03-27639. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2004  

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    AGENCY:

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

    ACTION:

    Final rule with comment period.

    SUMMARY:

    This final rule will refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The policy changes concern: Medicare Economic Index, practice expense for professional component services, definition of diabetes for diabetes self-management training, supplemental survey data for practice expense, geographic practice cost indices, and several coding issues. In addition, this rule updates the codes subject to the physician self-referral prohibition. We also make revisions to the sustainable growth rate and the anesthesia conversion factor.

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

    We are also finalizing the calendar year (CY) 2003 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2004.

    As required by the statute, we are announcing that the physician fee schedule update for CY 2004 is -4.5 percent, the initial estimate of the sustainable growth rate for CY 2004 is 7.4 percent, and the conversion factor for CY 2004 is $35.1339.

    We published a proposed rule (68 FR 50428) in the Federal Register on Part B drug payment reform on August 20, 2003. This proposed rule would also make changes to Medicare payment for furnishing or administering certain drugs and biologicals. We have not finalized these proposals to take into account that the Congress is considering legislation that would address these issues. We will continue to monitor legislative activity that would reform the Medicare Part B drug payment system. If legislation is not enacted soon on this issue, we remain committed to completing the regulatory process.

    DATES:

    Effective date: These regulations are effective on January 1, 2004.

    Comment date: We will consider comments on the physician self-referral designated health services additions and deletions identified in Tables 8 and 9, and the interim work RVUs for selected procedure codes identified in Addendum C if we receive them at the appropriate address, as provided in the addresses section, no later than 5 p.m. on January 6, 2004.

    ADDRESSES:

    In commenting, please refer to file code CMS-1476-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-1476-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 encouraged 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.

    Start Further Info

    FOR FURTHER INFORMATION CONTACT:

    Pam West (410) 786-2302 (for issues related to practice expense.)

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

    Rick Ensor (410) 786-5617 (for issues related to Geographic Cost Price Index (GPCI).)

    Mary Stojak (410) 786-6939 (for issues related to the definition of diabetes for diabetes self-management training (DSMT).)

    Shannon Martin (410) 786-7939 (for issues related to rebasing of the Medicare Economic Index (MEI).)

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

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

    Diane Milstead (410) 786-3355, Latesha Walker (410) 786-1101, or Gaysha Brooks (410) 786-3355 (for all other issues.)

    End Further Info End Preamble Start Supplemental Information

    SUPPLEMENTARY INFORMATION:

    Copies: To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250. The cost for each copy is $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.

    Accessing Physician Fee Schedule Web Site and Pricing Information

    Information on the physician fee schedule and pricing files can be found on our homepage. You can access this data by typing the following: http://cms.hhs.gov/​physicians/​pfs or you can access this data by using the following directions:

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

    2. Place your cursor over the word “Professionals” in the blue area near the top of the page. Select “Physicians” from the drop-down menu.

    3. Scroll down and under “Payment/Billing” select “Physician Fee Schedule'.

    The Physician Fee Schedule pricing information is contained in two public use files.

    (1) National Physician Fee Schedule Relative Value File—This file contains all CPT/HCPCS (excluding codes beginning with B, E, L, K, and O), their short descriptions and a status indicator, which denotes whether or not the service is priced under the physician fee schedule. The file also contains the components used in the calculation of the annual pricing amount (that is., the RVUs, GPCIs, and Start Printed Page 63197conversion factor), anesthesia conversion factors, and the payment policy indicators used to price the claims with surgical modifiers. This file does not contain the calculated pricing amounts.

    (2) Physician Fee Schedule Payment Amount File National/Carrier—This file contains the CPT code and the Medicare price for all services priced under the Physician Fee Schedule. These data can be downloaded for (a) the entire country, or (b) for a selected carrier (in most cases carriers correlate with states). There is no option of requesting data for selected HCPCS codes. The zip file, which is downloaded, contains a file named PF04pc.doc, which explains the data contained in each column. This file also contains a description of pricing localities used in the Physician Fee Schedule. Due to the size of the national file (as well as many of the carrier-specific files), these data are provided in a comma-delimited format, which can be used to populate database applications. Generally speaking, these data are too large for Excel, however if a carrier specific file has 3 or fewer localities, Excel can be used.

    Another file that providers may find useful is the Zipcode to Carrier Locality File. This file will map ZIP Codes to CMS carriers and localities and map Zip Codes to their State and determine whether the ZIP Code has a rural designation as determined by CMS. You can access this file by typing the following: http://cms.hhs.gov/​providers/​pufdownload/​default.asp#alphanu or you can access this data by using the following directions:

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

    2. Place your cursor over the word “Professionals” in the blue area near the top of the page. Select “Physicians” from the drop-down menu.

    3. Scroll down and under “Payment/Billing” select “Medicare Payment Systems.”

    4. Scroll down and under Coding Files select “Zipcode to Carrier Locality File.”

    Table of Contents

    I. Background

    A. Legislative History

    B. Published Changes to the Fee Schedule

    II. Specific Provisions for Calendar Year 2004

    A. Resource-Based Practice Expense Relative Value Units

    1. Resource-Based Practice Expense Legislation

    2. Current Methodology

    3. Practice Expense Proposals for Calendar Year 2004

    B. Geographic Practice Cost Indices (GPCIs)

    C. Coding Issues

    III. Other Issues

    A. Definition of Diabetes for Diabetes Self-Management Training (DSMT)

    B. Outpatient Therapy Services Performed “Incident To” Physicians Services

    C. Status of Anesthesia Work and 5-Year Review

    D. Payment Policies for Anesthesia Services

    E. Technical Correction

    F. Publication Issues

    IV. Refinement of Relative Value Units for Calendar Year 2004 and Response to Public Comments on Interim Relative Value Units for 2003

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

    VI. Physician Fee Schedule Update for Calendar Year 2004

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

    VIII. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2004

    IX. Telehealth Originating Site Facility Fee Payment Amount Update

    X. Provisions of the Final Rule

    XI. Collection of Information Requirements

    XII. Response to Comments

    XIII. Regulatory Impact Analysis

    Addendum A—Explanation and Use of Addendum B

    Addendum B—2004 Relative Value Units and Related Information Used in Determining Medicare Payments for 2004 Addendum C—Codes with Interim RVUs

    Addendum D—2004 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Addendum E—2005 Geographic Practice Cost Indices by Medicare Carrier and Locality

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

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

    AMA American Medical Association

    APC Ambulatory Payment Classification

    BBA Balanced Budget Act of 1997

    BBRA Balanced Budget Refinement Act of 1999

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

    CF Conversion factor

    CFR Code of Federal Regulations

    CMS Centers for Medicare & Medicaid Services

    CNS Clinical Nurse Specialist

    CPT [Physicians'] Current Procedural Terminology [4th Edition, 2002, copyrighted by the American Medical Association]

    CPEP Clinical Practice Expert Panel

    CRNA Certified Registered Nurse Anesthetist

    DHHS Department of Health and Human Services

    E/M Evaluation and management

    ESRD End-Stage Renal Disease

    GAF Geographic adjustment factor

    GPCI Geographic practice cost index

    HCPCS Healthcare Common Procedure Coding System

    HHA Home health agency

    IDTFs Independent Diagnostic Testing Facilities

    MCM Medicare Carrier Manual

    MedPAC Medicare Payment Advisory Commission

    MEI Medicare Economic Index

    MGMA Medical Group Management Association

    MPFS Medicare Physician Fee Schedule

    MSA Metropolitan Statistical Area

    OMB Office of Management and Budget

    PC Professional component

    PEAC Practice Expense Advisory Committee

    PPO Preferred Provider Organization

    PPS Prospective payment system

    PRA Paperwork Reduction Act of 1995

    RUC [AMA's Specialty Society] Relative [Value] Update Committee

    RVU Relative value unit

    SGR Sustainable growth rate

    SMS [AMA's] Socioeconomic Monitoring System

    SNF Skilled Nursing Facility

    TC Technical component

    I. Background

    A. Legislative History

    Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), “Payment for Physicians” Services.” This section provides for three major elements: (1) A fee schedule for the payment of physicians' services; (2) limits on the amounts that nonparticipating physicians can charge beneficiaries; and (3) a sustainable growth rate (SGR) 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) that are 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 Start Printed Page 63198$20 million, we must make adjustments to ensure that they do not increase or decrease by more than $20 million.

    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 made revisions to resource-based practice expense RVUs; services and supplies incident to a physician's professional service; anesthesia base unit variations; recognition of Physicians' Current Procedural Terminology (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. All these revisions ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule also conformed our regulations to reflect statutory provisions of Medicare, Medicaid, and State Child Health Insurance Program (SCHIP) Benefits Improvement and Protection Act of 2000 (Pub. L. 106-554) (BIPA) concerning: the mammography screening benefit; biennial screening pelvic examinations for certain beneficiaries; expanded coverage for screening colonoscopies to all beneficiaries; annual glaucoma screenings for high-risk beneficiaries; coverage for medical nutrition therapy services for certain beneficiaries; expanded payment for telehealth services; payment for certain Indian Health Service for some services under the physician fee schedule; and revision of the payment for certain physician pathology services.

    In the December 31, 2002 final rule with comment period (67 FR 79966), we refined resource-based practice expense RVUs and made other changes to Medicare Part B policy. These included: 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 application of endoscopic reduction rules for certain codes. In addition, this rule: Updated the codes subject to physician self-referral prohibitions, expanded the definition of a screening fecal-occult blood test, and modified our regulations to expand coverage for additional colorectal cancer screening tests through our national coverage determination process. We also made revisions to the SGR, the anesthesia conversion factor (CF), and the work values for some gastroenterologic services. We finalized the calendar year (CY) 2002 interim RVUs and assigned interim RVUs for new and revised procedure codes for CY 2003, clarified the enrollment of therapists in private practice and the policy regarding services and supplies incident to a physician's professional services, and made technical changes to the definition of outpatient rehabilitation services.

    This final rule also revised the regulations at § 485.618 to 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).

    As required by statute this final rule also announced that the physician fee schedule update for CY 2003 was −4.4 percent, the initial estimate of the SGR for CY 2003 was 7.6 percent, and the CF for CY 2003 was $34.5920, effective March 1, 2003. However, on February 28, 2003 (68 FR 9567), after enactment of the Consolidated Appropriations Resolution of 2003 (Pub. L. 108-7), we published a final rule that revised the estimates used to establish the SGRs for fiscal years 1998 and 1999 and announced a 1.6 percent increase in the CY 2003 physician fee schedule CF for March 1 to December 31, 2003. The CF from March 1 to December 31, 2003 is $36.7856 and the anesthesia CF for this period is $17.05. All other provisions of the December 31, 2002 final rule were unchanged by the rule published February 28, 2003.

    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 CY 2004 appears in section IX. The RVUs for CY 2004 are in Addendum B. The GPCIs for CY 2004 can be found in Addendum D.

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

    D. Development of the Relative Value System

    1. Work Relative Value Units (RVUs)

    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, Start Printed Page 63199which 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.

    II. Specific Provisions for Calendar Year 2004

    In response to the publication of the August 15, 2003 proposed rule, (68 FR 49030), and the December 2002 interim final rule, (67 FR 79966), we received approximately 2,433 comments. We received comments from individual physicians, health care workers, and professional associations and societies. The majority of comments addressed the physician fee schedule proposals related to the dialysis G codes, “incident to” therapy services, and the geographic practice cost indices locality payment discussion issue.

    The proposed rule discussed policies that affected the 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 2004. We discuss in detail the effects of these changes in the Regulatory Impact Analysis in section XIII.

    For the convenience of the reader, the headings for the policy issues correspond to the headings used in the August 15, 2003 proposed rule. More detailed background information for each issue can be found in the December 2002 interim final rule with comment period and the August 2003 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)(B)(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)(B)(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, can be seen as a “top-down” approach.

    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.
    • 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 Start Printed Page 63200divided 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) Nonphysician Work Pool

    For services with physician work RVUs equal to zero (including the technical components of radiology services and other diagnostic tests), 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. We have removed services from the nonphysician work pool if the requesting specialty predominates utilization of the 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 specialties to the most appropriate SMS specialty.

    (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.

    (iii) Physical Therapy Services

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

    3. Practice Expense Proposals for Calendar Year 2004

    a. Nonphysician Workpool

    The nonphysician work pool is a special methodology that we used to determine practice expense RVUs for many services that do not have physician work RVUs. While the nonphysician 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 from the pool. Because the nonphysician work pool includes a variety of services performed by many different specialties, we use the “all physician” average practice expense per hour in place of a specialty-specific practice expense per hour.

    As discussed in the August 15, 2003 proposed rule, we are continuing to study the alternatives that are available and any modifications to the nonphysician workpool would be published in proposed rulemaking.

    Comment: Several specialty societies expressed support for the ongoing study of this complex issue and appreciate that any modifications to the nonphysician workpool would be published as proposed rulemaking for review and comment prior to implementation. A biopharmaceutical company commented that we should move forward to develop a new methodology that better recognizes actual resource consumption so that we can develop a preferable alternative.

    Response: We are appreciative of the support and will continue to study this issue.

    b. Supplemental Practice Expense Survey Data

    i. Survey Criteria and Submission Dates

    As required by the BBRA, we established criteria to evaluate data collected by organizations to supplement the data normally used in determining the practice expense component of the physician fee schedule. We have required supplementary survey data to be submitted by August 1 to be considered for computing practice expense RVUs for the following year. We proposed to change the required submission date to March 1, which would allow us to publish our decisions regarding survey data in the proposed rule and provide an opportunity for public comment on survey results. We also proposed to extend for an additional 2 years the period for accepting survey data that meets the criteria set forth in the November 2000 final rule (as modified in the December 31, 2002 final rule). The deadline for submission of the supplemental data to be considered in CY 2005 and CY 2006 would be March 1, 2004 and March 1, 2005, respectively.

    Comment: Specialty societies expressed appreciation for our proposal to extend the deadline for submission of surveys. Commenters also approved of our proposal to change the due date for submission of supplemental practice expense survey data to March 1, so that the implications of the use of the survey data could be discussed in the proposed rule.

    Response: We will implement the change in the submission dates for supplementary surveys as proposed. The deadline for submission of the supplemental data to be considered in CY 2005 and CY 2006 would be March 1, 2004 and March 1, 2005, respectively. We will revise § 414.22(b)(6)(ii) to reflect this change.

    ii. Submission of Supplemental Surveys

    The College of American Pathologists (CAP) submitted supplemental survey data for independent laboratories for consideration for CY 2004. Our contractor, The Lewin Group, evaluated the data and has recommended acceptance.

    Comment: Based on our proposal to revise the date for submission of supplemental survey data, CAP requested that we delay incorporation of this survey data until next year's proposed rule. CAP also expressed an interest in being able to evaluate the combined effects of the use of the new survey data along with the technical change for pathology services before the changes are implemented. Therefore, CAP requested that we also extend the moratorium on calculating the technical component as the difference between the global and professional component practice expense RVUs by one additional year, as discussed in the August 15, 2003 proposed rule. This request for a delay in incorporating the new survey data, as well as extending the moratorium was supported by the AMA and several specialty societies.

    Response: We agree with the comments that suggest extending by one year the moratorium on calculating the technical component practice expense RVU as the difference between the global and professional component RVUs for pathology services. We also agree with comments suggesting that we not incorporate the CAP survey into the practice expense methodology until next year. We will evaluate the CAP Start Printed Page 63201survey in next year's proposed rule at the same time we show the effect of the above described change for pathology services.

    c. Practice Expense for a professional component service

    While we typically assign all staff, equipment and supply costs for services with professional and technical components (PC and TC) to the technical portion of the service, in the proposed rule we discussed limited instances where it is appropriate to assign direct inputs to a PC service. We proposed to modify the practice expense methodology to allow direct inputs to be added to PC services when these inputs are clearly associated with the professional service, including when the PEAC makes such recommendations. Specifically we proposed to add the PEAC recommended staff times to the PC of the following cardiac services: CPT codes 93508, 93510, 93511, 93514, 93524, 93526, 93527, 93528, 93529, 93530, 93531, 93532, 93533 and 93624.

    Comment: The RUC, the AMA, the American College of Physicians and societies representing cardiologists, cardiac rhythm specialists, interventional radiologists, nuclear medicine, chest physicians, radiation oncologists, radiologists, endocrinologists and dermatologists expressed support for this change in methodology. Commenters were also in agreement with the specific CPT codes mentioned in the proposed rule, but requested that direct inputs also be added to the PC of CPT codes 93619, 93620 and 93642, which were reviewed at the January PEAC meeting. The RUC comment indicated that additional codes might be identified at future PEAC/RUC meetings.

    Response: We will finalize the proposed assignment of direct practice expense to the proposed 14 cardiac services and will add the PEAC recommended inputs to the PC of CPT codes 93619, 93620 and 93642, as requested by the commenters.

    d. Utilization Data

    We use Medicare utilization data in the development of specialty-specific practice expense RVUs that are then weight averaged to determine a single practice expense RVU per code. Prior to 2003, we used the most recent complete year of utilization data to determine the practice expense RVUs. In the December 31, 2002 final rule (67 FR 79982), we adopted a policy of using the 1997 through 2000 Medicare utilization in the practice expense methodology. For new codes created since 2000, there are no Medicare utilization data. In the August 15, 2003 rule we proposed to follow a similar practice to the one described above and use specialty-specific Medicare utilization data for codes created after 2000 at the first opportunity they become available to us. Since we will not have any utilization data at the time we first establish practice expense RVUs for a new code, we proposed that we continue, whenever possible, to make an assumption about the specialty that will likely provide the service or to use the “all physician” average when we do not have sufficient information to assign any given specialty.

    Comment: The specialty societies representing internal medicine, rheumatology and pulmonary medicine supported our proposal to use 1997 through 2000 Medicare utilization data for all codes that were in existence at that time and to use specialty-specific Medicare utilization data for codes created after 2000 when utilization data first become available, using the “all physician” average when we do not have sufficient information to assign a given specialty. These commenters, as well as several others, suggested that the RUC and the specialty societies could provide information on the specialties that will likely perform a new service to minimize the potential changes to the practice expense RVUs that will occur when we substitute actual for estimated utilization. However, a specialty society representing gastroenterology expressed concern that we are moving forward with plans to shift the basis of our methodology for compiling data to a five-year basis. The commenter urged us to not make changes until extensive impact comparisons are conducted that can be evaluated by physician community.

    Response: We will implement our proposal to use specialty-specific Medicare utilization data for codes created after 2000 at the first opportunity they become available to us. We will also continue, whenever possible, to make an assumption about the specialty that will likely provide the service or to use the “all physician” average when we do not have sufficient information to assign any given specialty. Information about the specialty we assign to a code that has no utilization data can be found in the utilization data files we make available on the CMS web site following final rule publication. With respect to the comment about shifting to a 5-year basis of utilization data for the practice expense methodology, we are making no change in policy for codes that existed in the 1997 to 2000 period. We are using only the later year utilization data for codes that have been created since that time. Any information from the RUC that could assist us in this process would be welcomed.

    Comment: A specialty society representing colon and rectal surgeons agreed with our general utilization methodology, but disagreed that averaged 1997-2000 utilization data should be used for all codes that were not in existence for the entire period. The commenter argued that the frequency for these codes might be artificially low because the coding was new and that this may impact the relativity between new and old codes in the same family with similar inputs. The society suggested that any code that did not exist during the entire 1997-2000 period default to 2002 or most recent data.

    Response: As we have explained, the Medicare utilization is important to the practice expense methodology because it determines which specialty scaling factors will be applied to the estimated practice expense input values in determining the practice expense RVUs for each service. The proportion of the volume billed by each specialty is more important to determining the practice expense RVU for a given service than the total volume. If the code is low in volume but the proportion of the code's volume billed by each specialty is generally consistent over time, there will be little or no difference in a code's practice expense RVUs, whether we use its initial year of utilization or a later year to determine its value.

    Comment: Commenters representing dermatology as well as a pharmaceutical company expressed concern regarding the decrease in payment for photodynamic therapy, CPT code 95657. The commenters noted our discussion in the proposed rule indicating that this reduction in the practice expense RVUs is occurring because of updates to the Medicare utilization data used in the practice expense methodology. As a result of the updated utilization data, the practice expense methodology now uses the dermatology scaling factor (0.54) for supplies instead of the all physician average (1.29), and this change leads to the reduction in payment for the code. The commenters urged us to reconsider the proposal and at least to reinstate physicians' ability to bill separately in 2004 for the light-activating agent under the appropriate J code and also to remove the drug from the practice expense portion of the procedure.

    Response: One of the functions of the utilization data in our practice expense methodology is to assign all procedures to the specialty-specific cost pools of the Start Printed Page 63202specialty or specialties performing them. Each cost pool has its own scaling factor. This scaling factor is used to scale the aggregate CPEP procedure-level costs for a specialty to the aggregate costs for the same specialty as determined by the SMS practice expense data. As we indicated in the proposed rule, we do not have utilization data upon which to determine the practice expense RVUs for a new code at the time it is created. As a default, we have assigned many new codes the “all physician” scaling factor until we have the data to move these codes into the appropriate specialty cost pools. Because it allows us to apply the appropriate specialty scaling factor, the use of the updated utilization data in the practice expense methodology can lead to increases or decreases in the value of a code, even though its practice expenses remain unchanged. In this case, the supplies scaling factor for dermatology is lower than that for “all physicians,” leading to a decrease in practice expense RVUs when the dermatology scaling factor was applied to the CPEP data of the photodynamic therapy service.

    We believe the initial practice RVUs for photodynamic therapy were too high, because the later information on Medicare utilization indicates that we should have used the dermatology scaling factor which would have produced a lower practice expense value. As we indicate above, we are working to minimize changes that will occur in the practice expense RVUs for a service by making an initial assumption about which specialty will likely bill us for a service. However, we believe our policy for new codes should be consistent with how we determine the practice expense RVUs for existing codes, even if updates to the Medicare utilization data lead to increases or decreases in the practice expense RVUs.

    Though we believe that it is appropriate to use the updated utilization that results in a reduction in payment for CPT code 96567, we will pay separately for the light activating agent beginning January 1, 2004. However, we are also further considering whether Medicare should pay separately for certain topical drugs in certain circumstances. Any change in policy would be discussed in future rulemaking.

    Comment: Specialty societies representing radiation oncology, as well as individual commenters, expressed concern about the decrease in payment for the intensity modulated radiation therapy (IMRT) treatment service, CPT code 77418. The commenters stated that this was due to a “quirk” in the utilization data relating to new codes and requested that this code be priced by the non-physician work pool methodology.

    Response: We will calculate the practice expense RVUs for the IMRT treatment service, CPT code 77418, using the nonphysician workpool methodology. This will be consistent with the way we currently calculate the practice expense for all other radiation therapy services with no physician work RVUs.

    Comment: The specialty society representing radiation oncology also noted that there was a reduction in the practice expense RVUs for the intensity modulated radiation therapy planning procedure, CPT code 77301. A remote cardiac monitoring service questioned why the use of new utilization data could decrease the value of a code such as HCPCS code G0249 for the provision of test material and equipment for home INR monitoring.

    Response: Both CPT code 77301 and HCPCS code G0249 were new codes for which we did not have utilization data and which were initially assigned the “all physician” scaling factor. As described above, now that we have the utilization data, the services have been placed in the specialty-specific cost pools based on how the service is billed to Medicare, which have lower scaling factors than the “all physician.” This shift has led to the reduced practice expense RVUs for CPT code 77301. If we had placed this code in the radiation oncology cost pool to begin with, it would have had the reduced practice expense payments for the past two years as well. HCPCS code G0249 will actually have increased practice expense RVUs in 2004 due to the effect of the repricing of supplies.

    Comment: We received one comment that questioned how updated utilization data could have such a huge and direct effect on specific codes. The commenter requested clarification from us on the workings of the utilization data within the practice expense methodology so that the public will understand how utilization data will affect new technologies in the future.

    Response: As explained above, one of the functions of the utilization data in our practice expense methodology is to assign all procedures to the specialty-specific cost pools of the specialty or specialties performing them. If we do not know the specialty, we have used “all physician” scaling factors. The “all physician” scaling factors could be higher or lower than the specialty-specific scaling factor and produce different RVUs for the code. For instance, CPT code 77301-26 is a PC service that has no direct cost inputs. Thus, its practice expense RVUs are affected only by the indirect cost scaling factor. To develop the 2003 practice expense RVUs for this code, we adjusted indirect costs allocated to this code by the “all physician” indirect cost scaling factor of 0.57. However, for 2004, we have Medicare utilization data from 2002 for this procedure code. Radiation oncologists and radiologists respectively billed Medicare for 67 percent and 30 percent of the total volume of services provided to Medicare patients in 2002. The weighted average scaling factor for all the specialties that bill Medicare for this procedure code is 0.48. Since we are adjusting indirect costs by 0.48 instead of 0.57, the final practice expense value is lower.

    e. Practice Expense Advisory Committee (PEAC)

    The PEAC, a subcommittee of the RUC, has, since 1999, been providing us with recommendations for refining the direct practice expense inputs (clinical staff, supplies, and equipment) for existing CPT codes.

    1. Recommendations on CPEP Inputs for 2003

    In the December 31, 2002 proposed rule, we responded to the PEAC recommendations for the refinement to the CPEP direct practice expense inputs for over 1200 codes, including refinements to codes from almost every major specialty. In addition, the recommendations included 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 times for 323 neurosurgery procedures. We reviewed and accepted all of the recommendations. We received the following comments on these revisions.

    Comment: We received comments from specialty societies representing dermatology, dermatolgic surgery and Mohs surgery expressing concern regarding the decrease in practice expense RVUs for skin biopsy procedures, CPT codes 11100 and 11101 and the destruction of benign or premalignant lesion services, CPT codes 17000 and 17003. The commenters questioned whether the reductions reflect errors in the validated practice expense inputs used in the practice expense calculations.

    Response: We have checked the practice expense inputs and found that these match the clinical staff, supply and equipment inputs as recommended by the RUC. The reduction in practice expense RVUs was caused by the Start Printed Page 63203refinement of these inputs, which, in turn, was based on the presentation made to the PEAC by the dermatology specialty society. We will, therefore, not make any further revisions to the practice expense inputs for these services in this final rule.

    2. Recommendations on CPEP Inputs for 2004

    In the August 15, 2003 proposed rule we included the PEAC recommendations from meetings held in September of 2002 and January 2003 as well as recommendations on the refinements to the clinical staff time for all 90-day global services. In addition, the PEAC convened a workgroup to make recommendations on the refinement of all the 116 remaining evaluation and management codes. We reviewed the submitted PEAC recommendations and proposed to accept them.

    Comment: The American Osteopathic Association expressed appreciation that we supported the recommended changes for the osteopathic manipulative treatment codes and commended us for accepting the PEAC recommendations for the clinical staff times for 90-day global codes. The American College of Obstetricians and Gynecologists stated that our acceptance of the PEAC recommendations is an example of exceptional cooperation and collaboration in meeting the healthcare needs of Americans served by the Medicare program. The American Academy of Dermatology applauded our acceptance of the year's PEAC recommendations. The AMA and the American College of Radiology stated that they appreciate our recognition of the significant resources specialty societies have devoted to the practice expense refinement process and is thankful that our practice expense staff avail themselves of specialty society input. The American College of Surgeons also supported our acceptance of the PEAC recommendations, including the decision to permit exceptions to the standard pre-service times for some surgical procedures. The College other specialty societies also expressed appreciation for our commitment to the refinement process.

    Response: We, in turn, are appreciative of these positive comments. We believe that it is only because of the cooperative working relationship between the specialty societies, the AMA and CMS that there has been such a high level of success in tackling practice expense refinement.

    Comment: The American College of Physicians as well as other specialty societies representing surgeons, otolaryngologists, podiatrists, geriatric psychiatrists, obstetricians and gynecologists, cataract and refractive surgeons, neurosurgeons, dermatologists, rheumatologists, radiologists and radiation oncologists supported our inclusion of the PEAC recommendations in the proposed rule because this would better enable specialty societies to address their impact and make comments prior to publication of the final rule.

    However, specialty societies representing chest physicians and thoracic physicians disagreed with our decision to change our previous practice of including the PEAC recommendations in the final, rather than the proposed rule, because this meant that the recommendations from the March PEAC meeting were not included for this year. The society argued that changing this long-standing policy without announcing it in the Federal Register is inappropriate. The comment also contended that the specialty societies agreed to the inputs at the PEAC meeting; therefore, negative comments would not be forthcoming.

    Response: We discussed this issue at the January PEAC meeting and indicated that we were considering including the PEAC recommendations in the proposed rule and that the March recommendations would most likely not be included. We made this decision because, now that the PEAC is refining such a large number of codes, the revisions to the inputs were not only changing the practice expense RVUs of the refined codes, but also the values of services that were not refined. Therefore, we believed it was prudent that revisions be subject to comment before the revisions were implemented.

    Comment: The specialty society representing podiatry identified some discrepancies between the PEAC recommendations and the inputs in the CPEP database for CPT codes 10060, 11000, 11055, 11056, 11057 and 11752 and requested that these be corrected.

    Response: We have made the corrections as requested.

    Comment: The American Society of Transplant Surgeons (ASTS) commented that it is not appropriate to apply either the PEAC-approved standard clinical staff times or RN/LPN/MTA staff blend for 90-day global procedures to the transplant recipient or living donor services. ASTS stated that it had been unaware that the PEAC was applying the standard to all 90-day services unless a case was made to the PEAC that the times should be increased. ASTS argued that there are substantial atypical staff times required for transplant recipients due, in large part, to the intensive education required for the transplant patient. The commenter noted that the three new CPT codes for living donor hepatectomies, CPT codes 47140-47142, were given increased pre-service clinical staff time by the RUC and have an RN as the staff type. ASTS requested that the current clinical staff times be retained and that an RN be assigned rather than the blended staff type to the following transplant services: CPT codes 32851, 32852, 32853, 32854, 33935, 33945, 47135, 47136, 48554, 48556, 50320, 50360, 50365, 50380, 50547.

    Response: It does seem reasonable that at least some of these services would have increased pre-times as do the living donor hepatectomies recently reviewed by the RUC. Therefore, we will restore the original CPEP clinical staff pre-times and use the RN staff type for the above services on an interim basis for the coming year. We anticipate that the society will bring all of these codes to the PEAC for review for either the January or March meeting to ensure that the times for the codes receive the same scrutiny as did the new transplant codes. It should be noted that a few of the codes have lower original CPEP pre-time than the PEAC standard of 60 minutes; for those codes we did not change the PEAC standard time. We also are not revising the post-procedure clinical staff times for these codes, because the current times are in line with the post-service times assigned to the new living donor hepatectomy codes recently reviewed by the RUC.

    Comment: A commenter noted that high dose rate (HDR) brachytherapy CPT codes 77781, 77782, 77783 and 77784 were not listed in Addendum C of the proposed rule. Since these codes were approved by the PEAC and forwarded to CMS, ACR questioned why these codes were not listed.

    Response: The CPEP data base files had been revised to reflect the PEAC recommendations for these codes. It was an oversight that they were not included in Addendum C.

    Comment: The American College of Surgeons listed several possible errors in the CPEP database:

    CPT code 11450—missing 1 minute of staff time

    CPT codes 10080, 10081, 11770, 12032, 12035, 12046, 12047, 21550, 21920, 37609, 38300, 45300-45327, and 46600-46615—missing correct number of gloves.

    CPT codes 45900, 45905, 45910, 47382, 49320, 49321, 49322, 49422, 49429—supplies listed incorrectly—have nonfacility inputs when PEAC recommended none in office setting. Start Printed Page 63204

    Response: We thank the College for checking the database so carefully. We have made the suggested corrections, with the following notes: For CPT codes 10080, 10081 and 11770, the PEAC recommendation listed 5 gloves, not 6. For CPT codes 45300-45327 and 46600-46615, we adjusted the quantity of unsterile gloves to reflect that there are 2 pair in the minimum visit supply package; in addition, CPT codes 45321 and 45327 were not priced in the nonfacility setting.

    Comment: The American Society of Colon and Rectal Surgeons noted a few errors in the CPEP supply database. The supply inputs had not been changed to match the accepted new recommendations for CPT codes 45900, 45905, 45910, 47382, 49320, 49321, 49322, 49422 and 49429.

    Response: We have made the corrections to the supply database and thank the specialty for bringing this to our attention.

    Comment: The American Speech-Language-Hearing Association (ASHA) questioned the proposed 28 percent reduction in the practice expense for CPT code 92507, Treatment of speech, language, voice, communication, auditory processing and/or aural rehabilitation status. The reduction is attributable to a decrease in clinical staff time. ASHA contended that the PEAC recommendation was based on a vignette for a child receiving such therapy, but that the time involved with a typical adult patient receiving this treatment is much longer. ASHA stated that a more reasonable time for clinical staff for this service is 69 minutes compared to the proposed 46 minutes.

    Response: We understand that the scenario for performing this service for a child might be very different than for an adult because an adult can participate in a more protracted therapy session. Because it is not clear to us at this time what would be the typical scenario, we will, on an interim basis, average the clinical staff time needed during a speech therapy session for a child with that suggested by ASHA for an adult. We will, therefore, assign 58 minutes of clinical staff time to this service, with the expectation that ASHA will present CPT code 92507 for further discussion and review at the PEAC.

    Comment: We received several comments in response to our acceptance of PEAC recommendations for evaluation and management (E/M) codes that reduced payment rates for six nursing home services (CPT codes 99301-99303 and 99311-99313) and two home visit codes (CPT codes 99348 and 99350). This payment reduction is primarily due to a decrease in the clinical staff time assigned to these services.

    The American Academy of Family Physicians (AAFP) supported our acceptance of the PEAC recommendations for the E/M nursing facility services. The commenter noted that current practice expenses are higher for services provided in the non-SNF nursing facility than those provided in the SNF facility. The commenter contended that the direct practice expense inputs should not vary based on the type of nursing facility setting and supported the elimination of the current differential in the practice expense RVUs between the SNF and non-SNF facility setting.

    However, the American Medical Directors Association (AMDA) representing long term care physicians, the American Geriatrics Society (AGS) and a health care management company, Health Essentials, all disagreed with our decision to accept the E/M nursing facility PEAC recommendations and asked us to reconsider our decision to implement them in 2004. The request to delay implementation was echoed by the American Academy of Home Care Physicians and AGS relating to the two E/M home visit codes.

    The home care physicians argued that the PEAC recommendations for the two home visit codes are flawed because these codes have not yet been surveyed by the specialty performing this service. The commenters also contended that their views were not represented when the PEAC considered the refinements of the E/M home visit codes. Similarly, the AMDA noted that the PEAC workgroup responsible for formulating the recommendations for the nursing facility codes did not include long term care physicians. The AMA also commented on this issue and expressed concern that the PEAC recommendations did not include the views of all the relevant medical specialties and requested that we delay implementation of these E/M code recommendations to allow impacted medical specialties an opportunity to present new information to the PEAC.

    In addition, the AMDA expressed concern regarding the current work RVUs for nursing home visit services.

    Response: At the time the PEAC recommendations were forwarded to CMS, we agreed with the views expressed by the AFPP as to the reasonableness of the practice expense recommendations for the E/M codes for the nursing facility and home visits. However, we are also of the opinion that the relevant medical specialties should be given the opportunity to have their views considered by the PEAC. Consequently, we will not go forward with these E/M recommendations in 2004. This will allow time for the PEAC to reconsider the eight E/M codes with input from representatives from the nursing home and home visit specialties. We will use current CPEP practice expense inputs to price these codes for 2004.

    With regard to the concern expressed about the work RVUs for the nursing home visits, in the 2004 final rule we will solicit recommendations on codes to be reviewed during the next 5-year review of work and we suggest that the society recommend review of these codes.

    Comment: A specialty society representing gastroenterologists commented that the increased clinical staff pre-time added to certain colorectal procedures needs to be applied equally to gastroenterologists who provide those services.

    Response: We have a single payment for each procedure regardless of the specialty performing the service. Therefore, gastroenterologists will be paid the same as colorectal surgeons when performing those services for which we allowed increased pre-service clinical staff time.

    Comment: The American College of Radiology submitted several corrections to the CPEP database for those instances where the database differed from the PEAC recommendations that we accepted. The College stated its appreciation for the opportunity to review the practice expense data file for completeness and accuracy and applauded our efforts to ensure that the database captures correct and complete practice expense data.

    Response: We thank the College for the time and effort expended in checking this detailed data. We have made revisions to 19 codes: We changed the quantity of sodium chloride injection for CPT codes 78306, 78315, 78460, 78461, 78464, and 78465; adjusted the quantity of films for CPT code 76812; added missing supplies to CPT codes 77408, 77409, 77411, 77412, 77414, 77416, 76830 and 77290; removed equipment that had been deleted from CPT codes 78478 and 78480; and corrected a typographical error in the pre-service clinical staff time for CPT codes 73218 and 75555.

    g. Repricing of Clinical Practice Expense Inputs—Supplies

    We use the practice expense inputs (the clinical staff, supplies, and equipment assigned to each procedure) to allocate the specialty-specific practice expense cost pools to the procedures Start Printed Page 63205performed by each specialty. The costs of the original inputs assigned by the Clinical Practice Expert Panels (CPEP) were determined by our contractor, Abt Associates, based primarily on 1994 and 1995 pricing data from supply catalogs. In addition, for many items on the equipment and supply list, the associated costs were based on the recommendations of a CPEP panel member, rather than on actual catalog prices. Subsequent to the CPEP panels, equipment and supply items have also been added to the CPEP data, with the costs of the inputs provided by the relevant specialty society.

    We contracted with a consultant to assist in obtaining current pricing information and also to recommend revisions to improve the uniformity and consistency of the CPEP supply database. On the basis of these recommendations, in the August 15, 2003 proposed rule, we proposed updates to the cost information for supplies in the database. In addition, we proposed the following database revisions:

    Assignment of supply categories.

    We proposed that supplies be assigned to one of 14 categories.

    Consolidation/standardization of item descriptions.

    We proposed combining items which appeared to be duplicative and modifiying descriptions using a key first word when possible for easier identification of items. For example, “mayo stand cover” and “drape, sterile Mayo” have both been changed to “drape, sterile, for Mayo stand.”

    Standardization of unit descriptions.

    The current CPEP database contains over 72 unit descriptions associated with supplies (for example, item, gram, and cup). To provide consistency and ensure that inputs in the database accurately reflect the quantity of an item used, we proposed to standardize the unit description of items. We also proposed to specifically identify items intended for single use through the use of “uou” (unit of use) following the unit. These changes were reflected in Addendum D of the proposed rule.

    There were also items that had not been identified or for which pricing information was not found that were included in Table 1 in the August 15 proposed rule. Items that we proposed to delete from the database were also identified in this table. We requested that commenters, particularly the relevant specialty groups, provide us with the needed pricing information with appropriate documentation. We also stated if we did not obtain verified pricing information for an item, it would be eliminated from the database.

    Comment: The RUC expressed appreciation for the enormity of the repricing project and stated that the proposed approach was well organized and comprehensive. The American Association of Orthopedic Surgeons also agreed that the assignment of supply categories would be helpful in future refinement activities. The American College of Physicians, the American College of Surgeons, and the American Urological Association expressed support for our proposal to create a numbering system and to standardize the descriptions of supply items to increase accuracy of use. The American Academy of Dermatology also supported this standardization of proposed “unit of use” as long as its application does not assume that “one size fits all” as some supplies may go from milliliter to liter in usage. The American Society of Cataract and Refractive Surgery and the Outpatient Ophthalmic Surgery Society thanked us for the repricing proposal because this will ensure that we are using the more accurate and up-to-date supply costs, thus reimbursing physicians more fairly. The American College of Radiology recognized the need to update supply and pricing information in the practice expense database and commended us for committing to this extensive project. The American College of Surgeons also agreed that the update of prices for supplies will improve the accuracy of the direct practice expense data. The Society of Nuclear Medicine commended us for committing to this extensive project. The American Urological Association also appreciated this effort and acknowledged it as a huge undertaking.

    Response: We appreciate the positive feedback and would like to thank all the staff of the specialty societies who worked with our contractor to obtain the most representative prices for all of the supplies in the CPEP input database.

    Comment: A specialty society representing podiatrists agreed with removal of hallux implant and the broach kit from the list of supplies to be included under practice expense as both are separately billable and the broach kit is also reusable. The commenter did not agree with removal of the sterile ankle tourniquet since this is packaged as a single use item. The comment included pricing information at $42.87 each (with documentation) for this supply.

    Response: We will delete the hallux implant and the broach kit from the CPEP supply data. We will retain the ankle tourniquet using the pricing information supplied by the society.

    Comment: Several commenters expressed concern about the reduction in nonfacility practice expense for the interstitial laser coagulation of the prostate procedure, CPT code 52647. A manufacturer of endo-surgery equipment stated that the main reason for this decrease was the decrease in the price assigned to the laser fiber used in this procedure. We had proposed a price of $290 for this item, but the commenter submitted documentation that indicated that the laser fiber should be priced at $850 for CPT code 52647. In addition, the commenter noted that we had proposed in Table 1 to delete the laser fiber because it was reusable; however, this was incorrect as the laser fiber used in this procedure could not be reused and should not be deleted from our supply list.

    Response: When the laser fiber was repriced, we believed the item included in the supply list for CPT code 52647 was the same as a “laser tip,” which was priced at $290. We thank the commenters for clarifying the issue. We agree that the laser fiber used in this procedure is a disposable supply that we will retain in our CPEP supply data at the $850 price documented by the commenter.

    Comment: Commenters representing cardiac arrhythmia specialists and a remote cardiac monitoring system recommend that we not delete the transtelephonic monitor as a supply even though we are correct that the patient and physician re-use this supply during the course of the pacemaker's life. The specialty society commenter requested that the expense of this supply, which costs $190, should be spread out over approximately 5 years.

    Response: The transtelephonic monitor as described would be considered a piece of equipment, rather than a reusable supply. However, unless the equipment costs over $500, we consider it as an indirect cost and it is not included as a direct input. Therefore, we will delete the item from our list of direct practice expense inputs as proposed.

    Comment: A specialty society representing chest physicians agreed that the oximetry sensory probe, CPAP nasal pillow and flow sensor are reusable and should be deleted from the list of CPEP supply inputs. The society also agreed that albuterol is separately billable and should also be deleted. Another commenter, representing sleep medicine, agreed that the nasal pillow should be deleted. However, the commenter representing chest physicians and a commenter representing thoracic physicians disagreed with the proposal to delete Start Printed Page 63206methacholine chloride because there is no “J” code to use when billing, thus forcing physicians to used an unlisted service code. The commenters also contended that the aerochamber should not be deleted because, although reusable, it has a life of only about six months and should be costed out accordingly. In addition, the commenters disagreed that the inhaler is separately billable because a multi-use canister is utilized for this test; therefore, the amount used from the canister for each test should be included in the practice expense.

    Response: We will delete the oximetry sensory probe, CPAP nasal pillow and flow sensor and albuterol from the list of CPEP supply inputs. We will also delete the aerochamber, because an item that is reusable over a six-month period cannot be classified as a disposable supply. The commenter is correct that there is not a HCPCS “J” code for methacholine chloride. Therefore, we will keep this in the supply database as requested so that physicians can avoid the burden of submitting paper claims. We also will keep the inhalant in the database using the quantity of 1 gram per procedure at $0.788.

    Comment: Specialty societies representing radiologists and interventional radiologists disagreed with the classification of the Arrow mechanical thrombectomy device as reusable. The commenter contended that this device is single-use because the difficulty in cleaning the intra-luminary surface areas could lead to a risk of contamination if the device is reused. Moreover, reprocessing the thrombectomy device may result in fatigue-related failure.

    The societies also disagreed with our contention that a Seldinger needle is reusable; rather a Seldinger needle is single-use and should not be removed as a supply item. It is the commenter's understanding that hospitals are not in the practice of resterilizing Seldinger needles.

    While generally favoring reorganization of CMS' supply listing for ease of use and not directly opposed to supply categories, one of the commenters was concerned over the potential loss of granularity of cost data associated with the use of supply categories and would oppose the averaging of costs for the supply categories unless it is appropriate to average from a cost and clinical standpoint. A similar comment was sent by the radiology specialty society.

    Response: We will retain the thrombectomy device and the Seldinger needle as disposable supplies in our CPEP input database. With regard to the classification of supplies, the commenter misunderstands the purpose of assigning a classification to each supply. This will not be used for pricing purposes in any way. Rather, the classifications can be useful as a way to sort the long list of supplies in the database to make it easier to find a particular item.

    Comment: The contractor responsible for helping us with the repricing of supplies informed us that a supply assigned to the endometrial ablation procedure, CPT code 58353, was listed as a catheter tray when it should be described as a thermal ablation balloon catheter at a price of $727. In addition, our contractor supplied us with prices for several new supply and equipment items mainly for otolaryngology, that were not priced in the proposed rule but were included in the PEAC recommendations.

    Response: We will make the appropriate changes in the CPEP supply and equipment databases.

    Comment: Commenters representing pediatricians, pulmonary physicians and family physicians pointed out that the new price we had assigned to the safety syringe and needle did not cover the actual cost of purchasing the entire needle stick device that is required by the Occupational Safety and Health Administration.

    Response: Our repricing contractor researched this issue for us and agreed that the price we were proposing was too low for the appropriate item. Based on documentation for a 10 ml Syringe with SafetyGlide Needle, the safety syringe and needle will be priced at $.435 each, instead of the $.28 that was proposed.

    Comment: A surgical society commenter pointed out that we listed an achalasia balloon in Table 1 in the proposed rule and indicated that it was a supply used with CPT codes 45905 and 45910. The commenter stated that both of these codes were refined in January and that they were not priced in the office setting; therefore the balloon should no longer be listed as a supply used with these services.

    Response: Our CPEP database currently has these codes priced only in the facility setting. However, these services had previously been priced in the office and Table 1 was apparently developed before the last of the PEAC recommendations were entered. The achalasia balloon no longer appears on the CPEP supply database.

    Comment: We received comments from the American College of Physicians and another medical society representing allergy and immunology with concerns about reductions in reimbursement for the five venom immunology CPT Codes (95145-95149). The commenters believe the reductions are due, in part, to the use of incorrect supply costs for venom extracts that we priced at $5.18 per ml. The commenters provided documentation of current prices of five different venoms from two of the largest manufacturers of venom extracts. They proposed a price-averaging methodology utilizing the small and large quantities of venoms that are available from the two suppliers. A price of $12.22 per milliliter of venom antigen results from using this methodology, and the commenters suggest that this price be used in valuing four of the five CPT Codes for venom immunology, with the exception of CPT Code 95147. When a patient requires three stinging insect venoms, as for CPT 95147, the commenters believe the 3-Vespid mix is typically used. Again, the commenters suggested the same price-averaging method noted above using cost information from the two vendors, which results in a price of $23.49 per ml. This 3-vespid mix price could also be used to value CPT Codes 95148 (four venoms) and 96149 (five venoms) with the single venom, priced at $12.22, added once to CPT code 97148 and twice to CPT Code 97149.

    Response: We were pleased to receive the comments, as well as the requested documentation, on the price for various venom extracts, because the venom pricing information was not included in the PEAC recommendations forwarded after the September 2002 meeting for these CPT Codes. This lack of data necessitated the use of a generic stinging insect venom price of $5.18 per ml. We accept the pricing information supplied by these specialty societies, although we do not agree with their proposed averaging of prices from both the small (5ml and 6ml) and larger (10ml and 12ml) quantities of venoms. We believe it is more appropriate to average the venom prices using the larger (10ml and 12ml) quantities because of the volume that is used in an accepted venom immunotherapy program, which consists of a build up period of about four months followed by monthly maintenance therapy. The following prices result from this approach: $10.70 per ml of venom and $21.26 for the 3-Vespid Mix. Venom pricing for the five CPT codes would be as follows: CPT Code 95145 (one venom) at $10.70, CPT Code 95146 (two venoms) at $21.40, 95147 (three venoms using 3-vespid mix), would be $21.26; CPT Code 97148 (four venoms), $21.26 + $10.70 = $31.96; and the venom antigen price for Start Printed Page 63207CPT Code 97149 (five venoms) would be $42.66 ($21.26 + $10.70 + $10.70).

    Comment: JCAAI also supplied pricing information for the multi-tine device that was requested in Table 1 of our proposed rule. As was suggested above, the commenters again proposed we average costs for high and low volume purchases, excluding bulk pricing, to obtain the price for each test.

    Response: We appreciate the pricing information forwarded by JCAAI and selected a purchase quantity that is in the middle of the suggested range. For percutaneous allergy testing, CPT code 95004. This purchase quantity represents testing 200 typical patients, each receiving 40 tests. We have added this Multi-tine per test price, $0.233,to the CPEP database for CPT codes 95004 and 95010.

    Comment: The American Speech-Language-Hearing Association (ASHA) provided pricing information for the following items accompanied by the requested documentation: Aphasia assessment treatment forms—$2.84 (for a diagnostic aphasia examination form and aphasia diagnostic profile), communication books/treatment notebook—$1.50 and eartip insert—$0.65 each or $0.39 each (two sources). The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) submitted a price for the eartip insert of $0.23 each and suggested that the communication books/treatment notebook be deleted. The (AAO-HNS)also submitted a price for cottonoids at $0.875 each and for the phenol applicator kit at $15.95 each.

    Response: We will use the submitted price for the aphasia forms and will price the eartip insert at $0.423, which is the average of the three prices submitted. The notebook, which is assigned to the speech-language therapy code, would be used over a course of treatment, and is not a disposable supply that is used or priced for a single service. Therefore, we will delete this item from our CPEP supply data. For the phenol applicator kit, we will use the price of $15.152 per kit that represents an average price for a 6-kit and a 24-kit quantity purchase. Because these kits contain the phenol that is used in the procedures, phenol has been deleted as a separate supply from the 11 CPT codes that are assigned the kit. AAO-HNS used a 10-pack quantity to assign a price to each cottonoid, but we are using a 200-pack quantity that reflects the high usage of this item. Therefore, we are using $0.773 as the price for each cottonoid.

    Comment: Specialty societies representing radiation oncology and radiology disagreed that the fiducial screws used with the intensity modulated radiation therapy procedure should be deleted from the CPEP input supply list. The society argued that the screws are typically used for this procedure and that they are not separately billable.

    Response: We will retain the fiducial screws in the list of supplies assigned to the intensity modulated radiation therapy procedure.

    Comment: The American Society of Colon and Rectal Surgeons offered description changes for two services, CPT codes 46917 and 46924. The society recommended that the descriptor for the laser tip for both codes be changed to “laser tip, bare (single use)” at $150. The commenter also requested that an ablation laser generator at $59,890 be added to both codes and the existing laser, diode laser, and laser generator be deleted.

    Response: A note from our contractor who is working on our repricing effort verified the above changes and we have revised our supply and equipment databases to reflect them.

    Comment: The American Association of Orthopaedic Surgeons agreed with the proposed supply deletions listed in Table 1 of the proposed rule that are used in orthopaedic surgery. In addition, the association agreed with the concept of standardization of unit descriptions. However, the comment contends that the term “unit of use (uou)” is unclear and that we should consider alternative terms and abbreviations that would be more intuitive.

    Response: The supply items in Table 1 that were listed for orthopaedic surgery are broach kit, hallux implant, sterile hand table drape, sterile cuff tourniquet, cephalosporin and sterile ankle tourniquet. As stated above, we will be deleting the broach kit and hallux implant and will also delete the hand table drape, cuff tourniquet and cephalosporin. As also noted above, we will retain the sterile ankle tourniquet in the supply database because the comment from the podiatry society argued that this item was not typically reused.

    With regard to the comment on the use of “unit of use,” we selected the “unit of use” (uou) term to indicate any item that is packaged for single use, even if the item is not completely used up. This most often occurs with items that are packaged sterile. For example, “bacitracin (0.9gm uou)” refers to one 0.9gm foil package. The quantity entered would be 1 and not a smaller amount such as 0.3. Once this foil package is broken, it is considered “used up” and therefore the unit of use is 0.9gm. Specifically, any item with a “unit of use” designation is meant to be indicated in whole number “unit of use” quantities, not partials (e.g., entered as 1, 2, 3, etc, and not 0.5, 1.5, etc.).

    Comment: A commenter representing sleep medicine stated that our proposed price of $25 is significantly below prices for standard CPAP masks used in the polysomnography service, CPT code 95811. The commenter submitted prices from two manufacturers that average to $88.

    Response: It appears that the commenter has submitted prices for a reusable CPAP mask that would not be included in our CPEP data as a disposable supply. Therefore, we will price the disposable mask at $25.135, as proposed.

    Comment: We received a comment from the American Physical Therapy Association (APTA) that contended there is a rank order anomaly caused by the increased price for the electrode used for CPT code 97033, iontophoresis. APTA noted that the price of a “pair” of electrodes was $16 in 2001 but has increased to $23.98 under our current supply repricing initiative. APTA has asked that we review the proposed cost of this item as a means to moderate the rank order anomaly.

    Response: We appreciate the comments offered by APTA and have reviewed the cost of the supplies assigned to the iontophoresis service. We determined that the electrodes for this service are packaged and priced as “kits” that contain the complete set of electrodes needed to provide one iontophoresis treatment. Therefore, only one electrode “kit” is needed for this code, as opposed to the two electrode “pairs” currently in our supply database. Consequently, we have changed the supply list for iontophoresis in our database to reflect that there is one kit, not two electrodes, at the proposed price of $11.99. We believe that this should correct the rank order anomaly.

    The following table, “Table 1 Items Needing Specialty Input,” lists those items on which we had requested specialty input, comments we received and the actions we are taking.Start Printed Page 63208

    Table 1.—Items Needing Specialty Input

    2003 PE supply description2003 PE unit2003 PE pricePrimary specialtiesPrior status of supply itemCommenter responseCMS action taken
    Acetylcholine 10%1 gram$0.40Nurse practitioner, neurologySee Note C. Need patient-use item, not R&D itemNoneSee Note D.
    Aerochamber1 itemCardiology, internal medicineItem may be deleted. May not be typical and may be separately billableAgree—reusable. Requests item be retainedDisagree—Deleted.
    Albuterol1 ampuleFamily practice, internal medicineSee Note BAgree—separately billableDeleted
    Anthralin ointment1 g2.75DermatologySee Note CNoneSee Note D.
    Aphasia assessment—forms average1 item0.95Psychiatry, neurologySee Note CPricing information submitted at $2.84Retained at submitted price.
    Balloon, achalasia1 item255.00General surgery, colon and rectal surgerySee Note C. (Codes utilizing this item being reviewed by CPT)NA in non-facilityDeleted.
    Blood dress package1 itemNeurosurgeryItem may be deleted. Gowning items listed separatelyNoneDeleted.
    Broach kit1 itemPodiatry, orthopaedic surgerySee Note AAgree—separately billable and reusableDeleted.
    Cable for EMG needle electrode1 item1.20Neurology, PM&RSee Note ANoneDeleted.
    Centimeter ruler1 each2.39Radiation oncology, dermatologySee Note ANoneDeleted.
    Cephalosporin1 gmPodiatry, orthopedic surgerySee Note BAgree—separately billableDeleted
    Chordae Villae sampling kit1 itemObstetrics, gynecologyItem may be deleted. Duplicated item with catheter-stylet kitNoneDeleted.
    Collagen kit1 each1383.00UrologyNeed kit contents. Collagen sold as individual syringe. No commercial kit availableNA in non-facilityDeleted.
    Communication book/Treatment notebooks1 eachOtolaryngology, audiologySee Note CAudiology priced at $1.50 or $3.50. ENT proposed to deleteDeleted—reusable.
    Cottonoids1 itemOtolaryngologySee Note CSubmitted price of $0.875Retained at $0.73.
    CPAP nasal pillow1 eachPulmonary medicineItem may be deleted. Disposable CPAP face mask also included in code 95811. Nasal pillows used with reusable maskAgree—not typicalDeleted.
    Cysto-catheter kit1 item9.04Urology, general practiceNeed kit contents and source/pricing informationNoneDeleted.
    Detection kit1 slide8.50Pathology, neurologySee Note CNoneSee Note D.
    Developmental testing—forms average1 item2.64Clinical psychologist, multiple other specialtiesSee Note C. (Original item price estimated by CPEP member.)Submitted price of $0.40 for 96110 and $2.44 for 96111Retained at submitted prices.
    Eartip insert with sound tube1 itemOtolaryngology, audiologySee Note CPricing information submitted by two specialtiesRetained at $0.423.
    EEG electrode, gold DIN1 item0.07NeurologySee Note ANoneSee Note E.
    Electrode, ring1 item475.00Obstetrics, gynecology, urologySee Note ANoneDeleted.
    Start Printed Page 63209
    Electrodes, pickup, black tin, 9mm1 item0.42Podiatry, neurologySee Note ANoneSee Note E.
    Electrodes, pickup, red tin, 9mm1 item0.42Podiatry, neurologySee Note ANoneSee Note E.
    Fiducial screws, set of 41 set558.00Radiation oncologyItem may be deleted. May not be typical and may be separately billable. (Screws used for IMRT head fixation device, but typical patient vignette is prostate cancer.)Disagree—not separately billable. Specialty requests item be retainedAgree—Retained.
    Film, fluoroscopic1 sheet3.51Diagnostic radiology, anesthesiaSee Note CNoneSee Note D.
    Flow sensors1 item1.51Pulmonary medicine, internal medicineSee Note AAgree—reusableDeleted.
    Gold-palladium target1 item0.59PathologySee Note ANoneDeleted.
    Hallux implant1 itemPodiatry, orthopaedic surgerySee Note BAgree—separately billableDeleted.
    Headcover for MRI1 item0.05Diagnostic radiologySee Note CNoneSee Note D.
    Inhalant1 ml0.75Cardiology, internal medicineItem may be deleted (May not be “typical” for service.)Use is typicalRetained at $0.788.
    Laryngeal mirror1 itemDiagnostic radiology, otolaryngologySee Note ANoneDeleted.
    Laser fiber1 item595.00UrologySee Note ADisagree—not reusable. Submitted price of $850Agree—retained at submitted price.
    Laser fiber cleaving tool1 item200.00UrologySee Note ANoneDeleted.
    Methylcholine chloride1 dose48.50Pulmonary medicine, internal medicineSee Note BDisagree—not separately billable. Requests item be retainedAgree—Retained at $39.95.
    Mounting tray1 each40.00Radiation oncology, diagnostic radiologySee Note ANoneDeleted.
    Multi-tine device1 itemAllergy/immunologySee Note CSubmitted pricing informationRetained at $0.23.
    Needle, 4 inch1 itemObstetrics, gynecologySee Note CNoneDeleted.
    Needle, 4-6 inch1 itemObstetrics, gynecologySee Note CNoneDeleted.
    Needle, seldinger1 item72.90Diagnostic radiology, multiple other specialtiesSee Note ADisagree—not reusableAgree—Retained.
    Neurobehavioral status—forms average1 item5.77Clinical psychologist, multiple other specialitesSee Note C. (Original item price estimated by CPEP member.)NoneSee Note D.
    Oximetry sensor probe1 item15.00Multiple specialtiesSee Note AAgree—resuableDeleted.
    Penile clamp1 item40.70UrologySee Note ANoneDeleted.
    Phenol applicator kit1 unitOtolaryngologySee Note CPricing information submittedRetained at $15.152.
    Primary antibodies1 slide3.52Pathology, neurologySee Note CNoneSee Note D.
    Psych testing—forms average1 item2.30Clinical psychologistSee Note CNoneSee Note D.
    Receive coilDiagnostic radiologySee Note ANoneDeleted.
    Ruler1 each2.67Radiation oncology, diagnostic radiologySee Note ANoneDeleted.
    Scissors and clamp, disposable1 each0.62Radiation oncology, diagnostic radiologyNeed clamp description and source/pricingNoneSee Note D.
    Start Printed Page 63210
    Sealant sprayRadiation oncology, diagnosticSee Note CNoneSee Note D.
    Silverman needle1 item66.35UrologySee Note ANoneDeleted.
    Skin prep, one step1 item26.00CardiologyNeed inches used per procedure (196in per roll)NoneSee Note D.
    Smoke evacuation cartridge1 item146.50Obstetrics, gynecologySee Note ANoneDeleted.
    Sterile, hand table drape (24x43)Orthopaedic surgery, hand surgeryItem Deleted. Integral part of hand/upper extremity drape supply itemAgreeDeleted.
    Sterilizing tray1 each64.00Radiation oncology, diagnostic radiologySee Note ANoneDeleted.
    Steroid1 cc1.29UrologySee Note BNoneDeleted.
    Sweat cells, 4 in a set1 set260.00NeurologySee Note ANoneDeleted.
    Thrombectomy device1 item600.00Diagnostic radiologyAdditional information required. Device is reusable. Need to identify specific PTD single-use accessories (e.g. sheath rotator drive basket)Disagree—device is not reusableAgree—Retained.
    Tourniquet, ankle, sterile1 itemPodiatry, orthopaedic surgerySee Note ADisagree—packaged for single use. Price submitted at $42.87Agree—retained at submitted price.
    Tourniquet, cuff sterileOrthopaedic surgery, hand surgerySee Note AAgreeDeleted.
    Traction straps1 item60.00Radiation oncology, diagnostic radiologySee Note ANoneDeleted.
    Transtelephonic monitor10.56CardiologySee Note AAgree—resuable, but requests item be retainedDisagree—Deleted.
    * CPT codes/descriptions only are copyright 2003 American Medical Assn. All Rights Reserved. Applicable FARS/DFARS apply.
    Notes:
    A. Item deleted. Reusable
    B. Item deleted. Separately Billable
    C. Additional information required.
    D. Issue is pending. Still under review.
    E. Issue is pending. Reuse discussion needed.

    h. Miscellaneous Practice Expense Issues

    Hyperbaric Oxygen Services

    We proposed to assign, on an interim basis, the following practice expense inputs to CPT code 99183, Physician attendance and supervision of hyperbaric oxygen therapy, per session, when performed in the office setting:

    Staff: Respiratory Therapist for 135 minutes (for a 2 hour treatment); Supplies: Minimum Visit Supply Package, 180 liters of oxygen, 187 cubic feet of air; Equipment: Hyperbaric chamber.

    Comment: A freestanding hyperbaric oxygen center expressed appreciation that we priced this procedure in the non-facility setting. The commenter also requested that we add certain staff time and some supplies to the practice expense inputs assigned to this service.

    The additional supplies requested include disinfectant for cleaning the hyperbaric chamber after each patient, two otoscope covers to check patients' ears pre and post treatment, and a denture cup and urinal. An additional 24 minutes of clinical staff time (using the standard staff blend) was also requested for preparing the room, greeting and gowning the patient, patient education, taking vital signs before and after treatment, positioning the patient and cleaning the room.

    Response: We believe that the request for the above additional practice expense inputs is reasonable. Currently, we have assigned clinical staff time only for assisting during the procedure itself; additional time was calculated using the times used by the PEAC for the tasks listed. Therefore, we are adding these inputs to those already assigned to the hyperbaric oxygen service. We have also requesting that the PEAC review these inputs at a future meeting and the RUC has stated that the PEAC will be reviewing this CPT code at the January or March 2004 meeting.

    Comment: A commenter from another freestanding hyperbaric center expressed concern that the proposed physician fee schedule payment for CPT 99183 is approximately 25 percent of the payment in the hospital setting. The commenter lists additional costs that Start Printed Page 63211should be considered such as special cleaners and solvents for cleaning the chamber, the costs of adherence to quality standards and costs for laundering patients' clothing, sheets and blankets. The commenter also stated that the hyperbaric chamber costs more than the $125,000 we have assigned the item.

    Response: As mentioned above, we have added disinfectant solution for cleaning the chamber. We will be proposing the repricing of all equipment in our CPEP database next year, which should ensure that the price for the hyperbaric chamber reflects the typical cost. The cost of laundering and much of the quality assurance costs are considered indirect and are not reflected in our direct cost database. However, if the PEAC does refine this code as planned, we will review any recommendation submitted.

    Maxillofacial Prosthetics PE/hour

    We proposed to eliminate the special practice expense pool for maxillofacial prosthetic services and to use otolaryngology as the crosswalk for oral surgeons and maxillofacial surgeons as a more appropriate approximation of the specialties' practice expense per hour.

    Comment: The American Association of Oral and Maxillofacial Surgeons expressed appreciation for our work on this issue over the past three years and heartily concurred with the decision to crosswalk maxillofacial prosthetics to otolaryngology. The American Academy of Otolaryngology-Head and Neck Surgery also supported our proposed crosswalk.

    Response: We will implement the crosswalk of maxillofacial prosthetics to otolaryngology as proposed.

    Holter Monitoring Codes

    We proposed revising the practice expense inputs for holter monitoring codes to remove items that were not needed to perform the services. Specifically, we proposed deleting the ECG electrodes and laser paper, as well as the electric bed, computer and holter monitor from CPT codes 93225 and 93231 and deleting the razor, nonsterile gloves, alcohol swab and tape, as well as the electric bed and exam table from CPT codes 93226 and 93232.

    Comment: A commenter representing an independent diagnostic testing facility and another representing cardiologists expressed support for the proposed revisions to the holter monitor codes.

    We also received a comment from the RUC stating that the direct practice expense inputs for these above holter monitoring services will be reviewed by the PEAC at the January 2004 meeting.

    Response: We will make the proposed changes to the holter monitoring codes on an interim basis and will be glad to review the recommendations from the PEAC when we receive them next year.

    Other Practice Expense Issues

    Comment: We have received requests from several commenters that we value certain procedures currently priced only in the facility setting in the non-facility setting as well. A manufacturer commented that there is a need to price the hysteroscopic endometrial ablation procedure, CPT code 58563, in the office to ensure Medicare patient access to this alternative to hysterectomy in the least intrusive and least costly setting. Several individual gynecologists have expressed concern about the absence of a nonfacility rate for this service because the facility payment does not cover the costs of performing this procedure in the office.

    A manufacturer of endoscopic and surgical supplies and equipment expressed concern that several urology services which had previously been priced in the non-facility setting, are no longer priced in that setting. The commenter contended that the procedures can be performed safely in the office and that patients will be forced to go to a hospital or ambulatory surgical center for these procedures if the office payment does not reflect the direct costs incurred by the physician. The services in question are three cystourethroscopy procedures, CPT codes 52224, 52275, 52276, and two destruction of penile lesion procedures, CPT codes 54057 and 54065.

    A consultant representing non-hospital based providers of LDL apheresis, CPT code 36516, requested that we price this procedure in the nonfacility setting and provided some cost data for this code. The commenter stated that this procedure is commonly provided outside of hospitals. A medical technology company requested that we price the percutaneous implantation of neurostimulator electrodes procedure, CPT code 64561, in the nonfacility setting. This service had previously been priced in the office.

    Response: We are aware that technological advances make it now possible for more procedures to be safely performed in a physician's office. However, CPT code 58563 has recently been reviewed by the PEAC, and neither the gynecology specialty society nor the PEAC recommended pricing this code in the office setting. Likewise, the urology procedures and the neurostimulator service were reviewed this year by the PEAC and the apheresis services last year by the RUC, and the PEAC and the RUC recommended that these services not be priced in the office setting based on the presentation made by the specialty societies. We would not rule out working further with the commenters on these requests, but we believe that it would not be appropriate to take such an action in this final rule. We will be willing to discuss this issue further to determine whether any action should be proposed in the future.

    Comment: The RUC comment identified the following anomalies in the CPEP database for the clinical staff time for a few codes with 000 day global periods:

    B. (1) Percutaneous Abscess Drainage Codes

    In 1997, CPT created new codes to differentiate between open and percutaneous abscess drainage. Unlike their open procedure counterparts, all of the percutaneous codes were assigned a global period of 000 days with no follow-up visits assigned. However, CMS crosswalked the direct inputs from the open codes, which have a different global period, to the percutaneous codes, including the time assigned for post-procedure office visits. The percutaneous abscess drainage codes identified are CPT codes 32201, 44901, 47011, 48511, 49021, 49041, 49061, 50021, 58823. The comment stated that each of these codes is currently priced in the facility setting only. Because these procedures are predominately performed in the inpatient setting, the comment further recommended that we assign zero direct practice expense inputs for these codes.

    (2) Closure of Eyelid by Suture

    The commenter also pointed out that CPT code 67875, Closure of eyelid by suture, has an assigned global period of 000 and includes no post-procedure visits in the work relative value. However, the original CPEP process appears to have assigned the code clinical staff time, supplies, and equipment related to a follow up visit.

    Response: We agree with the RUC that these 0-day global codes should not have any direct costs assigned for post-procedure follow up visits. Therefore, we are deleting from the database all the inputs related to such visits.

    Comment: Several commenters have expressed concern with the unexplained reduction in nonfacility practice expense RVUs for HCPCS code G0166, External counterpulsation.

    Response: We have examined the practice expense data files and have Start Printed Page 63212discovered an error in the database. This has now been corrected.

    Comment: A specialty society representing dermatology commented that the practice expense RVUS for laser treatment of psoriasis procedures, CPT codes 96920-96922, appear overvalued.

    Response: The practice expense has increased for these codes because we did not have a price for the laser tip used in these procedures until this year. The laser tip is now priced at $240. We have made adjustments to ensure the practice expense RVUs reflect the correct pricing of supplies as well as the specialty performing the service.

    Comment: One specialty society that represents gastroenterologists commented that we cut the payment rate for the colonoscopy procedure, CPT 45385, by 10 percent in the nonfacility setting without explanation or justification.

    Response: The decrease in payment for this code is due to the decreased practice expense inputs now assigned to the service. The PEAC submitted recommendations for the direct practice expense inputs for this service that were based on a presentation made by two other gastroenterological specialty societies, and we have accepted these recommendations because we believe them to be reasonable. The code was included on Addendum C, “Codes for Which We Received PEAC Recommendation on Practice Expense Direct Cost Inputs,” in the proposed rule.

    Comment: Several commenters representing pediatricians, family physicians and chest physicians stated their concern with the proposed decrease in the practice expense RVUs for immunization services, CPT codes 90471 and 90472, which were removed from the non-physician work pool and priced under the top-down methodology starting in 2003.

    Response: We will return the two immunization services to the nonphysician work pool. As discussed above, we are increasing the price assigned to the needle stick prevention device that is in the supply list for the immunization codes. However, the practice expense RVUs for these codes would still be less than the current values. As discussed above, the price for the needle stick prevention device is still fluctuating as new manufacturers enter the market. In addition, it is still not clear exactly which device is optimal for the protection of medical staff. Therefore, until these issues are settled, we will price these immunization services in the nonphysician work pool. This will prevent any sharp decrease in payment for these codes, as well as for payments for the HCPCS G-codes for administration of influenza, hepatitis and pneumococcal vaccines, which are crosswalked to the payment for CPT code 90471.

    Comment: We received a comment from Venable, a diathermy manufacturer, who voiced concerns about previous decreases in both the work and the practice expense RVUs for the diathermy procedure, CPT code 97024. According to the commenter, the PEAC recommendations we accepted for 2002 included a substantial reduction in clinical labor time, the elimination of supplies, and the undervaluing of the diathermy equipment, including the assignment of inadequate time for equipment use. Citing our current CPEP price of $3,120 as too low, the commenter noted the cost of the diathermy machines they manufacture range from $19,000 to $30,000 and noted the actual time of a typical treatment is 20 minutes, and not 15, as currently listed. A previous comment from the electrophysiology specialty section of the American Physical Therapy Association (APTA) stated that the average cost of diathermy ranges between $10,000 and $15,000.

    Response: We believe the practice expense recommendation we accepted from the PEAC in 2001 for the clinical labor and supplies is appropriate. We would note here that the resultant PEAC recommendation for clinical labor was just one minute less than that proposed by the American Physical Therapy Association at the 2001 PEAC meeting. We continue to support the PEAC's decision to eliminate the supplies for some of the modality procedures, including diathermy, since these services are typically performed with other therapy procedures where the supply costs are captured. However, we agree with the commenter that the current pricing of the diathermy equipment in our CPEP database appears too low, and we will price the diathermy, on an interim basis, at $10,000 for the 2004 fee schedule. In addition, we will assign the requested 20 minutes as the typical time the diathermy equipment is in use for each service. We are planning to propose a repricing of all of the equipment included in our database next year and will revisit the pricing of the diathermy equipment at that time.

    In response to the commenter's work RVU concern, next year's final rule will solicit recommendations of codes to be considered for review under the five-year review of work that is to occur in 2005.

    Comment: A commenter representing prosthetic urology focused on reductions in payment for several 90-day global prosthetic urology procedures. The commenter contended that these procedures were affected by the adoption of the standard clinical staff times for 90-day global procedures that did not reflect the extra staff time required for patient training during post-procedure visits. In addition, almost half of the prosthetic urology services were established in 2002 and this appeared to have a negative effect on these codes. The commenter strongly recommended that the standard clinical staff times not be applied to the prosthetic urology codes and that we reinstate the “benchmark” clinical staff times.

    Response: The commenter is correct that the major cause of the decrease in practice expense RVUs for these services is the use of the standard clinical staff time for 90-day global services. We do not have “benchmark” clinical staff times to reinstate for any of these services. Rather, the current staff times are from the original CPEP panel estimates that have not been reviewed by any multi-specialty panel, such as the PEAC. We accepted the PEAC recommendation to apply the standard clinical staff time to all 90-day global services that had not been reviewed by the PEAC as having exceptions to the standard times. All specialties, including urology, had ample opportunity to present any codes for which they believed the standards did not apply; these urology codes were not brought to the PEAC for review. We do not believe we have a sufficient factual basis for changing the clinical staff times for these services in this final rule. However, we would consider any recommendations for revising the pre- and post-service clinical staff times in the future. As to the effect of using the most recent utilization data in calculating the practice expense RVUs for the new prosthetic urology services, please see the discussion on “Utilization Data” earlier in this section.

    Comment: A specialty society representing emergency medicine, an emergency medicine practice management association and an emergency medicine physician practice management organization all commented that the adjustment made in the November 2, 1998 final rule (63 FR 58821) to use the “all physician” practice expense per hour to calculate two indirect cost pools does not make up for the uncompensated care costs of emergency medicine physicians. The practice management association questioned our previous claim that this Start Printed Page 63213adjustment was made as a proxy for uncompensated care and asserted it was rather a generic measure to address the low practice expense per hour for emergency medicine. The specialty society commented that it would be difficult to design a supplementary survey to capture the needed data on the levels of uncompensated care.

    Response: It is amply clear from reading our entire response in the November 2, 1998 final rule that we considered the adjustment to the indirect costs to serve as a proxy for the uncompensated care experienced by emergency medicine physicians. We believe that, if this adjustment is seen by the specialty as insufficient, the best recourse is for the specialty to undertake a supplementary practice expense survey. By working with our contractor, the Lewin Group, the specialty society should be able to modify the survey in such a way that more accurate data on uncompensated care could be obtained. The data from such a survey could then take the place of the current adjustment to the practice expense per hour for emergency medicine because a proxy for uncompensated care would no longer be needed.

    Comment: We received comments from a provider of extracorporeal photopheresis therapy, CPT code 36522, requesting a refinement of the practice expenses of this service in the office setting. Believing this service to be undervalued, the commenter supplied a comprehensive listing of the direct inputs, for the labor, equipment and supplies deemed necessary for the provision of this in-office service. Of particular note among the various suggested supply items was the inclusion of a photopheresis procedural kit.

    Response: We want to thank the photopheresis provider for the practice expense suggestions. At this time, we do not have sufficient information regarding the typical resources needed to proceed with a comprehensive refinement of the practice expenses for the in-office provision of photopheresis. However, in reviewing the commenter's various practice expense proposals, we were struck by the obvious absence of the photopheresis procedural kit in our supply database. Consequently, this kit has been added to our CPEP database on an interim basis. We note that there are general similarities between the commenter's proposed inputs for clinical labor and equipment and our current data. We would anticipate a future discussion regarding this service in order to fully refine the practice expense direct cost inputs for photopheresis.

    B. Geographic Practice Cost Index Changes

    1. Background

    The Act requires that payments vary among Medicare physician fee schedule (MPFS) areas according to the extent that resource costs vary, as measured by the Geographic Practice Cost Indices (GPCIs). Section 1848(e)(1)(C) of the Act requires us to review, and, if necessary, adjust the GPCIs at least every 3 years. This section of the Act also requires us to phase in the adjustment and implement only 1/2 of any adjustment if more than 1 year has elapsed since the last GPCI revision. The GPCIs were first implemented in 1992. The first review and revision was implemented in 1995, the second review was implemented in 1998, and the third review was implemented in 2001. As explained in the August 15, 2003 proposed rule, the fourth GPCI review and revision was scheduled for implementation in 2004. However, because the work and practice expense GPCIs rely primarily on special tabulations of U.S. Census data not yet available, review and revision of only the malpractice GPCI component would occur for implementation in January 2004.

    2. Malpractice GPCI Proposal

    The malpractice GPCI is the most volatile of the three indices with relatively large variations existing between geographic payment localities. We proposed using actual 1999 through 2002 malpractice premium data and forecasting the malpractice premium rates for 2003. We were unable to include proposed malpractice GPCIs based upon this revised malpractice premium data in the August 15, 2003 proposed rule because we were still in the process of collecting the data. We stated that the revised malpractice GPCIs published in this year's final physician fee schedule regulation would be considered interim and subject to public comment.

    3. Collection and Review of Malpractice Premium Data

    For purposes of the 2004 update to the malpractice GPCIs we collected actual malpractice premium data for years 1999 through 2001. For 2002 we were able to obtain actual malpractice premium data for 32 states plus Puerto Rico. Where actual malpractice premium data were obtained, premiums were collected from the 20 physician specialties with the largest share of total Medicare RVUs for 2002. Premiums were collected from those insurers with the largest market share and those insurers that when summed with other large insurers comprised at least 50 percent of the state market share for claims-made policies with a $1 million individual case limit and $3 million aggregate case limit.

    For those 18 states plus the District of Columbia for which we were unable to obtain actual 2002 premium data, we estimated the 2002 premium based upon an examination of growth rates from 1999 to 2001.

    Malpractice premium data were not available for 2003. Two statistical approaches were examined to forecast 2003 malpractice premiums, simple extrapolation and projections based upon the average of historical year-to-year changes (mean rate of change). In most instances, the forecast 2003 premiums were similar using either approach. There was a tendency for the linear extrapolation method to yield slightly more extreme values (positive and negative) so the more conservative, mean rate of change approach was chosen.

    Comment: Several commenters expressed concern about the continued use of proxy data, especially HUD residential rent data and nonphysician professional wage data, in the GPCI methodology.

    Response: This final rule does not update the work or practice expense GPCIs. Any questions related to the use of proxy data in the calculation of the work and practice expense GPCIs will be responded to as part of future rulemaking.

    Comment: One commenter stated that there should be no geographic differences under the physician fee schedule. This commenter felt that the data sources utilized for the construction of the locality specific GPCI indices do not accurately reflect legitimate differences in physician practice costs and that the current methodology did not appropriately reflect the variation that might be caused by case mix, availability of health care resources, and individual practice styles.

    Response: Section 1848(e)(1)(A) of the Act requires that payments vary among areas as resources costs vary as reflected by the GPCIs. We agree that there will be some variation in case mix and practice styles between different specialties and individual practitioners. The physician fee schedule was established in 1992 to eliminate the large unjustifiable payment differences that existed among services, specialties, and geographic areas by establishing a national uniform payment system that can vary only as area resource costs vary as measured by the GPCIs. The GPCI component weights represent the Start Printed Page 63214average physician expense weights across all physician specialties and are intended to reflect the average costs across all services and specialties in a geographic area and not to reflect exactly the costs of each individual practitioner.

    Comment: One commenter stated that there should be no geographic payment differentials because these payment differentials operate as a disincentive for practitioners to practice medicine in rural areas.

    Response: Section 1848(e)(1)(A) of the Act requires that payments vary among areas as resources costs vary as reflected by the GPCIs. It should be recognized that the current methodology associated with the calculation of GPCIs partially benefits practitioners in rural areas. This is because the law requires that only one-quarter of area cost differences in physician work, the largest of the three fee schedule components, be recognized. Thus, about 40 percent of fee schedule payments are by statute not adjusted for area cost differences. When combined with the index of 1.000 for medical equipment, supplies, and miscellaneous (which represents about 13 percent of total physician resource costs) this means that there is a national fee schedule for about 53 percent of the average physician payment. That is, only about 47 percent of overall physician payments are adjusted for area resource cost differences. In addition, 34 states have a single statewide GPCI wherein all physicians, whether urban or rural, are paid the same. All of these factors shift payments from higher cost, usually urban, areas to lower cost, usually rural, areas.

    Comment: One commenter felt that we should not use projected 2003 premium data and instead should actually collect 2003 premium data.

    Response: Currently, 2003 premium data is not available. This is why we will utilize projected 2003 premium data in this update. We plan to utilize more current premium data as it becomes available.

    Comment: Although several commenters expressed their support for the use of more current malpractice premium data, a few commenters had concerns about the use of 2001 through projected 2003 premium data and felt that we should use only projected 2004 premium data in place of the three year average.

    Response: Since the malpractice index has proven to be the most volatile of the indices in past updates, with significant changes from year-to-year, we will not base the malpractice GPCI upon just one year of projected data. In order to protect against aberrant premiums for any given year, we will utilize a three-year average. We will use 2001 through projected 2003 premium data for the three-year average.

    The current methodology projects 2003 malpractice premiums based upon actual malpractice premiums for 1999 through 2002. Since we will continue to collect updated malpractice premium data, we do not think it is appropriate to project through 2004 absent actual 2003 malpractice premium data.

    Comment: One commenter suggested that due to the volatility associated with malpractice insurance premium data, we should collect premium data and re-scale the Malpractice GPCI annually.

    Response: We agree that, because malpractice insurance premiums are volatile, the Malpractice GPCI is also the most volatile of the three indices. We also agree with the commenter's suggestion regarding annual collection of malpractice premium data. We plan to undertake this collection for 2003 premium data in early 2004. If premium data suggest a re-scaling is warranted, we may revise the GPCIs more frequently than every three years.

    Comment: Several commenters requested that we make available to the public the malpractice premium data that was utilized in the calculation of the revised malpractice GPCIs.

    Response: Since some of the data upon which the GPCIs were constructed is based upon the reporting of individual malpractice insurance companies, there are some confidentiality issues associated with making the malpractice premium data public. We will attempt to make available any information that is appropriate on our Web site at http://www.cms.hhs.gov.

    Comment: The American Medical Association's Relative Value Update Committee (RUC) has requested that CMS work with the RUC's Professional Liability Insurance Workgroup to explore the utilization of premium data that might be collected by the RUC.

    Response: We agree with the RUC request and look forward to working with the RUC to obtain more current professional liability premium data.

    4. Interim 2004 Malpractice GPCIs

    Acquiring data on malpractice insurance rates and using that data to adjust Medicare payments for future malpractice insurance prices is a difficult task. Malpractice insurance rates are quite volatile due to a variety of factors. Some of these factors are changes in State insurance laws, business decisions of malpractice insurance carriers, and changes in how medicine is practiced.

    The volatility of malpractice premium data was quite evident in the data we collected in conducting our review of malpractice GPCIs. Based on these data and the comments received on the August 15, 2003 proposed rule, we have modified some of our GPCI calculations and assumptions.

    We are very concerned about implementing sharp changes in malpractice GPCIs for 2004, which directly impact physician fee schedule payment amounts. At the same time, we recognize the importance of updating malpractice GPCIs to ensure local differences in physician costs are included in payment amounts. To be sensitive to both of these considerations, we decided to apply a modulating factor of .5 to the changes in the malpractice GPCIs. In other words, as part of our review and analysis of the malpractice GPCIs, we reduced the difference between the new and previous malpractice GPCIs by 50 percent.

    As directed by the statute, we will implement 1/2 of this change in the first year (CY 2004) and 1/2 of this change in the second year (CY 2005). During this two-year phase-in, we will continue to monitor local malpractice markets, work with the State Departments of Insurance, and collaborate with the RUC to obtain the most current and best malpractice premium data available. As better data are obtained, we will review, propose changes, and revise the malpractice GPCIs as appropriate. The transitional 2004 and full 2005 GPCIs can be found at Addendum D and Addendum E, respectively. These malpractice GPCI revisions necessitate a budget neutrality adjustment, as required by law. Therefore, we adjusted the 2004 through 2006 malpractice GPCIs by 1.0021.

    5. Payment Localities

    In the August 15, 2003 proposed rule we requested comments on the composition of the current 89 Medicare physician payment localities to which the GPCIs are applied.

    Comment: We received numerous comments from professional medical associations, beneficiaries, and practitioners requesting that the specific counties in which they practice medicine or receive medical care be removed from their current locality assignment.

    Response: We will continue to examine alternatives for reconfiguring the current locality structure. We expect to further consider this issue as part of future rulemaking. Start Printed Page 63215

    C. Coding Issues

    1. Payment Policy for CPT Tracking Codes

    The November 1, 2001 final rule (66 FR 55269) included a discussion of CPT Category III codes (also known as CPT tracking codes) and stated that carriers have discretion for coverage and payment of services described by these CPT tracking codes unless we have made a national coverage determination (NCD). We have received requests to create national payment amounts for some CPT tracking codes even if there has been no NCD. Based on these requests, we proposed to change our policy regarding payment for CPT tracking codes and create national payment policy and determine national payment amounts for CPT tracking codes when there is a significant programmatic need for us to do so. This policy change would not change the contractor's discretion over coverage for the CPT tracking codes, but could establish a payment level to be used if the contractor finds that coverage is warranted. In addition, carriers would not be required to establish a payment amount for a tracking code until they receive a claim for the code.

    Comment: Several commenters expressed concerns about this proposal. They believe that establishing a national payment rate for these codes risks premature creation of payment levels of reimbursement and creates an expectation for the future value of the code. The commenters also stated that establishment of a national price could also subvert the RUC process because such pricing could influence subsequent RUC valuation or our acceptance of the RUC's recommendations. Other commenters were supportive of the proposal, with some suggesting that we work with the specialty societies and the RUC in determining appropriate payment rates. One commenter suggested that an alternative to the proposal would be to use the existing refinement panel process because these refinement panels are multispecialty and feature the relevant specialty expertise. One commenter also requested we establish RVUs for specific tracking codes in the final rule.

    Response: We understand the reservations and concerns of the commenters. As we indicated in the proposed rule, we would determine national payment amounts for CPT tracking codes only when there is a significant programmatic need for us to do so. If there is a need to establish payment amounts for a tracking code, we would appreciate the assistance of the relevant specialty societies and the RUC and such pricing would be subject to public comment. However, in some instances, interim values might need to be established if timing does not permit us to obtain prior input from the medical community.

    Final Decision

    We will finalize our proposal to create national payment policies and determine national payment amounts for CPT tracking codes when there is a significant programmatic need for us to do so. We note that, as discussed in the August 15, 2003 proposed rule, this policy change would not change the contractor's discretion over coverage for CPT tracking codes, but would establish a payment level if the contractor finds that coverage is warranted.

    2. Excision of Benign and Malignant Lesions

    The definitions for excision of benign lesions (CPT codes 11400 through 11446 inclusive) and excision of malignant lesions (CPT codes 11600 through 11646 inclusive) were substantively changed for 2003. These codes are now reported based on the excised diameter (actual skin removed) rather than on the size of the lesion. Based on these changes to the code descriptors, we proposed to make the work RVUs the same for removal of all skin lesions with the same excised diameters that are from the same area of the body, whether the lesions are benign or malignant. For example, the work RVUs for the removal of benign skin lesions from the trunk, arms or legs with excised diameter 1.1-2.0 cm, CPT code 11402, would be the same as the work RVUs for CPT code 11602, which is the removal of malignant skin lesions from trunk, arms or legs with excised diameter of 1.1-2.0 cm.

    Comment: The specialty society representing dermatology objected to this proposal and contended that the excision of malignant lesions generally goes deeper and is more time-consuming than the excision of benign lesions and that malignant lesion excision also requires greater skill and embodies greater risk. The society stated that this proposal ignores a multi-specialty effort by a CPT Integumentary Workgroup, the CPT Editorial Panel and the RUC to revise the code descriptors and to assign work RVUs to these services. This view was supported by a joint comment from the heads of several surgical specialties. The RUC also urged us to delay finalizing this proposal until the RUC has the opportunity to provide further recommendations related to these services. In addition, the specialty societies representing podiatry, general surgery, colon and rectal surgery, osteopathy, ophthalmology, plastic surgery, otolaryngology as well as the AMA, the Mayo Foundation and individual physicians also urged us to withdraw this proposal. Medical Group Management Association requested the policy rationale for equating the work RVUs for the benign and malignant code pairs. The specialty society representing family physicians agreed with and supported our position that there is no difference in physician work involved in excising a benign or malignant lesion. However, the commenter did not support our proposal to implement such RVU changes unilaterally and stated that we should utilize the CPT and RUC process.

    Response and Final Decision: We still believe that the physician work for these services is sufficiently similar not to warrant differences in the work RVUs. However, we will maintain the 2003 work RVUs as interim values for 2004 to allow opportunity for the specialty to resurvey these services. Note: That due to the adjustments to work RVUs to match the MEI weights, the work RVUs in Addendum B may differ from the values in 2003.

    3. Create G Codes for Monitoring Heart Rhythms

    As explained in the August 15, 2003 proposed rule, technological advances have made cardiac telemetry equipment, typically used in hospitals, available in the home setting. Coverage of this technology is currently at the discretion of the local Medicare contractors because there is no national coverage determination for this service. We proposed to establish new HCPCS codes to specifically describe this service along with proposed RVUs and PE inputs for payment as follows:

    GXXX1—Electrocardiographic monitoring for diagnosis of arrhythmias, utilizing a home computerized telemetry station and trans-telephonic transmission, with automatic activation and real time notification of monitoring station, 24-hour attended monitoring, per 30-day period of time; includes recording, monitoring, receipt of transmissions, analysis, and physician review and interpretation. (global)

    We proposed 0.52 physician work RVUs and 0.24 malpractice RVUs for this service and proposed crosswalking the practice expense inputs from 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. Start Printed Page 63216

    GXXX2—Electrocardiographic monitoring for diagnosis of arrhythmias, utilizing a home computerized telemetry station and trans-telephonic transmission, with automatic activation and real time notification of monitoring station, 24-hour attended monitoring, per 30-day period of time; recording (includes hook-up, recording and disconnection).

    We proposed 0.07 malpractice RVUs and crosswalked the practice expense inputs from 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).

    GXXX3—Electrocardiographic monitoring for diagnosis of arrhythmias, utilizing a home computerized telemetry station and trans-telephonic transmission, with automatic activation and real time notification of monitoring station, 24-hour attended monitoring, per 30-day period of time; monitoring, receipt of transmissions, and analysis

    We proposed 0.15 malpractice RVUs and crosswalked the practice expense inputs from 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 transmission, and analysis.

    GXXX4—Electrocardiographic monitoring for diagnosis of arrhythmias, utilizing a home computerized telemetry station and trans-telephonic transmission, with automatic activation and real time notification of monitoring station, 24-hour attended monitoring, per 30-day period of time; physician review and interpretation.

    We proposed 0.52 physician work RVUs and 0.02 malpractice RVUs and also crosswalked the practice expense inputs, from 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.

    Comment: Commenters representing cardiac arrhythmia specialists and cardiologists recommended that we withdraw the proposal to create new G codes for monitoring heart rhythms. The commenters stated that this request was not made by the medical community nor from the manufacturers of these heart rhythm monitoring systems. The commenters contended that the proposal appears to address specifically one manufacturer and specifies a particular mode of transmission and patient location, even though there are other new systems of this type that are not captured by this proposal.

    The commenters recommended that we allow this technology to be utilized on a local level before implementing a national coding solution. The commenters further supported that when this new technology warrants a national coding solution, a CPT coding application should be initiated and then the code should be sent to the RUC for review. The commenting specialties stated their willingness to provide medical input into the evaluation, coding and reimbursement for this new technology. Two commenters also stated that the descriptors and the proposed reimbursement do not reflect the monitoring systems that have been developed. Other commenters also requested that we withdraw or reconsider our proposal, as it did not follow the established process for creating and valuing new codes. One specialty society representing clinical endocrinologists supported the establishment of these HCPCS codes, while another commenter, a cardiac monitoring company, provided a general outline of how the various cardiac monitoring technologies can best be used for maximum quality and value. Another commenter suggested that until efficiency of the new technology is demonstrated this proposal should be postponed.

    Response: Our intention in proposing these G codes was to recognize and nationally price all currently available real time cardiac telemetry monitoring technology. It was not intended to address only one system currently in use. Based on the concerns raised by commenters, we will not proceed with these proposed HCPCS codes because we want to ensure that any HCPCS codes developed encompass the various technologies that are being utilized for such monitoring.

    4. CPT Code 88180 (Flow Cytometry; Each Cell Surface, Cytoplasmic or Nuclear Marker)

    Flow cytometry is a technique to analyze single cell suspensions from blood, bone marrow, body fluids, lymph nodes, and other tissues. The technique, currently coded as CPT code 88180, Flow cytometry, each cell surface, cytoplasmic or nuclear marker, quantifies cell surface, cytoplasmic, and nuclear antigens. The August 15, 2003 proposed rule discussed our concerns that the current coding scheme (payment on a per marker basis) may encourage the performance of more markers than may be medically necessary because the pathologist determines what markers to perform and when to perform them. We indicated that we understood the laboratory community would be reviewing this issue and considering whether to recommend changes to the current coding for the procedure. We also requested recommendations on appropriate values for the procedure should we wish to develop a future proposal.

    Comments: Commenters, both individuals and organizations, asked that we not put forth a proposal for payment of flow cytometry. The College of American Pathologists (CAP) has proposed coding revisions to both the immunology and anatomic pathology section of CPT and is working with other groups to establish practice guidelines for flow cytometry. CAP asked that we not establish new “G” codes for 2004, but work with CAP and allow the CPT and RUC evaluation process to be used to determine appropriate coding and relative value units for flow cytometry.

    Decision: We agree with the commenters. We will work with CAP, the CPT and the RUC to develop appropriate coding and payment policies for flow cytometry.

    5. Change in Payments to Physicians Managing Patients on Dialysis

    In the August 15, 2003 rule, we proposed to make CPT codes 90918, 90919, 90920, and 90921 for the monthly capitation payments (MCP) invalid for Medicare. We also proposed to create 3 new G codes in place of each CPT code with payments varying with the number of visits provided within each month to an end stage renal disease (ESRD) patient. Under our proposal, there would be separate codes when the physician provides 1 visit per month, 2-3 visits per month and 4 or more visits per month. The code for 1 visit per month would have the lowest payment while a higher payment will be provided for 2 to 3 visits per month and the highest payment for 4 or more visits per month. These new codes would be reported once per month for services performed in an outpatient setting that are related to the patient's ESRD. These physician services would continue to include the establishment of a dialyzing cycle, outpatient evaluation and management of the dialysis visits, telephone calls, and patient management provided during a full month. These codes would not be used if a hospitalization occurred during the month.

    The proposed codes are as follows:

    GXXX5—End Stage Renal Disease (ESRD) related services per full month, for patients under 2 years of age to Start Printed Page 63217include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    GXXX6—End Stage Renal Disease (ESRD) related services per full month, for patients under 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    GXXX7—End Stage Renal Disease (ESRD) related services per full month, for patients under 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    GXXX8—End Stage Renal Disease (ESRD) related services per full month, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    GXXX9—End Stage Renal Disease (ESRD) related services per full month, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    GXX10—End Stage Renal Disease (ESRD) related services per full month, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    GXX11—End Stage Renal Disease (ESRD) related services per full month, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    GXX12—End Stage Renal Disease (ESRD) related services per full month, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    GXX13—End Stage Renal Disease (ESRD) related services per full month, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    GXX14—End Stage Renal Disease (ESRD) related services per full month, for patients 20 years of age and over; with 4 or more face-to-face physician visits per month.

    GXX15—End Stage Renal Disease (ESRD) related services per full month, for patients 20 years of age and over; with 2 or 3 face-to-face physician visits per month.

    GXX16—End Stage Renal Disease (ESRD) related services per full month, for patients 20 years of age and over; with 1 face-to-face physician visit per month.

    We based the proposed payments on the assumption that many physicians would provide 4 or more visits to their ESRD patients and a smaller proportion would provide 2-3 visits or only 1 visit per month. Using Medicare utilization data from 2002, we proposed the following relative value units for the new G codes that would make Medicare's aggregate payments for ESRD related services under the physician fee schedule approximately equal to current payments for procedure codes 90918 to 90921:

    Table 2

    CodePhysician workPractice expenseMalpractice
    GXXX512.928.700.60
    GXXX65.193.490.24
    GXXX73.392.290.16
    GXXX89.914.860.43
    GXXX93.551.740.15
    GXX102.321.140.10
    GXX118.474.540.35
    GXX123.141.680.13
    GXX132.051.100.08
    GXX145.162.940.22
    GXX151.941.100.08
    GXX161.270.730.06

    As part of the proposed rule we also solicited comments on how to further revise our payment methodology to improve quality of care and outcomes. We requested information that could help us design future demonstrations that would study both dimensions of care (quality and utilization) and help ensure that payment is based on appropriate patient-specific care that has been shown to lead to improved outcomes for this complex patient population.

    Comment: We received many comments from physicians, the RUC, specialty societies, dialysis centers and nephrologists, as well as other individuals and organizations who expressed concerns with our proposal to alter the way physicians are reimbursed for services provided to End Stage Renal Disease (ESRD) patients and who urged us to withdraw the proposal. The RUC and the AMA, as well as other specialty organizations, expressed disappointment that we developed this proposal without consultation from the medical community and outside the usual CPT and RUC process. The Renal Physicians Association (RPA), the American Society for Nephrology (ASN), the American Association for Kidney Patients (AAKP), and the National Kidney Foundation (NKF) all supported the principle of optimizing nephrologist-dialysis patient interaction, which is included in the proposal. However, the RPA contended that the proposal as currently constituted is unworkable, may negatively impact some dialysis patients and is being put on an unreasonably precipitous implementation schedule. The AAKP outlined similar concerns but believed that increased nephrologist-dialysis patient interaction will lead to improved outcomes and also urged that an advisory committee be established to assist in the effort to further improve quality and coordination of care for dialysis Start Printed Page 63218patients. The Medicare Payment Advisory Commission (MedPAC) agreed that the current payment method lacks accountability and quality incentives, and thus encouraged CMS to address these issues. However, MedPAC also expressed concern that without baseline data it was unclear how we could determine and measure the impact of the proposed changes on quality and access. MedPAC further stated that the adjustments to payment should be made subsequent to the collection of information on resource costs and clinical guidelines. Together with these adjustments, further incentives should be added to the monthly payment to reward and improve the quality and access of dialysis-related physician care, which is consistent with MedPAC's June 2003 recommendations. Below are the specific issues raised by commenters:

    Disproportionate Payment Differences

    Many comments concerned the large variation in proposed payments to physicians who see a patient only once a month, compared to the proposed payment for seeing a patient either two or three times during the month or four or more times during the month. In addition, commenters stated there is more work involved in managing care of the ESRD patients between visits.

    Response: Based on our review of the comments, we agree that a significant amount of physician work for patients with ESRD occurs outside of the face-to-face visit with the patients. Since there may be significant physician work associated with providing physician services to ESRD patients between visits, we agree that there should be less difference in the payment levels than we proposed. By raising the minimum payment level, we are accounting for the extensive patient care coordination and other non-face-to-face management required by ESRD patients. However, we continue to believe that more physician work is associated with more frequent face-to-face visits with the patient, and any variation in the payment amounts should reflect this difference.

    First, we determined the appropriate relative relationship among different codes. For instance, we believe that approximately 25 percent more physician work is involved with providing two to three visits than with a single visit, and 50 percent more physician work is associated with providing four or more visits. By paying a single amount regardless of how often the patient is seen, we believe our current policy pays too much if the patient is seen fewer than four times per month. Thus, we revised our payment to be consistent with different levels of physician work associated with providing monthly management of dialysis patients. We are setting our aggregate revised payments equal to aggregate current payments. Consistent with these assumptions, we determined the following RVUs:

    Table 3.—Relative Values for New Monthly Capitation Codes

    Age of patientHCPCSNumber of visitsWorkPractice expenseMalpracticeTotal
    Patients Other Than Home Dialysis
    <2G03084+12.698.580.4221.69
    G03092 to 310.577.130.3618.06
    G0310One Visit8.455.720.2814.45
    2 to 11G03114+9.684.740.3414.76
    G03122 to 38.073.940.2912.30
    G0313One visit6.463.160.229.84
    12 to 19G03144+8.244.450.2612.95
    G03152 to 36.873.690.2310.79
    G0316One visit5.502.960.178.63
    20 +G03174+5.072.880.178.12
    G03182 to 34.232.390.146.76
    G0319One Visit3.381.920.115.41
    Home dialysis patients (entire month)
    <2G032010.577.130.3618.06
    12 to 19G03216.873.690.2310.79
    2 to 11G03228.073.940.2912.30
    20 +G03234.232.390.146.76
    Home dialysis patients (partial month only—per day)
    <2G03240.350.240.010.60
    12 to 19G03250.230.120.010.36
    2 to 11G03260.270.130.010.41
    20 +G03270.140.080.010.23

    We used the above principles to establish our monthly capitation payments (MCP) for patients 20 or older. For patients younger than 20, we are using the same relationship that exists among the current MCP codes for different age groups for the new codes that we are creating. For example, the current MCP code for a patient under 2 (CPT code 90918) has work RVUs that are approximately 2.5 times the work RVU for a patient 20 or older (CPT code 90921). Thus, Medicare's work RVU for each code for a patient 2 years or younger will be 2.5 times the amount of the corresponding service provided to a patient 20 or older. These values can be considered as interim and we plan to seek the advice of the RUC in evaluating these codes once the policy has been implemented. There are efforts underway (for example, in their 2004 workplan, the OIG has indicated they will conduct a review of ESRD monthly capitation payments and physician services) which will provide data on the type frequency and content of physician Start Printed Page 63219encounters as suggested by MedPAC. However, we believe a change should be made in the interim to improve care and accountability. The use of these new codes will also enable us to collect data about the frequency of physician visits.

    Regulatory Impact of Proposal on SGR and Conversion Factor

    We received comments regarding the impact of these proposed changes on the sustainable growth rate (SGR) calculations. Commenters expressed concern that, if physician behavior changes and physicians increase the number of visits provided per month, actual expenditures would surpass the target projection, resulting in a future payment reduction for all of medicine.

    Response: 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. As indicated above, we have established RVUs for the new monthly capitation codes so that Medicare's aggregate payments for these services are equal to what we would have paid in the absence of these changes. We are not expecting any impact on payment for other physician fee schedule services. However, we will continue to review this issue as we work with the medical community to further refine Medicare policy for treating patients needing dialysis services.

    Home Dialysis

    Many comments were received regarding home dialysis because patients who dialyze at home typically see their physicians less frequently than other ESRD patients. One commenter suggested that home dialysis patients be excluded from the proposed change and that we continue to pay the current MCP rate for services to these patients.

    Response: We have created four G codes for the management of home dialysis patients in each of the age groups and will pay for the home dialysis patients at the same rate as codes G0309, G0312, G0315, and G0318 respectively. Although the codes for home dialysis patients will pay physicians slightly less than the former MCP, physicians will still have a relative incentive to increase the use of home dialysis. We believe this is consistent with Section 1881(b)(3)(B) of the Social Security Act which states “With respect to payments for physicians’ services furnished to individuals determined to have end stage renal disease, the Secretary shall pay 80 percent of the amounts calculated for such services on a comprehensive monthly fee or other basis (which effectively encourages the efficient delivery of dialysis services and provides incentives for the increased use of home dialysis) for an aggregate of services provided over a period of time (as defined in regulations).”

    The new G codes for the monthly management of home dialysis patients will be as follows:

    G0320—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients under two years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0321—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients two to eleven years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0322—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients twelve to nineteen years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0323—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients twenty years of age and older.

    The American Society of Nephrology also commented that “reimbursement should be constructed so that home dialysis patients should see their nephrologist at least monthly, with further visits on an as needed basis.” We will not specify the frequency of required visits at this time but expect physicians to provide clinically appropriate care to manage the home dialysis patient.

    If home dialysis patients are hospitalized during the month, four new G codes have been created: G0324, G0325, G0326, and G0327. These codes will be used to report daily management of home dialysis patients for the days the patient is not in the hospital. CPT codes 90922, 90923, 90924, and 90925 will be considered inactive for Medicare because they are now redundant as other codes are to be used by physicians billing for services to ESRD patients.

    The new G codes are as follows:

    G0324—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients under two years of age.

    G0325—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients between two and eleven years of age.

    G0326—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients between twelve and nineteen years of age.

    G0327—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients twenty years of age and over.

    For example, if a home dialysis patient is in the hospital for 10 days (counting the calendar day of admission and the calendar day of discharge) and is cared for 20 days in his or her home, then 20 units of the code for the appropriate aged patient is billed.

    If a home dialysis patient receives dialysis in a dialysis center or other facility during the month, the physician is still paid the management fee for the home dialysis patient and cannot bill the codes in the range of G0308 through G0319 or CPT codes 90935 or 90937, even though the physician may see the patient during his/her center dialysis.

    Role of Non-Physician Practitioners or Physicians Other Than the MCP Physician

    We received comments about the role of nonphysician practitioners. It was not clear to the commenters whether visits by these practitioners could count as face-to-face encounters by the MCP physician. The commenters also asked about billing by physicians (for example, a “rounding” physician or fellow) other than the physician who is billing the monthly capitation rate.

    Response: Physicians may utilize nonphysician practitioners: nurse practitioners, physician assistants, and clinical nurse specialists, who are able under the Medicare statute to furnish services that would be physician services if furnished by a physician and who are eligible to enroll in the Medicare program, to deliver some of the visits during the month. The rules for the use of these physician extenders would be consistent with the rules for split/shared evaluation and management visits: The nonphysician practitioners and physician must be in the same group practice or employed by the same employer/entity; and the physician must perform some portion of the service in a face-to-face encounter, in this case one or more visits during the month with the patient. In this situation, to bill the service under the physician's UPIN/PIN, the physician and not the physician extender should be the practitioner to perform the visit with the complete assessment of the patient and to establish the patient's Start Printed Page 63220plan of care. If the nonphysician practitioner is the practitioner who performs the complete assessment and establishes the plan of care, then the MCP service should be billed under the UPIN/PIN of the nurse practitioner, physician assistant, or clinical nurse specialist.

    It is also possible for the physician to use another physician to provide some of the visits during the month, but the physician who provides the complete assessment, establishes the patient's plan of care and provides the ongoing management should be the physician who submits the bill for the monthly service. The non-MCP physician must have a relationship with the billing physician such as a partner, employees of the same practice, or supervising physician and fellow doing sub-specialty training.

    Each practitioner should document in a shared medical record services he/she personally performed. Only one practitioner can bill for the management of the ESRD patient in any month. In addition, when a nonphysician practitioner or a “rounding physician” sees a dialysis patient for management of ESRD, they cannot bill an evaluation and management service for the same patient unless there is a separate, substantial and documented service evaluating the patient for care unrelated to the patient's dialysis.

    Geographic Issues

    Commenters indicated that the lack of geographic considerations would negatively impact physicians and patients in rural and some urban settings where physician visits require significant travel time. Extended travel time can make it difficult for physicians to see patients as often as patients can be seen when the physician's office is near the dialysis facility.

    Response: We believe that the policy to allow nurse practitioners, physician's assistants, clinical nurse specialists, and other physicians to deliver some of the visits to patients as well as changes in the payment to more accurately reflect non-visit services and the relative value of additional visits will ameliorate these access issues.

    Lack of Clarity Regarding Hospitalization

    Commenters noted that the proposed rule did not provide enough detail regarding alternative billing procedures if hospitalization occurs during the month.

    Response: For ESRD patients (other than home dialysis patients) who are hospitalized during the month, the physician may bill the code that reflects the number of face-to-face visits during the month on days when the patient was not in the hospital (either admitted as an inpatient or in observation status).

    Documentation Requirements

    Comment: Many commenters asked for clarification regarding the documentation requirements, if any, associated with the new codes.

    Response: We have chosen not to include specific documentation guidelines in this rule. Instead, physicians should document what is clinically relevant, including but not limited to the patient's current status and complaints, a clinically appropriate physical examination, assessment of the patient's treatment for ESRD that includes assessment of the adequacy of the dialysis treatment, the status of the patient's vascular access, assessment and treatment of the other conditions associated with ESRD, such as anemia, electrolyte management, and bone density, as well as changes to the patient's management.

    HIPAA Compliance

    Comment: A comment was received that HIPAA transaction and code set rules may not be met if these new codes were implemented.

    Response: G codes are part of the HCPCS coding system and are in compliance with the HIPAA transaction and code set rules.

    Outpatient Settings

    Comment: Commenters asked for additional clarification on whether visits counted toward the MCP can be provided in settings other than the dialysis facility.

    Response: The visits for management of ESRD patients may occur in the physician's office, in an outpatient hospital or other outpatient setting or even in the patient's home as well as in the dialysis facility.

    Transient Patients

    Comment: Commenters inquired how physicians would deal with visits and related billing for traveling patients who receive their treatment away from their usual site of treatment.

    Response: If the physician manages the care of a patient who is receiving treatment away from the patient's usual site of treatment, the physician who bills for managing the care of the patient is still paid according to the number of times the physician has a face-to-face visit with the patient. If the patient is to be away for an extended period of time, the patient would be managed by the physician who has face-to-face visits with the patient, and that physician would be the one billing for the patient's care management.

    Quality of Care and Outcomes

    Comment: Commenters representing the American Osteopathic Association, the American Academy of Family Physicians, the National Coalition for Quality Diagnostic Imaging Services, the American Society for Echocardiography and Focus on Therapeutic Outcomes, Inc., provided information on quality initiatives their respective organizations have undertaken or suggestions for relating quality to payment. The National Kidney Foundation recommended the use of technology and other forms of communication to care for ESRD patients and to support constant attention to quality. In addition, the Society for Interventional Radiology commended our efforts to increase the use of arteriovenous fistulae for vascular access in dialysis patients as part of its National Vascular Access Improvement Initiative, but indicated there might be a need to clarify certain policies. The American Association of Kidney Patients (AAKP) also recommended the establishment of a commission or advisory group with representation of the kidney community that could be charged with recommending proposals to tie reimbursement to outcomes. AAKP stated that although the proposed changes are important, these changes remain a change in process of delivery of care that may improve actual outcomes, rather than a change in actual outcomes, that is, in rehabilitation, morbidity, mortality, and quality of life. MedPAC agreed with CMS that the proposed change to provide incentives for additional nephrologist-dialysis patient interactions may not be the ideal method to improve patient outcomes and to achieve this goal, CMS should partner with the ESRD community and work toward a long-term solution. MedPAC suggested that we investigate and incorporate physician clinical practice guidelines into our payment approach, and measure physician quality directly. MedPAC also suggested that we examine whether physician resources vary based on patient complexity, stating that to the extent that resources do vary, a case-mix adjustment—similar to the one MEDPAC recommended for payment to dialysis facilities in its June 2003 report—would be desirable.

    Response: We appreciate the information and suggestions provided by the commenters and will take these into consideration. We plan to investigate the use of new technology to improve the management of ESRD Start Printed Page 63221patients as part of our overall focus on quality.

    Final Decision—We will create the following G Codes to be used for ESRD patients other than home dialysis, based on the age of the patient and number of visits:

    G0308—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients under 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    G0309—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients under 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    G0310—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients under 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    G0311—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    G0312—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    G0313—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 2 and 11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    G0314—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face physician visits per month.

    G0315—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2 or 3 face-to-face physician visits per month.

    G0316—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients between 12 and 19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face physician visit per month.

    G0317—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients 20 years of age and over; with 4 or more face-to-face physician visits per month.

    G0318—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients 20 years of age and over; with 2 or 3 face-to-face physician visits per month.

    G0319—End Stage Renal Disease (ESRD) related services during the course of treatment, for patients 20 years of age and over; with 1 face-to-face physician visit per month.

    In addition we have created the following G codes for home dialysis patients:

    G0320—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients under two years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0321—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients two to eleven years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0322—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients twelve to nineteen years of age to include monitoring for adequacy of nutrition, assessment of growth and development, and counseling of parents.

    G0323—End stage renal disease (ESRD) related services for home dialysis patients per full month; for patients twenty years of age and older.

    G0324—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients under two years of age.

    G0325—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients between two and eleven years of age.

    G0326—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients between twelve and nineteen years of age.

    G0327—End stage renal disease (ESRD) related services for home dialysis (less than full month), per day; for patients twenty years of age and over.

    6. Miscellaneous Coding Issues

    Bioimpedance

    Comment: We received several comments concerning the pricing of CPT code 93701, electrical bioimpedance. One commenter, a carrier medical director, requested that this service be considered a technical component service as there is no physician work (professional component) required to produce the results. The commenter referenced the RUC recommendation of 0.00 work that was not accepted by CMS in November 2001. Other commenters stated that pricing of this service should be revisited and the American College of Cardiology recommended work component of 0.25 RVUs be accepted. Commenters also questioned the valuation of the practice expense component, particularly in light of the escalating costs associated with this service.

    Response: In next year's final rule we will be accepting recommendations for codes to be considered under the five-year review of work that will occur in 2005. The commenters will be able to respond to that solicitation, and submit this CPT code, as well as any other services they believe need to be reviewed to ensure they are appropriately valued. We are currently in the process of reviewing and obtaining updated pricing for equipment contained in the practice expense data files and proposed changes to pricing for equipment will be included in next year's proposed rule. We would suggest that the commenters review this information when published to ensure that the cost of the equipment is accurately reflected in the database.

    Ablation Procedures

    Comment: One commenter, a manufacturer, suggested that the work RVUs of certain codes for the ablation of liver tumors (CPT codes 47380, 47370 and 47382) appeared to be undervalued.

    Response: As discussed in the previous response, in next year's final rule we will be accepting recommendations for codes to be considered under the five-year review of work that will occur in 2005. The Start Printed Page 63222commenter will be able to respond to that solicitation and submit these codes, as well as any additional services they believe need to be reviewed to ensure they are appropriately valued.

    Stereotactic Radiosurgery and Stereotactic Radiotherapy

    Comment: Two commenters requested that HCPCS codes G0173 and G0251, which are used for reporting stereotactic radiotherapy and stereotactic radiosurgery under the hospital outpatient prospective payment system, be activated for payment under the physician fee schedule.

    Response: We are reluctant to establish payment for these services under the physician fee schedule at this time absent specific information on freestanding centers providing this service. We would welcome information and data from these commenters, and other individuals and providers, on the provision of these services in freestanding centers so that we can fully evaluate this issue.

    Creation of G Codes

    Comment: The AMA and several specialty organizations expressed concern about the establishment of the numerous G codes that were contained in the proposed rule. The commenters state that continual development of G codes, without consultation with the CPT Editorial Panel, the RUC or the physician community undermines the annual review process that CMS has established in the final rule. Further, the commenters argue that the establishment of G Codes undermines the requirements of the Health Insurance Portability and Accountability Act (HIPAA) for coding standardization and an open process for establishing codes.

    Response: As we have stated in previous rulemaking, it is sometimes necessary to develop G codes to accommodate changes in legislation, regulation, coverage, and payment policy. We appreciate the input of the medical community and to the extent possible, will work with the CPT Editorial Panel, the RUC and the physician community prior to establishment of these codes.

    Pain Management

    Comment: The American Society of Interventional Pain Management commented on the differences in payment allowances for various pain management services and other non-pain management services furnished in conjunction with pain management services in various settings, including the physician's office, the OPD and the ASC.

    Response: In accordance with the law, we have established payment rates for office-based procedures, using the non-facility practice expense relative value units. However, the office does not represent a practice site where these services are usually performed.

    Medicare payment under the physician fee schedule for the physician work is the same in all practice settings. However, the practice expenses are reimbursed differently depending on the practice site. Practice expenses associated with procedures performed in the outpatient departments (OPDs) or ambulatory surgical centers (ASCs) are paid under the OPD or ASC payment system respectively. Practice expenses associated with procedures performed in the physician's office are paid through the physician fee schedule payment system.

    III. Other Issues

    A. Definition of Diabetes for Diabetes Self-Management Training

    In the August 15, 2003 rule we proposed to adopt the definition of diabetes used to determine beneficiary eligibility for Medical Nutrition Therapy (MNT) for purposes of coverage for outpatient diabetes self-management training when the beneficiary has a diagnosis of diabetes. Specifically, we stated that the criteria currently set forth at § 410.141(d), would be replaced with definition of diabetes used for medical nutrition therapy at § 410.130 which reads as follows:

    Diabetes means diabetes mellitus consisting of two types. Type 1 is an autoimmune disease that destroys the beta cells of the pancreas, leading to insulin deficiency. Type 2 is familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. It is caused by an insulin resistance whose etiology is multiple and not totally understood. Gestational diabetes is any degree of glucose intolerance with onset or first recognition during pregnancy. The diagnostic criterion for a diagnosis of diabetes for a fasting glucose intolerance test is greater than or equal to 126 mg/dL.

    A technical error in the proposed rule on page 49070, placed the revised eligibility requirements in § 410.141(f). The eligibility requirements will replace those currently in § 410.141(d).

    Comment: We received comment noting that the language for the actual regulatory language had the wrong section letter.

    Response: As noted above, this was a technical error.

    Final Decision: The following language will replace what was in the proposed rule. “Section 410.141 is amended by replacing paragraph (d) to read as follows: § 410.141 Outpatient diabetes self-management training. (d) Beneficiaries who may be covered. Medicare Part B covers outpatient diabetes self-management training for a beneficiary who has been diagnosed with diabetes.”

    Comment: The comments were very supportive of our efforts to streamline this requirement. Several commenters recommended that the definition of diabetes be revised to include patients who might not be classified as Type 1, Type 2, or gestational diabetes in the definition. Most commenters recommended the use of a fasting glucose test of greater than or equal to 126 mg/dL. One commenter suggested the measurement be taken on two occasions. Most commenters also recommended the addition of a random glucose test of greater than 200 mg/dL, with one commenter adding with symptoms of uncontrolled diabetes. Several commenters suggested use of an abnormal glucose tolerance test (GTT). One commenter also suggested the use of a 2 hour post-glucose challenge of greater than or equal to 200 mg/dL test on two different occasions. The American Association of Clinical Endocrinologists (AACE) also suggested that coverage of medical nutrition therapy be expanded to those with impaired fasting glucose.

    Response: The definition of diabetes used in the MNT regulation was based on language found in the 2000 Institute of Medicine report entitled, “The Role of Nutrition in Maintaining Health in the Nation's Elderly. We did not have any other generally recognized definition of diabetes at that time and did not intend to limit our definition of diabetes. Regarding the laboratory tests, the characteristics of the commenters' suggestions are generally the same. The base measurement that is already in our MNT regulation, a fasting glucose of 126 mg/dL, is a common measure. Three commenters also noted the use of 200 mg/dL for a random glucose test. The major variation between the commenters was that one suggested multiple measurements. Also, we note that patients with an impaired fasting glucose level do not necessarily meet any of the popular definitions of diabetes.

    Final Decision: We agree that in some ways our proposed definition may not include some patients diagnosed with diabetes. We also agree that our clinical Start Printed Page 63223laboratory measurements used to determine the presence of diabetes should be expanded. The definition provided by AACE appears to meet the clinical concerns of the medical community and our concerns that no individuals have their treatments delayed unduly if they have obvious symptoms of uncontrolled diabetes. Therefore, we are adopting their clinical definition. We will also broaden our general language to include diabetes of other types. Our final language will be, “Diabetes is diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria: A fasting blood sugar greater than or equal to 126 mg/dL on two different occasions; a 2 hour post-glucose challenge greater than or equal to 200 mg/dL on 2 different occasions; or a random glucose test over 200 mg/dL for a person with symptoms of uncontrolled diabetes.” We will also make a conforming amendment to 410.130 for MNT. However, we are constrained from covering MNT for anyone who is not diagnosed with diabetes by the section 1861(s)(2)(V) of the Act that limits coverage of MNT to beneficiaries with diabetes or renal disease.

    Outpatient Therapy Services Performed “Incident To” Physicians” Services—Discussion Only

    In almost all settings, our regulations specify that outpatient therapy services can be delivered only by qualified physical therapists, occupational therapists, physical therapy assistants, occupational therapy assistants, and speech-language pathologists as defined by § 484.4. Section 1862(a)(20) of the Act requires that any therapy services furnished incident to a physician's professional services must meet the standards and conditions that would apply to such therapy services if they were furnished by a therapist, with the exception of the licensing requirement. While there are currently no national standards for qualifications of individuals providing outpatient therapy services incident to physicians' services, we believe that standards similar to those in § 484.4 are appropriate. In the proposed rule, we stated that we are considering adopting the existing qualification and training standards (with the exception of licensure) in § 484.4 for individuals providing therapy services independently and incident to physicians' services. While we did not propose a change at this time, we requested comments from the public, particularly physicians and staff who would be affected, on adoption of the existing standards in § 484.4, for services of independent therapists and “incident to” services, as well as comments regarding alternatives that we might use to ensure that qualified staff are providing “incident to” therapy services.

    We received comments from major therapy organizations and individual therapists representing therapy services, physician organizations and individual physicians and associations and individuals representing other health care professionals, such as athletic trainers, kinesiotherapists and exercise physiologists. A wide spectrum of views was expressed by these commenters. Commenters representing therapists were supportive of establishing consistent training standards in all settings, while physicians favored reliance on the individual physician for quality control. The non-therapist health care providers were concerned about their role in providing therapy services and cardiac rehabilitation and pulmonary service providers were concerned that their services might be affected.

    We will review and consider these comments as we determine whether to make a future proposal. Meanwhile, contractors may continue to develop local medical review policies that are consistent with the statute, applying to physical therapy, occupational therapy and speech-language pathology services the same standards and conditions that would apply to such therapy services if they were furnished by an independent therapist, with the exception of the licensing requirement.

    D. Status of Anesthesia Work and Five-Year Review

    In the December 2002 final rule, we modestly increased the work of anesthesia services. These changes were based on the analysis submitted by the RUC of its review of the work of 19 high volume anesthesia codes. The RUC had provided us with its analysis but did not furnish us with a definitive recommendation. The increase in anesthesia work resulted in an increase in the national anesthesia conversion factor. (We increased the physician work component of the anesthesia conversion factor by 2.10 percent to reflect a 9.13 percent increase in anesthesia work applied to 23 percent of anesthesia allowed charges represented by the 19 codes. As a result of this increase, we applied a 1.6 percent increase to the anesthesia CF.) The American Society of Anesthesiologists expressed concern about the completeness of the review of anesthesia codes under the five-year review. Therefore, in February 2003 we asked the RUC to continue its review of anesthesia work values so that we could develop a final recommendation for a change in the anesthesia CF involving all anesthesia codes. In the proposed rule we stated we were waiting on the RUC's response to our request.

    The RUC has spent a considerable amount of effort of studying this issue. The RUC's anesthesia workgroups consisted of a range of physician specialists, including various surgical specialists, who have knowledge about the anesthesia services studied. As a result of their review, the RUC approved and presented the following recommendations to CMS:

    1. The RUC position is that the 5-year review has been completed.

    2. The RUC anesthesia workgroup analysis only applies to the 19 anesthesia codes and associated 19 surgical codes.

    3. The Workgroup recommendations to the RUC stated that there are structural differences between the anesthesia coding system and the remainder of the physician coding system, which contributes to the difficulties in making extrapolations to the entire set of anesthesia services. Among other things, the workgroups and the RUC were concerned that the anesthesia codes cover too large a number of surgical codes making it necessary to examine surgical codes within the anesthesia code, and the 19 selected anesthesia codes may not be the most representative codes.

    The ASA disagrees with the RUC's recommendations and asked that we extrapolate from the 19 surveyed procedures to all anesthesia codes.

    Decision

    When we developed the 2002 final physician fee schedule rule on the second five-year review, one of our concerns was that the RUC's initial findings were not presented as specific recommendations. We wanted to pursue approaches consistent with RUC recommendations. Therefore, in early 2003, we asked the RUC to more clearly present their recommendations.

    Based on our review of the history and analysis of this issue and the final recommendation of the RUC, we have decided not to extrapolate from the surveyed procedures to the entire universe of anesthesia procedures; we will make no further adjustments to anesthesia work under the second five-year review. Start Printed Page 63224

    Payment Policies for Anesthesia Services

    There are differences in Medicare payment policies between a teaching anesthesiologist involved with two concurrent cases with residents and a teaching CRNA involved with two concurrent cases with student nurse anesthetists.

    Currently, if a teaching anesthesiologist is involved with two concurrent cases with anesthesia residents, the medical direction rules apply. Payment for the physician's medical direction is based on 50 percent of the allowance otherwise allowed if the anesthesiologist performed the anesthesia case alone.

    For anesthesia services furnished prior to July 1, 2002, we allowed full payment if a non-medically directed certified registered nurse anesthetist (CRNA) supervised a single case involving a student nurse anesthetist. No payment was made if the teaching CRNA supervised two cases involving student nurse anesthetists. In August 2002, we released the Medicare Carriers Manual Transmittal 1766 relating to the involvement of a non-medically directed teaching CRNA with two student nurse anesthetists. The American Association of Nurse Anesthetists (AANA) noted that their standards for approved nurse anesthesia training programs allow the teaching CRNA to supervise two concurrent cases involving student nurse anesthetists. The new policy allows the teaching CRNA to be paid, for his/her involvement with two concurrent cases with student nurse anesthetists, but not at the full fee level. If a teaching CRNA is involved with two concurrent cases with student nurse anesthetists, payment may be based on the base unit plus the time that the teaching CRNA is present with the student nurse anesthetist. To bill the base unit, the teaching CRNA must be present with the student nurse anesthetist throughout the pre- and post-anesthesia care. This payment per case is usually higher than the 50 percent paid to the teaching anesthesiologist for medically directing resident cases.

    In the proposed rule, we asked for comments on the appropriateness of applying the CRNA teaching/resident policy to teaching anesthesiologists.

    Comment: The American Association of Nurse Anesthetists commented that it was unclear how the new rule for teaching anesthesiologists would operate with the medical direction rules, particularly if there were more than two concurrent anesthesia cases.

    Response: The new policy for teaching anesthesiologists would apply only when there are two concurrent cases, and the cases involve residents. The medical direction payment policy would continue to apply, as it has previously, for three or four concurrent anesthesia cases regardless of the qualified individual (for example, CRNA, resident, or anesthesiologist assistant) who is administering and monitoring anesthesia under the physician's medical direction.

    Comment: The ASA requested that the teaching anesthesiology payment regulations be revised so that the teaching anesthesiologists be paid in a similar manner to teaching surgeons. Under the teaching physician rules, the teaching surgeon can be paid the full fee for each of two overlapping surgeries involving residents. The ASA understands that such a proposal would require a revision to Medicare regulations and would require rulemaking.

    The ASA requested that, at least, in the interim, we allow teaching anesthesiologists to be paid similarly to teaching CRNAs for two concurrent cases. However, ASA specifically requested that this policy be used in addition to the current medical direction payment policy. In other words, the ASA wants the teaching anesthesiologist to be able to choose case-by-case, whether to seek payment similar to the teaching CRNA (that is, full base units and time units based only on actual presence with the resident) or based on the medical direction rules (that is, 50 percent of the full base and time units).

    According to the ASA, a number of anesthesiology department heads believe the nurse anesthesia payment rule is not appropriate to the teaching of already-licensed physicians. They question the need for the teaching physician to participate in the pre- and post-op anesthesia care (to obtain full base units), they think that participation of the teaching anesthesiologist in the key portions of the procedure is far more important than the number of minutes present with the resident (which is the relevant consideration under the teaching physician policy for a single case with a resident).

    Response and Final Decision

    We have decided to allow teaching anesthesiologists to bill, similarly to teaching CRNAs, for their involvement in two concurrent cases involving residents. This will apply to anesthesia services furnished on or after January 1, 2004.

    The anesthesiologist can bill base units and actual time, based on the amount of time the physician is present with the resident during each of two concurrent cases. To bill base units, the physician must be present with the resident during the pre- and post-anesthesia care included in the base units. If the physician is not present with the resident during the pre- and post-anesthesia care, the physician may bill the case as a medically directed case.

    The anesthesiologist must document his/her involvement in cases with anesthesia residents. The documentation must be sufficient to support the payment of the fee and available for review upon request. We have revised § 414.46 to incorporate this change.

    F. Technical Correction

    CPT Code 96155 (Health and behavior intervention, each 15 minutes,face-to-face; family (without the patient present))

    This code describes a visit with a patient's family without the patient being present and was first included in the November 1, 2001 final rule. It was incorrectly listed as an active code for which payment could be made under the physician fee schedule. Our longstanding payment policy is that we do not pay for visits with family where the patient is not present. Payment for such visits is included in the pre- and post-service work of a visit where the patient is present. Consistent with this policy, this code is not payable under the physician fee schedule.

    Comment: A few commenters urged us to continue to list this code as an active code under the fee schedule as they do not agree with our policy. The commenters do not agree with our assertion that payment for such visits is included in the pre- and post-service work of a visit when the patient is present and believe that not covering the service could result in diminished quality of care. One commenter disagreed that this was a technical correction since this code is currently being paid for under the fee schedule.

    Response: As we indicated in the proposed rule, this was erroneously listed as an active code, contrary to longstanding Medicare policy. To be consistent with our policy, no payment may be made for this service under Medicare, and the code will be assigned a status indicator of “N”.

    G. Incomplete Screening Colonoscopy

    Section 1834(d)(3) of the Act requires that the payment amount for a screening colonoscopy be set at the level for a Start Printed Page 63225diagnostic colonoscopy. We have established RVUs for an incomplete diagnostic colonoscopy (CPT code 45378-53) However, an incomplete screening colonoscopy (HCPCS G0105 with modifier ‘53’ or HCPCS G0121 with modifier ‘53’) is currently carrier priced. To make payment for screening colonoscopy consistent with payment for a diagnostic colonoscopy, effective January 1, 2004, Medicare will make payment for an incomplete screening colonoscopy, HCPCS G0105 with modifier ‘53’ and HCPCS G0121 with modifier ‘53’, at the same rate as an incomplete diagnostic colonoscopy (CPT 45378-53). The Medicare carriers will no longer manually price the practitioner payment for an incomplete screening colonoscopy.

    H. Publication Issues

    Comment: Several commenters noted that section 1871 of the Act requires a 60-day public comment period. Such period traditionally starts with the date the proposed rule is published in the Federal Register. However, for the Physician Fee Schedule Proposed rule, CMS began the start of the 60-day comment period on August 8, the date the proposal was put on display at the Federal Register, rather than August 15, the date the proposal was published in the Federal Register. The commenters request that CMS revert to the traditional start of the comment period, that is, the date of publication in the Federal Register. One commenter suggested that CMS should accept electronically submitted comments when the comment period begins earlier than the publication date.

    In addition, several commenters urged CMS to resolve the process issues associated with publishing the proposed and final rule. They indicated that the delayed publication of the proposed rule, combined with missing information from addendums and impact tables, makes review and analysis problematic. The commenters also expressed concern that CMS has insufficient time to evaluate public comments and this is contrary to the spirit of the Administrative Procedures Act.

    Response: CMS is keenly aware of the tight time frame between publication of the proposed and final rules. We make every effort to respond to requests from physician specialty groups and providers to include items in the proposed rule that affect payment levels, such as assigning RVUs to new CPT codes and revising RVUs for existing codes. It is difficult to both address numerous concerns and publish the proposed rule in a timely fashion. We will continue to make every effort to publish the proposed rule as early as possible. However, despite the short time frame for issuing the final rule, we take the review and analysis of comments very seriously. CMS devotes the necessary staff resources to ensure that every comment is properly considered.

    Furthermore, the statute does not provide that the comment period commences with publication in the Federal Register. Section 1871(b)(1) of the Act states that before issuing a regulation in final form, “the Secretary shall provide for notice of the proposed regulation in the Federal Register and a period of not less than 60 days for public comment thereon.” While the proposed rule did not actually appear in the Federal Register until August 15, 2003, it was filed and went on public display at the Federal Register several days earlier on August 8, 2003. Accordingly, the contents of the proposed rule were, in fact, publicly available for the full 60-day comment period.

    IV. Refinement of Relative Value Units for Calendar Year 2004 and Response to Public Comments on Interim Relative Value Units for 2003

    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, 2004. The tables and discussions in this section concerning the work RVUs do not reflect the effect of the adjustment to work RVUs to match the MEI weights as discussed in section VI. The referenced work RVUs may differ from the work RVUs in Addenda B and C that reflect this adjustment.

    B. Process for Establishing Work Relative Value Units for the 2004 Physician Fee Schedule

    Our December 31, 2002 final rule (67 FR 79966) 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 March 1, 2003. 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 December 2002 final rule and our establishment of the work RVUs for new and revised codes for the 2004 physician fee schedule.

    C. Work Relative Value Unit Refinements of Interim Relative Value Units

    1. Methodology (Includes Table titled “Work Relative Value Unit Refinements of the 2003 Interim and Related Relative Value Units”)

    Although the RVUs in the December 2002 final rule were used to calculate 2003 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 10 CPT codes with interim work RVUs. Only comments on codes listed in Addendum C of the December 2002 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.
    • One primary care clinician nominated by 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 300 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 Start Printed Page 63226or 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 intent of the panel process was to capture each participant's independent judgment 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 addition, 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 December 2002 final rule. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the 1993 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 2003, but for which we did not submit the RVUs to the panel for review for a variety of reasons. These comments and our decisions on those RVUs commented upon are discussed in further detail below.

    The table below lists those interim codes reviewed under the refinement panel 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.
    • 2003 Work RVU. The work RVUs that appeared in the December 2002 rule are shown for each reviewed code.
    • Requested Work RVU. This column identifies the work RVUs requested by commenters.
    • 2004 Work RVU. This column contains the final RVUs for physician work. (These work RVUs may differ from the work RVUs in Addenda B that reflect the adjustment to work RVUs to match the MEI weights.)

    Table 4.—Codes Reviewed Under the Refinement Panel Process

    CPT code 1ModDescriptor2003 work RVURequested work RVU2004 work RVU
    17310Mohs any stage > 5spec each0.620.950.95
    43219 *Esophagus endoscopy2.802.80
    43256 *Uppr gi endoscopy w stent4.354.35
    44383 *Ileoscopy w/stent2.942.94
    45340Sig w/balloon dilation1.661.961.89
    51798Us urine capacity measure0.000.380.00
    75954Illiac aneurysm endovas rpr1.362.932.25
    92613Endoscopy swallow tst (fees)0.000.990.71
    92615Eval laryngoscopy sense test0.000.880.63
    92617Interprt fees/laryngeal test0.001.100.79
    1 All CPT codes and descriptions copyright 2003 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.
    * The work RVUs for these codes were revised for 2003 by CMS to finalize outstanding issues related to the five-year review of the gastroenterology codes.

    2. Interim 2003 Codes

    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).

    Prior to 2003, this code was reported once for all specimens over five generated during a particular stage of Mohs surgery. Beginning in 2003, the code is 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 disagreed and assigned a work value of 0.62 work RVUs to this code pending further recommendations from the RUC. We believed this value was appropriate for the new descriptor since it allows reporting of CPT code 17310 for each specimen rather than reporting once for all specimens. It also places this code in the correct rank with the other Mohs surgery services, CPT codes 17304-17307, and with the codes for pathology consultation during surgery, CPT codes 88331 and 88332.

    Commenters disagreed with the rationale we had used to arrive at the interim work value and indicated that we used inappropriate time/intensity data and failed to include surgery work, focusing only on pathology work. Commenters also stated that the intent of this code has not changed and that CMS had ignored past policy which recognizes CPT code 17310 as an add-on service and thus allows the separate billing of services for each additional specimen beyond the first five. Based on these comments, we referred this code to the multispecialty validation panel for review.Start Printed Page 63227

    Final decision: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we have assigned 0.95 work RVUs to CPT code 17310.

    CPT Code 38204 Management of recipient hematopoietic progenitor cell donor search and cell acquisition.

    We disagreed with the RUC recommendation of 2.00 work RVUs for CPT code 38204. We believed 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) and have significant concerns about how this code would be used in actual practice. Therefore, we assigned CPT code 38204 a status indicator of “B,” meaning that we will not make separate payment for this service.

    Comments: Some commenters urged us to reconsider the RUC recommendation. In addition, the RUC submitted a comment disagreeing with our contention that the physician work associated with this code is included in other transplant codes. The RUC also asserted that discussions of this issue at the RUC meetings provided substantive information on how this code would be used.

    Response: We continue to believe that the work of this service is contained in other transplant codes and are maintaining the status indicator of “B.” Therefore, we will not make separate payment for this service.

    CPT Codes 43219 Esophagoscopy, rigid or flexible; with insertion of plastic tube or stent, 43256 Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic stent placement (includes predilation), and 44383 Ileoscopy, through stoma; with transendoscopic stent placement (includes predilation).

    As explained in the December 31, 2002 final rule, the work RVUs for these codes were revised by CMS to finalize outstanding issues related to the five-year review of the gastroenterology codes. For CPT code 43219, we maintained the work RVU of 2.80. Review of information supplied by specialty societies did not provide compelling evidence that the work RVUs should be changed. Based on a review of the physician time data and a comparison to other stent placement codes, we assigned 4.35 work RVUs to CPT code 43256 and 2.94 work RVUs to CPT code 44383, in order to place these services in proper rank order to the other stent placement codes.

    Comment: Some commenters felt that we improperly intervened in assigning work RVUs to these services albeit to correct rank order anomalies. Based on these comments we referred these codes to the multispecialty validation panel for review.

    Response: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we are retaining work RVUs of 2.80 for CPT code 43219, 4.35 for CPT code 43256 and 2.94 for CPT code 44383.

    CPT code 45335 Sigmoidoscopy, flexible; with directed submucosal injections any substance.

    The RUC recommended work RVUs of 1.46 for CPT code 45335 based on a comparison to CPT code 45330, with incremental work RVUs added to reflect increased pre-, intra-, and post-service work. We disagreed with the RUC recommendation and compared this service to the analysis and recommendation provided by the RUC for CPT code 43201, which is also a new submucosal injection code. Based on the increased risk of complications (resulting in higher intra-service intensities) and the fact that several sites are being injected instead of one, we assigned a work RVU of 1.36 to CPT code 45335.

    Comment: Some commenters expressed concern about the rejection of the RUC recommendation for this service and believed that we had misinterpreted the RUC findings.

    Response: Upon further review and consideration of the RUC recommendation we will accept the RUC recommended work RVU of 1.46 for this service.

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

    The RUC recommended a work RVU of 1.96 for this code, which includes 1.00 RVU for the incremental work based on the need for conscious sedation to perform this procedure. (Other flexible sigmoidoscopies do not require conscious sedation.) In the December 31, 2002 rule we stated that we did 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 the provision of conscious sedation. Rather, we compared the RUC recommendations for work and physician time for other endoscopic dilation codes to the incremental times for CPT code 45340 and assigned a work RVU of 1.66 to CPT code 45340.

    Comment: Some commenters urged us to accept the RUC recommendation, noting that our characterization of RUC recommendations on conscious sedation was inaccurate. The commenters stated that the RUC has concluded that there is an increase in the amount of physician work relating to conscious sedation, but has been unable to identify a specific numerical value for that additional increment. The RUC is in the process of determining the universe of codes that include conscious sedation as an inherent part of the service provided by the operating physician to ensure these services are appropriately valued. Based on these comments we referred this code to the multispecialty validation panel for review.

    Response: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we have assigned 1.89 work RVUs to CPT code 45340.

    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 urology survey that reported that this procedure is performed 75 percent of the time by the physician and also 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 disagreed. This code is replacing a HCPCS level two code that was assigned 0.00 work RVUs because it is typically performed by a nurse or other clinical staff. We believed that CPT code 51798 is, therefore, also a nonphysician service and assigned 0.00 work RVUs to this service.

    Comment: Some commenters requested that we reconsider our decision to assign 0.00 work RVUS to this service. The commenters argued that our reason for disagreeing with the RUC recommendation is based on a stated belief that there is no physician work involved, not on actual survey data as presented by the American Urological Association (AUA) and accepted by the RUC. Commenters urged that CMS work with AUA to review this decision or include this code as part of the multi-specialty validation panel for refinement of work RVUs. Based on these comments, we referred this code to the multispecialty validation panel for review.

    Response: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we will retain 0.00 work RVUs for CPT code 51798.

    CPT Codes 58545-58554 Laproscopic hysterectomy/myonectomy procedures. Start Printed Page 63228

    We accepted the RUC recommendations for work RVUs for these services.

    Comment: Some commenters stated that new values have been established for these services based on new survey data and that the RUC has new recommendations for these services. In their comments on the December 31, 2002 rule, the RUC included these new work RVU recommendations and urged us to review these during the refinement process.

    Response: We are in agreement with the RUC recommended values for these services. However, to provide an opportunity for public comment we are including these in the RUC Recommendations for New and Revised codes for 2004 (table xx) and will consider the RVUs interim for 2004.

    CPT code 75954 Endovascular graft placement for repair of iliac artery (e.g. 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 codes 75952, Endovascular repair of infrarenal abdominal aortic anuerysm or dissection, radiological supervision and interpretation, (work RVU of 4.5) and 75953, Placement of proximal or distal extension prosthesis for endovascular repair of infra renal abdominal aortic aneurysm, radiological supervision and interpretation, (work RVU of 1.36). The recommended RVU was midway between the RVUs of the reference procedures. We did not agree with the RUC recommendation. Based on 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) and in order to maintain correct rank order in this family of codes, we assigned a work RVU of 1.36 to CPT code 75954.

    Comment: Some commenters expressed concern about the rejection of the RUC recommendation, particularly since the recommendation was based on data presented by several specialty societies. The commenters stated that the data reflected the proper rank order of this service and indicated that physicians in those specialties that perform ileac aneurysm endorepair may be in a better position to judge the relationship of this code to other imaging services. Based on these comments, we referred this code to the multispecialty validation panel for review.

    Response: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we have assigned 2.25 work RVUs to CPT code 75954.

    CPT code 92610 Clinical Evaluation of swallowing function.

    In the December 2002 final rule, this CPT code replaced HCPCS code G0195, which had a work RVU of 1.50 in 2002. The Healthcare Professionals Advisory Committee (HCPAC) recommendation of a work RVU of 0.00 for CPT code 92610 was accepted by CMS.

    Comment: Some commenters representing the long term care industry expressed concern with the reduction in work for this service. The rule provided no explanation of the HCPAC recommendation of 0.00 work RVUs for this service and the commenters requested that this issue be addressed.

    Response: As requested by the commenters, a discussion of the HCPAC recommendation of 0.00 work RVUS was provided as part of the multispecialty validation panel, which was attended by the commenters.

    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.

    We did not accept the RUC recommendations for work RVUs for these services (0.99 for 92613, 0.88 for 92615 and 1.10 for 92617) and assigned each of these CPT codes a work RVU of 0.00. We stated that these three services refer only to a separately identified physician review and interpretation of the fiberoptic endoscopic evaluation and that we consider this physician interpretation and report bundled into an E/M service. We stated that the physician who does not perform the testing should only bill for the patient when performing an E/M service, not as the supervisor of another professional performing and reviewing the initial fiberoptic endoscopic evaluation. The interpretation is an integral part of the testing itself and, if a nonphysician professional has the credentials and experience to perform this testing, then that professional should also provide the interpretation of the findings.

    Comment: Some commenters urged us to reconsider the RVUs and payment policies related to these services and to accept the RUC recommendations for these codes. The commenters asserted that the physician's detailed frame-by-frame analysis of the video recorded procedure needed to develop the diagnosis and report following this testing is not related to an E/M service. Rather, this is similar to other services where there is a report and interpretation by the physician that is separate from an E/M service. The commenters further stated that the RUC valued each procedure code and physician interpretation and report code separately, based on the coding structure created by CPT. As a result, the interpretation and reporting is separated from each test, and the RUC recommendations do not combine the interpretation with the testing. If the code were to combine the work of interpretation and the testing then the code descriptor would need to be modified and work RVUs revalued. As a final point, commenters disputed our assertion that a nonphysician professional with the credentials and experience to perform this testing should also provide the interpretation of the findings. Based on these comments we referred this code to the multispecialty validation panel for review.

    Response: As a result of the statistical analysis of the 2003 multispecialty validation panel ratings, we have assigned 0.71 work RVUs to CPT code 92613; 0.63 work RVUs to CPT code 92615; 0.79 work RVUs to CPT code 92617.

    In the December 31, 2002 final rule (67 FR 79966), we also responded to the RUC recommendations on the practice expense inputs for the new and revised CPT codes for CY 2003. There were no comments received on these and therefore we are finalizing our proposals.

    Late RUC Recommendations

    As we indicated in the August 15, 2003 proposed rule, RUC recommendations for RVUs for 23 new CPT codes for 2003 were received too late for incorporation in the December 31, 2002 final rule. We proposed interim RVUs for these codes and, as with all interim values, these were subject to comment. In their comments on the December 2002 final rule, the AMA-RUC requested that we consider their late recommendations for these codes during refinement. Several specialties also requested that we consider the late RUC recommendations. We had considered addressing these as part of the refinement process, but determined that we should follow the process used for all RUC recommendations and solicit public comment on the valuation Start Printed Page 63229of these services. Therefore, we are including the RVUs for codes listed in the table below, along with the codes that are new and revised for 2004, as interim for 2004. Following is a discussion of those codes for which did not accept the RUC recommendation.

    Table 5.—2003 Late RUC Recommendations

    CPT code 1Short descriptorCMS assigned 2003 work RVURUC recommendationCMS decision2004 work RVU
    21030Excise max/zygoma b9 tumor3.894.50Agree4.50
    21040Removal of jaw bone lesion3.894.50Agree4.50
    21742Repair sternum/nuss w/o scope(2)(2)Agree(2)
    21743Repair sternum/nuss w/o scope(2)(2)Agree(2)
    36511Apheresis wbc1.741.74Agree1.74
    36512Apheresis rbc1.741.74Agree1.74
    36513Apheresis platelets1.741.74Agree1.74
    36514Apheresis plasma1.741.74Agree1.74
    36515Apheresis, adsorp/reinfuse1.741.74Agree1.74
    36516Apheresis, selective1.741.22Agree1.22
    38207 (Lab Codes)Cryopreserve stem cells(3)0.47Disagree(4)
    38210 (Lab Codes)T-cell depletion of harvest(3)0.94Disagree(4)
    38211 (Lab Codes)Tumor cell deplete of harvest(3)0.71Disagree(4)
    38212 (Lab Codes)Rbc depletion of harvest(3)0.47Disagree(4)
    38213 (Lab Codes)Platelet deplete of harvest(3)0.24Disagree(4)
    38214 (Lab Codes)Volume deplete of harvest(3)0.24Disagree(4)
    38215 (Lab Codes)Harvest Stem cell concentrate(3)0.55Disagree(4)
    93784Ambulatory BP monitoring0.170.38Agree0.38
    93786Ambulatory BP recording0.000.00Agree0.00
    93788Ambulatory BP analysis(5)0.00Agree0.00
    93790Review/report BP recording0.170.38Agree0.38
    1 All CPT codes and descriptions copyright 2003 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.
    2 Carrier Priced.
    3 Assigned Status Indicator of “I”.
    4 Maintain Status Indicator of “I”.
    5 Assigned Status Indicator of “N”
    Start Printed Page 63230

    Note :

    CPT codes 38208, 38209 and 95990 are addressed later in this section (new and revised codes for 2004)and are also included in table 4. Also these work RVUs may differ from the work RVUs in Addenda B and C that reflect the adjustment to match the MEI weights.

    CPT codes 38207 Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage, 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.

    We continue to have the same concerns as outlined in the December 31, 2002 final rule (67 FR 80007) with respect to moving these codes off of the laboratory fee schedule. We are maintaining a status indicator “I” for these services making them not valid for Medicare purposes.

    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.

    The RUC recommendations for these codes were received too late for inclusion in the 2003 final rule. We had established the following work RVUs for these services during 2002 in response to a national coverage determination: CPT code 93784-0.17 work RVUs; 93786-0.00 work RVUs; 93790-0.17 work RVUs and had indicated that CPT code 93788 was not covered. We stated we would maintain these work RVUs until we receive a RUC recommendation.

    Comment: Some commenters urged us to consider the RUC recommendations during the refinement process and also questioned the noncovered status of CPT code 93788. CPT codes 93786 and 93788 are two separate codes for the technical component and the coding format is identical to the coding used for Holter monitoring, which also has two codes for the TC of the service. Commenters also requested that CPT code 93788 be listed as a covered service.

    Response: We are accepting the RUC recommendation of 0.38 work RVUs for CPT codes 93784 and 93790 and 0.00 work RVUs for CPT code 93786. We have reviewed the issue of noncoverage of CPT code 93788 and based upon the information provided by the commenters will recognize CPT code 93788 for coverage and payment under the physician fee schedule. We are also accepting the RUC recommendation of 0.00 for CPT code 93788.

    We received the following comments on HCPCS codes established in the December 31, 2002 final rule.

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

    We created this code to describe a new diagnostic test for which we will make separate payment under the physician fee schedule. We assigned a work RVU of 2.12 to the code based on a comparison to the work of other diagnostic tests and procedures that require review of significant amounts of data.

    Comment: Some commenters stated that that the time we used to establish the work RVU was greatly underestimated and may have been based on a misunderstanding of some of the time data contained in published literature. Based on limited survey data of physicians performing this procedure and comparison to the intensity of other services, commenters recommended a work RVU of 7.80.

    Response: We are deleting HCPCS code G0262 since there is a new CPT code 91110, Gastrointestinal tract imaging, intraluminal (e.g., capsule endoscopy), esophagus through ileum, with physician interpretation and report, which will be used to report this service in 2004. We note that we accepted the RUC recommendation of 3.65 work RVUs for CPT 91110. If the commenters do not agree with the valuation of this service they may submit comments on this issue.

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

    This code was created 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 noted that routine removal of cerumen is not paid separately, because it is considered to be part of the procedure with which it is billed (for example, audiologic function testing). This code is to be used only in those unusual circumstances when an employed audiologist who bills under a physician uniform provider identifier number (UPIN) 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.

    Comment: Commenters stated that creation of this G code was problematic because there could be many other “incident to” services in which a physician performs a separate medically necessary procedure, that, if less extensive, would be considered to be included in a nonphysician provider service. The commenters suggested that a modifier could be used to describe this situation, avoiding the creation of a G code.

    Response: We disagree and believe that this is a unique situation that is most appropriately handled through the use of a G code.

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

    We created this code due to the inappropriate reporting of this service with codes for such procedures as “blood vessel repair” and “repair of arterial pseudoaneurysm”, and indicated that there would be no separate payment for this service as the work, practice expense, and malpractice risk is included in the main invasive procedure.

    Comment: Commenters disagreed with the creation of this G code because it is intended to report a service that is a required component of another service and believed that the creation of this code may lead to the creation of many codes for reporting inclusive procedures separately. Some commenters suggested that the creation of parenthetical Start Printed Page 63231instructions in CPT to instruct that “referenced procedures (i.e., blood vessel repair, repair of arterial pseudoaneurysm) would not be appropriately reported in addition to the interventional vascular procedure” would address our concerns. Other commenters disagreed with our assertion that closure devices are included in the practice expense payment, as such devices are not typically used in every interventional or surgical case. Commenters suggested this code be a technical component service only and have RVUs commensurate with the cost of the device.

    Response: As we indicated in the December 31, 2002, final rule, this code was created to address a specific concern about inappropriate reporting of this service using such procedures as “blood vessel repair” and “repair of arterial pseudoaneurysm.” Since this service is considered part of the main invasive procedure, to the extent this is typically part of the invasive procedure, it is accounted for under the practice expense methodology. We will continue to consider this code bundled for Medicare purposes, that is, no separate payment will be made under the physician fee schedule.

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

    We indicated we were creating this code for use until an identical CPT code can become effective. We assigned this code a work RVU of 0.32.

    Comment: Commenters disagreed with the 0.32 value assigned to this service and recommended that we replace the work RVUs with the RUC recommended work value for CPT code 43752.

    Response: We are deleting HCPCS code G0272 and CPT code 43752, Naso-or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report), will be used to report this service.

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

    We created G0273 to describe radionuclide scanning to determine the biodistribution of Zevulin. We assigned 0.86 work RVUs to this code based on a comparison to CPT code 78802, Radiopharmaceutical localization of tumor; whole body. We established G0274 to allow appropriate reporting of this new service and assigned a work RVU of 2.07 to this code.

    Comment: Commenters urged us to reevaluate the RVUs assigned to these codes and expressed concern that a lack of understanding about this service has led to its inappropriate valuation. Additionally, commenters requested that we present these codes to the AMA for consideration by the CPT Editorial Panel and RUC.

    Response: We are deleting HCPCS codes G0273 and G0274. CPT codes 79403, Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion, and 78802, Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agent(s); whole body single day imaging, will be used to report these services.

    GO275 Renal artery 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, injection of dye, radiologic supervision and interpretation and production of images (List separately in addition to primary procedure)

    We created these add-on codes to assure proper reporting of and payment for renal and iliac angiography performed at the time of cardiac angiography. We determined the work value of 0.25 for these two add-on procedures by using the work values for CPT codes 75625, Aortography, abdominal, by serialography, radiological supervision and interpretation and 93544 Injection procedure during cardiac catherization; for aortography and adjusting for the procedure time.

    Comment: Commenters suggested that, if the true intention for the creation of G0275 was to assure correct coding of selective renal angiography performed in conjunction with cardiac catheterization, the RVUs are too low and not commensurate with the work associated with selective unilateral and/or bilateral renal angiography. However, if CMS” intention for G0275 is non-selective renal angiography, then this should be stated clearly in the code descriptor. Commenters also considered the work RVUs assigned to G0278 to be too low. If G0278 is meant to be a selective procedure, then the work RVU should take into consideration the selective catheterization codes (CPT codes 36425 and 36425) and associated imaging codes (CPT codes 75710 and 75716).

    Response: As announced in Program Memorandum, Transmittal AB-03-119, Change Request 2853) issued August 8, 2003, the descriptors for these two services specify that they apply to non-selective angiography and have been revised as follows:

    GO275 Renal artery angiography, non-selective, one or both kidneys, performed at the time of cardiac catheterization and/or coronary angiography, includes positioning or placement of any catheter in the abdominal aorta at or near the origins (ostia) of the renal arteries, injection of dye, flush aortogram, production of permanent images, and radiologic supervision and interpretation (List separately in addition to primary procedure). and

    GO278 Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inkjecton of dye, production of permanent images, and radioogic supervision and interpretation (List separately in addition to primary procedure). We will be retaining the work RVU of 0.25 for these two codes.

    GO279 Extracorporeal shock wave therapy; involving elbow epicondylitis

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

    In the December 31, 2002 final rule we incorrectly established RVUs for CPT code 0020T, Extracorporeal shock Start Printed Page 63232wave therapy; involving musculoskeletal system, which is an emerging technology code and also created two new HCPCS codes (G0279 and G0280) with payments based on our valuation of this CPT code. In the August 15, 2003 proposed rule we also requested additional information on these services.

    Comment: Commenters on the December 2002 rule indicated that assignment of RVUs for CPT code 0020T is contrary to national policy established in the November 1, 2001 (66 FR 55269) final rule. They also indicated that the assumptions used to assign RVUs to these services were incorrect and undervalued these services.

    Response: In a correction notice published May 30, 2003 (68 FR 32400) we indicated that we had incorrectly assigned RVUs to these services and they would be carrier priced.

    Comment: Commenters on the December 2002 rule expressed concern that the G codes were not reflective of the changes in technology and FDA approval of ESWT. Commenters also disagreed with our categorization and portrayal of CPT 0020T as a procedure similar to other physical therapy modalities. Commenters urged us to correct and clarify that CPT 0020T is not physical therapy service but a physician procedure and thus should be removed from the list of codes identifying certain designated health services.

    Response: We understand that this is a changing technology and believe the current descriptors accommodate these changes. We are removing CPT 0020T from the list of designated health services in Addendum F since we agree that, at this time, this service is predominantly performed by medical specialties such as orthopedists and podiatrists.

    Comment: Commenters on the August 15, 2003 proposed rule urged us to continue to have these services priced by the carrier and expressed concern that our request for additional information indicated we would be establishing national payment amounts for these services. In addition, several physicians provided information on how this service is used in their offices, including cost information as well as a description of the procedure. Some commenters recommended that separate G codes be established to differentiate between the high and low energy levels that are currently used, as this impacts the treatment protocols as well as the resources used in these procedures.

    Response: The purpose for soliciting information in the proposed rule was to gain a better understanding of the use of the various systems as well as the resources involved with this procedure. We appreciate the information the commenters provided and will continue to review this issue to determine if coding changes are warranted. We are retaining the current codes, G0279, G0280 and CPT code 0020T under the fee schedule and these will continue to be carrier priced. We believe this will enable the carriers to make appropriate payment for these services based on resources used. In addition, as previously discussed, we are removing CPT code 0020T from the list of designated health services in Addendum F.

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

    We created this code, which is a technical component code, to assure accurate reporting of this service by independent diagnostic testing facilities (IDTFs) that perform this service. This service 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 only 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.

    Comment: Commenters requested clarification on whether this code could be used for the treatment planning both prior to surgery as well as for post-surgical monitoring. They also indicated that it should be expanded to include the use of enhanced computed tomography scans or magnetic resonance images and not just those generated by CTA. In addition, one commenter suggested that CMS ensure that this HCPCS code is used only for those technologies that meet the following criteria: (1) The ability to perform precise modeling of multiple clinically-relevant objects; (2) the ability to generate specific measurements essential for surgical planning and follow-up; (3) built-in quality control and self-validation capabilities; (4) FDA marketing clearance for use in surgical planning and follow-up treatment; and (5) conformance to standards adopted by the International Standards of Organization (ISO).

    Commenters also suggested that the payment for this code be revised so that it is more in line with the payment for these services when administered in the outpatient setting.

    Response: We agree that this service can be used for treatment planning prior to surgery as well as for post-surgical monitoring and have revised the code descriptor to clarify this point. The descriptor for this code is revised as follows:

    G0288 Reconstruction, computed tomographic angiography of aorta for preoperative planning and evaluation post vascular surgery.

    However, we are not expanding this service to include the use of enhanced computed tomography scans or magnetic resonance, as we have not been presented with information to support its use with these other data sources. We assume that physicians providing this service will abide by the FDA labeling requirements for the specific equipment used. Payment for services under the outpatient prospective payment system is based on a different methodology than services paid under the physician fee schedule. As required by section 1848 of the Act, payment under the physician fee schedule is based on national relative value units based on resources used in furnishing the service. We believe the RVUs established for this service are reflective of the resources used, and therefore do not believe this should be carrier priced.

    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 created this add-on code to permit appropriate reporting of arthroscopic procedures performed in different compartments of the same knee during the same operative session. We stated that this code should be reported only when 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. We noted that this code is to be used when a procedure is performed in the lateral, medial, or patellar compartments in addition to the main procedure. We assigned a work RVU of 1.48 to this code RVUs based on a comparison to CPT codes 29874, 29877 and 29870, the base procedure for this family of codes.

    Comment: Commenters appreciated our efforts to address the issue of reimbursement for this procedure. However, they expressed concern about the specific reference to a 15 minute time requirement. The commenters believed that this was inappropriate because using time in this manner Start Printed Page 63233rewards and encourages inefficient work and penalizes efficient physicians, which ultimately has an impact on the quality of care delivered to Medicare beneficiaries.

    Response: We understand the concerns expressed by the commenters and regret any confusion that the time reference may have created. This reference to time was intended as a guideline to ensure that this add-on code is used only when the procedure performed is a substantive procedure needed to produce a significant improvement in the patient's condition. Documentation supporting this should be reflected in the operative note.

    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 2004 (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 2004 CPT Codes)

    One aspect of establishing RVUs for 2004 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 132 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). We reviewed all the RUC recommendations. We accepted approximately 95 percent and we disagreed with approximately 5 percent of 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.

    We received 2 recommendations from the HCPAC. We agreed with both of the HCPAC recommendations.

    Table 5, titled “AMA RUC and HCPAC Recommendations and CMS Decisions for New and Revised 2004 CPT Codes”, lists the new or revised CPT codes, and their associated work RVUs, that will be interim in 2004. This table includes the following information:

    • A “#” identifies a new code for 2004.
    • 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.
    • 2004 Work RVUs. This column establishes the 2004 work RVUs for physician work. These work RVUs may differ from the work RVUs in Addenda B and C that reflect the adjustments to work RVUs to match the MEI weights.

    Table 6.—AMA RUC and HCPAC Recommendations and CMS Decisions for New and Revised 2004 CPT Codes

    * CPT codeModDescriptionRUC recommendationHCPAC recommendationCMS decision2004 work RVU
    #20982Ablate, bone tumor(s) perq7.27Agree7.27
    #21685Hyoid myotomy & suspension13.00Agree13.00
    #22532Lat thorax spine fusion24.00Agree24.00
    #22533Lat lumbar spine fusion23.12Agree23.12
    #22534Lat thor/lumb, add'l seg6.00Agree6.00
    31622Dx bronchoscope/wash2.78Agree2.78
    31623Dx bronchoscope/brush2.88Agree2.88
    31624Dx bronchoscope/lavage2.88Agree2.88
    31625Bronchoscopy w/biopsy (s)3.37Agree3.37
    31628Bronchoscopy/lung bx, each3.81Agree3.81
    31629Bronchoscopy/needle bx, each4.10Agree4.10
    31630Bronchoscopy dilate/fx repr3.82Agree3.82
    31631Bronchoscopy, dilate w/stent4.37Agree4.37
    #31632Bronchoscopy/lung bx, add'l1.03Agree1.03
    #31633Bronchoscopy/needle bx add'l1.32Agree1.32
    31635Bronchoscopy w/fb removal3.68Agree3.68
    31640Bronchoscopy w/tumor excise4.94Agree4.94
    33310Exploratory heart surgery18.51Agree18.51
    33315Exploratory heart surgery22.37Agree22.37
    #34805Endovasc abdo repair w/pros21.88Agree21.88
    #35510Artery bypass graft23.00Agree23.00
    #35512Artery bypass graft22.50Agree22.50
    #35522Artery bypass graft21.76Agree21.76
    #35525Artery bypass graft20.63Agree20.63
    #35697Reimplant artery each3.00Agree3.00
    Start Printed Page 63234
    #36555Insert non-tunnel cv cath2.68Agree2.68
    #36556Insert non-tunnel cv cath2.50Agree2.50
    #36557Insert tunneled cv cath5.10Agree5.10
    #36558Insert tunneled cv cath4.80Agree4.80
    #36560Insert tunneled cv cath6.25Agree6.25
    #36561Insert tunneled cv cath6.00Agree6.00
    #36563Insert tunneled cv cath6.20Agree6.20
    #36565Insert tunneled cv cath6.00Agree6.00
    #36566Insert tunneled cv cath6.50Agree6.50
    #36568Insert tunneled cv cath1.92Agree1.92
    #36569Insert tunneled cv cath1.82Agree1.82
    #36570Insert tunneled cv cath5.32Agree5.32
    #36571Insert tunneled cv cath5.30Agree5.30
    #36575Repair tunneled cv cath0.67Agree0.67
    #36576Repair tunneled cv cath3.19Agree3.19
    #36578Repair tunneled cv cath3.50Agree3.50
    #36580Replace tunneled cv cath1.31Agree1.31
    #36581Replace tunneled cv cath3.44Agree3.44
    #36582Replace tunneled cv cath5.20Agree5.20
    #36583Replace tunneled cv cath5.25Agree5.25
    #36584Replace tunneled cv cath1.20Agree1.20
    #36585Replace tunneled cv cath4.80Agree4.80
    #36589Removal tunneled cv cath2.27Agree2.27
    #36590Removal tunneled cv cath3.30Agree3.30
    #36595Mech remov tunneled cv cath3.60Agree3.60
    #36596Mech remov tunneled cv cath0.75Agree0.75
    #36597Repositoin venous catheter1.21Agree1.21
    #36838Dist revas ligation, hemo20.63Agree20.63
    #37765Phleb veins—extrem—to 207.35Agree7.35
    #37766Phleb veins—extrem 20 +9.30Agree9.30
    37785Ligate/divide/excise vein3.84Agree3.84
    38208Thaw preserved stem cells0.56Disagree0.00
    38209Wash harvest stem cells0.24Disagree0.00
    43235Uppr gi endoscopy, diagnosis2.39Agree2.39
    #43237Endoscopic us exam, esoph3.99Agree3.99
    #43238Uppr gi endoscopy w/us fn bx5.03Agree5.03
    43242Uppr gi endoscopy w/us fn bx7.31Agree7.31
    43259Endoscopic ultrasound exam5.20Agree5.20
    43752Nasal/orogastric w/stent0.82Disagree0.68
    47133Removal of donor liverAgree
    #47140Partial removal, donor liver55.00Agree55.00
    #47141Partial removal, donor liver67.50Agree67.50
    #47142Partial removal, donor liver75.00Agree75.00
    #53500Urethrlys, transvag w/scope12.21Agree12.21
    #57425Laparoscopy, surg, colpopexy15.75Agree15.75
    58545Laparoscopic myomectomy14.21Agree14.21
    58546Laparo-myomectomy, complex19.00Agree19.00
    58550Laparo-asst vag hysterectomy14.19Agree14.19
    58552Laparo-vag hyst incl t/o16.00Agree16.00
    58553Laparo-vag hyst, complex20.00Agree20.00
    58554Laparo-vag hyst w/t/o, compl22.00Agree22.00
    #59070Transabdom amnioinfus w/us5.25Agree5.25
    #59072Umbilical cord occlud w/us9.00Agree9.00
    #59074Fetal fluid drainage w/us5.25Agree5.25
    #59076Fetal shunt placement, w/us9.00Agree9.00
    #59897Fetal invas px w/usAgree
    #61537Removal of brain tissue25.00Agree25.00
    61538Removal of brain tissue26.81Agree26.81
    61539Removal of brain tissue32.08Agree32.08
    #61540Removal of brain tissue30.00Agree30.00
    61543Removal of brain tissue29.22Agree29.22
    #61566Removal of brain tissue31.00Agree31.00
    #61567Incision of brain tissue35.50Agree35.50
    #61863Implant neuroelectrode19.00Disagree13.92
    #61864Implant neuroelectrode, add'l4.50Agree4.50
    #61867Implant neuroelectrode31.34Disagree22.96
    #61868Implant neuroelectrde, add'l7.92Agree7.92
    #63101Removal of vertebral boby32.00Agree32.00
    #63102Removal of vertebral body32.00Agree32.00
    Start Printed Page 63235
    #63103Removal vertebral body add-on5.00Disagree3.90
    #64449N block inj, lumbar plexus3.00Agree3.00
    #64517N block inj, hypogas plxs2.20Agree2.20
    64680Injection treatment of nerve2.62Agree2.62
    #64681Injection treatment of nerve3.55Agree3.55
    #65780Ocular reconst, transplant10.25Agree10.25
    #65781Ocular reconst, transplant17.67Agree17.67
    #65782Ocular reconst, transplant15.00Agree15.00
    #67912Correction eyelid w/ implant5.68Agree5.68
    #68371Harvest eye tissue, alograft4.90Agree4.90
    #70557Mri brain w/o dye2.90Agree2.90
    #70558Mri brain w/dye3.20Agree3.20
    #70559Mri brain w/o & w/dye3.20Agree3.20
    75901Remove cva device obstruct0.49Agree0.49
    75902Remove cva lumen obstruct0.39Agree0.39
    #75998Fluoroguide for vein device0.38Agree0.38
    #76082Computer mammogram add-on0.06Agree0.06
    #76083Computer mammogram add-on0.06Agree0.06
    #76514Echo exam of eye, thickness0.17Agree0.17
    #76937Us guide, vascular access0.30Agree0.30
    78800Tumor imaging, limited area0.66Agree0.66
    78801Tumor imaging, mult areas0.79Agree0.79
    78802Tumor imaging, whole body0.86Agree0.86
    78803Tumor imaging (3D)1.09Agree1.09
    #78804Tumor imaging, whole body1.07Agree1.07
    79100Repeat hyperthyroid therapy1.32Agree1.32
    79400Nonhemato nuclear therapy1.96Agree1.96
    #79403Hematopoetic nuclear therapy2.25Agree2.25
    #85396Clotting assay, whole blood0.37Agree0.37
    #88112Cytopath, cell enhance blood1.18Agree1.18
    88342Immunohistochemistry0.85Agree0.85
    88358Analysis, tumor0.95Agree0.95
    #88361Immunohistochemistry, tumor0.94Agree0.94
    #91110Gi tract capsule endoscopy3.65Agree3.65
    95990Spin/brain pump refil & main0.00Agree0.00
    #95991Spin/brain pump refil & main0.77Agree0.77
    96110Developmental test, lim0.00Agree0.00
    96111Developmental test, extend2.60Agree2.60
    97537Community/Work reintegration0.45Agree0.45
    #97755Assistive technology assess0.62Agree0.62
    (a) No Final RUC recommendation provided.
    # New CPT codes.
    * All CPT codes copyright 2004 American Medical Association.
    † Carrier.

    Table 6, which is titled “AMA RUC ANESTHESIA RECOMMENDATIONS AND CMS DECISIONS FOR NEW AND REVISED 2004 CPT CODES”, lists the new or revised CPT codes for anesthesia and their base units that will be interim in 2004. This table includes the following information:

    • CPT code. This is the CPT code for a service.
    • Description. This is an abbreviated version of the narrative description of the code.
    • RUC recommendations. This column identifies the base units recommended by the RUC.
    • CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table.
    • 2004 Base Units. This column establishes the 2004 base units for these services.

    Table 7.—AMA RUC ANESTHSIA RECOMMENDATIONS AND CMS DECISIONS FOR NEW AND REVISED CPT CODES

    * CPT codeDescriptionRUC recommendationCMS decision2003 base units
    00529#ANESTH, CHEST PARTITION VIEW11Agree11
    01173#ANESTH, FX REPAIR, PELVIS12Agree12
    Start Printed Page 63236
    01958#ANESTH, ANTEPARTUM MANIPUL5Agree5
    *All CPT codes copyright 2004 American Medical Association.
    # New CPT code.

    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.

    CPT code 43752 Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)

    The RUC recommended a work RVU of 0.82 for this service based on a comparison of this procedure to CPT code 44500. While we agree that CPT code 43752 is similar in work intensity to CPT code 44500, we feel the intra-service time is more appropriately valued at the 25th percentile (15 minutes of intra-service time vs. 20 minutes of intra-service time). This reduces the total time associated with CPT code 43752 from 30 minutes to 25 minutes. We applied the ratio of the RUC recommended value of 0.82 work RVU over 30 minutes to the revised intra-service time of 25 minutes to assign 0.68 interim work RVUs for CPT code 43752.

    CPT code 63103 Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (e.g., for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment. (List separately in addition to code for primary procedure)

    The RUC recommended a work RVU of 5.00 for this service based on a comparison of this procedure to CPT code 63088. It was unclear from the clinical vignettes supplied by the specialty society whether the additional corpectomy would more commonly involve the lumbar or the thoracic region of the spine. There is a significant difference in work intensity associated with the resection of an additional corpus in the thoracic region as opposed to the lumbar region. For this reason we applied the ratio of the reference service (CPT code 63088) to its primary service (CPT code 63087) to CPT code 63101 (primary service associated with CPT 63103) to assign 3.90 interim work RVUs for CPT code 63103.

    CPT code 61863 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array and CPT code 61867 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g., thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array

    The RUC recommended a work RVU of 19.00 for CPT code 61863 and 31.34 work RVUs for CPT code 61867. These two new CPT codes replace existing CPT code 61862 (work RVU=19.34). Although we agree with the relative relationship established by the RUC for these services, in order to retain budget neutrality, we adjusted the RUC recommended values. Thus, the recommended values were adjusted in order that the total relative values remain constant before and after the inclusion of the new CPT codes.

    We assigned 13.92 work RVUs to CPT code 61863 and 22.96 work RVUs to CPT code 61867.

    CPT code 38208 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing and CPT code 38209 Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing

    We continue to have the same concerns as outlined in the December 31, 2002 final rule (67 FR 80007) with respect to moving these codes from the laboratory fee schedule and thus establishing relative values under the physician fee schedule. We are maintaining a status indicator “I” for these services, making them not valid for payment under the Medicare Physician Fee Schedule.

    CPT code 96111 Developmental testing extended (includes assessment of motor, language, social, adaptive, and/or cognitive functioning by standardized developmental instruments, eg Bayley Scales of Infant Development) with interpretation and report, per hour

    Although we agree with the RUC recommended work RVU of 2.60 for CPT code 96111, we note that the tests under this code will no longer be paid on a per hour basis. That is, total payment for the services under CPT code 96111 is based on one hour of provision of the tests. It is our understanding that these tests can be completed typically in one hour. That is, some of the tests can be administered in less than one hour and some may require a little more than one hour, so that the average time for all of the tests works out to be one hour. Therefore, regardless of the total number of hours it takes to complete the services under CPT code 96111 or whether the services are split up and spread over a number of days, payment will be made for 96111 based on only one unit/hour at 2.6 RVUs.

    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 2004.

    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. Start Printed Page 63237

    The RUC recommendations on the practice expense inputs for the new and revised 2004 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, almost 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 2004 CPT Codes.”

    We made the following minor changes to the inputs where relevant:

    • We deleted the 3-minute phone calls in the post service period to conform to our established standard for all codes with 10 and 90-day global periods.
    • We also deleted equipment when individual items did not meet the minimum $500 requirement.
    • We deleted certain equipment items that represent indirect, rather than direct costs, including lead shielding, lead lined radioactive waste box and lead-lined sharps box.
    • We deleted the L-Block table shield because it is included in the price and description of the dose calibrator, another CPEP equipment item.
    • We made minor changes to clinical labor and supplies, for several central venous access (CVA) codes in order to bring uniformity to this new family of codes.
    • We assigned, on an interim basis, the clinical labor RN designation for CPT code 95991, physician administered refilling and maintenance of spinal or brain implantable pump, until the PEAC has an opportunity to review the necessity for this clinical assignment.

    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 (the “Code List”) 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. The last update of the Code List was included in the December 31, 2002 physician fee schedule final rule in Addendum E and was subsequently corrected in a notice that was published in the Federal Register (68 FR 32400) on May 30, 2003.

    The updated all-inclusive Code List effective January 1, 2004 is presented in Addendum F in this final rule. We intend to publish annually the all-inclusive Code List in an addendum to the physician fee schedule final rule. The updated all-inclusive Code List will also be available on our Web site at http://www.cms.hhs.gov/​medlearn/​refphys.asp.

    B. Response to Comments

    We received public comments on three issues relating to the most recent Code List. The comments and our responses are stated below.

    Comment: One commenter noted that we added three new “Q” codes (Q3021, Q3022, and Q3023) for hepatitis B vaccines. Program Memorandum AB-02-185 issued on December 31, 2002 deleted these HCPCS codes. However, the Program Memorandum also reactivated the following CPT codes for hepatitis B vaccine: 90740, 90743, 90744, 90746 and 90747.

    Response: The commenter is correct. We erred in adding the “Q” codes to the list of services that may qualify for an exception under 42 CFR 411.355(h) concerning exceptions for preventive screening tests, immunizations, and vaccines. This was corrected in the correction notice published on May 30, 2003 (68 FR 32400).

    Comment: Some commenters objected to the addition of CPT code 0020T (Extracorporeal shock wave therapy; involving plantar fascia) to the list of physical therapy services for purposes of the physician self-referral prohibition. The commenters stated that CPT 0020T is currently a physician service involving anesthesia and therefore, should not be characterized as a physical therapy service.

    Response: We agree with the commenters and have removed CPT code 0020T from the list of designated health services. Further discussion of this comment and response is included in section IV.C.2 of this preamble concerning the HCPCS codes G0279 and G0280 relating to extracorporeal shock wave therapy.

    Comment: One commenter noted that the annual Code List update does not include codes for the following designated health services: Durable medical equipment and supplies; parenteral and enteral nutrients, equipment and supplies; prosthetics, orthotics and prothestic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospital services. The commenter recommended that we include the CPT and HCPCS codes for these designated health services in the annual update and in the quarterly updated Microsoft Excel spreadsheet of RVU values, global periods and supervision levels for Medicare covered-services posted on the CMS Web site. Alternatively, the commenter requested that we clarify that the Code List is not exhaustive and indicate where providers can obtain more information on the remaining categories.

    Response: As explained in the January 4, 2001 final rule with comment (66 FR 923), we believe that the regulatory definitions of the designated health services at issue are sufficiently clear to permit entities and physicians to identify them readily. Moreover, some of these designated health services are not amenable to definition solely through codes. Regardless, to define these services through codes or to change the frequency of the Code List update would require a change in the text of the regulatory definitions for the various designated health services found in § 411.351. The purpose of this Code List is simply to make those ministerial changes necessary to conform the Code List to the current CPT and HCPCS code publications. Making substantive changes to the regulatory definitions is beyond the scope of this update and cannot be accomplished without first proposing Start Printed Page 63238the changes in a Notice of Proposed Rulemaking. Lastly, we cannot accept the commenter's suggestion that we explain that the Code List is not exhaustive because such a statement is false. The Code List is exhaustive with respect to the specific designated health services that it defines, and for the reasons noted above, we are not defining the remaining designated health services through codes.

    C. Revisions Effective for 2004

    Tables 7 and 8, below, identify the additions and deletions, respectively, to the comprehensive Code List last published in Addendum E of the December 2002 physician fee schedule final rule and subsequently corrected in the May 30, 2003 correction notice (68 FR 32400). Tables 7 and 8 also identify the additions and deletions 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 Tables 8 and 9 below, if we receive them by the date specified in the DATES section of this final rule.

    Table 8.—Additions to the Physician Self-Referral HCPCS/CPT 1 Codes

    Clinical Laboratory Services
    0058TCryopreservation, ovary tiss.
    0059TCryopreservation, oocyte.
    G0027Semen analysis.
    G0306CBC/diffwbc w/o platelet.
    G0307CBC without platelet.
    G0328Fecal blood scrn immunoassay.
    Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services
    97755Assistive technology assess.
    Radiology and Certain Other Imaging Services
    72198Mr angio pelvis w/o & w/dye.
    76082Computer mammogram add-on.
    76083Computer mammogram add-on.
    76514Echo exam of eye, thickness.
    91110Gi tract capsule endoscopy.
    Radiation Therapy Services and Supplies
    G0173Stereo radiosurgery, complete.
    G0251Linear acc based stero radio.
    G0338Linear accelerator stero pln.
    G0339Robot lin-radsurg com, first.
    G0340Robt lin-radsurg fractx 2-5.
    Drugs Used by Patients Undergoing Dialysis
    Q4054Darbepoetin alfa, esrd use.
    Q4055Epoetin alfa, esrd use.
    Preventive Screening Tests, Immunizations and Vaccines
    76083Computer mammogram add-on.
    90655Flu vaccine, 6-35 mo, im.
    1 CPT codes and descriptions only are copyright 2003 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.

    Table 9.—Deletions to the Physician Self-Referral HCPCS/CPT 1 Codes

    Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services
    0020TExtracorp shock wave tx, ft.
    Q0086Physical therapy evaluation.
    Radiology and Certain Other Imaging Services
    76085Computer mammogram add-on.
    76831Echo exam, uterus.
    G0236Digital film conv.
    GO262Sm intestinal image capsule.
    Radiation Therapy Services and Supplies
    G0274Radiopharm tx, non-Hodgkins.
    Drugs Used by Patients Undergoing Dialysis
    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.
    Preventive Screening Tests, Immunizations and Vaccines
    76085Computer mammogram add-on.
    90659Flu vacine, whole, im.
    1 CPT codes and descriptions only are copyright 2003 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.

    The additions specified in Table 8 generally reflect new CPT and HCPCS codes that become effective January 1, 2004 or that became effective since our last update. It also reflects the addition of codes recently recognized by Medicare for payment purposes.

    Additionally, we are adding two G-codes (G0173, “Stereo radiosurgery, complete” and G0251, “Linear acc based stero radio”) to the category of radiation therapy services and supplies. These codes became effective for Medicare payment purposes in August 2000 and July 2002, respectively and should have been reflected in previous Code Lists.

    Table 8 also reflects the addition of 2 new HCPCS codes (Q4054 and Q4055) 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 X also reflects the addition of a screening mammography code (CPT 76083) and a flu vaccine code (CPT 90655) 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 services if they meet the conditions set forth in § 411.355(h) concerning the exception for preventive screening tests, immunizations, and vaccines.

    Table 8 reflects the deletions necessary to conform the Code List to the most recent publications of CPT and HCPCS codes, as well as additional deletions that we have determined are necessary as described below.

    Under the category of physical therapy, occupational therapy and speech-language pathology services, we are removing CPT code 0020T, extracorporeal shock wave therapy for plantar fascia consistent with the response to the comment discussed in section IV.C.2 and VI.B of this preamble.

    Under the category of radiology and certain other imaging services, we are deleting CPT code 76831 for an echo exam of the uterus. This code should never have appeared on the Code List. Start Printed Page 63239Our definition of “radiology and certain other imaging services” at § 411.351 specifically excludes any x-ray, fluoroscopy or ultrasonic procedure that requires “the insertion of a needle, catheter, tube, or probe”. The type of procedure described by CPT code 76831 involves infusion tubing and should be removed from the Code List.

    Under the category of radiation therapy services and supplies, we are removing HCPCS code G0274 for radiopharmaceutical therapy for non-Hodgkin's lymphoma because it is a nuclear medicine service. Our definition of “radiation therapy services and supplies” at § 411.351 specifically excludes nuclear medicine procedures. Thus, HCPCS code G0274 should never have appeared on the Code List.

    VI. Physician Fee Schedule Update for Calendar Year 2004

    A. Physician Fee Schedule Update

    The physician fee schedule update is determined using a formula 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 (UAF). For CY 2004, the MEI is equal to 2.9 percent (1.029). The UAF is −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 2004. Thus, the product of the MEI (1.029), the UAF (0.930), and the statutory adjustment factor (0.998) equals the CY 2004 update of −4.5 percent (0.9551).

    The negative physician fee schedule update occurs under a mandatory statutory formula. The law gives us no alternative to reducing the physician fee schedule rates. Only Congress can change the law and avert a reduction in 2004 physician fee schedule rates. Without a congressional act to change the law, the Department is compelled to announce a physician fee schedule update for CY 2004 of −4.5 percent. The Department's calculations are explained below.

    B. Rebasing and Revising of the Medicare Economic Index

    1. Background

    The Medicare Economic Index (MEI) is required by section 1842(b)(3) 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 a higher level is justified by year-to-year economic changes.

    Beginning July 1, 1975, and continuing through today, the MEI has met this requirement by reflecting the weighted sum of the annual price changes of the inputs used to produce physicians' services. As such, the MEI attempts to be an equitable measure of price changes associated with physician time and operating expenses.

    The current form of the MEI was detailed in the November 25, 1992 Federal Register (57 FR 55896) and was based in part on the recommendations of a Congressionally-mandated meeting of experts held in March 1987. Since that time, the structure of the MEI has remained essentially unchanged, with two exceptions. First, the MEI was rebased in 1998 (63 FR 58845), which moved the cost structure of the index from 1992 data to 1996 data. Second, the methodology for adjusting for productivity was revised in 2002 (67 FR 80019) to reflect the percentage change in the 10-year moving average of economy-wide multifactor productivity.

    We are rebasing and revising the MEI for the 2004 physician fee schedule update. The terms “rebasing” and “revising”, while often used interchangeably, actually denote different activities. Rebasing means moving the base year for the structure of costs of an input price index, while revising means changing data sources, cost categories, or price proxies used in the input price index. As is always the case with a rebasing and revising exercise, we have attempted to use the most recently available, relevant, and appropriate information to develop the MEI cost category weights and price proxies. We detail below the updated cost weights for the MEI expense categories, our rationale for selecting the price proxies in the MEI, and the results of rebasing and revising the MEI.

    2. Use of More Current Data

    The MEI was last rebased and revised in 1998 for the 1999 physician fee schedule update (63 FR 58845). The base year for that version of the MEI was 1996, which means that the cost weights in the index reflect physicians' expenses in 1996. However, we believe it is desirable to periodically rebase and revise the index so that the expense shares and price proxies reflect more current conditions. For this reason, we are rebasing the MEI to reflect physicians' expenses in 2000. In addition, we are revising the cost categories in the MEI and changing three of the proxies we currently use to ensure that the index is appropriately reflecting price changes. We will continue to adjust the MEI using economy-wide multifactor productivity.

    The expense categories in the rebased and revised MEI were primarily derived from the 2003 AMA Physician Socioeconomic Characteristics publication (2003 Patient Care Physician Survey data), which measures physicians' earnings and overall practice expenses for 2000. The AMA data were used to determine expenditure weights for total expenses, physicians' earnings, and malpractice expenses, the only information detailed in this survey. To further disaggregate the weights into subcategories reflecting more detailed expenses, we used data from previous AMA surveys, the 1997 Bureau of Economic Analysis Benchmark Input-Output table (I/O), the 2003 Bureau of Labor Statistics (BLS) Employment Cost Index (ECI), and the 2002 Bureau of the Census Current Population Survey (CPS).

    3. Rebasing and Revising Expense Categories in the MEI

    a. Developing the Weights for Use in the MEI

    Developing a rebased and revised MEI requires selecting a base year and determining the number and composition of expense categories and their associated price proxies. We are rebasing the MEI to CY 2000. CY 2000 was chosen as the base year for two main reasons: (1) CY 2000 was the most recent year for which data were available from the AMA, and (2) we believed that the CY 2000 data were representative of the changing distribution of physicians' earnings and practice expenses over time.

    Comment: One commenter suggested that we update the weights in the MEI to a more recent base year, possibly CY 2004. While the commenter agreed with us that there is a lack of data to do so, the commenter suggested using the price change in each of the proxies to estimate weights for 2004 as an alternative to 2000 data.

    Response: We selected CY 2000 as the base year for two reasons: (1) CY 2000 data were the most recent data available from the AMA, and (2) we felt the CY 2000 data were representative of the changing distribution of physician earnings and practice expenses over time. We do not expect that the experience of the past 3 or 4 years would have a significant impact on the MEI for the CY 2004 update, particularly since changing the weights from 1996 to 2000 had such a minimal effect. In addition, the price proxies that we use capture the current price changes in each of the categories that make up the MEI. Start Printed Page 63240

    While we agree that it would be optimal to develop MEI weights based on more recent data, we recognize the lack of data to do so. We also recognize that an alternative would be to use price changes in each of the proxies to update the weights to a more recent base year, similar to the methodology we used to develop the distribution of detailed practice expense categories in the current structure. In that case, we used price changes from 1998 to 2000 to develop weights for 2000.

    However, as we indicated in the proposed rule, this method has a major drawback in that it assumes that the quantity of inputs would increase at the same rate as the price of those inputs. This may not be the case over longer time periods (for instance, 2000-2004) where there is likely to be substitution away from more costly inputs toward those which are less costly. Our experience with rebasing indexes has also shown that the weights for major categories do not change very much over time, even though the individual price changes for those categories can differ significantly. In addition, because the MEI is a Laspeyres-type index, the price changes between the base period and the current period are reflected in the relative importance of each category in determining the overall increase. Therefore, we feel that basing the index on CY 2000 data and reflecting current price changes likely represents a reasonable estimate of physicians' current experience.

    We determined the number and composition of expense categories based on the criteria used to develop the current MEI and other CMS input price index expenditure weights. These criteria are timeliness, reliability, relevance, and public availability. For more information on these criteria, see the May 9, 2002 Federal Register (67 FR 31444) and the detail later in this preamble. Table 10 lists the set of mutually exclusive and exhaustive cost categories that make up the rebased and revised MEI.

    Table 10.—Rebased and Revised Medicare Economic Index Expenditure Categories, Weights, and Price Proxies

    Expense category2000—Expense weights121996—Expense weightsPrice proxy
    Total100.000100.000
    Physician Earnings 352.46654.460
    Wages and Salaries42.73044.197AHE—Private.
    Benefits 49.73510.263ECI—Ben: Private.
    Physician Practice Expenses47.53445.540
    Nonphysician Employee Compensation18.65316.812
    Employee Wages and Salaries13.80812.424
    Prof/Tech Wages5.8875.662ECI—W/S: Private P&T.
    Managerial Wages3.3332.410ECI—W/S: Private Admin.
    Clerical Wages3.8923.830ECI—W/S: Private Clerical.
    Services Wages0.6960.522ECI—W/S: Private Service.
    Employee Benefits 44.8454.388ECI—Ben: Priv. White Collar.
    Other Practice Expenses18.129
    Office Expenses12.20911.581CPI(U)—Housing.
    Professional Liability Insurance3.8653.152CMS—Prof. Liab. Phys. Premiums.
    Medical Equipment2.0551.878PPI—Medical Instruments & Equip.
    Pharmaceuticals and Medical Materials and Supplies4.3194.516
    Medical Materials and Supplies2.011PPI Surg. Appliances and Supplies/CPI (U) Med Supplies.
    Pharmaceuticals2.308PPI Pharmaceutical Preparations.
    Other Expenses6.4337.601CPI-U All Items Less Food and Energy.
    1 Due to rounding, weights may not sum to 100.000 percent.
    2 Sources: Physician Socioeconomic Statistics, 2000-2002 Edition (SMS Survey), Physician Socioeconomic Statistics, 2003 Edition (PCPS Survey), Center for Health Policy Research, American Medical Association; 2003 Employment Cost Index, U.S. Department of Labor, Bureau of Labor Statistics; U.S. Department of Commerce, Bureau of Economic Analysis 1997 Benchmark Input Output Tables, and U.S. Department of Commerce, Bureau of the Census, 2002 Current Population Survey.
    3 Includes employee physician payroll.
    4 Includes paid leave.

    To determine the expenditure weights for the rebased and revised MEI, we used currently available and statistically valid data sources on physician earnings and practice expenses. While we consulted numerous data sources, we used five data sources to determine the MEI expenditure weights: (1) The 2003 AMA Physician Socioeconomic Statistics (2000 survey data) for self-employed physicians, (2) the 2000-2002 AMA Physician Socioeconomic Statistics (1998 data) for self-employed physicians, (3) the March 2003 BLS Employment Cost Index, (4) the 2002 Bureau of the Census Current Population Survey, and (5) the Bureau of Economic Analysis (BEA) 1997 Benchmark Input-Output tables (I/O). No one data source provided all of the information needed to determine expenditure weights according to our criteria. The development of each of the cost categories using these sources is described in detail below.

    b. Physician Earnings

    The rebased and revised MEI uses AMA data on mean physician net income (physician earnings) for self-employed physicians to develop a weight for physician earnings. The weight for this expense category is based on AMA data for 2000 and is calculated as a percentage of total mean expenses (physician earnings and practice expenses, including malpractice). The physician earnings expenditure category also includes employee physician compensation. Start Printed Page 63241Currently, physician earnings and overhead expenses generated by employee physicians are included in the AMA practice expenses category. However, we believe it is appropriate, for our purposes, to place employee physician compensation in the MEI cost category of physician earnings. Including employee physician payroll in physician earnings in the MEI is consistent with the current payment methodologies in accordance with the physician fee schedule, where the work RVU is computed based on what service is provided and not on who provides the service. Since employee physicians perform the same services as self-employed physicians, employee physician time is reflected in the work RVU. By including the compensation of employee physicians in the physician earnings expense category, these expenses will be adjusted by the appropriate price proxies for time spent by a physician.

    To obtain further detail for both wages/salaries and benefits, the ratio between these categories for 1996 (based on the 1996-based MEI) was updated to 2000 using the growth in the overall Employment Cost Index for private employees for wages/salaries and benefits. Alternative data for determining this split were not readily available from any other source. The main shortcoming of this method is that any changes in quantity and intensity (mix of physicians) are not reflected. However, faced with the lack of alternative data, we deemed this approach to be the most feasible, and the results appear to be consistent with anecdotal evidence on this ratio. Its application resulted in a wage-fringe benefit split of 81.4 and 18.6 percent, respectively, in the revised and rebased MEI compared with a wage-fringe benefit split of 81.2 and 18.8 percent, respectively, in the 1996-based MEI.

    c. Physician Practice Expenses

    To determine the remaining individual practice expense weights other than malpractice expense, we updated AMA expense data from 1998 to 2000 using the relative price change in an appropriate price index. After the levels were updated to 2000 values, it was necessary to normalize these levels to equal the 2000 mean total expense data provided by the 2003 AMA survey. The detailed explanations for the derivation of the individual weights are listed below.

    (i) Nonphysician Employee Compensation

    The cost share for nonphysician employee compensation was developed by updating the 1998 AMA Socioeconomic Survey data on nonphysician employee compensation costs for self-employed physicians to 2000, using the current proxy for this category, and dividing the resulting amount into total expenses (physician earnings plus practice expenses) for 2000 from the AMA survey. We further divided this cost share into wages/salaries and benefits using BLS Employment Cost Index data. The ECI survey contains data on the proportion of total compensation accounted for by wages/salaries and benefits (including paid leave) by private industry health services occupational category. These proportions can be used to distribute the total nonphysician employee compensation weight to wages/salaries and benefits for non-physician employees. We used 2000 data from the March 2003 publication. Although this survey does not contain data specifically for offices of physicians, data are available on wage/fringe shares for private industry health services, which include hospitals, nursing homes, offices of physicians, and offices of dentists. We believe the data for health services from the survey do provide a reasonable estimate of the split between wages and fringe benefits for employees in physicians' offices. Data for 2000 in the ECI survey for total health services indicate that wages and fringe benefits are 74.02 percent and 25.98 percent of compensation, respectively. As in the 1996-based MEI, we will use CPS data on earnings by occupation to develop cost shares for wages for nonphysician occupational groups shown in Table 6. To arrive at a distribution for these separate categories, we multiplied the overall share for nonphysician employee wages/salaries by each of the occupational proportions from the 2000 CPS. This distribution for the 1996-based and 2000-based MEI are presented in Table 10.

    Table 11.—Percent Distribution of Nonphysician Payroll Expense by Occupational Group: 2000 and 1996

    BLS occupational group2000 expenditure shares1996 expenditure shares
    Total100.000100.000
    Professional & Technical Workers42.63545.573
    Managers24.13819.398
    Clerical Workers28.18730.827
    Service Workers5.0404.202
    1 Due to rounding, weights may not sum to 100.000 percent.

    (ii) Professional Liability Expense

    The weight for professional liability expense was derived from the 2003 AMA survey (2000 data) and was calculated as the mean professional liability expense expressed as a percentage of total expenses (physician earnings plus practice expenses). This calculation resulted in a 3.865 percent share of total costs in 2000 compared to a 3.152 percent share in the 1996-based index. The increase in weight for professional liability insurance represents the increases in both premiums and the amount of coverage purchased by physicians in 2000 compared to 1996. While the weight does not reflect the cost experience for 2001 and 2002, the proxy used in the rebased and revised index does reflect the price increases associated with the recent rise in malpractice costs.

    Comment: Some commenters were concerned that the rebased and revised MEI does not appropriately reflect the recent increase in professional liability insurance (PLI) premiums that physicians are experiencing.

    Response: As we indicated in the proposed rule, the weights in the rebased and revised MEI reflect the distribution of physicians' costs in CY 2000 and do not reflect the more recent experience of physicians, particularly as it pertains to PLI. While it would be optimal to base the weights on more recent data, there is not a more recent, comprehensive measure that would meet our criteria for determining weights in the MEI.

    We also indicated that while the weights do not reflect the more recent Start Printed Page 63242experience, the proxy we use to measure the price change in this category does reflect more recent price changes in premiums and is the most current data available through the second quarter of 2003. This MEI PLI data, like that used in the development of the GPCIs, does not reflect total expenditures on PLI, which would be needed to develop more current weights for the MEI. In order to develop cost weights, expenditure data for all costs facing physicians are needed.

    (iii) Office, Medical Equipment, Pharmaceuticals and Medical Materials and Supplies Expenses, and Other Expenses

    The 2003 AMA survey provides less detail for expenses with respect to prior years' publications. Therefore, we calculated the share of each of the above categories by updating the AMA data for 1998 to 2000 using an appropriate price proxy. The primary reason for using the price proxy was that we lacked other data to develop cost weights for each of these categories. As stated previously, the main deficiency of this method is that it does not directly account for changes in the quantity or intensity associated with these expenses. Our belief, however, was that it was important to continue using these detailed breakouts so that each would be proxied by an appropriate price index and that the quantity/intensity effects over a short period of time are not likely to be large. In fact, we have found that even over longer periods of time, the distribution of costs tends to be relatively similar.

    Office expenses and medical equipment levels were moved to 2000 using the growth from 1998 to 2000 in their respective MEI price proxies. In the case of office expenses, we used the growth in the CPI-U Housing; for medical equipment expenses, we used the growth in the PPI for Medical Instruments and Equipment.

    The share for pharmaceuticals (prescription drugs) and medical materials and supplies was calculated by separating out pharmaceuticals and other medical materials and supplies using 1997 BEA Benchmark Input-Output data. First, the sum of all the pharmaceuticals and medical supplies categories from the Benchmark Input-Output tables for 1997 was calculated. The share of pharmaceuticals and medical supplies was then calculated as a percentage of this total and applied to the 1997 AMA medical supplies data. These calculated levels were then aged to 2000 using the growth in an appropriate price proxy. We thought it was important and appropriate to account for each of these categories separately so that differences in relative price growth between pharmaceuticals (prescription drugs) and other medical materials and supplies would be more accurately represented. The resulting 2000 data for the two separate categories were then aggregated (summed) together to form the overall total for the share for the pharmaceuticals and medical materials and supplies category in the rebased and revised MEI. The pharmaceuticals category was aged using the Producer Price Index (PPI) for Pharmaceutical preparations and the medical materials and supplies category was updated using the PPI for surgical appliances and supplies.

    Finally, the Other Expenses category was calculated as a residual (total expenses less the percentage of all categories currently accounted for). The additional detail for transportation expenses found in the 1996-based MEI was removed because the data were not readily available for measurement of a cost share for 2000. The effect on the MEI of removing the detail is negligible.

    Comment: One commenter suggested for the purposes of future changes to the MEI, that CMS consider inputs that are vastly different than when the MEI was first developed, such as costs of complying with government regulatory requirements and interpreter services for patients.

    Response: We thoroughly research many of the known data sources on a regular basis to determine the appropriate number of detailed categories that make up the MEI. If we determine that a different combination of inputs is needed we will revise the MEI to reflect a more current cost distribution. However, CMS does not have the detailed expenditure and price data for the types of expenditures the commenter indicated. CMS will continue to work with other outside entities in the future to ensure the MEI is as accurate and representative as possible. It should also be noted that these costs are already captured in the MEI, as all costs are captured in the index, just not separately broken out for the reasons previously stated.

    4. Selection of Price Proxies for Use in the MEI

    After the 2000 cost weights for the rebased and revised MEI were developed, we reviewed the current set of price proxies to determine whether they were still the most appropriate for each expenditure category. As was the case in the development of the 1996-based MEI (57 FR 55901), most of the indicators we considered are based on BLS data and are grouped into one of the following five categories:

    Producer Price Indices (PPIs)

    Producer price indices (PPIs) measure price changes for goods sold in other than retail markets. They are the preferred proxies for physician purchases at the wholesale level. These fixed-weight indices are a measure of price change at the producer or at the intermediate stage of production, a more likely mode of purchase for physicians.

    Consumer Price Indices (CPIs)

    Consumer price indices (CPIs) measure change in the prices of final goods and services purchased by consumers. Like the PPIs, they are fixed-weight. Since they may not represent the price changes faced by producers, CPIs were used if there were no appropriate PPI or if the expenditure category was similar to expenditure of retail consumers in general.

    Average Hourly Earnings (AHEs)

    Average hourly earnings (AHEs) are available for production and nonsupervisory workers for specific industries as well as for the nonfarm business economy. They are calculated by dividing gross payrolls for wages/salaries by total hours. The series reflects shifts in employment mix and, thus, is representative of actual changes in hourly earnings for industries or for the nonfarm business economy.

    ECIs for Wages/Salaries

    These ECIs measure the rate of change in employee wage rates per hour worked. These fixed-weight indices are not affected by shifts in industry or occupation employment levels and measure only the pure rate of change in wages.

    ECIs for Employee Benefits

    These ECIs measure the rate of change in employer costs of employee benefits, such as the employer's share of Social Security taxes, pension and other retirement plans, insurance benefits (life, health, disability, and accident), and paid leave. Like ECIs for wages/salaries, the ECIs for employee benefits are not affected by changes in industry output or occupational shifts.

    When choosing wage and price proxies for each expense category, we evaluate the strengths and weaknesses of each proxy variable using four criteria. The first criterion is relevance. The price variable should appropriately represent price changes for specific goods or services within the expense category. Relevance may encompass judgments about relative efficiency of Start Printed Page 63243the market generating the price and wage increases.

    The second criterion is reliability or low sampling variability. If the proxy wage-price variable has a high sampling variability or inexplicable erratic patterns over time, its value is greatly diminished, since it is unlikely to accurately reflect price changes in its associated expenditure category. Low sampling variability can conflict with relevance, since the more specifically a price variable is defined in terms of service, commodity, or geographic area, the higher the possibility of sampling variability.

    The third criterion is timeliness of actual published data. For this reason, we prefer monthly and quarterly data to annual data. The length of time the time series data have been published is also important. A well-established time series is needed to assess the reasonableness of the series and to provide a solid base from which to forecast future price changes in the series. We need to forecast the MEI to make Federal budget and Trustees Report estimates.

    The fourth criterion is public availability. We prefer to use data sources that are publicly available for our indices so that the public may track each of the individual components in the MEI.

    The BLS price proxy categories previously described meet the criteria of relevance, reliability, timeliness, and public availability. Below we discuss the price-wage proxies for the rebased and revised MEI (shown in Table 5).

    (a) Expense Categories in the MEI

    Physician Time

    In the rebased and revised MEI, we are using the AHE for the private nonfarm economy as the proxy for the physician wages/salaries component; this is the same price measure used in the 1996-based MEI. In our judgment, this proxy still most closely comports with Congressional intent as expressed in the Senate Finance Committee's 1972 report (S. Rept. No. 92-1230 at 191 (1972)). It should be noted that AHEs change in accordance with changes in the type and mix of workers.

    As we discussed extensively in the November 2, 1998 final rule (63 FR 58848) and again in the December 31, 2002 final rule (67 FR 80019), we believe that the current price proxy for physicians' earnings—AHE in the nonfarm business economy—is the most appropriate proxy to use in the MEI. The AHE for the nonfarm business economy reflects the impacts of supply, demand, and economy-wide productivity for the average worker in the economy. Using this measure as the proxy for physicians' earnings ensures parity in the rate of change in wages for the average worker and those 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. Since earnings are expressed per hour, a constant quantity of labor input per unit of time is reflected. The use of the AHE data is also consistent with our using the BLS economy-wide multifactor productivity measures since economy-wide wage increases reflect economy-wide productivity increases.

    Using the ECI for professional and technical workers or other occupational-specific wage proxies has a major shortcoming; in many instances, occupations such as engineering, computer science, and nursing have unique characteristics that are not representative of the overall economy or the physician market. Specifically, wage changes for such occupations can be influenced by excess supply or demand for these types of workers. We believe it would not be appropriate to proxy the physician earnings portion of the MEI with a wage proxy that reflects these other occupation's unique characteristics. The 2000-based MEI will use the ECI for fringe benefits for total private industry as the price proxy for physician fringe benefits, the same proxy used for the 1996-based MEI. This means that both the wage and fringe benefit proxies for physician earnings are derived from the nonfarm private sector and are computed on a per-hour basis.

    Nonphysician Employee Compensation

    As in the 1996-based MEI, we used Current Population Survey data on earnings and employment by occupation to develop labor cost shares for the nonphysician occupational groups shown in Table 10. BLS maintains an ECI for each occupational group, and we use these ECIs as price proxies for nonphysician employee wages in the 2000-based MEI.

    The skill mix shift in employees of physician offices in the last few years has been towards managerial occupations. While these skill mix shifts are captured in the expenditure weights, they are appropriately held constant in a Laspeyres price index such as the MEI. Skill mix shifts, which may reflect the changing intensity of services provided in physicians' offices, are accounted for in the payment system outside of the MEI. The 2000-based MEI will use the ECI for fringe benefits for white collar employees in the private sector as a proxy for nonphysician benefits since most nonphysician employees in physicians' offices are white-collar employees. This is the same proxy used for the 1996-based MEI.

    Office Expense

    Office expenses include rent or mortgage for office space, furnishings, insurance, utilities, and telephone. We continue to use the CPI-U for housing because it is a comprehensive measure of the cost of housing, including rent, owner's equivalent rent, and the types of goods and services associated with running an office. This proxy covers about 80 percent of the population.

    Pharmaceuticals and Medical Materials and Supplies

    This cost category includes drugs, outside laboratory work, x-ray films, and other related services. There is not one price proxy that includes this complete mix of materials and supplies. In the absence of one index, we separately accounted for pharmaceuticals and medical materials and supplies in the 2000-based MEI.

    • Medical Materials and Supplies

    We equally weighted two proxies together (the PPI Surgical Appliances and Supplies and the CPI-U for Medical Equipment and Supplies) since one proxy does not accurately measure the price change associated with these types of products used nor the mode of purchase used in physicians' offices. While both indexes include such items as bandages, dressings, catheters, I.V. equipment, syringes, and other general disposable medical supplies and nonprescription equipment, the indexes reflect significant differences in the mode of purchase. The PPI measures actual transaction prices at the wholesale level, the mode most likely used by physicians, while the CPI measures prices at the retail level or the final stage of production. The price movements in these two indexes can be different and we believe that it is appropriate to combine these indexes into one proxy since physicians likely use both purchasing methods when obtaining medical supplies.

    • Pharmaceuticals

    The PPI for pharmaceutical preparations is used to proxy pharmaceutical prices in other CMS market baskets and reflects the price change associated with the average mix of pharmaceuticals purchased economy-wide. We use the PPI for pharmaceutical preparations, rather than the CPI for prescription drugs, because physicians generally purchase drugs directly from a Start Printed Page 63244wholesaler. The PPIs we use measure price changes at the final stage of production and not intermediate production, however.

    Professional Liability Insurance

    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.

    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, on a voluntary basis, from a few national commercial carriers via letter. Generally between 5 and 8 carriers volunteer this information. For the CY 2004 update we were able to obtain data from 7 carriers, all of which were in the top 15 companies in 2001 in terms of market share. While the sample size certainly does not cover the entire professional liability insurance market, we have attempted to maximize the market share in terms of both national coverage and coverage within States.

    As we require for our other price proxies, the professional liability price proxy should 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, we 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 are 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 provide a quarterly time series, indexed to a base year consistent with the MEI and reflect 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.

    Our research has indicated that the most comprehensive data on professional liability costs are held by the State insurance commissioners but these data are available only with a substantial time lag and, therefore, the data currently incorporated into the MEI are much more timely. We believe that, given the limited data available on professional liability premiums, this methodology adequately reflects the price trends facing physicians.

    Comment: Several commenters were concerned about the 6.6 percent increase in the PLI component of the MEI published in the proposed rule and felt that this did not represent the actual increase in premiums physicians are experiencing.

    Response: We indicated in the proposed rule that the 6.6 percent increase in the PLI component of the index was based on a forecast. For this final rule we have incorporated actual data (through the second quarter of 2003) that indicates that the increase in the proxy for the PLI component of the MEI is 16.9 percent.

    Medical Equipment

    Medical equipment includes depreciation, leases, and rent on medical equipment. We will use the PPI for medical instruments and equipment as the price proxy for this category, consistent with the price proxy used in the 1996-based MEI and other CMS input price indexes.

    Other Expenses

    This category includes the residual subcategory of other expenses such as accounting services, legal services, office management services, continuing education, professional association memberships, journals, professional car expenses, and other professional expenses. In the absence of one price proxy or even a group of price proxies that might reflect this heterogeneous mix of goods and services, we use the CPI-U for all items less food and energy, consistent with the price proxy used in the 1996-based MEI. We also condensed the structure compared to that used in the 1996-based MEI because we lack the data to develop a representative weight for transportation, as discussed above. This change resulted in only a negligible effect on the overall MEI over the past 8 years; the average annual increase differs by less than a tenth of a percentage point over that time.

    (b) Productivity Adjustment to the MEI

    In the December 2002 final rule, we indicated that we were changing the methodology for adjusting for productivity in the MEI. The MEI used for the 2003 physician payment update reflected changes in the 10-year moving average of private nonfarm business (economy-wide) multifactor productivity applied to the entire index; we had previously used economy-wide private nonfarm business labor productivity applied to the labor portions of the index. We will continue to use the new method, adjusting for multifactor productivity applied to the entire index, in the rebased and revised MEI.

    As described in the December 31, 2002 (68 FR 9568) final rule, we use multifactor productivity 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 to be 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 also 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 1996-based MEI. The adjustment will be based on the latest available actual historical economy-wide multifactor productivity data, as measured by BLS. For the 2004 update, this means using the multifactor productivity data through 2001, the latest available information.

    5. Results of Rebasing

    Because the rebased and revised MEI is similar in structure to the 1996-based MEI, updating the MEI from a 1996 base year to a 2000 base year resulted in small changes in expense category weights. Physicians' earnings dropped slightly, from 54.5 percent of the index in 1996 to 52.5 percent in 2000. The expense shares for non-physician employee compensation, office expenses, professional liability insurance, and medical equipment all rose slightly, while expense shares for medical materials and supplies and other expenses declined.

    The update using the rebased and revised MEI for the 2004 Physician Fee Schedule is an increase of 2.9 percent. This incorporates historical data through the second quarter of 2003.Start Printed Page 63245

    Table 12.—Annual Percent Change in the Revised and Rebased Medicare Economic Index, 2004—All Categories

    Increase in the Medicare Economic Index Update for Calendar Year 2004 1
    Cost categories and price measures2000 weights 22004 percent changes
    Medicare Economic Index Total, productivity adjustedn/a2.9
    Productivity: 10-year moving average of Multifactor productivity, private nonfarm business sectorn/a0.9
    Medicare Economic Index Total, without productivity adjustment100.0003.8
    1. Physician's Own Time 352.4663.6
    a. Wages and Salaries: Average Hourly Earnings, private Nonfarm42.7303.2
    b. Fringe Benefits: Employment Cost Index, benefits, private nonfarm9.7355.4
    2. Physician's Practice Expense 347.5344.0
    a. Nonphysician Employee Compensation18.6533.4
    1. Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation13.8082.8
    2. Fringe Benefits: Employment Cost Index, fringe benefits, white collar4.8455.0
    b. Office Expense: Consumer Price Index (CPI-U), housing12.2092.5
    c. Drugs and Medical Materials and Supplies4.3193.1
    1. Medical Materials and Supplies: Producer Price Index, surgical appliances and supplies/Consumer Price Index (CPI-U), medical equipment and supplies (equally weighted)2.0111.0
    2. Pharmaceuticals: Producer Price Index (PPI pharmaceutical preparations)2.3084.9
    d. Professional Liability Insurance: premiums 43.86516.9
    e. Medical Equipment: PPI, medical instruments and equipment2.0552.3
    f. Other Expenses6.4331.9
    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 2004 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of September 22, 2002.
    2 The weights shown for the MEI components are the 2000 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 2000. To determine the MEI level for a given year, the price proxy level for each component is multiplied by its 2000 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. Due to rounding, weights may not sum to 100.000 percent.
    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 data collected from several major insurers (the latest available historical percent change data are for the period ending second quarter of 2003).
    n/a Productivity is factored into the MEI categories as an adjustment to the price variables; therefore, no explicit weight exists for productivity in the MEI.

    As is the case with this index rebasing, our experience in previous rebasing and revising indexes has been that there is usually a very small effect on the overall percent change. The difference is typically between zero and 0.3 percentage points per year on average. The rebased and revised MEI overall percent increase for the CY 2004 update is only 0.1 percentage point higher compared to the 1996-based MEI. This is also the case for this final rule. When the MEI was last rebased, there was no difference in the average annual percentage change from 1985 to 1998. When the PPS hospital indices were rebased, the average difference in the percentage change was less than one-tenth of a percentage point from 1995 to 2002.

    The first reason for this small difference between the 1996-based and 2000-based MEI percent changes is that the weight of professional liability insurance increased, giving it a higher relative importance in the index in 2000. This category also increased at a faster pace than other index categories during 2002 and projected for 2003, resulting in an even greater relative importance for this index by 2004 and causing it to have a larger effect on the overall index compared to the 1996-based MEI.

    In addition, the pharmaceuticals from the medical materials and supplies category grew faster than the overall medical materials and supplies in the 1996-based MEI. In addition, the faster growth in the aggregate medical materials and supplies category combined with a higher weight in the 2000-based index gave the category a higher relative importance. However, these increases were mostly offset by declines in weight of some of the other categories, most notably physician earnings.

    6. Adjustments to RVUs To Match the New MEI Weights

    As discussed in the August 15, 2003 proposed rule, section 1848(c)(2)(B)(ii)(II) of the Act requires that increases or decreases in RVUs may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we make across-the-board adjustments to preserve budget neutrality. Therefore, if we adjust the work, practice expense and malpractice RVUs to match the new MEI weights, we are required by statute to ensure that the adjustments do not increase or decrease Medicare expenditures by more than $20 million. To meet the requirements of the statute and ensure that aggregate pools of RVUs match the proposed new MEI weights, we considered two options. We considered either making no adjustments to the physician work RVUs and adjusting only the practice expense and malpractice RVUs or adjusting all 3 categories of RVUs. We proposed adjusting all 3 categories of RVUs rather than adjusting only the practice expense and malpractice RVUs, which would have resulted in a reduction to the physician fee schedule conversion factor in addition to the -4.2 percent reduction that was forecasted. Specifically, we proposed to reduce the physician work RVUs by an estimated 0.35 percent (0.9965) and the practice expense RVUs by an estimated 1.15 percent (0.9885) and to increase the malpractice RVUs by an estimated 21.7 percent (1.217) to match the rebased MEI weights. Start Printed Page 63246

    Comment: We received comments from a number of physician organizations opposing any adjustment to the physician work RVUs. Several of the comments appreciated our reluctance to reduce the physician fee schedule conversion factor by an additional 0.3 percentage points when there will already be a large reduction in the physician fee schedule update. One commenter stated that any additional reduction to the physician fee schedule conversion factor would be inappropriate. However, these comments also stated that that the physician work RVUs should remain constant and stable. There were a number of comments that stated that across-the-board adjustments should never be applied to the work component of the Resource Based Relative Value System. One comment indicated that we should not make any adjustments to the work RVUs unless they are recommended by the RUC. Several of the comments stated that the proposed adjustments to the RVUs to match the MEI weights would not assist the physician community in addressing the professional liability crisis since any increase in physician fees for some services will be offset by reductions in other services. Additional payments by Medicare to cover increased professional liability costs, or congressional action, are necessary to alleviate this problem. Some of the comments indicated that CMS did not provide sufficient information to make a determination as to how the two proposals would affect individual codes because the adjustments were not applied to the RVUs shown in Addendum B of the proposed rule. Several of the comments stated that the stability of work RVUs is essential since they are used by private payors, physician compensation systems, and in productivity analysis. The RUC commented that they depend upon the stability in these values as they review new and revised codes, both in magnitude estimation and in any calculations regarding intra-work per unit of time (IWPUT). One comment suggested CMS create a separate adjustment factor to adjust payments without changing the conversion factor or the RVUs, as it did for the first five-year review of the Medicare physician fee schedule in 1995. We also received a comment urging us to review the Secretary's “ancillary policies” authority under section 1848(c)(4) of Act to determine whether CMS has statutory authority to increase PLI relative value units without reducing the work and practice expense relative value units.

    We also received several comments that expressed support for maintaining stability in the practice expense RVUs. The comment stated “much like what is done with work relative values, any code-level refinements due to annual coding changes that result in a non-budget neutral impact should not result in a reduction of all practice expense relative values. The comment requested that CMS present an analysis of this issue in an upcoming proposed rule and recommended that adjustments related to the MEI rebasing not be applied to the practice expense relative values.

    Response: We share the concern about establishing stability in the practice expense RVUs. As we indicated in the June 28, 2002 proposed rule (67 FR 43851), “once the refinement process is complete, we believe the physician community has a reasonable expectation that the practice expense RVUs will not change from year to year unless further refinement is undertaken.” We plan to analyze in an upcoming proposed rule whether there are any alternatives to our current practice of rescaling the practice expense RVUs to apply budget neutrality. However, we disagree with the comments that suggest we only increase the malpractice expense RVUs and not apply any adjustments to the work and practice expense RVUs to match the MEI weights. It is not possible to match the aggregate RVUs to the new MEI weights if we make no adjustments to both work and practice expense and adjust only the malpractice RVUs and the conversion factor. While it would be possible to maintain budget neutrality for the increase in malpractice RVUs by reducing the conversion factor, the aggregate number of RVUs for work and practice expense would not match the MEI weights unless we could adjust at least two of the three RVUs in combination with applying a compensating adjustment to the CF.

    We have considered the comment suggesting that we use the Secretary's section 1848(c) “ancillary” policies authority to adjust the RVUs to match the MEI weights but not maintain budget neutrality. Section 1848(c) states that the Secretary may establish ancillary policies (with respect to the use of modifiers, local codes, and other matters) as may be necessary to implement this section.” We believe that this section of the statute must, nonetheless, be read consistently with the requirements of section 1848(c)(2)(B)(ii)(II) of the Act requiring 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 believe the statute is clear and any increase in the malpractice expense RVUs must be offset by decreases to the work and practice expense RVUs or the conversion factor.

    We also do not believe that the work RVUs should be maintained and a separate “work adjustor” established. While such policy was adopted following the 5-year review of physician work in 1997, we used this procedure only because the effect of the work adjustor could be removed once resource-based practice expense RVUs were adopted in 1999. We did not find the work adjustor to be desirable. It added an extra element to the physician fee schedule payment calculation and created confusion and questions among the public who had difficulty using the RVUs determine a payment amount that matched the amount actually paid by Medicare.

    We acknowledge the comments that indicate that the work RVUs are used for many purposes other than Medicare payment. While our proposal would slightly reduce the absolute value of the physician work RVUs, it would not change their relative values since there would be a uniform decrease to all of the RVUs. We believe the relative relationship among the values for the services makes them useful for analysis for purposes other than Medicare payment. Since the relative values will be left unchanged, we do not believe the work RVUs will lose their utility for these other uses.

    We disagree that our proposed rule did not provide enough information upon which to determine the impact on payment for a given service. The proposed rule provided the specific level of the estimated adjustments. While we did not actually apply the adjustments to the RVUs shown in Addendum B, any interested party could determine the effect of our proposal on any given service with the information we provided. We further noted that the adjustments we provided were estimated and would change once we made final determinations of the work, practice expense and malpractice RVUs for 2004. For the final rule, we will reduce the work RVUs by 0.57 percent (0.9943), the practice expense by 0.77 (0.9923) percent and increase the malpractice RVUs by 19.86 percent (1.1986). We have also modeled the impact of our proposal by specialty in the impact section of this final rule.

    With respect to the comments about our proposal and the large increases in professional liability premiums, we Start Printed Page 63247have not asserted that our policy to adjust the RVUs will resolve this issue. While the comments that our policy will increase payments for some service and decrease payments for payments for others are correct, we note that payments for services with high malpractice RVUs will increase the most in payment while there will be negligible impact on payment for most other services. Such a policy will improve our payment policies by giving more weight to the malpractice RVU in determining Medicare total payment consistent with the proportion that professional liability expenses represent of total physician expenses. As indicated in the impact section, services provided by cardiac and thoracic surgeons, neurosurgeons, orthopedic surgeons, vascular surgeons and emergency physicians are increasing in payment as a result of this proposal. There will be little impact of these adjustments on all other specialties.

    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” or UAF. The UAF 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.

    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 UAF for the year. Under section 1848(d)(4)(B) of the Act, the UAF 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 (2004 in this case), the current calendar year (2003) and the preceding calendar year (2002) 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 2002 allowed expenditures in this final rule). Once the SGR and allowed expenditures for a year have been revised twice, they are final.

    Table 13 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 13

    PeriodAnnual allowed expenditures ($ in billions)Cumulative allowed expenditures ($ in billions)FY/CY SGR
    4/1/96-3/31/9748.948.9N/A
    4/1/97-3/31/9850.599.4FY 1998 = 3.2%
    4/1/98-3/31/9952.6152.0FY 1999 = 4.2%
    1/1/99-3/31/9913.3(1)FY 1999 = 4.2%
    4/1/99-12/31/9942.1(2)FY 2000 = 6.9%
    1/1/99-12/31/9955.3194.1FY 1999/20003
    1/1/00-12/31/0059.4253.4CY 2000 = 7.3%
    1/1/01-12/31/0162.0315.5CY 2001 = 4.5%
    1/1/02-12/31/0267.2382.6CY 2002 = 8.2%
    1/1/03-12/31/0371.7454.2CY 2003 = 6.7%
    1/1/04-12/31/0477.0528.6CY 2004 = 7.4%
    1 Allowed expenditures for the first quarter of 1999 are based on the FY 1999 SGR.
    2 Allowed expenditures for the last three quarters of 1999 are based on the FY 2000 SGR.
    3 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 13 includes our final revision of allowed expenditures for 2002, a recalculation of allowed expenditures for 2003, and our initial estimate of allowed expenditures for 2004. To determine the update adjustment factor for 2004, the statute requires that we use allowed and actual expenditures from April 1, 1996 through December 31, 2003 and the 2004 SGR. Consistent with section 1848(d)(4)(E), we will be making further revisions to 2003 and 2004 SGRs and 2003 allowed expenditures. Because we have Start Printed Page 63248incomplete actual expenditure data for 2003, 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 13 in the statutory formula illustrated below:

    UAF = Update Adjustment Factor

    Target03 = Allowed Expenditures for 2003 or $71.7 billion

    Actual03 = Estimated Actual Expenditures for 2003 = $77.8 billion

    Target4/96-12/03 = Allowed Expenditures from 4/1/1996-12/31/2002 = $454.2 billion

    Actual4/96-12/02 = Estimated Actual Expenditures from 4/1/1996-12/31/2003 = $462.0 billion

    SGR03 = 7.4 percent (1.074)

    Section 1848(d)(4)(D) of the Act indicates that the UAF determined under section 1848(d)(4)(B) of the Act for a year may not be less than −0.070 or greater than 0.03. The calculated UAF of −0.090 is less than the statutory limit of −0.070. Therefore, the UAF for 2004 will be −0.70.

    Section 1848(d)(4)(A)(ii) of the Act indicates that 1 should be added to the UAF 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. (The Consolidated Appropriations Reduction Resolution of 2003 (P.L. 108-7) contained a provision permitting revision of the FY 1998 and FY 1999 SGRs. See the February 28, 2003 Federal Register (68 FR 9567) for a discussion of these SGRs. 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 2004 SGR, a revision to the 2003 SGR, and our final revision to the 2002 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 (and those items and services paid through intermediaries where specified):

    • Physicians' services.
    • Services and supplies furnished incident to physicians' services.
    • Outpatient physical therapy services and outpatient occupational therapy services.
    • Antigens prepared by or under the direct supervision of a physician.
    • Services of physician assistants, certified registered nurse anesthetists, certified nurse midwives, clinical psychologists, clinical social workers, nurse practitioners, and clinical nurse specialists.
    • Screening tests for prostate cancer, colorectal cancer, 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 (including outpatient diagnostic laboratory tests paid through intermediaries).
    • 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. Start Printed Page 63249

    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 2004, a revised estimate of the SGR for 2003, and our final determination of the SGR for 2002. Consistent with section 1848(f)(3)(C) of the Act, we are using the best data available to us as of September 1, 2003 for all of the figures.

    D. Preliminary Estimate of the SGR for 2004

    Our preliminary estimate of the 2004 SGR is 7.4 percent. We first estimated the 2004 SGR in March and made the estimate available to the Medicare Payment Advisory Commission and on our website. Table 13 shows our March estimates and our current estimates of the factors included in the SGR:

    Table 14

    Statutory factorsMarch estimateCurrent estimate
    Fees2.3% (1.023)2.7% (1.027)
    Enrollment1.3% (1.013)1.7% (1.017)
    Real Per Capita GDP2.7% (1.027)2.8% (1.028)
    Law and Regulation0.0% (1.000)0.0% (1.000)
    Total6.4% (1.064)7.4% (1.074)

    Note:

    Consistent with section 1848(f)(2) of the Act, the statutory factors are multiplied, not added, to produce the total (that is, 1.027 × 1.017 × 1.028 × 1.000 = 1.074.) A more detailed explanation of each figure is provided below in section G.1.

    E. Revised SGR for 2003

    Our current estimate of the 2003 SGR is 6.7 percent. Table 14 shows our preliminary estimate of the 2003 SGR that was published in the Federal Register on December 1, 2002 (67 FR 80027) and our current estimate:

    Table 15

    Statutory factors12/31/02 estimateCurrent estimate
    Fees2.9% (1.029)2.8% (1.028)
    Enrollment1.2% (1.012)2.4% (1.024)
    Real Per Capita GDP3.3% (1.033)1.4% (1.014)
    Law and Regulation0.0% (1.000)0.0% (1.000)
    Total7.6% (1.076)6.7% (1.067)

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

    F. Final Sustainable Growth Rate for 2002

    The SGR for 2002 is 8.3 percent. Table 16 shows our preliminary estimate of the SGR published in the Federal Register on November 1, 2001 (66 FR 55317), our revised estimate published in the Federal Register on December 31, 2001 (67 FR 80028) and the final figures determined using the latest available data:

    Table 16

    Statutory factors11/1/01 estimate12/31/02 estimate (1)Final
    Fees2.3% (1.023)2.5% (1.025)2.5% (1.025)
    Enrollment0.7% (1.007)2.8% (1.028)3.2% (1.032)
    Real Per Capita GDP1.7% (1.027)2.3% (1.023)1.4% (1.014)
    Law and Reg0.8% (1.008)1.1% (1.011)1.0% (1.010)
    Total5.6% (1.056)9.0% (1.090)8.3% (1.083)
    1 The figures for fees, enrollment and real per capita GDP from the 12/31/02 final rule are shown here. We made a subsequent change to the law and regulations factor and the total in the February 28, 2003 Federal Register (68 FR 9572). We show the revised law and regulation factor and total in the above table.
    Start Printed Page 63250

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

    G. Calculation of 2004, 2003, and 2002 Sustainable Growth Rates

    1. Detail on the 2004 SGR

    All of the figures used to determine the 2004 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 allowed expenditures and incorporated into subsequent physician fee schedule updates.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2004

    This factor is calculated as a weighted average of the 2004 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 are estimated to account for approximately 80.3 percent of total allowed charges included in the SGR in 2004 and are updated using the MEI. The MEI for 2004 is 2.9 percent. Diagnostic laboratory tests are estimated to represent approximately 7.4 percent of Medicare allowed charges included in the SGR in 2004 and the costs of these tests are updated by the CPI-U. The CPI-U for 2004 that will be used to update clinical diagnostic laboratory tests is 2.1 percent. Drugs represent 12.3 percent of Medicare allowed charges included in the SGR. We are projecting a weighted average change in fees for drugs that are included in the SGR of 2.0 percent. Table 16 shows the weighted average of the MEI, laboratory and drug price increases for 2004:

    Table 17

    WeightUpdate
    Physician0.8032.9
    Laboratory0.0742.1
    Drugs0.1232.0
    Weighted Average1.0002.7

    After taking into account the elements described in table 16, we estimate that the weighted-average increase in fees for physicians' services in 2004 under the SGR (before applying any legislative adjustments) will be 2.7 percent.

    Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2003 to 2004

    This factor is our estimate of the percent change in the average number of fee-for-service enrollees from 2003 to 2004. 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 1.7 percent from 2003 to 2004. Table 18 illustrates how this figure was determined:

    Table 18

    20032004
    Overall1 38.5351 39.013
    Medicare+Choice1 4.6891 4.606
    Net1 33.8471 34.407
    Percent Increase2 1.7
    1 Millions.
    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, the estimate may change substantially as actual Medicare fee-for-service enrollment for 2004 becomes known.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2004

    We estimate that the growth in real per capita GDP from 2003 to 2004 will be 2.8 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 2004.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2004 Compared With CY 2003

    We are not projecting any change in spending in 2004 due to changes in law or regulations.

    2. Detail on the 2003 SGR

    A more detailed discussion of our revised estimates of the four elements of the 2003 SGR follows.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for 2003

    This factor was calculated as a weighted average of the 2003 fee increases that apply for the different types of services included in the definition of physicians' services for the SGR.

    We estimate that services paid using the physician fee schedule account for approximately 82.7 percent of total allowed charges included in the SGR in 2003. These services were updated using the 2003 MEI of 3.0 percent. We estimate that diagnostic laboratory tests represent approximately 7.1 percent of total allowed charges included in the SGR in 2003. These services were updated by the 2003 CPI-U of 1.1 percent. We estimate that drugs represent 10.2 percent of Medicare allowed charges included in the SGR in 2003. 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 weighted average fee increases for drugs of 1.9 percent in 2003. Table 19 shows the weighted average of the MEI, laboratory and drug price increases for 2003:

    Table 19

    WeightUpdate
    Physician0.8273.0
    Laboratory0.0711.1
    Drugs0.1021.9
    Weighted Average1.0002.8

    After taking into account the elements described in table 19, we estimate that the weighted-average increase in fees for physicians' services in 2003 under the SGR (before applying any legislative adjustments) will be 2.8 percent.

    Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2002 to 2003

    Our actuaries estimate that the average number of Medicare Part B fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) increased by 2.4 percent in 2003. Table 20 illustrates how we determined this figure:

    Table 20

    [In millions]

    20022003
    Overall38.07438.535
    Start Printed Page 63251
    Medicare+Choice5.0054.689
    Net33.06933.847
    Percent Increase2.4%

    Our actuaries' estimate of the 2.8 percent change in the average number of fee-for-service enrollees, net of Medicare+Choice enrollment for 2003, compared to 2002 is different from our preliminary estimate (1.2 percent for 2003 from the December 31, 2002 final rule (67 FR 80029)) 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 2002 that is different than the figure we used one year ago. Further, we now have information on actual fee-for-service enrollment for the first 8 months of 2003. We would caution that our estimate of fee-for-service enrollment for 2003 could change again once we have complete information for the entire year.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2003

    We estimate that the growth in real per capita GDP will be 1.4 percent in 2003. Our past experience indicates that there have also been large differences between our estimates of real per capita GDP growth made prior to the year's end and the actual change in this factor. Thus, it is likely that this figure will change further as complete actual information on 2003 economic performance becomes available to us in 2004.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in 2003 Compared With 2002

    There were no statutory or regulatory changes that affected Medicare expenditures for services included in the SGR in 2003.

    3. 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 accounted for approximately 84.1 percent of total Medicare allowed charges included in the SGR in 2002, and are updated using the MEI. The MEI for 2002 was 2.6 percent. Diagnostic laboratory tests represent approximately 7.2 of total Medicare allowed charges included in the SGR, and are typically updated by the CPI-U. However, the BBA required a 0.0 percent update in 2002 for laboratory services. Drugs represented approximately 8.7 percent of total Medicare allowed charges included in the SGR in 2002. 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 2.8 percent in 2002. Table 21 shows the weighted average of the MEI, laboratory and drug price increases for 2002:

    Table 21

    WeightUpdate
    Physician0.8412.6
    Laboratory0.0720.0
    Drugs0.0872.8
    Weighted Average1.0002.5

    After taking into account the elements described in table 21, we estimate that the weighted-average increase in fees for physicians' services in 2002 under the SGR (before applying any legislative adjustments) was 2.5 percent.

    Factor 2—The Percentage Change in the Average Number of Part B Enrollees from 2001 to 2002

    We estimate the increase in the average number of fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) from 2001 to 2002 was 3.2 percent. Our calculation of this factor is based on complete data from 2002. Table 22 illustrates the calculation of this factor:

    Table 22

    [In millions]

    20012002
    Overall37.65038.074
    Medicare+Choice5.6085.005
    Net32.04133.069
    Percent Increase3.2%

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in 2002

    We estimate that the growth in real per capita GDP was 1.4 percent in 2002. This is a final figure based on complete data for 2002.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in 2002 Compared With 2001

    Sections 101 through 104 of the BIPA added Medicare coverage for a variety of new services that will affect the 2002 SGR. In addition, section 112 of BIPA made changes that will result in additional Medicare coverage for certain drugs that will affect 2002 spending for services included in the SGR. Prior to the enactment of the BIPA, Medicare paid only 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. We are also adjusting this factor to account for including screening mammography services in the SGR consistent with our discussion of this issue in the November 1, 2001 Federal Register (66 FR 55318). After taking these provisions into account, our final estimate of the percentage change in expenditures for physicians' services resulting from changes in law or regulations is 1.0 percent for 2002.

    VIII. Anesthesia and Physician Fee Schedule Conversion Factors for Calendar Year 2004

    The 2004 physician fee schedule CF will be $35.1339. The 2004 national average anesthesia conversion factor is $16.43.

    The specific calculations to determine the physician fee schedule and anesthesia CFs for 2004 are explained below.

    Detail on Calculation of the 2004 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.

    We are illustrating the calculation for the 2004 physician fee schedule CF in table 23: Start Printed Page 63252

    Table 23

    2003 Conversion Factor$36.7856
    2004 Update0.9551
    2004 Conversion Factor$35.1339

    Anesthesia Fee Schedule Conversion Factor

    Anesthesia services do not have RVUs like other physician fee schedule services. Therefore, we account for any necessary RVU adjustments through an adjustment to the anesthesia fee schedule CF. We are adjusting the anesthesia CF to reflect the RVUs adjustments being made to all other physician fee schedule services to match the revised MEI weights. The 2003 anesthesia CF is $17.05. Physician work represents 79.02 percent of the anesthesia CF (0.7902). We are decreasing this portion of the anesthesia CF by 0.57 percent (0.9943). Practice expenses represent 13.75 percent (0.1375) of the anesthesia CF. We are reducing this portion of the anesthesia conversion factor by 0.77 percent (0.9923) for the adjustment to match the RVUs with the MEI weights. In addition, we are increasing the practice expense portion of the anesthesia CF by 0.18 percent (1.0018) for changes to anesthesia practice expenses resulting from the refinement of practice expense RVUs. Taken together, we are reducing the practice expense portion of the anesthesia fee schedule CF by 0.59 percent (0.9923 × 1.0018 = 0.9941). Professional liability insurance represents 7.23 percent (0.0723) of the anesthesia CF. We are increasing this portion of the anesthesia CF by 19.86 percent (1.1986). Taken together, the adjustments to the work, practice expense and malpractice portions of the anesthesia CF result in a total adjustment of 1.090 percent (0.7903 *0.9943) + ((0.1347 × 0.9941) + (0.0723 × 1.1986) = 1.0090. To determine the anesthesia fee schedule CF for 2004, we used the following figures:

    Table 24

    2003 Anesthesia Conversion Factor$17.0522
    Adjustments to match MEI weights and practice expense factor1.0090
    2004 Update0.9551
    2004 Anesthesia Conversion Factor$16.4339

    IX. Telehealth Originating Site Facility Fee Payment Amount Update

    Section 1834(m) of the Act establishes the payment amount for the Medicare telehealth originating site facility fee for telehealth services provided from October 1, 2001, through December 31 2002, at $20. For telehealth services provided on or after January 1 of each subsequent calendar year, the telehealth originating site facility fee is increased by the percentage increase in the MEI as defined in section 1842(i)(3) of the Act. The MEI increase for 2004 is 2.9 percent.

    Therefore, for CY 2004, the payment amount for HCPCS code “Q3014, telehealth originating site facility fee” is 80 percent of the lesser of the actual charge or $21.20.

    The Medicare telehealth originating site facility fee and MEI increase by the applicable time period is shown below.

    Table 25

    Facility feeMEI increase (percent)Period
    $20.00N/A10/01/2001-12/31/2002
    $20.603.001/01/2003-12/31/2003
    $21.202.901/01/2004-12/31/2004

    X. Provisions of the Final Regulations

    This final rule with comment period adopts the provisions of the August 2003 proposed rule except as noted elsewhere in the preamble. The following is a highlight of the changes made from the proposed rule.

    For geographic practice cost indices, based upon the volatility of the premium data collected, our review of the comments received on the August 15, 2003 proposed rule, and our review of malpractice GPCIs, we have modified some of our GPCI calculations and assumptions. We reduced the overall impact associated with revision to the malpractice GPCIs by a factor of 50 percent to mitigate for the volatility of the data. As directed by the statute, we will implement half of this change in the first year (CY 2004) and half of this change in the second year (CY 2005).

    For the creation G codes for monitoring heart rhythms issue, based on concerns raised by commenters, we will not proceed with the proposed HCPCS codes because we want to ensure that any HCPCS codes developed, encompass the various technologies that are being utilized for such monitoring.

    For changes in payments to physicians managing patients on dialysis, we are moving forward with our proposals and we are adjusting the payment rates for the established G codes. In addition we are adding additional codes to address the concerns raised about home dialysis.

    For the definition of diabetes for diabetes self-management training we adopted the AACE clinical definition. We also expanded our general language to include other types of diabetes.

    For excision of benign and malignant lesions, we are not moving forward with our proposal, however, we will maintain the 2003 work RVUs as interim values for 2004 to allow opportunity for the specialty to resurvey these services.

    For payment policies for anesthesia services we have decided to allow teaching anesthesiologists to bill, similarly to teaching CRNAs, for their involvement in two concurrent cases involving residents.

    XI. Collection of Information Requirements

    This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 35).

    XII. Response to Comments

    Because of the large number of public comments we normally receive on Federal Register documents, 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 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 Start Printed Page 63253million 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 communities).

    We have simulated the effect of the physician fee schedule changes that we are adopting in this final rule. We are making several changes to the physician fee schedule RVUs in this final rule. In general, section 1848(c)(2)(B)(ii)(II) requires that changes to RVUs cannot increase or decrease expenditures more than $20 million. Thus, changes to the RVUs made pursuant to section 1848(c)(2)(B)(ii)(II) must be budget neutral. That is, increases in payments resulting from RVU changes must be offset by decreases in payments for other services and there will be redistribution in payment among physicians, practitioners and suppliers that bill Medicare for physician fee schedule services. We expect that the changes we are making to the physician fee schedule RVUs under section 1848(c) will result in a redistribution of Medicare allowed charges of more than $100 million in one year. For this reason, we are considering this final rule to be economically significant. Therefore, this final rule is a major rule and 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 and 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 final 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 603 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 $6 million or less. Approximately 95 percent of physicians (except mental health specialists) are considered to be small entities. There are about 900,000 physicians, other practitioners and medical suppliers that receive Medicare payment under the physician fee schedule.

    The analysis and discussion provided in this section as well as elsewhere in this final rule complies with the RFA requirements. 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. This final rule would not impose unfunded mandates on State, local, or tribal governments, or on the private sector of more than $110 million dollars.

    We have examined this final rule in accordance with Executive Order 13132 and have determined that this regulation would not have any significant 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 propose to use to minimize the burden on small entities. As indicated elsewhere in this final rule, we are making changes to the Medicare Economic Index, refining resource-based practice based practice expense RVUs, creating new codes for dialysis patient visits to their physicians and making a variety of other changes to our regulations, payments or payment policy 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 final rule. While this rule revises the definition of diabetes for the purposes of outpatient diabetes self-management training, it does not impose reporting, record-keeping and other compliance requirements. We are unaware of any relevant Federal rules that duplicate, overlap or conflict with this proposed rule. The relevant sections of this final rule contain a description of significant alternatives.

    A. Physician Fee Schedule Relative Value Units

    As indicated above, we are making changes to the work and practice expense RVUs under the provisions of section 1848(c)(2) of the Act and section 429(b) of BIPA. 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 making several changes under section 1848(c)(2) that would result in a change of expenditures that would exceed $20 million threshold if we made no offsetting adjustments to either the conversion factor 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 relative values that will be paid under current and revised policy in CY 2004. We apply a uniform adjustment factor to make the aggregate number of revised practice expense relative values equal the estimated number that would be paid under current policy. We are applying this policy for all changes that we are making under section 1848(c).

    Table 26 shows the specialty level impact on payment of changes being made for CY 2004. 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 specialties may receive substantial Medicare revenues for services that are not paid under the physician fee schedule. For instance, independent laboratories receive 17 of their revenues from physician schedule services and the remainder for laboratory fee schedule services that are unaffected by this rule. We modeled the impact of all changes to the relative value units and illustrated their effect in table 26. The column labeled “NPRM” shows the combined effect of all of the changes contained in the August 15, 2003 proposed rule (see 68 FR 49033 to 49038 for a detailed discussion of each provision).

    The column labeled “Practice Expense Refinements” shows the impact on payment from further changes to the practice expense inputs that we made using information that became available to us since the proposed rule. In some cases, we made changes to the practice expense inputs in response to public comments. In other situations, we may have received Start Printed Page 63254a price for an item of medical equipment or supplies where we previously did not have one. In most cases, these changes may increase or decrease the practice expense RVU for a given code but will have very little impact across all of the services provided by a specialty. However, in one case, we include prices for several items of equipment and supplies that are generally used by otolaryngologists. The addition of this new information increased payment for many procedural services provided by otolaryngologists and reduced payment for their diagnostic services. The net effect of these changes is to increase payments to otolaryngologists by the 1 percent shown in table x. Audiologists provide many of the same diagnostic services that are billed to Medicare by otolaryngologists resulting in the approximate 2 percent decrease in payment shown in table 26 for audiologists. Similarly, there may be some very small additional impact on allergy from the additional practice expense refinements. There were a number of coding changes made by CPT to central venous access codes. It is possible there may be small impact on payment from these coding changes for interventional radiology.

    The “Practice Expense Refinements” column also shows an increase in payment of 2 percent for radiation oncology and 1 percent for portable x-ray suppliers. These impacts are a result of our decision to use the non-physician work pool methodology to develop the practice expense RVUs for procedure code 77418 (Intensity Modulated Radiation Therapy).

    We also modeled the effect of adjusting the RVUs to match the new MEI weights. Because we are increasing the malpractice RVUs by approximately 20 percent, adjusting the RVUs to match the new MEI weights will result in an increase in payment for those specialties that perform services with high malpractice RVUs. Payments to cardiac surgery, neurosurgery, orthopedic surgery, thoracic surgery and vascular surgery will increase by approximately 1 percent. The column labeled “Total” shows the impact of all changes that we are making to the work and practice expense RVUs for 2004.

    Start Printed Page 63255

    Table 26.—Impact of Physician Fee Schedule Changes on Total Medicare Allowed Charges by Physician, Practitioner and Supplier Subcategory

    SpecialtyMedicare allowed charges (millions)NPRM (percent)Practice expense refinements (percent)Adjusting RVUs to match MEI weights (percent)Total (percent)
    Physicians:
    ALLERGY/IMMUNOLOGY$153−1−10−2
    ANESTHESIOLOGY1,3270000
    CARDIAC SURGERY3210010
    CARDIOLOGY5,7590000
    CLINICS1,1670000
    COLON AND RECTAL SURGERY1011001
    CRITICAL CARE108−100−1
    DERMATOLOGY1,7080000
    EMERGENCY MEDICINE1,4440000
    ENDOCRINOLOGY2461001
    FAMILY PRACTICE4,0051001
    GASTROENTEROLOGY1,513−100−1
    GENERAL PRACTICE9540000
    GENERAL SURGERY2,110−1000
    GERIATRICS97−1100
    HAND SURGERY46−200−2
    HEMATOLOGY/ONCOLOGY1,0861001
    INFECTIOUS DISEASE3360000
    INTERNAL MEDICINE7,9171001
    INTERVENTIONAL RADIOLOGY1550−100
    NEPHROLOGY1,1870000
    NEUROLOGY1,0721001
    NEUROSURGERY4330011
    OBSTETRICS/GYNECOLOGY5501001
    OPHTHALMOLOGY4,291−100−1
    ORTHOPEDIC SURGERY2,645−201−1
    OTOLARNGOLOGY7352103
    PATHOLOGY7990000
    PEDIATRICS580000
    PHYSICAL MEDICINE5941001
    PLASTIC SURGERY2740000
    PSYCHIATRY1,0730000
    PULMONARY DISEASE1,305−100−1
    RADIATION ONCOLOGY1,002−3200
    RADIOLOGY4,2300000
    RHEUMATOLOGY3521001
    THORACIC SURGERY446−1010
    UROLOGY1,5402001
    VASCULAR SURGERY429−1010
    Practitioners:
    AUDIOLOGIST25−1−21−1
    CHIROPRACTOR5890000
    CLINICAL PSYCHOLOGIST4490000
    CLINICAL SOCIAL WORKER2770000
    NURSE ANESTHETIST4520011
    NURSE PRACTITIONER434−1100
    OPTOMETRY6111000
    ORAL/MAXILLOFACIAL SURGERY338008
    PHYSICAL/OCCUPATIONAL THERAPY8350010
    PHYSICIANS ASSISTANT3220000
    PODIATRY1,307−100−1
    Suppliers:
    DIAGNOSTIC TESTING FACILITY7280000
    INDEPENDENT LABORATORY5082001
    PORTABLE X-RAY SUPPLIER82−1100
    Other:
    ALL OTHER540000
    ALL PHYSICIAN FEE SCHEDULE60,3850000

    The statutory methodology for updating physician fee schedule conversion factor is specified in section 1848(d)(4) of the Act. Consistent with the requirements of section 1848(d)(4) of the Act, as explained in section VI of this final rule, we are reducing the physician fee schedule conversion factor by approximately 4.5 percent. In table 27, we are showing the estimated change in average payments by specialty based on provisions of this final rule Start Printed Page 63256and the estimated physician fee schedule update.

    Table 27.—Impact of Physician Fee Schedule Changes on Total Medicare Allowed Charges by Physician, Practitioner, and Supplier Subcategory Including the Effect of the Physician Fee Schedule Update

    SpecialtyMedicare allowed charges (millions)Impact of RVU changes (percent)Physician fee schedule update (percent)Total (percent)
    Physicians:
    ALLERGY/IMMUNOLOGY$153−2−4.5−6
    ANESTHESIOLOGY1,3270−4.5−4
    CARDIAC SURGERY3210−4.5−4
    CARDIOLOGY5,7590−4.5−4
    CLINICS1,1670−4.5−4
    COLON AND RECTAL SURGERY1011−4.5−4
    CRITICAL CARE108−1−4.5−5
    DERMATOLOGY1,7080−4.5−5
    EMERGENCY MEDICINE1,4440−4.5−4
    ENDOCRINOLOGY2461−4.5−4
    FAMILY PRACTICE4,0051−4.5−4
    GASTROENTEROLOGY1,513−1−4.5−5
    GENERAL PRACTICE9540−4.5−4
    GENERAL SURGERY2,1100−4.5−5
    GERIATRICS970−4.5−5
    HAND SURGERY46−2−4.5−7
    HEMATOLOGY/ONCOLOGY1,0861−4.5−4
    INFECTIOUS DISEASE3360−4.5−5
    INTERNAL MEDICINE7,9171−4.5−4
    INTERVENTIONAL RADIOLOGY1550−4.5−5
    NEPHROLOGY1,1870−4.5−5
    NEUROLOGY1,0721−4.5−3
    NEUROSURGERY4331−4.5−4
    OBSTETRICS/GYNECOLOGY5501−4.5−4
    OPHTHALMOLOGY4,291−1−4.5−5
    ORTHOPEDIC SURGERY2,645−1−4.5−6
    OTOLARNGOLOGY7353−4.5−2
    PATHOLOGY7990−4.5−4
    PEDIATRICS580−4.5−4
    PHYSICAL MEDICINE5941−4.5−4
    PLASTIC SURGERY2740−4.5−4
    PSYCHIATRY1,0730−4.5−5
    PULMONARY DISEASE1,305−1−4.5−6
    RADIATION ONCOLOGY1,0020−4.5−5
    RADIOLOGY4,2300−4.5−5
    RHEUMATOLOGY3521−4.5−3
    THORACIC SURGERY4460−4.5−4
    UROLOGY1,5401−4.5−3
    VASCULAR SURGERY4290−4.5−5
    Practitioners:
    AUDIOLOGIST25−1−4.5−6
    CHIROPRACTOR5890−4.5−4
    CLINICAL PSYCHOLOGIST4490−4.5−5
    CLINICAL SOCIAL WORKER2770−4.5−5
    NURSE ANESTHETIST4521−4.5−4
    NURSE PRACTITIONER4340−4.5−4
    OPTOMETRY6110−4.5−4
    ORAL/MAXILLOFACIAL SURGERY338−4.53
    PHYSICAL/OCCUPATIONAL THERAPY8350−4.5−4
    PHYSICIANS ASSISTANT3220−4.5−4
    PODIATRY1,307−1−4.5−5
    Suppliers:
    DIAGNOSTIC TESTING FACILITY7280−4.5−5
    INDEPENDENT LABORATORY5081−4.5−3
    PORTABLE X-RAY SUPPLIER820−4.5−4
    Other:
    ALL OTHER540−4.5−4
    ALL PHYSICIAN FEE SCHEDULE60,3850−4.5−4
    Start Printed Page 63257

    Table 28 shows the impact on payments for selected high volume procedures of all of the changes previously discussed. This table shows the combined impact of the change in the work, practice expense and malpractice RVUs and the estimated physician fee schedule update on total payment for the procedure. There are separate columns that show the change in the facility rates and the non-facility rates. For an explanation of facility and non-facility practice expense refer to § 414.22(b)(5)(i).

    Table 28.—Impact of Final Rule and Physician Fee Schedule Update on Medicare Payment for Selected Procedures

    HCPCSMODDESCNon-FacilityFacility
    OldNew% changeOldNew% change
    11721Debride nail, 6 or more$37.52$36.19−429.0628.11−3
    17000Destroy benign/premlg lesion61.4357.27−733.1133.732
    27130Total hip arthroplastyN/AN/AN/A1,343.411,290.82−4
    27236Treat thigh fractureN/AN/AN/A1,068.991,024.86−4
    27244Treat thigh fractureN/AN/AN/A1,155.441,050.15−9
    27447Total knee arthroplastyN/AN/AN/A1,445.671,390.25−4
    33533CABG, arterial, singleN/AN/AN/A1,799.181,742.99−3
    35301Rechanneling of arteryN/AN/AN/A1,073.771,043.83−3
    43239Upper GI endoscopy, biopsy337.69305.31−10155.97150.02−4
    45385Lesion removal colonoscopy545.53471.85−14290.61271.23−7
    66821After cataract laser surgery231.01227.32−2214.83224.154
    66984Cataract surg w/iol, 1 stageN/AN/AN/A672.81645.06−4
    67210Treatment of retinal lesion604.39544.58−10548.47528.41−4
    7101026Chest x-ray9.208.78−59.208.78−5
    7102026Chest x-ray11.0410.54−511.0410.54−5
    76091Mammogram, both breasts94.1789.94−4N/AN/AN/A
    7609126Mammogram, both breasts44.1442.16−444.1442.16−4
    76092Mammogram, screening82.7779.40−4N/AN/AN/A
    7609226Mammogram, screening36.0534.08−536.0534.08−5
    77427Radiation tx management, x5168.11158.81−6168.11158.81−6
    7846526Heart image (3d), multiple75.4171.67−575.4171.67−5
    8830526Tissue exam by pathologist40.8339.00−440.8339.00−4
    90801Psy dx interview148.98141.94−5140.52133.16−5
    90806Psytx, off, 45-50 min96.3891.70−592.7088.54−4
    90807Psytx, off, 45-50 min w/e&m102.6397.32−5100.0695.21−5
    90862Medication management50.7648.13−547.8245.32−5
    90935Hemodialysis, one evaluationN/AN/AN/A71.3667.81−5
    92004Eye exam, new patient123.60119.46−388.2983.62−5
    92012Eye exam established pat61.4360.08−236.0534.08−5
    92014Eye exam & treatment91.6088.19−458.8655.86−5
    92980Insert intracoronary stentN/AN/AN/A800.45763.81−5
    92982Coronary artery dilationN/AN/AN/A594.46566.71−5
    93000Electrocardiogram, complete26.1224.95−2N/AN/AN/A
    93010Electrocardiogram report8.838.43−58.838.43−5
    93015Cardiovascular stress test104.1099.78−4N/AN/AN/A
    9330726Echo exam of heart48.1946.03−448.1946.03−4
    9351026Left heart catheterization231.38237.863231.38237.863
    98941Chiropractic manipulation35.6834.08−431.2729.86−5
    99203Office/outpatient visit, new92.7090.65−270.2667.46−4
    99204Office/outpatient visit, new132.06128.24−3103.7499.08−4
    99205Office/outpatient visit, new168.48161.97−4137.58130.70−5
    99211Office/outpatient visit, est20.6020.7318.838.43−5
    99212Office/outpatient visit, est36.4236.19−123.1722.13−4
    99213Office/outpatient visit, est51.1349.89−234.5833.03−4
    99214Office/outpatient visit, est79.8277.29−356.6553.75−5
    99215Office/outpatient visit, est116.98112.43−491.2386.78−5
    99221Initial hospital careN/AN/AN/A65.8562.54−5
    99222Initial hospital careN/AN/AN/A109.25104.00−5
    99223Initial hospital careN/AN/AN/A151.92144.75−5
    99231Subsequent hospital careN/AN/AN/A32.7431.27−4
    99232Subsequent hospital careN/AN/AN/A54.0751.30−5
    99233Subsequent hospital careN/AN/AN/A76.8873.43−4
    99236Observ/hosp same dateN/AN/AN/A216.67211.86−2
    99238Hospital discharge dayN/AN/AN/A69.1665.70−5
    99239Hospital discharge dayN/AN/AN/A93.8089.24−5
    99241Office consultation47.4547.08−133.1131.97−3
    99242Office consultation88.2986.08−368.0565.35−4
    99243Office consultation116.61113.83−290.4986.43−4
    99244Office consultation165.90160.91−3134.27127.89−5
    99245Office consultation215.20206.94−4177.67169.35−5
    99251Initial inpatient consultN/AN/AN/A34.9533.73−3
    99252Initial inpatient consultN/AN/AN/A70.2667.46−4
    99253Initial inpatient consultN/AN/AN/A96.0191.35−5
    Start Printed Page 63258
    99254Initial inpatient consultN/AN/AN/A137.95131.05−5
    99255Initial inpatient consultN/AN/AN/A189.81180.94−5
    99261Follow-up inpatient consultN/AN/AN/A22.0720.73−6
    99262Follow-up inpatient consultN/AN/AN/A43.7742.16−4
    99263Follow-up inpatient consultN/AN/AN/A65.1162.19−4
    99282Emergency dept visitN/AN/AN/A26.8526.00−3
    99283Emergency dept visitN/AN/AN/A60.3357.62−4
    99284Emergency dept visitN/AN/AN/A94.1789.94−4
    99285Emergency dept visitN/AN/AN/A146.77140.18−4
    99291Critical care, first hour210.05229.079200.11191.13−4
    99292Critical care, add'l 30 min107.78101.19−6100.0695.21−5
    99301Nursing facility care71.0067.46−561.0657.97−5
    99302Nursing facility care96.7592.05−581.3077.65−4
    99303Nursing facility care119.92114.19−5101.1696.27−5
    99311Nursing fac care, subseq40.8339.00−430.5328.81−6
    99312Nursing fac care, subseq62.5459.38−550.4048.13−5
    99313Nursing fac care, subseq85.7181.16−571.7368.16−5
    99348Home visit, est patient74.3170.62−5N/AN/AN/A
    99350Home visit, est patient167.74160.21−4N/AN/AN/A
    G0317ESRDrelsvc 4+/mo; 20+yr262.28285.299262.28285.299
    G0318ESRDrelsvc 2-3/mo; 20+yr262.28237.51−9262.28237.51−9
    G0319ESRDrelsvc 1/mo; 20+yr262.28190.07−28262.28190.07−28

    B. Geographic Practice Cost Index Changes

    Section 1848(e)(1)(A) of the Act requires that payments under the Medicare physician fee schedule vary among payment areas only to the extent that area costs vary as reflected by the area GPCIs. The GPCIs measure areas cost differences in the three components of the physician fee schedule: Physician work, practice expenses, and malpractice insurance. Section 1848(e)(1)(C) of the Act requires that the GPCIs be reviewed and, if necessary, revised at least every 3 years. Due to problems with the availability of U.S. Census Bureau data, which is the major resource utilized in both the work and practice expense GPCIs, we have updated only the malpractice GPCI in this regulation.

    The first GPCI revision was implemented in 1995. The second revision was implemented in 1998. The third revision was implemented in 2001. This constitutes the fourth revision to the GPCIs. Section 1848(e)(1)(C) of the Act also requires that GPCI revisions be phased in equally over a 2-year period if more than one year has elapsed since the last adjustment.

    In order to mitigate the volatility associated with malpractice insurance premiums, we reduced the percent change in the malpractice GPCIs by a factor of 50 percent. As directed by the statute, we will implement 1/2 of this change in the first year (CY 2004) and 1/2 of this change in the second year (CY 2005). During this two-year phase-in, we will continue to work with the State Departments of Insurance to obtain the most current malpractice premium data available. As more current data are obtained, we will review and revise the malpractice GPCIs as appropriate.

    An estimate of the 2004 proposed malpractice GPCI changes can be demonstrated by a comparison of area geographic adjustment factors (GAFs). The GAFs are a weighted composite of each area's work, practice expense, and malpractice expense GPCIs using the national GPCI cost share weights. While we do not actually use the GAFs in computing the fee schedule payment for a specific service, they are useful in comparing overall area costs and payments. The actual effect on payment for any specific service will deviate from the GAF to the extent that the service's proportions of work, practice expenses, and malpractice expense RVUs differ from those of the GAF. Table 27 shows the estimated effects of the revised 2004 malpractice GPCIs on area GAFs. As directed by statute, the 2004 GAFs reflect only 1/2 of the impact of the revision to the malpractice GPCIs.

    With the exception of Detroit, Michigan, no locality experienced an increase of more than 1 percent in total payments due to the revision of their malpractice GPCI for 2004. Alternatively, locality specific decreases in total payments due to the revision of the malpractice GPCIs do not exceed 1 percent for any given locality in 2004.

    Table 29.—Revised Geographic Adjustment Factors from Final Rule

    Carrier No.Locality No.Locality name2003 GAF2004 GAFPercent difference
    0051000Alabama0.9270.923−0.4
    0083101Alaska1.1151.113−0.1
    0083200Arizona0.9910.9910.0
    0052013Arkansas0.8890.885−0.4
    3114626Anaheim/Santa Ana, CA1.0961.0980.1
    3114618Los Angeles, CA1.0881.0880.0
    3114003Marin/Napa/Solano, CA1.1031.1040.0
    3114007Oakland/Berkeley, CA1.1121.1110.0
    Start Printed Page 63259
    3114005San Francisco, CA1.2211.2230.2
    3114006San Mateo, CA1.1991.2010.2
    3114009Santa Clara, CA1.1841.1840.1
    3114617Ventura, CA1.0611.060−0.1
    3114699Rest of California*1.0101.008−0.2
    3114099Rest of California*1.0101.008−0.2
    0082401Colorado0.9830.982−0.2
    0059100Connecticut1.0921.0920.0
    0090201Delaware1.0161.0180.2
    0090301DC + MD/VA Suburbs1.0941.0950.1
    0059003Fort Lauderdale, FL1.0341.0360.3
    0059004Miami, FL1.0791.0850.5
    0059099Rest of Florida0.9720.9740.2
    0051101Atlanta, GA1.0261.0270.1
    0051199Rest of Georgia0.9360.935−0.1
    0083301Hawaii/Guam1.0461.0460.0
    0513000Idaho0.9120.907−0.5
    0095216Chicago, IL1.0791.0870.7
    0095212East St. Louis, IL0.9830.9880.5
    0095215Suburban Chicago, IL1.0541.0590.5
    0095299Rest of Illinois0.9390.9400.1
    0063000Indiana0.9400.935−0.5
    0082600Iowa0.9120.909−0.4
    0065000Kansas *0.9280.925−0.3
    0074002Kansas *0.9280.925−0.3
    0066000Kentucky0.9230.921−0.2
    0052801New Orleans, LA0.9850.9840.0
    0052899Rest of Louisiana0.9300.929−0.1
    3114203Southern Maine0.9770.975−0.2
    3114299Rest of Maine0.9300.927−0.3
    0090101Baltimore/Surr. Cntys, MD1.0251.0250.0
    0090199Rest of Maryland0.9720.970−0.2
    3114301Metropolitan Boston1.1171.1180.2
    3114399Rest of Massachusetts1.0531.0540.1
    0095301Detroit, MI1.0951.1061.0
    0095399Rest of Michigan0.9900.9920.2
    0095400Minnesota0.9660.962−0.5
    0051200Mississippi0.9000.896−0.4
    0074004Metropolitan Kansas City, MO0.9740.9750.1
    0052301Metropolitan St. Louis, MO0.9650.9660.0
    0074099Rest of Missouri *0.8900.889−0.1
    0052399Rest of Missouri *0.8900.889−0.1
    0075101Montana0.9120.9130.1
    0065500Nebraska0.9020.898−0.4
    0083400Nevada1.0261.025−0.1
    3114440New Hampshire0.9991.0010.2
    0080501Northern NJ1.1091.1110.2
    0080599Rest of New Jersey1.0581.0600.2
    0052105New Mexico0.9400.938−0.2
    0080301Manhattan, NY1.2211.2250.3
    0080302Nyc Suburbs/Long I., NY1.1741.1790.4
    0080303Poughkpsie/N Nyc Suburbs, NY1.0461.0470.1
    1433004Queens, NY1.1561.1610.4
    0080199Rest of New York0.9680.964−0.4
    0553500North Carolina0.9410.939−0.2
    0082001North Dakota0.9110.907−0.4
    0088300Ohio0.9680.9680.0
    0052200Oklahoma0.9120.907−0.7
    0083501Portland, OR1.0000.998−0.3
    0083599Rest of Oregon0.9320.929−0.4
    0086501Metropolitan Philadelphia, PA1.0641.0670.3
    0086599Rest of Pennsylvania0.9570.955−0.2
    0097320Puerto Rico0.7900.784−0.8
    0087001Rhode Island1.0331.0330.0
    0088001South Carolina0.9220.919−0.4
    0082002South Dakota0.8940.889−0.6
    0544035Tennessee0.9310.928−0.3
    0090031Austin, TX0.9860.9880.2
    0090020Beaumont, TX0.9600.9600.0
    0090009Brazoria, TX0.9970.9990.1
    0090011Dallas, TX1.0311.0330.3
    Start Printed Page 63260
    0090028Fort Worth, TX0.9830.9850.2
    0090015Galveston, TX0.9910.9920.1
    0090018Houston, TX1.0251.0260.1
    0090099Rest of Texas0.9290.9320.2
    0091009Utah0.9510.948−0.2
    3114550Vermont0.9650.962−0.3
    0097350Virgin Islands0.9910.9920.1
    0090400Virginia0.9490.947−0.2
    0083602Seattle (King Cnty), WA1.0381.0380.0
    0083699Rest of Washington0.9710.970−0.1
    0088416West Virginia0.9290.9330.5
    0095100Wisconsin0.9580.954−0.4
    0082521Wyoming0.9380.936−0.2

    C. Tracking Codes

    We are adopting a policy that will allow CMS to create national payment policy and determine national payment amounts for CPT tracking codes regardless of whether a national coverage determination for a specific service has been made. Our policy will have no effect on Medicare expenditures but will allow for more flexibility in determining payment rates for new services.

    D. G Codes for Managing Dialysis Patients

    As previously discussed in section II.D., we have reviewed our current payment policy for the monthly dialysis capitation payment in response to concerns that have been raised over whether our payment policy is consistent with current medical practice. We are establishing new G codes for these services and are aligning Medicare's payment to recognize the higher amount of physician work associated with more frequent face-to-face visits. Aggregated Medicare payments to physicians for treating dialysis patients will not be increased or decreased by the establishment of these new procedure codes. Relative to payment based on the current CPT codes, Medicare payments to physicians for providing fewer than four visits per month will decrease. If the physician provides four or more visits per month, payment will increase. The net effect of these payment changes will not increase or decrease aggregate Medicare payment for physician services provided to dialysis patients.

    E. Rebasing and Revising the MEI

    Section IV.B. of this final rule discusses rebasing and revising the MEI for the CY 2004 physician fee schedule. Substituting the 2000 MEI weights in place of the 1996 weights increases the MEI by 0.1 percent for 2004. After 2004, the MEI in some years is likely to be unaffected by using more recent year weights while other years may have slightly higher increases (between 0.1 to 0.2 percentage points).

    F. Definition of Diabetes for Diabetes Self-Management Training

    In section III.A., we revised the definition of diabetes for purposes of the Outpatient Diabetes Self-Management Training benefit and are using this definition to determine beneficiary eligibility for Medical Nutrition Therapy when the beneficiary has a diagnosis of diabetes. The streamlining of the beneficiary eligibility requirements for Outpatient Diabetes Self-Management Training will reduce administrative burden for the referring physician or qualified non-physician practitioner and for the accredited Outpatient Diabetes Self-Management Training programs by simplifying documentation requirements and eliminating the need for reconsiderations and appeals to clarify that the requirements have been met. As indicated in the February 28, 2003 Federal Register (68 FR 9572), we incorporated an adjustment to the SGR consistent with our original estimates of expenditures associated with this new benefit. Our experience is that expenditures have been less than originally estimated. We expect that simplifying administrative requirements associated with this new benefit will make it more likely that expenditures for diabetes self-management training will be consistent with original estimates and there will be no increase in Medicare expenditures from making these modifications.

    G. Payment Policies for Anesthesia Services

    In section III.D. of this final rule, we discussed Medicare payment for anesthesia services involving anesthesiologists and residents. Effective January 1, 2004, we are revising our teaching anesthesia rules to allow teaching anesthesiologists to bill, similar to teaching CRNAs, for their involvement in two concurrent cases with residents. The policy change will allow anesthesiologists to be paid either under the rules for medical direction or the same way that teaching CRNAs are paid for two concurrent cases. We are uncertain how the practice arrangements of teaching anesthesiologists will change as a result of this new policy. We believe that most teaching anesthesiologists will continue to function under the medical direction practice model for concurrent cases involving residents. Therefore, we believe there will be minimal change in Medicare program expenditures as a result of this change.

    H. Alternatives Considered

    This proposed 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.

    I. 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. While it has been suggested that the negative update for 2004 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. Nevertheless, we remain concerned about the issue and will continue to study the issue to the best of our ability with available resources.

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

    Start List of Subjects Start Printed Page 63261

    List of Subjects

    42 CFR Part 410

    • Health facilities
    • Health professions
    • Kidney diseases,

    42 CFR Part 414

    • Administrative practice and procedure
    • Health facilities
    • Health professions
    • Kidney diseases
    • Medicare
    • Reporting and recordkeeping requirements
    • Rural areas
    • X-rays
    End List of Subjects Start Amendment Part

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

    End Amendment Part 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. Section 410.130 is amended by revising the definition of “Diabetes” to read as follows:

    End Amendment Part
    Definitions
    * * * * *

    Diabetes means diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria: A fasting blood sugar greater than or equal to 126 mg/dL on two different occasions; a 2 hour post-glucose challenge greater than or equal to 200 mg/dL on 2 different occasions; or a random glucose test over 200 mg/dL for a person with symptoms of uncontrolled diabetes.

    * * * * *
    Start Amendment Part

    3. Section 410.140 is amended by adding the definition of “Diabetes” in alphabetical order to read as follows:

    End Amendment Part
    Definitions
    * * * * *

    Diabetes means diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria: A fasting blood sugar greater than or equal to 126 mg/dL on two different occasions; a 2 hour post-glucose challenge greater than or equal to 200 mg/dL on 2 different occasions; or a random glucose test over 200 mg/dL for a person with symptoms of uncontrolled diabetes.

    * * * * *
    Start Amendment Part

    4. Section 410.141 is amended by revising paragraph (d) to read as follows:

    End Amendment Part
    Outpatient diabetes self-management training.
    * * * * *

    (d) Beneficiaries who may be covered. Medicare Part B covers outpatient diabetes self-management training for a beneficiary who has been diagnosed with diabetes.

    * * * * *
    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 414.22(b)(6)(iii) is revised to read as follows:

    End Amendment Part
    Relative value units (RVUs).
    * * * * *

    (b) * * *

    (6) * * *

    (iii) CMS will consider for use in determining practice expense RVUs for the physician fee schedule survey data and related materials submitted to CMS by March 1, 2004 to determine CY 2005 practice expense RVUs and by March 1, 2005 to determine CY 2006 practice expense RVUs.

    * * * * *
    Start Amendment Part

    3. Section 414.46 is amended to—

    End Amendment Part Start Amendment Part

    a. Redesignate paragraphs (e) through (g) as paragraphs (f) through (h), respectively.

    End Amendment Part Start Amendment Part

    b. Add new paragraph (e).

    End Amendment Part Start Amendment Part

    The addition reads as follows:

    End Amendment Part
    Additional rules for payment of anesthesia services.
    * * * * *

    (e) Physicians involved with two concurrent cases with residents. The physician can bill base units and time units based on the amount of time the physician is actually present with the resident during each of two concurrent cases furnished on or after January 1, 2004.

    (1) To bill the base units, the physician must be present with the resident during the pre- and post-anesthesia care included in the base units.

    (2) If the physician is not present with the resident during pre- and post-anesthesia care, then the physician may bill the case as a medically directed case in accordance with paragraph (d) of this section.

    * * * * *

    (Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

    Start Signature

    Dated: October 28, 2003.

    Thomas A Scully,

    Administrator, Centers for Medicare & Medicaid Services.

    Approved: October 28, 2003.

    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 alphanumeric 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, except for alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for non-physicians' services or items), or L (orthotics), and codes for anesthesiology.

    1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum.

    2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier −26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code: One for the global values (both professional and technical); one for modifier −26 (PC); and one for modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service.

    Modifier −53 is shown for a discontinued procedure. There will be RVUs for the code (CPT code 45378) with this modifier.

    3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the physician fee schedule and whether it is separately payable if the service is covered.

    A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an “A” indicator does not mean that Medicare has made a national decision regarding the coverage of Start Printed Page 63262the 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 = Non-covered service. These codes are non-covered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.

    P = Bundled or excluded code. There are no RVUs for these services. No separate payment should be made for them under the physician fee schedule.

    —If the item or service is covered as incident to a physician's service and is furnished on the same day as a physician's service, payment for it is bundled into the payment for the physician's service to which it is incident (an example is an elastic bandage furnished by a physician incident to a physician's service).

    —If the item or service is covered as other than incident to a physician's service, it is excluded from the physician fee schedule (for example, colostomy supplies) and is paid under the other payment provisions of the Act.

    R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced.

    T = 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.

    7. Non-facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for non-facility settings.

    8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 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 that is always included in the global period of the other service. (Note: Physician work and practice expense are associated with intra-service time and in some instances the post-service time.)

    —————————— 1 CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 2003 American Dental Association. All rights reserved. 3 +Indicates RVUs are not used for Medicare payment. Start Printed Page 63262

    Addendum B.—Relative Value Units (RVUS) and Related Information

    CPT1/HCPCS2MODStatusDescriptionPhysician work RVUs3Non-facility PE RVUsFacility PE RVUsMalpractice RVUsNon-facility TotalFacility totalGlobal
    0001TCEndovas repr abdo ao aneurys0.000.000.000.000.000.00XXX
    0002TDendo repair abd aa aorto uni0.000.000.000.000.000.00XXX
    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
    0019TIExtracorp shock wave tx, ms0.000.000.000.000.000.00XXX
    0020TCExtracorp shock wave tx, ft0.000.000.000.000.000.00XXX
    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
    0025TDUltrasonic pachymetry0.000.000.000.000.000.00XXX
    0026TCMeasure remnant lipoproteins0.000.000.000.000.000.00XXX
    Start Printed Page 63263
    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
    0045TCWhole body photography0.000.000.000.000.000.00XXX
    0046TCCath lavage, mammary duct(s0.000.000.000.000.000.00XXX
    0047TCCath lavage, mammary duct(s)0.000.000.000.000.000.00XXX
    0048TCImplant ventricular device0.000.000.000.000.000.00XXX
    0049TCExternal circulation assist0.000.000.000.000.000.00XXX
    0050TCRemoval circulation assist0.000.000.000.000.000.00XXX
    0051TCImplant total heart system0.000.000.000.000.000.00XXX
    0052TCReplace component heart syst0.000.000.000.000.000.00XXX
    0053TCReplace component heart syst0.000.000.000.000.000.00XXX
    0054TCBone surgery using computer0.000.000.000.000.000.00XXX
    0055TCBone surgery using computer0.000.000.000.000.000.00XXX
    0056TCBone surgery using computer0.000.000.000.000.000.00XXX
    0057TCUppr gi scope w/ thrml txmnt0.000.000.000.000.000.00XXX
    0058TCCryopreservation, ovary tiss0.000.000.000.000.000.00XXX
    0059TCCryopreservation, oocyte0.000.000.000.000.000.00XXX
    0060TCElectrical impedance scan0.000.000.000.000.000.00XXX
    0061TCDestruction of tumor, breast0.000.000.000.000.000.00XXX
    10021AFna w/o image1.262.220.550.083.561.89XXX
    10022AFna w/image1.262.650.430.063.971.75XXX
    10040AAcne surgery1.171.020.680.062.251.91010
    10060ADrainage of skin abscess1.161.220.950.102.482.21010
    10061ADrainage of skin abscess2.391.841.530.204.434.12010
    10080ADrainage of pilonidal cyst1.163.191.160.114.462.43010
    10081ADrainage of pilonidal cyst2.444.161.530.236.834.20010
    10120ARemove foreign body1.211.480.420.122.811.75010
    10121ARemove foreign body2.673.361.910.306.334.88010
    10140ADrainage of hematoma/fluid1.521.530.910.183.232.61010
    10160APuncture drainage of lesion1.190.730.470.132.051.79010
    10180AComplex drainage, wound2.243.272.090.305.814.63010
    11000ADebride infected skin0.600.580.220.061.240.88000
    11001ADebride infected skin add-on0.300.230.110.020.550.43ZZZ
    11010ADebride skin, fx4.186.802.350.5411.527.07010
    11011ADebride skin/muscle, fx4.928.122.390.6413.687.95000
    11012ADebride skin/muscle/bone, fx6.8412.023.901.0719.9311.81000
    11040ADebride skin, partial0.500.520.210.061.080.77000
    11041ADebride skin, full0.820.650.330.071.541.22000
    11042ADebride skin/tissue1.110.980.470.112.201.69000
    11043ADebride tissue/muscle2.373.472.630.296.135.29010
    11044ADebride tissue/muscle/bone3.044.583.800.418.037.25010
    11055RTrim skin lesion0.430.560.170.021.010.62000
    11056RTrim skin lesions, 2 to 40.610.640.240.041.290.89000
    11057RTrim skin lesions, over 40.790.730.310.051.571.15000
    11100ABiopsy, skin lesion0.811.270.370.052.131.23000
    11101ABiopsy, skin add-on0.410.340.190.020.770.62ZZZ
    11200ARemoval of skin tags0.771.070.780.051.891.60010
    11201ARemove skin tags add-on0.290.160.120.020.470.43ZZZ
    11300AShave skin lesion0.511.010.220.041.560.77000
    11301AShave skin lesion0.851.130.380.052.031.28000
    11302AShave skin lesion1.041.320.470.062.421.57000
    11303AShave skin lesion1.231.610.530.072.911.83000
    11305AShave skin lesion0.670.850.270.051.570.99000
    11306AShave skin lesion0.981.120.430.062.161.47000
    11307AShave skin lesion1.131.310.500.062.501.69000
    11308AShave skin lesion1.401.470.610.082.952.09000
    11310AShave skin lesion0.731.140.330.051.921.11000
    11311AShave skin lesion1.041.260.500.062.361.60000
    11312AShave skin lesion1.191.460.560.072.721.82000
    Start Printed Page 63264
    11313AShave skin lesion1.611.840.720.113.562.44000
    11400AExc tr-ext b9+marg 0.5 < cm0.852.040.900.072.961.82010
    11401AExc tr-ext b9+marg 0.6-1 cm1.222.101.040.113.432.37010
    11402AExc tr-ext b9+marg 1.1-2 cm1.502.271.100.143.912.74010
    11403AExc tr-ext b9+marg 2.1-3 cm1.782.451.350.194.423.32010
    11404AExc tr-ext b9+marg 3.1-4 cm2.052.771.430.225.043.70010
    11406AExc tr-ext b9+marg 4.0 cm2.743.141.690.306.184.73010
    11420AExc h-f-nk-sp b9+marg 0.5 <0.971.800.940.102.872.01010
    11421AExc h-f-nk-sp b9+marg 0.6-11.412.101.130.133.642.67010
    11422AExc h-f-nk-sp b9+marg 1.1-21.622.301.360.174.093.15010
    11423AExc h-f-nk-sp b9+marg 2.1-32.002.641.480.204.843.68010
    11424AExc h-f-nk-sp b9+marg 3.1-42.422.861.630.255.534.30010
    11426AExc h-f-nk-sp b9+marg > 4 cm3.763.572.130.417.746.30010
    11440AExc face-mm b9+marg 0.5 < cm1.052.311.350.103.462.50010
    11441AExc face-mm b9+marg 0.6-1 cm1.472.421.530.134.023.13010
    11442AExc face-mm b9+marg 1.1-2 cm1.712.621.600.174.503.48010
    11443AExc face-mm b9+marg 2.1-3 cm2.283.011.850.225.514.35010
    11444AExc face-mm b9+marg 3.1-4 cm3.123.582.210.307.005.63010
    11446AExc face-mm b9+marg > 4 cm4.464.162.820.368.987.64010
    11450ARemoval, sweat gland lesion2.715.202.060.318.225.08090
    11451ARemoval, sweat gland lesion3.936.842.590.4711.246.99090
    11462ARemoval, sweat gland lesion2.505.292.040.288.074.82090
    11463ARemoval, sweat gland lesion3.937.082.730.4811.497.14090
    11470ARemoval, sweat gland lesion3.235.232.300.368.825.89090
    11471ARemoval, sweat gland lesion4.386.962.820.4811.827.68090
    11600AExc tr-ext mlg+marg 0.5 < cm1.302.700.990.114.112.40010
    11601AExc tr-ext mlg+marg 0.6-1 cm1.792.761.240.144.693.17010
    11602AExc tr-ext mlg+marg 1.1-2 cm1.942.901.290.165.003.39010
    11603AExc tr-ext mlg+marg 2.1-3 cm2.183.151.350.195.523.72010
    11604AExc tr-ext mlg+marg 3.1-4 cm2.393.461.420.226.074.03010
    11606AExc tr-ext mlg+marg > 4 cm3.414.161.770.347.915.52010
    11620AExc h-f-nk-sp mlg+marg 0.5 <1.182.660.970.113.952.26010
    11621AExc h-f-nk-sp mlg+marg 0.6-11.752.771.260.144.663.15010
    11622AExc h-f-nk-sp mlg+marg 1.1-22.083.041.410.185.303.67010
    11623AExc h-f-nk-sp mlg+marg 2.1-32.603.411.610.246.254.45010
    11624AExc h-f-nk-sp mlg+marg 3.1-43.043.831.800.307.175.14010
    11626AExc h-f-nk-sp mlg+mar > 4 cm4.284.742.430.429.447.13010
    11640AExc face-mm malig+marg 0.5 <1.342.731.130.124.192.59010
    11641AExc face-mm malig+marg 0.6-12.153.101.550.185.433.88010
    11642AExc face-mm malig+marg 1.1-22.583.481.750.226.284.55010
    11643AExc face-mm malig+marg 2.1-33.083.891.980.297.265.35010
    11644AExc face-mm malig+marg 3.1-44.014.792.490.409.206.90010
    11646AExc face-mm mlg+marg > 4 cm5.925.873.530.5512.3410.00010
    11719RTrim nail(s)0.170.250.070.010.430.25000
    11720ADebride nail, 1-50.320.340.130.020.680.47000
    11721ADebride nail, 6 or more0.540.440.210.051.030.80000
    11730ARemoval of nail plate1.121.030.440.112.261.67000
    11732ARemove nail plate, add-on0.570.450.230.061.080.86ZZZ
    11740ADrain blood from under nail0.370.860.140.041.270.55000
    11750ARemoval of nail bed1.852.151.750.194.193.79010
    11752ARemove nail bed/finger tip2.652.992.990.406.046.04010
    11755ABiopsy, nail unit1.301.100.560.072.471.93000
    11760ARepair of nail bed1.571.861.230.203.633.00010
    11762AReconstruction of nail bed2.872.291.850.385.545.10010
    11765AExcision of nail fold, toe0.691.160.530.061.911.28010
    11770ARemoval of pilonidal lesion2.603.581.530.296.474.42010
    11771ARemoval of pilonidal lesion5.715.793.360.6712.179.74090
    11772ARemoval of pilonidal lesion6.947.273.900.8215.0311.66090
    11900AInjection into skin lesions0.520.660.220.021.200.76000
    11901AAdded skin lesions injection0.800.670.360.041.511.20000
    11920RCorrect skin color defects1.602.010.780.203.812.58000
    11921RCorrect skin color defects1.922.380.980.254.553.15000
    11922RCorrect skin color defects0.490.380.250.060.930.80ZZZ
    11950RTherapy for contour defects0.841.170.420.072.081.33000
    11951RTherapy for contour defects1.181.510.520.122.811.82000
    11952RTherapy for contour defects1.681.890.690.203.772.57000
    11954RTherapy for contour defects1.842.460.910.234.532.98000
    11960AInsert tissue expander(s)9.03NA10.651.05NA20.73090
    11970AReplace tissue expander7.02NA6.160.92NA14.10090
    11971ARemove tissue expander(s)2.127.204.810.259.577.18090
    11975NInsert contraceptive cap+1.471.430.580.173.072.22XXX
    11976RRemoval of contraceptive cap1.771.720.690.203.692.66000
    11977NRemoval/reinsert contra cap+3.282.281.270.375.934.92XXX
    11980AImplant hormone pellet(s)1.471.110.560.122.702.15000
    11981AInsert drug implant device1.471.760.690.173.402.33XXX
    Start Printed Page 63265
    11982ARemove drug implant device1.771.990.850.203.962.82XXX
    11983ARemove/insert drug implant3.282.341.490.375.995.14XXX
    12001ARepair superficial wound(s)1.692.040.500.163.892.35010
    12002ARepair superficial wound(s)1.852.100.950.184.132.98010
    12004ARepair superficial wound(s)2.232.401.060.204.833.49010
    12005ARepair superficial wound(s)2.842.901.250.286.024.37010
    12006ARepair superficial wound(s)3.653.481.560.377.505.58010
    12007ARepair superficial wound(s)4.103.911.860.448.456.40010
    12011ARepair superficial wound(s)1.752.200.510.174.122.43010
    12013ARepair superficial wound(s)1.982.350.980.194.523.15010
    12014ARepair superficial wound(s)2.452.651.110.225.323.78010
    12015ARepair superficial wound(s)3.173.231.300.296.694.76010
    12016ARepair superficial wound(s)3.913.651.580.387.945.87010
    12017ARepair superficial wound(s)4.68NA1.930.47NA7.08010
    12018ARepair superficial wound(s)5.50NA2.300.55NA8.35010
    12020AClosure of split wound2.612.701.770.295.604.67010
    12021AClosure of split wound1.831.771.420.233.833.48010
    12031ALayer closure of wound(s)2.142.330.820.184.653.14010
    12032ALayer closure of wound(s)2.463.931.860.186.574.50010
    12034ALayer closure of wound(s)2.903.211.430.256.364.58010
    12035ALayer closure of wound(s)3.415.342.210.369.115.98010
    12036ALayer closure of wound(s)4.035.432.410.499.956.93010
    12037ALayer closure of wound(s)4.646.522.810.5911.758.04010
    12041ALayer closure of wound(s)2.362.500.870.205.063.43010
    12042ALayer closure of wound(s)2.723.241.390.206.164.31010
    12044ALayer closure of wound(s)3.123.241.580.296.654.99010
    12045ALayer closure of wound(s)3.623.722.200.417.756.23010
    12046ALayer closure of wound(s)4.236.682.800.4811.397.51010
    12047ALayer closure of wound(s)4.626.543.130.4911.658.24010
    12051ALayer closure of wound(s)2.463.261.380.195.914.03010
    12052ALayer closure of wound(s)2.753.211.360.206.164.31010
    12053ALayer closure of wound(s)3.103.251.520.246.594.86010
    12054ALayer closure of wound(s)3.443.591.620.307.335.36010
    12055ALayer closure of wound(s)4.404.592.160.429.416.98010
    12056ALayer closure of wound(s)5.216.853.110.5212.588.84010
    12057ALayer closure of wound(s)5.936.183.800.6012.7110.33010
    13100ARepair of wound or lesion3.103.551.800.256.905.15010
    13101ARepair of wound or lesion3.903.792.240.267.956.40010
    13102ARepair wound/lesion add-on1.230.740.580.122.091.93ZZZ
    13120ARepair of wound or lesion3.283.651.840.287.215.40010
    13121ARepair of wound or lesion4.314.012.340.308.626.95010
    13122ARepair wound/lesion add-on1.430.870.640.142.442.21ZZZ
    13131ARepair of wound or lesion3.773.922.160.307.996.23010
    13132ARepair of wound or lesion5.924.733.210.3811.039.51010
    13133ARepair wound/lesion add-on2.181.211.040.203.593.42ZZZ
    13150ARepair of wound or lesion3.795.562.630.359.706.77010
    13151ARepair of wound or lesion4.425.463.070.3410.227.83010
    13152ARepair of wound or lesion6.296.143.970.4612.8910.72010
    13153ARepair wound/lesion add-on2.371.361.150.223.953.74ZZZ
    13160ALate closure of wound10.42NA7.191.43NA19.04090
    14000ASkin tissue rearrangement5.868.615.180.5515.0211.59090
    14001ASkin tissue rearrangement8.4210.066.660.7819.2615.86090
    14020ASkin tissue rearrangement6.559.276.050.6016.4213.20090
    14021ASkin tissue rearrangement10.0010.567.820.8321.3918.65090
    14040ASkin tissue rearrangement7.838.356.940.6616.8415.43090
    14041ASkin tissue rearrangement11.4210.768.780.8523.0321.05090
    14060ASkin tissue rearrangement8.459.187.770.7118.3416.93090
    14061ASkin tissue rearrangement12.2211.799.620.9024.9122.74090
    14300ASkin tissue rearrangement11.6911.319.271.0524.0522.01090
    14350ASkin tissue rearrangement9.56NA7.201.31NA18.07090
    15000ASkin graft3.983.852.220.448.276.64000
    15001ASkin graft add-on0.991.380.420.132.501.54ZZZ
    15050ASkin pinch graft4.286.034.780.5510.869.61090
    15100ASkin split graft9.0012.777.881.1322.9018.01090
    15101ASkin split graft add-on1.713.881.680.225.813.61ZZZ
    15120ASkin split graft9.7710.907.861.0821.7518.71090
    15121ASkin split graft add-on2.654.631.900.327.604.87ZZZ
    15200ASkin full graft7.9810.836.060.8719.6814.91090
    15201ASkin full graft add-on1.311.050.630.172.532.11ZZZ
    15220ASkin full graft7.8310.716.510.8219.3615.16090
    15221ASkin full graft add-on1.180.910.580.142.231.90ZZZ
    15240ASkin full graft8.9910.277.730.9620.2217.68090
    15241ASkin full graft add-on1.851.460.920.203.512.97ZZZ
    15260ASkin full graft10.009.988.700.7620.7419.46090
    15261ASkin full graft add-on2.222.751.440.205.173.86ZZZ
    Start Printed Page 63266
    15342ACultured skin graft, 25 cm0.991.840.560.112.941.66010
    15343ACulture skn graft addl 25 cm0.250.270.100.020.540.37ZZZ
    15350ASkin homograft3.988.314.880.5012.799.36090
    15351ASkin homograft add-on0.990.950.400.132.071.52ZZZ
    15400ASkin heterograft3.984.214.130.488.678.59090
    15401ASkin heterograft add-on0.991.230.450.132.351.57ZZZ
    15570AForm skin pedicle flap9.169.276.741.1519.5817.05090
    15572AForm skin pedicle flap9.228.486.321.1118.8116.65090
    15574AForm skin pedicle flap9.828.897.021.1019.8117.94090
    15576AForm skin pedicle flap8.649.516.490.8619.0115.99090
    15600ASkin graft1.907.172.730.239.304.86090
    15610ASkin graft2.413.783.070.306.495.78090
    15620ASkin graft2.927.543.710.3410.806.97090
    15630ASkin graft3.256.923.980.3410.517.57090
    15650ATransfer skin pedicle flap3.956.794.060.4311.178.44090
    15732AMuscle-skin graft, head/neck17.7418.2412.341.8037.7831.88090
    15734AMuscle-skin graft, trunk17.6918.1312.442.2938.1132.42090
    15736AMuscle-skin graft, arm16.1818.3511.332.1336.6629.64090
    15738AMuscle-skin graft, leg17.8218.1411.862.3438.3032.02090
    15740AIsland pedicle flap graft10.199.927.970.7420.8518.90090
    15750ANeurovascular pedicle graft11.34NA9.091.39NA21.82090
    15756AFree myo/skin flap microvasc35.03NA20.933.73NA59.69090
    15757AFree skin flap, microvasc35.03NA21.964.04NA61.03090
    15758AFree fascial flap, microvasc34.90NA21.954.22NA61.07090
    15760AComposite skin graft8.699.827.090.8619.3716.64090
    15770ADerma-fat-fascia graft7.48NA6.770.93NA15.18090
    15775RHair transplant punch grafts3.942.821.340.527.285.80000
    15776RHair transplant punch grafts5.515.442.850.7211.679.08000
    15780AAbrasion treatment of skin7.257.167.160.4914.9014.90090
    15781AAbrasion treatment of skin4.825.415.410.3210.5510.55090
    15782AAbrasion treatment of skin4.304.384.380.258.938.93090
    15783AAbrasion treatment of skin4.274.984.220.319.568.80090
    15786AAbrasion, lesion, single2.021.651.290.133.803.44010
    15787AAbrasion, lesions, add-on0.330.320.160.020.670.51ZZZ
    15788RChemical peel, face, epiderm2.083.382.290.135.594.50090
    15789RChemical peel, face, dermal4.896.485.020.3211.6910.23090
    15792RChemical peel, nonfacial1.853.212.790.125.184.76090
    15793AChemical peel, nonfacial3.72NA4.200.20NA8.12090
    15810ASalabrasion4.713.943.940.509.159.15090
    15811ASalabrasion5.366.375.580.6212.3511.56090
    15819APlastic surgery, neck9.33NA7.280.92NA17.53090
    15820ARevision of lower eyelid5.126.925.400.3612.4010.88090
    15821ARevision of lower eyelid5.697.315.580.3713.3711.64090
    15822ARevision of upper eyelid4.425.874.410.2610.559.09090
    15823ARevision of upper eyelid7.017.866.290.3815.2513.68090
    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 tissue12.33NA8.321.56NA22.21090
    15832AExcise excessive skin tissue11.52NA8.461.45NA21.43090
    15833AExcise excessive skin tissue10.58NA8.181.40NA20.16090
    15834AExcise excessive skin tissue10.79NA7.751.41NA19.95090
    15835AExcise excessive skin tissue11.6011.587.711.3524.5320.66090
    15836AExcise excessive skin tissue9.29NA6.881.14NA17.31090
    15837AExcise excessive skin tissue8.388.017.080.9317.3216.39090
    15838AExcise excessive skin tissue7.09NA6.150.70NA13.94090
    15839AExcise excessive skin tissue9.337.956.271.0518.3316.65090
    15840AGraft for face nerve palsy13.18NA10.151.38NA24.71090
    15841AGraft for face nerve palsy23.13NA15.243.18NA41.55090
    15842AFlap for face nerve palsy37.74NA23.294.78NA65.81090
    15845ASkin and muscle repair, face12.50NA9.470.96NA22.93090
    15850BRemoval of sutures+0.781.610.300.052.441.13XXX
    15851ARemoval of sutures0.861.750.340.062.671.26000
    15852ADressing change not for burn0.861.880.360.082.821.30000
    15860ATest for blood flow in graft1.941.290.790.163.392.89000
    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 ulcer7.90NA5.660.99NA14.55090
    15922ARemoval of tail bone ulcer9.84NA7.391.27NA18.50090
    15931ARemove sacrum pressure sore9.19NA5.801.14NA16.13090
    15933ARemove sacrum pressure sore10.79NA8.031.37NA20.19090
    Start Printed Page 63267
    15934ARemove sacrum pressure sore12.62NA8.241.62NA22.48090
    15935ARemove sacrum pressure sore14.49NA10.521.87NA26.88090
    15936ARemove sacrum pressure sore12.31NA8.441.58NA22.33090
    15937ARemove sacrum pressure sore14.13NA10.061.81NA26.00090
    15940ARemove hip pressure sore9.29NA6.291.17NA16.75090
    15941ARemove hip pressure sore11.36NA9.681.47NA22.51090
    15944ARemove hip pressure sore11.39NA8.801.45NA21.64090
    15945ARemove hip pressure sore12.62NA9.841.65NA24.11090
    15946ARemove hip pressure sore21.45NA14.572.78NA38.80090
    15950ARemove thigh pressure sore7.50NA5.520.96NA13.98090
    15951ARemove thigh pressure sore10.66NA8.041.37NA20.07090
    15952ARemove thigh pressure sore11.33NA7.911.43NA20.67090
    15953ARemove thigh pressure sore12.56NA9.161.65NA23.37090
    15956ARemove thigh pressure sore15.43NA10.951.97NA28.35090
    15958ARemove thigh pressure sore15.39NA11.241.99NA28.62090
    15999CRemoval of pressure sore0.000.000.000.000.000.00YYY
    16000AInitial treatment of burn(s)0.880.870.270.071.821.22000
    16010ATreatment of burn(s)0.870.670.640.081.621.59000
    16015ATreatment of burn(s)2.34NA1.170.26NA3.77000
    16020ATreatment of burn(s)0.801.300.620.072.171.49000
    16025ATreatment of burn(s)1.841.820.980.193.853.01000
    16030ATreatment of burn(s)2.072.231.140.224.523.43000
    16035AIncision of burn scab, initi3.73NA1.480.43NA5.64090
    16036AEscharotomy; addl incision1.49NA0.610.13NA2.23ZZZ
    17000ADestroy benign/premlg lesion0.600.990.320.041.630.96010
    17003ADestroy lesions, 2-140.150.110.070.010.270.23ZZZ
    17004ADestroy lesions, 15 or more2.772.341.310.145.254.22010
    17106ADestruction of skin lesions4.564.933.370.349.838.27090
    17107ADestruction of skin lesions9.117.605.510.6417.3515.26090
    17108ADestruction of skin lesions13.129.727.761.0723.9121.95090
    17110ADestruct lesion, 1-140.651.650.510.052.351.21010
    17111ADestruct lesion, 15 or more0.911.710.610.052.671.57010
    17250AChemical cautery, tissue0.501.250.360.051.800.91000
    17260ADestruction of skin lesions0.901.300.460.052.251.41010
    17261ADestruction of skin lesions1.161.640.600.062.861.82010
    17262ADestruction of skin lesions1.571.920.790.083.572.44010
    17263ADestruction of skin lesions1.782.090.860.103.972.74010
    17264ADestruction of skin lesions1.932.260.890.104.292.92010
    17266ADestruction of skin lesions2.332.551.000.135.013.46010
    17270ADestruction of skin lesions1.311.740.640.073.122.02010
    17271ADestruction of skin lesions1.481.810.750.073.362.30010
    17272ADestruction of skin lesions1.762.020.880.083.862.72010
    17273ADestruction of skin lesions2.042.240.990.114.393.14010
    17274ADestruction of skin lesions2.582.601.220.135.313.93010
    17276ADestruction of skin lesions3.183.001.460.186.364.82010
    17280ADestruction of skin lesions1.161.640.580.062.861.80010
    17281ADestruction of skin lesions1.711.930.860.083.722.65010
    17282ADestruction of skin lesions2.032.191.020.114.333.16010
    17283ADestruction of skin lesions2.622.591.270.135.344.02010
    17284ADestruction of skin lesions3.192.981.530.176.344.89010
    17286ADestruction of skin lesions4.413.752.210.268.426.88010
    17304A1 stage mohs, up to 5 spec7.568.193.610.3716.1211.54000
    17305A2 stage mohs, up to 5 spec2.833.861.360.146.834.33000
    17306A3 stage mohs, up to 5 spec2.833.881.370.146.854.34000
    17307AMohs addl stage up to 5 spec2.833.821.380.146.794.35000
    17310AMohs any stage > 5 spec each0.621.500.310.062.180.99ZZZ
    17340ACryotherapy of skin0.760.380.310.051.191.12010
    17360ASkin peel therapy1.421.480.750.072.972.24010
    17380RHair removal by electrolysis0.000.000.000.000.000.00000
    17999CSkin tissue procedure0.000.000.000.000.000.00YYY
    19000ADrainage of breast lesion0.842.050.360.082.971.28000
    19001ADrain breast lesion add-on0.420.800.140.041.260.60ZZZ
    19020AIncision of breast lesion3.556.082.810.4210.056.78090
    19030AInjection for breast x-ray1.523.370.510.084.972.11000
    19100ABx breast percut w/o image1.262.170.430.123.551.81000
    19101ABiopsy of breast, open3.164.721.700.248.125.10010
    19102ABx breast percut w/image1.994.010.660.166.162.81000
    19103ABx breast percut w/device3.6812.141.250.1916.015.12000
    19110ANipple exploration4.285.903.100.5310.717.91090
    19112AExcise breast duct fistula3.655.932.720.4610.046.83090
    19120ARemoval of breast lesion5.534.633.110.6710.839.31090
    19125AExcision, breast lesion6.034.893.330.7311.6510.09090
    19126AExcision, addl breast lesion2.91NA1.010.36NA4.28ZZZ
    19140ARemoval of breast tissue5.117.373.460.6213.109.19090
    19160ARemoval of breast tissue5.96NA3.490.73NA10.18090
    Start Printed Page 63268
    19162ARemove breast tissue, nodes13.45NA6.451.65NA21.55090
    19180ARemoval of breast8.75NA5.131.05NA14.93090
    19182ARemoval of breast7.69NA4.850.95NA13.49090
    19200ARemoval of breast15.40NA8.121.81NA25.33090
    19220ARemoval of breast15.63NA8.381.87NA25.88090
    19240ARemoval of breast15.91NA8.371.94NA26.22090
    19260ARemoval of chest wall lesion15.35NA11.131.97NA28.45090
    19271ARevision of chest wall18.79NA17.582.72NA39.09090
    19272AExtensive chest wall surgery21.43NA18.373.04NA42.84090
    19290APlace needle wire, breast1.263.020.430.074.351.76000
    19291APlace needle wire, breast0.631.750.210.042.420.88ZZZ
    19295APlace breast clip, percut0.002.81NA0.012.82NAZZZ
    19316ASuspension of breast10.63NA7.671.38NA19.68090
    19318AReduction of large breast15.53NA11.322.03NA28.88090
    19324AEnlarge breast5.82NA4.980.76NA11.56090
    19325AEnlarge breast with implant8.40NA6.671.08NA16.15090
    19328ARemoval of breast implant5.65NA5.130.73NA11.51090
    19330ARemoval of implant material7.55NA6.130.97NA14.65090
    19340AImmediate breast prosthesis6.29NA3.160.82NA10.27ZZZ
    19342ADelayed breast prosthesis11.14NA9.071.45NA21.66090
    19350ABreast reconstruction8.8714.357.191.1424.3617.20090
    19355ACorrect inverted nipple(s)7.5312.945.070.9621.4313.56090
    19357ABreast reconstruction18.06NA14.012.35NA34.42090
    19361ABreast reconstruction19.15NA11.912.49NA33.55090
    19364ABreast reconstruction40.77NA23.884.69NA69.34090
    19366ABreast reconstruction21.16NA11.352.72NA35.23090
    19367ABreast reconstruction25.58NA16.743.33NA45.65090
    19368ABreast reconstruction32.24NA20.484.21NA56.93090
    19369ABreast reconstruction29.65NA19.993.88NA53.52090
    19370ASurgery of breast capsule8.00NA7.031.03NA16.06090
    19371ARemoval of breast capsule9.30NA7.961.21NA18.47090
    19380ARevise breast reconstruction9.09NA7.841.17NA18.10090
    19396ADesign custom breast implant2.165.841.000.288.283.44000
    19499CBreast surgery procedure0.000.000.000.000.000.00YYY
    20000AIncision of abscess2.112.381.630.204.693.94010
    20005AIncision of deep abscess3.403.372.140.417.185.95010
    20100AExplore wound, neck10.025.864.421.1917.0715.63010
    20101AExplore wound, chest3.202.991.610.296.485.10010
    20102AExplore wound, abdomen3.923.561.820.427.906.16010
    20103AExplore wound, extremity5.274.193.250.6810.149.20010
    20150AExcise epiphyseal bar13.61NA7.301.15NA22.06090
    20200AMuscle biopsy1.453.170.790.204.822.44000
    20205ADeep muscle biopsy2.344.191.220.286.813.84000
    20206ANeedle biopsy, muscle0.983.210.350.074.261.40000
    20220ABone biopsy, trocar/needle1.264.802.820.076.134.15000
    20225ABone biopsy, trocar/needle1.864.382.990.136.374.98000
    20240ABone biopsy, excisional3.21NA2.540.40NA6.15010
    20245ABone biopsy, excisional7.74NA6.330.53NA14.60010
    20250AOpen bone biopsy5.00NA4.590.60NA10.19010
    20251AOpen bone biopsy5.53NA5.240.95NA11.72010
    20500AInjection of sinus tract1.226.003.940.127.345.28010
    20501AInject sinus tract for x-ray0.763.020.250.043.821.05000
    20520ARemoval of foreign body1.842.281.830.204.323.87010
    20525ARemoval of foreign body3.483.432.690.487.396.65010
    20526ATher injection, carp tunnel0.930.970.520.071.971.52000
    20550AInj tendon sheath/ligament0.750.720.240.071.541.06000
    20551AInj tendon origin/insertion0.750.690.340.071.511.16000
    20552AInj trigger point, 1/2 muscl0.660.740.210.071.470.94000
    20553AInject trigger points, =/> 30.750.850.230.071.671.05000
    20600ADrain/inject, joint/bursa0.660.650.360.071.381.09000
    20605ADrain/inject, joint/bursa0.680.760.370.071.511.12000
    20610ADrain/inject, joint/bursa0.790.950.430.101.841.32000
    20612AAspirate/inj ganglion cyst0.700.720.340.071.491.11000
    20615ATreatment of bone cyst2.272.571.850.235.074.35010
    20650AInsert and remove bone pin2.222.441.960.345.004.52010
    20660AApply, rem fixation device2.503.111.720.586.194.80000
    20661AApplication of head brace4.86NA5.031.10NA10.99090
    20662AApplication of pelvis brace6.04NA5.510.97NA12.52090
    20663AApplication of thigh brace5.40NA4.820.92NA11.14090
    20664AHalo brace application8.01NA7.121.79NA16.92090
    20665ARemoval of fixation device1.302.091.330.203.592.83010
    20670ARemoval of support implant1.736.773.950.288.785.96010
    20680ARemoval of support implant3.333.243.240.557.127.12090
    20690AApply bone fixation device3.50NA2.490.56NA6.55090
    20692AApply bone fixation device6.37NA3.780.72NA10.87090
    Start Printed Page 63269
    20693AAdjust bone fixation device5.83NA5.591.02NA12.44090
    20694ARemove bone fixation device4.146.944.530.6811.769.35090
    20802AReplantation, arm, complete40.92NA21.666.96NA69.54090
    20805AReplant forearm, complete49.72NA35.314.73NA89.76090
    20808AReplantation hand, complete61.30NA43.887.78NA112.96090
    20816AReplantation digit, complete30.76NA39.663.61NA74.03090
    20822AReplantation digit, complete25.44NA36.343.68NA65.46090
    20824AReplantation thumb, complete30.76NA38.524.17NA73.45090
    20827AReplantation thumb, complete26.26NA38.353.85NA68.46090
    20838AReplantation foot, complete41.17NA22.957.01NA71.13090
    20900ARemoval of bone for graft5.557.425.850.9213.8912.32090
    20902ARemoval of bone for graft7.51NA6.941.27NA15.72090
    20910ARemove cartilage for graft5.317.215.490.6013.1211.40090
    20912ARemove cartilage for graft6.31NA6.150.66NA13.12090
    20920ARemoval of fascia for graft5.28NA4.450.65NA10.38090
    20922ARemoval of fascia for graft6.576.835.131.0514.4512.75090
    20924ARemoval of tendon for graft6.44NA5.980.98NA13.40090
    20926ARemoval of tissue for graft5.50NA4.990.87NA11.36090
    20930BSpinal bone allograft0.000.000.000.000.000.00XXX
    20931ASpinal bone allograft1.80NA0.940.41NA3.15ZZZ
    20936BSpinal bone autograft0.000.000.000.000.000.00XXX
    20937ASpinal bone autograft2.77NA1.470.52NA4.76ZZZ
    20938ASpinal bone autograft3.00NA1.580.62NA5.20ZZZ
    20950AFluid pressure, muscle1.251.381.010.192.822.45000
    20955AFibula bone graft, microvasc38.99NA25.265.21NA69.46090
    20956AIliac bone graft, microvasc39.05NA25.126.92NA71.09090
    20957AMt bone graft, microvasc40.42NA19.286.88NA66.58090
    20962AOther bone graft, microvasc39.05NA26.686.22NA71.95090
    20969ABone/skin graft, microvasc43.67NA27.765.20NA76.63090
    20970ABone/skin graft, iliac crest42.81NA26.145.56NA74.51090
    20972ABone/skin graft, metatarsal42.7422.0120.357.2872.0370.37090
    20973ABone/skin graft, great toe45.50NA25.545.57NA76.61090
    20974AElectrical bone stimulation0.620.630.560.111.361.29000
    20975AElectrical bone stimulation2.59NA1.750.50NA4.84000
    20979AUs bone stimulation0.620.780.340.051.451.01000
    20982AAblate, bone tumor(s) perq7.24106.253.020.68114.1710.94000
    20999CMusculoskeletal surgery0.000.000.000.000.000.00YYY
    21010AIncision of jaw joint10.08NA7.330.65NA18.06090
    21015AResection of facial tumor5.26NA5.590.62NA11.47090
    21025AExcision of bone, lower jaw10.0010.338.320.9521.2819.27090
    21026AExcision of facial bone(s)4.827.035.590.4812.3310.89090
    21029AContour of face bone lesion7.678.706.330.8917.2614.89090
    21030AExcise max/zygoma b9 tumor3.876.574.050.7211.168.64090
    21031ARemove exostosis, mandible3.224.643.180.348.206.74090
    21032ARemove exostosis, maxilla3.224.683.290.328.226.83090
    21034AExcise max/zygoma mlg tumor16.0813.7311.441.6431.4529.16090
    21040AExcise mandible lesion3.876.613.880.2310.717.98090
    21044ARemoval of jaw bone lesion11.79NA8.801.04NA21.63090
    21045AExtensive jaw surgery16.08NA11.561.44NA29.08090
    21046ARemove mandible cyst complex12.93NA12.851.21NA26.99090
    21047AExcise lwr jaw cyst w/repair18.64NA13.601.83NA34.07090
    21048ARemove maxilla cyst complex13.42NA13.131.21NA27.76090
    21049AExcis uppr jaw cyst w/repair17.90NA13.191.21NA32.30090
    21050ARemoval of jaw joint10.71NA10.401.01NA22.12090
    21060ARemove jaw joint cartilage10.17NA9.921.39NA21.48090
    21070ARemove coronoid process8.15NA7.110.80NA16.06090
    21076APrepare face/oral prosthesis13.3412.8610.301.6327.8325.27010
    21077APrepare face/oral prosthesis33.5632.6126.514.1170.2864.18090
    21079APrepare face/oral prosthesis22.2122.5017.701.9146.6241.82090
    21080APrepare face/oral prosthesis24.9625.5420.023.0653.5648.04090
    21081APrepare face/oral prosthesis22.7523.2418.012.2448.2343.00090
    21082APrepare face/oral prosthesis20.7520.1316.181.7542.6338.68090
    21083APrepare face/oral prosthesis19.1919.6014.912.3541.1436.45090
    21084APrepare face/oral prosthesis22.3822.9717.871.8847.2342.13090
    21085APrepare face/oral prosthesis8.958.626.970.7818.3516.70010
    21086APrepare face/oral prosthesis24.7824.6119.862.2351.6246.87090
    21087APrepare face/oral prosthesis24.7824.1919.662.6651.6347.10090
    21088CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21089CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21100AMaxillofacial fixation4.205.714.680.2210.139.10090
    21110AInterdental fixation5.187.105.740.3412.6211.26090
    21116AInjection, jaw joint x-ray0.817.400.340.068.271.21000
    21120AReconstruction of chin4.908.975.360.3514.2210.61090
    21121AReconstruction of chin7.6010.566.730.6718.8315.00090
    21122AReconstruction of chin8.47NA7.160.71NA16.34090
    Start Printed Page 63270
    21123AReconstruction of chin11.10NA8.361.39NA20.85090
    21125AAugmentation, lower jaw bone10.5611.948.380.8623.3619.80090
    21127AAugmentation, lower jaw bone11.0614.709.230.9126.6721.20090
    21137AReduction of forehead9.76NA7.520.64NA17.92090
    21138AReduction of forehead12.12NA9.411.76NA23.29090
    21139AReduction of forehead14.53NA9.881.22NA25.63090
    21141AReconstruct midface, lefort18.00NA14.061.95NA34.01090
    21142AReconstruct midface, lefort18.70NA13.251.39NA33.34090
    21143AReconstruct midface, lefort19.47NA14.291.08NA34.84090
    21145AReconstruct midface, lefort19.83NA14.332.51NA36.67090
    21146AReconstruct midface, lefort20.59NA15.802.55NA38.94090
    21147AReconstruct midface, lefort21.65NA15.471.82NA38.94090
    21150AReconstruct midface, lefort25.10NA14.271.31NA40.68090
    21151AReconstruct midface, lefort28.14NA18.002.37NA48.51090
    21154AReconstruct midface, lefort30.35NA20.415.83NA56.59090
    21155AReconstruct midface, lefort34.25NA22.556.57NA63.37090
    21159AReconstruct midface, lefort42.14NA24.748.08NA74.96090
    21160AReconstruct midface, lefort46.18NA24.695.26NA76.13090
    21172AReconstruct orbit/forehead27.64NA14.222.29NA44.15090
    21175AReconstruct orbit/forehead32.98NA18.516.18NA57.67090
    21179AReconstruct entire forehead22.12NA15.022.97NA40.11090
    21180AReconstruct entire forehead25.05NA16.242.58NA43.87090
    21181AContour cranial bone lesion9.84NA7.611.16NA18.61090
    21182AReconstruct cranial bone32.01NA19.873.03NA54.91090
    21183AReconstruct cranial bone35.11NA21.593.30NA60.00090
    21184AReconstruct cranial bone38.02NA22.794.94NA65.75090
    21188AReconstruction of midface22.33NA15.342.22NA39.89090
    21193AReconst lwr jaw w/o graft17.05NA13.131.83NA32.01090
    21194AReconst lwr jaw w/graft19.73NA14.251.67NA35.65090
    21195AReconst lwr jaw w/o fixation17.14NA13.431.44NA32.01090
    21196AReconst lwr jaw w/fixation18.80NA14.051.94NA34.79090
    21198AReconstr lwr jaw segment14.08NA11.031.26NA26.37090
    21199AReconstr lwr jaw w/advance15.91NA9.291.51NA26.71090
    21206AReconstruct upper jaw bone14.02NA10.951.21NA26.18090
    21208AAugmentation of facial bones10.1714.689.391.1025.9520.66090
    21209AReduction of facial bones6.6812.027.320.7219.4214.72090
    21210AFace bone graft10.1713.859.531.0525.0720.75090
    21215ALower jaw bone graft10.7113.659.721.2525.6121.68090
    21230ARib cartilage graft10.71NA8.661.15NA20.52090
    21235AEar cartilage graft6.6811.497.170.6218.7914.47090
    21240AReconstruction of jaw joint13.97NA12.871.38NA28.22090
    21242AReconstruction of jaw joint12.88NA12.351.68NA26.91090
    21243AReconstruction of jaw joint20.67NA18.102.22NA40.99090
    21244AReconstruction of lower jaw11.79NA10.171.14NA23.10090
    21245AReconstruction of jaw11.7916.299.831.0529.1322.67090
    21246AReconstruction of jaw12.4014.739.961.4528.5823.81090
    21247AReconstruct lower jaw bone22.50NA18.152.65NA43.30090
    21248AReconstruction of jaw11.4113.189.421.2125.8022.04090
    21249AReconstruction of jaw17.4216.7812.811.6735.8731.90090
    21255AReconstruct lower jaw bone16.62NA12.901.35NA30.87090
    21256AReconstruction of orbit16.10NA12.291.25NA29.64090
    21260ARevise eye sockets16.43NA9.041.50NA26.97090
    21261ARevise eye sockets31.31NA19.432.64NA53.38090
    21263ARevise eye sockets28.26NA13.032.59NA43.88090
    21267ARevise eye sockets18.79NA13.351.62NA33.76090
    21268ARevise eye sockets24.34NA15.500.95NA40.79090
    21270AAugmentation, cheek bone10.1712.068.190.8723.1019.23090
    21275ARevision, orbitofacial bones11.18NA8.841.23NA21.25090
    21280ARevision of eyelid6.00NA6.130.32NA12.45090
    21282ARevision of eyelid3.47NA4.720.25NA8.44090
    21295ARevision of jaw muscle/bone1.52NA2.860.16NA4.54090
    21296ARevision of jaw muscle/bone4.23NA4.490.36NA9.08090
    21299CCranio/maxillofacial surgery0.000.000.000.000.000.00YYY
    21300ATreatment of skull fracture0.722.430.260.113.261.09000
    21310ATreatment of nose fracture0.582.380.150.063.020.79000
    21315ATreatment of nose fracture1.503.081.290.144.722.93010
    21320ATreatment of nose fracture1.844.301.860.186.323.88010
    21325ATreatment of nose fracture3.75NA3.800.37NA7.92090
    21330ATreatment of nose fracture5.35NA5.340.58NA11.27090
    21335ATreatment of nose fracture8.56NA6.880.77NA16.21090
    21336ATreat nasal septal fracture5.69NA6.140.54NA12.37090
    21337ATreat nasal septal fracture2.685.173.730.268.116.67090
    21338ATreat nasoethmoid fracture6.42NA6.040.64NA13.10090
    21339ATreat nasoethmoid fracture8.04NA6.830.91NA15.78090
    21340ATreatment of nose fracture10.71NA8.801.02NA20.53090
    Start Printed Page 63271
    21343ATreatment of sinus fracture12.88NA10.261.27NA24.41090
    21344ATreatment of sinus fracture19.61NA13.852.06NA35.52090
    21345ATreat nose/jaw fracture8.1111.688.000.7220.5116.83090
    21346ATreat nose/jaw fracture10.5513.359.121.0224.9220.69090
    21347ATreat nose/jaw fracture12.62NA9.871.37NA23.86090
    21348ATreat nose/jaw fracture16.59NA11.441.80NA29.83090
    21355ATreat cheek bone fracture3.754.762.400.358.866.50010
    21356ATreat cheek bone fracture4.1311.833.250.4316.397.81010
    21360ATreat cheek bone fracture6.4214.066.260.6221.1013.30090
    21365ATreat cheek bone fracture14.86NA11.911.56NA28.33090
    21366ATreat cheek bone fracture17.67NA11.781.69NA31.14090
    21385ATreat eye socket fracture9.11NA7.140.77NA17.02090
    21386ATreat eye socket fracture9.11NA7.560.91NA17.58090
    21387ATreat eye socket fracture9.64NA7.620.93NA18.19090
    21390ATreat eye socket fracture10.07NA8.110.84NA19.02090
    21395ATreat eye socket fracture12.61NA9.431.31NA23.35090
    21400ATreat eye socket fracture1.393.772.140.145.303.67090
    21401ATreat eye socket fracture3.245.153.910.418.807.56090
    21406ATreat eye socket fracture6.97NA6.420.71NA14.10090
    21407ATreat eye socket fracture8.56NA7.220.80NA16.58090
    21408ATreat eye socket fracture12.31NA9.311.49NA23.11090
    21421ATreat mouth roof fracture5.1110.046.230.5015.6511.84090
    21422ATreat mouth roof fracture8.2711.427.180.8320.5216.28090
    21423ATreat mouth roof fracture10.34NA8.581.14NA20.06090
    21431ATreat craniofacial fracture7.0110.796.930.7018.5014.64090
    21432ATreat craniofacial fracture8.56NA6.240.66NA15.46090
    21433ATreat craniofacial fracture25.21NA17.032.95NA45.19090
    21435ATreat craniofacial fracture17.15NA13.111.99NA32.25090
    21436ATreat craniofacial fracture27.88NA18.632.78NA49.29090
    21440ATreat dental ridge fracture2.688.154.170.2611.097.11090
    21445ATreat dental ridge fracture5.3510.586.360.6616.5912.37090
    21450ATreat lower jaw fracture2.9510.783.820.2814.017.05090
    21451ATreat lower jaw fracture4.848.885.830.4714.1911.14090
    21452ATreat lower jaw fracture1.977.963.610.1710.105.75090
    21453ATreat lower jaw fracture5.5110.646.920.5916.7413.02090
    21454ATreat lower jaw fracture6.42NA6.630.66NA13.71090
    21461ATreat lower jaw fracture8.0412.688.390.8721.5917.30090
    21462ATreat lower jaw fracture9.7314.249.130.9624.9319.82090
    21465ATreat lower jaw fracture11.84NA10.171.01NA23.02090
    21470ATreat lower jaw fracture15.25NA12.391.63NA29.27090
    21480AReset dislocated jaw0.611.980.190.062.650.86000
    21485AReset dislocated jaw3.976.014.860.3710.359.20090
    21490ARepair dislocated jaw11.79NA10.021.57NA23.38090
    21493ATreat hyoid bone fracture1.26NA2.890.12NA4.27090
    21494ATreat hyoid bone fracture6.24NA5.780.53NA12.55090
    21495ATreat hyoid bone fracture5.66NA6.050.49NA12.20090
    21497AInterdental wiring3.846.625.080.3710.839.29090
    21499CHead surgery procedure0.000.000.000.000.000.00YYY
    21501ADrain neck/chest lesion3.794.743.920.438.968.14090
    21502ADrain chest lesion7.08NA5.630.95NA13.66090
    21510ADrainage of bone lesion5.71NA5.620.80NA12.13090
    21550ABiopsy of neck/chest2.053.681.750.165.893.96010
    21555ARemove lesion, neck/chest4.335.123.200.499.948.02090
    21556ARemove lesion, neck/chest5.54NA4.150.61NA10.30090
    21557ARemove tumor, neck/chest8.83NA5.481.02NA15.33090
    21600APartial removal of rib6.85NA5.710.97NA13.53090
    21610APartial removal of rib14.53NA9.162.22NA25.91090
    21615ARemoval of rib9.81NA6.611.44NA17.86090
    21616ARemoval of rib and nerves11.97NA7.981.57NA21.52090
    21620APartial removal of sternum6.75NA5.980.92NA13.65090
    21627ASternal debridement6.77NA6.290.98NA14.04090
    21630AExtensive sternum surgery17.28NA11.992.34NA31.61090
    21632AExtensive sternum surgery18.04NA10.792.59NA31.42090
    21685AHyoid myotomy & suspension12.93NA10.211.51NA24.65090
    21700ARevision of neck muscle6.156.144.820.3712.6611.34090
    21705ARevision of neck muscle/rib9.55NA5.681.10NA16.33090
    21720ARevision of neck muscle5.655.534.680.9612.1411.29090
    21725ARevision of neck muscle6.95NA5.581.08NA13.61090
    21740AReconstruction of sternum16.41NA8.382.43NA27.22090
    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 separation10.71NA5.911.62NA18.24090
    21800ATreatment of rib fracture0.952.131.440.113.192.50090
    21805ATreatment of rib fracture2.73NA3.300.35NA6.38090
    21810ATreatment of rib fracture(s)6.82NA4.960.72NA12.50090
    Start Printed Page 63272
    21820ATreat sternum fracture1.272.671.850.184.123.30090
    21825ATreat sternum fracture7.37NA6.501.01NA14.88090
    21899CNeck/chest surgery procedure0.000.000.000.000.000.00YYY
    21920ABiopsy soft tissue of back2.053.311.500.145.503.69010
    21925ABiopsy soft tissue of back4.466.703.370.5311.698.36090
    21930ARemove lesion, back or flank4.975.553.500.5911.119.06090
    21935ARemove tumor, back17.86NA10.322.24NA30.42090
    22100ARemove part of neck vertebra9.67NA7.721.86NA19.25090
    22101ARemove part, thorax vertebra9.75NA7.931.81NA19.49090
    22102ARemove part, lumbar vertebra9.75NA8.181.75NA19.68090
    22103ARemove extra spine segment2.33NA1.230.44NA4.00ZZZ
    22110ARemove part of neck vertebra12.67NA9.392.64NA24.70090
    22112ARemove part, thorax vertebra12.74NA9.412.35NA24.50090
    22114ARemove part, lumbar vertebra12.74NA9.412.37NA24.52090
    22116ARemove extra spine segment2.31NA1.180.48NA3.97ZZZ
    22210ARevision of neck spine23.68NA15.715.07NA44.46090
    22212ARevision of thorax spine19.31NA13.413.33NA36.05090
    22214ARevision of lumbar spine19.34NA13.923.33NA36.59090
    22216ARevise, extra spine segment6.01NA3.181.17NA10.36ZZZ
    22220ARevision of neck spine21.25NA13.954.37NA39.57090
    22222ARevision of thorax spine21.40NA11.743.69NA36.83090
    22224ARevision of lumbar spine21.40NA14.393.84NA39.63090
    22226ARevise, extra spine segment6.01NA3.141.21NA10.36ZZZ
    22305ATreat spine process fracture2.043.222.410.355.614.80090
    22310ATreat spine fracture2.604.944.170.447.987.21090
    22315ATreat spine fracture8.7913.587.631.6424.0118.06090
    22318ATreat odontoid fx w/o graft21.38NA13.705.11NA40.19090
    22319ATreat odontoid fx w/graft23.86NA15.095.71NA44.66090
    22325ATreat spine fracture18.20NA12.283.13NA33.61090
    22326ATreat neck spine fracture19.48NA12.994.24NA36.71090
    22327ATreat thorax spine fracture19.09NA12.583.30NA34.97090
    22328ATreat each add spine fx4.58NA2.300.79NA7.67ZZZ
    22505AManipulation of spine1.86NA0.950.32NA3.13010
    22520APercut vertebroplasty thor8.86103.004.391.19113.0514.44010
    22521APercut vertebroplasty lumb8.2991.364.231.11100.7613.63010
    22522APercut vertebroplasty addl4.29NA1.710.40NA6.40ZZZ
    22532ALat thorax spine fusion23.86NA14.924.53NA43.31090
    22533ALat lumbar spine fusion22.99NA13.603.81NA40.40090
    22534ALat thor/lumb, addl seg5.97NA3.081.17NA10.22ZZZ
    22548ANeck spine fusion25.67NA16.035.97NA47.67090
    22554ANeck spine fusion18.51NA12.474.21NA35.19090
    22556AThorax spine fusion23.33NA14.814.53NA42.67090
    22558ALumbar spine fusion22.15NA13.373.81NA39.33090
    22585AAdditional spinal fusion5.50NA2.831.17NA9.50ZZZ
    22590ASpine & skull spinal fusion20.39NA13.474.57NA38.43090
    22595ANeck spinal fusion19.28NA12.964.34NA36.58090
    22600ANeck spine fusion16.05NA11.283.46NA30.79090
    22610AThorax spine fusion15.93NA11.463.19NA30.58090
    22612ALumbar spine fusion20.88NA14.253.93NA39.06090
    22614ASpine fusion, extra segment6.40NA3.401.25NA11.05ZZZ
    22630ALumbar spine fusion20.72NA13.714.54NA38.97090
    22632ASpine fusion, extra segment5.20NA2.701.08NA8.98ZZZ
    22800AFusion of spine18.15NA12.783.25NA34.18090
    22802AFusion of spine30.70NA19.685.30NA55.68090
    22804AFusion of spine36.06NA22.816.27NA65.14090
    22808AFusion of spine26.12NA16.425.23NA47.77090
    22810AFusion of spine30.10NA18.475.38NA53.95090
    22812AFusion of spine32.51NA20.135.60NA58.24090
    22818AKyphectomy, 1-2 segments31.65NA19.076.00NA56.72090
    22819AKyphectomy, 3 or more36.23NA20.216.23NA62.67090
    22830AExploration of spinal fusion10.79NA7.982.07NA20.84090
    22840AInsert spine fixation device12.47NA6.582.43NA21.48ZZZ
    22841BInsert spine fixation device0.000.000.000.000.000.00XXX
    22842AInsert spine fixation device12.51NA6.602.45NA21.56ZZZ
    22843AInsert spine fixation device13.38NA6.702.52NA22.60ZZZ
    22844AInsert spine fixation device16.35NA8.872.90NA28.12ZZZ
    22845AInsert spine fixation device11.89NA6.162.66NA20.71ZZZ
    22846AInsert spine fixation device12.35NA6.422.71NA21.48ZZZ
    22847AInsert spine fixation device13.72NA7.122.83NA23.67ZZZ
    22848AInsert pelv fixation device5.97NA3.231.05NA10.25ZZZ
    22849AReinsert spinal fixation18.40NA11.893.44NA33.73090
    22850ARemove spine fixation device9.47NA7.081.81NA18.36090
    22851AApply spine prosth device6.67NA3.401.33NA11.40ZZZ
    22852ARemove spine fixation device8.96NA6.871.68NA17.51090
    22855ARemove spine fixation device15.04NA9.833.28NA28.15090
    Start Printed Page 63273
    22899CSpine surgery procedure0.000.000.000.000.000.00YYY
    22900ARemove abdominal wall lesion5.77NA3.310.70NA9.78090
    22999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    23000ARemoval of calcium deposits4.345.274.210.6010.219.15090
    23020ARelease shoulder joint8.88NA7.651.47NA18.00090
    23030ADrain shoulder lesion3.413.052.970.506.966.88010
    23031ADrain shoulder bursa2.722.742.740.405.865.86010
    23035ADrain shoulder bone lesion8.56NA8.591.43NA18.58090
    23040AExploratory shoulder surgery9.15NA7.931.53NA18.61090
    23044AExploratory shoulder surgery7.08NA6.561.16NA14.80090
    23065ABiopsy shoulder tissues2.262.851.560.175.283.99010
    23066ABiopsy shoulder tissues4.145.154.110.609.898.85090
    23075ARemoval of shoulder lesion2.382.271.840.304.954.52010
    23076ARemoval of shoulder lesion7.59NA5.841.04NA14.47090
    23077ARemove tumor of shoulder16.00NA10.882.17NA29.05090
    23100ABiopsy of shoulder joint6.00NA5.760.97NA12.73090
    23101AShoulder joint surgery5.55NA5.440.92NA11.91090
    23105ARemove shoulder joint lining8.18NA7.251.35NA16.78090
    23106AIncision of collarbone joint5.93NA5.800.98NA12.71090
    23107AExplore treat shoulder joint8.57NA7.461.43NA17.46090
    23120APartial removal, collar bone7.07NA6.551.19NA14.81090
    23125ARemoval of collar bone9.34NA7.691.52NA18.55090
    23130ARemove shoulder bone, part7.51NA7.181.27NA15.96090
    23140ARemoval of bone lesion6.85NA5.460.98NA13.29090
    23145ARemoval of bone lesion9.04NA7.661.49NA18.19090
    23146ARemoval of bone lesion7.79NA7.211.33NA16.33090
    23150ARemoval of humerus lesion8.43NA7.051.37NA16.85090
    23155ARemoval of humerus lesion10.29NA8.551.44NA20.28090
    23156ARemoval of humerus lesion8.63NA7.461.41NA17.50090
    23170ARemove collar bone lesion6.82NA6.381.01NA14.21090
    23172ARemove shoulder blade lesion6.86NA6.471.14NA14.47090
    23174ARemove humerus lesion9.46NA8.461.56NA19.48090
    23180ARemove collar bone lesion8.48NA9.291.41NA19.18090
    23182ARemove shoulder blade lesion8.10NA8.941.29NA18.33090
    23184ARemove humerus lesion9.33NA9.651.49NA20.47090
    23190APartial removal of scapula7.20NA6.291.16NA14.65090
    23195ARemoval of head of humerus9.75NA7.851.65NA19.25090
    23200ARemoval of collar bone12.01NA9.001.77NA22.78090
    23210ARemoval of shoulder blade12.42NA9.371.93NA23.72090
    23220APartial removal of humerus14.48NA10.992.43NA27.90090
    23221APartial removal of humerus17.64NA11.963.01NA32.61090
    23222APartial removal of humerus23.78NA16.004.04NA43.82090
    23330ARemove shoulder foreign body1.842.071.910.224.133.97010
    23331ARemove shoulder foreign body7.34NA6.861.22NA15.42090
    23332ARemove shoulder foreign body11.55NA9.411.94NA22.90090
    23350AInjection for shoulder x-ray0.993.840.340.064.891.39000
    23395AMuscle transfer,shoulder/arm16.75NA12.872.74NA32.36090
    23397AMuscle transfers16.04NA11.502.68NA30.22090
    23400AFixation of shoulder blade13.46NA10.242.29NA25.99090
    23405AIncision of tendon & muscle8.32NA7.041.34NA16.70090
    23406AIncise tendon(s) & muscle(s)10.73NA8.491.77NA20.99090
    23410ARepair rotator cuff, acute12.38NA9.512.06NA23.95090
    23412ARepair rotator cuff, chronic13.23NA10.002.23NA25.46090
    23415ARelease of shoulder ligament9.91NA8.061.67NA19.64090
    23420ARepair of shoulder13.22NA10.892.23NA26.34090
    23430ARepair biceps tendon9.92NA8.201.68NA19.80090
    23440ARemove/transplant tendon10.42NA8.381.76NA20.56090
    23450ARepair shoulder capsule13.32NA9.972.23NA25.52090
    23455ARepair shoulder capsule14.29NA10.562.41NA27.26090
    23460ARepair shoulder capsule15.28NA11.492.60NA29.37090
    23462ARepair shoulder capsule15.21NA10.892.59NA28.69090
    23465ARepair shoulder capsule15.76NA11.421.93NA29.11090
    23466ARepair shoulder capsule14.14NA11.392.40NA27.93090
    23470AReconstruct shoulder joint17.05NA12.252.88NA32.18090
    23472AReconstruct shoulder joint20.98NA14.422.84NA38.24090
    23480ARevision of collar bone11.12NA8.871.87NA21.86090
    23485ARevision of collar bone13.35NA10.012.21NA25.57090
    23490AReinforce clavicle11.79NA8.791.33NA21.91090
    23491AReinforce shoulder bones14.13NA10.812.40NA27.34090
    23500ATreat clavicle fracture2.073.702.600.316.084.98090
    23505ATreat clavicle fracture3.675.393.800.609.668.07090
    23515ATreat clavicle fracture7.37NA6.601.23NA15.20090
    23520ATreat clavicle dislocation2.153.702.750.316.165.21090
    23525ATreat clavicle dislocation3.585.343.930.539.458.04090
    23530ATreat clavicle dislocation7.27NA6.051.02NA14.34090
    Start Printed Page 63274
    23532ATreat clavicle dislocation7.96NA6.991.35NA16.30090
    23540ATreat clavicle dislocation2.224.312.510.296.825.02090
    23545ATreat clavicle dislocation3.234.563.430.478.267.13090
    23550ATreat clavicle dislocation7.20NA6.461.13NA14.79090
    23552ATreat clavicle dislocation8.40NA7.341.41NA17.15090
    23570ATreat shoulder blade fx2.223.712.910.356.285.48090
    23575ATreat shoulder blade fx4.045.834.300.6410.518.98090
    23585ATreat scapula fracture8.91NA7.681.50NA18.09090
    23600ATreat humerus fracture2.915.803.870.479.187.25090
    23605ATreat humerus fracture4.846.675.010.8012.3110.65090
    23615ATreat humerus fracture9.30NA8.791.57NA19.66090
    23616ATreat humerus fracture21.15NA14.283.57NA39.00090
    23620ATreat humerus fracture2.395.263.270.388.036.04090
    23625ATreat humerus fracture3.916.394.600.6410.949.15090
    23630ATreat humerus fracture7.31NA6.671.23NA15.21090
    23650ATreat shoulder dislocation3.374.752.940.378.496.68090
    23655ATreat shoulder dislocation4.54NA4.230.62NA9.39090
    23660ATreat shoulder dislocation7.45NA6.441.21NA15.10090
    23665ATreat dislocation/fracture4.446.664.990.7211.8210.15090
    23670ATreat dislocation/fracture7.85NA6.901.32NA16.07090
    23675ATreat dislocation/fracture6.027.656.130.9914.6613.14090
    23680ATreat dislocation/fracture10.00NA8.181.67NA19.85090
    23700AFixation of shoulder2.51NA2.320.42NA5.25010
    23800AFusion of shoulder joint14.08NA10.582.36NA27.02090
    23802AFusion of shoulder joint16.51NA10.382.80NA29.69090
    23900AAmputation of arm & girdle19.61NA12.052.96NA34.62090
    23920AAmputation at shoulder joint14.53NA10.212.30NA27.04090
    23921AAmputation follow-up surgery5.465.285.280.9311.6711.67090
    23929CShoulder surgery procedure0.000.000.000.000.000.00YYY
    23930ADrainage of arm lesion2.922.752.360.386.055.66010
    23931ADrainage of arm bursa1.782.462.210.254.494.24010
    23935ADrain arm/elbow bone lesion6.06NA6.181.01NA13.25090
    24000AExploratory elbow surgery5.79NA5.420.92NA12.13090
    24006ARelease elbow joint9.26NA7.771.52NA18.55090
    24065ABiopsy arm/elbow soft tissue2.072.121.800.174.364.04010
    24066ABiopsy arm/elbow soft tissue5.185.814.330.7311.7210.24090
    24075ARemove arm/elbow lesion3.905.113.710.529.538.13090
    24076ARemove arm/elbow lesion6.26NA5.140.84NA12.24090
    24077ARemove tumor of arm/elbow11.69NA8.751.58NA22.02090
    24100ABiopsy elbow joint lining4.90NA4.520.74NA10.16090
    24101AExplore/treat elbow joint6.10NA5.921.01NA13.03090
    24102ARemove elbow joint lining7.98NA6.911.31NA16.20090
    24105ARemoval of elbow bursa3.59NA4.410.59NA8.59090
    24110ARemove humerus lesion7.35NA6.781.19NA15.32090
    24115ARemove/graft bone lesion9.58NA7.431.38NA18.39090
    24116ARemove/graft bone lesion11.74NA9.211.99NA22.94090
    24120ARemove elbow lesion6.61NA5.941.04NA13.59090
    24125ARemove/graft bone lesion7.85NA6.251.05NA15.15090
    24126ARemove/graft bone lesion8.26NA7.041.08NA16.38090
    24130ARemoval of head of radius6.21NA6.011.04NA13.26090
    24134ARemoval of arm bone lesion9.67NA9.271.57NA20.51090
    24136ARemove radius bone lesion7.94NA7.491.02NA16.45090
    24138ARemove elbow bone lesion8.00NA7.751.34NA17.09090
    24140APartial removal of arm bone9.13NA9.601.47NA20.20090
    24145APartial removal of radius7.54NA8.241.21NA16.99090
    24147APartial removal of elbow7.50NA8.731.25NA17.48090
    24149ARadical resection of elbow14.12NA11.542.28NA27.94090
    24150AExtensive humerus surgery13.19NA10.222.17NA25.58090
    24151AExtensive humerus surgery15.49NA11.812.62NA29.92090
    24152AExtensive radius surgery10.00NA7.961.43NA19.39090
    24153AExtensive radius surgery11.47NA5.900.77NA18.14090
    24155ARemoval of elbow joint11.66NA8.481.70NA21.84090
    24160ARemove elbow joint implant7.79NA6.851.28NA15.92090
    24164ARemove radius head implant6.19NA5.731.01NA12.93090
    24200ARemoval of arm foreign body1.751.991.690.183.923.62010
    24201ARemoval of arm foreign body4.535.754.370.6710.959.57090
    24220AInjection for elbow x-ray1.3010.480.450.0811.861.83000
    24300AManipulate elbow w/anesth3.73NA5.540.59NA9.86090
    24301AMuscle/tendon transfer10.14NA8.271.56NA19.97090
    24305AArm tendon lengthening7.41NA6.751.17NA15.33090
    24310ARevision of arm tendon5.95NA5.790.89NA12.63090
    24320ARepair of arm tendon10.50NA7.821.20NA19.52090
    24330ARevision of arm muscles9.55NA7.961.45NA18.96090
    24331ARevision of arm muscles10.59NA8.681.69NA20.96090
    24332ATenolysis, triceps7.41NA6.660.92NA14.99090
    Start Printed Page 63275
    24340ARepair of biceps tendon7.85NA6.991.29NA16.13090
    24341ARepair arm tendon/muscle7.85NA7.831.29NA16.97090
    24342ARepair of ruptured tendon10.56NA8.541.77NA20.87090
    24343ARepr elbow lat ligmnt w/tiss8.60NA8.021.35NA17.97090
    24344AReconstruct elbow lat ligmnt13.92NA11.432.19NA27.54090
    24345ARepr elbw med ligmnt w/tissu8.60NA7.911.35NA17.86090
    24346AReconstruct elbow med ligmnt13.92NA11.282.19NA27.39090
    24350ARepair of tennis elbow5.22NA5.570.86NA11.65090
    24351ARepair of tennis elbow5.88NA5.920.98NA12.78090
    24352ARepair of tennis elbow6.39NA6.181.08NA13.65090
    24354ARepair of tennis elbow6.44NA6.141.05NA13.63090
    24356ARevision of tennis elbow6.64NA6.321.08NA14.04090
    24360AReconstruct elbow joint12.27NA9.462.03NA23.76090
    24361AReconstruct elbow joint14.00NA10.562.34NA26.90090
    24362AReconstruct elbow joint14.90NA10.082.30NA27.28090
    24363AReplace elbow joint18.38NA13.673.02NA35.07090
    24365AReconstruct head of radius8.34NA7.151.33NA16.82090
    24366AReconstruct head of radius9.08NA7.511.53NA18.12090
    24400ARevision of humerus11.00NA9.001.83NA21.83090
    24410ARevision of humerus14.74NA10.542.27NA27.55090
    24420ARevision of humerus13.36NA10.772.18NA26.31090
    24430ARepair of humerus12.74NA9.852.16NA24.75090
    24435ARepair humerus with graft13.09NA10.952.21NA26.25090
    24470ARevision of elbow joint8.69NA7.691.47NA17.85090
    24495ADecompression of forearm8.07NA9.031.10NA18.20090
    24498AReinforce humerus11.85NA9.382.00NA23.23090
    24500ATreat humerus fracture3.195.463.660.499.147.34090
    24505ATreat humerus fracture5.147.375.340.8613.3711.34090
    24515ATreat humerus fracture11.58NA9.441.95NA22.97090
    24516ATreat humerus fracture11.58NA9.211.95NA22.74090
    24530ATreat humerus fracture3.485.453.990.569.498.03090
    24535ATreat humerus fracture6.838.476.481.1516.4514.46090
    24538ATreat humerus fracture9.38NA8.791.50NA19.67090
    24545ATreat humerus fracture10.40NA8.501.76NA20.66090
    24546ATreat humerus fracture15.60NA11.432.61NA29.64090
    24560ATreat humerus fracture2.785.133.260.428.336.46090
    24565ATreat humerus fracture5.537.375.460.8913.7911.88090
    24566ATreat humerus fracture7.75NA8.211.32NA17.28090
    24575ATreat humerus fracture10.60NA8.381.73NA20.71090
    24576ATreat humerus fracture2.845.003.640.468.306.94090
    24577ATreat humerus fracture5.767.655.760.9714.3812.49090
    24579ATreat humerus fracture11.53NA8.931.94NA22.40090
    24582ATreat humerus fracture8.50NA9.101.44NA19.04090
    24586ATreat elbow fracture15.12NA11.232.54NA28.89090
    24587ATreat elbow fracture15.07NA11.042.57NA28.68090
    24600ATreat elbow dislocation4.215.633.580.5910.438.38090
    24605ATreat elbow dislocation5.39NA5.320.86NA11.57090
    24615ATreat elbow dislocation9.37NA7.811.57NA18.75090
    24620ATreat elbow fracture6.94NA6.181.08NA14.20090
    24635ATreat elbow fracture13.11NA14.372.21NA29.69090
    24640ATreat elbow dislocation1.191.960.880.133.282.20010
    24650ATreat radius fracture2.154.602.780.347.095.27090
    24655ATreat radius fracture4.376.844.740.7011.919.81090
    24665ATreat radius fracture8.09NA7.561.35NA17.00090
    24666ATreat radius fracture9.44NA8.141.58NA19.16090
    24670ATreat ulnar fracture2.534.503.060.407.435.99090
    24675ATreat ulnar fracture4.696.804.870.7812.2710.34090
    24685ATreat ulnar fracture8.75NA7.601.47NA17.82090
    24800AFusion of elbow joint11.14NA8.811.69NA21.64090
    24802AFusion/graft of elbow joint13.61NA10.442.27NA26.32090
    24900AAmputation of upper arm9.55NA7.431.41NA18.39090
    24920AAmputation of upper arm9.49NA7.591.46NA18.54090
    24925AAmputation follow-up surgery7.03NA6.341.14NA14.51090
    24930AAmputation follow-up surgery10.19NA7.591.47NA19.25090
    24931AAmputate upper arm & implant12.65NA6.191.87NA20.71090
    24935ARevision of amputation15.47NA8.501.89NA25.86090
    24940CRevision of upper arm0.000.000.000.000.000.00090
    24999CUpper arm/elbow surgery0.000.000.000.000.000.00YYY
    25000AIncision of tendon sheath3.36NA7.030.54NA10.93090
    25001AIncise flexor carpi radialis3.36NA4.130.54NA8.03090
    25020ADecompress forearm 1 space5.89NA10.040.91NA16.84090
    25023ADecompress forearm 1 space12.89NA15.511.82NA30.22090
    25024ADecompress forearm 2 spaces9.45NA7.491.49NA18.43090
    25025ADecompress forearm 2 spaces16.45NA10.062.61NA29.12090
    25028ADrainage of forearm lesion5.22NA8.540.73NA14.49090
    Start Printed Page 63276
    25031ADrainage of forearm bursa4.12NA8.350.60NA13.07090
    25035ATreat forearm bone lesion7.32NA14.201.17NA22.69090
    25040AExplore/treat wrist joint7.14NA7.421.15NA15.71090
    25065ABiopsy forearm soft tissues1.982.832.830.144.954.95010
    25066ABiopsy forearm soft tissues4.11NA7.330.59NA12.03090
    25075ARemovel forearm lesion subcu3.72NA6.190.48NA10.39090
    25076ARemovel forearm lesion deep4.89NA10.080.71NA15.68090
    25077ARemove tumor, forearm/wrist9.70NA12.841.32NA23.86090
    25085AIncision of wrist capsule5.47NA7.380.85NA13.70090
    25100ABiopsy of wrist joint3.88NA5.460.60NA9.94090
    25101AExplore/treat wrist joint4.66NA6.020.72NA11.40090
    25105ARemove wrist joint lining5.82NA7.570.92NA14.31090
    25107ARemove wrist joint cartilage6.39NA8.500.98NA15.87090
    25110ARemove wrist tendon lesion3.90NA7.340.58NA11.82090
    25111ARemove wrist tendon lesion3.37NA4.880.50NA8.75090
    25112AReremove wrist tendon lesion4.50NA5.490.65NA10.64090
    25115ARemove wrist/forearm lesion8.77NA14.601.33NA24.70090
    25116ARemove wrist/forearm lesion7.07NA13.671.08NA21.82090
    25118AExcise wrist tendon sheath4.35NA5.940.66NA10.95090
    25119APartial removal of ulna6.01NA7.850.96NA14.82090
    25120ARemoval of forearm lesion6.07NA12.580.97NA19.62090
    25125ARemove/graft forearm lesion7.44NA13.371.22NA22.03090
    25126ARemove/graft forearm lesion7.51NA13.461.20NA22.17090
    25130ARemoval of wrist lesion5.23NA6.580.79NA12.60090
    25135ARemove & graft wrist lesion6.85NA7.611.07NA15.53090
    25136ARemove & graft wrist lesion5.94NA6.760.70NA13.40090
    25145ARemove forearm bone lesion6.33NA12.610.98NA19.92090
    25150APartial removal of ulna7.05NA8.491.15NA16.69090
    25151APartial removal of radius7.35NA13.231.11NA21.69090
    25170AExtensive forearm surgery11.03NA15.641.82NA28.49090
    25210ARemoval of wrist bone5.92NA6.980.87NA13.77090
    25215ARemoval of wrist bones7.85NA8.991.22NA18.06090
    25230APartial removal of radius5.20NA6.290.79NA12.28090
    25240APartial removal of ulna5.14NA7.160.83NA13.13090
    25246AInjection for wrist x-ray1.4410.140.490.0811.662.01000
    25248ARemove forearm foreign body5.11NA8.830.65NA14.59090
    25250ARemoval of wrist prosthesis6.56NA6.061.01NA13.63090
    25251ARemoval of wrist prosthesis9.52NA7.901.38NA18.80090
    25259AManipulate wrist w/anesthes3.73NA5.530.60NA9.86090
    25260ARepair forearm tendon/muscle7.76NA14.061.16NA22.98090
    25263ARepair forearm tendon/muscle7.78NA13.951.13NA22.86090
    25265ARepair forearm tendon/muscle9.82NA14.831.43NA26.08090
    25270ARepair forearm tendon/muscle5.97NA12.740.91NA19.62090
    25272ARepair forearm tendon/muscle7.00NA13.451.07NA21.52090
    25274ARepair forearm tendon/muscle8.70NA14.171.37NA24.24090
    25275ARepair forearm tendon sheath8.45NA7.541.35NA17.34090
    25280ARevise wrist/forearm tendon7.18NA13.171.09NA21.44090
    25290AIncise wrist/forearm tendon5.26NA15.710.79NA21.76090
    25295ARelease wrist/forearm tendon6.51NA12.731.03NA20.27090
    25300AFusion of tendons at wrist8.75NA8.611.28NA18.64090
    25301AFusion of tendons at wrist8.35NA8.251.29NA17.89090
    25310ATransplant forearm tendon8.09NA13.591.21NA22.89090
    25312ATransplant forearm tendon9.52NA14.491.46NA25.47090
    25315ARevise palsy hand tendon(s)10.14NA15.051.51NA26.70090
    25316ARevise palsy hand tendon(s)12.26NA16.802.09NA31.15090
    25320ARepair/revise wrist joint10.71NA11.331.58NA23.62090
    25332ARevise wrist joint11.34NA9.161.75NA22.25090
    25335ARealignment of hand12.81NA11.841.99NA26.64090
    25337AReconstruct ulna/radioulnar10.11NA11.191.57NA22.87090
    25350ARevision of radius8.73NA14.431.40NA24.56090
    25355ARevision of radius10.11NA15.081.73NA26.92090
    25360ARevision of ulna8.38NA14.331.40NA24.11090
    25365ARevise radius & ulna12.33NA16.132.00NA30.46090
    25370ARevise radius or ulna13.28NA16.472.25NA32.00090
    25375ARevise radius & ulna12.97NA16.952.21NA32.13090
    25390AShorten radius or ulna10.34NA15.081.65NA27.07090
    25391ALengthen radius or ulna13.57NA17.062.07NA32.70090
    25392AShorten radius & ulna13.87NA16.412.07NA32.35090
    25393ALengthen radius & ulna15.78NA18.062.24NA36.08090
    25394ARepair carpal bone, shorten10.34NA8.331.68NA20.35090
    25400ARepair radius or ulna10.86NA15.661.80NA28.32090
    25405ARepair/graft radius or ulna14.30NA17.772.34NA34.41090
    25415ARepair radius & ulna13.27NA17.012.24NA32.52090
    25420ARepair/graft radius & ulna16.24NA18.762.64NA37.64090
    25425ARepair/graft radius or ulna13.13NA22.341.93NA37.40090
    Start Printed Page 63277
    25426ARepair/graft radius & ulna15.73NA17.432.67NA35.83090
    25430AVasc graft into carpal bone9.20NA7.361.28NA17.84090
    25431ARepair nonunion carpal bone10.38NA8.320.67NA19.37090
    25440ARepair/graft wrist bone10.38NA9.531.69NA21.60090
    25441AReconstruct wrist joint12.83NA9.992.19NA25.01090
    25442AReconstruct wrist joint10.79NA8.861.49NA21.14090
    25443AReconstruct wrist joint10.33NA8.741.56NA20.63090
    25444AReconstruct wrist joint11.09NA9.161.71NA21.96090
    25445AReconstruct wrist joint9.63NA7.971.51NA19.11090
    25446AWrist replacement16.46NA11.942.64NA31.04090
    25447ARepair wrist joint(s)10.31NA8.621.61NA20.54090
    25449ARemove wrist joint implant14.41NA10.692.12NA27.22090
    25450ARevision of wrist joint7.83NA10.541.05NA19.42090
    25455ARevision of wrist joint9.44NA11.451.28NA22.17090
    25490AReinforce radius9.49NA14.191.43NA25.11090
    25491AReinforce ulna9.90NA14.921.69NA26.51090
    25492AReinforce radius and ulna12.26NA15.791.94NA29.99090
    25500ATreat fracture of radius2.444.042.760.346.825.54090
    25505ATreat fracture of radius5.187.315.310.8313.3211.32090
    25515ATreat fracture of radius9.13NA7.551.46NA18.14090
    25520ATreat fracture of radius6.227.525.931.0214.7613.17090
    25525ATreat fracture of radius12.17NA10.042.01NA24.22090
    25526ATreat fracture of radius12.91NA13.742.16NA28.81090
    25530ATreat fracture of ulna2.084.192.840.326.595.24090
    25535ATreat fracture of ulna5.116.935.230.8212.8611.16090
    25545ATreat fracture of ulna8.85NA7.731.47NA18.05090
    25560ATreat fracture radius & ulna2.434.092.700.326.845.45090
    25565ATreat fracture radius & ulna5.607.445.380.9113.9511.89090
    25574ATreat fracture radius & ulna6.97NA7.211.15NA15.33090
    25575ATreat fracture radius/ulna10.39NA9.501.75NA21.64090
    25600ATreat fracture radius/ulna2.624.522.990.417.556.02090
    25605ATreat fracture radius/ulna5.788.126.080.9714.8712.83090
    25611ATreat fracture radius/ulna7.73NA8.941.29NA17.96090
    25620ATreat fracture radius/ulna8.50NA7.361.40NA17.26090
    25622ATreat wrist bone fracture2.604.693.180.407.696.18090
    25624ATreat wrist bone fracture4.507.064.960.7312.2910.19090
    25628ATreat wrist bone fracture8.38NA7.891.37NA17.64090
    25630ATreat wrist bone fracture2.864.612.990.447.916.29090
    25635ATreat wrist bone fracture4.366.833.970.4711.668.80090
    25645ATreat wrist bone fracture7.21NA6.861.11NA15.18090
    25650ATreat wrist bone fracture3.034.883.270.448.356.74090
    25651APin ulnar styloid fracture5.33NA5.450.86NA11.64090
    25652ATreat fracture ulnar styloid7.56NA6.931.22NA15.71090
    25660ATreat wrist dislocation4.73NA4.710.71NA10.15090
    25670ATreat wrist dislocation7.87NA7.151.28NA16.30090
    25671APin radioulnar dislocation5.97NA6.040.97NA12.98090
    25675ATreat wrist dislocation4.646.574.660.6811.899.98090
    25676ATreat wrist dislocation7.99NA7.401.32NA16.71090
    25680ATreat wrist fracture5.96NA4.800.73NA11.49090
    25685ATreat wrist fracture9.72NA7.961.50NA19.18090
    25690ATreat wrist dislocation5.47NA5.450.93NA11.85090
    25695ATreat wrist dislocation8.29NA7.271.28NA16.84090
    25800AFusion of wrist joint9.70NA9.201.56NA20.46090
    25805AFusion/graft of wrist joint11.22NA10.351.81NA23.38090
    25810AFusion/graft of wrist joint10.51NA9.991.64NA22.14090
    25820AFusion of hand bones7.41NA7.961.15NA16.52090
    25825AFuse hand bones with graft9.22NA9.321.44NA19.98090
    25830AFusion, radioulnar jnt/ulna10.00NA14.861.52NA26.38090
    25900AAmputation of forearm8.96NA13.021.29NA23.27090
    25905AAmputation of forearm9.07NA12.991.27NA23.33090
    25907AAmputation follow-up surgery7.76NA12.361.21NA21.33090
    25909AAmputation follow-up surgery8.91NA12.891.28NA23.08090
    25915AAmputation of forearm16.98NA19.722.89NA39.59090
    25920AAmputate hand at wrist8.63NA8.091.27NA17.99090
    25922AAmputate hand at wrist7.38NA7.251.11NA15.74090
    25924AAmputation follow-up surgery8.41NA8.311.28NA18.00090
    25927AAmputation of hand8.75NA12.271.22NA22.24090
    25929AAmputation follow-up surgery7.55NA6.091.07NA14.71090
    25931AAmputation follow-up surgery7.77NA12.181.05NA21.00090
    25999CForearm or wrist surgery0.000.000.000.000.000.00YYY
    26010ADrainage of finger abscess1.535.771.690.177.473.39010
    26011ADrainage of finger abscess2.189.172.330.3011.654.81010
    26020ADrain hand tendon sheath4.64NA5.630.71NA10.98090
    26025ADrainage of palm bursa4.79NA5.420.72NA10.93090
    26030ADrainage of palm bursa(s)5.90NA6.060.86NA12.82090
    Start Printed Page 63278
    26034ATreat hand bone lesion6.19NA6.330.95NA13.47090
    26035ADecompress fingers/hand9.46NA8.201.34NA19.00090
    26037ADecompress fingers/hand7.21NA6.671.04NA14.92090
    26040ARelease palm contracture3.31NA4.030.54NA7.88090
    26045ARelease palm contracture5.53NA5.620.89NA12.04090
    26055AIncise finger tendon sheath2.6714.703.890.4317.806.99090
    26060AIncision of finger tendon2.79NA3.490.42NA6.70090
    26070AExplore/treat hand joint3.67NA3.400.42NA7.49090
    26075AExplore/treat finger joint3.77NA3.810.48NA8.06090
    26080AExplore/treat finger joint4.22NA4.830.62NA9.67090
    26100ABiopsy hand joint lining3.65NA4.140.54NA8.33090
    26105ABiopsy finger joint lining3.69NA4.220.54NA8.45090
    26110ABiopsy finger joint lining3.51NA4.020.53NA8.06090
    26115ARemovel hand lesion subcut3.8413.494.720.5817.919.14090
    26116ARemovel hand lesion, deep5.50NA5.980.83NA12.31090
    26117ARemove tumor, hand/finger8.50NA7.101.21NA16.81090
    26121ARelease palm contracture7.50NA6.971.13NA15.60090
    26123ARelease palm contracture9.24NA8.841.40NA19.48090
    26125ARelease palm contracture4.58NA2.480.68NA7.74ZZZ
    26130ARemove wrist joint lining5.39NA5.360.78NA11.53090
    26135ARevise finger joint, each6.92NA6.471.04NA14.43090
    26140ARevise finger joint, each6.13NA6.030.91NA13.07090
    26145ATendon excision, palm/finger6.28NA6.050.92NA13.25090
    26160ARemove tendon sheath lesion3.1312.844.080.4716.447.68090
    26170ARemoval of palm tendon, each4.74NA4.940.72NA10.40090
    26180ARemoval of finger tendon5.15NA5.410.77NA11.33090
    26185ARemove finger bone5.22NA5.970.80NA11.99090
    26200ARemove hand bone lesion5.48NA5.350.85NA11.68090
    26205ARemove/graft bone lesion7.66NA6.911.14NA15.71090
    26210ARemoval of finger lesion5.12NA5.420.77NA11.31090
    26215ARemove/graft finger lesion7.06NA6.320.92NA14.30090
    26230APartial removal of hand bone6.29NA5.911.01NA13.21090
    26235APartial removal, finger bone6.15NA5.810.93NA12.89090
    26236APartial removal, finger bone5.29NA5.340.79NA11.42090
    26250AExtensive hand surgery7.51NA6.461.10NA15.07090
    26255AExtensive hand surgery12.36NA9.451.26NA23.07090
    26260AExtensive finger surgery6.99NA6.200.99NA14.18090
    26261AExtensive finger surgery9.04NA6.281.01NA16.33090
    26262APartial removal of finger5.64NA5.350.84NA11.83090
    26320ARemoval of implant from hand3.96NA4.300.59NA8.85090
    26340AManipulate finger w/anesth2.49NA4.790.36NA7.64090
    26350ARepair finger/hand tendon5.96NA15.670.87NA22.50090
    26352ARepair/graft hand tendon7.64NA16.251.11NA25.00090
    26356ARepair finger/hand tendon8.02NA19.111.19NA28.32090
    26357ARepair finger/hand tendon8.53NA16.711.22NA26.46090
    26358ARepair/graft hand tendon9.09NA17.611.28NA27.98090
    26370ARepair finger/hand tendon7.07NA16.111.08NA24.26090
    26372ARepair/graft hand tendon8.71NA17.501.27NA27.48090
    26373ARepair finger/hand tendon8.11NA17.071.17NA26.35090
    26390ARevise hand/finger tendon9.14NA14.071.31NA24.52090
    26392ARepair/graft hand tendon10.20NA17.861.51NA29.57090
    26410ARepair hand tendon4.60NA12.740.68NA18.02090
    26412ARepair/graft hand tendon6.27NA14.080.96NA21.31090
    26415AExcision, hand/finger tendon8.29NA12.430.92NA21.64090
    26416AGraft hand or finger tendon9.32NA15.371.44NA26.13090
    26418ARepair finger tendon4.23NA13.100.60NA17.93090
    26420ARepair/graft finger tendon6.73NA14.430.99NA22.15090
    26426ARepair finger/hand tendon6.11NA13.920.92NA20.95090
    26428ARepair/graft finger tendon7.17NA14.731.01NA22.91090
    26432ARepair finger tendon4.00NA10.810.58NA15.39090
    26433ARepair finger tendon4.53NA11.490.67NA16.69090
    26434ARepair/graft finger tendon6.06NA12.200.85NA19.11090
    26437ARealignment of tendons5.79NA12.120.89NA18.80090
    26440ARelease palm/finger tendon4.99NA14.340.74NA20.07090
    26442ARelease palm & finger tendon8.11NA16.791.13NA26.03090
    26445ARelease hand/finger tendon4.29NA14.090.65NA19.03090
    26449ARelease forearm/hand tendon6.96NA16.571.01NA24.54090
    26450AIncision of palm tendon3.65NA7.660.55NA11.86090
    26455AIncision of finger tendon3.62NA7.590.56NA11.77090
    26460AIncise hand/finger tendon3.44NA7.400.53NA11.37090
    26471AFusion of finger tendons5.70NA11.790.87NA18.36090
    26474AFusion of finger tendons5.29NA11.970.83NA18.09090
    26476ATendon lengthening5.15NA11.490.74NA17.38090
    26477ATendon shortening5.12NA11.660.72NA17.50090
    26478ALengthening of hand tendon5.77NA12.370.92NA19.06090
    Start Printed Page 63279
    26479AShortening of hand tendon5.71NA12.220.91NA18.84090
    26480ATransplant hand tendon6.65NA15.851.01NA23.51090
    26483ATransplant/graft hand tendon8.24NA16.311.23NA25.78090
    26485ATransplant palm tendon7.66NA16.181.13NA24.97090
    26489ATransplant/graft palm tendon9.50NA12.701.17NA23.37090
    26490ARevise thumb tendon8.36NA13.321.26NA22.94090
    26492ATendon transfer with graft9.57NA14.141.43NA25.14090
    26494AHand tendon/muscle transfer8.42NA13.761.35NA23.53090
    26496ARevise thumb tendon9.54NA13.751.40NA24.69090
    26497AFinger tendon transfer9.52NA14.121.40NA25.04090
    26498AFinger tendon transfer13.92NA16.732.09NA32.74090
    26499ARevision of finger8.93NA13.661.13NA23.72090
    26500AHand tendon reconstruction5.93NA12.240.79NA18.96090
    26502AHand tendon reconstruction7.10NA12.721.04NA20.86090
    26504AHand tendon reconstruction7.43NA13.151.01NA21.59090
    26508ARelease thumb contracture5.98NA12.240.91NA19.13090
    26510AThumb tendon transfer5.40NA11.930.85NA18.18090
    26516AFusion of knuckle joint7.11NA12.791.08NA20.98090
    26517AFusion of knuckle joints8.78NA14.121.15NA24.05090
    26518AFusion of knuckle joints8.97NA13.931.35NA24.25090
    26520ARelease knuckle contracture5.27NA14.800.78NA20.85090
    26525ARelease finger contracture5.30NA14.910.79NA21.00090
    26530ARevise knuckle joint6.65NA6.081.03NA13.76090
    26531ARevise knuckle with implant7.86NA7.071.21NA16.14090
    26535ARevise finger joint5.21NA3.730.79NA9.73090
    26536ARevise/implant finger joint6.33NA9.840.96NA17.13090
    26540ARepair hand joint6.39NA12.490.97NA19.85090
    26541ARepair hand joint with graft8.57NA13.991.34NA23.90090
    26542ARepair hand joint with graft6.74NA12.541.04NA20.32090
    26545AReconstruct finger joint6.88NA12.930.95NA20.76090
    26546ARepair nonunion hand8.87NA15.371.37NA25.61090
    26548AReconstruct finger joint7.98NA13.551.17NA22.70090
    26550AConstruct thumb replacement21.12NA18.392.16NA41.67090
    26551AGreat toe-hand transfer46.31NA34.097.87NA88.27090
    26553ASingle transfer, toe-hand46.01NA23.432.39NA71.83090
    26554ADouble transfer, toe-hand54.64NA38.699.30NA102.63090
    26555APositional change of finger16.54NA18.862.55NA37.95090
    26556AToe joint transfer46.99NA34.887.99NA89.86090
    26560ARepair of web finger5.35NA10.410.72NA16.48090
    26561ARepair of web finger10.86NA13.070.83NA24.76090
    26562ARepair of web finger14.91NA17.781.17NA33.86090
    26565ACorrect metacarpal flaw6.70NA12.601.01NA20.31090
    26567ACorrect finger deformity6.78NA12.531.01NA20.32090
    26568ALengthen metacarpal/finger9.03NA16.271.32NA26.62090
    26580ARepair hand deformity18.08NA13.881.75NA33.71090
    26587AReconstruct extra finger13.97NA9.141.34NA24.45090
    26590ARepair finger deformity17.86NA14.561.58NA34.00090
    26591ARepair muscles of hand3.23NA10.560.44NA14.23090
    26593ARelease muscles of hand5.28NA11.630.77NA17.68090
    26596AExcision constricting tissue8.90NA9.121.04NA19.06090
    26600ATreat metacarpal fracture1.954.132.690.306.384.94090
    26605ATreat metacarpal fracture2.835.313.620.468.606.91090
    26607ATreat metacarpal fracture5.33NA6.410.84NA12.58090
    26608ATreat metacarpal fracture5.33NA6.420.87NA12.62090
    26615ATreat metacarpal fracture5.30NA5.590.84NA11.73090
    26641ATreat thumb dislocation3.925.473.640.509.898.06090
    26645ATreat thumb fracture4.386.174.230.6511.209.26090
    26650ATreat thumb fracture5.69NA6.840.92NA13.45090
    26665ATreat thumb fracture7.56NA6.881.16NA15.60090
    26670ATreat hand dislocation3.674.963.090.439.067.19090
    26675ATreat hand dislocation4.616.304.470.6711.589.75090
    26676APin hand dislocation5.49NA6.870.91NA13.27090
    26685ATreat hand dislocation6.94NA6.321.14NA14.40090
    26686ATreat hand dislocation7.89NA7.101.26NA16.25090
    26700ATreat knuckle dislocation3.674.713.020.428.807.11090
    26705ATreat knuckle dislocation4.176.104.310.6010.879.08090
    26706APin knuckle dislocation5.09NA5.150.77NA11.01090
    26715ATreat knuckle dislocation5.71NA5.780.90NA12.39090
    26720ATreat finger fracture, each1.653.942.650.245.834.54090
    26725ATreat finger fracture, each3.316.164.090.529.997.92090
    26727ATreat finger fracture, each5.20NA6.480.83NA12.51090
    26735ATreat finger fracture, each5.95NA5.920.92NA12.79090
    26740ATreat finger fracture, each1.933.602.730.295.824.95090
    26742ATreat finger fracture, each3.835.883.900.5910.308.32090
    26746ATreat finger fracture, each5.78NA5.970.89NA12.64090
    Start Printed Page 63280
    26750ATreat finger fracture, each1.693.182.120.235.104.04090
    26755ATreat finger fracture, each3.084.853.100.448.376.62090
    26756APin finger fracture, each4.36NA6.100.67NA11.13090
    26765ATreat finger fracture, each4.15NA4.820.61NA9.58090
    26770ATreat finger dislocation3.004.472.600.327.795.92090
    26775ATreat finger dislocation3.695.923.880.5210.138.09090
    26776APin finger dislocation4.77NA6.270.76NA11.80090
    26785ATreat finger dislocation4.19NA4.850.65NA9.69090
    26820AThumb fusion with graft8.21NA13.771.33NA23.31090
    26841AFusion of thumb7.09NA13.671.16NA21.92090
    26842AThumb fusion with graft8.19NA13.851.32NA23.36090
    26843AFusion of hand joint7.57NA12.791.19NA21.55090
    26844AFusion/graft of hand joint8.68NA13.821.34NA23.84090
    26850AFusion of knuckle6.93NA12.701.07NA20.70090
    26852AFusion of knuckle with graft8.41NA13.411.26NA23.08090
    26860AFusion of finger joint4.66NA11.680.72NA17.06090
    26861AFusion of finger jnt, add-on1.73NA0.940.26NA2.93ZZZ
    26862AFusion/graft of finger joint7.33NA12.891.10NA21.32090
    26863AFuse/graft added joint3.88NA2.140.61NA6.63ZZZ
    26910AAmputate metacarpal bone7.56NA11.831.08NA20.47090
    26951AAmputation of finger/thumb4.56NA10.740.67NA15.97090
    26952AAmputation of finger/thumb6.27NA12.350.89NA19.51090
    26989CHand/finger surgery0.000.000.000.000.000.00YYY
    26990ADrainage of pelvis lesion7.44NA7.701.10NA16.24090
    26991ADrainage of pelvis bursa6.647.566.001.0215.2213.66090
    26992ADrainage of bone lesion12.95NA11.002.10NA26.05090
    27000AIncision of hip tendon5.59NA5.350.91NA11.85090
    27001AIncision of hip tendon6.90NA6.211.14NA14.25090
    27003AIncision of hip tendon7.30NA6.621.11NA15.03090
    27005AIncision of hip tendon9.60NA7.931.63NA19.16090
    27006AIncision of hip tendons9.62NA8.081.59NA19.29090
    27025AIncision of hip/thigh fascia11.10NA8.671.65NA21.42090
    27030ADrainage of hip joint12.94NA9.762.17NA24.87090
    27033AExploration of hip joint13.31NA10.032.24NA25.58090
    27035ADenervation of hip joint16.59NA12.452.04NA31.08090
    27036AExcision of hip joint/muscle12.81NA10.132.16NA25.10090
    27040ABiopsy of soft tissues2.852.652.070.255.755.17010
    27041ABiopsy of soft tissues9.83NA6.801.21NA17.84090
    27047ARemove hip/pelvis lesion7.416.625.050.9514.9813.41090
    27048ARemove hip/pelvis lesion6.21NA5.100.87NA12.18090
    27049ARemove tumor, hip/pelvis13.58NA8.931.92NA24.43090
    27050ABiopsy of sacroiliac joint4.34NA4.520.64NA9.50090
    27052ABiopsy of hip joint6.19NA5.951.02NA13.16090
    27054ARemoval of hip joint lining8.49NA7.441.40NA17.33090
    27060ARemoval of ischial bursa5.40NA4.880.72NA11.00090
    27062ARemove femur lesion/bursa5.34NA5.280.89NA11.51090
    27065ARemoval of hip bone lesion5.87NA5.600.91NA12.38090
    27066ARemoval of hip bone lesion10.27NA8.591.70NA20.56090
    27067ARemove/graft hip bone lesion13.75NA10.792.34NA26.88090
    27070APartial removal of hip bone10.66NA9.881.63NA22.17090
    27071APartial removal of hip bone11.39NA10.861.81NA24.06090
    27075AExtensive hip surgery34.80NA19.892.66NA57.35090
    27076AExtensive hip surgery21.99NA14.933.43NA40.35090
    27077AExtensive hip surgery39.77NA23.363.81NA66.94090
    27078AExtensive hip surgery13.36NA10.542.00NA25.90090
    27079AExtensive hip surgery13.67NA10.202.23NA26.10090
    27080ARemoval of tail bone6.35NA5.140.96NA12.45090
    27086ARemove hip foreign body1.862.031.890.204.093.95010
    27087ARemove hip foreign body8.49NA6.791.31NA16.59090
    27090ARemoval of hip prosthesis11.09NA8.741.86NA21.69090
    27091ARemoval of hip prosthesis22.01NA14.023.73NA39.76090
    27093AInjection for hip x-ray1.2912.360.490.1113.761.89000
    27095AInjection for hip x-ray1.4910.910.530.1212.522.14000
    27096AInject sacroiliac joint1.399.630.340.1011.121.83000
    27097ARevision of hip tendon8.75NA6.561.46NA16.77090
    27098ATransfer tendon to pelvis8.78NA7.161.49NA17.43090
    27100ATransfer of abdominal muscle11.02NA8.831.88NA21.73090
    27105ATransfer of spinal muscle11.70NA9.311.99NA23.00090
    27110ATransfer of iliopsoas muscle13.18NA9.541.65NA24.37090
    27111ATransfer of iliopsoas muscle12.08NA9.281.77NA23.13090
    27120AReconstruction of hip socket17.91NA11.872.94NA32.72090
    27122AReconstruction of hip socket14.89NA11.022.49NA28.40090
    27125APartial hip replacement14.61NA10.602.46NA27.67090
    27130ATotal hip arthroplasty20.01NA13.353.38NA36.74090
    27132ATotal hip arthroplasty23.17NA15.653.91NA42.73090
    Start Printed Page 63281
    27134ARevise hip joint replacement28.36NA17.884.76NA51.00090
    27137ARevise hip joint replacement21.05NA13.963.56NA38.57090
    27138ARevise hip joint replacement22.04NA14.443.73NA40.21090
    27140ATransplant femur ridge12.17NA9.522.00NA23.69090
    27146AIncision of hip bone17.33NA12.382.72NA32.43090
    27147ARevision of hip bone20.46NA13.493.13NA37.08090
    27151AIncision of hip bones22.38NA8.383.74NA34.50090
    27156ARevision of hip bones24.49NA16.274.17NA44.93090
    27158ARevision of pelvis19.63NA11.373.12NA34.12090
    27161AIncision of neck of femur16.61NA12.212.78NA31.60090
    27165AIncision/fixation of femur17.81NA12.993.01NA33.81090
    27170ARepair/graft femur head/neck15.98NA11.422.64NA30.04090
    27175ATreat slipped epiphysis8.41NA6.651.43NA16.49090
    27176ATreat slipped epiphysis11.98NA9.092.01NA23.08090
    27177ATreat slipped epiphysis14.99NA10.952.53NA28.47090
    27178ATreat slipped epiphysis11.92NA8.512.01NA22.44090
    27179ARevise head/neck of femur12.91NA10.022.21NA25.14090
    27181ATreat slipped epiphysis14.60NA10.262.09NA26.95090
    27185ARevision of femur epiphysis9.13NA7.661.55NA18.34090
    27187AReinforce hip bones13.46NA10.442.27NA26.17090
    27193ATreat pelvic ring fracture5.537.185.800.9213.6312.25090
    27194ATreat pelvic ring fracture9.598.867.581.5820.0318.75090
    27200ATreat tail bone fracture1.833.082.210.265.174.30090
    27202ATreat tail bone fracture7.00NA17.890.83NA25.72090
    27215ATreat pelvic fracture(s)9.99NA7.251.64NA18.88090
    27216ATreat pelvic ring fracture15.10NA9.842.58NA27.52090
    27217ATreat pelvic ring fracture14.03NA10.272.34NA26.64090
    27218ATreat pelvic ring fracture20.04NA11.643.42NA35.10090
    27220ATreat hip socket fracture6.147.135.571.0214.2912.73090
    27222ATreat hip socket fracture12.63NA9.982.12NA24.73090
    27226ATreat hip wall fracture14.83NA8.052.48NA25.36090
    27227ATreat hip fracture(s)23.32NA15.523.88NA42.72090
    27228ATreat hip fracture(s)27.01NA17.764.52NA49.29090
    27230ATreat thigh fracture5.476.595.110.8712.9311.45090
    27232ATreat thigh fracture10.62NA7.261.74NA19.62090
    27235ATreat thigh fracture12.09NA9.502.05NA23.64090
    27236ATreat thigh fracture15.51NA11.052.61NA29.17090
    27238ATreat thigh fracture5.49NA5.150.91NA11.55090
    27240ATreat thigh fracture12.43NA9.472.03NA23.93090
    27244ATreat thigh fracture15.85NA11.372.67NA29.89090
    27245ATreat thigh fracture20.19NA13.843.42NA37.45090
    27246ATreat thigh fracture4.685.734.470.7911.209.94090
    27248ATreat thigh fracture10.39NA8.281.74NA20.41090
    27250ATreat hip dislocation6.91NA4.840.82NA12.57090
    27252ATreat hip dislocation10.33NA7.471.64NA19.44090
    27253ATreat hip dislocation12.85NA9.822.17NA24.84090
    27254ATreat hip dislocation18.16NA12.163.02NA33.34090
    27256ATreat hip dislocation4.103.472.110.598.166.80010
    27257ATreat hip dislocation5.19NA2.920.67NA8.78010
    27258ATreat hip dislocation15.34NA11.032.47NA28.84090
    27259ATreat hip dislocation21.43NA14.273.58NA39.28090
    27265ATreat hip dislocation5.02NA4.810.78NA10.61090
    27266ATreat hip dislocation7.45NA6.331.25NA15.03090
    27275AManipulation of hip joint2.26NA2.150.37NA4.78010
    27280AFusion of sacroiliac joint13.31NA10.412.37NA26.09090
    27282AFusion of pubic bones11.28NA8.331.37NA20.98090
    27284AFusion of hip joint23.32NA14.992.83NA41.14090
    27286AFusion of hip joint23.32NA15.982.84NA42.14090
    27290AAmputation of leg at hip23.15NA14.323.52NA40.99090
    27295AAmputation of leg at hip18.54NA11.652.82NA33.01090
    27299CPelvis/hip joint surgery0.000.000.000.000.000.00YYY
    27301ADrain thigh/knee lesion6.457.425.910.9614.8313.32090
    27303ADrainage of bone lesion8.23NA7.321.37NA16.92090
    27305AIncise thigh tendon & fascia5.89NA5.400.92NA12.21090
    27306AIncision of thigh tendon4.59NA4.850.74NA10.18090
    27307AIncision of thigh tendons5.77NA5.580.93NA12.28090
    27310AExploration of knee joint9.22NA7.621.55NA18.39090
    27315APartial removal, thigh nerve6.93NA4.880.95NA12.76090
    27320APartial removal, thigh nerve6.26NA5.180.93NA12.37090
    27323ABiopsy, thigh soft tissues2.272.221.940.204.694.41010
    27324ABiopsy, thigh soft tissues4.87NA4.400.71NA9.98090
    27327ARemoval of thigh lesion4.445.403.950.6010.448.99090
    27328ARemoval of thigh lesion5.54NA4.610.79NA10.94090
    27329ARemove tumor, thigh/knee14.06NA9.622.01NA25.69090
    27330ABiopsy, knee joint lining4.94NA4.690.79NA10.42090
    Start Printed Page 63282
    27331AExplore/treat knee joint5.85NA5.570.97NA12.39090
    27332ARemoval of knee cartilage8.22NA7.141.38NA16.74090
    27333ARemoval of knee cartilage7.26NA6.681.23NA15.17090
    27334ARemove knee joint lining8.65NA7.461.45NA17.56090
    27335ARemove knee joint lining9.94NA8.271.69NA19.90090
    27340ARemoval of kneecap bursa4.16NA4.570.70NA9.43090
    27345ARemoval of knee cyst5.89NA5.660.97NA12.52090
    27347ARemove knee cyst5.75NA5.480.91NA12.14090
    27350ARemoval of kneecap8.12NA7.261.38NA16.76090
    27355ARemove femur lesion7.61NA6.881.28NA15.77090
    27356ARemove femur lesion/graft9.43NA7.971.55NA18.95090
    27357ARemove femur lesion/graft10.47NA8.801.77NA21.04090
    27358ARemove femur lesion/fixation4.71NA2.560.80NA8.07ZZZ
    27360APartial removal, leg bone(s)10.44NA10.041.70NA22.18090
    27365AExtensive leg surgery16.18NA11.802.71NA30.69090
    27370AInjection for knee x-ray0.9512.160.330.0713.181.35000
    27372ARemoval of foreign body5.046.084.730.7411.8610.51090
    27380ARepair of kneecap tendon7.12NA7.331.20NA15.65090
    27381ARepair/graft kneecap tendon10.28NA9.141.73NA21.15090
    27385ARepair of thigh muscle7.72NA7.671.31NA16.70090
    27386ARepair/graft of thigh muscle10.50NA9.571.79NA21.86090
    27390AIncision of thigh tendon5.30NA5.310.83NA11.44090
    27391AIncision of thigh tendons7.16NA6.701.19NA15.05090
    27392AIncision of thigh tendons9.15NA7.801.47NA18.42090
    27393ALengthening of thigh tendon6.35NA5.911.08NA13.34090
    27394ALengthening of thigh tendons8.45NA7.351.40NA17.20090
    27395ALengthening of thigh tendons11.66NA9.491.95NA23.10090
    27396ATransplant of thigh tendon7.82NA7.131.33NA16.28090
    27397ATransplants of thigh tendons11.22NA9.141.89NA22.25090
    27400ARevise thigh muscles/tendons8.97NA7.421.41NA17.80090
    27403ARepair of knee cartilage8.28NA7.221.39NA16.89090
    27405ARepair of knee ligament8.60NA7.541.45NA17.59090
    27407ARepair of knee ligament10.22NA8.391.65NA20.26090
    27409ARepair of knee ligaments12.83NA10.012.10NA24.94090
    27418ARepair degenerated kneecap10.79NA8.951.81NA21.55090
    27420ARevision of unstable kneecap9.77NA8.151.65NA19.57090
    27422ARevision of unstable kneecap9.72NA8.161.64NA19.52090
    27424ARevision/removal of kneecap9.75NA8.131.65NA19.53090
    27425ALat retinacular release open5.19NA5.550.87NA11.61090
    27427AReconstruction, knee9.31NA7.821.55NA18.68090
    27428AReconstruction, knee13.92NA11.212.34NA27.47090
    27429AReconstruction, knee15.43NA12.472.61NA30.51090
    27430ARevision of thigh muscles9.61NA8.051.62NA19.28090
    27435AIncision of knee joint9.44NA8.451.59NA19.48090
    27437ARevise kneecap8.41NA7.191.41NA17.01090
    27438ARevise kneecap with implant11.17NA8.511.87NA21.55090
    27440ARevision of knee joint10.37NA6.081.70NA18.15090
    27441ARevision of knee joint10.76NA6.761.79NA19.31090
    27442ARevision of knee joint11.82NA8.902.01NA22.73090
    27443ARevision of knee joint10.87NA8.671.82NA21.36090
    27445ARevision of knee joint17.58NA12.352.98NA32.91090
    27446ARevision of knee joint15.75NA11.262.66NA29.67090
    27447ATotal knee arthroplasty21.36NA14.613.60NA39.57090
    27448AIncision of thigh11.00NA8.741.81NA21.55090
    27450AIncision of thigh13.90NA10.712.35NA26.96090
    27454ARealignment of thigh bone17.46NA12.622.95NA33.03090
    27455ARealignment of knee12.75NA9.962.13NA24.84090
    27457ARealignment of knee13.37NA10.012.25NA25.63090
    27465AShortening of thigh bone13.79NA10.452.23NA26.47090
    27466ALengthening of thigh bone16.24NA12.002.30NA30.54090
    27468AShorten/lengthen thighs18.86NA12.583.21NA34.65090
    27470ARepair of thigh15.98NA11.962.68NA30.62090
    27472ARepair/graft of thigh17.62NA12.862.98NA33.46090
    27475ASurgery to stop leg growth8.59NA7.301.35NA17.24090
    27477ASurgery to stop leg growth9.79NA7.821.57NA19.18090
    27479ASurgery to stop leg growth12.73NA9.962.17NA24.86090
    27485ASurgery to stop leg growth8.79NA7.461.49NA17.74090
    27486ARevise/replace knee joint19.16NA13.483.24NA35.88090
    27487ARevise/replace knee joint25.13NA16.594.24NA45.96090
    27488ARemoval of knee prosthesis15.65NA11.662.65NA29.96090
    27495AReinforce thigh15.46NA11.592.61NA29.66090
    27496ADecompression of thigh/knee6.08NA5.770.92NA12.77090
    27497ADecompression of thigh/knee7.13NA5.711.01NA13.85090
    27498ADecompression of thigh/knee7.94NA6.131.16NA15.23090
    27499ADecompression of thigh/knee8.95NA7.061.41NA17.42090
    Start Printed Page 63283
    27500ATreatment of thigh fracture5.897.095.050.9613.9411.90090
    27501ATreatment of thigh fracture5.897.655.730.9914.5312.61090
    27502ATreatment of thigh fracture10.52NA8.201.79NA20.51090
    27503ATreatment of thigh fracture10.52NA8.351.79NA20.66090
    27506ATreatment of thigh fracture17.35NA12.842.79NA32.98090
    27507ATreatment of thigh fracture13.91NA9.982.34NA26.23090
    27508ATreatment of thigh fracture5.807.055.380.9613.8112.14090
    27509ATreatment of thigh fracture7.67NA7.991.29NA16.95090
    27510ATreatment of thigh fracture9.08NA7.251.51NA17.84090
    27511ATreatment of thigh fracture13.56NA11.312.29NA27.16090
    27513ATreatment of thigh fracture17.82NA13.973.01NA34.80090
    27514ATreatment of thigh fracture17.20NA13.442.89NA33.53090
    27516ATreat thigh fx growth plate5.347.355.440.8913.5811.67090
    27517ATreat thigh fx growth plate8.738.997.421.4619.1817.61090
    27519ATreat thigh fx growth plate14.93NA11.752.51NA29.19090
    27520ATreat kneecap fracture2.845.293.460.468.596.76090
    27524ATreat kneecap fracture9.94NA8.231.68NA19.85090
    27530ATreat knee fracture3.765.954.320.6110.328.69090
    27532ATreat knee fracture7.267.906.321.2216.3814.80090
    27535ATreat knee fracture11.43NA10.201.93NA23.56090
    27536ATreat knee fracture15.56NA11.602.62NA29.78090
    27538ATreat knee fracture(s)4.847.145.140.8012.7810.78090
    27540ATreat knee fracture13.03NA9.572.16NA24.76090
    27550ATreat knee dislocation5.736.664.990.8213.2111.54090
    27552ATreat knee dislocation7.85NA6.941.32NA16.11090
    27556ATreat knee dislocation14.33NA11.782.41NA28.52090
    27557ATreat knee dislocation16.67NA13.262.84NA32.77090
    27558ATreat knee dislocation17.62NA13.223.01NA33.85090
    27560ATreat kneecap dislocation3.805.653.350.489.937.63090
    27562ATreat kneecap dislocation5.76NA4.850.83NA11.44090
    27566ATreat kneecap dislocation12.16NA9.352.07NA23.58090
    27570AFixation of knee joint1.73NA1.830.29NA3.85010
    27580AFusion of knee19.26NA14.913.24NA37.41090
    27590AAmputate leg at thigh11.96NA7.141.62NA20.72090
    27591AAmputate leg at thigh12.61NA8.951.95NA23.51090
    27592AAmputate leg at thigh9.96NA6.641.40NA18.00090
    27594AAmputation follow-up surgery6.88NA5.480.98NA13.34090
    27596AAmputation follow-up surgery10.54NA7.281.49NA19.31090
    27598AAmputate lower leg at knee10.47NA7.381.49NA19.34090
    27599CLeg surgery procedure0.000.000.000.000.000.00YYY
    27600ADecompression of lower leg5.62NA4.720.82NA11.16090
    27601ADecompression of lower leg5.61NA5.050.83NA11.49090
    27602ADecompression of lower leg7.31NA5.341.02NA13.67090
    27603ADrain lower leg lesion4.9110.784.880.6716.3610.46090
    27604ADrain lower leg bursa4.448.714.570.6513.809.66090
    27605AIncision of achilles tendon2.858.892.360.4612.205.67010
    27606AIncision of achilles tendon4.1210.173.440.6814.978.24010
    27607ATreat lower leg bone lesion7.92NA6.651.29NA15.86090
    27610AExplore/treat ankle joint8.29NA7.131.38NA16.80090
    27612AExploration of ankle joint7.29NA6.181.21NA14.68090
    27613ABiopsy lower leg soft tissue2.163.811.780.196.164.13010
    27614ABiopsy lower leg soft tissue5.638.894.670.7415.2611.04090
    27615ARemove tumor, lower leg12.49NA10.681.67NA24.84090
    27618ARemove lower leg lesion5.069.204.260.6514.919.97090
    27619ARemove lower leg lesion8.3510.736.231.2120.2915.79090
    27620AExplore/treat ankle joint5.95NA5.550.99NA12.49090
    27625ARemove ankle joint lining8.25NA6.611.39NA16.25090
    27626ARemove ankle joint lining8.86NA7.081.47NA17.41090
    27630ARemoval of tendon lesion4.779.124.510.7214.6110.00090
    27635ARemove lower leg bone lesion7.74NA6.921.27NA15.93090
    27637ARemove/graft leg bone lesion9.79NA8.431.65NA19.87090
    27638ARemove/graft leg bone lesion10.51NA8.481.76NA20.75090
    27640APartial removal of tibia11.31NA10.931.85NA24.09090
    27641APartial removal of fibula9.19NA8.921.46NA19.57090
    27645AExtensive lower leg surgery14.09NA12.472.37NA28.93090
    27646AExtensive lower leg surgery12.59NA11.451.86NA25.90090
    27647AExtensive ankle/heel surgery12.17NA7.911.97NA22.05090
    27648AInjection for ankle x-ray0.959.540.330.0610.551.34000
    27650ARepair achilles tendon9.63NA7.591.62NA18.84090
    27652ARepair/graft achilles tendon10.27NA8.101.74NA20.11090
    27654ARepair of achilles tendon9.96NA7.301.69NA18.95090
    27656ARepair leg fascia defect4.5410.074.040.5815.199.16090
    27658ARepair of leg tendon, each4.959.294.820.8215.0610.59090
    27659ARepair of leg tendon, each6.7711.425.851.1519.3413.77090
    27664ARepair of leg tendon, each4.5611.394.790.7616.7110.11090
    Start Printed Page 63284
    27665ARepair of leg tendon, each5.3711.175.240.9017.4411.51090
    27675ARepair lower leg tendons7.14NA5.851.21NA14.20090
    27676ARepair lower leg tendons8.37NA6.851.38NA16.60090
    27680ARelease of lower leg tendon5.71NA5.250.96NA11.92090
    27681ARelease of lower leg tendons6.78NA6.021.10NA13.90090
    27685ARevision of lower leg tendon6.468.215.571.0915.7613.12090
    27686ARevise lower leg tendons7.4212.676.661.2621.3515.34090
    27687ARevision of calf tendon6.20NA5.481.05NA12.73090
    27690ARevise lower leg tendon8.66NA6.521.46NA16.64090
    27691ARevise lower leg tendon9.90NA7.901.68NA19.48090
    27692ARevise additional leg tendon1.86NA0.940.31NA3.11ZZZ
    27695ARepair of ankle ligament6.47NA5.981.08NA13.53090
    27696ARepair of ankle ligaments8.22NA6.571.39NA16.18090
    27698ARepair of ankle ligament9.31NA7.061.57NA17.94090
    27700ARevision of ankle joint9.24NA5.691.49NA16.42090
    27702AReconstruct ankle joint13.59NA10.432.30NA26.32090
    27703AReconstruction, ankle joint15.78NA11.202.68NA29.66090
    27704ARemoval of ankle implant7.58NA5.610.73NA13.92090
    27705AIncision of tibia10.32NA8.331.73NA20.38090
    27707AIncision of fibula4.35NA5.070.72NA10.14090
    27709AIncision of tibia & fibula9.89NA8.251.67NA19.81090
    27712ARealignment of lower leg14.17NA10.842.40NA27.41090
    27715ARevision of lower leg14.31NA10.952.40NA27.66090
    27720ARepair of tibia11.72NA9.561.99NA23.27090
    27722ARepair/graft of tibia11.75NA9.321.98NA23.05090
    27724ARepair/graft of tibia18.10NA12.582.52NA33.20090
    27725ARepair of lower leg15.50NA12.012.64NA30.15090
    27727ARepair of lower leg13.93NA10.522.21NA26.66090
    27730ARepair of tibia epiphysis7.3717.946.520.9026.2114.79090
    27732ARepair of fibula epiphysis5.2911.725.060.7617.7711.11090
    27734ARepair lower leg epiphyses8.43NA6.491.02NA15.94090
    27740ARepair of leg epiphyses9.2520.848.011.5731.6618.83090
    27742ARepair of leg epiphyses10.2412.647.341.8624.7419.44090
    27745AReinforce tibia10.01NA8.301.65NA19.96090
    27750ATreatment of tibia fracture3.175.433.810.529.127.50090
    27752ATreatment of tibia fracture5.817.465.550.9814.2512.34090
    27756ATreatment of tibia fracture6.74NA6.601.13NA14.47090
    27758ATreatment of tibia fracture11.60NA9.291.82NA22.71090
    27759ATreatment of tibia fracture13.68NA10.432.31NA26.42090
    27760ATreatment of ankle fracture2.995.313.590.478.777.05090
    27762ATreatment of ankle fracture5.227.205.220.8513.2711.29090
    27766ATreatment of ankle fracture8.31NA7.241.40NA16.95090
    27780ATreatment of fibula fracture2.634.983.250.408.016.28090
    27781ATreatment of fibula fracture4.376.424.540.6811.479.59090
    27784ATreatment of fibula fracture7.07NA6.531.17NA14.77090
    27786ATreatment of ankle fracture2.825.153.370.448.416.63090
    27788ATreatment of ankle fracture4.426.544.540.7311.699.69090
    27792ATreatment of ankle fracture7.62NA6.981.28NA15.88090
    27808ATreatment of ankle fracture2.815.763.650.469.036.92090
    27810ATreatment of ankle fracture5.107.035.050.8512.9811.00090
    27814ATreatment of ankle fracture10.62NA8.631.80NA21.05090
    27816ATreatment of ankle fracture2.875.053.450.448.366.76090
    27818ATreatment of ankle fracture5.477.145.100.8913.5011.46090
    27822ATreatment of ankle fracture10.94NA10.751.55NA23.24090
    27823ATreatment of ankle fracture12.93NA11.611.98NA26.52090
    27824ATreat lower leg fracture2.875.633.780.478.977.12090
    27825ATreat lower leg fracture6.158.285.921.0215.4513.09090
    27826ATreat lower leg fracture8.49NA8.961.43NA18.88090
    27827ATreat lower leg fracture13.98NA12.852.35NA29.18090
    27828ATreat lower leg fracture16.14NA14.002.72NA32.86090
    27829ATreat lower leg joint5.46NA6.850.92NA13.23090
    27830ATreat lower leg dislocation3.775.193.880.539.498.18090
    27831ATreat lower leg dislocation4.53NA4.500.73NA9.76090
    27832ATreat lower leg dislocation6.45NA6.221.09NA13.76090
    27840ATreat ankle dislocation4.55NA3.950.56NA9.06090
    27842ATreat ankle dislocation6.17NA5.150.91NA12.23090
    27846ATreat ankle dislocation9.73NA8.011.63NA19.37090
    27848ATreat ankle dislocation11.14NA9.811.86NA22.81090
    27860AFixation of ankle joint2.33NA2.030.37NA4.73010
    27870AFusion of ankle joint, open13.83NA10.612.34NA26.78090
    27871AFusion of tibiofibular joint9.12NA7.701.55NA18.37090
    27880AAmputation of lower leg11.78NA7.511.65NA20.94090
    27881AAmputation of lower leg12.27NA9.091.91NA23.27090
    27882AAmputation of lower leg8.89NA7.001.23NA17.12090
    27884AAmputation follow-up surgery8.16NA6.131.14NA15.43090
    Start Printed Page 63285
    27886AAmputation follow-up surgery9.27NA6.881.35NA17.50090
    27888AAmputation of foot at ankle9.61NA7.671.51NA18.79090
    27889AAmputation of foot at ankle9.92NA6.791.43NA18.14090
    27892ADecompression of leg7.35NA5.891.03NA14.27090
    27893ADecompression of leg7.31NA5.801.08NA14.19090
    27894ADecompression of leg10.43NA7.991.50NA19.92090
    27899CLeg/ankle surgery procedure0.000.000.000.000.000.00YYY
    28001ADrainage of bursa of foot2.715.883.540.378.966.62010
    28002ATreatment of foot infection4.597.304.680.6712.569.94010
    28003ATreatment of foot infection8.367.756.101.2317.3415.69090
    28005ATreat foot bone lesion8.63NA6.431.37NA16.43090
    28008AIncision of foot fascia4.425.753.590.6710.848.68090
    28010AIncision of toe tendon2.825.592.940.478.886.23090
    28011AIncision of toe tendons4.127.504.290.7012.329.11090
    28020AExploration of foot joint4.987.144.250.7712.8910.00090
    28022AExploration of foot joint4.646.163.970.7411.549.35090
    28024AExploration of toe joint4.366.264.030.6011.228.99090
    28030ARemoval of foot nerve6.11NA3.621.02NA10.75090
    28035ADecompression of tibia nerve5.065.594.070.8511.509.98090
    28043AExcision of foot lesion3.525.853.310.549.917.37090
    28045AExcision of foot lesion4.696.193.750.7411.629.18090
    28046AResection of tumor, foot10.129.537.421.3521.0018.89090
    28050ABiopsy of foot joint lining4.235.843.700.6610.738.59090
    28052ABiopsy of foot joint lining3.926.053.600.6110.588.13090
    28054ABiopsy of toe joint lining3.435.883.400.549.857.37090
    28060APartial removal, foot fascia5.206.464.070.8312.4910.10090
    28062ARemoval of foot fascia6.487.214.241.0214.7111.74090
    28070ARemoval of foot joint lining5.076.023.930.8211.919.82090
    28072ARemoval of foot joint lining4.556.504.370.7711.829.69090
    28080ARemoval of foot lesion3.565.993.740.6010.157.90090
    28086AExcise foot tendon sheath4.759.604.740.7915.1410.28090
    28088AExcise foot tendon sheath3.847.134.040.6211.598.50090
    28090ARemoval of foot lesion4.386.093.590.6811.158.65090
    28092ARemoval of toe lesions3.626.403.650.5510.577.82090
    28100ARemoval of ankle/heel lesion5.639.334.860.9115.8711.40090
    28102ARemove/graft foot lesion7.69NA6.091.16NA14.94090
    28103ARemove/graft foot lesion6.468.504.811.0716.0312.34090
    28104ARemoval of foot lesion5.096.414.090.8312.3310.01090
    28106ARemove/graft foot lesion7.12NA4.641.21NA12.97090
    28107ARemove/graft foot lesion5.537.334.370.8913.7510.79090
    28108ARemoval of toe lesions4.145.503.380.6210.268.14090
    28110APart removal of metatarsal4.066.093.720.5910.748.37090
    28111APart removal of metatarsal4.987.284.230.7613.029.97090
    28112APart removal of metatarsal4.466.774.100.7211.959.28090
    28113APart removal of metatarsal4.766.894.710.7612.4110.23090
    28114ARemoval of metatarsal heads9.7312.068.601.6323.4219.96090
    28116ARevision of foot7.717.285.281.2316.2214.22090
    28118ARemoval of heel bone5.937.204.570.9514.0811.45090
    28119ARemoval of heel spur5.366.273.910.8912.5210.16090
    28120APart removal of ankle/heel5.378.795.120.8314.9911.32090
    28122APartial removal of foot bone7.257.985.751.1516.3814.15090
    28124APartial removal of toe4.786.144.100.7811.709.66090
    28126APartial removal of toe3.505.393.550.599.487.64090
    28130ARemoval of ankle bone8.06NA6.781.33NA16.17090
    28140ARemoval of metatarsal6.878.355.051.0116.2312.93090
    28150ARemoval of toe4.076.043.820.6210.738.51090
    28153APartial removal of toe3.645.463.110.599.697.34090
    28160APartial removal of toe3.725.753.870.6110.088.20090
    28171AExtensive foot surgery9.55NA5.761.35NA16.66090
    28173AExtensive foot surgery8.758.355.701.2518.3515.70090
    28175AExtensive foot surgery6.026.754.130.9013.6711.05090
    28190ARemoval of foot foreign body1.956.603.550.198.745.69010
    28192ARemoval of foot foreign body4.616.513.760.6211.748.99090
    28193ARemoval of foot foreign body5.706.424.160.7612.8810.62090
    28200ARepair of foot tendon4.576.003.750.7111.289.03090
    28202ARepair/graft of foot tendon6.808.174.671.0316.0012.50090
    28208ARepair of foot tendon4.355.793.500.7110.858.56090
    28210ARepair/graft of foot tendon6.317.204.250.9214.4311.48090
    28220ARelease of foot tendon4.505.623.600.7610.888.86090
    28222ARelease of foot tendons5.596.014.280.9212.5210.79090
    28225ARelease of foot tendon3.645.323.110.609.567.35090
    28226ARelease of foot tendons4.505.673.890.7410.919.13090
    28230AIncision of foot tendon(s)4.225.693.840.7110.628.77090
    28232AIncision of toe tendon3.375.733.480.589.687.43090
    28234AIncision of foot tendon3.355.893.510.559.797.41090
    Start Printed Page 63286
    28238ARevision of foot tendon7.698.065.121.2917.0414.10090
    28240ARelease of big toe4.345.653.670.7310.728.74090
    28250ARevision of foot fascia5.896.604.310.9713.4611.17090
    28260ARelease of midfoot joint7.917.155.191.2916.3514.39090
    28261ARevision of foot tendon11.669.007.411.9922.6521.06090
    28262ARevision of foot and ankle15.7414.4811.562.6632.8829.96090
    28264ARelease of midfoot joint10.298.597.901.7520.6319.94090
    28270ARelease of foot contracture4.735.964.240.8011.499.77090
    28272ARelease of toe joint, each3.785.203.070.629.607.47090
    28280AFusion of toes5.167.334.560.8613.3510.58090
    28285ARepair of hammertoe4.566.023.880.7711.359.21090
    28286ARepair of hammertoe4.535.803.710.7711.109.01090
    28288APartial removal of foot bone4.716.765.360.7812.2510.85090
    28289ARepair hallux rigidus7.009.076.271.1517.2214.42090
    28290ACorrection of bunion5.637.095.340.9513.6711.92090
    28292ACorrection of bunion7.007.885.811.1716.0513.98090
    28293ACorrection of bunion9.1010.956.071.5321.5816.70090
    28294ACorrection of bunion8.517.725.141.3917.6215.04090
    28296ACorrection of bunion9.138.235.861.5318.8916.52090
    28297ACorrection of bunion9.139.216.831.5719.9117.53090
    28298ACorrection of bunion7.897.385.461.3416.6114.69090
    28299ACorrection of bunion10.528.806.481.4920.8118.49090
    28300AIncision of heel bone9.4913.257.141.5724.3118.20090
    28302AIncision of ankle bone9.5013.257.031.3824.1317.91090
    28304AIncision of midfoot bones9.118.255.861.2018.5616.17090
    28305AIncise/graft midfoot bones10.4411.006.880.6622.1017.98090
    28306AIncision of metatarsal5.837.274.300.9714.0711.10090
    28307AIncision of metatarsal6.2911.705.390.8518.8412.53090
    28308AIncision of metatarsal5.266.133.800.8912.289.95090
    28309AIncision of metatarsals12.71NA8.141.97NA22.82090
    28310ARevision of big toe5.406.304.000.9112.6110.31090
    28312ARevision of toe4.526.034.150.7411.299.41090
    28313ARepair deformity of toe4.986.505.510.8212.3011.31090
    28315ARemoval of sesamoid bone4.835.883.700.7911.509.32090
    28320ARepair of foot bones9.13NA6.831.52NA17.48090
    28322ARepair of metatarsals8.2910.246.391.4019.9316.08090
    28340AResect enlarged toe tissue6.947.124.471.1715.2312.58090
    28341AResect enlarged toe8.367.305.001.4117.0714.77090
    28344ARepair extra toe(s)4.246.853.730.7211.818.69090
    28345ARepair webbed toe(s)5.897.074.831.0113.9711.73090
    28360AReconstruct cleft foot13.26NA10.612.25NA26.12090
    28400ATreatment of heel fracture2.154.333.030.356.835.53090
    28405ATreatment of heel fracture4.545.574.580.7610.879.88090
    28406ATreatment of heel fracture6.27NA6.871.04NA14.18090
    28415ATreat heel fracture15.88NA13.392.68NA31.95090
    28420ATreat/graft heel fracture16.55NA13.102.74NA32.39090
    28430ATreatment of ankle fracture2.084.122.650.326.525.05090
    28435ATreatment of ankle fracture3.384.563.680.568.507.62090
    28436ATreatment of ankle fracture4.68NA5.960.79NA11.43090
    28445ATreat ankle fracture15.53NA11.141.55NA28.22090
    28450ATreat midfoot fracture, each1.894.122.550.306.314.74090
    28455ATreat midfoot fracture, each3.074.013.450.527.607.04090
    28456ATreat midfoot fracture2.66NA4.260.43NA7.35090
    28465ATreat midfoot fracture, each6.97NA6.441.04NA14.45090
    28470ATreat metatarsal fracture1.983.922.520.316.214.81090
    28475ATreat metatarsal fracture2.954.103.220.497.546.66090
    28476ATreat metatarsal fracture3.36NA5.050.55NA8.96090
    28485ATreat metatarsal fracture5.68NA5.610.96NA12.25090
    28490ATreat big toe fracture1.082.231.770.163.473.01090
    28495ATreat big toe fracture1.572.522.100.234.323.90090
    28496ATreat big toe fracture2.329.823.670.3812.526.37090
    28505ATreat big toe fracture3.799.824.750.6014.219.14090
    28510ATreatment of toe fracture1.082.001.730.163.242.97090
    28515ATreatment of toe fracture1.452.362.020.204.013.67090
    28525ATreat toe fracture3.309.414.300.5313.248.13090
    28530ATreat sesamoid bone fracture1.052.101.490.163.312.70090
    28531ATreat sesamoid bone fracture2.349.072.530.4011.815.27090
    28540ATreat foot dislocation2.032.902.710.295.225.03090
    28545ATreat foot dislocation2.442.892.890.405.735.73090
    28546ATreat foot dislocation3.188.024.880.5511.758.61090
    28555ARepair foot dislocation6.2611.646.621.0518.9513.93090
    28570ATreat foot dislocation1.652.922.310.264.834.22090
    28575ATreat foot dislocation3.294.434.080.548.267.91090
    28576ATreat foot dislocation4.1510.335.570.6715.1510.39090
    28585ARepair foot dislocation7.948.236.611.3517.5215.90090
    Start Printed Page 63287
    28600ATreat foot dislocation1.883.322.700.295.494.87090
    28605ATreat foot dislocation2.693.793.650.426.906.76090
    28606ATreat foot dislocation4.8716.216.070.8221.9011.76090
    28615ARepair foot dislocation7.73NA8.081.31NA17.12090
    28630ATreat toe dislocation1.691.241.140.203.133.03010
    28635ATreat toe dislocation1.901.681.510.293.873.70010
    28636ATreat toe dislocation2.756.223.100.479.446.32010
    28645ARepair toe dislocation4.205.733.540.7010.638.44090
    28660ATreat toe dislocation1.221.631.190.132.982.54010
    28665ATreat toe dislocation1.911.671.650.293.873.85010
    28666ATreat toe dislocation2.646.072.260.469.175.36010
    28675ARepair of toe dislocation2.908.923.810.4912.317.20090
    28705AFusion of foot bones18.69NA12.562.55NA33.80090
    28715AFusion of foot bones13.03NA9.842.21NA25.08090
    28725AFusion of foot bones11.54NA8.391.95NA21.88090
    28730AFusion of foot bones10.70NA8.561.81NA21.07090
    28735AFusion of foot bones10.79NA7.961.81NA20.56090
    28737ARevision of foot bones9.59NA6.941.63NA18.16090
    28740AFusion of foot bones7.9711.726.511.3521.0415.83090
    28750AFusion of big toe joint7.2613.116.661.2321.6015.15090
    28755AFusion of big toe joint4.716.903.900.7912.409.40090
    28760AFusion of big toe joint7.718.145.691.2817.1314.68090
    28800AAmputation of midfoot8.16NA6.091.17NA15.42090
    28805AAmputation thru metatarsal8.34NA5.941.16NA15.44090
    28810AAmputation toe & metatarsal6.17NA4.790.84NA11.80090
    28820AAmputation of toe4.388.584.120.6113.579.11090
    28825APartial amputation of toe3.578.003.820.5212.097.91090
    28899CFoot/toes surgery procedure0.000.000.000.000.000.00YYY
    29000AApplication of body cast2.243.141.750.365.744.35000
    29010AApplication of body cast2.053.331.750.325.704.12000
    29015AApplication of body cast2.403.041.600.255.694.25000
    29020AApplication of body cast2.103.331.430.195.623.72000
    29025AApplication of body cast2.393.301.860.316.004.56000
    29035AApplication of body cast1.763.491.560.295.543.61000
    29040AApplication of body cast2.212.601.530.425.234.16000
    29044AApplication of body cast2.113.841.870.356.304.33000
    29046AApplication of body cast2.403.332.050.416.144.86000
    29049AApplication of figure eight0.881.260.550.142.281.57000
    29055AApplication of shoulder cast1.772.851.450.294.913.51000
    29058AApplication of shoulder cast1.301.520.730.172.992.20000
    29065AApplication of long arm cast0.871.280.740.142.291.75000
    29075AApplication of forearm cast0.771.220.670.132.121.57000
    29085AApply hand/wrist cast0.871.250.640.132.251.64000
    29086AApply finger cast0.620.940.530.071.631.22000
    29105AApply long arm splint0.871.200.530.132.201.53000
    29125AApply forearm splint0.591.000.410.071.661.07000
    29126AApply forearm splint0.771.220.480.072.061.32000
    29130AApplication of finger splint0.500.470.170.061.030.73000
    29131AApplication of finger splint0.550.740.250.041.330.84000
    29200AStrapping of chest0.650.760.370.051.461.07000
    29220AStrapping of low back0.640.730.400.081.451.12000
    29240AStrapping of shoulder0.710.870.390.061.641.16000
    29260AStrapping of elbow or wrist0.550.760.340.051.360.94000
    29280AStrapping of hand or finger0.510.830.350.051.390.91000
    29305AApplication of hip cast2.023.221.730.355.594.10000
    29325AApplication of hip casts2.313.401.920.376.084.60000
    29345AApplication of long leg cast1.391.711.050.233.332.67000
    29355AApplication of long leg cast1.521.671.110.243.432.87000
    29358AApply long leg cast brace1.421.981.080.233.632.73000
    29365AApplication of long leg cast1.171.600.930.202.972.30000
    29405AApply short leg cast0.861.190.700.142.191.70000
    29425AApply short leg cast1.001.190.730.172.361.90000
    29435AApply short leg cast1.171.510.910.202.882.28000
    29440AAddition of walker to cast0.570.670.280.081.320.93000
    29445AApply rigid leg cast1.771.770.970.293.833.03000
    29450AApplication of leg cast2.071.471.100.163.703.33000
    29505AApplication, long leg splint0.691.170.480.071.931.24000
    29515AApplication lower leg splint0.730.860.490.081.671.30000
    29520AStrapping of hip0.540.890.470.021.451.03000
    29530AStrapping of knee0.570.810.350.051.430.97000
    29540AStrapping of ankle and/or ft0.510.420.320.050.980.88000
    29550AStrapping of toes0.470.420.280.060.950.81000
    29580AApplication of paste boot0.570.660.360.061.290.99000
    29590AApplication of foot splint0.760.510.300.071.341.13000
    29700ARemoval/revision of cast0.570.880.290.081.530.94000
    Start Printed Page 63288
    29705ARemoval/revision of cast0.760.800.390.121.681.27000
    29710ARemoval/revision of cast1.331.510.700.203.042.23000
    29715ARemoval/revision of cast0.931.160.410.102.191.44000
    29720ARepair of body cast0.681.110.390.121.911.19000
    29730AWindowing of cast0.750.790.360.121.661.23000
    29740AWedging of cast1.111.120.500.182.411.79000
    29750AWedging of clubfoot cast1.251.050.590.192.492.03000
    29799CCasting/strapping procedure0.000.000.000.000.000.00YYY
    29800AJaw arthroscopy/surgery6.39NA7.201.01NA14.60090
    29804AJaw arthroscopy/surgery8.09NA8.510.79NA17.39090
    29805AShoulder arthroscopy, dx5.86NA5.721.01NA12.59090
    29806AShoulder arthroscopy/surgery14.29NA11.062.40NA27.75090
    29807AShoulder arthroscopy/surgery13.82NA10.892.33NA27.04090
    29819AShoulder arthroscopy/surgery7.58NA6.741.28NA15.60090
    29820AShoulder arthroscopy/surgery7.03NA6.181.19NA14.40090
    29821AShoulder arthroscopy/surgery7.68NA6.761.29NA15.73090
    29822AShoulder arthroscopy/surgery7.39NA6.641.25NA15.28090
    29823AShoulder arthroscopy/surgery8.12NA7.161.38NA16.66090
    29824AShoulder arthroscopy/surgery8.20NA7.411.38NA16.99090
    29825AShoulder arthroscopy/surgery7.58NA6.721.27NA15.57090
    29826AShoulder arthroscopy/surgery8.94NA7.491.51NA17.94090
    29827AArthroscop rotator cuff repr15.27NA11.442.23NA28.94090
    29830AElbow arthroscopy5.73NA5.310.95NA11.99090
    29834AElbow arthroscopy/surgery6.24NA5.791.03NA13.06090
    29835AElbow arthroscopy/surgery6.44NA5.831.05NA13.32090
    29836AElbow arthroscopy/surgery7.51NA6.731.27NA15.51090
    29837AElbow arthroscopy/surgery6.83NA6.081.15NA14.06090
    29838AElbow arthroscopy/surgery7.67NA6.841.28NA15.79090
    29840AWrist arthroscopy5.51NA5.300.83NA11.64090
    29843AWrist arthroscopy/surgery5.98NA5.600.98NA12.56090
    29844AWrist arthroscopy/surgery6.33NA5.791.03NA13.15090
    29845AWrist arthroscopy/surgery7.48NA6.461.01NA14.95090
    29846AWrist arthroscopy/surgery6.71NA6.011.07NA13.79090
    29847AWrist arthroscopy/surgery7.04NA6.161.09NA14.29090
    29848AWrist endoscopy/surgery5.41NA5.550.86NA11.82090
    29850AKnee arthroscopy/surgery8.14NA5.100.89NA14.13090
    29851AKnee arthroscopy/surgery13.03NA9.762.17NA24.96090
    29855ATibial arthroscopy/surgery10.56NA8.691.80NA21.05090
    29856ATibial arthroscopy/surgery14.06NA10.632.40NA27.09090
    29860AHip arthroscopy, dx8.00NA6.901.37NA16.27090
    29861AHip arthroscopy/surgery9.10NA7.311.55NA17.96090
    29862AHip arthroscopy/surgery9.84NA8.481.67NA19.99090
    29863AHip arthroscopy/surgery9.84NA8.421.68NA19.94090
    29870AKnee arthroscopy, dx5.04NA4.850.80NA10.69090
    29871AKnee arthroscopy/drainage6.51NA5.831.05NA13.39090
    29873AKnee arthroscopy/surgery5.97NA6.450.87NA13.29090
    29874AKnee arthroscopy/surgery7.01NA6.041.04NA14.09090
    29875AKnee arthroscopy/surgery6.27NA5.801.05NA13.12090
    29876AKnee arthroscopy/surgery7.87NA6.961.33NA16.16090
    29877AKnee arthroscopy/surgery7.31NA6.671.23NA15.21090
    29879AKnee arthroscopy/surgery7.99NA7.051.35NA16.39090
    29880AKnee arthroscopy/surgery8.45NA7.291.43NA17.17090
    29881AKnee arthroscopy/surgery7.72NA6.891.31NA15.92090
    29882AKnee arthroscopy/surgery8.60NA7.181.31NA17.09090
    29883AKnee arthroscopy/surgery10.99NA9.001.59NA21.58090
    29884AKnee arthroscopy/surgery7.29NA6.631.23NA15.15090
    29885AKnee arthroscopy/surgery9.04NA7.891.52NA18.45090
    29886AKnee arthroscopy/surgery7.50NA6.771.27NA15.54090
    29887AKnee arthroscopy/surgery8.99NA7.861.52NA18.37090
    29888AKnee arthroscopy/surgery13.82NA10.192.34NA26.35090
    29889AKnee arthroscopy/surgery15.91NA12.362.53NA30.80090
    29891AAnkle arthroscopy/surgery8.35NA7.421.40NA17.17090
    29892AAnkle arthroscopy/surgery8.95NA7.681.51NA18.14090
    29893AScope, plantar fasciotomy5.196.203.960.8912.2810.04090
    29894AAnkle arthroscopy/surgery7.17NA5.451.21NA13.83090
    29895AAnkle arthroscopy/surgery6.95NA5.451.16NA13.56090
    29897AAnkle arthroscopy/surgery7.14NA5.851.21NA14.20090
    29898AAnkle arthroscopy/surgery8.27NA6.171.37NA15.81090
    29899AAnkle arthroscopy/surgery13.83NA9.942.34NA26.11090
    29900AMcp joint arthroscopy, dx5.39NA5.770.90NA12.06090
    29901AMcp joint arthroscopy, surg6.10NA6.151.02NA13.27090
    29902AMcp joint arthroscopy, surg6.66NA6.451.11NA14.22090
    29999CArthroscopy of joint0.000.000.000.000.000.00YYY
    30000ADrainage of nose lesion1.424.241.430.125.782.97010
    30020ADrainage of nose lesion1.423.391.500.104.913.02010
    Start Printed Page 63289
    30100AIntranasal biopsy0.932.070.820.073.071.82000
    30110ARemoval of nose polyp(s)1.623.401.600.145.163.36010
    30115ARemoval of nose polyp(s)4.33NA4.060.37NA8.76090
    30117ARemoval of intranasal lesion3.144.433.310.267.836.71090
    30118ARemoval of intranasal lesion9.63NA7.350.79NA17.77090
    30120ARevision of nose5.245.595.540.4911.3211.27090
    30124ARemoval of nose lesion3.08NA3.070.24NA6.39090
    30125ARemoval of nose lesion7.12NA5.980.65NA13.75090
    30130ARemoval of turbinate bones3.36NA3.550.26NA7.17090
    30140ARemoval of turbinate bones3.41NA4.010.29NA7.71090
    30150APartial removal of nose9.09NA7.740.91NA17.74090
    30160ARemoval of nose9.53NA7.730.93NA18.19090
    30200AInjection treatment of nose0.781.720.780.072.571.63000
    30210ANasal sinus therapy1.072.191.340.103.362.51010
    30220AInsert nasal septal button1.534.551.560.136.213.22010
    30300ARemove nasal foreign body1.034.892.000.086.003.11010
    30310ARemove nasal foreign body1.95NA3.220.17NA5.34010
    30320ARemove nasal foreign body4.49NA4.530.43NA9.45090
    30400RReconstruction of nose9.77NA9.270.96NA20.00090
    30410RReconstruction of nose12.91NA11.061.29NA25.26090
    30420RReconstruction of nose15.79NA12.551.49NA29.83090
    30430RRevision of nose7.17NA8.200.74NA16.11090
    30435RRevision of nose11.64NA10.741.32NA23.70090
    30450RRevision of nose18.54NA14.261.83NA34.63090
    30460ARevision of nose9.90NA7.811.02NA18.73090
    30462ARevision of nose19.46NA13.832.30NA35.59090
    30465ARepair nasal stenosis11.57NA7.761.16NA20.49090
    30520ARepair of nasal septum5.67NA5.210.49NA11.37090
    30540ARepair nasal defect7.71NA5.700.64NA14.05090
    30545ARepair nasal defect11.32NA8.730.96NA21.01090
    30560ARelease of nasal adhesions1.254.992.180.116.353.54010
    30580ARepair upper jaw fistula6.657.266.190.6014.5113.44090
    30600ARepair mouth/nose fistula5.996.395.580.8413.2212.41090
    30620AIntranasal reconstruction5.94NA5.840.54NA12.32090
    30630ARepair nasal septum defect7.08NA6.250.61NA13.94090
    30801ACauterization, inner nose1.082.202.090.103.383.27010
    30802ACauterization, inner nose2.022.742.600.184.944.80010
    30901AControl of nosebleed1.201.380.330.112.691.64000
    30903AControl of nosebleed1.532.840.510.144.512.18000
    30905AControl of nosebleed1.963.620.770.185.762.91000
    30906ARepeat control of nosebleed2.444.001.220.206.643.86000
    30915ALigation, nasal sinus artery7.16NA5.890.60NA13.65090
    30920ALigation, upper jaw artery9.77NA7.560.83NA18.16090
    30930ATherapy, fracture of nose1.25NA1.670.11NA3.03010
    30999CNasal surgery procedure0.000.000.000.000.000.00YYY
    31000AIrrigation, maxillary sinus1.142.961.430.104.202.67010
    31002AIrrigation, sphenoid sinus1.90NA3.340.17NA5.41010
    31020AExploration, maxillary sinus2.924.183.550.247.346.71090
    31030AExploration, maxillary sinus5.895.734.850.5012.1211.24090
    31032AExplore sinus, remove polyps6.53NA5.660.56NA12.75090
    31040AExploration behind upper jaw9.37NA6.350.85NA16.57090
    31050AExploration, sphenoid sinus5.25NA4.550.47NA10.27090
    31051ASphenoid sinus surgery7.07NA5.920.66NA13.65090
    31070AExploration of frontal sinus4.26NA4.250.36NA8.87090
    31075AExploration of frontal sinus9.11NA7.290.77NA17.17090
    31080ARemoval of frontal sinus11.35NA8.530.93NA20.81090
    31081ARemoval of frontal sinus12.68NA9.592.21NA24.48090
    31084ARemoval of frontal sinus13.43NA10.151.15NA24.73090
    31085ARemoval of frontal sinus14.12NA10.521.41NA26.05090
    31086ARemoval of frontal sinus12.79NA9.961.08NA23.83090
    31087ARemoval of frontal sinus13.03NA9.891.38NA24.30090
    31090AExploration of sinuses9.48NA8.670.79NA18.94090
    31200ARemoval of ethmoid sinus4.94NA5.070.30NA10.31090
    31201ARemoval of ethmoid sinus8.32NA6.890.70NA15.91090
    31205ARemoval of ethmoid sinus10.18NA7.710.70NA18.59090
    31225ARemoval of upper jaw19.12NA13.881.65NA34.65090
    31230ARemoval of upper jaw21.81NA15.291.88NA38.98090
    31231ANasal endoscopy, dx1.093.590.920.104.782.11000
    31233ANasal/sinus endoscopy, dx2.174.531.530.196.893.89000
    31235ANasal/sinus endoscopy, dx2.625.161.780.228.004.62000
    31237ANasal/sinus endoscopy, surg2.965.461.930.258.675.14000
    31238ANasal/sinus endoscopy, surg3.245.512.140.289.035.66000
    31239ANasal/sinus endoscopy, surg8.65NA8.370.55NA17.57010
    31240ANasal/sinus endoscopy, surg2.60NA1.780.22NA4.60000
    31254ARevision of ethmoid sinus4.62NA2.920.38NA7.92000
    Start Printed Page 63290
    31255ARemoval of ethmoid sinus6.92NA4.200.59NA11.71000
    31256AExploration maxillary sinus3.27NA2.160.28NA5.71000
    31267AEndoscopy, maxillary sinus5.43NA3.360.46NA9.25000
    31276ASinus endoscopy, surgical8.80NA5.220.74NA14.76000
    31287ANasal/sinus endoscopy, surg3.90NA2.510.32NA6.73000
    31288ANasal/sinus endoscopy, surg4.55NA2.880.38NA7.81000
    31290ANasal/sinus endoscopy, surg17.14NA12.271.44NA30.85010
    31291ANasal/sinus endoscopy, surg18.09NA12.682.07NA32.84010
    31292ANasal/sinus endoscopy, surg14.68NA10.831.19NA26.70010
    31293ANasal/sinus endoscopy, surg16.12NA11.631.16NA28.91010
    31294ANasal/sinus endoscopy, surg18.95NA13.141.25NA33.34010
    31299CSinus surgery procedure0.000.000.000.000.000.00YYY
    31300ARemoval of larynx lesion14.21NA12.171.19NA27.57090
    31320ADiagnostic incision, larynx5.23NA7.360.48NA13.07090
    31360ARemoval of larynx16.98NA14.111.44NA32.53090
    31365ARemoval of larynx24.02NA17.822.06NA43.90090
    31367APartial removal of larynx21.74NA17.571.88NA41.19090
    31368APartial removal of larynx26.94NA21.232.28NA50.45090
    31370APartial removal of larynx21.26NA17.211.81NA40.28090
    31375APartial removal of larynx20.09NA15.531.71NA37.33090
    31380APartial removal of larynx20.09NA15.471.68NA37.24090
    31382APartial removal of larynx20.40NA16.741.73NA38.87090
    31390ARemoval of larynx & pharynx27.37NA21.472.34NA51.18090
    31395AReconstruct larynx & pharynx30.91NA25.412.72NA59.04090
    31400ARevision of larynx10.25NA10.130.86NA21.24090
    31420ARemoval of epiglottis10.16NA9.910.85NA20.92090
    31500AInsert emergency airway2.32NA0.560.18NA3.06000
    31502AChange of windpipe airway0.651.520.260.052.220.96000
    31505ADiagnostic laryngoscopy0.611.590.640.052.251.30000
    31510ALaryngoscopy with biopsy1.913.461.300.185.553.39000
    31511ARemove foreign body, larynx2.153.281.120.195.623.46000
    31512ARemoval of larynx lesion2.063.361.410.195.613.66000
    31513AInjection into vocal cord2.09NA1.510.18NA3.78000
    31515ALaryngoscopy for aspiration1.793.771.110.145.703.04000
    31520ADiagnostic laryngoscopy2.55NA1.620.20NA4.37000
    31525ADiagnostic laryngoscopy2.623.901.710.226.744.55000
    31526ADiagnostic laryngoscopy2.56NA1.770.22NA4.55000
    31527ALaryngoscopy for treatment3.25NA1.930.25NA5.43000
    31528ALaryngoscopy and dilation2.36NA1.470.19NA4.02000
    31529ALaryngoscopy and dilation2.66NA1.730.22NA4.61000
    31530AOperative laryngoscopy3.37NA2.000.29NA5.66000
    31531AOperative laryngoscopy3.57NA2.330.30NA6.20000
    31535AOperative laryngoscopy3.14NA2.040.26NA5.44000
    31536AOperative laryngoscopy3.54NA2.310.30NA6.15000
    31540AOperative laryngoscopy4.11NA2.610.35NA7.07000
    31541AOperative laryngoscopy4.50NA2.850.38NA7.73000
    31560AOperative laryngoscopy5.43NA3.200.46NA9.09000
    31561AOperative laryngoscopy5.97NA3.410.50NA9.88000
    31570ALaryngoscopy with injection3.855.812.450.299.956.59000
    31571ALaryngoscopy with injection4.25NA2.660.36NA7.27000
    31575ADiagnostic laryngoscopy1.091.910.920.103.102.11000
    31576ALaryngoscopy with biopsy1.963.661.330.165.783.45000
    31577ARemove foreign body, larynx2.463.781.590.206.444.25000
    31578ARemoval of larynx lesion2.824.301.580.247.364.64000
    31579ADiagnostic laryngoscopy2.253.841.540.196.283.98000
    31580ARevision of larynx12.31NA11.241.04NA24.59090
    31582ARevision of larynx21.50NA17.631.82NA40.95090
    31584ATreat larynx fracture19.53NA14.731.70NA35.96090
    31585ATreat larynx fracture4.61NA5.650.36NA10.62090
    31586ATreat larynx fracture7.98NA8.440.67NA17.09090
    31587ARevision of larynx11.92NA10.161.05NA23.13090
    31588ARevision of larynx13.04NA13.261.10NA27.40090
    31590AReinnervate larynx6.93NA8.920.60NA16.45090
    31595ALarynx nerve surgery8.29NA7.730.74NA16.76090
    31599CLarynx surgery procedure0.000.000.000.000.000.00YYY
    31600AIncision of windpipe7.14NA3.220.41NA10.77000
    31601AIncision of windpipe4.42NA2.420.47NA7.31000
    31603AIncision of windpipe4.13NA1.740.42NA6.29000
    31605AIncision of windpipe3.56NA1.200.40NA5.16000
    31610AIncision of windpipe8.71NA7.510.83NA17.05090
    31611ASurgery/speech prosthesis5.61NA6.020.48NA12.11090
    31612APuncture/clear windpipe0.901.130.360.072.101.33000
    31613ARepair windpipe opening4.56NA5.430.44NA10.43090
    31614ARepair windpipe opening7.08NA7.870.61NA15.56090
    31615AVisualization of windpipe2.082.661.220.174.913.47000
    Start Printed Page 63291
    31622ADx bronchoscope/wash2.764.200.890.177.133.82000
    31623ADx bronchoscope/brush2.865.090.900.178.123.93000
    31624ADx bronchoscope/lavage2.864.320.900.167.343.92000
    31625ABronchoscopy w/biopsy(s)3.355.411.270.198.954.81000
    31628ABronchoscopy/lung bx, each3.795.621.360.179.585.32000
    31629ABronchoscopy/needle bx, each3.35NA1.240.16NA4.75000
    31630ABronchoscopy dilate/fx repr3.80NA1.980.36NA6.14000
    31631ABronchoscopy, dilate w/stent4.35NA2.010.37NA6.73000
    31632ABronchoscopy/lung bx, addl1.020.760.320.171.951.51ZZZ
    31633ABronchoscopy/needle bx addl1.310.920.410.172.401.89ZZZ
    31635ABronchoscopy w/fb removal3.66NA1.680.25NA5.59000
    31640ABronchoscopy w/tumor excise4.91NA2.330.44NA7.68000
    31641ABronchoscopy, treat blockage5.00NA2.120.36NA7.48000
    31643ADiag bronchoscope/catheter3.48NA1.320.18NA4.98000
    31645ABronchoscopy, clear airways3.14NA1.220.16NA4.52000
    31646ABronchoscopy, reclear airway2.70NA1.090.14NA3.93000
    31656ABronchoscopy, inj for x-ray2.16NA0.930.12NA3.21000
    31700AInsertion of airway catheter1.332.080.690.083.492.10000
    31708AInstill airway contrast dye1.40NA0.600.07NA2.07000
    31710AInsertion of airway catheter1.29NA0.710.07NA2.07000
    31715AInjection for bronchus x-ray1.10NA0.610.07NA1.78000
    31717ABronchial brush biopsy2.112.890.870.115.113.09000
    31720AClearance of airways1.051.480.330.072.601.45000
    31725AClearance of airways1.951.840.590.123.912.66000
    31730AIntro, windpipe wire/tube2.832.241.090.185.254.10000
    31750ARepair of windpipe12.95NA11.611.22NA25.78090
    31755ARepair of windpipe15.84NA14.341.38NA31.56090
    31760ARepair of windpipe22.22NA10.501.77NA34.49090
    31766AReconstruction of windpipe30.26NA13.523.79NA47.57090
    31770ARepair/graft of bronchus22.38NA10.012.72NA35.11090
    31775AReconstruct bronchus23.41NA11.673.49NA38.57090
    31780AReconstruct windpipe17.62NA11.051.86NA30.53090
    31781AReconstruct windpipe23.40NA12.062.45NA37.91090
    31785ARemove windpipe lesion17.13NA10.321.63NA29.08090
    31786ARemove windpipe lesion23.84NA13.132.64NA39.61090
    31800ARepair of windpipe injury7.39NA4.880.80NA13.07090
    31805ARepair of windpipe injury13.06NA7.101.74NA21.90090
    31820AClosure of windpipe lesion4.465.594.960.4210.479.84090
    31825ARepair of windpipe defect6.777.687.110.6015.0514.48090
    31830ARevise windpipe scar4.475.745.330.4310.6410.23090
    31899CAirways surgical procedure0.000.000.000.000.000.00YYY
    32000ADrainage of chest1.533.130.490.084.742.10000
    32002ATreatment of collapsed lung2.183.340.840.135.653.15000
    32005ATreat lung lining chemically2.186.450.690.208.833.07000
    32020AInsertion of chest tube3.96NA1.450.43NA5.84000
    32035AExploration of chest8.62NA5.711.22NA15.55090
    32036AExploration of chest9.62NA6.231.44NA17.29090
    32095ABiopsy through chest wall8.31NA5.221.19NA14.72090
    32100AExploration/biopsy of chest15.15NA7.651.74NA24.54090
    32110AExplore/repair chest22.87NA10.541.95NA35.36090
    32120ARe-exploration of chest11.47NA6.871.70NA20.04090
    32124AExplore chest free adhesions12.65NA7.041.81NA21.50090
    32140ARemoval of lung lesion(s)13.85NA7.502.01NA23.36090
    32141ARemove/treat lung lesions13.92NA7.382.06NA23.36090
    32150ARemoval of lung lesion(s)14.07NA7.471.92NA23.46090
    32151ARemove lung foreign body14.13NA7.851.79NA23.77090
    32160AOpen chest heart massage9.25NA5.211.21NA15.67090
    32200ADrain, open, lung lesion15.20NA8.481.75NA25.43090
    32201ADrain, percut, lung lesion3.98NA1.320.22NA5.52000
    32215ATreat chest lining11.27NA6.691.61NA19.57090
    32220ARelease of lung23.86NA12.562.86NA39.28090
    32225APartial release of lung13.88NA7.472.04NA23.39090
    32310ARemoval of chest lining13.36NA7.221.98NA22.56090
    32320AFree/remove chest lining23.86NA11.883.00NA38.74090
    32400ANeedle biopsy chest lining1.751.730.560.083.562.39000
    32402AOpen biopsy chest lining7.52NA4.961.09NA13.57090
    32405ABiopsy, lung or mediastinum1.922.140.640.114.172.67000
    32420APuncture/clear lung2.17NA0.830.13NA3.13000
    32440ARemoval of lung24.86NA12.563.07NA40.49090
    32442ASleeve pneumonectomy26.09NA14.293.74NA44.12090
    32445ARemoval of lung24.95NA13.703.73NA42.38090
    32480APartial removal of lung23.61NA11.772.68NA38.06090
    32482ABilobectomy24.86NA12.622.82NA40.30090
    32484ASegmentectomy20.57NA11.083.04NA34.69090
    32486ASleeve lobectomy23.78NA12.843.60NA40.22090
    Start Printed Page 63292
    32488ACompletion pneumonectomy25.56NA13.393.81NA42.76090
    32491RLung volume reduction21.13NA12.193.19NA36.51090
    32500APartial removal of lung21.87NA11.982.12NA35.97090
    32501ARepair bronchus add-on4.66NA1.520.67NA6.85ZZZ
    32520ARemove lung & revise chest21.56NA10.983.25NA35.79090
    32522ARemove lung & revise chest24.06NA11.813.40NA39.27090
    32525ARemove lung & revise chest26.35NA12.503.90NA42.75090
    32540ARemoval of lung lesion14.56NA9.332.21NA26.10090
    32601AThoracoscopy, diagnostic5.43NA2.360.76NA8.55000
    32602AThoracoscopy, diagnostic5.93NA2.520.84NA9.29000
    32603AThoracoscopy, diagnostic7.77NA3.060.91NA11.74000
    32604AThoracoscopy, diagnostic8.73NA3.461.16NA13.35000
    32605AThoracoscopy, diagnostic6.89NA2.891.03NA10.81000
    32606AThoracoscopy, diagnostic8.35NA3.331.19NA12.87000
    32650AThoracoscopy, surgical10.69NA6.571.50NA18.76090
    32651AThoracoscopy, surgical12.84NA7.081.80NA21.72090
    32652AThoracoscopy, surgical18.55NA9.872.76NA31.18090
    32653AThoracoscopy, surgical12.80NA6.801.86NA21.46090
    32654AThoracoscopy, surgical12.37NA7.291.81NA21.47090
    32655AThoracoscopy, surgical13.03NA7.091.83NA21.95090
    32656AThoracoscopy, surgical12.84NA7.661.93NA22.43090
    32657AThoracoscopy, surgical13.57NA7.481.97NA23.02090
    32658AThoracoscopy, surgical11.56NA7.091.76NA20.41090
    32659AThoracoscopy, surgical11.52NA7.211.67NA20.40090
    32660AThoracoscopy, surgical17.33NA9.172.51NA29.01090
    32661AThoracoscopy, surgical13.17NA7.551.99NA22.71090
    32662AThoracoscopy, surgical16.35NA8.572.41NA27.33090
    32663AThoracoscopy, surgical18.36NA10.422.73NA31.51090
    32664AThoracoscopy, surgical14.12NA7.512.04NA23.67090
    32665AThoracoscopy, surgical15.45NA8.042.15NA25.64090
    32800ARepair lung hernia13.61NA7.291.81NA22.71090
    32810AClose chest after drainage12.98NA7.351.86NA22.19090
    32815AClose bronchial fistula23.02NA10.693.40NA37.11090
    32820AReconstruct injured chest21.36NA11.992.77NA36.12090
    32850XDonor pneumonectomy0.000.000.000.000.000.00XXX
    32851ALung transplant, single38.41NA26.785.87NA71.06090
    32852ALung transplant with bypass41.56NA31.656.20NA79.41090
    32853ALung transplant, double47.54NA30.497.35NA85.38090
    32854ALung transplant with bypass50.69NA33.597.68NA91.96090
    32900ARemoval of rib(s)20.15NA9.752.90NA32.80090
    32905ARevise & repair chest wall20.63NA9.953.04NA33.62090
    32906ARevise & repair chest wall26.62NA11.853.96NA42.43090
    32940ARevision of lung19.32NA9.222.96NA31.50090
    32960ATherapeutic pneumothorax1.831.800.580.143.772.55000
    32997ATotal lung lavage5.97NA1.920.66NA8.55000
    32999CChest surgery procedure0.000.000.000.000.000.00YYY
    33010ADrainage of heart sac2.23NA0.970.16NA3.36000
    33011ARepeat drainage of heart sac2.23NA1.000.16NA3.39000
    33015AIncision of heart sac6.76NA4.830.77NA12.36090
    33020AIncision of heart sac12.54NA6.611.80NA20.95090
    33025AIncision of heart sac12.02NA6.171.80NA19.99090
    33030APartial removal of heart sac18.60NA9.242.88NA30.72090
    33031APartial removal of heart sac21.67NA9.743.33NA34.74090
    33050ARemoval of heart sac lesion14.28NA7.632.07NA23.98090
    33120ARemoval of heart lesion24.42NA11.273.67NA39.36090
    33130ARemoval of heart lesion21.27NA9.933.01NA34.21090
    33140AHeart revascularize (tmr)19.89NA10.532.72NA33.14090
    33141AHeart tmr w/other procedure4.81NA1.550.66NA7.02ZZZ
    33200AInsertion of heart pacemaker12.41NA6.841.40NA20.65090
    33201AInsertion of heart pacemaker10.12NA6.481.45NA18.05090
    33206AInsertion of heart pacemaker6.63NA4.540.60NA11.77090
    33207AInsertion of heart pacemaker7.99NA4.750.68NA13.42090
    33208AInsertion of heart pacemaker8.08NA4.870.65NA13.60090
    33210AInsertion of heart electrode3.28NA1.270.20NA4.75000
    33211AInsertion of heart electrode3.38NA1.330.20NA4.91000
    33212AInsertion of pulse generator5.49NA3.400.53NA9.42090
    33213AInsertion of pulse generator6.33NA3.780.55NA10.66090
    33214AUpgrade of pacemaker system7.71NA4.990.62NA13.32090
    33215AReposition pacing-defib lead4.73NA3.190.43NA8.35090
    33216AInsert lead pace-defib, one5.75NA4.300.43NA10.48090
    33217AInsert lead pace-defib, dual5.72NA4.340.43NA10.49090
    33218ARepair lead pace-defib, one5.41NA4.350.48NA10.24090
    33220ARepair lead pace-defib, dual5.49NA4.340.47NA10.30090
    33222ARevise pocket, pacemaker4.93NA4.340.47NA9.74090
    33223ARevise pocket, pacing-defib6.42NA4.610.53NA11.56090
    Start Printed Page 63293
    33224AInsert pacing lead & connect9.00NA4.050.43NA13.48000
    33225AL ventric pacing lead add-on8.29NA3.240.43NA11.96ZZZ
    33226AReposition l ventric lead8.64NA3.910.43NA12.98000
    33233ARemoval of pacemaker system3.27NA3.280.26NA6.81090
    33234ARemoval of pacemaker system7.78NA4.930.67NA13.38090
    33235ARemoval pacemaker electrode9.35NA6.800.82NA16.97090
    33236ARemove electrode/thoracotomy12.53NA7.221.79NA21.54090
    33237ARemove electrode/thoracotomy13.63NA7.611.88NA23.12090
    33238ARemove electrode/thoracotomy15.13NA8.061.87NA25.06090
    33240AInsert pulse generator7.56NA4.620.64NA12.82090
    33241ARemove pulse generator3.22NA2.970.25NA6.44090
    33243ARemove eltrd/thoracotomy22.51NA11.153.03NA36.69090
    33244ARemove eltrd, transven13.68NA8.871.26NA23.81090
    33245AInsert epic eltrd pace-defib14.22NA7.861.53NA23.61090
    33246AInsert epic eltrd/generator20.59NA10.152.66NA33.40090
    33249AEltrd/insert pace-defib14.15NA8.510.96NA23.62090
    33250AAblate heart dysrhythm focus21.73NA11.221.21NA34.16090
    33251AAblate heart dysrhythm focus24.74NA11.332.89NA38.96090
    33253AReconstruct atria30.88NA13.444.41NA48.73090
    33261AAblate heart dysrhythm focus24.74NA11.463.38NA39.58090
    33282AImplant pat-active ht record4.15NA4.110.47NA8.73090
    33284ARemove pat-active ht record2.49NA3.520.28NA6.29090
    33300ARepair of heart wound17.82NA9.062.29NA29.17090
    33305ARepair of heart wound21.32NA10.303.21NA34.83090
    33310AExploratory heart surgery18.40NA9.272.71NA30.38090
    33315AExploratory heart surgery22.24NA10.533.48NA36.25090
    33320ARepair major blood vessel(s)16.69NA8.141.99NA26.82090
    33321ARepair major vessel20.08NA9.533.24NA32.85090
    33322ARepair major blood vessel(s)20.50NA10.073.01NA33.58090
    33330AInsert major vessel graft21.31NA10.062.98NA34.35090
    33332AInsert major vessel graft23.82NA10.372.94NA37.13090
    33335AInsert major vessel graft29.84NA12.984.54NA47.36090
    33400ARepair of aortic valve28.34NA15.163.70NA47.20090
    33401AValvuloplasty, open23.77NA13.233.25NA40.25090
    33403AValvuloplasty, w/cp bypass24.75NA13.872.97NA41.59090
    33404APrepare heart-aorta conduit28.38NA14.063.97NA46.41090
    33405AReplacement of aortic valve34.80NA17.664.63NA57.09090
    33406AReplacement of aortic valve37.29NA18.474.88NA60.64090
    33410AReplacement of aortic valve32.27NA16.114.93NA53.31090
    33411AReplacement of aortic valve36.04NA18.114.99NA59.14090
    33412AReplacement of aortic valve41.76NA19.845.59NA67.19090
    33413AReplacement of aortic valve43.25NA20.205.11NA68.56090
    33414ARepair of aortic valve30.18NA13.724.54NA48.44090
    33415ARevision, subvalvular tissue27.00NA11.753.90NA42.65090
    33416ARevise ventricle muscle30.18NA13.114.61NA47.90090
    33417ARepair of aortic valve28.37NA13.214.29NA45.87090
    33420ARevision of mitral valve22.57NA9.711.77NA34.05090
    33422ARevision of mitral valve25.79NA13.173.96NA42.92090
    33425ARepair of mitral valve26.85NA12.643.60NA43.09090
    33426ARepair of mitral valve32.81NA16.574.64NA54.02090
    33427ARepair of mitral valve39.77NA18.745.15NA63.66090
    33430AReplacement of mitral valve33.31NA16.714.73NA54.75090
    33460ARevision of tricuspid valve23.47NA10.933.62NA38.02090
    33463AValvuloplasty, tricuspid25.47NA12.513.80NA41.78090
    33464AValvuloplasty, tricuspid27.17NA13.094.16NA44.42090
    33465AReplace tricuspid valve28.63NA12.584.33NA45.54090
    33468ARevision of tricuspid valve29.95NA13.234.79NA47.97090
    33470ARevision of pulmonary valve20.69NA10.653.37NA34.71090
    33471AValvotomy, pulmonary valve22.12NA9.703.60NA35.42090
    33472ARevision of pulmonary valve22.12NA11.733.50NA37.35090
    33474ARevision of pulmonary valve22.91NA10.683.40NA36.99090
    33475AReplacement, pulmonary valve32.81NA14.873.16NA50.84090
    33476ARevision of heart chamber25.62NA11.872.88NA40.37090
    33478ARevision of heart chamber26.59NA12.584.27NA43.44090
    33496ARepair, prosth valve clot27.09NA12.394.12NA43.60090
    33500ARepair heart vessel fistula25.40NA11.233.36NA39.99090
    33501ARepair heart vessel fistula17.68NA8.202.46NA28.34090
    33502ACoronary artery correction20.92NA10.723.01NA34.65090
    33503ACoronary artery graft21.66NA9.771.70NA33.13090
    33504ACoronary artery graft24.52NA11.593.64NA39.75090
    33505ARepair artery w/tunnel26.69NA12.781.82NA41.29090
    33506ARepair artery, translocation35.30NA14.373.82NA53.49090
    33508AEndoscopic vein harvest0.31NA0.100.04NA0.45ZZZ
    33510ACABG, vein, single28.83NA15.763.75NA48.34090
    33511ACABG, vein, two29.83NA16.464.00NA50.29090
    Start Printed Page 63294
    33512ACABG, vein, three31.62NA17.004.43NA53.05090
    33513ACABG, vein, four31.82NA17.164.78NA53.76090
    33514ACABG, vein, five32.56NA17.415.24NA55.21090
    33516ACabg, vein, six or more34.80NA18.155.54NA58.49090
    33517ACABG, artery-vein, single2.56NA0.820.38NA3.76ZZZ
    33518ACABG, artery-vein, two4.82NA1.560.73NA7.11ZZZ
    33519ACABG, artery-vein, three7.08NA2.281.07NA10.43ZZZ
    33521ACABG, artery-vein, four9.35NA3.021.41NA13.78ZZZ
    33522ACABG, artery-vein, five11.60NA3.741.77NA17.11ZZZ
    33523ACabg, art-vein, six or more13.87NA4.452.13NA20.45ZZZ
    33530ACoronary artery, bypass/reop5.83NA1.880.87NA8.58ZZZ
    33533ACABG, arterial, single29.83NA15.903.88NA49.61090
    33534ACABG, arterial, two32.02NA17.074.35NA53.44090
    33535ACABG, arterial, three34.30NA17.544.76NA56.60090
    33536ACabg, arterial, four or more37.29NA17.823.94NA59.05090
    33542ARemoval of heart lesion28.69NA12.644.33NA45.66090
    33545ARepair of heart damage36.57NA15.305.27NA57.14090
    33572AOpen coronary endarterectomy4.42NA1.430.66NA6.51ZZZ
    33600AClosure of valve29.34NA12.452.76NA44.55090
    33602AClosure of valve28.38NA12.533.48NA44.39090
    33606AAnastomosis/artery-aorta30.56NA13.454.30NA48.31090
    33608ARepair anomaly w/conduit30.91NA13.705.00NA49.61090
    33610ARepair by enlargement30.44NA13.964.82NA49.22090
    33611ARepair double ventricle33.81NA13.753.93NA51.49090
    33612ARepair double ventricle34.80NA14.795.32NA54.91090
    33615ARepair, modified fontan33.81NA14.853.78NA52.44090
    33617ARepair single ventricle36.79NA15.614.90NA57.30090
    33619ARepair single ventricle44.74NA20.075.65NA70.46090
    33641ARepair heart septum defect21.27NA9.323.20NA33.79090
    33645ARevision of heart veins24.68NA11.443.92NA40.04090
    33647ARepair heart septum defects28.57NA13.424.04NA46.03090
    33660ARepair of heart defects29.83NA13.163.38NA46.37090
    33665ARepair of heart defects28.44NA13.264.57NA46.27090
    33670ARepair of heart chambers34.80NA13.402.61NA50.81090
    33681ARepair heart septum defect30.44NA14.214.23NA48.88090
    33684ARepair heart septum defect29.48NA13.354.52NA47.35090
    33688ARepair heart septum defect30.45NA10.804.66NA45.91090
    33690AReinforce pulmonary artery19.44NA9.983.07NA32.49090
    33692ARepair of heart defects30.57NA13.734.52NA48.82090
    33694ARepair of heart defects33.81NA14.165.12NA53.09090
    33697ARepair of heart defects35.79NA14.345.44NA55.57090
    33702ARepair of heart defects26.39NA12.184.14NA42.71090
    33710ARepair of heart defects29.54NA13.764.61NA47.91090
    33720ARepair of heart defect26.41NA12.043.85NA42.30090
    33722ARepair of heart defect28.25NA13.284.55NA46.08090
    33730ARepair heart-vein defect(s)34.05NA14.143.42NA51.61090
    33732ARepair heart-vein defect28.00NA13.313.33NA44.64090
    33735ARevision of heart chamber21.27NA10.061.34NA32.67090
    33736ARevision of heart chamber23.39NA11.673.24NA38.30090
    33737ARevision of heart chamber21.64NA10.873.51NA36.02090
    33750AMajor vessel shunt21.29NA10.322.09NA33.70090
    33755AMajor vessel shunt21.67NA8.653.51NA33.83090
    33762AMajor vessel shunt21.67NA10.351.91NA33.93090
    33764AMajor vessel shunt & graft21.67NA10.202.31NA34.18090
    33766AMajor vessel shunt22.63NA11.203.64NA37.47090
    33767AMajor vessel shunt24.36NA11.603.76NA39.72090
    33770ARepair great vessels defect36.79NA14.565.38NA56.73090
    33771ARepair great vessels defect34.45NA12.625.60NA52.67090
    33774ARepair great vessels defect30.80NA13.965.01NA49.77090
    33775ARepair great vessels defect32.02NA14.425.20NA51.64090
    33776ARepair great vessels defect33.85NA15.165.49NA54.50090
    33777ARepair great vessels defect33.27NA15.095.41NA53.77090
    33778ARepair great vessels defect39.77NA16.275.79NA61.83090
    33779ARepair great vessels defect36.00NA15.452.88NA54.33090
    33780ARepair great vessels defect41.51NA18.876.24NA66.62090
    33781ARepair great vessels defect36.24NA13.785.89NA55.91090
    33786ARepair arterial trunk38.78NA16.095.62NA60.49090
    33788ARevision of pulmonary artery26.47NA12.053.98NA42.50090
    33800AAortic suspension16.15NA7.731.33NA25.21090
    33802ARepair vessel defect17.56NA8.971.87NA28.40090
    33803ARepair vessel defect19.49NA9.533.15NA32.17090
    33813ARepair septal defect20.53NA10.553.33NA34.41090
    33814ARepair septal defect25.62NA12.263.02NA40.90090
    33820ARevise major vessel16.20NA8.052.52NA26.77090
    33822ARevise major vessel17.22NA8.582.79NA28.59090
    Start Printed Page 63295
    33824ARevise major vessel19.41NA9.683.13NA32.22090
    33840ARemove aorta constriction20.51NA9.992.83NA33.33090
    33845ARemove aorta constriction21.99NA10.973.48NA36.44090
    33851ARemove aorta constriction21.15NA10.363.43NA34.94090
    33852ARepair septal defect23.57NA11.203.82NA38.59090
    33853ARepair septal defect31.54NA14.325.07NA50.93090
    33860AAscending aortic graft37.78NA16.025.15NA58.95090
    33861AAscending aortic graft41.76NA17.275.08NA64.11090
    33863AAscending aortic graft44.74NA18.235.51NA68.48090
    33870ATransverse aortic arch graft43.75NA17.936.10NA67.78090
    33875AThoracic aortic graft32.87NA13.804.89NA51.56090
    33877AThoracoabdominal graft42.36NA16.286.08NA64.72090
    33910ARemove lung artery emboli24.45NA11.153.67NA39.27090
    33915ARemove lung artery emboli20.90NA9.601.44NA31.94090
    33916ASurgery of great vessel25.68NA11.183.64NA40.50090
    33917ARepair pulmonary artery24.36NA11.853.80NA40.01090
    33918ARepair pulmonary atresia26.30NA12.224.10NA42.62090
    33919ARepair pulmonary atresia39.77NA17.134.17NA61.07090
    33920ARepair pulmonary atresia31.77NA13.764.33NA49.86090
    33922ATransect pulmonary artery23.39NA10.812.76NA36.96090
    33924ARemove pulmonary shunt5.47NA1.800.89NA8.16ZZZ
    33930XRemoval of donor heart/lung0.000.000.000.000.000.00XXX
    33935RTransplantation, heart/lung60.61NA28.079.77NA98.45090
    33940XRemoval of donor heart0.000.000.000.000.000.00XXX
    33945RTransplantation of heart41.86NA20.816.50NA69.17090
    33960AExternal circulation assist19.25NA4.912.57NA26.73000
    33961AExternal circulation assist10.87NA3.601.76NA16.23ZZZ
    33967AInsert ia percut device4.82NA1.860.34NA7.02000
    33968ARemove aortic assist device0.64NA0.230.08NA0.95000
    33970AAortic circulation assist6.71NA2.250.84NA9.80000
    33971AAortic circulation assist9.63NA5.901.16NA16.69090
    33973AInsert balloon device9.70NA3.271.21NA14.18000
    33974ARemove intra-aortic balloon14.33NA7.801.77NA23.90090
    33975AImplant ventricular device20.88NA6.202.06NA29.14XXX
    33976AImplant ventricular device22.87NA7.423.38NA33.67XXX
    33977ARemove ventricular device19.18NA10.692.92NA32.79090
    33978ARemove ventricular device21.61NA11.383.19NA36.18090
    33979AInsert intracorporeal device45.74NA14.634.77NA65.14XXX
    33980ARemove intracorporeal device55.93NA24.645.51NA86.08090
    33999CCardiac surgery procedure0.000.000.000.000.000.00YYY
    34001ARemoval of artery clot12.84NA6.701.75NA21.29090
    34051ARemoval of artery clot15.12NA7.592.28NA24.99090
    34101ARemoval of artery clot9.94NA5.351.33NA16.62090
    34111ARemoval of arm artery clot9.94NA5.371.02NA16.33090
    34151ARemoval of artery clot24.86NA10.502.21NA37.57090
    34201ARemoval of artery clot9.97NA5.411.22NA16.60090
    34203ARemoval of leg artery clot16.41NA8.091.64NA26.14090
    34401ARemoval of vein clot24.86NA10.711.44NA37.01090
    34421ARemoval of vein clot11.93NA6.291.14NA19.36090
    34451ARemoval of vein clot26.85NA11.431.91NA40.19090
    34471ARemoval of vein clot10.12NA5.381.08NA16.58090
    34490ARemoval of vein clot9.80NA5.430.87NA16.10090
    34501ARepair valve, femoral vein15.91NA8.341.64NA25.89090
    34502AReconstruct vena cava26.80NA12.203.58NA42.58090
    34510ATransposition of vein valve18.84NA9.291.92NA30.05090
    34520ACross-over vein graft17.85NA8.741.69NA28.28090
    34530ALeg vein fusion16.55NA8.632.47NA27.65090
    34800AEndovasc abdo repair w/tube20.63NA9.191.79NA31.61090
    34802AEndovasc abdo repr w/device22.87NA9.881.98NA34.73090
    34804AEndovasc abdo repr w/device22.87NA9.881.98NA34.73090
    34805AEndovasc abdo repair w/pros21.76NA9.511.98NA33.25090
    34808AEndovasc abdo occlud device4.11NA1.380.35NA5.84ZZZ
    34812AXpose for endoprosth, femorl6.71NA2.250.59NA9.55000
    34813AFemoral endovas graft add-on4.77NA1.580.41NA6.76ZZZ
    34820AXpose for endoprosth, iliac9.69NA3.260.84NA13.79000
    34825AEndovasc extend prosth, init11.93NA6.201.03NA19.16090
    34826AEndovasc exten prosth, addl4.11NA1.390.35NA5.85ZZZ
    34830AOpen aortic tube prosth repr32.40NA13.682.80NA48.88090
    34831AOpen aortoiliac prosth repr35.14NA11.903.03NA50.07090
    34832AOpen aortofemor prosth repr35.14NA14.673.03NA52.84090
    34833AXpose for endoprosth, iliac11.93NA4.540.84NA17.31000
    34834AXpose, endoprosth, brachial5.32NA2.250.59NA8.16000
    34900AEndovasc iliac repr w/graft16.29NA7.901.79NA25.98090
    35001ARepair defect of artery19.53NA9.522.92NA31.97090
    35002ARepair artery rupture, neck20.88NA9.782.18NA32.84090
    Start Printed Page 63296
    35005ARepair defect of artery18.02NA8.881.62NA28.52090
    35011ARepair defect of artery17.90NA8.001.56NA27.46090
    35013ARepair artery rupture, arm21.87NA9.712.29NA33.87090
    35021ARepair defect of artery19.54NA9.252.31NA31.10090
    35022ARepair artery rupture, chest23.05NA10.012.39NA35.45090
    35045ARepair defect of arm artery17.47NA7.611.50NA26.58090
    35081ARepair defect of artery27.85NA11.453.84NA43.14090
    35082ARepair artery rupture, aorta38.28NA15.354.88NA58.51090
    35091ARepair defect of artery35.20NA13.614.90NA53.71090
    35092ARepair artery rupture, aorta44.74NA17.735.17NA67.64090
    35102ARepair defect of artery30.58NA12.404.12NA47.10090
    35103ARepair artery rupture, groin40.27NA15.954.54NA60.76090
    35111ARepair defect of artery24.86NA10.532.17NA37.56090
    35112ARepair artery rupture,spleen29.83NA12.072.34NA44.24090
    35121ARepair defect of artery29.83NA12.413.51NA45.75090
    35122ARepair artery rupture, belly34.80NA13.934.24NA52.97090
    35131ARepair defect of artery24.86NA10.762.53NA38.15090
    35132ARepair artery rupture, groin29.83NA12.422.97NA45.22090
    35141ARepair defect of artery19.89NA8.891.98NA30.76090
    35142ARepair artery rupture, thigh23.17NA10.392.10NA35.66090
    35151ARepair defect of artery22.51NA10.022.31NA34.84090
    35152ARepair artery rupture, knee25.47NA11.342.31NA39.12090
    35161ARepair defect of artery18.65NA9.082.65NA30.38090
    35162ARepair artery rupture19.67NA9.572.65NA31.89090
    35180ARepair blood vessel lesion13.54NA6.991.73NA22.26090
    35182ARepair blood vessel lesion29.83NA12.762.25NA44.84090
    35184ARepair blood vessel lesion17.90NA8.311.61NA27.82090
    35188ARepair blood vessel lesion14.20NA7.611.83NA23.64090
    35189ARepair blood vessel lesion27.84NA11.942.54NA42.32090
    35190ARepair blood vessel lesion12.68NA6.491.59NA20.76090
    35201ARepair blood vessel lesion16.05NA7.991.40NA25.44090
    35206ARepair blood vessel lesion13.17NA6.601.25NA21.02090
    35207ARepair blood vessel lesion10.09NA7.591.38NA19.06090
    35211ARepair blood vessel lesion21.99NA10.313.39NA35.69090
    35216ARepair blood vessel lesion18.64NA8.812.60NA30.05090
    35221ARepair blood vessel lesion24.25NA10.022.15NA36.42090
    35226ARepair blood vessel lesion14.42NA7.511.01NA22.94090
    35231ARepair blood vessel lesion19.89NA9.791.58NA31.26090
    35236ARepair blood vessel lesion17.01NA7.961.43NA26.40090
    35241ARepair blood vessel lesion22.99NA10.743.48NA37.21090
    35246ARepair blood vessel lesion26.30NA11.292.66NA40.25090
    35251ARepair blood vessel lesion30.03NA11.912.24NA44.18090
    35256ARepair blood vessel lesion18.26NA8.431.58NA28.27090
    35261ARepair blood vessel lesion17.70NA8.031.61NA27.34090
    35266ARepair blood vessel lesion14.83NA7.041.39NA23.26090
    35271ARepair blood vessel lesion21.99NA10.213.32NA35.52090
    35276ARepair blood vessel lesion24.11NA11.012.84NA37.96090
    35281ARepair blood vessel lesion27.84NA11.792.18NA41.81090
    35286ARepair blood vessel lesion16.07NA8.081.63NA25.78090
    35301ARechanneling of artery18.59NA8.452.67NA29.71090
    35311ARechanneling of artery26.85NA11.493.30NA41.64090
    35321ARechanneling of artery15.91NA7.341.63NA24.88090
    35331ARechanneling of artery26.05NA11.223.25NA40.52090
    35341ARechanneling of artery24.97NA10.933.44NA39.34090
    35351ARechanneling of artery22.87NA9.642.74NA35.25090
    35355ARechanneling of artery18.39NA8.132.16NA28.68090
    35361ARechanneling of artery28.04NA11.773.19NA43.00090
    35363ARechanneling of artery30.03NA12.583.32NA45.93090
    35371ARechanneling of artery14.64NA6.981.58NA23.20090
    35372ARechanneling of artery17.90NA8.091.83NA27.82090
    35381ARechanneling of artery15.72NA7.832.16NA25.71090
    35390AReoperation, carotid add-on3.17NA1.060.46NA4.69ZZZ
    35400AAngioscopy2.98NA1.040.41NA4.43ZZZ
    35450ARepair arterial blockage10.01NA4.051.01NA15.07000
    35452ARepair arterial blockage6.87NA3.150.91NA10.93000
    35454ARepair arterial blockage6.01NA2.840.80NA9.65000
    35456ARepair arterial blockage7.31NA3.270.98NA11.56000
    35458ARepair arterial blockage9.44NA3.981.31NA14.73000
    35459ARepair arterial blockage8.58NA3.641.15NA13.37000
    35460ARepair venous blockage6.01NA2.680.79NA9.48000
    35470ARepair arterial blockage8.58NA3.880.60NA13.06000
    35471ARepair arterial blockage10.01NA4.500.60NA15.11000
    35472ARepair arterial blockage6.87NA3.260.47NA10.60000
    35473ARepair arterial blockage6.01NA2.940.41NA9.36000
    35474ARepair arterial blockage7.32NA2.910.48NA10.71000
    Start Printed Page 63297
    35475RRepair arterial blockage9.44NA4.100.56NA14.10000
    35476ARepair venous blockage6.01NA2.880.32NA9.21000
    35480AAtherectomy, open11.02NA4.511.35NA16.88000
    35481AAtherectomy, open7.57NA3.441.01NA12.02000
    35482AAtherectomy, open6.61NA3.090.90NA10.60000
    35483AAtherectomy, open8.05NA3.530.97NA12.55000
    35484AAtherectomy, open10.38NA4.231.35NA15.96000
    35485AAtherectomy, open9.44NA4.061.27NA14.77000
    35490AAtherectomy, percutaneous11.02NA4.750.66NA16.43000
    35491AAtherectomy, percutaneous7.57NA3.320.59NA11.48000
    35492AAtherectomy, percutaneous6.61NA3.220.52NA10.35000
    35493AAtherectomy, percutaneous8.05NA3.830.56NA12.44000
    35494AAtherectomy, percutaneous10.38NA4.450.58NA15.41000
    35495AAtherectomy, percutaneous9.44NA4.420.61NA14.47000
    35500AHarvest vein for bypass6.41NA2.040.76NA9.21ZZZ
    35501AArtery bypass graft19.08NA8.432.79NA30.30090
    35506AArtery bypass graft19.56NA9.392.79NA31.74090
    35507AArtery bypass graft19.56NA9.362.72NA31.64090
    35508AArtery bypass graft18.54NA9.282.80NA30.62090
    35509AArtery bypass graft17.97NA8.762.54NA29.27090
    35510AArtery bypass graft22.87NA10.222.09NA35.18090
    35511AArtery bypass graft21.08NA9.342.09NA32.51090
    35512AArtery bypass graft22.37NA10.052.09NA34.51090
    35515AArtery bypass graft18.54NA9.232.71NA30.48090
    35516AArtery bypass graft16.23NA6.872.25NA25.35090
    35518AArtery bypass graft21.08NA9.042.13NA32.25090
    35521AArtery bypass graft22.07NA9.812.18NA34.06090
    35522AArtery bypass graft21.64NA9.792.09NA33.52090
    35525AArtery bypass graft20.51NA9.412.09NA32.01090
    35526AArtery bypass graft29.78NA12.372.61NA44.76090
    35531AArtery bypass graft35.99NA14.573.49NA54.05090
    35533AArtery bypass graft27.84NA11.772.82NA42.43090
    35536AArtery bypass graft31.52NA13.063.14NA47.72090
    35541AArtery bypass graft25.65NA11.173.28NA40.10090
    35546AArtery bypass graft25.39NA10.903.40NA39.69090
    35548AArtery bypass graft21.45NA9.452.94NA33.84090
    35549AArtery bypass graft23.22NA10.303.32NA36.84090
    35551AArtery bypass graft26.52NA11.413.82NA41.75090
    35556AArtery bypass graft21.64NA9.732.97NA34.34090
    35558AArtery bypass graft21.08NA9.561.89NA32.53090
    35560AArtery bypass graft31.82NA13.313.27NA48.40090
    35563AArtery bypass graft24.06NA10.532.01NA36.60090
    35565AArtery bypass graft23.07NA10.182.05NA35.30090
    35566AArtery bypass graft26.77NA11.463.62NA41.85090
    35571AArtery bypass graft23.92NA10.932.57NA37.42090
    35572AHarvest femoropopliteal vein6.78NA2.350.76NA9.89ZZZ
    35582AVein bypass graft26.98NA11.613.73NA42.32090
    35583AVein bypass graft22.24NA10.223.03NA35.49090
    35585AVein bypass graft28.23NA12.353.85NA44.43090
    35587AVein bypass graft24.61NA11.532.60NA38.74090
    35600AHarvest artery for cabg4.92NA1.600.72NA7.24ZZZ
    35601AArtery bypass graft17.40NA8.592.49NA28.48090
    35606AArtery bypass graft18.60NA8.972.60NA30.17090
    35612AArtery bypass graft15.67NA7.832.06NA25.56090
    35616AArtery bypass graft15.61NA8.022.21NA25.84090
    35621AArtery bypass graft19.89NA8.692.01NA30.59090
    35623ABypass graft, not vein23.86NA10.512.29NA36.66090
    35626AArtery bypass graft27.59NA11.783.46NA42.83090
    35631AArtery bypass graft33.81NA13.903.39NA51.10090
    35636AArtery bypass graft29.33NA12.432.84NA44.60090
    35641AArtery bypass graft24.43NA11.003.39NA38.82090
    35642AArtery bypass graft17.88NA8.702.21NA28.79090
    35645AArtery bypass graft17.37NA8.352.29NA28.01090
    35646AArtery bypass graft30.82NA13.104.35NA48.27090
    35647AArtery bypass graft27.84NA11.783.93NA43.55090
    35650AArtery bypass graft18.89NA8.381.97NA29.24090
    35651AArtery bypass graft24.90NA10.863.03NA38.79090
    35654AArtery bypass graft24.86NA10.702.52NA38.08090
    35656AArtery bypass graft19.42NA8.602.65NA30.67090
    35661AArtery bypass graft18.89NA8.931.80NA29.62090
    35663AArtery bypass graft21.87NA9.961.86NA33.69090
    35665AArtery bypass graft20.88NA9.492.11NA32.48090
    35666AArtery bypass graft22.06NA10.682.62NA35.36090
    35671AArtery bypass graft19.22NA9.402.01NA30.63090
    35681AComposite bypass graft1.59NA0.540.22NA2.35ZZZ
    Start Printed Page 63298
    35682AComposite bypass graft7.16NA2.410.99NA10.56ZZZ
    35683AComposite bypass graft8.45NA2.841.17NA12.46ZZZ
    35685ABypass graft patency/patch4.03NA1.360.30NA5.69ZZZ
    35686ABypass graft/av fist patency3.33NA1.140.25NA4.72ZZZ
    35691AArterial transposition17.95NA8.462.47NA28.88090
    35693AArterial transposition15.27NA7.672.16NA25.10090
    35694AArterial transposition19.05NA8.692.55NA30.29090
    35695AArterial transposition19.05NA8.612.62NA30.28090
    35697AReimplant artery each2.98NA1.030.41NA4.42ZZZ
    35700AReoperation, bypass graft3.06NA1.020.43NA4.51ZZZ
    35701AExploration, carotid artery8.45NA5.160.77NA14.38090
    35721AExploration, femoral artery7.14NA4.430.71NA12.28090
    35741AExploration popliteal artery7.95NA4.690.72NA13.36090
    35761AExploration of artery/vein5.34NA4.050.72NA10.11090
    35800AExplore neck vessels6.98NA4.630.95NA12.56090
    35820AExplore chest vessels12.81NA6.931.93NA21.67090
    35840AExplore abdominal vessels9.71NA5.311.27NA16.29090
    35860AExplore limb vessels5.52NA4.030.76NA10.31090
    35870ARepair vessel graft defect22.04NA9.812.96NA34.81090
    35875ARemoval of clot in graft10.07NA5.241.16NA16.47090
    35876ARemoval of clot in graft16.90NA7.592.25NA26.74090
    35879ARevise graft w/vein15.91NA7.741.62NA25.27090
    35881ARevise graft w/vein17.90NA8.711.73NA28.34090
    35901AExcision, graft, neck8.14NA5.341.08NA14.56090
    35903AExcision, graft, extremity9.34NA5.991.23NA16.56090
    35905AExcision, graft, thorax31.07NA13.142.58NA46.79090
    35907AExcision, graft, abdomen34.80NA14.152.60NA51.55090
    36000APlace needle in vein0.180.620.050.010.810.24XXX
    36002APseudoaneurysm injection trt1.952.921.000.124.993.07000
    36005AInjection ext venography0.948.420.320.059.411.31000
    36010APlace catheter in vein2.42NA0.790.19NA3.40XXX
    36011APlace catheter in vein3.12NA1.040.20NA4.36XXX
    36012APlace catheter in vein3.50NA1.160.20NA4.86XXX
    36013APlace catheter in artery2.51NA0.660.20NA3.37XXX
    36014APlace catheter in artery3.00NA1.000.17NA4.17XXX
    36015APlace catheter in artery3.50NA1.160.19NA4.85XXX
    36100AEstablish access to artery3.00NA1.110.22NA4.33XXX
    36120AEstablish access to artery2.00NA0.650.13NA2.78XXX
    36140AEstablish access to artery2.00NA0.640.14NA2.78XXX
    36145AArtery to vein shunt2.00NA0.660.12NA2.78XXX
    36160AEstablish access to aorta2.51NA0.840.24NA3.59XXX
    36200APlace catheter in aorta3.0077.011.020.1880.194.20XXX
    36215APlace catheter in artery4.65NA1.590.26NA6.50XXX
    36216APlace catheter in artery5.25NA1.780.29NA7.32XXX
    36217APlace catheter in artery6.26NA2.160.38NA8.80XXX
    36218APlace catheter in artery1.00NA0.350.06NA1.41ZZZ
    36245APlace catheter in artery4.65NA1.670.28NA6.60XXX
    36246APlace catheter in artery5.25NA1.810.31NA7.37XXX
    36247APlace catheter in artery6.26NA2.120.38NA8.76XXX
    36248APlace catheter in artery1.00NA0.350.07NA1.42ZZZ
    36260AInsertion of infusion pump9.65NA4.961.20NA15.81090
    36261ARevision of infusion pump5.42NA3.620.60NA9.64090
    36262ARemoval of infusion pump4.00NA2.800.52NA7.32090
    36299CVessel injection procedure0.000.000.000.000.000.00YYY
    36400ABl draw < 3 yrs fem/jugular0.380.290.090.010.680.48XXX
    36405ABl draw < 3 yrs scalp vein0.310.270.080.010.590.40XXX
    36406ABl draw < 3 yrs other vein0.180.310.050.010.500.24XXX
    36410ANon-routine bl draw > 3 yrs0.180.310.050.010.500.24XXX
    36415IRoutine venipuncture0.000.000.000.000.000.00XXX
    36416ICapillary blood draw0.000.000.000.000.000.00XXX
    36420AVein access cutdown < 1 yr1.003.160.280.114.271.39XXX
    36425AVein access cutdown > 1 yr0.76NA0.220.06NA1.04XXX
    36430ABlood transfusion service0.000.99NA0.061.05NAXXX
    36440ABl push transfuse, 2 yr or <1.02NA0.290.10NA1.41XXX
    36450ABl exchange/transfuse, nb2.22NA0.700.19NA3.11XXX
    36455ABl exchange/transfuse non-nb2.42NA0.830.12NA3.37XXX
    36460ATransfusion service, fetal6.55NA2.240.67NA9.46XXX
    36468RInjection(s), spider veins0.000.000.000.000.000.00000
    36469RInjection(s), spider veins0.000.000.000.000.000.00000
    36470AInjection therapy of vein1.082.750.450.123.951.65010
    36471AInjection therapy of veins1.563.100.610.184.842.35010
    36481AInsertion of catheter, vein6.957.002.760.4814.4310.19000
    36488DInsertion of catheter, vein0.000.000.000.000.000.00000
    36489DInsertion of catheter, vein0.000.000.000.000.000.00000
    36490DInsertion of catheter, vein0.000.000.000.000.000.00000
    Start Printed Page 63299
    36491DInsertion of catheter, vein0.000.000.000.000.000.00000
    36493DRepositioning of cvc0.000.000.000.000.000.00000
    36500AInsertion of catheter, vein3.50NA1.240.17NA4.91000
    36510AInsertion of catheter, vein1.083.810.630.074.961.78000
    36511AApheresis wbc1.73NA0.690.07NA2.49000
    36512AApheresis rbc1.73NA0.690.07NA2.49000
    36513AApheresis platelets1.73NA0.690.07NA2.49000
    36514AApheresis plasma1.73NA0.690.07NA2.49000
    36515AApheresis, adsorp/reinfuse1.73NA0.730.07NA2.53000
    36516AApheresis, selective1.73NA0.730.07NA2.53000
    36522APhotopheresis1.6630.381.140.0832.122.88000
    36530DInsertion of infusion pump0.000.000.000.000.000.00010
    36531DRevision of infusion pump0.000.000.000.000.000.00010
    36532DRemoval of infusion pump0.000.000.000.000.000.00010
    36533DInsertion of access device0.000.000.000.000.000.00010
    36534DRevision of access device0.000.000.000.000.000.00010
    36535DRemoval of access device0.000.000.000.000.000.00010
    36536DRemove cva device obstruct0.000.000.000.000.000.00000
    36537DRemove cva lumen obstruct0.000.000.000.000.000.00000
    36540BCollect blood venous device0.000.000.000.000.000.00XXX
    36550ADeclot vascular device0.000.41NA0.370.78NAXXX
    36555AInsert non-tunnel cv cath2.666.060.820.208.923.68000
    36556AInsert non-tunnel cv cath2.495.060.750.107.653.34000
    36557AInsert tunneled cv cath5.0713.642.590.5919.308.25010
    36558AInsert tunneled cv cath4.7713.542.480.5918.907.84010
    36560AInsert tunneled cv cath6.2129.382.980.5936.189.78010
    36561AInsert tunneled cv cath5.9729.292.890.5935.859.45010
    36563AInsert tunneled cv cath6.1626.752.990.6733.589.82010
    36565AInsert tunneled cv cath5.9722.302.890.5928.869.45010
    36566AInsert tunneled cv cath6.4623.113.060.5930.1610.11010
    36568AInsert tunneled cv cath1.918.290.600.2010.402.71000
    36569AInsert tunneled cv cath1.816.770.580.168.742.55000
    36570AInsert tunneled cv cath5.2940.532.660.5946.418.54010
    36571AInsert tunneled cv cath5.2735.862.650.5941.728.51010
    36575ARepair tunneled cv cath0.673.350.260.594.611.52000
    36576ARepair tunneled cv cath3.177.731.770.5911.495.53010
    36578AReplace tunneled cv cath3.4810.572.210.5914.646.28010
    36580AReplace tunneled cv cath1.305.880.420.167.341.88000
    36581AReplace tunneled cv cath3.4213.301.850.5917.315.86010
    36582AReplace tunneled cv cath5.1726.692.780.5932.458.54010
    36583AReplace tunneled cv cath5.2213.172.800.5918.988.61010
    36584AReplace tunneled cv cath1.196.330.560.167.681.91000
    36585AReplace tunneled cv cath4.7735.522.650.5940.888.01010
    36589ARemoval tunneled cv cath2.262.131.420.254.643.93010
    36590ARemoval tunneled cv cath3.286.341.640.4110.035.33010
    36595AMech remov tunneled cv cath3.5818.941.470.2822.805.33000
    36596AMech remov tunneled cv cath0.754.430.500.055.231.30000
    36597AReposition venous catheter1.203.180.440.074.451.71000
    36600AWithdrawal of arterial blood0.320.490.090.020.830.43XXX
    36620AInsertion catheter, artery1.14NA0.240.07NA1.45000
    36625AInsertion catheter, artery2.10NA0.530.19NA2.82000
    36640AInsertion catheter, artery2.09NA1.030.22NA3.34000
    36660AInsertion catheter, artery1.39NA0.440.10NA1.93000
    36680AInsert needle, bone cavity1.19NA0.500.10NA1.79000
    36800AInsertion of cannula2.42NA1.820.20NA4.44000
    36810AInsertion of cannula3.95NA1.690.48NA6.12000
    36815AInsertion of cannula2.61NA1.180.31NA4.10000
    36819AAv fusion/uppr arm vein13.92NA6.431.87NA22.22090
    36820AAv fusion/forearm vein13.92NA6.431.87NA22.22090
    36821AAv fusion direct any site8.88NA4.721.16NA14.76090
    36822AInsertion of cannula(s)5.39NA4.310.76NA10.46090
    36823AInsertion of cannula(s)20.88NA9.562.61NA33.05090
    36825AArtery-vein autograft9.78NA5.131.31NA16.22090
    36830AArtery-vein nonautograft11.93NA5.301.58NA18.81090
    36831AOpen thrombect av fistula7.95NA3.980.95NA12.88090
    36832AAv fistula revision, open10.44NA4.791.35NA16.58090
    36833AAv fistula revision11.88NA5.271.55NA18.70090
    36834ARepair A-V aneurysm9.87NA4.811.27NA15.95090
    36835AArtery to vein shunt7.11NA4.340.96NA12.41090
    36838ADist revas ligation, hemo20.51NA9.412.97NA32.89090
    36860AExternal cannula declotting2.002.541.360.124.663.48000
    36861ACannula declotting2.51NA1.500.17NA4.18000
    36870APercut thrombect av fistula5.1347.273.170.2852.688.58090
    37140ARevision of circulation23.47NA10.601.45NA35.52090
    37145ARevision of circulation24.47NA11.072.97NA38.51090
    Start Printed Page 63300
    37160ARevision of circulation21.48NA9.382.59NA33.45090
    37180ARevision of circulation24.47NA10.453.15NA38.07090
    37181ASplice spleen/kidney veins26.53NA11.133.20NA40.86090
    37182AInsert hepatic shunt (tips)16.90NA6.321.79NA25.01000
    37183ARemove hepatic shunt (tips)7.95NA3.110.52NA11.58000
    37195AThrombolytic therapy, stroke0.007.99NA0.468.45NAXXX
    37200ATranscatheter biopsy4.53NA1.520.23NA6.28000
    37201ATranscatheter therapy infuse4.97NA2.540.29NA7.80000
    37202ATranscatheter therapy infuse5.65NA3.070.46NA9.18000
    37203ATranscatheter retrieval5.00NA2.550.28NA7.83000
    37204ATranscatheter occlusion18.04NA5.991.09NA25.12000
    37205ATranscatheter stent8.23NA3.770.52NA12.52000
    37206ATranscatheter stent add-on4.11NA1.460.26NA5.83ZZZ
    37207ATranscatheter stent8.23NA3.181.07NA12.48000
    37208ATranscatheter stent add-on4.11NA1.400.53NA6.04ZZZ
    37209AExchange arterial catheter2.26NA0.750.13NA3.14000
    37250AIv us first vessel add-on2.09NA0.750.20NA3.04ZZZ
    37251AIv us each add vessel add-on1.59NA0.560.17NA2.32ZZZ
    37500AEndoscopy ligate perf veins10.94NA7.090.48NA18.51090
    37501CVascular endoscopy procedure0.000.000.000.000.000.00YYY
    37565ALigation of neck vein10.82NA5.690.54NA17.05090
    37600ALigation of neck artery11.19NA6.710.48NA18.38090
    37605ALigation of neck artery13.04NA6.980.92NA20.94090
    37606ALigation of neck artery6.24NA4.620.95NA11.81090
    37607ALigation of a-v fistula6.12NA3.600.80NA10.52090
    37609ATemporal artery procedure2.984.741.990.257.975.22010
    37615ALigation of neck artery5.70NA4.140.68NA10.52090
    37616ALigation of chest artery16.40NA7.962.31NA26.67090
    37617ALigation of abdomen artery21.93NA9.302.03NA33.26090
    37618ALigation of extremity artery4.81NA3.600.65NA9.06090
    37620ARevision of major vein10.50NA5.750.90NA17.15090
    37650ARevision of major vein7.76NA4.700.67NA13.13090
    37660ARevision of major vein20.88NA9.101.40NA31.38090
    37700ARevise leg vein3.71NA2.830.48NA7.02090
    37720ARemoval of leg vein5.63NA3.740.73NA10.10090
    37730ARemoval of leg veins7.29NA4.310.92NA12.52090
    37735ARemoval of leg veins/lesion10.47NA5.561.40NA17.43090
    37760ALigation, leg veins, open10.41NA5.401.33NA17.14090
    37765APhleb veins—extrem—to 207.31NA4.560.48NA12.35090
    37766APhleb veins—extrem 20+9.25NA5.280.48NA15.01090
    37780ARevision of leg vein3.82NA2.880.49NA7.19090
    37785ALigate/divide/excise vein3.825.162.660.499.476.97090
    37788ARevascularization, penis21.88NA9.391.62NA32.89090
    37790APenile venous occlusion8.29NA4.520.76NA13.57090
    37799CVascular surgery procedure0.000.000.000.000.000.00YYY
    38100ARemoval of spleen, total14.42NA6.281.56NA22.26090
    38101ARemoval of spleen, partial15.22NA6.641.65NA23.51090
    38102ARemoval of spleen, total4.77NA1.660.59NA7.02ZZZ
    38115ARepair of ruptured spleen15.73NA6.761.68NA24.17090
    38120ALaparoscopy, splenectomy16.90NA7.512.07NA26.48090
    38129CLaparoscope proc, spleen0.000.000.000.000.000.00YYY
    38200AInjection for spleen x-ray2.62NA0.900.14NA3.66000
    38204BBl donor search management0.000.000.000.000.000.00XXX
    38205RHarvest allogenic stem cells1.49NA0.610.06NA2.16000
    38206RHarvest auto stem cells1.49NA0.610.06NA2.16000
    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 aspiration1.073.970.430.045.081.54XXX
    38221ABone marrow biopsy1.364.150.540.055.561.95XXX
    38230RBone marrow collection4.51NA2.510.30NA7.32010
    38240RBone marrow/stem transplant2.23NA0.820.10NA3.15XXX
    38241RBone marrow/stem transplant2.23NA0.820.10NA3.15XXX
    38242ALymphocyte infuse transplant1.70NA0.680.06NA2.44000
    38300ADrainage, lymph node lesion1.984.502.100.186.664.26010
    38305ADrainage, lymph node lesion5.976.064.420.4312.4610.82090
    38308AIncision of lymph channels6.415.813.770.6112.8310.79090
    38380AThoracic duct procedure7.42NA5.750.82NA13.99090
    38381AThoracic duct procedure12.81NA6.721.89NA21.42090
    Start Printed Page 63301
    38382AThoracic duct procedure10.02NA5.811.29NA17.12090
    38500ABiopsy/removal, lymph nodes3.733.832.120.347.906.19010
    38505ANeedle biopsy, lymph nodes1.132.160.790.113.402.03000
    38510ABiopsy/removal, lymph nodes6.395.713.540.4612.5610.39010
    38520ABiopsy/removal, lymph nodes6.63NA4.090.62NA11.34090
    38525ABiopsy/removal, lymph nodes6.04NA3.390.58NA10.01090
    38530ABiopsy/removal, lymph nodes7.93NA4.450.76NA13.14090
    38542AExplore deep node(s), neck5.88NA4.530.60NA11.01090
    38550ARemoval, neck/armpit lesion6.88NA4.040.83NA11.75090
    38555ARemoval, neck/armpit lesion14.06NA8.521.75NA24.33090
    38562ARemoval, pelvic lymph nodes10.43NA5.991.16NA17.58090
    38564ARemoval, abdomen lymph nodes10.77NA5.391.27NA17.43090
    38570ALaparoscopy, lymph node biop9.20NA4.001.07NA14.27010
    38571ALaparoscopy, lymphadenectomy14.60NA5.670.96NA21.23010
    38572ALaparoscopy, lymphadenectomy16.50NA7.241.58NA25.32010
    38589CLaparoscope proc, lymphatic0.000.000.000.000.000.00YYY
    38700ARemoval of lymph nodes, neck8.19NA8.190.72NA17.10090
    38720ARemoval of lymph nodes, neck13.53NA11.181.23NA25.94090
    38724ARemoval of lymph nodes, neck14.46NA11.701.32NA27.48090
    38740ARemove armpit lymph nodes9.97NA5.060.83NA15.86090
    38745ARemove armpit lymph nodes13.03NA6.251.08NA20.36090
    38746ARemove thoracic lymph nodes4.86NA1.590.66NA7.11ZZZ
    38747ARemove abdominal lymph nodes4.86NA1.690.60NA7.15ZZZ
    38760ARemove groin lymph nodes12.88NA6.291.05NA20.22090
    38765ARemove groin lymph nodes19.87NA9.051.80NA30.72090
    38770ARemove pelvis lymph nodes13.15NA5.911.19NA20.25090
    38780ARemove abdomen lymph nodes16.50NA8.531.92NA26.95090
    38790AInject for lymphatic x-ray1.2810.810.800.1112.202.19000
    38792AIdentify sentinel node0.52NA0.450.05NA1.02000
    38794AAccess thoracic lymph duct4.42NA3.430.20NA8.05090
    38999CBlood/lymph system procedure0.000.000.000.000.000.00YYY
    39000AExploration of chest6.07NA4.510.87NA11.45090
    39010AExploration of chest11.72NA6.431.75NA19.90090
    39200ARemoval chest lesion13.54NA6.611.98NA22.13090
    39220ARemoval chest lesion17.32NA8.312.52NA28.15090
    39400AVisualization of chest5.58NA4.650.83NA11.06010
    39499CChest procedure0.000.000.000.000.000.00YYY
    39501ARepair diaphragm laceration13.11NA6.531.65NA21.29090
    39502ARepair paraesophageal hernia16.24NA7.252.01NA25.50090
    39503ARepair of diaphragm hernia94.46NA33.854.22NA132.53090
    39520ARepair of diaphragm hernia16.01NA7.992.19NA26.19090
    39530ARepair of diaphragm hernia15.32NA7.161.99NA24.47090
    39531ARepair of diaphragm hernia16.33NA7.412.19NA25.93090
    39540ARepair of diaphragm hernia13.24NA6.281.65NA21.17090
    39541ARepair of diaphragm hernia14.33NA6.661.82NA22.81090
    39545ARevision of diaphragm13.29NA7.411.86NA22.56090
    39560AResect diaphragm, simple11.93NA6.341.62NA19.89090
    39561AResect diaphragm, complex17.40NA9.312.36NA29.07090
    39599CDiaphragm surgery procedure0.000.000.000.000.000.00YYY
    40490ABiopsy of lip1.211.870.620.073.151.90000
    40500APartial excision of lip4.266.154.950.3710.789.58090
    40510APartial excision of lip4.676.904.840.4612.039.97090
    40520APartial excision of lip4.647.415.090.5012.5510.23090
    40525AReconstruct lip with flap7.51NA6.980.82NA15.31090
    40527AReconstruct lip with flap9.08NA7.940.98NA18.00090
    40530APartial removal of lip5.376.655.250.5612.5811.18090
    40650ARepair lip3.625.623.860.379.617.85090
    40652ARepair lip4.246.595.300.4711.3010.01090
    40654ARepair lip5.287.246.030.5813.1011.89090
    40700ARepair cleft lip/nasal12.72NA9.631.11NA23.46090
    40701ARepair cleft lip/nasal15.76NA11.921.63NA29.31090
    40702ARepair cleft lip/nasal12.97NA8.561.21NA22.74090
    40720ARepair cleft lip/nasal13.47NA10.621.57NA25.66090
    40761ARepair cleft lip/nasal14.64NA10.931.69NA27.26090
    40799CLip surgery procedure0.000.000.000.000.000.00YYY
    40800ADrainage of mouth lesion1.162.241.160.113.512.43010
    40801ADrainage of mouth lesion2.523.212.050.225.954.79010
    40804ARemoval, foreign body, mouth1.232.581.130.113.922.47010
    40805ARemoval, foreign body, mouth2.673.442.000.206.314.87010
    40806AIncision of lip fold0.311.390.960.021.721.29000
    40808ABiopsy of mouth lesion0.952.321.090.083.352.12010
    40810AExcision of mouth lesion1.302.411.230.113.822.64010
    40812AExcise/repair mouth lesion2.303.271.800.205.774.30010
    40814AExcise/repair mouth lesion3.404.793.320.318.507.03090
    40816AExcision of mouth lesion3.654.983.430.328.957.40090
    Start Printed Page 63302
    40818AExcise oral mucosa for graft2.405.233.580.177.806.15090
    40819AExcise lip or cheek fold2.404.452.960.207.055.56090
    40820ATreatment of mouth lesion1.272.742.370.104.113.74010
    40830ARepair mouth laceration1.753.122.560.175.044.48010
    40831ARepair mouth laceration2.453.663.120.256.365.82010
    40840RReconstruction of mouth8.688.697.450.9518.3217.08090
    40842RReconstruction of mouth8.688.797.190.7818.2516.65090
    40843RReconstruction of mouth12.0311.018.711.0124.0521.75090
    40844RReconstruction of mouth15.9213.9811.901.9531.8529.77090
    40845RReconstruction of mouth18.4716.0313.701.7636.2633.93090
    40899CMouth surgery procedure0.000.000.000.000.000.00YYY
    41000ADrainage of mouth lesion1.292.501.420.113.902.82010
    41005ADrainage of mouth lesion1.252.711.640.114.073.00010
    41006ADrainage of mouth lesion3.224.443.490.307.967.01090
    41007ADrainage of mouth lesion3.084.233.340.267.576.68090
    41008ADrainage of mouth lesion3.354.583.530.298.227.17090
    41009ADrainage of mouth lesion3.574.923.900.308.797.77090
    41010AIncision of tongue fold1.053.513.510.074.634.63010
    41015ADrainage of mouth lesion3.945.434.110.359.728.40090
    41016ADrainage of mouth lesion4.055.514.120.349.908.51090
    41017ADrainage of mouth lesion4.055.434.200.389.868.63090
    41018ADrainage of mouth lesion5.075.874.320.4211.369.81090
    41100ABiopsy of tongue1.622.581.440.144.343.20010
    41105ABiopsy of tongue1.412.481.330.124.012.86010
    41108ABiopsy of floor of mouth1.042.231.140.103.372.28010
    41110AExcision of tongue lesion1.502.551.350.134.182.98010
    41112AExcision of tongue lesion2.714.302.740.247.255.69090
    41113AExcision of tongue lesion3.174.663.020.288.116.47090
    41114AExcision of tongue lesion8.428.866.370.7718.0515.56090
    41115AExcision of tongue fold1.733.472.600.165.364.49010
    41116AExcision of mouth lesion2.434.282.810.206.915.44090
    41120APartial removal of tongue9.71NA7.670.84NA18.22090
    41130APartial removal of tongue11.09NA8.450.97NA20.51090
    41135ATongue and neck surgery22.96NA14.991.99NA39.94090
    41140ARemoval of tongue25.35NA16.242.22NA43.81090
    41145ATongue removal, neck surgery29.89NA19.392.53NA51.81090
    41150ATongue, mouth, jaw surgery22.91NA15.662.00NA40.57090
    41153ATongue, mouth, neck surgery23.63NA16.132.05NA41.81090
    41155ATongue, jaw, & neck surgery27.56NA18.182.42NA48.16090
    41250ARepair tongue laceration1.903.121.650.185.203.73010
    41251ARepair tongue laceration2.263.631.960.226.114.44010
    41252ARepair tongue laceration2.954.222.310.287.455.54010
    41500AFixation of tongue3.69NA3.670.31NA7.67090
    41510ATongue to lip surgery3.40NA3.150.29NA6.84090
    41520AReconstruction, tongue fold2.714.123.250.237.066.19090
    41599CTongue and mouth surgery0.000.000.000.000.000.00YYY
    41800ADrainage of gum lesion1.162.701.470.113.972.74010
    41805ARemoval foreign body, gum1.232.772.380.114.113.72010
    41806ARemoval foreign body,jawbone2.673.663.190.266.596.12010
    41820RExcision, gum, each quadrant0.000.000.000.000.000.00000
    41821RExcision of gum flap0.000.000.000.000.000.00000
    41822RExcision of gum lesion2.304.141.340.296.733.93010
    41823RExcision of gum lesion3.285.894.150.359.527.78090
    41825AExcision of gum lesion1.303.302.380.124.723.80010
    41826AExcision of gum lesion2.303.892.930.206.395.43010
    41827AExcision of gum lesion3.405.683.890.309.387.59090
    41828RExcision of gum lesion3.074.443.380.267.776.71010
    41830RRemoval of gum tissue3.334.983.620.288.597.23010
    41850RTreatment of gum lesion0.000.000.000.000.000.00000
    41870RGum graft0.000.000.000.000.000.00000
    41872RRepair gum2.584.683.570.227.486.37090
    41874RRepair tooth socket3.074.743.320.288.096.67090
    41899CDental surgery procedure0.000.000.000.000.000.00YYY
    42000ADrainage mouth roof lesion1.222.761.270.124.102.61010
    42100ABiopsy roof of mouth1.302.301.380.123.722.80010
    42104AExcision lesion, mouth roof1.632.801.570.144.573.34010
    42106AExcision lesion, mouth roof2.093.762.850.196.045.13010
    42107AExcision lesion, mouth roof4.416.144.240.3810.939.03090
    42120ARemove palate/lesion6.13NA5.620.53NA12.28090
    42140AExcision of uvula1.612.502.390.144.254.14090
    42145ARepair palate, pharynx/uvula8.00NA6.690.67NA15.36090
    42160ATreatment mouth roof lesion1.793.632.690.165.584.64010
    42180ARepair palate2.493.432.150.236.154.87010
    42182ARepair palate3.814.293.090.328.427.22010
    42200AReconstruct cleft palate11.93NA9.101.16NA22.19090
    Start Printed Page 63303
    42205AReconstruct cleft palate13.21NA9.460.98NA23.65090
    42210AReconstruct cleft palate14.42NA10.651.49NA26.56090
    42215AReconstruct cleft palate8.77NA7.651.15NA17.57090
    42220AReconstruct cleft palate6.98NA5.710.49NA13.18090
    42225AReconstruct cleft palate9.49NA7.760.90NA18.15090
    42226ALengthening of palate9.95NA7.970.87NA18.79090
    42227ALengthening of palate9.47NA7.430.84NA17.74090
    42235ARepair palate7.83NA5.420.59NA13.84090
    42260ARepair nose to lip fistula9.749.347.531.0220.1018.29090
    42280APreparation, palate mold1.532.030.890.143.702.56010
    42281AInsertion, palate prosthesis1.922.961.920.175.054.01010
    42299CPalate/uvula surgery0.000.000.000.000.000.00YYY
    42300ADrainage of salivary gland1.922.991.850.185.093.95010
    42305ADrainage of salivary gland6.04NA5.000.55NA11.59090
    42310ADrainage of salivary gland1.552.371.560.134.053.24010
    42320ADrainage of salivary gland2.343.562.130.206.104.67010
    42325ACreate salivary cyst drain2.733.592.260.206.525.19090
    42326ACreate salivary cyst drain3.764.603.150.418.777.32090
    42330ARemoval of salivary stone2.203.331.890.195.724.28010
    42335ARemoval of salivary stone3.293.943.400.287.516.97090
    42340ARemoval of salivary stone4.575.204.330.4110.189.31090
    42400ABiopsy of salivary gland0.781.770.720.072.621.57000
    42405ABiopsy of salivary gland3.274.212.500.297.776.06010
    42408AExcision of salivary cyst4.515.114.100.4110.039.02090
    42409ADrainage of salivary cyst2.793.593.130.246.626.16090
    42410AExcise parotid gland/lesion9.29NA6.710.92NA16.92090
    42415AExcise parotid gland/lesion16.79NA11.381.51NA29.68090
    42420AExcise parotid gland/lesion19.48NA12.901.74NA34.12090
    42425AExcise parotid gland/lesion12.95NA9.171.17NA23.29090
    42426AExcise parotid gland/lesion21.14NA13.571.88NA36.59090
    42440AExcise submaxillary gland6.93NA5.120.61NA12.66090
    42450AExcise sublingual gland4.595.734.290.4110.739.29090
    42500ARepair salivary duct4.285.524.240.3610.168.88090
    42505ARepair salivary duct6.146.995.420.5313.6612.09090
    42507AParotid duct diversion6.08NA5.260.79NA12.13090
    42508AParotid duct diversion9.05NA7.100.77NA16.92090
    42509AParotid duct diversion11.47NA8.501.49NA21.46090
    42510AParotid duct diversion8.10NA6.170.68NA14.95090
    42550AInjection for salivary x-ray1.2413.070.420.0714.381.73000
    42600AClosure of salivary fistula4.795.904.570.4111.109.77090
    42650ADilation of salivary duct0.771.180.720.072.021.56000
    42660ADilation of salivary duct1.121.500.850.082.702.05000
    42665ALigation of salivary duct2.523.603.010.206.325.73090
    42699CSalivary surgery procedure0.000.000.000.000.000.00YYY
    42700ADrainage of tonsil abscess1.612.781.750.144.533.50010
    42720ADrainage of throat abscess5.395.103.860.4710.969.72010
    42725ADrainage of throat abscess10.66NA8.080.96NA19.70090
    42800ABiopsy of throat1.382.251.420.123.752.92010
    42802ABiopsy of throat1.534.431.960.136.093.62010
    42804ABiopsy of upper nose/throat1.234.011.810.115.353.15010
    42806ABiopsy of upper nose/throat1.574.161.940.145.873.65010
    42808AExcise pharynx lesion2.293.211.950.205.704.44010
    42809ARemove pharynx foreign body1.802.391.390.164.353.35010
    42810AExcision of neck cyst3.234.903.410.308.436.94090
    42815AExcision of neck cyst7.03NA5.470.64NA13.14090
    42820ARemove tonsils and adenoids3.89NA3.510.34NA7.74090
    42821ARemove tonsils and adenoids4.27NA3.720.36NA8.35090
    42825ARemoval of tonsils3.40NA3.350.29NA7.04090
    42826ARemoval of tonsils3.36NA3.240.28NA6.88090
    42830ARemoval of adenoids2.56NA2.650.22NA5.43090
    42831ARemoval of adenoids2.69NA2.900.23NA5.82090
    42835ARemoval of adenoids2.29NA2.660.20NA5.15090
    42836ARemoval of adenoids3.16NA3.170.26NA6.59090
    42842AExtensive surgery of throat8.71NA6.820.73NA16.26090
    42844AExtensive surgery of throat14.23NA10.131.25NA25.61090
    42845AExtensive surgery of throat24.15NA16.282.11NA42.54090
    42860AExcision of tonsil tags2.21NA2.600.19NA5.00090
    42870AExcision of lingual tonsil5.37NA4.830.46NA10.66090
    42890APartial removal of pharynx12.87NA9.441.09NA23.40090
    42892ARevision of pharyngeal walls15.74NA11.011.37NA28.12090
    42894ARevision of pharyngeal walls22.75NA15.231.97NA39.95090
    42900ARepair throat wound5.22NA3.730.47NA9.42010
    42950AReconstruction of throat8.05NA6.680.70NA15.43090
    42953ARepair throat, esophagus8.91NA7.590.87NA17.37090
    42955ASurgical opening of throat7.35NA5.620.76NA13.73090
    Start Printed Page 63304
    42960AControl throat bleeding2.32NA2.030.20NA4.55010
    42961AControl throat bleeding5.56NA4.900.48NA10.94090
    42962AControl throat bleeding7.10NA5.800.61NA13.51090
    42970AControl nose/throat bleeding5.40NA3.660.44NA9.50090
    42971AControl nose/throat bleeding6.17NA5.030.54NA11.74090
    42972AControl nose/throat bleeding7.16NA5.530.65NA13.34090
    42999CThroat surgery procedure0.000.000.000.000.000.00YYY
    43020AIncision of esophagus8.04NA5.680.84NA14.56090
    43030AThroat muscle surgery7.65NA5.850.72NA14.22090
    43045AIncision of esophagus20.01NA10.482.58NA33.07090
    43100AExcision of esophagus lesion9.14NA6.270.95NA16.36090
    43101AExcision of esophagus lesion16.15NA7.792.17NA26.11090
    43107ARemoval of esophagus39.77NA16.943.94NA60.65090
    43108ARemoval of esophagus34.00NA14.234.53NA52.76090
    43112ARemoval of esophagus43.25NA17.984.40NA65.63090
    43113ARemoval of esophagus35.07NA15.065.19NA55.32090
    43116APartial removal of esophagus31.04NA16.903.14NA51.08090
    43117APartial removal of esophagus39.77NA16.174.21NA60.15090
    43118APartial removal of esophagus33.01NA13.764.27NA51.04090
    43121APartial removal of esophagus29.02NA12.514.12NA45.65090
    43122APartial removal of esophagus39.77NA16.383.92NA60.07090
    43123APartial removal of esophagus33.01NA13.984.75NA51.74090
    43124ARemoval of esophagus27.16NA13.023.54NA43.72090
    43130ARemoval of esophagus pouch11.68NA7.611.27NA20.56090
    43135ARemoval of esophagus pouch16.01NA7.962.22NA26.19090
    43200AEsophagus endoscopy1.584.051.100.135.762.81000
    43201AEsoph scope w/submucous inj2.084.751.280.146.973.50000
    43202AEsophagus endoscopy, biopsy1.885.470.970.147.492.99000
    43204AEsoph scope w/sclerosis inj3.75NA1.560.22NA5.53000
    43205AEsophagus endoscopy/ligation3.77NA1.570.20NA5.54000
    43215AEsophagus endoscopy2.59NA1.240.20NA4.03000
    43216AEsophagus endoscopy/lesion2.39NA1.200.18NA3.77000
    43217AEsophagus endoscopy2.886.891.230.209.974.31000
    43219AEsophagus endoscopy2.78NA1.380.19NA4.35000
    43220AEsoph endoscopy, dilation2.09NA0.990.14NA3.22000
    43226AEsoph endoscopy, dilation2.33NA1.060.14NA3.53000
    43227AEsoph endoscopy, repair3.58NA1.490.22NA5.29000
    43228AEsoph endoscopy, ablation3.75NA1.590.30NA5.64000
    43231AEsoph endoscopy w/us exam3.17NA1.340.24NA4.75000
    43232AEsoph endoscopy w/us fn bx4.45NA1.860.31NA6.62000
    43234AUpper GI endoscopy, exam2.005.300.900.167.463.06000
    43235AUppr gi endoscopy, diagnosis2.385.121.080.167.663.62000
    43236AUppr gi scope w/submuc inj2.906.421.270.179.494.34000
    43237AEndoscopic us exam, esoph3.97NA1.630.26NA5.86000
    43238AUppr gi endoscopy w/us fn bx5.00NA1.990.26NA7.25000
    43239AUpper GI endoscopy, biopsy2.855.671.250.178.694.27000
    43240AEsoph endoscope w/drain cyst6.82NA2.690.43NA9.94000
    43241AUpper GI endoscopy with tube2.58NA1.150.17NA3.90000
    43242AUppr gi endoscopy w/us fn bx7.27NA2.820.35NA10.44000
    43243AUpper gi endoscopy & inject4.54NA1.860.25NA6.65000
    43244AUpper GI endoscopy/ligation5.02NA2.030.25NA7.30000
    43245AUppr gi scope dilate strictr3.16NA1.360.22NA4.74000
    43246APlace gastrostomy tube4.31NA1.760.29NA6.36000
    43247AOperative upper GI endoscopy3.37NA1.440.20NA5.01000
    43248AUppr gi endoscopy/guide wire3.13NA1.370.18NA4.68000
    43249AEsoph endoscopy, dilation2.88NA1.270.18NA4.33000
    43250AUpper GI endoscopy/tumor3.18NA1.370.20NA4.75000
    43251AOperative upper GI endoscopy3.68NA1.550.23NA5.46000
    43255AOperative upper GI endoscopy4.79NA1.940.24NA6.97000
    43256AUppr gi endoscopy w stent4.33NA1.780.28NA6.39000
    43258AOperative upper GI endoscopy4.52NA1.860.26NA6.64000
    43259AEndoscopic ultrasound exam5.17NA2.060.26NA7.49000
    43260AEndo cholangiopancreatograph5.93NA2.330.32NA8.58000
    43261AEndo cholangiopancreatograph6.23NA2.440.35NA9.02000
    43262AEndo cholangiopancreatograph7.35NA2.840.41NA10.60000
    43263AEndo cholangiopancreatograph7.25NA2.820.34NA10.41000
    43264AEndo cholangiopancreatograph8.85NA3.370.49NA12.71000
    43265AEndo cholangiopancreatograph9.96NA3.760.50NA14.22000
    43267AEndo cholangiopancreatograph7.35NA2.840.41NA10.60000
    43268AEndo cholangiopancreatograph7.35NA2.940.41NA10.70000
    43269AEndo cholangiopancreatograph8.16NA3.130.34NA11.63000
    43271AEndo cholangiopancreatograph7.35NA2.830.41NA10.59000
    43272AEndo cholangiopancreatograph7.35NA2.840.41NA10.60000
    43280ALaparoscopy, fundoplasty17.15NA7.402.11NA26.66090
    43289CLaparoscope proc, esoph0.000.000.000.000.000.00YYY
    Start Printed Page 63305
    43300ARepair of esophagus9.09NA6.531.02NA16.64090
    43305ARepair esophagus and fistula17.29NA10.841.63NA29.76090
    43310ARepair of esophagus25.25NA10.953.81NA40.01090
    43312ARepair esophagus and fistula28.26NA11.794.05NA44.10090
    43313AEsophagoplasty congenital45.02NA20.356.51NA71.88090
    43314ATracheo-esophagoplasty cong49.98NA22.276.63NA78.88090
    43320AFuse esophagus & stomach19.82NA9.211.91NA30.94090
    43324ARevise esophagus & stomach20.45NA8.882.06NA31.39090
    43325ARevise esophagus & stomach19.95NA8.871.98NA30.80090
    43326ARevise esophagus & stomach19.63NA9.222.21NA31.06090
    43330ARepair of esophagus19.66NA8.641.82NA30.12090
    43331ARepair of esophagus20.02NA9.662.31NA31.99090
    43340AFuse esophagus & intestine19.50NA8.991.83NA30.32090
    43341AFuse esophagus & intestine20.73NA9.912.57NA33.21090
    43350ASurgical opening, esophagus15.69NA8.471.38NA25.54090
    43351ASurgical opening, esophagus18.25NA9.651.81NA29.71090
    43352ASurgical opening, esophagus15.17NA8.371.53NA25.07090
    43360AGastrointestinal repair35.50NA15.023.60NA54.12090
    43361AGastrointestinal repair40.27NA16.864.22NA61.35090
    43400ALigate esophagus veins21.08NA9.541.19NA31.81090
    43401AEsophagus surgery for veins21.96NA9.632.07NA33.66090
    43405ALigate/staple esophagus19.90NA9.561.95NA31.41090
    43410ARepair esophagus wound13.39NA7.581.38NA22.35090
    43415ARepair esophagus wound24.86NA11.652.30NA38.81090
    43420ARepair esophagus opening14.27NA7.511.03NA22.81090
    43425ARepair esophagus opening20.91NA9.842.43NA33.18090
    43450ADilate esophagus1.372.540.740.083.992.19000
    43453ADilate esophagus1.506.040.780.107.642.38000
    43456ADilate esophagus2.5613.881.160.1716.613.89000
    43458ADilate esophagus3.046.641.350.209.884.59000
    43460APressure treatment esophagus3.78NA1.500.25NA5.53000
    43496CFree jejunum flap, microvasc0.000.000.000.000.000.00090
    43499CEsophagus surgery procedure0.000.000.000.000.000.00YYY
    43500ASurgical opening of stomach10.99NA5.051.01NA17.05090
    43501ASurgical repair of stomach19.93NA8.431.86NA30.22090
    43502ASurgical repair of stomach23.00NA9.592.19NA34.78090
    43510ASurgical opening of stomach13.01NA6.631.08NA20.72090
    43520AIncision of pyloric muscle9.93NA5.221.01NA16.16090
    43600ABiopsy of stomach1.90NA1.040.13NA3.07000
    43605ABiopsy of stomach11.91NA5.371.11NA18.39090
    43610AExcision of stomach lesion14.52NA6.251.37NA22.14090
    43611AExcision of stomach lesion17.74NA7.691.65NA27.08090
    43620ARemoval of stomach29.87NA11.962.74NA44.57090
    43621ARemoval of stomach30.55NA12.172.83NA45.55090
    43622ARemoval of stomach32.34NA12.762.97NA48.07090
    43631ARemoval of stomach, partial22.46NA9.292.39NA34.14090
    43632ARemoval of stomach, partial22.46NA9.302.40NA34.16090
    43633ARemoval of stomach, partial22.97NA9.472.46NA34.90090
    43634ARemoval of stomach, partial24.98NA10.222.61NA37.81090
    43635ARemoval of stomach, partial2.05NA0.710.25NA3.01ZZZ
    43638ARemoval of stomach, partial28.83NA12.022.68NA43.53090
    43639ARemoval of stomach, partial29.48NA11.822.77NA44.07090
    43640AVagotomy & pylorus repair16.92NA7.371.81NA26.10090
    43641AVagotomy & pylorus repair17.17NA7.481.83NA26.48090
    43651ALaparoscopy, vagus nerve10.09NA4.811.23NA16.13090
    43652ALaparoscopy, vagus nerve12.08NA5.461.50NA19.04090
    43653ALaparoscopy, gastrostomy7.69NA4.270.93NA12.89090
    43659CLaparoscope proc, stom0.000.000.000.000.000.00YYY
    43750APlace gastrostomy tube4.46NA2.750.40NA7.61010
    43752ANasal/orogastric w/stent0.680.260.260.020.960.96000
    43760AChange gastrostomy tube1.091.670.460.082.841.63000
    43761AReposition gastrostomy tube2.00NA0.790.12NA2.91000
    43800AReconstruction of pylorus13.61NA5.981.28NA20.87090
    43810AFusion of stomach and bowel14.57NA6.281.32NA22.17090
    43820AFusion of stomach and bowel15.28NA6.521.41NA23.21090
    43825AFusion of stomach and bowel19.11NA8.141.80NA29.05090
    43830APlace gastrostomy tube9.48NA4.930.83NA15.24090
    43831APlace gastrostomy tube7.80NA4.570.97NA13.34090
    43832APlace gastrostomy tube15.51NA6.971.35NA23.83090
    43840ARepair of stomach lesion15.47NA6.881.44NA23.79090
    43842AGastroplasty for obesity18.36NA8.221.81NA28.39090
    43843AGastroplasty for obesity18.54NA8.211.83NA28.58090
    43846AGastric bypass for obesity23.91NA10.492.35NA36.75090
    43847AGastric bypass for obesity26.77NA11.432.57NA40.77090
    43848ARevision gastroplasty29.22NA12.362.86NA44.44090
    Start Printed Page 63306
    43850ARevise stomach-bowel fusion24.58NA9.972.36NA36.91090
    43855ARevise stomach-bowel fusion26.01NA10.482.41NA38.90090
    43860ARevise stomach-bowel fusion24.86NA10.122.43NA37.41090
    43865ARevise stomach-bowel fusion26.37NA10.652.58NA39.60090
    43870ARepair stomach opening9.63NA4.590.85NA15.07090
    43880ARepair stomach-bowel fistula24.51NA10.062.33NA36.90090
    43999CStomach surgery procedure0.000.000.000.000.000.00YYY
    44005AFreeing of bowel adhesion16.14NA6.841.67NA24.65090
    44010AIncision of small bowel12.45NA5.551.26NA19.26090
    44015AInsert needle cath bowel2.61NA0.890.30NA3.80ZZZ
    44020AExplore small intestine13.91NA6.041.44NA21.39090
    44021ADecompress small bowel14.00NA6.071.41NA21.48090
    44025AIncision of large bowel14.20NA6.131.45NA21.78090
    44050AReduce bowel obstruction13.95NA6.061.38NA21.39090
    44055ACorrect malrotation of bowel21.87NA8.871.58NA32.32090
    44100ABiopsy of bowel2.00NA1.100.14NA3.24000
    44110AExcise intestine lesion(s)11.74NA5.341.20NA18.28090
    44111AExcision of bowel lesion(s)14.21NA6.241.46NA21.91090
    44120ARemoval of small intestine16.90NA7.201.75NA25.85090
    44121ARemoval of small intestine4.42NA1.540.55NA6.51ZZZ
    44125ARemoval of small intestine17.44NA7.381.79NA26.61090
    44126AEnterectomy w/o taper, cong35.30NA14.310.43NA50.04090
    44127AEnterectomy w/taper, cong40.77NA15.950.49NA57.21090
    44128AEnterectomy cong, add-on4.42NA1.560.54NA6.52ZZZ
    44130ABowel to bowel fusion14.41NA6.331.47NA22.21090
    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 colon2.22NA0.770.25NA3.24ZZZ
    44140APartial removal of colon20.88NA8.782.57NA32.23090
    44141APartial removal of colon19.40NA10.272.34NA32.01090
    44143APartial removal of colon22.86NA10.912.42NA36.19090
    44144APartial removal of colon21.41NA9.792.27NA33.47090
    44145APartial removal of colon26.27NA10.982.66NA39.91090
    44146APartial removal of colon27.38NA13.132.64NA43.15090
    44147APartial removal of colon20.59NA8.822.09NA31.50090
    44150ARemoval of colon23.81NA12.282.46NA38.55090
    44151ARemoval of colon/ileostomy26.73NA13.682.36NA42.77090
    44152ARemoval of colon/ileostomy27.67NA11.812.83NA42.31090
    44153ARemoval of colon/ileostomy30.42NA14.722.79NA47.93090
    44155ARemoval of colon/ileostomy27.70NA13.582.71NA43.99090
    44156ARemoval of colon/ileostomy30.61NA15.302.62NA48.53090
    44160ARemoval of colon18.51NA7.872.23NA28.61090
    44200ALaparoscopy, enterolysis14.36NA6.291.75NA22.40090
    44201ALaparoscopy, jejunostomy9.72NA4.731.16NA15.61090
    44202ALap resect s/intestine singl21.91NA9.072.59NA33.57090
    44203ALap resect s/intestine, addl4.42NA1.520.55NA6.49ZZZ
    44204ALaparo partial colectomy24.94NA10.093.06NA38.09090
    44205ALap colectomy part w/ileum22.10NA8.972.67NA33.74090
    44206ALap part colectomy w/stoma26.85NA11.482.42NA40.75090
    44207AL colectomy/coloproctostomy29.83NA11.722.66NA44.21090
    44208AL colectomy/coloproctostomy31.82NA13.422.64NA47.88090
    44210ALaparo total proctocolectomy27.84NA12.162.46NA42.46090
    44211ALaparo total proctocolectomy34.80NA14.902.79NA52.49090
    44212ALaparo total proctocolectomy32.31NA14.042.71NA49.06090
    44238CLaparoscope proc, intestine0.000.000.000.000.000.00YYY
    44239CLaparoscope proc, rectum0.000.000.000.000.000.00YYY
    44300AOpen bowel to skin12.04NA5.581.05NA18.67090
    44310AIleostomy/jejunostomy15.86NA6.801.35NA24.01090
    44312ARevision of ileostomy7.97NA4.070.65NA12.69090
    44314ARevision of ileostomy14.96NA6.671.19NA22.82090
    44316ADevise bowel pouch20.97NA8.681.69NA31.34090
    44320AColostomy17.54NA7.791.53NA26.86090
    44322AColostomy with biopsies11.91NA8.821.41NA22.14090
    44340ARevision of colostomy7.68NA4.360.67NA12.71090
    44345ARevision of colostomy15.34NA7.011.33NA23.68090
    44346ARevision of colostomy16.89NA7.511.44NA25.84090
    44360ASmall bowel endoscopy2.58NA1.130.17NA3.88000
    44361ASmall bowel endoscopy/biopsy2.85NA1.230.18NA4.26000
    44363ASmall bowel endoscopy3.48NA1.420.23NA5.13000
    44364ASmall bowel endoscopy3.72NA1.540.25NA5.51000
    44365ASmall bowel endoscopy3.29NA1.400.22NA4.91000
    44366ASmall bowel endoscopy4.38NA1.780.26NA6.42000
    44369ASmall bowel endoscopy4.49NA1.780.28NA6.55000
    Start Printed Page 63307
    44370ASmall bowel endoscopy/stent4.77NA2.010.25NA7.03000
    44372ASmall bowel endoscopy4.38NA1.770.32NA6.47000
    44373ASmall bowel endoscopy3.48NA1.460.23NA5.17000
    44376ASmall bowel endoscopy5.23NA2.060.35NA7.64000
    44377ASmall bowel endoscopy/biopsy5.50NA2.180.34NA8.02000
    44378ASmall bowel endoscopy7.09NA2.750.44NA10.28000
    44379AS bowel endoscope w/stent7.43NA2.970.46NA10.86000
    44380ASmall bowel endoscopy1.04NA0.580.10NA1.72000
    44382ASmall bowel endoscopy1.26NA0.650.11NA2.02000
    44383AIleoscopy w/stent2.92NA1.300.16NA4.38000
    44385AEndoscopy of bowel pouch1.815.030.970.146.982.92000
    44386AEndoscopy, bowel pouch/biop2.116.601.130.188.893.42000
    44388AColonoscopy2.805.221.180.228.244.20000
    44389AColonoscopy with biopsy3.116.591.300.229.924.63000
    44390AColonoscopy for foreign body3.816.841.530.2610.915.60000
    44391AColonoscopy for bleeding4.308.841.740.2813.426.32000
    44392AColonoscopy & polypectomy3.806.641.530.2810.725.61000
    44393AColonoscopy, lesion removal4.817.011.910.3212.147.04000
    44394AColonoscopy w/snare4.407.871.770.3112.586.48000
    44397AColonoscopy w/stent4.68NA2.080.34NA7.10000
    44500AIntro, gastrointestinal tube0.49NA0.360.02NA0.87000
    44602ASuture, small intestine15.94NA6.491.28NA23.71090
    44603ASuture, small intestine18.55NA7.391.67NA27.61090
    44604ASuture, large intestine15.94NA6.561.70NA24.20090
    44605ARepair of bowel lesion19.42NA8.551.85NA29.82090
    44615AIntestinal stricturoplasty15.84NA6.791.67NA24.30090
    44620ARepair bowel opening12.13NA5.421.26NA18.81090
    44625ARepair bowel opening14.96NA6.411.56NA22.93090
    44626ARepair bowel opening25.22NA9.963.03NA38.21090
    44640ARepair bowel-skin fistula21.53NA8.711.75NA31.99090
    44650ARepair bowel fistula22.44NA9.011.79NA33.24090
    44660ARepair bowel-bladder fistula21.24NA8.481.37NA31.09090
    44661ARepair bowel-bladder fistula24.67NA9.691.83NA36.19090
    44680ASurgical revision, intestine15.31NA6.561.64NA23.51090
    44700ASuspend bowel w/prosthesis16.02NA6.771.45NA24.24090
    44701AIntraop colon lavage add-on3.08NA1.070.25NA4.40ZZZ
    44799CUnlisted procedure intestine0.000.000.000.000.000.00YYY
    44800AExcision of bowel pouch11.17NA5.491.33NA17.99090
    44820AExcision of mesentery lesion12.02NA5.581.23NA18.83090
    44850ARepair of mesentery10.68NA5.071.19NA16.94090
    44899CBowel surgery procedure0.000.000.000.000.000.00YYY
    44900ADrain app abscess, open10.08NA4.781.01NA15.87090
    44901ADrain app abscess, percut3.36NA1.130.20NA4.69000
    44950AAppendectomy9.94NA4.401.05NA15.39090
    44955AAppendectomy add-on1.52NA0.550.19NA2.26ZZZ
    44960AAppendectomy12.27NA5.441.31NA19.02090
    44970ALaparoscopy, appendectomy8.65NA4.291.05NA13.99090
    44979CLaparoscope proc, app0.000.000.000.000.000.00YYY
    45000ADrainage of pelvic abscess4.49NA3.020.44NA7.95090
    45005ADrainage of rectal abscess1.984.901.720.227.103.92010
    45020ADrainage of rectal abscess4.69NA3.340.49NA8.52090
    45100ABiopsy of rectum3.66NA2.410.40NA6.47090
    45108ARemoval of anorectal lesion4.73NA2.940.55NA8.22090
    45110ARemoval of rectum27.84NA12.632.71NA43.18090
    45111APartial removal of rectum16.39NA7.301.92NA25.61090
    45112ARemoval of rectum30.37NA11.952.82NA45.14090
    45113APartial proctectomy30.41NA12.842.55NA45.80090
    45114APartial removal of rectum27.16NA11.122.73NA41.01090
    45116APartial removal of rectum24.44NA10.202.40NA37.04090
    45119ARemove rectum w/reservoir30.66NA12.682.55NA45.89090
    45120ARemoval of rectum24.46NA10.302.73NA37.49090
    45121ARemoval of rectum and colon26.89NA11.283.19NA41.36090
    45123APartial proctectomy16.61NA6.991.25NA24.85090
    45126APelvic exenteration44.90NA19.713.87NA68.48090
    45130AExcision of rectal prolapse16.35NA6.871.34NA24.56090
    45135AExcision of rectal prolapse19.17NA8.561.82NA29.55090
    45136AExcise ileoanal reservior27.14NA12.663.26NA43.06090
    45150AExcision of rectal stricture5.64NA3.020.55NA9.21090
    45160AExcision of rectal lesion15.23NA6.751.28NA23.26090
    45170AExcision of rectal lesion11.42NA5.331.07NA17.82090
    45190ADestruction, rectal tumor9.68NA4.730.91NA15.32090
    45300AProctosigmoidoscopy dx0.381.500.310.061.940.75000
    45303AProctosigmoidoscopy dilate0.4419.470.360.0719.980.87000
    45305AProctosigmoidoscopy w/bx1.002.620.530.113.731.64000
    45307AProctosigmoidoscopy fb0.933.060.510.184.171.62000
    Start Printed Page 63308
    45308AProctosigmoidoscopy removal0.831.960.470.162.951.46000
    45309AProctosigmoidoscopy removal2.002.820.860.205.023.06000
    45315AProctosigmoidoscopy removal1.392.850.660.244.482.29000
    45317AProctosigmoidoscopy bleed1.492.410.690.244.142.42000
    45320AProctosigmoidoscopy ablate1.572.880.730.244.692.54000
    45321AProctosigmoidoscopy volvul1.16NA0.600.20NA1.96000
    45327AProctosigmoidoscopy w/stent1.64NA0.710.12NA2.47000
    45330ADiagnostic sigmoidoscopy0.952.240.530.063.251.54000
    45331ASigmoidoscopy and biopsy1.142.980.640.084.201.86000
    45332ASigmoidoscopy w/fb removal1.784.960.850.136.872.76000
    45333ASigmoidoscopy & polypectomy1.784.800.850.146.722.77000
    45334ASigmoidoscopy for bleeding2.71NA1.200.19NA4.10000
    45335ASigmoidoscopy w/submuc inj1.353.450.650.084.882.08000
    45337ASigmoidoscopy & decompress2.35NA1.060.18NA3.59000
    45338ASigmoidoscopy w/tumr remove2.335.121.060.187.633.57000
    45339ASigmoidoscopy w/ablate tumr3.123.381.340.206.704.66000
    45340ASig w/balloon dilation1.656.740.760.088.472.49000
    45341ASigmoidoscopy w/ultrasound2.59NA1.140.24NA3.97000
    45342ASigmoidoscopy w/us guide bx4.04NA1.620.28NA5.94000
    45345ASigmoidoscopy w/stent2.90NA1.220.18NA4.30000
    45355ASurgical colonoscopy3.50NA1.420.31NA5.23000
    45378ADiagnostic colonoscopy3.686.131.600.2410.055.52000
    4537853ADiagnostic colonoscopy0.952.240.530.063.251.54000
    45379AColonoscopy w/fb removal4.667.701.880.3012.666.84000
    45380AColonoscopy and biopsy4.417.171.800.2511.836.46000
    45381AColonoscopy, submucous inj4.188.261.710.2512.696.14000
    45382AColonoscopy/control bleeding5.669.862.250.3215.848.23000
    45383ALesion removal colonoscopy5.847.962.290.3814.188.51000
    45384ALesion remove colonoscopy4.676.791.900.2911.756.86000
    45385ALesion removal colonoscopy5.287.812.100.3413.437.72000
    45386AColonoscopy dilate stricture4.5513.861.850.2518.666.65000
    45387AColonoscopy w/stent5.88NA2.380.40NA8.66000
    45500ARepair of rectum7.25NA3.640.67NA11.56090
    45505ARepair of rectum7.54NA3.910.60NA12.05090
    45520ATreatment of rectal prolapse0.550.860.190.051.460.79000
    45540ACorrect rectal prolapse16.18NA6.941.40NA24.52090
    45541ACorrect rectal prolapse13.32NA6.061.05NA20.43090
    45550ARepair rectum/remove sigmoid22.87NA9.391.89NA34.15090
    45560ARepair of rectocele10.52NA5.190.87NA16.58090
    45562AExploration/repair of rectum15.29NA7.131.38NA23.80090
    45563AExploration/repair of rectum23.34NA10.732.21NA36.28090
    45800ARepair rect/bladder fistula17.67NA7.591.37NA26.63090
    45805ARepair fistula w/colostomy20.66NA9.711.76NA32.13090
    45820ARepair rectourethral fistula18.37NA7.771.40NA27.54090
    45825ARepair fistula w/colostomy21.13NA10.021.16NA32.31090
    45900AReduction of rectal prolapse2.60NA1.540.20NA4.34010
    45905ADilation of anal sphincter2.29NA1.450.17NA3.91010
    45910ADilation of rectal narrowing2.78NA1.680.17NA4.63010
    45915ARemove rectal obstruction3.124.801.190.208.124.51010
    45999CRectum surgery procedure0.000.000.000.000.000.00YYY
    46020APlacement of seton2.882.301.880.265.445.02010
    46030ARemoval of rectal marker1.221.370.720.132.722.07010
    46040AIncision of rectal abscess4.935.363.210.5810.878.72090
    46045AIncision of rectal abscess4.30NA2.960.48NA7.74090
    46050AIncision of anal abscess1.182.600.870.133.912.18010
    46060AIncision of rectal abscess5.66NA3.330.62NA9.61090
    46070AIncision of anal septum2.69NA1.910.32NA4.92090
    46080AIncision of anal sphincter2.482.411.140.285.173.90010
    46083AIncise external hemorrhoid1.392.540.960.144.072.49010
    46200ARemoval of anal fissure3.403.692.450.367.456.21090
    46210ARemoval of anal crypt2.654.882.170.317.845.13090
    46211ARemoval of anal crypts4.235.162.980.449.837.65090
    46220ARemoval of anal tag1.552.300.940.174.022.66010
    46221ALigation of hemorrhoid(s)2.031.641.140.143.813.31010
    46230ARemoval of anal tags2.563.081.300.265.904.12010
    46250AHemorrhoidectomy3.874.932.480.529.326.87090
    46255AHemorrhoidectomy4.575.482.710.6110.667.89090
    46257ARemove hemorrhoids & fissure5.37NA2.950.71NA9.03090
    46258ARemove hemorrhoids & fistula5.70NA3.340.77NA9.81090
    46260AHemorrhoidectomy6.33NA3.280.82NA10.43090
    46261ARemove hemorrhoids & fissure7.04NA3.690.84NA11.57090
    46262ARemove hemorrhoids & fistula7.46NA3.830.91NA12.20090
    46270ARemoval of anal fistula3.704.722.400.438.856.53090
    46275ARemoval of anal fistula4.534.422.600.489.437.61090
    46280ARemoval of anal fistula5.95NA3.340.60NA9.89090
    Start Printed Page 63309
    46285ARemoval of anal fistula4.073.642.380.418.126.86090
    46288ARepair anal fistula7.09NA3.780.72NA11.59090
    46320ARemoval of hemorrhoid clot1.602.150.860.173.922.63010
    46500AInjection into hemorrhoid(s)1.602.820.630.144.562.37010
    46600ADiagnostic anoscopy0.501.610.390.052.160.94000
    46604AAnoscopy and dilation1.309.490.640.1110.902.05000
    46606AAnoscopy and biopsy0.813.900.460.084.791.35000
    46608AAnoscopy, remove for body1.504.510.690.166.172.35000
    46610AAnoscopy, remove lesion1.314.140.640.145.592.09000
    46611AAnoscopy1.803.400.800.185.382.78000
    46612AAnoscopy, remove lesions2.335.261.010.227.813.56000
    46614AAnoscopy, control bleeding2.002.300.870.174.473.04000
    46615AAnoscopy2.662.551.100.285.494.04000
    46700ARepair of anal stricture9.08NA4.290.67NA14.04090
    46705ARepair of anal stricture6.86NA3.790.87NA11.52090
    46706ARepr of anal fistula w/glue2.38NA1.260.20NA3.84010
    46715ARepair of anovaginal fistula7.16NA3.680.91NA11.75090
    46716ARepair of anovaginal fistula14.98NA8.071.56NA24.61090
    46730AConstruction of absent anus26.60NA12.212.43NA41.24090
    46735AConstruction of absent anus31.99NA13.723.16NA48.87090
    46740AConstruction of absent anus29.83NA13.362.39NA45.58090
    46742ARepair of imperforated anus35.60NA17.983.15NA56.73090
    46744ARepair of cloacal anomaly52.33NA21.442.72NA76.49090
    46746ARepair of cloacal anomaly57.89NA25.483.01NA86.38090
    46748ARepair of cloacal anomaly63.84NA24.123.32NA91.28090
    46750ARepair of anal sphincter10.19NA5.180.83NA16.20090
    46751ARepair of anal sphincter8.72NA5.700.93NA15.35090
    46753AReconstruction of anus8.24NA3.920.70NA12.86090
    46754ARemoval of suture from anus2.193.681.710.146.014.04010
    46760ARepair of anal sphincter14.35NA7.191.03NA22.57090
    46761ARepair of anal sphincter13.76NA6.161.01NA20.93090
    46762AImplant artificial sphincter12.64NA5.620.85NA19.11090
    46900ADestruction, anal lesion(s)1.903.570.800.165.632.86010
    46910ADestruction, anal lesion(s)1.852.721.110.174.743.13010
    46916ACryosurgery, anal lesion(s)1.853.101.420.115.063.38010
    46917ALaser surgery, anal lesions1.859.331.140.1911.373.18010
    46922AExcision of anal lesion(s)1.853.361.100.205.413.15010
    46924ADestruction, anal lesion(s)2.748.541.380.2411.524.36010
    46934ADestruction of hemorrhoids3.495.092.740.318.896.54090
    46935ADestruction of hemorrhoids2.423.501.230.206.123.85010
    46936ADestruction of hemorrhoids3.674.512.280.368.546.31090
    46937ACryotherapy of rectal lesion2.672.771.240.145.584.05010
    46938ACryotherapy of rectal lesion4.634.272.740.489.387.85090
    46940ATreatment of anal fissure2.312.011.100.204.523.61010
    46942ATreatment of anal fissure2.031.861.020.174.063.22010
    46945ALigation of hemorrhoids1.833.591.910.205.623.94090
    46946ALigation of hemorrhoids2.574.261.870.267.094.70090
    46999CAnus surgery procedure0.000.000.000.000.000.00YYY
    47000ANeedle biopsy of liver1.893.280.640.115.282.64000
    47001ANeedle biopsy, liver add-on1.89NA0.650.22NA2.76ZZZ
    47010AOpen drainage, liver lesion15.92NA8.620.78NA25.32090
    47011APercut drain, liver lesion3.68NA1.230.20NA5.11000
    47015AInject/aspirate liver cyst15.02NA7.621.03NA23.67090
    47100AWedge biopsy of liver11.60NA6.160.90NA18.66090
    47120APartial removal of liver35.30NA15.442.74NA53.48090
    47122AExtensive removal of liver54.82NA21.844.31NA80.97090
    47125APartial removal of liver48.91NA19.853.81NA72.57090
    47130APartial removal of liver53.05NA21.324.16NA78.53090
    47133XRemoval of donor liver0.000.000.000.000.000.00XXX
    47134DPartial removal, donor liver0.000.000.000.000.000.00XXX
    47135RTransplantation of liver81.06NA32.439.74NA123.23090
    47136RTransplantation of liver68.21NA27.788.31NA104.30090
    47140APartial removal, donor liver54.69NA22.984.77NA82.44090
    47141APartial removal, donor liver67.12NA27.704.77NA99.59090
    47142APartial removal, donor liver74.57NA30.294.77NA109.63090
    47300ASurgery for liver lesion14.99NA7.361.16NA23.51090
    47350ARepair liver wound19.45NA9.011.50NA29.96090
    47360ARepair liver wound26.77NA11.782.05NA40.60090
    47361ARepair liver wound46.85NA18.813.73NA69.39090
    47362ARepair liver wound18.40NA8.901.46NA28.76090
    47370ALaparo ablate liver tumor rf19.58NA8.281.02NA28.88090
    47371ALaparo ablate liver cryosurg19.58NA8.291.02NA28.89090
    47379CLaparoscope procedure, liver0.000.000.000.000.000.00YYY
    47380AOpen ablate liver tumor rf22.87NA9.501.02NA33.39090
    47381AOpen ablate liver tumor cryo23.14NA9.771.02NA33.93090
    Start Printed Page 63310
    47382APercut ablate liver rf15.10NA6.161.37NA22.63010
    47399CLiver surgery procedure0.000.000.000.000.000.00YYY
    47400AIncision of liver duct32.30NA13.692.18NA48.17090
    47420AIncision of bile duct19.77NA8.902.04NA30.71090
    47425AIncision of bile duct19.72NA8.951.92NA30.59090
    47460AIncise bile duct sphincter17.94NA8.501.49NA27.93090
    47480AIncision of gallbladder10.76NA6.031.02NA17.81090
    47490AIncision of gallbladder7.19NA5.870.40NA13.46090
    47500AInjection for liver x-rays1.95NA0.640.11NA2.70000
    47505AInjection for liver x-rays0.762.580.250.043.381.05000
    47510AInsert catheter, bile duct7.79NA5.050.43NA13.27090
    47511AInsert bile duct drain10.44NA5.130.56NA16.13090
    47525AChange bile duct catheter5.52NA3.280.29NA9.09010
    47530ARevise/reinsert bile tube5.82NA4.360.35NA10.53090
    47550ABile duct endoscopy add-on3.00NA1.040.36NA4.40ZZZ
    47552ABiliary endoscopy thru skin6.01NA2.420.50NA8.93000
    47553ABiliary endoscopy thru skin6.31NA2.620.36NA9.29000
    47554ABiliary endoscopy thru skin9.01NA3.410.89NA13.31000
    47555ABiliary endoscopy thru skin7.52NA3.040.42NA10.98000
    47556ABiliary endoscopy thru skin8.51NA3.350.46NA12.32000
    47560ALaparoscopy w/cholangio4.86NA1.840.59NA7.29000
    47561ALaparo w/cholangio/biopsy5.15NA2.150.59NA7.89000
    47562ALaparoscopic cholecystectomy11.03NA5.061.35NA17.44090
    47563ALaparo cholecystectomy/graph11.87NA5.371.45NA18.69090
    47564ALaparo cholecystectomy/explr14.15NA6.031.73NA21.91090
    47570ALaparo cholecystoenterostomy12.51NA5.451.53NA19.49090
    47579CLaparoscope proc, biliary0.000.000.000.000.000.00YYY
    47600ARemoval of gallbladder13.50NA6.251.39NA21.14090
    47605ARemoval of gallbladder14.61NA6.611.50NA22.72090
    47610ARemoval of gallbladder18.71NA8.071.93NA28.71090
    47612ARemoval of gallbladder18.67NA8.021.92NA28.61090
    47620ARemoval of gallbladder20.52NA8.662.12NA31.30090
    47630ARemove bile duct stone9.06NA4.840.55NA14.45090
    47700AExploration of bile ducts15.53NA7.551.68NA24.76090
    47701ABile duct revision27.65NA11.713.60NA42.96090
    47711AExcision of bile duct tumor22.90NA10.122.37NA35.39090
    47712AExcision of bile duct tumor30.07NA12.653.20NA45.92090
    47715AExcision of bile duct cyst18.69NA8.571.91NA29.17090
    47716AFusion of bile duct cyst16.35NA8.001.69NA26.04090
    47720AFuse gallbladder & bowel15.82NA7.611.64NA25.07090
    47721AFuse upper gi structures19.01NA8.721.95NA29.68090
    47740AFuse gallbladder & bowel18.37NA8.521.91NA28.80090
    47741AFuse gallbladder & bowel21.22NA9.452.18NA32.85090
    47760AFuse bile ducts and bowel25.70NA11.022.65NA39.37090
    47765AFuse liver ducts & bowel24.74NA11.022.61NA38.37090
    47780AFuse bile ducts and bowel26.35NA11.392.72NA40.46090
    47785AFuse bile ducts and bowel31.00NA13.163.22NA47.38090
    47800AReconstruction of bile ducts23.17NA10.232.34NA35.74090
    47801APlacement, bile duct support15.08NA8.380.83NA24.29090
    47802AFuse liver duct & intestine21.43NA9.862.21NA33.50090
    47900ASuture bile duct injury19.79NA9.021.98NA30.79090
    47999CBile tract surgery procedure0.000.000.000.000.000.00YYY
    48000ADrainage of abdomen27.91NA11.681.58NA41.17090
    48001APlacement of drain, pancreas35.25NA14.092.28NA51.62090
    48005AResect/debride pancreas41.93NA16.802.71NA61.44090
    48020ARemoval of pancreatic stone15.61NA7.431.63NA24.67090
    48100ABiopsy of pancreas, open12.16NA5.711.29NA19.16090
    48102ANeedle biopsy, pancreas4.659.112.470.2414.007.36010
    48120ARemoval of pancreas lesion15.76NA6.981.62NA24.36090
    48140APartial removal of pancreas22.81NA9.692.54NA35.04090
    48145APartial removal of pancreas23.88NA10.012.70NA36.59090
    48146APancreatectomy26.25NA12.202.91NA41.36090
    48148ARemoval of pancreatic duct17.24NA7.761.93NA26.93090
    48150APartial removal of pancreas47.73NA19.865.31NA72.90090
    48152APancreatectomy43.50NA18.534.88NA66.91090
    48153APancreatectomy47.62NA19.965.27NA72.85090
    48154APancreatectomy43.85NA18.594.91NA67.35090
    48155ARemoval of pancreas24.50NA11.962.76NA39.22090
    48160NPancreas removal/transplant0.000.000.000.000.000.00XXX
    48180AFuse pancreas and bowel24.58NA10.322.68NA37.58090
    48400AInjection, intraop add-on1.94NA0.650.12NA2.71ZZZ
    48500ASurgery of pancreatic cyst15.19NA7.481.62NA24.29090
    48510ADrain pancreatic pseudocyst14.23NA7.601.28NA23.11090
    48511ADrain pancreatic pseudocyst3.98NA1.330.20NA5.51000
    48520AFuse pancreas cyst and bowel15.50NA6.821.69NA24.01090
    Start Printed Page 63311
    48540AFuse pancreas cyst and bowel19.61NA8.252.18NA30.04090
    48545APancreatorrhaphy18.08NA8.111.93NA28.12090
    48547ADuodenal exclusion25.68NA10.652.76NA39.09090
    48550XDonor pancreatectomy0.000.000.000.000.000.00XXX
    48554RTranspl allograft pancreas33.98NA17.513.96NA55.45090
    48556ARemoval, allograft pancreas15.62NA8.381.82NA25.82090
    48999CPancreas surgery procedure0.000.000.000.000.000.00YYY
    49000AExploration of abdomen11.61NA5.481.40NA18.49090
    49002AReopening of abdomen10.43NA5.131.27NA16.83090
    49010AExploration behind abdomen12.21NA5.991.46NA19.66090
    49020ADrain abdominal abscess22.71NA10.351.57NA34.63090
    49021ADrain abdominal abscess3.36NA1.120.19NA4.67000
    49040ADrain, open, abdom abscess13.44NA6.541.01NA20.99090
    49041ADrain, percut, abdom abscess3.98NA1.330.22NA5.53000
    49060ADrain, open, retrop abscess15.77NA7.550.92NA24.24090
    49061ADrain, percut, retroper absc3.68NA1.230.20NA5.11000
    49062ADrain to peritoneal cavity11.30NA5.541.29NA18.13090
    49080APuncture, peritoneal cavity1.344.140.460.085.561.88000
    49081ARemoval of abdominal fluid1.252.660.580.073.981.90000
    49085ARemove abdomen foreign body12.07NA5.611.05NA18.73090
    49180ABiopsy, abdominal mass1.723.340.580.105.162.40000
    49200ARemoval of abdominal lesion10.19NA5.161.10NA16.45090
    49201ARemove abdom lesion, complex14.76NA7.261.76NA23.78090
    49215AExcise sacral spine tumor33.31NA14.242.97NA50.52090
    49220AMultiple surgery, abdomen14.80NA6.761.81NA23.37090
    49250AExcision of umbilicus8.30NA4.401.01NA13.71090
    49255ARemoval of omentum11.08NA5.781.34NA18.20090
    49320ADiag laparo separate proc5.07NA2.690.60NA8.36010
    49321ALaparoscopy, biopsy5.37NA2.690.64NA8.70010
    49322ALaparoscopy, aspiration5.67NA3.030.68NA9.38010
    49323ALaparo drain lymphocele9.43NA4.571.05NA15.05090
    49329CLaparo proc, abdm/per/oment0.000.000.000.000.000.00YYY
    49400AAir injection into abdomen1.87NA0.790.13NA2.79000
    49419AInsrt abdom cath for chemotx6.61NA3.590.66NA10.86090
    49420AInsert abdom drain, temp2.21NA1.120.16NA3.49000
    49421AInsert abdom drain, perm5.51NA3.220.66NA9.39090
    49422ARemove perm cannula/catheter6.21NA2.940.76NA9.91010
    49423AExchange drainage catheter1.45NA0.670.08NA2.20000
    49424AAssess cyst, contrast inject0.76NA0.450.04NA1.25000
    49425AInsert abdomen-venous drain11.31NA5.661.45NA18.42090
    49426ARevise abdomen-venous shunt9.58NA4.861.11NA15.55090
    49427AInjection, abdominal shunt0.88NA0.490.06NA1.43000
    49428ALigation of shunt6.03NA3.310.37NA9.71010
    49429ARemoval of shunt7.36NA3.440.97NA11.77010
    49491ARpr hern preemie reduc11.07NA5.131.32NA17.52090
    49492ARpr ing hern premie, blocked13.95NA6.211.76NA21.92090
    49495ARpr ing hernia baby, reduc5.86NA3.020.70NA9.58090
    49496ARpr ing hernia baby, blocked8.74NA4.411.10NA14.25090
    49500ARpr ing hernia, init, reduce5.45NA3.190.55NA9.19090
    49501ARpr ing hernia, init blocked8.83NA4.280.91NA14.02090
    49505APrp i/hern init reduc>5 yr7.564.153.910.7812.4912.25090
    49507APrp i/hern init block>5 yr9.52NA4.580.99NA15.09090
    49520ARerepair ing hernia, reduce9.58NA4.531.01NA15.12090
    49521ARerepair ing hernia, blocked11.90NA5.341.25NA18.49090
    49525ARepair ing hernia, sliding8.52NA4.180.89NA13.59090
    49540ARepair lumbar hernia10.33NA4.841.08NA16.25090
    49550ARpr rem hernia, init, reduce8.58NA4.210.90NA13.69090
    49553ARpr fem hernia, init blocked9.39NA4.510.99NA14.89090
    49555ARerepair fem hernia, reduce8.98NA4.370.95NA14.30090
    49557ARerepair fem hernia, blocked11.09NA5.091.16NA17.34090
    49560ARpr ventral hern init, reduc11.50NA5.261.20NA17.96090
    49561ARpr ventral hern init, block14.17NA6.171.47NA21.81090
    49565ARerepair ventrl hern, reduce11.50NA5.331.20NA18.03090
    49566ARerepair ventrl hern, block14.32NA6.241.49NA22.05090
    49568AHernia repair w/mesh4.86NA1.700.60NA7.16ZZZ
    49570ARpr epigastric hern, reduce5.66NA3.220.60NA9.48090
    49572ARpr epigastric hern, blocked6.69NA3.540.70NA10.93090
    49580ARpr umbil hern, reduc < 5 yr4.09NA2.680.41NA7.18090
    49582ARpr umbil hern, block < 5 yr6.61NA3.570.68NA10.86090
    49585ARpr umbil hern, reduc > 5 yr6.19NA3.380.64NA10.21090
    49587ARpr umbil hern, block > 5 yr7.52NA3.820.78NA12.12090
    49590ARepair spigilian hernia8.49NA4.180.89NA13.56090
    49600ARepair umbilical lesion10.90NA5.421.35NA17.67090
    49605ARepair umbilical lesion75.57NA28.953.08NA107.60090
    49606ARepair umbilical lesion18.49NA7.822.66NA28.97090
    Start Printed Page 63312
    49610ARepair umbilical lesion10.44NA5.340.92NA16.70090
    49611ARepair umbilical lesion8.87NA6.560.78NA16.21090
    49650ALaparo hernia repair initial6.23NA3.260.77NA10.26090
    49651ALaparo hernia repair recur8.19NA4.131.01NA13.33090
    49659CLaparo proc, hernia repair0.000.000.000.000.000.00YYY
    49900ARepair of abdominal wall12.21NA6.341.47NA20.02090
    49904AOmental flap, extra-abdom19.89NA15.642.29NA37.82090
    49905AOmental flap, intra-abdom6.51NA2.310.73NA9.55ZZZ
    49906CFree omental flap, microvasc0.000.000.000.000.000.00090
    49999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    50010AExploration of kidney10.92NA5.480.95NA17.35090
    50020ARenal abscess, open drain14.58NA8.900.96NA24.44090
    50021ARenal abscess, percut drain3.36NA1.110.18NA4.65000
    50040ADrainage of kidney14.85NA8.510.98NA24.34090
    50045AExploration of kidney15.37NA6.881.27NA23.52090
    50060ARemoval of kidney stone19.19NA8.131.37NA28.69090
    50065AIncision of kidney20.67NA6.381.35NA28.40090
    50070AIncision of kidney20.20NA8.521.44NA30.16090
    50075ARemoval of kidney stone25.20NA10.301.81NA37.31090
    50080ARemoval of kidney stone14.63NA7.921.03NA23.58090
    50081ARemoval of kidney stone21.68NA10.461.56NA33.70090
    50100ARevise kidney blood vessels16.00NA8.011.97NA25.98090
    50120AExploration of kidney15.82NA7.061.25NA24.13090
    50125AExplore and drain kidney16.43NA7.211.28NA24.92090
    50130ARemoval of kidney stone17.19NA7.461.25NA25.90090
    50135AExploration of kidney19.07NA8.081.41NA28.56090
    50200ABiopsy of kidney2.62NA0.910.14NA3.67000
    50205ABiopsy of kidney11.25NA5.301.13NA17.68090
    50220ARemove kidney, open17.05NA7.521.39NA25.96090
    50225ARemoval kidney open, complex20.11NA8.451.51NA30.07090
    50230ARemoval kidney open, radical21.94NA8.931.62NA32.49090
    50234ARemoval of kidney & ureter22.27NA9.141.64NA33.05090
    50236ARemoval of kidney & ureter24.72NA11.521.80NA38.04090
    50240APartial removal of kidney21.87NA10.611.63NA34.11090
    50280ARemoval of kidney lesion15.58NA6.971.19NA23.74090
    50290ARemoval of kidney lesion14.65NA6.731.33NA22.71090
    50300XRemoval of donor kidney0.000.000.000.000.000.00XXX
    50320ARemoval of donor kidney22.08NA10.072.13NA34.28090
    50340ARemoval of kidney12.08NA7.001.38NA20.46090
    50360ATransplantation of kidney31.35NA15.953.56NA50.86090
    50365ATransplantation of kidney36.60NA18.884.21NA59.69090
    50370ARemove transplanted kidney13.64NA7.601.51NA22.75090
    50380AReimplantation of kidney20.64NA13.462.16NA36.26090
    50390ADrainage of kidney lesion1.95NA0.640.11NA2.70000
    50392AInsert kidney drain3.36NA1.110.18NA4.65000
    50393AInsert ureteral tube4.14NA1.370.22NA5.73000
    50394AInjection for kidney x-ray0.762.530.250.053.341.06000
    50395ACreate passage to kidney3.36NA1.110.19NA4.66000
    50396AMeasure kidney pressure2.08NA0.860.12NA3.06000
    50398AChange kidney tube1.451.210.480.082.742.01000
    50400ARevision of kidney/ureter19.39NA7.811.45NA28.65090
    50405ARevision of kidney/ureter23.79NA10.531.74NA36.06090
    50500ARepair of kidney wound19.46NA8.841.74NA30.04090
    50520AClose kidney-skin fistula17.13NA8.841.51NA27.48090
    50525ARepair renal-abdomen fistula22.14NA10.281.81NA34.23090
    50526ARepair renal-abdomen fistula23.88NA10.991.94NA36.81090
    50540ARevision of horseshoe kidney19.82NA8.591.53NA29.94090
    50541ALaparo ablate renal cyst15.91NA6.491.19NA23.59090
    50542ALaparo ablate renal mass19.89NA8.231.63NA29.75090
    50543ALaparo partial nephrectomy25.35NA10.391.63NA37.37090
    50544ALaparoscopy, pyeloplasty22.27NA8.561.69NA32.52090
    50545ALaparo radical nephrectomy23.86NA9.221.83NA34.91090
    50546ALaparoscopic nephrectomy20.36NA8.391.64NA30.39090
    50547ALaparo removal donor kidney25.35NA10.562.45NA38.36090
    50548ALaparo remove w/ ureter24.26NA9.201.79NA35.25090
    50549CLaparoscope proc, renal0.000.000.000.000.000.00YYY
    50551AKidney endoscopy5.574.991.810.4010.967.78000
    50553AKidney endoscopy5.9618.711.960.4225.098.34000
    50555AKidney endoscopy & biopsy6.4919.362.130.4626.319.08000
    50557AKidney endoscopy & treatment6.5820.152.140.4727.209.19000
    50559ARenal endoscopy/radiotracer6.74NA2.210.32NA9.27000
    50561AKidney endoscopy & treatment7.5517.842.460.5325.9210.54000
    50562ARenal scope w/tumor resect10.86NA3.881.01NA15.75090
    50570AKidney endoscopy9.49NA3.090.67NA13.25000
    50572AKidney endoscopy10.29NA3.350.77NA14.41000
    Start Printed Page 63313
    50574AKidney endoscopy & biopsy10.96NA3.580.78NA15.32000
    50575AKidney endoscopy13.90NA4.521.01NA19.43000
    50576AKidney endoscopy & treatment10.93NA3.540.79NA15.26000
    50578ARenal endoscopy/radiotracer11.29NA3.670.80NA15.76000
    50580AKidney endoscopy & treatment11.79NA3.830.84NA16.46000
    50590AFragmenting of kidney stone9.0410.925.110.6520.6114.80090
    50600AExploration of ureter15.75NA7.071.19NA24.01090
    50605AInsert ureteral support15.37NA7.091.35NA23.81090
    50610ARemoval of ureter stone15.83NA7.321.29NA24.44090
    50620ARemoval of ureter stone15.07NA6.691.09NA22.85090
    50630ARemoval of ureter stone14.85NA6.631.08NA22.56090
    50650ARemoval of ureter17.31NA7.591.28NA26.18090
    50660ARemoval of ureter19.44NA8.331.43NA29.20090
    50684AInjection for ureter x-ray0.7615.430.250.0516.241.06000
    50686AMeasure ureter pressure1.504.600.650.116.212.26000
    50688AChange of ureter tube1.16NA1.760.07NA2.99010
    50690AInjection for ureter x-ray1.1515.920.380.0717.141.60000
    50700ARevision of ureter15.12NA7.391.03NA23.54090
    50715ARelease of ureter18.79NA9.282.01NA30.08090
    50722ARelease of ureter16.26NA8.181.69NA26.13090
    50725ARelease/revise ureter18.38NA8.411.73NA28.52090
    50727ARevise ureter8.13NA5.290.61NA14.03090
    50728ARevise ureter11.95NA6.821.05NA19.82090
    50740AFusion of ureter & kidney18.32NA8.061.79NA28.17090
    50750AFusion of ureter & kidney19.40NA8.361.49NA29.25090
    50760AFusion of ureters18.32NA8.051.50NA27.87090
    50770ASplicing of ureters19.40NA8.351.50NA29.25090
    50780AReimplant ureter in bladder18.26NA7.961.44NA27.66090
    50782AReimplant ureter in bladder19.43NA9.731.35NA30.51090
    50783AReimplant ureter in bladder20.43NA9.481.62NA31.53090
    50785AReimplant ureter in bladder20.40NA8.681.56NA30.64090
    50800AImplant ureter in bowel14.44NA7.081.10NA22.62090
    50810AFusion of ureter & bowel19.94NA9.702.13NA31.77090
    50815AUrine shunt to intestine19.82NA9.071.57NA30.46090
    50820AConstruct bowel bladder21.77NA9.251.65NA32.67090
    50825AConstruct bowel bladder28.02NA11.812.17NA42.00090
    50830ARevise urine flow31.10NA12.812.64NA46.55090
    50840AReplace ureter by bowel19.89NA9.031.51NA30.43090
    50845AAppendico-vesicostomy20.77NA8.991.51NA31.27090
    50860ATransplant ureter to skin15.27NA6.981.21NA23.46090
    50900ARepair of ureter13.54NA6.441.17NA21.15090
    50920AClosure ureter/skin fistula14.25NA6.871.01NA22.13090
    50930AClosure ureter/bowel fistula18.61NA8.301.88NA28.79090
    50940ARelease of ureter14.43NA6.721.25NA22.40090
    50945ALaparoscopy ureterolithotomy16.90NA7.041.38NA25.32090
    50947ALaparo new ureter/bladder24.36NA9.762.39NA36.51090
    50948ALaparo new ureter/bladder22.37NA8.722.19NA33.28090
    50949CLaparoscope proc, ureter0.000.000.000.000.000.00YYY
    50951AEndoscopy of ureter5.815.411.890.4211.648.12000
    50953AEndoscopy of ureter6.2018.722.020.4425.368.66000
    50955AUreter endoscopy & biopsy6.7119.642.220.4626.819.39000
    50957AUreter endoscopy & treatment6.7518.382.200.4825.619.43000
    50959AUreter endoscopy & tracer4.37NA1.390.22NA5.98000
    50961AUreter endoscopy & treatment6.0225.581.950.4232.028.39000
    50970AUreter endoscopy7.10NA2.320.52NA9.94000
    50972AUreter endoscopy & catheter6.85NA2.280.47NA9.60000
    50974AUreter endoscopy & biopsy9.12NA2.960.64NA12.72000
    50976AUreter endoscopy & treatment8.99NA2.940.64NA12.57000
    50978AUreter endoscopy & tracer5.07NA1.690.36NA7.12000
    50980AUreter endoscopy & treatment6.81NA2.220.49NA9.52000
    51000ADrainage of bladder0.782.010.240.062.851.08000
    51005ADrainage of bladder1.014.880.340.105.991.45000
    51010ADrainage of bladder3.515.801.930.289.595.72010
    51020AIncise & treat bladder6.67NA4.040.50NA11.21090
    51030AIncise & treat bladder6.73NA4.140.50NA11.37090
    51040AIncise & drain bladder4.37NA2.920.32NA7.61090
    51045AIncise bladder/drain ureter6.73NA4.130.56NA11.42090
    51050ARemoval of bladder stone6.88NA3.790.50NA11.17090
    51060ARemoval of ureter stone8.80NA4.680.65NA14.13090
    51065ARemove ureter calculus8.80NA4.530.64NA13.97090
    51080ADrainage of bladder abscess5.93NA3.700.42NA10.05090
    51500ARemoval of bladder cyst10.08NA5.141.05NA16.27090
    51520ARemoval of bladder lesion9.24NA4.860.70NA14.80090
    51525ARemoval of bladder lesion13.89NA6.321.02NA21.23090
    51530ARemoval of bladder lesion12.31NA5.950.98NA19.24090
    Start Printed Page 63314
    51535ARepair of ureter lesion12.50NA6.341.08NA19.92090
    51550APartial removal of bladder15.57NA6.941.26NA23.77090
    51555APartial removal of bladder21.11NA8.911.64NA31.66090
    51565ARevise bladder & ureter(s)21.50NA9.231.68NA32.41090
    51570ARemoval of bladder24.10NA10.051.91NA36.06090
    51575ARemoval of bladder & nodes30.28NA12.382.25NA44.91090
    51580ARemove bladder/revise tract30.90NA12.852.33NA46.08090
    51585ARemoval of bladder & nodes35.03NA14.082.61NA51.72090
    51590ARemove bladder/revise tract32.47NA12.972.41NA47.85090
    51595ARemove bladder/revise tract36.93NA14.512.67NA54.11090
    51596ARemove bladder/create pouch39.29NA15.642.86NA57.79090
    51597ARemoval of pelvic structures38.13NA15.242.98NA56.35090
    51600AInjection for bladder x-ray0.875.860.290.056.781.21000
    51605APreparation for bladder xray0.6410.870.350.0511.561.04000
    51610AInjection for bladder x-ray1.041.750.620.062.851.72000
    51700AIrrigation of bladder0.871.670.290.062.601.22000
    51701AInsert bladder catheter0.501.660.190.042.200.73000
    51702AInsert temp bladder cath0.502.360.260.042.900.80000
    51703AInsert bladder cath, complex1.463.080.580.114.652.15000
    51705AChange of bladder tube1.012.360.630.073.441.71010
    51710AChange of bladder tube1.483.460.780.115.052.37010
    51715AEndoscopic injection/implant3.724.041.370.298.055.38000
    51720ATreatment of bladder lesion1.951.800.710.143.892.80000
    51725ASimple cystometrogram1.505.83NA0.167.49NA000
    5172526ASimple cystometrogram1.500.500.500.122.122.12000
    51725TCASimple cystometrogram0.005.33NA0.045.37NA000
    51726AComplex cystometrogram1.707.91NA0.189.79NA000
    5172626AComplex cystometrogram1.700.570.570.132.402.40000
    51726TCAComplex cystometrogram0.007.34NA0.057.39NA000
    51736AUrine flow measurement0.610.60NA0.061.27NA000
    5173626AUrine flow measurement0.610.200.200.050.860.86000
    51736TCAUrine flow measurement0.000.40NA0.010.41NA000
    51741AElectro-uroflowmetry, first1.130.83NA0.102.06NA000
    5174126AElectro-uroflowmetry, first1.130.380.380.081.591.59000
    51741TCAElectro-uroflowmetry, first0.000.45NA0.020.47NA000
    51772AUrethra pressure profile1.605.86NA0.197.65NA000
    5177226AUrethra pressure profile1.600.560.560.142.302.30000
    51772TCAUrethra pressure profile0.005.30NA0.055.35NA000
    51784AAnal/urinary muscle study1.524.16NA0.165.84NA000
    5178426AAnal/urinary muscle study1.520.510.510.122.152.15000
    51784TCAAnal/urinary muscle study0.003.65NA0.043.69NA000
    51785AAnal/urinary muscle study1.524.68NA0.156.35NA000
    5178526AAnal/urinary muscle study1.520.510.510.112.142.14000
    51785TCAAnal/urinary muscle study0.004.17NA0.044.21NA000
    51792AUrinary reflex study1.096.06NA0.247.39NA000
    5179226AUrinary reflex study1.090.420.420.111.621.62000
    51792TCAUrinary reflex study0.005.64NA0.135.77NA000
    51795AUrine voiding pressure study1.527.69NA0.229.43NA000
    5179526AUrine voiding pressure study1.520.510.510.122.152.15000
    51795TCAUrine voiding pressure study0.007.18NA0.107.28NA000
    51797AIntraabdominal pressure test1.596.02NA0.177.78NA000
    5179726AIntraabdominal pressure test1.590.540.540.122.252.25000
    51797TCAIntraabdominal pressure test0.005.48NA0.055.53NA000
    51798AUs urine capacity measure0.000.36NA0.080.44NAXXX
    51800ARevision of bladder/urethra17.32NA7.791.40NA26.51090
    51820ARevision of urinary tract17.79NA8.581.74NA28.11090
    51840AAttach bladder/urethra10.65NA5.651.04NA17.34090
    51841AAttach bladder/urethra12.96NA6.461.25NA20.67090
    51845ARepair bladder neck9.67NA4.930.74NA15.34090
    51860ARepair of bladder wound11.95NA5.981.07NA19.00090
    51865ARepair of bladder wound14.95NA6.911.21NA23.07090
    51880ARepair of bladder opening7.62NA4.150.65NA12.42090
    51900ARepair bladder/vagina lesion12.90NA6.301.04NA20.24090
    51920AClose bladder-uterus fistula11.74NA5.821.03NA18.59090
    51925AHysterectomy/bladder repair15.49NA8.821.77NA26.08090
    51940ACorrection of bladder defect28.27NA12.512.36NA43.14090
    51960ARevision of bladder & bowel22.88NA9.981.69NA34.55090
    51980AConstruct bladder opening11.30NA5.560.89NA17.75090
    51990ALaparo urethral suspension12.43NA6.261.22NA19.91090
    51992ALaparo sling operation13.93NA6.321.11NA21.36090
    52000ACystoscopy2.003.410.760.145.552.90000
    52001ACystoscopy, removal of clots5.425.221.890.3811.027.69000
    52005ACystoscopy & ureter catheter2.366.010.900.188.553.44000
    52007ACystoscopy and biopsy3.00NA1.170.22NA4.39000
    52010ACystoscopy & duct catheter3.00NA1.150.22NA4.37000
    Start Printed Page 63315
    52204ACystoscopy2.363.670.920.186.213.46000
    52214ACystoscopy and treatment3.69NA1.350.26NA5.30000
    52224ACystoscopy and treatment3.12NA1.170.22NA4.51000
    52234ACystoscopy and treatment4.60NA1.650.32NA6.57000
    52235ACystoscopy and treatment5.42NA1.930.38NA7.73000
    52240ACystoscopy and treatment9.66NA3.330.70NA13.69000
    52250ACystoscopy and radiotracer4.47NA1.690.32NA6.48000
    52260ACystoscopy and treatment3.90NA1.450.28NA5.63000
    52265ACystoscopy and treatment2.923.791.130.226.934.27000
    52270ACystoscopy & revise urethra3.35NA1.260.24NA4.85000
    52275ACystoscopy & revise urethra4.67NA1.690.34NA6.70000
    52276ACystoscopy and treatment4.97NA1.810.36NA7.14000
    52277ACystoscopy and treatment6.13NA2.280.46NA8.87000
    52281ACystoscopy and treatment2.787.471.090.2010.454.07000
    52282ACystoscopy, implant stent6.36NA2.260.46NA9.08000
    52283ACystoscopy and treatment3.724.061.410.268.045.39000
    52285ACystoscopy and treatment3.594.141.360.267.995.21000
    52290ACystoscopy and treatment4.56NA1.680.32NA6.56000
    52300ACystoscopy and treatment5.28NA1.930.38NA7.59000
    52301ACystoscopy and treatment5.48NA2.020.47NA7.97000
    52305ACystoscopy and treatment5.28NA1.880.37NA7.53000
    52310ACystoscopy and treatment2.793.561.040.206.554.03000
    52315ACystoscopy and treatment5.18NA1.860.37NA7.41000
    52317ARemove bladder stone6.68NA2.310.48NA9.47000
    52318ARemove bladder stone9.14NA3.140.65NA12.93000
    52320ACystoscopy and treatment4.67NA1.660.34NA6.67000
    52325ACystoscopy, stone removal6.12NA2.130.44NA8.69000
    52327ACystoscopy, inject material5.16NA1.850.38NA7.39000
    52330ACystoscopy and treatment5.01NA1.780.36NA7.15000
    52332ACystoscopy and treatment2.81NA1.070.20NA4.08000
    52334ACreate passage to kidney4.80NA1.780.34NA6.92000
    52341ACysto w/ureter stricture tx5.97NA2.240.44NA8.65000
    52342ACysto w/up stricture tx6.46NA2.380.48NA9.32000
    52343ACysto w/renal stricture tx7.16NA2.620.53NA10.31000
    52344ACysto/uretero, stone remove7.66NA2.840.56NA11.06000
    52345ACysto/uretero w/up stricture8.15NA3.000.60NA11.75000
    52346ACystouretero w/renal strict9.18NA3.320.68NA13.18000
    52347ACystoscopy, resect ducts5.25NA1.730.40NA7.38000
    52351ACystouretero & or pyeloscope5.83NA2.170.43NA8.43000
    52352ACystouretero w/stone remove6.84NA2.540.50NA9.88000
    52353ACystouretero w/lithotripsy7.92NA2.900.59NA11.41000
    52354ACystouretero w/biopsy7.30NA2.710.54NA10.55000
    52355ACystouretero w/excise tumor8.77NA3.190.66NA12.62000
    52400ACystouretero w/congen repr9.62NA3.830.72NA14.17090
    52450AIncision of prostate7.60NA3.770.55NA11.92090
    52500ARevision of bladder neck8.42NA4.020.60NA13.04090
    52510ADilation prostatic urethra6.68NA3.200.48NA10.36090
    52601AProstatectomy (TURP)12.30NA5.220.89NA18.41090
    52606AControl postop bleeding8.08NA3.630.59NA12.30090
    52612AProstatectomy, first stage7.93NA3.830.58NA12.34090
    52614AProstatectomy, second stage6.80NA3.430.49NA10.72090
    52620ARemove residual prostate6.57NA3.060.47NA10.10090
    52630ARemove prostate regrowth7.22NA3.250.52NA10.99090
    52640ARelieve bladder contracture6.58NA3.030.47NA10.08090
    52647ALaser surgery of prostate10.3077.334.630.7388.3615.66090
    52648ALaser surgery of prostate11.15NA4.900.79NA16.84090
    52700ADrainage of prostate abscess6.76NA3.250.49NA10.50090
    53000AIncision of urethra2.27NA1.580.16NA4.01010
    53010AIncision of urethra3.62NA3.070.24NA6.93090
    53020AIncision of urethra1.763.120.680.135.012.57000
    53025AIncision of urethra1.123.880.520.085.081.72000
    53040ADrainage of urethra abscess6.3611.426.380.4918.2713.23090
    53060ADrainage of urethra abscess2.62NA1.480.28NA4.38010
    53080ADrainage of urinary leakage6.25NA6.220.50NA12.97090
    53085ADrainage of urinary leakage10.21NA7.710.80NA18.72090
    53200ABiopsy of urethra2.584.350.990.207.133.77000
    53210ARemoval of urethra12.50NA6.110.97NA19.58090
    53215ARemoval of urethra15.49NA6.851.11NA23.45090
    53220ATreatment of urethra lesion6.96NA3.920.53NA11.41090
    53230ARemoval of urethra lesion9.53NA4.890.72NA15.14090
    53235ARemoval of urethra lesion10.08NA5.090.72NA15.89090
    53240ASurgery for urethra pouch6.41NA3.690.50NA10.60090
    53250ARemoval of urethra gland5.86NA3.430.42NA9.71090
    53260ATreatment of urethra lesion2.963.321.830.286.565.07010
    53265ATreatment of urethra lesion3.10NA1.860.24NA5.20010
    Start Printed Page 63316
    53270ARemoval of urethra gland3.07NA1.910.25NA5.23010
    53275ARepair of urethra defect4.50NA2.300.34NA7.14010
    53400ARevise urethra, stage 112.70NA6.171.02NA19.89090
    53405ARevise urethra, stage 214.40NA6.531.09NA22.02090
    53410AReconstruction of urethra16.35NA7.291.19NA24.83090
    53415AReconstruction of urethra19.30NA7.581.39NA28.27090
    53420AReconstruct urethra, stage 114.00NA6.551.08NA21.63090
    53425AReconstruct urethra, stage 215.89NA7.121.16NA24.17090
    53430AReconstruction of urethra16.25NA7.231.21NA24.69090
    53431AReconstruct urethra/bladder19.78NA8.281.56NA29.62090
    53440AMale sling procedure13.54NA6.110.87NA20.52090
    53442ARemove/revise male sling11.50NA5.580.66NA17.74090
    53444AInsert tandem cuff13.32NA5.981.05NA20.35090
    53445AInsert uro/ves nck sphincter13.98NA7.341.01NA22.33090
    53446ARemove uro sphincter10.17NA5.340.80NA16.31090
    53447ARemove/replace ur sphincter13.41NA6.560.95NA20.92090
    53448ARemov/replc ur sphinctr comp21.03NA9.231.67NA31.93090
    53449ARepair uro sphincter9.64NA4.910.68NA15.23090
    53450ARevision of urethra6.11NA3.450.44NA10.00090
    53460ARevision of urethra7.08NA3.870.52NA11.47090
    53500AUrethrlys, transvag w/ scope12.14NA6.270.89NA19.30090
    53502ARepair of urethra injury7.59NA4.190.60NA12.38090
    53505ARepair of urethra injury7.59NA4.040.55NA12.18090
    53510ARepair of urethra injury10.05NA5.350.72NA16.12090
    53515ARepair of urethra injury13.23NA6.120.99NA20.34090
    53520ARepair of urethra defect8.63NA4.650.64NA13.92090
    53600ADilate urethra stricture1.201.190.450.082.471.73000
    53601ADilate urethra stricture0.971.320.390.072.361.43000
    53605ADilate urethra stricture1.27NA0.420.10NA1.79000
    53620ADilate urethra stricture1.612.060.620.123.792.35000
    53621ADilate urethra stricture1.342.140.510.103.581.95000
    53660ADilation of urethra0.711.360.330.052.121.09000
    53661ADilation of urethra0.721.360.310.052.131.08000
    53665ADilation of urethra0.76NA0.260.06NA1.08000
    53850AProstatic microwave thermotx9.4099.304.370.67109.3714.44090
    53852AProstatic rf thermotx9.8293.704.750.70104.2215.27090
    53853AProstatic water thermother5.2158.093.230.3263.628.76090
    53899CUrology surgery procedure0.000.000.000.000.000.00YYY
    54000ASlitting of prepuce1.53NA1.350.12NA3.00010
    54001ASlitting of prepuce2.184.351.530.176.703.88010
    54015ADrain penis lesion5.29NA2.610.40NA8.30010
    54050ADestruction, penis lesion(s)1.231.711.060.083.022.37010
    54055ADestruction, penis lesion(s)1.211.620.820.082.912.11010
    54056ACryosurgery, penis lesion(s)1.232.501.390.073.802.69010
    54057ALaser surg, penis lesion(s)1.23NA0.880.10NA2.21010
    54060AExcision of penis lesion(s)1.923.921.470.145.983.53010
    54065ADestruction, penis lesion(s)2.41NA1.740.16NA4.31010
    54100ABiopsy of penis1.892.900.830.124.912.84000
    54105ABiopsy of penis3.48NA1.990.25NA5.72010
    54110ATreatment of penis lesion10.07NA5.710.72NA16.50090
    54111ATreat penis lesion, graft13.49NA6.770.95NA21.21090
    54112ATreat penis lesion, graft15.77NA7.781.13NA24.68090
    54115ATreatment of penis lesion6.118.614.520.4715.1911.10090
    54120APartial removal of penis9.91NA5.670.72NA16.30090
    54125ARemoval of penis13.45NA6.830.97NA21.25090
    54130ARemove penis & nodes20.03NA9.201.43NA30.66090
    54135ARemove penis & nodes26.21NA11.221.89NA39.32090
    54150ACircumcision1.80NA0.990.20NA2.99010
    54152ACircumcision2.30NA1.230.19NA3.72010
    54160ACircumcision2.47NA1.120.19NA3.78010
    54161ACircumcision3.25NA1.600.24NA5.09010
    54162ALysis penil circumic lesion2.98NA2.030.24NA5.25010
    54163ARepair of circumcision2.98NA2.040.24NA5.26010
    54164AFrenulotomy of penis2.49NA1.880.19NA4.56010
    54200ATreatment of penis lesion1.051.871.020.072.992.14010
    54205ATreatment of penis lesion7.88NA4.890.56NA13.33090
    54220ATreatment of penis lesion2.413.980.970.186.573.56000
    54230APrepare penis study1.331.130.640.102.562.07000
    54231ADynamic cavernosometry2.031.420.880.173.623.08000
    54235APenile injection1.180.990.600.082.251.86000
    54240APenis study1.301.04NA0.162.50NA000
    5424026APenis study1.300.430.430.101.831.83000
    54240TCAPenis study0.000.61NA0.060.67NA000
    54250APenis study2.210.93NA0.193.33NA000
    5425026APenis study2.210.710.710.173.093.09000
    Start Printed Page 63317
    54250TCAPenis study0.000.22NA0.020.24NA000
    54300ARevision of penis10.35NA5.810.77NA16.93090
    54304ARevision of penis12.42NA6.620.89NA19.93090
    54308AReconstruction of urethra11.76NA6.240.84NA18.84090
    54312AReconstruction of urethra13.49NA7.280.97NA21.74090
    54316AReconstruction of urethra16.72NA8.281.20NA26.20090
    54318AReconstruction of urethra11.19NA6.061.38NA18.63090
    54322AReconstruction of urethra12.94NA6.710.92NA20.57090
    54324AReconstruction of urethra16.22NA8.311.23NA25.76090
    54326AReconstruction of urethra15.63NA8.101.11NA24.84090
    54328ARevise penis/urethra15.56NA7.531.10NA24.19090
    54332ARevise penis/urethra16.98NA8.031.21NA26.22090
    54336ARevise penis/urethra19.93NA10.832.28NA33.04090
    54340ASecondary urethral surgery8.86NA5.320.86NA15.04090
    54344ASecondary urethral surgery15.85NA8.071.32NA25.24090
    54348ASecondary urethral surgery17.05NA8.711.22NA26.98090
    54352AReconstruct urethra/penis24.60NA11.621.94NA38.16090
    54360APenis plastic surgery11.86NA6.250.86NA18.97090
    54380ARepair penis13.10NA6.911.39NA21.40090
    54385ARepair penis15.30NA8.570.85NA24.72090
    54390ARepair penis and bladder21.49NA9.711.53NA32.73090
    54400AInsert semi-rigid prosthesis8.94NA4.520.64NA14.10090
    54401AInsert self-contd prosthesis10.22NA5.920.73NA16.87090
    54405AInsert multi-comp penis pros13.35NA6.130.96NA20.44090
    54406ARemove muti-comp penis pros12.03NA5.530.90NA18.46090
    54408ARepair multi-comp penis pros12.68NA5.840.95NA19.47090
    54410ARemove/replace penis prosth15.41NA6.751.15NA23.31090
    54411ARemov/replc penis pros, comp15.91NA7.170.96NA24.04090
    54415ARemove self-contd penis pros8.15NA4.290.65NA13.09090
    54416ARemv/repl penis contain pros10.81NA5.490.66NA16.96090
    54417ARemv/replc penis pros, compl14.11NA6.280.66NA21.05090
    54420ARevision of penis11.35NA5.780.86NA17.99090
    54430ARevision of penis10.09NA5.320.72NA16.13090
    54435ARevision of penis6.09NA3.780.43NA10.30090
    54440CRepair of penis0.000.000.000.000.000.00090
    54450APreputial stretching1.111.120.480.082.311.67000
    54500ABiopsy of testis1.300.620.580.102.021.98000
    54505ABiopsy of testis3.44NA1.960.25NA5.65010
    54512AExcise lesion testis8.53NA4.210.67NA13.41090
    54520ARemoval of testis5.20NA2.890.40NA8.49090
    54522AOrchiectomy, partial9.45NA4.970.74NA15.16090
    54530ARemoval of testis8.53NA4.380.64NA13.55090
    54535AExtensive testis surgery12.09NA5.740.99NA18.82090
    54550AExploration for testis7.74NA3.940.59NA12.27090
    54560AExploration for testis11.07NA5.330.95NA17.35090
    54600AReduce testis torsion6.97NA3.660.54NA11.17090
    54620ASuspension of testis4.87NA2.500.37NA7.74010
    54640ASuspension of testis6.86NA3.850.59NA11.30090
    54650AOrchiopexy (Fowler-Stephens)11.38NA5.600.97NA17.95090
    54660ARevision of testis5.08NA3.110.42NA8.61090
    54670ARepair testis injury6.37NA3.650.49NA10.51090
    54680ARelocation of testis(es)12.58NA6.361.13NA20.07090
    54690ALaparoscopy, orchiectomy10.90NA5.121.19NA17.21090
    54692ALaparoscopy, orchiopexy12.81NA5.521.04NA19.37090
    54699CLaparoscope proc, testis0.000.000.000.000.000.00YYY
    54700ADrainage of scrotum3.41NA1.970.28NA5.66010
    54800ABiopsy of epididymis2.320.950.910.173.443.40000
    54820AExploration of epididymis5.11NA3.050.40NA8.56090
    54830ARemove epididymis lesion5.35NA3.130.41NA8.89090
    54840ARemove epididymis lesion5.17NA2.880.37NA8.42090
    54860ARemoval of epididymis6.28NA3.420.46NA10.16090
    54861ARemoval of epididymis8.85NA4.440.62NA13.91090
    54900AFusion of spermatic ducts13.12NA5.931.61NA20.66090
    54901AFusion of spermatic ducts17.84NA7.652.19NA27.68090
    55000ADrainage of hydrocele1.422.130.650.123.672.19000
    55040ARemoval of hydrocele5.33NA3.000.42NA8.75090
    55041ARemoval of hydroceles7.70NA4.090.60NA12.39090
    55060ARepair of hydrocele5.49NA3.170.44NA9.10090
    55100ADrainage of scrotum abscess2.123.811.610.186.113.91010
    55110AExplore scrotum5.67NA3.220.43NA9.32090
    55120ARemoval of scrotum lesion5.065.813.030.4011.278.49090
    55150ARemoval of scrotum7.18NA4.010.56NA11.75090
    55175ARevision of scrotum5.21NA3.110.40NA8.72090
    55180ARevision of scrotum10.66NA5.530.86NA17.05090
    55200AIncision of sperm duct4.225.582.450.3010.106.97090
    Start Printed Page 63318
    55250ARemoval of sperm duct(s)3.279.142.820.2512.666.34090
    55300APrepare, sperm duct x-ray3.49NA1.330.24NA5.06000
    55400ARepair of sperm duct8.44NA4.240.60NA13.28090
    55450ALigation of sperm duct4.107.261.910.2911.656.30010
    55500ARemoval of hydrocele5.56NA3.190.52NA9.27090
    55520ARemoval of sperm cord lesion6.00NA3.340.67NA10.01090
    55530ARevise spermatic cord veins5.63NA3.110.43NA9.17090
    55535ARevise spermatic cord veins6.52NA3.500.50NA10.52090
    55540ARevise hernia & sperm veins7.63NA3.900.89NA12.42090
    55550ALaparo ligate spermatic vein6.53NA3.360.56NA10.45090
    55559CLaparo proc, spermatic cord0.000.000.000.000.000.00YYY
    55600AIncise sperm duct pouch6.34NA3.440.46NA10.24090
    55605AIncise sperm duct pouch7.91NA4.420.65NA12.98090
    55650ARemove sperm duct pouch11.73NA5.420.86NA18.01090
    55680ARemove sperm pouch lesion5.16NA3.070.37NA8.60090
    55700ABiopsy of prostate1.564.370.720.126.052.40000
    55705ABiopsy of prostate4.54NA2.340.31NA7.19010
    55720ADrainage of prostate abscess7.60NA4.000.53NA12.13090
    55725ADrainage of prostate abscess8.63NA4.680.61NA13.92090
    55801ARemoval of prostate17.70NA7.471.29NA26.46090
    55810AExtensive prostate surgery22.45NA8.821.62NA32.89090
    55812AExtensive prostate surgery27.35NA11.272.03NA40.65090
    55815AExtensive prostate surgery30.29NA12.202.21NA44.70090
    55821ARemoval of prostate14.17NA6.391.02NA21.58090
    55831ARemoval of prostate15.53NA6.851.13NA23.51090
    55840AExtensive prostate surgery22.56NA9.551.64NA33.75090
    55842AExtensive prostate surgery24.24NA10.111.77NA36.12090
    55845AExtensive prostate surgery28.39NA11.222.05NA41.66090
    55859APercut/needle insert, pros12.45NA5.980.89NA19.32090
    55860ASurgical exposure, prostate14.37NA6.520.98NA21.87090
    55862AExtensive prostate surgery18.29NA8.071.37NA27.73090
    55865AExtensive prostate surgery22.74NA9.491.64NA33.87090
    55866ALaparo radical prostatectomy30.56NA11.951.64NA44.15090
    55870AElectroejaculation2.571.581.100.174.323.84000
    55873ACryoablate prostate19.36NA9.121.22NA29.70090
    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/perineum1.431.361.170.172.962.77010
    56420ADrainage of gland abscess1.382.341.100.163.882.64010
    56440ASurgery for vulva lesion2.82NA1.740.34NA4.90010
    56441ALysis of labial lesion(s)1.961.861.450.204.023.61010
    56501ADestroy, vulva lesions, sim1.521.831.290.183.532.99010
    56515ADestroy vulva lesion/s compl2.742.601.870.225.564.83010
    56605ABiopsy of vulva/perineum1.091.110.470.132.331.69000
    56606ABiopsy of vulva/perineum0.550.510.220.071.130.84ZZZ
    56620APartial removal of vulva7.43NA5.060.91NA13.40090
    56625AComplete removal of vulva8.35NA5.661.01NA15.02090
    56630AExtensive vulva surgery12.29NA7.321.47NA21.08090
    56631AExtensive vulva surgery16.11NA9.381.95NA27.44090
    56632AExtensive vulva surgery20.17NA10.072.43NA32.67090
    56633AExtensive vulva surgery16.38NA9.161.99NA27.53090
    56634AExtensive vulva surgery17.78NA10.042.13NA29.95090
    56637AExtensive vulva surgery21.84NA11.702.61NA36.15090
    56640AExtensive vulva surgery22.04NA11.122.71NA35.87090
    56700APartial removal of hymen2.51NA1.770.29NA4.57010
    56720AIncision of hymen0.68NA0.410.08NA1.17000
    56740ARemove vagina gland lesion4.54NA2.510.44NA7.49010
    56800ARepair of vagina3.87NA2.230.44NA6.54010
    56805ARepair clitoris18.75NA9.552.18NA30.48090
    56810ARepair of perineum4.11NA2.340.49NA6.94010
    56820AExam of vulva w/scope1.491.390.640.123.002.25000
    56821AExam/biopsy of vulva w/scope2.041.820.910.164.023.11000
    57000AExploration of vagina2.95NA1.770.34NA5.06010
    57010ADrainage of pelvic abscess6.00NA3.930.68NA10.61090
    57020ADrainage of pelvic fluid1.490.970.610.182.642.28000
    57022AI & d vaginal hematoma, pp2.55NA1.540.29NA4.38010
    57023AI & d vag hematoma, non-ob4.72NA2.640.29NA7.65010
    57061ADestroy vag lesions, simple1.241.701.160.163.102.56010
    57065ADestroy vag lesions, complex2.602.361.750.315.274.66010
    57100ABiopsy of vagina1.191.130.490.122.441.80000
    57105ABiopsy of vagina1.681.991.370.203.873.25010
    57106ARemove vagina wall, partial6.32NA4.370.70NA11.39090
    57107ARemove vagina tissue, part22.87NA10.762.60NA36.23090
    57109AVaginectomy partial w/nodes26.85NA11.552.36NA40.76090
    Start Printed Page 63319
    57110ARemove vagina wall, complete14.21NA7.441.71NA23.36090
    57111ARemove vagina tissue, compl26.85NA12.843.25NA42.94090
    57112AVaginectomy w/nodes, compl28.83NA12.382.62NA43.83090
    57120AClosure of vagina7.37NA4.710.90NA12.98090
    57130ARemove vagina lesion2.422.221.590.284.924.29010
    57135ARemove vagina lesion2.652.311.690.315.274.65010
    57150ATreat vagina infection0.551.120.220.071.740.84000
    57155AInsert uteri tandems/ovoids6.23NA4.310.71NA11.25090
    57160AInsert pessary/other device0.881.110.400.112.101.39000
    57170AFitting of diaphragm/cap0.901.520.340.112.531.35000
    57180ATreat vaginal bleeding1.572.261.350.194.023.11010
    57200ARepair of vagina3.92NA2.980.46NA7.36090
    57210ARepair vagina/perineum5.14NA3.510.60NA9.25090
    57220ARevision of urethra4.29NA3.190.50NA7.98090
    57230ARepair of urethral lesion5.61NA3.470.60NA9.68090
    57240ARepair bladder & vagina6.04NA3.900.64NA10.58090
    57250ARepair rectum & vagina5.50NA3.650.65NA9.80090
    57260ARepair of vagina8.22NA4.930.99NA14.14090
    57265AExtensive repair of vagina11.28NA6.161.37NA18.81090
    57268ARepair of bowel bulge6.72NA4.300.79NA11.81090
    57270ARepair of bowel pouch12.04NA6.391.40NA19.83090
    57280ASuspension of vagina14.95NA7.511.73NA24.19090
    57282ARepair of vaginal prolapse8.81NA5.411.03NA15.25090
    57284ARepair paravaginal defect12.63NA7.291.40NA21.32090
    57287ARevise/remove sling repair10.65NA5.600.89NA17.14090
    57288ARepair bladder defect12.95NA6.021.03NA20.00090
    57289ARepair bladder & vagina11.51NA6.161.14NA18.81090
    57291AConstruction of vagina7.90NA5.040.93NA13.87090
    57292AConstruct vagina with graft13.02NA7.111.55NA21.68090
    57300ARepair rectum-vagina fistula7.57NA4.370.84NA12.78090
    57305ARepair rectum-vagina fistula13.69NA6.371.59NA21.65090
    57307AFistula repair & colostomy15.84NA7.141.91NA24.89090
    57308AFistula repair, transperine9.88NA5.241.09NA16.21090
    57310ARepair urethrovaginal lesion6.74NA3.950.54NA11.23090
    57311ARepair urethrovaginal lesion7.93NA4.280.61NA12.82090
    57320ARepair bladder-vagina lesion7.96NA4.510.72NA13.19090
    57330ARepair bladder-vagina lesion12.28NA5.871.03NA19.18090
    57335ARepair vagina18.62NA9.311.99NA29.92090
    57400ADilation of vagina2.26NA1.150.26NA3.67000
    57410APelvic examination1.742.050.900.173.962.81000
    57415ARemove vaginal foreign body2.16NA1.460.23NA3.85010
    57420AExam of vagina w/scope1.591.430.680.123.142.39000
    57421AExam/biopsy of vag w/scope2.191.920.970.164.273.32000
    57425ALaparoscopy, surg, colpopexy15.66NA6.761.73NA24.15090
    57452AExam of cervix w/scope1.491.450.640.123.062.25000
    57454ABx/curett of cervix w/scope2.321.801.010.164.283.49000
    57455ABiopsy of cervix w/scope1.981.800.880.163.943.02000
    57456AEndocerv curettage w/scope1.841.720.830.163.722.83000
    57460ABx of cervix w/scope, leep2.816.181.230.349.334.38000
    57461AConz of cervix w/scope, leep3.426.431.420.3410.195.18000
    57500ABiopsy of cervix0.962.730.480.123.811.56000
    57505AEndocervical curettage1.131.511.130.142.782.40010
    57510ACauterization of cervix1.891.601.060.223.713.17010
    57511ACryocautery of cervix1.891.871.410.223.983.52010
    57513ALaser surgery of cervix1.891.921.440.234.043.56010
    57520AConization of cervix4.025.002.840.499.517.35090
    57522AConization of cervix3.344.462.740.418.216.49090
    57530ARemoval of cervix4.76NA3.520.58NA8.86090
    57531ARemoval of cervix, radical27.84NA13.512.95NA44.30090
    57540ARemoval of residual cervix12.15NA6.381.45NA19.98090
    57545ARemove cervix/repair pelvis12.96NA6.831.56NA21.35090
    57550ARemoval of residual cervix5.50NA3.930.66NA10.09090
    57555ARemove cervix/repair vagina8.90NA5.231.07NA15.20090
    57556ARemove cervix, repair bowel8.32NA4.960.96NA14.24090
    57700ARevision of cervix3.53NA3.160.40NA7.09090
    57720ARevision of cervix4.11NA3.210.49NA7.81090
    57800ADilation of cervical canal0.770.780.490.101.651.36000
    57820AD & c of residual cervix1.661.511.160.203.373.02010
    58100ABiopsy of uterus lining1.521.360.730.082.962.33000
    58120ADilation and curettage3.252.351.910.406.005.56010
    58140AMyomectomy abdom method14.52NA7.221.75NA23.49090
    58145AMyomectomy vag method7.99NA4.910.96NA13.86090
    58146AMyomectomy abdom complex18.89NA8.891.75NA29.53090
    58150ATotal hysterectomy15.15NA7.641.88NA24.67090
    58152ATotal hysterectomy20.48NA10.021.82NA32.32090
    Start Printed Page 63320
    58180APartial hysterectomy15.20NA7.611.85NA24.66090
    58200AExtensive hysterectomy21.47NA10.292.58NA34.34090
    58210AExtensive hysterectomy28.69NA13.633.49NA45.81090
    58240ARemoval of pelvis contents38.17NA18.224.51NA60.90090
    58260AVaginal hysterectomy12.91NA6.821.47NA21.20090
    58262AVag hyst including t/o14.69NA7.511.70NA23.90090
    58263AVag hyst w/t/o & vag repair15.97NA8.031.86NA25.86090
    58267AVag hyst w/urinary repair16.94NA8.521.81NA27.27090
    58270AVag hyst w/enterocele repair14.18NA7.191.64NA23.01090
    58275AHysterectomy/revise vagina15.67NA7.911.81NA25.39090
    58280AHysterectomy/revise vagina16.91NA8.401.85NA27.16090
    58285AExtensive hysterectomy22.13NA10.332.25NA34.71090
    58290AVag hyst complex18.89NA9.011.47NA29.37090
    58291AVag hyst incl t/o, complex20.67NA10.011.70NA32.38090
    58292AVag hyst t/o & repair, compl21.95NA10.551.86NA34.36090
    58293AVag hyst w/uro repair, compl22.93NA11.041.81NA35.78090
    58294AVag hyst w/enterocele, compl20.16NA9.791.64NA31.59090
    58300NInsert intrauterine device+1.001.430.390.122.551.51XXX
    58301ARemove intrauterine device1.261.360.490.162.781.91000
    58321AArtificial insemination0.911.180.380.122.211.41000
    58322AArtificial insemination1.091.230.420.132.451.64000
    58323ASperm washing0.230.240.100.020.490.35000
    58340ACatheter for hysterography0.876.200.650.107.171.62000
    58345AReopen fallopian tube4.63NA2.460.43NA7.52010
    58346AInsert heyman uteri capsule6.71NA4.020.77NA11.50090
    58350AReopen fallopian tube1.001.530.940.122.652.06010
    58353AEndometr ablate, thermal3.5437.172.080.4441.156.06010
    58400ASuspension of uterus6.32NA4.060.74NA11.12090
    58410ASuspension of uterus12.66NA6.571.31NA20.54090
    58520ARepair of ruptured uterus11.85NA6.121.40NA19.37090
    58540ARevision of uterus14.56NA7.071.53NA23.16090
    58545ALaparoscopic myomectomy14.52NA7.311.74NA23.57090
    58546ALaparo-myomectomy, complex18.89NA9.121.74NA29.75090
    58550ALaparo-asst vag hysterectomy14.11NA7.441.73NA23.28090
    58552ALaparo-vag hyst incl t/o14.11NA7.421.73NA23.26090
    58553ALaparo-vag hyst, complex18.89NA9.081.47NA29.44090
    58554ALaparo-vag hyst w/t/o, compl18.89NA9.381.47NA29.74090
    58555AHysteroscopy, dx, sep proc3.312.131.480.415.855.20000
    58558AHysteroscopy, biopsy4.72NA2.090.59NA7.40000
    58559AHysteroscopy, lysis6.13NA2.650.74NA9.52000
    58560AHysteroscopy, resect septum6.96NA3.010.85NA10.82000
    58561AHysteroscopy, remove myoma9.94NA4.231.22NA15.39000
    58562AHysteroscopy, remove fb5.18NA2.230.62NA8.03000
    58563AHysteroscopy, ablation6.13NA2.670.74NA9.54000
    58578CLaparo proc, uterus0.000.000.000.000.000.00YYY
    58579CHysteroscope procedure0.000.000.000.000.000.00YYY
    58600ADivision of fallopian tube5.57NA3.410.47NA9.45090
    58605ADivision of fallopian tube4.97NA3.200.40NA8.57090
    58611ALigate oviduct(s) add-on1.44NA0.580.08NA2.10ZZZ
    58615AOcclude fallopian tube(s)3.88NA2.770.48NA7.13010
    58660ALaparoscopy, lysis11.23NA5.351.37NA17.95090
    58661ALaparoscopy, remove adnexa10.99NA5.221.34NA17.55010
    58662ALaparoscopy, excise lesions11.72NA5.881.41NA19.01090
    58670ALaparoscopy, tubal cautery5.57NA3.330.66NA9.56090
    58671ALaparoscopy, tubal block5.57NA3.340.67NA9.58090
    58672ALaparoscopy, fimbrioplasty12.81NA6.301.46NA20.57090
    58673ALaparoscopy, salpingostomy13.66NA6.711.68NA22.05090
    58679CLaparo proc, oviduct-ovary0.000.000.000.000.000.00YYY
    58700ARemoval of fallopian tube11.98NA6.090.77NA18.84090
    58720ARemoval of ovary/tube(s)11.30NA5.911.37NA18.58090
    58740ARevise fallopian tube(s)13.92NA7.280.71NA21.91090
    58750ARepair oviduct14.76NA7.501.82NA24.08090
    58752ARevise ovarian tube(s)14.76NA7.161.81NA23.73090
    58760ARemove tubal obstruction13.06NA6.841.61NA21.51090
    58770ACreate new tubal opening13.89NA7.061.70NA22.65090
    58800ADrainage of ovarian cyst(s)4.124.553.040.439.107.59090
    58805ADrainage of ovarian cyst(s)5.85NA3.590.67NA10.11090
    58820ADrain ovary abscess, open4.20NA3.380.35NA7.93090
    58822ADrain ovary abscess, percut10.07NA5.321.10NA16.49090
    58823ADrain pelvic abscess, percut3.36NA1.140.22NA4.72000
    58825ATransposition, ovary(s)10.92NA5.910.74NA17.57090
    58900ABiopsy of ovary(s)5.96NA3.670.67NA10.30090
    58920APartial removal of ovary(s)11.30NA5.700.82NA17.82090
    58925ARemoval of ovarian cyst(s)11.30NA5.791.37NA18.46090
    58940ARemoval of ovary(s)7.25NA4.200.87NA12.32090
    Start Printed Page 63321
    58943ARemoval of ovary(s)18.32NA8.942.23NA29.49090
    58950AResect ovarian malignancy16.83NA8.771.86NA27.46090
    58951AResect ovarian malignancy22.25NA10.832.64NA35.72090
    58952AResect ovarian malignancy24.87NA12.213.08NA40.16090
    58953ATah, rad dissect for debulk31.82NA14.923.96NA50.70090
    58954ATah rad debulk/lymph remove34.80NA16.084.27NA55.15090
    58960AExploration of abdomen14.57NA7.681.76NA24.01090
    58970ARetrieval of oocyte3.512.351.530.436.295.47000
    58974CTransfer of embryo0.000.000.000.000.000.00000
    58976ATransfer of embryo3.812.671.850.476.956.13000
    58999CGenital surgery procedure0.000.000.000.000.000.00YYY
    59000AAmniocentesis, diagnostic1.292.140.690.283.712.26000
    59001AAmniocentesis, therapeutic2.98NA1.430.28NA4.69000
    59012AFetal cord puncture,prenatal3.43NA1.580.74NA5.75000
    59015AChorion biopsy2.191.601.070.484.273.74000
    59020AFetal contract stress test0.660.79NA0.241.69NA000
    5902026AFetal contract stress test0.660.270.270.141.071.07000
    59020TCAFetal contract stress test0.000.52NA0.100.62NA000
    59025AFetal non-stress test0.530.44NA0.141.11NA000
    5902526AFetal non-stress test0.530.210.210.120.860.86000
    59025TCAFetal non-stress test0.000.23NA0.020.25NA000
    59030AFetal scalp blood sample1.98NA1.050.43NA3.46000
    59050AFetal monitor w/report0.88NA0.360.19NA1.43XXX
    59051AFetal monitor/interpret only0.74NA0.300.17NA1.21XXX
    59070ATransabdom amnioinfus w/ us5.225.192.430.2810.697.93000
    59072AUmbilical cord occlud w/ us8.95NA3.170.67NA12.79000
    59074AFetal fluid drainage w/ us5.224.662.430.2810.167.93000
    59076AFetal shunt placement, w/ us8.95NA3.170.67NA12.79000
    59100ARemove uterus lesion12.28NA6.572.65NA21.50090
    59120ATreat ectopic pregnancy11.42NA6.362.47NA20.25090
    59121ATreat ectopic pregnancy11.60NA6.432.51NA20.54090
    59130ATreat ectopic pregnancy14.14NA5.083.04NA22.26090
    59135ATreat ectopic pregnancy13.80NA7.342.98NA24.12090
    59136ATreat ectopic pregnancy13.10NA6.722.83NA22.65090
    59140ATreat ectopic pregnancy5.435.293.651.1711.8910.25090
    59150ATreat ectopic pregnancy11.60NA6.131.47NA19.20090
    59151ATreat ectopic pregnancy11.42NA6.171.69NA19.28090
    59160AD & c after delivery2.693.312.140.596.595.42010
    59200AInsert cervical dilator0.791.240.310.182.211.28000
    59300AEpisiotomy or vaginal repair2.402.190.970.525.113.89000
    59320ARevision of cervix2.47NA1.280.54NA4.29000
    59325ARevision of cervix4.05NA1.940.87NA6.86000
    59350ARepair of uterus4.92NA1.971.05NA7.94000
    59400AObstetrical care22.93NA15.734.96NA43.62MMM
    59409AObstetrical care13.42NA5.372.90NA21.69MMM
    59410AObstetrical care14.70NA6.403.18NA24.28MMM
    59412AAntepartum manipulation1.70NA0.820.37NA2.89MMM
    59414ADeliver placenta1.60NA0.640.35NA2.59MMM
    59425AAntepartum care only4.784.341.881.0310.157.69MMM
    59426AAntepartum care only8.237.783.251.7917.8013.27MMM
    59430ACare after delivery2.121.260.950.463.843.53MMM
    59510ACesarean delivery26.07NA17.695.63NA49.39MMM
    59514ACesarean delivery only15.88NA6.293.43NA25.60MMM
    59515ACesarean delivery17.27NA7.973.74NA28.98MMM
    59525ARemove uterus after cesarean8.49NA3.341.83NA13.66ZZZ
    59610AVbac delivery24.48NA16.295.29NA46.06MMM
    59612AVbac delivery only14.97NA6.133.24NA24.34MMM
    59614AVbac care after delivery16.25NA7.043.51NA26.80MMM
    59618AAttempted vbac delivery27.62NA18.815.97NA52.40MMM
    59620AAttempted vbac delivery only17.43NA6.853.78NA28.06MMM
    59622AAttempted vbac after care18.82NA8.774.06NA31.65MMM
    59812ATreatment of miscarriage3.99NA2.600.70NA7.29090
    59820ACare of miscarriage3.99NA3.590.86NA8.44090
    59821ATreatment of miscarriage4.44NA3.510.96NA8.91090
    59830ATreat uterus infection6.08NA4.081.32NA11.48090
    59840RAbortion2.99NA2.160.65NA5.80010
    59841RAbortion5.212.602.601.138.948.94010
    59850RAbortion5.88NA3.301.27NA10.45090
    59851RAbortion5.90NA3.791.27NA10.96090
    59852RAbortion8.19NA5.401.77NA15.36090
    59855RAbortion6.09NA3.621.32NA11.03090
    59856RAbortion7.44NA4.121.61NA13.17090
    59857RAbortion9.24NA4.631.99NA15.86090
    59866RAbortion (mpr)3.98NA1.850.86NA6.69000
    59870AEvacuate mole of uterus5.98NA4.510.92NA11.41090
    Start Printed Page 63322
    59871ARemove cerclage suture2.121.791.150.464.373.73000
    59897CFetal invas px w/ us0.000.000.000.000.000.00YYY
    59898CLaparo proc, ob care/deliver0.000.000.000.000.000.00YYY
    59899CMaternity care procedure0.000.000.000.000.000.00YYY
    60000ADrain thyroid/tongue cyst1.752.202.070.174.123.99010
    60001AAspirate/inject thyriod cyst0.961.520.350.072.551.38000
    60100ABiopsy of thyroid1.551.440.540.063.052.15000
    60200ARemove thyroid lesion9.50NA6.181.01NA16.69090
    60210APartial thyroid excision10.82NA5.831.21NA17.86090
    60212APartial thyroid excision15.94NA7.881.81NA25.63090
    60220APartial removal of thyroid11.83NA6.351.16NA19.34090
    60225APartial removal of thyroid14.11NA7.621.57NA23.30090
    60240ARemoval of thyroid15.97NA7.821.80NA25.59090
    60252ARemoval of thyroid20.45NA10.391.95NA32.79090
    60254AExtensive thyroid surgery26.84NA14.522.35NA43.71090
    60260ARepeat thyroid surgery17.37NA8.931.67NA27.97090
    60270ARemoval of thyroid20.15NA10.572.13NA32.85090
    60271ARemoval of thyroid16.73NA8.821.62NA27.17090
    60280ARemove thyroid duct lesion5.84NA4.880.54NA11.26090
    60281ARemove thyroid duct lesion8.48NA6.050.80NA15.33090
    60500AExplore parathyroid glands16.14NA7.601.93NA25.67090
    60502ARe-explore parathyroids20.23NA9.582.40NA32.21090
    60505AExplore parathyroid glands21.37NA11.082.57NA35.02090
    60512AAutotransplant parathyroid4.42NA1.640.53NA6.59ZZZ
    60520ARemoval of thymus gland16.71NA8.282.21NA27.20090
    60521ARemoval of thymus gland18.76NA9.292.80NA30.85090
    60522ARemoval of thymus gland22.96NA11.003.39NA37.35090
    60540AExplore adrenal gland16.93NA7.721.70NA26.35090
    60545AExplore adrenal gland19.77NA8.682.10NA30.55090
    60600ARemove carotid body lesion17.83NA10.902.24NA30.97090
    60605ARemove carotid body lesion20.12NA12.832.73NA35.68090
    60650ALaparoscopy adrenalectomy19.89NA8.082.37NA30.34090
    60659CLaparo proc, endocrine0.000.000.000.000.000.00YYY
    60699CEndocrine surgery procedure0.000.000.000.000.000.00YYY
    61000ARemove cranial cavity fluid1.57NA0.970.16NA2.70000
    61001ARemove cranial cavity fluid1.48NA1.080.18NA2.74000
    61020ARemove brain cavity fluid1.50NA1.380.31NA3.19000
    61026AInjection into brain canal1.68NA1.450.25NA3.38000
    61050ARemove brain canal fluid1.50NA1.280.16NA2.94000
    61055AInjection into brain canal2.09NA1.440.16NA3.69000
    61070ABrain canal shunt procedure0.88NA1.050.11NA2.04000
    61105ATwist drill hole5.11NA4.011.26NA10.38090
    61107ADrill skull for implantation4.97NA3.361.22NA9.55000
    61108ADrill skull for drainage10.13NA7.252.45NA19.83090
    61120ABurr hole for puncture8.71NA6.092.17NA16.97090
    61140APierce skull for biopsy15.81NA10.043.78NA29.63090
    61150APierce skull for drainage17.47NA10.544.22NA32.23090
    61151APierce skull for drainage12.35NA7.952.94NA23.24090
    61154APierce skull & remove clot14.90NA9.643.66NA28.20090
    61156APierce skull for drainage16.23NA9.984.10NA30.31090
    61210APierce skull, implant device5.81NA3.761.39NA10.96000
    61215AInsert brain-fluid device4.86NA4.081.19NA10.13090
    61250APierce skull & explore10.36NA6.962.42NA19.74090
    61253APierce skull & explore12.29NA7.842.71NA22.84090
    61304AOpen skull for exploration21.83NA13.045.19NA40.06090
    61305AOpen skull for exploration26.46NA15.566.29NA48.31090
    61312AOpen skull for drainage24.43NA15.275.98NA45.68090
    61313AOpen skull for drainage24.79NA15.046.08NA45.91090
    61314AOpen skull for drainage24.09NA13.264.79NA42.14090
    61315AOpen skull for drainage27.52NA16.266.74NA50.52090
    61316AImplt cran bone flap to abdo1.38NA0.580.52NA2.48ZZZ
    61320AOpen skull for drainage25.47NA14.986.23NA46.68090
    61321AOpen skull for drainage28.34NA16.376.41NA51.12090
    61322ADecompressive craniotomy29.33NA14.645.98NA49.95090
    61323ADecompressive lobectomy30.82NA14.825.98NA51.62090
    61330ADecompress eye socket23.19NA13.953.09NA40.23090
    61332AExplore/biopsy eye socket27.12NA15.844.97NA47.93090
    61333AExplore orbit/remove lesion27.79NA15.832.68NA46.30090
    61334AExplore orbit/remove object18.17NA10.823.62NA32.61090
    61340ASubtemporal decompression18.55NA11.304.39NA34.24090
    61343AIncise skull (press relief)29.60NA17.097.24NA53.93090
    61345ARelieve cranial pressure27.04NA15.666.27NA48.97090
    61440AIncise skull for surgery26.48NA14.466.68NA47.62090
    61450AIncise skull for surgery25.80NA14.536.12NA46.45090
    61458AIncise skull for brain wound27.13NA15.776.33NA49.23090
    Start Printed Page 63323
    61460AIncise skull for surgery28.23NA16.686.15NA51.06090
    61470AIncise skull for surgery25.91NA14.085.57NA45.56090
    61480AIncise skull for surgery26.34NA15.536.64NA48.51090
    61490AIncise skull for surgery25.51NA14.576.44NA46.52090
    61500ARemoval of skull lesion17.82NA10.993.91NA32.72090
    61501ARemove infected skull bone14.76NA9.373.15NA27.28090
    61510ARemoval of brain lesion28.29NA16.976.92NA52.18090
    61512ARemove brain lining lesion34.89NA19.998.56NA63.44090
    61514ARemoval of brain abscess25.12NA14.686.14NA45.94090
    61516ARemoval of brain lesion24.47NA14.515.92NA44.90090
    61517AImplt brain chemotx add-on1.37NA0.570.10NA2.04ZZZ
    61518ARemoval of brain lesion37.11NA21.459.03NA67.59090
    61519ARemove brain lining lesion41.15NA23.019.77NA73.93090
    61520ARemoval of brain lesion54.53NA30.8112.11NA97.45090
    61521ARemoval of brain lesion44.23NA24.6110.61NA79.45090
    61522ARemoval of brain abscess29.28NA16.706.35NA52.33090
    61524ARemoval of brain lesion27.70NA15.936.00NA49.63090
    61526ARemoval of brain lesion51.87NA29.958.05NA89.87090
    61530ARemoval of brain lesion43.61NA25.477.40NA76.48090
    61531AImplant brain electrodes14.55NA9.303.40NA27.25090
    61533AImplant brain electrodes19.60NA11.754.55NA35.90090
    61534ARemoval of brain lesion20.85NA12.314.97NA38.13090
    61535ARemove brain electrodes11.56NA7.562.74NA21.86090
    61536ARemoval of brain lesion35.32NA20.118.01NA63.44090
    61537ARemoval of brain tissue24.86NA14.636.45NA45.94090
    61538ARemoval of brain tissue26.66NA15.586.45NA48.69090
    61539ARemoval of brain tissue31.90NA18.077.93NA57.90090
    61540ARemoval of brain tissue29.83NA17.697.93NA55.45090
    61541AIncision of brain tissue28.69NA16.486.59NA51.76090
    61542ARemoval of brain tissue30.84NA18.127.78NA56.74090
    61543ARemoval of brain tissue29.05NA16.657.32NA53.02090
    61544ARemove & treat brain lesion25.35NA14.085.89NA45.32090
    61545AExcision of brain tumor43.55NA24.6310.64NA78.82090
    61546ARemoval of pituitary gland31.12NA17.797.26NA56.17090
    61548ARemoval of pituitary gland21.41NA13.004.35NA38.76090
    61550ARelease of skull seams14.57NA7.101.37NA23.04090
    61552ARelease of skull seams19.45NA9.311.05NA29.81090
    61556AIncise skull/sutures22.13NA11.574.28NA37.98090
    61557AIncise skull/sutures22.25NA13.855.61NA41.71090
    61558AExcision of skull/sutures25.43NA14.433.13NA42.99090
    61559AExcision of skull/sutures32.60NA19.638.22NA60.45090
    61563AExcision of skull tumor26.68NA15.515.35NA47.54090
    61564AExcision of skull tumor33.64NA18.598.49NA60.72090
    61566ARemoval of brain tissue30.82NA17.626.45NA54.89090
    61567AIncision of brain tissue35.30NA20.986.45NA62.73090
    61570ARemove foreign body, brain24.46NA14.155.51NA44.12090
    61571AIncise skull for brain wound26.24NA15.396.27NA47.90090
    61575ASkull base/brainstem surgery34.16NA19.966.02NA60.14090
    61576ASkull base/brainstem surgery52.13NA30.005.61NA87.74090
    61580ACraniofacial approach, skull30.18NA25.773.30NA59.25090
    61581ACraniofacial approach, skull34.40NA23.504.04NA61.94090
    61582ACraniofacial approach, skull31.48NA27.437.55NA66.46090
    61583ACraniofacial approach, skull36.00NA25.348.32NA69.66090
    61584AOrbitocranial approach/skull34.45NA24.757.83NA67.03090
    61585AOrbitocranial approach/skull38.39NA26.797.42NA72.60090
    61586AResect nasopharynx, skull24.96NA22.674.22NA51.85090
    61590AInfratemporal approach/skull41.54NA29.155.13NA75.82090
    61591AInfratemporal approach/skull43.43NA30.096.30NA79.82090
    61592AOrbitocranial approach/skull39.41NA26.969.05NA75.42090
    61595ATranstemporal approach/skull29.40NA22.783.66NA55.84090
    61596ATranscochlear approach/skull35.43NA24.895.09NA65.41090
    61597ATranscondylar approach/skull37.74NA23.377.97NA69.08090
    61598ATranspetrosal approach/skull33.22NA23.665.51NA62.39090
    61600AResect/excise cranial lesion25.70NA20.163.74NA49.60090
    61601AResect/excise cranial lesion27.73NA20.866.34NA54.93090
    61605AResect/excise cranial lesion29.16NA22.423.01NA54.59090
    61606AResect/excise cranial lesion38.61NA25.558.16NA72.32090
    61607AResect/excise cranial lesion36.06NA24.196.82NA67.07090
    61608AResect/excise cranial lesion41.86NA27.029.96NA78.84090
    61609ATransect artery, sinus9.83NA4.922.48NA17.23ZZZ
    61610ATransect artery, sinus29.50NA13.334.22NA47.05ZZZ
    61611ATransect artery, sinus7.38NA3.871.86NA13.11ZZZ
    61612ATransect artery, sinus27.72NA13.504.26NA45.48ZZZ
    61613ARemove aneurysm, sinus40.63NA26.689.97NA77.28090
    61615AResect/excise lesion, skull31.89NA23.115.56NA60.56090
    Start Printed Page 63324
    61616AResect/excise lesion, skull43.08NA29.138.41NA80.62090
    61618ARepair dura16.89NA10.643.50NA31.03090
    61619ARepair dura20.59NA12.464.10NA37.15090
    61623AEndovasc tempory vessel occl9.90NA4.280.60NA14.78000
    61624ATranscath occlusion, cns20.04NA7.001.38NA28.42000
    61626ATranscath occlusion, non-cns16.53NA5.591.01NA23.13000
    61680AIntracranial vessel surgery30.53NA17.737.24NA55.50090
    61682AIntracranial vessel surgery61.22NA32.7215.21NA109.15090
    61684AIntracranial vessel surgery39.58NA22.379.43NA71.38090
    61686AIntracranial vessel surgery64.12NA35.2815.82NA115.22090
    61690AIntracranial vessel surgery29.14NA17.006.60NA52.74090
    61692AIntracranial vessel surgery51.57NA27.9312.19NA91.69090
    61697ABrain aneurysm repr, complx50.23NA28.4712.36NA91.06090
    61698ABrain aneurysm repr, complx48.13NA27.1211.97NA87.22090
    61700ABrain aneurysm repr, simple50.23NA28.2512.20NA90.68090
    61702AInner skull vessel surgery48.13NA26.4411.69NA86.26090
    61703AClamp neck artery17.37NA10.664.34NA32.37090
    61705ARevise circulation to head35.99NA19.577.99NA63.55090
    61708ARevise circulation to head35.10NA15.352.61NA53.06090
    61710ARevise circulation to head29.50NA13.802.90NA46.20090
    61711AFusion of skull arteries36.12NA20.148.86NA65.12090
    61720AIncise skull/brain surgery16.67NA10.154.21NA31.03090
    61735AIncise skull/brain surgery20.31NA12.374.99NA37.67090
    61750AIncise skull/brain biopsy18.10NA10.804.45NA33.35090
    61751ABrain biopsy w/ct/mr guide17.52NA11.014.28NA32.81090
    61760AImplant brain electrodes22.14NA8.915.50NA36.55090
    61770AIncise skull for treatment21.32NA12.454.90NA38.67090
    61790ATreat trigeminal nerve10.80NA6.052.18NA19.03090
    61791ATreat trigeminal tract14.53NA9.073.63NA27.23090
    61793AFocus radiation beam17.14NA10.294.21NA31.64090
    61795ABrain surgery using computer4.02NA2.060.97NA7.05ZZZ
    61850AImplant neuroelectrodes12.32NA7.812.67NA22.80090
    61860AImplant neuroelectrodes20.75NA12.274.84NA37.86090
    61862DImplant neurostimul, subcort0.000.000.000.000.000.00090
    61863AImplant neuroelectrode13.84NA9.344.76NA27.94090
    61864AImplant neuroelectrde, addl4.47NA2.311.13NA7.91ZZZ
    61867AImplant neuroelectrode22.83NA13.984.76NA41.57090
    61868AImplant neuroelectrde, addl7.87NA4.071.20NA13.14ZZZ
    61870AImplant neuroelectrodes14.85NA9.952.04NA26.84090
    61875AImplant neuroelectrodes14.97NA8.722.90NA26.59090
    61880ARevise/remove neuroelectrode6.25NA4.671.57NA12.49090
    61885AImplant neurostim one array5.82NA5.421.46NA12.70090
    61886AImplant neurostim arrays7.95NA6.471.97NA16.39090
    61888ARevise/remove neuroreceiver5.04NA3.941.25NA10.23010
    62000ATreat skull fracture12.46NA5.621.04NA19.12090
    62005ATreat skull fracture16.08NA8.952.79NA27.82090
    62010ATreatment of head injury19.70NA11.914.85NA36.46090
    62100ARepair brain fluid leakage21.90NA13.014.88NA39.79090
    62115AReduction of skull defect21.54NA11.845.43NA38.81090
    62116AReduction of skull defect23.46NA13.585.81NA42.85090
    62117AReduction of skull defect26.45NA15.636.66NA48.74090
    62120ARepair skull cavity lesion23.22NA14.493.68NA41.39090
    62121AIncise skull repair21.46NA12.892.96NA37.31090
    62140ARepair of skull defect13.43NA8.473.12NA25.02090
    62141ARepair of skull defect14.83NA9.213.42NA27.46090
    62142ARemove skull plate/flap10.73NA7.122.52NA20.37090
    62143AReplace skull plate/flap12.98NA8.193.06NA24.23090
    62145ARepair of skull & brain18.71NA11.094.57NA34.37090
    62146ARepair of skull with graft16.03NA9.803.52NA29.35090
    62147ARepair of skull with graft19.23NA11.514.36NA35.10090
    62148ARetr bone flap to fix skull1.99NA0.830.52NA3.34ZZZ
    62160ANeuroendoscopy add-on2.98NA1.150.62NA4.75ZZZ
    62161ADissect brain w/scope19.89NA9.664.43NA33.98090
    62162ARemove colloid cyst w/scope25.11NA11.826.92NA43.85090
    62163ANeuroendoscopy w/fb removal15.41NA7.934.43NA27.77090
    62164ARemove brain tumor w/scope27.34NA13.036.92NA47.29090
    62165ARemove pituit tumor w/scope21.87NA10.614.35NA36.83090
    62180AEstablish brain cavity shunt20.94NA12.495.18NA38.61090
    62190AEstablish brain cavity shunt11.01NA7.212.61NA20.83090
    62192AEstablish brain cavity shunt12.18NA7.762.95NA22.89090
    62194AReplace/irrigate catheter5.00NA2.860.60NA8.46010
    62200AEstablish brain cavity shunt18.22NA11.034.43NA33.68090
    62201ABrain cavity shunt w/scope14.78NA9.623.02NA27.42090
    62220AEstablish brain cavity shunt12.93NA8.133.03NA24.09090
    62223AEstablish brain cavity shunt12.80NA8.393.09NA24.28090
    Start Printed Page 63325
    62225AReplace/irrigate catheter5.38NA4.181.31NA10.87090
    62230AReplace/revise brain shunt10.48NA6.612.52NA19.61090
    62252ACsf shunt reprogram0.741.47NA0.212.42NAXXX
    6225226ACsf shunt reprogram0.740.380.380.191.311.31XXX
    62252TCACsf shunt reprogram0.001.09NA0.021.11NAXXX
    62256ARemove brain cavity shunt6.56NA4.791.61NA12.96090
    62258AReplace brain cavity shunt14.46NA8.863.49NA26.81090
    62263AEpidural lysis mult sessions6.1112.192.440.5018.809.05010
    62264AEpidural lysis on single day4.407.901.430.3612.666.19010
    62268ADrain spinal cord cyst4.7110.722.200.3515.787.26000
    62269ANeedle biopsy, spinal cord4.9912.342.030.3517.687.37000
    62270ASpinal fluid tap, diagnostic1.123.060.500.074.251.69000
    62272ADrain cerebro spinal fluid1.343.680.640.165.182.14000
    62273ATreat epidural spine lesion2.142.810.590.175.122.90000
    62280ATreat spinal cord lesion2.626.700.890.209.523.71010
    62281ATreat spinal cord lesion2.645.860.780.198.693.61010
    62282ATreat spinal canal lesion2.328.270.800.1710.763.29010
    62284AInjection for myelogram1.534.920.610.126.572.26000
    62287APercutaneous diskectomy8.03NA5.600.79NA14.42090
    62290AInject for spine disk x-ray2.986.871.300.2410.094.52000
    62291AInject for spine disk x-ray2.895.751.150.208.844.24000
    62292AInjection into disk lesion7.82NA4.570.78NA13.17090
    62294AInjection into spinal artery11.76NA5.701.02NA18.48090
    62310AInject spine c/t1.904.930.520.136.962.55000
    62311AInject spine l/s (cd)1.535.010.460.116.652.10000
    62318AInject spine w/cath, c/t2.035.630.530.147.802.70000
    62319AInject spine w/cath l/s (cd)1.864.920.490.136.912.48000
    62350AImplant spinal canal cath6.83NA4.090.77NA11.69090
    62351AImplant spinal canal cath9.94NA7.192.15NA19.28090
    62355ARemove spinal canal catheter5.42NA3.280.56NA9.26090
    62360AInsert spine infusion device2.61NA2.800.25NA5.66090
    62361AImplant spine infusion pump5.39NA4.000.60NA9.99090
    62362AImplant spine infusion pump7.00NA4.491.03NA12.52090
    62365ARemove spine infusion device5.39NA3.680.70NA9.77090
    62367CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236726AAnalyze spine infusion pump0.480.130.130.040.650.65XXX
    62367TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    62368CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236826AAnalyze spine infusion pump0.750.190.190.061.001.00XXX
    62368TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    63001ARemoval of spinal lamina15.73NA9.653.63NA29.01090
    63003ARemoval of spinal lamina15.86NA9.983.57NA29.41090
    63005ARemoval of spinal lamina14.83NA10.053.14NA28.02090
    63011ARemoval of spinal lamina14.44NA8.381.71NA24.53090
    63012ARemoval of spinal lamina15.31NA10.213.25NA28.77090
    63015ARemoval of spinal lamina19.24NA12.054.60NA35.89090
    63016ARemoval of spinal lamina19.09NA11.944.34NA35.37090
    63017ARemoval of spinal lamina15.85NA10.493.49NA29.83090
    63020ANeck spine disk surgery14.73NA9.793.46NA27.98090
    63030ALow back disk surgery11.93NA8.492.65NA23.07090
    63035ASpinal disk surgery add-on3.13NA1.610.68NA5.42ZZZ
    63040ALaminotomy, single cervical18.70NA11.644.03NA34.37090
    63042ALaminotomy, single lumbar17.37NA11.443.73NA32.54090
    63043CLaminotomy, addl cervical0.000.000.000.000.000.00ZZZ
    63044CLaminotomy, addl lumbar0.000.000.000.000.000.00ZZZ
    63045ARemoval of spinal lamina16.41NA10.493.82NA30.72090
    63046ARemoval of spinal lamina15.71NA10.293.46NA29.46090
    63047ARemoval of spinal lamina14.53NA9.963.13NA27.62090
    63048ARemove spinal lamina add-on3.24NA1.690.70NA5.63ZZZ
    63055ADecompress spinal cord21.86NA13.314.90NA40.07090
    63056ADecompress spinal cord20.24NA12.694.00NA36.93090
    63057ADecompress spine cord add-on5.23NA2.670.97NA8.87ZZZ
    63064ADecompress spinal cord24.47NA14.625.66NA44.75090
    63066ADecompress spine cord add-on3.24NA1.690.76NA5.69ZZZ
    63075ANeck spine disk surgery19.30NA12.244.47NA36.01090
    63076ANeck spine disk surgery4.03NA2.080.93NA7.04ZZZ
    63077ASpine disk surgery, thorax21.32NA12.864.12NA38.30090
    63078ASpine disk surgery, thorax3.26NA1.660.60NA5.52ZZZ
    63081ARemoval of vertebral body23.59NA14.505.35NA43.44090
    63082ARemove vertebral body add-on4.35NA2.250.98NA7.58ZZZ
    63085ARemoval of vertebral body26.77NA15.585.63NA47.98090
    63086ARemove vertebral body add-on3.17NA1.610.66NA5.44ZZZ
    63087ARemoval of vertebral body35.37NA19.637.04NA62.04090
    63088ARemove vertebral body add-on4.31NA2.200.92NA7.43ZZZ
    63090ARemoval of vertebral body28.00NA16.145.12NA49.26090
    Start Printed Page 63326
    63091ARemove vertebral body add-on3.01NA1.470.54NA5.02ZZZ
    63101ARemoval of vertebral body31.82NA19.575.66NA57.05090
    63102ARemoval of vertebral body31.82NA19.575.66NA57.05090
    63103ARemove vertebral body add-on3.88NA2.030.76NA6.67ZZZ
    63170AIncise spinal cord tract(s)19.72NA12.224.66NA36.60090
    63172ADrainage of spinal cyst17.56NA10.994.15NA32.70090
    63173ADrainage of spinal cyst21.86NA13.194.96NA40.01090
    63180ARevise spinal cord ligaments18.17NA11.354.59NA34.11090
    63182ARevise spinal cord ligaments20.38NA11.314.17NA35.86090
    63185AIncise spinal column/nerves14.95NA8.382.49NA25.82090
    63190AIncise spinal column/nerves17.35NA10.453.45NA31.25090
    63191AIncise spinal column/nerves17.44NA10.844.20NA32.48090
    63194AIncise spinal column & cord19.08NA12.054.81NA35.94090
    63195AIncise spinal column & cord18.73NA11.364.12NA34.21090
    63196AIncise spinal column & cord22.17NA13.745.59NA41.50090
    63197AIncise spinal column & cord20.99NA12.555.30NA38.84090
    63198AIncise spinal column & cord25.24NA8.776.36NA40.37090
    63199AIncise spinal column & cord26.74NA15.426.74NA48.90090
    63200ARelease of spinal cord19.07NA11.624.33NA35.02090
    63250ARevise spinal cord vessels40.53NA20.279.17NA69.97090
    63251ARevise spinal cord vessels40.97NA22.959.56NA73.48090
    63252ARevise spinal cord vessels40.96NA22.599.29NA72.84090
    63265AExcise intraspinal lesion21.44NA12.975.14NA39.55090
    63266AExcise intraspinal lesion22.17NA13.395.36NA40.92090
    63267AExcise intraspinal lesion17.85NA11.234.20NA33.28090
    63268AExcise intraspinal lesion18.41NA10.563.81NA32.78090
    63270AExcise intraspinal lesion26.65NA15.716.48NA48.84090
    63271AExcise intraspinal lesion26.77NA15.826.66NA49.25090
    63272AExcise intraspinal lesion25.18NA14.916.08NA46.17090
    63273AExcise intraspinal lesion24.15NA14.566.09NA44.80090
    63275ABiopsy/excise spinal tumor23.55NA13.995.61NA43.15090
    63276ABiopsy/excise spinal tumor23.32NA13.885.55NA42.75090
    63277ABiopsy/excise spinal tumor20.71NA12.694.83NA38.23090
    63278ABiopsy/excise spinal tumor20.44NA12.554.82NA37.81090
    63280ABiopsy/excise spinal tumor28.19NA16.576.95NA51.71090
    63281ABiopsy/excise spinal tumor27.89NA16.426.80NA51.11090
    63282ABiopsy/excise spinal tumor26.24NA15.576.39NA48.20090
    63283ABiopsy/excise spinal tumor24.86NA14.896.14NA45.89090
    63285ABiopsy/excise spinal tumor35.79NA20.268.76NA64.81090
    63286ABiopsy/excise spinal tumor35.43NA20.218.47NA64.11090
    63287ABiopsy/excise spinal tumor36.49NA20.778.97NA66.23090
    63290ABiopsy/excise spinal tumor37.17NA20.919.17NA67.25090
    63300ARemoval of vertebral body24.29NA14.515.73NA44.53090
    63301ARemoval of vertebral body27.44NA15.716.03NA49.18090
    63302ARemoval of vertebral body27.65NA16.036.29NA49.97090
    63303ARemoval of vertebral body30.33NA17.116.24NA53.68090
    63304ARemoval of vertebral body30.16NA17.545.66NA53.36090
    63305ARemoval of vertebral body31.85NA18.186.46NA56.49090
    63306ARemoval of vertebral body32.04NA18.002.86NA52.90090
    63307ARemoval of vertebral body31.45NA17.005.07NA53.52090
    63308ARemove vertebral body add-on5.22NA2.641.21NA9.07ZZZ
    63600ARemove spinal cord lesion13.94NA5.541.46NA20.94090
    63610AStimulation of spinal cord8.6856.382.330.5265.5811.53000
    63615ARemove lesion of spinal cord16.19NA9.353.42NA28.96090
    63650AImplant neuroelectrodes6.70NA3.300.58NA10.58090
    63655AImplant neuroelectrodes10.23NA7.002.22NA19.45090
    63660ARevise/remove neuroelectrode6.12NA3.710.78NA10.61090
    63685AImplant neuroreceiver7.00NA4.251.15NA12.40090
    63688ARevise/remove neuroreceiver5.36NA3.640.84NA9.84090
    63700ARepair of spinal herniation16.44NA10.403.22NA30.06090
    63702ARepair of spinal herniation18.37NA10.941.63NA30.94090
    63704ARepair of spinal herniation21.06NA13.054.60NA38.71090
    63706ARepair of spinal herniation23.97NA13.835.67NA43.47090
    63707ARepair spinal fluid leakage11.20NA7.782.35NA21.33090
    63709ARepair spinal fluid leakage14.24NA9.482.98NA26.70090
    63710AGraft repair of spine defect13.99NA9.163.13NA26.28090
    63740AInstall spinal shunt11.30NA7.482.58NA21.36090
    63741AInstall spinal shunt8.20NA4.861.26NA14.32090
    63744ARevision of spinal shunt8.05NA5.361.81NA15.22090
    63746ARemoval of spinal shunt6.39NA3.881.38NA11.65090
    64400AN block inj, trigeminal1.102.040.370.073.211.54000
    64402AN block inj, facial1.241.770.540.083.091.86000
    64405AN block inj, occipital1.311.550.400.102.961.81000
    64408AN block inj, vagus1.401.600.660.113.112.17000
    64410AN block inj, phrenic1.422.640.410.104.161.93000
    Start Printed Page 63327
    64412AN block inj, spinal accessor1.172.780.370.104.051.64000
    64413AN block inj, cervical plexus1.391.930.450.113.431.95000
    64415AN block inj, brachial plexus1.472.910.400.104.481.97000
    64416AN block cont infuse, b plex3.48NA0.720.10NA4.30010
    64417AN block inj, axillary1.433.160.440.114.701.98000
    64418AN block inj, suprascapular1.312.720.380.084.111.77000
    64420AN block inj, intercost, sng1.173.580.360.084.831.61000
    64421AN block inj, intercost, mlt1.675.450.470.127.242.26000
    64425AN block inj ilio-ing/hypogi1.741.740.490.133.612.36000
    64430AN block inj, pudendal1.452.630.510.134.212.09000
    64435AN block inj, paracervical1.442.640.640.184.262.26000
    64445AN block inj, sciatic, sng1.472.750.390.104.321.96000
    64446AN blk inj, sciatic, cont inf3.23NA1.200.10NA4.53010
    64447AN block inj fem, single1.49NA0.520.10NA2.11000
    64448AN block inj fem, cont inf2.98NA1.030.10NA4.11010
    64449AN block inj, lumbar plexus2.98NA0.980.10NA4.06010
    64450AN block, other peripheral1.261.290.420.102.651.78000
    64470AInj paravertebral c/t1.844.920.580.146.902.56000
    64472AInj paravertebral c/t add-on1.281.960.320.113.351.71ZZZ
    64475AInj paravertebral l/s1.404.610.490.116.122.00000
    64476AInj paravertebral l/s add-on0.971.840.250.072.881.29ZZZ
    64479AInj foramen epidural c/t2.197.140.730.179.503.09000
    64480AInj foramen epidural add-on1.532.430.480.114.072.12ZZZ
    64483AInj foramen epidural l/s1.897.640.660.149.672.69000
    64484AInj foramen epidural add-on1.322.840.380.104.261.80ZZZ
    64505AN block, spenopalatine gangl1.351.240.490.102.691.94000
    64508AN block, carotid sinus s/p1.113.010.520.074.191.70000
    64510AN block, stellate ganglion1.213.270.390.084.561.68000
    64517AN block inj, hypogas plxs2.192.760.890.135.083.21000
    64520AN block, lumbar/thoracic1.344.630.430.106.071.87000
    64530AN block inj, celiac pelus1.574.010.490.115.692.17000
    64550AApply neurostimulator0.180.300.050.010.490.24000
    64553AImplant neuroelectrodes2.302.771.880.205.274.38010
    64555AImplant neuroelectrodes2.263.161.230.135.553.62010
    64560AImplant neuroelectrodes2.352.691.340.205.243.89010
    64561AImplant neuroelectrodes6.70NA3.200.13NA10.03010
    64565AImplant neuroelectrodes1.753.391.280.105.243.13010
    64573AImplant neuroelectrodes7.46NA5.301.77NA14.53090
    64575AImplant neuroelectrodes4.33NA2.750.44NA7.52090
    64577AImplant neuroelectrodes4.59NA3.310.60NA8.50090
    64580AImplant neuroelectrodes4.10NA3.600.25NA7.95090
    64581AImplant neuroelectrodes13.42NA5.470.44NA19.33090
    64585ARevise/remove neuroelectrode2.0511.701.750.3514.104.15010
    64590AImplant neuroreceiver2.397.411.930.4810.284.80010
    64595ARevise/remove neuroreceiver1.7210.901.530.2612.883.51010
    64600AInjection treatment of nerve3.438.561.600.3412.335.37010
    64605AInjection treatment of nerve5.588.742.090.6414.968.31010
    64610AInjection treatment of nerve7.128.003.631.3416.4612.09010
    64612ADestroy nerve, face muscle1.952.661.080.114.723.14010
    64613ADestroy nerve, spine muscle1.953.011.000.125.083.07010
    64614ADestroy nerve, extrem musc2.193.281.130.115.583.43010
    64620AInjection treatment of nerve2.824.671.210.207.694.23010
    64622ADestr paravertebrl nerve l/s2.987.741.260.2010.924.44010
    64623ADestr paravertebral n add-on0.982.460.230.073.511.28ZZZ
    64626ADestr paravertebrl nerve c/t3.266.791.900.2610.315.42010
    64627ADestr paravertebral n add-on1.152.650.270.103.901.52ZZZ
    64630AInjection treatment of nerve2.982.781.310.195.954.48010
    64640AInjection treatment of nerve2.744.321.710.137.194.58010
    64680AInjection treatment of nerve2.616.081.310.188.874.10010
    64681AInjection treatment of nerve3.538.812.130.1812.525.84010
    64702ARevise finger/toe nerve4.21NA3.860.61NA8.68090
    64704ARevise hand/foot nerve4.54NA3.310.71NA8.56090
    64708ARevise arm/leg nerve6.09NA4.870.98NA11.94090
    64712ARevision of sciatic nerve7.71NA5.090.65NA13.45090
    64713ARevision of arm nerve(s)10.94NA5.981.21NA18.13090
    64714ARevise low back nerve(s)10.27NA4.350.77NA15.39090
    64716ARevision of cranial nerve6.27NA5.320.71NA12.30090
    64718ARevise ulnar nerve at elbow5.96NA5.941.04NA12.94090
    64719ARevise ulnar nerve at wrist4.82NA4.510.76NA10.09090
    64721ACarpal tunnel surgery4.275.015.010.719.999.99090
    64722ARelieve pressure on nerve(s)4.67NA3.130.38NA8.18090
    64726ARelease foot/toe nerve4.16NA2.800.68NA7.64090
    64727AInternal nerve revision3.08NA1.520.48NA5.08ZZZ
    64732AIncision of brow nerve4.38NA3.580.92NA8.88090
    64734AIncision of cheek nerve4.89NA4.120.99NA10.00090
    Start Printed Page 63328
    64736AIncision of chin nerve4.57NA4.090.85NA9.51090
    64738AIncision of jaw nerve5.70NA4.671.01NA11.38090
    64740AIncision of tongue nerve5.56NA4.450.52NA10.53090
    64742AIncision of facial nerve6.18NA4.790.83NA11.80090
    64744AIncise nerve, back of head5.21NA3.851.17NA10.23090
    64746AIncise diaphragm nerve5.90NA4.400.90NA11.20090
    64752AIncision of vagus nerve7.02NA4.270.99NA12.28090
    64755AIncision of stomach nerves13.44NA5.751.39NA20.58090
    64760AIncision of vagus nerve6.92NA3.570.61NA11.10090
    64761AIncision of pelvis nerve6.37NA3.620.31NA10.30090
    64763AIncise hip/thigh nerve6.89NA5.300.92NA13.11090
    64766AIncise hip/thigh nerve8.62NA5.341.19NA15.15090
    64771ASever cranial nerve7.31NA5.651.58NA14.54090
    64772AIncision of spinal nerve7.17NA4.991.44NA13.60090
    64774ARemove skin nerve lesion5.14NA3.850.72NA9.71090
    64776ARemove digit nerve lesion5.09NA3.720.76NA9.57090
    64778ADigit nerve surgery add-on3.09NA1.520.46NA5.07ZZZ
    64782ARemove limb nerve lesion6.19NA3.790.95NA10.93090
    64783ALimb nerve surgery add-on3.70NA1.870.58NA6.15ZZZ
    64784ARemove nerve lesion9.76NA6.641.40NA17.80090
    64786ARemove sciatic nerve lesion15.37NA9.942.66NA27.97090
    64787AImplant nerve end4.28NA2.150.67NA7.10ZZZ
    64788ARemove skin nerve lesion4.58NA3.510.65NA8.74090
    64790ARemoval of nerve lesion11.25NA7.282.01NA20.54090
    64792ARemoval of nerve lesion14.83NA8.932.25NA26.01090
    64795ABiopsy of nerve2.99NA1.610.48NA5.08000
    64802ARemove sympathetic nerves9.10NA5.181.04NA15.32090
    64804ARemove sympathetic nerves14.56NA7.142.15NA23.85090
    64809ARemove sympathetic nerves13.59NA5.821.15NA20.56090
    64818ARemove sympathetic nerves10.24NA5.281.29NA16.81090
    64820ARemove sympathetic nerves10.31NA7.201.40NA18.91090
    64821ARemove sympathetic nerves8.70NA7.421.19NA17.31090
    64822ARemove sympathetic nerves8.70NA7.351.19NA17.24090
    64823ARemove sympathetic nerves10.31NA8.271.40NA19.98090
    64831ARepair of digit nerve9.39NA7.121.37NA17.88090
    64832ARepair nerve add-on5.63NA2.980.82NA9.43ZZZ
    64834ARepair of hand or foot nerve10.13NA7.141.47NA18.74090
    64835ARepair of hand or foot nerve10.88NA7.751.63NA20.26090
    64836ARepair of hand or foot nerve10.88NA7.721.58NA20.18090
    64837ARepair nerve add-on6.22NA3.270.96NA10.45ZZZ
    64840ARepair of leg nerve12.95NA8.381.03NA22.36090
    64856ARepair/transpose nerve13.72NA9.272.05NA25.04090
    64857ARepair arm/leg nerve14.41NA9.722.11NA26.24090
    64858ARepair sciatic nerve16.40NA10.863.33NA30.59090
    64859ANerve surgery4.24NA2.220.60NA7.06ZZZ
    64861ARepair of arm nerves19.13NA11.932.94NA34.00090
    64862ARepair of low back nerves19.33NA12.102.96NA34.39090
    64864ARepair of facial nerve12.48NA8.191.35NA22.02090
    64865ARepair of facial nerve15.15NA9.971.64NA26.76090
    64866AFusion of facial/other nerve15.65NA9.821.27NA26.74090
    64868AFusion of facial/other nerve13.96NA8.971.68NA24.61090
    64870AFusion of facial/other nerve15.90NA8.841.29NA26.03090
    64872ASubsequent repair of nerve1.98NA1.090.29NA3.36ZZZ
    64874ARepair & revise nerve add-on2.96NA1.550.41NA4.92ZZZ
    64876ARepair nerve/shorten bone3.36NA1.300.47NA5.13ZZZ
    64885ANerve graft, head or neck17.43NA11.041.81NA30.28090
    64886ANerve graft, head or neck20.63NA12.892.07NA35.59090
    64890ANerve graft, hand or foot15.06NA10.092.09NA27.24090
    64891ANerve graft, hand or foot16.05NA7.741.65NA25.44090
    64892ANerve graft, arm or leg14.57NA8.971.98NA25.52090
    64893ANerve graft, arm or leg15.51NA9.992.12NA27.62090
    64895ANerve graft, hand or foot19.14NA9.762.45NA31.35090
    64896ANerve graft, hand or foot20.37NA11.152.22NA33.74090
    64897ANerve graft, arm or leg18.14NA10.823.16NA32.12090
    64898ANerve graft, arm or leg19.39NA11.953.25NA34.59090
    64901ANerve graft add-on10.16NA5.341.19NA16.69ZZZ
    64902ANerve graft add-on11.76NA6.051.32NA19.13ZZZ
    64905ANerve pedicle transfer13.94NA8.651.82NA24.41090
    64907ANerve pedicle transfer18.72NA12.622.15NA33.49090
    64999CNervous system surgery0.000.000.000.000.000.00YYY
    65091ARevise eye6.42NA9.830.31NA16.56090
    65093ARevise eye with implant6.83NA10.190.34NA17.36090
    65101ARemoval of eye6.99NA10.770.34NA18.10090
    65103ARemove eye/insert implant7.53NA10.980.36NA18.87090
    65105ARemove eye/attach implant8.44NA11.640.41NA20.49090
    Start Printed Page 63329
    65110ARemoval of eye13.87NA14.770.82NA29.46090
    65112ARemove eye/revise socket16.29NA17.061.15NA34.50090
    65114ARemove eye/revise socket17.43NA17.281.13NA35.84090
    65125ARevise ocular implant3.109.323.000.1812.606.28090
    65130AInsert ocular implant7.11NA10.360.34NA17.81090
    65135AInsert ocular implant7.29NA10.530.35NA18.17090
    65140AAttach ocular implant7.97NA10.990.37NA19.33090
    65150ARevise ocular implant6.22NA9.380.30NA15.90090
    65155AReinsert ocular implant8.61NA11.720.48NA20.81090
    65175ARemoval of ocular implant6.24NA9.750.31NA16.30090
    65205ARemove foreign body from eye0.710.610.190.041.360.94000
    65210ARemove foreign body from eye0.840.740.300.041.621.18000
    65220ARemove foreign body from eye0.710.610.180.061.380.95000
    65222ARemove foreign body from eye0.920.760.270.051.731.24000
    65235ARemove foreign body from eye7.53NA7.340.36NA15.23090
    65260ARemove foreign body from eye10.90NA11.540.52NA22.96090
    65265ARemove foreign body from eye12.52NA12.780.60NA25.90090
    65270ARepair of eye wound1.893.862.270.105.854.26010
    65272ARepair of eye wound3.805.855.270.199.849.26090
    65273ARepair of eye wound4.34NA5.700.20NA10.24090
    65275ARepair of eye wound5.315.745.740.3211.3711.37090
    65280ARepair of eye wound7.62NA8.260.36NA16.24090
    65285ARepair of eye wound12.83NA12.510.61NA25.95090
    65286ARepair of eye wound5.488.517.600.2514.2413.33090
    65290ARepair of eye socket wound5.38NA6.550.31NA12.24090
    65400ARemoval of eye lesion6.038.727.550.2915.0413.87090
    65410ABiopsy of cornea1.461.730.650.073.262.18000
    65420ARemoval of eye lesion4.157.606.800.2011.9511.15090
    65426ARemoval of eye lesion5.227.566.610.2413.0212.07090
    65430ACorneal smear1.465.000.660.076.532.19000
    65435ACurette/treat cornea0.911.340.400.052.301.36000
    65436ACurette/treat cornea4.175.915.280.2010.289.65090
    65450ATreatment of corneal lesion3.257.276.390.1610.689.80090
    65600ARevision of cornea3.385.703.150.179.256.70090
    65710ACorneal transplant12.28NA12.460.59NA25.33090
    65730ACorneal transplant14.17NA11.980.67NA26.82090
    65750ACorneal transplant14.91NA13.490.71NA29.11090
    65755ACorneal transplant14.81NA13.410.70NA28.92090
    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 implant17.46NA14.470.83NA32.76090
    65771NRadial keratotomy0.000.000.000.000.000.00XXX
    65772ACorrection of astigmatism4.277.236.530.2011.7011.00090
    65775ACorrection of astigmatism5.76NA7.430.26NA13.45090
    65780AOcular reconst, transplant10.19NA10.040.35NA20.58090
    65781AOcular reconst, transplant17.57NA13.450.35NA31.37090
    65782AOcular reconst, transplant14.91NA11.790.35NA27.05090
    65800ADrainage of eye1.902.291.190.104.293.19000
    65805ADrainage of eye1.902.291.190.104.293.19000
    65810ADrainage of eye4.84NA8.130.23NA13.20090
    65815ADrainage of eye5.028.467.560.2413.7212.82090
    65820ARelieve inner eye pressure8.08NA10.750.38NA19.21090
    65850AIncision of eye10.46NA9.490.49NA20.44090
    65855ALaser surgery of eye3.835.264.090.209.298.12010
    65860AIncise inner eye adhesions3.533.943.280.177.646.98090
    65865AIncise inner eye adhesions5.57NA6.560.26NA12.39090
    65870AIncise inner eye adhesions6.23NA7.210.29NA13.73090
    65875AIncise inner eye adhesions6.50NA7.520.30NA14.32090
    65880AIncise inner eye adhesions7.05NA7.760.34NA15.15090
    65900ARemove eye lesion10.87NA11.600.55NA23.02090
    65920ARemove implant of eye8.35NA8.800.40NA17.55090
    65930ARemove blood clot from eye7.40NA7.820.35NA15.57090
    66020AInjection treatment of eye1.582.401.600.084.063.26010
    66030AInjection treatment of eye1.242.231.440.063.532.74010
    66130ARemove eye lesion7.657.566.990.3715.5815.01090
    66150AGlaucoma surgery8.25NA9.940.40NA18.59090
    66155AGlaucoma surgery8.24NA9.910.38NA18.53090
    66160AGlaucoma surgery10.11NA10.770.49NA21.37090
    66165AGlaucoma surgery7.96NA9.790.37NA18.12090
    66170AGlaucoma surgery12.09NA12.560.58NA25.23090
    66172AIncision of eye14.95NA15.260.71NA30.92090
    66180AImplant eye shunt14.47NA11.670.68NA26.82090
    66185ARevise eye shunt8.09NA8.280.38NA16.75090
    66220ARepair eye lesion7.73NA8.830.38NA16.94090
    Start Printed Page 63330
    66225ARepair/graft eye lesion10.99NA9.420.53NA20.94090
    66250AFollow-up surgery of eye5.957.746.570.2813.9712.80090
    66500AIncision of iris3.69NA5.150.18NA9.02090
    66505AIncision of iris4.06NA5.440.20NA9.70090
    66600ARemove iris and lesion8.63NA8.990.41NA18.03090
    66605ARemoval of iris12.72NA11.370.73NA24.82090
    66625ARemoval of iris5.107.096.350.2412.4311.69090
    66630ARemoval of iris6.12NA7.500.29NA13.91090
    66635ARemoval of iris6.21NA6.710.29NA13.21090
    66680ARepair iris & ciliary body5.41NA6.100.25NA11.76090
    66682ARepair iris & ciliary body6.17NA7.500.29NA13.96090
    66700ADestruction, ciliary body4.755.404.090.2310.389.07090
    66710ADestruction, ciliary body4.755.273.880.2210.248.85090
    66720ADestruction, ciliary body4.755.764.640.2310.749.62090
    66740ADestruction, ciliary body4.755.434.260.2210.409.23090
    66761ARevision of iris4.055.614.280.199.858.52090
    66762ARevision of iris4.555.694.270.2210.469.04090
    66770ARemoval of inner eye lesion5.156.114.770.2411.5010.16090
    66820AIncision, secondary cataract3.87NA7.180.19NA11.24090
    66821AAfter cataract laser surgery2.344.013.920.126.476.38090
    66825AReposition intraocular lens8.18NA10.180.38NA18.74090
    66830ARemoval of lens lesion8.15NA7.150.38NA15.68090
    66840ARemoval of lens material7.86NA7.070.37NA15.30090
    66850ARemoval of lens material9.06NA7.830.43NA17.32090
    66852ARemoval of lens material9.91NA8.290.47NA18.67090
    66920AExtraction of lens8.81NA7.510.42NA16.74090
    66930AExtraction of lens10.12NA8.640.49NA19.25090
    66940AExtraction of lens8.88NA8.100.42NA17.40090
    66982ACataract surgery, complex13.42NA10.020.67NA24.11090
    66983ACataract surg w/iol, 1 stage8.94NA6.270.44NA15.65090
    66984ACataract surg w/iol, 1 stage10.17NA7.700.49NA18.36090
    66985AInsert lens prosthesis8.34NA7.540.40NA16.28090
    66986AExchange lens prosthesis12.21NA9.310.59NA22.11090
    66990AOphthalmic endoscope add-on1.50NA0.690.07NA2.26ZZZ
    66999CEye surgery procedure0.000.000.000.000.000.00YYY
    67005APartial removal of eye fluid5.67NA4.430.26NA10.36090
    67010APartial removal of eye fluid6.83NA4.980.32NA12.13090
    67015ARelease of eye fluid6.88NA7.810.32NA15.01090
    67025AReplace eye fluid6.8014.387.580.3221.5014.70090
    67027AImplant eye drug system10.7912.918.890.5524.2520.23090
    67028AInjection eye drug2.516.571.150.139.213.79000
    67030AIncise inner eye strands4.81NA6.880.23NA11.92090
    67031ALaser surgery, eye strands3.654.784.130.188.617.96090
    67036ARemoval of inner eye fluid11.82NA9.450.56NA21.83090
    67038AStrip retinal membrane21.12NA16.001.01NA38.13090
    67039ALaser treatment of retina14.44NA12.670.68NA27.79090
    67040ALaser treatment of retina17.13NA14.170.82NA32.12090
    67101ARepair detached retina7.499.958.200.3517.7916.04090
    67105ARepair detached retina7.378.086.300.3515.8014.02090
    67107ARepair detached retina14.76NA12.950.70NA28.41090
    67108ARepair detached retina20.70NA17.210.98NA38.89090
    67110ARepair detached retina8.7615.549.330.4224.7218.51090
    67112ARerepair detached retina16.76NA14.760.79NA32.31090
    67115ARelease encircling material4.96NA7.160.23NA12.35090
    67120ARemove eye implant material5.9512.437.010.2818.6613.24090
    67121ARemove eye implant material10.61NA11.280.50NA22.39090
    67141ATreatment of retina5.177.326.560.2412.7311.97090
    67145ATreatment of retina5.345.814.990.2511.4010.58090
    67208ATreatment of retinal lesion6.666.015.440.3112.9812.41090
    67210ATreatment of retinal lesion8.776.315.850.4215.5015.04090
    67218ATreatment of retinal lesion18.42NA14.280.64NA33.34090
    67220ATreatment of choroid lesion13.069.938.930.6123.6022.60090
    67221ROcular photodynamic ther3.994.741.830.198.926.01000
    67225AEye photodynamic ther add-on0.470.260.220.010.740.70ZZZ
    67227ATreatment of retinal lesion6.546.455.440.3113.3012.29090
    67228ATreatment of retinal lesion12.6710.948.500.6024.2121.77090
    67250AReinforce eye wall8.61NA10.480.43NA19.52090
    67255AReinforce/graft eye wall8.85NA11.070.42NA20.34090
    67299CEye surgery procedure0.000.000.000.000.000.00YYY
    67311ARevise eye muscle6.61NA6.490.32NA13.42090
    67312ARevise two eye muscles8.49NA7.630.42NA16.54090
    67314ARevise eye muscle7.48NA7.340.36NA15.18090
    67316ARevise two eye muscles9.60NA8.310.48NA18.39090
    67318ARevise eye muscle(s)7.81NA7.720.37NA15.90090
    67320ARevise eye muscle(s) add-on4.31NA1.980.20NA6.49ZZZ
    Start Printed Page 63331
    67331AEye surgery follow-up add-on4.04NA1.930.20NA6.17ZZZ
    67332ARerevise eye muscles add-on4.46NA2.050.22NA6.73ZZZ
    67334ARevise eye muscle w/suture3.96NA1.820.19NA5.97ZZZ
    67335AEye suture during surgery2.48NA1.140.12NA3.74ZZZ
    67340ARevise eye muscle add-on4.90NA2.250.23NA7.38ZZZ
    67343ARelease eye tissue7.31NA7.410.36NA15.08090
    67345ADestroy nerve of eye muscle2.944.421.390.167.524.49010
    67350ABiopsy eye muscle2.85NA1.890.16NA4.90000
    67399CEye muscle surgery procedure0.000.000.000.000.000.00YYY
    67400AExplore/biopsy eye socket9.70NA12.640.52NA22.86090
    67405AExplore/drain eye socket7.88NA11.210.43NA19.52090
    67412AExplore/treat eye socket9.45NA13.100.49NA23.04090
    67413AExplore/treat eye socket9.94NA12.260.52NA22.72090
    67414AExplr/decompress eye socket11.07NA14.170.58NA25.82090
    67415AAspiration, orbital contents1.75NA0.770.11NA2.63000
    67420AExplore/treat eye socket19.95NA18.961.01NA39.92090
    67430AExplore/treat eye socket13.31NA16.041.16NA30.51090
    67440AExplore/drain eye socket13.02NA15.640.70NA29.36090
    67445AExplr/decompress eye socket14.34NA15.840.76NA30.94090
    67450AExplore/biopsy eye socket13.43NA15.990.67NA30.09090
    67500AInject/treat eye socket0.790.830.190.051.671.03000
    67505AInject/treat eye socket0.820.920.210.051.791.08000
    67515AInject/treat eye socket0.610.830.280.021.460.91000
    67550AInsert eye socket implant10.13NA12.400.60NA23.13090
    67560ARevise eye socket implant10.54NA12.430.56NA23.53090
    67570ADecompress optic nerve13.50NA15.380.83NA29.71090
    67599COrbit surgery procedure0.000.000.000.000.000.00YYY
    67700ADrainage of eyelid abscess1.344.880.640.076.292.05010
    67710AIncision of eyelid1.015.040.540.056.101.60010
    67715AIncision of eyelid fold1.214.620.630.065.891.90010
    67800ARemove eyelid lesion1.372.520.690.073.962.13010
    67801ARemove eyelid lesions1.875.400.930.107.372.90010
    67805ARemove eyelid lesions2.215.551.080.117.873.40010
    67808ARemove eyelid lesion(s)3.78NA5.290.20NA9.27090
    67810ABiopsy of eyelid1.473.690.680.075.232.22000
    67820ARevise eyelashes0.881.120.380.052.051.31000
    67825ARevise eyelashes1.371.601.080.073.042.52010
    67830ARevise eyelashes1.697.551.970.089.323.74010
    67835ARevise eyelashes5.53NA5.050.26NA10.84090
    67840ARemove eyelid lesion2.035.381.000.107.513.13010
    67850ATreat eyelid lesion1.686.121.920.087.883.68010
    67875AClosure of eyelid by suture1.347.110.630.078.522.04000
    67880ARevision of eyelid3.789.754.350.1913.728.32090
    67882ARevision of eyelid5.0411.135.560.2516.4210.85090
    67900ARepair brow defect6.1110.636.380.3617.1012.85090
    67901ARepair eyelid defect6.93NA6.470.38NA13.78090
    67902ARepair eyelid defect6.99NA6.540.41NA13.94090
    67903ARepair eyelid defect6.3311.396.760.4718.1913.56090
    67904ARepair eyelid defect6.2212.617.240.3119.1413.77090
    67906ARepair eyelid defect6.759.206.070.5016.4513.32090
    67908ARepair eyelid defect5.108.935.740.2414.2711.08090
    67909ARevise eyelid defect5.379.476.140.3015.1411.81090
    67911ARevise eyelid defect5.24NA6.100.28NA11.62090
    67912ACorrection eyelid w/ implant5.6520.595.330.2826.5211.26090
    67914ARepair eyelid defect3.669.403.990.1913.257.84090
    67915ARepair eyelid defect3.167.992.610.1611.315.93090
    67916ARepair eyelid defect5.2811.905.750.2617.4411.29090
    67917ARepair eyelid defect5.999.816.210.3016.1012.50090
    67921ARepair eyelid defect3.389.203.790.1712.757.34090
    67922ARepair eyelid defect3.047.943.520.1611.146.72090
    67923ARepair eyelid defect5.8511.475.960.2917.6112.10090
    67924ARepair eyelid defect5.769.205.720.2815.2411.76090
    67930ARepair eyelid wound3.598.482.980.2012.276.77010
    67935ARepair eyelid wound6.1811.486.010.3518.0112.54090
    67938ARemove eyelid foreign body1.325.870.570.077.261.96010
    67950ARevision of eyelid5.798.346.640.3614.4912.79090
    67961ARevision of eyelid5.6610.275.760.3116.2411.73090
    67966ARevision of eyelid6.538.425.730.4015.3512.66090
    67971AReconstruction of eyelid9.73NA7.340.50NA17.57090
    67973AReconstruction of eyelid12.80NA9.330.71NA22.84090
    67974AReconstruction of eyelid12.77NA9.240.65NA22.66090
    67975AReconstruction of eyelid9.08NA7.020.46NA16.56090
    67999CRevision of eyelid0.000.000.000.000.000.00YYY
    68020AIncise/drain eyelid lining1.365.750.680.077.182.11010
    68040ATreatment of eyelid lesions0.854.860.390.045.751.28000
    Start Printed Page 63332
    68100ABiopsy of eyelid lining1.345.070.620.076.482.03000
    68110ARemove eyelid lining lesion1.766.121.420.087.963.26010
    68115ARemove eyelid lining lesion2.355.621.140.128.093.61010
    68130ARemove eyelid lining lesion4.908.204.330.2313.339.46090
    68135ARemove eyelid lining lesion1.835.380.910.087.292.82010
    68200ATreat eyelid by injection0.490.730.230.021.240.74000
    68320ARevise/graft eyelid lining5.346.635.470.2512.2211.06090
    68325ARevise/graft eyelid lining7.32NA6.460.36NA14.14090
    68326ARevise/graft eyelid lining7.11NA6.340.36NA13.81090
    68328ARevise/graft eyelid lining8.13NA7.080.48NA15.69090
    68330ARevise eyelid lining4.807.326.110.2312.3511.14090
    68335ARevise/graft eyelid lining7.15NA6.870.35NA14.37090
    68340ASeparate eyelid adhesions4.1510.914.790.2015.269.14090
    68360ARevise eyelid lining4.356.685.640.2011.2310.19090
    68362ARevise eyelid lining7.30NA7.800.35NA15.45090
    68371AHarvest eye tissue, alograft4.87NA4.660.20NA9.73010
    68399CEyelid lining surgery0.000.000.000.000.000.00YYY
    68400AIncise/drain tear gland1.687.692.060.089.453.82010
    68420AIncise/drain tear sac2.298.012.350.1210.424.76010
    68440AIncise tear duct opening0.934.990.500.055.971.48010
    68500ARemoval of tear gland10.96NA10.270.72NA21.95090
    68505APartial removal, tear gland10.88NA11.280.68NA22.84090
    68510ABiopsy of tear gland4.588.502.110.2313.316.92000
    68520ARemoval of tear sac7.47NA7.850.40NA15.72090
    68525ABiopsy of tear sac4.40NA2.040.22NA6.66000
    68530AClearance of tear duct3.649.552.880.1913.386.71010
    68540ARemove tear gland lesion10.54NA9.880.55NA20.97090
    68550ARemove tear gland lesion13.18NA11.870.79NA25.84090
    68700ARepair tear ducts6.56NA7.360.32NA14.24090
    68705ARevise tear duct opening2.055.511.010.107.663.16010
    68720ACreate tear sac drain8.91NA8.350.46NA17.72090
    68745ACreate tear duct drain8.58NA8.320.46NA17.36090
    68750ACreate tear duct drain8.61NA8.770.44NA17.82090
    68760AClose tear duct opening1.724.041.250.085.843.05010
    68761AClose tear duct opening1.353.460.990.074.882.41010
    68770AClose tear system fistula6.9812.896.850.3420.2114.17090
    68801ADilate tear duct opening0.930.940.610.051.921.59010
    68810AProbe nasolacrimal duct1.892.340.930.104.332.92010
    68811AProbe nasolacrimal duct2.34NA2.370.12NA4.83010
    68815AProbe nasolacrimal duct3.188.252.710.1711.606.06010
    68840AExplore/irrigate tear ducts1.241.660.970.062.962.27010
    68850AInjection for tear sac x-ray0.8016.480.300.0417.321.14000
    68899CTear duct system surgery0.000.000.000.000.000.00YYY
    69000ADrain external ear lesion1.443.011.430.124.572.99010
    69005ADrain external ear lesion2.103.001.870.195.294.16010
    69020ADrain outer ear canal lesion1.473.972.070.135.573.67010
    69090NPierce earlobes0.000.000.000.000.000.00XXX
    69100ABiopsy of external ear0.811.760.400.052.621.26000
    69105ABiopsy of external ear canal0.852.330.770.073.251.69000
    69110ARemove external ear, partial3.424.113.060.297.826.77090
    69120ARemoval of external ear4.03NA4.010.37NA8.41090
    69140ARemove ear canal lesion(s)7.92NA6.760.67NA15.35090
    69145ARemove ear canal lesion(s)2.613.612.620.226.445.45090
    69150AExtensive ear canal surgery13.35NA10.001.28NA24.63090
    69155AExtensive ear/neck surgery20.68NA14.621.81NA37.11090
    69200AClear outer ear canal0.772.360.600.063.191.43000
    69205AClear outer ear canal1.19NA1.370.11NA2.67010
    69210ARemove impacted ear wax0.610.640.240.051.300.90000
    69220AClean out mastoid cavity0.832.340.740.073.241.64000
    69222AClean out mastoid cavity1.393.822.050.125.333.56010
    69300RRevise external ear6.32NA4.280.52NA11.12YYY
    69310ARebuild outer ear canal10.73NA8.460.92NA20.11090
    69320ARebuild outer ear canal16.86NA12.231.40NA30.49090
    69399COuter ear surgery procedure0.000.000.000.000.000.00YYY
    69400AInflate middle ear canal0.832.360.680.073.261.58000
    69401AInflate middle ear canal0.631.310.650.051.991.33000
    69405ACatheterize middle ear canal2.623.522.310.226.365.15010
    69410AInset middle ear (baffle)0.332.060.500.022.410.85000
    69420AIncision of eardrum1.323.111.600.124.553.04010
    69421AIncision of eardrum1.72NA2.110.16NA3.99010
    69424ARemove ventilating tube0.852.160.690.073.081.61000
    69433ACreate eardrum opening1.513.131.680.134.773.32010
    69436ACreate eardrum opening1.95NA2.240.17NA4.36010
    69440AExploration of middle ear7.53NA6.340.64NA14.51090
    69450AEardrum revision5.54NA5.070.47NA11.08090
    Start Printed Page 63333
    69501AMastoidectomy9.02NA7.130.78NA16.93090
    69502AMastoidectomy12.31NA9.361.03NA22.70090
    69505ARemove mastoid structures12.92NA9.621.10NA23.64090
    69511AExtensive mastoid surgery13.44NA9.951.15NA24.54090
    69530AExtensive mastoid surgery19.08NA13.141.58NA33.80090
    69535ARemove part of temporal bone35.93NA22.593.10NA61.62090
    69540ARemove ear lesion1.193.721.950.115.023.25010
    69550ARemove ear lesion10.93NA8.390.96NA20.28090
    69552ARemove ear lesion19.35NA13.061.63NA34.04090
    69554ARemove ear lesion32.97NA21.102.78NA56.85090
    69601AMastoid surgery revision13.16NA10.111.10NA24.37090
    69602AMastoid surgery revision13.50NA10.051.13NA24.68090
    69603AMastoid surgery revision13.94NA10.281.20NA25.42090
    69604AMastoid surgery revision13.94NA10.261.17NA25.37090
    69605AMastoid surgery revision18.38NA12.941.55NA32.87090
    69610ARepair of eardrum4.405.453.300.3710.228.07010
    69620ARepair of eardrum5.866.194.550.4812.5310.89090
    69631ARepair eardrum structures9.80NA7.940.83NA18.57090
    69632ARebuild eardrum structures12.68NA9.831.07NA23.58090
    69633ARebuild eardrum structures12.03NA9.491.01NA22.53090
    69635ARepair eardrum structures13.25NA9.501.04NA23.79090
    69636ARebuild eardrum structures15.13NA11.261.28NA27.67090
    69637ARebuild eardrum structures15.02NA11.201.27NA27.49090
    69641ARevise middle ear & mastoid12.64NA9.581.07NA23.29090
    69642ARevise middle ear & mastoid16.74NA12.241.41NA30.39090
    69643ARevise middle ear & mastoid15.23NA11.271.29NA27.79090
    69644ARevise middle ear & mastoid16.87NA12.191.43NA30.49090
    69645ARevise middle ear & mastoid16.29NA11.831.39NA29.51090
    69646ARevise middle ear & mastoid17.89NA12.761.51NA32.16090
    69650ARelease middle ear bone9.60NA7.480.82NA17.90090
    69660ARevise middle ear bone11.83NA8.701.01NA21.54090
    69661ARevise middle ear bone15.65NA11.191.32NA28.16090
    69662ARevise middle ear bone15.35NA10.911.29NA27.55090
    69666ARepair middle ear structures9.69NA7.550.82NA18.06090
    69667ARepair middle ear structures9.70NA7.540.86NA18.10090
    69670ARemove mastoid air cells11.44NA8.730.93NA21.10090
    69676ARemove middle ear nerve9.47NA7.680.83NA17.98090
    69700AClose mastoid fistula8.18NA5.930.66NA14.77090
    69710NImplant/replace hearing aid0.000.000.000.000.000.00XXX
    69711ARemove/repair hearing aid10.38NA8.150.74NA19.27090
    69714AImplant temple bone w/stimul13.92NA10.001.21NA25.13090
    69715ATemple bne implnt w/stimulat18.15NA12.501.58NA32.23090
    69717ATemple bone implant revision14.89NA9.671.29NA25.85090
    69718ARevise temple bone implant18.39NA12.411.61NA32.41090
    69720ARelease facial nerve14.30NA10.861.23NA26.39090
    69725ARelease facial nerve25.24NA17.012.13NA44.38090
    69740ARepair facial nerve15.87NA10.461.35NA27.68090
    69745ARepair facial nerve16.59NA11.461.20NA29.25090
    69799CMiddle ear surgery procedure0.000.000.000.000.000.00YYY
    69801AIncise inner ear8.51NA6.880.72NA16.11090
    69802AIncise inner ear13.03NA9.691.09NA23.81090
    69805AExplore inner ear13.74NA10.141.16NA25.04090
    69806AExplore inner ear12.28NA9.261.03NA22.57090
    69820AEstablish inner ear window10.28NA7.910.79NA18.98090
    69840ARevise inner ear window10.20NA6.980.77NA17.95090
    69905ARemove inner ear11.04NA8.380.92NA20.34090
    69910ARemove inner ear & mastoid13.55NA9.811.13NA24.49090
    69915AIncise inner ear nerve21.11NA14.301.85NA37.26090
    69930AImplant cochlear device16.71NA11.951.43NA30.09090
    69949CInner ear surgery procedure0.000.000.000.000.000.00YYY
    69950AIncise inner ear nerve25.49NA16.213.48NA45.18090
    69955ARelease facial nerve26.89NA17.762.27NA46.92090
    69960ARelease inner ear canal26.89NA17.242.91NA47.04090
    69970ARemove inner ear lesion29.87NA18.532.80NA51.20090
    69979CTemporal bone surgery0.000.000.000.000.000.00YYY
    69990RMicrosurgery add-on3.45NA1.820.67NA5.94ZZZ
    70010AContrast x-ray of brain1.184.70NA0.296.17NAXXX
    7001026AContrast x-ray of brain1.180.400.400.071.651.65XXX
    70010TCAContrast x-ray of brain0.004.30NA0.224.52NAXXX
    70015AContrast x-ray of brain1.181.74NA0.143.06NAXXX
    7001526AContrast x-ray of brain1.180.400.400.061.641.64XXX
    70015TCAContrast x-ray of brain0.001.34NA0.081.42NAXXX
    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
    Start Printed Page 63334
    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 jaw0.250.70NA0.051.00NAXXX
    7011026AX-ray exam of jaw0.250.080.080.010.340.34XXX
    70110TCAX-ray exam of jaw0.000.62NA0.040.66NAXXX
    70120AX-ray exam of mastoids0.180.68NA0.050.91NAXXX
    7012026AX-ray exam of mastoids0.180.060.060.010.250.25XXX
    70120TCAX-ray exam of mastoids0.000.62NA0.040.66NAXXX
    70130AX-ray exam of mastoids0.340.88NA0.061.28NAXXX
    7013026AX-ray exam of mastoids0.340.110.110.010.460.46XXX
    70130TCAX-ray exam of mastoids0.000.77NA0.050.82NAXXX
    70134AX-ray exam of middle ear0.340.83NA0.061.23NAXXX
    7013426AX-ray exam of middle ear0.340.110.110.010.460.46XXX
    70134TCAX-ray exam of middle ear0.000.72NA0.050.77NAXXX
    70140AX-ray exam of facial bones0.190.68NA0.050.92NAXXX
    7014026AX-ray exam of facial bones0.190.060.060.010.260.26XXX
    70140TCAX-ray exam of facial bones0.000.62NA0.040.66NAXXX
    70150AX-ray exam of facial bones0.260.86NA0.061.18NAXXX
    7015026AX-ray exam of facial bones0.260.090.090.010.360.36XXX
    70150TCAX-ray exam of facial bones0.000.77NA0.050.82NAXXX
    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 duct0.301.04NA0.071.41NAXXX
    7017026AX-ray exam of tear duct0.300.100.100.010.410.41XXX
    70170TCAX-ray exam of tear duct0.000.94NA0.061.00NAXXX
    70190AX-ray exam of eye sockets0.210.69NA0.050.95NAXXX
    7019026AX-ray exam of eye sockets0.210.070.070.010.290.29XXX
    70190TCAX-ray exam of eye sockets0.000.62NA0.040.66NAXXX
    70200AX-ray exam of eye sockets0.280.86NA0.061.20NAXXX
    7020026AX-ray exam of eye sockets0.280.090.090.010.380.38XXX
    70200TCAX-ray exam of eye sockets0.000.77NA0.050.82NAXXX
    70210AX-ray exam of sinuses0.170.68NA0.050.90NAXXX
    7021026AX-ray exam of sinuses0.170.060.060.010.240.24XXX
    70210TCAX-ray exam of sinuses0.000.62NA0.040.66NAXXX
    70220AX-ray exam of sinuses0.250.85NA0.061.16NAXXX
    7022026AX-ray exam of sinuses0.250.080.080.010.340.34XXX
    70220TCAX-ray exam of sinuses0.000.77NA0.050.82NAXXX
    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 skull0.240.70NA0.050.99NAXXX
    7025026AX-ray exam of skull0.240.080.080.010.330.33XXX
    70250TCAX-ray exam of skull0.000.62NA0.040.66NAXXX
    70260AX-ray exam of skull0.340.99NA0.071.40NAXXX
    7026026AX-ray exam of skull0.340.110.110.010.460.46XXX
    70260TCAX-ray exam of skull0.000.88NA0.060.94NAXXX
    70300AX-ray exam of teeth0.100.31NA0.030.44NAXXX
    7030026AX-ray exam of teeth0.100.050.050.010.160.16XXX
    70300TCAX-ray exam of teeth0.000.26NA0.020.28NAXXX
    70310AX-ray exam of teeth0.160.50NA0.030.69NAXXX
    7031026AX-ray exam of teeth0.160.080.080.010.250.25XXX
    70310TCAX-ray exam of teeth0.000.42NA0.020.44NAXXX
    70320AFull mouth x-ray of teeth0.220.85NA0.061.13NAXXX
    7032026AFull mouth x-ray of teeth0.220.080.080.010.310.31XXX
    70320TCAFull mouth x-ray of teeth0.000.77NA0.050.82NAXXX
    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 joints0.240.91NA0.061.21NAXXX
    7033026AX-ray exam of jaw joints0.240.080.080.010.330.33XXX
    70330TCAX-ray exam of jaw joints0.000.83NA0.050.88NAXXX
    70332AX-ray exam of jaw joint0.542.28NA0.142.96NAXXX
    7033226AX-ray exam of jaw joint0.540.200.200.020.760.76XXX
    70332TCAX-ray exam of jaw joint0.002.08NA0.122.20NAXXX
    70336AMagnetic image, jaw joint1.4711.61NA0.6713.75NAXXX
    7033626AMagnetic image, jaw joint1.470.500.500.082.052.05XXX
    70336TCAMagnetic image, jaw joint0.0011.11NA0.5911.70NAXXX
    70350AX-ray head for orthodontia0.170.45NA0.030.65NAXXX
    7035026AX-ray head for orthodontia0.170.070.070.010.250.25XXX
    70350TCAX-ray head for orthodontia0.000.38NA0.020.40NAXXX
    70355APanoramic x-ray of jaws0.200.65NA0.050.90NAXXX
    7035526APanoramic x-ray of jaws0.200.080.080.010.290.29XXX
    70355TCAPanoramic x-ray of jaws0.000.57NA0.040.61NAXXX
    Start Printed Page 63335
    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 & fluoroscopy0.321.40NA0.081.80NAXXX
    7037026AThroat x-ray & fluoroscopy0.320.110.110.010.440.44XXX
    70370TCAThroat x-ray & fluoroscopy0.001.29NA0.071.36NAXXX
    70371ASpeech evaluation, complex0.842.36NA0.173.37NAXXX
    7037126ASpeech evaluation, complex0.840.280.280.051.171.17XXX
    70371TCASpeech evaluation, complex0.002.08NA0.122.20NAXXX
    70373AContrast x-ray of larynx0.441.92NA0.132.49NAXXX
    7037326AContrast x-ray of larynx0.440.150.150.020.610.61XXX
    70373TCAContrast x-ray of larynx0.001.77NA0.111.88NAXXX
    70380AX-ray exam of salivary gland0.170.72NA0.050.94NAXXX
    7038026AX-ray exam of salivary gland0.170.060.060.010.240.24XXX
    70380TCAX-ray exam of salivary gland0.000.66NA0.040.70NAXXX
    70390AX-ray exam of salivary duct0.381.90NA0.132.41NAXXX
    7039026AX-ray exam of salivary duct0.380.130.130.020.530.53XXX
    70390TCAX-ray exam of salivary duct0.001.77NA0.111.88NAXXX
    70450ACt head/brain w/o dye0.854.95NA0.306.10NAXXX
    7045026ACt head/brain w/o dye0.850.280.280.051.181.18XXX
    70450TCACt head/brain w/o dye0.004.67NA0.254.92NAXXX
    70460ACt head/brain w/dye1.125.99NA0.367.47NAXXX
    7046026ACt head/brain w/dye1.120.380.380.061.561.56XXX
    70460TCACt head/brain w/dye0.005.61NA0.305.91NAXXX
    70470ACt head/brain w/o & w/ dye1.267.43NA0.449.13NAXXX
    7047026ACt head/brain w/o & w/ dye1.260.420.420.071.751.75XXX
    70470TCACt head/brain w/o & w/ dye0.007.01NA0.377.38NAXXX
    70480ACt orbit/ear/fossa w/o dye1.275.10NA0.326.69NAXXX
    7048026ACt orbit/ear/fossa w/o dye1.270.430.430.071.771.77XXX
    70480TCACt orbit/ear/fossa w/o dye0.004.67NA0.254.92NAXXX
    70481ACt orbit/ear/fossa w/dye1.376.07NA0.377.81NAXXX
    7048126ACt orbit/ear/fossa w/dye1.370.460.460.071.901.90XXX
    70481TCACt orbit/ear/fossa w/dye0.005.61NA0.305.91NAXXX
    70482ACt orbit/ear/fossa w/o&w dye1.447.50NA0.449.38NAXXX
    7048226ACt orbit/ear/fossa w/o&w dye1.440.490.490.072.002.00XXX
    70482TCACt orbit/ear/fossa w/o&w dye0.007.01NA0.377.38NAXXX
    70486ACt maxillofacial w/o dye1.135.05NA0.316.49NAXXX
    7048626ACt maxillofacial w/o dye1.130.380.380.061.571.57XXX
    70486TCACt maxillofacial w/o dye0.004.67NA0.254.92NAXXX
    70487ACt maxillofacial w/dye1.296.05NA0.377.71NAXXX
    7048726ACt maxillofacial w/dye1.290.440.440.071.801.80XXX
    70487TCACt maxillofacial w/dye0.005.61NA0.305.91NAXXX
    70488ACt maxillofacial w/o & w dye1.417.48NA0.449.33NAXXX
    7048826ACt maxillofacial w/o & w dye1.410.470.470.071.951.95XXX
    70488TCACt maxillofacial w/o & w dye0.007.01NA0.377.38NAXXX
    70490ACt soft tissue neck w/o dye1.275.10NA0.326.69NAXXX
    7049026ACt soft tissue neck w/o dye1.270.430.430.071.771.77XXX
    70490TCACt soft tissue neck w/o dye0.004.67NA0.254.92NAXXX
    70491ACt soft tissue neck w/dye1.376.07NA0.377.81NAXXX
    7049126ACt soft tissue neck w/dye1.370.460.460.071.901.90XXX
    70491TCACt soft tissue neck w/dye0.005.61NA0.305.91NAXXX
    70492ACt sft tsue nck w/o & w/dye1.447.49NA0.449.37NAXXX
    7049226ACt sft tsue nck w/o & w/dye1.440.480.480.071.991.99XXX
    70492TCACt sft tsue nck w/o & w/dye0.007.01NA0.377.38NAXXX
    70496ACt angiography, head1.7411.10NA0.6813.52NAXXX
    7049626ACt angiography, head1.740.580.580.102.422.42XXX
    70496TCACt angiography, head0.0010.52NA0.5811.10NAXXX
    70498ACt angiography, neck1.7411.11NA0.6813.53NAXXX
    7049826ACt angiography, neck1.740.590.590.102.432.43XXX
    70498TCACt angiography, neck0.0010.52NA0.5811.10NAXXX
    70540AMri orbit/face/neck w/o dye1.3411.56NA0.4313.33NAXXX
    7054026AMri orbit/face/neck w/o dye1.340.450.450.051.841.84XXX
    70540TCAMri orbit/face/neck w/o dye0.0011.11NA0.3811.49NAXXX
    70542AMri orbit/face/neck w/dye1.6113.88NA0.5316.02NAXXX
    7054226AMri orbit/face/neck w/dye1.610.550.550.062.222.22XXX
    70542TCAMri orbit/face/neck w/dye0.0013.33NA0.4713.80NAXXX
    70543AMri orbt/fac/nck w/o & w dye2.1425.39NA0.9228.45NAXXX
    7054326AMri orbt/fac/nck w/o & w dye2.140.710.710.082.932.93XXX
    70543TCAMri orbt/fac/nck w/o & w dye0.0024.68NA0.8425.52NAXXX
    70544AMr angiography head w/o dye1.1911.51NA0.6513.35NAXXX
    7054426AMr angiography head w/o dye1.190.400.400.061.651.65XXX
    70544TCAMr angiography head w/o dye0.0011.11NA0.5911.70NAXXX
    70545AMr angiography head w/dye1.1911.51NA0.6513.35NAXXX
    7054526AMr angiography head w/dye1.190.400.400.061.651.65XXX
    70545TCAMr angiography head w/dye0.0011.11NA0.5911.70NAXXX
    Start Printed Page 63336
    70546AMr angiograph head w/o&w dye1.7922.83NA0.6925.31NAXXX
    7054626AMr angiograph head w/o&w dye1.790.610.610.102.502.50XXX
    70546TCAMr angiograph head w/o&w dye0.0022.22NA0.5922.81NAXXX
    70547AMr angiography neck w/o dye1.1911.51NA0.6513.35NAXXX
    7054726AMr angiography neck w/o dye1.190.400.400.061.651.65XXX
    70547TCAMr angiography neck w/o dye0.0011.11NA0.5911.70NAXXX
    70548AMr angiography neck w/dye1.1911.51NA0.6513.35NAXXX
    7054826AMr angiography neck w/dye1.190.400.400.061.651.65XXX
    70548TCAMr angiography neck w/dye0.0011.11NA0.5911.70NAXXX
    70549AMr angiograph neck w/o&w dye1.7922.83NA0.6925.31NAXXX
    7054926AMr angiograph neck w/o&w dye1.790.610.610.102.502.50XXX
    70549TCAMr angiograph neck w/o&w dye0.0022.22NA0.5922.81NAXXX
    70551AMri brain w/o dye1.4711.61NA0.6713.75NAXXX
    7055126AMri brain w/o dye1.470.500.500.082.052.05XXX
    70551TCAMri brain w/o dye0.0011.11NA0.5911.70NAXXX
    70552AMri brain w/ dye1.7713.94NA0.8016.51NAXXX
    7055226AMri brain w/ dye1.770.610.610.102.482.48XXX
    70552TCAMri brain w/ dye0.0013.33NA0.7014.03NAXXX
    70553AMri brain w/o & w/ dye2.3525.46NA1.4329.24NAXXX
    7055326AMri brain w/o & w/ dye2.350.780.780.123.253.25XXX
    70553TCAMri brain w/o & w/ dye0.0024.68NA1.3125.99NAXXX
    70557CMri brain w/o dye0.000.000.000.000.000.00XXX
    7055726AMri brain w/o dye2.880.990.990.083.953.95XXX
    70557TCCMri brain w/o dye0.000.000.000.000.000.00XXX
    70558CMri brain w/ dye0.000.000.000.000.000.00XXX
    7055826AMri brain w/ dye3.181.091.090.104.374.37XXX
    70558TCCMri brain w/ dye0.000.000.000.000.000.00XXX
    70559CMri brain w/o & w/ dye0.000.000.000.000.000.00XXX
    7055926AMri brain w/o & w/ dye3.181.091.090.124.394.39XXX
    70559TCCMri brain w/o & w/ dye0.000.000.000.000.000.00XXX
    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-ray0.220.69NA0.050.96NAXXX
    7102026AChest x-ray0.220.070.070.010.300.30XXX
    71020TCAChest x-ray0.000.62NA0.040.66NAXXX
    71021AChest x-ray0.270.81NA0.061.14NAXXX
    7102126AChest x-ray0.270.090.090.010.370.37XXX
    71021TCAChest x-ray0.000.72NA0.050.77NAXXX
    71022AChest x-ray0.310.82NA0.071.20NAXXX
    7102226AChest x-ray0.310.100.100.020.430.43XXX
    71022TCAChest x-ray0.000.72NA0.050.77NAXXX
    71023AChest x-ray and fluoroscopy0.380.90NA0.071.35NAXXX
    7102326AChest x-ray and fluoroscopy0.380.130.130.020.530.53XXX
    71023TCAChest x-ray and fluoroscopy0.000.77NA0.050.82NAXXX
    71030AChest x-ray0.310.87NA0.061.24NAXXX
    7103026AChest x-ray0.310.100.100.010.420.42XXX
    71030TCAChest x-ray0.000.77NA0.050.82NAXXX
    71034AChest x-ray and fluoroscopy0.461.59NA0.102.15NAXXX
    7103426AChest x-ray and fluoroscopy0.460.160.160.020.640.64XXX
    71034TCAChest x-ray and fluoroscopy0.001.43NA0.081.51NAXXX
    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 bronchi0.581.64NA0.122.34NAXXX
    7104026AContrast x-ray of bronchi0.580.190.190.040.810.81XXX
    71040TCAContrast x-ray of bronchi0.001.45NA0.081.53NAXXX
    71060AContrast x-ray of bronchi0.742.43NA0.173.34NAXXX
    7106026AContrast x-ray of bronchi0.740.250.250.041.031.03XXX
    71060TCAContrast x-ray of bronchi0.002.18NA0.132.31NAXXX
    71090AX-ray & pacemaker insertion0.541.88NA0.132.55NAXXX
    7109026AX-ray & pacemaker insertion0.540.210.210.020.770.77XXX
    71090TCAX-ray & pacemaker insertion0.001.67NA0.111.78NAXXX
    71100AX-ray exam of ribs0.220.64NA0.050.91NAXXX
    7110026AX-ray exam of ribs0.220.070.070.010.300.30XXX
    71100TCAX-ray exam of ribs0.000.57NA0.040.61NAXXX
    71101AX-ray exam of ribs/chest0.270.75NA0.051.07NAXXX
    7110126AX-ray exam of ribs/chest0.270.090.090.010.370.37XXX
    71101TCAX-ray exam of ribs/chest0.000.66NA0.040.70NAXXX
    71110AX-ray exam of ribs0.270.86NA0.061.19NAXXX
    7111026AX-ray exam of ribs0.270.090.090.010.370.37XXX
    71110TCAX-ray exam of ribs0.000.77NA0.050.82NAXXX
    Start Printed Page 63337
    71111AX-ray exam of ribs/ chest0.320.99NA0.071.38NAXXX
    7111126AX-ray exam of ribs/ chest0.320.110.110.010.440.44XXX
    71111TCAX-ray exam of ribs/ chest0.000.88NA0.060.94NAXXX
    71120AX-ray exam of breastbone0.200.71NA0.050.96NAXXX
    7112026AX-ray exam of breastbone0.200.070.070.010.280.28XXX
    71120TCAX-ray exam of breastbone0.000.64NA0.040.68NAXXX
    71130AX-ray exam of breastbone0.220.77NA0.051.04NAXXX
    7113026AX-ray exam of breastbone0.220.070.070.010.300.30XXX
    71130TCAX-ray exam of breastbone0.000.70NA0.040.74NAXXX
    71250ACt thorax w/o dye1.156.24NA0.377.76NAXXX
    7125026ACt thorax w/o dye1.150.390.390.061.601.60XXX
    71250TCACt thorax w/o dye0.005.85NA0.316.16NAXXX
    71260ACt thorax w/dye1.237.42NA0.439.08NAXXX
    7126026ACt thorax w/dye1.230.410.410.061.701.70XXX
    71260TCACt thorax w/dye0.007.01NA0.377.38NAXXX
    71270ACt thorax w/o & w/ dye1.379.23NA0.5311.13NAXXX
    7127026ACt thorax w/o & w/ dye1.370.460.460.071.901.90XXX
    71270TCACt thorax w/o & w/ dye0.008.77NA0.469.23NAXXX
    71275ACt angiography, chest1.9112.92NA0.4515.28NAXXX
    7127526ACt angiography, chest1.910.640.640.072.622.62XXX
    71275TCACt angiography, chest0.0012.28NA0.3812.66NAXXX
    71550AMri chest w/o dye1.4511.60NA0.4913.54NAXXX
    7155026AMri chest w/o dye1.450.490.490.051.991.99XXX
    71550TCAMri chest w/o dye0.0011.11NA0.4411.55NAXXX
    71551AMri chest w/dye1.7213.91NA0.5916.22NAXXX
    7155126AMri chest w/dye1.720.580.580.072.372.37XXX
    71551TCAMri chest w/dye0.0013.33NA0.5213.85NAXXX
    71552AMri chest w/o & w/dye2.2525.43NA0.7728.45NAXXX
    7155226AMri chest w/o & w/dye2.250.750.750.103.103.10XXX
    71552TCAMri chest w/o & w/dye0.0024.68NA0.6725.35NAXXX
    71555RMri angio chest w or w/o dye1.8011.72NA0.6914.21NAXXX
    7155526RMri angio chest w or w/o dye1.800.610.610.102.512.51XXX
    71555TCRMri angio chest w or w/o dye0.0011.11NA0.5911.70NAXXX
    72010AX-ray exam of spine0.451.16NA0.101.71NAXXX
    7201026AX-ray exam of spine0.450.150.150.040.640.64XXX
    72010TCAX-ray exam of spine0.001.01NA0.061.07NAXXX
    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 spine0.220.67NA0.050.94NAXXX
    7204026AX-ray exam of neck spine0.220.070.070.010.300.30XXX
    72040TCAX-ray exam of neck spine0.000.60NA0.040.64NAXXX
    72050AX-ray exam of neck spine0.310.98NA0.081.37NAXXX
    7205026AX-ray exam of neck spine0.310.100.100.020.430.43XXX
    72050TCAX-ray exam of neck spine0.000.88NA0.060.94NAXXX
    72052AX-ray exam of neck spine0.361.24NA0.081.68NAXXX
    7205226AX-ray exam of neck spine0.360.120.120.020.500.50XXX
    72052TCAX-ray exam of neck spine0.001.12NA0.061.18NAXXX
    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 spine0.220.71NA0.050.98NAXXX
    7207026AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72070TCAX-ray exam of thoracic spine0.000.64NA0.040.68NAXXX
    72072AX-ray exam of thoracic spine0.220.79NA0.061.07NAXXX
    7207226AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72072TCAX-ray exam of thoracic spine0.000.72NA0.050.77NAXXX
    72074AX-ray exam of thoracic spine0.220.97NA0.071.26NAXXX
    7207426AX-ray exam of thoracic spine0.220.070.070.010.300.30XXX
    72074TCAX-ray exam of thoracic spine0.000.90NA0.060.96NAXXX
    72080AX-ray exam of trunk spine0.220.73NA0.061.01NAXXX
    7208026AX-ray exam of trunk spine0.220.070.070.020.310.31XXX
    72080TCAX-ray exam of trunk spine0.000.66NA0.040.70NAXXX
    72090AX-ray exam of trunk spine0.280.76NA0.061.10NAXXX
    7209026AX-ray exam of trunk spine0.280.100.100.020.400.40XXX
    72090TCAX-ray exam of trunk spine0.000.66NA0.040.70NAXXX
    72100AX-ray exam of lower spine0.220.73NA0.061.01NAXXX
    7210026AX-ray exam of lower spine0.220.070.070.020.310.31XXX
    72100TCAX-ray exam of lower spine0.000.66NA0.040.70NAXXX
    72110AX-ray exam of lower spine0.311.00NA0.081.39NAXXX
    7211026AX-ray exam of lower spine0.310.100.100.020.430.43XXX
    72110TCAX-ray exam of lower spine0.000.90NA0.060.96NAXXX
    72114AX-ray exam of lower spine0.361.30NA0.101.76NAXXX
    7211426AX-ray exam of lower spine0.360.120.120.040.520.52XXX
    72114TCAX-ray exam of lower spine0.001.18NA0.061.24NAXXX
    Start Printed Page 63338
    72120AX-ray exam of lower spine0.220.95NA0.081.25NAXXX
    7212026AX-ray exam of lower spine0.220.070.070.020.310.31XXX
    72120TCAX-ray exam of lower spine0.000.88NA0.060.94NAXXX
    72125ACt neck spine w/o dye1.156.24NA0.377.76NAXXX
    7212526ACt neck spine w/o dye1.150.390.390.061.601.60XXX
    72125TCACt neck spine w/o dye0.005.85NA0.316.16NAXXX
    72126ACt neck spine w/dye1.217.42NA0.439.06NAXXX
    7212626ACt neck spine w/dye1.210.410.410.061.681.68XXX
    72126TCACt neck spine w/dye0.007.01NA0.377.38NAXXX
    72127ACt neck spine w/o & w/dye1.269.20NA0.5310.99NAXXX
    7212726ACt neck spine w/o & w/dye1.260.430.430.071.761.76XXX
    72127TCACt neck spine w/o & w/dye0.008.77NA0.469.23NAXXX
    72128ACt chest spine w/o dye1.156.24NA0.377.76NAXXX
    7212826ACt chest spine w/o dye1.150.390.390.061.601.60XXX
    72128TCACt chest spine w/o dye0.005.85NA0.316.16NAXXX
    72129ACt chest spine w/dye1.217.42NA0.439.06NAXXX
    7212926ACt chest spine w/dye1.210.410.410.061.681.68XXX
    72129TCACt chest spine w/dye0.007.01NA0.377.38NAXXX
    72130ACt chest spine w/o & w/dye1.269.19NA0.5310.98NAXXX
    7213026ACt chest spine w/o & w/dye1.260.420.420.071.751.75XXX
    72130TCACt chest spine w/o & w/dye0.008.77NA0.469.23NAXXX
    72131ACt lumbar spine w/o dye1.156.24NA0.377.76NAXXX
    7213126ACt lumbar spine w/o dye1.150.390.390.061.601.60XXX
    72131TCACt lumbar spine w/o dye0.005.85NA0.316.16NAXXX
    72132ACt lumbar spine w/dye1.217.42NA0.449.07NAXXX
    7213226ACt lumbar spine w/dye1.210.410.410.071.691.69XXX
    72132TCACt lumbar spine w/dye0.007.01NA0.377.38NAXXX
    72133ACt lumbar spine w/o & w/dye1.269.20NA0.5310.99NAXXX
    7213326ACt lumbar spine w/o & w/dye1.260.430.430.071.761.76XXX
    72133TCACt lumbar spine w/o & w/dye0.008.77NA0.469.23NAXXX
    72141AMri neck spine w/o dye1.5911.65NA0.6713.91NAXXX
    7214126AMri neck spine w/o dye1.590.540.540.082.212.21XXX
    72141TCAMri neck spine w/o dye0.0011.11NA0.5911.70NAXXX
    72142AMri neck spine w/dye1.9113.98NA0.8116.70NAXXX
    7214226AMri neck spine w/dye1.910.650.650.112.672.67XXX
    72142TCAMri neck spine w/dye0.0013.33NA0.7014.03NAXXX
    72146AMri chest spine w/o dye1.5912.87NA0.7215.18NAXXX
    7214626AMri chest spine w/o dye1.590.540.540.082.212.21XXX
    72146TCAMri chest spine w/o dye0.0012.33NA0.6412.97NAXXX
    72147AMri chest spine w/dye1.9113.97NA0.8116.69NAXXX
    7214726AMri chest spine w/dye1.910.640.640.112.662.66XXX
    72147TCAMri chest spine w/dye0.0013.33NA0.7014.03NAXXX
    72148AMri lumbar spine w/o dye1.4712.83NA0.7215.02NAXXX
    7214826AMri lumbar spine w/o dye1.470.500.500.082.052.05XXX
    72148TCAMri lumbar spine w/o dye0.0012.33NA0.6412.97NAXXX
    72149AMri lumbar spine w/dye1.7713.94NA0.8116.52NAXXX
    7214926AMri lumbar spine w/dye1.770.610.610.112.492.49XXX
    72149TCAMri lumbar spine w/dye0.0013.33NA0.7014.03NAXXX
    72156AMri neck spine w/o & w/dye2.5625.53NA1.4429.53NAXXX
    7215626AMri neck spine w/o & w/dye2.560.850.850.133.543.54XXX
    72156TCAMri neck spine w/o & w/dye0.0024.68NA1.3125.99NAXXX
    72157AMri chest spine w/o & w/dye2.5625.53NA1.4429.53NAXXX
    7215726AMri chest spine w/o & w/dye2.560.850.850.133.543.54XXX
    72157TCAMri chest spine w/o & w/dye0.0024.68NA1.3125.99NAXXX
    72158AMri lumbar spine w/o & w/dye2.3525.46NA1.4429.25NAXXX
    7215826AMri lumbar spine w/o & w/dye2.350.780.780.133.263.26XXX
    72158TCAMri lumbar spine w/o & w/dye0.0024.68NA1.3125.99NAXXX
    72159NMr angio spine w/o&w/dye+1.7912.9812.980.7415.5115.51XXX
    7215926NMr angio spine w/o&w/dye+1.790.690.690.102.582.58XXX
    72159TCNMr angio spine w/o&w/dye+0.0012.2912.290.6412.9312.93XXX
    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 pelvis0.210.73NA0.050.99NAXXX
    7219026AX-ray exam of pelvis0.210.070.070.010.290.29XXX
    72190TCAX-ray exam of pelvis0.000.66NA0.040.70NAXXX
    72191ACt angiograph pelv w/o&w/dye1.8012.54NA0.4514.79NAXXX
    7219126ACt angiograph pelv w/o&w/dye1.800.610.610.072.482.48XXX
    72191TCACt angiograph pelv w/o&w/dye0.0011.93NA0.3812.31NAXXX
    72192ACt pelvis w/o dye1.086.21NA0.377.66NAXXX
    7219226ACt pelvis w/o dye1.080.360.360.061.501.50XXX
    72192TCACt pelvis w/o dye0.005.85NA0.316.16NAXXX
    72193ACt pelvis w/dye1.157.18NA0.428.75NAXXX
    7219326ACt pelvis w/dye1.150.390.390.061.601.60XXX
    72193TCACt pelvis w/dye0.006.79NA0.367.15NAXXX
    Start Printed Page 63339
    72194ACt pelvis w/o & w/dye1.218.82NA0.4910.52NAXXX
    7219426ACt pelvis w/o & w/dye1.210.410.410.061.681.68XXX
    72194TCACt pelvis w/o & w/dye0.008.41NA0.438.84NAXXX
    72195AMri pelvis w/o dye1.4511.60NA0.5013.55NAXXX
    7219526AMri pelvis w/o dye1.450.490.490.062.002.00XXX
    72195TCAMri pelvis w/o dye0.0011.11NA0.4411.55NAXXX
    72196AMri pelvis w/dye1.7213.91NA0.5816.21NAXXX
    7219626AMri pelvis w/dye1.720.580.580.062.362.36XXX
    72196TCAMri pelvis w/dye0.0013.33NA0.5213.85NAXXX
    72197AMri pelvis w/o & w/dye2.2525.43NA1.0128.69NAXXX
    7219726AMri pelvis w/o & w/dye2.250.750.750.103.103.10XXX
    72197TCAMri pelvis w/o & w/dye0.0024.68NA0.9125.59NAXXX
    72198AMr angio pelvis w/o & w/dye1.7911.80NA0.6914.28NAXXX
    7219826AMr angio pelvis w/o & w/dye1.790.690.690.102.582.58XXX
    72198TCAMr angio pelvis w/o & w/dye0.0011.11NA0.5911.70NAXXX
    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 joints0.190.68NA0.050.92NAXXX
    7220226AX-ray exam sacroiliac joints0.190.060.060.010.260.26XXX
    72202TCAX-ray exam sacroiliac joints0.000.62NA0.040.66NAXXX
    72220AX-ray exam of tailbone0.170.63NA0.050.85NAXXX
    7222026AX-ray exam of tailbone0.170.060.060.010.240.24XXX
    72220TCAX-ray exam of tailbone0.000.57NA0.040.61NAXXX
    72240AContrast x-ray of neck spine0.904.99NA0.306.19NAXXX
    7224026AContrast x-ray of neck spine0.900.290.290.051.241.24XXX
    72240TCAContrast x-ray of neck spine0.004.70NA0.254.95NAXXX
    72255AContrast x-ray, thorax spine0.904.58NA0.275.75NAXXX
    7225526AContrast x-ray, thorax spine0.900.280.280.051.231.23XXX
    72255TCAContrast x-ray, thorax spine0.004.30NA0.224.52NAXXX
    72265AContrast x-ray, lower spine0.834.30NA0.275.40NAXXX
    7226526AContrast x-ray, lower spine0.830.260.260.051.141.14XXX
    72265TCAContrast x-ray, lower spine0.004.04NA0.224.26NAXXX
    72270AContrast x-ray, spine1.326.48NA0.408.20NAXXX
    7227026AContrast x-ray, spine1.320.430.430.081.831.83XXX
    72270TCAContrast x-ray, spine0.006.05NA0.326.37NAXXX
    72275AEpidurography0.762.28NA0.263.30NAXXX
    7227526AEpidurography0.760.200.200.041.001.00XXX
    72275TCAEpidurography0.002.08NA0.222.30NAXXX
    72285AX-ray c/t spine disk1.158.68NA0.5010.33NAXXX
    7228526AX-ray c/t spine disk1.150.360.360.071.581.58XXX
    72285TCAX-ray c/t spine disk0.008.32NA0.438.75NAXXX
    72295AX-ray of lower spine disk0.838.06NA0.459.34NAXXX
    7229526AX-ray of lower spine disk0.830.270.270.051.151.15XXX
    72295TCAX-ray of lower spine disk0.007.79NA0.408.19NAXXX
    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 shoulder0.180.63NA0.050.86NAXXX
    7303026AX-ray exam of shoulder0.180.060.060.010.250.25XXX
    73030TCAX-ray exam of shoulder0.000.57NA0.040.61NAXXX
    73040AContrast x-ray of shoulder0.542.26NA0.162.96NAXXX
    7304026AContrast x-ray of shoulder0.540.180.180.040.760.76XXX
    73040TCAContrast x-ray of shoulder0.002.08NA0.122.20NAXXX
    73050AX-ray exam of shoulders0.200.73NA0.060.99NAXXX
    7305026AX-ray exam of shoulders0.200.070.070.020.290.29XXX
    73050TCAX-ray exam of shoulders0.000.66NA0.040.70NAXXX
    73060AX-ray exam of humerus0.170.63NA0.050.85NAXXX
    7306026AX-ray exam of humerus0.170.060.060.010.240.24XXX
    73060TCAX-ray exam of humerus0.000.57NA0.040.61NAXXX
    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 elbow0.170.63NA0.050.85NAXXX
    7308026AX-ray exam of elbow0.170.060.060.010.240.24XXX
    73080TCAX-ray exam of elbow0.000.57NA0.040.61NAXXX
    73085AContrast x-ray of elbow0.542.27NA0.162.97NAXXX
    7308526AContrast x-ray of elbow0.540.190.190.040.770.77XXX
    73085TCAContrast x-ray of elbow0.002.08NA0.122.20NAXXX
    Start Printed Page 63340
    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 wrist0.541.75NA0.142.43NAXXX
    7311526AContrast x-ray of wrist0.540.190.190.040.770.77XXX
    73115TCAContrast x-ray of wrist0.001.56NA0.101.66NAXXX
    73120AX-ray exam of hand0.160.54NA0.030.73NAXXX
    7312026AX-ray exam of hand0.160.050.050.010.220.22XXX
    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 dye1.085.28NA0.316.67NAXXX
    7320026ACt upper extremity w/o dye1.080.360.360.061.501.50XXX
    73200TCACt upper extremity w/o dye0.004.92NA0.255.17NAXXX
    73201ACt upper extremity w/dye1.156.24NA0.377.76NAXXX
    7320126ACt upper extremity w/dye1.150.390.390.061.601.60XXX
    73201TCACt upper extremity w/dye0.005.85NA0.316.16NAXXX
    73202ACt uppr extremity w/o&w/dye1.217.77NA0.459.43NAXXX
    7320226ACt uppr extremity w/o&w/dye1.210.410.410.071.691.69XXX
    73202TCACt uppr extremity w/o&w/dye0.007.36NA0.387.74NAXXX
    73206ACt angio upr extrm w/o&w/dye1.8011.47NA0.4513.72NAXXX
    7320626ACt angio upr extrm w/o&w/dye1.800.600.600.072.472.47XXX
    73206TCACt angio upr extrm w/o&w/dye0.0010.87NA0.3811.25NAXXX
    73218AMri upper extremity w/o dye1.3411.56NA0.4313.33NAXXX
    7321826AMri upper extremity w/o dye1.340.450.450.051.841.84XXX
    73218TCAMri upper extremity w/o dye0.0011.11NA0.3811.49NAXXX
    73219AMri upper extremity w/dye1.6113.88NA0.5316.02NAXXX
    7321926AMri upper extremity w/dye1.610.550.550.062.222.22XXX
    73219TCAMri upper extremity w/dye0.0013.33NA0.4713.80NAXXX
    73220AMri uppr extremity w/o&w/dye2.1425.39NA0.9428.47NAXXX
    7322026AMri uppr extremity w/o&w/dye2.140.710.710.102.952.95XXX
    73220TCAMri uppr extremity w/o&w/dye0.0024.68NA0.8425.52NAXXX
    73221AMri joint upr extrem w/o dye1.3411.56NA0.4313.33NAXXX
    7322126AMri joint upr extrem w/o dye1.340.450.450.051.841.84XXX
    73221TCAMri joint upr extrem w/o dye0.0011.11NA0.3811.49NAXXX
    73222AMri joint upr extrem w/dye1.6113.87NA0.5316.01NAXXX
    7322226AMri joint upr extrem w/dye1.610.540.540.062.212.21XXX
    73222TCAMri joint upr extrem w/dye0.0013.33NA0.4713.80NAXXX
    73223AMri joint upr extr w/o&w/dye2.1425.39NA0.9228.45NAXXX
    7322326AMri joint upr extr w/o&w/dye2.140.710.710.082.932.93XXX
    73223TCAMri joint upr extr w/o&w/dye0.0024.68NA0.8425.52NAXXX
    73225NMr angio upr extr w/o&w/dye+1.7211.7411.740.6914.1514.15XXX
    7322526NMr angio upr extr w/o&w/dye+1.720.670.670.102.492.49XXX
    73225TCNMr angio upr extr w/o&w/dye+0.0011.0711.070.5911.6611.66XXX
    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 hip0.210.64NA0.060.91NAXXX
    7351026AX-ray exam of hip0.210.070.070.020.300.30XXX
    73510TCAX-ray exam of hip0.000.57NA0.040.61NAXXX
    73520AX-ray exam of hips0.260.75NA0.061.07NAXXX
    7352026AX-ray exam of hips0.260.090.090.020.370.37XXX
    73520TCAX-ray exam of hips0.000.66NA0.040.70NAXXX
    73525AContrast x-ray of hip0.542.26NA0.162.96NAXXX
    7352526AContrast x-ray of hip0.540.180.180.040.760.76XXX
    73525TCAContrast x-ray of hip0.002.08NA0.122.20NAXXX
    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 & hips0.200.64NA0.060.90NAXXX
    7354026AX-ray exam of pelvis & hips0.200.070.070.020.290.29XXX
    73540TCAX-ray exam of pelvis & hips0.000.57NA0.040.61NAXXX
    Start Printed Page 63341
    73542AX-ray exam, sacroiliac joint0.592.24NA0.162.99NAXXX
    7354226AX-ray exam, sacroiliac joint0.590.160.160.040.790.79XXX
    73542TCAX-ray exam, sacroiliac joint0.002.08NA0.122.20NAXXX
    73550AX-ray exam of thigh0.170.63NA0.050.85NAXXX
    7355026AX-ray exam of thigh0.170.060.060.010.240.24XXX
    73550TCAX-ray exam of thigh0.000.57NA0.040.61NAXXX
    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, 30.180.63NA0.060.87NAXXX
    7356226AX-ray exam of knee, 30.180.060.060.020.260.26XXX
    73562TCAX-ray exam of knee, 30.000.57NA0.040.61NAXXX
    73564AX-ray exam, knee, 4 or more0.220.70NA0.060.98NAXXX
    7356426AX-ray exam, knee, 4 or more0.220.080.080.020.320.32XXX
    73564TCAX-ray exam, knee, 4 or more0.000.62NA0.040.66NAXXX
    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 joint0.542.78NA0.183.50NAXXX
    7358026AContrast x-ray of knee joint0.540.180.180.040.760.76XXX
    73580TCAContrast x-ray of knee joint0.002.60NA0.142.74NAXXX
    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 ankle0.160.54NA0.030.73NAXXX
    7360026AX-ray exam of ankle0.160.050.050.010.220.22XXX
    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 ankle0.542.27NA0.162.97NAXXX
    7361526AContrast x-ray of ankle0.540.190.190.040.770.77XXX
    73615TCAContrast x-ray of ankle0.002.08NA0.122.20NAXXX
    73620AX-ray exam of foot0.160.54NA0.030.73NAXXX
    7362026AX-ray exam of foot0.160.050.050.010.220.22XXX
    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 heel0.160.52NA0.030.71NAXXX
    7365026AX-ray exam of heel0.160.050.050.010.220.22XXX
    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 dye1.085.28NA0.316.67NAXXX
    7370026ACt lower extremity w/o dye1.080.360.360.061.501.50XXX
    73700TCACt lower extremity w/o dye0.004.92NA0.255.17NAXXX
    73701ACt lower extremity w/dye1.156.24NA0.377.76NAXXX
    7370126ACt lower extremity w/dye1.150.390.390.061.601.60XXX
    73701TCACt lower extremity w/dye0.005.85NA0.316.16NAXXX
    73702ACt lwr extremity w/o&w/dye1.217.77NA0.449.42NAXXX
    7370226ACt lwr extremity w/o&w/dye1.210.410.410.061.681.68XXX
    73702TCACt lwr extremity w/o&w/dye0.007.36NA0.387.74NAXXX
    73706ACt angio lwr extr w/o&w/dye1.8911.51NA0.4513.85NAXXX
    7370626ACt angio lwr extr w/o&w/dye1.890.640.640.072.602.60XXX
    73706TCACt angio lwr extr w/o&w/dye0.0010.87NA0.3811.25NAXXX
    73718AMri lower extremity w/o dye1.3411.56NA0.4313.33NAXXX
    7371826AMri lower extremity w/o dye1.340.450.450.051.841.84XXX
    73718TCAMri lower extremity w/o dye0.0011.11NA0.3811.49NAXXX
    73719AMri lower extremity w/dye1.6113.87NA0.5316.01NAXXX
    7371926AMri lower extremity w/dye1.610.540.540.062.212.21XXX
    73719TCAMri lower extremity w/dye0.0013.33NA0.4713.80NAXXX
    73720AMri lwr extremity w/o&w/dye2.1425.39NA0.9428.47NAXXX
    7372026AMri lwr extremity w/o&w/dye2.140.710.710.102.952.95XXX
    73720TCAMri lwr extremity w/o&w/dye0.0024.68NA0.8425.52NAXXX
    73721AMri jnt of lwr extre w/o dye1.3411.56NA0.4313.33NAXXX
    7372126AMri jnt of lwr extre w/o dye1.340.450.450.051.841.84XXX
    73721TCAMri jnt of lwr extre w/o dye0.0011.11NA0.3811.49NAXXX
    73722AMri joint of lwr extr w/dye1.6113.88NA0.5416.03NAXXX
    7372226AMri joint of lwr extr w/dye1.610.550.550.072.232.23XXX
    73722TCAMri joint of lwr extr w/dye0.0013.33NA0.4713.80NAXXX
    Start Printed Page 63342
    73723AMri joint lwr extr w/o&w/dye2.1425.39NA0.9228.45NAXXX
    7372326AMri joint lwr extr w/o&w/dye2.140.710.710.082.932.93XXX
    73723TCAMri joint lwr extr w/o&w/dye0.0024.68NA0.8425.52NAXXX
    73725RMr ang lwr ext w or w/o dye1.8111.72NA0.6914.22NAXXX
    7372526RMr ang lwr ext w or w/o dye1.810.610.610.102.522.52XXX
    73725TCRMr ang lwr ext w or w/o dye0.0011.11NA0.5911.70NAXXX
    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 abdomen0.230.65NA0.050.93NAXXX
    7401026AX-ray exam of abdomen0.230.080.080.010.320.32XXX
    74010TCAX-ray exam of abdomen0.000.57NA0.040.61NAXXX
    74020AX-ray exam of abdomen0.270.71NA0.051.03NAXXX
    7402026AX-ray exam of abdomen0.270.090.090.010.370.37XXX
    74020TCAX-ray exam of abdomen0.000.62NA0.040.66NAXXX
    74022AX-ray exam series, abdomen0.320.83NA0.061.21NAXXX
    7402226AX-ray exam series, abdomen0.320.110.110.010.440.44XXX
    74022TCAX-ray exam series, abdomen0.000.72NA0.050.77NAXXX
    74150ACt abdomen w/o dye1.186.01NA0.367.55NAXXX
    7415026ACt abdomen w/o dye1.180.400.400.061.641.64XXX
    74150TCACt abdomen w/o dye0.005.61NA0.305.91NAXXX
    74160ACt abdomen w/dye1.267.21NA0.438.90NAXXX
    7416026ACt abdomen w/dye1.260.420.420.071.751.75XXX
    74160TCACt abdomen w/dye0.006.79NA0.367.15NAXXX
    74170ACt abdomen w/o &w /dye1.398.88NA0.5010.77NAXXX
    7417026ACt abdomen w/o &w /dye1.390.470.470.071.931.93XXX
    74170TCACt abdomen w/o &w /dye0.008.41NA0.438.84NAXXX
    74175ACt angio abdom w/o & w/dye1.8912.57NA0.4514.91NAXXX
    7417526ACt angio abdom w/o & w/dye1.890.640.640.072.602.60XXX
    74175TCACt angio abdom w/o & w/dye0.0011.93NA0.3812.31NAXXX
    74181AMri abdomen w/o dye1.4511.60NA0.5113.56NAXXX
    7418126AMri abdomen w/o dye1.450.490.490.072.012.01XXX
    74181TCAMri abdomen w/o dye0.0011.11NA0.4411.55NAXXX
    74182AMri abdomen w/dye1.7213.91NA0.5916.22NAXXX
    7418226AMri abdomen w/dye1.720.580.580.072.372.37XXX
    74182TCAMri abdomen w/dye0.0013.33NA0.5213.85NAXXX
    74183AMri abdomen w/o & w/dye2.2525.43NA1.0128.69NAXXX
    7418326AMri abdomen w/o & w/dye2.250.750.750.103.103.10XXX
    74183TCAMri abdomen w/o & w/dye0.0024.68NA0.9125.59NAXXX
    74185RMri angio, abdom w orw/o dye1.7911.71NA0.6914.19NAXXX
    7418526RMri angio, abdom w orw/o dye1.790.600.600.102.492.49XXX
    74185TCRMri angio, abdom w orw/o dye0.0011.11NA0.5911.70NAXXX
    74190AX-ray exam of peritoneum0.481.45NA0.092.02NAXXX
    7419026AX-ray exam of peritoneum0.480.160.160.020.660.66XXX
    74190TCAX-ray exam of peritoneum0.001.29NA0.071.36NAXXX
    74210AContrst x-ray exam of throat0.361.30NA0.081.74NAXXX
    7421026AContrst x-ray exam of throat0.360.120.120.020.500.50XXX
    74210TCAContrst x-ray exam of throat0.001.18NA0.061.24NAXXX
    74220AContrast x-ray, esophagus0.461.33NA0.081.87NAXXX
    7422026AContrast x-ray, esophagus0.460.150.150.020.630.63XXX
    74220TCAContrast x-ray, esophagus0.001.18NA0.061.24NAXXX
    74230ACine/vid x-ray, throat/esoph0.531.47NA0.092.09NAXXX
    7423026ACine/vid x-ray, throat/esoph0.530.180.180.020.730.73XXX
    74230TCACine/vid x-ray, throat/esoph0.001.29NA0.071.36NAXXX
    74235ARemove esophagus obstruction1.183.00NA0.204.38NAXXX
    7423526ARemove esophagus obstruction1.180.400.400.061.641.64XXX
    74235TCARemove esophagus obstruction0.002.60NA0.142.74NAXXX
    74240AX-ray exam, upper gi tract0.691.68NA0.122.49NAXXX
    7424026AX-ray exam, upper gi tract0.690.230.230.040.960.96XXX
    74240TCAX-ray exam, upper gi tract0.001.45NA0.081.53NAXXX
    74241AX-ray exam, upper gi tract0.691.71NA0.122.52NAXXX
    7424126AX-ray exam, upper gi tract0.690.230.230.040.960.96XXX
    74241TCAX-ray exam, upper gi tract0.001.48NA0.081.56NAXXX
    74245AX-ray exam, upper gi tract0.902.66NA0.183.74NAXXX
    7424526AX-ray exam, upper gi tract0.900.300.300.051.251.25XXX
    74245TCAX-ray exam, upper gi tract0.002.36NA0.132.49NAXXX
    74246AContrst x-ray uppr gi tract0.691.86NA0.142.69NAXXX
    7424626AContrst x-ray uppr gi tract0.690.230.230.040.960.96XXX
    74246TCAContrst x-ray uppr gi tract0.001.63NA0.101.73NAXXX
    74247AContrst x-ray uppr gi tract0.691.90NA0.152.74NAXXX
    7424726AContrst x-ray uppr gi tract0.690.230.230.040.960.96XXX
    74247TCAContrst x-ray uppr gi tract0.001.67NA0.111.78NAXXX
    74249AContrst x-ray uppr gi tract0.902.85NA0.193.94NAXXX
    7424926AContrst x-ray uppr gi tract0.900.300.300.051.251.25XXX
    74249TCAContrst x-ray uppr gi tract0.002.55NA0.142.69NAXXX
    Start Printed Page 63343
    74250AX-ray exam of small bowel0.471.45NA0.092.01NAXXX
    7425026AX-ray exam of small bowel0.470.160.160.020.650.65XXX
    74250TCAX-ray exam of small bowel0.001.29NA0.071.36NAXXX
    74251AX-ray exam of small bowel0.691.52NA0.112.32NAXXX
    7425126AX-ray exam of small bowel0.690.230.230.040.960.96XXX
    74251TCAX-ray exam of small bowel0.001.29NA0.071.36NAXXX
    74260AX-ray exam of small bowel0.501.65NA0.102.25NAXXX
    7426026AX-ray exam of small bowel0.500.170.170.020.690.69XXX
    74260TCAX-ray exam of small bowel0.001.48NA0.081.56NAXXX
    74270AContrast x-ray exam of colon0.691.92NA0.152.76NAXXX
    7427026AContrast x-ray exam of colon0.690.230.230.040.960.96XXX
    74270TCAContrast x-ray exam of colon0.001.69NA0.111.80NAXXX
    74280AContrast x-ray exam of colon0.982.54NA0.183.70NAXXX
    7428026AContrast x-ray exam of colon0.980.330.330.051.361.36XXX
    74280TCAContrast x-ray exam of colon0.002.21NA0.132.34NAXXX
    74283AContrast x-ray exam of colon2.013.20NA0.255.46NAXXX
    7428326AContrast x-ray exam of colon2.010.660.660.112.782.78XXX
    74283TCAContrast x-ray exam of colon0.002.54NA0.142.68NAXXX
    74290AContrast x-ray, gallbladder0.320.83NA0.061.21NAXXX
    7429026AContrast x-ray, gallbladder0.320.110.110.010.440.44XXX
    74290TCAContrast x-ray, gallbladder0.000.72NA0.050.77NAXXX
    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/pancreas0.420.91NA0.071.40NAXXX
    7430526AX-ray bile ducts/pancreas0.420.140.140.020.580.58XXX
    74305TCAX-ray bile ducts/pancreas0.000.77NA0.050.82NAXXX
    74320AContrast x-ray of bile ducts0.543.31NA0.194.04NAXXX
    7432026AContrast x-ray of bile ducts0.540.180.180.020.740.74XXX
    74320TCAContrast x-ray of bile ducts0.003.13NA0.173.30NAXXX
    74327AX-ray bile stone removal0.701.98NA0.152.83NAXXX
    7432726AX-ray bile stone removal0.700.230.230.040.970.97XXX
    74327TCAX-ray bile stone removal0.001.75NA0.111.86NAXXX
    74328AX-ray bile duct endoscopy0.703.36NA0.214.27NAXXX
    7432826AX-ray bile duct endoscopy0.700.230.230.040.970.97XXX
    74328TCAX-ray bile duct endoscopy0.003.13NA0.173.30NAXXX
    74329AX-ray for pancreas endoscopy0.703.36NA0.214.27NAXXX
    7432926AX-ray for pancreas endoscopy0.700.230.230.040.970.97XXX
    74329TCAX-ray for pancreas endoscopy0.003.13NA0.173.30NAXXX
    74330AX-ray bile/panc endoscopy0.893.43NA0.224.54NAXXX
    7433026AX-ray bile/panc endoscopy0.890.300.300.051.241.24XXX
    74330TCAX-ray bile/panc endoscopy0.003.13NA0.173.30NAXXX
    74340AX-ray guide for GI tube0.542.78NA0.163.48NAXXX
    7434026AX-ray guide for GI tube0.540.180.180.020.740.74XXX
    74340TCAX-ray guide for GI tube0.002.60NA0.142.74NAXXX
    74350AX-ray guide, stomach tube0.763.38NA0.214.35NAXXX
    7435026AX-ray guide, stomach tube0.760.250.250.041.051.05XXX
    74350TCAX-ray guide, stomach tube0.003.13NA0.173.30NAXXX
    74355AX-ray guide, intestinal tube0.762.85NA0.183.79NAXXX
    7435526AX-ray guide, intestinal tube0.760.250.250.041.051.05XXX
    74355TCAX-ray guide, intestinal tube0.002.60NA0.142.74NAXXX
    74360AX-ray guide, GI dilation0.543.32NA0.194.05NAXXX
    7436026AX-ray guide, GI dilation0.540.190.190.020.750.75XXX
    74360TCAX-ray guide, GI dilation0.003.13NA0.173.30NAXXX
    74363AX-ray, bile duct dilation0.876.34NA0.377.58NAXXX
    7436326AX-ray, bile duct dilation0.870.290.290.051.211.21XXX
    74363TCAX-ray, bile duct dilation0.006.05NA0.326.37NAXXX
    74400AContrst x-ray, urinary tract0.491.83NA0.132.45NAXXX
    7440026AContrst x-ray, urinary tract0.490.160.160.020.670.67XXX
    74400TCAContrst x-ray, urinary tract0.001.67NA0.111.78NAXXX
    74410AContrst x-ray, urinary tract0.492.09NA0.132.71NAXXX
    7441026AContrst x-ray, urinary tract0.490.160.160.020.670.67XXX
    74410TCAContrst x-ray, urinary tract0.001.93NA0.112.04NAXXX
    74415AContrst x-ray, urinary tract0.492.26NA0.142.89NAXXX
    7441526AContrst x-ray, urinary tract0.490.160.160.020.670.67XXX
    74415TCAContrst x-ray, urinary tract0.002.10NA0.122.22NAXXX
    74420AContrst x-ray, urinary tract0.362.72NA0.163.24NAXXX
    7442026AContrst x-ray, urinary tract0.360.120.120.020.500.50XXX
    74420TCAContrst x-ray, urinary tract0.002.60NA0.142.74NAXXX
    Start Printed Page 63344
    74425AContrst x-ray, urinary tract0.361.41NA0.091.86NAXXX
    7442526AContrst x-ray, urinary tract0.360.120.120.020.500.50XXX
    74425TCAContrst x-ray, urinary tract0.001.29NA0.071.36NAXXX
    74430AContrast x-ray, bladder0.321.15NA0.081.55NAXXX
    7443026AContrast x-ray, bladder0.320.110.110.020.450.45XXX
    74430TCAContrast x-ray, bladder0.001.04NA0.061.10NAXXX
    74440AX-ray, male genital tract0.381.24NA0.081.70NAXXX
    7444026AX-ray, male genital tract0.380.120.120.020.520.52XXX
    74440TCAX-ray, male genital tract0.001.12NA0.061.18NAXXX
    74445AX-ray exam of penis1.131.50NA0.122.75NAXXX
    7444526AX-ray exam of penis1.130.380.380.061.571.57XXX
    74445TCAX-ray exam of penis0.001.12NA0.061.18NAXXX
    74450AX-ray, urethra/bladder0.331.56NA0.101.99NAXXX
    7445026AX-ray, urethra/bladder0.330.110.110.020.460.46XXX
    74450TCAX-ray, urethra/bladder0.001.45NA0.081.53NAXXX
    74455AX-ray, urethra/bladder0.331.67NA0.122.12NAXXX
    7445526AX-ray, urethra/bladder0.330.110.110.020.460.46XXX
    74455TCAX-ray, urethra/bladder0.001.56NA0.101.66NAXXX
    74470AX-ray exam of kidney lesion0.541.42NA0.092.05NAXXX
    7447026AX-ray exam of kidney lesion0.540.180.180.020.740.74XXX
    74470TCAX-ray exam of kidney lesion0.001.24NA0.071.31NAXXX
    74475AX-ray control, cath insert0.544.22NA0.245.00NAXXX
    7447526AX-ray control, cath insert0.540.180.180.020.740.74XXX
    74475TCAX-ray control, cath insert0.004.04NA0.224.26NAXXX
    74480AX-ray control, cath insert0.544.22NA0.245.00NAXXX
    7448026AX-ray control, cath insert0.540.180.180.020.740.74XXX
    74480TCAX-ray control, cath insert0.004.04NA0.224.26NAXXX
    74485AX-ray guide, GU dilation0.543.31NA0.214.06NAXXX
    7448526AX-ray guide, GU dilation0.540.180.180.040.760.76XXX
    74485TCAX-ray guide, GU dilation0.003.13NA0.173.30NAXXX
    74710AX-ray measurement of pelvis0.341.15NA0.081.57NAXXX
    7471026AX-ray measurement of pelvis0.340.110.110.020.470.47XXX
    74710TCAX-ray measurement of pelvis0.001.04NA0.061.10NAXXX
    74740AX-ray, female genital tract0.381.42NA0.091.89NAXXX
    7474026AX-ray, female genital tract0.380.130.130.020.530.53XXX
    74740TCAX-ray, female genital tract0.001.29NA0.071.36NAXXX
    74742AX-ray, fallopian tube0.613.34NA0.194.14NAXXX
    7474226AX-ray, fallopian tube0.610.210.210.020.840.84XXX
    74742TCAX-ray, fallopian tube0.003.13NA0.173.30NAXXX
    74775AX-ray exam of perineum0.621.66NA0.122.40NAXXX
    7477526AX-ray exam of perineum0.620.210.210.040.870.87XXX
    74775TCAX-ray exam of perineum0.001.45NA0.081.53NAXXX
    75552AHeart mri for morph w/o dye1.5911.65NA0.6713.91NAXXX
    7555226AHeart mri for morph w/o dye1.590.540.540.082.212.21XXX
    75552TCAHeart mri for morph w/o dye0.0011.11NA0.5911.70NAXXX
    75553AHeart mri for morph w/dye1.9911.77NA0.7014.46NAXXX
    7555326AHeart mri for morph w/dye1.990.660.660.112.762.76XXX
    75553TCAHeart mri for morph w/dye0.0011.11NA0.5911.70NAXXX
    75554ACardiac MRI/function1.8211.76NA0.6714.25NAXXX
    7555426ACardiac MRI/function1.820.650.650.082.552.55XXX
    75554TCACardiac MRI/function0.0011.11NA0.5911.70NAXXX
    75555ACardiac MRI/limited study1.7311.75NA0.6714.15NAXXX
    7555526ACardiac MRI/limited study1.730.640.640.082.452.45XXX
    75555TCACardiac MRI/limited study0.0011.11NA0.5911.70NAXXX
    75556NCardiac MRI/flow mapping0.000.000.000.000.000.00XXX
    75600AContrast x-ray exam of aorta0.4912.68NA0.6713.84NAXXX
    7560026AContrast x-ray exam of aorta0.490.190.190.020.700.70XXX
    75600TCAContrast x-ray exam of aorta0.0012.49NA0.6513.14NAXXX
    75605AContrast x-ray exam of aorta1.1312.90NA0.7114.74NAXXX
    7560526AContrast x-ray exam of aorta1.130.410.410.061.601.60XXX
    75605TCAContrast x-ray exam of aorta0.0012.49NA0.6513.14NAXXX
    75625AContrast x-ray exam of aorta1.1312.88NA0.7114.72NAXXX
    7562526AContrast x-ray exam of aorta1.130.390.390.061.581.58XXX
    75625TCAContrast x-ray exam of aorta0.0012.49NA0.6513.14NAXXX
    75630AX-ray aorta, leg arteries1.7813.65NA0.7816.21NAXXX
    7563026AX-ray aorta, leg arteries1.780.630.630.102.512.51XXX
    75630TCAX-ray aorta, leg arteries0.0013.02NA0.6813.70NAXXX
    75635ACt angio abdominal arteries2.3916.58NA0.4919.46NAXXX
    7563526ACt angio abdominal arteries2.390.800.800.113.303.30XXX
    75635TCACt angio abdominal arteries0.0015.78NA0.3816.16NAXXX
    75650AArtery x-rays, head & neck1.4812.99NA0.7315.20NAXXX
    7565026AArtery x-rays, head & neck1.480.500.500.082.062.06XXX
    75650TCAArtery x-rays, head & neck0.0012.49NA0.6513.14NAXXX
    75658AArtery x-rays, arm1.3012.97NA0.7214.99NAXXX
    7565826AArtery x-rays, arm1.300.480.480.071.851.85XXX
    Start Printed Page 63345
    75658TCAArtery x-rays, arm0.0012.49NA0.6513.14NAXXX
    75660AArtery x-rays, head & neck1.3012.94NA0.7214.96NAXXX
    7566026AArtery x-rays, head & neck1.300.450.450.071.821.82XXX
    75660TCAArtery x-rays, head & neck0.0012.49NA0.6513.14NAXXX
    75662AArtery x-rays, head & neck1.6513.09NA0.7515.49NAXXX
    7566226AArtery x-rays, head & neck1.650.600.600.102.352.35XXX
    75662TCAArtery x-rays, head & neck0.0012.49NA0.6513.14NAXXX
    75665AArtery x-rays, head & neck1.3012.94NA0.7314.97NAXXX
    7566526AArtery x-rays, head & neck1.300.450.450.081.831.83XXX
    75665TCAArtery x-rays, head & neck0.0012.49NA0.6513.14NAXXX
    75671AArtery x-rays, head & neck1.6513.05NA0.7515.45NAXXX
    7567126AArtery x-rays, head & neck1.650.560.560.102.312.31XXX
    75671TCAArtery x-rays, head & neck0.0012.49NA0.6513.14NAXXX
    75676AArtery x-rays, neck1.3012.94NA0.7314.97NAXXX
    7567626AArtery x-rays, neck1.300.450.450.081.831.83XXX
    75676TCAArtery x-rays, neck0.0012.49NA0.6513.14NAXXX
    75680AArtery x-rays, neck1.6513.05NA0.7515.45NAXXX
    7568026AArtery x-rays, neck1.650.560.560.102.312.31XXX
    75680TCAArtery x-rays, neck0.0012.49NA0.6513.14NAXXX
    75685AArtery x-rays, spine1.3012.93NA0.7214.95NAXXX
    7568526AArtery x-rays, spine1.300.440.440.071.811.81XXX
    75685TCAArtery x-rays, spine0.0012.49NA0.6513.14NAXXX
    75705AArtery x-rays, spine2.1713.23NA0.7816.18NAXXX
    7570526AArtery x-rays, spine2.170.740.740.133.043.04XXX
    75705TCAArtery x-rays, spine0.0012.49NA0.6513.14NAXXX
    75710AArtery x-rays, arm/leg1.1312.88NA0.7214.73NAXXX
    7571026AArtery x-rays, arm/leg1.130.390.390.071.591.59XXX
    75710TCAArtery x-rays, arm/leg0.0012.49NA0.6513.14NAXXX
    75716AArtery x-rays, arms/legs1.3012.93NA0.7214.95NAXXX
    7571626AArtery x-rays, arms/legs1.300.440.440.071.811.81XXX
    75716TCAArtery x-rays, arms/legs0.0012.49NA0.6513.14NAXXX
    75722AArtery x-rays, kidney1.1312.90NA0.7114.74NAXXX
    7572226AArtery x-rays, kidney1.130.410.410.061.601.60XXX
    75722TCAArtery x-rays, kidney0.0012.49NA0.6513.14NAXXX
    75724AArtery x-rays, kidneys1.4813.06NA0.7115.25NAXXX
    7572426AArtery x-rays, kidneys1.480.570.570.062.112.11XXX
    75724TCAArtery x-rays, kidneys0.0012.49NA0.6513.14NAXXX
    75726AArtery x-rays, abdomen1.1312.87NA0.7114.71NAXXX
    7572626AArtery x-rays, abdomen1.130.380.380.061.571.57XXX
    75726TCAArtery x-rays, abdomen0.0012.49NA0.6513.14NAXXX
    75731AArtery x-rays, adrenal gland1.1312.87NA0.7114.71NAXXX
    7573126AArtery x-rays, adrenal gland1.130.380.380.061.571.57XXX
    75731TCAArtery x-rays, adrenal gland0.0012.49NA0.6513.14NAXXX
    75733AArtery x-rays, adrenals1.3012.93NA0.7214.95NAXXX
    7573326AArtery x-rays, adrenals1.300.440.440.071.811.81XXX
    75733TCAArtery x-rays, adrenals0.0012.49NA0.6513.14NAXXX
    75736AArtery x-rays, pelvis1.1312.87NA0.7114.71NAXXX
    7573626AArtery x-rays, pelvis1.130.380.380.061.571.57XXX
    75736TCAArtery x-rays, pelvis0.0012.49NA0.6513.14NAXXX
    75741AArtery x-rays, lung1.3012.93NA0.7214.95NAXXX
    7574126AArtery x-rays, lung1.300.440.440.071.811.81XXX
    75741TCAArtery x-rays, lung0.0012.49NA0.6513.14NAXXX
    75743AArtery x-rays, lungs1.6513.04NA0.7315.42NAXXX
    7574326AArtery x-rays, lungs1.650.550.550.082.282.28XXX
    75743TCAArtery x-rays, lungs0.0012.49NA0.6513.14NAXXX
    75746AArtery x-rays, lung1.1312.87NA0.7114.71NAXXX
    7574626AArtery x-rays, lung1.130.380.380.061.571.57XXX
    75746TCAArtery x-rays, lung0.0012.49NA0.6513.14NAXXX
    75756AArtery x-rays, chest1.1312.95NA0.7014.78NAXXX
    7575626AArtery x-rays, chest1.130.460.460.051.641.64XXX
    75756TCAArtery x-rays, chest0.0012.49NA0.6513.14NAXXX
    75774AArtery x-ray, each vessel0.3612.62NA0.6713.65NAZZZ
    7577426AArtery x-ray, each vessel0.360.130.130.020.510.51ZZZ
    75774TCAArtery x-ray, each vessel0.0012.49NA0.6513.14NAZZZ
    75790AVisualize A-V shunt1.831.95NA0.193.97NAXXX
    7579026AVisualize A-V shunt1.830.610.610.112.552.55XXX
    75790TCAVisualize A-V shunt0.001.34NA0.081.42NAXXX
    75801ALymph vessel x-ray, arm/leg0.815.64NA0.356.80NAXXX
    7580126ALymph vessel x-ray, arm/leg0.810.270.270.061.141.14XXX
    75801TCALymph vessel x-ray, arm/leg0.005.37NA0.295.66NAXXX
    75803ALymph vessel x-ray,arms/legs1.165.76NA0.357.27NAXXX
    7580326ALymph vessel x-ray,arms/legs1.160.390.390.061.611.61XXX
    75803TCALymph vessel x-ray,arms/legs0.005.37NA0.295.66NAXXX
    75805ALymph vessel x-ray, trunk0.816.32NA0.377.50NAXXX
    7580526ALymph vessel x-ray, trunk0.810.270.270.051.131.13XXX
    Start Printed Page 63346
    75805TCALymph vessel x-ray, trunk0.006.05NA0.326.37NAXXX
    75807ALymph vessel x-ray, trunk1.166.44NA0.387.98NAXXX
    7580726ALymph vessel x-ray, trunk1.160.390.390.061.611.61XXX
    75807TCALymph vessel x-ray, trunk0.006.05NA0.326.37NAXXX
    75809ANonvascular shunt, x-ray0.470.93NA0.071.47NAXXX
    7580926ANonvascular shunt, x-ray0.470.160.160.020.650.65XXX
    75809TCANonvascular shunt, x-ray0.000.77NA0.050.82NAXXX
    75810AVein x-ray, spleen/liver1.1312.87NA0.7214.72NAXXX
    7581026AVein x-ray, spleen/liver1.130.380.380.071.581.58XXX
    75810TCAVein x-ray, spleen/liver0.0012.49NA0.6513.14NAXXX
    75820AVein x-ray, arm/leg0.701.17NA0.101.97NAXXX
    7582026AVein x-ray, arm/leg0.700.230.230.040.970.97XXX
    75820TCAVein x-ray, arm/leg0.000.94NA0.061.00NAXXX
    75822AVein x-ray, arms/legs1.051.82NA0.143.01NAXXX
    7582226AVein x-ray, arms/legs1.050.350.350.061.461.46XXX
    75822TCAVein x-ray, arms/legs0.001.47NA0.081.55NAXXX
    75825AVein x-ray, trunk1.1312.87NA0.7214.72NAXXX
    7582526AVein x-ray, trunk1.130.380.380.071.581.58XXX
    75825TCAVein x-ray, trunk0.0012.49NA0.6513.14NAXXX
    75827AVein x-ray, chest1.1312.87NA0.7114.71NAXXX
    7582726AVein x-ray, chest1.130.380.380.061.571.57XXX
    75827TCAVein x-ray, chest0.0012.49NA0.6513.14NAXXX
    75831AVein x-ray, kidney1.1312.87NA0.7114.71NAXXX
    7583126AVein x-ray, kidney1.130.380.380.061.571.57XXX
    75831TCAVein x-ray, kidney0.0012.49NA0.6513.14NAXXX
    75833AVein x-ray, kidneys1.4812.99NA0.7315.20NAXXX
    7583326AVein x-ray, kidneys1.480.500.500.082.062.06XXX
    75833TCAVein x-ray, kidneys0.0012.49NA0.6513.14NAXXX
    75840AVein x-ray, adrenal gland1.1312.88NA0.7314.74NAXXX
    7584026AVein x-ray, adrenal gland1.130.390.390.081.601.60XXX
    75840TCAVein x-ray, adrenal gland0.0012.49NA0.6513.14NAXXX
    75842AVein x-ray, adrenal glands1.4812.98NA0.7315.19NAXXX
    7584226AVein x-ray, adrenal glands1.480.490.490.082.052.05XXX
    75842TCAVein x-ray, adrenal glands0.0012.49NA0.6513.14NAXXX
    75860AVein x-ray, neck1.1312.89NA0.7214.74NAXXX
    7586026AVein x-ray, neck1.130.400.400.071.601.60XXX
    75860TCAVein x-ray, neck0.0012.49NA0.6513.14NAXXX
    75870AVein x-ray, skull1.1312.89NA0.7214.74NAXXX
    7587026AVein x-ray, skull1.130.400.400.071.601.60XXX
    75870TCAVein x-ray, skull0.0012.49NA0.6513.14NAXXX
    75872AVein x-ray, skull1.1312.87NA0.7114.71NAXXX
    7587226AVein x-ray, skull1.130.380.380.061.571.57XXX
    75872TCAVein x-ray, skull0.0012.49NA0.6513.14NAXXX
    75880AVein x-ray, eye socket0.701.18NA0.101.98NAXXX
    7588026AVein x-ray, eye socket0.700.240.240.040.980.98XXX
    75880TCAVein x-ray, eye socket0.000.94NA0.061.00NAXXX
    75885AVein x-ray, liver1.4312.97NA0.7215.12NAXXX
    7588526AVein x-ray, liver1.430.480.480.071.981.98XXX
    75885TCAVein x-ray, liver0.0012.49NA0.6513.14NAXXX
    75887AVein x-ray, liver1.4312.97NA0.7215.12NAXXX
    7588726AVein x-ray, liver1.430.480.480.071.981.98XXX
    75887TCAVein x-ray, liver0.0012.49NA0.6513.14NAXXX
    75889AVein x-ray, liver1.1312.87NA0.7114.71NAXXX
    7588926AVein x-ray, liver1.130.380.380.061.571.57XXX
    75889TCAVein x-ray, liver0.0012.49NA0.6513.14NAXXX
    75891AVein x-ray, liver1.1312.87NA0.7114.71NAXXX
    7589126AVein x-ray, liver1.130.380.380.061.571.57XXX
    75891TCAVein x-ray, liver0.0012.49NA0.6513.14NAXXX
    75893AVenous sampling by catheter0.5412.67NA0.6713.88NAXXX
    7589326AVenous sampling by catheter0.540.180.180.020.740.74XXX
    75893TCAVenous sampling by catheter0.0012.49NA0.6513.14NAXXX
    75894AX-rays, transcath therapy1.3024.36NA1.3427.00NAXXX
    7589426AX-rays, transcath therapy1.300.440.440.081.821.82XXX
    75894TCAX-rays, transcath therapy0.0023.92NA1.2625.18NAXXX
    75896AX-rays, transcath therapy1.3021.27NA1.1623.73NAXXX
    7589626AX-rays, transcath therapy1.300.460.460.071.831.83XXX
    75896TCAX-rays, transcath therapy0.0020.81NA1.0921.90NAXXX
    75898AFollow-up angiography1.641.60NA0.143.38NAXXX
    7589826AFollow-up angiography1.640.560.560.082.282.28XXX
    75898TCAFollow-up angiography0.001.04NA0.061.10NAXXX
    75900AArterial catheter exchange0.4920.95NA1.1222.56NAXXX
    7590026AArterial catheter exchange0.490.160.160.020.670.67XXX
    75900TCAArterial catheter exchange0.0020.79NA1.1021.89NAXXX
    75901ARemove cva device obstruct0.491.45NA0.852.79NAXXX
    7590126ARemove cva device obstruct0.490.160.160.020.670.67XXX
    Start Printed Page 63347
    75901TCARemove cva device obstruct0.001.29NA0.832.12NAXXX
    75902ARemove cva lumen obstruct0.391.42NA0.852.66NAXXX
    7590226ARemove cva lumen obstruct0.390.130.130.020.540.54XXX
    75902TCARemove cva lumen obstruct0.001.29NA0.832.12NAXXX
    75940AX-ray placement, vein filter0.5412.67NA0.6913.90NAXXX
    7594026AX-ray placement, vein filter0.540.180.180.040.760.76XXX
    75940TCAX-ray placement, vein filter0.0012.49NA0.6513.14NAXXX
    75945AIntravascular us0.404.66NA0.285.34NAXXX
    7594526AIntravascular us0.400.140.140.040.580.58XXX
    75945TCAIntravascular us0.004.52NA0.244.76NAXXX
    75946AIntravascular us add-on0.402.41NA0.172.98NAZZZ
    7594626AIntravascular us add-on0.400.140.140.040.580.58ZZZ
    75946TCAIntravascular us add-on0.002.27NA0.132.40NAZZZ
    75952CEndovasc repair abdom aorta0.000.000.000.000.000.00XXX
    7595226AEndovasc repair abdom aorta4.471.511.510.826.806.80XXX
    75952TCCEndovasc repair abdom aorta0.000.000.000.000.000.00XXX
    75953CAbdom aneurysm endovas rpr0.000.000.000.000.000.00XXX
    7595326AAbdom aneurysm endovas rpr1.350.460.460.822.632.63XXX
    75953TCCAbdom aneurysm endovas rpr0.000.000.000.000.000.00XXX
    75954CIliac aneurysm endovas rpr0.000.000.000.000.000.00XXX
    7595426AIliac aneurysm endovas rpr1.350.480.480.822.652.65XXX
    75954TCCIliac aneurysm endovas rpr0.000.000.000.000.000.00XXX
    75960ATranscatheter intro, stent0.8215.07NA0.8216.71NAXXX
    7596026ATranscatheter intro, stent0.820.290.290.051.161.16XXX
    75960TCATranscatheter intro, stent0.0014.78NA0.7715.55NAXXX
    75961ARetrieval, broken catheter4.2311.82NA0.7716.82NAXXX
    7596126ARetrieval, broken catheter4.231.411.410.225.865.86XXX
    75961TCARetrieval, broken catheter0.0010.41NA0.5510.96NAXXX
    75962ARepair arterial blockage0.5415.80NA0.8717.21NAXXX
    7596226ARepair arterial blockage0.540.190.190.040.770.77XXX
    75962TCARepair arterial blockage0.0015.61NA0.8316.44NAXXX
    75964ARepair artery blockage, each0.368.45NA0.459.26NAZZZ
    7596426ARepair artery blockage, each0.360.120.120.020.500.50ZZZ
    75964TCARepair artery blockage, each0.008.33NA0.438.76NAZZZ
    75966ARepair arterial blockage1.3016.08NA0.9018.28NAXXX
    7596626ARepair arterial blockage1.300.470.470.071.841.84XXX
    75966TCARepair arterial blockage0.0015.61NA0.8316.44NAXXX
    75968ARepair artery blockage, each0.368.46NA0.449.26NAZZZ
    7596826ARepair artery blockage, each0.360.130.130.010.500.50ZZZ
    75968TCARepair artery blockage, each0.008.33NA0.438.76NAZZZ
    75970AVascular biopsy0.8311.73NA0.6513.21NAXXX
    7597026AVascular biopsy0.830.290.290.051.171.17XXX
    75970TCAVascular biopsy0.0011.44NA0.6012.04NAXXX
    75978ARepair venous blockage0.5415.79NA0.8517.18NAXXX
    7597826ARepair venous blockage0.540.180.180.020.740.74XXX
    75978TCARepair venous blockage0.0015.61NA0.8316.44NAXXX
    75980AContrast xray exam bile duct1.435.85NA0.367.64NAXXX
    7598026AContrast xray exam bile duct1.430.480.480.071.981.98XXX
    75980TCAContrast xray exam bile duct0.005.37NA0.295.66NAXXX
    75982AContrast xray exam bile duct1.436.53NA0.398.35NAXXX
    7598226AContrast xray exam bile duct1.430.480.480.071.981.98XXX
    75982TCAContrast xray exam bile duct0.006.05NA0.326.37NAXXX
    75984AXray control catheter change0.722.17NA0.153.04NAXXX
    7598426AXray control catheter change0.720.240.240.041.001.00XXX
    75984TCAXray control catheter change0.001.93NA0.112.04NAXXX
    75989AAbscess drainage under x-ray1.183.53NA0.234.94NAXXX
    7598926AAbscess drainage under x-ray1.180.400.400.061.641.64XXX
    75989TCAAbscess drainage under x-ray0.003.13NA0.173.30NAXXX
    75992AAtherectomy, x-ray exam0.5415.80NA0.8517.19NAXXX
    7599226AAtherectomy, x-ray exam0.540.190.190.020.750.75XXX
    75992TCAAtherectomy, x-ray exam0.0015.61NA0.8316.44NAXXX
    75993AAtherectomy, x-ray exam0.368.47NA0.449.27NAZZZ
    7599326AAtherectomy, x-ray exam0.360.140.140.010.510.51ZZZ
    75993TCAAtherectomy, x-ray exam0.008.33NA0.438.76NAZZZ
    75994AAtherectomy, x-ray exam1.3016.08NA0.9018.28NAXXX
    7599426AAtherectomy, x-ray exam1.300.470.470.071.841.84XXX
    75994TCAAtherectomy, x-ray exam0.0015.61NA0.8316.44NAXXX
    75995AAtherectomy, x-ray exam1.3016.09NA0.9018.29NAXXX
    7599526AAtherectomy, x-ray exam1.300.480.480.071.851.85XXX
    75995TCAAtherectomy, x-ray exam0.0015.61NA0.8316.44NAXXX
    75996AAtherectomy, x-ray exam0.368.45NA0.449.25NAZZZ
    7599626AAtherectomy, x-ray exam0.360.120.120.010.490.49ZZZ
    75996TCAAtherectomy, x-ray exam0.008.33NA0.438.76NAZZZ
    75998AFluoroguide for vein device0.381.42NA0.151.95NAZZZ
    7599826AFluoroguide for vein device0.380.130.130.050.560.56ZZZ
    Start Printed Page 63348
    75998TCAFluoroguide for vein device0.001.29NA0.101.39NAZZZ
    76000AFluoroscope examination0.171.34NA0.081.59NAXXX
    7600026AFluoroscope examination0.170.050.050.010.230.23XXX
    76000TCAFluoroscope examination0.001.29NA0.071.36NAXXX
    76001AFluoroscope exam, extensive0.672.82NA0.183.67NAXXX
    7600126AFluoroscope exam, extensive0.670.220.220.040.930.93XXX
    76001TCAFluoroscope exam, extensive0.002.60NA0.142.74NAXXX
    76003ANeedle localization by x-ray0.541.46NA0.112.11NAXXX
    7600326ANeedle localization by x-ray0.540.170.170.040.750.75XXX
    76003TCANeedle localization by x-ray0.001.29NA0.071.36NAXXX
    76005AFluoroguide for spine inject0.601.45NA0.112.16NAXXX
    7600526AFluoroguide for spine inject0.600.160.160.040.800.80XXX
    76005TCAFluoroguide for spine inject0.001.29NA0.071.36NAXXX
    76006AX-ray stress view0.410.190.190.050.650.65XXX
    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 fluor1.300.480.480.282.062.06XXX
    76012TCCPercut vertebroplasty fluor0.000.000.000.000.000.00XXX
    76013CPercut vertebroplasty, ct0.000.000.000.000.000.00XXX
    7601326APercut vertebroplasty, ct1.370.490.490.582.442.44XXX
    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 evaluation0.270.86NA0.091.22NAXXX
    7604026AX-rays, bone evaluation0.270.090.090.040.400.40XXX
    76040TCAX-rays, bone evaluation0.000.77NA0.050.82NAXXX
    76061AX-rays, bone survey0.451.14NA0.081.67NAXXX
    7606126AX-rays, bone survey0.450.150.150.020.620.62XXX
    76061TCAX-rays, bone survey0.000.99NA0.061.05NAXXX
    76062AX-rays, bone survey0.541.61NA0.102.25NAXXX
    7606226AX-rays, bone survey0.540.180.180.020.740.74XXX
    76062TCAX-rays, bone survey0.001.43NA0.081.51NAXXX
    76065AX-rays, bone evaluation0.700.96NA0.061.72NAXXX
    7606526AX-rays, bone evaluation0.700.240.240.010.950.95XXX
    76065TCAX-rays, bone evaluation0.000.72NA0.050.77NAXXX
    76066AJoint survey, single view0.311.21NA0.081.60NAXXX
    7606626AJoint survey, single view0.310.110.110.020.440.44XXX
    76066TCAJoint survey, single view0.001.10NA0.061.16NAXXX
    76070ACt bone density, axial0.253.01NA0.173.43NAXXX
    7607026ACt bone density, axial0.250.080.080.010.340.34XXX
    76070TCACt bone density, axial0.002.93NA0.163.09NAXXX
    76071ACt bone density, peripheral0.223.00NA0.063.28NAXXX
    7607126ACt bone density, peripheral0.220.070.070.010.300.30XXX
    76071TCACt bone density, peripheral0.002.93NA0.052.98NAXXX
    76075ADexa, axial skeleton study0.303.17NA0.183.65NAXXX
    7607526ADexa, axial skeleton study0.300.100.100.010.410.41XXX
    76075TCADexa, axial skeleton study0.003.07NA0.173.24NAXXX
    76076ADexa, peripheral study0.220.82NA0.061.10NAXXX
    7607626ADexa, peripheral study0.220.080.080.010.310.31XXX
    76076TCADexa, peripheral study0.000.74NA0.050.79NAXXX
    76078ARadiographic absorptiometry0.200.81NA0.061.07NAXXX
    7607826ARadiographic absorptiometry0.200.070.070.010.280.28XXX
    76078TCARadiographic absorptiometry0.000.74NA0.050.79NAXXX
    76080AX-ray exam of fistula0.541.22NA0.081.84NAXXX
    7608026AX-ray exam of fistula0.540.180.180.020.740.74XXX
    76080TCAX-ray exam of fistula0.001.04NA0.061.10NAXXX
    76082AComputer mammogram add-on0.060.44NA0.020.52NAZZZ
    7608226AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    76082TCAComputer mammogram add-on0.000.42NA0.010.43NAZZZ
    76083AComputer mammogram add-on0.060.44NA0.020.52NAZZZ
    7608326AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    76083TCAComputer mammogram add-on0.000.42NA0.010.43NAZZZ
    76085FComputer mammogram add-on+0.000.000.000.000.000.00ZZZ
    7608526FComputer mammogram add-on+0.000.000.000.000.000.00ZZZ
    76085TCFComputer mammogram add-on+0.000.000.000.000.000.00ZZZ
    76086AX-ray of mammary duct0.362.72NA0.163.24NAXXX
    7608626AX-ray of mammary duct0.360.120.120.020.500.50XXX
    76086TCAX-ray of mammary duct0.002.60NA0.142.74NAXXX
    76088AX-ray of mammary ducts0.453.78NA0.214.44NAXXX
    7608826AX-ray of mammary ducts0.450.150.150.020.620.62XXX
    76088TCAX-ray of mammary ducts0.003.63NA0.193.82NAXXX
    76090AMammogram, one breast0.701.27NA0.102.07NAXXX
    Start Printed Page 63349
    7609026AMammogram, one breast0.700.230.230.040.970.97XXX
    76090TCAMammogram, one breast0.001.04NA0.061.10NAXXX
    76091AMammogram, both breasts0.871.58NA0.112.56NAXXX
    7609126AMammogram, both breasts0.870.290.290.041.201.20XXX
    76091TCAMammogram, both breasts0.001.29NA0.071.36NAXXX
    76092AMammogram, screening0.701.45NA0.112.26NAXXX
    7609226AMammogram, screening0.700.230.230.040.970.97XXX
    76092TCAMammogram, screening0.001.22NA0.071.29NAXXX
    76093AMagnetic image, breast1.6218.02NA0.9920.63NAXXX
    7609326AMagnetic image, breast1.620.550.550.082.252.25XXX
    76093TCAMagnetic image, breast0.0017.47NA0.9118.38NAXXX
    76094AMagnetic image, both breasts1.6224.25NA1.3127.18NAXXX
    7609426AMagnetic image, both breasts1.620.540.540.082.242.24XXX
    76094TCAMagnetic image, both breasts0.0023.71NA1.2324.94NAXXX
    76095AStereotactic breast biopsy1.587.63NA0.489.69NAXXX
    7609526AStereotactic breast biopsy1.580.530.530.112.222.22XXX
    76095TCAStereotactic breast biopsy0.007.10NA0.377.47NAXXX
    76096AX-ray of needle wire, breast0.561.48NA0.112.15NAXXX
    7609626AX-ray of needle wire, breast0.560.190.190.040.790.79XXX
    76096TCAX-ray of needle wire, breast0.001.29NA0.071.36NAXXX
    76098AX-ray exam, breast specimen0.160.47NA0.030.66NAXXX
    7609826AX-ray exam, breast specimen0.160.050.050.010.220.22XXX
    76098TCAX-ray exam, breast specimen0.000.42NA0.020.44NAXXX
    76100AX-ray exam of body section0.581.43NA0.112.12NAXXX
    7610026AX-ray exam of body section0.580.190.190.040.810.81XXX
    76100TCAX-ray exam of body section0.001.24NA0.071.31NAXXX
    76101AComplex body section x-ray0.581.60NA0.122.30NAXXX
    7610126AComplex body section x-ray0.580.190.190.040.810.81XXX
    76101TCAComplex body section x-ray0.001.41NA0.081.49NAXXX
    76102AComplex body section x-rays0.581.92NA0.152.65NAXXX
    7610226AComplex body section x-rays0.580.200.200.040.820.82XXX
    76102TCAComplex body section x-rays0.001.72NA0.111.83NAXXX
    76120ACine/video x-rays0.381.17NA0.081.63NAXXX
    7612026ACine/video x-rays0.380.130.130.020.530.53XXX
    76120TCACine/video x-rays0.001.04NA0.061.10NAXXX
    76125ACine/video x-rays add-on0.270.86NA0.061.19NAZZZ
    7612526ACine/video x-rays add-on0.270.090.090.010.370.37ZZZ
    76125TCACine/video x-rays add-on0.000.77NA0.050.82NAZZZ
    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
    76355ACt scan for localization1.208.60NA0.4910.29NAXXX
    7635526ACt scan for localization1.200.410.410.071.681.68XXX
    76355TCACt scan for localization0.008.19NA0.428.61NAXXX
    76360ACt scan for needle biopsy1.158.58NA0.4810.21NAXXX
    7636026ACt scan for needle biopsy1.150.390.390.061.601.60XXX
    76360TCACt scan for needle biopsy0.008.19NA0.428.61NAXXX
    76362ACt guide for tissue ablation3.989.51NA1.6715.16NAXXX
    7636226ACt guide for tissue ablation3.981.321.320.225.525.52XXX
    76362TCACt guide for tissue ablation0.008.19NA1.459.64NAXXX
    76370ACt scan for therapy guide0.853.21NA0.214.27NAXXX
    7637026ACt scan for therapy guide0.850.280.280.051.181.18XXX
    76370TCACt scan for therapy guide0.002.93NA0.163.09NAXXX
    76375A3d/holograph reconstr add-on0.163.56NA0.193.91NAXXX
    7637526A3d/holograph reconstr add-on0.160.050.050.010.220.22XXX
    76375TCA3d/holograph reconstr add-on0.003.51NA0.183.69NAXXX
    76380ACAT scan follow-up study0.973.80NA0.235.00NAXXX
    7638026ACAT scan follow-up study0.970.330.330.051.351.35XXX
    76380TCACAT scan follow-up study0.003.47NA0.183.65NAXXX
    76390NMr spectroscopy+1.3911.5511.550.6613.6013.60XXX
    7639026NMr spectroscopy+1.390.480.480.071.941.94XXX
    76390TCNMr spectroscopy+0.0011.0711.070.5911.6611.66XXX
    76393AMr guidance for needle place1.4911.62NA0.6313.74NAXXX
    7639326AMr guidance for needle place1.490.510.510.082.082.08XXX
    76393TCAMr guidance for needle place0.0011.11NA0.5511.66NAXXX
    76394AMri for tissue ablation4.2312.52NA1.7818.53NAXXX
    7639426AMri for tissue ablation4.231.411.410.235.875.87XXX
    76394TCAMri for tissue ablation0.0011.11NA1.5512.66NAXXX
    76400AMagnetic image, bone marrow1.5911.64NA0.6713.90NAXXX
    7640026AMagnetic image, bone marrow1.590.530.530.082.202.20XXX
    76400TCAMagnetic image, bone marrow0.0011.11NA0.5911.70NAXXX
    76490DUs for tissue ablation0.000.000.000.000.000.00XXX
    7649026DUs for tissue ablation0.000.000.000.000.000.00XXX
    76490TCDUs for tissue ablation0.000.000.000.000.000.00XXX
    76496CFluoroscopic procedure0.000.000.000.000.000.00XXX
    Start Printed Page 63350
    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 head0.631.66NA0.122.41NAXXX
    7650626AEcho exam of head0.630.250.250.040.920.92XXX
    76506TCAEcho exam of head0.001.41NA0.081.49NAXXX
    76511AEcho exam of eye0.931.10NA0.092.12NAXXX
    7651126AEcho exam of eye0.930.410.410.021.361.36XXX
    76511TCAEcho exam of eye0.000.69NA0.070.76NAXXX
    76512AEcho exam of eye0.661.03NA0.111.80NAXXX
    7651226AEcho exam of eye0.660.300.300.010.970.97XXX
    76512TCAEcho exam of eye0.000.73NA0.100.83NAXXX
    76513AEcho exam of eye, water bath0.661.11NA0.111.88NAXXX
    7651326AEcho exam of eye, water bath0.660.300.300.010.970.97XXX
    76513TCAEcho exam of eye, water bath0.000.81NA0.100.91NAXXX
    76514AEcho exam of eye, thickness0.170.14NA0.020.33NAXXX
    7651426AEcho exam of eye, thickness0.170.080.080.010.260.26XXX
    76514TCAEcho exam of eye, thickness0.000.06NA0.010.07NAXXX
    76516AEcho exam of eye0.540.74NA0.081.36NAXXX
    7651626AEcho exam of eye0.540.250.250.010.800.80XXX
    76516TCAEcho exam of eye0.000.49NA0.070.56NAXXX
    76519AEcho exam of eye0.540.83NA0.081.45NAXXX
    7651926AEcho exam of eye0.540.250.250.010.800.80XXX
    76519TCAEcho exam of eye0.000.58NA0.070.65NAXXX
    76529AEcho exam of eye0.570.78NA0.091.44NAXXX
    7652926AEcho exam of eye0.570.250.250.010.830.83XXX
    76529TCAEcho exam of eye0.000.53NA0.080.61NAXXX
    76536AUs exam of head and neck0.561.60NA0.102.26NAXXX
    7653626AUs exam of head and neck0.560.190.190.020.770.77XXX
    76536TCAUs exam of head and neck0.001.41NA0.081.49NAXXX
    76604AUs exam, chest, b-scan0.551.47NA0.092.11NAXXX
    7660426AUs exam, chest, b-scan0.550.180.180.020.750.75XXX
    76604TCAUs exam, chest, b-scan0.001.29NA0.071.36NAXXX
    76645AUs exam, breast(s)0.541.22NA0.101.86NAXXX
    7664526AUs exam, breast(s)0.540.180.180.040.760.76XXX
    76645TCAUs exam, breast(s)0.001.04NA0.061.10NAXXX
    76700AUs exam, abdom, complete0.812.22NA0.163.19NAXXX
    7670026AUs exam, abdom, complete0.810.270.270.051.131.13XXX
    76700TCAUs exam, abdom, complete0.001.95NA0.112.06NAXXX
    76705AEcho exam of abdomen0.591.61NA0.122.32NAXXX
    7670526AEcho exam of abdomen0.590.200.200.040.830.83XXX
    76705TCAEcho exam of abdomen0.001.41NA0.081.49NAXXX
    76770AUs exam abdo back wall, comp0.742.20NA0.153.09NAXXX
    7677026AUs exam abdo back wall, comp0.740.250.250.041.031.03XXX
    76770TCAUs exam abdo back wall, comp0.001.95NA0.112.06NAXXX
    76775AUs exam abdo back wall, lim0.581.60NA0.122.30NAXXX
    7677526AUs exam abdo back wall, lim0.580.190.190.040.810.81XXX
    76775TCAUs exam abdo back wall, lim0.001.41NA0.081.49NAXXX
    76778AUs exam kidney transplant0.742.20NA0.153.09NAXXX
    7677826AUs exam kidney transplant0.740.250.250.041.031.03XXX
    76778TCAUs exam kidney transplant0.001.95NA0.112.06NAXXX
    76800AUs exam, spinal canal1.121.76NA0.133.01NAXXX
    7680026AUs exam, spinal canal1.120.350.350.051.521.52XXX
    76800TCAUs exam, spinal canal0.001.41NA0.081.49NAXXX
    76801AOb us < 14 wks, single fetus0.982.43NA0.173.58NAXXX
    7680126AOb us < 14 wks, single fetus0.980.350.350.051.381.38XXX
    76801TCAOb us < 14 wks, single fetus0.002.08NA0.122.20NAXXX
    76802AOb us < 14 wks, addl fetus0.831.33NA0.172.33NAZZZ
    7680226AOb us < 14 wks, addl fetus0.830.290.290.051.171.17ZZZ
    76802TCAOb us < 14 wks, addl fetus0.001.04NA0.121.16NAZZZ
    76805AOb us >/= 14 wks, sngl fetus0.982.43NA0.173.58NAXXX
    7680526AOb us >/= 14 wks, sngl fetus0.980.350.350.051.381.38XXX
    76805TCAOb us >/= 14 wks, sngl fetus0.002.08NA0.122.20NAXXX
    76810AOb us >/= 14 wks, addl fetus0.971.39NA0.302.66NAZZZ
    7681026AOb us >/= 14 wks, addl fetus0.970.350.350.081.401.40ZZZ
    76810TCAOb us >/= 14 wks, addl fetus0.001.04NA0.221.26NAZZZ
    76811AOb us, detailed, sngl fetus1.894.16NA0.616.66NAXXX
    Start Printed Page 63351
    7681126AOb us, detailed, sngl fetus1.890.660.660.182.732.73XXX
    76811TCAOb us, detailed, sngl fetus0.003.50NA0.433.93NAXXX
    76812AOb us, detailed, addl fetus1.771.68NA0.554.00NAZZZ
    7681226AOb us, detailed, addl fetus1.770.640.640.142.552.55ZZZ
    76812TCAOb us, detailed, addl fetus0.001.04NA0.411.45NAZZZ
    76815AOb us, limited, fetus(s)0.651.64NA0.102.39NAXXX
    7681526AOb us, limited, fetus(s)0.650.230.230.020.900.90XXX
    76815TCAOb us, limited, fetus(s)0.001.41NA0.081.49NAXXX
    76816AOb us, follow-up, per fetus0.851.42NA0.082.35NAXXX
    7681626AOb us, follow-up, per fetus0.850.320.320.021.191.19XXX
    76816TCAOb us, follow-up, per fetus0.001.10NA0.061.16NAXXX
    76817ATransvaginal us, obstetric0.751.79NA0.082.62NAXXX
    7681726ATransvaginal us, obstetric0.750.280.280.021.051.05XXX
    76817TCATransvaginal us, obstetric0.001.51NA0.061.57NAXXX
    76818AFetal biophys profile w/nst1.042.00NA0.153.19NAXXX
    7681826AFetal biophys profile w/nst1.040.400.400.051.491.49XXX
    76818TCAFetal biophys profile w/nst0.001.60NA0.101.70NAXXX
    76819AFetal biophys profil w/o nst0.771.89NA0.122.78NAXXX
    7681926AFetal biophys profil w/o nst0.770.290.290.021.081.08XXX
    76819TCAFetal biophys profil w/o nst0.001.60NA0.101.70NAXXX
    76825AEcho exam of fetal heart1.662.57NA0.184.41NAXXX
    7682526AEcho exam of fetal heart1.660.620.620.072.352.35XXX
    76825TCAEcho exam of fetal heart0.001.95NA0.112.06NAXXX
    76826AEcho exam of fetal heart0.831.00NA0.091.92NAXXX
    7682626AEcho exam of fetal heart0.830.300.300.041.171.17XXX
    76826TCAEcho exam of fetal heart0.000.70NA0.050.75NAXXX
    76827AEcho exam of fetal heart0.581.93NA0.142.65NAXXX
    7682726AEcho exam of fetal heart0.580.220.220.020.820.82XXX
    76827TCAEcho exam of fetal heart0.001.71NA0.121.83NAXXX
    76828AEcho exam of fetal heart0.561.32NA0.101.98NAXXX
    7682826AEcho exam of fetal heart0.560.220.220.020.800.80XXX
    76828TCAEcho exam of fetal heart0.001.10NA0.081.18NAXXX
    76830ATransvaginal us, non-ob0.691.74NA0.142.57NAXXX
    7683026ATransvaginal us, non-ob0.690.230.230.040.960.96XXX
    76830TCATransvaginal us, non-ob0.001.51NA0.101.61NAXXX
    76831AEcho exam, uterus0.721.77NA0.122.61NAXXX
    7683126AEcho exam, uterus0.720.260.260.021.001.00XXX
    76831TCAEcho exam, uterus0.001.51NA0.101.61NAXXX
    76856AUs exam, pelvic, complete0.691.74NA0.142.57NAXXX
    7685626AUs exam, pelvic, complete0.690.230.230.040.960.96XXX
    76856TCAUs exam, pelvic, complete0.001.51NA0.101.61NAXXX
    76857AUs exam, pelvic, limited0.381.71NA0.082.17NAXXX
    7685726AUs exam, pelvic, limited0.380.130.130.020.530.53XXX
    76857TCAUs exam, pelvic, limited0.001.58NA0.061.64NAXXX
    76870AUs exam, scrotum0.641.72NA0.142.50NAXXX
    7687026AUs exam, scrotum0.640.210.210.040.890.89XXX
    76870TCAUs exam, scrotum0.001.51NA0.101.61NAXXX
    76872AUs, transrectal0.692.10NA0.152.94NAXXX
    7687226AUs, transrectal0.690.230.230.050.970.97XXX
    76872TCAUs, transrectal0.001.87NA0.101.97NAXXX
    76873AEchograp trans r, pros study1.542.59NA0.264.39NAXXX
    7687326AEchograp trans r, pros study1.540.510.510.102.152.15XXX
    76873TCAEchograp trans r, pros study0.002.08NA0.162.24NAXXX
    76880AUs exam, extremity0.591.61NA0.122.32NAXXX
    7688026AUs exam, extremity0.590.200.200.040.830.83XXX
    76880TCAUs exam, extremity0.001.41NA0.081.49NAXXX
    76885AUs exam infant hips, dynamic0.741.76NA0.142.64NAXXX
    7688526AUs exam infant hips, dynamic0.740.250.250.041.031.03XXX
    76885TCAUs exam infant hips, dynamic0.001.51NA0.101.61NAXXX
    76886AUs exam infant hips, static0.621.62NA0.122.36NAXXX
    7688626AUs exam infant hips, static0.620.210.210.040.870.87XXX
    76886TCAUs exam infant hips, static0.001.41NA0.081.49NAXXX
    76930AEcho guide, cardiocentesis0.671.77NA0.122.56NAXXX
    7693026AEcho guide, cardiocentesis0.670.260.260.020.950.95XXX
    76930TCAEcho guide, cardiocentesis0.001.51NA0.101.61NAXXX
    76932AEcho guide for heart biopsy0.671.77NA0.122.56NAXXX
    7693226AEcho guide for heart biopsy0.670.260.260.020.950.95XXX
    76932TCAEcho guide for heart biopsy0.001.51NA0.101.61NAXXX
    76936AEcho guide for artery repair1.986.90NA0.479.35NAXXX
    7693626AEcho guide for artery repair1.980.660.660.132.772.77XXX
    76936TCAEcho guide for artery repair0.006.24NA0.346.58NAXXX
    76937AUs guide, vascular access0.300.48NA0.150.93NAZZZ
    7693726AUs guide, vascular access0.300.100.100.050.450.45ZZZ
    76937TCAUs guide, vascular access0.000.38NA0.100.48NAZZZ
    76940AUs guide, tissue ablation1.992.16NA0.424.57NAXXX
    Start Printed Page 63352
    7694026AUs guide, tissue ablation1.990.650.650.132.772.77XXX
    76940TCAUs guide, tissue ablation0.001.51NA0.291.80NAXXX
    76941AEcho guide for transfusion1.332.00NA0.153.48NAXXX
    7694126AEcho guide for transfusion1.330.480.480.071.881.88XXX
    76941TCAEcho guide for transfusion0.001.52NA0.081.60NAXXX
    76942AEcho guide for biopsy0.672.77NA0.153.59NAXXX
    7694226AEcho guide for biopsy0.670.220.220.050.940.94XXX
    76942TCAEcho guide for biopsy0.002.55NA0.102.65NAXXX
    76945AEcho guide, villus sampling0.671.75NA0.122.54NAXXX
    7694526AEcho guide, villus sampling0.670.230.230.040.940.94XXX
    76945TCAEcho guide, villus sampling0.001.52NA0.081.60NAXXX
    76946AEcho guide for amniocentesis0.381.65NA0.112.14NAXXX
    7694626AEcho guide for amniocentesis0.380.140.140.010.530.53XXX
    76946TCAEcho guide for amniocentesis0.001.51NA0.101.61NAXXX
    76948AEcho guide, ova aspiration0.381.64NA0.122.14NAXXX
    7694826AEcho guide, ova aspiration0.380.130.130.020.530.53XXX
    76948TCAEcho guide, ova aspiration0.001.51NA0.101.61NAXXX
    76950AEcho guidance radiotherapy0.581.48NA0.112.17NAXXX
    7695026AEcho guidance radiotherapy0.580.190.190.040.810.81XXX
    76950TCAEcho guidance radiotherapy0.001.29NA0.071.36NAXXX
    76965AEcho guidance radiotherapy1.335.96NA0.377.66NAXXX
    7696526AEcho guidance radiotherapy1.330.440.440.081.851.85XXX
    76965TCAEcho guidance radiotherapy0.005.52NA0.295.81NAXXX
    76970AUltrasound exam follow-up0.401.17NA0.081.65NAXXX
    7697026AUltrasound exam follow-up0.400.130.130.020.550.55XXX
    76970TCAUltrasound exam follow-up0.001.04NA0.061.10NAXXX
    76975AGI endoscopic ultrasound0.811.79NA0.142.74NAXXX
    7697526AGI endoscopic ultrasound0.810.280.280.041.131.13XXX
    76975TCAGI endoscopic ultrasound0.001.51NA0.101.61NAXXX
    76977AUs bone density measure0.050.83NA0.060.94NAXXX
    7697726AUs bone density measure0.050.020.020.010.080.08XXX
    76977TCAUs bone density measure0.000.81NA0.050.86NAXXX
    76986AUltrasound guide intraoper1.193.01NA0.224.42NAXXX
    7698626AUltrasound guide intraoper1.190.410.410.081.681.68XXX
    76986TCAUltrasound guide intraoper0.002.60NA0.142.74NAXXX
    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 planning1.380.520.520.071.971.97XXX
    77262ARadiation therapy planning2.100.760.760.112.972.97XXX
    77263ARadiation therapy planning3.121.121.120.164.404.40XXX
    77280ASet radiation therapy field0.703.67NA0.224.59NAXXX
    7728026ASet radiation therapy field0.700.230.230.040.970.97XXX
    77280TCASet radiation therapy field0.003.44NA0.183.62NAXXX
    77285ASet radiation therapy field1.045.86NA0.357.25NAXXX
    7728526ASet radiation therapy field1.040.340.340.051.431.43XXX
    77285TCASet radiation therapy field0.005.52NA0.305.82NAXXX
    77290ASet radiation therapy field1.556.95NA0.428.92NAXXX
    7729026ASet radiation therapy field1.550.500.500.072.122.12XXX
    77290TCASet radiation therapy field0.006.45NA0.356.80NAXXX
    77295ASet radiation therapy field4.5429.16NA1.6935.39NAXXX
    7729526ASet radiation therapy field4.541.461.460.226.226.22XXX
    77295TCASet radiation therapy field0.0027.70NA1.4729.17NAXXX
    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 plan0.621.53NA0.112.26NAXXX
    7730026ARadiation therapy dose plan0.620.200.200.040.860.86XXX
    77300TCARadiation therapy dose plan0.001.33NA0.071.40NAXXX
    77301ARadiotherapy dose plan, imrt7.9530.26NA1.6939.90NAXXX
    7730126ARadiotherapy dose plan, imrt7.952.562.560.2210.7310.73XXX
    77301TCARadiotherapy dose plan, imrt0.0027.70NA1.4729.17NAXXX
    77305ATeletx isodose plan simple0.702.07NA0.152.92NAXXX
    7730526ATeletx isodose plan simple0.700.230.230.040.970.97XXX
    77305TCATeletx isodose plan simple0.001.84NA0.111.95NAXXX
    77310ATeletx isodose plan intermed1.042.65NA0.183.87NAXXX
    7731026ATeletx isodose plan intermed1.040.340.340.051.431.43XXX
    77310TCATeletx isodose plan intermed0.002.31NA0.132.44NAXXX
    77315ATeletx isodose plan complex1.553.14NA0.214.90NAXXX
    7731526ATeletx isodose plan complex1.550.500.500.072.122.12XXX
    77315TCATeletx isodose plan complex0.002.64NA0.142.78NAXXX
    77321ASpecial teletx port plan0.944.32NA0.255.51NAXXX
    7732126ASpecial teletx port plan0.940.310.310.051.301.30XXX
    77321TCASpecial teletx port plan0.004.01NA0.204.21NAXXX
    77326ABrachytx isodose calc simp0.922.64NA0.183.74NAXXX
    Start Printed Page 63353
    7732626ABrachytx isodose calc simp0.920.300.300.051.271.27XXX
    77326TCABrachytx isodose calc simp0.002.34NA0.132.47NAXXX
    77327ABrachytx isodose calc interm1.383.89NA0.255.52NAXXX
    7732726ABrachytx isodose calc interm1.380.450.450.071.901.90XXX
    77327TCABrachytx isodose calc interm0.003.44NA0.183.62NAXXX
    77328ABrachytx isodose plan compl2.085.58NA0.368.02NAXXX
    7732826ABrachytx isodose plan compl2.080.660.660.112.852.85XXX
    77328TCABrachytx isodose plan compl0.004.92NA0.255.17NAXXX
    77331ASpecial radiation dosimetry0.870.78NA0.071.72NAXXX
    7733126ASpecial radiation dosimetry0.870.280.280.051.201.20XXX
    77331TCASpecial radiation dosimetry0.000.50NA0.020.52NAXXX
    77332ARadiation treatment aid(s)0.541.50NA0.092.13NAXXX
    7733226ARadiation treatment aid(s)0.540.170.170.020.730.73XXX
    77332TCARadiation treatment aid(s)0.001.33NA0.071.40NAXXX
    77333ARadiation treatment aid(s)0.842.15NA0.163.15NAXXX
    7733326ARadiation treatment aid(s)0.840.270.270.051.161.16XXX
    77333TCARadiation treatment aid(s)0.001.88NA0.111.99NAXXX
    77334ARadiation treatment aid(s)1.233.62NA0.235.08NAXXX
    7733426ARadiation treatment aid(s)1.230.400.400.061.691.69XXX
    77334TCARadiation treatment aid(s)0.003.22NA0.173.39NAXXX
    77336ARadiation physics consult0.002.96NA0.163.12NAXXX
    77370ARadiation physics consult0.003.46NA0.183.64NAXXX
    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 delivery0.001.76NA0.111.87NAXXX
    77402ARadiation treatment delivery0.001.76NA0.111.87NAXXX
    77403ARadiation treatment delivery0.001.76NA0.111.87NAXXX
    77404ARadiation treatment delivery0.001.76NA0.111.87NAXXX
    77406ARadiation treatment delivery0.001.76NA0.111.87NAXXX
    77407ARadiation treatment delivery0.002.07NA0.122.19NAXXX
    77408ARadiation treatment delivery0.002.07NA0.122.19NAXXX
    77409ARadiation treatment delivery0.002.07NA0.122.19NAXXX
    77411ARadiation treatment delivery0.002.07NA0.122.19NAXXX
    77412ARadiation treatment delivery0.002.31NA0.132.44NAXXX
    77413ARadiation treatment delivery0.002.31NA0.132.44NAXXX
    77414ARadiation treatment delivery0.002.31NA0.132.44NAXXX
    77416ARadiation treatment delivery0.002.31NA0.132.44NAXXX
    77417ARadiology port film(s)0.000.59NA0.040.63NAXXX
    77418ARadiation tx delivery, imrt0.0017.83NA0.1317.96NAXXX
    77427ARadiation tx management, x53.291.061.060.174.524.52XXX
    77431ARadiation therapy management1.800.680.680.082.562.56XXX
    77432AStereotactic radiation trmt7.882.932.930.4011.2111.21XXX
    77470ASpecial radiation treatment2.0811.71NA0.7014.49NAXXX
    7747026ASpecial radiation treatment2.080.660.660.112.852.85XXX
    77470TCASpecial radiation treatment0.0011.05NA0.5911.64NAXXX
    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 treatment1.553.52NA0.265.33NAXXX
    7760026RHyperthermia treatment1.550.500.500.102.152.15XXX
    77600TCRHyperthermia treatment0.003.02NA0.163.18NAXXX
    77605RHyperthermia treatment2.084.69NA0.387.15NAXXX
    7760526RHyperthermia treatment2.080.660.660.162.902.90XXX
    77605TCRHyperthermia treatment0.004.03NA0.224.25NAXXX
    77610RHyperthermia treatment1.553.53NA0.245.32NAXXX
    7761026RHyperthermia treatment1.550.510.510.082.142.14XXX
    77610TCRHyperthermia treatment0.003.02NA0.163.18NAXXX
    77615RHyperthermia treatment2.084.69NA0.337.10NAXXX
    7761526RHyperthermia treatment2.080.660.660.112.852.85XXX
    77615TCRHyperthermia treatment0.004.03NA0.224.25NAXXX
    77620RHyperthermia treatment1.553.54NA0.235.32NAXXX
    7762026RHyperthermia treatment1.550.520.520.072.142.14XXX
    77620TCRHyperthermia treatment0.003.02NA0.163.18NAXXX
    77750AInfuse radioactive materials4.882.91NA0.278.06NA090
    7775026AInfuse radioactive materials4.881.591.590.206.676.67090
    77750TCAInfuse radioactive materials0.001.32NA0.071.39NA090
    77761AApply intrcav radiat simple3.793.58NA0.337.70NA090
    7776126AApply intrcav radiat simple3.791.101.100.195.085.08090
    77761TCAApply intrcav radiat simple0.002.48NA0.142.62NA090
    77762AApply intrcav radiat interm5.695.42NA0.4511.56NA090
    Start Printed Page 63354
    7776226AApply intrcav radiat interm5.691.851.850.267.807.80090
    77762TCAApply intrcav radiat interm0.003.57NA0.193.76NA090
    77763AApply intrcav radiat compl8.527.20NA0.6416.36NA090
    7776326AApply intrcav radiat compl8.522.752.750.4111.6811.68090
    77763TCAApply intrcav radiat compl0.004.45NA0.234.68NA090
    77776AApply interstit radiat simpl4.633.12NA0.428.17NA090
    7777626AApply interstit radiat simpl4.630.970.970.295.895.89090
    77776TCAApply interstit radiat simpl0.002.15NA0.132.28NA090
    77777AApply interstit radiat inter7.446.57NA0.6014.61NA090
    7777726AApply interstit radiat inter7.442.372.370.3810.1910.19090
    77777TCAApply interstit radiat inter0.004.20NA0.224.42NA090
    77778AApply interstit radiat compl11.138.66NA0.8220.61NA090
    7777826AApply interstit radiat compl11.133.573.570.5615.2615.26090
    77778TCAApply interstit radiat compl0.005.09NA0.265.35NA090
    77781AHigh intensity brachytherapy1.6520.67NA1.1323.45NA090
    7778126AHigh intensity brachytherapy1.650.540.540.082.272.27090
    77781TCAHigh intensity brachytherapy0.0020.13NA1.0521.18NA090
    77782AHigh intensity brachytherapy2.4820.93NA1.1724.58NA090
    7778226AHigh intensity brachytherapy2.480.800.800.123.403.40090
    77782TCAHigh intensity brachytherapy0.0020.13NA1.0521.18NA090
    77783AHigh intensity brachytherapy3.7121.32NA1.2326.26NA090
    7778326AHigh intensity brachytherapy3.711.191.190.185.085.08090
    77783TCAHigh intensity brachytherapy0.0020.13NA1.0521.18NA090
    77784AHigh intensity brachytherapy5.5821.93NA1.3128.82NA090
    7778426AHigh intensity brachytherapy5.581.801.800.267.647.64090
    77784TCAHigh intensity brachytherapy0.0020.13NA1.0521.18NA090
    77789AApply surface radiation1.110.82NA0.061.99NA000
    7778926AApply surface radiation1.110.370.370.041.521.52000
    77789TCAApply surface radiation0.000.45NA0.020.47NA000
    77790ARadiation handling1.040.84NA0.071.95NAXXX
    7779026ARadiation handling1.040.340.340.051.431.43XXX
    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 uptake0.191.03NA0.071.29NAXXX
    7800026AThyroid, single uptake0.190.070.070.010.270.27XXX
    78000TCAThyroid, single uptake0.000.96NA0.061.02NAXXX
    78001AThyroid, multiple uptakes0.261.38NA0.081.72NAXXX
    7800126AThyroid, multiple uptakes0.260.090.090.010.360.36XXX
    78001TCAThyroid, multiple uptakes0.001.29NA0.071.36NAXXX
    78003AThyroid suppress/stimul0.331.07NA0.071.47NAXXX
    7800326AThyroid suppress/stimul0.330.110.110.010.450.45XXX
    78003TCAThyroid suppress/stimul0.000.96NA0.061.02NAXXX
    78006AThyroid imaging with uptake0.492.53NA0.153.17NAXXX
    7800626AThyroid imaging with uptake0.490.170.170.020.680.68XXX
    78006TCAThyroid imaging with uptake0.002.36NA0.132.49NAXXX
    78007AThyroid image, mult uptakes0.502.72NA0.163.38NAXXX
    7800726AThyroid image, mult uptakes0.500.170.170.020.690.69XXX
    78007TCAThyroid image, mult uptakes0.002.55NA0.142.69NAXXX
    78010AThyroid imaging0.391.94NA0.132.46NAXXX
    7801026AThyroid imaging0.390.130.130.020.540.54XXX
    78010TCAThyroid imaging0.001.81NA0.111.92NAXXX
    78011AThyroid imaging with flow0.452.55NA0.153.15NAXXX
    7801126AThyroid imaging with flow0.450.160.160.020.630.63XXX
    78011TCAThyroid imaging with flow0.002.39NA0.132.52NAXXX
    78015AThyroid met imaging0.672.78NA0.183.63NAXXX
    7801526AThyroid met imaging0.670.230.230.040.940.94XXX
    78015TCAThyroid met imaging0.002.55NA0.142.69NAXXX
    78016AThyroid met imaging/studies0.823.74NA0.224.78NAXXX
    7801626AThyroid met imaging/studies0.820.290.290.041.151.15XXX
    78016TCAThyroid met imaging/studies0.003.45NA0.183.63NAXXX
    78018AThyroid met imaging, body0.865.68NA0.336.87NAXXX
    7801826AThyroid met imaging, body0.860.300.300.041.201.20XXX
    78018TCAThyroid met imaging, body0.005.38NA0.295.67NAXXX
    78020AThyroid met uptake0.601.50NA0.162.26NAZZZ
    7802026AThyroid met uptake0.600.210.210.020.830.83ZZZ
    78020TCAThyroid met uptake0.001.29NA0.141.43NAZZZ
    78070AParathyroid nuclear imaging0.822.09NA0.153.06NAXXX
    7807026AParathyroid nuclear imaging0.820.280.280.041.141.14XXX
    78070TCAParathyroid nuclear imaging0.001.81NA0.111.92NAXXX
    78075AAdrenal nuclear imaging0.745.65NA0.336.72NAXXX
    7807526AAdrenal nuclear imaging0.740.270.270.041.051.05XXX
    78075TCAAdrenal nuclear imaging0.005.38NA0.295.67NAXXX
    78099CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    Start Printed Page 63355
    7809926CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78099TCCEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78102ABone marrow imaging, ltd0.552.22NA0.142.91NAXXX
    7810226ABone marrow imaging, ltd0.550.200.200.020.770.77XXX
    78102TCABone marrow imaging, ltd0.002.02NA0.122.14NAXXX
    78103ABone marrow imaging, mult0.753.41NA0.214.37NAXXX
    7810326ABone marrow imaging, mult0.750.260.260.041.051.05XXX
    78103TCABone marrow imaging, mult0.003.15NA0.173.32NAXXX
    78104ABone marrow imaging, body0.804.32NA0.265.38NAXXX
    7810426ABone marrow imaging, body0.800.280.280.041.121.12XXX
    78104TCABone marrow imaging, body0.004.04NA0.224.26NAXXX
    78110APlasma volume, single0.191.01NA0.071.27NAXXX
    7811026APlasma volume, single0.190.070.070.010.270.27XXX
    78110TCAPlasma volume, single0.000.94NA0.061.00NAXXX
    78111APlasma volume, multiple0.222.63NA0.153.00NAXXX
    7811126APlasma volume, multiple0.220.080.080.010.310.31XXX
    78111TCAPlasma volume, multiple0.002.55NA0.142.69NAXXX
    78120ARed cell mass, single0.231.80NA0.122.15NAXXX
    7812026ARed cell mass, single0.230.080.080.010.320.32XXX
    78120TCARed cell mass, single0.001.72NA0.111.83NAXXX
    78121ARed cell mass, multiple0.323.00NA0.153.47NAXXX
    7812126ARed cell mass, multiple0.320.110.110.010.440.44XXX
    78121TCARed cell mass, multiple0.002.89NA0.143.03NAXXX
    78122ABlood volume0.454.72NA0.265.43NAXXX
    7812226ABlood volume0.450.160.160.020.630.63XXX
    78122TCABlood volume0.004.56NA0.244.80NAXXX
    78130ARed cell survival study0.613.04NA0.183.83NAXXX
    7813026ARed cell survival study0.610.210.210.040.860.86XXX
    78130TCARed cell survival study0.002.83NA0.142.97NAXXX
    78135ARed cell survival kinetics0.645.05NA0.295.98NAXXX
    7813526ARed cell survival kinetics0.640.220.220.040.900.90XXX
    78135TCARed cell survival kinetics0.004.83NA0.255.08NAXXX
    78140ARed cell sequestration0.614.10NA0.244.95NAXXX
    7814026ARed cell sequestration0.610.200.200.040.850.85XXX
    78140TCARed cell sequestration0.003.90NA0.204.10NAXXX
    78160APlasma iron turnover0.333.75NA0.234.31NAXXX
    7816026APlasma iron turnover0.330.120.120.040.490.49XXX
    78160TCAPlasma iron turnover0.003.63NA0.193.82NAXXX
    78162ARadioiron absorption exam0.453.37NA0.184.00NAXXX
    7816226ARadioiron absorption exam0.450.190.190.010.650.65XXX
    78162TCARadioiron absorption exam0.003.18NA0.173.35NAXXX
    78170ARed cell iron utilization0.415.40NA0.336.14NAXXX
    7817026ARed cell iron utilization0.410.140.140.050.600.60XXX
    78170TCARed cell iron utilization0.005.26NA0.285.54NAXXX
    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 imaging0.402.48NA0.153.03NAXXX
    7818526ASpleen imaging0.400.140.140.020.560.56XXX
    78185TCASpleen imaging0.002.34NA0.132.47NAXXX
    78190APlatelet survival, kinetics1.086.06NA0.377.51NAXXX
    7819026APlatelet survival, kinetics1.080.390.390.071.541.54XXX
    78190TCAPlatelet survival, kinetics0.005.67NA0.305.97NAXXX
    78191APlatelet survival0.617.48NA0.418.50NAXXX
    7819126APlatelet survival0.610.210.210.040.860.86XXX
    78191TCAPlatelet survival0.007.27NA0.377.64NAXXX
    78195ALymph system imaging1.194.46NA0.285.93NAXXX
    7819526ALymph system imaging1.190.420.420.061.671.67XXX
    78195TCALymph system imaging0.004.04NA0.224.26NAXXX
    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 imaging0.442.49NA0.153.08NAXXX
    7820126ALiver imaging0.440.150.150.020.610.61XXX
    78201TCALiver imaging0.002.34NA0.132.47NAXXX
    78202ALiver imaging with flow0.513.04NA0.163.71NAXXX
    7820226ALiver imaging with flow0.510.180.180.020.710.71XXX
    78202TCALiver imaging with flow0.002.86NA0.143.00NAXXX
    78205ALiver imaging (3D)0.716.10NA0.357.16NAXXX
    7820526ALiver imaging (3D)0.710.250.250.041.001.00XXX
    78205TCALiver imaging (3D)0.005.85NA0.316.16NAXXX
    78206ALiver image (3d) with flow0.956.19NA0.167.30NAXXX
    7820626ALiver image (3d) with flow0.950.340.340.051.341.34XXX
    78206TCALiver image (3d) with flow0.005.85NA0.115.96NAXXX
    78215ALiver and spleen imaging0.493.09NA0.163.74NAXXX
    Start Printed Page 63356
    7821526ALiver and spleen imaging0.490.170.170.020.680.68XXX
    78215TCALiver and spleen imaging0.002.92NA0.143.06NAXXX
    78216ALiver & spleen image/flow0.573.65NA0.204.42NAXXX
    7821626ALiver & spleen image/flow0.570.200.200.020.790.79XXX
    78216TCALiver & spleen image/flow0.003.45NA0.183.63NAXXX
    78220ALiver function study0.493.86NA0.214.56NAXXX
    7822026ALiver function study0.490.170.170.020.680.68XXX
    78220TCALiver function study0.003.69NA0.193.88NAXXX
    78223AHepatobiliary imaging0.843.91NA0.244.99NAXXX
    7822326AHepatobiliary imaging0.840.280.280.051.171.17XXX
    78223TCAHepatobiliary imaging0.003.63NA0.193.82NAXXX
    78230ASalivary gland imaging0.452.30NA0.152.90NAXXX
    7823026ASalivary gland imaging0.450.150.150.020.620.62XXX
    78230TCASalivary gland imaging0.002.15NA0.132.28NAXXX
    78231ASerial salivary imaging0.523.34NA0.194.05NAXXX
    7823126ASerial salivary imaging0.520.190.190.020.730.73XXX
    78231TCASerial salivary imaging0.003.15NA0.173.32NAXXX
    78232ASalivary gland function exam0.473.68NA0.194.34NAXXX
    7823226ASalivary gland function exam0.470.170.170.010.650.65XXX
    78232TCASalivary gland function exam0.003.51NA0.183.69NAXXX
    78258AEsophageal motility study0.743.11NA0.184.03NAXXX
    7825826AEsophageal motility study0.740.250.250.041.031.03XXX
    78258TCAEsophageal motility study0.002.86NA0.143.00NAXXX
    78261AGastric mucosa imaging0.694.32NA0.265.27NAXXX
    7826126AGastric mucosa imaging0.690.250.250.040.980.98XXX
    78261TCAGastric mucosa imaging0.004.07NA0.224.29NAXXX
    78262AGastroesophageal reflux exam0.684.46NA0.265.40NAXXX
    7826226AGastroesophageal reflux exam0.680.240.240.040.960.96XXX
    78262TCAGastroesophageal reflux exam0.004.22NA0.224.44NAXXX
    78264AGastric emptying study0.784.37NA0.265.41NAXXX
    7826426AGastric emptying study0.780.270.270.041.091.09XXX
    78264TCAGastric emptying study0.004.10NA0.224.32NAXXX
    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 exam0.201.61NA0.111.92NAXXX
    7827026AVit B-12 absorption exam0.200.070.070.010.280.28XXX
    78270TCAVit B-12 absorption exam0.001.54NA0.101.64NAXXX
    78271AVit b-12 absrp exam, int fac0.201.70NA0.112.01NAXXX
    7827126AVit b-12 absrp exam, int fac0.200.070.070.010.280.28XXX
    78271TCAVit b-12 absrp exam, int fac0.001.63NA0.101.73NAXXX
    78272AVit B-12 absorp, combined0.272.40NA0.142.81NAXXX
    7827226AVit B-12 absorp, combined0.270.100.100.010.380.38XXX
    78272TCAVit B-12 absorp, combined0.002.30NA0.132.43NAXXX
    78278AAcute GI blood loss imaging0.985.17NA0.306.45NAXXX
    7827826AAcute GI blood loss imaging0.980.340.340.051.371.37XXX
    78278TCAAcute GI blood loss imaging0.004.83NA0.255.08NAXXX
    78282CGI protein loss exam0.000.000.000.000.000.00XXX
    7828226AGI protein loss exam0.380.130.130.020.530.53XXX
    78282TCCGI protein loss exam0.000.000.000.000.000.00XXX
    78290AMeckel's divert exam0.683.25NA0.204.13NAXXX
    7829026AMeckel's divert exam0.680.230.230.040.950.95XXX
    78290TCAMeckel's divert exam0.003.02NA0.163.18NAXXX
    78291ALeveen/shunt patency exam0.873.35NA0.214.43NAXXX
    7829126ALeveen/shunt patency exam0.870.310.310.051.231.23XXX
    78291TCALeveen/shunt patency exam0.003.04NA0.163.20NAXXX
    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 area0.622.67NA0.183.47NAXXX
    7830026ABone imaging, limited area0.620.210.210.040.870.87XXX
    78300TCABone imaging, limited area0.002.46NA0.142.60NAXXX
    78305ABone imaging, multiple areas0.833.91NA0.234.97NAXXX
    7830526ABone imaging, multiple areas0.830.280.280.041.151.15XXX
    78305TCABone imaging, multiple areas0.003.63NA0.193.82NAXXX
    78306ABone imaging, whole body0.864.53NA0.275.66NAXXX
    7830626ABone imaging, whole body0.860.290.290.051.201.20XXX
    78306TCABone imaging, whole body0.004.24NA0.224.46NAXXX
    78315ABone imaging, 3 phase1.015.08NA0.306.39NAXXX
    7831526ABone imaging, 3 phase1.010.350.350.051.411.41XXX
    78315TCABone imaging, 3 phase0.004.73NA0.254.98NAXXX
    78320ABone imaging (3D)1.036.22NA0.367.61NAXXX
    7832026ABone imaging (3D)1.030.370.370.051.451.45XXX
    78320TCABone imaging (3D)0.005.85NA0.316.16NAXXX
    78350ABone mineral, single photon0.220.81NA0.061.09NAXXX
    7835026ABone mineral, single photon0.220.070.070.010.300.30XXX
    Start Printed Page 63357
    78350TCABone mineral, single photon0.000.74NA0.050.79NAXXX
    78351NBone mineral, dual photon+0.301.730.120.012.040.43XXX
    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 imaging0.782.53NA0.173.48NAXXX
    7842826ACardiac shunt imaging0.780.300.300.041.121.12XXX
    78428TCACardiac shunt imaging0.002.23NA0.132.36NAXXX
    78445AVascular flow imaging0.492.01NA0.132.63NAXXX
    7844526AVascular flow imaging0.490.170.170.020.680.68XXX
    78445TCAVascular flow imaging0.001.84NA0.111.95NAXXX
    78455AVenous thrombosis study0.734.20NA0.245.17NAXXX
    7845526AVenous thrombosis study0.730.250.250.041.021.02XXX
    78455TCAVenous thrombosis study0.003.95NA0.204.15NAXXX
    78456AAcute venous thrombus image0.994.30NA0.345.63NAXXX
    7845626AAcute venous thrombus image0.990.350.350.051.391.39XXX
    78456TCAAcute venous thrombus image0.003.95NA0.294.24NAXXX
    78457AVenous thrombosis imaging0.772.91NA0.183.86NAXXX
    7845726AVenous thrombosis imaging0.770.270.270.041.081.08XXX
    78457TCAVenous thrombosis imaging0.002.64NA0.142.78NAXXX
    78458AVen thrombosis images, bilat0.894.32NA0.245.45NAXXX
    7845826AVen thrombosis images, bilat0.890.330.330.041.261.26XXX
    78458TCAVen thrombosis images, bilat0.003.99NA0.204.19NAXXX
    78459CHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    7845926RHeart muscle imaging (PET)1.490.590.590.052.132.13XXX
    78459TCCHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    78460AHeart muscle blood, single0.862.64NA0.173.67NAXXX
    7846026AHeart muscle blood, single0.860.300.300.041.201.20XXX
    78460TCAHeart muscle blood, single0.002.34NA0.132.47NAXXX
    78461AHeart muscle blood, multiple1.225.11NA0.316.64NAXXX
    7846126AHeart muscle blood, multiple1.220.440.440.061.721.72XXX
    78461TCAHeart muscle blood, multiple0.004.67NA0.254.92NAXXX
    78464AHeart image (3d), single1.087.40NA0.428.90NAXXX
    7846426AHeart image (3d), single1.080.390.390.051.521.52XXX
    78464TCAHeart image (3d), single0.007.01NA0.377.38NAXXX
    78465AHeart image (3d), multiple1.4512.23NA0.6714.35NAXXX
    7846526AHeart image (3d), multiple1.450.530.530.062.042.04XXX
    78465TCAHeart image (3d), multiple0.0011.70NA0.6112.31NAXXX
    78466AHeart infarct image0.692.85NA0.183.72NAXXX
    7846626AHeart infarct image0.690.250.250.040.980.98XXX
    78466TCAHeart infarct image0.002.60NA0.142.74NAXXX
    78468AHeart infarct image (ef)0.803.91NA0.234.94NAXXX
    7846826AHeart infarct image (ef)0.800.280.280.041.121.12XXX
    78468TCAHeart infarct image (ef)0.003.63NA0.193.82NAXXX
    78469AHeart infarct image (3D)0.915.50NA0.326.73NAXXX
    7846926AHeart infarct image (3D)0.910.320.320.041.271.27XXX
    78469TCAHeart infarct image (3D)0.005.18NA0.285.46NAXXX
    78472AGated heart, planar, single0.975.82NA0.357.14NAXXX
    7847226AGated heart, planar, single0.970.350.350.051.371.37XXX
    78472TCAGated heart, planar, single0.005.47NA0.305.77NAXXX
    78473AGated heart, multiple1.468.71NA0.4810.65NAXXX
    7847326AGated heart, multiple1.460.520.520.062.042.04XXX
    78473TCAGated heart, multiple0.008.19NA0.428.61NAXXX
    78478AHeart wall motion add-on0.621.78NA0.122.52NAXXX
    7847826AHeart wall motion add-on0.620.230.230.020.870.87XXX
    78478TCAHeart wall motion add-on0.001.55NA0.101.65NAXXX
    78480AHeart function add-on0.621.78NA0.122.52NAXXX
    7848026AHeart function add-on0.620.230.230.020.870.87XXX
    78480TCAHeart function add-on0.001.55NA0.101.65NAXXX
    78481AHeart first pass, single0.975.55NA0.326.84NAXXX
    7848126AHeart first pass, single0.970.370.370.041.381.38XXX
    78481TCAHeart first pass, single0.005.18NA0.285.46NAXXX
    78483AHeart first pass, multiple1.468.35NA0.4710.28NAXXX
    7848326AHeart first pass, multiple1.460.550.550.062.072.07XXX
    78483TCAHeart first pass, multiple0.007.80NA0.418.21NAXXX
    78491IHeart image (pet), single0.000.000.000.000.000.00XXX
    7849126IHeart image (pet), single+1.490.600.600.062.152.15XXX
    78491TCIHeart image (pet), single0.000.000.000.000.000.00XXX
    78492IHeart image (pet), multiple0.000.000.000.000.000.00XXX
    7849226IHeart image (pet), multiple+1.860.740.740.072.672.67XXX
    78492TCIHeart image (pet), multiple0.000.000.000.000.000.00XXX
    78494AHeart image, spect1.187.43NA0.358.96NAXXX
    Start Printed Page 63358
    7849426AHeart image, spect1.180.420.420.051.651.65XXX
    78494TCAHeart image, spect0.007.01NA0.307.31NAXXX
    78496AHeart first pass add-on0.507.20NA0.328.02NAZZZ
    7849626AHeart first pass add-on0.500.190.190.020.710.71ZZZ
    78496TCAHeart first pass add-on0.007.01NA0.307.31NAZZZ
    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 imaging0.743.65NA0.224.61NAXXX
    7858026ALung perfusion imaging0.740.250.250.041.031.03XXX
    78580TCALung perfusion imaging0.003.40NA0.183.58NAXXX
    78584ALung V/Q image single breath0.983.51NA0.224.71NAXXX
    7858426ALung V/Q image single breath0.980.330.330.051.361.36XXX
    78584TCALung V/Q image single breath0.003.18NA0.173.35NAXXX
    78585ALung V/Q imaging1.085.96NA0.367.40NAXXX
    7858526ALung V/Q imaging1.080.370.370.061.511.51XXX
    78585TCALung V/Q imaging0.005.59NA0.305.89NAXXX
    78586AAerosol lung image, single0.402.70NA0.163.26NAXXX
    7858626AAerosol lung image, single0.400.130.130.020.550.55XXX
    78586TCAAerosol lung image, single0.002.57NA0.142.71NAXXX
    78587AAerosol lung image, multiple0.492.95NA0.163.60NAXXX
    7858726AAerosol lung image, multiple0.490.170.170.020.680.68XXX
    78587TCAAerosol lung image, multiple0.002.78NA0.142.92NAXXX
    78588APerfusion lung image1.083.55NA0.244.87NAXXX
    7858826APerfusion lung image1.080.370.370.061.511.51XXX
    78588TCAPerfusion lung image0.003.18NA0.183.36NAXXX
    78591AVent image, 1 breath, 1 proj0.402.97NA0.163.53NAXXX
    7859126AVent image, 1 breath, 1 proj0.400.140.140.020.560.56XXX
    78591TCAVent image, 1 breath, 1 proj0.002.83NA0.142.97NAXXX
    78593AVent image, 1 proj, gas0.493.59NA0.204.28NAXXX
    7859326AVent image, 1 proj, gas0.490.170.170.020.680.68XXX
    78593TCAVent image, 1 proj, gas0.003.42NA0.183.60NAXXX
    78594AVent image, mult proj, gas0.535.12NA0.275.92NAXXX
    7859426AVent image, mult proj, gas0.530.180.180.020.730.73XXX
    78594TCAVent image, mult proj, gas0.004.94NA0.255.19NAXXX
    78596ALung differential function1.267.44NA0.439.13NAXXX
    7859626ALung differential function1.260.430.430.061.751.75XXX
    78596TCALung differential function0.007.01NA0.377.38NAXXX
    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 static0.443.01NA0.163.61NAXXX
    7860026ABrain imaging, ltd static0.440.150.150.020.610.61XXX
    78600TCABrain imaging, ltd static0.002.86NA0.143.00NAXXX
    78601ABrain imaging, ltd w/flow0.513.55NA0.204.26NAXXX
    7860126ABrain imaging, ltd w/flow0.510.180.180.020.710.71XXX
    78601TCABrain imaging, ltd w/flow0.003.37NA0.183.55NAXXX
    78605ABrain imaging, complete0.533.56NA0.204.29NAXXX
    7860526ABrain imaging, complete0.530.190.190.020.740.74XXX
    78605TCABrain imaging, complete0.003.37NA0.183.55NAXXX
    78606ABrain imaging, compl w/flow0.644.05NA0.244.93NAXXX
    7860626ABrain imaging, compl w/flow0.640.220.220.040.900.90XXX
    78606TCABrain imaging, compl w/flow0.003.83NA0.204.03NAXXX
    78607ABrain imaging (3D)1.226.94NA0.418.57NAXXX
    7860726ABrain imaging (3D)1.220.440.440.061.721.72XXX
    78607TCABrain imaging (3D)0.006.50NA0.356.85NAXXX
    78608NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78609NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78610ABrain flow imaging only0.301.67NA0.112.08NAXXX
    7861026ABrain flow imaging only0.300.110.110.010.420.42XXX
    78610TCABrain flow imaging only0.001.56NA0.101.66NAXXX
    78615ACerebral vascular flow image0.423.97NA0.224.61NAXXX
    7861526ACerebral vascular flow image0.420.160.160.020.600.60XXX
    78615TCACerebral vascular flow image0.003.81NA0.204.01NAXXX
    78630ACerebrospinal fluid scan0.685.22NA0.306.20NAXXX
    7863026ACerebrospinal fluid scan0.680.230.230.040.950.95XXX
    78630TCACerebrospinal fluid scan0.004.99NA0.265.25NAXXX
    78635ACSF ventriculography0.612.76NA0.163.53NAXXX
    7863526ACSF ventriculography0.610.240.240.020.870.87XXX
    78635TCACSF ventriculography0.002.52NA0.142.66NAXXX
    78645ACSF shunt evaluation0.573.60NA0.204.37NAXXX
    7864526ACSF shunt evaluation0.570.200.200.020.790.79XXX
    78645TCACSF shunt evaluation0.003.40NA0.183.58NAXXX
    78647ACerebrospinal fluid scan0.896.17NA0.357.41NAXXX
    7864726ACerebrospinal fluid scan0.890.320.320.041.251.25XXX
    Start Printed Page 63359
    78647TCACerebrospinal fluid scan0.005.85NA0.316.16NAXXX
    78650ACSF leakage imaging0.614.81NA0.265.68NAXXX
    7865026ACSF leakage imaging0.610.210.210.020.840.84XXX
    78650TCACSF leakage imaging0.004.60NA0.244.84NAXXX
    78660ANuclear exam of tear flow0.532.28NA0.142.95NAXXX
    7866026ANuclear exam of tear flow0.530.180.180.020.730.73XXX
    78660TCANuclear exam of tear flow0.002.10NA0.122.22NAXXX
    78699CNervous system nuclear exam0.000.000.000.000.000.00XXX
    7869926CNervous system nuclear exam0.000.000.000.000.000.00XXX
    78699TCCNervous system nuclear exam0.000.000.000.000.000.00XXX
    78700AKidney imaging, static0.453.17NA0.183.80NAXXX
    7870026AKidney imaging, static0.450.150.150.020.620.62XXX
    78700TCAKidney imaging, static0.003.02NA0.163.18NAXXX
    78701AKidney imaging with flow0.493.70NA0.204.39NAXXX
    7870126AKidney imaging with flow0.490.170.170.020.680.68XXX
    78701TCAKidney imaging with flow0.003.53NA0.183.71NAXXX
    78704AImaging renogram0.744.17NA0.245.15NAXXX
    7870426AImaging renogram0.740.250.250.041.031.03XXX
    78704TCAImaging renogram0.003.92NA0.204.12NAXXX
    78707AKidney flow/function image0.954.76NA0.285.99NAXXX
    7870726AKidney flow/function image0.950.330.330.051.331.33XXX
    78707TCAKidney flow/function image0.004.43NA0.234.66NAXXX
    78708AKidney flow/function image1.204.85NA0.296.34NAXXX
    7870826AKidney flow/function image1.200.420.420.061.681.68XXX
    78708TCAKidney flow/function image0.004.43NA0.234.66NAXXX
    78709AKidney flow/function image1.404.91NA0.306.61NAXXX
    7870926AKidney flow/function image1.400.480.480.071.951.95XXX
    78709TCAKidney flow/function image0.004.43NA0.234.66NAXXX
    78710AKidney imaging (3D)0.666.08NA0.357.09NAXXX
    7871026AKidney imaging (3D)0.660.230.230.040.930.93XXX
    78710TCAKidney imaging (3D)0.005.85NA0.316.16NAXXX
    78715ARenal vascular flow exam0.301.67NA0.112.08NAXXX
    7871526ARenal vascular flow exam0.300.110.110.010.420.42XXX
    78715TCARenal vascular flow exam0.001.56NA0.101.66NAXXX
    78725AKidney function study0.381.90NA0.122.40NAXXX
    7872526AKidney function study0.380.130.130.010.520.52XXX
    78725TCAKidney function study0.001.77NA0.111.88NAXXX
    78730AUrinary bladder retention0.361.58NA0.102.04NAXXX
    7873026AUrinary bladder retention0.360.130.130.020.510.51XXX
    78730TCAUrinary bladder retention0.001.45NA0.081.53NAXXX
    78740AUreteral reflux study0.572.29NA0.143.00NAXXX
    7874026AUreteral reflux study0.570.190.190.020.780.78XXX
    78740TCAUreteral reflux study0.002.10NA0.122.22NAXXX
    78760ATesticular imaging0.662.88NA0.183.72NAXXX
    7876026ATesticular imaging0.660.220.220.040.920.92XXX
    78760TCATesticular imaging0.002.66NA0.142.80NAXXX
    78761ATesticular imaging/flow0.713.42NA0.214.34NAXXX
    7876126ATesticular imaging/flow0.710.240.240.040.990.99XXX
    78761TCATesticular imaging/flow0.003.18NA0.173.35NAXXX
    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 area0.663.59NA0.224.47NAXXX
    7880026ATumor imaging, limited area0.660.220.220.040.920.92XXX
    78800TCATumor imaging, limited area0.003.37NA0.183.55NAXXX
    78801ATumor imaging, mult areas0.794.46NA0.265.51NAXXX
    7880126ATumor imaging, mult areas0.790.270.270.041.101.10XXX
    78801TCATumor imaging, mult areas0.004.19NA0.224.41NAXXX
    78802ATumor imaging, whole body0.865.79NA0.346.99NAXXX
    7880226ATumor imaging, whole body0.860.300.300.041.201.20XXX
    78802TCATumor imaging, whole body0.005.49NA0.305.79NAXXX
    78803ATumor imaging (3D)1.086.89NA0.408.37NAXXX
    7880326ATumor imaging (3D)1.080.390.390.051.521.52XXX
    78803TCATumor imaging (3D)0.006.50NA0.356.85NAXXX
    78804ATumor imaging, whole body1.064.62NA0.346.02NAXXX
    7880426ATumor imaging, whole body1.060.380.380.041.481.48XXX
    78804TCATumor imaging, whole body0.004.24NA0.304.54NAXXX
    78805AAbscess imaging, ltd area0.733.62NA0.224.57NAXXX
    7880526AAbscess imaging, ltd area0.730.250.250.041.021.02XXX
    78805TCAAbscess imaging, ltd area0.003.37NA0.183.55NAXXX
    78806AAbscess imaging, whole body0.866.67NA0.397.92NAXXX
    7880626AAbscess imaging, whole body0.860.300.300.041.201.20XXX
    78806TCAAbscess imaging, whole body0.006.37NA0.356.72NAXXX
    78807ANuclear localization/abscess1.086.90NA0.408.38NAXXX
    7880726ANuclear localization/abscess1.080.400.400.051.531.53XXX
    Start Printed Page 63360
    78807TCANuclear localization/abscess0.006.50NA0.356.85NAXXX
    78810NTumor imaging (PET)0.000.000.000.000.000.00XXX
    7881026NTumor imaging (PET)+1.920.740.740.112.772.77XXX
    78810TCNTumor imaging (PET)0.000.000.000.000.000.00XXX
    78890BNuclear medicine data proc+0.051.31NA0.071.43NAXXX
    7889026BNuclear medicine data proc+0.050.020.020.010.080.08XXX
    78890TCBNuclear medicine data proc+0.001.29NA0.061.35NAXXX
    78891BNuclear med data proc+0.102.64NA0.142.88NAXXX
    7889126BNuclear med data proc+0.100.040.040.010.150.15XXX
    78891TCBNuclear med data proc+0.002.60NA0.132.73NAXXX
    78990IProvide diag radionuclide(s)0.000.000.000.000.000.00XXX
    78999CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    7899926CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    78999TCCNuclear diagnostic exam0.000.000.000.000.000.00XXX
    79000AInit hyperthyroid therapy1.793.22NA0.225.23NAXXX
    7900026AInit hyperthyroid therapy1.790.620.620.082.492.49XXX
    79000TCAInit hyperthyroid therapy0.002.60NA0.142.74NAXXX
    79001ARepeat hyperthyroid therapy1.041.65NA0.122.81NAXXX
    7900126ARepeat hyperthyroid therapy1.040.360.360.051.451.45XXX
    79001TCARepeat hyperthyroid therapy0.001.29NA0.071.36NAXXX
    79020AThyroid ablation1.803.21NA0.225.23NAXXX
    7902026AThyroid ablation1.800.610.610.082.492.49XXX
    79020TCAThyroid ablation0.002.60NA0.142.74NAXXX
    79030AThyroid ablation, carcinoma2.093.31NA0.245.64NAXXX
    7903026AThyroid ablation, carcinoma2.090.710.710.102.902.90XXX
    79030TCAThyroid ablation, carcinoma0.002.60NA0.142.74NAXXX
    79035AThyroid metastatic therapy2.513.48NA0.256.24NAXXX
    7903526AThyroid metastatic therapy2.510.880.880.113.503.50XXX
    79035TCAThyroid metastatic therapy0.002.60NA0.142.74NAXXX
    79100AHematopoetic nuclear therapy1.313.07NA0.204.58NAXXX
    7910026AHematopoetic nuclear therapy1.310.470.470.061.841.84XXX
    79100TCAHematopoetic nuclear therapy0.002.60NA0.142.74NAXXX
    79200AIntracavitary nuclear trmt1.983.29NA0.225.49NAXXX
    7920026AIntracavitary nuclear trmt1.980.690.690.082.752.75XXX
    79200TCAIntracavitary nuclear trmt0.002.60NA0.142.74NAXXX
    79300CInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    7930026AInterstitial nuclear therapy1.590.570.570.082.242.24XXX
    79300TCCInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    79400ANonhemato nuclear therapy1.953.27NA0.245.46NAXXX
    7940026ANonhemato nuclear therapy1.950.670.670.102.722.72XXX
    79400TCANonhemato nuclear therapy0.002.60NA0.142.74NAXXX
    79403AHematopoetic nuclear therapy2.245.15NA0.247.63NAXXX
    7940326AHematopoetic nuclear therapy2.240.910.910.103.253.25XXX
    79403TCAHematopoetic nuclear therapy0.004.24NA0.144.38NAXXX
    79420CIntravascular nuclear ther0.000.000.000.000.000.00XXX
    7942026AIntravascular nuclear ther1.500.500.500.072.072.07XXX
    79420TCCIntravascular nuclear ther0.000.000.000.000.000.00XXX
    79440ANuclear joint therapy1.983.33NA0.245.55NAXXX
    7944026ANuclear joint therapy1.980.730.730.102.812.81XXX
    79440TCANuclear joint therapy0.002.60NA0.142.74NAXXX
    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 consultation0.370.210.160.010.590.54XXX
    80502ALab pathology consultation1.320.640.590.062.021.97XXX
    8302026AHemoglobin electrophoresis0.370.160.160.010.540.54XXX
    8391226AGenetic examination0.370.150.150.010.530.53XXX
    8416526AElectrophoreisis of 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 interpretation0.931.640.410.042.611.38XXX
    8539026AFibrinolysins screen0.370.120.120.010.500.50XXX
    85396AClotting assay, whole blood0.37NA0.170.04NA0.58XXX
    8557626ABlood platelet aggregation0.370.160.160.010.540.54XXX
    86077APhysician blood bank service0.930.470.410.041.441.38XXX
    86078APhysician blood bank service0.930.500.410.041.471.38XXX
    86079APhysician blood bank service0.930.500.420.041.471.39XXX
    8625526AFluorescent antibody, screen0.370.170.160.010.550.54XXX
    8625626AFluorescent antibody, titer0.370.160.160.010.540.54XXX
    8632026ASerum immunoelectrophoresis0.370.160.160.010.540.54XXX
    8632526AOther immunoelectrophoresis0.370.160.160.010.540.54XXX
    8632726AImmunoelectrophoresis assay0.420.190.190.010.620.62XXX
    8633426AImmunofixation procedure0.370.160.160.010.540.54XXX
    Start Printed Page 63361
    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 stain0.370.170.160.010.550.54XXX
    88104ACytopathology, fluids0.560.76NA0.041.36NAXXX
    8810426ACytopathology, fluids0.560.250.250.020.830.83XXX
    88104TCACytopathology, fluids0.000.51NA0.020.53NAXXX
    88106ACytopathology, fluids0.560.62NA0.041.22NAXXX
    8810626ACytopathology, fluids0.560.250.250.020.830.83XXX
    88106TCACytopathology, fluids0.000.37NA0.020.39NAXXX
    88107ACytopathology, fluids0.760.98NA0.061.80NAXXX
    8810726ACytopathology, fluids0.760.340.340.041.141.14XXX
    88107TCACytopathology, fluids0.000.64NA0.020.66NAXXX
    88108ACytopath, concentrate tech0.560.82NA0.041.42NAXXX
    8810826ACytopath, concentrate tech0.560.250.250.020.830.83XXX
    88108TCACytopath, concentrate tech0.000.57NA0.020.59NAXXX
    88112ACytopath, cell enhance tech1.172.02NA0.083.27NAXXX
    8811226ACytopath, cell enhance tech1.170.530.530.061.761.76XXX
    88112TCACytopath, cell enhance tech0.001.49NA0.021.51NAXXX
    88125AForensic cytopathology0.260.27NA0.020.55NAXXX
    8812526AForensic cytopathology0.260.120.120.010.390.39XXX
    88125TCAForensic cytopathology0.000.15NA0.010.16NAXXX
    88141ACytopath, c/v, interpret0.420.180.180.010.610.61XXX
    88160ACytopath smear, other source0.500.93NA0.041.47NAXXX
    8816026ACytopath smear, other source0.500.220.220.020.740.74XXX
    88160TCACytopath smear, other source0.000.71NA0.020.73NAXXX
    88161ACytopath smear, other source0.500.88NA0.041.42NAXXX
    8816126ACytopath smear, other source0.500.220.220.020.740.74XXX
    88161TCACytopath smear, other source0.000.66NA0.020.68NAXXX
    88162ACytopath smear, other source0.760.68NA0.061.50NAXXX
    8816226ACytopath smear, other source0.760.340.340.041.141.14XXX
    88162TCACytopath smear, other source0.000.34NA0.020.36NAXXX
    88172ACytopathology eval of fna0.600.67NA0.041.31NAXXX
    8817226ACytopathology eval of fna0.600.270.270.020.890.89XXX
    88172TCACytopathology eval of fna0.000.40NA0.020.42NAXXX
    88173ACytopath eval, fna, report1.381.78NA0.083.24NAXXX
    8817326ACytopath eval, fna, report1.380.620.620.062.062.06XXX
    88173TCACytopath eval, fna, report0.001.16NA0.021.18NAXXX
    88180ACell marker study0.361.45NA0.031.84NAXXX
    8818026ACell marker study0.360.160.160.010.530.53XXX
    88180TCACell marker study0.001.29NA0.021.31NAXXX
    88182ACell marker study0.771.61NA0.082.46NAXXX
    8818226ACell marker study0.770.340.340.041.151.15XXX
    88182TCACell marker study0.001.27NA0.041.31NAXXX
    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 report0.520.280.280.020.820.82XXX
    88299CCytogenetic study0.000.000.000.000.000.00XXX
    88300ASurgical path, gross0.080.28NA0.020.38NAXXX
    8830026ASurgical path, gross0.080.040.040.010.130.13XXX
    88300TCASurgical path, gross0.000.24NA0.010.25NAXXX
    88302ATissue exam by pathologist0.130.70NA0.030.86NAXXX
    8830226ATissue exam by pathologist0.130.060.060.010.200.20XXX
    88302TCATissue exam by pathologist0.000.64NA0.020.66NAXXX
    88304ATissue exam by pathologist0.220.88NA0.031.13NAXXX
    8830426ATissue exam by pathologist0.220.100.100.010.330.33XXX
    88304TCATissue exam by pathologist0.000.78NA0.020.80NAXXX
    88305ATissue exam by pathologist0.751.75NA0.062.56NAXXX
    8830526ATissue exam by pathologist0.750.340.340.021.111.11XXX
    88305TCATissue exam by pathologist0.001.41NA0.041.45NAXXX
    88307ATissue exam by pathologist1.582.67NA0.134.38NAXXX
    8830726ATissue exam by pathologist1.580.700.700.072.352.35XXX
    88307TCATissue exam by pathologist0.001.97NA0.062.03NAXXX
    88309ATissue exam by pathologist2.273.27NA0.165.70NAXXX
    8830926ATissue exam by pathologist2.271.001.000.103.373.37XXX
    88309TCATissue exam by pathologist0.002.27NA0.062.33NAXXX
    88311ADecalcify tissue0.240.20NA0.020.46NAXXX
    8831126ADecalcify tissue0.240.110.110.010.360.36XXX
    88311TCADecalcify tissue0.000.09NA0.010.10NAXXX
    88312ASpecial stains0.541.36NA0.031.93NAXXX
    Start Printed Page 63362
    8831226ASpecial stains0.540.240.240.020.800.80XXX
    88312TCASpecial stains0.001.12NA0.011.13NAXXX
    88313ASpecial stains0.241.10NA0.021.36NAXXX
    8831326ASpecial stains0.240.110.110.010.360.36XXX
    88313TCASpecial stains0.000.99NA0.011.00NAXXX
    88314AHistochemical stain0.450.89NA0.041.38NAXXX
    8831426AHistochemical stain0.450.200.200.020.670.67XXX
    88314TCAHistochemical stain0.000.69NA0.020.71NAXXX
    88318AChemical histochemistry0.420.81NA0.021.25NAXXX
    8831826AChemical histochemistry0.420.190.190.010.620.62XXX
    88318TCAChemical histochemistry0.000.62NA0.010.63NAXXX
    88319AEnzyme histochemistry0.531.90NA0.042.47NAXXX
    8831926AEnzyme histochemistry0.530.230.230.020.780.78XXX
    88319TCAEnzyme histochemistry0.001.67NA0.021.69NAXXX
    88321AMicroslide consultation1.290.810.570.052.151.91XXX
    88323AMicroslide consultation1.341.45NA0.082.87NAXXX
    8832326AMicroslide consultation1.340.600.600.062.002.00XXX
    88323TCAMicroslide consultation0.000.85NA0.020.87NAXXX
    88325AComprehensive review of data2.212.980.970.105.293.28XXX
    88329APath consult introp0.670.640.300.021.330.99XXX
    88331APath consult intraop, 1 bloc1.181.00NA0.092.27NAXXX
    8833126APath consult intraop, 1 bloc1.180.530.530.051.761.76XXX
    88331TCAPath consult intraop, 1 bloc0.000.47NA0.040.51NAXXX
    88332APath consult intraop, addl0.590.50NA0.041.13NAXXX
    8833226APath consult intraop, addl0.590.260.260.020.870.87XXX
    88332TCAPath consult intraop, addl0.000.24NA0.020.26NAXXX
    88342AImmunohistochemistry0.851.36NA0.062.27NAXXX
    8834226AImmunohistochemistry0.850.380.380.041.271.27XXX
    88342TCAImmunohistochemistry0.000.98NA0.021.00NAXXX
    88346AImmunofluorescent study0.861.46NA0.062.38NAXXX
    8834626AImmunofluorescent study0.860.380.380.041.281.28XXX
    88346TCAImmunofluorescent study0.001.08NA0.021.10NAXXX
    88347AImmunofluorescent study0.861.78NA0.062.70NAXXX
    8834726AImmunofluorescent study0.860.360.360.041.261.26XXX
    88347TCAImmunofluorescent study0.001.42NA0.021.44NAXXX
    88348AElectron microscopy1.508.57NA0.1310.20NAXXX
    8834826AElectron microscopy1.500.650.650.062.212.21XXX
    88348TCAElectron microscopy0.007.92NA0.077.99NAXXX
    88349AScanning electron microscopy0.7610.00NA0.1010.86NAXXX
    8834926AScanning electron microscopy0.760.340.340.041.141.14XXX
    88349TCAScanning electron microscopy0.009.66NA0.069.72NAXXX
    88355AAnalysis, skeletal muscle1.842.63NA0.144.61NAXXX
    8835526AAnalysis, skeletal muscle1.840.810.810.082.732.73XXX
    88355TCAAnalysis, skeletal muscle0.001.82NA0.061.88NAXXX
    88356AAnalysis, nerve3.002.91NA0.196.10NAXXX
    8835626AAnalysis, nerve3.001.291.290.124.414.41XXX
    88356TCAAnalysis, nerve0.001.62NA0.071.69NAXXX
    88358AAnalysis, tumor2.801.39NA0.194.38NAXXX
    8835826AAnalysis, tumor2.801.241.240.124.164.16XXX
    88358TCAAnalysis, tumor0.000.15NA0.070.22NAXXX
    88361AImmunohistochemistry, tumor0.932.62NA0.193.74NAXXX
    8836126AImmunohistochemistry, tumor0.930.420.420.121.471.47XXX
    88361TCAImmunohistochemistry, tumor0.002.20NA0.072.27NAXXX
    88362ANerve teasing preparations2.164.44NA0.146.74NAXXX
    8836226ANerve teasing preparations2.160.930.930.083.173.17XXX
    88362TCANerve teasing preparations0.003.51NA0.063.57NAXXX
    88365ATissue hybridization0.922.23NA0.063.21NAXXX
    8836526ATissue hybridization0.920.410.410.041.371.37XXX
    88365TCATissue hybridization0.001.82NA0.021.84NAXXX
    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 crystals0.370.170.160.010.550.54XXX
    89100ASample intestinal contents0.601.620.220.022.240.84XXX
    89105ASample intestinal contents0.502.260.170.022.780.69XXX
    89130ASample stomach contents0.451.760.130.022.230.60XXX
    89132ASample stomach contents0.191.510.060.011.710.26XXX
    89135ASample stomach contents0.791.610.250.042.441.08XXX
    89136ASample stomach contents0.211.660.090.011.880.31XXX
    89140ASample stomach contents0.932.090.280.043.061.25XXX
    Start Printed Page 63363
    89141ASample stomach contents0.852.750.340.043.641.23XXX
    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
    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
    90655XFlu vaccine, 6-35 mo, 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
    90659DFlu 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
    90698EDtap-hib-ip vaccine, im0.000.000.000.000.000.00XXX
    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
    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
    90715ETdap vaccine >7 im0.000.000.000.000.000.00XXX
    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
    90723IDtap-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
    Start Printed Page 63364
    90734EMeningococcal vaccine, im0.000.000.000.000.000.00XXX
    90735EEncephalitis vaccine, sc0.000.000.000.000.000.00XXX
    90740XHepb vacc, ill pat 3 dose im0.000.000.000.000.000.00XXX
    90743XHep b vacc, adol, 2 dose, im0.000.000.000.000.000.00XXX
    90744XHepb vacc ped/adol 3 dose im0.000.000.000.000.000.00XXX
    90746XHep b vaccine, adult, im0.000.000.000.000.000.00XXX
    90747XHepb vacc, ill pat 4 dose im0.000.000.000.000.000.00XXX
    90748IHep b/hib vaccine, im0.000.000.000.000.000.00XXX
    90749EVaccine toxoid0.000.000.000.000.000.00XXX
    90780AIV infusion therapy, 1 hour0.001.10NA0.071.17NAXXX
    90781AIV infusion, additional hour0.000.56NA0.040.60NAZZZ
    90782TInjection, sc/im0.000.11NA0.010.12NAXXX
    90783TInjection, ia0.000.41NA0.020.43NAXXX
    90784TInjection, iv0.000.47NA0.040.51NAXXX
    90788TInjection of antibiotic0.000.12NA0.010.13NAXXX
    90799CTher/prophylactic/dx inject0.000.000.000.000.000.00XXX
    90801APsy dx interview2.781.190.940.074.043.79XXX
    90802AIntac psy dx interview2.991.220.990.084.294.06XXX
    90804APsytx, office, 20-30 min1.200.500.390.041.741.63XXX
    90805APsytx, off, 20-30 min w/e&m1.360.510.430.041.911.83XXX
    90806APsytx, off, 45-50 min1.850.710.620.052.612.52XXX
    90807APsytx, off, 45-50 min w/e&m2.010.700.640.062.772.71XXX
    90808APsytx, office, 75-80 min2.771.040.910.083.893.76XXX
    90809APsytx, off, 75-80, w/e&m2.931.010.930.084.023.94XXX
    90810AIntac psytx, off, 20-30 min1.310.520.430.041.871.78XXX
    90811AIntac psytx, 20-30, w/e&m1.470.580.470.042.091.98XXX
    90812AIntac psytx, off, 45-50 min1.960.790.650.062.812.67XXX
    90813AIntac psytx, 45-50 min w/e&m2.120.770.670.062.952.85XXX
    90814AIntac psytx, off, 75-80 min2.881.110.990.084.073.95XXX
    90815AIntac psytx, 75-80 w/e&m3.041.060.960.084.184.08XXX
    90816APsytx, hosp, 20-30 min1.24NA0.470.04NA1.75XXX
    90817APsytx, hosp, 20-30 min w/e&m1.40NA0.470.04NA1.91XXX
    90818APsytx, hosp, 45-50 min1.88NA0.690.05NA2.62XXX
    90819APsytx, hosp, 45-50 min w/e&m2.04NA0.660.06NA2.76XXX
    90821APsytx, hosp, 75-80 min2.81NA1.020.07NA3.90XXX
    90822APsytx, hosp, 75-80 min w/e&m2.97NA0.960.08NA4.01XXX
    90823AIntac psytx, hosp, 20-30 min1.35NA0.490.04NA1.88XXX
    90824AIntac psytx, hsp 20-30 w/e&m1.51NA0.500.04NA2.05XXX
    90826AIntac psytx, hosp, 45-50 min2.00NA0.730.05NA2.78XXX
    90827AIntac psytx, hsp 45-50 w/e&m2.15NA0.690.06NA2.90XXX
    90828AIntac psytx, hosp, 75-80 min2.92NA1.080.08NA4.08XXX
    90829AIntac psytx, hsp 75-80 w/e&m3.08NA0.990.08NA4.15XXX
    90845APsychoanalysis1.780.590.570.052.422.40XXX
    90846RFamily psytx w/o patient1.820.660.650.052.532.52XXX
    90847RFamily psytx w/patient2.200.820.770.063.083.03XXX
    90849RMultiple family group psytx0.590.280.240.010.880.84XXX
    90853AGroup psychotherapy0.590.250.230.010.850.83XXX
    90857AIntac group psytx0.630.300.260.020.950.91XXX
    90862AMedication management0.940.410.330.021.371.29XXX
    90865ANarcosynthesis2.821.620.900.084.523.80XXX
    90870AElectroconvulsive therapy1.870.800.800.052.722.72000
    90871NElectroconvulsive therapy+2.701.071.070.073.843.84000
    90875NPsychophysiological therapy+1.190.900.470.042.131.70XXX
    90876NPsychophysiological therapy+1.891.170.730.053.112.67XXX
    90880AHypnotherapy2.181.050.690.063.292.93XXX
    90882NEnvironmental manipulation0.000.000.000.000.000.00XXX
    90885BPsy evaluation of records+0.960.380.380.021.361.36XXX
    90887BConsultation with family+1.470.830.570.042.342.08XXX
    90889BPreparation of report0.000.000.000.000.000.00XXX
    90899CPsychiatric service/therapy0.000.000.000.000.000.00XXX
    90901ABiofeedback train, any meth0.410.670.140.021.100.57000
    90911ABiofeedback peri/uro/rectal0.881.640.320.052.571.25000
    90918IESRD related services, month+11.127.507.500.3618.9818.98XXX
    90919IESRD related services, month+8.494.154.150.2912.9312.93XXX
    90920IESRD related services, month+7.233.893.890.2311.3511.35XXX
    90921IESRD related services, month+4.442.522.520.147.107.10XXX
    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 evaluation1.21NA0.680.04NA1.93000
    90937AHemodialysis, repeated eval2.10NA0.990.07NA3.16000
    90939XHemodialysis study, transcut0.000.000.000.000.000.00XXX
    90940XHemodialysis access study0.000.000.000.000.000.00XXX
    90945ADialysis, one evaluation1.27NA0.700.05NA2.02000
    Start Printed Page 63365
    90947ADialysis, repeated eval2.15NA1.010.07NA3.23000
    90989XDialysis training, complete0.000.000.000.000.000.00XXX
    90993XDialysis training, incompl0.000.000.000.000.000.00XXX
    90997AHemoperfusion1.83NA1.430.06NA3.32000
    90999CDialysis procedure0.000.000.000.000.000.00XXX
    91000AEsophageal intubation0.730.33NA0.051.11NA000
    9100026AEsophageal intubation0.730.250.250.041.021.02000
    91000TCAEsophageal intubation0.000.08NA0.010.09NA000
    91010AEsophagus motility study1.242.76NA0.124.12NA000
    9101026AEsophagus motility study1.240.450.450.061.751.75000
    91010TCAEsophagus motility study0.002.31NA0.062.37NA000
    91011AEsophagus motility study1.493.25NA0.124.86NA000
    9101126AEsophagus motility study1.490.540.540.062.092.09000
    91011TCAEsophagus motility study0.002.71NA0.062.77NA000
    91012AEsophagus motility study1.453.40NA0.144.99NA000
    9101226AEsophagus motility study1.450.520.520.072.042.04000
    91012TCAEsophagus motility study0.002.88NA0.072.95NA000
    91020AGastric motility1.432.99NA0.134.55NA000
    9102026AGastric motility1.430.500.500.072.002.00000
    91020TCAGastric motility0.002.49NA0.062.55NA000
    91030AAcid perfusion of esophagus0.902.43NA0.063.39NA000
    9103026AAcid perfusion of esophagus0.900.330.330.041.271.27000
    91030TCAAcid perfusion of esophagus0.002.10NA0.022.12NA000
    91032AEsophagus, acid reflux test1.204.20NA0.125.52NA000
    9103226AEsophagus, acid reflux test1.200.430.430.061.691.69000
    91032TCAEsophagus, acid reflux test0.003.77NA0.063.83NA000
    91033AProlonged acid reflux test1.294.23NA0.175.69NA000
    9103326AProlonged acid reflux test1.290.460.460.061.811.81000
    91033TCAProlonged acid reflux test0.003.77NA0.113.88NA000
    91052AGastric analysis test0.792.22NA0.063.07NA000
    9105226AGastric analysis test0.790.280.280.041.111.11000
    91052TCAGastric analysis test0.001.94NA0.021.96NA000
    91055AGastric intubation for smear0.932.39NA0.073.39NA000
    9105526AGastric intubation for smear0.930.270.270.051.251.25000
    91055TCAGastric intubation for smear0.002.12NA0.022.14NA000
    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 test0.202.00NA0.032.23NA000
    9106526ABreath hydrogen test0.200.070.070.010.280.28000
    91065TCABreath hydrogen test0.001.93NA0.021.95NA000
    91100APass intestine bleeding tube1.07NA0.290.07NA1.43000
    91105AGastric intubation treatment0.37NA0.090.02NA0.48000
    91110AGi tract capsule endoscopy3.6321.39NA0.0925.11NAXXX
    9111026AGi tract capsule endoscopy3.631.311.310.024.964.96XXX
    91110TCAGi tract capsule endoscopy0.0020.08NA0.0720.15NAXXX
    91122AAnal pressure record1.766.14NA0.208.10NA000
    9112226AAnal pressure record1.760.620.620.122.502.50000
    91122TCAAnal pressure record0.005.52NA0.085.60NA000
    91123BIrrigate fecal impaction0.000.000.000.000.000.00XXX
    91132CElectrogastrography0.000.000.000.000.000.00XXX
    9113226AElectrogastrography0.520.190.190.040.750.75XXX
    91132TCCElectrogastrography0.000.000.000.000.000.00XXX
    91133CElectrogastrography w/test0.000.000.000.000.000.00XXX
    9113326AElectrogastrography w/test0.660.240.240.040.940.94XXX
    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 patient0.870.970.350.021.861.24XXX
    92004AEye exam, new patient1.661.700.680.043.402.38XXX
    92012AEye exam established pat0.671.030.290.011.710.97XXX
    92014AEye exam & treatment1.091.400.480.022.511.59XXX
    92015NRefraction+0.381.500.150.011.890.54XXX
    92018ANew eye exam & treatment2.49NA1.090.04NA3.62XXX
    92019AEye exam & treatment1.30NA0.570.04NA1.91XXX
    92020ASpecial eye evaluation0.370.340.160.010.720.54XXX
    92060ASpecial eye evaluation0.690.73NA0.021.44NAXXX
    9206026ASpecial eye evaluation0.690.290.290.010.990.99XXX
    92060TCASpecial eye evaluation0.000.44NA0.010.45NAXXX
    92065AOrthoptic/pleoptic training0.370.55NA0.020.94NAXXX
    9206526AOrthoptic/pleoptic training0.370.150.150.010.530.53XXX
    92065TCAOrthoptic/pleoptic training0.000.40NA0.010.41NAXXX
    92070AFitting of contact lens0.701.080.320.011.791.03XXX
    92081AVisual field examination(s)0.360.87NA0.021.25NAXXX
    Start Printed Page 63366
    9208126AVisual field examination(s)0.360.160.160.010.530.53XXX
    92081TCAVisual field examination(s)0.000.71NA0.010.72NAXXX
    92082AVisual field examination(s)0.441.15NA0.021.61NAXXX
    9208226AVisual field examination(s)0.440.190.190.010.640.64XXX
    92082TCAVisual field examination(s)0.000.96NA0.010.97NAXXX
    92083AVisual field examination(s)0.501.34NA0.021.86NAXXX
    9208326AVisual field examination(s)0.500.220.220.010.730.73XXX
    92083TCAVisual field examination(s)0.001.12NA0.011.13NAXXX
    92100ASerial tonometry exam(s)0.911.270.370.022.201.30XXX
    92120ATonography & eye evaluation0.811.050.320.021.881.15XXX
    92130AWater provocation tonography0.811.250.380.022.081.21XXX
    92135AOpthalmic dx imaging0.350.80NA0.021.17NAXXX
    9213526AOpthalmic dx imaging0.350.160.160.010.520.52XXX
    92135TCAOpthalmic dx imaging0.000.64NA0.010.65NAXXX
    92136AOphthalmic biometry0.541.77NA0.082.39NAXXX
    9213626AOphthalmic biometry0.540.250.250.010.800.80XXX
    92136TCAOphthalmic biometry0.001.52NA0.071.59NAXXX
    92140AGlaucoma provocative tests0.500.940.220.011.450.73XXX
    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 photos0.812.95NA0.083.84NAXXX
    9223526AEye exam with photos0.810.370.370.021.201.20XXX
    92235TCAEye exam with photos0.002.58NA0.062.64NAXXX
    92240AIcg angiography1.097.12NA0.088.29NAXXX
    9224026AIcg angiography1.090.510.510.021.621.62XXX
    92240TCAIcg angiography0.006.61NA0.066.67NAXXX
    92250AEye exam with photos0.441.75NA0.022.21NAXXX
    9225026AEye exam with photos0.440.200.200.010.650.65XXX
    92250TCAEye exam with photos0.001.55NA0.011.56NAXXX
    92260AOphthalmoscopy/dynamometry0.200.290.090.010.500.30XXX
    92265AEye muscle evaluation0.811.90NA0.042.75NAXXX
    9226526AEye muscle evaluation0.810.290.290.021.121.12XXX
    92265TCAEye muscle evaluation0.001.61NA0.021.63NAXXX
    92270AElectro-oculography0.811.57NA0.062.44NAXXX
    9227026AElectro-oculography0.810.340.340.041.191.19XXX
    92270TCAElectro-oculography0.001.23NA0.021.25NAXXX
    92275AElectroretinography1.001.97NA0.043.01NAXXX
    9227526AElectroretinography1.000.440.440.021.461.46XXX
    92275TCAElectroretinography0.001.53NA0.021.55NAXXX
    92283AColor vision examination0.170.84NA0.021.03NAXXX
    9228326AColor vision examination0.170.070.070.010.250.25XXX
    92283TCAColor vision examination0.000.77NA0.010.78NAXXX
    92284ADark adaptation eye exam0.242.33NA0.022.59NAXXX
    9228426ADark adaptation eye exam0.240.090.090.010.340.34XXX
    92284TCADark adaptation eye exam0.002.24NA0.012.25NAXXX
    92285AEye photography0.201.07NA0.021.29NAXXX
    9228526AEye photography0.200.090.090.010.300.30XXX
    92285TCAEye photography0.000.98NA0.010.99NAXXX
    92286AInternal eye photography0.663.40NA0.034.09NAXXX
    9228626AInternal eye photography0.660.300.300.010.970.97XXX
    92286TCAInternal eye photography0.003.10NA0.023.12NAXXX
    92287AInternal eye photography0.812.730.310.023.561.14XXX
    92310NContact lens fitting+1.161.120.460.042.321.66XXX
    92311AContact lens fitting1.071.200.350.042.311.46XXX
    92312AContact lens fitting1.251.170.500.042.461.79XXX
    92313AContact lens fitting0.911.170.290.022.101.22XXX
    92314NPrescription of contact lens+0.690.940.270.011.640.97XXX
    92315APrescription of contact lens0.450.960.160.011.420.62XXX
    92316APrescription of contact lens0.681.000.300.011.690.99XXX
    92317APrescription of contact lens0.451.060.140.011.520.60XXX
    92325AModification of contact lens0.000.40NA0.010.41NAXXX
    92326AReplacement of contact lens0.001.62NA0.061.68NAXXX
    92330AFitting of artificial eye1.071.080.330.052.201.45XXX
    92335AFitting of artificial eye0.451.010.170.011.470.63XXX
    92340NFitting of spectacles+0.370.700.140.011.080.52XXX
    92341NFitting of spectacles+0.470.740.180.011.220.66XXX
    92342NFitting of spectacles+0.530.760.210.011.300.75XXX
    92352BSpecial spectacles fitting+0.370.730.140.011.110.52XXX
    92353BSpecial spectacles fitting+0.500.780.190.021.300.71XXX
    92354BSpecial spectacles fitting+0.008.78NA0.108.88NAXXX
    92355BSpecial spectacles fitting+0.004.30NA0.014.31NAXXX
    92358BEye prosthesis service+0.000.96NA0.051.01NAXXX
    92370NRepair & adjust spectacles+0.320.560.130.020.900.47XXX
    92371BRepair & adjust spectacles+0.000.62NA0.020.64NAXXX
    Start Printed Page 63367
    92390NSupply of spectacles0.000.000.000.000.000.00XXX
    92391NSupply of contact lenses0.000.000.000.000.000.00XXX
    92392ISupply of low vision aids+0.003.813.810.023.833.83XXX
    92393ISupply of artificial eye+0.0011.8311.830.5612.3912.39XXX
    92395ISupply of spectacles+0.001.291.290.101.391.39XXX
    92396ISupply of contact lenses+0.002.172.170.072.242.24XXX
    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 examination1.50NA1.150.07NA2.72000
    92504AEar microscopy examination0.180.510.090.010.700.28XXX
    92506ASpeech/hearing evaluation0.862.650.410.053.561.32XXX
    92507ASpeech/hearing therapy0.521.150.240.021.690.78XXX
    92508ASpeech/hearing therapy0.260.530.120.010.800.39XXX
    92510IRehab for ear implant+1.492.090.820.073.652.38XXX
    92511ANasopharyngoscopy0.843.180.800.044.061.68000
    92512ANasal function studies0.551.090.180.021.660.75XXX
    92516AFacial nerve function test0.430.900.220.021.350.67XXX
    92520ALaryngeal function studies0.760.510.390.041.311.19XXX
    92526AOral function therapy0.551.680.200.022.250.77XXX
    92531BSpontaneous nystagmus study0.000.000.000.000.000.00XXX
    92532BPositional nystagmus test0.000.000.000.000.000.00XXX
    92533BCaloric vestibular test0.000.000.000.000.000.00XXX
    92534BOptokinetic nystagmus test0.000.000.000.000.000.00XXX
    92541ASpontaneous nystagmus test0.400.97NA0.041.41NAXXX
    9254126ASpontaneous nystagmus test0.400.190.190.020.610.61XXX
    92541TCASpontaneous nystagmus test0.000.78NA0.020.80NAXXX
    92542APositional nystagmus test0.331.07NA0.031.43NAXXX
    9254226APositional nystagmus test0.330.160.160.010.500.50XXX
    92542TCAPositional nystagmus test0.000.91NA0.020.93NAXXX
    92543ACaloric vestibular test0.100.55NA0.020.67NAXXX
    9254326ACaloric vestibular test0.100.050.050.010.160.16XXX
    92543TCACaloric vestibular test0.000.50NA0.010.51NAXXX
    92544AOptokinetic nystagmus test0.260.85NA0.031.14NAXXX
    9254426AOptokinetic nystagmus test0.260.130.130.010.400.40XXX
    92544TCAOptokinetic nystagmus test0.000.72NA0.020.74NAXXX
    92545AOscillating tracking test0.230.80NA0.031.06NAXXX
    9254526AOscillating tracking test0.230.110.110.010.350.35XXX
    92545TCAOscillating tracking test0.000.69NA0.020.71NAXXX
    92546ASinusoidal rotational test0.291.82NA0.032.14NAXXX
    9254626ASinusoidal rotational test0.290.130.130.010.430.43XXX
    92546TCASinusoidal rotational test0.001.69NA0.021.71NAXXX
    92547ASupplemental electrical test0.001.17NA0.061.23NAZZZ
    92548APosturography0.503.23NA0.153.88NAXXX
    9254826APosturography0.500.260.260.020.780.78XXX
    92548TCAPosturography0.002.97NA0.133.10NAXXX
    92551NPure tone hearing test, air0.000.000.000.000.000.00XXX
    92552APure tone audiometry, air0.000.44NA0.040.48NAXXX
    92553AAudiometry, air & bone0.000.65NA0.060.71NAXXX
    92555ASpeech threshold audiometry0.000.38NA0.040.42NAXXX
    92556ASpeech audiometry, complete0.000.57NA0.060.63NAXXX
    92557AComprehensive hearing test0.001.18NA0.121.30NAXXX
    92559NGroup audiometric testing0.000.000.000.000.000.00XXX
    92560NBekesy audiometry, screen0.000.000.000.000.000.00XXX
    92561ABekesy audiometry, diagnosis0.000.70NA0.060.76NAXXX
    92562ALoudness balance test0.000.41NA0.040.45NAXXX
    92563ATone decay hearing test0.000.38NA0.040.42NAXXX
    92564ASisi hearing test0.000.47NA0.050.52NAXXX
    92565AStenger test, pure tone0.000.40NA0.040.44NAXXX
    92567ATympanometry0.000.52NA0.060.58NAXXX
    92568AAcoustic reflex testing0.000.38NA0.040.42NAXXX
    92569AAcoustic reflex decay test0.000.41NA0.040.45NAXXX
    92571AFiltered speech hearing test0.000.39NA0.040.43NAXXX
    92572AStaggered spondaic word test0.000.09NA0.010.10NAXXX
    92573ALombard test0.000.35NA0.040.39NAXXX
    92575ASensorineural acuity test0.000.30NA0.020.32NAXXX
    92576ASynthetic sentence test0.000.44NA0.050.49NAXXX
    92577AStenger test, speech0.000.70NA0.070.77NAXXX
    92579AVisual audiometry (vra)0.000.71NA0.060.77NAXXX
    92582AConditioning play audiometry0.000.71NA0.060.77NAXXX
    92583ASelect picture audiometry0.000.88NA0.080.96NAXXX
    92584AElectrocochleography0.002.45NA0.202.65NAXXX
    92585AAuditor evoke potent, compre0.502.06NA0.162.72NAXXX
    9258526AAuditor evoke potent, compre0.500.220.220.020.740.74XXX
    92585TCAAuditor evoke potent, compre0.001.84NA0.141.98NAXXX
    Start Printed Page 63368
    92586AAuditor evoke potent, limit0.001.84NA0.141.98NAXXX
    92587AEvoked auditory test0.131.36NA0.121.61NAXXX
    9258726AEvoked auditory test0.130.070.070.010.210.21XXX
    92587TCAEvoked auditory test0.001.29NA0.111.40NAXXX
    92588AEvoked auditory test0.361.63NA0.142.13NAXXX
    9258826AEvoked auditory test0.360.170.170.010.540.54XXX
    92588TCAEvoked auditory test0.001.46NA0.131.59NAXXX
    92589AAuditory function test(s)0.000.53NA0.060.59NAXXX
    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 evaluation0.000.59NA0.060.65NAXXX
    92597AOral speech device eval0.861.710.460.052.621.37XXX
    92601ACochlear implt f/up exam < 70.003.46NA0.073.53NAXXX
    92602AReprogram cochlear implt < 70.002.39NA0.072.46NAXXX
    92603ACochlear implt f/up exam 7 >0.002.26NA0.072.33NAXXX
    92604AReprogram cochlear implt 7 >0.001.49NA0.071.56NAXXX
    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, 1hr0.003.25NA0.053.30NAXXX
    92608AEx for speech device rx addl0.000.67NA0.050.72NAXXX
    92609AUse of speech device service0.001.62NA0.041.66NAXXX
    92610AEvaluate swallowing function0.003.40NA0.083.48NAXXX
    92611AMotion fluoroscopy/swallow0.003.40NA0.083.48NAXXX
    92612AEndoscopy swallow tst (fees)1.262.740.670.084.082.01XXX
    92613BEndoscopy swallow tst (fees)0.000.000.000.000.000.00XXX
    92614ALaryngoscopic sensory test1.262.430.630.083.771.97XXX
    92615BEval laryngoscopy sense tst0.000.000.000.000.000.00XXX
    92616AFees w/laryngeal sense test1.873.310.970.085.262.92XXX
    92617BInterprt fees/laryngeal test0.000.000.000.000.000.00XXX
    92700CEnt procedure/service0.000.000.000.000.000.00XXX
    92950AHeart/lung resuscitation cpr3.78NA0.990.25NA5.02000
    92953ATemporary external pacing0.23NA0.230.01NA0.47000
    92960ACardioversion electric, ext2.246.761.190.109.103.53000
    92961ACardioversion, electric, int4.57NA2.100.20NA6.87000
    92970ACardioassist, internal3.50NA1.070.20NA4.77000
    92971ACardioassist, external1.76NA0.860.07NA2.69000
    92973APercut coronary thrombectomy3.26NA1.310.14NA4.71ZZZ
    92974ACath place, cardio brachytx2.98NA1.200.17NA4.35ZZZ
    92975ADissolve clot, heart vessel7.21NA2.850.26NA10.32000
    92977ADissolve clot, heart vessel0.007.99NA0.468.45NAXXX
    92978AIntravasc us, heart add-on1.795.23NA0.317.33NAZZZ
    9297826AIntravasc us, heart add-on1.790.710.710.072.572.57ZZZ
    92978TCAIntravasc us, heart add-on0.004.52NA0.244.76NAZZZ
    92979AIntravasc us, heart add-on1.432.84NA0.184.45NAZZZ
    9297926AIntravasc us, heart add-on1.430.570.570.052.052.05ZZZ
    92979TCAIntravasc us, heart add-on0.002.27NA0.132.40NAZZZ
    92980AInsert intracoronary stent14.76NA6.130.85NA21.74000
    92981AInsert intracoronary stent4.15NA1.660.24NA6.05ZZZ
    92982ACoronary artery dilation10.92NA4.590.62NA16.13000
    92984ACoronary artery dilation2.95NA1.180.17NA4.30ZZZ
    92986ARevision of aortic valve21.68NA11.781.37NA34.83090
    92987ARevision of mitral valve22.57NA12.171.41NA36.15090
    92990ARevision of pulmonary valve17.24NA9.761.08NA28.08090
    92992CRevision of heart chamber0.000.000.000.000.000.00090
    92993CRevision of heart chamber0.000.000.000.000.000.00090
    92995ACoronary atherectomy12.02NA5.040.70NA17.76000
    92996ACoronary atherectomy add-on3.24NA1.290.19NA4.72ZZZ
    92997APul art balloon repr, percut11.93NA4.890.76NA17.58000
    92998APul art balloon repr, percut5.97NA2.230.37NA8.57ZZZ
    93000AElectrocardiogram, complete0.170.51NA0.030.71NAXXX
    93005AElectrocardiogram, tracing0.000.45NA0.020.47NAXXX
    93010AElectrocardiogram report0.170.060.060.010.240.24XXX
    93012ATransmission of ecg0.005.96NA0.186.14NAXXX
    93014AReport on transmitted ecg0.520.190.190.020.730.73XXX
    93015ACardiovascular stress test0.751.96NA0.132.84NAXXX
    93016ACardiovascular stress test0.450.170.170.010.630.63XXX
    93017ACardiovascular stress test0.001.67NA0.111.78NAXXX
    93018ACardiovascular stress test0.300.120.120.010.430.43XXX
    93024ACardiac drug stress test1.161.57NA0.132.86NAXXX
    9302426ACardiac drug stress test1.160.460.460.051.671.67XXX
    93024TCACardiac drug stress test0.001.11NA0.081.19NAXXX
    Start Printed Page 63369
    93025AMicrovolt t-wave assess0.758.30NA0.139.18NAXXX
    9302526AMicrovolt t-wave assess0.750.300.300.021.071.07XXX
    93025TCAMicrovolt t-wave assess0.008.00NA0.118.11NAXXX
    93040ARhythm ECG with report0.160.19NA0.020.37NAXXX
    93041ARhythm ECG, tracing0.000.14NA0.010.15NAXXX
    93042ARhythm ECG, report0.160.050.050.010.220.22XXX
    93224AECG monitor/report, 24 hrs0.523.59NA0.244.35NAXXX
    93225AECG monitor/record, 24 hrs0.001.23NA0.081.31NAXXX
    93226AECG monitor/report, 24 hrs0.002.16NA0.142.30NAXXX
    93227AECG monitor/review, 24 hrs0.520.200.200.020.740.74XXX
    93230AECG monitor/report, 24 hrs0.523.86NA0.264.64NAXXX
    93231AEcg monitor/record, 24 hrs0.001.51NA0.111.62NAXXX
    93232AECG monitor/report, 24 hrs0.002.15NA0.132.28NAXXX
    93233AECG monitor/review, 24 hrs0.520.200.200.020.740.74XXX
    93235AECG monitor/report, 24 hrs0.452.77NA0.153.37NAXXX
    93236AECG monitor/report, 24 hrs0.002.60NA0.142.74NAXXX
    93237AECG monitor/review, 24 hrs0.450.170.170.010.630.63XXX
    93268AECG record/review0.527.38NA0.288.18NAXXX
    93270AECG recording0.001.23NA0.081.31NAXXX
    93271AEcg/monitoring and analysis0.005.96NA0.186.14NAXXX
    93272AEcg/review, interpret only0.520.190.190.020.730.73XXX
    93278AECG/signal-averaged0.251.24NA0.121.61NAXXX
    9327826AECG/signal-averaged0.250.100.100.010.360.36XXX
    93278TCAECG/signal-averaged0.001.14NA0.111.25NAXXX
    93303AEcho transthoracic1.294.31NA0.285.88NAXXX
    9330326AEcho transthoracic1.290.490.490.051.831.83XXX
    93303TCAEcho transthoracic0.003.82NA0.234.05NAXXX
    93304AEcho transthoracic0.752.22NA0.153.12NAXXX
    9330426AEcho transthoracic0.750.290.290.021.061.06XXX
    93304TCAEcho transthoracic0.001.93NA0.132.06NAXXX
    93307AEcho exam of heart0.914.18NA0.275.36NAXXX
    9330726AEcho exam of heart0.910.360.360.041.311.31XXX
    93307TCAEcho exam of heart0.003.82NA0.234.05NAXXX
    93308AEcho exam of heart0.532.14NA0.152.82NAXXX
    9330826AEcho exam of heart0.530.210.210.020.760.76XXX
    93308TCAEcho exam of heart0.001.93NA0.132.06NAXXX
    93312AEcho transesophageal2.194.54NA0.397.12NAXXX
    9331226AEcho transesophageal2.190.790.790.103.083.08XXX
    93312TCAEcho transesophageal0.003.75NA0.294.04NAXXX
    93313AEcho transesophageal0.94NA0.210.06NA1.21XXX
    93314AEcho transesophageal1.244.23NA0.345.81NAXXX
    9331426AEcho transesophageal1.240.480.480.051.771.77XXX
    93314TCAEcho transesophageal0.003.75NA0.294.04NAXXX
    93315CEcho transesophageal0.000.00NA0.000.00NAXXX
    9331526AEcho transesophageal2.761.021.020.123.903.90XXX
    93315TCCEcho transesophageal0.000.00NA0.000.00NAXXX
    93316AEcho transesophageal0.94NA0.240.06NA1.24XXX
    93317CEcho transesophageal0.000.00NA0.000.00NAXXX
    9331726AEcho transesophageal1.820.670.670.072.562.56XXX
    93317TCCEcho transesophageal0.000.00NA0.000.00NAXXX
    93318CEcho transesophageal intraop0.000.000.000.000.000.00XXX
    9331826AEcho transesophageal intraop2.190.490.490.072.752.75XXX
    93318TCCEcho transesophageal intraop0.000.000.000.000.000.00XXX
    93320ADoppler echo exam, heart0.381.85NA0.132.36NAZZZ
    9332026ADoppler echo exam, heart0.380.150.150.010.540.54ZZZ
    93320TCADoppler echo exam, heart0.001.70NA0.121.82NAZZZ
    93321ADoppler echo exam, heart0.151.16NA0.091.40NAZZZ
    9332126ADoppler echo exam, heart0.150.060.060.010.220.22ZZZ
    93321TCADoppler echo exam, heart0.001.10NA0.081.18NAZZZ
    93325ADoppler color flow add-on0.072.91NA0.213.19NAZZZ
    9332526ADoppler color flow add-on0.070.030.030.010.110.11ZZZ
    93325TCADoppler color flow add-on0.002.88NA0.203.08NAZZZ
    93350AEcho transthoracic1.472.33NA0.153.95NAXXX
    9335026AEcho transthoracic1.470.580.580.022.072.07XXX
    93350TCAEcho transthoracic0.001.75NA0.131.88NAXXX
    93501ARight heart catheterization3.0017.93NA1.2322.16NA000
    9350126ARight heart catheterization3.001.171.170.194.364.36000
    93501TCARight heart catheterization0.0016.76NA1.0417.80NA000
    93503AInsert/place heart catheter2.89NA0.680.19NA3.76000
    93505ABiopsy of heart lining4.363.67NA0.448.47NA000
    9350526ABiopsy of heart lining4.361.711.710.286.356.35000
    93505TCABiopsy of heart lining0.001.96NA0.162.12NA000
    93508ACath placement, angiography4.0814.60NA0.9019.58NA000
    9350826ACath placement, angiography4.082.112.110.256.446.44000
    93508TCACath placement, angiography0.0012.49NA0.6513.14NA000
    Start Printed Page 63370
    93510ALeft heart catheterization4.3138.84NA2.5545.70NA000
    9351026ALeft heart catheterization4.312.202.200.266.776.77000
    93510TCALeft heart catheterization0.0036.64NA2.2938.93NA000
    93511ALeft heart catheterization5.0038.15NA2.5345.68NA000
    9351126ALeft heart catheterization5.002.482.480.317.797.79000
    93511TCALeft heart catheterization0.0035.67NA2.2237.89NA000
    93514ALeft heart catheterization7.0138.85NA2.6648.52NA000
    9351426ALeft heart catheterization7.013.183.180.4410.6310.63000
    93514TCALeft heart catheterization0.0035.67NA2.2237.89NA000
    93524ALeft heart catheterization6.9149.83NA3.3460.08NA000
    9352426ALeft heart catheterization6.913.223.220.4310.5610.56000
    93524TCALeft heart catheterization0.0046.61NA2.9149.52NA000
    93526ARt & Lt heart catheters5.9650.74NA3.3760.07NA000
    9352626ARt & Lt heart catheters5.962.862.860.379.199.19000
    93526TCARt & Lt heart catheters0.0047.88NA3.0050.88NA000
    93527ARt & Lt heart catheters7.2449.97NA3.3760.58NA000
    9352726ARt & Lt heart catheters7.243.363.360.4611.0611.06000
    93527TCARt & Lt heart catheters0.0046.61NA2.9149.52NA000
    93528ARt & Lt heart catheters8.9550.70NA3.4763.12NA000
    9352826ARt & Lt heart catheters8.954.094.090.5613.6013.60000
    93528TCARt & Lt heart catheters0.0046.61NA2.9149.52NA000
    93529ARt, lt heart catheterization4.7748.92NA3.2156.90NA000
    9352926ARt, lt heart catheterization4.772.312.310.307.387.38000
    93529TCARt, lt heart catheterization0.0046.61NA2.9149.52NA000
    93530ARt heart cath, congenital4.2118.73NA1.3324.27NA000
    9353026ARt heart cath, congenital4.211.971.970.296.476.47000
    93530TCARt heart cath, congenital0.0016.76NA1.0417.80NA000
    93531AR & l heart cath, congenital8.3051.52NA3.5563.37NA000
    9353126AR & l heart cath, congenital8.303.643.640.5512.4912.49000
    93531TCAR & l heart cath, congenital0.0047.88NA3.0050.88NA000
    93532AR & l heart cath, congenital9.9450.93NA3.5364.40NA000
    9353226AR & l heart cath, congenital9.944.324.320.6214.8814.88000
    93532TCAR & l heart cath, congenital0.0046.61NA2.9149.52NA000
    93533AR & l heart cath, congenital6.6649.46NA3.4359.55NA000
    9353326AR & l heart cath, congenital6.662.852.850.5210.0310.03000
    93533TCAR & l heart cath, congenital0.0046.61NA2.9149.52NA000
    93539AInjection, cardiac cath0.40NA0.160.01NA0.57000
    93540AInjection, cardiac cath0.43NA0.170.01NA0.61000
    93541AInjection for lung angiogram0.29NA0.110.01NA0.41000
    93542AInjection for heart x-rays0.29NA0.110.01NA0.41000
    93543AInjection for heart x-rays0.29NA0.120.01NA0.42000
    93544AInjection for aortography0.25NA0.100.01NA0.36000
    93545AInject for coronary x-rays0.40NA0.160.01NA0.57000
    93555AImaging, cardiac cath0.816.54NA0.387.73NAXXX
    9355526AImaging, cardiac cath0.810.320.320.041.171.17XXX
    93555TCAImaging, cardiac cath0.006.22NA0.346.56NAXXX
    93556AImaging, cardiac cath0.8310.13NA0.5411.50NAXXX
    9355626AImaging, cardiac cath0.830.330.330.041.201.20XXX
    93556TCAImaging, cardiac cath0.009.80NA0.5010.30NAXXX
    93561ACardiac output measurement0.500.68NA0.081.26NA000
    9356126ACardiac output measurement0.500.160.160.020.680.68000
    93561TCACardiac output measurement0.000.52NA0.060.58NA000
    93562ACardiac output measurement0.160.37NA0.050.58NA000
    9356226ACardiac output measurement0.160.050.050.010.220.22000
    93562TCACardiac output measurement0.000.32NA0.040.36NA000
    93571AHeart flow reserve measure1.795.20NA0.377.36NAZZZ
    9357126AHeart flow reserve measure1.790.680.680.132.602.60ZZZ
    93571TCAHeart flow reserve measure0.004.52NA0.244.76NAZZZ
    93572AHeart flow reserve measure1.432.77NA0.334.53NAZZZ
    9357226AHeart flow reserve measure1.430.500.500.202.132.13ZZZ
    93572TCAHeart flow reserve measure0.002.27NA0.132.40NAZZZ
    93580ATranscath closure of asd17.90NA7.271.37NA26.54000
    93581ATranscath closure of vsd24.29NA9.741.37NA35.40000
    93600ABundle of His recording2.112.77NA0.265.14NA000
    9360026ABundle of His recording2.110.840.840.133.083.08000
    93600TCABundle of His recording0.001.93NA0.132.06NA000
    93602AIntra-atrial recording2.111.93NA0.214.25NA000
    9360226AIntra-atrial recording2.110.830.830.143.083.08000
    93602TCAIntra-atrial recording0.001.10NA0.071.17NA000
    93603ARight ventricular recording2.112.49NA0.244.84NA000
    9360326ARight ventricular recording2.110.820.820.133.063.06000
    93603TCARight ventricular recording0.001.67NA0.111.78NA000
    93609AMap tachycardia, add-on4.974.66NA0.7910.42NAZZZ
    9360926AMap tachycardia, add-on4.971.971.970.627.567.56ZZZ
    93609TCAMap tachycardia, add-on0.002.69NA0.172.86NAZZZ
    Start Printed Page 63371
    93610AIntra-atrial pacing3.002.51NA0.305.81NA000
    9361026AIntra-atrial pacing3.001.171.170.204.374.37000
    93610TCAIntra-atrial pacing0.001.34NA0.101.44NA000
    93612AIntraventricular pacing3.002.77NA0.316.08NA000
    9361226AIntraventricular pacing3.001.171.170.204.374.37000
    93612TCAIntraventricular pacing0.001.60NA0.111.71NA000
    93613AElectrophys map 3d, add-on6.96NA2.800.62NA10.38ZZZ
    93615AEsophageal recording0.980.59NA0.061.63NA000
    9361526AEsophageal recording0.980.270.270.041.291.29000
    93615TCAEsophageal recording0.000.32NA0.020.34NA000
    93616AEsophageal recording1.480.76NA0.092.33NA000
    9361626AEsophageal recording1.480.440.440.071.991.99000
    93616TCAEsophageal recording0.000.32NA0.020.34NA000
    93618AHeart rhythm pacing4.245.62NA0.5010.36NA000
    9361826AHeart rhythm pacing4.241.691.690.266.196.19000
    93618TCAHeart rhythm pacing0.003.93NA0.244.17NA000
    93619AElectrophysiology evaluation7.2810.86NA0.9319.07NA000
    9361926AElectrophysiology evaluation7.283.223.220.4610.9610.96000
    93619TCAElectrophysiology evaluation0.007.64NA0.478.11NA000
    93620CElectrophysiology evaluation0.000.00NA0.000.00NA000
    9362026AElectrophysiology evaluation11.524.914.910.7217.1517.15000
    93620TCCElectrophysiology evaluation0.000.00NA0.000.00NA000
    93621CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362126AElectrophysiology evaluation2.090.830.830.183.103.10ZZZ
    93621TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93622CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362226AElectrophysiology evaluation3.081.221.220.805.105.10ZZZ
    93622TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93623CStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    9362326AStimulation, pacing heart2.831.121.120.184.134.13ZZZ
    93623TCCStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    93624AElectrophysiologic study4.784.19NA0.439.40NA000
    9362426AElectrophysiologic study4.782.232.230.307.317.31000
    93624TCAElectrophysiologic study0.001.96NA0.132.09NA000
    93631AHeart pacing, mapping7.568.87NA1.4017.83NA000
    9363126AHeart pacing, mapping7.562.782.780.7911.1311.13000
    93631TCAHeart pacing, mapping0.006.09NA0.616.70NA000
    93640AEvaluation heart device3.508.49NA0.6412.63NA000
    9364026AEvaluation heart device3.501.381.380.225.105.10000
    93640TCAEvaluation heart device0.007.11NA0.427.53NA000
    93641AElectrophysiology evaluation5.909.45NA0.7916.14NA000
    9364126AElectrophysiology evaluation5.902.342.340.378.618.61000
    93641TCAElectrophysiology evaluation0.007.11NA0.427.53NA000
    93642AElectrophysiology evaluation4.869.36NA0.6114.83NA000
    9364226AElectrophysiology evaluation4.862.252.250.197.307.30000
    93642TCAElectrophysiology evaluation0.007.11NA0.427.53NA000
    93650AAblate heart dysrhythm focus10.45NA4.500.66NA15.61000
    93651AAblate heart dysrhythm focus16.16NA6.411.02NA23.59000
    93652AAblate heart dysrhythm focus17.58NA6.981.10NA25.66000
    93660ATilt table evaluation1.882.42NA0.094.39NA000
    9366026ATilt table evaluation1.880.750.750.072.702.70000
    93660TCATilt table evaluation0.001.67NA0.021.69NA000
    93662CIntracardiac ecg (ice)0.000.000.000.000.000.00ZZZ
    9366226AIntracardiac ecg (ice)2.781.121.120.494.394.39ZZZ
    93662TCCIntracardiac ecg (ice)0.000.00NA0.000.00NAZZZ
    93668NPeripheral vascular rehab0.000.000.000.000.000.00XXX
    93701ABioimpedance, thoracic0.171.03NA0.021.22NAXXX
    9370126ABioimpedance, thoracic0.170.070.070.010.250.25XXX
    93701TCABioimpedance, thoracic0.000.96NA0.010.97NAXXX
    93720ATotal body plethysmography0.170.75NA0.070.99NAXXX
    93721APlethysmography tracing0.000.70NA0.060.76NAXXX
    93722APlethysmography report0.170.050.050.010.230.23XXX
    93724AAnalyze pacemaker system4.865.86NA0.4611.18NA000
    9372426AAnalyze pacemaker system4.861.931.930.227.017.01000
    93724TCAAnalyze pacemaker system0.003.93NA0.244.17NA000
    93727AAnalyze ilr system0.520.200.200.060.780.78XXX
    93731AAnalyze pacemaker system0.450.67NA0.061.18NAXXX
    9373126AAnalyze pacemaker system0.450.180.180.020.650.65XXX
    93731TCAAnalyze pacemaker system0.000.49NA0.040.53NAXXX
    93732AAnalyze pacemaker system0.910.87NA0.081.86NAXXX
    9373226AAnalyze pacemaker system0.910.360.360.041.311.31XXX
    93732TCAAnalyze pacemaker system0.000.51NA0.040.55NAXXX
    93733ATelephone analy, pacemaker0.170.78NA0.071.02NAXXX
    9373326ATelephone analy, pacemaker0.170.070.070.010.250.25XXX
    93733TCATelephone analy, pacemaker0.000.71NA0.060.77NAXXX
    Start Printed Page 63372
    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 system0.740.73NA0.081.55NAXXX
    9373526AAnalyze pacemaker system0.740.290.290.041.071.07XXX
    93735TCAAnalyze pacemaker system0.000.44NA0.040.48NAXXX
    93736ATelephonic analy, pacemaker0.150.69NA0.070.91NAXXX
    9373626ATelephonic analy, pacemaker0.150.060.060.010.220.22XXX
    93736TCATelephonic analy, pacemaker0.000.63NA0.060.69NAXXX
    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 sngl0.800.98NA0.061.84NAXXX
    9374126AAnalyze ht pace device sngl0.800.320.320.021.141.14XXX
    93741TCAAnalyze ht pace device sngl0.000.66NA0.040.70NAXXX
    93742AAnalyze ht pace device sngl0.901.02NA0.061.98NAXXX
    9374226AAnalyze ht pace device sngl0.900.360.360.021.281.28XXX
    93742TCAAnalyze ht pace device sngl0.000.66NA0.040.70NAXXX
    93743AAnalyze ht pace device dual1.021.13NA0.082.23NAXXX
    9374326AAnalyze ht pace device dual1.020.410.410.041.471.47XXX
    93743TCAAnalyze ht pace device dual0.000.72NA0.040.76NAXXX
    93744AAnalyze ht pace device dual1.171.13NA0.082.38NAXXX
    9374426AAnalyze ht pace device dual1.170.470.470.041.681.68XXX
    93744TCAAnalyze ht pace device dual0.000.66NA0.040.70NAXXX
    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 monitoring0.170.970.970.021.161.16XXX
    93786AAmbulatory BP recording0.000.90NA0.010.91NAXXX
    93788AAmbulatory BP analysis0.000.51NA0.010.52NAXXX
    93790AReview/report BP recording0.170.060.060.010.240.24XXX
    93797ACardiac rehab0.180.390.070.010.580.26000
    93798ACardiac rehab/monitor0.280.510.110.010.800.40000
    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 study0.221.67NA0.122.01NAXXX
    9387526AExtracranial study0.220.080.080.010.310.31XXX
    93875TCAExtracranial study0.001.59NA0.111.70NAXXX
    93880AExtracranial study0.604.20NA0.405.20NAXXX
    9388026AExtracranial study0.600.210.210.050.860.86XXX
    93880TCAExtracranial study0.003.99NA0.354.34NAXXX
    93882AExtracranial study0.403.02NA0.273.69NAXXX
    9388226AExtracranial study0.400.140.140.050.590.59XXX
    93882TCAExtracranial study0.002.88NA0.223.10NAXXX
    93886AIntracranial study0.934.51NA0.445.88NAXXX
    9388626AIntracranial study0.930.380.380.061.371.37XXX
    93886TCAIntracranial study0.004.13NA0.384.51NAXXX
    93888AIntracranial study0.623.06NA0.313.99NAXXX
    9388826AIntracranial study0.620.230.230.050.900.90XXX
    93888TCAIntracranial study0.002.83NA0.263.09NAXXX
    93922AExtremity study0.251.94NA0.152.34NAXXX
    9392226AExtremity study0.250.090.090.020.360.36XXX
    93922TCAExtremity study0.001.85NA0.131.98NAXXX
    93923AExtremity study0.453.03NA0.273.75NAXXX
    9392326AExtremity study0.450.160.160.050.660.66XXX
    93923TCAExtremity study0.002.87NA0.223.09NAXXX
    93924AExtremity study0.503.78NA0.314.59NAXXX
    9392426AExtremity study0.500.170.170.060.730.73XXX
    93924TCAExtremity study0.003.61NA0.253.86NAXXX
    93925ALower extremity study0.584.90NA0.405.88NAXXX
    9392526ALower extremity study0.580.200.200.050.830.83XXX
    93925TCALower extremity study0.004.70NA0.355.05NAXXX
    93926ALower extremity study0.393.49NA0.274.15NAXXX
    9392626ALower extremity study0.390.130.130.040.560.56XXX
    93926TCALower extremity study0.003.36NA0.233.59NAXXX
    93930AUpper extremity study0.463.89NA0.414.76NAXXX
    9393026AUpper extremity study0.460.160.160.040.660.66XXX
    93930TCAUpper extremity study0.003.73NA0.374.10NAXXX
    93931AUpper extremity study0.312.84NA0.263.41NAXXX
    9393126AUpper extremity study0.310.110.110.020.440.44XXX
    93931TCAUpper extremity study0.002.73NA0.242.97NAXXX
    93965AExtremity study0.351.87NA0.142.36NAXXX
    Start Printed Page 63373
    9396526AExtremity study0.350.120.120.020.490.49XXX
    93965TCAExtremity study0.001.75NA0.121.87NAXXX
    93970AExtremity study0.683.98NA0.465.12NAXXX
    9397026AExtremity study0.680.230.230.060.970.97XXX
    93970TCAExtremity study0.003.75NA0.404.15NAXXX
    93971AExtremity study0.452.87NA0.303.62NAXXX
    9397126AExtremity study0.450.150.150.040.640.64XXX
    93971TCAExtremity study0.002.72NA0.262.98NAXXX
    93975AVascular study1.795.86NA0.568.21NAXXX
    9397526AVascular study1.790.610.610.132.532.53XXX
    93975TCAVascular study0.005.25NA0.435.68NAXXX
    93976AVascular study1.203.48NA0.375.05NAXXX
    9397626AVascular study1.200.410.410.071.681.68XXX
    93976TCAVascular study0.003.07NA0.303.37NAXXX
    93978AVascular study0.653.60NA0.434.68NAXXX
    9397826AVascular study0.650.220.220.060.930.93XXX
    93978TCAVascular study0.003.38NA0.373.75NAXXX
    93979AVascular study0.442.67NA0.293.40NAXXX
    9397926AVascular study0.440.160.160.050.650.65XXX
    93979TCAVascular study0.002.51NA0.242.75NAXXX
    93980APenile vascular study1.244.84NA0.426.50NAXXX
    9398026APenile vascular study1.240.420.420.081.741.74XXX
    93980TCAPenile vascular study0.004.42NA0.344.76NAXXX
    93981APenile vascular study0.444.66NA0.335.43NAXXX
    9398126APenile vascular study0.440.150.150.020.610.61XXX
    93981TCAPenile vascular study0.004.51NA0.314.82NAXXX
    93990ADoppler flow testing0.253.41NA0.253.91NAXXX
    9399026ADoppler flow testing0.250.090.090.020.360.36XXX
    93990TCADoppler flow testing0.003.32NA0.233.55NAXXX
    94010ABreathing capacity test0.170.69NA0.030.89NAXXX
    9401026ABreathing capacity test0.170.050.050.010.230.23XXX
    94010TCABreathing capacity test0.000.64NA0.020.66NAXXX
    94014APatient recorded spirometry0.520.78NA0.031.33NAXXX
    94015APatient recorded spirometry0.000.61NA0.010.62NAXXX
    94016AReview patient spirometry0.520.170.170.020.710.71XXX
    94060AEvaluation of wheezing0.311.14NA0.071.52NAXXX
    9406026AEvaluation of wheezing0.310.100.100.010.420.42XXX
    94060TCAEvaluation of wheezing0.001.04NA0.061.10NAXXX
    94070AEvaluation of wheezing0.603.05NA0.123.77NAXXX
    9407026AEvaluation of wheezing0.600.190.190.020.810.81XXX
    94070TCAEvaluation of wheezing0.002.86NA0.102.96NAXXX
    94150BVital capacity test+0.070.49NA0.020.58NAXXX
    9415026BVital capacity test+0.070.030.030.010.110.11XXX
    94150TCBVital capacity test+0.000.46NA0.010.47NAXXX
    94200ALung function test (MBC/MVV)0.110.45NA0.030.59NAXXX
    9420026ALung function test (MBC/MVV)0.110.030.030.010.150.15XXX
    94200TCALung function test (MBC/MVV)0.000.42NA0.020.44NAXXX
    94240AResidual lung capacity0.260.67NA0.060.99NAXXX
    9424026AResidual lung capacity0.260.080.080.010.350.35XXX
    94240TCAResidual lung capacity0.000.59NA0.050.64NAXXX
    94250AExpired gas collection0.110.67NA0.020.80NAXXX
    9425026AExpired gas collection0.110.030.030.010.150.15XXX
    94250TCAExpired gas collection0.000.64NA0.010.65NAXXX
    94260AThoracic gas volume0.130.59NA0.050.77NAXXX
    9426026AThoracic gas volume0.130.040.040.010.180.18XXX
    94260TCAThoracic gas volume0.000.55NA0.040.59NAXXX
    94350ALung nitrogen washout curve0.260.76NA0.051.07NAXXX
    9435026ALung nitrogen washout curve0.260.080.080.010.350.35XXX
    94350TCALung nitrogen washout curve0.000.68NA0.040.72NAXXX
    94360AMeasure airflow resistance0.260.71NA0.071.04NAXXX
    9436026AMeasure airflow resistance0.260.080.080.010.350.35XXX
    94360TCAMeasure airflow resistance0.000.63NA0.060.69NAXXX
    94370ABreath airway closing volume0.260.73NA0.031.02NAXXX
    9437026ABreath airway closing volume0.260.080.080.010.350.35XXX
    94370TCABreath airway closing volume0.000.65NA0.020.67NAXXX
    94375ARespiratory flow volume loop0.310.63NA0.030.97NAXXX
    9437526ARespiratory flow volume loop0.310.100.100.010.420.42XXX
    94375TCARespiratory flow volume loop0.000.53NA0.020.55NAXXX
    94400ACO2 breathing response curve0.400.85NA0.071.32NAXXX
    9440026ACO2 breathing response curve0.400.130.130.010.540.54XXX
    94400TCACO2 breathing response curve0.000.72NA0.060.78NAXXX
    94450AHypoxia response curve0.400.69NA0.041.13NAXXX
    9445026AHypoxia response curve0.400.120.120.020.540.54XXX
    94450TCAHypoxia response curve0.000.57NA0.020.59NAXXX
    94620APulmonary stress test/simple0.642.45NA0.123.21NAXXX
    Start Printed Page 63374
    9462026APulmonary stress test/simple0.640.200.200.020.860.86XXX
    94620TCAPulmonary stress test/simple0.002.25NA0.102.35NAXXX
    94621APulm stress test/complex1.412.10NA0.163.67NAXXX
    9462126APulm stress test/complex1.410.440.440.061.911.91XXX
    94621TCAPulm stress test/complex0.001.66NA0.101.76NAXXX
    94640AAirway inhalation treatment0.000.32NA0.020.34NAXXX
    94642CAerosol inhalation treatment0.000.000.000.000.000.00XXX
    94656AInitial ventilator mgmt1.211.210.320.072.491.60XXX
    94657AContinued ventilator mgmt0.831.020.250.041.891.12XXX
    94660APos airway pressure, CPAP0.760.670.240.041.471.04XXX
    94662ANeg press ventilation, cnp0.76NA0.240.02NA1.02XXX
    94664AEvaluate pt use of inhaler0.000.33NA0.040.37NAXXX
    94667AChest wall manipulation0.000.57NA0.050.62NAXXX
    94668AChest wall manipulation0.000.48NA0.020.50NAXXX
    94680AExhaled air analysis, o20.261.93NA0.072.26NAXXX
    9468026AExhaled air analysis, o20.260.080.080.010.350.35XXX
    94680TCAExhaled air analysis, o20.001.85NA0.061.91NAXXX
    94681AExhaled air analysis, o2/co20.202.66NA0.132.99NAXXX
    9468126AExhaled air analysis, o2/co20.200.070.070.010.280.28XXX
    94681TCAExhaled air analysis, o2/co20.002.59NA0.122.71NAXXX
    94690AExhaled air analysis0.072.01NA0.052.13NAXXX
    9469026AExhaled air analysis0.070.020.020.010.100.10XXX
    94690TCAExhaled air analysis0.001.99NA0.042.03NAXXX
    94720AMonoxide diffusing capacity0.261.01NA0.071.34NAXXX
    9472026AMonoxide diffusing capacity0.260.080.080.010.350.35XXX
    94720TCAMonoxide diffusing capacity0.000.93NA0.060.99NAXXX
    94725AMembrane diffusion capacity0.263.00NA0.133.39NAXXX
    9472526AMembrane diffusion capacity0.260.080.080.010.350.35XXX
    94725TCAMembrane diffusion capacity0.002.92NA0.123.04NAXXX
    94750APulmonary compliance study0.231.38NA0.051.66NAXXX
    9475026APulmonary compliance study0.230.070.070.010.310.31XXX
    94750TCAPulmonary compliance study0.001.31NA0.041.35NAXXX
    94760TMeasure blood oxygen level0.000.04NA0.020.06NAXXX
    94761TMeasure blood oxygen level0.000.07NA0.060.13NAXXX
    94762AMeasure blood oxygen level0.000.41NA0.100.51NAXXX
    94770AExhaled carbon dioxide test0.151.70NA0.081.93NAXXX
    9477026AExhaled carbon dioxide test0.150.040.040.010.200.20XXX
    94770TCAExhaled carbon dioxide test0.001.66NA0.071.73NAXXX
    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 test0.150.330.060.010.490.22XXX
    95015AId allergy titrate-drug/bug0.150.150.060.010.310.22XXX
    95024AId allergy test, drug/bug0.000.14NA0.010.15NAXXX
    95027AId allergy titrate-airborne0.000.14NA0.010.15NAXXX
    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 tests0.002.26NA0.022.28NAXXX
    95071ABronchial allergy tests0.002.90NA0.022.92NAXXX
    95075AIngestion challenge test0.940.830.390.041.811.37XXX
    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 services0.060.150.020.010.220.09000
    95145AAntigen therapy services0.060.330.020.010.400.09000
    95146AAntigen therapy services0.060.460.030.010.530.10000
    95147AAntigen therapy services0.060.430.020.010.500.09000
    95148AAntigen therapy services0.060.600.030.010.670.10000
    95149AAntigen therapy services0.060.820.030.010.890.10000
    95165AAntigen therapy services0.060.200.020.010.270.09000
    Start Printed Page 63375
    95170AAntigen therapy services0.060.140.020.010.210.09000
    95180ARapid desensitization2.001.540.830.053.592.88000
    95199CAllergy immunology services0.000.000.000.000.000.00000
    95250AGlucose monitoring, cont0.003.89NA0.013.90NAXXX
    95805AMultiple sleep latency test1.8716.50NA0.4118.78NAXXX
    9580526AMultiple sleep latency test1.870.660.660.072.602.60XXX
    95805TCAMultiple sleep latency test0.0015.84NA0.3416.18NAXXX
    95806ASleep study, unattended1.653.88NA0.385.91NAXXX
    9580626ASleep study, unattended1.650.550.550.072.272.27XXX
    95806TCASleep study, unattended0.003.33NA0.313.64NAXXX
    95807ASleep study, attended1.6511.91NA0.4814.04NAXXX
    9580726ASleep study, attended1.650.540.540.062.252.25XXX
    95807TCASleep study, attended0.0011.37NA0.4211.79NAXXX
    95808APolysomnography, 1-32.6313.20NA0.5316.36NAXXX
    9580826APolysomnography, 1-32.630.930.930.113.673.67XXX
    95808TCAPolysomnography, 1-30.0012.27NA0.4212.69NAXXX
    95810APolysomnography, 4 or more3.5117.30NA0.5621.37NAXXX
    9581026APolysomnography, 4 or more3.511.201.200.144.854.85XXX
    95810TCAPolysomnography, 4 or more0.0016.10NA0.4216.52NAXXX
    95811APolysomnography w/cpap3.7818.74NA0.5923.11NAXXX
    9581126APolysomnography w/cpap3.781.291.290.165.235.23XXX
    95811TCAPolysomnography w/cpap0.0017.45NA0.4317.88NAXXX
    95812AEeg, 41-60 minutes1.073.98NA0.165.21NAXXX
    9581226AEeg, 41-60 minutes1.070.460.460.051.581.58XXX
    95812TCAEeg, 41-60 minutes0.003.52NA0.113.63NAXXX
    95813AEeg, over 1 hour1.725.00NA0.186.90NAXXX
    9581326AEeg, over 1 hour1.720.700.700.072.492.49XXX
    95813TCAEeg, over 1 hour0.004.30NA0.114.41NAXXX
    95816AEeg, awake and drowsy1.073.20NA0.154.42NAXXX
    9581626AEeg, awake and drowsy1.070.470.470.051.591.59XXX
    95816TCAEeg, awake and drowsy0.002.73NA0.102.83NAXXX
    95819AEeg, awake and asleep1.073.74NA0.154.96NAXXX
    9581926AEeg, awake and asleep1.070.470.470.051.591.59XXX
    95819TCAEeg, awake and asleep0.003.27NA0.103.37NAXXX
    95822AEeg, coma or sleep only1.074.43NA0.185.68NAXXX
    9582226AEeg, coma or sleep only1.070.470.470.051.591.59XXX
    95822TCAEeg, coma or sleep only0.003.96NA0.134.09NAXXX
    95824CEeg, cerebral death only0.000.000.000.000.000.00XXX
    9582426AEeg, cerebral death only0.740.320.320.061.121.12XXX
    95824TCCEeg, cerebral death only0.000.00NA0.000.00NAXXX
    95827AEeg, all night recording1.072.68NA0.183.93NAXXX
    9582726AEeg, all night recording1.070.410.410.041.521.52XXX
    95827TCAEeg, all night recording0.002.27NA0.142.41NAXXX
    95829ASurgery electrocorticogram6.1732.01NA0.3938.57NAXXX
    9582926ASurgery electrocorticogram6.172.352.350.378.898.89XXX
    95829TCASurgery electrocorticogram0.0029.66NA0.0229.68NAXXX
    95830AInsert electrodes for EEG1.693.420.730.085.192.50XXX
    95831ALimb muscle testing, manual0.280.350.130.010.640.42XXX
    95832AHand muscle testing, manual0.290.260.120.010.560.42XXX
    95833ABody muscle testing, manual0.470.460.230.010.940.71XXX
    95834ABody muscle testing, manual0.600.510.280.021.130.90XXX
    95851ARange of motion measurements0.160.370.080.010.540.25XXX
    95852ARange of motion measurements0.110.260.050.010.380.17XXX
    95857ATensilon test0.530.620.230.021.170.78XXX
    95858ATensilon test & myogram1.551.07NA0.092.71NAXXX
    9585826ATensilon test & myogram1.550.670.670.052.272.27XXX
    95858TCATensilon test & myogram0.000.40NA0.040.44NAXXX
    95860AMuscle test, one limb0.951.47NA0.062.48NAXXX
    9586026AMuscle test, one limb0.950.430.430.041.421.42XXX
    95860TCAMuscle test, one limb0.001.04NA0.021.06NAXXX
    95861AMuscle test, 2 limbs1.531.40NA0.123.05NAXXX
    9586126AMuscle test, 2 limbs1.530.680.680.062.272.27XXX
    95861TCAMuscle test, 2 limbs0.000.72NA0.060.78NAXXX
    95863AMuscle test, 3 limbs1.861.74NA0.133.73NAXXX
    9586326AMuscle test, 3 limbs1.860.810.810.072.742.74XXX
    95863TCAMuscle test, 3 limbs0.000.93NA0.060.99NAXXX
    95864AMuscle test, 4 limbs1.982.65NA0.194.82NAXXX
    9586426AMuscle test, 4 limbs1.980.880.880.072.932.93XXX
    95864TCAMuscle test, 4 limbs0.001.77NA0.121.89NAXXX
    95867AMuscle test cran nerv unilat0.790.93NA0.081.80NAXXX
    9586726AMuscle test cran nerv unilat0.790.350.350.041.181.18XXX
    95867TCAMuscle test cran nerv unilat0.000.58NA0.040.62NAXXX
    95868AMuscle test cran nerve bilat1.171.21NA0.102.48NAXXX
    9586826AMuscle test cran nerve bilat1.170.520.520.051.741.74XXX
    95868TCAMuscle test cran nerve bilat0.000.69NA0.050.74NAXXX
    Start Printed Page 63376
    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 fiber1.491.24NA0.102.83NAXXX
    9587226AMuscle test, one fiber1.490.640.640.052.182.18XXX
    95872TCAMuscle test, one fiber0.000.60NA0.050.65NAXXX
    95875ALimb exercise test1.091.49NA0.112.69NAXXX
    9587526ALimb exercise test1.090.480.480.051.621.62XXX
    95875TCALimb exercise test0.001.01NA0.061.07NAXXX
    95900AMotor nerve conduction test0.421.30NA0.031.75NAXXX
    9590026AMotor nerve conduction test0.420.190.190.010.620.62XXX
    95900TCAMotor nerve conduction test0.001.11NA0.021.13NAXXX
    95903AMotor nerve conduction test0.601.22NA0.041.86NAXXX
    9590326AMotor nerve conduction test0.600.260.260.020.880.88XXX
    95903TCAMotor nerve conduction test0.000.96NA0.020.98NAXXX
    95904ASense nerve conduction test0.341.12NA0.031.49NAXXX
    9590426ASense nerve conduction test0.340.150.150.010.500.50XXX
    95904TCASense nerve conduction test0.000.97NA0.020.99NAXXX
    95920AIntraop nerve test add-on2.102.23NA0.244.57NAZZZ
    9592026AIntraop nerve test add-on2.100.940.940.173.213.21ZZZ
    95920TCAIntraop nerve test add-on0.001.29NA0.071.36NAZZZ
    95921AAutonomic nerv function test0.890.71NA0.061.66NAXXX
    9592126AAutonomic nerv function test0.890.330.330.041.261.26XXX
    95921TCAAutonomic nerv function test0.000.38NA0.020.40NAXXX
    95922AAutonomic nerv function test0.950.79NA0.061.80NAXXX
    9592226AAutonomic nerv function test0.950.410.410.041.401.40XXX
    95922TCAAutonomic nerv function test0.000.38NA0.020.40NAXXX
    95923AAutonomic nerv function test0.892.13NA0.063.08NAXXX
    9592326AAutonomic nerv function test0.890.380.380.041.311.31XXX
    95923TCAAutonomic nerv function test0.001.75NA0.021.77NAXXX
    95925ASomatosensory testing0.541.13NA0.081.75NAXXX
    9592526ASomatosensory testing0.540.230.230.020.790.79XXX
    95925TCASomatosensory testing0.000.90NA0.060.96NAXXX
    95926ASomatosensory testing0.541.14NA0.081.76NAXXX
    9592626ASomatosensory testing0.540.240.240.020.800.80XXX
    95926TCASomatosensory testing0.000.90NA0.060.96NAXXX
    95927ASomatosensory testing0.541.15NA0.101.79NAXXX
    9592726ASomatosensory testing0.540.250.250.040.830.83XXX
    95927TCASomatosensory testing0.000.90NA0.060.96NAXXX
    95930AVisual evoked potential test0.351.45NA0.021.82NAXXX
    9593026AVisual evoked potential test0.350.150.150.010.510.51XXX
    95930TCAVisual evoked potential test0.001.30NA0.011.31NAXXX
    95933ABlink reflex test0.591.02NA0.081.69NAXXX
    9593326ABlink reflex test0.590.250.250.020.860.86XXX
    95933TCABlink reflex test0.000.77NA0.060.83NAXXX
    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 test0.550.45NA0.041.04NAXXX
    9593626AH-reflex test0.550.240.240.020.810.81XXX
    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 monitoring1.504.53NA0.536.56NAXXX
    9595026AAmbulatory eeg monitoring1.500.640.640.102.242.24XXX
    95950TCAAmbulatory eeg monitoring0.003.89NA0.434.32NAXXX
    95951CEEG monitoring/videorecord0.000.00NA0.000.00NAXXX
    9595126AEEG monitoring/videorecord5.972.592.590.248.808.80XXX
    95951TCCEEG monitoring/videorecord0.000.00NA0.000.00NAXXX
    95953AEEG monitoring/computer3.067.59NA0.5511.20NAXXX
    9595326AEEG monitoring/computer3.061.311.310.124.494.49XXX
    95953TCAEEG monitoring/computer0.006.28NA0.436.71NAXXX
    95954AEEG monitoring/giving drugs2.444.33NA0.186.95NAXXX
    9595426AEEG monitoring/giving drugs2.441.051.050.123.613.61XXX
    95954TCAEEG monitoring/giving drugs0.003.28NA0.063.34NAXXX
    95955AEEG during surgery1.002.31NA0.233.54NAXXX
    9595526AEEG during surgery1.000.370.370.061.431.43XXX
    95955TCAEEG during surgery0.001.94NA0.172.11NAXXX
    95956AEeg monitoring, cable/radio3.0614.32NA0.5617.94NAXXX
    9595626AEeg monitoring, cable/radio3.061.321.320.134.514.51XXX
    95956TCAEeg monitoring, cable/radio0.0013.00NA0.4313.43NAXXX
    Start Printed Page 63377
    95957AEEG digital analysis1.972.55NA0.204.72NAXXX
    9595726AEEG digital analysis1.970.860.860.082.912.91XXX
    95957TCAEEG digital analysis0.001.69NA0.121.81NAXXX
    95958AEEG monitoring/function test4.233.50NA0.358.08NAXXX
    9595826AEEG monitoring/function test4.231.771.770.226.226.22XXX
    95958TCAEEG monitoring/function test0.001.73NA0.131.86NAXXX
    95961AElectrode stimulation, brain2.952.63NA0.295.87NAXXX
    9596126AElectrode stimulation, brain2.951.341.340.224.514.51XXX
    95961TCAElectrode stimulation, brain0.001.29NA0.071.36NAXXX
    95962AElectrode stim, brain add-on3.192.70NA0.276.16NAZZZ
    9596226AElectrode stim, brain add-on3.191.411.410.204.804.80ZZZ
    95962TCAElectrode stim, brain add-on0.001.29NA0.071.36NAZZZ
    95965CMeg, spontaneous0.000.000.000.000.000.00XXX
    9596526AMeg, spontaneous7.953.463.460.3711.7811.78XXX
    95965TCCMeg, spontaneous0.000.000.000.000.000.00XXX
    95966CMeg, evoked, single0.000.000.000.000.000.00XXX
    9596626AMeg, evoked, single3.981.741.740.185.905.90XXX
    95966TCCMeg, evoked, single0.000.000.000.000.000.00XXX
    95967CMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    9596726AMeg, evoked, each addl3.481.351.350.164.994.99ZZZ
    95967TCCMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    95970AAnalyze neurostim, no prog0.450.170.150.040.660.64XXX
    95971AAnalyze neurostim, simple0.780.280.230.071.131.08XXX
    95972AAnalyze neurostim, complex1.490.600.500.202.292.19XXX
    95973AAnalyze neurostim, complex0.910.400.350.081.391.34ZZZ
    95974ACranial neurostim, complex2.981.311.310.184.474.47XXX
    95975ACranial neurostim, complex1.690.730.730.082.502.50ZZZ
    95990ASpin/brain pump refil & main0.001.49NA0.061.55NAXXX
    95991ASpin/brain pump refil & main0.771.490.190.062.321.02XXX
    95999CNeurological procedure0.000.000.000.000.000.00XXX
    96000AMotion analysis, video/3d1.79NA0.570.02NA2.38XXX
    96001AMotion test w/ft press meas2.14NA0.670.02NA2.83XXX
    96002ADynamic surface emg0.41NA0.150.02NA0.58XXX
    96003ADynamic fine wire emg0.37NA0.140.04NA0.55XXX
    96004APhys review of motion tests2.130.960.960.103.193.19XXX
    96100APsychological testing0.001.75NA0.181.93NAXXX
    96105AAssessment of aphasia0.001.75NA0.181.93NAXXX
    96110ADevelopmental test, lim0.000.18NA0.180.36NAXXX
    96111ADevelopmental test, extend2.591.07NA0.183.84NAXXX
    96115ANeurobehavior status exam0.001.75NA0.181.93NAXXX
    96117ANeuropsych test battery0.001.75NA0.181.93NAXXX
    96150AAssess lth/behave, init0.500.190.180.020.710.70XXX
    96151AAssess hlth/behave, subseq0.480.180.170.020.680.67XXX
    96152AIntervene hlth/behave, indiv0.460.180.160.020.660.64XXX
    96153AIntervene hlth/behave, group0.100.040.040.010.150.15XXX
    96154AInterv hlth/behav, fam w/pt0.450.170.160.020.640.63XXX
    96155NInterv hlth/behav fam no pt+0.440.180.170.020.640.63XXX
    96400AChemotherapy, sc/im0.000.88NA0.010.89NAXXX
    96405AIntralesional chemo admin0.521.940.230.022.480.77000
    96406AIntralesional chemo admin0.802.580.300.023.401.12000
    96408AChemotherapy, push technique0.000.96NA0.061.02NAXXX
    96410AChemotherapy,infusion method0.001.54NA0.081.62NAXXX
    96412AChemo, infuse method add-on0.001.14NA0.071.21NAZZZ
    96414AChemo, infuse method add-on0.001.32NA0.081.40NAXXX
    96420AChemotherapy, push technique0.001.24NA0.081.32NAXXX
    96422AChemotherapy,infusion method0.001.22NA0.081.30NAXXX
    96423AChemo, infuse method add-on0.000.48NA0.020.50NAZZZ
    96425AChemotherapy,infusion method0.001.42NA0.081.50NAXXX
    96440AChemotherapy, intracavitary2.367.401.040.149.903.54000
    96445AChemotherapy, intracavitary2.197.381.030.089.653.30000
    96450AChemotherapy, into CNS1.886.260.910.078.212.86000
    96520APort pump refill & main0.000.88NA0.060.94NAXXX
    96530ASyst pump refill & main0.001.05NA0.061.11NAXXX
    96542AChemotherapy injection1.413.800.550.065.272.02XXX
    96545BProvide chemotherapy agent0.000.000.000.000.000.00XXX
    96549CChemotherapy, unspecified0.000.000.000.000.000.00XXX
    96567APhotodynamic tx, skin0.000.99NA0.041.03NAXXX
    96570APhotodynamic tx, 30 min1.09NA0.370.05NA1.51ZZZ
    96571APhotodynamic tx, addl 15 min0.55NA0.200.02NA0.77ZZZ
    96900AUltraviolet light therapy0.000.49NA0.020.51NAXXX
    96902BTrichogram+0.410.250.160.010.670.58XXX
    96910APhotochemotherapy with UV-B0.001.08NA0.041.12NAXXX
    96912APhotochemotherapy with UV-A0.001.36NA0.051.41NAXXX
    96913APhotochemotherapy, UV-A or B0.001.80NA0.101.90NAXXX
    96920ALaser tx, skin < 250 sq cm1.147.740.580.118.991.83000
    Start Printed Page 63378
    96921ALaser tx, skin 250-500 sq cm1.167.810.590.119.081.86000
    96922ALaser tx, skin > 500 sq cm2.098.561.040.1910.843.32000
    96999CDermatological procedure0.000.000.000.000.000.00XXX
    97001APt evaluation1.190.740.460.061.991.71XXX
    97002APt re-evaluation0.600.450.240.021.070.86XXX
    97003AOt evaluation1.190.870.410.062.121.66XXX
    97004AOt re-evaluation0.600.620.200.021.240.82XXX
    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
    97022AWhirlpool therapy0.170.22NA0.010.40NAXXX
    97024ADiathermy treatment0.060.09NA0.010.16NAXXX
    97026AInfrared therapy0.060.06NA0.010.13NAXXX
    97028AUltraviolet therapy0.080.07NA0.010.16NAXXX
    97032AElectrical stimulation0.250.16NA0.010.42NAXXX
    97033AElectric current therapy0.260.28NA0.020.56NAXXX
    97034AContrast bath therapy0.210.16NA0.010.38NAXXX
    97035AUltrasound therapy0.210.11NA0.010.33NAXXX
    97036AHydrotherapy0.280.33NA0.010.62NAXXX
    97039APhysical therapy treatment0.200.10NA0.010.31NAXXX
    97110ATherapeutic exercises0.450.28NA0.040.77NAXXX
    97112ANeuromuscular reeducation0.450.31NA0.020.78NAXXX
    97113AAquatic therapy/exercises0.440.41NA0.040.89NAXXX
    97116AGait training therapy0.400.24NA0.020.66NAXXX
    97124AMassage therapy0.350.23NA0.010.59NAXXX
    97139APhysical medicine procedure0.210.21NA0.010.43NAXXX
    97140AManual therapy0.430.26NA0.020.71NAXXX
    97150AGroup therapeutic procedures0.270.18NA0.020.47NAXXX
    97504AOrthotic training0.450.33NA0.040.82NAXXX
    97520AProsthetic training0.450.28NA0.020.75NAXXX
    97530ATherapeutic activities0.440.32NA0.020.78NAXXX
    97532ACognitive skills development0.440.21NA0.010.66NAXXX
    97533ASensory integration0.440.24NA0.010.69NAXXX
    97535ASelf care mngment training0.450.34NA0.020.81NAXXX
    97537ACommunity/work reintegration0.450.27NA0.010.73NAXXX
    97542AWheelchair mngment training0.450.28NA0.010.74NAXXX
    97545RWork hardening0.000.000.000.000.000.00XXX
    97546RWork hardening add-on0.000.000.000.000.000.00ZZZ
    97601AWound(s) care, selective0.500.50NA0.051.05NAXXX
    97602BWound(s) care non-selective0.000.000.000.000.000.00XXX
    97703AProsthetic checkout0.250.42NA0.020.69NAXXX
    97750APhysical performance test0.450.30NA0.020.77NAXXX
    97755AAssistive technology assess0.620.29NA0.020.93NAXXX
    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 manipulation0.450.330.140.010.790.60000
    98926AOsteopathic manipulation0.650.430.250.021.100.92000
    98927AOsteopathic manipulation0.870.520.300.041.431.21000
    98928AOsteopathic manipulation1.020.610.350.041.671.41000
    98929AOsteopathic manipulation1.180.690.370.051.921.60000
    98940AChiropractic manipulation0.450.240.120.010.700.58000
    98941AChiropractic manipulation0.650.300.180.020.970.85000
    98942AChiropractic manipulation0.870.370.240.041.281.15000
    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
    99025FInitial surgical evaluation0.000.000.000.000.000.00XXX
    99026NIn-hospital on call service0.000.000.000.000.000.00XXX
    99027NOut-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
    Start Printed Page 63379
    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+0.801.950.390.052.801.24XXX
    99142BSedation, oral/rectal/nasal+0.601.000.310.041.640.95XXX
    99170AAnogenital exam, child1.741.720.530.083.542.35000
    99172NOcular function screen0.000.000.000.000.000.00XXX
    99173NVisual acuity screen0.000.000.000.000.000.00XXX
    99175AInduction of vomiting0.001.38NA0.101.48NAXXX
    99183AHyperbaric oxygen therapy2.334.860.730.147.333.20XXX
    99185ARegional hypothermia0.000.64NA0.040.68NAXXX
    99186ATotal body hypothermia0.001.77NA0.442.21NAXXX
    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
    99195APhlebotomy0.000.44NA0.020.46NAXXX
    99199CSpecial service/proc/report0.000.000.000.000.000.00XXX
    99201AOffice/outpatient visit, new0.450.510.160.020.980.63XXX
    99202AOffice/outpatient visit, new0.870.790.320.061.721.25XXX
    99203AOffice/outpatient visit, new1.331.150.490.102.581.92XXX
    99204AOffice/outpatient visit, new1.991.540.710.123.652.82XXX
    99205AOffice/outpatient visit, new2.651.820.930.144.613.72XXX
    99211AOffice/outpatient visit, est0.170.410.060.010.590.24XXX
    99212AOffice/outpatient visit, est0.450.560.160.021.030.63XXX
    99213AOffice/outpatient visit, est0.670.710.230.041.420.94XXX
    99214AOffice/outpatient visit, est1.091.060.390.052.201.53XXX
    99215AOffice/outpatient visit, est1.761.360.630.083.202.47XXX
    99217AObservation care discharge1.27NA0.540.06NA1.87XXX
    99218AObservation care1.27NA0.440.06NA1.77XXX
    99219AObservation care2.13NA0.710.10NA2.94XXX
    99220AObservation care2.97NA1.020.13NA4.12XXX
    99221AInitial hospital care1.27NA0.450.06NA1.78XXX
    99222AInitial hospital care2.13NA0.730.10NA2.96XXX
    99223AInitial hospital care2.97NA1.030.12NA4.12XXX
    99231ASubsequent hospital care0.64NA0.230.02NA0.89XXX
    99232ASubsequent hospital care1.05NA0.370.04NA1.46XXX
    99233ASubsequent hospital care1.50NA0.530.06NA2.09XXX
    99234AObserv/hosp same date2.55NA0.990.13NA3.67XXX
    99235AObserv/hosp same date3.40NA1.290.16NA4.85XXX
    99236AObserv/hosp same date4.25NA1.580.20NA6.03XXX
    99238AHospital discharge day1.27NA0.550.05NA1.87XXX
    99239AHospital discharge day1.74NA0.740.06NA2.54XXX
    99241AOffice consultation0.640.650.220.051.340.91XXX
    99242AOffice consultation1.281.060.470.112.451.86XXX
    99243AOffice consultation1.711.410.630.123.242.46XXX
    99244AOffice consultation2.571.850.910.164.583.64XXX
    99245AOffice consultation3.412.291.220.195.894.82XXX
    99251AInitial inpatient consult0.66NA0.250.05NA0.96XXX
    99252AInitial inpatient consult1.31NA0.510.10NA1.92XXX
    99253AInitial inpatient consult1.81NA0.680.11NA2.60XXX
    99254AInitial inpatient consult2.62NA0.980.13NA3.73XXX
    99255AInitial inpatient consult3.63NA1.340.18NA5.15XXX
    99261AFollow-up inpatient consult0.42NA0.150.02NA0.59XXX
    99262AFollow-up inpatient consult0.85NA0.310.04NA1.20XXX
    99263AFollow-up inpatient consult1.26NA0.460.05NA1.77XXX
    99271AConfirmatory consultation0.450.560.160.041.050.65XXX
    99272AConfirmatory consultation0.840.830.310.071.741.22XXX
    99273AConfirmatory consultation1.181.110.450.082.371.71XXX
    99274AConfirmatory consultation1.721.370.640.113.202.47XXX
    99275AConfirmatory consultation2.301.640.820.124.063.24XXX
    99281AEmergency dept visit0.33NA0.090.02NA0.44XXX
    99282AEmergency dept visit0.55NA0.150.04NA0.74XXX
    99283AEmergency dept visit1.23NA0.310.10NA1.64XXX
    99284AEmergency dept visit1.94NA0.480.14NA2.56XXX
    99285AEmergency dept visit3.04NA0.720.23NA3.99XXX
    99288BDirect advanced life support0.000.000.000.000.000.00XXX
    Start Printed Page 63380
    99289APed crit care transport4.77NA1.680.17NA6.62XXX
    99290APed crit care transport addl2.39NA0.830.08NA3.30ZZZ
    99291ACritical care, first hour3.982.371.290.176.525.44XXX
    99292ACritical care, addl 30 min1.990.810.640.082.882.71ZZZ
    99293APed critical care, initial15.91NA5.000.84NA21.75XXX
    99294APed critical care, subseq7.95NA2.500.28NA10.73XXX
    99295ANeonate crit care, initial18.38NA5.430.84NA24.65XXX
    99296ANeonate critical care subseq7.95NA2.570.28NA10.80XXX
    99298AIc for lbw infant < 1500 gm2.73NA0.940.12NA3.79XXX
    99299AIc, lbw infant 1500-2500 gm2.49NA0.960.12NA3.57XXX
    99301ANursing facility care1.190.680.410.051.921.65XXX
    99302ANursing facility care1.600.960.550.062.622.21XXX
    99303ANursing facility care2.001.180.670.073.252.74XXX
    99311ANursing fac care, subseq0.600.490.200.021.110.82XXX
    99312ANursing fac care, subseq0.990.660.340.041.691.37XXX
    99313ANursing fac care, subseq1.410.850.480.052.311.94XXX
    99315ANursing fac discharge day1.120.470.380.051.641.55XXX
    99316ANursing fac discharge day1.490.630.520.062.182.07XXX
    99321ARest home visit, new patient0.710.35NA0.021.08NAXXX
    99322ARest home visit, new patient1.000.47NA0.041.51NAXXX
    99323ARest home visit, new patient1.270.56NA0.051.88NAXXX
    99331ARest home visit, est pat0.600.32NA0.020.94NAXXX
    99332ARest home visit, est pat0.800.39NA0.041.23NAXXX
    99333ARest home visit, est pat0.990.47NA0.041.50NAXXX
    99341AHome visit, new patient1.000.49NA0.061.55NAXXX
    99342AHome visit, new patient1.510.68NA0.062.25NAXXX
    99343AHome visit, new patient2.260.95NA0.083.29NAXXX
    99344AHome visit, new patient3.011.20NA0.124.33NAXXX
    99345AHome visit, new patient3.771.45NA0.145.36NAXXX
    99347AHome visit, est patient0.760.41NA0.041.21NAXXX
    99348AHome visit, est patient1.250.71NA0.052.01NAXXX
    99349AHome visit, est patient2.011.05NA0.073.13NAXXX
    99350AHome visit, est patient3.011.43NA0.124.56NAXXX
    99354AProlonged service, office1.760.740.610.072.572.44ZZZ
    99355AProlonged service, office1.760.720.580.072.552.41ZZZ
    99356AProlonged service, inpatient1.70NA0.620.07NA2.39ZZZ
    99357AProlonged service, inpatient1.70NA0.640.07NA2.41ZZZ
    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+1.090.700.430.051.841.57XXX
    99375IHome health care supervision+1.721.561.560.073.353.35XXX
    99377BHospice care supervision+1.090.700.430.051.841.57XXX
    99378IHospice care supervision+1.721.951.950.073.743.74XXX
    99379BNursing fac care supervision+1.090.700.700.041.831.83XXX
    99380BNursing fac care supervision+1.721.001.000.062.782.78XXX
    99381NPrev visit, new, infant+1.181.510.460.052.741.69XXX
    99382NPrev visit, new, age 1-4+1.351.550.530.052.951.93XXX
    99383NPrev visit, new, age 5-11+1.351.490.530.052.891.93XXX
    99384NPrev visit, new, age 12-17+1.521.560.600.063.142.18XXX
    99385NPrev visit, new, age 18-39+1.521.560.600.063.142.18XXX
    99386NPrev visit, new, age 40-64+1.871.750.720.073.692.66XXX
    99387NPrev visit, new, 65 & over+2.051.880.790.074.002.91XXX
    99391NPrev visit, est, infant+1.011.020.400.042.071.45XXX
    99392NPrev visit, est, age 1-4+1.181.090.460.052.321.69XXX
    99393NPrev visit, est, age 5-11+1.181.060.460.052.291.69XXX
    99394NPrev visit, est, age 12-17+1.351.140.530.052.541.93XXX
    99395NPrev visit, est, age 18-39+1.351.170.530.052.571.93XXX
    99396NPrev visit, est, age 40-64+1.521.260.600.062.842.18XXX
    99397NPrev visit, est, 65 & over+1.701.370.660.063.132.42XXX
    99401NPreventive counseling, indiv+0.480.630.190.011.120.68XXX
    99402NPreventive counseling, indiv+0.970.870.380.021.861.37XXX
    99403NPreventive counseling, indiv+1.451.090.570.042.582.06XXX
    99404NPreventive counseling, indiv+1.941.330.750.053.322.74XXX
    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 newborn1.16NA0.390.05NA1.60XXX
    99432ANewborn care, not in hosp1.250.910.410.072.231.73XXX
    Start Printed Page 63381
    99433ANormal newborn care/hospital0.62NA0.200.02NA0.84XXX
    99435ANewborn discharge day hosp1.49NA0.510.06NA2.06XXX
    99436AAttendance, birth1.49NA0.480.06NA2.03XXX
    99440ANewborn resuscitation2.91NA0.930.13NA3.97XXX
    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
    99507IHome visit, cath maintain0.000.000.000.000.000.00XXX
    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 for hemodialysis0.000.000.000.000.000.00XXX
    99551FHome infus, pain mgmt, iv/sc0.000.000.000.000.000.00XXX
    99552FHm infus pain mgmt, epid/ith0.000.000.000.000.000.00XXX
    99553FHome infuse, tocolytic tx0.000.000.000.000.000.00XXX
    99554FHome infus, hormone/platelet0.000.000.000.000.000.00XXX
    99555FHome infuse, chemotheraphy0.000.000.000.000.000.00XXX
    99556FHome infus, antibio/fung/vir0.000.000.000.000.000.00XXX
    99557FHome infuse, anticoagulant0.000.000.000.000.000.00XXX
    99558FHome infuse, immunotherapy0.000.000.000.000.000.00XXX
    99559FHome infus, periton dialysis0.000.000.000.000.000.00XXX
    99560FHome infus, entero nutrition0.000.000.000.000.000.00XXX
    99561FHome infuse, hydration tx0.000.000.000.000.000.00XXX
    99562FHome infus, parent nutrition0.000.000.000.000.000.00XXX
    99563FHome admin, pentamidine0.000.000.000.000.000.00XXX
    99564FHme infus, antihemophil agnt0.000.000.000.000.000.00XXX
    99565FHome infus, proteinase inhib0.000.000.000.000.000.00XXX
    99566FHome infuse, iv therapy0.000.000.000.000.000.00XXX
    99567FHome infuse, sympath agent0.000.000.000.000.000.00XXX
    99568FHome infus, misc drug, daily0.000.000.000.000.000.00XXX
    99569FHome infuse, each addl tx0.000.000.000.000.000.00XXX
    99600IHome visit nos0.000.000.000.000.000.00XXX
    99601IHome infusion/visit, 2 hrs0.000.000.000.000.000.00XXX
    99602IHome infusion, each addl hr0.000.000.000.000.000.00XXX
    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
    Start Printed Page 63382
    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
    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
    G0008XAdmin influenza virus vac0.000.000.000.000.000.00XXX
    G0009XAdmin pneumococcal vaccine0.000.000.000.000.000.00XXX
    G0010XAdmin hepatitis b vaccine0.000.000.000.000.000.00XXX
    G0027XSemen analysis0.000.000.000.000.000.00XXX
    G0030CPET imaging prev PET single0.000.000.000.000.000.00XXX
    G003026APET imaging prev PET single1.490.600.600.052.142.14XXX
    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 multple1.860.720.720.072.652.65XXX
    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 singl1.490.550.550.062.102.10XXX
    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 mult1.860.740.740.072.672.67XXX
    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 singl1.490.580.580.062.132.13XXX
    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 mult1.860.730.730.072.662.66XXX
    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 sing1.490.570.570.052.112.11XXX
    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 mult1.860.710.710.072.642.64XXX
    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 sing1.490.530.530.052.072.07XXX
    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 mult1.860.720.720.082.662.66XXX
    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 singl1.490.610.610.052.152.15XXX
    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 mult1.860.740.740.062.662.66XXX
    G0041TCCPET follow stress echo mult0.000.000.000.000.000.00XXX
    G0042CPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G004226APET follow ventriculogm sing1.490.620.620.052.162.16XXX
    G0042TCCPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G0043CPET follow ventriculogm mult0.000.000.000.000.000.00XXX
    Start Printed Page 63383
    G004326APET follow ventriculogm mult1.860.750.750.072.682.68XXX
    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 singl1.490.600.600.052.142.14XXX
    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 mult1.860.730.730.072.662.66XXX
    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 singl1.490.600.600.052.142.14XXX
    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 mult1.860.740.740.072.672.67XXX
    G0047TCCPET follow stress ECG mult0.000.000.000.000.000.00XXX
    G0101ACA screen;pelvic/breast exam0.450.540.170.011.000.63XXX
    G0102AProstate ca screening; dre0.170.410.060.010.590.24XXX
    G0103XPsa, total screening0.000.000.000.000.000.00XXX
    G0104ACA screen;flexi sigmoidscope0.952.240.530.063.251.54000
    G0105AColorectal scrn; hi risk ind3.686.131.600.2410.055.52000
    G010553AColorectal scrn; hi risk ind0.952.240.530.063.251.54000
    G0106AColon CA screen;barium enema0.982.54NA0.183.70NAXXX
    G010626AColon CA screen;barium enema0.980.330.330.051.361.36XXX
    G0106TCAColon CA screen;barium enema0.002.21NA0.132.34NAXXX
    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
    G0110DNett pulm-rehab educ; ind0.000.000.000.000.000.00XXX
    G0111DNett pulm-rehab educ; group0.000.000.000.000.000.00XXX
    G0112DNett;nutrition guid, initial0.000.000.000.000.000.00XXX
    G0113DNett;nutrition guid,subseqnt0.000.000.000.000.000.00XXX
    G0114DNett; psychosocial consult0.000.000.000.000.000.00XXX
    G0115DNett; psychological testing0.000.000.000.000.000.00XXX
    G0116DNett; psychosocial counsel0.000.000.000.000.000.00XXX
    G0117TGlaucoma scrn hgh risk direc0.450.710.190.021.180.66XXX
    G0118TGlaucoma scrn hgh risk direc0.170.530.070.010.710.25XXX
    G0120AColon ca scrn; barium enema0.982.54NA0.183.70NAXXX
    G012026AColon ca scrn; barium enema0.980.330.330.051.361.36XXX
    G0120TCAColon ca scrn; barium enema0.002.21NA0.132.34NAXXX
    G0121AColon ca scrn not hi rsk ind3.686.131.600.2410.055.52000
    G012153AColon ca scrn not hi rsk ind0.952.240.530.063.251.54000
    G0122NColon ca scrn; barium enema+0.982.592.590.183.753.75XXX
    G012226NColon ca scrn; barium enema+0.980.390.390.051.421.42XXX
    G0122TCNColon ca scrn; barium enema+0.002.202.200.132.332.33XXX
    G0123XScreen cerv/vag thin layer0.000.000.000.000.000.00XXX
    G0124AScreen c/v thin layer by MD0.420.180.180.010.610.61XXX
    G0125CPET image pulmonary nodule0.000.00NA0.000.00NAXXX
    G012526APET image pulmonary nodule1.490.540.540.062.092.09XXX
    G0125TCCPET image pulmonary nodule0.000.00NA0.000.00NAXXX
    G0127RTrim nail(s)0.170.260.070.010.440.25000
    G0128RCORF skilled nursing service0.080.030.030.010.120.12XXX
    G0130ASingle energy x-ray study0.220.86NA0.061.14NAXXX
    G013026ASingle energy x-ray study0.220.070.070.010.300.30XXX
    G0130TCASingle energy x-ray study0.000.79NA0.050.84NAXXX
    G0141AScr c/v cyto,autosys and md0.420.180.180.010.610.61XXX
    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 tx0.073.670.030.013.750.11XXX
    G0167DHyperbaric oz tx;no md reqrd0.000.000.000.000.000.00XXX
    G0168AWound closure by adhesive0.451.960.160.012.420.62000
    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 patient0.671.33NA0.022.02NAXXX
    G0181AHome health care supervision1.721.56NA0.073.35NAXXX
    G0182AHospice care supervision1.721.76NA0.073.55NAXXX
    G0186CDstry eye lesn,fdr vssl tech0.000.000.000.000.000.00YYY
    G0202AScreeningmammographydigital0.702.75NA0.113.56NAXXX
    G020226AScreeningmammographydigital0.700.230.230.040.970.97XXX
    G0202TCAScreeningmammographydigital0.002.52NA0.072.59NAXXX
    G0204ADiagnosticmammographydigital0.872.77NA0.123.76NAXXX
    Start Printed Page 63384
    G020426ADiagnosticmammographydigital0.870.290.290.051.211.21XXX
    G0204TCADiagnosticmammographydigital0.002.48NA0.072.55NAXXX
    G0206ADiagnosticmammographydigital0.702.23NA0.113.04NAXXX
    G020626ADiagnosticmammographydigital0.700.230.230.050.980.98XXX
    G0206TCADiagnosticmammographydigital0.002.00NA0.062.06NAXXX
    G0210CPET img wholebody dxlung0.000.000.000.000.000.00XXX
    G021026APET img wholebody dxlung1.490.520.520.052.062.06XXX
    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 lung1.490.520.520.052.062.06XXX
    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 lung1.490.520.520.052.062.06XXX
    G0212TCCPET img wholebod restag lung0.000.000.000.000.000.00XXX
    G0213CPET img wholbody dx0.000.000.000.000.000.00XXX
    G021326APET img wholbody dx1.490.520.520.052.062.06XXX
    G0213TCCPET img wholbody dx0.000.000.000.000.000.00XXX
    G0214CPET img wholebod init0.000.000.000.000.000.00XXX
    G021426APET img wholebod init1.490.520.520.052.062.06XXX
    G0214TCCPET img wholebod init0.000.000.000.000.000.00XXX
    G0215CPETimg wholebod restag0.000.000.000.000.000.00XXX
    G021526APETimg wholebod restag1.490.530.530.052.072.07XXX
    G0215TCCPETimg wholebod restag0.000.000.000.000.000.00XXX
    G0216CPET img wholebod dx melanoma0.000.000.000.000.000.00XXX
    G021626APET img wholebod dx melanoma1.490.520.520.052.062.06XXX
    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 melan1.490.530.530.052.072.07XXX
    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 mela1.490.530.530.052.072.07XXX
    G0218TCCPET img wholebod restag mela0.000.000.000.000.000.00XXX
    G0219NPET img wholbod melano nonco0.000.000.000.000.000.00XXX
    G021926NPET img wholbod melano nonco0.000.000.000.000.000.00XXX
    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 lymphoma1.490.520.520.052.062.06XXX
    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 lympho1.490.520.520.052.062.06XXX
    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 lymph1.490.530.530.052.072.07XXX
    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 head1.490.520.520.052.062.06XXX
    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 hea1.490.520.520.052.062.06XXX
    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 headneckonly1.490.530.530.052.072.07XXX
    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 esophagl1.490.540.540.052.082.08XXX
    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 esophage1.490.540.540.052.082.08XXX
    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 esopha1.490.520.520.052.062.06XXX
    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 pres1.490.530.530.052.072.07XXX
    G0229TCCPET img metaboloc brain pres0.000.000.000.000.000.00XXX
    G0230CPET myocard viability post0.000.000.000.000.000.00XXX
    G023026APET myocard viability post1.490.550.550.052.092.09XXX
    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 cam1.490.520.520.052.062.06XXX
    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 cam1.490.530.530.052.072.07XXX
    G0232TCCPET whbd lymphoma; gamma cam0.000.000.000.000.000.00XXX
    G0233CPET whbd melanoma; gamma cam0.000.000.000.000.000.00XXX
    Start Printed Page 63385
    G023326APET whbd melanoma; gamma cam1.490.530.530.052.072.07XXX
    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 cam1.490.530.530.052.072.07XXX
    G0234TCCPET WhBD pulm nod; gamma cam0.000.000.000.000.000.00XXX
    G0236FDigital film convert diag ma+0.000.000.000.000.000.00ZZZ
    G023626FDigital film convert diag ma+0.000.000.000.000.000.00ZZZ
    G0236TCFDigital film convert diag ma+0.000.000.000.000.000.00ZZZ
    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
    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 lops0.870.790.320.061.721.25XXX
    G0246RFollowup eval of foot pt lop0.450.560.160.021.030.63XXX
    G0247RRoutine footcare pt w lops0.500.520.210.061.080.77ZZZ
    G0248RDemonstrate use home inr mon0.006.84NA0.016.85NAXXX
    G0249RProvide test material,equipm0.003.97NA0.013.98NAXXX
    G0250RMD review interpret of test0.180.060.060.010.250.25XXX
    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 recur1.860.710.710.082.652.65XXX
    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 tx1.860.710.710.082.652.65XXX
    G0254TCCPET image brst eval to tx0.000.000.000.000.000.00XXX
    G0255NCurrent percep threshold tst0.000.000.000.000.000.00XXX
    G025526NCurrent percep threshold tst0.000.000.000.000.000.00XXX
    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
    G0262DSm intestinal image capsule0.000.000.000.000.000.00XXX
    G026226DSm intestinal image capsule0.000.000.000.000.000.00XXX
    G0262TCDSm intestinal image capsule0.000.000.000.000.000.00XXX
    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 md0.610.640.250.051.300.91000
    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
    G0272DNaso/oro gastric tube pl MD0.000.000.000.000.000.00000
    G0273DPretx planning, non-Hodgkins0.000.000.000.000.000.00XXX
    G027326DPretx planning, non-Hodgkins0.000.000.000.000.000.00XXX
    G0273TCDPretx planning, non-Hodgkins0.000.000.000.000.000.00XXX
    G0274DRadiopharm tx, non-Hodgkins0.000.000.000.000.000.00XXX
    G027426DRadiopharm tx, non-Hodgkins0.000.000.000.000.000.00XXX
    G0274TCDRadiopharm tx, non-Hodgkins0.000.000.000.000.000.00XXX
    G0275ARenal angio, cardiac cath0.25NA0.100.01NA0.36ZZZ
    G0278AIliac art angio,cardiac cath0.25NA0.100.01NA0.36ZZZ
    G0279CExcorp shock tx, elbow epi0.000.000.000.000.000.00XXX
    G0280CExcorp shock tx other than0.000.000.000.000.000.00XXX
    G0281AElec stim unattend for press0.180.11NA0.010.30NAXXX
    G0282NElect stim wound care not pd0.000.000.000.000.000.00XXX
    G0283AElec stim other than wound0.180.11NA0.010.30NAXXX
    G0288ARecon, CTA for surg plan0.0010.53NA0.1810.71NAXXX
    G0289AArthro, loose body + chondro1.47NA0.570.32NA2.36ZZZ
    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
    G0296CPET imge restag thyrod cance0.000.000.000.000.000.00XXX
    G029626APET imge restag thyrod cance1.860.710.710.082.652.65XXX
    Start Printed Page 63386
    G0296TCCPET imge restag thyrod cance0.000.000.000.000.000.00XXX
    G0297XInsert single chamber/cd0.000.000.000.000.000.00XXX
    G0298XInsert dual chamber/cd0.000.000.000.000.000.00XXX
    G0299XInser/repos single icd+leads0.000.000.000.000.000.00XXX
    G0300XInsert reposit lead dual+gen0.000.000.000.000.000.00XXX
    G0302XPre-op service LVRS complete0.000.000.000.000.000.00XXX
    G0303XPre-op service LVRS 10-15dos0.000.000.000.000.000.00XXX
    G0304XPre-op service LVRS 1-9 dos0.000.000.000.000.000.00XXX
    G0305XPost op service LVRS min 60.000.000.000.000.000.00XXX
    G0306XCBC/diffwbc w/o platelet0.000.000.000.000.000.00XXX
    G0307XCBC without platelet0.000.000.000.000.000.00XXX
    G0308AESRD related svc 4+mo<2yrs12.698.588.580.4221.6921.69XXX
    G0309AESRD related svc 2-3mo<2yrs10.577.137.130.3618.0618.06XXX
    G0310AESRD related svc 1 visit<2yr8.455.725.720.2814.4514.45XXX
    G0311AESRD related svs 4+mo 2-11yr9.684.744.740.3414.7614.76XXX
    G0312AESRD relate svs 2-3 mo 2-11y8.073.943.940.2912.3012.30XXX
    G0313AESRD related svs 1 mon 2-11y6.463.163.160.229.849.84XXX
    G0314AESRD related svs 4+ mo 12-198.244.454.450.2612.9512.95XXX
    G0315AESRD related svs 2-3mo 12-196.873.693.690.2310.7910.79XXX
    G0316AESRD relate svs 1 vist 12-195.502.962.960.178.638.63XXX
    G0317AESRD related svs 4+mo 20+yrs5.072.882.880.178.128.12XXX
    G0318AESRD related svs 2-3 mo 20+y4.232.392.390.146.766.76XXX
    G0319AESRD related svs 1 visit 20+3.381.921.920.115.415.41XXX
    G0320AESRD related svs home under210.577.137.130.3618.0618.06XXX
    G0321AESRD related svs home mo<2ys6.873.693.690.2310.7910.79XXX
    G0322AESRD relate svs home mo12-198.073.943.940.2912.3012.30XXX
    G0323AESRD related svs home mo 20+4.232.392.390.146.766.76XXX
    G0324AESRD related svs home/dy<2y0.350.240.240.010.600.60XXX
    G0325AESRD relate home/dy 2-11 yr0.230.120.120.010.360.36XXX
    G0326AESRD relate home/dy 12-19y0.270.130.130.010.410.41XXX
    G0327AESRD relate home/dy 20+yrs0.140.080.080.010.230.23XXX
    G3001XAdmin + supply, tositumomab0.000.000.000.000.000.00XXX
    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
    M0064AVisit for drug monitoring0.370.350.120.010.730.50XXX
    P3001AScreening pap smear by phys0.420.180.180.010.610.61XXX
    Q0035ACardiokymography0.170.46NA0.030.66NAXXX
    Q003526ACardiokymography0.170.070.070.010.250.25XXX
    Q0035TCACardiokymography0.000.39NA0.020.41NAXXX
    Q0091AObtaining screen pap smear0.370.670.140.011.050.52XXX
    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
    1 CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 2003 American Dental Association. All rights reserved.
    3 +Indicates RVUs are not used for Medicare payment.
            Start Printed Page 63386

    —————————— 1 CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 2003 American Dental Association. All rights reserved. 3 +Indicates RVUs are not used for Medicare payment. Start Printed Page 63386

    Addendum C.—Codes With Interim RVUs

    CPT 1/HCPCS 2MODStatusDescriptionPhysician work RVUs3Non-facility PE RVUsFacility PE RVUsMalpractice RVUsNon-facility totalFacility totalGlobal
    11400AExc tr-ext b9+marg 0.5 < cm0.852.040.900.072.961.82010
    11401AExc tr-ext b9+marg 0.6-1 cm1.222.101.040.113.432.37010
    11402AExc tr-ext b9+marg 1.1-2 cm1.502.271.100.143.912.74010
    11403AExc tr-ext b9+marg 2.1-3 cm1.782.451.350.194.423.32010
    11404AExc tr-ext b9+marg 3.1-4 cm2.052.771.430.225.043.70010
    11406AExc tr-ext b9+marg > 4.0 cm2.743.141.690.306.184.73010
    Start Printed Page 63387
    11420AExc h-f-nk-sp b9+marg 0.5 <0.971.800.940.102.872.01010
    11421AExc h-f-nk-sp b9+marg 0.6-11.412.101.130.133.642.67010
    11422AExc h-f-nk-sp b9+marg 1.1-21.622.301.360.174.093.15010
    11423AExc h-f-nk-sp b9+marg 2.1-32.002.641.480.204.843.68010
    11424AExc h-f-nk-sp b9+marg 3.1-42.422.861.630.255.534.30010
    11426AExc h-f-nk-sp b9+marg > 4 cm3.763.572.130.417.746.30010
    11440AExc face-mm b9+marg 0.5 < cm1.052.311.350.103.462.50010
    11441AExc face-mm b9+marg 0.6-1 cm1.472.421.530.134.023.13010
    11442AExc face-mm b9+marg 1.1-2 cm1.712.621.600.174.503.48010
    11443AExc face-mm b9+marg 2.1-3 cm2.283.011.850.225.514.35010
    11444AExc face-mm b9+marg 3.1-4 cm3.123.582.210.307.005.63010
    11446AExc face-mm b9+marg > 4 cm4.464.162.820.368.987.64010
    11600AExc tr-ext mlg+marg 0.5 < cm1.302.700.990.114.112.40010
    11601AExc tr-ext mlg+marg 0.6-1 cm1.792.761.240.144.693.17010
    11602AExc tr-ext mlg+marg 1.1-2 cm1.942.901.290.165.003.39010
    11603AExc tr-ext mlg+marg 2.1-3 cm2.183.151.350.195.523.72010
    11604AExc tr-ext mlg+marg 3.1-4 cm2.393.461.420.226.074.03010
    11606AExc tr-ext mlg+marg > 4 cm3.414.161.770.347.915.52010
    11620AExc h-f-nk-sp mlg+marg 0.5 <1.182.660.970.113.952.26010
    11621AExc h-f-nk-sp mlg+marg 0.6-11.752.771.260.144.663.15010
    11622AExc h-f-nk-sp mlg+marg 1.1-22.083.041.410.185.303.67010
    11623AExc h-f-nk-sp mlg+marg 2.1-32.603.411.610.246.254.45010
    11624AExc h-f-nk-sp mlg+marg 3.1-43.043.831.800.307.175.14010
    11626AExc h-f-nk-sp mlg+mar > 4 cm4.284.742.430.429.447.13010
    11640AExc face-mm malig+marg 0.5 <1.342.731.130.124.192.59010
    11641AExc face-mm malig+marg 0.6-12.153.101.550.185.433.88010
    11642AExc face-mm malig+marg 1.1-22.583.481.750.226.284.55010
    11643AExc face-mm malig+marg 2.1-33.083.891.980.297.265.35010
    11644AExc face-mm malig+marg 3.1-44.014.792.490.409.206.90010
    11646AExc face-mm mlg+marg > 4 cm5.925.873.530.5512.3410.00010
    20982AAblate, bone tumor(s) perq7.24106.253.020.68114.1710.94000
    21030AExcise max/zygoma b9 tumor3.876.574.050.7211.168.64090
    21040AExcise mandible lesion3.876.613.880.2310.717.98090
    21685AHyoid myotomy & suspension12.93NA10.211.51NA24.65090
    21742CRepair stern/nuss w/o scope0.000.000.000.000.000.00090
    21743CRepair sternum/nuss w/scope0.000.000.000.000.000.00090
    22532ALat thorax spine fusion23.86NA14.924.53NA43.31090
    22533ALat lumbar spine fusion22.99NA13.603.81NA40.40090
    22534ALat thor/lumb, addl seg5.97NA3.081.17NA10.22ZZZ
    31622ADx bronchoscope/wash2.764.200.890.177.133.82000
    31623ADx bronchoscope/brush2.865.090.900.178.123.93000
    31624ADx bronchoscope/lavage2.864.320.900.167.343.92000
    31625ABronchoscopy w/biopsy(s)3.355.411.270.198.954.81000
    31628ABronchoscopy/lung bx, each3.795.621.360.179.585.32000
    31629ABronchoscopy/needle bx, each3.35NA1.240.16NA4.75000
    31630ABronchoscopy dilate/fx repr3.80NA1.980.36NA6.14000
    31631ABronchoscopy, dilate w/stent4.35NA2.010.37NA6.73000
    31632ABronchoscopy/lung bx, addl1.020.760.320.171.951.51ZZZ
    31633ABronchoscopy/needle bx addl1.310.920.410.172.401.89ZZZ
    31635ABronchoscopy w/fb removal3.66NA1.680.25NA5.59000
    31640ABronchoscopy w/tumor excise4.91NA2.330.44NA7.68000
    33310AExploratory heart surgery18.40NA9.272.71NA30.38090
    33315AExploratory heart surgery22.24NA10.533.48NA36.25090
    34805AEndovasc abdo repair w/pros21.76NA9.511.98NA33.25090
    35510AArtery bypass graft22.87NA10.222.09NA35.18090
    35512AArtery bypass graft22.37NA10.052.09NA34.51090
    35522AArtery bypass graft21.64NA9.792.09NA33.52090
    35525AArtery bypass graft20.51NA9.412.09NA32.01090
    35697AReimplant artery each2.98NA1.030.41NA4.42ZZZ
    36511AApheresis wbc1.73NA0.690.07NA2.49000
    36512AApheresis rbc1.73NA0.690.07NA2.49000
    36513AApheresis platelets1.73NA0.690.07NA2.49000
    36514AApheresis plasma1.73NA0.690.07NA2.49000
    36515AApheresis, adsorp/reinfuse1.73NA0.730.07NA2.53000
    36516AApheresis, selective1.73NA0.730.07NA2.53000
    36555AInsert non-tunnel cv cath2.666.060.820.208.923.68000
    36556AInsert non-tunnel cv cath2.495.060.750.107.653.34000
    36557AInsert tunneled cv cath5.0713.642.590.5919.308.25010
    36558AInsert tunneled cv cath4.7713.542.480.5918.907.84010
    36560AInsert tunneled cv cath6.2129.382.980.5936.189.78010
    36561AInsert tunneled cv cath5.9729.292.890.5935.859.45010
    36563AInsert tunneled cv cath6.1626.752.990.6733.589.82010
    36565AInsert tunneled cv cath5.9722.302.890.5928.869.45010
    36566AInsert tunneled cv cath6.4623.113.060.5930.1610.11010
    36568AInsert tunneled cv cath1.918.290.600.2010.402.71000
    Start Printed Page 63388
    36569AInsert tunneled cv cath1.816.770.580.168.742.55000
    36570AInsert tunneled cv cath5.2940.532.660.5946.418.54010
    36571AInsert tunneled cv cath5.2735.862.650.5941.728.51010
    36575ARepair tunneled cv cath0.673.350.260.594.611.52000
    36576ARepair tunneled cv cath3.177.731.770.5911.495.53010
    36578AReplace tunneled cv cath3.4810.572.210.5914.646.28010
    36580AReplace tunneled cv cath1.305.880.420.167.341.88000
    36581AReplace tunneled cv cath3.4213.301.850.5917.315.86010
    36582AReplace tunneled cv cath5.1726.692.780.5932.458.54010
    36583AReplace tunneled cv cath5.2213.172.800.5918.988.61010
    36584AReplace tunneled cv cath1.196.330.560.167.681.91000
    36585AReplace tunneled cv cath4.7735.522.650.5940.888.01010
    36589ARemoval tunneled cv cath2.262.131.420.254.643.93010
    36590ARemoval tunneled cv cath3.286.341.640.4110.035.33010
    36595AMech remov tunneled cv cath3.5818.941.470.2822.805.33000
    36596AMech remov tunneled cv cath0.754.430.500.055.231.30000
    36597AReposition venous catheter1.203.180.440.074.451.71000
    36838ADist revas ligation, hemo20.51NA9.412.97NA32.89090
    37765APhleb veins—extrem—to 207.31NA4.560.48NA12.35090
    37766APhleb veins—extrem 20+9.25NA5.280.48NA15.01090
    37785ALigate/divide/excise vein3.825.162.660.499.476.97090
    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
    43235AUppr gi endoscopy, diagnosis2.385.121.080.167.663.62000
    43237AEndoscopic us exam, esoph3.97NA1.630.26NA5.86000
    43238AUppr gi endoscopy w/us fn bx5.00NA1.990.26NA7.25000
    43242AUppr gi endoscopy w/us fn bx7.27NA2.820.35NA10.44000
    43259AEndoscopic ultrasound exam5.17NA2.060.26NA7.49000
    43752ANasal/orogastric w/stent0.680.260.260.020.960.96000
    47133XRemoval of donor liver0.000.000.000.000.000.00XXX
    47140APartial removal, donor liver54.69NA22.984.77NA82.44090
    47141APartial removal, donor liver67.12NA27.704.77NA99.59090
    47142APartial removal, donor liver74.57NA30.294.77NA109.63090
    53500AUrethrlys, transvag w/ scope12.14NA6.270.89NA19.30090
    57425ALaparoscopy, surg, colpopexy15.66NA6.761.73NA24.15090
    58545ALaparoscopic myomectomy14.52NA7.311.74NA23.57090
    58546ALaparo-myomectomy, complex18.89NA9.121.74NA29.75090
    58550ALaparo-asst vag hysterectomy14.11NA7.441.73NA23.28090
    58552ALaparo-vag hyst incl t/o14.11NA7.421.73NA23.26090
    58553ALaparo-vag hyst, complex18.89NA9.081.47NA29.44090
    58554ALaparo-vag hyst w/t/o, compl18.89NA9.381.47NA29.74090
    59070ATransabdom amnioinfus w/ us5.225.192.430.2810.697.93000
    59072AUmbilical cord occlud w/ us8.95NA3.170.67NA12.79000
    59074AFetal fluid drainage w/ us5.224.662.430.2810.167.93000
    59076AFetal shunt placement, w/ us8.95NA3.170.67NA12.79000
    59897CFetal invas px w/ us0.000.000.000.000.000.00YYY
    61537ARemoval of brain tissue24.86NA14.636.45NA45.94090
    61538ARemoval of brain tissue26.66NA15.586.45NA48.69090
    61539ARemoval of brain tissue31.90NA18.077.93NA57.90090
    61540ARemoval of brain tissue29.83NA17.697.93NA55.45090
    61543ARemoval of brain tissue29.05NA16.657.32NA53.02090
    61566ARemoval of brain tissue30.82NA17.626.45NA54.89090
    61567AIncision of brain tissue35.30NA20.986.45NA62.73090
    61863AImplant neuroelectrode13.84NA9.344.76NA27.94090
    61864AImplant neuroelectrde, addl4.47NA2.311.13NA7.91ZZZ
    61867AImplant neuroelectrode22.83NA13.984.76NA41.57090
    61868AImplant neuroelectrde, addl7.87NA4.071.20NA13.14ZZZ
    63101ARemoval of vertebral body31.82NA19.575.66NA57.05090
    63102ARemoval of vertebral body31.82NA19.575.66NA57.05090
    63103ARemove vertebral body add-on3.88NA2.030.76NA6.67ZZZ
    64449AN block inj, lumbar plexus2.98NA0.980.10NA4.06010
    64517AN block inj, hypogas plxs2.192.760.890.135.083.21000
    64680AInjection treatment of nerve2.616.081.310.188.874.10010
    64681AInjection treatment of nerve3.538.812.130.1812.525.84010
    65780AOcular reconst, transplant10.19NA10.040.35NA20.58090
    65781AOcular reconst, transplant17.57NA13.450.35NA31.37090
    65782AOcular reconst, transplant14.91NA11.790.35NA27.05090
    67912ACorrection eyelid w/ implant5.6520.595.330.2826.5211.26090
    Start Printed Page 63389
    68371AHarvest eye tissue, alograft4.87NA4.660.20NA9.73010
    7055726AMri brain w/o dye2.880.990.990.083.953.95XXX
    7055826AMri brain w/ dye3.181.091.090.104.374.37XXX
    7055926AMri brain w/o & w/ dye3.181.091.090.124.394.39XXX
    7590126ARemove cva device obstruct0.490.160.160.020.670.67XXX
    7590226ARemove cva lumen obstruct0.390.130.130.020.540.54XXX
    7599826AFluoroguide for vein device0.380.130.130.050.560.56ZZZ
    7608226AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    7608326AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    7651426AEcho exam of eye, thickness0.170.080.080.010.260.26XXX
    7693726AUs guide, vascular access0.300.100.100.050.450.45ZZZ
    7880026ATumor imaging, limited area0.660.220.220.040.920.92XXX
    7880126ATumor imaging, mult areas0.790.270.270.041.101.10XXX
    7880226ATumor imaging, whole body0.860.300.300.041.201.20XXX
    7880326ATumor imaging (3D)1.080.390.390.051.521.52XXX
    7880426ATumor imaging, whole body1.060.380.380.041.481.48XXX
    7910026AHematopoetic nuclear therapy1.310.470.470.061.841.84XXX
    7940026ANonhemato nuclear therapy1.950.670.670.102.722.72XXX
    7940326AHematopoetic nuclear therapy2.240.910.910.103.253.25XXX
    85396AClotting assay, whole blood0.37NA0.170.04NA0.58XXX
    8811226ACytopath, cell enhance tech1.170.530.530.061.761.76XXX
    8834226AImmunohistochemistry0.850.380.380.041.271.27XXX
    8835826AAnalysis, tumor2.801.241.240.124.164.16XXX
    8836126AImmunohistochemistry, tumor0.930.420.420.121.471.47XXX
    9111026AGi tract capsule endoscopy3.631.311.310.024.964.96XXX
    93784AAmbulatory BP monitoring0.170.970.970.021.161.16XXX
    93786AAmbulatory BP recording0.000.90NA0.010.91NAXXX
    93788AAmbulatory BP analysis0.000.51NA0.010.52NAXXX
    93790AReview/report BP recording0.170.060.060.010.240.24XXX
    95990ASpin/brain pump refil & main0.001.49NA0.061.55NAXXX
    95991ASpin/brain pump refil & main0.771.490.190.062.321.02XXX
    96110ADevelopmental test, lim0.000.18NA0.180.36NAXXX
    96111ADevelopmental test, extend2.591.07NA0.183.84NAXXX
    97537ACommunity/work reintegration0.450.27NA0.010.73NAXXX
    97755AAssistive technology assess0.620.29NA0.020.93NAXXX
    G0308AESRD related svc 4+mo<2yrs12.698.588.580.4221.6921.69XXX
    G0309AESRD related svc 2-3mo<2yrs10.577.137.130.3618.0618.06XXX
    G0310AESRD related svc 1 visit<2yr8.455.725.720.2814.4514.45XXX
    G0311AESRD related svs 4+mo 2-11yr9.684.744.740.3414.7614.76XXX
    G0312AESRD relate svs 2-3 mo 2-11y8.073.943.940.2912.3012.30XXX
    G0313AESRD related svs 1 mon 2-11y6.463.163.160.229.849.84XXX
    G0314AESRD related svs 4+ mo 12-198.244.454.450.2612.9512.95XXX
    G0315AESRD related svs 2-3mo 12-196.873.693.690.2310.7910.79XXX
    G0316AESRD relate svs 1 vist 12-195.502.962.960.178.638.63XXX
    G0317AESRD related svs 4+mo 20+yrs5.072.882.880.178.128.12XXX
    G0318AESRD related svs 2-3 mo 20+y4.232.392.390.146.766.76XXX
    G0319AESRD related svs 1 visit 20+3.381.921.920.115.415.41XXX
    G0320AESRD related svs home under210.577.137.130.3618.0618.06XXX
    G0321AESRD related svs home mo<2ys6.873.693.690.2310.7910.79XXX
    G0322AESRD relate svs home mo12-198.073.943.940.2912.3012.30XXX
    G0323AESRD related svs home mo 20+4.232.392.390.146.766.76XXX
    G0324AESRD related svs home/dy<2y0.350.240.240.010.600.60XXX
    G0325AESRD relate home/dy 2-11 yr0.230.120.120.010.360.36XXX
    G0326AESRD relate home/dy 12-19y0.270.130.130.010.410.41XXX
    G0327AESRD relate home/dy 20+yrs0.140.080.080.010.230.23XXX
    1 CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 2003 American Dental Association. All rights reserved.
    3 +Indicates RVUs are not used for Medicare payment.
            Start Printed Page 63389

    —————————— Payment locality serviced by two carriers. Note: Only malpractice GPCI has been updated. The work and practice expense GPCIs will be updated as part of a mid-year, 2004 regulation. Malpractice GPCI scaled by 1.0021 to retain budget neutrality. Start Printed Page 63389

    Addendum D.—2004 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Carrier No.Locality No.Locality nameWorkPractice expenseMalpractice
    0051000Alabama0.9780.8700.779
    0083101Alaska1.0641.1721.126
    0083200Arizona0.9940.9781.090
    0052013Arkansas0.9530.8470.389
    3114626Anaheim/Santa Ana, CA1.0371.1840.955
    3114618Los Angeles, CA1.0561.1390.955
    3114003Marin/Napa/Solano, CA1.0151.2480.669
    3114007Oakland/Berkeley, CA1.0411.2350.669
    Start Printed Page 63390
    3114005San Francisco, CA1.0681.4580.669
    3114006San Mateo, CA1.0481.432.663
    3114009Santa Clara, CA1.0631.3800.622
    3114617Ventura, CA1.0281.1250.763
    3114699Rest of California*1.0071.0340.740
    3114099Rest of California*1.0071.0340.740
    0082401Colorado0.9850.9920.821
    0059100Connecticut1.0501.1560.933
    0090201Delaware1.0191.0350.802
    0090301DC + MD/VA Suburbs1.0501.1660.917
    0059003Fort Lauderdale, FL0.9961.0181.790
    0059004Miami, FL1.0151.0522.399
    0059099Rest of Florida0.9750.9461.268
    0051101Atlanta, GA1.0061.0590.951
    0051199Rest of Georgia0.9700.8920.951
    0083301Hawaii/Guam0.9971.1240.817
    0513000Idaho0.9600.8810.478
    0095216Chicago, IL1.0281.0921.832
    0095212East St. Louis, IL0.9880.9241.720
    0095215Suburban Chicago, IL1.0061.0711.648
    0095299Rest of Illinois0.9640.8891.175
    0063000Indiana0.9810.9220.459
    0082600Iowa0.9590.8760.593
    0065000Kansas*0.9630.8950.738
    0074004Kansas*0.9630.8950.738
    0066000Kentucky0.9700.8660.875
    0052801New Orleans, LA0.9980.9451.240
    0052899Rest of Louisiana0.9680.8701.066
    3114203Southern Maine0.9790.9990.652
    3114299Rest of Maine0.9610.9100.652
    0090101Baltimore/Surr. Cntys, MD1.0211.0380.931
    0090199Rest of Maryland0.9840.9720.767
    3114301Metropolitan Boston1.0411.2390.803
    3114399Rest of Massachusetts1.0101.1290.803
    0095301Detroit, MI1.0431.0382.741
    0095399Rest of Michigan0.9970.9381.545
    0095400Minnesota0.9900.9740.431
    0051200Mississippi0.9570.8370.750
    0074002Metropolitan Kansas City, MO0.9880.9670.896
    0052301Metropolitan St. Louis, MO0.9940.9380.893
    0074099Rest of Missouri*0.9460.8250.842
    0052399Rest of Missouri*0.9460.8250.842
    0075101Montana0.9500.8760.815
    0065500Nebraska0.9480.8770.442
    0083400Nevada1.0051.0391.138
    3114440New Hampshire0.9861.0300.883
    0080501Northern NJ1.0581.1930.916
    0080599Rest of New Jersey1.0291.1100.916
    0052105New Mexico0.9730.9000.898
    0080301Manhattan, NY1.0941.3511.586
    0080302Nyc Suburbs/Long I., NY1.0681.2511.869
    0080303Poughkpsie/N Nyc Suburbs, NY1.0111.0751.221
    1433004Queens, NY1.0581.2281.791
    0080199Rest of New York0.9980.9440.720
    0553500North Carolina0.9700.9310.618
    0082001North Dakota0.9500.8800.630
    0088300Ohio0.9880.9440.967
    0052200Oklahoma0.9680.8760.413
    0083501Portland, OR0.9961.0490.438
    0083599Rest of Oregon0.9610.9330.438
    0086501Metropolitan Philadelphia, PA1.0231.0921.400
    0086599Rest of Pennsylvania0.9890.9290.790
    0097320Puerto Rico0.8810.7120.268
    0087001Rhode Island1.0171.0650.896
    0088001South Carolina0.9740.9040.336
    0082002South Dakota0.9350.8780.385
    0544035Tennessee0.9750.9000.612
    Start Printed Page 63391
    0090031Austin, TX0.9860.9960.922
    0090020Beaumont, TX0.9920.8901.318
    0090009Brazoria, TX0.9920.9781.318
    0090011Dallas, TX1.0101.0650.996
    0090028Fort Worth, TX0.9870.9810.996
    0090015Galveston, TX0.9880.9691.318
    0090018Houston, TX1.0201.0071.316
    0090099Rest of Texas0.9660.8801.047
    0091009Utah0.9760.9410.653
    3114550Vermont0.9730.9860.527
    0097350Virgin Islands0.9651.0231.003
    0090400Virginia0.9840.9380.540
    0083602Seattle (King Cnty), WA1.0051.1000.803
    0083699Rest of Washington0.9810.9720.803
    0088416West Virginia0.9630.8501.462
    0095100Wisconsin0.9810.9290.865
    0082521Wyoming0.9670.8950.970
    Payment locality serviced by two carriers.
    Note: Only malpractice GPCI has been updated. The work and practice expense GPCIs will be updated as part of a mid-year, 2004 regulation. Malpractice GPCI scaled by 1.0021 to retain budget neutrality.
          Start Printed Page 63391

    —————————— Payment locality serviced by two carriers. Note: Only malpractice GPCI has been updated. The work and practice expense GPCIs will be updated as part of a mid-year, 2004 regulation. Malpractice GPCI scaled by 1.0021 to retain budget neutrality. Start Printed Page 63391

    Addendum E.—2005 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Carrier No.Locality No.Locality nameWorkPractice expenseMalpractice
    0051000Alabama0.9780.8700.752
    0083101Alaska1.0641.1721.029
    0083200Arizona0.9940.9781.069
    0052013Arkansas0.9530.8470.438
    3114626Anaheim/Santa Ana, CA1.0371.1840.954
    3114618Los Angeles, CA1.0561.1390.954
    3114003Marin/Napa/Solano, CA1.0151.2480.651
    3114007Oakland/Berkeley, CA1.0411.2350.651
    3114005San Francisco, CA1.0681.4580.651
    3114006San Mateo, CA1.0481.4320.639
    3114009Santa Clara, CA1.0631.3800.604
    3114617Ventura, CA1.0281.1250.744
    3114699Rest of California*1.0071.0340.733
    3114099Rest of California*1.0071.0340.733
    0082401Colorado0.9850.9920.803
    0059100Connecticut1.0501.1560.900
    0090201Delaware1.0191.0350.892
    0090301DC + MD/VA Suburbs1.0501.1660.926
    0059003Fort Lauderdale, FL0.9961.0181.703
    0059004Miami, FL1.0151.0522.269
    0059099Rest of Florida0.9750.9461.272
    0051101Atlanta, GA1.0061.0590.966
    0051199Rest of Georgia0.9700.8920.966
    0083301Hawaii/Guam0.9971.1240.800
    0513000Idaho0.9600.8810.459
    0095216Chicago, IL1.0281.0921.867
    0095212East St. Louis, IL0.9880.9241.750
    0095215Suburban Chicago, IL1.0061.0711.652
    0095299Rest of Illinois0.9640.8891.193
    0063000Indiana0.9810.9220.436
    0082600Iowa0.9590.8760.589
    0065000Kansas*0.9630.8950.721
    0074004Kansas*0.9630.8950.721
    0066000Kentucky0.9700.8660.873
    0052801New Orleans, LA0.9980.9451.197
    0052899Rest of Louisiana0.9680.8701.058
    3114203Southern Maine0.9790.9990.637
    3114299Rest of Maine0.9610.9100.637
    0090101Baltimore/Surr. Cntys, MD1.0211.0380.947
    0090199Rest of Maryland0.9840.9720.760
    3114301Metropolitan Boston1.0411.2390.823
    Start Printed Page 63392
    3114399Rest of Massachusetts1.0101.1290.823
    0095301Detroit, MI1.0431.0382.744
    0095399Rest of Michigan0.9970.9381.518
    0095400Minnesota0.9900.9740.410
    0051200Mississippi0.9570.8370.722
    0074002Metropolitan Kansas City, MO0.9880.9670.946
    0052301Metropolitan St. Louis, MO0.9940.9380.941
    0074099Rest of Missouri*0.9460.8250.892
    0052399Rest of Missouri*0.9460.8250.892
    0075101Montana0.9500.8760.904
    0065500Nebraska0.9480.8770.454
    0083400Nevada1.0051.0391.068
    3114440New Hampshire0.9861.0300.942
    0080501Northern NJ1.0581.1930.973
    0080599Rest of New Jersey1.0291.1100.973
    0052105New Mexico0.9730.9000.895
    0080301Manhattan, NY1.0941.3511.504
    0080302Nyc Suburbs/Long I., NY1.0681.2511.785
    0080303Poughkpsie/N Nyc Suburbs, NY1.0111.0751.167
    1433004Queens, NY1.0581.2281.710
    0080199Rest of New York0.9980.9440.677
    0553500North Carolina0.9700.9310.640
    0082001North Dakota0.9500.8800.602
    0088300Ohio0.9880.9440.976
    0052200Oklahoma0.9680.8760.382
    0083501Portland, OR0.9961.0490.441
    0083599Rest of Oregon0.9610.9330.441
    0086501Metropolitan Philadelphia, PA1.0231.0921.386
    0086599Rest of Pennsylvania0.9890.9290.806
    0097320Puerto Rico0.8810.7120.261
    0087001Rhode Island1.0171.0650.909
    0088001South Carolina0.9740.9040.394
    0082002South Dakota0.9350.8780.365
    0544035Tennessee0.9750.9000.631
    0090031Austin, TX0.9860.9960.986
    0090020Beaumont, TX0.9920.8901.298
    0090009Brazoria, TX0.9920.9781.298
    0090011Dallas, TX1.0101.0651.061
    0090028Fort Worth, TX0.9870.9811.061
    0090015Galveston, TX0.9880.9691.298
    0090018Houston, TX1.0201.0071.297
    0090099Rest of Texas0.9660.8801.138
    0091009Utah0.9760.9410.662
    3114550Vermont0.9730.9860.514
    0097350Virgin Islands0.9651.0231.003
    0090400Virginia0.9840.9380.579
    0083602Seattle (King Cnty), WA1.0051.1000.819
    0083699Rest of Washington0.9810.9720.819
    0088416West Virginia0.9630.8501.547
    0095100Wisconsin0.9810.9290.790
    0082521Wyoming0.9670.8950.935
    Payment locality serviced by two carriers.
    Note: Only malpractice GPCI has been updated. The work and practice expense GPCIs will be updated as part of a mid-year, 2004 regulation. Malpractice GPCI scaled by 1.0021 to retain budget neutrality.
          Start Printed Page 63392

    Addendum F.—Updated List of CPT 1/HCPCS Codes Used to Describe Certain Designated Health Services Under the Physician Self-Referral Provisions (Section 1877 of the Social Security Act)

    CLINICAL LABORATORY SERVICES
    INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services:
    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
    Start Printed Page 63393
    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 agnt w/cpas
    0043TCo expired gas analysis
    0058TCryopreservation, ovary tiss
    0059TCryopreservation, oocyte
    G0001Drawing blood for specimen
    G0027Semen analysis
    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
    G0306CBC/diffwbc w/o platelet
    G0307CBC without platelet
    P2028Cephalin floculation test
    P2029Congo red blood test
    P2033Blood thymol turbidity
    P2038Blood mucoprotein
    P3000Screen pap by tech w md supv
    P3001Screening pap smear by phys
    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 SERVICES
    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
    97755Assistive technology assess
    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
    92597Oral speech device eval
    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-
    0029TMagnetic tx for incontinence
    INCLUDE HCPCS level 2 codes for the following physical therapy/occupational therapy/speech-language pathology services:
    G0279Excorp shock tx, elbow epi
    G0280Excorp shock tx other than
    G0281Elec stim unattend for press
    G0283Elec stim other than wound
    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-
    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
    Start Printed Page 63394
    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
    72198Mr angio 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 orw/o dye
    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
    76082Computer mammogram add-on
    76083Computer 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
    76370Ct 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
    76514Echo exam of eye, thickness
    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 exam abdo back wall, lim
    76778Us exam kidney transplant
    76800Us exam, spinal canal
    76801Ob us < 14 wks, single fetus-
    76802Ob us < 14 wks, add'l 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
    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 93303-93308]
    93321Doppler echo exam, heart [if used in conjunction with 93303-93308]
    93325Doppler color flow add-on [if used in conjunction with 93303-93308]
    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
    Start Printed Page 63395
    93980Penile vascular study
    93981Penile vascular study
    93990Doppler flow testing
    INCLUDE the following CPT and HCPCS level 2 codes:
    51798Us urine capacity measure
    91110Gi tract capsule endoscopy
    0028TDexa body composition study
    0042TCt perfusion w/contrast, cbf
    G0202Screeningmammographydigital
    G0204Diagnosticmammographydigital
    G0206Diagnosticmammographydigital
    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
    G0173Stereo radiosurgery,complete
    G0242Multisource photon ster plan-
    G0243Multisour photon stero treat
    G0251Linear acc based stero radio
    G0256Prostate brachy w palladium
    G0261Prostate brachytherapy w/rad
    G0338Linear accelerator stero pln
    G0339Robot lin-radsurg com, first
    G0340Robt lin-radsurg fractx 2-5
    DRUGS USED BY PATIENTS UNDERGOING DIALYSIS
    The physician self-referral prohibition does not apply to the following 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
    Q4054Darbepoetin alfa, esrd use
    Q4055Epoetin alfa, esrd use
    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):
    76083Computer mammogram add-on
    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):
    90655Flu vaccine, 6-35 mo, im
    90657Flu vaccine, 6-35 mo, im
    90658Flu vaccine, 3 yrs, im
    90732Pneumococcal vaccine
    90740Hepb vacc, ill pat dose im
    90743Hep b vacc, adol, 2 dose im
    90744Hepb vacc ped/adol 3 dose im
    90746Hepb vaccine, adult, im
    90747Hepb vacc, ill pat 4 dose im
    1 CPT codes and descriptions only are copyright 2003 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.
    End Supplemental Information

    [FR Doc. 03-27639 Filed 10-30-03; 3:43 pm]

    BILLING CODE 4120-01-P

Document Information

Published:
11/07/2003
Department:
Centers for Medicare & Medicaid Services
Entry Type:
Rule
Action:
Final rule with comment period.
Document Number:
03-27639
Pages:
63195-63395 (201 pages)
Docket Numbers:
CMS-1476-FC
RINs:
0938-AL96: Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2004 (CMS-1476-P)
RIN Links:
https://www.federalregister.gov/regulations/0938-AL96/revisions-to-payment-policies-under-the-physician-fee-schedule-for-calendar-year-2004-cms-1476-p-
Topics:
Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays
PDF File:
03-27639.pdf
CFR: (5)
42 CFR 410.130
42 CFR 410.140
42 CFR 410.141
42 CFR 414.22
42 CFR 414.46