    7688026AUs exam, extremity0.590.200.200.030.820.82XXX
    76880TCAUs exam, extremity0.001.41NA0.071.48NAXXX
    76885AUs exam infant hips, dynamic0.741.76NA0.112.61NAXXX
    7688526AUs exam infant hips, dynamic0.740.250.250.031.021.02XXX
    76885TCAUs exam infant hips, dynamic0.001.51NA0.081.59NAXXX
    76886AUs exam infant hips, static0.621.62NA0.102.34NAXXX
    7688626AUs exam infant hips, static0.620.210.210.030.860.86XXX
    76886TCAUs exam infant hips, static0.001.41NA0.071.48NAXXX
    76930AEcho guide, cardiocentesis0.671.77NA0.102.54NAXXX
    7693026AEcho guide, cardiocentesis0.670.260.260.020.950.95XXX
    76930TCAEcho guide, cardiocentesis0.001.51NA0.081.59NAXXX
    76932AEcho guide for heart biopsy0.671.77NA0.102.54NAXXX
    7693226AEcho guide for heart biopsy0.670.260.260.020.950.95XXX
    76932TCAEcho guide for heart biopsy0.001.51NA0.081.59NAXXX
    76936AEcho guide for artery repair1.996.95NA0.399.33NAXXX
    7693626AEcho guide for artery repair1.990.680.680.112.782.78XXX
    76936TCAEcho guide for artery repair0.006.27NA0.286.55NAXXX
    76941AEcho guide for transfusion1.342.01NA0.133.48NAXXX
    7694126AEcho guide for transfusion1.340.490.490.061.891.89XXX
    76941TCAEcho guide for transfusion0.001.52NA0.071.59NAXXX
    76942AEcho guide for biopsy0.673.18NA0.123.97NAXXX
    7694226AEcho guide for biopsy0.670.230.230.040.940.94XXX
    76942TCAEcho guide for biopsy0.002.95NA0.083.03NAXXX
    76945AEcho guide, villus sampling0.671.75NA0.102.52NAXXX
    Start Printed Page 80132
    7694526AEcho guide, villus sampling0.670.230.230.030.930.93XXX
    76945TCAEcho guide, villus sampling0.001.52NA0.071.59NAXXX
    76946AEcho guide for amniocentesis0.381.65NA0.092.12NAXXX
    7694626AEcho guide for amniocentesis0.380.140.140.010.530.53XXX
    76946TCAEcho guide for amniocentesis0.001.51NA0.081.59NAXXX
    76948AEcho guide, ova aspiration0.381.64NA0.102.12NAXXX
    7694826AEcho guide, ova aspiration0.380.130.130.020.530.53XXX
    76948TCAEcho guide, ova aspiration0.001.51NA0.081.59NAXXX
    76950AEcho guidance radiotherapy0.581.50NA0.092.17NAXXX
    7695026AEcho guidance radiotherapy0.580.200.200.030.810.81XXX
    76950TCAEcho guidance radiotherapy0.001.30NA0.061.36NAXXX
    76965AEcho guidance radiotherapy1.345.99NA0.317.64NAXXX
    7696526AEcho guidance radiotherapy1.340.450.450.071.861.86XXX
    76965TCAEcho guidance radiotherapy0.005.54NA0.245.78NAXXX
    76970AUltrasound exam follow-up0.401.18NA0.071.65NAXXX
    7697026AUltrasound exam follow-up0.400.140.140.020.560.56XXX
    76970TCAUltrasound exam follow-up0.001.04NA0.051.09NAXXX
    76975AGI endoscopic ultrasound0.811.80NA0.112.72NAXXX
    7697526AGI endoscopic ultrasound0.810.290.290.031.131.13XXX
    76975TCAGI endoscopic ultrasound0.001.51NA0.081.59NAXXX
    76977AUs bone density measure0.050.84NA0.050.94NAXXX
    7697726AUs bone density measure0.050.020.020.010.080.08XXX
    76977TCAUs bone density measure0.000.82NA0.040.86NAXXX
    76986AUltrasound guide intraoper1.203.02NA0.194.41NAXXX
    7698626AUltrasound guide intraoper1.200.410.410.071.681.68XXX
    76986TCAUltrasound guide intraoper0.002.61NA0.122.73NAXXX
    76999CEcho examination procedure0.000.000.000.000.000.00XXX
    7699926CEcho examination procedure0.000.000.000.000.000.00XXX
    76999TCCEcho examination procedure0.000.000.000.000.000.00XXX
    77261ARadiation therapy planning1.390.540.540.061.991.99XXX
    77262ARadiation therapy planning2.110.800.800.093.003.00XXX
    77263ARadiation therapy planning3.141.171.170.134.444.44XXX
    77280ASet radiation therapy field0.703.69NA0.184.57NAXXX
    7728026ASet radiation therapy field0.700.240.240.030.970.97XXX
    77280TCASet radiation therapy field0.003.45NA0.153.60NAXXX
    77285ASet radiation therapy field1.055.90NA0.297.24NAXXX
    7728526ASet radiation therapy field1.050.360.360.041.451.45XXX
    77285TCASet radiation therapy field0.005.54NA0.255.79NAXXX
    77290ASet radiation therapy field1.567.01NA0.358.92NAXXX
    7729026ASet radiation therapy field1.560.530.530.062.152.15XXX
    77290TCASet radiation therapy field0.006.48NA0.296.77NAXXX
    77295ASet radiation therapy field4.5729.35NA1.4135.33NAXXX
    7729526ASet radiation therapy field4.571.541.540.186.296.29XXX
    77295TCASet radiation therapy field0.0027.81NA1.2329.04NAXXX
    77299CRadiation therapy planning0.000.000.000.000.000.00XXX
    7729926CRadiation therapy planning0.000.000.000.000.000.00XXX
    77299TCCRadiation therapy planning0.000.000.000.000.000.00XXX
    77300ARadiation therapy dose plan0.621.54NA0.092.25NAXXX
    7730026ARadiation therapy dose plan0.620.210.210.030.860.86XXX
    77300TCARadiation therapy dose plan0.001.33NA0.061.39NAXXX
    77301ARadiotherapy dose plan, imrt8.0030.92NA1.4140.33NAXXX
    7730126ARadiotherapy dose plan, imrt8.003.113.110.1811.2911.29XXX
    77301TCARadiotherapy dose plan, imrt0.0027.81NA1.2329.04NAXXX
    77305ATeletx isodose plan simple0.702.09NA0.122.91NAXXX
    7730526ATeletx isodose plan simple0.700.240.240.030.970.97XXX
    77305TCATeletx isodose plan simple0.001.85NA0.091.94NAXXX
    77310ATeletx isodose plan intermed1.052.68NA0.153.88NAXXX
    7731026ATeletx isodose plan intermed1.050.360.360.041.451.45XXX
    77310TCATeletx isodose plan intermed0.002.32NA0.112.43NAXXX
    77315ATeletx isodose plan complex1.563.18NA0.184.92NAXXX
    7731526ATeletx isodose plan complex1.560.530.530.062.152.15XXX
    77315TCATeletx isodose plan complex0.002.65NA0.122.77NAXXX
    77321ASpecial teletx port plan0.954.34NA0.215.50NAXXX
    7732126ASpecial teletx port plan0.950.320.320.041.311.31XXX
    77321TCASpecial teletx port plan0.004.02NA0.174.19NAXXX
    77326ABrachytx isodose calc simp0.932.66NA0.153.74NAXXX
    7732626ABrachytx isodose calc simp0.930.310.310.041.281.28XXX
    77326TCABrachytx isodose calc simp0.002.35NA0.112.46NAXXX
    77327ABrachytx isodose calc interm1.393.92NA0.215.52NAXXX
    7732726ABrachytx isodose calc interm1.390.470.470.061.921.92XXX
    77327TCABrachytx isodose calc interm0.003.45NA0.153.60NAXXX
    77328ABrachytx isodose plan compl2.095.65NA0.308.04NAXXX
    7732826ABrachytx isodose plan compl2.090.710.710.092.892.89XXX
    77328TCABrachytx isodose plan compl0.004.94NA0.215.15NAXXX
    77331ASpecial radiation dosimetry0.870.80NA0.061.73NAXXX
    Start Printed Page 80133
    7733126ASpecial radiation dosimetry0.870.300.300.041.211.21XXX
    77331TCASpecial radiation dosimetry0.000.50NA0.020.52NAXXX
    77332ARadiation treatment aid(s)0.541.51NA0.082.13NAXXX
    7733226ARadiation treatment aid(s)0.540.180.180.020.740.74XXX
    77332TCARadiation treatment aid(s)0.001.33NA0.061.39NAXXX
    77333ARadiation treatment aid(s)0.842.18NA0.133.15NAXXX
    7733326ARadiation treatment aid(s)0.840.290.290.041.171.17XXX
    77333TCARadiation treatment aid(s)0.001.89NA0.091.98NAXXX
    77334ARadiation treatment aid(s)1.243.65NA0.195.08NAXXX
    7733426ARadiation treatment aid(s)1.240.420.420.051.711.71XXX
    77334TCARadiation treatment aid(s)0.003.23NA0.143.37NAXXX
    77336ARadiation physics consult0.002.97NA0.133.10NAXXX
    77370ARadiation physics consult0.003.47NA0.153.62NAXXX
    77399CExternal radiation dosimetry0.000.000.000.000.000.00XXX
    7739926CExternal radiation dosimetry0.000.000.000.000.000.00XXX
    77399TCCExternal radiation dosimetry0.000.000.000.000.000.00XXX
    77401ARadiation treatment delivery0.001.76NA0.091.85NAXXX
    77402ARadiation treatment delivery0.001.76NA0.091.85NAXXX
    77403ARadiation treatment delivery0.001.76NA0.091.85NAXXX
    77404ARadiation treatment delivery0.001.76NA0.091.85NAXXX
    77406ARadiation treatment delivery0.001.76NA0.091.85NAXXX
    77407ARadiation treatment delivery0.002.08NA0.102.18NAXXX
    77408ARadiation treatment delivery0.002.08NA0.102.18NAXXX
    77409ARadiation treatment delivery0.002.08NA0.102.18NAXXX
    77411ARadiation treatment delivery0.002.08NA0.102.18NAXXX
    77412ARadiation treatment delivery0.002.32NA0.112.43NAXXX
    77413ARadiation treatment delivery0.002.32NA0.112.43NAXXX
    77414ARadiation treatment delivery0.002.32NA0.112.43NAXXX
    77416ARadiation treatment delivery0.002.32NA0.112.43NAXXX
    77417ARadiology port film(s)0.000.59NA0.030.62NAXXX
    77418ARadiation tx delivery, imrt0.0017.97NA0.1118.08NAXXX
    77427ARadiation tx management, x53.311.121.120.144.574.57XXX
    77431ARadiation therapy management1.810.710.710.072.592.59XXX
    77432AStereotactic radiation trmt7.933.063.060.3311.3211.32XXX
    77470ASpecial radiation treatment2.0911.81NA0.5814.48NAXXX
    7747026ASpecial radiation treatment2.090.710.710.092.892.89XXX
    77470TCASpecial radiation treatment0.0011.10NA0.4911.59NAXXX
    77499CRadiation therapy management0.000.000.000.000.000.00XXX
    7749926CRadiation therapy management0.000.000.000.000.000.00XXX
    77499TCCRadiation therapy management0.000.000.000.000.000.00XXX
    77520CProton trmt, simple w/o comp0.000.000.000.000.000.00XXX
    77522CProton trmt, simple w/comp0.000.000.000.000.000.00XXX
    77523CProton trmt, intermediate0.000.000.000.000.000.00XXX
    77525CProton treatment, complex0.000.000.000.000.000.00XXX
    77600RHyperthermia treatment1.563.57NA0.215.34NAXXX
    7760026RHyperthermia treatment1.560.530.530.082.172.17XXX
    77600TCRHyperthermia treatment0.003.04NA0.133.17NAXXX
    77605RHyperthermia treatment2.094.75NA0.317.15NAXXX
    7760526RHyperthermia treatment2.090.710.710.132.932.93XXX
    77605TCRHyperthermia treatment0.004.04NA0.184.22NAXXX
    77610RHyperthermia treatment1.563.57NA0.205.33NAXXX
    7761026RHyperthermia treatment1.560.530.530.072.162.16XXX
    77610TCRHyperthermia treatment0.003.04NA0.133.17NAXXX
    77615RHyperthermia treatment2.094.75NA0.277.11NAXXX
    7761526RHyperthermia treatment2.090.710.710.092.892.89XXX
    77615TCRHyperthermia treatment0.004.04NA0.184.22NAXXX
    77620RHyperthermia treatment1.563.58NA0.195.33NAXXX
    7762026RHyperthermia treatment1.560.540.540.062.162.16XXX
    77620TCRHyperthermia treatment0.003.04NA0.133.17NAXXX
    77750AInfuse radioactive materials4.913.00NA0.238.14NA090
    7775026AInfuse radioactive materials4.911.671.670.176.756.75090
    77750TCAInfuse radioactive materials0.001.33NA0.061.39NA090
    77761AApply intrcav radiat simple3.813.64NA0.287.73NA090
    7776126AApply intrcav radiat simple3.811.141.140.165.115.11090
    77761TCAApply intrcav radiat simple0.002.50NA0.122.62NA090
    77762AApply intrcav radiat interm5.725.51NA0.3811.61NA090
    7776226AApply intrcav radiat interm5.721.921.920.227.867.86090
    77762TCAApply intrcav radiat interm0.003.59NA0.163.75NA090
    77763AApply intrcav radiat compl8.577.35NA0.5316.45NA090
    7776326AApply intrcav radiat compl8.572.882.880.3411.7911.79090
    77763TCAApply intrcav radiat compl0.004.47NA0.194.66NA090
    77776AApply interstit radiat simpl4.663.15NA0.358.16NA090
    7777626AApply interstit radiat simpl4.660.980.980.245.885.88090
    77776TCAApply interstit radiat simpl0.002.17NA0.112.28NA090
    77777AApply interstit radiat inter7.486.70NA0.5014.68NA090
    Start Printed Page 80134
    7777726AApply interstit radiat inter7.482.482.480.3210.2810.28090
    77777TCAApply interstit radiat inter0.004.22NA0.184.40NA090
    77778AApply interstit radiat compl11.198.88NA0.6920.76NA090
    7777826AApply interstit radiat compl11.193.773.770.4715.4315.43090
    77778TCAApply interstit radiat compl0.005.11NA0.225.33NA090
    77781AHigh intensity brachytherapy1.6620.79NA0.9523.40NA090
    7778126AHigh intensity brachytherapy1.660.570.570.072.302.30090
    77781TCAHigh intensity brachytherapy0.0020.22NA0.8821.10NA090
    77782AHigh intensity brachytherapy2.4921.07NA0.9824.54NA090
    7778226AHigh intensity brachytherapy2.490.850.850.103.443.44090
    77782TCAHigh intensity brachytherapy0.0020.22NA0.8821.10NA090
    77783AHigh intensity brachytherapy3.7321.48NA1.0326.24NA090
    7778326AHigh intensity brachytherapy3.731.261.260.155.145.14090
    77783TCAHigh intensity brachytherapy0.0020.22NA0.8821.10NA090
    77784AHigh intensity brachytherapy5.6122.11NA1.1028.82NA090
    7778426AHigh intensity brachytherapy5.611.891.890.227.727.72090
    77784TCAHigh intensity brachytherapy0.0020.22NA0.8821.10NA090
    77789AApply surface radiation1.120.84NA0.052.01NA090
    7778926AApply surface radiation1.120.390.390.031.541.54090
    77789TCAApply surface radiation0.000.45NA0.020.47NA090
    77790ARadiation handling1.050.86NA0.061.97NAXXX
    7779026ARadiation handling1.050.360.360.041.451.45XXX
    77790TCARadiation handling0.000.50NA0.020.52NAXXX
    77799CRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    7779926CRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    77799TCCRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    78000AThyroid, single uptake0.191.04NA0.061.29NAXXX
    7800026AThyroid, single uptake0.190.070.070.010.270.27XXX
    78000TCAThyroid, single uptake0.000.97NA0.051.02NAXXX
    78001AThyroid, multiple uptakes0.261.39NA0.071.72NAXXX
    7800126AThyroid, multiple uptakes0.260.090.090.010.360.36XXX
    78001TCAThyroid, multiple uptakes0.001.30NA0.061.36NAXXX
    78003AThyroid suppress/stimul0.331.08NA0.061.47NAXXX
    7800326AThyroid suppress/stimul0.330.110.110.010.450.45XXX
    78003TCAThyroid suppress/stimul0.000.97NA0.051.02NAXXX
    78006AThyroid imaging with uptake0.492.54NA0.133.16NAXXX
    7800626AThyroid imaging with uptake0.490.170.170.020.680.68XXX
    78006TCAThyroid imaging with uptake0.002.37NA0.112.48NAXXX
    78007AThyroid image, mult uptakes0.502.73NA0.143.37NAXXX
    7800726AThyroid image, mult uptakes0.500.170.170.020.690.69XXX
    78007TCAThyroid image, mult uptakes0.002.56NA0.122.68NAXXX
    78010AThyroid imaging0.391.95NA0.112.45NAXXX
    7801026AThyroid imaging0.390.140.140.020.550.55XXX
    78010TCAThyroid imaging0.001.81NA0.091.90NAXXX
    78011AThyroid imaging with flow0.452.56NA0.133.14NAXXX
    7801126AThyroid imaging with flow0.450.160.160.020.630.63XXX
    78011TCAThyroid imaging with flow0.002.40NA0.112.51NAXXX
    78015AThyroid met imaging0.672.79NA0.153.61NAXXX
    7801526AThyroid met imaging0.670.230.230.030.930.93XXX
    78015TCAThyroid met imaging0.002.56NA0.122.68NAXXX
    78016AThyroid met imaging/studies0.823.76NA0.184.76NAXXX
    7801626AThyroid met imaging/studies0.820.300.300.031.151.15XXX
    78016TCAThyroid met imaging/studies0.003.46NA0.153.61NAXXX
    78018AThyroid met imaging, body0.865.71NA0.276.84NAXXX
    7801826AThyroid met imaging, body0.860.310.310.031.201.20XXX
    78018TCAThyroid met imaging, body0.005.40NA0.245.64NAXXX
    78020AThyroid met uptake0.601.52NA0.142.26NAZZZ
    7802026AThyroid met uptake0.600.220.220.020.840.84ZZZ
    78020TCAThyroid met uptake0.001.30NA0.121.42NAZZZ
    78070AParathyroid nuclear imaging0.822.10NA0.123.04NAXXX
    7807026AParathyroid nuclear imaging0.820.290.290.031.141.14XXX
    78070TCAParathyroid nuclear imaging0.001.81NA0.091.90NAXXX
    78075AAdrenal nuclear imaging0.745.67NA0.276.68NAXXX
    7807526AAdrenal nuclear imaging0.740.270.270.031.041.04XXX
    78075TCAAdrenal nuclear imaging0.005.40NA0.245.64NAXXX
    78099CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    7809926CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78099TCCEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78102ABone marrow imaging, ltd0.552.23NA0.122.90NAXXX
    7810226ABone marrow imaging, ltd0.550.200.200.020.770.77XXX
    78102TCABone marrow imaging, ltd0.002.03NA0.102.13NAXXX
    78103ABone marrow imaging, mult0.753.42NA0.174.34NAXXX
    7810326ABone marrow imaging, mult0.750.270.270.031.051.05XXX
    78103TCABone marrow imaging, mult0.003.15NA0.143.29NAXXX
    78104ABone marrow imaging, body0.804.33NA0.215.34NAXXX
    Start Printed Page 80135
    7810426ABone marrow imaging, body0.800.280.280.031.111.11XXX
    78104TCABone marrow imaging, body0.004.05NA0.184.23NAXXX
    78110APlasma volume, single0.191.02NA0.061.27NAXXX
    7811026APlasma volume, single0.190.070.070.010.270.27XXX
    78110TCAPlasma volume, single0.000.95NA0.051.00NAXXX
    78111APlasma volume, multiple0.222.64NA0.132.99NAXXX
    7811126APlasma volume, multiple0.220.080.080.010.310.31XXX
    78111TCAPlasma volume, multiple0.002.56NA0.122.68NAXXX
    78120ARed cell mass, single0.231.80NA0.102.13NAXXX
    7812026ARed cell mass, single0.230.080.080.010.320.32XXX
    78120TCARed cell mass, single0.001.72NA0.091.81NAXXX
    78121ARed cell mass, multiple0.323.02NA0.133.47NAXXX
    7812126ARed cell mass, multiple0.320.120.120.010.450.45XXX
    78121TCARed cell mass, multiple0.002.90NA0.123.02NAXXX
    78122ABlood volume0.454.74NA0.225.41NAXXX
    7812226ABlood volume0.450.160.160.020.630.63XXX
    78122TCABlood volume0.004.58NA0.204.78NAXXX
    78130ARed cell survival study0.613.06NA0.153.82NAXXX
    7813026ARed cell survival study0.610.220.220.030.860.86XXX
    78130TCARed cell survival study0.002.84NA0.122.96NAXXX
    78135ARed cell survival kinetics0.645.09NA0.245.97NAXXX
    7813526ARed cell survival kinetics0.640.230.230.030.900.90XXX
    78135TCARed cell survival kinetics0.004.86NA0.215.07NAXXX
    78140ARed cell sequestration0.614.13NA0.204.94NAXXX
    7814026ARed cell sequestration0.610.210.210.030.850.85XXX
    78140TCARed cell sequestration0.003.92NA0.174.09NAXXX
    78160APlasma iron turnover0.333.77NA0.194.29NAXXX
    7816026APlasma iron turnover0.330.120.120.030.480.48XXX
    78160TCAPlasma iron turnover0.003.65NA0.163.81NAXXX
    78162ARadioiron absorption exam0.453.37NA0.153.97NAXXX
    7816226ARadioiron absorption exam0.450.190.190.010.650.65XXX
    78162TCARadioiron absorption exam0.003.18NA0.143.32NAXXX
    78170ARed cell iron utilization0.415.42NA0.276.10NAXXX
    7817026ARed cell iron utilization0.410.140.140.040.590.59XXX
    78170TCARed cell iron utilization0.005.28NA0.235.51NAXXX
    78172CTotal body iron estimation0.000.000.000.000.000.00XXX
    7817226ATotal body iron estimation0.530.180.180.020.730.73XXX
    78172TCCTotal body iron estimation0.000.000.000.000.000.00XXX
    78185ASpleen imaging0.402.49NA0.133.02NAXXX
    7818526ASpleen imaging0.400.140.140.020.560.56XXX
    78185TCASpleen imaging0.002.35NA0.112.46NAXXX
    78190APlatelet survival, kinetics1.096.09NA0.317.49NAXXX
    7819026APlatelet survival, kinetics1.090.400.400.061.551.55XXX
    78190TCAPlatelet survival, kinetics0.005.69NA0.255.94NAXXX
    78191APlatelet survival0.617.51NA0.348.46NAXXX
    7819126APlatelet survival0.610.210.210.030.850.85XXX
    78191TCAPlatelet survival0.007.30NA0.317.61NAXXX
    78195ALymph system imaging1.204.48NA0.235.91NAXXX
    7819526ALymph system imaging1.200.430.430.051.681.68XXX
    78195TCALymph system imaging0.004.05NA0.184.23NAXXX
    78199CBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    7819926CBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    78199TCCBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    78201ALiver imaging0.442.50NA0.133.07NAXXX
    7820126ALiver imaging0.440.150.150.020.610.61XXX
    78201TCALiver imaging0.002.35NA0.112.46NAXXX
    78202ALiver imaging with flow0.513.05NA0.143.70NAXXX
    7820226ALiver imaging with flow0.510.180.180.020.710.71XXX
    78202TCALiver imaging with flow0.002.87NA0.122.99NAXXX
    78205ALiver imaging (3D)0.716.13NA0.297.13NAXXX
    7820526ALiver imaging (3D)0.710.250.250.030.990.99XXX
    78205TCALiver imaging (3D)0.005.88NA0.266.14NAXXX
    78206ALiver image (3d) with flow0.966.22NA0.137.31NAXXX
    7820626ALiver image (3d) with flow0.960.340.340.041.341.34XXX
    78206TCALiver image (3d) with flow0.005.88NA0.095.97NAXXX
    78215ALiver and spleen imaging0.493.10NA0.143.73NAXXX
    7821526ALiver and spleen imaging0.490.170.170.020.680.68XXX
    78215TCALiver and spleen imaging0.002.93NA0.123.05NAXXX
    78216ALiver & spleen image/flow0.573.66NA0.174.40NAXXX
    7821626ALiver & spleen image/flow0.570.200.200.020.790.79XXX
    78216TCALiver & spleen image/flow0.003.46NA0.153.61NAXXX
    78220ALiver function study0.493.87NA0.184.54NAXXX
    7822026ALiver function study0.490.170.170.020.680.68XXX
    78220TCALiver function study0.003.70NA0.163.86NAXXX
    78223AHepatobiliary imaging0.843.94NA0.204.98NAXXX
    Start Printed Page 80136
    7822326AHepatobiliary imaging0.840.290.290.041.171.17XXX
    78223TCAHepatobiliary imaging0.003.65NA0.163.81NAXXX
    78230ASalivary gland imaging0.452.32NA0.132.90NAXXX
    7823026ASalivary gland imaging0.450.150.150.020.620.62XXX
    78230TCASalivary gland imaging0.002.17NA0.112.28NAXXX
    78231ASerial salivary imaging0.523.34NA0.164.02NAXXX
    7823126ASerial salivary imaging0.520.190.190.020.730.73XXX
    78231TCASerial salivary imaging0.003.15NA0.143.29NAXXX
    78232ASalivary gland function exam0.473.69NA0.164.32NAXXX
    7823226ASalivary gland function exam0.470.170.170.010.650.65XXX
    78232TCASalivary gland function exam0.003.52NA0.153.67NAXXX
    78258AEsophageal motility study0.743.13NA0.154.02NAXXX
    7825826AEsophageal motility study0.740.260.260.031.031.03XXX
    78258TCAEsophageal motility study0.002.87NA0.122.99NAXXX
    78261AGastric mucosa imaging0.694.33NA0.215.23NAXXX
    7826126AGastric mucosa imaging0.690.250.250.030.970.97XXX
    78261TCAGastric mucosa imaging0.004.08NA0.184.26NAXXX
    78262AGastroesophageal reflux exam0.684.48NA0.215.37NAXXX
    7826226AGastroesophageal reflux exam0.680.240.240.030.950.95XXX
    78262TCAGastroesophageal reflux exam0.004.24NA0.184.42NAXXX
    78264AGastric emptying study0.784.38NA0.215.37NAXXX
    7826426AGastric emptying study0.780.270.270.031.081.08XXX
    78264TCAGastric emptying study0.004.11NA0.184.29NAXXX
    78267XBreath tst attain/anal c-140.000.000.000.000.000.00XXX
    78268XBreath test analysis, c-140.000.000.000.000.000.00XXX
    78270AVit B-12 absorption exam0.201.61NA0.091.90NAXXX
    7827026AVit B-12 absorption exam0.200.070.070.010.280.28XXX
    78270TCAVit B-12 absorption exam0.001.54NA0.081.62NAXXX
    78271AVit b-12 absrp exam, int fac0.201.70NA0.091.99NAXXX
    7827126AVit b-12 absrp exam, int fac0.200.070.070.010.280.28XXX
    78271TCAVit b-12 absrp exam, int fac0.001.63NA0.081.71NAXXX
    78272AVit B-12 absorp, combined0.272.41NA0.122.80NAXXX
    7827226AVit B-12 absorp, combined0.270.100.100.010.380.38XXX
    78272TCAVit B-12 absorp, combined0.002.31NA0.112.42NAXXX
    78278AAcute GI blood loss imaging0.995.20NA0.256.44NAXXX
    7827826AAcute GI blood loss imaging0.990.340.340.041.371.37XXX
    78278TCAAcute GI blood loss imaging0.004.86NA0.215.07NAXXX
    78282CGI protein loss exam0.000.000.000.000.000.00XXX
    7828226AGI protein loss exam0.380.140.140.020.540.54XXX
    78282TCCGI protein loss exam0.000.000.000.000.000.00XXX
    78290AMeckel's divert exam0.683.28NA0.164.12NAXXX
    7829026AMeckel's divert exam0.680.240.240.030.950.95XXX
    78290TCAMeckel's divert exam0.003.04NA0.133.17NAXXX
    78291ALeveen/shunt patency exam0.883.36NA0.174.41NAXXX
    7829126ALeveen/shunt patency exam0.880.310.310.041.231.23XXX
    78291TCALeveen/shunt patency exam0.003.05NA0.133.18NAXXX
    78299CGI nuclear procedure0.000.000.000.000.000.00XXX
    7829926CGI nuclear procedure0.000.000.000.000.000.00XXX
    78299TCCGI nuclear procedure0.000.000.000.000.000.00XXX
    78300ABone imaging, limited area0.622.69NA0.153.46NAXXX
    7830026ABone imaging, limited area0.620.210.210.030.860.86XXX
    78300TCABone imaging, limited area0.002.48NA0.122.60NAXXX
    78305ABone imaging, multiple areas0.833.94NA0.194.96NAXXX
    7830526ABone imaging, multiple areas0.830.290.290.031.151.15XXX
    78305TCABone imaging, multiple areas0.003.65NA0.163.81NAXXX
    78306ABone imaging, whole body0.864.56NA0.225.64NAXXX
    7830626ABone imaging, whole body0.860.300.300.041.201.20XXX
    78306TCABone imaging, whole body0.004.26NA0.184.44NAXXX
    78315ABone imaging, 3 phase1.025.12NA0.256.39NAXXX
    7831526ABone imaging, 3 phase1.020.360.360.041.421.42XXX
    78315TCABone imaging, 3 phase0.004.76NA0.214.97NAXXX
    78320ABone imaging (3D)1.046.25NA0.307.59NAXXX
    7832026ABone imaging (3D)1.040.370.370.041.451.45XXX
    78320TCABone imaging (3D)0.005.88NA0.266.14NAXXX
    78350ABone mineral, single photon0.220.83NA0.051.10NAXXX
    7835026ABone mineral, single photon0.220.080.080.010.310.31XXX
    78350TCABone mineral, single photon0.000.75NA0.040.79NAXXX
    78351NBone mineral, dual photon+0.301.740.120.012.050.43XXX
    78399CMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    7839926CMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    78399TCCMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    78414CNon-imaging heart function0.000.000.000.000.000.00XXX
    7841426ANon-imaging heart function0.450.160.160.020.630.63XXX
    78414TCCNon-imaging heart function0.000.000.000.000.000.00XXX
    78428ACardiac shunt imaging0.782.54NA0.143.46NAXXX
    Start Printed Page 80137
    7842826ACardiac shunt imaging0.780.300.300.031.111.11XXX
    78428TCACardiac shunt imaging0.002.24NA0.112.35NAXXX
    78445AVascular flow imaging0.492.03NA0.112.63NAXXX
    7844526AVascular flow imaging0.490.180.180.020.690.69XXX
    78445TCAVascular flow imaging0.001.85NA0.091.94NAXXX
    78455AVenous thrombosis study0.734.23NA0.205.16NAXXX
    7845526AVenous thrombosis study0.730.260.260.031.021.02XXX
    78455TCAVenous thrombosis study0.003.97NA0.174.14NAXXX
    78456AAcute venous thrombus image1.004.33NA0.285.61NAXXX
    7845626AAcute venous thrombus image1.000.360.360.041.401.40XXX
    78456TCAAcute venous thrombus image0.003.97NA0.244.21NAXXX
    78457AVenous thrombosis imaging0.772.92NA0.153.84NAXXX
    7845726AVenous thrombosis imaging0.770.270.270.031.071.07XXX
    78457TCAVenous thrombosis imaging0.002.65NA0.122.77NAXXX
    78458AVen thrombosis images, bilat0.904.33NA0.205.43NAXXX
    7845826AVen thrombosis images, bilat0.900.330.330.031.261.26XXX
    78458TCAVen thrombosis images, bilat0.004.00NA0.174.17NAXXX
    78459CHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    7845926RHeart muscle imaging (PET)1.500.590.590.042.132.13XXX
    78459TCCHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    78460AHeart muscle blood, single0.862.65NA0.143.65NAXXX
    7846026AHeart muscle blood, single0.860.300.300.031.191.19XXX
    78460TCAHeart muscle blood, single0.002.35NA0.112.46NAXXX
    78461AHeart muscle blood, multiple1.235.15NA0.266.64NAXXX
    7846126AHeart muscle blood, multiple1.230.450.450.051.731.73XXX
    78461TCAHeart muscle blood, multiple0.004.70NA0.214.91NAXXX
    78464AHeart image (3d), single1.097.43NA0.358.87NAXXX
    7846426AHeart image (3d), single1.090.390.390.041.521.52XXX
    78464TCAHeart image (3d), single0.007.04NA0.317.35NAXXX
    78465AHeart image (3d), multiple1.4612.28NA0.5614.30NAXXX
    7846526AHeart image (3d), multiple1.460.540.540.052.052.05XXX
    78465TCAHeart image (3d), multiple0.0011.74NA0.5112.25NAXXX
    78466AHeart infarct image0.692.86NA0.153.70NAXXX
    7846626AHeart infarct image0.690.250.250.030.970.97XXX
    78466TCAHeart infarct image0.002.61NA0.122.73NAXXX
    78468AHeart infarct image (ef)0.803.93NA0.194.92NAXXX
    7846826AHeart infarct image (ef)0.800.280.280.031.111.11XXX
    78468TCAHeart infarct image (ef)0.003.65NA0.163.81NAXXX
    78469AHeart infarct image (3D)0.925.51NA0.266.69NAXXX
    7846926AHeart infarct image (3D)0.920.320.320.031.271.27XXX
    78469TCAHeart infarct image (3D)0.005.19NA0.235.42NAXXX
    78472AGated heart, planar, single0.985.83NA0.297.10NAXXX
    7847226AGated heart, planar, single0.980.350.350.041.371.37XXX
    78472TCAGated heart, planar, single0.005.48NA0.255.73NAXXX
    78473AGated heart, multiple1.478.75NA0.4010.62NAXXX
    7847326AGated heart, multiple1.470.530.530.052.052.05XXX
    78473TCAGated heart, multiple0.008.22NA0.358.57NAXXX
    78478AHeart wall motion add-on0.621.78NA0.102.50NAXXX
    7847826AHeart wall motion add-on0.620.230.230.020.870.87XXX
    78478TCAHeart wall motion add-on0.001.55NA0.081.63NAXXX
    78480AHeart function add-on0.621.78NA0.102.50NAXXX
    7848026AHeart function add-on0.620.230.230.020.870.87XXX
    78480TCAHeart function add-on0.001.55NA0.081.63NAXXX
    78481AHeart first pass, single0.985.56NA0.266.80NAXXX
    7848126AHeart first pass, single0.980.370.370.031.381.38XXX
    78481TCAHeart first pass, single0.005.19NA0.235.42NAXXX
    78483AHeart first pass, multiple1.478.39NA0.3910.25NAXXX
    7848326AHeart first pass, multiple1.470.560.560.052.082.08XXX
    78483TCAHeart first pass, multiple0.007.83NA0.348.17NAXXX
    78491IHeart image (pet), single0.000.000.000.000.000.00XXX
    7849126IHeart image (pet), single+1.500.600.600.052.152.15XXX
    78491TCIHeart image (pet), single0.000.000.000.000.000.00XXX
    78492IHeart image (pet), multiple0.000.000.000.000.000.00XXX
    7849226IHeart image (pet), multiple+1.870.750.750.062.682.68XXX
    78492TCIHeart image (pet), multiple0.000.000.000.000.000.00XXX
    78494AHeart image, spect1.197.47NA0.298.95NAXXX
    7849426AHeart image, spect1.190.430.430.041.661.66XXX
    78494TCAHeart image, spect0.007.04NA0.257.29NAXXX
    78496AHeart first pass add-on0.507.23NA0.278.00NAZZZ
    7849626AHeart first pass add-on0.500.190.190.020.710.71ZZZ
    78496TCAHeart first pass add-on0.007.04NA0.257.29NAZZZ
    78499CCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    7849926CCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    78499TCCCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    78580ALung perfusion imaging0.743.67NA0.184.59NAXXX
    Start Printed Page 80138
    7858026ALung perfusion imaging0.740.260.260.031.031.03XXX
    78580TCALung perfusion imaging0.003.41NA0.153.56NAXXX
    78584ALung V/Q image single breath0.993.52NA0.184.69NAXXX
    7858426ALung V/Q image single breath0.990.340.340.041.371.37XXX
    78584TCALung V/Q image single breath0.003.18NA0.143.32NAXXX
    78585ALung V/Q imaging1.095.99NA0.307.38NAXXX
    7858526ALung V/Q imaging1.090.380.380.051.521.52XXX
    78585TCALung V/Q imaging0.005.61NA0.255.86NAXXX
    78586AAerosol lung image, single0.402.72NA0.143.26NAXXX
    7858626AAerosol lung image, single0.400.140.140.020.560.56XXX
    78586TCAAerosol lung image, single0.002.58NA0.122.70NAXXX
    78587AAerosol lung image, multiple0.492.97NA0.143.60NAXXX
    7858726AAerosol lung image, multiple0.490.170.170.020.680.68XXX
    78587TCAAerosol lung image, multiple0.002.80NA0.122.92NAXXX
    78588APerfusion lung image1.093.56NA0.204.85NAXXX
    7858826APerfusion lung image1.090.380.380.051.521.52XXX
    78588TCAPerfusion lung image0.003.18NA0.153.33NAXXX
    78591AVent image, 1 breath, 1 proj0.402.98NA0.143.52NAXXX
    7859126AVent image, 1 breath, 1 proj0.400.140.140.020.560.56XXX
    78591TCAVent image, 1 breath, 1 proj0.002.84NA0.122.96NAXXX
    78593AVent image, 1 proj, gas0.493.60NA0.174.26NAXXX
    7859326AVent image, 1 proj, gas0.490.170.170.020.680.68XXX
    78593TCAVent image, 1 proj, gas0.003.43NA0.153.58NAXXX
    78594AVent image, mult proj, gas0.535.15NA0.235.91NAXXX
    7859426AVent image, mult proj, gas0.530.190.190.020.740.74XXX
    78594TCAVent image, mult proj, gas0.004.96NA0.215.17NAXXX
    78596ALung differential function1.277.48NA0.369.11NAXXX
    7859626ALung differential function1.270.440.440.051.761.76XXX
    78596TCALung differential function0.007.04NA0.317.35NAXXX
    78599CRespiratory nuclear exam0.000.000.000.000.000.00XXX
    7859926CRespiratory nuclear exam0.000.000.000.000.000.00XXX
    78599TCCRespiratory nuclear exam0.000.000.000.000.000.00XXX
    78600ABrain imaging, ltd static0.443.03NA0.143.61NAXXX
    7860026ABrain imaging, ltd static0.440.160.160.020.620.62XXX
    78600TCABrain imaging, ltd static0.002.87NA0.122.99NAXXX
    78601ABrain imaging, ltd w/ flow0.513.57NA0.174.25NAXXX
    7860126ABrain imaging, ltd w/ flow0.510.180.180.020.710.71XXX
    78601TCABrain imaging, ltd w/ flow0.003.39NA0.153.54NAXXX
    78605ABrain imaging, complete0.533.58NA0.174.28NAXXX
    7860526ABrain imaging, complete0.530.190.190.020.740.74XXX
    78605TCABrain imaging, complete0.003.39NA0.153.54NAXXX
    78606ABrain imaging, compl w/flow0.644.07NA0.204.91NAXXX
    7860626ABrain imaging, compl w/flow0.640.220.220.030.890.89XXX
    78606TCABrain imaging, compl w/flow0.003.85NA0.174.02NAXXX
    78607ABrain imaging (3D)1.236.98NA0.348.55NAXXX
    7860726ABrain imaging (3D)1.230.450.450.051.731.73XXX
    78607TCABrain imaging (3D)0.006.53NA0.296.82NAXXX
    78608NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78609NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78610ABrain flow imaging only0.301.68NA0.092.07NAXXX
    7861026ABrain flow imaging only0.300.110.110.010.420.42XXX
    78610TCABrain flow imaging only0.001.57NA0.081.65NAXXX
    78615ACerebral vascular flow image0.423.99NA0.194.60NAXXX
    7861526ACerebral vascular flow image0.420.160.160.020.600.60XXX
    78615TCACerebral vascular flow image0.003.83NA0.174.00NAXXX
    78630ACerebrospinal fluid scan0.685.26NA0.256.19NAXXX
    7863026ACerebrospinal fluid scan0.680.240.240.030.950.95XXX
    78630TCACerebrospinal fluid scan0.005.02NA0.225.24NAXXX
    78635ACSF ventriculography0.612.77NA0.143.52NAXXX
    7863526ACSF ventriculography0.610.240.240.020.870.87XXX
    78635TCACSF ventriculography0.002.53NA0.122.65NAXXX
    78645ACSF shunt evaluation0.573.61NA0.174.35NAXXX
    7864526ACSF shunt evaluation0.570.200.200.020.790.79XXX
    78645TCACSF shunt evaluation0.003.41NA0.153.56NAXXX
    78647ACerebrospinal fluid scan0.906.21NA0.297.40NAXXX
    7864726ACerebrospinal fluid scan0.900.330.330.031.261.26XXX
    78647TCACerebrospinal fluid scan0.005.88NA0.266.14NAXXX
    78650ACSF leakage imaging0.614.84NA0.225.67NAXXX
    7865026ACSF leakage imaging0.610.220.220.020.850.85XXX
    78650TCACSF leakage imaging0.004.62NA0.204.82NAXXX
    78660ANuclear exam of tear flow0.532.30NA0.122.95NAXXX
    7866026ANuclear exam of tear flow0.530.190.190.020.740.74XXX
    78660TCANuclear exam of tear flow0.002.11NA0.102.21NAXXX
    78699CNervous system nuclear exam0.000.000.000.000.000.00XXX
    7869926CNervous system nuclear exam0.000.000.000.000.000.00XXX
    Start Printed Page 80139
    78699TCCNervous system nuclear exam0.000.000.000.000.000.00XXX
    78700AKidney imaging, static0.453.20NA0.153.80NAXXX
    7870026AKidney imaging, static0.450.160.160.020.630.63XXX
    78700TCAKidney imaging, static0.003.04NA0.133.17NAXXX
    78701AKidney imaging with flow0.493.71NA0.174.37NAXXX
    7870126AKidney imaging with flow0.490.170.170.020.680.68XXX
    78701TCAKidney imaging with flow0.003.54NA0.153.69NAXXX
    78704AImaging renogram0.744.20NA0.205.14NAXXX
    7870426AImaging renogram0.740.260.260.031.031.03XXX
    78704TCAImaging renogram0.003.94NA0.174.11NAXXX
    78707AKidney flow/function image0.964.79NA0.235.98NAXXX
    7870726AKidney flow/function image0.960.340.340.041.341.34XXX
    78707TCAKidney flow/function image0.004.45NA0.194.64NAXXX
    78708AKidney flow/function image1.214.88NA0.246.33NAXXX
    7870826AKidney flow/function image1.210.430.430.051.691.69XXX
    78708TCAKidney flow/function image0.004.45NA0.194.64NAXXX
    78709AKidney flow/function image1.414.94NA0.256.60NAXXX
    7870926AKidney flow/function image1.410.490.490.061.961.96XXX
    78709TCAKidney flow/function image0.004.45NA0.194.64NAXXX
    78710AKidney imaging (3D)0.666.11NA0.297.06NAXXX
    7871026AKidney imaging (3D)0.660.230.230.030.920.92XXX
    78710TCAKidney imaging (3D)0.005.88NA0.266.14NAXXX
    78715ARenal vascular flow exam0.301.68NA0.092.07NAXXX
    7871526ARenal vascular flow exam0.300.110.110.010.420.42XXX
    78715TCARenal vascular flow exam0.001.57NA0.081.65NAXXX
    78725AKidney function study0.381.90NA0.102.38NAXXX
    7872526AKidney function study0.380.130.130.010.520.52XXX
    78725TCAKidney function study0.001.77NA0.091.86NAXXX
    78730AUrinary bladder retention0.361.58NA0.092.03NAXXX
    7873026AUrinary bladder retention0.360.130.130.020.510.51XXX
    78730TCAUrinary bladder retention0.001.45NA0.071.52NAXXX
    78740AUreteral reflux study0.572.30NA0.122.99NAXXX
    7874026AUreteral reflux study0.570.190.190.020.780.78XXX
    78740TCAUreteral reflux study0.002.11NA0.102.21NAXXX
    78760ATesticular imaging0.662.90NA0.153.71NAXXX
    7876026ATesticular imaging0.660.230.230.030.920.92XXX
    78760TCATesticular imaging0.002.67NA0.122.79NAXXX
    78761ATesticular imaging/flow0.713.43NA0.174.31NAXXX
    7876126ATesticular imaging/flow0.710.250.250.030.990.99XXX
    78761TCATesticular imaging/flow0.003.18NA0.143.32NAXXX
    78799CGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    7879926CGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    78799TCCGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    78800ATumor imaging, limited area0.663.62NA0.184.46NAXXX
    7880026ATumor imaging, limited area0.660.230.230.030.920.92XXX
    78800TCATumor imaging, limited area0.003.39NA0.153.54NAXXX
    78801ATumor imaging, mult areas0.794.49NA0.215.49NAXXX
    7880126ATumor imaging, mult areas0.790.280.280.031.101.10XXX
    78801TCATumor imaging, mult areas0.004.21NA0.184.39NAXXX
    78802ATumor imaging, whole body0.865.81NA0.286.95NAXXX
    7880226ATumor imaging, whole body0.860.310.310.031.201.20XXX
    78802TCATumor imaging, whole body0.005.50NA0.255.75NAXXX
    78803ATumor imaging (3D)1.096.93NA0.338.35NAXXX
    7880326ATumor imaging (3D)1.090.400.400.041.531.53XXX
    78803TCATumor imaging (3D)0.006.53NA0.296.82NAXXX
    78805AAbscess imaging, ltd area0.733.65NA0.184.56NAXXX
    7880526AAbscess imaging, ltd area0.730.260.260.031.021.02XXX
    78805TCAAbscess imaging, ltd area0.003.39NA0.153.54NAXXX
    78806AAbscess imaging, whole body0.866.71NA0.327.89NAXXX
    7880626AAbscess imaging, whole body0.860.310.310.031.201.20XXX
    78806TCAAbscess imaging, whole body0.006.40NA0.296.69NAXXX
    78807ANuclear localization/abscess1.096.94NA0.338.36NAXXX
    7880726ANuclear localization/abscess1.090.410.410.041.541.54XXX
    78807TCANuclear localization/abscess0.006.53NA0.296.82NAXXX
    78810NTumor imaging (PET)0.000.000.000.000.000.00XXX
    7881026NTumor imaging (PET)+1.930.750.750.092.772.77XXX
    78810TCNTumor imaging (PET)0.000.000.000.000.000.00XXX
    78890BNuclear medicine data proc+0.051.32NA0.061.43NAXXX
    7889026BNuclear medicine data proc+0.050.020.020.010.080.08XXX
    78890TCBNuclear medicine data proc+0.001.30NA0.051.35NAXXX
    78891BNuclear med data proc+0.102.65NA0.122.87NAXXX
    7889126BNuclear med data proc+0.100.040.040.010.150.15XXX
    78891TCBNuclear med data proc+0.002.61NA0.112.72NAXXX
    78990IProvide diag radionuclide(s)0.000.000.000.000.000.00XXX
    78999CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    Start Printed Page 80140
    7899926CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    78999TCCNuclear diagnostic exam0.000.000.000.000.000.00XXX
    79000AInit hyperthyroid therapy1.803.24NA0.195.23NAXXX
    7900026AInit hyperthyroid therapy1.800.630.630.072.502.50XXX
    79000TCAInit hyperthyroid therapy0.002.61NA0.122.73NAXXX
    79001ARepeat hyperthyroid therapy1.051.67NA0.102.82NAXXX
    7900126ARepeat hyperthyroid therapy1.050.370.370.041.461.46XXX
    79001TCARepeat hyperthyroid therapy0.001.30NA0.061.36NAXXX
    79020AThyroid ablation1.813.23NA0.195.23NAXXX
    7902026AThyroid ablation1.810.620.620.072.502.50XXX
    79020TCAThyroid ablation0.002.61NA0.122.73NAXXX
    79030AThyroid ablation, carcinoma2.103.35NA0.205.65NAXXX
    7903026AThyroid ablation, carcinoma2.100.740.740.082.922.92XXX
    79030TCAThyroid ablation, carcinoma0.002.61NA0.122.73NAXXX
    79035AThyroid metastatic therapy2.523.52NA0.216.25NAXXX
    7903526AThyroid metastatic therapy2.520.910.910.093.523.52XXX
    79035TCAThyroid metastatic therapy0.002.61NA0.122.73NAXXX
    79100AHematopoetic nuclear therapy1.323.09NA0.174.58NAXXX
    7910026AHematopoetic nuclear therapy1.320.480.480.051.851.85XXX
    79100TCAHematopoetic nuclear therapy0.002.61NA0.122.73NAXXX
    79200AIntracavitary nuclear trmt1.993.33NA0.195.51NAXXX
    7920026AIntracavitary nuclear trmt1.990.720.720.072.782.78XXX
    79200TCAIntracavitary nuclear trmt0.002.61NA0.122.73NAXXX
    79300CInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    7930026AInterstitial nuclear therapy1.600.590.590.072.262.26XXX
    79300TCCInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    79400ANonhemato nuclear therapy1.963.31NA0.205.47NAXXX
    7940026ANonhemato nuclear therapy1.960.700.700.082.742.74XXX
    79400TCANonhemato nuclear therapy0.002.61NA0.122.73NAXXX
    79420CIntravascular nuclear ther0.000.000.000.000.000.00XXX
    7942026AIntravascular nuclear ther1.510.520.520.062.092.09XXX
    79420TCCIntravascular nuclear ther0.000.000.000.000.000.00XXX
    79440ANuclear joint therapy1.993.36NA0.205.55NAXXX
    7944026ANuclear joint therapy1.990.750.750.082.822.82XXX
    79440TCANuclear joint therapy0.002.61NA0.122.73NAXXX
    79900CProvide ther radiopharm(s)0.000.000.000.000.000.00XXX
    79999CNuclear medicine therapy0.000.000.000.000.000.00XXX
    7999926CNuclear medicine therapy0.000.000.000.000.000.00XXX
    79999TCCNuclear medicine therapy0.000.000.000.000.000.00XXX
    80500ALab pathology consultation0.370.220.170.010.600.55XXX
    80502ALab pathology consultation1.330.650.600.052.031.98XXX
    8302026AHemoglobin electrophoresis0.370.160.160.010.540.54XXX
    8391226AGenetic examination0.370.150.150.010.530.53XXX
    8416526AAssay of serum proteins0.370.160.160.010.540.54XXX
    8418126AWestern blot test0.370.140.140.010.520.52XXX
    8418226AProtein, western blot test0.370.170.170.010.550.55XXX
    85060ABlood smear interpretation0.450.190.190.020.660.66XXX
    85097ABone marrow interpretation0.941.810.410.032.781.38XXX
    8539026AFibrinolysins screen0.370.130.130.010.510.51XXX
    8557626ABlood platelet aggregation0.370.160.160.010.540.54XXX
    86077APhysician blood bank service0.940.470.420.031.441.39XXX
    86078APhysician blood bank service0.940.510.420.031.481.39XXX
    86079APhysician blood bank service0.940.500.420.031.471.39XXX
    8625526AFluorescent antibody, screen0.370.170.170.010.550.55XXX
    8625626AFluorescent antibody, titer0.370.160.160.010.540.54XXX
    8632026ASerum immunoelectrophoresis0.370.170.160.010.550.54XXX
    8632526AOther immunoelectrophoresis0.370.160.160.010.540.54XXX
    8632726AImmunoelectrophoresis assay0.420.190.190.010.620.62XXX
    8633426AImmunofixation procedure0.370.160.160.010.540.54XXX
    86485CSkin test, candida0.000.000.000.000.000.00XXX
    86490ACoccidioidomycosis skin test0.000.29NA0.020.31NAXXX
    86510AHistoplasmosis skin test0.000.32NA0.020.34NAXXX
    86580ATB intradermal test0.000.25NA0.020.27NAXXX
    86585ATB tine test0.000.20NA0.010.21NAXXX
    86586CSkin test, unlisted0.000.000.000.000.000.00XXX
    8716426ADark field examination0.370.120.120.010.500.50XXX
    8720726ASmear, special stain0.370.170.170.010.550.55XXX
    88104ACytopathology, fluids0.560.79NA0.041.39NAXXX
    8810426ACytopathology, fluids0.560.250.250.020.830.83XXX
    88104TCACytopathology, fluids0.000.54NA0.020.56NAXXX
    88106ACytopathology, fluids0.560.62NA0.041.22NAXXX
    8810626ACytopathology, fluids0.560.250.250.020.830.83XXX
    88106TCACytopathology, fluids0.000.37NA0.020.39NAXXX
    88107ACytopathology, fluids0.761.00NA0.051.81NAXXX
    8810726ACytopathology, fluids0.760.340.340.031.131.13XXX
    Start Printed Page 80141
    88107TCACytopathology, fluids0.000.66NA0.020.68NAXXX
    88108ACytopath, concentrate tech0.560.83NA0.041.43NAXXX
    8810826ACytopath, concentrate tech0.560.250.250.020.830.83XXX
    88108TCACytopath, concentrate tech0.000.58NA0.020.60NAXXX
    88125AForensic cytopathology0.260.30NA0.020.58NAXXX
    8812526AForensic cytopathology0.260.120.120.010.390.39XXX
    88125TCAForensic cytopathology0.000.18NA0.010.19NAXXX
    88141ACytopath, c/v, interpret0.420.990.990.011.421.42XXX
    88160ACytopath smear, other source0.500.98NA0.041.52NAXXX
    8816026ACytopath smear, other source0.500.220.220.020.740.74XXX
    88160TCACytopath smear, other source0.000.76NA0.020.78NAXXX
    88161ACytopath smear, other source0.500.93NA0.041.47NAXXX
    8816126ACytopath smear, other source0.500.220.220.020.740.74XXX
    88161TCACytopath smear, other source0.000.71NA0.020.73NAXXX
    88162ACytopath smear, other source0.760.71NA0.051.52NAXXX
    8816226ACytopath smear, other source0.760.340.340.031.131.13XXX
    88162TCACytopath smear, other source0.000.37NA0.020.39NAXXX
    88172ACytopathology eval of fna0.600.69NA0.041.33NAXXX
    8817226ACytopathology eval of fna0.600.270.270.020.890.89XXX
    88172TCACytopathology eval of fna0.000.42NA0.020.44NAXXX
    88173ACytopath eval, fna, report1.391.83NA0.073.29NAXXX
    8817326ACytopath eval, fna, report1.390.620.620.052.062.06XXX
    88173TCACytopath eval, fna, report0.001.21NA0.021.23NAXXX
    88180ACell marker study0.361.20NA0.031.59NAXXX
    8818026ACell marker study0.360.160.160.010.530.53XXX
    88180TCACell marker study0.001.04NA0.021.06NAXXX
    88182ACell marker study0.771.56NA0.062.39NAXXX
    8818226ACell marker study0.770.350.350.031.151.15XXX
    88182TCACell marker study0.001.21NA0.031.24NAXXX
    88199CCytopathology procedure0.000.000.000.000.000.00XXX
    8819926CCytopathology procedure0.000.000.000.000.000.00XXX
    88199TCCCytopathology procedure0.000.000.000.000.000.00XXX
    88291ACyto/molecular report0.520.300.300.020.840.84XXX
    88299CCytogenetic study0.000.000.000.000.000.00XXX
    88300ASurgical path, gross0.080.30NA0.020.40NAXXX
    8830026ASurgical path, gross0.080.040.040.010.130.13XXX
    88300TCASurgical path, gross0.000.26NA0.010.27NAXXX
    88302ATissue exam by pathologist0.130.73NA0.030.89NAXXX
    8830226ATissue exam by pathologist0.130.060.060.010.200.20XXX
    88302TCATissue exam by pathologist0.000.67NA0.020.69NAXXX
    88304ATissue exam by pathologist0.220.90NA0.031.15NAXXX
    8830426ATissue exam by pathologist0.220.100.100.010.330.33XXX
    88304TCATissue exam by pathologist0.000.80NA0.020.82NAXXX
    88305ATissue exam by pathologist0.751.77NA0.052.57NAXXX
    8830526ATissue exam by pathologist0.750.340.340.021.111.11XXX
    88305TCATissue exam by pathologist0.001.43NA0.031.46NAXXX
    88307ATissue exam by pathologist1.592.72NA0.114.42NAXXX
    8830726ATissue exam by pathologist1.590.710.710.062.362.36XXX
    88307TCATissue exam by pathologist0.002.01NA0.052.06NAXXX
    88309ATissue exam by pathologist2.283.33NA0.135.74NAXXX
    8830926ATissue exam by pathologist2.281.021.020.083.383.38XXX
    88309TCATissue exam by pathologist0.002.31NA0.052.36NAXXX
    88311ADecalcify tissue0.240.20NA0.020.46NAXXX
    8831126ADecalcify tissue0.240.110.110.010.360.36XXX
    88311TCADecalcify tissue0.000.09NA0.010.10NAXXX
    88312ASpecial stains0.541.61NA0.032.18NAXXX
    8831226ASpecial stains0.540.240.240.020.800.80XXX
    88312TCASpecial stains0.001.37NA0.011.38NAXXX
    88313ASpecial stains0.241.19NA0.021.45NAXXX
    8831326ASpecial stains0.240.110.110.010.360.36XXX
    88313TCASpecial stains0.001.08NA0.011.09NAXXX
    88314AHistochemical stain0.450.84NA0.041.33NAXXX
    8831426AHistochemical stain0.450.200.200.020.670.67XXX
    88314TCAHistochemical stain0.000.64NA0.020.66NAXXX
    88318AChemical histochemistry0.420.74NA0.021.18NAXXX
    8831826AChemical histochemistry0.420.190.190.010.620.62XXX
    88318TCAChemical histochemistry0.000.55NA0.010.56NAXXX
    88319AEnzyme histochemistry0.532.18NA0.042.75NAXXX
    8831926AEnzyme histochemistry0.530.240.240.020.790.79XXX
    88319TCAEnzyme histochemistry0.001.94NA0.021.96NAXXX
    88321AMicroslide consultation1.300.830.580.042.171.92XXX
    88323AMicroslide consultation1.351.42NA0.072.84NAXXX
    8832326AMicroslide consultation1.350.610.610.052.012.01XXX
    88323TCAMicroslide consultation0.000.81NA0.020.83NAXXX
    88325AComprehensive review of data2.222.930.990.085.233.29XXX
    Start Printed Page 80142
    88329APath consult introp0.670.660.300.021.350.99XXX
    88331APath consult intraop, 1 bloc1.191.03NA0.072.29NAXXX
    8833126APath consult intraop, 1 bloc1.190.540.540.041.771.77XXX
    88331TCAPath consult intraop, 1 bloc0.000.49NA0.030.52NAXXX
    88332APath consult intraop, addl0.590.52NA0.041.15NAXXX
    8833226APath consult intraop, addl0.590.270.270.020.880.88XXX
    88332TCAPath consult intraop, addl0.000.25NA0.020.27NAXXX
    88342AImmunocytochemistry0.851.31NA0.052.21NAXXX
    8834226AImmunocytochemistry0.850.380.380.031.261.26XXX
    88342TCAImmunocytochemistry0.000.93NA0.020.95NAXXX
    88346AImmunofluorescent study0.861.46NA0.052.37NAXXX
    8834626AImmunofluorescent study0.860.380.380.031.271.27XXX
    88346TCAImmunofluorescent study0.001.08NA0.021.10NAXXX
    88347AImmunofluorescent study0.861.86NA0.052.77NAXXX
    8834726AImmunofluorescent study0.860.360.360.031.251.25XXX
    88347TCAImmunofluorescent study0.001.50NA0.021.52NAXXX
    88348AElectron microscopy1.518.09NA0.119.71NAXXX
    8834826AElectron microscopy1.510.670.670.052.232.23XXX
    88348TCAElectron microscopy0.007.42NA0.067.48NAXXX
    88349AScanning electron microscopy0.769.38NA0.0810.22NAXXX
    8834926AScanning electron microscopy0.760.340.340.031.131.13XXX
    88349TCAScanning electron microscopy0.009.04NA0.059.09NAXXX
    88355AAnalysis, skeletal muscle1.852.55NA0.124.52NAXXX
    8835526AAnalysis, skeletal muscle1.850.830.830.072.752.75XXX
    88355TCAAnalysis, skeletal muscle0.001.72NA0.051.77NAXXX
    88356AAnalysis, nerve3.022.83NA0.166.01NAXXX
    8835626AAnalysis, nerve3.021.301.300.104.424.42XXX
    88356TCAAnalysis, nerve0.001.53NA0.061.59NAXXX
    88358AAnalysis, tumor2.821.72NA0.164.70NAXXX
    8835826AAnalysis, tumor2.821.251.250.104.174.17XXX
    88358TCAAnalysis, tumor0.000.47NA0.060.53NAXXX
    88362ANerve teasing preparations2.174.54NA0.126.83NAXXX
    8836226ANerve teasing preparations2.170.950.950.073.193.19XXX
    88362TCANerve teasing preparations0.003.59NA0.053.64NAXXX
    88365ATissue hybridization0.932.03NA0.053.01NAXXX
    8836526ATissue hybridization0.930.410.410.031.371.37XXX
    88365TCATissue hybridization0.001.62NA0.021.64NAXXX
    8837126AProtein, western blot tissue0.370.130.130.010.510.51XXX
    8837226AProtein analysis w/probe0.370.170.170.010.550.55XXX
    88380CMicrodissection0.000.000.000.000.000.00XXX
    8838026CMicrodissection0.000.000.000.000.000.00XXX
    88380TCCMicrodissection0.000.000.000.000.000.00XXX
    88399CSurgical pathology procedure0.000.000.000.000.000.00XXX
    8839926CSurgical pathology procedure0.000.000.000.000.000.00XXX
    88399TCCSurgical pathology procedure0.000.000.000.000.000.00XXX
    8906026AExam,synovial fluid crystals0.370.170.170.010.550.55XXX
    89100ASample intestinal contents0.601.720.220.022.340.84XXX
    89105ASample intestinal contents0.502.280.180.022.800.70XXX
    89130ASample stomach contents0.451.970.130.022.440.60XXX
    89132ASample stomach contents0.191.760.070.011.960.27XXX
    89135ASample stomach contents0.791.750.260.032.571.08XXX
    89136ASample stomach contents0.211.770.080.011.990.30XXX
    89140ASample stomach contents0.942.220.280.033.191.25XXX
    89141ASample stomach contents0.852.800.350.033.681.23XXX
    89350ASputum specimen collection0.000.41NA0.020.43NAXXX
    89360ACollect sweat for test0.000.45NA0.020.47NAXXX
    89399CPathology lab procedure0.000.000.000.000.000.00XXX
    8939926CPathology lab procedure0.000.000.000.000.000.00XXX
    89399TCCPathology lab procedure0.000.000.000.000.000.00XXX
    90281IHuman ig, im0.000.000.000.000.000.00XXX
    90283IHuman ig, iv0.000.000.000.000.000.00XXX
    90287IBotulinum antitoxin0.000.000.000.000.000.00XXX
    90288IBotulism ig, iv0.000.000.000.000.000.00XXX
    90291ICmv ig, iv0.000.000.000.000.000.00XXX
    90296EDiphtheria antitoxin0.000.000.000.000.000.00XXX
    90371EHep b ig, im0.000.000.000.000.000.00XXX
    90375ERabies ig, im/sc0.000.000.000.000.000.00XXX
    90376ERabies ig, heat treated0.000.000.000.000.000.00XXX
    90378XRsv ig, im, 50mg0.000.000.000.000.000.00XXX
    90379IRsv ig, iv0.000.000.000.000.000.00XXX
    90384IRh ig, full-dose, im0.000.000.000.000.000.00XXX
    90385ERh ig, minidose, im0.000.000.000.000.000.00XXX
    90386IRh ig, iv0.000.000.000.000.000.00XXX
    90389ITetanus ig, im0.000.000.000.000.000.00XXX
    90393EVaccina ig, im0.000.000.000.000.000.00XXX
    Start Printed Page 80143
    90396EVaricella-zoster ig, im0.000.000.000.000.000.00XXX
    90399IImmune globulin0.000.000.000.000.000.00XXX
    90471AImmunization admin0.000.20NA0.010.21NAXXX
    90472AImmunization admin, each add0.000.14NA0.010.15NAZZZ
    90473NImmune admin oral/nasal0.000.000.000.000.000.00XXX
    90474NImmune admin oral/nasal addl0.000.000.000.000.000.00ZZZ
    90476EAdenovirus vaccine, type 40.000.000.000.000.000.00XXX
    90477EAdenovirus vaccine, type 70.000.000.000.000.000.00XXX
    90581EAnthrax vaccine, sc0.000.000.000.000.000.00XXX
    90585EBcg vaccine, percut0.000.000.000.000.000.00XXX
    90586EBcg vaccine, intravesical0.000.000.000.000.000.00XXX
    90632EHep a vaccine, adult im0.000.000.000.000.000.00XXX
    90633EHep a vacc, ped/adol, 2 dose0.000.000.000.000.000.00XXX
    90634EHep a vacc, ped/adol, 3 dose0.000.000.000.000.000.00XXX
    90636EHep a/hep b vacc, adult im0.000.000.000.000.000.00XXX
    90645EHib vaccine, hboc, im0.000.000.000.000.000.00XXX
    90646EHib vaccine, prp-d, im0.000.000.000.000.000.00XXX
    90647EHib vaccine, prp-omp, im0.000.000.000.000.000.00XXX
    90648EHib vaccine, prp-t, im0.000.000.000.000.000.00XXX
    90657XFlu vaccine, 6-35 mo, im0.000.000.000.000.000.00XXX
    90658XFlu vaccine, 3 yrs, im0.000.000.000.000.000.00XXX
    90659XFlu vaccine, whole, im0.000.000.000.000.000.00XXX
    90660XFlu vaccine, nasal0.000.000.000.000.000.00XXX
    90665ELyme disease vaccine, im0.000.000.000.000.000.00XXX
    90669NPneumococcal vacc, ped <50.000.000.000.000.000.00XXX
    90675ERabies vaccine, im0.000.000.000.000.000.00XXX
    90676ERabies vaccine, id0.000.000.000.000.000.00XXX
    90680ERotovirus vaccine, oral0.000.000.000.000.000.00XXX
    90690ETyphoid vaccine, oral0.000.000.000.000.000.00XXX
    90691ETyphoid vaccine, im0.000.000.000.000.000.00XXX
    90692ETyphoid vaccine, h-p, sc/id0.000.000.000.000.000.00XXX
    90693ETyphoid vaccine, akd, sc0.000.000.000.000.000.00XXX
    90700EDtap vaccine, im0.000.000.000.000.000.00XXX
    90701EDtp vaccine, im0.000.000.000.000.000.00XXX
    90702EDt vaccine < 7, im0.000.000.000.000.000.00XXX
    90703ETetanus vaccine, im0.000.000.000.000.000.00XXX
    90704EMumps vaccine, sc0.000.000.000.000.000.00XXX
    90705EMeasles vaccine, sc0.000.000.000.000.000.00XXX
    90706ERubella vaccine, sc0.000.000.000.000.000.00XXX
    90707EMmr vaccine, sc0.000.000.000.000.000.00XXX
    90708EMeasles-rubella vaccine, sc0.000.000.000.000.000.00XXX
    90709DRubella & mumps vaccine, sc0.000.000.000.000.000.00XXX
    90710EMmrv vaccine, sc0.000.000.000.000.000.00XXX
    90712EOral poliovirus vaccine0.000.000.000.000.000.00XXX
    90713EPoliovirus, ipv, sc0.000.000.000.000.000.00XXX
    90716EChicken pox vaccine, sc0.000.000.000.000.000.00XXX
    90717EYellow fever vaccine, sc0.000.000.000.000.000.00XXX
    90718ETd vaccine > 7, im0.000.000.000.000.000.00XXX
    90719EDiphtheria vaccine, im0.000.000.000.000.000.00XXX
    90720EDtp/hib vaccine, im0.000.000.000.000.000.00XXX
    90721EDtap/hib vaccine, im0.000.000.000.000.000.00XXX
    90723XDtap-hep b-ipv vaccine, im0.000.000.000.000.000.00XXX
    90725ECholera vaccine, injectable0.000.000.000.000.000.00XXX
    90727EPlague vaccine, im0.000.000.000.000.000.00XXX
    90732XPneumococcal vaccine0.000.000.000.000.000.00XXX
    90733EMeningococcal vaccine, sc0.000.000.000.000.000.00XXX
    90735EEncephalitis vaccine, sc0.000.000.000.000.000.00XXX
    90740IHepb vacc, ill pat 3 dose im0.000.000.000.000.000.00XXX
    90743IHep b vacc, adol, 2 dose, im0.000.000.000.000.000.00XXX
    90744IHepb vacc ped/adol 3 dose im0.000.000.000.000.000.00XXX
    90746IHep b vaccine, adult, im0.000.000.000.000.000.00XXX
    90747IHepb vacc, ill pat 4 dose im0.000.000.000.000.000.00XXX
    90748EHep b/hib vaccine, im0.000.000.000.000.000.00XXX
    90749EVaccine toxoid0.000.000.000.000.000.00XXX
    90780AIV infusion therapy, 1 hour0.001.10NA0.061.16NAXXX
    90781AIV infusion, additional hour0.000.56NA0.030.59NAZZZ
    90782TInjection, sc/im0.000.11NA0.010.12NAXXX
    90783TInjection, ia0.000.41NA0.020.43NAXXX
    90784TInjection, iv0.000.47NA0.030.50NAXXX
    90788TInjection of antibiotic0.000.12NA0.010.13NAXXX
    90799CTher/prophylactic/dx inject0.000.000.000.000.000.00XXX
    90801APsy dx interview2.801.190.960.064.053.82XXX
    90802AIntac psy dx interview3.011.231.010.074.314.09XXX
    90804APsytx, office, 20-30 min1.210.510.390.031.751.63XXX
    90805APsytx, off, 20-30 min w/e&m1.370.520.440.031.921.84XXX
    Start Printed Page 80144
    90806APsytx, off, 45-50 min1.860.720.620.042.622.52XXX
    90807APsytx, off, 45-50 min w/e&m2.020.720.650.052.792.72XXX
    90808APsytx, office, 75-80 min2.791.050.930.073.913.79XXX
    90809APsytx, off, 75-80, w/e&m2.951.020.950.074.043.97XXX
    90810AIntac psytx, off, 20-30 min1.320.530.430.031.881.78XXX
    90811AIntac psytx, 20-30, w/e&m1.480.590.480.032.101.99XXX
    90812AIntac psytx, off, 45-50 min1.970.820.660.052.842.68XXX
    90813AIntac psytx, 45-50 min w/e&m2.130.790.690.052.972.87XXX
    90814AIntac psytx, off, 75-80 min2.901.131.010.074.103.98XXX
    90815AIntac psytx, 75-80 w/e&m3.061.080.980.074.214.11XXX
    90816APsytx, hosp, 20-30 min1.25NA0.480.03NA1.76XXX
    90817APsytx, hosp, 20-30 min w/e&m1.41NA0.470.03NA1.91XXX
    90818APsytx, hosp, 45-50 min1.89NA0.710.04NA2.64XXX
    90819APsytx, hosp, 45-50 min w/e&m2.05NA0.670.05NA2.77XXX
    90821APsytx, hosp, 75-80 min2.83NA1.030.06NA3.92XXX
    90822APsytx, hosp, 75-80 min w/e&m2.99NA0.970.07NA4.03XXX
    90823AIntac psytx, hosp, 20-30 min1.36NA0.490.03NA1.88XXX
    90824AIntac psytx, hsp 20-30 w/e&m1.52NA0.510.03NA2.06XXX
    90826AIntac psytx, hosp, 45-50 min2.01NA0.750.04NA2.80XXX
    90827AIntac psytx, hsp 45-50 w/e&m2.16NA0.710.05NA2.92XXX
    90828AIntac psytx, hosp, 75-80 min2.94NA1.090.07NA4.10XXX
    90829AIntac psytx, hsp 75-80 w/e&m3.10NA1.010.07NA4.18XXX
    90845APsychoanalysis1.790.600.570.042.432.40XXX
    90846RFamily psytx w/o patient1.830.670.660.042.542.53XXX
    90847RFamily psytx w/patient2.210.840.780.053.103.04XXX
    90849RMultiple family group psytx0.590.280.250.010.880.85XXX
    90853AGroup psychotherapy0.590.260.240.010.860.84XXX
    90857AIntac group psytx0.630.310.260.020.960.91XXX
    90862AMedication management0.950.410.330.021.381.30XXX
    90865ANarcosynthesis2.841.620.910.074.533.82XXX
    90870AElectroconvulsive therapy1.880.810.810.042.732.73000
    90871AElectroconvulsive therapy2.72NA1.080.06NA3.86000
    90875NPsychophysiological therapy+1.200.910.470.032.141.70XXX
    90876NPsychophysiological therapy+1.901.180.740.043.122.68XXX
    90880AHypnotherapy2.191.060.710.053.302.95XXX
    90882NEnvironmental manipulation0.000.000.000.000.000.00XXX
    90885BPsy evaluation of records+0.970.380.380.021.371.37XXX
    90887BConsultation with family+1.480.830.580.032.342.09XXX
    90889BPreparation of report0.000.000.000.000.000.00XXX
    90899CPsychiatric service/therapy0.000.000.000.000.000.00XXX
    90901ABiofeedback train, any meth0.410.860.190.021.290.62000
    90911ABiofeedback peri/uro/rectal0.890.880.360.041.811.29000
    90918AESRD related services, month11.187.567.560.3019.0419.04XXX
    90919AESRD related services, month8.544.184.180.2412.9612.96XXX
    90920AESRD related services, month7.273.923.920.1911.3811.38XXX
    90921AESRD related services, month4.472.542.540.127.137.13XXX
    90922AESRD related services, day0.370.220.220.010.600.60XXX
    90923AEsrd related services, day0.280.130.130.010.420.42XXX
    90924AEsrd related services, day0.240.120.120.010.370.37XXX
    90925AEsrd related services, day0.150.080.080.010.240.24XXX
    90935AHemodialysis, one evaluation1.22NA0.690.03NA1.94000
    90937AHemodialysis, repeated eval2.11NA1.000.06NA3.17000
    90939XHemodialysis study, transcut0.000.000.000.000.000.00XXX
    90940XHemodialysis access study0.000.000.000.000.000.00XXX
    90945ADialysis, one evaluation1.28NA0.720.04NA2.04000
    90947ADialysis, repeated eval2.16NA1.020.06NA3.24000
    90989XDialysis training, complete0.000.000.000.000.000.00XXX
    90993XDialysis training, incompl0.000.000.000.000.000.00XXX
    90997AHemoperfusion1.84NA1.430.05NA3.32000
    90999CDialysis procedure0.000.000.000.000.000.00XXX
    91000AEsophageal intubation0.730.33NA0.041.10NA000
    9100026AEsophageal intubation0.730.250.250.031.011.01000
    91000TCAEsophageal intubation0.000.08NA0.010.09NA000
    91010AEsophagus motility study1.252.75NA0.104.10NA000
    9101026AEsophagus motility study1.250.450.450.051.751.75000
    91010TCAEsophagus motility study0.002.30NA0.052.35NA000
    91011AEsophagus motility study1.503.18NA0.104.78NA000
    9101126AEsophagus motility study1.500.540.540.052.092.09000
    91011TCAEsophagus motility study0.002.64NA0.052.69NA000
    91012AEsophagus motility study1.463.31NA0.124.89NA000
    9101226AEsophagus motility study1.460.530.530.062.052.05000
    91012TCAEsophagus motility study0.002.78NA0.062.84NA000
    91020AGastric motility1.443.05NA0.114.60NA000
    9102026AGastric motility1.440.500.500.062.002.00000
    91020TCAGastric motility0.002.55NA0.052.60NA000
    Start Printed Page 80145
    91030AAcid perfusion of esophagus0.912.57NA0.053.53NA000
    9103026AAcid perfusion of esophagus0.910.330.330.031.271.27000
    91030TCAAcid perfusion of esophagus0.002.24NA0.022.26NA000
    91032AEsophagus, acid reflux test1.212.43NA0.103.74NA000
    9103226AEsophagus, acid reflux test1.210.430.430.051.691.69000
    91032TCAEsophagus, acid reflux test0.002.00NA0.052.05NA000
    91033AProlonged acid reflux test1.302.64NA0.144.08NA000
    9103326AProlonged acid reflux test1.300.470.470.051.821.82000
    91033TCAProlonged acid reflux test0.002.17NA0.092.26NA000
    91052AGastric analysis test0.792.38NA0.053.22NA000
    9105226AGastric analysis test0.790.280.280.031.101.10000
    91052TCAGastric analysis test0.002.10NA0.022.12NA000
    91055AGastric intubation for smear0.942.17NA0.063.17NA000
    9105526AGastric intubation for smear0.940.270.270.041.251.25000
    91055TCAGastric intubation for smear0.001.90NA0.021.92NA000
    91060AGastric saline load test0.450.30NA0.040.79NA000
    9106026AGastric saline load test0.450.140.140.020.610.61000
    91060TCAGastric saline load test0.000.16NA0.020.18NA000
    91065ABreath hydrogen test0.203.88NA0.034.11NA000
    9106526ABreath hydrogen test0.200.070.070.010.280.28000
    91065TCABreath hydrogen test0.003.81NA0.023.83NA000
    91100APass intestine bleeding tube1.08NA0.290.06NA1.43000
    91105AGastric intubation treatment0.37NA0.100.02NA0.49000
    91122AAnal pressure record1.773.85NA0.175.79NA000
    9112226AAnal pressure record1.770.620.620.102.492.49000
    91122TCAAnal pressure record0.003.23NA0.073.30NA000
    91123BIrrigate fecal impaction0.000.000.000.000.000.00XXX
    91132CElectrogastrography0.000.000.000.000.000.00XXX
    9113226AElectrogastrography0.520.19NA0.030.74NAXXX
    91132TCCElectrogastrography0.000.000.000.000.000.00XXX
    91133CElectrogastrography w/test0.000.000.000.000.000.00XXX
    9113326AElectrogastrography w/test0.660.24NA0.030.93NAXXX
    91133TCCElectrogastrography w/test0.000.000.000.000.000.00XXX
    91299CGastroenterology procedure0.000.000.000.000.000.00XXX
    9129926CGastroenterology procedure0.000.000.000.000.000.00XXX
    91299TCCGastroenterology procedure0.000.000.000.000.000.00XXX
    92002AEye exam, new patient0.880.940.350.021.841.25XXX
    92004AEye exam, new patient1.671.660.700.033.362.40XXX
    92012AEye exam established pat0.670.990.300.011.670.98XXX
    92014AEye exam & treatment1.101.350.480.022.471.60XXX
    92015NRefraction+0.381.510.150.011.900.54XXX
    92018ANew eye exam & treatment2.50NA1.100.03NA3.63XXX
    92019AEye exam & treatment1.31NA0.580.03NA1.92XXX
    92020ASpecial eye evaluation0.370.920.160.011.300.54XXX
    92060ASpecial eye evaluation0.690.74NA0.021.45NAXXX
    9206026ASpecial eye evaluation0.690.300.300.011.001.00XXX
    92060TCASpecial eye evaluation0.000.44NA0.010.45NAXXX
    92065AOrthoptic/pleoptic training0.370.56NA0.020.95NAXXX
    9206526AOrthoptic/pleoptic training0.370.160.160.010.540.54XXX
    92065TCAOrthoptic/pleoptic training0.000.40NA0.010.41NAXXX
    92070AFitting of contact lens0.701.040.330.011.751.04XXX
    92081AVisual field examination(s)0.362.04NA0.022.42NAXXX
    9208126AVisual field examination(s)0.360.160.160.010.530.53XXX
    92081TCAVisual field examination(s)0.001.88NA0.011.89NAXXX
    92082AVisual field examination(s)0.441.06NA0.021.52NAXXX
    9208226AVisual field examination(s)0.440.190.190.010.640.64XXX
    92082TCAVisual field examination(s)0.000.87NA0.010.88NAXXX
    92083AVisual field examination(s)0.501.59NA0.022.11NAXXX
    9208326AVisual field examination(s)0.500.230.230.010.740.74XXX
    92083TCAVisual field examination(s)0.001.36NA0.011.37NAXXX
    92100ASerial tonometry exam(s)0.920.730.380.021.671.32XXX
    92120ATonography & eye evaluation0.810.800.330.021.631.16XXX
    92130AWater provocation tonography0.810.910.380.021.741.21XXX
    92135AOpthalmic dx imaging0.351.54NA0.021.91NAXXX
    9213526AOpthalmic dx imaging0.350.160.160.010.520.52XXX
    92135TCAOpthalmic dx imaging0.001.38NA0.011.39NAXXX
    92136AOphthalmic biometry0.541.88NA0.072.49NAXXX
    9213626AOphthalmic biometry0.540.250.250.010.800.80XXX
    92136TCAOphthalmic biometry0.001.63NA0.061.69NAXXX
    92140AGlaucoma provocative tests0.500.990.220.011.500.73XXX
    92225ASpecial eye exam, initial0.380.220.160.010.610.55XXX
    92226ASpecial eye exam, subsequent0.330.210.150.010.550.49XXX
    92230AEye exam with photos0.601.690.200.022.310.82XXX
    92235AEye exam with photos0.812.61NA0.073.49NAXXX
    9223526AEye exam with photos0.810.380.380.021.211.21XXX
    Start Printed Page 80146
    92235TCAEye exam with photos0.002.23NA0.052.28NAXXX
    92240AIcg angiography1.105.09NA0.076.26NAXXX
    9224026AIcg angiography1.100.510.510.021.631.63XXX
    92240TCAIcg angiography0.004.58NA0.054.63NAXXX
    92250AEye exam with photos0.441.49NA0.021.95NAXXX
    9225026AEye exam with photos0.440.200.200.010.650.65XXX
    92250TCAEye exam with photos0.001.29NA0.011.30NAXXX
    92260AOphthalmoscopy/dynamometry0.200.240.090.010.450.30XXX
    92265AEye muscle evaluation0.811.89NA0.042.74NAXXX
    9226526AEye muscle evaluation0.810.290.290.021.121.12XXX
    92265TCAEye muscle evaluation0.001.60NA0.021.62NAXXX
    92270AElectro-oculography0.811.76NA0.052.62NAXXX
    9227026AElectro-oculography0.810.350.350.031.191.19XXX
    92270TCAElectro-oculography0.001.41NA0.021.43NAXXX
    92275AElectroretinography1.011.98NA0.043.03NAXXX
    9227526AElectroretinography1.010.440.440.021.471.47XXX
    92275TCAElectroretinography0.001.54NA0.021.56NAXXX
    92283AColor vision examination0.170.86NA0.021.05NAXXX
    9228326AColor vision examination0.170.070.070.010.250.25XXX
    92283TCAColor vision examination0.000.79NA0.010.80NAXXX
    92284ADark adaptation eye exam0.242.28NA0.022.54NAXXX
    9228426ADark adaptation eye exam0.240.090.090.010.340.34XXX
    92284TCADark adaptation eye exam0.002.19NA0.012.20NAXXX
    92285AEye photography0.200.85NA0.021.07NAXXX
    9228526AEye photography0.200.090.090.010.300.30XXX
    92285TCAEye photography0.000.76NA0.010.77NAXXX
    92286AInternal eye photography0.662.86NA0.033.55NAXXX
    9228626AInternal eye photography0.660.300.300.010.970.97XXX
    92286TCAInternal eye photography0.002.56NA0.022.58NAXXX
    92287AInternal eye photography0.812.700.320.023.531.15XXX
    92310NContact lens fitting+1.171.130.460.032.331.66XXX
    92311AContact lens fitting1.081.140.360.032.251.47XXX
    92312AContact lens fitting1.261.130.510.032.421.80XXX
    92313AContact lens fitting0.921.110.290.022.051.23XXX
    92314NPrescription of contact lens+0.690.950.270.011.650.97XXX
    92315APrescription of contact lens0.450.900.170.011.360.63XXX
    92316APrescription of contact lens0.680.960.300.011.650.99XXX
    92317APrescription of contact lens0.450.990.140.011.450.60XXX
    92325AModification of contact lens0.000.40NA0.010.41NAXXX
    92326AReplacement of contact lens0.001.62NA0.051.67NAXXX
    92330AFitting of artificial eye1.081.030.330.042.151.45XXX
    92335AFitting of artificial eye0.450.960.170.011.420.63XXX
    92340NFitting of spectacles+0.370.710.140.011.090.52XXX
    92341NFitting of spectacles+0.470.750.180.011.230.66XXX
    92342NFitting of spectacles+0.530.770.210.011.310.75XXX
    92352BSpecial spectacles fitting+0.370.710.140.011.090.52XXX
    92353BSpecial spectacles fitting+0.500.760.200.021.280.72XXX
    92354BSpecial spectacles fitting+0.008.82NA0.088.90NAXXX
    92355BSpecial spectacles fitting+0.004.31NA0.014.32NAXXX
    92358BEye prosthesis service+0.000.97NA0.041.01NAXXX
    92370NRepair & adjust spectacles+0.320.560.130.020.900.47XXX
    92371BRepair & adjust spectacles+0.000.62NA0.020.64NAXXX
    92390NSupply of spectacles0.000.000.000.000.000.00XXX
    92391NSupply of contact lenses0.000.000.000.000.000.00XXX
    92392ISupply of low vision aids+0.003.843.840.023.863.86XXX
    92393ISupply of artificial eye+0.0011.9211.920.4712.3912.39XXX
    92395ISupply of spectacles+0.001.301.300.081.381.38XXX
    92396ISupply of contact lenses+0.002.192.190.062.252.25XXX
    92499CEye service or procedure0.000.000.000.000.000.00XXX
    9249926CEye service or procedure0.000.000.000.000.000.00XXX
    92499TCCEye service or procedure0.000.000.000.000.000.00XXX
    92502AEar and throat examination1.51NA1.240.06NA2.81000
    92504AEar microscopy examination0.180.510.090.010.700.28XXX
    92506ASpeech/hearing evaluation0.861.630.410.042.531.31XXX
    92507ASpeech/hearing therapy0.521.560.240.022.100.78XXX
    92508ASpeech/hearing therapy0.261.450.120.011.720.39XXX
    92510IRehab for ear implant+1.502.110.830.063.672.39XXX
    92511ANasopharyngoscopy0.841.380.420.032.251.29000
    92512ANasal function studies0.551.100.180.021.670.75XXX
    92516AFacial nerve function test0.430.970.220.021.420.67XXX
    92520ALaryngeal function studies0.760.550.400.031.341.19XXX
    92525FOral function evaluation+0.000.000.000.000.000.00XXX
    92526AOral function therapy0.551.620.210.022.190.78XXX
    92531BSpontaneous nystagmus study0.000.000.000.000.000.00XXX
    92532BPositional nystagmus test0.000.000.000.000.000.00XXX
    Start Printed Page 80147
    92533BCaloric vestibular test0.000.000.000.000.000.00XXX
    92534BOptokinetic nystagmus test0.000.000.000.000.000.00XXX
    92541ASpontaneous nystagmus test0.401.11NA0.041.55NAXXX
    9254126ASpontaneous nystagmus test0.400.200.200.020.620.62XXX
    92541TCASpontaneous nystagmus test0.000.91NA0.020.93NAXXX
    92542APositional nystagmus test0.331.20NA0.031.56NAXXX
    9254226APositional nystagmus test0.330.160.160.010.500.50XXX
    92542TCAPositional nystagmus test0.001.04NA0.021.06NAXXX
    92543ACaloric vestibular test0.100.63NA0.020.75NAXXX
    9254326ACaloric vestibular test0.100.050.050.010.160.16XXX
    92543TCACaloric vestibular test0.000.58NA0.010.59NAXXX
    92544AOptokinetic nystagmus test0.260.97NA0.031.26NAXXX
    9254426AOptokinetic nystagmus test0.260.130.130.010.400.40XXX
    92544TCAOptokinetic nystagmus test0.000.84NA0.020.86NAXXX
    92545AOscillating tracking test0.230.90NA0.031.16NAXXX
    9254526AOscillating tracking test0.230.110.110.010.350.35XXX
    92545TCAOscillating tracking test0.000.79NA0.020.81NAXXX
    92546ASinusoidal rotational test0.292.25NA0.032.57NAXXX
    9254626ASinusoidal rotational test0.290.140.140.010.440.44XXX
    92546TCASinusoidal rotational test0.002.11NA0.022.13NAXXX
    92547ASupplemental electrical test0.001.34NA0.051.39NAZZZ
    92548APosturography0.503.98NA0.134.61NAXXX
    9254826APosturography0.500.270.270.020.790.79XXX
    92548TCAPosturography0.003.71NA0.113.82NAXXX
    92551NPure tone hearing test, air0.000.000.000.000.000.00XXX
    92552APure tone audiometry, air0.000.45NA0.030.48NAXXX
    92553AAudiometry, air & bone0.000.66NA0.050.71NAXXX
    92555ASpeech threshold audiometry0.000.38NA0.030.41NAXXX
    92556ASpeech audiometry, complete0.000.57NA0.050.62NAXXX
    92557AComprehensive hearing test0.001.18NA0.101.28NAXXX
    92559NGroup audiometric testing0.000.000.000.000.000.00XXX
    92560NBekesy audiometry, screen0.000.000.000.000.000.00XXX
    92561ABekesy audiometry, diagnosis0.000.72NA0.050.77NAXXX
    92562ALoudness balance test0.000.41NA0.030.44NAXXX
    92563ATone decay hearing test0.000.38NA0.030.41NAXXX
    92564ASisi hearing test0.000.47NA0.040.51NAXXX
    92565AStenger test, pure tone0.000.40NA0.030.43NAXXX
    92567ATympanometry0.000.52NA0.050.57NAXXX
    92568AAcoustic reflex testing0.000.38NA0.030.41NAXXX
    92569AAcoustic reflex decay test0.000.41NA0.030.44NAXXX
    92571AFiltered speech hearing test0.000.39NA0.030.42NAXXX
    92572AStaggered spondaic word test0.000.09NA0.010.10NAXXX
    92573ALombard test0.000.35NA0.030.38NAXXX
    92575ASensorineural acuity test0.000.30NA0.020.32NAXXX
    92576ASynthetic sentence test0.000.45NA0.040.49NAXXX
    92577AStenger test, speech0.000.72NA0.060.78NAXXX
    92579AVisual audiometry (vra)0.000.73NA0.050.78NAXXX
    92582AConditioning play audiometry0.000.73NA0.050.78NAXXX
    92583ASelect picture audiometry0.000.89NA0.070.96NAXXX
    92584AElectrocochleography0.002.47NA0.172.64NAXXX
    92585AAuditor evoke potent, compre0.502.06NA0.142.70NAXXX
    9258526AAuditor evoke potent, compre0.500.220.220.020.740.74XXX
    92585TCAAuditor evoke potent, compre0.001.84NA0.121.96NAXXX
    92586AAuditor evoke potent, limit0.001.84NA0.121.96NAXXX
    92587AEvoked auditory test0.131.37NA0.101.60NAXXX
    9258726AEvoked auditory test0.130.070.070.010.210.21XXX
    92587TCAEvoked auditory test0.001.30NA0.091.39NAXXX
    92588AEvoked auditory test0.361.63NA0.122.11NAXXX
    9258826AEvoked auditory test0.360.170.170.010.540.54XXX
    92588TCAEvoked auditory test0.001.46NA0.111.57NAXXX
    92589AAuditory function test(s)0.000.53NA0.050.58NAXXX
    92590NHearing aid exam, one ear0.000.000.000.000.000.00XXX
    92591NHearing aid exam, both ears0.000.000.000.000.000.00XXX
    92592NHearing aid check, one ear0.000.000.000.000.000.00XXX
    92593NHearing aid check, both ears0.000.000.000.000.000.00XXX
    92594NElectro hearng aid test, one0.000.000.000.000.000.00XXX
    92595NElectro hearng aid tst, both0.000.000.000.000.000.00XXX
    92596AEar protector evaluation0.000.59NA0.050.64NAXXX
    92597IOral speech device eval+1.351.490.540.052.891.94XXX
    92598FModify oral speech device+0.000.000.000.000.000.00XXX
    92599DENT procedure/service0.000.000.000.000.000.00XXX
    9259926DENT procedure/service0.000.000.000.000.000.00XXX
    92599TCDENT procedure/service0.000.000.000.000.000.00XXX
    92601ACochlear implt f/up exam < 70.003.50NA0.063.56NAXXX
    92602AReprogram cochlear implt < 70.002.44NA0.062.50NAXXX
    Start Printed Page 80148
    92603ACochlear implt f/up exam 7 >0.002.34NA0.062.40NAXXX
    92604AReprogram cochlear implt 7 >0.001.58NA0.061.64NAXXX
    92605BEval for nonspeech device rx0.000.000.000.000.000.00XXX
    92606BNon-speech device service0.000.000.000.000.000.00XXX
    92607AEx for speech device rx, 1hr0.002.93NA0.042.97NAXXX
    92608AEx for speech device rx addl0.000.55NA0.040.59NAXXX
    92609AUse of speech device service0.001.58NA0.031.61NAXXX
    92610AEvaluate swallowing function0.001.08NA0.071.15NAXXX
    92611AMotion fluoroscopy/swallow0.001.18NA0.071.25NAXXX
    92612AEndoscopy swallow tst (fees)1.273.360.500.074.701.84XXX
    92613BEndoscopy swallow tst (fees)0.000.000.000.000.000.00XXX
    92614ALaryngoscopic sensory test1.272.290.500.073.631.84XXX
    92615BEval laryngoscopy sense tst0.000.000.000.000.000.00XXX
    92616AFees w/laryngeal sense test1.883.020.730.074.972.68XXX
    92617BInterprt fees/laryngeal test0.000.000.000.000.000.00XXX
    92700CEnt procedure/service0.000.000.000.000.000.00XXX
    92950AHeart/lung resuscitation cpr3.80NA1.010.21NA5.02000
    92953ATemporary external pacing0.23NA0.230.01NA0.47000
    92960ACardioversion electric, ext2.252.280.860.084.613.19000
    92961ACardioversion, electric, int4.60NA1.770.17NA6.54000
    92970ACardioassist, internal3.52NA1.080.17NA4.77000
    92971ACardioassist, external1.77NA0.880.06NA2.71000
    92973APercut coronary thrombectomy3.28NA1.320.12NA4.72ZZZ
    92974ACath place, cardio brachytx3.00NA1.200.14NA4.34ZZZ
    92975ADissolve clot, heart vessel7.25NA2.880.22NA10.35000
    92977ADissolve clot, heart vessel0.008.02NA0.388.40NAXXX
    92978AIntravasc us, heart add-on1.805.28NA0.267.34NAZZZ
    9297826AIntravasc us, heart add-on1.800.730.730.062.592.59ZZZ
    92978TCAIntravasc us, heart add-on0.004.55NA0.204.75NAZZZ
    92979AIntravasc us, heart add-on1.442.86NA0.154.45NAZZZ
    9297926AIntravasc us, heart add-on1.440.580.580.042.062.06ZZZ
    92979TCAIntravasc us, heart add-on0.002.28NA0.112.39NAZZZ
    92980AInsert intracoronary stent14.84NA6.210.71NA21.76000
    92981AInsert intracoronary stent4.17NA1.680.20NA6.05ZZZ
    92982ACoronary artery dilation10.98NA4.660.52NA16.16000
    92984ACoronary artery dilation2.97NA1.190.14NA4.30ZZZ
    92986ARevision of aortic valve21.80NA10.271.14NA33.21090
    92987ARevision of mitral valve22.70NA10.661.18NA34.54090
    92990ARevision of pulmonary valve17.34NA8.240.90NA26.48090
    92992CRevision of heart chamber0.000.000.000.000.000.00090
    92993CRevision of heart chamber0.000.000.000.000.000.00090
    92995ACoronary atherectomy12.09NA5.100.58NA17.77000
    92996ACoronary atherectomy add-on3.26NA1.300.16NA4.72ZZZ
    92997APul art balloon repr, percut12.00NA4.960.63NA17.59000
    92998APul art balloon repr, percut6.00NA2.260.31NA8.57ZZZ
    93000AElectrocardiogram, complete0.170.51NA0.030.71NAXXX
    93005AElectrocardiogram, tracing0.000.45NA0.020.47NAXXX
    93010AElectrocardiogram report0.170.060.060.010.240.24XXX
    93012ATransmission of ecg0.002.35NA0.152.50NAXXX
    93014AReport on transmitted ecg0.520.190.190.020.730.73XXX
    93015ACardiovascular stress test0.751.97NA0.112.83NAXXX
    93016ACardiovascular stress test0.450.180.180.010.640.64XXX
    93017ACardiovascular stress test0.001.67NA0.091.76NAXXX
    93018ACardiovascular stress test0.300.120.120.010.430.43XXX
    93024ACardiac drug stress test1.171.57NA0.112.85NAXXX
    9302426ACardiac drug stress test1.170.460.460.041.671.67XXX
    93024TCACardiac drug stress test0.001.11NA0.071.18NAXXX
    93025AMicrovolt t-wave assess0.7510.73NA0.1111.59NAXXX
    9302526AMicrovolt t-wave assess0.750.310.310.021.081.08XXX
    93025TCAMicrovolt t-wave assess0.0010.42NA0.0910.51NAXXX
    93040ARhythm ECG with report0.160.20NA0.020.38NAXXX
    93041ARhythm ECG, tracing0.000.15NA0.010.16NAXXX
    93042ARhythm ECG, report0.160.050.050.010.220.22XXX
    93224AECG monitor/report, 24 hrs0.523.61NA0.214.34NAXXX
    93225AECG monitor/record, 24 hrs0.001.23NA0.071.30NAXXX
    93226AECG monitor/report, 24 hrs0.002.18NA0.122.30NAXXX
    93227AECG monitor/review, 24 hrs0.520.200.200.020.740.74XXX
    93230AECG monitor/report, 24 hrs0.523.88NA0.224.62NAXXX
    93231AEcg monitor/record, 24 hrs0.001.51NA0.091.60NAXXX
    93232AECG monitor/report, 24 hrs0.002.17NA0.112.28NAXXX
    93233AECG monitor/review, 24 hrs0.520.200.200.020.740.74XXX
    93235AECG monitor/report, 24 hrs0.452.78NA0.133.36NAXXX
    93236AECG monitor/report, 24 hrs0.002.61NA0.122.73NAXXX
    93237AECG monitor/review, 24 hrs0.450.170.170.010.630.63XXX
    93268AECG record/review0.527.41NA0.248.17NAXXX
    Start Printed Page 80149
    93270AECG recording0.001.23NA0.071.30NAXXX
    93271AEcg/monitoring and analysis0.005.99NA0.156.14NAXXX
    93272AEcg/review, interpret only0.520.190.190.020.730.73XXX
    93278AECG/signal-averaged0.251.24NA0.101.59NAXXX
    9327826AECG/signal-averaged0.250.100.100.010.360.36XXX
    93278TCAECG/signal-averaged0.001.14NA0.091.23NAXXX
    93303AEcho transthoracic1.304.33NA0.235.86NAXXX
    9330326AEcho transthoracic1.300.490.490.041.831.83XXX
    93303TCAEcho transthoracic0.003.84NA0.194.03NAXXX
    93304AEcho transthoracic0.752.22NA0.133.10NAXXX
    9330426AEcho transthoracic0.750.290.290.021.061.06XXX
    93304TCAEcho transthoracic0.001.93NA0.112.04NAXXX
    93307AEcho exam of heart0.924.20NA0.225.34NAXXX
    9330726AEcho exam of heart0.920.360.360.031.311.31XXX
    93307TCAEcho exam of heart0.003.84NA0.194.03NAXXX
    93308AEcho exam of heart0.532.14NA0.132.80NAXXX
    9330826AEcho exam of heart0.530.210.210.020.760.76XXX
    93308TCAEcho exam of heart0.001.93NA0.112.04NAXXX
    93312AEcho transesophageal2.204.57NA0.327.09NAXXX
    9331226AEcho transesophageal2.200.810.810.083.093.09XXX
    93312TCAEcho transesophageal0.003.76NA0.244.00NAXXX
    93313AEcho transesophageal0.950.220.210.051.221.21XXX
    93314AEcho transesophageal1.254.24NA0.285.77NAXXX
    9331426AEcho transesophageal1.250.480.480.041.771.77XXX
    93314TCAEcho transesophageal0.003.76NA0.244.00NAXXX
    93315AEcho transesophageal2.784.79NA0.347.91NAXXX
    9331526AEcho transesophageal2.781.031.030.103.913.91XXX
    93315TCAEcho transesophageal0.003.76NA0.244.00NAXXX
    93316AEcho transesophageal0.95NA0.240.05NA1.24XXX
    93317AEcho transesophageal1.834.45NA0.306.58NAXXX
    9331726AEcho transesophageal1.830.690.690.062.582.58XXX
    93317TCAEcho transesophageal0.003.76NA0.244.00NAXXX
    93318CEcho transesophageal intraop0.000.000.000.000.000.00XXX
    9331826AEcho transesophageal intraop2.200.49NA0.062.75NAXXX
    93318TCCEcho transesophageal intraop0.000.000.000.000.000.00XXX
    93320ADoppler echo exam, heart0.381.85NA0.112.34NAZZZ
    9332026ADoppler echo exam, heart0.380.150.150.010.540.54ZZZ
    93320TCADoppler echo exam, heart0.001.70NA0.101.80NAZZZ
    93321ADoppler echo exam, heart0.151.16NA0.081.39NAZZZ
    9332126ADoppler echo exam, heart0.150.060.060.010.220.22ZZZ
    93321TCADoppler echo exam, heart0.001.10NA0.071.17NAZZZ
    93325ADoppler color flow add-on0.072.92NA0.183.17NAZZZ
    9332526ADoppler color flow add-on0.070.030.030.010.110.11ZZZ
    93325TCADoppler color flow add-on0.002.89NA0.173.06NAZZZ
    93350AEcho transthoracic1.482.33NA0.133.94NAXXX
    9335026AEcho transthoracic1.480.580.580.022.082.08XXX
    93350TCAEcho transthoracic0.001.75NA0.111.86NAXXX
    93501ARight heart catheterization3.0218.01NA1.0322.06NA000
    9350126ARight heart catheterization3.021.181.180.164.364.36000
    93501TCARight heart catheterization0.0016.83NA0.8717.70NA000
    93503AInsert/place heart catheter2.91NA0.690.16NA3.76000
    93505ABiopsy of heart lining4.383.69NA0.368.43NA000
    9350526ABiopsy of heart lining4.381.721.720.236.336.33000
    93505TCABiopsy of heart lining0.001.97NA0.132.10NA000
    93508ACath placement, angiography4.1014.19NA0.7519.04NA000
    9350826ACath placement, angiography4.101.641.640.215.955.95000
    93508TCACath placement, angiography0.0012.55NA0.5413.09NA000
    93510ALeft heart catheterization4.3338.53NA2.1344.99NA000
    9351026ALeft heart catheterization4.331.741.740.226.296.29000
    93510TCALeft heart catheterization0.0036.79NA1.9138.70NA000
    93511ALeft heart catheterization5.0337.84NA2.1144.98NA000
    9351126ALeft heart catheterization5.032.022.020.267.317.31000
    93511TCALeft heart catheterization0.0035.82NA1.8537.67NA000
    93514ALeft heart catheterization7.0538.58NA2.2247.85NA000
    9351426ALeft heart catheterization7.052.762.760.3710.1810.18000
    93514TCALeft heart catheterization0.0035.82NA1.8537.67NA000
    93524ALeft heart catheterization6.9549.57NA2.7959.31NA000
    9352426ALeft heart catheterization6.952.772.770.3610.0810.08000
    93524TCALeft heart catheterization0.0046.80NA2.4349.23NA000
    93526ARt & Lt heart catheters5.9950.48NA2.8159.28NA000
    9352626ARt & Lt heart catheters5.992.402.400.318.708.70000
    93526TCARt & Lt heart catheters0.0048.08NA2.5050.58NA000
    93527ARt & Lt heart catheters7.2849.72NA2.8159.81NA000
    9352726ARt & Lt heart catheters7.282.922.920.3810.5810.58000
    93527TCARt & Lt heart catheters0.0046.80NA2.4349.23NA000
    Start Printed Page 80150
    93528ARt & Lt heart catheters9.0050.44NA2.9062.34NA000
    9352826ARt & Lt heart catheters9.003.643.640.4713.1113.11000
    93528TCARt & Lt heart catheters0.0046.80NA2.4349.23NA000
    93529ARt, lt heart catheterization4.8048.67NA2.6856.15NA000
    9352926ARt, lt heart catheterization4.801.871.870.256.926.92000
    93529TCARt, lt heart catheterization0.0046.80NA2.4349.23NA000
    93530ARt heart cath, congenital4.2318.37NA1.1123.71NA000
    9353026ARt heart cath, congenital4.231.541.540.246.016.01000
    93530TCARt heart cath, congenital0.0016.83NA0.8717.70NA000
    93531AR & l heart cath, congenital8.3551.30NA2.9662.61NA000
    9353126AR & l heart cath, congenital8.353.223.220.4612.0312.03000
    93531TCAR & l heart cath, congenital0.0048.08NA2.5050.58NA000
    93532AR & l heart cath, congenital10.0050.70NA2.9563.65NA000
    9353226AR & l heart cath, congenital10.003.903.900.5214.4214.42000
    93532TCAR & l heart cath, congenital0.0046.80NA2.4349.23NA000
    93533AR & l heart cath, congenital6.7049.24NA2.8658.80NA000
    9353326AR & l heart cath, congenital6.702.442.440.439.579.57000
    93533TCAR & l heart cath, congenital0.0046.80NA2.4349.23NA000
    93539AInjection, cardiac cath0.400.160.160.010.570.57000
    93540AInjection, cardiac cath0.430.170.170.010.610.61000
    93541AInjection for lung angiogram0.29NA0.120.01NA0.42000
    93542AInjection for heart x-rays0.29NA0.120.01NA0.42000
    93543AInjection for heart x-rays0.290.120.120.010.420.42000
    93544AInjection for aortography0.250.100.100.010.360.36000
    93545AInject for coronary x-rays0.400.160.160.010.570.57000
    93555AImaging, cardiac cath0.816.58NA0.317.70NAXXX
    9355526AImaging, cardiac cath0.810.330.330.031.171.17XXX
    93555TCAImaging, cardiac cath0.006.25NA0.286.53NAXXX
    93556AImaging, cardiac cath0.8310.18NA0.4511.46NAXXX
    9355626AImaging, cardiac cath0.830.330.330.031.191.19XXX
    93556TCAImaging, cardiac cath0.009.85NA0.4210.27NAXXX
    93561ACardiac output measurement0.500.68NA0.071.25NA000
    9356126ACardiac output measurement0.500.160.160.020.680.68000
    93561TCACardiac output measurement0.000.52NA0.050.57NA000
    93562ACardiac output measurement0.160.37NA0.040.57NA000
    9356226ACardiac output measurement0.160.050.050.010.220.22000
    93562TCACardiac output measurement0.000.32NA0.030.35NA000
    93571AHeart flow reserve measure1.805.25NA0.317.36NAZZZ
    9357126AHeart flow reserve measure1.800.700.700.112.612.61ZZZ
    93571TCAHeart flow reserve measure0.004.55NA0.204.75NAZZZ
    93572AHeart flow reserve measure1.442.78NA0.284.50NAZZZ
    9357226AHeart flow reserve measure1.440.500.500.172.112.11ZZZ
    93572TCAHeart flow reserve measure0.002.28NA0.112.39NAZZZ
    93580ATranscath closure of asd18.00NA7.341.14NA26.48000
    93581ATranscath closure of vsd24.43NA9.841.14NA35.41000
    93600ABundle of His recording2.122.79NA0.225.13NA000
    9360026ABundle of His recording2.120.850.850.113.083.08000
    93600TCABundle of His recording0.001.94NA0.112.05NA000
    93602AIntra-atrial recording2.121.94NA0.184.24NA000
    9360226AIntra-atrial recording2.120.840.840.123.083.08000
    93602TCAIntra-atrial recording0.001.10NA0.061.16NA000
    93603ARight ventricular recording2.122.51NA0.204.83NA000
    9360326ARight ventricular recording2.120.840.840.113.073.07000
    93603TCARight ventricular recording0.001.67NA0.091.76NA000
    93609AMap tachycardia, add-on5.004.71NA0.6610.37NAZZZ
    9360926AMap tachycardia, add-on5.002.002.000.527.527.52ZZZ
    93609TCAMap tachycardia, add-on0.002.71NA0.142.85NAZZZ
    93610AIntra-atrial pacing3.022.52NA0.255.79NA000
    9361026AIntra-atrial pacing3.021.181.180.174.374.37000
    93610TCAIntra-atrial pacing0.001.34NA0.081.42NA000
    93612AIntraventricular pacing3.022.79NA0.266.07NA000
    9361226AIntraventricular pacing3.021.181.180.174.374.37000
    93612TCAIntraventricular pacing0.001.61NA0.091.70NA000
    93613AElectrophys map 3d, add-on7.002.722.720.5210.2410.24ZZZ
    93615AEsophageal recording0.990.59NA0.051.63NA000
    9361526AEsophageal recording0.990.270.270.031.291.29000
    93615TCAEsophageal recording0.000.32NA0.020.34NA000
    93616AEsophageal recording1.490.76NA0.082.33NA000
    9361626AEsophageal recording1.490.440.440.061.991.99000
    93616TCAEsophageal recording0.000.32NA0.020.34NA000
    93618AHeart rhythm pacing4.265.66NA0.4210.34NA000
    9361826AHeart rhythm pacing4.261.711.710.226.196.19000
    93618TCAHeart rhythm pacing0.003.95NA0.204.15NA000
    93619AElectrophysiology evaluation7.3210.59NA0.7718.68NA000
    9361926AElectrophysiology evaluation7.322.922.920.3810.6210.62000
    Start Printed Page 80151
    93619TCAElectrophysiology evaluation0.007.67NA0.398.06NA000
    93620CElectrophysiology evaluation+0.000.00NA0.000.00NA000
    9362026AElectrophysiology evaluation11.594.624.620.6016.8116.81000
    93620TCCElectrophysiology evaluation+0.000.00NA0.000.00NA000
    93621CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362126AElectrophysiology evaluation2.100.840.840.153.093.09ZZZ
    93621TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93622CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362226AElectrophysiology evaluation3.101.231.230.675.005.00ZZZ
    93622TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93623CStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    9362326AStimulation, pacing heart2.851.131.130.154.134.13ZZZ
    93623TCCStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    93624AElectrophysiologic study4.813.88NA0.369.05NA000
    9362426AElectrophysiologic study4.811.911.910.256.976.97000
    93624TCAElectrophysiologic study0.001.97NA0.112.08NA000
    93631AHeart pacing, mapping7.608.93NA1.1717.70NA000
    9363126AHeart pacing, mapping7.602.812.810.6611.0711.07000
    93631TCAHeart pacing, mapping0.006.12NA0.516.63NA000
    93640AEvaluation heart device3.528.53NA0.5312.58NA000
    9364026AEvaluation heart device3.521.391.390.185.095.09000
    93640TCAEvaluation heart device0.007.14NA0.357.49NA000
    93641AElectrophysiology evaluation5.939.51NA0.6616.10NA000
    9364126AElectrophysiology evaluation5.932.372.370.318.618.61000
    93641TCAElectrophysiology evaluation0.007.14NA0.357.49NA000
    93642AElectrophysiology evaluation4.899.07NA0.5114.47NA000
    9364226AElectrophysiology evaluation4.891.931.930.166.986.98000
    93642TCAElectrophysiology evaluation0.007.14NA0.357.49NA000
    93650AAblate heart dysrhythm focus10.51NA4.190.55NA15.25000
    93651AAblate heart dysrhythm focus16.25NA6.490.85NA23.59000
    93652AAblate heart dysrhythm focus17.68NA7.070.92NA25.67000
    93660ATilt table evaluation1.892.43NA0.084.40NA000
    9366026ATilt table evaluation1.890.760.760.062.712.71000
    93660TCATilt table evaluation0.001.67NA0.021.69NA000
    93662CIntracardiac ecg (ice)0.000.000.000.000.000.00ZZZ
    9366226AIntracardiac ecg (ice)2.801.081.080.414.294.29ZZZ
    93662TCCIntracardiac ecg (ice)0.000.00NA0.000.00NAZZZ
    93668NPeripheral vascular rehab0.000.000.000.000.000.00XXX
    93701ABioimpedance, thoracic0.171.14NA0.021.33NAXXX
    9370126ABioimpedance, thoracic0.170.070.070.010.250.25XXX
    93701TCABioimpedance, thoracic0.001.07NA0.011.08NAXXX
    93720ATotal body plethysmography0.170.76NA0.060.99NAXXX
    93721APlethysmography tracing0.000.71NA0.050.76NAXXX
    93722APlethysmography report0.170.050.050.010.230.23XXX
    93724AAnalyze pacemaker system4.895.91NA0.3811.18NA000
    9372426AAnalyze pacemaker system4.891.961.960.187.037.03000
    93724TCAAnalyze pacemaker system0.003.95NA0.204.15NA000
    93727AAnalyze ilr system0.520.200.200.050.770.77XXX
    93731AAnalyze pacemaker system0.450.67NA0.051.17NAXXX
    9373126AAnalyze pacemaker system0.450.180.180.020.650.65XXX
    93731TCAAnalyze pacemaker system0.000.49NA0.030.52NAXXX
    93732AAnalyze pacemaker system0.920.87NA0.061.85NAXXX
    9373226AAnalyze pacemaker system0.920.360.360.031.311.31XXX
    93732TCAAnalyze pacemaker system0.000.51NA0.030.54NAXXX
    93733ATelephone analy, pacemaker0.170.80NA0.061.03NAXXX
    9373326ATelephone analy, pacemaker0.170.070.070.010.250.25XXX
    93733TCATelephone analy, pacemaker0.000.73NA0.050.78NAXXX
    93734AAnalyze pacemaker system0.380.50NA0.030.91NAXXX
    9373426AAnalyze pacemaker system0.380.150.150.010.540.54XXX
    93734TCAAnalyze pacemaker system0.000.35NA0.020.37NAXXX
    93735AAnalyze pacemaker system0.740.74NA0.061.54NAXXX
    9373526AAnalyze pacemaker system0.740.290.290.031.061.06XXX
    93735TCAAnalyze pacemaker system0.000.45NA0.030.48NAXXX
    93736ATelephone analy, pacemaker0.150.69NA0.060.90NAXXX
    9373626ATelephone analy, pacemaker0.150.060.060.010.220.22XXX
    93736TCATelephone analy, pacemaker0.000.63NA0.050.68NAXXX
    93740BTemperature gradient studies+0.160.19NA0.020.37NAXXX
    9374026BTemperature gradient studies+0.160.040.040.010.210.21XXX
    93740TCBTemperature gradient studies+0.000.15NA0.010.16NAXXX
    93741AAnalyze ht pace device sngl0.800.99NA0.051.84NAXXX
    9374126AAnalyze ht pace device sngl0.800.320.320.021.141.14XXX
    93741TCAAnalyze ht pace device sngl0.000.67NA0.030.70NAXXX
    93742AAnalyze ht pace device sngl0.911.04NA0.052.00NAXXX
    9374226AAnalyze ht pace device sngl0.910.370.370.021.301.30XXX
    93742TCAAnalyze ht pace device sngl0.000.67NA0.030.70NAXXX
    Start Printed Page 80152
    93743AAnalyze ht pace device dual1.031.15NA0.062.24NAXXX
    9374326AAnalyze ht pace device dual1.030.410.410.031.471.47XXX
    93743TCAAnalyze ht pace device dual0.000.74NA0.030.77NAXXX
    93744AAnalyze ht pace device dual1.181.14NA0.062.38NAXXX
    9374426AAnalyze ht pace device dual1.180.470.470.031.681.68XXX
    93744TCAAnalyze ht pace device dual0.000.67NA0.030.70NAXXX
    93760NCephalic thermogram0.000.000.000.000.000.00XXX
    93762NPeripheral thermogram0.000.000.000.000.000.00XXX
    93770BMeasure venous pressure+0.160.08NA0.020.26NAXXX
    9377026BMeasure venous pressure+0.160.050.050.010.220.22XXX
    93770TCBMeasure venous pressure+0.000.03NA0.010.04NAXXX
    93784AAmbulatory BP monitoring0.170.98NA0.021.17NAXXX
    93786AAmbulatory BP recording0.000.91NA0.010.92NAXXX
    93788NAmbulatory BP analysis0.000.000.000.000.000.00XXX
    93790AReview/report BP recording0.170.070.070.010.250.25XXX
    93797ACardiac rehab0.180.390.070.010.580.26000
    93798ACardiac rehab/monitor0.280.500.110.010.790.40000
    93799CCardiovascular procedure0.000.000.000.000.000.00XXX
    9379926CCardiovascular procedure0.000.000.000.000.000.00XXX
    93799TCCCardiovascular procedure0.000.000.000.000.000.00XXX
    93875AExtracranial study0.221.65NA0.101.97NAXXX
    9387526AExtracranial study0.220.080.080.010.310.31XXX
    93875TCAExtracranial study0.001.57NA0.091.66NAXXX
    93880AExtracranial study0.604.30NA0.335.23NAXXX
    9388026AExtracranial study0.600.210.210.040.850.85XXX
    93880TCAExtracranial study0.004.09NA0.294.38NAXXX
    93882AExtracranial study0.402.95NA0.223.57NAXXX
    9388226AExtracranial study0.400.140.140.040.580.58XXX
    93882TCAExtracranial study0.002.81NA0.182.99NAXXX
    93886AIntracranial study0.944.73NA0.376.04NAXXX
    9388626AIntracranial study0.940.380.380.051.371.37XXX
    93886TCAIntracranial study0.004.35NA0.324.67NAXXX
    93888AIntracranial study0.623.14NA0.264.02NAXXX
    9388826AIntracranial study0.620.230.230.040.890.89XXX
    93888TCAIntracranial study0.002.91NA0.223.13NAXXX
    93922AExtremity study0.251.88NA0.132.26NAXXX
    9392226AExtremity study0.250.090.090.020.360.36XXX
    93922TCAExtremity study0.001.79NA0.111.90NAXXX
    93923AExtremity study0.452.95NA0.223.62NAXXX
    9392326AExtremity study0.450.160.160.040.650.65XXX
    93923TCAExtremity study0.002.79NA0.182.97NAXXX
    93924AExtremity study0.503.67NA0.264.43NAXXX
    9392426AExtremity study0.500.170.170.050.720.72XXX
    93924TCAExtremity study0.003.50NA0.213.71NAXXX
    93925ALower extremity study0.584.95NA0.335.86NAXXX
    9392526ALower extremity study0.580.200.200.040.820.82XXX
    93925TCALower extremity study0.004.75NA0.295.04NAXXX
    93926ALower extremity study0.393.39NA0.224.00NAXXX
    9392626ALower extremity study0.390.130.130.030.550.55XXX
    93926TCALower extremity study0.003.26NA0.193.45NAXXX
    93930AUpper extremity study0.463.94NA0.344.74NAXXX
    9393026AUpper extremity study0.460.160.160.030.650.65XXX
    93930TCAUpper extremity study0.003.78NA0.314.09NAXXX
    93931AUpper extremity study0.312.83NA0.223.36NAXXX
    9393126AUpper extremity study0.310.110.110.020.440.44XXX
    93931TCAUpper extremity study0.002.72NA0.202.92NAXXX
    93965AExtremity study0.351.85NA0.122.32NAXXX
    9396526AExtremity study0.350.120.120.020.490.49XXX
    93965TCAExtremity study0.001.73NA0.101.83NAXXX
    93970AExtremity study0.684.05NA0.385.11NAXXX
    9397026AExtremity study0.680.240.240.050.970.97XXX
    93970TCAExtremity study0.003.81NA0.334.14NAXXX
    93971AExtremity study0.452.87NA0.253.57NAXXX
    9397126AExtremity study0.450.150.150.030.630.63XXX
    93971TCAExtremity study0.002.72NA0.222.94NAXXX
    93975AVascular study1.805.92NA0.478.19NAXXX
    9397526AVascular study1.800.620.620.112.532.53XXX
    93975TCAVascular study0.005.30NA0.365.66NAXXX
    93976AVascular study1.213.49NA0.315.01NAXXX
    9397626AVascular study1.210.410.410.061.681.68XXX
    93976TCAVascular study0.003.08NA0.253.33NAXXX
    93978AVascular study0.653.63NA0.364.64NAXXX
    9397826AVascular study0.650.230.230.050.930.93XXX
    93978TCAVascular study0.003.40NA0.313.71NAXXX
    93979AVascular study0.442.63NA0.243.31NAXXX
    Start Printed Page 80153
    9397926AVascular study0.440.160.160.040.640.64XXX
    93979TCAVascular study0.002.47NA0.202.67NAXXX
    93980APenile vascular study1.254.50NA0.356.10NAXXX
    9398026APenile vascular study1.250.420.420.071.741.74XXX
    93980TCAPenile vascular study0.004.08NA0.284.36NAXXX
    93981APenile vascular study0.444.82NA0.285.54NAXXX
    9398126APenile vascular study0.440.150.150.020.610.61XXX
    93981TCAPenile vascular study0.004.67NA0.264.93NAXXX
    93990ADoppler flow testing0.253.35NA0.213.81NAXXX
    9399026ADoppler flow testing0.250.090.090.020.360.36XXX
    93990TCADoppler flow testing0.003.26NA0.193.45NAXXX
    94010ABreathing capacity test0.170.88NA0.031.08NAXXX
    9401026ABreathing capacity test0.170.050.050.010.230.23XXX
    94010TCABreathing capacity test0.000.83NA0.020.85NAXXX
    94014APatient recorded spirometry0.520.46NA0.031.01NAXXX
    94015APatient recorded spirometry0.000.29NA0.010.30NAXXX
    94016AReview patient spirometry0.520.170.170.020.710.71XXX
    94060AEvaluation of wheezing0.311.52NA0.061.89NAXXX
    9406026AEvaluation of wheezing0.310.100.100.010.420.42XXX
    94060TCAEvaluation of wheezing0.001.42NA0.051.47NAXXX
    94070AEvaluation of wheezing0.604.34NA0.105.04NAXXX
    9407026AEvaluation of wheezing0.600.190.190.020.810.81XXX
    94070TCAEvaluation of wheezing0.004.15NA0.084.23NAXXX
    94150BVital capacity test+0.070.66NA0.020.75NAXXX
    9415026BVital capacity test+0.070.030.030.010.110.11XXX
    94150TCBVital capacity test+0.000.63NA0.010.64NAXXX
    94200ALung function test (MBC/MVV)0.110.63NA0.030.77NAXXX
    9420026ALung function test (MBC/MVV)0.110.030.030.010.150.15XXX
    94200TCALung function test (MBC/MVV)0.000.60NA0.020.62NAXXX
    94240AResidual lung capacity0.261.89NA0.052.20NAXXX
    9424026AResidual lung capacity0.260.080.080.010.350.35XXX
    94240TCAResidual lung capacity0.001.81NA0.041.85NAXXX
    94250AExpired gas collection0.110.70NA0.020.83NAXXX
    9425026AExpired gas collection0.110.030.030.010.150.15XXX
    94250TCAExpired gas collection0.000.67NA0.010.68NAXXX
    94260AThoracic gas volume0.130.55NA0.040.72NAXXX
    9426026AThoracic gas volume0.130.040.040.010.180.18XXX
    94260TCAThoracic gas volume0.000.51NA0.030.54NAXXX
    94350ALung nitrogen washout curve0.261.96NA0.042.26NAXXX
    9435026ALung nitrogen washout curve0.260.080.080.010.350.35XXX
    94350TCALung nitrogen washout curve0.001.88NA0.031.91NAXXX
    94360AMeasure airflow resistance0.260.57NA0.060.89NAXXX
    9436026AMeasure airflow resistance0.260.080.080.010.350.35XXX
    94360TCAMeasure airflow resistance0.000.49NA0.050.54NAXXX
    94370ABreath airway closing volume0.261.96NA0.032.25NAXXX
    9437026ABreath airway closing volume0.260.080.080.010.350.35XXX
    94370TCABreath airway closing volume0.001.88NA0.021.90NAXXX
    94375ARespiratory flow volume loop0.310.67NA0.031.01NAXXX
    9437526ARespiratory flow volume loop0.310.100.100.010.420.42XXX
    94375TCARespiratory flow volume loop0.000.57NA0.020.59NAXXX
    94400ACO2 breathing response curve0.400.89NA0.061.35NAXXX
    9440026ACO2 breathing response curve0.400.130.130.010.540.54XXX
    94400TCACO2 breathing response curve0.000.76NA0.050.81NAXXX
    94450AHypoxia response curve0.400.68NA0.041.12NAXXX
    9445026AHypoxia response curve0.400.120.120.020.540.54XXX
    94450TCAHypoxia response curve0.000.56NA0.020.58NAXXX
    94620APulmonary stress test/simple0.642.47NA0.103.21NAXXX
    9462026APulmonary stress test/simple0.640.200.200.020.860.86XXX
    94620TCAPulmonary stress test/simple0.002.27NA0.082.35NAXXX
    94621APulm stress test/complex1.422.12NA0.133.67NAXXX
    9462126APulm stress test/complex1.420.450.450.051.921.92XXX
    94621TCAPulm stress test/complex0.001.67NA0.081.75NAXXX
    94640AAirway inhalation treatment0.000.70NA0.020.72NAXXX
    94642CAerosol inhalation treatment0.000.000.000.000.000.00XXX
    94650DPressure breathing (IPPB)0.000.000.000.000.000.00XXX
    94651DPressure breathing (IPPB)0.000.000.000.000.000.00XXX
    94652DPressure breathing (IPPB)0.000.000.000.000.000.00XXX
    94656AInitial ventilator mgmt1.22NA0.320.06NA1.60XXX
    94657AContinued ventilator mgmt0.83NA0.260.03NA1.12XXX
    94660APos airway pressure, CPAP0.760.680.240.031.471.03XXX
    94662ANeg press ventilation, cnp0.76NA0.240.02NA1.02XXX
    94664AEvaluate pt use of inhaler0.000.52NA0.030.55NAXXX
    94665DAerosol or vapor inhalations0.000.000.000.000.000.00XXX
    94667AChest wall manipulation0.000.81NA0.040.85NAXXX
    94668AChest wall manipulation0.000.71NA0.020.73NAXXX
    Start Printed Page 80154
    94680AExhaled air analysis, o20.261.91NA0.062.23NAXXX
    9468026AExhaled air analysis, o20.260.090.090.010.360.36XXX
    94680TCAExhaled air analysis, o20.001.82NA0.051.87NAXXX
    94681AExhaled air analysis, o2/co20.202.80NA0.113.11NAXXX
    9468126AExhaled air analysis, o2/co20.200.070.070.010.280.28XXX
    94681TCAExhaled air analysis, o2/co20.002.73NA0.102.83NAXXX
    94690AExhaled air analysis0.072.13NA0.042.24NAXXX
    9469026AExhaled air analysis0.070.020.020.010.100.10XXX
    94690TCAExhaled air analysis0.002.11NA0.032.14NAXXX
    94720AMonoxide diffusing capacity0.261.55NA0.061.87NAXXX
    9472026AMonoxide diffusing capacity0.260.080.080.010.350.35XXX
    94720TCAMonoxide diffusing capacity0.001.47NA0.051.52NAXXX
    94725AMembrane diffusion capacity0.262.56NA0.112.93NAXXX
    9472526AMembrane diffusion capacity0.260.080.080.010.350.35XXX
    94725TCAMembrane diffusion capacity0.002.48NA0.102.58NAXXX
    94750APulmonary compliance study0.232.07NA0.042.34NAXXX
    9475026APulmonary compliance study0.230.070.070.010.310.31XXX
    94750TCAPulmonary compliance study0.002.00NA0.032.03NAXXX
    94760TMeasure blood oxygen level0.000.09NA0.020.11NAXXX
    94761TMeasure blood oxygen level0.000.17NA0.050.22NAXXX
    94762AMeasure blood oxygen level0.000.74NA0.080.82NAXXX
    94770AExhaled carbon dioxide test0.151.68NA0.071.90NAXXX
    9477026AExhaled carbon dioxide test0.150.040.040.010.200.20XXX
    94770TCAExhaled carbon dioxide test0.001.64NA0.061.70NAXXX
    94772CBreath recording, infant0.000.000.000.000.000.00XXX
    9477226CBreath recording, infant0.000.000.000.000.000.00XXX
    94772TCCBreath recording, infant0.000.000.000.000.000.00XXX
    94799CPulmonary service/procedure0.000.000.000.000.000.00XXX
    9479926CPulmonary service/procedure0.000.000.000.000.000.00XXX
    94799TCCPulmonary service/procedure0.000.000.000.000.000.00XXX
    95004APercut allergy skin tests0.000.10NA0.010.11NAXXX
    95010APercut allergy titrate test0.150.440.060.010.600.22XXX
    95015AId allergy titrate-drug/bug0.150.380.060.010.540.22XXX
    95024AId allergy test, drug/bug0.000.15NA0.010.16NAXXX
    95027AId allergy titrate-airborne0.000.15NA0.010.16NAXXX
    95028AId allergy test-delayed type0.000.23NA0.010.24NAXXX
    95044AAllergy patch tests0.000.20NA0.010.21NAXXX
    95052APhoto patch test0.000.25NA0.010.26NAXXX
    95056APhotosensitivity tests0.000.17NA0.010.18NAXXX
    95060AEye allergy tests0.000.35NA0.020.37NAXXX
    95065ANose allergy test0.000.20NA0.010.21NAXXX
    95070ABronchial allergy tests0.002.27NA0.022.29NAXXX
    95071ABronchial allergy tests0.002.91NA0.022.93NAXXX
    95075AIngestion challenge test0.950.840.400.031.821.38XXX
    95078AProvocative testing0.000.25NA0.020.27NAXXX
    95115AImmunotherapy, one injection0.000.39NA0.020.41NA000
    95117AImmunotherapy injections0.000.50NA0.020.52NA000
    95120IImmunotherapy, one injection0.000.000.000.000.000.00XXX
    95125IImmunotherapy, many antigens0.000.000.000.000.000.00XXX
    95130IImmunotherapy, insect venom0.000.000.000.000.000.00XXX
    95131IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95132IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95133IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95134IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95144AAntigen therapy services0.060.250.020.010.320.09000
    95145AAntigen therapy services0.060.490.020.010.560.09000
    95146AAntigen therapy services0.060.610.030.010.680.10000
    95147AAntigen therapy services0.060.830.020.010.900.09000
    95148AAntigen therapy services0.060.810.030.010.880.10000
    95149AAntigen therapy services0.061.020.030.011.090.10000
    95165AAntigen therapy services0.060.200.020.010.270.09000
    95170AAntigen therapy services0.060.260.020.010.330.09000
    95180ARapid desensitization2.011.600.840.043.652.89000
    95199CAllergy immunology services0.000.000.000.000.000.00000
    95250AGlucose monitoring, cont0.003.22NA0.013.23NAXXX
    95805AMultiple sleep latency test1.8817.11NA0.3419.33NAXXX
    9580526AMultiple sleep latency test1.880.680.680.062.622.62XXX
    95805TCAMultiple sleep latency test0.0016.43NA0.2816.71NAXXX
    95806ASleep study, unattended1.664.10NA0.326.08NAXXX
    9580626ASleep study, unattended1.660.550.550.062.272.27XXX
    95806TCASleep study, unattended0.003.55NA0.263.81NAXXX
    95807ASleep study, attended1.6612.00NA0.4014.06NAXXX
    9580726ASleep study, attended1.660.540.540.052.252.25XXX
    95807TCASleep study, attended0.0011.46NA0.3511.81NAXXX
    95808APolysomnography, 1-32.6513.10NA0.4416.19NAXXX
    Start Printed Page 80155
    9580826APolysomnography, 1-32.650.950.950.093.693.69XXX
    95808TCAPolysomnography, 1-30.0012.15NA0.3512.50NAXXX
    95810APolysomnography, 4 or more3.5317.29NA0.4721.29NAXXX
    9581026APolysomnography, 4 or more3.531.211.210.124.864.86XXX
    95810TCAPolysomnography, 4 or more0.0016.08NA0.3516.43NAXXX
    95811APolysomnography w/cpap3.8017.67NA0.4921.96NAXXX
    9581126APolysomnography w/cpap3.801.301.300.135.235.23XXX
    95811TCAPolysomnography w/cpap0.0016.37NA0.3616.73NAXXX
    95812AEeg, 41-60 minutes1.084.72NA0.135.93NAXXX
    9581226AEeg, 41-60 minutes1.080.460.460.041.581.58XXX
    95812TCAEeg, 41-60 minutes0.004.26NA0.094.35NAXXX
    95813AEeg, over 1 hour1.735.80NA0.157.68NAXXX
    9581326AEeg, over 1 hour1.730.720.720.062.512.51XXX
    95813TCAEeg, over 1 hour0.005.08NA0.095.17NAXXX
    95816AEeg, awake and drowsy1.083.67NA0.124.87NAXXX
    9581626AEeg, awake and drowsy1.080.470.470.041.591.59XXX
    95816TCAEeg, awake and drowsy0.003.20NA0.083.28NAXXX
    95819AEeg, awake and asleep1.084.31NA0.125.51NAXXX
    9581926AEeg, awake and asleep1.080.470.470.041.591.59XXX
    95819TCAEeg, awake and asleep0.003.84NA0.083.92NAXXX
    95822AEeg, coma or sleep only1.085.11NA0.156.34NAXXX
    9582226AEeg, coma or sleep only1.080.470.470.041.591.59XXX
    95822TCAEeg, coma or sleep only0.004.64NA0.114.75NAXXX
    95824CEeg, cerebral death only0.000.000.000.000.000.00XXX
    9582426AEeg, cerebral death only0.740.320.320.051.111.11XXX
    95824TCCEeg, cerebral death only0.000.00NA0.000.00NAXXX
    95827AEeg, all night recording1.082.70NA0.153.93NAXXX
    9582726AEeg, all night recording1.080.420.420.031.531.53XXX
    95827TCAEeg, all night recording0.002.28NA0.122.40NAXXX
    95829ASurgery electrocorticogram6.2140.12NA0.3346.66NAXXX
    9582926ASurgery electrocorticogram6.212.382.380.318.908.90XXX
    95829TCASurgery electrocorticogram0.0037.74NA0.0237.76NAXXX
    95830AInsert electrodes for EEG1.703.550.750.075.322.52XXX
    95831ALimb muscle testing, manual0.280.530.130.010.820.42XXX
    95832AHand muscle testing, manual0.290.450.120.010.750.42XXX
    95833ABody muscle testing, manual0.470.610.230.011.090.71XXX
    95834ABody muscle testing, manual0.600.580.280.021.200.90XXX
    95851ARange of motion measurements0.160.570.080.010.740.25XXX
    95852ARange of motion measurements0.110.470.050.010.590.17XXX
    95857ATensilon test0.530.650.230.021.200.78XXX
    95858ATensilon test & myogram1.561.09NA0.072.72NAXXX
    9585826ATensilon test & myogram1.560.690.690.042.292.29XXX
    95858TCATensilon test & myogram0.000.40NA0.030.43NAXXX
    95860AMuscle test, one limb0.961.62NA0.052.63NAXXX
    9586026AMuscle test, one limb0.960.430.430.031.421.42XXX
    95860TCAMuscle test, one limb0.001.19NA0.021.21NAXXX
    95861AMuscle test, 2 limbs1.541.44NA0.103.08NAXXX
    9586126AMuscle test, 2 limbs1.540.700.700.052.292.29XXX
    95861TCAMuscle test, 2 limbs0.000.74NA0.050.79NAXXX
    95863AMuscle test, 3 limbs1.871.77NA0.113.75NAXXX
    9586326AMuscle test, 3 limbs1.870.830.830.062.762.76XXX
    95863TCAMuscle test, 3 limbs0.000.94NA0.050.99NAXXX
    95864AMuscle test, 4 limbs1.992.66NA0.164.81NAXXX
    9586426AMuscle test, 4 limbs1.990.890.890.062.942.94XXX
    95864TCAMuscle test, 4 limbs0.001.77NA0.101.87NAXXX
    95867AMuscle test cran nerv unilat0.790.94NA0.061.79NAXXX
    9586726AMuscle test cran nerv unilat0.790.360.360.031.181.18XXX
    95867TCAMuscle test cran nerv unilat0.000.58NA0.030.61NAXXX
    95868AMuscle test cran nerve bilat1.181.23NA0.082.49NAXXX
    9586826AMuscle test cran nerve bilat1.180.530.530.041.751.75XXX
    95868TCAMuscle test cran nerve bilat0.000.70NA0.040.74NAXXX
    95869AMuscle test, thor paraspinal0.370.38NA0.030.78NAXXX
    9586926AMuscle test, thor paraspinal0.370.170.170.010.550.55XXX
    95869TCAMuscle test, thor paraspinal0.000.21NA0.020.23NAXXX
    95870AMuscle test, nonparaspinal0.370.37NA0.030.77NAXXX
    9587026AMuscle test, nonparaspinal0.370.160.160.010.540.54XXX
    95870TCAMuscle test, nonparaspinal0.000.21NA0.020.23NAXXX
    95872AMuscle test, one fiber1.501.25NA0.082.83NAXXX
    9587226AMuscle test, one fiber1.500.650.650.042.192.19XXX
    95872TCAMuscle test, one fiber0.000.60NA0.040.64NAXXX
    95875ALimb exercise test1.101.72NA0.092.91NAXXX
    9587526ALimb exercise test1.100.480.480.041.621.62XXX
    95875TCALimb exercise test0.001.24NA0.051.29NAXXX
    95900AMotor nerve conduction test0.421.12NA0.031.57NAXXX
    9590026AMotor nerve conduction test0.420.190.190.010.620.62XXX
    Start Printed Page 80156
    95900TCAMotor nerve conduction test0.000.93NA0.020.95NAXXX
    95903AMotor nerve conduction test0.601.07NA0.041.71NAXXX
    9590326AMotor nerve conduction test0.600.270.270.020.890.89XXX
    95903TCAMotor nerve conduction test0.000.80NA0.020.82NAXXX
    95904ASense nerve conduction test0.340.95NA0.031.32NAXXX
    9590426ASense nerve conduction test0.340.150.150.010.500.50XXX
    95904TCASense nerve conduction test0.000.80NA0.020.82NAXXX
    95920AIntraop nerve test add-on2.112.26NA0.204.57NAZZZ
    9592026AIntraop nerve test add-on2.110.960.960.143.213.21ZZZ
    95920TCAIntraop nerve test add-on0.001.30NA0.061.36NAZZZ
    95921AAutonomic nerv function test0.900.72NA0.051.67NAXXX
    9592126AAutonomic nerv function test0.900.340.340.031.271.27XXX
    95921TCAAutonomic nerv function test0.000.38NA0.020.40NAXXX
    95922AAutonomic nerv function test0.960.79NA0.051.80NAXXX
    9592226AAutonomic nerv function test0.960.410.410.031.401.40XXX
    95922TCAAutonomic nerv function test0.000.38NA0.020.40NAXXX
    95923AAutonomic nerv function test0.902.92NA0.053.87NAXXX
    9592326AAutonomic nerv function test0.900.390.390.031.321.32XXX
    95923TCAAutonomic nerv function test0.002.53NA0.022.55NAXXX
    95925ASomatosensory testing0.541.14NA0.071.75NAXXX
    9592526ASomatosensory testing0.540.230.230.020.790.79XXX
    95925TCASomatosensory testing0.000.91NA0.050.96NAXXX
    95926ASomatosensory testing0.541.15NA0.071.76NAXXX
    9592626ASomatosensory testing0.540.240.240.020.800.80XXX
    95926TCASomatosensory testing0.000.91NA0.050.96NAXXX
    95927ASomatosensory testing0.541.17NA0.081.79NAXXX
    9592726ASomatosensory testing0.540.260.260.030.830.83XXX
    95927TCASomatosensory testing0.000.91NA0.050.96NAXXX
    95930AVisual evoked potential test0.351.18NA0.021.55NAXXX
    9593026AVisual evoked potential test0.350.150.150.010.510.51XXX
    95930TCAVisual evoked potential test0.001.03NA0.011.04NAXXX
    95933ABlink reflex test0.591.03NA0.071.69NAXXX
    9593326ABlink reflex test0.590.250.250.020.860.86XXX
    95933TCABlink reflex test0.000.78NA0.050.83NAXXX
    95934AH-reflex test0.510.44NA0.040.99NAXXX
    9593426AH-reflex test0.510.230.230.020.760.76XXX
    95934TCAH-reflex test0.000.21NA0.020.23NAXXX
    95936AH-reflex test0.550.46NA0.041.05NAXXX
    9593626AH-reflex test0.550.250.250.020.820.82XXX
    95936TCAH-reflex test0.000.21NA0.020.23NAXXX
    95937ANeuromuscular junction test0.650.61NA0.041.30NAXXX
    9593726ANeuromuscular junction test0.650.270.270.020.940.94XXX
    95937TCANeuromuscular junction test0.000.34NA0.020.36NAXXX
    95950AAmbulatory eeg monitoring1.516.79NA0.448.74NAXXX
    9595026AAmbulatory eeg monitoring1.510.650.650.082.242.24XXX
    95950TCAAmbulatory eeg monitoring0.006.14NA0.366.50NAXXX
    95951AEEG monitoring/videorecord6.002.63NA0.589.21NAXXX
    9595126AEEG monitoring/videorecord6.002.622.620.208.828.82XXX
    95951TCAEEG monitoring/videorecord0.000.01NA0.380.39NAXXX
    95953AEEG monitoring/computer3.087.63NA0.4611.17NAXXX
    9595326AEEG monitoring/computer3.081.321.320.104.504.50XXX
    95953TCAEEG monitoring/computer0.006.31NA0.366.67NAXXX
    95954AEEG monitoring/giving drugs2.455.04NA0.157.64NAXXX
    9595426AEEG monitoring/giving drugs2.451.061.060.103.613.61XXX
    95954TCAEEG monitoring/giving drugs0.003.98NA0.054.03NAXXX
    95955AEEG during surgery1.012.32NA0.193.52NAXXX
    9595526AEEG during surgery1.010.370.370.051.431.43XXX
    95955TCAEEG during surgery0.001.95NA0.142.09NAXXX
    95956AEeg monitoring, cable/radio3.0815.69NA0.4719.24NAXXX
    9595626AEeg monitoring, cable/radio3.081.331.330.114.524.52XXX
    95956TCAEeg monitoring, cable/radio0.0014.36NA0.3614.72NAXXX
    95957AEEG digital analysis1.982.56NA0.174.71NAXXX
    9595726AEEG digital analysis1.980.870.870.072.922.92XXX
    95957TCAEEG digital analysis0.001.69NA0.101.79NAXXX
    95958AEEG monitoring/function test4.253.51NA0.298.05NAXXX
    9595826AEEG monitoring/function test4.251.781.780.186.216.21XXX
    95958TCAEEG monitoring/function test0.001.73NA0.111.84NAXXX
    95961AElectrode stimulation, brain2.972.65NA0.245.86NAXXX
    9596126AElectrode stimulation, brain2.971.351.350.184.504.50XXX
    95961TCAElectrode stimulation, brain0.001.30NA0.061.36NAXXX
    95962AElectrode stim, brain add-on3.212.72NA0.236.16NAZZZ
    9596226AElectrode stim, brain add-on3.211.421.420.174.804.80ZZZ
    95962TCAElectrode stim, brain add-on0.001.30NA0.061.36NAZZZ
    95965CMeg, spontaneous0.000.000.000.000.000.00XXX
    9596526AMeg, spontaneous8.003.113.110.3111.4211.42XXX
    Start Printed Page 80157
    95965TCCMeg, spontaneous0.000.000.000.000.000.00XXX
    95966CMeg, evoked, single0.000.000.000.000.000.00XXX
    9596626AMeg, evoked, single4.001.551.550.155.705.70XXX
    95966TCCMeg, evoked, single0.000.000.000.000.000.00XXX
    95967CMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    9596726AMeg, evoked, each addl3.501.361.360.134.994.99ZZZ
    95967TCCMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    95970AAnalyze neurostim, no prog0.450.170.150.030.650.63XXX
    95971AAnalyze neurostim, simple0.780.280.230.061.121.07XXX
    95972AAnalyze neurostim, complex1.500.610.510.172.282.18XXX
    95973AAnalyze neurostim, complex0.920.410.350.071.401.34ZZZ
    95974ACranial neurostim, complex3.001.321.320.154.474.47XXX
    95975ACranial neurostim, complex1.700.750.750.072.522.52ZZZ
    95990ASpin/brain pump refil & main0.001.49NA0.051.54NAXXX
    95999CNeurological procedure0.000.000.000.000.000.00XXX
    96000AMotion analysis, video/3d1.80NA0.700.02NA2.52XXX
    96001AMotion test w/ft press meas2.15NA0.840.02NA3.01XXX
    96002ADynamic surface emg0.41NA0.160.02NA0.59XXX
    96003ADynamic fine wire emg0.37NA0.140.03NA0.54XXX
    96004APhys review of motion tests2.140.840.840.083.063.06XXX
    96100APsychological testing0.001.75NA0.151.90NAXXX
    96105AAssessment of aphasia0.001.75NA0.151.90NAXXX
    96110CDevelopmental test, lim0.000.000.000.000.000.00XXX
    96111ADevelopmental test, extend0.001.75NA0.151.90NAXXX
    96115ANeurobehavior status exam0.001.75NA0.151.90NAXXX
    96117ANeuropsych test battery0.001.75NA0.151.90NAXXX
    96150AAssess lth/behave, init0.500.210.200.020.730.72XXX
    96151AAssess hlth/behave, subseq0.480.200.190.020.700.69XXX
    96152AIntervene hlth/behave, indiv0.460.190.180.020.670.66XXX
    96153AIntervene hlth/behave, group0.100.040.040.010.150.15XXX
    96154AInterv hlth/behav, fam w/pt0.450.190.180.020.660.65XXX
    96155AInterv hlth/behav fam no pt0.440.180.170.020.640.63XXX
    96400AChemotherapy, sc/im0.001.01NA0.011.02NAXXX
    96405AIntralesional chemo admin0.521.680.230.022.220.77000
    96406AIntralesional chemo admin0.802.540.300.023.361.12000
    96408AChemotherapy, push technique0.000.97NA0.051.02NAXXX
    96410AChemotherapy,infusion method0.001.54NA0.071.61NAXXX
    96412AChemo, infuse method add-on0.001.14NA0.061.20NAZZZ
    96414AChemo, infuse method add-on0.001.33NA0.071.40NAXXX
    96420AChemotherapy, push technique0.001.24NA0.071.31NAXXX
    96422AChemotherapy,infusion method0.001.22NA0.071.29NAXXX
    96423AChemo, infuse method add-on0.000.48NA0.020.50NAZZZ
    96425AChemotherapy,infusion method0.001.42NA0.071.49NAXXX
    96440AChemotherapy, intracavitary2.377.921.040.1210.413.53000
    96445AChemotherapy, intracavitary2.207.971.020.0710.243.29000
    96450AChemotherapy, into CNS1.896.300.930.068.252.88000
    96520APort pump refill & main0.000.89NA0.050.94NAXXX
    96530ASyst pump refill & main0.001.05NA0.051.10NAXXX
    96542AChemotherapy injection1.423.990.550.055.462.02XXX
    96545BProvide chemotherapy agent0.000.000.000.000.000.00XXX
    96549CChemotherapy, unspecified0.000.000.000.000.000.00XXX
    96567APhotodynamic tx, skin0.005.10NA0.035.13NAXXX
    96570APhotodynamic tx, 30 min1.100.380.370.041.521.51ZZZ
    96571APhotodynamic tx, addl 15 min0.550.210.200.020.780.77ZZZ
    96900AUltraviolet light therapy0.000.49NA0.020.51NAXXX
    96902BTrichogram+0.410.250.160.010.670.58XXX
    96910APhotochemotherapy with UV-B0.001.57NA0.031.60NAXXX
    96912APhotochemotherapy with UV-A0.001.80NA0.041.84NAXXX
    96913APhotochemotherapy, UV-A or B0.002.71NA0.082.79NAXXX
    96920ALaser tx, skin < 250 sq cm1.152.880.450.094.121.69000
    96921ALaser tx, skin 250-500 sq cm1.172.960.460.094.221.72000
    96922ALaser tx, skin > 500 sq cm2.103.560.820.165.823.08000
    96999CDermatological procedure0.000.000.000.000.000.00XXX
    97001APt evaluation1.200.740.460.051.991.71XXX
    97002APt re-evaluation0.600.450.240.021.070.86XXX
    97003AOt evaluation1.200.870.410.052.121.66XXX
    97004AOt re-evaluation0.600.680.200.021.300.82XXX
    97005IAthletic train eval0.000.000.000.000.000.00XXX
    97006IAthletic train reeval0.000.000.000.000.000.00XXX
    97010BHot or cold packs therapy+0.060.05NA0.010.12NAXXX
    97012AMechanical traction therapy0.250.14NA0.010.40NAXXX
    97014IElectric stimulation therapy+0.180.190.190.010.380.38XXX
    97016AVasopneumatic device therapy0.180.19NA0.010.38NAXXX
    97018AParaffin bath therapy0.060.11NA0.010.18NAXXX
    97020AMicrowave therapy0.060.06NA0.010.13NAXXX
    Start Printed Page 80158
    97022AWhirlpool therapy0.170.22NA0.010.40NAXXX
    97024ADiathermy treatment0.060.06NA0.010.13NAXXX
    97026AInfrared therapy0.060.06NA0.010.13NAXXX
    97028AUltraviolet therapy0.080.07NA0.010.16NAXXX
    97032AElectrical stimulation0.250.18NA0.010.44NAXXX
    97033AElectric current therapy0.260.27NA0.020.55NAXXX
    97034AContrast bath therapy0.210.16NA0.010.38NAXXX
    97035AUltrasound therapy0.210.11NA0.010.33NAXXX
    97036AHydrotherapy0.280.33NA0.010.62NAXXX
    97039APhysical therapy treatment0.200.11NA0.010.32NAXXX
    97110ATherapeutic exercises0.450.28NA0.030.76NAXXX
    97112ANeuromuscular reeducation0.450.31NA0.020.78NAXXX
    97113AAquatic therapy/exercises0.440.34NA0.030.81NAXXX
    97116AGait training therapy0.400.25NA0.020.67NAXXX
    97124AMassage therapy0.350.24NA0.010.60NAXXX
    97139APhysical medicine procedure0.210.21NA0.010.43NAXXX
    97140AManual therapy0.430.27NA0.020.72NAXXX
    97150AGroup therapeutic procedures0.270.21NA0.020.50NAXXX
    97504AOrthotic training0.450.29NA0.030.77NAXXX
    97520AProsthetic training0.450.28NA0.020.75NAXXX
    97530ATherapeutic activities0.440.31NA0.020.77NAXXX
    97532ACognitive skills development0.440.20NA0.010.65NAXXX
    97533ASensory integration0.440.24NA0.010.69NAXXX
    97535ASelf care mngment training0.450.36NA0.020.83NAXXX
    97537ACommunity/work reintegration0.450.27NA0.010.73NAXXX
    97542AWheelchair mngment training0.450.29NA0.010.75NAXXX
    97545RWork hardening0.000.000.000.000.000.00XXX
    97546RWork hardening add-on0.000.000.000.000.000.00ZZZ
    97601AWound(s) care, selective0.500.53NA0.041.07NAXXX
    97602BWound(s) care non-selective0.000.000.000.000.000.00XXX
    97703AProsthetic checkout0.250.33NA0.020.60NAXXX
    97750APhysical performance test0.450.31NA0.020.78NAXXX
    97780NAcupuncture w/o stimul0.000.000.000.000.000.00XXX
    97781NAcupuncture w/stimul0.000.000.000.000.000.00XXX
    97799CPhysical medicine procedure0.000.000.000.000.000.00XXX
    97802AMedical nutrition, indiv, in0.000.47NA0.010.48NAXXX
    97803AMed nutrition, indiv, subseq0.000.47NA0.010.48NAXXX
    97804AMedical nutrition, group0.000.18NA0.010.19NAXXX
    98925AOsteopathic manipulation0.450.370.150.010.830.61000
    98926AOsteopathic manipulation0.650.440.260.021.110.93000
    98927AOsteopathic manipulation0.870.510.300.031.411.20000
    98928AOsteopathic manipulation1.030.590.350.031.651.41000
    98929AOsteopathic manipulation1.190.650.380.041.881.61000
    98940AChiropractic manipulation0.450.240.130.010.700.59000
    98941AChiropractic manipulation0.650.300.180.020.970.85000
    98942AChiropractic manipulation0.870.370.240.031.271.14000
    98943NChiropractic manipulation+0.400.240.160.010.650.57XXX
    99000BSpecimen handling0.000.000.000.000.000.00XXX
    99001BSpecimen handling0.000.000.000.000.000.00XXX
    99002BDevice handling0.000.000.000.000.000.00XXX
    99024BPostop follow-up visit0.000.000.000.000.000.00XXX
    99025BInitial surgical evaluation0.000.000.000.000.000.00XXX
    99026IIn-hospital on call service0.000.000.000.000.000.00XXX
    99027IOut-of-hosp on call service0.000.000.000.000.000.00XXX
    99050BMedical services after hrs0.000.000.000.000.000.00XXX
    99052BMedical services at night0.000.000.000.000.000.00XXX
    99054BMedical servcs, unusual hrs0.000.000.000.000.000.00XXX
    99056BNon-office medical services0.000.000.000.000.000.00XXX
    99058BOffice emergency care0.000.000.000.000.000.00XXX
    99070BSpecial supplies0.000.000.000.000.000.00XXX
    99071BPatient education materials0.000.000.000.000.000.00XXX
    99075NMedical testimony0.000.000.000.000.000.00XXX
    99078BGroup health education0.000.000.000.000.000.00XXX
    99080BSpecial reports or forms0.000.000.000.000.000.00XXX
    99082CUnusual physician travel0.000.000.000.000.000.00XXX
    99090BComputer data analysis0.000.000.000.000.000.00XXX
    99091BCollect/review data from pt0.000.000.000.000.000.00XXX
    99100BSpecial anesthesia service0.000.000.000.000.000.00ZZZ
    99116BAnesthesia with hypothermia0.000.000.000.000.000.00ZZZ
    99135BSpecial anesthesia procedure0.000.000.000.000.000.00ZZZ
    99140BEmergency anesthesia0.000.000.000.000.000.00ZZZ
    99141BSedation, iv/im or inhalant+0.802.150.390.042.991.23XXX
    99142BSedation, oral/rectal/nasal+0.601.250.310.031.880.94XXX
    99170AAnogenital exam, child1.752.070.530.073.892.35000
    99172NOcular function screen0.000.000.000.000.000.00XXX
    Start Printed Page 80159
    99173NVisual acuity screen0.000.000.000.000.000.00XXX
    99175AInduction of vomiting0.001.38NA0.081.46NAXXX
    99183AHyperbaric oxygen therapy2.34NA0.750.12NA3.21XXX
    99185ARegional hypothermia0.000.64NA0.030.67NAXXX
    99186ATotal body hypothermia0.001.77NA0.372.14NAXXX
    99190XSpecial pump services0.000.000.000.000.000.00XXX
    99191XSpecial pump services0.000.000.000.000.000.00XXX
    99192XSpecial pump services0.000.000.000.000.000.00XXX
    99195APhlebotomy0.000.45NA0.020.47NAXXX
    99199CSpecial service/proc/report0.000.000.000.000.000.00XXX
    99201AOffice/outpatient visit, new0.450.480.160.020.950.63XXX
    99202AOffice/outpatient visit, new0.880.770.320.051.701.25XXX
    99203AOffice/outpatient visit, new1.341.100.490.082.521.91XXX
    99204AOffice/outpatient visit, new2.001.490.720.103.592.82XXX
    99205AOffice/outpatient visit, new2.671.790.950.124.583.74XXX
    99211AOffice/outpatient visit, est0.170.380.060.010.560.24XXX
    99212AOffice/outpatient visit, est0.450.520.160.020.990.63XXX
    99213AOffice/outpatient visit, est0.670.690.240.031.390.94XXX
    99214AOffice/outpatient visit, est1.101.030.400.042.171.54XXX
    99215AOffice/outpatient visit, est1.771.340.640.073.182.48XXX
    99217AObservation care discharge1.28NA0.440.05NA1.77XXX
    99218AObservation care1.28NA0.440.05NA1.77XXX
    99219AObservation care2.14NA0.730.08NA2.95XXX
    99220AObservation care2.99NA1.030.11NA4.13XXX
    99221AInitial hospital care1.28NA0.460.05NA1.79XXX
    99222AInitial hospital care2.14NA0.750.08NA2.97XXX
    99223AInitial hospital care2.99NA1.040.10NA4.13XXX
    99231ASubsequent hospital care0.64NA0.230.02NA0.89XXX
    99232ASubsequent hospital care1.06NA0.380.03NA1.47XXX
    99233ASubsequent hospital care1.51NA0.530.05NA2.09XXX
    99234AObserv/hosp same date2.56NA0.890.11NA3.56XXX
    99235AObserv/hosp same date3.42NA1.160.13NA4.71XXX
    99236AObserv/hosp same date4.27NA1.450.17NA5.89XXX
    99238AHospital discharge day1.28NA0.560.04NA1.88XXX
    99239AHospital discharge day1.75NA0.750.05NA2.55XXX
    99241AOffice consultation0.640.610.220.041.290.90XXX
    99242AOffice consultation1.291.020.470.092.401.85XXX
    99243AOffice consultation1.721.350.640.103.172.46XXX
    99244AOffice consultation2.581.800.940.134.513.65XXX
    99245AOffice consultation3.432.261.240.165.854.83XXX
    99251AInitial inpatient consult0.66NA0.250.04NA0.95XXX
    99252AInitial inpatient consult1.32NA0.510.08NA1.91XXX
    99253AInitial inpatient consult1.82NA0.700.09NA2.61XXX
    99254AInitial inpatient consult2.64NA1.000.11NA3.75XXX
    99255AInitial inpatient consult3.65NA1.360.15NA5.16XXX
    99261AFollow-up inpatient consult0.42NA0.160.02NA0.60XXX
    99262AFollow-up inpatient consult0.85NA0.310.03NA1.19XXX
    99263AFollow-up inpatient consult1.27NA0.460.04NA1.77XXX
    99271AConfirmatory consultation0.450.660.160.031.140.64XXX
    99272AConfirmatory consultation0.840.890.320.061.791.22XXX
    99273AConfirmatory consultation1.191.090.450.072.351.71XXX
    99274AConfirmatory consultation1.731.390.650.093.212.47XXX
    99275AConfirmatory consultation2.311.640.840.104.053.25XXX
    99281AEmergency dept visit0.33NA0.090.02NA0.44XXX
    99282AEmergency dept visit0.55NA0.150.03NA0.73XXX
    99283AEmergency dept visit1.24NA0.320.08NA1.64XXX
    99284AEmergency dept visit1.95NA0.490.12NA2.56XXX
    99285AEmergency dept visit3.06NA0.740.19NA3.99XXX
    99288BDirect advanced life support0.000.000.000.000.000.00XXX
    99289APed crit care transport4.80NA1.870.14NA6.81XXX
    99290APed crit care transport addl2.40NA0.940.07NA3.41ZZZ
    99291ACritical care, first hour4.001.571.300.145.715.44XXX
    99292ACritical care, addl 30 min2.000.860.650.072.932.72ZZZ
    99293APed critical care, initial16.00NA5.130.70NA21.83XXX
    99294APed critical care, subseq8.00NA2.570.23NA10.80XXX
    99295ANeonate crit care, initial18.49NA5.480.70NA24.67XXX
    99296ANeonate critical care subseq8.00NA2.610.23NA10.84XXX
    99297DNeonatal critical care0.000.000.000.000.000.00XXX
    99298AIc for lbw infant < 1500 gm2.75NA0.960.10NA3.81XXX
    99299AIc, lbw infant 1500-2500 gm2.50NA0.980.10NA3.58XXX
    99301ANursing facility care1.200.690.420.041.931.66XXX
    99302ANursing facility care1.610.970.550.052.632.21XXX
    99303ANursing facility care2.011.190.680.063.262.75XXX
    99311ANursing fac care, subseq0.600.490.210.021.110.83XXX
    99312ANursing fac care, subseq1.000.670.340.031.701.37XXX
    Start Printed Page 80160
    99313ANursing fac care, subseq1.420.870.490.042.331.95XXX
    99315ANursing fac discharge day1.130.730.380.041.901.55XXX
    99316ANursing fac discharge day1.500.930.520.052.482.07XXX
    99321ARest home visit, new patient0.710.45NA0.021.18NAXXX
    99322ARest home visit, new patient1.010.70NA0.031.74NAXXX
    99323ARest home visit, new patient1.280.92NA0.042.24NAXXX
    99331ARest home visit, est pat0.600.47NA0.021.09NAXXX
    99332ARest home visit, est pat0.800.58NA0.031.41NAXXX
    99333ARest home visit, est pat1.000.71NA0.031.74NAXXX
    99341AHome visit, new patient1.010.55NA0.051.61NAXXX
    99342AHome visit, new patient1.520.85NA0.052.42NAXXX
    99343AHome visit, new patient2.271.26NA0.073.60NAXXX
    99344AHome visit, new patient3.031.55NA0.104.68NAXXX
    99345AHome visit, new patient3.791.81NA0.125.72NAXXX
    99347AHome visit, est patient0.760.48NA0.031.27NAXXX
    99348AHome visit, est patient1.260.72NA0.042.02NAXXX
    99349AHome visit, est patient2.021.05NA0.063.13NAXXX
    99350AHome visit, est patient3.031.43NA0.104.56NAXXX
    99354AProlonged service, office1.771.460.610.063.292.44ZZZ
    99355AProlonged service, office1.771.240.590.063.072.42ZZZ
    99356AProlonged service, inpatient1.71NA0.600.06NA2.37ZZZ
    99357AProlonged service, inpatient1.71NA0.610.06NA2.38ZZZ
    99358BProlonged serv, w/o contact0.000.000.000.000.000.00ZZZ
    99359BProlonged serv, w/o contact0.000.000.000.000.000.00ZZZ
    99360XPhysician standby services0.000.000.000.000.000.00XXX
    99361BPhysician/team conference0.000.000.000.000.000.00XXX
    99362BPhysician/team conference0.000.000.000.000.000.00XXX
    99371BPhysician phone consultation0.000.000.000.000.000.00XXX
    99372BPhysician phone consultation0.000.000.000.000.000.00XXX
    99373BPhysician phone consultation0.000.000.000.000.000.00XXX
    99374BHome health care supervision+1.101.490.430.042.631.57XXX
    99375IHome health care supervision+1.731.571.570.063.363.36XXX
    99377BHospice care supervision+1.101.490.430.042.631.57XXX
    99378IHospice care supervision+1.731.971.970.063.763.76XXX
    99379BNursing fac care supervision+1.101.490.430.032.621.56XXX
    99380BNursing fac care supervision+1.731.740.680.053.522.46XXX
    99381NPrev visit, new, infant+1.191.520.460.042.751.69XXX
    99382NPrev visit, new, age 1-4+1.361.560.530.042.961.93XXX
    99383NPrev visit, new, age 5-11+1.361.500.530.042.901.93XXX
    99384NPrev visit, new, age 12-17+1.531.570.600.053.152.18XXX
    99385NPrev visit, new, age 18-39+1.531.570.600.053.152.18XXX
    99386NPrev visit, new, age 40-64+1.881.760.730.063.702.67XXX
    99387NPrev visit, new, 65 & over+2.061.890.800.064.012.92XXX
    99391NPrev visit, est, infant+1.021.030.400.032.081.45XXX
    99392NPrev visit, est, age 1-4+1.191.100.460.042.331.69XXX
    99393NPrev visit, est, age 5-11+1.191.070.460.042.301.69XXX
    99394NPrev visit, est, age 12-17+1.361.150.530.042.551.93XXX
    99395NPrev visit, est, age 18-39+1.361.180.530.042.581.93XXX
    99396NPrev visit, est, age 40-64+1.531.270.600.052.852.18XXX
    99397NPrev visit, est, 65 & over+1.711.380.670.053.142.43XXX
    99401NPreventive counseling, indiv+0.480.630.190.011.120.68XXX
    99402NPreventive counseling, indiv+0.980.880.380.021.881.38XXX
    99403NPreventive counseling, indiv+1.461.100.570.032.592.06XXX
    99404NPreventive counseling, indiv+1.951.340.760.043.332.75XXX
    99411NPreventive counseling, group+0.150.180.060.010.340.22XXX
    99412NPreventive counseling, group+0.250.250.100.010.510.36XXX
    99420NHealth risk assessment test0.000.000.000.000.000.00XXX
    99429NUnlisted preventive service0.000.000.000.000.000.00XXX
    99431AInitial care, normal newborn1.17NA0.390.04NA1.60XXX
    99432ANewborn care, not in hosp1.260.840.410.062.161.73XXX
    99433ANormal newborn care/hospital0.62NA0.200.02NA0.84XXX
    99435ANewborn discharge day hosp1.50NA0.510.05NA2.06XXX
    99436AAttendance, birth1.500.490.480.052.042.03XXX
    99440ANewborn resuscitation2.93NA0.950.11NA3.99XXX
    99450NLife/disability evaluation0.000.000.000.000.000.00XXX
    99455RDisability examination0.000.000.000.000.000.00XXX
    99456RDisability examination0.000.000.000.000.000.00XXX
    99499CUnlisted e&m service0.000.000.000.000.000.00XXX
    99500IHome visit, prenatal0.000.000.000.000.000.00XXX
    99501IHome visit, postnatal0.000.000.000.000.000.00XXX
    99502IHome visit, nb care0.000.000.000.000.000.00XXX
    99503IHome visit, resp therapy0.000.000.000.000.000.00XXX
    99504IHome visit mech ventilator0.000.000.000.000.000.00XXX
    99505IHome visit, stoma care0.000.000.000.000.000.00XXX
    99506IHome visit, im injection0.000.000.000.000.000.00XXX
    Start Printed Page 80161
    99507IHome visit, cath maintain0.000.000.000.000.000.00XXX
    99508FHome visit, sleep studies0.000.000.000.000.000.00XXX
    99509IHome visit day life activity0.000.000.000.000.000.00XXX
    99510IHome visit, sing/m/fam couns0.000.000.000.000.000.00XXX
    99511IHome visit, fecal/enema mgmt0.000.000.000.000.000.00XXX
    99512IHome visit, hemodialysis0.000.000.000.000.000.00XXX
    99539FHome visit, nos0.000.000.000.000.000.00XXX
    99551IHome infus, pain mgmt, iv/sc0.000.000.000.000.000.00XXX
    99552IHm infus pain mgmt, epid/ith0.000.000.000.000.000.00XXX
    99553IHome infuse, tocolytic tx0.000.000.000.000.000.00XXX
    99554IHome infus, hormone/platelet0.000.000.000.000.000.00XXX
    99555IHome infuse, chemotheraphy0.000.000.000.000.000.00XXX
    99556IHome infus, antibio/fung/vir0.000.000.000.000.000.00XXX
    99557IHome infuse, anticoagulant0.000.000.000.000.000.00XXX
    99558IHome infuse, immunotherapy0.000.000.000.000.000.00XXX
    99559IHome infus, periton dialysis0.000.000.000.000.000.00XXX
    99560IHome infus, entero nutrition0.000.000.000.000.000.00XXX
    99561IHome infuse, hydration tx0.000.000.000.000.000.00XXX
    99562IHome infus, parent nutrition0.000.000.000.000.000.00XXX
    99563IHome admin, pentamidine0.000.000.000.000.000.00XXX
    99564IHme infus, antihemophil agnt0.000.000.000.000.000.00XXX
    99565IHome infus, proteinase inhib0.000.000.000.000.000.00XXX
    99566IHome infuse, iv therapy0.000.000.000.000.000.00XXX
    99567IHome infuse, sympath agent0.000.000.000.000.000.00XXX
    99568IHome infus, misc drug, daily0.000.000.000.000.000.00XXX
    99569IHome infuse, each addl tx0.000.000.000.000.000.00XXX
    99600IHome visit nos0.000.000.000.000.000.00XXX
    A4890RRepair/maint cont hemo equip0.000.000.000.000.000.00XXX
    D0150RComprehensve oral evaluation0.000.000.000.000.000.00YYY
    D0240RIntraoral occlusal film0.000.000.000.000.000.00YYY
    D0250RExtraoral first film0.000.000.000.000.000.00YYY
    D0260RExtraoral ea additional film0.000.000.000.000.000.00YYY
    D0270RDental bitewing single film0.000.000.000.000.000.00YYY
    D0272RDental bitewings two films0.000.000.000.000.000.00YYY
    D0274RDental bitewings four films0.000.000.000.000.000.00YYY
    D0277RVert bitewings-sev to eight0.000.000.000.000.000.00XXX
    D0460RPulp vitality test0.000.000.000.000.000.00YYY
    D0472RGross exam, prep & report0.000.000.000.000.000.00XXX
    D0473RMicro exam, prep & report0.000.000.000.000.000.00XXX
    D0474RMicro w exam of surg margins0.000.000.000.000.000.00XXX
    D0480RCytopath smear prep & report0.000.000.000.000.000.00XXX
    D0502ROther oral pathology procedu0.000.000.000.000.000.00YYY
    D0999RUnspecified diagnostic proce0.000.000.000.000.000.00YYY
    D1510RSpace maintainer fxd unilat0.000.000.000.000.000.00YYY
    D1515RFixed bilat space maintainer0.000.000.000.000.000.00YYY
    D1520RRemove unilat space maintain0.000.000.000.000.000.00YYY
    D1525RRemove bilat space maintain0.000.000.000.000.000.00YYY
    D1550RRecement space maintainer0.000.000.000.000.000.00YYY
    D2970RTemporary- fractured tooth0.000.000.000.000.000.00YYY
    D2999RDental unspec restorative pr0.000.000.000.000.000.00YYY
    D3460REndodontic endosseous implan0.000.000.000.000.000.00YYY
    D3999REndodontic procedure0.000.000.000.000.000.00YYY
    D4260ROsseous surgery per quadrant0.000.000.000.000.000.00YYY
    D4263RBone replce graft first site0.000.000.000.000.000.00YYY
    D4264RBone replce graft each add0.000.000.000.000.000.00YYY
    D4268RSurgical revision procedure0.000.000.000.000.000.00XXX
    D4270RPedicle soft tissue graft pr0.000.000.000.000.000.00YYY
    D4271RFree soft tissue graft proc0.000.000.000.000.000.00YYY
    D4273RSubepithelial tissue graft0.000.000.000.000.000.00YYY
    D4355RFull mouth debridement0.000.000.000.000.000.00YYY
    D4381RLocalized chemo delivery0.000.000.000.000.000.00YYY
    D5911RFacial moulage sectional0.000.000.000.000.000.00YYY
    D5912RFacial moulage complete0.000.000.000.000.000.00YYY
    D5951RFeeding aid0.000.000.000.000.000.00YYY
    D5983RRadiation applicator0.000.000.000.000.000.00YYY
    D5984RRadiation shield0.000.000.000.000.000.00YYY
    D5985RRadiation cone locator0.000.000.000.000.000.00YYY
    D5987RCommissure splint0.000.000.000.000.000.00YYY
    D6920RDental connector bar0.000.000.000.000.000.00YYY
    D7111RCoronal remnants deciduous t0.000.000.000.000.000.00XXX
    D7140RExtraction erupted tooth/exr0.000.000.000.000.000.00XXX
    D7210RRem imp tooth w mucoper flp0.000.000.000.000.000.00YYY
    D7220RImpact tooth remov soft tiss0.000.000.000.000.000.00YYY
    D7230RImpact tooth remov part bony0.000.000.000.000.000.00YYY
    D7240RImpact tooth remov comp bony0.000.000.000.000.000.00YYY
    Start Printed Page 80162
    D7241RImpact tooth rem bony w/comp0.000.000.000.000.000.00YYY
    D7250RTooth root removal0.000.000.000.000.000.00YYY
    D7260ROral antral fistula closure0.000.000.000.000.000.00YYY
    D7261RPrimary closure sinus perf0.000.000.000.000.000.00XXX
    D7291RTransseptal fiberotomy0.000.000.000.000.000.00YYY
    D7940RReshaping bone orthognathic0.000.000.000.000.000.00YYY
    D9110RTx dental pain minor proc0.000.000.000.000.000.00YYY
    D9230RAnalgesia0.000.000.000.000.000.00YYY
    D9248RSedation (non-iv)0.000.000.000.000.000.00XXX
    D9630ROther drugs/medicaments0.000.000.000.000.000.00YYY
    D9930RTreatment of complications0.000.000.000.000.000.00YYY
    D9940RDental occlusal guard0.000.000.000.000.000.00YYY
    D9950ROcclusion analysis0.000.000.000.000.000.00YYY
    D9951RLimited occlusal adjustment0.000.000.000.000.000.00YYY
    D9952RComplete occlusal adjustment0.000.000.000.000.000.00YYY
    G0001XDrawing blood for specimen0.000.000.000.000.000.00XXX
    G0002DTemporary urinary catheter0.000.000.000.000.000.00000
    G0004DECG transm phys review & int0.000.000.000.000.000.00XXX
    G0005DECG 24 hour recording0.000.000.000.000.000.00XXX
    G0006DECG transmission & analysis0.000.000.000.000.000.00XXX
    G0007DECG phy review & interpret0.000.000.000.000.000.00XXX
    G0008XAdmin influenza virus vac0.000.00NA0.000.00NAXXX
    G0009XAdmin pneumococcal vaccine0.000.00NA0.000.00NAXXX
    G0010XAdmin hepatitis b vaccine0.000.00NA0.000.00NAXXX
    G0015DPost symptom ECG tracing0.000.000.000.000.000.00XXX
    G0025BCollagen skin test kit0.000.000.000.000.000.00XXX
    G0026DFecal leukocyte examination0.000.000.000.000.000.00XXX
    G0027DSemen analysis0.000.000.000.000.000.00XXX
    G0030CPET imaging prev PET single0.000.000.000.000.000.00XXX
    G003026APET imaging prev PET single1.500.520.520.042.062.06XXX
    G0030TCCPET imaging prev PET single0.000.000.000.000.000.00XXX
    G0031CPET imaging prev PET multple0.000.000.000.000.000.00XXX
    G003126APET imaging prev PET multple1.870.700.700.062.632.63XXX
    G0031TCCPET imaging prev PET multple0.000.000.000.000.000.00XXX
    G0032CPET follow SPECT 78464 singl0.000.000.000.000.000.00XXX
    G003226APET follow SPECT 78464 singl1.500.520.520.052.072.07XXX
    G0032TCCPET follow SPECT 78464 singl0.000.000.000.000.000.00XXX
    G0033CPET follow SPECT 78464 mult0.000.000.000.000.000.00XXX
    G003326APET follow SPECT 78464 mult1.870.700.700.062.632.63XXX
    G0033TCCPET follow SPECT 78464 mult0.000.000.000.000.000.00XXX
    G0034CPET follow SPECT 76865 singl0.000.000.000.000.000.00XXX
    G003426APET follow SPECT 76865 singl1.500.520.520.052.072.07XXX
    G0034TCCPET follow SPECT 76865 singl0.000.000.000.000.000.00XXX
    G0035CPET follow SPECT 78465 mult0.000.000.000.000.000.00XXX
    G003526APET follow SPECT 78465 mult1.870.700.700.062.632.63XXX
    G0035TCCPET follow SPECT 78465 mult0.000.000.000.000.000.00XXX
    G0036CPET follow cornry angio sing0.000.000.000.000.000.00XXX
    G003626APET follow cornry angio sing1.500.520.520.042.062.06XXX
    G0036TCCPET follow cornry angio sing0.000.000.000.000.000.00XXX
    G0037CPET follow cornry angio mult0.000.000.000.000.000.00XXX
    G003726APET follow cornry angio mult1.870.700.700.062.632.63XXX
    G0037TCCPET follow cornry angio mult0.000.000.000.000.000.00XXX
    G0038CPET follow myocard perf sing0.000.000.000.000.000.00XXX
    G003826APET follow myocard perf sing1.500.520.520.042.062.06XXX
    G0038TCCPET follow myocard perf sing0.000.000.000.000.000.00XXX
    G0039CPET follow myocard perf mult0.000.000.000.000.000.00XXX
    G003926APET follow myocard perf mult1.870.700.700.072.642.64XXX
    G0039TCCPET follow myocard perf mult0.000.000.000.000.000.00XXX
    G0040CPET follow stress echo singl0.000.000.000.000.000.00XXX
    G004026APET follow stress echo singl1.500.520.520.042.062.06XXX
    G0040TCCPET follow stress echo singl0.000.000.000.000.000.00XXX
    G0041CPET follow stress echo mult0.000.000.000.000.000.00XXX
    G004126APET follow stress echo mult1.870.700.700.052.622.62XXX
    G0041TCCPET follow stress echo mult0.000.000.000.000.000.00XXX
    G0042CPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G004226APET follow ventriculogm sing1.500.520.520.042.062.06XXX
    G0042TCCPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G0043CPET follow ventriculogm mult0.000.000.000.000.000.00XXX
    G004326APET follow ventriculogm mult1.870.700.700.062.632.63XXX
    G0043TCCPET follow ventriculogm mult0.000.000.000.000.000.00XXX
    G0044CPET following rest ECG singl0.000.000.000.000.000.00XXX
    G004426APET following rest ECG singl1.500.520.520.042.062.06XXX
    G0044TCCPET following rest ECG singl0.000.000.000.000.000.00XXX
    G0045CPET following rest ECG mult0.000.000.000.000.000.00XXX
    G004526APET following rest ECG mult1.870.700.700.062.632.63XXX
    Start Printed Page 80163
    G0045TCCPET following rest ECG mult0.000.000.000.000.000.00XXX
    G0046CPET follow stress ECG singl0.000.000.000.000.000.00XXX
    G004626APET follow stress ECG singl1.500.520.520.042.062.06XXX
    G0046TCCPET follow stress ECG singl0.000.000.000.000.000.00XXX
    G0047CPET follow stress ECG mult0.000.000.000.000.000.00XXX
    G004726APET follow stress ECG mult1.870.700.700.062.632.63XXX
    G0047TCCPET follow stress ECG mult0.000.000.000.000.000.00XXX
    G0050DResidual urine by ultrasound0.000.000.000.000.000.00XXX
    G0101ACA screen;pelvic/breast exam0.450.510.170.010.970.63XXX
    G0102AProstate ca screening; dre0.170.380.060.010.560.24XXX
    G0103XPsa, total screening0.000.000.000.000.000.00XXX
    G0104ACA screen;flexi sigmoidscope0.961.820.520.052.831.53000
    G0105AColorectal scrn; hi risk ind3.708.031.720.2011.935.62000
    G0106AColon CA screen;barium enema0.992.56NA0.153.70NAXXX
    G010626AColon CA screen;barium enema0.990.340.340.041.371.37XXX
    G0106TCAColon CA screen;barium enema0.002.22NA0.112.33NAXXX
    G0107XCA screen; fecal blood test0.000.000.000.000.000.00XXX
    G0108ADiab manage trn per indiv0.000.82NA0.010.83NAXXX
    G0109ADiab manage trn ind/group0.000.48NA0.010.49NAXXX
    G0110RNett pulm-rehab educ; ind0.900.710.300.031.641.23XXX
    G0111RNett pulm-rehab educ; group0.270.290.140.010.570.42XXX
    G0112RNett;nutrition guid, initial1.721.220.670.052.992.44XXX
    G0113RNett;nutrition guid,subseqnt1.290.840.420.042.171.75XXX
    G0114RNett; psychosocial consult1.200.500.380.031.731.61XXX
    G0115RNett; psychological testing1.200.650.380.041.891.62XXX
    G0116RNett; psychosocial counsel1.111.020.340.042.171.49XXX
    G0117TGlaucoma scrn hgh risk direc0.450.940.210.021.410.68XXX
    G0118TGlaucoma scrn hgh risk direc0.170.810.080.010.990.26XXX
    G0120AColon ca scrn; barium enema0.992.56NA0.153.70NAXXX
    G012026AColon ca scrn; barium enema0.990.340.340.041.371.37XXX
    G0120TCAColon ca scrn; barium enema0.002.22NA0.112.33NAXXX
    G0121AColon ca scrn not hi rsk ind3.708.031.720.2011.935.62000
    G0122NColon ca scrn; barium enema+0.992.61NA0.153.75NAXXX
    G012226NColon ca scrn; barium enema+0.990.390.390.041.421.42XXX
    G0122TCNColon ca scrn; barium enema+0.002.22NA0.112.33NAXXX
    G0123XScreen cerv/vag thin layer0.000.000.000.000.000.00XXX
    G0124AScreen c/v thin layer by MD0.420.990.990.011.421.42XXX
    G0125APET image pulmonary nodule1.5055.83NA2.0059.33NAXXX
    G012526APET image pulmonary nodule1.500.520.520.052.072.07XXX
    G0125TCAPET image pulmonary nodule0.0055.31NA1.9557.26NAXXX
    G0127RTrim nail(s)0.170.260.070.010.440.25000
    G0128RCORF skilled nursing service0.080.030.030.010.120.12XXX
    G0130ASingle energy x-ray study0.220.90NA0.051.17NAXXX
    G013026ASingle energy x-ray study0.220.110.110.010.340.34XXX
    G0130TCASingle energy x-ray study0.000.79NA0.040.83NAXXX
    G0131DCT scan, bone density study0.000.000.000.000.000.00XXX
    G013126DCT scan, bone density study0.000.000.000.000.000.00XXX
    G0131TCDCT scan, bone density study0.000.000.000.000.000.00XXX
    G0132DCT scan, bone density study0.000.000.000.000.000.00XXX
    G013226DCT scan, bone density study0.000.000.000.000.000.00XXX
    G0132TCDCT scan, bone density study0.000.000.000.000.000.00XXX
    G0141AScr c/v cyto,autosys and md0.420.990.990.011.421.42XXX
    G0143XScr c/v cyto,thinlayer,rescr0.000.000.000.000.000.00XXX
    G0144XScr c/v cyto,thinlayer,rescr0.000.000.000.000.000.00XXX
    G0145XScr c/v cyto,thinlayer,rescr0.000.000.000.000.000.00XXX
    G0147XScr c/v cyto, automated sys0.000.000.000.000.000.00XXX
    G0148XScr c/v cyto, autosys, rescr0.000.000.000.000.000.00XXX
    G0166AExtrnl counterpulse, per tx0.075.570.030.015.650.11XXX
    G0167CHyperbaric oz tx;no md reqrd0.000.000.000.000.000.00XXX
    G0168AWound closure by adhesive0.452.240.180.012.700.64000
    G0173XStereo radoisurgery,complete0.000.000.000.000.000.00XXX
    G0175XOPPS Service,sched team conf0.000.000.000.000.000.00XXX
    G0176XOPPS/PHP;activity therapy0.000.000.000.000.000.00XXX
    G0177XOPPS/PHP; train & educ serv0.000.000.000.000.000.00XXX
    G0179AMD recertification HHA PT0.451.09NA0.011.55NAXXX
    G0180AMD certification HHA patient0.671.31NA0.022.00NAXXX
    G0181AHome health care supervision1.731.56NA0.063.35NAXXX
    G0182AHospice care supervision1.731.75NA0.063.54NAXXX
    G0185DTranspuppillary thermotx0.000.000.000.000.000.00YYY
    G0186CDstry eye lesn,fdr vssl tech0.000.000.000.000.000.00YYY
    G0187DDstry mclr drusen,photocoag0.000.000.000.000.000.00YYY
    G0192FImmunization oral/intranasal0.000.000.000.000.000.00XXX
    G0193DEndoscopicstudyswallowfunctn0.000.000.000.000.000.00XXX
    G0194DSensorytestingendoscopicstud0.000.000.000.000.000.00XXX
    G0195DClinicalevalswallowingfunct0.000.000.000.000.000.00XXX
    Start Printed Page 80164
    G0196DEvalofswallowingwithradioopa0.000.000.000.000.000.00XXX
    G0197DEvalofptforprescipspeechdevi0.000.000.000.000.000.00XXX
    G0198DPatientadapation&trainforspe0.000.000.000.000.000.00XXX
    G0199DReevaluationofpatientusespec0.000.000.000.000.000.00XXX
    G0200DEvalofpatientprescipofvoicep0.000.000.000.000.000.00XXX
    G0201DModifortraininginusevoicepro0.000.000.000.000.000.00XXX
    G0202AScreeningmammographydigital0.702.80NA0.093.59NAXXX
    G020226AScreeningmammographydigital0.700.270.270.031.001.00XXX
    G0202TCAScreeningmammographydigital0.002.53NA0.062.59NAXXX
    G0204ADiagnosticmammographydigital0.872.84NA0.103.81NAXXX
    G020426ADiagnosticmammographydigital0.870.340.340.041.251.25XXX
    G0204TCADiagnosticmammographydigital0.002.50NA0.062.56NAXXX
    G0206ADiagnosticmammographydigital0.702.28NA0.093.07NAXXX
    G020626ADiagnosticmammographydigital0.700.270.270.041.011.01XXX
    G0206TCADiagnosticmammographydigital0.002.01NA0.052.06NAXXX
    G0210CPET img wholebody dxlung0.000.000.000.000.000.00XXX
    G021026APET img wholebody dxlung1.500.590.590.042.132.13XXX
    G0210TCCPET img wholebody dxlung0.000.000.000.000.000.00XXX
    G0211CPET img wholbody init lung0.000.000.000.000.000.00XXX
    G021126APET img wholbody init lung1.500.590.590.042.132.13XXX
    G0211TCCPET img wholbody init lung0.000.000.000.000.000.00XXX
    G0212CPET img wholebod restag lung0.000.000.000.000.000.00XXX
    G021226APET img wholebod restag lung1.500.590.590.042.132.13XXX
    G0212TCCPET img wholebod restag lung0.000.000.000.000.000.00XXX
    G0213CPET img wholbody dx0.000.000.000.000.000.00XXX
    G021326APET img wholbody dx1.500.590.590.042.132.13XXX
    G0213TCCPET img wholbody dx0.000.000.000.000.000.00XXX
    G0214CPET img wholebod init0.000.000.000.000.000.00XXX
    G021426APET img wholebod init1.500.590.590.042.132.13XXX
    G0214TCCPET img wholebod init0.000.000.000.000.000.00XXX
    G0215CPETimg wholebod restag0.000.000.000.000.000.00XXX
    G021526APETimg wholebod restag1.500.590.590.042.132.13XXX
    G0215TCCPETimg wholebod restag0.000.000.000.000.000.00XXX
    G0216CPET img wholebod dx melanoma0.000.000.000.000.000.00XXX
    G021626APET img wholebod dx melanoma1.500.590.590.042.132.13XXX
    G0216TCCPET img wholebod dx melanoma0.000.000.000.000.000.00XXX
    G0217CPET img wholebod init melan0.000.000.000.000.000.00XXX
    G021726APET img wholebod init melan1.500.590.590.042.132.13XXX
    G0217TCCPET img wholebod init melan0.000.000.000.000.000.00XXX
    G0218CPET img wholebod restag mela0.000.000.000.000.000.00XXX
    G021826APET img wholebod restag mela1.500.590.590.042.132.13XXX
    G0218TCCPET img wholebod restag mela0.000.000.000.000.000.00XXX
    G0219NPET img wholbod melano nonco+1.500.590.590.042.132.13XXX
    G021926NPET img wholbod melano nonco+1.500.590.590.042.132.13XXX
    G0219TCNPET img wholbod melano nonco0.000.000.000.000.000.00XXX
    G0220CPET img wholebod dx lymphoma0.000.000.000.000.000.00XXX
    G022026APET img wholebod dx lymphoma1.500.590.590.042.132.13XXX
    G0220TCCPET img wholebod dx lymphoma0.000.000.000.000.000.00XXX
    G0221CPET imag wholbod init lympho0.000.000.000.000.000.00XXX
    G022126APET imag wholbod init lympho1.500.590.590.042.132.13XXX
    G0221TCCPET imag wholbod init lympho0.000.000.000.000.000.00XXX
    G0222CPET imag wholbod resta lymph0.000.000.000.000.000.00XXX
    G022226APET imag wholbod resta lymph1.500.590.590.042.132.13XXX
    G0222TCCPET imag wholbod resta lymph0.000.000.000.000.000.00XXX
    G0223CPET imag wholbod reg dx head0.000.000.000.000.000.00XXX
    G022326APET imag wholbod reg dx head1.500.590.590.042.132.13XXX
    G0223TCCPET imag wholbod reg dx head0.000.000.000.000.000.00XXX
    G0224CPET imag wholbod reg ini hea0.000.000.000.000.000.00XXX
    G022426APET imag wholbod reg ini hea1.500.590.590.042.132.13XXX
    G0224TCCPET imag wholbod reg ini hea0.000.000.000.000.000.00XXX
    G0225CPET whol restag headneckonly0.000.000.000.000.000.00XXX
    G022526APET whol restag headneckonly1.500.590.590.042.132.13XXX
    G0225TCCPET whol restag headneckonly0.000.000.000.000.000.00XXX
    G0226CPET img wholbody dx esophagl0.000.000.000.000.000.00XXX
    G022626APET img wholbody dx esophagl1.500.590.590.042.132.13XXX
    G0226TCCPET img wholbody dx esophagl0.000.000.000.000.000.00XXX
    G0227CPET img wholbod ini esophage0.000.000.000.000.000.00XXX
    G022726APET img wholbod ini esophage1.500.590.590.042.132.13XXX
    G0227TCCPET img wholbod ini esophage0.000.000.000.000.000.00XXX
    G0228CPET img wholbod restg esopha0.000.000.000.000.000.00XXX
    G022826APET img wholbod restg esopha1.500.590.590.042.132.13XXX
    G0228TCCPET img wholbod restg esopha0.000.000.000.000.000.00XXX
    G0229CPET img metaboloc brain pres0.000.000.000.000.000.00XXX
    G022926APET img metaboloc brain pres1.500.590.590.042.132.13XXX
    G0229TCCPET img metaboloc brain pres0.000.000.000.000.000.00XXX
    Start Printed Page 80165
    G0230CPET myocard viability post0.000.000.000.000.000.00XXX
    G023026APET myocard viability post1.500.590.590.042.132.13XXX
    G0230TCCPET myocard viability post0.000.000.000.000.000.00XXX
    G0231CPET WhBD colorec; gamma cam0.000.000.000.000.000.00XXX
    G023126APET WhBD colorec; gamma cam1.500.590.590.042.132.13XXX
    G0231TCCPET WhBD colorec; gamma cam0.000.000.000.000.000.00XXX
    G0232CPET whbd lymphoma; gamma cam0.000.000.000.000.000.00XXX
    G023226APET whbd lymphoma; gamma cam1.500.590.590.042.132.13XXX
    G0232TCCPET whbd lymphoma; gamma cam0.000.000.000.000.000.00XXX
    G0233CPET whbd melanoma; gamma cam0.000.000.000.000.000.00XXX
    G023326APET whbd melanoma; gamma cam1.500.590.590.042.132.13XXX
    G0233TCCPET whbd melanoma; gamma cam0.000.000.000.000.000.00XXX
    G0234CPET WhBD pulm nod; gamma cam0.000.000.000.000.000.00XXX
    G023426APET WhBD pulm nod; gamma cam1.500.590.590.042.132.13XXX
    G0234TCCPET WhBD pulm nod; gamma cam0.000.000.000.000.000.00XXX
    G0236ADigital film convert diag ma0.060.44NA0.020.52NAZZZ
    G023626ADigital film convert diag ma0.060.020.020.010.090.09ZZZ
    G0236TCADigital film convert diag ma0.000.42NA0.010.43NAZZZ
    G0237ATherapeutic procd strg endur0.000.47NA0.020.49NAXXX
    G0238COth resp proc, indiv0.000.000.000.000.000.00XXX
    G0239COth resp proc, group0.000.000.000.000.000.00XXX
    G0240DCritic care by MD transport0.000.000.000.000.000.00XXX
    G0241DEach additional 30 minutes0.000.000.000.000.000.00ZZZ
    G0242XMultisource photon ster plan0.000.000.000.000.000.00XXX
    G0243XMultisour photon stero treat0.000.000.000.000.000.00XXX
    G0244EObserv care by facility topt0.000.000.000.000.000.00XXX
    G0245RInitial foot exam pt lops0.880.770.320.051.701.25XXX
    G0246RFollowup eval of foot pt lop0.450.520.160.020.990.63XXX
    G0247RRoutine footcare pt w lops0.500.520.210.051.070.76ZZZ
    G0248RDemonstrate use home inr mon0.004.30NA0.014.31NAXXX
    G0249RProvide test material,equipm0.003.35NA0.013.36NAXXX
    G0250RMD review interpret of test0.180.070.070.010.260.26XXX
    G0251ELinear acc based stero radio0.000.000.000.000.000.00XXX
    G0252NPET imaging initial dx0.000.000.000.000.000.00XXX
    G025226NPET imaging initial dx+1.500.600.600.042.142.14XXX
    G0252TCNPET imaging initial dx0.000.000.000.000.000.00XXX
    G0253CPET image brst dection recur0.000.000.000.000.000.00XXX
    G025326APET image brst dection recur1.870.730.730.072.672.67XXX
    G0253TCCPET image brst dection recur0.000.000.000.000.000.00XXX
    G0254CPET image brst eval to tx0.000.000.000.000.000.00XXX
    G025426APET image brst eval to tx1.870.730.730.072.672.67XXX
    G0254TCCPET image brst eval to tx0.000.000.000.000.000.00XXX
    G0255NCurrent percep threshold tst+1.500.590.590.042.132.13XXX
    G025526NCurrent percep threshold tst+1.500.590.590.042.132.13XXX
    G0255TCNCurrent percep threshold tst0.000.000.000.000.000.00XXX
    G0256EProstate brachy w palladium0.000.000.000.000.000.00XXX
    G0257EUnsched dialysis ESRD pt hos0.000.000.000.000.000.00XXX
    G0258EIV infusion during obs stay0.000.000.000.000.000.00XXX
    G0259EInject for sacroiliac joint0.000.000.000.000.000.00XXX
    G0260EInj for sacroiliac jt anesth0.000.000.000.000.000.00XXX
    G0261EProstate brachy w iodine see0.000.000.000.000.000.00XXX
    G0262ASm intestinal image capsule2.1218.67NA0.0820.87NAXXX
    G026226ASm intestinal image capsule2.120.830.830.022.972.97XXX
    G0262TCASm intestinal image capsule0.0017.84NA0.0617.90NAXXX
    G0263EAdm with CHF, CP, asthma0.000.000.000.000.000.00XXX
    G0264EAssmt otr CHF, CP, asthma0.000.000.000.000.000.00XXX
    G0265XCryopresevation Freeze+stora0.000.000.000.000.000.00XXX
    G0266XThawing + expansion froz cel0.000.000.000.000.000.00XXX
    G0267XBone marrow or psc harvest0.000.000.000.000.000.00XXX
    G0268ARemoval of impacted wax md0.610.570.240.041.220.89000
    G0269BOcclusive device in vein art0.000.000.000.000.000.00XXX
    G0270AMNT subs tx for change dx0.000.47NA0.010.48NAXXX
    G0271AGroup MNT 2 or more 30 mins0.000.18NA0.010.19NAXXX
    G0272ANaso/oro gastric tube pl MD0.320.13NA0.020.47NA000
    G0273APretx planning, non-Hodgkins0.8611.36NA0.2812.50NAXXX
    G027326APretx planning, non-Hodgkins0.860.340.340.031.231.23XXX
    G0273TCAPretx planning, non-Hodgkins0.0011.02NA0.2511.27NAXXX
    G0274ARadiopharm tx, non-Hodgkins2.073.42NA0.205.69NAXXX
    G027426ARadiopharm tx, non-Hodgkins2.070.810.810.082.962.96XXX
    G0274TCARadiopharm tx, non-Hodgkins0.002.61NA0.122.73NAXXX
    G0275ARenal angio, cardiac cath0.250.10NA0.010.36NAZZZ
    G0278AIliac art angio,cardiac cath0.250.10NA0.010.36NAZZZ
    G0279AExcorp shock tx, elbow epi0.061.46NA0.011.53NAXXX
    G0280AExcorp shock tx other than0.061.46NA0.011.53NAXXX
    G0281AElec stim unattend for press0.180.350.070.010.540.26XXX
    Start Printed Page 80166
    G0282NElect stim wound care not pd0.000.000.000.000.000.00XXX
    G0283AElec stim other than wound0.180.350.070.010.540.26XXX
    G0288ARecon, CTA for surg plan0.0010.57NA0.1510.72NAXXX
    G0289AArthro, loose body + chondro1.480.58NA0.272.33NAZZZ
    G0290EDrug-eluting stents, single0.000.000.000.000.000.00XXX
    G0291EDrug-eluting stents,each add0.000.000.000.000.000.00XXX
    G0292EAdm exp drugs,clinical trial0.000.000.000.000.000.00XXX
    G0293ENon-cov surg proc,clin trial0.000.000.000.000.000.00XXX
    G0294ENon-cov proc, clinical trial0.000.000.000.000.000.00XXX
    G0295NElectromagnetic therapy onc0.000.000.000.000.000.00XXX
    G9001XMCCD, initial rate0.000.000.000.000.000.00XXX
    G9002XMCCD,maintenance rate0.000.000.000.000.000.00XXX
    G9003XMCCD, risk adj hi, initial0.000.000.000.000.000.00XXX
    G9004XMCCD, risk adj lo, initial0.000.000.000.000.000.00XXX
    G9005XMCCD, risk adj, maintenance0.000.000.000.000.000.00XXX
    G9006XMCCD, Home monitoring0.000.000.000.000.000.00XXX
    G9007XMCCD, sch team conf0.000.000.000.000.000.00XXX
    G9008XMccd,phys coor-care ovrsght0.000.000.000.000.000.00XXX
    G9009XMCCD, risk adj, level 30.000.000.000.000.000.00XXX
    G9010XMCCD, risk adj, level 40.000.000.000.000.000.00XXX
    G9011XMCCD, risk adj, level 50.000.000.000.000.000.00XXX
    G9012XOther Specified Case Mgmt0.000.000.000.000.000.00XXX
    G9016NDemo-smoking cessation coun0.000.000.000.000.000.00XXX
    J3370RVancomycin hcl injection0.000.000.000.000.000.00XXX
    M0064AVisit for drug monitoring0.370.350.120.010.730.50XXX
    P3001AScreening pap smear by phys0.420.990.990.011.421.42XXX
    Q0035ACardiokymography0.170.46NA0.030.66NAXXX
    Q003526ACardiokymography0.170.070.070.010.250.25XXX
    Q0035TCACardiokymography0.000.39NA0.020.41NAXXX
    Q0091AObtaining screen pap smear0.370.680.140.011.060.52XXX
    Q0092ASet up port xray equipment0.000.32NA0.010.33NAXXX
    Q3014XTelehealth facility fee0.000.000.000.000.000.00XXX
    R0070CTransport portable x-ray0.000.000.000.000.000.00XXX
    R0075CTransport port x-ray multipl0.000.000.000.000.000.00XXX
    R0076BTransport portable EKG0.000.000.000.000.000.00XXX
    V5299RHearing service0.000.000.000.000.000.00XXX
    V5362RSpeech screening0.000.000.000.000.000.00XXX
    V5363RLanguage screening0.000.000.000.000.000.00XXX
    V5364RDysphagia screening0.000.000.000.000.000.00XXX
    1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 2002 American Dental Association. All rights reserved.
    3 + Indicates RVUs are not used for Medicare payment.
            Start Printed Page 80166

    —————————— 1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 2002 American Dental Association. All rights reserved. 3 + Indicates RVUs are not used for Medicare payment. Start Printed Page 80166

    Addendum C.—CODES WITH INTERIM RVUs

    CPT 1 /HCPCS 2MODStatusDescriptionPhysician Work RVUs3Non- Facility PE RVUsFacility PE RVUsMal- Practice RVUsNon- Facility TotalFacility TotalGlobal
    11400AExc tr-ext b9+marg 0.5 < cm0.852.080.960.062.991.87010
    11401AExc tr-ext b9+marg 0.6-1 cm1.232.121.080.093.442.40010
    11402AExc tr-ext b9+marg 1.1-2 cm1.512.281.140.123.912.77010
    11403AExc tr-ext b9+marg 2.1-3 cm1.792.501.350.164.453.30010
    11404AExc tr-ext b9+marg 3.1-4 cm2.062.841.420.185.083.66010
    11406AExc tr-ext b9+marg > 4.0 cm2.763.241.680.256.254.69010
    11420AExc h-f-nk-sp b9+marg 0.5 <0.981.811.000.082.872.06010
    11421AExc h-f-nk-sp b9+marg 0.6-11.422.121.180.113.652.71010
    11422AExc h-f-nk-sp b9+marg 1.1-21.632.301.380.144.073.15010
    11423AExc h-f-nk-sp b9+marg 2.1-32.012.661.490.174.843.67010
    11424AExc h-f-nk-sp b9+marg 3.1-42.432.931.640.215.574.28010
    11426AExc h-f-nk-sp b9+marg > 4 cm3.783.752.150.347.876.27010
    11440AExc face-mm b9+marg 0.5 < cm1.062.271.410.083.412.55010
    11441AExc face-mm b9+marg 0.6-1 cm1.482.401.590.113.993.18010
    11442AExc face-mm b9+marg 1.1-2 cm1.722.661.660.144.523.52010
    11443AExc face-mm b9+marg 2.1-3 cm2.293.041.900.185.514.37010
    11444AExc face-mm b9+marg 3.1-4 cm3.143.642.280.257.035.67010
    11446AExc face-mm b9+marg > 4 cm4.494.262.880.309.057.67010
    11600AExc tr-ext mlg+marg 0.5 < cm1.312.530.990.093.932.39010
    11601AExc tr-ext mlg+marg 0.6-1 cm1.802.601.240.124.523.16010
    11602AExc tr-ext mlg+marg 1.1-2 cm1.952.731.290.134.813.37010
    11603AExc tr-ext mlg+marg 2.1-3 cm2.192.961.350.165.313.70010
    11604AExc tr-ext mlg+marg 3.1-4 cm2.403.271.410.185.853.99010
    11606AExc tr-ext mlg+marg > 4 cm3.433.961.760.287.675.47010
    11620AExc h-f-nk-sp mlg+marg 0.5 <1.192.490.970.093.772.25010
    Start Printed Page 80167
    11621AExc h-f-nk-sp mlg+marg 0.6-11.762.601.270.124.483.15010
    11622AExc h-f-nk-sp mlg+marg 1.1-22.092.871.420.155.113.66010
    11623AExc h-f-nk-sp mlg+marg 2.1-32.613.221.620.206.034.43010
    11624AExc h-f-nk-sp mlg+marg 3.1-43.063.611.810.256.925.12010
    11626AExc h-f-nk-sp mlg+mar > 4 cm4.304.562.440.359.217.09010
    11640AExc face-mm malig+marg 0.5 <1.352.541.140.103.992.59010
    11641AExc face-mm malig+marg 0.6-12.162.921.570.155.233.88010
    11642AExc face-mm malig+marg 1.1-22.593.301.770.186.074.54010
    11643AExc face-mm malig+marg 2.1-33.103.702.010.247.045.35010
    11644AExc face-mm malig+marg 3.1-44.034.632.560.338.996.92010
    11646AExc face-mm mlg+marg > 4 cm5.955.733.600.4612.1410.01010
    11981AInsert drug implant device1.481.590.580.143.212.20XXX
    11982ARemove drug implant device1.781.710.700.173.662.65XXX
    11983ARemove/insert drug implant3.302.301.280.315.914.89XXX
    17304A1 stage mohs, up to 5 spec7.608.093.660.3116.0011.57000
    17305A2 stage mohs, up to 5 spec2.853.811.370.126.784.34000
    17306A3 stage mohs, up to 5 spec2.853.811.380.126.784.35000
    17307AMohs addl stage up to 5 spec2.853.821.400.126.794.37000
    17310AMohs any stage > 5 spec each0.621.480.310.052.150.98ZZZ
    20526ATher injection, carp tunnel0.940.770.410.061.771.41000
    20550AInj tendon sheath/ligament0.750.760.240.061.571.05000
    20551AInject tendon origin/insert0.750.700.340.061.511.15000
    20552AInject trigger point, 1 or 20.660.660.300.061.381.02000
    20553AInject trigger points, =/> 30.750.750.340.061.561.15000
    20600ADrain/inject, joint/bursa0.660.660.360.061.381.08000
    20605ADrain/inject, joint/bursa0.680.780.370.061.521.11000
    20612AAspirate/inj ganglion cyst0.700.770.280.061.531.04000
    21030AExcise max/zygoma b9 tumor3.894.363.640.608.858.13090
    21034AExcise max/zygoma mlg tumor16.1710.6710.641.3728.2128.18090
    21040AExcise mandible lesion3.893.762.580.197.846.66090
    21046ARemove mandible cyst complex13.00NA10.421.01NA24.43090
    21047AExcise lwr jaw cyst w/repair18.75NA9.871.53NA30.15090
    21048ARemove maxilla cyst complex13.50NA10.631.01NA25.14090
    21049AExcis uppr jaw cyst w/repair18.00NA9.551.01NA28.56090
    21740AReconstruction of sternum16.50NA12.482.03NA31.01090
    21742CRepair stern/nuss w/o scope0.000.000.000.000.000.00090
    21743CRepair sternum/nuss w/scope0.000.000.000.000.000.00090
    23410ARepair rotator cuff, acute12.45NA12.811.72NA26.98090
    23412ARepair rotator cuff, chronic13.31NA13.321.86NA28.49090
    24344AReconstruct elbow lat ligmnt14.00NA11.181.83NA27.01090
    24346AReconstruct elbow med ligmnt14.00NA11.181.83NA27.01090
    25320ARepair/revise wrist joint10.77NA11.501.32NA23.59090
    27425ALat retinacular release open5.22NA7.580.73NA13.53090
    27730ARepair of tibia epiphysis7.4121.2210.170.7529.3818.33090
    27732ARepair of fibula epiphysis5.3214.218.710.6320.1614.66090
    27734ARepair lower leg epiphyses8.48NA9.910.85NA19.24090
    27870AFusion of ankle joint, open13.91NA14.081.95NA29.94090
    29806AShoulder arthroscopy/surgery14.37NA11.172.00NA27.54090
    29827AArthroscop rotator cuff repr15.36NA11.551.86NA28.77090
    29873AKnee arthroscopy/surgery6.00NA6.560.73NA13.29090
    29899AAnkle arthroscopy/surgery13.91NA10.581.95NA26.44090
    33215AReposition pacing-defib lead4.76NA3.150.36NA8.27090
    33216AInsert lead pace-defib, one5.78NA5.320.36NA11.46090
    33217AInsert lead pace-defib, dual5.75NA5.580.36NA11.69090
    33224AInsert pacing lead & connect9.05NA3.920.36NA13.33090
    33225AL ventric pacing lead add-on8.34NA3.110.36NA11.81ZZZ
    33226AReposition l ventric lead8.69NA3.790.36NA12.84000
    33508AEndoscopic vein harvest0.31NA0.110.03NA0.45ZZZ
    33979AInsert intracorporeal device46.0017.8817.883.9867.8667.86XXX
    33980ARemove intracorporeal device56.25NA26.474.60NA87.32090
    34812AXpose for endoprosth, femorl6.75NA2.290.49NA9.53000
    34825AEndovasc extend prosth, init12.00NA5.950.86NA18.81090
    34826AEndovasc exten prosth, addl4.13NA1.410.29NA5.83ZZZ
    34833AXpose for endoprosth, iliac12.00NA4.980.70NA17.68000
    34834AXpose, endoprosth, brachial5.35NA2.480.49NA8.32000
    34900AEndovasc iliac repr w/graft16.38NA8.241.49NA26.11090
    35572AHarvest femoropopliteal vein6.82NA2.570.63NA10.02ZZZ
    36415IRoutine venipuncture0.000.000.000.000.000.00XXX
    36416ICapillary blood draw0.000.000.000.000.000.00XXX
    36511AApheresis wbc1.74NA0.700.06NA2.50000
    36512AApheresis rbc1.74NA0.700.06NA2.50000
    36513AApheresis platelets1.74NA0.700.06NA2.50000
    36514AApheresis plasma1.74NA0.700.06NA2.50000
    36515AApheresis, adsorp/reinfuse1.74NA0.700.06NA2.50000
    36516AApheresis, selective1.74NA0.700.06NA2.50000
    Start Printed Page 80168
    36536ARemove cva device obstruct3.6033.541.470.2337.375.30000
    36537ARemove cva lumen obstruct0.757.690.490.048.481.28000
    36540BCollect blood venous device0.000.000.000.000.000.00XXX
    37182AInsert hepatic shunt (tips)17.00NA6.371.49NA24.86000
    37183ARemove hepatic shunt (tips)8.00NA3.120.43NA11.55000
    37500AEndoscopy ligate perf veins11.00NA8.700.40NA20.10090
    37760ALigation, leg veins, open10.47NA5.631.11NA17.21090
    38204BBl donor search management0.000.000.000.000.000.00XXX
    38205RHarvest allogenic stem cells1.50NA0.610.05NA2.16000
    38206RHarvest auto stem cells1.50NA0.610.05NA2.16000
    38207ICryopreserve stem cells0.000.000.000.000.000.00XXX
    38208IThaw preserved stem cells0.000.000.000.000.000.00XXX
    38209IWash harvest stem cells0.000.000.000.000.000.00XXX
    38210IT-cell depletion of harvest0.000.000.000.000.000.00XXX
    38211ITumor cell deplete of harvst0.000.000.000.000.000.00XXX
    38212IRbc depletion of harvest0.000.000.000.000.000.00XXX
    38213IPlatelet deplete of harvest0.000.000.000.000.000.00XXX
    38214IVolume deplete of harvest0.000.000.000.000.000.00XXX
    38215IHarvest stem cell concentrte0.000.000.000.000.000.00XXX
    38242ALymphocyte infuse transplant1.71NA0.700.05NA2.46000
    43201AEsoph scope w/submucous inj2.094.441.270.126.653.48000
    43219AEsophagus endoscopy2.80NA1.400.16NA4.36000
    43236AUppr gi scope w/submuc inj2.924.701.260.147.764.32000
    43245AUppr gi scope dilate strictr3.1813.871.340.1817.234.70000
    43256AUppr gi endoscopy w stent4.35NA1.770.23NA6.35000
    44206ALap part colectomy w/stoma27.00NA11.222.02NA40.24090
    44207AL colectomy/coloproctostomy30.00NA11.822.22NA44.04090
    44208AL colectomy/coloproctostomy32.00NA13.422.20NA47.62090
    44210ALaparo total proctocolectomy28.00NA12.112.05NA42.16090
    44211ALaparo total proctocolectomy35.00NA15.022.33NA52.35090
    44212ALaparo total proctocolectomy32.50NA14.162.26NA48.92090
    44383AIleoscopy w/stent2.94NA1.420.13NA4.49000
    44701AIntraop colon lavage add-on3.10NA1.070.21NA4.38ZZZ
    45335ASigmoidoscope w/submuc inj1.362.480.650.073.912.08000
    45340ASig w/balloon dilation1.667.190.760.078.922.49000
    45381AColonoscope, submucous inj4.206.151.700.2110.566.11000
    45386AColonoscope dilate stricture4.5815.291.840.2120.086.63000
    46706ARepr of anal fistula w/glue2.39NA1.240.17NA3.80010
    47370ALaparo ablate liver tumor rf19.69NA9.720.85NA30.26090
    47371ALaparo ablate liver cryosurg19.69NA9.720.85NA30.26090
    47380AOpen ablate liver tumor rf23.00NA11.010.85NA34.86090
    47381AOpen ablate liver tumor cryo23.27NA11.120.85NA35.24090
    47382APercut ablate liver rf15.19NA6.251.14NA22.58010
    49419AInsrt abdom cath for chemotx6.65NA3.810.55NA11.01090
    49904AOmental flap, extra-abdom20.00NA15.981.91NA37.89090
    49905AOmental flap, intra-abdom6.55NA2.340.61NA9.50ZZZ
    50542ALaparo ablate renal mass20.00NA8.341.36NA29.70090
    50543ALaparo partial nephrectomy25.50NA10.481.36NA37.34090
    50562ARenal scope w/tumor resect10.92NA4.020.84NA15.78090
    51701AInsert bladder catheter0.501.060.200.031.590.73000
    51702AInsert temp bladder cath0.501.970.270.032.500.80000
    51703AInsert bladder cath, complex1.471.910.590.093.472.15000
    51798AUs urine capacity measure0.000.48NA0.070.55NAXXX
    52001ACystoscopy, removal of clots5.457.892.330.3213.668.10000
    53440AMale sling procedure13.62NA6.330.73NA20.68090
    53442ARemove/revise male sling11.57NA5.930.55NA18.05090
    55866ALaparo radical prostatectomy30.74NA11.791.37NA43.90090
    56820AExam of vulva w/scope1.501.640.650.103.242.25000
    56821AExam/biopsy of vulva w/scope2.052.020.920.134.203.10000
    57420AExam of vagina w/scope1.601.680.690.103.382.39000
    57421AExam/biopsy of vag w/scope2.202.080.980.134.413.31000
    57452AExam of cervix w/scope1.501.700.650.103.302.25000
    57454ABx/curett of cervix w/scope2.332.051.020.134.513.48000
    57455ABiopsy of cervix w/scope1.991.940.890.134.063.01000
    57456AEndocerv curettage w/scope1.851.860.840.133.842.82000
    57460ABx of cervix w/scope, leep2.835.011.250.288.124.36000
    57461AConz of cervix w/scope, leep3.445.321.500.289.045.22000
    58140AMyomectomy abdom method14.60NA7.011.46NA23.07090
    58145AMyomectomy vag method8.04NA4.840.80NA13.68090
    58146AMyomectomy abdom complex19.00NA9.151.46NA29.61090
    58260AVaginal hysterectomy12.98NA6.681.23NA20.89090
    58262AVag hyst including t/o14.77NA7.431.42NA23.62090
    58263AVag hyst w/t/o & vag repair16.06NA7.951.55NA25.56090
    58267AVag hyst w/urinary repair17.04NA8.521.51NA27.07090
    58270AVag hyst w/enterocele repair14.26NA7.191.37NA22.82090
    Start Printed Page 80169
    58290AVag hyst complex19.00NA9.371.23NA29.60090
    58291AVag hyst incl t/o, complex20.79NA10.341.42NA32.55090
    58292AVag hyst t/o & repair, compl22.08NA10.851.55NA34.48090
    58293AVag hyst w/uro repair, compl23.06NA11.251.51NA35.82090
    58294AVag hyst w/enterocele, compl20.28NA10.101.37NA31.75090
    58545ALaparoscopic myomectomy14.60NA7.761.45NA23.81090
    58546ALaparo-myomectomy, complex19.00NA9.551.45NA30.00090
    58550ALaparo-asst vag hysterectomy14.19NA7.211.44NA22.84010
    58552ALaparo-vag hyst incl t/o14.19NA7.561.44NA23.19090
    58553ALaparo-vag hyst, complex19.00NA9.571.23NA29.80090
    58554ALaparo-vag hyst w/t/o, compl19.00NA9.261.23NA29.49090
    61316AImplt cran bone flap to abdo1.39NA0.570.43NA2.39ZZZ
    61322ADecompressive craniotomy29.50NA13.884.99NA48.37090
    61323ADecompressive lobectomy31.00NA14.084.99NA50.07090
    61340ASubtemporal decompression18.66NA11.413.66NA33.73090
    61517AImplt brain chemotx add-on1.38NA0.560.08NA2.02ZZZ
    61623AEndovasc tempory vessel occl9.96NA4.230.50NA14.69000
    61624ATranscath occlusion, cns20.15NA7.131.15NA28.43000
    62148ARetr bone flap to fix skull2.00NA0.820.43NA3.25ZZZ
    62160ANeuroendoscopy add-on3.00NA1.160.52NA4.68ZZZ
    62161ADissect brain w/scope20.00NA9.713.70NA33.41090
    62162ARemove colloid cyst w/scope25.25NA11.895.77NA42.91090
    62163ANeuroendoscopy w/fb removal15.50NA7.973.70NA27.17090
    62164ARemove brain tumor w/scope27.50NA13.125.77NA46.39090
    62165ARemove pituit tumor w/scope22.00NA10.683.63NA36.31090
    62201ABrain cavity shunt w/scope14.86NA9.772.52NA27.15090
    62263AEpidural lysis mult sessions6.1413.452.430.4220.018.99010
    62264AEpidural lysis on single day4.4311.381.320.3016.116.05010
    64415AN block inj, brachial plexus1.483.050.390.084.611.95000
    64416AN block cont infuse, b plex3.50NA0.750.08NA4.33010
    64445AN block inj, sciatic, sng1.482.780.380.084.341.94000
    64446AN blk inj, sciatic, cont inf3.25NA1.150.08NA4.48010
    64447AN block inj fem, single1.50NA0.520.08NA2.10000
    64448AN block inj fem, cont inf3.00NA1.040.08NA4.12010
    64450AN block, other peripheral1.271.300.420.082.651.77000
    66990AOphthalmic endoscope add-on1.51NA0.700.06NA2.27ZZZ
    7590126ARemove cva device obstruct0.490.170.170.020.680.68XXX
    7590226ARemove cva lumen obstruct0.390.130.130.020.540.54XXX
    7595326AAbdom aneurysm endovas rpr1.360.530.530.682.572.57XXX
    7595426AIliac aneurysm endovas rpr1.360.480.480.682.522.52XXX
    7607026ACt bone density, axial0.250.080.080.010.340.34XXX
    7607126ACt bone density, peripheral0.220.070.070.010.300.30XXX
    7608526AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    7636226ACat scan for tissue ablation4.001.351.350.185.535.53XXX
    7639426AMri for tissue ablation4.251.441.440.195.885.88XXX
    7649026AUs for tissue ablation4.001.341.340.115.455.45XXX
    7680126AOb us < 14 wks, single fetus0.990.360.360.041.391.39XXX
    7680226AOb us < 14 wks, addl fetus0.830.300.300.041.171.17XXX
    7680526AOb us >/= 14 wks, sngl fetus0.990.350.350.041.381.38XXX
    7681026AOb us >/= 14 wks, addl fetus0.980.360.360.071.411.41ZZZ
    7681126AOb us, detailed, sngl fetus1.900.680.680.152.732.73XXX
    7681226AOb us, detailed, addl fetus1.780.650.650.122.552.55ZZZ
    7681526AOb us, limited, fetus(s)0.650.240.240.020.910.91XXX
    7681626AOb us, follow-up, per fetus0.850.330.330.021.201.20XXX
    7681726ATransvaginal us, obstetric0.750.280.280.021.051.05XXX
    92601ACochlear implt f/up exam < 70.003.50NA0.063.56NAXXX
    92602AReprogram cochlear implt < 70.002.44NA0.062.50NAXXX
    92603ACochlear implt f/up exam 7 >0.002.34NA0.062.40NAXXX
    92604AReprogram cochlear implt 7 >0.001.58NA0.061.64NAXXX
    92605BEval for nonspeech device rx0.000.000.000.000.000.00XXX
    92606BNon-speech device service0.000.000.000.000.000.00XXX
    92607AEx for speech device rx, 1hr0.002.93NA0.042.97NAXXX
    92608AEx for speech device rx addl0.000.55NA0.040.59NAXXX
    92609AUse of speech device service0.001.58NA0.031.61NAXXX
    92610AEvaluate swallowing function0.001.08NA0.071.15NAXXX
    92611AMotion fluoroscopy/swallow0.001.18NA0.071.25NAXXX
    92612AEndoscopy swallow tst (fees)1.273.360.500.074.701.84XXX
    92613BEndoscopy swallow tst (fees)0.000.000.000.000.000.00XXX
    92614ALaryngoscopic sensory test1.272.290.500.073.631.84XXX
    92615BEval laryngoscopy sense tst0.000.000.000.000.000.00XXX
    92616AFees w/laryngeal sense test1.883.020.730.074.972.68XXX
    92617BInterprt fees/laryngeal test0.000.000.000.000.000.00XXX
    93580ATranscath closure of asd18.00NA7.341.14NA26.48000
    93581ATranscath closure of vsd24.43NA9.841.14NA35.41000
    9360926AMap tachycardia, add-on5.002.002.000.527.527.52ZZZ
    Start Printed Page 80170
    93613AElectrophys map 3d, add-on7.002.722.720.5210.2410.24ZZZ
    9361926AElectrophysiology evaluation7.322.922.920.3810.6210.62000
    9362026AElectrophysiology evaluation11.594.624.620.6016.8116.81000
    9362126AElectrophysiology evaluation2.100.840.840.153.093.09ZZZ
    9362226AElectrophysiology evaluation3.101.231.230.675.005.00ZZZ
    95990ASpin/brain pump refil & main0.001.49NA0.051.54NAXXX
    96000AMotion analysis, video/3d1.80NA0.700.02NA2.52XXX
    96001AMotion test w/ft press meas2.15NA0.840.02NA3.01XXX
    96002ADynamic surface emg0.41NA0.160.02NA0.59XXX
    96003ADynamic fine wire emg0.37NA0.140.03NA0.54XXX
    96004APhys review of motion tests2.140.840.840.083.063.06XXX
    96530ASyst pump refill & main0.001.05NA0.051.10NAXXX
    96920ALaser tx, skin < 250 sq cm1.152.880.450.094.121.69000
    96921ALaser tx, skin 250-500 sq cm1.172.960.460.094.221.72000
    96922ALaser tx, skin > 500 sq cm2.103.560.820.165.823.08000
    99026IIn-hospital on call service0.000.000.000.000.000.00XXX
    99027IOut-of-hosp on call service0.000.000.000.000.000.00XXX
    99289APed crit care transport4.80NA1.870.14NA6.81XXX
    99290APed crit care transport addl2.40NA0.940.07NA3.41ZZZ
    99293APed critical care, initial16.00NA5.130.70NA21.83XXX
    99294APed critical care, subseq8.00NA2.570.23NA10.80XXX
    99295ANeonate crit care, initial18.49NA5.480.70NA24.67XXX
    99296ANeonate critical care subseq8.00NA2.610.23NA10.84XXX
    99298AIc for lbw infant < 1500 gm2.75NA0.960.10NA3.81XXX
    99299AIc, lbw infant 1500-2500 gm2.50NA0.980.10NA3.58XXX
    G026226ASm intestinal image capsule2.120.830.830.022.972.97XXX
    G0268ARemoval of impacted wax md0.610.570.240.041.220.89000
    G0269BOcclusive device in vein art0.000.000.000.000.000.00XXX
    G0270AMNT subs tx for change dx0.000.47NA0.010.48NAXXX
    G0271AGroup MNT 2 or more 30 mins0.000.18NA0.010.19NAXXX
    G0272ANaso/oro gastric tube pl MD0.320.13NA0.020.47NA000
    G027326APretx planning, non-Hodgkins0.860.340.340.031.231.23XXX
    G027426ARadiopharm tx, non-Hodgkins2.070.810.810.082.962.96XXX
    G0275ARenal angio, cardiac cath0.250.10NA0.010.36NAZZZ
    G0278AIliac art angio,cardiac cath0.250.10NA0.010.36NAZZZ
    G0279AExcorp shock tx, elbow epi0.061.46NA0.011.53NAXXX
    G0280AExcorp shock tx other than0.061.46NA0.011.53NAXXX
    G0281AElec stim unattend for press0.180.350.070.010.540.26XXX
    G0283AElec stim other than wound0.180.350.070.010.540.26XXX
    G0288ARecon, CTA for surg plan0.0010.57NA0.1510.72NAXXX
    G0289AArthro, loose body + chondro1.480.58NA0.272.33NAZZZ
    1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 2002 American Dental Association. All rights reserved.
    3 + Indicates RVUs are not used for Medicare payment.
            Start Printed Page 80170

    Addendum D.—2002/2003 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Carrier No.Locality No. -Locality nameWorkPractice expenseMal- practice
    0051000ALABAMA0.9780.8700.807
    0083101ALASKA1.0641.1721.223
    0083200ARIZONA0.9940.9781.111
    0052013ARKANSAS0.9530.8470.340
    3114626ANAHEIM/SANTA ANA, CA1.0371.1840.955
    3114618LOS ANGELES, CA1.0561.1390.955
    3114003MARIN/NAPA/SOLANO, CA1.0151.2480.687
    3114007OAKLAND/BERKELEY, CA1.0411.2350.687
    3114005SAN FRANCISCO, CA1.0681.4580.687
    3114006SAN MATEO, CA1.0481.4320.687
    3114009SANTA CLARA, CA1.0631.3800.639
    3114617VENTURA, CA1.0281.1250.783
    3114699REST OF CALIFORNIA*1.0071.0340.748
    3114099REST OF CALIFORNIA*1.0071.0340.748
    0082401COLORADO0.9850.9920.840
    0059100CONNECTICUT1.0501.1560.966
    0090201DELAWARE1.0191.0350.712
    0090301DC + MD/VA SUBURBS1.0501.1660.909
    0059003FORT LAUDERDALE, FL0.9961.0181.877
    0059004MIAMI, FL1.0151.0522.528
    0059099REST OF FLORIDA0.9750.9461.265
    0051101ATLANTA, GA1.0061.0590.935
    0051199REST OF GEORGIA0.9700.8920.935
    Start Printed Page 80171
    0083301HAWAII/GUAM0.9971.1240.834
    0513000IDAHO0.9600.8810.497
    0095216CHICAGO, IL1.0281.0921.797
    0095212EAST ST. LOUIS, IL0.9880.9241.691
    0095215SUBURBAN CHICAGO, IL1.0061.0711.645
    0095299REST OF ILLINOIS0.9640.8891.157
    0063000INDIANA0.9810.9220.481
    0082600IOWA0.9590.8760.596
    0065000KANSAS*0.9630.8950.756
    0074004KANSAS*0.9630.8950.756
    0066000KENTUCKY0.9700.8660.877
    0052801NEW ORLEANS, LA0.9980.9451.283
    0052899REST OF LOUISIANA0.9680.8701.073
    3114203SOUTHERN MAINE0.9790.9990.666
    3114299REST OF MAINE0.9610.9100.666
    0090101BALTIMORE/SURR. CNTYS, MD1.0211.0380.916
    0090199REST OF MARYLAND0.9840.9720.774
    3114301METROPOLITAN BOSTON1.0411.2390.784
    3114399REST OF MASSACHUSETTS1.0101.1290.784
    0095301DETROIT, MI1.0431.0382.738
    0095399REST OF MICHIGAN0.9970.9381.571
    0095400MINNESOTA0.9900.9740.452
    0051200MISSISSIPPI0.9570.8370.779
    0074002METROPOLITAN KANSAS CITY, MO0.9880.9670.846
    0052301METROPOLITAN ST. LOUIS, MO0.9940.9380.846
    0074099REST OF MISSOURI*0.9460.8250.793
    0052399REST OF MISSOURI*0.9460.8250.793
    0075101MONTANA0.9500.8760.727
    0065500NEBRASKA0.9480.8770.430
    0083400NEVADA1.0051.0391.209
    3114440NEW HAMPSHIRE0.9861.0300.825
    0080501NORTHERN NJ1.0581.1930.860
    0080599REST OF NEW JERSEY1.0291.1100.860
    0052105NEW MEXICO0.9730.9000.902
    0080301MANHATTAN, NY1.0941.3511.668
    0080302NYC SUBURBS/LONG I., NY1.0681.2511.952
    0080303POUGHKPSIE/N NYC SUBURBS, NY1.0111.0751.275
    1433004QUEENS, NY1.0581.2281.871
    0080199REST OF NEW YORK0.9980.9440.764
    0553500NORTH CAROLINA0.9700.9310.595
    0082001NORTH DAKOTA0.9500.8800.657
    1636000OHIO0.9880.9440.957
    0052200OKLAHOMA0.9680.8760.444
    0083501PORTLAND, OR0.9961.0490.436
    0083599REST OF OREGON0.9610.9330.436
    0086501METROPOLITAN PHILADELPHIA, PA1.0231.0921.413
    0086599REST OF PENNSYLVANIA0.9890.9290.774
    0097320PUERTO RICO0.8810.7120.275
    0087001RHODE ISLAND1.0171.0650.883
    0088001SOUTH CAROLINA0.9740.9040.279
    0082002SOUTH DAKOTA0.9350.8780.406
    0544035TENNESSEE0.9750.9000.592
    0090031AUSTIN, TX0.9860.9960.859
    0090020BEAUMONT, TX0.9920.8901.338
    0090009BRAZORIA, TX0.9920.9781.338
    0090011DALLAS, TX1.0101.0650.931
    0090028FORT WORTH, TX0.9870.9810.931
    0090015GALVESTON, TX0.9880.9691.338
    0090018HOUSTON, TX1.0201.0071.336
    0090099REST OF TEXAS0.9660.8800.956
    0091009UTAH0.9760.9410.644
    3114550VERMONT0.9730.9860.539
    0097350VIRGIN ISLANDS0.9651.0231.002
    0090400VIRGINIA0.9840.9380.500
    0083602SEATTLE (KING CNTY), WA1.0051.1000.788
    0083699REST OF WASHINGTON0.9810.9720.788
    1651016WEST VIRGINIA0.9630.8501.378
    0095100WISCONSIN0.9810.9290.939
    0082521WYOMING0.9670.8951.005
    *Payment locality is serviced by two carriers. Start Printed Page 80172
    Note: Work GPCI is the 1/4 work GPCI required by Section 1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the following factors for budget netrality: Work = 0.99699; Practice Expense = 0.99235; Malpractice Expense = 1.00215.

    Addendum E.—Updated List of CPT1/HCPCS Codes Used To Describe Certain Designated Health Services Under the Physician Referral Provisions

    [Section 1877 of the Social Security Act—Effective January 1, 2003]

    CLINICAL LABORATORY SERVICES
    INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services:
    86890Autologous blood process
    86891Autologous blood, op salvage
    86927Plasma, fresh frozen
    86930Frozen blood prep
    86931Frozen blood thaw
    86932Frozen blood freeze/thaw
    86945Blood product/irradiation
    86950Leukacyte transfusion
    86965Pooling blood platelets
    86985Split blood or products
    INCLUDE the following CPT and HCPCS level 2 codes for other clinical laboratory services:
    0010TTB test,gamma interferon-
    0023TPhenotype drug test, hiv 1
    0026TMeasure remnant lipoproteins
    0030TAntiprothrombin antibody
    0041TDetect ur infect agent w/cpas
    0043TCo expired gas analysis
    G0001Drawing blood for specimen
    G0103Psa, total screening
    G0107CA screen; fecal blood test
    G0123Screen cerv/vag thin layer
    G0124Screen c/v thin layer by MD
    G0141Scr c/v cyto,autosys and md
    G0143Scr c/v cyto,thinlayer,rescr
    G0144Scr c/v cyto,thinlayer,rescr
    G0145Scr c/v cyto,thinlayer,rescr
    G0147Scr c/v cyto, automated sys
    G0148Scr c/v cyto, autosys, rescr
    P2028Cephalin floculation test
    P2029Congo red blood test
    P2031Hair analysis
    P2033Blood thymol turbidity
    P2038Blood mucoprotein
    P3000Screen pap by tech w md supv
    P3001Screening pap smear by phys
    P7001Culture bacterial urine
    P9612Catheterize for urine spec
    P9615Urine specimen collect mult
    Q0111Wet mounts/ w preparations
    Q0112Potassium hydroxide preps
    Q0113Pinworm examinations
    Q0114Fern test
    Q0115Post-coital mucous exam
    PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY
    INCLUDE the following CPT codes for the physical therapy/occupational therapy/speech-language pathology services in the 97000 series:
    97001Pt evaluation
    97002Pt re-evaluation
    97003Ot evaluation
    97004Ot re-evaluation
    97010Hot or cold packs therapy
    97012Mechanical traction therapy
    97016Vasopneumatic device therapy
    97018Paraffin bath therapy
    97020Microwave therapy
    97022Whirlpool therapy
    97024Diathermy treatment
    97026Infrared therapy
    97028Ultraviolet therapy
    97032Electrical stimulation
    97033Electric current therapy
    97034Contrast bath therapy
    97035Ultrasound therapy
    97036Hydrotherapy
    97039Physical therapy treatment
    97110Therapeutic exercises
    97112Neuromuscular reeducation
    97113Aquatic therapy/exercises
    97116Gait training therapy
    97124Massage therapy
    97139Physical medicine procedure
    97140Manual therapy
    97150Group therapeutic procedures
    97504Orthotic training
    97520Prosthetic training
    97530Therapeutic activities
    97532Cognitive skills development
    97533Sensory integration
    97535Self care mngment training
    97537Community/work reintegration
    97542Wheelchair mngment training
    97545Work hardening
    97546Work hardening add-on
    97703Prosthetic checkout
    97750Physical performance test
    97799Physical medicine procedure
    INCLUDE CPT codes for physical therapy/occupational therapy/speech-language pathology services not in the 97000 series:
    64550Apply neurostimulator
    90901Biofeedback train, any meth
    90911Biofeedback peri/uro/rectal
    92506Speech/hearing evaluation
    92507Speech/hearing therapy
    92508Speech/hearing therapy-
    92526Oral function therapy
    92601Cochlear implt f/up exam < 7
    92602Reprogram cochlear implt < 7
    92603Cochlear implt f/up exam 7 >
    92604Reprogram cochlear implt 7 >-
    92607Ex for speech device rx, 1hr
    92608Ex for speech device rx addl
    92609Use of speech device service
    92610Evaluate swallowing function
    92611Motion fluoroscopy/swallow
    92612Endoscopy swallow tst (fees)
    92614Laryngoscopic sensory test
    92616Fees w/laryngeal sense test
    93797Cardiac rehab
    93798Cardiac rehab/monitor
    94667Chest wall manipulation
    94668Chest wall manipulation
    94762Measure blood oxygen level
    95831Limb muscle testing, manual
    95832Hand muscle testing, manual
    95833Body muscle testing, manual
    95834Body muscle testing, manual
    95851Range of motion measurements
    95852Range of motion measurements
    96000Motion analysis, video/3d
    96001Motion test w/ft press meas
    96002Dynamic surface emg
    96003Dynamic fine wire emg
    96105Assessment of aphasia
    96110Developmental test, lim
    96111Developmental test, extend
    96115Neurobehavior status exam
    0019TExtracorp shock wave tx, ms-
    0020TExtracorp shock wave tx, ft
    0029TMagnetic tx for incontinence
    INCLUDE HCPCS level 2 codes for the following physical therapy/occupational therapy/speech-language pathology service:
    G0279Excorp shock tx, elbow epi
    G0280Excorp shock tx other than
    G0281Elec stim unattend for press
    G0283Elec stim other than wound
    Q0086Physical therapy evaluation/
    RADIOLOGY AND CERTAIN OTHER IMAGING SERVICES
    INCLUDE the following codes in the CPT 70000 series:
    70100X-ray exam of jaw
    70110X-ray exam of jaw
    70120X-ray exam of mastoids
    70130X-ray exam of mastoids
    70134X-ray exam of middle ear
    70140X-ray exam of facial bones
    70150X-ray exam of facial bones
    70160X-ray exam of nasal bones
    70190X-ray exam of eye sockets
    70200X-ray exam of eye sockets
    70210X-ray exam of sinuses
    70220X-ray exam of sinuses
    70240X-ray exam, pituitary saddle
    70250X-ray exam of skull
    70260X-ray exam of skull
    70300X-ray exam of teeth
    70310X-ray exam of teeth
    70320Full mouth x-ray of teeth
    70328X-ray exam of jaw joint
    70330X-ray exam of jaw joints
    70336Magnetic image, jaw joint
    70350X-ray head for orthodontia
    70355Panoramic x-ray of jaws
    70360X-ray exam of neck
    70370Throat x-ray & fluoroscopy
    70371Speech evaluation, complex
    70380X-ray exam of salivary gland
    70450Ct head/brain w/o dye
    70460Ct head/brain w/dye
    70470Ct head/brain w/o&w dye
    70480Ct orbit/ear/fossa w/o dye
    70481Ct orbit/ear/fossa w/dye
    70482Ct orbit/ear/fossa w/o&w dye
    70486Ct maxillofacial w/o dye
    70487Ct maxillofacial w/dye
    70488Ct maxillofacial w/o&w dye
    70490Ct soft tissue neck w/o dye
    70491Ct soft tissue neck w/dye
    70492Ct sft tsue nck w/o & w/dye
    70496Ct angiography, head
    70498Ct angiography, neck
    70540Mri orbit/face/neck w/o dye
    70542Mri orbit/face/neck w/dye
    70543Mri orbt/fac/nck w/o&w dye
    70544Mr angiography head w/o dye
    70545Mr angiography head w/dye
    70546Mr angiograph head w/o&w dye
    70547Mr angiography neck w/o dye
    70548Mr angiography neck w/dye
    70549Mr angiograph neck w/o&w dye
    70551Mri brain w/o dye
    70552Mri brain w/dye
    70553Mri brain w/o&w dye
    71010Chest x-ray
    71015Chest x-ray
    71020Chest x-ray
    71021Chest x-ray
    71022Chest x-ray
    71023Chest x-ray and fluoroscopy
    71030Chest x-ray
    71034Chest x-ray and fluoroscopy
    71035Chest x-ray-
    Start Printed Page 80173
    71100X-ray exam of ribs
    71101X-ray exam of ribs/chest
    71110X-ray exam of ribs
    71111X-ray exam of ribs/ chest
    71120X-ray exam of breastbone
    71130X-ray exam of breastbone
    71250Ct thorax w/o dye
    71260Ct thorax w/dye
    71270Ct thorax w/o&w dye
    71275Ct angiography, chest
    71550Mri chest w/o dye
    71551Mri chest w/dye
    71552Mri chest w/o&w/dye
    71555Mri angio chest w or w/o dye
    72010X-ray exam of spine
    72020X-ray exam of spine
    72040X-ray exam of neck spine
    72050X-ray exam of neck spine
    72052X-ray exam of neck spine
    72069X-ray exam of trunk spine
    72070X-ray exam of thoracic spine
    72072X-ray exam of thoracic spine
    72074X-ray exam of thoracic spine
    72080X-ray exam of trunk spine
    72090X-ray exam of trunk spine
    72100X-ray exam of lower spine
    72110X-ray exam of lower spine
    72114X-ray exam of lower spine
    72120X-ray exam of lower spine
    72125Ct neck spine w/o dye
    72126Ct neck spine w/dye
    72127Ct neck spine w/o&w/dye
    72128Ct chest spine w/o dye
    72129Ct chest spine w/dye
    72130Ct chest spine w/o&w/dye
    72131Ct lumbar spine w/o dye
    72132Ct lumbar spine w/dye
    72133Ct lumbar spine w/o&w/dye
    72141Mri neck spine w/o dye
    72142Mri neck spine w/dye
    72146Mri chest spine w/o dye
    72147Mri chest spine w/dye
    72148Mri lumbar spine w/o dye
    72149Mri lumbar spine w/dye
    72156Mri neck spine w/o&w/dye
    72157Mri chest spine w/o&w/dye
    72158Mri lumbar spine w/o&w/dye
    72170X-ray exam of pelvis
    72190X-ray exam of pelvis
    72191Ct angiograph pelv w/o&w/dye
    72192Ct pelvis w/o dye
    72193Ct pelvis w/dye
    72194Ct pelvis w/o&w/dye
    72195Mri pelvis w/o dye
    72196Mri pelvis w/dye
    72197Mri pelvis w/o & w dye
    72200X-ray exam sacroiliac joints
    72202X-ray exam sacroiliac joints
    72220X-ray exam of tailbone
    73000X-ray exam of collar bone
    73010X-ray exam of shoulder blade
    73020X-ray exam of shoulder
    73030X-ray exam of shoulder
    73050X-ray exam of shoulders
    73060X-ray exam of humerus
    73070X-ray exam of elbow
    73080X-ray exam of elbow
    73090X-ray exam of forearm
    73092X-ray exam of arm, infant
    73100X-ray exam of wrist
    73110X-ray exam of wrist
    73120X-ray exam of hand
    73130X-ray exam of hand
    73140X-ray exam of finger(s)
    73200Ct upper extremity w/o dye
    73201Ct upper extremity w/dye
    73202Ct uppr extremity w/o&w/dye
    73206Ct angio upr extrm w/o&w/dye
    73218Mri upper extremity w/o dye
    73219Mri upper extremity w/dye
    73220Mri uppr extremity w/o&w/dye
    73221Mri joint upr extrem w/o dye
    73222Mri joint upr extrem w/dye
    73223Mri joint upr extr w/o&w/dye
    73500X-ray exam of hip
    73510X-ray exam of hip
    73520X-ray exam of hips
    73540X-ray exam of pelvis & hips
    73550X-ray exam of thigh
    73560X-ray exam of knee, 1 or 2
    73562X-ray exam of knee, 3
    73564X-ray exam, knee, 4 or more
    73565X-ray exam of knees
    73590X-ray exam of lower leg
    73592X-ray exam of leg, infant
    73600X-ray exam of ankle
    73610X-ray exam of ankle
    73620X-ray exam of foot
    73630X-ray exam of foot
    73650X-ray exam of heel
    73660X-ray exam of toe(s)
    73700Ct lower extremity w/o dye
    73701Ct lower extremity w/dye
    73702Ct lwr extremity w/o&w/dye
    73706Ct angio lwr extr w/o&w/dye
    73718Mri lower extremity w/o dye
    73719Mri lower extremity w/dye
    73720Mri lwr extremity w/o&w/dye
    73721Mri jnt of lwr extre w/o dye
    73722Mri joint of lwr extr w/dye
    73723Mri joint lwr extr w/o&w/dye
    73725Mr ang lwr ext w or w/o dye
    74000X-ray exam of abdomen
    74010X-ray exam of abdomen
    74020X-ray exam of abdomen
    74022X-ray exam series, abdomen
    74150Ct abdomen w/o dye
    74160Ct abdomen w/dye
    74170Ct abdomen w/o&w/dye
    74175Ct angio abdom w/o&w/dye
    74181Mri abdomen w/o dye
    74182Mri abdomen w/dye
    74183Mri abdomen w/o&w/dye
    74185Mri angio, abdom w or w/o dy
    74210Contrst x-ray exam of throat
    74220Contrast x-ray, esophagus
    74230Cine/vid x-ray, throat/esoph
    74240X-ray exam, upper gi tract
    74241X-ray exam, upper gi tract
    74245X-ray exam, upper gi tract
    74246Contrst x-ray uppr gi tract
    74247Contrst x-ray uppr gi tract
    74249Contrst x-ray uppr gi tract
    74250X-ray exam of small bowel
    74290Contrast x-ray, gallbladder
    74291Contrast x-rays, gallbladder
    74710X-ray measurement of pelvis
    75552Heart mri for morph w/o dye
    75553Heart mri for morph w/dye
    75554Cardiac MRI/function
    75555Cardiac MRI/limited study
    75635Ct angio abdominal arteries
    76000Fluoroscope examination
    76006X-ray stress view
    76010X-ray, nose to rectum
    76020X-rays for bone age
    76040X-rays, bone evaluation
    76061X-rays, bone survey
    76062X-rays, bone survey
    76065X-rays, bone evaluation
    76066Joint survey, single view
    76070Ct bone density, axial
    76071Ct bone density, peripheral
    76085Computer mammogram add-on
    76090Mammogram, one breast
    76091Mammogram, both breasts
    76092Mammogram, screening
    76093Magnetic image, breast
    76094Magnetic image, both breasts
    76100X-ray exam of body section
    76101Complex body section x-ray
    76102Complex body section x-rays
    76120Cine/video x-rays
    76125Cine/video x-rays add-on
    76150X-ray exam, dry process
    76370CAT scan for therapy guide
    763753d/holograph reconstr add-on
    76380CAT scan follow-up study
    76400Magnetic image, bone marrow
    76499Radiographic procedure
    76506Echo exam of head
    76511Echo exam of eye
    76512Echo exam of eye
    76513Echo exam of eye, water bath
    76516Echo exam of eye
    76519Echo exam of eye
    76536Us exam of head and neck
    76604Us exam, chest, b-scan
    76645Us exam, breast(s)
    76700Us exam, abdom, complete
    76705Echo exam of abdomen
    76770Us exam abdo back wall, comp
    76775Us eam abdo back wall,lim
    76778Us exam kidney transplant
    76800Us exam, spinal canal
    76801Ob us < 14 wks, single fetus-
    76802Ob us < 14 wks, addl fetus
    76805Ob us >/= 14 wks, sngl fetus
    76810Ob us >/= 14 wks, addl fetus
    76811Ob us, detailed, sngl fetus
    76812Ob us, detailed, addl fetus
    76815Ob us, limited, fetus(s)
    76816Ob us, follow-up, per fetus
    76818Fetal biophys profile w/nst
    76819Fetal biophys profil w/o nst
    76825Echo exam of fetal heart
    76826Echo exam of fetal heart
    76827Echo exam of fetal heart
    76828Echo exam of fetal heart
    76831Echo exam, uterus
    76856Us exam, pelvic, complete
    76857Us exam, pelvic, limited
    76870Us exam, scrotum
    76880Us exam, extremity
    76885Us exam infant hips, dynamic
    76886Us exam infant hips, static
    76970Ultrasound exam follow-up
    76977Us bone density measure
    76999Echo examination procedure
    INCLUDE the following CPT codes for echocardiography and vascular ultrasound:
    93303Echo transthoracic
    93304Echo transthoracic
    93307Echo exam of heart
    93308Echo exam of heart
    93320Doppler echo exam, heart [if used in conjunction with 9330393308]
    93321Doppler echo exam, heart [if used in conjunction with 9330393308]
    Start Printed Page 80174
    93325Doppler color flow add-on [if used in conjunction with 9330393308]
    93875Extracranial study
    93880Extracranial study
    93882Extracranial study
    93886Intracranial study
    93888Intracranial study
    93922Extremity study
    93923Extremity study
    93924Extremity study
    93925Lower extremity study
    93926Lower extremity study
    93930Upper extremity study
    93931Upper extremity study
    93965Extremity study
    93970Extremity study
    93971Extremity study
    93975Vascular study
    93976Vascular study
    93978Vascular study
    93979Vascular study
    93980Penile vascular study
    93981Penile vascular study
    93990Doppler flow testing
    INCLUDE the following CPT and HCPCS level 2 codes:
    51798Us urine capacity measure
    0028TDexa body composition study
    0042TCt perfusion w/contrast, cbf
    G0202Screeningmammographydigital
    G0204Diagnosticmammographydigital
    G0206Diagnosticmammographydigital
    G0236digital film convert diag ma
    G0262Sm intestinal image capsule
    G0288Recon, CTA for surg plan
    R0070Transport portable x-ray
    R0075Transport port x-ray multipl
    RADIATION THERAPY SERVICES AND SUPPLIES
    INCLUDE the following codes in the CPT 70000 series:
    77261Radiation therapy planning
    77262Radiation therapy planning
    77263Radiation therapy planning
    77280Set radiation therapy field
    77285Set radiation therapy field
    77290Set radiation therapy field
    77295Set radiation therapy field
    77299Radiation therapy planning
    77300Radiation therapy dose plan
    77301Radiotherapy dose plan, imrt
    77305Teletx isodose plan simple
    77310Teletx isodose plan intermed
    77315Teletx isodose plan complex
    77321Special teletx port plan
    77326Brachytx isodose calc simp
    77327Brachytx isodose calc interm
    77328Brachytx isodose plan compl
    77331Special radiation dosimetry
    77332Radiation treatment aid(s)
    77333Radiation treatment aid(s)
    77334Radiation treatment aid(s)
    77336Radiation physics consult
    77370Radiation physics consult
    77399External radiation dosimetry
    77401Radiation treatment delivery
    77402Radiation treatment delivery
    77403Radiation treatment delivery
    77404Radiation treatment delivery
    77406Radiation treatment delivery
    77407Radiation treatment delivery
    77408Radiation treatment delivery-
    77409Radiation treatment delivery
    77411Radiation treatment delivery
    77412Radiation treatment delivery
    77413Radiation treatment delivery
    77414Radiation treatment delivery
    77416Radiation treatment delivery
    77417Radiology port film(s)
    77418Radiation tx delivery, imrt
    77427Radiation tx management, x5
    77431Radiation therapy management
    77432Stereotactic radiation trmt
    77470Special radiation treatment
    77499Radiation therapy management
    77520Proton trmt, simple w/o comp
    77522Proton trmt, simple w/comp
    77523Proton trmt, intermediate
    77525Proton treatment, complex
    77600Hyperthermia treatment
    77605Hyperthermia treatment
    77610Hyperthermia treatment
    77615Hyperthermia treatment
    77620Hyperthermia treatment
    77750Infuse radioactive materials
    77761Apply intrcav radiat simple
    77762Apply intrcav radiat interm
    77763Apply intrcav radiat compl
    77776Apply interstit radiat simpl
    77777Apply interstit radiat inter
    77778Apply interstit radiat compl
    77781High intensity brachytherapy
    77782High intensity brachytherapy
    77783High intensity brachytherapy
    77784High intensity brachytherapy
    77789Apply surface radiation
    77790Radiation handling
    77799Radium/radioisotope therapy
    INCLUDE the following CPT and HCPCS level 2 codes classified elsewhere:
    31643Diag bronchoscope/catheter
    50559Renal endoscopy/radiotracer
    55859Percut/needle insert, pros
    61770Incise skull for treatment
    61793Focus radiation beam
    92974Cath place, cardio brachytx
    G0242Multisource photon ster plan-
    G0243Multisour photon stero treat
    G0256Prostate brachy w palladium
    G0261Prostate brachytherapy w/rad
    G0274Radiopharm tx, non-Hodgkins
    PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES
    The physician self-referral prohibition does not apply to the following tests if they are performed for screening purposes and satisfy the conditions in § 411.355(h):
    76085Computer mammogram add-on [when used in conjunction with 76092]
    76092Mammogram, screening
    76977Us bone density measure
    G0103Psa, total screening
    G0107CA screen; fecal blood test
    G0123Screen cerv/vag thin layer
    G0124Screen c/v thin layer by MD
    G0141Scr c/v cyto,autosys and md
    G0143Scr c/v cyto,thinlayer,rescr
    G0144Scr c/v cyto,thinlayer,rescr
    G0145Scr c/v cyto,thinlayer,rescr
    G0147Scr c/v cyto, automated sys
    G0148Scr c/v cyto, autosys, rescr
    G0202Screeningmammographydigital
    P3000Screen pap by tech w md supv
    P3001Screening pap smear by phys
    The physician self-referral prohibition does not apply to the following immunization and vaccine codes if they satisfy the conditions in § 411.355(h):
    90657Flu vaccine, 635 mo, im
    90658Flu vaccine, 3 yrs, im
    90659Flu vacine, whole, im
    90732Pneumococcal vaccine
    90748Hep b/hib vaccine, im
    Q3021Ped hepatitis b vaccine inj
    Q3022Hepatitis b vaccine adult ds
    Q3023Injection hepatitis Bvaccine
    DRUGS USED BY PATIENTS UNDERGOING DIALYSIS
    The physician self-referral prohibition does not apply to the following EPO and other dialysis-related outpatient prescription drugs furnished in or by an ESRD facility if the conditions in § 411.355(g) are satisfied:
    J0636Inj calcitriol per 0.1 mcg
    J0895Deferoxamine mesylate inj
    J1270Injection, doxercalciferol
    J1750Iron dextran
    J1756Iron sucrose injection
    J2501Paricalcitol
    J2916Na ferric gluconate complex
    J2997Alteplase recombinant
    Q9920Epoetin with hct <=20
    Q9921Epoetin with hct = 21
    Q9922Epoetin with hct = 22
    Q9923Epoetin with hct = 23
    Q9924Epoetin with hct = 24
    Q9925Epoetin with hct = 25
    Q9926Epoetin with hct = 26
    Q9927Epoetin with hct = 27
    Q9928Epoetin with hct = 28
    Q9929Epoetin with hct = 29
    Q9930Epoetin with hct = 30
    Q9931Epoetin with hct = 31
    Q9932Epoetin with hct = 32
    Q9933Epoetin with hct = 33
    Q9934Epoetin with hct = 34
    Q9935Epoetin with hct = 35
    Q9936Epoetin with hct = 36
    Q9937Epoetin with hct = 37
    Q9938Epoetin with hct = 38
    Q9939Epoetin with hct = 39
    Q9940Epoetin with hct >= 40
    1 CPT codes and descriptions only are copyright 2002 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.

    Addendum F.—Codes Reviewed by PEAC

    [Codes Refined by the Practice Expense Advisory Committee (PEAC)

    CPT codeShort descriptorsCPT codeShort descriptors
    11043DEBRIDE TISSUE/MUSCLE15736MUSCLE-SKIN GRAFT, ARM
    Start Printed Page 80175
    11044DEBRIDE TISSUE/MUSCLE/BONE15738MUSCLE-SKIN GRAFT, LEG
    11100BIOPSY OF SKIN LESION15820REVISION OF LOWER EYELID
    11101BIOPSY, SKIN ADD-ON15821REVISION OF LOWER EYELID
    11300SHAVE SKIN LESION15822REVISION OF UPPER EYELID
    11301SHAVE SKIN LESION15823REVISION OF UPPER EYELID
    11302SHAVE SKIN LESION17000DETROY BENIGN/PREMLG LESION
    11303SHAVE SKIN LESION17003DESTROY LESIONS, 2-14
    11305SHAVE SKIN LESION17004DESTROY LESIONS, 15 OR MORE
    11306SHAVE SKIN LESION17106DESTRUCTION OF SKIN LESIONS
    11307SHAVE SKIN LESION17107DESTRUCTION OF SKIN LESIONS
    11308SHAVE SKIN LESION17108DESTRUCTION OF SKIN LESIONS
    11310SHAVE SKIN LESION17110DESTRUCT LESION, 1-14
    11311SHAVE SKIN LESION17111DESTRUCT LESION, 15 OR MORE
    11312SHAVE SKIN LESION17250CHEMICAL CAUTERY, TISSUE
    11313SHAVE SKIN LESION17260DESTRUCTION OF SKIN LESIONS
    11400EXC TR -EXT B9+MARG 0.5 < CM17261DESTRUCTION OF SKIN LESIONS
    11401EXC TR -EXT B9+MARG 0.6-1 CM17262DESTRUCTION OF SKIN LESIONS
    11402EXC TR -EXT B9+MARG 1.1-2 CM17263DESTRUCTION OF SKIN LESIONS
    11403EXC TR -EXT B9+MARG 2.1-3 CM17264DESTRUCTION OF SKIN LESIONS
    11404EXC TR - EXT B9+MARG 3.1-4 CM17266DESTRUCTION OF SKIN LESIONS
    11406EXC TR —EXT B9=MARG > 4.0 CM17270DESTRUCTION OF SKIN LESIONS
    11420EXC H-F-NK-SP B9+MARG 0.5 <17271DESTRUCTION OF SKIN LESIONS
    11421EXC H-F-NK-SP B9+MARG 0.6-117272DESTRUCTION OF SKIN LESIONS
    11422EXC H-F-NK-SP B9+MARG 1.1-217273DESTRUCTION OF SKIN LESIONS
    11423EXC H-F-NK-SP B9+MARG 2.1-317274DESTRUCTION OF SKIN LESIONS
    11424EXC H-F-NK-SP B9+MARG 3.1-417276DESTRUCTION OF SKIN LESIONS
    11426EXC H-F-NK-SP B9+MARG > 4 CM17280DESTRUCTION OF SKIN LESIONS
    11440EXC FACE-MM B9+MARG 0.5 < CM17281DESTRUCTION OF SKIN LESIONS
    11441EXC FACE-MM B9+MARG 0.6-1 CM17282DESTRUCTION OF SKIN LESIONS
    11442EXC FACE-MM B9+MARG 1.1-2 CM17283DESTRUCTION OF SKIN LESIONS
    11443EXC FACE-MM B9+MARG 2.1-3 CM17284DESTRUCTION OF SKIN LESIONS
    11444EXC FACE-MM B9+MARG 3.1-4 CM17286DESTRUCTION OF SKIN LESIONS
    11446EXC FACE-MM B9+MARG > 4 CM19318REDUCTION OF LARGE BREAST
    11900INJECTION INTO SKIN LESIONS19357BREAST RECONSTRUCTION
    11901ADDED SKIN LESIONS INJECTIONS19361BREAST RECONSTRUCTION
    14040SKIN TISSUE REARRANGEMENT19364BREAST RECONSTRUCTION
    14041SKIN TISSUE REARRANGEMENT19366BREAST RECONSTRUCTION
    14060SKIN TISSUE REARRANGEMENT19367BREAST RECONSTRUCTION
    14061SKIN TISSUE REARRANGEMENT19368BREAST RECONSTRUCTION
    14300SKIN TISSUE REARRANGEMENT19369BREAST RECONSTRUCTION
    15000SKIN GRAFT22548NECK SPINE FUSION
    15001SKIN GRAFT ADD-ON22554NECK SPINE FUSION
    15100SKIN SPLIT GRAFT22556THORAX SPINE FUSION
    15101SKIN SPLIT GRAFT ADD-ON22558LUMBAR SPINE FUSION
    15120SKIN SPLIT GRAFT22590SPINE & SKULL SPINAL FUSION
    15121SKIN SPLIT GRAFT ADD-ON22595NECK SPINAL FUSION
    15260SKIN FULL GRAFT22600NECK SPINE FUSION
    15261SKIN FULL GRAFT ADD-ON22610THORAX SPINE FUSION
    15732MUSCLE-SKIN GRAFT, HEAD/NECK22612LUMBAR SPINE FUSION
    15734MUSCLE-SKIN GRAFT, TRUNK22630LUMBAR SPINE FUSION
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80176

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    22800FUSION OF SPINE26121RELEASE PALM CONTRACTURE
    22802FUSION OF SPINE26123RELEASE PALM CONTRACTURE
    22804FUSION OF SPINE26130REMOVE WRIST JOINT LINING
    22808FUSION OF SPINE26135REVISE FINGER JOINT, EACH
    22810FUSION OF SPINE26140REVISE FINGER JOINT, EACH
    22812FUSION OF SPINE26145TENDON EXCISION, PALM/FINGER
    22818KYPHECTOMY, 1-2 SEGMENTS26160REMOVE TENDON SHEATH LESION
    22819KYPHECTOMY, 3 OR MORE26170REMOVAL OF PALM TENDON, EACH
    22830EXPLORATION OF SPINAL FUSION26180REMOVAL OF FINGER TENDON
    23470RECONSTRUCT SHOULDER JOINT26185REMOVE FINGER BONE
    23472RECONSTRUCT SHOULDER JOINT26200REMOVE HAND BONE LESION
    24160REMOVE ELBOW JOINT IMPLANT26205REMOVE/GRAFT BONE LESION
    24164REMOVE RADIUS HEAD IMPLANT26210REMOVAL OF FINGER LESION
    24360RECONSTRUCT ELBOW JOINT26215REMOVE/GRAFT FINGER LESION
    24361RECONSTRUCT ELBOW JOINT26230PARTIAL REMOVAL OF HAND BONE
    24362RECONSTRUCT ELBOW JOINT26235PARTIAL REMOVAL, FINGER BONE
    24363REPLACE ELBOW JOINT26236PARTIAL REMOVAL, FINGER BONE
    24365RECONSTRUCT HEAD OF RADIUS26250EXTENSIVE HAND SURGERY
    24366RECONSTRUCT HEAD OF RADIUS26255EXTENSIVE HAND SURGERY
    25250REMOVAL OF WRIST PROSTHESIS26260EXTENSIVE FINGER SURGERY
    25251REMOVAL OF WRIST PROSTHESIS26261EXTENSIVE FINGER SURGERY
    25332REVISE WRIST JOINT26262PARTIAL REMOVAL OF FINGER
    25441RECONSTRUCT WRIST JOINT26320REMOVAL OF IMPLANT FROM HAND
    25442RECONSTRUCT WRIST JOINT26530REVISE KNUCKLE JOINT
    25443RECONSTRUCT WRIST JOINT26531REVISE KNUCKLE WITH IMPLANT
    25444RECONSTRUCT WRIST JOINT26535REVISE FINGER JOINT
    25445RECONSTRUCT WRIST JOINT26536REVISE/IMPLANT FINGER JOINT
    25446WRIST REPLACEMENT27090REMOVAL OF HIP PROSTHESIS
    25447REPAIR WRIST JOINT(S)27091REMOVAL OF HIP PROSTHESIS
    25449REMOVE WRIST JOINT IMPLANT27120RECONSTRUCTION OF HIP SOCKET
    26010DRAINAGE OF FINGER ABSCESS27122RECONSTRUCTION OF HIP SOCKET
    26011DRAINAGE OF FINGER ABSCESS27125PARTIAL HIP REPLACEMENT
    26020DRAIN HAND TENDON SHEATH27130TOTAL HIP ARTHROPLASTY
    26025DRAINAGE OF PALM BURSA27132TOTAL HIP ARTHROPLASTY
    26030DRAINAGE OF PALM BURSA(S)27134REVISE HIP JOINT REPLACEMENT
    26034TREAT HAND BONE LESION27137REVISE HIP JOINT REPLACEMENT
    26035DECOMPRESS FINGERS/HAND27138REVISE HIP JOINT REPLACEMENT
    26037DECOMPRESS FINGERS/HAND27236TREAT THIGH FRACTURE
    26040RELEASE PALM CONTRACTURE27437REVISE KNEECAP
    26045RELEASE PALM CONTRACTURE27438REVISE KNEECAP WITH IMPLANT
    26055INCISE FINGER TENDON SHEATH27440REVISION OF KNEE JOINT
    26060INCISION OF FINGER TENDON27441REVISION OF KNEE JOINT
    26070EXPLORE/TREAT HAND JOINT27442REVISION OF KNEE JOINT
    26075EXPLORE/TREAT FINGER JOINT27443REVISION OF KNEE JOINT
    26080EXPLORE/TREAT FINGER JOINT27445REVISION OF KNEE JOINT
    26100BIOPSY HAND JOINT LINING27446REVISION OF KNEE JOINT
    26105BIOPSY FINGER JOINT LINING27447TOTAL KNEE ARTHROPLASTY
    26110BIOPSY FINGER JOINT LINING27486REVISE/REPLACE KNEE JOINT
    26115REMOVEL HAND LESION SUBCUT27487REVISE/REPLACE KNEE JOINT
    26116REMOVEL HAND LESION, DEEP27488REMOVAL OF KNEE PROSTHESIS
    26117REMOVE TUMOR, HAND/FINGER27700REVISION OF ANKLE JOINT
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80177

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    27702RECONSTRUCT ANKLE JOINT29889KNEE ARTHROSCOPY/SURGERY
    27703RECONSTRUCTION, ANKLE JOINT29891ANKLE ARTHROSCOPY/SURGERY
    27704REMOVAL OF ANKLE IMPLANT29892ANKLE ARTHROSCOPY/SURGERY
    28293CORRECTION OF BUNION29894ANKLE ARTHROSCOPY/SURGERY
    29800JAW ARTHROSCOPY/SURGERY29895ANKLE ARTHROSCOPY/SURGERY
    29804JAW ARTHROSCOPY/SURGERY29897ANKLE ARTHROSCOPY/SURGERY
    29819SHOULDER ARTHROSCOPY/SURGERY29898ANKLE ARTHROSCOPY/SURGERY
    29820SHOULDER ARTHROSCOPY/SURGERY31505DIAGNOSTIC LARYNGOSCOPY
    29821SHOULDER ARTHROSCOPY/SURGERY32440REMOVAL OF LUNG
    29822SHOULDER ARTHROSCOPY/SURGERY32442SLEEVE PNEUMONECTOMY
    29823SHOULDER ARTHROSCOPY/SURGERY32445REMOVAL OF LUNG
    29825SHOULDER ARTHROSCOPY/SURGERY32480PARTIAL REMOVAL OF LUNG
    29826SHOULDER ARTHROSCOPY/SURGERY32482BILOBECTOMY
    29830ELBOW ARTHROSCOPY32484SEGMENTECTOMY
    29834ELBOW ARTHROSCOPY/SURGERY32486SLEEVE LOBECTOMY
    29835ELBOW ARTHROSCOPY/SURGERY32488COMPLETION PNEUMONECTOMY
    29836ELBOW ARTHROSCOPY/SURGERY32491LUNG VOLUME REDUCTION
    29837ELBOW ARTHROSCOPY/SURGERY32500PARTIAL REMOVAL OF LUNG
    29838ELBOW ARTHROSCOPY/SURGERY32501REPAIR BRONCHUS ADD-ON
    29840WRIST ARTHROSCOPY32520REMOVE LUNG & REVISE CHEST
    29843WRIST ARTHROSCOPY/SURGERY32522REMOVE LUNG & REVISE CHEST
    29844WRIST ARTHROSCOPY/SURGERY32525REMOVE LUNG & REVISE CHEST
    29845WRIST ARTHROSCOPY/SURGERY32540REMOVAL OF LUNG LESION
    29846WRIST ARTHROSCOPY/SURGERY32650THORACOSCOPY, SURGICAL
    29847WRIST ARTHROSCOPY/SURGERY32651THORACOSCOPY, SURGICAL
    29848WRIST ENDOSCOPY/SURGERY32652THORACOSCOPY, SURGICAL
    29850KNEE ARTHROSCOPY/SURGERY32653THORACOSCOPY, SURGICAL
    29851KNEE ARTHROSCOPY/SURGERY32654THORACOSCOPY, SURGICAL
    29855TIBIAL ARTHROSCOPY/SURGERY32655THORACOSCOPY, SURGICAL
    29856TIBIAL ARTHROSCOPY/SURGERY32656THORACOSCOPY, SURGICAL
    29860HIP ARTHROSCOPY, DX32657THORACOSCOPY, SURGICAL
    29861HIP ARTHROSCOPY/SURGERY32658THORACOSCOPY, SURGICAL
    29862HIP ARTHROSCOPY/SURGERY32659THORACOSCOPY, SURGICAL
    29863HIP ARTHROSCOPY/SURGERY32660THORACOSCOPY, SURGICAL
    29870KNEE ARTHROSCOPY, DX32661THORACOSCOPY, SURGICAL
    29871KNEE ARTHROSCOPY/DRAINAGE32662THORACOSCOPY, SURGICAL
    29874KNEE ARTHROSCOPY/SURGERY32663THORACOSCOPY, SURGICAL
    29875KNEE ARTHROSCOPY/SURGERY32664THORACOSCOPY, SURGICAL
    29876KNEE ARTHROSCOPY/SURGERY32665THORACOSCOPY, SURGICAL
    29877KNEE ARTHROSCOPY/SURGERY33400REPAIR OF AORTIC VALVE
    29879KNEE ARTHROSCOPY/SURGERY33401VALVULOPLASTY, OPEN
    29880KNEE ARTHROSCOPY/SURGERY33403VALVULOPLASTY, W/CP BYPASS
    29881KNEE ARTHROSCOPY/SURGERY33404PREPARE HEART-AORTA CONDUIT
    29882KNEE ARTHROSCOPY/SURGERY33405REPLACEMENT OF AORTIC VALVE
    29883KNEE ARTHROSCOPY/SURGERY33406REPLACEMENT OF AORTIC VALVE
    29884KNEE ARTHROSCOPY/SURGERY33410REPLACEMENT OF AORTIC VALVE
    29885KNEE ARTHROSCOPY/SURGERY33411REPLACEMENT OF AORTIC VALVE
    29886KNEE ARTHROSCOPY/SURGERY33412REPLACEMENT OF AORTIC VALVE
    29887KNEE ARTHROSCOPY/SURGERY33413REPLACEMENT OF AORTIC VALVE
    29888KNEE ARTHROSCOPY/SURGERY33420REVISION OF MITRAL VALVE
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80178

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    33422REVISION OF MITRAL VALVE43239UPPER GI ENDOSCOPY, BIOPSY*
    33425REPAIR OF MITRAL VALVE43240ESOPH ENDOSCOPE W/DRAIN CYST*
    33426REPAIR OF MITRAL VALVE43241UPPER GI ENDOSCOPY WITH TUBE*
    33427REPAIR OF MITRAL VALVE43242UPPR GI ENDOSCOPY W/US FN BX*
    33430REPLACEMENT OF MITRAL VALVE43243UPPER GI ENDOSCOPY & INJECT*
    33510CABG, VEIN, SINGLE43244UPPER GI ENSOSCOPY/LIGATION*
    33511CABG, VEIN, TWO43245UPPR GI SCOPY DILATE STRICTR*
    33512CABG, VEIN, THREE43246PLACE GASTROSTOMY TUBE*
    33513CABG, VEIN, FOUR43247OPERATIVE UPPER GI ENDOSCOPY*
    33514CABG, VEIN, FIVE43248UPPR GI ENDOSCOPY/GUIDE WIRE*
    33516CABG, VEIN, SIX OR MORE43249ESOPH ENDOSCOPY, DILATION*
    33533CABG, ARTERIAL, SINGLE43250UPPER GI ENDOSCOPY/TUMOR*
    33534CABG, ARTERIAL, TWO43251OPERATIVE UPPER GI ENDOSCOPY*
    33535CABG, ARTERIAL, THREE43255OPERATIVE UPPER GI ENDOSCOPY*
    33536CABG, ARTERIAL, FOUR OR MORE43256UPPR GI ENDOSCOPY W STENT*
    35474REPAIR ARTERIAL BLOCKAGE43258OPERATIVE UPPER GI ENDOSCOPY*
    36400BL DRAW < 3 YRS FEM/JUGULAR43259ENDOSCOPIC ULTRASOUND EXAM*
    36405BL DRAW < 3 YRS SCALP VEIN43752NASAL/OROGASTRIC W/STENT
    36406BL DRAW < 3 YRS OTHER VEIN44140PARTIAL REMOVAL OF COLON
    36410NON-ROUTINE BL DRAW > 3 YRS44141PARTIAL REMOVAL OF COLON
    36415ROUTINE VENIPUNCTURE44143PARTIAL REMOVAL OF COLON
    36416CAPILLARY BLOOD DRAW44144PARTIAL REMOVAL OF COLON
    36420VEIN ACCESS CUTDOWN < 1 YR44145PARTIAL REMOVAL OF COLON
    36425VEIN ACCESS CUTDOWN > 1 YR44146PARTIAL REMOVAL OF COLON
    36540COLLECT BLOOD VENOUS DEVICE44147PARTIAL REMOVAL OF COLON
    36660INSERTION CATHETER, ARTERY44150REMOVAL OF COLON
    39010EXPLORATION OF CHEST44151REMOVAL OF COLON/ILEOSTOMY
    39200REMOVAL CHEST LESION44152REMOVAL OF COLON/ILEOSTOMY
    39220REMOVAL CHEST LESION44153REMOVAL OF COLON/ILEOSTOMY
    39400VISUALIZATION OF CHEST44155REMOVAL OF COLON/ILEOSTOMY
    40800DRAINAGE OF MOUTH LESION44156REMOVAL OF COLON/ILEOSTOMY
    40801DRAINAGE OF MOUTH LESION44160REMOVAL OF COLON
    40804REMOVAL, FOREIGN BODY, MOUTH44200LAPAROSCOPY, ENTEROLYSIS
    40805REMOVAL, FOREIGN BODY, MOUTH44201LAPAROSCOPY, JEJUNOSTOMY
    40808BIOPSY OF MOUTH LESION44202LAP RESECT S/INTESTINE SINGL
    40810EXCISION OF MOUTH LESION44300OPEN BOWEL TO SKIN
    40812EXCISE/REPAIR MOUTH LESION44310ILEOSTOMY/JEJUNOSTOMY
    40814EXCISE/REPAIR MOUTH LESION44312REVISION OF ILEOSTOMY
    40816EXCISION OF MOUTH LESION44314REVISION OF ILEOSTOMY
    41100BIOPSY OF TONGUE44316DEVISE BOWEL POUCH
    41105BIOPSY OF TONGUE44320COLOSTOMY
    41108BIOPSY OF FLOOR OF MOUTH44322COLOSTOMY WITH BIOPSIES
    41110EXCISION OF TONGUE LESION44340REVISION OF COLOSTOMY
    41112EXCISION OF TONGUE LESION44345REVISION OF COLOSTOMY
    41113EXCISION OF TONGUE LESION44346REVISION OF COLOSTOMY
    41114EXCISION OF TONGUE LESION44602SUTURE, SMALL INTESTINE
    43107REMOVAL OF ESOPHAGUS44603SUTURE, SMALL INTESTINE
    43112REMOVAL OF ESOPHAGUS44604SUTURE, LARGE INTESTINE
    43117PARTIAL REMOVAL OF ESOPHAGUS44605REPAIR OF BOWEL LESION
    43121PARTIAL REMOVAL OF ESOPHAGUS44615INTESTINAL STRICTUROPLASTY
    43122PARTIAL REMOVAL OF ESOPHAGUS44620REPAIR BOWEL OPENING
    43235UPPR GI ENDOSCOPY, DIAGNOSIS*
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80179

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    44625REPAIR BOWEL OPENING52007CYSTOSCOPY AND BIOPSY
    44626REPAIR BOWEL OPENING52010CYSTOSCOPY & DUCT CATHETER
    44640REPAIR BOWEL-SKIN FISTULA52204CYSTOSCOPY
    44650REPAIR BOWEL FISTULA52214CYSTOSCOPY AND TREATMENT
    44660REPAIR BOWEL-BLADDER FISTULA52224CYSTOSCOPY AND TREATMENT
    44661REPAIR BOWEL-BLADDER FISTULA52234CYSTOSCOPY AND TREATMENT
    44680SURGICAL REVISION, INTESTINE52235CYSTOSCOPY AND TREATMENT
    44700SUSPEND BOWEL W/PROSTHESIS52240CYSTOSCOPY AND TREATMENT
    44800EXCISION OF BOWEL POUCH52250CYSTOSCOPY AND RADIOTRACER
    44820EXCISION OF MESENTERY LESION52260CYSTOSCOPY AND TREATMENT
    44850REPAIR OF MESENTERY52265CYSTOSCOPY AND TREATMENT
    44900DRAIN APP ABSCESS, OPEN52270CYSTOSCOPY & REVISE URETHRA
    44950APPENDECTOMY52275CYSTOSCOPY & REVISE URETHRA
    44955APPENDECTOMY ADD-ON52276CYSTOSCOPY AND TREATMENT
    44960APPENDECTOMY52277CYSTOSCOPY AND TREATMENT
    44970LAPAROSCOPY, APPENDECTOMY52281CYSTOSCOPY AND TREATMENT
    45000DRAINAGE OF PELVIC ABSCESS52282CYSTOSCOPY, IMPLANT STENT
    45020DRAINAGE OF RECTAL ABSCESS52283CYSTOSCOPY AND TREATMENT
    45100BIOPSY OF RECTUM52285CYSTOSCOPY AND TREATMENT
    45108REMOVAL OF ANORECTAL LESION52290CYSTOSCOPY AND TREATMENT
    45110REMOVAL OF RECTUM52300CYSTOSCOPY AND TREATMENT
    45111PARTIAL REMOVAL OF RECTUM52301CYSTOSCOPY AND TREATMENT
    45112REMOVAL OF RECTUM52305CYSTOSCOPY AND TREATMENT
    45113PARTIAL PROCTECTOMY52310CYSTOSCOPY AND TREATMENT
    45114PARTIAL REMOVAL OF RECTUM52315CYSTOSCOPY AND TREATMENT
    45116PARTIAL REMOVAL OF RECTUM52317REMOVE BLADDER STONE
    45119REMOVE RECTUM W/RESERVOIR52318REMOVE BLADDER STONE
    45120REMOVAL OF RECTUM52320CYSTOSCOPY AND TREATMENT
    45121REMOVAL OF RECTUM AND COLON52325CYSTOSCOPY, STONE REMOVAL
    45123PARTIAL PROCTECTOMY52327CYSTOSCOPY, INJECT MATERIAL
    45126PELVIC EXENTERATION52330CYSTOSCOPY AND TREATMENT
    45130EXCISION OF RECTAL PROLAPSE52332CYSTOSCOPY AND TREATMENT
    45135EXCISION OF RECTAL PROLAPSE52334CREATE PASSAGE TO KIDNEY
    45150EXCISION OF RECTAL STRICTURE52341CYSTO W/URETER STRICTURE TX
    45160EXCISION OF RECTAL LESION52342CYSTO W/UP STRICTURE TX
    45170EXCISION OF RECTAL LESION52343CYSTO W/RENAL STRICTURE TX
    45190DESTRUCTION, RECTAL TUMOR52344CYSTO/URETERO, STONE REMOVE
    47510INSERT CATHETER, BILE DUCT52345CYSTO/URETERO W/UP STRICTURE
    51725SIMPLE CYSTOMETROGRAM52346CYSTOURETERO W/RENAL STRICT
    51726COMPLEX CYSTOMETROGRAM52351CYSTOURETRO & OR PYELOSCOPE
    51736URINE FLOW MEASUREMENT52352CYSTOURETRO W/STONE REMOVE
    51741ELECTRO-UROFLOWMETRY, FIRST52353CYSTOURETERO W/LITHOTRIPSY
    51772URETHRA PRESSURE PROFILE52354CYSTOURETERO W/BIOPSY
    51784ANAL/URINARY MUSCLE STUDY52355CYSTOURETERO W/EXCISE TUMOR
    51785ANAL/URINARY MUSCLE STUDY52400CYSTOURETERO W/CONGEN REPR
    51792URINARY REFLEX STUDY52450INCISION OF PROSTATE
    51795URINE VOIDING PRESSURE STUDY52500REVISION OF BLADDER NECK
    51797INTRAABDOMINAL PRESSURE TEST52510DILATION PROSTATIC URETHRA
    52000CYSTOSCOPY52601PROSTATECTOMY (TURP)
    52001CYSTOSCOPY, REMOVAL OF CLOTS52606CONTROL POSTOP BLEEDING
    52005CYSTOSCOPY & URETER CATHETER52612PROSTATECTOMY, FIRST STAGE
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80180

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    52614PROSTATECTOMY, SECOND58555HYSTEROSCOPY, DX, SEP PROC
    52620REMOVE RESIDUAL PROSTATE58558HYSTEROSCOPY, BIOPSY
    52630REMOVE PROSTATE REGROWTH58559HYSTEROSCOPY, LYSIS
    52640RELIEVE BLADDER CONTRACTURE58560HYSTEROSCOPY, RESECT SPECTUM
    52647LASER SURGERY OF PROSTATE58561HYSTEROSCOPY, REMOVE MYOMA
    52648LASER SURGERY OF PROSTATE58563HYSTEROSCOPY, ABLATION
    52700DRAINAGE OF PROSTATE ABSCESS59400OBSTETRICAL CARE
    56605BIOPSY OF VULVA/PERINEUM59409OBSTETRICAL CARE
    56606BIOPSY OF VULVA/PERINEUM59410OBSTETRICAL CARE
    56700PARTIAL REMOVAL OF HYMEN59412ANTEPARTUM MANIPULATION
    56720INCISION OF HYMEN59414DELIVER PLACENTA
    56740REMOVE VAGINA GLAND LESION59425ANTEPARTUM CARE ONLY
    57100BIOPSY OF VAGINA59426ANTEPARTUM CARE ONLY
    57105BIOPSY OF VAGINA59430CARE AFTER DELIVERY
    57200REPAIR OF VAGINA59510CESAREAN DELIVERY
    57210REPAIR VAGINA/PERINEUM59514CESAREAN DELIVERY ONLY
    57220REVISION OF URETHRA59515CESAREAN DELIVERY
    57230REPAIR OF URETHRAL LESION59525REMOVE UTERUS AFTER CESAREAN
    57240REPAIR BLADDER & VAGINA59610VBAC DELIVERY
    57250REPAIR RECTUM & VAGINA59612VBAC DELIVERY ONLY
    57260REPAIR OF VAGINA59614VBAC CARE AFTER DELIVERY
    57265EXTENSIVE REPAIR OF VAGINA59618ATTEMPTED VBAC DELIVERY
    57268REPAIR OF BOWEL BULGE59620ATTEMPTED VBAC DELIVERY ONLY
    57270REPAIR OF BOWEL POUCH59622ATTEMPTED VBAC AFTER CARE
    57280SUSPENSION OF VAGINA60100BIOPSY OF THYROID
    57282REPAIR OF VAGINAL PROLAPSE61000REMOVE CRANIAL CAVITY FLUID
    57284REPAIR PARAVAGINAL DEFECT61001REMOVE CRANIAL CAVITY FLUID
    57287REVISE/REMOVE SLING REPAIR61020REMOVE BRAIN CAVITY FLUID
    57288REPAIR BLADDER DEFECT61026INJECTION INTO BRAIN CANAL
    57289REPAIR BLADDER & VAGINA61050REMOVE BRAIN CANAL FLUID
    57291CONSTRUCTION OF VAGINA61055INJECTION INTO BRAIN CANAL
    57292CONSTRUCT VAGINA WITH GRAFT61070BRAIN CANAL SHUNT PROCEDURE
    57300REPAIR RECTUM-VAGINA FISTULA61105TWIST DRILL HOLE
    57305REPAIR RECTUM-VAGINA FISTULA61108DRILL SKULL FOR DRAINAGE
    57307FISTULA REPAIR & COLOSTOMY61120BURR HOLE FOR PUNCTURE
    57308FISTULA REPAIR, TRANSPERINE61140PIERCE SKULL FOR BIOPSY
    57310REPAIR URETHROVAGINAL LESION61150PIERCE SKULL FOR DRAINAGE
    57311REPAIR URETHROVAGINAL LESION61151PIERCE SKULL FOR DRAINAGE
    57320REPAIR BLADDER-VAGINA LESION61154PIERCE SKULL & REMOVE CLOT
    57330REPAIR BLADDER-VAGINA LESION61156PIERCE SKULL FOR DRAINAGE
    57335REPAIR VAGINA61215INSERT BRAIN-FLUID DEVICE
    57460BX OF CERVIX W/SCOPE, LEEP61250PIERCE SKULL & EXPLORE
    57800DILATION OF CERVICAL CANAL61253PIERCE SKULL & EXPLORE
    57820D & C OF RESIDUAL CERVIX61304OPEN SKULL FOR EXPLORATION
    58120DILATION AND CURETTAGE61305OPEN SKULL FOR EXPLORATION
    58150TOTAL HYSTERECTOMY61312OPEN SKULL FOR DRAINAGE
    58152TOTAL HYSTERECTOMY61313OPEN SKULL FOR DRAINAGE
    58180PARTIAL HYSTERECTOMY61314OPEN SKULL FOR DRAINAGE
    58200EXTENSIVE HYSTERECTOMY61315OPEN SKULL FOR DRAINAGE
    58210EXTENSIVE HYSTERECTOMY61320OPEN SKULL FOR DRAINAGE
    58240REMOVAL OF PELVIS CONTENTS61321OPEN SKULL FOR DRAINAGE
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80181

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    61330DECOMPRESS EYE SOCKET64418N BLOCK INJ, SUPRASCAPULAR
    61332EXPLORE/BIOPSY EYE SOCKET64420N BLOCK INJ, INTERCOST, SNG
    61333EXPLORE ORBIT/REMOVE LESION64421N BLOCK INJ, INTERCOST, MLT
    61334EXPLORE ORBIT/REMOVE OBJECT64425N BLOCK INJ ILIO-ING/HYPOGI
    61340SUBTEMPORAL DECOMPRESSION64430N BLOCK INJ, PUDENDAL
    62270SPINAL FLUID TAP, DIAGNOSTIC64435N BLOCK INJ, PARACERVICAL
    62272DRAIN CEREBRO SPINAL FLUID64445N BLOCK INJ, SCIATIC, SNG
    62273TREAT EPIDURAL SPINE LESION64450N BLOCK, OTHER PERIPHERAL
    62280TREAT SPINAL CORD LESION64470INJ PARAVERTEBRAL C/T
    62281TREAT SPINAL CORD LESION64472INJ PARAVERTEBRAL C/T ADD-ON
    62282TREAT SPINAL CANAL LESION64475INJ PARAVERTEBRAL L/S
    62284INJECTION FOR MYELOGRAM64476INJ PARAVERTEBRAL L/S ADD-ON
    62290INJECT FOR SPINE DISK X-RAY64479INJ FORAMEN EPIDURAL C/T
    62291INJECT FOR SPINE DISK X-RAY64480INJ FORAMEN EPIDURAL ADD-ON
    62310INJECT SPINE C/T64483INJ FORAMEN EPIDURAL L/S
    62311INJECT SPINE L/S (CD)64484INJ FORAMEN EPIDURAL ADD-ON
    62318INJECT SPINE W/CATH, C/T64505N BLOCK, SPENOPALATINE GANGL
    62319INJECT SPINE W/CATH L/S (CD)64508N BLOCK, CAROTID SINUS S/P
    63001REMOVAL OF SPINAL LAMINA64510N BLOCK, STELLATE GANGLION
    63003REMOVAL OF SPINAL LAMINA64520N BLOCK, LUMBAR/THORACIC
    63005REMOVAL OF SPINAL LAMINA64530N BLOCK INJ, CELIAC PELUS
    63011REMOVAL OF SPINAL LAMINA64600INJECTION TREATMENT OF NERVE
    63012REMOVAL OF SPINAL LAMINA64605INJECTION TREATMENT OF NERVE
    63015REMOVAL OF SPINAL LAMINA64610INJECTION TREATMENT OF NERVE
    63016REMOVAL OF SPINAL LAMINA64612DESTROY NERVE, FACE MUSCLE
    63017REMOVAL OF SPINAL LAMINA64613DESTROY NERVE, SPINE MUSCLE
    63020NECK SPINE DISK SURGERY64614DESTROY NERVE, EXTREM MUSC
    63030LOW BACK DISK SURGERY64620INJECTION TREATMENT OF NERVE
    63040LAMINOTOMY, SINGLE CERVICAL64622DESTR PARAVERTEBRL NERVE L/S
    63042LAMINOTOMY, SINGLE LUMBAR64623DESTR PARAVERTEBRAL N ADD-ON
    63045REMOVAL OF SPINAL LAMINA64626DESTR PARAVERTEBRL NERVE C/T
    63046REMOVAL OF SPINAL LAMINA64627DESTR PARAVERTEBRAL N ADD-ON
    63047REMOVAL OF SPINAL LAMINA64630INJECTION TREATMENT OF NERVE
    63055DECOMPRESS SPINAL CORD64640INJECTION TREATMENT OF NERVE
    63056DECOMPRESS SPINAL CORD64680INJECTION TREATMENT OF NERVE
    63064DECOMPRESS SPINAL CORD66700DESTRUCTION, CILIARY BODY
    63075NECK SPINE DISK SURGERY66710DESTRUCTION, CILIARY BODY
    63077SPINE DISK SURGERY, THORAX66720DESTRUCTION, CILIARY BODY
    63081REMOVAL OF VERTEBRAL BODY66740DESTRUCTION, CILIARY BODY
    63085REMOVAL OF VERTEBRAL BODY66761REVISION OF IRIS
    63087REMOVAL OF VERTEBRAL BODY66762REVISION OF IRIS
    63090REMOVAL OF VERTEBRAL BODY66770REMOVAL OF INNER EYE LESION
    64400N BLOCK INJ, TRIGEMINAL70336MAGNETIC IMAGE, JAW JOINT
    64402N BLOCK INJ, FACIAL70540MRI ORBIT/FACE/NECK W/O DYE
    64405N BLOCK INJ, OCCIPITAL70551MRI BRAIN W/O DYE
    64408N BLOCK INJ, VAGUS71550MRI CHEST W/O DYE
    64410N BLOCK INJ, PHRENIC72141MRI NECK SPINE W/O DYE
    64412N BLOCK INJ, SPINAL ACCESSOR72146MRI CHEST SPINE W/O DYE
    64413N BLOCK INJ, CERVICAL PLEXUS72148MRI LUMBAR SPINE W/O DYE
    64415N BLOCK INJ, BRACHIAL PLEXUS72195MRI PELVIS W/O DYE
    64417N BLOCK INJ, AXILLARY73218MRI UPPER EXTREMITY W/O
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80182

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    73221MRI JOINT UPR EXTREM W/O DYE88332PATH CONSULT INTRAOP, ADDL
    73718MRI LOWER EXTREMITY W/O DYE88342IMMUNOCYTOCHEMISTRY
    73721MRI JOINT OF LWR EXTRE W/O DYE88346IMMUNOFLUORESCENT STUDY
    74181MRI ABDOMEN W/O DYE88347IMMUNOFLUORESCENT STUDY
    75552HEART MRI FOR MORPH W/O DYE88362NERVE TEASING PREPARATIONS
    75554CARDIAC MRI/FUNCTION90471IMMUNIZATION ADMIN
    75555CARDIAC MRI/LIMITED STUDY90472IMMUNIZATION ADMIN, EACH ADD
    76075DEXA, AXIAL SKELETON STUDY90780IV INFUSION THERAPY, 1 HOUR
    76076DEXA, PERIPHERAL STUDY90781IV INFUSION, ADDITIONAL HOUR
    76400MAGNETIC IMAGE, BONE MARROW90782INJECTION, SC/IM
    76506ECHO EXAM OF HEAD90783INJECTION, IA
    76536US EXAM OF HEAD AND NECK90784INJECTION, IV
    76700US EXAM, ABDOM, COMPLETE90788INJECTION OF ANTIBIOTIC
    76770US EXAM ABDO BACK WALL, COMP90801PSY DX INTERVIEW
    76778US EXAM KIDNEY TRANSPLANT90802INTAC PSY DX INTERVIEW
    76818FETAL BIOPHYS PROFILE W/NST90804PSYTX, OFFICE, 20-30 MIN
    76819FETAL BIOPHYS PROFIL W/O NST90805PSYTX, OFF, 20-30 MIN W/E&M
    76825ECHO EXAM OF FETAL HEART90806PSYTX, OFF, 45-50 MIN
    76826ECHO EXAM OF FETAL HEART90807PSYTX, OFF, 45-50 MIN W/E&M
    76827ECHO EXAM OF FETAL HEART90808PSYTX, OFFICE, 75-80 MIN
    76828ECHO EXAM OF FETAL HEART90809PSYTX, OFF, 75-80, W/E&M
    76830TRANSVAGINAL US, NON-OB90810INTAC PSYTX, OFF, 20-30 MIN
    76831ECHO EXAM, UTERUS90811INTAC PSYTX, 20-30, W/E&M
    76856US EXAM, PELVIC, COMPLETE90812INTAC PSYTX, OFF, 45-50 MIN
    76857US EXAM, PELVIC, LIMITED90813INTAC PSYTX, 45-50 MIN W/E&M
    76870US EXAM, SCROTUM90814INTAC PSYTX, OFF, 75-80 MIN
    76872ECHO EXAM, TRANSRECTAL90815INTAC PSYTX, 75-80 W/E&M
    76873ECHOGRAP TRANS R, PROS STUDY90816PSYTX, HOSP, 20-30 MIN
    76880US EXAM, EXTREMITY90817PSYTX, HOSP, 20-30 MIN W/E&M
    76885US EXAM INFANT HIPS, DYNAMIC90818PSYTX, HOSP, 45-50 MIN
    76942ECHO GUIDE FOR BIOPSY90819PSYTX, HOSP, 45-50 MIN W/E&M
    77789APPLY SURFACE RADIATION90821PSYTX, HOSP, 75-80 MIN
    78070PARATHYROID NUCLEAR IMAGING90822PSYTX, HOSP, 75-80 MIN W/E&M
    78306BONE IMAGING, WHOLE BODY90823INTAC PSYTX, HOSP, 20-30 MIN
    78315BONE IMAGING, 3 PHASE90824INTAC PSYTX, HSP 20-30 W/E&M
    78460HEART MUSCLE BLOOD, SINGLE90826INTAC PSYTX, HOSP, 45-50 MIN
    78461HEART MUSCLE BLOOD, MULTIPLE90827INTAC PSYTX, HSP 45-50 W/E&M
    78464HEART IMAGE (3D), SINGLE90828INTAC PSYTX, HOSP, 75-80 MIN
    78465HEART IMAGE (3D), MULTIPLE90829INTAC PSYTX, HSP 75-80 W/E&M
    78478HEART WALL MOTION ADD-ON90845PSYCHOANALYSIS
    78480HEART FUNCTION ADD-ON90846FAMILY PSYTX W/O PATIENT
    78580LUNG PERFUSION IMAGING90847FAMILY PSYTX W/PATIENT
    88180CELL MARKER STUDY90849MULTIPLE FAMILY GROUP PSYTX
    88182CELL MARKER STUDY90853GROUP PSYCHOTHERAPY
    88291CYTO/MOLECULAR REPORT90857INTAC GROUP PSYTX
    88321MICROSLIDE CONSULTATION90862MEDICATION MANAGEMENT
    88323MICROSLIDE CONSULTATION90918ESRD RELATED SERVICES, MONTH
    88325COMPREHENSIVE REVIEW OF DATA90919ESRD RELATED SERVICES, MONTH
    88329PATH CONSULT INTROP90920ESRD RELATED SERVICES, MONTH
    88331PATH CONSULT INTRAOP, 1 BLOC90921ESRD RELATED SERVICES, MONTH
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80183

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    90922ESRD RELATED SERVICES, DAY93314ECHO TRANSESOPHAGEAL
    90923ESRD RELATED SERVICES, DAY93315ECHO TRANSESOPHAGEAL
    90924ESRD RELATED SERVICES, DAY93317ECHO TRANSESOPHAGEAL
    90925ESRD RELATED SERVICES, DAY93320DOPPLER ECHO EXAM, HEART
    90935HEMODIALYSIS, ONE EVALUATION93321DOPPLER ECHO EXAM, HEART
    90937HEMODIALYSIS, REPEATED EVAL93325DOPPLER COLOR FLOW ADD-ON
    90945DIALYSIS, ONE EVALUATION93350ECHO TRANSTHORACIC
    90947DIALYSIS, REPEATED EVAL93508CATH PLACEMENT, ANGIOGRAPHY
    91100PASS INTESTINE BLEEDING TUBE93510LEFT HEART CATHETERIZATION
    91105GASTRIC INTUBATION TREATMENT93511LEFT HEART CATHETERIZATION
    92065ORTHOPTIC/PLEOPTIC TRAINING93514LEFT HEART CATHETERIZATION
    92070FITTING OF CONTACT LENS93524LEFT HEART CATHETERIZATION
    92283COLOR VISION EXAMINATION93526RT & LT HEART CATHETERS
    92504EAR MICROSCOPY EXAMINATION93527RT & LT HEART CATHETERS
    92541SPONTANEOUS NYSTAGMUS TEST93528RT & LT HEART CATHETERS
    92542POSITIONAL NYSTAGMUS TEST93529RT & LT HEART CATHETERIZATION
    92543CALORIC VESTIBULAR TEST93530RT HEART CATH, CONGENITAL
    92544OPTOKINETIC NYSTAGMUS TEST93531R & L HEART CATH, CONGENITAL
    92545OSCILLATING TRACKING TEST93532R & L HEART CATH, CONGENITAL
    92546SINUSOIDAL ROTATIONAL TEST93533R & L HEART CATH, CONGENITAL
    92552PURE TONE AUDIOMETRY, AIR93539INJECTION, CARDIAC CATH
    92553AUDIOMETRY, AIR & BONE93540INJECTION, CARDIAC CATH
    92555SPEECH THRESHOLD AUDIOMETRY93541INJECTION FOR LUNG ANGIOGRAM
    92556SPEECH AUDIOMETRY, COMPLETE93542INJECTION FOR HEART X-RAYS
    92557COMPREHENSIVE HEARING TEST93543INJECTION FOR HEART X-RAYS
    92567TYMPANOMETRY93544INJECTION FOR AORTOGRAPHY
    92568ACOUSTIC REFLEX TESTING93545INJECT FOR CORONARY X-RAYS
    92569ACOUSTIC REFLEX DECAY TEST93555IMAGING, CARDIAC CATH
    92980INSERT INTRACORONARY STENT93556IMAGING, CARDIAC CATH
    92981INSERT INTRACORONARY STENT93733TELEPHONE ANALY, PACEMAKER
    92982CORONARY ARTERY DILATION93736TELEPHONE ANALY, PACEMAKER
    92984CORONARY ARTERY DILATION93740TEMPERATURE GRADIENT STUDIES
    92995CORONARY ATHERECTOMY93770MEASURE VENOUS PRESSURE
    92996CORONARY ATHERECTOMY ADD-ON93875 TCEXTRACRANIAL STUDY
    92997PUL ART BALLOON REPR, PERCUT93880 TCEXTRACRANIAL STUDY
    92998PUL ART BALLOON REPR, PERCUT93882 TCEXTRACRANIAL STUDY
    93000ELECTROCARDIOGRAM, COMPLETE93886 TCINTRACRANIAL STUDY
    93005ELECTROCARDIOGRAM, TRACING93888 TCINTRACRANIAL STUDY
    93010ELECTROCARDIOGRAM REPORT93922 TCEXTREMITY STUDY
    93015CARDIOVASCULAR STRESS TEST93923 TCEXTREMITY STUDY
    93016CARDIOVASCULAR STRESS TEST93924 TCEXTREMITY STUDY
    93017CARDIOVASCULAR STRESS TEST93925 TCLOWER EXTREMITY STUDY
    93018CARDIOVASCULAR STRESS TEST93926 TCLOWER EXTREMITY STUDY
    93040RHYTHM ECG WITH REPORT93930 TCUPPER EXTREMITY STUDY
    93041RHYTHM ECG, TRACING93931 TCUPPER EXTREMITY STUDY
    93042RHYTHM ECG, REPORT93965 TCEXTREMITY STUDY
    93303ECHO TRANSTHORACIC93970 TCEXTREMITY STUDY
    93304ECHO TRANSTHORACIC93971 TCEXTREMITY STUDY
    93307ECHO EXAM OF HEART93975 TCVASCULAR STUDY
    93308ECHO EXAM OF HEART93976 TCVASCULAR STUDY
    93312ECHO TRANSESOPHAGEAL93978 TCVASCULAR STUDY
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    Start Printed Page 80184

    Addendum F.—Codes Reviewed by PEAC—Continued

    CPT codeShort descriptorsCPT codeShort descriptors
    93979 TCVASCULAR STUDY
    93990 TCDOPPLER FLOW TESTING
    95807SLEEP STUDY, ATTENDED
    95808POLYSOMNOGRAPHY, 1-3
    95810POLYSOMNOGRAPHY, 4 OR MORE
    95811POLYSOMNOGRAPHY W/CPAP
    95951EEG MONITORING/VIDEORECORD
    96400CHEMOTHERAPY, SC/IM
    96408CHEMOTHERAPY, PUSH TECHNIQUE
    96410CHEMOTHERAPY, INFUSION METHOD
    96412CHEMO, INFUSE METHOD ADD-ON
    96414CHEMO, INFUSE METHOD ADD-ON
    96420CHEMOTHERAPY, PUSH TECHNIQUE
    96422CHEMOTHERAPY, INFUSION METHOD
    96423CHEMO, INFUSE METHOD ADD-ON
    96425CHEMOTHERAPY, INFUSION METHOD
    96520PORT PUMP REFILL & MAIN
    96530SYST PUMP REFILL & MAIN
    98940CHIROPRACTIC MANIPULATION
    98941CHIROPRACTIC MANIPULATION
    98942CHIROPRACTIC MANIPULATION
    98943CHIROPRACTIC MANIPULATION
    99183HYPERBARIC OXYGEN THERAPY
    99195PHLEBOTOMY
    99199SPECIAL SERVICE/PROC/REPORT
    99431INITIAL CARE, NORMAL NEWBORN
    99432NEWBORN CARE, NOT IN HOSP
    99433NORMAL NEWBORN CARE/HOSPITAL
    99435NEWBORN DISCHARGE DAY HOSP
    99436ATTENDANCE, BIRTH
    99440NEWBORN RESUSCITATION
    *PEAC refined in office inputs only.
    CPT Codes and descriptions are copyright 2002 by the Amercian Medical Association, all rights reserved.
    End Supplemental Information

    [FR Doc. 02-32503 Filed 12-20-02; 11:52 am]

    BILLING CODE 4120-01-P

Document Information

Published:
12/31/2002
Department:
Centers for Medicare & Medicaid Services
Entry Type:
Rule
Action:
Final rule with comment period.
Document Number:
02-32503
Pages:
79965-80184 (220 pages)
Docket Numbers:
CMS-1204-FC
RINs:
0938-AL21: Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2003 (CMS-1204-FC)
RIN Links:
https://www.federalregister.gov/regulations/0938-AL21/revisions-to-payment-policies-under-the-physician-fee-schedule-for-calendar-year-2003-cms-1204-fc-
Topics:
Administrative practice and procedure, Grant programs-health, Health facilities, Health professions, Kidney diseases, Laboratories, Medicaid, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays
PDF File:
02-32503.pdf
CFR: (9)
42 CFR 410.37
42 CFR 410.59
42 CFR 410.60
42 CFR 410.61
42 CFR 410.76
More ...