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 InfoFOR 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 InformationSUPPLEMENTARY 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 description 2003 PE unit 2003 PE price Primary specialties Prior status of supply item Commenter response CMS action taken Acetylcholine 10% 1 gram $0.40 Nurse practitioner, neurology See Note C. Need patient-use item, not R&D item None See Note D. Aerochamber 1 item Cardiology, internal medicine Item may be deleted. May not be typical and may be separately billable Agree—reusable. Requests item be retained Disagree—Deleted. Albuterol 1 ampule Family practice, internal medicine See Note B Agree—separately billable Deleted Anthralin ointment 1 g 2.75 Dermatology See Note C None See Note D. Aphasia assessment—forms average 1 item 0.95 Psychiatry, neurology See Note C Pricing information submitted at $2.84 Retained at submitted price. Balloon, achalasia 1 item 255.00 General surgery, colon and rectal surgery See Note C. (Codes utilizing this item being reviewed by CPT) NA in non-facility Deleted. Blood dress package 1 item Neurosurgery Item may be deleted. Gowning items listed separately None Deleted. Broach kit 1 item Podiatry, orthopaedic surgery See Note A Agree—separately billable and reusable Deleted. Cable for EMG needle electrode 1 item 1.20 Neurology, PM&R See Note A None Deleted. Centimeter ruler 1 each 2.39 Radiation oncology, dermatology See Note A None Deleted. Cephalosporin 1 gm Podiatry, orthopedic surgery See Note B Agree—separately billable Deleted Chordae Villae sampling kit 1 item Obstetrics, gynecology Item may be deleted. Duplicated item with catheter-stylet kit None Deleted. Collagen kit 1 each 1383.00 Urology Need kit contents. Collagen sold as individual syringe. No commercial kit available NA in non-facility Deleted. Communication book/Treatment notebooks 1 each Otolaryngology, audiology See Note C Audiology priced at $1.50 or $3.50. ENT proposed to delete Deleted—reusable. Cottonoids 1 item Otolaryngology See Note C Submitted price of $0.875 Retained at $0.73. CPAP nasal pillow 1 each Pulmonary medicine Item may be deleted. Disposable CPAP face mask also included in code 95811. Nasal pillows used with reusable mask Agree—not typical Deleted. Cysto-catheter kit 1 item 9.04 Urology, general practice Need kit contents and source/pricing information None Deleted. Detection kit 1 slide 8.50 Pathology, neurology See Note C None See Note D. Developmental testing—forms average 1 item 2.64 Clinical psychologist, multiple other specialties See Note C. (Original item price estimated by CPEP member.) Submitted price of $0.40 for 96110 and $2.44 for 96111 Retained at submitted prices. Eartip insert with sound tube 1 item Otolaryngology, audiology See Note C Pricing information submitted by two specialties Retained at $0.423. EEG electrode, gold DIN 1 item 0.07 Neurology See Note A None See Note E. Electrode, ring 1 item 475.00 Obstetrics, gynecology, urology See Note A None Deleted. Start Printed Page 63209 Electrodes, pickup, black tin, 9mm 1 item 0.42 Podiatry, neurology See Note A None See Note E. Electrodes, pickup, red tin, 9mm 1 item 0.42 Podiatry, neurology See Note A None See Note E. Fiducial screws, set of 4 1 set 558.00 Radiation oncology Item 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 retained Agree—Retained. Film, fluoroscopic 1 sheet 3.51 Diagnostic radiology, anesthesia See Note C None See Note D. Flow sensors 1 item 1.51 Pulmonary medicine, internal medicine See Note A Agree—reusable Deleted. Gold-palladium target 1 item 0.59 Pathology See Note A None Deleted. Hallux implant 1 item Podiatry, orthopaedic surgery See Note B Agree—separately billable Deleted. Headcover for MRI 1 item 0.05 Diagnostic radiology See Note C None See Note D. Inhalant 1 ml 0.75 Cardiology, internal medicine Item may be deleted (May not be “typical” for service.) Use is typical Retained at $0.788. Laryngeal mirror 1 item Diagnostic radiology, otolaryngology See Note A None Deleted. Laser fiber 1 item 595.00 Urology See Note A Disagree—not reusable. Submitted price of $850 Agree—retained at submitted price. Laser fiber cleaving tool 1 item 200.00 Urology See Note A None Deleted. Methylcholine chloride 1 dose 48.50 Pulmonary medicine, internal medicine See Note B Disagree—not separately billable. Requests item be retained Agree—Retained at $39.95. Mounting tray 1 each 40.00 Radiation oncology, diagnostic radiology See Note A None Deleted. Multi-tine device 1 item Allergy/immunology See Note C Submitted pricing information Retained at $0.23. Needle, 4 inch 1 item Obstetrics, gynecology See Note C None Deleted. Needle, 4-6 inch 1 item Obstetrics, gynecology See Note C None Deleted. Needle, seldinger 1 item 72.90 Diagnostic radiology, multiple other specialties See Note A Disagree—not reusable Agree—Retained. Neurobehavioral status—forms average 1 item 5.77 Clinical psychologist, multiple other specialites See Note C. (Original item price estimated by CPEP member.) None See Note D. Oximetry sensor probe 1 item 15.00 Multiple specialties See Note A Agree—resuable Deleted. Penile clamp 1 item 40.70 Urology See Note A None Deleted. Phenol applicator kit 1 unit Otolaryngology See Note C Pricing information submitted Retained at $15.152. Primary antibodies 1 slide 3.52 Pathology, neurology See Note C None See Note D. Psych testing—forms average 1 item 2.30 Clinical psychologist See Note C None See Note D. Receive coil Diagnostic radiology See Note A None Deleted. Ruler 1 each 2.67 Radiation oncology, diagnostic radiology See Note A None Deleted. Scissors and clamp, disposable 1 each 0.62 Radiation oncology, diagnostic radiology Need clamp description and source/pricing None See Note D. Start Printed Page 63210 Sealant spray Radiation oncology, diagnostic See Note C None See Note D. Silverman needle 1 item 66.35 Urology See Note A None Deleted. Skin prep, one step 1 item 26.00 Cardiology Need inches used per procedure (196in per roll) None See Note D. Smoke evacuation cartridge 1 item 146.50 Obstetrics, gynecology See Note A None Deleted. Sterile, hand table drape (24x43) Orthopaedic surgery, hand surgery Item Deleted. Integral part of hand/upper extremity drape supply item Agree Deleted. Sterilizing tray 1 each 64.00 Radiation oncology, diagnostic radiology See Note A None Deleted. Steroid 1 cc 1.29 Urology See Note B None Deleted. Sweat cells, 4 in a set 1 set 260.00 Neurology See Note A None Deleted. Thrombectomy device 1 item 600.00 Diagnostic radiology Additional information required. Device is reusable. Need to identify specific PTD single-use accessories (e.g. sheath rotator drive basket) Disagree—device is not reusable Agree—Retained. Tourniquet, ankle, sterile 1 item Podiatry, orthopaedic surgery See Note A Disagree—packaged for single use. Price submitted at $42.87 Agree—retained at submitted price. Tourniquet, cuff sterile Orthopaedic surgery, hand surgery See Note A Agree Deleted. Traction straps 1 item 60.00 Radiation oncology, diagnostic radiology See Note A None Deleted. Transtelephonic monitor 10.56 Cardiology See Note A Agree—resuable, but requests item be retained Disagree—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
Code Physician work Practice expense Malpractice GXXX5 12.92 8.70 0.60 GXXX6 5.19 3.49 0.24 GXXX7 3.39 2.29 0.16 GXXX8 9.91 4.86 0.43 GXXX9 3.55 1.74 0.15 GXX10 2.32 1.14 0.10 GXX11 8.47 4.54 0.35 GXX12 3.14 1.68 0.13 GXX13 2.05 1.10 0.08 GXX14 5.16 2.94 0.22 GXX15 1.94 1.10 0.08 GXX16 1.27 0.73 0.06 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 patient HCPCS Number of visits Work Practice expense Malpractice Total Patients Other Than Home Dialysis <2 G0308 4+ 12.69 8.58 0.42 21.69 G0309 2 to 3 10.57 7.13 0.36 18.06 G0310 One Visit 8.45 5.72 0.28 14.45 2 to 11 G0311 4+ 9.68 4.74 0.34 14.76 G0312 2 to 3 8.07 3.94 0.29 12.30 G0313 One visit 6.46 3.16 0.22 9.84 12 to 19 G0314 4+ 8.24 4.45 0.26 12.95 G0315 2 to 3 6.87 3.69 0.23 10.79 G0316 One visit 5.50 2.96 0.17 8.63 20 + G0317 4+ 5.07 2.88 0.17 8.12 G0318 2 to 3 4.23 2.39 0.14 6.76 G0319 One Visit 3.38 1.92 0.11 5.41 Home dialysis patients (entire month) <2 G0320 10.57 7.13 0.36 18.06 12 to 19 G0321 6.87 3.69 0.23 10.79 2 to 11 G0322 8.07 3.94 0.29 12.30 20 + G0323 4.23 2.39 0.14 6.76 Home dialysis patients (partial month only—per day) <2 G0324 0.35 0.24 0.01 0.60 12 to 19 G0325 0.23 0.12 0.01 0.36 2 to 11 G0326 0.27 0.13 0.01 0.41 20 + G0327 0.14 0.08 0.01 0.23 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 1 Mod Descriptor 2003 work RVU Requested work RVU 2004 work RVU 17310 Mohs any stage > 5spec each 0.62 0.95 0.95 43219 * Esophagus endoscopy 2.80 2.80 43256 * Uppr gi endoscopy w stent 4.35 4.35 44383 * Ileoscopy w/stent 2.94 2.94 45340 Sig w/balloon dilation 1.66 1.96 1.89 51798 Us urine capacity measure 0.00 0.38 0.00 75954 Illiac aneurysm endovas rpr 1.36 2.93 2.25 92613 Endoscopy swallow tst (fees) 0.00 0.99 0.71 92615 Eval laryngoscopy sense test 0.00 0.88 0.63 92617 Interprt fees/laryngeal test 0.00 1.10 0.79 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.
Start Printed Page 63230Table 5.—2003 Late RUC Recommendations
CPT code 1 Short descriptor CMS assigned 2003 work RVU RUC recommendation CMS decision 2004 work RVU 21030 Excise max/zygoma b9 tumor 3.89 4.50 Agree 4.50 21040 Removal of jaw bone lesion 3.89 4.50 Agree 4.50 21742 Repair sternum/nuss w/o scope (2) (2) Agree (2) 21743 Repair sternum/nuss w/o scope (2) (2) Agree (2) 36511 Apheresis wbc 1.74 1.74 Agree 1.74 36512 Apheresis rbc 1.74 1.74 Agree 1.74 36513 Apheresis platelets 1.74 1.74 Agree 1.74 36514 Apheresis plasma 1.74 1.74 Agree 1.74 36515 Apheresis, adsorp/reinfuse 1.74 1.74 Agree 1.74 36516 Apheresis, selective 1.74 1.22 Agree 1.22 38207 (Lab Codes) Cryopreserve stem cells (3) 0.47 Disagree (4) 38210 (Lab Codes) T-cell depletion of harvest (3) 0.94 Disagree (4) 38211 (Lab Codes) Tumor cell deplete of harvest (3) 0.71 Disagree (4) 38212 (Lab Codes) Rbc depletion of harvest (3) 0.47 Disagree (4) 38213 (Lab Codes) Platelet deplete of harvest (3) 0.24 Disagree (4) 38214 (Lab Codes) Volume deplete of harvest (3) 0.24 Disagree (4) 38215 (Lab Codes) Harvest Stem cell concentrate (3) 0.55 Disagree (4) 93784 Ambulatory BP monitoring 0.17 0.38 Agree 0.38 93786 Ambulatory BP recording 0.00 0.00 Agree 0.00 93788 Ambulatory BP analysis (5) 0.00 Agree 0.00 93790 Review/report BP recording 0.17 0.38 Agree 0.38 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” 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 code Mod Description RUC recommendation HCPAC recommendation CMS decision 2004 work RVU #20982 Ablate, bone tumor(s) perq 7.27 Agree 7.27 #21685 Hyoid myotomy & suspension 13.00 Agree 13.00 #22532 Lat thorax spine fusion 24.00 Agree 24.00 #22533 Lat lumbar spine fusion 23.12 Agree 23.12 #22534 Lat thor/lumb, add'l seg 6.00 Agree 6.00 31622 Dx bronchoscope/wash 2.78 Agree 2.78 31623 Dx bronchoscope/brush 2.88 Agree 2.88 31624 Dx bronchoscope/lavage 2.88 Agree 2.88 31625 Bronchoscopy w/biopsy (s) 3.37 Agree 3.37 31628 Bronchoscopy/lung bx, each 3.81 Agree 3.81 31629 Bronchoscopy/needle bx, each 4.10 Agree 4.10 31630 Bronchoscopy dilate/fx repr 3.82 Agree 3.82 31631 Bronchoscopy, dilate w/stent 4.37 Agree 4.37 #31632 Bronchoscopy/lung bx, add'l 1.03 Agree 1.03 #31633 Bronchoscopy/needle bx add'l 1.32 Agree 1.32 31635 Bronchoscopy w/fb removal 3.68 Agree 3.68 31640 Bronchoscopy w/tumor excise 4.94 Agree 4.94 33310 Exploratory heart surgery 18.51 Agree 18.51 33315 Exploratory heart surgery 22.37 Agree 22.37 #34805 Endovasc abdo repair w/pros 21.88 Agree 21.88 #35510 Artery bypass graft 23.00 Agree 23.00 #35512 Artery bypass graft 22.50 Agree 22.50 #35522 Artery bypass graft 21.76 Agree 21.76 #35525 Artery bypass graft 20.63 Agree 20.63 #35697 Reimplant artery each 3.00 Agree 3.00 Start Printed Page 63234 #36555 Insert non-tunnel cv cath 2.68 Agree 2.68 #36556 Insert non-tunnel cv cath 2.50 Agree 2.50 #36557 Insert tunneled cv cath 5.10 Agree 5.10 #36558 Insert tunneled cv cath 4.80 Agree 4.80 #36560 Insert tunneled cv cath 6.25 Agree 6.25 #36561 Insert tunneled cv cath 6.00 Agree 6.00 #36563 Insert tunneled cv cath 6.20 Agree 6.20 #36565 Insert tunneled cv cath 6.00 Agree 6.00 #36566 Insert tunneled cv cath 6.50 Agree 6.50 #36568 Insert tunneled cv cath 1.92 Agree 1.92 #36569 Insert tunneled cv cath 1.82 Agree 1.82 #36570 Insert tunneled cv cath 5.32 Agree 5.32 #36571 Insert tunneled cv cath 5.30 Agree 5.30 #36575 Repair tunneled cv cath 0.67 Agree 0.67 #36576 Repair tunneled cv cath 3.19 Agree 3.19 #36578 Repair tunneled cv cath 3.50 Agree 3.50 #36580 Replace tunneled cv cath 1.31 Agree 1.31 #36581 Replace tunneled cv cath 3.44 Agree 3.44 #36582 Replace tunneled cv cath 5.20 Agree 5.20 #36583 Replace tunneled cv cath 5.25 Agree 5.25 #36584 Replace tunneled cv cath 1.20 Agree 1.20 #36585 Replace tunneled cv cath 4.80 Agree 4.80 #36589 Removal tunneled cv cath 2.27 Agree 2.27 #36590 Removal tunneled cv cath 3.30 Agree 3.30 #36595 Mech remov tunneled cv cath 3.60 Agree 3.60 #36596 Mech remov tunneled cv cath 0.75 Agree 0.75 #36597 Repositoin venous catheter 1.21 Agree 1.21 #36838 Dist revas ligation, hemo 20.63 Agree 20.63 #37765 Phleb veins—extrem—to 20 7.35 Agree 7.35 #37766 Phleb veins—extrem 20 + 9.30 Agree 9.30 37785 Ligate/divide/excise vein 3.84 Agree 3.84 38208 Thaw preserved stem cells 0.56 Disagree 0.00 38209 Wash harvest stem cells 0.24 Disagree 0.00 43235 Uppr gi endoscopy, diagnosis 2.39 Agree 2.39 #43237 Endoscopic us exam, esoph 3.99 Agree 3.99 #43238 Uppr gi endoscopy w/us fn bx 5.03 Agree 5.03 43242 Uppr gi endoscopy w/us fn bx 7.31 Agree 7.31 43259 Endoscopic ultrasound exam 5.20 Agree 5.20 43752 Nasal/orogastric w/stent 0.82 Disagree 0.68 47133 Removal of donor liver † Agree † #47140 Partial removal, donor liver 55.00 Agree 55.00 #47141 Partial removal, donor liver 67.50 Agree 67.50 #47142 Partial removal, donor liver 75.00 Agree 75.00 #53500 Urethrlys, transvag w/scope 12.21 Agree 12.21 #57425 Laparoscopy, surg, colpopexy 15.75 Agree 15.75 58545 Laparoscopic myomectomy 14.21 Agree 14.21 58546 Laparo-myomectomy, complex 19.00 Agree 19.00 58550 Laparo-asst vag hysterectomy 14.19 Agree 14.19 58552 Laparo-vag hyst incl t/o 16.00 Agree 16.00 58553 Laparo-vag hyst, complex 20.00 Agree 20.00 58554 Laparo-vag hyst w/t/o, compl 22.00 Agree 22.00 #59070 Transabdom amnioinfus w/us 5.25 Agree 5.25 #59072 Umbilical cord occlud w/us 9.00 Agree 9.00 #59074 Fetal fluid drainage w/us 5.25 Agree 5.25 #59076 Fetal shunt placement, w/us 9.00 Agree 9.00 #59897 † Fetal invas px w/us † Agree † #61537 Removal of brain tissue 25.00 Agree 25.00 61538 Removal of brain tissue 26.81 Agree 26.81 61539 Removal of brain tissue 32.08 Agree 32.08 #61540 Removal of brain tissue 30.00 Agree 30.00 61543 Removal of brain tissue 29.22 Agree 29.22 #61566 Removal of brain tissue 31.00 Agree 31.00 #61567 Incision of brain tissue 35.50 Agree 35.50 #61863 Implant neuroelectrode 19.00 Disagree 13.92 #61864 Implant neuroelectrode, add'l 4.50 Agree 4.50 #61867 Implant neuroelectrode 31.34 Disagree 22.96 #61868 Implant neuroelectrde, add'l 7.92 Agree 7.92 #63101 Removal of vertebral boby 32.00 Agree 32.00 #63102 Removal of vertebral body 32.00 Agree 32.00 Start Printed Page 63235 #63103 Removal vertebral body add-on 5.00 Disagree 3.90 #64449 N block inj, lumbar plexus 3.00 Agree 3.00 #64517 N block inj, hypogas plxs 2.20 Agree 2.20 64680 Injection treatment of nerve 2.62 Agree 2.62 #64681 Injection treatment of nerve 3.55 Agree 3.55 #65780 Ocular reconst, transplant 10.25 Agree 10.25 #65781 Ocular reconst, transplant 17.67 Agree 17.67 #65782 Ocular reconst, transplant 15.00 Agree 15.00 #67912 Correction eyelid w/ implant 5.68 Agree 5.68 #68371 Harvest eye tissue, alograft 4.90 Agree 4.90 #70557 Mri brain w/o dye 2.90 Agree 2.90 #70558 Mri brain w/dye 3.20 Agree 3.20 #70559 Mri brain w/o & w/dye 3.20 Agree 3.20 75901 Remove cva device obstruct 0.49 Agree 0.49 75902 Remove cva lumen obstruct 0.39 Agree 0.39 #75998 Fluoroguide for vein device 0.38 Agree 0.38 #76082 Computer mammogram add-on 0.06 Agree 0.06 #76083 Computer mammogram add-on 0.06 Agree 0.06 #76514 Echo exam of eye, thickness 0.17 Agree 0.17 #76937 Us guide, vascular access 0.30 Agree 0.30 78800 Tumor imaging, limited area 0.66 Agree 0.66 78801 Tumor imaging, mult areas 0.79 Agree 0.79 78802 Tumor imaging, whole body 0.86 Agree 0.86 78803 Tumor imaging (3D) 1.09 Agree 1.09 #78804 Tumor imaging, whole body 1.07 Agree 1.07 79100 Repeat hyperthyroid therapy 1.32 Agree 1.32 79400 Nonhemato nuclear therapy 1.96 Agree 1.96 #79403 Hematopoetic nuclear therapy 2.25 Agree 2.25 #85396 Clotting assay, whole blood 0.37 Agree 0.37 #88112 Cytopath, cell enhance blood 1.18 Agree 1.18 88342 Immunohistochemistry 0.85 Agree 0.85 88358 Analysis, tumor 0.95 Agree 0.95 #88361 Immunohistochemistry, tumor 0.94 Agree 0.94 #91110 Gi tract capsule endoscopy 3.65 Agree 3.65 95990 Spin/brain pump refil & main 0.00 Agree 0.00 #95991 Spin/brain pump refil & main 0.77 Agree 0.77 96110 Developmental test, lim 0.00 Agree 0.00 96111 Developmental test, extend 2.60 Agree 2.60 97537 Community/Work reintegration 0.45 Agree 0.45 #97755 Assistive technology assess 0.62 Agree 0.62 (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 code Description RUC recommendation CMS decision 2003 base units 00529# ANESTH, CHEST PARTITION VIEW 11 Agree 11 01173# ANESTH, FX REPAIR, PELVIS 12 Agree 12 Start Printed Page 63236 01958# ANESTH, ANTEPARTUM MANIPUL 5 Agree 5 *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 0058T Cryopreservation, ovary tiss. 0059T Cryopreservation, oocyte. G0027 Semen analysis. G0306 CBC/diffwbc w/o platelet. G0307 CBC without platelet. G0328 Fecal blood scrn immunoassay. Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services 97755 Assistive technology assess. Radiology and Certain Other Imaging Services 72198 Mr angio pelvis w/o & w/dye. 76082 Computer mammogram add-on. 76083 Computer mammogram add-on. 76514 Echo exam of eye, thickness. 91110 Gi tract capsule endoscopy. Radiation Therapy Services and Supplies G0173 Stereo radiosurgery, complete. G0251 Linear acc based stero radio. G0338 Linear accelerator stero pln. G0339 Robot lin-radsurg com, first. G0340 Robt lin-radsurg fractx 2-5. Drugs Used by Patients Undergoing Dialysis Q4054 Darbepoetin alfa, esrd use. Q4055 Epoetin alfa, esrd use. Preventive Screening Tests, Immunizations and Vaccines 76083 Computer mammogram add-on. 90655 Flu 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 0020T Extracorp shock wave tx, ft. Q0086 Physical therapy evaluation. Radiology and Certain Other Imaging Services 76085 Computer mammogram add-on. 76831 Echo exam, uterus. G0236 Digital film conv. GO262 Sm intestinal image capsule. Radiation Therapy Services and Supplies G0274 Radiopharm tx, non-Hodgkins. Drugs Used by Patients Undergoing Dialysis Q9920 Epoetin with hct < = 20. Q9921 Epoetin with hct = 21. Q9922 Epoetin with hct = 22. Q9923 Epoetin with hct = 23. Q9924 Epoetin with hct = 24. Q9925 Epoetin with hct = 25. Q9926 Epoetin with hct = 26. Q9927 Epoetin with hct = 27. Q9928 Epoetin with hct = 28. Q9929 Epoetin with hct = 29. Q9930 Epoetin with hct = 30. Q9931 Epoetin with hct = 31. Q9932 Epoetin with hct = 32. Q9933 Epoetin with hct = 33. Q9934 Epoetin with hct = 34. Q9935 Epoetin with hct = 35. Q9936 Epoetin with hct = 36. Q9937 Epoetin with hct = 37. Q9938 Epoetin with hct = 38. Q9939 Epoetin with hct = 39. Q9940 Epoetin with hct > = 40. Preventive Screening Tests, Immunizations and Vaccines 76085 Computer mammogram add-on. 90659 Flu 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 category 2000—Expense weights1 2 1996—Expense weights Price proxy Total 100.000 100.000 Physician Earnings 3 52.466 54.460 Wages and Salaries 42.730 44.197 AHE—Private. Benefits 4 9.735 10.263 ECI—Ben: Private. Physician Practice Expenses 47.534 45.540 Nonphysician Employee Compensation 18.653 16.812 Employee Wages and Salaries 13.808 12.424 Prof/Tech Wages 5.887 5.662 ECI—W/S: Private P&T. Managerial Wages 3.333 2.410 ECI—W/S: Private Admin. Clerical Wages 3.892 3.830 ECI—W/S: Private Clerical. Services Wages 0.696 0.522 ECI—W/S: Private Service. Employee Benefits 4 4.845 4.388 ECI—Ben: Priv. White Collar. Other Practice Expenses 18.129 Office Expenses 12.209 11.581 CPI(U)—Housing. Professional Liability Insurance 3.865 3.152 CMS—Prof. Liab. Phys. Premiums. Medical Equipment 2.055 1.878 PPI—Medical Instruments & Equip. Pharmaceuticals and Medical Materials and Supplies 4.319 4.516 Medical Materials and Supplies 2.011 PPI Surg. Appliances and Supplies/CPI (U) Med Supplies. Pharmaceuticals 2.308 PPI Pharmaceutical Preparations. Other Expenses 6.433 7.601 CPI-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 group 2000 expenditure shares 1996 expenditure shares Total 100.000 100.000 Professional & Technical Workers 42.635 45.573 Managers 24.138 19.398 Clerical Workers 28.187 30.827 Service Workers 5.040 4.202 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 measures 2000 weights 2 2004 percent changes Medicare Economic Index Total, productivity adjusted n/a 2.9 Productivity: 10-year moving average of Multifactor productivity, private nonfarm business sector n/a 0.9 Medicare Economic Index Total, without productivity adjustment 100.000 3.8 1. Physician's Own Time 3 52.466 3.6 a. Wages and Salaries: Average Hourly Earnings, private Nonfarm 42.730 3.2 b. Fringe Benefits: Employment Cost Index, benefits, private nonfarm 9.735 5.4 2. Physician's Practice Expense 3 47.534 4.0 a. Nonphysician Employee Compensation 18.653 3.4 1. Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation 13.808 2.8 2. Fringe Benefits: Employment Cost Index, fringe benefits, white collar 4.845 5.0 b. Office Expense: Consumer Price Index (CPI-U), housing 12.209 2.5 c. Drugs and Medical Materials and Supplies 4.319 3.1 1. Medical Materials and Supplies: Producer Price Index, surgical appliances and supplies/Consumer Price Index (CPI-U), medical equipment and supplies (equally weighted) 2.011 1.0 2. Pharmaceuticals: Producer Price Index (PPI pharmaceutical preparations) 2.308 4.9 d. Professional Liability Insurance: premiums 4 3.865 16.9 e. Medical Equipment: PPI, medical instruments and equipment 2.055 2.3 f. Other Expenses 6.433 1.9 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
Period Annual allowed expenditures ($ in billions) Cumulative allowed expenditures ($ in billions) FY/CY SGR 4/1/96-3/31/97 48.9 48.9 N/A 4/1/97-3/31/98 50.5 99.4 FY 1998 = 3.2% 4/1/98-3/31/99 52.6 152.0 FY 1999 = 4.2% 1/1/99-3/31/99 13.3 (1) FY 1999 = 4.2% 4/1/99-12/31/99 42.1 (2) FY 2000 = 6.9% 1/1/99-12/31/99 55.3 194.1 FY 1999/20003 1/1/00-12/31/00 59.4 253.4 CY 2000 = 7.3% 1/1/01-12/31/01 62.0 315.5 CY 2001 = 4.5% 1/1/02-12/31/02 67.2 382.6 CY 2002 = 8.2% 1/1/03-12/31/03 71.7 454.2 CY 2003 = 6.7% 1/1/04-12/31/04 77.0 528.6 CY 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 factors March estimate Current estimate Fees 2.3% (1.023) 2.7% (1.027) Enrollment 1.3% (1.013) 1.7% (1.017) Real Per Capita GDP 2.7% (1.027) 2.8% (1.028) Law and Regulation 0.0% (1.000) 0.0% (1.000) Total 6.4% (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 factors 12/31/02 estimate Current estimate Fees 2.9% (1.029) 2.8% (1.028) Enrollment 1.2% (1.012) 2.4% (1.024) Real Per Capita GDP 3.3% (1.033) 1.4% (1.014) Law and Regulation 0.0% (1.000) 0.0% (1.000) Total 7.6% (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:
Start Printed Page 63250Table 16
Statutory factors 11/1/01 estimate 12/31/02 estimate (1) Final Fees 2.3% (1.023) 2.5% (1.025) 2.5% (1.025) Enrollment 0.7% (1.007) 2.8% (1.028) 3.2% (1.032) Real Per Capita GDP 1.7% (1.027) 2.3% (1.023) 1.4% (1.014) Law and Reg 0.8% (1.008) 1.1% (1.011) 1.0% (1.010) Total 5.6% (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. 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
Weight Update Physician 0.803 2.9 Laboratory 0.074 2.1 Drugs 0.123 2.0 Weighted Average 1.000 2.7 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
2003 2004 Overall 1 38.535 1 39.013 Medicare+Choice 1 4.689 1 4.606 Net 1 33.847 1 34.407 Percent Increase 2 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
Weight Update Physician 0.827 3.0 Laboratory 0.071 1.1 Drugs 0.102 1.9 Weighted Average 1.000 2.8 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]
2002 2003 Overall 38.074 38.535 Start Printed Page 63251 Medicare+Choice 5.005 4.689 Net 33.069 33.847 Percent Increase 2.4% 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
Weight Update Physician 0.841 2.6 Laboratory 0.072 0.0 Drugs 0.087 2.8 Weighted Average 1.000 2.5 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]
2001 2002 Overall 37.650 38.074 Medicare+Choice 5.608 5.005 Net 32.041 33.069 Percent Increase 3.2% 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 Update 0.9551 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 factor 1.0090 2004 Update 0.9551 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 fee MEI increase (percent) Period $20.00 N/A 10/01/2001-12/31/2002 $20.60 3.0 01/01/2003-12/31/2003 $21.20 2.9 01/01/2004-12/31/2004 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 63255Table 26.—Impact of Physician Fee Schedule Changes on Total Medicare Allowed Charges by Physician, Practitioner and Supplier Subcategory
Specialty Medicare allowed charges (millions) NPRM (percent) Practice expense refinements (percent) Adjusting RVUs to match MEI weights (percent) Total (percent) Physicians: ALLERGY/IMMUNOLOGY $153 −1 −1 0 −2 ANESTHESIOLOGY 1,327 0 0 0 0 CARDIAC SURGERY 321 0 0 1 0 CARDIOLOGY 5,759 0 0 0 0 CLINICS 1,167 0 0 0 0 COLON AND RECTAL SURGERY 101 1 0 0 1 CRITICAL CARE 108 −1 0 0 −1 DERMATOLOGY 1,708 0 0 0 0 EMERGENCY MEDICINE 1,444 0 0 0 0 ENDOCRINOLOGY 246 1 0 0 1 FAMILY PRACTICE 4,005 1 0 0 1 GASTROENTEROLOGY 1,513 −1 0 0 −1 GENERAL PRACTICE 954 0 0 0 0 GENERAL SURGERY 2,110 −1 0 0 0 GERIATRICS 97 −1 1 0 0 HAND SURGERY 46 −2 0 0 −2 HEMATOLOGY/ONCOLOGY 1,086 1 0 0 1 INFECTIOUS DISEASE 336 0 0 0 0 INTERNAL MEDICINE 7,917 1 0 0 1 INTERVENTIONAL RADIOLOGY 155 0 −1 0 0 NEPHROLOGY 1,187 0 0 0 0 NEUROLOGY 1,072 1 0 0 1 NEUROSURGERY 433 0 0 1 1 OBSTETRICS/GYNECOLOGY 550 1 0 0 1 OPHTHALMOLOGY 4,291 −1 0 0 −1 ORTHOPEDIC SURGERY 2,645 −2 0 1 −1 OTOLARNGOLOGY 735 2 1 0 3 PATHOLOGY 799 0 0 0 0 PEDIATRICS 58 0 0 0 0 PHYSICAL MEDICINE 594 1 0 0 1 PLASTIC SURGERY 274 0 0 0 0 PSYCHIATRY 1,073 0 0 0 0 PULMONARY DISEASE 1,305 −1 0 0 −1 RADIATION ONCOLOGY 1,002 −3 2 0 0 RADIOLOGY 4,230 0 0 0 0 RHEUMATOLOGY 352 1 0 0 1 THORACIC SURGERY 446 −1 0 1 0 UROLOGY 1,540 2 0 0 1 VASCULAR SURGERY 429 −1 0 1 0 Practitioners: AUDIOLOGIST 25 −1 −2 1 −1 CHIROPRACTOR 589 0 0 0 0 CLINICAL PSYCHOLOGIST 449 0 0 0 0 CLINICAL SOCIAL WORKER 277 0 0 0 0 NURSE ANESTHETIST 452 0 0 1 1 NURSE PRACTITIONER 434 −1 1 0 0 OPTOMETRY 611 1 0 0 0 ORAL/MAXILLOFACIAL SURGERY 33 8 0 0 8 PHYSICAL/OCCUPATIONAL THERAPY 835 0 0 1 0 PHYSICIANS ASSISTANT 322 0 0 0 0 PODIATRY 1,307 −1 0 0 −1 Suppliers: DIAGNOSTIC TESTING FACILITY 728 0 0 0 0 INDEPENDENT LABORATORY 508 2 0 0 1 PORTABLE X-RAY SUPPLIER 82 −1 1 0 0 Other: ALL OTHER 54 0 0 0 0 ALL PHYSICIAN FEE SCHEDULE 60,385 0 0 0 0 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.
Start Printed Page 63257Table 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
Specialty Medicare allowed charges (millions) Impact of RVU changes (percent) Physician fee schedule update (percent) Total (percent) Physicians: ALLERGY/IMMUNOLOGY $153 −2 −4.5 −6 ANESTHESIOLOGY 1,327 0 −4.5 −4 CARDIAC SURGERY 321 0 −4.5 −4 CARDIOLOGY 5,759 0 −4.5 −4 CLINICS 1,167 0 −4.5 −4 COLON AND RECTAL SURGERY 101 1 −4.5 −4 CRITICAL CARE 108 −1 −4.5 −5 DERMATOLOGY 1,708 0 −4.5 −5 EMERGENCY MEDICINE 1,444 0 −4.5 −4 ENDOCRINOLOGY 246 1 −4.5 −4 FAMILY PRACTICE 4,005 1 −4.5 −4 GASTROENTEROLOGY 1,513 −1 −4.5 −5 GENERAL PRACTICE 954 0 −4.5 −4 GENERAL SURGERY 2,110 0 −4.5 −5 GERIATRICS 97 0 −4.5 −5 HAND SURGERY 46 −2 −4.5 −7 HEMATOLOGY/ONCOLOGY 1,086 1 −4.5 −4 INFECTIOUS DISEASE 336 0 −4.5 −5 INTERNAL MEDICINE 7,917 1 −4.5 −4 INTERVENTIONAL RADIOLOGY 155 0 −4.5 −5 NEPHROLOGY 1,187 0 −4.5 −5 NEUROLOGY 1,072 1 −4.5 −3 NEUROSURGERY 433 1 −4.5 −4 OBSTETRICS/GYNECOLOGY 550 1 −4.5 −4 OPHTHALMOLOGY 4,291 −1 −4.5 −5 ORTHOPEDIC SURGERY 2,645 −1 −4.5 −6 OTOLARNGOLOGY 735 3 −4.5 −2 PATHOLOGY 799 0 −4.5 −4 PEDIATRICS 58 0 −4.5 −4 PHYSICAL MEDICINE 594 1 −4.5 −4 PLASTIC SURGERY 274 0 −4.5 −4 PSYCHIATRY 1,073 0 −4.5 −5 PULMONARY DISEASE 1,305 −1 −4.5 −6 RADIATION ONCOLOGY 1,002 0 −4.5 −5 RADIOLOGY 4,230 0 −4.5 −5 RHEUMATOLOGY 352 1 −4.5 −3 THORACIC SURGERY 446 0 −4.5 −4 UROLOGY 1,540 1 −4.5 −3 VASCULAR SURGERY 429 0 −4.5 −5 Practitioners: AUDIOLOGIST 25 −1 −4.5 −6 CHIROPRACTOR 589 0 −4.5 −4 CLINICAL PSYCHOLOGIST 449 0 −4.5 −5 CLINICAL SOCIAL WORKER 277 0 −4.5 −5 NURSE ANESTHETIST 452 1 −4.5 −4 NURSE PRACTITIONER 434 0 −4.5 −4 OPTOMETRY 611 0 −4.5 −4 ORAL/MAXILLOFACIAL SURGERY 33 8 −4.5 3 PHYSICAL/OCCUPATIONAL THERAPY 835 0 −4.5 −4 PHYSICIANS ASSISTANT 322 0 −4.5 −4 PODIATRY 1,307 −1 −4.5 −5 Suppliers: DIAGNOSTIC TESTING FACILITY 728 0 −4.5 −5 INDEPENDENT LABORATORY 508 1 −4.5 −3 PORTABLE X-RAY SUPPLIER 82 0 −4.5 −4 Other: ALL OTHER 54 0 −4.5 −4 ALL PHYSICIAN FEE SCHEDULE 60,385 0 −4.5 −4 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
HCPCS MOD DESC Non-Facility Facility Old New % change Old New % change 11721 Debride nail, 6 or more $37.52 $36.19 −4 29.06 28.11 −3 17000 Destroy benign/premlg lesion 61.43 57.27 −7 33.11 33.73 2 27130 Total hip arthroplasty N/A N/A N/A 1,343.41 1,290.82 −4 27236 Treat thigh fracture N/A N/A N/A 1,068.99 1,024.86 −4 27244 Treat thigh fracture N/A N/A N/A 1,155.44 1,050.15 −9 27447 Total knee arthroplasty N/A N/A N/A 1,445.67 1,390.25 −4 33533 CABG, arterial, single N/A N/A N/A 1,799.18 1,742.99 −3 35301 Rechanneling of artery N/A N/A N/A 1,073.77 1,043.83 −3 43239 Upper GI endoscopy, biopsy 337.69 305.31 −10 155.97 150.02 −4 45385 Lesion removal colonoscopy 545.53 471.85 −14 290.61 271.23 −7 66821 After cataract laser surgery 231.01 227.32 −2 214.83 224.15 4 66984 Cataract surg w/iol, 1 stage N/A N/A N/A 672.81 645.06 −4 67210 Treatment of retinal lesion 604.39 544.58 −10 548.47 528.41 −4 71010 26 Chest x-ray 9.20 8.78 −5 9.20 8.78 −5 71020 26 Chest x-ray 11.04 10.54 −5 11.04 10.54 −5 76091 Mammogram, both breasts 94.17 89.94 −4 N/A N/A N/A 76091 26 Mammogram, both breasts 44.14 42.16 −4 44.14 42.16 −4 76092 Mammogram, screening 82.77 79.40 −4 N/A N/A N/A 76092 26 Mammogram, screening 36.05 34.08 −5 36.05 34.08 −5 77427 Radiation tx management, x5 168.11 158.81 −6 168.11 158.81 −6 78465 26 Heart image (3d), multiple 75.41 71.67 −5 75.41 71.67 −5 88305 26 Tissue exam by pathologist 40.83 39.00 −4 40.83 39.00 −4 90801 Psy dx interview 148.98 141.94 −5 140.52 133.16 −5 90806 Psytx, off, 45-50 min 96.38 91.70 −5 92.70 88.54 −4 90807 Psytx, off, 45-50 min w/e&m 102.63 97.32 −5 100.06 95.21 −5 90862 Medication management 50.76 48.13 −5 47.82 45.32 −5 90935 Hemodialysis, one evaluation N/A N/A N/A 71.36 67.81 −5 92004 Eye exam, new patient 123.60 119.46 −3 88.29 83.62 −5 92012 Eye exam established pat 61.43 60.08 −2 36.05 34.08 −5 92014 Eye exam & treatment 91.60 88.19 −4 58.86 55.86 −5 92980 Insert intracoronary stent N/A N/A N/A 800.45 763.81 −5 92982 Coronary artery dilation N/A N/A N/A 594.46 566.71 −5 93000 Electrocardiogram, complete 26.12 24.95 −2 N/A N/A N/A 93010 Electrocardiogram report 8.83 8.43 −5 8.83 8.43 −5 93015 Cardiovascular stress test 104.10 99.78 −4 N/A N/A N/A 93307 26 Echo exam of heart 48.19 46.03 −4 48.19 46.03 −4 93510 26 Left heart catheterization 231.38 237.86 3 231.38 237.86 3 98941 Chiropractic manipulation 35.68 34.08 −4 31.27 29.86 −5 99203 Office/outpatient visit, new 92.70 90.65 −2 70.26 67.46 −4 99204 Office/outpatient visit, new 132.06 128.24 −3 103.74 99.08 −4 99205 Office/outpatient visit, new 168.48 161.97 −4 137.58 130.70 −5 99211 Office/outpatient visit, est 20.60 20.73 1 8.83 8.43 −5 99212 Office/outpatient visit, est 36.42 36.19 −1 23.17 22.13 −4 99213 Office/outpatient visit, est 51.13 49.89 −2 34.58 33.03 −4 99214 Office/outpatient visit, est 79.82 77.29 −3 56.65 53.75 −5 99215 Office/outpatient visit, est 116.98 112.43 −4 91.23 86.78 −5 99221 Initial hospital care N/A N/A N/A 65.85 62.54 −5 99222 Initial hospital care N/A N/A N/A 109.25 104.00 −5 99223 Initial hospital care N/A N/A N/A 151.92 144.75 −5 99231 Subsequent hospital care N/A N/A N/A 32.74 31.27 −4 99232 Subsequent hospital care N/A N/A N/A 54.07 51.30 −5 99233 Subsequent hospital care N/A N/A N/A 76.88 73.43 −4 99236 Observ/hosp same date N/A N/A N/A 216.67 211.86 −2 99238 Hospital discharge day N/A N/A N/A 69.16 65.70 −5 99239 Hospital discharge day N/A N/A N/A 93.80 89.24 −5 99241 Office consultation 47.45 47.08 −1 33.11 31.97 −3 99242 Office consultation 88.29 86.08 −3 68.05 65.35 −4 99243 Office consultation 116.61 113.83 −2 90.49 86.43 −4 99244 Office consultation 165.90 160.91 −3 134.27 127.89 −5 99245 Office consultation 215.20 206.94 −4 177.67 169.35 −5 99251 Initial inpatient consult N/A N/A N/A 34.95 33.73 −3 99252 Initial inpatient consult N/A N/A N/A 70.26 67.46 −4 99253 Initial inpatient consult N/A N/A N/A 96.01 91.35 −5 Start Printed Page 63258 99254 Initial inpatient consult N/A N/A N/A 137.95 131.05 −5 99255 Initial inpatient consult N/A N/A N/A 189.81 180.94 −5 99261 Follow-up inpatient consult N/A N/A N/A 22.07 20.73 −6 99262 Follow-up inpatient consult N/A N/A N/A 43.77 42.16 −4 99263 Follow-up inpatient consult N/A N/A N/A 65.11 62.19 −4 99282 Emergency dept visit N/A N/A N/A 26.85 26.00 −3 99283 Emergency dept visit N/A N/A N/A 60.33 57.62 −4 99284 Emergency dept visit N/A N/A N/A 94.17 89.94 −4 99285 Emergency dept visit N/A N/A N/A 146.77 140.18 −4 99291 Critical care, first hour 210.05 229.07 9 200.11 191.13 −4 99292 Critical care, add'l 30 min 107.78 101.19 −6 100.06 95.21 −5 99301 Nursing facility care 71.00 67.46 −5 61.06 57.97 −5 99302 Nursing facility care 96.75 92.05 −5 81.30 77.65 −4 99303 Nursing facility care 119.92 114.19 −5 101.16 96.27 −5 99311 Nursing fac care, subseq 40.83 39.00 −4 30.53 28.81 −6 99312 Nursing fac care, subseq 62.54 59.38 −5 50.40 48.13 −5 99313 Nursing fac care, subseq 85.71 81.16 −5 71.73 68.16 −5 99348 Home visit, est patient 74.31 70.62 −5 N/A N/A N/A 99350 Home visit, est patient 167.74 160.21 −4 N/A N/A N/A G0317 ESRDrelsvc 4+/mo; 20+yr 262.28 285.29 9 262.28 285.29 9 G0318 ESRDrelsvc 2-3/mo; 20+yr 262.28 237.51 −9 262.28 237.51 −9 G0319 ESRDrelsvc 1/mo; 20+yr 262.28 190.07 −28 262.28 190.07 −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 name 2003 GAF 2004 GAF Percent difference 00510 00 Alabama 0.927 0.923 −0.4 00831 01 Alaska 1.115 1.113 −0.1 00832 00 Arizona 0.991 0.991 0.0 00520 13 Arkansas 0.889 0.885 −0.4 31146 26 Anaheim/Santa Ana, CA 1.096 1.098 0.1 31146 18 Los Angeles, CA 1.088 1.088 0.0 31140 03 Marin/Napa/Solano, CA 1.103 1.104 0.0 31140 07 Oakland/Berkeley, CA 1.112 1.111 0.0 Start Printed Page 63259 31140 05 San Francisco, CA 1.221 1.223 0.2 31140 06 San Mateo, CA 1.199 1.201 0.2 31140 09 Santa Clara, CA 1.184 1.184 0.1 31146 17 Ventura, CA 1.061 1.060 −0.1 31146 99 Rest of California* 1.010 1.008 −0.2 31140 99 Rest of California* 1.010 1.008 −0.2 00824 01 Colorado 0.983 0.982 −0.2 00591 00 Connecticut 1.092 1.092 0.0 00902 01 Delaware 1.016 1.018 0.2 00903 01 DC + MD/VA Suburbs 1.094 1.095 0.1 00590 03 Fort Lauderdale, FL 1.034 1.036 0.3 00590 04 Miami, FL 1.079 1.085 0.5 00590 99 Rest of Florida 0.972 0.974 0.2 00511 01 Atlanta, GA 1.026 1.027 0.1 00511 99 Rest of Georgia 0.936 0.935 −0.1 00833 01 Hawaii/Guam 1.046 1.046 0.0 05130 00 Idaho 0.912 0.907 −0.5 00952 16 Chicago, IL 1.079 1.087 0.7 00952 12 East St. Louis, IL 0.983 0.988 0.5 00952 15 Suburban Chicago, IL 1.054 1.059 0.5 00952 99 Rest of Illinois 0.939 0.940 0.1 00630 00 Indiana 0.940 0.935 −0.5 00826 00 Iowa 0.912 0.909 −0.4 00650 00 Kansas * 0.928 0.925 −0.3 00740 02 Kansas * 0.928 0.925 −0.3 00660 00 Kentucky 0.923 0.921 −0.2 00528 01 New Orleans, LA 0.985 0.984 0.0 00528 99 Rest of Louisiana 0.930 0.929 −0.1 31142 03 Southern Maine 0.977 0.975 −0.2 31142 99 Rest of Maine 0.930 0.927 −0.3 00901 01 Baltimore/Surr. Cntys, MD 1.025 1.025 0.0 00901 99 Rest of Maryland 0.972 0.970 −0.2 31143 01 Metropolitan Boston 1.117 1.118 0.2 31143 99 Rest of Massachusetts 1.053 1.054 0.1 00953 01 Detroit, MI 1.095 1.106 1.0 00953 99 Rest of Michigan 0.990 0.992 0.2 00954 00 Minnesota 0.966 0.962 −0.5 00512 00 Mississippi 0.900 0.896 −0.4 00740 04 Metropolitan Kansas City, MO 0.974 0.975 0.1 00523 01 Metropolitan St. Louis, MO 0.965 0.966 0.0 00740 99 Rest of Missouri * 0.890 0.889 −0.1 00523 99 Rest of Missouri * 0.890 0.889 −0.1 00751 01 Montana 0.912 0.913 0.1 00655 00 Nebraska 0.902 0.898 −0.4 00834 00 Nevada 1.026 1.025 −0.1 31144 40 New Hampshire 0.999 1.001 0.2 00805 01 Northern NJ 1.109 1.111 0.2 00805 99 Rest of New Jersey 1.058 1.060 0.2 00521 05 New Mexico 0.940 0.938 −0.2 00803 01 Manhattan, NY 1.221 1.225 0.3 00803 02 Nyc Suburbs/Long I., NY 1.174 1.179 0.4 00803 03 Poughkpsie/N Nyc Suburbs, NY 1.046 1.047 0.1 14330 04 Queens, NY 1.156 1.161 0.4 00801 99 Rest of New York 0.968 0.964 −0.4 05535 00 North Carolina 0.941 0.939 −0.2 00820 01 North Dakota 0.911 0.907 −0.4 00883 00 Ohio 0.968 0.968 0.0 00522 00 Oklahoma 0.912 0.907 −0.7 00835 01 Portland, OR 1.000 0.998 −0.3 00835 99 Rest of Oregon 0.932 0.929 −0.4 00865 01 Metropolitan Philadelphia, PA 1.064 1.067 0.3 00865 99 Rest of Pennsylvania 0.957 0.955 −0.2 00973 20 Puerto Rico 0.790 0.784 −0.8 00870 01 Rhode Island 1.033 1.033 0.0 00880 01 South Carolina 0.922 0.919 −0.4 00820 02 South Dakota 0.894 0.889 −0.6 05440 35 Tennessee 0.931 0.928 −0.3 00900 31 Austin, TX 0.986 0.988 0.2 00900 20 Beaumont, TX 0.960 0.960 0.0 00900 09 Brazoria, TX 0.997 0.999 0.1 00900 11 Dallas, TX 1.031 1.033 0.3 Start Printed Page 63260 00900 28 Fort Worth, TX 0.983 0.985 0.2 00900 15 Galveston, TX 0.991 0.992 0.1 00900 18 Houston, TX 1.025 1.026 0.1 00900 99 Rest of Texas 0.929 0.932 0.2 00910 09 Utah 0.951 0.948 −0.2 31145 50 Vermont 0.965 0.962 −0.3 00973 50 Virgin Islands 0.991 0.992 0.1 00904 00 Virginia 0.949 0.947 −0.2 00836 02 Seattle (King Cnty), WA 1.038 1.038 0.0 00836 99 Rest of Washington 0.971 0.970 −0.1 00884 16 West Virginia 0.929 0.933 0.5 00951 00 Wisconsin 0.958 0.954 −0.4 00825 21 Wyoming 0.938 0.936 −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 63261List 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
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 PartPART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
End Part Start Amendment Part1. The authority citation for part 410 continues to read as follows:
End Amendment Part Start Amendment Part2. Section 410.130 is amended by revising the definition of “Diabetes” to read as follows:
End Amendment PartDefinitions* * * * *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.
* * * * *3. Section 410.140 is amended by adding the definition of “Diabetes” in alphabetical order to read as follows:
End Amendment PartDefinitions* * * * *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.
* * * * *4. Section 410.141 is amended by revising paragraph (d) to read as follows:
End Amendment PartOutpatient 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.
* * * * *PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
End Part Start Amendment Part1. The authority citation for part 414 continues to read as follows:
End Amendment Part Start Amendment Part2. Section 414.22(b)(6)(iii) is revised to read as follows:
End Amendment PartRelative 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.
* * * * *3. Section 414.46 is amended to—
End Amendment Part Start Amendment Parta. Redesignate paragraphs (e) through (g) as paragraphs (f) through (h), respectively.
End Amendment Part Start Amendment Partb. Add new paragraph (e).
End Amendment Part Start Amendment PartThe addition reads as follows:
End Amendment PartAdditional 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 SignatureDated: October 28, 2003.
Thomas A Scully,
Administrator, Centers for Medicare & Medicaid Services.
Approved: October 28, 2003.Tommy G. Thompson,
Secretary.
Note:
These addenda will not appear in the Code of Federal Regulations.
Addendum A—Explanation and Use of Addenda B
The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians' services furnished in 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 63262Start Printed Page 63386Addendum B.—Relative Value Units (RVUS) and Related Information
CPT1/HCPCS2 MOD Status Description Physician work RVUs3 Non-facility PE RVUs Facility PE RVUs Malpractice RVUs Non-facility Total Facility total Global 0001T C Endovas repr abdo ao aneurys 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0002T D endo repair abd aa aorto uni 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0003T C Cervicography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0005T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0006T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0007T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0008T C Upper gi endoscopy w/suture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0009T C Endometrial cryoablation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0010T C Tb test, gamma interferon 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0012T C Osteochondral knee autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0013T C Osteochondral knee allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0014T C Meniscal transplant, knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0016T C Thermotx choroid vasc lesion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0017T C Photocoagulat macular drusen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0018T C Transcranial magnetic stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0019T I Extracorp shock wave tx, ms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0020T C Extracorp shock wave tx, ft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0021T C Fetal oximetry, trnsvag/cerv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0023T C Phenotype drug test, hiv 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0024T C Transcath cardiac reduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0025T D Ultrasonic pachymetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0026T C Measure remnant lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63263 0027T C Endoscopic epidural lysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0028T C Dexa body composition study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0029T C Magnetic tx for incontinence 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0030T C Antiprothrombin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0031T C Speculoscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0032T C Speculoscopy w/direct sample 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0033T C Endovasc taa repr incl subcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0034T C Endovasc taa repr w/o subcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0035T C Insert endovasc prosth, taa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0036T C Endovasc prosth, taa, add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0037T C Artery transpose/endovas taa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0038T C Rad endovasc taa rpr w/cover 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0039T C Rad s/i, endovasc taa repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0040T C Rad s/i, endovasc taa prosth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0041T C Detect ur infect agnt w/cpas 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0042T C Ct perfusion w/contrast, cbf 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0043T C Co expired gas analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0044T C Whole body photography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0045T C Whole body photography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0046T C Cath lavage, mammary duct(s 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0047T C Cath lavage, mammary duct(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0048T C Implant ventricular device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0049T C External circulation assist 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0050T C Removal circulation assist 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0051T C Implant total heart system 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0052T C Replace component heart syst 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0053T C Replace component heart syst 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0054T C Bone surgery using computer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0055T C Bone surgery using computer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0056T C Bone surgery using computer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0057T C Uppr gi scope w/ thrml txmnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0058T C Cryopreservation, ovary tiss 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0059T C Cryopreservation, oocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0060T C Electrical impedance scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0061T C Destruction of tumor, breast 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10021 A Fna w/o image 1.26 2.22 0.55 0.08 3.56 1.89 XXX 10022 A Fna w/image 1.26 2.65 0.43 0.06 3.97 1.75 XXX 10040 A Acne surgery 1.17 1.02 0.68 0.06 2.25 1.91 010 10060 A Drainage of skin abscess 1.16 1.22 0.95 0.10 2.48 2.21 010 10061 A Drainage of skin abscess 2.39 1.84 1.53 0.20 4.43 4.12 010 10080 A Drainage of pilonidal cyst 1.16 3.19 1.16 0.11 4.46 2.43 010 10081 A Drainage of pilonidal cyst 2.44 4.16 1.53 0.23 6.83 4.20 010 10120 A Remove foreign body 1.21 1.48 0.42 0.12 2.81 1.75 010 10121 A Remove foreign body 2.67 3.36 1.91 0.30 6.33 4.88 010 10140 A Drainage of hematoma/fluid 1.52 1.53 0.91 0.18 3.23 2.61 010 10160 A Puncture drainage of lesion 1.19 0.73 0.47 0.13 2.05 1.79 010 10180 A Complex drainage, wound 2.24 3.27 2.09 0.30 5.81 4.63 010 11000 A Debride infected skin 0.60 0.58 0.22 0.06 1.24 0.88 000 11001 A Debride infected skin add-on 0.30 0.23 0.11 0.02 0.55 0.43 ZZZ 11010 A Debride skin, fx 4.18 6.80 2.35 0.54 11.52 7.07 010 11011 A Debride skin/muscle, fx 4.92 8.12 2.39 0.64 13.68 7.95 000 11012 A Debride skin/muscle/bone, fx 6.84 12.02 3.90 1.07 19.93 11.81 000 11040 A Debride skin, partial 0.50 0.52 0.21 0.06 1.08 0.77 000 11041 A Debride skin, full 0.82 0.65 0.33 0.07 1.54 1.22 000 11042 A Debride skin/tissue 1.11 0.98 0.47 0.11 2.20 1.69 000 11043 A Debride tissue/muscle 2.37 3.47 2.63 0.29 6.13 5.29 010 11044 A Debride tissue/muscle/bone 3.04 4.58 3.80 0.41 8.03 7.25 010 11055 R Trim skin lesion 0.43 0.56 0.17 0.02 1.01 0.62 000 11056 R Trim skin lesions, 2 to 4 0.61 0.64 0.24 0.04 1.29 0.89 000 11057 R Trim skin lesions, over 4 0.79 0.73 0.31 0.05 1.57 1.15 000 11100 A Biopsy, skin lesion 0.81 1.27 0.37 0.05 2.13 1.23 000 11101 A Biopsy, skin add-on 0.41 0.34 0.19 0.02 0.77 0.62 ZZZ 11200 A Removal of skin tags 0.77 1.07 0.78 0.05 1.89 1.60 010 11201 A Remove skin tags add-on 0.29 0.16 0.12 0.02 0.47 0.43 ZZZ 11300 A Shave skin lesion 0.51 1.01 0.22 0.04 1.56 0.77 000 11301 A Shave skin lesion 0.85 1.13 0.38 0.05 2.03 1.28 000 11302 A Shave skin lesion 1.04 1.32 0.47 0.06 2.42 1.57 000 11303 A Shave skin lesion 1.23 1.61 0.53 0.07 2.91 1.83 000 11305 A Shave skin lesion 0.67 0.85 0.27 0.05 1.57 0.99 000 11306 A Shave skin lesion 0.98 1.12 0.43 0.06 2.16 1.47 000 11307 A Shave skin lesion 1.13 1.31 0.50 0.06 2.50 1.69 000 11308 A Shave skin lesion 1.40 1.47 0.61 0.08 2.95 2.09 000 11310 A Shave skin lesion 0.73 1.14 0.33 0.05 1.92 1.11 000 11311 A Shave skin lesion 1.04 1.26 0.50 0.06 2.36 1.60 000 11312 A Shave skin lesion 1.19 1.46 0.56 0.07 2.72 1.82 000 Start Printed Page 63264 11313 A Shave skin lesion 1.61 1.84 0.72 0.11 3.56 2.44 000 11400 A Exc tr-ext b9+marg 0.5 < cm 0.85 2.04 0.90 0.07 2.96 1.82 010 11401 A Exc tr-ext b9+marg 0.6-1 cm 1.22 2.10 1.04 0.11 3.43 2.37 010 11402 A Exc tr-ext b9+marg 1.1-2 cm 1.50 2.27 1.10 0.14 3.91 2.74 010 11403 A Exc tr-ext b9+marg 2.1-3 cm 1.78 2.45 1.35 0.19 4.42 3.32 010 11404 A Exc tr-ext b9+marg 3.1-4 cm 2.05 2.77 1.43 0.22 5.04 3.70 010 11406 A Exc tr-ext b9+marg 4.0 cm 2.74 3.14 1.69 0.30 6.18 4.73 010 11420 A Exc h-f-nk-sp b9+marg 0.5 < 0.97 1.80 0.94 0.10 2.87 2.01 010 11421 A Exc h-f-nk-sp b9+marg 0.6-1 1.41 2.10 1.13 0.13 3.64 2.67 010 11422 A Exc h-f-nk-sp b9+marg 1.1-2 1.62 2.30 1.36 0.17 4.09 3.15 010 11423 A Exc h-f-nk-sp b9+marg 2.1-3 2.00 2.64 1.48 0.20 4.84 3.68 010 11424 A Exc h-f-nk-sp b9+marg 3.1-4 2.42 2.86 1.63 0.25 5.53 4.30 010 11426 A Exc h-f-nk-sp b9+marg > 4 cm 3.76 3.57 2.13 0.41 7.74 6.30 010 11440 A Exc face-mm b9+marg 0.5 < cm 1.05 2.31 1.35 0.10 3.46 2.50 010 11441 A Exc face-mm b9+marg 0.6-1 cm 1.47 2.42 1.53 0.13 4.02 3.13 010 11442 A Exc face-mm b9+marg 1.1-2 cm 1.71 2.62 1.60 0.17 4.50 3.48 010 11443 A Exc face-mm b9+marg 2.1-3 cm 2.28 3.01 1.85 0.22 5.51 4.35 010 11444 A Exc face-mm b9+marg 3.1-4 cm 3.12 3.58 2.21 0.30 7.00 5.63 010 11446 A Exc face-mm b9+marg > 4 cm 4.46 4.16 2.82 0.36 8.98 7.64 010 11450 A Removal, sweat gland lesion 2.71 5.20 2.06 0.31 8.22 5.08 090 11451 A Removal, sweat gland lesion 3.93 6.84 2.59 0.47 11.24 6.99 090 11462 A Removal, sweat gland lesion 2.50 5.29 2.04 0.28 8.07 4.82 090 11463 A Removal, sweat gland lesion 3.93 7.08 2.73 0.48 11.49 7.14 090 11470 A Removal, sweat gland lesion 3.23 5.23 2.30 0.36 8.82 5.89 090 11471 A Removal, sweat gland lesion 4.38 6.96 2.82 0.48 11.82 7.68 090 11600 A Exc tr-ext mlg+marg 0.5 < cm 1.30 2.70 0.99 0.11 4.11 2.40 010 11601 A Exc tr-ext mlg+marg 0.6-1 cm 1.79 2.76 1.24 0.14 4.69 3.17 010 11602 A Exc tr-ext mlg+marg 1.1-2 cm 1.94 2.90 1.29 0.16 5.00 3.39 010 11603 A Exc tr-ext mlg+marg 2.1-3 cm 2.18 3.15 1.35 0.19 5.52 3.72 010 11604 A Exc tr-ext mlg+marg 3.1-4 cm 2.39 3.46 1.42 0.22 6.07 4.03 010 11606 A Exc tr-ext mlg+marg > 4 cm 3.41 4.16 1.77 0.34 7.91 5.52 010 11620 A Exc h-f-nk-sp mlg+marg 0.5 < 1.18 2.66 0.97 0.11 3.95 2.26 010 11621 A Exc h-f-nk-sp mlg+marg 0.6-1 1.75 2.77 1.26 0.14 4.66 3.15 010 11622 A Exc h-f-nk-sp mlg+marg 1.1-2 2.08 3.04 1.41 0.18 5.30 3.67 010 11623 A Exc h-f-nk-sp mlg+marg 2.1-3 2.60 3.41 1.61 0.24 6.25 4.45 010 11624 A Exc h-f-nk-sp mlg+marg 3.1-4 3.04 3.83 1.80 0.30 7.17 5.14 010 11626 A Exc h-f-nk-sp mlg+mar > 4 cm 4.28 4.74 2.43 0.42 9.44 7.13 010 11640 A Exc face-mm malig+marg 0.5 < 1.34 2.73 1.13 0.12 4.19 2.59 010 11641 A Exc face-mm malig+marg 0.6-1 2.15 3.10 1.55 0.18 5.43 3.88 010 11642 A Exc face-mm malig+marg 1.1-2 2.58 3.48 1.75 0.22 6.28 4.55 010 11643 A Exc face-mm malig+marg 2.1-3 3.08 3.89 1.98 0.29 7.26 5.35 010 11644 A Exc face-mm malig+marg 3.1-4 4.01 4.79 2.49 0.40 9.20 6.90 010 11646 A Exc face-mm mlg+marg > 4 cm 5.92 5.87 3.53 0.55 12.34 10.00 010 11719 R Trim nail(s) 0.17 0.25 0.07 0.01 0.43 0.25 000 11720 A Debride nail, 1-5 0.32 0.34 0.13 0.02 0.68 0.47 000 11721 A Debride nail, 6 or more 0.54 0.44 0.21 0.05 1.03 0.80 000 11730 A Removal of nail plate 1.12 1.03 0.44 0.11 2.26 1.67 000 11732 A Remove nail plate, add-on 0.57 0.45 0.23 0.06 1.08 0.86 ZZZ 11740 A Drain blood from under nail 0.37 0.86 0.14 0.04 1.27 0.55 000 11750 A Removal of nail bed 1.85 2.15 1.75 0.19 4.19 3.79 010 11752 A Remove nail bed/finger tip 2.65 2.99 2.99 0.40 6.04 6.04 010 11755 A Biopsy, nail unit 1.30 1.10 0.56 0.07 2.47 1.93 000 11760 A Repair of nail bed 1.57 1.86 1.23 0.20 3.63 3.00 010 11762 A Reconstruction of nail bed 2.87 2.29 1.85 0.38 5.54 5.10 010 11765 A Excision of nail fold, toe 0.69 1.16 0.53 0.06 1.91 1.28 010 11770 A Removal of pilonidal lesion 2.60 3.58 1.53 0.29 6.47 4.42 010 11771 A Removal of pilonidal lesion 5.71 5.79 3.36 0.67 12.17 9.74 090 11772 A Removal of pilonidal lesion 6.94 7.27 3.90 0.82 15.03 11.66 090 11900 A Injection into skin lesions 0.52 0.66 0.22 0.02 1.20 0.76 000 11901 A Added skin lesions injection 0.80 0.67 0.36 0.04 1.51 1.20 000 11920 R Correct skin color defects 1.60 2.01 0.78 0.20 3.81 2.58 000 11921 R Correct skin color defects 1.92 2.38 0.98 0.25 4.55 3.15 000 11922 R Correct skin color defects 0.49 0.38 0.25 0.06 0.93 0.80 ZZZ 11950 R Therapy for contour defects 0.84 1.17 0.42 0.07 2.08 1.33 000 11951 R Therapy for contour defects 1.18 1.51 0.52 0.12 2.81 1.82 000 11952 R Therapy for contour defects 1.68 1.89 0.69 0.20 3.77 2.57 000 11954 R Therapy for contour defects 1.84 2.46 0.91 0.23 4.53 2.98 000 11960 A Insert tissue expander(s) 9.03 NA 10.65 1.05 NA 20.73 090 11970 A Replace tissue expander 7.02 NA 6.16 0.92 NA 14.10 090 11971 A Remove tissue expander(s) 2.12 7.20 4.81 0.25 9.57 7.18 090 11975 N Insert contraceptive cap +1.47 1.43 0.58 0.17 3.07 2.22 XXX 11976 R Removal of contraceptive cap 1.77 1.72 0.69 0.20 3.69 2.66 000 11977 N Removal/reinsert contra cap +3.28 2.28 1.27 0.37 5.93 4.92 XXX 11980 A Implant hormone pellet(s) 1.47 1.11 0.56 0.12 2.70 2.15 000 11981 A Insert drug implant device 1.47 1.76 0.69 0.17 3.40 2.33 XXX Start Printed Page 63265 11982 A Remove drug implant device 1.77 1.99 0.85 0.20 3.96 2.82 XXX 11983 A Remove/insert drug implant 3.28 2.34 1.49 0.37 5.99 5.14 XXX 12001 A Repair superficial wound(s) 1.69 2.04 0.50 0.16 3.89 2.35 010 12002 A Repair superficial wound(s) 1.85 2.10 0.95 0.18 4.13 2.98 010 12004 A Repair superficial wound(s) 2.23 2.40 1.06 0.20 4.83 3.49 010 12005 A Repair superficial wound(s) 2.84 2.90 1.25 0.28 6.02 4.37 010 12006 A Repair superficial wound(s) 3.65 3.48 1.56 0.37 7.50 5.58 010 12007 A Repair superficial wound(s) 4.10 3.91 1.86 0.44 8.45 6.40 010 12011 A Repair superficial wound(s) 1.75 2.20 0.51 0.17 4.12 2.43 010 12013 A Repair superficial wound(s) 1.98 2.35 0.98 0.19 4.52 3.15 010 12014 A Repair superficial wound(s) 2.45 2.65 1.11 0.22 5.32 3.78 010 12015 A Repair superficial wound(s) 3.17 3.23 1.30 0.29 6.69 4.76 010 12016 A Repair superficial wound(s) 3.91 3.65 1.58 0.38 7.94 5.87 010 12017 A Repair superficial wound(s) 4.68 NA 1.93 0.47 NA 7.08 010 12018 A Repair superficial wound(s) 5.50 NA 2.30 0.55 NA 8.35 010 12020 A Closure of split wound 2.61 2.70 1.77 0.29 5.60 4.67 010 12021 A Closure of split wound 1.83 1.77 1.42 0.23 3.83 3.48 010 12031 A Layer closure of wound(s) 2.14 2.33 0.82 0.18 4.65 3.14 010 12032 A Layer closure of wound(s) 2.46 3.93 1.86 0.18 6.57 4.50 010 12034 A Layer closure of wound(s) 2.90 3.21 1.43 0.25 6.36 4.58 010 12035 A Layer closure of wound(s) 3.41 5.34 2.21 0.36 9.11 5.98 010 12036 A Layer closure of wound(s) 4.03 5.43 2.41 0.49 9.95 6.93 010 12037 A Layer closure of wound(s) 4.64 6.52 2.81 0.59 11.75 8.04 010 12041 A Layer closure of wound(s) 2.36 2.50 0.87 0.20 5.06 3.43 010 12042 A Layer closure of wound(s) 2.72 3.24 1.39 0.20 6.16 4.31 010 12044 A Layer closure of wound(s) 3.12 3.24 1.58 0.29 6.65 4.99 010 12045 A Layer closure of wound(s) 3.62 3.72 2.20 0.41 7.75 6.23 010 12046 A Layer closure of wound(s) 4.23 6.68 2.80 0.48 11.39 7.51 010 12047 A Layer closure of wound(s) 4.62 6.54 3.13 0.49 11.65 8.24 010 12051 A Layer closure of wound(s) 2.46 3.26 1.38 0.19 5.91 4.03 010 12052 A Layer closure of wound(s) 2.75 3.21 1.36 0.20 6.16 4.31 010 12053 A Layer closure of wound(s) 3.10 3.25 1.52 0.24 6.59 4.86 010 12054 A Layer closure of wound(s) 3.44 3.59 1.62 0.30 7.33 5.36 010 12055 A Layer closure of wound(s) 4.40 4.59 2.16 0.42 9.41 6.98 010 12056 A Layer closure of wound(s) 5.21 6.85 3.11 0.52 12.58 8.84 010 12057 A Layer closure of wound(s) 5.93 6.18 3.80 0.60 12.71 10.33 010 13100 A Repair of wound or lesion 3.10 3.55 1.80 0.25 6.90 5.15 010 13101 A Repair of wound or lesion 3.90 3.79 2.24 0.26 7.95 6.40 010 13102 A Repair wound/lesion add-on 1.23 0.74 0.58 0.12 2.09 1.93 ZZZ 13120 A Repair of wound or lesion 3.28 3.65 1.84 0.28 7.21 5.40 010 13121 A Repair of wound or lesion 4.31 4.01 2.34 0.30 8.62 6.95 010 13122 A Repair wound/lesion add-on 1.43 0.87 0.64 0.14 2.44 2.21 ZZZ 13131 A Repair of wound or lesion 3.77 3.92 2.16 0.30 7.99 6.23 010 13132 A Repair of wound or lesion 5.92 4.73 3.21 0.38 11.03 9.51 010 13133 A Repair wound/lesion add-on 2.18 1.21 1.04 0.20 3.59 3.42 ZZZ 13150 A Repair of wound or lesion 3.79 5.56 2.63 0.35 9.70 6.77 010 13151 A Repair of wound or lesion 4.42 5.46 3.07 0.34 10.22 7.83 010 13152 A Repair of wound or lesion 6.29 6.14 3.97 0.46 12.89 10.72 010 13153 A Repair wound/lesion add-on 2.37 1.36 1.15 0.22 3.95 3.74 ZZZ 13160 A Late closure of wound 10.42 NA 7.19 1.43 NA 19.04 090 14000 A Skin tissue rearrangement 5.86 8.61 5.18 0.55 15.02 11.59 090 14001 A Skin tissue rearrangement 8.42 10.06 6.66 0.78 19.26 15.86 090 14020 A Skin tissue rearrangement 6.55 9.27 6.05 0.60 16.42 13.20 090 14021 A Skin tissue rearrangement 10.00 10.56 7.82 0.83 21.39 18.65 090 14040 A Skin tissue rearrangement 7.83 8.35 6.94 0.66 16.84 15.43 090 14041 A Skin tissue rearrangement 11.42 10.76 8.78 0.85 23.03 21.05 090 14060 A Skin tissue rearrangement 8.45 9.18 7.77 0.71 18.34 16.93 090 14061 A Skin tissue rearrangement 12.22 11.79 9.62 0.90 24.91 22.74 090 14300 A Skin tissue rearrangement 11.69 11.31 9.27 1.05 24.05 22.01 090 14350 A Skin tissue rearrangement 9.56 NA 7.20 1.31 NA 18.07 090 15000 A Skin graft 3.98 3.85 2.22 0.44 8.27 6.64 000 15001 A Skin graft add-on 0.99 1.38 0.42 0.13 2.50 1.54 ZZZ 15050 A Skin pinch graft 4.28 6.03 4.78 0.55 10.86 9.61 090 15100 A Skin split graft 9.00 12.77 7.88 1.13 22.90 18.01 090 15101 A Skin split graft add-on 1.71 3.88 1.68 0.22 5.81 3.61 ZZZ 15120 A Skin split graft 9.77 10.90 7.86 1.08 21.75 18.71 090 15121 A Skin split graft add-on 2.65 4.63 1.90 0.32 7.60 4.87 ZZZ 15200 A Skin full graft 7.98 10.83 6.06 0.87 19.68 14.91 090 15201 A Skin full graft add-on 1.31 1.05 0.63 0.17 2.53 2.11 ZZZ 15220 A Skin full graft 7.83 10.71 6.51 0.82 19.36 15.16 090 15221 A Skin full graft add-on 1.18 0.91 0.58 0.14 2.23 1.90 ZZZ 15240 A Skin full graft 8.99 10.27 7.73 0.96 20.22 17.68 090 15241 A Skin full graft add-on 1.85 1.46 0.92 0.20 3.51 2.97 ZZZ 15260 A Skin full graft 10.00 9.98 8.70 0.76 20.74 19.46 090 15261 A Skin full graft add-on 2.22 2.75 1.44 0.20 5.17 3.86 ZZZ Start Printed Page 63266 15342 A Cultured skin graft, 25 cm 0.99 1.84 0.56 0.11 2.94 1.66 010 15343 A Culture skn graft addl 25 cm 0.25 0.27 0.10 0.02 0.54 0.37 ZZZ 15350 A Skin homograft 3.98 8.31 4.88 0.50 12.79 9.36 090 15351 A Skin homograft add-on 0.99 0.95 0.40 0.13 2.07 1.52 ZZZ 15400 A Skin heterograft 3.98 4.21 4.13 0.48 8.67 8.59 090 15401 A Skin heterograft add-on 0.99 1.23 0.45 0.13 2.35 1.57 ZZZ 15570 A Form skin pedicle flap 9.16 9.27 6.74 1.15 19.58 17.05 090 15572 A Form skin pedicle flap 9.22 8.48 6.32 1.11 18.81 16.65 090 15574 A Form skin pedicle flap 9.82 8.89 7.02 1.10 19.81 17.94 090 15576 A Form skin pedicle flap 8.64 9.51 6.49 0.86 19.01 15.99 090 15600 A Skin graft 1.90 7.17 2.73 0.23 9.30 4.86 090 15610 A Skin graft 2.41 3.78 3.07 0.30 6.49 5.78 090 15620 A Skin graft 2.92 7.54 3.71 0.34 10.80 6.97 090 15630 A Skin graft 3.25 6.92 3.98 0.34 10.51 7.57 090 15650 A Transfer skin pedicle flap 3.95 6.79 4.06 0.43 11.17 8.44 090 15732 A Muscle-skin graft, head/neck 17.74 18.24 12.34 1.80 37.78 31.88 090 15734 A Muscle-skin graft, trunk 17.69 18.13 12.44 2.29 38.11 32.42 090 15736 A Muscle-skin graft, arm 16.18 18.35 11.33 2.13 36.66 29.64 090 15738 A Muscle-skin graft, leg 17.82 18.14 11.86 2.34 38.30 32.02 090 15740 A Island pedicle flap graft 10.19 9.92 7.97 0.74 20.85 18.90 090 15750 A Neurovascular pedicle graft 11.34 NA 9.09 1.39 NA 21.82 090 15756 A Free myo/skin flap microvasc 35.03 NA 20.93 3.73 NA 59.69 090 15757 A Free skin flap, microvasc 35.03 NA 21.96 4.04 NA 61.03 090 15758 A Free fascial flap, microvasc 34.90 NA 21.95 4.22 NA 61.07 090 15760 A Composite skin graft 8.69 9.82 7.09 0.86 19.37 16.64 090 15770 A Derma-fat-fascia graft 7.48 NA 6.77 0.93 NA 15.18 090 15775 R Hair transplant punch grafts 3.94 2.82 1.34 0.52 7.28 5.80 000 15776 R Hair transplant punch grafts 5.51 5.44 2.85 0.72 11.67 9.08 000 15780 A Abrasion treatment of skin 7.25 7.16 7.16 0.49 14.90 14.90 090 15781 A Abrasion treatment of skin 4.82 5.41 5.41 0.32 10.55 10.55 090 15782 A Abrasion treatment of skin 4.30 4.38 4.38 0.25 8.93 8.93 090 15783 A Abrasion treatment of skin 4.27 4.98 4.22 0.31 9.56 8.80 090 15786 A Abrasion, lesion, single 2.02 1.65 1.29 0.13 3.80 3.44 010 15787 A Abrasion, lesions, add-on 0.33 0.32 0.16 0.02 0.67 0.51 ZZZ 15788 R Chemical peel, face, epiderm 2.08 3.38 2.29 0.13 5.59 4.50 090 15789 R Chemical peel, face, dermal 4.89 6.48 5.02 0.32 11.69 10.23 090 15792 R Chemical peel, nonfacial 1.85 3.21 2.79 0.12 5.18 4.76 090 15793 A Chemical peel, nonfacial 3.72 NA 4.20 0.20 NA 8.12 090 15810 A Salabrasion 4.71 3.94 3.94 0.50 9.15 9.15 090 15811 A Salabrasion 5.36 6.37 5.58 0.62 12.35 11.56 090 15819 A Plastic surgery, neck 9.33 NA 7.28 0.92 NA 17.53 090 15820 A Revision of lower eyelid 5.12 6.92 5.40 0.36 12.40 10.88 090 15821 A Revision of lower eyelid 5.69 7.31 5.58 0.37 13.37 11.64 090 15822 A Revision of upper eyelid 4.42 5.87 4.41 0.26 10.55 9.09 090 15823 A Revision of upper eyelid 7.01 7.86 6.29 0.38 15.25 13.68 090 15824 R Removal of forehead wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15825 R Removal of neck wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15826 R Removal of brow wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15828 R Removal of face wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15829 R Removal of skin wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15831 A Excise excessive skin tissue 12.33 NA 8.32 1.56 NA 22.21 090 15832 A Excise excessive skin tissue 11.52 NA 8.46 1.45 NA 21.43 090 15833 A Excise excessive skin tissue 10.58 NA 8.18 1.40 NA 20.16 090 15834 A Excise excessive skin tissue 10.79 NA 7.75 1.41 NA 19.95 090 15835 A Excise excessive skin tissue 11.60 11.58 7.71 1.35 24.53 20.66 090 15836 A Excise excessive skin tissue 9.29 NA 6.88 1.14 NA 17.31 090 15837 A Excise excessive skin tissue 8.38 8.01 7.08 0.93 17.32 16.39 090 15838 A Excise excessive skin tissue 7.09 NA 6.15 0.70 NA 13.94 090 15839 A Excise excessive skin tissue 9.33 7.95 6.27 1.05 18.33 16.65 090 15840 A Graft for face nerve palsy 13.18 NA 10.15 1.38 NA 24.71 090 15841 A Graft for face nerve palsy 23.13 NA 15.24 3.18 NA 41.55 090 15842 A Flap for face nerve palsy 37.74 NA 23.29 4.78 NA 65.81 090 15845 A Skin and muscle repair, face 12.50 NA 9.47 0.96 NA 22.93 090 15850 B Removal of sutures +0.78 1.61 0.30 0.05 2.44 1.13 XXX 15851 A Removal of sutures 0.86 1.75 0.34 0.06 2.67 1.26 000 15852 A Dressing change not for burn 0.86 1.88 0.36 0.08 2.82 1.30 000 15860 A Test for blood flow in graft 1.94 1.29 0.79 0.16 3.39 2.89 000 15876 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15877 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15878 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15879 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15920 A Removal of tail bone ulcer 7.90 NA 5.66 0.99 NA 14.55 090 15922 A Removal of tail bone ulcer 9.84 NA 7.39 1.27 NA 18.50 090 15931 A Remove sacrum pressure sore 9.19 NA 5.80 1.14 NA 16.13 090 15933 A Remove sacrum pressure sore 10.79 NA 8.03 1.37 NA 20.19 090 Start Printed Page 63267 15934 A Remove sacrum pressure sore 12.62 NA 8.24 1.62 NA 22.48 090 15935 A Remove sacrum pressure sore 14.49 NA 10.52 1.87 NA 26.88 090 15936 A Remove sacrum pressure sore 12.31 NA 8.44 1.58 NA 22.33 090 15937 A Remove sacrum pressure sore 14.13 NA 10.06 1.81 NA 26.00 090 15940 A Remove hip pressure sore 9.29 NA 6.29 1.17 NA 16.75 090 15941 A Remove hip pressure sore 11.36 NA 9.68 1.47 NA 22.51 090 15944 A Remove hip pressure sore 11.39 NA 8.80 1.45 NA 21.64 090 15945 A Remove hip pressure sore 12.62 NA 9.84 1.65 NA 24.11 090 15946 A Remove hip pressure sore 21.45 NA 14.57 2.78 NA 38.80 090 15950 A Remove thigh pressure sore 7.50 NA 5.52 0.96 NA 13.98 090 15951 A Remove thigh pressure sore 10.66 NA 8.04 1.37 NA 20.07 090 15952 A Remove thigh pressure sore 11.33 NA 7.91 1.43 NA 20.67 090 15953 A Remove thigh pressure sore 12.56 NA 9.16 1.65 NA 23.37 090 15956 A Remove thigh pressure sore 15.43 NA 10.95 1.97 NA 28.35 090 15958 A Remove thigh pressure sore 15.39 NA 11.24 1.99 NA 28.62 090 15999 C Removal of pressure sore 0.00 0.00 0.00 0.00 0.00 0.00 YYY 16000 A Initial treatment of burn(s) 0.88 0.87 0.27 0.07 1.82 1.22 000 16010 A Treatment of burn(s) 0.87 0.67 0.64 0.08 1.62 1.59 000 16015 A Treatment of burn(s) 2.34 NA 1.17 0.26 NA 3.77 000 16020 A Treatment of burn(s) 0.80 1.30 0.62 0.07 2.17 1.49 000 16025 A Treatment of burn(s) 1.84 1.82 0.98 0.19 3.85 3.01 000 16030 A Treatment of burn(s) 2.07 2.23 1.14 0.22 4.52 3.43 000 16035 A Incision of burn scab, initi 3.73 NA 1.48 0.43 NA 5.64 090 16036 A Escharotomy; addl incision 1.49 NA 0.61 0.13 NA 2.23 ZZZ 17000 A Destroy benign/premlg lesion 0.60 0.99 0.32 0.04 1.63 0.96 010 17003 A Destroy lesions, 2-14 0.15 0.11 0.07 0.01 0.27 0.23 ZZZ 17004 A Destroy lesions, 15 or more 2.77 2.34 1.31 0.14 5.25 4.22 010 17106 A Destruction of skin lesions 4.56 4.93 3.37 0.34 9.83 8.27 090 17107 A Destruction of skin lesions 9.11 7.60 5.51 0.64 17.35 15.26 090 17108 A Destruction of skin lesions 13.12 9.72 7.76 1.07 23.91 21.95 090 17110 A Destruct lesion, 1-14 0.65 1.65 0.51 0.05 2.35 1.21 010 17111 A Destruct lesion, 15 or more 0.91 1.71 0.61 0.05 2.67 1.57 010 17250 A Chemical cautery, tissue 0.50 1.25 0.36 0.05 1.80 0.91 000 17260 A Destruction of skin lesions 0.90 1.30 0.46 0.05 2.25 1.41 010 17261 A Destruction of skin lesions 1.16 1.64 0.60 0.06 2.86 1.82 010 17262 A Destruction of skin lesions 1.57 1.92 0.79 0.08 3.57 2.44 010 17263 A Destruction of skin lesions 1.78 2.09 0.86 0.10 3.97 2.74 010 17264 A Destruction of skin lesions 1.93 2.26 0.89 0.10 4.29 2.92 010 17266 A Destruction of skin lesions 2.33 2.55 1.00 0.13 5.01 3.46 010 17270 A Destruction of skin lesions 1.31 1.74 0.64 0.07 3.12 2.02 010 17271 A Destruction of skin lesions 1.48 1.81 0.75 0.07 3.36 2.30 010 17272 A Destruction of skin lesions 1.76 2.02 0.88 0.08 3.86 2.72 010 17273 A Destruction of skin lesions 2.04 2.24 0.99 0.11 4.39 3.14 010 17274 A Destruction of skin lesions 2.58 2.60 1.22 0.13 5.31 3.93 010 17276 A Destruction of skin lesions 3.18 3.00 1.46 0.18 6.36 4.82 010 17280 A Destruction of skin lesions 1.16 1.64 0.58 0.06 2.86 1.80 010 17281 A Destruction of skin lesions 1.71 1.93 0.86 0.08 3.72 2.65 010 17282 A Destruction of skin lesions 2.03 2.19 1.02 0.11 4.33 3.16 010 17283 A Destruction of skin lesions 2.62 2.59 1.27 0.13 5.34 4.02 010 17284 A Destruction of skin lesions 3.19 2.98 1.53 0.17 6.34 4.89 010 17286 A Destruction of skin lesions 4.41 3.75 2.21 0.26 8.42 6.88 010 17304 A 1 stage mohs, up to 5 spec 7.56 8.19 3.61 0.37 16.12 11.54 000 17305 A 2 stage mohs, up to 5 spec 2.83 3.86 1.36 0.14 6.83 4.33 000 17306 A 3 stage mohs, up to 5 spec 2.83 3.88 1.37 0.14 6.85 4.34 000 17307 A Mohs addl stage up to 5 spec 2.83 3.82 1.38 0.14 6.79 4.35 000 17310 A Mohs any stage > 5 spec each 0.62 1.50 0.31 0.06 2.18 0.99 ZZZ 17340 A Cryotherapy of skin 0.76 0.38 0.31 0.05 1.19 1.12 010 17360 A Skin peel therapy 1.42 1.48 0.75 0.07 2.97 2.24 010 17380 R Hair removal by electrolysis 0.00 0.00 0.00 0.00 0.00 0.00 000 17999 C Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 19000 A Drainage of breast lesion 0.84 2.05 0.36 0.08 2.97 1.28 000 19001 A Drain breast lesion add-on 0.42 0.80 0.14 0.04 1.26 0.60 ZZZ 19020 A Incision of breast lesion 3.55 6.08 2.81 0.42 10.05 6.78 090 19030 A Injection for breast x-ray 1.52 3.37 0.51 0.08 4.97 2.11 000 19100 A Bx breast percut w/o image 1.26 2.17 0.43 0.12 3.55 1.81 000 19101 A Biopsy of breast, open 3.16 4.72 1.70 0.24 8.12 5.10 010 19102 A Bx breast percut w/image 1.99 4.01 0.66 0.16 6.16 2.81 000 19103 A Bx breast percut w/device 3.68 12.14 1.25 0.19 16.01 5.12 000 19110 A Nipple exploration 4.28 5.90 3.10 0.53 10.71 7.91 090 19112 A Excise breast duct fistula 3.65 5.93 2.72 0.46 10.04 6.83 090 19120 A Removal of breast lesion 5.53 4.63 3.11 0.67 10.83 9.31 090 19125 A Excision, breast lesion 6.03 4.89 3.33 0.73 11.65 10.09 090 19126 A Excision, addl breast lesion 2.91 NA 1.01 0.36 NA 4.28 ZZZ 19140 A Removal of breast tissue 5.11 7.37 3.46 0.62 13.10 9.19 090 19160 A Removal of breast tissue 5.96 NA 3.49 0.73 NA 10.18 090 Start Printed Page 63268 19162 A Remove breast tissue, nodes 13.45 NA 6.45 1.65 NA 21.55 090 19180 A Removal of breast 8.75 NA 5.13 1.05 NA 14.93 090 19182 A Removal of breast 7.69 NA 4.85 0.95 NA 13.49 090 19200 A Removal of breast 15.40 NA 8.12 1.81 NA 25.33 090 19220 A Removal of breast 15.63 NA 8.38 1.87 NA 25.88 090 19240 A Removal of breast 15.91 NA 8.37 1.94 NA 26.22 090 19260 A Removal of chest wall lesion 15.35 NA 11.13 1.97 NA 28.45 090 19271 A Revision of chest wall 18.79 NA 17.58 2.72 NA 39.09 090 19272 A Extensive chest wall surgery 21.43 NA 18.37 3.04 NA 42.84 090 19290 A Place needle wire, breast 1.26 3.02 0.43 0.07 4.35 1.76 000 19291 A Place needle wire, breast 0.63 1.75 0.21 0.04 2.42 0.88 ZZZ 19295 A Place breast clip, percut 0.00 2.81 NA 0.01 2.82 NA ZZZ 19316 A Suspension of breast 10.63 NA 7.67 1.38 NA 19.68 090 19318 A Reduction of large breast 15.53 NA 11.32 2.03 NA 28.88 090 19324 A Enlarge breast 5.82 NA 4.98 0.76 NA 11.56 090 19325 A Enlarge breast with implant 8.40 NA 6.67 1.08 NA 16.15 090 19328 A Removal of breast implant 5.65 NA 5.13 0.73 NA 11.51 090 19330 A Removal of implant material 7.55 NA 6.13 0.97 NA 14.65 090 19340 A Immediate breast prosthesis 6.29 NA 3.16 0.82 NA 10.27 ZZZ 19342 A Delayed breast prosthesis 11.14 NA 9.07 1.45 NA 21.66 090 19350 A Breast reconstruction 8.87 14.35 7.19 1.14 24.36 17.20 090 19355 A Correct inverted nipple(s) 7.53 12.94 5.07 0.96 21.43 13.56 090 19357 A Breast reconstruction 18.06 NA 14.01 2.35 NA 34.42 090 19361 A Breast reconstruction 19.15 NA 11.91 2.49 NA 33.55 090 19364 A Breast reconstruction 40.77 NA 23.88 4.69 NA 69.34 090 19366 A Breast reconstruction 21.16 NA 11.35 2.72 NA 35.23 090 19367 A Breast reconstruction 25.58 NA 16.74 3.33 NA 45.65 090 19368 A Breast reconstruction 32.24 NA 20.48 4.21 NA 56.93 090 19369 A Breast reconstruction 29.65 NA 19.99 3.88 NA 53.52 090 19370 A Surgery of breast capsule 8.00 NA 7.03 1.03 NA 16.06 090 19371 A Removal of breast capsule 9.30 NA 7.96 1.21 NA 18.47 090 19380 A Revise breast reconstruction 9.09 NA 7.84 1.17 NA 18.10 090 19396 A Design custom breast implant 2.16 5.84 1.00 0.28 8.28 3.44 000 19499 C Breast surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 20000 A Incision of abscess 2.11 2.38 1.63 0.20 4.69 3.94 010 20005 A Incision of deep abscess 3.40 3.37 2.14 0.41 7.18 5.95 010 20100 A Explore wound, neck 10.02 5.86 4.42 1.19 17.07 15.63 010 20101 A Explore wound, chest 3.20 2.99 1.61 0.29 6.48 5.10 010 20102 A Explore wound, abdomen 3.92 3.56 1.82 0.42 7.90 6.16 010 20103 A Explore wound, extremity 5.27 4.19 3.25 0.68 10.14 9.20 010 20150 A Excise epiphyseal bar 13.61 NA 7.30 1.15 NA 22.06 090 20200 A Muscle biopsy 1.45 3.17 0.79 0.20 4.82 2.44 000 20205 A Deep muscle biopsy 2.34 4.19 1.22 0.28 6.81 3.84 000 20206 A Needle biopsy, muscle 0.98 3.21 0.35 0.07 4.26 1.40 000 20220 A Bone biopsy, trocar/needle 1.26 4.80 2.82 0.07 6.13 4.15 000 20225 A Bone biopsy, trocar/needle 1.86 4.38 2.99 0.13 6.37 4.98 000 20240 A Bone biopsy, excisional 3.21 NA 2.54 0.40 NA 6.15 010 20245 A Bone biopsy, excisional 7.74 NA 6.33 0.53 NA 14.60 010 20250 A Open bone biopsy 5.00 NA 4.59 0.60 NA 10.19 010 20251 A Open bone biopsy 5.53 NA 5.24 0.95 NA 11.72 010 20500 A Injection of sinus tract 1.22 6.00 3.94 0.12 7.34 5.28 010 20501 A Inject sinus tract for x-ray 0.76 3.02 0.25 0.04 3.82 1.05 000 20520 A Removal of foreign body 1.84 2.28 1.83 0.20 4.32 3.87 010 20525 A Removal of foreign body 3.48 3.43 2.69 0.48 7.39 6.65 010 20526 A Ther injection, carp tunnel 0.93 0.97 0.52 0.07 1.97 1.52 000 20550 A Inj tendon sheath/ligament 0.75 0.72 0.24 0.07 1.54 1.06 000 20551 A Inj tendon origin/insertion 0.75 0.69 0.34 0.07 1.51 1.16 000 20552 A Inj trigger point, 1/2 muscl 0.66 0.74 0.21 0.07 1.47 0.94 000 20553 A Inject trigger points, =/> 3 0.75 0.85 0.23 0.07 1.67 1.05 000 20600 A Drain/inject, joint/bursa 0.66 0.65 0.36 0.07 1.38 1.09 000 20605 A Drain/inject, joint/bursa 0.68 0.76 0.37 0.07 1.51 1.12 000 20610 A Drain/inject, joint/bursa 0.79 0.95 0.43 0.10 1.84 1.32 000 20612 A Aspirate/inj ganglion cyst 0.70 0.72 0.34 0.07 1.49 1.11 000 20615 A Treatment of bone cyst 2.27 2.57 1.85 0.23 5.07 4.35 010 20650 A Insert and remove bone pin 2.22 2.44 1.96 0.34 5.00 4.52 010 20660 A Apply, rem fixation device 2.50 3.11 1.72 0.58 6.19 4.80 000 20661 A Application of head brace 4.86 NA 5.03 1.10 NA 10.99 090 20662 A Application of pelvis brace 6.04 NA 5.51 0.97 NA 12.52 090 20663 A Application of thigh brace 5.40 NA 4.82 0.92 NA 11.14 090 20664 A Halo brace application 8.01 NA 7.12 1.79 NA 16.92 090 20665 A Removal of fixation device 1.30 2.09 1.33 0.20 3.59 2.83 010 20670 A Removal of support implant 1.73 6.77 3.95 0.28 8.78 5.96 010 20680 A Removal of support implant 3.33 3.24 3.24 0.55 7.12 7.12 090 20690 A Apply bone fixation device 3.50 NA 2.49 0.56 NA 6.55 090 20692 A Apply bone fixation device 6.37 NA 3.78 0.72 NA 10.87 090 Start Printed Page 63269 20693 A Adjust bone fixation device 5.83 NA 5.59 1.02 NA 12.44 090 20694 A Remove bone fixation device 4.14 6.94 4.53 0.68 11.76 9.35 090 20802 A Replantation, arm, complete 40.92 NA 21.66 6.96 NA 69.54 090 20805 A Replant forearm, complete 49.72 NA 35.31 4.73 NA 89.76 090 20808 A Replantation hand, complete 61.30 NA 43.88 7.78 NA 112.96 090 20816 A Replantation digit, complete 30.76 NA 39.66 3.61 NA 74.03 090 20822 A Replantation digit, complete 25.44 NA 36.34 3.68 NA 65.46 090 20824 A Replantation thumb, complete 30.76 NA 38.52 4.17 NA 73.45 090 20827 A Replantation thumb, complete 26.26 NA 38.35 3.85 NA 68.46 090 20838 A Replantation foot, complete 41.17 NA 22.95 7.01 NA 71.13 090 20900 A Removal of bone for graft 5.55 7.42 5.85 0.92 13.89 12.32 090 20902 A Removal of bone for graft 7.51 NA 6.94 1.27 NA 15.72 090 20910 A Remove cartilage for graft 5.31 7.21 5.49 0.60 13.12 11.40 090 20912 A Remove cartilage for graft 6.31 NA 6.15 0.66 NA 13.12 090 20920 A Removal of fascia for graft 5.28 NA 4.45 0.65 NA 10.38 090 20922 A Removal of fascia for graft 6.57 6.83 5.13 1.05 14.45 12.75 090 20924 A Removal of tendon for graft 6.44 NA 5.98 0.98 NA 13.40 090 20926 A Removal of tissue for graft 5.50 NA 4.99 0.87 NA 11.36 090 20930 B Spinal bone allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20931 A Spinal bone allograft 1.80 NA 0.94 0.41 NA 3.15 ZZZ 20936 B Spinal bone autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20937 A Spinal bone autograft 2.77 NA 1.47 0.52 NA 4.76 ZZZ 20938 A Spinal bone autograft 3.00 NA 1.58 0.62 NA 5.20 ZZZ 20950 A Fluid pressure, muscle 1.25 1.38 1.01 0.19 2.82 2.45 000 20955 A Fibula bone graft, microvasc 38.99 NA 25.26 5.21 NA 69.46 090 20956 A Iliac bone graft, microvasc 39.05 NA 25.12 6.92 NA 71.09 090 20957 A Mt bone graft, microvasc 40.42 NA 19.28 6.88 NA 66.58 090 20962 A Other bone graft, microvasc 39.05 NA 26.68 6.22 NA 71.95 090 20969 A Bone/skin graft, microvasc 43.67 NA 27.76 5.20 NA 76.63 090 20970 A Bone/skin graft, iliac crest 42.81 NA 26.14 5.56 NA 74.51 090 20972 A Bone/skin graft, metatarsal 42.74 22.01 20.35 7.28 72.03 70.37 090 20973 A Bone/skin graft, great toe 45.50 NA 25.54 5.57 NA 76.61 090 20974 A Electrical bone stimulation 0.62 0.63 0.56 0.11 1.36 1.29 000 20975 A Electrical bone stimulation 2.59 NA 1.75 0.50 NA 4.84 000 20979 A Us bone stimulation 0.62 0.78 0.34 0.05 1.45 1.01 000 20982 A Ablate, bone tumor(s) perq 7.24 106.25 3.02 0.68 114.17 10.94 000 20999 C Musculoskeletal surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21010 A Incision of jaw joint 10.08 NA 7.33 0.65 NA 18.06 090 21015 A Resection of facial tumor 5.26 NA 5.59 0.62 NA 11.47 090 21025 A Excision of bone, lower jaw 10.00 10.33 8.32 0.95 21.28 19.27 090 21026 A Excision of facial bone(s) 4.82 7.03 5.59 0.48 12.33 10.89 090 21029 A Contour of face bone lesion 7.67 8.70 6.33 0.89 17.26 14.89 090 21030 A Excise max/zygoma b9 tumor 3.87 6.57 4.05 0.72 11.16 8.64 090 21031 A Remove exostosis, mandible 3.22 4.64 3.18 0.34 8.20 6.74 090 21032 A Remove exostosis, maxilla 3.22 4.68 3.29 0.32 8.22 6.83 090 21034 A Excise max/zygoma mlg tumor 16.08 13.73 11.44 1.64 31.45 29.16 090 21040 A Excise mandible lesion 3.87 6.61 3.88 0.23 10.71 7.98 090 21044 A Removal of jaw bone lesion 11.79 NA 8.80 1.04 NA 21.63 090 21045 A Extensive jaw surgery 16.08 NA 11.56 1.44 NA 29.08 090 21046 A Remove mandible cyst complex 12.93 NA 12.85 1.21 NA 26.99 090 21047 A Excise lwr jaw cyst w/repair 18.64 NA 13.60 1.83 NA 34.07 090 21048 A Remove maxilla cyst complex 13.42 NA 13.13 1.21 NA 27.76 090 21049 A Excis uppr jaw cyst w/repair 17.90 NA 13.19 1.21 NA 32.30 090 21050 A Removal of jaw joint 10.71 NA 10.40 1.01 NA 22.12 090 21060 A Remove jaw joint cartilage 10.17 NA 9.92 1.39 NA 21.48 090 21070 A Remove coronoid process 8.15 NA 7.11 0.80 NA 16.06 090 21076 A Prepare face/oral prosthesis 13.34 12.86 10.30 1.63 27.83 25.27 010 21077 A Prepare face/oral prosthesis 33.56 32.61 26.51 4.11 70.28 64.18 090 21079 A Prepare face/oral prosthesis 22.21 22.50 17.70 1.91 46.62 41.82 090 21080 A Prepare face/oral prosthesis 24.96 25.54 20.02 3.06 53.56 48.04 090 21081 A Prepare face/oral prosthesis 22.75 23.24 18.01 2.24 48.23 43.00 090 21082 A Prepare face/oral prosthesis 20.75 20.13 16.18 1.75 42.63 38.68 090 21083 A Prepare face/oral prosthesis 19.19 19.60 14.91 2.35 41.14 36.45 090 21084 A Prepare face/oral prosthesis 22.38 22.97 17.87 1.88 47.23 42.13 090 21085 A Prepare face/oral prosthesis 8.95 8.62 6.97 0.78 18.35 16.70 010 21086 A Prepare face/oral prosthesis 24.78 24.61 19.86 2.23 51.62 46.87 090 21087 A Prepare face/oral prosthesis 24.78 24.19 19.66 2.66 51.63 47.10 090 21088 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21089 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21100 A Maxillofacial fixation 4.20 5.71 4.68 0.22 10.13 9.10 090 21110 A Interdental fixation 5.18 7.10 5.74 0.34 12.62 11.26 090 21116 A Injection, jaw joint x-ray 0.81 7.40 0.34 0.06 8.27 1.21 000 21120 A Reconstruction of chin 4.90 8.97 5.36 0.35 14.22 10.61 090 21121 A Reconstruction of chin 7.60 10.56 6.73 0.67 18.83 15.00 090 21122 A Reconstruction of chin 8.47 NA 7.16 0.71 NA 16.34 090 Start Printed Page 63270 21123 A Reconstruction of chin 11.10 NA 8.36 1.39 NA 20.85 090 21125 A Augmentation, lower jaw bone 10.56 11.94 8.38 0.86 23.36 19.80 090 21127 A Augmentation, lower jaw bone 11.06 14.70 9.23 0.91 26.67 21.20 090 21137 A Reduction of forehead 9.76 NA 7.52 0.64 NA 17.92 090 21138 A Reduction of forehead 12.12 NA 9.41 1.76 NA 23.29 090 21139 A Reduction of forehead 14.53 NA 9.88 1.22 NA 25.63 090 21141 A Reconstruct midface, lefort 18.00 NA 14.06 1.95 NA 34.01 090 21142 A Reconstruct midface, lefort 18.70 NA 13.25 1.39 NA 33.34 090 21143 A Reconstruct midface, lefort 19.47 NA 14.29 1.08 NA 34.84 090 21145 A Reconstruct midface, lefort 19.83 NA 14.33 2.51 NA 36.67 090 21146 A Reconstruct midface, lefort 20.59 NA 15.80 2.55 NA 38.94 090 21147 A Reconstruct midface, lefort 21.65 NA 15.47 1.82 NA 38.94 090 21150 A Reconstruct midface, lefort 25.10 NA 14.27 1.31 NA 40.68 090 21151 A Reconstruct midface, lefort 28.14 NA 18.00 2.37 NA 48.51 090 21154 A Reconstruct midface, lefort 30.35 NA 20.41 5.83 NA 56.59 090 21155 A Reconstruct midface, lefort 34.25 NA 22.55 6.57 NA 63.37 090 21159 A Reconstruct midface, lefort 42.14 NA 24.74 8.08 NA 74.96 090 21160 A Reconstruct midface, lefort 46.18 NA 24.69 5.26 NA 76.13 090 21172 A Reconstruct orbit/forehead 27.64 NA 14.22 2.29 NA 44.15 090 21175 A Reconstruct orbit/forehead 32.98 NA 18.51 6.18 NA 57.67 090 21179 A Reconstruct entire forehead 22.12 NA 15.02 2.97 NA 40.11 090 21180 A Reconstruct entire forehead 25.05 NA 16.24 2.58 NA 43.87 090 21181 A Contour cranial bone lesion 9.84 NA 7.61 1.16 NA 18.61 090 21182 A Reconstruct cranial bone 32.01 NA 19.87 3.03 NA 54.91 090 21183 A Reconstruct cranial bone 35.11 NA 21.59 3.30 NA 60.00 090 21184 A Reconstruct cranial bone 38.02 NA 22.79 4.94 NA 65.75 090 21188 A Reconstruction of midface 22.33 NA 15.34 2.22 NA 39.89 090 21193 A Reconst lwr jaw w/o graft 17.05 NA 13.13 1.83 NA 32.01 090 21194 A Reconst lwr jaw w/graft 19.73 NA 14.25 1.67 NA 35.65 090 21195 A Reconst lwr jaw w/o fixation 17.14 NA 13.43 1.44 NA 32.01 090 21196 A Reconst lwr jaw w/fixation 18.80 NA 14.05 1.94 NA 34.79 090 21198 A Reconstr lwr jaw segment 14.08 NA 11.03 1.26 NA 26.37 090 21199 A Reconstr lwr jaw w/advance 15.91 NA 9.29 1.51 NA 26.71 090 21206 A Reconstruct upper jaw bone 14.02 NA 10.95 1.21 NA 26.18 090 21208 A Augmentation of facial bones 10.17 14.68 9.39 1.10 25.95 20.66 090 21209 A Reduction of facial bones 6.68 12.02 7.32 0.72 19.42 14.72 090 21210 A Face bone graft 10.17 13.85 9.53 1.05 25.07 20.75 090 21215 A Lower jaw bone graft 10.71 13.65 9.72 1.25 25.61 21.68 090 21230 A Rib cartilage graft 10.71 NA 8.66 1.15 NA 20.52 090 21235 A Ear cartilage graft 6.68 11.49 7.17 0.62 18.79 14.47 090 21240 A Reconstruction of jaw joint 13.97 NA 12.87 1.38 NA 28.22 090 21242 A Reconstruction of jaw joint 12.88 NA 12.35 1.68 NA 26.91 090 21243 A Reconstruction of jaw joint 20.67 NA 18.10 2.22 NA 40.99 090 21244 A Reconstruction of lower jaw 11.79 NA 10.17 1.14 NA 23.10 090 21245 A Reconstruction of jaw 11.79 16.29 9.83 1.05 29.13 22.67 090 21246 A Reconstruction of jaw 12.40 14.73 9.96 1.45 28.58 23.81 090 21247 A Reconstruct lower jaw bone 22.50 NA 18.15 2.65 NA 43.30 090 21248 A Reconstruction of jaw 11.41 13.18 9.42 1.21 25.80 22.04 090 21249 A Reconstruction of jaw 17.42 16.78 12.81 1.67 35.87 31.90 090 21255 A Reconstruct lower jaw bone 16.62 NA 12.90 1.35 NA 30.87 090 21256 A Reconstruction of orbit 16.10 NA 12.29 1.25 NA 29.64 090 21260 A Revise eye sockets 16.43 NA 9.04 1.50 NA 26.97 090 21261 A Revise eye sockets 31.31 NA 19.43 2.64 NA 53.38 090 21263 A Revise eye sockets 28.26 NA 13.03 2.59 NA 43.88 090 21267 A Revise eye sockets 18.79 NA 13.35 1.62 NA 33.76 090 21268 A Revise eye sockets 24.34 NA 15.50 0.95 NA 40.79 090 21270 A Augmentation, cheek bone 10.17 12.06 8.19 0.87 23.10 19.23 090 21275 A Revision, orbitofacial bones 11.18 NA 8.84 1.23 NA 21.25 090 21280 A Revision of eyelid 6.00 NA 6.13 0.32 NA 12.45 090 21282 A Revision of eyelid 3.47 NA 4.72 0.25 NA 8.44 090 21295 A Revision of jaw muscle/bone 1.52 NA 2.86 0.16 NA 4.54 090 21296 A Revision of jaw muscle/bone 4.23 NA 4.49 0.36 NA 9.08 090 21299 C Cranio/maxillofacial surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21300 A Treatment of skull fracture 0.72 2.43 0.26 0.11 3.26 1.09 000 21310 A Treatment of nose fracture 0.58 2.38 0.15 0.06 3.02 0.79 000 21315 A Treatment of nose fracture 1.50 3.08 1.29 0.14 4.72 2.93 010 21320 A Treatment of nose fracture 1.84 4.30 1.86 0.18 6.32 3.88 010 21325 A Treatment of nose fracture 3.75 NA 3.80 0.37 NA 7.92 090 21330 A Treatment of nose fracture 5.35 NA 5.34 0.58 NA 11.27 090 21335 A Treatment of nose fracture 8.56 NA 6.88 0.77 NA 16.21 090 21336 A Treat nasal septal fracture 5.69 NA 6.14 0.54 NA 12.37 090 21337 A Treat nasal septal fracture 2.68 5.17 3.73 0.26 8.11 6.67 090 21338 A Treat nasoethmoid fracture 6.42 NA 6.04 0.64 NA 13.10 090 21339 A Treat nasoethmoid fracture 8.04 NA 6.83 0.91 NA 15.78 090 21340 A Treatment of nose fracture 10.71 NA 8.80 1.02 NA 20.53 090 Start Printed Page 63271 21343 A Treatment of sinus fracture 12.88 NA 10.26 1.27 NA 24.41 090 21344 A Treatment of sinus fracture 19.61 NA 13.85 2.06 NA 35.52 090 21345 A Treat nose/jaw fracture 8.11 11.68 8.00 0.72 20.51 16.83 090 21346 A Treat nose/jaw fracture 10.55 13.35 9.12 1.02 24.92 20.69 090 21347 A Treat nose/jaw fracture 12.62 NA 9.87 1.37 NA 23.86 090 21348 A Treat nose/jaw fracture 16.59 NA 11.44 1.80 NA 29.83 090 21355 A Treat cheek bone fracture 3.75 4.76 2.40 0.35 8.86 6.50 010 21356 A Treat cheek bone fracture 4.13 11.83 3.25 0.43 16.39 7.81 010 21360 A Treat cheek bone fracture 6.42 14.06 6.26 0.62 21.10 13.30 090 21365 A Treat cheek bone fracture 14.86 NA 11.91 1.56 NA 28.33 090 21366 A Treat cheek bone fracture 17.67 NA 11.78 1.69 NA 31.14 090 21385 A Treat eye socket fracture 9.11 NA 7.14 0.77 NA 17.02 090 21386 A Treat eye socket fracture 9.11 NA 7.56 0.91 NA 17.58 090 21387 A Treat eye socket fracture 9.64 NA 7.62 0.93 NA 18.19 090 21390 A Treat eye socket fracture 10.07 NA 8.11 0.84 NA 19.02 090 21395 A Treat eye socket fracture 12.61 NA 9.43 1.31 NA 23.35 090 21400 A Treat eye socket fracture 1.39 3.77 2.14 0.14 5.30 3.67 090 21401 A Treat eye socket fracture 3.24 5.15 3.91 0.41 8.80 7.56 090 21406 A Treat eye socket fracture 6.97 NA 6.42 0.71 NA 14.10 090 21407 A Treat eye socket fracture 8.56 NA 7.22 0.80 NA 16.58 090 21408 A Treat eye socket fracture 12.31 NA 9.31 1.49 NA 23.11 090 21421 A Treat mouth roof fracture 5.11 10.04 6.23 0.50 15.65 11.84 090 21422 A Treat mouth roof fracture 8.27 11.42 7.18 0.83 20.52 16.28 090 21423 A Treat mouth roof fracture 10.34 NA 8.58 1.14 NA 20.06 090 21431 A Treat craniofacial fracture 7.01 10.79 6.93 0.70 18.50 14.64 090 21432 A Treat craniofacial fracture 8.56 NA 6.24 0.66 NA 15.46 090 21433 A Treat craniofacial fracture 25.21 NA 17.03 2.95 NA 45.19 090 21435 A Treat craniofacial fracture 17.15 NA 13.11 1.99 NA 32.25 090 21436 A Treat craniofacial fracture 27.88 NA 18.63 2.78 NA 49.29 090 21440 A Treat dental ridge fracture 2.68 8.15 4.17 0.26 11.09 7.11 090 21445 A Treat dental ridge fracture 5.35 10.58 6.36 0.66 16.59 12.37 090 21450 A Treat lower jaw fracture 2.95 10.78 3.82 0.28 14.01 7.05 090 21451 A Treat lower jaw fracture 4.84 8.88 5.83 0.47 14.19 11.14 090 21452 A Treat lower jaw fracture 1.97 7.96 3.61 0.17 10.10 5.75 090 21453 A Treat lower jaw fracture 5.51 10.64 6.92 0.59 16.74 13.02 090 21454 A Treat lower jaw fracture 6.42 NA 6.63 0.66 NA 13.71 090 21461 A Treat lower jaw fracture 8.04 12.68 8.39 0.87 21.59 17.30 090 21462 A Treat lower jaw fracture 9.73 14.24 9.13 0.96 24.93 19.82 090 21465 A Treat lower jaw fracture 11.84 NA 10.17 1.01 NA 23.02 090 21470 A Treat lower jaw fracture 15.25 NA 12.39 1.63 NA 29.27 090 21480 A Reset dislocated jaw 0.61 1.98 0.19 0.06 2.65 0.86 000 21485 A Reset dislocated jaw 3.97 6.01 4.86 0.37 10.35 9.20 090 21490 A Repair dislocated jaw 11.79 NA 10.02 1.57 NA 23.38 090 21493 A Treat hyoid bone fracture 1.26 NA 2.89 0.12 NA 4.27 090 21494 A Treat hyoid bone fracture 6.24 NA 5.78 0.53 NA 12.55 090 21495 A Treat hyoid bone fracture 5.66 NA 6.05 0.49 NA 12.20 090 21497 A Interdental wiring 3.84 6.62 5.08 0.37 10.83 9.29 090 21499 C Head surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21501 A Drain neck/chest lesion 3.79 4.74 3.92 0.43 8.96 8.14 090 21502 A Drain chest lesion 7.08 NA 5.63 0.95 NA 13.66 090 21510 A Drainage of bone lesion 5.71 NA 5.62 0.80 NA 12.13 090 21550 A Biopsy of neck/chest 2.05 3.68 1.75 0.16 5.89 3.96 010 21555 A Remove lesion, neck/chest 4.33 5.12 3.20 0.49 9.94 8.02 090 21556 A Remove lesion, neck/chest 5.54 NA 4.15 0.61 NA 10.30 090 21557 A Remove tumor, neck/chest 8.83 NA 5.48 1.02 NA 15.33 090 21600 A Partial removal of rib 6.85 NA 5.71 0.97 NA 13.53 090 21610 A Partial removal of rib 14.53 NA 9.16 2.22 NA 25.91 090 21615 A Removal of rib 9.81 NA 6.61 1.44 NA 17.86 090 21616 A Removal of rib and nerves 11.97 NA 7.98 1.57 NA 21.52 090 21620 A Partial removal of sternum 6.75 NA 5.98 0.92 NA 13.65 090 21627 A Sternal debridement 6.77 NA 6.29 0.98 NA 14.04 090 21630 A Extensive sternum surgery 17.28 NA 11.99 2.34 NA 31.61 090 21632 A Extensive sternum surgery 18.04 NA 10.79 2.59 NA 31.42 090 21685 A Hyoid myotomy & suspension 12.93 NA 10.21 1.51 NA 24.65 090 21700 A Revision of neck muscle 6.15 6.14 4.82 0.37 12.66 11.34 090 21705 A Revision of neck muscle/rib 9.55 NA 5.68 1.10 NA 16.33 090 21720 A Revision of neck muscle 5.65 5.53 4.68 0.96 12.14 11.29 090 21725 A Revision of neck muscle 6.95 NA 5.58 1.08 NA 13.61 090 21740 A Reconstruction of sternum 16.41 NA 8.38 2.43 NA 27.22 090 21742 C Repair stern/nuss w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 090 21743 C Repair sternum/nuss w/scope 0.00 0.00 0.00 0.00 0.00 0.00 090 21750 A Repair of sternum separation 10.71 NA 5.91 1.62 NA 18.24 090 21800 A Treatment of rib fracture 0.95 2.13 1.44 0.11 3.19 2.50 090 21805 A Treatment of rib fracture 2.73 NA 3.30 0.35 NA 6.38 090 21810 A Treatment of rib fracture(s) 6.82 NA 4.96 0.72 NA 12.50 090 Start Printed Page 63272 21820 A Treat sternum fracture 1.27 2.67 1.85 0.18 4.12 3.30 090 21825 A Treat sternum fracture 7.37 NA 6.50 1.01 NA 14.88 090 21899 C Neck/chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21920 A Biopsy soft tissue of back 2.05 3.31 1.50 0.14 5.50 3.69 010 21925 A Biopsy soft tissue of back 4.46 6.70 3.37 0.53 11.69 8.36 090 21930 A Remove lesion, back or flank 4.97 5.55 3.50 0.59 11.11 9.06 090 21935 A Remove tumor, back 17.86 NA 10.32 2.24 NA 30.42 090 22100 A Remove part of neck vertebra 9.67 NA 7.72 1.86 NA 19.25 090 22101 A Remove part, thorax vertebra 9.75 NA 7.93 1.81 NA 19.49 090 22102 A Remove part, lumbar vertebra 9.75 NA 8.18 1.75 NA 19.68 090 22103 A Remove extra spine segment 2.33 NA 1.23 0.44 NA 4.00 ZZZ 22110 A Remove part of neck vertebra 12.67 NA 9.39 2.64 NA 24.70 090 22112 A Remove part, thorax vertebra 12.74 NA 9.41 2.35 NA 24.50 090 22114 A Remove part, lumbar vertebra 12.74 NA 9.41 2.37 NA 24.52 090 22116 A Remove extra spine segment 2.31 NA 1.18 0.48 NA 3.97 ZZZ 22210 A Revision of neck spine 23.68 NA 15.71 5.07 NA 44.46 090 22212 A Revision of thorax spine 19.31 NA 13.41 3.33 NA 36.05 090 22214 A Revision of lumbar spine 19.34 NA 13.92 3.33 NA 36.59 090 22216 A Revise, extra spine segment 6.01 NA 3.18 1.17 NA 10.36 ZZZ 22220 A Revision of neck spine 21.25 NA 13.95 4.37 NA 39.57 090 22222 A Revision of thorax spine 21.40 NA 11.74 3.69 NA 36.83 090 22224 A Revision of lumbar spine 21.40 NA 14.39 3.84 NA 39.63 090 22226 A Revise, extra spine segment 6.01 NA 3.14 1.21 NA 10.36 ZZZ 22305 A Treat spine process fracture 2.04 3.22 2.41 0.35 5.61 4.80 090 22310 A Treat spine fracture 2.60 4.94 4.17 0.44 7.98 7.21 090 22315 A Treat spine fracture 8.79 13.58 7.63 1.64 24.01 18.06 090 22318 A Treat odontoid fx w/o graft 21.38 NA 13.70 5.11 NA 40.19 090 22319 A Treat odontoid fx w/graft 23.86 NA 15.09 5.71 NA 44.66 090 22325 A Treat spine fracture 18.20 NA 12.28 3.13 NA 33.61 090 22326 A Treat neck spine fracture 19.48 NA 12.99 4.24 NA 36.71 090 22327 A Treat thorax spine fracture 19.09 NA 12.58 3.30 NA 34.97 090 22328 A Treat each add spine fx 4.58 NA 2.30 0.79 NA 7.67 ZZZ 22505 A Manipulation of spine 1.86 NA 0.95 0.32 NA 3.13 010 22520 A Percut vertebroplasty thor 8.86 103.00 4.39 1.19 113.05 14.44 010 22521 A Percut vertebroplasty lumb 8.29 91.36 4.23 1.11 100.76 13.63 010 22522 A Percut vertebroplasty addl 4.29 NA 1.71 0.40 NA 6.40 ZZZ 22532 A Lat thorax spine fusion 23.86 NA 14.92 4.53 NA 43.31 090 22533 A Lat lumbar spine fusion 22.99 NA 13.60 3.81 NA 40.40 090 22534 A Lat thor/lumb, addl seg 5.97 NA 3.08 1.17 NA 10.22 ZZZ 22548 A Neck spine fusion 25.67 NA 16.03 5.97 NA 47.67 090 22554 A Neck spine fusion 18.51 NA 12.47 4.21 NA 35.19 090 22556 A Thorax spine fusion 23.33 NA 14.81 4.53 NA 42.67 090 22558 A Lumbar spine fusion 22.15 NA 13.37 3.81 NA 39.33 090 22585 A Additional spinal fusion 5.50 NA 2.83 1.17 NA 9.50 ZZZ 22590 A Spine & skull spinal fusion 20.39 NA 13.47 4.57 NA 38.43 090 22595 A Neck spinal fusion 19.28 NA 12.96 4.34 NA 36.58 090 22600 A Neck spine fusion 16.05 NA 11.28 3.46 NA 30.79 090 22610 A Thorax spine fusion 15.93 NA 11.46 3.19 NA 30.58 090 22612 A Lumbar spine fusion 20.88 NA 14.25 3.93 NA 39.06 090 22614 A Spine fusion, extra segment 6.40 NA 3.40 1.25 NA 11.05 ZZZ 22630 A Lumbar spine fusion 20.72 NA 13.71 4.54 NA 38.97 090 22632 A Spine fusion, extra segment 5.20 NA 2.70 1.08 NA 8.98 ZZZ 22800 A Fusion of spine 18.15 NA 12.78 3.25 NA 34.18 090 22802 A Fusion of spine 30.70 NA 19.68 5.30 NA 55.68 090 22804 A Fusion of spine 36.06 NA 22.81 6.27 NA 65.14 090 22808 A Fusion of spine 26.12 NA 16.42 5.23 NA 47.77 090 22810 A Fusion of spine 30.10 NA 18.47 5.38 NA 53.95 090 22812 A Fusion of spine 32.51 NA 20.13 5.60 NA 58.24 090 22818 A Kyphectomy, 1-2 segments 31.65 NA 19.07 6.00 NA 56.72 090 22819 A Kyphectomy, 3 or more 36.23 NA 20.21 6.23 NA 62.67 090 22830 A Exploration of spinal fusion 10.79 NA 7.98 2.07 NA 20.84 090 22840 A Insert spine fixation device 12.47 NA 6.58 2.43 NA 21.48 ZZZ 22841 B Insert spine fixation device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 22842 A Insert spine fixation device 12.51 NA 6.60 2.45 NA 21.56 ZZZ 22843 A Insert spine fixation device 13.38 NA 6.70 2.52 NA 22.60 ZZZ 22844 A Insert spine fixation device 16.35 NA 8.87 2.90 NA 28.12 ZZZ 22845 A Insert spine fixation device 11.89 NA 6.16 2.66 NA 20.71 ZZZ 22846 A Insert spine fixation device 12.35 NA 6.42 2.71 NA 21.48 ZZZ 22847 A Insert spine fixation device 13.72 NA 7.12 2.83 NA 23.67 ZZZ 22848 A Insert pelv fixation device 5.97 NA 3.23 1.05 NA 10.25 ZZZ 22849 A Reinsert spinal fixation 18.40 NA 11.89 3.44 NA 33.73 090 22850 A Remove spine fixation device 9.47 NA 7.08 1.81 NA 18.36 090 22851 A Apply spine prosth device 6.67 NA 3.40 1.33 NA 11.40 ZZZ 22852 A Remove spine fixation device 8.96 NA 6.87 1.68 NA 17.51 090 22855 A Remove spine fixation device 15.04 NA 9.83 3.28 NA 28.15 090 Start Printed Page 63273 22899 C Spine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 22900 A Remove abdominal wall lesion 5.77 NA 3.31 0.70 NA 9.78 090 22999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23000 A Removal of calcium deposits 4.34 5.27 4.21 0.60 10.21 9.15 090 23020 A Release shoulder joint 8.88 NA 7.65 1.47 NA 18.00 090 23030 A Drain shoulder lesion 3.41 3.05 2.97 0.50 6.96 6.88 010 23031 A Drain shoulder bursa 2.72 2.74 2.74 0.40 5.86 5.86 010 23035 A Drain shoulder bone lesion 8.56 NA 8.59 1.43 NA 18.58 090 23040 A Exploratory shoulder surgery 9.15 NA 7.93 1.53 NA 18.61 090 23044 A Exploratory shoulder surgery 7.08 NA 6.56 1.16 NA 14.80 090 23065 A Biopsy shoulder tissues 2.26 2.85 1.56 0.17 5.28 3.99 010 23066 A Biopsy shoulder tissues 4.14 5.15 4.11 0.60 9.89 8.85 090 23075 A Removal of shoulder lesion 2.38 2.27 1.84 0.30 4.95 4.52 010 23076 A Removal of shoulder lesion 7.59 NA 5.84 1.04 NA 14.47 090 23077 A Remove tumor of shoulder 16.00 NA 10.88 2.17 NA 29.05 090 23100 A Biopsy of shoulder joint 6.00 NA 5.76 0.97 NA 12.73 090 23101 A Shoulder joint surgery 5.55 NA 5.44 0.92 NA 11.91 090 23105 A Remove shoulder joint lining 8.18 NA 7.25 1.35 NA 16.78 090 23106 A Incision of collarbone joint 5.93 NA 5.80 0.98 NA 12.71 090 23107 A Explore treat shoulder joint 8.57 NA 7.46 1.43 NA 17.46 090 23120 A Partial removal, collar bone 7.07 NA 6.55 1.19 NA 14.81 090 23125 A Removal of collar bone 9.34 NA 7.69 1.52 NA 18.55 090 23130 A Remove shoulder bone, part 7.51 NA 7.18 1.27 NA 15.96 090 23140 A Removal of bone lesion 6.85 NA 5.46 0.98 NA 13.29 090 23145 A Removal of bone lesion 9.04 NA 7.66 1.49 NA 18.19 090 23146 A Removal of bone lesion 7.79 NA 7.21 1.33 NA 16.33 090 23150 A Removal of humerus lesion 8.43 NA 7.05 1.37 NA 16.85 090 23155 A Removal of humerus lesion 10.29 NA 8.55 1.44 NA 20.28 090 23156 A Removal of humerus lesion 8.63 NA 7.46 1.41 NA 17.50 090 23170 A Remove collar bone lesion 6.82 NA 6.38 1.01 NA 14.21 090 23172 A Remove shoulder blade lesion 6.86 NA 6.47 1.14 NA 14.47 090 23174 A Remove humerus lesion 9.46 NA 8.46 1.56 NA 19.48 090 23180 A Remove collar bone lesion 8.48 NA 9.29 1.41 NA 19.18 090 23182 A Remove shoulder blade lesion 8.10 NA 8.94 1.29 NA 18.33 090 23184 A Remove humerus lesion 9.33 NA 9.65 1.49 NA 20.47 090 23190 A Partial removal of scapula 7.20 NA 6.29 1.16 NA 14.65 090 23195 A Removal of head of humerus 9.75 NA 7.85 1.65 NA 19.25 090 23200 A Removal of collar bone 12.01 NA 9.00 1.77 NA 22.78 090 23210 A Removal of shoulder blade 12.42 NA 9.37 1.93 NA 23.72 090 23220 A Partial removal of humerus 14.48 NA 10.99 2.43 NA 27.90 090 23221 A Partial removal of humerus 17.64 NA 11.96 3.01 NA 32.61 090 23222 A Partial removal of humerus 23.78 NA 16.00 4.04 NA 43.82 090 23330 A Remove shoulder foreign body 1.84 2.07 1.91 0.22 4.13 3.97 010 23331 A Remove shoulder foreign body 7.34 NA 6.86 1.22 NA 15.42 090 23332 A Remove shoulder foreign body 11.55 NA 9.41 1.94 NA 22.90 090 23350 A Injection for shoulder x-ray 0.99 3.84 0.34 0.06 4.89 1.39 000 23395 A Muscle transfer,shoulder/arm 16.75 NA 12.87 2.74 NA 32.36 090 23397 A Muscle transfers 16.04 NA 11.50 2.68 NA 30.22 090 23400 A Fixation of shoulder blade 13.46 NA 10.24 2.29 NA 25.99 090 23405 A Incision of tendon & muscle 8.32 NA 7.04 1.34 NA 16.70 090 23406 A Incise tendon(s) & muscle(s) 10.73 NA 8.49 1.77 NA 20.99 090 23410 A Repair rotator cuff, acute 12.38 NA 9.51 2.06 NA 23.95 090 23412 A Repair rotator cuff, chronic 13.23 NA 10.00 2.23 NA 25.46 090 23415 A Release of shoulder ligament 9.91 NA 8.06 1.67 NA 19.64 090 23420 A Repair of shoulder 13.22 NA 10.89 2.23 NA 26.34 090 23430 A Repair biceps tendon 9.92 NA 8.20 1.68 NA 19.80 090 23440 A Remove/transplant tendon 10.42 NA 8.38 1.76 NA 20.56 090 23450 A Repair shoulder capsule 13.32 NA 9.97 2.23 NA 25.52 090 23455 A Repair shoulder capsule 14.29 NA 10.56 2.41 NA 27.26 090 23460 A Repair shoulder capsule 15.28 NA 11.49 2.60 NA 29.37 090 23462 A Repair shoulder capsule 15.21 NA 10.89 2.59 NA 28.69 090 23465 A Repair shoulder capsule 15.76 NA 11.42 1.93 NA 29.11 090 23466 A Repair shoulder capsule 14.14 NA 11.39 2.40 NA 27.93 090 23470 A Reconstruct shoulder joint 17.05 NA 12.25 2.88 NA 32.18 090 23472 A Reconstruct shoulder joint 20.98 NA 14.42 2.84 NA 38.24 090 23480 A Revision of collar bone 11.12 NA 8.87 1.87 NA 21.86 090 23485 A Revision of collar bone 13.35 NA 10.01 2.21 NA 25.57 090 23490 A Reinforce clavicle 11.79 NA 8.79 1.33 NA 21.91 090 23491 A Reinforce shoulder bones 14.13 NA 10.81 2.40 NA 27.34 090 23500 A Treat clavicle fracture 2.07 3.70 2.60 0.31 6.08 4.98 090 23505 A Treat clavicle fracture 3.67 5.39 3.80 0.60 9.66 8.07 090 23515 A Treat clavicle fracture 7.37 NA 6.60 1.23 NA 15.20 090 23520 A Treat clavicle dislocation 2.15 3.70 2.75 0.31 6.16 5.21 090 23525 A Treat clavicle dislocation 3.58 5.34 3.93 0.53 9.45 8.04 090 23530 A Treat clavicle dislocation 7.27 NA 6.05 1.02 NA 14.34 090 Start Printed Page 63274 23532 A Treat clavicle dislocation 7.96 NA 6.99 1.35 NA 16.30 090 23540 A Treat clavicle dislocation 2.22 4.31 2.51 0.29 6.82 5.02 090 23545 A Treat clavicle dislocation 3.23 4.56 3.43 0.47 8.26 7.13 090 23550 A Treat clavicle dislocation 7.20 NA 6.46 1.13 NA 14.79 090 23552 A Treat clavicle dislocation 8.40 NA 7.34 1.41 NA 17.15 090 23570 A Treat shoulder blade fx 2.22 3.71 2.91 0.35 6.28 5.48 090 23575 A Treat shoulder blade fx 4.04 5.83 4.30 0.64 10.51 8.98 090 23585 A Treat scapula fracture 8.91 NA 7.68 1.50 NA 18.09 090 23600 A Treat humerus fracture 2.91 5.80 3.87 0.47 9.18 7.25 090 23605 A Treat humerus fracture 4.84 6.67 5.01 0.80 12.31 10.65 090 23615 A Treat humerus fracture 9.30 NA 8.79 1.57 NA 19.66 090 23616 A Treat humerus fracture 21.15 NA 14.28 3.57 NA 39.00 090 23620 A Treat humerus fracture 2.39 5.26 3.27 0.38 8.03 6.04 090 23625 A Treat humerus fracture 3.91 6.39 4.60 0.64 10.94 9.15 090 23630 A Treat humerus fracture 7.31 NA 6.67 1.23 NA 15.21 090 23650 A Treat shoulder dislocation 3.37 4.75 2.94 0.37 8.49 6.68 090 23655 A Treat shoulder dislocation 4.54 NA 4.23 0.62 NA 9.39 090 23660 A Treat shoulder dislocation 7.45 NA 6.44 1.21 NA 15.10 090 23665 A Treat dislocation/fracture 4.44 6.66 4.99 0.72 11.82 10.15 090 23670 A Treat dislocation/fracture 7.85 NA 6.90 1.32 NA 16.07 090 23675 A Treat dislocation/fracture 6.02 7.65 6.13 0.99 14.66 13.14 090 23680 A Treat dislocation/fracture 10.00 NA 8.18 1.67 NA 19.85 090 23700 A Fixation of shoulder 2.51 NA 2.32 0.42 NA 5.25 010 23800 A Fusion of shoulder joint 14.08 NA 10.58 2.36 NA 27.02 090 23802 A Fusion of shoulder joint 16.51 NA 10.38 2.80 NA 29.69 090 23900 A Amputation of arm & girdle 19.61 NA 12.05 2.96 NA 34.62 090 23920 A Amputation at shoulder joint 14.53 NA 10.21 2.30 NA 27.04 090 23921 A Amputation follow-up surgery 5.46 5.28 5.28 0.93 11.67 11.67 090 23929 C Shoulder surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23930 A Drainage of arm lesion 2.92 2.75 2.36 0.38 6.05 5.66 010 23931 A Drainage of arm bursa 1.78 2.46 2.21 0.25 4.49 4.24 010 23935 A Drain arm/elbow bone lesion 6.06 NA 6.18 1.01 NA 13.25 090 24000 A Exploratory elbow surgery 5.79 NA 5.42 0.92 NA 12.13 090 24006 A Release elbow joint 9.26 NA 7.77 1.52 NA 18.55 090 24065 A Biopsy arm/elbow soft tissue 2.07 2.12 1.80 0.17 4.36 4.04 010 24066 A Biopsy arm/elbow soft tissue 5.18 5.81 4.33 0.73 11.72 10.24 090 24075 A Remove arm/elbow lesion 3.90 5.11 3.71 0.52 9.53 8.13 090 24076 A Remove arm/elbow lesion 6.26 NA 5.14 0.84 NA 12.24 090 24077 A Remove tumor of arm/elbow 11.69 NA 8.75 1.58 NA 22.02 090 24100 A Biopsy elbow joint lining 4.90 NA 4.52 0.74 NA 10.16 090 24101 A Explore/treat elbow joint 6.10 NA 5.92 1.01 NA 13.03 090 24102 A Remove elbow joint lining 7.98 NA 6.91 1.31 NA 16.20 090 24105 A Removal of elbow bursa 3.59 NA 4.41 0.59 NA 8.59 090 24110 A Remove humerus lesion 7.35 NA 6.78 1.19 NA 15.32 090 24115 A Remove/graft bone lesion 9.58 NA 7.43 1.38 NA 18.39 090 24116 A Remove/graft bone lesion 11.74 NA 9.21 1.99 NA 22.94 090 24120 A Remove elbow lesion 6.61 NA 5.94 1.04 NA 13.59 090 24125 A Remove/graft bone lesion 7.85 NA 6.25 1.05 NA 15.15 090 24126 A Remove/graft bone lesion 8.26 NA 7.04 1.08 NA 16.38 090 24130 A Removal of head of radius 6.21 NA 6.01 1.04 NA 13.26 090 24134 A Removal of arm bone lesion 9.67 NA 9.27 1.57 NA 20.51 090 24136 A Remove radius bone lesion 7.94 NA 7.49 1.02 NA 16.45 090 24138 A Remove elbow bone lesion 8.00 NA 7.75 1.34 NA 17.09 090 24140 A Partial removal of arm bone 9.13 NA 9.60 1.47 NA 20.20 090 24145 A Partial removal of radius 7.54 NA 8.24 1.21 NA 16.99 090 24147 A Partial removal of elbow 7.50 NA 8.73 1.25 NA 17.48 090 24149 A Radical resection of elbow 14.12 NA 11.54 2.28 NA 27.94 090 24150 A Extensive humerus surgery 13.19 NA 10.22 2.17 NA 25.58 090 24151 A Extensive humerus surgery 15.49 NA 11.81 2.62 NA 29.92 090 24152 A Extensive radius surgery 10.00 NA 7.96 1.43 NA 19.39 090 24153 A Extensive radius surgery 11.47 NA 5.90 0.77 NA 18.14 090 24155 A Removal of elbow joint 11.66 NA 8.48 1.70 NA 21.84 090 24160 A Remove elbow joint implant 7.79 NA 6.85 1.28 NA 15.92 090 24164 A Remove radius head implant 6.19 NA 5.73 1.01 NA 12.93 090 24200 A Removal of arm foreign body 1.75 1.99 1.69 0.18 3.92 3.62 010 24201 A Removal of arm foreign body 4.53 5.75 4.37 0.67 10.95 9.57 090 24220 A Injection for elbow x-ray 1.30 10.48 0.45 0.08 11.86 1.83 000 24300 A Manipulate elbow w/anesth 3.73 NA 5.54 0.59 NA 9.86 090 24301 A Muscle/tendon transfer 10.14 NA 8.27 1.56 NA 19.97 090 24305 A Arm tendon lengthening 7.41 NA 6.75 1.17 NA 15.33 090 24310 A Revision of arm tendon 5.95 NA 5.79 0.89 NA 12.63 090 24320 A Repair of arm tendon 10.50 NA 7.82 1.20 NA 19.52 090 24330 A Revision of arm muscles 9.55 NA 7.96 1.45 NA 18.96 090 24331 A Revision of arm muscles 10.59 NA 8.68 1.69 NA 20.96 090 24332 A Tenolysis, triceps 7.41 NA 6.66 0.92 NA 14.99 090 Start Printed Page 63275 24340 A Repair of biceps tendon 7.85 NA 6.99 1.29 NA 16.13 090 24341 A Repair arm tendon/muscle 7.85 NA 7.83 1.29 NA 16.97 090 24342 A Repair of ruptured tendon 10.56 NA 8.54 1.77 NA 20.87 090 24343 A Repr elbow lat ligmnt w/tiss 8.60 NA 8.02 1.35 NA 17.97 090 24344 A Reconstruct elbow lat ligmnt 13.92 NA 11.43 2.19 NA 27.54 090 24345 A Repr elbw med ligmnt w/tissu 8.60 NA 7.91 1.35 NA 17.86 090 24346 A Reconstruct elbow med ligmnt 13.92 NA 11.28 2.19 NA 27.39 090 24350 A Repair of tennis elbow 5.22 NA 5.57 0.86 NA 11.65 090 24351 A Repair of tennis elbow 5.88 NA 5.92 0.98 NA 12.78 090 24352 A Repair of tennis elbow 6.39 NA 6.18 1.08 NA 13.65 090 24354 A Repair of tennis elbow 6.44 NA 6.14 1.05 NA 13.63 090 24356 A Revision of tennis elbow 6.64 NA 6.32 1.08 NA 14.04 090 24360 A Reconstruct elbow joint 12.27 NA 9.46 2.03 NA 23.76 090 24361 A Reconstruct elbow joint 14.00 NA 10.56 2.34 NA 26.90 090 24362 A Reconstruct elbow joint 14.90 NA 10.08 2.30 NA 27.28 090 24363 A Replace elbow joint 18.38 NA 13.67 3.02 NA 35.07 090 24365 A Reconstruct head of radius 8.34 NA 7.15 1.33 NA 16.82 090 24366 A Reconstruct head of radius 9.08 NA 7.51 1.53 NA 18.12 090 24400 A Revision of humerus 11.00 NA 9.00 1.83 NA 21.83 090 24410 A Revision of humerus 14.74 NA 10.54 2.27 NA 27.55 090 24420 A Revision of humerus 13.36 NA 10.77 2.18 NA 26.31 090 24430 A Repair of humerus 12.74 NA 9.85 2.16 NA 24.75 090 24435 A Repair humerus with graft 13.09 NA 10.95 2.21 NA 26.25 090 24470 A Revision of elbow joint 8.69 NA 7.69 1.47 NA 17.85 090 24495 A Decompression of forearm 8.07 NA 9.03 1.10 NA 18.20 090 24498 A Reinforce humerus 11.85 NA 9.38 2.00 NA 23.23 090 24500 A Treat humerus fracture 3.19 5.46 3.66 0.49 9.14 7.34 090 24505 A Treat humerus fracture 5.14 7.37 5.34 0.86 13.37 11.34 090 24515 A Treat humerus fracture 11.58 NA 9.44 1.95 NA 22.97 090 24516 A Treat humerus fracture 11.58 NA 9.21 1.95 NA 22.74 090 24530 A Treat humerus fracture 3.48 5.45 3.99 0.56 9.49 8.03 090 24535 A Treat humerus fracture 6.83 8.47 6.48 1.15 16.45 14.46 090 24538 A Treat humerus fracture 9.38 NA 8.79 1.50 NA 19.67 090 24545 A Treat humerus fracture 10.40 NA 8.50 1.76 NA 20.66 090 24546 A Treat humerus fracture 15.60 NA 11.43 2.61 NA 29.64 090 24560 A Treat humerus fracture 2.78 5.13 3.26 0.42 8.33 6.46 090 24565 A Treat humerus fracture 5.53 7.37 5.46 0.89 13.79 11.88 090 24566 A Treat humerus fracture 7.75 NA 8.21 1.32 NA 17.28 090 24575 A Treat humerus fracture 10.60 NA 8.38 1.73 NA 20.71 090 24576 A Treat humerus fracture 2.84 5.00 3.64 0.46 8.30 6.94 090 24577 A Treat humerus fracture 5.76 7.65 5.76 0.97 14.38 12.49 090 24579 A Treat humerus fracture 11.53 NA 8.93 1.94 NA 22.40 090 24582 A Treat humerus fracture 8.50 NA 9.10 1.44 NA 19.04 090 24586 A Treat elbow fracture 15.12 NA 11.23 2.54 NA 28.89 090 24587 A Treat elbow fracture 15.07 NA 11.04 2.57 NA 28.68 090 24600 A Treat elbow dislocation 4.21 5.63 3.58 0.59 10.43 8.38 090 24605 A Treat elbow dislocation 5.39 NA 5.32 0.86 NA 11.57 090 24615 A Treat elbow dislocation 9.37 NA 7.81 1.57 NA 18.75 090 24620 A Treat elbow fracture 6.94 NA 6.18 1.08 NA 14.20 090 24635 A Treat elbow fracture 13.11 NA 14.37 2.21 NA 29.69 090 24640 A Treat elbow dislocation 1.19 1.96 0.88 0.13 3.28 2.20 010 24650 A Treat radius fracture 2.15 4.60 2.78 0.34 7.09 5.27 090 24655 A Treat radius fracture 4.37 6.84 4.74 0.70 11.91 9.81 090 24665 A Treat radius fracture 8.09 NA 7.56 1.35 NA 17.00 090 24666 A Treat radius fracture 9.44 NA 8.14 1.58 NA 19.16 090 24670 A Treat ulnar fracture 2.53 4.50 3.06 0.40 7.43 5.99 090 24675 A Treat ulnar fracture 4.69 6.80 4.87 0.78 12.27 10.34 090 24685 A Treat ulnar fracture 8.75 NA 7.60 1.47 NA 17.82 090 24800 A Fusion of elbow joint 11.14 NA 8.81 1.69 NA 21.64 090 24802 A Fusion/graft of elbow joint 13.61 NA 10.44 2.27 NA 26.32 090 24900 A Amputation of upper arm 9.55 NA 7.43 1.41 NA 18.39 090 24920 A Amputation of upper arm 9.49 NA 7.59 1.46 NA 18.54 090 24925 A Amputation follow-up surgery 7.03 NA 6.34 1.14 NA 14.51 090 24930 A Amputation follow-up surgery 10.19 NA 7.59 1.47 NA 19.25 090 24931 A Amputate upper arm & implant 12.65 NA 6.19 1.87 NA 20.71 090 24935 A Revision of amputation 15.47 NA 8.50 1.89 NA 25.86 090 24940 C Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.00 090 24999 C Upper arm/elbow surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 25000 A Incision of tendon sheath 3.36 NA 7.03 0.54 NA 10.93 090 25001 A Incise flexor carpi radialis 3.36 NA 4.13 0.54 NA 8.03 090 25020 A Decompress forearm 1 space 5.89 NA 10.04 0.91 NA 16.84 090 25023 A Decompress forearm 1 space 12.89 NA 15.51 1.82 NA 30.22 090 25024 A Decompress forearm 2 spaces 9.45 NA 7.49 1.49 NA 18.43 090 25025 A Decompress forearm 2 spaces 16.45 NA 10.06 2.61 NA 29.12 090 25028 A Drainage of forearm lesion 5.22 NA 8.54 0.73 NA 14.49 090 Start Printed Page 63276 25031 A Drainage of forearm bursa 4.12 NA 8.35 0.60 NA 13.07 090 25035 A Treat forearm bone lesion 7.32 NA 14.20 1.17 NA 22.69 090 25040 A Explore/treat wrist joint 7.14 NA 7.42 1.15 NA 15.71 090 25065 A Biopsy forearm soft tissues 1.98 2.83 2.83 0.14 4.95 4.95 010 25066 A Biopsy forearm soft tissues 4.11 NA 7.33 0.59 NA 12.03 090 25075 A Removel forearm lesion subcu 3.72 NA 6.19 0.48 NA 10.39 090 25076 A Removel forearm lesion deep 4.89 NA 10.08 0.71 NA 15.68 090 25077 A Remove tumor, forearm/wrist 9.70 NA 12.84 1.32 NA 23.86 090 25085 A Incision of wrist capsule 5.47 NA 7.38 0.85 NA 13.70 090 25100 A Biopsy of wrist joint 3.88 NA 5.46 0.60 NA 9.94 090 25101 A Explore/treat wrist joint 4.66 NA 6.02 0.72 NA 11.40 090 25105 A Remove wrist joint lining 5.82 NA 7.57 0.92 NA 14.31 090 25107 A Remove wrist joint cartilage 6.39 NA 8.50 0.98 NA 15.87 090 25110 A Remove wrist tendon lesion 3.90 NA 7.34 0.58 NA 11.82 090 25111 A Remove wrist tendon lesion 3.37 NA 4.88 0.50 NA 8.75 090 25112 A Reremove wrist tendon lesion 4.50 NA 5.49 0.65 NA 10.64 090 25115 A Remove wrist/forearm lesion 8.77 NA 14.60 1.33 NA 24.70 090 25116 A Remove wrist/forearm lesion 7.07 NA 13.67 1.08 NA 21.82 090 25118 A Excise wrist tendon sheath 4.35 NA 5.94 0.66 NA 10.95 090 25119 A Partial removal of ulna 6.01 NA 7.85 0.96 NA 14.82 090 25120 A Removal of forearm lesion 6.07 NA 12.58 0.97 NA 19.62 090 25125 A Remove/graft forearm lesion 7.44 NA 13.37 1.22 NA 22.03 090 25126 A Remove/graft forearm lesion 7.51 NA 13.46 1.20 NA 22.17 090 25130 A Removal of wrist lesion 5.23 NA 6.58 0.79 NA 12.60 090 25135 A Remove & graft wrist lesion 6.85 NA 7.61 1.07 NA 15.53 090 25136 A Remove & graft wrist lesion 5.94 NA 6.76 0.70 NA 13.40 090 25145 A Remove forearm bone lesion 6.33 NA 12.61 0.98 NA 19.92 090 25150 A Partial removal of ulna 7.05 NA 8.49 1.15 NA 16.69 090 25151 A Partial removal of radius 7.35 NA 13.23 1.11 NA 21.69 090 25170 A Extensive forearm surgery 11.03 NA 15.64 1.82 NA 28.49 090 25210 A Removal of wrist bone 5.92 NA 6.98 0.87 NA 13.77 090 25215 A Removal of wrist bones 7.85 NA 8.99 1.22 NA 18.06 090 25230 A Partial removal of radius 5.20 NA 6.29 0.79 NA 12.28 090 25240 A Partial removal of ulna 5.14 NA 7.16 0.83 NA 13.13 090 25246 A Injection for wrist x-ray 1.44 10.14 0.49 0.08 11.66 2.01 000 25248 A Remove forearm foreign body 5.11 NA 8.83 0.65 NA 14.59 090 25250 A Removal of wrist prosthesis 6.56 NA 6.06 1.01 NA 13.63 090 25251 A Removal of wrist prosthesis 9.52 NA 7.90 1.38 NA 18.80 090 25259 A Manipulate wrist w/anesthes 3.73 NA 5.53 0.60 NA 9.86 090 25260 A Repair forearm tendon/muscle 7.76 NA 14.06 1.16 NA 22.98 090 25263 A Repair forearm tendon/muscle 7.78 NA 13.95 1.13 NA 22.86 090 25265 A Repair forearm tendon/muscle 9.82 NA 14.83 1.43 NA 26.08 090 25270 A Repair forearm tendon/muscle 5.97 NA 12.74 0.91 NA 19.62 090 25272 A Repair forearm tendon/muscle 7.00 NA 13.45 1.07 NA 21.52 090 25274 A Repair forearm tendon/muscle 8.70 NA 14.17 1.37 NA 24.24 090 25275 A Repair forearm tendon sheath 8.45 NA 7.54 1.35 NA 17.34 090 25280 A Revise wrist/forearm tendon 7.18 NA 13.17 1.09 NA 21.44 090 25290 A Incise wrist/forearm tendon 5.26 NA 15.71 0.79 NA 21.76 090 25295 A Release wrist/forearm tendon 6.51 NA 12.73 1.03 NA 20.27 090 25300 A Fusion of tendons at wrist 8.75 NA 8.61 1.28 NA 18.64 090 25301 A Fusion of tendons at wrist 8.35 NA 8.25 1.29 NA 17.89 090 25310 A Transplant forearm tendon 8.09 NA 13.59 1.21 NA 22.89 090 25312 A Transplant forearm tendon 9.52 NA 14.49 1.46 NA 25.47 090 25315 A Revise palsy hand tendon(s) 10.14 NA 15.05 1.51 NA 26.70 090 25316 A Revise palsy hand tendon(s) 12.26 NA 16.80 2.09 NA 31.15 090 25320 A Repair/revise wrist joint 10.71 NA 11.33 1.58 NA 23.62 090 25332 A Revise wrist joint 11.34 NA 9.16 1.75 NA 22.25 090 25335 A Realignment of hand 12.81 NA 11.84 1.99 NA 26.64 090 25337 A Reconstruct ulna/radioulnar 10.11 NA 11.19 1.57 NA 22.87 090 25350 A Revision of radius 8.73 NA 14.43 1.40 NA 24.56 090 25355 A Revision of radius 10.11 NA 15.08 1.73 NA 26.92 090 25360 A Revision of ulna 8.38 NA 14.33 1.40 NA 24.11 090 25365 A Revise radius & ulna 12.33 NA 16.13 2.00 NA 30.46 090 25370 A Revise radius or ulna 13.28 NA 16.47 2.25 NA 32.00 090 25375 A Revise radius & ulna 12.97 NA 16.95 2.21 NA 32.13 090 25390 A Shorten radius or ulna 10.34 NA 15.08 1.65 NA 27.07 090 25391 A Lengthen radius or ulna 13.57 NA 17.06 2.07 NA 32.70 090 25392 A Shorten radius & ulna 13.87 NA 16.41 2.07 NA 32.35 090 25393 A Lengthen radius & ulna 15.78 NA 18.06 2.24 NA 36.08 090 25394 A Repair carpal bone, shorten 10.34 NA 8.33 1.68 NA 20.35 090 25400 A Repair radius or ulna 10.86 NA 15.66 1.80 NA 28.32 090 25405 A Repair/graft radius or ulna 14.30 NA 17.77 2.34 NA 34.41 090 25415 A Repair radius & ulna 13.27 NA 17.01 2.24 NA 32.52 090 25420 A Repair/graft radius & ulna 16.24 NA 18.76 2.64 NA 37.64 090 25425 A Repair/graft radius or ulna 13.13 NA 22.34 1.93 NA 37.40 090 Start Printed Page 63277 25426 A Repair/graft radius & ulna 15.73 NA 17.43 2.67 NA 35.83 090 25430 A Vasc graft into carpal bone 9.20 NA 7.36 1.28 NA 17.84 090 25431 A Repair nonunion carpal bone 10.38 NA 8.32 0.67 NA 19.37 090 25440 A Repair/graft wrist bone 10.38 NA 9.53 1.69 NA 21.60 090 25441 A Reconstruct wrist joint 12.83 NA 9.99 2.19 NA 25.01 090 25442 A Reconstruct wrist joint 10.79 NA 8.86 1.49 NA 21.14 090 25443 A Reconstruct wrist joint 10.33 NA 8.74 1.56 NA 20.63 090 25444 A Reconstruct wrist joint 11.09 NA 9.16 1.71 NA 21.96 090 25445 A Reconstruct wrist joint 9.63 NA 7.97 1.51 NA 19.11 090 25446 A Wrist replacement 16.46 NA 11.94 2.64 NA 31.04 090 25447 A Repair wrist joint(s) 10.31 NA 8.62 1.61 NA 20.54 090 25449 A Remove wrist joint implant 14.41 NA 10.69 2.12 NA 27.22 090 25450 A Revision of wrist joint 7.83 NA 10.54 1.05 NA 19.42 090 25455 A Revision of wrist joint 9.44 NA 11.45 1.28 NA 22.17 090 25490 A Reinforce radius 9.49 NA 14.19 1.43 NA 25.11 090 25491 A Reinforce ulna 9.90 NA 14.92 1.69 NA 26.51 090 25492 A Reinforce radius and ulna 12.26 NA 15.79 1.94 NA 29.99 090 25500 A Treat fracture of radius 2.44 4.04 2.76 0.34 6.82 5.54 090 25505 A Treat fracture of radius 5.18 7.31 5.31 0.83 13.32 11.32 090 25515 A Treat fracture of radius 9.13 NA 7.55 1.46 NA 18.14 090 25520 A Treat fracture of radius 6.22 7.52 5.93 1.02 14.76 13.17 090 25525 A Treat fracture of radius 12.17 NA 10.04 2.01 NA 24.22 090 25526 A Treat fracture of radius 12.91 NA 13.74 2.16 NA 28.81 090 25530 A Treat fracture of ulna 2.08 4.19 2.84 0.32 6.59 5.24 090 25535 A Treat fracture of ulna 5.11 6.93 5.23 0.82 12.86 11.16 090 25545 A Treat fracture of ulna 8.85 NA 7.73 1.47 NA 18.05 090 25560 A Treat fracture radius & ulna 2.43 4.09 2.70 0.32 6.84 5.45 090 25565 A Treat fracture radius & ulna 5.60 7.44 5.38 0.91 13.95 11.89 090 25574 A Treat fracture radius & ulna 6.97 NA 7.21 1.15 NA 15.33 090 25575 A Treat fracture radius/ulna 10.39 NA 9.50 1.75 NA 21.64 090 25600 A Treat fracture radius/ulna 2.62 4.52 2.99 0.41 7.55 6.02 090 25605 A Treat fracture radius/ulna 5.78 8.12 6.08 0.97 14.87 12.83 090 25611 A Treat fracture radius/ulna 7.73 NA 8.94 1.29 NA 17.96 090 25620 A Treat fracture radius/ulna 8.50 NA 7.36 1.40 NA 17.26 090 25622 A Treat wrist bone fracture 2.60 4.69 3.18 0.40 7.69 6.18 090 25624 A Treat wrist bone fracture 4.50 7.06 4.96 0.73 12.29 10.19 090 25628 A Treat wrist bone fracture 8.38 NA 7.89 1.37 NA 17.64 090 25630 A Treat wrist bone fracture 2.86 4.61 2.99 0.44 7.91 6.29 090 25635 A Treat wrist bone fracture 4.36 6.83 3.97 0.47 11.66 8.80 090 25645 A Treat wrist bone fracture 7.21 NA 6.86 1.11 NA 15.18 090 25650 A Treat wrist bone fracture 3.03 4.88 3.27 0.44 8.35 6.74 090 25651 A Pin ulnar styloid fracture 5.33 NA 5.45 0.86 NA 11.64 090 25652 A Treat fracture ulnar styloid 7.56 NA 6.93 1.22 NA 15.71 090 25660 A Treat wrist dislocation 4.73 NA 4.71 0.71 NA 10.15 090 25670 A Treat wrist dislocation 7.87 NA 7.15 1.28 NA 16.30 090 25671 A Pin radioulnar dislocation 5.97 NA 6.04 0.97 NA 12.98 090 25675 A Treat wrist dislocation 4.64 6.57 4.66 0.68 11.89 9.98 090 25676 A Treat wrist dislocation 7.99 NA 7.40 1.32 NA 16.71 090 25680 A Treat wrist fracture 5.96 NA 4.80 0.73 NA 11.49 090 25685 A Treat wrist fracture 9.72 NA 7.96 1.50 NA 19.18 090 25690 A Treat wrist dislocation 5.47 NA 5.45 0.93 NA 11.85 090 25695 A Treat wrist dislocation 8.29 NA 7.27 1.28 NA 16.84 090 25800 A Fusion of wrist joint 9.70 NA 9.20 1.56 NA 20.46 090 25805 A Fusion/graft of wrist joint 11.22 NA 10.35 1.81 NA 23.38 090 25810 A Fusion/graft of wrist joint 10.51 NA 9.99 1.64 NA 22.14 090 25820 A Fusion of hand bones 7.41 NA 7.96 1.15 NA 16.52 090 25825 A Fuse hand bones with graft 9.22 NA 9.32 1.44 NA 19.98 090 25830 A Fusion, radioulnar jnt/ulna 10.00 NA 14.86 1.52 NA 26.38 090 25900 A Amputation of forearm 8.96 NA 13.02 1.29 NA 23.27 090 25905 A Amputation of forearm 9.07 NA 12.99 1.27 NA 23.33 090 25907 A Amputation follow-up surgery 7.76 NA 12.36 1.21 NA 21.33 090 25909 A Amputation follow-up surgery 8.91 NA 12.89 1.28 NA 23.08 090 25915 A Amputation of forearm 16.98 NA 19.72 2.89 NA 39.59 090 25920 A Amputate hand at wrist 8.63 NA 8.09 1.27 NA 17.99 090 25922 A Amputate hand at wrist 7.38 NA 7.25 1.11 NA 15.74 090 25924 A Amputation follow-up surgery 8.41 NA 8.31 1.28 NA 18.00 090 25927 A Amputation of hand 8.75 NA 12.27 1.22 NA 22.24 090 25929 A Amputation follow-up surgery 7.55 NA 6.09 1.07 NA 14.71 090 25931 A Amputation follow-up surgery 7.77 NA 12.18 1.05 NA 21.00 090 25999 C Forearm or wrist surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26010 A Drainage of finger abscess 1.53 5.77 1.69 0.17 7.47 3.39 010 26011 A Drainage of finger abscess 2.18 9.17 2.33 0.30 11.65 4.81 010 26020 A Drain hand tendon sheath 4.64 NA 5.63 0.71 NA 10.98 090 26025 A Drainage of palm bursa 4.79 NA 5.42 0.72 NA 10.93 090 26030 A Drainage of palm bursa(s) 5.90 NA 6.06 0.86 NA 12.82 090 Start Printed Page 63278 26034 A Treat hand bone lesion 6.19 NA 6.33 0.95 NA 13.47 090 26035 A Decompress fingers/hand 9.46 NA 8.20 1.34 NA 19.00 090 26037 A Decompress fingers/hand 7.21 NA 6.67 1.04 NA 14.92 090 26040 A Release palm contracture 3.31 NA 4.03 0.54 NA 7.88 090 26045 A Release palm contracture 5.53 NA 5.62 0.89 NA 12.04 090 26055 A Incise finger tendon sheath 2.67 14.70 3.89 0.43 17.80 6.99 090 26060 A Incision of finger tendon 2.79 NA 3.49 0.42 NA 6.70 090 26070 A Explore/treat hand joint 3.67 NA 3.40 0.42 NA 7.49 090 26075 A Explore/treat finger joint 3.77 NA 3.81 0.48 NA 8.06 090 26080 A Explore/treat finger joint 4.22 NA 4.83 0.62 NA 9.67 090 26100 A Biopsy hand joint lining 3.65 NA 4.14 0.54 NA 8.33 090 26105 A Biopsy finger joint lining 3.69 NA 4.22 0.54 NA 8.45 090 26110 A Biopsy finger joint lining 3.51 NA 4.02 0.53 NA 8.06 090 26115 A Removel hand lesion subcut 3.84 13.49 4.72 0.58 17.91 9.14 090 26116 A Removel hand lesion, deep 5.50 NA 5.98 0.83 NA 12.31 090 26117 A Remove tumor, hand/finger 8.50 NA 7.10 1.21 NA 16.81 090 26121 A Release palm contracture 7.50 NA 6.97 1.13 NA 15.60 090 26123 A Release palm contracture 9.24 NA 8.84 1.40 NA 19.48 090 26125 A Release palm contracture 4.58 NA 2.48 0.68 NA 7.74 ZZZ 26130 A Remove wrist joint lining 5.39 NA 5.36 0.78 NA 11.53 090 26135 A Revise finger joint, each 6.92 NA 6.47 1.04 NA 14.43 090 26140 A Revise finger joint, each 6.13 NA 6.03 0.91 NA 13.07 090 26145 A Tendon excision, palm/finger 6.28 NA 6.05 0.92 NA 13.25 090 26160 A Remove tendon sheath lesion 3.13 12.84 4.08 0.47 16.44 7.68 090 26170 A Removal of palm tendon, each 4.74 NA 4.94 0.72 NA 10.40 090 26180 A Removal of finger tendon 5.15 NA 5.41 0.77 NA 11.33 090 26185 A Remove finger bone 5.22 NA 5.97 0.80 NA 11.99 090 26200 A Remove hand bone lesion 5.48 NA 5.35 0.85 NA 11.68 090 26205 A Remove/graft bone lesion 7.66 NA 6.91 1.14 NA 15.71 090 26210 A Removal of finger lesion 5.12 NA 5.42 0.77 NA 11.31 090 26215 A Remove/graft finger lesion 7.06 NA 6.32 0.92 NA 14.30 090 26230 A Partial removal of hand bone 6.29 NA 5.91 1.01 NA 13.21 090 26235 A Partial removal, finger bone 6.15 NA 5.81 0.93 NA 12.89 090 26236 A Partial removal, finger bone 5.29 NA 5.34 0.79 NA 11.42 090 26250 A Extensive hand surgery 7.51 NA 6.46 1.10 NA 15.07 090 26255 A Extensive hand surgery 12.36 NA 9.45 1.26 NA 23.07 090 26260 A Extensive finger surgery 6.99 NA 6.20 0.99 NA 14.18 090 26261 A Extensive finger surgery 9.04 NA 6.28 1.01 NA 16.33 090 26262 A Partial removal of finger 5.64 NA 5.35 0.84 NA 11.83 090 26320 A Removal of implant from hand 3.96 NA 4.30 0.59 NA 8.85 090 26340 A Manipulate finger w/anesth 2.49 NA 4.79 0.36 NA 7.64 090 26350 A Repair finger/hand tendon 5.96 NA 15.67 0.87 NA 22.50 090 26352 A Repair/graft hand tendon 7.64 NA 16.25 1.11 NA 25.00 090 26356 A Repair finger/hand tendon 8.02 NA 19.11 1.19 NA 28.32 090 26357 A Repair finger/hand tendon 8.53 NA 16.71 1.22 NA 26.46 090 26358 A Repair/graft hand tendon 9.09 NA 17.61 1.28 NA 27.98 090 26370 A Repair finger/hand tendon 7.07 NA 16.11 1.08 NA 24.26 090 26372 A Repair/graft hand tendon 8.71 NA 17.50 1.27 NA 27.48 090 26373 A Repair finger/hand tendon 8.11 NA 17.07 1.17 NA 26.35 090 26390 A Revise hand/finger tendon 9.14 NA 14.07 1.31 NA 24.52 090 26392 A Repair/graft hand tendon 10.20 NA 17.86 1.51 NA 29.57 090 26410 A Repair hand tendon 4.60 NA 12.74 0.68 NA 18.02 090 26412 A Repair/graft hand tendon 6.27 NA 14.08 0.96 NA 21.31 090 26415 A Excision, hand/finger tendon 8.29 NA 12.43 0.92 NA 21.64 090 26416 A Graft hand or finger tendon 9.32 NA 15.37 1.44 NA 26.13 090 26418 A Repair finger tendon 4.23 NA 13.10 0.60 NA 17.93 090 26420 A Repair/graft finger tendon 6.73 NA 14.43 0.99 NA 22.15 090 26426 A Repair finger/hand tendon 6.11 NA 13.92 0.92 NA 20.95 090 26428 A Repair/graft finger tendon 7.17 NA 14.73 1.01 NA 22.91 090 26432 A Repair finger tendon 4.00 NA 10.81 0.58 NA 15.39 090 26433 A Repair finger tendon 4.53 NA 11.49 0.67 NA 16.69 090 26434 A Repair/graft finger tendon 6.06 NA 12.20 0.85 NA 19.11 090 26437 A Realignment of tendons 5.79 NA 12.12 0.89 NA 18.80 090 26440 A Release palm/finger tendon 4.99 NA 14.34 0.74 NA 20.07 090 26442 A Release palm & finger tendon 8.11 NA 16.79 1.13 NA 26.03 090 26445 A Release hand/finger tendon 4.29 NA 14.09 0.65 NA 19.03 090 26449 A Release forearm/hand tendon 6.96 NA 16.57 1.01 NA 24.54 090 26450 A Incision of palm tendon 3.65 NA 7.66 0.55 NA 11.86 090 26455 A Incision of finger tendon 3.62 NA 7.59 0.56 NA 11.77 090 26460 A Incise hand/finger tendon 3.44 NA 7.40 0.53 NA 11.37 090 26471 A Fusion of finger tendons 5.70 NA 11.79 0.87 NA 18.36 090 26474 A Fusion of finger tendons 5.29 NA 11.97 0.83 NA 18.09 090 26476 A Tendon lengthening 5.15 NA 11.49 0.74 NA 17.38 090 26477 A Tendon shortening 5.12 NA 11.66 0.72 NA 17.50 090 26478 A Lengthening of hand tendon 5.77 NA 12.37 0.92 NA 19.06 090 Start Printed Page 63279 26479 A Shortening of hand tendon 5.71 NA 12.22 0.91 NA 18.84 090 26480 A Transplant hand tendon 6.65 NA 15.85 1.01 NA 23.51 090 26483 A Transplant/graft hand tendon 8.24 NA 16.31 1.23 NA 25.78 090 26485 A Transplant palm tendon 7.66 NA 16.18 1.13 NA 24.97 090 26489 A Transplant/graft palm tendon 9.50 NA 12.70 1.17 NA 23.37 090 26490 A Revise thumb tendon 8.36 NA 13.32 1.26 NA 22.94 090 26492 A Tendon transfer with graft 9.57 NA 14.14 1.43 NA 25.14 090 26494 A Hand tendon/muscle transfer 8.42 NA 13.76 1.35 NA 23.53 090 26496 A Revise thumb tendon 9.54 NA 13.75 1.40 NA 24.69 090 26497 A Finger tendon transfer 9.52 NA 14.12 1.40 NA 25.04 090 26498 A Finger tendon transfer 13.92 NA 16.73 2.09 NA 32.74 090 26499 A Revision of finger 8.93 NA 13.66 1.13 NA 23.72 090 26500 A Hand tendon reconstruction 5.93 NA 12.24 0.79 NA 18.96 090 26502 A Hand tendon reconstruction 7.10 NA 12.72 1.04 NA 20.86 090 26504 A Hand tendon reconstruction 7.43 NA 13.15 1.01 NA 21.59 090 26508 A Release thumb contracture 5.98 NA 12.24 0.91 NA 19.13 090 26510 A Thumb tendon transfer 5.40 NA 11.93 0.85 NA 18.18 090 26516 A Fusion of knuckle joint 7.11 NA 12.79 1.08 NA 20.98 090 26517 A Fusion of knuckle joints 8.78 NA 14.12 1.15 NA 24.05 090 26518 A Fusion of knuckle joints 8.97 NA 13.93 1.35 NA 24.25 090 26520 A Release knuckle contracture 5.27 NA 14.80 0.78 NA 20.85 090 26525 A Release finger contracture 5.30 NA 14.91 0.79 NA 21.00 090 26530 A Revise knuckle joint 6.65 NA 6.08 1.03 NA 13.76 090 26531 A Revise knuckle with implant 7.86 NA 7.07 1.21 NA 16.14 090 26535 A Revise finger joint 5.21 NA 3.73 0.79 NA 9.73 090 26536 A Revise/implant finger joint 6.33 NA 9.84 0.96 NA 17.13 090 26540 A Repair hand joint 6.39 NA 12.49 0.97 NA 19.85 090 26541 A Repair hand joint with graft 8.57 NA 13.99 1.34 NA 23.90 090 26542 A Repair hand joint with graft 6.74 NA 12.54 1.04 NA 20.32 090 26545 A Reconstruct finger joint 6.88 NA 12.93 0.95 NA 20.76 090 26546 A Repair nonunion hand 8.87 NA 15.37 1.37 NA 25.61 090 26548 A Reconstruct finger joint 7.98 NA 13.55 1.17 NA 22.70 090 26550 A Construct thumb replacement 21.12 NA 18.39 2.16 NA 41.67 090 26551 A Great toe-hand transfer 46.31 NA 34.09 7.87 NA 88.27 090 26553 A Single transfer, toe-hand 46.01 NA 23.43 2.39 NA 71.83 090 26554 A Double transfer, toe-hand 54.64 NA 38.69 9.30 NA 102.63 090 26555 A Positional change of finger 16.54 NA 18.86 2.55 NA 37.95 090 26556 A Toe joint transfer 46.99 NA 34.88 7.99 NA 89.86 090 26560 A Repair of web finger 5.35 NA 10.41 0.72 NA 16.48 090 26561 A Repair of web finger 10.86 NA 13.07 0.83 NA 24.76 090 26562 A Repair of web finger 14.91 NA 17.78 1.17 NA 33.86 090 26565 A Correct metacarpal flaw 6.70 NA 12.60 1.01 NA 20.31 090 26567 A Correct finger deformity 6.78 NA 12.53 1.01 NA 20.32 090 26568 A Lengthen metacarpal/finger 9.03 NA 16.27 1.32 NA 26.62 090 26580 A Repair hand deformity 18.08 NA 13.88 1.75 NA 33.71 090 26587 A Reconstruct extra finger 13.97 NA 9.14 1.34 NA 24.45 090 26590 A Repair finger deformity 17.86 NA 14.56 1.58 NA 34.00 090 26591 A Repair muscles of hand 3.23 NA 10.56 0.44 NA 14.23 090 26593 A Release muscles of hand 5.28 NA 11.63 0.77 NA 17.68 090 26596 A Excision constricting tissue 8.90 NA 9.12 1.04 NA 19.06 090 26600 A Treat metacarpal fracture 1.95 4.13 2.69 0.30 6.38 4.94 090 26605 A Treat metacarpal fracture 2.83 5.31 3.62 0.46 8.60 6.91 090 26607 A Treat metacarpal fracture 5.33 NA 6.41 0.84 NA 12.58 090 26608 A Treat metacarpal fracture 5.33 NA 6.42 0.87 NA 12.62 090 26615 A Treat metacarpal fracture 5.30 NA 5.59 0.84 NA 11.73 090 26641 A Treat thumb dislocation 3.92 5.47 3.64 0.50 9.89 8.06 090 26645 A Treat thumb fracture 4.38 6.17 4.23 0.65 11.20 9.26 090 26650 A Treat thumb fracture 5.69 NA 6.84 0.92 NA 13.45 090 26665 A Treat thumb fracture 7.56 NA 6.88 1.16 NA 15.60 090 26670 A Treat hand dislocation 3.67 4.96 3.09 0.43 9.06 7.19 090 26675 A Treat hand dislocation 4.61 6.30 4.47 0.67 11.58 9.75 090 26676 A Pin hand dislocation 5.49 NA 6.87 0.91 NA 13.27 090 26685 A Treat hand dislocation 6.94 NA 6.32 1.14 NA 14.40 090 26686 A Treat hand dislocation 7.89 NA 7.10 1.26 NA 16.25 090 26700 A Treat knuckle dislocation 3.67 4.71 3.02 0.42 8.80 7.11 090 26705 A Treat knuckle dislocation 4.17 6.10 4.31 0.60 10.87 9.08 090 26706 A Pin knuckle dislocation 5.09 NA 5.15 0.77 NA 11.01 090 26715 A Treat knuckle dislocation 5.71 NA 5.78 0.90 NA 12.39 090 26720 A Treat finger fracture, each 1.65 3.94 2.65 0.24 5.83 4.54 090 26725 A Treat finger fracture, each 3.31 6.16 4.09 0.52 9.99 7.92 090 26727 A Treat finger fracture, each 5.20 NA 6.48 0.83 NA 12.51 090 26735 A Treat finger fracture, each 5.95 NA 5.92 0.92 NA 12.79 090 26740 A Treat finger fracture, each 1.93 3.60 2.73 0.29 5.82 4.95 090 26742 A Treat finger fracture, each 3.83 5.88 3.90 0.59 10.30 8.32 090 26746 A Treat finger fracture, each 5.78 NA 5.97 0.89 NA 12.64 090 Start Printed Page 63280 26750 A Treat finger fracture, each 1.69 3.18 2.12 0.23 5.10 4.04 090 26755 A Treat finger fracture, each 3.08 4.85 3.10 0.44 8.37 6.62 090 26756 A Pin finger fracture, each 4.36 NA 6.10 0.67 NA 11.13 090 26765 A Treat finger fracture, each 4.15 NA 4.82 0.61 NA 9.58 090 26770 A Treat finger dislocation 3.00 4.47 2.60 0.32 7.79 5.92 090 26775 A Treat finger dislocation 3.69 5.92 3.88 0.52 10.13 8.09 090 26776 A Pin finger dislocation 4.77 NA 6.27 0.76 NA 11.80 090 26785 A Treat finger dislocation 4.19 NA 4.85 0.65 NA 9.69 090 26820 A Thumb fusion with graft 8.21 NA 13.77 1.33 NA 23.31 090 26841 A Fusion of thumb 7.09 NA 13.67 1.16 NA 21.92 090 26842 A Thumb fusion with graft 8.19 NA 13.85 1.32 NA 23.36 090 26843 A Fusion of hand joint 7.57 NA 12.79 1.19 NA 21.55 090 26844 A Fusion/graft of hand joint 8.68 NA 13.82 1.34 NA 23.84 090 26850 A Fusion of knuckle 6.93 NA 12.70 1.07 NA 20.70 090 26852 A Fusion of knuckle with graft 8.41 NA 13.41 1.26 NA 23.08 090 26860 A Fusion of finger joint 4.66 NA 11.68 0.72 NA 17.06 090 26861 A Fusion of finger jnt, add-on 1.73 NA 0.94 0.26 NA 2.93 ZZZ 26862 A Fusion/graft of finger joint 7.33 NA 12.89 1.10 NA 21.32 090 26863 A Fuse/graft added joint 3.88 NA 2.14 0.61 NA 6.63 ZZZ 26910 A Amputate metacarpal bone 7.56 NA 11.83 1.08 NA 20.47 090 26951 A Amputation of finger/thumb 4.56 NA 10.74 0.67 NA 15.97 090 26952 A Amputation of finger/thumb 6.27 NA 12.35 0.89 NA 19.51 090 26989 C Hand/finger surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26990 A Drainage of pelvis lesion 7.44 NA 7.70 1.10 NA 16.24 090 26991 A Drainage of pelvis bursa 6.64 7.56 6.00 1.02 15.22 13.66 090 26992 A Drainage of bone lesion 12.95 NA 11.00 2.10 NA 26.05 090 27000 A Incision of hip tendon 5.59 NA 5.35 0.91 NA 11.85 090 27001 A Incision of hip tendon 6.90 NA 6.21 1.14 NA 14.25 090 27003 A Incision of hip tendon 7.30 NA 6.62 1.11 NA 15.03 090 27005 A Incision of hip tendon 9.60 NA 7.93 1.63 NA 19.16 090 27006 A Incision of hip tendons 9.62 NA 8.08 1.59 NA 19.29 090 27025 A Incision of hip/thigh fascia 11.10 NA 8.67 1.65 NA 21.42 090 27030 A Drainage of hip joint 12.94 NA 9.76 2.17 NA 24.87 090 27033 A Exploration of hip joint 13.31 NA 10.03 2.24 NA 25.58 090 27035 A Denervation of hip joint 16.59 NA 12.45 2.04 NA 31.08 090 27036 A Excision of hip joint/muscle 12.81 NA 10.13 2.16 NA 25.10 090 27040 A Biopsy of soft tissues 2.85 2.65 2.07 0.25 5.75 5.17 010 27041 A Biopsy of soft tissues 9.83 NA 6.80 1.21 NA 17.84 090 27047 A Remove hip/pelvis lesion 7.41 6.62 5.05 0.95 14.98 13.41 090 27048 A Remove hip/pelvis lesion 6.21 NA 5.10 0.87 NA 12.18 090 27049 A Remove tumor, hip/pelvis 13.58 NA 8.93 1.92 NA 24.43 090 27050 A Biopsy of sacroiliac joint 4.34 NA 4.52 0.64 NA 9.50 090 27052 A Biopsy of hip joint 6.19 NA 5.95 1.02 NA 13.16 090 27054 A Removal of hip joint lining 8.49 NA 7.44 1.40 NA 17.33 090 27060 A Removal of ischial bursa 5.40 NA 4.88 0.72 NA 11.00 090 27062 A Remove femur lesion/bursa 5.34 NA 5.28 0.89 NA 11.51 090 27065 A Removal of hip bone lesion 5.87 NA 5.60 0.91 NA 12.38 090 27066 A Removal of hip bone lesion 10.27 NA 8.59 1.70 NA 20.56 090 27067 A Remove/graft hip bone lesion 13.75 NA 10.79 2.34 NA 26.88 090 27070 A Partial removal of hip bone 10.66 NA 9.88 1.63 NA 22.17 090 27071 A Partial removal of hip bone 11.39 NA 10.86 1.81 NA 24.06 090 27075 A Extensive hip surgery 34.80 NA 19.89 2.66 NA 57.35 090 27076 A Extensive hip surgery 21.99 NA 14.93 3.43 NA 40.35 090 27077 A Extensive hip surgery 39.77 NA 23.36 3.81 NA 66.94 090 27078 A Extensive hip surgery 13.36 NA 10.54 2.00 NA 25.90 090 27079 A Extensive hip surgery 13.67 NA 10.20 2.23 NA 26.10 090 27080 A Removal of tail bone 6.35 NA 5.14 0.96 NA 12.45 090 27086 A Remove hip foreign body 1.86 2.03 1.89 0.20 4.09 3.95 010 27087 A Remove hip foreign body 8.49 NA 6.79 1.31 NA 16.59 090 27090 A Removal of hip prosthesis 11.09 NA 8.74 1.86 NA 21.69 090 27091 A Removal of hip prosthesis 22.01 NA 14.02 3.73 NA 39.76 090 27093 A Injection for hip x-ray 1.29 12.36 0.49 0.11 13.76 1.89 000 27095 A Injection for hip x-ray 1.49 10.91 0.53 0.12 12.52 2.14 000 27096 A Inject sacroiliac joint 1.39 9.63 0.34 0.10 11.12 1.83 000 27097 A Revision of hip tendon 8.75 NA 6.56 1.46 NA 16.77 090 27098 A Transfer tendon to pelvis 8.78 NA 7.16 1.49 NA 17.43 090 27100 A Transfer of abdominal muscle 11.02 NA 8.83 1.88 NA 21.73 090 27105 A Transfer of spinal muscle 11.70 NA 9.31 1.99 NA 23.00 090 27110 A Transfer of iliopsoas muscle 13.18 NA 9.54 1.65 NA 24.37 090 27111 A Transfer of iliopsoas muscle 12.08 NA 9.28 1.77 NA 23.13 090 27120 A Reconstruction of hip socket 17.91 NA 11.87 2.94 NA 32.72 090 27122 A Reconstruction of hip socket 14.89 NA 11.02 2.49 NA 28.40 090 27125 A Partial hip replacement 14.61 NA 10.60 2.46 NA 27.67 090 27130 A Total hip arthroplasty 20.01 NA 13.35 3.38 NA 36.74 090 27132 A Total hip arthroplasty 23.17 NA 15.65 3.91 NA 42.73 090 Start Printed Page 63281 27134 A Revise hip joint replacement 28.36 NA 17.88 4.76 NA 51.00 090 27137 A Revise hip joint replacement 21.05 NA 13.96 3.56 NA 38.57 090 27138 A Revise hip joint replacement 22.04 NA 14.44 3.73 NA 40.21 090 27140 A Transplant femur ridge 12.17 NA 9.52 2.00 NA 23.69 090 27146 A Incision of hip bone 17.33 NA 12.38 2.72 NA 32.43 090 27147 A Revision of hip bone 20.46 NA 13.49 3.13 NA 37.08 090 27151 A Incision of hip bones 22.38 NA 8.38 3.74 NA 34.50 090 27156 A Revision of hip bones 24.49 NA 16.27 4.17 NA 44.93 090 27158 A Revision of pelvis 19.63 NA 11.37 3.12 NA 34.12 090 27161 A Incision of neck of femur 16.61 NA 12.21 2.78 NA 31.60 090 27165 A Incision/fixation of femur 17.81 NA 12.99 3.01 NA 33.81 090 27170 A Repair/graft femur head/neck 15.98 NA 11.42 2.64 NA 30.04 090 27175 A Treat slipped epiphysis 8.41 NA 6.65 1.43 NA 16.49 090 27176 A Treat slipped epiphysis 11.98 NA 9.09 2.01 NA 23.08 090 27177 A Treat slipped epiphysis 14.99 NA 10.95 2.53 NA 28.47 090 27178 A Treat slipped epiphysis 11.92 NA 8.51 2.01 NA 22.44 090 27179 A Revise head/neck of femur 12.91 NA 10.02 2.21 NA 25.14 090 27181 A Treat slipped epiphysis 14.60 NA 10.26 2.09 NA 26.95 090 27185 A Revision of femur epiphysis 9.13 NA 7.66 1.55 NA 18.34 090 27187 A Reinforce hip bones 13.46 NA 10.44 2.27 NA 26.17 090 27193 A Treat pelvic ring fracture 5.53 7.18 5.80 0.92 13.63 12.25 090 27194 A Treat pelvic ring fracture 9.59 8.86 7.58 1.58 20.03 18.75 090 27200 A Treat tail bone fracture 1.83 3.08 2.21 0.26 5.17 4.30 090 27202 A Treat tail bone fracture 7.00 NA 17.89 0.83 NA 25.72 090 27215 A Treat pelvic fracture(s) 9.99 NA 7.25 1.64 NA 18.88 090 27216 A Treat pelvic ring fracture 15.10 NA 9.84 2.58 NA 27.52 090 27217 A Treat pelvic ring fracture 14.03 NA 10.27 2.34 NA 26.64 090 27218 A Treat pelvic ring fracture 20.04 NA 11.64 3.42 NA 35.10 090 27220 A Treat hip socket fracture 6.14 7.13 5.57 1.02 14.29 12.73 090 27222 A Treat hip socket fracture 12.63 NA 9.98 2.12 NA 24.73 090 27226 A Treat hip wall fracture 14.83 NA 8.05 2.48 NA 25.36 090 27227 A Treat hip fracture(s) 23.32 NA 15.52 3.88 NA 42.72 090 27228 A Treat hip fracture(s) 27.01 NA 17.76 4.52 NA 49.29 090 27230 A Treat thigh fracture 5.47 6.59 5.11 0.87 12.93 11.45 090 27232 A Treat thigh fracture 10.62 NA 7.26 1.74 NA 19.62 090 27235 A Treat thigh fracture 12.09 NA 9.50 2.05 NA 23.64 090 27236 A Treat thigh fracture 15.51 NA 11.05 2.61 NA 29.17 090 27238 A Treat thigh fracture 5.49 NA 5.15 0.91 NA 11.55 090 27240 A Treat thigh fracture 12.43 NA 9.47 2.03 NA 23.93 090 27244 A Treat thigh fracture 15.85 NA 11.37 2.67 NA 29.89 090 27245 A Treat thigh fracture 20.19 NA 13.84 3.42 NA 37.45 090 27246 A Treat thigh fracture 4.68 5.73 4.47 0.79 11.20 9.94 090 27248 A Treat thigh fracture 10.39 NA 8.28 1.74 NA 20.41 090 27250 A Treat hip dislocation 6.91 NA 4.84 0.82 NA 12.57 090 27252 A Treat hip dislocation 10.33 NA 7.47 1.64 NA 19.44 090 27253 A Treat hip dislocation 12.85 NA 9.82 2.17 NA 24.84 090 27254 A Treat hip dislocation 18.16 NA 12.16 3.02 NA 33.34 090 27256 A Treat hip dislocation 4.10 3.47 2.11 0.59 8.16 6.80 010 27257 A Treat hip dislocation 5.19 NA 2.92 0.67 NA 8.78 010 27258 A Treat hip dislocation 15.34 NA 11.03 2.47 NA 28.84 090 27259 A Treat hip dislocation 21.43 NA 14.27 3.58 NA 39.28 090 27265 A Treat hip dislocation 5.02 NA 4.81 0.78 NA 10.61 090 27266 A Treat hip dislocation 7.45 NA 6.33 1.25 NA 15.03 090 27275 A Manipulation of hip joint 2.26 NA 2.15 0.37 NA 4.78 010 27280 A Fusion of sacroiliac joint 13.31 NA 10.41 2.37 NA 26.09 090 27282 A Fusion of pubic bones 11.28 NA 8.33 1.37 NA 20.98 090 27284 A Fusion of hip joint 23.32 NA 14.99 2.83 NA 41.14 090 27286 A Fusion of hip joint 23.32 NA 15.98 2.84 NA 42.14 090 27290 A Amputation of leg at hip 23.15 NA 14.32 3.52 NA 40.99 090 27295 A Amputation of leg at hip 18.54 NA 11.65 2.82 NA 33.01 090 27299 C Pelvis/hip joint surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27301 A Drain thigh/knee lesion 6.45 7.42 5.91 0.96 14.83 13.32 090 27303 A Drainage of bone lesion 8.23 NA 7.32 1.37 NA 16.92 090 27305 A Incise thigh tendon & fascia 5.89 NA 5.40 0.92 NA 12.21 090 27306 A Incision of thigh tendon 4.59 NA 4.85 0.74 NA 10.18 090 27307 A Incision of thigh tendons 5.77 NA 5.58 0.93 NA 12.28 090 27310 A Exploration of knee joint 9.22 NA 7.62 1.55 NA 18.39 090 27315 A Partial removal, thigh nerve 6.93 NA 4.88 0.95 NA 12.76 090 27320 A Partial removal, thigh nerve 6.26 NA 5.18 0.93 NA 12.37 090 27323 A Biopsy, thigh soft tissues 2.27 2.22 1.94 0.20 4.69 4.41 010 27324 A Biopsy, thigh soft tissues 4.87 NA 4.40 0.71 NA 9.98 090 27327 A Removal of thigh lesion 4.44 5.40 3.95 0.60 10.44 8.99 090 27328 A Removal of thigh lesion 5.54 NA 4.61 0.79 NA 10.94 090 27329 A Remove tumor, thigh/knee 14.06 NA 9.62 2.01 NA 25.69 090 27330 A Biopsy, knee joint lining 4.94 NA 4.69 0.79 NA 10.42 090 Start Printed Page 63282 27331 A Explore/treat knee joint 5.85 NA 5.57 0.97 NA 12.39 090 27332 A Removal of knee cartilage 8.22 NA 7.14 1.38 NA 16.74 090 27333 A Removal of knee cartilage 7.26 NA 6.68 1.23 NA 15.17 090 27334 A Remove knee joint lining 8.65 NA 7.46 1.45 NA 17.56 090 27335 A Remove knee joint lining 9.94 NA 8.27 1.69 NA 19.90 090 27340 A Removal of kneecap bursa 4.16 NA 4.57 0.70 NA 9.43 090 27345 A Removal of knee cyst 5.89 NA 5.66 0.97 NA 12.52 090 27347 A Remove knee cyst 5.75 NA 5.48 0.91 NA 12.14 090 27350 A Removal of kneecap 8.12 NA 7.26 1.38 NA 16.76 090 27355 A Remove femur lesion 7.61 NA 6.88 1.28 NA 15.77 090 27356 A Remove femur lesion/graft 9.43 NA 7.97 1.55 NA 18.95 090 27357 A Remove femur lesion/graft 10.47 NA 8.80 1.77 NA 21.04 090 27358 A Remove femur lesion/fixation 4.71 NA 2.56 0.80 NA 8.07 ZZZ 27360 A Partial removal, leg bone(s) 10.44 NA 10.04 1.70 NA 22.18 090 27365 A Extensive leg surgery 16.18 NA 11.80 2.71 NA 30.69 090 27370 A Injection for knee x-ray 0.95 12.16 0.33 0.07 13.18 1.35 000 27372 A Removal of foreign body 5.04 6.08 4.73 0.74 11.86 10.51 090 27380 A Repair of kneecap tendon 7.12 NA 7.33 1.20 NA 15.65 090 27381 A Repair/graft kneecap tendon 10.28 NA 9.14 1.73 NA 21.15 090 27385 A Repair of thigh muscle 7.72 NA 7.67 1.31 NA 16.70 090 27386 A Repair/graft of thigh muscle 10.50 NA 9.57 1.79 NA 21.86 090 27390 A Incision of thigh tendon 5.30 NA 5.31 0.83 NA 11.44 090 27391 A Incision of thigh tendons 7.16 NA 6.70 1.19 NA 15.05 090 27392 A Incision of thigh tendons 9.15 NA 7.80 1.47 NA 18.42 090 27393 A Lengthening of thigh tendon 6.35 NA 5.91 1.08 NA 13.34 090 27394 A Lengthening of thigh tendons 8.45 NA 7.35 1.40 NA 17.20 090 27395 A Lengthening of thigh tendons 11.66 NA 9.49 1.95 NA 23.10 090 27396 A Transplant of thigh tendon 7.82 NA 7.13 1.33 NA 16.28 090 27397 A Transplants of thigh tendons 11.22 NA 9.14 1.89 NA 22.25 090 27400 A Revise thigh muscles/tendons 8.97 NA 7.42 1.41 NA 17.80 090 27403 A Repair of knee cartilage 8.28 NA 7.22 1.39 NA 16.89 090 27405 A Repair of knee ligament 8.60 NA 7.54 1.45 NA 17.59 090 27407 A Repair of knee ligament 10.22 NA 8.39 1.65 NA 20.26 090 27409 A Repair of knee ligaments 12.83 NA 10.01 2.10 NA 24.94 090 27418 A Repair degenerated kneecap 10.79 NA 8.95 1.81 NA 21.55 090 27420 A Revision of unstable kneecap 9.77 NA 8.15 1.65 NA 19.57 090 27422 A Revision of unstable kneecap 9.72 NA 8.16 1.64 NA 19.52 090 27424 A Revision/removal of kneecap 9.75 NA 8.13 1.65 NA 19.53 090 27425 A Lat retinacular release open 5.19 NA 5.55 0.87 NA 11.61 090 27427 A Reconstruction, knee 9.31 NA 7.82 1.55 NA 18.68 090 27428 A Reconstruction, knee 13.92 NA 11.21 2.34 NA 27.47 090 27429 A Reconstruction, knee 15.43 NA 12.47 2.61 NA 30.51 090 27430 A Revision of thigh muscles 9.61 NA 8.05 1.62 NA 19.28 090 27435 A Incision of knee joint 9.44 NA 8.45 1.59 NA 19.48 090 27437 A Revise kneecap 8.41 NA 7.19 1.41 NA 17.01 090 27438 A Revise kneecap with implant 11.17 NA 8.51 1.87 NA 21.55 090 27440 A Revision of knee joint 10.37 NA 6.08 1.70 NA 18.15 090 27441 A Revision of knee joint 10.76 NA 6.76 1.79 NA 19.31 090 27442 A Revision of knee joint 11.82 NA 8.90 2.01 NA 22.73 090 27443 A Revision of knee joint 10.87 NA 8.67 1.82 NA 21.36 090 27445 A Revision of knee joint 17.58 NA 12.35 2.98 NA 32.91 090 27446 A Revision of knee joint 15.75 NA 11.26 2.66 NA 29.67 090 27447 A Total knee arthroplasty 21.36 NA 14.61 3.60 NA 39.57 090 27448 A Incision of thigh 11.00 NA 8.74 1.81 NA 21.55 090 27450 A Incision of thigh 13.90 NA 10.71 2.35 NA 26.96 090 27454 A Realignment of thigh bone 17.46 NA 12.62 2.95 NA 33.03 090 27455 A Realignment of knee 12.75 NA 9.96 2.13 NA 24.84 090 27457 A Realignment of knee 13.37 NA 10.01 2.25 NA 25.63 090 27465 A Shortening of thigh bone 13.79 NA 10.45 2.23 NA 26.47 090 27466 A Lengthening of thigh bone 16.24 NA 12.00 2.30 NA 30.54 090 27468 A Shorten/lengthen thighs 18.86 NA 12.58 3.21 NA 34.65 090 27470 A Repair of thigh 15.98 NA 11.96 2.68 NA 30.62 090 27472 A Repair/graft of thigh 17.62 NA 12.86 2.98 NA 33.46 090 27475 A Surgery to stop leg growth 8.59 NA 7.30 1.35 NA 17.24 090 27477 A Surgery to stop leg growth 9.79 NA 7.82 1.57 NA 19.18 090 27479 A Surgery to stop leg growth 12.73 NA 9.96 2.17 NA 24.86 090 27485 A Surgery to stop leg growth 8.79 NA 7.46 1.49 NA 17.74 090 27486 A Revise/replace knee joint 19.16 NA 13.48 3.24 NA 35.88 090 27487 A Revise/replace knee joint 25.13 NA 16.59 4.24 NA 45.96 090 27488 A Removal of knee prosthesis 15.65 NA 11.66 2.65 NA 29.96 090 27495 A Reinforce thigh 15.46 NA 11.59 2.61 NA 29.66 090 27496 A Decompression of thigh/knee 6.08 NA 5.77 0.92 NA 12.77 090 27497 A Decompression of thigh/knee 7.13 NA 5.71 1.01 NA 13.85 090 27498 A Decompression of thigh/knee 7.94 NA 6.13 1.16 NA 15.23 090 27499 A Decompression of thigh/knee 8.95 NA 7.06 1.41 NA 17.42 090 Start Printed Page 63283 27500 A Treatment of thigh fracture 5.89 7.09 5.05 0.96 13.94 11.90 090 27501 A Treatment of thigh fracture 5.89 7.65 5.73 0.99 14.53 12.61 090 27502 A Treatment of thigh fracture 10.52 NA 8.20 1.79 NA 20.51 090 27503 A Treatment of thigh fracture 10.52 NA 8.35 1.79 NA 20.66 090 27506 A Treatment of thigh fracture 17.35 NA 12.84 2.79 NA 32.98 090 27507 A Treatment of thigh fracture 13.91 NA 9.98 2.34 NA 26.23 090 27508 A Treatment of thigh fracture 5.80 7.05 5.38 0.96 13.81 12.14 090 27509 A Treatment of thigh fracture 7.67 NA 7.99 1.29 NA 16.95 090 27510 A Treatment of thigh fracture 9.08 NA 7.25 1.51 NA 17.84 090 27511 A Treatment of thigh fracture 13.56 NA 11.31 2.29 NA 27.16 090 27513 A Treatment of thigh fracture 17.82 NA 13.97 3.01 NA 34.80 090 27514 A Treatment of thigh fracture 17.20 NA 13.44 2.89 NA 33.53 090 27516 A Treat thigh fx growth plate 5.34 7.35 5.44 0.89 13.58 11.67 090 27517 A Treat thigh fx growth plate 8.73 8.99 7.42 1.46 19.18 17.61 090 27519 A Treat thigh fx growth plate 14.93 NA 11.75 2.51 NA 29.19 090 27520 A Treat kneecap fracture 2.84 5.29 3.46 0.46 8.59 6.76 090 27524 A Treat kneecap fracture 9.94 NA 8.23 1.68 NA 19.85 090 27530 A Treat knee fracture 3.76 5.95 4.32 0.61 10.32 8.69 090 27532 A Treat knee fracture 7.26 7.90 6.32 1.22 16.38 14.80 090 27535 A Treat knee fracture 11.43 NA 10.20 1.93 NA 23.56 090 27536 A Treat knee fracture 15.56 NA 11.60 2.62 NA 29.78 090 27538 A Treat knee fracture(s) 4.84 7.14 5.14 0.80 12.78 10.78 090 27540 A Treat knee fracture 13.03 NA 9.57 2.16 NA 24.76 090 27550 A Treat knee dislocation 5.73 6.66 4.99 0.82 13.21 11.54 090 27552 A Treat knee dislocation 7.85 NA 6.94 1.32 NA 16.11 090 27556 A Treat knee dislocation 14.33 NA 11.78 2.41 NA 28.52 090 27557 A Treat knee dislocation 16.67 NA 13.26 2.84 NA 32.77 090 27558 A Treat knee dislocation 17.62 NA 13.22 3.01 NA 33.85 090 27560 A Treat kneecap dislocation 3.80 5.65 3.35 0.48 9.93 7.63 090 27562 A Treat kneecap dislocation 5.76 NA 4.85 0.83 NA 11.44 090 27566 A Treat kneecap dislocation 12.16 NA 9.35 2.07 NA 23.58 090 27570 A Fixation of knee joint 1.73 NA 1.83 0.29 NA 3.85 010 27580 A Fusion of knee 19.26 NA 14.91 3.24 NA 37.41 090 27590 A Amputate leg at thigh 11.96 NA 7.14 1.62 NA 20.72 090 27591 A Amputate leg at thigh 12.61 NA 8.95 1.95 NA 23.51 090 27592 A Amputate leg at thigh 9.96 NA 6.64 1.40 NA 18.00 090 27594 A Amputation follow-up surgery 6.88 NA 5.48 0.98 NA 13.34 090 27596 A Amputation follow-up surgery 10.54 NA 7.28 1.49 NA 19.31 090 27598 A Amputate lower leg at knee 10.47 NA 7.38 1.49 NA 19.34 090 27599 C Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27600 A Decompression of lower leg 5.62 NA 4.72 0.82 NA 11.16 090 27601 A Decompression of lower leg 5.61 NA 5.05 0.83 NA 11.49 090 27602 A Decompression of lower leg 7.31 NA 5.34 1.02 NA 13.67 090 27603 A Drain lower leg lesion 4.91 10.78 4.88 0.67 16.36 10.46 090 27604 A Drain lower leg bursa 4.44 8.71 4.57 0.65 13.80 9.66 090 27605 A Incision of achilles tendon 2.85 8.89 2.36 0.46 12.20 5.67 010 27606 A Incision of achilles tendon 4.12 10.17 3.44 0.68 14.97 8.24 010 27607 A Treat lower leg bone lesion 7.92 NA 6.65 1.29 NA 15.86 090 27610 A Explore/treat ankle joint 8.29 NA 7.13 1.38 NA 16.80 090 27612 A Exploration of ankle joint 7.29 NA 6.18 1.21 NA 14.68 090 27613 A Biopsy lower leg soft tissue 2.16 3.81 1.78 0.19 6.16 4.13 010 27614 A Biopsy lower leg soft tissue 5.63 8.89 4.67 0.74 15.26 11.04 090 27615 A Remove tumor, lower leg 12.49 NA 10.68 1.67 NA 24.84 090 27618 A Remove lower leg lesion 5.06 9.20 4.26 0.65 14.91 9.97 090 27619 A Remove lower leg lesion 8.35 10.73 6.23 1.21 20.29 15.79 090 27620 A Explore/treat ankle joint 5.95 NA 5.55 0.99 NA 12.49 090 27625 A Remove ankle joint lining 8.25 NA 6.61 1.39 NA 16.25 090 27626 A Remove ankle joint lining 8.86 NA 7.08 1.47 NA 17.41 090 27630 A Removal of tendon lesion 4.77 9.12 4.51 0.72 14.61 10.00 090 27635 A Remove lower leg bone lesion 7.74 NA 6.92 1.27 NA 15.93 090 27637 A Remove/graft leg bone lesion 9.79 NA 8.43 1.65 NA 19.87 090 27638 A Remove/graft leg bone lesion 10.51 NA 8.48 1.76 NA 20.75 090 27640 A Partial removal of tibia 11.31 NA 10.93 1.85 NA 24.09 090 27641 A Partial removal of fibula 9.19 NA 8.92 1.46 NA 19.57 090 27645 A Extensive lower leg surgery 14.09 NA 12.47 2.37 NA 28.93 090 27646 A Extensive lower leg surgery 12.59 NA 11.45 1.86 NA 25.90 090 27647 A Extensive ankle/heel surgery 12.17 NA 7.91 1.97 NA 22.05 090 27648 A Injection for ankle x-ray 0.95 9.54 0.33 0.06 10.55 1.34 000 27650 A Repair achilles tendon 9.63 NA 7.59 1.62 NA 18.84 090 27652 A Repair/graft achilles tendon 10.27 NA 8.10 1.74 NA 20.11 090 27654 A Repair of achilles tendon 9.96 NA 7.30 1.69 NA 18.95 090 27656 A Repair leg fascia defect 4.54 10.07 4.04 0.58 15.19 9.16 090 27658 A Repair of leg tendon, each 4.95 9.29 4.82 0.82 15.06 10.59 090 27659 A Repair of leg tendon, each 6.77 11.42 5.85 1.15 19.34 13.77 090 27664 A Repair of leg tendon, each 4.56 11.39 4.79 0.76 16.71 10.11 090 Start Printed Page 63284 27665 A Repair of leg tendon, each 5.37 11.17 5.24 0.90 17.44 11.51 090 27675 A Repair lower leg tendons 7.14 NA 5.85 1.21 NA 14.20 090 27676 A Repair lower leg tendons 8.37 NA 6.85 1.38 NA 16.60 090 27680 A Release of lower leg tendon 5.71 NA 5.25 0.96 NA 11.92 090 27681 A Release of lower leg tendons 6.78 NA 6.02 1.10 NA 13.90 090 27685 A Revision of lower leg tendon 6.46 8.21 5.57 1.09 15.76 13.12 090 27686 A Revise lower leg tendons 7.42 12.67 6.66 1.26 21.35 15.34 090 27687 A Revision of calf tendon 6.20 NA 5.48 1.05 NA 12.73 090 27690 A Revise lower leg tendon 8.66 NA 6.52 1.46 NA 16.64 090 27691 A Revise lower leg tendon 9.90 NA 7.90 1.68 NA 19.48 090 27692 A Revise additional leg tendon 1.86 NA 0.94 0.31 NA 3.11 ZZZ 27695 A Repair of ankle ligament 6.47 NA 5.98 1.08 NA 13.53 090 27696 A Repair of ankle ligaments 8.22 NA 6.57 1.39 NA 16.18 090 27698 A Repair of ankle ligament 9.31 NA 7.06 1.57 NA 17.94 090 27700 A Revision of ankle joint 9.24 NA 5.69 1.49 NA 16.42 090 27702 A Reconstruct ankle joint 13.59 NA 10.43 2.30 NA 26.32 090 27703 A Reconstruction, ankle joint 15.78 NA 11.20 2.68 NA 29.66 090 27704 A Removal of ankle implant 7.58 NA 5.61 0.73 NA 13.92 090 27705 A Incision of tibia 10.32 NA 8.33 1.73 NA 20.38 090 27707 A Incision of fibula 4.35 NA 5.07 0.72 NA 10.14 090 27709 A Incision of tibia & fibula 9.89 NA 8.25 1.67 NA 19.81 090 27712 A Realignment of lower leg 14.17 NA 10.84 2.40 NA 27.41 090 27715 A Revision of lower leg 14.31 NA 10.95 2.40 NA 27.66 090 27720 A Repair of tibia 11.72 NA 9.56 1.99 NA 23.27 090 27722 A Repair/graft of tibia 11.75 NA 9.32 1.98 NA 23.05 090 27724 A Repair/graft of tibia 18.10 NA 12.58 2.52 NA 33.20 090 27725 A Repair of lower leg 15.50 NA 12.01 2.64 NA 30.15 090 27727 A Repair of lower leg 13.93 NA 10.52 2.21 NA 26.66 090 27730 A Repair of tibia epiphysis 7.37 17.94 6.52 0.90 26.21 14.79 090 27732 A Repair of fibula epiphysis 5.29 11.72 5.06 0.76 17.77 11.11 090 27734 A Repair lower leg epiphyses 8.43 NA 6.49 1.02 NA 15.94 090 27740 A Repair of leg epiphyses 9.25 20.84 8.01 1.57 31.66 18.83 090 27742 A Repair of leg epiphyses 10.24 12.64 7.34 1.86 24.74 19.44 090 27745 A Reinforce tibia 10.01 NA 8.30 1.65 NA 19.96 090 27750 A Treatment of tibia fracture 3.17 5.43 3.81 0.52 9.12 7.50 090 27752 A Treatment of tibia fracture 5.81 7.46 5.55 0.98 14.25 12.34 090 27756 A Treatment of tibia fracture 6.74 NA 6.60 1.13 NA 14.47 090 27758 A Treatment of tibia fracture 11.60 NA 9.29 1.82 NA 22.71 090 27759 A Treatment of tibia fracture 13.68 NA 10.43 2.31 NA 26.42 090 27760 A Treatment of ankle fracture 2.99 5.31 3.59 0.47 8.77 7.05 090 27762 A Treatment of ankle fracture 5.22 7.20 5.22 0.85 13.27 11.29 090 27766 A Treatment of ankle fracture 8.31 NA 7.24 1.40 NA 16.95 090 27780 A Treatment of fibula fracture 2.63 4.98 3.25 0.40 8.01 6.28 090 27781 A Treatment of fibula fracture 4.37 6.42 4.54 0.68 11.47 9.59 090 27784 A Treatment of fibula fracture 7.07 NA 6.53 1.17 NA 14.77 090 27786 A Treatment of ankle fracture 2.82 5.15 3.37 0.44 8.41 6.63 090 27788 A Treatment of ankle fracture 4.42 6.54 4.54 0.73 11.69 9.69 090 27792 A Treatment of ankle fracture 7.62 NA 6.98 1.28 NA 15.88 090 27808 A Treatment of ankle fracture 2.81 5.76 3.65 0.46 9.03 6.92 090 27810 A Treatment of ankle fracture 5.10 7.03 5.05 0.85 12.98 11.00 090 27814 A Treatment of ankle fracture 10.62 NA 8.63 1.80 NA 21.05 090 27816 A Treatment of ankle fracture 2.87 5.05 3.45 0.44 8.36 6.76 090 27818 A Treatment of ankle fracture 5.47 7.14 5.10 0.89 13.50 11.46 090 27822 A Treatment of ankle fracture 10.94 NA 10.75 1.55 NA 23.24 090 27823 A Treatment of ankle fracture 12.93 NA 11.61 1.98 NA 26.52 090 27824 A Treat lower leg fracture 2.87 5.63 3.78 0.47 8.97 7.12 090 27825 A Treat lower leg fracture 6.15 8.28 5.92 1.02 15.45 13.09 090 27826 A Treat lower leg fracture 8.49 NA 8.96 1.43 NA 18.88 090 27827 A Treat lower leg fracture 13.98 NA 12.85 2.35 NA 29.18 090 27828 A Treat lower leg fracture 16.14 NA 14.00 2.72 NA 32.86 090 27829 A Treat lower leg joint 5.46 NA 6.85 0.92 NA 13.23 090 27830 A Treat lower leg dislocation 3.77 5.19 3.88 0.53 9.49 8.18 090 27831 A Treat lower leg dislocation 4.53 NA 4.50 0.73 NA 9.76 090 27832 A Treat lower leg dislocation 6.45 NA 6.22 1.09 NA 13.76 090 27840 A Treat ankle dislocation 4.55 NA 3.95 0.56 NA 9.06 090 27842 A Treat ankle dislocation 6.17 NA 5.15 0.91 NA 12.23 090 27846 A Treat ankle dislocation 9.73 NA 8.01 1.63 NA 19.37 090 27848 A Treat ankle dislocation 11.14 NA 9.81 1.86 NA 22.81 090 27860 A Fixation of ankle joint 2.33 NA 2.03 0.37 NA 4.73 010 27870 A Fusion of ankle joint, open 13.83 NA 10.61 2.34 NA 26.78 090 27871 A Fusion of tibiofibular joint 9.12 NA 7.70 1.55 NA 18.37 090 27880 A Amputation of lower leg 11.78 NA 7.51 1.65 NA 20.94 090 27881 A Amputation of lower leg 12.27 NA 9.09 1.91 NA 23.27 090 27882 A Amputation of lower leg 8.89 NA 7.00 1.23 NA 17.12 090 27884 A Amputation follow-up surgery 8.16 NA 6.13 1.14 NA 15.43 090 Start Printed Page 63285 27886 A Amputation follow-up surgery 9.27 NA 6.88 1.35 NA 17.50 090 27888 A Amputation of foot at ankle 9.61 NA 7.67 1.51 NA 18.79 090 27889 A Amputation of foot at ankle 9.92 NA 6.79 1.43 NA 18.14 090 27892 A Decompression of leg 7.35 NA 5.89 1.03 NA 14.27 090 27893 A Decompression of leg 7.31 NA 5.80 1.08 NA 14.19 090 27894 A Decompression of leg 10.43 NA 7.99 1.50 NA 19.92 090 27899 C Leg/ankle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 28001 A Drainage of bursa of foot 2.71 5.88 3.54 0.37 8.96 6.62 010 28002 A Treatment of foot infection 4.59 7.30 4.68 0.67 12.56 9.94 010 28003 A Treatment of foot infection 8.36 7.75 6.10 1.23 17.34 15.69 090 28005 A Treat foot bone lesion 8.63 NA 6.43 1.37 NA 16.43 090 28008 A Incision of foot fascia 4.42 5.75 3.59 0.67 10.84 8.68 090 28010 A Incision of toe tendon 2.82 5.59 2.94 0.47 8.88 6.23 090 28011 A Incision of toe tendons 4.12 7.50 4.29 0.70 12.32 9.11 090 28020 A Exploration of foot joint 4.98 7.14 4.25 0.77 12.89 10.00 090 28022 A Exploration of foot joint 4.64 6.16 3.97 0.74 11.54 9.35 090 28024 A Exploration of toe joint 4.36 6.26 4.03 0.60 11.22 8.99 090 28030 A Removal of foot nerve 6.11 NA 3.62 1.02 NA 10.75 090 28035 A Decompression of tibia nerve 5.06 5.59 4.07 0.85 11.50 9.98 090 28043 A Excision of foot lesion 3.52 5.85 3.31 0.54 9.91 7.37 090 28045 A Excision of foot lesion 4.69 6.19 3.75 0.74 11.62 9.18 090 28046 A Resection of tumor, foot 10.12 9.53 7.42 1.35 21.00 18.89 090 28050 A Biopsy of foot joint lining 4.23 5.84 3.70 0.66 10.73 8.59 090 28052 A Biopsy of foot joint lining 3.92 6.05 3.60 0.61 10.58 8.13 090 28054 A Biopsy of toe joint lining 3.43 5.88 3.40 0.54 9.85 7.37 090 28060 A Partial removal, foot fascia 5.20 6.46 4.07 0.83 12.49 10.10 090 28062 A Removal of foot fascia 6.48 7.21 4.24 1.02 14.71 11.74 090 28070 A Removal of foot joint lining 5.07 6.02 3.93 0.82 11.91 9.82 090 28072 A Removal of foot joint lining 4.55 6.50 4.37 0.77 11.82 9.69 090 28080 A Removal of foot lesion 3.56 5.99 3.74 0.60 10.15 7.90 090 28086 A Excise foot tendon sheath 4.75 9.60 4.74 0.79 15.14 10.28 090 28088 A Excise foot tendon sheath 3.84 7.13 4.04 0.62 11.59 8.50 090 28090 A Removal of foot lesion 4.38 6.09 3.59 0.68 11.15 8.65 090 28092 A Removal of toe lesions 3.62 6.40 3.65 0.55 10.57 7.82 090 28100 A Removal of ankle/heel lesion 5.63 9.33 4.86 0.91 15.87 11.40 090 28102 A Remove/graft foot lesion 7.69 NA 6.09 1.16 NA 14.94 090 28103 A Remove/graft foot lesion 6.46 8.50 4.81 1.07 16.03 12.34 090 28104 A Removal of foot lesion 5.09 6.41 4.09 0.83 12.33 10.01 090 28106 A Remove/graft foot lesion 7.12 NA 4.64 1.21 NA 12.97 090 28107 A Remove/graft foot lesion 5.53 7.33 4.37 0.89 13.75 10.79 090 28108 A Removal of toe lesions 4.14 5.50 3.38 0.62 10.26 8.14 090 28110 A Part removal of metatarsal 4.06 6.09 3.72 0.59 10.74 8.37 090 28111 A Part removal of metatarsal 4.98 7.28 4.23 0.76 13.02 9.97 090 28112 A Part removal of metatarsal 4.46 6.77 4.10 0.72 11.95 9.28 090 28113 A Part removal of metatarsal 4.76 6.89 4.71 0.76 12.41 10.23 090 28114 A Removal of metatarsal heads 9.73 12.06 8.60 1.63 23.42 19.96 090 28116 A Revision of foot 7.71 7.28 5.28 1.23 16.22 14.22 090 28118 A Removal of heel bone 5.93 7.20 4.57 0.95 14.08 11.45 090 28119 A Removal of heel spur 5.36 6.27 3.91 0.89 12.52 10.16 090 28120 A Part removal of ankle/heel 5.37 8.79 5.12 0.83 14.99 11.32 090 28122 A Partial removal of foot bone 7.25 7.98 5.75 1.15 16.38 14.15 090 28124 A Partial removal of toe 4.78 6.14 4.10 0.78 11.70 9.66 090 28126 A Partial removal of toe 3.50 5.39 3.55 0.59 9.48 7.64 090 28130 A Removal of ankle bone 8.06 NA 6.78 1.33 NA 16.17 090 28140 A Removal of metatarsal 6.87 8.35 5.05 1.01 16.23 12.93 090 28150 A Removal of toe 4.07 6.04 3.82 0.62 10.73 8.51 090 28153 A Partial removal of toe 3.64 5.46 3.11 0.59 9.69 7.34 090 28160 A Partial removal of toe 3.72 5.75 3.87 0.61 10.08 8.20 090 28171 A Extensive foot surgery 9.55 NA 5.76 1.35 NA 16.66 090 28173 A Extensive foot surgery 8.75 8.35 5.70 1.25 18.35 15.70 090 28175 A Extensive foot surgery 6.02 6.75 4.13 0.90 13.67 11.05 090 28190 A Removal of foot foreign body 1.95 6.60 3.55 0.19 8.74 5.69 010 28192 A Removal of foot foreign body 4.61 6.51 3.76 0.62 11.74 8.99 090 28193 A Removal of foot foreign body 5.70 6.42 4.16 0.76 12.88 10.62 090 28200 A Repair of foot tendon 4.57 6.00 3.75 0.71 11.28 9.03 090 28202 A Repair/graft of foot tendon 6.80 8.17 4.67 1.03 16.00 12.50 090 28208 A Repair of foot tendon 4.35 5.79 3.50 0.71 10.85 8.56 090 28210 A Repair/graft of foot tendon 6.31 7.20 4.25 0.92 14.43 11.48 090 28220 A Release of foot tendon 4.50 5.62 3.60 0.76 10.88 8.86 090 28222 A Release of foot tendons 5.59 6.01 4.28 0.92 12.52 10.79 090 28225 A Release of foot tendon 3.64 5.32 3.11 0.60 9.56 7.35 090 28226 A Release of foot tendons 4.50 5.67 3.89 0.74 10.91 9.13 090 28230 A Incision of foot tendon(s) 4.22 5.69 3.84 0.71 10.62 8.77 090 28232 A Incision of toe tendon 3.37 5.73 3.48 0.58 9.68 7.43 090 28234 A Incision of foot tendon 3.35 5.89 3.51 0.55 9.79 7.41 090 Start Printed Page 63286 28238 A Revision of foot tendon 7.69 8.06 5.12 1.29 17.04 14.10 090 28240 A Release of big toe 4.34 5.65 3.67 0.73 10.72 8.74 090 28250 A Revision of foot fascia 5.89 6.60 4.31 0.97 13.46 11.17 090 28260 A Release of midfoot joint 7.91 7.15 5.19 1.29 16.35 14.39 090 28261 A Revision of foot tendon 11.66 9.00 7.41 1.99 22.65 21.06 090 28262 A Revision of foot and ankle 15.74 14.48 11.56 2.66 32.88 29.96 090 28264 A Release of midfoot joint 10.29 8.59 7.90 1.75 20.63 19.94 090 28270 A Release of foot contracture 4.73 5.96 4.24 0.80 11.49 9.77 090 28272 A Release of toe joint, each 3.78 5.20 3.07 0.62 9.60 7.47 090 28280 A Fusion of toes 5.16 7.33 4.56 0.86 13.35 10.58 090 28285 A Repair of hammertoe 4.56 6.02 3.88 0.77 11.35 9.21 090 28286 A Repair of hammertoe 4.53 5.80 3.71 0.77 11.10 9.01 090 28288 A Partial removal of foot bone 4.71 6.76 5.36 0.78 12.25 10.85 090 28289 A Repair hallux rigidus 7.00 9.07 6.27 1.15 17.22 14.42 090 28290 A Correction of bunion 5.63 7.09 5.34 0.95 13.67 11.92 090 28292 A Correction of bunion 7.00 7.88 5.81 1.17 16.05 13.98 090 28293 A Correction of bunion 9.10 10.95 6.07 1.53 21.58 16.70 090 28294 A Correction of bunion 8.51 7.72 5.14 1.39 17.62 15.04 090 28296 A Correction of bunion 9.13 8.23 5.86 1.53 18.89 16.52 090 28297 A Correction of bunion 9.13 9.21 6.83 1.57 19.91 17.53 090 28298 A Correction of bunion 7.89 7.38 5.46 1.34 16.61 14.69 090 28299 A Correction of bunion 10.52 8.80 6.48 1.49 20.81 18.49 090 28300 A Incision of heel bone 9.49 13.25 7.14 1.57 24.31 18.20 090 28302 A Incision of ankle bone 9.50 13.25 7.03 1.38 24.13 17.91 090 28304 A Incision of midfoot bones 9.11 8.25 5.86 1.20 18.56 16.17 090 28305 A Incise/graft midfoot bones 10.44 11.00 6.88 0.66 22.10 17.98 090 28306 A Incision of metatarsal 5.83 7.27 4.30 0.97 14.07 11.10 090 28307 A Incision of metatarsal 6.29 11.70 5.39 0.85 18.84 12.53 090 28308 A Incision of metatarsal 5.26 6.13 3.80 0.89 12.28 9.95 090 28309 A Incision of metatarsals 12.71 NA 8.14 1.97 NA 22.82 090 28310 A Revision of big toe 5.40 6.30 4.00 0.91 12.61 10.31 090 28312 A Revision of toe 4.52 6.03 4.15 0.74 11.29 9.41 090 28313 A Repair deformity of toe 4.98 6.50 5.51 0.82 12.30 11.31 090 28315 A Removal of sesamoid bone 4.83 5.88 3.70 0.79 11.50 9.32 090 28320 A Repair of foot bones 9.13 NA 6.83 1.52 NA 17.48 090 28322 A Repair of metatarsals 8.29 10.24 6.39 1.40 19.93 16.08 090 28340 A Resect enlarged toe tissue 6.94 7.12 4.47 1.17 15.23 12.58 090 28341 A Resect enlarged toe 8.36 7.30 5.00 1.41 17.07 14.77 090 28344 A Repair extra toe(s) 4.24 6.85 3.73 0.72 11.81 8.69 090 28345 A Repair webbed toe(s) 5.89 7.07 4.83 1.01 13.97 11.73 090 28360 A Reconstruct cleft foot 13.26 NA 10.61 2.25 NA 26.12 090 28400 A Treatment of heel fracture 2.15 4.33 3.03 0.35 6.83 5.53 090 28405 A Treatment of heel fracture 4.54 5.57 4.58 0.76 10.87 9.88 090 28406 A Treatment of heel fracture 6.27 NA 6.87 1.04 NA 14.18 090 28415 A Treat heel fracture 15.88 NA 13.39 2.68 NA 31.95 090 28420 A Treat/graft heel fracture 16.55 NA 13.10 2.74 NA 32.39 090 28430 A Treatment of ankle fracture 2.08 4.12 2.65 0.32 6.52 5.05 090 28435 A Treatment of ankle fracture 3.38 4.56 3.68 0.56 8.50 7.62 090 28436 A Treatment of ankle fracture 4.68 NA 5.96 0.79 NA 11.43 090 28445 A Treat ankle fracture 15.53 NA 11.14 1.55 NA 28.22 090 28450 A Treat midfoot fracture, each 1.89 4.12 2.55 0.30 6.31 4.74 090 28455 A Treat midfoot fracture, each 3.07 4.01 3.45 0.52 7.60 7.04 090 28456 A Treat midfoot fracture 2.66 NA 4.26 0.43 NA 7.35 090 28465 A Treat midfoot fracture, each 6.97 NA 6.44 1.04 NA 14.45 090 28470 A Treat metatarsal fracture 1.98 3.92 2.52 0.31 6.21 4.81 090 28475 A Treat metatarsal fracture 2.95 4.10 3.22 0.49 7.54 6.66 090 28476 A Treat metatarsal fracture 3.36 NA 5.05 0.55 NA 8.96 090 28485 A Treat metatarsal fracture 5.68 NA 5.61 0.96 NA 12.25 090 28490 A Treat big toe fracture 1.08 2.23 1.77 0.16 3.47 3.01 090 28495 A Treat big toe fracture 1.57 2.52 2.10 0.23 4.32 3.90 090 28496 A Treat big toe fracture 2.32 9.82 3.67 0.38 12.52 6.37 090 28505 A Treat big toe fracture 3.79 9.82 4.75 0.60 14.21 9.14 090 28510 A Treatment of toe fracture 1.08 2.00 1.73 0.16 3.24 2.97 090 28515 A Treatment of toe fracture 1.45 2.36 2.02 0.20 4.01 3.67 090 28525 A Treat toe fracture 3.30 9.41 4.30 0.53 13.24 8.13 090 28530 A Treat sesamoid bone fracture 1.05 2.10 1.49 0.16 3.31 2.70 090 28531 A Treat sesamoid bone fracture 2.34 9.07 2.53 0.40 11.81 5.27 090 28540 A Treat foot dislocation 2.03 2.90 2.71 0.29 5.22 5.03 090 28545 A Treat foot dislocation 2.44 2.89 2.89 0.40 5.73 5.73 090 28546 A Treat foot dislocation 3.18 8.02 4.88 0.55 11.75 8.61 090 28555 A Repair foot dislocation 6.26 11.64 6.62 1.05 18.95 13.93 090 28570 A Treat foot dislocation 1.65 2.92 2.31 0.26 4.83 4.22 090 28575 A Treat foot dislocation 3.29 4.43 4.08 0.54 8.26 7.91 090 28576 A Treat foot dislocation 4.15 10.33 5.57 0.67 15.15 10.39 090 28585 A Repair foot dislocation 7.94 8.23 6.61 1.35 17.52 15.90 090 Start Printed Page 63287 28600 A Treat foot dislocation 1.88 3.32 2.70 0.29 5.49 4.87 090 28605 A Treat foot dislocation 2.69 3.79 3.65 0.42 6.90 6.76 090 28606 A Treat foot dislocation 4.87 16.21 6.07 0.82 21.90 11.76 090 28615 A Repair foot dislocation 7.73 NA 8.08 1.31 NA 17.12 090 28630 A Treat toe dislocation 1.69 1.24 1.14 0.20 3.13 3.03 010 28635 A Treat toe dislocation 1.90 1.68 1.51 0.29 3.87 3.70 010 28636 A Treat toe dislocation 2.75 6.22 3.10 0.47 9.44 6.32 010 28645 A Repair toe dislocation 4.20 5.73 3.54 0.70 10.63 8.44 090 28660 A Treat toe dislocation 1.22 1.63 1.19 0.13 2.98 2.54 010 28665 A Treat toe dislocation 1.91 1.67 1.65 0.29 3.87 3.85 010 28666 A Treat toe dislocation 2.64 6.07 2.26 0.46 9.17 5.36 010 28675 A Repair of toe dislocation 2.90 8.92 3.81 0.49 12.31 7.20 090 28705 A Fusion of foot bones 18.69 NA 12.56 2.55 NA 33.80 090 28715 A Fusion of foot bones 13.03 NA 9.84 2.21 NA 25.08 090 28725 A Fusion of foot bones 11.54 NA 8.39 1.95 NA 21.88 090 28730 A Fusion of foot bones 10.70 NA 8.56 1.81 NA 21.07 090 28735 A Fusion of foot bones 10.79 NA 7.96 1.81 NA 20.56 090 28737 A Revision of foot bones 9.59 NA 6.94 1.63 NA 18.16 090 28740 A Fusion of foot bones 7.97 11.72 6.51 1.35 21.04 15.83 090 28750 A Fusion of big toe joint 7.26 13.11 6.66 1.23 21.60 15.15 090 28755 A Fusion of big toe joint 4.71 6.90 3.90 0.79 12.40 9.40 090 28760 A Fusion of big toe joint 7.71 8.14 5.69 1.28 17.13 14.68 090 28800 A Amputation of midfoot 8.16 NA 6.09 1.17 NA 15.42 090 28805 A Amputation thru metatarsal 8.34 NA 5.94 1.16 NA 15.44 090 28810 A Amputation toe & metatarsal 6.17 NA 4.79 0.84 NA 11.80 090 28820 A Amputation of toe 4.38 8.58 4.12 0.61 13.57 9.11 090 28825 A Partial amputation of toe 3.57 8.00 3.82 0.52 12.09 7.91 090 28899 C Foot/toes surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29000 A Application of body cast 2.24 3.14 1.75 0.36 5.74 4.35 000 29010 A Application of body cast 2.05 3.33 1.75 0.32 5.70 4.12 000 29015 A Application of body cast 2.40 3.04 1.60 0.25 5.69 4.25 000 29020 A Application of body cast 2.10 3.33 1.43 0.19 5.62 3.72 000 29025 A Application of body cast 2.39 3.30 1.86 0.31 6.00 4.56 000 29035 A Application of body cast 1.76 3.49 1.56 0.29 5.54 3.61 000 29040 A Application of body cast 2.21 2.60 1.53 0.42 5.23 4.16 000 29044 A Application of body cast 2.11 3.84 1.87 0.35 6.30 4.33 000 29046 A Application of body cast 2.40 3.33 2.05 0.41 6.14 4.86 000 29049 A Application of figure eight 0.88 1.26 0.55 0.14 2.28 1.57 000 29055 A Application of shoulder cast 1.77 2.85 1.45 0.29 4.91 3.51 000 29058 A Application of shoulder cast 1.30 1.52 0.73 0.17 2.99 2.20 000 29065 A Application of long arm cast 0.87 1.28 0.74 0.14 2.29 1.75 000 29075 A Application of forearm cast 0.77 1.22 0.67 0.13 2.12 1.57 000 29085 A Apply hand/wrist cast 0.87 1.25 0.64 0.13 2.25 1.64 000 29086 A Apply finger cast 0.62 0.94 0.53 0.07 1.63 1.22 000 29105 A Apply long arm splint 0.87 1.20 0.53 0.13 2.20 1.53 000 29125 A Apply forearm splint 0.59 1.00 0.41 0.07 1.66 1.07 000 29126 A Apply forearm splint 0.77 1.22 0.48 0.07 2.06 1.32 000 29130 A Application of finger splint 0.50 0.47 0.17 0.06 1.03 0.73 000 29131 A Application of finger splint 0.55 0.74 0.25 0.04 1.33 0.84 000 29200 A Strapping of chest 0.65 0.76 0.37 0.05 1.46 1.07 000 29220 A Strapping of low back 0.64 0.73 0.40 0.08 1.45 1.12 000 29240 A Strapping of shoulder 0.71 0.87 0.39 0.06 1.64 1.16 000 29260 A Strapping of elbow or wrist 0.55 0.76 0.34 0.05 1.36 0.94 000 29280 A Strapping of hand or finger 0.51 0.83 0.35 0.05 1.39 0.91 000 29305 A Application of hip cast 2.02 3.22 1.73 0.35 5.59 4.10 000 29325 A Application of hip casts 2.31 3.40 1.92 0.37 6.08 4.60 000 29345 A Application of long leg cast 1.39 1.71 1.05 0.23 3.33 2.67 000 29355 A Application of long leg cast 1.52 1.67 1.11 0.24 3.43 2.87 000 29358 A Apply long leg cast brace 1.42 1.98 1.08 0.23 3.63 2.73 000 29365 A Application of long leg cast 1.17 1.60 0.93 0.20 2.97 2.30 000 29405 A Apply short leg cast 0.86 1.19 0.70 0.14 2.19 1.70 000 29425 A Apply short leg cast 1.00 1.19 0.73 0.17 2.36 1.90 000 29435 A Apply short leg cast 1.17 1.51 0.91 0.20 2.88 2.28 000 29440 A Addition of walker to cast 0.57 0.67 0.28 0.08 1.32 0.93 000 29445 A Apply rigid leg cast 1.77 1.77 0.97 0.29 3.83 3.03 000 29450 A Application of leg cast 2.07 1.47 1.10 0.16 3.70 3.33 000 29505 A Application, long leg splint 0.69 1.17 0.48 0.07 1.93 1.24 000 29515 A Application lower leg splint 0.73 0.86 0.49 0.08 1.67 1.30 000 29520 A Strapping of hip 0.54 0.89 0.47 0.02 1.45 1.03 000 29530 A Strapping of knee 0.57 0.81 0.35 0.05 1.43 0.97 000 29540 A Strapping of ankle and/or ft 0.51 0.42 0.32 0.05 0.98 0.88 000 29550 A Strapping of toes 0.47 0.42 0.28 0.06 0.95 0.81 000 29580 A Application of paste boot 0.57 0.66 0.36 0.06 1.29 0.99 000 29590 A Application of foot splint 0.76 0.51 0.30 0.07 1.34 1.13 000 29700 A Removal/revision of cast 0.57 0.88 0.29 0.08 1.53 0.94 000 Start Printed Page 63288 29705 A Removal/revision of cast 0.76 0.80 0.39 0.12 1.68 1.27 000 29710 A Removal/revision of cast 1.33 1.51 0.70 0.20 3.04 2.23 000 29715 A Removal/revision of cast 0.93 1.16 0.41 0.10 2.19 1.44 000 29720 A Repair of body cast 0.68 1.11 0.39 0.12 1.91 1.19 000 29730 A Windowing of cast 0.75 0.79 0.36 0.12 1.66 1.23 000 29740 A Wedging of cast 1.11 1.12 0.50 0.18 2.41 1.79 000 29750 A Wedging of clubfoot cast 1.25 1.05 0.59 0.19 2.49 2.03 000 29799 C Casting/strapping procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 A Jaw arthroscopy/surgery 6.39 NA 7.20 1.01 NA 14.60 090 29804 A Jaw arthroscopy/surgery 8.09 NA 8.51 0.79 NA 17.39 090 29805 A Shoulder arthroscopy, dx 5.86 NA 5.72 1.01 NA 12.59 090 29806 A Shoulder arthroscopy/surgery 14.29 NA 11.06 2.40 NA 27.75 090 29807 A Shoulder arthroscopy/surgery 13.82 NA 10.89 2.33 NA 27.04 090 29819 A Shoulder arthroscopy/surgery 7.58 NA 6.74 1.28 NA 15.60 090 29820 A Shoulder arthroscopy/surgery 7.03 NA 6.18 1.19 NA 14.40 090 29821 A Shoulder arthroscopy/surgery 7.68 NA 6.76 1.29 NA 15.73 090 29822 A Shoulder arthroscopy/surgery 7.39 NA 6.64 1.25 NA 15.28 090 29823 A Shoulder arthroscopy/surgery 8.12 NA 7.16 1.38 NA 16.66 090 29824 A Shoulder arthroscopy/surgery 8.20 NA 7.41 1.38 NA 16.99 090 29825 A Shoulder arthroscopy/surgery 7.58 NA 6.72 1.27 NA 15.57 090 29826 A Shoulder arthroscopy/surgery 8.94 NA 7.49 1.51 NA 17.94 090 29827 A Arthroscop rotator cuff repr 15.27 NA 11.44 2.23 NA 28.94 090 29830 A Elbow arthroscopy 5.73 NA 5.31 0.95 NA 11.99 090 29834 A Elbow arthroscopy/surgery 6.24 NA 5.79 1.03 NA 13.06 090 29835 A Elbow arthroscopy/surgery 6.44 NA 5.83 1.05 NA 13.32 090 29836 A Elbow arthroscopy/surgery 7.51 NA 6.73 1.27 NA 15.51 090 29837 A Elbow arthroscopy/surgery 6.83 NA 6.08 1.15 NA 14.06 090 29838 A Elbow arthroscopy/surgery 7.67 NA 6.84 1.28 NA 15.79 090 29840 A Wrist arthroscopy 5.51 NA 5.30 0.83 NA 11.64 090 29843 A Wrist arthroscopy/surgery 5.98 NA 5.60 0.98 NA 12.56 090 29844 A Wrist arthroscopy/surgery 6.33 NA 5.79 1.03 NA 13.15 090 29845 A Wrist arthroscopy/surgery 7.48 NA 6.46 1.01 NA 14.95 090 29846 A Wrist arthroscopy/surgery 6.71 NA 6.01 1.07 NA 13.79 090 29847 A Wrist arthroscopy/surgery 7.04 NA 6.16 1.09 NA 14.29 090 29848 A Wrist endoscopy/surgery 5.41 NA 5.55 0.86 NA 11.82 090 29850 A Knee arthroscopy/surgery 8.14 NA 5.10 0.89 NA 14.13 090 29851 A Knee arthroscopy/surgery 13.03 NA 9.76 2.17 NA 24.96 090 29855 A Tibial arthroscopy/surgery 10.56 NA 8.69 1.80 NA 21.05 090 29856 A Tibial arthroscopy/surgery 14.06 NA 10.63 2.40 NA 27.09 090 29860 A Hip arthroscopy, dx 8.00 NA 6.90 1.37 NA 16.27 090 29861 A Hip arthroscopy/surgery 9.10 NA 7.31 1.55 NA 17.96 090 29862 A Hip arthroscopy/surgery 9.84 NA 8.48 1.67 NA 19.99 090 29863 A Hip arthroscopy/surgery 9.84 NA 8.42 1.68 NA 19.94 090 29870 A Knee arthroscopy, dx 5.04 NA 4.85 0.80 NA 10.69 090 29871 A Knee arthroscopy/drainage 6.51 NA 5.83 1.05 NA 13.39 090 29873 A Knee arthroscopy/surgery 5.97 NA 6.45 0.87 NA 13.29 090 29874 A Knee arthroscopy/surgery 7.01 NA 6.04 1.04 NA 14.09 090 29875 A Knee arthroscopy/surgery 6.27 NA 5.80 1.05 NA 13.12 090 29876 A Knee arthroscopy/surgery 7.87 NA 6.96 1.33 NA 16.16 090 29877 A Knee arthroscopy/surgery 7.31 NA 6.67 1.23 NA 15.21 090 29879 A Knee arthroscopy/surgery 7.99 NA 7.05 1.35 NA 16.39 090 29880 A Knee arthroscopy/surgery 8.45 NA 7.29 1.43 NA 17.17 090 29881 A Knee arthroscopy/surgery 7.72 NA 6.89 1.31 NA 15.92 090 29882 A Knee arthroscopy/surgery 8.60 NA 7.18 1.31 NA 17.09 090 29883 A Knee arthroscopy/surgery 10.99 NA 9.00 1.59 NA 21.58 090 29884 A Knee arthroscopy/surgery 7.29 NA 6.63 1.23 NA 15.15 090 29885 A Knee arthroscopy/surgery 9.04 NA 7.89 1.52 NA 18.45 090 29886 A Knee arthroscopy/surgery 7.50 NA 6.77 1.27 NA 15.54 090 29887 A Knee arthroscopy/surgery 8.99 NA 7.86 1.52 NA 18.37 090 29888 A Knee arthroscopy/surgery 13.82 NA 10.19 2.34 NA 26.35 090 29889 A Knee arthroscopy/surgery 15.91 NA 12.36 2.53 NA 30.80 090 29891 A Ankle arthroscopy/surgery 8.35 NA 7.42 1.40 NA 17.17 090 29892 A Ankle arthroscopy/surgery 8.95 NA 7.68 1.51 NA 18.14 090 29893 A Scope, plantar fasciotomy 5.19 6.20 3.96 0.89 12.28 10.04 090 29894 A Ankle arthroscopy/surgery 7.17 NA 5.45 1.21 NA 13.83 090 29895 A Ankle arthroscopy/surgery 6.95 NA 5.45 1.16 NA 13.56 090 29897 A Ankle arthroscopy/surgery 7.14 NA 5.85 1.21 NA 14.20 090 29898 A Ankle arthroscopy/surgery 8.27 NA 6.17 1.37 NA 15.81 090 29899 A Ankle arthroscopy/surgery 13.83 NA 9.94 2.34 NA 26.11 090 29900 A Mcp joint arthroscopy, dx 5.39 NA 5.77 0.90 NA 12.06 090 29901 A Mcp joint arthroscopy, surg 6.10 NA 6.15 1.02 NA 13.27 090 29902 A Mcp joint arthroscopy, surg 6.66 NA 6.45 1.11 NA 14.22 090 29999 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 A Drainage of nose lesion 1.42 4.24 1.43 0.12 5.78 2.97 010 30020 A Drainage of nose lesion 1.42 3.39 1.50 0.10 4.91 3.02 010 Start Printed Page 63289 30100 A Intranasal biopsy 0.93 2.07 0.82 0.07 3.07 1.82 000 30110 A Removal of nose polyp(s) 1.62 3.40 1.60 0.14 5.16 3.36 010 30115 A Removal of nose polyp(s) 4.33 NA 4.06 0.37 NA 8.76 090 30117 A Removal of intranasal lesion 3.14 4.43 3.31 0.26 7.83 6.71 090 30118 A Removal of intranasal lesion 9.63 NA 7.35 0.79 NA 17.77 090 30120 A Revision of nose 5.24 5.59 5.54 0.49 11.32 11.27 090 30124 A Removal of nose lesion 3.08 NA 3.07 0.24 NA 6.39 090 30125 A Removal of nose lesion 7.12 NA 5.98 0.65 NA 13.75 090 30130 A Removal of turbinate bones 3.36 NA 3.55 0.26 NA 7.17 090 30140 A Removal of turbinate bones 3.41 NA 4.01 0.29 NA 7.71 090 30150 A Partial removal of nose 9.09 NA 7.74 0.91 NA 17.74 090 30160 A Removal of nose 9.53 NA 7.73 0.93 NA 18.19 090 30200 A Injection treatment of nose 0.78 1.72 0.78 0.07 2.57 1.63 000 30210 A Nasal sinus therapy 1.07 2.19 1.34 0.10 3.36 2.51 010 30220 A Insert nasal septal button 1.53 4.55 1.56 0.13 6.21 3.22 010 30300 A Remove nasal foreign body 1.03 4.89 2.00 0.08 6.00 3.11 010 30310 A Remove nasal foreign body 1.95 NA 3.22 0.17 NA 5.34 010 30320 A Remove nasal foreign body 4.49 NA 4.53 0.43 NA 9.45 090 30400 R Reconstruction of nose 9.77 NA 9.27 0.96 NA 20.00 090 30410 R Reconstruction of nose 12.91 NA 11.06 1.29 NA 25.26 090 30420 R Reconstruction of nose 15.79 NA 12.55 1.49 NA 29.83 090 30430 R Revision of nose 7.17 NA 8.20 0.74 NA 16.11 090 30435 R Revision of nose 11.64 NA 10.74 1.32 NA 23.70 090 30450 R Revision of nose 18.54 NA 14.26 1.83 NA 34.63 090 30460 A Revision of nose 9.90 NA 7.81 1.02 NA 18.73 090 30462 A Revision of nose 19.46 NA 13.83 2.30 NA 35.59 090 30465 A Repair nasal stenosis 11.57 NA 7.76 1.16 NA 20.49 090 30520 A Repair of nasal septum 5.67 NA 5.21 0.49 NA 11.37 090 30540 A Repair nasal defect 7.71 NA 5.70 0.64 NA 14.05 090 30545 A Repair nasal defect 11.32 NA 8.73 0.96 NA 21.01 090 30560 A Release of nasal adhesions 1.25 4.99 2.18 0.11 6.35 3.54 010 30580 A Repair upper jaw fistula 6.65 7.26 6.19 0.60 14.51 13.44 090 30600 A Repair mouth/nose fistula 5.99 6.39 5.58 0.84 13.22 12.41 090 30620 A Intranasal reconstruction 5.94 NA 5.84 0.54 NA 12.32 090 30630 A Repair nasal septum defect 7.08 NA 6.25 0.61 NA 13.94 090 30801 A Cauterization, inner nose 1.08 2.20 2.09 0.10 3.38 3.27 010 30802 A Cauterization, inner nose 2.02 2.74 2.60 0.18 4.94 4.80 010 30901 A Control of nosebleed 1.20 1.38 0.33 0.11 2.69 1.64 000 30903 A Control of nosebleed 1.53 2.84 0.51 0.14 4.51 2.18 000 30905 A Control of nosebleed 1.96 3.62 0.77 0.18 5.76 2.91 000 30906 A Repeat control of nosebleed 2.44 4.00 1.22 0.20 6.64 3.86 000 30915 A Ligation, nasal sinus artery 7.16 NA 5.89 0.60 NA 13.65 090 30920 A Ligation, upper jaw artery 9.77 NA 7.56 0.83 NA 18.16 090 30930 A Therapy, fracture of nose 1.25 NA 1.67 0.11 NA 3.03 010 30999 C Nasal surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31000 A Irrigation, maxillary sinus 1.14 2.96 1.43 0.10 4.20 2.67 010 31002 A Irrigation, sphenoid sinus 1.90 NA 3.34 0.17 NA 5.41 010 31020 A Exploration, maxillary sinus 2.92 4.18 3.55 0.24 7.34 6.71 090 31030 A Exploration, maxillary sinus 5.89 5.73 4.85 0.50 12.12 11.24 090 31032 A Explore sinus, remove polyps 6.53 NA 5.66 0.56 NA 12.75 090 31040 A Exploration behind upper jaw 9.37 NA 6.35 0.85 NA 16.57 090 31050 A Exploration, sphenoid sinus 5.25 NA 4.55 0.47 NA 10.27 090 31051 A Sphenoid sinus surgery 7.07 NA 5.92 0.66 NA 13.65 090 31070 A Exploration of frontal sinus 4.26 NA 4.25 0.36 NA 8.87 090 31075 A Exploration of frontal sinus 9.11 NA 7.29 0.77 NA 17.17 090 31080 A Removal of frontal sinus 11.35 NA 8.53 0.93 NA 20.81 090 31081 A Removal of frontal sinus 12.68 NA 9.59 2.21 NA 24.48 090 31084 A Removal of frontal sinus 13.43 NA 10.15 1.15 NA 24.73 090 31085 A Removal of frontal sinus 14.12 NA 10.52 1.41 NA 26.05 090 31086 A Removal of frontal sinus 12.79 NA 9.96 1.08 NA 23.83 090 31087 A Removal of frontal sinus 13.03 NA 9.89 1.38 NA 24.30 090 31090 A Exploration of sinuses 9.48 NA 8.67 0.79 NA 18.94 090 31200 A Removal of ethmoid sinus 4.94 NA 5.07 0.30 NA 10.31 090 31201 A Removal of ethmoid sinus 8.32 NA 6.89 0.70 NA 15.91 090 31205 A Removal of ethmoid sinus 10.18 NA 7.71 0.70 NA 18.59 090 31225 A Removal of upper jaw 19.12 NA 13.88 1.65 NA 34.65 090 31230 A Removal of upper jaw 21.81 NA 15.29 1.88 NA 38.98 090 31231 A Nasal endoscopy, dx 1.09 3.59 0.92 0.10 4.78 2.11 000 31233 A Nasal/sinus endoscopy, dx 2.17 4.53 1.53 0.19 6.89 3.89 000 31235 A Nasal/sinus endoscopy, dx 2.62 5.16 1.78 0.22 8.00 4.62 000 31237 A Nasal/sinus endoscopy, surg 2.96 5.46 1.93 0.25 8.67 5.14 000 31238 A Nasal/sinus endoscopy, surg 3.24 5.51 2.14 0.28 9.03 5.66 000 31239 A Nasal/sinus endoscopy, surg 8.65 NA 8.37 0.55 NA 17.57 010 31240 A Nasal/sinus endoscopy, surg 2.60 NA 1.78 0.22 NA 4.60 000 31254 A Revision of ethmoid sinus 4.62 NA 2.92 0.38 NA 7.92 000 Start Printed Page 63290 31255 A Removal of ethmoid sinus 6.92 NA 4.20 0.59 NA 11.71 000 31256 A Exploration maxillary sinus 3.27 NA 2.16 0.28 NA 5.71 000 31267 A Endoscopy, maxillary sinus 5.43 NA 3.36 0.46 NA 9.25 000 31276 A Sinus endoscopy, surgical 8.80 NA 5.22 0.74 NA 14.76 000 31287 A Nasal/sinus endoscopy, surg 3.90 NA 2.51 0.32 NA 6.73 000 31288 A Nasal/sinus endoscopy, surg 4.55 NA 2.88 0.38 NA 7.81 000 31290 A Nasal/sinus endoscopy, surg 17.14 NA 12.27 1.44 NA 30.85 010 31291 A Nasal/sinus endoscopy, surg 18.09 NA 12.68 2.07 NA 32.84 010 31292 A Nasal/sinus endoscopy, surg 14.68 NA 10.83 1.19 NA 26.70 010 31293 A Nasal/sinus endoscopy, surg 16.12 NA 11.63 1.16 NA 28.91 010 31294 A Nasal/sinus endoscopy, surg 18.95 NA 13.14 1.25 NA 33.34 010 31299 C Sinus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31300 A Removal of larynx lesion 14.21 NA 12.17 1.19 NA 27.57 090 31320 A Diagnostic incision, larynx 5.23 NA 7.36 0.48 NA 13.07 090 31360 A Removal of larynx 16.98 NA 14.11 1.44 NA 32.53 090 31365 A Removal of larynx 24.02 NA 17.82 2.06 NA 43.90 090 31367 A Partial removal of larynx 21.74 NA 17.57 1.88 NA 41.19 090 31368 A Partial removal of larynx 26.94 NA 21.23 2.28 NA 50.45 090 31370 A Partial removal of larynx 21.26 NA 17.21 1.81 NA 40.28 090 31375 A Partial removal of larynx 20.09 NA 15.53 1.71 NA 37.33 090 31380 A Partial removal of larynx 20.09 NA 15.47 1.68 NA 37.24 090 31382 A Partial removal of larynx 20.40 NA 16.74 1.73 NA 38.87 090 31390 A Removal of larynx & pharynx 27.37 NA 21.47 2.34 NA 51.18 090 31395 A Reconstruct larynx & pharynx 30.91 NA 25.41 2.72 NA 59.04 090 31400 A Revision of larynx 10.25 NA 10.13 0.86 NA 21.24 090 31420 A Removal of epiglottis 10.16 NA 9.91 0.85 NA 20.92 090 31500 A Insert emergency airway 2.32 NA 0.56 0.18 NA 3.06 000 31502 A Change of windpipe airway 0.65 1.52 0.26 0.05 2.22 0.96 000 31505 A Diagnostic laryngoscopy 0.61 1.59 0.64 0.05 2.25 1.30 000 31510 A Laryngoscopy with biopsy 1.91 3.46 1.30 0.18 5.55 3.39 000 31511 A Remove foreign body, larynx 2.15 3.28 1.12 0.19 5.62 3.46 000 31512 A Removal of larynx lesion 2.06 3.36 1.41 0.19 5.61 3.66 000 31513 A Injection into vocal cord 2.09 NA 1.51 0.18 NA 3.78 000 31515 A Laryngoscopy for aspiration 1.79 3.77 1.11 0.14 5.70 3.04 000 31520 A Diagnostic laryngoscopy 2.55 NA 1.62 0.20 NA 4.37 000 31525 A Diagnostic laryngoscopy 2.62 3.90 1.71 0.22 6.74 4.55 000 31526 A Diagnostic laryngoscopy 2.56 NA 1.77 0.22 NA 4.55 000 31527 A Laryngoscopy for treatment 3.25 NA 1.93 0.25 NA 5.43 000 31528 A Laryngoscopy and dilation 2.36 NA 1.47 0.19 NA 4.02 000 31529 A Laryngoscopy and dilation 2.66 NA 1.73 0.22 NA 4.61 000 31530 A Operative laryngoscopy 3.37 NA 2.00 0.29 NA 5.66 000 31531 A Operative laryngoscopy 3.57 NA 2.33 0.30 NA 6.20 000 31535 A Operative laryngoscopy 3.14 NA 2.04 0.26 NA 5.44 000 31536 A Operative laryngoscopy 3.54 NA 2.31 0.30 NA 6.15 000 31540 A Operative laryngoscopy 4.11 NA 2.61 0.35 NA 7.07 000 31541 A Operative laryngoscopy 4.50 NA 2.85 0.38 NA 7.73 000 31560 A Operative laryngoscopy 5.43 NA 3.20 0.46 NA 9.09 000 31561 A Operative laryngoscopy 5.97 NA 3.41 0.50 NA 9.88 000 31570 A Laryngoscopy with injection 3.85 5.81 2.45 0.29 9.95 6.59 000 31571 A Laryngoscopy with injection 4.25 NA 2.66 0.36 NA 7.27 000 31575 A Diagnostic laryngoscopy 1.09 1.91 0.92 0.10 3.10 2.11 000 31576 A Laryngoscopy with biopsy 1.96 3.66 1.33 0.16 5.78 3.45 000 31577 A Remove foreign body, larynx 2.46 3.78 1.59 0.20 6.44 4.25 000 31578 A Removal of larynx lesion 2.82 4.30 1.58 0.24 7.36 4.64 000 31579 A Diagnostic laryngoscopy 2.25 3.84 1.54 0.19 6.28 3.98 000 31580 A Revision of larynx 12.31 NA 11.24 1.04 NA 24.59 090 31582 A Revision of larynx 21.50 NA 17.63 1.82 NA 40.95 090 31584 A Treat larynx fracture 19.53 NA 14.73 1.70 NA 35.96 090 31585 A Treat larynx fracture 4.61 NA 5.65 0.36 NA 10.62 090 31586 A Treat larynx fracture 7.98 NA 8.44 0.67 NA 17.09 090 31587 A Revision of larynx 11.92 NA 10.16 1.05 NA 23.13 090 31588 A Revision of larynx 13.04 NA 13.26 1.10 NA 27.40 090 31590 A Reinnervate larynx 6.93 NA 8.92 0.60 NA 16.45 090 31595 A Larynx nerve surgery 8.29 NA 7.73 0.74 NA 16.76 090 31599 C Larynx surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31600 A Incision of windpipe 7.14 NA 3.22 0.41 NA 10.77 000 31601 A Incision of windpipe 4.42 NA 2.42 0.47 NA 7.31 000 31603 A Incision of windpipe 4.13 NA 1.74 0.42 NA 6.29 000 31605 A Incision of windpipe 3.56 NA 1.20 0.40 NA 5.16 000 31610 A Incision of windpipe 8.71 NA 7.51 0.83 NA 17.05 090 31611 A Surgery/speech prosthesis 5.61 NA 6.02 0.48 NA 12.11 090 31612 A Puncture/clear windpipe 0.90 1.13 0.36 0.07 2.10 1.33 000 31613 A Repair windpipe opening 4.56 NA 5.43 0.44 NA 10.43 090 31614 A Repair windpipe opening 7.08 NA 7.87 0.61 NA 15.56 090 31615 A Visualization of windpipe 2.08 2.66 1.22 0.17 4.91 3.47 000 Start Printed Page 63291 31622 A Dx bronchoscope/wash 2.76 4.20 0.89 0.17 7.13 3.82 000 31623 A Dx bronchoscope/brush 2.86 5.09 0.90 0.17 8.12 3.93 000 31624 A Dx bronchoscope/lavage 2.86 4.32 0.90 0.16 7.34 3.92 000 31625 A Bronchoscopy w/biopsy(s) 3.35 5.41 1.27 0.19 8.95 4.81 000 31628 A Bronchoscopy/lung bx, each 3.79 5.62 1.36 0.17 9.58 5.32 000 31629 A Bronchoscopy/needle bx, each 3.35 NA 1.24 0.16 NA 4.75 000 31630 A Bronchoscopy dilate/fx repr 3.80 NA 1.98 0.36 NA 6.14 000 31631 A Bronchoscopy, dilate w/stent 4.35 NA 2.01 0.37 NA 6.73 000 31632 A Bronchoscopy/lung bx, addl 1.02 0.76 0.32 0.17 1.95 1.51 ZZZ 31633 A Bronchoscopy/needle bx addl 1.31 0.92 0.41 0.17 2.40 1.89 ZZZ 31635 A Bronchoscopy w/fb removal 3.66 NA 1.68 0.25 NA 5.59 000 31640 A Bronchoscopy w/tumor excise 4.91 NA 2.33 0.44 NA 7.68 000 31641 A Bronchoscopy, treat blockage 5.00 NA 2.12 0.36 NA 7.48 000 31643 A Diag bronchoscope/catheter 3.48 NA 1.32 0.18 NA 4.98 000 31645 A Bronchoscopy, clear airways 3.14 NA 1.22 0.16 NA 4.52 000 31646 A Bronchoscopy, reclear airway 2.70 NA 1.09 0.14 NA 3.93 000 31656 A Bronchoscopy, inj for x-ray 2.16 NA 0.93 0.12 NA 3.21 000 31700 A Insertion of airway catheter 1.33 2.08 0.69 0.08 3.49 2.10 000 31708 A Instill airway contrast dye 1.40 NA 0.60 0.07 NA 2.07 000 31710 A Insertion of airway catheter 1.29 NA 0.71 0.07 NA 2.07 000 31715 A Injection for bronchus x-ray 1.10 NA 0.61 0.07 NA 1.78 000 31717 A Bronchial brush biopsy 2.11 2.89 0.87 0.11 5.11 3.09 000 31720 A Clearance of airways 1.05 1.48 0.33 0.07 2.60 1.45 000 31725 A Clearance of airways 1.95 1.84 0.59 0.12 3.91 2.66 000 31730 A Intro, windpipe wire/tube 2.83 2.24 1.09 0.18 5.25 4.10 000 31750 A Repair of windpipe 12.95 NA 11.61 1.22 NA 25.78 090 31755 A Repair of windpipe 15.84 NA 14.34 1.38 NA 31.56 090 31760 A Repair of windpipe 22.22 NA 10.50 1.77 NA 34.49 090 31766 A Reconstruction of windpipe 30.26 NA 13.52 3.79 NA 47.57 090 31770 A Repair/graft of bronchus 22.38 NA 10.01 2.72 NA 35.11 090 31775 A Reconstruct bronchus 23.41 NA 11.67 3.49 NA 38.57 090 31780 A Reconstruct windpipe 17.62 NA 11.05 1.86 NA 30.53 090 31781 A Reconstruct windpipe 23.40 NA 12.06 2.45 NA 37.91 090 31785 A Remove windpipe lesion 17.13 NA 10.32 1.63 NA 29.08 090 31786 A Remove windpipe lesion 23.84 NA 13.13 2.64 NA 39.61 090 31800 A Repair of windpipe injury 7.39 NA 4.88 0.80 NA 13.07 090 31805 A Repair of windpipe injury 13.06 NA 7.10 1.74 NA 21.90 090 31820 A Closure of windpipe lesion 4.46 5.59 4.96 0.42 10.47 9.84 090 31825 A Repair of windpipe defect 6.77 7.68 7.11 0.60 15.05 14.48 090 31830 A Revise windpipe scar 4.47 5.74 5.33 0.43 10.64 10.23 090 31899 C Airways surgical procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 32000 A Drainage of chest 1.53 3.13 0.49 0.08 4.74 2.10 000 32002 A Treatment of collapsed lung 2.18 3.34 0.84 0.13 5.65 3.15 000 32005 A Treat lung lining chemically 2.18 6.45 0.69 0.20 8.83 3.07 000 32020 A Insertion of chest tube 3.96 NA 1.45 0.43 NA 5.84 000 32035 A Exploration of chest 8.62 NA 5.71 1.22 NA 15.55 090 32036 A Exploration of chest 9.62 NA 6.23 1.44 NA 17.29 090 32095 A Biopsy through chest wall 8.31 NA 5.22 1.19 NA 14.72 090 32100 A Exploration/biopsy of chest 15.15 NA 7.65 1.74 NA 24.54 090 32110 A Explore/repair chest 22.87 NA 10.54 1.95 NA 35.36 090 32120 A Re-exploration of chest 11.47 NA 6.87 1.70 NA 20.04 090 32124 A Explore chest free adhesions 12.65 NA 7.04 1.81 NA 21.50 090 32140 A Removal of lung lesion(s) 13.85 NA 7.50 2.01 NA 23.36 090 32141 A Remove/treat lung lesions 13.92 NA 7.38 2.06 NA 23.36 090 32150 A Removal of lung lesion(s) 14.07 NA 7.47 1.92 NA 23.46 090 32151 A Remove lung foreign body 14.13 NA 7.85 1.79 NA 23.77 090 32160 A Open chest heart massage 9.25 NA 5.21 1.21 NA 15.67 090 32200 A Drain, open, lung lesion 15.20 NA 8.48 1.75 NA 25.43 090 32201 A Drain, percut, lung lesion 3.98 NA 1.32 0.22 NA 5.52 000 32215 A Treat chest lining 11.27 NA 6.69 1.61 NA 19.57 090 32220 A Release of lung 23.86 NA 12.56 2.86 NA 39.28 090 32225 A Partial release of lung 13.88 NA 7.47 2.04 NA 23.39 090 32310 A Removal of chest lining 13.36 NA 7.22 1.98 NA 22.56 090 32320 A Free/remove chest lining 23.86 NA 11.88 3.00 NA 38.74 090 32400 A Needle biopsy chest lining 1.75 1.73 0.56 0.08 3.56 2.39 000 32402 A Open biopsy chest lining 7.52 NA 4.96 1.09 NA 13.57 090 32405 A Biopsy, lung or mediastinum 1.92 2.14 0.64 0.11 4.17 2.67 000 32420 A Puncture/clear lung 2.17 NA 0.83 0.13 NA 3.13 000 32440 A Removal of lung 24.86 NA 12.56 3.07 NA 40.49 090 32442 A Sleeve pneumonectomy 26.09 NA 14.29 3.74 NA 44.12 090 32445 A Removal of lung 24.95 NA 13.70 3.73 NA 42.38 090 32480 A Partial removal of lung 23.61 NA 11.77 2.68 NA 38.06 090 32482 A Bilobectomy 24.86 NA 12.62 2.82 NA 40.30 090 32484 A Segmentectomy 20.57 NA 11.08 3.04 NA 34.69 090 32486 A Sleeve lobectomy 23.78 NA 12.84 3.60 NA 40.22 090 Start Printed Page 63292 32488 A Completion pneumonectomy 25.56 NA 13.39 3.81 NA 42.76 090 32491 R Lung volume reduction 21.13 NA 12.19 3.19 NA 36.51 090 32500 A Partial removal of lung 21.87 NA 11.98 2.12 NA 35.97 090 32501 A Repair bronchus add-on 4.66 NA 1.52 0.67 NA 6.85 ZZZ 32520 A Remove lung & revise chest 21.56 NA 10.98 3.25 NA 35.79 090 32522 A Remove lung & revise chest 24.06 NA 11.81 3.40 NA 39.27 090 32525 A Remove lung & revise chest 26.35 NA 12.50 3.90 NA 42.75 090 32540 A Removal of lung lesion 14.56 NA 9.33 2.21 NA 26.10 090 32601 A Thoracoscopy, diagnostic 5.43 NA 2.36 0.76 NA 8.55 000 32602 A Thoracoscopy, diagnostic 5.93 NA 2.52 0.84 NA 9.29 000 32603 A Thoracoscopy, diagnostic 7.77 NA 3.06 0.91 NA 11.74 000 32604 A Thoracoscopy, diagnostic 8.73 NA 3.46 1.16 NA 13.35 000 32605 A Thoracoscopy, diagnostic 6.89 NA 2.89 1.03 NA 10.81 000 32606 A Thoracoscopy, diagnostic 8.35 NA 3.33 1.19 NA 12.87 000 32650 A Thoracoscopy, surgical 10.69 NA 6.57 1.50 NA 18.76 090 32651 A Thoracoscopy, surgical 12.84 NA 7.08 1.80 NA 21.72 090 32652 A Thoracoscopy, surgical 18.55 NA 9.87 2.76 NA 31.18 090 32653 A Thoracoscopy, surgical 12.80 NA 6.80 1.86 NA 21.46 090 32654 A Thoracoscopy, surgical 12.37 NA 7.29 1.81 NA 21.47 090 32655 A Thoracoscopy, surgical 13.03 NA 7.09 1.83 NA 21.95 090 32656 A Thoracoscopy, surgical 12.84 NA 7.66 1.93 NA 22.43 090 32657 A Thoracoscopy, surgical 13.57 NA 7.48 1.97 NA 23.02 090 32658 A Thoracoscopy, surgical 11.56 NA 7.09 1.76 NA 20.41 090 32659 A Thoracoscopy, surgical 11.52 NA 7.21 1.67 NA 20.40 090 32660 A Thoracoscopy, surgical 17.33 NA 9.17 2.51 NA 29.01 090 32661 A Thoracoscopy, surgical 13.17 NA 7.55 1.99 NA 22.71 090 32662 A Thoracoscopy, surgical 16.35 NA 8.57 2.41 NA 27.33 090 32663 A Thoracoscopy, surgical 18.36 NA 10.42 2.73 NA 31.51 090 32664 A Thoracoscopy, surgical 14.12 NA 7.51 2.04 NA 23.67 090 32665 A Thoracoscopy, surgical 15.45 NA 8.04 2.15 NA 25.64 090 32800 A Repair lung hernia 13.61 NA 7.29 1.81 NA 22.71 090 32810 A Close chest after drainage 12.98 NA 7.35 1.86 NA 22.19 090 32815 A Close bronchial fistula 23.02 NA 10.69 3.40 NA 37.11 090 32820 A Reconstruct injured chest 21.36 NA 11.99 2.77 NA 36.12 090 32850 X Donor pneumonectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32851 A Lung transplant, single 38.41 NA 26.78 5.87 NA 71.06 090 32852 A Lung transplant with bypass 41.56 NA 31.65 6.20 NA 79.41 090 32853 A Lung transplant, double 47.54 NA 30.49 7.35 NA 85.38 090 32854 A Lung transplant with bypass 50.69 NA 33.59 7.68 NA 91.96 090 32900 A Removal of rib(s) 20.15 NA 9.75 2.90 NA 32.80 090 32905 A Revise & repair chest wall 20.63 NA 9.95 3.04 NA 33.62 090 32906 A Revise & repair chest wall 26.62 NA 11.85 3.96 NA 42.43 090 32940 A Revision of lung 19.32 NA 9.22 2.96 NA 31.50 090 32960 A Therapeutic pneumothorax 1.83 1.80 0.58 0.14 3.77 2.55 000 32997 A Total lung lavage 5.97 NA 1.92 0.66 NA 8.55 000 32999 C Chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 A Drainage of heart sac 2.23 NA 0.97 0.16 NA 3.36 000 33011 A Repeat drainage of heart sac 2.23 NA 1.00 0.16 NA 3.39 000 33015 A Incision of heart sac 6.76 NA 4.83 0.77 NA 12.36 090 33020 A Incision of heart sac 12.54 NA 6.61 1.80 NA 20.95 090 33025 A Incision of heart sac 12.02 NA 6.17 1.80 NA 19.99 090 33030 A Partial removal of heart sac 18.60 NA 9.24 2.88 NA 30.72 090 33031 A Partial removal of heart sac 21.67 NA 9.74 3.33 NA 34.74 090 33050 A Removal of heart sac lesion 14.28 NA 7.63 2.07 NA 23.98 090 33120 A Removal of heart lesion 24.42 NA 11.27 3.67 NA 39.36 090 33130 A Removal of heart lesion 21.27 NA 9.93 3.01 NA 34.21 090 33140 A Heart revascularize (tmr) 19.89 NA 10.53 2.72 NA 33.14 090 33141 A Heart tmr w/other procedure 4.81 NA 1.55 0.66 NA 7.02 ZZZ 33200 A Insertion of heart pacemaker 12.41 NA 6.84 1.40 NA 20.65 090 33201 A Insertion of heart pacemaker 10.12 NA 6.48 1.45 NA 18.05 090 33206 A Insertion of heart pacemaker 6.63 NA 4.54 0.60 NA 11.77 090 33207 A Insertion of heart pacemaker 7.99 NA 4.75 0.68 NA 13.42 090 33208 A Insertion of heart pacemaker 8.08 NA 4.87 0.65 NA 13.60 090 33210 A Insertion of heart electrode 3.28 NA 1.27 0.20 NA 4.75 000 33211 A Insertion of heart electrode 3.38 NA 1.33 0.20 NA 4.91 000 33212 A Insertion of pulse generator 5.49 NA 3.40 0.53 NA 9.42 090 33213 A Insertion of pulse generator 6.33 NA 3.78 0.55 NA 10.66 090 33214 A Upgrade of pacemaker system 7.71 NA 4.99 0.62 NA 13.32 090 33215 A Reposition pacing-defib lead 4.73 NA 3.19 0.43 NA 8.35 090 33216 A Insert lead pace-defib, one 5.75 NA 4.30 0.43 NA 10.48 090 33217 A Insert lead pace-defib, dual 5.72 NA 4.34 0.43 NA 10.49 090 33218 A Repair lead pace-defib, one 5.41 NA 4.35 0.48 NA 10.24 090 33220 A Repair lead pace-defib, dual 5.49 NA 4.34 0.47 NA 10.30 090 33222 A Revise pocket, pacemaker 4.93 NA 4.34 0.47 NA 9.74 090 33223 A Revise pocket, pacing-defib 6.42 NA 4.61 0.53 NA 11.56 090 Start Printed Page 63293 33224 A Insert pacing lead & connect 9.00 NA 4.05 0.43 NA 13.48 000 33225 A L ventric pacing lead add-on 8.29 NA 3.24 0.43 NA 11.96 ZZZ 33226 A Reposition l ventric lead 8.64 NA 3.91 0.43 NA 12.98 000 33233 A Removal of pacemaker system 3.27 NA 3.28 0.26 NA 6.81 090 33234 A Removal of pacemaker system 7.78 NA 4.93 0.67 NA 13.38 090 33235 A Removal pacemaker electrode 9.35 NA 6.80 0.82 NA 16.97 090 33236 A Remove electrode/thoracotomy 12.53 NA 7.22 1.79 NA 21.54 090 33237 A Remove electrode/thoracotomy 13.63 NA 7.61 1.88 NA 23.12 090 33238 A Remove electrode/thoracotomy 15.13 NA 8.06 1.87 NA 25.06 090 33240 A Insert pulse generator 7.56 NA 4.62 0.64 NA 12.82 090 33241 A Remove pulse generator 3.22 NA 2.97 0.25 NA 6.44 090 33243 A Remove eltrd/thoracotomy 22.51 NA 11.15 3.03 NA 36.69 090 33244 A Remove eltrd, transven 13.68 NA 8.87 1.26 NA 23.81 090 33245 A Insert epic eltrd pace-defib 14.22 NA 7.86 1.53 NA 23.61 090 33246 A Insert epic eltrd/generator 20.59 NA 10.15 2.66 NA 33.40 090 33249 A Eltrd/insert pace-defib 14.15 NA 8.51 0.96 NA 23.62 090 33250 A Ablate heart dysrhythm focus 21.73 NA 11.22 1.21 NA 34.16 090 33251 A Ablate heart dysrhythm focus 24.74 NA 11.33 2.89 NA 38.96 090 33253 A Reconstruct atria 30.88 NA 13.44 4.41 NA 48.73 090 33261 A Ablate heart dysrhythm focus 24.74 NA 11.46 3.38 NA 39.58 090 33282 A Implant pat-active ht record 4.15 NA 4.11 0.47 NA 8.73 090 33284 A Remove pat-active ht record 2.49 NA 3.52 0.28 NA 6.29 090 33300 A Repair of heart wound 17.82 NA 9.06 2.29 NA 29.17 090 33305 A Repair of heart wound 21.32 NA 10.30 3.21 NA 34.83 090 33310 A Exploratory heart surgery 18.40 NA 9.27 2.71 NA 30.38 090 33315 A Exploratory heart surgery 22.24 NA 10.53 3.48 NA 36.25 090 33320 A Repair major blood vessel(s) 16.69 NA 8.14 1.99 NA 26.82 090 33321 A Repair major vessel 20.08 NA 9.53 3.24 NA 32.85 090 33322 A Repair major blood vessel(s) 20.50 NA 10.07 3.01 NA 33.58 090 33330 A Insert major vessel graft 21.31 NA 10.06 2.98 NA 34.35 090 33332 A Insert major vessel graft 23.82 NA 10.37 2.94 NA 37.13 090 33335 A Insert major vessel graft 29.84 NA 12.98 4.54 NA 47.36 090 33400 A Repair of aortic valve 28.34 NA 15.16 3.70 NA 47.20 090 33401 A Valvuloplasty, open 23.77 NA 13.23 3.25 NA 40.25 090 33403 A Valvuloplasty, w/cp bypass 24.75 NA 13.87 2.97 NA 41.59 090 33404 A Prepare heart-aorta conduit 28.38 NA 14.06 3.97 NA 46.41 090 33405 A Replacement of aortic valve 34.80 NA 17.66 4.63 NA 57.09 090 33406 A Replacement of aortic valve 37.29 NA 18.47 4.88 NA 60.64 090 33410 A Replacement of aortic valve 32.27 NA 16.11 4.93 NA 53.31 090 33411 A Replacement of aortic valve 36.04 NA 18.11 4.99 NA 59.14 090 33412 A Replacement of aortic valve 41.76 NA 19.84 5.59 NA 67.19 090 33413 A Replacement of aortic valve 43.25 NA 20.20 5.11 NA 68.56 090 33414 A Repair of aortic valve 30.18 NA 13.72 4.54 NA 48.44 090 33415 A Revision, subvalvular tissue 27.00 NA 11.75 3.90 NA 42.65 090 33416 A Revise ventricle muscle 30.18 NA 13.11 4.61 NA 47.90 090 33417 A Repair of aortic valve 28.37 NA 13.21 4.29 NA 45.87 090 33420 A Revision of mitral valve 22.57 NA 9.71 1.77 NA 34.05 090 33422 A Revision of mitral valve 25.79 NA 13.17 3.96 NA 42.92 090 33425 A Repair of mitral valve 26.85 NA 12.64 3.60 NA 43.09 090 33426 A Repair of mitral valve 32.81 NA 16.57 4.64 NA 54.02 090 33427 A Repair of mitral valve 39.77 NA 18.74 5.15 NA 63.66 090 33430 A Replacement of mitral valve 33.31 NA 16.71 4.73 NA 54.75 090 33460 A Revision of tricuspid valve 23.47 NA 10.93 3.62 NA 38.02 090 33463 A Valvuloplasty, tricuspid 25.47 NA 12.51 3.80 NA 41.78 090 33464 A Valvuloplasty, tricuspid 27.17 NA 13.09 4.16 NA 44.42 090 33465 A Replace tricuspid valve 28.63 NA 12.58 4.33 NA 45.54 090 33468 A Revision of tricuspid valve 29.95 NA 13.23 4.79 NA 47.97 090 33470 A Revision of pulmonary valve 20.69 NA 10.65 3.37 NA 34.71 090 33471 A Valvotomy, pulmonary valve 22.12 NA 9.70 3.60 NA 35.42 090 33472 A Revision of pulmonary valve 22.12 NA 11.73 3.50 NA 37.35 090 33474 A Revision of pulmonary valve 22.91 NA 10.68 3.40 NA 36.99 090 33475 A Replacement, pulmonary valve 32.81 NA 14.87 3.16 NA 50.84 090 33476 A Revision of heart chamber 25.62 NA 11.87 2.88 NA 40.37 090 33478 A Revision of heart chamber 26.59 NA 12.58 4.27 NA 43.44 090 33496 A Repair, prosth valve clot 27.09 NA 12.39 4.12 NA 43.60 090 33500 A Repair heart vessel fistula 25.40 NA 11.23 3.36 NA 39.99 090 33501 A Repair heart vessel fistula 17.68 NA 8.20 2.46 NA 28.34 090 33502 A Coronary artery correction 20.92 NA 10.72 3.01 NA 34.65 090 33503 A Coronary artery graft 21.66 NA 9.77 1.70 NA 33.13 090 33504 A Coronary artery graft 24.52 NA 11.59 3.64 NA 39.75 090 33505 A Repair artery w/tunnel 26.69 NA 12.78 1.82 NA 41.29 090 33506 A Repair artery, translocation 35.30 NA 14.37 3.82 NA 53.49 090 33508 A Endoscopic vein harvest 0.31 NA 0.10 0.04 NA 0.45 ZZZ 33510 A CABG, vein, single 28.83 NA 15.76 3.75 NA 48.34 090 33511 A CABG, vein, two 29.83 NA 16.46 4.00 NA 50.29 090 Start Printed Page 63294 33512 A CABG, vein, three 31.62 NA 17.00 4.43 NA 53.05 090 33513 A CABG, vein, four 31.82 NA 17.16 4.78 NA 53.76 090 33514 A CABG, vein, five 32.56 NA 17.41 5.24 NA 55.21 090 33516 A Cabg, vein, six or more 34.80 NA 18.15 5.54 NA 58.49 090 33517 A CABG, artery-vein, single 2.56 NA 0.82 0.38 NA 3.76 ZZZ 33518 A CABG, artery-vein, two 4.82 NA 1.56 0.73 NA 7.11 ZZZ 33519 A CABG, artery-vein, three 7.08 NA 2.28 1.07 NA 10.43 ZZZ 33521 A CABG, artery-vein, four 9.35 NA 3.02 1.41 NA 13.78 ZZZ 33522 A CABG, artery-vein, five 11.60 NA 3.74 1.77 NA 17.11 ZZZ 33523 A Cabg, art-vein, six or more 13.87 NA 4.45 2.13 NA 20.45 ZZZ 33530 A Coronary artery, bypass/reop 5.83 NA 1.88 0.87 NA 8.58 ZZZ 33533 A CABG, arterial, single 29.83 NA 15.90 3.88 NA 49.61 090 33534 A CABG, arterial, two 32.02 NA 17.07 4.35 NA 53.44 090 33535 A CABG, arterial, three 34.30 NA 17.54 4.76 NA 56.60 090 33536 A Cabg, arterial, four or more 37.29 NA 17.82 3.94 NA 59.05 090 33542 A Removal of heart lesion 28.69 NA 12.64 4.33 NA 45.66 090 33545 A Repair of heart damage 36.57 NA 15.30 5.27 NA 57.14 090 33572 A Open coronary endarterectomy 4.42 NA 1.43 0.66 NA 6.51 ZZZ 33600 A Closure of valve 29.34 NA 12.45 2.76 NA 44.55 090 33602 A Closure of valve 28.38 NA 12.53 3.48 NA 44.39 090 33606 A Anastomosis/artery-aorta 30.56 NA 13.45 4.30 NA 48.31 090 33608 A Repair anomaly w/conduit 30.91 NA 13.70 5.00 NA 49.61 090 33610 A Repair by enlargement 30.44 NA 13.96 4.82 NA 49.22 090 33611 A Repair double ventricle 33.81 NA 13.75 3.93 NA 51.49 090 33612 A Repair double ventricle 34.80 NA 14.79 5.32 NA 54.91 090 33615 A Repair, modified fontan 33.81 NA 14.85 3.78 NA 52.44 090 33617 A Repair single ventricle 36.79 NA 15.61 4.90 NA 57.30 090 33619 A Repair single ventricle 44.74 NA 20.07 5.65 NA 70.46 090 33641 A Repair heart septum defect 21.27 NA 9.32 3.20 NA 33.79 090 33645 A Revision of heart veins 24.68 NA 11.44 3.92 NA 40.04 090 33647 A Repair heart septum defects 28.57 NA 13.42 4.04 NA 46.03 090 33660 A Repair of heart defects 29.83 NA 13.16 3.38 NA 46.37 090 33665 A Repair of heart defects 28.44 NA 13.26 4.57 NA 46.27 090 33670 A Repair of heart chambers 34.80 NA 13.40 2.61 NA 50.81 090 33681 A Repair heart septum defect 30.44 NA 14.21 4.23 NA 48.88 090 33684 A Repair heart septum defect 29.48 NA 13.35 4.52 NA 47.35 090 33688 A Repair heart septum defect 30.45 NA 10.80 4.66 NA 45.91 090 33690 A Reinforce pulmonary artery 19.44 NA 9.98 3.07 NA 32.49 090 33692 A Repair of heart defects 30.57 NA 13.73 4.52 NA 48.82 090 33694 A Repair of heart defects 33.81 NA 14.16 5.12 NA 53.09 090 33697 A Repair of heart defects 35.79 NA 14.34 5.44 NA 55.57 090 33702 A Repair of heart defects 26.39 NA 12.18 4.14 NA 42.71 090 33710 A Repair of heart defects 29.54 NA 13.76 4.61 NA 47.91 090 33720 A Repair of heart defect 26.41 NA 12.04 3.85 NA 42.30 090 33722 A Repair of heart defect 28.25 NA 13.28 4.55 NA 46.08 090 33730 A Repair heart-vein defect(s) 34.05 NA 14.14 3.42 NA 51.61 090 33732 A Repair heart-vein defect 28.00 NA 13.31 3.33 NA 44.64 090 33735 A Revision of heart chamber 21.27 NA 10.06 1.34 NA 32.67 090 33736 A Revision of heart chamber 23.39 NA 11.67 3.24 NA 38.30 090 33737 A Revision of heart chamber 21.64 NA 10.87 3.51 NA 36.02 090 33750 A Major vessel shunt 21.29 NA 10.32 2.09 NA 33.70 090 33755 A Major vessel shunt 21.67 NA 8.65 3.51 NA 33.83 090 33762 A Major vessel shunt 21.67 NA 10.35 1.91 NA 33.93 090 33764 A Major vessel shunt & graft 21.67 NA 10.20 2.31 NA 34.18 090 33766 A Major vessel shunt 22.63 NA 11.20 3.64 NA 37.47 090 33767 A Major vessel shunt 24.36 NA 11.60 3.76 NA 39.72 090 33770 A Repair great vessels defect 36.79 NA 14.56 5.38 NA 56.73 090 33771 A Repair great vessels defect 34.45 NA 12.62 5.60 NA 52.67 090 33774 A Repair great vessels defect 30.80 NA 13.96 5.01 NA 49.77 090 33775 A Repair great vessels defect 32.02 NA 14.42 5.20 NA 51.64 090 33776 A Repair great vessels defect 33.85 NA 15.16 5.49 NA 54.50 090 33777 A Repair great vessels defect 33.27 NA 15.09 5.41 NA 53.77 090 33778 A Repair great vessels defect 39.77 NA 16.27 5.79 NA 61.83 090 33779 A Repair great vessels defect 36.00 NA 15.45 2.88 NA 54.33 090 33780 A Repair great vessels defect 41.51 NA 18.87 6.24 NA 66.62 090 33781 A Repair great vessels defect 36.24 NA 13.78 5.89 NA 55.91 090 33786 A Repair arterial trunk 38.78 NA 16.09 5.62 NA 60.49 090 33788 A Revision of pulmonary artery 26.47 NA 12.05 3.98 NA 42.50 090 33800 A Aortic suspension 16.15 NA 7.73 1.33 NA 25.21 090 33802 A Repair vessel defect 17.56 NA 8.97 1.87 NA 28.40 090 33803 A Repair vessel defect 19.49 NA 9.53 3.15 NA 32.17 090 33813 A Repair septal defect 20.53 NA 10.55 3.33 NA 34.41 090 33814 A Repair septal defect 25.62 NA 12.26 3.02 NA 40.90 090 33820 A Revise major vessel 16.20 NA 8.05 2.52 NA 26.77 090 33822 A Revise major vessel 17.22 NA 8.58 2.79 NA 28.59 090 Start Printed Page 63295 33824 A Revise major vessel 19.41 NA 9.68 3.13 NA 32.22 090 33840 A Remove aorta constriction 20.51 NA 9.99 2.83 NA 33.33 090 33845 A Remove aorta constriction 21.99 NA 10.97 3.48 NA 36.44 090 33851 A Remove aorta constriction 21.15 NA 10.36 3.43 NA 34.94 090 33852 A Repair septal defect 23.57 NA 11.20 3.82 NA 38.59 090 33853 A Repair septal defect 31.54 NA 14.32 5.07 NA 50.93 090 33860 A Ascending aortic graft 37.78 NA 16.02 5.15 NA 58.95 090 33861 A Ascending aortic graft 41.76 NA 17.27 5.08 NA 64.11 090 33863 A Ascending aortic graft 44.74 NA 18.23 5.51 NA 68.48 090 33870 A Transverse aortic arch graft 43.75 NA 17.93 6.10 NA 67.78 090 33875 A Thoracic aortic graft 32.87 NA 13.80 4.89 NA 51.56 090 33877 A Thoracoabdominal graft 42.36 NA 16.28 6.08 NA 64.72 090 33910 A Remove lung artery emboli 24.45 NA 11.15 3.67 NA 39.27 090 33915 A Remove lung artery emboli 20.90 NA 9.60 1.44 NA 31.94 090 33916 A Surgery of great vessel 25.68 NA 11.18 3.64 NA 40.50 090 33917 A Repair pulmonary artery 24.36 NA 11.85 3.80 NA 40.01 090 33918 A Repair pulmonary atresia 26.30 NA 12.22 4.10 NA 42.62 090 33919 A Repair pulmonary atresia 39.77 NA 17.13 4.17 NA 61.07 090 33920 A Repair pulmonary atresia 31.77 NA 13.76 4.33 NA 49.86 090 33922 A Transect pulmonary artery 23.39 NA 10.81 2.76 NA 36.96 090 33924 A Remove pulmonary shunt 5.47 NA 1.80 0.89 NA 8.16 ZZZ 33930 X Removal of donor heart/lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33935 R Transplantation, heart/lung 60.61 NA 28.07 9.77 NA 98.45 090 33940 X Removal of donor heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33945 R Transplantation of heart 41.86 NA 20.81 6.50 NA 69.17 090 33960 A External circulation assist 19.25 NA 4.91 2.57 NA 26.73 000 33961 A External circulation assist 10.87 NA 3.60 1.76 NA 16.23 ZZZ 33967 A Insert ia percut device 4.82 NA 1.86 0.34 NA 7.02 000 33968 A Remove aortic assist device 0.64 NA 0.23 0.08 NA 0.95 000 33970 A Aortic circulation assist 6.71 NA 2.25 0.84 NA 9.80 000 33971 A Aortic circulation assist 9.63 NA 5.90 1.16 NA 16.69 090 33973 A Insert balloon device 9.70 NA 3.27 1.21 NA 14.18 000 33974 A Remove intra-aortic balloon 14.33 NA 7.80 1.77 NA 23.90 090 33975 A Implant ventricular device 20.88 NA 6.20 2.06 NA 29.14 XXX 33976 A Implant ventricular device 22.87 NA 7.42 3.38 NA 33.67 XXX 33977 A Remove ventricular device 19.18 NA 10.69 2.92 NA 32.79 090 33978 A Remove ventricular device 21.61 NA 11.38 3.19 NA 36.18 090 33979 A Insert intracorporeal device 45.74 NA 14.63 4.77 NA 65.14 XXX 33980 A Remove intracorporeal device 55.93 NA 24.64 5.51 NA 86.08 090 33999 C Cardiac surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 34001 A Removal of artery clot 12.84 NA 6.70 1.75 NA 21.29 090 34051 A Removal of artery clot 15.12 NA 7.59 2.28 NA 24.99 090 34101 A Removal of artery clot 9.94 NA 5.35 1.33 NA 16.62 090 34111 A Removal of arm artery clot 9.94 NA 5.37 1.02 NA 16.33 090 34151 A Removal of artery clot 24.86 NA 10.50 2.21 NA 37.57 090 34201 A Removal of artery clot 9.97 NA 5.41 1.22 NA 16.60 090 34203 A Removal of leg artery clot 16.41 NA 8.09 1.64 NA 26.14 090 34401 A Removal of vein clot 24.86 NA 10.71 1.44 NA 37.01 090 34421 A Removal of vein clot 11.93 NA 6.29 1.14 NA 19.36 090 34451 A Removal of vein clot 26.85 NA 11.43 1.91 NA 40.19 090 34471 A Removal of vein clot 10.12 NA 5.38 1.08 NA 16.58 090 34490 A Removal of vein clot 9.80 NA 5.43 0.87 NA 16.10 090 34501 A Repair valve, femoral vein 15.91 NA 8.34 1.64 NA 25.89 090 34502 A Reconstruct vena cava 26.80 NA 12.20 3.58 NA 42.58 090 34510 A Transposition of vein valve 18.84 NA 9.29 1.92 NA 30.05 090 34520 A Cross-over vein graft 17.85 NA 8.74 1.69 NA 28.28 090 34530 A Leg vein fusion 16.55 NA 8.63 2.47 NA 27.65 090 34800 A Endovasc abdo repair w/tube 20.63 NA 9.19 1.79 NA 31.61 090 34802 A Endovasc abdo repr w/device 22.87 NA 9.88 1.98 NA 34.73 090 34804 A Endovasc abdo repr w/device 22.87 NA 9.88 1.98 NA 34.73 090 34805 A Endovasc abdo repair w/pros 21.76 NA 9.51 1.98 NA 33.25 090 34808 A Endovasc abdo occlud device 4.11 NA 1.38 0.35 NA 5.84 ZZZ 34812 A Xpose for endoprosth, femorl 6.71 NA 2.25 0.59 NA 9.55 000 34813 A Femoral endovas graft add-on 4.77 NA 1.58 0.41 NA 6.76 ZZZ 34820 A Xpose for endoprosth, iliac 9.69 NA 3.26 0.84 NA 13.79 000 34825 A Endovasc extend prosth, init 11.93 NA 6.20 1.03 NA 19.16 090 34826 A Endovasc exten prosth, addl 4.11 NA 1.39 0.35 NA 5.85 ZZZ 34830 A Open aortic tube prosth repr 32.40 NA 13.68 2.80 NA 48.88 090 34831 A Open aortoiliac prosth repr 35.14 NA 11.90 3.03 NA 50.07 090 34832 A Open aortofemor prosth repr 35.14 NA 14.67 3.03 NA 52.84 090 34833 A Xpose for endoprosth, iliac 11.93 NA 4.54 0.84 NA 17.31 000 34834 A Xpose, endoprosth, brachial 5.32 NA 2.25 0.59 NA 8.16 000 34900 A Endovasc iliac repr w/graft 16.29 NA 7.90 1.79 NA 25.98 090 35001 A Repair defect of artery 19.53 NA 9.52 2.92 NA 31.97 090 35002 A Repair artery rupture, neck 20.88 NA 9.78 2.18 NA 32.84 090 Start Printed Page 63296 35005 A Repair defect of artery 18.02 NA 8.88 1.62 NA 28.52 090 35011 A Repair defect of artery 17.90 NA 8.00 1.56 NA 27.46 090 35013 A Repair artery rupture, arm 21.87 NA 9.71 2.29 NA 33.87 090 35021 A Repair defect of artery 19.54 NA 9.25 2.31 NA 31.10 090 35022 A Repair artery rupture, chest 23.05 NA 10.01 2.39 NA 35.45 090 35045 A Repair defect of arm artery 17.47 NA 7.61 1.50 NA 26.58 090 35081 A Repair defect of artery 27.85 NA 11.45 3.84 NA 43.14 090 35082 A Repair artery rupture, aorta 38.28 NA 15.35 4.88 NA 58.51 090 35091 A Repair defect of artery 35.20 NA 13.61 4.90 NA 53.71 090 35092 A Repair artery rupture, aorta 44.74 NA 17.73 5.17 NA 67.64 090 35102 A Repair defect of artery 30.58 NA 12.40 4.12 NA 47.10 090 35103 A Repair artery rupture, groin 40.27 NA 15.95 4.54 NA 60.76 090 35111 A Repair defect of artery 24.86 NA 10.53 2.17 NA 37.56 090 35112 A Repair artery rupture,spleen 29.83 NA 12.07 2.34 NA 44.24 090 35121 A Repair defect of artery 29.83 NA 12.41 3.51 NA 45.75 090 35122 A Repair artery rupture, belly 34.80 NA 13.93 4.24 NA 52.97 090 35131 A Repair defect of artery 24.86 NA 10.76 2.53 NA 38.15 090 35132 A Repair artery rupture, groin 29.83 NA 12.42 2.97 NA 45.22 090 35141 A Repair defect of artery 19.89 NA 8.89 1.98 NA 30.76 090 35142 A Repair artery rupture, thigh 23.17 NA 10.39 2.10 NA 35.66 090 35151 A Repair defect of artery 22.51 NA 10.02 2.31 NA 34.84 090 35152 A Repair artery rupture, knee 25.47 NA 11.34 2.31 NA 39.12 090 35161 A Repair defect of artery 18.65 NA 9.08 2.65 NA 30.38 090 35162 A Repair artery rupture 19.67 NA 9.57 2.65 NA 31.89 090 35180 A Repair blood vessel lesion 13.54 NA 6.99 1.73 NA 22.26 090 35182 A Repair blood vessel lesion 29.83 NA 12.76 2.25 NA 44.84 090 35184 A Repair blood vessel lesion 17.90 NA 8.31 1.61 NA 27.82 090 35188 A Repair blood vessel lesion 14.20 NA 7.61 1.83 NA 23.64 090 35189 A Repair blood vessel lesion 27.84 NA 11.94 2.54 NA 42.32 090 35190 A Repair blood vessel lesion 12.68 NA 6.49 1.59 NA 20.76 090 35201 A Repair blood vessel lesion 16.05 NA 7.99 1.40 NA 25.44 090 35206 A Repair blood vessel lesion 13.17 NA 6.60 1.25 NA 21.02 090 35207 A Repair blood vessel lesion 10.09 NA 7.59 1.38 NA 19.06 090 35211 A Repair blood vessel lesion 21.99 NA 10.31 3.39 NA 35.69 090 35216 A Repair blood vessel lesion 18.64 NA 8.81 2.60 NA 30.05 090 35221 A Repair blood vessel lesion 24.25 NA 10.02 2.15 NA 36.42 090 35226 A Repair blood vessel lesion 14.42 NA 7.51 1.01 NA 22.94 090 35231 A Repair blood vessel lesion 19.89 NA 9.79 1.58 NA 31.26 090 35236 A Repair blood vessel lesion 17.01 NA 7.96 1.43 NA 26.40 090 35241 A Repair blood vessel lesion 22.99 NA 10.74 3.48 NA 37.21 090 35246 A Repair blood vessel lesion 26.30 NA 11.29 2.66 NA 40.25 090 35251 A Repair blood vessel lesion 30.03 NA 11.91 2.24 NA 44.18 090 35256 A Repair blood vessel lesion 18.26 NA 8.43 1.58 NA 28.27 090 35261 A Repair blood vessel lesion 17.70 NA 8.03 1.61 NA 27.34 090 35266 A Repair blood vessel lesion 14.83 NA 7.04 1.39 NA 23.26 090 35271 A Repair blood vessel lesion 21.99 NA 10.21 3.32 NA 35.52 090 35276 A Repair blood vessel lesion 24.11 NA 11.01 2.84 NA 37.96 090 35281 A Repair blood vessel lesion 27.84 NA 11.79 2.18 NA 41.81 090 35286 A Repair blood vessel lesion 16.07 NA 8.08 1.63 NA 25.78 090 35301 A Rechanneling of artery 18.59 NA 8.45 2.67 NA 29.71 090 35311 A Rechanneling of artery 26.85 NA 11.49 3.30 NA 41.64 090 35321 A Rechanneling of artery 15.91 NA 7.34 1.63 NA 24.88 090 35331 A Rechanneling of artery 26.05 NA 11.22 3.25 NA 40.52 090 35341 A Rechanneling of artery 24.97 NA 10.93 3.44 NA 39.34 090 35351 A Rechanneling of artery 22.87 NA 9.64 2.74 NA 35.25 090 35355 A Rechanneling of artery 18.39 NA 8.13 2.16 NA 28.68 090 35361 A Rechanneling of artery 28.04 NA 11.77 3.19 NA 43.00 090 35363 A Rechanneling of artery 30.03 NA 12.58 3.32 NA 45.93 090 35371 A Rechanneling of artery 14.64 NA 6.98 1.58 NA 23.20 090 35372 A Rechanneling of artery 17.90 NA 8.09 1.83 NA 27.82 090 35381 A Rechanneling of artery 15.72 NA 7.83 2.16 NA 25.71 090 35390 A Reoperation, carotid add-on 3.17 NA 1.06 0.46 NA 4.69 ZZZ 35400 A Angioscopy 2.98 NA 1.04 0.41 NA 4.43 ZZZ 35450 A Repair arterial blockage 10.01 NA 4.05 1.01 NA 15.07 000 35452 A Repair arterial blockage 6.87 NA 3.15 0.91 NA 10.93 000 35454 A Repair arterial blockage 6.01 NA 2.84 0.80 NA 9.65 000 35456 A Repair arterial blockage 7.31 NA 3.27 0.98 NA 11.56 000 35458 A Repair arterial blockage 9.44 NA 3.98 1.31 NA 14.73 000 35459 A Repair arterial blockage 8.58 NA 3.64 1.15 NA 13.37 000 35460 A Repair venous blockage 6.01 NA 2.68 0.79 NA 9.48 000 35470 A Repair arterial blockage 8.58 NA 3.88 0.60 NA 13.06 000 35471 A Repair arterial blockage 10.01 NA 4.50 0.60 NA 15.11 000 35472 A Repair arterial blockage 6.87 NA 3.26 0.47 NA 10.60 000 35473 A Repair arterial blockage 6.01 NA 2.94 0.41 NA 9.36 000 35474 A Repair arterial blockage 7.32 NA 2.91 0.48 NA 10.71 000 Start Printed Page 63297 35475 R Repair arterial blockage 9.44 NA 4.10 0.56 NA 14.10 000 35476 A Repair venous blockage 6.01 NA 2.88 0.32 NA 9.21 000 35480 A Atherectomy, open 11.02 NA 4.51 1.35 NA 16.88 000 35481 A Atherectomy, open 7.57 NA 3.44 1.01 NA 12.02 000 35482 A Atherectomy, open 6.61 NA 3.09 0.90 NA 10.60 000 35483 A Atherectomy, open 8.05 NA 3.53 0.97 NA 12.55 000 35484 A Atherectomy, open 10.38 NA 4.23 1.35 NA 15.96 000 35485 A Atherectomy, open 9.44 NA 4.06 1.27 NA 14.77 000 35490 A Atherectomy, percutaneous 11.02 NA 4.75 0.66 NA 16.43 000 35491 A Atherectomy, percutaneous 7.57 NA 3.32 0.59 NA 11.48 000 35492 A Atherectomy, percutaneous 6.61 NA 3.22 0.52 NA 10.35 000 35493 A Atherectomy, percutaneous 8.05 NA 3.83 0.56 NA 12.44 000 35494 A Atherectomy, percutaneous 10.38 NA 4.45 0.58 NA 15.41 000 35495 A Atherectomy, percutaneous 9.44 NA 4.42 0.61 NA 14.47 000 35500 A Harvest vein for bypass 6.41 NA 2.04 0.76 NA 9.21 ZZZ 35501 A Artery bypass graft 19.08 NA 8.43 2.79 NA 30.30 090 35506 A Artery bypass graft 19.56 NA 9.39 2.79 NA 31.74 090 35507 A Artery bypass graft 19.56 NA 9.36 2.72 NA 31.64 090 35508 A Artery bypass graft 18.54 NA 9.28 2.80 NA 30.62 090 35509 A Artery bypass graft 17.97 NA 8.76 2.54 NA 29.27 090 35510 A Artery bypass graft 22.87 NA 10.22 2.09 NA 35.18 090 35511 A Artery bypass graft 21.08 NA 9.34 2.09 NA 32.51 090 35512 A Artery bypass graft 22.37 NA 10.05 2.09 NA 34.51 090 35515 A Artery bypass graft 18.54 NA 9.23 2.71 NA 30.48 090 35516 A Artery bypass graft 16.23 NA 6.87 2.25 NA 25.35 090 35518 A Artery bypass graft 21.08 NA 9.04 2.13 NA 32.25 090 35521 A Artery bypass graft 22.07 NA 9.81 2.18 NA 34.06 090 35522 A Artery bypass graft 21.64 NA 9.79 2.09 NA 33.52 090 35525 A Artery bypass graft 20.51 NA 9.41 2.09 NA 32.01 090 35526 A Artery bypass graft 29.78 NA 12.37 2.61 NA 44.76 090 35531 A Artery bypass graft 35.99 NA 14.57 3.49 NA 54.05 090 35533 A Artery bypass graft 27.84 NA 11.77 2.82 NA 42.43 090 35536 A Artery bypass graft 31.52 NA 13.06 3.14 NA 47.72 090 35541 A Artery bypass graft 25.65 NA 11.17 3.28 NA 40.10 090 35546 A Artery bypass graft 25.39 NA 10.90 3.40 NA 39.69 090 35548 A Artery bypass graft 21.45 NA 9.45 2.94 NA 33.84 090 35549 A Artery bypass graft 23.22 NA 10.30 3.32 NA 36.84 090 35551 A Artery bypass graft 26.52 NA 11.41 3.82 NA 41.75 090 35556 A Artery bypass graft 21.64 NA 9.73 2.97 NA 34.34 090 35558 A Artery bypass graft 21.08 NA 9.56 1.89 NA 32.53 090 35560 A Artery bypass graft 31.82 NA 13.31 3.27 NA 48.40 090 35563 A Artery bypass graft 24.06 NA 10.53 2.01 NA 36.60 090 35565 A Artery bypass graft 23.07 NA 10.18 2.05 NA 35.30 090 35566 A Artery bypass graft 26.77 NA 11.46 3.62 NA 41.85 090 35571 A Artery bypass graft 23.92 NA 10.93 2.57 NA 37.42 090 35572 A Harvest femoropopliteal vein 6.78 NA 2.35 0.76 NA 9.89 ZZZ 35582 A Vein bypass graft 26.98 NA 11.61 3.73 NA 42.32 090 35583 A Vein bypass graft 22.24 NA 10.22 3.03 NA 35.49 090 35585 A Vein bypass graft 28.23 NA 12.35 3.85 NA 44.43 090 35587 A Vein bypass graft 24.61 NA 11.53 2.60 NA 38.74 090 35600 A Harvest artery for cabg 4.92 NA 1.60 0.72 NA 7.24 ZZZ 35601 A Artery bypass graft 17.40 NA 8.59 2.49 NA 28.48 090 35606 A Artery bypass graft 18.60 NA 8.97 2.60 NA 30.17 090 35612 A Artery bypass graft 15.67 NA 7.83 2.06 NA 25.56 090 35616 A Artery bypass graft 15.61 NA 8.02 2.21 NA 25.84 090 35621 A Artery bypass graft 19.89 NA 8.69 2.01 NA 30.59 090 35623 A Bypass graft, not vein 23.86 NA 10.51 2.29 NA 36.66 090 35626 A Artery bypass graft 27.59 NA 11.78 3.46 NA 42.83 090 35631 A Artery bypass graft 33.81 NA 13.90 3.39 NA 51.10 090 35636 A Artery bypass graft 29.33 NA 12.43 2.84 NA 44.60 090 35641 A Artery bypass graft 24.43 NA 11.00 3.39 NA 38.82 090 35642 A Artery bypass graft 17.88 NA 8.70 2.21 NA 28.79 090 35645 A Artery bypass graft 17.37 NA 8.35 2.29 NA 28.01 090 35646 A Artery bypass graft 30.82 NA 13.10 4.35 NA 48.27 090 35647 A Artery bypass graft 27.84 NA 11.78 3.93 NA 43.55 090 35650 A Artery bypass graft 18.89 NA 8.38 1.97 NA 29.24 090 35651 A Artery bypass graft 24.90 NA 10.86 3.03 NA 38.79 090 35654 A Artery bypass graft 24.86 NA 10.70 2.52 NA 38.08 090 35656 A Artery bypass graft 19.42 NA 8.60 2.65 NA 30.67 090 35661 A Artery bypass graft 18.89 NA 8.93 1.80 NA 29.62 090 35663 A Artery bypass graft 21.87 NA 9.96 1.86 NA 33.69 090 35665 A Artery bypass graft 20.88 NA 9.49 2.11 NA 32.48 090 35666 A Artery bypass graft 22.06 NA 10.68 2.62 NA 35.36 090 35671 A Artery bypass graft 19.22 NA 9.40 2.01 NA 30.63 090 35681 A Composite bypass graft 1.59 NA 0.54 0.22 NA 2.35 ZZZ Start Printed Page 63298 35682 A Composite bypass graft 7.16 NA 2.41 0.99 NA 10.56 ZZZ 35683 A Composite bypass graft 8.45 NA 2.84 1.17 NA 12.46 ZZZ 35685 A Bypass graft patency/patch 4.03 NA 1.36 0.30 NA 5.69 ZZZ 35686 A Bypass graft/av fist patency 3.33 NA 1.14 0.25 NA 4.72 ZZZ 35691 A Arterial transposition 17.95 NA 8.46 2.47 NA 28.88 090 35693 A Arterial transposition 15.27 NA 7.67 2.16 NA 25.10 090 35694 A Arterial transposition 19.05 NA 8.69 2.55 NA 30.29 090 35695 A Arterial transposition 19.05 NA 8.61 2.62 NA 30.28 090 35697 A Reimplant artery each 2.98 NA 1.03 0.41 NA 4.42 ZZZ 35700 A Reoperation, bypass graft 3.06 NA 1.02 0.43 NA 4.51 ZZZ 35701 A Exploration, carotid artery 8.45 NA 5.16 0.77 NA 14.38 090 35721 A Exploration, femoral artery 7.14 NA 4.43 0.71 NA 12.28 090 35741 A Exploration popliteal artery 7.95 NA 4.69 0.72 NA 13.36 090 35761 A Exploration of artery/vein 5.34 NA 4.05 0.72 NA 10.11 090 35800 A Explore neck vessels 6.98 NA 4.63 0.95 NA 12.56 090 35820 A Explore chest vessels 12.81 NA 6.93 1.93 NA 21.67 090 35840 A Explore abdominal vessels 9.71 NA 5.31 1.27 NA 16.29 090 35860 A Explore limb vessels 5.52 NA 4.03 0.76 NA 10.31 090 35870 A Repair vessel graft defect 22.04 NA 9.81 2.96 NA 34.81 090 35875 A Removal of clot in graft 10.07 NA 5.24 1.16 NA 16.47 090 35876 A Removal of clot in graft 16.90 NA 7.59 2.25 NA 26.74 090 35879 A Revise graft w/vein 15.91 NA 7.74 1.62 NA 25.27 090 35881 A Revise graft w/vein 17.90 NA 8.71 1.73 NA 28.34 090 35901 A Excision, graft, neck 8.14 NA 5.34 1.08 NA 14.56 090 35903 A Excision, graft, extremity 9.34 NA 5.99 1.23 NA 16.56 090 35905 A Excision, graft, thorax 31.07 NA 13.14 2.58 NA 46.79 090 35907 A Excision, graft, abdomen 34.80 NA 14.15 2.60 NA 51.55 090 36000 A Place needle in vein 0.18 0.62 0.05 0.01 0.81 0.24 XXX 36002 A Pseudoaneurysm injection trt 1.95 2.92 1.00 0.12 4.99 3.07 000 36005 A Injection ext venography 0.94 8.42 0.32 0.05 9.41 1.31 000 36010 A Place catheter in vein 2.42 NA 0.79 0.19 NA 3.40 XXX 36011 A Place catheter in vein 3.12 NA 1.04 0.20 NA 4.36 XXX 36012 A Place catheter in vein 3.50 NA 1.16 0.20 NA 4.86 XXX 36013 A Place catheter in artery 2.51 NA 0.66 0.20 NA 3.37 XXX 36014 A Place catheter in artery 3.00 NA 1.00 0.17 NA 4.17 XXX 36015 A Place catheter in artery 3.50 NA 1.16 0.19 NA 4.85 XXX 36100 A Establish access to artery 3.00 NA 1.11 0.22 NA 4.33 XXX 36120 A Establish access to artery 2.00 NA 0.65 0.13 NA 2.78 XXX 36140 A Establish access to artery 2.00 NA 0.64 0.14 NA 2.78 XXX 36145 A Artery to vein shunt 2.00 NA 0.66 0.12 NA 2.78 XXX 36160 A Establish access to aorta 2.51 NA 0.84 0.24 NA 3.59 XXX 36200 A Place catheter in aorta 3.00 77.01 1.02 0.18 80.19 4.20 XXX 36215 A Place catheter in artery 4.65 NA 1.59 0.26 NA 6.50 XXX 36216 A Place catheter in artery 5.25 NA 1.78 0.29 NA 7.32 XXX 36217 A Place catheter in artery 6.26 NA 2.16 0.38 NA 8.80 XXX 36218 A Place catheter in artery 1.00 NA 0.35 0.06 NA 1.41 ZZZ 36245 A Place catheter in artery 4.65 NA 1.67 0.28 NA 6.60 XXX 36246 A Place catheter in artery 5.25 NA 1.81 0.31 NA 7.37 XXX 36247 A Place catheter in artery 6.26 NA 2.12 0.38 NA 8.76 XXX 36248 A Place catheter in artery 1.00 NA 0.35 0.07 NA 1.42 ZZZ 36260 A Insertion of infusion pump 9.65 NA 4.96 1.20 NA 15.81 090 36261 A Revision of infusion pump 5.42 NA 3.62 0.60 NA 9.64 090 36262 A Removal of infusion pump 4.00 NA 2.80 0.52 NA 7.32 090 36299 C Vessel injection procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 36400 A Bl draw < 3 yrs fem/jugular 0.38 0.29 0.09 0.01 0.68 0.48 XXX 36405 A Bl draw < 3 yrs scalp vein 0.31 0.27 0.08 0.01 0.59 0.40 XXX 36406 A Bl draw < 3 yrs other vein 0.18 0.31 0.05 0.01 0.50 0.24 XXX 36410 A Non-routine bl draw > 3 yrs 0.18 0.31 0.05 0.01 0.50 0.24 XXX 36415 I Routine venipuncture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36416 I Capillary blood draw 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36420 A Vein access cutdown < 1 yr 1.00 3.16 0.28 0.11 4.27 1.39 XXX 36425 A Vein access cutdown > 1 yr 0.76 NA 0.22 0.06 NA 1.04 XXX 36430 A Blood transfusion service 0.00 0.99 NA 0.06 1.05 NA XXX 36440 A Bl push transfuse, 2 yr or < 1.02 NA 0.29 0.10 NA 1.41 XXX 36450 A Bl exchange/transfuse, nb 2.22 NA 0.70 0.19 NA 3.11 XXX 36455 A Bl exchange/transfuse non-nb 2.42 NA 0.83 0.12 NA 3.37 XXX 36460 A Transfusion service, fetal 6.55 NA 2.24 0.67 NA 9.46 XXX 36468 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 000 36469 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 000 36470 A Injection therapy of vein 1.08 2.75 0.45 0.12 3.95 1.65 010 36471 A Injection therapy of veins 1.56 3.10 0.61 0.18 4.84 2.35 010 36481 A Insertion of catheter, vein 6.95 7.00 2.76 0.48 14.43 10.19 000 36488 D Insertion of catheter, vein 0.00 0.00 0.00 0.00 0.00 0.00 000 36489 D Insertion of catheter, vein 0.00 0.00 0.00 0.00 0.00 0.00 000 36490 D Insertion of catheter, vein 0.00 0.00 0.00 0.00 0.00 0.00 000 Start Printed Page 63299 36491 D Insertion of catheter, vein 0.00 0.00 0.00 0.00 0.00 0.00 000 36493 D Repositioning of cvc 0.00 0.00 0.00 0.00 0.00 0.00 000 36500 A Insertion of catheter, vein 3.50 NA 1.24 0.17 NA 4.91 000 36510 A Insertion of catheter, vein 1.08 3.81 0.63 0.07 4.96 1.78 000 36511 A Apheresis wbc 1.73 NA 0.69 0.07 NA 2.49 000 36512 A Apheresis rbc 1.73 NA 0.69 0.07 NA 2.49 000 36513 A Apheresis platelets 1.73 NA 0.69 0.07 NA 2.49 000 36514 A Apheresis plasma 1.73 NA 0.69 0.07 NA 2.49 000 36515 A Apheresis, adsorp/reinfuse 1.73 NA 0.73 0.07 NA 2.53 000 36516 A Apheresis, selective 1.73 NA 0.73 0.07 NA 2.53 000 36522 A Photopheresis 1.66 30.38 1.14 0.08 32.12 2.88 000 36530 D Insertion of infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 010 36531 D Revision of infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 010 36532 D Removal of infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 010 36533 D Insertion of access device 0.00 0.00 0.00 0.00 0.00 0.00 010 36534 D Revision of access device 0.00 0.00 0.00 0.00 0.00 0.00 010 36535 D Removal of access device 0.00 0.00 0.00 0.00 0.00 0.00 010 36536 D Remove cva device obstruct 0.00 0.00 0.00 0.00 0.00 0.00 000 36537 D Remove cva lumen obstruct 0.00 0.00 0.00 0.00 0.00 0.00 000 36540 B Collect blood venous device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36550 A Declot vascular device 0.00 0.41 NA 0.37 0.78 NA XXX 36555 A Insert non-tunnel cv cath 2.66 6.06 0.82 0.20 8.92 3.68 000 36556 A Insert non-tunnel cv cath 2.49 5.06 0.75 0.10 7.65 3.34 000 36557 A Insert tunneled cv cath 5.07 13.64 2.59 0.59 19.30 8.25 010 36558 A Insert tunneled cv cath 4.77 13.54 2.48 0.59 18.90 7.84 010 36560 A Insert tunneled cv cath 6.21 29.38 2.98 0.59 36.18 9.78 010 36561 A Insert tunneled cv cath 5.97 29.29 2.89 0.59 35.85 9.45 010 36563 A Insert tunneled cv cath 6.16 26.75 2.99 0.67 33.58 9.82 010 36565 A Insert tunneled cv cath 5.97 22.30 2.89 0.59 28.86 9.45 010 36566 A Insert tunneled cv cath 6.46 23.11 3.06 0.59 30.16 10.11 010 36568 A Insert tunneled cv cath 1.91 8.29 0.60 0.20 10.40 2.71 000 36569 A Insert tunneled cv cath 1.81 6.77 0.58 0.16 8.74 2.55 000 36570 A Insert tunneled cv cath 5.29 40.53 2.66 0.59 46.41 8.54 010 36571 A Insert tunneled cv cath 5.27 35.86 2.65 0.59 41.72 8.51 010 36575 A Repair tunneled cv cath 0.67 3.35 0.26 0.59 4.61 1.52 000 36576 A Repair tunneled cv cath 3.17 7.73 1.77 0.59 11.49 5.53 010 36578 A Replace tunneled cv cath 3.48 10.57 2.21 0.59 14.64 6.28 010 36580 A Replace tunneled cv cath 1.30 5.88 0.42 0.16 7.34 1.88 000 36581 A Replace tunneled cv cath 3.42 13.30 1.85 0.59 17.31 5.86 010 36582 A Replace tunneled cv cath 5.17 26.69 2.78 0.59 32.45 8.54 010 36583 A Replace tunneled cv cath 5.22 13.17 2.80 0.59 18.98 8.61 010 36584 A Replace tunneled cv cath 1.19 6.33 0.56 0.16 7.68 1.91 000 36585 A Replace tunneled cv cath 4.77 35.52 2.65 0.59 40.88 8.01 010 36589 A Removal tunneled cv cath 2.26 2.13 1.42 0.25 4.64 3.93 010 36590 A Removal tunneled cv cath 3.28 6.34 1.64 0.41 10.03 5.33 010 36595 A Mech remov tunneled cv cath 3.58 18.94 1.47 0.28 22.80 5.33 000 36596 A Mech remov tunneled cv cath 0.75 4.43 0.50 0.05 5.23 1.30 000 36597 A Reposition venous catheter 1.20 3.18 0.44 0.07 4.45 1.71 000 36600 A Withdrawal of arterial blood 0.32 0.49 0.09 0.02 0.83 0.43 XXX 36620 A Insertion catheter, artery 1.14 NA 0.24 0.07 NA 1.45 000 36625 A Insertion catheter, artery 2.10 NA 0.53 0.19 NA 2.82 000 36640 A Insertion catheter, artery 2.09 NA 1.03 0.22 NA 3.34 000 36660 A Insertion catheter, artery 1.39 NA 0.44 0.10 NA 1.93 000 36680 A Insert needle, bone cavity 1.19 NA 0.50 0.10 NA 1.79 000 36800 A Insertion of cannula 2.42 NA 1.82 0.20 NA 4.44 000 36810 A Insertion of cannula 3.95 NA 1.69 0.48 NA 6.12 000 36815 A Insertion of cannula 2.61 NA 1.18 0.31 NA 4.10 000 36819 A Av fusion/uppr arm vein 13.92 NA 6.43 1.87 NA 22.22 090 36820 A Av fusion/forearm vein 13.92 NA 6.43 1.87 NA 22.22 090 36821 A Av fusion direct any site 8.88 NA 4.72 1.16 NA 14.76 090 36822 A Insertion of cannula(s) 5.39 NA 4.31 0.76 NA 10.46 090 36823 A Insertion of cannula(s) 20.88 NA 9.56 2.61 NA 33.05 090 36825 A Artery-vein autograft 9.78 NA 5.13 1.31 NA 16.22 090 36830 A Artery-vein nonautograft 11.93 NA 5.30 1.58 NA 18.81 090 36831 A Open thrombect av fistula 7.95 NA 3.98 0.95 NA 12.88 090 36832 A Av fistula revision, open 10.44 NA 4.79 1.35 NA 16.58 090 36833 A Av fistula revision 11.88 NA 5.27 1.55 NA 18.70 090 36834 A Repair A-V aneurysm 9.87 NA 4.81 1.27 NA 15.95 090 36835 A Artery to vein shunt 7.11 NA 4.34 0.96 NA 12.41 090 36838 A Dist revas ligation, hemo 20.51 NA 9.41 2.97 NA 32.89 090 36860 A External cannula declotting 2.00 2.54 1.36 0.12 4.66 3.48 000 36861 A Cannula declotting 2.51 NA 1.50 0.17 NA 4.18 000 36870 A Percut thrombect av fistula 5.13 47.27 3.17 0.28 52.68 8.58 090 37140 A Revision of circulation 23.47 NA 10.60 1.45 NA 35.52 090 37145 A Revision of circulation 24.47 NA 11.07 2.97 NA 38.51 090 Start Printed Page 63300 37160 A Revision of circulation 21.48 NA 9.38 2.59 NA 33.45 090 37180 A Revision of circulation 24.47 NA 10.45 3.15 NA 38.07 090 37181 A Splice spleen/kidney veins 26.53 NA 11.13 3.20 NA 40.86 090 37182 A Insert hepatic shunt (tips) 16.90 NA 6.32 1.79 NA 25.01 000 37183 A Remove hepatic shunt (tips) 7.95 NA 3.11 0.52 NA 11.58 000 37195 A Thrombolytic therapy, stroke 0.00 7.99 NA 0.46 8.45 NA XXX 37200 A Transcatheter biopsy 4.53 NA 1.52 0.23 NA 6.28 000 37201 A Transcatheter therapy infuse 4.97 NA 2.54 0.29 NA 7.80 000 37202 A Transcatheter therapy infuse 5.65 NA 3.07 0.46 NA 9.18 000 37203 A Transcatheter retrieval 5.00 NA 2.55 0.28 NA 7.83 000 37204 A Transcatheter occlusion 18.04 NA 5.99 1.09 NA 25.12 000 37205 A Transcatheter stent 8.23 NA 3.77 0.52 NA 12.52 000 37206 A Transcatheter stent add-on 4.11 NA 1.46 0.26 NA 5.83 ZZZ 37207 A Transcatheter stent 8.23 NA 3.18 1.07 NA 12.48 000 37208 A Transcatheter stent add-on 4.11 NA 1.40 0.53 NA 6.04 ZZZ 37209 A Exchange arterial catheter 2.26 NA 0.75 0.13 NA 3.14 000 37250 A Iv us first vessel add-on 2.09 NA 0.75 0.20 NA 3.04 ZZZ 37251 A Iv us each add vessel add-on 1.59 NA 0.56 0.17 NA 2.32 ZZZ 37500 A Endoscopy ligate perf veins 10.94 NA 7.09 0.48 NA 18.51 090 37501 C Vascular endoscopy procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 37565 A Ligation of neck vein 10.82 NA 5.69 0.54 NA 17.05 090 37600 A Ligation of neck artery 11.19 NA 6.71 0.48 NA 18.38 090 37605 A Ligation of neck artery 13.04 NA 6.98 0.92 NA 20.94 090 37606 A Ligation of neck artery 6.24 NA 4.62 0.95 NA 11.81 090 37607 A Ligation of a-v fistula 6.12 NA 3.60 0.80 NA 10.52 090 37609 A Temporal artery procedure 2.98 4.74 1.99 0.25 7.97 5.22 010 37615 A Ligation of neck artery 5.70 NA 4.14 0.68 NA 10.52 090 37616 A Ligation of chest artery 16.40 NA 7.96 2.31 NA 26.67 090 37617 A Ligation of abdomen artery 21.93 NA 9.30 2.03 NA 33.26 090 37618 A Ligation of extremity artery 4.81 NA 3.60 0.65 NA 9.06 090 37620 A Revision of major vein 10.50 NA 5.75 0.90 NA 17.15 090 37650 A Revision of major vein 7.76 NA 4.70 0.67 NA 13.13 090 37660 A Revision of major vein 20.88 NA 9.10 1.40 NA 31.38 090 37700 A Revise leg vein 3.71 NA 2.83 0.48 NA 7.02 090 37720 A Removal of leg vein 5.63 NA 3.74 0.73 NA 10.10 090 37730 A Removal of leg veins 7.29 NA 4.31 0.92 NA 12.52 090 37735 A Removal of leg veins/lesion 10.47 NA 5.56 1.40 NA 17.43 090 37760 A Ligation, leg veins, open 10.41 NA 5.40 1.33 NA 17.14 090 37765 A Phleb veins—extrem—to 20 7.31 NA 4.56 0.48 NA 12.35 090 37766 A Phleb veins—extrem 20+ 9.25 NA 5.28 0.48 NA 15.01 090 37780 A Revision of leg vein 3.82 NA 2.88 0.49 NA 7.19 090 37785 A Ligate/divide/excise vein 3.82 5.16 2.66 0.49 9.47 6.97 090 37788 A Revascularization, penis 21.88 NA 9.39 1.62 NA 32.89 090 37790 A Penile venous occlusion 8.29 NA 4.52 0.76 NA 13.57 090 37799 C Vascular surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38100 A Removal of spleen, total 14.42 NA 6.28 1.56 NA 22.26 090 38101 A Removal of spleen, partial 15.22 NA 6.64 1.65 NA 23.51 090 38102 A Removal of spleen, total 4.77 NA 1.66 0.59 NA 7.02 ZZZ 38115 A Repair of ruptured spleen 15.73 NA 6.76 1.68 NA 24.17 090 38120 A Laparoscopy, splenectomy 16.90 NA 7.51 2.07 NA 26.48 090 38129 C Laparoscope proc, spleen 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38200 A Injection for spleen x-ray 2.62 NA 0.90 0.14 NA 3.66 000 38204 B Bl donor search management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38205 R Harvest allogenic stem cells 1.49 NA 0.61 0.06 NA 2.16 000 38206 R Harvest auto stem cells 1.49 NA 0.61 0.06 NA 2.16 000 38207 I Cryopreserve stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38208 I Thaw preserved stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38209 I Wash harvest stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38210 I T-cell depletion of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38211 I Tumor cell deplete of harvst 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38212 I Rbc depletion of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38213 I Platelet deplete of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38214 I Volume deplete of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38215 I Harvest stem cell concentrte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38220 A Bone marrow aspiration 1.07 3.97 0.43 0.04 5.08 1.54 XXX 38221 A Bone marrow biopsy 1.36 4.15 0.54 0.05 5.56 1.95 XXX 38230 R Bone marrow collection 4.51 NA 2.51 0.30 NA 7.32 010 38240 R Bone marrow/stem transplant 2.23 NA 0.82 0.10 NA 3.15 XXX 38241 R Bone marrow/stem transplant 2.23 NA 0.82 0.10 NA 3.15 XXX 38242 A Lymphocyte infuse transplant 1.70 NA 0.68 0.06 NA 2.44 000 38300 A Drainage, lymph node lesion 1.98 4.50 2.10 0.18 6.66 4.26 010 38305 A Drainage, lymph node lesion 5.97 6.06 4.42 0.43 12.46 10.82 090 38308 A Incision of lymph channels 6.41 5.81 3.77 0.61 12.83 10.79 090 38380 A Thoracic duct procedure 7.42 NA 5.75 0.82 NA 13.99 090 38381 A Thoracic duct procedure 12.81 NA 6.72 1.89 NA 21.42 090 Start Printed Page 63301 38382 A Thoracic duct procedure 10.02 NA 5.81 1.29 NA 17.12 090 38500 A Biopsy/removal, lymph nodes 3.73 3.83 2.12 0.34 7.90 6.19 010 38505 A Needle biopsy, lymph nodes 1.13 2.16 0.79 0.11 3.40 2.03 000 38510 A Biopsy/removal, lymph nodes 6.39 5.71 3.54 0.46 12.56 10.39 010 38520 A Biopsy/removal, lymph nodes 6.63 NA 4.09 0.62 NA 11.34 090 38525 A Biopsy/removal, lymph nodes 6.04 NA 3.39 0.58 NA 10.01 090 38530 A Biopsy/removal, lymph nodes 7.93 NA 4.45 0.76 NA 13.14 090 38542 A Explore deep node(s), neck 5.88 NA 4.53 0.60 NA 11.01 090 38550 A Removal, neck/armpit lesion 6.88 NA 4.04 0.83 NA 11.75 090 38555 A Removal, neck/armpit lesion 14.06 NA 8.52 1.75 NA 24.33 090 38562 A Removal, pelvic lymph nodes 10.43 NA 5.99 1.16 NA 17.58 090 38564 A Removal, abdomen lymph nodes 10.77 NA 5.39 1.27 NA 17.43 090 38570 A Laparoscopy, lymph node biop 9.20 NA 4.00 1.07 NA 14.27 010 38571 A Laparoscopy, lymphadenectomy 14.60 NA 5.67 0.96 NA 21.23 010 38572 A Laparoscopy, lymphadenectomy 16.50 NA 7.24 1.58 NA 25.32 010 38589 C Laparoscope proc, lymphatic 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38700 A Removal of lymph nodes, neck 8.19 NA 8.19 0.72 NA 17.10 090 38720 A Removal of lymph nodes, neck 13.53 NA 11.18 1.23 NA 25.94 090 38724 A Removal of lymph nodes, neck 14.46 NA 11.70 1.32 NA 27.48 090 38740 A Remove armpit lymph nodes 9.97 NA 5.06 0.83 NA 15.86 090 38745 A Remove armpit lymph nodes 13.03 NA 6.25 1.08 NA 20.36 090 38746 A Remove thoracic lymph nodes 4.86 NA 1.59 0.66 NA 7.11 ZZZ 38747 A Remove abdominal lymph nodes 4.86 NA 1.69 0.60 NA 7.15 ZZZ 38760 A Remove groin lymph nodes 12.88 NA 6.29 1.05 NA 20.22 090 38765 A Remove groin lymph nodes 19.87 NA 9.05 1.80 NA 30.72 090 38770 A Remove pelvis lymph nodes 13.15 NA 5.91 1.19 NA 20.25 090 38780 A Remove abdomen lymph nodes 16.50 NA 8.53 1.92 NA 26.95 090 38790 A Inject for lymphatic x-ray 1.28 10.81 0.80 0.11 12.20 2.19 000 38792 A Identify sentinel node 0.52 NA 0.45 0.05 NA 1.02 000 38794 A Access thoracic lymph duct 4.42 NA 3.43 0.20 NA 8.05 090 38999 C Blood/lymph system procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39000 A Exploration of chest 6.07 NA 4.51 0.87 NA 11.45 090 39010 A Exploration of chest 11.72 NA 6.43 1.75 NA 19.90 090 39200 A Removal chest lesion 13.54 NA 6.61 1.98 NA 22.13 090 39220 A Removal chest lesion 17.32 NA 8.31 2.52 NA 28.15 090 39400 A Visualization of chest 5.58 NA 4.65 0.83 NA 11.06 010 39499 C Chest procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39501 A Repair diaphragm laceration 13.11 NA 6.53 1.65 NA 21.29 090 39502 A Repair paraesophageal hernia 16.24 NA 7.25 2.01 NA 25.50 090 39503 A Repair of diaphragm hernia 94.46 NA 33.85 4.22 NA 132.53 090 39520 A Repair of diaphragm hernia 16.01 NA 7.99 2.19 NA 26.19 090 39530 A Repair of diaphragm hernia 15.32 NA 7.16 1.99 NA 24.47 090 39531 A Repair of diaphragm hernia 16.33 NA 7.41 2.19 NA 25.93 090 39540 A Repair of diaphragm hernia 13.24 NA 6.28 1.65 NA 21.17 090 39541 A Repair of diaphragm hernia 14.33 NA 6.66 1.82 NA 22.81 090 39545 A Revision of diaphragm 13.29 NA 7.41 1.86 NA 22.56 090 39560 A Resect diaphragm, simple 11.93 NA 6.34 1.62 NA 19.89 090 39561 A Resect diaphragm, complex 17.40 NA 9.31 2.36 NA 29.07 090 39599 C Diaphragm surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40490 A Biopsy of lip 1.21 1.87 0.62 0.07 3.15 1.90 000 40500 A Partial excision of lip 4.26 6.15 4.95 0.37 10.78 9.58 090 40510 A Partial excision of lip 4.67 6.90 4.84 0.46 12.03 9.97 090 40520 A Partial excision of lip 4.64 7.41 5.09 0.50 12.55 10.23 090 40525 A Reconstruct lip with flap 7.51 NA 6.98 0.82 NA 15.31 090 40527 A Reconstruct lip with flap 9.08 NA 7.94 0.98 NA 18.00 090 40530 A Partial removal of lip 5.37 6.65 5.25 0.56 12.58 11.18 090 40650 A Repair lip 3.62 5.62 3.86 0.37 9.61 7.85 090 40652 A Repair lip 4.24 6.59 5.30 0.47 11.30 10.01 090 40654 A Repair lip 5.28 7.24 6.03 0.58 13.10 11.89 090 40700 A Repair cleft lip/nasal 12.72 NA 9.63 1.11 NA 23.46 090 40701 A Repair cleft lip/nasal 15.76 NA 11.92 1.63 NA 29.31 090 40702 A Repair cleft lip/nasal 12.97 NA 8.56 1.21 NA 22.74 090 40720 A Repair cleft lip/nasal 13.47 NA 10.62 1.57 NA 25.66 090 40761 A Repair cleft lip/nasal 14.64 NA 10.93 1.69 NA 27.26 090 40799 C Lip surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40800 A Drainage of mouth lesion 1.16 2.24 1.16 0.11 3.51 2.43 010 40801 A Drainage of mouth lesion 2.52 3.21 2.05 0.22 5.95 4.79 010 40804 A Removal, foreign body, mouth 1.23 2.58 1.13 0.11 3.92 2.47 010 40805 A Removal, foreign body, mouth 2.67 3.44 2.00 0.20 6.31 4.87 010 40806 A Incision of lip fold 0.31 1.39 0.96 0.02 1.72 1.29 000 40808 A Biopsy of mouth lesion 0.95 2.32 1.09 0.08 3.35 2.12 010 40810 A Excision of mouth lesion 1.30 2.41 1.23 0.11 3.82 2.64 010 40812 A Excise/repair mouth lesion 2.30 3.27 1.80 0.20 5.77 4.30 010 40814 A Excise/repair mouth lesion 3.40 4.79 3.32 0.31 8.50 7.03 090 40816 A Excision of mouth lesion 3.65 4.98 3.43 0.32 8.95 7.40 090 Start Printed Page 63302 40818 A Excise oral mucosa for graft 2.40 5.23 3.58 0.17 7.80 6.15 090 40819 A Excise lip or cheek fold 2.40 4.45 2.96 0.20 7.05 5.56 090 40820 A Treatment of mouth lesion 1.27 2.74 2.37 0.10 4.11 3.74 010 40830 A Repair mouth laceration 1.75 3.12 2.56 0.17 5.04 4.48 010 40831 A Repair mouth laceration 2.45 3.66 3.12 0.25 6.36 5.82 010 40840 R Reconstruction of mouth 8.68 8.69 7.45 0.95 18.32 17.08 090 40842 R Reconstruction of mouth 8.68 8.79 7.19 0.78 18.25 16.65 090 40843 R Reconstruction of mouth 12.03 11.01 8.71 1.01 24.05 21.75 090 40844 R Reconstruction of mouth 15.92 13.98 11.90 1.95 31.85 29.77 090 40845 R Reconstruction of mouth 18.47 16.03 13.70 1.76 36.26 33.93 090 40899 C Mouth surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41000 A Drainage of mouth lesion 1.29 2.50 1.42 0.11 3.90 2.82 010 41005 A Drainage of mouth lesion 1.25 2.71 1.64 0.11 4.07 3.00 010 41006 A Drainage of mouth lesion 3.22 4.44 3.49 0.30 7.96 7.01 090 41007 A Drainage of mouth lesion 3.08 4.23 3.34 0.26 7.57 6.68 090 41008 A Drainage of mouth lesion 3.35 4.58 3.53 0.29 8.22 7.17 090 41009 A Drainage of mouth lesion 3.57 4.92 3.90 0.30 8.79 7.77 090 41010 A Incision of tongue fold 1.05 3.51 3.51 0.07 4.63 4.63 010 41015 A Drainage of mouth lesion 3.94 5.43 4.11 0.35 9.72 8.40 090 41016 A Drainage of mouth lesion 4.05 5.51 4.12 0.34 9.90 8.51 090 41017 A Drainage of mouth lesion 4.05 5.43 4.20 0.38 9.86 8.63 090 41018 A Drainage of mouth lesion 5.07 5.87 4.32 0.42 11.36 9.81 090 41100 A Biopsy of tongue 1.62 2.58 1.44 0.14 4.34 3.20 010 41105 A Biopsy of tongue 1.41 2.48 1.33 0.12 4.01 2.86 010 41108 A Biopsy of floor of mouth 1.04 2.23 1.14 0.10 3.37 2.28 010 41110 A Excision of tongue lesion 1.50 2.55 1.35 0.13 4.18 2.98 010 41112 A Excision of tongue lesion 2.71 4.30 2.74 0.24 7.25 5.69 090 41113 A Excision of tongue lesion 3.17 4.66 3.02 0.28 8.11 6.47 090 41114 A Excision of tongue lesion 8.42 8.86 6.37 0.77 18.05 15.56 090 41115 A Excision of tongue fold 1.73 3.47 2.60 0.16 5.36 4.49 010 41116 A Excision of mouth lesion 2.43 4.28 2.81 0.20 6.91 5.44 090 41120 A Partial removal of tongue 9.71 NA 7.67 0.84 NA 18.22 090 41130 A Partial removal of tongue 11.09 NA 8.45 0.97 NA 20.51 090 41135 A Tongue and neck surgery 22.96 NA 14.99 1.99 NA 39.94 090 41140 A Removal of tongue 25.35 NA 16.24 2.22 NA 43.81 090 41145 A Tongue removal, neck surgery 29.89 NA 19.39 2.53 NA 51.81 090 41150 A Tongue, mouth, jaw surgery 22.91 NA 15.66 2.00 NA 40.57 090 41153 A Tongue, mouth, neck surgery 23.63 NA 16.13 2.05 NA 41.81 090 41155 A Tongue, jaw, & neck surgery 27.56 NA 18.18 2.42 NA 48.16 090 41250 A Repair tongue laceration 1.90 3.12 1.65 0.18 5.20 3.73 010 41251 A Repair tongue laceration 2.26 3.63 1.96 0.22 6.11 4.44 010 41252 A Repair tongue laceration 2.95 4.22 2.31 0.28 7.45 5.54 010 41500 A Fixation of tongue 3.69 NA 3.67 0.31 NA 7.67 090 41510 A Tongue to lip surgery 3.40 NA 3.15 0.29 NA 6.84 090 41520 A Reconstruction, tongue fold 2.71 4.12 3.25 0.23 7.06 6.19 090 41599 C Tongue and mouth surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41800 A Drainage of gum lesion 1.16 2.70 1.47 0.11 3.97 2.74 010 41805 A Removal foreign body, gum 1.23 2.77 2.38 0.11 4.11 3.72 010 41806 A Removal foreign body,jawbone 2.67 3.66 3.19 0.26 6.59 6.12 010 41820 R Excision, gum, each quadrant 0.00 0.00 0.00 0.00 0.00 0.00 000 41821 R Excision of gum flap 0.00 0.00 0.00 0.00 0.00 0.00 000 41822 R Excision of gum lesion 2.30 4.14 1.34 0.29 6.73 3.93 010 41823 R Excision of gum lesion 3.28 5.89 4.15 0.35 9.52 7.78 090 41825 A Excision of gum lesion 1.30 3.30 2.38 0.12 4.72 3.80 010 41826 A Excision of gum lesion 2.30 3.89 2.93 0.20 6.39 5.43 010 41827 A Excision of gum lesion 3.40 5.68 3.89 0.30 9.38 7.59 090 41828 R Excision of gum lesion 3.07 4.44 3.38 0.26 7.77 6.71 010 41830 R Removal of gum tissue 3.33 4.98 3.62 0.28 8.59 7.23 010 41850 R Treatment of gum lesion 0.00 0.00 0.00 0.00 0.00 0.00 000 41870 R Gum graft 0.00 0.00 0.00 0.00 0.00 0.00 000 41872 R Repair gum 2.58 4.68 3.57 0.22 7.48 6.37 090 41874 R Repair tooth socket 3.07 4.74 3.32 0.28 8.09 6.67 090 41899 C Dental surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42000 A Drainage mouth roof lesion 1.22 2.76 1.27 0.12 4.10 2.61 010 42100 A Biopsy roof of mouth 1.30 2.30 1.38 0.12 3.72 2.80 010 42104 A Excision lesion, mouth roof 1.63 2.80 1.57 0.14 4.57 3.34 010 42106 A Excision lesion, mouth roof 2.09 3.76 2.85 0.19 6.04 5.13 010 42107 A Excision lesion, mouth roof 4.41 6.14 4.24 0.38 10.93 9.03 090 42120 A Remove palate/lesion 6.13 NA 5.62 0.53 NA 12.28 090 42140 A Excision of uvula 1.61 2.50 2.39 0.14 4.25 4.14 090 42145 A Repair palate, pharynx/uvula 8.00 NA 6.69 0.67 NA 15.36 090 42160 A Treatment mouth roof lesion 1.79 3.63 2.69 0.16 5.58 4.64 010 42180 A Repair palate 2.49 3.43 2.15 0.23 6.15 4.87 010 42182 A Repair palate 3.81 4.29 3.09 0.32 8.42 7.22 010 42200 A Reconstruct cleft palate 11.93 NA 9.10 1.16 NA 22.19 090 Start Printed Page 63303 42205 A Reconstruct cleft palate 13.21 NA 9.46 0.98 NA 23.65 090 42210 A Reconstruct cleft palate 14.42 NA 10.65 1.49 NA 26.56 090 42215 A Reconstruct cleft palate 8.77 NA 7.65 1.15 NA 17.57 090 42220 A Reconstruct cleft palate 6.98 NA 5.71 0.49 NA 13.18 090 42225 A Reconstruct cleft palate 9.49 NA 7.76 0.90 NA 18.15 090 42226 A Lengthening of palate 9.95 NA 7.97 0.87 NA 18.79 090 42227 A Lengthening of palate 9.47 NA 7.43 0.84 NA 17.74 090 42235 A Repair palate 7.83 NA 5.42 0.59 NA 13.84 090 42260 A Repair nose to lip fistula 9.74 9.34 7.53 1.02 20.10 18.29 090 42280 A Preparation, palate mold 1.53 2.03 0.89 0.14 3.70 2.56 010 42281 A Insertion, palate prosthesis 1.92 2.96 1.92 0.17 5.05 4.01 010 42299 C Palate/uvula surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42300 A Drainage of salivary gland 1.92 2.99 1.85 0.18 5.09 3.95 010 42305 A Drainage of salivary gland 6.04 NA 5.00 0.55 NA 11.59 090 42310 A Drainage of salivary gland 1.55 2.37 1.56 0.13 4.05 3.24 010 42320 A Drainage of salivary gland 2.34 3.56 2.13 0.20 6.10 4.67 010 42325 A Create salivary cyst drain 2.73 3.59 2.26 0.20 6.52 5.19 090 42326 A Create salivary cyst drain 3.76 4.60 3.15 0.41 8.77 7.32 090 42330 A Removal of salivary stone 2.20 3.33 1.89 0.19 5.72 4.28 010 42335 A Removal of salivary stone 3.29 3.94 3.40 0.28 7.51 6.97 090 42340 A Removal of salivary stone 4.57 5.20 4.33 0.41 10.18 9.31 090 42400 A Biopsy of salivary gland 0.78 1.77 0.72 0.07 2.62 1.57 000 42405 A Biopsy of salivary gland 3.27 4.21 2.50 0.29 7.77 6.06 010 42408 A Excision of salivary cyst 4.51 5.11 4.10 0.41 10.03 9.02 090 42409 A Drainage of salivary cyst 2.79 3.59 3.13 0.24 6.62 6.16 090 42410 A Excise parotid gland/lesion 9.29 NA 6.71 0.92 NA 16.92 090 42415 A Excise parotid gland/lesion 16.79 NA 11.38 1.51 NA 29.68 090 42420 A Excise parotid gland/lesion 19.48 NA 12.90 1.74 NA 34.12 090 42425 A Excise parotid gland/lesion 12.95 NA 9.17 1.17 NA 23.29 090 42426 A Excise parotid gland/lesion 21.14 NA 13.57 1.88 NA 36.59 090 42440 A Excise submaxillary gland 6.93 NA 5.12 0.61 NA 12.66 090 42450 A Excise sublingual gland 4.59 5.73 4.29 0.41 10.73 9.29 090 42500 A Repair salivary duct 4.28 5.52 4.24 0.36 10.16 8.88 090 42505 A Repair salivary duct 6.14 6.99 5.42 0.53 13.66 12.09 090 42507 A Parotid duct diversion 6.08 NA 5.26 0.79 NA 12.13 090 42508 A Parotid duct diversion 9.05 NA 7.10 0.77 NA 16.92 090 42509 A Parotid duct diversion 11.47 NA 8.50 1.49 NA 21.46 090 42510 A Parotid duct diversion 8.10 NA 6.17 0.68 NA 14.95 090 42550 A Injection for salivary x-ray 1.24 13.07 0.42 0.07 14.38 1.73 000 42600 A Closure of salivary fistula 4.79 5.90 4.57 0.41 11.10 9.77 090 42650 A Dilation of salivary duct 0.77 1.18 0.72 0.07 2.02 1.56 000 42660 A Dilation of salivary duct 1.12 1.50 0.85 0.08 2.70 2.05 000 42665 A Ligation of salivary duct 2.52 3.60 3.01 0.20 6.32 5.73 090 42699 C Salivary surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42700 A Drainage of tonsil abscess 1.61 2.78 1.75 0.14 4.53 3.50 010 42720 A Drainage of throat abscess 5.39 5.10 3.86 0.47 10.96 9.72 010 42725 A Drainage of throat abscess 10.66 NA 8.08 0.96 NA 19.70 090 42800 A Biopsy of throat 1.38 2.25 1.42 0.12 3.75 2.92 010 42802 A Biopsy of throat 1.53 4.43 1.96 0.13 6.09 3.62 010 42804 A Biopsy of upper nose/throat 1.23 4.01 1.81 0.11 5.35 3.15 010 42806 A Biopsy of upper nose/throat 1.57 4.16 1.94 0.14 5.87 3.65 010 42808 A Excise pharynx lesion 2.29 3.21 1.95 0.20 5.70 4.44 010 42809 A Remove pharynx foreign body 1.80 2.39 1.39 0.16 4.35 3.35 010 42810 A Excision of neck cyst 3.23 4.90 3.41 0.30 8.43 6.94 090 42815 A Excision of neck cyst 7.03 NA 5.47 0.64 NA 13.14 090 42820 A Remove tonsils and adenoids 3.89 NA 3.51 0.34 NA 7.74 090 42821 A Remove tonsils and adenoids 4.27 NA 3.72 0.36 NA 8.35 090 42825 A Removal of tonsils 3.40 NA 3.35 0.29 NA 7.04 090 42826 A Removal of tonsils 3.36 NA 3.24 0.28 NA 6.88 090 42830 A Removal of adenoids 2.56 NA 2.65 0.22 NA 5.43 090 42831 A Removal of adenoids 2.69 NA 2.90 0.23 NA 5.82 090 42835 A Removal of adenoids 2.29 NA 2.66 0.20 NA 5.15 090 42836 A Removal of adenoids 3.16 NA 3.17 0.26 NA 6.59 090 42842 A Extensive surgery of throat 8.71 NA 6.82 0.73 NA 16.26 090 42844 A Extensive surgery of throat 14.23 NA 10.13 1.25 NA 25.61 090 42845 A Extensive surgery of throat 24.15 NA 16.28 2.11 NA 42.54 090 42860 A Excision of tonsil tags 2.21 NA 2.60 0.19 NA 5.00 090 42870 A Excision of lingual tonsil 5.37 NA 4.83 0.46 NA 10.66 090 42890 A Partial removal of pharynx 12.87 NA 9.44 1.09 NA 23.40 090 42892 A Revision of pharyngeal walls 15.74 NA 11.01 1.37 NA 28.12 090 42894 A Revision of pharyngeal walls 22.75 NA 15.23 1.97 NA 39.95 090 42900 A Repair throat wound 5.22 NA 3.73 0.47 NA 9.42 010 42950 A Reconstruction of throat 8.05 NA 6.68 0.70 NA 15.43 090 42953 A Repair throat, esophagus 8.91 NA 7.59 0.87 NA 17.37 090 42955 A Surgical opening of throat 7.35 NA 5.62 0.76 NA 13.73 090 Start Printed Page 63304 42960 A Control throat bleeding 2.32 NA 2.03 0.20 NA 4.55 010 42961 A Control throat bleeding 5.56 NA 4.90 0.48 NA 10.94 090 42962 A Control throat bleeding 7.10 NA 5.80 0.61 NA 13.51 090 42970 A Control nose/throat bleeding 5.40 NA 3.66 0.44 NA 9.50 090 42971 A Control nose/throat bleeding 6.17 NA 5.03 0.54 NA 11.74 090 42972 A Control nose/throat bleeding 7.16 NA 5.53 0.65 NA 13.34 090 42999 C Throat surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43020 A Incision of esophagus 8.04 NA 5.68 0.84 NA 14.56 090 43030 A Throat muscle surgery 7.65 NA 5.85 0.72 NA 14.22 090 43045 A Incision of esophagus 20.01 NA 10.48 2.58 NA 33.07 090 43100 A Excision of esophagus lesion 9.14 NA 6.27 0.95 NA 16.36 090 43101 A Excision of esophagus lesion 16.15 NA 7.79 2.17 NA 26.11 090 43107 A Removal of esophagus 39.77 NA 16.94 3.94 NA 60.65 090 43108 A Removal of esophagus 34.00 NA 14.23 4.53 NA 52.76 090 43112 A Removal of esophagus 43.25 NA 17.98 4.40 NA 65.63 090 43113 A Removal of esophagus 35.07 NA 15.06 5.19 NA 55.32 090 43116 A Partial removal of esophagus 31.04 NA 16.90 3.14 NA 51.08 090 43117 A Partial removal of esophagus 39.77 NA 16.17 4.21 NA 60.15 090 43118 A Partial removal of esophagus 33.01 NA 13.76 4.27 NA 51.04 090 43121 A Partial removal of esophagus 29.02 NA 12.51 4.12 NA 45.65 090 43122 A Partial removal of esophagus 39.77 NA 16.38 3.92 NA 60.07 090 43123 A Partial removal of esophagus 33.01 NA 13.98 4.75 NA 51.74 090 43124 A Removal of esophagus 27.16 NA 13.02 3.54 NA 43.72 090 43130 A Removal of esophagus pouch 11.68 NA 7.61 1.27 NA 20.56 090 43135 A Removal of esophagus pouch 16.01 NA 7.96 2.22 NA 26.19 090 43200 A Esophagus endoscopy 1.58 4.05 1.10 0.13 5.76 2.81 000 43201 A Esoph scope w/submucous inj 2.08 4.75 1.28 0.14 6.97 3.50 000 43202 A Esophagus endoscopy, biopsy 1.88 5.47 0.97 0.14 7.49 2.99 000 43204 A Esoph scope w/sclerosis inj 3.75 NA 1.56 0.22 NA 5.53 000 43205 A Esophagus endoscopy/ligation 3.77 NA 1.57 0.20 NA 5.54 000 43215 A Esophagus endoscopy 2.59 NA 1.24 0.20 NA 4.03 000 43216 A Esophagus endoscopy/lesion 2.39 NA 1.20 0.18 NA 3.77 000 43217 A Esophagus endoscopy 2.88 6.89 1.23 0.20 9.97 4.31 000 43219 A Esophagus endoscopy 2.78 NA 1.38 0.19 NA 4.35 000 43220 A Esoph endoscopy, dilation 2.09 NA 0.99 0.14 NA 3.22 000 43226 A Esoph endoscopy, dilation 2.33 NA 1.06 0.14 NA 3.53 000 43227 A Esoph endoscopy, repair 3.58 NA 1.49 0.22 NA 5.29 000 43228 A Esoph endoscopy, ablation 3.75 NA 1.59 0.30 NA 5.64 000 43231 A Esoph endoscopy w/us exam 3.17 NA 1.34 0.24 NA 4.75 000 43232 A Esoph endoscopy w/us fn bx 4.45 NA 1.86 0.31 NA 6.62 000 43234 A Upper GI endoscopy, exam 2.00 5.30 0.90 0.16 7.46 3.06 000 43235 A Uppr gi endoscopy, diagnosis 2.38 5.12 1.08 0.16 7.66 3.62 000 43236 A Uppr gi scope w/submuc inj 2.90 6.42 1.27 0.17 9.49 4.34 000 43237 A Endoscopic us exam, esoph 3.97 NA 1.63 0.26 NA 5.86 000 43238 A Uppr gi endoscopy w/us fn bx 5.00 NA 1.99 0.26 NA 7.25 000 43239 A Upper GI endoscopy, biopsy 2.85 5.67 1.25 0.17 8.69 4.27 000 43240 A Esoph endoscope w/drain cyst 6.82 NA 2.69 0.43 NA 9.94 000 43241 A Upper GI endoscopy with tube 2.58 NA 1.15 0.17 NA 3.90 000 43242 A Uppr gi endoscopy w/us fn bx 7.27 NA 2.82 0.35 NA 10.44 000 43243 A Upper gi endoscopy & inject 4.54 NA 1.86 0.25 NA 6.65 000 43244 A Upper GI endoscopy/ligation 5.02 NA 2.03 0.25 NA 7.30 000 43245 A Uppr gi scope dilate strictr 3.16 NA 1.36 0.22 NA 4.74 000 43246 A Place gastrostomy tube 4.31 NA 1.76 0.29 NA 6.36 000 43247 A Operative upper GI endoscopy 3.37 NA 1.44 0.20 NA 5.01 000 43248 A Uppr gi endoscopy/guide wire 3.13 NA 1.37 0.18 NA 4.68 000 43249 A Esoph endoscopy, dilation 2.88 NA 1.27 0.18 NA 4.33 000 43250 A Upper GI endoscopy/tumor 3.18 NA 1.37 0.20 NA 4.75 000 43251 A Operative upper GI endoscopy 3.68 NA 1.55 0.23 NA 5.46 000 43255 A Operative upper GI endoscopy 4.79 NA 1.94 0.24 NA 6.97 000 43256 A Uppr gi endoscopy w stent 4.33 NA 1.78 0.28 NA 6.39 000 43258 A Operative upper GI endoscopy 4.52 NA 1.86 0.26 NA 6.64 000 43259 A Endoscopic ultrasound exam 5.17 NA 2.06 0.26 NA 7.49 000 43260 A Endo cholangiopancreatograph 5.93 NA 2.33 0.32 NA 8.58 000 43261 A Endo cholangiopancreatograph 6.23 NA 2.44 0.35 NA 9.02 000 43262 A Endo cholangiopancreatograph 7.35 NA 2.84 0.41 NA 10.60 000 43263 A Endo cholangiopancreatograph 7.25 NA 2.82 0.34 NA 10.41 000 43264 A Endo cholangiopancreatograph 8.85 NA 3.37 0.49 NA 12.71 000 43265 A Endo cholangiopancreatograph 9.96 NA 3.76 0.50 NA 14.22 000 43267 A Endo cholangiopancreatograph 7.35 NA 2.84 0.41 NA 10.60 000 43268 A Endo cholangiopancreatograph 7.35 NA 2.94 0.41 NA 10.70 000 43269 A Endo cholangiopancreatograph 8.16 NA 3.13 0.34 NA 11.63 000 43271 A Endo cholangiopancreatograph 7.35 NA 2.83 0.41 NA 10.59 000 43272 A Endo cholangiopancreatograph 7.35 NA 2.84 0.41 NA 10.60 000 43280 A Laparoscopy, fundoplasty 17.15 NA 7.40 2.11 NA 26.66 090 43289 C Laparoscope proc, esoph 0.00 0.00 0.00 0.00 0.00 0.00 YYY Start Printed Page 63305 43300 A Repair of esophagus 9.09 NA 6.53 1.02 NA 16.64 090 43305 A Repair esophagus and fistula 17.29 NA 10.84 1.63 NA 29.76 090 43310 A Repair of esophagus 25.25 NA 10.95 3.81 NA 40.01 090 43312 A Repair esophagus and fistula 28.26 NA 11.79 4.05 NA 44.10 090 43313 A Esophagoplasty congenital 45.02 NA 20.35 6.51 NA 71.88 090 43314 A Tracheo-esophagoplasty cong 49.98 NA 22.27 6.63 NA 78.88 090 43320 A Fuse esophagus & stomach 19.82 NA 9.21 1.91 NA 30.94 090 43324 A Revise esophagus & stomach 20.45 NA 8.88 2.06 NA 31.39 090 43325 A Revise esophagus & stomach 19.95 NA 8.87 1.98 NA 30.80 090 43326 A Revise esophagus & stomach 19.63 NA 9.22 2.21 NA 31.06 090 43330 A Repair of esophagus 19.66 NA 8.64 1.82 NA 30.12 090 43331 A Repair of esophagus 20.02 NA 9.66 2.31 NA 31.99 090 43340 A Fuse esophagus & intestine 19.50 NA 8.99 1.83 NA 30.32 090 43341 A Fuse esophagus & intestine 20.73 NA 9.91 2.57 NA 33.21 090 43350 A Surgical opening, esophagus 15.69 NA 8.47 1.38 NA 25.54 090 43351 A Surgical opening, esophagus 18.25 NA 9.65 1.81 NA 29.71 090 43352 A Surgical opening, esophagus 15.17 NA 8.37 1.53 NA 25.07 090 43360 A Gastrointestinal repair 35.50 NA 15.02 3.60 NA 54.12 090 43361 A Gastrointestinal repair 40.27 NA 16.86 4.22 NA 61.35 090 43400 A Ligate esophagus veins 21.08 NA 9.54 1.19 NA 31.81 090 43401 A Esophagus surgery for veins 21.96 NA 9.63 2.07 NA 33.66 090 43405 A Ligate/staple esophagus 19.90 NA 9.56 1.95 NA 31.41 090 43410 A Repair esophagus wound 13.39 NA 7.58 1.38 NA 22.35 090 43415 A Repair esophagus wound 24.86 NA 11.65 2.30 NA 38.81 090 43420 A Repair esophagus opening 14.27 NA 7.51 1.03 NA 22.81 090 43425 A Repair esophagus opening 20.91 NA 9.84 2.43 NA 33.18 090 43450 A Dilate esophagus 1.37 2.54 0.74 0.08 3.99 2.19 000 43453 A Dilate esophagus 1.50 6.04 0.78 0.10 7.64 2.38 000 43456 A Dilate esophagus 2.56 13.88 1.16 0.17 16.61 3.89 000 43458 A Dilate esophagus 3.04 6.64 1.35 0.20 9.88 4.59 000 43460 A Pressure treatment esophagus 3.78 NA 1.50 0.25 NA 5.53 000 43496 C Free jejunum flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 43499 C Esophagus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43500 A Surgical opening of stomach 10.99 NA 5.05 1.01 NA 17.05 090 43501 A Surgical repair of stomach 19.93 NA 8.43 1.86 NA 30.22 090 43502 A Surgical repair of stomach 23.00 NA 9.59 2.19 NA 34.78 090 43510 A Surgical opening of stomach 13.01 NA 6.63 1.08 NA 20.72 090 43520 A Incision of pyloric muscle 9.93 NA 5.22 1.01 NA 16.16 090 43600 A Biopsy of stomach 1.90 NA 1.04 0.13 NA 3.07 000 43605 A Biopsy of stomach 11.91 NA 5.37 1.11 NA 18.39 090 43610 A Excision of stomach lesion 14.52 NA 6.25 1.37 NA 22.14 090 43611 A Excision of stomach lesion 17.74 NA 7.69 1.65 NA 27.08 090 43620 A Removal of stomach 29.87 NA 11.96 2.74 NA 44.57 090 43621 A Removal of stomach 30.55 NA 12.17 2.83 NA 45.55 090 43622 A Removal of stomach 32.34 NA 12.76 2.97 NA 48.07 090 43631 A Removal of stomach, partial 22.46 NA 9.29 2.39 NA 34.14 090 43632 A Removal of stomach, partial 22.46 NA 9.30 2.40 NA 34.16 090 43633 A Removal of stomach, partial 22.97 NA 9.47 2.46 NA 34.90 090 43634 A Removal of stomach, partial 24.98 NA 10.22 2.61 NA 37.81 090 43635 A Removal of stomach, partial 2.05 NA 0.71 0.25 NA 3.01 ZZZ 43638 A Removal of stomach, partial 28.83 NA 12.02 2.68 NA 43.53 090 43639 A Removal of stomach, partial 29.48 NA 11.82 2.77 NA 44.07 090 43640 A Vagotomy & pylorus repair 16.92 NA 7.37 1.81 NA 26.10 090 43641 A Vagotomy & pylorus repair 17.17 NA 7.48 1.83 NA 26.48 090 43651 A Laparoscopy, vagus nerve 10.09 NA 4.81 1.23 NA 16.13 090 43652 A Laparoscopy, vagus nerve 12.08 NA 5.46 1.50 NA 19.04 090 43653 A Laparoscopy, gastrostomy 7.69 NA 4.27 0.93 NA 12.89 090 43659 C Laparoscope proc, stom 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43750 A Place gastrostomy tube 4.46 NA 2.75 0.40 NA 7.61 010 43752 A Nasal/orogastric w/stent 0.68 0.26 0.26 0.02 0.96 0.96 000 43760 A Change gastrostomy tube 1.09 1.67 0.46 0.08 2.84 1.63 000 43761 A Reposition gastrostomy tube 2.00 NA 0.79 0.12 NA 2.91 000 43800 A Reconstruction of pylorus 13.61 NA 5.98 1.28 NA 20.87 090 43810 A Fusion of stomach and bowel 14.57 NA 6.28 1.32 NA 22.17 090 43820 A Fusion of stomach and bowel 15.28 NA 6.52 1.41 NA 23.21 090 43825 A Fusion of stomach and bowel 19.11 NA 8.14 1.80 NA 29.05 090 43830 A Place gastrostomy tube 9.48 NA 4.93 0.83 NA 15.24 090 43831 A Place gastrostomy tube 7.80 NA 4.57 0.97 NA 13.34 090 43832 A Place gastrostomy tube 15.51 NA 6.97 1.35 NA 23.83 090 43840 A Repair of stomach lesion 15.47 NA 6.88 1.44 NA 23.79 090 43842 A Gastroplasty for obesity 18.36 NA 8.22 1.81 NA 28.39 090 43843 A Gastroplasty for obesity 18.54 NA 8.21 1.83 NA 28.58 090 43846 A Gastric bypass for obesity 23.91 NA 10.49 2.35 NA 36.75 090 43847 A Gastric bypass for obesity 26.77 NA 11.43 2.57 NA 40.77 090 43848 A Revision gastroplasty 29.22 NA 12.36 2.86 NA 44.44 090 Start Printed Page 63306 43850 A Revise stomach-bowel fusion 24.58 NA 9.97 2.36 NA 36.91 090 43855 A Revise stomach-bowel fusion 26.01 NA 10.48 2.41 NA 38.90 090 43860 A Revise stomach-bowel fusion 24.86 NA 10.12 2.43 NA 37.41 090 43865 A Revise stomach-bowel fusion 26.37 NA 10.65 2.58 NA 39.60 090 43870 A Repair stomach opening 9.63 NA 4.59 0.85 NA 15.07 090 43880 A Repair stomach-bowel fistula 24.51 NA 10.06 2.33 NA 36.90 090 43999 C Stomach surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44005 A Freeing of bowel adhesion 16.14 NA 6.84 1.67 NA 24.65 090 44010 A Incision of small bowel 12.45 NA 5.55 1.26 NA 19.26 090 44015 A Insert needle cath bowel 2.61 NA 0.89 0.30 NA 3.80 ZZZ 44020 A Explore small intestine 13.91 NA 6.04 1.44 NA 21.39 090 44021 A Decompress small bowel 14.00 NA 6.07 1.41 NA 21.48 090 44025 A Incision of large bowel 14.20 NA 6.13 1.45 NA 21.78 090 44050 A Reduce bowel obstruction 13.95 NA 6.06 1.38 NA 21.39 090 44055 A Correct malrotation of bowel 21.87 NA 8.87 1.58 NA 32.32 090 44100 A Biopsy of bowel 2.00 NA 1.10 0.14 NA 3.24 000 44110 A Excise intestine lesion(s) 11.74 NA 5.34 1.20 NA 18.28 090 44111 A Excision of bowel lesion(s) 14.21 NA 6.24 1.46 NA 21.91 090 44120 A Removal of small intestine 16.90 NA 7.20 1.75 NA 25.85 090 44121 A Removal of small intestine 4.42 NA 1.54 0.55 NA 6.51 ZZZ 44125 A Removal of small intestine 17.44 NA 7.38 1.79 NA 26.61 090 44126 A Enterectomy w/o taper, cong 35.30 NA 14.31 0.43 NA 50.04 090 44127 A Enterectomy w/taper, cong 40.77 NA 15.95 0.49 NA 57.21 090 44128 A Enterectomy cong, add-on 4.42 NA 1.56 0.54 NA 6.52 ZZZ 44130 A Bowel to bowel fusion 14.41 NA 6.33 1.47 NA 22.21 090 44132 R Enterectomy, cadaver donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44133 R Enterectomy, live donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44135 R Intestine transplnt, cadaver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44136 R Intestine transplant, live 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44139 A Mobilization of colon 2.22 NA 0.77 0.25 NA 3.24 ZZZ 44140 A Partial removal of colon 20.88 NA 8.78 2.57 NA 32.23 090 44141 A Partial removal of colon 19.40 NA 10.27 2.34 NA 32.01 090 44143 A Partial removal of colon 22.86 NA 10.91 2.42 NA 36.19 090 44144 A Partial removal of colon 21.41 NA 9.79 2.27 NA 33.47 090 44145 A Partial removal of colon 26.27 NA 10.98 2.66 NA 39.91 090 44146 A Partial removal of colon 27.38 NA 13.13 2.64 NA 43.15 090 44147 A Partial removal of colon 20.59 NA 8.82 2.09 NA 31.50 090 44150 A Removal of colon 23.81 NA 12.28 2.46 NA 38.55 090 44151 A Removal of colon/ileostomy 26.73 NA 13.68 2.36 NA 42.77 090 44152 A Removal of colon/ileostomy 27.67 NA 11.81 2.83 NA 42.31 090 44153 A Removal of colon/ileostomy 30.42 NA 14.72 2.79 NA 47.93 090 44155 A Removal of colon/ileostomy 27.70 NA 13.58 2.71 NA 43.99 090 44156 A Removal of colon/ileostomy 30.61 NA 15.30 2.62 NA 48.53 090 44160 A Removal of colon 18.51 NA 7.87 2.23 NA 28.61 090 44200 A Laparoscopy, enterolysis 14.36 NA 6.29 1.75 NA 22.40 090 44201 A Laparoscopy, jejunostomy 9.72 NA 4.73 1.16 NA 15.61 090 44202 A Lap resect s/intestine singl 21.91 NA 9.07 2.59 NA 33.57 090 44203 A Lap resect s/intestine, addl 4.42 NA 1.52 0.55 NA 6.49 ZZZ 44204 A Laparo partial colectomy 24.94 NA 10.09 3.06 NA 38.09 090 44205 A Lap colectomy part w/ileum 22.10 NA 8.97 2.67 NA 33.74 090 44206 A Lap part colectomy w/stoma 26.85 NA 11.48 2.42 NA 40.75 090 44207 A L colectomy/coloproctostomy 29.83 NA 11.72 2.66 NA 44.21 090 44208 A L colectomy/coloproctostomy 31.82 NA 13.42 2.64 NA 47.88 090 44210 A Laparo total proctocolectomy 27.84 NA 12.16 2.46 NA 42.46 090 44211 A Laparo total proctocolectomy 34.80 NA 14.90 2.79 NA 52.49 090 44212 A Laparo total proctocolectomy 32.31 NA 14.04 2.71 NA 49.06 090 44238 C Laparoscope proc, intestine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44239 C Laparoscope proc, rectum 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44300 A Open bowel to skin 12.04 NA 5.58 1.05 NA 18.67 090 44310 A Ileostomy/jejunostomy 15.86 NA 6.80 1.35 NA 24.01 090 44312 A Revision of ileostomy 7.97 NA 4.07 0.65 NA 12.69 090 44314 A Revision of ileostomy 14.96 NA 6.67 1.19 NA 22.82 090 44316 A Devise bowel pouch 20.97 NA 8.68 1.69 NA 31.34 090 44320 A Colostomy 17.54 NA 7.79 1.53 NA 26.86 090 44322 A Colostomy with biopsies 11.91 NA 8.82 1.41 NA 22.14 090 44340 A Revision of colostomy 7.68 NA 4.36 0.67 NA 12.71 090 44345 A Revision of colostomy 15.34 NA 7.01 1.33 NA 23.68 090 44346 A Revision of colostomy 16.89 NA 7.51 1.44 NA 25.84 090 44360 A Small bowel endoscopy 2.58 NA 1.13 0.17 NA 3.88 000 44361 A Small bowel endoscopy/biopsy 2.85 NA 1.23 0.18 NA 4.26 000 44363 A Small bowel endoscopy 3.48 NA 1.42 0.23 NA 5.13 000 44364 A Small bowel endoscopy 3.72 NA 1.54 0.25 NA 5.51 000 44365 A Small bowel endoscopy 3.29 NA 1.40 0.22 NA 4.91 000 44366 A Small bowel endoscopy 4.38 NA 1.78 0.26 NA 6.42 000 44369 A Small bowel endoscopy 4.49 NA 1.78 0.28 NA 6.55 000 Start Printed Page 63307 44370 A Small bowel endoscopy/stent 4.77 NA 2.01 0.25 NA 7.03 000 44372 A Small bowel endoscopy 4.38 NA 1.77 0.32 NA 6.47 000 44373 A Small bowel endoscopy 3.48 NA 1.46 0.23 NA 5.17 000 44376 A Small bowel endoscopy 5.23 NA 2.06 0.35 NA 7.64 000 44377 A Small bowel endoscopy/biopsy 5.50 NA 2.18 0.34 NA 8.02 000 44378 A Small bowel endoscopy 7.09 NA 2.75 0.44 NA 10.28 000 44379 A S bowel endoscope w/stent 7.43 NA 2.97 0.46 NA 10.86 000 44380 A Small bowel endoscopy 1.04 NA 0.58 0.10 NA 1.72 000 44382 A Small bowel endoscopy 1.26 NA 0.65 0.11 NA 2.02 000 44383 A Ileoscopy w/stent 2.92 NA 1.30 0.16 NA 4.38 000 44385 A Endoscopy of bowel pouch 1.81 5.03 0.97 0.14 6.98 2.92 000 44386 A Endoscopy, bowel pouch/biop 2.11 6.60 1.13 0.18 8.89 3.42 000 44388 A Colonoscopy 2.80 5.22 1.18 0.22 8.24 4.20 000 44389 A Colonoscopy with biopsy 3.11 6.59 1.30 0.22 9.92 4.63 000 44390 A Colonoscopy for foreign body 3.81 6.84 1.53 0.26 10.91 5.60 000 44391 A Colonoscopy for bleeding 4.30 8.84 1.74 0.28 13.42 6.32 000 44392 A Colonoscopy & polypectomy 3.80 6.64 1.53 0.28 10.72 5.61 000 44393 A Colonoscopy, lesion removal 4.81 7.01 1.91 0.32 12.14 7.04 000 44394 A Colonoscopy w/snare 4.40 7.87 1.77 0.31 12.58 6.48 000 44397 A Colonoscopy w/stent 4.68 NA 2.08 0.34 NA 7.10 000 44500 A Intro, gastrointestinal tube 0.49 NA 0.36 0.02 NA 0.87 000 44602 A Suture, small intestine 15.94 NA 6.49 1.28 NA 23.71 090 44603 A Suture, small intestine 18.55 NA 7.39 1.67 NA 27.61 090 44604 A Suture, large intestine 15.94 NA 6.56 1.70 NA 24.20 090 44605 A Repair of bowel lesion 19.42 NA 8.55 1.85 NA 29.82 090 44615 A Intestinal stricturoplasty 15.84 NA 6.79 1.67 NA 24.30 090 44620 A Repair bowel opening 12.13 NA 5.42 1.26 NA 18.81 090 44625 A Repair bowel opening 14.96 NA 6.41 1.56 NA 22.93 090 44626 A Repair bowel opening 25.22 NA 9.96 3.03 NA 38.21 090 44640 A Repair bowel-skin fistula 21.53 NA 8.71 1.75 NA 31.99 090 44650 A Repair bowel fistula 22.44 NA 9.01 1.79 NA 33.24 090 44660 A Repair bowel-bladder fistula 21.24 NA 8.48 1.37 NA 31.09 090 44661 A Repair bowel-bladder fistula 24.67 NA 9.69 1.83 NA 36.19 090 44680 A Surgical revision, intestine 15.31 NA 6.56 1.64 NA 23.51 090 44700 A Suspend bowel w/prosthesis 16.02 NA 6.77 1.45 NA 24.24 090 44701 A Intraop colon lavage add-on 3.08 NA 1.07 0.25 NA 4.40 ZZZ 44799 C Unlisted procedure intestine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44800 A Excision of bowel pouch 11.17 NA 5.49 1.33 NA 17.99 090 44820 A Excision of mesentery lesion 12.02 NA 5.58 1.23 NA 18.83 090 44850 A Repair of mesentery 10.68 NA 5.07 1.19 NA 16.94 090 44899 C Bowel surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44900 A Drain app abscess, open 10.08 NA 4.78 1.01 NA 15.87 090 44901 A Drain app abscess, percut 3.36 NA 1.13 0.20 NA 4.69 000 44950 A Appendectomy 9.94 NA 4.40 1.05 NA 15.39 090 44955 A Appendectomy add-on 1.52 NA 0.55 0.19 NA 2.26 ZZZ 44960 A Appendectomy 12.27 NA 5.44 1.31 NA 19.02 090 44970 A Laparoscopy, appendectomy 8.65 NA 4.29 1.05 NA 13.99 090 44979 C Laparoscope proc, app 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45000 A Drainage of pelvic abscess 4.49 NA 3.02 0.44 NA 7.95 090 45005 A Drainage of rectal abscess 1.98 4.90 1.72 0.22 7.10 3.92 010 45020 A Drainage of rectal abscess 4.69 NA 3.34 0.49 NA 8.52 090 45100 A Biopsy of rectum 3.66 NA 2.41 0.40 NA 6.47 090 45108 A Removal of anorectal lesion 4.73 NA 2.94 0.55 NA 8.22 090 45110 A Removal of rectum 27.84 NA 12.63 2.71 NA 43.18 090 45111 A Partial removal of rectum 16.39 NA 7.30 1.92 NA 25.61 090 45112 A Removal of rectum 30.37 NA 11.95 2.82 NA 45.14 090 45113 A Partial proctectomy 30.41 NA 12.84 2.55 NA 45.80 090 45114 A Partial removal of rectum 27.16 NA 11.12 2.73 NA 41.01 090 45116 A Partial removal of rectum 24.44 NA 10.20 2.40 NA 37.04 090 45119 A Remove rectum w/reservoir 30.66 NA 12.68 2.55 NA 45.89 090 45120 A Removal of rectum 24.46 NA 10.30 2.73 NA 37.49 090 45121 A Removal of rectum and colon 26.89 NA 11.28 3.19 NA 41.36 090 45123 A Partial proctectomy 16.61 NA 6.99 1.25 NA 24.85 090 45126 A Pelvic exenteration 44.90 NA 19.71 3.87 NA 68.48 090 45130 A Excision of rectal prolapse 16.35 NA 6.87 1.34 NA 24.56 090 45135 A Excision of rectal prolapse 19.17 NA 8.56 1.82 NA 29.55 090 45136 A Excise ileoanal reservior 27.14 NA 12.66 3.26 NA 43.06 090 45150 A Excision of rectal stricture 5.64 NA 3.02 0.55 NA 9.21 090 45160 A Excision of rectal lesion 15.23 NA 6.75 1.28 NA 23.26 090 45170 A Excision of rectal lesion 11.42 NA 5.33 1.07 NA 17.82 090 45190 A Destruction, rectal tumor 9.68 NA 4.73 0.91 NA 15.32 090 45300 A Proctosigmoidoscopy dx 0.38 1.50 0.31 0.06 1.94 0.75 000 45303 A Proctosigmoidoscopy dilate 0.44 19.47 0.36 0.07 19.98 0.87 000 45305 A Proctosigmoidoscopy w/bx 1.00 2.62 0.53 0.11 3.73 1.64 000 45307 A Proctosigmoidoscopy fb 0.93 3.06 0.51 0.18 4.17 1.62 000 Start Printed Page 63308 45308 A Proctosigmoidoscopy removal 0.83 1.96 0.47 0.16 2.95 1.46 000 45309 A Proctosigmoidoscopy removal 2.00 2.82 0.86 0.20 5.02 3.06 000 45315 A Proctosigmoidoscopy removal 1.39 2.85 0.66 0.24 4.48 2.29 000 45317 A Proctosigmoidoscopy bleed 1.49 2.41 0.69 0.24 4.14 2.42 000 45320 A Proctosigmoidoscopy ablate 1.57 2.88 0.73 0.24 4.69 2.54 000 45321 A Proctosigmoidoscopy volvul 1.16 NA 0.60 0.20 NA 1.96 000 45327 A Proctosigmoidoscopy w/stent 1.64 NA 0.71 0.12 NA 2.47 000 45330 A Diagnostic sigmoidoscopy 0.95 2.24 0.53 0.06 3.25 1.54 000 45331 A Sigmoidoscopy and biopsy 1.14 2.98 0.64 0.08 4.20 1.86 000 45332 A Sigmoidoscopy w/fb removal 1.78 4.96 0.85 0.13 6.87 2.76 000 45333 A Sigmoidoscopy & polypectomy 1.78 4.80 0.85 0.14 6.72 2.77 000 45334 A Sigmoidoscopy for bleeding 2.71 NA 1.20 0.19 NA 4.10 000 45335 A Sigmoidoscopy w/submuc inj 1.35 3.45 0.65 0.08 4.88 2.08 000 45337 A Sigmoidoscopy & decompress 2.35 NA 1.06 0.18 NA 3.59 000 45338 A Sigmoidoscopy w/tumr remove 2.33 5.12 1.06 0.18 7.63 3.57 000 45339 A Sigmoidoscopy w/ablate tumr 3.12 3.38 1.34 0.20 6.70 4.66 000 45340 A Sig w/balloon dilation 1.65 6.74 0.76 0.08 8.47 2.49 000 45341 A Sigmoidoscopy w/ultrasound 2.59 NA 1.14 0.24 NA 3.97 000 45342 A Sigmoidoscopy w/us guide bx 4.04 NA 1.62 0.28 NA 5.94 000 45345 A Sigmoidoscopy w/stent 2.90 NA 1.22 0.18 NA 4.30 000 45355 A Surgical colonoscopy 3.50 NA 1.42 0.31 NA 5.23 000 45378 A Diagnostic colonoscopy 3.68 6.13 1.60 0.24 10.05 5.52 000 45378 53 A Diagnostic colonoscopy 0.95 2.24 0.53 0.06 3.25 1.54 000 45379 A Colonoscopy w/fb removal 4.66 7.70 1.88 0.30 12.66 6.84 000 45380 A Colonoscopy and biopsy 4.41 7.17 1.80 0.25 11.83 6.46 000 45381 A Colonoscopy, submucous inj 4.18 8.26 1.71 0.25 12.69 6.14 000 45382 A Colonoscopy/control bleeding 5.66 9.86 2.25 0.32 15.84 8.23 000 45383 A Lesion removal colonoscopy 5.84 7.96 2.29 0.38 14.18 8.51 000 45384 A Lesion remove colonoscopy 4.67 6.79 1.90 0.29 11.75 6.86 000 45385 A Lesion removal colonoscopy 5.28 7.81 2.10 0.34 13.43 7.72 000 45386 A Colonoscopy dilate stricture 4.55 13.86 1.85 0.25 18.66 6.65 000 45387 A Colonoscopy w/stent 5.88 NA 2.38 0.40 NA 8.66 000 45500 A Repair of rectum 7.25 NA 3.64 0.67 NA 11.56 090 45505 A Repair of rectum 7.54 NA 3.91 0.60 NA 12.05 090 45520 A Treatment of rectal prolapse 0.55 0.86 0.19 0.05 1.46 0.79 000 45540 A Correct rectal prolapse 16.18 NA 6.94 1.40 NA 24.52 090 45541 A Correct rectal prolapse 13.32 NA 6.06 1.05 NA 20.43 090 45550 A Repair rectum/remove sigmoid 22.87 NA 9.39 1.89 NA 34.15 090 45560 A Repair of rectocele 10.52 NA 5.19 0.87 NA 16.58 090 45562 A Exploration/repair of rectum 15.29 NA 7.13 1.38 NA 23.80 090 45563 A Exploration/repair of rectum 23.34 NA 10.73 2.21 NA 36.28 090 45800 A Repair rect/bladder fistula 17.67 NA 7.59 1.37 NA 26.63 090 45805 A Repair fistula w/colostomy 20.66 NA 9.71 1.76 NA 32.13 090 45820 A Repair rectourethral fistula 18.37 NA 7.77 1.40 NA 27.54 090 45825 A Repair fistula w/colostomy 21.13 NA 10.02 1.16 NA 32.31 090 45900 A Reduction of rectal prolapse 2.60 NA 1.54 0.20 NA 4.34 010 45905 A Dilation of anal sphincter 2.29 NA 1.45 0.17 NA 3.91 010 45910 A Dilation of rectal narrowing 2.78 NA 1.68 0.17 NA 4.63 010 45915 A Remove rectal obstruction 3.12 4.80 1.19 0.20 8.12 4.51 010 45999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46020 A Placement of seton 2.88 2.30 1.88 0.26 5.44 5.02 010 46030 A Removal of rectal marker 1.22 1.37 0.72 0.13 2.72 2.07 010 46040 A Incision of rectal abscess 4.93 5.36 3.21 0.58 10.87 8.72 090 46045 A Incision of rectal abscess 4.30 NA 2.96 0.48 NA 7.74 090 46050 A Incision of anal abscess 1.18 2.60 0.87 0.13 3.91 2.18 010 46060 A Incision of rectal abscess 5.66 NA 3.33 0.62 NA 9.61 090 46070 A Incision of anal septum 2.69 NA 1.91 0.32 NA 4.92 090 46080 A Incision of anal sphincter 2.48 2.41 1.14 0.28 5.17 3.90 010 46083 A Incise external hemorrhoid 1.39 2.54 0.96 0.14 4.07 2.49 010 46200 A Removal of anal fissure 3.40 3.69 2.45 0.36 7.45 6.21 090 46210 A Removal of anal crypt 2.65 4.88 2.17 0.31 7.84 5.13 090 46211 A Removal of anal crypts 4.23 5.16 2.98 0.44 9.83 7.65 090 46220 A Removal of anal tag 1.55 2.30 0.94 0.17 4.02 2.66 010 46221 A Ligation of hemorrhoid(s) 2.03 1.64 1.14 0.14 3.81 3.31 010 46230 A Removal of anal tags 2.56 3.08 1.30 0.26 5.90 4.12 010 46250 A Hemorrhoidectomy 3.87 4.93 2.48 0.52 9.32 6.87 090 46255 A Hemorrhoidectomy 4.57 5.48 2.71 0.61 10.66 7.89 090 46257 A Remove hemorrhoids & fissure 5.37 NA 2.95 0.71 NA 9.03 090 46258 A Remove hemorrhoids & fistula 5.70 NA 3.34 0.77 NA 9.81 090 46260 A Hemorrhoidectomy 6.33 NA 3.28 0.82 NA 10.43 090 46261 A Remove hemorrhoids & fissure 7.04 NA 3.69 0.84 NA 11.57 090 46262 A Remove hemorrhoids & fistula 7.46 NA 3.83 0.91 NA 12.20 090 46270 A Removal of anal fistula 3.70 4.72 2.40 0.43 8.85 6.53 090 46275 A Removal of anal fistula 4.53 4.42 2.60 0.48 9.43 7.61 090 46280 A Removal of anal fistula 5.95 NA 3.34 0.60 NA 9.89 090 Start Printed Page 63309 46285 A Removal of anal fistula 4.07 3.64 2.38 0.41 8.12 6.86 090 46288 A Repair anal fistula 7.09 NA 3.78 0.72 NA 11.59 090 46320 A Removal of hemorrhoid clot 1.60 2.15 0.86 0.17 3.92 2.63 010 46500 A Injection into hemorrhoid(s) 1.60 2.82 0.63 0.14 4.56 2.37 010 46600 A Diagnostic anoscopy 0.50 1.61 0.39 0.05 2.16 0.94 000 46604 A Anoscopy and dilation 1.30 9.49 0.64 0.11 10.90 2.05 000 46606 A Anoscopy and biopsy 0.81 3.90 0.46 0.08 4.79 1.35 000 46608 A Anoscopy, remove for body 1.50 4.51 0.69 0.16 6.17 2.35 000 46610 A Anoscopy, remove lesion 1.31 4.14 0.64 0.14 5.59 2.09 000 46611 A Anoscopy 1.80 3.40 0.80 0.18 5.38 2.78 000 46612 A Anoscopy, remove lesions 2.33 5.26 1.01 0.22 7.81 3.56 000 46614 A Anoscopy, control bleeding 2.00 2.30 0.87 0.17 4.47 3.04 000 46615 A Anoscopy 2.66 2.55 1.10 0.28 5.49 4.04 000 46700 A Repair of anal stricture 9.08 NA 4.29 0.67 NA 14.04 090 46705 A Repair of anal stricture 6.86 NA 3.79 0.87 NA 11.52 090 46706 A Repr of anal fistula w/glue 2.38 NA 1.26 0.20 NA 3.84 010 46715 A Repair of anovaginal fistula 7.16 NA 3.68 0.91 NA 11.75 090 46716 A Repair of anovaginal fistula 14.98 NA 8.07 1.56 NA 24.61 090 46730 A Construction of absent anus 26.60 NA 12.21 2.43 NA 41.24 090 46735 A Construction of absent anus 31.99 NA 13.72 3.16 NA 48.87 090 46740 A Construction of absent anus 29.83 NA 13.36 2.39 NA 45.58 090 46742 A Repair of imperforated anus 35.60 NA 17.98 3.15 NA 56.73 090 46744 A Repair of cloacal anomaly 52.33 NA 21.44 2.72 NA 76.49 090 46746 A Repair of cloacal anomaly 57.89 NA 25.48 3.01 NA 86.38 090 46748 A Repair of cloacal anomaly 63.84 NA 24.12 3.32 NA 91.28 090 46750 A Repair of anal sphincter 10.19 NA 5.18 0.83 NA 16.20 090 46751 A Repair of anal sphincter 8.72 NA 5.70 0.93 NA 15.35 090 46753 A Reconstruction of anus 8.24 NA 3.92 0.70 NA 12.86 090 46754 A Removal of suture from anus 2.19 3.68 1.71 0.14 6.01 4.04 010 46760 A Repair of anal sphincter 14.35 NA 7.19 1.03 NA 22.57 090 46761 A Repair of anal sphincter 13.76 NA 6.16 1.01 NA 20.93 090 46762 A Implant artificial sphincter 12.64 NA 5.62 0.85 NA 19.11 090 46900 A Destruction, anal lesion(s) 1.90 3.57 0.80 0.16 5.63 2.86 010 46910 A Destruction, anal lesion(s) 1.85 2.72 1.11 0.17 4.74 3.13 010 46916 A Cryosurgery, anal lesion(s) 1.85 3.10 1.42 0.11 5.06 3.38 010 46917 A Laser surgery, anal lesions 1.85 9.33 1.14 0.19 11.37 3.18 010 46922 A Excision of anal lesion(s) 1.85 3.36 1.10 0.20 5.41 3.15 010 46924 A Destruction, anal lesion(s) 2.74 8.54 1.38 0.24 11.52 4.36 010 46934 A Destruction of hemorrhoids 3.49 5.09 2.74 0.31 8.89 6.54 090 46935 A Destruction of hemorrhoids 2.42 3.50 1.23 0.20 6.12 3.85 010 46936 A Destruction of hemorrhoids 3.67 4.51 2.28 0.36 8.54 6.31 090 46937 A Cryotherapy of rectal lesion 2.67 2.77 1.24 0.14 5.58 4.05 010 46938 A Cryotherapy of rectal lesion 4.63 4.27 2.74 0.48 9.38 7.85 090 46940 A Treatment of anal fissure 2.31 2.01 1.10 0.20 4.52 3.61 010 46942 A Treatment of anal fissure 2.03 1.86 1.02 0.17 4.06 3.22 010 46945 A Ligation of hemorrhoids 1.83 3.59 1.91 0.20 5.62 3.94 090 46946 A Ligation of hemorrhoids 2.57 4.26 1.87 0.26 7.09 4.70 090 46999 C Anus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47000 A Needle biopsy of liver 1.89 3.28 0.64 0.11 5.28 2.64 000 47001 A Needle biopsy, liver add-on 1.89 NA 0.65 0.22 NA 2.76 ZZZ 47010 A Open drainage, liver lesion 15.92 NA 8.62 0.78 NA 25.32 090 47011 A Percut drain, liver lesion 3.68 NA 1.23 0.20 NA 5.11 000 47015 A Inject/aspirate liver cyst 15.02 NA 7.62 1.03 NA 23.67 090 47100 A Wedge biopsy of liver 11.60 NA 6.16 0.90 NA 18.66 090 47120 A Partial removal of liver 35.30 NA 15.44 2.74 NA 53.48 090 47122 A Extensive removal of liver 54.82 NA 21.84 4.31 NA 80.97 090 47125 A Partial removal of liver 48.91 NA 19.85 3.81 NA 72.57 090 47130 A Partial removal of liver 53.05 NA 21.32 4.16 NA 78.53 090 47133 X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47134 D Partial removal, donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47135 R Transplantation of liver 81.06 NA 32.43 9.74 NA 123.23 090 47136 R Transplantation of liver 68.21 NA 27.78 8.31 NA 104.30 090 47140 A Partial removal, donor liver 54.69 NA 22.98 4.77 NA 82.44 090 47141 A Partial removal, donor liver 67.12 NA 27.70 4.77 NA 99.59 090 47142 A Partial removal, donor liver 74.57 NA 30.29 4.77 NA 109.63 090 47300 A Surgery for liver lesion 14.99 NA 7.36 1.16 NA 23.51 090 47350 A Repair liver wound 19.45 NA 9.01 1.50 NA 29.96 090 47360 A Repair liver wound 26.77 NA 11.78 2.05 NA 40.60 090 47361 A Repair liver wound 46.85 NA 18.81 3.73 NA 69.39 090 47362 A Repair liver wound 18.40 NA 8.90 1.46 NA 28.76 090 47370 A Laparo ablate liver tumor rf 19.58 NA 8.28 1.02 NA 28.88 090 47371 A Laparo ablate liver cryosurg 19.58 NA 8.29 1.02 NA 28.89 090 47379 C Laparoscope procedure, liver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47380 A Open ablate liver tumor rf 22.87 NA 9.50 1.02 NA 33.39 090 47381 A Open ablate liver tumor cryo 23.14 NA 9.77 1.02 NA 33.93 090 Start Printed Page 63310 47382 A Percut ablate liver rf 15.10 NA 6.16 1.37 NA 22.63 010 47399 C Liver surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47400 A Incision of liver duct 32.30 NA 13.69 2.18 NA 48.17 090 47420 A Incision of bile duct 19.77 NA 8.90 2.04 NA 30.71 090 47425 A Incision of bile duct 19.72 NA 8.95 1.92 NA 30.59 090 47460 A Incise bile duct sphincter 17.94 NA 8.50 1.49 NA 27.93 090 47480 A Incision of gallbladder 10.76 NA 6.03 1.02 NA 17.81 090 47490 A Incision of gallbladder 7.19 NA 5.87 0.40 NA 13.46 090 47500 A Injection for liver x-rays 1.95 NA 0.64 0.11 NA 2.70 000 47505 A Injection for liver x-rays 0.76 2.58 0.25 0.04 3.38 1.05 000 47510 A Insert catheter, bile duct 7.79 NA 5.05 0.43 NA 13.27 090 47511 A Insert bile duct drain 10.44 NA 5.13 0.56 NA 16.13 090 47525 A Change bile duct catheter 5.52 NA 3.28 0.29 NA 9.09 010 47530 A Revise/reinsert bile tube 5.82 NA 4.36 0.35 NA 10.53 090 47550 A Bile duct endoscopy add-on 3.00 NA 1.04 0.36 NA 4.40 ZZZ 47552 A Biliary endoscopy thru skin 6.01 NA 2.42 0.50 NA 8.93 000 47553 A Biliary endoscopy thru skin 6.31 NA 2.62 0.36 NA 9.29 000 47554 A Biliary endoscopy thru skin 9.01 NA 3.41 0.89 NA 13.31 000 47555 A Biliary endoscopy thru skin 7.52 NA 3.04 0.42 NA 10.98 000 47556 A Biliary endoscopy thru skin 8.51 NA 3.35 0.46 NA 12.32 000 47560 A Laparoscopy w/cholangio 4.86 NA 1.84 0.59 NA 7.29 000 47561 A Laparo w/cholangio/biopsy 5.15 NA 2.15 0.59 NA 7.89 000 47562 A Laparoscopic cholecystectomy 11.03 NA 5.06 1.35 NA 17.44 090 47563 A Laparo cholecystectomy/graph 11.87 NA 5.37 1.45 NA 18.69 090 47564 A Laparo cholecystectomy/explr 14.15 NA 6.03 1.73 NA 21.91 090 47570 A Laparo cholecystoenterostomy 12.51 NA 5.45 1.53 NA 19.49 090 47579 C Laparoscope proc, biliary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47600 A Removal of gallbladder 13.50 NA 6.25 1.39 NA 21.14 090 47605 A Removal of gallbladder 14.61 NA 6.61 1.50 NA 22.72 090 47610 A Removal of gallbladder 18.71 NA 8.07 1.93 NA 28.71 090 47612 A Removal of gallbladder 18.67 NA 8.02 1.92 NA 28.61 090 47620 A Removal of gallbladder 20.52 NA 8.66 2.12 NA 31.30 090 47630 A Remove bile duct stone 9.06 NA 4.84 0.55 NA 14.45 090 47700 A Exploration of bile ducts 15.53 NA 7.55 1.68 NA 24.76 090 47701 A Bile duct revision 27.65 NA 11.71 3.60 NA 42.96 090 47711 A Excision of bile duct tumor 22.90 NA 10.12 2.37 NA 35.39 090 47712 A Excision of bile duct tumor 30.07 NA 12.65 3.20 NA 45.92 090 47715 A Excision of bile duct cyst 18.69 NA 8.57 1.91 NA 29.17 090 47716 A Fusion of bile duct cyst 16.35 NA 8.00 1.69 NA 26.04 090 47720 A Fuse gallbladder & bowel 15.82 NA 7.61 1.64 NA 25.07 090 47721 A Fuse upper gi structures 19.01 NA 8.72 1.95 NA 29.68 090 47740 A Fuse gallbladder & bowel 18.37 NA 8.52 1.91 NA 28.80 090 47741 A Fuse gallbladder & bowel 21.22 NA 9.45 2.18 NA 32.85 090 47760 A Fuse bile ducts and bowel 25.70 NA 11.02 2.65 NA 39.37 090 47765 A Fuse liver ducts & bowel 24.74 NA 11.02 2.61 NA 38.37 090 47780 A Fuse bile ducts and bowel 26.35 NA 11.39 2.72 NA 40.46 090 47785 A Fuse bile ducts and bowel 31.00 NA 13.16 3.22 NA 47.38 090 47800 A Reconstruction of bile ducts 23.17 NA 10.23 2.34 NA 35.74 090 47801 A Placement, bile duct support 15.08 NA 8.38 0.83 NA 24.29 090 47802 A Fuse liver duct & intestine 21.43 NA 9.86 2.21 NA 33.50 090 47900 A Suture bile duct injury 19.79 NA 9.02 1.98 NA 30.79 090 47999 C Bile tract surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 48000 A Drainage of abdomen 27.91 NA 11.68 1.58 NA 41.17 090 48001 A Placement of drain, pancreas 35.25 NA 14.09 2.28 NA 51.62 090 48005 A Resect/debride pancreas 41.93 NA 16.80 2.71 NA 61.44 090 48020 A Removal of pancreatic stone 15.61 NA 7.43 1.63 NA 24.67 090 48100 A Biopsy of pancreas, open 12.16 NA 5.71 1.29 NA 19.16 090 48102 A Needle biopsy, pancreas 4.65 9.11 2.47 0.24 14.00 7.36 010 48120 A Removal of pancreas lesion 15.76 NA 6.98 1.62 NA 24.36 090 48140 A Partial removal of pancreas 22.81 NA 9.69 2.54 NA 35.04 090 48145 A Partial removal of pancreas 23.88 NA 10.01 2.70 NA 36.59 090 48146 A Pancreatectomy 26.25 NA 12.20 2.91 NA 41.36 090 48148 A Removal of pancreatic duct 17.24 NA 7.76 1.93 NA 26.93 090 48150 A Partial removal of pancreas 47.73 NA 19.86 5.31 NA 72.90 090 48152 A Pancreatectomy 43.50 NA 18.53 4.88 NA 66.91 090 48153 A Pancreatectomy 47.62 NA 19.96 5.27 NA 72.85 090 48154 A Pancreatectomy 43.85 NA 18.59 4.91 NA 67.35 090 48155 A Removal of pancreas 24.50 NA 11.96 2.76 NA 39.22 090 48160 N Pancreas removal/transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48180 A Fuse pancreas and bowel 24.58 NA 10.32 2.68 NA 37.58 090 48400 A Injection, intraop add-on 1.94 NA 0.65 0.12 NA 2.71 ZZZ 48500 A Surgery of pancreatic cyst 15.19 NA 7.48 1.62 NA 24.29 090 48510 A Drain pancreatic pseudocyst 14.23 NA 7.60 1.28 NA 23.11 090 48511 A Drain pancreatic pseudocyst 3.98 NA 1.33 0.20 NA 5.51 000 48520 A Fuse pancreas cyst and bowel 15.50 NA 6.82 1.69 NA 24.01 090 Start Printed Page 63311 48540 A Fuse pancreas cyst and bowel 19.61 NA 8.25 2.18 NA 30.04 090 48545 A Pancreatorrhaphy 18.08 NA 8.11 1.93 NA 28.12 090 48547 A Duodenal exclusion 25.68 NA 10.65 2.76 NA 39.09 090 48550 X Donor pancreatectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48554 R Transpl allograft pancreas 33.98 NA 17.51 3.96 NA 55.45 090 48556 A Removal, allograft pancreas 15.62 NA 8.38 1.82 NA 25.82 090 48999 C Pancreas surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49000 A Exploration of abdomen 11.61 NA 5.48 1.40 NA 18.49 090 49002 A Reopening of abdomen 10.43 NA 5.13 1.27 NA 16.83 090 49010 A Exploration behind abdomen 12.21 NA 5.99 1.46 NA 19.66 090 49020 A Drain abdominal abscess 22.71 NA 10.35 1.57 NA 34.63 090 49021 A Drain abdominal abscess 3.36 NA 1.12 0.19 NA 4.67 000 49040 A Drain, open, abdom abscess 13.44 NA 6.54 1.01 NA 20.99 090 49041 A Drain, percut, abdom abscess 3.98 NA 1.33 0.22 NA 5.53 000 49060 A Drain, open, retrop abscess 15.77 NA 7.55 0.92 NA 24.24 090 49061 A Drain, percut, retroper absc 3.68 NA 1.23 0.20 NA 5.11 000 49062 A Drain to peritoneal cavity 11.30 NA 5.54 1.29 NA 18.13 090 49080 A Puncture, peritoneal cavity 1.34 4.14 0.46 0.08 5.56 1.88 000 49081 A Removal of abdominal fluid 1.25 2.66 0.58 0.07 3.98 1.90 000 49085 A Remove abdomen foreign body 12.07 NA 5.61 1.05 NA 18.73 090 49180 A Biopsy, abdominal mass 1.72 3.34 0.58 0.10 5.16 2.40 000 49200 A Removal of abdominal lesion 10.19 NA 5.16 1.10 NA 16.45 090 49201 A Remove abdom lesion, complex 14.76 NA 7.26 1.76 NA 23.78 090 49215 A Excise sacral spine tumor 33.31 NA 14.24 2.97 NA 50.52 090 49220 A Multiple surgery, abdomen 14.80 NA 6.76 1.81 NA 23.37 090 49250 A Excision of umbilicus 8.30 NA 4.40 1.01 NA 13.71 090 49255 A Removal of omentum 11.08 NA 5.78 1.34 NA 18.20 090 49320 A Diag laparo separate proc 5.07 NA 2.69 0.60 NA 8.36 010 49321 A Laparoscopy, biopsy 5.37 NA 2.69 0.64 NA 8.70 010 49322 A Laparoscopy, aspiration 5.67 NA 3.03 0.68 NA 9.38 010 49323 A Laparo drain lymphocele 9.43 NA 4.57 1.05 NA 15.05 090 49329 C Laparo proc, abdm/per/oment 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49400 A Air injection into abdomen 1.87 NA 0.79 0.13 NA 2.79 000 49419 A Insrt abdom cath for chemotx 6.61 NA 3.59 0.66 NA 10.86 090 49420 A Insert abdom drain, temp 2.21 NA 1.12 0.16 NA 3.49 000 49421 A Insert abdom drain, perm 5.51 NA 3.22 0.66 NA 9.39 090 49422 A Remove perm cannula/catheter 6.21 NA 2.94 0.76 NA 9.91 010 49423 A Exchange drainage catheter 1.45 NA 0.67 0.08 NA 2.20 000 49424 A Assess cyst, contrast inject 0.76 NA 0.45 0.04 NA 1.25 000 49425 A Insert abdomen-venous drain 11.31 NA 5.66 1.45 NA 18.42 090 49426 A Revise abdomen-venous shunt 9.58 NA 4.86 1.11 NA 15.55 090 49427 A Injection, abdominal shunt 0.88 NA 0.49 0.06 NA 1.43 000 49428 A Ligation of shunt 6.03 NA 3.31 0.37 NA 9.71 010 49429 A Removal of shunt 7.36 NA 3.44 0.97 NA 11.77 010 49491 A Rpr hern preemie reduc 11.07 NA 5.13 1.32 NA 17.52 090 49492 A Rpr ing hern premie, blocked 13.95 NA 6.21 1.76 NA 21.92 090 49495 A Rpr ing hernia baby, reduc 5.86 NA 3.02 0.70 NA 9.58 090 49496 A Rpr ing hernia baby, blocked 8.74 NA 4.41 1.10 NA 14.25 090 49500 A Rpr ing hernia, init, reduce 5.45 NA 3.19 0.55 NA 9.19 090 49501 A Rpr ing hernia, init blocked 8.83 NA 4.28 0.91 NA 14.02 090 49505 A Prp i/hern init reduc>5 yr 7.56 4.15 3.91 0.78 12.49 12.25 090 49507 A Prp i/hern init block>5 yr 9.52 NA 4.58 0.99 NA 15.09 090 49520 A Rerepair ing hernia, reduce 9.58 NA 4.53 1.01 NA 15.12 090 49521 A Rerepair ing hernia, blocked 11.90 NA 5.34 1.25 NA 18.49 090 49525 A Repair ing hernia, sliding 8.52 NA 4.18 0.89 NA 13.59 090 49540 A Repair lumbar hernia 10.33 NA 4.84 1.08 NA 16.25 090 49550 A Rpr rem hernia, init, reduce 8.58 NA 4.21 0.90 NA 13.69 090 49553 A Rpr fem hernia, init blocked 9.39 NA 4.51 0.99 NA 14.89 090 49555 A Rerepair fem hernia, reduce 8.98 NA 4.37 0.95 NA 14.30 090 49557 A Rerepair fem hernia, blocked 11.09 NA 5.09 1.16 NA 17.34 090 49560 A Rpr ventral hern init, reduc 11.50 NA 5.26 1.20 NA 17.96 090 49561 A Rpr ventral hern init, block 14.17 NA 6.17 1.47 NA 21.81 090 49565 A Rerepair ventrl hern, reduce 11.50 NA 5.33 1.20 NA 18.03 090 49566 A Rerepair ventrl hern, block 14.32 NA 6.24 1.49 NA 22.05 090 49568 A Hernia repair w/mesh 4.86 NA 1.70 0.60 NA 7.16 ZZZ 49570 A Rpr epigastric hern, reduce 5.66 NA 3.22 0.60 NA 9.48 090 49572 A Rpr epigastric hern, blocked 6.69 NA 3.54 0.70 NA 10.93 090 49580 A Rpr umbil hern, reduc < 5 yr 4.09 NA 2.68 0.41 NA 7.18 090 49582 A Rpr umbil hern, block < 5 yr 6.61 NA 3.57 0.68 NA 10.86 090 49585 A Rpr umbil hern, reduc > 5 yr 6.19 NA 3.38 0.64 NA 10.21 090 49587 A Rpr umbil hern, block > 5 yr 7.52 NA 3.82 0.78 NA 12.12 090 49590 A Repair spigilian hernia 8.49 NA 4.18 0.89 NA 13.56 090 49600 A Repair umbilical lesion 10.90 NA 5.42 1.35 NA 17.67 090 49605 A Repair umbilical lesion 75.57 NA 28.95 3.08 NA 107.60 090 49606 A Repair umbilical lesion 18.49 NA 7.82 2.66 NA 28.97 090 Start Printed Page 63312 49610 A Repair umbilical lesion 10.44 NA 5.34 0.92 NA 16.70 090 49611 A Repair umbilical lesion 8.87 NA 6.56 0.78 NA 16.21 090 49650 A Laparo hernia repair initial 6.23 NA 3.26 0.77 NA 10.26 090 49651 A Laparo hernia repair recur 8.19 NA 4.13 1.01 NA 13.33 090 49659 C Laparo proc, hernia repair 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49900 A Repair of abdominal wall 12.21 NA 6.34 1.47 NA 20.02 090 49904 A Omental flap, extra-abdom 19.89 NA 15.64 2.29 NA 37.82 090 49905 A Omental flap, intra-abdom 6.51 NA 2.31 0.73 NA 9.55 ZZZ 49906 C Free omental flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 49999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50010 A Exploration of kidney 10.92 NA 5.48 0.95 NA 17.35 090 50020 A Renal abscess, open drain 14.58 NA 8.90 0.96 NA 24.44 090 50021 A Renal abscess, percut drain 3.36 NA 1.11 0.18 NA 4.65 000 50040 A Drainage of kidney 14.85 NA 8.51 0.98 NA 24.34 090 50045 A Exploration of kidney 15.37 NA 6.88 1.27 NA 23.52 090 50060 A Removal of kidney stone 19.19 NA 8.13 1.37 NA 28.69 090 50065 A Incision of kidney 20.67 NA 6.38 1.35 NA 28.40 090 50070 A Incision of kidney 20.20 NA 8.52 1.44 NA 30.16 090 50075 A Removal of kidney stone 25.20 NA 10.30 1.81 NA 37.31 090 50080 A Removal of kidney stone 14.63 NA 7.92 1.03 NA 23.58 090 50081 A Removal of kidney stone 21.68 NA 10.46 1.56 NA 33.70 090 50100 A Revise kidney blood vessels 16.00 NA 8.01 1.97 NA 25.98 090 50120 A Exploration of kidney 15.82 NA 7.06 1.25 NA 24.13 090 50125 A Explore and drain kidney 16.43 NA 7.21 1.28 NA 24.92 090 50130 A Removal of kidney stone 17.19 NA 7.46 1.25 NA 25.90 090 50135 A Exploration of kidney 19.07 NA 8.08 1.41 NA 28.56 090 50200 A Biopsy of kidney 2.62 NA 0.91 0.14 NA 3.67 000 50205 A Biopsy of kidney 11.25 NA 5.30 1.13 NA 17.68 090 50220 A Remove kidney, open 17.05 NA 7.52 1.39 NA 25.96 090 50225 A Removal kidney open, complex 20.11 NA 8.45 1.51 NA 30.07 090 50230 A Removal kidney open, radical 21.94 NA 8.93 1.62 NA 32.49 090 50234 A Removal of kidney & ureter 22.27 NA 9.14 1.64 NA 33.05 090 50236 A Removal of kidney & ureter 24.72 NA 11.52 1.80 NA 38.04 090 50240 A Partial removal of kidney 21.87 NA 10.61 1.63 NA 34.11 090 50280 A Removal of kidney lesion 15.58 NA 6.97 1.19 NA 23.74 090 50290 A Removal of kidney lesion 14.65 NA 6.73 1.33 NA 22.71 090 50300 X Removal of donor kidney 0.00 0.00 0.00 0.00 0.00 0.00 XXX 50320 A Removal of donor kidney 22.08 NA 10.07 2.13 NA 34.28 090 50340 A Removal of kidney 12.08 NA 7.00 1.38 NA 20.46 090 50360 A Transplantation of kidney 31.35 NA 15.95 3.56 NA 50.86 090 50365 A Transplantation of kidney 36.60 NA 18.88 4.21 NA 59.69 090 50370 A Remove transplanted kidney 13.64 NA 7.60 1.51 NA 22.75 090 50380 A Reimplantation of kidney 20.64 NA 13.46 2.16 NA 36.26 090 50390 A Drainage of kidney lesion 1.95 NA 0.64 0.11 NA 2.70 000 50392 A Insert kidney drain 3.36 NA 1.11 0.18 NA 4.65 000 50393 A Insert ureteral tube 4.14 NA 1.37 0.22 NA 5.73 000 50394 A Injection for kidney x-ray 0.76 2.53 0.25 0.05 3.34 1.06 000 50395 A Create passage to kidney 3.36 NA 1.11 0.19 NA 4.66 000 50396 A Measure kidney pressure 2.08 NA 0.86 0.12 NA 3.06 000 50398 A Change kidney tube 1.45 1.21 0.48 0.08 2.74 2.01 000 50400 A Revision of kidney/ureter 19.39 NA 7.81 1.45 NA 28.65 090 50405 A Revision of kidney/ureter 23.79 NA 10.53 1.74 NA 36.06 090 50500 A Repair of kidney wound 19.46 NA 8.84 1.74 NA 30.04 090 50520 A Close kidney-skin fistula 17.13 NA 8.84 1.51 NA 27.48 090 50525 A Repair renal-abdomen fistula 22.14 NA 10.28 1.81 NA 34.23 090 50526 A Repair renal-abdomen fistula 23.88 NA 10.99 1.94 NA 36.81 090 50540 A Revision of horseshoe kidney 19.82 NA 8.59 1.53 NA 29.94 090 50541 A Laparo ablate renal cyst 15.91 NA 6.49 1.19 NA 23.59 090 50542 A Laparo ablate renal mass 19.89 NA 8.23 1.63 NA 29.75 090 50543 A Laparo partial nephrectomy 25.35 NA 10.39 1.63 NA 37.37 090 50544 A Laparoscopy, pyeloplasty 22.27 NA 8.56 1.69 NA 32.52 090 50545 A Laparo radical nephrectomy 23.86 NA 9.22 1.83 NA 34.91 090 50546 A Laparoscopic nephrectomy 20.36 NA 8.39 1.64 NA 30.39 090 50547 A Laparo removal donor kidney 25.35 NA 10.56 2.45 NA 38.36 090 50548 A Laparo remove w/ ureter 24.26 NA 9.20 1.79 NA 35.25 090 50549 C Laparoscope proc, renal 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50551 A Kidney endoscopy 5.57 4.99 1.81 0.40 10.96 7.78 000 50553 A Kidney endoscopy 5.96 18.71 1.96 0.42 25.09 8.34 000 50555 A Kidney endoscopy & biopsy 6.49 19.36 2.13 0.46 26.31 9.08 000 50557 A Kidney endoscopy & treatment 6.58 20.15 2.14 0.47 27.20 9.19 000 50559 A Renal endoscopy/radiotracer 6.74 NA 2.21 0.32 NA 9.27 000 50561 A Kidney endoscopy & treatment 7.55 17.84 2.46 0.53 25.92 10.54 000 50562 A Renal scope w/tumor resect 10.86 NA 3.88 1.01 NA 15.75 090 50570 A Kidney endoscopy 9.49 NA 3.09 0.67 NA 13.25 000 50572 A Kidney endoscopy 10.29 NA 3.35 0.77 NA 14.41 000 Start Printed Page 63313 50574 A Kidney endoscopy & biopsy 10.96 NA 3.58 0.78 NA 15.32 000 50575 A Kidney endoscopy 13.90 NA 4.52 1.01 NA 19.43 000 50576 A Kidney endoscopy & treatment 10.93 NA 3.54 0.79 NA 15.26 000 50578 A Renal endoscopy/radiotracer 11.29 NA 3.67 0.80 NA 15.76 000 50580 A Kidney endoscopy & treatment 11.79 NA 3.83 0.84 NA 16.46 000 50590 A Fragmenting of kidney stone 9.04 10.92 5.11 0.65 20.61 14.80 090 50600 A Exploration of ureter 15.75 NA 7.07 1.19 NA 24.01 090 50605 A Insert ureteral support 15.37 NA 7.09 1.35 NA 23.81 090 50610 A Removal of ureter stone 15.83 NA 7.32 1.29 NA 24.44 090 50620 A Removal of ureter stone 15.07 NA 6.69 1.09 NA 22.85 090 50630 A Removal of ureter stone 14.85 NA 6.63 1.08 NA 22.56 090 50650 A Removal of ureter 17.31 NA 7.59 1.28 NA 26.18 090 50660 A Removal of ureter 19.44 NA 8.33 1.43 NA 29.20 090 50684 A Injection for ureter x-ray 0.76 15.43 0.25 0.05 16.24 1.06 000 50686 A Measure ureter pressure 1.50 4.60 0.65 0.11 6.21 2.26 000 50688 A Change of ureter tube 1.16 NA 1.76 0.07 NA 2.99 010 50690 A Injection for ureter x-ray 1.15 15.92 0.38 0.07 17.14 1.60 000 50700 A Revision of ureter 15.12 NA 7.39 1.03 NA 23.54 090 50715 A Release of ureter 18.79 NA 9.28 2.01 NA 30.08 090 50722 A Release of ureter 16.26 NA 8.18 1.69 NA 26.13 090 50725 A Release/revise ureter 18.38 NA 8.41 1.73 NA 28.52 090 50727 A Revise ureter 8.13 NA 5.29 0.61 NA 14.03 090 50728 A Revise ureter 11.95 NA 6.82 1.05 NA 19.82 090 50740 A Fusion of ureter & kidney 18.32 NA 8.06 1.79 NA 28.17 090 50750 A Fusion of ureter & kidney 19.40 NA 8.36 1.49 NA 29.25 090 50760 A Fusion of ureters 18.32 NA 8.05 1.50 NA 27.87 090 50770 A Splicing of ureters 19.40 NA 8.35 1.50 NA 29.25 090 50780 A Reimplant ureter in bladder 18.26 NA 7.96 1.44 NA 27.66 090 50782 A Reimplant ureter in bladder 19.43 NA 9.73 1.35 NA 30.51 090 50783 A Reimplant ureter in bladder 20.43 NA 9.48 1.62 NA 31.53 090 50785 A Reimplant ureter in bladder 20.40 NA 8.68 1.56 NA 30.64 090 50800 A Implant ureter in bowel 14.44 NA 7.08 1.10 NA 22.62 090 50810 A Fusion of ureter & bowel 19.94 NA 9.70 2.13 NA 31.77 090 50815 A Urine shunt to intestine 19.82 NA 9.07 1.57 NA 30.46 090 50820 A Construct bowel bladder 21.77 NA 9.25 1.65 NA 32.67 090 50825 A Construct bowel bladder 28.02 NA 11.81 2.17 NA 42.00 090 50830 A Revise urine flow 31.10 NA 12.81 2.64 NA 46.55 090 50840 A Replace ureter by bowel 19.89 NA 9.03 1.51 NA 30.43 090 50845 A Appendico-vesicostomy 20.77 NA 8.99 1.51 NA 31.27 090 50860 A Transplant ureter to skin 15.27 NA 6.98 1.21 NA 23.46 090 50900 A Repair of ureter 13.54 NA 6.44 1.17 NA 21.15 090 50920 A Closure ureter/skin fistula 14.25 NA 6.87 1.01 NA 22.13 090 50930 A Closure ureter/bowel fistula 18.61 NA 8.30 1.88 NA 28.79 090 50940 A Release of ureter 14.43 NA 6.72 1.25 NA 22.40 090 50945 A Laparoscopy ureterolithotomy 16.90 NA 7.04 1.38 NA 25.32 090 50947 A Laparo new ureter/bladder 24.36 NA 9.76 2.39 NA 36.51 090 50948 A Laparo new ureter/bladder 22.37 NA 8.72 2.19 NA 33.28 090 50949 C Laparoscope proc, ureter 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50951 A Endoscopy of ureter 5.81 5.41 1.89 0.42 11.64 8.12 000 50953 A Endoscopy of ureter 6.20 18.72 2.02 0.44 25.36 8.66 000 50955 A Ureter endoscopy & biopsy 6.71 19.64 2.22 0.46 26.81 9.39 000 50957 A Ureter endoscopy & treatment 6.75 18.38 2.20 0.48 25.61 9.43 000 50959 A Ureter endoscopy & tracer 4.37 NA 1.39 0.22 NA 5.98 000 50961 A Ureter endoscopy & treatment 6.02 25.58 1.95 0.42 32.02 8.39 000 50970 A Ureter endoscopy 7.10 NA 2.32 0.52 NA 9.94 000 50972 A Ureter endoscopy & catheter 6.85 NA 2.28 0.47 NA 9.60 000 50974 A Ureter endoscopy & biopsy 9.12 NA 2.96 0.64 NA 12.72 000 50976 A Ureter endoscopy & treatment 8.99 NA 2.94 0.64 NA 12.57 000 50978 A Ureter endoscopy & tracer 5.07 NA 1.69 0.36 NA 7.12 000 50980 A Ureter endoscopy & treatment 6.81 NA 2.22 0.49 NA 9.52 000 51000 A Drainage of bladder 0.78 2.01 0.24 0.06 2.85 1.08 000 51005 A Drainage of bladder 1.01 4.88 0.34 0.10 5.99 1.45 000 51010 A Drainage of bladder 3.51 5.80 1.93 0.28 9.59 5.72 010 51020 A Incise & treat bladder 6.67 NA 4.04 0.50 NA 11.21 090 51030 A Incise & treat bladder 6.73 NA 4.14 0.50 NA 11.37 090 51040 A Incise & drain bladder 4.37 NA 2.92 0.32 NA 7.61 090 51045 A Incise bladder/drain ureter 6.73 NA 4.13 0.56 NA 11.42 090 51050 A Removal of bladder stone 6.88 NA 3.79 0.50 NA 11.17 090 51060 A Removal of ureter stone 8.80 NA 4.68 0.65 NA 14.13 090 51065 A Remove ureter calculus 8.80 NA 4.53 0.64 NA 13.97 090 51080 A Drainage of bladder abscess 5.93 NA 3.70 0.42 NA 10.05 090 51500 A Removal of bladder cyst 10.08 NA 5.14 1.05 NA 16.27 090 51520 A Removal of bladder lesion 9.24 NA 4.86 0.70 NA 14.80 090 51525 A Removal of bladder lesion 13.89 NA 6.32 1.02 NA 21.23 090 51530 A Removal of bladder lesion 12.31 NA 5.95 0.98 NA 19.24 090 Start Printed Page 63314 51535 A Repair of ureter lesion 12.50 NA 6.34 1.08 NA 19.92 090 51550 A Partial removal of bladder 15.57 NA 6.94 1.26 NA 23.77 090 51555 A Partial removal of bladder 21.11 NA 8.91 1.64 NA 31.66 090 51565 A Revise bladder & ureter(s) 21.50 NA 9.23 1.68 NA 32.41 090 51570 A Removal of bladder 24.10 NA 10.05 1.91 NA 36.06 090 51575 A Removal of bladder & nodes 30.28 NA 12.38 2.25 NA 44.91 090 51580 A Remove bladder/revise tract 30.90 NA 12.85 2.33 NA 46.08 090 51585 A Removal of bladder & nodes 35.03 NA 14.08 2.61 NA 51.72 090 51590 A Remove bladder/revise tract 32.47 NA 12.97 2.41 NA 47.85 090 51595 A Remove bladder/revise tract 36.93 NA 14.51 2.67 NA 54.11 090 51596 A Remove bladder/create pouch 39.29 NA 15.64 2.86 NA 57.79 090 51597 A Removal of pelvic structures 38.13 NA 15.24 2.98 NA 56.35 090 51600 A Injection for bladder x-ray 0.87 5.86 0.29 0.05 6.78 1.21 000 51605 A Preparation for bladder xray 0.64 10.87 0.35 0.05 11.56 1.04 000 51610 A Injection for bladder x-ray 1.04 1.75 0.62 0.06 2.85 1.72 000 51700 A Irrigation of bladder 0.87 1.67 0.29 0.06 2.60 1.22 000 51701 A Insert bladder catheter 0.50 1.66 0.19 0.04 2.20 0.73 000 51702 A Insert temp bladder cath 0.50 2.36 0.26 0.04 2.90 0.80 000 51703 A Insert bladder cath, complex 1.46 3.08 0.58 0.11 4.65 2.15 000 51705 A Change of bladder tube 1.01 2.36 0.63 0.07 3.44 1.71 010 51710 A Change of bladder tube 1.48 3.46 0.78 0.11 5.05 2.37 010 51715 A Endoscopic injection/implant 3.72 4.04 1.37 0.29 8.05 5.38 000 51720 A Treatment of bladder lesion 1.95 1.80 0.71 0.14 3.89 2.80 000 51725 A Simple cystometrogram 1.50 5.83 NA 0.16 7.49 NA 000 51725 26 A Simple cystometrogram 1.50 0.50 0.50 0.12 2.12 2.12 000 51725 TC A Simple cystometrogram 0.00 5.33 NA 0.04 5.37 NA 000 51726 A Complex cystometrogram 1.70 7.91 NA 0.18 9.79 NA 000 51726 26 A Complex cystometrogram 1.70 0.57 0.57 0.13 2.40 2.40 000 51726 TC A Complex cystometrogram 0.00 7.34 NA 0.05 7.39 NA 000 51736 A Urine flow measurement 0.61 0.60 NA 0.06 1.27 NA 000 51736 26 A Urine flow measurement 0.61 0.20 0.20 0.05 0.86 0.86 000 51736 TC A Urine flow measurement 0.00 0.40 NA 0.01 0.41 NA 000 51741 A Electro-uroflowmetry, first 1.13 0.83 NA 0.10 2.06 NA 000 51741 26 A Electro-uroflowmetry, first 1.13 0.38 0.38 0.08 1.59 1.59 000 51741 TC A Electro-uroflowmetry, first 0.00 0.45 NA 0.02 0.47 NA 000 51772 A Urethra pressure profile 1.60 5.86 NA 0.19 7.65 NA 000 51772 26 A Urethra pressure profile 1.60 0.56 0.56 0.14 2.30 2.30 000 51772 TC A Urethra pressure profile 0.00 5.30 NA 0.05 5.35 NA 000 51784 A Anal/urinary muscle study 1.52 4.16 NA 0.16 5.84 NA 000 51784 26 A Anal/urinary muscle study 1.52 0.51 0.51 0.12 2.15 2.15 000 51784 TC A Anal/urinary muscle study 0.00 3.65 NA 0.04 3.69 NA 000 51785 A Anal/urinary muscle study 1.52 4.68 NA 0.15 6.35 NA 000 51785 26 A Anal/urinary muscle study 1.52 0.51 0.51 0.11 2.14 2.14 000 51785 TC A Anal/urinary muscle study 0.00 4.17 NA 0.04 4.21 NA 000 51792 A Urinary reflex study 1.09 6.06 NA 0.24 7.39 NA 000 51792 26 A Urinary reflex study 1.09 0.42 0.42 0.11 1.62 1.62 000 51792 TC A Urinary reflex study 0.00 5.64 NA 0.13 5.77 NA 000 51795 A Urine voiding pressure study 1.52 7.69 NA 0.22 9.43 NA 000 51795 26 A Urine voiding pressure study 1.52 0.51 0.51 0.12 2.15 2.15 000 51795 TC A Urine voiding pressure study 0.00 7.18 NA 0.10 7.28 NA 000 51797 A Intraabdominal pressure test 1.59 6.02 NA 0.17 7.78 NA 000 51797 26 A Intraabdominal pressure test 1.59 0.54 0.54 0.12 2.25 2.25 000 51797 TC A Intraabdominal pressure test 0.00 5.48 NA 0.05 5.53 NA 000 51798 A Us urine capacity measure 0.00 0.36 NA 0.08 0.44 NA XXX 51800 A Revision of bladder/urethra 17.32 NA 7.79 1.40 NA 26.51 090 51820 A Revision of urinary tract 17.79 NA 8.58 1.74 NA 28.11 090 51840 A Attach bladder/urethra 10.65 NA 5.65 1.04 NA 17.34 090 51841 A Attach bladder/urethra 12.96 NA 6.46 1.25 NA 20.67 090 51845 A Repair bladder neck 9.67 NA 4.93 0.74 NA 15.34 090 51860 A Repair of bladder wound 11.95 NA 5.98 1.07 NA 19.00 090 51865 A Repair of bladder wound 14.95 NA 6.91 1.21 NA 23.07 090 51880 A Repair of bladder opening 7.62 NA 4.15 0.65 NA 12.42 090 51900 A Repair bladder/vagina lesion 12.90 NA 6.30 1.04 NA 20.24 090 51920 A Close bladder-uterus fistula 11.74 NA 5.82 1.03 NA 18.59 090 51925 A Hysterectomy/bladder repair 15.49 NA 8.82 1.77 NA 26.08 090 51940 A Correction of bladder defect 28.27 NA 12.51 2.36 NA 43.14 090 51960 A Revision of bladder & bowel 22.88 NA 9.98 1.69 NA 34.55 090 51980 A Construct bladder opening 11.30 NA 5.56 0.89 NA 17.75 090 51990 A Laparo urethral suspension 12.43 NA 6.26 1.22 NA 19.91 090 51992 A Laparo sling operation 13.93 NA 6.32 1.11 NA 21.36 090 52000 A Cystoscopy 2.00 3.41 0.76 0.14 5.55 2.90 000 52001 A Cystoscopy, removal of clots 5.42 5.22 1.89 0.38 11.02 7.69 000 52005 A Cystoscopy & ureter catheter 2.36 6.01 0.90 0.18 8.55 3.44 000 52007 A Cystoscopy and biopsy 3.00 NA 1.17 0.22 NA 4.39 000 52010 A Cystoscopy & duct catheter 3.00 NA 1.15 0.22 NA 4.37 000 Start Printed Page 63315 52204 A Cystoscopy 2.36 3.67 0.92 0.18 6.21 3.46 000 52214 A Cystoscopy and treatment 3.69 NA 1.35 0.26 NA 5.30 000 52224 A Cystoscopy and treatment 3.12 NA 1.17 0.22 NA 4.51 000 52234 A Cystoscopy and treatment 4.60 NA 1.65 0.32 NA 6.57 000 52235 A Cystoscopy and treatment 5.42 NA 1.93 0.38 NA 7.73 000 52240 A Cystoscopy and treatment 9.66 NA 3.33 0.70 NA 13.69 000 52250 A Cystoscopy and radiotracer 4.47 NA 1.69 0.32 NA 6.48 000 52260 A Cystoscopy and treatment 3.90 NA 1.45 0.28 NA 5.63 000 52265 A Cystoscopy and treatment 2.92 3.79 1.13 0.22 6.93 4.27 000 52270 A Cystoscopy & revise urethra 3.35 NA 1.26 0.24 NA 4.85 000 52275 A Cystoscopy & revise urethra 4.67 NA 1.69 0.34 NA 6.70 000 52276 A Cystoscopy and treatment 4.97 NA 1.81 0.36 NA 7.14 000 52277 A Cystoscopy and treatment 6.13 NA 2.28 0.46 NA 8.87 000 52281 A Cystoscopy and treatment 2.78 7.47 1.09 0.20 10.45 4.07 000 52282 A Cystoscopy, implant stent 6.36 NA 2.26 0.46 NA 9.08 000 52283 A Cystoscopy and treatment 3.72 4.06 1.41 0.26 8.04 5.39 000 52285 A Cystoscopy and treatment 3.59 4.14 1.36 0.26 7.99 5.21 000 52290 A Cystoscopy and treatment 4.56 NA 1.68 0.32 NA 6.56 000 52300 A Cystoscopy and treatment 5.28 NA 1.93 0.38 NA 7.59 000 52301 A Cystoscopy and treatment 5.48 NA 2.02 0.47 NA 7.97 000 52305 A Cystoscopy and treatment 5.28 NA 1.88 0.37 NA 7.53 000 52310 A Cystoscopy and treatment 2.79 3.56 1.04 0.20 6.55 4.03 000 52315 A Cystoscopy and treatment 5.18 NA 1.86 0.37 NA 7.41 000 52317 A Remove bladder stone 6.68 NA 2.31 0.48 NA 9.47 000 52318 A Remove bladder stone 9.14 NA 3.14 0.65 NA 12.93 000 52320 A Cystoscopy and treatment 4.67 NA 1.66 0.34 NA 6.67 000 52325 A Cystoscopy, stone removal 6.12 NA 2.13 0.44 NA 8.69 000 52327 A Cystoscopy, inject material 5.16 NA 1.85 0.38 NA 7.39 000 52330 A Cystoscopy and treatment 5.01 NA 1.78 0.36 NA 7.15 000 52332 A Cystoscopy and treatment 2.81 NA 1.07 0.20 NA 4.08 000 52334 A Create passage to kidney 4.80 NA 1.78 0.34 NA 6.92 000 52341 A Cysto w/ureter stricture tx 5.97 NA 2.24 0.44 NA 8.65 000 52342 A Cysto w/up stricture tx 6.46 NA 2.38 0.48 NA 9.32 000 52343 A Cysto w/renal stricture tx 7.16 NA 2.62 0.53 NA 10.31 000 52344 A Cysto/uretero, stone remove 7.66 NA 2.84 0.56 NA 11.06 000 52345 A Cysto/uretero w/up stricture 8.15 NA 3.00 0.60 NA 11.75 000 52346 A Cystouretero w/renal strict 9.18 NA 3.32 0.68 NA 13.18 000 52347 A Cystoscopy, resect ducts 5.25 NA 1.73 0.40 NA 7.38 000 52351 A Cystouretero & or pyeloscope 5.83 NA 2.17 0.43 NA 8.43 000 52352 A Cystouretero w/stone remove 6.84 NA 2.54 0.50 NA 9.88 000 52353 A Cystouretero w/lithotripsy 7.92 NA 2.90 0.59 NA 11.41 000 52354 A Cystouretero w/biopsy 7.30 NA 2.71 0.54 NA 10.55 000 52355 A Cystouretero w/excise tumor 8.77 NA 3.19 0.66 NA 12.62 000 52400 A Cystouretero w/congen repr 9.62 NA 3.83 0.72 NA 14.17 090 52450 A Incision of prostate 7.60 NA 3.77 0.55 NA 11.92 090 52500 A Revision of bladder neck 8.42 NA 4.02 0.60 NA 13.04 090 52510 A Dilation prostatic urethra 6.68 NA 3.20 0.48 NA 10.36 090 52601 A Prostatectomy (TURP) 12.30 NA 5.22 0.89 NA 18.41 090 52606 A Control postop bleeding 8.08 NA 3.63 0.59 NA 12.30 090 52612 A Prostatectomy, first stage 7.93 NA 3.83 0.58 NA 12.34 090 52614 A Prostatectomy, second stage 6.80 NA 3.43 0.49 NA 10.72 090 52620 A Remove residual prostate 6.57 NA 3.06 0.47 NA 10.10 090 52630 A Remove prostate regrowth 7.22 NA 3.25 0.52 NA 10.99 090 52640 A Relieve bladder contracture 6.58 NA 3.03 0.47 NA 10.08 090 52647 A Laser surgery of prostate 10.30 77.33 4.63 0.73 88.36 15.66 090 52648 A Laser surgery of prostate 11.15 NA 4.90 0.79 NA 16.84 090 52700 A Drainage of prostate abscess 6.76 NA 3.25 0.49 NA 10.50 090 53000 A Incision of urethra 2.27 NA 1.58 0.16 NA 4.01 010 53010 A Incision of urethra 3.62 NA 3.07 0.24 NA 6.93 090 53020 A Incision of urethra 1.76 3.12 0.68 0.13 5.01 2.57 000 53025 A Incision of urethra 1.12 3.88 0.52 0.08 5.08 1.72 000 53040 A Drainage of urethra abscess 6.36 11.42 6.38 0.49 18.27 13.23 090 53060 A Drainage of urethra abscess 2.62 NA 1.48 0.28 NA 4.38 010 53080 A Drainage of urinary leakage 6.25 NA 6.22 0.50 NA 12.97 090 53085 A Drainage of urinary leakage 10.21 NA 7.71 0.80 NA 18.72 090 53200 A Biopsy of urethra 2.58 4.35 0.99 0.20 7.13 3.77 000 53210 A Removal of urethra 12.50 NA 6.11 0.97 NA 19.58 090 53215 A Removal of urethra 15.49 NA 6.85 1.11 NA 23.45 090 53220 A Treatment of urethra lesion 6.96 NA 3.92 0.53 NA 11.41 090 53230 A Removal of urethra lesion 9.53 NA 4.89 0.72 NA 15.14 090 53235 A Removal of urethra lesion 10.08 NA 5.09 0.72 NA 15.89 090 53240 A Surgery for urethra pouch 6.41 NA 3.69 0.50 NA 10.60 090 53250 A Removal of urethra gland 5.86 NA 3.43 0.42 NA 9.71 090 53260 A Treatment of urethra lesion 2.96 3.32 1.83 0.28 6.56 5.07 010 53265 A Treatment of urethra lesion 3.10 NA 1.86 0.24 NA 5.20 010 Start Printed Page 63316 53270 A Removal of urethra gland 3.07 NA 1.91 0.25 NA 5.23 010 53275 A Repair of urethra defect 4.50 NA 2.30 0.34 NA 7.14 010 53400 A Revise urethra, stage 1 12.70 NA 6.17 1.02 NA 19.89 090 53405 A Revise urethra, stage 2 14.40 NA 6.53 1.09 NA 22.02 090 53410 A Reconstruction of urethra 16.35 NA 7.29 1.19 NA 24.83 090 53415 A Reconstruction of urethra 19.30 NA 7.58 1.39 NA 28.27 090 53420 A Reconstruct urethra, stage 1 14.00 NA 6.55 1.08 NA 21.63 090 53425 A Reconstruct urethra, stage 2 15.89 NA 7.12 1.16 NA 24.17 090 53430 A Reconstruction of urethra 16.25 NA 7.23 1.21 NA 24.69 090 53431 A Reconstruct urethra/bladder 19.78 NA 8.28 1.56 NA 29.62 090 53440 A Male sling procedure 13.54 NA 6.11 0.87 NA 20.52 090 53442 A Remove/revise male sling 11.50 NA 5.58 0.66 NA 17.74 090 53444 A Insert tandem cuff 13.32 NA 5.98 1.05 NA 20.35 090 53445 A Insert uro/ves nck sphincter 13.98 NA 7.34 1.01 NA 22.33 090 53446 A Remove uro sphincter 10.17 NA 5.34 0.80 NA 16.31 090 53447 A Remove/replace ur sphincter 13.41 NA 6.56 0.95 NA 20.92 090 53448 A Remov/replc ur sphinctr comp 21.03 NA 9.23 1.67 NA 31.93 090 53449 A Repair uro sphincter 9.64 NA 4.91 0.68 NA 15.23 090 53450 A Revision of urethra 6.11 NA 3.45 0.44 NA 10.00 090 53460 A Revision of urethra 7.08 NA 3.87 0.52 NA 11.47 090 53500 A Urethrlys, transvag w/ scope 12.14 NA 6.27 0.89 NA 19.30 090 53502 A Repair of urethra injury 7.59 NA 4.19 0.60 NA 12.38 090 53505 A Repair of urethra injury 7.59 NA 4.04 0.55 NA 12.18 090 53510 A Repair of urethra injury 10.05 NA 5.35 0.72 NA 16.12 090 53515 A Repair of urethra injury 13.23 NA 6.12 0.99 NA 20.34 090 53520 A Repair of urethra defect 8.63 NA 4.65 0.64 NA 13.92 090 53600 A Dilate urethra stricture 1.20 1.19 0.45 0.08 2.47 1.73 000 53601 A Dilate urethra stricture 0.97 1.32 0.39 0.07 2.36 1.43 000 53605 A Dilate urethra stricture 1.27 NA 0.42 0.10 NA 1.79 000 53620 A Dilate urethra stricture 1.61 2.06 0.62 0.12 3.79 2.35 000 53621 A Dilate urethra stricture 1.34 2.14 0.51 0.10 3.58 1.95 000 53660 A Dilation of urethra 0.71 1.36 0.33 0.05 2.12 1.09 000 53661 A Dilation of urethra 0.72 1.36 0.31 0.05 2.13 1.08 000 53665 A Dilation of urethra 0.76 NA 0.26 0.06 NA 1.08 000 53850 A Prostatic microwave thermotx 9.40 99.30 4.37 0.67 109.37 14.44 090 53852 A Prostatic rf thermotx 9.82 93.70 4.75 0.70 104.22 15.27 090 53853 A Prostatic water thermother 5.21 58.09 3.23 0.32 63.62 8.76 090 53899 C Urology surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54000 A Slitting of prepuce 1.53 NA 1.35 0.12 NA 3.00 010 54001 A Slitting of prepuce 2.18 4.35 1.53 0.17 6.70 3.88 010 54015 A Drain penis lesion 5.29 NA 2.61 0.40 NA 8.30 010 54050 A Destruction, penis lesion(s) 1.23 1.71 1.06 0.08 3.02 2.37 010 54055 A Destruction, penis lesion(s) 1.21 1.62 0.82 0.08 2.91 2.11 010 54056 A Cryosurgery, penis lesion(s) 1.23 2.50 1.39 0.07 3.80 2.69 010 54057 A Laser surg, penis lesion(s) 1.23 NA 0.88 0.10 NA 2.21 010 54060 A Excision of penis lesion(s) 1.92 3.92 1.47 0.14 5.98 3.53 010 54065 A Destruction, penis lesion(s) 2.41 NA 1.74 0.16 NA 4.31 010 54100 A Biopsy of penis 1.89 2.90 0.83 0.12 4.91 2.84 000 54105 A Biopsy of penis 3.48 NA 1.99 0.25 NA 5.72 010 54110 A Treatment of penis lesion 10.07 NA 5.71 0.72 NA 16.50 090 54111 A Treat penis lesion, graft 13.49 NA 6.77 0.95 NA 21.21 090 54112 A Treat penis lesion, graft 15.77 NA 7.78 1.13 NA 24.68 090 54115 A Treatment of penis lesion 6.11 8.61 4.52 0.47 15.19 11.10 090 54120 A Partial removal of penis 9.91 NA 5.67 0.72 NA 16.30 090 54125 A Removal of penis 13.45 NA 6.83 0.97 NA 21.25 090 54130 A Remove penis & nodes 20.03 NA 9.20 1.43 NA 30.66 090 54135 A Remove penis & nodes 26.21 NA 11.22 1.89 NA 39.32 090 54150 A Circumcision 1.80 NA 0.99 0.20 NA 2.99 010 54152 A Circumcision 2.30 NA 1.23 0.19 NA 3.72 010 54160 A Circumcision 2.47 NA 1.12 0.19 NA 3.78 010 54161 A Circumcision 3.25 NA 1.60 0.24 NA 5.09 010 54162 A Lysis penil circumic lesion 2.98 NA 2.03 0.24 NA 5.25 010 54163 A Repair of circumcision 2.98 NA 2.04 0.24 NA 5.26 010 54164 A Frenulotomy of penis 2.49 NA 1.88 0.19 NA 4.56 010 54200 A Treatment of penis lesion 1.05 1.87 1.02 0.07 2.99 2.14 010 54205 A Treatment of penis lesion 7.88 NA 4.89 0.56 NA 13.33 090 54220 A Treatment of penis lesion 2.41 3.98 0.97 0.18 6.57 3.56 000 54230 A Prepare penis study 1.33 1.13 0.64 0.10 2.56 2.07 000 54231 A Dynamic cavernosometry 2.03 1.42 0.88 0.17 3.62 3.08 000 54235 A Penile injection 1.18 0.99 0.60 0.08 2.25 1.86 000 54240 A Penis study 1.30 1.04 NA 0.16 2.50 NA 000 54240 26 A Penis study 1.30 0.43 0.43 0.10 1.83 1.83 000 54240 TC A Penis study 0.00 0.61 NA 0.06 0.67 NA 000 54250 A Penis study 2.21 0.93 NA 0.19 3.33 NA 000 54250 26 A Penis study 2.21 0.71 0.71 0.17 3.09 3.09 000 Start Printed Page 63317 54250 TC A Penis study 0.00 0.22 NA 0.02 0.24 NA 000 54300 A Revision of penis 10.35 NA 5.81 0.77 NA 16.93 090 54304 A Revision of penis 12.42 NA 6.62 0.89 NA 19.93 090 54308 A Reconstruction of urethra 11.76 NA 6.24 0.84 NA 18.84 090 54312 A Reconstruction of urethra 13.49 NA 7.28 0.97 NA 21.74 090 54316 A Reconstruction of urethra 16.72 NA 8.28 1.20 NA 26.20 090 54318 A Reconstruction of urethra 11.19 NA 6.06 1.38 NA 18.63 090 54322 A Reconstruction of urethra 12.94 NA 6.71 0.92 NA 20.57 090 54324 A Reconstruction of urethra 16.22 NA 8.31 1.23 NA 25.76 090 54326 A Reconstruction of urethra 15.63 NA 8.10 1.11 NA 24.84 090 54328 A Revise penis/urethra 15.56 NA 7.53 1.10 NA 24.19 090 54332 A Revise penis/urethra 16.98 NA 8.03 1.21 NA 26.22 090 54336 A Revise penis/urethra 19.93 NA 10.83 2.28 NA 33.04 090 54340 A Secondary urethral surgery 8.86 NA 5.32 0.86 NA 15.04 090 54344 A Secondary urethral surgery 15.85 NA 8.07 1.32 NA 25.24 090 54348 A Secondary urethral surgery 17.05 NA 8.71 1.22 NA 26.98 090 54352 A Reconstruct urethra/penis 24.60 NA 11.62 1.94 NA 38.16 090 54360 A Penis plastic surgery 11.86 NA 6.25 0.86 NA 18.97 090 54380 A Repair penis 13.10 NA 6.91 1.39 NA 21.40 090 54385 A Repair penis 15.30 NA 8.57 0.85 NA 24.72 090 54390 A Repair penis and bladder 21.49 NA 9.71 1.53 NA 32.73 090 54400 A Insert semi-rigid prosthesis 8.94 NA 4.52 0.64 NA 14.10 090 54401 A Insert self-contd prosthesis 10.22 NA 5.92 0.73 NA 16.87 090 54405 A Insert multi-comp penis pros 13.35 NA 6.13 0.96 NA 20.44 090 54406 A Remove muti-comp penis pros 12.03 NA 5.53 0.90 NA 18.46 090 54408 A Repair multi-comp penis pros 12.68 NA 5.84 0.95 NA 19.47 090 54410 A Remove/replace penis prosth 15.41 NA 6.75 1.15 NA 23.31 090 54411 A Remov/replc penis pros, comp 15.91 NA 7.17 0.96 NA 24.04 090 54415 A Remove self-contd penis pros 8.15 NA 4.29 0.65 NA 13.09 090 54416 A Remv/repl penis contain pros 10.81 NA 5.49 0.66 NA 16.96 090 54417 A Remv/replc penis pros, compl 14.11 NA 6.28 0.66 NA 21.05 090 54420 A Revision of penis 11.35 NA 5.78 0.86 NA 17.99 090 54430 A Revision of penis 10.09 NA 5.32 0.72 NA 16.13 090 54435 A Revision of penis 6.09 NA 3.78 0.43 NA 10.30 090 54440 C Repair of penis 0.00 0.00 0.00 0.00 0.00 0.00 090 54450 A Preputial stretching 1.11 1.12 0.48 0.08 2.31 1.67 000 54500 A Biopsy of testis 1.30 0.62 0.58 0.10 2.02 1.98 000 54505 A Biopsy of testis 3.44 NA 1.96 0.25 NA 5.65 010 54512 A Excise lesion testis 8.53 NA 4.21 0.67 NA 13.41 090 54520 A Removal of testis 5.20 NA 2.89 0.40 NA 8.49 090 54522 A Orchiectomy, partial 9.45 NA 4.97 0.74 NA 15.16 090 54530 A Removal of testis 8.53 NA 4.38 0.64 NA 13.55 090 54535 A Extensive testis surgery 12.09 NA 5.74 0.99 NA 18.82 090 54550 A Exploration for testis 7.74 NA 3.94 0.59 NA 12.27 090 54560 A Exploration for testis 11.07 NA 5.33 0.95 NA 17.35 090 54600 A Reduce testis torsion 6.97 NA 3.66 0.54 NA 11.17 090 54620 A Suspension of testis 4.87 NA 2.50 0.37 NA 7.74 010 54640 A Suspension of testis 6.86 NA 3.85 0.59 NA 11.30 090 54650 A Orchiopexy (Fowler-Stephens) 11.38 NA 5.60 0.97 NA 17.95 090 54660 A Revision of testis 5.08 NA 3.11 0.42 NA 8.61 090 54670 A Repair testis injury 6.37 NA 3.65 0.49 NA 10.51 090 54680 A Relocation of testis(es) 12.58 NA 6.36 1.13 NA 20.07 090 54690 A Laparoscopy, orchiectomy 10.90 NA 5.12 1.19 NA 17.21 090 54692 A Laparoscopy, orchiopexy 12.81 NA 5.52 1.04 NA 19.37 090 54699 C Laparoscope proc, testis 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54700 A Drainage of scrotum 3.41 NA 1.97 0.28 NA 5.66 010 54800 A Biopsy of epididymis 2.32 0.95 0.91 0.17 3.44 3.40 000 54820 A Exploration of epididymis 5.11 NA 3.05 0.40 NA 8.56 090 54830 A Remove epididymis lesion 5.35 NA 3.13 0.41 NA 8.89 090 54840 A Remove epididymis lesion 5.17 NA 2.88 0.37 NA 8.42 090 54860 A Removal of epididymis 6.28 NA 3.42 0.46 NA 10.16 090 54861 A Removal of epididymis 8.85 NA 4.44 0.62 NA 13.91 090 54900 A Fusion of spermatic ducts 13.12 NA 5.93 1.61 NA 20.66 090 54901 A Fusion of spermatic ducts 17.84 NA 7.65 2.19 NA 27.68 090 55000 A Drainage of hydrocele 1.42 2.13 0.65 0.12 3.67 2.19 000 55040 A Removal of hydrocele 5.33 NA 3.00 0.42 NA 8.75 090 55041 A Removal of hydroceles 7.70 NA 4.09 0.60 NA 12.39 090 55060 A Repair of hydrocele 5.49 NA 3.17 0.44 NA 9.10 090 55100 A Drainage of scrotum abscess 2.12 3.81 1.61 0.18 6.11 3.91 010 55110 A Explore scrotum 5.67 NA 3.22 0.43 NA 9.32 090 55120 A Removal of scrotum lesion 5.06 5.81 3.03 0.40 11.27 8.49 090 55150 A Removal of scrotum 7.18 NA 4.01 0.56 NA 11.75 090 55175 A Revision of scrotum 5.21 NA 3.11 0.40 NA 8.72 090 55180 A Revision of scrotum 10.66 NA 5.53 0.86 NA 17.05 090 55200 A Incision of sperm duct 4.22 5.58 2.45 0.30 10.10 6.97 090 Start Printed Page 63318 55250 A Removal of sperm duct(s) 3.27 9.14 2.82 0.25 12.66 6.34 090 55300 A Prepare, sperm duct x-ray 3.49 NA 1.33 0.24 NA 5.06 000 55400 A Repair of sperm duct 8.44 NA 4.24 0.60 NA 13.28 090 55450 A Ligation of sperm duct 4.10 7.26 1.91 0.29 11.65 6.30 010 55500 A Removal of hydrocele 5.56 NA 3.19 0.52 NA 9.27 090 55520 A Removal of sperm cord lesion 6.00 NA 3.34 0.67 NA 10.01 090 55530 A Revise spermatic cord veins 5.63 NA 3.11 0.43 NA 9.17 090 55535 A Revise spermatic cord veins 6.52 NA 3.50 0.50 NA 10.52 090 55540 A Revise hernia & sperm veins 7.63 NA 3.90 0.89 NA 12.42 090 55550 A Laparo ligate spermatic vein 6.53 NA 3.36 0.56 NA 10.45 090 55559 C Laparo proc, spermatic cord 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55600 A Incise sperm duct pouch 6.34 NA 3.44 0.46 NA 10.24 090 55605 A Incise sperm duct pouch 7.91 NA 4.42 0.65 NA 12.98 090 55650 A Remove sperm duct pouch 11.73 NA 5.42 0.86 NA 18.01 090 55680 A Remove sperm pouch lesion 5.16 NA 3.07 0.37 NA 8.60 090 55700 A Biopsy of prostate 1.56 4.37 0.72 0.12 6.05 2.40 000 55705 A Biopsy of prostate 4.54 NA 2.34 0.31 NA 7.19 010 55720 A Drainage of prostate abscess 7.60 NA 4.00 0.53 NA 12.13 090 55725 A Drainage of prostate abscess 8.63 NA 4.68 0.61 NA 13.92 090 55801 A Removal of prostate 17.70 NA 7.47 1.29 NA 26.46 090 55810 A Extensive prostate surgery 22.45 NA 8.82 1.62 NA 32.89 090 55812 A Extensive prostate surgery 27.35 NA 11.27 2.03 NA 40.65 090 55815 A Extensive prostate surgery 30.29 NA 12.20 2.21 NA 44.70 090 55821 A Removal of prostate 14.17 NA 6.39 1.02 NA 21.58 090 55831 A Removal of prostate 15.53 NA 6.85 1.13 NA 23.51 090 55840 A Extensive prostate surgery 22.56 NA 9.55 1.64 NA 33.75 090 55842 A Extensive prostate surgery 24.24 NA 10.11 1.77 NA 36.12 090 55845 A Extensive prostate surgery 28.39 NA 11.22 2.05 NA 41.66 090 55859 A Percut/needle insert, pros 12.45 NA 5.98 0.89 NA 19.32 090 55860 A Surgical exposure, prostate 14.37 NA 6.52 0.98 NA 21.87 090 55862 A Extensive prostate surgery 18.29 NA 8.07 1.37 NA 27.73 090 55865 A Extensive prostate surgery 22.74 NA 9.49 1.64 NA 33.87 090 55866 A Laparo radical prostatectomy 30.56 NA 11.95 1.64 NA 44.15 090 55870 A Electroejaculation 2.57 1.58 1.10 0.17 4.32 3.84 000 55873 A Cryoablate prostate 19.36 NA 9.12 1.22 NA 29.70 090 55899 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55970 N Sex transformation, M to F 0.00 0.00 0.00 0.00 0.00 0.00 XXX 55980 N Sex transformation, F to M 0.00 0.00 0.00 0.00 0.00 0.00 XXX 56405 A I & D of vulva/perineum 1.43 1.36 1.17 0.17 2.96 2.77 010 56420 A Drainage of gland abscess 1.38 2.34 1.10 0.16 3.88 2.64 010 56440 A Surgery for vulva lesion 2.82 NA 1.74 0.34 NA 4.90 010 56441 A Lysis of labial lesion(s) 1.96 1.86 1.45 0.20 4.02 3.61 010 56501 A Destroy, vulva lesions, sim 1.52 1.83 1.29 0.18 3.53 2.99 010 56515 A Destroy vulva lesion/s compl 2.74 2.60 1.87 0.22 5.56 4.83 010 56605 A Biopsy of vulva/perineum 1.09 1.11 0.47 0.13 2.33 1.69 000 56606 A Biopsy of vulva/perineum 0.55 0.51 0.22 0.07 1.13 0.84 ZZZ 56620 A Partial removal of vulva 7.43 NA 5.06 0.91 NA 13.40 090 56625 A Complete removal of vulva 8.35 NA 5.66 1.01 NA 15.02 090 56630 A Extensive vulva surgery 12.29 NA 7.32 1.47 NA 21.08 090 56631 A Extensive vulva surgery 16.11 NA 9.38 1.95 NA 27.44 090 56632 A Extensive vulva surgery 20.17 NA 10.07 2.43 NA 32.67 090 56633 A Extensive vulva surgery 16.38 NA 9.16 1.99 NA 27.53 090 56634 A Extensive vulva surgery 17.78 NA 10.04 2.13 NA 29.95 090 56637 A Extensive vulva surgery 21.84 NA 11.70 2.61 NA 36.15 090 56640 A Extensive vulva surgery 22.04 NA 11.12 2.71 NA 35.87 090 56700 A Partial removal of hymen 2.51 NA 1.77 0.29 NA 4.57 010 56720 A Incision of hymen 0.68 NA 0.41 0.08 NA 1.17 000 56740 A Remove vagina gland lesion 4.54 NA 2.51 0.44 NA 7.49 010 56800 A Repair of vagina 3.87 NA 2.23 0.44 NA 6.54 010 56805 A Repair clitoris 18.75 NA 9.55 2.18 NA 30.48 090 56810 A Repair of perineum 4.11 NA 2.34 0.49 NA 6.94 010 56820 A Exam of vulva w/scope 1.49 1.39 0.64 0.12 3.00 2.25 000 56821 A Exam/biopsy of vulva w/scope 2.04 1.82 0.91 0.16 4.02 3.11 000 57000 A Exploration of vagina 2.95 NA 1.77 0.34 NA 5.06 010 57010 A Drainage of pelvic abscess 6.00 NA 3.93 0.68 NA 10.61 090 57020 A Drainage of pelvic fluid 1.49 0.97 0.61 0.18 2.64 2.28 000 57022 A I & d vaginal hematoma, pp 2.55 NA 1.54 0.29 NA 4.38 010 57023 A I & d vag hematoma, non-ob 4.72 NA 2.64 0.29 NA 7.65 010 57061 A Destroy vag lesions, simple 1.24 1.70 1.16 0.16 3.10 2.56 010 57065 A Destroy vag lesions, complex 2.60 2.36 1.75 0.31 5.27 4.66 010 57100 A Biopsy of vagina 1.19 1.13 0.49 0.12 2.44 1.80 000 57105 A Biopsy of vagina 1.68 1.99 1.37 0.20 3.87 3.25 010 57106 A Remove vagina wall, partial 6.32 NA 4.37 0.70 NA 11.39 090 57107 A Remove vagina tissue, part 22.87 NA 10.76 2.60 NA 36.23 090 57109 A Vaginectomy partial w/nodes 26.85 NA 11.55 2.36 NA 40.76 090 Start Printed Page 63319 57110 A Remove vagina wall, complete 14.21 NA 7.44 1.71 NA 23.36 090 57111 A Remove vagina tissue, compl 26.85 NA 12.84 3.25 NA 42.94 090 57112 A Vaginectomy w/nodes, compl 28.83 NA 12.38 2.62 NA 43.83 090 57120 A Closure of vagina 7.37 NA 4.71 0.90 NA 12.98 090 57130 A Remove vagina lesion 2.42 2.22 1.59 0.28 4.92 4.29 010 57135 A Remove vagina lesion 2.65 2.31 1.69 0.31 5.27 4.65 010 57150 A Treat vagina infection 0.55 1.12 0.22 0.07 1.74 0.84 000 57155 A Insert uteri tandems/ovoids 6.23 NA 4.31 0.71 NA 11.25 090 57160 A Insert pessary/other device 0.88 1.11 0.40 0.11 2.10 1.39 000 57170 A Fitting of diaphragm/cap 0.90 1.52 0.34 0.11 2.53 1.35 000 57180 A Treat vaginal bleeding 1.57 2.26 1.35 0.19 4.02 3.11 010 57200 A Repair of vagina 3.92 NA 2.98 0.46 NA 7.36 090 57210 A Repair vagina/perineum 5.14 NA 3.51 0.60 NA 9.25 090 57220 A Revision of urethra 4.29 NA 3.19 0.50 NA 7.98 090 57230 A Repair of urethral lesion 5.61 NA 3.47 0.60 NA 9.68 090 57240 A Repair bladder & vagina 6.04 NA 3.90 0.64 NA 10.58 090 57250 A Repair rectum & vagina 5.50 NA 3.65 0.65 NA 9.80 090 57260 A Repair of vagina 8.22 NA 4.93 0.99 NA 14.14 090 57265 A Extensive repair of vagina 11.28 NA 6.16 1.37 NA 18.81 090 57268 A Repair of bowel bulge 6.72 NA 4.30 0.79 NA 11.81 090 57270 A Repair of bowel pouch 12.04 NA 6.39 1.40 NA 19.83 090 57280 A Suspension of vagina 14.95 NA 7.51 1.73 NA 24.19 090 57282 A Repair of vaginal prolapse 8.81 NA 5.41 1.03 NA 15.25 090 57284 A Repair paravaginal defect 12.63 NA 7.29 1.40 NA 21.32 090 57287 A Revise/remove sling repair 10.65 NA 5.60 0.89 NA 17.14 090 57288 A Repair bladder defect 12.95 NA 6.02 1.03 NA 20.00 090 57289 A Repair bladder & vagina 11.51 NA 6.16 1.14 NA 18.81 090 57291 A Construction of vagina 7.90 NA 5.04 0.93 NA 13.87 090 57292 A Construct vagina with graft 13.02 NA 7.11 1.55 NA 21.68 090 57300 A Repair rectum-vagina fistula 7.57 NA 4.37 0.84 NA 12.78 090 57305 A Repair rectum-vagina fistula 13.69 NA 6.37 1.59 NA 21.65 090 57307 A Fistula repair & colostomy 15.84 NA 7.14 1.91 NA 24.89 090 57308 A Fistula repair, transperine 9.88 NA 5.24 1.09 NA 16.21 090 57310 A Repair urethrovaginal lesion 6.74 NA 3.95 0.54 NA 11.23 090 57311 A Repair urethrovaginal lesion 7.93 NA 4.28 0.61 NA 12.82 090 57320 A Repair bladder-vagina lesion 7.96 NA 4.51 0.72 NA 13.19 090 57330 A Repair bladder-vagina lesion 12.28 NA 5.87 1.03 NA 19.18 090 57335 A Repair vagina 18.62 NA 9.31 1.99 NA 29.92 090 57400 A Dilation of vagina 2.26 NA 1.15 0.26 NA 3.67 000 57410 A Pelvic examination 1.74 2.05 0.90 0.17 3.96 2.81 000 57415 A Remove vaginal foreign body 2.16 NA 1.46 0.23 NA 3.85 010 57420 A Exam of vagina w/scope 1.59 1.43 0.68 0.12 3.14 2.39 000 57421 A Exam/biopsy of vag w/scope 2.19 1.92 0.97 0.16 4.27 3.32 000 57425 A Laparoscopy, surg, colpopexy 15.66 NA 6.76 1.73 NA 24.15 090 57452 A Exam of cervix w/scope 1.49 1.45 0.64 0.12 3.06 2.25 000 57454 A Bx/curett of cervix w/scope 2.32 1.80 1.01 0.16 4.28 3.49 000 57455 A Biopsy of cervix w/scope 1.98 1.80 0.88 0.16 3.94 3.02 000 57456 A Endocerv curettage w/scope 1.84 1.72 0.83 0.16 3.72 2.83 000 57460 A Bx of cervix w/scope, leep 2.81 6.18 1.23 0.34 9.33 4.38 000 57461 A Conz of cervix w/scope, leep 3.42 6.43 1.42 0.34 10.19 5.18 000 57500 A Biopsy of cervix 0.96 2.73 0.48 0.12 3.81 1.56 000 57505 A Endocervical curettage 1.13 1.51 1.13 0.14 2.78 2.40 010 57510 A Cauterization of cervix 1.89 1.60 1.06 0.22 3.71 3.17 010 57511 A Cryocautery of cervix 1.89 1.87 1.41 0.22 3.98 3.52 010 57513 A Laser surgery of cervix 1.89 1.92 1.44 0.23 4.04 3.56 010 57520 A Conization of cervix 4.02 5.00 2.84 0.49 9.51 7.35 090 57522 A Conization of cervix 3.34 4.46 2.74 0.41 8.21 6.49 090 57530 A Removal of cervix 4.76 NA 3.52 0.58 NA 8.86 090 57531 A Removal of cervix, radical 27.84 NA 13.51 2.95 NA 44.30 090 57540 A Removal of residual cervix 12.15 NA 6.38 1.45 NA 19.98 090 57545 A Remove cervix/repair pelvis 12.96 NA 6.83 1.56 NA 21.35 090 57550 A Removal of residual cervix 5.50 NA 3.93 0.66 NA 10.09 090 57555 A Remove cervix/repair vagina 8.90 NA 5.23 1.07 NA 15.20 090 57556 A Remove cervix, repair bowel 8.32 NA 4.96 0.96 NA 14.24 090 57700 A Revision of cervix 3.53 NA 3.16 0.40 NA 7.09 090 57720 A Revision of cervix 4.11 NA 3.21 0.49 NA 7.81 090 57800 A Dilation of cervical canal 0.77 0.78 0.49 0.10 1.65 1.36 000 57820 A D & c of residual cervix 1.66 1.51 1.16 0.20 3.37 3.02 010 58100 A Biopsy of uterus lining 1.52 1.36 0.73 0.08 2.96 2.33 000 58120 A Dilation and curettage 3.25 2.35 1.91 0.40 6.00 5.56 010 58140 A Myomectomy abdom method 14.52 NA 7.22 1.75 NA 23.49 090 58145 A Myomectomy vag method 7.99 NA 4.91 0.96 NA 13.86 090 58146 A Myomectomy abdom complex 18.89 NA 8.89 1.75 NA 29.53 090 58150 A Total hysterectomy 15.15 NA 7.64 1.88 NA 24.67 090 58152 A Total hysterectomy 20.48 NA 10.02 1.82 NA 32.32 090 Start Printed Page 63320 58180 A Partial hysterectomy 15.20 NA 7.61 1.85 NA 24.66 090 58200 A Extensive hysterectomy 21.47 NA 10.29 2.58 NA 34.34 090 58210 A Extensive hysterectomy 28.69 NA 13.63 3.49 NA 45.81 090 58240 A Removal of pelvis contents 38.17 NA 18.22 4.51 NA 60.90 090 58260 A Vaginal hysterectomy 12.91 NA 6.82 1.47 NA 21.20 090 58262 A Vag hyst including t/o 14.69 NA 7.51 1.70 NA 23.90 090 58263 A Vag hyst w/t/o & vag repair 15.97 NA 8.03 1.86 NA 25.86 090 58267 A Vag hyst w/urinary repair 16.94 NA 8.52 1.81 NA 27.27 090 58270 A Vag hyst w/enterocele repair 14.18 NA 7.19 1.64 NA 23.01 090 58275 A Hysterectomy/revise vagina 15.67 NA 7.91 1.81 NA 25.39 090 58280 A Hysterectomy/revise vagina 16.91 NA 8.40 1.85 NA 27.16 090 58285 A Extensive hysterectomy 22.13 NA 10.33 2.25 NA 34.71 090 58290 A Vag hyst complex 18.89 NA 9.01 1.47 NA 29.37 090 58291 A Vag hyst incl t/o, complex 20.67 NA 10.01 1.70 NA 32.38 090 58292 A Vag hyst t/o & repair, compl 21.95 NA 10.55 1.86 NA 34.36 090 58293 A Vag hyst w/uro repair, compl 22.93 NA 11.04 1.81 NA 35.78 090 58294 A Vag hyst w/enterocele, compl 20.16 NA 9.79 1.64 NA 31.59 090 58300 N Insert intrauterine device +1.00 1.43 0.39 0.12 2.55 1.51 XXX 58301 A Remove intrauterine device 1.26 1.36 0.49 0.16 2.78 1.91 000 58321 A Artificial insemination 0.91 1.18 0.38 0.12 2.21 1.41 000 58322 A Artificial insemination 1.09 1.23 0.42 0.13 2.45 1.64 000 58323 A Sperm washing 0.23 0.24 0.10 0.02 0.49 0.35 000 58340 A Catheter for hysterography 0.87 6.20 0.65 0.10 7.17 1.62 000 58345 A Reopen fallopian tube 4.63 NA 2.46 0.43 NA 7.52 010 58346 A Insert heyman uteri capsule 6.71 NA 4.02 0.77 NA 11.50 090 58350 A Reopen fallopian tube 1.00 1.53 0.94 0.12 2.65 2.06 010 58353 A Endometr ablate, thermal 3.54 37.17 2.08 0.44 41.15 6.06 010 58400 A Suspension of uterus 6.32 NA 4.06 0.74 NA 11.12 090 58410 A Suspension of uterus 12.66 NA 6.57 1.31 NA 20.54 090 58520 A Repair of ruptured uterus 11.85 NA 6.12 1.40 NA 19.37 090 58540 A Revision of uterus 14.56 NA 7.07 1.53 NA 23.16 090 58545 A Laparoscopic myomectomy 14.52 NA 7.31 1.74 NA 23.57 090 58546 A Laparo-myomectomy, complex 18.89 NA 9.12 1.74 NA 29.75 090 58550 A Laparo-asst vag hysterectomy 14.11 NA 7.44 1.73 NA 23.28 090 58552 A Laparo-vag hyst incl t/o 14.11 NA 7.42 1.73 NA 23.26 090 58553 A Laparo-vag hyst, complex 18.89 NA 9.08 1.47 NA 29.44 090 58554 A Laparo-vag hyst w/t/o, compl 18.89 NA 9.38 1.47 NA 29.74 090 58555 A Hysteroscopy, dx, sep proc 3.31 2.13 1.48 0.41 5.85 5.20 000 58558 A Hysteroscopy, biopsy 4.72 NA 2.09 0.59 NA 7.40 000 58559 A Hysteroscopy, lysis 6.13 NA 2.65 0.74 NA 9.52 000 58560 A Hysteroscopy, resect septum 6.96 NA 3.01 0.85 NA 10.82 000 58561 A Hysteroscopy, remove myoma 9.94 NA 4.23 1.22 NA 15.39 000 58562 A Hysteroscopy, remove fb 5.18 NA 2.23 0.62 NA 8.03 000 58563 A Hysteroscopy, ablation 6.13 NA 2.67 0.74 NA 9.54 000 58578 C Laparo proc, uterus 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58579 C Hysteroscope procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58600 A Division of fallopian tube 5.57 NA 3.41 0.47 NA 9.45 090 58605 A Division of fallopian tube 4.97 NA 3.20 0.40 NA 8.57 090 58611 A Ligate oviduct(s) add-on 1.44 NA 0.58 0.08 NA 2.10 ZZZ 58615 A Occlude fallopian tube(s) 3.88 NA 2.77 0.48 NA 7.13 010 58660 A Laparoscopy, lysis 11.23 NA 5.35 1.37 NA 17.95 090 58661 A Laparoscopy, remove adnexa 10.99 NA 5.22 1.34 NA 17.55 010 58662 A Laparoscopy, excise lesions 11.72 NA 5.88 1.41 NA 19.01 090 58670 A Laparoscopy, tubal cautery 5.57 NA 3.33 0.66 NA 9.56 090 58671 A Laparoscopy, tubal block 5.57 NA 3.34 0.67 NA 9.58 090 58672 A Laparoscopy, fimbrioplasty 12.81 NA 6.30 1.46 NA 20.57 090 58673 A Laparoscopy, salpingostomy 13.66 NA 6.71 1.68 NA 22.05 090 58679 C Laparo proc, oviduct-ovary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58700 A Removal of fallopian tube 11.98 NA 6.09 0.77 NA 18.84 090 58720 A Removal of ovary/tube(s) 11.30 NA 5.91 1.37 NA 18.58 090 58740 A Revise fallopian tube(s) 13.92 NA 7.28 0.71 NA 21.91 090 58750 A Repair oviduct 14.76 NA 7.50 1.82 NA 24.08 090 58752 A Revise ovarian tube(s) 14.76 NA 7.16 1.81 NA 23.73 090 58760 A Remove tubal obstruction 13.06 NA 6.84 1.61 NA 21.51 090 58770 A Create new tubal opening 13.89 NA 7.06 1.70 NA 22.65 090 58800 A Drainage of ovarian cyst(s) 4.12 4.55 3.04 0.43 9.10 7.59 090 58805 A Drainage of ovarian cyst(s) 5.85 NA 3.59 0.67 NA 10.11 090 58820 A Drain ovary abscess, open 4.20 NA 3.38 0.35 NA 7.93 090 58822 A Drain ovary abscess, percut 10.07 NA 5.32 1.10 NA 16.49 090 58823 A Drain pelvic abscess, percut 3.36 NA 1.14 0.22 NA 4.72 000 58825 A Transposition, ovary(s) 10.92 NA 5.91 0.74 NA 17.57 090 58900 A Biopsy of ovary(s) 5.96 NA 3.67 0.67 NA 10.30 090 58920 A Partial removal of ovary(s) 11.30 NA 5.70 0.82 NA 17.82 090 58925 A Removal of ovarian cyst(s) 11.30 NA 5.79 1.37 NA 18.46 090 58940 A Removal of ovary(s) 7.25 NA 4.20 0.87 NA 12.32 090 Start Printed Page 63321 58943 A Removal of ovary(s) 18.32 NA 8.94 2.23 NA 29.49 090 58950 A Resect ovarian malignancy 16.83 NA 8.77 1.86 NA 27.46 090 58951 A Resect ovarian malignancy 22.25 NA 10.83 2.64 NA 35.72 090 58952 A Resect ovarian malignancy 24.87 NA 12.21 3.08 NA 40.16 090 58953 A Tah, rad dissect for debulk 31.82 NA 14.92 3.96 NA 50.70 090 58954 A Tah rad debulk/lymph remove 34.80 NA 16.08 4.27 NA 55.15 090 58960 A Exploration of abdomen 14.57 NA 7.68 1.76 NA 24.01 090 58970 A Retrieval of oocyte 3.51 2.35 1.53 0.43 6.29 5.47 000 58974 C Transfer of embryo 0.00 0.00 0.00 0.00 0.00 0.00 000 58976 A Transfer of embryo 3.81 2.67 1.85 0.47 6.95 6.13 000 58999 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59000 A Amniocentesis, diagnostic 1.29 2.14 0.69 0.28 3.71 2.26 000 59001 A Amniocentesis, therapeutic 2.98 NA 1.43 0.28 NA 4.69 000 59012 A Fetal cord puncture,prenatal 3.43 NA 1.58 0.74 NA 5.75 000 59015 A Chorion biopsy 2.19 1.60 1.07 0.48 4.27 3.74 000 59020 A Fetal contract stress test 0.66 0.79 NA 0.24 1.69 NA 000 59020 26 A Fetal contract stress test 0.66 0.27 0.27 0.14 1.07 1.07 000 59020 TC A Fetal contract stress test 0.00 0.52 NA 0.10 0.62 NA 000 59025 A Fetal non-stress test 0.53 0.44 NA 0.14 1.11 NA 000 59025 26 A Fetal non-stress test 0.53 0.21 0.21 0.12 0.86 0.86 000 59025 TC A Fetal non-stress test 0.00 0.23 NA 0.02 0.25 NA 000 59030 A Fetal scalp blood sample 1.98 NA 1.05 0.43 NA 3.46 000 59050 A Fetal monitor w/report 0.88 NA 0.36 0.19 NA 1.43 XXX 59051 A Fetal monitor/interpret only 0.74 NA 0.30 0.17 NA 1.21 XXX 59070 A Transabdom amnioinfus w/ us 5.22 5.19 2.43 0.28 10.69 7.93 000 59072 A Umbilical cord occlud w/ us 8.95 NA 3.17 0.67 NA 12.79 000 59074 A Fetal fluid drainage w/ us 5.22 4.66 2.43 0.28 10.16 7.93 000 59076 A Fetal shunt placement, w/ us 8.95 NA 3.17 0.67 NA 12.79 000 59100 A Remove uterus lesion 12.28 NA 6.57 2.65 NA 21.50 090 59120 A Treat ectopic pregnancy 11.42 NA 6.36 2.47 NA 20.25 090 59121 A Treat ectopic pregnancy 11.60 NA 6.43 2.51 NA 20.54 090 59130 A Treat ectopic pregnancy 14.14 NA 5.08 3.04 NA 22.26 090 59135 A Treat ectopic pregnancy 13.80 NA 7.34 2.98 NA 24.12 090 59136 A Treat ectopic pregnancy 13.10 NA 6.72 2.83 NA 22.65 090 59140 A Treat ectopic pregnancy 5.43 5.29 3.65 1.17 11.89 10.25 090 59150 A Treat ectopic pregnancy 11.60 NA 6.13 1.47 NA 19.20 090 59151 A Treat ectopic pregnancy 11.42 NA 6.17 1.69 NA 19.28 090 59160 A D & c after delivery 2.69 3.31 2.14 0.59 6.59 5.42 010 59200 A Insert cervical dilator 0.79 1.24 0.31 0.18 2.21 1.28 000 59300 A Episiotomy or vaginal repair 2.40 2.19 0.97 0.52 5.11 3.89 000 59320 A Revision of cervix 2.47 NA 1.28 0.54 NA 4.29 000 59325 A Revision of cervix 4.05 NA 1.94 0.87 NA 6.86 000 59350 A Repair of uterus 4.92 NA 1.97 1.05 NA 7.94 000 59400 A Obstetrical care 22.93 NA 15.73 4.96 NA 43.62 MMM 59409 A Obstetrical care 13.42 NA 5.37 2.90 NA 21.69 MMM 59410 A Obstetrical care 14.70 NA 6.40 3.18 NA 24.28 MMM 59412 A Antepartum manipulation 1.70 NA 0.82 0.37 NA 2.89 MMM 59414 A Deliver placenta 1.60 NA 0.64 0.35 NA 2.59 MMM 59425 A Antepartum care only 4.78 4.34 1.88 1.03 10.15 7.69 MMM 59426 A Antepartum care only 8.23 7.78 3.25 1.79 17.80 13.27 MMM 59430 A Care after delivery 2.12 1.26 0.95 0.46 3.84 3.53 MMM 59510 A Cesarean delivery 26.07 NA 17.69 5.63 NA 49.39 MMM 59514 A Cesarean delivery only 15.88 NA 6.29 3.43 NA 25.60 MMM 59515 A Cesarean delivery 17.27 NA 7.97 3.74 NA 28.98 MMM 59525 A Remove uterus after cesarean 8.49 NA 3.34 1.83 NA 13.66 ZZZ 59610 A Vbac delivery 24.48 NA 16.29 5.29 NA 46.06 MMM 59612 A Vbac delivery only 14.97 NA 6.13 3.24 NA 24.34 MMM 59614 A Vbac care after delivery 16.25 NA 7.04 3.51 NA 26.80 MMM 59618 A Attempted vbac delivery 27.62 NA 18.81 5.97 NA 52.40 MMM 59620 A Attempted vbac delivery only 17.43 NA 6.85 3.78 NA 28.06 MMM 59622 A Attempted vbac after care 18.82 NA 8.77 4.06 NA 31.65 MMM 59812 A Treatment of miscarriage 3.99 NA 2.60 0.70 NA 7.29 090 59820 A Care of miscarriage 3.99 NA 3.59 0.86 NA 8.44 090 59821 A Treatment of miscarriage 4.44 NA 3.51 0.96 NA 8.91 090 59830 A Treat uterus infection 6.08 NA 4.08 1.32 NA 11.48 090 59840 R Abortion 2.99 NA 2.16 0.65 NA 5.80 010 59841 R Abortion 5.21 2.60 2.60 1.13 8.94 8.94 010 59850 R Abortion 5.88 NA 3.30 1.27 NA 10.45 090 59851 R Abortion 5.90 NA 3.79 1.27 NA 10.96 090 59852 R Abortion 8.19 NA 5.40 1.77 NA 15.36 090 59855 R Abortion 6.09 NA 3.62 1.32 NA 11.03 090 59856 R Abortion 7.44 NA 4.12 1.61 NA 13.17 090 59857 R Abortion 9.24 NA 4.63 1.99 NA 15.86 090 59866 R Abortion (mpr) 3.98 NA 1.85 0.86 NA 6.69 000 59870 A Evacuate mole of uterus 5.98 NA 4.51 0.92 NA 11.41 090 Start Printed Page 63322 59871 A Remove cerclage suture 2.12 1.79 1.15 0.46 4.37 3.73 000 59897 C Fetal invas px w/ us 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59898 C Laparo proc, ob care/deliver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59899 C Maternity care procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60000 A Drain thyroid/tongue cyst 1.75 2.20 2.07 0.17 4.12 3.99 010 60001 A Aspirate/inject thyriod cyst 0.96 1.52 0.35 0.07 2.55 1.38 000 60100 A Biopsy of thyroid 1.55 1.44 0.54 0.06 3.05 2.15 000 60200 A Remove thyroid lesion 9.50 NA 6.18 1.01 NA 16.69 090 60210 A Partial thyroid excision 10.82 NA 5.83 1.21 NA 17.86 090 60212 A Partial thyroid excision 15.94 NA 7.88 1.81 NA 25.63 090 60220 A Partial removal of thyroid 11.83 NA 6.35 1.16 NA 19.34 090 60225 A Partial removal of thyroid 14.11 NA 7.62 1.57 NA 23.30 090 60240 A Removal of thyroid 15.97 NA 7.82 1.80 NA 25.59 090 60252 A Removal of thyroid 20.45 NA 10.39 1.95 NA 32.79 090 60254 A Extensive thyroid surgery 26.84 NA 14.52 2.35 NA 43.71 090 60260 A Repeat thyroid surgery 17.37 NA 8.93 1.67 NA 27.97 090 60270 A Removal of thyroid 20.15 NA 10.57 2.13 NA 32.85 090 60271 A Removal of thyroid 16.73 NA 8.82 1.62 NA 27.17 090 60280 A Remove thyroid duct lesion 5.84 NA 4.88 0.54 NA 11.26 090 60281 A Remove thyroid duct lesion 8.48 NA 6.05 0.80 NA 15.33 090 60500 A Explore parathyroid glands 16.14 NA 7.60 1.93 NA 25.67 090 60502 A Re-explore parathyroids 20.23 NA 9.58 2.40 NA 32.21 090 60505 A Explore parathyroid glands 21.37 NA 11.08 2.57 NA 35.02 090 60512 A Autotransplant parathyroid 4.42 NA 1.64 0.53 NA 6.59 ZZZ 60520 A Removal of thymus gland 16.71 NA 8.28 2.21 NA 27.20 090 60521 A Removal of thymus gland 18.76 NA 9.29 2.80 NA 30.85 090 60522 A Removal of thymus gland 22.96 NA 11.00 3.39 NA 37.35 090 60540 A Explore adrenal gland 16.93 NA 7.72 1.70 NA 26.35 090 60545 A Explore adrenal gland 19.77 NA 8.68 2.10 NA 30.55 090 60600 A Remove carotid body lesion 17.83 NA 10.90 2.24 NA 30.97 090 60605 A Remove carotid body lesion 20.12 NA 12.83 2.73 NA 35.68 090 60650 A Laparoscopy adrenalectomy 19.89 NA 8.08 2.37 NA 30.34 090 60659 C Laparo proc, endocrine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60699 C Endocrine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 61000 A Remove cranial cavity fluid 1.57 NA 0.97 0.16 NA 2.70 000 61001 A Remove cranial cavity fluid 1.48 NA 1.08 0.18 NA 2.74 000 61020 A Remove brain cavity fluid 1.50 NA 1.38 0.31 NA 3.19 000 61026 A Injection into brain canal 1.68 NA 1.45 0.25 NA 3.38 000 61050 A Remove brain canal fluid 1.50 NA 1.28 0.16 NA 2.94 000 61055 A Injection into brain canal 2.09 NA 1.44 0.16 NA 3.69 000 61070 A Brain canal shunt procedure 0.88 NA 1.05 0.11 NA 2.04 000 61105 A Twist drill hole 5.11 NA 4.01 1.26 NA 10.38 090 61107 A Drill skull for implantation 4.97 NA 3.36 1.22 NA 9.55 000 61108 A Drill skull for drainage 10.13 NA 7.25 2.45 NA 19.83 090 61120 A Burr hole for puncture 8.71 NA 6.09 2.17 NA 16.97 090 61140 A Pierce skull for biopsy 15.81 NA 10.04 3.78 NA 29.63 090 61150 A Pierce skull for drainage 17.47 NA 10.54 4.22 NA 32.23 090 61151 A Pierce skull for drainage 12.35 NA 7.95 2.94 NA 23.24 090 61154 A Pierce skull & remove clot 14.90 NA 9.64 3.66 NA 28.20 090 61156 A Pierce skull for drainage 16.23 NA 9.98 4.10 NA 30.31 090 61210 A Pierce skull, implant device 5.81 NA 3.76 1.39 NA 10.96 000 61215 A Insert brain-fluid device 4.86 NA 4.08 1.19 NA 10.13 090 61250 A Pierce skull & explore 10.36 NA 6.96 2.42 NA 19.74 090 61253 A Pierce skull & explore 12.29 NA 7.84 2.71 NA 22.84 090 61304 A Open skull for exploration 21.83 NA 13.04 5.19 NA 40.06 090 61305 A Open skull for exploration 26.46 NA 15.56 6.29 NA 48.31 090 61312 A Open skull for drainage 24.43 NA 15.27 5.98 NA 45.68 090 61313 A Open skull for drainage 24.79 NA 15.04 6.08 NA 45.91 090 61314 A Open skull for drainage 24.09 NA 13.26 4.79 NA 42.14 090 61315 A Open skull for drainage 27.52 NA 16.26 6.74 NA 50.52 090 61316 A Implt cran bone flap to abdo 1.38 NA 0.58 0.52 NA 2.48 ZZZ 61320 A Open skull for drainage 25.47 NA 14.98 6.23 NA 46.68 090 61321 A Open skull for drainage 28.34 NA 16.37 6.41 NA 51.12 090 61322 A Decompressive craniotomy 29.33 NA 14.64 5.98 NA 49.95 090 61323 A Decompressive lobectomy 30.82 NA 14.82 5.98 NA 51.62 090 61330 A Decompress eye socket 23.19 NA 13.95 3.09 NA 40.23 090 61332 A Explore/biopsy eye socket 27.12 NA 15.84 4.97 NA 47.93 090 61333 A Explore orbit/remove lesion 27.79 NA 15.83 2.68 NA 46.30 090 61334 A Explore orbit/remove object 18.17 NA 10.82 3.62 NA 32.61 090 61340 A Subtemporal decompression 18.55 NA 11.30 4.39 NA 34.24 090 61343 A Incise skull (press relief) 29.60 NA 17.09 7.24 NA 53.93 090 61345 A Relieve cranial pressure 27.04 NA 15.66 6.27 NA 48.97 090 61440 A Incise skull for surgery 26.48 NA 14.46 6.68 NA 47.62 090 61450 A Incise skull for surgery 25.80 NA 14.53 6.12 NA 46.45 090 61458 A Incise skull for brain wound 27.13 NA 15.77 6.33 NA 49.23 090 Start Printed Page 63323 61460 A Incise skull for surgery 28.23 NA 16.68 6.15 NA 51.06 090 61470 A Incise skull for surgery 25.91 NA 14.08 5.57 NA 45.56 090 61480 A Incise skull for surgery 26.34 NA 15.53 6.64 NA 48.51 090 61490 A Incise skull for surgery 25.51 NA 14.57 6.44 NA 46.52 090 61500 A Removal of skull lesion 17.82 NA 10.99 3.91 NA 32.72 090 61501 A Remove infected skull bone 14.76 NA 9.37 3.15 NA 27.28 090 61510 A Removal of brain lesion 28.29 NA 16.97 6.92 NA 52.18 090 61512 A Remove brain lining lesion 34.89 NA 19.99 8.56 NA 63.44 090 61514 A Removal of brain abscess 25.12 NA 14.68 6.14 NA 45.94 090 61516 A Removal of brain lesion 24.47 NA 14.51 5.92 NA 44.90 090 61517 A Implt brain chemotx add-on 1.37 NA 0.57 0.10 NA 2.04 ZZZ 61518 A Removal of brain lesion 37.11 NA 21.45 9.03 NA 67.59 090 61519 A Remove brain lining lesion 41.15 NA 23.01 9.77 NA 73.93 090 61520 A Removal of brain lesion 54.53 NA 30.81 12.11 NA 97.45 090 61521 A Removal of brain lesion 44.23 NA 24.61 10.61 NA 79.45 090 61522 A Removal of brain abscess 29.28 NA 16.70 6.35 NA 52.33 090 61524 A Removal of brain lesion 27.70 NA 15.93 6.00 NA 49.63 090 61526 A Removal of brain lesion 51.87 NA 29.95 8.05 NA 89.87 090 61530 A Removal of brain lesion 43.61 NA 25.47 7.40 NA 76.48 090 61531 A Implant brain electrodes 14.55 NA 9.30 3.40 NA 27.25 090 61533 A Implant brain electrodes 19.60 NA 11.75 4.55 NA 35.90 090 61534 A Removal of brain lesion 20.85 NA 12.31 4.97 NA 38.13 090 61535 A Remove brain electrodes 11.56 NA 7.56 2.74 NA 21.86 090 61536 A Removal of brain lesion 35.32 NA 20.11 8.01 NA 63.44 090 61537 A Removal of brain tissue 24.86 NA 14.63 6.45 NA 45.94 090 61538 A Removal of brain tissue 26.66 NA 15.58 6.45 NA 48.69 090 61539 A Removal of brain tissue 31.90 NA 18.07 7.93 NA 57.90 090 61540 A Removal of brain tissue 29.83 NA 17.69 7.93 NA 55.45 090 61541 A Incision of brain tissue 28.69 NA 16.48 6.59 NA 51.76 090 61542 A Removal of brain tissue 30.84 NA 18.12 7.78 NA 56.74 090 61543 A Removal of brain tissue 29.05 NA 16.65 7.32 NA 53.02 090 61544 A Remove & treat brain lesion 25.35 NA 14.08 5.89 NA 45.32 090 61545 A Excision of brain tumor 43.55 NA 24.63 10.64 NA 78.82 090 61546 A Removal of pituitary gland 31.12 NA 17.79 7.26 NA 56.17 090 61548 A Removal of pituitary gland 21.41 NA 13.00 4.35 NA 38.76 090 61550 A Release of skull seams 14.57 NA 7.10 1.37 NA 23.04 090 61552 A Release of skull seams 19.45 NA 9.31 1.05 NA 29.81 090 61556 A Incise skull/sutures 22.13 NA 11.57 4.28 NA 37.98 090 61557 A Incise skull/sutures 22.25 NA 13.85 5.61 NA 41.71 090 61558 A Excision of skull/sutures 25.43 NA 14.43 3.13 NA 42.99 090 61559 A Excision of skull/sutures 32.60 NA 19.63 8.22 NA 60.45 090 61563 A Excision of skull tumor 26.68 NA 15.51 5.35 NA 47.54 090 61564 A Excision of skull tumor 33.64 NA 18.59 8.49 NA 60.72 090 61566 A Removal of brain tissue 30.82 NA 17.62 6.45 NA 54.89 090 61567 A Incision of brain tissue 35.30 NA 20.98 6.45 NA 62.73 090 61570 A Remove foreign body, brain 24.46 NA 14.15 5.51 NA 44.12 090 61571 A Incise skull for brain wound 26.24 NA 15.39 6.27 NA 47.90 090 61575 A Skull base/brainstem surgery 34.16 NA 19.96 6.02 NA 60.14 090 61576 A Skull base/brainstem surgery 52.13 NA 30.00 5.61 NA 87.74 090 61580 A Craniofacial approach, skull 30.18 NA 25.77 3.30 NA 59.25 090 61581 A Craniofacial approach, skull 34.40 NA 23.50 4.04 NA 61.94 090 61582 A Craniofacial approach, skull 31.48 NA 27.43 7.55 NA 66.46 090 61583 A Craniofacial approach, skull 36.00 NA 25.34 8.32 NA 69.66 090 61584 A Orbitocranial approach/skull 34.45 NA 24.75 7.83 NA 67.03 090 61585 A Orbitocranial approach/skull 38.39 NA 26.79 7.42 NA 72.60 090 61586 A Resect nasopharynx, skull 24.96 NA 22.67 4.22 NA 51.85 090 61590 A Infratemporal approach/skull 41.54 NA 29.15 5.13 NA 75.82 090 61591 A Infratemporal approach/skull 43.43 NA 30.09 6.30 NA 79.82 090 61592 A Orbitocranial approach/skull 39.41 NA 26.96 9.05 NA 75.42 090 61595 A Transtemporal approach/skull 29.40 NA 22.78 3.66 NA 55.84 090 61596 A Transcochlear approach/skull 35.43 NA 24.89 5.09 NA 65.41 090 61597 A Transcondylar approach/skull 37.74 NA 23.37 7.97 NA 69.08 090 61598 A Transpetrosal approach/skull 33.22 NA 23.66 5.51 NA 62.39 090 61600 A Resect/excise cranial lesion 25.70 NA 20.16 3.74 NA 49.60 090 61601 A Resect/excise cranial lesion 27.73 NA 20.86 6.34 NA 54.93 090 61605 A Resect/excise cranial lesion 29.16 NA 22.42 3.01 NA 54.59 090 61606 A Resect/excise cranial lesion 38.61 NA 25.55 8.16 NA 72.32 090 61607 A Resect/excise cranial lesion 36.06 NA 24.19 6.82 NA 67.07 090 61608 A Resect/excise cranial lesion 41.86 NA 27.02 9.96 NA 78.84 090 61609 A Transect artery, sinus 9.83 NA 4.92 2.48 NA 17.23 ZZZ 61610 A Transect artery, sinus 29.50 NA 13.33 4.22 NA 47.05 ZZZ 61611 A Transect artery, sinus 7.38 NA 3.87 1.86 NA 13.11 ZZZ 61612 A Transect artery, sinus 27.72 NA 13.50 4.26 NA 45.48 ZZZ 61613 A Remove aneurysm, sinus 40.63 NA 26.68 9.97 NA 77.28 090 61615 A Resect/excise lesion, skull 31.89 NA 23.11 5.56 NA 60.56 090 Start Printed Page 63324 61616 A Resect/excise lesion, skull 43.08 NA 29.13 8.41 NA 80.62 090 61618 A Repair dura 16.89 NA 10.64 3.50 NA 31.03 090 61619 A Repair dura 20.59 NA 12.46 4.10 NA 37.15 090 61623 A Endovasc tempory vessel occl 9.90 NA 4.28 0.60 NA 14.78 000 61624 A Transcath occlusion, cns 20.04 NA 7.00 1.38 NA 28.42 000 61626 A Transcath occlusion, non-cns 16.53 NA 5.59 1.01 NA 23.13 000 61680 A Intracranial vessel surgery 30.53 NA 17.73 7.24 NA 55.50 090 61682 A Intracranial vessel surgery 61.22 NA 32.72 15.21 NA 109.15 090 61684 A Intracranial vessel surgery 39.58 NA 22.37 9.43 NA 71.38 090 61686 A Intracranial vessel surgery 64.12 NA 35.28 15.82 NA 115.22 090 61690 A Intracranial vessel surgery 29.14 NA 17.00 6.60 NA 52.74 090 61692 A Intracranial vessel surgery 51.57 NA 27.93 12.19 NA 91.69 090 61697 A Brain aneurysm repr, complx 50.23 NA 28.47 12.36 NA 91.06 090 61698 A Brain aneurysm repr, complx 48.13 NA 27.12 11.97 NA 87.22 090 61700 A Brain aneurysm repr, simple 50.23 NA 28.25 12.20 NA 90.68 090 61702 A Inner skull vessel surgery 48.13 NA 26.44 11.69 NA 86.26 090 61703 A Clamp neck artery 17.37 NA 10.66 4.34 NA 32.37 090 61705 A Revise circulation to head 35.99 NA 19.57 7.99 NA 63.55 090 61708 A Revise circulation to head 35.10 NA 15.35 2.61 NA 53.06 090 61710 A Revise circulation to head 29.50 NA 13.80 2.90 NA 46.20 090 61711 A Fusion of skull arteries 36.12 NA 20.14 8.86 NA 65.12 090 61720 A Incise skull/brain surgery 16.67 NA 10.15 4.21 NA 31.03 090 61735 A Incise skull/brain surgery 20.31 NA 12.37 4.99 NA 37.67 090 61750 A Incise skull/brain biopsy 18.10 NA 10.80 4.45 NA 33.35 090 61751 A Brain biopsy w/ct/mr guide 17.52 NA 11.01 4.28 NA 32.81 090 61760 A Implant brain electrodes 22.14 NA 8.91 5.50 NA 36.55 090 61770 A Incise skull for treatment 21.32 NA 12.45 4.90 NA 38.67 090 61790 A Treat trigeminal nerve 10.80 NA 6.05 2.18 NA 19.03 090 61791 A Treat trigeminal tract 14.53 NA 9.07 3.63 NA 27.23 090 61793 A Focus radiation beam 17.14 NA 10.29 4.21 NA 31.64 090 61795 A Brain surgery using computer 4.02 NA 2.06 0.97 NA 7.05 ZZZ 61850 A Implant neuroelectrodes 12.32 NA 7.81 2.67 NA 22.80 090 61860 A Implant neuroelectrodes 20.75 NA 12.27 4.84 NA 37.86 090 61862 D Implant neurostimul, subcort 0.00 0.00 0.00 0.00 0.00 0.00 090 61863 A Implant neuroelectrode 13.84 NA 9.34 4.76 NA 27.94 090 61864 A Implant neuroelectrde, addl 4.47 NA 2.31 1.13 NA 7.91 ZZZ 61867 A Implant neuroelectrode 22.83 NA 13.98 4.76 NA 41.57 090 61868 A Implant neuroelectrde, addl 7.87 NA 4.07 1.20 NA 13.14 ZZZ 61870 A Implant neuroelectrodes 14.85 NA 9.95 2.04 NA 26.84 090 61875 A Implant neuroelectrodes 14.97 NA 8.72 2.90 NA 26.59 090 61880 A Revise/remove neuroelectrode 6.25 NA 4.67 1.57 NA 12.49 090 61885 A Implant neurostim one array 5.82 NA 5.42 1.46 NA 12.70 090 61886 A Implant neurostim arrays 7.95 NA 6.47 1.97 NA 16.39 090 61888 A Revise/remove neuroreceiver 5.04 NA 3.94 1.25 NA 10.23 010 62000 A Treat skull fracture 12.46 NA 5.62 1.04 NA 19.12 090 62005 A Treat skull fracture 16.08 NA 8.95 2.79 NA 27.82 090 62010 A Treatment of head injury 19.70 NA 11.91 4.85 NA 36.46 090 62100 A Repair brain fluid leakage 21.90 NA 13.01 4.88 NA 39.79 090 62115 A Reduction of skull defect 21.54 NA 11.84 5.43 NA 38.81 090 62116 A Reduction of skull defect 23.46 NA 13.58 5.81 NA 42.85 090 62117 A Reduction of skull defect 26.45 NA 15.63 6.66 NA 48.74 090 62120 A Repair skull cavity lesion 23.22 NA 14.49 3.68 NA 41.39 090 62121 A Incise skull repair 21.46 NA 12.89 2.96 NA 37.31 090 62140 A Repair of skull defect 13.43 NA 8.47 3.12 NA 25.02 090 62141 A Repair of skull defect 14.83 NA 9.21 3.42 NA 27.46 090 62142 A Remove skull plate/flap 10.73 NA 7.12 2.52 NA 20.37 090 62143 A Replace skull plate/flap 12.98 NA 8.19 3.06 NA 24.23 090 62145 A Repair of skull & brain 18.71 NA 11.09 4.57 NA 34.37 090 62146 A Repair of skull with graft 16.03 NA 9.80 3.52 NA 29.35 090 62147 A Repair of skull with graft 19.23 NA 11.51 4.36 NA 35.10 090 62148 A Retr bone flap to fix skull 1.99 NA 0.83 0.52 NA 3.34 ZZZ 62160 A Neuroendoscopy add-on 2.98 NA 1.15 0.62 NA 4.75 ZZZ 62161 A Dissect brain w/scope 19.89 NA 9.66 4.43 NA 33.98 090 62162 A Remove colloid cyst w/scope 25.11 NA 11.82 6.92 NA 43.85 090 62163 A Neuroendoscopy w/fb removal 15.41 NA 7.93 4.43 NA 27.77 090 62164 A Remove brain tumor w/scope 27.34 NA 13.03 6.92 NA 47.29 090 62165 A Remove pituit tumor w/scope 21.87 NA 10.61 4.35 NA 36.83 090 62180 A Establish brain cavity shunt 20.94 NA 12.49 5.18 NA 38.61 090 62190 A Establish brain cavity shunt 11.01 NA 7.21 2.61 NA 20.83 090 62192 A Establish brain cavity shunt 12.18 NA 7.76 2.95 NA 22.89 090 62194 A Replace/irrigate catheter 5.00 NA 2.86 0.60 NA 8.46 010 62200 A Establish brain cavity shunt 18.22 NA 11.03 4.43 NA 33.68 090 62201 A Brain cavity shunt w/scope 14.78 NA 9.62 3.02 NA 27.42 090 62220 A Establish brain cavity shunt 12.93 NA 8.13 3.03 NA 24.09 090 62223 A Establish brain cavity shunt 12.80 NA 8.39 3.09 NA 24.28 090 Start Printed Page 63325 62225 A Replace/irrigate catheter 5.38 NA 4.18 1.31 NA 10.87 090 62230 A Replace/revise brain shunt 10.48 NA 6.61 2.52 NA 19.61 090 62252 A Csf shunt reprogram 0.74 1.47 NA 0.21 2.42 NA XXX 62252 26 A Csf shunt reprogram 0.74 0.38 0.38 0.19 1.31 1.31 XXX 62252 TC A Csf shunt reprogram 0.00 1.09 NA 0.02 1.11 NA XXX 62256 A Remove brain cavity shunt 6.56 NA 4.79 1.61 NA 12.96 090 62258 A Replace brain cavity shunt 14.46 NA 8.86 3.49 NA 26.81 090 62263 A Epidural lysis mult sessions 6.11 12.19 2.44 0.50 18.80 9.05 010 62264 A Epidural lysis on single day 4.40 7.90 1.43 0.36 12.66 6.19 010 62268 A Drain spinal cord cyst 4.71 10.72 2.20 0.35 15.78 7.26 000 62269 A Needle biopsy, spinal cord 4.99 12.34 2.03 0.35 17.68 7.37 000 62270 A Spinal fluid tap, diagnostic 1.12 3.06 0.50 0.07 4.25 1.69 000 62272 A Drain cerebro spinal fluid 1.34 3.68 0.64 0.16 5.18 2.14 000 62273 A Treat epidural spine lesion 2.14 2.81 0.59 0.17 5.12 2.90 000 62280 A Treat spinal cord lesion 2.62 6.70 0.89 0.20 9.52 3.71 010 62281 A Treat spinal cord lesion 2.64 5.86 0.78 0.19 8.69 3.61 010 62282 A Treat spinal canal lesion 2.32 8.27 0.80 0.17 10.76 3.29 010 62284 A Injection for myelogram 1.53 4.92 0.61 0.12 6.57 2.26 000 62287 A Percutaneous diskectomy 8.03 NA 5.60 0.79 NA 14.42 090 62290 A Inject for spine disk x-ray 2.98 6.87 1.30 0.24 10.09 4.52 000 62291 A Inject for spine disk x-ray 2.89 5.75 1.15 0.20 8.84 4.24 000 62292 A Injection into disk lesion 7.82 NA 4.57 0.78 NA 13.17 090 62294 A Injection into spinal artery 11.76 NA 5.70 1.02 NA 18.48 090 62310 A Inject spine c/t 1.90 4.93 0.52 0.13 6.96 2.55 000 62311 A Inject spine l/s (cd) 1.53 5.01 0.46 0.11 6.65 2.10 000 62318 A Inject spine w/cath, c/t 2.03 5.63 0.53 0.14 7.80 2.70 000 62319 A Inject spine w/cath l/s (cd) 1.86 4.92 0.49 0.13 6.91 2.48 000 62350 A Implant spinal canal cath 6.83 NA 4.09 0.77 NA 11.69 090 62351 A Implant spinal canal cath 9.94 NA 7.19 2.15 NA 19.28 090 62355 A Remove spinal canal catheter 5.42 NA 3.28 0.56 NA 9.26 090 62360 A Insert spine infusion device 2.61 NA 2.80 0.25 NA 5.66 090 62361 A Implant spine infusion pump 5.39 NA 4.00 0.60 NA 9.99 090 62362 A Implant spine infusion pump 7.00 NA 4.49 1.03 NA 12.52 090 62365 A Remove spine infusion device 5.39 NA 3.68 0.70 NA 9.77 090 62367 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62367 26 A Analyze spine infusion pump 0.48 0.13 0.13 0.04 0.65 0.65 XXX 62367 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 26 A Analyze spine infusion pump 0.75 0.19 0.19 0.06 1.00 1.00 XXX 62368 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 63001 A Removal of spinal lamina 15.73 NA 9.65 3.63 NA 29.01 090 63003 A Removal of spinal lamina 15.86 NA 9.98 3.57 NA 29.41 090 63005 A Removal of spinal lamina 14.83 NA 10.05 3.14 NA 28.02 090 63011 A Removal of spinal lamina 14.44 NA 8.38 1.71 NA 24.53 090 63012 A Removal of spinal lamina 15.31 NA 10.21 3.25 NA 28.77 090 63015 A Removal of spinal lamina 19.24 NA 12.05 4.60 NA 35.89 090 63016 A Removal of spinal lamina 19.09 NA 11.94 4.34 NA 35.37 090 63017 A Removal of spinal lamina 15.85 NA 10.49 3.49 NA 29.83 090 63020 A Neck spine disk surgery 14.73 NA 9.79 3.46 NA 27.98 090 63030 A Low back disk surgery 11.93 NA 8.49 2.65 NA 23.07 090 63035 A Spinal disk surgery add-on 3.13 NA 1.61 0.68 NA 5.42 ZZZ 63040 A Laminotomy, single cervical 18.70 NA 11.64 4.03 NA 34.37 090 63042 A Laminotomy, single lumbar 17.37 NA 11.44 3.73 NA 32.54 090 63043 C Laminotomy, addl cervical 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63044 C Laminotomy, addl lumbar 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63045 A Removal of spinal lamina 16.41 NA 10.49 3.82 NA 30.72 090 63046 A Removal of spinal lamina 15.71 NA 10.29 3.46 NA 29.46 090 63047 A Removal of spinal lamina 14.53 NA 9.96 3.13 NA 27.62 090 63048 A Remove spinal lamina add-on 3.24 NA 1.69 0.70 NA 5.63 ZZZ 63055 A Decompress spinal cord 21.86 NA 13.31 4.90 NA 40.07 090 63056 A Decompress spinal cord 20.24 NA 12.69 4.00 NA 36.93 090 63057 A Decompress spine cord add-on 5.23 NA 2.67 0.97 NA 8.87 ZZZ 63064 A Decompress spinal cord 24.47 NA 14.62 5.66 NA 44.75 090 63066 A Decompress spine cord add-on 3.24 NA 1.69 0.76 NA 5.69 ZZZ 63075 A Neck spine disk surgery 19.30 NA 12.24 4.47 NA 36.01 090 63076 A Neck spine disk surgery 4.03 NA 2.08 0.93 NA 7.04 ZZZ 63077 A Spine disk surgery, thorax 21.32 NA 12.86 4.12 NA 38.30 090 63078 A Spine disk surgery, thorax 3.26 NA 1.66 0.60 NA 5.52 ZZZ 63081 A Removal of vertebral body 23.59 NA 14.50 5.35 NA 43.44 090 63082 A Remove vertebral body add-on 4.35 NA 2.25 0.98 NA 7.58 ZZZ 63085 A Removal of vertebral body 26.77 NA 15.58 5.63 NA 47.98 090 63086 A Remove vertebral body add-on 3.17 NA 1.61 0.66 NA 5.44 ZZZ 63087 A Removal of vertebral body 35.37 NA 19.63 7.04 NA 62.04 090 63088 A Remove vertebral body add-on 4.31 NA 2.20 0.92 NA 7.43 ZZZ 63090 A Removal of vertebral body 28.00 NA 16.14 5.12 NA 49.26 090 Start Printed Page 63326 63091 A Remove vertebral body add-on 3.01 NA 1.47 0.54 NA 5.02 ZZZ 63101 A Removal of vertebral body 31.82 NA 19.57 5.66 NA 57.05 090 63102 A Removal of vertebral body 31.82 NA 19.57 5.66 NA 57.05 090 63103 A Remove vertebral body add-on 3.88 NA 2.03 0.76 NA 6.67 ZZZ 63170 A Incise spinal cord tract(s) 19.72 NA 12.22 4.66 NA 36.60 090 63172 A Drainage of spinal cyst 17.56 NA 10.99 4.15 NA 32.70 090 63173 A Drainage of spinal cyst 21.86 NA 13.19 4.96 NA 40.01 090 63180 A Revise spinal cord ligaments 18.17 NA 11.35 4.59 NA 34.11 090 63182 A Revise spinal cord ligaments 20.38 NA 11.31 4.17 NA 35.86 090 63185 A Incise spinal column/nerves 14.95 NA 8.38 2.49 NA 25.82 090 63190 A Incise spinal column/nerves 17.35 NA 10.45 3.45 NA 31.25 090 63191 A Incise spinal column/nerves 17.44 NA 10.84 4.20 NA 32.48 090 63194 A Incise spinal column & cord 19.08 NA 12.05 4.81 NA 35.94 090 63195 A Incise spinal column & cord 18.73 NA 11.36 4.12 NA 34.21 090 63196 A Incise spinal column & cord 22.17 NA 13.74 5.59 NA 41.50 090 63197 A Incise spinal column & cord 20.99 NA 12.55 5.30 NA 38.84 090 63198 A Incise spinal column & cord 25.24 NA 8.77 6.36 NA 40.37 090 63199 A Incise spinal column & cord 26.74 NA 15.42 6.74 NA 48.90 090 63200 A Release of spinal cord 19.07 NA 11.62 4.33 NA 35.02 090 63250 A Revise spinal cord vessels 40.53 NA 20.27 9.17 NA 69.97 090 63251 A Revise spinal cord vessels 40.97 NA 22.95 9.56 NA 73.48 090 63252 A Revise spinal cord vessels 40.96 NA 22.59 9.29 NA 72.84 090 63265 A Excise intraspinal lesion 21.44 NA 12.97 5.14 NA 39.55 090 63266 A Excise intraspinal lesion 22.17 NA 13.39 5.36 NA 40.92 090 63267 A Excise intraspinal lesion 17.85 NA 11.23 4.20 NA 33.28 090 63268 A Excise intraspinal lesion 18.41 NA 10.56 3.81 NA 32.78 090 63270 A Excise intraspinal lesion 26.65 NA 15.71 6.48 NA 48.84 090 63271 A Excise intraspinal lesion 26.77 NA 15.82 6.66 NA 49.25 090 63272 A Excise intraspinal lesion 25.18 NA 14.91 6.08 NA 46.17 090 63273 A Excise intraspinal lesion 24.15 NA 14.56 6.09 NA 44.80 090 63275 A Biopsy/excise spinal tumor 23.55 NA 13.99 5.61 NA 43.15 090 63276 A Biopsy/excise spinal tumor 23.32 NA 13.88 5.55 NA 42.75 090 63277 A Biopsy/excise spinal tumor 20.71 NA 12.69 4.83 NA 38.23 090 63278 A Biopsy/excise spinal tumor 20.44 NA 12.55 4.82 NA 37.81 090 63280 A Biopsy/excise spinal tumor 28.19 NA 16.57 6.95 NA 51.71 090 63281 A Biopsy/excise spinal tumor 27.89 NA 16.42 6.80 NA 51.11 090 63282 A Biopsy/excise spinal tumor 26.24 NA 15.57 6.39 NA 48.20 090 63283 A Biopsy/excise spinal tumor 24.86 NA 14.89 6.14 NA 45.89 090 63285 A Biopsy/excise spinal tumor 35.79 NA 20.26 8.76 NA 64.81 090 63286 A Biopsy/excise spinal tumor 35.43 NA 20.21 8.47 NA 64.11 090 63287 A Biopsy/excise spinal tumor 36.49 NA 20.77 8.97 NA 66.23 090 63290 A Biopsy/excise spinal tumor 37.17 NA 20.91 9.17 NA 67.25 090 63300 A Removal of vertebral body 24.29 NA 14.51 5.73 NA 44.53 090 63301 A Removal of vertebral body 27.44 NA 15.71 6.03 NA 49.18 090 63302 A Removal of vertebral body 27.65 NA 16.03 6.29 NA 49.97 090 63303 A Removal of vertebral body 30.33 NA 17.11 6.24 NA 53.68 090 63304 A Removal of vertebral body 30.16 NA 17.54 5.66 NA 53.36 090 63305 A Removal of vertebral body 31.85 NA 18.18 6.46 NA 56.49 090 63306 A Removal of vertebral body 32.04 NA 18.00 2.86 NA 52.90 090 63307 A Removal of vertebral body 31.45 NA 17.00 5.07 NA 53.52 090 63308 A Remove vertebral body add-on 5.22 NA 2.64 1.21 NA 9.07 ZZZ 63600 A Remove spinal cord lesion 13.94 NA 5.54 1.46 NA 20.94 090 63610 A Stimulation of spinal cord 8.68 56.38 2.33 0.52 65.58 11.53 000 63615 A Remove lesion of spinal cord 16.19 NA 9.35 3.42 NA 28.96 090 63650 A Implant neuroelectrodes 6.70 NA 3.30 0.58 NA 10.58 090 63655 A Implant neuroelectrodes 10.23 NA 7.00 2.22 NA 19.45 090 63660 A Revise/remove neuroelectrode 6.12 NA 3.71 0.78 NA 10.61 090 63685 A Implant neuroreceiver 7.00 NA 4.25 1.15 NA 12.40 090 63688 A Revise/remove neuroreceiver 5.36 NA 3.64 0.84 NA 9.84 090 63700 A Repair of spinal herniation 16.44 NA 10.40 3.22 NA 30.06 090 63702 A Repair of spinal herniation 18.37 NA 10.94 1.63 NA 30.94 090 63704 A Repair of spinal herniation 21.06 NA 13.05 4.60 NA 38.71 090 63706 A Repair of spinal herniation 23.97 NA 13.83 5.67 NA 43.47 090 63707 A Repair spinal fluid leakage 11.20 NA 7.78 2.35 NA 21.33 090 63709 A Repair spinal fluid leakage 14.24 NA 9.48 2.98 NA 26.70 090 63710 A Graft repair of spine defect 13.99 NA 9.16 3.13 NA 26.28 090 63740 A Install spinal shunt 11.30 NA 7.48 2.58 NA 21.36 090 63741 A Install spinal shunt 8.20 NA 4.86 1.26 NA 14.32 090 63744 A Revision of spinal shunt 8.05 NA 5.36 1.81 NA 15.22 090 63746 A Removal of spinal shunt 6.39 NA 3.88 1.38 NA 11.65 090 64400 A N block inj, trigeminal 1.10 2.04 0.37 0.07 3.21 1.54 000 64402 A N block inj, facial 1.24 1.77 0.54 0.08 3.09 1.86 000 64405 A N block inj, occipital 1.31 1.55 0.40 0.10 2.96 1.81 000 64408 A N block inj, vagus 1.40 1.60 0.66 0.11 3.11 2.17 000 64410 A N block inj, phrenic 1.42 2.64 0.41 0.10 4.16 1.93 000 Start Printed Page 63327 64412 A N block inj, spinal accessor 1.17 2.78 0.37 0.10 4.05 1.64 000 64413 A N block inj, cervical plexus 1.39 1.93 0.45 0.11 3.43 1.95 000 64415 A N block inj, brachial plexus 1.47 2.91 0.40 0.10 4.48 1.97 000 64416 A N block cont infuse, b plex 3.48 NA 0.72 0.10 NA 4.30 010 64417 A N block inj, axillary 1.43 3.16 0.44 0.11 4.70 1.98 000 64418 A N block inj, suprascapular 1.31 2.72 0.38 0.08 4.11 1.77 000 64420 A N block inj, intercost, sng 1.17 3.58 0.36 0.08 4.83 1.61 000 64421 A N block inj, intercost, mlt 1.67 5.45 0.47 0.12 7.24 2.26 000 64425 A N block inj ilio-ing/hypogi 1.74 1.74 0.49 0.13 3.61 2.36 000 64430 A N block inj, pudendal 1.45 2.63 0.51 0.13 4.21 2.09 000 64435 A N block inj, paracervical 1.44 2.64 0.64 0.18 4.26 2.26 000 64445 A N block inj, sciatic, sng 1.47 2.75 0.39 0.10 4.32 1.96 000 64446 A N blk inj, sciatic, cont inf 3.23 NA 1.20 0.10 NA 4.53 010 64447 A N block inj fem, single 1.49 NA 0.52 0.10 NA 2.11 000 64448 A N block inj fem, cont inf 2.98 NA 1.03 0.10 NA 4.11 010 64449 A N block inj, lumbar plexus 2.98 NA 0.98 0.10 NA 4.06 010 64450 A N block, other peripheral 1.26 1.29 0.42 0.10 2.65 1.78 000 64470 A Inj paravertebral c/t 1.84 4.92 0.58 0.14 6.90 2.56 000 64472 A Inj paravertebral c/t add-on 1.28 1.96 0.32 0.11 3.35 1.71 ZZZ 64475 A Inj paravertebral l/s 1.40 4.61 0.49 0.11 6.12 2.00 000 64476 A Inj paravertebral l/s add-on 0.97 1.84 0.25 0.07 2.88 1.29 ZZZ 64479 A Inj foramen epidural c/t 2.19 7.14 0.73 0.17 9.50 3.09 000 64480 A Inj foramen epidural add-on 1.53 2.43 0.48 0.11 4.07 2.12 ZZZ 64483 A Inj foramen epidural l/s 1.89 7.64 0.66 0.14 9.67 2.69 000 64484 A Inj foramen epidural add-on 1.32 2.84 0.38 0.10 4.26 1.80 ZZZ 64505 A N block, spenopalatine gangl 1.35 1.24 0.49 0.10 2.69 1.94 000 64508 A N block, carotid sinus s/p 1.11 3.01 0.52 0.07 4.19 1.70 000 64510 A N block, stellate ganglion 1.21 3.27 0.39 0.08 4.56 1.68 000 64517 A N block inj, hypogas plxs 2.19 2.76 0.89 0.13 5.08 3.21 000 64520 A N block, lumbar/thoracic 1.34 4.63 0.43 0.10 6.07 1.87 000 64530 A N block inj, celiac pelus 1.57 4.01 0.49 0.11 5.69 2.17 000 64550 A Apply neurostimulator 0.18 0.30 0.05 0.01 0.49 0.24 000 64553 A Implant neuroelectrodes 2.30 2.77 1.88 0.20 5.27 4.38 010 64555 A Implant neuroelectrodes 2.26 3.16 1.23 0.13 5.55 3.62 010 64560 A Implant neuroelectrodes 2.35 2.69 1.34 0.20 5.24 3.89 010 64561 A Implant neuroelectrodes 6.70 NA 3.20 0.13 NA 10.03 010 64565 A Implant neuroelectrodes 1.75 3.39 1.28 0.10 5.24 3.13 010 64573 A Implant neuroelectrodes 7.46 NA 5.30 1.77 NA 14.53 090 64575 A Implant neuroelectrodes 4.33 NA 2.75 0.44 NA 7.52 090 64577 A Implant neuroelectrodes 4.59 NA 3.31 0.60 NA 8.50 090 64580 A Implant neuroelectrodes 4.10 NA 3.60 0.25 NA 7.95 090 64581 A Implant neuroelectrodes 13.42 NA 5.47 0.44 NA 19.33 090 64585 A Revise/remove neuroelectrode 2.05 11.70 1.75 0.35 14.10 4.15 010 64590 A Implant neuroreceiver 2.39 7.41 1.93 0.48 10.28 4.80 010 64595 A Revise/remove neuroreceiver 1.72 10.90 1.53 0.26 12.88 3.51 010 64600 A Injection treatment of nerve 3.43 8.56 1.60 0.34 12.33 5.37 010 64605 A Injection treatment of nerve 5.58 8.74 2.09 0.64 14.96 8.31 010 64610 A Injection treatment of nerve 7.12 8.00 3.63 1.34 16.46 12.09 010 64612 A Destroy nerve, face muscle 1.95 2.66 1.08 0.11 4.72 3.14 010 64613 A Destroy nerve, spine muscle 1.95 3.01 1.00 0.12 5.08 3.07 010 64614 A Destroy nerve, extrem musc 2.19 3.28 1.13 0.11 5.58 3.43 010 64620 A Injection treatment of nerve 2.82 4.67 1.21 0.20 7.69 4.23 010 64622 A Destr paravertebrl nerve l/s 2.98 7.74 1.26 0.20 10.92 4.44 010 64623 A Destr paravertebral n add-on 0.98 2.46 0.23 0.07 3.51 1.28 ZZZ 64626 A Destr paravertebrl nerve c/t 3.26 6.79 1.90 0.26 10.31 5.42 010 64627 A Destr paravertebral n add-on 1.15 2.65 0.27 0.10 3.90 1.52 ZZZ 64630 A Injection treatment of nerve 2.98 2.78 1.31 0.19 5.95 4.48 010 64640 A Injection treatment of nerve 2.74 4.32 1.71 0.13 7.19 4.58 010 64680 A Injection treatment of nerve 2.61 6.08 1.31 0.18 8.87 4.10 010 64681 A Injection treatment of nerve 3.53 8.81 2.13 0.18 12.52 5.84 010 64702 A Revise finger/toe nerve 4.21 NA 3.86 0.61 NA 8.68 090 64704 A Revise hand/foot nerve 4.54 NA 3.31 0.71 NA 8.56 090 64708 A Revise arm/leg nerve 6.09 NA 4.87 0.98 NA 11.94 090 64712 A Revision of sciatic nerve 7.71 NA 5.09 0.65 NA 13.45 090 64713 A Revision of arm nerve(s) 10.94 NA 5.98 1.21 NA 18.13 090 64714 A Revise low back nerve(s) 10.27 NA 4.35 0.77 NA 15.39 090 64716 A Revision of cranial nerve 6.27 NA 5.32 0.71 NA 12.30 090 64718 A Revise ulnar nerve at elbow 5.96 NA 5.94 1.04 NA 12.94 090 64719 A Revise ulnar nerve at wrist 4.82 NA 4.51 0.76 NA 10.09 090 64721 A Carpal tunnel surgery 4.27 5.01 5.01 0.71 9.99 9.99 090 64722 A Relieve pressure on nerve(s) 4.67 NA 3.13 0.38 NA 8.18 090 64726 A Release foot/toe nerve 4.16 NA 2.80 0.68 NA 7.64 090 64727 A Internal nerve revision 3.08 NA 1.52 0.48 NA 5.08 ZZZ 64732 A Incision of brow nerve 4.38 NA 3.58 0.92 NA 8.88 090 64734 A Incision of cheek nerve 4.89 NA 4.12 0.99 NA 10.00 090 Start Printed Page 63328 64736 A Incision of chin nerve 4.57 NA 4.09 0.85 NA 9.51 090 64738 A Incision of jaw nerve 5.70 NA 4.67 1.01 NA 11.38 090 64740 A Incision of tongue nerve 5.56 NA 4.45 0.52 NA 10.53 090 64742 A Incision of facial nerve 6.18 NA 4.79 0.83 NA 11.80 090 64744 A Incise nerve, back of head 5.21 NA 3.85 1.17 NA 10.23 090 64746 A Incise diaphragm nerve 5.90 NA 4.40 0.90 NA 11.20 090 64752 A Incision of vagus nerve 7.02 NA 4.27 0.99 NA 12.28 090 64755 A Incision of stomach nerves 13.44 NA 5.75 1.39 NA 20.58 090 64760 A Incision of vagus nerve 6.92 NA 3.57 0.61 NA 11.10 090 64761 A Incision of pelvis nerve 6.37 NA 3.62 0.31 NA 10.30 090 64763 A Incise hip/thigh nerve 6.89 NA 5.30 0.92 NA 13.11 090 64766 A Incise hip/thigh nerve 8.62 NA 5.34 1.19 NA 15.15 090 64771 A Sever cranial nerve 7.31 NA 5.65 1.58 NA 14.54 090 64772 A Incision of spinal nerve 7.17 NA 4.99 1.44 NA 13.60 090 64774 A Remove skin nerve lesion 5.14 NA 3.85 0.72 NA 9.71 090 64776 A Remove digit nerve lesion 5.09 NA 3.72 0.76 NA 9.57 090 64778 A Digit nerve surgery add-on 3.09 NA 1.52 0.46 NA 5.07 ZZZ 64782 A Remove limb nerve lesion 6.19 NA 3.79 0.95 NA 10.93 090 64783 A Limb nerve surgery add-on 3.70 NA 1.87 0.58 NA 6.15 ZZZ 64784 A Remove nerve lesion 9.76 NA 6.64 1.40 NA 17.80 090 64786 A Remove sciatic nerve lesion 15.37 NA 9.94 2.66 NA 27.97 090 64787 A Implant nerve end 4.28 NA 2.15 0.67 NA 7.10 ZZZ 64788 A Remove skin nerve lesion 4.58 NA 3.51 0.65 NA 8.74 090 64790 A Removal of nerve lesion 11.25 NA 7.28 2.01 NA 20.54 090 64792 A Removal of nerve lesion 14.83 NA 8.93 2.25 NA 26.01 090 64795 A Biopsy of nerve 2.99 NA 1.61 0.48 NA 5.08 000 64802 A Remove sympathetic nerves 9.10 NA 5.18 1.04 NA 15.32 090 64804 A Remove sympathetic nerves 14.56 NA 7.14 2.15 NA 23.85 090 64809 A Remove sympathetic nerves 13.59 NA 5.82 1.15 NA 20.56 090 64818 A Remove sympathetic nerves 10.24 NA 5.28 1.29 NA 16.81 090 64820 A Remove sympathetic nerves 10.31 NA 7.20 1.40 NA 18.91 090 64821 A Remove sympathetic nerves 8.70 NA 7.42 1.19 NA 17.31 090 64822 A Remove sympathetic nerves 8.70 NA 7.35 1.19 NA 17.24 090 64823 A Remove sympathetic nerves 10.31 NA 8.27 1.40 NA 19.98 090 64831 A Repair of digit nerve 9.39 NA 7.12 1.37 NA 17.88 090 64832 A Repair nerve add-on 5.63 NA 2.98 0.82 NA 9.43 ZZZ 64834 A Repair of hand or foot nerve 10.13 NA 7.14 1.47 NA 18.74 090 64835 A Repair of hand or foot nerve 10.88 NA 7.75 1.63 NA 20.26 090 64836 A Repair of hand or foot nerve 10.88 NA 7.72 1.58 NA 20.18 090 64837 A Repair nerve add-on 6.22 NA 3.27 0.96 NA 10.45 ZZZ 64840 A Repair of leg nerve 12.95 NA 8.38 1.03 NA 22.36 090 64856 A Repair/transpose nerve 13.72 NA 9.27 2.05 NA 25.04 090 64857 A Repair arm/leg nerve 14.41 NA 9.72 2.11 NA 26.24 090 64858 A Repair sciatic nerve 16.40 NA 10.86 3.33 NA 30.59 090 64859 A Nerve surgery 4.24 NA 2.22 0.60 NA 7.06 ZZZ 64861 A Repair of arm nerves 19.13 NA 11.93 2.94 NA 34.00 090 64862 A Repair of low back nerves 19.33 NA 12.10 2.96 NA 34.39 090 64864 A Repair of facial nerve 12.48 NA 8.19 1.35 NA 22.02 090 64865 A Repair of facial nerve 15.15 NA 9.97 1.64 NA 26.76 090 64866 A Fusion of facial/other nerve 15.65 NA 9.82 1.27 NA 26.74 090 64868 A Fusion of facial/other nerve 13.96 NA 8.97 1.68 NA 24.61 090 64870 A Fusion of facial/other nerve 15.90 NA 8.84 1.29 NA 26.03 090 64872 A Subsequent repair of nerve 1.98 NA 1.09 0.29 NA 3.36 ZZZ 64874 A Repair & revise nerve add-on 2.96 NA 1.55 0.41 NA 4.92 ZZZ 64876 A Repair nerve/shorten bone 3.36 NA 1.30 0.47 NA 5.13 ZZZ 64885 A Nerve graft, head or neck 17.43 NA 11.04 1.81 NA 30.28 090 64886 A Nerve graft, head or neck 20.63 NA 12.89 2.07 NA 35.59 090 64890 A Nerve graft, hand or foot 15.06 NA 10.09 2.09 NA 27.24 090 64891 A Nerve graft, hand or foot 16.05 NA 7.74 1.65 NA 25.44 090 64892 A Nerve graft, arm or leg 14.57 NA 8.97 1.98 NA 25.52 090 64893 A Nerve graft, arm or leg 15.51 NA 9.99 2.12 NA 27.62 090 64895 A Nerve graft, hand or foot 19.14 NA 9.76 2.45 NA 31.35 090 64896 A Nerve graft, hand or foot 20.37 NA 11.15 2.22 NA 33.74 090 64897 A Nerve graft, arm or leg 18.14 NA 10.82 3.16 NA 32.12 090 64898 A Nerve graft, arm or leg 19.39 NA 11.95 3.25 NA 34.59 090 64901 A Nerve graft add-on 10.16 NA 5.34 1.19 NA 16.69 ZZZ 64902 A Nerve graft add-on 11.76 NA 6.05 1.32 NA 19.13 ZZZ 64905 A Nerve pedicle transfer 13.94 NA 8.65 1.82 NA 24.41 090 64907 A Nerve pedicle transfer 18.72 NA 12.62 2.15 NA 33.49 090 64999 C Nervous system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 65091 A Revise eye 6.42 NA 9.83 0.31 NA 16.56 090 65093 A Revise eye with implant 6.83 NA 10.19 0.34 NA 17.36 090 65101 A Removal of eye 6.99 NA 10.77 0.34 NA 18.10 090 65103 A Remove eye/insert implant 7.53 NA 10.98 0.36 NA 18.87 090 65105 A Remove eye/attach implant 8.44 NA 11.64 0.41 NA 20.49 090 Start Printed Page 63329 65110 A Removal of eye 13.87 NA 14.77 0.82 NA 29.46 090 65112 A Remove eye/revise socket 16.29 NA 17.06 1.15 NA 34.50 090 65114 A Remove eye/revise socket 17.43 NA 17.28 1.13 NA 35.84 090 65125 A Revise ocular implant 3.10 9.32 3.00 0.18 12.60 6.28 090 65130 A Insert ocular implant 7.11 NA 10.36 0.34 NA 17.81 090 65135 A Insert ocular implant 7.29 NA 10.53 0.35 NA 18.17 090 65140 A Attach ocular implant 7.97 NA 10.99 0.37 NA 19.33 090 65150 A Revise ocular implant 6.22 NA 9.38 0.30 NA 15.90 090 65155 A Reinsert ocular implant 8.61 NA 11.72 0.48 NA 20.81 090 65175 A Removal of ocular implant 6.24 NA 9.75 0.31 NA 16.30 090 65205 A Remove foreign body from eye 0.71 0.61 0.19 0.04 1.36 0.94 000 65210 A Remove foreign body from eye 0.84 0.74 0.30 0.04 1.62 1.18 000 65220 A Remove foreign body from eye 0.71 0.61 0.18 0.06 1.38 0.95 000 65222 A Remove foreign body from eye 0.92 0.76 0.27 0.05 1.73 1.24 000 65235 A Remove foreign body from eye 7.53 NA 7.34 0.36 NA 15.23 090 65260 A Remove foreign body from eye 10.90 NA 11.54 0.52 NA 22.96 090 65265 A Remove foreign body from eye 12.52 NA 12.78 0.60 NA 25.90 090 65270 A Repair of eye wound 1.89 3.86 2.27 0.10 5.85 4.26 010 65272 A Repair of eye wound 3.80 5.85 5.27 0.19 9.84 9.26 090 65273 A Repair of eye wound 4.34 NA 5.70 0.20 NA 10.24 090 65275 A Repair of eye wound 5.31 5.74 5.74 0.32 11.37 11.37 090 65280 A Repair of eye wound 7.62 NA 8.26 0.36 NA 16.24 090 65285 A Repair of eye wound 12.83 NA 12.51 0.61 NA 25.95 090 65286 A Repair of eye wound 5.48 8.51 7.60 0.25 14.24 13.33 090 65290 A Repair of eye socket wound 5.38 NA 6.55 0.31 NA 12.24 090 65400 A Removal of eye lesion 6.03 8.72 7.55 0.29 15.04 13.87 090 65410 A Biopsy of cornea 1.46 1.73 0.65 0.07 3.26 2.18 000 65420 A Removal of eye lesion 4.15 7.60 6.80 0.20 11.95 11.15 090 65426 A Removal of eye lesion 5.22 7.56 6.61 0.24 13.02 12.07 090 65430 A Corneal smear 1.46 5.00 0.66 0.07 6.53 2.19 000 65435 A Curette/treat cornea 0.91 1.34 0.40 0.05 2.30 1.36 000 65436 A Curette/treat cornea 4.17 5.91 5.28 0.20 10.28 9.65 090 65450 A Treatment of corneal lesion 3.25 7.27 6.39 0.16 10.68 9.80 090 65600 A Revision of cornea 3.38 5.70 3.15 0.17 9.25 6.70 090 65710 A Corneal transplant 12.28 NA 12.46 0.59 NA 25.33 090 65730 A Corneal transplant 14.17 NA 11.98 0.67 NA 26.82 090 65750 A Corneal transplant 14.91 NA 13.49 0.71 NA 29.11 090 65755 A Corneal transplant 14.81 NA 13.41 0.70 NA 28.92 090 65760 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65765 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65767 N Corneal tissue transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65770 A Revise cornea with implant 17.46 NA 14.47 0.83 NA 32.76 090 65771 N Radial keratotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65772 A Correction of astigmatism 4.27 7.23 6.53 0.20 11.70 11.00 090 65775 A Correction of astigmatism 5.76 NA 7.43 0.26 NA 13.45 090 65780 A Ocular reconst, transplant 10.19 NA 10.04 0.35 NA 20.58 090 65781 A Ocular reconst, transplant 17.57 NA 13.45 0.35 NA 31.37 090 65782 A Ocular reconst, transplant 14.91 NA 11.79 0.35 NA 27.05 090 65800 A Drainage of eye 1.90 2.29 1.19 0.10 4.29 3.19 000 65805 A Drainage of eye 1.90 2.29 1.19 0.10 4.29 3.19 000 65810 A Drainage of eye 4.84 NA 8.13 0.23 NA 13.20 090 65815 A Drainage of eye 5.02 8.46 7.56 0.24 13.72 12.82 090 65820 A Relieve inner eye pressure 8.08 NA 10.75 0.38 NA 19.21 090 65850 A Incision of eye 10.46 NA 9.49 0.49 NA 20.44 090 65855 A Laser surgery of eye 3.83 5.26 4.09 0.20 9.29 8.12 010 65860 A Incise inner eye adhesions 3.53 3.94 3.28 0.17 7.64 6.98 090 65865 A Incise inner eye adhesions 5.57 NA 6.56 0.26 NA 12.39 090 65870 A Incise inner eye adhesions 6.23 NA 7.21 0.29 NA 13.73 090 65875 A Incise inner eye adhesions 6.50 NA 7.52 0.30 NA 14.32 090 65880 A Incise inner eye adhesions 7.05 NA 7.76 0.34 NA 15.15 090 65900 A Remove eye lesion 10.87 NA 11.60 0.55 NA 23.02 090 65920 A Remove implant of eye 8.35 NA 8.80 0.40 NA 17.55 090 65930 A Remove blood clot from eye 7.40 NA 7.82 0.35 NA 15.57 090 66020 A Injection treatment of eye 1.58 2.40 1.60 0.08 4.06 3.26 010 66030 A Injection treatment of eye 1.24 2.23 1.44 0.06 3.53 2.74 010 66130 A Remove eye lesion 7.65 7.56 6.99 0.37 15.58 15.01 090 66150 A Glaucoma surgery 8.25 NA 9.94 0.40 NA 18.59 090 66155 A Glaucoma surgery 8.24 NA 9.91 0.38 NA 18.53 090 66160 A Glaucoma surgery 10.11 NA 10.77 0.49 NA 21.37 090 66165 A Glaucoma surgery 7.96 NA 9.79 0.37 NA 18.12 090 66170 A Glaucoma surgery 12.09 NA 12.56 0.58 NA 25.23 090 66172 A Incision of eye 14.95 NA 15.26 0.71 NA 30.92 090 66180 A Implant eye shunt 14.47 NA 11.67 0.68 NA 26.82 090 66185 A Revise eye shunt 8.09 NA 8.28 0.38 NA 16.75 090 66220 A Repair eye lesion 7.73 NA 8.83 0.38 NA 16.94 090 Start Printed Page 63330 66225 A Repair/graft eye lesion 10.99 NA 9.42 0.53 NA 20.94 090 66250 A Follow-up surgery of eye 5.95 7.74 6.57 0.28 13.97 12.80 090 66500 A Incision of iris 3.69 NA 5.15 0.18 NA 9.02 090 66505 A Incision of iris 4.06 NA 5.44 0.20 NA 9.70 090 66600 A Remove iris and lesion 8.63 NA 8.99 0.41 NA 18.03 090 66605 A Removal of iris 12.72 NA 11.37 0.73 NA 24.82 090 66625 A Removal of iris 5.10 7.09 6.35 0.24 12.43 11.69 090 66630 A Removal of iris 6.12 NA 7.50 0.29 NA 13.91 090 66635 A Removal of iris 6.21 NA 6.71 0.29 NA 13.21 090 66680 A Repair iris & ciliary body 5.41 NA 6.10 0.25 NA 11.76 090 66682 A Repair iris & ciliary body 6.17 NA 7.50 0.29 NA 13.96 090 66700 A Destruction, ciliary body 4.75 5.40 4.09 0.23 10.38 9.07 090 66710 A Destruction, ciliary body 4.75 5.27 3.88 0.22 10.24 8.85 090 66720 A Destruction, ciliary body 4.75 5.76 4.64 0.23 10.74 9.62 090 66740 A Destruction, ciliary body 4.75 5.43 4.26 0.22 10.40 9.23 090 66761 A Revision of iris 4.05 5.61 4.28 0.19 9.85 8.52 090 66762 A Revision of iris 4.55 5.69 4.27 0.22 10.46 9.04 090 66770 A Removal of inner eye lesion 5.15 6.11 4.77 0.24 11.50 10.16 090 66820 A Incision, secondary cataract 3.87 NA 7.18 0.19 NA 11.24 090 66821 A After cataract laser surgery 2.34 4.01 3.92 0.12 6.47 6.38 090 66825 A Reposition intraocular lens 8.18 NA 10.18 0.38 NA 18.74 090 66830 A Removal of lens lesion 8.15 NA 7.15 0.38 NA 15.68 090 66840 A Removal of lens material 7.86 NA 7.07 0.37 NA 15.30 090 66850 A Removal of lens material 9.06 NA 7.83 0.43 NA 17.32 090 66852 A Removal of lens material 9.91 NA 8.29 0.47 NA 18.67 090 66920 A Extraction of lens 8.81 NA 7.51 0.42 NA 16.74 090 66930 A Extraction of lens 10.12 NA 8.64 0.49 NA 19.25 090 66940 A Extraction of lens 8.88 NA 8.10 0.42 NA 17.40 090 66982 A Cataract surgery, complex 13.42 NA 10.02 0.67 NA 24.11 090 66983 A Cataract surg w/iol, 1 stage 8.94 NA 6.27 0.44 NA 15.65 090 66984 A Cataract surg w/iol, 1 stage 10.17 NA 7.70 0.49 NA 18.36 090 66985 A Insert lens prosthesis 8.34 NA 7.54 0.40 NA 16.28 090 66986 A Exchange lens prosthesis 12.21 NA 9.31 0.59 NA 22.11 090 66990 A Ophthalmic endoscope add-on 1.50 NA 0.69 0.07 NA 2.26 ZZZ 66999 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67005 A Partial removal of eye fluid 5.67 NA 4.43 0.26 NA 10.36 090 67010 A Partial removal of eye fluid 6.83 NA 4.98 0.32 NA 12.13 090 67015 A Release of eye fluid 6.88 NA 7.81 0.32 NA 15.01 090 67025 A Replace eye fluid 6.80 14.38 7.58 0.32 21.50 14.70 090 67027 A Implant eye drug system 10.79 12.91 8.89 0.55 24.25 20.23 090 67028 A Injection eye drug 2.51 6.57 1.15 0.13 9.21 3.79 000 67030 A Incise inner eye strands 4.81 NA 6.88 0.23 NA 11.92 090 67031 A Laser surgery, eye strands 3.65 4.78 4.13 0.18 8.61 7.96 090 67036 A Removal of inner eye fluid 11.82 NA 9.45 0.56 NA 21.83 090 67038 A Strip retinal membrane 21.12 NA 16.00 1.01 NA 38.13 090 67039 A Laser treatment of retina 14.44 NA 12.67 0.68 NA 27.79 090 67040 A Laser treatment of retina 17.13 NA 14.17 0.82 NA 32.12 090 67101 A Repair detached retina 7.49 9.95 8.20 0.35 17.79 16.04 090 67105 A Repair detached retina 7.37 8.08 6.30 0.35 15.80 14.02 090 67107 A Repair detached retina 14.76 NA 12.95 0.70 NA 28.41 090 67108 A Repair detached retina 20.70 NA 17.21 0.98 NA 38.89 090 67110 A Repair detached retina 8.76 15.54 9.33 0.42 24.72 18.51 090 67112 A Rerepair detached retina 16.76 NA 14.76 0.79 NA 32.31 090 67115 A Release encircling material 4.96 NA 7.16 0.23 NA 12.35 090 67120 A Remove eye implant material 5.95 12.43 7.01 0.28 18.66 13.24 090 67121 A Remove eye implant material 10.61 NA 11.28 0.50 NA 22.39 090 67141 A Treatment of retina 5.17 7.32 6.56 0.24 12.73 11.97 090 67145 A Treatment of retina 5.34 5.81 4.99 0.25 11.40 10.58 090 67208 A Treatment of retinal lesion 6.66 6.01 5.44 0.31 12.98 12.41 090 67210 A Treatment of retinal lesion 8.77 6.31 5.85 0.42 15.50 15.04 090 67218 A Treatment of retinal lesion 18.42 NA 14.28 0.64 NA 33.34 090 67220 A Treatment of choroid lesion 13.06 9.93 8.93 0.61 23.60 22.60 090 67221 R Ocular photodynamic ther 3.99 4.74 1.83 0.19 8.92 6.01 000 67225 A Eye photodynamic ther add-on 0.47 0.26 0.22 0.01 0.74 0.70 ZZZ 67227 A Treatment of retinal lesion 6.54 6.45 5.44 0.31 13.30 12.29 090 67228 A Treatment of retinal lesion 12.67 10.94 8.50 0.60 24.21 21.77 090 67250 A Reinforce eye wall 8.61 NA 10.48 0.43 NA 19.52 090 67255 A Reinforce/graft eye wall 8.85 NA 11.07 0.42 NA 20.34 090 67299 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67311 A Revise eye muscle 6.61 NA 6.49 0.32 NA 13.42 090 67312 A Revise two eye muscles 8.49 NA 7.63 0.42 NA 16.54 090 67314 A Revise eye muscle 7.48 NA 7.34 0.36 NA 15.18 090 67316 A Revise two eye muscles 9.60 NA 8.31 0.48 NA 18.39 090 67318 A Revise eye muscle(s) 7.81 NA 7.72 0.37 NA 15.90 090 67320 A Revise eye muscle(s) add-on 4.31 NA 1.98 0.20 NA 6.49 ZZZ Start Printed Page 63331 67331 A Eye surgery follow-up add-on 4.04 NA 1.93 0.20 NA 6.17 ZZZ 67332 A Rerevise eye muscles add-on 4.46 NA 2.05 0.22 NA 6.73 ZZZ 67334 A Revise eye muscle w/suture 3.96 NA 1.82 0.19 NA 5.97 ZZZ 67335 A Eye suture during surgery 2.48 NA 1.14 0.12 NA 3.74 ZZZ 67340 A Revise eye muscle add-on 4.90 NA 2.25 0.23 NA 7.38 ZZZ 67343 A Release eye tissue 7.31 NA 7.41 0.36 NA 15.08 090 67345 A Destroy nerve of eye muscle 2.94 4.42 1.39 0.16 7.52 4.49 010 67350 A Biopsy eye muscle 2.85 NA 1.89 0.16 NA 4.90 000 67399 C Eye muscle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67400 A Explore/biopsy eye socket 9.70 NA 12.64 0.52 NA 22.86 090 67405 A Explore/drain eye socket 7.88 NA 11.21 0.43 NA 19.52 090 67412 A Explore/treat eye socket 9.45 NA 13.10 0.49 NA 23.04 090 67413 A Explore/treat eye socket 9.94 NA 12.26 0.52 NA 22.72 090 67414 A Explr/decompress eye socket 11.07 NA 14.17 0.58 NA 25.82 090 67415 A Aspiration, orbital contents 1.75 NA 0.77 0.11 NA 2.63 000 67420 A Explore/treat eye socket 19.95 NA 18.96 1.01 NA 39.92 090 67430 A Explore/treat eye socket 13.31 NA 16.04 1.16 NA 30.51 090 67440 A Explore/drain eye socket 13.02 NA 15.64 0.70 NA 29.36 090 67445 A Explr/decompress eye socket 14.34 NA 15.84 0.76 NA 30.94 090 67450 A Explore/biopsy eye socket 13.43 NA 15.99 0.67 NA 30.09 090 67500 A Inject/treat eye socket 0.79 0.83 0.19 0.05 1.67 1.03 000 67505 A Inject/treat eye socket 0.82 0.92 0.21 0.05 1.79 1.08 000 67515 A Inject/treat eye socket 0.61 0.83 0.28 0.02 1.46 0.91 000 67550 A Insert eye socket implant 10.13 NA 12.40 0.60 NA 23.13 090 67560 A Revise eye socket implant 10.54 NA 12.43 0.56 NA 23.53 090 67570 A Decompress optic nerve 13.50 NA 15.38 0.83 NA 29.71 090 67599 C Orbit surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67700 A Drainage of eyelid abscess 1.34 4.88 0.64 0.07 6.29 2.05 010 67710 A Incision of eyelid 1.01 5.04 0.54 0.05 6.10 1.60 010 67715 A Incision of eyelid fold 1.21 4.62 0.63 0.06 5.89 1.90 010 67800 A Remove eyelid lesion 1.37 2.52 0.69 0.07 3.96 2.13 010 67801 A Remove eyelid lesions 1.87 5.40 0.93 0.10 7.37 2.90 010 67805 A Remove eyelid lesions 2.21 5.55 1.08 0.11 7.87 3.40 010 67808 A Remove eyelid lesion(s) 3.78 NA 5.29 0.20 NA 9.27 090 67810 A Biopsy of eyelid 1.47 3.69 0.68 0.07 5.23 2.22 000 67820 A Revise eyelashes 0.88 1.12 0.38 0.05 2.05 1.31 000 67825 A Revise eyelashes 1.37 1.60 1.08 0.07 3.04 2.52 010 67830 A Revise eyelashes 1.69 7.55 1.97 0.08 9.32 3.74 010 67835 A Revise eyelashes 5.53 NA 5.05 0.26 NA 10.84 090 67840 A Remove eyelid lesion 2.03 5.38 1.00 0.10 7.51 3.13 010 67850 A Treat eyelid lesion 1.68 6.12 1.92 0.08 7.88 3.68 010 67875 A Closure of eyelid by suture 1.34 7.11 0.63 0.07 8.52 2.04 000 67880 A Revision of eyelid 3.78 9.75 4.35 0.19 13.72 8.32 090 67882 A Revision of eyelid 5.04 11.13 5.56 0.25 16.42 10.85 090 67900 A Repair brow defect 6.11 10.63 6.38 0.36 17.10 12.85 090 67901 A Repair eyelid defect 6.93 NA 6.47 0.38 NA 13.78 090 67902 A Repair eyelid defect 6.99 NA 6.54 0.41 NA 13.94 090 67903 A Repair eyelid defect 6.33 11.39 6.76 0.47 18.19 13.56 090 67904 A Repair eyelid defect 6.22 12.61 7.24 0.31 19.14 13.77 090 67906 A Repair eyelid defect 6.75 9.20 6.07 0.50 16.45 13.32 090 67908 A Repair eyelid defect 5.10 8.93 5.74 0.24 14.27 11.08 090 67909 A Revise eyelid defect 5.37 9.47 6.14 0.30 15.14 11.81 090 67911 A Revise eyelid defect 5.24 NA 6.10 0.28 NA 11.62 090 67912 A Correction eyelid w/ implant 5.65 20.59 5.33 0.28 26.52 11.26 090 67914 A Repair eyelid defect 3.66 9.40 3.99 0.19 13.25 7.84 090 67915 A Repair eyelid defect 3.16 7.99 2.61 0.16 11.31 5.93 090 67916 A Repair eyelid defect 5.28 11.90 5.75 0.26 17.44 11.29 090 67917 A Repair eyelid defect 5.99 9.81 6.21 0.30 16.10 12.50 090 67921 A Repair eyelid defect 3.38 9.20 3.79 0.17 12.75 7.34 090 67922 A Repair eyelid defect 3.04 7.94 3.52 0.16 11.14 6.72 090 67923 A Repair eyelid defect 5.85 11.47 5.96 0.29 17.61 12.10 090 67924 A Repair eyelid defect 5.76 9.20 5.72 0.28 15.24 11.76 090 67930 A Repair eyelid wound 3.59 8.48 2.98 0.20 12.27 6.77 010 67935 A Repair eyelid wound 6.18 11.48 6.01 0.35 18.01 12.54 090 67938 A Remove eyelid foreign body 1.32 5.87 0.57 0.07 7.26 1.96 010 67950 A Revision of eyelid 5.79 8.34 6.64 0.36 14.49 12.79 090 67961 A Revision of eyelid 5.66 10.27 5.76 0.31 16.24 11.73 090 67966 A Revision of eyelid 6.53 8.42 5.73 0.40 15.35 12.66 090 67971 A Reconstruction of eyelid 9.73 NA 7.34 0.50 NA 17.57 090 67973 A Reconstruction of eyelid 12.80 NA 9.33 0.71 NA 22.84 090 67974 A Reconstruction of eyelid 12.77 NA 9.24 0.65 NA 22.66 090 67975 A Reconstruction of eyelid 9.08 NA 7.02 0.46 NA 16.56 090 67999 C Revision of eyelid 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68020 A Incise/drain eyelid lining 1.36 5.75 0.68 0.07 7.18 2.11 010 68040 A Treatment of eyelid lesions 0.85 4.86 0.39 0.04 5.75 1.28 000 Start Printed Page 63332 68100 A Biopsy of eyelid lining 1.34 5.07 0.62 0.07 6.48 2.03 000 68110 A Remove eyelid lining lesion 1.76 6.12 1.42 0.08 7.96 3.26 010 68115 A Remove eyelid lining lesion 2.35 5.62 1.14 0.12 8.09 3.61 010 68130 A Remove eyelid lining lesion 4.90 8.20 4.33 0.23 13.33 9.46 090 68135 A Remove eyelid lining lesion 1.83 5.38 0.91 0.08 7.29 2.82 010 68200 A Treat eyelid by injection 0.49 0.73 0.23 0.02 1.24 0.74 000 68320 A Revise/graft eyelid lining 5.34 6.63 5.47 0.25 12.22 11.06 090 68325 A Revise/graft eyelid lining 7.32 NA 6.46 0.36 NA 14.14 090 68326 A Revise/graft eyelid lining 7.11 NA 6.34 0.36 NA 13.81 090 68328 A Revise/graft eyelid lining 8.13 NA 7.08 0.48 NA 15.69 090 68330 A Revise eyelid lining 4.80 7.32 6.11 0.23 12.35 11.14 090 68335 A Revise/graft eyelid lining 7.15 NA 6.87 0.35 NA 14.37 090 68340 A Separate eyelid adhesions 4.15 10.91 4.79 0.20 15.26 9.14 090 68360 A Revise eyelid lining 4.35 6.68 5.64 0.20 11.23 10.19 090 68362 A Revise eyelid lining 7.30 NA 7.80 0.35 NA 15.45 090 68371 A Harvest eye tissue, alograft 4.87 NA 4.66 0.20 NA 9.73 010 68399 C Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68400 A Incise/drain tear gland 1.68 7.69 2.06 0.08 9.45 3.82 010 68420 A Incise/drain tear sac 2.29 8.01 2.35 0.12 10.42 4.76 010 68440 A Incise tear duct opening 0.93 4.99 0.50 0.05 5.97 1.48 010 68500 A Removal of tear gland 10.96 NA 10.27 0.72 NA 21.95 090 68505 A Partial removal, tear gland 10.88 NA 11.28 0.68 NA 22.84 090 68510 A Biopsy of tear gland 4.58 8.50 2.11 0.23 13.31 6.92 000 68520 A Removal of tear sac 7.47 NA 7.85 0.40 NA 15.72 090 68525 A Biopsy of tear sac 4.40 NA 2.04 0.22 NA 6.66 000 68530 A Clearance of tear duct 3.64 9.55 2.88 0.19 13.38 6.71 010 68540 A Remove tear gland lesion 10.54 NA 9.88 0.55 NA 20.97 090 68550 A Remove tear gland lesion 13.18 NA 11.87 0.79 NA 25.84 090 68700 A Repair tear ducts 6.56 NA 7.36 0.32 NA 14.24 090 68705 A Revise tear duct opening 2.05 5.51 1.01 0.10 7.66 3.16 010 68720 A Create tear sac drain 8.91 NA 8.35 0.46 NA 17.72 090 68745 A Create tear duct drain 8.58 NA 8.32 0.46 NA 17.36 090 68750 A Create tear duct drain 8.61 NA 8.77 0.44 NA 17.82 090 68760 A Close tear duct opening 1.72 4.04 1.25 0.08 5.84 3.05 010 68761 A Close tear duct opening 1.35 3.46 0.99 0.07 4.88 2.41 010 68770 A Close tear system fistula 6.98 12.89 6.85 0.34 20.21 14.17 090 68801 A Dilate tear duct opening 0.93 0.94 0.61 0.05 1.92 1.59 010 68810 A Probe nasolacrimal duct 1.89 2.34 0.93 0.10 4.33 2.92 010 68811 A Probe nasolacrimal duct 2.34 NA 2.37 0.12 NA 4.83 010 68815 A Probe nasolacrimal duct 3.18 8.25 2.71 0.17 11.60 6.06 010 68840 A Explore/irrigate tear ducts 1.24 1.66 0.97 0.06 2.96 2.27 010 68850 A Injection for tear sac x-ray 0.80 16.48 0.30 0.04 17.32 1.14 000 68899 C Tear duct system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69000 A Drain external ear lesion 1.44 3.01 1.43 0.12 4.57 2.99 010 69005 A Drain external ear lesion 2.10 3.00 1.87 0.19 5.29 4.16 010 69020 A Drain outer ear canal lesion 1.47 3.97 2.07 0.13 5.57 3.67 010 69090 N Pierce earlobes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69100 A Biopsy of external ear 0.81 1.76 0.40 0.05 2.62 1.26 000 69105 A Biopsy of external ear canal 0.85 2.33 0.77 0.07 3.25 1.69 000 69110 A Remove external ear, partial 3.42 4.11 3.06 0.29 7.82 6.77 090 69120 A Removal of external ear 4.03 NA 4.01 0.37 NA 8.41 090 69140 A Remove ear canal lesion(s) 7.92 NA 6.76 0.67 NA 15.35 090 69145 A Remove ear canal lesion(s) 2.61 3.61 2.62 0.22 6.44 5.45 090 69150 A Extensive ear canal surgery 13.35 NA 10.00 1.28 NA 24.63 090 69155 A Extensive ear/neck surgery 20.68 NA 14.62 1.81 NA 37.11 090 69200 A Clear outer ear canal 0.77 2.36 0.60 0.06 3.19 1.43 000 69205 A Clear outer ear canal 1.19 NA 1.37 0.11 NA 2.67 010 69210 A Remove impacted ear wax 0.61 0.64 0.24 0.05 1.30 0.90 000 69220 A Clean out mastoid cavity 0.83 2.34 0.74 0.07 3.24 1.64 000 69222 A Clean out mastoid cavity 1.39 3.82 2.05 0.12 5.33 3.56 010 69300 R Revise external ear 6.32 NA 4.28 0.52 NA 11.12 YYY 69310 A Rebuild outer ear canal 10.73 NA 8.46 0.92 NA 20.11 090 69320 A Rebuild outer ear canal 16.86 NA 12.23 1.40 NA 30.49 090 69399 C Outer ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69400 A Inflate middle ear canal 0.83 2.36 0.68 0.07 3.26 1.58 000 69401 A Inflate middle ear canal 0.63 1.31 0.65 0.05 1.99 1.33 000 69405 A Catheterize middle ear canal 2.62 3.52 2.31 0.22 6.36 5.15 010 69410 A Inset middle ear (baffle) 0.33 2.06 0.50 0.02 2.41 0.85 000 69420 A Incision of eardrum 1.32 3.11 1.60 0.12 4.55 3.04 010 69421 A Incision of eardrum 1.72 NA 2.11 0.16 NA 3.99 010 69424 A Remove ventilating tube 0.85 2.16 0.69 0.07 3.08 1.61 000 69433 A Create eardrum opening 1.51 3.13 1.68 0.13 4.77 3.32 010 69436 A Create eardrum opening 1.95 NA 2.24 0.17 NA 4.36 010 69440 A Exploration of middle ear 7.53 NA 6.34 0.64 NA 14.51 090 69450 A Eardrum revision 5.54 NA 5.07 0.47 NA 11.08 090 Start Printed Page 63333 69501 A Mastoidectomy 9.02 NA 7.13 0.78 NA 16.93 090 69502 A Mastoidectomy 12.31 NA 9.36 1.03 NA 22.70 090 69505 A Remove mastoid structures 12.92 NA 9.62 1.10 NA 23.64 090 69511 A Extensive mastoid surgery 13.44 NA 9.95 1.15 NA 24.54 090 69530 A Extensive mastoid surgery 19.08 NA 13.14 1.58 NA 33.80 090 69535 A Remove part of temporal bone 35.93 NA 22.59 3.10 NA 61.62 090 69540 A Remove ear lesion 1.19 3.72 1.95 0.11 5.02 3.25 010 69550 A Remove ear lesion 10.93 NA 8.39 0.96 NA 20.28 090 69552 A Remove ear lesion 19.35 NA 13.06 1.63 NA 34.04 090 69554 A Remove ear lesion 32.97 NA 21.10 2.78 NA 56.85 090 69601 A Mastoid surgery revision 13.16 NA 10.11 1.10 NA 24.37 090 69602 A Mastoid surgery revision 13.50 NA 10.05 1.13 NA 24.68 090 69603 A Mastoid surgery revision 13.94 NA 10.28 1.20 NA 25.42 090 69604 A Mastoid surgery revision 13.94 NA 10.26 1.17 NA 25.37 090 69605 A Mastoid surgery revision 18.38 NA 12.94 1.55 NA 32.87 090 69610 A Repair of eardrum 4.40 5.45 3.30 0.37 10.22 8.07 010 69620 A Repair of eardrum 5.86 6.19 4.55 0.48 12.53 10.89 090 69631 A Repair eardrum structures 9.80 NA 7.94 0.83 NA 18.57 090 69632 A Rebuild eardrum structures 12.68 NA 9.83 1.07 NA 23.58 090 69633 A Rebuild eardrum structures 12.03 NA 9.49 1.01 NA 22.53 090 69635 A Repair eardrum structures 13.25 NA 9.50 1.04 NA 23.79 090 69636 A Rebuild eardrum structures 15.13 NA 11.26 1.28 NA 27.67 090 69637 A Rebuild eardrum structures 15.02 NA 11.20 1.27 NA 27.49 090 69641 A Revise middle ear & mastoid 12.64 NA 9.58 1.07 NA 23.29 090 69642 A Revise middle ear & mastoid 16.74 NA 12.24 1.41 NA 30.39 090 69643 A Revise middle ear & mastoid 15.23 NA 11.27 1.29 NA 27.79 090 69644 A Revise middle ear & mastoid 16.87 NA 12.19 1.43 NA 30.49 090 69645 A Revise middle ear & mastoid 16.29 NA 11.83 1.39 NA 29.51 090 69646 A Revise middle ear & mastoid 17.89 NA 12.76 1.51 NA 32.16 090 69650 A Release middle ear bone 9.60 NA 7.48 0.82 NA 17.90 090 69660 A Revise middle ear bone 11.83 NA 8.70 1.01 NA 21.54 090 69661 A Revise middle ear bone 15.65 NA 11.19 1.32 NA 28.16 090 69662 A Revise middle ear bone 15.35 NA 10.91 1.29 NA 27.55 090 69666 A Repair middle ear structures 9.69 NA 7.55 0.82 NA 18.06 090 69667 A Repair middle ear structures 9.70 NA 7.54 0.86 NA 18.10 090 69670 A Remove mastoid air cells 11.44 NA 8.73 0.93 NA 21.10 090 69676 A Remove middle ear nerve 9.47 NA 7.68 0.83 NA 17.98 090 69700 A Close mastoid fistula 8.18 NA 5.93 0.66 NA 14.77 090 69710 N Implant/replace hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69711 A Remove/repair hearing aid 10.38 NA 8.15 0.74 NA 19.27 090 69714 A Implant temple bone w/stimul 13.92 NA 10.00 1.21 NA 25.13 090 69715 A Temple bne implnt w/stimulat 18.15 NA 12.50 1.58 NA 32.23 090 69717 A Temple bone implant revision 14.89 NA 9.67 1.29 NA 25.85 090 69718 A Revise temple bone implant 18.39 NA 12.41 1.61 NA 32.41 090 69720 A Release facial nerve 14.30 NA 10.86 1.23 NA 26.39 090 69725 A Release facial nerve 25.24 NA 17.01 2.13 NA 44.38 090 69740 A Repair facial nerve 15.87 NA 10.46 1.35 NA 27.68 090 69745 A Repair facial nerve 16.59 NA 11.46 1.20 NA 29.25 090 69799 C Middle ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69801 A Incise inner ear 8.51 NA 6.88 0.72 NA 16.11 090 69802 A Incise inner ear 13.03 NA 9.69 1.09 NA 23.81 090 69805 A Explore inner ear 13.74 NA 10.14 1.16 NA 25.04 090 69806 A Explore inner ear 12.28 NA 9.26 1.03 NA 22.57 090 69820 A Establish inner ear window 10.28 NA 7.91 0.79 NA 18.98 090 69840 A Revise inner ear window 10.20 NA 6.98 0.77 NA 17.95 090 69905 A Remove inner ear 11.04 NA 8.38 0.92 NA 20.34 090 69910 A Remove inner ear & mastoid 13.55 NA 9.81 1.13 NA 24.49 090 69915 A Incise inner ear nerve 21.11 NA 14.30 1.85 NA 37.26 090 69930 A Implant cochlear device 16.71 NA 11.95 1.43 NA 30.09 090 69949 C Inner ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69950 A Incise inner ear nerve 25.49 NA 16.21 3.48 NA 45.18 090 69955 A Release facial nerve 26.89 NA 17.76 2.27 NA 46.92 090 69960 A Release inner ear canal 26.89 NA 17.24 2.91 NA 47.04 090 69970 A Remove inner ear lesion 29.87 NA 18.53 2.80 NA 51.20 090 69979 C Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69990 R Microsurgery add-on 3.45 NA 1.82 0.67 NA 5.94 ZZZ 70010 A Contrast x-ray of brain 1.18 4.70 NA 0.29 6.17 NA XXX 70010 26 A Contrast x-ray of brain 1.18 0.40 0.40 0.07 1.65 1.65 XXX 70010 TC A Contrast x-ray of brain 0.00 4.30 NA 0.22 4.52 NA XXX 70015 A Contrast x-ray of brain 1.18 1.74 NA 0.14 3.06 NA XXX 70015 26 A Contrast x-ray of brain 1.18 0.40 0.40 0.06 1.64 1.64 XXX 70015 TC A Contrast x-ray of brain 0.00 1.34 NA 0.08 1.42 NA XXX 70030 A X-ray eye for foreign body 0.17 0.48 NA 0.03 0.68 NA XXX 70030 26 A X-ray eye for foreign body 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70030 TC A X-ray eye for foreign body 0.00 0.42 NA 0.02 0.44 NA XXX Start Printed Page 63334 70100 A X-ray exam of jaw 0.18 0.58 NA 0.03 0.79 NA XXX 70100 26 A X-ray exam of jaw 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70100 TC A X-ray exam of jaw 0.00 0.52 NA 0.02 0.54 NA XXX 70110 A X-ray exam of jaw 0.25 0.70 NA 0.05 1.00 NA XXX 70110 26 A X-ray exam of jaw 0.25 0.08 0.08 0.01 0.34 0.34 XXX 70110 TC A X-ray exam of jaw 0.00 0.62 NA 0.04 0.66 NA XXX 70120 A X-ray exam of mastoids 0.18 0.68 NA 0.05 0.91 NA XXX 70120 26 A X-ray exam of mastoids 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70120 TC A X-ray exam of mastoids 0.00 0.62 NA 0.04 0.66 NA XXX 70130 A X-ray exam of mastoids 0.34 0.88 NA 0.06 1.28 NA XXX 70130 26 A X-ray exam of mastoids 0.34 0.11 0.11 0.01 0.46 0.46 XXX 70130 TC A X-ray exam of mastoids 0.00 0.77 NA 0.05 0.82 NA XXX 70134 A X-ray exam of middle ear 0.34 0.83 NA 0.06 1.23 NA XXX 70134 26 A X-ray exam of middle ear 0.34 0.11 0.11 0.01 0.46 0.46 XXX 70134 TC A X-ray exam of middle ear 0.00 0.72 NA 0.05 0.77 NA XXX 70140 A X-ray exam of facial bones 0.19 0.68 NA 0.05 0.92 NA XXX 70140 26 A X-ray exam of facial bones 0.19 0.06 0.06 0.01 0.26 0.26 XXX 70140 TC A X-ray exam of facial bones 0.00 0.62 NA 0.04 0.66 NA XXX 70150 A X-ray exam of facial bones 0.26 0.86 NA 0.06 1.18 NA XXX 70150 26 A X-ray exam of facial bones 0.26 0.09 0.09 0.01 0.36 0.36 XXX 70150 TC A X-ray exam of facial bones 0.00 0.77 NA 0.05 0.82 NA XXX 70160 A X-ray exam of nasal bones 0.17 0.58 NA 0.03 0.78 NA XXX 70160 26 A X-ray exam of nasal bones 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70160 TC A X-ray exam of nasal bones 0.00 0.52 NA 0.02 0.54 NA XXX 70170 A X-ray exam of tear duct 0.30 1.04 NA 0.07 1.41 NA XXX 70170 26 A X-ray exam of tear duct 0.30 0.10 0.10 0.01 0.41 0.41 XXX 70170 TC A X-ray exam of tear duct 0.00 0.94 NA 0.06 1.00 NA XXX 70190 A X-ray exam of eye sockets 0.21 0.69 NA 0.05 0.95 NA XXX 70190 26 A X-ray exam of eye sockets 0.21 0.07 0.07 0.01 0.29 0.29 XXX 70190 TC A X-ray exam of eye sockets 0.00 0.62 NA 0.04 0.66 NA XXX 70200 A X-ray exam of eye sockets 0.28 0.86 NA 0.06 1.20 NA XXX 70200 26 A X-ray exam of eye sockets 0.28 0.09 0.09 0.01 0.38 0.38 XXX 70200 TC A X-ray exam of eye sockets 0.00 0.77 NA 0.05 0.82 NA XXX 70210 A X-ray exam of sinuses 0.17 0.68 NA 0.05 0.90 NA XXX 70210 26 A X-ray exam of sinuses 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70210 TC A X-ray exam of sinuses 0.00 0.62 NA 0.04 0.66 NA XXX 70220 A X-ray exam of sinuses 0.25 0.85 NA 0.06 1.16 NA XXX 70220 26 A X-ray exam of sinuses 0.25 0.08 0.08 0.01 0.34 0.34 XXX 70220 TC A X-ray exam of sinuses 0.00 0.77 NA 0.05 0.82 NA XXX 70240 A X-ray exam, pituitary saddle 0.19 0.48 NA 0.03 0.70 NA XXX 70240 26 A X-ray exam, pituitary saddle 0.19 0.06 0.06 0.01 0.26 0.26 XXX 70240 TC A X-ray exam, pituitary saddle 0.00 0.42 NA 0.02 0.44 NA XXX 70250 A X-ray exam of skull 0.24 0.70 NA 0.05 0.99 NA XXX 70250 26 A X-ray exam of skull 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70250 TC A X-ray exam of skull 0.00 0.62 NA 0.04 0.66 NA XXX 70260 A X-ray exam of skull 0.34 0.99 NA 0.07 1.40 NA XXX 70260 26 A X-ray exam of skull 0.34 0.11 0.11 0.01 0.46 0.46 XXX 70260 TC A X-ray exam of skull 0.00 0.88 NA 0.06 0.94 NA XXX 70300 A X-ray exam of teeth 0.10 0.31 NA 0.03 0.44 NA XXX 70300 26 A X-ray exam of teeth 0.10 0.05 0.05 0.01 0.16 0.16 XXX 70300 TC A X-ray exam of teeth 0.00 0.26 NA 0.02 0.28 NA XXX 70310 A X-ray exam of teeth 0.16 0.50 NA 0.03 0.69 NA XXX 70310 26 A X-ray exam of teeth 0.16 0.08 0.08 0.01 0.25 0.25 XXX 70310 TC A X-ray exam of teeth 0.00 0.42 NA 0.02 0.44 NA XXX 70320 A Full mouth x-ray of teeth 0.22 0.85 NA 0.06 1.13 NA XXX 70320 26 A Full mouth x-ray of teeth 0.22 0.08 0.08 0.01 0.31 0.31 XXX 70320 TC A Full mouth x-ray of teeth 0.00 0.77 NA 0.05 0.82 NA XXX 70328 A X-ray exam of jaw joint 0.18 0.55 NA 0.03 0.76 NA XXX 70328 26 A X-ray exam of jaw joint 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70328 TC A X-ray exam of jaw joint 0.00 0.49 NA 0.02 0.51 NA XXX 70330 A X-ray exam of jaw joints 0.24 0.91 NA 0.06 1.21 NA XXX 70330 26 A X-ray exam of jaw joints 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70330 TC A X-ray exam of jaw joints 0.00 0.83 NA 0.05 0.88 NA XXX 70332 A X-ray exam of jaw joint 0.54 2.28 NA 0.14 2.96 NA XXX 70332 26 A X-ray exam of jaw joint 0.54 0.20 0.20 0.02 0.76 0.76 XXX 70332 TC A X-ray exam of jaw joint 0.00 2.08 NA 0.12 2.20 NA XXX 70336 A Magnetic image, jaw joint 1.47 11.61 NA 0.67 13.75 NA XXX 70336 26 A Magnetic image, jaw joint 1.47 0.50 0.50 0.08 2.05 2.05 XXX 70336 TC A Magnetic image, jaw joint 0.00 11.11 NA 0.59 11.70 NA XXX 70350 A X-ray head for orthodontia 0.17 0.45 NA 0.03 0.65 NA XXX 70350 26 A X-ray head for orthodontia 0.17 0.07 0.07 0.01 0.25 0.25 XXX 70350 TC A X-ray head for orthodontia 0.00 0.38 NA 0.02 0.40 NA XXX 70355 A Panoramic x-ray of jaws 0.20 0.65 NA 0.05 0.90 NA XXX 70355 26 A Panoramic x-ray of jaws 0.20 0.08 0.08 0.01 0.29 0.29 XXX 70355 TC A Panoramic x-ray of jaws 0.00 0.57 NA 0.04 0.61 NA XXX Start Printed Page 63335 70360 A X-ray exam of neck 0.17 0.48 NA 0.03 0.68 NA XXX 70360 26 A X-ray exam of neck 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70360 TC A X-ray exam of neck 0.00 0.42 NA 0.02 0.44 NA XXX 70370 A Throat x-ray & fluoroscopy 0.32 1.40 NA 0.08 1.80 NA XXX 70370 26 A Throat x-ray & fluoroscopy 0.32 0.11 0.11 0.01 0.44 0.44 XXX 70370 TC A Throat x-ray & fluoroscopy 0.00 1.29 NA 0.07 1.36 NA XXX 70371 A Speech evaluation, complex 0.84 2.36 NA 0.17 3.37 NA XXX 70371 26 A Speech evaluation, complex 0.84 0.28 0.28 0.05 1.17 1.17 XXX 70371 TC A Speech evaluation, complex 0.00 2.08 NA 0.12 2.20 NA XXX 70373 A Contrast x-ray of larynx 0.44 1.92 NA 0.13 2.49 NA XXX 70373 26 A Contrast x-ray of larynx 0.44 0.15 0.15 0.02 0.61 0.61 XXX 70373 TC A Contrast x-ray of larynx 0.00 1.77 NA 0.11 1.88 NA XXX 70380 A X-ray exam of salivary gland 0.17 0.72 NA 0.05 0.94 NA XXX 70380 26 A X-ray exam of salivary gland 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70380 TC A X-ray exam of salivary gland 0.00 0.66 NA 0.04 0.70 NA XXX 70390 A X-ray exam of salivary duct 0.38 1.90 NA 0.13 2.41 NA XXX 70390 26 A X-ray exam of salivary duct 0.38 0.13 0.13 0.02 0.53 0.53 XXX 70390 TC A X-ray exam of salivary duct 0.00 1.77 NA 0.11 1.88 NA XXX 70450 A Ct head/brain w/o dye 0.85 4.95 NA 0.30 6.10 NA XXX 70450 26 A Ct head/brain w/o dye 0.85 0.28 0.28 0.05 1.18 1.18 XXX 70450 TC A Ct head/brain w/o dye 0.00 4.67 NA 0.25 4.92 NA XXX 70460 A Ct head/brain w/dye 1.12 5.99 NA 0.36 7.47 NA XXX 70460 26 A Ct head/brain w/dye 1.12 0.38 0.38 0.06 1.56 1.56 XXX 70460 TC A Ct head/brain w/dye 0.00 5.61 NA 0.30 5.91 NA XXX 70470 A Ct head/brain w/o & w/ dye 1.26 7.43 NA 0.44 9.13 NA XXX 70470 26 A Ct head/brain w/o & w/ dye 1.26 0.42 0.42 0.07 1.75 1.75 XXX 70470 TC A Ct head/brain w/o & w/ dye 0.00 7.01 NA 0.37 7.38 NA XXX 70480 A Ct orbit/ear/fossa w/o dye 1.27 5.10 NA 0.32 6.69 NA XXX 70480 26 A Ct orbit/ear/fossa w/o dye 1.27 0.43 0.43 0.07 1.77 1.77 XXX 70480 TC A Ct orbit/ear/fossa w/o dye 0.00 4.67 NA 0.25 4.92 NA XXX 70481 A Ct orbit/ear/fossa w/dye 1.37 6.07 NA 0.37 7.81 NA XXX 70481 26 A Ct orbit/ear/fossa w/dye 1.37 0.46 0.46 0.07 1.90 1.90 XXX 70481 TC A Ct orbit/ear/fossa w/dye 0.00 5.61 NA 0.30 5.91 NA XXX 70482 A Ct orbit/ear/fossa w/o&w dye 1.44 7.50 NA 0.44 9.38 NA XXX 70482 26 A Ct orbit/ear/fossa w/o&w dye 1.44 0.49 0.49 0.07 2.00 2.00 XXX 70482 TC A Ct orbit/ear/fossa w/o&w dye 0.00 7.01 NA 0.37 7.38 NA XXX 70486 A Ct maxillofacial w/o dye 1.13 5.05 NA 0.31 6.49 NA XXX 70486 26 A Ct maxillofacial w/o dye 1.13 0.38 0.38 0.06 1.57 1.57 XXX 70486 TC A Ct maxillofacial w/o dye 0.00 4.67 NA 0.25 4.92 NA XXX 70487 A Ct maxillofacial w/dye 1.29 6.05 NA 0.37 7.71 NA XXX 70487 26 A Ct maxillofacial w/dye 1.29 0.44 0.44 0.07 1.80 1.80 XXX 70487 TC A Ct maxillofacial w/dye 0.00 5.61 NA 0.30 5.91 NA XXX 70488 A Ct maxillofacial w/o & w dye 1.41 7.48 NA 0.44 9.33 NA XXX 70488 26 A Ct maxillofacial w/o & w dye 1.41 0.47 0.47 0.07 1.95 1.95 XXX 70488 TC A Ct maxillofacial w/o & w dye 0.00 7.01 NA 0.37 7.38 NA XXX 70490 A Ct soft tissue neck w/o dye 1.27 5.10 NA 0.32 6.69 NA XXX 70490 26 A Ct soft tissue neck w/o dye 1.27 0.43 0.43 0.07 1.77 1.77 XXX 70490 TC A Ct soft tissue neck w/o dye 0.00 4.67 NA 0.25 4.92 NA XXX 70491 A Ct soft tissue neck w/dye 1.37 6.07 NA 0.37 7.81 NA XXX 70491 26 A Ct soft tissue neck w/dye 1.37 0.46 0.46 0.07 1.90 1.90 XXX 70491 TC A Ct soft tissue neck w/dye 0.00 5.61 NA 0.30 5.91 NA XXX 70492 A Ct sft tsue nck w/o & w/dye 1.44 7.49 NA 0.44 9.37 NA XXX 70492 26 A Ct sft tsue nck w/o & w/dye 1.44 0.48 0.48 0.07 1.99 1.99 XXX 70492 TC A Ct sft tsue nck w/o & w/dye 0.00 7.01 NA 0.37 7.38 NA XXX 70496 A Ct angiography, head 1.74 11.10 NA 0.68 13.52 NA XXX 70496 26 A Ct angiography, head 1.74 0.58 0.58 0.10 2.42 2.42 XXX 70496 TC A Ct angiography, head 0.00 10.52 NA 0.58 11.10 NA XXX 70498 A Ct angiography, neck 1.74 11.11 NA 0.68 13.53 NA XXX 70498 26 A Ct angiography, neck 1.74 0.59 0.59 0.10 2.43 2.43 XXX 70498 TC A Ct angiography, neck 0.00 10.52 NA 0.58 11.10 NA XXX 70540 A Mri orbit/face/neck w/o dye 1.34 11.56 NA 0.43 13.33 NA XXX 70540 26 A Mri orbit/face/neck w/o dye 1.34 0.45 0.45 0.05 1.84 1.84 XXX 70540 TC A Mri orbit/face/neck w/o dye 0.00 11.11 NA 0.38 11.49 NA XXX 70542 A Mri orbit/face/neck w/dye 1.61 13.88 NA 0.53 16.02 NA XXX 70542 26 A Mri orbit/face/neck w/dye 1.61 0.55 0.55 0.06 2.22 2.22 XXX 70542 TC A Mri orbit/face/neck w/dye 0.00 13.33 NA 0.47 13.80 NA XXX 70543 A Mri orbt/fac/nck w/o & w dye 2.14 25.39 NA 0.92 28.45 NA XXX 70543 26 A Mri orbt/fac/nck w/o & w dye 2.14 0.71 0.71 0.08 2.93 2.93 XXX 70543 TC A Mri orbt/fac/nck w/o & w dye 0.00 24.68 NA 0.84 25.52 NA XXX 70544 A Mr angiography head w/o dye 1.19 11.51 NA 0.65 13.35 NA XXX 70544 26 A Mr angiography head w/o dye 1.19 0.40 0.40 0.06 1.65 1.65 XXX 70544 TC A Mr angiography head w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 70545 A Mr angiography head w/dye 1.19 11.51 NA 0.65 13.35 NA XXX 70545 26 A Mr angiography head w/dye 1.19 0.40 0.40 0.06 1.65 1.65 XXX 70545 TC A Mr angiography head w/dye 0.00 11.11 NA 0.59 11.70 NA XXX Start Printed Page 63336 70546 A Mr angiograph head w/o&w dye 1.79 22.83 NA 0.69 25.31 NA XXX 70546 26 A Mr angiograph head w/o&w dye 1.79 0.61 0.61 0.10 2.50 2.50 XXX 70546 TC A Mr angiograph head w/o&w dye 0.00 22.22 NA 0.59 22.81 NA XXX 70547 A Mr angiography neck w/o dye 1.19 11.51 NA 0.65 13.35 NA XXX 70547 26 A Mr angiography neck w/o dye 1.19 0.40 0.40 0.06 1.65 1.65 XXX 70547 TC A Mr angiography neck w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 70548 A Mr angiography neck w/dye 1.19 11.51 NA 0.65 13.35 NA XXX 70548 26 A Mr angiography neck w/dye 1.19 0.40 0.40 0.06 1.65 1.65 XXX 70548 TC A Mr angiography neck w/dye 0.00 11.11 NA 0.59 11.70 NA XXX 70549 A Mr angiograph neck w/o&w dye 1.79 22.83 NA 0.69 25.31 NA XXX 70549 26 A Mr angiograph neck w/o&w dye 1.79 0.61 0.61 0.10 2.50 2.50 XXX 70549 TC A Mr angiograph neck w/o&w dye 0.00 22.22 NA 0.59 22.81 NA XXX 70551 A Mri brain w/o dye 1.47 11.61 NA 0.67 13.75 NA XXX 70551 26 A Mri brain w/o dye 1.47 0.50 0.50 0.08 2.05 2.05 XXX 70551 TC A Mri brain w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 70552 A Mri brain w/ dye 1.77 13.94 NA 0.80 16.51 NA XXX 70552 26 A Mri brain w/ dye 1.77 0.61 0.61 0.10 2.48 2.48 XXX 70552 TC A Mri brain w/ dye 0.00 13.33 NA 0.70 14.03 NA XXX 70553 A Mri brain w/o & w/ dye 2.35 25.46 NA 1.43 29.24 NA XXX 70553 26 A Mri brain w/o & w/ dye 2.35 0.78 0.78 0.12 3.25 3.25 XXX 70553 TC A Mri brain w/o & w/ dye 0.00 24.68 NA 1.31 25.99 NA XXX 70557 C Mri brain w/o dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70557 26 A Mri brain w/o dye 2.88 0.99 0.99 0.08 3.95 3.95 XXX 70557 TC C Mri brain w/o dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70558 C Mri brain w/ dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70558 26 A Mri brain w/ dye 3.18 1.09 1.09 0.10 4.37 4.37 XXX 70558 TC C Mri brain w/ dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70559 C Mri brain w/o & w/ dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70559 26 A Mri brain w/o & w/ dye 3.18 1.09 1.09 0.12 4.39 4.39 XXX 70559 TC C Mri brain w/o & w/ dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 71010 A Chest x-ray 0.18 0.53 NA 0.03 0.74 NA XXX 71010 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71010 TC A Chest x-ray 0.00 0.47 NA 0.02 0.49 NA XXX 71015 A Chest x-ray 0.21 0.59 NA 0.03 0.83 NA XXX 71015 26 A Chest x-ray 0.21 0.07 0.07 0.01 0.29 0.29 XXX 71015 TC A Chest x-ray 0.00 0.52 NA 0.02 0.54 NA XXX 71020 A Chest x-ray 0.22 0.69 NA 0.05 0.96 NA XXX 71020 26 A Chest x-ray 0.22 0.07 0.07 0.01 0.30 0.30 XXX 71020 TC A Chest x-ray 0.00 0.62 NA 0.04 0.66 NA XXX 71021 A Chest x-ray 0.27 0.81 NA 0.06 1.14 NA XXX 71021 26 A Chest x-ray 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71021 TC A Chest x-ray 0.00 0.72 NA 0.05 0.77 NA XXX 71022 A Chest x-ray 0.31 0.82 NA 0.07 1.20 NA XXX 71022 26 A Chest x-ray 0.31 0.10 0.10 0.02 0.43 0.43 XXX 71022 TC A Chest x-ray 0.00 0.72 NA 0.05 0.77 NA XXX 71023 A Chest x-ray and fluoroscopy 0.38 0.90 NA 0.07 1.35 NA XXX 71023 26 A Chest x-ray and fluoroscopy 0.38 0.13 0.13 0.02 0.53 0.53 XXX 71023 TC A Chest x-ray and fluoroscopy 0.00 0.77 NA 0.05 0.82 NA XXX 71030 A Chest x-ray 0.31 0.87 NA 0.06 1.24 NA XXX 71030 26 A Chest x-ray 0.31 0.10 0.10 0.01 0.42 0.42 XXX 71030 TC A Chest x-ray 0.00 0.77 NA 0.05 0.82 NA XXX 71034 A Chest x-ray and fluoroscopy 0.46 1.59 NA 0.10 2.15 NA XXX 71034 26 A Chest x-ray and fluoroscopy 0.46 0.16 0.16 0.02 0.64 0.64 XXX 71034 TC A Chest x-ray and fluoroscopy 0.00 1.43 NA 0.08 1.51 NA XXX 71035 A Chest x-ray 0.18 0.58 NA 0.03 0.79 NA XXX 71035 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71035 TC A Chest x-ray 0.00 0.52 NA 0.02 0.54 NA XXX 71040 A Contrast x-ray of bronchi 0.58 1.64 NA 0.12 2.34 NA XXX 71040 26 A Contrast x-ray of bronchi 0.58 0.19 0.19 0.04 0.81 0.81 XXX 71040 TC A Contrast x-ray of bronchi 0.00 1.45 NA 0.08 1.53 NA XXX 71060 A Contrast x-ray of bronchi 0.74 2.43 NA 0.17 3.34 NA XXX 71060 26 A Contrast x-ray of bronchi 0.74 0.25 0.25 0.04 1.03 1.03 XXX 71060 TC A Contrast x-ray of bronchi 0.00 2.18 NA 0.13 2.31 NA XXX 71090 A X-ray & pacemaker insertion 0.54 1.88 NA 0.13 2.55 NA XXX 71090 26 A X-ray & pacemaker insertion 0.54 0.21 0.21 0.02 0.77 0.77 XXX 71090 TC A X-ray & pacemaker insertion 0.00 1.67 NA 0.11 1.78 NA XXX 71100 A X-ray exam of ribs 0.22 0.64 NA 0.05 0.91 NA XXX 71100 26 A X-ray exam of ribs 0.22 0.07 0.07 0.01 0.30 0.30 XXX 71100 TC A X-ray exam of ribs 0.00 0.57 NA 0.04 0.61 NA XXX 71101 A X-ray exam of ribs/chest 0.27 0.75 NA 0.05 1.07 NA XXX 71101 26 A X-ray exam of ribs/chest 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71101 TC A X-ray exam of ribs/chest 0.00 0.66 NA 0.04 0.70 NA XXX 71110 A X-ray exam of ribs 0.27 0.86 NA 0.06 1.19 NA XXX 71110 26 A X-ray exam of ribs 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71110 TC A X-ray exam of ribs 0.00 0.77 NA 0.05 0.82 NA XXX Start Printed Page 63337 71111 A X-ray exam of ribs/ chest 0.32 0.99 NA 0.07 1.38 NA XXX 71111 26 A X-ray exam of ribs/ chest 0.32 0.11 0.11 0.01 0.44 0.44 XXX 71111 TC A X-ray exam of ribs/ chest 0.00 0.88 NA 0.06 0.94 NA XXX 71120 A X-ray exam of breastbone 0.20 0.71 NA 0.05 0.96 NA XXX 71120 26 A X-ray exam of breastbone 0.20 0.07 0.07 0.01 0.28 0.28 XXX 71120 TC A X-ray exam of breastbone 0.00 0.64 NA 0.04 0.68 NA XXX 71130 A X-ray exam of breastbone 0.22 0.77 NA 0.05 1.04 NA XXX 71130 26 A X-ray exam of breastbone 0.22 0.07 0.07 0.01 0.30 0.30 XXX 71130 TC A X-ray exam of breastbone 0.00 0.70 NA 0.04 0.74 NA XXX 71250 A Ct thorax w/o dye 1.15 6.24 NA 0.37 7.76 NA XXX 71250 26 A Ct thorax w/o dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 71250 TC A Ct thorax w/o dye 0.00 5.85 NA 0.31 6.16 NA XXX 71260 A Ct thorax w/dye 1.23 7.42 NA 0.43 9.08 NA XXX 71260 26 A Ct thorax w/dye 1.23 0.41 0.41 0.06 1.70 1.70 XXX 71260 TC A Ct thorax w/dye 0.00 7.01 NA 0.37 7.38 NA XXX 71270 A Ct thorax w/o & w/ dye 1.37 9.23 NA 0.53 11.13 NA XXX 71270 26 A Ct thorax w/o & w/ dye 1.37 0.46 0.46 0.07 1.90 1.90 XXX 71270 TC A Ct thorax w/o & w/ dye 0.00 8.77 NA 0.46 9.23 NA XXX 71275 A Ct angiography, chest 1.91 12.92 NA 0.45 15.28 NA XXX 71275 26 A Ct angiography, chest 1.91 0.64 0.64 0.07 2.62 2.62 XXX 71275 TC A Ct angiography, chest 0.00 12.28 NA 0.38 12.66 NA XXX 71550 A Mri chest w/o dye 1.45 11.60 NA 0.49 13.54 NA XXX 71550 26 A Mri chest w/o dye 1.45 0.49 0.49 0.05 1.99 1.99 XXX 71550 TC A Mri chest w/o dye 0.00 11.11 NA 0.44 11.55 NA XXX 71551 A Mri chest w/dye 1.72 13.91 NA 0.59 16.22 NA XXX 71551 26 A Mri chest w/dye 1.72 0.58 0.58 0.07 2.37 2.37 XXX 71551 TC A Mri chest w/dye 0.00 13.33 NA 0.52 13.85 NA XXX 71552 A Mri chest w/o & w/dye 2.25 25.43 NA 0.77 28.45 NA XXX 71552 26 A Mri chest w/o & w/dye 2.25 0.75 0.75 0.10 3.10 3.10 XXX 71552 TC A Mri chest w/o & w/dye 0.00 24.68 NA 0.67 25.35 NA XXX 71555 R Mri angio chest w or w/o dye 1.80 11.72 NA 0.69 14.21 NA XXX 71555 26 R Mri angio chest w or w/o dye 1.80 0.61 0.61 0.10 2.51 2.51 XXX 71555 TC R Mri angio chest w or w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 72010 A X-ray exam of spine 0.45 1.16 NA 0.10 1.71 NA XXX 72010 26 A X-ray exam of spine 0.45 0.15 0.15 0.04 0.64 0.64 XXX 72010 TC A X-ray exam of spine 0.00 1.01 NA 0.06 1.07 NA XXX 72020 A X-ray exam of spine 0.15 0.47 NA 0.03 0.65 NA XXX 72020 26 A X-ray exam of spine 0.15 0.05 0.05 0.01 0.21 0.21 XXX 72020 TC A X-ray exam of spine 0.00 0.42 NA 0.02 0.44 NA XXX 72040 A X-ray exam of neck spine 0.22 0.67 NA 0.05 0.94 NA XXX 72040 26 A X-ray exam of neck spine 0.22 0.07 0.07 0.01 0.30 0.30 XXX 72040 TC A X-ray exam of neck spine 0.00 0.60 NA 0.04 0.64 NA XXX 72050 A X-ray exam of neck spine 0.31 0.98 NA 0.08 1.37 NA XXX 72050 26 A X-ray exam of neck spine 0.31 0.10 0.10 0.02 0.43 0.43 XXX 72050 TC A X-ray exam of neck spine 0.00 0.88 NA 0.06 0.94 NA XXX 72052 A X-ray exam of neck spine 0.36 1.24 NA 0.08 1.68 NA XXX 72052 26 A X-ray exam of neck spine 0.36 0.12 0.12 0.02 0.50 0.50 XXX 72052 TC A X-ray exam of neck spine 0.00 1.12 NA 0.06 1.18 NA XXX 72069 A X-ray exam of trunk spine 0.22 0.57 NA 0.04 0.83 NA XXX 72069 26 A X-ray exam of trunk spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72069 TC A X-ray exam of trunk spine 0.00 0.49 NA 0.02 0.51 NA XXX 72070 A X-ray exam of thoracic spine 0.22 0.71 NA 0.05 0.98 NA XXX 72070 26 A X-ray exam of thoracic spine 0.22 0.07 0.07 0.01 0.30 0.30 XXX 72070 TC A X-ray exam of thoracic spine 0.00 0.64 NA 0.04 0.68 NA XXX 72072 A X-ray exam of thoracic spine 0.22 0.79 NA 0.06 1.07 NA XXX 72072 26 A X-ray exam of thoracic spine 0.22 0.07 0.07 0.01 0.30 0.30 XXX 72072 TC A X-ray exam of thoracic spine 0.00 0.72 NA 0.05 0.77 NA XXX 72074 A X-ray exam of thoracic spine 0.22 0.97 NA 0.07 1.26 NA XXX 72074 26 A X-ray exam of thoracic spine 0.22 0.07 0.07 0.01 0.30 0.30 XXX 72074 TC A X-ray exam of thoracic spine 0.00 0.90 NA 0.06 0.96 NA XXX 72080 A X-ray exam of trunk spine 0.22 0.73 NA 0.06 1.01 NA XXX 72080 26 A X-ray exam of trunk spine 0.22 0.07 0.07 0.02 0.31 0.31 XXX 72080 TC A X-ray exam of trunk spine 0.00 0.66 NA 0.04 0.70 NA XXX 72090 A X-ray exam of trunk spine 0.28 0.76 NA 0.06 1.10 NA XXX 72090 26 A X-ray exam of trunk spine 0.28 0.10 0.10 0.02 0.40 0.40 XXX 72090 TC A X-ray exam of trunk spine 0.00 0.66 NA 0.04 0.70 NA XXX 72100 A X-ray exam of lower spine 0.22 0.73 NA 0.06 1.01 NA XXX 72100 26 A X-ray exam of lower spine 0.22 0.07 0.07 0.02 0.31 0.31 XXX 72100 TC A X-ray exam of lower spine 0.00 0.66 NA 0.04 0.70 NA XXX 72110 A X-ray exam of lower spine 0.31 1.00 NA 0.08 1.39 NA XXX 72110 26 A X-ray exam of lower spine 0.31 0.10 0.10 0.02 0.43 0.43 XXX 72110 TC A X-ray exam of lower spine 0.00 0.90 NA 0.06 0.96 NA XXX 72114 A X-ray exam of lower spine 0.36 1.30 NA 0.10 1.76 NA XXX 72114 26 A X-ray exam of lower spine 0.36 0.12 0.12 0.04 0.52 0.52 XXX 72114 TC A X-ray exam of lower spine 0.00 1.18 NA 0.06 1.24 NA XXX Start Printed Page 63338 72120 A X-ray exam of lower spine 0.22 0.95 NA 0.08 1.25 NA XXX 72120 26 A X-ray exam of lower spine 0.22 0.07 0.07 0.02 0.31 0.31 XXX 72120 TC A X-ray exam of lower spine 0.00 0.88 NA 0.06 0.94 NA XXX 72125 A Ct neck spine w/o dye 1.15 6.24 NA 0.37 7.76 NA XXX 72125 26 A Ct neck spine w/o dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 72125 TC A Ct neck spine w/o dye 0.00 5.85 NA 0.31 6.16 NA XXX 72126 A Ct neck spine w/dye 1.21 7.42 NA 0.43 9.06 NA XXX 72126 26 A Ct neck spine w/dye 1.21 0.41 0.41 0.06 1.68 1.68 XXX 72126 TC A Ct neck spine w/dye 0.00 7.01 NA 0.37 7.38 NA XXX 72127 A Ct neck spine w/o & w/dye 1.26 9.20 NA 0.53 10.99 NA XXX 72127 26 A Ct neck spine w/o & w/dye 1.26 0.43 0.43 0.07 1.76 1.76 XXX 72127 TC A Ct neck spine w/o & w/dye 0.00 8.77 NA 0.46 9.23 NA XXX 72128 A Ct chest spine w/o dye 1.15 6.24 NA 0.37 7.76 NA XXX 72128 26 A Ct chest spine w/o dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 72128 TC A Ct chest spine w/o dye 0.00 5.85 NA 0.31 6.16 NA XXX 72129 A Ct chest spine w/dye 1.21 7.42 NA 0.43 9.06 NA XXX 72129 26 A Ct chest spine w/dye 1.21 0.41 0.41 0.06 1.68 1.68 XXX 72129 TC A Ct chest spine w/dye 0.00 7.01 NA 0.37 7.38 NA XXX 72130 A Ct chest spine w/o & w/dye 1.26 9.19 NA 0.53 10.98 NA XXX 72130 26 A Ct chest spine w/o & w/dye 1.26 0.42 0.42 0.07 1.75 1.75 XXX 72130 TC A Ct chest spine w/o & w/dye 0.00 8.77 NA 0.46 9.23 NA XXX 72131 A Ct lumbar spine w/o dye 1.15 6.24 NA 0.37 7.76 NA XXX 72131 26 A Ct lumbar spine w/o dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 72131 TC A Ct lumbar spine w/o dye 0.00 5.85 NA 0.31 6.16 NA XXX 72132 A Ct lumbar spine w/dye 1.21 7.42 NA 0.44 9.07 NA XXX 72132 26 A Ct lumbar spine w/dye 1.21 0.41 0.41 0.07 1.69 1.69 XXX 72132 TC A Ct lumbar spine w/dye 0.00 7.01 NA 0.37 7.38 NA XXX 72133 A Ct lumbar spine w/o & w/dye 1.26 9.20 NA 0.53 10.99 NA XXX 72133 26 A Ct lumbar spine w/o & w/dye 1.26 0.43 0.43 0.07 1.76 1.76 XXX 72133 TC A Ct lumbar spine w/o & w/dye 0.00 8.77 NA 0.46 9.23 NA XXX 72141 A Mri neck spine w/o dye 1.59 11.65 NA 0.67 13.91 NA XXX 72141 26 A Mri neck spine w/o dye 1.59 0.54 0.54 0.08 2.21 2.21 XXX 72141 TC A Mri neck spine w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 72142 A Mri neck spine w/dye 1.91 13.98 NA 0.81 16.70 NA XXX 72142 26 A Mri neck spine w/dye 1.91 0.65 0.65 0.11 2.67 2.67 XXX 72142 TC A Mri neck spine w/dye 0.00 13.33 NA 0.70 14.03 NA XXX 72146 A Mri chest spine w/o dye 1.59 12.87 NA 0.72 15.18 NA XXX 72146 26 A Mri chest spine w/o dye 1.59 0.54 0.54 0.08 2.21 2.21 XXX 72146 TC A Mri chest spine w/o dye 0.00 12.33 NA 0.64 12.97 NA XXX 72147 A Mri chest spine w/dye 1.91 13.97 NA 0.81 16.69 NA XXX 72147 26 A Mri chest spine w/dye 1.91 0.64 0.64 0.11 2.66 2.66 XXX 72147 TC A Mri chest spine w/dye 0.00 13.33 NA 0.70 14.03 NA XXX 72148 A Mri lumbar spine w/o dye 1.47 12.83 NA 0.72 15.02 NA XXX 72148 26 A Mri lumbar spine w/o dye 1.47 0.50 0.50 0.08 2.05 2.05 XXX 72148 TC A Mri lumbar spine w/o dye 0.00 12.33 NA 0.64 12.97 NA XXX 72149 A Mri lumbar spine w/dye 1.77 13.94 NA 0.81 16.52 NA XXX 72149 26 A Mri lumbar spine w/dye 1.77 0.61 0.61 0.11 2.49 2.49 XXX 72149 TC A Mri lumbar spine w/dye 0.00 13.33 NA 0.70 14.03 NA XXX 72156 A Mri neck spine w/o & w/dye 2.56 25.53 NA 1.44 29.53 NA XXX 72156 26 A Mri neck spine w/o & w/dye 2.56 0.85 0.85 0.13 3.54 3.54 XXX 72156 TC A Mri neck spine w/o & w/dye 0.00 24.68 NA 1.31 25.99 NA XXX 72157 A Mri chest spine w/o & w/dye 2.56 25.53 NA 1.44 29.53 NA XXX 72157 26 A Mri chest spine w/o & w/dye 2.56 0.85 0.85 0.13 3.54 3.54 XXX 72157 TC A Mri chest spine w/o & w/dye 0.00 24.68 NA 1.31 25.99 NA XXX 72158 A Mri lumbar spine w/o & w/dye 2.35 25.46 NA 1.44 29.25 NA XXX 72158 26 A Mri lumbar spine w/o & w/dye 2.35 0.78 0.78 0.13 3.26 3.26 XXX 72158 TC A Mri lumbar spine w/o & w/dye 0.00 24.68 NA 1.31 25.99 NA XXX 72159 N Mr angio spine w/o&w/dye +1.79 12.98 12.98 0.74 15.51 15.51 XXX 72159 26 N Mr angio spine w/o&w/dye +1.79 0.69 0.69 0.10 2.58 2.58 XXX 72159 TC N Mr angio spine w/o&w/dye +0.00 12.29 12.29 0.64 12.93 12.93 XXX 72170 A X-ray exam of pelvis 0.17 0.58 NA 0.03 0.78 NA XXX 72170 26 A X-ray exam of pelvis 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72170 TC A X-ray exam of pelvis 0.00 0.52 NA 0.02 0.54 NA XXX 72190 A X-ray exam of pelvis 0.21 0.73 NA 0.05 0.99 NA XXX 72190 26 A X-ray exam of pelvis 0.21 0.07 0.07 0.01 0.29 0.29 XXX 72190 TC A X-ray exam of pelvis 0.00 0.66 NA 0.04 0.70 NA XXX 72191 A Ct angiograph pelv w/o&w/dye 1.80 12.54 NA 0.45 14.79 NA XXX 72191 26 A Ct angiograph pelv w/o&w/dye 1.80 0.61 0.61 0.07 2.48 2.48 XXX 72191 TC A Ct angiograph pelv w/o&w/dye 0.00 11.93 NA 0.38 12.31 NA XXX 72192 A Ct pelvis w/o dye 1.08 6.21 NA 0.37 7.66 NA XXX 72192 26 A Ct pelvis w/o dye 1.08 0.36 0.36 0.06 1.50 1.50 XXX 72192 TC A Ct pelvis w/o dye 0.00 5.85 NA 0.31 6.16 NA XXX 72193 A Ct pelvis w/dye 1.15 7.18 NA 0.42 8.75 NA XXX 72193 26 A Ct pelvis w/dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 72193 TC A Ct pelvis w/dye 0.00 6.79 NA 0.36 7.15 NA XXX Start Printed Page 63339 72194 A Ct pelvis w/o & w/dye 1.21 8.82 NA 0.49 10.52 NA XXX 72194 26 A Ct pelvis w/o & w/dye 1.21 0.41 0.41 0.06 1.68 1.68 XXX 72194 TC A Ct pelvis w/o & w/dye 0.00 8.41 NA 0.43 8.84 NA XXX 72195 A Mri pelvis w/o dye 1.45 11.60 NA 0.50 13.55 NA XXX 72195 26 A Mri pelvis w/o dye 1.45 0.49 0.49 0.06 2.00 2.00 XXX 72195 TC A Mri pelvis w/o dye 0.00 11.11 NA 0.44 11.55 NA XXX 72196 A Mri pelvis w/dye 1.72 13.91 NA 0.58 16.21 NA XXX 72196 26 A Mri pelvis w/dye 1.72 0.58 0.58 0.06 2.36 2.36 XXX 72196 TC A Mri pelvis w/dye 0.00 13.33 NA 0.52 13.85 NA XXX 72197 A Mri pelvis w/o & w/dye 2.25 25.43 NA 1.01 28.69 NA XXX 72197 26 A Mri pelvis w/o & w/dye 2.25 0.75 0.75 0.10 3.10 3.10 XXX 72197 TC A Mri pelvis w/o & w/dye 0.00 24.68 NA 0.91 25.59 NA XXX 72198 A Mr angio pelvis w/o & w/dye 1.79 11.80 NA 0.69 14.28 NA XXX 72198 26 A Mr angio pelvis w/o & w/dye 1.79 0.69 0.69 0.10 2.58 2.58 XXX 72198 TC A Mr angio pelvis w/o & w/dye 0.00 11.11 NA 0.59 11.70 NA XXX 72200 A X-ray exam sacroiliac joints 0.17 0.58 NA 0.03 0.78 NA XXX 72200 26 A X-ray exam sacroiliac joints 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72200 TC A X-ray exam sacroiliac joints 0.00 0.52 NA 0.02 0.54 NA XXX 72202 A X-ray exam sacroiliac joints 0.19 0.68 NA 0.05 0.92 NA XXX 72202 26 A X-ray exam sacroiliac joints 0.19 0.06 0.06 0.01 0.26 0.26 XXX 72202 TC A X-ray exam sacroiliac joints 0.00 0.62 NA 0.04 0.66 NA XXX 72220 A X-ray exam of tailbone 0.17 0.63 NA 0.05 0.85 NA XXX 72220 26 A X-ray exam of tailbone 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72220 TC A X-ray exam of tailbone 0.00 0.57 NA 0.04 0.61 NA XXX 72240 A Contrast x-ray of neck spine 0.90 4.99 NA 0.30 6.19 NA XXX 72240 26 A Contrast x-ray of neck spine 0.90 0.29 0.29 0.05 1.24 1.24 XXX 72240 TC A Contrast x-ray of neck spine 0.00 4.70 NA 0.25 4.95 NA XXX 72255 A Contrast x-ray, thorax spine 0.90 4.58 NA 0.27 5.75 NA XXX 72255 26 A Contrast x-ray, thorax spine 0.90 0.28 0.28 0.05 1.23 1.23 XXX 72255 TC A Contrast x-ray, thorax spine 0.00 4.30 NA 0.22 4.52 NA XXX 72265 A Contrast x-ray, lower spine 0.83 4.30 NA 0.27 5.40 NA XXX 72265 26 A Contrast x-ray, lower spine 0.83 0.26 0.26 0.05 1.14 1.14 XXX 72265 TC A Contrast x-ray, lower spine 0.00 4.04 NA 0.22 4.26 NA XXX 72270 A Contrast x-ray, spine 1.32 6.48 NA 0.40 8.20 NA XXX 72270 26 A Contrast x-ray, spine 1.32 0.43 0.43 0.08 1.83 1.83 XXX 72270 TC A Contrast x-ray, spine 0.00 6.05 NA 0.32 6.37 NA XXX 72275 A Epidurography 0.76 2.28 NA 0.26 3.30 NA XXX 72275 26 A Epidurography 0.76 0.20 0.20 0.04 1.00 1.00 XXX 72275 TC A Epidurography 0.00 2.08 NA 0.22 2.30 NA XXX 72285 A X-ray c/t spine disk 1.15 8.68 NA 0.50 10.33 NA XXX 72285 26 A X-ray c/t spine disk 1.15 0.36 0.36 0.07 1.58 1.58 XXX 72285 TC A X-ray c/t spine disk 0.00 8.32 NA 0.43 8.75 NA XXX 72295 A X-ray of lower spine disk 0.83 8.06 NA 0.45 9.34 NA XXX 72295 26 A X-ray of lower spine disk 0.83 0.27 0.27 0.05 1.15 1.15 XXX 72295 TC A X-ray of lower spine disk 0.00 7.79 NA 0.40 8.19 NA XXX 73000 A X-ray exam of collar bone 0.16 0.57 NA 0.03 0.76 NA XXX 73000 26 A X-ray exam of collar bone 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73000 TC A X-ray exam of collar bone 0.00 0.52 NA 0.02 0.54 NA XXX 73010 A X-ray exam of shoulder blade 0.17 0.58 NA 0.03 0.78 NA XXX 73010 26 A X-ray exam of shoulder blade 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73010 TC A X-ray exam of shoulder blade 0.00 0.52 NA 0.02 0.54 NA XXX 73020 A X-ray exam of shoulder 0.15 0.52 NA 0.03 0.70 NA XXX 73020 26 A X-ray exam of shoulder 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73020 TC A X-ray exam of shoulder 0.00 0.47 NA 0.02 0.49 NA XXX 73030 A X-ray exam of shoulder 0.18 0.63 NA 0.05 0.86 NA XXX 73030 26 A X-ray exam of shoulder 0.18 0.06 0.06 0.01 0.25 0.25 XXX 73030 TC A X-ray exam of shoulder 0.00 0.57 NA 0.04 0.61 NA XXX 73040 A Contrast x-ray of shoulder 0.54 2.26 NA 0.16 2.96 NA XXX 73040 26 A Contrast x-ray of shoulder 0.54 0.18 0.18 0.04 0.76 0.76 XXX 73040 TC A Contrast x-ray of shoulder 0.00 2.08 NA 0.12 2.20 NA XXX 73050 A X-ray exam of shoulders 0.20 0.73 NA 0.06 0.99 NA XXX 73050 26 A X-ray exam of shoulders 0.20 0.07 0.07 0.02 0.29 0.29 XXX 73050 TC A X-ray exam of shoulders 0.00 0.66 NA 0.04 0.70 NA XXX 73060 A X-ray exam of humerus 0.17 0.63 NA 0.05 0.85 NA XXX 73060 26 A X-ray exam of humerus 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73060 TC A X-ray exam of humerus 0.00 0.57 NA 0.04 0.61 NA XXX 73070 A X-ray exam of elbow 0.15 0.57 NA 0.03 0.75 NA XXX 73070 26 A X-ray exam of elbow 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73070 TC A X-ray exam of elbow 0.00 0.52 NA 0.02 0.54 NA XXX 73080 A X-ray exam of elbow 0.17 0.63 NA 0.05 0.85 NA XXX 73080 26 A X-ray exam of elbow 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73080 TC A X-ray exam of elbow 0.00 0.57 NA 0.04 0.61 NA XXX 73085 A Contrast x-ray of elbow 0.54 2.27 NA 0.16 2.97 NA XXX 73085 26 A Contrast x-ray of elbow 0.54 0.19 0.19 0.04 0.77 0.77 XXX 73085 TC A Contrast x-ray of elbow 0.00 2.08 NA 0.12 2.20 NA XXX Start Printed Page 63340 73090 A X-ray exam of forearm 0.16 0.57 NA 0.03 0.76 NA XXX 73090 26 A X-ray exam of forearm 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73090 TC A X-ray exam of forearm 0.00 0.52 NA 0.02 0.54 NA XXX 73092 A X-ray exam of arm, infant 0.16 0.54 NA 0.03 0.73 NA XXX 73092 26 A X-ray exam of arm, infant 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73092 TC A X-ray exam of arm, infant 0.00 0.49 NA 0.02 0.51 NA XXX 73100 A X-ray exam of wrist 0.16 0.55 NA 0.04 0.75 NA XXX 73100 26 A X-ray exam of wrist 0.16 0.06 0.06 0.02 0.24 0.24 XXX 73100 TC A X-ray exam of wrist 0.00 0.49 NA 0.02 0.51 NA XXX 73110 A X-ray exam of wrist 0.17 0.59 NA 0.03 0.79 NA XXX 73110 26 A X-ray exam of wrist 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73110 TC A X-ray exam of wrist 0.00 0.53 NA 0.02 0.55 NA XXX 73115 A Contrast x-ray of wrist 0.54 1.75 NA 0.14 2.43 NA XXX 73115 26 A Contrast x-ray of wrist 0.54 0.19 0.19 0.04 0.77 0.77 XXX 73115 TC A Contrast x-ray of wrist 0.00 1.56 NA 0.10 1.66 NA XXX 73120 A X-ray exam of hand 0.16 0.54 NA 0.03 0.73 NA XXX 73120 26 A X-ray exam of hand 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73120 TC A X-ray exam of hand 0.00 0.49 NA 0.02 0.51 NA XXX 73130 A X-ray exam of hand 0.17 0.59 NA 0.03 0.79 NA XXX 73130 26 A X-ray exam of hand 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73130 TC A X-ray exam of hand 0.00 0.53 NA 0.02 0.55 NA XXX 73140 A X-ray exam of finger(s) 0.13 0.46 NA 0.03 0.62 NA XXX 73140 26 A X-ray exam of finger(s) 0.13 0.04 0.04 0.01 0.18 0.18 XXX 73140 TC A X-ray exam of finger(s) 0.00 0.42 NA 0.02 0.44 NA XXX 73200 A Ct upper extremity w/o dye 1.08 5.28 NA 0.31 6.67 NA XXX 73200 26 A Ct upper extremity w/o dye 1.08 0.36 0.36 0.06 1.50 1.50 XXX 73200 TC A Ct upper extremity w/o dye 0.00 4.92 NA 0.25 5.17 NA XXX 73201 A Ct upper extremity w/dye 1.15 6.24 NA 0.37 7.76 NA XXX 73201 26 A Ct upper extremity w/dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 73201 TC A Ct upper extremity w/dye 0.00 5.85 NA 0.31 6.16 NA XXX 73202 A Ct uppr extremity w/o&w/dye 1.21 7.77 NA 0.45 9.43 NA XXX 73202 26 A Ct uppr extremity w/o&w/dye 1.21 0.41 0.41 0.07 1.69 1.69 XXX 73202 TC A Ct uppr extremity w/o&w/dye 0.00 7.36 NA 0.38 7.74 NA XXX 73206 A Ct angio upr extrm w/o&w/dye 1.80 11.47 NA 0.45 13.72 NA XXX 73206 26 A Ct angio upr extrm w/o&w/dye 1.80 0.60 0.60 0.07 2.47 2.47 XXX 73206 TC A Ct angio upr extrm w/o&w/dye 0.00 10.87 NA 0.38 11.25 NA XXX 73218 A Mri upper extremity w/o dye 1.34 11.56 NA 0.43 13.33 NA XXX 73218 26 A Mri upper extremity w/o dye 1.34 0.45 0.45 0.05 1.84 1.84 XXX 73218 TC A Mri upper extremity w/o dye 0.00 11.11 NA 0.38 11.49 NA XXX 73219 A Mri upper extremity w/dye 1.61 13.88 NA 0.53 16.02 NA XXX 73219 26 A Mri upper extremity w/dye 1.61 0.55 0.55 0.06 2.22 2.22 XXX 73219 TC A Mri upper extremity w/dye 0.00 13.33 NA 0.47 13.80 NA XXX 73220 A Mri uppr extremity w/o&w/dye 2.14 25.39 NA 0.94 28.47 NA XXX 73220 26 A Mri uppr extremity w/o&w/dye 2.14 0.71 0.71 0.10 2.95 2.95 XXX 73220 TC A Mri uppr extremity w/o&w/dye 0.00 24.68 NA 0.84 25.52 NA XXX 73221 A Mri joint upr extrem w/o dye 1.34 11.56 NA 0.43 13.33 NA XXX 73221 26 A Mri joint upr extrem w/o dye 1.34 0.45 0.45 0.05 1.84 1.84 XXX 73221 TC A Mri joint upr extrem w/o dye 0.00 11.11 NA 0.38 11.49 NA XXX 73222 A Mri joint upr extrem w/dye 1.61 13.87 NA 0.53 16.01 NA XXX 73222 26 A Mri joint upr extrem w/dye 1.61 0.54 0.54 0.06 2.21 2.21 XXX 73222 TC A Mri joint upr extrem w/dye 0.00 13.33 NA 0.47 13.80 NA XXX 73223 A Mri joint upr extr w/o&w/dye 2.14 25.39 NA 0.92 28.45 NA XXX 73223 26 A Mri joint upr extr w/o&w/dye 2.14 0.71 0.71 0.08 2.93 2.93 XXX 73223 TC A Mri joint upr extr w/o&w/dye 0.00 24.68 NA 0.84 25.52 NA XXX 73225 N Mr angio upr extr w/o&w/dye +1.72 11.74 11.74 0.69 14.15 14.15 XXX 73225 26 N Mr angio upr extr w/o&w/dye +1.72 0.67 0.67 0.10 2.49 2.49 XXX 73225 TC N Mr angio upr extr w/o&w/dye +0.00 11.07 11.07 0.59 11.66 11.66 XXX 73500 A X-ray exam of hip 0.17 0.53 NA 0.03 0.73 NA XXX 73500 26 A X-ray exam of hip 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73500 TC A X-ray exam of hip 0.00 0.47 NA 0.02 0.49 NA XXX 73510 A X-ray exam of hip 0.21 0.64 NA 0.06 0.91 NA XXX 73510 26 A X-ray exam of hip 0.21 0.07 0.07 0.02 0.30 0.30 XXX 73510 TC A X-ray exam of hip 0.00 0.57 NA 0.04 0.61 NA XXX 73520 A X-ray exam of hips 0.26 0.75 NA 0.06 1.07 NA XXX 73520 26 A X-ray exam of hips 0.26 0.09 0.09 0.02 0.37 0.37 XXX 73520 TC A X-ray exam of hips 0.00 0.66 NA 0.04 0.70 NA XXX 73525 A Contrast x-ray of hip 0.54 2.26 NA 0.16 2.96 NA XXX 73525 26 A Contrast x-ray of hip 0.54 0.18 0.18 0.04 0.76 0.76 XXX 73525 TC A Contrast x-ray of hip 0.00 2.08 NA 0.12 2.20 NA XXX 73530 A X-ray exam of hip 0.29 0.62 NA 0.03 0.94 NA XXX 73530 26 A X-ray exam of hip 0.29 0.10 0.10 0.01 0.40 0.40 XXX 73530 TC A X-ray exam of hip 0.00 0.52 NA 0.02 0.54 NA XXX 73540 A X-ray exam of pelvis & hips 0.20 0.64 NA 0.06 0.90 NA XXX 73540 26 A X-ray exam of pelvis & hips 0.20 0.07 0.07 0.02 0.29 0.29 XXX 73540 TC A X-ray exam of pelvis & hips 0.00 0.57 NA 0.04 0.61 NA XXX Start Printed Page 63341 73542 A X-ray exam, sacroiliac joint 0.59 2.24 NA 0.16 2.99 NA XXX 73542 26 A X-ray exam, sacroiliac joint 0.59 0.16 0.16 0.04 0.79 0.79 XXX 73542 TC A X-ray exam, sacroiliac joint 0.00 2.08 NA 0.12 2.20 NA XXX 73550 A X-ray exam of thigh 0.17 0.63 NA 0.05 0.85 NA XXX 73550 26 A X-ray exam of thigh 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73550 TC A X-ray exam of thigh 0.00 0.57 NA 0.04 0.61 NA XXX 73560 A X-ray exam of knee, 1 or 2 0.17 0.58 NA 0.04 0.79 NA XXX 73560 26 A X-ray exam of knee, 1 or 2 0.17 0.06 0.06 0.02 0.25 0.25 XXX 73560 TC A X-ray exam of knee, 1 or 2 0.00 0.52 NA 0.02 0.54 NA XXX 73562 A X-ray exam of knee, 3 0.18 0.63 NA 0.06 0.87 NA XXX 73562 26 A X-ray exam of knee, 3 0.18 0.06 0.06 0.02 0.26 0.26 XXX 73562 TC A X-ray exam of knee, 3 0.00 0.57 NA 0.04 0.61 NA XXX 73564 A X-ray exam, knee, 4 or more 0.22 0.70 NA 0.06 0.98 NA XXX 73564 26 A X-ray exam, knee, 4 or more 0.22 0.08 0.08 0.02 0.32 0.32 XXX 73564 TC A X-ray exam, knee, 4 or more 0.00 0.62 NA 0.04 0.66 NA XXX 73565 A X-ray exam of knees 0.17 0.55 NA 0.04 0.76 NA XXX 73565 26 A X-ray exam of knees 0.17 0.06 0.06 0.02 0.25 0.25 XXX 73565 TC A X-ray exam of knees 0.00 0.49 NA 0.02 0.51 NA XXX 73580 A Contrast x-ray of knee joint 0.54 2.78 NA 0.18 3.50 NA XXX 73580 26 A Contrast x-ray of knee joint 0.54 0.18 0.18 0.04 0.76 0.76 XXX 73580 TC A Contrast x-ray of knee joint 0.00 2.60 NA 0.14 2.74 NA XXX 73590 A X-ray exam of lower leg 0.17 0.58 NA 0.03 0.78 NA XXX 73590 26 A X-ray exam of lower leg 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73590 TC A X-ray exam of lower leg 0.00 0.52 NA 0.02 0.54 NA XXX 73592 A X-ray exam of leg, infant 0.16 0.55 NA 0.03 0.74 NA XXX 73592 26 A X-ray exam of leg, infant 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73592 TC A X-ray exam of leg, infant 0.00 0.49 NA 0.02 0.51 NA XXX 73600 A X-ray exam of ankle 0.16 0.54 NA 0.03 0.73 NA XXX 73600 26 A X-ray exam of ankle 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73600 TC A X-ray exam of ankle 0.00 0.49 NA 0.02 0.51 NA XXX 73610 A X-ray exam of ankle 0.17 0.59 NA 0.03 0.79 NA XXX 73610 26 A X-ray exam of ankle 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73610 TC A X-ray exam of ankle 0.00 0.53 NA 0.02 0.55 NA XXX 73615 A Contrast x-ray of ankle 0.54 2.27 NA 0.16 2.97 NA XXX 73615 26 A Contrast x-ray of ankle 0.54 0.19 0.19 0.04 0.77 0.77 XXX 73615 TC A Contrast x-ray of ankle 0.00 2.08 NA 0.12 2.20 NA XXX 73620 A X-ray exam of foot 0.16 0.54 NA 0.03 0.73 NA XXX 73620 26 A X-ray exam of foot 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73620 TC A X-ray exam of foot 0.00 0.49 NA 0.02 0.51 NA XXX 73630 A X-ray exam of foot 0.17 0.59 NA 0.03 0.79 NA XXX 73630 26 A X-ray exam of foot 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73630 TC A X-ray exam of foot 0.00 0.53 NA 0.02 0.55 NA XXX 73650 A X-ray exam of heel 0.16 0.52 NA 0.03 0.71 NA XXX 73650 26 A X-ray exam of heel 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73650 TC A X-ray exam of heel 0.00 0.47 NA 0.02 0.49 NA XXX 73660 A X-ray exam of toe(s) 0.13 0.46 NA 0.03 0.62 NA XXX 73660 26 A X-ray exam of toe(s) 0.13 0.04 0.04 0.01 0.18 0.18 XXX 73660 TC A X-ray exam of toe(s) 0.00 0.42 NA 0.02 0.44 NA XXX 73700 A Ct lower extremity w/o dye 1.08 5.28 NA 0.31 6.67 NA XXX 73700 26 A Ct lower extremity w/o dye 1.08 0.36 0.36 0.06 1.50 1.50 XXX 73700 TC A Ct lower extremity w/o dye 0.00 4.92 NA 0.25 5.17 NA XXX 73701 A Ct lower extremity w/dye 1.15 6.24 NA 0.37 7.76 NA XXX 73701 26 A Ct lower extremity w/dye 1.15 0.39 0.39 0.06 1.60 1.60 XXX 73701 TC A Ct lower extremity w/dye 0.00 5.85 NA 0.31 6.16 NA XXX 73702 A Ct lwr extremity w/o&w/dye 1.21 7.77 NA 0.44 9.42 NA XXX 73702 26 A Ct lwr extremity w/o&w/dye 1.21 0.41 0.41 0.06 1.68 1.68 XXX 73702 TC A Ct lwr extremity w/o&w/dye 0.00 7.36 NA 0.38 7.74 NA XXX 73706 A Ct angio lwr extr w/o&w/dye 1.89 11.51 NA 0.45 13.85 NA XXX 73706 26 A Ct angio lwr extr w/o&w/dye 1.89 0.64 0.64 0.07 2.60 2.60 XXX 73706 TC A Ct angio lwr extr w/o&w/dye 0.00 10.87 NA 0.38 11.25 NA XXX 73718 A Mri lower extremity w/o dye 1.34 11.56 NA 0.43 13.33 NA XXX 73718 26 A Mri lower extremity w/o dye 1.34 0.45 0.45 0.05 1.84 1.84 XXX 73718 TC A Mri lower extremity w/o dye 0.00 11.11 NA 0.38 11.49 NA XXX 73719 A Mri lower extremity w/dye 1.61 13.87 NA 0.53 16.01 NA XXX 73719 26 A Mri lower extremity w/dye 1.61 0.54 0.54 0.06 2.21 2.21 XXX 73719 TC A Mri lower extremity w/dye 0.00 13.33 NA 0.47 13.80 NA XXX 73720 A Mri lwr extremity w/o&w/dye 2.14 25.39 NA 0.94 28.47 NA XXX 73720 26 A Mri lwr extremity w/o&w/dye 2.14 0.71 0.71 0.10 2.95 2.95 XXX 73720 TC A Mri lwr extremity w/o&w/dye 0.00 24.68 NA 0.84 25.52 NA XXX 73721 A Mri jnt of lwr extre w/o dye 1.34 11.56 NA 0.43 13.33 NA XXX 73721 26 A Mri jnt of lwr extre w/o dye 1.34 0.45 0.45 0.05 1.84 1.84 XXX 73721 TC A Mri jnt of lwr extre w/o dye 0.00 11.11 NA 0.38 11.49 NA XXX 73722 A Mri joint of lwr extr w/dye 1.61 13.88 NA 0.54 16.03 NA XXX 73722 26 A Mri joint of lwr extr w/dye 1.61 0.55 0.55 0.07 2.23 2.23 XXX 73722 TC A Mri joint of lwr extr w/dye 0.00 13.33 NA 0.47 13.80 NA XXX Start Printed Page 63342 73723 A Mri joint lwr extr w/o&w/dye 2.14 25.39 NA 0.92 28.45 NA XXX 73723 26 A Mri joint lwr extr w/o&w/dye 2.14 0.71 0.71 0.08 2.93 2.93 XXX 73723 TC A Mri joint lwr extr w/o&w/dye 0.00 24.68 NA 0.84 25.52 NA XXX 73725 R Mr ang lwr ext w or w/o dye 1.81 11.72 NA 0.69 14.22 NA XXX 73725 26 R Mr ang lwr ext w or w/o dye 1.81 0.61 0.61 0.10 2.52 2.52 XXX 73725 TC R Mr ang lwr ext w or w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 74000 A X-ray exam of abdomen 0.18 0.58 NA 0.03 0.79 NA XXX 74000 26 A X-ray exam of abdomen 0.18 0.06 0.06 0.01 0.25 0.25 XXX 74000 TC A X-ray exam of abdomen 0.00 0.52 NA 0.02 0.54 NA XXX 74010 A X-ray exam of abdomen 0.23 0.65 NA 0.05 0.93 NA XXX 74010 26 A X-ray exam of abdomen 0.23 0.08 0.08 0.01 0.32 0.32 XXX 74010 TC A X-ray exam of abdomen 0.00 0.57 NA 0.04 0.61 NA XXX 74020 A X-ray exam of abdomen 0.27 0.71 NA 0.05 1.03 NA XXX 74020 26 A X-ray exam of abdomen 0.27 0.09 0.09 0.01 0.37 0.37 XXX 74020 TC A X-ray exam of abdomen 0.00 0.62 NA 0.04 0.66 NA XXX 74022 A X-ray exam series, abdomen 0.32 0.83 NA 0.06 1.21 NA XXX 74022 26 A X-ray exam series, abdomen 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74022 TC A X-ray exam series, abdomen 0.00 0.72 NA 0.05 0.77 NA XXX 74150 A Ct abdomen w/o dye 1.18 6.01 NA 0.36 7.55 NA XXX 74150 26 A Ct abdomen w/o dye 1.18 0.40 0.40 0.06 1.64 1.64 XXX 74150 TC A Ct abdomen w/o dye 0.00 5.61 NA 0.30 5.91 NA XXX 74160 A Ct abdomen w/dye 1.26 7.21 NA 0.43 8.90 NA XXX 74160 26 A Ct abdomen w/dye 1.26 0.42 0.42 0.07 1.75 1.75 XXX 74160 TC A Ct abdomen w/dye 0.00 6.79 NA 0.36 7.15 NA XXX 74170 A Ct abdomen w/o &w /dye 1.39 8.88 NA 0.50 10.77 NA XXX 74170 26 A Ct abdomen w/o &w /dye 1.39 0.47 0.47 0.07 1.93 1.93 XXX 74170 TC A Ct abdomen w/o &w /dye 0.00 8.41 NA 0.43 8.84 NA XXX 74175 A Ct angio abdom w/o & w/dye 1.89 12.57 NA 0.45 14.91 NA XXX 74175 26 A Ct angio abdom w/o & w/dye 1.89 0.64 0.64 0.07 2.60 2.60 XXX 74175 TC A Ct angio abdom w/o & w/dye 0.00 11.93 NA 0.38 12.31 NA XXX 74181 A Mri abdomen w/o dye 1.45 11.60 NA 0.51 13.56 NA XXX 74181 26 A Mri abdomen w/o dye 1.45 0.49 0.49 0.07 2.01 2.01 XXX 74181 TC A Mri abdomen w/o dye 0.00 11.11 NA 0.44 11.55 NA XXX 74182 A Mri abdomen w/dye 1.72 13.91 NA 0.59 16.22 NA XXX 74182 26 A Mri abdomen w/dye 1.72 0.58 0.58 0.07 2.37 2.37 XXX 74182 TC A Mri abdomen w/dye 0.00 13.33 NA 0.52 13.85 NA XXX 74183 A Mri abdomen w/o & w/dye 2.25 25.43 NA 1.01 28.69 NA XXX 74183 26 A Mri abdomen w/o & w/dye 2.25 0.75 0.75 0.10 3.10 3.10 XXX 74183 TC A Mri abdomen w/o & w/dye 0.00 24.68 NA 0.91 25.59 NA XXX 74185 R Mri angio, abdom w orw/o dye 1.79 11.71 NA 0.69 14.19 NA XXX 74185 26 R Mri angio, abdom w orw/o dye 1.79 0.60 0.60 0.10 2.49 2.49 XXX 74185 TC R Mri angio, abdom w orw/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 74190 A X-ray exam of peritoneum 0.48 1.45 NA 0.09 2.02 NA XXX 74190 26 A X-ray exam of peritoneum 0.48 0.16 0.16 0.02 0.66 0.66 XXX 74190 TC A X-ray exam of peritoneum 0.00 1.29 NA 0.07 1.36 NA XXX 74210 A Contrst x-ray exam of throat 0.36 1.30 NA 0.08 1.74 NA XXX 74210 26 A Contrst x-ray exam of throat 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74210 TC A Contrst x-ray exam of throat 0.00 1.18 NA 0.06 1.24 NA XXX 74220 A Contrast x-ray, esophagus 0.46 1.33 NA 0.08 1.87 NA XXX 74220 26 A Contrast x-ray, esophagus 0.46 0.15 0.15 0.02 0.63 0.63 XXX 74220 TC A Contrast x-ray, esophagus 0.00 1.18 NA 0.06 1.24 NA XXX 74230 A Cine/vid x-ray, throat/esoph 0.53 1.47 NA 0.09 2.09 NA XXX 74230 26 A Cine/vid x-ray, throat/esoph 0.53 0.18 0.18 0.02 0.73 0.73 XXX 74230 TC A Cine/vid x-ray, throat/esoph 0.00 1.29 NA 0.07 1.36 NA XXX 74235 A Remove esophagus obstruction 1.18 3.00 NA 0.20 4.38 NA XXX 74235 26 A Remove esophagus obstruction 1.18 0.40 0.40 0.06 1.64 1.64 XXX 74235 TC A Remove esophagus obstruction 0.00 2.60 NA 0.14 2.74 NA XXX 74240 A X-ray exam, upper gi tract 0.69 1.68 NA 0.12 2.49 NA XXX 74240 26 A X-ray exam, upper gi tract 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74240 TC A X-ray exam, upper gi tract 0.00 1.45 NA 0.08 1.53 NA XXX 74241 A X-ray exam, upper gi tract 0.69 1.71 NA 0.12 2.52 NA XXX 74241 26 A X-ray exam, upper gi tract 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74241 TC A X-ray exam, upper gi tract 0.00 1.48 NA 0.08 1.56 NA XXX 74245 A X-ray exam, upper gi tract 0.90 2.66 NA 0.18 3.74 NA XXX 74245 26 A X-ray exam, upper gi tract 0.90 0.30 0.30 0.05 1.25 1.25 XXX 74245 TC A X-ray exam, upper gi tract 0.00 2.36 NA 0.13 2.49 NA XXX 74246 A Contrst x-ray uppr gi tract 0.69 1.86 NA 0.14 2.69 NA XXX 74246 26 A Contrst x-ray uppr gi tract 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74246 TC A Contrst x-ray uppr gi tract 0.00 1.63 NA 0.10 1.73 NA XXX 74247 A Contrst x-ray uppr gi tract 0.69 1.90 NA 0.15 2.74 NA XXX 74247 26 A Contrst x-ray uppr gi tract 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74247 TC A Contrst x-ray uppr gi tract 0.00 1.67 NA 0.11 1.78 NA XXX 74249 A Contrst x-ray uppr gi tract 0.90 2.85 NA 0.19 3.94 NA XXX 74249 26 A Contrst x-ray uppr gi tract 0.90 0.30 0.30 0.05 1.25 1.25 XXX 74249 TC A Contrst x-ray uppr gi tract 0.00 2.55 NA 0.14 2.69 NA XXX Start Printed Page 63343 74250 A X-ray exam of small bowel 0.47 1.45 NA 0.09 2.01 NA XXX 74250 26 A X-ray exam of small bowel 0.47 0.16 0.16 0.02 0.65 0.65 XXX 74250 TC A X-ray exam of small bowel 0.00 1.29 NA 0.07 1.36 NA XXX 74251 A X-ray exam of small bowel 0.69 1.52 NA 0.11 2.32 NA XXX 74251 26 A X-ray exam of small bowel 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74251 TC A X-ray exam of small bowel 0.00 1.29 NA 0.07 1.36 NA XXX 74260 A X-ray exam of small bowel 0.50 1.65 NA 0.10 2.25 NA XXX 74260 26 A X-ray exam of small bowel 0.50 0.17 0.17 0.02 0.69 0.69 XXX 74260 TC A X-ray exam of small bowel 0.00 1.48 NA 0.08 1.56 NA XXX 74270 A Contrast x-ray exam of colon 0.69 1.92 NA 0.15 2.76 NA XXX 74270 26 A Contrast x-ray exam of colon 0.69 0.23 0.23 0.04 0.96 0.96 XXX 74270 TC A Contrast x-ray exam of colon 0.00 1.69 NA 0.11 1.80 NA XXX 74280 A Contrast x-ray exam of colon 0.98 2.54 NA 0.18 3.70 NA XXX 74280 26 A Contrast x-ray exam of colon 0.98 0.33 0.33 0.05 1.36 1.36 XXX 74280 TC A Contrast x-ray exam of colon 0.00 2.21 NA 0.13 2.34 NA XXX 74283 A Contrast x-ray exam of colon 2.01 3.20 NA 0.25 5.46 NA XXX 74283 26 A Contrast x-ray exam of colon 2.01 0.66 0.66 0.11 2.78 2.78 XXX 74283 TC A Contrast x-ray exam of colon 0.00 2.54 NA 0.14 2.68 NA XXX 74290 A Contrast x-ray, gallbladder 0.32 0.83 NA 0.06 1.21 NA XXX 74290 26 A Contrast x-ray, gallbladder 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74290 TC A Contrast x-ray, gallbladder 0.00 0.72 NA 0.05 0.77 NA XXX 74291 A Contrast x-rays, gallbladder 0.20 0.49 NA 0.03 0.72 NA XXX 74291 26 A Contrast x-rays, gallbladder 0.20 0.07 0.07 0.01 0.28 0.28 XXX 74291 TC A Contrast x-rays, gallbladder 0.00 0.42 NA 0.02 0.44 NA XXX 74300 C X-ray bile ducts/pancreas 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74300 26 A X-ray bile ducts/pancreas 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74300 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74301 C X-rays at surgery add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74301 26 A X-rays at surgery add-on 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ 74301 TC C X-rays at surgery add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74305 A X-ray bile ducts/pancreas 0.42 0.91 NA 0.07 1.40 NA XXX 74305 26 A X-ray bile ducts/pancreas 0.42 0.14 0.14 0.02 0.58 0.58 XXX 74305 TC A X-ray bile ducts/pancreas 0.00 0.77 NA 0.05 0.82 NA XXX 74320 A Contrast x-ray of bile ducts 0.54 3.31 NA 0.19 4.04 NA XXX 74320 26 A Contrast x-ray of bile ducts 0.54 0.18 0.18 0.02 0.74 0.74 XXX 74320 TC A Contrast x-ray of bile ducts 0.00 3.13 NA 0.17 3.30 NA XXX 74327 A X-ray bile stone removal 0.70 1.98 NA 0.15 2.83 NA XXX 74327 26 A X-ray bile stone removal 0.70 0.23 0.23 0.04 0.97 0.97 XXX 74327 TC A X-ray bile stone removal 0.00 1.75 NA 0.11 1.86 NA XXX 74328 A X-ray bile duct endoscopy 0.70 3.36 NA 0.21 4.27 NA XXX 74328 26 A X-ray bile duct endoscopy 0.70 0.23 0.23 0.04 0.97 0.97 XXX 74328 TC A X-ray bile duct endoscopy 0.00 3.13 NA 0.17 3.30 NA XXX 74329 A X-ray for pancreas endoscopy 0.70 3.36 NA 0.21 4.27 NA XXX 74329 26 A X-ray for pancreas endoscopy 0.70 0.23 0.23 0.04 0.97 0.97 XXX 74329 TC A X-ray for pancreas endoscopy 0.00 3.13 NA 0.17 3.30 NA XXX 74330 A X-ray bile/panc endoscopy 0.89 3.43 NA 0.22 4.54 NA XXX 74330 26 A X-ray bile/panc endoscopy 0.89 0.30 0.30 0.05 1.24 1.24 XXX 74330 TC A X-ray bile/panc endoscopy 0.00 3.13 NA 0.17 3.30 NA XXX 74340 A X-ray guide for GI tube 0.54 2.78 NA 0.16 3.48 NA XXX 74340 26 A X-ray guide for GI tube 0.54 0.18 0.18 0.02 0.74 0.74 XXX 74340 TC A X-ray guide for GI tube 0.00 2.60 NA 0.14 2.74 NA XXX 74350 A X-ray guide, stomach tube 0.76 3.38 NA 0.21 4.35 NA XXX 74350 26 A X-ray guide, stomach tube 0.76 0.25 0.25 0.04 1.05 1.05 XXX 74350 TC A X-ray guide, stomach tube 0.00 3.13 NA 0.17 3.30 NA XXX 74355 A X-ray guide, intestinal tube 0.76 2.85 NA 0.18 3.79 NA XXX 74355 26 A X-ray guide, intestinal tube 0.76 0.25 0.25 0.04 1.05 1.05 XXX 74355 TC A X-ray guide, intestinal tube 0.00 2.60 NA 0.14 2.74 NA XXX 74360 A X-ray guide, GI dilation 0.54 3.32 NA 0.19 4.05 NA XXX 74360 26 A X-ray guide, GI dilation 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74360 TC A X-ray guide, GI dilation 0.00 3.13 NA 0.17 3.30 NA XXX 74363 A X-ray, bile duct dilation 0.87 6.34 NA 0.37 7.58 NA XXX 74363 26 A X-ray, bile duct dilation 0.87 0.29 0.29 0.05 1.21 1.21 XXX 74363 TC A X-ray, bile duct dilation 0.00 6.05 NA 0.32 6.37 NA XXX 74400 A Contrst x-ray, urinary tract 0.49 1.83 NA 0.13 2.45 NA XXX 74400 26 A Contrst x-ray, urinary tract 0.49 0.16 0.16 0.02 0.67 0.67 XXX 74400 TC A Contrst x-ray, urinary tract 0.00 1.67 NA 0.11 1.78 NA XXX 74410 A Contrst x-ray, urinary tract 0.49 2.09 NA 0.13 2.71 NA XXX 74410 26 A Contrst x-ray, urinary tract 0.49 0.16 0.16 0.02 0.67 0.67 XXX 74410 TC A Contrst x-ray, urinary tract 0.00 1.93 NA 0.11 2.04 NA XXX 74415 A Contrst x-ray, urinary tract 0.49 2.26 NA 0.14 2.89 NA XXX 74415 26 A Contrst x-ray, urinary tract 0.49 0.16 0.16 0.02 0.67 0.67 XXX 74415 TC A Contrst x-ray, urinary tract 0.00 2.10 NA 0.12 2.22 NA XXX 74420 A Contrst x-ray, urinary tract 0.36 2.72 NA 0.16 3.24 NA XXX 74420 26 A Contrst x-ray, urinary tract 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74420 TC A Contrst x-ray, urinary tract 0.00 2.60 NA 0.14 2.74 NA XXX Start Printed Page 63344 74425 A Contrst x-ray, urinary tract 0.36 1.41 NA 0.09 1.86 NA XXX 74425 26 A Contrst x-ray, urinary tract 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74425 TC A Contrst x-ray, urinary tract 0.00 1.29 NA 0.07 1.36 NA XXX 74430 A Contrast x-ray, bladder 0.32 1.15 NA 0.08 1.55 NA XXX 74430 26 A Contrast x-ray, bladder 0.32 0.11 0.11 0.02 0.45 0.45 XXX 74430 TC A Contrast x-ray, bladder 0.00 1.04 NA 0.06 1.10 NA XXX 74440 A X-ray, male genital tract 0.38 1.24 NA 0.08 1.70 NA XXX 74440 26 A X-ray, male genital tract 0.38 0.12 0.12 0.02 0.52 0.52 XXX 74440 TC A X-ray, male genital tract 0.00 1.12 NA 0.06 1.18 NA XXX 74445 A X-ray exam of penis 1.13 1.50 NA 0.12 2.75 NA XXX 74445 26 A X-ray exam of penis 1.13 0.38 0.38 0.06 1.57 1.57 XXX 74445 TC A X-ray exam of penis 0.00 1.12 NA 0.06 1.18 NA XXX 74450 A X-ray, urethra/bladder 0.33 1.56 NA 0.10 1.99 NA XXX 74450 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX 74450 TC A X-ray, urethra/bladder 0.00 1.45 NA 0.08 1.53 NA XXX 74455 A X-ray, urethra/bladder 0.33 1.67 NA 0.12 2.12 NA XXX 74455 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX 74455 TC A X-ray, urethra/bladder 0.00 1.56 NA 0.10 1.66 NA XXX 74470 A X-ray exam of kidney lesion 0.54 1.42 NA 0.09 2.05 NA XXX 74470 26 A X-ray exam of kidney lesion 0.54 0.18 0.18 0.02 0.74 0.74 XXX 74470 TC A X-ray exam of kidney lesion 0.00 1.24 NA 0.07 1.31 NA XXX 74475 A X-ray control, cath insert 0.54 4.22 NA 0.24 5.00 NA XXX 74475 26 A X-ray control, cath insert 0.54 0.18 0.18 0.02 0.74 0.74 XXX 74475 TC A X-ray control, cath insert 0.00 4.04 NA 0.22 4.26 NA XXX 74480 A X-ray control, cath insert 0.54 4.22 NA 0.24 5.00 NA XXX 74480 26 A X-ray control, cath insert 0.54 0.18 0.18 0.02 0.74 0.74 XXX 74480 TC A X-ray control, cath insert 0.00 4.04 NA 0.22 4.26 NA XXX 74485 A X-ray guide, GU dilation 0.54 3.31 NA 0.21 4.06 NA XXX 74485 26 A X-ray guide, GU dilation 0.54 0.18 0.18 0.04 0.76 0.76 XXX 74485 TC A X-ray guide, GU dilation 0.00 3.13 NA 0.17 3.30 NA XXX 74710 A X-ray measurement of pelvis 0.34 1.15 NA 0.08 1.57 NA XXX 74710 26 A X-ray measurement of pelvis 0.34 0.11 0.11 0.02 0.47 0.47 XXX 74710 TC A X-ray measurement of pelvis 0.00 1.04 NA 0.06 1.10 NA XXX 74740 A X-ray, female genital tract 0.38 1.42 NA 0.09 1.89 NA XXX 74740 26 A X-ray, female genital tract 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74740 TC A X-ray, female genital tract 0.00 1.29 NA 0.07 1.36 NA XXX 74742 A X-ray, fallopian tube 0.61 3.34 NA 0.19 4.14 NA XXX 74742 26 A X-ray, fallopian tube 0.61 0.21 0.21 0.02 0.84 0.84 XXX 74742 TC A X-ray, fallopian tube 0.00 3.13 NA 0.17 3.30 NA XXX 74775 A X-ray exam of perineum 0.62 1.66 NA 0.12 2.40 NA XXX 74775 26 A X-ray exam of perineum 0.62 0.21 0.21 0.04 0.87 0.87 XXX 74775 TC A X-ray exam of perineum 0.00 1.45 NA 0.08 1.53 NA XXX 75552 A Heart mri for morph w/o dye 1.59 11.65 NA 0.67 13.91 NA XXX 75552 26 A Heart mri for morph w/o dye 1.59 0.54 0.54 0.08 2.21 2.21 XXX 75552 TC A Heart mri for morph w/o dye 0.00 11.11 NA 0.59 11.70 NA XXX 75553 A Heart mri for morph w/dye 1.99 11.77 NA 0.70 14.46 NA XXX 75553 26 A Heart mri for morph w/dye 1.99 0.66 0.66 0.11 2.76 2.76 XXX 75553 TC A Heart mri for morph w/dye 0.00 11.11 NA 0.59 11.70 NA XXX 75554 A Cardiac MRI/function 1.82 11.76 NA 0.67 14.25 NA XXX 75554 26 A Cardiac MRI/function 1.82 0.65 0.65 0.08 2.55 2.55 XXX 75554 TC A Cardiac MRI/function 0.00 11.11 NA 0.59 11.70 NA XXX 75555 A Cardiac MRI/limited study 1.73 11.75 NA 0.67 14.15 NA XXX 75555 26 A Cardiac MRI/limited study 1.73 0.64 0.64 0.08 2.45 2.45 XXX 75555 TC A Cardiac MRI/limited study 0.00 11.11 NA 0.59 11.70 NA XXX 75556 N Cardiac MRI/flow mapping 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75600 A Contrast x-ray exam of aorta 0.49 12.68 NA 0.67 13.84 NA XXX 75600 26 A Contrast x-ray exam of aorta 0.49 0.19 0.19 0.02 0.70 0.70 XXX 75600 TC A Contrast x-ray exam of aorta 0.00 12.49 NA 0.65 13.14 NA XXX 75605 A Contrast x-ray exam of aorta 1.13 12.90 NA 0.71 14.74 NA XXX 75605 26 A Contrast x-ray exam of aorta 1.13 0.41 0.41 0.06 1.60 1.60 XXX 75605 TC A Contrast x-ray exam of aorta 0.00 12.49 NA 0.65 13.14 NA XXX 75625 A Contrast x-ray exam of aorta 1.13 12.88 NA 0.71 14.72 NA XXX 75625 26 A Contrast x-ray exam of aorta 1.13 0.39 0.39 0.06 1.58 1.58 XXX 75625 TC A Contrast x-ray exam of aorta 0.00 12.49 NA 0.65 13.14 NA XXX 75630 A X-ray aorta, leg arteries 1.78 13.65 NA 0.78 16.21 NA XXX 75630 26 A X-ray aorta, leg arteries 1.78 0.63 0.63 0.10 2.51 2.51 XXX 75630 TC A X-ray aorta, leg arteries 0.00 13.02 NA 0.68 13.70 NA XXX 75635 A Ct angio abdominal arteries 2.39 16.58 NA 0.49 19.46 NA XXX 75635 26 A Ct angio abdominal arteries 2.39 0.80 0.80 0.11 3.30 3.30 XXX 75635 TC A Ct angio abdominal arteries 0.00 15.78 NA 0.38 16.16 NA XXX 75650 A Artery x-rays, head & neck 1.48 12.99 NA 0.73 15.20 NA XXX 75650 26 A Artery x-rays, head & neck 1.48 0.50 0.50 0.08 2.06 2.06 XXX 75650 TC A Artery x-rays, head & neck 0.00 12.49 NA 0.65 13.14 NA XXX 75658 A Artery x-rays, arm 1.30 12.97 NA 0.72 14.99 NA XXX 75658 26 A Artery x-rays, arm 1.30 0.48 0.48 0.07 1.85 1.85 XXX Start Printed Page 63345 75658 TC A Artery x-rays, arm 0.00 12.49 NA 0.65 13.14 NA XXX 75660 A Artery x-rays, head & neck 1.30 12.94 NA 0.72 14.96 NA XXX 75660 26 A Artery x-rays, head & neck 1.30 0.45 0.45 0.07 1.82 1.82 XXX 75660 TC A Artery x-rays, head & neck 0.00 12.49 NA 0.65 13.14 NA XXX 75662 A Artery x-rays, head & neck 1.65 13.09 NA 0.75 15.49 NA XXX 75662 26 A Artery x-rays, head & neck 1.65 0.60 0.60 0.10 2.35 2.35 XXX 75662 TC A Artery x-rays, head & neck 0.00 12.49 NA 0.65 13.14 NA XXX 75665 A Artery x-rays, head & neck 1.30 12.94 NA 0.73 14.97 NA XXX 75665 26 A Artery x-rays, head & neck 1.30 0.45 0.45 0.08 1.83 1.83 XXX 75665 TC A Artery x-rays, head & neck 0.00 12.49 NA 0.65 13.14 NA XXX 75671 A Artery x-rays, head & neck 1.65 13.05 NA 0.75 15.45 NA XXX 75671 26 A Artery x-rays, head & neck 1.65 0.56 0.56 0.10 2.31 2.31 XXX 75671 TC A Artery x-rays, head & neck 0.00 12.49 NA 0.65 13.14 NA XXX 75676 A Artery x-rays, neck 1.30 12.94 NA 0.73 14.97 NA XXX 75676 26 A Artery x-rays, neck 1.30 0.45 0.45 0.08 1.83 1.83 XXX 75676 TC A Artery x-rays, neck 0.00 12.49 NA 0.65 13.14 NA XXX 75680 A Artery x-rays, neck 1.65 13.05 NA 0.75 15.45 NA XXX 75680 26 A Artery x-rays, neck 1.65 0.56 0.56 0.10 2.31 2.31 XXX 75680 TC A Artery x-rays, neck 0.00 12.49 NA 0.65 13.14 NA XXX 75685 A Artery x-rays, spine 1.30 12.93 NA 0.72 14.95 NA XXX 75685 26 A Artery x-rays, spine 1.30 0.44 0.44 0.07 1.81 1.81 XXX 75685 TC A Artery x-rays, spine 0.00 12.49 NA 0.65 13.14 NA XXX 75705 A Artery x-rays, spine 2.17 13.23 NA 0.78 16.18 NA XXX 75705 26 A Artery x-rays, spine 2.17 0.74 0.74 0.13 3.04 3.04 XXX 75705 TC A Artery x-rays, spine 0.00 12.49 NA 0.65 13.14 NA XXX 75710 A Artery x-rays, arm/leg 1.13 12.88 NA 0.72 14.73 NA XXX 75710 26 A Artery x-rays, arm/leg 1.13 0.39 0.39 0.07 1.59 1.59 XXX 75710 TC A Artery x-rays, arm/leg 0.00 12.49 NA 0.65 13.14 NA XXX 75716 A Artery x-rays, arms/legs 1.30 12.93 NA 0.72 14.95 NA XXX 75716 26 A Artery x-rays, arms/legs 1.30 0.44 0.44 0.07 1.81 1.81 XXX 75716 TC A Artery x-rays, arms/legs 0.00 12.49 NA 0.65 13.14 NA XXX 75722 A Artery x-rays, kidney 1.13 12.90 NA 0.71 14.74 NA XXX 75722 26 A Artery x-rays, kidney 1.13 0.41 0.41 0.06 1.60 1.60 XXX 75722 TC A Artery x-rays, kidney 0.00 12.49 NA 0.65 13.14 NA XXX 75724 A Artery x-rays, kidneys 1.48 13.06 NA 0.71 15.25 NA XXX 75724 26 A Artery x-rays, kidneys 1.48 0.57 0.57 0.06 2.11 2.11 XXX 75724 TC A Artery x-rays, kidneys 0.00 12.49 NA 0.65 13.14 NA XXX 75726 A Artery x-rays, abdomen 1.13 12.87 NA 0.71 14.71 NA XXX 75726 26 A Artery x-rays, abdomen 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75726 TC A Artery x-rays, abdomen 0.00 12.49 NA 0.65 13.14 NA XXX 75731 A Artery x-rays, adrenal gland 1.13 12.87 NA 0.71 14.71 NA XXX 75731 26 A Artery x-rays, adrenal gland 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75731 TC A Artery x-rays, adrenal gland 0.00 12.49 NA 0.65 13.14 NA XXX 75733 A Artery x-rays, adrenals 1.30 12.93 NA 0.72 14.95 NA XXX 75733 26 A Artery x-rays, adrenals 1.30 0.44 0.44 0.07 1.81 1.81 XXX 75733 TC A Artery x-rays, adrenals 0.00 12.49 NA 0.65 13.14 NA XXX 75736 A Artery x-rays, pelvis 1.13 12.87 NA 0.71 14.71 NA XXX 75736 26 A Artery x-rays, pelvis 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75736 TC A Artery x-rays, pelvis 0.00 12.49 NA 0.65 13.14 NA XXX 75741 A Artery x-rays, lung 1.30 12.93 NA 0.72 14.95 NA XXX 75741 26 A Artery x-rays, lung 1.30 0.44 0.44 0.07 1.81 1.81 XXX 75741 TC A Artery x-rays, lung 0.00 12.49 NA 0.65 13.14 NA XXX 75743 A Artery x-rays, lungs 1.65 13.04 NA 0.73 15.42 NA XXX 75743 26 A Artery x-rays, lungs 1.65 0.55 0.55 0.08 2.28 2.28 XXX 75743 TC A Artery x-rays, lungs 0.00 12.49 NA 0.65 13.14 NA XXX 75746 A Artery x-rays, lung 1.13 12.87 NA 0.71 14.71 NA XXX 75746 26 A Artery x-rays, lung 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75746 TC A Artery x-rays, lung 0.00 12.49 NA 0.65 13.14 NA XXX 75756 A Artery x-rays, chest 1.13 12.95 NA 0.70 14.78 NA XXX 75756 26 A Artery x-rays, chest 1.13 0.46 0.46 0.05 1.64 1.64 XXX 75756 TC A Artery x-rays, chest 0.00 12.49 NA 0.65 13.14 NA XXX 75774 A Artery x-ray, each vessel 0.36 12.62 NA 0.67 13.65 NA ZZZ 75774 26 A Artery x-ray, each vessel 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75774 TC A Artery x-ray, each vessel 0.00 12.49 NA 0.65 13.14 NA ZZZ 75790 A Visualize A-V shunt 1.83 1.95 NA 0.19 3.97 NA XXX 75790 26 A Visualize A-V shunt 1.83 0.61 0.61 0.11 2.55 2.55 XXX 75790 TC A Visualize A-V shunt 0.00 1.34 NA 0.08 1.42 NA XXX 75801 A Lymph vessel x-ray, arm/leg 0.81 5.64 NA 0.35 6.80 NA XXX 75801 26 A Lymph vessel x-ray, arm/leg 0.81 0.27 0.27 0.06 1.14 1.14 XXX 75801 TC A Lymph vessel x-ray, arm/leg 0.00 5.37 NA 0.29 5.66 NA XXX 75803 A Lymph vessel x-ray,arms/legs 1.16 5.76 NA 0.35 7.27 NA XXX 75803 26 A Lymph vessel x-ray,arms/legs 1.16 0.39 0.39 0.06 1.61 1.61 XXX 75803 TC A Lymph vessel x-ray,arms/legs 0.00 5.37 NA 0.29 5.66 NA XXX 75805 A Lymph vessel x-ray, trunk 0.81 6.32 NA 0.37 7.50 NA XXX 75805 26 A Lymph vessel x-ray, trunk 0.81 0.27 0.27 0.05 1.13 1.13 XXX Start Printed Page 63346 75805 TC A Lymph vessel x-ray, trunk 0.00 6.05 NA 0.32 6.37 NA XXX 75807 A Lymph vessel x-ray, trunk 1.16 6.44 NA 0.38 7.98 NA XXX 75807 26 A Lymph vessel x-ray, trunk 1.16 0.39 0.39 0.06 1.61 1.61 XXX 75807 TC A Lymph vessel x-ray, trunk 0.00 6.05 NA 0.32 6.37 NA XXX 75809 A Nonvascular shunt, x-ray 0.47 0.93 NA 0.07 1.47 NA XXX 75809 26 A Nonvascular shunt, x-ray 0.47 0.16 0.16 0.02 0.65 0.65 XXX 75809 TC A Nonvascular shunt, x-ray 0.00 0.77 NA 0.05 0.82 NA XXX 75810 A Vein x-ray, spleen/liver 1.13 12.87 NA 0.72 14.72 NA XXX 75810 26 A Vein x-ray, spleen/liver 1.13 0.38 0.38 0.07 1.58 1.58 XXX 75810 TC A Vein x-ray, spleen/liver 0.00 12.49 NA 0.65 13.14 NA XXX 75820 A Vein x-ray, arm/leg 0.70 1.17 NA 0.10 1.97 NA XXX 75820 26 A Vein x-ray, arm/leg 0.70 0.23 0.23 0.04 0.97 0.97 XXX 75820 TC A Vein x-ray, arm/leg 0.00 0.94 NA 0.06 1.00 NA XXX 75822 A Vein x-ray, arms/legs 1.05 1.82 NA 0.14 3.01 NA XXX 75822 26 A Vein x-ray, arms/legs 1.05 0.35 0.35 0.06 1.46 1.46 XXX 75822 TC A Vein x-ray, arms/legs 0.00 1.47 NA 0.08 1.55 NA XXX 75825 A Vein x-ray, trunk 1.13 12.87 NA 0.72 14.72 NA XXX 75825 26 A Vein x-ray, trunk 1.13 0.38 0.38 0.07 1.58 1.58 XXX 75825 TC A Vein x-ray, trunk 0.00 12.49 NA 0.65 13.14 NA XXX 75827 A Vein x-ray, chest 1.13 12.87 NA 0.71 14.71 NA XXX 75827 26 A Vein x-ray, chest 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75827 TC A Vein x-ray, chest 0.00 12.49 NA 0.65 13.14 NA XXX 75831 A Vein x-ray, kidney 1.13 12.87 NA 0.71 14.71 NA XXX 75831 26 A Vein x-ray, kidney 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75831 TC A Vein x-ray, kidney 0.00 12.49 NA 0.65 13.14 NA XXX 75833 A Vein x-ray, kidneys 1.48 12.99 NA 0.73 15.20 NA XXX 75833 26 A Vein x-ray, kidneys 1.48 0.50 0.50 0.08 2.06 2.06 XXX 75833 TC A Vein x-ray, kidneys 0.00 12.49 NA 0.65 13.14 NA XXX 75840 A Vein x-ray, adrenal gland 1.13 12.88 NA 0.73 14.74 NA XXX 75840 26 A Vein x-ray, adrenal gland 1.13 0.39 0.39 0.08 1.60 1.60 XXX 75840 TC A Vein x-ray, adrenal gland 0.00 12.49 NA 0.65 13.14 NA XXX 75842 A Vein x-ray, adrenal glands 1.48 12.98 NA 0.73 15.19 NA XXX 75842 26 A Vein x-ray, adrenal glands 1.48 0.49 0.49 0.08 2.05 2.05 XXX 75842 TC A Vein x-ray, adrenal glands 0.00 12.49 NA 0.65 13.14 NA XXX 75860 A Vein x-ray, neck 1.13 12.89 NA 0.72 14.74 NA XXX 75860 26 A Vein x-ray, neck 1.13 0.40 0.40 0.07 1.60 1.60 XXX 75860 TC A Vein x-ray, neck 0.00 12.49 NA 0.65 13.14 NA XXX 75870 A Vein x-ray, skull 1.13 12.89 NA 0.72 14.74 NA XXX 75870 26 A Vein x-ray, skull 1.13 0.40 0.40 0.07 1.60 1.60 XXX 75870 TC A Vein x-ray, skull 0.00 12.49 NA 0.65 13.14 NA XXX 75872 A Vein x-ray, skull 1.13 12.87 NA 0.71 14.71 NA XXX 75872 26 A Vein x-ray, skull 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75872 TC A Vein x-ray, skull 0.00 12.49 NA 0.65 13.14 NA XXX 75880 A Vein x-ray, eye socket 0.70 1.18 NA 0.10 1.98 NA XXX 75880 26 A Vein x-ray, eye socket 0.70 0.24 0.24 0.04 0.98 0.98 XXX 75880 TC A Vein x-ray, eye socket 0.00 0.94 NA 0.06 1.00 NA XXX 75885 A Vein x-ray, liver 1.43 12.97 NA 0.72 15.12 NA XXX 75885 26 A Vein x-ray, liver 1.43 0.48 0.48 0.07 1.98 1.98 XXX 75885 TC A Vein x-ray, liver 0.00 12.49 NA 0.65 13.14 NA XXX 75887 A Vein x-ray, liver 1.43 12.97 NA 0.72 15.12 NA XXX 75887 26 A Vein x-ray, liver 1.43 0.48 0.48 0.07 1.98 1.98 XXX 75887 TC A Vein x-ray, liver 0.00 12.49 NA 0.65 13.14 NA XXX 75889 A Vein x-ray, liver 1.13 12.87 NA 0.71 14.71 NA XXX 75889 26 A Vein x-ray, liver 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75889 TC A Vein x-ray, liver 0.00 12.49 NA 0.65 13.14 NA XXX 75891 A Vein x-ray, liver 1.13 12.87 NA 0.71 14.71 NA XXX 75891 26 A Vein x-ray, liver 1.13 0.38 0.38 0.06 1.57 1.57 XXX 75891 TC A Vein x-ray, liver 0.00 12.49 NA 0.65 13.14 NA XXX 75893 A Venous sampling by catheter 0.54 12.67 NA 0.67 13.88 NA XXX 75893 26 A Venous sampling by catheter 0.54 0.18 0.18 0.02 0.74 0.74 XXX 75893 TC A Venous sampling by catheter 0.00 12.49 NA 0.65 13.14 NA XXX 75894 A X-rays, transcath therapy 1.30 24.36 NA 1.34 27.00 NA XXX 75894 26 A X-rays, transcath therapy 1.30 0.44 0.44 0.08 1.82 1.82 XXX 75894 TC A X-rays, transcath therapy 0.00 23.92 NA 1.26 25.18 NA XXX 75896 A X-rays, transcath therapy 1.30 21.27 NA 1.16 23.73 NA XXX 75896 26 A X-rays, transcath therapy 1.30 0.46 0.46 0.07 1.83 1.83 XXX 75896 TC A X-rays, transcath therapy 0.00 20.81 NA 1.09 21.90 NA XXX 75898 A Follow-up angiography 1.64 1.60 NA 0.14 3.38 NA XXX 75898 26 A Follow-up angiography 1.64 0.56 0.56 0.08 2.28 2.28 XXX 75898 TC A Follow-up angiography 0.00 1.04 NA 0.06 1.10 NA XXX 75900 A Arterial catheter exchange 0.49 20.95 NA 1.12 22.56 NA XXX 75900 26 A Arterial catheter exchange 0.49 0.16 0.16 0.02 0.67 0.67 XXX 75900 TC A Arterial catheter exchange 0.00 20.79 NA 1.10 21.89 NA XXX 75901 A Remove cva device obstruct 0.49 1.45 NA 0.85 2.79 NA XXX 75901 26 A Remove cva device obstruct 0.49 0.16 0.16 0.02 0.67 0.67 XXX Start Printed Page 63347 75901 TC A Remove cva device obstruct 0.00 1.29 NA 0.83 2.12 NA XXX 75902 A Remove cva lumen obstruct 0.39 1.42 NA 0.85 2.66 NA XXX 75902 26 A Remove cva lumen obstruct 0.39 0.13 0.13 0.02 0.54 0.54 XXX 75902 TC A Remove cva lumen obstruct 0.00 1.29 NA 0.83 2.12 NA XXX 75940 A X-ray placement, vein filter 0.54 12.67 NA 0.69 13.90 NA XXX 75940 26 A X-ray placement, vein filter 0.54 0.18 0.18 0.04 0.76 0.76 XXX 75940 TC A X-ray placement, vein filter 0.00 12.49 NA 0.65 13.14 NA XXX 75945 A Intravascular us 0.40 4.66 NA 0.28 5.34 NA XXX 75945 26 A Intravascular us 0.40 0.14 0.14 0.04 0.58 0.58 XXX 75945 TC A Intravascular us 0.00 4.52 NA 0.24 4.76 NA XXX 75946 A Intravascular us add-on 0.40 2.41 NA 0.17 2.98 NA ZZZ 75946 26 A Intravascular us add-on 0.40 0.14 0.14 0.04 0.58 0.58 ZZZ 75946 TC A Intravascular us add-on 0.00 2.27 NA 0.13 2.40 NA ZZZ 75952 C Endovasc repair abdom aorta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75952 26 A Endovasc repair abdom aorta 4.47 1.51 1.51 0.82 6.80 6.80 XXX 75952 TC C Endovasc repair abdom aorta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 C Abdom aneurysm endovas rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 26 A Abdom aneurysm endovas rpr 1.35 0.46 0.46 0.82 2.63 2.63 XXX 75953 TC C Abdom aneurysm endovas rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75954 C Iliac aneurysm endovas rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75954 26 A Iliac aneurysm endovas rpr 1.35 0.48 0.48 0.82 2.65 2.65 XXX 75954 TC C Iliac aneurysm endovas rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75960 A Transcatheter intro, stent 0.82 15.07 NA 0.82 16.71 NA XXX 75960 26 A Transcatheter intro, stent 0.82 0.29 0.29 0.05 1.16 1.16 XXX 75960 TC A Transcatheter intro, stent 0.00 14.78 NA 0.77 15.55 NA XXX 75961 A Retrieval, broken catheter 4.23 11.82 NA 0.77 16.82 NA XXX 75961 26 A Retrieval, broken catheter 4.23 1.41 1.41 0.22 5.86 5.86 XXX 75961 TC A Retrieval, broken catheter 0.00 10.41 NA 0.55 10.96 NA XXX 75962 A Repair arterial blockage 0.54 15.80 NA 0.87 17.21 NA XXX 75962 26 A Repair arterial blockage 0.54 0.19 0.19 0.04 0.77 0.77 XXX 75962 TC A Repair arterial blockage 0.00 15.61 NA 0.83 16.44 NA XXX 75964 A Repair artery blockage, each 0.36 8.45 NA 0.45 9.26 NA ZZZ 75964 26 A Repair artery blockage, each 0.36 0.12 0.12 0.02 0.50 0.50 ZZZ 75964 TC A Repair artery blockage, each 0.00 8.33 NA 0.43 8.76 NA ZZZ 75966 A Repair arterial blockage 1.30 16.08 NA 0.90 18.28 NA XXX 75966 26 A Repair arterial blockage 1.30 0.47 0.47 0.07 1.84 1.84 XXX 75966 TC A Repair arterial blockage 0.00 15.61 NA 0.83 16.44 NA XXX 75968 A Repair artery blockage, each 0.36 8.46 NA 0.44 9.26 NA ZZZ 75968 26 A Repair artery blockage, each 0.36 0.13 0.13 0.01 0.50 0.50 ZZZ 75968 TC A Repair artery blockage, each 0.00 8.33 NA 0.43 8.76 NA ZZZ 75970 A Vascular biopsy 0.83 11.73 NA 0.65 13.21 NA XXX 75970 26 A Vascular biopsy 0.83 0.29 0.29 0.05 1.17 1.17 XXX 75970 TC A Vascular biopsy 0.00 11.44 NA 0.60 12.04 NA XXX 75978 A Repair venous blockage 0.54 15.79 NA 0.85 17.18 NA XXX 75978 26 A Repair venous blockage 0.54 0.18 0.18 0.02 0.74 0.74 XXX 75978 TC A Repair venous blockage 0.00 15.61 NA 0.83 16.44 NA XXX 75980 A Contrast xray exam bile duct 1.43 5.85 NA 0.36 7.64 NA XXX 75980 26 A Contrast xray exam bile duct 1.43 0.48 0.48 0.07 1.98 1.98 XXX 75980 TC A Contrast xray exam bile duct 0.00 5.37 NA 0.29 5.66 NA XXX 75982 A Contrast xray exam bile duct 1.43 6.53 NA 0.39 8.35 NA XXX 75982 26 A Contrast xray exam bile duct 1.43 0.48 0.48 0.07 1.98 1.98 XXX 75982 TC A Contrast xray exam bile duct 0.00 6.05 NA 0.32 6.37 NA XXX 75984 A Xray control catheter change 0.72 2.17 NA 0.15 3.04 NA XXX 75984 26 A Xray control catheter change 0.72 0.24 0.24 0.04 1.00 1.00 XXX 75984 TC A Xray control catheter change 0.00 1.93 NA 0.11 2.04 NA XXX 75989 A Abscess drainage under x-ray 1.18 3.53 NA 0.23 4.94 NA XXX 75989 26 A Abscess drainage under x-ray 1.18 0.40 0.40 0.06 1.64 1.64 XXX 75989 TC A Abscess drainage under x-ray 0.00 3.13 NA 0.17 3.30 NA XXX 75992 A Atherectomy, x-ray exam 0.54 15.80 NA 0.85 17.19 NA XXX 75992 26 A Atherectomy, x-ray exam 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75992 TC A Atherectomy, x-ray exam 0.00 15.61 NA 0.83 16.44 NA XXX 75993 A Atherectomy, x-ray exam 0.36 8.47 NA 0.44 9.27 NA ZZZ 75993 26 A Atherectomy, x-ray exam 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ 75993 TC A Atherectomy, x-ray exam 0.00 8.33 NA 0.43 8.76 NA ZZZ 75994 A Atherectomy, x-ray exam 1.30 16.08 NA 0.90 18.28 NA XXX 75994 26 A Atherectomy, x-ray exam 1.30 0.47 0.47 0.07 1.84 1.84 XXX 75994 TC A Atherectomy, x-ray exam 0.00 15.61 NA 0.83 16.44 NA XXX 75995 A Atherectomy, x-ray exam 1.30 16.09 NA 0.90 18.29 NA XXX 75995 26 A Atherectomy, x-ray exam 1.30 0.48 0.48 0.07 1.85 1.85 XXX 75995 TC A Atherectomy, x-ray exam 0.00 15.61 NA 0.83 16.44 NA XXX 75996 A Atherectomy, x-ray exam 0.36 8.45 NA 0.44 9.25 NA ZZZ 75996 26 A Atherectomy, x-ray exam 0.36 0.12 0.12 0.01 0.49 0.49 ZZZ 75996 TC A Atherectomy, x-ray exam 0.00 8.33 NA 0.43 8.76 NA ZZZ 75998 A Fluoroguide for vein device 0.38 1.42 NA 0.15 1.95 NA ZZZ 75998 26 A Fluoroguide for vein device 0.38 0.13 0.13 0.05 0.56 0.56 ZZZ Start Printed Page 63348 75998 TC A Fluoroguide for vein device 0.00 1.29 NA 0.10 1.39 NA ZZZ 76000 A Fluoroscope examination 0.17 1.34 NA 0.08 1.59 NA XXX 76000 26 A Fluoroscope examination 0.17 0.05 0.05 0.01 0.23 0.23 XXX 76000 TC A Fluoroscope examination 0.00 1.29 NA 0.07 1.36 NA XXX 76001 A Fluoroscope exam, extensive 0.67 2.82 NA 0.18 3.67 NA XXX 76001 26 A Fluoroscope exam, extensive 0.67 0.22 0.22 0.04 0.93 0.93 XXX 76001 TC A Fluoroscope exam, extensive 0.00 2.60 NA 0.14 2.74 NA XXX 76003 A Needle localization by x-ray 0.54 1.46 NA 0.11 2.11 NA XXX 76003 26 A Needle localization by x-ray 0.54 0.17 0.17 0.04 0.75 0.75 XXX 76003 TC A Needle localization by x-ray 0.00 1.29 NA 0.07 1.36 NA XXX 76005 A Fluoroguide for spine inject 0.60 1.45 NA 0.11 2.16 NA XXX 76005 26 A Fluoroguide for spine inject 0.60 0.16 0.16 0.04 0.80 0.80 XXX 76005 TC A Fluoroguide for spine inject 0.00 1.29 NA 0.07 1.36 NA XXX 76006 A X-ray stress view 0.41 0.19 0.19 0.05 0.65 0.65 XXX 76010 A X-ray, nose to rectum 0.18 0.58 NA 0.03 0.79 NA XXX 76010 26 A X-ray, nose to rectum 0.18 0.06 0.06 0.01 0.25 0.25 XXX 76010 TC A X-ray, nose to rectum 0.00 0.52 NA 0.02 0.54 NA XXX 76012 C Percut vertebroplasty fluor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76012 26 A Percut vertebroplasty fluor 1.30 0.48 0.48 0.28 2.06 2.06 XXX 76012 TC C Percut vertebroplasty fluor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 C Percut vertebroplasty, ct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 26 A Percut vertebroplasty, ct 1.37 0.49 0.49 0.58 2.44 2.44 XXX 76013 TC C Percut vertebroplasty, ct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76020 A X-rays for bone age 0.19 0.58 NA 0.03 0.80 NA XXX 76020 26 A X-rays for bone age 0.19 0.06 0.06 0.01 0.26 0.26 XXX 76020 TC A X-rays for bone age 0.00 0.52 NA 0.02 0.54 NA XXX 76040 A X-rays, bone evaluation 0.27 0.86 NA 0.09 1.22 NA XXX 76040 26 A X-rays, bone evaluation 0.27 0.09 0.09 0.04 0.40 0.40 XXX 76040 TC A X-rays, bone evaluation 0.00 0.77 NA 0.05 0.82 NA XXX 76061 A X-rays, bone survey 0.45 1.14 NA 0.08 1.67 NA XXX 76061 26 A X-rays, bone survey 0.45 0.15 0.15 0.02 0.62 0.62 XXX 76061 TC A X-rays, bone survey 0.00 0.99 NA 0.06 1.05 NA XXX 76062 A X-rays, bone survey 0.54 1.61 NA 0.10 2.25 NA XXX 76062 26 A X-rays, bone survey 0.54 0.18 0.18 0.02 0.74 0.74 XXX 76062 TC A X-rays, bone survey 0.00 1.43 NA 0.08 1.51 NA XXX 76065 A X-rays, bone evaluation 0.70 0.96 NA 0.06 1.72 NA XXX 76065 26 A X-rays, bone evaluation 0.70 0.24 0.24 0.01 0.95 0.95 XXX 76065 TC A X-rays, bone evaluation 0.00 0.72 NA 0.05 0.77 NA XXX 76066 A Joint survey, single view 0.31 1.21 NA 0.08 1.60 NA XXX 76066 26 A Joint survey, single view 0.31 0.11 0.11 0.02 0.44 0.44 XXX 76066 TC A Joint survey, single view 0.00 1.10 NA 0.06 1.16 NA XXX 76070 A Ct bone density, axial 0.25 3.01 NA 0.17 3.43 NA XXX 76070 26 A Ct bone density, axial 0.25 0.08 0.08 0.01 0.34 0.34 XXX 76070 TC A Ct bone density, axial 0.00 2.93 NA 0.16 3.09 NA XXX 76071 A Ct bone density, peripheral 0.22 3.00 NA 0.06 3.28 NA XXX 76071 26 A Ct bone density, peripheral 0.22 0.07 0.07 0.01 0.30 0.30 XXX 76071 TC A Ct bone density, peripheral 0.00 2.93 NA 0.05 2.98 NA XXX 76075 A Dexa, axial skeleton study 0.30 3.17 NA 0.18 3.65 NA XXX 76075 26 A Dexa, axial skeleton study 0.30 0.10 0.10 0.01 0.41 0.41 XXX 76075 TC A Dexa, axial skeleton study 0.00 3.07 NA 0.17 3.24 NA XXX 76076 A Dexa, peripheral study 0.22 0.82 NA 0.06 1.10 NA XXX 76076 26 A Dexa, peripheral study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 76076 TC A Dexa, peripheral study 0.00 0.74 NA 0.05 0.79 NA XXX 76078 A Radiographic absorptiometry 0.20 0.81 NA 0.06 1.07 NA XXX 76078 26 A Radiographic absorptiometry 0.20 0.07 0.07 0.01 0.28 0.28 XXX 76078 TC A Radiographic absorptiometry 0.00 0.74 NA 0.05 0.79 NA XXX 76080 A X-ray exam of fistula 0.54 1.22 NA 0.08 1.84 NA XXX 76080 26 A X-ray exam of fistula 0.54 0.18 0.18 0.02 0.74 0.74 XXX 76080 TC A X-ray exam of fistula 0.00 1.04 NA 0.06 1.10 NA XXX 76082 A Computer mammogram add-on 0.06 0.44 NA 0.02 0.52 NA ZZZ 76082 26 A Computer mammogram add-on 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76082 TC A Computer mammogram add-on 0.00 0.42 NA 0.01 0.43 NA ZZZ 76083 A Computer mammogram add-on 0.06 0.44 NA 0.02 0.52 NA ZZZ 76083 26 A Computer mammogram add-on 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76083 TC A Computer mammogram add-on 0.00 0.42 NA 0.01 0.43 NA ZZZ 76085 F Computer mammogram add-on +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 76085 26 F Computer mammogram add-on +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 76085 TC F Computer mammogram add-on +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 76086 A X-ray of mammary duct 0.36 2.72 NA 0.16 3.24 NA XXX 76086 26 A X-ray of mammary duct 0.36 0.12 0.12 0.02 0.50 0.50 XXX 76086 TC A X-ray of mammary duct 0.00 2.60 NA 0.14 2.74 NA XXX 76088 A X-ray of mammary ducts 0.45 3.78 NA 0.21 4.44 NA XXX 76088 26 A X-ray of mammary ducts 0.45 0.15 0.15 0.02 0.62 0.62 XXX 76088 TC A X-ray of mammary ducts 0.00 3.63 NA 0.19 3.82 NA XXX 76090 A Mammogram, one breast 0.70 1.27 NA 0.10 2.07 NA XXX Start Printed Page 63349 76090 26 A Mammogram, one breast 0.70 0.23 0.23 0.04 0.97 0.97 XXX 76090 TC A Mammogram, one breast 0.00 1.04 NA 0.06 1.10 NA XXX 76091 A Mammogram, both breasts 0.87 1.58 NA 0.11 2.56 NA XXX 76091 26 A Mammogram, both breasts 0.87 0.29 0.29 0.04 1.20 1.20 XXX 76091 TC A Mammogram, both breasts 0.00 1.29 NA 0.07 1.36 NA XXX 76092 A Mammogram, screening 0.70 1.45 NA 0.11 2.26 NA XXX 76092 26 A Mammogram, screening 0.70 0.23 0.23 0.04 0.97 0.97 XXX 76092 TC A Mammogram, screening 0.00 1.22 NA 0.07 1.29 NA XXX 76093 A Magnetic image, breast 1.62 18.02 NA 0.99 20.63 NA XXX 76093 26 A Magnetic image, breast 1.62 0.55 0.55 0.08 2.25 2.25 XXX 76093 TC A Magnetic image, breast 0.00 17.47 NA 0.91 18.38 NA XXX 76094 A Magnetic image, both breasts 1.62 24.25 NA 1.31 27.18 NA XXX 76094 26 A Magnetic image, both breasts 1.62 0.54 0.54 0.08 2.24 2.24 XXX 76094 TC A Magnetic image, both breasts 0.00 23.71 NA 1.23 24.94 NA XXX 76095 A Stereotactic breast biopsy 1.58 7.63 NA 0.48 9.69 NA XXX 76095 26 A Stereotactic breast biopsy 1.58 0.53 0.53 0.11 2.22 2.22 XXX 76095 TC A Stereotactic breast biopsy 0.00 7.10 NA 0.37 7.47 NA XXX 76096 A X-ray of needle wire, breast 0.56 1.48 NA 0.11 2.15 NA XXX 76096 26 A X-ray of needle wire, breast 0.56 0.19 0.19 0.04 0.79 0.79 XXX 76096 TC A X-ray of needle wire, breast 0.00 1.29 NA 0.07 1.36 NA XXX 76098 A X-ray exam, breast specimen 0.16 0.47 NA 0.03 0.66 NA XXX 76098 26 A X-ray exam, breast specimen 0.16 0.05 0.05 0.01 0.22 0.22 XXX 76098 TC A X-ray exam, breast specimen 0.00 0.42 NA 0.02 0.44 NA XXX 76100 A X-ray exam of body section 0.58 1.43 NA 0.11 2.12 NA XXX 76100 26 A X-ray exam of body section 0.58 0.19 0.19 0.04 0.81 0.81 XXX 76100 TC A X-ray exam of body section 0.00 1.24 NA 0.07 1.31 NA XXX 76101 A Complex body section x-ray 0.58 1.60 NA 0.12 2.30 NA XXX 76101 26 A Complex body section x-ray 0.58 0.19 0.19 0.04 0.81 0.81 XXX 76101 TC A Complex body section x-ray 0.00 1.41 NA 0.08 1.49 NA XXX 76102 A Complex body section x-rays 0.58 1.92 NA 0.15 2.65 NA XXX 76102 26 A Complex body section x-rays 0.58 0.20 0.20 0.04 0.82 0.82 XXX 76102 TC A Complex body section x-rays 0.00 1.72 NA 0.11 1.83 NA XXX 76120 A Cine/video x-rays 0.38 1.17 NA 0.08 1.63 NA XXX 76120 26 A Cine/video x-rays 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76120 TC A Cine/video x-rays 0.00 1.04 NA 0.06 1.10 NA XXX 76125 A Cine/video x-rays add-on 0.27 0.86 NA 0.06 1.19 NA ZZZ 76125 26 A Cine/video x-rays add-on 0.27 0.09 0.09 0.01 0.37 0.37 ZZZ 76125 TC A Cine/video x-rays add-on 0.00 0.77 NA 0.05 0.82 NA ZZZ 76140 I X-ray consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76150 A X-ray exam, dry process 0.00 0.42 NA 0.02 0.44 NA XXX 76350 C Special x-ray contrast study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76355 A Ct scan for localization 1.20 8.60 NA 0.49 10.29 NA XXX 76355 26 A Ct scan for localization 1.20 0.41 0.41 0.07 1.68 1.68 XXX 76355 TC A Ct scan for localization 0.00 8.19 NA 0.42 8.61 NA XXX 76360 A Ct scan for needle biopsy 1.15 8.58 NA 0.48 10.21 NA XXX 76360 26 A Ct scan for needle biopsy 1.15 0.39 0.39 0.06 1.60 1.60 XXX 76360 TC A Ct scan for needle biopsy 0.00 8.19 NA 0.42 8.61 NA XXX 76362 A Ct guide for tissue ablation 3.98 9.51 NA 1.67 15.16 NA XXX 76362 26 A Ct guide for tissue ablation 3.98 1.32 1.32 0.22 5.52 5.52 XXX 76362 TC A Ct guide for tissue ablation 0.00 8.19 NA 1.45 9.64 NA XXX 76370 A Ct scan for therapy guide 0.85 3.21 NA 0.21 4.27 NA XXX 76370 26 A Ct scan for therapy guide 0.85 0.28 0.28 0.05 1.18 1.18 XXX 76370 TC A Ct scan for therapy guide 0.00 2.93 NA 0.16 3.09 NA XXX 76375 A 3d/holograph reconstr add-on 0.16 3.56 NA 0.19 3.91 NA XXX 76375 26 A 3d/holograph reconstr add-on 0.16 0.05 0.05 0.01 0.22 0.22 XXX 76375 TC A 3d/holograph reconstr add-on 0.00 3.51 NA 0.18 3.69 NA XXX 76380 A CAT scan follow-up study 0.97 3.80 NA 0.23 5.00 NA XXX 76380 26 A CAT scan follow-up study 0.97 0.33 0.33 0.05 1.35 1.35 XXX 76380 TC A CAT scan follow-up study 0.00 3.47 NA 0.18 3.65 NA XXX 76390 N Mr spectroscopy +1.39 11.55 11.55 0.66 13.60 13.60 XXX 76390 26 N Mr spectroscopy +1.39 0.48 0.48 0.07 1.94 1.94 XXX 76390 TC N Mr spectroscopy +0.00 11.07 11.07 0.59 11.66 11.66 XXX 76393 A Mr guidance for needle place 1.49 11.62 NA 0.63 13.74 NA XXX 76393 26 A Mr guidance for needle place 1.49 0.51 0.51 0.08 2.08 2.08 XXX 76393 TC A Mr guidance for needle place 0.00 11.11 NA 0.55 11.66 NA XXX 76394 A Mri for tissue ablation 4.23 12.52 NA 1.78 18.53 NA XXX 76394 26 A Mri for tissue ablation 4.23 1.41 1.41 0.23 5.87 5.87 XXX 76394 TC A Mri for tissue ablation 0.00 11.11 NA 1.55 12.66 NA XXX 76400 A Magnetic image, bone marrow 1.59 11.64 NA 0.67 13.90 NA XXX 76400 26 A Magnetic image, bone marrow 1.59 0.53 0.53 0.08 2.20 2.20 XXX 76400 TC A Magnetic image, bone marrow 0.00 11.11 NA 0.59 11.70 NA XXX 76490 D Us for tissue ablation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76490 26 D Us for tissue ablation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76490 TC D Us for tissue ablation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76496 C Fluoroscopic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63350 76496 26 C Fluoroscopic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76496 TC C Fluoroscopic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 C Ct procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 26 C Ct procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 TC C Ct procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 C Mri procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 26 C Mri procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 TC C Mri procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 26 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 TC C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76506 A Echo exam of head 0.63 1.66 NA 0.12 2.41 NA XXX 76506 26 A Echo exam of head 0.63 0.25 0.25 0.04 0.92 0.92 XXX 76506 TC A Echo exam of head 0.00 1.41 NA 0.08 1.49 NA XXX 76511 A Echo exam of eye 0.93 1.10 NA 0.09 2.12 NA XXX 76511 26 A Echo exam of eye 0.93 0.41 0.41 0.02 1.36 1.36 XXX 76511 TC A Echo exam of eye 0.00 0.69 NA 0.07 0.76 NA XXX 76512 A Echo exam of eye 0.66 1.03 NA 0.11 1.80 NA XXX 76512 26 A Echo exam of eye 0.66 0.30 0.30 0.01 0.97 0.97 XXX 76512 TC A Echo exam of eye 0.00 0.73 NA 0.10 0.83 NA XXX 76513 A Echo exam of eye, water bath 0.66 1.11 NA 0.11 1.88 NA XXX 76513 26 A Echo exam of eye, water bath 0.66 0.30 0.30 0.01 0.97 0.97 XXX 76513 TC A Echo exam of eye, water bath 0.00 0.81 NA 0.10 0.91 NA XXX 76514 A Echo exam of eye, thickness 0.17 0.14 NA 0.02 0.33 NA XXX 76514 26 A Echo exam of eye, thickness 0.17 0.08 0.08 0.01 0.26 0.26 XXX 76514 TC A Echo exam of eye, thickness 0.00 0.06 NA 0.01 0.07 NA XXX 76516 A Echo exam of eye 0.54 0.74 NA 0.08 1.36 NA XXX 76516 26 A Echo exam of eye 0.54 0.25 0.25 0.01 0.80 0.80 XXX 76516 TC A Echo exam of eye 0.00 0.49 NA 0.07 0.56 NA XXX 76519 A Echo exam of eye 0.54 0.83 NA 0.08 1.45 NA XXX 76519 26 A Echo exam of eye 0.54 0.25 0.25 0.01 0.80 0.80 XXX 76519 TC A Echo exam of eye 0.00 0.58 NA 0.07 0.65 NA XXX 76529 A Echo exam of eye 0.57 0.78 NA 0.09 1.44 NA XXX 76529 26 A Echo exam of eye 0.57 0.25 0.25 0.01 0.83 0.83 XXX 76529 TC A Echo exam of eye 0.00 0.53 NA 0.08 0.61 NA XXX 76536 A Us exam of head and neck 0.56 1.60 NA 0.10 2.26 NA XXX 76536 26 A Us exam of head and neck 0.56 0.19 0.19 0.02 0.77 0.77 XXX 76536 TC A Us exam of head and neck 0.00 1.41 NA 0.08 1.49 NA XXX 76604 A Us exam, chest, b-scan 0.55 1.47 NA 0.09 2.11 NA XXX 76604 26 A Us exam, chest, b-scan 0.55 0.18 0.18 0.02 0.75 0.75 XXX 76604 TC A Us exam, chest, b-scan 0.00 1.29 NA 0.07 1.36 NA XXX 76645 A Us exam, breast(s) 0.54 1.22 NA 0.10 1.86 NA XXX 76645 26 A Us exam, breast(s) 0.54 0.18 0.18 0.04 0.76 0.76 XXX 76645 TC A Us exam, breast(s) 0.00 1.04 NA 0.06 1.10 NA XXX 76700 A Us exam, abdom, complete 0.81 2.22 NA 0.16 3.19 NA XXX 76700 26 A Us exam, abdom, complete 0.81 0.27 0.27 0.05 1.13 1.13 XXX 76700 TC A Us exam, abdom, complete 0.00 1.95 NA 0.11 2.06 NA XXX 76705 A Echo exam of abdomen 0.59 1.61 NA 0.12 2.32 NA XXX 76705 26 A Echo exam of abdomen 0.59 0.20 0.20 0.04 0.83 0.83 XXX 76705 TC A Echo exam of abdomen 0.00 1.41 NA 0.08 1.49 NA XXX 76770 A Us exam abdo back wall, comp 0.74 2.20 NA 0.15 3.09 NA XXX 76770 26 A Us exam abdo back wall, comp 0.74 0.25 0.25 0.04 1.03 1.03 XXX 76770 TC A Us exam abdo back wall, comp 0.00 1.95 NA 0.11 2.06 NA XXX 76775 A Us exam abdo back wall, lim 0.58 1.60 NA 0.12 2.30 NA XXX 76775 26 A Us exam abdo back wall, lim 0.58 0.19 0.19 0.04 0.81 0.81 XXX 76775 TC A Us exam abdo back wall, lim 0.00 1.41 NA 0.08 1.49 NA XXX 76778 A Us exam kidney transplant 0.74 2.20 NA 0.15 3.09 NA XXX 76778 26 A Us exam kidney transplant 0.74 0.25 0.25 0.04 1.03 1.03 XXX 76778 TC A Us exam kidney transplant 0.00 1.95 NA 0.11 2.06 NA XXX 76800 A Us exam, spinal canal 1.12 1.76 NA 0.13 3.01 NA XXX 76800 26 A Us exam, spinal canal 1.12 0.35 0.35 0.05 1.52 1.52 XXX 76800 TC A Us exam, spinal canal 0.00 1.41 NA 0.08 1.49 NA XXX 76801 A Ob us < 14 wks, single fetus 0.98 2.43 NA 0.17 3.58 NA XXX 76801 26 A Ob us < 14 wks, single fetus 0.98 0.35 0.35 0.05 1.38 1.38 XXX 76801 TC A Ob us < 14 wks, single fetus 0.00 2.08 NA 0.12 2.20 NA XXX 76802 A Ob us < 14 wks, addl fetus 0.83 1.33 NA 0.17 2.33 NA ZZZ 76802 26 A Ob us < 14 wks, addl fetus 0.83 0.29 0.29 0.05 1.17 1.17 ZZZ 76802 TC A Ob us < 14 wks, addl fetus 0.00 1.04 NA 0.12 1.16 NA ZZZ 76805 A Ob us >/= 14 wks, sngl fetus 0.98 2.43 NA 0.17 3.58 NA XXX 76805 26 A Ob us >/= 14 wks, sngl fetus 0.98 0.35 0.35 0.05 1.38 1.38 XXX 76805 TC A Ob us >/= 14 wks, sngl fetus 0.00 2.08 NA 0.12 2.20 NA XXX 76810 A Ob us >/= 14 wks, addl fetus 0.97 1.39 NA 0.30 2.66 NA ZZZ 76810 26 A Ob us >/= 14 wks, addl fetus 0.97 0.35 0.35 0.08 1.40 1.40 ZZZ 76810 TC A Ob us >/= 14 wks, addl fetus 0.00 1.04 NA 0.22 1.26 NA ZZZ 76811 A Ob us, detailed, sngl fetus 1.89 4.16 NA 0.61 6.66 NA XXX Start Printed Page 63351 76811 26 A Ob us, detailed, sngl fetus 1.89 0.66 0.66 0.18 2.73 2.73 XXX 76811 TC A Ob us, detailed, sngl fetus 0.00 3.50 NA 0.43 3.93 NA XXX 76812 A Ob us, detailed, addl fetus 1.77 1.68 NA 0.55 4.00 NA ZZZ 76812 26 A Ob us, detailed, addl fetus 1.77 0.64 0.64 0.14 2.55 2.55 ZZZ 76812 TC A Ob us, detailed, addl fetus 0.00 1.04 NA 0.41 1.45 NA ZZZ 76815 A Ob us, limited, fetus(s) 0.65 1.64 NA 0.10 2.39 NA XXX 76815 26 A Ob us, limited, fetus(s) 0.65 0.23 0.23 0.02 0.90 0.90 XXX 76815 TC A Ob us, limited, fetus(s) 0.00 1.41 NA 0.08 1.49 NA XXX 76816 A Ob us, follow-up, per fetus 0.85 1.42 NA 0.08 2.35 NA XXX 76816 26 A Ob us, follow-up, per fetus 0.85 0.32 0.32 0.02 1.19 1.19 XXX 76816 TC A Ob us, follow-up, per fetus 0.00 1.10 NA 0.06 1.16 NA XXX 76817 A Transvaginal us, obstetric 0.75 1.79 NA 0.08 2.62 NA XXX 76817 26 A Transvaginal us, obstetric 0.75 0.28 0.28 0.02 1.05 1.05 XXX 76817 TC A Transvaginal us, obstetric 0.00 1.51 NA 0.06 1.57 NA XXX 76818 A Fetal biophys profile w/nst 1.04 2.00 NA 0.15 3.19 NA XXX 76818 26 A Fetal biophys profile w/nst 1.04 0.40 0.40 0.05 1.49 1.49 XXX 76818 TC A Fetal biophys profile w/nst 0.00 1.60 NA 0.10 1.70 NA XXX 76819 A Fetal biophys profil w/o nst 0.77 1.89 NA 0.12 2.78 NA XXX 76819 26 A Fetal biophys profil w/o nst 0.77 0.29 0.29 0.02 1.08 1.08 XXX 76819 TC A Fetal biophys profil w/o nst 0.00 1.60 NA 0.10 1.70 NA XXX 76825 A Echo exam of fetal heart 1.66 2.57 NA 0.18 4.41 NA XXX 76825 26 A Echo exam of fetal heart 1.66 0.62 0.62 0.07 2.35 2.35 XXX 76825 TC A Echo exam of fetal heart 0.00 1.95 NA 0.11 2.06 NA XXX 76826 A Echo exam of fetal heart 0.83 1.00 NA 0.09 1.92 NA XXX 76826 26 A Echo exam of fetal heart 0.83 0.30 0.30 0.04 1.17 1.17 XXX 76826 TC A Echo exam of fetal heart 0.00 0.70 NA 0.05 0.75 NA XXX 76827 A Echo exam of fetal heart 0.58 1.93 NA 0.14 2.65 NA XXX 76827 26 A Echo exam of fetal heart 0.58 0.22 0.22 0.02 0.82 0.82 XXX 76827 TC A Echo exam of fetal heart 0.00 1.71 NA 0.12 1.83 NA XXX 76828 A Echo exam of fetal heart 0.56 1.32 NA 0.10 1.98 NA XXX 76828 26 A Echo exam of fetal heart 0.56 0.22 0.22 0.02 0.80 0.80 XXX 76828 TC A Echo exam of fetal heart 0.00 1.10 NA 0.08 1.18 NA XXX 76830 A Transvaginal us, non-ob 0.69 1.74 NA 0.14 2.57 NA XXX 76830 26 A Transvaginal us, non-ob 0.69 0.23 0.23 0.04 0.96 0.96 XXX 76830 TC A Transvaginal us, non-ob 0.00 1.51 NA 0.10 1.61 NA XXX 76831 A Echo exam, uterus 0.72 1.77 NA 0.12 2.61 NA XXX 76831 26 A Echo exam, uterus 0.72 0.26 0.26 0.02 1.00 1.00 XXX 76831 TC A Echo exam, uterus 0.00 1.51 NA 0.10 1.61 NA XXX 76856 A Us exam, pelvic, complete 0.69 1.74 NA 0.14 2.57 NA XXX 76856 26 A Us exam, pelvic, complete 0.69 0.23 0.23 0.04 0.96 0.96 XXX 76856 TC A Us exam, pelvic, complete 0.00 1.51 NA 0.10 1.61 NA XXX 76857 A Us exam, pelvic, limited 0.38 1.71 NA 0.08 2.17 NA XXX 76857 26 A Us exam, pelvic, limited 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76857 TC A Us exam, pelvic, limited 0.00 1.58 NA 0.06 1.64 NA XXX 76870 A Us exam, scrotum 0.64 1.72 NA 0.14 2.50 NA XXX 76870 26 A Us exam, scrotum 0.64 0.21 0.21 0.04 0.89 0.89 XXX 76870 TC A Us exam, scrotum 0.00 1.51 NA 0.10 1.61 NA XXX 76872 A Us, transrectal 0.69 2.10 NA 0.15 2.94 NA XXX 76872 26 A Us, transrectal 0.69 0.23 0.23 0.05 0.97 0.97 XXX 76872 TC A Us, transrectal 0.00 1.87 NA 0.10 1.97 NA XXX 76873 A Echograp trans r, pros study 1.54 2.59 NA 0.26 4.39 NA XXX 76873 26 A Echograp trans r, pros study 1.54 0.51 0.51 0.10 2.15 2.15 XXX 76873 TC A Echograp trans r, pros study 0.00 2.08 NA 0.16 2.24 NA XXX 76880 A Us exam, extremity 0.59 1.61 NA 0.12 2.32 NA XXX 76880 26 A Us exam, extremity 0.59 0.20 0.20 0.04 0.83 0.83 XXX 76880 TC A Us exam, extremity 0.00 1.41 NA 0.08 1.49 NA XXX 76885 A Us exam infant hips, dynamic 0.74 1.76 NA 0.14 2.64 NA XXX 76885 26 A Us exam infant hips, dynamic 0.74 0.25 0.25 0.04 1.03 1.03 XXX 76885 TC A Us exam infant hips, dynamic 0.00 1.51 NA 0.10 1.61 NA XXX 76886 A Us exam infant hips, static 0.62 1.62 NA 0.12 2.36 NA XXX 76886 26 A Us exam infant hips, static 0.62 0.21 0.21 0.04 0.87 0.87 XXX 76886 TC A Us exam infant hips, static 0.00 1.41 NA 0.08 1.49 NA XXX 76930 A Echo guide, cardiocentesis 0.67 1.77 NA 0.12 2.56 NA XXX 76930 26 A Echo guide, cardiocentesis 0.67 0.26 0.26 0.02 0.95 0.95 XXX 76930 TC A Echo guide, cardiocentesis 0.00 1.51 NA 0.10 1.61 NA XXX 76932 A Echo guide for heart biopsy 0.67 1.77 NA 0.12 2.56 NA XXX 76932 26 A Echo guide for heart biopsy 0.67 0.26 0.26 0.02 0.95 0.95 XXX 76932 TC A Echo guide for heart biopsy 0.00 1.51 NA 0.10 1.61 NA XXX 76936 A Echo guide for artery repair 1.98 6.90 NA 0.47 9.35 NA XXX 76936 26 A Echo guide for artery repair 1.98 0.66 0.66 0.13 2.77 2.77 XXX 76936 TC A Echo guide for artery repair 0.00 6.24 NA 0.34 6.58 NA XXX 76937 A Us guide, vascular access 0.30 0.48 NA 0.15 0.93 NA ZZZ 76937 26 A Us guide, vascular access 0.30 0.10 0.10 0.05 0.45 0.45 ZZZ 76937 TC A Us guide, vascular access 0.00 0.38 NA 0.10 0.48 NA ZZZ 76940 A Us guide, tissue ablation 1.99 2.16 NA 0.42 4.57 NA XXX Start Printed Page 63352 76940 26 A Us guide, tissue ablation 1.99 0.65 0.65 0.13 2.77 2.77 XXX 76940 TC A Us guide, tissue ablation 0.00 1.51 NA 0.29 1.80 NA XXX 76941 A Echo guide for transfusion 1.33 2.00 NA 0.15 3.48 NA XXX 76941 26 A Echo guide for transfusion 1.33 0.48 0.48 0.07 1.88 1.88 XXX 76941 TC A Echo guide for transfusion 0.00 1.52 NA 0.08 1.60 NA XXX 76942 A Echo guide for biopsy 0.67 2.77 NA 0.15 3.59 NA XXX 76942 26 A Echo guide for biopsy 0.67 0.22 0.22 0.05 0.94 0.94 XXX 76942 TC A Echo guide for biopsy 0.00 2.55 NA 0.10 2.65 NA XXX 76945 A Echo guide, villus sampling 0.67 1.75 NA 0.12 2.54 NA XXX 76945 26 A Echo guide, villus sampling 0.67 0.23 0.23 0.04 0.94 0.94 XXX 76945 TC A Echo guide, villus sampling 0.00 1.52 NA 0.08 1.60 NA XXX 76946 A Echo guide for amniocentesis 0.38 1.65 NA 0.11 2.14 NA XXX 76946 26 A Echo guide for amniocentesis 0.38 0.14 0.14 0.01 0.53 0.53 XXX 76946 TC A Echo guide for amniocentesis 0.00 1.51 NA 0.10 1.61 NA XXX 76948 A Echo guide, ova aspiration 0.38 1.64 NA 0.12 2.14 NA XXX 76948 26 A Echo guide, ova aspiration 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76948 TC A Echo guide, ova aspiration 0.00 1.51 NA 0.10 1.61 NA XXX 76950 A Echo guidance radiotherapy 0.58 1.48 NA 0.11 2.17 NA XXX 76950 26 A Echo guidance radiotherapy 0.58 0.19 0.19 0.04 0.81 0.81 XXX 76950 TC A Echo guidance radiotherapy 0.00 1.29 NA 0.07 1.36 NA XXX 76965 A Echo guidance radiotherapy 1.33 5.96 NA 0.37 7.66 NA XXX 76965 26 A Echo guidance radiotherapy 1.33 0.44 0.44 0.08 1.85 1.85 XXX 76965 TC A Echo guidance radiotherapy 0.00 5.52 NA 0.29 5.81 NA XXX 76970 A Ultrasound exam follow-up 0.40 1.17 NA 0.08 1.65 NA XXX 76970 26 A Ultrasound exam follow-up 0.40 0.13 0.13 0.02 0.55 0.55 XXX 76970 TC A Ultrasound exam follow-up 0.00 1.04 NA 0.06 1.10 NA XXX 76975 A GI endoscopic ultrasound 0.81 1.79 NA 0.14 2.74 NA XXX 76975 26 A GI endoscopic ultrasound 0.81 0.28 0.28 0.04 1.13 1.13 XXX 76975 TC A GI endoscopic ultrasound 0.00 1.51 NA 0.10 1.61 NA XXX 76977 A Us bone density measure 0.05 0.83 NA 0.06 0.94 NA XXX 76977 26 A Us bone density measure 0.05 0.02 0.02 0.01 0.08 0.08 XXX 76977 TC A Us bone density measure 0.00 0.81 NA 0.05 0.86 NA XXX 76986 A Ultrasound guide intraoper 1.19 3.01 NA 0.22 4.42 NA XXX 76986 26 A Ultrasound guide intraoper 1.19 0.41 0.41 0.08 1.68 1.68 XXX 76986 TC A Ultrasound guide intraoper 0.00 2.60 NA 0.14 2.74 NA XXX 76999 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 TC C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77261 A Radiation therapy planning 1.38 0.52 0.52 0.07 1.97 1.97 XXX 77262 A Radiation therapy planning 2.10 0.76 0.76 0.11 2.97 2.97 XXX 77263 A Radiation therapy planning 3.12 1.12 1.12 0.16 4.40 4.40 XXX 77280 A Set radiation therapy field 0.70 3.67 NA 0.22 4.59 NA XXX 77280 26 A Set radiation therapy field 0.70 0.23 0.23 0.04 0.97 0.97 XXX 77280 TC A Set radiation therapy field 0.00 3.44 NA 0.18 3.62 NA XXX 77285 A Set radiation therapy field 1.04 5.86 NA 0.35 7.25 NA XXX 77285 26 A Set radiation therapy field 1.04 0.34 0.34 0.05 1.43 1.43 XXX 77285 TC A Set radiation therapy field 0.00 5.52 NA 0.30 5.82 NA XXX 77290 A Set radiation therapy field 1.55 6.95 NA 0.42 8.92 NA XXX 77290 26 A Set radiation therapy field 1.55 0.50 0.50 0.07 2.12 2.12 XXX 77290 TC A Set radiation therapy field 0.00 6.45 NA 0.35 6.80 NA XXX 77295 A Set radiation therapy field 4.54 29.16 NA 1.69 35.39 NA XXX 77295 26 A Set radiation therapy field 4.54 1.46 1.46 0.22 6.22 6.22 XXX 77295 TC A Set radiation therapy field 0.00 27.70 NA 1.47 29.17 NA XXX 77299 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 26 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 TC C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77300 A Radiation therapy dose plan 0.62 1.53 NA 0.11 2.26 NA XXX 77300 26 A Radiation therapy dose plan 0.62 0.20 0.20 0.04 0.86 0.86 XXX 77300 TC A Radiation therapy dose plan 0.00 1.33 NA 0.07 1.40 NA XXX 77301 A Radiotherapy dose plan, imrt 7.95 30.26 NA 1.69 39.90 NA XXX 77301 26 A Radiotherapy dose plan, imrt 7.95 2.56 2.56 0.22 10.73 10.73 XXX 77301 TC A Radiotherapy dose plan, imrt 0.00 27.70 NA 1.47 29.17 NA XXX 77305 A Teletx isodose plan simple 0.70 2.07 NA 0.15 2.92 NA XXX 77305 26 A Teletx isodose plan simple 0.70 0.23 0.23 0.04 0.97 0.97 XXX 77305 TC A Teletx isodose plan simple 0.00 1.84 NA 0.11 1.95 NA XXX 77310 A Teletx isodose plan intermed 1.04 2.65 NA 0.18 3.87 NA XXX 77310 26 A Teletx isodose plan intermed 1.04 0.34 0.34 0.05 1.43 1.43 XXX 77310 TC A Teletx isodose plan intermed 0.00 2.31 NA 0.13 2.44 NA XXX 77315 A Teletx isodose plan complex 1.55 3.14 NA 0.21 4.90 NA XXX 77315 26 A Teletx isodose plan complex 1.55 0.50 0.50 0.07 2.12 2.12 XXX 77315 TC A Teletx isodose plan complex 0.00 2.64 NA 0.14 2.78 NA XXX 77321 A Special teletx port plan 0.94 4.32 NA 0.25 5.51 NA XXX 77321 26 A Special teletx port plan 0.94 0.31 0.31 0.05 1.30 1.30 XXX 77321 TC A Special teletx port plan 0.00 4.01 NA 0.20 4.21 NA XXX 77326 A Brachytx isodose calc simp 0.92 2.64 NA 0.18 3.74 NA XXX Start Printed Page 63353 77326 26 A Brachytx isodose calc simp 0.92 0.30 0.30 0.05 1.27 1.27 XXX 77326 TC A Brachytx isodose calc simp 0.00 2.34 NA 0.13 2.47 NA XXX 77327 A Brachytx isodose calc interm 1.38 3.89 NA 0.25 5.52 NA XXX 77327 26 A Brachytx isodose calc interm 1.38 0.45 0.45 0.07 1.90 1.90 XXX 77327 TC A Brachytx isodose calc interm 0.00 3.44 NA 0.18 3.62 NA XXX 77328 A Brachytx isodose plan compl 2.08 5.58 NA 0.36 8.02 NA XXX 77328 26 A Brachytx isodose plan compl 2.08 0.66 0.66 0.11 2.85 2.85 XXX 77328 TC A Brachytx isodose plan compl 0.00 4.92 NA 0.25 5.17 NA XXX 77331 A Special radiation dosimetry 0.87 0.78 NA 0.07 1.72 NA XXX 77331 26 A Special radiation dosimetry 0.87 0.28 0.28 0.05 1.20 1.20 XXX 77331 TC A Special radiation dosimetry 0.00 0.50 NA 0.02 0.52 NA XXX 77332 A Radiation treatment aid(s) 0.54 1.50 NA 0.09 2.13 NA XXX 77332 26 A Radiation treatment aid(s) 0.54 0.17 0.17 0.02 0.73 0.73 XXX 77332 TC A Radiation treatment aid(s) 0.00 1.33 NA 0.07 1.40 NA XXX 77333 A Radiation treatment aid(s) 0.84 2.15 NA 0.16 3.15 NA XXX 77333 26 A Radiation treatment aid(s) 0.84 0.27 0.27 0.05 1.16 1.16 XXX 77333 TC A Radiation treatment aid(s) 0.00 1.88 NA 0.11 1.99 NA XXX 77334 A Radiation treatment aid(s) 1.23 3.62 NA 0.23 5.08 NA XXX 77334 26 A Radiation treatment aid(s) 1.23 0.40 0.40 0.06 1.69 1.69 XXX 77334 TC A Radiation treatment aid(s) 0.00 3.22 NA 0.17 3.39 NA XXX 77336 A Radiation physics consult 0.00 2.96 NA 0.16 3.12 NA XXX 77370 A Radiation physics consult 0.00 3.46 NA 0.18 3.64 NA XXX 77399 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 TC C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77401 A Radiation treatment delivery 0.00 1.76 NA 0.11 1.87 NA XXX 77402 A Radiation treatment delivery 0.00 1.76 NA 0.11 1.87 NA XXX 77403 A Radiation treatment delivery 0.00 1.76 NA 0.11 1.87 NA XXX 77404 A Radiation treatment delivery 0.00 1.76 NA 0.11 1.87 NA XXX 77406 A Radiation treatment delivery 0.00 1.76 NA 0.11 1.87 NA XXX 77407 A Radiation treatment delivery 0.00 2.07 NA 0.12 2.19 NA XXX 77408 A Radiation treatment delivery 0.00 2.07 NA 0.12 2.19 NA XXX 77409 A Radiation treatment delivery 0.00 2.07 NA 0.12 2.19 NA XXX 77411 A Radiation treatment delivery 0.00 2.07 NA 0.12 2.19 NA XXX 77412 A Radiation treatment delivery 0.00 2.31 NA 0.13 2.44 NA XXX 77413 A Radiation treatment delivery 0.00 2.31 NA 0.13 2.44 NA XXX 77414 A Radiation treatment delivery 0.00 2.31 NA 0.13 2.44 NA XXX 77416 A Radiation treatment delivery 0.00 2.31 NA 0.13 2.44 NA XXX 77417 A Radiology port film(s) 0.00 0.59 NA 0.04 0.63 NA XXX 77418 A Radiation tx delivery, imrt 0.00 17.83 NA 0.13 17.96 NA XXX 77427 A Radiation tx management, x5 3.29 1.06 1.06 0.17 4.52 4.52 XXX 77431 A Radiation therapy management 1.80 0.68 0.68 0.08 2.56 2.56 XXX 77432 A Stereotactic radiation trmt 7.88 2.93 2.93 0.40 11.21 11.21 XXX 77470 A Special radiation treatment 2.08 11.71 NA 0.70 14.49 NA XXX 77470 26 A Special radiation treatment 2.08 0.66 0.66 0.11 2.85 2.85 XXX 77470 TC A Special radiation treatment 0.00 11.05 NA 0.59 11.64 NA XXX 77499 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 26 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 TC C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77520 C Proton trmt, simple w/o comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77522 C Proton trmt, simple w/comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77523 C Proton trmt, intermediate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77525 C Proton treatment, complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77600 R Hyperthermia treatment 1.55 3.52 NA 0.26 5.33 NA XXX 77600 26 R Hyperthermia treatment 1.55 0.50 0.50 0.10 2.15 2.15 XXX 77600 TC R Hyperthermia treatment 0.00 3.02 NA 0.16 3.18 NA XXX 77605 R Hyperthermia treatment 2.08 4.69 NA 0.38 7.15 NA XXX 77605 26 R Hyperthermia treatment 2.08 0.66 0.66 0.16 2.90 2.90 XXX 77605 TC R Hyperthermia treatment 0.00 4.03 NA 0.22 4.25 NA XXX 77610 R Hyperthermia treatment 1.55 3.53 NA 0.24 5.32 NA XXX 77610 26 R Hyperthermia treatment 1.55 0.51 0.51 0.08 2.14 2.14 XXX 77610 TC R Hyperthermia treatment 0.00 3.02 NA 0.16 3.18 NA XXX 77615 R Hyperthermia treatment 2.08 4.69 NA 0.33 7.10 NA XXX 77615 26 R Hyperthermia treatment 2.08 0.66 0.66 0.11 2.85 2.85 XXX 77615 TC R Hyperthermia treatment 0.00 4.03 NA 0.22 4.25 NA XXX 77620 R Hyperthermia treatment 1.55 3.54 NA 0.23 5.32 NA XXX 77620 26 R Hyperthermia treatment 1.55 0.52 0.52 0.07 2.14 2.14 XXX 77620 TC R Hyperthermia treatment 0.00 3.02 NA 0.16 3.18 NA XXX 77750 A Infuse radioactive materials 4.88 2.91 NA 0.27 8.06 NA 090 77750 26 A Infuse radioactive materials 4.88 1.59 1.59 0.20 6.67 6.67 090 77750 TC A Infuse radioactive materials 0.00 1.32 NA 0.07 1.39 NA 090 77761 A Apply intrcav radiat simple 3.79 3.58 NA 0.33 7.70 NA 090 77761 26 A Apply intrcav radiat simple 3.79 1.10 1.10 0.19 5.08 5.08 090 77761 TC A Apply intrcav radiat simple 0.00 2.48 NA 0.14 2.62 NA 090 77762 A Apply intrcav radiat interm 5.69 5.42 NA 0.45 11.56 NA 090 Start Printed Page 63354 77762 26 A Apply intrcav radiat interm 5.69 1.85 1.85 0.26 7.80 7.80 090 77762 TC A Apply intrcav radiat interm 0.00 3.57 NA 0.19 3.76 NA 090 77763 A Apply intrcav radiat compl 8.52 7.20 NA 0.64 16.36 NA 090 77763 26 A Apply intrcav radiat compl 8.52 2.75 2.75 0.41 11.68 11.68 090 77763 TC A Apply intrcav radiat compl 0.00 4.45 NA 0.23 4.68 NA 090 77776 A Apply interstit radiat simpl 4.63 3.12 NA 0.42 8.17 NA 090 77776 26 A Apply interstit radiat simpl 4.63 0.97 0.97 0.29 5.89 5.89 090 77776 TC A Apply interstit radiat simpl 0.00 2.15 NA 0.13 2.28 NA 090 77777 A Apply interstit radiat inter 7.44 6.57 NA 0.60 14.61 NA 090 77777 26 A Apply interstit radiat inter 7.44 2.37 2.37 0.38 10.19 10.19 090 77777 TC A Apply interstit radiat inter 0.00 4.20 NA 0.22 4.42 NA 090 77778 A Apply interstit radiat compl 11.13 8.66 NA 0.82 20.61 NA 090 77778 26 A Apply interstit radiat compl 11.13 3.57 3.57 0.56 15.26 15.26 090 77778 TC A Apply interstit radiat compl 0.00 5.09 NA 0.26 5.35 NA 090 77781 A High intensity brachytherapy 1.65 20.67 NA 1.13 23.45 NA 090 77781 26 A High intensity brachytherapy 1.65 0.54 0.54 0.08 2.27 2.27 090 77781 TC A High intensity brachytherapy 0.00 20.13 NA 1.05 21.18 NA 090 77782 A High intensity brachytherapy 2.48 20.93 NA 1.17 24.58 NA 090 77782 26 A High intensity brachytherapy 2.48 0.80 0.80 0.12 3.40 3.40 090 77782 TC A High intensity brachytherapy 0.00 20.13 NA 1.05 21.18 NA 090 77783 A High intensity brachytherapy 3.71 21.32 NA 1.23 26.26 NA 090 77783 26 A High intensity brachytherapy 3.71 1.19 1.19 0.18 5.08 5.08 090 77783 TC A High intensity brachytherapy 0.00 20.13 NA 1.05 21.18 NA 090 77784 A High intensity brachytherapy 5.58 21.93 NA 1.31 28.82 NA 090 77784 26 A High intensity brachytherapy 5.58 1.80 1.80 0.26 7.64 7.64 090 77784 TC A High intensity brachytherapy 0.00 20.13 NA 1.05 21.18 NA 090 77789 A Apply surface radiation 1.11 0.82 NA 0.06 1.99 NA 000 77789 26 A Apply surface radiation 1.11 0.37 0.37 0.04 1.52 1.52 000 77789 TC A Apply surface radiation 0.00 0.45 NA 0.02 0.47 NA 000 77790 A Radiation handling 1.04 0.84 NA 0.07 1.95 NA XXX 77790 26 A Radiation handling 1.04 0.34 0.34 0.05 1.43 1.43 XXX 77790 TC A Radiation handling 0.00 0.50 NA 0.02 0.52 NA XXX 77799 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 26 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 TC C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78000 A Thyroid, single uptake 0.19 1.03 NA 0.07 1.29 NA XXX 78000 26 A Thyroid, single uptake 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78000 TC A Thyroid, single uptake 0.00 0.96 NA 0.06 1.02 NA XXX 78001 A Thyroid, multiple uptakes 0.26 1.38 NA 0.08 1.72 NA XXX 78001 26 A Thyroid, multiple uptakes 0.26 0.09 0.09 0.01 0.36 0.36 XXX 78001 TC A Thyroid, multiple uptakes 0.00 1.29 NA 0.07 1.36 NA XXX 78003 A Thyroid suppress/stimul 0.33 1.07 NA 0.07 1.47 NA XXX 78003 26 A Thyroid suppress/stimul 0.33 0.11 0.11 0.01 0.45 0.45 XXX 78003 TC A Thyroid suppress/stimul 0.00 0.96 NA 0.06 1.02 NA XXX 78006 A Thyroid imaging with uptake 0.49 2.53 NA 0.15 3.17 NA XXX 78006 26 A Thyroid imaging with uptake 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78006 TC A Thyroid imaging with uptake 0.00 2.36 NA 0.13 2.49 NA XXX 78007 A Thyroid image, mult uptakes 0.50 2.72 NA 0.16 3.38 NA XXX 78007 26 A Thyroid image, mult uptakes 0.50 0.17 0.17 0.02 0.69 0.69 XXX 78007 TC A Thyroid image, mult uptakes 0.00 2.55 NA 0.14 2.69 NA XXX 78010 A Thyroid imaging 0.39 1.94 NA 0.13 2.46 NA XXX 78010 26 A Thyroid imaging 0.39 0.13 0.13 0.02 0.54 0.54 XXX 78010 TC A Thyroid imaging 0.00 1.81 NA 0.11 1.92 NA XXX 78011 A Thyroid imaging with flow 0.45 2.55 NA 0.15 3.15 NA XXX 78011 26 A Thyroid imaging with flow 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78011 TC A Thyroid imaging with flow 0.00 2.39 NA 0.13 2.52 NA XXX 78015 A Thyroid met imaging 0.67 2.78 NA 0.18 3.63 NA XXX 78015 26 A Thyroid met imaging 0.67 0.23 0.23 0.04 0.94 0.94 XXX 78015 TC A Thyroid met imaging 0.00 2.55 NA 0.14 2.69 NA XXX 78016 A Thyroid met imaging/studies 0.82 3.74 NA 0.22 4.78 NA XXX 78016 26 A Thyroid met imaging/studies 0.82 0.29 0.29 0.04 1.15 1.15 XXX 78016 TC A Thyroid met imaging/studies 0.00 3.45 NA 0.18 3.63 NA XXX 78018 A Thyroid met imaging, body 0.86 5.68 NA 0.33 6.87 NA XXX 78018 26 A Thyroid met imaging, body 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78018 TC A Thyroid met imaging, body 0.00 5.38 NA 0.29 5.67 NA XXX 78020 A Thyroid met uptake 0.60 1.50 NA 0.16 2.26 NA ZZZ 78020 26 A Thyroid met uptake 0.60 0.21 0.21 0.02 0.83 0.83 ZZZ 78020 TC A Thyroid met uptake 0.00 1.29 NA 0.14 1.43 NA ZZZ 78070 A Parathyroid nuclear imaging 0.82 2.09 NA 0.15 3.06 NA XXX 78070 26 A Parathyroid nuclear imaging 0.82 0.28 0.28 0.04 1.14 1.14 XXX 78070 TC A Parathyroid nuclear imaging 0.00 1.81 NA 0.11 1.92 NA XXX 78075 A Adrenal nuclear imaging 0.74 5.65 NA 0.33 6.72 NA XXX 78075 26 A Adrenal nuclear imaging 0.74 0.27 0.27 0.04 1.05 1.05 XXX 78075 TC A Adrenal nuclear imaging 0.00 5.38 NA 0.29 5.67 NA XXX 78099 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63355 78099 26 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 TC C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78102 A Bone marrow imaging, ltd 0.55 2.22 NA 0.14 2.91 NA XXX 78102 26 A Bone marrow imaging, ltd 0.55 0.20 0.20 0.02 0.77 0.77 XXX 78102 TC A Bone marrow imaging, ltd 0.00 2.02 NA 0.12 2.14 NA XXX 78103 A Bone marrow imaging, mult 0.75 3.41 NA 0.21 4.37 NA XXX 78103 26 A Bone marrow imaging, mult 0.75 0.26 0.26 0.04 1.05 1.05 XXX 78103 TC A Bone marrow imaging, mult 0.00 3.15 NA 0.17 3.32 NA XXX 78104 A Bone marrow imaging, body 0.80 4.32 NA 0.26 5.38 NA XXX 78104 26 A Bone marrow imaging, body 0.80 0.28 0.28 0.04 1.12 1.12 XXX 78104 TC A Bone marrow imaging, body 0.00 4.04 NA 0.22 4.26 NA XXX 78110 A Plasma volume, single 0.19 1.01 NA 0.07 1.27 NA XXX 78110 26 A Plasma volume, single 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78110 TC A Plasma volume, single 0.00 0.94 NA 0.06 1.00 NA XXX 78111 A Plasma volume, multiple 0.22 2.63 NA 0.15 3.00 NA XXX 78111 26 A Plasma volume, multiple 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78111 TC A Plasma volume, multiple 0.00 2.55 NA 0.14 2.69 NA XXX 78120 A Red cell mass, single 0.23 1.80 NA 0.12 2.15 NA XXX 78120 26 A Red cell mass, single 0.23 0.08 0.08 0.01 0.32 0.32 XXX 78120 TC A Red cell mass, single 0.00 1.72 NA 0.11 1.83 NA XXX 78121 A Red cell mass, multiple 0.32 3.00 NA 0.15 3.47 NA XXX 78121 26 A Red cell mass, multiple 0.32 0.11 0.11 0.01 0.44 0.44 XXX 78121 TC A Red cell mass, multiple 0.00 2.89 NA 0.14 3.03 NA XXX 78122 A Blood volume 0.45 4.72 NA 0.26 5.43 NA XXX 78122 26 A Blood volume 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78122 TC A Blood volume 0.00 4.56 NA 0.24 4.80 NA XXX 78130 A Red cell survival study 0.61 3.04 NA 0.18 3.83 NA XXX 78130 26 A Red cell survival study 0.61 0.21 0.21 0.04 0.86 0.86 XXX 78130 TC A Red cell survival study 0.00 2.83 NA 0.14 2.97 NA XXX 78135 A Red cell survival kinetics 0.64 5.05 NA 0.29 5.98 NA XXX 78135 26 A Red cell survival kinetics 0.64 0.22 0.22 0.04 0.90 0.90 XXX 78135 TC A Red cell survival kinetics 0.00 4.83 NA 0.25 5.08 NA XXX 78140 A Red cell sequestration 0.61 4.10 NA 0.24 4.95 NA XXX 78140 26 A Red cell sequestration 0.61 0.20 0.20 0.04 0.85 0.85 XXX 78140 TC A Red cell sequestration 0.00 3.90 NA 0.20 4.10 NA XXX 78160 A Plasma iron turnover 0.33 3.75 NA 0.23 4.31 NA XXX 78160 26 A Plasma iron turnover 0.33 0.12 0.12 0.04 0.49 0.49 XXX 78160 TC A Plasma iron turnover 0.00 3.63 NA 0.19 3.82 NA XXX 78162 A Radioiron absorption exam 0.45 3.37 NA 0.18 4.00 NA XXX 78162 26 A Radioiron absorption exam 0.45 0.19 0.19 0.01 0.65 0.65 XXX 78162 TC A Radioiron absorption exam 0.00 3.18 NA 0.17 3.35 NA XXX 78170 A Red cell iron utilization 0.41 5.40 NA 0.33 6.14 NA XXX 78170 26 A Red cell iron utilization 0.41 0.14 0.14 0.05 0.60 0.60 XXX 78170 TC A Red cell iron utilization 0.00 5.26 NA 0.28 5.54 NA XXX 78172 C Total body iron estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78172 26 A Total body iron estimation 0.53 0.18 0.18 0.02 0.73 0.73 XXX 78172 TC C Total body iron estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78185 A Spleen imaging 0.40 2.48 NA 0.15 3.03 NA XXX 78185 26 A Spleen imaging 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78185 TC A Spleen imaging 0.00 2.34 NA 0.13 2.47 NA XXX 78190 A Platelet survival, kinetics 1.08 6.06 NA 0.37 7.51 NA XXX 78190 26 A Platelet survival, kinetics 1.08 0.39 0.39 0.07 1.54 1.54 XXX 78190 TC A Platelet survival, kinetics 0.00 5.67 NA 0.30 5.97 NA XXX 78191 A Platelet survival 0.61 7.48 NA 0.41 8.50 NA XXX 78191 26 A Platelet survival 0.61 0.21 0.21 0.04 0.86 0.86 XXX 78191 TC A Platelet survival 0.00 7.27 NA 0.37 7.64 NA XXX 78195 A Lymph system imaging 1.19 4.46 NA 0.28 5.93 NA XXX 78195 26 A Lymph system imaging 1.19 0.42 0.42 0.06 1.67 1.67 XXX 78195 TC A Lymph system imaging 0.00 4.04 NA 0.22 4.26 NA XXX 78199 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 26 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 TC C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78201 A Liver imaging 0.44 2.49 NA 0.15 3.08 NA XXX 78201 26 A Liver imaging 0.44 0.15 0.15 0.02 0.61 0.61 XXX 78201 TC A Liver imaging 0.00 2.34 NA 0.13 2.47 NA XXX 78202 A Liver imaging with flow 0.51 3.04 NA 0.16 3.71 NA XXX 78202 26 A Liver imaging with flow 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78202 TC A Liver imaging with flow 0.00 2.86 NA 0.14 3.00 NA XXX 78205 A Liver imaging (3D) 0.71 6.10 NA 0.35 7.16 NA XXX 78205 26 A Liver imaging (3D) 0.71 0.25 0.25 0.04 1.00 1.00 XXX 78205 TC A Liver imaging (3D) 0.00 5.85 NA 0.31 6.16 NA XXX 78206 A Liver image (3d) with flow 0.95 6.19 NA 0.16 7.30 NA XXX 78206 26 A Liver image (3d) with flow 0.95 0.34 0.34 0.05 1.34 1.34 XXX 78206 TC A Liver image (3d) with flow 0.00 5.85 NA 0.11 5.96 NA XXX 78215 A Liver and spleen imaging 0.49 3.09 NA 0.16 3.74 NA XXX Start Printed Page 63356 78215 26 A Liver and spleen imaging 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78215 TC A Liver and spleen imaging 0.00 2.92 NA 0.14 3.06 NA XXX 78216 A Liver & spleen image/flow 0.57 3.65 NA 0.20 4.42 NA XXX 78216 26 A Liver & spleen image/flow 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78216 TC A Liver & spleen image/flow 0.00 3.45 NA 0.18 3.63 NA XXX 78220 A Liver function study 0.49 3.86 NA 0.21 4.56 NA XXX 78220 26 A Liver function study 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78220 TC A Liver function study 0.00 3.69 NA 0.19 3.88 NA XXX 78223 A Hepatobiliary imaging 0.84 3.91 NA 0.24 4.99 NA XXX 78223 26 A Hepatobiliary imaging 0.84 0.28 0.28 0.05 1.17 1.17 XXX 78223 TC A Hepatobiliary imaging 0.00 3.63 NA 0.19 3.82 NA XXX 78230 A Salivary gland imaging 0.45 2.30 NA 0.15 2.90 NA XXX 78230 26 A Salivary gland imaging 0.45 0.15 0.15 0.02 0.62 0.62 XXX 78230 TC A Salivary gland imaging 0.00 2.15 NA 0.13 2.28 NA XXX 78231 A Serial salivary imaging 0.52 3.34 NA 0.19 4.05 NA XXX 78231 26 A Serial salivary imaging 0.52 0.19 0.19 0.02 0.73 0.73 XXX 78231 TC A Serial salivary imaging 0.00 3.15 NA 0.17 3.32 NA XXX 78232 A Salivary gland function exam 0.47 3.68 NA 0.19 4.34 NA XXX 78232 26 A Salivary gland function exam 0.47 0.17 0.17 0.01 0.65 0.65 XXX 78232 TC A Salivary gland function exam 0.00 3.51 NA 0.18 3.69 NA XXX 78258 A Esophageal motility study 0.74 3.11 NA 0.18 4.03 NA XXX 78258 26 A Esophageal motility study 0.74 0.25 0.25 0.04 1.03 1.03 XXX 78258 TC A Esophageal motility study 0.00 2.86 NA 0.14 3.00 NA XXX 78261 A Gastric mucosa imaging 0.69 4.32 NA 0.26 5.27 NA XXX 78261 26 A Gastric mucosa imaging 0.69 0.25 0.25 0.04 0.98 0.98 XXX 78261 TC A Gastric mucosa imaging 0.00 4.07 NA 0.22 4.29 NA XXX 78262 A Gastroesophageal reflux exam 0.68 4.46 NA 0.26 5.40 NA XXX 78262 26 A Gastroesophageal reflux exam 0.68 0.24 0.24 0.04 0.96 0.96 XXX 78262 TC A Gastroesophageal reflux exam 0.00 4.22 NA 0.22 4.44 NA XXX 78264 A Gastric emptying study 0.78 4.37 NA 0.26 5.41 NA XXX 78264 26 A Gastric emptying study 0.78 0.27 0.27 0.04 1.09 1.09 XXX 78264 TC A Gastric emptying study 0.00 4.10 NA 0.22 4.32 NA XXX 78267 X Breath tst attain/anal c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78268 X Breath test analysis, c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78270 A Vit B-12 absorption exam 0.20 1.61 NA 0.11 1.92 NA XXX 78270 26 A Vit B-12 absorption exam 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78270 TC A Vit B-12 absorption exam 0.00 1.54 NA 0.10 1.64 NA XXX 78271 A Vit b-12 absrp exam, int fac 0.20 1.70 NA 0.11 2.01 NA XXX 78271 26 A Vit b-12 absrp exam, int fac 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78271 TC A Vit b-12 absrp exam, int fac 0.00 1.63 NA 0.10 1.73 NA XXX 78272 A Vit B-12 absorp, combined 0.27 2.40 NA 0.14 2.81 NA XXX 78272 26 A Vit B-12 absorp, combined 0.27 0.10 0.10 0.01 0.38 0.38 XXX 78272 TC A Vit B-12 absorp, combined 0.00 2.30 NA 0.13 2.43 NA XXX 78278 A Acute GI blood loss imaging 0.98 5.17 NA 0.30 6.45 NA XXX 78278 26 A Acute GI blood loss imaging 0.98 0.34 0.34 0.05 1.37 1.37 XXX 78278 TC A Acute GI blood loss imaging 0.00 4.83 NA 0.25 5.08 NA XXX 78282 C GI protein loss exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78282 26 A GI protein loss exam 0.38 0.13 0.13 0.02 0.53 0.53 XXX 78282 TC C GI protein loss exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78290 A Meckel's divert exam 0.68 3.25 NA 0.20 4.13 NA XXX 78290 26 A Meckel's divert exam 0.68 0.23 0.23 0.04 0.95 0.95 XXX 78290 TC A Meckel's divert exam 0.00 3.02 NA 0.16 3.18 NA XXX 78291 A Leveen/shunt patency exam 0.87 3.35 NA 0.21 4.43 NA XXX 78291 26 A Leveen/shunt patency exam 0.87 0.31 0.31 0.05 1.23 1.23 XXX 78291 TC A Leveen/shunt patency exam 0.00 3.04 NA 0.16 3.20 NA XXX 78299 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 26 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 TC C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78300 A Bone imaging, limited area 0.62 2.67 NA 0.18 3.47 NA XXX 78300 26 A Bone imaging, limited area 0.62 0.21 0.21 0.04 0.87 0.87 XXX 78300 TC A Bone imaging, limited area 0.00 2.46 NA 0.14 2.60 NA XXX 78305 A Bone imaging, multiple areas 0.83 3.91 NA 0.23 4.97 NA XXX 78305 26 A Bone imaging, multiple areas 0.83 0.28 0.28 0.04 1.15 1.15 XXX 78305 TC A Bone imaging, multiple areas 0.00 3.63 NA 0.19 3.82 NA XXX 78306 A Bone imaging, whole body 0.86 4.53 NA 0.27 5.66 NA XXX 78306 26 A Bone imaging, whole body 0.86 0.29 0.29 0.05 1.20 1.20 XXX 78306 TC A Bone imaging, whole body 0.00 4.24 NA 0.22 4.46 NA XXX 78315 A Bone imaging, 3 phase 1.01 5.08 NA 0.30 6.39 NA XXX 78315 26 A Bone imaging, 3 phase 1.01 0.35 0.35 0.05 1.41 1.41 XXX 78315 TC A Bone imaging, 3 phase 0.00 4.73 NA 0.25 4.98 NA XXX 78320 A Bone imaging (3D) 1.03 6.22 NA 0.36 7.61 NA XXX 78320 26 A Bone imaging (3D) 1.03 0.37 0.37 0.05 1.45 1.45 XXX 78320 TC A Bone imaging (3D) 0.00 5.85 NA 0.31 6.16 NA XXX 78350 A Bone mineral, single photon 0.22 0.81 NA 0.06 1.09 NA XXX 78350 26 A Bone mineral, single photon 0.22 0.07 0.07 0.01 0.30 0.30 XXX Start Printed Page 63357 78350 TC A Bone mineral, single photon 0.00 0.74 NA 0.05 0.79 NA XXX 78351 N Bone mineral, dual photon +0.30 1.73 0.12 0.01 2.04 0.43 XXX 78399 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 26 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 TC C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 C Non-imaging heart function 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 26 A Non-imaging heart function 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78414 TC C Non-imaging heart function 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78428 A Cardiac shunt imaging 0.78 2.53 NA 0.17 3.48 NA XXX 78428 26 A Cardiac shunt imaging 0.78 0.30 0.30 0.04 1.12 1.12 XXX 78428 TC A Cardiac shunt imaging 0.00 2.23 NA 0.13 2.36 NA XXX 78445 A Vascular flow imaging 0.49 2.01 NA 0.13 2.63 NA XXX 78445 26 A Vascular flow imaging 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78445 TC A Vascular flow imaging 0.00 1.84 NA 0.11 1.95 NA XXX 78455 A Venous thrombosis study 0.73 4.20 NA 0.24 5.17 NA XXX 78455 26 A Venous thrombosis study 0.73 0.25 0.25 0.04 1.02 1.02 XXX 78455 TC A Venous thrombosis study 0.00 3.95 NA 0.20 4.15 NA XXX 78456 A Acute venous thrombus image 0.99 4.30 NA 0.34 5.63 NA XXX 78456 26 A Acute venous thrombus image 0.99 0.35 0.35 0.05 1.39 1.39 XXX 78456 TC A Acute venous thrombus image 0.00 3.95 NA 0.29 4.24 NA XXX 78457 A Venous thrombosis imaging 0.77 2.91 NA 0.18 3.86 NA XXX 78457 26 A Venous thrombosis imaging 0.77 0.27 0.27 0.04 1.08 1.08 XXX 78457 TC A Venous thrombosis imaging 0.00 2.64 NA 0.14 2.78 NA XXX 78458 A Ven thrombosis images, bilat 0.89 4.32 NA 0.24 5.45 NA XXX 78458 26 A Ven thrombosis images, bilat 0.89 0.33 0.33 0.04 1.26 1.26 XXX 78458 TC A Ven thrombosis images, bilat 0.00 3.99 NA 0.20 4.19 NA XXX 78459 C Heart muscle imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78459 26 R Heart muscle imaging (PET) 1.49 0.59 0.59 0.05 2.13 2.13 XXX 78459 TC C Heart muscle imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78460 A Heart muscle blood, single 0.86 2.64 NA 0.17 3.67 NA XXX 78460 26 A Heart muscle blood, single 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78460 TC A Heart muscle blood, single 0.00 2.34 NA 0.13 2.47 NA XXX 78461 A Heart muscle blood, multiple 1.22 5.11 NA 0.31 6.64 NA XXX 78461 26 A Heart muscle blood, multiple 1.22 0.44 0.44 0.06 1.72 1.72 XXX 78461 TC A Heart muscle blood, multiple 0.00 4.67 NA 0.25 4.92 NA XXX 78464 A Heart image (3d), single 1.08 7.40 NA 0.42 8.90 NA XXX 78464 26 A Heart image (3d), single 1.08 0.39 0.39 0.05 1.52 1.52 XXX 78464 TC A Heart image (3d), single 0.00 7.01 NA 0.37 7.38 NA XXX 78465 A Heart image (3d), multiple 1.45 12.23 NA 0.67 14.35 NA XXX 78465 26 A Heart image (3d), multiple 1.45 0.53 0.53 0.06 2.04 2.04 XXX 78465 TC A Heart image (3d), multiple 0.00 11.70 NA 0.61 12.31 NA XXX 78466 A Heart infarct image 0.69 2.85 NA 0.18 3.72 NA XXX 78466 26 A Heart infarct image 0.69 0.25 0.25 0.04 0.98 0.98 XXX 78466 TC A Heart infarct image 0.00 2.60 NA 0.14 2.74 NA XXX 78468 A Heart infarct image (ef) 0.80 3.91 NA 0.23 4.94 NA XXX 78468 26 A Heart infarct image (ef) 0.80 0.28 0.28 0.04 1.12 1.12 XXX 78468 TC A Heart infarct image (ef) 0.00 3.63 NA 0.19 3.82 NA XXX 78469 A Heart infarct image (3D) 0.91 5.50 NA 0.32 6.73 NA XXX 78469 26 A Heart infarct image (3D) 0.91 0.32 0.32 0.04 1.27 1.27 XXX 78469 TC A Heart infarct image (3D) 0.00 5.18 NA 0.28 5.46 NA XXX 78472 A Gated heart, planar, single 0.97 5.82 NA 0.35 7.14 NA XXX 78472 26 A Gated heart, planar, single 0.97 0.35 0.35 0.05 1.37 1.37 XXX 78472 TC A Gated heart, planar, single 0.00 5.47 NA 0.30 5.77 NA XXX 78473 A Gated heart, multiple 1.46 8.71 NA 0.48 10.65 NA XXX 78473 26 A Gated heart, multiple 1.46 0.52 0.52 0.06 2.04 2.04 XXX 78473 TC A Gated heart, multiple 0.00 8.19 NA 0.42 8.61 NA XXX 78478 A Heart wall motion add-on 0.62 1.78 NA 0.12 2.52 NA XXX 78478 26 A Heart wall motion add-on 0.62 0.23 0.23 0.02 0.87 0.87 XXX 78478 TC A Heart wall motion add-on 0.00 1.55 NA 0.10 1.65 NA XXX 78480 A Heart function add-on 0.62 1.78 NA 0.12 2.52 NA XXX 78480 26 A Heart function add-on 0.62 0.23 0.23 0.02 0.87 0.87 XXX 78480 TC A Heart function add-on 0.00 1.55 NA 0.10 1.65 NA XXX 78481 A Heart first pass, single 0.97 5.55 NA 0.32 6.84 NA XXX 78481 26 A Heart first pass, single 0.97 0.37 0.37 0.04 1.38 1.38 XXX 78481 TC A Heart first pass, single 0.00 5.18 NA 0.28 5.46 NA XXX 78483 A Heart first pass, multiple 1.46 8.35 NA 0.47 10.28 NA XXX 78483 26 A Heart first pass, multiple 1.46 0.55 0.55 0.06 2.07 2.07 XXX 78483 TC A Heart first pass, multiple 0.00 7.80 NA 0.41 8.21 NA XXX 78491 I Heart image (pet), single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78491 26 I Heart image (pet), single +1.49 0.60 0.60 0.06 2.15 2.15 XXX 78491 TC I Heart image (pet), single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 I Heart image (pet), multiple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 26 I Heart image (pet), multiple +1.86 0.74 0.74 0.07 2.67 2.67 XXX 78492 TC I Heart image (pet), multiple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78494 A Heart image, spect 1.18 7.43 NA 0.35 8.96 NA XXX Start Printed Page 63358 78494 26 A Heart image, spect 1.18 0.42 0.42 0.05 1.65 1.65 XXX 78494 TC A Heart image, spect 0.00 7.01 NA 0.30 7.31 NA XXX 78496 A Heart first pass add-on 0.50 7.20 NA 0.32 8.02 NA ZZZ 78496 26 A Heart first pass add-on 0.50 0.19 0.19 0.02 0.71 0.71 ZZZ 78496 TC A Heart first pass add-on 0.00 7.01 NA 0.30 7.31 NA ZZZ 78499 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 26 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 TC C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78580 A Lung perfusion imaging 0.74 3.65 NA 0.22 4.61 NA XXX 78580 26 A Lung perfusion imaging 0.74 0.25 0.25 0.04 1.03 1.03 XXX 78580 TC A Lung perfusion imaging 0.00 3.40 NA 0.18 3.58 NA XXX 78584 A Lung V/Q image single breath 0.98 3.51 NA 0.22 4.71 NA XXX 78584 26 A Lung V/Q image single breath 0.98 0.33 0.33 0.05 1.36 1.36 XXX 78584 TC A Lung V/Q image single breath 0.00 3.18 NA 0.17 3.35 NA XXX 78585 A Lung V/Q imaging 1.08 5.96 NA 0.36 7.40 NA XXX 78585 26 A Lung V/Q imaging 1.08 0.37 0.37 0.06 1.51 1.51 XXX 78585 TC A Lung V/Q imaging 0.00 5.59 NA 0.30 5.89 NA XXX 78586 A Aerosol lung image, single 0.40 2.70 NA 0.16 3.26 NA XXX 78586 26 A Aerosol lung image, single 0.40 0.13 0.13 0.02 0.55 0.55 XXX 78586 TC A Aerosol lung image, single 0.00 2.57 NA 0.14 2.71 NA XXX 78587 A Aerosol lung image, multiple 0.49 2.95 NA 0.16 3.60 NA XXX 78587 26 A Aerosol lung image, multiple 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78587 TC A Aerosol lung image, multiple 0.00 2.78 NA 0.14 2.92 NA XXX 78588 A Perfusion lung image 1.08 3.55 NA 0.24 4.87 NA XXX 78588 26 A Perfusion lung image 1.08 0.37 0.37 0.06 1.51 1.51 XXX 78588 TC A Perfusion lung image 0.00 3.18 NA 0.18 3.36 NA XXX 78591 A Vent image, 1 breath, 1 proj 0.40 2.97 NA 0.16 3.53 NA XXX 78591 26 A Vent image, 1 breath, 1 proj 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78591 TC A Vent image, 1 breath, 1 proj 0.00 2.83 NA 0.14 2.97 NA XXX 78593 A Vent image, 1 proj, gas 0.49 3.59 NA 0.20 4.28 NA XXX 78593 26 A Vent image, 1 proj, gas 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78593 TC A Vent image, 1 proj, gas 0.00 3.42 NA 0.18 3.60 NA XXX 78594 A Vent image, mult proj, gas 0.53 5.12 NA 0.27 5.92 NA XXX 78594 26 A Vent image, mult proj, gas 0.53 0.18 0.18 0.02 0.73 0.73 XXX 78594 TC A Vent image, mult proj, gas 0.00 4.94 NA 0.25 5.19 NA XXX 78596 A Lung differential function 1.26 7.44 NA 0.43 9.13 NA XXX 78596 26 A Lung differential function 1.26 0.43 0.43 0.06 1.75 1.75 XXX 78596 TC A Lung differential function 0.00 7.01 NA 0.37 7.38 NA XXX 78599 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 26 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 TC C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78600 A Brain imaging, ltd static 0.44 3.01 NA 0.16 3.61 NA XXX 78600 26 A Brain imaging, ltd static 0.44 0.15 0.15 0.02 0.61 0.61 XXX 78600 TC A Brain imaging, ltd static 0.00 2.86 NA 0.14 3.00 NA XXX 78601 A Brain imaging, ltd w/flow 0.51 3.55 NA 0.20 4.26 NA XXX 78601 26 A Brain imaging, ltd w/flow 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78601 TC A Brain imaging, ltd w/flow 0.00 3.37 NA 0.18 3.55 NA XXX 78605 A Brain imaging, complete 0.53 3.56 NA 0.20 4.29 NA XXX 78605 26 A Brain imaging, complete 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78605 TC A Brain imaging, complete 0.00 3.37 NA 0.18 3.55 NA XXX 78606 A Brain imaging, compl w/flow 0.64 4.05 NA 0.24 4.93 NA XXX 78606 26 A Brain imaging, compl w/flow 0.64 0.22 0.22 0.04 0.90 0.90 XXX 78606 TC A Brain imaging, compl w/flow 0.00 3.83 NA 0.20 4.03 NA XXX 78607 A Brain imaging (3D) 1.22 6.94 NA 0.41 8.57 NA XXX 78607 26 A Brain imaging (3D) 1.22 0.44 0.44 0.06 1.72 1.72 XXX 78607 TC A Brain imaging (3D) 0.00 6.50 NA 0.35 6.85 NA XXX 78608 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78609 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78610 A Brain flow imaging only 0.30 1.67 NA 0.11 2.08 NA XXX 78610 26 A Brain flow imaging only 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78610 TC A Brain flow imaging only 0.00 1.56 NA 0.10 1.66 NA XXX 78615 A Cerebral vascular flow image 0.42 3.97 NA 0.22 4.61 NA XXX 78615 26 A Cerebral vascular flow image 0.42 0.16 0.16 0.02 0.60 0.60 XXX 78615 TC A Cerebral vascular flow image 0.00 3.81 NA 0.20 4.01 NA XXX 78630 A Cerebrospinal fluid scan 0.68 5.22 NA 0.30 6.20 NA XXX 78630 26 A Cerebrospinal fluid scan 0.68 0.23 0.23 0.04 0.95 0.95 XXX 78630 TC A Cerebrospinal fluid scan 0.00 4.99 NA 0.26 5.25 NA XXX 78635 A CSF ventriculography 0.61 2.76 NA 0.16 3.53 NA XXX 78635 26 A CSF ventriculography 0.61 0.24 0.24 0.02 0.87 0.87 XXX 78635 TC A CSF ventriculography 0.00 2.52 NA 0.14 2.66 NA XXX 78645 A CSF shunt evaluation 0.57 3.60 NA 0.20 4.37 NA XXX 78645 26 A CSF shunt evaluation 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78645 TC A CSF shunt evaluation 0.00 3.40 NA 0.18 3.58 NA XXX 78647 A Cerebrospinal fluid scan 0.89 6.17 NA 0.35 7.41 NA XXX 78647 26 A Cerebrospinal fluid scan 0.89 0.32 0.32 0.04 1.25 1.25 XXX Start Printed Page 63359 78647 TC A Cerebrospinal fluid scan 0.00 5.85 NA 0.31 6.16 NA XXX 78650 A CSF leakage imaging 0.61 4.81 NA 0.26 5.68 NA XXX 78650 26 A CSF leakage imaging 0.61 0.21 0.21 0.02 0.84 0.84 XXX 78650 TC A CSF leakage imaging 0.00 4.60 NA 0.24 4.84 NA XXX 78660 A Nuclear exam of tear flow 0.53 2.28 NA 0.14 2.95 NA XXX 78660 26 A Nuclear exam of tear flow 0.53 0.18 0.18 0.02 0.73 0.73 XXX 78660 TC A Nuclear exam of tear flow 0.00 2.10 NA 0.12 2.22 NA XXX 78699 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 26 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 TC C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78700 A Kidney imaging, static 0.45 3.17 NA 0.18 3.80 NA XXX 78700 26 A Kidney imaging, static 0.45 0.15 0.15 0.02 0.62 0.62 XXX 78700 TC A Kidney imaging, static 0.00 3.02 NA 0.16 3.18 NA XXX 78701 A Kidney imaging with flow 0.49 3.70 NA 0.20 4.39 NA XXX 78701 26 A Kidney imaging with flow 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78701 TC A Kidney imaging with flow 0.00 3.53 NA 0.18 3.71 NA XXX 78704 A Imaging renogram 0.74 4.17 NA 0.24 5.15 NA XXX 78704 26 A Imaging renogram 0.74 0.25 0.25 0.04 1.03 1.03 XXX 78704 TC A Imaging renogram 0.00 3.92 NA 0.20 4.12 NA XXX 78707 A Kidney flow/function image 0.95 4.76 NA 0.28 5.99 NA XXX 78707 26 A Kidney flow/function image 0.95 0.33 0.33 0.05 1.33 1.33 XXX 78707 TC A Kidney flow/function image 0.00 4.43 NA 0.23 4.66 NA XXX 78708 A Kidney flow/function image 1.20 4.85 NA 0.29 6.34 NA XXX 78708 26 A Kidney flow/function image 1.20 0.42 0.42 0.06 1.68 1.68 XXX 78708 TC A Kidney flow/function image 0.00 4.43 NA 0.23 4.66 NA XXX 78709 A Kidney flow/function image 1.40 4.91 NA 0.30 6.61 NA XXX 78709 26 A Kidney flow/function image 1.40 0.48 0.48 0.07 1.95 1.95 XXX 78709 TC A Kidney flow/function image 0.00 4.43 NA 0.23 4.66 NA XXX 78710 A Kidney imaging (3D) 0.66 6.08 NA 0.35 7.09 NA XXX 78710 26 A Kidney imaging (3D) 0.66 0.23 0.23 0.04 0.93 0.93 XXX 78710 TC A Kidney imaging (3D) 0.00 5.85 NA 0.31 6.16 NA XXX 78715 A Renal vascular flow exam 0.30 1.67 NA 0.11 2.08 NA XXX 78715 26 A Renal vascular flow exam 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78715 TC A Renal vascular flow exam 0.00 1.56 NA 0.10 1.66 NA XXX 78725 A Kidney function study 0.38 1.90 NA 0.12 2.40 NA XXX 78725 26 A Kidney function study 0.38 0.13 0.13 0.01 0.52 0.52 XXX 78725 TC A Kidney function study 0.00 1.77 NA 0.11 1.88 NA XXX 78730 A Urinary bladder retention 0.36 1.58 NA 0.10 2.04 NA XXX 78730 26 A Urinary bladder retention 0.36 0.13 0.13 0.02 0.51 0.51 XXX 78730 TC A Urinary bladder retention 0.00 1.45 NA 0.08 1.53 NA XXX 78740 A Ureteral reflux study 0.57 2.29 NA 0.14 3.00 NA XXX 78740 26 A Ureteral reflux study 0.57 0.19 0.19 0.02 0.78 0.78 XXX 78740 TC A Ureteral reflux study 0.00 2.10 NA 0.12 2.22 NA XXX 78760 A Testicular imaging 0.66 2.88 NA 0.18 3.72 NA XXX 78760 26 A Testicular imaging 0.66 0.22 0.22 0.04 0.92 0.92 XXX 78760 TC A Testicular imaging 0.00 2.66 NA 0.14 2.80 NA XXX 78761 A Testicular imaging/flow 0.71 3.42 NA 0.21 4.34 NA XXX 78761 26 A Testicular imaging/flow 0.71 0.24 0.24 0.04 0.99 0.99 XXX 78761 TC A Testicular imaging/flow 0.00 3.18 NA 0.17 3.35 NA XXX 78799 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 26 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 TC C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78800 A Tumor imaging, limited area 0.66 3.59 NA 0.22 4.47 NA XXX 78800 26 A Tumor imaging, limited area 0.66 0.22 0.22 0.04 0.92 0.92 XXX 78800 TC A Tumor imaging, limited area 0.00 3.37 NA 0.18 3.55 NA XXX 78801 A Tumor imaging, mult areas 0.79 4.46 NA 0.26 5.51 NA XXX 78801 26 A Tumor imaging, mult areas 0.79 0.27 0.27 0.04 1.10 1.10 XXX 78801 TC A Tumor imaging, mult areas 0.00 4.19 NA 0.22 4.41 NA XXX 78802 A Tumor imaging, whole body 0.86 5.79 NA 0.34 6.99 NA XXX 78802 26 A Tumor imaging, whole body 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78802 TC A Tumor imaging, whole body 0.00 5.49 NA 0.30 5.79 NA XXX 78803 A Tumor imaging (3D) 1.08 6.89 NA 0.40 8.37 NA XXX 78803 26 A Tumor imaging (3D) 1.08 0.39 0.39 0.05 1.52 1.52 XXX 78803 TC A Tumor imaging (3D) 0.00 6.50 NA 0.35 6.85 NA XXX 78804 A Tumor imaging, whole body 1.06 4.62 NA 0.34 6.02 NA XXX 78804 26 A Tumor imaging, whole body 1.06 0.38 0.38 0.04 1.48 1.48 XXX 78804 TC A Tumor imaging, whole body 0.00 4.24 NA 0.30 4.54 NA XXX 78805 A Abscess imaging, ltd area 0.73 3.62 NA 0.22 4.57 NA XXX 78805 26 A Abscess imaging, ltd area 0.73 0.25 0.25 0.04 1.02 1.02 XXX 78805 TC A Abscess imaging, ltd area 0.00 3.37 NA 0.18 3.55 NA XXX 78806 A Abscess imaging, whole body 0.86 6.67 NA 0.39 7.92 NA XXX 78806 26 A Abscess imaging, whole body 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78806 TC A Abscess imaging, whole body 0.00 6.37 NA 0.35 6.72 NA XXX 78807 A Nuclear localization/abscess 1.08 6.90 NA 0.40 8.38 NA XXX 78807 26 A Nuclear localization/abscess 1.08 0.40 0.40 0.05 1.53 1.53 XXX Start Printed Page 63360 78807 TC A Nuclear localization/abscess 0.00 6.50 NA 0.35 6.85 NA XXX 78810 N Tumor imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78810 26 N Tumor imaging (PET) +1.92 0.74 0.74 0.11 2.77 2.77 XXX 78810 TC N Tumor imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78890 B Nuclear medicine data proc +0.05 1.31 NA 0.07 1.43 NA XXX 78890 26 B Nuclear medicine data proc +0.05 0.02 0.02 0.01 0.08 0.08 XXX 78890 TC B Nuclear medicine data proc +0.00 1.29 NA 0.06 1.35 NA XXX 78891 B Nuclear med data proc +0.10 2.64 NA 0.14 2.88 NA XXX 78891 26 B Nuclear med data proc +0.10 0.04 0.04 0.01 0.15 0.15 XXX 78891 TC B Nuclear med data proc +0.00 2.60 NA 0.13 2.73 NA XXX 78990 I Provide diag radionuclide(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 26 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 TC C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79000 A Init hyperthyroid therapy 1.79 3.22 NA 0.22 5.23 NA XXX 79000 26 A Init hyperthyroid therapy 1.79 0.62 0.62 0.08 2.49 2.49 XXX 79000 TC A Init hyperthyroid therapy 0.00 2.60 NA 0.14 2.74 NA XXX 79001 A Repeat hyperthyroid therapy 1.04 1.65 NA 0.12 2.81 NA XXX 79001 26 A Repeat hyperthyroid therapy 1.04 0.36 0.36 0.05 1.45 1.45 XXX 79001 TC A Repeat hyperthyroid therapy 0.00 1.29 NA 0.07 1.36 NA XXX 79020 A Thyroid ablation 1.80 3.21 NA 0.22 5.23 NA XXX 79020 26 A Thyroid ablation 1.80 0.61 0.61 0.08 2.49 2.49 XXX 79020 TC A Thyroid ablation 0.00 2.60 NA 0.14 2.74 NA XXX 79030 A Thyroid ablation, carcinoma 2.09 3.31 NA 0.24 5.64 NA XXX 79030 26 A Thyroid ablation, carcinoma 2.09 0.71 0.71 0.10 2.90 2.90 XXX 79030 TC A Thyroid ablation, carcinoma 0.00 2.60 NA 0.14 2.74 NA XXX 79035 A Thyroid metastatic therapy 2.51 3.48 NA 0.25 6.24 NA XXX 79035 26 A Thyroid metastatic therapy 2.51 0.88 0.88 0.11 3.50 3.50 XXX 79035 TC A Thyroid metastatic therapy 0.00 2.60 NA 0.14 2.74 NA XXX 79100 A Hematopoetic nuclear therapy 1.31 3.07 NA 0.20 4.58 NA XXX 79100 26 A Hematopoetic nuclear therapy 1.31 0.47 0.47 0.06 1.84 1.84 XXX 79100 TC A Hematopoetic nuclear therapy 0.00 2.60 NA 0.14 2.74 NA XXX 79200 A Intracavitary nuclear trmt 1.98 3.29 NA 0.22 5.49 NA XXX 79200 26 A Intracavitary nuclear trmt 1.98 0.69 0.69 0.08 2.75 2.75 XXX 79200 TC A Intracavitary nuclear trmt 0.00 2.60 NA 0.14 2.74 NA XXX 79300 C Interstitial nuclear therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79300 26 A Interstitial nuclear therapy 1.59 0.57 0.57 0.08 2.24 2.24 XXX 79300 TC C Interstitial nuclear therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79400 A Nonhemato nuclear therapy 1.95 3.27 NA 0.24 5.46 NA XXX 79400 26 A Nonhemato nuclear therapy 1.95 0.67 0.67 0.10 2.72 2.72 XXX 79400 TC A Nonhemato nuclear therapy 0.00 2.60 NA 0.14 2.74 NA XXX 79403 A Hematopoetic nuclear therapy 2.24 5.15 NA 0.24 7.63 NA XXX 79403 26 A Hematopoetic nuclear therapy 2.24 0.91 0.91 0.10 3.25 3.25 XXX 79403 TC A Hematopoetic nuclear therapy 0.00 4.24 NA 0.14 4.38 NA XXX 79420 C Intravascular nuclear ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79420 26 A Intravascular nuclear ther 1.50 0.50 0.50 0.07 2.07 2.07 XXX 79420 TC C Intravascular nuclear ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79440 A Nuclear joint therapy 1.98 3.33 NA 0.24 5.55 NA XXX 79440 26 A Nuclear joint therapy 1.98 0.73 0.73 0.10 2.81 2.81 XXX 79440 TC A Nuclear joint therapy 0.00 2.60 NA 0.14 2.74 NA XXX 79900 C Provide ther radiopharm(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 26 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 TC C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80500 A Lab pathology consultation 0.37 0.21 0.16 0.01 0.59 0.54 XXX 80502 A Lab pathology consultation 1.32 0.64 0.59 0.06 2.02 1.97 XXX 83020 26 A Hemoglobin electrophoresis 0.37 0.16 0.16 0.01 0.54 0.54 XXX 83912 26 A Genetic examination 0.37 0.15 0.15 0.01 0.53 0.53 XXX 84165 26 A Electrophoreisis of proteins 0.37 0.16 0.16 0.01 0.54 0.54 XXX 84181 26 A Western blot test 0.37 0.14 0.14 0.01 0.52 0.52 XXX 84182 26 A Protein, western blot test 0.37 0.17 0.17 0.01 0.55 0.55 XXX 85060 A Blood smear interpretation 0.45 0.19 0.19 0.02 0.66 0.66 XXX 85097 A Bone marrow interpretation 0.93 1.64 0.41 0.04 2.61 1.38 XXX 85390 26 A Fibrinolysins screen 0.37 0.12 0.12 0.01 0.50 0.50 XXX 85396 A Clotting assay, whole blood 0.37 NA 0.17 0.04 NA 0.58 XXX 85576 26 A Blood platelet aggregation 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86077 A Physician blood bank service 0.93 0.47 0.41 0.04 1.44 1.38 XXX 86078 A Physician blood bank service 0.93 0.50 0.41 0.04 1.47 1.38 XXX 86079 A Physician blood bank service 0.93 0.50 0.42 0.04 1.47 1.39 XXX 86255 26 A Fluorescent antibody, screen 0.37 0.17 0.16 0.01 0.55 0.54 XXX 86256 26 A Fluorescent antibody, titer 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86320 26 A Serum immunoelectrophoresis 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86325 26 A Other immunoelectrophoresis 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86327 26 A Immunoelectrophoresis assay 0.42 0.19 0.19 0.01 0.62 0.62 XXX 86334 26 A Immunofixation procedure 0.37 0.16 0.16 0.01 0.54 0.54 XXX Start Printed Page 63361 86485 C Skin test, candida 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86490 A Coccidioidomycosis skin test 0.00 0.29 NA 0.02 0.31 NA XXX 86510 A Histoplasmosis skin test 0.00 0.32 NA 0.02 0.34 NA XXX 86580 A TB intradermal test 0.00 0.25 NA 0.02 0.27 NA XXX 86585 A TB tine test 0.00 0.20 NA 0.01 0.21 NA XXX 86586 C Skin test, unlisted 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87164 26 A Dark field examination 0.37 0.12 0.12 0.01 0.50 0.50 XXX 87207 26 A Smear, special stain 0.37 0.17 0.16 0.01 0.55 0.54 XXX 88104 A Cytopathology, fluids 0.56 0.76 NA 0.04 1.36 NA XXX 88104 26 A Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83 XXX 88104 TC A Cytopathology, fluids 0.00 0.51 NA 0.02 0.53 NA XXX 88106 A Cytopathology, fluids 0.56 0.62 NA 0.04 1.22 NA XXX 88106 26 A Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83 XXX 88106 TC A Cytopathology, fluids 0.00 0.37 NA 0.02 0.39 NA XXX 88107 A Cytopathology, fluids 0.76 0.98 NA 0.06 1.80 NA XXX 88107 26 A Cytopathology, fluids 0.76 0.34 0.34 0.04 1.14 1.14 XXX 88107 TC A Cytopathology, fluids 0.00 0.64 NA 0.02 0.66 NA XXX 88108 A Cytopath, concentrate tech 0.56 0.82 NA 0.04 1.42 NA XXX 88108 26 A Cytopath, concentrate tech 0.56 0.25 0.25 0.02 0.83 0.83 XXX 88108 TC A Cytopath, concentrate tech 0.00 0.57 NA 0.02 0.59 NA XXX 88112 A Cytopath, cell enhance tech 1.17 2.02 NA 0.08 3.27 NA XXX 88112 26 A Cytopath, cell enhance tech 1.17 0.53 0.53 0.06 1.76 1.76 XXX 88112 TC A Cytopath, cell enhance tech 0.00 1.49 NA 0.02 1.51 NA XXX 88125 A Forensic cytopathology 0.26 0.27 NA 0.02 0.55 NA XXX 88125 26 A Forensic cytopathology 0.26 0.12 0.12 0.01 0.39 0.39 XXX 88125 TC A Forensic cytopathology 0.00 0.15 NA 0.01 0.16 NA XXX 88141 A Cytopath, c/v, interpret 0.42 0.18 0.18 0.01 0.61 0.61 XXX 88160 A Cytopath smear, other source 0.50 0.93 NA 0.04 1.47 NA XXX 88160 26 A Cytopath smear, other source 0.50 0.22 0.22 0.02 0.74 0.74 XXX 88160 TC A Cytopath smear, other source 0.00 0.71 NA 0.02 0.73 NA XXX 88161 A Cytopath smear, other source 0.50 0.88 NA 0.04 1.42 NA XXX 88161 26 A Cytopath smear, other source 0.50 0.22 0.22 0.02 0.74 0.74 XXX 88161 TC A Cytopath smear, other source 0.00 0.66 NA 0.02 0.68 NA XXX 88162 A Cytopath smear, other source 0.76 0.68 NA 0.06 1.50 NA XXX 88162 26 A Cytopath smear, other source 0.76 0.34 0.34 0.04 1.14 1.14 XXX 88162 TC A Cytopath smear, other source 0.00 0.34 NA 0.02 0.36 NA XXX 88172 A Cytopathology eval of fna 0.60 0.67 NA 0.04 1.31 NA XXX 88172 26 A Cytopathology eval of fna 0.60 0.27 0.27 0.02 0.89 0.89 XXX 88172 TC A Cytopathology eval of fna 0.00 0.40 NA 0.02 0.42 NA XXX 88173 A Cytopath eval, fna, report 1.38 1.78 NA 0.08 3.24 NA XXX 88173 26 A Cytopath eval, fna, report 1.38 0.62 0.62 0.06 2.06 2.06 XXX 88173 TC A Cytopath eval, fna, report 0.00 1.16 NA 0.02 1.18 NA XXX 88180 A Cell marker study 0.36 1.45 NA 0.03 1.84 NA XXX 88180 26 A Cell marker study 0.36 0.16 0.16 0.01 0.53 0.53 XXX 88180 TC A Cell marker study 0.00 1.29 NA 0.02 1.31 NA XXX 88182 A Cell marker study 0.77 1.61 NA 0.08 2.46 NA XXX 88182 26 A Cell marker study 0.77 0.34 0.34 0.04 1.15 1.15 XXX 88182 TC A Cell marker study 0.00 1.27 NA 0.04 1.31 NA XXX 88199 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 26 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 TC C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88291 A Cyto/molecular report 0.52 0.28 0.28 0.02 0.82 0.82 XXX 88299 C Cytogenetic study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88300 A Surgical path, gross 0.08 0.28 NA 0.02 0.38 NA XXX 88300 26 A Surgical path, gross 0.08 0.04 0.04 0.01 0.13 0.13 XXX 88300 TC A Surgical path, gross 0.00 0.24 NA 0.01 0.25 NA XXX 88302 A Tissue exam by pathologist 0.13 0.70 NA 0.03 0.86 NA XXX 88302 26 A Tissue exam by pathologist 0.13 0.06 0.06 0.01 0.20 0.20 XXX 88302 TC A Tissue exam by pathologist 0.00 0.64 NA 0.02 0.66 NA XXX 88304 A Tissue exam by pathologist 0.22 0.88 NA 0.03 1.13 NA XXX 88304 26 A Tissue exam by pathologist 0.22 0.10 0.10 0.01 0.33 0.33 XXX 88304 TC A Tissue exam by pathologist 0.00 0.78 NA 0.02 0.80 NA XXX 88305 A Tissue exam by pathologist 0.75 1.75 NA 0.06 2.56 NA XXX 88305 26 A Tissue exam by pathologist 0.75 0.34 0.34 0.02 1.11 1.11 XXX 88305 TC A Tissue exam by pathologist 0.00 1.41 NA 0.04 1.45 NA XXX 88307 A Tissue exam by pathologist 1.58 2.67 NA 0.13 4.38 NA XXX 88307 26 A Tissue exam by pathologist 1.58 0.70 0.70 0.07 2.35 2.35 XXX 88307 TC A Tissue exam by pathologist 0.00 1.97 NA 0.06 2.03 NA XXX 88309 A Tissue exam by pathologist 2.27 3.27 NA 0.16 5.70 NA XXX 88309 26 A Tissue exam by pathologist 2.27 1.00 1.00 0.10 3.37 3.37 XXX 88309 TC A Tissue exam by pathologist 0.00 2.27 NA 0.06 2.33 NA XXX 88311 A Decalcify tissue 0.24 0.20 NA 0.02 0.46 NA XXX 88311 26 A Decalcify tissue 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88311 TC A Decalcify tissue 0.00 0.09 NA 0.01 0.10 NA XXX 88312 A Special stains 0.54 1.36 NA 0.03 1.93 NA XXX Start Printed Page 63362 88312 26 A Special stains 0.54 0.24 0.24 0.02 0.80 0.80 XXX 88312 TC A Special stains 0.00 1.12 NA 0.01 1.13 NA XXX 88313 A Special stains 0.24 1.10 NA 0.02 1.36 NA XXX 88313 26 A Special stains 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88313 TC A Special stains 0.00 0.99 NA 0.01 1.00 NA XXX 88314 A Histochemical stain 0.45 0.89 NA 0.04 1.38 NA XXX 88314 26 A Histochemical stain 0.45 0.20 0.20 0.02 0.67 0.67 XXX 88314 TC A Histochemical stain 0.00 0.69 NA 0.02 0.71 NA XXX 88318 A Chemical histochemistry 0.42 0.81 NA 0.02 1.25 NA XXX 88318 26 A Chemical histochemistry 0.42 0.19 0.19 0.01 0.62 0.62 XXX 88318 TC A Chemical histochemistry 0.00 0.62 NA 0.01 0.63 NA XXX 88319 A Enzyme histochemistry 0.53 1.90 NA 0.04 2.47 NA XXX 88319 26 A Enzyme histochemistry 0.53 0.23 0.23 0.02 0.78 0.78 XXX 88319 TC A Enzyme histochemistry 0.00 1.67 NA 0.02 1.69 NA XXX 88321 A Microslide consultation 1.29 0.81 0.57 0.05 2.15 1.91 XXX 88323 A Microslide consultation 1.34 1.45 NA 0.08 2.87 NA XXX 88323 26 A Microslide consultation 1.34 0.60 0.60 0.06 2.00 2.00 XXX 88323 TC A Microslide consultation 0.00 0.85 NA 0.02 0.87 NA XXX 88325 A Comprehensive review of data 2.21 2.98 0.97 0.10 5.29 3.28 XXX 88329 A Path consult introp 0.67 0.64 0.30 0.02 1.33 0.99 XXX 88331 A Path consult intraop, 1 bloc 1.18 1.00 NA 0.09 2.27 NA XXX 88331 26 A Path consult intraop, 1 bloc 1.18 0.53 0.53 0.05 1.76 1.76 XXX 88331 TC A Path consult intraop, 1 bloc 0.00 0.47 NA 0.04 0.51 NA XXX 88332 A Path consult intraop, addl 0.59 0.50 NA 0.04 1.13 NA XXX 88332 26 A Path consult intraop, addl 0.59 0.26 0.26 0.02 0.87 0.87 XXX 88332 TC A Path consult intraop, addl 0.00 0.24 NA 0.02 0.26 NA XXX 88342 A Immunohistochemistry 0.85 1.36 NA 0.06 2.27 NA XXX 88342 26 A Immunohistochemistry 0.85 0.38 0.38 0.04 1.27 1.27 XXX 88342 TC A Immunohistochemistry 0.00 0.98 NA 0.02 1.00 NA XXX 88346 A Immunofluorescent study 0.86 1.46 NA 0.06 2.38 NA XXX 88346 26 A Immunofluorescent study 0.86 0.38 0.38 0.04 1.28 1.28 XXX 88346 TC A Immunofluorescent study 0.00 1.08 NA 0.02 1.10 NA XXX 88347 A Immunofluorescent study 0.86 1.78 NA 0.06 2.70 NA XXX 88347 26 A Immunofluorescent study 0.86 0.36 0.36 0.04 1.26 1.26 XXX 88347 TC A Immunofluorescent study 0.00 1.42 NA 0.02 1.44 NA XXX 88348 A Electron microscopy 1.50 8.57 NA 0.13 10.20 NA XXX 88348 26 A Electron microscopy 1.50 0.65 0.65 0.06 2.21 2.21 XXX 88348 TC A Electron microscopy 0.00 7.92 NA 0.07 7.99 NA XXX 88349 A Scanning electron microscopy 0.76 10.00 NA 0.10 10.86 NA XXX 88349 26 A Scanning electron microscopy 0.76 0.34 0.34 0.04 1.14 1.14 XXX 88349 TC A Scanning electron microscopy 0.00 9.66 NA 0.06 9.72 NA XXX 88355 A Analysis, skeletal muscle 1.84 2.63 NA 0.14 4.61 NA XXX 88355 26 A Analysis, skeletal muscle 1.84 0.81 0.81 0.08 2.73 2.73 XXX 88355 TC A Analysis, skeletal muscle 0.00 1.82 NA 0.06 1.88 NA XXX 88356 A Analysis, nerve 3.00 2.91 NA 0.19 6.10 NA XXX 88356 26 A Analysis, nerve 3.00 1.29 1.29 0.12 4.41 4.41 XXX 88356 TC A Analysis, nerve 0.00 1.62 NA 0.07 1.69 NA XXX 88358 A Analysis, tumor 2.80 1.39 NA 0.19 4.38 NA XXX 88358 26 A Analysis, tumor 2.80 1.24 1.24 0.12 4.16 4.16 XXX 88358 TC A Analysis, tumor 0.00 0.15 NA 0.07 0.22 NA XXX 88361 A Immunohistochemistry, tumor 0.93 2.62 NA 0.19 3.74 NA XXX 88361 26 A Immunohistochemistry, tumor 0.93 0.42 0.42 0.12 1.47 1.47 XXX 88361 TC A Immunohistochemistry, tumor 0.00 2.20 NA 0.07 2.27 NA XXX 88362 A Nerve teasing preparations 2.16 4.44 NA 0.14 6.74 NA XXX 88362 26 A Nerve teasing preparations 2.16 0.93 0.93 0.08 3.17 3.17 XXX 88362 TC A Nerve teasing preparations 0.00 3.51 NA 0.06 3.57 NA XXX 88365 A Tissue hybridization 0.92 2.23 NA 0.06 3.21 NA XXX 88365 26 A Tissue hybridization 0.92 0.41 0.41 0.04 1.37 1.37 XXX 88365 TC A Tissue hybridization 0.00 1.82 NA 0.02 1.84 NA XXX 88371 26 A Protein, western blot tissue 0.37 0.13 0.13 0.01 0.51 0.51 XXX 88372 26 A Protein analysis w/probe 0.37 0.17 0.17 0.01 0.55 0.55 XXX 88380 C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 26 C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 TC C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 26 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 TC C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89060 26 A Exam,synovial fluid crystals 0.37 0.17 0.16 0.01 0.55 0.54 XXX 89100 A Sample intestinal contents 0.60 1.62 0.22 0.02 2.24 0.84 XXX 89105 A Sample intestinal contents 0.50 2.26 0.17 0.02 2.78 0.69 XXX 89130 A Sample stomach contents 0.45 1.76 0.13 0.02 2.23 0.60 XXX 89132 A Sample stomach contents 0.19 1.51 0.06 0.01 1.71 0.26 XXX 89135 A Sample stomach contents 0.79 1.61 0.25 0.04 2.44 1.08 XXX 89136 A Sample stomach contents 0.21 1.66 0.09 0.01 1.88 0.31 XXX 89140 A Sample stomach contents 0.93 2.09 0.28 0.04 3.06 1.25 XXX Start Printed Page 63363 89141 A Sample stomach contents 0.85 2.75 0.34 0.04 3.64 1.23 XXX 90281 I Human ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90283 I Human ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90287 I Botulinum antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90288 I Botulism ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90291 I Cmv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90296 E Diphtheria antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90371 E Hep b ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90375 E Rabies ig, im/sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90376 E Rabies ig, heat treated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90378 X Rsv ig, im, 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90379 I Rsv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90384 I Rh ig, full-dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90385 E Rh ig, minidose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90386 I Rh ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90389 I Tetanus ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90393 E Vaccina ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90396 E Varicella-zoster ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90399 I Immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90471 A Immunization admin 0.00 0.20 NA 0.01 0.21 NA XXX 90472 A Immunization admin, each add 0.00 0.14 NA 0.01 0.15 NA ZZZ 90473 N Immune admin oral/nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90474 N Immune admin oral/nasal addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 90476 E Adenovirus vaccine, type 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90477 E Adenovirus vaccine, type 7 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90581 E Anthrax vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90585 E Bcg vaccine, percut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90586 E Bcg vaccine, intravesical 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90632 E Hep a vaccine, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90633 E Hep a vacc, ped/adol, 2 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90634 E Hep a vacc, ped/adol, 3 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90636 E Hep a/hep b vacc, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90645 E Hib vaccine, hboc, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90646 E Hib vaccine, prp-d, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90647 E Hib vaccine, prp-omp, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90648 E Hib vaccine, prp-t, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90655 X Flu vaccine, 6-35 mo, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90657 X Flu vaccine, 6-35 mo, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90658 X Flu vaccine, 3 yrs, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90659 D Flu vaccine, whole, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90660 X Flu vaccine, nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90665 E Lyme disease vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90669 N Pneumococcal vacc, ped <5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90675 E Rabies vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90676 E Rabies vaccine, id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90680 E Rotovirus vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90690 E Typhoid vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90691 E Typhoid vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90692 E Typhoid vaccine, h-p, sc/id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90693 E Typhoid vaccine, akd, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90698 E Dtap-hib-ip vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90700 E Dtap vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90701 E Dtp vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90702 E Dt vaccine < 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90703 E Tetanus vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90704 E Mumps vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90705 E Measles vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90706 E Rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90707 E Mmr vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90708 E Measles-rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90710 E Mmrv vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90712 E Oral poliovirus vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90713 E Poliovirus, ipv, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90715 E Tdap vaccine >7 im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90716 E Chicken pox vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90717 E Yellow fever vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90718 E Td vaccine > 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90719 E Diphtheria vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90720 E Dtp/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90721 E Dtap/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90723 I Dtap-hep b-ipv vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90725 E Cholera vaccine, injectable 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90727 E Plague vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90732 X Pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90733 E Meningococcal vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63364 90734 E Meningococcal vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90735 E Encephalitis vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90740 X Hepb vacc, ill pat 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90743 X Hep b vacc, adol, 2 dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90744 X Hepb vacc ped/adol 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90746 X Hep b vaccine, adult, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90747 X Hepb vacc, ill pat 4 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90748 I Hep b/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90749 E Vaccine toxoid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90780 A IV infusion therapy, 1 hour 0.00 1.10 NA 0.07 1.17 NA XXX 90781 A IV infusion, additional hour 0.00 0.56 NA 0.04 0.60 NA ZZZ 90782 T Injection, sc/im 0.00 0.11 NA 0.01 0.12 NA XXX 90783 T Injection, ia 0.00 0.41 NA 0.02 0.43 NA XXX 90784 T Injection, iv 0.00 0.47 NA 0.04 0.51 NA XXX 90788 T Injection of antibiotic 0.00 0.12 NA 0.01 0.13 NA XXX 90799 C Ther/prophylactic/dx inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90801 A Psy dx interview 2.78 1.19 0.94 0.07 4.04 3.79 XXX 90802 A Intac psy dx interview 2.99 1.22 0.99 0.08 4.29 4.06 XXX 90804 A Psytx, office, 20-30 min 1.20 0.50 0.39 0.04 1.74 1.63 XXX 90805 A Psytx, off, 20-30 min w/e&m 1.36 0.51 0.43 0.04 1.91 1.83 XXX 90806 A Psytx, off, 45-50 min 1.85 0.71 0.62 0.05 2.61 2.52 XXX 90807 A Psytx, off, 45-50 min w/e&m 2.01 0.70 0.64 0.06 2.77 2.71 XXX 90808 A Psytx, office, 75-80 min 2.77 1.04 0.91 0.08 3.89 3.76 XXX 90809 A Psytx, off, 75-80, w/e&m 2.93 1.01 0.93 0.08 4.02 3.94 XXX 90810 A Intac psytx, off, 20-30 min 1.31 0.52 0.43 0.04 1.87 1.78 XXX 90811 A Intac psytx, 20-30, w/e&m 1.47 0.58 0.47 0.04 2.09 1.98 XXX 90812 A Intac psytx, off, 45-50 min 1.96 0.79 0.65 0.06 2.81 2.67 XXX 90813 A Intac psytx, 45-50 min w/e&m 2.12 0.77 0.67 0.06 2.95 2.85 XXX 90814 A Intac psytx, off, 75-80 min 2.88 1.11 0.99 0.08 4.07 3.95 XXX 90815 A Intac psytx, 75-80 w/e&m 3.04 1.06 0.96 0.08 4.18 4.08 XXX 90816 A Psytx, hosp, 20-30 min 1.24 NA 0.47 0.04 NA 1.75 XXX 90817 A Psytx, hosp, 20-30 min w/e&m 1.40 NA 0.47 0.04 NA 1.91 XXX 90818 A Psytx, hosp, 45-50 min 1.88 NA 0.69 0.05 NA 2.62 XXX 90819 A Psytx, hosp, 45-50 min w/e&m 2.04 NA 0.66 0.06 NA 2.76 XXX 90821 A Psytx, hosp, 75-80 min 2.81 NA 1.02 0.07 NA 3.90 XXX 90822 A Psytx, hosp, 75-80 min w/e&m 2.97 NA 0.96 0.08 NA 4.01 XXX 90823 A Intac psytx, hosp, 20-30 min 1.35 NA 0.49 0.04 NA 1.88 XXX 90824 A Intac psytx, hsp 20-30 w/e&m 1.51 NA 0.50 0.04 NA 2.05 XXX 90826 A Intac psytx, hosp, 45-50 min 2.00 NA 0.73 0.05 NA 2.78 XXX 90827 A Intac psytx, hsp 45-50 w/e&m 2.15 NA 0.69 0.06 NA 2.90 XXX 90828 A Intac psytx, hosp, 75-80 min 2.92 NA 1.08 0.08 NA 4.08 XXX 90829 A Intac psytx, hsp 75-80 w/e&m 3.08 NA 0.99 0.08 NA 4.15 XXX 90845 A Psychoanalysis 1.78 0.59 0.57 0.05 2.42 2.40 XXX 90846 R Family psytx w/o patient 1.82 0.66 0.65 0.05 2.53 2.52 XXX 90847 R Family psytx w/patient 2.20 0.82 0.77 0.06 3.08 3.03 XXX 90849 R Multiple family group psytx 0.59 0.28 0.24 0.01 0.88 0.84 XXX 90853 A Group psychotherapy 0.59 0.25 0.23 0.01 0.85 0.83 XXX 90857 A Intac group psytx 0.63 0.30 0.26 0.02 0.95 0.91 XXX 90862 A Medication management 0.94 0.41 0.33 0.02 1.37 1.29 XXX 90865 A Narcosynthesis 2.82 1.62 0.90 0.08 4.52 3.80 XXX 90870 A Electroconvulsive therapy 1.87 0.80 0.80 0.05 2.72 2.72 000 90871 N Electroconvulsive therapy +2.70 1.07 1.07 0.07 3.84 3.84 000 90875 N Psychophysiological therapy +1.19 0.90 0.47 0.04 2.13 1.70 XXX 90876 N Psychophysiological therapy +1.89 1.17 0.73 0.05 3.11 2.67 XXX 90880 A Hypnotherapy 2.18 1.05 0.69 0.06 3.29 2.93 XXX 90882 N Environmental manipulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90885 B Psy evaluation of records +0.96 0.38 0.38 0.02 1.36 1.36 XXX 90887 B Consultation with family +1.47 0.83 0.57 0.04 2.34 2.08 XXX 90889 B Preparation of report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90899 C Psychiatric service/therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90901 A Biofeedback train, any meth 0.41 0.67 0.14 0.02 1.10 0.57 000 90911 A Biofeedback peri/uro/rectal 0.88 1.64 0.32 0.05 2.57 1.25 000 90918 I ESRD related services, month +11.12 7.50 7.50 0.36 18.98 18.98 XXX 90919 I ESRD related services, month +8.49 4.15 4.15 0.29 12.93 12.93 XXX 90920 I ESRD related services, month +7.23 3.89 3.89 0.23 11.35 11.35 XXX 90921 I ESRD related services, month +4.44 2.52 2.52 0.14 7.10 7.10 XXX 90922 A ESRD related services, day 0.37 0.22 0.22 0.01 0.60 0.60 XXX 90923 A Esrd related services, day 0.28 0.13 0.13 0.01 0.42 0.42 XXX 90924 A Esrd related services, day 0.24 0.12 0.12 0.01 0.37 0.37 XXX 90925 A Esrd related services, day 0.15 0.08 0.08 0.01 0.24 0.24 XXX 90935 A Hemodialysis, one evaluation 1.21 NA 0.68 0.04 NA 1.93 000 90937 A Hemodialysis, repeated eval 2.10 NA 0.99 0.07 NA 3.16 000 90939 X Hemodialysis study, transcut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90940 X Hemodialysis access study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90945 A Dialysis, one evaluation 1.27 NA 0.70 0.05 NA 2.02 000 Start Printed Page 63365 90947 A Dialysis, repeated eval 2.15 NA 1.01 0.07 NA 3.23 000 90989 X Dialysis training, complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90993 X Dialysis training, incompl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90997 A Hemoperfusion 1.83 NA 1.43 0.06 NA 3.32 000 90999 C Dialysis procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91000 A Esophageal intubation 0.73 0.33 NA 0.05 1.11 NA 000 91000 26 A Esophageal intubation 0.73 0.25 0.25 0.04 1.02 1.02 000 91000 TC A Esophageal intubation 0.00 0.08 NA 0.01 0.09 NA 000 91010 A Esophagus motility study 1.24 2.76 NA 0.12 4.12 NA 000 91010 26 A Esophagus motility study 1.24 0.45 0.45 0.06 1.75 1.75 000 91010 TC A Esophagus motility study 0.00 2.31 NA 0.06 2.37 NA 000 91011 A Esophagus motility study 1.49 3.25 NA 0.12 4.86 NA 000 91011 26 A Esophagus motility study 1.49 0.54 0.54 0.06 2.09 2.09 000 91011 TC A Esophagus motility study 0.00 2.71 NA 0.06 2.77 NA 000 91012 A Esophagus motility study 1.45 3.40 NA 0.14 4.99 NA 000 91012 26 A Esophagus motility study 1.45 0.52 0.52 0.07 2.04 2.04 000 91012 TC A Esophagus motility study 0.00 2.88 NA 0.07 2.95 NA 000 91020 A Gastric motility 1.43 2.99 NA 0.13 4.55 NA 000 91020 26 A Gastric motility 1.43 0.50 0.50 0.07 2.00 2.00 000 91020 TC A Gastric motility 0.00 2.49 NA 0.06 2.55 NA 000 91030 A Acid perfusion of esophagus 0.90 2.43 NA 0.06 3.39 NA 000 91030 26 A Acid perfusion of esophagus 0.90 0.33 0.33 0.04 1.27 1.27 000 91030 TC A Acid perfusion of esophagus 0.00 2.10 NA 0.02 2.12 NA 000 91032 A Esophagus, acid reflux test 1.20 4.20 NA 0.12 5.52 NA 000 91032 26 A Esophagus, acid reflux test 1.20 0.43 0.43 0.06 1.69 1.69 000 91032 TC A Esophagus, acid reflux test 0.00 3.77 NA 0.06 3.83 NA 000 91033 A Prolonged acid reflux test 1.29 4.23 NA 0.17 5.69 NA 000 91033 26 A Prolonged acid reflux test 1.29 0.46 0.46 0.06 1.81 1.81 000 91033 TC A Prolonged acid reflux test 0.00 3.77 NA 0.11 3.88 NA 000 91052 A Gastric analysis test 0.79 2.22 NA 0.06 3.07 NA 000 91052 26 A Gastric analysis test 0.79 0.28 0.28 0.04 1.11 1.11 000 91052 TC A Gastric analysis test 0.00 1.94 NA 0.02 1.96 NA 000 91055 A Gastric intubation for smear 0.93 2.39 NA 0.07 3.39 NA 000 91055 26 A Gastric intubation for smear 0.93 0.27 0.27 0.05 1.25 1.25 000 91055 TC A Gastric intubation for smear 0.00 2.12 NA 0.02 2.14 NA 000 91060 A Gastric saline load test 0.45 0.30 NA 0.04 0.79 NA 000 91060 26 A Gastric saline load test 0.45 0.14 0.14 0.02 0.61 0.61 000 91060 TC A Gastric saline load test 0.00 0.16 NA 0.02 0.18 NA 000 91065 A Breath hydrogen test 0.20 2.00 NA 0.03 2.23 NA 000 91065 26 A Breath hydrogen test 0.20 0.07 0.07 0.01 0.28 0.28 000 91065 TC A Breath hydrogen test 0.00 1.93 NA 0.02 1.95 NA 000 91100 A Pass intestine bleeding tube 1.07 NA 0.29 0.07 NA 1.43 000 91105 A Gastric intubation treatment 0.37 NA 0.09 0.02 NA 0.48 000 91110 A Gi tract capsule endoscopy 3.63 21.39 NA 0.09 25.11 NA XXX 91110 26 A Gi tract capsule endoscopy 3.63 1.31 1.31 0.02 4.96 4.96 XXX 91110 TC A Gi tract capsule endoscopy 0.00 20.08 NA 0.07 20.15 NA XXX 91122 A Anal pressure record 1.76 6.14 NA 0.20 8.10 NA 000 91122 26 A Anal pressure record 1.76 0.62 0.62 0.12 2.50 2.50 000 91122 TC A Anal pressure record 0.00 5.52 NA 0.08 5.60 NA 000 91123 B Irrigate fecal impaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 C Electrogastrography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 26 A Electrogastrography 0.52 0.19 0.19 0.04 0.75 0.75 XXX 91132 TC C Electrogastrography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 C Electrogastrography w/test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 26 A Electrogastrography w/test 0.66 0.24 0.24 0.04 0.94 0.94 XXX 91133 TC C Electrogastrography w/test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 26 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 TC C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92002 A Eye exam, new patient 0.87 0.97 0.35 0.02 1.86 1.24 XXX 92004 A Eye exam, new patient 1.66 1.70 0.68 0.04 3.40 2.38 XXX 92012 A Eye exam established pat 0.67 1.03 0.29 0.01 1.71 0.97 XXX 92014 A Eye exam & treatment 1.09 1.40 0.48 0.02 2.51 1.59 XXX 92015 N Refraction +0.38 1.50 0.15 0.01 1.89 0.54 XXX 92018 A New eye exam & treatment 2.49 NA 1.09 0.04 NA 3.62 XXX 92019 A Eye exam & treatment 1.30 NA 0.57 0.04 NA 1.91 XXX 92020 A Special eye evaluation 0.37 0.34 0.16 0.01 0.72 0.54 XXX 92060 A Special eye evaluation 0.69 0.73 NA 0.02 1.44 NA XXX 92060 26 A Special eye evaluation 0.69 0.29 0.29 0.01 0.99 0.99 XXX 92060 TC A Special eye evaluation 0.00 0.44 NA 0.01 0.45 NA XXX 92065 A Orthoptic/pleoptic training 0.37 0.55 NA 0.02 0.94 NA XXX 92065 26 A Orthoptic/pleoptic training 0.37 0.15 0.15 0.01 0.53 0.53 XXX 92065 TC A Orthoptic/pleoptic training 0.00 0.40 NA 0.01 0.41 NA XXX 92070 A Fitting of contact lens 0.70 1.08 0.32 0.01 1.79 1.03 XXX 92081 A Visual field examination(s) 0.36 0.87 NA 0.02 1.25 NA XXX Start Printed Page 63366 92081 26 A Visual field examination(s) 0.36 0.16 0.16 0.01 0.53 0.53 XXX 92081 TC A Visual field examination(s) 0.00 0.71 NA 0.01 0.72 NA XXX 92082 A Visual field examination(s) 0.44 1.15 NA 0.02 1.61 NA XXX 92082 26 A Visual field examination(s) 0.44 0.19 0.19 0.01 0.64 0.64 XXX 92082 TC A Visual field examination(s) 0.00 0.96 NA 0.01 0.97 NA XXX 92083 A Visual field examination(s) 0.50 1.34 NA 0.02 1.86 NA XXX 92083 26 A Visual field examination(s) 0.50 0.22 0.22 0.01 0.73 0.73 XXX 92083 TC A Visual field examination(s) 0.00 1.12 NA 0.01 1.13 NA XXX 92100 A Serial tonometry exam(s) 0.91 1.27 0.37 0.02 2.20 1.30 XXX 92120 A Tonography & eye evaluation 0.81 1.05 0.32 0.02 1.88 1.15 XXX 92130 A Water provocation tonography 0.81 1.25 0.38 0.02 2.08 1.21 XXX 92135 A Opthalmic dx imaging 0.35 0.80 NA 0.02 1.17 NA XXX 92135 26 A Opthalmic dx imaging 0.35 0.16 0.16 0.01 0.52 0.52 XXX 92135 TC A Opthalmic dx imaging 0.00 0.64 NA 0.01 0.65 NA XXX 92136 A Ophthalmic biometry 0.54 1.77 NA 0.08 2.39 NA XXX 92136 26 A Ophthalmic biometry 0.54 0.25 0.25 0.01 0.80 0.80 XXX 92136 TC A Ophthalmic biometry 0.00 1.52 NA 0.07 1.59 NA XXX 92140 A Glaucoma provocative tests 0.50 0.94 0.22 0.01 1.45 0.73 XXX 92225 A Special eye exam, initial 0.38 0.22 0.16 0.01 0.61 0.55 XXX 92226 A Special eye exam, subsequent 0.33 0.21 0.15 0.01 0.55 0.49 XXX 92230 A Eye exam with photos 0.60 1.69 0.20 0.02 2.31 0.82 XXX 92235 A Eye exam with photos 0.81 2.95 NA 0.08 3.84 NA XXX 92235 26 A Eye exam with photos 0.81 0.37 0.37 0.02 1.20 1.20 XXX 92235 TC A Eye exam with photos 0.00 2.58 NA 0.06 2.64 NA XXX 92240 A Icg angiography 1.09 7.12 NA 0.08 8.29 NA XXX 92240 26 A Icg angiography 1.09 0.51 0.51 0.02 1.62 1.62 XXX 92240 TC A Icg angiography 0.00 6.61 NA 0.06 6.67 NA XXX 92250 A Eye exam with photos 0.44 1.75 NA 0.02 2.21 NA XXX 92250 26 A Eye exam with photos 0.44 0.20 0.20 0.01 0.65 0.65 XXX 92250 TC A Eye exam with photos 0.00 1.55 NA 0.01 1.56 NA XXX 92260 A Ophthalmoscopy/dynamometry 0.20 0.29 0.09 0.01 0.50 0.30 XXX 92265 A Eye muscle evaluation 0.81 1.90 NA 0.04 2.75 NA XXX 92265 26 A Eye muscle evaluation 0.81 0.29 0.29 0.02 1.12 1.12 XXX 92265 TC A Eye muscle evaluation 0.00 1.61 NA 0.02 1.63 NA XXX 92270 A Electro-oculography 0.81 1.57 NA 0.06 2.44 NA XXX 92270 26 A Electro-oculography 0.81 0.34 0.34 0.04 1.19 1.19 XXX 92270 TC A Electro-oculography 0.00 1.23 NA 0.02 1.25 NA XXX 92275 A Electroretinography 1.00 1.97 NA 0.04 3.01 NA XXX 92275 26 A Electroretinography 1.00 0.44 0.44 0.02 1.46 1.46 XXX 92275 TC A Electroretinography 0.00 1.53 NA 0.02 1.55 NA XXX 92283 A Color vision examination 0.17 0.84 NA 0.02 1.03 NA XXX 92283 26 A Color vision examination 0.17 0.07 0.07 0.01 0.25 0.25 XXX 92283 TC A Color vision examination 0.00 0.77 NA 0.01 0.78 NA XXX 92284 A Dark adaptation eye exam 0.24 2.33 NA 0.02 2.59 NA XXX 92284 26 A Dark adaptation eye exam 0.24 0.09 0.09 0.01 0.34 0.34 XXX 92284 TC A Dark adaptation eye exam 0.00 2.24 NA 0.01 2.25 NA XXX 92285 A Eye photography 0.20 1.07 NA 0.02 1.29 NA XXX 92285 26 A Eye photography 0.20 0.09 0.09 0.01 0.30 0.30 XXX 92285 TC A Eye photography 0.00 0.98 NA 0.01 0.99 NA XXX 92286 A Internal eye photography 0.66 3.40 NA 0.03 4.09 NA XXX 92286 26 A Internal eye photography 0.66 0.30 0.30 0.01 0.97 0.97 XXX 92286 TC A Internal eye photography 0.00 3.10 NA 0.02 3.12 NA XXX 92287 A Internal eye photography 0.81 2.73 0.31 0.02 3.56 1.14 XXX 92310 N Contact lens fitting +1.16 1.12 0.46 0.04 2.32 1.66 XXX 92311 A Contact lens fitting 1.07 1.20 0.35 0.04 2.31 1.46 XXX 92312 A Contact lens fitting 1.25 1.17 0.50 0.04 2.46 1.79 XXX 92313 A Contact lens fitting 0.91 1.17 0.29 0.02 2.10 1.22 XXX 92314 N Prescription of contact lens +0.69 0.94 0.27 0.01 1.64 0.97 XXX 92315 A Prescription of contact lens 0.45 0.96 0.16 0.01 1.42 0.62 XXX 92316 A Prescription of contact lens 0.68 1.00 0.30 0.01 1.69 0.99 XXX 92317 A Prescription of contact lens 0.45 1.06 0.14 0.01 1.52 0.60 XXX 92325 A Modification of contact lens 0.00 0.40 NA 0.01 0.41 NA XXX 92326 A Replacement of contact lens 0.00 1.62 NA 0.06 1.68 NA XXX 92330 A Fitting of artificial eye 1.07 1.08 0.33 0.05 2.20 1.45 XXX 92335 A Fitting of artificial eye 0.45 1.01 0.17 0.01 1.47 0.63 XXX 92340 N Fitting of spectacles +0.37 0.70 0.14 0.01 1.08 0.52 XXX 92341 N Fitting of spectacles +0.47 0.74 0.18 0.01 1.22 0.66 XXX 92342 N Fitting of spectacles +0.53 0.76 0.21 0.01 1.30 0.75 XXX 92352 B Special spectacles fitting +0.37 0.73 0.14 0.01 1.11 0.52 XXX 92353 B Special spectacles fitting +0.50 0.78 0.19 0.02 1.30 0.71 XXX 92354 B Special spectacles fitting +0.00 8.78 NA 0.10 8.88 NA XXX 92355 B Special spectacles fitting +0.00 4.30 NA 0.01 4.31 NA XXX 92358 B Eye prosthesis service +0.00 0.96 NA 0.05 1.01 NA XXX 92370 N Repair & adjust spectacles +0.32 0.56 0.13 0.02 0.90 0.47 XXX 92371 B Repair & adjust spectacles +0.00 0.62 NA 0.02 0.64 NA XXX Start Printed Page 63367 92390 N Supply of spectacles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92391 N Supply of contact lenses 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92392 I Supply of low vision aids +0.00 3.81 3.81 0.02 3.83 3.83 XXX 92393 I Supply of artificial eye +0.00 11.83 11.83 0.56 12.39 12.39 XXX 92395 I Supply of spectacles +0.00 1.29 1.29 0.10 1.39 1.39 XXX 92396 I Supply of contact lenses +0.00 2.17 2.17 0.07 2.24 2.24 XXX 92499 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 26 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 TC C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92502 A Ear and throat examination 1.50 NA 1.15 0.07 NA 2.72 000 92504 A Ear microscopy examination 0.18 0.51 0.09 0.01 0.70 0.28 XXX 92506 A Speech/hearing evaluation 0.86 2.65 0.41 0.05 3.56 1.32 XXX 92507 A Speech/hearing therapy 0.52 1.15 0.24 0.02 1.69 0.78 XXX 92508 A Speech/hearing therapy 0.26 0.53 0.12 0.01 0.80 0.39 XXX 92510 I Rehab for ear implant +1.49 2.09 0.82 0.07 3.65 2.38 XXX 92511 A Nasopharyngoscopy 0.84 3.18 0.80 0.04 4.06 1.68 000 92512 A Nasal function studies 0.55 1.09 0.18 0.02 1.66 0.75 XXX 92516 A Facial nerve function test 0.43 0.90 0.22 0.02 1.35 0.67 XXX 92520 A Laryngeal function studies 0.76 0.51 0.39 0.04 1.31 1.19 XXX 92526 A Oral function therapy 0.55 1.68 0.20 0.02 2.25 0.77 XXX 92531 B Spontaneous nystagmus study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92532 B Positional nystagmus test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92533 B Caloric vestibular test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92534 B Optokinetic nystagmus test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92541 A Spontaneous nystagmus test 0.40 0.97 NA 0.04 1.41 NA XXX 92541 26 A Spontaneous nystagmus test 0.40 0.19 0.19 0.02 0.61 0.61 XXX 92541 TC A Spontaneous nystagmus test 0.00 0.78 NA 0.02 0.80 NA XXX 92542 A Positional nystagmus test 0.33 1.07 NA 0.03 1.43 NA XXX 92542 26 A Positional nystagmus test 0.33 0.16 0.16 0.01 0.50 0.50 XXX 92542 TC A Positional nystagmus test 0.00 0.91 NA 0.02 0.93 NA XXX 92543 A Caloric vestibular test 0.10 0.55 NA 0.02 0.67 NA XXX 92543 26 A Caloric vestibular test 0.10 0.05 0.05 0.01 0.16 0.16 XXX 92543 TC A Caloric vestibular test 0.00 0.50 NA 0.01 0.51 NA XXX 92544 A Optokinetic nystagmus test 0.26 0.85 NA 0.03 1.14 NA XXX 92544 26 A Optokinetic nystagmus test 0.26 0.13 0.13 0.01 0.40 0.40 XXX 92544 TC A Optokinetic nystagmus test 0.00 0.72 NA 0.02 0.74 NA XXX 92545 A Oscillating tracking test 0.23 0.80 NA 0.03 1.06 NA XXX 92545 26 A Oscillating tracking test 0.23 0.11 0.11 0.01 0.35 0.35 XXX 92545 TC A Oscillating tracking test 0.00 0.69 NA 0.02 0.71 NA XXX 92546 A Sinusoidal rotational test 0.29 1.82 NA 0.03 2.14 NA XXX 92546 26 A Sinusoidal rotational test 0.29 0.13 0.13 0.01 0.43 0.43 XXX 92546 TC A Sinusoidal rotational test 0.00 1.69 NA 0.02 1.71 NA XXX 92547 A Supplemental electrical test 0.00 1.17 NA 0.06 1.23 NA ZZZ 92548 A Posturography 0.50 3.23 NA 0.15 3.88 NA XXX 92548 26 A Posturography 0.50 0.26 0.26 0.02 0.78 0.78 XXX 92548 TC A Posturography 0.00 2.97 NA 0.13 3.10 NA XXX 92551 N Pure tone hearing test, air 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92552 A Pure tone audiometry, air 0.00 0.44 NA 0.04 0.48 NA XXX 92553 A Audiometry, air & bone 0.00 0.65 NA 0.06 0.71 NA XXX 92555 A Speech threshold audiometry 0.00 0.38 NA 0.04 0.42 NA XXX 92556 A Speech audiometry, complete 0.00 0.57 NA 0.06 0.63 NA XXX 92557 A Comprehensive hearing test 0.00 1.18 NA 0.12 1.30 NA XXX 92559 N Group audiometric testing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92560 N Bekesy audiometry, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92561 A Bekesy audiometry, diagnosis 0.00 0.70 NA 0.06 0.76 NA XXX 92562 A Loudness balance test 0.00 0.41 NA 0.04 0.45 NA XXX 92563 A Tone decay hearing test 0.00 0.38 NA 0.04 0.42 NA XXX 92564 A Sisi hearing test 0.00 0.47 NA 0.05 0.52 NA XXX 92565 A Stenger test, pure tone 0.00 0.40 NA 0.04 0.44 NA XXX 92567 A Tympanometry 0.00 0.52 NA 0.06 0.58 NA XXX 92568 A Acoustic reflex testing 0.00 0.38 NA 0.04 0.42 NA XXX 92569 A Acoustic reflex decay test 0.00 0.41 NA 0.04 0.45 NA XXX 92571 A Filtered speech hearing test 0.00 0.39 NA 0.04 0.43 NA XXX 92572 A Staggered spondaic word test 0.00 0.09 NA 0.01 0.10 NA XXX 92573 A Lombard test 0.00 0.35 NA 0.04 0.39 NA XXX 92575 A Sensorineural acuity test 0.00 0.30 NA 0.02 0.32 NA XXX 92576 A Synthetic sentence test 0.00 0.44 NA 0.05 0.49 NA XXX 92577 A Stenger test, speech 0.00 0.70 NA 0.07 0.77 NA XXX 92579 A Visual audiometry (vra) 0.00 0.71 NA 0.06 0.77 NA XXX 92582 A Conditioning play audiometry 0.00 0.71 NA 0.06 0.77 NA XXX 92583 A Select picture audiometry 0.00 0.88 NA 0.08 0.96 NA XXX 92584 A Electrocochleography 0.00 2.45 NA 0.20 2.65 NA XXX 92585 A Auditor evoke potent, compre 0.50 2.06 NA 0.16 2.72 NA XXX 92585 26 A Auditor evoke potent, compre 0.50 0.22 0.22 0.02 0.74 0.74 XXX 92585 TC A Auditor evoke potent, compre 0.00 1.84 NA 0.14 1.98 NA XXX Start Printed Page 63368 92586 A Auditor evoke potent, limit 0.00 1.84 NA 0.14 1.98 NA XXX 92587 A Evoked auditory test 0.13 1.36 NA 0.12 1.61 NA XXX 92587 26 A Evoked auditory test 0.13 0.07 0.07 0.01 0.21 0.21 XXX 92587 TC A Evoked auditory test 0.00 1.29 NA 0.11 1.40 NA XXX 92588 A Evoked auditory test 0.36 1.63 NA 0.14 2.13 NA XXX 92588 26 A Evoked auditory test 0.36 0.17 0.17 0.01 0.54 0.54 XXX 92588 TC A Evoked auditory test 0.00 1.46 NA 0.13 1.59 NA XXX 92589 A Auditory function test(s) 0.00 0.53 NA 0.06 0.59 NA XXX 92590 N Hearing aid exam, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92591 N Hearing aid exam, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92592 N Hearing aid check, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92593 N Hearing aid check, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92594 N Electro hearng aid test, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92595 N Electro hearng aid tst, both 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92596 A Ear protector evaluation 0.00 0.59 NA 0.06 0.65 NA XXX 92597 A Oral speech device eval 0.86 1.71 0.46 0.05 2.62 1.37 XXX 92601 A Cochlear implt f/up exam < 7 0.00 3.46 NA 0.07 3.53 NA XXX 92602 A Reprogram cochlear implt < 7 0.00 2.39 NA 0.07 2.46 NA XXX 92603 A Cochlear implt f/up exam 7 > 0.00 2.26 NA 0.07 2.33 NA XXX 92604 A Reprogram cochlear implt 7 > 0.00 1.49 NA 0.07 1.56 NA XXX 92605 B Eval for nonspeech device rx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92606 B Non-speech device service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92607 A Ex for speech device rx, 1hr 0.00 3.25 NA 0.05 3.30 NA XXX 92608 A Ex for speech device rx addl 0.00 0.67 NA 0.05 0.72 NA XXX 92609 A Use of speech device service 0.00 1.62 NA 0.04 1.66 NA XXX 92610 A Evaluate swallowing function 0.00 3.40 NA 0.08 3.48 NA XXX 92611 A Motion fluoroscopy/swallow 0.00 3.40 NA 0.08 3.48 NA XXX 92612 A Endoscopy swallow tst (fees) 1.26 2.74 0.67 0.08 4.08 2.01 XXX 92613 B Endoscopy swallow tst (fees) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92614 A Laryngoscopic sensory test 1.26 2.43 0.63 0.08 3.77 1.97 XXX 92615 B Eval laryngoscopy sense tst 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92616 A Fees w/laryngeal sense test 1.87 3.31 0.97 0.08 5.26 2.92 XXX 92617 B Interprt fees/laryngeal test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92700 C Ent procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92950 A Heart/lung resuscitation cpr 3.78 NA 0.99 0.25 NA 5.02 000 92953 A Temporary external pacing 0.23 NA 0.23 0.01 NA 0.47 000 92960 A Cardioversion electric, ext 2.24 6.76 1.19 0.10 9.10 3.53 000 92961 A Cardioversion, electric, int 4.57 NA 2.10 0.20 NA 6.87 000 92970 A Cardioassist, internal 3.50 NA 1.07 0.20 NA 4.77 000 92971 A Cardioassist, external 1.76 NA 0.86 0.07 NA 2.69 000 92973 A Percut coronary thrombectomy 3.26 NA 1.31 0.14 NA 4.71 ZZZ 92974 A Cath place, cardio brachytx 2.98 NA 1.20 0.17 NA 4.35 ZZZ 92975 A Dissolve clot, heart vessel 7.21 NA 2.85 0.26 NA 10.32 000 92977 A Dissolve clot, heart vessel 0.00 7.99 NA 0.46 8.45 NA XXX 92978 A Intravasc us, heart add-on 1.79 5.23 NA 0.31 7.33 NA ZZZ 92978 26 A Intravasc us, heart add-on 1.79 0.71 0.71 0.07 2.57 2.57 ZZZ 92978 TC A Intravasc us, heart add-on 0.00 4.52 NA 0.24 4.76 NA ZZZ 92979 A Intravasc us, heart add-on 1.43 2.84 NA 0.18 4.45 NA ZZZ 92979 26 A Intravasc us, heart add-on 1.43 0.57 0.57 0.05 2.05 2.05 ZZZ 92979 TC A Intravasc us, heart add-on 0.00 2.27 NA 0.13 2.40 NA ZZZ 92980 A Insert intracoronary stent 14.76 NA 6.13 0.85 NA 21.74 000 92981 A Insert intracoronary stent 4.15 NA 1.66 0.24 NA 6.05 ZZZ 92982 A Coronary artery dilation 10.92 NA 4.59 0.62 NA 16.13 000 92984 A Coronary artery dilation 2.95 NA 1.18 0.17 NA 4.30 ZZZ 92986 A Revision of aortic valve 21.68 NA 11.78 1.37 NA 34.83 090 92987 A Revision of mitral valve 22.57 NA 12.17 1.41 NA 36.15 090 92990 A Revision of pulmonary valve 17.24 NA 9.76 1.08 NA 28.08 090 92992 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92993 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92995 A Coronary atherectomy 12.02 NA 5.04 0.70 NA 17.76 000 92996 A Coronary atherectomy add-on 3.24 NA 1.29 0.19 NA 4.72 ZZZ 92997 A Pul art balloon repr, percut 11.93 NA 4.89 0.76 NA 17.58 000 92998 A Pul art balloon repr, percut 5.97 NA 2.23 0.37 NA 8.57 ZZZ 93000 A Electrocardiogram, complete 0.17 0.51 NA 0.03 0.71 NA XXX 93005 A Electrocardiogram, tracing 0.00 0.45 NA 0.02 0.47 NA XXX 93010 A Electrocardiogram report 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93012 A Transmission of ecg 0.00 5.96 NA 0.18 6.14 NA XXX 93014 A Report on transmitted ecg 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93015 A Cardiovascular stress test 0.75 1.96 NA 0.13 2.84 NA XXX 93016 A Cardiovascular stress test 0.45 0.17 0.17 0.01 0.63 0.63 XXX 93017 A Cardiovascular stress test 0.00 1.67 NA 0.11 1.78 NA XXX 93018 A Cardiovascular stress test 0.30 0.12 0.12 0.01 0.43 0.43 XXX 93024 A Cardiac drug stress test 1.16 1.57 NA 0.13 2.86 NA XXX 93024 26 A Cardiac drug stress test 1.16 0.46 0.46 0.05 1.67 1.67 XXX 93024 TC A Cardiac drug stress test 0.00 1.11 NA 0.08 1.19 NA XXX Start Printed Page 63369 93025 A Microvolt t-wave assess 0.75 8.30 NA 0.13 9.18 NA XXX 93025 26 A Microvolt t-wave assess 0.75 0.30 0.30 0.02 1.07 1.07 XXX 93025 TC A Microvolt t-wave assess 0.00 8.00 NA 0.11 8.11 NA XXX 93040 A Rhythm ECG with report 0.16 0.19 NA 0.02 0.37 NA XXX 93041 A Rhythm ECG, tracing 0.00 0.14 NA 0.01 0.15 NA XXX 93042 A Rhythm ECG, report 0.16 0.05 0.05 0.01 0.22 0.22 XXX 93224 A ECG monitor/report, 24 hrs 0.52 3.59 NA 0.24 4.35 NA XXX 93225 A ECG monitor/record, 24 hrs 0.00 1.23 NA 0.08 1.31 NA XXX 93226 A ECG monitor/report, 24 hrs 0.00 2.16 NA 0.14 2.30 NA XXX 93227 A ECG monitor/review, 24 hrs 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93230 A ECG monitor/report, 24 hrs 0.52 3.86 NA 0.26 4.64 NA XXX 93231 A Ecg monitor/record, 24 hrs 0.00 1.51 NA 0.11 1.62 NA XXX 93232 A ECG monitor/report, 24 hrs 0.00 2.15 NA 0.13 2.28 NA XXX 93233 A ECG monitor/review, 24 hrs 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93235 A ECG monitor/report, 24 hrs 0.45 2.77 NA 0.15 3.37 NA XXX 93236 A ECG monitor/report, 24 hrs 0.00 2.60 NA 0.14 2.74 NA XXX 93237 A ECG monitor/review, 24 hrs 0.45 0.17 0.17 0.01 0.63 0.63 XXX 93268 A ECG record/review 0.52 7.38 NA 0.28 8.18 NA XXX 93270 A ECG recording 0.00 1.23 NA 0.08 1.31 NA XXX 93271 A Ecg/monitoring and analysis 0.00 5.96 NA 0.18 6.14 NA XXX 93272 A Ecg/review, interpret only 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93278 A ECG/signal-averaged 0.25 1.24 NA 0.12 1.61 NA XXX 93278 26 A ECG/signal-averaged 0.25 0.10 0.10 0.01 0.36 0.36 XXX 93278 TC A ECG/signal-averaged 0.00 1.14 NA 0.11 1.25 NA XXX 93303 A Echo transthoracic 1.29 4.31 NA 0.28 5.88 NA XXX 93303 26 A Echo transthoracic 1.29 0.49 0.49 0.05 1.83 1.83 XXX 93303 TC A Echo transthoracic 0.00 3.82 NA 0.23 4.05 NA XXX 93304 A Echo transthoracic 0.75 2.22 NA 0.15 3.12 NA XXX 93304 26 A Echo transthoracic 0.75 0.29 0.29 0.02 1.06 1.06 XXX 93304 TC A Echo transthoracic 0.00 1.93 NA 0.13 2.06 NA XXX 93307 A Echo exam of heart 0.91 4.18 NA 0.27 5.36 NA XXX 93307 26 A Echo exam of heart 0.91 0.36 0.36 0.04 1.31 1.31 XXX 93307 TC A Echo exam of heart 0.00 3.82 NA 0.23 4.05 NA XXX 93308 A Echo exam of heart 0.53 2.14 NA 0.15 2.82 NA XXX 93308 26 A Echo exam of heart 0.53 0.21 0.21 0.02 0.76 0.76 XXX 93308 TC A Echo exam of heart 0.00 1.93 NA 0.13 2.06 NA XXX 93312 A Echo transesophageal 2.19 4.54 NA 0.39 7.12 NA XXX 93312 26 A Echo transesophageal 2.19 0.79 0.79 0.10 3.08 3.08 XXX 93312 TC A Echo transesophageal 0.00 3.75 NA 0.29 4.04 NA XXX 93313 A Echo transesophageal 0.94 NA 0.21 0.06 NA 1.21 XXX 93314 A Echo transesophageal 1.24 4.23 NA 0.34 5.81 NA XXX 93314 26 A Echo transesophageal 1.24 0.48 0.48 0.05 1.77 1.77 XXX 93314 TC A Echo transesophageal 0.00 3.75 NA 0.29 4.04 NA XXX 93315 C Echo transesophageal 0.00 0.00 NA 0.00 0.00 NA XXX 93315 26 A Echo transesophageal 2.76 1.02 1.02 0.12 3.90 3.90 XXX 93315 TC C Echo transesophageal 0.00 0.00 NA 0.00 0.00 NA XXX 93316 A Echo transesophageal 0.94 NA 0.24 0.06 NA 1.24 XXX 93317 C Echo transesophageal 0.00 0.00 NA 0.00 0.00 NA XXX 93317 26 A Echo transesophageal 1.82 0.67 0.67 0.07 2.56 2.56 XXX 93317 TC C Echo transesophageal 0.00 0.00 NA 0.00 0.00 NA XXX 93318 C Echo transesophageal intraop 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93318 26 A Echo transesophageal intraop 2.19 0.49 0.49 0.07 2.75 2.75 XXX 93318 TC C Echo transesophageal intraop 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93320 A Doppler echo exam, heart 0.38 1.85 NA 0.13 2.36 NA ZZZ 93320 26 A Doppler echo exam, heart 0.38 0.15 0.15 0.01 0.54 0.54 ZZZ 93320 TC A Doppler echo exam, heart 0.00 1.70 NA 0.12 1.82 NA ZZZ 93321 A Doppler echo exam, heart 0.15 1.16 NA 0.09 1.40 NA ZZZ 93321 26 A Doppler echo exam, heart 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ 93321 TC A Doppler echo exam, heart 0.00 1.10 NA 0.08 1.18 NA ZZZ 93325 A Doppler color flow add-on 0.07 2.91 NA 0.21 3.19 NA ZZZ 93325 26 A Doppler color flow add-on 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ 93325 TC A Doppler color flow add-on 0.00 2.88 NA 0.20 3.08 NA ZZZ 93350 A Echo transthoracic 1.47 2.33 NA 0.15 3.95 NA XXX 93350 26 A Echo transthoracic 1.47 0.58 0.58 0.02 2.07 2.07 XXX 93350 TC A Echo transthoracic 0.00 1.75 NA 0.13 1.88 NA XXX 93501 A Right heart catheterization 3.00 17.93 NA 1.23 22.16 NA 000 93501 26 A Right heart catheterization 3.00 1.17 1.17 0.19 4.36 4.36 000 93501 TC A Right heart catheterization 0.00 16.76 NA 1.04 17.80 NA 000 93503 A Insert/place heart catheter 2.89 NA 0.68 0.19 NA 3.76 000 93505 A Biopsy of heart lining 4.36 3.67 NA 0.44 8.47 NA 000 93505 26 A Biopsy of heart lining 4.36 1.71 1.71 0.28 6.35 6.35 000 93505 TC A Biopsy of heart lining 0.00 1.96 NA 0.16 2.12 NA 000 93508 A Cath placement, angiography 4.08 14.60 NA 0.90 19.58 NA 000 93508 26 A Cath placement, angiography 4.08 2.11 2.11 0.25 6.44 6.44 000 93508 TC A Cath placement, angiography 0.00 12.49 NA 0.65 13.14 NA 000 Start Printed Page 63370 93510 A Left heart catheterization 4.31 38.84 NA 2.55 45.70 NA 000 93510 26 A Left heart catheterization 4.31 2.20 2.20 0.26 6.77 6.77 000 93510 TC A Left heart catheterization 0.00 36.64 NA 2.29 38.93 NA 000 93511 A Left heart catheterization 5.00 38.15 NA 2.53 45.68 NA 000 93511 26 A Left heart catheterization 5.00 2.48 2.48 0.31 7.79 7.79 000 93511 TC A Left heart catheterization 0.00 35.67 NA 2.22 37.89 NA 000 93514 A Left heart catheterization 7.01 38.85 NA 2.66 48.52 NA 000 93514 26 A Left heart catheterization 7.01 3.18 3.18 0.44 10.63 10.63 000 93514 TC A Left heart catheterization 0.00 35.67 NA 2.22 37.89 NA 000 93524 A Left heart catheterization 6.91 49.83 NA 3.34 60.08 NA 000 93524 26 A Left heart catheterization 6.91 3.22 3.22 0.43 10.56 10.56 000 93524 TC A Left heart catheterization 0.00 46.61 NA 2.91 49.52 NA 000 93526 A Rt & Lt heart catheters 5.96 50.74 NA 3.37 60.07 NA 000 93526 26 A Rt & Lt heart catheters 5.96 2.86 2.86 0.37 9.19 9.19 000 93526 TC A Rt & Lt heart catheters 0.00 47.88 NA 3.00 50.88 NA 000 93527 A Rt & Lt heart catheters 7.24 49.97 NA 3.37 60.58 NA 000 93527 26 A Rt & Lt heart catheters 7.24 3.36 3.36 0.46 11.06 11.06 000 93527 TC A Rt & Lt heart catheters 0.00 46.61 NA 2.91 49.52 NA 000 93528 A Rt & Lt heart catheters 8.95 50.70 NA 3.47 63.12 NA 000 93528 26 A Rt & Lt heart catheters 8.95 4.09 4.09 0.56 13.60 13.60 000 93528 TC A Rt & Lt heart catheters 0.00 46.61 NA 2.91 49.52 NA 000 93529 A Rt, lt heart catheterization 4.77 48.92 NA 3.21 56.90 NA 000 93529 26 A Rt, lt heart catheterization 4.77 2.31 2.31 0.30 7.38 7.38 000 93529 TC A Rt, lt heart catheterization 0.00 46.61 NA 2.91 49.52 NA 000 93530 A Rt heart cath, congenital 4.21 18.73 NA 1.33 24.27 NA 000 93530 26 A Rt heart cath, congenital 4.21 1.97 1.97 0.29 6.47 6.47 000 93530 TC A Rt heart cath, congenital 0.00 16.76 NA 1.04 17.80 NA 000 93531 A R & l heart cath, congenital 8.30 51.52 NA 3.55 63.37 NA 000 93531 26 A R & l heart cath, congenital 8.30 3.64 3.64 0.55 12.49 12.49 000 93531 TC A R & l heart cath, congenital 0.00 47.88 NA 3.00 50.88 NA 000 93532 A R & l heart cath, congenital 9.94 50.93 NA 3.53 64.40 NA 000 93532 26 A R & l heart cath, congenital 9.94 4.32 4.32 0.62 14.88 14.88 000 93532 TC A R & l heart cath, congenital 0.00 46.61 NA 2.91 49.52 NA 000 93533 A R & l heart cath, congenital 6.66 49.46 NA 3.43 59.55 NA 000 93533 26 A R & l heart cath, congenital 6.66 2.85 2.85 0.52 10.03 10.03 000 93533 TC A R & l heart cath, congenital 0.00 46.61 NA 2.91 49.52 NA 000 93539 A Injection, cardiac cath 0.40 NA 0.16 0.01 NA 0.57 000 93540 A Injection, cardiac cath 0.43 NA 0.17 0.01 NA 0.61 000 93541 A Injection for lung angiogram 0.29 NA 0.11 0.01 NA 0.41 000 93542 A Injection for heart x-rays 0.29 NA 0.11 0.01 NA 0.41 000 93543 A Injection for heart x-rays 0.29 NA 0.12 0.01 NA 0.42 000 93544 A Injection for aortography 0.25 NA 0.10 0.01 NA 0.36 000 93545 A Inject for coronary x-rays 0.40 NA 0.16 0.01 NA 0.57 000 93555 A Imaging, cardiac cath 0.81 6.54 NA 0.38 7.73 NA XXX 93555 26 A Imaging, cardiac cath 0.81 0.32 0.32 0.04 1.17 1.17 XXX 93555 TC A Imaging, cardiac cath 0.00 6.22 NA 0.34 6.56 NA XXX 93556 A Imaging, cardiac cath 0.83 10.13 NA 0.54 11.50 NA XXX 93556 26 A Imaging, cardiac cath 0.83 0.33 0.33 0.04 1.20 1.20 XXX 93556 TC A Imaging, cardiac cath 0.00 9.80 NA 0.50 10.30 NA XXX 93561 A Cardiac output measurement 0.50 0.68 NA 0.08 1.26 NA 000 93561 26 A Cardiac output measurement 0.50 0.16 0.16 0.02 0.68 0.68 000 93561 TC A Cardiac output measurement 0.00 0.52 NA 0.06 0.58 NA 000 93562 A Cardiac output measurement 0.16 0.37 NA 0.05 0.58 NA 000 93562 26 A Cardiac output measurement 0.16 0.05 0.05 0.01 0.22 0.22 000 93562 TC A Cardiac output measurement 0.00 0.32 NA 0.04 0.36 NA 000 93571 A Heart flow reserve measure 1.79 5.20 NA 0.37 7.36 NA ZZZ 93571 26 A Heart flow reserve measure 1.79 0.68 0.68 0.13 2.60 2.60 ZZZ 93571 TC A Heart flow reserve measure 0.00 4.52 NA 0.24 4.76 NA ZZZ 93572 A Heart flow reserve measure 1.43 2.77 NA 0.33 4.53 NA ZZZ 93572 26 A Heart flow reserve measure 1.43 0.50 0.50 0.20 2.13 2.13 ZZZ 93572 TC A Heart flow reserve measure 0.00 2.27 NA 0.13 2.40 NA ZZZ 93580 A Transcath closure of asd 17.90 NA 7.27 1.37 NA 26.54 000 93581 A Transcath closure of vsd 24.29 NA 9.74 1.37 NA 35.40 000 93600 A Bundle of His recording 2.11 2.77 NA 0.26 5.14 NA 000 93600 26 A Bundle of His recording 2.11 0.84 0.84 0.13 3.08 3.08 000 93600 TC A Bundle of His recording 0.00 1.93 NA 0.13 2.06 NA 000 93602 A Intra-atrial recording 2.11 1.93 NA 0.21 4.25 NA 000 93602 26 A Intra-atrial recording 2.11 0.83 0.83 0.14 3.08 3.08 000 93602 TC A Intra-atrial recording 0.00 1.10 NA 0.07 1.17 NA 000 93603 A Right ventricular recording 2.11 2.49 NA 0.24 4.84 NA 000 93603 26 A Right ventricular recording 2.11 0.82 0.82 0.13 3.06 3.06 000 93603 TC A Right ventricular recording 0.00 1.67 NA 0.11 1.78 NA 000 93609 A Map tachycardia, add-on 4.97 4.66 NA 0.79 10.42 NA ZZZ 93609 26 A Map tachycardia, add-on 4.97 1.97 1.97 0.62 7.56 7.56 ZZZ 93609 TC A Map tachycardia, add-on 0.00 2.69 NA 0.17 2.86 NA ZZZ Start Printed Page 63371 93610 A Intra-atrial pacing 3.00 2.51 NA 0.30 5.81 NA 000 93610 26 A Intra-atrial pacing 3.00 1.17 1.17 0.20 4.37 4.37 000 93610 TC A Intra-atrial pacing 0.00 1.34 NA 0.10 1.44 NA 000 93612 A Intraventricular pacing 3.00 2.77 NA 0.31 6.08 NA 000 93612 26 A Intraventricular pacing 3.00 1.17 1.17 0.20 4.37 4.37 000 93612 TC A Intraventricular pacing 0.00 1.60 NA 0.11 1.71 NA 000 93613 A Electrophys map 3d, add-on 6.96 NA 2.80 0.62 NA 10.38 ZZZ 93615 A Esophageal recording 0.98 0.59 NA 0.06 1.63 NA 000 93615 26 A Esophageal recording 0.98 0.27 0.27 0.04 1.29 1.29 000 93615 TC A Esophageal recording 0.00 0.32 NA 0.02 0.34 NA 000 93616 A Esophageal recording 1.48 0.76 NA 0.09 2.33 NA 000 93616 26 A Esophageal recording 1.48 0.44 0.44 0.07 1.99 1.99 000 93616 TC A Esophageal recording 0.00 0.32 NA 0.02 0.34 NA 000 93618 A Heart rhythm pacing 4.24 5.62 NA 0.50 10.36 NA 000 93618 26 A Heart rhythm pacing 4.24 1.69 1.69 0.26 6.19 6.19 000 93618 TC A Heart rhythm pacing 0.00 3.93 NA 0.24 4.17 NA 000 93619 A Electrophysiology evaluation 7.28 10.86 NA 0.93 19.07 NA 000 93619 26 A Electrophysiology evaluation 7.28 3.22 3.22 0.46 10.96 10.96 000 93619 TC A Electrophysiology evaluation 0.00 7.64 NA 0.47 8.11 NA 000 93620 C Electrophysiology evaluation 0.00 0.00 NA 0.00 0.00 NA 000 93620 26 A Electrophysiology evaluation 11.52 4.91 4.91 0.72 17.15 17.15 000 93620 TC C Electrophysiology evaluation 0.00 0.00 NA 0.00 0.00 NA 000 93621 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93621 26 A Electrophysiology evaluation 2.09 0.83 0.83 0.18 3.10 3.10 ZZZ 93621 TC C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 26 A Electrophysiology evaluation 3.08 1.22 1.22 0.80 5.10 5.10 ZZZ 93622 TC C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 C Stimulation, pacing heart 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 26 A Stimulation, pacing heart 2.83 1.12 1.12 0.18 4.13 4.13 ZZZ 93623 TC C Stimulation, pacing heart 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93624 A Electrophysiologic study 4.78 4.19 NA 0.43 9.40 NA 000 93624 26 A Electrophysiologic study 4.78 2.23 2.23 0.30 7.31 7.31 000 93624 TC A Electrophysiologic study 0.00 1.96 NA 0.13 2.09 NA 000 93631 A Heart pacing, mapping 7.56 8.87 NA 1.40 17.83 NA 000 93631 26 A Heart pacing, mapping 7.56 2.78 2.78 0.79 11.13 11.13 000 93631 TC A Heart pacing, mapping 0.00 6.09 NA 0.61 6.70 NA 000 93640 A Evaluation heart device 3.50 8.49 NA 0.64 12.63 NA 000 93640 26 A Evaluation heart device 3.50 1.38 1.38 0.22 5.10 5.10 000 93640 TC A Evaluation heart device 0.00 7.11 NA 0.42 7.53 NA 000 93641 A Electrophysiology evaluation 5.90 9.45 NA 0.79 16.14 NA 000 93641 26 A Electrophysiology evaluation 5.90 2.34 2.34 0.37 8.61 8.61 000 93641 TC A Electrophysiology evaluation 0.00 7.11 NA 0.42 7.53 NA 000 93642 A Electrophysiology evaluation 4.86 9.36 NA 0.61 14.83 NA 000 93642 26 A Electrophysiology evaluation 4.86 2.25 2.25 0.19 7.30 7.30 000 93642 TC A Electrophysiology evaluation 0.00 7.11 NA 0.42 7.53 NA 000 93650 A Ablate heart dysrhythm focus 10.45 NA 4.50 0.66 NA 15.61 000 93651 A Ablate heart dysrhythm focus 16.16 NA 6.41 1.02 NA 23.59 000 93652 A Ablate heart dysrhythm focus 17.58 NA 6.98 1.10 NA 25.66 000 93660 A Tilt table evaluation 1.88 2.42 NA 0.09 4.39 NA 000 93660 26 A Tilt table evaluation 1.88 0.75 0.75 0.07 2.70 2.70 000 93660 TC A Tilt table evaluation 0.00 1.67 NA 0.02 1.69 NA 000 93662 C Intracardiac ecg (ice) 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93662 26 A Intracardiac ecg (ice) 2.78 1.12 1.12 0.49 4.39 4.39 ZZZ 93662 TC C Intracardiac ecg (ice) 0.00 0.00 NA 0.00 0.00 NA ZZZ 93668 N Peripheral vascular rehab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93701 A Bioimpedance, thoracic 0.17 1.03 NA 0.02 1.22 NA XXX 93701 26 A Bioimpedance, thoracic 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93701 TC A Bioimpedance, thoracic 0.00 0.96 NA 0.01 0.97 NA XXX 93720 A Total body plethysmography 0.17 0.75 NA 0.07 0.99 NA XXX 93721 A Plethysmography tracing 0.00 0.70 NA 0.06 0.76 NA XXX 93722 A Plethysmography report 0.17 0.05 0.05 0.01 0.23 0.23 XXX 93724 A Analyze pacemaker system 4.86 5.86 NA 0.46 11.18 NA 000 93724 26 A Analyze pacemaker system 4.86 1.93 1.93 0.22 7.01 7.01 000 93724 TC A Analyze pacemaker system 0.00 3.93 NA 0.24 4.17 NA 000 93727 A Analyze ilr system 0.52 0.20 0.20 0.06 0.78 0.78 XXX 93731 A Analyze pacemaker system 0.45 0.67 NA 0.06 1.18 NA XXX 93731 26 A Analyze pacemaker system 0.45 0.18 0.18 0.02 0.65 0.65 XXX 93731 TC A Analyze pacemaker system 0.00 0.49 NA 0.04 0.53 NA XXX 93732 A Analyze pacemaker system 0.91 0.87 NA 0.08 1.86 NA XXX 93732 26 A Analyze pacemaker system 0.91 0.36 0.36 0.04 1.31 1.31 XXX 93732 TC A Analyze pacemaker system 0.00 0.51 NA 0.04 0.55 NA XXX 93733 A Telephone analy, pacemaker 0.17 0.78 NA 0.07 1.02 NA XXX 93733 26 A Telephone analy, pacemaker 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93733 TC A Telephone analy, pacemaker 0.00 0.71 NA 0.06 0.77 NA XXX Start Printed Page 63372 93734 A Analyze pacemaker system 0.38 0.50 NA 0.03 0.91 NA XXX 93734 26 A Analyze pacemaker system 0.38 0.15 0.15 0.01 0.54 0.54 XXX 93734 TC A Analyze pacemaker system 0.00 0.35 NA 0.02 0.37 NA XXX 93735 A Analyze pacemaker system 0.74 0.73 NA 0.08 1.55 NA XXX 93735 26 A Analyze pacemaker system 0.74 0.29 0.29 0.04 1.07 1.07 XXX 93735 TC A Analyze pacemaker system 0.00 0.44 NA 0.04 0.48 NA XXX 93736 A Telephonic analy, pacemaker 0.15 0.69 NA 0.07 0.91 NA XXX 93736 26 A Telephonic analy, pacemaker 0.15 0.06 0.06 0.01 0.22 0.22 XXX 93736 TC A Telephonic analy, pacemaker 0.00 0.63 NA 0.06 0.69 NA XXX 93740 B Temperature gradient studies +0.16 0.19 NA 0.02 0.37 NA XXX 93740 26 B Temperature gradient studies +0.16 0.04 0.04 0.01 0.21 0.21 XXX 93740 TC B Temperature gradient studies +0.00 0.15 NA 0.01 0.16 NA XXX 93741 A Analyze ht pace device sngl 0.80 0.98 NA 0.06 1.84 NA XXX 93741 26 A Analyze ht pace device sngl 0.80 0.32 0.32 0.02 1.14 1.14 XXX 93741 TC A Analyze ht pace device sngl 0.00 0.66 NA 0.04 0.70 NA XXX 93742 A Analyze ht pace device sngl 0.90 1.02 NA 0.06 1.98 NA XXX 93742 26 A Analyze ht pace device sngl 0.90 0.36 0.36 0.02 1.28 1.28 XXX 93742 TC A Analyze ht pace device sngl 0.00 0.66 NA 0.04 0.70 NA XXX 93743 A Analyze ht pace device dual 1.02 1.13 NA 0.08 2.23 NA XXX 93743 26 A Analyze ht pace device dual 1.02 0.41 0.41 0.04 1.47 1.47 XXX 93743 TC A Analyze ht pace device dual 0.00 0.72 NA 0.04 0.76 NA XXX 93744 A Analyze ht pace device dual 1.17 1.13 NA 0.08 2.38 NA XXX 93744 26 A Analyze ht pace device dual 1.17 0.47 0.47 0.04 1.68 1.68 XXX 93744 TC A Analyze ht pace device dual 0.00 0.66 NA 0.04 0.70 NA XXX 93760 N Cephalic thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93762 N Peripheral thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93770 B Measure venous pressure +0.16 0.08 NA 0.02 0.26 NA XXX 93770 26 B Measure venous pressure +0.16 0.05 0.05 0.01 0.22 0.22 XXX 93770 TC B Measure venous pressure +0.00 0.03 NA 0.01 0.04 NA XXX 93784 A Ambulatory BP monitoring 0.17 0.97 0.97 0.02 1.16 1.16 XXX 93786 A Ambulatory BP recording 0.00 0.90 NA 0.01 0.91 NA XXX 93788 A Ambulatory BP analysis 0.00 0.51 NA 0.01 0.52 NA XXX 93790 A Review/report BP recording 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93797 A Cardiac rehab 0.18 0.39 0.07 0.01 0.58 0.26 000 93798 A Cardiac rehab/monitor 0.28 0.51 0.11 0.01 0.80 0.40 000 93799 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 26 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 TC C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93875 A Extracranial study 0.22 1.67 NA 0.12 2.01 NA XXX 93875 26 A Extracranial study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 93875 TC A Extracranial study 0.00 1.59 NA 0.11 1.70 NA XXX 93880 A Extracranial study 0.60 4.20 NA 0.40 5.20 NA XXX 93880 26 A Extracranial study 0.60 0.21 0.21 0.05 0.86 0.86 XXX 93880 TC A Extracranial study 0.00 3.99 NA 0.35 4.34 NA XXX 93882 A Extracranial study 0.40 3.02 NA 0.27 3.69 NA XXX 93882 26 A Extracranial study 0.40 0.14 0.14 0.05 0.59 0.59 XXX 93882 TC A Extracranial study 0.00 2.88 NA 0.22 3.10 NA XXX 93886 A Intracranial study 0.93 4.51 NA 0.44 5.88 NA XXX 93886 26 A Intracranial study 0.93 0.38 0.38 0.06 1.37 1.37 XXX 93886 TC A Intracranial study 0.00 4.13 NA 0.38 4.51 NA XXX 93888 A Intracranial study 0.62 3.06 NA 0.31 3.99 NA XXX 93888 26 A Intracranial study 0.62 0.23 0.23 0.05 0.90 0.90 XXX 93888 TC A Intracranial study 0.00 2.83 NA 0.26 3.09 NA XXX 93922 A Extremity study 0.25 1.94 NA 0.15 2.34 NA XXX 93922 26 A Extremity study 0.25 0.09 0.09 0.02 0.36 0.36 XXX 93922 TC A Extremity study 0.00 1.85 NA 0.13 1.98 NA XXX 93923 A Extremity study 0.45 3.03 NA 0.27 3.75 NA XXX 93923 26 A Extremity study 0.45 0.16 0.16 0.05 0.66 0.66 XXX 93923 TC A Extremity study 0.00 2.87 NA 0.22 3.09 NA XXX 93924 A Extremity study 0.50 3.78 NA 0.31 4.59 NA XXX 93924 26 A Extremity study 0.50 0.17 0.17 0.06 0.73 0.73 XXX 93924 TC A Extremity study 0.00 3.61 NA 0.25 3.86 NA XXX 93925 A Lower extremity study 0.58 4.90 NA 0.40 5.88 NA XXX 93925 26 A Lower extremity study 0.58 0.20 0.20 0.05 0.83 0.83 XXX 93925 TC A Lower extremity study 0.00 4.70 NA 0.35 5.05 NA XXX 93926 A Lower extremity study 0.39 3.49 NA 0.27 4.15 NA XXX 93926 26 A Lower extremity study 0.39 0.13 0.13 0.04 0.56 0.56 XXX 93926 TC A Lower extremity study 0.00 3.36 NA 0.23 3.59 NA XXX 93930 A Upper extremity study 0.46 3.89 NA 0.41 4.76 NA XXX 93930 26 A Upper extremity study 0.46 0.16 0.16 0.04 0.66 0.66 XXX 93930 TC A Upper extremity study 0.00 3.73 NA 0.37 4.10 NA XXX 93931 A Upper extremity study 0.31 2.84 NA 0.26 3.41 NA XXX 93931 26 A Upper extremity study 0.31 0.11 0.11 0.02 0.44 0.44 XXX 93931 TC A Upper extremity study 0.00 2.73 NA 0.24 2.97 NA XXX 93965 A Extremity study 0.35 1.87 NA 0.14 2.36 NA XXX Start Printed Page 63373 93965 26 A Extremity study 0.35 0.12 0.12 0.02 0.49 0.49 XXX 93965 TC A Extremity study 0.00 1.75 NA 0.12 1.87 NA XXX 93970 A Extremity study 0.68 3.98 NA 0.46 5.12 NA XXX 93970 26 A Extremity study 0.68 0.23 0.23 0.06 0.97 0.97 XXX 93970 TC A Extremity study 0.00 3.75 NA 0.40 4.15 NA XXX 93971 A Extremity study 0.45 2.87 NA 0.30 3.62 NA XXX 93971 26 A Extremity study 0.45 0.15 0.15 0.04 0.64 0.64 XXX 93971 TC A Extremity study 0.00 2.72 NA 0.26 2.98 NA XXX 93975 A Vascular study 1.79 5.86 NA 0.56 8.21 NA XXX 93975 26 A Vascular study 1.79 0.61 0.61 0.13 2.53 2.53 XXX 93975 TC A Vascular study 0.00 5.25 NA 0.43 5.68 NA XXX 93976 A Vascular study 1.20 3.48 NA 0.37 5.05 NA XXX 93976 26 A Vascular study 1.20 0.41 0.41 0.07 1.68 1.68 XXX 93976 TC A Vascular study 0.00 3.07 NA 0.30 3.37 NA XXX 93978 A Vascular study 0.65 3.60 NA 0.43 4.68 NA XXX 93978 26 A Vascular study 0.65 0.22 0.22 0.06 0.93 0.93 XXX 93978 TC A Vascular study 0.00 3.38 NA 0.37 3.75 NA XXX 93979 A Vascular study 0.44 2.67 NA 0.29 3.40 NA XXX 93979 26 A Vascular study 0.44 0.16 0.16 0.05 0.65 0.65 XXX 93979 TC A Vascular study 0.00 2.51 NA 0.24 2.75 NA XXX 93980 A Penile vascular study 1.24 4.84 NA 0.42 6.50 NA XXX 93980 26 A Penile vascular study 1.24 0.42 0.42 0.08 1.74 1.74 XXX 93980 TC A Penile vascular study 0.00 4.42 NA 0.34 4.76 NA XXX 93981 A Penile vascular study 0.44 4.66 NA 0.33 5.43 NA XXX 93981 26 A Penile vascular study 0.44 0.15 0.15 0.02 0.61 0.61 XXX 93981 TC A Penile vascular study 0.00 4.51 NA 0.31 4.82 NA XXX 93990 A Doppler flow testing 0.25 3.41 NA 0.25 3.91 NA XXX 93990 26 A Doppler flow testing 0.25 0.09 0.09 0.02 0.36 0.36 XXX 93990 TC A Doppler flow testing 0.00 3.32 NA 0.23 3.55 NA XXX 94010 A Breathing capacity test 0.17 0.69 NA 0.03 0.89 NA XXX 94010 26 A Breathing capacity test 0.17 0.05 0.05 0.01 0.23 0.23 XXX 94010 TC A Breathing capacity test 0.00 0.64 NA 0.02 0.66 NA XXX 94014 A Patient recorded spirometry 0.52 0.78 NA 0.03 1.33 NA XXX 94015 A Patient recorded spirometry 0.00 0.61 NA 0.01 0.62 NA XXX 94016 A Review patient spirometry 0.52 0.17 0.17 0.02 0.71 0.71 XXX 94060 A Evaluation of wheezing 0.31 1.14 NA 0.07 1.52 NA XXX 94060 26 A Evaluation of wheezing 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94060 TC A Evaluation of wheezing 0.00 1.04 NA 0.06 1.10 NA XXX 94070 A Evaluation of wheezing 0.60 3.05 NA 0.12 3.77 NA XXX 94070 26 A Evaluation of wheezing 0.60 0.19 0.19 0.02 0.81 0.81 XXX 94070 TC A Evaluation of wheezing 0.00 2.86 NA 0.10 2.96 NA XXX 94150 B Vital capacity test +0.07 0.49 NA 0.02 0.58 NA XXX 94150 26 B Vital capacity test +0.07 0.03 0.03 0.01 0.11 0.11 XXX 94150 TC B Vital capacity test +0.00 0.46 NA 0.01 0.47 NA XXX 94200 A Lung function test (MBC/MVV) 0.11 0.45 NA 0.03 0.59 NA XXX 94200 26 A Lung function test (MBC/MVV) 0.11 0.03 0.03 0.01 0.15 0.15 XXX 94200 TC A Lung function test (MBC/MVV) 0.00 0.42 NA 0.02 0.44 NA XXX 94240 A Residual lung capacity 0.26 0.67 NA 0.06 0.99 NA XXX 94240 26 A Residual lung capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94240 TC A Residual lung capacity 0.00 0.59 NA 0.05 0.64 NA XXX 94250 A Expired gas collection 0.11 0.67 NA 0.02 0.80 NA XXX 94250 26 A Expired gas collection 0.11 0.03 0.03 0.01 0.15 0.15 XXX 94250 TC A Expired gas collection 0.00 0.64 NA 0.01 0.65 NA XXX 94260 A Thoracic gas volume 0.13 0.59 NA 0.05 0.77 NA XXX 94260 26 A Thoracic gas volume 0.13 0.04 0.04 0.01 0.18 0.18 XXX 94260 TC A Thoracic gas volume 0.00 0.55 NA 0.04 0.59 NA XXX 94350 A Lung nitrogen washout curve 0.26 0.76 NA 0.05 1.07 NA XXX 94350 26 A Lung nitrogen washout curve 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94350 TC A Lung nitrogen washout curve 0.00 0.68 NA 0.04 0.72 NA XXX 94360 A Measure airflow resistance 0.26 0.71 NA 0.07 1.04 NA XXX 94360 26 A Measure airflow resistance 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94360 TC A Measure airflow resistance 0.00 0.63 NA 0.06 0.69 NA XXX 94370 A Breath airway closing volume 0.26 0.73 NA 0.03 1.02 NA XXX 94370 26 A Breath airway closing volume 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94370 TC A Breath airway closing volume 0.00 0.65 NA 0.02 0.67 NA XXX 94375 A Respiratory flow volume loop 0.31 0.63 NA 0.03 0.97 NA XXX 94375 26 A Respiratory flow volume loop 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94375 TC A Respiratory flow volume loop 0.00 0.53 NA 0.02 0.55 NA XXX 94400 A CO2 breathing response curve 0.40 0.85 NA 0.07 1.32 NA XXX 94400 26 A CO2 breathing response curve 0.40 0.13 0.13 0.01 0.54 0.54 XXX 94400 TC A CO2 breathing response curve 0.00 0.72 NA 0.06 0.78 NA XXX 94450 A Hypoxia response curve 0.40 0.69 NA 0.04 1.13 NA XXX 94450 26 A Hypoxia response curve 0.40 0.12 0.12 0.02 0.54 0.54 XXX 94450 TC A Hypoxia response curve 0.00 0.57 NA 0.02 0.59 NA XXX 94620 A Pulmonary stress test/simple 0.64 2.45 NA 0.12 3.21 NA XXX Start Printed Page 63374 94620 26 A Pulmonary stress test/simple 0.64 0.20 0.20 0.02 0.86 0.86 XXX 94620 TC A Pulmonary stress test/simple 0.00 2.25 NA 0.10 2.35 NA XXX 94621 A Pulm stress test/complex 1.41 2.10 NA 0.16 3.67 NA XXX 94621 26 A Pulm stress test/complex 1.41 0.44 0.44 0.06 1.91 1.91 XXX 94621 TC A Pulm stress test/complex 0.00 1.66 NA 0.10 1.76 NA XXX 94640 A Airway inhalation treatment 0.00 0.32 NA 0.02 0.34 NA XXX 94642 C Aerosol inhalation treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94656 A Initial ventilator mgmt 1.21 1.21 0.32 0.07 2.49 1.60 XXX 94657 A Continued ventilator mgmt 0.83 1.02 0.25 0.04 1.89 1.12 XXX 94660 A Pos airway pressure, CPAP 0.76 0.67 0.24 0.04 1.47 1.04 XXX 94662 A Neg press ventilation, cnp 0.76 NA 0.24 0.02 NA 1.02 XXX 94664 A Evaluate pt use of inhaler 0.00 0.33 NA 0.04 0.37 NA XXX 94667 A Chest wall manipulation 0.00 0.57 NA 0.05 0.62 NA XXX 94668 A Chest wall manipulation 0.00 0.48 NA 0.02 0.50 NA XXX 94680 A Exhaled air analysis, o2 0.26 1.93 NA 0.07 2.26 NA XXX 94680 26 A Exhaled air analysis, o2 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94680 TC A Exhaled air analysis, o2 0.00 1.85 NA 0.06 1.91 NA XXX 94681 A Exhaled air analysis, o2/co2 0.20 2.66 NA 0.13 2.99 NA XXX 94681 26 A Exhaled air analysis, o2/co2 0.20 0.07 0.07 0.01 0.28 0.28 XXX 94681 TC A Exhaled air analysis, o2/co2 0.00 2.59 NA 0.12 2.71 NA XXX 94690 A Exhaled air analysis 0.07 2.01 NA 0.05 2.13 NA XXX 94690 26 A Exhaled air analysis 0.07 0.02 0.02 0.01 0.10 0.10 XXX 94690 TC A Exhaled air analysis 0.00 1.99 NA 0.04 2.03 NA XXX 94720 A Monoxide diffusing capacity 0.26 1.01 NA 0.07 1.34 NA XXX 94720 26 A Monoxide diffusing capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94720 TC A Monoxide diffusing capacity 0.00 0.93 NA 0.06 0.99 NA XXX 94725 A Membrane diffusion capacity 0.26 3.00 NA 0.13 3.39 NA XXX 94725 26 A Membrane diffusion capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94725 TC A Membrane diffusion capacity 0.00 2.92 NA 0.12 3.04 NA XXX 94750 A Pulmonary compliance study 0.23 1.38 NA 0.05 1.66 NA XXX 94750 26 A Pulmonary compliance study 0.23 0.07 0.07 0.01 0.31 0.31 XXX 94750 TC A Pulmonary compliance study 0.00 1.31 NA 0.04 1.35 NA XXX 94760 T Measure blood oxygen level 0.00 0.04 NA 0.02 0.06 NA XXX 94761 T Measure blood oxygen level 0.00 0.07 NA 0.06 0.13 NA XXX 94762 A Measure blood oxygen level 0.00 0.41 NA 0.10 0.51 NA XXX 94770 A Exhaled carbon dioxide test 0.15 1.70 NA 0.08 1.93 NA XXX 94770 26 A Exhaled carbon dioxide test 0.15 0.04 0.04 0.01 0.20 0.20 XXX 94770 TC A Exhaled carbon dioxide test 0.00 1.66 NA 0.07 1.73 NA XXX 94772 C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 26 C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 TC C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 26 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 TC C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95004 A Percut allergy skin tests 0.00 0.10 NA 0.01 0.11 NA XXX 95010 A Percut allergy titrate test 0.15 0.33 0.06 0.01 0.49 0.22 XXX 95015 A Id allergy titrate-drug/bug 0.15 0.15 0.06 0.01 0.31 0.22 XXX 95024 A Id allergy test, drug/bug 0.00 0.14 NA 0.01 0.15 NA XXX 95027 A Id allergy titrate-airborne 0.00 0.14 NA 0.01 0.15 NA XXX 95028 A Id allergy test-delayed type 0.00 0.23 NA 0.01 0.24 NA XXX 95044 A Allergy patch tests 0.00 0.20 NA 0.01 0.21 NA XXX 95052 A Photo patch test 0.00 0.25 NA 0.01 0.26 NA XXX 95056 A Photosensitivity tests 0.00 0.17 NA 0.01 0.18 NA XXX 95060 A Eye allergy tests 0.00 0.35 NA 0.02 0.37 NA XXX 95065 A Nose allergy test 0.00 0.20 NA 0.01 0.21 NA XXX 95070 A Bronchial allergy tests 0.00 2.26 NA 0.02 2.28 NA XXX 95071 A Bronchial allergy tests 0.00 2.90 NA 0.02 2.92 NA XXX 95075 A Ingestion challenge test 0.94 0.83 0.39 0.04 1.81 1.37 XXX 95078 A Provocative testing 0.00 0.25 NA 0.02 0.27 NA XXX 95115 A Immunotherapy, one injection 0.00 0.39 NA 0.02 0.41 NA 000 95117 A Immunotherapy injections 0.00 0.50 NA 0.02 0.52 NA 000 95120 I Immunotherapy, one injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95125 I Immunotherapy, many antigens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95130 I Immunotherapy, insect venom 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95131 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95132 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95133 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95134 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95144 A Antigen therapy services 0.06 0.15 0.02 0.01 0.22 0.09 000 95145 A Antigen therapy services 0.06 0.33 0.02 0.01 0.40 0.09 000 95146 A Antigen therapy services 0.06 0.46 0.03 0.01 0.53 0.10 000 95147 A Antigen therapy services 0.06 0.43 0.02 0.01 0.50 0.09 000 95148 A Antigen therapy services 0.06 0.60 0.03 0.01 0.67 0.10 000 95149 A Antigen therapy services 0.06 0.82 0.03 0.01 0.89 0.10 000 95165 A Antigen therapy services 0.06 0.20 0.02 0.01 0.27 0.09 000 Start Printed Page 63375 95170 A Antigen therapy services 0.06 0.14 0.02 0.01 0.21 0.09 000 95180 A Rapid desensitization 2.00 1.54 0.83 0.05 3.59 2.88 000 95199 C Allergy immunology services 0.00 0.00 0.00 0.00 0.00 0.00 000 95250 A Glucose monitoring, cont 0.00 3.89 NA 0.01 3.90 NA XXX 95805 A Multiple sleep latency test 1.87 16.50 NA 0.41 18.78 NA XXX 95805 26 A Multiple sleep latency test 1.87 0.66 0.66 0.07 2.60 2.60 XXX 95805 TC A Multiple sleep latency test 0.00 15.84 NA 0.34 16.18 NA XXX 95806 A Sleep study, unattended 1.65 3.88 NA 0.38 5.91 NA XXX 95806 26 A Sleep study, unattended 1.65 0.55 0.55 0.07 2.27 2.27 XXX 95806 TC A Sleep study, unattended 0.00 3.33 NA 0.31 3.64 NA XXX 95807 A Sleep study, attended 1.65 11.91 NA 0.48 14.04 NA XXX 95807 26 A Sleep study, attended 1.65 0.54 0.54 0.06 2.25 2.25 XXX 95807 TC A Sleep study, attended 0.00 11.37 NA 0.42 11.79 NA XXX 95808 A Polysomnography, 1-3 2.63 13.20 NA 0.53 16.36 NA XXX 95808 26 A Polysomnography, 1-3 2.63 0.93 0.93 0.11 3.67 3.67 XXX 95808 TC A Polysomnography, 1-3 0.00 12.27 NA 0.42 12.69 NA XXX 95810 A Polysomnography, 4 or more 3.51 17.30 NA 0.56 21.37 NA XXX 95810 26 A Polysomnography, 4 or more 3.51 1.20 1.20 0.14 4.85 4.85 XXX 95810 TC A Polysomnography, 4 or more 0.00 16.10 NA 0.42 16.52 NA XXX 95811 A Polysomnography w/cpap 3.78 18.74 NA 0.59 23.11 NA XXX 95811 26 A Polysomnography w/cpap 3.78 1.29 1.29 0.16 5.23 5.23 XXX 95811 TC A Polysomnography w/cpap 0.00 17.45 NA 0.43 17.88 NA XXX 95812 A Eeg, 41-60 minutes 1.07 3.98 NA 0.16 5.21 NA XXX 95812 26 A Eeg, 41-60 minutes 1.07 0.46 0.46 0.05 1.58 1.58 XXX 95812 TC A Eeg, 41-60 minutes 0.00 3.52 NA 0.11 3.63 NA XXX 95813 A Eeg, over 1 hour 1.72 5.00 NA 0.18 6.90 NA XXX 95813 26 A Eeg, over 1 hour 1.72 0.70 0.70 0.07 2.49 2.49 XXX 95813 TC A Eeg, over 1 hour 0.00 4.30 NA 0.11 4.41 NA XXX 95816 A Eeg, awake and drowsy 1.07 3.20 NA 0.15 4.42 NA XXX 95816 26 A Eeg, awake and drowsy 1.07 0.47 0.47 0.05 1.59 1.59 XXX 95816 TC A Eeg, awake and drowsy 0.00 2.73 NA 0.10 2.83 NA XXX 95819 A Eeg, awake and asleep 1.07 3.74 NA 0.15 4.96 NA XXX 95819 26 A Eeg, awake and asleep 1.07 0.47 0.47 0.05 1.59 1.59 XXX 95819 TC A Eeg, awake and asleep 0.00 3.27 NA 0.10 3.37 NA XXX 95822 A Eeg, coma or sleep only 1.07 4.43 NA 0.18 5.68 NA XXX 95822 26 A Eeg, coma or sleep only 1.07 0.47 0.47 0.05 1.59 1.59 XXX 95822 TC A Eeg, coma or sleep only 0.00 3.96 NA 0.13 4.09 NA XXX 95824 C Eeg, cerebral death only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95824 26 A Eeg, cerebral death only 0.74 0.32 0.32 0.06 1.12 1.12 XXX 95824 TC C Eeg, cerebral death only 0.00 0.00 NA 0.00 0.00 NA XXX 95827 A Eeg, all night recording 1.07 2.68 NA 0.18 3.93 NA XXX 95827 26 A Eeg, all night recording 1.07 0.41 0.41 0.04 1.52 1.52 XXX 95827 TC A Eeg, all night recording 0.00 2.27 NA 0.14 2.41 NA XXX 95829 A Surgery electrocorticogram 6.17 32.01 NA 0.39 38.57 NA XXX 95829 26 A Surgery electrocorticogram 6.17 2.35 2.35 0.37 8.89 8.89 XXX 95829 TC A Surgery electrocorticogram 0.00 29.66 NA 0.02 29.68 NA XXX 95830 A Insert electrodes for EEG 1.69 3.42 0.73 0.08 5.19 2.50 XXX 95831 A Limb muscle testing, manual 0.28 0.35 0.13 0.01 0.64 0.42 XXX 95832 A Hand muscle testing, manual 0.29 0.26 0.12 0.01 0.56 0.42 XXX 95833 A Body muscle testing, manual 0.47 0.46 0.23 0.01 0.94 0.71 XXX 95834 A Body muscle testing, manual 0.60 0.51 0.28 0.02 1.13 0.90 XXX 95851 A Range of motion measurements 0.16 0.37 0.08 0.01 0.54 0.25 XXX 95852 A Range of motion measurements 0.11 0.26 0.05 0.01 0.38 0.17 XXX 95857 A Tensilon test 0.53 0.62 0.23 0.02 1.17 0.78 XXX 95858 A Tensilon test & myogram 1.55 1.07 NA 0.09 2.71 NA XXX 95858 26 A Tensilon test & myogram 1.55 0.67 0.67 0.05 2.27 2.27 XXX 95858 TC A Tensilon test & myogram 0.00 0.40 NA 0.04 0.44 NA XXX 95860 A Muscle test, one limb 0.95 1.47 NA 0.06 2.48 NA XXX 95860 26 A Muscle test, one limb 0.95 0.43 0.43 0.04 1.42 1.42 XXX 95860 TC A Muscle test, one limb 0.00 1.04 NA 0.02 1.06 NA XXX 95861 A Muscle test, 2 limbs 1.53 1.40 NA 0.12 3.05 NA XXX 95861 26 A Muscle test, 2 limbs 1.53 0.68 0.68 0.06 2.27 2.27 XXX 95861 TC A Muscle test, 2 limbs 0.00 0.72 NA 0.06 0.78 NA XXX 95863 A Muscle test, 3 limbs 1.86 1.74 NA 0.13 3.73 NA XXX 95863 26 A Muscle test, 3 limbs 1.86 0.81 0.81 0.07 2.74 2.74 XXX 95863 TC A Muscle test, 3 limbs 0.00 0.93 NA 0.06 0.99 NA XXX 95864 A Muscle test, 4 limbs 1.98 2.65 NA 0.19 4.82 NA XXX 95864 26 A Muscle test, 4 limbs 1.98 0.88 0.88 0.07 2.93 2.93 XXX 95864 TC A Muscle test, 4 limbs 0.00 1.77 NA 0.12 1.89 NA XXX 95867 A Muscle test cran nerv unilat 0.79 0.93 NA 0.08 1.80 NA XXX 95867 26 A Muscle test cran nerv unilat 0.79 0.35 0.35 0.04 1.18 1.18 XXX 95867 TC A Muscle test cran nerv unilat 0.00 0.58 NA 0.04 0.62 NA XXX 95868 A Muscle test cran nerve bilat 1.17 1.21 NA 0.10 2.48 NA XXX 95868 26 A Muscle test cran nerve bilat 1.17 0.52 0.52 0.05 1.74 1.74 XXX 95868 TC A Muscle test cran nerve bilat 0.00 0.69 NA 0.05 0.74 NA XXX Start Printed Page 63376 95869 A Muscle test, thor paraspinal 0.37 0.38 NA 0.03 0.78 NA XXX 95869 26 A Muscle test, thor paraspinal 0.37 0.17 0.17 0.01 0.55 0.55 XXX 95869 TC A Muscle test, thor paraspinal 0.00 0.21 NA 0.02 0.23 NA XXX 95870 A Muscle test, nonparaspinal 0.37 0.37 NA 0.03 0.77 NA XXX 95870 26 A Muscle test, nonparaspinal 0.37 0.16 0.16 0.01 0.54 0.54 XXX 95870 TC A Muscle test, nonparaspinal 0.00 0.21 NA 0.02 0.23 NA XXX 95872 A Muscle test, one fiber 1.49 1.24 NA 0.10 2.83 NA XXX 95872 26 A Muscle test, one fiber 1.49 0.64 0.64 0.05 2.18 2.18 XXX 95872 TC A Muscle test, one fiber 0.00 0.60 NA 0.05 0.65 NA XXX 95875 A Limb exercise test 1.09 1.49 NA 0.11 2.69 NA XXX 95875 26 A Limb exercise test 1.09 0.48 0.48 0.05 1.62 1.62 XXX 95875 TC A Limb exercise test 0.00 1.01 NA 0.06 1.07 NA XXX 95900 A Motor nerve conduction test 0.42 1.30 NA 0.03 1.75 NA XXX 95900 26 A Motor nerve conduction test 0.42 0.19 0.19 0.01 0.62 0.62 XXX 95900 TC A Motor nerve conduction test 0.00 1.11 NA 0.02 1.13 NA XXX 95903 A Motor nerve conduction test 0.60 1.22 NA 0.04 1.86 NA XXX 95903 26 A Motor nerve conduction test 0.60 0.26 0.26 0.02 0.88 0.88 XXX 95903 TC A Motor nerve conduction test 0.00 0.96 NA 0.02 0.98 NA XXX 95904 A Sense nerve conduction test 0.34 1.12 NA 0.03 1.49 NA XXX 95904 26 A Sense nerve conduction test 0.34 0.15 0.15 0.01 0.50 0.50 XXX 95904 TC A Sense nerve conduction test 0.00 0.97 NA 0.02 0.99 NA XXX 95920 A Intraop nerve test add-on 2.10 2.23 NA 0.24 4.57 NA ZZZ 95920 26 A Intraop nerve test add-on 2.10 0.94 0.94 0.17 3.21 3.21 ZZZ 95920 TC A Intraop nerve test add-on 0.00 1.29 NA 0.07 1.36 NA ZZZ 95921 A Autonomic nerv function test 0.89 0.71 NA 0.06 1.66 NA XXX 95921 26 A Autonomic nerv function test 0.89 0.33 0.33 0.04 1.26 1.26 XXX 95921 TC A Autonomic nerv function test 0.00 0.38 NA 0.02 0.40 NA XXX 95922 A Autonomic nerv function test 0.95 0.79 NA 0.06 1.80 NA XXX 95922 26 A Autonomic nerv function test 0.95 0.41 0.41 0.04 1.40 1.40 XXX 95922 TC A Autonomic nerv function test 0.00 0.38 NA 0.02 0.40 NA XXX 95923 A Autonomic nerv function test 0.89 2.13 NA 0.06 3.08 NA XXX 95923 26 A Autonomic nerv function test 0.89 0.38 0.38 0.04 1.31 1.31 XXX 95923 TC A Autonomic nerv function test 0.00 1.75 NA 0.02 1.77 NA XXX 95925 A Somatosensory testing 0.54 1.13 NA 0.08 1.75 NA XXX 95925 26 A Somatosensory testing 0.54 0.23 0.23 0.02 0.79 0.79 XXX 95925 TC A Somatosensory testing 0.00 0.90 NA 0.06 0.96 NA XXX 95926 A Somatosensory testing 0.54 1.14 NA 0.08 1.76 NA XXX 95926 26 A Somatosensory testing 0.54 0.24 0.24 0.02 0.80 0.80 XXX 95926 TC A Somatosensory testing 0.00 0.90 NA 0.06 0.96 NA XXX 95927 A Somatosensory testing 0.54 1.15 NA 0.10 1.79 NA XXX 95927 26 A Somatosensory testing 0.54 0.25 0.25 0.04 0.83 0.83 XXX 95927 TC A Somatosensory testing 0.00 0.90 NA 0.06 0.96 NA XXX 95930 A Visual evoked potential test 0.35 1.45 NA 0.02 1.82 NA XXX 95930 26 A Visual evoked potential test 0.35 0.15 0.15 0.01 0.51 0.51 XXX 95930 TC A Visual evoked potential test 0.00 1.30 NA 0.01 1.31 NA XXX 95933 A Blink reflex test 0.59 1.02 NA 0.08 1.69 NA XXX 95933 26 A Blink reflex test 0.59 0.25 0.25 0.02 0.86 0.86 XXX 95933 TC A Blink reflex test 0.00 0.77 NA 0.06 0.83 NA XXX 95934 A H-reflex test 0.51 0.44 NA 0.04 0.99 NA XXX 95934 26 A H-reflex test 0.51 0.23 0.23 0.02 0.76 0.76 XXX 95934 TC A H-reflex test 0.00 0.21 NA 0.02 0.23 NA XXX 95936 A H-reflex test 0.55 0.45 NA 0.04 1.04 NA XXX 95936 26 A H-reflex test 0.55 0.24 0.24 0.02 0.81 0.81 XXX 95936 TC A H-reflex test 0.00 0.21 NA 0.02 0.23 NA XXX 95937 A Neuromuscular junction test 0.65 0.61 NA 0.04 1.30 NA XXX 95937 26 A Neuromuscular junction test 0.65 0.27 0.27 0.02 0.94 0.94 XXX 95937 TC A Neuromuscular junction test 0.00 0.34 NA 0.02 0.36 NA XXX 95950 A Ambulatory eeg monitoring 1.50 4.53 NA 0.53 6.56 NA XXX 95950 26 A Ambulatory eeg monitoring 1.50 0.64 0.64 0.10 2.24 2.24 XXX 95950 TC A Ambulatory eeg monitoring 0.00 3.89 NA 0.43 4.32 NA XXX 95951 C EEG monitoring/videorecord 0.00 0.00 NA 0.00 0.00 NA XXX 95951 26 A EEG monitoring/videorecord 5.97 2.59 2.59 0.24 8.80 8.80 XXX 95951 TC C EEG monitoring/videorecord 0.00 0.00 NA 0.00 0.00 NA XXX 95953 A EEG monitoring/computer 3.06 7.59 NA 0.55 11.20 NA XXX 95953 26 A EEG monitoring/computer 3.06 1.31 1.31 0.12 4.49 4.49 XXX 95953 TC A EEG monitoring/computer 0.00 6.28 NA 0.43 6.71 NA XXX 95954 A EEG monitoring/giving drugs 2.44 4.33 NA 0.18 6.95 NA XXX 95954 26 A EEG monitoring/giving drugs 2.44 1.05 1.05 0.12 3.61 3.61 XXX 95954 TC A EEG monitoring/giving drugs 0.00 3.28 NA 0.06 3.34 NA XXX 95955 A EEG during surgery 1.00 2.31 NA 0.23 3.54 NA XXX 95955 26 A EEG during surgery 1.00 0.37 0.37 0.06 1.43 1.43 XXX 95955 TC A EEG during surgery 0.00 1.94 NA 0.17 2.11 NA XXX 95956 A Eeg monitoring, cable/radio 3.06 14.32 NA 0.56 17.94 NA XXX 95956 26 A Eeg monitoring, cable/radio 3.06 1.32 1.32 0.13 4.51 4.51 XXX 95956 TC A Eeg monitoring, cable/radio 0.00 13.00 NA 0.43 13.43 NA XXX Start Printed Page 63377 95957 A EEG digital analysis 1.97 2.55 NA 0.20 4.72 NA XXX 95957 26 A EEG digital analysis 1.97 0.86 0.86 0.08 2.91 2.91 XXX 95957 TC A EEG digital analysis 0.00 1.69 NA 0.12 1.81 NA XXX 95958 A EEG monitoring/function test 4.23 3.50 NA 0.35 8.08 NA XXX 95958 26 A EEG monitoring/function test 4.23 1.77 1.77 0.22 6.22 6.22 XXX 95958 TC A EEG monitoring/function test 0.00 1.73 NA 0.13 1.86 NA XXX 95961 A Electrode stimulation, brain 2.95 2.63 NA 0.29 5.87 NA XXX 95961 26 A Electrode stimulation, brain 2.95 1.34 1.34 0.22 4.51 4.51 XXX 95961 TC A Electrode stimulation, brain 0.00 1.29 NA 0.07 1.36 NA XXX 95962 A Electrode stim, brain add-on 3.19 2.70 NA 0.27 6.16 NA ZZZ 95962 26 A Electrode stim, brain add-on 3.19 1.41 1.41 0.20 4.80 4.80 ZZZ 95962 TC A Electrode stim, brain add-on 0.00 1.29 NA 0.07 1.36 NA ZZZ 95965 C Meg, spontaneous 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95965 26 A Meg, spontaneous 7.95 3.46 3.46 0.37 11.78 11.78 XXX 95965 TC C Meg, spontaneous 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 C Meg, evoked, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 26 A Meg, evoked, single 3.98 1.74 1.74 0.18 5.90 5.90 XXX 95966 TC C Meg, evoked, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95967 C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95967 26 A Meg, evoked, each addl 3.48 1.35 1.35 0.16 4.99 4.99 ZZZ 95967 TC C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95970 A Analyze neurostim, no prog 0.45 0.17 0.15 0.04 0.66 0.64 XXX 95971 A Analyze neurostim, simple 0.78 0.28 0.23 0.07 1.13 1.08 XXX 95972 A Analyze neurostim, complex 1.49 0.60 0.50 0.20 2.29 2.19 XXX 95973 A Analyze neurostim, complex 0.91 0.40 0.35 0.08 1.39 1.34 ZZZ 95974 A Cranial neurostim, complex 2.98 1.31 1.31 0.18 4.47 4.47 XXX 95975 A Cranial neurostim, complex 1.69 0.73 0.73 0.08 2.50 2.50 ZZZ 95990 A Spin/brain pump refil & main 0.00 1.49 NA 0.06 1.55 NA XXX 95991 A Spin/brain pump refil & main 0.77 1.49 0.19 0.06 2.32 1.02 XXX 95999 C Neurological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96000 A Motion analysis, video/3d 1.79 NA 0.57 0.02 NA 2.38 XXX 96001 A Motion test w/ft press meas 2.14 NA 0.67 0.02 NA 2.83 XXX 96002 A Dynamic surface emg 0.41 NA 0.15 0.02 NA 0.58 XXX 96003 A Dynamic fine wire emg 0.37 NA 0.14 0.04 NA 0.55 XXX 96004 A Phys review of motion tests 2.13 0.96 0.96 0.10 3.19 3.19 XXX 96100 A Psychological testing 0.00 1.75 NA 0.18 1.93 NA XXX 96105 A Assessment of aphasia 0.00 1.75 NA 0.18 1.93 NA XXX 96110 A Developmental test, lim 0.00 0.18 NA 0.18 0.36 NA XXX 96111 A Developmental test, extend 2.59 1.07 NA 0.18 3.84 NA XXX 96115 A Neurobehavior status exam 0.00 1.75 NA 0.18 1.93 NA XXX 96117 A Neuropsych test battery 0.00 1.75 NA 0.18 1.93 NA XXX 96150 A Assess lth/behave, init 0.50 0.19 0.18 0.02 0.71 0.70 XXX 96151 A Assess hlth/behave, subseq 0.48 0.18 0.17 0.02 0.68 0.67 XXX 96152 A Intervene hlth/behave, indiv 0.46 0.18 0.16 0.02 0.66 0.64 XXX 96153 A Intervene hlth/behave, group 0.10 0.04 0.04 0.01 0.15 0.15 XXX 96154 A Interv hlth/behav, fam w/pt 0.45 0.17 0.16 0.02 0.64 0.63 XXX 96155 N Interv hlth/behav fam no pt +0.44 0.18 0.17 0.02 0.64 0.63 XXX 96400 A Chemotherapy, sc/im 0.00 0.88 NA 0.01 0.89 NA XXX 96405 A Intralesional chemo admin 0.52 1.94 0.23 0.02 2.48 0.77 000 96406 A Intralesional chemo admin 0.80 2.58 0.30 0.02 3.40 1.12 000 96408 A Chemotherapy, push technique 0.00 0.96 NA 0.06 1.02 NA XXX 96410 A Chemotherapy,infusion method 0.00 1.54 NA 0.08 1.62 NA XXX 96412 A Chemo, infuse method add-on 0.00 1.14 NA 0.07 1.21 NA ZZZ 96414 A Chemo, infuse method add-on 0.00 1.32 NA 0.08 1.40 NA XXX 96420 A Chemotherapy, push technique 0.00 1.24 NA 0.08 1.32 NA XXX 96422 A Chemotherapy,infusion method 0.00 1.22 NA 0.08 1.30 NA XXX 96423 A Chemo, infuse method add-on 0.00 0.48 NA 0.02 0.50 NA ZZZ 96425 A Chemotherapy,infusion method 0.00 1.42 NA 0.08 1.50 NA XXX 96440 A Chemotherapy, intracavitary 2.36 7.40 1.04 0.14 9.90 3.54 000 96445 A Chemotherapy, intracavitary 2.19 7.38 1.03 0.08 9.65 3.30 000 96450 A Chemotherapy, into CNS 1.88 6.26 0.91 0.07 8.21 2.86 000 96520 A Port pump refill & main 0.00 0.88 NA 0.06 0.94 NA XXX 96530 A Syst pump refill & main 0.00 1.05 NA 0.06 1.11 NA XXX 96542 A Chemotherapy injection 1.41 3.80 0.55 0.06 5.27 2.02 XXX 96545 B Provide chemotherapy agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96549 C Chemotherapy, unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96567 A Photodynamic tx, skin 0.00 0.99 NA 0.04 1.03 NA XXX 96570 A Photodynamic tx, 30 min 1.09 NA 0.37 0.05 NA 1.51 ZZZ 96571 A Photodynamic tx, addl 15 min 0.55 NA 0.20 0.02 NA 0.77 ZZZ 96900 A Ultraviolet light therapy 0.00 0.49 NA 0.02 0.51 NA XXX 96902 B Trichogram +0.41 0.25 0.16 0.01 0.67 0.58 XXX 96910 A Photochemotherapy with UV-B 0.00 1.08 NA 0.04 1.12 NA XXX 96912 A Photochemotherapy with UV-A 0.00 1.36 NA 0.05 1.41 NA XXX 96913 A Photochemotherapy, UV-A or B 0.00 1.80 NA 0.10 1.90 NA XXX 96920 A Laser tx, skin < 250 sq cm 1.14 7.74 0.58 0.11 8.99 1.83 000 Start Printed Page 63378 96921 A Laser tx, skin 250-500 sq cm 1.16 7.81 0.59 0.11 9.08 1.86 000 96922 A Laser tx, skin > 500 sq cm 2.09 8.56 1.04 0.19 10.84 3.32 000 96999 C Dermatological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97001 A Pt evaluation 1.19 0.74 0.46 0.06 1.99 1.71 XXX 97002 A Pt re-evaluation 0.60 0.45 0.24 0.02 1.07 0.86 XXX 97003 A Ot evaluation 1.19 0.87 0.41 0.06 2.12 1.66 XXX 97004 A Ot re-evaluation 0.60 0.62 0.20 0.02 1.24 0.82 XXX 97005 I Athletic train eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97006 I Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97010 B Hot or cold packs therapy +0.06 0.05 NA 0.01 0.12 NA XXX 97012 A Mechanical traction therapy 0.25 0.14 NA 0.01 0.40 NA XXX 97014 I Electric stimulation therapy +0.18 0.19 0.19 0.01 0.38 0.38 XXX 97016 A Vasopneumatic device therapy 0.18 0.19 NA 0.01 0.38 NA XXX 97018 A Paraffin bath therapy 0.06 0.11 NA 0.01 0.18 NA XXX 97020 A Microwave therapy 0.06 0.06 NA 0.01 0.13 NA XXX 97022 A Whirlpool therapy 0.17 0.22 NA 0.01 0.40 NA XXX 97024 A Diathermy treatment 0.06 0.09 NA 0.01 0.16 NA XXX 97026 A Infrared therapy 0.06 0.06 NA 0.01 0.13 NA XXX 97028 A Ultraviolet therapy 0.08 0.07 NA 0.01 0.16 NA XXX 97032 A Electrical stimulation 0.25 0.16 NA 0.01 0.42 NA XXX 97033 A Electric current therapy 0.26 0.28 NA 0.02 0.56 NA XXX 97034 A Contrast bath therapy 0.21 0.16 NA 0.01 0.38 NA XXX 97035 A Ultrasound therapy 0.21 0.11 NA 0.01 0.33 NA XXX 97036 A Hydrotherapy 0.28 0.33 NA 0.01 0.62 NA XXX 97039 A Physical therapy treatment 0.20 0.10 NA 0.01 0.31 NA XXX 97110 A Therapeutic exercises 0.45 0.28 NA 0.04 0.77 NA XXX 97112 A Neuromuscular reeducation 0.45 0.31 NA 0.02 0.78 NA XXX 97113 A Aquatic therapy/exercises 0.44 0.41 NA 0.04 0.89 NA XXX 97116 A Gait training therapy 0.40 0.24 NA 0.02 0.66 NA XXX 97124 A Massage therapy 0.35 0.23 NA 0.01 0.59 NA XXX 97139 A Physical medicine procedure 0.21 0.21 NA 0.01 0.43 NA XXX 97140 A Manual therapy 0.43 0.26 NA 0.02 0.71 NA XXX 97150 A Group therapeutic procedures 0.27 0.18 NA 0.02 0.47 NA XXX 97504 A Orthotic training 0.45 0.33 NA 0.04 0.82 NA XXX 97520 A Prosthetic training 0.45 0.28 NA 0.02 0.75 NA XXX 97530 A Therapeutic activities 0.44 0.32 NA 0.02 0.78 NA XXX 97532 A Cognitive skills development 0.44 0.21 NA 0.01 0.66 NA XXX 97533 A Sensory integration 0.44 0.24 NA 0.01 0.69 NA XXX 97535 A Self care mngment training 0.45 0.34 NA 0.02 0.81 NA XXX 97537 A Community/work reintegration 0.45 0.27 NA 0.01 0.73 NA XXX 97542 A Wheelchair mngment training 0.45 0.28 NA 0.01 0.74 NA XXX 97545 R Work hardening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97546 R Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 97601 A Wound(s) care, selective 0.50 0.50 NA 0.05 1.05 NA XXX 97602 B Wound(s) care non-selective 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97703 A Prosthetic checkout 0.25 0.42 NA 0.02 0.69 NA XXX 97750 A Physical performance test 0.45 0.30 NA 0.02 0.77 NA XXX 97755 A Assistive technology assess 0.62 0.29 NA 0.02 0.93 NA XXX 97780 N Acupuncture w/o stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97781 N Acupuncture w/stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97799 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 A Medical nutrition, indiv, in 0.00 0.47 NA 0.01 0.48 NA XXX 97803 A Med nutrition, indiv, subseq 0.00 0.47 NA 0.01 0.48 NA XXX 97804 A Medical nutrition, group 0.00 0.18 NA 0.01 0.19 NA XXX 98925 A Osteopathic manipulation 0.45 0.33 0.14 0.01 0.79 0.60 000 98926 A Osteopathic manipulation 0.65 0.43 0.25 0.02 1.10 0.92 000 98927 A Osteopathic manipulation 0.87 0.52 0.30 0.04 1.43 1.21 000 98928 A Osteopathic manipulation 1.02 0.61 0.35 0.04 1.67 1.41 000 98929 A Osteopathic manipulation 1.18 0.69 0.37 0.05 1.92 1.60 000 98940 A Chiropractic manipulation 0.45 0.24 0.12 0.01 0.70 0.58 000 98941 A Chiropractic manipulation 0.65 0.30 0.18 0.02 0.97 0.85 000 98942 A Chiropractic manipulation 0.87 0.37 0.24 0.04 1.28 1.15 000 98943 N Chiropractic manipulation +0.40 0.24 0.16 0.01 0.65 0.57 XXX 99000 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99001 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99002 B Device handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99024 B Postop follow-up visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99025 F Initial surgical evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99026 N In-hospital on call service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99027 N Out-of-hosp on call service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99050 B Medical services after hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99052 B Medical services at night 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99054 B Medical servcs, unusual hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99056 B Non-office medical services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99058 B Office emergency care 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63379 99070 B Special supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99071 B Patient education materials 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99075 N Medical testimony 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99078 B Group health education 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99080 B Special reports or forms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99082 C Unusual physician travel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99090 B Computer data analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99091 B Collect/review data from pt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99100 B Special anesthesia service 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99116 B Anesthesia with hypothermia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99135 B Special anesthesia procedure 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99140 B Emergency anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99141 B Sedation, iv/im or inhalant +0.80 1.95 0.39 0.05 2.80 1.24 XXX 99142 B Sedation, oral/rectal/nasal +0.60 1.00 0.31 0.04 1.64 0.95 XXX 99170 A Anogenital exam, child 1.74 1.72 0.53 0.08 3.54 2.35 000 99172 N Ocular function screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99173 N Visual acuity screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99175 A Induction of vomiting 0.00 1.38 NA 0.10 1.48 NA XXX 99183 A Hyperbaric oxygen therapy 2.33 4.86 0.73 0.14 7.33 3.20 XXX 99185 A Regional hypothermia 0.00 0.64 NA 0.04 0.68 NA XXX 99186 A Total body hypothermia 0.00 1.77 NA 0.44 2.21 NA XXX 99190 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99191 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99192 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99195 A Phlebotomy 0.00 0.44 NA 0.02 0.46 NA XXX 99199 C Special service/proc/report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99201 A Office/outpatient visit, new 0.45 0.51 0.16 0.02 0.98 0.63 XXX 99202 A Office/outpatient visit, new 0.87 0.79 0.32 0.06 1.72 1.25 XXX 99203 A Office/outpatient visit, new 1.33 1.15 0.49 0.10 2.58 1.92 XXX 99204 A Office/outpatient visit, new 1.99 1.54 0.71 0.12 3.65 2.82 XXX 99205 A Office/outpatient visit, new 2.65 1.82 0.93 0.14 4.61 3.72 XXX 99211 A Office/outpatient visit, est 0.17 0.41 0.06 0.01 0.59 0.24 XXX 99212 A Office/outpatient visit, est 0.45 0.56 0.16 0.02 1.03 0.63 XXX 99213 A Office/outpatient visit, est 0.67 0.71 0.23 0.04 1.42 0.94 XXX 99214 A Office/outpatient visit, est 1.09 1.06 0.39 0.05 2.20 1.53 XXX 99215 A Office/outpatient visit, est 1.76 1.36 0.63 0.08 3.20 2.47 XXX 99217 A Observation care discharge 1.27 NA 0.54 0.06 NA 1.87 XXX 99218 A Observation care 1.27 NA 0.44 0.06 NA 1.77 XXX 99219 A Observation care 2.13 NA 0.71 0.10 NA 2.94 XXX 99220 A Observation care 2.97 NA 1.02 0.13 NA 4.12 XXX 99221 A Initial hospital care 1.27 NA 0.45 0.06 NA 1.78 XXX 99222 A Initial hospital care 2.13 NA 0.73 0.10 NA 2.96 XXX 99223 A Initial hospital care 2.97 NA 1.03 0.12 NA 4.12 XXX 99231 A Subsequent hospital care 0.64 NA 0.23 0.02 NA 0.89 XXX 99232 A Subsequent hospital care 1.05 NA 0.37 0.04 NA 1.46 XXX 99233 A Subsequent hospital care 1.50 NA 0.53 0.06 NA 2.09 XXX 99234 A Observ/hosp same date 2.55 NA 0.99 0.13 NA 3.67 XXX 99235 A Observ/hosp same date 3.40 NA 1.29 0.16 NA 4.85 XXX 99236 A Observ/hosp same date 4.25 NA 1.58 0.20 NA 6.03 XXX 99238 A Hospital discharge day 1.27 NA 0.55 0.05 NA 1.87 XXX 99239 A Hospital discharge day 1.74 NA 0.74 0.06 NA 2.54 XXX 99241 A Office consultation 0.64 0.65 0.22 0.05 1.34 0.91 XXX 99242 A Office consultation 1.28 1.06 0.47 0.11 2.45 1.86 XXX 99243 A Office consultation 1.71 1.41 0.63 0.12 3.24 2.46 XXX 99244 A Office consultation 2.57 1.85 0.91 0.16 4.58 3.64 XXX 99245 A Office consultation 3.41 2.29 1.22 0.19 5.89 4.82 XXX 99251 A Initial inpatient consult 0.66 NA 0.25 0.05 NA 0.96 XXX 99252 A Initial inpatient consult 1.31 NA 0.51 0.10 NA 1.92 XXX 99253 A Initial inpatient consult 1.81 NA 0.68 0.11 NA 2.60 XXX 99254 A Initial inpatient consult 2.62 NA 0.98 0.13 NA 3.73 XXX 99255 A Initial inpatient consult 3.63 NA 1.34 0.18 NA 5.15 XXX 99261 A Follow-up inpatient consult 0.42 NA 0.15 0.02 NA 0.59 XXX 99262 A Follow-up inpatient consult 0.85 NA 0.31 0.04 NA 1.20 XXX 99263 A Follow-up inpatient consult 1.26 NA 0.46 0.05 NA 1.77 XXX 99271 A Confirmatory consultation 0.45 0.56 0.16 0.04 1.05 0.65 XXX 99272 A Confirmatory consultation 0.84 0.83 0.31 0.07 1.74 1.22 XXX 99273 A Confirmatory consultation 1.18 1.11 0.45 0.08 2.37 1.71 XXX 99274 A Confirmatory consultation 1.72 1.37 0.64 0.11 3.20 2.47 XXX 99275 A Confirmatory consultation 2.30 1.64 0.82 0.12 4.06 3.24 XXX 99281 A Emergency dept visit 0.33 NA 0.09 0.02 NA 0.44 XXX 99282 A Emergency dept visit 0.55 NA 0.15 0.04 NA 0.74 XXX 99283 A Emergency dept visit 1.23 NA 0.31 0.10 NA 1.64 XXX 99284 A Emergency dept visit 1.94 NA 0.48 0.14 NA 2.56 XXX 99285 A Emergency dept visit 3.04 NA 0.72 0.23 NA 3.99 XXX 99288 B Direct advanced life support 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63380 99289 A Ped crit care transport 4.77 NA 1.68 0.17 NA 6.62 XXX 99290 A Ped crit care transport addl 2.39 NA 0.83 0.08 NA 3.30 ZZZ 99291 A Critical care, first hour 3.98 2.37 1.29 0.17 6.52 5.44 XXX 99292 A Critical care, addl 30 min 1.99 0.81 0.64 0.08 2.88 2.71 ZZZ 99293 A Ped critical care, initial 15.91 NA 5.00 0.84 NA 21.75 XXX 99294 A Ped critical care, subseq 7.95 NA 2.50 0.28 NA 10.73 XXX 99295 A Neonate crit care, initial 18.38 NA 5.43 0.84 NA 24.65 XXX 99296 A Neonate critical care subseq 7.95 NA 2.57 0.28 NA 10.80 XXX 99298 A Ic for lbw infant < 1500 gm 2.73 NA 0.94 0.12 NA 3.79 XXX 99299 A Ic, lbw infant 1500-2500 gm 2.49 NA 0.96 0.12 NA 3.57 XXX 99301 A Nursing facility care 1.19 0.68 0.41 0.05 1.92 1.65 XXX 99302 A Nursing facility care 1.60 0.96 0.55 0.06 2.62 2.21 XXX 99303 A Nursing facility care 2.00 1.18 0.67 0.07 3.25 2.74 XXX 99311 A Nursing fac care, subseq 0.60 0.49 0.20 0.02 1.11 0.82 XXX 99312 A Nursing fac care, subseq 0.99 0.66 0.34 0.04 1.69 1.37 XXX 99313 A Nursing fac care, subseq 1.41 0.85 0.48 0.05 2.31 1.94 XXX 99315 A Nursing fac discharge day 1.12 0.47 0.38 0.05 1.64 1.55 XXX 99316 A Nursing fac discharge day 1.49 0.63 0.52 0.06 2.18 2.07 XXX 99321 A Rest home visit, new patient 0.71 0.35 NA 0.02 1.08 NA XXX 99322 A Rest home visit, new patient 1.00 0.47 NA 0.04 1.51 NA XXX 99323 A Rest home visit, new patient 1.27 0.56 NA 0.05 1.88 NA XXX 99331 A Rest home visit, est pat 0.60 0.32 NA 0.02 0.94 NA XXX 99332 A Rest home visit, est pat 0.80 0.39 NA 0.04 1.23 NA XXX 99333 A Rest home visit, est pat 0.99 0.47 NA 0.04 1.50 NA XXX 99341 A Home visit, new patient 1.00 0.49 NA 0.06 1.55 NA XXX 99342 A Home visit, new patient 1.51 0.68 NA 0.06 2.25 NA XXX 99343 A Home visit, new patient 2.26 0.95 NA 0.08 3.29 NA XXX 99344 A Home visit, new patient 3.01 1.20 NA 0.12 4.33 NA XXX 99345 A Home visit, new patient 3.77 1.45 NA 0.14 5.36 NA XXX 99347 A Home visit, est patient 0.76 0.41 NA 0.04 1.21 NA XXX 99348 A Home visit, est patient 1.25 0.71 NA 0.05 2.01 NA XXX 99349 A Home visit, est patient 2.01 1.05 NA 0.07 3.13 NA XXX 99350 A Home visit, est patient 3.01 1.43 NA 0.12 4.56 NA XXX 99354 A Prolonged service, office 1.76 0.74 0.61 0.07 2.57 2.44 ZZZ 99355 A Prolonged service, office 1.76 0.72 0.58 0.07 2.55 2.41 ZZZ 99356 A Prolonged service, inpatient 1.70 NA 0.62 0.07 NA 2.39 ZZZ 99357 A Prolonged service, inpatient 1.70 NA 0.64 0.07 NA 2.41 ZZZ 99358 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99359 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99360 X Physician standby services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99361 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99362 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99371 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99372 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99373 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99374 B Home health care supervision +1.09 0.70 0.43 0.05 1.84 1.57 XXX 99375 I Home health care supervision +1.72 1.56 1.56 0.07 3.35 3.35 XXX 99377 B Hospice care supervision +1.09 0.70 0.43 0.05 1.84 1.57 XXX 99378 I Hospice care supervision +1.72 1.95 1.95 0.07 3.74 3.74 XXX 99379 B Nursing fac care supervision +1.09 0.70 0.70 0.04 1.83 1.83 XXX 99380 B Nursing fac care supervision +1.72 1.00 1.00 0.06 2.78 2.78 XXX 99381 N Prev visit, new, infant +1.18 1.51 0.46 0.05 2.74 1.69 XXX 99382 N Prev visit, new, age 1-4 +1.35 1.55 0.53 0.05 2.95 1.93 XXX 99383 N Prev visit, new, age 5-11 +1.35 1.49 0.53 0.05 2.89 1.93 XXX 99384 N Prev visit, new, age 12-17 +1.52 1.56 0.60 0.06 3.14 2.18 XXX 99385 N Prev visit, new, age 18-39 +1.52 1.56 0.60 0.06 3.14 2.18 XXX 99386 N Prev visit, new, age 40-64 +1.87 1.75 0.72 0.07 3.69 2.66 XXX 99387 N Prev visit, new, 65 & over +2.05 1.88 0.79 0.07 4.00 2.91 XXX 99391 N Prev visit, est, infant +1.01 1.02 0.40 0.04 2.07 1.45 XXX 99392 N Prev visit, est, age 1-4 +1.18 1.09 0.46 0.05 2.32 1.69 XXX 99393 N Prev visit, est, age 5-11 +1.18 1.06 0.46 0.05 2.29 1.69 XXX 99394 N Prev visit, est, age 12-17 +1.35 1.14 0.53 0.05 2.54 1.93 XXX 99395 N Prev visit, est, age 18-39 +1.35 1.17 0.53 0.05 2.57 1.93 XXX 99396 N Prev visit, est, age 40-64 +1.52 1.26 0.60 0.06 2.84 2.18 XXX 99397 N Prev visit, est, 65 & over +1.70 1.37 0.66 0.06 3.13 2.42 XXX 99401 N Preventive counseling, indiv +0.48 0.63 0.19 0.01 1.12 0.68 XXX 99402 N Preventive counseling, indiv +0.97 0.87 0.38 0.02 1.86 1.37 XXX 99403 N Preventive counseling, indiv +1.45 1.09 0.57 0.04 2.58 2.06 XXX 99404 N Preventive counseling, indiv +1.94 1.33 0.75 0.05 3.32 2.74 XXX 99411 N Preventive counseling, group +0.15 0.18 0.06 0.01 0.34 0.22 XXX 99412 N Preventive counseling, group +0.25 0.25 0.10 0.01 0.51 0.36 XXX 99420 N Health risk assessment test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99429 N Unlisted preventive service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99431 A Initial care, normal newborn 1.16 NA 0.39 0.05 NA 1.60 XXX 99432 A Newborn care, not in hosp 1.25 0.91 0.41 0.07 2.23 1.73 XXX Start Printed Page 63381 99433 A Normal newborn care/hospital 0.62 NA 0.20 0.02 NA 0.84 XXX 99435 A Newborn discharge day hosp 1.49 NA 0.51 0.06 NA 2.06 XXX 99436 A Attendance, birth 1.49 NA 0.48 0.06 NA 2.03 XXX 99440 A Newborn resuscitation 2.91 NA 0.93 0.13 NA 3.97 XXX 99450 N Life/disability evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99455 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99456 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99499 C Unlisted e&m service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99500 I Home visit, prenatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99501 I Home visit, postnatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99502 I Home visit, nb care 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99503 I Home visit, resp therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99504 I Home visit mech ventilator 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99505 I Home visit, stoma care 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99506 I Home visit, im injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99507 I Home visit, cath maintain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99509 I Home visit day life activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99510 I Home visit, sing/m/fam couns 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99511 I Home visit, fecal/enema mgmt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99512 I Home visit for hemodialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99551 F Home infus, pain mgmt, iv/sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99552 F Hm infus pain mgmt, epid/ith 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99553 F Home infuse, tocolytic tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99554 F Home infus, hormone/platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99555 F Home infuse, chemotheraphy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99556 F Home infus, antibio/fung/vir 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99557 F Home infuse, anticoagulant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99558 F Home infuse, immunotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99559 F Home infus, periton dialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99560 F Home infus, entero nutrition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99561 F Home infuse, hydration tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99562 F Home infus, parent nutrition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99563 F Home admin, pentamidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99564 F Hme infus, antihemophil agnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99565 F Home infus, proteinase inhib 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99566 F Home infuse, iv therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99567 F Home infuse, sympath agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99568 F Home infus, misc drug, daily 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99569 F Home infuse, each addl tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99600 I Home visit nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99601 I Home infusion/visit, 2 hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99602 I Home infusion, each addl hr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4890 R Repair/maint cont hemo equip 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0150 R Comprehensve oral evaluation 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0240 R Intraoral occlusal film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0250 R Extraoral first film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0260 R Extraoral ea additional film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0270 R Dental bitewing single film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0272 R Dental bitewings two films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0274 R Dental bitewings four films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0277 R Vert bitewings-sev to eight 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0460 R Pulp vitality test 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0472 R Gross exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0473 R Micro exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0474 R Micro w exam of surg margins 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0480 R Cytopath smear prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0502 R Other oral pathology procedu 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0999 R Unspecified diagnostic proce 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1510 R Space maintainer fxd unilat 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1515 R Fixed bilat space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1520 R Remove unilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1525 R Remove bilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1550 R Recement space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2970 R Temporary- fractured tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2999 R Dental unspec restorative pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3460 R Endodontic endosseous implan 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3999 R Endodontic procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4260 R Osseous surgery per quadrant 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4263 R Bone replce graft first site 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4264 R Bone replce graft each add 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4268 R Surgical revision procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4270 R Pedicle soft tissue graft pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4271 R Free soft tissue graft proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4273 R Subepithelial tissue graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4355 R Full mouth debridement 0.00 0.00 0.00 0.00 0.00 0.00 YYY Start Printed Page 63382 D4381 R Localized chemo delivery 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5911 R Facial moulage sectional 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5912 R Facial moulage complete 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5951 R Feeding aid 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5983 R Radiation applicator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5984 R Radiation shield 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5985 R Radiation cone locator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5987 R Commissure splint 0.00 0.00 0.00 0.00 0.00 0.00 YYY D6920 R Dental connector bar 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7111 R Coronal remnants deciduous t 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7140 R Extraction erupted tooth/exr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7210 R Rem imp tooth w mucoper flp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7220 R Impact tooth remov soft tiss 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7230 R Impact tooth remov part bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7240 R Impact tooth remov comp bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7241 R Impact tooth rem bony w/comp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7250 R Tooth root removal 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7260 R Oral antral fistula closure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7261 R Primary closure sinus perf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7291 R Transseptal fiberotomy 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7940 R Reshaping bone orthognathic 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9110 R Tx dental pain minor proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9230 R Analgesia 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9248 R Sedation (non-iv) 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9630 R Other drugs/medicaments 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9930 R Treatment of complications 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9940 R Dental occlusal guard 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9950 R Occlusion analysis 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9951 R Limited occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9952 R Complete occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0001 X Drawing blood for specimen 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0008 X Admin influenza virus vac 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0009 X Admin pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0010 X Admin hepatitis b vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0027 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 C PET imaging prev PET single 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 26 A PET imaging prev PET single 1.49 0.60 0.60 0.05 2.14 2.14 XXX G0030 TC C PET imaging prev PET single 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 C PET imaging prev PET multple 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 26 A PET imaging prev PET multple 1.86 0.72 0.72 0.07 2.65 2.65 XXX G0031 TC C PET imaging prev PET multple 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 C PET follow SPECT 78464 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 26 A PET follow SPECT 78464 singl 1.49 0.55 0.55 0.06 2.10 2.10 XXX G0032 TC C PET follow SPECT 78464 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 C PET follow SPECT 78464 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 26 A PET follow SPECT 78464 mult 1.86 0.74 0.74 0.07 2.67 2.67 XXX G0033 TC C PET follow SPECT 78464 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 C PET follow SPECT 76865 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 26 A PET follow SPECT 76865 singl 1.49 0.58 0.58 0.06 2.13 2.13 XXX G0034 TC C PET follow SPECT 76865 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 C PET follow SPECT 78465 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 26 A PET follow SPECT 78465 mult 1.86 0.73 0.73 0.07 2.66 2.66 XXX G0035 TC C PET follow SPECT 78465 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 C PET follow cornry angio sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 26 A PET follow cornry angio sing 1.49 0.57 0.57 0.05 2.11 2.11 XXX G0036 TC C PET follow cornry angio sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 C PET follow cornry angio mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 26 A PET follow cornry angio mult 1.86 0.71 0.71 0.07 2.64 2.64 XXX G0037 TC C PET follow cornry angio mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 C PET follow myocard perf sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 26 A PET follow myocard perf sing 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0038 TC C PET follow myocard perf sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 C PET follow myocard perf mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 26 A PET follow myocard perf mult 1.86 0.72 0.72 0.08 2.66 2.66 XXX G0039 TC C PET follow myocard perf mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 C PET follow stress echo singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 26 A PET follow stress echo singl 1.49 0.61 0.61 0.05 2.15 2.15 XXX G0040 TC C PET follow stress echo singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 C PET follow stress echo mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 26 A PET follow stress echo mult 1.86 0.74 0.74 0.06 2.66 2.66 XXX G0041 TC C PET follow stress echo mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 C PET follow ventriculogm sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 26 A PET follow ventriculogm sing 1.49 0.62 0.62 0.05 2.16 2.16 XXX G0042 TC C PET follow ventriculogm sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0043 C PET follow ventriculogm mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63383 G0043 26 A PET follow ventriculogm mult 1.86 0.75 0.75 0.07 2.68 2.68 XXX G0043 TC C PET follow ventriculogm mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 C PET following rest ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 26 A PET following rest ECG singl 1.49 0.60 0.60 0.05 2.14 2.14 XXX G0044 TC C PET following rest ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 C PET following rest ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 26 A PET following rest ECG mult 1.86 0.73 0.73 0.07 2.66 2.66 XXX G0045 TC C PET following rest ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 C PET follow stress ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 26 A PET follow stress ECG singl 1.49 0.60 0.60 0.05 2.14 2.14 XXX G0046 TC C PET follow stress ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 C PET follow stress ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 26 A PET follow stress ECG mult 1.86 0.74 0.74 0.07 2.67 2.67 XXX G0047 TC C PET follow stress ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0101 A CA screen;pelvic/breast exam 0.45 0.54 0.17 0.01 1.00 0.63 XXX G0102 A Prostate ca screening; dre 0.17 0.41 0.06 0.01 0.59 0.24 XXX G0103 X Psa, total screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0104 A CA screen;flexi sigmoidscope 0.95 2.24 0.53 0.06 3.25 1.54 000 G0105 A Colorectal scrn; hi risk ind 3.68 6.13 1.60 0.24 10.05 5.52 000 G0105 53 A Colorectal scrn; hi risk ind 0.95 2.24 0.53 0.06 3.25 1.54 000 G0106 A Colon CA screen;barium enema 0.98 2.54 NA 0.18 3.70 NA XXX G0106 26 A Colon CA screen;barium enema 0.98 0.33 0.33 0.05 1.36 1.36 XXX G0106 TC A Colon CA screen;barium enema 0.00 2.21 NA 0.13 2.34 NA XXX G0107 X CA screen; fecal blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0108 A Diab manage trn per indiv 0.00 0.82 NA 0.01 0.83 NA XXX G0109 A Diab manage trn ind/group 0.00 0.48 NA 0.01 0.49 NA XXX G0110 D Nett pulm-rehab educ; ind 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0111 D Nett pulm-rehab educ; group 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0112 D Nett;nutrition guid, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0113 D Nett;nutrition guid,subseqnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0114 D Nett; psychosocial consult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0115 D Nett; psychological testing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0116 D Nett; psychosocial counsel 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0117 T Glaucoma scrn hgh risk direc 0.45 0.71 0.19 0.02 1.18 0.66 XXX G0118 T Glaucoma scrn hgh risk direc 0.17 0.53 0.07 0.01 0.71 0.25 XXX G0120 A Colon ca scrn; barium enema 0.98 2.54 NA 0.18 3.70 NA XXX G0120 26 A Colon ca scrn; barium enema 0.98 0.33 0.33 0.05 1.36 1.36 XXX G0120 TC A Colon ca scrn; barium enema 0.00 2.21 NA 0.13 2.34 NA XXX G0121 A Colon ca scrn not hi rsk ind 3.68 6.13 1.60 0.24 10.05 5.52 000 G0121 53 A Colon ca scrn not hi rsk ind 0.95 2.24 0.53 0.06 3.25 1.54 000 G0122 N Colon ca scrn; barium enema +0.98 2.59 2.59 0.18 3.75 3.75 XXX G0122 26 N Colon ca scrn; barium enema +0.98 0.39 0.39 0.05 1.42 1.42 XXX G0122 TC N Colon ca scrn; barium enema +0.00 2.20 2.20 0.13 2.33 2.33 XXX G0123 X Screen cerv/vag thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0124 A Screen c/v thin layer by MD 0.42 0.18 0.18 0.01 0.61 0.61 XXX G0125 C PET image pulmonary nodule 0.00 0.00 NA 0.00 0.00 NA XXX G0125 26 A PET image pulmonary nodule 1.49 0.54 0.54 0.06 2.09 2.09 XXX G0125 TC C PET image pulmonary nodule 0.00 0.00 NA 0.00 0.00 NA XXX G0127 R Trim nail(s) 0.17 0.26 0.07 0.01 0.44 0.25 000 G0128 R CORF skilled nursing service 0.08 0.03 0.03 0.01 0.12 0.12 XXX G0130 A Single energy x-ray study 0.22 0.86 NA 0.06 1.14 NA XXX G0130 26 A Single energy x-ray study 0.22 0.07 0.07 0.01 0.30 0.30 XXX G0130 TC A Single energy x-ray study 0.00 0.79 NA 0.05 0.84 NA XXX G0141 A Scr c/v cyto,autosys and md 0.42 0.18 0.18 0.01 0.61 0.61 XXX G0143 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0144 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0145 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0147 X Scr c/v cyto, automated sys 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0148 X Scr c/v cyto, autosys, rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0166 A Extrnl counterpulse, per tx 0.07 3.67 0.03 0.01 3.75 0.11 XXX G0167 D Hyperbaric oz tx;no md reqrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0168 A Wound closure by adhesive 0.45 1.96 0.16 0.01 2.42 0.62 000 G0173 X Stereo radoisurgery,complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0175 X OPPS Service,sched team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0176 X OPPS/PHP;activity therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0177 X OPPS/PHP; train & educ serv 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0179 A MD recertification HHA PT 0.45 1.09 NA 0.01 1.55 NA XXX G0180 A MD certification HHA patient 0.67 1.33 NA 0.02 2.02 NA XXX G0181 A Home health care supervision 1.72 1.56 NA 0.07 3.35 NA XXX G0182 A Hospice care supervision 1.72 1.76 NA 0.07 3.55 NA XXX G0186 C Dstry eye lesn,fdr vssl tech 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0202 A Screeningmammographydigital 0.70 2.75 NA 0.11 3.56 NA XXX G0202 26 A Screeningmammographydigital 0.70 0.23 0.23 0.04 0.97 0.97 XXX G0202 TC A Screeningmammographydigital 0.00 2.52 NA 0.07 2.59 NA XXX G0204 A Diagnosticmammographydigital 0.87 2.77 NA 0.12 3.76 NA XXX Start Printed Page 63384 G0204 26 A Diagnosticmammographydigital 0.87 0.29 0.29 0.05 1.21 1.21 XXX G0204 TC A Diagnosticmammographydigital 0.00 2.48 NA 0.07 2.55 NA XXX G0206 A Diagnosticmammographydigital 0.70 2.23 NA 0.11 3.04 NA XXX G0206 26 A Diagnosticmammographydigital 0.70 0.23 0.23 0.05 0.98 0.98 XXX G0206 TC A Diagnosticmammographydigital 0.00 2.00 NA 0.06 2.06 NA XXX G0210 C PET img wholebody dxlung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0210 26 A PET img wholebody dxlung 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0210 TC C PET img wholebody dxlung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 C PET img wholbody init lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 26 A PET img wholbody init lung 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0211 TC C PET img wholbody init lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 C PET img wholebod restag lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 26 A PET img wholebod restag lung 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0212 TC C PET img wholebod restag lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 C PET img wholbody dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 26 A PET img wholbody dx 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0213 TC C PET img wholbody dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 26 A PET img wholebod init 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0214 TC C PET img wholebod init 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 C PETimg wholebod restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 26 A PETimg wholebod restag 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0215 TC C PETimg wholebod restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 C PET img wholebod dx melanoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 26 A PET img wholebod dx melanoma 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0216 TC C PET img wholebod dx melanoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 C PET img wholebod init melan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 26 A PET img wholebod init melan 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0217 TC C PET img wholebod init melan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 C PET img wholebod restag mela 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 26 A PET img wholebod restag mela 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0218 TC C PET img wholebod restag mela 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 N PET img wholbod melano nonco 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 26 N PET img wholbod melano nonco 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 TC N PET img wholbod melano nonco 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 C PET img wholebod dx lymphoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 26 A PET img wholebod dx lymphoma 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0220 TC C PET img wholebod dx lymphoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 C PET imag wholbod init lympho 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 26 A PET imag wholbod init lympho 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0221 TC C PET imag wholbod init lympho 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 C PET imag wholbod resta lymph 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 26 A PET imag wholbod resta lymph 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0222 TC C PET imag wholbod resta lymph 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 C PET imag wholbod reg dx head 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 26 A PET imag wholbod reg dx head 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0223 TC C PET imag wholbod reg dx head 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 C PET imag wholbod reg ini hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 26 A PET imag wholbod reg ini hea 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0224 TC C PET imag wholbod reg ini hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0225 C PET whol restag headneckonly 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0225 26 A PET whol restag headneckonly 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0225 TC C PET whol restag headneckonly 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 C PET img wholbody dx esophagl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 26 A PET img wholbody dx esophagl 1.49 0.54 0.54 0.05 2.08 2.08 XXX G0226 TC C PET img wholbody dx esophagl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 C PET img wholbod ini esophage 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 26 A PET img wholbod ini esophage 1.49 0.54 0.54 0.05 2.08 2.08 XXX G0227 TC C PET img wholbod ini esophage 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 C PET img wholbod restg esopha 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 26 A PET img wholbod restg esopha 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0228 TC C PET img wholbod restg esopha 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 C PET img metaboloc brain pres 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 26 A PET img metaboloc brain pres 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0229 TC C PET img metaboloc brain pres 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0230 C PET myocard viability post 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0230 26 A PET myocard viability post 1.49 0.55 0.55 0.05 2.09 2.09 XXX G0230 TC C PET myocard viability post 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 C PET WhBD colorec; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 26 A PET WhBD colorec; gamma cam 1.49 0.52 0.52 0.05 2.06 2.06 XXX G0231 TC C PET WhBD colorec; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 C PET whbd lymphoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 26 A PET whbd lymphoma; gamma cam 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0232 TC C PET whbd lymphoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0233 C PET whbd melanoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 63385 G0233 26 A PET whbd melanoma; gamma cam 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0233 TC C PET whbd melanoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 C PET WhBD pulm nod; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 26 A PET WhBD pulm nod; gamma cam 1.49 0.53 0.53 0.05 2.07 2.07 XXX G0234 TC C PET WhBD pulm nod; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0236 F Digital film convert diag ma +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ G0236 26 F Digital film convert diag ma +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ G0236 TC F Digital film convert diag ma +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ G0237 A Therapeutic procd strg endur 0.00 0.47 NA 0.02 0.49 NA XXX G0238 C Oth resp proc, indiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0239 C Oth resp proc, group 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0242 X Multisource photon ster plan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0243 X Multisour photon stero treat 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0244 E Observ care by facility topt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0245 R Initial foot exam pt lops 0.87 0.79 0.32 0.06 1.72 1.25 XXX G0246 R Followup eval of foot pt lop 0.45 0.56 0.16 0.02 1.03 0.63 XXX G0247 R Routine footcare pt w lops 0.50 0.52 0.21 0.06 1.08 0.77 ZZZ G0248 R Demonstrate use home inr mon 0.00 6.84 NA 0.01 6.85 NA XXX G0249 R Provide test material,equipm 0.00 3.97 NA 0.01 3.98 NA XXX G0250 R MD review interpret of test 0.18 0.06 0.06 0.01 0.25 0.25 XXX G0251 E Linear acc based stero radio 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0252 N PET imaging initial dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0252 26 N PET imaging initial dx +1.50 0.60 0.60 0.04 2.14 2.14 XXX G0252 TC N PET imaging initial dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0253 C PET image brst dection recur 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0253 26 A PET image brst dection recur 1.86 0.71 0.71 0.08 2.65 2.65 XXX G0253 TC C PET image brst dection recur 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0254 C PET image brst eval to tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0254 26 A PET image brst eval to tx 1.86 0.71 0.71 0.08 2.65 2.65 XXX G0254 TC C PET image brst eval to tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 N Current percep threshold tst 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 26 N Current percep threshold tst 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 TC N Current percep threshold tst 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0256 E Prostate brachy w palladium 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0257 E Unsched dialysis ESRD pt hos 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0258 E IV infusion during obs stay 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0259 E Inject for sacroiliac joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0260 E Inj for sacroiliac jt anesth 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0261 E Prostate brachy w iodine see 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0262 D Sm intestinal image capsule 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0262 26 D Sm intestinal image capsule 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0262 TC D Sm intestinal image capsule 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0263 E Adm with CHF, CP, asthma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0264 E Assmt otr CHF, CP, asthma 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0265 X Cryopresevation Freeze+stora 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0266 X Thawing + expansion froz cel 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0267 X Bone marrow or psc harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0268 A Removal of impacted wax md 0.61 0.64 0.25 0.05 1.30 0.91 000 G0269 B Occlusive device in vein art 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0270 A MNT subs tx for change dx 0.00 0.47 NA 0.01 0.48 NA XXX G0271 A Group MNT 2 or more 30 mins 0.00 0.18 NA 0.01 0.19 NA XXX G0272 D Naso/oro gastric tube pl MD 0.00 0.00 0.00 0.00 0.00 0.00 000 G0273 D Pretx planning, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0273 26 D Pretx planning, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0273 TC D Pretx planning, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0274 D Radiopharm tx, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0274 26 D Radiopharm tx, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0274 TC D Radiopharm tx, non-Hodgkins 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0275 A Renal angio, cardiac cath 0.25 NA 0.10 0.01 NA 0.36 ZZZ G0278 A Iliac art angio,cardiac cath 0.25 NA 0.10 0.01 NA 0.36 ZZZ G0279 C Excorp shock tx, elbow epi 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0280 C Excorp shock tx other than 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0281 A Elec stim unattend for press 0.18 0.11 NA 0.01 0.30 NA XXX G0282 N Elect stim wound care not pd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0283 A Elec stim other than wound 0.18 0.11 NA 0.01 0.30 NA XXX G0288 A Recon, CTA for surg plan 0.00 10.53 NA 0.18 10.71 NA XXX G0289 A Arthro, loose body + chondro 1.47 NA 0.57 0.32 NA 2.36 ZZZ G0290 E Drug-eluting stents, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0291 E Drug-eluting stents,each add 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0292 E Adm exp drugs,clinical trial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0293 E Non-cov surg proc,clin trial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0294 E Non-cov proc, clinical trial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0295 N Electromagnetic therapy onc 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0296 C PET imge restag thyrod cance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0296 26 A PET imge restag thyrod cance 1.86 0.71 0.71 0.08 2.65 2.65 XXX Start Printed Page 63386 G0296 TC C PET imge restag thyrod cance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0297 X Insert single chamber/cd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0298 X Insert dual chamber/cd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0299 X Inser/repos single icd+leads 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0300 X Insert reposit lead dual+gen 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0302 X Pre-op service LVRS complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0303 X Pre-op service LVRS 10-15dos 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0304 X Pre-op service LVRS 1-9 dos 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0305 X Post op service LVRS min 6 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0306 X CBC/diffwbc w/o platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0307 X CBC without platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0308 A ESRD related svc 4+mo<2yrs 12.69 8.58 8.58 0.42 21.69 21.69 XXX G0309 A ESRD related svc 2-3mo<2yrs 10.57 7.13 7.13 0.36 18.06 18.06 XXX G0310 A ESRD related svc 1 visit<2yr 8.45 5.72 5.72 0.28 14.45 14.45 XXX G0311 A ESRD related svs 4+mo 2-11yr 9.68 4.74 4.74 0.34 14.76 14.76 XXX G0312 A ESRD relate svs 2-3 mo 2-11y 8.07 3.94 3.94 0.29 12.30 12.30 XXX G0313 A ESRD related svs 1 mon 2-11y 6.46 3.16 3.16 0.22 9.84 9.84 XXX G0314 A ESRD related svs 4+ mo 12-19 8.24 4.45 4.45 0.26 12.95 12.95 XXX G0315 A ESRD related svs 2-3mo 12-19 6.87 3.69 3.69 0.23 10.79 10.79 XXX G0316 A ESRD relate svs 1 vist 12-19 5.50 2.96 2.96 0.17 8.63 8.63 XXX G0317 A ESRD related svs 4+mo 20+yrs 5.07 2.88 2.88 0.17 8.12 8.12 XXX G0318 A ESRD related svs 2-3 mo 20+y 4.23 2.39 2.39 0.14 6.76 6.76 XXX G0319 A ESRD related svs 1 visit 20+ 3.38 1.92 1.92 0.11 5.41 5.41 XXX G0320 A ESRD related svs home under2 10.57 7.13 7.13 0.36 18.06 18.06 XXX G0321 A ESRD related svs home mo<2ys 6.87 3.69 3.69 0.23 10.79 10.79 XXX G0322 A ESRD relate svs home mo12-19 8.07 3.94 3.94 0.29 12.30 12.30 XXX G0323 A ESRD related svs home mo 20+ 4.23 2.39 2.39 0.14 6.76 6.76 XXX G0324 A ESRD related svs home/dy<2y 0.35 0.24 0.24 0.01 0.60 0.60 XXX G0325 A ESRD relate home/dy 2-11 yr 0.23 0.12 0.12 0.01 0.36 0.36 XXX G0326 A ESRD relate home/dy 12-19y 0.27 0.13 0.13 0.01 0.41 0.41 XXX G0327 A ESRD relate home/dy 20+yrs 0.14 0.08 0.08 0.01 0.23 0.23 XXX G3001 X Admin + supply, tositumomab 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9001 X MCCD, initial rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9002 X MCCD,maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9003 X MCCD, risk adj hi, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9004 X MCCD, risk adj lo, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9005 X MCCD, risk adj, maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9006 X MCCD, Home monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9007 X MCCD, sch team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9008 X Mccd,phys coor-care ovrsght 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9009 X MCCD, risk adj, level 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9010 X MCCD, risk adj, level 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9011 X MCCD, risk adj, level 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9012 X Other Specified Case Mgmt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9016 N Demo-smoking cessation coun 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0064 A Visit for drug monitoring 0.37 0.35 0.12 0.01 0.73 0.50 XXX P3001 A Screening pap smear by phys 0.42 0.18 0.18 0.01 0.61 0.61 XXX Q0035 A Cardiokymography 0.17 0.46 NA 0.03 0.66 NA XXX Q0035 26 A Cardiokymography 0.17 0.07 0.07 0.01 0.25 0.25 XXX Q0035 TC A Cardiokymography 0.00 0.39 NA 0.02 0.41 NA XXX Q0091 A Obtaining screen pap smear 0.37 0.67 0.14 0.01 1.05 0.52 XXX Q0092 A Set up port xray equipment 0.00 0.32 NA 0.01 0.33 NA XXX Q3014 X Telehealth facility fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0076 B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 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 63389Addendum C.—Codes With Interim RVUs
CPT 1/HCPCS 2 MOD Status Description Physician work RVUs3 Non-facility PE RVUs Facility PE RVUs Malpractice RVUs Non-facility total Facility total Global 11400 A Exc tr-ext b9+marg 0.5 < cm 0.85 2.04 0.90 0.07 2.96 1.82 010 11401 A Exc tr-ext b9+marg 0.6-1 cm 1.22 2.10 1.04 0.11 3.43 2.37 010 11402 A Exc tr-ext b9+marg 1.1-2 cm 1.50 2.27 1.10 0.14 3.91 2.74 010 11403 A Exc tr-ext b9+marg 2.1-3 cm 1.78 2.45 1.35 0.19 4.42 3.32 010 11404 A Exc tr-ext b9+marg 3.1-4 cm 2.05 2.77 1.43 0.22 5.04 3.70 010 11406 A Exc tr-ext b9+marg > 4.0 cm 2.74 3.14 1.69 0.30 6.18 4.73 010 Start Printed Page 63387 11420 A Exc h-f-nk-sp b9+marg 0.5 < 0.97 1.80 0.94 0.10 2.87 2.01 010 11421 A Exc h-f-nk-sp b9+marg 0.6-1 1.41 2.10 1.13 0.13 3.64 2.67 010 11422 A Exc h-f-nk-sp b9+marg 1.1-2 1.62 2.30 1.36 0.17 4.09 3.15 010 11423 A Exc h-f-nk-sp b9+marg 2.1-3 2.00 2.64 1.48 0.20 4.84 3.68 010 11424 A Exc h-f-nk-sp b9+marg 3.1-4 2.42 2.86 1.63 0.25 5.53 4.30 010 11426 A Exc h-f-nk-sp b9+marg > 4 cm 3.76 3.57 2.13 0.41 7.74 6.30 010 11440 A Exc face-mm b9+marg 0.5 < cm 1.05 2.31 1.35 0.10 3.46 2.50 010 11441 A Exc face-mm b9+marg 0.6-1 cm 1.47 2.42 1.53 0.13 4.02 3.13 010 11442 A Exc face-mm b9+marg 1.1-2 cm 1.71 2.62 1.60 0.17 4.50 3.48 010 11443 A Exc face-mm b9+marg 2.1-3 cm 2.28 3.01 1.85 0.22 5.51 4.35 010 11444 A Exc face-mm b9+marg 3.1-4 cm 3.12 3.58 2.21 0.30 7.00 5.63 010 11446 A Exc face-mm b9+marg > 4 cm 4.46 4.16 2.82 0.36 8.98 7.64 010 11600 A Exc tr-ext mlg+marg 0.5 < cm 1.30 2.70 0.99 0.11 4.11 2.40 010 11601 A Exc tr-ext mlg+marg 0.6-1 cm 1.79 2.76 1.24 0.14 4.69 3.17 010 11602 A Exc tr-ext mlg+marg 1.1-2 cm 1.94 2.90 1.29 0.16 5.00 3.39 010 11603 A Exc tr-ext mlg+marg 2.1-3 cm 2.18 3.15 1.35 0.19 5.52 3.72 010 11604 A Exc tr-ext mlg+marg 3.1-4 cm 2.39 3.46 1.42 0.22 6.07 4.03 010 11606 A Exc tr-ext mlg+marg > 4 cm 3.41 4.16 1.77 0.34 7.91 5.52 010 11620 A Exc h-f-nk-sp mlg+marg 0.5 < 1.18 2.66 0.97 0.11 3.95 2.26 010 11621 A Exc h-f-nk-sp mlg+marg 0.6-1 1.75 2.77 1.26 0.14 4.66 3.15 010 11622 A Exc h-f-nk-sp mlg+marg 1.1-2 2.08 3.04 1.41 0.18 5.30 3.67 010 11623 A Exc h-f-nk-sp mlg+marg 2.1-3 2.60 3.41 1.61 0.24 6.25 4.45 010 11624 A Exc h-f-nk-sp mlg+marg 3.1-4 3.04 3.83 1.80 0.30 7.17 5.14 010 11626 A Exc h-f-nk-sp mlg+mar > 4 cm 4.28 4.74 2.43 0.42 9.44 7.13 010 11640 A Exc face-mm malig+marg 0.5 < 1.34 2.73 1.13 0.12 4.19 2.59 010 11641 A Exc face-mm malig+marg 0.6-1 2.15 3.10 1.55 0.18 5.43 3.88 010 11642 A Exc face-mm malig+marg 1.1-2 2.58 3.48 1.75 0.22 6.28 4.55 010 11643 A Exc face-mm malig+marg 2.1-3 3.08 3.89 1.98 0.29 7.26 5.35 010 11644 A Exc face-mm malig+marg 3.1-4 4.01 4.79 2.49 0.40 9.20 6.90 010 11646 A Exc face-mm mlg+marg > 4 cm 5.92 5.87 3.53 0.55 12.34 10.00 010 20982 A Ablate, bone tumor(s) perq 7.24 106.25 3.02 0.68 114.17 10.94 000 21030 A Excise max/zygoma b9 tumor 3.87 6.57 4.05 0.72 11.16 8.64 090 21040 A Excise mandible lesion 3.87 6.61 3.88 0.23 10.71 7.98 090 21685 A Hyoid myotomy & suspension 12.93 NA 10.21 1.51 NA 24.65 090 21742 C Repair stern/nuss w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 090 21743 C Repair sternum/nuss w/scope 0.00 0.00 0.00 0.00 0.00 0.00 090 22532 A Lat thorax spine fusion 23.86 NA 14.92 4.53 NA 43.31 090 22533 A Lat lumbar spine fusion 22.99 NA 13.60 3.81 NA 40.40 090 22534 A Lat thor/lumb, addl seg 5.97 NA 3.08 1.17 NA 10.22 ZZZ 31622 A Dx bronchoscope/wash 2.76 4.20 0.89 0.17 7.13 3.82 000 31623 A Dx bronchoscope/brush 2.86 5.09 0.90 0.17 8.12 3.93 000 31624 A Dx bronchoscope/lavage 2.86 4.32 0.90 0.16 7.34 3.92 000 31625 A Bronchoscopy w/biopsy(s) 3.35 5.41 1.27 0.19 8.95 4.81 000 31628 A Bronchoscopy/lung bx, each 3.79 5.62 1.36 0.17 9.58 5.32 000 31629 A Bronchoscopy/needle bx, each 3.35 NA 1.24 0.16 NA 4.75 000 31630 A Bronchoscopy dilate/fx repr 3.80 NA 1.98 0.36 NA 6.14 000 31631 A Bronchoscopy, dilate w/stent 4.35 NA 2.01 0.37 NA 6.73 000 31632 A Bronchoscopy/lung bx, addl 1.02 0.76 0.32 0.17 1.95 1.51 ZZZ 31633 A Bronchoscopy/needle bx addl 1.31 0.92 0.41 0.17 2.40 1.89 ZZZ 31635 A Bronchoscopy w/fb removal 3.66 NA 1.68 0.25 NA 5.59 000 31640 A Bronchoscopy w/tumor excise 4.91 NA 2.33 0.44 NA 7.68 000 33310 A Exploratory heart surgery 18.40 NA 9.27 2.71 NA 30.38 090 33315 A Exploratory heart surgery 22.24 NA 10.53 3.48 NA 36.25 090 34805 A Endovasc abdo repair w/pros 21.76 NA 9.51 1.98 NA 33.25 090 35510 A Artery bypass graft 22.87 NA 10.22 2.09 NA 35.18 090 35512 A Artery bypass graft 22.37 NA 10.05 2.09 NA 34.51 090 35522 A Artery bypass graft 21.64 NA 9.79 2.09 NA 33.52 090 35525 A Artery bypass graft 20.51 NA 9.41 2.09 NA 32.01 090 35697 A Reimplant artery each 2.98 NA 1.03 0.41 NA 4.42 ZZZ 36511 A Apheresis wbc 1.73 NA 0.69 0.07 NA 2.49 000 36512 A Apheresis rbc 1.73 NA 0.69 0.07 NA 2.49 000 36513 A Apheresis platelets 1.73 NA 0.69 0.07 NA 2.49 000 36514 A Apheresis plasma 1.73 NA 0.69 0.07 NA 2.49 000 36515 A Apheresis, adsorp/reinfuse 1.73 NA 0.73 0.07 NA 2.53 000 36516 A Apheresis, selective 1.73 NA 0.73 0.07 NA 2.53 000 36555 A Insert non-tunnel cv cath 2.66 6.06 0.82 0.20 8.92 3.68 000 36556 A Insert non-tunnel cv cath 2.49 5.06 0.75 0.10 7.65 3.34 000 36557 A Insert tunneled cv cath 5.07 13.64 2.59 0.59 19.30 8.25 010 36558 A Insert tunneled cv cath 4.77 13.54 2.48 0.59 18.90 7.84 010 36560 A Insert tunneled cv cath 6.21 29.38 2.98 0.59 36.18 9.78 010 36561 A Insert tunneled cv cath 5.97 29.29 2.89 0.59 35.85 9.45 010 36563 A Insert tunneled cv cath 6.16 26.75 2.99 0.67 33.58 9.82 010 36565 A Insert tunneled cv cath 5.97 22.30 2.89 0.59 28.86 9.45 010 36566 A Insert tunneled cv cath 6.46 23.11 3.06 0.59 30.16 10.11 010 36568 A Insert tunneled cv cath 1.91 8.29 0.60 0.20 10.40 2.71 000 Start Printed Page 63388 36569 A Insert tunneled cv cath 1.81 6.77 0.58 0.16 8.74 2.55 000 36570 A Insert tunneled cv cath 5.29 40.53 2.66 0.59 46.41 8.54 010 36571 A Insert tunneled cv cath 5.27 35.86 2.65 0.59 41.72 8.51 010 36575 A Repair tunneled cv cath 0.67 3.35 0.26 0.59 4.61 1.52 000 36576 A Repair tunneled cv cath 3.17 7.73 1.77 0.59 11.49 5.53 010 36578 A Replace tunneled cv cath 3.48 10.57 2.21 0.59 14.64 6.28 010 36580 A Replace tunneled cv cath 1.30 5.88 0.42 0.16 7.34 1.88 000 36581 A Replace tunneled cv cath 3.42 13.30 1.85 0.59 17.31 5.86 010 36582 A Replace tunneled cv cath 5.17 26.69 2.78 0.59 32.45 8.54 010 36583 A Replace tunneled cv cath 5.22 13.17 2.80 0.59 18.98 8.61 010 36584 A Replace tunneled cv cath 1.19 6.33 0.56 0.16 7.68 1.91 000 36585 A Replace tunneled cv cath 4.77 35.52 2.65 0.59 40.88 8.01 010 36589 A Removal tunneled cv cath 2.26 2.13 1.42 0.25 4.64 3.93 010 36590 A Removal tunneled cv cath 3.28 6.34 1.64 0.41 10.03 5.33 010 36595 A Mech remov tunneled cv cath 3.58 18.94 1.47 0.28 22.80 5.33 000 36596 A Mech remov tunneled cv cath 0.75 4.43 0.50 0.05 5.23 1.30 000 36597 A Reposition venous catheter 1.20 3.18 0.44 0.07 4.45 1.71 000 36838 A Dist revas ligation, hemo 20.51 NA 9.41 2.97 NA 32.89 090 37765 A Phleb veins—extrem—to 20 7.31 NA 4.56 0.48 NA 12.35 090 37766 A Phleb veins—extrem 20+ 9.25 NA 5.28 0.48 NA 15.01 090 37785 A Ligate/divide/excise vein 3.82 5.16 2.66 0.49 9.47 6.97 090 38207 I Cryopreserve stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38208 I Thaw preserved stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38209 I Wash harvest stem cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38210 I T-cell depletion of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38211 I Tumor cell deplete of harvst 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38212 I Rbc depletion of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38213 I Platelet deplete of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38214 I Volume deplete of harvest 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38215 I Harvest stem cell concentrte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 43235 A Uppr gi endoscopy, diagnosis 2.38 5.12 1.08 0.16 7.66 3.62 000 43237 A Endoscopic us exam, esoph 3.97 NA 1.63 0.26 NA 5.86 000 43238 A Uppr gi endoscopy w/us fn bx 5.00 NA 1.99 0.26 NA 7.25 000 43242 A Uppr gi endoscopy w/us fn bx 7.27 NA 2.82 0.35 NA 10.44 000 43259 A Endoscopic ultrasound exam 5.17 NA 2.06 0.26 NA 7.49 000 43752 A Nasal/orogastric w/stent 0.68 0.26 0.26 0.02 0.96 0.96 000 47133 X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47140 A Partial removal, donor liver 54.69 NA 22.98 4.77 NA 82.44 090 47141 A Partial removal, donor liver 67.12 NA 27.70 4.77 NA 99.59 090 47142 A Partial removal, donor liver 74.57 NA 30.29 4.77 NA 109.63 090 53500 A Urethrlys, transvag w/ scope 12.14 NA 6.27 0.89 NA 19.30 090 57425 A Laparoscopy, surg, colpopexy 15.66 NA 6.76 1.73 NA 24.15 090 58545 A Laparoscopic myomectomy 14.52 NA 7.31 1.74 NA 23.57 090 58546 A Laparo-myomectomy, complex 18.89 NA 9.12 1.74 NA 29.75 090 58550 A Laparo-asst vag hysterectomy 14.11 NA 7.44 1.73 NA 23.28 090 58552 A Laparo-vag hyst incl t/o 14.11 NA 7.42 1.73 NA 23.26 090 58553 A Laparo-vag hyst, complex 18.89 NA 9.08 1.47 NA 29.44 090 58554 A Laparo-vag hyst w/t/o, compl 18.89 NA 9.38 1.47 NA 29.74 090 59070 A Transabdom amnioinfus w/ us 5.22 5.19 2.43 0.28 10.69 7.93 000 59072 A Umbilical cord occlud w/ us 8.95 NA 3.17 0.67 NA 12.79 000 59074 A Fetal fluid drainage w/ us 5.22 4.66 2.43 0.28 10.16 7.93 000 59076 A Fetal shunt placement, w/ us 8.95 NA 3.17 0.67 NA 12.79 000 59897 C Fetal invas px w/ us 0.00 0.00 0.00 0.00 0.00 0.00 YYY 61537 A Removal of brain tissue 24.86 NA 14.63 6.45 NA 45.94 090 61538 A Removal of brain tissue 26.66 NA 15.58 6.45 NA 48.69 090 61539 A Removal of brain tissue 31.90 NA 18.07 7.93 NA 57.90 090 61540 A Removal of brain tissue 29.83 NA 17.69 7.93 NA 55.45 090 61543 A Removal of brain tissue 29.05 NA 16.65 7.32 NA 53.02 090 61566 A Removal of brain tissue 30.82 NA 17.62 6.45 NA 54.89 090 61567 A Incision of brain tissue 35.30 NA 20.98 6.45 NA 62.73 090 61863 A Implant neuroelectrode 13.84 NA 9.34 4.76 NA 27.94 090 61864 A Implant neuroelectrde, addl 4.47 NA 2.31 1.13 NA 7.91 ZZZ 61867 A Implant neuroelectrode 22.83 NA 13.98 4.76 NA 41.57 090 61868 A Implant neuroelectrde, addl 7.87 NA 4.07 1.20 NA 13.14 ZZZ 63101 A Removal of vertebral body 31.82 NA 19.57 5.66 NA 57.05 090 63102 A Removal of vertebral body 31.82 NA 19.57 5.66 NA 57.05 090 63103 A Remove vertebral body add-on 3.88 NA 2.03 0.76 NA 6.67 ZZZ 64449 A N block inj, lumbar plexus 2.98 NA 0.98 0.10 NA 4.06 010 64517 A N block inj, hypogas plxs 2.19 2.76 0.89 0.13 5.08 3.21 000 64680 A Injection treatment of nerve 2.61 6.08 1.31 0.18 8.87 4.10 010 64681 A Injection treatment of nerve 3.53 8.81 2.13 0.18 12.52 5.84 010 65780 A Ocular reconst, transplant 10.19 NA 10.04 0.35 NA 20.58 090 65781 A Ocular reconst, transplant 17.57 NA 13.45 0.35 NA 31.37 090 65782 A Ocular reconst, transplant 14.91 NA 11.79 0.35 NA 27.05 090 67912 A Correction eyelid w/ implant 5.65 20.59 5.33 0.28 26.52 11.26 090 Start Printed Page 63389 68371 A Harvest eye tissue, alograft 4.87 NA 4.66 0.20 NA 9.73 010 70557 26 A Mri brain w/o dye 2.88 0.99 0.99 0.08 3.95 3.95 XXX 70558 26 A Mri brain w/ dye 3.18 1.09 1.09 0.10 4.37 4.37 XXX 70559 26 A Mri brain w/o & w/ dye 3.18 1.09 1.09 0.12 4.39 4.39 XXX 75901 26 A Remove cva device obstruct 0.49 0.16 0.16 0.02 0.67 0.67 XXX 75902 26 A Remove cva lumen obstruct 0.39 0.13 0.13 0.02 0.54 0.54 XXX 75998 26 A Fluoroguide for vein device 0.38 0.13 0.13 0.05 0.56 0.56 ZZZ 76082 26 A Computer mammogram add-on 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76083 26 A Computer mammogram add-on 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76514 26 A Echo exam of eye, thickness 0.17 0.08 0.08 0.01 0.26 0.26 XXX 76937 26 A Us guide, vascular access 0.30 0.10 0.10 0.05 0.45 0.45 ZZZ 78800 26 A Tumor imaging, limited area 0.66 0.22 0.22 0.04 0.92 0.92 XXX 78801 26 A Tumor imaging, mult areas 0.79 0.27 0.27 0.04 1.10 1.10 XXX 78802 26 A Tumor imaging, whole body 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78803 26 A Tumor imaging (3D) 1.08 0.39 0.39 0.05 1.52 1.52 XXX 78804 26 A Tumor imaging, whole body 1.06 0.38 0.38 0.04 1.48 1.48 XXX 79100 26 A Hematopoetic nuclear therapy 1.31 0.47 0.47 0.06 1.84 1.84 XXX 79400 26 A Nonhemato nuclear therapy 1.95 0.67 0.67 0.10 2.72 2.72 XXX 79403 26 A Hematopoetic nuclear therapy 2.24 0.91 0.91 0.10 3.25 3.25 XXX 85396 A Clotting assay, whole blood 0.37 NA 0.17 0.04 NA 0.58 XXX 88112 26 A Cytopath, cell enhance tech 1.17 0.53 0.53 0.06 1.76 1.76 XXX 88342 26 A Immunohistochemistry 0.85 0.38 0.38 0.04 1.27 1.27 XXX 88358 26 A Analysis, tumor 2.80 1.24 1.24 0.12 4.16 4.16 XXX 88361 26 A Immunohistochemistry, tumor 0.93 0.42 0.42 0.12 1.47 1.47 XXX 91110 26 A Gi tract capsule endoscopy 3.63 1.31 1.31 0.02 4.96 4.96 XXX 93784 A Ambulatory BP monitoring 0.17 0.97 0.97 0.02 1.16 1.16 XXX 93786 A Ambulatory BP recording 0.00 0.90 NA 0.01 0.91 NA XXX 93788 A Ambulatory BP analysis 0.00 0.51 NA 0.01 0.52 NA XXX 93790 A Review/report BP recording 0.17 0.06 0.06 0.01 0.24 0.24 XXX 95990 A Spin/brain pump refil & main 0.00 1.49 NA 0.06 1.55 NA XXX 95991 A Spin/brain pump refil & main 0.77 1.49 0.19 0.06 2.32 1.02 XXX 96110 A Developmental test, lim 0.00 0.18 NA 0.18 0.36 NA XXX 96111 A Developmental test, extend 2.59 1.07 NA 0.18 3.84 NA XXX 97537 A Community/work reintegration 0.45 0.27 NA 0.01 0.73 NA XXX 97755 A Assistive technology assess 0.62 0.29 NA 0.02 0.93 NA XXX G0308 A ESRD related svc 4+mo<2yrs 12.69 8.58 8.58 0.42 21.69 21.69 XXX G0309 A ESRD related svc 2-3mo<2yrs 10.57 7.13 7.13 0.36 18.06 18.06 XXX G0310 A ESRD related svc 1 visit<2yr 8.45 5.72 5.72 0.28 14.45 14.45 XXX G0311 A ESRD related svs 4+mo 2-11yr 9.68 4.74 4.74 0.34 14.76 14.76 XXX G0312 A ESRD relate svs 2-3 mo 2-11y 8.07 3.94 3.94 0.29 12.30 12.30 XXX G0313 A ESRD related svs 1 mon 2-11y 6.46 3.16 3.16 0.22 9.84 9.84 XXX G0314 A ESRD related svs 4+ mo 12-19 8.24 4.45 4.45 0.26 12.95 12.95 XXX G0315 A ESRD related svs 2-3mo 12-19 6.87 3.69 3.69 0.23 10.79 10.79 XXX G0316 A ESRD relate svs 1 vist 12-19 5.50 2.96 2.96 0.17 8.63 8.63 XXX G0317 A ESRD related svs 4+mo 20+yrs 5.07 2.88 2.88 0.17 8.12 8.12 XXX G0318 A ESRD related svs 2-3 mo 20+y 4.23 2.39 2.39 0.14 6.76 6.76 XXX G0319 A ESRD related svs 1 visit 20+ 3.38 1.92 1.92 0.11 5.41 5.41 XXX G0320 A ESRD related svs home under2 10.57 7.13 7.13 0.36 18.06 18.06 XXX G0321 A ESRD related svs home mo<2ys 6.87 3.69 3.69 0.23 10.79 10.79 XXX G0322 A ESRD relate svs home mo12-19 8.07 3.94 3.94 0.29 12.30 12.30 XXX G0323 A ESRD related svs home mo 20+ 4.23 2.39 2.39 0.14 6.76 6.76 XXX G0324 A ESRD related svs home/dy<2y 0.35 0.24 0.24 0.01 0.60 0.60 XXX G0325 A ESRD relate home/dy 2-11 yr 0.23 0.12 0.12 0.01 0.36 0.36 XXX G0326 A ESRD relate home/dy 12-19y 0.27 0.13 0.13 0.01 0.41 0.41 XXX G0327 A ESRD relate home/dy 20+yrs 0.14 0.08 0.08 0.01 0.23 0.23 XXX 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 63391Addendum D.—2004 Geographic Practice Cost Indices by Medicare Carrier and Locality
Carrier No. Locality No. Locality name Work Practice expense Malpractice 00510 00 Alabama 0.978 0.870 0.779 00831 01 Alaska 1.064 1.172 1.126 00832 00 Arizona 0.994 0.978 1.090 00520 13 Arkansas 0.953 0.847 0.389 31146 26 Anaheim/Santa Ana, CA 1.037 1.184 0.955 31146 18 Los Angeles, CA 1.056 1.139 0.955 31140 03 Marin/Napa/Solano, CA 1.015 1.248 0.669 31140 07 Oakland/Berkeley, CA 1.041 1.235 0.669 Start Printed Page 63390 31140 05 San Francisco, CA 1.068 1.458 0.669 31140 06 San Mateo, CA 1.048 1.432 .663 31140 09 Santa Clara, CA 1.063 1.380 0.622 31146 17 Ventura, CA 1.028 1.125 0.763 31146 99 Rest of California* 1.007 1.034 0.740 31140 99 Rest of California* 1.007 1.034 0.740 00824 01 Colorado 0.985 0.992 0.821 00591 00 Connecticut 1.050 1.156 0.933 00902 01 Delaware 1.019 1.035 0.802 00903 01 DC + MD/VA Suburbs 1.050 1.166 0.917 00590 03 Fort Lauderdale, FL 0.996 1.018 1.790 00590 04 Miami, FL 1.015 1.052 2.399 00590 99 Rest of Florida 0.975 0.946 1.268 00511 01 Atlanta, GA 1.006 1.059 0.951 00511 99 Rest of Georgia 0.970 0.892 0.951 00833 01 Hawaii/Guam 0.997 1.124 0.817 05130 00 Idaho 0.960 0.881 0.478 00952 16 Chicago, IL 1.028 1.092 1.832 00952 12 East St. Louis, IL 0.988 0.924 1.720 00952 15 Suburban Chicago, IL 1.006 1.071 1.648 00952 99 Rest of Illinois 0.964 0.889 1.175 00630 00 Indiana 0.981 0.922 0.459 00826 00 Iowa 0.959 0.876 0.593 00650 00 Kansas* 0.963 0.895 0.738 00740 04 Kansas* 0.963 0.895 0.738 00660 00 Kentucky 0.970 0.866 0.875 00528 01 New Orleans, LA 0.998 0.945 1.240 00528 99 Rest of Louisiana 0.968 0.870 1.066 31142 03 Southern Maine 0.979 0.999 0.652 31142 99 Rest of Maine 0.961 0.910 0.652 00901 01 Baltimore/Surr. Cntys, MD 1.021 1.038 0.931 00901 99 Rest of Maryland 0.984 0.972 0.767 31143 01 Metropolitan Boston 1.041 1.239 0.803 31143 99 Rest of Massachusetts 1.010 1.129 0.803 00953 01 Detroit, MI 1.043 1.038 2.741 00953 99 Rest of Michigan 0.997 0.938 1.545 00954 00 Minnesota 0.990 0.974 0.431 00512 00 Mississippi 0.957 0.837 0.750 00740 02 Metropolitan Kansas City, MO 0.988 0.967 0.896 00523 01 Metropolitan St. Louis, MO 0.994 0.938 0.893 00740 99 Rest of Missouri* 0.946 0.825 0.842 00523 99 Rest of Missouri* 0.946 0.825 0.842 00751 01 Montana 0.950 0.876 0.815 00655 00 Nebraska 0.948 0.877 0.442 00834 00 Nevada 1.005 1.039 1.138 31144 40 New Hampshire 0.986 1.030 0.883 00805 01 Northern NJ 1.058 1.193 0.916 00805 99 Rest of New Jersey 1.029 1.110 0.916 00521 05 New Mexico 0.973 0.900 0.898 00803 01 Manhattan, NY 1.094 1.351 1.586 00803 02 Nyc Suburbs/Long I., NY 1.068 1.251 1.869 00803 03 Poughkpsie/N Nyc Suburbs, NY 1.011 1.075 1.221 14330 04 Queens, NY 1.058 1.228 1.791 00801 99 Rest of New York 0.998 0.944 0.720 05535 00 North Carolina 0.970 0.931 0.618 00820 01 North Dakota 0.950 0.880 0.630 00883 00 Ohio 0.988 0.944 0.967 00522 00 Oklahoma 0.968 0.876 0.413 00835 01 Portland, OR 0.996 1.049 0.438 00835 99 Rest of Oregon 0.961 0.933 0.438 00865 01 Metropolitan Philadelphia, PA 1.023 1.092 1.400 00865 99 Rest of Pennsylvania 0.989 0.929 0.790 00973 20 Puerto Rico 0.881 0.712 0.268 00870 01 Rhode Island 1.017 1.065 0.896 00880 01 South Carolina 0.974 0.904 0.336 00820 02 South Dakota 0.935 0.878 0.385 05440 35 Tennessee 0.975 0.900 0.612 Start Printed Page 63391 00900 31 Austin, TX 0.986 0.996 0.922 00900 20 Beaumont, TX 0.992 0.890 1.318 00900 09 Brazoria, TX 0.992 0.978 1.318 00900 11 Dallas, TX 1.010 1.065 0.996 00900 28 Fort Worth, TX 0.987 0.981 0.996 00900 15 Galveston, TX 0.988 0.969 1.318 00900 18 Houston, TX 1.020 1.007 1.316 00900 99 Rest of Texas 0.966 0.880 1.047 00910 09 Utah 0.976 0.941 0.653 31145 50 Vermont 0.973 0.986 0.527 00973 50 Virgin Islands 0.965 1.023 1.003 00904 00 Virginia 0.984 0.938 0.540 00836 02 Seattle (King Cnty), WA 1.005 1.100 0.803 00836 99 Rest of Washington 0.981 0.972 0.803 00884 16 West Virginia 0.963 0.850 1.462 00951 00 Wisconsin 0.981 0.929 0.865 00825 21 Wyoming 0.967 0.895 0.970 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 63392Addendum E.—2005 Geographic Practice Cost Indices by Medicare Carrier and Locality
Carrier No. Locality No. Locality name Work Practice expense Malpractice 00510 00 Alabama 0.978 0.870 0.752 00831 01 Alaska 1.064 1.172 1.029 00832 00 Arizona 0.994 0.978 1.069 00520 13 Arkansas 0.953 0.847 0.438 31146 26 Anaheim/Santa Ana, CA 1.037 1.184 0.954 31146 18 Los Angeles, CA 1.056 1.139 0.954 31140 03 Marin/Napa/Solano, CA 1.015 1.248 0.651 31140 07 Oakland/Berkeley, CA 1.041 1.235 0.651 31140 05 San Francisco, CA 1.068 1.458 0.651 31140 06 San Mateo, CA 1.048 1.432 0.639 31140 09 Santa Clara, CA 1.063 1.380 0.604 31146 17 Ventura, CA 1.028 1.125 0.744 31146 99 Rest of California* 1.007 1.034 0.733 31140 99 Rest of California* 1.007 1.034 0.733 00824 01 Colorado 0.985 0.992 0.803 00591 00 Connecticut 1.050 1.156 0.900 00902 01 Delaware 1.019 1.035 0.892 00903 01 DC + MD/VA Suburbs 1.050 1.166 0.926 00590 03 Fort Lauderdale, FL 0.996 1.018 1.703 00590 04 Miami, FL 1.015 1.052 2.269 00590 99 Rest of Florida 0.975 0.946 1.272 00511 01 Atlanta, GA 1.006 1.059 0.966 00511 99 Rest of Georgia 0.970 0.892 0.966 00833 01 Hawaii/Guam 0.997 1.124 0.800 05130 00 Idaho 0.960 0.881 0.459 00952 16 Chicago, IL 1.028 1.092 1.867 00952 12 East St. Louis, IL 0.988 0.924 1.750 00952 15 Suburban Chicago, IL 1.006 1.071 1.652 00952 99 Rest of Illinois 0.964 0.889 1.193 00630 00 Indiana 0.981 0.922 0.436 00826 00 Iowa 0.959 0.876 0.589 00650 00 Kansas* 0.963 0.895 0.721 00740 04 Kansas* 0.963 0.895 0.721 00660 00 Kentucky 0.970 0.866 0.873 00528 01 New Orleans, LA 0.998 0.945 1.197 00528 99 Rest of Louisiana 0.968 0.870 1.058 31142 03 Southern Maine 0.979 0.999 0.637 31142 99 Rest of Maine 0.961 0.910 0.637 00901 01 Baltimore/Surr. Cntys, MD 1.021 1.038 0.947 00901 99 Rest of Maryland 0.984 0.972 0.760 31143 01 Metropolitan Boston 1.041 1.239 0.823 Start Printed Page 63392 31143 99 Rest of Massachusetts 1.010 1.129 0.823 00953 01 Detroit, MI 1.043 1.038 2.744 00953 99 Rest of Michigan 0.997 0.938 1.518 00954 00 Minnesota 0.990 0.974 0.410 00512 00 Mississippi 0.957 0.837 0.722 00740 02 Metropolitan Kansas City, MO 0.988 0.967 0.946 00523 01 Metropolitan St. Louis, MO 0.994 0.938 0.941 00740 99 Rest of Missouri* 0.946 0.825 0.892 00523 99 Rest of Missouri* 0.946 0.825 0.892 00751 01 Montana 0.950 0.876 0.904 00655 00 Nebraska 0.948 0.877 0.454 00834 00 Nevada 1.005 1.039 1.068 31144 40 New Hampshire 0.986 1.030 0.942 00805 01 Northern NJ 1.058 1.193 0.973 00805 99 Rest of New Jersey 1.029 1.110 0.973 00521 05 New Mexico 0.973 0.900 0.895 00803 01 Manhattan, NY 1.094 1.351 1.504 00803 02 Nyc Suburbs/Long I., NY 1.068 1.251 1.785 00803 03 Poughkpsie/N Nyc Suburbs, NY 1.011 1.075 1.167 14330 04 Queens, NY 1.058 1.228 1.710 00801 99 Rest of New York 0.998 0.944 0.677 05535 00 North Carolina 0.970 0.931 0.640 00820 01 North Dakota 0.950 0.880 0.602 00883 00 Ohio 0.988 0.944 0.976 00522 00 Oklahoma 0.968 0.876 0.382 00835 01 Portland, OR 0.996 1.049 0.441 00835 99 Rest of Oregon 0.961 0.933 0.441 00865 01 Metropolitan Philadelphia, PA 1.023 1.092 1.386 00865 99 Rest of Pennsylvania 0.989 0.929 0.806 00973 20 Puerto Rico 0.881 0.712 0.261 00870 01 Rhode Island 1.017 1.065 0.909 00880 01 South Carolina 0.974 0.904 0.394 00820 02 South Dakota 0.935 0.878 0.365 05440 35 Tennessee 0.975 0.900 0.631 00900 31 Austin, TX 0.986 0.996 0.986 00900 20 Beaumont, TX 0.992 0.890 1.298 00900 09 Brazoria, TX 0.992 0.978 1.298 00900 11 Dallas, TX 1.010 1.065 1.061 00900 28 Fort Worth, TX 0.987 0.981 1.061 00900 15 Galveston, TX 0.988 0.969 1.298 00900 18 Houston, TX 1.020 1.007 1.297 00900 99 Rest of Texas 0.966 0.880 1.138 00910 09 Utah 0.976 0.941 0.662 31145 50 Vermont 0.973 0.986 0.514 00973 50 Virgin Islands 0.965 1.023 1.003 00904 00 Virginia 0.984 0.938 0.579 00836 02 Seattle (King Cnty), WA 1.005 1.100 0.819 00836 99 Rest of Washington 0.981 0.972 0.819 00884 16 West Virginia 0.963 0.850 1.547 00951 00 Wisconsin 0.981 0.929 0.790 00825 21 Wyoming 0.967 0.895 0.935 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. End Supplemental InformationAddendum 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: 86890 Autologous blood process 86891 Autologous blood, op salvage 86927 Plasma, fresh frozen 86930 Frozen blood prep 86931 Frozen blood thaw 86932 Frozen blood freeze/thaw 86945 Blood product/irradiation 86950 Leukacyte transfusion Start Printed Page 63393 86965 Pooling blood platelets 86985 Split blood or products INCLUDE the following CPT and HCPCS level 2 codes for other clinical laboratory services: 0010T TB test, gamma interferon- 0023T Phenotype drug test, hiv 1 0026T Measure remnant lipoproteins 0030T Antiprothrombin antibody 0041T Detect ur infect agnt w/cpas 0043T Co expired gas analysis 0058T Cryopreservation, ovary tiss 0059T Cryopreservation, oocyte G0001 Drawing blood for specimen G0027 Semen analysis G0103 Psa, total screening G0107 CA screen; fecal blood test G0123 Screen cerv/vag thin layer G0124 Screen c/v thin layer by MD G0141 Scr c/v cyto,autosys and md G0143 Scr c/v cyto,thinlayer,rescr G0144 Scr c/v cyto,thinlayer,rescr G0145 Scr c/v cyto,thinlayer,rescr G0147 Scr c/v cyto, automated sys G0148 Scr c/v cyto, autosys, rescr G0306 CBC/diffwbc w/o platelet G0307 CBC without platelet P2028 Cephalin floculation test P2029 Congo red blood test P2033 Blood thymol turbidity P2038 Blood mucoprotein P3000 Screen pap by tech w md supv P3001 Screening pap smear by phys P9612 Catheterize for urine spec P9615 Urine specimen collect mult Q0111 Wet mounts/ w preparations Q0112 Potassium hydroxide preps Q0113 Pinworm examinations Q0114 Fern test Q0115 Post-coital mucous exam PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH-LANGUAGE PATHOLOGY SERVICES INCLUDE the following CPT codes for the physical therapy/occupational therapy/speech-language pathology services in the 97000 series: 97001 Pt evaluation 97002 Pt re-evaluation 97003 Ot evaluation 97004 Ot re-evaluation 97010 Hot or cold packs therapy 97012 Mechanical traction therapy 97016 Vasopneumatic device therapy 97018 Paraffin bath therapy 97020 Microwave therapy 97022 Whirlpool therapy 97024 Diathermy treatment 97026 Infrared therapy 97028 Ultraviolet therapy 97032 Electrical stimulation 97033 Electric current therapy 97034 Contrast bath therapy 97035 Ultrasound therapy 97036 Hydrotherapy 97039 Physical therapy treatment 97110 Therapeutic exercises 97112 Neuromuscular reeducation 97113 Aquatic therapy/exercises 97116 Gait training therapy 97124 Massage therapy 97139 Physical medicine procedure 97140 Manual therapy 97150 Group therapeutic procedures 97504 Orthotic training 97520 Prosthetic training 97530 Therapeutic activities 97532 Cognitive skills development 97533 Sensory integration 97535 Self care mngment training 97537 Community/work reintegration 97542 Wheelchair mngment training 97545 Work hardening 97546 Work hardening add-on 97703 Prosthetic checkout 97750 Physical performance test 97755 Assistive technology assess 97799 Physical medicine procedure INCLUDE CPT codes for physical therapy/occupational therapy/speech-language pathology services not in the 97000 series: 64550 Apply neurostimulator 90901 Biofeedback train, any meth 90911 Biofeedback peri/uro/rectal 92506 Speech/hearing evaluation 92507 Speech/hearing therapy 92508 Speech/hearing therapy- 92526 Oral function therapy 92597 Oral speech device eval 92601 Cochlear implt f/up exam < 7 92602 Reprogram cochlear implt < 7 92603 Cochlear implt f/up exam 7 > 92604 Reprogram cochlear implt 7 >- 92607 Ex for speech device rx, 1hr 92608 Ex for speech device rx addl 92609 Use of speech device service 92610 Evaluate swallowing function 92611 Motion fluoroscopy/swallow 92612 Endoscopy swallow tst (fees) 92614 Laryngoscopic sensory test 92616 Fees w/laryngeal sense test 93797 Cardiac rehab 93798 Cardiac rehab/monitor 94667 Chest wall manipulation 94668 Chest wall manipulation 94762 Measure blood oxygen level 95831 Limb muscle testing, manual 95832 Hand muscle testing, manual 95833 Body muscle testing, manual 95834 Body muscle testing, manual 95851 Range of motion measurements 95852 Range of motion measurements 96000 Motion analysis, video/3d 96001 Motion test w/ft press meas 96002 Dynamic surface emg 96003 Dynamic fine wire emg 96105 Assessment of aphasia 96110 Developmental test, lim 96111 Developmental test, extend 96115 Neurobehavior status exam- 0029T Magnetic tx for incontinence INCLUDE HCPCS level 2 codes for the following physical therapy/occupational therapy/speech-language pathology services: G0279 Excorp shock tx, elbow epi G0280 Excorp shock tx other than G0281 Elec stim unattend for press G0283 Elec stim other than wound RADIOLOGY AND CERTAIN OTHER IMAGING SERVICES INCLUDE the following codes in the CPT 70000 series: 70100 X-ray exam of jaw 70110 X-ray exam of jaw 70120 X-ray exam of mastoids 70130 X-ray exam of mastoids 70134 X-ray exam of middle ear 70140 X-ray exam of facial bones 70150 X-ray exam of facial bones 70160 X-ray exam of nasal bones 70190 X-ray exam of eye sockets 70200 X-ray exam of eye sockets 70210 X-ray exam of sinuses 70220 X-ray exam of sinuses 70240 X-ray exam, pituitary saddle 70250 X-ray exam of skull 70260 X-ray exam of skull 70300 X-ray exam of teeth 70310 X-ray exam of teeth 70320 Full mouth x-ray of teeth 70328 X-ray exam of jaw joint 70330 X-ray exam of jaw joints 70336 Magnetic image, jaw joint 70350 X-ray head for orthodontia 70355 Panoramic x-ray of jaws 70360 X-ray exam of neck 70370 Throat x-ray & fluoroscopy 70371 Speech evaluation, complex 70380 X-ray exam of salivary gland 70450 Ct head/brain w/o dye 70460 Ct head/brain w/dye 70470 Ct head/brain w/o & w/ dye 70480 Ct orbit/ear/fossa w/o dye 70481 Ct orbit/ear/fossa w/dye 70482 Ct orbit/ear/fossa w/o&w dye 70486 Ct maxillofacial w/o dye 70487 Ct maxillofacial w/dye 70488 Ct maxillofacial w/o & w dye 70490 Ct soft tissue neck w/o dye 70491 Ct soft tissue neck w/dye 70492 Ct sft tsue nck w/o & w/dye 70496 Ct angiography, head 70498 Ct angiography, neck 70540 Mri orbit/face/neck w/o dye 70542 Mri orbit/face/neck w/dye 70543 Mri orbt/fac/nck w/o & w dye 70544 Mr angiography head w/o dye 70545 Mr angiography head w/dye 70546 Mr angiograph head w/o&w dye 70547 Mr angiography neck w/o dye 70548 Mr angiography neck w/dye 70549 Mr angiograph neck w/o&w dye 70551 Mri brain w/o dye 70552 Mri brain w/ dye 70553 Mri brain w/o & w/ dye 71010 Chest x-ray 71015 Chest x-ray 71020 Chest x-ray 71021 Chest x-ray 71022 Chest x-ray 71023 Chest x-ray and fluoroscopy 71030 Chest x-ray 71034 Chest x-ray and fluoroscopy 71035 Chest x-ray- 71100 X-ray exam of ribs 71101 X-ray exam of ribs/chest 71110 X-ray exam of ribs 71111 X-ray exam of ribs/ chest 71120 X-ray exam of breastbone 71130 X-ray exam of breastbone 71250 Ct thorax w/o dye 71260 Ct thorax w/dye 71270 Ct thorax w/o & w/ dye 71275 Ct angiography, chest 71550 Mri chest w/o dye 71551 Mri chest w/dye 71552 Mri chest w/o & w/dye 71555 Mri angio chest w or w/o dye 72010 X-ray exam of spine 72020 X-ray exam of spine 72040 X-ray exam of neck spine 72050 X-ray exam of neck spine 72052 X-ray exam of neck spine 72069 X-ray exam of trunk spine Start Printed Page 63394 72070 X-ray exam of thoracic spine 72072 X-ray exam of thoracic spine 72074 X-ray exam of thoracic spine 72080 X-ray exam of trunk spine 72090 X-ray exam of trunk spine 72100 X-ray exam of lower spine 72110 X-ray exam of lower spine 72114 X-ray exam of lower spine 72120 X-ray exam of lower spine 72125 Ct neck spine w/o dye 72126 Ct neck spine w/dye 72127 Ct neck spine w/o & w/dye 72128 Ct chest spine w/o dye 72129 Ct chest spine w/dye 72130 Ct chest spine w/o & w/dye 72131 Ct lumbar spine w/o dye 72132 Ct lumbar spine w/dye 72133 Ct lumbar spine w/o & w/dye 72141 Mri neck spine w/o dye 72142 Mri neck spine w/dye 72146 Mri chest spine w/o dye 72147 Mri chest spine w/dye 72148 Mri lumbar spine w/o dye 72149 Mri lumbar spine w/dye 72156 Mri neck spine w/o & w/dye 72157 Mri chest spine w/o & w/dye 72158 Mri lumbar spine w/o & w/dye 72170 X-ray exam of pelvis 72190 X-ray exam of pelvis 72191 Ct angiograph pelv w/o&w/dye 72192 Ct pelvis w/o dye 72193 Ct pelvis w/dye 72194 Ct pelvis w/o & w/dye 72195 Mri pelvis w/o dye 72196 Mri pelvis w/dye 72197 Mri pelvis w/o & w dye 72198 Mr angio pelvis w/o & w/dye 72200 X-ray exam sacroiliac joints 72202 X-ray exam sacroiliac joints 72220 X-ray exam of tailbone 73000 X-ray exam of collar bone 73010 X-ray exam of shoulder blade 73020 X-ray exam of shoulder 73030 X-ray exam of shoulder 73050 X-ray exam of shoulders 73060 X-ray exam of humerus 73070 X-ray exam of elbow 73080 X-ray exam of elbow 73090 X-ray exam of forearm 73092 X-ray exam of arm, infant 73100 X-ray exam of wrist 73110 X-ray exam of wrist 73120 X-ray exam of hand 73130 X-ray exam of hand 73140 X-ray exam of finger(s) 73200 Ct upper extremity w/o dye 73201 Ct upper extremity w/dye 73202 Ct uppr extremity w/o&w/dye 73206 Ct angio upr extrm w/o&w/dye 73218 Mri upper extremity w/o dye 73219 Mri upper extremity w/dye 73220 Mri uppr extremity w/o&w/dye 73221 Mri joint upr extrem w/o dye 73222 Mri joint upr extrem w/dye 73223 Mri joint upr extr w/o&w/dye 73500 X-ray exam of hip 73510 X-ray exam of hip 73520 X-ray exam of hips 73540 X-ray exam of pelvis & hips 73550 X-ray exam of thigh 73560 X-ray exam of knee, 1 or 2 73562 X-ray exam of knee, 3 73564 X-ray exam, knee, 4 or more 73565 X-ray exam of knees 73590 X-ray exam of lower leg 73592 X-ray exam of leg, infant 73600 X-ray exam of ankle 73610 X-ray exam of ankle 73620 X-ray exam of foot 73630 X-ray exam of foot 73650 X-ray exam of heel 73660 X-ray exam of toe(s) 73700 Ct lower extremity w/o dye 73701 Ct lower extremity w/dye 73702 Ct lwr extremity w/o&w/dye 73706 Ct angio lwr extr w/o&w/dye 73718 Mri lower extremity w/o dye 73719 Mri lower extremity w/dye 73720 Mri lwr extremity w/o&w/dye 73721 Mri jnt of lwr extre w/o dye 73722 Mri joint of lwr extr w/dye 73723 Mri joint lwr extr w/o&w/dye 73725 Mr ang lwr ext w or w/o dye 74000 X-ray exam of abdomen 74010 X-ray exam of abdomen 74020 X-ray exam of abdomen 74022 X-ray exam series, abdomen 74150 Ct abdomen w/o dye 74160 Ct abdomen w/dye 74170 Ct abdomen w/o &w /dye 74175 Ct angio abdom w/o & w/dye 74181 Mri abdomen w/o dye 74182 Mri abdomen w/dye 74183 Mri abdomen w/o & w/dye 74185 Mri angio, abdom w orw/o dye 74210 Contrst x-ray exam of throat 74220 Contrast x-ray, esophagus 74230 Cine/vid x-ray, throat/esoph 74240 X-ray exam, upper gi tract 74241 X-ray exam, upper gi tract 74245 X-ray exam, upper gi tract 74246 Contrst x-ray uppr gi tract 74247 Contrst x-ray uppr gi tract 74249 Contrst x-ray uppr gi tract 74250 X-ray exam of small bowel 74290 Contrast x-ray, gallbladder 74291 Contrast x-rays, gallbladder 74710 X-ray measurement of pelvis 75552 Heart mri for morph w/o dye 75553 Heart mri for morph w/dye 75554 Cardiac MRI/function 75555 Cardiac MRI/limited study 75635 Ct angio abdominal arteries 76000 Fluoroscope examination 76006 X-ray stress view 76010 X-ray, nose to rectum 76020 X-rays for bone age 76040 X-rays, bone evaluation 76061 X-rays, bone survey 76062 X-rays, bone survey 76065 X-rays, bone evaluation 76066 Joint survey, single view 76070 Ct bone density, axial 76071 Ct bone density, peripheral 76082 Computer mammogram add-on 76083 Computer mammogram add-on 76090 Mammogram, one breast 76091 Mammogram, both breasts 76092 Mammogram, screening 76093 Magnetic image, breast 76094 Magnetic image, both breasts 76100 X-ray exam of body section 76101 Complex body section x-ray 76102 Complex body section x-rays 76120 Cine/video x-rays 76125 Cine/video x-rays add-on 76150 X-ray exam, dry process 76370 Ct scan for therapy guide 76375 3d/holograph reconstr add-on 76380 CAT scan follow-up study 76400 Magnetic image, bone marrow 76499 Radiographic procedure 76506 Echo exam of head 76511 Echo exam of eye 76512 Echo exam of eye 76513 Echo exam of eye, water bath 76514 Echo exam of eye, thickness 76516 Echo exam of eye 76519 Echo exam of eye 76536 Us exam of head and neck 76604 Us exam, chest, b-scan 76645 Us exam, breast(s) 76700 Us exam, abdom, complete 76705 Echo exam of abdomen 76770 Us exam abdo back wall, comp 76775 Us exam abdo back wall, lim 76778 Us exam kidney transplant 76800 Us exam, spinal canal 76801 Ob us < 14 wks, single fetus- 76802 Ob us < 14 wks, add'l fetus 76805 Ob us >/= 14 wks, sngl fetus 76810 Ob us >/= 14 wks, addl fetus 76811 Ob us, detailed, sngl fetus 76812 Ob us, detailed, addl fetus 76815 Ob us, limited, fetus(s) 76816 Ob us, follow-up, per fetus 76818 Fetal biophys profile w/nst 76819 Fetal biophys profil w/o nst 76825 Echo exam of fetal heart 76826 Echo exam of fetal heart 76827 Echo exam of fetal heart 76828 Echo exam of fetal heart 76856 Us exam, pelvic, complete 76857 Us exam, pelvic, limited 76870 Us exam, scrotum 76880 Us exam, extremity 76885 Us exam infant hips, dynamic 76886 Us exam infant hips, static 76970 Ultrasound exam follow-up 76977 Us bone density measure 76999 Echo examination procedure INCLUDE the following CPT codes for echocardiography and vascular ultrasound: 93303 Echo transthoracic 93304 Echo transthoracic 93307 Echo exam of heart 93308 Echo exam of heart 93320 Doppler echo exam, heart [if used in conjunction with 93303-93308] 93321 Doppler echo exam, heart [if used in conjunction with 93303-93308] 93325 Doppler color flow add-on [if used in conjunction with 93303-93308] 93875 Extracranial study 93880 Extracranial study 93882 Extracranial study 93886 Intracranial study 93888 Intracranial study 93922 Extremity study 93923 Extremity study 93924 Extremity study 93925 Lower extremity study 93926 Lower extremity study 93930 Upper extremity study 93931 Upper extremity study 93965 Extremity study 93970 Extremity study 93971 Extremity study 93975 Vascular study 93976 Vascular study 93978 Vascular study 93979 Vascular study Start Printed Page 63395 93980 Penile vascular study 93981 Penile vascular study 93990 Doppler flow testing INCLUDE the following CPT and HCPCS level 2 codes: 51798 Us urine capacity measure 91110 Gi tract capsule endoscopy 0028T Dexa body composition study 0042T Ct perfusion w/contrast, cbf G0202 Screeningmammographydigital G0204 Diagnosticmammographydigital G0206 Diagnosticmammographydigital G0288 Recon, CTA for surg plan R0070 Transport portable x-ray R0075 Transport port x-ray multipl RADIATION THERAPY SERVICES AND SUPPLIES INCLUDE the following codes in the CPT 70000 series: 77261 Radiation therapy planning 77262 Radiation therapy planning 77263 Radiation therapy planning 77280 Set radiation therapy field 77285 Set radiation therapy field 77290 Set radiation therapy field 77295 Set radiation therapy field 77299 Radiation therapy planning 77300 Radiation therapy dose plan 77301 Radiotherapy dose plan, imrt 77305 Teletx isodose plan simple 77310 Teletx isodose plan intermed 77315 Teletx isodose plan complex 77321 Special teletx port plan 77326 Brachytx isodose calc simp 77327 Brachytx isodose calc interm 77328 Brachytx isodose plan compl 77331 Special radiation dosimetry 77332 Radiation treatment aid(s) 77333 Radiation treatment aid(s) 77334 Radiation treatment aid(s) 77336 Radiation physics consult 77370 Radiation physics consult 77399 External radiation dosimetry 77401 Radiation treatment delivery 77402 Radiation treatment delivery 77403 Radiation treatment delivery 77404 Radiation treatment delivery 77406 Radiation treatment delivery 77407 Radiation treatment delivery 77408 Radiation treatment delivery- 77409 Radiation treatment delivery 77411 Radiation treatment delivery 77412 Radiation treatment delivery 77413 Radiation treatment delivery 77414 Radiation treatment delivery 77416 Radiation treatment delivery 77417 Radiology port film(s) 77418 Radiation tx delivery, imrt 77427 Radiation tx management, x5 77431 Radiation therapy management 77432 Stereotactic radiation trmt 77470 Special radiation treatment 77499 Radiation therapy management 77520 Proton trmt, simple w/o comp 77522 Proton trmt, simple w/comp 77523 Proton trmt, intermediate 77525 Proton treatment, complex 77600 Hyperthermia treatment 77605 Hyperthermia treatment 77610 Hyperthermia treatment 77615 Hyperthermia treatment 77620 Hyperthermia treatment 77750 Infuse radioactive materials 77761 Apply intrcav radiat simple 77762 Apply intrcav radiat interm 77763 Apply intrcav radiat compl 77776 Apply interstit radiat simpl 77777 Apply interstit radiat inter 77778 Apply interstit radiat compl 77781 High intensity brachytherapy 77782 High intensity brachytherapy 77783 High intensity brachytherapy 77784 High intensity brachytherapy 77789 Apply surface radiation 77790 Radiation handling 77799 Radium/radioisotope therapy INCLUDE the following CPT and HCPCS level 2 codes classified elsewhere: 31643 Diag bronchoscope/catheter 50559 Renal endoscopy/radiotracer 55859 Percut/needle insert, pros 61770 Incise skull for treatment 61793 Focus radiation beam 92974 Cath place, cardio brachytx G0173 Stereo radiosurgery,complete G0242 Multisource photon ster plan- G0243 Multisour photon stero treat G0251 Linear acc based stero radio G0256 Prostate brachy w palladium G0261 Prostate brachytherapy w/rad G0338 Linear accelerator stero pln G0339 Robot lin-radsurg com, first G0340 Robt 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: J0636 Inj calcitriol per 0.1 mcg J0895 Deferoxamine mesylate inj J1270 Injection, doxercalciferol J1750 Iron dextran J1756 Iron sucrose injection J2501 Paricalcitol J2916 Na ferric gluconate complex J2997 Alteplase recombinant Q4054 Darbepoetin alfa, esrd use Q4055 Epoetin 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): 76083 Computer mammogram add-on 76092 Mammogram, screening 76977 Us bone density measure G0103 Psa, total screening G0107 CA screen; fecal blood test G0123 Screen cerv/vag thin layer G0124 Screen c/v thin layer by MD G0141 Scr c/v cyto,autosys and md G0143 Scr c/v cyto,thinlayer,rescr G0144 Scr c/v cyto,thinlayer,rescr G0145 Scr c/v cyto,thinlayer,rescr G0147 Scr c/v cyto, automated sys G0148 Scr c/v cyto, autosys, rescr G0202 Screeningmammographydigital P3000 Screen pap by tech w md supv P3001 Screening 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): 90655 Flu vaccine, 6-35 mo, im 90657 Flu vaccine, 6-35 mo, im 90658 Flu vaccine, 3 yrs, im 90732 Pneumococcal vaccine 90740 Hepb vacc, ill pat dose im 90743 Hep b vacc, adol, 2 dose im 90744 Hepb vacc ped/adol 3 dose im 90746 Hepb vaccine, adult, im 90747 Hepb 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. [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