01-27275. Medicare Program; Revisions to Payment Policies and Five-Year Review of and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 2002  

  • Start Printed Page 55246 Start Preamble

    AGENCY:

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

    ACTION:

    Final rule with comment period.

    SUMMARY:

    This final rule with comment period makes several changes affecting Medicare Part B payment. The changes affect: refinement of resource-based practice expense relative value units (RVUs); services and supplies incident to a physician's professional service; anesthesia base unit variations; recognition of CPT tracking codes; and nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies. It also addresses comments received on the June 8, 2001 proposed notice for the 5-year review of work RVUs and finalizes these work RVUs. In addition, we acknowledge comments received on our request for information on our policy for CPT modifier 62 that is used to report the work of co-surgeons. The rule also updates the list of certain services subject to the physician self-referral prohibitions to reflect changes to CPT codes and Healthcare Common Procedure Coding System codes effective January 1, 2002. These refinements and changes will ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.

    The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 modernizes the mammography screening benefit and authorizes payment under the physician fee schedule effective January 1, 2002; provides for biennial screening pelvic examinations for certain beneficiaries effective July 1, 2001; provides for annual glaucoma screenings for high-risk beneficiaries effective January 1, 2002; expands coverage for screening colonoscopies to all beneficiaries effective July 1, 2001; establishes coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002; expands payment for telehealth services effective October 1, 2001; requires certain Indian Health Service providers to be paid for some services under the physician fee schedule effective July 1, 2001; and revises the payment for certain physician pathology services effective January 1, 2001. This final rule will conform our regulations to reflect these statutory provisions.

    In addition, we are finalizing the calendar year (CY) 2001 interim RVUs and are issuing interim RVUs for new and revised procedure codes for calendar year (CY) 2002. As required by the statute, we are announcing that the physician fee schedule update for CY 2002 is −4.8 percent, the initial estimate of the Sustainable Growth Rate (SGR) for CY 2002 is 5.6 percent, and the conversion factor for CY 2002 is $36.1992.

    DATES:

    Effective date: This rule is effective January 1, 2002.

    Comment date: We will consider comments on the Clinical Practice Expert Panel data, the physician self-referral designated health services identified in Table 8, and the interim RVUs for selected procedure codes identified in Addendum C if we receive them at the appropriate address, as provided below, no later than 5 p.m. on December 31, 2001.

    ADDRESSES:

    Mail written comments (1 original and 2 copies) to the following address: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1169-FC, P.O. Box 8013, Baltimore, MD 21244-8013.

    To insure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them. If you prefer, you may deliver your written comments (1 original and 2 copies) by courier to one of the following addresses: Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013 or Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201.

    Comments mailed to the two above addresses may be delayed and received too late for us to consider them.

    Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code CMS-1169-FC.

    For information on viewing public comments, please see the beginning of the Supplementary Information section below.

    Start Further Info

    FOR FURTHER INFORMATION CONTACT:

    Carolyn Mullen, (410) 786-4589 or Marc Hartstein, (410) 786-4539 (for issues related to resource-based practice expense relative value units).

    Carlos Cano, (410) 786-0245 (for issues related to screening sigmoidoscopies).

    Paul W. Kim, (410) 786-7410 (for issues related to incident to services).

    Rick Ensor, (410) 786-5617 (for issues related to screening mammography).

    Bill Larson, (410) 786-4639 (for issues related to screening pelvic examinations, screening for glaucoma, and coverage for screening colonoscopies).

    Bob Ulikowski, (410) 786-5721 (for issues related to the payment for screening colonoscopies).

    Mary Stojak, (410) 786-6939 (for issues related to medical nutrition therapy).

    Joan Mitchell, (410) 786-4508 (for issues related to the payment for medical nutrition therapy).

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

    Terri Harris, (410) 786-6830 (for issues related to Indian Health Service providers).

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

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

    Diane Milstead, (410) 786-3355 (for all other issues).

    End Further Info End Preamble Start Supplemental Information

    SUPPLEMENTARY INFORMATION:

    Inspection of Public Comments

    Comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at 7500 Security Blvd, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 5 p.m. Please call (410) 786-7197 to make an appointment to view the public comments.

    Copies

    To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250. The cost for each copy is $9. As an alternative, you can view and photocopy the Federal Register Start Printed Page 55247document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the Federal Register.

    To order the disks containing this document, send your request to: Superintendent of Documents, Attention: Electronic Products, P.O. Box 37082, Washington, DC 20013-7082. Please specify, “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2001,” and enclose a check or money order payable to the Superintendent of Documents, or enclose your VISA, Discover, or MasterCard number and expiration date. Credit card orders can be placed by calling the order clerk at (202) 512-1530 (or toll free at 1-888-293-6498) or by faxing to (202) 512-1262.

    This Federal Register document is also available from the Federal Register online database through GPO Access, a service of the U.S. Government Printing Office. The Website address is: http://www.access.gpo.gov/​nara/​index.html.

    Information on the physician fee schedule can be found on our homepage. You can access these data by using the following directions:

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

    2. Click on “Professionals.”

    3. Under the heading “Physicians and Health Care Professionals,” click on “Medicare Coding and Payment Systems.”

    4. Select Physician Fee Schedule.

    Or, you can go directly to the Physician Fee Schedule page by typing the following: http://www.hcfa.gov/​medicare/​pfsmain.htm.

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

    Table of Contents

    I. Background

    A. Legislative History

    B. Published Changes to the Fee Schedule

    C. Components of the Fee Schedule Payment Amounts

    D. Development of the Relative Value Units

    II. Specific Provisions for Calendar Year 2002

    A. Resource-Based Practice Expense Relative Value Units

    B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies

    C. Services and Supplies Incident to a Physician's Professional Services: Conditions

    D. Anesthesia Services

    E. Performance Measurement and Emerging Technology Codes

    F. Payment Policy for CPT Modifier 62 (Co-Surgery)

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

    A. Screening Mammography

    B. Screening Pelvic Examinations

    C. Screening for Glaucoma

    D. Screening Colonoscopy

    E. Medical Nutrition Therapy

    F. Telehealth Services

    G. Indian Health Service

    H. Pathology Services

    IV. Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule; Responses to Public Comments on the Five-Year Review of Work Relative Value Units

    V. Refinement of Relative Value Units for Calendar Year 2002 and Response to Public Comments on Interim Relative Value Units for 2001 (Including the Interim Relative Value Units Contained in the August 2001 Proposed Rule)

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

    B. Process for Establishing Work Relative Value Units for the 2002 Physician Fee Schedule

    VI. Physician Self-Referral Prohibitions

    VII. Physician Fee Schedule Update for Calendar Year 2002

    VIII. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate for Calendar Year 2002

    A. Medicare Sustainable Growth Rate

    B. Physicians' Services

    C. Provisions Related to the SGR

    D. Preliminary Estimate of the SGR for 2002

    E. Sustainable Growth Rate for CY 2001

    F. Sustainable Growth Rate for FY 2001

    G. Calculation of the FY 2001, CY 2001, and CY 2002 Sustainable Growth Rates

    IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2002

    X. Provisions of the Final Rule

    XI. Collection of Information Requirements

    XII. Response to Comments

    XIII. Regulatory Impact Analysis

    Addendum A—Explanation and Use of Addendum B

    Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002

    Addendum C—Codes with Interim RVUs

    Addendum D—2002 Geographic Practice Cost Indices by Medicare Carrier and Locality

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

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

    AMA American Medical Association

    BBA Balanced Budget Act of 1997

    BBRA Balanced Budget Refinement Act of 1999

    CF Conversion factor

    CFR Code of Federal Regulations

    CPT [Physicians'] Current Procedural Terminology [4th Edition, 1997, copyrighted by the American Medical Association]

    CPEP Clinical Practice Expert Panel

    CRNA Certified Registered Nurse Anesthetist

    E/M Evaluation and management

    EB Electrical bioimpedance

    FMR Fair market rental

    GAF Geographic adjustment factor

    GPCI Geographic practice cost index

    GDP Gross Domestic Product

    CMS Centers for Medicare & Medicaid Services

    HCPCS Healthcare Common Procedure Coding System

    HHA Home health agency

    HHS [Department of] Health and Human Services

    IDTFs Independent Diagnostic Testing Facilities

    MCM Medicare Carrier Manual

    MedPAC Medicare Payment Advisory Commission

    MEI Medicare Economic Index

    MGMA Medical Group Management Association

    MSA Metropolitan Statistical Area

    NAMCS National Ambulatory Medical Care Survey

    NCD National coverage determination

    PC Professional component

    PEAC Practice Expense Advisory Committee

    PPAC Practicing Physicians Advisory Council

    PPS Prospective payment system

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

    RVU Relative value unit

    SGR Sustainable growth rate

    SMS [AMA's] Socioeconomic Monitoring System

    TC Technical component

    I. Background

    A. Legislative History

    Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), “Payment for Physicians' Services.” This section provides for three major elements: (1) a fee schedule for the payment of physicians’ services; (2) a sustainable growth rate for the rates of increase in Medicare expenditures for physicians' services; and (3) limits on the amounts that nonparticipating physicians can charge beneficiaries. The Act requires that payments under the fee schedule be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense, and malpractice expense. Start Printed Page 55248Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may not cause total physician fee schedule payments to differ by more than $20 million from what they would have been had the adjustments not been made. If adjustments to RVUs cause expenditures to change by more than $20 million, we must make adjustments to preserve budget neutrality.

    B. Published Changes to the Fee Schedule

    In the July 17, 2000 proposed rule (65 FR 44177), we listed all of the final rules published through November 1999 relating to the updates to the RVUs and revisions to payment policies under the physician fee schedule.

    In the June 8, 2001 Federal Register (66 FR 31028), we published a proposed notice concerning the 5-year review of work RVUs.

    In the August 2, 2001 proposed rule (66 FR 40373) we discussed revisions contained in the November 1, 2000 final rule with comment period and the following issues affecting Medicare payment under the physician fee schedule:

    • We listed the revisions to payment policies under the physician fee schedule that were made in the November 2000 final rule with comment period (65 FR 65376).
    • We discussed policy issues affecting Medicare payment for physicians' services, including—

    —refinement of the resource-based practice expense relative value units;

    —services and supplies incident to a physician's professional service;

    —anesthesia base unit variations;

    —recognition of CPT tracking codes; and

    —nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies.

    We also solicited comments on the payment policy for CPT modifier 62 used to report the work of co-surgeons.

    In addition, the August 2, 2001 proposed rule addressed the following provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA):

    • Payment for the screening mammography benefit under the physician fee schedule effective January 1, 2002.
    • Biennial screening pelvic examinations for certain beneficiaries effective July 1, 2001.
    • Annual glaucoma screenings for high-risk beneficiaries effective January 1, 2002.
    • Expansion of coverage for screening colonoscopies to all beneficiaries effective July 1, 2001.
    • Coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002.
    • Expansion of payment for telehealth services effective October 1, 2001.
    • Payment for some services of certain Indian Health Service providers under the physician fee schedule effective July 1, 2001.
    • Revision to the payment for certain physician pathology services effective January 1, 2001.

    This final rule affects the regulations set forth at Part 405, Federal health insurance for the aged and disabled; Part 410, Supplementary medical insurance (SMI) benefits; Part 411, Exclusions from Medicare and limitations on Medicare payment; Part 414, Payment for Part B medical and other health services; and Part 415, Services furnished by physicians in providers, supervising physicians in teaching settings, and residents in certain settings.

    The information in this final rule finalizes information in the June 8, 2001 proposed notice and the August 2, 2001 proposed rule.

    C. Components of the Fee Schedule Payment Amounts

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

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

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

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

    The CF for calendar year (CY) 2002 appears in section XIII. The RVUs for CY 2002 are in Addendum B. The GPCIs for CY 2002 can be found in Addendum D.

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

    D. Development of the Relative Value System

    1. Work Relative Value Units

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

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

    II. Specific Proposals for Calendar Year 2002

    In response to the publication of the August 2001 proposed rule, we received approximately 2,000 comments. We received comments from individual physicians, health care workers, and professional associations and societies. The majority of comments addressed the proposals related to medical nutrition therapy and the practice expense refinement.

    The proposed rule discussed policies that affected the number of RVUs on which payment for certain services would be based. Certain changes implemented through this final rule are subject to the $20 million limitation on Start Printed Page 55249annual adjustments contained in section 1848(c)(2)(B)(ii)(II) of the Act.

    After reviewing the comments and determining the policies we would implement, we have estimated the costs and savings of these policies and added those costs and savings to the estimated costs associated with any other changes in RVUs for 2002. We discuss in detail the effects of these changes in the Regulatory Impact Analysis in section XIII.

    For the convenience of the reader, the headings for the policy issues correspond to the headings used in the August 2001 proposed rule. More detailed background information for each issue can be found in the June 2001 proposed notice with comment period and the August 2001 proposed rule.

    A. Resource-Based Practice Expense Relative Value Units

    1. Resource-Based Practice Expense Legislation

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

    Section 4505(a) of the BBA amended section 1848(c)(2)(ii) of the Act and delayed the effective date of the resource-based practice expense RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based practice expense RVUs to resource-based RVUs. The practice expense RVUs for CY 1999 were the product of 75 percent of charge-based RVUs and 25 percent of the resource-based RVUs. For CY 2000, the RVUs were 50 percent charge-based RVUs and 50 percent resource-based RVUs. For CY 2001, the RVUs are 25 percent charge-based and 75 percent resource-based. After CY 2001, the RVUs will be totally resource-based.

    Section 4505(e) of the BBA amended section 1848(c)(2) of the Act by providing that 1998 practice expense RVUs be adjusted for certain services in anticipation of implementation of resource-based practice expenses beginning in 1999. As a result, the statute required us to increase practice expense RVUs for office visits. For other services in which practice expense RVUs exceeded 110 percent of the work RVUs and were furnished less than 75 percent of the time in an office setting, the statute required us to reduce the 1998 practice expense RVUs to a number equal to 110 percent of the work RVUs. This reduction did not apply to services that had proposed resource-based practice expense RVUs that increased from their 1997 practice expense RVUs as reflected in the June 18, 1997 proposed rule (62 FR 33196). The services affected and the final RVUs for 1998 were published in the October 1997 final rule (62 FR 59103).

    Further legislation affecting resource-based practice expense RVUs was included in the Balanced Budget Refinement Act of 1999 (BBRA) (Public Law 106-113). Section 212 of the BBRA amended section 1848(c)(2)(ii) of the Act by directing us to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations. These data would supplement the data we normally collect in determining the practice expense component of the physician fee schedule for payments in CY 2001 and CY 2002.

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

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

    a. Practice Expense Cost Pools

    We used actual practice expense data by specialty, derived from the 1995 through 1998 SMS survey data, to create six cost pools—administrative labor, clinical labor, medical supplies, medical equipment, office supplies, and all other expenses. There were three steps in the creation of the cost pools. (Please note that the 1999 SMS data are being incorporated for CY 2002.)

    • Step (1) We used the AMA's SMS survey of actual cost data to determine practice expenses per hour by cost category. The practice expenses per hour for each physician respondent's practice were calculated as the practice expenses for the practice divided by the total number of hours spent in patient care activities. The practice expenses per hour for the specialty were an average of the practice expenses per hour for the respondent physicians in that specialty. For the CY 2000 physician fee schedule, we also used data from a survey submitted by the Society of Thoracic Surgeons (STS) in calculating thoracic and cardiac surgeons' practice expenses per hour. (Please see the November 1999 final rule (64 FR 59391) for additional information concerning acceptance of these data.) For CY 2001, we used these STS data, as well as survey data submitted by the American Society of Vascular Surgery and the Society of Vascular Surgery. (Please see the November 2000 final rule (65 FR 65385) for additional information on the acceptance of these data.)
    • Step (2) We determined the total number of physician hours (by specialty) spent treating Medicare patients. This was calculated from physician time data for each procedure code and from Medicare claims data.
    • Step (3) We calculated the practice expense pools by specialty and by cost category by multiplying the specialty practice expenses per hour for each category by the total physician hours.

    For services with work RVUs equal to zero (including the technical component (TC) of services with a TC and a professional component (PC)), we created a separate practice expense pool using the average clinical staff time from the Clinical Practice Expert Panel (CPEP) data (since these codes, by definition, do not have physician time) and the “all physicians” practice expense per hour.

    b. Cost Allocation Methodology

    For each specialty, we divided the six practice expense pools into two groups, based on whether direct or indirect costs were involved, and we used a different allocation basis for each group. The first group included clinical labor, medical supplies, and medical equipment. The second group included administrative labor, office expenses, and all other expenses.Start Printed Page 55250

    (i) Direct Costs

    For direct costs (including clinical labor, medical supplies, and medical equipment), we used the CPEP data as the allocation basis. The CPEP data for clinical labor, medical supplies, and medical equipment were used to allocate the costs for each of the respective cost pools.

    For the separate practice expense pool for services with work RVUs equal to zero, we used adjusted 1998 practice expense RVUs as an interim measure to allocate the direct cost pools. (Please see the November 1998 final rule (63 FR 58891) for further information related to this adjustment.) Also, for all radiology services that are assigned work RVUs, we used the adjusted 1998 practice expense RVUs for radiology services as an interim measure to allocate the direct practice expense cost pool for radiology. For all other specialties that perform radiology services, we used the CPEP data for radiology services in the allocation of that specialty's direct practice expense cost pools.

    (ii) Indirect Costs

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

    The SMS pool was divided by the CPEP pool for each specialty to produce a scaling factor that was applied to the CPEP direct cost inputs. This was intended to match costs counted as practice expenses in the SMS survey with items counted as practice expenses in the CPEP process. When the specialty-specific scaling factor exceeded the average scaling factor by more than 3 standard deviations, we used the average scaling factor. (Please see the November 1999 final rule (64 FR 59390) for further discussion of this issue.)

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

    c. Other Methodological Issues

    (i) Global Practice Expense Relative Value Units

    For services with the PC and TC paid under the physician fee schedule, the global practice expense RVUs were set equal to the sum of the PC and TC.

    (ii) Practice Expenses per Hour Adjustments and Specialty Crosswalks

    Since many specialties identified in our claims data did not correspond exactly to the specialties included in the practice expense tables from the SMS survey data, it was necessary to crosswalk these specialties to the most appropriate SMS specialty category. We also made the following adjustments to the practice expense per hour data. (For the rationale for these adjustments to the practice expense per hour, see the November 1998 final rule (63 FR 58841)).

    • We set the medical materials and supplies practice expenses per hour for the specialty of “oncology” equal to the “all physician” medical materials and supplies practice expenses per hour.
    • We based the administrative payroll, office, and other practice expenses per hour for the specialties of “physical therapy” and “occupational therapy” on data used to develop the salary equivalency guidelines for these specialties. We set the remaining practice expense per hour categories equal to the “all physician” practice expenses per hour from the SMS survey data. (Note that in the November 2000 final rule (65 FR 65403), we increased the space allotment for therapy services to 750 square feet.)
    • Due to uncertainty concerning the appropriate crosswalk and time data for the nonphysician specialty “audiologist,” we derived the resource-based practice expense RVUs for codes performed by audiologists from the practice expenses per hour of the other specialties that perform these services.
    • For the specialty of “emergency medicine,” we used the “all physician” practice expense per hour to create practice expense cost pools for the categories “clerical payroll” and “other expenses.”
    • For the specialty of “podiatry,” we used the “all physician” practice expense per hour to create the practice expense pool.
    • For the specialty of “pathology,” we removed the supervision and autopsy hours reimbursed through Part A of the Medicare program from the practice expense per hour calculation.
    • For the specialty “maxillofacial prosthetics,” we used the “all physician” practice expense per hour to create practice expense cost pools and, as an interim measure, allocated these pools using the adjusted 1998 practice expense RVUs.
    • We split the practice expenses per hour for the specialty “radiology” into “radiation oncology” and “radiology other than radiation oncology” and used this split practice expense per hour to create practice expense cost pools for these specialties.

    (iii) Time Associated With the Work RVUs

    The time data resulting from the refinement of the work RVUs have been, on average, 25 percent greater than the time data obtained by the Harvard study for the same services. We adjusted the Harvard study's time data to ensure consistency between these data sources.

    For services with no assigned physician time, such as dialysis, physical therapy, psychology, and many radiology and other diagnostic services, we calculated estimated total physician time based on work RVUs, maximum clinical staff time for each service as shown in the CPEP data, or the judgment of our clinical staff.

    We calculated the time for CPT codes (hereafter referred to as “codes”) 00100 through 01996 using the base and time units from the anesthesia fee schedule and the Medicare allowed claims data.

    3. Refinement

    a. Background

    Section 4505(d)(1)(C) of the BBA directed us to develop a refinement process to be used during each of the 4 years of the transition period. We did not propose a specific long-term refinement process in the June 1998 proposed rule (63 FR 30835). Rather, we set out the parameters for an acceptable refinement process for practice expense RVUs and solicited comments on our proposal. We received a variety of comments about broad methodology issues, practice expense per-hour data, and detailed code-level data. We made adjustments to our proposal based on the comments we received. We also indicated that we would consider other comments for possible refinement and that the RVUs for all codes would be considered interim for 1999 and for future years during the transition period.

    We outlined in the November 1998 final rule (63 FR 58832) the steps we were undertaking as part of the initial refinement process. These steps included the following:

    • Establishment of a mechanism to receive independent advice for dealing with broad practice expense RVU technical and methodological issues.
    • Evaluation of any additional recommendations from the General Accounting Office, the Medicare Payment Advisory Commission (MedPAC), and the Practicing Physicians Advisory Council (PPAC).Start Printed Page 55251
    • Consultation with physician and other groups about these issues.

    We also discussed a proposal submitted by the AMA's Specialty Society Relative Value Update Committee (RUC) for development of a new advisory committee, the Practice Expense Advisory Committee (PEAC), to review comments and recommendations on the code-specific CPEP data during the refinement period. In addition, we solicited comments and suggestions about our practice expense methodology from organizations that have a broad range of interests and expertise in practice expense and survey issues.

    b. Current Status of Refinement Activities

    In the 1999 and 2000 final rules and the 2001 proposed rule, we provided further information on refinement activities underway, including the AMA's formation of the PEAC and the support contract that we awarded to the Lewin Group to focus on methodologic issues. In addition, in these rules, we announced actions taken and decisions made in response to the hundreds of comments received on our resource-based physician practice expense initiative. Because the transition will be completed in CY 2002 and the practice expense RVUs will then be totally resource-based, it is appropriate to recap the specific achievements reached and decisions implemented during this refinement effort to date.

    (i) Use of the Top-Down Approach

    Most of the physician organizations commenting agreed that this methodology was preferred for computing resource-based practice expense RVUs and that it was in accordance with the requirements of the BBA. KPMG Peat Marwick, under contract to us, reviewed the top-down methodology in which aggregate specialty costs are applied to specific procedures and concluded that it followed reasonable cost accounting principles. A 1999 GAO report concludes, “HCFA's new approach represents a reasonable starting point for creating resource-based practice expense RVUs. It uses the best available data for this purpose and explicitly recognizes specialty differences in practice expense.” Based on these comments and assessments, we made the decision to continue to use the top-down methodology to calculate the resource-based practice expense RVUs.

    (ii) Use of the SMS Survey

    The supplemental non-SMS survey data submitted by several specialties in response to the 1998 proposed rule, with the exception of the survey data from the thoracic surgeons, were not compatible with the format or methodology of the SMS. We awarded a contract to the Lewin Group to recommend criteria for the acceptance of specialty-specific practice expense data so that we could supplement the SMS data as appropriate. These recommended criteria are contained in the final report, “An Evaluation of the Health Care Financing Administration's Resource-Based Practice Expense Methodology.” This report is available on our web page under the same title. (Access to our web site is discussed in the Supplementary Information section above.)

    The report also contains recommendations for revisions to the SMS or other surveys to efficiently meet the needs of our practice expense methodology. We augmented these recommendations and forwarded our suggestions for revisions to any future surveys to the AMA. For example, we developed supplementary survey questions that would allow us to distinguish both costs and direct patient care hours for all midlevel practitioners. We also suggested revisions that would capture the necessary information on separately billable supplies and services so that we could eliminate these costs from the specialty-specific practice expense per-hour calculations.

    To obtain supplementary specialty-specific practice expense data that could be used in computing practice expense RVUs beginning January 1, 2001, we published an interim final rule on May 3, 2000 (65 FR 25664) that set forth the criteria applicable to supplemental survey data submitted to us by August 1, 2000.

    We also provided a 60-day period for submission of public comments on our criteria for survey data submitted between August 2, 2000 and August 1, 2001 for use in computing the practice expense RVUs for the CY 2002 physician fee schedule.

    In the November 1, 2000 final rule (65 FR 65385), we responded to comments received on the interim final rule and made modifications to the criteria for supplemental survey data that will be considered in computing practice expense RVUs for the CY 2002 physician fee schedule. These data can then be used to supplement the SMS survey data currently used to estimate each specialty's aggregate practice costs or to replace the crosswalks used for specialties not represented in the SMS.

    In our November 1999 final rule, we accepted supplementary data submitted by the thoracic surgeons and, in our November 2000 final rule, we accepted survey data from the vascular surgeons that replaced the previously crosswalked practice expense per hour data for that specialty. In the November 2000 final rule, we also stated that if we received additional specialty-specific survey data before August 1, 2001 that met the criteria outlined in that rule, we would use these supplementary data in calculating the CY 2002 practice expense RVUs.

    We accepted our contractor's recommendation to incorporate the latest SMS data into our practice expense per hour calculations. For CY 2001, we incorporated the 1998 SMS data into a 4-year average, and we are incorporating the 1999 SMS data into a 5-year average to calculate the CY 2002 practice expense RVUs.

    We also accepted the contractor's recommendation to standardize the survey practice expense data to a common year. We adjusted the data to reflect a 1995 cost year.

    We received comments that urged us to use the median SMS specialty-specific data instead of the mean, as well as comments supporting our use of the mean values. We made a decision to continue to use the mean in calculating the specialty-specific practice expense per hour. We believe that, in a small sample, using the median could eliminate outlying data from the calculation that represent real costs and thus should be considered.

    (iii) CPEP Data

    The AMA has formed a multispecialty sub-committee of their Relative Value Update Committee (RUC), the Practice Expense Advisory Committee (PEAC), to review the CPEP clinical staff, equipment, and supply data for all physicians' services. This multispecialty committee, which includes representatives from all major specialty societies, will then make recommendations on suggested refinements to these data. We indicated in our November 1998 final rule (63 FR 58833) that we would work with the PEAC and RUC to refine the practice expense direct cost inputs. This refinement process was supported in comments we received from almost every major physician specialty society.

    In our November 1999 physician fee schedule final rule, we implemented most clinical staff time, supply and equipment refinements recommended by the RUC. For the November 2000 final rule, the RUC forwarded to us significant additional refinement recommendations that reflected multispecialty agreement on the typical resources for many important services, including visit codes, which account for Start Printed Page 55252approximately 24 percent of Medicare spending for physicians' services. Again we accepted almost all of these RUC recommendations. In addition, at its October 2000, February 2001, and April 2001 meetings, the PEAC focused on refining high-volume services and on standardizing inputs across wide ranges of services. The RUC and PEAC forwarded to us recommendation on refinements for over 1,100 services. We anticipate that the pace of refinement of the CPEP inputs will continue to accelerate.

    In addition to implementing most of the RUC-recommended refinements, we responded to comments on errors and anomalies in the CPEP data in both the November 1999 and November 2000 final rules. For example, we removed separately billable casting supplies and drugs from all services; we adjusted the prices of certain supplies that were clearly in error; we removed duplicated equipment from the direct inputs of the nuclear medicine codes; we added clearly essential equipment that was missing from the lithotripsy and photochemotherapy codes; we corrected anomalies in inputs within several families of codes; and we changed the crosswalks for the CPEP inputs of several codes not valued by the CPEP panels when a commenter suggested more appropriate crosswalks.

    We simplified the refinement of equipment inputs by combining both the procedure-specific and overhead equipment into a single equipment category. We also deleted stand-by equipment and equipment used for multiple services at one time from the direct cost inputs because of the difficulty of allocating these costs at the code-specific level.

    We are resolving issues related to averaging input costs for codes that were valued by more than one CPEP panel. While we have received comments agreeing and disagreeing with our use of mean costs, the issue is moot because we are substituting refined data for the data previously produced by multiple CPEPs.

    (iv) Physician Time Data

    In the November 1999 rule (64 FR 59404), we stated that, in general, requests for revisions for the procedure-specific physician times should be deferred to either the RUC process or the 5-year review process. However, we did adopt the newer data to correct the physician time for the pediatric surgery codes and made the requested revisions to correct anomalies in the times of certain psychotherapy codes.

    In response to comments on the times associated with physical and occupational therapy services, we added preservice and postservice times to all of these codes.

    (v) Crosswalk Issues

    In response to concerns expressed by specialty societies representing emergency medicine that the SMS data did not capture the costs of uncompensated care, we crosswalked emergency medicine's cost pools for administrative labor and other expenses to the practice expense per hour for “all physicians.”

    We resolved issues related to the specialty crosswalk for nursing specialties by eliminating the separate practice expense pools for midlevel practitioners.

    (vi) Calculation of Practice Expense Pools—Other Issues

    We addressed concerns that potential errors in our specialty utilization data will have an effect on the calculation of practice expense RVUs. In the July 2000 proposed rule (65 FR 44178), we discussed our simulations that demonstrated that the small percentage of potential errors in our very large database have no adverse effect on specialty-specific practice expense RVUs.

    We have created the zero-work pool for services with no physician work to ensure that these services are not inappropriately disadvantaged by our methodology. We have also agreed with the request of all the specialty societies that commented that their services should be moved out of the zero-work pool and into the specialty-specific pool. The specialties whose services remain in the zero-work pool have indicated that they wish their services to remain there. We plan to eliminate this separate pool for services with no physician work only when we have determined what revisions to our methodology are required so that we can value these services appropriately outside of the zero-work pool.

    (vii) Calculation of Indirect Cost

    We requested that our contractor evaluate various options for calculating indirect costs. The final report, referenced above, contains an analysis of the impacts of six alternative allocation methodologies. In confirming the suitability of our allocation methodology, the report concludes that “HCFA's approach is broadly consistent with most of the alternative methods. This consistency suggests that, from a broad perspective, no other allocation methodology offers a compelling reason to abandon the current HCFA approach.”

    (viii) Site-of-Service

    The practice expense RVUs would be expected to be higher in the nonfacility setting, where the practitioner bears the costs of the necessary staff, supplies, and equipment, than in the facility setting. To prevent potential anomalies in our calculations due to the different mix of specialties performing a given service in different settings, we capped the practice expense RVUs for a physician service in facilities at the nonfacility practice expense level for each specific service.

    In the November 1999 final rule (64 FR 59407), in response to a comment from the Renal Physicians Association, we agreed that the monthly capitated service codes should always be reported using the nonfacility designation. The site-of-service designations are not meaningful for a monthly service that may be provided in different settings for the same patient during a given month.

    Although we are continuing our refinement of all practice expense RVUs, we believe that the above description of our actions to date illustrates that much has been accomplished. We also believe that it demonstrates that we have been responsive to comments from the medical community and have established a process that enables this community to participate fully in the refinement of both the specialty-specific practice expense per hour and the CPEP code-specific inputs.

    4. Practice Expense Provisions for Calendar Year 2002

    a. SMS Data

    (i) Use of 1999 SMS Survey Data

    We are currently using data from the 1995 through the 1998 SMS surveys (1994 through 1997 practice expense data) in order to calculate the specialty-specific practice expense per hour. The 1999 SMS survey data are now available. Because we want to incorporate the most recent survey data into our methodology during the transition period, we proposed in our August 2001 rule (66 FR 40377) to add this 1999 data to the 4 years of data we are currently using.

    We proposed to use these 5 years of data in addition to any supplemental specialty-specific data that meet our criteria as the basis of the practice expense per hour calculations until the first 5-year review of practice expense RVUs in 2007. At that time, we anticipate that newer practice expense survey data might be available.

    Comment: Specialty societies representing internal medicine, family Start Printed Page 55253practice and a number of their subspecialties were opposed to using the 1999 SMS data in the calculation of the practice expense RVUs. While many of these commenters were generally supportive of incorporating the most current SMS data, they are concerned that the sample size and results from the 1999 SMS data may not warrant their inclusion. Several of these commenters indicated that the American Medical Association is on record stating that “it normally would not provide or publish data with so few responses for some specialties.”

    A number of these commenters suggested that the practice expense information from the 1999 SMS would be less reliable because the data were collected after CMS announced the new resource-based practice expense methodology in the Federal Register. These commenters suggested that the opportunity for “gaming” now exists because the public was aware that the SMS data were used to calculate Medicare payments.

    One commenter noted that the practice expense per hour for cardiology dropped by 15 percent in one year and doubted that the actual change in practice expense of this magnitude could have occurred. Another commenter indicated that the cardiac subspecialty of electrophysiology is very likely not represented at all in this flawed data set.

    One association that represents eye surgeons commented that the 1999 SMS survey included about half as many usable responses as the 1995 through 1997 surveys. This commenter questioned our decision to disregard responses received by mail and indicated that an already poor response rate to the survey has become even lower. Another commenter that represents ophthalmology indicated that use of 1999 data with such low response rates violates good statistical practice. The 1999 responses included only 23 ophthalmologists, while over 200 offered responses to the survey in years before 1999. Another commenter that represents gastroenterology indicated that the SMS is perhaps the best available source of data on multispecialty practice costs. However, this comment indicated that it is by no means a perfect data source for the manner in which it has been used by CMS and is even less reliable for certain specialties, such as gastroenterology. This commenter appreciates our willingness to accept supplementary data from specialties, but believes that it is our responsibility to overcome data deficiencies. We were encouraged to develop a uniform and fair process to overcome data deficiencies, without relying on individual medical specialties to provide such data.

    In light of AMA's suspension of the SMS survey, this commenter urged us to discuss in the final rule our plans for updating practice expense RVUs in future years beginning with 2003, and, if need be, for replacing the SMS survey with an alternative data source. Another commenter expressed concern that the newer data from the SMS surveys will not be incorporated until the first 5-year review of practice expense RVUs in 2007; by that time, some of the practice expense data will have been in existence for 13 years.

    Similarly, another commenter expressed concern that using the SMS data set from 1995 through 1999 until 2007 will mean that the data will not accurately reflect the changes in technology that will increase costs, particularly for specialties with rapid changes in technology.

    Response: In response to the comment that the SMS data are not a perfect data source for developing practice expense RVUs, as we have said previously, we believe the SMS survey is the best available source of data on multispecialty practice costs. This comment was echoed by one of the same commenters that objected to including the 1999 SMS data in the practice expense methodology for determining 2002 RVUs. While we have previously acknowledged that the data have potential limitations for determining practice expense RVUs, there are no alternative data sources that are better for this purpose.

    Since there are no other data on aggregate multispecialty practice costs that are better than the SMS, our only alternative would be to eliminate the SMS data from the methodology and rely solely on estimates of practice expense inputs for individual codes. We believe a better approach would be to continue using the SMS data in the practice expense methodology and to work with the physician community to develop even better data for establishing practice expense RVUs in the future.

    One commenter noted that we only included telephone survey responses and not mail responses from the 1999 SMS and suggested that this decision further reduces an already low response rate. Our understanding is that the AMA, as a result of concerns about a declining number of responses to the SMS survey, used several approaches to obtain more surveys in the 1999 SMS. As part of this effort, some survey respondents received a mail survey instead of the normal telephone survey. Our review of information from the AMA suggested that there were significant differences between the mail and telephone surveys on questions related to practice expense. Since our objective has been to use a consistent approach to obtaining practice expense data for use in our methodology, we felt that it would be better to incorporate only the traditional telephone survey responses in the methodology consistent with how the data were obtained in earlier years.

    While a few commenters indicated that the SMS data are not representative of a particular specialty's costs, they provided no information to support the contention. One commenter suggested that electrophysiology, a subspecialty of cardiology, was unlikely to be included in the SMS survey. Since the SMS survey draws a random sample from the AMA's Physician Masterfile, we believe all physicians are equally likely to be selected for participation in the survey. We would further note that the SMS weights response information based on known characteristics of the population to make the final figures as representative of the self-employed population as possible. As we have stated previously, we believe the SMS survey is the best source of data for specialty practice expenses. If a specialty believes that the SMS is unrepresentative of their actual practice expenses, we have established a process by which additional data can be submitted to us. To date, we have used two specialty practice expense surveys in addition to or in place of the SMS survey. We encourage specialties to use this process to provide us with additional practice expense data that improve the representativeness of the data that we are using to determine the practice expense RVUs.

    One commenter doubted that cardiology practice expense could have declined as much as suggested by the 1999 SMS data. We would note that the practice expense per hour in any given year can show more variability than the change in practice expense per hour over time. While the specialty of cardiology shows some level of variability in practice expense per hour, with some years showing a higher value than the average and other years a lower value, the change in practice expense per hour including the 1999 SMS data is far more modest than that suggested by the commenter. There is a −2.0 percent change in practice expense per hour as a result of including the 1999 SMS data. As indicated below, use of the 1999 SMS data changed average specialty level payments to cardiologists by less than 0.5 percent.Start Printed Page 55254

    We acknowledge that response rates and the number of usable responses from the 1999 SMS are lower than in prior years. Nevertheless, as we have stated previously, it is unclear to us why this alone indicates that we should reject incorporating the data. To the extent that there are few responses to the latest SMS survey, there will be less impact on a given specialty because the practice expense per hour calculation is weighted by the number of respondents from each respective year. Further, we believe inclusion of more survey data will improve the data's representativeness and lead to more stability in the practice expense per hour. The use of the 1999 SMS data appears to have little effect on the practice expense RVUs. In our August 2, 2001 proposed rule (66 FR 40397), we simulated the impact of including the 1999 SMS data on average specialty level payments. The increase or decrease in average specialty level payment was less than 0.5 percent for 29 of the 35 specialties listed, including nearly all of the specialties that expressed concern about including the latest SMS data. For 4 of the remaining 6 specialties, the increase or decrease in payments was between 0.5 and 1.0 percent. Payments for the remaining two specialties (pathology and suppliers) increased by more than 2 percent.

    We are doubtful that respondents “gamed” responses in the 1999 SMS because of an awareness that reporting higher practice expenses would lead to increased payments from Medicare. We observed no noticeable increase in practice expense per hour from the 1999 SMS survey than from earlier years. In fact, the inflation-adjusted all-physician practice expense per hour from the 1999 SMS data is lower than the same figure from the 1998 SMS data. Further, if the concern is that physicians were aware of how the data would be used and would “game” responses to obtain higher payments from Medicare, our expectation would be that the number of responses in the 1999 SMS would be higher, not lower, than in prior years. For these reasons, we are doubtful that there is any reason to assume that the 1999 SMS survey would show more bias than surveys from previous years.

    We welcome the comments that suggest that we develop a long-term strategy for using aggregate specialty practice expense data to make refinements to RVUs. As noted by some commenters, the AMA is no longer conducting the SMS survey in its current form. We would like to engage physician specialty societies, as well as other practitioner groups and representatives of organizations affected by Medicare physician fee schedule payments, in discussions of how to best obtain practice expense data that will be useful in updating our methodology for determining practice expense RVUs. Although it has been beneficial to use 5 years of SMS data to develop practice expense RVUs, we believe that it may not be necessary to make annual updates to aggregate specialty practice cost data if relative practice expenses do not change significantly from year to year. However, it may be beneficial to periodically review aggregate practice expenses and make changes when necessary. For instance, one commenter suggested that technological innovation may change relative expenses among services. For this reason, we believe a review of aggregate practice costs at least every 5 years is necessary. In fact, the statute requires that we review RVUs at least every 5 years. At this time, we have incorporated all of the data from the SMS surveys into the practice expense methodology. We will consider public input on the best way to obtain practice expense data for use in future practice expense calculations.

    (ii) Supplemental Practice Expense Survey Data

    To ensure the maximum opportunity for specialties to submit supplementary practice expense data, we proposed to accept survey data that meet the criteria set forth in the November 2000 final rule for an additional 2 years. The deadlines for submission of such supplemental data to be considered in CY 2003 and CY 2004 are August 1, 2002 and August 1, 2003, respectively.

    Comment: Several commenters expressed their strong support for our decision to accept specialty-specific practice expense surveys for an additional 2 years. Specialty societies representing podiatry, pediatrics, internal medicine, rheumatology and surgery, as well as the American Medical Association (AMA) stated their agreement with this decision.

    An organization representing medical colleges commented that this will send an important message to the physician community about our willingness to consider all legitimate data sources in analyses of this critical portion of payments, and one that has been a subject of controversy within the community. A specialty society representing dermatology stated that the additional time will allow specialties to collect specialty-specific data that should be useful as we determine practice expense RVUs.

    The AMA and a commenter representing podiatry expressed some concern about the criteria for the acceptance of survey data and the AMA also expressed hope that we would be flexible concerning any data submitted. The commenter representing emergency medicine argued that collecting specialty-specific data would be fruitless, due to a number of stringent criteria for submitting supplemental practice expense survey data.

    On the other hand, three commenters indicated that we should accept only survey data that meet our criteria. The commenter representing rheumatology stated that it is critically important that any data accepted must meet the criteria in the November 2000 final rule.

    Response: We received only comments supporting this proposal, and we will be extending the period of acceptance of supplemental survey data for another 2 years, as proposed. We hope to demonstrate flexibility in helping those specialties that conduct a survey to do so successfully, and we understand that for some specialties some revision to the survey format may be necessary. For example, questions regarding uncompensated care for emergency physicians or separately billable drugs for oncologists might need to be added to a survey to determine the appropriate practice expense for these specialties. However, like several of the commenters, we believe that fairness to all can only be achieved if we consistently apply the rules for determining validity to any survey that is submitted.

    Comment: A specialty society representing geriatrics expressed concern regarding the use of SMS data in formulating practice expense costs because the sample size for geriatricians is not large enough to yield reliable data. The commenter stated that smaller specialty societies will be unable to provide supplementary survey data because of expense limitations and recommended that we continue to review alternative data sources that recognize the greater resources spent in caring for frail elderly persons. The society further recommended that we consider the use of “non-compliant” survey data for smaller specialty groups that do not meet our stringent and costly criteria.

    Response: We could not justify accepting “non-compliant” surveys from some specialties, due solely to the specialty's size, while holding others to a more rigorous standard. However, though we would welcome survey data from any specialty that submits a survey that meets our criteria, we do recognize that performing a survey can be costly. We, therefore, suggest that the specialty society consider in advance the extent to which any possible survey result Start Printed Page 55255might actually alter the practice expense RVUs for their services. Note that we have only one payment amount for each service on the fee schedule. We have no authority to pay more to one specialty than to another for performing the same service. If a small specialty provides only a small percentage of a given service, a change in the practice expense per hour for that small specialty could have very little effect on the payment for the service. For example, if geriatricians perform mainly evaluation and management (E/M) services, even a survey that shows increased practice costs for geriatricians would not necessarily have any effect on the practice expense RVUs for E/M services because geriatricians' services would represent only a small part of the universe of E/M services. However, it is incumbent upon each specialty society to weigh both the costs and benefits to their specialty to determine whether conducting a practice expense survey would be worthwhile.

    (iii) Submission of Supplemental Surveys

    Three organizations submitted supplemental survey data for consideration for CY 2002. Survey data were submitted by the American Physical Therapy Association (APTA), the American Optometric Association (AOA), and the American Academy of Pediatrics (AAP). Our contractor, The Lewin Group, has evaluated the data submitted by each organization. They have recommended that we use the data submitted by APTA and AOA and reject the data submitted by AAP. The full recommendation and discussion will be made available on the CMS web site. (See the Supplementary Information section of this rule for directions on accessing our web site.)

    We have decided not to use the data submitted by APTA, AOA, or AAP because none of the surveys met all of our stated criteria. In our May 3, 2000 interim final rule (65 FR 25666), we indicated that, based on our review of existing physician practice expense surveys, we believe that an achievable level of precision is a coefficient of variation (that is, the ratio of the standard error of the mean to the mean expressed as a percent) not greater than 10 percent for overall practice expenses or practice expenses per hour. For existing surveys, the standard deviation is frequently the same magnitude as the mean. We indicated in the May 2000 interim final rule that we would consider practice expenses for which the precision of practice expenses is equal to or better than this level of precision and that meet the other survey criteria. None of the surveys submitted for 2002 met the level of precision criteria; therefore, we have decided not to use the survey data.

    b. CPEP Data

    (i) 2000 RUC Recommendations on CPEP Inputs

    In the November 2000 final rule (65 FR 65393), we responded to the RUC recommendations for the refinement of the direct inputs for 49 CPT codes and for the supply and equipment inputs for four additional services. These recommendations reflected multispecialty agreement on the typical resources for many important services, including visit codes, which account for approximately 24 percent of Medicare spending for physicians' services. We accepted almost all of these recommendations. We received the following comments on our responses to the RUC recommendations and on the PEAC/RUC refinement process:

    Comment: Several specialty societies representing osteopaths, rheumatologists, neurologists, ophthalmologists, obstetricians, and gynecologists commended us for implementing the refinements submitted by the PEAC and RUC as part of the on-going refinement process. One specialty society stated that it was encouraged by the direction pursued with the physician fee schedule for 2001, because it demonstrated the ability to achieve refinement within the parameters of the fee schedule comment process. Another commenter expressed appreciation for our support of the PEAC and RUC refinement process because this relationship is critical to establishing fair and balanced payment policies.

    In addition, other commenters praised our staff for being helpful in responding to the PEAC members' questions during meetings, as well as for the willingness to work with physician specialty societies toward establishing fair and appropriate reimbursement values. The RUC commented that it agreed that the PEAC has made significant progress in its ability to review and refine direct practice expense inputs for individual CPT codes.

    Response: We appreciate the above comments and are also encouraged by the progress that the PEAC and RUC have made in refining the practice expense inputs.

    Comment: The RUC agreed that the PEAC should continue to meet and refine the direct practice expense data. Therefore, it hopes that we will state that the practice expense RVUs will continue to be interim and subject to refinement as the PEAC continues its review. A specialty society representing ophthalmology echoed this request stating that, because the PEAC is continuing the refinement process, the interim status of the practice expense RVUs should be reaffirmed in the rule. The commenter requested that the RVUs remain interim and subject to change until 2007, that is, until the first update of the five-year review of practice expense RVUs.

    Response: We are pleased that the RUC and PEAC are willing to continue the task of helping us to refine the practice expense inputs for the approximately 7,000 services in the physician fee schedule. We intend to keep the practice expense RVUs as interim as long as this refinement process is necessary. Also, as noted above, we will accept, for another 2 years, supplemental survey data that meet our criteria. During this period, we will also continue to make improvements to our practice expense methodology.

    Comment: A commenter representing three ophthalmology sub-specialties, though appreciative of our implementation of the PEAC recommendations, expressed disappointment that we have not made the non-controversial revisions to correct additional errors in the CPEP database. The commenter encouraged us to explore alternative ways to improve the quality of the CPEP data without waiting for the PEAC to consider each of the thousands of alleged errors.

    Response: We have made changes to the CPEP data in those instances when there was a clear anomaly in the data and when the more appropriate revision would be obvious, without the benefit of a multispecialty recommendation. However, we have found that the input and recommendations of a multispecialty group, such as the PEAC, have played a crucial role for the vast majority of suggested revisions when clinical judgment is involved.

    Comment: An organization representing diagnostic imaging centers stated that it would be inappropriate for the PEAC to constitute the review body for direct cost data for technical component services, because the PEAC does not include any representatives of diagnostic imaging centers. The commenter requested that, if any of the CPEP direct cost data form the basis for future payment for technical component services, the accuracy of these data should be reviewed by representatives of centers that actually provide the services involved.

    Response: We do not agree that it is inappropriate for the PEAC to review Start Printed Page 55256the direct cost inputs for imaging services. The presentations for each service discussed at the PEAC are based either on surveys or panels of individuals who are familiar with the procedure in question. In addition, any of the recommendations of the PEAC that we accept are subject to review and comment by any interested party.

    Comment: Societies representing surgeons, urologists, ophthalmologists, pediatrics, internists, and family physicians strongly support our acceptance of the revisions of CPEP inputs for office-based E/M services. One specialty society commented that the refined inputs for these services reflect the work of a multidisciplinary workgroup and demonstrate a major positive step toward streamlining practice expense inputs. One surgical specialty society did not fully agree that it is appropriate to use these E/M inputs to refine postsurgical visits because the direct costs associated with these visits are not necessarily comparable to the typical E/M visit. On the other hand, a primary care specialty society commented that the “rolling” implementation of CPEP refinement creates an anomaly because the surgical global services have not yet had these lower PEAC estimates for the E/M visits applied.

    Response: We also saw the refinement of the practice expense inputs for the E/M codes as a significant milestone in the whole refinement process. These codes not only represent a sizeable portion of Medicare payments, but they also are used by most medical specialties, and, thus, most members of the PEAC had a stake in the outcome of this issue. We believe that, as a result of the extensive multispecialty discussion held by the PEAC on this issue, the recommendations on the E/M codes represent the best available estimates of the direct inputs needed for performing these services. With respect to the issue of applying these E/M inputs to the surgical global services, we will not be taking separate action now, but will be responding to the specific PEAC recommendations. We understand that it is expected that all the 90-day global surgical services will be refined by the PEAC by next year.

    Comment: A specialty society representing internal medicine commented that the registered nurse (RN) and licensed practical nurse (LPN) staff mix should be used for the E/M codes rather than the RN, LPN, and medical assistant staff mix, which is less typical. The commenter also stated that we should increase the postservice clinical staff work for these services by 20 percent.

    Response: We do not agree with changing the staff mix at this time, particularly because the PEAC recommendations have used this staff mix across the majority of refined services. We also have seen no evidence to suggest that the post-times for these services were undervalued.

    (ii) 2001 RUC Recommendations on CPEP Inputs

    We have received recommendations from the PEAC on the refinement to the CPEP inputs for over 1,100 codes. These include refinements of large numbers of orthopedic, dermatology, pathology, physical medicine, and ophthalmology services. In addition, the PEAC confirmed that there were no inputs for over 150 ZZZ-global procedures that are performed only in the facility and no supply or equipment inputs for almost 700 facility-only services with an XXX or 0-day global period. We believe this large increase in the number of CPT codes that have been refined demonstrates that the PEAC refinement process is working due to the valiant efforts of the AMA staff and the specialty societies participating in this mammoth undertaking. There is also reason to believe that the pace of refinement will continue to increase because of the steps that the PEAC is taking to create standardized packages of clinical staff time, supplies, or equipment that can be applied over a wide range of services.

    We have reviewed the submitted PEAC recommendations and have accepted most of them with only minor revisions. The complete PEAC recommendations and the revised CPEP database can be found on our web site. (See the Supplementary Information section of this rule for directions on accessing our web site.)The following is a list of the only revisions we made to the PEAC recommendations:

    • We substituted the multispecialty minimum visit supply package or the ophthalmology supply package for the list of individual supplies, when appropriate.
    • We deleted separately billable supplies, for example, drugs, fluids, and casting supplies, when listed in the recommended supply list.
    • We rounded fractions of minutes of clinical staff time to the nearest minute.
    • For CPT code 52281, cystoscopy and treatment, we deleted the bougie a boule from the equipment list. The specialty society supplied us with the price of $105 for this item, which does not meet the minimum cost of $500 for an item to be included in the equipment list.
    • For several ophthalmology services that did not involve dilation of the pupil, we consulted with the specialty society and deleted the ophthalmology visit supply package that was listed for the post-procedure visit. This package is intended for those services where dilation is necessary. The society confirmed that no supplies are needed for the post-procedure visit for these services.
    • The recommendation did not specify the number of EEG electrodes for CPT code 92585, auditory evoked potential, comprehensive. We added seven electrodes, which is the same number assigned to the visual evoked potential code.
    • The PEAC/RUC recommendations included time for the clinical staff type, “Physical Therapy Assistant (PTA),” which currently is not included in our CPEP input database. We are pricing the PTAs by using the Bureau of Labor Statistics wage estimates for physical therapy assistants. The base annual salary we are using will be $33,690. After factoring in benefits and adjusting this to 2001 dollars, the per minute rate will be $0.386.
    • We have two concerns about the PEAC recommendations for therapy services. First, we believe that some of the duties ascribed to the physical therapy assistant are actually therapist services that are already captured in the work RVUs. Therefore, we are deleting from all the therapy codes the clinical staff time for obtaining vital signs and measurements, patient education, and phone calls. Because we believe that the resulting clinical staff times may be too low for the physical therapy and occupational therapy evaluation and reevaluation services, we are adding 7 additional minutes for the therapy aide in each of these codes. In addition, some of the occupational therapy codes contain several pieces of very expensive equipment called environmental modules. Because it is unclear how many of these modules would typically be used for each service, we are only including one module for each code that might use this equipment. We note that for three services, CPT codes 97530, 97535, and 97537, the PEAC did not submit a recommendation for equipment, presumably because of the difficulty of determining what would be typically used. In those cases, as in those with a PEAC recommendation, we are allowing for one module and some smaller equipment that was suggested by the specialty. We would hope to work with the specialty societies to obtain more precise information on the appropriate equipment for all of these therapy services.Start Printed Page 55257
    • We note that one of the services for which we received recommendations, the casting/strapping procedure CPT code 29799, is carrier-priced. In addition, we received recommendations for two fine needle aspiration services, CPT codes 88170 and 88171, which are now deleted.

    (iii) Other Comments on Refinement of CPEP Inputs

    Comment: Several commenters were pleased that we finalized certain proposals regarding CPEP inputs, such as the following:

    • The reinstatement of the pre-procedure clinical staff time in the facility setting for certain 0-day global services as well as pre-service time for the vitrectomy codes.
    • Our decision to uphold the proposed refinements regarding inpatient dialysis CPT codes 90935 and 90945.
    • The clarification of Medicare payment policy for cast supplies when used for non-fracture/dislocation procedures.
    • The decision to retain Unna boot in the supplies for CPT code 29580.
    • The correction of the supply list for CPT code 88104 and the establishment of a separate nonfacility practice expense RVU for CPT code 85607 in the 2001 fee schedule.
    • The extension of the code-specific refinement beyond 2002.

    Response: We appreciate the above comments and will strive to continue refining the practice expense RVUs in a manner that is fair and beneficial to the medical community.

    Comment: An allergy clinic commented that because of our definition of a dose for CPT code 95165, Allergy Immunotherapy, doctors will be forced to use a dosage that could be harmful to certain patients.

    Response: The definition of a dose will be used only for pricing the practice expense inputs for this service. Physicians should use their clinical judgment in determining what dose to use for any particular patient.

    Comment: A commenter noted that the two codes for anal balloon sphincterplasty (CPT codes 49505 and 49510) did not have the balloon listed in the supply inputs.

    Response: We agree that this was an omission and have added the balloon to the supply list for both services.

    Comment: A commenter stated that there are no practice expense inputs assigned to CPT code 36533, insertion of implantable venous access port, with or without subcutaneous reservoir, in the nonfacility setting, because the CPEP panels priced it only in the facility. In particular, the supply inputs do not contain the cost of the catheter that is an integral part of the procedure.

    Response: It is true that the original CPEP panel did not price this in the nonfacility setting; however, we subsequently crosswalked the inputs from the facility to the nonfacility setting for supplies, equipment, and clinical staff, adding clinical staff time for the intraservice period in the office. However, we agree that the catheter is an appropriate supply and have added it to the supply list for this code.

    Comment: A specialty society representing podiatrists questioned why the practice expense RVUs for the nail trimming codes G0127 and CPT code 11719 are not the same. The commenter stated that they should have the same CPEP inputs since both were refined by the PEAC this year with identical inputs.

    Response: The CPEP inputs are now identical for both codes, except that the supplies recommendation for CPT code 11719 does not include a surgical mask. However, none of this year's PEAC recommendations were reflected in the August 2001 proposed rule. In addition, even codes with identical CPEP inputs can have different practice expense RVUs if a different mix of specialties performs each service.

    Comment: Two specialty societies representing cardiologists and electrophysiologists commented that we have allowed 60 minutes of clinical staff time to arrange for surgical procedures with a 90-day global period, but we have not yet allowed the same for 0-day global period procedures in facilities. The commenters stated that they may present specific codes to the PEAC with the recommendation that this time be recognized for these services, and they hope that we will be receptive to these recommendations.

    Response: We will be glad to review any PEAC recommendations on clinical staff pre-service time for 0-day global period services in the facility setting if and when we receive them.

    (iv) Repricing of Clinical Staff Wage Rates

    In the August 2, 2001 proposed rule (66 FR 40378), we proposed modifications of wage rates for the clinical staff types contained in the CPEP database. Our contractor, Abt Associates, assigned the costs of the original CPEP inputs for staff, supplies, and equipment based primarily on 1994 and 1995 pricing data.

    The original Abt Associates' estimates of clinical staff wage rates relied primarily on the Bureau of Labor Statistics (BLS) data. Abt's report on the CPEP cost estimation stated that, “* * * the BLS data were considered to be the preferred data set. The BLS” reputation for publishing valid estimates that are nationally representative led to the choice of the BLS data as the main source. If more than one data set provided an exact mapping for a receptionist, then the BLS wage was chosen over any other mapping.”

    We agreed with this assessment and have used the most current BLS survey (1999) as the main source of wage data.

    It should be noted that the BLS discontinued the Occupational Compensation Survey used by Abt in 1995 and now conducts the National Compensation Survey that has a breakdown of staff types different from the earlier survey. Also, this survey does not cover all the staff types contained in the CPEP data. Therefore, it was necessary for us to crosswalk or extrapolate the wages for several staff types using supplementary data sources for verification whenever possible.

    We used three other data sources to price wages of staff types that were not referenced in the BLS data:

    • The American Society of Clinical Pathologists' survey of laboratory staff salaries (found at www.ascp.org).
    • The survey performed by the American Academy of Health Physics and the American Board of Health Physics (found at www.hps1.org).
    • The national salary data from the Salary Expert, an Internet site that develops national and local salary ranges and averages for thousands of job titles using mainly government sources. (A detailed explanation of the methodology used to determine the specific job salaries can be found at www.salaryexpert.com).

    We also solicited any valid survey data that commenters might be able to submit to us.

    The proposed cost per minute for each staff type was derived by dividing the proposed annual salary (converted to 2001 dollars using the Medicare Economic Index) by 2080 to arrive at the hourly wage rate and then again by 60 to arrive at the per minute cost. To account for the employers' cost of providing fringe benefits, such as sick leave, we used the same benefits multiplier of 1.366 used by Abt Associates.

    Comment: We received several supportive comments on our efforts to update the clinical staff salaries used in calculating the practice expense RVUs. Specialty societies representing family physicians and surgeons supported the proposal to reprice clinical staff salaries to approximate current practice Start Printed Page 55258expenses. A specialty society representing rheumatology stated that the repricing of clinical staff salary data represents an overdue positive step toward more accurate refinement of practice expense inputs. A specialty society representing dermatology agreed with the appropriateness of bundling similar clinical staff types into more easily identified and easily tracked clinical labor blended categories.

    Response: We agree that using current wage data to price the clinical staff CPEP inputs is one step in ensuring that the practice expense RVUs are based on the resources needed to perform each service. We also would like to express our appreciation to the groups that included salary survey data on various staff types as part of their comments. These additional data have helped us to make appropriate revisions to our original proposals.

    The following is a discussion of the specific proposals we made on the pricing of clinical staff types.

    • We received no comments on the following proposals. Therefore, they will be implemented as proposed.
    • We will price as proposed the staff types physical therapy aide, LPN, RN, certified surgical technician, laboratory technician, cytotechnologist, cardiovascular technician, nuclear medicine technician, optician, respiratory therapist, speech pathologist, audiologist, and counselor.
    • We will collapse the medical assistant, technical aide, medical technician, EKG technician, anesthesia technician, technician, and cast technician staff types into a new staff type, “medical or technical assistant (MTA),” that will be priced at the medical assistant wage rate of $0.26 per minute.

    + We will bundle the staff type “RN-cardiology” into the staff type “RN.”

    + We will adjust the wage rate for the oncology-certified nurse to be 18 percent higher than the RN.

    + We will bundle the staff type “surgery assistant” into the staff type “certified surgical technician (CST).”

    + We will use the average hourly rate of $15.60 for histologic technologists from the 1998 American Society of Clinical Pathologists' survey to price the histotechnologist staff type.

    + We will use the BLS salary data for electroneurodiagnostic technologists contained in the BLS Occupational Outlook Handbook to price the electrodiagnostic technologist staff type.

    + We will price the wage rate for the EEG technician using survey data from the Salary Expert.

    + We will merge the nuclear cardiology technician in with the nuclear medicine technician staff type.

    • We were unable to find any national salary data for the electron microscopy technician and, in the absence of such data, proposed crosswalking the salary from the wage rate for the histotechnologist. Though this represented an increase in the per minute cost for this staff type, we stated that we would welcome reliable national survey data from the specialty that we could use in pricing electron microscopy technicians.

    Comment: The specialty society representing pathologists recommended that the wage rate for electron microscopy (EM) technician, which we proposed crosswalking from that of the histologic technologist, should more accurately be priced at the same wage rate as the cytotechnologist. The commenter stated that histologic technologists are generally bachelor degree level personnel, whereas EM technicians generally have post-baccalaureate education, parallel to that of a cytotechnologist. In addition, they receive salaries that are higher than general histotechnologists. The commenter also recommended that the title of the EM technician category be changed to EM technologist.

    Response: We are persuaded that the commenter has proposed a more suitable crosswalk for this staff type. Therefore, we will crosswalk the wage rate for the EM technologist from that of the cytotechnologist. We will also change the title as suggested by the specialty society.

    • We were unable to find any national salary data for registered electroencephalograph technologists (REEGTs) and proposed to maintain the current rate, since the speciality society had recently recommended this rate of pay. However, we also requested reliable national survey data from the specialty that we could use in pricing these three levels of neurodiagnostic staff.

    Comment: The American Academy of Neurology (AAN), on behalf of seven related organizations, submitted an abbreviated version of the 2000 American Society of Electroneurodiagnostic Technologists (ASET) Salary Survey. The commenter stated that this national salary survey has been collected triennially by ASET, the main national body representing this allied health professional field, and was not collected for any purpose connected with the physician fee schedule. For office-based registered electroencephalograph technologists, there were 31 responses and a mean salary per hour of $20.11. For all REEGTs, there were 559 responses and a mean salary of $20.53 per hour. The commenters recommend that we substitute either of these salary rates to determine the costs for the REEGT staff type. The specialty society representing sleep medicine requested that we consider the updated salary data that AAN included in its comments on the proposed rule.

    Response: We have reviewed this survey and believe that it provides a more appropriate estimate of the wage rate of REEGTs than did our crosswalk to a staff type used in a different specialty. We will use the data for the office-based REEGTS, which results in a wage rate of $0.47 per minute, which we note is not significantly different from our proposed rate for the REEGT staff type.

    • We proposed to bundle the vascular technician with the cardiovascular technologist staff type. Currently both are priced at the same rate.

    Comment: The American Association for Vascular Surgery, American Society of Neuroimaging, Society of Diagnostic Medical Sonography, Society for Vascular Surgery, and Society of Vascular Technology submitted a joint comment as “The Coalition.” The Coalition argued that the BLS was wrong to classify vascular technologists with cardiovascular technologists and technicians because the BLS description of duties for this classification does not include any of the duties performed by a vascular technologist. In addition, the commenters contended that, unlike most cardiovascular technicians, a vascular technologist functions as a direct and largely independent health care practitioner. A skilled vascular technologist undergoes between 2 and 4 years of didactic and clinical post-secondary education as evidenced by the presence of a baccalaureate degree program in vascular technology.

    The Coalition recommended that we base the salaries for vascular technologists on data from a survey conducted earlier this year by nVision Research that surveyed by mail 406 randomly selected vascular technologists from a variety of settings. The response rate for this survey was 55 percent. Based on the survey, nVision Research determined that the median annual salary of a vascular technologist is $49,758. A copy of the survey was included with the comment. The commenters also recommended that we change the description of the “vascular technician” to “vascular technologist.” A specialty society representing echocardiography urged that we adopt the classification of “vascular Start Printed Page 55259technologist” as proposed by the above groups.

    Response: We agree that the nomenclature of the staff type should be changed to “vascular technologist.” We have studied the data provided by the Coalition and have consulted with our medical advisors and now also agree that the salary shown in the submitted survey better represents the current wage rate for vascular technologists. Therefore, we will assign the vascular technologist staff type the recommended yearly salary of $49,758 which results in a per minute wage rate of $0.54.

    • We proposed to merge the x-ray technician and radiation technologist staff types, which are currently priced at the same rate, into a staff type called “Radiologic Technologist.”

    Comment: The American Society of Radiologic Technologists (ASRT) submitted with their comment the 2001 “Radiologic Technologist Wage and Salary Survey” commissioned by the organization. The comment disagreed with our proposal to merge the x-ray technician and radiation technologist staff types. The society stated that the radiation technologist has completed a formal educational program and has successfully passed a nationally recognized credentialing examination; an x-ray technician denotes a person who is most likely informally trained and who is often employed to perform only very limited x-ray examinations. On the other hand, a society representing therapeutic radiology and oncology recommended that we not crosswalk radiation technologists to “radiologic technologists and technicians,” but, instead, change the crosswalk and the name to “radiation therapist.”

    Response: We can understand why the original nomenclature assigned by the CPEP panels to these staff types would be confusing to the commenters. However, it is clear from the imaging services to which the radiation technologist is assigned that this staff type was not considered to be a radiation therapist. In addition, we do not disagree with the distinction made by ASRT between an x-ray technician and a radiation technologist. However, the CPEP panel did not appear to make this same distinction. In fact, the x-ray technician is often assigned to more complex services than the radiation therapist and Abt Associates priced the two staff types at the same wage rate. Therefore, we have made the decision to consider both staff types to be at the same level and to change the title of both to “radiologic technologist.” If it is necessary to make a distinction between different levels of radiologic staff, this can be done as part of the refinement process.

    Comment: A commenter representing imaging centers recommended that we substitute the “more accurate and recent salary information” obtained by the ASRT for the pricing of radiologic technologists. The commenter stated that these data indicate that the mean salary of full-time radiologic technologists is $53,919.

    Response: We have reviewed the survey submitted to us by ASRT and have found it to be both comprehensive and useful. We would note that the $53,919 referenced in the comment is the mean salary for all radiologic personnel and includes the salaries of staff level personnel as well as chief technologists and of radiography staff as well as dosimetrists. Therefore, this is not salary information that can be used to price the specific radiology staff types in our database. However, as discussed below, we have used other ASRT data to price certain staff types for which we had no other pricing information. It is interesting to note that the mean salary in the ASRT survey for radiography staff is $36,862, while the 2001 salary rate for the equivalent staff based on the BLS is $37,126; the use of either figure would result in an almost identical per-minute wage rate. This information gives us extra confidence in our proposed wage rate of $0.41 per minute for radiologic technologists, and we will be implementing this salary rate as proposed.

    • Because we were unable to find any national survey data regarding the salaries for CAT scan technician, MRI technician, or angiographic technician, we proposed crosswalking these staff types to the BLS radiologic technologist pay scale. We also stated that we would welcome any reliable national survey data that would allow us to separately price these staff types.

    Comment: The American Society of Radiologic Technologists (ASRT) recommended that we use the 2001 ASRT survey submitted with its comment to price the MRI, CAT scan and angiographic technologists, rather than crosswalking their wage rate from the radiologic technologist. The ASRT data show an annual salary of $42,143 for a CAT scan technologist and $43,118 for an MRI technologist.

    Response: We have reviewed the ASRT data for MRI and CAT scan technologists and will use that data for MRI and CT staff to price these staff types. There is a close congruence between the ASRT and the BLS salaries for those radiologic staff for whom we have data from both sources. Therefore, we have confidence that the wage rate we will use for the CAT scan and MRI technologists will be relatively correct. The wage rate for the CAT scan technologist will be $0.46 per minute and for the MRI technologist $0.47 per minute. We could not find data in the ASRT survey corresponding to the angiographic technician. Therefore, until some reliable national data are available, we will continue to crosswalk this wage rate from that of the radiologic technologist.

    • We proposed merging the cardiac sonographer and the ultrasound technician into the sonographer staff type. Currently, all three are priced at the same rate.

    Comment: The group of specialty societies commenting as the “Coalition” recommended that we maintain the description, “cardiac sonographer,” eliminate the description, “ultrasound technician,” and change the description “sonographer” to “diagnostic medical sonographer.” A specialty society representing echocardiography strongly urged that we adopt the above classifications proposed by the Coalition. This commenter also contended that crosswalking the salary for cardiac sonographers from that of diagnostic medical sonographers does not adequately reflect the salaries currently paid to cardiac sonographers. The society is currently seeking a reliable source of current survey information so that we can price cardiac sonographers separately.

    Response: We have already proposed eliminating the description “ultrasound technician” and will accept the description of “diagnostic medical sonographer.” We proposed merging the cardiac sonographer into the sonographer classification because the two staff types were currently priced the same and we did not have any other salary data for the cardiac sonographers. However, we will accept the recommendation to keep the category “cardiac sonographer” and would be willing to reconsider the pricing if valid salary data are submitted.

    • Because we were unable to find salary information for the staff type “dosimetrist,” we proposed crosswalking their salary from that of radiation therapists.

    Comment: The American Society of Radiologic Technologists (ASRT) recommended that we review our proposed equal wages rates for radiation therapists and dosimetrists. The commenter reported that the annual salary of $57,330 for staff dosimetrists shown in the submitted 2001 ASRT survey is considerably higher than that for radiation therapists, which reflects their additional educational Start Printed Page 55260requirements. The specialty society representing radiology also opposed combining dosimetrists and radiation therapists in the same group because these two staff types provide very different services for radiation oncology procedures and are paid on different pay scales. This commenter agreed with the proposed increased wage rate for radiation therapists, but believed that the dosimetrists would be paid approximately 20 percent more than their proposed rate. Two other societies, one representing therapeutic radiology and oncology and one representing radiation oncology centers, also supported an increase for dosimetrists and one commenter suggested that we substitute the title “medical dosimetrist.” In addition, these two commenters recommended that we use the ASRT data for radiation therapists as well.

    Response: We appreciate receiving the ASRT data for dosimetrists and agree that the annual salary suggested by the ASRT survey more accurately reflects the appropriate wage rate for this staff type. The wage rate will be $0.63 per minute. We will also change the title for this staff type to “medical dosimetrist.” We will continue to use the BLS data to determine the wage rate for radiation therapists since there has been no evidence presented to show that the BLS survey was in any way not representative.

    • We proposed using the average salary data for all certified health physicists from the 1999 survey conducted by the American Academy of Health Physics and the American Board of Health Physics to price the “physicist” staff type.

    Comment: Three specialty societies representing radiology, therapeutic radiology and oncology, and radiation oncology centers recommended that we use the Professional Information Survey data from The American Association of Physicists in Medicine (AAPM) rather than from the American Academy of Health Physics (AAHP). One commenter pointed out that the AAHP survey does not include physicists working in radiation oncology. The AAPM survey for CY 2000 had an overall response rate of 58 percent and demonstrated an average annual salary of $107,900. One commenter suggested that we also change the title to “medical physicist.”

    Response: No copy of the AAPM survey was included with any of the comments, and we have been unable to review it at this time. However, we would not question the commenters' assertion that the AAPM survey was more relevant to physicists working in radiation oncology than the survey we used to determine our proposed wage rate. Therefore, we are using the AAPM survey salary of $107,900 on an interim basis to price the physicist wage rate and will endeavor to obtain and review this survey to finalize this issue. The wage rate for 2002 will be $1.21 per minute. For clarity, we will also accept the recommendation to change the title to “medical physicist.”

    • We were unable to obtain representative national salary data for the certified ophthalmic technician (COT), the certified ophthalmic medical technologist (COMT), or the orthoptist staff types. We proposed to crosswalk the COT and COMT to the laboratory technician and histotechnician, respectively, since we believe that the skill and responsibility of these staff types would generally correspond. In the absence of any national salary data for the orthoptist, we proposed to crosswalk the salary from that of the COMT, the highest level of ophthalmic medical personnel. We also proposed crosswalking the salary data for the certified retinal angiographer from the data listed for ophthalmic photographers in the Salary Expert. We stated that we would welcome reliable and representative national salary data for these staff types.

    Comment: The specialty society representing ophthalmologists commented that they would be pleased to offer additional assistance to validate the salaries for ophthalmic medical technicians and other ophthalmic clinical staff. At this time, the commenter agreed that the proposed crosswalks for these staff types are acceptable.

    Response: We will be implementing these crosswalks as proposed.

    • We proposed to crosswalk the wage rate for the staff type “dietitian” from the BLS salary data for dietitians and nutritionists.

    Comment: The American Dietetic Association (ADA) commented that it believed that the BLS database includes salaries for non-credentialed dietitians and nutritionists and that we should reference ADA data from its membership surveys that estimates 2001 adjusted median annual income for dietitians to be $51,006.

    Response: We would be willing to look at the ADA survey data if they were submitted to us. We would, of course, have to review and analyze these alternative survey data before we could substitute them for the BLS data that we have proposed to use. However, until we are convinced that the ADA data were equally or more representative of dietitians who serve as clinical staff for services on the fee schedule, we will continue to use the BLS data as our source of salary data for dietitians.

    • We proposed to delete those clinical staff that can bill separately from the list of CPEP staff types. Therefore, we proposed substituting physical therapy aide for physical therapist, registered nurse for physician assistant, nurse practitioner and psychologist, and counselor for social worker.

    Comment: Two specialty societies representing internal medicine and family practice expressed support for this proposal because these staff types, for example, nurse practitioners, are used as physician extenders and their salaries should not be considered as practice expense. A society representing geriatrics argued that we should not delete the clinical staff that can bill separately from the list of CPEP staff types because not all of these individuals bill separately, resulting in a negative impact on geriatrics.

    Response: We will implement our proposal to delete clinical staff that can bill independently from our practice expense input database, with the two exceptions noted below. We believe that the costs of these staff types are not practice expenses and should be captured in the work RVUs. This revision to our clinical staff list should not have a negative impact on geriatrics because none of the deleted staff types were assigned to any of the E/M services that would make up a large percentage of geriatricians' case loads.

    Comment: A society representing social workers commented that it was not opposed to the deletion from the practice expense inputs of staff types that can bill directly. However, the commenter pointed out that only clinical social workers are able to bill directly, while other social workers cannot. Therefore, the society is opposed to the deletion of the staff type, “social worker,” from the CPEP inputs and the substitution of the staff type, “counselor.” In addition, the society would at least want the BLS data for “social worker” to be used for pricing, though it believes that the BLS data does not differentiate enough between the various types of practice within social work.

    Response: The commenter is correct in stating that not all social workers can bill directly. Therefore, we will keep the social worker staff type in our database and will use the BLS data for “social worker” to determine the appropriate wage rate. In addition, we will not delete the staff type, “psychologist,” which is listed as the clinical staff for the psychological testing services. Because these services have no Start Printed Page 55261physician work RVUs, the work of the psychologist can only be captured through the practice expense RVUs. We can find no appropriate national salary at this time for this staff type. Therefore, we will use the current wage rate of $0.82 per minute.

    • We proposed to delete, as redundant, the ophthalmic medical personnel (OMP) staff type and to substitute the COMT/COT/RN/CST blend that was suggested by the American Academy of Ophthalmology and recommended by the PEAC.

    Comment: The specialty society representing optometrists agrees with our proposal to delete, as redundant, the ophthalmic medical personnel (OMP) staff type and substitute the COMT/COT/RN/CST staff blend.

    Response: We will implement this as proposed. Table 1 lists each staff type remaining in our practice expense input database, the source of the data, the staff type crosswalk used, the proposed annual salary in 2001 dollars, the 2002 wage rate per minute (including benefits) and the current cost per minute (including benefits).

    Table 1.—Revised Wage Rates for CPEP Staff Types

    DescriptionSourceCrosswalkMean yrly 2001Hrly + benefitsRevised per minuteCurrent per minute
    Physical Therapy AideBLSPhysical Therapist Aides21,07713.840.230.23
    Physical Therapy AssistantBLSPhysical Therapist Assistants35,22323.130.39N/A
    Medical or Technical AssistantBLSMedical Assistants23,68115.550.260.16
    LPNBLSLicensed Practical Nurses30,34119.930.330.27
    RNBLSRegistered Nurses46,49430.530.510.42
    RN OncologyBLSRegistered Nurses plus adjustment54,86236.030.600.50
    Certified Surgical TechnicianBLSSurgical Technologists28,81418.920.320.26
    Lab TechnicianBLSMedical and Clinical Laboratory Technicians29,72419.520.330.29
    HistotechnologistASCPHistologic Technologist33,92522.280.370.31
    Electron Microscopy TechnologistX-WALKCytotechnologist41,09926.990.450.31
    CytotechnologistBLSMedical and Clinical Laboratory Technologists41,09926.990.450.42
    EEG TechnicianSalary ExpertElectroencephalographic Technician29,15119.140.320.28
    Electrodiagnostic TechnologistBLSElectroneurodiagnostic Technologists33,52922.020.370.30
    Registered EEG TechnologistASETRegistered EEG Technologist42,70728.050.470.40
    Vascular TechnologistnVision SurveyVascular Technologist49,75832.680.540.35
    Cardiovascular TechnicianBLSCardiovascular Technologists and Technicians34,79422.850.380.35
    Radiologic TechnologistBLSRadiologic Technologists and Technicians37,12624.380.410.32
    Mammography TechnologistASRTMammography Technologist39,21225.750.43N/A
    Angiographic TechnicianBLSRadiologic Technologists and Technicians37,12624.380.410.35
    CAT Scan TechnologistASRTComputed Tomography Technologist42,14327.680.460.32
    MRI TechnologistASRTMagnetic Resonance Imaging Technologist43,11828.320.470.32
    Nuclear Medicine TechnicianBLSNuclear Medicine Technologists44,36129.130.490.39
    Diagnostic Medical SonographerBLSDiagnostic Medical Sonographers45,75130.050.500.39
    Cardiac SonographerBLSDiagnostic Medical Sonographers45,75130.050.500.39
    Radiation Technical TherapistBLSRadiation Therapists45,33329.770.500.40
    Medical DosimetristASRTMedical Dosimetrist57,33037.650.630.50
    Medical PhysicistAAPMMedical Physicist110,16672.351.210.97
    COTX-WALKLab Technician29,72419.520.330.26
    COMTX-WALKHistotechnician33,92522.280.370.28
    OpticianBLSOpticians, Dispensing26,33617.300.290.28
    Certified Retinal AngiographerSalary ExpertOphthalmic Photographer35,45323.280.390.35
    OrthoptistX-WALKCOMT33,92522.280.370.32
    Respiratory TherapistBLSRespiratory Therapists38,53725.310.420.42
    Speech PathologistBLSSpeech-Language Pathologists49,99632.830.550.42
    AudiologistBLSAudiologists47,74831.360.520.41
    Registered DieticianBLSDieticians and Nutritionists39,05025.650.430.37
    CounselorBLSMental Health Counselors30,76920.210.340.42
    Social WorkerBLSMedical and Public Health Social Workers37,01124.310.410.33

    The CPEP clinical staff inputs also include blends of staff types that are used for those services when more than one type of clinical staff may be used in the performance of the service. We will establish the payment rates for these blends by calculating a simple average of the wage rates of the staff types included. Table 2 shows the blended staff types, the 2002 cost per minute and the current cost per minute.

    Note:

    We received no comments on the proposed cost per minute for the staff blends, so these rates will be implemented as proposed.

    Table 2.—Revised Wage Rates for CPEP Blended Clinical Staff Types

    DescriptionRevised per minuteCurrent per minute
    COMT/COT/RN/CST0.380.307Start Printed Page 55262
    Lab Tech/Histotech0.350.297
    Lab Tech/MTA0.300.257
    Optician/COMT0.330.278
    RN/LPN0.420.389
    RN/LPN/MTA0.370.317
    RN/OCN0.560.497
    RN/Respiratory Therapist0.470.421
    RN/Sonographer0.510.405
    Dosimetrist/Physicist0.920N/A

    (v) Revision of the Ophthalmology Visit Supply Package

    In its May 2000 submission to us, the RUC recommended the use of an ophthalmology visit supply package that would contain the routine supplies typically used in each 90-day global postsurgical visit for ophthalmology services. We accepted this recommendation. However, upon further review, we noted that two of the supplies, rev eyes and post myd spectacles, were not used in many of the postsurgical office visits. Therefore, after consulting with the ophthalmology specialty society, we proposed to remove these two items from the ophthalmology visit package. Instead, we proposed including these items as appropriate on a code-by-code basis.

    Note:

    Since we received no comments on this issue, we will implement this revision on the supply package as proposed.

    (vi) Deletion of Contrast Agents from the Practice Expense Inputs

    Section 430(b) of BIPA amends section 1861(t)(1) of the Act to include contrast agents in the definition of drugs and biologicals. Previously, contrast agents were defined as supplies and were included in the list of CPEP supplies for the appropriate services. Therefore, we proposed to delete the costs of the following contrast agents from our CPEP data: hypaque, methylene blue, high-density barium, polibar, telopaque tablets, barium paste contrast, effervescent sparkies (fizzies), and renographin-60 iodinated contrast.

    Comment: The specialty society representing radiology had no comment on the suggested list of deletions from the CPEP supplies. However, the society expressed concern that there are no HCPCS codes established for these deleted items and wanted information on how to bill for these supplies.

    Response: As stated above, we proposed to delete contrast agents from the practice expense inputs in response to legislation that included contrast agents in the definition of drugs. This proposal was made to ensure that we did not include in the practice expense the costs of items that could also be billed separately. However, section 1842(o)(1) of the Act makes clear that the payment of 95 percent of the average wholesale price (AWP) can be made only if the drug is not paid on a cost or prospective payment basis. We believe that if we do include payment for any contrast agent in the practice expense RVUs, no other payment should be made for this item. After further consideration of this issue, however, we will continue to include the contrast agents listed in our proposal in our practice expense inputs at this time. Therefore, we are withdrawing the proposal.

    c. Physician Time

    RUC Time Database

    The primary sources for the physician time data used in creating the specialty-specific practice expense pools are the surveys performed for the initial establishment of the work RVUs and the surveys submitted to the AMA RUC. The AMA informed us that some of the times used for the November 1998 final rule (63 FR 58823) differed from the official RUC database, and we agreed to use the RUC-verified physician time database when we received it from the AMA. Subsequently, the AMA notified us that there were gaps in its own database for certain global surgery codes and that a revised time database would be sent to us once all the times were verified. We have now received this revised database and proposed to use it in the calculation of the specialty-specific practice expense pools. It should be noted that the RUC database reflects the physician times for those codes that were surveyed as part of the second 5-year review of physician work.

    Comment: We received a number of comments that supported using the physician time data. One commenter indicated that the new time database is expected to provide greater accuracy and consistency in the practice expense calculations. While commenters representing family physicians, internists, and rheumatologists supported use of the new time data, they also indicated that improvement is still needed. Specifically, these commenters suggested that the number and level of postoperative visits and the corresponding physician time included in the global surgical period may be overstated. The commenters noted that we previously indicated that we would study length of stay data relative to the number of postoperative visits and included in the surgical period, and they encouraged us to use this information to further refine the physician time data. One commenter indicated that surgeons rarely meet the criteria for billing critical care services in the postoperative period even though the time and value of critical care services are proposed for inclusion in the global period of some surgical codes.

    Organizations representing thoracic surgeons indicated that we should not incorporate the new time data that will result in additional practice expense reductions for thoracic and cardiac surgery. These commenters said that no further reductions in the practice expense RVUs for cardiac surgery should be made until new studies of practice expense related issues by the Office of Inspector General and the General Accounting Office are completed. This commenter indicated that the new physician time data covers only 585 of the 7,928 codes in the physician fee schedule but directly affects cardiothoracic surgery because there are revised times for many high volume heart and chest procedures. The commenter suggested that the new time information needs to be put in the context of changes in physician time that may have occurred in the last five to ten years on the remaining 7,343 procedure codes where there are no new physician times. Another commenter representing a cardiology subspecialty indicated that we incorporated RUC time data for only 1,900 of the more than 7,000 procedure codes. This commenter suggested that we should continue using available time from a single source until a consistent source that includes information on all CPT codes is available.

    Response: As indicated in the proposed rule, the RUC submitted physician time data for nearly 2,000 CPT codes in May 2001 and recommended that we use these new physician times in the practice expense methodology. The RUC recently sent new time for use in the final rule that reflected refinements for a few codes. We note that the source of the RUC times are actually the physician specialty societies themselves, including those associations that have objected to our use of the data. The data largely come from the specialty society surveys that were forwarded to the RUC to support requests for physician work RVUs for new and revised codes or services that were part of the 5-year review. The RUC made a comprehensive effort to validate these times before forwarding them to us. The RUC indicated to us that, over a period of 2 Start Printed Page 55263years, specialties had been provided with an opportunity to review the data and determine that they were accurately recorded.

    While the new times forwarded by the RUC represent a minority of CPT procedure codes, we note that they account for over 60 percent of the allowed services that are paid under the physician fee schedule. In response to the comment that we should make changes only when we have a single source of time data for all codes, we note that there has never been a single source of time for all codes. While time for some codes is based on the original work of Harvard University, there are many codes that came into existence since the Harvard survey was completed. The only data source for these codes is the RUC.

    We acknowledge that the Office of Inspector General is studying issues related to physicians bringing clinical staff to the hospital and the General Accounting Office is reviewing our use of supplemental practice expense survey data. Since these studies are unrelated to physician time, we do not believe they constitute a reason to suspend incorporation of the new time data into the practice expense methodology.

    In response to the comments that suggest that the physician times in the postoperative period may be overstated, the RUC indicated to us that “a number of improvements were made to the specifications regarding the level of postoperative visits to more accurately capture each element of physician time.” While the total times we received from the RUC reflect the number, types, and level of E/M services furnished in the postoperative surgical period, these services are not separately paid when furnished as part of a global surgical service. Since these services are not paid separately, it is difficult to find objective information that indicates how E/M services are provided in the postoperative period. Currently, the only source of information we can use is information that the RUC has supplied and data that previously existed in our files. While we have undertaken research that combines information on inpatient hospital stays with claims for physicians' services, these data have limitations for determining the level or type of visit being furnished in the postoperative period. We would consider any further evaluation by the RUC on this issue.

    d. Calculation of Practice Expense—Other Issues

    Comment: Several commenters requested additional clarification and information concerning the cause of reductions of 9 to 13 percent in the practice expense RVUs for electrophysiology services. One commenter indicated that there was no explanation of the proposed reduction in practice expense for CPT codes 33207, 33208, 33249, and 93651. The commenter suggested that we should provide a more complete explanation of the proposed reductions or rescind them.

    Response: Our observation is that there is no more than a 9 percent reduction in practice expense RVUs for any of these codes. We also note that the change in total payment for these codes as a result of the change in practice expense RVUs is less than half of this amount. We modeled five different changes to the practice expense methodology in our August 2, 2001 proposed rule (66 FR 40397). Of these changes, the change to physician time has the greatest effect on these codes. Since the change in the practice expense RVUs results from new information that affects payments for all procedure codes, we are continuing to implement the reduction in practice expense RVUs that were proposed for these codes.

    Comment: We received one comment expressing concern that the separate professional interpretation and technical components for CPT code 95824 (cerebral death evaluation) have been eliminated. The commenter requested that we restore the professional and technical components of this service and crosswalk the technical component value from a similar code, CPT code 95822 (EEG, sleep only). The commenter also suggested that the work RVUs should be 1.08 RVUs, the same as similar EEG codes.

    Response: We have restored the separate professional and technical components of this service. This service will likely be exclusively furnished for patients who are in an institutional setting. Thus, we will pay under the physician fee schedule only for the professional interpretation. Payment for the technical component of the service will be made through our payment to the institution for facility services. Since the technical component of this service is never provided outside of a hospital, we do not have enough information under the resource-based methodology to establish nonfacility pricing. In the unlikely event that this service is provided in the nonfacility setting, we are making the global and technical component of this service subject to carrier pricing. This change will apply to several other services that are not furnished in nonfacility settings. We are not making changes to the physician work RVUs for cerebral death evaluation in this final rule. There were no requests to revise the work RVUs for this code as part of the 5-year review of physician work.

    Comment: An organization representing vascular surgeons stated that the methodology used to incorporate the supplemental practice expense survey data has failed. This commenter indicated that the practice expense per hour for vascular surgeons increased by 9 percent from using supplemental data; however, payments actually declined between the November 2000 final rule and the August 2001 proposed rule. The commenter provided potential explanations for the change to practice expense RVUs. The commenter suggested that the results are inconsistent with the statute that requires payments to recognize all costs and violates the Administrative Procedure Act that rulemaking cannot be arbitrary and capricious.

    The commenter suggested an option that would result in a total increase in vascular surgery payments of 9 percent, consistent with the results of the supplemental survey. This option would involve identifying vascular surgery procedure codes that decreased in payment and reallocating RVUs such that aggregate payments to vascular surgeons would increase by 9 percent.

    Response: While the commenter is correct in stating that the practice RVUs for several high-volume vascular surgery procedures declined in our proposed rule, it is important to note that the changes occurred independent of the use of supplemental practice expense survey data. The supplemental practice expense survey data were incorporated into the methodology in the November 1, 2000 final rule (65 FR 65385).

    The changes that occurred between the November 2000 final rule and the August 2001 proposed rule were the result of the five changes to the methodology that we modeled and described in the August 2, 2001 (66 FR 40397) proposed rule. The additional reductions in practice expense payments for vascular surgery codes that concern this commenter are attributed to the changes we made to physician time. As we have stated previously, the explanation of how time affects specific codes is complex and requires extensive data analysis. We would be willing to meet with interested parties to discuss the effects of the practice expense methodology further.

    The commenter suggests that we make decisions about an appropriate increase Start Printed Page 55264in value for specific services and reallocate RVUs consistent with these decisions. We do not believe that such a policy would be appropriate. We have established a methodology for determining practice expenses and have valued all services using that process with the exception of services that have no physician work RVUs. For these services, we have established RVUs using an alternative methodology. It is not possible to deviate from those methodologies and reallocate RVUs to achieve particular results that may be more desirable to some individuals than to others. Such decisions about “appropriateness” would become highly subjective and would, in our view, be more likely to be criticized as arbitrary and capricious.

    Comment: We received comments from specialty societies representing technical component providers regarding the status of the zero-work pool. Commenters representing radiology, cardiology, echocardiography and radiation oncology centers strongly supported our position of maintaining the status of the zero-work pool until an appropriate alternative methodology can be determined. Two commenters argued that none of the direct or indirect cost information resulting from the CPEP process should be utilized to establish payment amounts for technical component services unless and until we further consider the entire methodology to be applied for technical component services. All commenters urged us to consult closely with associations representing the zero-work pool providers before making any changes in this regard. One commenter emphasized that no changes should be made without further research and discussion.

    Response: We agree that the status of the zero-work pool should not be changed until an alternate approach that values technical component services appropriately can be developed. Over the next several months, we will be analyzing the options for such an alternative approach contained in the report, “The Resource-Based Practice Expense Methodology: An Analysis of Selected Topics,” prepared by our contractor, The Lewin Group. This report can be found on our web site, and we would welcome comments on these options from all interested parties. (See the Supplementary Information section of this rule for directions on accessing our web site.) We also agree with the commenters that we should consult with the affected specialties as we proceed, and we will seek to maintain an open dialogue with the medical community on this issue.

    Comment: A commenter representing speech, language, and hearing professionals recommended that the zero-work pool be modified to accept the clinical staff wage increases. Seventy percent of the procedure codes used by audiologists that are covered by Medicare are in that pool and, thus, even though the proposed wage rate for audiologist has increased by 24 percent, this increase will not be reflected for those non-work services.

    Response: The commenter is correct in stating that, because the CPEP data are not used as allocators in the zero-work pool, the increases in the clinical staff wage rates will not affect the payments for audiology services at this time. However, as we mentioned above, we are seeking to develop an appropriate alternative for the zero-work pool and, when such an alternative is implemented, the revised wage rates will be applied to audiology services. In addition, we allow specialties to withdraw their services from the zero-work pool if the specialty believes that their services will be more appropriately valued outside that pool.

    Comment: An organization representing diagnostic imaging centers stated that, if we adopt the suggestion in the report of The Lewin Group to establish specialty-specific zero-work pools, it has already conducted a survey that establishes the costs per hour of providing diagnostic imaging technical component services. The commenter added that, regardless of the approach that we choose, the organization welcomes the opportunity to work with us with respect to any changes that may be contemplated in the zero-work pool methodology.

    Response: As we have noted above in our discussion on specialty-specific supplementary surveys, all of these surveys must meet the criteria stated in our November 2000 final rule. We would be willing to review the survey to see if the data can be used to develop a specialty-specific practice expense per hour. In addition, we, too, would welcome the opportunity to work with the organization as we develop an alternative to the zero-work methodology.

    e. Site-of-Service

    Comments on Site-of-Service Clarification of Payment Policy

    In the November 2, 1998 final rule (63 FR 58830) and the November 2, 1999 final rule (64 FR 59407), we indicated the circumstances under which either the facility or the nonfacility RVUs are used to calculate payment for a service. Specifically, we indicated that the lower facility practice expense RVUs apply when the service is performed in an Ambulatory Surgical Center (ASC) and the procedure is on the ASC-approved procedures list. The higher nonfacility practice expense RVUs apply to procedures performed in an ASC that are not on the ASC-approved list because there will be no separate facility payment for these services. As explained in the August 2001 proposed rule, we have received a number of inquiries about the place-of-service that should be used on the Medicare claim when a service that is not on the ASC-approved procedures list is furnished in an ASC. In these circumstances, we stated that physicians should indicate ASC as the place-of-service on the Medicare claim. Other questions have arisen as to whether a beneficiary can be billed for the ASC facility fee when Medicare does not pay a facility fee because a procedure not on the ASC list is performed in a certified ASC. In this situation, Medicare pays the physician the higher nonfacility practice expense RVUs because the ASC is effectively serving as a physician's office, and Medicare's payment for the physician's service includes payment for all practice expenses incurred in furnishing the service. The ASC benefit is not implicated since the services do not meet the provisions of section 1833(i) of the Act. The services are covered as physicians' services and paid under the physician fee schedule. Therefore, payment to the physician reflects payment for the whole service, and the beneficiary cannot be charged in excess of the limiting charge for the physician fee schedule service.

    Comment: Two commenters indicated that conditions of participation and/or survey and certification guidelines limit physicians in an ASC to furnishing only surgical procedures on the ASC approved list of procedures. They stated that such restrictions interfere with providing medical care that is in the patient's interest. The commenters request that we revise the regulations to allow physicians to furnish surgical and other medical procedures that are not on the approved ASC list in an ASC.

    Response: Because our proposal relates only to payment policy, we are finalizing it as proposed. The payment policy will apply to services furnished in an ASC that are not on the ASC-approved list to the extent that such services are permitted under the conditions of participation developed by our Office of Clinical Standards and Quality (OCSQ) and by the survey rules developed by our Center for Medicaid and State Operations (CMSO). It is our understanding that current regulations Start Printed Page 55265that restrict ASCs to furnishing surgical services does not limit them to surgical services on the ASC-approved list, but rather, includes all surgical services. However, questions about rules that limit services that can be furnished in an ASC are beyond the scope of this final rule.

    B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies

    Based on our review of current medical literature, we believe that nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants (PAs) whose services are covered under Medicare and who have been trained are qualified to perform screening sigmoidoscopies safely and accurately. Therefore, in the August 2, 2001 proposed rule, we proposed revising § 410.37(d) to provide that, in order for screening sigmoidoscopies to be covered, they must be performed by medical doctors, doctors of osteopathy, PAs, NPs, and CNSs, if they meet the applicable Medicare qualification requirements in §§ 410.74, 410.75, and 410.76, and if they are authorized to perform these services under State law.

    Comment: Fifteen commenters addressed the issue of whether to allow non-physician health care professionals to perform screening flexible sigmoidoscopies for Medicare coverage and payment purposes. Four of the commenters representing national non-physician health care professional organizations and a health care consultant group enthusiastically supported the proposal. Ten commenters, all national medical associations or medical specialty groups, expressed various concerns about the proposal but agreed that it was appropriate for NPs, PAs, and CNSs to perform these services. These commenters suggested clarification and revision of the rule in a number of different areas, such as the need for physician supervision and appropriate training and experience standards, to ensure quality of care in the non-physician performance of these examinations. Two of these ten commenters that suggested the need for additional requirements were national gastroenterological physician groups which were divided in their enthusiasm for the proposal. The American Gastroenterological Association indicated that properly trained physician assistants, nurse practitioners and clinical nurse specialists are capable and qualified to perform screening flexible sigmoidoscopies. However, the Association insisted that in no case should such practitioners be permitted to do so without being directly supervised by an appropriately trained and qualified onsite physician. In addition, the Association urged that these non-physician providers should never be allowed to perform these examinations without some assurance that they have been properly educated and trained to perform them. These comments were echoed by several other physician groups. On the other hand, the American College of Gastroenterologists supported the proposal without specifically mentioning the need for physician supervision and education and experience requirements. The College emphasized that there is a great need for sigmoidoscopy screening to be performed in the Medicare age group. Moreover, they observed that there may not be sufficient numbers of physicians available to perform the procedure, posing an access problem for our beneficiaries. The College stated that, if we proceed with the proposal, non-physician practitioners should be required to provide certain specific information to beneficiaries stating who had performed the examination and its impact on available benefits in future years.

    Another organization representing family physicians also noted conditions which should be met if these practitioners provide this service as proposed, but indicated that the existing Medicare regulations for these practitioners suggested that these conditions are met. For example, existing Medicare regulations require general (not onsite) rather than direct (onsite) supervision of PAs. Several other physician organizations in their recommendations also appear to support a requirement less strict than direct physician supervision.

    One other commenter—a national medical association—opposed the proposal because of concerns as to whether non-physician health care professionals could respond appropriately to problems or complications that might possibly occur during the performance of the screening procedure when a physician (with a higher level of medical skills) is not present at the facility. None of the commenters who suggested revisions to the proposed rule to specify requirements for physician supervision and/or formal training and experience, or who opposed it, produced scientific evidence in support of their views.

    Response: As we indicated in the proposed rule, a growing body of evidence from the medical literature has shown that certain properly trained non-physician health care professionals can carry out screening by flexible sigmoidoscopy as accurately and safely as physicians. (Scheon et al. Archives of Internal Medicine 2000) This procedure requires fewer supervised examinations to attain objective measures of technical competency than other endoscopic procedures, does not require sedation, and has a low rate of related complications. In the studies reviewed, physician and non-physician endoscopists achieved similar polyp detection rates and depth of insertion in screening performed independently. No significant complications from sigmoidoscopy were reported in any of these studies. The level of satisfaction with the procedure was similar for all practitioners.

    This demonstration of the ability of non-physician practitioners to perform flexible sigmoidoscopy screening safely and accurately is a very significant development. As the American College of Gastroenterology noted in its comments, there is a physician availability and a related beneficiary access problem of concern to CMS. The Balanced Budget Act of 1997, effective January 1, 1998, expanded Medicare coverage of non-physician practitioner services to address concerns about access to services, especially in rural and other areas of the United States where there is a lack of availability of physicians for performing certain services such as screening flexible sigmoidoscopies. The law and related regulations also outline the level of supervision or medical direction for these non-physician practitioners.

    Flexible sigmoidoscopy is one of the promising modalities available for decreasing mortality from colorectal cancer. The American Cancer Society estimates that more than 56,000 Americans will die of colorectal cancer this year. Studies have found that the use of screening flexible sigmoidoscopy could lead to a 30 percent reduction in total colorectal cancer mortality. (Selby et al. New England Journal of Medicine 1992.) In view of limited Medicare beneficiary access in certain areas, because screening flexible sigmoidoscopy remains an underused cancer-prevention procedure, and, in the absence of any submitted scientific literature that contradicts the underlying medical evidence supporting the proposal, we do not believe that commenters have presented us with a basis for revising the proposal as they have suggested. However, we have found that a number of commenters have offered us interesting suggestions for implementing the proposal and clarifying the agency's intent in this Start Printed Page 55266regard, which we explain in our response to the more specific comments summarized below.

    Comment: Several commenters referenced a recent OIG report entitled “Medicare Coverage of Non-Physician Practitioner Services” (OEI-02-00-00290), which they believe makes clear that CMS does not have systems in place to ensure that non-physician practitioners who provide beneficiaries with medical services and who bill Medicare directly, are performing their services in accordance with State law. One commenter states that the report implies that it is not possible for Medicare to ensure that a State law allows non-physician practitioners to provide flexible sigmoidoscopies or that the services are provided in an integrated practice arrangement with appropriate physician supervision. For example, the commenter pointed out that 16 carrier medical directors interviewed by the OIG reported that they do not verify that non-physician practitioners are performing services within their State scope of practice, and at least 22 carriers do not check the collaborative agreement required for nurse practitioners and clinical nurse specialists. The commenter indicated that the OIG concluded that services performed and billed by non-physician practitioners create potential payment and quality of care vulnerabilities since, (1) “non-physician practitioner billings are rising rapidly, but controls, which are based on scopes of practice, are limited”, and (2) carriers “do not have sufficient guidance to distinguish which non-physician practitioner services should be reimbursed by the program and which should not.” In light of these OIG findings, the commenter urges CMS to review whether and how the agency and its carriers can ensure that the above-mentioned concerns are resolved successfully when non-physician practitioners perform screening flexible sigmoidoscopies. The commenter says that “it is vital that CMS takes steps to ensure the fulfillment of these requirements to minimize any risk of experiencing the vulnerabilities referenced in the OIG report with respect to quality and payment issues.”

    Response: We agree with OIG's conclusion identifying program vulnerabilities when non-physician practitioners bill Medicare directly for their services. We also respect beneficiaries' choices and their need for access to medical services. While appreciative of OIG's suggestion that it may be appropriate to consider additional controls for Medicare payments to non-physician practitioners, we are sensitive to issues that might arise from different treatment of different classes of practitioners. As appropriate, we will monitor non-physician practitioner services for both overall trends and for complex services.

    Medicare currently defers to State licensing boards for regulating and enforcing scope of practice laws. Before issuing a Medicare billing number to a nurse practitioner or a nurse clinical specialist, contractors first determine whether the applicant has a valid license within the State. If a licensing board subsequently acts to suspend a practitioner's license to practice, then Medicare suspends payments under the practitioner's Medicare billing number. This practice is the same for physician and non-physician practitioners.

    To protect the integrity of the Medicare program, all claims submitted are subject to data analysis that may lead to a focused or a random review by a Medicare contractor. If Medicare is to begin monitoring practitioners for compliance with State laws and regulations, the program will have to develop additional regulations and policies and impose additional workloads on contractors and perhaps for all practitioners as well. In deciding whether such a process is necessary and appropriate, we will carefully consider these comments in this regard.

    Comment: One commenter asked CMS, in implementing the proposal, to ensure that non-physician practitioners are required to tender a standard notification to Medicare beneficiaries providing them with a clear statement that the screening flexible sigmoidoscopy is being furnished by a non-physician practitioner. In addition, the commenter suggests that the beneficiary be notified that under the new colorectal cancer screening benefit, effective July 1, 2001, any average-risk individual receiving a covered screening flexible sigmoidoscopy will be precluded by law from receiving Medicare payment for a screening colonoscopy (which under Medicare regulations (§ 410.37(f) must be furnished by a physician)) for four years.

    Response: We believe that our Medicare beneficiaries generally are knowledgeable about the identity of the Medicare practitioner that is furnishing them with a flexible sigmoidoscopy screening examination. Accordingly, we believe that there is no need for non-physician practitioners to provide beneficiaries with any formal notification statement in this regard. As for the suggestion that a non-physician practitioner should notify an average-risk beneficiary that providing him/her with a screening flexible sigmoidoscopy will preclude Medicare from paying for a screening colonoscopy (which must be performed by a physician) for four years, we believe that all Medicare practitioners should help to inform beneficiaries with respect to this limitation. However, we do not believe that any practitioner should be required to formally notify beneficiaries to this effect. While we believe that our Medicare contractors, and all our practitioners have an important role to play in educating our beneficiaries about the various conditions of coverage and payment limitations that apply to different colorectal cancer screening options that are available to them, we will not use these regulations as a mechanism for implementing the requested educational efforts.

    Comment: One commenter suggested that we allow registered nurses to perform these as well, as a delegated act, under a physician's direction with the physician billing Medicare for the procedure.

    Response: The regulation proposal to allow nurse practitioners, physician assistants, and clinical nurse specialists to perform screening flexible sigmoidoscopies for Medicare purposes was designed to increase beneficiary access to these screening services, especially in rural and other areas where there is a shortage or a lack of availability of physicians who are trained and qualified to perform these examinations. These non-physician practitioners are typically licensed independent practitioners who are recognized under the Medicare law and regulations for coverage and payment purposes. Under Medicare, these non-physician practitioners may be paid under the physician fee schedule for their tests (and treatments) that would be physicians' services if furnished by a physician when they are authorized by the State to perform such services. Registered nurses are not licensed independent practitioners who are recognized under Medicare law for coverage and payment purposes.

    Comment: One commenter suggested that we should monitor beneficiary health outcomes that result from the performance of sigmoidoscopy examinations by non-physician practitioners to ensure that they are done safely and accurately.

    Response: We had not planned to monitor beneficiary outcomes that might be related to implementation of the proposal to allow non-physician practitioners to perform flexible sigmoidoscopy screening because of the available evidence that they can provide these services safely and effectively. If we were to consider doing this, Start Printed Page 55267however, we would probably want to consider doing a comparative study of health outcomes of beneficiaries who have been screened by both physician and non-physician practitioners who have performed these examinations.

    Such a study would mean that a number of physician and non-physician practitioners would have to collect and report data to us on their Medicare patients for a certain period of time, which could be burdensome for them. We may be interested in doing a study in this area in the future if we had any credible evidence of a serious problem in this area, but, at this time, we do not believe a study is necessary.

    Result of Evaluation of Comments

    We are adopting our proposal to allow certain non-physician practitioners to perform screening flexible sigmoidoscopies.

    C. Services and Supplies Incident to a Physician's Professional Services: Conditions

    Section 1861(s)(2)(A) of the Act authorizes coverage of services and supplies (including drugs and biologicals that are not usually self-administered by the patient) furnished incident to a physician's service. These drugs and biologicals are commonly furnished in physicians' offices without charge or included in the physicians' bills. This statutory “incident to” benefit differs from the “incident to” benefit in the hospital setting as set forth in section 1861(s)(2)(B) of the Act, which authorizes coverage of hospital services (including drugs and biologicals which are not usually self-administered by the patient) incident to a physician's service furnished to outpatients and partial hospitalization services furnished to outpatients incident to a physician's service. This provision only addresses coverage of “incident to” services under section 1861(s)(2)(A) of the Act. In addition, the statute provides Medicare coverage of services incident to practitioners other than physicians.

    The Medicare Carriers Manual currently requires that the physician (or other practitioner) be either the employer of the auxiliary personnel or be an employee of the same entity that employs the auxiliary personnel. In the August 2, 2001 rule, we proposed to revise § 410.26 to codify our existing policy outlined in section 2050 of the manual. Specifically, we proposed to codify the definitions of auxiliary personnel, direct supervision, independent contractor, leased employment, non-institutional setting, practitioner, and services and supplies for purposes of services provided incident to a physician's service.

    In addition, we proposed to allow auxiliary personnel to provide services incident to the services of physicians (or other practitioners) who supervise them, regardless of the employment relationship of the physician (or other practitioner) to the entity that employed the auxiliary personnel.

    All commenters supported the proposal. Their specific comments are addressed below.

    Comment: Commenters noted three errors in the proposed text of the regulation. First, in the definition of auxiliary personnel set forth in § 410.26(a)(1), after the phrase “under the supervision of a physician,” the term “(or other practitioner)” was omitted. Second, in the definition of services and supplies set forth in § 410.26(a)(7), the phrase “(including drugs and biologicals that, as determined in accordance with regulations, cannot be self-administered)” should be changed to “(including drugs and biologicals which are not usually self-administered by the patient)” in accordance with section 112 of the BIPA, which amended sections 1861(s)(2)(A) and (B) of the Act. Third, in the supervision requirement set forth in § 410.26(b)(5), the word “direct” was omitted.

    Response: We agree with these comments, and we have corrected these errors.

    Comment: One commenter requested that independent contractor physicians also be recognized as employees under the reassignment policy set forth in section 3060 of the Medicare Carrier Manual.

    Response: As stated in the August 2, 2001 rule, this proposal only applies to the incident to policy. Furthermore, we are not defining or re-defining the term employment. Instead, we proposed to permit physicians (or other practitioners) to directly supervise auxiliary personnel regardless of the employment relationship of the physicians (or other practitioners) with the entity that hired the auxiliary personnel. In order to bill and receive payment from Medicare under this policy, all other applicable requirements must also be met. For example, the service must be medically reasonable and necessary, and appropriate reassignment must be executed.

    Comment: One commenter suggested using in § 410.26(b) all of the terms defined in § 410.26(a) or deleting the terms not used in § 410.26(b).

    Response: We found one term—leased employment—that was not used in § 410.26(b). However, we will not eliminate this term because it is used to define the term auxiliary personnel.

    Comment: Several commenters requested that we clarify and distinguish between the physician (or other practitioner) ordering the incident to service and the physician (or other practitioner) supervising the auxiliary personnel who perform the incident to service. They stated that confusion exists as to whose Medicare Part B billing number should be used on the claim form.

    Response: Inherent in the definition of an incident to service is the requirement that the incident to service be furnished incident to a professional service of a physician (or other practitioner). When a claim is submitted to Medicare under the billing number of a physician (or other practitioner) for an incident to service, the physician is stating that he or she either performed the service or directly supervised the auxiliary personnel performing the service. Accordingly, the Medicare billing number of the ordering physician (or other practitioner) should not be used if that person did not directly supervise the auxiliary personnel. We added language to the supervision requirement set forth in § 410.26(b)(5) to reflect this clarification.

    Comment: One commenter pointed out that the claim form currently requires the physician (or other practitioner) to certify that he or she personally supervised the employee. Therefore, the commenter requested that we update the claim form to reflect the proposed regulations.

    Response: We plan to update not only the claim form but also section 2050 of the Medicare Carriers Manual to reflect the new regulations.

    Comment: A few commenters noted that the individual does not always receive an IRS-1099 form under an independent contractor arrangement. Instead, when a clinic, for example, contracts with an entity that has hired individuals to be furnished to the clinic, then the entity (and not the individual) receives the IRS-1099 form.

    Response: We agree with these commenters. Therefore, we have added language to the definition of an independent contractor set forth in § 410.26(a)(3) to reflect this practice. However, we again emphasize that the applicable reassignment rules must also be met and that this incident to policy does not in any way alter the current requirements for valid reassignment.

    Comment: One commenter encouraged us to specify in the regulations the acceptability of forms (other than the IRS W-2 form) that the Internal Revenue Service recognizes as Start Printed Page 55268proof of employment, such as the Payroll Agent arrangement where IRS forms 2678 and 1997C are used instead.

    Response: Under our proposal, the employment relationship is irrelevant to whether a physician (or other practitioner) can effectively furnish direct supervision of the auxiliary staff. Therefore, we decline to include language that may define or re-define the term employment.

    Comment: One commenter suggested that we also include Ambulatory Surgical Centers (ASCs) and Community Mental Health Clinics (CMHCs) in the definition of a non-institutional setting because Medicare Part B payments for services provided in these settings are paid through the facility relative value units (RVUs) rather than the non-facility RVUs.

    Response: The definition of a non-institutional setting is not derived from the definition of a facility used to determine the site of service and the application of the facility or non-facility RVUs. Because section 1861(s)(2)(B) of the Act authorizes payment for hospital incident to services, section 1861(s)(2)(A) of the Act cannot authorize payment for hospital incident to services. This provision is reiterated in § 411.15(m)(2). Similarly, § 411.15(p)(2)(ii) specifically excludes payment for incident to services in skilled nursing facilities (SNFs). Consequently, we defined non-institutional settings as all settings except hospitals and SNFs, and we do not plan to define ASCs and CMHCs as institutional settings.

    Comment: Many commenters wanted us to restrict the definition of auxiliary personnel so that only certain individuals may perform a given incident to service. For example, they want us to mandate that only audiologists may perform cochlear implant rehabilitation services as incident to services. Likewise, they want us to permit only physical or occupational therapists to perform physical or occupational therapy as incident to services. In support, they noted that section 4541(b) of the BBA amended section 1862(a)(20) of the Act and required that physical or occupational therapy furnished as an incident to service meet the same requirements outlined in the physical or occupational therapy benefit set forth in sections 1861(g) and (p) of the Act.

    Response: We have not further clarified who may serve as auxiliary personnel for a particular incident to service because the scope of practice of the auxiliary personnel and the supervising physician (or other practitioner) is determined by State law. We deliberately used the term any individual so that the physician (or other practitioner), under his or her discretion and license, may use the service of anyone ranging from another physician to a medical assistant. In addition, it is impossible to exhaustively list all incident to services and those specific auxiliary personnel who may perform each service.

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

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

    Comment: Recognizing that this proposal affords flexibility in the way physicians (or other practitioners) are hired by an office or clinic, one commenter requested that non-physician practitioners be permitted to stand as locum tenens (taking the place of) for other non-physician practitioners as well.

    Response: This proposed rule does not alter in any way the current locum tenens policy.

    Result of Evaluation of Comments

    We are finalizing our proposed revisions to § 410.26 with the corrections noted above.

    D. Anesthesia Services

    We generally use the 1988 American Society of Anesthesiologists' (ASA) Relative Value Guide as the basis for the uniform relative value guide. This guide is used in all carrier localities to determine payment for anesthesia services furnished by physicians under Medicare Part B. We proposed using the ASA base unit values from the 1999 guide beginning in CY 2002 for eight codes with ASA base unit values that were different from CMS's values (specifically, CPT codes 00810; 00902; 01150; 01214; 01432; 01440; 01770; and 01921). These are older codes and, while we accepted the ASA base unit value initially, the ASA has changed this base unit subsequently and no additional adjustment was made by us to the base unit. For CPT codes 00142 and 00147, we proposed maintaining the current base unit values although they differed from the ASA values because values for these two codes were established under the “inherent reasonableness” process in 1987.

    Comment: The ASA identified additional CPT codes 00548, 00700, 00800, and 01916 with different base unit values in the most current ASA guide from our base unit values.

    Response: We are accepting the ASA's comments subject to the following clarification. In all, 12 codes were presented where the ASA base unit differs from our base unit. Of these, code 01921, which appeared on the list in the August 2, 2001 proposed rule, will be deleted in 2002. Since this code has been deleted and will no longer be used, we will not assign base units to it and, as a result, only 11 codes will be considered.

    These additional four codes were added to CPT before CY 2000. New and revised codes starting in CY 2000 and for subsequent years are evaluated on a code-specific basis under our usual process after we receive recommendations from the RUC. Thus, because we review the RUC recommendations and may make changes based on them, there could be differences between the ASA guide and our base unit values beginning in 2000. If the RUC or other commenters recommend and we agree to a base unit different from what ASA recommends, we will use that value and not the ASA Start Printed Page 55269value, even though it may be published in the ASA's guide.

    Result of Evaluation of Comments

    The complete list of 11 CPT codes for which we will assign the ASA base unit values instead of the current CMS base unit values are as follows:

    CodeCMSASA
    005481517
    0070034
    0080034
    0081065
    0090245
    01150810
    01214108
    0143256
    0144058
    0177086
    0191656

    A related issue is the treatment of base unit values for new codes for 2002 as discussed in section V. The RUC reviewed the work values for 19 new anesthesia codes for 2002. We agree with the RUC on 17 of these codes but recommend lower values for 2 codes. The RUC recommended 9 units for CPT code 00797 (anesthesia for gastric restrictive procedure for morbid obesity) and we proposed 8 units. The RUC recommended 3 units for CPT code 01968 (cesarean delivery following neuraxial labor analgesia/anesthesia—list separately in addition to the code for primary procedure), and we proposed 2 units. (See section V for additional information on the valuing of these new anesthesia services.)

    Result of Evaluation of Comments

    We are implementing the base units for the 11 existing codes where there are differences between the ASA's guide and our base units and for which we received comments. In addition, we are implementing the base units which the RUC recommended for 17 new codes and the base units which we recommended and which are lower than the RUC's recommendation for 2 new codes.

    E. Performance Measurement and Emerging Technology Codes

    In the August 2, 2001 proposed rule (66 FR 40383) we included a discussion of the two new categories of CPT codes: Performance Measure codes, referred to as Category II CPT codes, which are intended to facilitate data collection; and, Emerging Technology codes, referred to as Category III CPT codes, which are intended to track new and emerging technologies.

    For the Performance Measure codes, which have a syntax of four digits followed by the letter “F,” we stated that no values would be placed on the Performance Measure codes and no additional payment would be made for the use of these codes. Practitioners would, however, be able to report them on their Medicare bills to enable us to track these services.

    For the Emerging Technology Codes, which have a syntax of four digits followed by the letter “T,” we stated that we would pay, on a case-by-case basis in specific situations, when we determine that the codes represent services that are not, in fact, experimental, but have been shown to be safe and effective. If the coverage policy is not consistent with the existing tracking codes, a Medicare-specific code may need to be developed to allow payment for the service. Thus, only specific emerging technology codes would be recognized for Medicare payment.

    Comment: Commenters expressed appreciation for our recognition of these new categories of CPT codes. However, one commenter believed that we should refrain from categorically denying payment for category III (emerging technology) CPT codes, because these CPT codes may sometimes warrant payment. Another commenter believed that we were proposing not to pay for these codes at all. The commenter recommended that we clarify in the final rule that carriers may determine if payment should be made for a particular emerging technology code.

    Response: We believe that these codes will serve a useful purpose. We regret that some commenters believed that the discussion in the proposed rule implied that these services should not be covered. We only intended to indicate that by publishing these codes we are not indicating that we would pay for these services in all instances. As the commenter indicates, coverage of emerging technologies and payment for these services is at the discretion of the carriers. We also want to clarify that our carriers will be able to incorporate these codes only after they are entered into our system during our regularly scheduled updates and not as soon as the AMA posts them on the CPT web site.

    Result of Evaluation of Comments

    We would like to clarify the intent of our proposal regarding emerging technology CPT codes. The emerging technology CPT codes will be published in the physician fee schedule with a status indicator of “C” to indicate that coverage and payment of these services is at the discretion of the carrier. The only exceptions will be for those emerging technology CPT codes that describe services for which Medicare has issued an NCD. In these situations, coverage will be based on the NCD, and we may establish national payment or may leave payment to the discretion of the carriers. It is also possible that an NCD or an established payment policy may foreclose coverage and/or payment for an emerging technology CPT code. In summary, we will finalize our proposal to allow both the CPT Performance Measure Codes (that is, codes with four digits followed by the letter “F”) and Emerging Technology Codes (that is, codes with four digits followed by the letter “T”) to be listed on Medicare bills and provide payment for the emerging technology codes as determined by the carrier.

    F. Payment Policy for CPT Modifier 62 (Co-Surgery)

    The CPT modifier code 62 is used to report the work of co-surgeons. Currently, if we pay for co-surgery, we pay a total of 125 percent of the fee schedule amount to the co-surgeons who each receive half of this total payment. In the August 2, 2001 proposed rule (66 FR 40383), we stated that we would be examining our payment policies for co-surgery to consider possible ways to ensure that they reflect current clinical practices and properly reflect the relative resources and work effort required to perform these services. We outlined several issues under consideration and specifically solicited information to assist us in deciding whether to make a future proposal affecting payments for co-surgery.

    Result of Evaluation of Comments

    Commenters responded to the specific questions in the proposed rule. Many commenters believe that the current payment policy is reasonable and that the focus should be on education efforts to ensure the appropriate use of the modifier. We will review carefully the information the commenters have provided. If we determine that we need to proceed with a change in payment policy for co-surgery, the change would be proposed as part of future rulemaking.

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

    The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) (Public Law 106-554), enacted on December 21, 2000, provides for revisions to policies applicable to the physician fee Start Printed Page 55270schedule. These revisions are presented below.

    A. Screening Mammography

    Medicare has paid for screening mammography since January 1, 1991. Section 1834(c) of the Act governing these screenings did not include screening mammography under the physician fee schedule; it provided for payment under a separate statutory methodology. Section 104 of BIPA amends section 1848(j)(3) of the Act to include screening mammography as a physician's service for which payment is made under the physician fee schedule beginning January 1, 2002. In the August 2001 proposed rule, we proposed amending §§ 405.534 and 405.535 to reflect the inclusion of screening mammography as a physician's service which will be payable under the physician fee schedule. In addition, we proposed amending § 414.2 to include screening mammography under the definition for physicians' services. In accordance with part 414, payments for screening mammography will be resource-based and will have geographic adjustments that reflect cost differences among areas as do all other services under the physician fee schedule, including diagnostic mammography.

    The following is a summary of the RVUs proposed for the professional and technical components (PC and TC) of a screening mammography, CPT code 76092, under the physician fee schedule.

    Professional Component

    A screening mammography service typically requires the same number of views as a unilateral diagnostic mammography. Therefore, for screening mammography, we proposed a physician work RVU of 0.70 based on the physician work established for a unilateral diagnostic mammography. This value is equal to the proposed work RVUs from the 5-year review of physician work for CPT code 76090, unilateral diagnostic mammogram (see June 8, 2001 proposed notice, “Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule”). Since we believe that the practice expense and malpractice expense for the professional component of screening mammography is similar to the professional component of unilateral diagnostic mammography, we proposed establishing 0.25 practice expense RVUs and 0.03 malpractice RVUs for the PC of screening mammography.

    Technical Component

    We proposed valuing the technical component of screening mammography using a methodology that updates the original statutory limit for the technical component of screening mammography of $37.40, by the cumulative increase in physician fee schedule rates between 1992 and 2001 (see the August 2, 2001 proposed rule (66 FR 40384) for specific information on methodology). This resulted in proposed practice expense and malpractice RVUs for the technical component of screening mammography of 1.27 and 0.06, respectively.

    Overall, the total proposed RVUs associated with the combined PC and TC of CPT code 76092 were 2.31 (0.70 work RVUs, 1.52 practice expense RVUs, and 0.09 malpractice expense RVUs).

    New Technology Mammography

    The BIPA also required us to determine whether the assignment of new HCPCS codes is appropriate for both screening and diagnostic mammography performed using new digital technologies.

    We determined that new HCPCS codes are appropriate for the new digital technology mammography beginning January 1, 2002. We proposed three separate codes for directly taking a digital image (one for screening and one each for unilateral and bilateral diagnostic). We also proposed a single add-on code for computer-aided diagnosis with conversion of standard film images to digital images, since, at the time of the development of the proposed rule, the FDA approved computer-aided diagnosis only for screening mammography. Following is a summary of our proposed coding and payment methodologies for digital mammography.

    Screening Mammography, Direct Digital Image (Gxxx1)

    We proposed HCPCS code Gxxx1 to report screening mammography performed using direct digital images as opposed to mammography that is performed using the standard film images associated with CPT code 76092, or conversion of a standard film image to a digital image. For the PC of HCPCS code Gxxx1, we proposed 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx1, for which there is no physician work associated, we proposed 2.50 practice expense RVUs and 0.06 malpractice RVUs.

    Diagnostic Mammography, Unilateral, Direct Digital Image (Gxxx2)

    We proposed HCPCS code Gxxx2 to report unilateral diagnostic mammography performed using direct digital images as opposed to mammography performed using the standard film images associated with CPT code 76090, or conversion of a standard film image to a digital image.

    For the professional component of HCPCS code Gxxx2, we proposed 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx2, with which there is no physician work associated, we proposed 1.99 practice expense RVUs and 0.05 malpractice expense RVUs.

    Diagnostic Mammography, Bilateral, Direct Digital Image (Gxxx3)

    We proposed HCPCS code Gxxx3 to report bilateral diagnostic mammography that is performed using direct digital images as opposed to mammography performed using the standard film images associated with CPT code 76091, or conversion of a standard film image to a digital image.

    For the PC of HCPCS code Gxxx3, we proposed 0.87 work RVUs, 0.34 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx3, with which there is no physician work associated, we proposed 2.47 practice expense RVUs and 0.06 malpractice expense RVUs.

    Computer-Aided Detection, With Either Direct Digital Image or Conversion of Standard Film Images to Digital Images (HCPCS Code Gxxx4)

    We proposed HCPCS code Gxxx4 to report conversion of standard film images to digital images when used in conjunction with computer-aided diagnosis software. This code was proposed as an add-on code that can be billed only in conjunction with the primary service, CPT code 76092, based on our understanding that the only FDA-approved use of the computer-aided diagnosis mammography software is with screening film images. If there are other FDA-approved uses of computer-aided diagnosis, we stated we would allow for use of Gxxx4 as an add-on to other mammography services.

    For the PC of code Gxxx4, we proposed 0.06 work RVUs, 0.02 practice expense RVUs, and 0.01 malpractice expense RVUs. For the TC of HCPCS code Gxxx4, with which there is no physician work associated, we proposed 0.41 practice expense RVUs and 0.01 malpractice expense RVUs.

    Since publication of the proposed rule, the FDA has also approved the use Start Printed Page 55271of computer-aided diagnosis with diagnostic mammography.

    Comment: The majority of comments received from manufacturers, specialty organizations, individuals, and representatives of the Congress were supportive of our proposed payment of mammography services beginning January 1, 2002. The general consensus from commenters was that the proposed 21 and 26 percent increase, respectively, in payments for unilateral and bilateral diagnostic mammography, as a result of the 5-year review of work (see section IV), the new resource-based payment for screening mammography, the new resource-based payments for both digital screening and digital diagnostic mammography, and the payments for computer-aided diagnosis reflect the relative resources associated with each individual service.

    However, two commenters still believe that the 21 percent and 26 percent increase in payments for unilateral and bilateral diagnostic mammography, respectively, was still inadequate to cover the costs of these services.

    Response: In agreement with the majority of comments received, we continue to believe that our proposed relative values are an accurate reflection of the resources associated with the provision of these services.

    Comment: We received comments that suggested that Medicare payment is inadequate to cover the cost of screening mammography. One commenter stated that, due to the Federally-mandated Mammography Quality Standards Act (MQSA) requirements intrinsic to mammography (both screening and diagnostic), it is difficult to use the current methodology to account for all practice expenses. This commenter did indicate support for our proposal to develop practice expense RVUs for screening mammography using a comparison to unilateral diagnostic mammography.

    Response: We are currently using the “no work” methodology to price the technical component of diagnostic mammography and a special method for the technical component of screening mammography. We believe that most costs associated with mammography services are likely to be associated with the technical component. At this time, we plan to continue using these methods to establish the practice expense relative value units for the technical component of mammography services. However, if we propose a change to the methodology for no-work services in the future, we agree that it is important to consider whether MQSA costs are incorporated in the data sources we are using to develop RVUs.

    Comment: We received two comments that suggested Medicare should not pay for screening mammography using the physician fee schedule until payment is set at an appropriate level so as not to require reduction in payments for other services. The commenters were concerned about the reduction in payment for other services that would result from the increase in payment for screening mammography using the methodology we proposed. These commenters acknowledged that the statute requires us to pay for screening mammography using the physician fee schedule. One commenter appreciated the significant effort that CMS put forth to comply with the mandate.

    Response: As indicated by the comments, section 104(a) of the BIPA requires us to pay for screening mammography using the Medicare physician fee schedule beginning January 1, 2002. We estimate that payment in 2002 for screening mammography under the statutory methodology would have been about $71, which is less than the $81 that Medicare will pay under the physician fee schedule. Since screening mammography is paid under the physician fee schedule, the increase in payment will be subject to the budget neutrality calculations under section 1848(c) of the Act. The increase in payment, although large, will have little effect on payment for other physician fee schedule services. The required adjustment to other physician fee schedule payments is less than −0.1 percent.

    Comment: We received comments about coding for new technology screening mammograms. These comments indicated support for our proposed coding but noted that two developments have since occurred that we could not have taken into account in our proposed rule. First, CPT created a new code for computer-aided detection (CAD) as an add-on for screening mammography. Second, the Food and Drug Administration approved use of CAD for diagnostic mammography. The commenters requested that we use the CPT code for CAD as an add-on to screening mammography and create a slightly modified HCPCS alphanumeric code as an add-on for diagnostic mammography. The modification would specify that the alphanumeric code is to be used as an add-on for diagnostic mammography. Commenters also suggested that we accommodate potential future FDA approved uses of CAD as an add-on to digital mammography through necessary coding and payment changes as soon as possible without having to await the next rulemaking cycle.

    Response: We agree with the comments about coding of CAD. Medicare will recognize CPT code 76085 for CAD as an add-on to screening mammography and procedure code G0236 as an add-on to diagnostic mammography. The code descriptors make clear that the CPT code is for use as an add-on to screening mammography and the alphanumeric code is an add-on to diagnostic mammography. Payment for the revised codes follows the proposed rule approach for physician work, practice expense and malpractice for all mammography services. There may be slight changes to the RVUs for practice expenses as a result of updated information included in this final rule that affect all physician fee schedule services.

    In response to the comment about potential future FDA approved uses of CAD as add-on to digital mammography, it is possible that additional coding changes will be necessary or that editorial revisions to existing codes will allow for CAD to be paid as an add-on for digital mammography. We would like to coordinate our efforts with those of the CPT to minimize the need for alphanumeric codes and additional CPT codes.

    Comment: One commenter expressed concern about the payment associated with the Outpatient Prospective Payment System for all forms of mammography.

    Response: Any issues related to the Outpatient Prospective Payment System are outside the scope of this regulation and will be addressed by a separate regulation.

    Comment: One commenter asked for clarification on Federally Qualified Health Centers (FQHC) reimbursement for screening mammography and other new services.

    Response: Any issues related to FQHC reimbursement are outside the scope of this regulation.

    Comment: One commenter expressed concern that CMS did not work more closely with the CPT codes in the establishment of coding for digital mammography.

    Response: Whenever possible, CMS works with the American Medical Association's CPT Editorial Panel to establish coding for new technologies. The AMA CPT Editorial Panel has not established codes for digital mammography; therefore, CMS proactively established temporary G-codes for the digital mammography and Start Printed Page 55272computer-aided detection for diagnostic mammograms.

    Comment: One commenter indicated that the malpractice expense for screening mammography should be higher than the unilateral diagnostic value of 0.03 since most mammography malpractice claims arise from allegations of cancers not detected or inappropriate follow-up of screening mammograms, not diagnostic studies. In addition, the screening mammography malpractice apportionment should be reversed for the PC and TC portions as the malpractice expense and risk is primarily with the interpreter of the screening mammogram, not the facility producing the technical component.

    Response: We will consider the malpractice RVUs for these services interim for 2002 and will examine this issue with respect to the methodology used to establish malpractice RVUs.

    Result of Evaluation of Comments

    We will finalize our proposed relative values, because we believe they are an accurate reflection of the cost associated with the provision of these services. Additionally, we will also establish a temporary G-code (G0236) for the recent FDA approval of computer-aided detection used in conjunction with diagnostic mammography.

    Table 3.—2002 Mammography Payments

    CPT 1 HCPCSMODDescriptorWork RVUPractice Expense RVUMalpractice RVUTotal
    76090Mammogram, one breast0.701.250.082.03
    7609026Mammogram, one breast0.700.250.030.98
    76090TCMammogram, one breast0.001.000.051.05
    76091Mammogram, both breast0.871.540.092.50
    7609126Mammogram, both breast0.870.300.031.20
    76091TCMammogram, both breast0.001.240.061.30
    76092Mammogram, screening0.701.440.092.23
    7609226Mammogram, screening0.700.250.030.98
    76092TCMammogram, screening0.001.190.061.25
    G0202Mammogram, screen, dir dig0.702.520.093.31
    G020226Mammogram, screen, dir dig0.700.300.031.03
    G0202TCMammogram, screen, dir dig0.002.420.062.48
    G0204Diag mammo, bilat, dir dig0.872.730.093.69
    G020426Diag mammo, bilat, dir dig0.870.350.031.25
    G0204TCDiag mammo, bilat, dir dig0.002.380.062.44
    G0206Diag mammo, unilat, dir dig0.702.200.082.98
    G020626Diag mammo, unilat, dir dig0.700.280.031.01
    G0206TCDiag mammo, unilat, dir dig0.001.920.051.97
    G0236Computer aided detect, diag0.060.310.020.39
    G023626Computer aided detect, diag0.060.020.010.09
    G0236TCComputer aided detect, diag0.000.290.010.30
    76085Computer aided detection0.060.310.020.39
    7608526Computer aided detection0.060.020.010.09
    76085TCComputer aided detection0.000.290.010.30
    1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.

    B. Screening Pelvic Examinations

    Section 101 of the BIPA amends section 1861(nn)(2) of the Act (effective July 1, 2001) to provide that a woman who does not qualify for annual coverage of a screening pelvic examination under one of the statutory exceptions, qualifies for coverage of a screening pelvic examination (including a clinical breast examination) once every 2 years rather than once every 3 years.

    In the August 2, 2001 proposed rule, we made conforming changes to § 410.56 (Screening Pelvic Examinations) of the regulations to reflect this statutory provision that has been implemented through sections 4603, 3628.1 and 4731 of the Medicare Carrier Manual, the Medicare Intermediary Manual, and the Medicare Hospital Manual, respectively.We received only one specific comment on the new screening pelvic examination proposal. That comment supported our proposed rule and recognized that the regulations are consistent with the Medicare law.

    Result of Evaluation of Comments

    We are adopting our proposal to conform the regulations to the law to provide coverage for biennial screening pelvic examination for women not at high risk for cervical or vaginal cancer, effective July 1, 2001.

    C. Screening for Glaucoma

    Section 102 of the BIPA provides for Medicare coverage under Part B for screening for glaucoma for individuals with diabetes, a family history of glaucoma, or others determined to be at “high risk” for glaucoma effective for services furnished on or after January 1, 2002. The statute provides for coverage of glaucoma screening, including (1) a dilated eye examination with an intraocular pressure measurement, and (2) a direct ophthalmoscopy or a slit-lamp biomicroscopic examination, subject to certain frequency and other limitations.

    In the August 2, 2001 rule, we proposed a new § 410.23 (Screening for Glaucoma: Conditions for and Limitations on Coverage), to provide for coverage of the various types of glaucoma screening examinations specified in the statute. As provided in the statute, this new coverage allows payment for one glaucoma screening examination every year. To implement the statutory provisions, we proposed definitions for the following terms—screening for glaucoma, eligible beneficiaries, and direct supervision.

    In keeping with the language of section 102(b) of the BIPA we proposed defining the term “screening for glaucoma” to mean a dilated eye examination with an intraocular pressure measurement and a direct ophthalmoscopy or a slit-lamp biomicroscopic examination for the Start Printed Page 55273early detection of glaucoma. This section also provides that the screening examinations that are to be covered under Medicare are to be furnished by or under the direct supervision of an optometrist or ophthalmologist who is legally authorized to furnish these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished. These are services that would otherwise be covered if furnished by a physician or as incident to a physician's professional service. We also proposed incorporating this language in § 410.23.

    We used the term “eligible beneficiaries” to indicate who may qualify for the new screening glaucoma benefit, and we proposed defining that term to include—individuals with diabetes mellitus, individuals with a family history of glaucoma, and African-Americans age 50 and over. As explained in the August 2 proposed rule, based on our review of the medical literature, and consultation with staff of the National Eye Institute and representatives of the American Academy of Ophthalmology and the American Optometric Association, we interpreted the statutory language, “individuals determined to be at high risk for glaucoma” to include Medicare beneficiaries who are African-Americans age 50 and over.

    We felt that the medical evidence available at this time was only sufficient to support inclusion of African-Americans age 50 and over in the statutory “high risk” category, in addition to individuals with diabetes and those with a family history of glaucoma who are covered separately under the new screening benefit. However, we specifically solicited public comment on the appropriateness of including other individuals in the statutory definition of “high risk” for glaucoma, with supporting documentation from medical literature.

    Section 102(b) of the BIPA provides that the glaucoma screening examination is to be furnished by or under the direct supervision of an ophthalmologist or optometrist who is legally authorized to furnish such services under State law or regulation in which the services are furnished. We proposed defining the term “direct supervision” as that term is defined in § 410.32(b)(3)(ii) for purposes of the oversight of covered diagnostic laboratory services as they are performed in the office setting. Specifically, for purposes of screening glaucoma we proposed defining the term “direct supervision” to mean that the ophthalmologist or optometrist must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. The definition states that the term “direct supervision” does not mean the physician must be present in the room when the procedure is performed.

    We also proposed conforming changes to specify an exception to the list of examples of routine physical checkups excluded from coverage in §§ 411.15(a)(1) and 411.15(k)(9) for glaucoma screening examinations that meet the frequency limitation and the conditions for coverage that we are specifying under new § 410.23.

    We received six comments that generally supported the proposal to implement section 102 of BIPA that provides for Medicare coverage of screening for glaucoma. Four of these comments were submitted by national medical associations, one was submitted by a pharmaceutical company, and another was provided by a consulting group. Only one commenter had a suggestion for revising the specific coverage provisions of the proposal.

    Comment: One commenter responded to our invitation to the public in the proposed rule to submit comments on the question of whether it might be appropriate to include other individuals (and not just African-Americans over age 50) in the statutory definition of those at “high risk” for glaucoma. First, the commenter cites an article from the medical literature that notes that “one of the clearest factors relating to increased glaucoma prevalence is age.” (Gilchrist. Ophthalmic Physiol Opt 2000) Second, the commenter refers to other eye experts in the research of the epidemiology of glaucoma who have suggested that “the appropriate age at which screening might be most effective is 6 to 10 years younger among those of African descent because of the earlier onset of disease.” (Quigley and Vitale. Invest Ophthalmol Vis Sci 1997) Third, the commenter states that the latter conclusion is supported by data showing that in African-Americans who eventually develop glaucoma, the disease is present in 25 percent by age 54, 50 percent by age 65, and 75 percent by age 75. The commenter cites from the same Quigley article that comparable ages for these percentages of disease development in non-African-Americans are 64, 72, and 81 years, respectively. Finally, the commenter concludes that this literature supports a policy that would provide the glaucoma screening benefit for non-African Americans at an age 6 to 10 years older than for African-Americans (for example, 50 years of age), or beginning at age 56 to 60 years of age.

    Response: We believe that the commenter has not interpreted the results of the Quigley and Vitale studies correctly. The article by Quigley and Vitale reported the results of a meta-analysis and statistical modeling to estimate the prevalence and incidence of glaucoma. In general, results from meta-analysis and remodeling are often limited by the quality and comparability of the original source data. In the proposed rule, we used data reported directly from the Baltimore Eye Study (Tielsch, et al. JAMA 1991) and the Beaver Dam Eye Study (Klein, et al. JAMA 1992), two of the largest published studies on glaucoma. These studies indicated that the prevalence of glaucoma in non-African-Americans starts to increase after the age of 65 to 70 years, whereas the prevalence increases much earlier in African-Americans. Our decision to include African-Americans in the statutory category of those at “high risk” for glaucoma was based on these studies and the increased prevalence of glaucoma in African-Americans.

    Although we have decided not to add new populations to the definition of high risk at this time, the comment does raise the issue of how we should revise the definition in the future, if there is evidence to do so. We have decided to revise the proposed language in § 410.23(a)(2) so that it specifically refers to “individuals in the following high risk categories” to make it more consistent with the statute. This new structure for the regulation language will permit CMS to more easily add high risk groups to the glaucoma screening benefit through the rulemaking process should the evidence in the medical literature warrant it.

    Payment for Glaucoma Screening

    We believe that services provided as part of glaucoma screening will often overlap with services a physician provides during a patient encounter for ophthalmological services without requiring any additional work or practice expense. Therefore, we proposed bundling payment for glaucoma screening when it is provided on the same day as an evaluation and management (E/M) service or when it is provided as part of any ophthalmology service. In instances when glaucoma screening is the only service provided or when it is provided as part of an otherwise non-covered service (for example, CPT code 99397, preventive services visit,) we proposed the following HCPCS codes and payments: Start Printed Page 55274Gxxx5, Glaucoma Screening Furnished by a Physician for High Risk Patients.

    For physician work and for malpractice, we proposed work and malpractice RVUs of 0.45 and 0.02, respectively, by crosswalking these values from CPT code 99212. Gxxx6, Glaucoma Screening Furnished Under the Direct Supervision of a Physician for High Risk Patients.

    For physician work and for malpractice, we believe this new HCPCS code represents a level of work comparable to other E/M services performed “incident to” a physician's service and therefore proposed to crosswalk the work and malpractice RVUs from CPT code 99211 (E/M service that may not require the presence of a physician) which are 0.17 and 0.01, respectively.

    For non-facility settings, we proposed the following practice expense inputs for both of the above HCPCS Codes— clinical staff time-certified ophthalmic medical technologist/certified ophthalmic technician/registered nurse: five minutes; equipment: screening lane; and supplies: ophthalmology visit supply package.

    Comment: We received a comment from the American Academy of Ophthalmology (AAO) agreeing with our decision to bundle glaucoma screening with other E/M services and with our decision to create two levels of glaucoma screening services based on whether or not the physician performed the evaluation. The AAO also agreed with our proposal regarding RVUs for glaucoma screening performed “incident to” but commented that the level of payment for glaucoma screening performed by a physician was too low. They believe that payment rate should be a blend between CPT codes 99202 (Office or other outpatient visit for evaluation and management of a new patient) and 99213 (Office or other outpatient visit for evaluation and management of an established patient). This is based on the expectation that some patients receiving the service will be “new” patients to the ophthalmologist while others will have previously seen the ophthalmologist and therefore be “established” patients.

    The AAO proposes that for 2002, payment be equivalent to CPT code 99202 for both physician work and practice expense, that for 2003, payment be equivalent to a 4.4 percent/95.6 percent blend of CPT codes 99202 and 99213 for both physician work and practice expense, that for 2004, payment be equivalent to a blend of 4.5 percent/95.5 percent blend of CPT codes 99202/99213, and that for 2005 and thereafter, payment be equivalent to a blend of 4.6 percent/95.4 percent of CPT codes 99202/99213. The AAO believes that the amount of history, physical examination, and medical decision making required for glaucoma screening approximates the amount of history, physical examination and medical decision making required for CPT code 99202 at the time of the first glaucoma screening and approximates the amount of history, physical examination, and medical decision making required for 99213 at the time of subsequent glaucoma screenings.

    The American Optometric Association (AOA) echoed the AAO's comments concerning the crosswalk for physician work. They also noted that the practice expense inputs should be crosswalked to the intermediate ophthalmologic codes.

    Response: We are finalizing our proposal to assign 0.45 work RVUs and .02 malpractice RVUs to Gxxx5, glaucoma screening performed by a physician (now G0117). This service is a screening service and therefore cannot be easily compared to the key components of a level III evaluation and management service (CPT code 99213). We also believe that the vast majority of beneficiaries receiving this service will be patients who have been previously seen by the ophthalmologist performing the service and, therefore, CPT code 99202 would not be an appropriate crosswalk for this service. We believe the work required for this service is similar whether or not the patient is “new” or “established”. Patients undergoing a screening service have no chief complaint or history of present illness. To perform this service, the only historical information required is a determination as to whether the beneficiary meets the criteria in the law, (for example, is at high risk for glaucoma). Therefore, the requirements for taking a history are actually less than the requirements of CPT code 99212. Additionally, the physical examination requirements are specified in the statute and are similar to the requirements of CPT code 99212. Furthermore, the vast majority of patients undergoing screening will not have glaucoma, so the typical screening service will require routine medical decision making. For those few patients with glaucoma who will need to schedule a return visit, the medical decision making is straightforward. Therefore, the glaucoma screening requirements are similar to CPT code 99212. Our decision to assign 0.45 work RVUs to this service is also consistent with the time required to perform the service and places it in correct rank order with regard to other screening services payable under Medicare. We have decided to accept the recommendation of AOA on practice expense inputs and will crosswalk the inputs from CPT code 92012, brief ophthalmic exam performed on an established patient, rather than using the practice expense inputs from CPT codes 99202 and 99213 as suggested by AAO.

    Because we received no comments on the RVUs for the Gxxx6 code, Glaucoma Screening Furnished Under the Direct Supervision of a Physician for High Risk Patients (now G0118), we will implement this as proposed and will assign .17 work RVUs and .01 malpractice RVUs. For practice expense, we will also crosswalk this code to CPT 92012.

    Comment: Several commenters noted that medical technicians do not have the education or training to provide screening glaucoma services. One commenter noted that ophthalmic medical personnel (OMP) are not licensed by State regulatory agencies and are precluded from ordering medications, including eyedrops. The commenter states that, according to the Joint Commission on Allied Health Personnel in Ophthalmology and the Association of Technical Personnel in Ophthalmology, OMPs cannot be independent practitioners, cannot diagnose or treat eye disorders and cannot prescribe medications. Since a dilated eye exam requires medication, the OMP cannot perform the exam without the patient first being seen by an ophthalmologist or optometrist.

    Response: The regulation is drafted based on the statutory provision; however, it does not supersede any State laws or licensing requirements.

    Result of Evaluation of Comments

    We are adopting our proposal to include only African-Americans age 50 and over in the statutory category of those at “high risk” for glaucoma. We are revising the regulation in § 410.23(a)(2) to read “Eligible beneficiary means individuals in the following high risk categories.” This should allow CMS to more easily add high risk groups by rulemaking should the medical evidence warrant it.

    For G0117 Glaucoma Screening for High Risk Patients Furnished by an Optometrist or Ophthalmologist—we will assign 0.45 work RVUs, .02 malpractice RVUs and we will crosswalk practice expense inputs from CPT code 92012.

    For G0118 Glaucoma Screening for High Risk Patients Furnished Under the Direct Supervision of an Optometrist or Ophthalmologist—we will assign .17 work RVUs and .01 malpractice RVUs. Start Printed Page 55275For practice expense we will also crosswalk this code to CPT code 92012.

    D. Screening Colonoscopy

    Before the enactment of the BIPA, sections 1861(pp)(1)(C) and 1834(d)(3)(E) of the Act authorized Medicare coverage of screening colonoscopies once every 2 years for individuals at high risk for colorectal cancer. Individuals not at high risk for colorectal cancer did not qualify for coverage of screening colonoscopies under the colorectal cancer screening benefit, but they did qualify for coverage of other colorectal cancer screening examinations specified in the statute. These other examinations that were covered for individuals not at high risk for colorectal cancer included screening fecal-occult blood tests, screening flexible sigmoidoscopies, and screening barium enema examinations at certain frequency intervals specified in the statute and the regulations at § 410.37 (Colorectal cancer screening tests).

    Section 103 of the BIPA amended sections 1861(pp)(1)(C), 1834(d)(2)(E)(ii), and 1834(d)(3)(F) of the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. However, in the case of an individual who is not at high risk for colorectal cancer, but who has had a screening flexible sigmoidoscopy within the last 4 years, the statute provides that payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed. In addition, the statute provides that, in the case of an individual who is not at high risk for colorectal cancer but who does have a screening colonoscopy performed on or after July 1, 2001, payment may be made for a screening flexible sigmoidoscopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.

    In view of the statutory changes, we are conforming §§ 410.37(e) and 410.37(g) (related to limitations on coverage of screening colonoscopies and screening flexible sigmoidoscopies) to make them consistent with the new provisions of the statute that have been implemented through manual provisions of the Medicare Carriers Manual, the Medicare Intermediary Manual Part III, and the Medicare Hospital Manual in transmittal numbers 6097, 1824, and 7069, respectively, in February 2001.

    Payment for Screening Colonoscopy

    Payment for screening colonoscopy will be made under HCPCS code G0121: colorectal screening; colonoscopy for an individual not meeting criteria for high risk. As with current code G0105, screening colonoscopy for an individual at high risk, payment will be made at the level for a diagnostic colonoscopy, CPT code 45378, because the work is the same whether a procedure is screening or diagnostic. As the statute requires that, for both individuals who are or are not at high risk, if, during the course of the screening colonoscopy, a lesion or growth is detected that results in a biopsy or removal of the growth, the appropriate diagnostic procedure classified as colonoscopy with biopsy or removal should be billed and paid rather than HCPCS code G0105 or G0121.

    We received four comments in support of the proposal to conform the regulations to the Medicare law implementing the new screening colonoscopy provision (section 103 of the BIPA) for individuals not at high risk for colorectal cancer. One of the commenters, however, did have a suggestion for how we could improve the manual instructions that we issue to our carriers on this subject.

    Comment: The commenter suggests that we instruct our Medicare carriers to identify which International Classification of Diseases—Volume Nine (ICD-9) codes are acceptable to use in conjunction with the interim GO121 code that has been proposed for billing for covered screening colonoscopies performed for individuals not at high risk for colorectal cancer. The commenter stated that our failure to do this for screening flexible sigmoidoscopy code G0104 in the billing instructions we issued to our carriers in 1998 created problems for everyone concerned because individual carriers adopted a variety of acceptable ICD-9 codes, but did not inform the public under what circumstances the examinations were covered and when they were not.

    Response: We are not aware of the problems stated above with respect to the Medicare billing codes for screening flexible sigmoidoscopies in 1998. In addition, we have not received any complaints about the new billing instructions that we released to our carriers in February of this year in conjunction with the interim G0121 code that was issued (effective July 1, 2001) for use in billing for screening colonoscopies for individuals not at high risk for colorectal cancer. Since individuals who might qualify for coverage under this new screening benefit are those who would not be at “high risk” for colorectal cancer, it is not clear to us why the physician billing for the service would need to provide any ICD-9 code for the examination to the carrier for Medicare payment to be made. We do not require that such information be submitted to the carrier at the present time in these circumstances.

    Result of Evaluation of Comments

    We are implementing our proposal as stated above. In view of the comment, we will review the matter, and we will take any necessary action that might be deemed appropriate.

    E. Medical Nutrition Therapy

    Section 105 of the BIPA amended section 1861(s)(2) of the Act to authorize Medicare Part B coverage of medical nutrition therapy (MNT) for certain beneficiaries who have diabetes or a renal disease, effective for services furnished on or after January 1, 2002. This new benefit is similar to a benefit initially established by section 4105 of the BBA as a component of the diabetes outpatient self-management training (DSMT) benefit. The DSMT benefit, described at section 1861(qq) of the Act, is a comprehensive diabetes training program, of which nutrition training is only one component.

    Consistent with section 105(a)(3) of the BIPA, we considered the protocols of the American Dietetic Association (ADA) and the National Kidney Foundation (NKF) regarding medical nutrition therapy training for both diabetes and renal disease in order to establish criteria for coverage of these services. Because the protocols were inconclusive with respect to duration and frequency issues, we proposed to determine the duration and frequency of the benefit through the NCD process rather than through the rulemaking process.

    We proposed to set forth the provisions regarding medical nutrition therapy at Part 410, subpart G and at § 414.64. The MNT provisions of the final rule follow.

    Definitions (§ 410.130)

    We defined “renal disease” for the purpose of this benefit as only chronic renal insufficiency and post-transplant care provided after discharge from the hospital. We proposed to limit post-transplant care to care furnished within 6 months after discharge from the hospital, if the transplant is viable and effective, because, under such conditions, we believe the beneficiary would no longer have renal disease and Start Printed Page 55276would not be eligible to receive the benefit under the statutory provision. We specifically solicited comments on this proposed time period, and requested that the commenters support their comments with articles from medical journals. We also established definitions of “diabetes”, “renal disease”, and “chronic renal insufficiency” for the purpose of this benefit using definitions from the Institute of Medicine report, “The Role of Nutrition in Maintaining Health in the Nation's Elderly,” published in 2000.

    We proposed defining “episode of care” as a time period not to exceed 12 months, starting with the assessment (based on a referral from a physician), and including all covered interventions. Finally, in accordance with the statute, we defined MNT services as nutritional diagnostic, therapy, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing disease.

    Medical Nutrition Therapy (§ 410.132)

    At § 410.132(a), we proposed the conditions for coverage of MNT services. Specifically, we proposed that Medicare Part B pay for MNT services furnished by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the beneficiary's treating physician. We proposed to limit the definition of physician to “treating physician” to ensure that the physician establishing the need for MNT is actually treating the beneficiary for a covered chronic disease and that the therapy is coordinated with the care being provided by the treating physician.

    We proposed that the services covered consist of nutritional assessment, interventions, reassessment, and follow-up interventions. We chose not to define the specific components of the benefit in more detail because we anticipated that registered dietitians and nutritionists would use nationally recognized protocols, such as those developed by the ADA, as they normally would in their practice. As previously mentioned, we also proposed to use the NCD process to develop duration and frequency limits.

    At § 410.132(b), we set forth the coverage limitations for MNT services. In accordance with section 1861(s)(2)(V)(ii) of the Act, we provided that MNT services would not be covered for beneficiaries on dialysis for end-stage renal disease. We did not exclude all beneficiaries who are diagnosed with end-stage renal disease because a few individuals with end-stage renal disease do not receive maintenance dialysis, and the statute specifically excludes beneficiaries receiving maintenance dialysis under section 1881 of the Act. The other provisions of this section outlined the coordination of referrals for MNT for diabetes and renal disease, and coordination of MNT and DSMT services.

    Eligibility for MNT services will be dependent upon diagnoses and referrals made by the treating physician. At § 410.132(c), we proposed that referral only be made by the treating physician when the beneficiary has been diagnosed with diabetes or a renal disease, with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care.

    At § 410.132(d), we discussed requirements regarding reassessment and follow-up interventions. Specifically, we proposed that reassessments and follow-up interventions would only be covered when the referring physician determined that there was a change of diagnosis or medical condition within an episode of care that made a change in diet necessary.

    Provider Qualifications (§ 410.134)

    The BIPA specifies how we must define “registered dietitian or nutrition professional” for the purposes of this benefit, and allows for the grandfathering of nutrition professionals licensed or certified by States at the time of its enactment. The proposed qualifications for a registered dietitian or nutrition professional are set forth at § 410.134, and include alternative criteria for recognition of registered dietitians in States that do not provide for licensure or certification of these individuals.

    We received nearly 1,000 comments on the MNT portion of the proposed rule. The most frequently received comments concerned: the definitions of diabetes, renal disease, and treating physician; the coordination of the diabetes self-management training and MNT benefits; and proposed reimbursement. We also received comments about provider qualifications.

    Comment: We received a large number of comments that stated we had defined diabetes and renal disease too narrowly and asked for further clarification of the definitions.

    Response: Our definition of diabetes does not specifically state how physicians should perform lab tests to determine if a beneficiary should be diagnosed with diabetes. However, as with the national protocols for medical nutrition therapy, we assume that physicians will conduct tests in accordance with nationally accepted clinical guidelines, which require testing on multiple occasions to determine a diagnosis of diabetes. We are clarifying our definition of diabetes by adding a sentence to further explain the etiology of the disease. We also have extended coverage to include gestational diabetes for the few Medicare beneficiaries who would need such coverage. We believe that we do not have the statutory authority to extend coverage to beneficiaries who have not yet been diagnosed with diabetes.

    We also expand the definition of renal disease in this final rule. First, we clarify that beneficiaries with end-stage renal disease who are not receiving dialysis are eligible for the service. In addition, we have expanded the time period in which we will cover MNT for beneficiaries who have received a renal transplant to 36 months, to bring the coverage into conformance with the Medicare eligibility period for individuals under age 65.

    Comment: A few commenters requested that we change our definition for renal disease to encompass all patients with glomerular filtration rates (GFR) below 60. The GFR is the measurement of renal function and has a range in normal adult males of 98 to 150 ml/min/1.7m2 and in normal adult females of 106 to 132 ml/min/1.72. The commenters believe that we did not fulfill the intent of the Congress.

    Response: We disagree with the comment. Neither the BIPA nor its legislative history indicates any specific intention regarding how to define renal disease for purposes of eligibility for this benefit. Section 4108 of the BBA required the Department of Health and Human Services to contract with the National Academy of Sciences (NAS) to examine the benefits and costs associated with extending Medicare coverage for certain services, including medical nutrition therapy. We believe the NAS Institute of Medicine (IOM) report, “The Role of Nutrition in Maintaining Health in the Nation's Elderly,” published in 2000, provides a reasonable definition for determining the scope of the benefit. In that report, “renal disease” is defined as chronic renal insufficiency, end-stage renal disease, and the beneficiary's condition following renal transplant. The GFR rate for chronic renal insufficiency (GFR of 13 to 50 ml/min/1.73m2) used in the proposed rule was also in the IOM report.

    The IOM report did not cover the period of time MNT should be available to beneficiaries following a renal Start Printed Page 55277transplant. The Congress has authorized us to provide a reasonable interpretation of how much coverage will be provided for beneficiaries after renal transplant.

    The suggested eligibility criterion of a GFR under 60 suggested by commentators appears to be too expansive, because typically the GFR for beneficiaries after they receive a transplant never goes above 60. We also received comments recommending that we match our coverage to the length of time an under-65 beneficiary is entitled to post-transplant coverage. We agree that this is a reasonable criterion for our coverage of MNT services for post-renal-transplant beneficiaries.

    Comment: We received a large number of comments expressing concern about our use of the term “treating physician”. Most commenters believe that the term does not include both primary care physicians and specialists. One commenter believes we exceeded our statutory authority. Also, some commenters believe that we should allow any physician to provide a referral for the service.

    Response: We did not intend to exclude primary care physicians from the term “treating physician”. In this final rule, we now define the term “treating physician” to mean the primary care physician or specialist coordinating care for the beneficiary with diabetes or renal disease.

    Regarding our statutory authority, the statute, as amended at section 1861(s)(2)(V)(iii) of the Act, clearly states that the Secretary has authority to impose other criteria, after considering protocols established by dietetic or nutrition professional organizations. Requiring referral by the treating physician is within this statutory authority. We continue to believe that we must assure the quality of services received by Medicare beneficiaries. Therefore, our coverage guidelines must require coordination of care for beneficiaries with chronic diseases in order to assure that quality. We have not changed the final rule to allow any physician to make the referral for MNT.

    Comment: We also received comments concerning the definition of the benefit and episode of care.

    Response: As stated in the proposed rule, we relied on the national dietetic therapy protocols of major organizations to define the basic benefit. In seeking to understand the reason for these comments, we discovered that the use of the term “reassessment and follow-up interventions” in §§ 410.132(a) and (d) was confusing to many commenters. In the national protocols, reassessments and follow-up interventions are always considered part of the basic service. In the proposed rule, we had used the terms to define a special circumstance that happens only when a beneficiary has a change in medical condition or diagnosis.

    In this final rule, we clarify our policy by eliminating the use of the terms “reassessment” and “follow-up interventions”. We also have changed the language slightly in several other parts of the final rule to help clarify our intent, such as adding, “treatment regimen” as another reason why we would allow additional coverage in special circumstances. Our definition of “episode of care” (except in the case of coordination of services with initial DSMT and gestational diabetes) is based on our intent to pay providers of the service more efficiently by conforming the definition to our claims processing requirements. Our intent continues to be that dietitians and nutritionists should follow national MNT protocols.

    Comment: Some commenters stated that the DSMT and MNT benefits for beneficiaries with diabetes should only be coordinated to the extent of reducing the total of number of MNT hours by one hour.

    Response: In the proposed rule, we assumed that all of the MNT benefit for diabetes would be provided as part of the initial DSMT benefit and that follow-up DSMT and MNT for diabetes should be fully coordinated. In our discussions with interested organizations concerning the amount of services that should be covered for the NCD process, great concern was expressed about the coordination of the DSMT and MNT benefits. Therefore, we have spent a great deal of time researching this issue. We have found no evidence to date to suggest that the language of the proposed rule should be changed for this requirement. However, because we are still developing our NCD concerning the duration and frequency of the MNT benefit, we will continue to consider any evidence that might lead to the conclusion that additional hours should be covered when both benefits are provided during the same time period.

    Until such time as an NCD alters this requirement, if initial DSMT and MNT benefits for diabetes are provided in the same 12 month episode of care, only 10 total hours of services will be covered, regardless of whether the hours are covered as MNT, DSMT, or a combination of both. In situations where follow-up DSMT and MNT for diabetes is provided, only the total amount of hours allowed under the MNT benefit will be covered. (The MNT cap will be applied to any DSMT services provided to a beneficiary during the follow-up period, until such time as an NCD alters this requirement.)

    Comment: We received comments that MNT for a diagnosis of renal disease and MNT for a diagnosis of diabetes should not be fully coordinated.

    Response: In this final rule, we are not changing this requirement because the provision at § 410.132(d) (in this final rule § 410.132(b)(5)) already provides for additional coverage in this situation and we believe that additional coverage is not necessary. However, we are clarifying that beneficiaries receiving initial DSMT can receive the full initial DSMT benefit.

    Comment: One commenter was concerned that providers that had completed a full course of study of dietetics or nutrition after completion of a bachelor's degree would be excluded. We also received comments asking us to clarify the requirements further.

    Response: We agree that individuals that complete the full course of study of an accredited dietetics or nutrition program after completion of a bachelor's degree would still meet the intent of the legislation. Therefore, we have altered the regulatory language to include these individuals. However, we will require our contractors to require the practitioner to provide proof of completion of the course of study in addition to proof of receiving the degree.

    In situations where the individual is credentialed as a registered dietitian by an organization appropriate for this purpose, we will recognize that credential as proof that the individual meets both the education and experience required in the regulation. We have added language at §§ 410.134(a) and (d) to change the final rule.

    Comment: A commenter noted that State licensure requirements vary considerably; providers will need to obtain multiple licenses when they perform services in more than one State; and providers will have to meet different requirements if State licensure provisions change.

    Response: The statutory intent to recognize State licensure and State licensure requirements is clear. We cannot require States to have similar licensure requirements, recognize licensure by other States, or to provide for grandfathering of providers when State licensure laws change. Therefore, we have not changed the final rule to reflect these comments.Start Printed Page 55278

    Payment for Medical Nutrition Therapy (§ 414.64)

    Section 105(c) of the BIPA requires that we pay for medical nutrition therapy services at 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the physician fee schedule for the same services if the services had been furnished by a physician. Based upon consultation with the American Dietetic Association (ADA) to assess the types of resource inputs used to furnish a 15-minute medical nutrition therapy session by a registered dietitian or professional nutritionist, we proposed the following:

    For CPT code 97802—Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes, we did not propose physician work RVUs for this service, based on the statutory provision that specifically provides that medical nutrition therapy services may only be furnished by registered dietitians or nutrition professionals. For practice expense, we proposed 0.47 RVUs and, for malpractice, we proposed 0.01 RVUs for a total of 0.48 RVUs.

    For CPT code 97803—Reassessments and intervention, individual, face-to-face with the patient, each 15 minutes, we proposed 0.0 work RVUs, 0.34 practice expense RVUs and 0.01 malpractice RVUs for a total of 0.35 RVUs.

    For CPT code 97804—Group, 2 or more individuals, each 30 minutes, we proposed 0.0 work RVUs, 0.14 practice expense RVUs and 0.01 malpractice RVUs for a total of 0.15 RVUs. To determine payment, the RVUs shown above would need to be multiplied by the physician fee schedule conversion factor and 0.85 (to reflect the statutory requirement that payment be 85 percent of the amount determined under the physician fee schedule).

    We also stated that, consistent with the definition in the CPT's Physical Medicine Rehabilitation codes, a group is considered to be 2 or more individuals and that Medicare co-payments and deductibles would apply for medical nutritional therapy services.

    Comment: The American Dietetic Association (ADA) and many individuals submitted comments concerning the proposed reimbursement rate for medical nutrition therapy services. They stated that the proposed reimbursement rate for these services is too low and would result in limited beneficiary access to these services since private practice dietitians will choose not to participate. Some commenters referenced reimbursement rates currently paid by private insurers of $85 to $125 for 1 to 11/2 hours for an initial visit and $85 per hour for follow-up. They believe that the proposed rate for Medicare is far short of what was envisioned by the Congress. Commenters indicated that the statute clearly states that medical nutrition therapy payment should be 80 percent of the lesser of the actual charge or 85 percent of the amount determined under the physician fee schedule for the same service, provided by a physician. According to commenters, physicians who are also registered dietitians, use E/M codes 99213 through 99215 and 99244 when providing medical nutrition therapy services. The commenters stated that E/M codes 99203 through 99205 are appropriate reference points for determining medical nutrition therapy payment. The commenters also stated that any refinement of medical nutrition therapy values should be based on the underlying E/M codes that they believe are the statutory basis for medical nutrition therapy payment. While commenters acknowledge that physicians may perform other tasks besides nutritional assessment, therapy and counseling during an office visit, they believe those additional services are the basis for the Congress' instruction to reimburse non-physician providers of medical nutrition therapy at 85 percent of the amount physicians receive. The AMA's Health Care Professionals Advisory Committee (HCPAC) submitted a comment that suggested there should be physician work for medical nutrition therapy. This group provides recommendations on valuing services for codes used by non-physician providers. The HCPAC indicated that it evaluated each of the medical nutrition therapy codes and compared them to services that are available to other providers but not nutritionists (for example, physical therapy services). The comment further stated that the 15 percent reduction should not apply because the HCPAC took this into account when developing the recommendations. The HCPAC further added that there should be work values for medical nutrition therapy just as there are for physical and occupational therapy.

    Response: We have reviewed the statute and legislative history. There is no indication that Congress envisioned a particular payment amount or expected us to use an E/M service to determine the value of medical nutrition therapy. Section 105(c) of the BIPA states that “the amount paid shall be 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the fee schedule established under section 1848(b) of the Act for the same services if furnished by a physician.” The BIPA Conference Report indicates that payment will equal “the lesser of the actual charge for the service or 85 percent of the amount that would be paid under the physician fee schedule if such services were provided by a physician.” The statute and Conference Report direct us to establish the physician fee schedule amount for nutrition therapy services. The Medicare allowed charge would equal 100 percent of the physician fee schedule amount if the services are performed by a physician and 85 percent of the physician fee schedule amount if the services are performed by a registered dietitian or nutrition professional. The commenters suggest that physicians currently bill for an E/M service when they provide nutrition services. We do not believe that it is appropriate to compare medical nutrition therapy provided by a registered dietitian to an E/M service provided by a physician. Registered dietitians do not take medical histories, they are not trained to and do not perform physical examinations, nor do they make medical decisions. Furthermore, when physicians use an E/M code to report the provision of counseling or coordination of care, they typically have also performed a medical history, physical examination, and engaged in medical decision making as part of that service. If such an individual performed a service that met the requirements of an E/M service, then it would be be appropriate for him or her to report an E/M service. Further, we note that the E/M services include not only an amount attributable to physician work, but also payment for physician practice expenses. For instance, a level 3 new patient office visit (CPT code 99203) includes payment for 50 minutes of nurse time. A level 3 established patient office visit (CPT code 99213) includes 36 minutes of nurse time. Both of these codes include additional compensation for medical equipment and supplies that are typically used in an office visit but are not used as part of a medical nutrition therapy service. If we were to adopt the commenters' view and crosswalk values for medical nutrition therapy to an E/M service, we would be including payment not only for the counseling service of the practitioner, but also, inappropriately for the costs of clinical personnel that are not involved in the nutrition therapy service.Start Printed Page 55279

    Commenters indicated that the statute established the 85 percent adjustment to account for activities that are typically performed by a physician during an E/M service are not performed by a nutritionist. The statute and legislative history do not indicate that the 85 percent adjustment is intended to serve this purpose. In fact, the commenters themselves note that “consistent with other non-physician providers, reimbursement is set at a percentage of the physician's fee schedule.” Under the physician fee schedule, we will pay a physician 80 percent of 100 percent of the physician fee schedule amount, and, if a non-physician practitioner provides an identical service, Medicare pays 80 percent of 85 percent of the physician fee schedule amount. For instance, under CPT code 99213, a level 3 established patient office visit is one of the most common services provided by physicians, physician assistants and nurse practitioners. Even though the service is considered to be identical, we can by law pay a physician assistant and nurse practitioner only 85 percent of what we pay a physician to do the same service. Thus, in the case of other practitioners, the percentage does not reflect that a non-physician practitioner provides fewer services than a physician. Because there is no indication in the statute that the 85 percent adjustment should apply differently in the context of medical nutrition therapy than for other services performed by non-physician practitioners, we believe it is appropriate to pay 80 percent of 100 percent of the physician fee schedule amount when medical nutrition therapy is provided by a physician and 80 percent of 85 percent of the physician fee schedule amount when the service is provided by a registered dietitian or nutrition professional.

    In response to the comment about payment rates of private insurers for medical nutrition therapy, we cannot use such information in a relative value system to establish payment. Section 1848(c) of the Act requires us to establish RVUs that recognize the relative resources involved in furnishing different physician fee schedule services. Thus, our role is to establish the appropriate relative payment amounts. The total payment amount is determined under a formula prescribed in section 1848(d) of the Act. We have no authority to change the formula.

    In response to the HCPAC recommendation, we reiterate that it is inappropriate to compare medical nutrition therapy services to E/M services performed by physicians. While medical nutrition therapy may be performed by a physician who is also a registered dietitian, this does not make it a physician's service that requires a work RVU. Physicians may occasionally perform other services that have no physician work, such as chemotherapy administration or the technical component of a diagnostic x-ray test. When such services with no physician work are performed by a physician, we do not establish a physician work RVU just because the service was performed by a physician in that instance. Physicians will occasionally meet the statutory qualifications to be considered a registered dietitian or nutrition professional who can bill Medicare for medical nutrition therapy services. In these circumstances, we will pay the physician 80 percent of 100 percent of the physician fee schedule amount. In this unusual circumstance, we are paying for a medical nutrition therapy service provided by a physician under section 1861(s)(2)(V) and not a physician's service under section 1861(s)(1) of the Act.

    Comment: One comment indicated that the 85 percent adjustment should not apply because the RVUs we used are not based on physician work or physician practice expenses to deliver the service. This commenter indicated that we proposed an inadequate payment by not following the statutory scheme and proceeded to apply a 15 percent discount that is neither fair nor reasonable.

    Response: The statute requires us to establish a physician fee schedule amount for the service and pay 80 percent of 100 percent of the amount if the service is provided by a physician and 80 percent of 85 percent if the service is provided by a registered dietitian or nutrition professional. We initially anticipated that physicians would never bill Medicare for medical nutrition therapy services because they generally would not meet the statutory requirements to be considered registered dietitians or nutrition professionals. In this circumstance, we agree that it seems unusual to apply a reduction for a service that seldom would be furnished by a physician. However, we believe that the statute requires that Medicare payment be based on the 85 percent level. We understand that, although not common, there are physicians who do meet the statutory requirements to be considered registered dietitians or nutrition professionals. In these circumstances, our payment to the physician will be based on 100 percent of the physician fee schedule amount, not the 85 percent that we will pay to a registered dietitian or nutrition professional. We believe the statute would not allow a physician who does not meet the statutory requirements for a registered dietitian or nutrition professional to be paid for a medical nutrition therapy service. If a physician provides medical nutrition counseling as part of a patient encounter that meets the requirements for an E/M service, the physician can bill Medicare for a physician's service.

    Comment: We received one comment requesting that we clarify that Medicare will pay qualified providers in private practice settings or physician offices where they may be independent contractors. The commenter also asked how we intend to pay for medical nutrition therapy in the hospital outpatient department. The commenter also asked for clarification on reassignment of payment if a registered dietitian is an employee of physicians or hospital outpatient facilities.

    Response: Medicare will pay qualified dietitians and nutrition professionals who enroll in the Medicare program regardless of whether they provide medical nutrition therapy services in an independent practice setting, hospital outpatient department or any other setting, with the exception of services provided to patients in an inpatient stay in a hospital or skilled nursing facility. In these circumstances, our payment to the hospital or skilled nursing facility includes payment for medical nutrition therapy. If a qualified practitioner provides medical nutrition therapy in any other setting, including a private practice setting, section 1833(a)(1)(T) of the Act requires that Medicare payment equal 80 percent of the lesser of actual charges or 80 percent of 85 percent of the amount determined under the physician fee schedule. Payment in the hospital outpatient department will be made under the physician fee schedule, not under the hospital outpatient prospective payment system.

    Current rules regarding reassignment of benefits would apply to medical nutrition therapy. We want to emphasize that medical nutrition therapy cannot be provided incident to a physician's service unless the physician also meets the qualifications to bill Medicare as a registered dietitian or nutrition professional.

    Comment: Commenters objected to the methodology used to establish the proposed RVUs for this service. They believe it is inappropriate to use the top-down or no-work pool methodology to determine medical nutrition therapy payment. They believe that medical nutrition therapy payment should not be based on comparison to a preventive medicine code (CPT code 99401) in the zero-work pool methodology. The Start Printed Page 55280commenters indicated that preventive medicine services omit the problem-oriented components of the comprehensive history, as well as other essential assessment points, such as the patient's chief complaint and history of present illness. They disagree with our assertion in the proposed rule that physicians do not perform nutrition services and assert that it is inappropriate to use the top-down or zero-work methodology to establish the RVU for medical nutrition therapy.

    Response: We use the top-down methodology or no-work pool methodology to price the practice expense RVUs for all services priced under the Medicare physician fee schedule. Given that the statute indicates that medical nutrition therapy should be paid using the physician fee schedule, we believe it is reasonable and appropriate to use the same methodologies that we use to develop RVUs for other physician fee schedule services. With respect to use of the preventive medicine service, we used a service that we felt had similar practice expenses to medical nutrition therapy. It is not clear why practice expenses for a counseling service would differ based on the health status of the patient.

    Comment: A commenter representing dietitians asked us to review the relativity of payment across the three medical nutrition CPT codes. The commenter indicated that payment for CPT code 97803 was set at 72.9 percent of proposed RVUs for CPT code 97802 and 97804 was set at 31 percent of CPT code 97802. The commenter argues that, because reassessments are shorter than initial assessments, the proposed RVUs are actually discounted twice (that is, less payment per 15 minutes of time as well as less total time). They believe that the value of CPT codes 97802 and 97803 should be identical. The commenters indicated that E/M services provided by physicians do not receive the same discount. The commenter also stated that the payment for CPT code 97804 was less than for other group services and gave the example of a nurse or pharmacist providing nutrition instruction under the diabetes self-management training benefit.

    Response: We have reviewed the payments for CPT codes 97802 and 97803 and agree with the commenter that these two codes should have the same values. The essential difference between an initial and follow up medical nutrition therapy service is the time spent performing the service. Initial visits will be longer than follow-up visits and will likely involve Medicare payment for more increments of service. We will pay less for follow up visits because they will typically involve fewer 15 minute increments of time than an initial visit. The payment rate we are establishing in this final rule for CPT code 97803 will be the same as the proposed rate for CPT code 97802. We have also changed the payment rate for CPT code 97804 assuming that the code will normally be billed for 4 to 6 patients with the average of 5. Using the revised values, the payment rate for group medical nutrition therapy would approximate the hourly rate paid for other medical nutrition therapy services. (We note that the RVU units between the proposed and final rule show some marginal change because of changes made in the practice expense methodology that affect all physician fee schedule services). We do not agree with the comment that “evaluation and management services provided by physicians do not receive the same discount.” E/M service are not time based services and, as stated above, for many reasons are inappropriate comparisons to medical nutrition therapy service codes.

    Comment: Many commenters stated that co-payments must be structured so that they are not barriers to the medical nutrition therapy benefit.

    Response: Section 105(c) of the BIPA modifies section 1833(a)(1) of the Act to add subparagraph (T) that requires that Medicare payment equal 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under physician fee schedule. The statute requires the same coinsurance for medical nutrition therapy services that applies to other Part B services.

    Comment: Commenters suggested that initial medical nutrition therapy sessions for treatment of diabetes or renal disease should be billed under CPT code 97802 and subsequent medical nutrition therapy sessions should be billed under CPT code 97803. New diagnoses due to a change in medical condition or unanticipated complications should be billed under CPT code 97802 and subsequent medical nutrition therapy sessions should be billed under CPT code 97803.

    Response: At the present time, we are requiring that medical nutrition therapy be reported by using CPT codes 97802, 97803, and 97804. We will revisit our coding requirements when we publish the NCD for medical nutrition therapy. The NCD will set forth the structure of the medical nutrition therapy benefit in detail. We will make a decision concerning creation or modification of codes and creation of modifiers for reporting medical nutrition therapy once the NCD has been published. Until the NCD is published, creation or modification of codes and creation of modifiers would be premature. Therefore, we are requiring that the initial individual medical nutrition therapy visit be reported as CPT code 97802 and all follow up visits (for interventions and reassessments) for individual medical nutrition therapy be reported as CPT code 97803. All group medical nutrition therapy visits should be reported as CPT code 97804 whether they are initial or follow up visits.

    Comment: Commenters urged us to define medical nutrition therapy descriptors consistently. They stated that the descriptors in Table 5 of the proposed rule should agree with the descriptors in § 414.132.

    Response: We agree. We will make the descriptors for medical nutrition therapy consistent with the nomenclature in CPT and our regulations.

    Comment: We received a comment that recommended that we consider including additional items in the practice expense inputs for medical nutrition therapy. The commenter indicated that inputs should include staff costs for training on billing procedures, Health Insurance Portability and Accountability Act training, audit expenses, and other costs resulting from Medicare policies and procedures. The commenter indicated that expenses of registered dietitians in private practice differ little from other practitioners.

    Response: There are two major data sources used in the practice expense methodology—estimates of direct inputs and aggregate practice expense per hour information from the AMA's Socioeconomic Monitoring Survey. At this time, we are using the practice expense per hour for all physicians to establish the practice expense RVUs for medical nutrition therapy. We are not currently using the estimates of direct expenses for medical nutrition therapy because the services are valued in the no-work pool. However, we are researching alternatives to the no-work pool that would allow all no-work services to be priced under the top-down methodology. If we develop such an alternative, the estimates of direct expenses will be important in determining the RVUs for medical nutrition therapy. Indirect expenses are based on physician work and direct inputs. We believe that many of the costs identified by this commenter are indirect costs that would likely be included in practice expenses reported through the SMS survey. Since the commenter has suggested that practice expenses for private practice registered dietitians differ little from other Start Printed Page 55281practitioners, we believe the average practice expense per hour for all physicians is sufficient to use in the practice expense methodology.

    Result of Evaluation of Comments

    The payment rate we are establishing in this final rule for CPT code 97803 will be the same as the rate for CPT code 97802. We are also changing the payment rate for CPT code 97804 using the assumption that the code will normally be billed for 4 to 6 patients with the average of 5. Using these revised values, the payment rate for group medical nutrition therapy will approximate the hourly rate paid for other medical nutrition therapy services.

    F. Telehealth Services

    Beginning October 1, 2001, the BIPA amended section 1834 of the Act to specify that we pay a physician (as defined in section 1861(r) of the Act) or a practitioner (described in section 1842(b)(18)(C) of the Act) for telehealth services that are furnished via a telecommunications system to an eligible telehealth individual.

    The BIPA defined Medicare telehealth services as professional consultations, office or other outpatient visits, and office psychiatry services identified as of July 1, 2000, by CPT codes 99241 through 99275; 99201 through 99215, 90804 through 90809 and 90862 (and as we may subsequently modify) and any additional service we specify. The BIPA defines an eligible telehealth individual as an individual enrolled under Part B who receives a telehealth service furnished at an originating site.

    Section 1834(m) of the Act, as added by the BIPA, limited an originating site to a physician's or practitioner's office, hospital, critical access hospital, rural health clinic, or Federally qualified health center. Additionally, the BIPA specified that the originating site must be located in one of the following geographic areas:

    • In an area that is designated as a rural health professional shortage area (HPSA) under section 332(a)(1)(A) of the Public Health Service Act.
    • In a county that is not included in a Metropolitan Statistical Area (MSA).

    However, an entity participating in a Federal telemedicine demonstration project that has been approved by, or receives funding from us as of December 31, 2000 would not be required to be in a rural HPSA or non-MSA.

    The BIPA also required that we pay a physician or practitioner located at a distant site that furnishes a telehealth service to an eligible telehealth beneficiary an amount equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.

    This section also provided for a facility fee payment for the period beginning October 1, 2001 through December 31, 2002, to the originating site of $20. For each subsequent year, the facility fee for the preceding year is increased by the percentage increase in the MEI as defined in section 1842(i)(3) of the Act. The BIPA also amended section 1833(a)(1) of the Act to specify that the amount paid must be 80 percent of the lesser of the actual charge or the amounts specified in new section 1834(m)(2) of the Act.

    In order for us to have this benefit expansion implemented timely, we have used a program memorandum. The program memorandum was effective October 1, 2001. This final rule will be effective January 1, 2002.

    The rule published on August 2, 2001 proposed to establish policies for implementing the provisions of section 1834(m) of the Act, as added by the BIPA, that change Medicare payment for telehealth services.

    We proposed to revise § 410.78 to specify that Medicare beneficiaries are eligible for telehealth services only if they receive services from an originating site located in either a rural HPSA as defined by section 332(a)(1)(A) of the Public Health Services Act or in a county outside of a MSA as defined by section 1886(d)(2)(D) of the Act.

    1. Definitions

    Section 1834(m)(4)(F) of the Act, which was added by the BIPA and became effective for services beginning October 1, 2001, defined telehealth services as professional consultations, office and other outpatient visits, individual psychotherapy, pharmacologic management, and any additional service we specify. Additionally, this provision identified covered services by HCPCS codes identified as of July 1, 2000. We proposed to revise § 410.78 to implement this coverage expansion to include the following services (and corresponding CPT codes):

    • Consultations (codes 99241 through 99275).
    • Office and other outpatient visits (codes 99201 through 99215).
    • Individual psychotherapy (codes 90804 through 90809).
    • Pharmacologic management (code 90862).

    We solicited comments regarding the guidelines that we should use to make additions or deletions of services. We also solicited comments about specific services that may be appropriate to be covered under the Medicare telehealth benefit.

    In this final rule, we are specifying at § 410.78 that, except for the use of store and forward technology in the demonstration programs conducted in Alaska or Hawaii, an interactive telecommunications system must be used and the medical examination of the patient must be at the control of the physician or practitioner at the distant site. We are defining interactive telecommunications system as multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and physician or practitioner at the distant site. We are also specifying that telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.

    A patient need not be present for a Federal telemedicine demonstration program conducted in Alaska or Hawaii. We are specifying that for Federal telemedicine demonstration programs conducted in Alaska or Hawaii, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system. Additionally, we are specifying that the physician or practitioner at the distant site must be affiliated with the demonstration program.

    We are defining asynchronous, store and forward technologies, as the transmission of the patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. An asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines, and text messages without visualization of the patient (electronic mail). Photographs must be specific to the patient's medical condition and adequate for rendering or confirming a diagnosis or treatment plan. Finally, we are defining the originating site as the location of an eligible telehealth individual at the time the service being furnished via a telecommunications system occurs.

    2. Conditions of Payment

    The BIPA changed the telepresenter requirements. In accordance with section 1834(m)(2)(C) of the Act, a Start Printed Page 55282telepresenter is not required to be present. Therefore, we would not require a telepresenter as a condition of Medicare payment.

    Section 1834(m)(1) of the Act requires that Medicare make payments for telehealth services furnished via a telecommunications system by a physician or a practitioner (described in section 1842(b)(18)(C) of the Act). Non-physician practitioners described in this section of the Act include nurse practitioners, physician assistants, clinical nurse specialists, certified nurse midwives, clinical psychologists, clinical social workers, and certified registered nurse anesthetists or anesthesiologists' assistants. Section 1834(m)(2) of the Act specifies that we pay the physician or practitioner at the distant site who furnishes a telehealth service an amount equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.

    Certified registered nurse anesthetists and anesthesiologists' assistants would not be permitted to bill for and receive payment for a telehealth service under this provision. Under the Medicare program, these practitioners do not receive payment for office visits, consultation, individual psychotherapy, or pharmacologic management when these services are furnished without the use of a telecommunications system. Section 1834(m)(2) of the Act specifies that we pay to the distant site physician or practitioner an amount equal to what would have been paid for the service without the use of a telecommunications system. Therefore, certified registered nurse anesthetists and anesthesiologists' assistants would not receive payment for telehealth services.

    We proposed at § 410.78 that, as a condition of Part B payment for telehealth services, the physician or practitioner at the distant site must be licensed to provide the service under State law.

    Section 1834(m)(2)(A) of the Act specifies that the payment amount for the professional service is equal to the amount that would have been paid without the use of a telecommunications system. Medicare payment for physicians' services is generally based, under section 1848 of the Act, on the resource-based physician fee schedule. Payment to other health care practitioners listed earlier, authorized under section 1833 of the Act, is based on a percentage of the physician fee schedule payment amount. Therefore, we will pay for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management services furnished by physicians at 80 percent of the lower of the actual charge or the fee schedule amount for physicians' services. We will also pay for services furnished by other practitioners at 80 percent of the lower of the actual charge or that practitioner's respective percentage of the physician fee schedule.

    Section 1834(m)(2) of the Act provides for a professional fee for the physician or practitioner at the distant site (equal to the applicable Part B fee schedule amount) and a $20 facility fee for the originating site. Telepresenters are not required, unless one is deemed medically necessary by the physician or practitioner at the distant site. The BIPA does not address the issue of payment for the telepresenter. The Office of the Inspector General has advised us that permitting the physician or practitioner at the distant site to pay the telepresenter creates a significant risk under the anti-kickback statute. Therefore, we establish in § 414.65 that payments made to the distant site physician or practitioner for professional fees, including deductible and coinsurance (for the professional service), are not to be shared with the referring practitioner or telepresenter.

    However, the telepresenter could bill and receive payment for services that are not telehealth services that a telepresenter would otherwise be allowed to provide under the Medicare statute, including services furnished on the same day as the telehealth service.

    The BBA prohibited any payment for line charges or facility fees associated with a professional consultation via a telecommunications system. Section 1834(m)(2)(B) of the Act, as added by the BIPA, provides for a facility fee payment to the originating site, specifying that the amount of payment is 80 percent of the lesser of the actual charge or a facility fee of $20.00. The BIPA further specifies that, beginning January 1, 2003, the originating facility fee be increased annually by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act. Additionally, we clarify that the Geographic Practice Cost Index (GPCI) would not apply to the facility fee for the originating site. This fee is statutorily set and is not subject to the geographic payment adjustments authorized under the physician's fee schedule. The beneficiary is responsible for any unmet deductible amount and Medicare coinsurance. We would revise § 414.65 to provide for payment of a facility fee to the originating site.

    Section 1834(m)(3) of the Act specifies that sections 1842(b)(18)(A) and (B) apply to physicians and practitioners receiving payment for telehealth services and to originating sites receiving a facility fee, in the same manner as they apply to practitioners. This section requires that payment for such services may only be made on an assignment-related basis. We did not reflect this provision in the proposed rule. Because this requirement is specified in the BIPA and we have no discretion, we are implementing it in this final rule in new § 414.65(d).

    Comment: One commenter believed that requiring an originating site to be located in a rural HPSA or non-MSA county would not permit medical practitioners located in urban and suburban areas to offer telehealth services.

    Response: We clarify that, as a condition of payment under Medicare, the originating site must be located in a rural HPSA or non-MSA county. The physician or practitioner at the distant site, who provides the telehealth service, is not subject to these limitations. For example, a psychologist in Salt Lake City, Utah would be able to provide a mental health visit to a beneficiary at a physician's office located in a non-MSA county.

    Comment: We received various comments on the definition of an originating site. Many commenters believe that the list of facilities eligible to be a telehealth originating site should be expanded beyond those specified in the statute. Specific suggestions were received to include the patient's residence, skilled nursing facilities, nursing homes, and community mental health centers as originating site facilities within this provision. Another commenter suggested that we recommend legislative changes to remove the requirement that an originating site facility be located in a HPSA or non-MSA county.

    Moreover, one organization requested that all locations included within the Alaska Native Tribal Health Consortium, including but not limited to outpatient health facilities recognized by the Indian Health Service as tribal health facilities be included as an originating site. The commenter requested that these sites be defined as an originating site regardless of whether they are certified as a Medicare Federally qualified health center or not.

    Response: Section 1834(m) of the Act defines an originating site facility to include only a physician's or practitioner's office, hospital, critical access hospital, rural health clinic or Federally qualified health center. Start Printed Page 55283Further, the Act specifies that the originating site must be located in a rural HPSA or non-MSA county. We do not have the legislative authority to expand the definition of a telehealth originating site beyond this provision. However, we will be studying this issue as part of a report to the Congress as authorized by section 223(d) of the BIPA.

    Comment: One specialty college requested confirmation that the patient's medical information provided via store and forward telehealth is furnished to the physician or practitioner at the distant site in order to recommend or confirm a diagnosis and or treatment plan and not to provide a formal interpretation of imaging exams.

    Response: The commenter is correct. Payment for services via store and forward technology under this provision does not include formal interpretation of an imaging exam. Medicare currently allows coverage and payment for medical services delivered via a telecommunications system that do not require a face-to-face “hands on” encounter. Section 2020(A) of the Medicare Carriers Manual addresses this issue and lists radiology, electrocardiogram, and electroencephalogram interpretations as examples of such services.

    Comment: In the proposed rule, we requested comments on the guidelines that we should use to make additions or deletions to covered Medicare telehealth services. We also requested suggestions and comments about specific services that may be appropriate for payment under the Medicare telehealth benefit. In response to our solicitation, we received one comment regarding the guidelines we should use to make changes to the scope of Medicare telehealth coverage. Ten commenters provided specific suggestions regarding additional services that may be appropriate for the Medicare telehealth benefit.

    Several commenters indicated that a psychiatric diagnostic interview, CPT code 90801, would be appropriate for Medicare telehealth payment. One association stated that the elements of this service are directly comparable to a new patient office visit, which the law defines as a telehealth service. Given that the law permits us to add additional services as appropriate, this commenter suggested that we include a psychiatric diagnostic interview within the definition of a telehealth service. Another association suggested that interactive psychotherapy, CPT codes 90810, 90812 and 90814, should be covered Medicare telehealth services. Interactive psychotherapy uses play equipment, physical devices and other mechanisms of non-verbal communication in an office or outpatient facility.

    Several commenters suggested that telerehabilitation interventions that provide education, mentoring and consultation be included within the scope of Medicare telehealth coverage. The commenters specifically note that speech therapy and physical and occupational therapy should be included as telehealth services.

    One consortium requested that all services provided under the Federal telehealth project in Alaska be included as covered telehealth services within this provision. The commenter believes that virtually all evaluation & management and psychiatry services should be included as Medicare telehealth services. Additionally, the commenter notes that many respiratory, digestive, ophthalmology and otorhinolaryngology services are appropriate for telehealth coverage.

    One organization suggested that we consider guidelines similar to those currently in place for non-telehealth services. For instance, the commenter stated the service should be reasonable and necessary, safe and effective, medically appropriate, and provided within the purview of accepted standards of medical practice. The commenter stresses that the type of technology used to deliver the service should be secondary to the reasonable and necessary criteria.

    Response: We will use these comments and suggestions to assist us in establishing guidelines for a telehealth coverage process and the addition of specific telehealth services that may be appropriate for Medicare beneficiaries. However, we do not believe it would be appropriate to expand the scope of telehealth services beyond the services explicitly listed in the Act until we have a process in place for adding new telehealth services.

    Comment: With regard to the definition of a “telecommunications system”, one organization encouraged us to permit store and forward technologies in other circumstances beyond federal telemedicine demonstration projects conducted in Alaska or Hawaii. The commenter believes that emphasis should be given to whether a particular service is reasonable and necessary rather than specific technology requirements. Moreover, the commenter stated that the face-to-face requirement is outdated for telehealth as well as other areas of the Medicare fee schedule and suggested that current technology, such as electronic mail, permits physicians to care for their patients even when the patient is not present.

    Response: Section 1834(m) of the Act defines a telehealth service as office and other outpatient visits (99201 through 99215), professional consultations (99241 through 99275), individual psychotherapy (90804 through 90809), and pharmacologic management (90862). Further, the law specifies that payment must be equal to what would have been paid without the use of a telecommunications system.

    As a condition of payment under Medicare, these services require a face-to-face patient encounter. We believe that the patient's presence and use of an interactive audio and video telecommunications system permitting the distant site practitioner to interact with the patient provides a reasonable substitute for a face-to-face encounter. The law provides for the use of asynchronous, store and forward technologies for delivering telehealth services only for telemedicine demonstration projects conducted in Alaska or Hawaii. We do not have the authority to expand the use of store and forward technology in delivering telehealth services.

    Comment: One organization in a remote region requested that a definition of a telepresenter be added to § 410.78. The commenter suggested we permit a certified community health aid to present a patient when the aide is the only medical professional available to act as a telepresenter.

    Response: The physician or practitioner at the distant site has the authority to determine whether it is medically necessary to require a telepresenter and, if necessary, the appropriate medical professional needed to present the patient. We do not believe it is appropriate for us to specify the type of medical professionals that are necessary to act as a telepresenter.

    Comment: We received conflicting comments concerning interstate telehealth services. One organization requested that we require the physician or practitioner at the distant site to be licensed in the State where the originating site is located. On the other hand, an association requested clarification that the physician or practitioner at the distant site only needs to be licensed in the State where he or she is located and does not need to be licensed in the State where the originating site is located. Another commenter requested that we clarify that the service is considered rendered where the distant site physician or practitioner is located.

    Response: We defer to State law regarding licensure issues. When the Start Printed Page 55284State law for the originating site permits an out-of-State practitioner to provide a telehealth service, without being licensed in the State in which the originating site is located, Medicare would make payment for the telehealth service. However, when State law precludes an out-of-State practitioner from delivering a telehealth service, Medicare would not pay for that service.

    We clarify that for payment purposes, the site of service for the telehealth service is the location of the physician or practitioner at the distant site. Given that section 1834(m) of the Act specifies that payment to the physician or practitioner at the distant site must be equal to the amount that would have been paid without the use of telehealth, it is appropriate to use the Geographic Practice Cost Index (GPCI) relevant to the distant site. However, our determination of the distant site physician's or practitioner's location as the site of service for Medicare payment is not intended to make a comment regarding the scope of medical practice.

    Comment: One consortium believes that the proposed rule would not permit the physician or practitioner at the distant site to bill for a telehealth service when State or Federal law exempts a physician or practitioner from being licensed in the State in which he or she is currently employed. The consortium is a Federal telemedicine demonstration project that would be permitted to use store and forward telecommunications technologies in delivering telehealth services. The commenter notes that the State of Alaska exempts physicians or practitioners who are part of the military or Public Health Service that provide health care services in Alaska from its licensure requirements. Further, the commenter stated that Federal law authorizes health care professionals who are members of the military providing services for the Department of Defense to practice in any State provided the professionals are licensed in a State, the District of Columbia or other specific locations. The commenter also noted that current Medicare manual instructions specify that when a physician in a Federal hospital provides services to the public generally as a community institution, he or she may be considered as meeting the statutory definition of a physician even though he or she may not have a license to practice in the State in which he or she is employed.

    Response: The telehealth provision does not affect State or Federal legislation providing certain physicians or practitioners an exemption from State licensure. When Federal or State law exempts a physician or practitioner from State licensure, then the physician or practitioner at the distant site is permitted to provide a telehealth service regardless of whether he or she is licensed within the State where he or she is employed.

    Comment: One organization requested that § 414.65(a)(2) be revised to specify for what services the physician or practitioner who presents the patient could bill. The commenter believes that when the physician at the distant site determines that it is medically necessary for another practitioner to assist in providing the telehealth service, the telepresenter should be compensated. The commenter suggested that a telepresenter be permitted to bill for a consultation or confirmatory consultation.

    Response: On the day the telehealth service occurs, the telepresenter may bill and receive payment for services that are not telehealth services that he or she would otherwise be allowed to provide under Medicare. A telepresenter, for example, a nurse practitioner, could bill for and be paid for a medically necessary office, outpatient or inpatient visit preceding or subsequent to a telehealth service. Additionally, the telepresenter could be paid for other medically necessary services requested by the physician or practitioner at the distant site. However, the physician at the distant site may not share any portion of the telehealth payment with the telepresenter or referring practitioner. We do not agree that § 414.65(a)(2) should be changed to specify the services for which a telepresenter can and cannot bill. This section implements payment for telehealth services only, and the Act does not provide for a payment to the telepresenter for telehealth services.

    Comment: Many organizations and individual commenters expressed overall support for the revision of Medicare payment for telehealth. Specifically, commenters mentioned removal of the fee sharing requirement, relaxed conditions of payment, and the addition of non-MSA counties to the geographic areas eligible for telehealth under Medicare. The commenters noted that these changes will have a positive effect on health care delivery and will help provide services to areas where specialty care is sparse.

    Response: We agree that the proposed revisions to Medicare telehealth coverage and payment policies, as authorized by the BIPA, remove significant barriers for physicians and practitioners wishing to provide telehealth services.

    Comment: One commenter indicated that the cost of collecting the coinsurance for the originating site facility fee could easily exceed the amount the facility would collect from the beneficiary. The commenter encouraged us to permit originating sites to waive the coinsurance in those situations where the telehealth facility charge is the only amount to be billed to the beneficiary.

    Response: We do not have the authority to eliminate the coinsurance requirement outright for telehealth originating sites. However, Medicare permits the waiver of coinsurance for limited situations. Section 5220 of the Medicare Carriers Manual specifies that physicians and suppliers may waive billing for or collection of coinsurance or deductibles for indigent patients or when the physicians' or suppliers' cost of billing or collecting exceeds or is disproportionate to the amounts to be collected. Documentation must be sufficient to support that costs for billing the beneficiary exceed or are disproportionate to the amount collected from the beneficiary. In this instance, the amount collected refers to 20 percent of the originating site telehealth facility fee.

    We clarify that when the patient owes additional coinsurance to the originating site for other Medicare services, billing for the telehealth facility fee coinsurance amount may be consolidated with the coinsurance amount owed for those services. We believe that this would resolve the commenter's concern that the cost for billing and or collecting the coinsurance for a single facility fee could exceed or be disproportionate to the amount collected from the beneficiary.

    Comment: One association submitted a number of comments that have payment implications for the Federally qualified health center benefit.

    Response: These issues involve specific aspects of the Federally qualified health center payment methodology and are beyond the scope of this provision. We will take these comments into consideration in formulating future instructions for payment implications on FQHCs.

    Result of Evaluation of Comments

    We are implementing this provision as stated above.

    G. Indian Health Service

    The Indian health care system provides primary health care to many American Indian and Alaska Native Medicare beneficiaries. This system consists of programs operated by a Federal agency, the Indian Health Start Printed Page 55285Service (IHS), and Federally funded programs operated by Indian tribes, tribal organizations, and urban Indian organizations (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These programs deliver a range of clinical and preventive health services to their beneficiaries through a network of facilities including hospitals and outpatient clinics. Programs operated in IHS-owned or leased facilities, by IHS or by tribes or tribal organizations, are considered “Federal providers” by Medicare. Sections 1814(c) and 1835(d) of the Act generally prohibit payment to Federal providers, subject to exceptions contained in section 1880 of the Act for these IHS facilities. Before enactment of the BIPA, the exception in section 1880 of the Act was applicable only to IHS owned or leased hospitals, provider-based clinics, and skilled nursing facilities (regardless of whether the entity is tribally operated). The exception did not permit Medicare to pay for services furnished by IHS owned or leased free-standing outpatient clinics or to pay any IHS owned or leased facilities for services by physicians and other practitioners paid under a fee schedule.

    Effective July 1, 2001, section 432 of the BIPA extends the exception in section 1880 of the Act to permit Medicare payments to hospitals and outpatient clinics (provider-based or free-standing), operated by the IHS or by a tribe or tribal organization, for services furnished by physicians and specified non-physician practitioners in or at the direction of the hospital or outpatient clinic. Payments for these services are made to the hospital or outpatient clinic, not to the physician or other practitioner. These payments are subject to the same situations, terms, and conditions as would apply if the services were furnished in, or at the direction of, a hospital or outpatient clinic that is not operated by the IHS or by a tribe or tribal organization. The payments include incentive payments for physicians furnishing covered physicians' services in rural or urban health professional shortage areas (HPSAs) if the usual HPSA criteria are met. (For further information see section 1833 of the Act and § 414.42 of our regulations.) Payments will not be made under these provisions to the extent that Medicare is otherwise paying for the same services under other provisions (for example, as part of a bundled payment, or if a tribal outpatient clinic continues to bill as a Federally qualified health center (FQHC)).

    We have added a new § 410.46 to our regulations to reflect this new statutory provision. Due to the statutory effective date of July 1, 2001, we implemented this BIPA provision through program memorandum instructions.

    Result of Evaluation of Comments

    We received no comments on the statutory requirement to pay Indian Health Service and tribal hospitals and clinics for the services of physicians and other practitioners under Medicare fee schedules.

    H. Pathology Services

    The November 2, 1999 final rule (64 FR 59380) provided that, for services furnished on or after January 1, 2001, carriers would no longer pay claims to independent laboratories under the physician fee schedule for the technical component (TC) of physician pathology services for hospital inpatients. Before that rule, independent laboratories could bill the carrier under the physician fee schedule for the TC of a physician pathology service furnished to a hospital inpatient. Also, under that rule, independent laboratories would still have been able to bill and receive payment for the TC of physician pathology services furnished to patients who are not hospital inpatients.

    Section 542 of the BIPA requires the Medicare carrier to continue to pay for the TC of physician pathology services when an independent laboratory furnishes these services to an inpatient or outpatient of a covered hospital. The BIPA provisions apply to TC services furnished during the 2-year period beginning January 1, 2001 and continuing through December 31, 2002. We informed the carriers and the intermediaries of this provision through program memorandum AB-01-47, which was issued in March 2001. This program memorandum requested the carriers to notify independent laboratories of this provision in their next regularly scheduled bulletin and to place this bulletin on their Internet web site. In the absence of further legislation, the policy of the November 1999 final rule will take effect for the TC of physician pathology services furnished to hospital patients after December 31, 2002. We have revised § 415.130 to conform to the statutory change in section 542 of BIPA concerning the payment for the TC of physician pathology services.

    Result of Evaluation of Comments

    We have received no comments on this issue.

    IV. Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule; Responses to Public Comments on the Five-Year Review of Work Relative Value Units

    A. Scope of Five-Year Review

    This final rule includes the culmination of the 5-year review of work RVUs required by statute. The work RVUs affected by this review will be effective for services furnished beginning January 1, 2002.

    In our June 8, 2001 proposed notice (66 FR 31028), we explained the process used to conduct the 5-year review of work RVUs. During the comment period we received approximately 35 public comments on approximately 900 codes. After review by our medical staff, we forwarded all of the comments we received concerning potentially misvalued services to the AMA's Specialty Society Relative Value Update Committee (RUC).

    The RUC submitted work RVU recommendations for all of the codes we forwarded with the exception of the anesthesia codes and conscious sedation codes. We analyzed all of the RUC recommendations and evaluated both the recommended work RVUs and the rationale for the recommendations. If we had concerns about the application of a particular methodology, but thought the recommended work RVUs were reasonable, we verified that the recommended work RVUs were appropriate by using alternative methodologies. (For additional information on the review process, please see the proposed notice published June 8, 2001.)

    B. Review of Comments (Includes Table 4 Work RVU Refinements of 5-Year Review Codes Commented on in Response to the June 8, 2001 Proposed Notice)

    During the comment period for our June 8, 2001 proposed notice, commenters generally supported our proposed changes. We received more than 125 comments on approximately 39 specific codes plus all the anesthesia services. The majority of these comments addressed the gastrointestinal endoscopy codes and anesthesia services.

    We convened a multispecialty panel of physicians to assist us in the review of the comments. The comments we did not submit for panel review are discussed at the end of this section. The panel was moderated by our medical staff and consisted of:

    • Clinicians representing the commenting specialties, based on our determination of those specialties which Start Printed Page 55286are most identified with the services in question. Although commenting specialties were welcomed to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate.
    • Primary care clinicians nominated by the American Academy of Family Physicians and the American College of Physicians and American Society of Internal Medicine.
    • Four carrier medical directors.
    • Four clinicians with practices in related specialties who had knowledge of the services under review.

    We submitted 6 codes for evaluation by the panel. The panel discussed the work RVUs involved in each procedure under review in comparison to the work RVUs associated with other services on the fee schedule. We assembled a set of reference services and asked each panel member to compare the clinical aspects for the services they believed were incorrectly valued to one or more of the reference services. In compiling the reference set, we attempted to include—(1) services that are commonly performed whose work RVUs are not controversial; (2) services that span the entire work spectrum from the easiest to the most difficult; and (3) at least three services performed by each of the major specialties so that each specialty would be represented. The reference set listed over 300 services. Group members were encouraged to make comparisons to these reference services. The intent of the panel process was to capture each participant's independent judgement based on the discussion and his or her clinical experience. Following each discussion, each participant rated the work for the procedure. Ratings were individual and confidential; there was no attempt to achieve consensus among the panel members.

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

    Ratings of work were analyzed for consistency among the groups represented on each panel. We used statistical tests to determine whether there was enough agreement among the groups on the panel, and whether the agreed-upon RVUs were significantly different from the proposed RVUs published in the June 8, 2001 proposed notice. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group, and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the 1993 fee schedule. The statistical tests we used are described in detail in the November 25, 1992 final rule (57 FR 55938).

    Our decision to convene a multispecialty refinement panel of physicians and to apply the statistical tests referred to above was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Of the 6 codes reviewed by the multispecialty panel, all were the subject of requests for increased values.

    We also received comments that we did not submit to the panels for a variety of reasons. These comments are discussed later in this section. Of the proposed codes that were reviewed, 3 increased, and 3 were not changed.

    Table 4.—Work Relative Value Unit Refinements of Five-Year Review Codes Commented on in Response to the June 8, 2001 Proposed Notice

    Table 4 lists the codes reviewed during the 5-year review on which we received comments. This table includes the following information:

    • CPT/HCPCS Code. This is the CPT or alphanumeric HCPCS code for a service.
    • Modifier. A modifier-26 is shown if the work RVUs represent the professional component of the service.
    • Description. This is an abbreviated version of the narrative description of the code.
    • Proposed Work RVUs. This column includes the work RVUs proposed in the June 8, 2001 proposed notice for each reviewed code.
    • Requested Work RVUs. This column identifies the work RVUs requested by the commenters. If the commenters requested different RVUs, the table lists the highest requested RVUs. For some codes we received recommendations for an increase but no specific RVUs were recommended.
    • RUC Recommendation. This column identifies the work RVUs recommended by the RUC if the RUC made a specific work value recommendation as part of its comments on the June 8, 2001 proposed notice.
    • 2002 Work RVUs. This column contains the 2002 work RVUs.
    • Basis for Decision. This column indicates whether:

    + The recommendations of the multispecialty refinement panel were the basis upon which we determined that the proposed work RVUs published June 8, 2001 should be retained (indicator 1).

    + A new value emerged from our analysis of the refinement panel ratings (indicator 2).

    + A new or retained value came from review of the comment(s) received (indicator 3).

    + A new value came from the need to make a rank-order change to maintain or correct existing relationships among services (indicator 4).

    + A value is retained and the code has been referred to the RUC (indicator 5).

    + There is no change in value but we have adjusted the global period (indicator 6).

    Table 4.—Work RVU Refinements of the Five-Year Review Codes Commented on in Response to June 8, 2001 Proposed Notice

    CPT/HCPCS Code 1ModDescriptorProposed Work RVURequested Work RVURUC REC2002 Work RVUBasis for decision
    00100-01999Anesthesia services(2)(3)(2)#5
    11055Trim skin lesion0.270.430.43#3
    11056Trim skin lesion, 2 to 40.390.610.61#3
    11057Trim skin lesions, over 40.500.790.79#3
    11719Trim nail(s)0.110.170.17#3
    27286Fusion of hip joint23.4523.45#4Start Printed Page 55287
    36400Drawing blood0.180.380.38#2
    36405Drawing blood0.180.320.31#2
    38510Biopsy/removal, lymph nodes6.436.43#6
    38571Laparoscopy, lymphadenectomy12.3819.8414.68#2
    38740Remove armpit lymph nodes10.0210.0310.03#3
    38745Remove armpit lymph nodes13.0013.1013.10#3
    38760Remove groin lymph nodes12.9412.9512.95#3
    39503Repair of diaphragm hernia34.8595.0095.00#3
    43219Esophagus endoscopy2.803.182.80#3
    43239Upper GI endoscopy, biopsy2.692.871 2.87#3
    43244Upper GI endoscopy/ligation4.595.055.05#3
    43247Operative upper GI endoscopy3.393.403.39#3
    43249Esoph endoscopy, dilation2.903.252.90#3
    43255Operative upper GI endoscopy4.404.824.82#3
    43259Endoscopic ultrasound exam4.896.534.89#3
    43263Endo cholangiopancreatograph6.197.297.29#3
    43265Endo cholangiopancreatograph8.9010.0210.02#3
    43269Endo cholangiopancreatograph6.048.218.21#3
    44388Colon endoscopy2.823.242.82#3
    44389Colonoscopy with biopsy3.133.543.13#3
    44390Colonoscopy for foreign body3.834.253.83#3
    44391Colonoscopy for bleeding4.325.254.32#3
    44392Colonoscopy and polypectomy3.824.233.82#3
    44393Colonoscopy, lesion removal4.845.794.84#3
    45380Colonoscopy and biopsy4.014.441 4.44#3
    49605Repair umbilical lesion22.6676.0076.00#3
    56515Destruction, vulva lesion(s)2.763.632.76#1
    56605Biopsy of vulva/perineum1.101.104 1.10#3
    56810Repair of perineum4.134.134 4.13#3
    57500Biopsy of cervix0.970.97#5
    58100Biopsy of uterus lining0.711.534 1.53#3
    76090Mammogram, one breast0.700.930.70#1
    76091Mammogram, both breasts0.871.100.87#1
    G0127Trim nail(s)0.110.17#3
    1 All CPT codes and descriptors copyright 2000 American Medical Association.Start Printed Page 55288
    2 No change.
    3 26% incr.
    4 RVUS to remain interim for 2002.

    C. Discussion of Comments by Clinical Area

    In this section, we discuss the comments we received on the 39 codes of the more than 900 codes for which we sought public comment. For the codes for which we did not receive any comments, our proposed RVUs are being made final. We have categorized the comments into the same clinical areas we used in the June 8, 2001 notice. Within each clinical area, listed below, we discuss the comments received in CPT code order.

    1. Vascular Surgery

    Comment: The American Association for Vascular Surgery and the Society for Vascular Surgery expressed appreciation that we agreed with the RUC recommendations for work RVUs for the vascular surgery codes reviewed under the second 5-year review. However, it indicated that some of these services may still be undervalued. It will be reviewing these services as well as a small number of vascular surgery services that were not submitted this year and possibly submit these under the next 5-year review.

    Response and final decision: We will finalize the RVUs for the vascular surgery codes as proposed.

    2. General Surgery and Colon and Rectal Surgery

    Family 2 Lymphadenectomy

    Comment: The American College of Surgery (ACS) was supportive of the work performed by CMS medical officers to ensure that rank order anomalies were eliminated from 6 families of codes where acceptance of the RUC recommendations would create distortions in family work value relativity and the rest of the physician fee schedule.

    The ACS pointed out a typographical error in the proposed notice. For Family 2 Lymphadenectomy, CMS disagreed with the RUC, and stated that the median survey result of 13 is appropriate for CPT code 38745. The ACS commented that the survey median is actually 13.10. The correction of this error would lead to increases for related family codes 38740 (from 10.02 to 10.03) and 38760 (from 12.94 to 12.95).

    Response and final decision: We agree with the commenter's response and will adjust the work values for CPT code 38740 to 10.03; for CPT code 38745 to 13.10; and for CPT code 38760 to 12.95.

    Family 3 Lymph Nodes and Lymphatic Channels—Incision/Excision

    Comment: The American Academy of Otolaryngology recommended that CMS change the global surgical period of CPT code 38510 from 90 days to 10 days following the RUC survey data for this CPT code. It alleges that there were no postoperative visits beyond 10 days associated with this procedure for the relative work established.

    Response: The RUC valued this service based on the fact that it is typically furnished to an outpatient. The value of a hospital discharge day was subtracted from the median survey value. The median survey value is based on one followup office visit. We believe there is merit to the group's point and will change the global period from 90 days to 10 days.

    3. Thoracic Surgery

    Comment: The Society of Thoracic Surgeons expressed appreciation that we had accepted the RUC recommendations for corrections to work values of many thoracic and cardiac procedures.

    Response and final decision: We will finalize the RVUs for these codes as proposed.

    4. Orthopedic Surgery

    We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the orthopedic surgery codes. We would also note that, in the June rule, we proposed to correct a rank order anomaly by increasing values for CPT code 27286. This code, however, was inadvertently omitted from the table and addendum; it is included in Table 4 and Addendum A of this final rule.

    5. Ophthalmology

    We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the ophthalmology codes.

    6. Urology

    We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the urology codes.

    7. Obstetrics/Gynecology

    CPT Code 38571, Laparoscopy, Surgical; With Bilateral Total Pelvic Lympadenectomy

    Comment: The Society of Gynecologic Oncologists (SGO) stated that, while we had proposed an increase for CPT code 38572, an increase was not proposed for CPT code 38571. The SGO believes that both of these codes are undervalued based on insufficient work RVUs being assigned for the laparoscopy with bilateral total pelvic lymphadenectomy procedure, which is common to both codes. It requested that a proportional increase in work RVUs be made for CPT 38571 as well.

    Response: We accepted the RUC recommendation that no increase be made in the work RVU for this service based on the lack of compelling evidence to support an increase, and we had proposed retaining the current work RVU for this service. However, based on the comments received, we referred this code to a multispecialty refinement panel for review.

    Final decision: As a result of our analysis of the multispecialty refinement panel ratings, we are increasing the work RVUs for CPT code 38571 to 14.68 work RVUs.

    CPT Code 56515, Destruction of Lesion(s), Vulva; Extensive, Any Method

    Comment: For CPT code 56515, SGO disagreed with the rationale that CPT codes 56515 and 46924 have comparable physician and intraservice work time. It indicated that CPT code 56515 involves lasering a much larger area; therefore, the amount of intraservice time and the number of postoperative visits can be significantly higher.

    Response: We had accepted the RUC recommendation of 2.76 work RVUs for this code which was lower than the 3.625 which had been requested by the specialty. Based on the comments received, we referred this code to a multispecialty refinement panel for review.

    Final decision: As a result of our analysis of the refinement panel ratings, we are retaining the work RVU of 2.76.

    CPT Code 57500, Biopsy, Single or Multiple, or Excision of Lesion, With or Without Fulguration (Separate Procedure)

    Comment: In addition to comments on the 2 codes referenced above, SGO also recommended that, while CPT code 57500 was not considered part of the 5-year review, this gender-specific code be forwarded to the RUC for evaluation. It believes the amount of physician time and level of pre- and postoperative work for this procedure is similar to that for the male-specific procedures of CPT Start Printed Page 55289code 54100 (Biopsy of penis (separate procedure)), and CPT code 54505 (Biopsy of testis, incisional (separate procedure)), and thus the physician work for CPT code 57500 should be increased.

    Response and final decision: We will refer this code to the RUC for review.

    Comment: In our June 8, 2001 proposed notice, we also stated that we referred three female-specific procedure codes that appeared to be misvalued to the RUC for review. As part of its comments on the proposed notice, and in response to our request to review these services, the RUC has provided recommendations on work RVUs for the three codes as follows:

    • CPT code 56605, Biopsy of vulva or perineum (separate procedure); one lesion.

    The RUC stated that this code was reviewed during the first 5-year review and was increased at that time to double the original work RVU for CPT code 56605. While the current work RVU for this code is less than CPT code 54100, Biopsy of penis (WRVU 1.90), the structure of CPT code 56605 allows additional reporting when more than one lesion is biopsied, while the penile code (54100) may be only reported once, regardless of the number of biopsies. The RUC recommended that the current work RVU of 1.10 be maintained for CPT code 56605.

    • CPT code 56810, Perineoplasty, repair of perineum, nonobsterical (separate procedure).

    The RUC indicated that the specialty stated that this service may be undervalued; however, perineoplasty is performed so rarely as a separate procedure that it would be difficult to obtain valid survey data to appropriately value this service. In addition, the specialty is currently considering CPT revisions to this family of codes and will review this issue at that time. The RUC recommended that the current work RVU of 4.13 be maintained for the service.

    • CPT code 58100, Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure).

    The RUC indicated that, based on a review of survey data, CPT code 58100 is undervalued. The RUC compared this code to CPT code 55700 and determined that these 2 services are similar in time and intensity. The RUC also agreed that 58100 is more work than the reference procedure, CPT code 57505, and recommended an increase in the work RVU for CPT code 58100 to 1.53. The RUC also provided refinements to the practice expense inputs for this code.

    Response and final decision: We agree with the RUC recommendations for these three codes and will maintain the current work RVUs of 1.10 for CPT code 56605 and 4.13 for CPT code 56810 and increase the work RVUs for CPT code 58100 to 1.53. Because the public has not had a chance to comment on these work RVUs, we will consider them to be interim and will accept comments on values for these 3 codes.

    8. Gastroenterology

    In the June 8, 2001 proposed notice, we explained that, for the selected series of gastrointestinal endoscopy codes for the 5-year review, the RUC recommended increases in work RVUs for some of the codes and no change in work for other codes. While some of these endoscopy codes may be misvalued, we proposed to keep all work RVUs for gastrointestinal endoscopy codes unchanged. We also requested that the RUC perform a comprehensive review of all gastrointestinal endoscopy codes to ensure that all codes are properly valued and that no rank-order anomalies within and across specialties are created or exacerbated.

    With respect to the RUC recommendation concerning permitting separate reporting and payment of conscious sedation codes 90141 and 90142, we stated we would be reviewing data concerning this issue. Any proposal we would have concerning payment and reporting of conscious sedation codes would be the subject of future rulemaking.

    Comment: Many physicians and several medical organizations expressed concern about our decision to propose no changes for the 17 endoscopy codes for which the RUC had recommended increases. The American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, and the American Gastroenterological Association provided an extensive discussion on each of the codes which we will summarize and respond to below.

    CPT Code 43219, Esophagoscopy, Rigid or Flexible; With Insertion of Plastic Tube or Stent

    The RUC recommended an increase in work RVUs from 2.8 to 3.18 for CPT code 43219 based upon the increased complexity of the condition of the patients receiving these stents. We proposed to maintain the current work RVUs due to our concerns about creating rank order anomalies in the fee schedule.

    Comment: We received comments regarding this code from several societies representing gastroenterologists who said that the incremental work involved with esophageal stent placement, presently valued at 1.21 RVUs, should be increased to 1.59 RVUs. The commenters agreed with CMS that several other stent codes were recently reviewed by the RUC and valued using the incremental work value of 1.21 RVUs. Increasing the incremental work value for CPT code 43219 to 1.59 RVUs would result in rank order anomalies for several codes. The commenters acknowledged that these anomalies resulted from the timing of the 5-year review and the valuation of new stent placement codes. In spite of this, the commenters felt the RUC-recommended value was appropriate.

    Response: We feel the current work increment of 1.21 RVUs for placement of a stent over the base code 43200 is the appropriate value when assessing incremental work. We do not agree that the incremental work for stent placement should be increased to 1.59 RVUs. The upper GI endoscopy base CPT code 43235 has RVUs of 2.39 and CPT code 43256, upper GI endoscopy with stent placement (including predilation) has work RVUs of 4.35. This results in an incremental value of 1.96 RVUs which includes placement of the stent (1.21 RVUs) and predilation (0.75 RVUs).

    Furthermore, diagnostic bronchoscopy, CPT code 31622, has work RVUs of 2.78, and bronchoscopy with tracheal dilation and placement of a tracheal stent (CPT code 31631) has an RVU of 4.37. This means that the incremental work value for tracheal dilation and stent placement is 1.59 RVUs which is significantly less than the work increment of 1.96 listed for CPT code 43256. We also note that CPT code 43219 will be billed with CPT code 43226 (dilation of the esophagus over a guidewire) which has an incremental value of 0.75 work RVUs. This means that when an esophageal stent is placed, the total work value is 1.59 (base code) plus 1.21 (stent placement) plus 0.75 (dilation) for a total of 3.55 RVUs.

    More important, the incremental work of placing the stent is 1.96 RVUs which is similar to the incremental work of placing a stent elsewhere in the GI tract and more than the incremental work of placing a stent in the trachea. Increasing the incremental work of placing an esophageal stent to 1.59 RVUs from 1.21 would create a significant rank order anomaly in the physician fee schedule because esophageal stent placement would be valued more than stent placement elsewhere.Start Printed Page 55290

    Lastly, we note that less work is required to place a plastic stent than to place a wire stent. Both, however, are coded using CPT code 43219 and are valued similarly. For these reasons, we have decided to maintain the current RVUs of 2.80 for this code, and we would like the RUC to review all of the GI endoscopic stent placement codes and all of the GI endoscopic dilation codes simultaneously. Because these services are performed by gastroenterologists and various surgical specialties (general surgery, thoracic surgery, otolaryngology, and colorectal surgery), the RUC should obtain input from all specialties performing these services.

    CPT Code 43239, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate, With Biopsy, Single or Multiple

    The RUC recommended an increase in work RVUs from 2.69 to 2.87 based on an increase in the number of biopsies obtained during each procedure. The RUC also stated that technological advances allowing for greater precision and detail in finding abnormalities have increased the complexity of this service. The RUC also stated that technological advances have allowed results to be reported more quickly which increases the postservice work because biopsy information and treatment guidance are conveyed to the patient the same day as the procedure. We disagreed, and in the June rule we proposed to maintain the current work RVUs.

    Comment: We received comments from several societies representing gastroenterologists and the following concerns were expressed: First, they did not feel that the work of performing biopsy procedures at different sites in the GI tract was the same. They commented that biopsy of lesions in different anatomic sites required different amounts of work. Second, they felt that even though CPT code 43239 was used to report both single and multiple biopsies, the typical patient requires multiple biopsies.

    Response: We reviewed these comments and compared the intraservice time for this procedure to other endoscopic biopsy procedures and we have decided to accept the RUC recommendations for this code. However, we are making this value interim. Please see the discussion under CPT code 45380 regarding this issue.

    CPT Code 43244, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Band Ligation of Esophageal and or Gastric Varices; CPT Code 43255, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Control of Bleeding, Any Method

    The RUC recommended an increase in work RVUs for CPT code 43255 from 4.4 to 4.82 work RVUs, based on the use of new technology, such as lasers, to control bleeding. The RUC also recommended an increase in work RVUs for CPT code 43244 from 4.59 to 5.05 RVUs, based on the increased number of bands typically used to treat esophageal varices. We disagreed and proposed to maintain the current work RVUs.

    Comment: We received comments from several societies representing gastroenterologists and the following concerns were expressed: First, they felt that we had incorrectly determined that these two services should be valued identically because the RUC stated that they were “similar” in terms of work. Second, although they acknowledged that the use of cautery to control bleeding is not new, they said that the service is undervalued irrespective of which method is used to control bleeding.

    Response: We reviewed these comments and compared the intraservice time to other similar procedures and have decided to accept the RUC recommendations for the above CPT codes.

    CPT Code 43247, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Removal of Foreign Body

    The RUC recommended an increase in work RVUs for this CPT code from 3.39 to 3.59 work RVUs, based on increased complexity of patients undergoing this procedure with a concomitant increase in risk of morbidity. We disagreed and proposed to maintain the current work RVUs.

    Comment: We received comments from several societies representing gastroenterologists with the following concerns: First, they felt the increase in the work RVU for this procedure was justified because the procedure is usually performed under emergent conditions. Second, they did not favor uniform incremental work values for removal of foreign bodies from different sites in the gastrointestinal tract.

    Response: The RUC used a building-block approach to validate its acceptance of the median work RVUs from the survey. We do not believe the approach used by the RUC is valid for this CPT code. We compared this service to other similar services and continue to believe that the RUC recommendation does not represent the appropriate work increments for foreign body removal from various gastrointestinal sites. Furthermore, it would create a clear rank-order anomaly with CPT code 43215 that should have an identical work increment. Therefore, we will maintain the current work RVUs for this procedure. If the RUC reviews this service again, we ask that all GI endoscopic services for removal of foreign bodies be included in the review.

    CPT Code 43249, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Balloon Dilation

    The RUC recommended an increase from 2.9 to 3.35 work RVUs for this CPT code based on increased complexity of the condition of patients undergoing this procedure. We disagreed and proposed to maintain the current work RVUs.

    Comment: We received comments from several organizations representing gastroenterologists who felt the increase in incremental work value was justified based on their survey. However, they admitted that revaluing CPT code 43249 would create a rank order anomaly with CPT code 43220, an identical procedure. They stated that CPT code 43220 is also undervalued.

    Response: The current work increment for “balloon dilation of esophagus (less than 30mm diameter)” is 0.51 RVUs for both the esophagus and upper gastrointestinal endoscopy families. Since this is the same procedure in both families, it is unclear why the work should be increased for the upper gastrointestinal family only. This would create a rank-order anomaly. We have decided to maintain the current work RVUs for CPT code 43249. We plan to ask the RUC to review the incremental work RVUs for both CPT code 43249 and CPT code 43220.

    CPT Code 43259, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Endoscopic Ultrasound Examination

    The RUC recommended an increase in work RVUs from 4.59 to 8.59 based on the complexity of the equipment and the skill and judgement required. The Start Printed Page 55291RUC also noted that the survey results supported this procedure as requiring more work than CPT code 43260—diagnostic endoscopic retrograde cholangio-pancreatography (ERCP)—which has 5.96 work RVUs.

    Comment: We received comments from several societies representing gastroenterologists who agreed with us that the RUC values for the new endoscopic ultrasound codes (EUS) were inconsistent with the value recommended by the RUC for CPT code 43259. They felt that new survey data should have been used by the RUC when valuing CPT code 43259 instead of the current incremental work values used by the RUC for the 5-year review.

    Response: The RUC used the following building-block methodology to arrive at its recommendation for 43259—1) The RUC added 1.5 work RVUs, which is approximately 75 percent of the difference between the RUC recommendation from the last 5-year review (6.11 work RVUs) and the work RVUs that we assigned (4.0 work RVUs); (2) the RUC then added 2.2 work RVUs, which are the work RVUs of CPT code

    93312 (Echocardiography, Transesophageal, Real Time With Image Documentation (2D) (With or Without M-Mode Recording); Including Probe Placement, Image Acquisition, Interpretation and report)

    Not only do we disagree with the RUC methodology for this recommendation, but we also note that the RUC has used the current work RVUs for CPT code 43259 to value not only other gastrointestinal transendoscopic ultrasound procedures but also many transendoscopic ultrasound guided biopsy codes. We also note that the RUC has recently re-evaluated CPT code 43231, Esophagoscopy, rigid or flexible; with endoscopic ultrasound examination, and recommended much lower RVUs for the incremental work of the ultrasound examination. Therefore, accepting the RUC recommendation for this code would be inconsistent with the RUC's reevaluation of CPT code 43231, would invalidate the work valuation of many other gastrointestinal endoscopy codes, and would create numerous rank-order anomalies. Therefore, we recommend that the RUC review CPT code 43259 along with all the other endoscopic ultrasound examination codes and all the transendoscopic ultrasound guided biopsy codes.

    CPT Code 43263, Endoscopic Retrograde Cholangio-pancreatography (ERCP); With Pressure Measurement of Sphincter of Oddi (Pancreatic Duct or Common Bile Duct)

    CPT Code 43265, Endoscopic Retrograde Cholangio-pancreatography (ERCP) With Endoscopic Retrograde Destruction, Lithotripsy of Stone(s), Any Method

    CPT Code 43269, Endoscopic Retrograde Cholangio-pancreatography (ERCP); With Endoscopic Retrograde Removal of Foreign Body and/or Change of Tube or Stent

    The RUC recommended an increase in work RVUs from 6.19 to 7.29 for CPT code 43263 based on the need to measure pressures in both the biliary and pancreatic sphincters, as well as the need for prolonged postoperative monitoring.

    The RUC recommended an increase in work RVUs from 8.9 to 10.02 for CPT code 43265 based on a rank-order anomaly with code 43264 because this procedure is considered to be more time-consuming and complex than CPT code 43264.

    The RUC recommended an increase in work RVUs from 6.04 to 8.21 for CPT code 43269 based on a rank-order anomaly between this code and CPT code 43268.

    Comment: We received comments on these three codes from several organizations representing gastroenterologists. It was their position that these codes were commonly performed, undervalued procedures and that the survey data the organizations provided justify the increase in RVUs. We disagreed and proposed to maintain the current work RVUs for these three codes.

    Response: We have reviewed the codes and compared their intraservice times to other similar procedures and have decided to accept the RUC recommendations.

    CPT Code 44388, Colonoscopy Through Stoma; Diagnostic With or Without Collection of Specimen(s) by Brushing or Washing (Separate Procedure)

    CPT Code 44389, Colonoscopy Through Stoma; With Biopsy, Single or Multiple

    CPT Code 44390, Colonoscopy Through Stoma; With Removal of Foreign Body

    CPT Code 44391, Colonoscopy Through Stoma; With Control of Bleeding, any Method

    CPT Code 44392, Colonoscopy Through Stoma; With Removal of Tumor(s), Polyp(s), or Other Lesion(s) by Hot Biopsy Forceps or Bipolar Cautery

    CPT Code 44393, Colonoscopy Through Stoma: With Ablation of Tumor(s), Polyp(s), or Other Lesion(s) Not Amenable to Removal by Hot Biopsy Forceps, Bipolar Cautery or Snare Technique

    These 6 codes are in the same family, and the RUC recommended an increase for each code in this family primarily because it felt that the base CPT code, 44388, should be valued the same as CPT code 45378, diagnostic colonoscopy, at 3.7 work RVUs. The RUC also recommended that the values for the other codes in this family be increased to maintain their relativity to CPT code 44388. We disagreed and proposed to maintain the current work RVUs for all codes in this family.

    Comment: We received comments from several societies representing gastroenterologists who commented that, although performing a colonoscopy through a stoma involves less physician work than performing a standard colonoscopy, they believed that performing a colonoscopy through a stoma is more technically challenging than performing a standard colonoscopy.

    Response: We disagree with valuing the performance of a colonoscopy through a stoma identically to performing a standard colonoscopy. We feel the proposed valuation creates a series of rank-order anomalies. Consequently, we will finalize our proposal to maintain the current RVUs for this family of codes. In addition to determining that the RUC recommendation for the base code 44388 was incorrect, we note that the RUC recommendations create increments of work for performance of “biopsy, single or multiple,” “control of bleeding, any method,” “removal of tumors,” and “ablation of tumors” during a colonoscopy through a stoma, which are inconsistent with the same increments for the complete colonoscopy family of codes that begins Start Printed Page 55292with code 45378. We note that, in addition to gastroenterologists, general surgeons and colorectal surgeons perform these procedures. Therefore, if the RUC reconsiders the work values of these codes, we believe that information should be obtained from all physicians who perform these services.

    CPT Code 45380, Colonoscopy, Flexible Proximal to Splenic Flexure; With Biopsy, Single or Multiple

    The RUC recommended an increase in work RVUs from 3.98 to 4.44 for this CPT code, based on the increased number of biopsies generally taken during this procedure and the increased difficulty in removing these polyps. We disagreed and proposed to maintain the current work RVUs for this service.

    Comment: We received comments from several societies representing gastroenterologists who commented that work increments for performing biopsies at different sites within the gastrointestinal tract are different. Furthermore, the societies believe that the incremental work of biopsy procedures performed by different specialties (for example, gastrointestinal endoscopic biopsies and tracheobronchial endoscopic biopsies) need not be valued identically. They also note that even though this code is reported for both single and multiple biopsies, the “typical” patient usually has multiple biopsies performed.

    Response: We have reviewed these comments and compared the intraservice time of this code to the intraservice time of other similar procedures. We have decided to accept the RUC recommendation. However, CMS believes the best approach to accurately value gastrointestinal endoscopy biopsy procedures is to evaluate all the biopsy procedures in the gastrointestinal tract. This would provide the opportunity to establish the correct incremental work RVUs and avoid creating rank-order anomalies. Therefore, we will make the work values for CPT code 43239 (as indicated earlier) and 45380, interim until we receive further recommendations from the RUC regarding the entire spectrum of gastrointestinal biopsy procedures.

    9. Conscious Sedation

    Comment: The American Academy of Family Physicians indicated that the RUC has appointed an ad hoc workgroup to review the issue of conscious sedation, including identifying codes where conscious sedation is not inherently included as a component of the physician work. It recommended that, when the workgroup and RUC complete this review, we allow separate reporting and payment for CPT codes 90141 and 90142 in conjunction with the identified codes. The AMA and the RUC also referred to the newly formed workgroup in their comments, and the AMA urged us to work with the RUC and the CPT to reach a solution on the coding and payment issues surrounding conscious sedation.

    Response and Final Decision: We welcome suggestions on this issue from both the coding and payment perspective. When the workgroup review of these issues is complete, we will evaluate any recommendations we receive for the development of any future proposals.

    10. Pulmonary Medicine/Critical Care

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the pulmonary medicine and critical care codes.

    11. Cardiology

    CPT Code 93350, Transthoracic Echocardiography

    Comment: The American College of Cardiology expressed appreciation of our acceptance of the RUC recommendation to increase the work RVUs for this code.

    Response and Final Decision: We are finalizing the proposed RVUs for CPT code 93350 and maintaining the work values for the other 2 CPT codes, 32234 and 32235, as discussed in the proposed notice.

    12. Pediatrics

    CPT Code 36400 (Venipuncture Under Age 3 Years; Femoral, Jugular or Sagittal Sinus) and CPT Code 36405 (Venipuncture, Under Age 3 Years, Scalp Vein)

    Comment: The American Academy of Pediatrics (AAP) disagreed with our recommendations for CPT codes 36400 and 36405. The RUC recommended work RVUs of .38 and .32, respectively. We proposed that the work RVUs remain unchanged at .18 for each code. We do not believe it is appropriate to compare the work RVUs of a venipuncture to the work of an evaluation and management service. The AAP pointed out that the work involved in providing a venipuncture to a patient under age 3 is more intense than it has been in the past.

    Response: Based on the comments received, we referred this code to a multispecialty refinement panel for review.

    Final decision: As a result of our analysis of the multispecialty refinement panel ratings, we are increasing the work RVUs for CPT code 36400 to 0.38 and also increasing the work RVUs for CPT code 36405 to 0.31.

    13. Pediatric Surgery

    CPT Code 39503 (Repair, Neonatal Diaphragmatic Hernia, With or Without Chest Tube Insertion and With or Without Creation of Ventral Hernia) and CPT Code 49605 (Repair of Large Omphalacele or Gastroschisis; With or Without Prosthesis)

    Comment: The AAP and the American Pediatric Surgical Association (ASPA) recommend that codes 39503 (Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia), and 49605 (Repair of large omphalacele or gastroschisis; with or without prosthesis) receive interim values of 95 and 76, respectively, until the issue of critical care in the postoperative period is resolved. We had proposed to maintain the current work RVUs of 37.54 and 24.94, respectively, as interim 2002 work values and asked the RUC to resubmit recommendations for work RVUs for CPT codes 39503 and 49605 with either a 000 or 010 global period. As an option, pending resolution of the critical care issue, the APSA recommended that the interim work values for CPT codes 39503 and 49605 be 46.35 and 30.14, respectively.

    The RUC agreed that the physician work in the postoperative period caring for these seriously ill neonates was significant and required the services of both surgeon and the neonatologist. The RUC requests that CMS treat these codes in the same manner as the other 90-day global codes that include extensive postoperative care.

    Response: Upon further review, we agree with the RUC's recommendation and will establish the work values for CPT codes 39503 and 49605 at 95 and 76 units, respectively.

    14. Radiology

    CPT Code 76090, Mammography; Unilateral and CPT Code 76091 Mammography; Bilateral

    Comment: The American College of Radiology (ACR) requested that CMS increase the work RVUs for unilateral mammography, that is, CPT code 76090, from the proposed .70, to .93 and for bilateral mammography, that is, code 76091, from the proposed .87, to 1.10. The ACR believes these values, which are the median survey values, more accurately reflect the work involved with these two procedures. The ACR points out that there is a significant amount of physician time associated Start Printed Page 55293with reviewing the results with these anxious patients and complying with the mandatory Mammography Quality Standards Act requirements.

    The ACR commented that the chart at 66 FR 31045 of the June 8, 2001 proposed rule indicates that CPT code 76005 had a RUC recommendation of 10.60. However, that column should read .60.

    The ACR also took exception to the requested work RVUs reported in the chart at 66 FR 31045 for codes 76065, 76090 and 76091. The chart displayed requested work RVUs of .60 for 76065, .64 for 76090, and .76 for code 76091. The ACR asked that the chart be corrected to reflect the actual requested work RVUs for each code. These corrected values, based on the median survey values, are .70 for CPT code 76065, .93 for 76090, and 1.10 for CPT code 76091.

    Response: Based on the comments received, we referred these codes to a refinement panel for review. We regret the error in the chart concerning the requested work RVUs.

    Final decision: As a result of our analysis of the multispecialty panel ratings, we are retaining the work RVU of 0.70 for CPT code 76090 and 0.87 for CPT code 76091, the work RVUs we proposed in the June 8 proposed rule.

    CPT Code 76092, Screening Mammography, Bilateral Two View Film Study of Each Breast

    In addition, we had requested the RUC to review the work RVUs for code 76092 (Screening mammography, bilateral two view film study of each breast). In its comments on the June 8, 2001 proposed rule, the RUC indicated it had placed this issue on the September 2001 meeting agenda and would provide recommendations to us following that meeting. The September meeting had to be cancelled and the issues to be addressed at that meeting will be discussed at the first meeting early next year. Therefore, we are finalizing the current RVUs for this code.

    15. Plastic Surgery

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the plastic surgery codes.

    B. Other Comments

    1. Anesthesia Services

    In our June 8, 2001 proposed rule (66 FR 31065), we stated that the American Society of Anesthesiologists (ASA) contended that the work of anesthesia services is undervalued and, based on discussions with the RUC, the ASA requested a 24 percent increase in anesthesia work. However, the RUC furnished no recommendation on anesthesia services; instead, it assigned to a newly created workgroup the responsibility for reviewing anesthesia services in the context of the physician fee schedule. We indicated that the ASA will be working with this workgroup on clinical issues, such as induction and postinduction intensity, and did not propose any changes to the anesthesia CF at this time to reflect the 5-year review of physician work for anesthesia services. However, we did indicate that we might make changes in response to recommendations the RUC may provide.

    Comment: Many individual anesthesiologists commented that their services are undervalued. The American Society of Anesthesiologists also commented that its services are undervalued and asked that we accept the results of the first RUC workgroup (weighted average increase of 26 percent on representative codes) and extrapolate this to all anesthesia codes. We also received letters from individuals indicating that anesthesia services are undervalued.

    In its comments, the RUC stated that it had not come to an agreement on extrapolating the results of the work of the 19 studied anesthesia codes to all anesthesia codes. The RUC agreed that the five quintiles for postinduction anesthesia and the examples associated with each quintile were appropriate. The RUC also examined the intensity values assigned to each quintile and made adjustments to the intensity values based on comparisons to evaluation and management codes and critical care services. It agreed to the following values—.224 for Level 1; .031 for Level 2; .051 for Level 3; .070 for Level 4; and .085 for Level 5.

    The RUC approved the following intensity factors for the induction period—.067 for induction of general anesthesia; .067 for induction of spinal and epidural anesthesia; and .051 for induction of regional anesthesia.

    Although the RUC recommended acceptance of the building block work values for the 19 codes studied, it did not resolve issues related to how often anesthesiologists provide the retrobulbar bloc for code 00142 and agreed that the distribution of postinduction time among the quintiles should be reviewed in more detail after it receives more input from surgical specialties.

    Response and final decision: The RUC has informed us that it will continue to look at anesthesia work beginning at its first meeting in CY 2002. We will review the RUC recommendation and address anesthesia work in next year's proposed physician fee schedule rule.

    2. Spine Injection Procedures

    We received no comments on these codes. Therefore we will finalize the proposed work RVUs for the spine injection procedure codes.

    3. Biofeedback

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the biofeedback codes.

    4. Surgical Management of Burn Wounds

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the codes involving surgical management of burn wounds.

    5. Transplantation

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the transplantation codes.

    6. Arthroscopy Services

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the arthroscopy service codes.

    7. Wheelchair Management

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the wheelchair management codes.

    8. Psychological Testing

    We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the psychological testing codes.

    9. Podiatric Services

    In our June 8, 2001 proposed notice (66 FR 31067), we stated the American Podiatric Medical Association (APMA) submitted 5 codes (trim skin lesions/trim nails) for review (11719, 11055, 11056, 11057, and G0127) and that the HCPAC requested we review our current utilization data to ensure that the original utilization assumptions were correct. The HCPAC recommended that the current review of data should be based on actual 1999 utilization data since these codes were not fully implemented until April 1, 1998. We stated that we would review the utilization data associated with the aforementioned codes to ensure the original assumptions are still correct and that we would publish our decision in the final rule.Start Printed Page 55294

    Comment: The APMA was pleased that we would review the utilization data; however, it indicated that the work RVUs should not be revised based on current utilization. It recommended that we accept the original RUC recommendations since these values were based on the results of surveys of practicing podiatrists that were considered and approved by the RUC.

    Response and final decision: Based on our review of the data and the APMA recommendation that we accept the original RUC recommended values, we are increasing the work values for these services as follows:

    • CPT code 11719, Trimming of nondystrophic nails, any number, a work RVU of 0.17.
    • CPT code 11055, Paring or cutting of benign hyperkeratotic lesion (for example, corn or callus) single lesion, a work RVU of 0.43.
    • CPT code 11056, two to four lesions, a work RVU of 0.61.

    CPT code 11057, more than four lesions, a work RVU of 0.79 .

    For HCPCS code G0127, Trim nails, while we did not receive a RUC recommendation on this code (since we created the code), we are increasing the work RVU to 0.17 to be consistent with the increase made to CPT code 11719.

    D. Other Issues

    1. Critical Care Services in a Global Period

    The June 8, 2001 proposed rule included a discussion on critical care services (66 FR 31067-68). We stated that current Medicare policy allows separate payment to the surgeon for postoperative critical care services during the surgical global period only when the patient has suffered trauma or burns. If the surgeon provides critical care services during the global period, for reasons unrelated to the surgery, that is separately payable as well. However, the approach the RUC used for the 5-year review had previously been used to validate postoperative work. That approach compared the work of a postoperative intensive care unit visit by the surgeon to code 99291, Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes, which is valued at 4.00 work RVUs, rather than comparing a level three subsequent hospital visit (code 99233), which is valued at 1.51 work RVUs).

    We indicated that valuing the surgeon's postoperative intensive care unit visits as critical care services had raised a number of issues that could require a change in payment policy to ensure that postoperative critical care is appropriately paid. In order to ensure that we make appropriate payments to physicians furnishing postoperative critical care services to Medicare beneficiaries, we specifically solicited information and comments on several questions and issues. We also proposed that the work RVUs for those surgical codes where any postoperative intensive care unit visits were valued as critical care remain interim, until we address the issues discussed above.

    Many individual physicians, specialty societies, and health benefit programs provided comments and addressed the points we had outlined in the proposed notice. We appreciate their responses and will carefully review this information as we determine whether to make a future proposal.

    2. Budget Neutrality

    As explained in the proposed rule published June 8, 2001 (66 FR 31068-69), section 1848(c)(2)(B)(ii)(II) of the Act requires that increases or decreases in RVUs may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we make across-the-board adjustments to preserve budget neutrality. Based on the proposed changes in work RVUs, we indicated that budget-neutrality adjustments would be required. We proposed to reduce the conversion factor to meet the budget neutrality requirement, rather than applying a reduction to all work RVUs. We also indicated that revisions in payment policies, including the establishment of interim and final RVUs for coding changes contained in a separate proposed rule, might result in additional budget-neutrality adjustments.

    Comment: The American Academy of Family Physicians, American College of Radiology, American College of Physicians, American Society for Internal Medicine, and the American Medical Association Specialty Society RVUs Update Committee indicated that they supported our proposal to maintain budget neutrality by adjusting the conversion factor.

    Response and final decision: We will proceed with our proposal to maintain budget neutrality by adjusting the conversion factor.

    V. Refinement of Relative Value Units for Calendar Year 2002 and Responses to Public Comments on Interim Relative Value Units for 2001

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

    Section V.B of this final rule describes the methodology used to review the comments received on the RVUs for physician work and the process used to establish RVUs for new and revised CPT codes. Changes to codes on the physician fee schedule (Addendum B) are effective for services furnished beginning January 1, 2002.

    B. Process for Establishing Work Relative Value Units for the 2002 Fee Schedule and Clarification of CPT Definitions

    Our November 1, 2000 final rule on the 2001 physician fee schedule (65 FR 65376) announced the final work RVUs for Medicare payment for existing procedure codes under the physician fee schedule and interim RVUs for new and revised codes. The RVUs contained in the rule applied to physician services furnished beginning January 1, 2001. We announced that we considered the RVUs for the interim codes to be subject to public comment under the annual refinement process. In this section, we summarize the refinements to the interim work RVUs that have occurred since publication of the November 2000 final rule and our establishment of the interim work RVUs for new and revised codes for the 2002 fee schedule.

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

    a. Methodology (Includes Table 5, Refinements of the 2001 Interim Work Relative Value Units)

    Although the RVUs in the November 2000 final rule were used to calculate 2001 payment amounts, we considered the RVUs for the new or revised codes to be interim. We accepted comments for a period of 60 days. We received substantive comments from many individual physicians and several specialty societies on 52 CPT codes with interim work RVUs. Only comments on codes listed in Addendum C of the November 2000 final rule were considered.

    We used a process similar to the process used in 1997 to address substantive comments. (See the October 31, 1997 final rule on the physician fee schedule (62 FR 59084) for the discussion of refinement of CPT codes with interim work RVUs.) We convened Start Printed Page 55295a multispecialty refinement panel of physicians to assist us in the review of the comments. The comments that we did not submit to panel review are discussed at the end of this section, as well as those comments that were reviewed by the panel. We invited representatives from each of the specialty societies from which substantive comments were received to attend a panel for discussion of the codes on which they had commented. The panel was moderated by our medical staff and consisted of the following voting members:

    • One to two clinicians representing the commenting specialty or specialties, based upon our determination of those specialties which are most identified with the service(s) in question. Although commenting specialties were welcome to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate.
    • Two primary care clinicians nominated by the American Academy of Family Physicians and the American Society of Internal Medicine.
    • Four carrier medical directors.
    • Four clinicians with practices in related specialties, who were expected to have knowledge of the services under review.

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

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

    Ratings of work were analyzed for consistency among the groups represented on the panel. In general, we used statistical tests to determine whether there was enough agreement among the groups of the panel, and whether the agreed-upon RVUs were significantly different from the interim RVUs published in Addendum C of the November 2000 final rule. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the 1993 fee schedule. The statistical tests were described in detail in the November 25, 1992 final rule (57 FR 55938).

    Our decision to convene a multispecialty refinement panel of physicians and to apply the statistical tests described above was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Of the 3 codes reviewed by the multispecialty panel, all were the subject of requests for increased values. Of the 3 interim work RVUs that were reviewed, 2 were increased and 1 was unchanged.

    We also received comments on RVUs that were interim for 2001, but which we did not submit to the panel for review for a variety of reasons. These comments and our decisions on those comments are discussed in further detail below.

    Table 5 lists the interim and related codes reviewed during the refinement process described in this section. This table includes the following information:

    • CPT Code. This is the CPT code for a service.
    • Descriptor. This is an abbreviated version of the narrative description of the code.
    • 2001 Work RVU. The work RVUs that appeared in the November 2000 rule are shown for each reviewed code.
    • Requested Work RVU. This column identifies the work RVUs requested by commenters.
    • 2002 Work RVU. This column contains the final RVUs for physician work.

    Table 5.—Refinement of 2001 Interim Work Relative Value Units

    1 CPT codeDescriptor2001 work RVURequested work RVU2002 work RVU
    19102Bx breast percut w/image2.002.732.00
    19103Bx breast percut w/device2.375.553.70
    22522Percutaneous vertebroplasty, addl3.004.314.31
    1 All CPT codes and descriptions copyright 2002 American Medical Association.

    2. Interim 2001 Codes

    Stenting Procedures—(CPT Codes 43256, 44370, 44379, 44383, 44397, 45345, 45387, and 45342)

    We accepted the RUC recommended increase over the base code of 1.96 work RVUs. Commenters suggested that this increment should be increased to 2.59 work RVUs to reflect the work increase the RUC had recommended for CPT code 43219 (one of the codes used to arrive at this increase) as part of the 5-year review. Additionally, they also commented that the increment for the pre-dilation service should be from the dilation of gastric outlet in connection with an upper GI as opposed to the esophagoscopy code. Finally, commenters did not believe that these services should be subject to “within family work neutrality adjustments” (see Final Decision below) and instead believed that any increase in total RVUs should be addressed through the SGR or conversion factor. They felt that these stent placements are new technology and should not be viewed as code splitting/unbundling of services. They stated that stent placements have only been performed over the last 4-5 years and any work associated with them is Start Printed Page 55296not reflected in current work values for endoscopic codes.

    Final decision: “Within family work neutrality adjustments” are used for new or revised services that are not considered new technologies. To achieve work neutrality within families of services, we compare the new or revised work RVUs (weighted by projected frequency) to the old work RVUs (weighted by actual frequency) to ensure that additional RVUs have not been added based on fragmentation of existing codes. We agree with the commenter that these services are new technologies and thus should not be subject to within family work neutrality adjustments. With regard to the final work value for CPT code 43219 and the use of dilation and stent placement codes in assigning a work value to 43219, please see our discussion elsewhere in this rule.

    Cryosurgical Ablation of the Prostate—CPT Code 55873

    We agreed with the RUC recommended work RVU for CPT code 55873 as we felt that the comparison to CPT code 55801, Prostatectomy, perineal, subtotal, was appropriate to aid in setting the work RVU of CPT code 55873. One commenter did not agree that this comparison was appropriate. The commenter indicated that the RUC was being requested to review this service again at its February meeting.

    Final decision: The RUC provided comments on interim valued CPT code 55873 that re-visited the appropriate comparison service. Based upon comments received, the final work RVUs for CPT code 55873 will be increased to 19.47.

    Percutaneous Vertebroplasty—CPT Code 22522

    We disagreed with the RUC-recommended work RVUs of 4.31 for this service. CPT code 22522 is an add-on code that should have no associated pre- or postservice work. We removed the pre- and postservice work from the weighted average of CPT codes 22520 and 22521, which are the base services with which add-on CPT code 22522 should be billed in conjunction, and recalculated the value. Thus, we assigned interim work RVUs of 3.00 for CPT code 22522. Several commenters disagreed and do not believe that our methodology has appropriately valued this add-on service. Commenters felt we should sum the work RVUs of CPT codes 22520 and 22521 and then take 50 percent of this value. They believe that this is how we historically have calculated work RVUs for add-on services. Based on these comments, we referred this code to a multispecialty refinement panel for review.

    Final decision: As a result of the statistical analysis of the refinement panel ratings, the final work RVUs are 4.31 for CPT code 22522.

    Fetal Biophysical Stress Testing—CPT Codes 76818 and 76819

    Although we agreed with the relativity presented by the RUC, we reduced the RVUs for these aforementioned services due to within family work neutrality adjustments. As previously discussed, within family work neutrality adjustments are used to ensure that additional relative values are not added based on fragmentation of existing codes. One specialty organization felt that we inappropriately determined that the work associated with the original CPT code 76818 (CPT code 76819 was added for January 1, 2001), included the average work of both with and without non-stress test. It believes that the survey data presented to the RUC suggest that this assumption is invalid and that the inappropriate within family neutralization of these services creates a rank-order anomaly in this family of codes.

    The survey data indicated that CPT code 76818 required more time and greater mental effort than CPT code 76805 (Complete OB ultrasound), which has 0.99 work RVUs, since the ultrasound portion of CPT code 76818, while less extensive, is typically performed in a high-risk situation. In addition, CPT code 76818 also includes CPT code 59025 (Fetal non-stress test) with work RVUs of 0.53. The specialty organization also reported that CPT code 76819 requires more work than CPT code 76815 (Limited obstetric ultrasound) with work RVUs of 0.65. The assignment of 0.86 RVUs to CPT code 76818 and 0.63 RVUs to 76819 creates a rank-order anomaly with this family of obstetric ultrasound procedures.

    Final Decision: We agree with the commenter that the within family neutrality adjustment we made for 2001 was not appropriate and created a rank-order anomaly within this family of services. We will remove the neutrality adjustments for January 1, 2002.

    Cognitive Skills and Sensory Integrative Techniques—CPT Codes 97532 and 97533

    We did not agree with the HCPAC recommendation for CPT codes 97532 and 97533 (work RVUs of 0.51 and 0.48, respectively). These two new services were created to replace deleted CPT code 97770. We believed that the work associated with these new services is analogous to deleted CPT code 97770 and therefore, we assigned work RVUs of 0.44 (the value assigned to the deleted code) to these new replacement codes. Commenters felt that assignment of this work value was arbitrary on our part, particularly since the HCPAC information had been based on information from a survey completed by the practitioners who provide these services.

    Final Decision: We disagree with the commenters and are finalizing the interim work values. This is an example of replacing one CPT code with two new CPT codes that describe identical work. Because there is no new technology involved, we will finalize the interim work RVUs.

    Wound Care CPT Codes

    Absent a HCPAC recommendation for either of the aforementioned CPT codes, we valued the work of CPT code 97601 as 0.50 RVUs, the same as deleted service G0169 that described the work in the new code. We considered CPT code 97602 to be bundled into CPT code 97601 and therefore did not establish work RVUs for this service. Commenters believed that we inappropriately bundled CPT code 97602 into 97601 since they represent distinct services. The commenters requested that we reconsider bundling CPT code 97602.

    Final Decision: We have re-examined our determination but have not changed our decision. CPT code 97602 describes services that typically involve placement of a wound covering, for example, wet-to-dry gauze or enzyme-treated dressing. It also includes nonspecific removal of devitalized tissue that is an inherent part of changing a dressing. This service is already included in the work and practice expenses of CPT code 97601. In the typical service described by 97601, the patient has a dressing placed over the wound. We would add that the services described by 97602 are also included in the work and practice expenses of the whirlpool code, CPT 97022. For this reason, we consider this a bundled service that is not paid separately.

    Percutaneous Breast Biopsy—CPT Codes 19102 and 19103

    We agreed with the RUC recommended work RVUs of CPT codes 19102 (RVU = 2.00) and 19103 (RVU = 2.37). Commenters believed that the work RVUs assigned to these codes were inappropriately low and did not accurately reflect the time and intensity of the work involved. Commenters supplied information to support their request for increasing the work RVUs for Start Printed Page 55297these services. Based on these comments, we referred this code to a multispecialty refinement panel for review.

    Final decision: As a result of the statistical analysis of the multispecialty refinement panel ratings, the final work RVUs for CPT code 19102 are 2.00, and the final work RVUs for CPT code 19103 are 3.70.

    Magnetic Resonance Imaging Procedures—CPT codes 70540, 70542, 70543, 71550, 71551, 71552, 72195, 72196, 72197, 73218, 73219, 73220, 73221, 73222, 73223, 73718, 73719, 73720, 73721, 73722, 73723, 74181, 74182, and 74183

    We received a RUC recommendation for only 3 of these codes (70540, 70542, 70543) for January 1, 2001. However, this recommendation did not reflect the required within family work neutrality adjustment. The work RVUs of 0.98, 1.17, and 1.56 were assigned to these services to ensure that there would not be additional work RVUs introduced into the system. We did not receive work recommendations or utilization data for any of the other new MRI codes and assigned work RVUs for these other codes based on the methodology outlined in the November 2000 final rule.

    Commenters expressed concern about the within family work neutrality adjustment applied to the RUC-recommended work RVUs, and the methodology that was used to establish work values for the other MRI procedures. Commenters requested that we re-evaluate the within family work neutrality adjustment based upon updated information supplied in their respective comments.

    Final decision: We are accepting the work values for these services which were submitted by the RUC in its comment on the interim work values we assigned in last year's final rule. We note that these work values are virtually identical to the work values that we assigned as interim last year. Based upon comments received, we have re-evaluated the utilization crosswalks upon which our within family work neutrality adjustments were based.

    Since 2001 is the first year for which actual data is available for these services, we used available data (first two quarters of 2001) to capture the actual utilization of these new services. This utilization was then subjected to a standard analysis of reporting trends to estimate the completion percentage of 2001 utilization data. The available utilization was then “aged” to represent one full year of data for 2001. After determining the utilization for 2001, we applied this revised within family work neutrality adjustment across the entire family of MRI procedures rather than applying this adjustment to subsets. We are finalizing these within family work neutral values and note that the re-calculation of this neutrality adjustment results in increases to the work RVUs of the MRI services referenced above.

    Computed Tomographic Angiography (CTA)—CPT Codes 70496, 70498, 71275, 72191, 73206, 73706, 74175 and 75635

    We agreed with the RUC recommendation of 1.75 for CPT codes 70496 and 70498 for January 1, 2001. However, the RUC did not submit work recommendations for the other CTA codes. We assigned work RVUs for these other codes based on the methodology outlined in the November 2000 rule. Commenters disagreed with the interim values we had proposed for CTA codes and provided additional information for valuing these services. The commenter felt that our decisions created rank-order anomalies between anatomic sites.

    Final decision: We are accepting the work values for these services which were submitted by the RUC in its comment on the interim work values we assigned in last year's final rule. We will implement them as final values for 2002.

    Practice Expense Refinements of 2001 Interim and Revised RVUs

    Percutaneous Breast Biopsy—CPT Codes 19102 and 19103

    Comment: A specialty organization representing breast surgeons submitted its suggested direct cost inputs for these two services and had several comments on their practice expenses. The commenter indicated that the price in the database for the biopsy driver was too low, that the clinical staff type should be a registered nurse rather than a technician and that there should be pre- and postservice clinical staff time when the procedure is performed in the facility setting. In addition, the commenter questioned whether the 50 percent utilization rate used to price equipment was realistic for new technology and recommended that device-specific utilization rates be determined. The society also questioned the lack of direct cost inputs for equipment and supplies for CPT 76095, the associated procedure for image guidance. A manufacturer commented that the equipment inputs for CPT 19102 were erroneously dropped from the CPEP database.

    Response: We had accepted the RUC recommendations on these two services, making only the following technical changes to the supplies and equipment: we did not include the cost of the crash cart, because we consider this an indirect expense, nor the cost of the biopsy gun handle, because this was less than the $500 required for an item to be on the equipment list. We also did not include separately billable fluids, the formalin that would be supplied by the lab, or the biohazard bag and skin marking pen that could be used for more than one procedure.

    If the specialty that was involved in the presentation of these codes to the RUC now believes that the direct inputs do not adequately represent the costs of performing these services, one option would be to have these codes refined by the PEAC. In the meantime, we are prepared to make certain changes to the CPEP data in response to the recommendations made by the commenters. We will add the power table and surgical lamp to both codes and will increase the price associated with the biopsy device driver, subject to verification when we undertake our repricing of the CPEP equipment inputs. Because the specialties presenting the codes to the RUC, and the RUC itself, recommended using radiologic staff for these services, we will not change the staff type to registered nurse at this time. However, we will substitute the higher-paid mammography technologist, which we have just added to our staff type list, for the current x-ray technician staff type.

    We have in the past solicited information from the specialties regarding equipment-specific utilization rates, but we have never received sufficient information to propose any changes in our policy. Additionally, for most services, changing the utilization rate would have very little effect.

    The commenter is correct that the associated procedure for image guidance, CPT 76095, currently does not have CPEP inputs assigned to the non-facility setting. However, at this time, it is priced as a part of the “zero work” pool, and the CPEP inputs are not used to calculate the practice expense RVUs for this service. We would hope that this code could be refined in the near future and given the appropriate inputs for the office setting.

    CPT Codes 34812, 34820, 34830, 34831 and 34832 for Repair of Aortic Aneurysm

    Comment: A specialty organization representing vascular surgery stated that CPT codes 34812 and 34820 should have clinical staff preservice time added and that CPT codes 34830, 34831 and Start Printed Page 5529834832 were assigned inappropriately low postservice clinical staff times.

    Response: We accepted the RUC recommendations for all of these services. There was no preservice time included in the RUC recommendation for CPT codes 34812 and 34820. In addition, we have assigned 99 minutes of clinical staff postservice time to CPT codes 34830, 34831 and 34832, as recommended by the RUC. These codes can be refined by the PEAC which now has a standard package for 90-day global pre- and postservice times for clinical staff and is also discussing the coordination of care clinical staff times for 0-day global services.

    We received the following comments on HCPCS codes established in the November 1, 2000 final rule.

    • G0169 Removal of Devitalized tissue, without use of anesthesia.

    Comment: The American Podiatric Medical Association recognized that, effective January 1, 2001, this code was eliminated and we have adopted CPT code 97601, which is sufficiently similar to the services described by G0169. However, it requested we address a policy issue related to the discussion of this service. In the November 2, 1999 Federal Register (64 FR 59426), we stated that G0169 was created because CPT codes 11040 through 11044 for debridement were created to describe “complex surgical services requiring the use of general anesthesia.” APMA indicates that there had never been a policy requiring the use of any anesthesia, much less general anesthesia, when performing surgical debridement that is reported with CPT codes 11040 through 11044. However, as a result of the statement in the November 2 Federal Register, some carriers developed policies denying payment for these codes if anesthesia was not used. The APMA urged us to clarify that anesthesia, whether general or local, is not required when billing CPT codes 11040 through 11044.

    Response: We acknowledge that the use of “general anesthesia” in the preamble to the November 2, 1999 rule was an error, and we believe all our contractors are aware of our misstatement. As the commenter stated, the code G0169 has been deleted and replaced by CPT code 97601, Removal of devitalized tissue from wound(s); selective debridement, without anesthesia (e.g., high pressure waterjet, shape selective debridement with scissors, scalpel, and tweezers) including topical application(s), wound assessment, and instruction(s) for ongoing care, one session. We expect that our contractors will develop policies to distinguish this service from the debridement codes, 11040 through 11044. We anticipate that they may consider a variety of factors, including the extent of the debridement and the amount of medical skill required to perform the service, and not simply whether a local anesthetic was used in the procedure.

    Comment: The American College of Surgeons urged us to issue instructions to carriers specifying that the use of CPT code 97061 is limited to physical therapists and other non-physician practitioners and that the debridement of wounds by surgeons is properly reported with a code from the CPT debridement codes 11040-11044.

    Response: As we stated in the response to the previous comment, we believe that our contractors are likely to make this distinction in their local policies. If we determine that relying on local carrier policies is unsatisfactory, then we will consider whether national guidance is needed.

    • G0181 and G0182, Care plan Oversight.

    Comment: A few organizations expressed disappointment that we finalized our proposal to establish two new G codes for care plan oversight services, rather than continue to recognize the CPT codes related to these services.

    Response: The CPT codes for care plan oversight were modified so that they included services that extend beyond the limits of our current payment policy. As a result, we will continue to use the G-codes that are consistent with our payment policies.

    • G0180 and G0179 Certification and Recertification of Medicare Covered Home Health Services.

    Comment: Several specialty organizations expressed appreciation for our willingness to recognize and compensate physicians for these services and supported our decision to pursue this coding and reimbursement issue through the CPT and RUC processes. The American College of Surgeons expressed concern that claims submitted by surgeons for physician certification or recertification would be denied inappropriately due to longstanding rules that preclude payment for services that are provided during the global period.

    Response: As was stated in the November 1, 2000 final rule (66 FR 65408), surgeons performing these services could be paid for G0179 and G0180 during the global period. We have heard no specific complaints that this policy has not been implemented appropriately.

    G Codes Related to Swallowing Function

    Comment: The American College of Surgeons objected to the creation of these G codes and requested that we discontinue their use and work with the otolaryngologists to submit a coding request on these services to the CPT Editorial Panel. The American Academy of Otolaryngology—Head and Neck Surgery, Inc. (AAO-HNS) also expressed concern about creation of these codes. It felt that our description of the codes was incomplete and inaccurate.

    In the November 1, 2000 final rule we proposed 4 new G codes and stated that these would replace the more general CPT code 92525, Evaluation of swallowing and oral function for feeding. AAO-HNS believes that this incorrectly implies that the single code 92525 includes 4 unique services and, therefore, we have significantly understated the work and practice expenses required for these procedures.

    For G0193, Endoscopy study of swallowing function, and GO194 Sensory testing during endoscoping study of swallowing, we stated that coverage of these services remains at the discretion of the carrier and that they would be carrier priced. AAO-HNS expressed concern that carriers might misinterpret this statement to mean the codes should not be covered and, if covered, the payment might be inappropriately low. AAO-HNS requested we clarify that these services should be covered and recommended that pricing for GO193 should equal to the sum of the RVUs for CPT code 31575, Laryngoscopy, flexible fiberoptic; diagnostic, and CPT code 92525.

    AAO-HNS also did not agree with our decision to treat G0194 as an “add-on” code as this group felt this would create confusion. Rather, AAO-HNS suggested that GO194 be treated as a stand-alone code with RVUs equal to CPT codes 31575, 92525 and 92520 (Laryngeal function studies).

    In addition, AAO-HNS was concerned about our statement that CPT code 31575 and CPT code 31579 (Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy) should not be used for evaluations of swallowing and urged that we clarify that these codes could still be used to report flexible fiberoptic laryngosopies for patients with swallowing problems.

    Response: These G codes related to swallowing function were created because of the ambiguity of the CPT code, 92525. The CPT editorial panel will be reviewing codes designed to substitute for the G-codes created. The specialty advisors, including AAO-Start Printed Page 55299HNS, will have the opportunity to comment on these proposals and to create codes that they believe will describe the services more accurately. If the CPT editorial panel adopts these revised codes, they could be in the 2003 CPT book.

    Comment: The American Occupational Therapy Association stated that in the specific discussion of code GO195, and by implication the related codes, we stated these services are performed typically by a speech and language pathologist. While AOTA does not disagree with this characterization, it requested that we clarify that other professionals, specifically occupational therapists, also may be trained in these procedures. It noted that in some areas of the country occupational therapists typically perform swallowing evaluations, particularly in conjunction with feeding and eating deficits.

    Response: These G codes did not specify which professionals could perform these services. The description of the new G codes only stated that these services would be most commonly performed by speech and language pathologists. Our contractors, who have the capacity to be responsive to local differences in practice patterns, will be aware of whether occupational therapists have the qualifications to perform these evaluations and will make the decisions about whether the service performed matches the services described by the code.

    Comment: The American College of Radiology requested clarification on the specialties we anticipate using G0196; they asked if this G code would be used by the speech pathologist while the radiologist would use CPT code 74230. ACR expressed concern that provision of such a G code would promote performance of fluoroscopy by non-trained individuals.

    Response: We do not believe that the development of these G codes should lead to non-trained individuals performing fluoroscopy. Prior to the development of the G codes, we were asked by speech and language pathologists if they could bill 74230 to describe the work they did in conjunction with a fluoroscopic or video evaluation of swallowing. We did not think that the speech and language pathologists should bill the code 74230 and created this G code to describe the portion of the examination that they typically performed.

    We were also asked whether the services of a speech and language pathologist should have remained bundled into the technical portion of the 74230 examination, because this may have been the method of billing these services prior to the development of the G code. Because this new G code separates the services of the speech and language pathologists in this examination, we may need to clarify which services are included in the technical portion of 74230. None of these concerns would lead a non-skilled practitioner to perform either of these services.

    G Codes Related to Speech Generating Devices and Voice Prostheses G0197-G0201

    Comment: AAO-HNS expressed concern about the establishment of G codes related to speech generating devices and voice prostheses. It continues to believe that the creation of codes used to describe services that are already described in CPT makes compliance with Medicare policy difficult and confusing.

    Response: The current CPT codes, 92597 and 92598, identify two distinct services—evaluation or modification of voice prosthetics and augmentative or alternative communicative devices. Since different types of patients require either voice prosthetics (for example, an artificial larynx) or augmentative or alternative communicative devices, we believe that separating these two services through the use of G-codes actually should make compliance with Medicare policies easier, since the services being delivered are more accurately described.

    Revisions to Malpractice RVUs for New and Revised CPT Codes for 2001

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

    The malpractice RVUs for 2001 new and revised codes published in Addendum B of the November 1, 2000 final rule were thus extrapolated from (RVUs for existing similar codes). The malpractice RVUs for these codes in this year's Addendum B were calculated by our consultant, KPMG, using the same methodology used for all other codes. Likewise, the malpractice RVUs for new and revised 2002 codes are being extrapolated from existing similar codes and will be calculated using the malpractice RVU methodology next year.

    Comment: One commenter stated that malpractice premiums are rapidly increasing all over the country and that we should ensure that the physician fee schedule reflect these increases.

    Response: We agree that changes in malpractice premiums should, to the extent possible, be reflected in the physician fee schedule. The most recent malpractice data available were used in constructing the 2001 malpractice RVUs and the revised 2001 GPCIs. In addition, the relative weights of the component cost shares (work, practice expense, malpractice) in the physician fee schedule and in the MEI are periodically adjusted when the most recent AMA SMS data indicate significant shifts among physician practice cost components. However, because of the time needed to collect the data and propose changes through the rulemaking process, there is a time lag in making these changes.

    Establishment of Interim Work Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2002 (Includes Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes)

    One aspect of establishing RVUs for 2002 was related to the assignment of interim work RVUs for all new and revised CPT codes. As described in our November 25, 1992 notice in the 1993 fee schedule (57 FR 55983), and in section III.B. of our November 22, 1996 final rule (61 FR 59505-59506), we established a process, based on recommendations received from the AMA's RUC, for establishing interim work RVUs for new and revised codes.

    This year we received RUC work RVU recommendations for approximately 314 new and revised CPT codes. Our staff and medical officers reviewed the RUC recommendations by comparing them to our reference set or to other comparable services for which work RVUs had been previously established, or to both of these criteria. We also considered the relationships among the new and revised codes for which we received RUC recommendations. We agreed with the majority of these relationships reflected in the RUC values. In some instances, when we agreed with the relationships, we revised the work RVUs to achieve work neutrality within families of codes, that is, the work RVUs have been adjusted so that the sum of the new or revised work RVUs Start Printed Page 55300(weighted by projected frequency of use) for a family will be the same as the sum of the current work RVUs (weighted by projected frequency of use for that family of codes). For approximately 93 percent of the RUC recommendations, proposed work RVUs were accepted, and for approximately 7 percent, we disagreed with the RUC recommendation. In a majority of instances, we agreed with the relativity proposed by the RUC, but needed to decrease work RVUs to retain budget neutrality.

    There were also 10 CPT codes for which we did not receive a RUC recommendation. After a review of these CPT codes by our staff and medical officers, we established interim work RVUs for the majority of these services. For those services for which we could not arrive at interim work RVUs, we have assigned a carrier-priced status until such time as the RUC provides work RVU recommendations.

    We received 18 recommendations from the Health Care Professionals Advisory Committee (HCPAC). We accepted 12, or 67 percent, of the HCPAC recommendations.

    Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes, lists the new or revised CPT codes, and their associated work RVUs, that will be interim in 2002. This table includes the following information:

    • A “#” identifies a new code for 2002.
    • CPT code. This is the CPT code for a service.
    • Modifier. A “26” in this column indicates that the work RVUs are for the professional component of the code.
    • Description. This is an abbreviated version of the narrative description of the code.
    • RUC recommendations. This column identifies the work RVUs recommended by the RUC.
    • HCPAC recommendations. This column identifies the work RVUs recommended by the HCPAC.
    • CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table. An “(a)” indicates that no RUC recommendation was provided. A discussion follows the table.
    • 2002 Work RVUs. This column establishes the 2002 work RVUs for physician work.

    Table 6.—AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes

    * CPT CODEModDescriptionRUC recommendationHCPAC recommendationCMS decision2002 work RVU
    10021 #26FNA W/O IMAGE1.27Agree1.27
    10022 #26FNA W/IMAGE1.27Agree1.27
    11755BIOPSY, NAIL UNIT1.31Agree1.31
    11981 #INSERT DRUG IMPLANT DEVICE1.48Agree1.48
    11982 #REMOVE DRUG IMPLANT DEVICE1.78Agree1.78
    11983 #REMOVE/INSERT DRUG IMPLANT3.30Agree3.30
    17000DESTROY BENIGN/PREMAL LESION0.60Agree0.60
    17003DESTROY LESIONS, 2-140.15Agree0.15
    17004DESTROY LESIONS, 15 OR MORE2.79Agree2.79
    17110DESTRUCT LESION, 1-140.65Agree0.65
    17111DESTRUCT LESION, 15 OR MORE0.92Agree0.92
    17260DESTRUCTION OF SKIN LESIONS0.91Agree0.91
    17261DESTRUCTION OF SKIN LESIONS1.71Agree1.71
    17262DESTRUCTION OF SKIN LESIONS1.58Agree1.58
    17263DESTRUCTION OF SKIN LESIONS1.79Agree1.79
    17264DESTRUCTION OF SKIN LESIONS1.94Agree1.94
    17266DESTRUCTION OF SKIN LESIONS2.34Agree2.34
    17270DESTRUCTION OF SKIN LESIONS1.32Agree1.32
    17271DESTRUCTION OF SKIN LESIONS1.49Agree1.49
    17272DESTRUCTION OF SKIN LESIONS1.77Agree1.77
    17273DESTRUCTION OF SKIN LESIONS2.05Agree2.05
    17274DESTRUCTION OF SKIN LESIONS2.59Agree2.59
    17276DESTRUCTION OF SKIN LESIONS3.20Agree3.20
    17280DESTRUCTION OF SKIN LESIONS1.17Agree1.17
    17281DESTRUCTION OF SKIN LESIONS1.72Agree1.72
    17282DESTRUCTION OF SKIN LESIONS2.04Agree2.04
    17283DESTRUCTION OF SKIN LESIONS2.64Agree2.64
    17284DESTRUCTION OF SKIN LESIONS3.21Agree3.21
    17286DESTRUCTION OF SKIN LESIONS4.44Agree4.44
    20225BONE BIOPSY, TROCAR/NEEDLE1.87Agree1.87
    20526 #THER INJECTION, CARPAL TUNNEL0.86Agree0.86
    20550INJECT TENDON/LIGAMENT/CYST0.86Agree0.86
    20551 #INJECT TENDON ORIGIN/INSERT0.86Agree0.86
    20552 #INJECT TRIGGER POINT, 1 OR 20.86Agree0.86
    20553 #INJECT TRIGGER POINTS, 30.86Agree0.86
    23000REMOVAL OF CALCIUM DEPOSITS4.36Agree4.36
    23350INJECTION FOR SHOULDER X-RAY1.00Agree1.00
    24075REMOVE ARM/ELBOW LESION3.92Agree3.92
    24076REMOVE ARM/ELBOW LESION6.30Agree6.30
    24300 #MANIPULATE ELBOW W/ANESTH3.75Agree3.75
    24332 #TENOLYSIS, TRICEPS7.45Agree7.45
    24343 #REPR ELBOW LAT LIGMNT W/TISS8.65Agree8.65
    24344 #RECONSTRUCT ELBOW LAT LIGMNT14.00Agree14.00Start Printed Page 55301
    24345 #REPR ELBW MED LIGMNT W/TISS8.65Agree8.65
    24346 #RECONSTRUCT ELBOW MED LIGMNT14.00Agree14.00
    25001 #INCISE FLEXOR CARPI RADIALIS3.38Agree3.38
    25020DECOMPRESS FOREARM 1 SPACE5.92Agree5.92
    25023DECOMPRESS FOREARM 1 SPACE12.96Agree12.96
    25024 #DECOMPRESS FOREARM 2 SPACES9.50Agree9.50
    25025 #DECOMPRESS FORAM 2 SPACES16.54Agree16.54
    25075REMOVE FOREARM LESION SUBCUT3.74Agree3.74
    25076REMOVE FOREARM LESION DEEP4.92Agree4.92
    25259 #MANIPULATE WRIST W/ANESTHES3.75Agree3.75
    25274REPAIR FOREARM TENDON/MUSCLE8.75Agree8.75
    25275 #REPAIR FOREARM TENDON SHEATH8.50Agree8.50
    25394 #REPAIR CARPAL BONE, SHORTEN10.40Agree10.40
    25405REPAIR/GRAFT RADIUS OR ULNA14.38Agree14.38
    25420REPAIR/GRAFT RADIUS & ULNA16.33Agree16.33
    25430 #VASC GRAFT INTO CARPAL BONE9.25Agree9.25
    25431 #REPAIR NONUNION CARPAL BONE10.44Agree10.44
    25440REPAIR/GRAFT WRIST BONE10.44Agree10.44
    25520TREAT FRACTURE OR RADIUS6.26Agree6.26
    25526TREAT FRACTURE OF RADIUS12.98Agree12.98
    25645TREAT WRITST BONE FRACTURE7.25Agree7.25
    25651 #PIN ULNAR STYLOID FRACTURE5.36Agree5.36
    25652 #TREAT FRACTURE ULNAR STYLOID7.60Agree7.60
    25671 #PIN RADIOULNAR DISLOCATION6.00Agree6.00
    26115REMOVE HAND LESION SUBCUT3.86Agree3.86
    26116REMOVE HAND LESION, DEEP5.53Agree5.53
    26160REMOVE TENDON SHEATH LESION3.15Agree3.15
    26250EXTENSIVE HAND SURGERY7.55Agree7.55
    26255EXTENSIVE HAND SURGERY12.43Agree12.43
    26340 #MANIPULATE FINGER W/ANESTH2.50Agree2.50
    26350REPAIR FINGER/HAND TENDON5.99Agree5.99
    26352REPAIR/GRAFT HAND TENDON7.68Agree7.68
    26356REPAIR FINGER/HAND TENDON8.07Agree8.07
    26357REPAIR FINGER/HAND TENDON8.58Agree8.58
    26358REPAIR/GRAFT HAND TENDON9.14Agree9.14
    26390REVISE HAND/FINGER TENDON9.19Agree9.19
    26392REPAIR/GRAFT HAND TENDON10.26Agree10.26
    26415EXCISION, HAND/FINGER TENDON8.34Agree8.34
    26416GRAFT HAND OR FINGER TENDON9.37Agree9.37
    26426REPAIR FINGER/HAND TENDON6.15Agree6.15
    26428REPAIR/GRAFT FINGER TENDON7.21Agree7.21
    26445RELEASE HAND/FINGER TENDON4.31Agree4.31
    26510THUMB TENDON TRANSFER5.43Agree5.43
    26587RECONSTRUCT EXTRA FINGER14.05Agree14.05
    26590REPAIR FINGER DEFORMITY17.96Agree17.96
    26607TREAT METACARPAL FRACTURE5.36Agree5.36
    26608TREAT METACARPAL FRACTURE5.36Agree5.36
    26670TREAT HAND DISLOCATION3.69Agree3.69
    26675TREAT HAND DISLOCATION4.54Agree4.54
    26676PINE HAND DISLOCATION5.52Agree5.52
    26685TREAT HAND DISLOCATION6.98Agree6.98
    26843FUSION OF HAND JOINT7.61Agree7.61
    26844FUSION/GRAFT OF HAND JOINT8.73Agree8.73
    27096INJECT SACROILIAC JOINT1.40Agree1.40
    28299CORRECTION OF BUNION10.58Agree10.58
    29086 #APPLY FINGER CAST0.62Agree0.62
    29805 #SHOULDER ARTHROSCOPY, DX5.89Agree5.89
    29806 #SHOULDER ARTHROSCOPY/SURGERY14.37Agree14.37
    29807 #SHOULDER ARTHROSCOPY/SURGERY13.90Agree13.90
    29819SHOULDER ARTHROSCOPY/SURGERY7.62Agree7.62
    29820SHOULDER ARTHROSCOPY/SURGERY7.07Agree7.07
    29821SHOULDER ARTHROSCOPY/SURGERY7.72Agree7.72
    29822SHOULDER ARTHROSCOPY/SURGERY7.43Agree7.43Start Printed Page 55302
    29823SHOULDER ARTHROSCOPY/SURGERY8.17Agree8.17
    29824 #SHOULDER ARTHROSCOPY/SURGERY8.25Agree8.25
    29900 #MCP JOINT ARTHROSCOPY, DX5.42Agree5.42
    29901 #MCP JOINT ARTHROSCOPY, SURG6.13Agree6.13
    29902 #MCP JOINT ARTHROSCOPY, SURG6.70Agree6.70
    30117REMOVAL OF INTRANASAL LESION3.16Agree3.16
    30118REMOVAL OF INTRANASAL LESION9.69Agree9.69
    31641BRONCHOSCOPY, TREAT BLOCKAGE5.03Agree5.03
    32650THORACOSCOPY, SURGICAL10.75Agree10.75
    33967 #INSERT IA PERCUT DEVICE4.85Agree4.85
    33975IMPLANT VENTRICULAR DEVICE21.00Agree21.00
    33976IMPLANT VENTRICULAR DEVICE23.00Agree23.00
    33977REMOVE VENTRICULAR DEVICE19.29Agree19.29
    33978REMOVE VENTRICULAR DEVICE21.73Agree21.73
    33979 #INSERT INTRACORPOREAL DEVICEcarrierAgreecarrier
    33980 #REMOVE INTRACORPOREAL DEVICEcarrierAgreecarrier
    35646ARTERY BYPASS GRAFT31.00Agree31.00
    35647 #ARTERY BYPASS GRAFT28.00Agree28.00
    35685BYPASS GRAFT PATENCY/PATCH4.05Agree4.05
    35686 #BYPASS GRAFT/AV FIST PATENCY3.35Agree3.35
    36002 #PSEUDOANEURYSM INJECTION TRT1.96Agree1.96
    36005INJECTION EXT VENOGRAPHY0.95Agree0.95
    36400DRAWING BLOOD0.38Agree0.38
    36819AV FUSION/UPPR ARM VEIN14.00Agree14.00
    36820 #AV FUSION/FOREARM VEIN14.00Agree14.00
    36823INSERTION OF CANNULA(S)21.00Agree21.00
    38220 #BONE MARROW ASPIRATION1.08Agree1.08
    38221 #BONE MARROW BIOPSY1.37Agree1.37
    43200ESOPHAGUS ENDOSCOPY1.59Agree1.59
    43227ESOPH ENDOSCOPY, REPAIR3.60Agree3.60
    43245OPERATIVE UPPER GI ENDOSCOPY3.39Agree3.39
    43310REPAIR OF ESOPHAGUS27.47Agree27.47
    43312REPAIR ESOPHAGUS AND FISTULA30.50Agree30.50
    43313 #ESOPHAGOPLASTY CONGENITAL45.28Agree45.28
    43314 #TRACHEO-ESOPHAGOPLASTY CONG50.27Agree50.27
    44120REMOVAL OF SMALL INTESTINE17.00Agree17.00
    44121REMOVAL OF SMALL INTESTINE4.45Agree4.45
    44126 #ENTERECTOMY W/TAPER, CONG35.50Agree35.50
    44127 #ENTERECTOMY W/O TAPER, CONG41.00Agree41.00
    44128 #ENTERECTOMY CONG, ADD-ON4.45Agree4.45
    44140PARTIAL REMOVAL OF COLON18.35Agree18.35
    44160REMOVAL OF COLON18.62Agree18.62
    44202LAP RESPECT S/INTESTINE SINGL22.04Agree22.04
    44203 #LAP RESECT S/INTESTINE, ADDL4.45Agree4.45
    44204 #LAPARO PARTIAL COLECTOMY22.00Disagree25.08
    44205 #LAP COLECTOMY PART W/ILEUM19.50Disagree22.23
    44366SMALL BOWEL ENDOSCOPY4.41Agree4.41
    44378SMALL BOWEL ENDOSCOPY5.26Agree5.26
    44391COLONOSCOPY FOR BLEEDING3.82Agree3.82
    45136 #EXCISE ILEOANAL RESERVOIR27.30Agree27.30
    45190DESTRUCTION, RECTAL TUMOR8.28Agree8.28
    45303PROCTOSIGMOIDOSCOPY DILATE0.44Agree0.44
    45317PROTOSIGMOIDOSCOPY BLEED1.50Agree1.50
    45334SIGMOIDOSCOPY FOR BLEEDING2.73Agree2.73
    45382COLONOSCOPY/CONTROL BLEEDING5.69Agree5.69
    46020 #PLACEMENT OF SETON2.90Agree2.90
    46604ANOSCOPY AND DILATION1.31Agree1.31
    46614ANOSCOPY/CONTROL BLEEDING2.01Agree2.01
    46924DESTRUCTION, ANAL LESION(S)2.76Agree2.76
    47370 #LAPARO ABLATE LIVER TUMORE RF(a)(a)18.00
    47371 #LAPARO ABLATE LIVER CRYOSUG(a)(a)16.94
    47380 #OPEN ABLATE LIVER TUMOR RF(a)(a)21.25
    47381 #OPEN ABLATE LIVER TUMOR CRYO(a)(a)21.00
    47382 #PERCUT ABLATE LIVER RF(a)(a)12.00
    48100BIOPSY OF PANCREAS, OPEN11.08Agree11.08
    49424ASSESS CYST, CONTRAST INJECT0.76Agree0.76
    49491 #REPAIRING HERN PREMIE REDUC11.13Agree11.13Start Printed Page 55303
    49492 #RPR ING HERN PREMIE, BLOCKED14.03Agree14.03
    49495RPR ING HERNIA BABY, REDUC5.89Agree5.89
    49496RPR ING HERNIA BABY, BLOCKED8.79Agree8.79
    50220REMOVE KIDNEY, OPEN17.15Agree17.15
    50225REMOVAL KIDNEY OPEN, COMPLEX20.23Agree20.23
    50230REMOVAL KIDNEY OPEN, RADICAL22.07Agree22.07
    51596REMOVE BLADDER/CREATE POUCH39.52Agree39.52
    52001 #CYSTOSCOPY, REMOVAL OF CLOTS5.45Disagree2.37
    52347 #CYSTOSCOPY, RESECT DUCTS5.28Agree5.28
    52510DILATIONPROSTATIC URETHRA6.72Agree6.72
    53431 #RECONSTRUCT URETHRA/BLADDER19.89Agree19.89
    53444 #INSERT TANDEM CUFF13.40Agree13.40
    53445INSERT URO./VES NCK SPHINCTER14.06Agree14.06
    53446 #REMOVE URO SPHINCTER10.23Agree10.23
    53447REMOVE/REPLACE UR SPHINCTER13.49Agree13.49
    53448 #REMOVE/REPLC UR SPHINCTR COMP21.15Agree21.15
    53449REPAIR URO SPHINCTER9.70Agree9.70
    53853 #PROSTATIC WATER THERMOTHER6.41Disagree4.14
    54065DESTRUCTION, PENIS LESION(S)2.42Agree2.42
    54162 #LYSIS PENIL CIRCUMCIS LESION3.00Agree3.00
    54163 #REPAIR OF CIRCUMSION3.00Agree3.00
    54164 #FRENULOTOMY OF PENIS2.50Agree2.50
    54400INSERT SEMI-RIGID PROSTHESIS8.99Agree8.99
    54401INSERT SELF-CONTD PROSTHESIS10.28Agree10.28
    54405INSERT MULTI-COMP PENIS PROS13.43Agree13.43
    54406 #REMOVE MULTI-COMP PENIS PROS12.10Agree12.10
    54408 #REPAIR MUTLI-COMP PENIS PROS12.75Agree12.75
    54410 #REMOVE/REPLACE PENIS PROSTH15.50Agree15.50
    54411 #REMV/REPLC PENIS PROS, COMP16.00Agree16.00
    54415 #REMOVE SELF-CONTD PENIS PROS8.20Agree8.20
    54416 #REMV/REPL PENIS CONTAIN PROS10.87Agree10.87
    54417 #REMV/REPLC PENIS PROS, COMPL14.19Agree14.19
    54512EXCISE LESION TESTIS8.58Agree8.58
    56501DESTROY, VULVA LESIONS, SIMP1.53Agree1.53
    56515DESTROY VULVA LESION/S COMPL1.88Agree1.88
    56605BIOPSY OF VULVA/PERINEUM1.10Agree1.10
    56810REPAIR OF PERINEUM4.13Agree4.13
    57022I & D VAGINAL HEMATOMA, PP2.56Agree2.56
    57061DESTROY VAG LESIONS, SIMPLE1.25Agree1.25
    57065DESTROY VAG LESIONS, COMPLEX2.61Agree2.61
    57155 #INSERT UTERI TANDEMNS/OVOIDS6.27Agree6.27
    58100BIOPSY OF UTERUS LINING1.53Agree1.53
    58346 #INSERT HEYMAN UTERI CAPSULE6.75Agree6.75
    58563HYSTEROSCOPY, ABLATION6.17Agree6.17
    58953 #TAH, RAD DISSECT FOR DEBULK32.00Agree32.00
    58954 #TAH RAD DEBULK/LYMPH REMOVE35.00Agree35.00
    59000AMNIOCENTESIS, DIAGNOSTIC1.30Agree1.30
    59001 #AMINOCENTESIS, THERAPEUTIC3.00Agree3.00
    64555IMPLANT NEUROELECTRODES2.27Agree2.27
    64561 #IMPLANT NEUROELECTRODES6.74Agree6.74
    64575IMPLANT NEUROELECTRODES4.53Agree4.53
    64581 #IMPLANT NEUROELECTRODES13.50Agree13.50
    64820REMOVE SYMPATHETIC NERVES10.37Agree10.37
    64821 #REMOVE SYMPATHETIC NERVES8.75Agree8.75
    64822 #REMOVE SYMPATHETIC NERVES8.75Agree8.75
    64823 #REMOVE SYMPATHETIC NERVES10.37Agree10.37
    66982CATARACT SURGERY, COMPLEX13.50Agree13.50
    67225 #EYE PHOTODYNAMIC THER ADD-ON(a)(a)0.47
    69990MICROSURGERY ADD-ON3.47Agree3.47
    7423026CINE/VIDEO X-RAY, THROAT/ESO0.53Agree0.53
    7430526X-RAY BILE DUCTS/PANCREAS0.42Agree0.42
    7606626JOINT SURVEY, SINGLE VIEW0.31Agree0.31
    7607826RADIOGRAPHIC ABSORPTIONMETRY0.20Agree0.20
    76085 #26COMPUTER MAMMOGRAM ADD-ON(a)(a)0.06
    7612026CINE/VIDEO X-RAYS0.38Agree0.38
    7612526CINE/VIDEO X-RAYS ADD-ON0.27Agree0.27
    76362 #26CAT SCAN FOR TISSUE ABLATION(a)(a)4.00
    76394 #26MRI FOR TISSUE ABLATION(a)(a)4.25
    76490 #26US FOR TISSUE ABLATION(a)(a)2.00Start Printed Page 55304
    7681926FETAL BIOPHYS PROFIL W/O NST0.63Disagree0.77
    7688526US EXAM INFANT HIPS, DYNAMIC0.74Agree0.74
    7688626US EXAM INFANT HIPS, STATIC0.62Agree0.62
    7730026RADIATION THERAPY DOSE PLAN0.62Agree0.62
    77301 #26RADIOL THERAPY DOSE PLAN, IMRT8.00Agree8.00
    77418 #RADIATION TX DELIVERY, IMRT0.00Agree0.00
    85097BONE MARROW INTERPRETATION0.94Agree0.94
    88380 #26MICRODISSECTIONcarrierAgreecarrier
    90471IMMUNIZATION ADMIN0.17Disagree0.00
    90472IMMUNIZATION ADMIN, EACH ADD0.15Disagree0.00
    90473 #IMMUNE ADMIN ORAL/NASAL0.17Disagree0.00
    90939 #HEMODIALYSIS STUDY, TRANSCUT0.00Agree0.00
    91123 #IRRIGATE FECAL IMPACTION0.00Agree0.00
    92136 #26OPHTHALMIC BIOMETRY0.54Agree0.54
    92973 #PERCUT CORONARY THROMBECTOMY3.28Agree3.28
    92974 #CATH PLACE, CARDIO BRACHYTX3.00Agree3.00
    93025 #MICROVOLT T-WAVE ASSESS0.75Agree0.75
    9360926MAP TACHYCARDIA, ADD-ON(a)Disagree4.81
    9361226INTRAVENTRICULAR PACING3.02Agree3.02
    93613 #26ELECTROPHYS MAP, 3D, ADD-ONcarrierDisagree7.00
    9361926ELECTROPHYSIOLOGY EVALUATION7.32Agree7.32
    936202ELECTROPHYSIOLOGY EVALUATION11.59Agree11.59
    9362126ELECTROPHYSIOLOGY EVALUATION2.10Agree2.10
    9362226ELECTROPHYSIOLOGY EVALUATION3.10Agree3.10
    93701 #26BIOIMPEDANCE, THORACIC0.00Disagree0.17
    9472026MONOXIDE DIFFUSING CAPACITY0.26Agree0.26
    9475026PULMONARY COMPLIANCE STUDY0.23Agree0.23
    95144ANTIGEN THERAPY SERVICES0.06Agree0.06
    95145ANTIGEN THERAPY SERVICES0.06Agree0.06
    95165ANTIGEN THERAPY SERVICES0.06Agree0.06
    95170ANTIGEN THERAPY SERVICES0.06Agree0.06
    95250 #GLUCOSE MONITORING, CONT0.00Agree0.00
    9587526LIMB EXERCISE TEST1.10Agree1.10
    9590426SENSE NERVE CONDUCTION TEST0.34Agree0.34
    95965 #26MEG, SPONTANEOUS8.00Agree8.00
    95966 #26MEG, EVOKED, SINGLE4.00Agree4.00
    95967 #26MEG, EVOKED, EACH ADDL3.50Agree3.50
    96000 #MOTION ANALYSIS, VIDEO/3DcarrierDisagree1.80
    96001 #MOTION TEST W/FT PRESS MEAScarrierDisagree2.15
    96002 #DYNAMIC SURFACE EMGcarrierDisagree0.41
    96003 #DYNAMIC FINE WIRE EMGcarrierDisagree0.37
    96004 #PHYS REVIEW OF MOTION TESTScarrierDisagree1.80
    96150 #ASSESS HLTH/BEHAVE, INIT0.50Agree0.50
    96151 #ASSESS HLTH/BEHAVE, SUBSEQ0.48Agree0.48
    96152 #INTERVENE HLTH/BEHAVE, INDIV0.46Agree0.46
    96153 #INTERVENE HLTH/BEHAVE, GROUP0.10Agree0.10
    96154 #INTERV HLTH/BEHAV, FAM W/PT0.45Agree0.45
    96155 #INTERV HLTH/BEHAV FAM NO PT0.44Agree0.44
    96567 #PHOTODYNAMIC TX, SKIN0.00Agree0.00
    97005 #ATHLETIC TRAIN EVAL(a)Agree0.00
    97006 #ATHLETIC TRAIN REEVAL(a)Agree0.00
    97112NEUROMUSCULAR REEDUCATION0.45Agree0.45
    97504ORTHOTIC TRAINING0.45Agree0.45
    97535SELF CARE MNGMENT TRAINING0.45Agree0.45
    97601WOUND CARE SELECTIVE0.50Agree0.50
    97602WOUND CARE NON-SELECTIVE0.32Disagree0.00
    99090COMPUTER DATA ANALYSIS0.00Agree0.00
    99091 #COLLECT/REVIEW DATA FROM PT1.10Disagree0.00
    99289 #PT TRANSPORT, 30-74 MIN4.80Disagree0.00
    99290 #PT TRANSPORT, ADDL 30 MIN2.40Disagree0.00
    99374HOME HEALTH CARE SUPERVISION1.10Agree1.10
    99375HOME HEALTH CARE SUPERVISION1.73Agree1.73
    99377HOSPICE CARE SUPERVISION1.10Agree1.10
    99378HOSPICE CARE SUPERVISION1.73Agree1.73
    99379NURSING FAC CARE SUPERVISION1.10Agree1.10
    99380NURSING FAC CARE SUPERVISION1.73Agree1.73
    99381PREV VISIT, NEW, INFANT1.19Agree1.19
    99382PREV VISIT, NEW, AGE 1-41.36Agree1.36Start Printed Page 55305
    99383PREV VISIT, NEW, AGE 5-111.36Agree1.36
    99384PREV VISIT, NEW, AGE 12-171.53Agree1.53
    99385PREV VISIT, NEW, AGE 18-391.53Agree1.53
    99386PREV VISIT, NEW, AGE 40-641.88Agree1.88
    99387PREV VISIT, NEW, 65 & OVER2.06Agree2.06
    99391PREV VISIT, EST, INFANT1.02Agree1.02
    99392PREV VISIT, EST, AGE 1-41.19Agree1.19
    99393PREV VISIT, EST, AGE 5-111.19Agree1.19
    99394PREV VISIT, EST, AGE 12-171.36Agree1.36
    99395PREV VISIT, EST, AGE 18-391.36Agree1.36
    99396PREV VISIT, EST, AGE 40-641.53Agree1.53
    99397PREV VISIT, EST, 65 & OVER1.71Agree1.71
    (a) No RUC recommendation provided.
    # New CPT codes.
    * All CPT codes copyright 2002 American Medical Association.

    Table 7, AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2002 CPT Codes, lists the new or revised CPT codes for anesthesia and their base units that will be interim in 2002. This table includes the following information:

    • CPT code. This is the CPT code for a service.
    • Description. This is an abbreviated version of the narrative description of the code.
    • RUC recommendations. This column identifies the base units recommended by the RUC.
    • CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table.
    • 2002 Base Units. This column establishes the 2002 base units for these services.

    Table 7.—AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2002 CPT Codes

    *CPT codeDescriptionRUC recommendationCMS decision2002 Base units
    00797ANESTH, SURGERY FOR OBESITY9Disagree8
    00851ANESTH, TUBAL LIGATION6Agree6
    00869ANESTH, VASECTOMY3Agree3
    01905ANES, SPINE INJECT, X-RAY/RE5Agree5
    01916ANESTH, DX ARTERIOGRAPHY5Agree5
    01924ANES, THER INTERVEN RAD, ART5Agree5
    01925ANES, THER INTERVEN RAD, CAR7Agree7
    01926ANES, TX INTERV RAD HRT/CRAN8Agree8
    01930ANES, THER INTERVEN RAD, VEI5Agree5
    01931ANES, THER INTERVEN RAD, TIP7Agree7
    01932ANES, TX INTERV RAD, TH VEIN6Agree6
    01933ANES, TX INTERV RAD, CRAN V7Agree7
    01951ANESTH, BURN, LESS 4 PERCENT3Agree3
    01952ANESTH, BURN, 4-9 PERCENT5Agree5
    01960ANESTH, VAGINAL DELIVERY5Agree5
    01961ANESTH, CS DELIVERY7Agree7
    01962ANESTH, EMER HYSTERECTOMY8Agree8
    01963ANESTH, CS HYSTERECTOMY8Agree8
    01964ANESTH, ABORTION PROCEDURES4Agree4
    01967ANESTH/ANALG, VAG DELIVERY5Agree5
    01968ANES/ANALG CS DELIVER ADD-ON3Disagree2
    01969ANESTH/ANALG CS HYST ADD-ON5Agree5
    * All CPT codes copyright 2002 American Medical Association.

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

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

    Anesthesia for Intraperitoneal Procedures in Upper Abdomen Including Laparoscopy; Gastric Restrictive Procedure for Morbid Obesity (CPT Code 00797).

    The RUC recommended that 9 base units be assigned to this procedure Start Printed Page 55306based on a comparison to CPT code 00790 (Anesthesia for intraperitoneal procedures in the upper abdomen including laparoscopy; not otherwise specified). We disagree. We believe that assigning 9 base units to 00797 creates a rank order anomaly with CPT code 00794 (Anesthesia for intraperitoneal procedures in the upper abdomen including laparoscopy; pancreatectomy, partial or total (for example, Whipple procedure)) which is assigned 8 base units.

    While obese patients do make the work of an anesthesiologist more difficult, we believe that the vignette used in the RUC survey was atypical and exaggerated the required work because the patient in the vignette was described as having asthma. We believe the work of an anesthesiologist is greater for patients undergoing Whipple procedures because, typically, these patients are sicker and require longer operative time and more intense anesthesia care than patients undergoing gastric restrictive procedures. Therefore, we are assigning 8 base units to 00797.

    Cesarean Delivery Following Neuraxial Labor Analgesia/Anesthesia (List Separately in Addition to Code for Primary Procedure (CPT Code 01968))

    The RUC recommended 3 base units for this add-on procedure. This procedure is reported in addition to CPT code 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)), when a patient who has been given neuraxial anesthesia for a planned vaginal delivery requires conversion to a cesarian delivery and must be given anesthesia for the cesarian delivery. The RUC recommended 7 base units for CPT code 01961 (Anesthesia for, cesarian delivery only), a recommendation with which we agree. We note the following:

    • The base units of 01961, anesthesia for cesarian delivery, are the same as the base units of 01967 plus 01968.
    • The survey respondents valued the add-on code 01968 as if it were a stand-alone code with a median base unit of 7 and an intraservice time of 75 minutes. Both the median base units and the intraservice time are identical to the survey results for 01961.
    • CPT code 01968 is currently reported (per the American Society of Anesthesiologists) as 00857 (Neuraxial analgesia/anesthesia for labor ending in a cesarian delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor), which is valued at 7 base units. Moreover, the work of CPT code 01967 plus CPT code 01968 is completely described by CPT code 00857 so it is unclear why the sum of the base units assigned to 01967 and 01968 should not be identical to the base units currently assigned to CPT code 00857.

    In view of these concerns, we are assigning 2 base units to CPT code 01968. We are also making a neutrality adjustment to the anesthesia conversion factor based on our analysis of the estimated difference in base units between previously repeated anesthesia codes and the new codes.

    Injection, Therapeutic (Eg, Local Anesthetic, Corticosteroid); Carpal Canal, (CPT Code 20526) Injection; Tendon Sheath, Ligament, Ganglion Cyst, (CPT Code 20550)

    Injection; Tendon Origin/Insertion, (CPT Code 20551)

    Injection; Single or Multiple Trigger Point(s), One or Two Muscle Group(s) (CPT Code 20552), and

    Injection; Single or Multiple Trigger Point(s), Three or More Muscle Groups (CPT Code 20553)

    CPT codes 20526, 20551, 20552, and 20553 are new codes, while 20550 is being revised from its current descriptor “Injection, tendon sheath, ligament; ganglion cyst, or trigger points” to the descriptor above. We received an interim recommendation of 0.86 work RVUs for these codes, from the RUC, based on the fact that all these procedures are currently reported as 20550 which is valued at 0.86 RVUs.

    CPT code 20550 comprises several procedures with varying amounts of physician work that will now be reported separately. We are assigning 0.86 RVUs to all these codes on an interim basis, and will review this further for 2002 if we receive recommendations from the RUC. At that time we will also have utilization data on these services to assist us in making work neutrality adjustments should any adjustments be required.

    Laparoscopy, Surgical; Colectomy, Partial With Anastomosis (CPT Code 44204) and Laparoscopy, Surgical; Colectomy, Partial, With Removal of Terminal Ileum With Ileocecostomy (CPT Code 44205)

    The RUC recommended 22.00 RVUs for CPT code 44204 and 19.50 RVUs for CPT Code 44205 based on the reference code 44140 (Colectomy, partial; with anastomosis) which, at the time of the recommendation, had a work RVU of 18.35. We increased the work RVU of CPT Code 44140 to 21 as part of the 5-year review of physician work. In order to prevent rank order anomalies we are assigning work RVUs of 25.08 and 22.23 to CPT Codes 44204 and 44205, respectively. These work RVUs represent a 14 percent increase over the RUC recommendation and are consistent with our valuation of CPT Code 44140.

    Laparoscopy, Surgical, Ablation of One or More Liver Tumor(s); Radiofrequency (CPT Code 47370), Laparoscopy, Surgical, Ablation of One or More Liver Tumor(s); Cryosurgical (CPT Code 47371), Ablation, Open, of One or More Liver Tumor(s); Radiofrequency (CPT Code 47380), Ablation, Open, of One or More Liver Tumor(s); Cryosurgical (CPT Code 47381), Ablation, One or More Liver Tumor(s), Percutaneous, Radiofrequency (CPT Code 47382), Computerized Axial Tomography Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76362), Magnetic Resonance Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76394); and Ultrasound Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76490)

    We have not received recommendations from the RUC for these procedures. We have assigned work RVUs as follows:

    47370—18 work RVUs

    47371—16.94 work RVUs

    47380—21.25 work RVUs

    47381—21.00 work RVUs

    47382—12.00 work RVUs

    To arrive at the values listed above, we compared the time and intensity of these services to other open and laparoscopic liver, colon, and renal procedures. We believe that the RVUs assigned place them in the correct rank order with these other services and with respect to each other.

    76362—4.00 work RVUs

    76394—4.25 work RVUs

    76490—2.00 work RVUs

    To arrive at the values above, we compared the time and intensity of these procedures to other radiologic guidance codes and to radiologic supervision and interpretation codes. We believe that the assigned RVUs place them in correct rank order to other radiologic guidance services and to each other.

    Cystourethroscopy with irrigation and evacuation of clots, (CPT Code 52001)

    The RUC recommended 5.45 work RVUs based on a comparison to the reference procedures CPT code 52315 (Cystourethroscopy, with removal of Start Printed Page 55307foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated), and CPT Code 52235 (Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)).

    We are concerned that 52001, with its current descriptor, will be reported whenever a cystoscopy is performed and blood is present during the examination. As written, the code may be reported whenever any blood clots are present. The RUC recommendation is based upon the urologists' response to a scenario where the bladder outlet was obstructed due to large blood clots and removal of the blood clots required a resectoscope. Unfortunately, the code descriptor does not require the presence of bladder obstruction due to blood clots, nor does it require the use of a resectoscope. Therefore, until the descriptor of this code is clarified by the AMA CPT editorial panel, we are assigning 2.37 RVUs to this procedure. As the CPT code is now written, the time and intensity of the physician work for this procedure are comparable to CPT Code 52005. (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service).

    Transurethral Destruction of Prostatic Tissue; By Water Induced Thermotherapy (CPT Code 53853)

    The RUC recommended 6.41 work RVUs for this procedure based on a comparison to CPT Code 54670 (Suture or repair of testicular injury) which has a similar work value and similar pre-, intra-, and postservice times to the median times in the survey for 53853. The RUC also noted that CPT Code 53850 (Transurethral destruction of prostate; by microwave thermotherapy) has 90 minutes of intraservice time as compared to 60 minutes for CPT code 53853 and that the recommended work value for CPT code 53853 was approximately 2/3 of the work value for CPT code 53850.

    We note that although the intraservice time for CPT code 53853 is 60 minutes, most of that time is spent monitoring the flow of hot water through a catheter and balloon and checking the water's temperature. We estimate that the maximum amount of time spent on activities other than monitoring is 20 minutes. This means that the work intensity for the intraservice portion of this procedure is significantly less than it is for most other surgical procedures and, specifically, the reference codes examined by the RUC. Therefore, we believe it is more appropriate to compare CPT code 53853 to 90-day global procedures with less than 30 minutes of intraservice time. For these reasons we compared CPT code 58350 to the following procedures:

    CPT codeWork RVUIntraservice time (minutes)Pre/post service time
    53853 Transurethral destruction of prostate tissue; by water-induced thermotherapyRUC Recommendation—6.4160*113
    CMS assigned RVU 4.14
    30130 Excision turbinate, partial or complete, any method3.382778
    42826 Tonsillectomy, primary or secondary; age 12 or over3.382882
    46045 Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia4.3225206
    46946 Ligation of internal hemorrhoids; multiple procedures3.02575
    58800 Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach4.1423100
    61105 Twist burr hole for subdural or ventricular puncture5.142797
    65810 Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection4.8728104
    67031 Severing of vitreous strands, vitreous face adhesions, sheets, membranes, or opacities, laser surgery (one or more stages)3.672679
    * see below.

    The RUC sent us a postservice time of 131 minutes, which we believe is incorrect. The RUC assigned 3 postservice visits to this procedure which have a combined time of 35 minutes, not 53 minutes as recommended by the RUC. Therefore, the correct postservice time is 118 minutes.

    With respect to the services listed above, we note that all of them carry significant risks to the patient and have intraservice work of high intensity. In fact, we believe the intraservice work of all the above procedures is of greater intensity than any portion of the intraservice work of CPT code 53853. After review of the procedures considered by the RUC and the above procedures, we believe that the time and intensity of CPT code 53853 is most comparable to CPT code 58800 and are assigning 4.14 work RVUs to CPT code 53853. This places CPT code 53853 in the correct rank order with respect not only to the procedures listed above but also to the prostate ablation, cystourethroscopy, and testicular procedures considered by the RUC.

    Destruction of Localized Lesion of Choroids (eg, Choroidal Neovascularization); Photodynamic Therapy, Second Eye, at Single Session (List Separately in Addition To Code for Primary Eye Treatment) CPT Code 67225

    We did not receive a RUC recommendation on this code. We are assigning work RVUs of 0.47, which is the work value for G0184, the code previously used for reporting this service.

    Immunization Administration (Includes Percutaneous, Intradermal, Subcutaneous, Intramuscular and Jet Injections); One Vaccine (Single or Combination Vaccine/Toxoid) (CPT Code 90471), Immunization Administration (Includes Percutaneous, Intradermal, Subcutaneous, Intramuscular and Jet Injections); Each Additional Vaccine/Toxoid (List Separately in Addition To Code for Primary Procedure) One Vaccine (CPT Code 90472)

    The RUC recommended a work RVU of .17 for CPT code 90471 and .15 work RVUs for CPT code 90472. These Start Printed Page 55308services are analogous to CPT code 90872 (Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular) which has no physician work RVUs. They are services performed by a nurse and have no physician work. If the physician performs any counseling related to this service, it is considered part of the work of the preventive medicine visit during which the immunization was administered. If the vaccine is administered during a visit other than a preventive medicine service, any physician counseling should be billed separately as an E/M service. For these reasons we are not assigning work RVUs to these codes.

    Immunization Administration by Intranasal or Oral Route; One Vaccine (Single or Combination Vaccine/Toxoid) (CPT Code 90473); and, Immunization Administration by Intranasal or Oral Route Each Additional Vaccine/Toxoid (List Separately in Addition To Code for Primary Procedure) CPT Code 90474

    The RUC recommended a work RVU of .17 for CPT code 90473 and .15 work RVUs for CPT code 90474. These are noncovered services. Medicare does not cover self-administered vaccines, and, therefore, we are not assigning work RVUs to these services.

    Intraventricular and/or Intra-Atrial Mapping of Tachycardia Site(s) With Catheter Manipulation to Record From Multiple Sites to Identify Origin of Tachycardia (CPT Code 93609)

    We have not received a recommendation from the RUC for this service. The descriptor for this service has not changed but the AMA CPT editorial panel changed the global period for this service from a zero day global to a ZZZ global. This means that it is now an “add on” code and the physician work RVUs will no longer include any pre- or postservice work. It currently has a work RVU of 10.07. In order to appropriately value this add on service, we compared it to several other electrophysiology services, including CPT code 93619, (Comprehensive electrophyisologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters; without induction or attempted induction of arrhythmia) with a work RVU of 7.32, and CPT code 93618, Induction of arrhythmia by electrical pacing (work RVU 4.26), and CPT code 93624, (Electrophysiologic follow up study with pacing and recording to test effectiveness of therapy, including induction of attempted induction of arrhythmia), with a work RVU of 4.81. After reviewing these services, we believe that the time and intensity of physician work for CPT code 93609 as an add-on code is most similar to CPT code 93624 and are assigning a work RVU of 4.81 to CPT code 93609.

    Intracardiac Electrophysiologic 3-Dimensional Mapping (CPT Code 93613)

    This is a new add-on code for which we have not received a recommendation from the RUC. As an add-on code, this service does not include and pre- or postservice work. We compared this service to CPT code 93619 (Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters; without induction or attempted induction of arrhythmia) with work RVUs of 7.32 and to CPT code 93651 (Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathways, accessory atrioventricular connections or other atrial foci, singly or in combination) with work RVUs of 16.25. We also wanted to ensure that the work value for this service was placed in correct rank order to CPT code 93609 (see above). We believe that the intraservice time and intensity of this service is slightly less than that of CPT code 93619 and are assigning 7.00 work RVUs to CPT code 93613.

    Bioimpedence, Thoracic, Electrical CPT Code 93701

    We received a RUC recommendation that this service has no physician work. We currently cover this service under the HCPCS code M0302. We assigned 0.17 physician work RVUs to this service in the November 2000 final rule after conducting a notice and comment period. We will consider the RUC recommendation. If we considered changing the work RVUs for this service, we would discuss any proposed change in a future notice of proposed rule making. However, we are going to discontinue HCPCS code M0302 and will recognize CPT Code 93701 for this service.

    Comprehensive Computer-Based Motion Analysis by Video-Taping And 3-D Kinematics (CPT Code 96000), Comprehensive Computer-Based Motion Analysis by Video-Taping and 3-D Kinematics; With Dynamic Plantar Pressure Measurements During Walking (CPT Code 96001), Dynamic Surface Electromyography, During Walking or Other Functional Activities, 1-12 Muscles (CPT Code 96002), Dynamic Fine Wire Electromyography, During Walking or Other Functional Activities, 1 Muscle (CPT Code 96003), and Physician Review and Interpretation of Comprehensive Computer Based Motion Analysis, Dynamic Plantar Pressure Measurements, Dynamic Surface Electromyography During Walking or Other Functional Activities, and Dynamic Fine Wire Electromyography, With Written Report (CPT Code 96004)

    HCPAC recommended that these services be carrier priced. We disagree and are assigning work RVUs to these services as follows:

    CPT code 96000—1.8 work RVUs

    CPT code 96001—2.15 work RVUs

    CPT code 96002—.41 work RVUs

    CPT code 96003—.37 work RVUs

    CPT code 96004—1.8 work RVUs

    To arrive at these values, we compared the time and intensity of CPT codes 96000 and 96001 to other physical therapy services. We believe that the assigned RVUs place these services in the correct rank order with other physical therapy services. We compared the time and intensity of CPT codes 96002 and 96003 to other electromyography services and believe that the assigned RVUs place these services in the correct rank order with other electromyography services. We compared the time and intensity of CPT code 96004 with other physical therapy services and physician consultation services and believe the assigned RVUs place CPT code 96004 in the correct rank order with these other services.

    Removal of Devitalized Tissue From Wound(s); Non-Selective Debridement, Without Anesthesia (eg, Wet-To-Moist Dressings, Enzymatic, Abrasion), Including Topical Applications(s), Wound Assessment and Instruction(s) for Ongoing Care, Per Session, CPT 97602

    The HCPAC recommended a work RVU of .32 for this service. We disagree with this recommendation as we continue to believe that this code is bundled into 97602 for the reasons discussed earlier in this section. Therefore, we are not establishing work RVUs for this service.Start Printed Page 55309

    Collection and Interpretation of Physiologic Data (eg, ECG, Blood Pressure, Glucose Monitoring) Digitally Stored and/or Transmitted by the Patient and/or Caregiver to the Physician or Other Qualified Health Care Professional, Requiring a Minimum of 30 Minutes of Time CPT CODE 99091

    The RUC recommended work RVUs of 1.10 for this code. We disagree as this work is considered part of the pre and postservice work of an E/M service and propose to bundle payment for this code. (Note that payment for similar CPT code, 99090, Analysis of clinical data in computers (eg, ECGs, blood pressures, hematologic data, is also currently bundled.)

    CPT Codes 99289, Physician Constant Attention of the Critically Ill or Injured Patient During an Interfacility Transport; First 30-74 Minutes, and 99290 Each Additional 30 Minutes (List Separately in Addition To Code for Primary Service)

    These two new codes were created for CPT 2002 that describe services provided during patient transport. The RUC recommended that CPT code 99289 be valued at 4.8 work RVUs and CPT code 99290 be valued at 2.4 work RVUs. The CPT explanatory notes accompanying these two new codes state:

    The following codes 99289 and 99290 are used to report the physical attendance and direct face-to-face care by a physician during the interfacility transport of a critically ill or injured patient. For the purposes of reporting codes 99289 and 99290, face-to-face care begins when the physician assumes the primary responsibility of the patient at the referring hospital or facility, and ends when the receiving hospital or facility accepts responsibility for the patient's care. Only the time the physician spends in direct face-to-face contact the patient during the transport should be reported. Patient transport services involving less than 30 minutes of face-to-face physician care should not be reported using 99289, 99290.

    Procedure(s) or service(s) performed by other members of the transporting team may not be reported by the supervising physician. Any procedure(s) or service(s) performed by the physician before or during transport that are identified in CPT may be reported separately with the exception of routine monitoring evaluations (eg, heart rate, respiratory rate, blood pressure, and pulse oximetry) and the initiation of mechanical ventilation.

    The time spent by the physician performing separately reportable services or procedures should not be included in the face-to-face time reported by codes 99289, 99290. The direction of emergency care to transporting staff by a physician located in a hospital or other facility by two-way communication is not considered direct face-to-face care and should not be reported with codes 99289, 99290.

    The CPT explanatory notes go on to state that physicians should report emergency department services codes, initial hospital care codes, and critical care codes only after the patient has been admitted to the emergency department, the inpatient floor, or the critical care unit of the receiving facility.

    Decision: We would like to note that, currently, physician services provided to patients during interfacility transport are reported, and paid, using the appropriate E/M service codes (for example, outpatient visits, emergency visits, prolonged services, critical care).

    We have several significant concerns about the new CPT codes, 99289 and 99290. First, other than requiring face-to-face contact with the patient, there is no requirement for delivery of any specific physician service. This is in contrast to requirements for reporting critical care services under CPT codes 99291, 99292, 99295, 99296, 99297, and 99298. When reporting CPT codes 99291 and 99292 the CPT requires that, in addition to the patient being critically ill or critically injured, and the physician devoting his or her full attention to the patient, “high complexity decision making to assess, manipulate, and support vital system function(s) to treat single or multiple vital organ system failure and/or to prevent further life-threatening deterioration of the patient's condition.” These codes are valued at 4.0 work RVUs and 2.0 work RVUs, respectively.

    The CPT goes on to state that—

    “Although critical care typically requires interpretation of multiple physiologic parameters and/or application of advanced technology(s), critical care may be provided in life threatening situations when those elements are not present.”

    “ * * * Providing medical care to a critically ill, injured, or postoperative patient qualifies as a critical care service only if both the illness or injury and the treatment being provided, meet the above requirements.”

    As the code descriptors are written, the care described by the new CPT patient transport codes 99289 and 99290 do not meet the requirements for critical care. In fact, some services that will be reported as 99289 and 99290 would also be more appropriately reported as a new or established outpatient visit, an emergency visit, or as prolonged services, depending on the type of care that was delivered. We believe that the descriptors for CPT codes 99289 and 99290 will make it difficult for physicians to know when to report 99289 and 99290 appropriately.

    Second, the beginning and ending times for 99289 and 99290 are unclear. We do not believe time spent in the referring and receiving facility should be counted towards this service. Time spent in the facility prior to and after transfer may not require any physician services even though the physician is face-to-face with the patient. Furthermore, if services are provided at the referring or receiving facility they should be billed as the appropriate E/M service (for example, new patient visit, emergency visit).

    Third, we note that the descriptors for 99289 and 99290 include the phrase “ * * * critically ill or injured patient” while the descriptors for 99291 and 99292 include the phrase “ * * * critically ill or critically injured patient.” We realize that CPT descriptors are carefully developed, so we are concerned about this discrepancy and believe it needs to be clarified.

    Fourth, we note that although CPT specifically includes (or bundles) certain services into critical care, it does not include those same services in the payment for 99289 and 99290 (for example, gastric intubation, temporary transcutaneous pacing).

    Therefore, after careful review of the descriptors and explanatory notes for CPT codes 99289 and 99290, we have decided to not recognize these codes for Medicare purposes. Instead, we have created two HCPCS Level II codes to describe critical care services provided to patients during inter-facility transport. These codes are:

    G0240—Critical Care Service delivered by a physician; face-to-face, during inter-facility transport of a critically ill or critically injured patient: first 30-74 minutes of active transport.

    G0240 will be valued at 4.0 work RVUs.

    G0241—each additional 30 minutes (list separately in addition to G0240)

    G0241 will be valued at 2.0 work RVUs.

    We believe that these two G codes carry out the intent of 99289 and 99290 with less ambiguity and thus will facilitate accurate reporting of these services by physicians. We have decided to value these services at the present value for 99291 (4.0 work RVUs) and 99292 (2.0 work RVUs). Although critical care is the most intense E/M service delivered by physicians, there is considerable variation in the intensity range of the services provided under the umbrella of critical care. We value all critical care services uniformly and do not believe there is a need to develop a Start Printed Page 55310tiered approach to valuing critical care services.

    We will apply all the requirements for critical care services (CPT codes 99291 and 99292) to G0240 and G0241 with the following two exceptions: (1) All time counted towards patient transport time must be face-to-face time with the patient; (2) We will only allow face-to-face time spent in actual transport to be counted towards G0240 and G0241; E/M services delivered in the referring and receiving facilities may be reported under other appropriate E/M codes (for example, outpatient, emergency, or critical care services).

    If the actual transportation time is less than 30 minutes and/or the service does not meet the requirements of G0240 and G0241, then the physician may report his or her services under the appropriate E/M code (for example, outpatient visit, emergency visit, prolonged services).

    In order for G0240 and G0241 to be payable, the medical record must document the time spent in actual patient transport, the nature of the patient's critical illness or critical injury, and the critical care services delivered to the patient. Consistent with the teaching physician policies in section 15016 of the Medicare Carriers Manual, residents who provide this service are paid through graduate medical education payments. Therefore, their services are not payable through Medicare Part B.

    Any services delivered, or face-to-face time spent with the patient, by a resident, nurse, emergency medical technician, or other non-physician may not be billed using G0240 or G0241. Nor may any services performed by any physician or non-physician who is not physically present with the patient during interfacility transport be billed. Time spent in the referring facility, the receiving facility, and time spent prior to transport are not countable towards G0240 and G0241. Additionally, any time spent performing separately billable procedures may not be counted towards G0240 and G0241 (for example, insertion of chest tubes, insertion of intravenous lines and pacemakers, and cardiopulmonary resuscitation). All services bundled into 99291 and 99292 will also be bundled into G0240 and G0241.

    Establishment of Interim Practice Expense Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New HCFA Common Procedure Coding System Codes for 2002

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

    The RUC recommendations on the practice expense inputs for the new and revised 2002 codes were submitted to us as interim recommendations. We, therefore, consider that these recommendations are still subject to further refinement by the PEAC, or by us, if it is determined that such future review is needed. We may also revisit these inputs in light of future decisions of the PEAC regarding supply and equipment packages and standardized approaches to pre- and postservice clinical staff times.

    We have accepted, at least in the interim, almost all of the practice expense recommendations submitted by the RUC for the codes listed in table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes.” We made the following minor changes to the inputs where relevant:

    • We substituted the RUC agreed-upon multispecialty minimum visit supply package for the list of individual supplies where appropriate.
    • We deleted separately billable supplies, for example, drugs, fluids, casting supplies, when listed in the recommended supply list.
    • We rounded fractions of minutes of clinical staff time to the nearest minute.
    • The RUC agreed with the specialty society representing neurology that the magnetoencephalography codes, CPT 95965, 95966, 95967, are only performed in the facility setting and that they therefore had no direct practice expense inputs. However, we have subsequently heard from the specialty society that it has determined that a small number of practitioners do perform these services in the office setting and that there would be costs in that setting that should be reflected. We have accepted the suggestion that the TC of these codes be carrier-priced, at least until we can ascertain what direct cost inputs should be included when these services are performed in the non-facility setting.
    • We are accepting the practice expense inputs recommended for CPT code 77418 (Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams (binary, dynamic, MLC, etc.), per treatment session, with the exception of the time for the radiation therapist which we are reducing from the recommended 123 minutes to 60 minutes. We are concerned that there may be overlap in the staff time for other codes billed in conjunction with CPT code 77418, such as CPT code 76950 (Ultrasound guidance for placement of radiation therapy fields) and CPT code 77417 (Therapeutic radiology port film(s)).

    Further, we understand that the code was valued assuming the typical time for the service was 60 minutes and included the time of two radiation therapists. We believe that the service commonly takes less than the recommended 123 minutes and it may involve only one therapist. As a result of these concerns, we are valuing the service using 60 minutes of radiation technician time. This valuation is considered interim during the refinement of practice expense RVUs. We also note that the practice expense RVUs for 77418 are being determined under the resource-based methodology even though the service has no physician work. We believe that the service will have a more appropriate relative payment amount if the practice expense RVUs are determined outside of the no work methodology.

    • We did not receive a RUC recommendation for CPT code 93613, Intracardiac electrophysiology, or CPT 96004, Gait and motion studies. We have assumed that these services are performed only in the facility setting and have no direct inputs.

    For the following CPT codes we did not receive practice expense recommendations. Therefore, we are providing practice expense inputs through crosswalking to an existing code as indicated below:

    New/revised CPT codeExisting CPT/HCPCS code
    20553 Therapeutic Injections20550 Therapeutic Injections.
    47370 Ablation of Hepatic Tumors47562 Laparoscopic cholecystectomy.
    47371 Ablation of Hepatic Tumors47562 Laparoscopic cholecystectomy.
    47380 Ablation of Hepatic Tumors47350 Repair liver wound.Start Printed Page 55311
    47381 Ablation of Hepatic Tumors47350 Repair liver wound.
    47382 Ablation of Hepatic Tumors47525 Change bile duct catheter.
    67225 Ocular Photodynamic TherapyG0184 Ocular photodynamic tx, 2nd.
    76362 Ablation of Hepatic Tumors76360 CAT scan for needle biopsy.
    76394 Ablation of Hepatic Tumors76393 Mr guidance for needle place.
    76490 Ablation of Hepatic Tumors76942 Echo guide for biopsy.

    C. Other Changes to the 2002 Physician Fee Schedule and Clarification of CPT Definitions

    For the 2002 physician fee schedule, we are establishing or revising several alpha-numeric HCPCS codes for reporting certain services that are not clearly described by existing CPT codes.

    In addition to the two new HCPCS codes for patient transport we have discussed in section IV.B., “Establishment of Interim Work Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2002” above; we are also establishing the HCPCS codes for the respiratory therapy services below.

    Respiratory Therapy Codes

    Respiratory therapists can deliver services incident to a physician's service or in a provider setting such as an outpatient hospital or a comprehensive outpatient rehabilitation facility. In the past, services delivered by respiratory therapists or other health professionals often have not been clearly described by the existing CPT codes. In order to clarify coding of these services, typically delivered by respiratory therapists, but at times delivered by other specially trained health professionals, we are instituting new G codes to describe these services.

    We developed three codes for use to describe services to improve respiratory function:

    G0237 Therapeutic Procedures To Increase Strength or Endurance of Respiratory Muscles, Face-to-Face, One-on-One, Each 15 Minutes (Includes Monitoring).

    This service is to be billed when the therapist works with the patient to perform specific exercises aimed at strengthening the main and accessory muscles of respiration.

    We have provided a specific value for this code based upon the time that a respiratory therapist, who we believe will be the typical professional providing this service, will spend performing this service and practice expenses crosswalked from other similar services. This code will have no physician work.

    G0238 Therapeutic Procedures To Improve Respiratory Function, Other Than Ones Described by G0237, One-on-One, Face-to-Face, per 15 Minutes (Includes Monitoring)

    G0239 Therapeutic Procedures To Improve Respiratory Function, Two or More Patients Treated During the Same Period, Face-to-Face (Includes Monitoring)

    Codes G0237 and G0238 are billed in 15-minute increments. The method for “counting” the 15 minutes will be consistent with the method for counting minutes in many of the 97000 series CPT codes (see PM-01-68 for details). These codes would describe activities, such as monitored exercise, that improve respiratory function. Both G0238 and G0239 would be carrier-priced. The carriers have the authority to request information about the specific nature of the services delivered. CPT codes G0237-G0239 may not be billed with codes G0110 and G0111, which are restricted to services in the National Emphysema Treatment Trial (NETT), since they represent the same services.

    These codes are designed to provide more specific information about the services being delivered. The availability of codes for services to improve respiratory function will make billing of CPT codes 97000-97799 inappropriate for professionals involved in treating respiratory conditions, unless these services are delivered by physical and occupational therapists and meet the other requirements for physical and occupational therapy services. We recognize that speech and language pathologists also occasionally treat patients to improve respiratory function as part of their treatment of speech and language disorders. Because the primary goal of these services is not to improve respiratory function, but to restore speech and communication, these services should be coded with 92507, “treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation, individual).”

    VI. Update of the Codes for the Physician Self-Referral Prohibition

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

    In the January 4, 2001 final rule, we stated that we would update the list of codes used to define these designated health services in an addendum to the annual final rule concerning physician fee schedule payment policies. Thus, we are now publishing an updated all-inclusive list of codes at Addendum E. We also will provide that update on our website at www.hcfa.gov/​medlearn/​refphys.htm. The purpose of this update is to conform the code list to the most recent publication of CPT and HCPCS codes. The list of codes will become effective on January 4, 2002. We are using the January 4, 2002 date because that is the effective date for all but one provision of the January 4, 2001 physician self-referral final rule (changes made to 42 CFR 424.22 in the final rule became effective on April 6, 2001). In future years, we intend to use a January 1 effective date to coincide with the effective date of the new CPT and HCPCS codes.

    Table 8, below, identifies the CPT and HCPCS codes that have been added to Start Printed Page 55312or deleted from the list of codes published as an attachment to the January 4, 2001 physician self-referral final rule. In that final rule, we stated that we would consider timely comments regarding the updated code list. Accordingly, we will consider comments with respect to the codes listed in Table 8, below, if we receive them by the date specified in the date section of this final rule.

    Table 8.—Additions and Deletions to the Physician Self-Referral Codes

    CPT1 or HCPCS code
    Additions
    76085 Computer mammogram add-on.
    77301 Radioltherapy dos plan, imrt.
    77418 Radiation tx delivery, imrt.
    92974 Cath place, cardio brachytx.
    96000 Motion analysis, video/3d.
    96001 Motion test w/ft press meas.
    96002 Dynamic surface emg.
    96003 Dynamic fine wire emg.
    G0202 Screening mammography digital.
    G0204 Diagnostic mammography digital.
    G0206 Diagnostic mammography digital.
    G0236 Digital film convert diag ma.
    J1270 Injection, doxercalciferol.
    J1755 Iron sucrose injection.
    Q3018 Hepatitis B vaccine.
    Deletions
    90744  Hepb vacc ped/adol 3 dose im.
    90746 Hep B vaccine, adult, im.
    90747 Hepb vacc, ill pat 4 dose im.
    1 CPT codes, descriptions and other data only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Clauses Apply.

    Table 8 includes 2 codes (J1270 and J1755) that we have identified as dialysis-related outpatient prescription drugs. The physician self-referral prohibition will not apply to these services if they meet the conditions set forth in § 411.355(g) concerning the exception to the physician self-referral rule for EPO and other dialysis-related outpatient prescription drugs furnished in or by an ESRD facility. Table 8 also includes codes (G0202, 76085 and Q3018) that we have identified as screening tests and a vaccine. The physician self-referral prohibition will not apply to these services if they meet the conditions at § 411.355(h) concerning the exception for preventive screening tests, immunizations, and vaccines.

    We note that, in response to our January 4, 2001 final rule with comment, we received a number of comments regarding designated health services. We intend to address those comments in a second final rule regarding the physician self-referral prohibition.

    VII. Physician Fee Schedule Update for Calendar Year 2002

    A. Physician Fee Schedule Update

    The physician fee schedule update for 2002 is -4.8 percent. Under section 1848(d)(3) of the Act, the update is equal to 1 plus the product of the Medicare Economic Index (MEI) (divided by 100) and 1 plus the update adjustment factor. For 2002, the MEI is equal to 2.6 percent (1.026). A more detailed description of the MEI and its calculation follows. The update adjustment factor is equal to -7.0 percent (0.930). Section 1848(d)(4)(F) of the Act requires an additional -0.2 percent (0.998) reduction to the update for 2002. Thus, the product of the MEI (1.026), the update adjustment factor (0.930), and the statutory adjustment factor (0.998) equals the 2002 update of -4.8 percent (0.9523). The MEI and the update adjustment factor are described below.

    B. The Percentage Change in the Medicare Economic Index

    The MEI measures the weighted-average annual price change for various inputs needed to produce physicians' services. The MEI is a fixed-weight input price index, with an adjustment for the change in economy-wide labor productivity. This index, which has 1996 base weights, is comprised of two broad categories—physician's own time and physician's practice expense.

    The physician's own time component represents the net income portion of business receipts and primarily reflects the input of the physician's own time into the production of physicians' services in physicians' offices. This category consists of two subcomponents—wages and salaries, and fringe benefits. These components are adjusted by the 10-year moving average annual percent change in output per man-hour for the nonfarm business sector to reflect productivity growth in physicians' offices.

    The physician's practice expense category represents the rate of price growth in nonphysician inputs to the production of services in physicians' offices. This category consists of wages and salaries and fringe benefits for nonphysician staff and other nonlabor inputs. Like physician's own time, the nonphysician staff categories are adjusted for productivity using the 10-year moving average annual percent change in output per man-hour for the nonfarm business sector. The physician's practice expense component also includes the following categories of nonlabor inputs—office expense, medical materials and supplies, professional liability insurance, medical equipment, professional car, and other expense. Table 9 presents a listing of the MEI cost categories with associated weights and percent changes for price proxies for the 2002 update. The calendar year 2002 MEI is 2.6 percent.

    Table 9.—Increase in the Medicare Economic Index Update for Calendar Year 2002 1

    Cost categories and price measures1996 Weights 2CY 2002 percent changes
    Medicare Economic Index Total100.02.6
    1. Physician's Own Time 3454.52.1Start Printed Page 55313
    a. Wages and Salaries: Average hourly earnings private nonfarm, net of productivity44.22.0
    b. Fringe Benefits: Employment Cost Index, benefits, private nonfarm, net of productivity10.33.2
    2. Physician's Practice Expense 3445.53.0
    a. Nonphysician Employee Compensation16.82.5
    1. Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation, net of productivity12.42.3
    2. Fringe Benefits: Employment Cost Index, fringe benefits, white collar, net of productivity4.43.7
    b. Office Expense: Consumer Price Index for Urban Consumers (CPI-U), housing11.64.2
    c. Medical Materials and Supplies: Producer Price Index (PPI), ethical drugs/PPI, surgical appliances and supplies/CPI-U, medical equipment and supplies (equally weighted)4.51.8
    d. Professional Liability Insurance: HCFA professional liability insurance survey 53.24.0
    e. Medical Equipment: PPI, medical instruments and equipment1.90.6
    f. Other Professional Expense7.62.8
    1. Professional Car: CP-U, private transportation1.33.9
    Other: CPI-U, all items less food and energy6.32.6
    Addendum:
    Productivity: 10-year moving average of output per man-hour, nonfarm business sectorn/a2.0
    Physician's Own Time, not productivity adjusted54.54.3
    Wages and salaries, not productivity adjusted44.24.1
    Fringe benefits, not productivity adjusted10.35.3
    Nonphysician Employee Compensation, not productivity adjusted16.84.7
    Wages and salaries, not productivity adjusted12.44.3
    Fringe benefits, not productivity adjusted4.45.9
    1 The rates of historical change are for the 12-month period ending June 30, 2001, which is the period used for computing the calendar year 2002 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of September 18, 2001.
    2 The weights shown for the MEI components are the 1996 base-year weights, which may not sum to subtotals or totals because of rounding. The MEI is a fixed-weight, Laspeyres-type input price index whose category weights indicate the distribution of expenditures among the inputs to physicians' services for calendar year 1996. To determine the MEI level for a given year, the price proxy level for each component is multiplied by its 1996 weight. The sum of these products (weights multiplied by the price index levels) over all cost categories yields the composite MEI level for a given year. The annual percent change in the MEI levels is an estimate of price change over time for a fixed market basket of inputs to physicians' services.
    3 The Physician's Own Time and Nonphysician Employee Compensation category price measures include an adjustment for productivity. The price measure for each category is divided by the 10-year moving average of output per man-hour in the nonfarm business sector. For example, the fringe benefits component of the Physician's Own Time category is calculated by dividing the rate of growth in the employment cost index-benefits for private, nonfarm workers by the 10-year moving average rate of growth of output per man-hour for the nonfarm business sector. Dividing one plus the decimal form of the percent change in the employment cost index-benefits (1+.053=1.053) by one plus the decimal form of the percent change in the 10-year moving average of labor productivity(1+.020=1.020) equals one plus the change in the employment cost index-benefits for white collar workers net of the change in output per manhour (1.053/1.020=1.032). All Physician's Own Time and Nonphysician Employee Compensation categories are adjusted in this way. Due to a higher level of precision the computer calculated quotient may differ from the quotient calculated from rounded individual percent changes.
    4 The measures of productivity, average hourly earnings, Employment Cost Indexes, as well as the various Producer and Consumer Price Indexes can be found on the Bureau of Labor Statistics website—http://stats.bls.gov.
    5 Derived from a CMS survey of several major insurers (the latest available historical percent change data are for the period ending second quarter of 2001).
    n/a Productivity is factored into the MEI compensation categories as an adjustment to the price variables; therefore, no explicit weight exists for productivity in the MEI.

    C. The Update Adjustment Factor

    Paragraphs (3) and (4) of section 1848(d)(3) of the Act indicate that the physician fee schedule update is equal to the product of the Medicare Economic Index and an “update adjustment factor.” The update adjustment factor is applied to the inflation update to reflect success or failure in meeting the expenditure target that the law refers to as “allowed expenditures.” Allowed expenditures are equal to actual expenditures in a base period updated each year by the sustainable growth rate (SGR). The SGR is a percentage increase that is determined by a formula specified in section 1848(f) of the Act. The next section of this final rule describes the SGR and its calculation in detail. The update adjustment factor is determined based on a comparison of actual and allowed expenditures. For years beginning with 1999, the BBA required that the update adjustment factor be determined under section 1848(d)(3) of the Act to equal—

    • The difference between (1) the sum of the allowed expenditures for physicians' services (as determined under subparagraph (C)) for the period beginning April 1, 1997, and ending on March 31 of the year involved, and (2) the amount of actual expenditures for physicians' services furnished during the period beginning April 1, 1997, and ending on March 31 of the preceding year; divided by—
    • The actual expenditures for physicians' services for the 12-month period ending on March 31 of the preceding year, increased by the sustainable growth rate under subsection (f) for the fiscal year which begins during such 12-month period.

    The BBRA made changes to the methodology for determining the physician fee schedule update beginning in 2001. In particular, it established that the methodology in section 1848(d)(3) of the Act would only be used for determining the physician fee schedule update for 1999 and 2000; the physician fee schedule update for 2001 and subsequent years is determined under section 1848(d)(4) of the Act. While the general principle of adjusting the inflation update (the MEI) based on a comparison of actual and target expenditures (the update adjustment factor) is continuing, the BBRA made fundamental changes to the calculation of the update adjustment factor. These changes do two things. First, the measurement of actual Start Printed Page 55314expenditures will occur on the basis of a calendar year rather than a April 1 to March 31 year. This essentially conforms the measurement of actual expenditures with other aspects of the SGR system that are also occurring on the basis of a calendar year as a result of BBRA amendments. As explained in our April 10, 2000 SGR notice (65 FR 19000), the BBRA essentially changed the SGR system from one that spanned 3 different time periods (1—Measurement of actual expenditures on the basis of a April 1 to March 31 period; 2—calculation of the SGR rate of increase on a Federal fiscal year basis; and 3—application of the update on a calendar year basis) to one that spans only one time period (all three elements are computed on the basis of a calendar year). Second, it ensures that any deviation between cumulative actual expenditures and cumulative allowed expenditures will be corrected over several years rather than in a single year. This will result in less year-to-year volatility in the physician fee schedule update than will occur if adjustments to the update are made to bring expenditures in line with the target in one year.

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

    • Prior Year Adjustment Component. An amount determined by—

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

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

    + Multiplying that quotient by 0.75.

    • Cumulative Adjustment Component. An amount determined by—

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

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

    + Multiplying that quotient by 0.33.

    Section 1848(d)(4)(D) of the Act indicates that the update adjustment factor determined under section 1848(d)(4)(B) for a year may not be less than −0.07 or greater than 0.03. At this time, we estimate that the sum of the prior year and cumulative adjustment components will be less than −0.07 limit. In a letter to the Medicare Payment Advisory Commission and in data we made available to the public on the CMS website in March, we indicated that the estimated update adjustment factor for 2002 would be −1.5 percent. However, we also indicated that a number of factors could change our estimate of the update adjustment factor. Since our March estimate, a number of factors have changed that lower our estimate of allowed expenditures and increase our estimate of actual expenditures. Allowed expenditures have declined because real per capita gross domestic product (GDP) growth for 2000 is lower than the estimates in March. This occurs because of changes to economic figures for 2000 made at the Bureau of Economic Analysis. Further, current estimates of real GDP per capita growth for 2001 and 2002 are lower than in March. We provide a more detailed explanation of factors that affect our estimate of allowed expenditures in the next section of this final regulation on the SGR. An explanation of changes to actual expenditures follows.

    As indicated above, we are currently estimating higher 2001 actual expenditures than we did in March. We did not have any Medicare claims data to develop our March estimates of actual expenditures for 2001. At this time, we are using claims received through June 30 to estimate actual expenditures for all of 2001. Based on the claims received in the first half of the year, our current estimates of actual expenditures for 2001 are higher than earlier estimates. We will be revising the measurement of actual expenditures for CY 2001 based on claims received through June 30, 2002. These revised figures will be determined no later than November 1, 2002. If the revised figures are different than current estimates, the difference will be reflected in the update adjustment factor used in determining the 2003 physician fee schedule update.

    After taking into account the factors described above that affect allowed and actual expenditures, we originally estimated that the update adjustment factor for 2002 would be −5.4 percent or 1.6 percentage points more than the −7.0 percent limit on the update adjustment factor. However, in making updates to the list of codes that are included in the SGR, we discovered that a number of new procedure codes were inadvertently not included in the measurement of actual expenditures beginning in 1998. Therefore, the measurement of actual expenditures for 1998, 1999, and 2000 was lower than it should have been. As a result, the physician fee schedule update was higher in 2000 and 2001 than if we had included these codes. Including these codes in the measurement of actual expenditures results in a lower update adjustment factor than we earlier estimated. We will be making no changes to physician fee schedule payments made for services furnished in 2000 and 2001. However, under section 1848(d) of the Act, we must include these codes in the measurement of actual expenditures for historical, current, and future periods. While we do not currently know the precise effect of not measuring expenditures for all codes included in the SGR on the update adjustment factor for 2002, we are certain that it is in excess of 1.6 percentage points and is of sufficient magnitude to result in the update adjustment factor being less than the −7.0 percent statutory limit. In the near future, we expect to complete this analysis and update information that we make available on the CMS website. We plan to provide complete data that show quarterly allowed and actual expenditures for all procedure codes included in the SGR, as well as a list of the codes themselves.

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

    (As indicated in the SGR discussion below, allowed expenditures through the end of CY 2001 will be revised one more time, not later than November 1, 2002. We will also be revising the measurement of actual expenditures for CY 2001 based on claims received through June 30, 2002, not later than November 1, 2002. The SGR for 2001 will also be revised one more time, and the SGR for 2002 will be revised two more times. The resulting effect from revisions of estimates will be reflected in the update adjustment factor determined for 2003.)Start Printed Page 55315

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

    A. Medicare Sustainable Growth Rate

    Section 1848(f) of the Act, as amended by section 4503 of the BBA, replaced the Medicare Volume Performance Standard (MVPS) with a Sustainable Growth Rate (SGR). Section 1848(f)(2) of the Act specifies the formula for establishing yearly SGR targets for physicians' services under Medicare. The use of SGR targets is intended to control the actual growth in aggregate Medicare expenditures for physicians' services.

    The SGR targets are not limits on expenditures. Payments for services are not withheld if the SGR target is exceeded by actual expenditures. Rather, the appropriate fee schedule update, as specified in section 1848(d)(3) of the Act, is adjusted to reflect the success or failure in meeting the SGR target. If expenditures exceed the target, the update is reduced. If expenditures are less than the target, the update is increased.

    As with the MVPS, the statute specifies a formula to calculate the SGR based on our estimate of the change in each of four factors. The four factors for calculating the SGR are as follows—

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

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

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

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

    Section 211 of the BBRA amended sections 1848(d) and 1848(f) of the Act with respect to the physician fee schedule update and the SGR. Section 211(b) of the BBRA maintains the formula for calculating the SGR, but amends section 1848(f)(2) of the Act to apply the SGR on a calendar year (CY) basis beginning with 2000 while maintaining the SGR on a fiscal year (FY) basis for FY 1998 through FY 2000. Specifically, section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, states that “* * * [t]he sustainable growth rate for all physicians' services for a fiscal year (beginning with fiscal year 1998 and ending with fiscal year 2000) and a year beginning with 2000 shall be equal to the product of—

    (1) 1 plus the Secretary's estimate of the weighted average percentage increase (divided by 100) in the fees for all physicians' services in the applicable period involved,

    (2) 1 plus the Secretary's estimate of the percentage change (divided by 100) in the average number of individuals enrolled under this part (other than Medicare+Choice plan enrollees) from the previous applicable period to the applicable period involved,

    (3) 1 plus the Secretary's estimate of the projected percentage growth in real gross domestic product per capita (divided by 100) from the previous applicable period to the applicable period involved; and

    (4) 1 plus the Secretary's estimate of the percentage change (divided by 100) in expenditures for all physicians' services in the applicable period (compared with the previous applicable period) which will result from changes in law and regulations, determined without taking into account estimated changes in expenditures resulting from the update adjustment factor determined under section 1848 (d)(3)(B) or (d)(4)(B) of the Act, as the case may be, minus 1 and multiplied by 100.”

    Under section 1848(f)(4)(C) of the Act, the term “applicable period” means—(1) a FY, in the case of FY 1998, FY 1999 and FY 2000, and (2) a CY with respect to a year beginning with 2000.

    Section 1848(d)(4)(C) of the Act requires us to make the transition from a FY SGR to a CY SGR in 1999 by using the FY 1999 SGR for the first 3 months of 1999 and the FY 2000 SGR for the 9-month period beginning April 1, 1999. Allowed expenditures for the year are equal to the sum of allowed expenditures for each respective period. The SGR for CY 2000 is then applied to allowed expenditures for CY 1999.

    As stated in the April 10, 2000 final notice (65 FR 19000), the BBRA requires the estimates of the FY 2000 and CY 2000 SGRs to be revised based on more recent data, but, as explained below, the BBRA does not provide for revision of either the FY 1998 or the FY 1999 SGR. This means that, for the transition to a calendar year SGR system, allowed expenditures for the period April 1, 1999 through December 31, 1999 (determined by applying the FY 2000 SGR to allowed expenditures for the 12-month period ending March 31, 1999) are subject to change based on revision of the FY 2000 SGR; allowed expenditures for the period January 1, 1999 through March 31, 1999 (determined using the FY 1999 SGR) are not subject to revision.

    In general, the BBRA requires us to publish SGRs for 3 different time periods, no later than November 1 of each year, using the best data available as of September 1 of each year. Under section 1848(f)(3)(C)(i) of the Act, as added by section 211(b)(5) of the BBRA, the SGR is estimated and subsequently revised twice (beginning with the FY and CY 2000 SGRs) based on later data. Under section 1848(f)(3)(C)(ii) of the Act, there are no further revisions to the SGR once it has been estimated and subsequently revised in each of the 2 years following the initial estimate.

    The requirement of revisions to the SGR based on later data means that we will estimate and publish an SGR for the upcoming year, the contemporaneous year, and the preceding year by no later than November 1 of each year. For example, by no later than November 1, 2002, we will publish an estimate of the SGR for CY 2003, a revision of the CY 2002 SGR that is first being estimated in this notice, and a revision of the CY 2001 SGR first estimated in the final rule published on November 2, 2000 (65 FR 65429) and revised in this final rule. Under section 1848(f)(3)(C)(ii) of the Act, the final revision to the CY 2001 SGR will be announced in the Federal Register no later than November 1, 2002.

    Subparagraphs (A) and (B) of section 1848(f)(3) of the Act, specify special rules with respect to the SGR and the CY 2001 and CY 2002 updates. Section 1848(f)(3)(A) of the Act required us, no later than November 1, 2000, to revise the SGRs for FY 2000 and CY 2000 and to establish the SGR for CY 2001, based on the best data available, as of September 1, 2000. We published our first estimate of the SGRs for FY 2000 and CY 2000 in a Federal Register notice on April 10, 2000 (65 FR 19000). Revised estimates of the SGRs for FY 2000 and CY 2000 and our original estimate of the SGR for CY 2001 appeared in the Federal Register on November 1, 2000 (65 FR 65429). We used each of the SGRs published in the November 1, 2000 Federal Register to determine the physician fee schedule update for 2001. Section 1848(f)(3)(B) of the Act requires us, by no later than November 1, 2001, to revise the SGRs for FY 2000 and CYs 2000 and 2001 and establish the SGR for CY 2002, based on the best data available as of September 1, 2001 and to use each of these SGRs to determine the physician fee schedule update for 2002. We are using each of the SGRs established in this notice to determine the 2002 physician fee schedule update. In accordance with section 1848(f)(3)(C)(ii) of the Act, there will be no further revisions to the FY 2000 and CY 2000 SGRs after the revisions we are making in this final rule.

    B. Physicians' Services

    Section 1848(f)(4)(A) of the Act defines the scope of physicians' services Start Printed Page 55316covered by the SGR. The statute indicates that the term “physicians’ services” includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office, but does not include services furnished to a Medicare+Choice plan enrollee. The BBA and BBRA made no changes to this definition which was also used for the MVPS. We published a definition of physicians' services for use in the MVPS and subsequent SGR in the Federal Register (61 FR 59717) on November 22, 1996. We defined “physicians’ services” to include many of the medical and other health services listed in section 1861(s) of the Act. Since the statute has made a number of changes to the definition of medical and other health services included in section 1861(s), we are updating our definition of physicians' services consistent with the statutory changes. Our practice has been to make adjustments to the SGR for medical and other health services added to the statute that meet the criterion of being “commonly performed by a physician or a physicians’ office.” For instance, the BBA and the BIPA amended section 1861(s) of the Act to add new preventive benefits to the Medicare statute. Since these preventive services are generally provided by physicians or in physicians' offices, we made adjustments to the SGR to reflect additional Medicare expenditures for the newly-added Medicare benefits. Physicians' services for the SGR include the following medical and other health services if bills for the items and services are processed and paid by Medicare carriers:

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

    C. Provisions Related to the SGR

    Section 211(b)(1) of the BBRA amends section 1848(f)(1) of the Act to require that SGR estimates be published in the Federal Register not later than November 1 of every year. In this notice, we are publishing our initial estimate of the SGR for 2002, a revised estimate of the SGR for 2001 and final estimates of the SGRs for FY and CY 2000.

    In general, the update for a year is based on the Medicare Economic Index (MEI) as adjusted, within bounds, by the amount of actual expenditures for physicians' services compared to target (referred to as “allowed” in the statute) expenditures. A key difference between the MVPS and the SGR is that the comparison of actual and allowed expenditures is made on a cumulative basis under the SGR, while it was made on an annual basis under the MVPS. The “update adjustment factor” in section 1848(d)(4)(B) of the Act is an adjustment to the MEI that reflects the difference between actual expenditures and target expenditures.

    Section 1848(d)(3)(C) of the Act, as modified by the BBA, defines allowed expenditures for the 12-month period ending March 31, 1997 to be equal to actual expenditures for physicians' services during that period (that is, April 1, 1996 through March 31, 1997), as we have estimated. Section 1848(d)(3)(C) of the Act defines allowed expenditures for subsequent 12-month periods to be equal to allowed expenditures for physicians' services for the previous year increased by the SGR for the FY which begins during the 12-month period. For example, allowed expenditures for the 12-month period April 1, 1997 through March 31, 1998 are equal to allowed expenditures for the 12 months ending March 31, 1997, increased by the SGR for FY 1998. The BBRA subsequently provided for a transition to a calendar year SGR system in 1999. Allowed expenditures for the first quarter of 1999 are determined using the FY 1999 SGR and allowed expenditures for the April 1, 1999 to December 31, 1999 period are determined using the FY 2000 SGR. Allowed expenditures in 2000 are equal to 1999 allowed expenditures increased by the 2000 SGR. Allowed expenditures for each subsequent year will equal expenditures from the prior year updated by the SGR.

    Table 10 shows annual and cumulative allowed expenditures for physicians' services for each of the 12-month periods between April 1, 1996 and March 31, 2000, for 1999 and 2000.

    Table 10

    PeriodAnnual allowed expenditures (in billions)Cumulative allowed expenditures (in billions)FY or CY SGR
    4/1/96-3/31/97$48.9$48.9N/A
    4/1/97-3/31/9849.698.5FY 1998=1.5%
    4/1/98-3/31/9949.447.9FY 1998=−0.3%
    1/1/99-3/31/9912.5(1)FY 1999=−0.3%
    4/1/99-12/31/9939.6(2)FY 2000=6.9%
    1/1/99-12/31/9952.1187.6FY 1999/FY 2000
    1/1/00-12/31/0055.9243.5CY 2000=7.3%
    1/1/01-12/31/0159.3302.7CY 2001=6.1%
    1/1/02-12/31/0262.6365.3CY 2002=5.6%
    1 Included in $147.9 above.
    2 Included in $187.6 below.
    Start Printed Page 55317

    Note:

    Allowed Expenditures for the first quarter of 1999 are based on the FY 1999 SGR and allowed expenditures for the last three quarters of 1999 are based on the FY 2000 SGR.

    Allowed Expenditures in the First Year

    (April 1, 1996-March 31, 1997) are equal to actual expenditures. All subsequent figures are equal to quarterly allowed expenditure figures increased by the applicable SGR. Cumulative allowed expenditures are equal to the sum of annual allowed expenditures. We provide more detailed quarterly allowed and actual expenditure data on the CMS website under the Medicare Actuary's publications at the following address: http://www.hcfa.gov/​pubforms/​actuary/​. We expect to update this information in November.

    Allowed expenditures for the April 1, 1999 through the December 31, 1999 period are based on the FY 2000 SGR. As previously discussed, section 1848(f)(3) of the Act requires two revisions to the FY and CY 2000 SGR. We made the first revision to the FY and CY 2000 SGR in the physician fee schedule final rule published in the Federal Register on November 1, 2000 (65 FR 65427). We are making the second and final revision in this final rule. Consistent with section 1848(f)(3)(B) of the Act, the revised FY and CY 2000 SGR uses the best data available to us as of September 1, 2001.

    D. Preliminary Estimate of the SGR for 2002

    According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, we have determined the preliminary estimate of the CY 2002 SGR to be 5.6 percent. We first estimated the CY 2002 SGR in March and made the estimate available to the Medicare Payment Advisory Commission and our website. Our March and current estimates of the four statutory factors are indicated in table 11:

    Table 11

    Statutory factorsMarch estimateCurrent estimate
    Fees1.62.3
    Enrollment0.40.7
    Real Per Capita GDP2.41.7
    Law and Regulation1.50.8
    Total6.05.6

    Note:

    Consistent with section 1848(f)(2) of the Act, the statutory factors are multiplied, not added, to produce the total (that is, 1.023 × 1.007 × 1.017 × 1.008 = 1.056.) A more detailed explanation of each figure is provided below in section H.1.

    E. Sustainable Growth Rate for CY 2001

    According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the CY 2001 SGR is 6.1 percent. Table 12 shows our original estimate of the CY 2001 SGR published in the Federal Register on November 1, 2000 (65 FR 65433) and current estimates of the four statutory factors that determine the CY 2001 SGR:

    Table 12

    Statutory factors11/1/00 estimateCurrent estimate
    Fees1.91.9
    Enrollment0.93.0
    Real Per Capita GDP2.70.7
    Law and Regulation0.00.4
    Total5.66.1

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

    F. Sustainable Growth Rate for CY 2000

    According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the CY 2000 SGR is 7.3 percent. Table 13 shows estimates included in the November 1, 2000 Federal Register (65 FR 65433) and current estimates of the four statutory factors that determine the CY 2000 SGR:

    Table 13

    Statutory factors11/1/00 estimateCurrent estimate
    Fees2.12.1
    Enrollment1.01.0
    Real Per Capita GDP4.33.2
    Law and Regulation0.50.8
    Total8.17.3

    A more detailed explanation of each figure is provided below in section H.3.

    G. Sustainable Growth Rate for FY 2000

    According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the FY 2000 SGR is 6.9 percent. Table 14 shows estimates included in the November 1, 2000 Federal Register (65 FR 65433) and current estimates of the four statutory factors that determine the FY 2000 SGR:

    Table 14

    Statutory factors11/1/00 estimateCurrent estimate
    Fees2.12.1
    Enrollment0.80.5
    Real Per Capita GDP4.53.6
    Law and Regulation0.30.6
    Total7.96.9

    A more detailed explanation of each figure is provided below in section H.3.

    H. Calculation of the FY 2000, CY 2000, CY 2001, and CY 2002 Sustainable Growth Rates

    1. Detail on the CY 2002 SGR

    A more detailed discussion of our preliminary estimates of the four elements of the 2002 SGR follows.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2002

    This factor was calculated as a weighted average of the CY 2002 fee increases that apply for the different types of services included in the definition of physicians' services for the SGR.

    Physicians' services as defined in sections 1861(s)(1) and (2) of the Act represent approximately 89 percent of allowed charges for physicians' services under the SGR and are updated by the Medicare Economic Index (MEI). Our current estimate of the MEI for 2002 is 2.6 percent. Diagnostic laboratory tests represent approximately 11 percent of the Medicare allowed charges for physicians' services under the SGR. The BBA provided for a 0.0 percent update for CY 2002 for laboratory services. Table 15 shows both the physicians' and laboratory service updates that were used to determine the percentage increase in physicians' fees for CY 2002.

    Table 15

    WeightUpdate
    Physician0.892.6
    Laboratory0.110.0
    Weighted Average1.02.3

    After taking into account the elements described in the table, we estimate that the weighted-average increase in fees for CY 2002 for physicians' services under the SGR (before applying any legislative adjustments) will be 2.3 percent.

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

    This factor is our estimate of the percent change in the average number of Start Printed Page 55318fee-for-service enrollees for CY 2002 as compared to CY 2001 Medicare+Choice (M+C) plan enrollees, whose Medicare-covered medical care is outside the scope of the SGR, and who are excluded from this estimate. Our actuaries estimate that the average number of Medicare Part B fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) will increase by 0.7 percent in calendar year 2002. This estimate was derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 16.

    Table 16

    [In millions]

    20012002
    Overall37.82838.149
    Medicare+Choice5.6625.761
    Net32.16632.388
    Percent Increase:0.7

    Since 2002 has yet to begin, we currently only have estimates of this figure for 2002. An important factor affecting fee-for-service enrollment is beneficiary enrollment in Medicare+Choice plans. At this time, we do not know how actual enrollment in Medicare+Choice plans will compare to current estimates. While we do receive information on whether a Medicare+Choice plan will continue to participate or withdraw from the program, it remains difficult to estimate the number of beneficiaries who will select a Medicare+Choice plan or fee-for-service before the start of the calendar year. While some plans will no longer offer a Medicare+Choice plan, other plans are available as an option to most beneficiaries in areas where there have been plan withdrawals. It is difficult to estimate the size of the Medicare+Choice enrollee population before the start of a calendar year. Because we determine the fee-for-service enrollment figure net of the change in Medicare+Choice enrollment, early estimates of this factor are difficult to make. Our estimate of this factor is preliminary and only has minimal effect on the physician fee schedule update for CY 2002. The CY 2002 SGR will also be used in the calculation of the 2003 physician fee schedule update in a final rule to be published no later than November 1, 2002. By that time, we will have information on actual enrollment in Medicare+Choice plans for the first 8 months of CY 2002 and will be better able to predict the change in fee-for-service enrollment for the year.

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

    Section 1848(f)(2)(C) of the Act, as amended by section 211 of the BBRA, requires us to estimate growth in real GDP per capita. This factor is applied on a CY basis beginning with the CY 2000 SGR. We estimate that the growth in real per capita GDP will be 1.7 percent in CY 2002. Our past experience indicates that there have also been large changes in estimates of real per capita GDP growth and the actual change in this factor. It is likely that this figure will change further as actual information on economic performance becomes available to us in 2002. Again, we note that we will use revised estimates of real per capita GDP growth in setting future year updates.

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

    Sections 101 through 104 of BIPA added Medicare coverage for screening glaucoma, authorized Medicare to pay for specific new technology mammography services, and changed coverage for screening pap smears, screening pelvic exams, and screening colonoscopy for average-risk individuals. In addition, section 105 of the BIPA also establishes a new benefit for medical nutrition therapy and expands access to telehealth services in section 223. Section 432 of the BIPA also requires that Medicare make payment to Indian Health Service hospitals and ambulatory clinics for physicians' and practitioners' services as well as outpatient physical and occupational therapy services that are included in the definition of physicians' services for purposes of the SGR. Since these provisions will increase Medicare expenditures for services that are included in the SGR, we are making an upward adjustment to reflect additional Medicare expenditures in 2002. Our estimates of the cost of these provisions for the period FY 2002-FY 2006 are included in our Notice of Proposed Rulemaking published in the Federal Register on August 2, 2001 (66 FR 40400).

    We are making an adjustment to the SGR for one additional factor. In section VI.B. of this final rule, we provided a definition of physicians' services for purposes of the SGR. Historically, we have not measured expenditures for screening mammography under the SGR. However, section 1848(f)(4) of the Act indicates that “physicians” services includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office.” Screening mammography services are “radiology services” that are performed by “physicians or in a physician's office.” As a result, we are using this rule to add screening mammography to the list of services that are part of the SGR definition. Since we have not previously measured expenditures for screening mammography services under the SGR, it is appropriate to make an adjustment to this factor for the change to the definition of physicians' services. We are making an adjustment that reflects estimated payments for screening mammography services in CY 2002. We will make a subsequent revision based on actual expenditures for screening mammography.

    After taking these provisions into account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.8 percent for 2002. In March, we estimated that this figure would be 1.5 percent. The 0.7 percentage point difference is due to a change in our estimate of the BIPA provisions. In March, we had no information about implementation of these provisions. We used updated assumptions about pricing and utilization based on proposed policies published in the August 2, 2001 proposed rule (66 FR 40400).

    2. Detail on the CY 2001 SGR

    A more detailed discussion of our current estimates of the four elements of the 2001 SGR follows.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2001

    We are continuing to use 1.9 percent for this element of the SGR for the CY 2001 SGR. This factor is unchanged from earlier estimates previously described for CY 2001 in the November 1, 2000 Federal Register (65 FR 65433).

    Factor 2—The Percentage Change in the Average Number of Fee-for-Service Part B Enrollees From CY 2000 to CY 2001

    This factor is our estimate of the percent change in the average number of fee-for-service enrollees for CY 2001 as compared to CY 2000. As we indicated above, this factor is difficult to estimate prior to the beginning of the period for which the estimates are being made because of the interaction of the fee-for-service and Medicare+Choice program and the lack of availability of actual data Start Printed Page 55319on beneficiary selection of Medicare+Choice enrollment. We currently have information on actual enrollment in the Medicare+Choice program for CY 2001 and CY 2000 that permits estimates of the change in fee-for-service enrollment for these years that will be more reflective of the final actual enrollment and percent year-to-year change. The estimates for CY 2000 and CY 2001 were derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 17.

    Table 17

    [In millions]

    20002001
    Overall37.45337.828
    Medicare+Choice6.2335.662
    Net31.22132.166
    Percent Increase3.0

    Our actuaries estimate of the percent change in the average number of fee-for-service enrollees net of Medicare+Choice enrollment for 2001 compared to 2000 of 3.0 percent is more than our early estimate of this factor (0.9 percent for CY 2001 from the November 1, 2000 Federal Register (65 FR 65433)) because the historical base from which our actuarial estimate is made has changed. We currently have complete information on Medicare fee-for-service enrollment for 2000 that is lower than the figure we used one year ago. Further, we now have information on actual fee-for-service enrollment for the first 8 months of 2001. This figure is slightly higher than the figure used in the November 1, 2000 Federal Register (65 FR 65433). We would caution that our estimate of fee-for-service enrollment for 2001 may change once we have complete information for the entire year.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in CY 2001

    Section 1848(f)(2)(C) of the Act, as amended by section 211 of the BBRA, requires us to estimate growth in real GDP per capita. We estimate that the growth in real per capita GDP will be 0.7 percent in CY 2001. There have also been large changes in initial estimates of real per capita GDP growth and the actual change in this factor. There could be further changes in this factor once we have complete information on economic performance for the entire year. Again, we note that we will use revised estimates of real per capita GDP growth in setting future year updates.

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2001 Compared With CY 2000

    As described above, the BIPA makes changes to the Act that affect Medicare expenditures for services that are included in the SGR. Some of these provisions have no effect on Medicare expenditures in 2001 because they do not go into effect until 2002. Other provisions are effective at some time during 2001. Provisions that become effective in 2001 relate to new technology mammography and coverage changes for screening pap smears, screening pelvic exams and screening colonoscopy, expanded access to telehealth services and Medicare payment for services provided in Indian Health Service hospitals and clinics. After taking these provisions into account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.4 percent for 2001.

    3. Detail on Calculation of the FY 2000 and CY 2000 SGRs

    A more detailed discussion of our revised estimates of the four elements of the FY 2000 and CY 2000 SGRs follows.

    Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for FY 2000 SGR and CY 2000 SGR

    We are continuing to use 2.1 percent for this element of the SGR for the FY 2000 SGR and the CY 2000 SGR. This factor is unchanged from earlier estimates previously described respectively for FY 2000 and CY 2000 in the October 1, 1999 Federal Register (64 FR 53395), the April 10, 2000 Federal Register (65 FR 19003) and the August 2, 2001 Federal Register (66 FR 40397).

    Factor 2—The Percentage Change in the Average Number of Fee-for-Service Part B Enrollees for the FY 2000 SGR and CY 2000 SGR

    This factor is our estimate of the percent change in the average number of fee-for-service enrollees for FY 2000 as compared to FY 1999 and CY 2000 as compared to CY 1999. We currently have complete information on actual enrollment in the Medicare+Choice program for FY 2000 and CY 2000 that permits a measure of change in fee-for-service enrollment for these years that reflects the actual change. The estimates for CY 2000 were derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 18.

    Table 18

    [In millions]

    19992000
    Overall37.11537.453
    Medicare+Choice6.1916.233
    Net30.92331.221
    Percent Increase1.0

    Our actuaries' estimate of the percent change in the average number of fee-for-service enrollees net of Medicare+Choice enrollment for 2000 compared to 1999 of 1.0 percent is the same as our estimate of this factor at this time last year (1.0 percent). However, the current estimate of 0.5 percent for FY 2000 is lower than the 0.8 percent estimate of this factor at this time last year.

    Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in FY 2000 and CY 2000

    We estimate that real GDP per capita growth will be 3.6 percent for FY 2000 and 3.2 percent for CY 2000. In the FY 2000 SGR notice published on October 1, 1999 (64 FR 53396), we estimated that real GDP per capita growth for FY 2000 would be 1.8 percent. In our April 10, 2000 SGR notice, we estimated that real GDP per capita growth for CY 2000 would be 2.5 percent. In our November 1, 2000 final rule (65 FR 65433), we estimated that real GDP per capita growth would be 4.5 percent for FY 2000 and 4.3 percent CY 2000. The final figures that we will use for this factor are 3.6 percent for FY 2000 and 3.2 percent for CY 2000. The latest figures on real GDP per capita growth are approximately one percentage point less than estimated last year. The lower estimates are due to annual revisions of the National Income and Product Accounts (NIPA) by the Bureau of Economic Analysis. Usually, in annual revisions of the NIPA, new estimates incorporate source data that are more complete, more detailed, and otherwise more appropriate than those that were previously incorporated. In addition, several methodological changes have been made. (For detailed description of the NIPA revisions, see Brent R. Moulton, Eugene P. Seskin, and David F. Sullivan, “Annual Revision of the National Income and Product Accounts: Annual Estimates, 1998-2000, Quarterly Estimates, 1998: 1-2000: I, Survey of Current Business” (August, 2001): 7-32.)Start Printed Page 55320

    Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in FY 2000 Compared with FY 1999, and CY 2000, Compared With CY 1999

    As we explained in our October 1, 1999 and April 10, 2000 SGR notices, legislative changes contained in the BBA and the BBRA will have an impact on expenditures for physicians' services under the SGR in FY 2000 and CY 2000. Section 4103 of the BBA mandates a new prostate screening benefit effective January 1, 2000. Additionally, effective January 1, 2000, section 4513 of the BBA removes the requirement that a subluxation of the spine be demonstrated by an x-ray before Medicare payment can be made for chiropractic services furnished to a beneficiary. This provision will also result in a small increase in expenditures in FY 2000 and CY 2000. The impact of BBA Medicare Secondary Payer provisions will have small marginal impact on reducing expenditures in FY 2000 and CY 2000.

    Certain BBRA provisions also have a small impact on expenditures in FY 2000 and CY 2000. Section 224 of the BBRA increases payments for pap smears and is slightly increasing expenditures. Section 221 of the BBRA postponed the implementation of payment caps on physical and occupational therapy and speech-language pathology services. The effect of this provision on physicians and independent practitioners is a small increase in expenditures for these years. Medicare expenditures for outpatient physical and occupational therapy services by therapists in independent practice are growing rapidly as a result of provisions of section 4541 of the BBA that require Medicare to make payments for facility-based therapy services under the physician fee schedule. Physical and occupational therapy services previously paid on the basis of a cost report through the Medicare fiscal intermediaries are more likely to be billed by therapists in independent practice because these services are no longer being paid on a cost basis. We analyzed growth in Medicare expenditures for physical and occupational therapy and believe that the larger rate of increase in Medicare expenditures for these services billed to carriers is likely a result of the statutory provisions that require the services to be paid under the Medicare physician fee schedule. We are making an upward adjustment to the SGR for this factor.

    After taking into account these provisions, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.6 percent for FY 2000 and 0.8 percent for CY 2000.

    IX. Calculation of the 2002 Physician Fee Schedule and Anesthesia Conversion Factor

    The 2002 physician fee schedule conversion factor is $36.1992. The separate 2002 national average anesthesia conversion factor is $16.60.

    The specific calculations to determine the physician fee schedule and anesthesia conversion factor for calendar year 2002 are explained below.

    Detail on Calculation of the Calendar Year 2002 Physician Fee Schedule Conversion Factor

    • Physician Fee Schedule Conversion Factor

    Under section 1848(d)(1)(A) of the Act, the physician fee schedule conversion factor is equal to the conversion factor for the previous year multiplied by the update determined under section 1848(d)(4) of the Act. In addition, section 1848(c)(2)(B)(ii)(II) of the Act requires that changes to relative value units (RVUs) cannot cause expenditures to increase or decrease by more than $20 million from the amount of expenditures that would have been made if such adjustments had not been made. We implement this requirement through a uniform budget neutrality adjustment to the conversion factor. There are two changes that will require us to make an adjustment to the conversion factor to comply with the budget neutrality requirement in section 1848(c)(2)(B)(ii)(II) of the Act. We are making a 0.460 percent reduction (0.9954) in the conversion factor to account for the increase in work RVUs resulting from the 5-year review. We are also making a 0.18 percent (0.9982) reduction in the conversion factor to account for an anticipated increase in the volume and intensity of services in response to the final year of the implementation of resource-based practice expense RVUs. As a result of the 5-year review of RVUs and additional budget-neutrality adjustments required by law, the conversion factor is 5.4 percent lower than last year's conversion factor.

    The two budget neutrality factors are applied after the update is applied to the 2001 conversion factor:

    Table 19

    2001 Conversion Factor$38.2581
    2002 Update0.9523
    Budget-Neutrality Adjustment: 5 Year Review0.9954
    Budget-Neutrality Adjustment: Practice Expense Transition0.9982
    2002 Conversion Factor$36.1992
    • Anesthesia Fee Schedule Conversion Factor

    Section 1848(b)(2)(B) of the Act indicates that, to the extent practicable, the Secretary will use the anesthesia relative value guide with appropriate adjustment of the conversion factor, in a manner to assure that the fee schedule amounts for anesthesia services are consistent with the fee schedule amounts for other services. The statute also requires the Secretary to adjust the conversion factor by geographic adjustment factors in the same manner as for other physician fee schedule services. Unlike other physician fee schedule services, anesthesia services are paid using a system of base and time units. The base and time units are summed and multiplied by a conversion factor. The base unit is fixed depending upon the type of anesthesia procedure performed, and the time units will vary based on the length of the anesthesia time associated with the surgical procedure. Thus, Medicare's payment will increase as anesthesia time lengthens. The same anesthesia service provided in two different surgeries will be paid different amounts if the associated anesthesia time is different. This system differs from other physician fee schedule services where payment is determined based on the product of RVUs and a conversion factor; payment for a given procedure will not vary based on the length of time it takes to perform the procedure in a specific instance.

    Since anesthesia services do not have RVUs like other physician fee schedule services, we have had to make appropriate adjustments to the anesthesia fee schedule conversion factor to simulate changes to RVUs. We modeled the resource-based practice expense methodology using imputed anesthesia RVUs that were made comparable to other physician fee schedule services. As a result of modeling these changes, we are incorporating a 1.89 percent reduction (0.9811) to the anesthesia fee schedule conversion factor. We are incorporating an additional increase of 0.2 percent (1.002) to account for base unit revisions for 2002, both for the five-year review and for the alignment of CMS base units with ASA base units. All other adjustments (physician fee schedule update, adjustment for 5-year review of Start Printed Page 55321physician work, adjustment for volume and intensity changes) made to the anesthesia fee schedule conversion factor are the same as those applied to the physician fee schedule. To determine the anesthesia fee schedule conversion factor for 2002, we used the following figures:

    Table 20

    2001 Anesthesia Conversion Factor$17.83
    2002 Update0.9523
    Practice Expense RVU Adjustment for 20020.9823
    Adjustment for Base Unit Alignment1.0020
    5-Year Review0.9954
    Volume and Intensity Adjustment0.9982
    2003 Conversion Factor$16.60

    X. Provisions of the Final Rule

    The provisions of this final rule restate the provisions of the August 2001 proposed rule, except as noted elsewhere in the preamble. Following is a highlight of the changes made from the proposed rule:

    For screening glaucoma, we are revising the regulation in § 410.23(a)(2) to read “Eligible beneficiary means individuals in the following high risk categories.” This should allow us to more easily add high-risk groups by rulemaking should the medical evidence warrant it.

    For G0117 Glaucoma Screening for High Risk Patients Furnished by an Optometrist or Ophthalmologist, we will assign 0.45 work RVUs, .02 malpractice RVUs, and we will crosswalk practice expense inputs from CPT code 92012.

    For G0118 Glaucoma Screening for High Risk Patients Furnished Under the Direct Supervision of an Optometrist or Ophthalmologist, we will assign 0.17 work RVUs and 0.01 malpractice RVUs. For practice expense, we will also crosswalk this code to CPT code 92012.

    For medical nutrition therapy, we made various changes in response to comments received. For detailed information, see section III.G.

    For telehealth services section 1834(m)(3) of the Act specifies that sections 1842(b)(18)(A) and (B) apply to physicians and practitioners receiving payment for telehealth services and to originating sites receiving a facility fee, in the same manner as they apply to practitioners. This section requires that payment for these services may only be made on an assignment-related basis. We did not reflect this provision in the proposed rule. Nonetheless, because this requirement is required by the plain language of the law and because we are without discretion with respect to its application, we are implementing it in this final rule in new § 414.65(d).

    Other Issues

    Included in the comments we received were issues and topics that were not specifically included as proposals in the August 2, 2001 proposed rule such as coding issues on specific services, the need to expand dissemination of information on Medicare benefits and a variety of other topics. While we do not address these specifically in this rule, we will ensure that the appropriate CMS components are aware of the concerns expressed and would hope that these concerns can be addressed through appropriate channels.

    XI. Collection of Information Requirements

    Under the Paperwork Reduction Act (PRA) of 1995, we are required to provide 30-day notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues:

    • The need for the information collection and its usefulness in carrying out the proper functions of our agency.
    • The accuracy of our estimate of the information collection burden.
    • The quality, utility, and clarity of the information to be collected.
    • Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.

    We are soliciting public comment on each of these issues for § 410.132 in this document, which contains information collection requirements.

    Paragraph (c) of this section requires a referring physician or practitioner to maintain referral documentation in the beneficiary's medical record for each referral.

    We believe the burden associated with these provisions is exempt in accordance with 5 CFR 1320.3(b)(2) because the time, effort, and financial resources necessary to comply with these requirements would be incurred by referring physicians and practitioners in the normal course of business activities.

    If you comment on these information collection and recordkeeping requirements, please mail copies directly to the following:

    Centers for Medicare & Medicaid Services, Office of Information Services, Information Technology Investment Management Group, Attn.: John Burke, CMS-1169-FC, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850.

    Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Allison Eydt, CMS Desk Officer.

    XII. Response to Comments

    Because of the large number of items of correspondence we normally receive on Federal Register documents published for comment, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, if we proceed with a subsequent document, we will respond to the comments in the preamble to that document.

    XIII. Regulatory Impact Analysis

    We have examined the impact of this final rule as required by Executive Order 12866, the Unfunded Mandates Reform Act of 1995 (UMRA) (Pub. L. 104-4), the Regulatory Flexibility Act of 1980 (RFA) (Pub. L. 96-354), and Executive Order 13132 of August 4, 1999 (Federalism).

    EO 12866 directs agencies to assess costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more annually). While the changes in the Medicare physician fee schedule are, for the most part, budget neutral, they do involve redistribution of Medicare spending among procedures and physician specialties. The redistributive effect of this rule on any particular specialty is in our estimate likely to exceed $100 million for at least one specialty group. For this reason we are considering this a major economic rule.

    However, it is important to note, as indicated in section VII of this preamble, the physician fee update for 2002 under section 1848(d) of the Act is −4.8 percent of an estimated $41.2 billion in physician expenditures for 2001. Even though the physician fee schedule update is −4.8 percent, we project that the total Medicare Start Printed Page 55322expenditures for physicians' services will increase from $41.2 billion to $41.7 billion in 2002.

    The UMRA also requires (in section 202) that agencies prepare an assessment of anticipated costs and benefits before developing any rule that may result in expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million or more. We have determined that this rule has no consequential effect on State, local, or tribal governments. We believe the private sector cost of this rule falls below the above-stated threshold as well.

    The RFA requires that we analyze regulatory options for small businesses and other small entities. We prepare a Regulatory Flexibility Analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives and lessen significant adverse economic impact on the small entities.

    In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area and has fewer than 100 beds.

    For purposes of the RFA, all physicians are considered to be small entities. There are about 700,000 physicians and other practitioners who receive Medicare payment under the physician fee schedule.

    For the purpose of EO 12866 and the RFA we have prepared the following analysis, which, together with the rest of this preamble, meets all four assessment requirements. It explains the rationale for and purpose of the rule, details the costs and benefits of the rule, analyzes alternatives, and presents the measures we considered to minimize the burden on small entities.

    A. 5 Year Review of Physician Work and Resource-Based Practice Expense Relative Value Units

    Revisions in physician work and resource-based practice expense RVUs for physicians' services are required by law to be budget neutral. We calculate total payments from the revisions to work and practice expense relative value units such that total payments do not change more than $20 million as a result of the revisions. Increases in payments for some services are necessarily offset by decreases in payments for other services. For revisions to physician work values that are occuring as part of the 5-year review, we are making a budget neutrality adjustment to the physician fee schedule conversion factor. For practice expense, we adjust all the practice expense RVUs upwards or downwards to meet the budget neutrality requirement in the statute. This means that increases in practice expense RVUs for some services will be offset by corresponding decreases in values for other services. We showed the impact of proposed changes in physician work and practice expense RVUs in our Notice of Proposed Rulemaking in the Federal Register on August 2, 2001 (65 FR 40397). Table 21 shows the impact on total allowed charges by specialty of this final rule's physician work and practice expense RVU changes. We are showing the impact of the proposed rule changes as well additional changes that are occurring as a result of this final rule. There are five changes we are adopting in this final rule that result in changes to the impacts displayed in the proposed rule. Table 21 incorporates additional impacts that result from using 2000 utilization data to determine the resource-based practice expense RVUs. This change has a very modest effect on payment for nearly all specialties. Based on public comments to our notice of proposed rulemaking, we have also made changes to physician work RVUs that were part of the 5-year review. These changes will increase payments to Gastronterology, General Surgery, Obstetrics and Gynecology and Podiatry. We also incorporated revised physician time data supplied to us by the Relative Value Update Committee (RUC). Relative to the physician times used in our proposed rule, there were slight refinements to some codes. With the exception of Nephrology, the new times have virtually no impact on specialty level payments. Nephrology payments will go up as a result of using new physician times supplied to us by the RUC. The RUC supplied us with a time of 186 minutes for the highest volume nephrology procedure code, 90921. This compared to a physician time of 153 minutes that was previously used. Finally, we also incorporated refinements to the practice expense inputs that are being recommended by the Practice Expense Advisory Committee (PEAC) and the RUC. These changes will result in a reduction in average payments to rheumatology of about 6 percent. This occurs primarily as a result of refinements to 4 codes that are frequently performed by rheumatologists (20610, 20550, 20605 and 20600). Based on the PEAC and RUC comments, we made changes to the practice expense inputs that result in a reduction in relative payments for these procedure codes. Other specialties that will experience a smaller reduction in payments as a result of the practice expense refinements for 2002 are Orthopedic Surgery, Podiatry and Urology. Since the changes are budget neutral, the reductions in practice expense RVUs will be offset by increases in practice expense payments that will be broadly distributed among other physician specialties.

    Table 21 shows the impact of this final rule compared to the proposed rule that was published on August 2, 2001. We note that the table shows the impact of this rule only and does not incorporate practice expense changes from three other final rules, November 2, 1998 (63 FR 58895), November 2, 1999 (64 FR 59433) and November 1, 2000 (65 FR 65377). The table shows the average specialty change in payments in CY 2002 that are occurring as a result of this final rule relative to what would have occurred in 2002 had this rule not been published. The rule shows the redistributive (or relative) change in payments among specialties. It does not show the absolute average change in specialty level payments from 2001 to 2002 that are also affected by the final year of the transition to resource-based practice expense RVUs and the physician fee schedule update. The transition to resource-based RVUs is complete in CY 2002 and has no effect when comparing the impact on CY 2002 payments before and after changes made in this final rule. The physician fee schedule update and change to the conversion factor are discussed in sections VII and IX, respectively.Start Printed Page 55323

    Table 21.—Impact of Physician Work and Practice Expense Relative Value Unit Changes—Final Rule Compared to Proposed Rule

    SpecialtyAllowed charges (billions)Proposed rule impact (percent)Final rule impact (percent)
    Anesthesiology$1.511
    Cardiac Surgery0.300
    Cardiology4.20−1
    Chiropractor0.400
    Clinics1.600
    Dermatology1.412
    Emergency Medicine1.000
    Family Practice3.300
    Gastroenterology1.213
    General Practice1.000
    General Surgery2.044
    Hematology Oncology0.601
    Internal Medicine7.101
    Nephrology1.002
    Neurology0.900
    Neurosurgery0.400
    Nonphysician Practitioner1.201
    Obstetrics/Gynecology0.412
    Ophthalmology3.9-1-1
    Optometrist0.50-3
    Orthopedic Surgery2.30-1
    Other Physician1.410
    Otolaryngology0.601
    Pathology0.633
    Plastic Surgery0.201
    Podiatry1.110
    Psychiatry1.100
    Pulmonary1.101
    Radiation Oncology0.70−2
    Radiology3.30−1
    Rheumatology0.30−6
    Suppliers0.720
    Thoracic Surgery0.510
    Urology1.311
    Vascular Surgery0.321

    Table 22, titled Impact of 5-Year Review and Proposed Rule on Medicare Payments for Selected Procedures, shows the percentage change in total payment (in CY 2002 physician fee schedule dollars) for selected high-volume procedures that result from changes to the physician work, practice expense and malpractice announced in this final rule. These tables reflect the impact of this final rule only on the fully implemented fee schedule amount. The payments in these columns are determined using a conversion factor $36.1992. The RVUs used for calculating payment in the “old” columns are from the November 1, 2000 final rule. The RVUs used in calculating payments in the “new” columns are from this final rule. By using the same conversion factor of $36.1992 to calculate payments in both the “old” and “new” columns, the impact of changes to the RVUs that are included in this final rule are illustrated. These tables do not show the actual impact on payment from 2001 to 2002 that are also affected by the final year of the practice expense transition and physician fee schedule update.

    Table 22.—Impact of 5 Year Review and Proposed Rule on Medicare Payment for Selected Procedures

    HCPCSMODDESCOld non- facilityNew non- facilityPercent changeOld facilityNew facilityPercent change
    11721Debride nail, 6 or more$40.18$36.92−8$28.96$28.960
    17000Destroy benign/premal lesion60.4562.62432.5832.941
    27130Total hip replacementNANANA1,419.011,452.312
    27236Treat thigh fractureNANANA1,088.871,113.852
    27244Treat thigh fractureNANANA1,111.681,137.382
    27447Total knee replacementNANANA1,483.081,514.212
    33533CABG, arterial, singleNANANA1,756.021,827.344
    35301Rechanneling of arteryNANANA1,107.331,061.36−4
    43239Upper GI endoscopy, biopsy281.99354.7526148.78154.934
    45385Lesion removal colonoscopy474.93571.2220283.44287.782
    66821After cataract laser surgery217.56229.506203.44213.945
    66984Cataract surg w/iol, i stageNANANA660.27669.321
    67210Treatment of retinal lesion594.03603.082544.44546.610Start Printed Page 55324
    7101026Chest x-ray9.059.0509.059.050
    7102026Chest x-ray11.2211.22011.2211.220
    76091Mammogram, both breasts84.3490.507NANANA
    7609126Mammogram, both breasts35.1143.442435.1143.4424
    76092Mammogram, screening71.0380.721471.0380.7214
    7609226Mammogram, screening22.7335.485622.7335.4856
    77427Radiation tx management, x5167.24167.960167.24167.960
    7846526Heart image (3d), multiple75.2974.93−175.2974.93−1
    8830526Tissue exam by pathologist39.8240.54239.8240.542
    90801Psy dx interview145.52144.80−1137.19137.190
    90806Psytx, off, 45-50 min96.6595.93−191.2291.220
    90807Psytx, off, 45-50 min w/e&m103.89103.53098.8298.820
    90862Medication management51.0451.04046.3346.330
    90921ESRD related services, month263.89273.304263.89273.304
    90935Hemodialysis, one evaluationNANANA73.4876.384
    92004Eye exam, new patient124.16123.44−187.6087.960
    92012Eye exam established pat62.6261.18−235.8435.840
    92014Eye exam & treatment89.7791.22259.0058.64−1
    92980Insert intracoronary stentNANANA799.64790.59−1
    92982Coronary artery dilationNANANA592.22584.26−1
    93000Electrocardiogram, complete26.0625.34−3NANANA
    93010Electrocardiogram report9.059.0509.059.050
    93015Cardiovascular stress test102.8199.91−3NANANA
    9330726Echo exam of heart48.5148.14−148.5148.14−1
    9351026Left heart catheterization232.76230.59−1232.76230.59−1
    98941Chiropractic manipulation35.4835.48030.7731.131
    99202Office/outpatient visit, new60.4561.54245.6145.610
    99203Office/outpatient visit, new90.5091.95269.5069.500
    99204Office/outpatient visit, new130.32130.680102.81102.810
    99205Office/outpatient visit, new165.07166.151136.11136.470
    99211Office/outpatient visit, est19.9120.2728.698.690
    99212Office/outpatient visit, est35.4836.20223.1723.170
    99213Office/outpatient visit, est49.5950.32234.0334.030
    99214Office/outpatient visit, est78.1978.91155.7556.111
    99215Office/outpatient visit, est114.39115.84190.1490.500
    99221Initial hospital careNANANA65.1665.160
    99222Initial hospital careNANANA107.87108.240
    99223Initial hospital careNANANA150.59150.950
    99231Subsequent hospital careNANANA32.5832.580
    99232Subsequent hospital careNANANA53.2153.571
    99233Subsequent hospital careNANANA76.0276.381
    99236Observ/hosp same dateNANANA213.58214.661
    99238Hospital discharge dayNANANA64.0766.243
    99239Hospital discharge dayNANANA87.6090.864
    99241Office consultation46.3347.06232.9433.301
    99242Office consultation86.1587.24167.6968.051
    99243Office consultation114.39115.84190.1490.140
    99244Office consultation162.53164.341133.21133.580
    99245Office consultation211.04212.851176.65177.010
    99251Initial inpatient consultNANANA36.2034.75−4
    99252Initial inpatient consultNANANA71.3169.86−2
    99253Initial inpatient consultNANANA96.6595.20−2
    99254Initial inpatient consultNANANA138.28136.83−1
    99255Initial inpatient consultNANANA189.68188.60−1
    99261Follow-up inpatient consultNANANA23.5321.72−8
    99262Follow-up inpatient consultNANANA45.2543.44−4
    99263Follow-up inpatient consultNANANA66.2464.80−2
    99282Emergency dept visitNANANA26.4326.430
    99283Emergency dept visitNANANA59.3759.370
    99284Emergency dept visitNANANA92.6792.670
    99285Emergency dept visitNANANA144.43144.800
    99291Critical care, first hourNANANA197.65198.370
    99292Critical care, addl 30 minNANANA98.4698.820
    99301Nursing facility care60.0970.231760.0960.090
    99302Nursing facility care80.3695.571980.3680.720
    99303Nursing facility care99.91118.731999.91100.270
    99311Nursing fac care, subseq30.0540.183430.0530.050
    99312Nursing fac care, subseq49.5961.902549.5949.951
    99313Nursing fac care, subseq70.5984.342070.5970.951Start Printed Page 55325
    99348Home visit, est patient73.1273.851NANANA
    99350Home visit, est patient166.88166.520NANANA

    (In two different places above, we indicate that the tables do not include the effect of the “final” year of the practice expense transition. While we note that resource-based practice expense will be fully implemented in 2002, our expectation is that we would continue to make refinements that improve the practice expense relative value units. We acknowledge that the efforts of the PEAC and RUC to make useful comments on practice expense inputs have resulted in significant improvements to the data we are using to determine practice expense relative value units. The refinements we have made to date have affected hundreds of procedure codes accounting for a high percentage of Medicare expenditures paid under the physician fee schedule. Our expectation is that this work will continue and we continue, to welcome comments and input from all members of the public interested in these issues).

    B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies

    As discussed in section II.B. of the preamble, this regulation will expand the list of practitioners for whose services Medicare may make payment for screening flexible sigmoidoscopies to include nurse practitioners, physician assistants, and clinical nurse specialists, as long as those practitioners meet applicable Medicare qualification requirements, and they are authorized to perform those screening services under State law. At present, the Medicare condition of coverage for screening flexible sigmoidoscopies limits coverage of those services to those that are performed by either a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act) who is authorized under State law to perform the examination.

    We estimate that this expansion in the scope of practitioners who can receive Medicare payment for screening flexible sigmoidoscopies will increase beneficiary access to these screening services and will result in an increase in the number of covered exams that are performed. At the same time, we estimate that this final rule will result in a decrease in payments that are made for certain screening flexible sigmoidoscopies because they will be performed by nurse practitioners, physician assistants, and clinical nurse specialists, since services they provide are paid at 85 percent of the amount of payment that is made to physicians for the same screening service. Taking these factors into account, we estimate that this provision will result in negligible additional Medicare program costs. For a more detailed discussion of this provision see section II.B. of this preamble.

    C. Services and Supplies Incident to a Physician's Professional Services—Conditions

    Under this rule auxiliary personnel may provide services incident to the services of physicians (or other practitioners) who supervise them, regardless of the employment relationship. There are no costs or savings to the Medicare program associated with this provision. This provision could result in increased beneficiary access to the auxiliary personnel. For a more detailed discussion of this provision see section II.C. of this preamble.

    D. Anesthesia Services—Anesthesia Base Units

    As previously discussed in section II.D. of the preamble, with the exception of codes 00142 and 00147, we are using the same anesthesia base unit per anesthesia code as the ASA provides in its uniform relative value guide. There are eleven codes where our base unit value for an anesthesia code differed from the corresponding ASA base unit. Using the ASA base units resulted in an increase for 8 codes and a decrease for 3 codes. New and revised codes starting in CY 2000 and for subsequent years are evaluated on a code-specific basis under our usual process after we receive recommendations from the RUC. Thus, because of our review of the RUC recommendations, there could be differences between the ASA's guide and our base units beginning in CY 2000.

    We have determined the budget neutrality impact on the anesthesia CF for the 11 codes for which CMS's base units are equal to the ASA's base units as well as the addition of 19 new anesthesia codes in CY 2002. The impact was determined by estimating the increase or decrease in base units between our base units and the ASA's base units for existing codes as well as the increase and decrease in base units between the new 2002 codes and the previous codes by which the services would have been reported. This results in an increase of approximately .2 percent in the 2002 anesthesia CF. For a more detailed discussion of this provision see section II.D. of this preamble.

    E. Performance Measurement and Emerging Technology Codes

    As previously discussed in section II.E. of the preamble, the AMA has developed two new categories of codes—performance codes and emerging technology. Allowing the performance measurement code to be recorded on Medicare billing forms will have no budgetary impact since we are not proposing payment for these codes. We are allowing for carrier pricing of the emerging technology codes.

    We expect that the emerging technology codes will be used infrequently and may be used in place of “unlisted” procedure codes that are also carrier-priced. There would be few, if any, Medicare program costs associated with this proposal. For a more detailed discussion of this provision see section II.E. of this preamble.

    F. BIPA Provisions Included in This Final Rule

    The following provisions of the BIPA are discussed in detail in section III of this preamble. This final rule conforms the regulations text to the BIPA provisions. We showed the anticipated costs associated with the BIPA provisions in our August 2, 2001 proposed rule (66 FR 40400). We are showing that same table again in table 23 below.Start Printed Page 55326

     Table 23.—Medicare Cost Estimates for BIPA 2000 Provisions

    [In millions]

    BIPA provisionsFY 2002FY 2003FY 2004FY 2005FY 2006
    Sec. 101 Biennial Pelvic Examinations1020202020
    Sec. 102 Screening Glaucoma3050506060
    Sec. 103 Screening Colonoscopy4040301010
    Sec. 104 Screening Mammography3040404050
    Sec. 105 Medical Nutrition2050607070
    Sec. 223 Telehealth Services2030405060
    Sec. 432 Indian Health6070808090

    1. Screening Mammography

    As discussed in section III.A. of the preamble, the BIPA eliminates the statutorily prescribed payment rate for screening mammography and specifies that it will be paid under the physician fee schedule beginning January 1, 2002. To pay for the professional component of the screening mammography, we are using the work and malpractice RVUs that have been established for unilateral diagnostic mammography. We are establishing the practice expense RVUs for the professional component under the resource-based methodology. The process we used to establish the practice expense RVU for the TC is described in detail in section III.A. Currently, we pay for screening mammography under section 1834(c) of the Act. Payment for screening mammography under that section is not subject to the budget neutrality requirements that apply to physician fee schedule services under section 1848(c)(2)(B)(ii)(II) of the Act. However, effective January 1, 2002, screening mammography will be paid under the physician fee schedule and, thus, subject to the budget neutrality requirements that apply to physician fee schedule services. We will include the current payment amounts for screening mammography in aggregate physician fee schedule payments subject to the budget neutrality requirements. As a result, the BIPA requirement that we pay for screening mammography under the physician fee schedule will not result in an increase in Medicare program expenditures. However, the increase in payment for screening mammography under the physician fee schedule will be included in the budget neutrality adjustments that apply to physician fee schedule services. The BIPA also establishes a methodology for determining payment for certain types of new technology that are used in providing both diagnostic and screening mammography services. The statutory provisions are in effect from April 1, 2001 to December 31, 2001. The statute gives us the authority to determine whether separate codes and payment amounts are appropriate for screening and diagnostic mammography services that involve use of a new technology on or after January 1, 2002. We are establishing several new codes and fee schedule amounts for screening and diagnostic mammography services that involve use of a new technology. We believe this will help ensure that all Medicare beneficiaries have access to the benefits of mammography, including recent advances that further enhance the clinical capability of this vital health service for women. The BIPA provisions related to new technology mammography will result in the Medicare program costs shown in Table 23. The BIPA makes no changes to provisions for Medicare coverage of screening mammography.

    2. Screening Pelvic Examinations

    As discussed in section III.B. of the preamble, section 101 of the BIPA provides for expanded coverage for screening pelvic examinations (including a clinical breast examination) furnished on or after July 1, 2001. Specifically, the revised benefit will allow for biennial coverage of screening pelvic examination for all women who do not qualify under the law for annual coverage of such tests. We estimate that this change in the frequency of coverage for certain beneficiaries will result in an increase in Medicare payments. These payments will be made to a large number of physicians and other practitioners who provide these tests and for any medically necessary follow-up tests, or treatment that may be required as a result of the increased frequency of coverage of these tests. Medicare program expenditures associated with screening pelvic examinations have been included in the President's budget for Medicare expenditures. The impact of this provision is shown in Table 23.

    3. Screening for Glaucoma

    As discussed in section III.C. of the preamble, section 102 of the BIPA authorizes coverage of glaucoma screening examinations effective January 1, 2002, subject to certain frequency and other limitations. We believe services provided as part of glaucoma screening will often overlap with other services a physician provides during a patient encounter that is associated with a higher payment amount. We believe that physicians will more commonly provide glaucoma tests in conjunction with other services and will rarely provide only glaucoma screening to Medicare patients. Based on the projected utilization of these screening services and related medically necessary follow-up tests and treatment that may be required for the beneficiaries screened, we estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to ophthalmologists or optometrists who will provide these screening tests and for any related follow-up tests and treatment that may be required. Medicare program expenditures associated with the BIPA provision that establishes coverage for screening glaucoma are shown in Table 23. The addition of the screening glaucoma benefit will allow a greater number of beneficiaries access to a preventive service.

    4. Screening Colonoscopy

    As discussed in section III.D. of the preamble, section 103 of the BIPA amended the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to practitioners who will provide these screening tests and related follow-up tests and treatment that may be required. The addition of the screening colonoscopy benefit will allow beneficiaries who are not at high risk for colorectal cancer greater access to preventive services. The impact of this provision is shown in Table 23.

    5. Medical Nutrition Therapy

    As discussed in section III.E. of the preamble, section 105 of the BIPA Start Printed Page 55327amended the Act to authorize Medicare coverage under Part B of medical nutrition therapy (MNT) for beneficiaries who have diabetes or renal disease, effective for services furnished on or after January 1, 2002. We are implementing this provision in 42 CFR at part 410, in subpart G. Specifically, the final rule discusses the education, experience, and licensing requirements for dietitians or nutritionists furnishing the service. In addition, the final rule discusses a referral requirement and the manner by which the medical nutrition therapy and diabetes outpatient self-management training benefits will be coordinated to avoid duplicate payment. We are also establishing payment amounts for these services under the physician fee schedule.

    We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to dietitians and nutrition professionals who will provide these diagnostic therapy and counseling services. Costs to the Medicare program associated with this provision are shown in Table 23.

    6. Telehealth

    We estimate that the cost of providing office or other outpatient visits, consultation services, individual psychotherapy, and pharmacologic management in accordance with section 223 of the BIPA will be approximately $20 million in FY 2002 and approximately $60 million by FY 2006, as indicated above in Table 23.

    This final rule does not mandate that entities provide consultation, office or other outpatient visits, individual psychotherapy or pharmacological management services via a telecommunications system. Thus, this final rule will not require entities to purchase telehealth equipment or to acquire the telecommunications infrastructure necessary to deliver these services via a telecommunications system. Therefore, this final rule does not impose costs associated with starting and operating a telehealth network.

    7. Indian Health Services

    As discussed in section III.G. of the preamble, section 432 of the BIPA authorizes payment under the physician fee schedule to physicians and certain practitioners for services furnished in a hospital and an ambulatory care clinic, whether provider-based or free-standing, of the Indian Health Service effective for services furnished on or after July 1, 2001. We are adding a new § 410.46 to conform our regulations to the statute. Costs to the Medicare program for this BIPA provision are shown in Table 23.

    8. Pathology Services

    As discussed in section III.H. of the preamble, in the November 2, 1999 physician fee schedule final rule (64 FR 59381), we stated that we would implement a policy to pay only hospitals for the TC of physician pathology services furnished to hospital inpatients. Before the effective date of this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology to a hospital inpatient. That regulation provided that for services furnished on or after January 1, 2001, the carriers would no longer pay claims to an independent laboratory under the physician fee schedule for the TC of physician pathology services furnished for hospital inpatients. Similar treatment was provided under the hospital outpatient prospective payment system for the TC of physician pathology services to hospital outpatients. We delayed implementation of this provision for one year; it was to take effect for services furnished on or after January 1, 2001. The delay was intended to allow independent laboratories and hospitals sufficient time to negotiate arrangements.

    Section 542 of the BIPA requires Medicare to continue to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital. This provision applies to TC services furnished during the 2-year period beginning on January 1, 2001.

    In the November 2, 1999 final rule, we estimated that payment under the physician fee schedule for TC billings by independent laboratories would decrease by $6 million per year if the original proposal had been implemented on January 1, 2001. As a result of the BIPA, these savings are not realized for two years.

    G. Update of the Codes for the Physician Self-Referral Prohibition

    As discussed in section VI of this preamble, we are updating the list of codes used to define certain designated health services for the purposes of section 1877 of the Act. We are not making any substantive change to the description of any designated health service as set forth in the January 4, 2001 physician self-referral final rule (66 FR 856). Instead, we are merely updating our list of codes to conform to coding changes in the most recent publication of CPT and HCPCS codes. For this reason, we certify that the changes we are making will not have a significant economic effect on a substantial number of small entities or on the operations of a substantial number of small rural hospitals. For an in-depth discussion of the anticipated effects of the recent physician self-referral final rule, refer to the regulatory impact statement in that rule as published in the January 4, 2001 Federal Register (66 FR 856).

    H. Budget-Neutrality

    The increase in physician work RVUs will necessitate an adjustment to meet the statute's budget neutrality requirements. We are reducing the physician fee schedule CF by -0.46 percent (CF X 0.9954) to ensure that the increase in physician work RVUs remains budget neutral across all physician fee schedule services. Each year since the fee schedule has been implemented, our actuaries have determined any adjustments needed to meet the budget-neutrality requirement of the statute. A component of the actuarial determination of budget-neutrality involves estimating the impact of changes in the volume and intensity of physicians' services provided to Medicare beneficiaries as a result of the proposed changes to relative value units. Consistent with the provision in the November 1998 final rule, the actuaries would use a model that assumes a 30 percent volume-and-intensity response to price reductions. Based on the practice expense changes that will occur in 2002, the actuaries estimate that a -0.18 (CF X 0.9982) percent adjustment to the conversion factor is necessary to meet the budget neutrality requirements in the statute. If the assumed volume and intensity offset does not occur, the offset applied to the RVUs will be, in essence, returned because there will be a future year adjustment to the physician fee schedule update.

    I. Impact on Beneficiaries

    Although changes in physicians' payments when the physician fee schedule was implemented in 1992 were large, we detected no problems with beneficiary access to care. Furthermore, since beginning our transition to a resource-based practice expense system in 1999, we have not found that there are problems with beneficiary access to care.

    J. Federalism

    We have reviewed this proposed rule under the threshold criteria of EO 13132, Federalism, and we have determined that the proposed rule does Start Printed Page 55328not significantly affect the rights, roles, and responsibilities of States.

    Start List of Subjects

    List of Subjects

    42 CFR Part 405

    • Administrative practice and procedure
    • Health facilities
    • Health professions
    • Kidney diseases
    • Medicare
    • Reporting and recordkeeping requirements
    • Rural areas
    • X-rays

    42 CFR Part 410

    • Health facilities
    • Health professions
    • Kidney diseases
    • Laboratories
    • Medicare
    • Rural areas
    • X-rays

    42 CFR Part 411

    • Kidney diseases
    • Medicare
    • Reporting and recordkeeping requirements

    42 CFR Part 414

    • Administrative practice and procedure
    • Health facilities
    • Health professions
    • Kidney diseases
    • Medicare
    • Reporting and recordkeeping requirements
    • Rural areas
    • X-rays

    42 CFR Part 415

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

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

    End Amendment Part Start Part

    PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED

    End Part Start Amendment Part

    1. The authority citation for part 405 continues to read as follows:

    End Amendment Part Start Authority

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

    End Authority Start Amendment Part

    2. In § 405.534, an introductory paragraph is added to read as follows:

    End Amendment Part
    Limitation on payment for screening mammography services.

    The provisions in paragraphs (a), (b), and (c) of this section apply for services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are paid under the physician fee schedule in accordance with § 414.2 of this chapter.

    * * * * *
    Start Amendment Part

    3. In § 405.535, the section heading is revised and the introductory text is amended by adding two sentences to the beginning to read as follows:

    End Amendment Part
    Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.

    The provisions in this section apply for screening mammography services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are physician services pursuant to § 414.2 of this chapter paid under the physician fee schedule. * * *

    * * * * *
    Start Part

    PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

    End Part Start Amendment Part

    1. The authority citation for part 410 continues to read as follows:

    End Amendment Part Start Authority

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

    End Authority Start Amendment Part

    2. Section 410.3 is amended by revising paragraph (a)(1) to read as follows:

    End Amendment Part
    Scope of benefits.

    (a) * * *

    (1) Medical and other health services such as physicians' services, outpatient services furnished by a hospital or a CAH, diagnostic tests, outpatient physical therapy and speech pathology services, rural health clinic services, Federally qualified health center services, IHS, Indian tribe, or tribal organization facility services, and outpatient renal dialysis services.

    * * * * *
    Start Amendment Part

    3. Section 410.10 is amended by adding paragraph (x) to read as follows:

    End Amendment Part
    Medical and other health services: Included services.
    * * * * *

    (x) Services of physicians and other practitioners furnished in or at the direction of an IHS or Indian tribal hospital or clinic.

    Start Amendment Part

    4. Section 410.22 is redesignated as § 410.21, § 410.23 is redesignated as § 410.22, and a new § 410.23 is added to read as follows:

    End Amendment Part
    Screening for glaucoma: Conditions for and limitations on coverage.

    (a) Definitions: As used in this section, the following definitions apply:

    (1) Direct supervision in the office setting means the optometrist or the ophthalmologist must be present in the office suite and be immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed.

    (2) Eligible beneficiary means individuals in the following high risk categories:

    (i) Individual with diabetes mellitus;

    (ii) Individual with a family history of glaucoma; or

    (iii) African-Americans age 50 and over.

    (3) Screening for glaucoma means the following procedures furnished to an individual for the early detection of glaucoma:

    (i) A dilated eye examination with an intraocular pressure measurement.

    (ii) A direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination.

    (b) Condition for coverage of screening for glaucoma.

    Medicare Part B pays for glaucoma screening examinations provided to eligible beneficiaries as described in paragraph (a)(2) of this section if they are furnished by or under the direct supervision in the office setting of an optometrist or ophthalmologist who is legally authorized to perform these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished, as would otherwise be covered if furnished by a physician or incident to a physician's professional service.

    (c) Limitations on coverage of glaucoma screening examinations.

    (1) Payment may not be made for a glaucoma screening examination that is performed for an individual who is not an eligible beneficiary as described in paragraph (a)(2) of this section.

    (2) Payment may be made for a glaucoma screening examination that is performed on an individual who is an eligible beneficiary as described in paragraph (a)(2) of this section, after at least 11 months have passed following the month in which the last glaucoma screening examination was performed.

    Start Amendment Part

    5. In § 410.26, paragraph (b) is redesignated as paragraph (c), paragraph (a) is redesignated as paragraph (b) and revised, a new paragraph (a) is added, and newly designated paragraph (c) is amended by adding a paragraph heading:

    End Amendment Part
    Services and supplies incident to a physician's professional service: Conditions.

    (a) Definitions. For purposes of this section, the following definitions apply:

    (1) Auxiliary personnel means any individual who is acting under the supervision of a physician (or other practitioner), regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner).

    (2) Direct supervision means the level of supervision by the physician (or other practitioner) of auxiliary personnel as defined in § 410.32(b)(3)(ii).Start Printed Page 55329

    (3) Independent contractor means an individual who performs part-time or full-time work for which the individual receives an IRS-1099 form.

    (4) Leased employment means an employment relationship that is recognized by applicable State law and that is established by two employers by a contract such that one employer hires the services of an employee of the other employer.

    (5) Noninstitutional setting means all settings other than a hospital or skilled nursing facility.

    (6) Practitioner means a non-physician practitioner who is authorized by the Act to receive payment for services incident to his or her own services.

    (7) Services and supplies means any services or supplies (including drugs or biologicals that are not usually self-administered) that are included in section 1861(s)(2)(A) of the Act and are not specifically listed in the Act as a separate benefit included in the Medicare program.

    (b) Medicare Part B pays for services and supplies incident to the service of a physician (or other practitioner).

    (1) Services and supplies must be furnished in a noninstitutional setting to noninstitutional patients.

    (2) Services and supplies must be an integral, though incidental, part of the service of a physician (or other practitioner) in the course of diagnosis or treatment of an injury or illness.

    (3) Services and supplies must be commonly furnished without charge or included in the bill of a physician (or other practitioner).

    (4) Services and supplies must be of a type that are commonly furnished in the office or clinic of a physician (or other practitioner).

    (5) Services and supplies must be furnished under the direct supervision of the physician (or other practitioner). The physician (or other practitioner) directly supervising the auxiliary personnel need not be the same physician (or other practitioner) upon whose professional service the incident to service is based.

    (6) Services and supplies must be furnished by the physician, practitioner with an incident to benefit, or auxiliary personnel.

    (7) A physician (or other practitioner) may be an employee or an independent contractor.

    (c) Limitation. * * *

    Start Amendment Part

    6. In § 410.37, paragraphs (d), (e)(2), and (g) are revised and paragraph (e)(3) is added to read as follows:

    End Amendment Part
    Colorectal cancer screening tests: Conditions for and limitations on coverage.
    * * * * *

    (d) Condition for coverage of flexible sigmoidoscopy screening. Medicare Part B pays for a flexible sigmoidoscopy screening service if it is performed by a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act), or by a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5) of the Act and §§ 410.74, 410.75, and 410.76) who is authorized under State law to perform the examination.

    (e) Limitations on coverage of screening flexible sigmoidoscopies. * * *

    (2) For an individual 50 years of age or over, except as described in paragraph (e)(3) of this section, payment may be made for screening flexible sigmoidoscopy after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.

    (3) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening colonoscopy performed, payment may be made for a screening flexible sigmoidosocopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.

    * * * * *

    (g) Limitations on coverage of screening colonoscopies. (1) Effective for services furnished on or after January 1, 1998 through June 30, 2001, payment may not be made for a screening colonoscopy for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section.

    (2) Effective for services furnished on or after July 1, 2001, except as described in paragraph (g)(4) of this section, payment may be made for a screening colonoscopy performed for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 119 months have passed following the month in which the last screening colonoscopy was performed.

    (3) Payment may be made for a screening colonoscopy performed for an individual who is at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 23 months have passed following the month in which the last screening colonoscopy was performed, or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.

    (4) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening flexible sigmoidoscopy performed, payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed.

    * * * * *
    Start Amendment Part

    7. Section 410.46 is added to read as follows:

    End Amendment Part
    Physician and other practitioner services furnished in or at the direction of an IHS or Indian tribal hospital or clinic: Scope and conditions.

    (a) Medicare Part B pays, in accordance with the physician fee schedule, for services furnished in or at the direction of a hospital or outpatient clinic (provider-based or free-standing) that is operated by the Indian Health Service (IHS) or by an Indian tribe or tribal organization (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These services are subject to the same situations, terms, and conditions that would apply if the services were furnished in or at the direction of a hospital or clinic that is not operated by IHS or by an Indian tribe or tribal organization. Payments include health professional shortage areas incentive payments when the requirements for these incentive payments in § 414.42 of this chapter are met.

    (b) Payment is not made under this section to the extent that Medicare otherwise pays for the same services under other provisions.

    (c) Payment is made under these provisions for the following services:

    (1) Services for which payment is made under the physician fee schedule in accordance with part 414 of this chapter.

    (2) Services furnished by non-physician practitioners for which payment under Part B is made under the physician fee schedule.

    (3) Services furnished by a physical therapist or occupational therapist, for which payment under Part B is made under the physician fee schedule.

    (d) Payments under these provisions will be paid to the IHS or tribal hospital or clinic.

    Start Amendment Part

    8. In § 410.56, paragraphs (b)(1), the introductory text of (b)(2), and (b)(3) are revised to read as follows:

    End Amendment Part
    Screening pelvic examinations.
    * * * * *
    Start Printed Page 55330

    (b) * * *

    (1) General rule. Except as specified in paragraphs (b)(2) and (b)(3) of this section, payment may be made for a pelvic examination performed on an asymptomatic woman only if the individual has not had a pelvic examination paid for by Medicare during the preceding 23 months following the month in which her last Medicare-covered screening pelvic examination was performed.

    (2) More frequent screening based on high-risk factors. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner specified in paragraph (a) of this section, and there is evidence that the woman is at high risk (on the basis of her medical history or other findings) of developing cervical cancer or vaginal cancer, as determined in accordance with the following risk factors:

    * * * * *

    (3) More frequent screening for women of childbearing age. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner as specified in paragraph (a) of this section for a woman of childbearing age who has had an examination that indicated the presence of cervical or vaginal cancer or other abnormality during any of the preceding 3 years. The term “woman of childbearing age” means a woman who is premenopausal, and has been determined by a physician, or a qualified practitioner, as specified in paragraph (a) of this section, to be of childbearing age, based on her medical history or other findings.

    * * * * *
    Start Amendment Part

    9. Section 410.78 is revised to read as follows:

    End Amendment Part
    Office and other outpatient visits, consultation, individual psychotherapy and pharmacologic management via an interactive telecommunications system.

    (a) Definitions. For the purposes of this section the following definitions apply:

    (1) Asynchronous store and forward technologies means the transmission of a patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. An asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines and text messages without visualization of the patient (electronic mail). Photographs visualized by a telecommunications system must be specific to the patient's medical condition and adequate for furnishing or confirming a diagnosis and or treatment plan. Dermatological photographs, for example, a photograph of a skin lesion, may be considered to meet the requirement of a single media format under this provision.

    (2) Distant site means the site at which the physician or practitioner delivering the service is located at the time the service is provided via a telecommunications system.

    (3) Interactive telecommunications system means multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.

    (4) Originating site means, for purposes of a consultation, office or other outpatient visit, individual psychotherapy, or pharmacologic management via an interactive telecommunications system, the location of an eligible Medicare beneficiary at the time the service being furnished via a telecommunications system occurs. For asynchronous store and forward telecommunications technologies, the only originating sites are Federal telemedicine demonstration programs conducted in Alaska or Hawaii.

    (b) General rule. Medicare Part B pays for office and other outpatient visits, professional consultation, individual psychotherapy, and pharmacologic management furnished by means of an interactive telecommunications system if the following conditions are met:

    (1) The physician or practitioner at the distant site must be licensed to provide the service under State law. When the physician or practitioner at the distant site is licensed under State law to provide a covered telehealth service (that is, professional consultations, office and other outpatient visits, individual psychotherapy, and pharmacologic management), he or she may bill for, and receive payment for, this service when delivered via a telecommunications system.

    (2) The practitioner at the distant site is one of the following:

    (i) A physician as described in § 410.20.

    (ii) A physician assistant as described § 410.74.

    (iii) A nurse practitioner as described in § 410.75.

    (iv) A clinical nurse specialist as described in § 410.76.

    (v) A nurse-midwife as described in § 410.77.

    (vi) A clinical psychologist as described in § 410.71.

    (vii) A clinical social worker as described in § 410.73.

    (3) The services are furnished to a beneficiary at an originating site, which is one of the following:

    (i) The office of a physician or practitioner.

    (ii) A critical access hospital (as described in section 1861(mm)(1) of the Act).

    (iii) A rural health clinic (as described in section 1861(aa)(2) of the Act).

    (iv) A Federally qualified health center (as defined in section 1861(aa)(4) of the Act).

    (v) A hospital (as defined in section 1861(e) of the Act).

    (4) Originating sites must be located in either a rural health professional shortage area as defined under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in section 1886(d)(2)(D) of the Act. Entities participating in a Federal telemedicine demonstration project that have been approved by, or receive funding from, the Secretary as of December 31, 2000 qualify as an eligible originating site regardless of geographic location.

    (5) The medical examination of the patient is under the control of the physician or practitioner at the distant site.

    (c) Telepresenter not required. A telepresenter is not required as a condition of payment unless a telepresenter is medically necessary as determined by the physician or practitioner at the distant site.

    (d) Exception to the interactive telecommunications system requirement. For Federal telemedicine demonstration programs conducted in Alaska or Hawaii only, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system.

    (e) Limitation. A clinical psychologist and a clinical social worker may bill and receive payment for individual psychotherapy via a telecommunications system, but may Start Printed Page 55331not seek payment for medical evaluation and management services.

    Start Amendment Part

    10. A new subpart G is added to read as follows:

    End Amendment Part
    Subpart G—Medical Nutrition Therapy
    410.130
    Definitions.
    410.132
    Medical nutrition therapy.
    410.134
    Provider qualifications.

    Subpart G—Medical Nutrition Therapy

    Definitions.

    For the purposes of this subpart, the following definitions apply:

    Chronic renal insufficiency means the stage of renal disease associated with a reduction in renal function not severe enough to require dialysis or transplantation (glomerular filtration rate [GFR] 13-50 ml/min/1.73m2).

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

    Episode of care means services covered in a 12-month time period when coordinated with initial diabetes self-management training (DSMT) and one calendar year for each year thereafter, starting with the assessment and including all covered interventions based on referral(s) from a physician as specified in § 410.132(c). The time period covered for gestational diabetes extends only until the pregnancy ends.

    Medical nutrition therapy services means nutritional diagnostic, therapeutic, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing diabetes or a renal disease.

    Physician means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action (including a physician within the meaning of section of 1101(a)(7) of the Act).

    Renal disease means chronic renal insufficiency, end-stage renal disease when dialysis is not received, or the medical condition of a beneficiary for 36 months after kidney transplant.

    Treating physician means the primary care physician or specialist coordinating care for the beneficiary with diabetes or renal disease.

    Medical nutrition therapy.

    (a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services provided by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the treating physician. Services covered consist of face-to-face nutritional assessments and interventions in accordance with nationally accepted dietary or nutritional protocols.

    (b) Limitations on coverage of MNT services.

    (1) MNT services based on a diagnosis of renal disease as described in this subpart are not covered for beneficiaries receiving maintenance dialysis for which payment is made under section 1881 of the Act.

    (2) A beneficiary may only receive the maximum number of hours covered under the DSMT benefit for both DSMT and MNT during the initial DSMT training period unless additional hours are determined to be medically necessary under the national coverage determination process.

    (3) In years when the beneficiary is eligible for MNT and follow-up DSMT, the beneficiary may only receive the maximum number of hours covered under MNT unless additional hours are determined to be medically necessary under the national coverage determination process.

    (4) If a beneficiary has both diabetes and renal disease, the beneficiary may only receive the maximum number of hours covered under the renal MNT benefit in one episode of care unless he or she is receiving initial DSMT services, in which case the beneficiary would receive whichever is greater.

    (5) An exception to the maximum number of hours in (b)(2), (3), and (4) of this section may be made when the treating physician determines that there is a change of diagnosis, medical condition, or treatment regimen related to diabetes or renal disease that requires a change in MNT during an episode of care.

    (c) Referrals. Referral may only be made by the treating physician when the beneficiary has been diagnosed with diabetes or renal disease as defined in this subpart with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care and any additional assessments or interventions required by a change of diagnosis, medical condition, or treatment regimen during an episode of care.

    Provider qualifications.

    For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on or after December 22, 2000:

    (a) Holds a bachelor's or higher degree granted by a regionally accredited college or university in the United States (or an equivalent foreign degree) with completion of the academic requirements of a program in nutrition or dietetics accredited by an appropriate national accreditation organization recognized for this purpose.

    (b) Has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional.

    (c) Is licensed or certified as a dietitian or nutrition professional by the State in which the services are performed. In a State that does not provide for licensure or certification, the individual will be deemed to have met this requirement if he or she is recognized as a “registered dietitian” by the Commission on Dietetic Registration or its successor organization, or meets the requirements of paragraphs (a) and (b) of this section.

    (d) Exceptions.

    (i) A dietitian or nutritionist licensed or certified in a State as of December 21, 2000 is not required to meet the requirements of (a) and (b) of this section.

    (ii) A “registered dietician” in good standing, as recognized by the Commission of Dietetic Registration or its successor organization, is deemed to have met the requirements of (a) and (b) of this section.

    Start Part

    PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

    End Part Start Amendment Part

    1. The authority citation for part 411 continues to read as follows:

    End Amendment Part Start Authority

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

    End Authority Start Amendment Part

    2. In § 411.15, paragraph (a)(1) is revised, and a new paragraph (k)(10) is added to read as follows:

    End Amendment Part
    Particular services excluded from coverage.
    * * * * *

    (a) * * *

    (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic examinations, prostate cancer screening Start Printed Page 55332tests, or glaucoma screening exams that meet the criteria specified in paragraphs (k)(6) through (k)(10) of this section.

    * * * * *

    (k) * * *

    (10) In the case of screening exams for glaucoma, for the purpose of early detection of glaucoma, subject to the conditions and limitations specified in § 410.23 of this chapter.

    * * * * *
    Start Part

    PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES

    End Part Start Amendment Part

    1. The authority citation for part 414 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).

    End Authority Start Amendment Part

    2. In 414.2, the definition of “Physician services” is amended by adding a new paragraph (8) to read as follows:

    End Amendment Part
    Definitions.
    * * * * *

    Physician Services * * *

    (8) Screening mammography services.

    * * * * *
    Start Amendment Part

    3. A new § 414.64 is added to read as follows:

    End Amendment Part
    Payment for medical nutrition therapy.

    (a) Payment under the physician fee schedule. Medicare payment for medical nutrition therapy is made under the physician fee schedule in accordance with subpart B of this part. Payment to non-physician professionals, as specified in paragraph (b) of this section, is the lesser of the actual charges or 80 percent of 85 percent of the physician fee schedule amount.

    (b) To whom payment may be made. Payment may be made to a registered dietician or nutrition professional qualified to furnish medical nutrition therapy in accordance with part 410, subpart G of this chapter.

    (c) Effective date of payment. Medicare pays suppliers of medical nutrition therapy on or after the effective date of enrollment of the supplier at the carrier.

    (d) Limitation on payment. Payment is made only for documented nutritional therapy sessions actually attended by the beneficiary.

    (e) Other conditions for fee-for-service payment. Payment is made only if the beneficiary:

    (1) Is not an inpatient of a hospital, SNF, nursing home, or hospice.

    (2) Is not receiving services in an RHC, FQHC or ESRD dialysis facility.

    Start Amendment Part

    4. Section 414.65 is revised to read as follows:

    End Amendment Part
    Payment for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via interactive telecommunications systems.

    (a) Professional service. Medicare payment for the professional service via an interactive telecommunications system is made according to the following limitations:

    (1) The Medicare payment amount for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via an interactive telecommunications system is equal to the current fee schedule amount applicable to services of the physician or practitioner.

    (2) Only the physician or practitioner at the distant site may bill and receive payment for the professional service via an interactive telecommunications system.

    (3) Payments made to the physician or practitioner at the distant site, including deductible and coinsurance, for the professional service may not be shared with the referring practitioner or telepresenter.

    (b) Originating site facility fee. For office or other outpatient visits, consultation, individual psychotherapy, or pharmacologic management services delivered via an interactive telecommunications system furnished on or after October 1, 2001:

    (1) For services furnished on or after October 1, 2001 through December 31, 2002, the payment amount to the originating site is the lesser of the actual charge or the originating site facility fee of $20. For services furnished on or after January 1 of each subsequent year, the facility fee for the originating site will be updated by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act.

    (2) Only the originating site may bill for the originating site facility fee and only on an assignment-related basis. The distant site physician or practitioner may not bill for or receive payment for facility fees associated with the professional service furnished via an interactive telecommunications system.

    (c) Deductible and coinsurance apply. The payment for the professional service and originating site facility fee is subject to the coinsurance and deductible requirements of sections 1833(a)(1) and (b) of the Act.

    (d) Assignment required for physicians, practitioners, and originating sites. Payment to physicians, practitioners, and originating sites is made only on an assignment-related basis.

    (e) Sanctions. A distant site practitioner or originating site facility may be subject to the applicable sanctions provided for in chapter IV, part 402 and chapter V, parts 1001, 1002, and 1003 of this title if he or she does any of the following:

    (1) Knowingly and willfully bills or collects for services in violation of the limitation of this section.

    (2) Fails to timely correct excess charges by reducing the actual charge billed for the service in an amount that does not exceed the limiting charge for the service or fails to timely refund excess collections.

    (3) Fails to submit a claim on a standard form for services provided for which payment is made on a fee schedule basis.

    (4) Imposes a charge for completing and submitting the standard claims form.

    Start Part

    PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS

    End Part Start Amendment Part

    1. The authority citation for part 415 continues to read as follows:

    End Amendment Part Start Authority

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

    End Authority Start Amendment Part

    2. Section 415.130 is amended by:

    End Amendment Part Start Amendment Part

    A. Redesignating paragraphs (a), (b), and (c) as paragraphs (b), (c), and (d).

    End Amendment Part Start Amendment Part

    B. Adding a new paragraph (a).

    End Amendment Part Start Amendment Part

    C. Amending newly designated paragraph (b)(3) by removing the reference “paragraph (b)” and adding “paragraph (c)” in its place.

    End Amendment Part Start Amendment Part

    D. Amending newly designated paragraph (b)(4) by removing the reference “paragraphs (b)(1), (b)(3), and (b)(4)” and adding “paragraphs (c)(1), (c)(3), and (c)(4)” in their place.

    End Amendment Part Start Amendment Part

    E. Revising newly designated paragraph (d).

    End Amendment Part
    Conditions for payment: Physician pathology services.

    (a) Definitions. The following definitions are used in this section.

    (1) Covered hospital means, with respect to an inpatient or an outpatient, a hospital that had an arrangement with an independent laboratory that was in effect as of July 22, 1999, under which a laboratory furnished the technical component of physician pathology services to fee-for-service Medicare beneficiaries who were hospital inpatients or outpatients, and submitted claims for payment for this technical component directly to a Medicare carrier.

    (2) Fee-for-service Medicare beneficiaries means those beneficiaries who are entitled to benefits under Part Start Printed Page 55333A or are enrolled under Part B of Title XVIII of the Act or both and are not enrolled in any of the following:

    (i) A Medicare+Choice plan under Part C of Title XVIII of the Act.

    (ii) A plan offered by an eligible organization under section 1876 of the Act;

    (iii) A program of all-inclusive care for the elderly (PACE) under 1894 of the Act; or

    (iv) A social health maintenance organization (SHMO) demonstration project established under section 4018(b) of the Omnibus Budget Reconciliation Act of 1987.

    * * * * *

    (d) Physician pathology services furnished by an independent laboratory. The technical component of physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient before January 1, 2001 may be paid to the laboratory on a fee schedule basis. After December 31, 2000 but before January 1, 2003, if an independent laboratory furnishes the technical component of a physician pathology service to a fee-for-service Medicare beneficiary who is an inpatient or outpatient of a covered hospital, the carrier will treat the technical component as a service for which payment will be made to the laboratory under the physician fee schedule. For these two years the service will not be treated as an inpatient hospital service for which payment is made to the hospital under section 1886(d) of the Act or as an outpatient hospital service for which payment is made to the hospital under section 1833(t) of the Act. After December 31, 2002, the technical component for physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient is paid only to the hospital.

    Start Signature

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

    Dated: October 22, 2001.

    Thomas A. Scully,

    Administrator, Centers for Medicare & Medicaid Services.

    Approved: October 24, 2001.

    Tommy G. Thompson,

    Secretary.

    End Signature

    Note:

    These addenda will not appear in the Code of Federal Regulations.

    Addendum A—Explanation and Use of Addenda B

    The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians' services furnished in 2002. Addendum B contains the RVUs for work, non-facility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.

    Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002

    This addendum contains the following information for each CPT code and alphanumeric HCPCS code, except for alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for nonphysicians' services or items), or L (orthotics), and codes for anesthesiology.

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

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

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

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

    A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an “A” indicator does not mean that Medicare has made a national decision regarding the coverage of the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.

    B = Bundled code. Payment for covered services is always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient.)

    C = Carrier-priced code. Carriers will establish RVUs and payment amounts for these services, generally on a case-by-case basis following review of documentation, such as an operative report.

    D = Deleted code. These codes are deleted effective with the beginning of the calendar year.

    E = Excluded from physician fee schedule by regulation. These codes are for items or services that we chose to exclude from the physician fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the physician fee schedule for these codes. Payment for them, if they are covered, continues under reasonable charge or other payment procedures.

    G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services.

    H = Deleted modifier (code used to have modifier of TC and PC).

    I = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for the reporting of, and payment for, these services. This indicator is treated in the same manner as status indicator “G”. It's use allows for more efficient processing of Medicare claims.

    N = Noncovered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.

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

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

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

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

    T = There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these Start Printed Page 55334services are bundled into the service(s) for which payment is made.

    X = Exclusion by law. These codes represent an item or service that is not within the definition of “physicians' services” for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)

    4. Description of code. This is an abbreviated version of the narrative description of the code.

    5. Physician work RVUs. These are the RVUs for the physician work for this service in 2000. Codes that are not used for Medicare payment are identified with a “+.”

    6. Facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for facility settings.

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

    8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2000.

    9. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.

    10. Non-facility total. This is the sum of the work, fully implemented non-facility practice expense, and malpractice expense RVUs.

    11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows:

    MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians' Current Procedural Terminology for specific definitions.

    XXX = The global concept does not apply.

    YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).

    ZZZ = The code is part of another service and falls within the global period for the other service.

    —————————— 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved. 3 +Indicates RVUs are not used for Medicare payment.Start Printed Page 55334

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

    CPT 1/HCPCS 2MODStatusDescriptionPhysician work RVUs 3Fully implemented non-facility PE RVUsFully implemented facility PE RVUsMal- practice RVUsFully implemented non-facility totalFully implemented facility totalGlobal
    0001TCEndovas repr abdo ao aneurys0.000.000.000.000.000.00XXX
    0002TCEndovas repr abdo ao aneurys0.000.000.000.000.000.00XXX
    0003TCCervicography0.000.000.000.000.000.00XXX
    0005TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0006TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0007TCPerc cath stent/brain cv art0.000.000.000.000.000.00XXX
    0008TCUpper gi endoscopy w/suture0.000.000.000.000.000.00XXX
    0009TCEndometrial cryoablation0.000.000.000.000.000.00XXX
    0010TCTb test, gamma interferon0.000.000.000.000.000.00XXX
    0012TCOsteochondral knee autograft0.000.000.000.000.000.00XXX
    0013TCOsteochondral knee allograft0.000.000.000.000.000.00XXX
    0014TCMeniscal transplant, knee0.000.000.000.000.000.00XXX
    0016TCThermotx choroid vasc lesion0.000.000.000.000.000.00XXX
    0017TCPhotocoagulat macular drusen0.000.000.000.000.000.00XXX
    0018TCTranscranial magnetic stimul0.000.000.000.000.000.00XXX
    0019TCExtracorp shock wave tx, ms0.000.000.000.000.000.00XXX
    0020TCExtracorp shock wave tx, ft0.000.000.000.000.000.00XXX
    0021TCFetal oximetry, trnsvag/cerv0.000.000.000.000.000.00XXX
    0023TCPhenotype drug test, hiv 10.000.000.000.000.000.00XXX
    0024TCTranscath cardiac reduction0.000.000.000.000.000.00XXX
    0025TCUltrasonic pachymetry0.000.000.000.000.000.00XXX
    0026TCMeasure remnant lipoproteins0.000.000.000.000.000.00XXX
    10021AFna w/o image1.271.02NA0.102.39NAXXX
    1002126AFna w/o image1.270.550.550.071.891.89XXX
    10021TCAFna w/o image0.000.47NA0.030.50NAXXX
    10022AFna w/image1.271.11NA0.082.46NAXXX
    1002226AFna w/image1.270.480.480.051.801.80XXX
    10022TCAFna w/image0.000.63NA0.030.66NAXXX
    10040AAcne surgery1.181.000.540.052.231.77010
    10060ADrainage of skin abscess1.171.510.700.082.761.95010
    10061ADrainage of skin abscess2.401.881.480.174.454.05010
    10080ADrainage of pilonidal cyst1.172.180.750.093.442.01010
    10081ADrainage of pilonidal cyst2.453.021.610.195.664.25010
    10120ARemove foreign body1.221.520.360.102.841.68010
    10121ARemove foreign body2.692.991.830.255.934.77010
    10140ADrainage of hematoma/fluid1.531.540.900.153.222.58010
    10160APuncture drainage of lesion1.200.740.430.112.051.74010
    10180AComplex drainage, wound2.251.511.330.254.013.83010
    11000ADebride infected skin0.600.660.240.051.310.89000
    11001ADebride infected skin add-on0.300.370.110.020.690.43ZZZ
    11010ADebride skin, fx4.202.532.100.457.186.75010
    11011ADebride skin/muscle, fx4.953.902.690.539.388.17000
    11012ADebride skin/muscle/bone, fx6.885.524.350.8913.2912.12000
    11040ADebride skin, partial0.500.550.220.051.100.77000
    11041ADebride skin, full0.820.690.340.081.591.24000
    11042ADebride skin/tissue1.121.040.470.112.271.70000Start Printed Page 55335
    11043ADebride tissue/muscle2.382.721.420.245.344.04010
    11044ADebride tissue/muscle/bone3.063.301.860.346.705.26010
    11055RTrim skin lesion0.430.520.190.020.970.64000
    11056RTrim skin lesions, 2 to 40.610.590.260.031.230.90000
    11057RTrim skin lesions, over 40.790.660.340.041.491.17000
    11100ABiopsy of skin lesion0.811.490.380.042.341.23000
    11101ABiopsy, skin add-on0.410.710.200.021.140.63ZZZ
    11200ARemoval of skin tags0.771.200.320.042.011.13010
    11201ARemove skin tags add-on0.290.530.120.020.840.43ZZZ
    11300AShave skin lesion0.511.050.220.031.590.76000
    11301AShave skin lesion0.851.120.390.042.011.28000
    11302AShave skin lesion1.051.210.490.052.311.59000
    11303AShave skin lesion1.241.360.550.062.661.85000
    11305AShave skin lesion0.670.770.290.041.481.00000
    11306AShave skin lesion0.991.020.440.052.061.48000
    11307AShave skin lesion1.141.150.510.052.341.70000
    11308AShave skin lesion1.411.290.620.072.772.10000
    11310AShave skin lesion0.731.150.340.041.921.11000
    11311AShave skin lesion1.051.240.510.052.341.61000
    11312AShave skin lesion1.201.320.580.062.581.84000
    11313AShave skin lesion1.621.630.740.093.342.45000
    11400ARemoval of skin lesion0.911.680.360.062.651.33010
    11401ARemoval of skin lesion1.321.830.530.093.241.94010
    11402ARemoval of skin lesion1.612.610.980.124.342.71010
    11403ARemoval of skin lesion1.922.841.120.164.923.20010
    11404ARemoval of skin lesion2.203.021.190.185.403.57010
    11406ARemoval of skin lesion2.763.331.410.256.344.42010
    11420ARemoval of skin lesion1.061.520.440.082.661.58010
    11421ARemoval of skin lesion1.531.840.640.113.482.28010
    11422ARemoval of skin lesion1.762.601.080.144.502.98010
    11423ARemoval of skin lesion2.173.021.260.175.363.60010
    11424ARemoval of skin lesion2.623.201.430.216.034.26010
    11426ARemoval of skin lesion3.783.811.890.347.936.01010
    11440ARemoval of skin lesion1.152.260.530.083.491.76010
    11441ARemoval of skin lesion1.612.480.740.114.202.46010
    11442ARemoval of skin lesion1.872.911.300.144.923.31010
    11443ARemoval of skin lesion2.493.411.640.186.084.31010
    11444ARemoval of skin lesion3.423.922.080.257.595.75010
    11446ARemoval of skin lesion4.494.372.580.309.167.37010
    11450ARemoval, sweat gland lesion2.734.201.030.267.194.02090
    11451ARemoval, sweat gland lesion3.955.231.330.399.575.67090
    11462ARemoval, sweat gland lesion2.514.320.980.237.063.72090
    11463ARemoval, sweat gland lesion3.955.671.670.4010.026.02090
    11470ARemoval, sweat gland lesion3.254.971.260.308.524.81090
    11471ARemoval, sweat gland lesion4.415.541.740.4010.356.55090
    11600ARemoval of skin lesion1.412.481.080.093.982.58010
    11601ARemoval of skin lesion1.932.521.360.124.573.41010
    11602ARemoval of skin lesion2.092.661.400.134.883.62010
    11603ARemoval of skin lesion2.352.931.490.165.444.00010
    11604ARemoval of skin lesion2.583.271.560.186.034.32010
    11606ARemoval of skin lesion3.433.881.850.287.595.56010
    11620ARemoval of skin lesion1.342.471.090.093.902.52010
    11621ARemoval of skin lesion1.972.561.410.124.653.50010
    11622ARemoval of skin lesion2.342.871.600.155.364.09010
    11623ARemoval of skin lesion2.933.301.860.206.434.99010
    11624ARemoval of skin lesion3.433.722.080.257.405.76010
    11626ARemoval of skin lesion4.304.482.570.359.137.22010
    11640ARemoval of skin lesion1.532.511.290.104.142.92010
    11641ARemoval of skin lesion2.442.941.780.155.534.37010
    11642ARemoval of skin lesion2.933.372.030.186.485.14010
    11643ARemoval of skin lesion3.503.832.320.247.576.06010
    11644ARemoval of skin lesion4.554.812.950.339.697.83010
    11646ARemoval of skin lesion5.955.683.770.4612.0910.18010
    11719RTrim nail(s)0.170.250.070.010.430.25000
    11720ADebride nail, 1-50.320.340.130.020.680.47000
    11721ADebride nail, 6 or more0.540.440.220.041.020.80000
    11730ARemoval of nail plate1.130.830.460.092.051.68000
    11732ARemove nail plate, add-on0.570.300.240.050.920.86ZZZ
    11740ADrain blood from under nail0.370.810.140.031.210.54000
    11750ARemoval of nail bed1.861.750.780.163.772.80010
    11752ARemove nail bed/finger tip2.672.201.770.335.204.77010
    11755ABiopsy, nail unit1.311.100.600.062.471.97000
    11760ARepair of nail bed1.581.801.280.173.553.03010Start Printed Page 55336
    11762AReconstruction of nail bed2.892.281.950.325.495.16010
    11765AExcision of nail fold, toe0.691.140.510.051.881.25010
    11770ARemoval of pilonidal lesion2.613.111.260.245.964.11010
    11771ARemoval of pilonidal lesion5.745.804.010.5612.1010.31090
    11772ARemoval of pilonidal lesion6.986.954.440.6814.6112.10090
    11900AInjection into skin lesions0.520.770.230.021.310.77000
    11901AAdded skin lesions injection0.800.890.380.031.721.21000
    11920RCorrect skin color defects1.612.250.810.174.032.59000
    11921RCorrect skin color defects1.932.781.020.214.923.16000
    11922RCorrect skin color defects0.490.400.260.050.940.80ZZZ
    11950RTherapy for contour defects0.841.230.470.062.131.37000
    11951RTherapy for contour defects1.191.470.490.102.761.78000
    11952RTherapy for contour defects1.691.650.640.173.512.50000
    11954RTherapy for contour defects1.852.620.970.194.663.01000
    11960AInsert tissue expander(s)9.08NA11.540.88NA21.50090
    11970AReplace tissue expander7.06NA5.150.77NA12.98090
    11971ARemove tissue expander(s)2.136.104.070.218.446.41090
    11975NInsert contraceptive cap+1.481.580.590.143.202.21XXX
    11976RRemoval of contraceptive cap1.781.720.690.173.672.64000
    11977NRemoval/reinsert contra cap+3.302.311.320.315.924.93XXX
    11980AImplant hormone pellet(s)1.481.140.580.102.722.16000
    11981AInsert drug implant device1.481.580.590.143.202.21XXX
    11982ARemove drug implant device1.781.700.710.173.652.66XXX
    11983ARemove/insert drug implant3.302.311.320.315.924.93XXX
    12001ARepair superficial wound(s)1.702.130.440.133.962.27010
    12002ARepair superficial wound(s)1.862.210.950.154.222.96010
    12004ARepair superficial wound(s)2.242.471.070.174.883.48010
    12005ARepair superficial wound(s)2.863.041.250.236.134.34010
    12006ARepair superficial wound(s)3.673.591.590.317.575.57010
    12007ARepair superficial wound(s)4.124.261.850.378.756.34010
    12011ARepair superficial wound(s)1.762.300.450.144.202.35010
    12013ARepair superficial wound(s)1.992.450.990.164.603.14010
    12014ARepair superficial wound(s)2.462.721.110.185.363.75010
    12015ARepair superficial wound(s)3.193.381.310.246.814.74010
    12016ARepair superficial wound(s)3.933.891.580.328.145.83010
    12017ARepair superficial wound(s)4.71NA1.930.39NA7.03010
    12018ARepair superficial wound(s)5.53NA2.180.46NA8.17010
    12020AClosure of split wound2.622.511.440.245.374.30010
    12021AClosure of split wound1.841.651.020.193.683.05010
    12031ALayer closure of wound(s)2.152.210.810.154.513.11010
    12032ALayer closure of wound(s)2.472.841.360.155.463.98010
    12034ALayer closure of wound(s)2.923.121.510.216.254.64010
    12035ALayer closure of wound(s)3.433.201.730.306.935.46010
    12036ALayer closure of wound(s)4.055.332.500.419.796.96010
    12037ALayer closure of wound(s)4.675.572.860.4910.738.02010
    12041ALayer closure of wound(s)2.372.410.870.174.953.41010
    12042ALayer closure of wound(s)2.743.031.490.175.944.40010
    12044ALayer closure of wound(s)3.143.221.670.246.605.05010
    12045ALayer closure of wound(s)3.643.541.930.347.525.91010
    12046ALayer closure of wound(s)4.256.242.620.4010.897.27010
    12047ALayer closure of wound(s)4.657.212.860.4112.277.92010
    12051ALayer closure of wound(s)2.473.111.490.165.744.12010
    12052ALayer closure of wound(s)2.773.001.470.175.944.41010
    12053ALayer closure of wound(s)3.123.201.630.206.524.95010
    12054ALayer closure of wound(s)3.463.521.720.257.235.43010
    12055ALayer closure of wound(s)4.434.492.270.359.277.05010
    12056ALayer closure of wound(s)5.247.313.260.4312.988.93010
    12057ALayer closure of wound(s)5.966.313.660.5012.7710.12010
    13100ARepair of wound or lesion3.123.391.930.216.725.26010
    13101ARepair of wound or lesion3.923.592.390.227.736.53010
    13102ARepair wound/lesion add-on1.240.750.600.102.091.94ZZZ
    13120ARepair of wound or lesion3.303.481.950.237.015.48010
    13121ARepair of wound or lesion4.333.842.520.258.427.10010
    13122ARepair wound/lesion add-on1.440.890.670.122.452.23ZZZ
    13131ARepair of wound or lesion3.793.752.300.257.796.34010
    13132ARepair of wound or lesion5.954.573.380.3210.849.65010
    13133ARepair wound/lesion add-on2.191.231.080.173.593.44ZZZ
    13150ARepair of wound or lesion3.815.192.750.299.296.85010
    13151ARepair of wound or lesion4.455.073.190.289.807.92010
    13152ARepair of wound or lesion6.335.784.140.3812.4910.85010
    13153ARepair wound/lesion add-on2.381.381.200.183.943.76ZZZ
    13160ALate closure of wound10.48NA6.471.19NA18.14090
    14000ASkin tissue rearrangement5.897.584.830.4613.9311.18090Start Printed Page 55337
    14001ASkin tissue rearrangement8.478.726.180.6517.8415.30090
    14020ASkin tissue rearrangement6.598.055.560.5015.1412.65090
    14021ASkin tissue rearrangement10.069.297.380.6920.0418.13090
    14040ASkin tissue rearrangement7.878.196.270.5316.5914.67090
    14041ASkin tissue rearrangement11.499.908.170.6822.0720.34090
    14060ASkin tissue rearrangement8.508.647.130.5917.7316.22090
    14061ASkin tissue rearrangement12.2910.859.080.7523.8922.12090
    14300ASkin tissue rearrangement11.7610.118.680.8822.7521.32090
    14350ASkin tissue rearrangement9.61NA6.481.09NA17.18090
    15000ASkin graft4.002.511.910.376.886.28000
    15001ASkin graft add-on1.000.640.430.111.751.54ZZZ
    15050ASkin pinch graft4.304.984.120.469.748.88090
    15100ASkin split graft9.056.276.260.9416.2616.25090
    15101ASkin split graft add-on1.721.400.760.183.302.66ZZZ
    15120ASkin split graft9.838.626.970.8719.3217.67090
    15121ASkin split graft add-on2.671.831.230.274.774.17ZZZ
    15200ASkin full graft8.039.905.640.7318.6614.40090
    15201ASkin full graft add-on1.321.000.680.142.462.14ZZZ
    15220ASkin full graft7.879.386.470.6817.9315.02090
    15221ASkin full graft add-on1.190.920.600.122.231.91ZZZ
    15240ASkin full graft9.049.017.270.7718.8217.08090
    15241ASkin full graft add-on1.861.470.950.173.502.98ZZZ
    15260ASkin full graft10.069.017.740.6319.7018.43090
    15261ASkin full graft add-on2.231.591.160.173.993.56ZZZ
    15342ACultured skin graft, 25 cm1.002.181.040.093.272.13010
    15343ACultured skin graft addl 25 cm0.250.420.100.020.690.37ZZZ
    15350ASkin homograft4.007.784.230.4212.208.65090
    15351ASkin homograft add-on1.000.850.420.111.961.53ZZZ
    15400ASkin heterograft4.004.894.890.409.299.29090
    15401ASkin heterograft add-on1.001.590.470.112.701.58ZZZ
    15570AForm skin pedicle flap9.217.806.370.9617.9716.54090
    15572AForm skin pedicle flap9.278.086.340.9318.2816.54090
    15574AForm skin pedicle flap9.888.617.140.9219.4117.94090
    15576AForm skin pedicle flap8.698.896.550.7218.3015.96090
    15600ASkin graft1.916.662.510.198.764.61090
    15610ASkin graft2.425.902.670.258.575.34090
    15620ASkin graft2.947.043.540.2810.266.76090
    15630ASkin graft3.276.093.830.289.647.38090
    15650ATransfer skin pedicle flap3.975.693.990.3610.028.32090
    15732AMuscle-skin graft, head/neck17.84NA11.631.50NA30.97090
    15734AMuscle-skin graft, trunk17.79NA11.491.91NA31.19090
    15736AMuscle-skin graft, arm16.27NA11.141.78NA29.19090
    15738AMuscle-skin graft, leg17.92NA11.471.95NA31.34090
    15740AIsland pedicle flap graft10.258.747.200.6219.6118.07090
    15750ANeurovascular pedicle graft11.41NA8.451.12NA20.98090
    15756AFree muscle flap, microvasc35.23NA22.503.11NA60.84090
    15757AFree skin flap, microvasc35.23NA22.543.37NA61.14090
    15758AFree fascial flap, microvasc35.10NA22.753.52NA61.37090
    15760AComposite skin graft8.749.276.930.7218.7316.39090
    15770ADerma-fat-fascia graft7.52NA6.140.78NA14.44090
    15775RHair transplant punch grafts3.963.121.600.437.515.99000
    15776RHair transplant punch grafts5.543.972.970.6010.119.11000
    15780AAbrasion treatment of skin7.296.416.130.4114.1113.83090
    15781AAbrasion treatment of skin4.855.174.830.2710.299.95090
    15782AAbrasion treatment of skin4.324.374.090.218.908.62090
    15783AAbrasion treatment of skin4.295.023.510.269.578.06090
    15786AAbrasion, lesion, single2.031.731.290.113.873.43010
    15787AAbrasion, lesions, add-on0.330.390.180.020.740.53ZZZ
    15788RChemical peel, face, epiderm2.093.151.070.115.353.27090
    15789RChemical peel, face, dermal4.925.653.320.2710.848.51090
    15792RChemical peel, nonfacial1.862.871.630.104.833.59090
    15793AChemical peel, nonfacial3.74NA3.810.17NA7.72090
    15810ASalabrasion4.744.044.040.429.209.20090
    15811ASalabrasion5.395.855.060.5211.7610.97090
    15819APlastic surgery, neck9.38NA6.240.77NA16.39090
    15820ARevision of lower eyelid5.1510.347.130.3015.7912.58090
    15821ARevision of lower eyelid5.7211.877.340.3117.9013.37090
    15822ARevision of upper eyelid4.4510.586.580.2215.2511.25090
    15823ARevision of upper eyelid7.0511.387.600.3218.7514.97090
    15824RRemoval of forehead wrinkles0.000.000.000.000.000.00000
    15825RRemoval of neck wrinkles0.000.000.000.000.000.00000
    15826RRemoval of brow wrinkles0.000.000.000.000.000.00000
    15828RRemoval of face wrinkles0.000.000.000.000.000.00000Start Printed Page 55338
    15829RRemoval of skin wrinkles0.000.000.000.000.000.00000
    15831AExcise excessive skin tissue12.40NA8.141.30NA21.84090
    15832AExcise excessive skin tissue11.59NA8.041.21NA20.84090
    15833AExcise excessive skin tissue10.64NA7.341.17NA19.15090
    15834AExcise excessive skin tissue10.85NA7.591.18NA19.62090
    15835AExcise excessive skin tissue11.67NA7.941.13NA20.74090
    15836AExcise excessive skin tissue9.34NA6.510.95NA16.80090
    15837AExcise excessive skin tissue8.437.306.380.7816.5115.59090
    15838AExcise excessive skin tissue7.13NA5.700.58NA13.41090
    15839AExcise excessive skin tissue9.387.645.970.8817.9016.23090
    15840AGraft for face nerve palsy13.26NA10.101.15NA24.51090
    15841AGraft for face nerve palsy23.26NA14.682.65NA40.59090
    15842AFlap for face nerve palsy37.96NA22.813.99NA64.76090
    15845ASkin and muscle repair, face12.57NA8.810.80NA22.18090
    15850BRemoval of sutures+0.781.430.310.042.251.13XXX
    15851ARemoval of sutures0.861.640.350.052.551.26000
    15852ADressing change, not for burn0.861.930.360.072.861.29000
    15860ATest for blood flow in graft1.951.350.840.133.432.92000
    15876RSuction assisted lipectomy0.000.000.000.000.000.00000
    15877RSuction assisted lipectomy0.000.000.000.000.000.00000
    15878RSuction assisted lipectomy0.000.000.000.000.000.00000
    15879RSuction assisted lipectomy0.000.000.000.000.000.00000
    15920ARemoval of tail bone ulcer7.95NA5.900.83NA14.68090
    15922ARemoval of tail bone ulcer9.90NA7.781.06NA18.74090
    15931ARemove sacrum pressure sore9.24NA5.890.95NA16.08090
    15933ARemove sacrum pressure sore10.85NA8.321.14NA20.31090
    15934ARemove sacrum pressure sore12.69NA8.481.35NA22.52090
    15935ARemove sacrum pressure sore14.57NA10.121.56NA26.25090
    15936ARemove sacrum pressure sore12.38NA8.811.32NA22.51090
    15937ARemove sacrum pressure sore14.21NA10.751.51NA26.47090
    15940ARemove hip pressure sore9.34NA6.170.98NA16.49090
    15941ARemove hip pressure sore11.43NA10.441.23NA23.10090
    15944ARemove hip pressure sore11.46NA8.771.21NA21.44090
    15945ARemove hip pressure sore12.69NA9.731.38NA23.80090
    15946ARemove hip pressure sore21.57NA14.652.32NA38.54090
    15950ARemove thigh pressure sore7.54NA5.430.80NA13.77090
    15951ARemove thigh pressure sore10.72NA8.071.14NA19.93090
    15952ARemove thigh pressure sore11.39NA7.861.19NA20.44090
    15953ARemove thigh pressure sore12.63NA9.241.38NA23.25090
    15956ARemove thigh pressure sore15.52NA10.711.64NA27.87090
    15958ARemove thigh pressure sore15.48NA11.201.66NA28.34090
    15999CRemoval of pressure sore0.000.000.000.000.000.00YYY
    16000AInitial treatment of burn(s)0.891.090.270.062.041.22000
    16010ATreatment of burn(s)0.871.210.370.072.151.31000
    16015ATreatment of burn(s)2.352.011.030.224.583.60000
    16020ATreatment of burn(s)0.801.200.270.062.061.13000
    16025ATreatment of burn(s)1.851.940.690.163.952.70000
    16030ATreatment of burn(s)2.083.360.970.185.623.23000
    16035AIncision of burn scab, initi3.75NA1.560.36NA5.67090
    16036AIncise burn scab, addl incis1.50NA0.620.11NA2.23ZZZ
    17000ADetroy benign/premal lesion0.601.100.280.031.730.91010
    17003ADestroy lesions, 2-140.150.240.070.010.400.23ZZZ
    17004ADestroy lesions, 15 or more2.792.561.300.125.474.21010
    17106ADestruction of skin lesions4.594.882.880.289.757.75090
    17107ADestruction of skin lesions9.166.925.280.5316.6114.97090
    17108ADestruction of skin lesions13.208.877.260.8922.9621.35090
    17110ADestruct lesion, 1-140.651.110.260.041.800.95010
    17111ADestruct lesion, 15 or more0.921.130.410.042.091.37010
    17250AChemical cautery, tissue0.500.760.210.041.300.75000
    17260ADestruction of skin lesions0.911.370.390.042.321.34010
    17261ADestruction of skin lesions1.171.480.560.052.701.78010
    17262ADestruction of skin lesions1.581.690.760.073.342.41010
    17263ADestruction of skin lesions1.791.800.830.083.672.70010
    17264ADestruction of skin lesions1.941.870.870.083.892.89010
    17266ADestruction of skin lesions2.342.081.050.114.533.50010
    17270ADestruction of skin lesions1.321.570.600.062.951.98010
    17271ADestruction of skin lesions1.491.650.720.063.202.27010
    17272ADestruction of skin lesions1.771.790.860.073.632.70010
    17273ADestruction of skin lesions2.051.930.970.094.073.11010
    17274ADestruction of skin lesions2.592.211.200.114.913.90010
    17276ADestruction of skin lesions3.202.521.840.155.875.19010
    17280ADestruction of skin lesions1.171.410.540.052.631.76010
    17281ADestruction of skin lesions1.721.770.830.073.562.62010Start Printed Page 55339
    17282ADestruction of skin lesions2.041.930.990.094.063.12010
    17283ADestruction of skin lesions2.642.231.240.114.983.99010
    17284ADestruction of skin lesions3.212.521.510.145.874.86010
    17286ADestruction of skin lesions4.443.232.520.227.897.18010
    17304AChemosurgery of skin lesion7.607.763.740.3115.6711.65000
    17305A2nd stage chemosurgery2.853.601.400.126.574.37000
    17306A3rd stage chemosurgery2.853.641.410.126.614.38000
    17307AFollowup skin lesion therapy2.853.621.430.126.594.40000
    17310AExtensive skin chemosurgery0.951.540.480.052.541.48000
    17340ACryotherapy of skin0.760.390.270.041.191.07010
    17360ASkin peel therapy1.431.460.730.062.952.22010
    17380RHair removal by electrolysis0.000.000.000.000.000.00000
    17999CSkin tissue procedure0.000.000.000.000.000.00YYY
    19000ADrainage of breast lesion0.841.270.300.072.181.21000
    19001ADrain breast lesion add-on0.420.860.150.031.310.60ZZZ
    19020AIncision of breast lesion3.577.133.510.3511.057.43090
    19030AInjection for breast x-ray1.533.700.540.075.302.14000
    19100ABx breast percut w/o image1.271.500.450.102.871.82000
    19101ABiopsy of breast, open3.185.271.970.208.655.35010
    19102ABx breast percut w/image2.005.130.710.137.262.84000
    19103ABx breast percut w/device3.7012.731.310.1616.595.17000
    19110ANipple exploration4.309.794.560.4414.539.30090
    19112AExcise breast duct fistula3.6710.913.190.3814.967.24090
    19120ARemoval of breast lesion5.565.183.200.5611.309.32090
    19125AExcision, breast lesion6.065.363.360.6112.0310.03090
    19126AExcision, addl breast lesion2.93NA1.060.30NA4.29ZZZ
    19140ARemoval of breast tissue5.1410.263.790.5215.929.45090
    19160ARemoval of breast tissue5.99NA4.620.61NA11.22090
    19162ARemove breast tissue, nodes13.53NA8.071.38NA22.98090
    19180ARemoval of breast8.80NA6.080.88NA15.76090
    19182ARemoval of breast7.73NA5.060.79NA13.58090
    19200ARemoval of breast15.49NA9.331.51NA26.33090
    19220ARemoval of breast15.72NA9.521.56NA26.80090
    19240ARemoval of breast16.00NA8.941.62NA26.56090
    19260ARemoval of chest wall lesion15.44NA9.121.64NA26.20090
    19271ARevision of chest wall18.90NA11.132.27NA32.30090
    19272AExtensive chest wall surgery21.55NA12.362.54NA36.45090
    19290APlace needle wire, breast1.272.950.450.064.281.78000
    19291APlace needle wire, breast0.631.740.220.032.400.88ZZZ
    19295APlace breast clip, percut0.002.83NA0.012.84NAZZZ
    19316ASuspension of breast10.69NA8.001.15NA19.84090
    19318AReduction of large breast15.62NA10.641.69NA27.95090
    19324AEnlarge breast5.85NA4.410.63NA10.89090
    19325AEnlarge breast with implant8.45NA7.000.90NA16.35090
    19328ARemoval of breast implant5.68NA4.730.61NA11.02090
    19330ARemoval of implant material7.59NA5.410.81NA13.81090
    19340AImmediate breast prosthesis6.33NA3.300.68NA10.31ZZZ
    19342ADelayed breast prosthesis11.20NA8.151.21NA20.56090
    19350ABreast reconstruction8.9214.557.090.9524.4216.96090
    19355ACorrect inverted nipple(s)7.5712.425.930.8020.7914.30090
    19357ABreast reconstruction18.16NA14.401.96NA34.52090
    19361ABreast reconstruction19.26NA12.452.08NA33.79090
    19364ABreast reconstruction41.00NA25.453.91NA70.36090
    19366ABreast reconstruction21.28NA12.022.27NA35.57090
    19367ABreast reconstruction25.73NA15.772.78NA44.28090
    19368ABreast reconstruction32.42NA19.043.51NA54.97090
    19369ABreast reconstruction29.82NA18.293.24NA51.35090
    19370ASurgery of breast capsule8.05NA6.390.86NA15.30090
    19371ARemoval of breast capsule9.35NA7.461.01NA17.82090
    19380ARevise breast reconstruction9.14NA7.350.98NA17.47090
    19396ADesign custom breast implant2.177.080.870.239.483.27000
    19499CBreast surgery procedure0.000.000.000.000.000.00YYY
    20000AIncision of abscess2.122.231.200.174.523.49010
    20005AIncision of deep abscess3.423.072.220.346.835.98010
    20100AExplore wound, neck10.086.494.120.9917.5615.19010
    20101AExplore wound, chest3.223.031.640.246.495.10010
    20102AExplore wound, abdomen3.943.431.850.357.726.14010
    20103AExplore wound, extremity5.304.413.010.5710.288.88010
    20150AExcise epiphyseal bar13.69NA9.720.96NA24.37090
    20200AMuscle biopsy1.461.720.620.173.352.25000
    20205ADeep muscle biopsy2.354.040.980.236.623.56000
    20206ANeedle biopsy, muscle0.993.270.360.064.321.41000
    20220ABone biopsy, trocar/needle1.274.962.980.066.294.31000Start Printed Page 55340
    20225ABone biopsy, trocar/needle1.874.473.060.116.455.04000
    20240ABone biopsy, excisional3.23NA4.150.33NA7.71010
    20245ABone biopsy, excisional7.78NA6.910.44NA15.13010
    20250AOpen bone biopsy5.03NA4.370.50NA9.90010
    20251AOpen bone biopsy5.56NA4.860.79NA11.21010
    20500AInjection of sinus tract1.235.343.910.106.675.24010
    20501AInject sinus tract for x-ray0.763.320.270.034.111.06000
    20520ARemoval of foreign body1.855.623.620.177.645.64010
    20525ARemoval of foreign body3.507.264.400.4011.168.30010
    20526ATher injection carpal tunnel0.860.780.390.061.701.31000
    20550AInject tendon/ligament/cyst0.860.850.280.061.771.20000
    20551AInject tendon origin/insert0.860.780.390.061.701.31000
    20552AInject trigger point, 1 or 20.860.780.390.061.701.31000
    20553AInject trigger points, > 30.860.780.390.061.701.31000
    20600ADrain/inject, joint/bursa0.660.670.370.061.391.09000
    20605ADrain/inject, joint/bursa0.680.780.380.061.521.12000
    20610ADrain/inject, joint/bursa0.790.960.440.081.831.31000
    20615ATreatment of bone cyst2.284.892.520.197.364.99010
    20650AInsert and remove bone pin2.235.063.190.287.575.70010
    20660AApply, remove fixation device2.51NA1.490.48NA4.48000
    20661AApplication of head brace4.89NA6.740.92NA12.55090
    20662AApplication of pelvis brace6.07NA5.120.81NA12.00090
    20663AApplication of thigh brace5.43NA4.940.77NA11.14090
    20664AHalo brace application8.06NA8.551.49NA18.10090
    20665ARemoval of fixation device1.312.331.250.173.812.73010
    20670ARemoval of support implant1.745.733.420.237.705.39010
    20680ARemoval of support implant3.355.045.040.468.858.85090
    20690AApply bone fixation device3.52NA1.910.47NA5.90090
    20692AApply bone fixation device6.41NA3.570.60NA10.58090
    20693AAdjust bone fixation device5.86NA12.980.85NA19.69090
    20694ARemove bone fixation device4.168.966.300.5713.6911.03090
    20802AReplantation, arm, complete41.15NA28.955.81NA75.91090
    20805AReplant, forearm, complete50.00NA38.723.95NA92.67090
    20808AReplantation hand, complete61.65NA56.416.49NA124.55090
    20816AReplantation digit, complete30.94NA49.503.01NA83.45090
    20822AReplantation digit, complete25.59NA45.973.07NA74.63090
    20824AReplantation thumb, complete30.94NA49.103.48NA83.52090
    20827AReplantation thumb, complete26.41NA45.653.21NA75.27090
    20838AReplantation foot, complete41.41NA25.825.85NA73.08090
    20900ARemoval of bone for graft5.585.975.970.7712.3212.32090
    20902ARemoval of bone for graft7.55NA8.911.06NA17.52090
    20910ARemove cartilage for graft5.349.096.940.5014.9312.78090
    20912ARemove cartilage for graft6.35NA7.680.55NA14.58090
    20920ARemoval of fascia for graft5.31NA5.440.54NA11.29090
    20922ARemoval of fascia for graft6.618.506.280.8815.9913.77090
    20924ARemoval of tendon for graft6.48NA7.030.82NA14.33090
    20926ARemoval of tissue for graft5.53NA6.540.73NA12.80090
    20930BSpinal bone allograft0.000.000.000.000.000.00XXX
    20931ASpinal bone allograft1.81NA0.980.34NA3.13ZZZ
    20936BSpinal bone autograft0.000.000.000.000.000.00XXX
    20937ASpinal bone autograft2.79NA1.540.43NA4.76ZZZ
    20938ASpinal bone autograft3.02NA1.640.52NA5.18ZZZ
    20950AFluid pressure, muscle1.26NA2.150.16NA3.57000
    20955AFibula bone graft, microvasc39.21NA30.524.35NA74.08090
    20956AIliac bone graft, microvasc39.27NA28.185.77NA73.22090
    20957AMt bone graft, microvasc40.65NA21.715.74NA68.10090
    20962AOther bone graft, microvasc39.27NA28.545.19NA73.00090
    20969ABone/skin graft, microvasc43.92NA33.314.34NA81.57090
    20970ABone/skin graft, iliac crest43.06NA30.084.64NA77.78090
    20972ABone/skin graft, metatarsal42.99NA18.236.07NA67.29090
    20973ABone/skin graft, great toe45.76NA30.524.65NA80.93090
    20974AElectrical bone stimulation0.620.470.340.091.181.05000
    20975AElectrical bone stimulation2.60NA1.420.42NA4.44000
    20979AUs bone stimulation0.620.580.250.041.240.91000
    20999CMusculoskeletal surgery0.000.000.000.000.000.00YYY
    21010AIncision of jaw joint10.14NA7.240.54NA17.92090
    21015AResection of facial tumor5.29NA7.380.52NA13.19090
    21025AExcision of bone, lower jaw10.067.407.000.7918.2517.85090
    21026AExcision of facial bone(s)4.855.235.120.4010.4810.37090
    21029AContour of face bone lesion7.717.186.730.7415.6315.18090
    21030ARemoval of face bone lesion6.465.474.940.6012.5312.00090
    21031ARemove exostosis, mandible3.243.392.190.286.915.71090
    21032ARemove exostosis, maxilla3.243.382.470.276.895.98090Start Printed Page 55341
    21034ARemoval of face bone lesion16.1710.5910.591.3728.1328.13090
    21040ARemoval of jaw bone lesion2.113.031.810.195.334.11090
    21041ARemoval of jaw bone lesion6.715.684.460.5612.9511.73090
    21044ARemoval of jaw bone lesion11.86NA8.330.87NA21.06090
    21045AExtensive jaw surgery16.17NA10.631.20NA28.00090
    21050ARemoval of jaw joint10.77NA11.930.84NA23.54090
    21060ARemove jaw joint cartilage10.23NA10.591.16NA21.98090
    21070ARemove coronoid process8.20NA6.360.67NA15.23090
    21076APrepare face/oral prosthesis13.429.877.411.3624.6522.19010
    21077APrepare face/oral prosthesis33.7524.8318.643.4362.0155.82090
    21079APrepare face/oral prosthesis22.3417.5512.901.5941.4836.83090
    21080APrepare face/oral prosthesis25.1019.7214.492.5547.3742.14090
    21081APrepare face/oral prosthesis22.8817.9713.211.8742.7237.96090
    21082APrepare face/oral prosthesis20.8715.3511.531.4637.6833.86090
    21083APrepare face/oral prosthesis19.3015.1611.141.9636.4232.40090
    21084APrepare face/oral prosthesis22.5117.6812.991.5741.7637.07090
    21085APrepare face/oral prosthesis9.006.624.970.6516.2714.62010
    21086APrepare face/oral prosthesis24.9219.5814.391.8646.3641.17090
    21087APrepare face/oral prosthesis24.9218.3313.762.2245.4740.90090
    21088CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21089CPrepare face/oral prosthesis0.000.000.000.000.000.00090
    21100AMaxillofacial fixation4.225.663.700.1810.068.10090
    21110AInterdental fixation5.215.254.480.2810.749.97090
    21116AInjection, jaw joint x-ray0.817.880.300.058.741.16000
    21120AReconstruction of chin4.937.964.980.2913.1810.20090
    21121AReconstruction of chin7.647.686.650.5615.8814.85090
    21122AReconstruction of chin8.52NA7.950.59NA17.06090
    21123AReconstruction of chin11.16NA7.681.16NA20.00090
    21125AAugmentation, lower jaw bone10.629.567.840.7220.9019.18090
    21127AAugmentation, lower jaw bone11.1210.667.330.7622.5419.21090
    21137AReduction of forehead9.82NA8.200.53NA18.55090
    21138AReduction of forehead12.19NA8.821.47NA22.48090
    21139AReduction of forehead14.61NA8.231.02NA23.86090
    21141AReconstruct midface, lefort18.10NA10.691.63NA30.42090
    21142AReconstruct midface, lefort18.81NA13.801.16NA33.77090
    21143AReconstruct midface, lefort19.58NA11.210.90NA31.69090
    21145AReconstruct midface, lefort19.94NA11.692.09NA33.72090
    21146AReconstruct midface, lefort20.71NA11.612.13NA34.45090
    21147AReconstruct midface, lefort21.77NA12.071.52NA35.36090
    21150AReconstruct midface, lefort25.24NA17.201.09NA43.53090
    21151AReconstruct midface, lefort28.30NA21.351.98NA51.63090
    21154AReconstruct midface, lefort30.52NA21.034.86NA56.41090
    21155AReconstruct midface, lefort34.45NA23.205.48NA63.13090
    21159AReconstruct midface, lefort42.38NA21.726.74NA70.84090
    21160AReconstruct midface, lefort46.44NA30.394.39NA81.22090
    21172AReconstruct orbit/forehead27.80NA16.391.91NA46.10090
    21175AReconstruct orbit/forehead33.17NA19.795.16NA58.12090
    21179AReconstruct entire forehead22.25NA18.942.48NA43.67090
    21180AReconstruct entire forehead25.19NA18.332.15NA45.67090
    21181AContour cranial bone lesion9.90NA8.460.97NA19.33090
    21182AReconstruct cranial bone32.19NA21.972.53NA56.69090
    21183AReconstruct cranial bone35.31NA22.932.75NA60.99090
    21184AReconstruct cranial bone38.24NA19.544.12NA61.90090
    21188AReconstruction of midface22.46NA15.861.85NA40.17090
    21193AReconst lwr jaw w/o graft17.15NA10.771.53NA29.45090
    21194AReconst lwr jaw w/graft19.84NA12.441.39NA33.67090
    21195AReconst lwr jaw w/o fixation17.24NA12.361.20NA30.80090
    21196AReconst lwr jaw w/fixation18.91NA12.831.62NA33.36090
    21198AReconstr lwr jaw segment14.16NA12.301.05NA27.51090
    21199AReconstr lwr jaw w/advance16.00NA10.851.26NA28.11090
    21206AReconstruct upper jaw bone14.10NA9.391.01NA24.50090
    21208AAugmentation of facial bones10.238.958.620.9220.1019.77090
    21209AReduction of facial bones6.728.056.540.6015.3713.86090
    21210AFace bone graft10.238.828.280.8819.9319.39090
    21215ALower jaw bone graft10.778.957.481.0420.7619.29090
    21230ARib cartilage graft10.77NA10.850.96NA22.58090
    21235AEar cartilage graft6.7211.908.360.5219.1415.60090
    21240AReconstruction of jaw joint14.05NA11.791.15NA26.99090
    21242AReconstruction of jaw joint12.95NA10.851.40NA25.20090
    21243AReconstruction of jaw joint20.79NA13.971.85NA36.61090
    21244AReconstruction of lower jaw11.86NA9.560.95NA22.37090
    21245AReconstruction of jaw11.8624.8510.250.8837.5922.99090
    21246AReconstruction of jaw12.4710.2010.201.2123.8823.88090Start Printed Page 55342
    21247AReconstruct lower jaw bone22.63NA20.172.21NA45.01090
    21248AReconstruction of jaw11.488.917.861.0121.4020.35090
    21249AReconstruction of jaw17.5211.4410.351.3930.3529.26090
    21255AReconstruct lower jaw bone16.72NA13.161.13NA31.01090
    21256AReconstruction of orbit16.19NA13.871.04NA31.10090
    21260ARevise eye sockets16.52NA13.541.25NA31.31090
    21261ARevise eye sockets31.49NA20.042.20NA53.73090
    21263ARevise eye sockets28.42NA15.092.16NA45.67090
    21267ARevise eye sockets18.90NA14.751.35NA35.00090
    21268ARevise eye sockets24.48NA15.150.79NA40.42090
    21270AAugmentation, cheek bone10.2310.399.990.7321.3520.95090
    21275ARevision, orbitofacial bones11.24NA11.021.03NA23.29090
    21280ARevision of eyelid6.03NA6.270.27NA12.57090
    21282ARevision of eyelid3.49NA5.380.21NA9.08090
    21295ARevision of jaw muscle/bone1.53NA4.340.13NA6.00090
    21296ARevision of jaw muscle/bone4.25NA4.090.30NA8.64090
    21299CCranio/maxillofacial surgery0.000.000.000.000.000.00YYY
    21300ATreatment of skull fracture0.722.770.300.093.581.11000
    21310ATreatment of nose fracture0.582.700.150.053.330.78000
    21315ATreatment of nose fracture1.513.491.270.125.122.90010
    21320ATreatment of nose fracture1.854.962.100.156.964.10010
    21325ATreatment of nose fracture3.77NA3.730.31NA7.81090
    21330ATreatment of nose fracture5.38NA5.670.48NA11.53090
    21335ATreatment of nose fracture8.61NA7.340.64NA16.59090
    21336ATreat nasal septal fracture5.72NA5.740.45NA11.91090
    21337ATreat nasal septal fracture2.705.243.420.228.166.34090
    21338ATreat nasoethmoid fracture6.46NA5.750.53NA12.74090
    21339ATreat nasoethmoid fracture8.09NA6.970.76NA15.82090
    21340ATreatment of nose fracture10.77NA8.780.85NA20.40090
    21343ATreatment of sinus fracture12.95NA9.481.06NA23.49090
    21344ATreatment of sinus fracture19.72NA13.821.72NA35.26090
    21345ATreat nose/jaw fracture8.1610.367.910.6019.1216.67090
    21346ATreat nose/jaw fracture10.61NA10.120.85NA21.58090
    21347ATreat nose/jaw fracture12.69NA9.681.14NA23.51090
    21348ATreat nose/jaw fracture16.69NA11.571.50NA29.76090
    21355ATreat cheek bone fracture3.773.892.540.297.956.60010
    21356ATreat cheek bone fracture4.15NA3.310.36NA7.82010
    21360ATreat cheek bone fracture6.46NA5.740.52NA12.72090
    21365ATreat cheek bone fracture14.95NA11.721.30NA27.97090
    21366ATreat cheek bone fracture17.77NA14.281.41NA33.46090
    21385ATreat eye socket fracture9.16NA8.040.64NA17.84090
    21386ATreat eye socket fracture9.16NA8.430.76NA18.35090
    21387ATreat eye socket fracture9.70NA8.550.78NA19.03090
    21390ATreat eye socket fracture10.13NA8.730.70NA19.56090
    21395ATreat eye socket fracture12.68NA9.241.09NA23.01090
    21400ATreat eye socket fracture1.403.291.050.124.812.57090
    21401ATreat eye socket fracture3.264.343.650.347.947.25090
    21406ATreat eye socket fracture7.01NA7.200.59NA14.80090
    21407ATreat eye socket fracture8.61NA7.990.67NA17.27090
    21408ATreat eye socket fracture12.38NA10.291.24NA23.91090
    21421ATreat mouth roof fracture5.147.236.840.4212.7912.40090
    21422ATreat mouth roof fracture8.32NA7.930.69NA16.94090
    21423ATreat mouth roof fracture10.40NA8.630.95NA19.98090
    21431ATreat craniofacial fracture7.05NA8.440.58NA16.07090
    21432ATreat craniofacial fracture8.61NA8.060.55NA17.22090
    21433ATreat craniofacial fracture25.35NA17.292.46NA45.10090
    21435ATreat craniofacial fracture17.25NA12.971.66NA31.88090
    21436ATreat craniofacial fracture28.04NA16.022.32NA46.38090
    21440ATreat dental ridge fracture2.705.443.730.228.366.65090
    21445ATreat dental ridge fracture5.387.145.040.5513.0710.97090
    21450ATreat lower jaw fracture2.976.452.900.239.656.10090
    21451ATreat lower jaw fracture4.876.466.110.3911.7211.37090
    21452ATreat lower jaw fracture1.9813.444.350.1415.566.47090
    21453ATreat lower jaw fracture5.547.326.690.4913.3512.72090
    21454ATreat lower jaw fracture6.46NA5.720.55NA12.73090
    21461ATreat lower jaw fracture8.098.408.260.7317.2217.08090
    21462ATreat lower jaw fracture9.7910.068.180.8020.6518.77090
    21465ATreat lower jaw fracture11.91NA8.420.84NA21.17090
    21470ATreat lower jaw fracture15.34NA10.311.36NA27.01090
    21480AReset dislocated jaw0.611.620.180.052.280.84000
    21485AReset dislocated jaw3.993.823.340.318.127.64090
    21490ARepair dislocated jaw11.86NA7.691.31NA20.86090
    21493ATreat hyoid bone fracture1.27NA3.680.10NA5.05090Start Printed Page 55343
    21494ATreat hyoid bone fracture6.28NA4.210.44NA10.93090
    21495ATreat hyoid bone fracture5.69NA5.280.41NA11.38090
    21497AInterdental wiring3.864.683.810.318.857.98090
    21499CHead surgery procedure0.000.000.000.000.000.00YYY
    21501ADrain neck/chest lesion3.814.503.640.368.677.81090
    21502ADrain chest lesion7.12NA7.050.79NA14.96090
    21510ADrainage of bone lesion5.74NA7.470.67NA13.88090
    21550ABiopsy of neck/chest2.062.321.250.134.513.44010
    21555ARemove lesion, neck/chest4.354.252.430.419.017.19090
    21556ARemove lesion, neck/chest5.57NA3.290.51NA9.37090
    21557ARemove tumor, neck/chest8.88NA7.870.85NA17.60090
    21600APartial removal of rib6.89NA7.800.81NA15.50090
    21610APartial removal of rib14.61NA11.261.85NA27.72090
    21615ARemoval of rib9.87NA7.901.20NA18.97090
    21616ARemoval of rib and nerves12.04NA8.941.31NA22.29090
    21620APartial removal of sternum6.79NA8.130.77NA15.69090
    21627ASternal debridement6.81NA12.160.82NA19.79090
    21630AExtensive sternum surgery17.38NA14.031.95NA33.36090
    21632AExtensive sternum surgery18.14NA12.352.16NA32.65090
    21700ARevision of neck muscle6.198.637.190.3115.1313.69090
    21705ARevision of neck muscle/rib9.60NA7.870.92NA18.39090
    21720ARevision of neck muscle5.688.715.930.8015.1912.41090
    21725ARevision of neck muscle6.99NA7.280.90NA15.17090
    21740AReconstruction of sternum16.50NA12.852.03NA31.38090
    21750ARepair of sternum separation10.77NA9.411.35NA21.53090
    21800ATreatment of rib fracture0.962.311.110.093.362.16090
    21805ATreatment of rib fracture2.75NA4.080.29NA7.12090
    21810ATreatment of rib fracture(s)6.86NA7.490.60NA14.95090
    21820ATreat sternum fracture1.282.801.580.154.233.01090
    21825ATreat sternum fracture7.41NA9.900.84NA18.15090
    21899CNeck/chest surgery procedure0.000.000.000.000.000.00YYY
    21920ABiopsy soft tissue of back2.062.400.770.124.582.95010
    21925ABiopsy soft tissue of back4.4910.194.790.4415.129.72090
    21930ARemove lesion, back or flank5.004.552.660.4910.048.15090
    21935ARemove tumor, back17.96NA13.531.87NA33.36090
    22100ARemove part of neck vertebra9.73NA8.361.55NA19.64090
    22101ARemove part, thorax vertebra9.81NA9.041.51NA20.36090
    22102ARemove part, lumbar vertebra9.81NA9.181.46NA20.45090
    22103ARemove extra spine segment2.34NA1.270.37NA3.98ZZZ
    22110ARemove part of neck vertebra12.74NA11.062.20NA26.00090
    22112ARemove part, thorax vertebra12.81NA10.951.96NA25.72090
    22114ARemove part, lumbar vertebra12.81NA10.711.98NA25.50090
    22116ARemove extra spine segment2.32NA1.260.40NA3.98ZZZ
    22210ARevision of neck spine23.82NA17.424.23NA45.47090
    22212ARevision of thorax spine19.42NA14.602.78NA36.80090
    22214ARevision of lumbar spine19.45NA15.322.78NA37.55090
    22216ARevise, extra spine segment6.04NA3.310.98NA10.33ZZZ
    22220ARevision of neck spine21.37NA15.613.65NA40.63090
    22222ARevision of thorax spine21.52NA15.083.08NA39.68090
    22224ARevision of lumbar spine21.52NA15.703.20NA40.42090
    22226ARevise, extra spine segment6.04NA3.221.01NA10.27ZZZ
    22305ATreat spine process fracture2.053.252.010.295.594.35090
    22310ATreat spine fracture2.614.773.540.377.756.52090
    22315ATreat spine fracture8.84NA9.321.37NA19.53090
    22318ATreat odontoid fx w/o graft21.50NA15.024.26NA40.78090
    22319ATreat odontoid fx w/graft24.00NA17.424.76NA46.18090
    22325ATreat spine fracture18.30NA14.942.61NA35.85090
    22326ATreat neck spine fracture19.59NA15.673.54NA38.80090
    22327ATreat thorax spine fracture19.20NA15.432.75NA37.38090
    22328ATreat each add spine fx4.61NA2.430.66NA7.70ZZZ
    22505AManipulation of spine1.874.583.200.276.725.34010
    22520APercut vertebroplasty thor8.91NA4.150.99NA14.05010
    22521APercut vertebroplasty lumb8.34NA3.920.93NA13.19010
    22522APercut vertebroplasty addl4.31NA1.750.33NA6.39ZZZ
    22548ANeck spine fusion25.82NA18.084.98NA48.88090
    22554ANeck spine fusion18.62NA13.943.51NA36.07090
    22556AThorax spine fusion23.46NA16.803.78NA44.04090
    22558ALumbar spine fusion22.28NA15.273.18NA40.73090
    22585AAdditional spinal fusion5.53NA2.940.98NA9.45ZZZ
    22590ASpine & skull spinal fusion20.51NA15.563.81NA39.88090
    22595ANeck spinal fusion19.39NA14.583.62NA37.59090
    22600ANeck spine fusion16.14NA12.662.89NA31.69090
    22610AThorax spine fusion16.02NA12.982.66NA31.66090Start Printed Page 55344
    22612ALumbar spine fusion21.00NA15.753.28NA40.03090
    22614ASpine fusion, extra segment6.44NA3.541.04NA11.02ZZZ
    22630ALumbar spine fusion20.84NA16.013.79NA40.64090
    22632ASpine fusion, extra segment5.23NA2.750.90NA8.88ZZZ
    22800AFusion of spine18.25NA14.302.71NA35.26090
    22802AFusion of spine30.88NA21.884.42NA57.18090
    22804AFusion of spine36.27NA24.485.23NA65.98090
    22808AFusion of spine26.27NA18.274.36NA48.90090
    22810AFusion of spine30.27NA19.634.49NA54.39090
    22812AFusion of spine32.70NA21.894.67NA59.26090
    22818AKyphectomy, 1-2 segments31.83NA21.695.01NA58.53090
    22819AKyphectomy, 3 or more36.44NA22.195.20NA63.83090
    22830AExploration of spinal fusion10.85NA10.051.73NA22.63090
    22840AInsert spine fixation device12.54NA6.842.03NA21.41ZZZ
    22841BInsert spine fixation device0.000.000.000.000.000.00XXX
    22842AInsert spine fixation device12.58NA6.832.04NA21.45ZZZ
    22843AInsert spine fixation device13.46NA7.392.10NA22.95ZZZ
    22844AInsert spine fixation device16.44NA9.262.42NA28.12ZZZ
    22845AInsert spine fixation device11.96NA6.382.22NA20.56ZZZ
    22846AInsert spine fixation device12.42NA6.702.26NA21.38ZZZ
    22847AInsert spine fixation device13.80NA7.082.36NA23.24ZZZ
    22848AInsert pelv fixation device6.00NA3.380.88NA10.26ZZZ
    22849AReinsert spinal fixation18.51NA14.222.87NA35.60090
    22850ARemove spine fixation device9.52NA8.891.51NA19.92090
    22851AApply spine prosth device6.71NA3.541.11NA11.36ZZZ
    22852ARemove spine fixation device9.01NA8.601.40NA19.01090
    22855ARemove spine fixation device15.13NA11.672.74NA29.54090
    22899CSpine surgery procedure0.000.000.000.000.000.00YYY
    22900ARemove abdominal wall lesion5.80NA4.420.58NA10.80090
    22999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    23000ARemoval of calcium deposits4.369.046.970.5013.9011.83090
    23020ARelease shoulder joint8.93NA10.531.23NA20.69090
    23030ADrain shoulder lesion3.436.404.440.4210.258.29010
    23031ADrain shoulder bursa2.745.804.160.338.877.23010
    23035ADrain shoulder bone lesion8.61NA16.131.19NA25.93090
    23040AExploratory shoulder surgery9.20NA11.711.28NA22.19090
    23044AExploratory shoulder surgery7.12NA10.730.97NA18.82090
    23065ABiopsy shoulder tissues2.272.611.340.145.023.75010
    23066ABiopsy shoulder tissues4.168.346.160.5013.0010.82090
    23075ARemoval of shoulder lesion2.395.403.170.258.045.81010
    23076ARemoval of shoulder lesion7.63NA8.360.87NA16.86090
    23077ARemove tumor of shoulder16.09NA14.411.81NA32.31090
    23100ABiopsy of shoulder joint6.03NA8.730.81NA15.57090
    23101AShoulder joint surgery5.58NA8.630.77NA14.98090
    23105ARemove shoulder joint lining8.23NA10.181.13NA19.54090
    23106AIncision of collarbone joint5.96NA9.270.82NA16.05090
    23107AExplore treat shoulder joint8.62NA10.411.19NA20.22090
    23120APartial removal, collar bone7.11NA9.550.99NA17.65090
    23125ARemoval of collar bone9.39NA10.781.27NA21.44090
    23130ARemove shoulder bone, part7.55NA9.821.06NA18.43090
    23140ARemoval of bone lesion6.89NA8.310.82NA16.02090
    23145ARemoval of bone lesion9.09NA10.871.24NA21.20090
    23146ARemoval of bone lesion7.83NA10.701.11NA19.64090
    23150ARemoval of humerus lesion8.48NA10.141.14NA19.76090
    23155ARemoval of humerus lesion10.35NA12.331.20NA23.88090
    23156ARemoval of humerus lesion8.68NA10.451.18NA20.31090
    23170ARemove collar bone lesion6.86NA11.330.84NA19.03090
    23172ARemove shoulder blade lesion6.90NA9.590.95NA17.44090
    23174ARemove humerus lesion9.51NA11.741.30NA22.55090
    23180ARemove collar bone lesion8.53NA16.161.18NA25.87090
    23182ARemove shoulder blade lesion8.15NA16.181.08NA25.41090
    23184ARemove humerus lesion9.38NA16.431.24NA27.05090
    23190APartial removal of scapula7.24NA8.740.97NA16.95090
    23195ARemoval of head of humerus9.81NA10.031.38NA21.22090
    23200ARemoval of collar bone12.08NA14.391.48NA27.95090
    23210ARemoval of shoulder blade12.49NA13.961.61NA28.06090
    23220APartial removal of humerus14.56NA15.572.03NA32.16090
    23221APartial removal of humerus17.74NA16.932.51NA37.18090
    23222APartial removal of humerus23.92NA20.663.37NA47.95090
    23330ARemove shoulder foreign body1.856.153.490.188.185.52010
    23331ARemove shoulder foreign body7.38NA9.701.02NA18.10090
    23332ARemove shoulder foreign body11.62NA12.121.62NA25.36090
    23350AInjection for shoulder x-ray1.007.220.350.058.271.40000Start Printed Page 55345
    23395AMuscle transfer, shoulder/arm16.85NA14.092.29NA33.23090
    23397AMuscle transfers16.13NA13.862.24NA32.23090
    23400AFixation of shoulder blade13.54NA14.521.91NA29.97090
    23405AIncision of tendon & muscle8.37NA9.661.12NA19.15090
    23406AIncise tendon(s) & muscle(s)10.79NA11.551.48NA23.82090
    23410ARepair of tendon(s)12.45NA12.551.72NA26.72090
    23412ARepair of tendon(s)13.31NA13.051.86NA28.22090
    23415ARelease of shoulder ligament9.97NA10.221.39NA21.58090
    23420ARepair of shoulder13.30NA13.941.86NA29.10090
    23430ARepair biceps tendon9.98NA11.151.40NA22.53090
    23440ARemove/transplant tendon10.48NA11.541.47NA23.49090
    23450ARepair shoulder capsule13.40NA13.021.86NA28.28090
    23455ARepair shoulder capsule14.37NA13.622.01NA30.00090
    23460ARepair shoulder capsule15.37NA14.212.17NA31.75090
    23462ARepair shoulder capsule15.30NA13.682.16NA31.14090
    23465ARepair shoulder capsule15.85NA14.471.61NA31.93090
    23466ARepair shoulder capsule14.22NA13.632.00NA29.85090
    23470AReconstruct shoulder joint17.15NA15.162.40NA34.71090
    23472AReconstruct shoulder joint21.10NA17.402.37NA40.87090
    23480ARevision of collar bone11.18NA11.941.56NA24.68090
    23485ARevision of collar bone13.43NA13.101.84NA28.37090
    23490AReinforce clavicle11.86NA13.741.11NA26.71090
    23491AReinforce shoulder bones14.21NA13.542.00NA29.75090
    23500ATreat clavicle fracture2.083.872.600.266.214.94090
    23505ATreat clavicle fracture3.695.984.020.5010.178.21090
    23515ATreat clavicle fracture7.41NA8.241.03NA16.68090
    23520ATreat clavicle dislocation2.163.912.670.266.335.09090
    23525ATreat clavicle dislocation3.607.164.080.4411.208.12090
    23530ATreat clavicle dislocation7.31NA7.940.85NA16.10090
    23532ATreat clavicle dislocation8.01NA8.671.13NA17.81090
    23540ATreat clavicle dislocation2.234.562.630.247.035.10090
    23545ATreat clavicle dislocation3.254.993.650.398.637.29090
    23550ATreat clavicle dislocation7.24NA8.290.94NA16.47090
    23552ATreat clavicle dislocation8.45NA8.821.18NA18.45090
    23570ATreat shoulder blade fx2.233.842.700.296.365.22090
    23575ATreat shoulder blade fx4.066.224.180.5310.818.77090
    23585ATreat scapula fracture8.96NA9.311.25NA19.52090
    23600ATreat humerus fracture2.935.653.710.398.977.03090
    23605ATreat humerus fracture4.878.326.550.6713.8612.09090
    23615ATreat humerus fracture9.35NA10.191.31NA20.85090
    23616ATreat humerus fracture21.27NA16.262.98NA40.51090
    23620ATreat humerus fracture2.405.353.430.328.076.15090
    23625ATreat humerus fracture3.937.355.570.5311.8110.03090
    23630ATreat humerus fracture7.35NA8.201.03NA16.58090
    23650ATreat shoulder dislocation3.395.583.670.319.287.37090
    23655ATreat shoulder dislocation4.57NA4.390.52NA9.48090
    23660ATreat shoulder dislocation7.49NA8.271.01NA16.77090
    23665ATreat dislocation/fracture4.477.685.810.6012.7510.88090
    23670ATreat dislocation/fracture7.90NA8.721.10NA17.72090
    23675ATreat dislocation/fracture6.058.226.710.8315.1013.59090
    23680ATreat dislocation/fracture10.06NA9.891.39NA21.34090
    23700AFixation of shoulder2.52NA3.480.35NA6.35010
    23800AFusion of shoulder joint14.16NA14.281.97NA30.41090
    23802AFusion of shoulder joint16.60NA15.832.34NA34.77090
    23900AAmputation of arm & girdle19.72NA16.352.47NA38.54090
    23920AAmputation at shoulder joint14.61NA13.701.92NA30.23090
    23921AAmputation follow-up surgery5.49NA6.670.78NA12.94090
    23929CShoulder surgery procedure0.000.000.000.000.000.00YYY
    23930ADrainage of arm lesion2.946.104.010.329.367.27010
    23931ADrainage of arm bursa1.795.763.740.217.765.74010
    23935ADrain arm/elbow bone lesion6.09NA12.900.84NA19.83090
    24000AExploratory elbow surgery5.82NA6.060.77NA12.65090
    24006ARelease elbow joint9.31NA8.641.27NA19.22090
    24065ABiopsy arm/elbow soft tissue2.085.503.250.147.725.47010
    24066ABiopsy arm/elbow soft tissue5.218.486.400.6114.3012.22090
    24075ARemove arm/elbow lesion3.927.805.910.4312.1510.26090
    24076ARemove arm/elbow lesion6.30NA7.390.70NA14.39090
    24077ARemove tumor of arm/elbow11.76NA14.231.32NA27.31090
    24100ABiopsy elbow joint lining4.93NA5.830.62NA11.38090
    24101AExplore/treat elbow joint6.13NA6.820.84NA13.79090
    24102ARemove elbow joint lining8.03NA7.811.09NA16.93090
    24105ARemoval of elbow bursa3.61NA5.260.49NA9.36090
    24110ARemove humerus lesion7.39NA9.750.99NA18.13090Start Printed Page 55346
    24115ARemove/graft bone lesion9.63NA10.801.15NA21.58090
    24116ARemove/graft bone lesion11.81NA12.201.66NA25.67090
    24120ARemove elbow lesion6.65NA6.960.87NA14.48090
    24125ARemove/graft bone lesion7.89NA6.670.88NA15.44090
    24126ARemove/graft bone lesion8.31NA7.790.90NA17.00090
    24130ARemoval of head of radius6.25NA6.910.87NA14.03090
    24134ARemoval of arm bone lesion9.73NA16.501.31NA27.54090
    24136ARemove radius bone lesion7.99NA7.090.85NA15.93090
    24138ARemove elbow bone lesion8.05NA8.061.12NA17.23090
    24140APartial removal of arm bone9.18NA16.671.23NA27.08090
    24145APartial removal of radius7.58NA11.431.01NA20.02090
    24147APartial removal of elbow7.54NA11.401.04NA19.98090
    24149ARadical resection of elbow14.20NA11.281.90NA27.38090
    24150AExtensive humerus surgery13.27NA14.921.81NA30.00090
    24151AExtensive humerus surgery15.58NA16.642.19NA34.41090
    24152AExtensive radius surgery10.06NA9.961.19NA21.21090
    24153AExtensive radius surgery11.54NA7.550.64NA19.73090
    24155ARemoval of elbow joint11.73NA9.661.42NA22.81090
    24160ARemove elbow joint implant7.83NA7.771.07NA16.67090
    24164ARemove radius head implant6.23NA6.930.84NA14.00090
    24200ARemoval of arm foreign body1.765.803.250.157.715.16010
    24201ARemoval of arm foreign body4.568.426.970.5613.5412.09090
    24220AInjection for elbow x-ray1.3111.160.470.0712.541.85000
    24300AManipulate elbow w/anesth3.75NA5.460.52NA9.73090
    24301AMuscle/tendon transfer10.20NA9.111.30NA20.61090
    24305AArm tendon lengthening7.45NA7.700.98NA16.13090
    24310ARevision of arm tendon5.98NA8.430.74NA15.15090
    24320ARepair of arm tendon10.56NA11.291.00NA22.85090
    24330ARevision of arm muscles9.60NA8.791.21NA19.60090
    24331ARevision of arm muscles10.65NA9.251.41NA21.31090
    24332ATenolysis, triceps7.45NA5.230.77NA13.45090
    24340ARepair of biceps tendon7.89NA7.741.08NA16.71090
    24341ARepair arm tendon/muscle7.90NA7.851.08NA16.83090
    24342ARepair of ruptured tendon10.62NA9.371.48NA21.47090
    24343ARepr elbow lat ligmnt w/tiss8.65NA7.911.21NA17.77090
    24344AReconstruct elbow lat ligmnt14.00NA10.871.95NA26.82090
    24345ARepr elbw med ligmnt w/tiss8.65NA7.911.21NA17.77090
    24346AReconstruct elbow med ligmnt14.00NA10.871.95NA26.82090
    24350ARepair of tennis elbow5.25NA6.250.72NA12.22090
    24351ARepair of tennis elbow5.91NA6.720.82NA13.45090
    24352ARepair of tennis elbow6.43NA7.010.90NA14.34090
    24354ARepair of tennis elbow6.48NA6.850.88NA14.21090
    24356ARevision of tennis elbow6.68NA7.210.90NA14.79090
    24360AReconstruct elbow joint12.34NA10.261.69NA24.29090
    24361AReconstruct elbow joint14.08NA11.301.95NA27.33090
    24362AReconstruct elbow joint14.99NA11.301.92NA28.21090
    24363AReplace elbow joint18.49NA13.802.52NA34.81090
    24365AReconstruct head of radius8.39NA7.961.11NA17.46090
    24366AReconstruct head of radius9.13NA8.481.28NA18.89090
    24400ARevision of humerus11.06NA12.481.53NA25.07090
    24410ARevision of humerus14.82NA13.751.89NA30.46090
    24420ARevision of humerus13.44NA16.081.82NA31.34090
    24430ARepair of humerus12.81NA12.881.80NA27.49090
    24435ARepair humerus with graft13.17NA13.981.84NA28.99090
    24470ARevision of elbow joint8.74NA6.591.23NA16.56090
    24495ADecompression of forearm8.12NA10.330.92NA19.37090
    24498AReinforce humerus11.92NA12.311.67NA25.90090
    24500ATreat humerus fracture3.215.093.380.418.717.00090
    24505ATreat humerus fracture5.178.886.810.7214.7712.70090
    24515ATreat humerus fracture11.65NA11.401.63NA24.68090
    24516ATreat humerus fracture11.65NA11.851.63NA25.13090
    24530ATreat humerus fracture3.506.194.860.4710.168.83090
    24535ATreat humerus fracture6.878.816.720.9616.6414.55090
    24538ATreat humerus fracture9.43NA10.611.25NA21.29090
    24545ATreat humerus fracture10.46NA10.181.47NA22.11090
    24546ATreat humerus fracture15.69NA13.692.18NA31.56090
    24560ATreat humerus fracture2.804.873.230.358.026.38090
    24565ATreat humerus fracture5.568.095.820.7414.3912.12090
    24566ATreat humerus fracture7.79NA9.961.10NA18.85090
    24575ATreat humerus fracture10.66NA8.491.44NA20.59090
    24576ATreat humerus fracture2.864.623.260.387.866.50090
    24577ATreat humerus fracture5.798.226.130.8114.8212.73090
    24579ATreat humerus fracture11.60NA11.321.62NA24.54090Start Printed Page 55347
    24582ATreat humerus fracture8.55NA10.461.20NA20.21090
    24586ATreat elbow fracture15.21NA11.232.12NA28.56090
    24587ATreat elbow fracture15.16NA11.132.14NA28.43090
    24600ATreat elbow dislocation4.236.825.120.4911.549.84090
    24605ATreat elbow dislocation5.42NA5.020.72NA11.16090
    24615ATreat elbow dislocation9.42NA7.941.31NA18.67090
    24620ATreat elbow fracture6.98NA6.630.90NA14.51090
    24635ATreat elbow fracture13.19NA16.551.84NA31.58090
    24640ATreat elbow dislocation1.203.351.880.114.663.19010
    24650ATreat radius fracture2.164.552.920.286.995.36090
    24655ATreat radius fracture4.407.335.220.5812.3110.20090
    24665ATreat radius fracture8.14NA9.401.13NA18.67090
    24666ATreat radius fracture9.49NA10.181.32NA20.99090
    24670ATreat ulnar fracture2.544.493.100.337.365.97090
    24675ATreat ulnar fracture4.727.555.490.6512.9210.86090
    24685ATreat ulnar fracture8.80NA9.791.23NA19.82090
    24800AFusion of elbow joint11.20NA9.901.41NA22.51090
    24802AFusion/graft of elbow joint13.69NA11.501.89NA27.08090
    24900AAmputation of upper arm9.60NA11.371.18NA22.15090
    24920AAmputation of upper arm9.54NA13.961.22NA24.72090
    24925AAmputation follow-up surgery7.07NA9.640.95NA17.66090
    24930AAmputation follow-up surgery10.25NA10.861.23NA22.34090
    24931AAmputate upper arm & implant12.72NA11.631.56NA25.91090
    24935ARevision of amputation15.56NA13.221.58NA30.36090
    24940CRevision of upper arm0.000.000.000.000.000.00090
    24999CUpper arm/elbow surgery0.000.000.000.000.000.00YYY
    25000AIncision of tendon sheath3.38NA7.490.45NA11.32090
    25001AIncise flexor carpi radialis3.38NA4.300.45NA8.13090
    25020ADecompress forearm 1 space5.92NA11.490.75NA18.16090
    25023ADecompress forearm 1 space12.96NA17.501.50NA31.96090
    25024ADecompress forearm 2 spaces9.50NA8.171.20NA18.87090
    25025ADecompress forearm 2 spaces16.54NA12.051.91NA30.50090
    25028ADrainage of forearm lesion5.25NA10.200.61NA16.06090
    25031ADrainage of forearm bursa4.14NA10.240.50NA14.88090
    25035ATreat forearm bone lesion7.36NA16.180.98NA24.52090
    25040AExplore/treat wrist joint7.18NA9.400.96NA17.54090
    25065ABiopsy forearm soft tissues1.992.532.530.124.644.64010
    25066ABiopsy forearm soft tissues4.13NA8.400.49NA13.02090
    25075ARemove forearm lesion subcut3.74NA7.130.40NA11.27090
    25076ARemove forearm lesion deep4.92NA12.680.59NA18.19090
    25077ARemove tumor, forearm/wrist9.76NA15.661.10NA26.52090
    25085AIncision of wrist capsule5.50NA11.290.71NA17.50090
    25100ABiopsy of wrist joint3.90NA7.990.50NA12.39090
    25101AExplore/treat wrist joint4.69NA7.750.60NA13.04090
    25105ARemove wrist joint lining5.85NA11.220.77NA17.84090
    25107ARemove wrist joint cartilage6.43NA11.410.82NA18.66090
    25110ARemove wrist tendon lesion3.92NA8.940.48NA13.34090
    25111ARemove wrist tendon lesion3.39NA6.700.42NA10.51090
    25112AReremove wrist tendon lesion4.53NA7.430.54NA12.50090
    25115ARemove wrist/forearm lesion8.82NA17.191.11NA27.12090
    25116ARemove wrist/forearm lesion7.11NA16.200.90NA24.21090
    25118AExcise wrist tendon sheath4.37NA7.930.55NA12.85090
    25119APartial removal of ulna6.04NA11.450.80NA18.29090
    25120ARemoval of forearm lesion6.10NA14.870.81NA21.78090
    25125ARemove/graft forearm lesion7.48NA16.111.02NA24.61090
    25126ARemove/graft forearm lesion7.55NA15.761.00NA24.31090
    25130ARemoval of wrist lesion5.26NA8.330.66NA14.25090
    25135ARemove & graft wrist lesion6.89NA9.000.89NA16.78090
    25136ARemove & graft wrist lesion5.97NA9.260.58NA15.81090
    25145ARemove forearm bone lesion6.37NA15.430.82NA22.62090
    25150APartial removal of ulna7.09NA12.000.96NA20.05090
    25151APartial removal of radius7.39NA16.220.93NA24.54090
    25170AExtensive forearm surgery11.09NA17.561.52NA30.17090
    25210ARemoval of wrist bone5.95NA8.710.73NA15.39090
    25215ARemoval of wrist bones7.89NA12.271.02NA21.18090
    25230APartial removal of radius5.23NA8.230.66NA14.12090
    25240APartial removal of ulna5.17NA10.780.69NA16.64090
    25246AInjection for wrist x-ray1.4510.200.520.0711.722.04000
    25248ARemove forearm foreign body5.14NA10.660.54NA16.34090
    25250ARemoval of wrist prosthesis6.60NA8.910.84NA16.35090
    25251ARemoval of wrist prosthesis9.57NA12.521.15NA23.24090
    25259AManipulate wrist w/anesthes3.75NA5.350.52NA9.62090
    25260ARepair forearm tendon/muscle7.80NA17.110.97NA25.88090Start Printed Page 55348
    25263ARepair forearm tendon/muscle7.82NA15.650.94NA24.41090
    25265ARepair forearm tendon/muscle9.88NA17.111.19NA28.18090
    25270ARepair forearm tendon/muscle6.00NA16.040.76NA22.80090
    25272ARepair forearm tendon/muscle7.04NA16.500.89NA24.43090
    25274ARepair forearm tendon/muscle8.75NA17.361.11NA27.22090
    25275ARepair forearm tendon sheath8.50NA7.531.11NA17.14090
    25280ARevise wrist/forearm tendon7.22NA15.800.91NA23.93090
    25290AIncise wrist/forearm tendon5.29NA18.170.66NA24.12090
    25295ARelease wrist/forearm tendon6.55NA15.160.84NA22.55090
    25300AFusion of tendons at wrist8.80NA10.021.07NA19.89090
    25301AFusion of tendons at wrist8.40NA10.151.08NA19.63090
    25310ATransplant forearm tendon8.14NA16.471.01NA25.62090
    25312ATransplant forearm tendon9.57NA17.241.22NA28.03090
    25315ARevise palsy hand tendon(s)10.20NA18.591.26NA30.05090
    25316ARevise palsy hand tendon(s)12.33NA18.401.74NA32.47090
    25320ARepair/revise wrist joint10.77NA11.531.32NA23.62090
    25332ARevise wrist joint11.41NA11.891.46NA24.76090
    25335ARealignment of hand12.88NA13.601.66NA28.14090
    25337AReconstruct ulna/radioulnar10.17NA13.801.31NA25.28090
    25350ARevision of radius8.78NA16.681.17NA26.63090
    25355ARevision of radius10.17NA17.171.44NA28.78090
    25360ARevision of ulna8.43NA16.861.17NA26.46090
    25365ARevise radius & ulna12.40NA18.741.67NA32.81090
    25370ARevise radius or ulna13.36NA17.841.88NA33.08090
    25375ARevise radius & ulna13.04NA16.441.84NA31.32090
    25390AShorten radius or ulna10.40NA17.381.38NA29.16090
    25391ALengthen radius or ulna13.65NA19.011.73NA34.39090
    25392AShorten radius & ulna13.95NA15.591.73NA31.27090
    25393ALengthen radius & ulna15.87NA21.721.87NA39.46090
    25394ARepair carpal bone, shorten10.40NA8.431.15NA19.98090
    25400ARepair radius or ulna10.92NA17.981.50NA30.40090
    25405ARepair/graft radius or ulna14.38NA20.381.95NA36.71090
    25415ARepair radius & ulna13.35NA19.141.87NA34.36090
    25420ARepair/graft radius & ulna16.33NA21.722.20NA40.25090
    25425ARepair/graft radius or ulna13.21NA24.751.61NA39.57090
    25426ARepair/graft radius & ulna15.82NA18.152.23NA36.20090
    25430AVasc graft into carpal bone9.25NA7.820.56NA17.63090
    25431ARepair nonunion carpal bone10.44NA6.420.56NA17.42090
    25440ARepair/graft wrist bone10.44NA11.051.41NA22.90090
    25441AReconstruct wrist joint12.90NA12.241.83NA26.97090
    25442AReconstruct wrist joint10.85NA11.461.24NA23.55090
    25443AReconstruct wrist joint10.39NA13.291.30NA24.98090
    25444AReconstruct wrist joint11.15NA14.291.43NA26.87090
    25445AReconstruct wrist joint9.69NA13.501.26NA24.45090
    25446AWrist replacement16.55NA14.452.20NA33.20090
    25447ARepair wrist joint(s)10.37NA11.271.34NA22.98090
    25449ARemove wrist joint implant14.49NA16.201.77NA32.46090
    25450ARevision of wrist joint7.87NA13.910.88NA22.66090
    25455ARevision of wrist joint9.49NA15.221.07NA25.78090
    25490AReinforce radius9.54NA16.701.19NA27.43090
    25491AReinforce ulna9.96NA16.981.41NA28.35090
    25492AReinforce radius and ulna12.33NA16.091.62NA30.04090
    25500ATreat fracture of radius2.454.272.940.287.005.67090
    25505ATreat fracture of radius5.217.875.650.6913.7711.55090
    25515ATreat fracture of radius9.18NA10.001.22NA20.40090
    25520ATreat fracture of radius6.268.006.280.8515.1113.39090
    25525ATreat fracture of radius12.24NA11.651.68NA25.57090
    25526ATreat fracture of radius12.98NA15.011.80NA29.79090
    25530ATreat fracture of ulna2.094.212.870.276.575.23090
    25535ATreat fracture of ulna5.147.745.720.6813.5611.54090
    25545ATreat fracture of ulna8.90NA9.881.23NA20.01090
    25560ATreat fracture radius & ulna2.444.282.930.276.995.64090
    25565ATreat fracture radius & ulna5.638.025.940.7614.4112.33090
    25574ATreat fracture radius & ulna7.01NA8.720.96NA16.69090
    25575ATreat fracture radius/ulna10.45NA10.741.46NA22.65090
    25600ATreat fracture radius/ulna2.634.533.100.347.506.07090
    25605ATreat fracture radius/ulna5.818.186.110.8114.8012.73090
    25611ATreat fracture radius/ulna7.77NA10.041.08NA18.89090
    25620ATreat fracture radius/ulna8.55NA9.671.17NA19.39090
    25622ATreat wrist bone fracture2.614.483.100.337.426.04090
    25624ATreat wrist bone fracture4.537.405.340.6112.5410.48090
    25628ATreat wrist bone fracture8.43NA9.681.14NA19.25090
    25630ATreat wrist bone fracture2.884.663.200.377.916.45090Start Printed Page 55349
    25635ATreat wrist bone fracture4.397.455.110.3912.239.89090
    25645ATreat wrist bone fracture7.25NA9.560.93NA17.74090
    25650ATreat wrist bone fracture3.054.753.240.378.176.66090
    25651APin ulnar styloid fracture5.36NA4.390.73NA10.48090
    25652ATreat fracture ulnar styloid7.60NA6.900.97NA15.47090
    25660ATreat wrist dislocation4.76NA5.450.59NA10.80090
    25670ATreat wrist dislocation7.92NA9.541.07NA18.53090
    25671APin radioulnar dislocation6.00NA6.020.75NA12.77090
    25675ATreat wrist dislocation4.677.575.390.5712.8110.63090
    25676ATreat wrist dislocation8.04NA9.521.10NA18.66090
    25680ATreat wrist fracture5.99NA6.450.61NA13.05090
    25685ATreat wrist fracture9.78NA10.201.25NA21.23090
    25690ATreat wrist dislocation5.50NA7.000.78NA13.28090
    25695ATreat wrist dislocation8.34NA9.681.07NA19.09090
    25800AFusion of wrist joint9.76NA10.871.30NA21.93090
    25805AFusion/graft of wrist joint11.28NA11.611.51NA24.40090
    25810AFusion/graft of wrist joint10.57NA11.331.37NA23.27090
    25820AFusion of hand bones7.45NA9.540.96NA17.95090
    25825AFuse hand bones with graft9.27NA10.511.20NA20.98090
    25830AFusion, radioulnar jnt/ulna10.06NA16.991.27NA28.32090
    25900AAmputation of forearm9.01NA15.041.08NA25.13090
    25905AAmputation of forearm9.12NA14.251.06NA24.43090
    25907AAmputation follow-up surgery7.80NA15.261.01NA24.07090
    25909AAmputation follow-up surgery8.96NA14.511.07NA24.54090
    25915AAmputation of forearm17.08NA15.112.41NA34.60090
    25920AAmputate hand at wrist8.68NA10.121.06NA19.86090
    25922AAmputate hand at wrist7.42NA7.580.93NA15.93090
    25924AAmputation follow-up surgery8.46NA10.191.07NA19.72090
    25927AAmputation of hand8.80NA14.111.02NA23.93090
    25929AAmputation follow-up surgery7.59NA7.420.89NA15.90090
    25931AAmputation follow-up surgery7.81NA15.790.88NA24.48090
    25999CForearm or wrist surgery0.000.000.000.000.000.00YYY
    26010ADrainage of finger abscess1.545.243.940.146.925.62010
    26011ADrainage of finger abscess2.197.486.500.259.928.94010
    26020ADrain hand tendon sheath4.67NA13.100.59NA18.36090
    26025ADrainage of palm bursa4.82NA13.260.60NA18.68090
    26030ADrainage of palm bursa(s)5.93NA14.020.72NA20.67090
    26034ATreat hand bone lesion6.23NA14.840.79NA21.86090
    26035ADecompress fingers/hand9.51NA15.171.12NA25.80090
    26037ADecompress fingers/hand7.25NA12.670.87NA20.79090
    26040ARelease palm contracture3.33NA12.870.45NA16.65090
    26045ARelease palm contracture5.56NA14.170.74NA20.47090
    26055AIncise finger tendon sheath2.698.127.690.3611.1710.74090
    26060AIncision of finger tendon2.81NA7.570.35NA10.73090
    26070AExplore/treat hand joint3.69NA11.690.35NA15.73090
    26075AExplore/treat finger joint3.79NA12.470.40NA16.66090
    26080AExplore/treat finger joint4.24NA13.090.52NA17.85090
    26100ABiopsy hand joint lining3.67NA8.430.45NA12.55090
    26105ABiopsy finger joint lining3.71NA12.950.45NA17.11090
    26110ABiopsy finger joint lining3.53NA12.460.44NA16.43090
    26115ARemove hand lesion subcut3.867.667.660.4812.0012.00090
    26116ARemove hand lesion, deep5.53NA13.910.69NA20.13090
    26117ARemove tumor, hand/finger8.55NA15.411.01NA24.97090
    26121ARelease palm contracture7.54NA15.800.94NA24.28090
    26123ARelease palm contracture9.29NA16.731.17NA27.19090
    26125ARelease palm contracture4.61NA2.600.57NA7.78ZZZ
    26130ARemove wrist joint lining5.42NA15.620.65NA21.69090
    26135ARevise finger joint, each6.96NA17.040.87NA24.87090
    26140ARevise finger joint, each6.17NA16.330.76NA23.26090
    26145ATendon excision, palm/finger6.32NA16.860.77NA23.95090
    26160ARemove tendon sheath lesion3.157.937.880.3911.4711.42090
    26170ARemoval of palm tendon, each4.77NA8.530.60NA13.90090
    26180ARemoval of finger tendon5.18NA9.190.64NA15.01090
    26185ARemove finger bone5.25NA8.760.67NA14.68090
    26200ARemove hand bone lesion5.51NA13.970.71NA20.19090
    26205ARemove/graft bone lesion7.70NA15.350.95NA24.00090
    26210ARemoval of finger lesion5.15NA14.320.64NA20.11090
    26215ARemove/graft finger lesion7.10NA14.890.77NA22.76090
    26230APartial removal of hand bone6.33NA12.870.84NA20.04090
    26235APartial removal, finger bone6.19NA12.560.78NA19.53090
    26236APartial removal, finger bone5.32NA12.620.66NA18.60090
    26250AExtensive hand surgery7.55NA17.330.92NA25.80090
    26255AExtensive hand surgery12.43NA18.741.05NA32.22090Start Printed Page 55350
    26260AExtensive finger surgery7.03NA16.390.83NA24.25090
    26261AExtensive finger surgery9.09NA16.100.84NA26.03090
    26262APartial removal of finger5.67NA14.810.70NA21.18090
    26320ARemoval of implant from hand3.98NA13.080.49NA17.55090
    26340AManipulate finger w/anesth2.50NA4.530.32NA7.35090
    26350ARepair finger/hand tendon5.99NA20.240.73NA26.96090
    26352ARepair/graft hand tendon7.68NA19.740.93NA28.35090
    26356ARepair finger/hand tendon8.07NA21.550.99NA30.61090
    26357ARepair finger/hand tendon8.58NA21.301.02NA30.90090
    26358ARepair/graft hand tendon9.14NA22.431.07NA32.64090
    26370ARepair finger/hand tendon7.11NA20.610.90NA28.62090
    26372ARepair/graft hand tendon8.76NA20.461.06NA30.28090
    26373ARepair finger/hand tendon8.16NA22.610.98NA31.75090
    26390ARevise hand/finger tendon9.19NA16.931.09NA27.21090
    26392ARepair/graft hand tendon10.26NA23.051.26NA34.57090
    26410ARepair hand tendon4.63NA16.260.57NA21.46090
    26412ARepair/graft hand tendon6.31NA16.830.80NA23.94090
    26415AExcision, hand/finger tendon8.34NA18.140.77NA27.25090
    26416AGraft hand or finger tendon9.37NA18.951.20NA29.52090
    26418ARepair finger tendon4.25NA16.340.50NA21.09090
    26420ARepair/graft finger tendon6.77NA17.920.83NA25.52090
    26426ARepair finger/hand tendon6.15NA17.050.77NA23.97090
    26428ARepair/graft finger tendon7.21NA16.050.84NA24.10090
    26432ARepair finger tendon4.02NA13.490.48NA17.99090
    26433ARepair finger tendon4.56NA14.420.56NA19.54090
    26434ARepair/graft finger tendon6.09NA15.340.71NA22.14090
    26437ARealignment of tendons5.82NA14.160.74NA20.72090
    26440ARelease palm/finger tendon5.02NA18.480.62NA24.12090
    26442ARelease palm & finger tendon8.16NA19.400.94NA28.50090
    26445ARelease hand/finger tendon4.31NA18.270.54NA23.12090
    26449ARelease forearm/hand tendon7.00NA20.160.84NA28.00090
    26450AIncision of palm tendon3.67NA8.710.46NA12.84090
    26455AIncision of finger tendon3.64NA8.380.47NA12.49090
    26460AIncise hand/finger tendon3.46NA8.060.44NA11.96090
    26471AFusion of finger tendons5.73NA13.930.73NA20.39090
    26474AFusion of finger tendons5.32NA13.300.69NA19.31090
    26476ATendon lengthening5.18NA12.720.62NA18.52090
    26477ATendon shortening5.15NA13.730.60NA19.48090
    26478ALengthening of hand tendon5.80NA14.730.77NA21.30090
    26479AShortening of hand tendon5.74NA13.710.76NA20.21090
    26480ATransplant hand tendon6.69NA19.630.84NA27.16090
    26483ATransplant/graft hand tendon8.29NA19.791.03NA29.11090
    26485ATransplant palm tendon7.70NA20.080.94NA28.72090
    26489ATransplant/graft palm tendon9.55NA17.340.98NA27.87090
    26490ARevise thumb tendon8.41NA14.871.05NA24.33090
    26492ATendon transfer with graft9.62NA15.841.19NA26.65090
    26494AHand tendon/muscle transfer8.47NA13.521.13NA23.12090
    26496ARevise thumb tendon9.59NA15.531.17NA26.29090
    26497AFinger tendon transfer9.57NA16.421.17NA27.16090
    26498AFinger tendon transfer14.00NA18.191.74NA33.93090
    26499ARevision of finger8.98NA14.610.94NA24.53090
    26500AHand tendon reconstruction5.96NA15.160.66NA21.78090
    26502AHand tendon reconstruction7.14NA15.140.87NA23.15090
    26504AHand tendon reconstruction7.47NA14.310.84NA22.62090
    26508ARelease thumb contracture6.01NA14.110.76NA20.88090
    26510AThumb tendon transfer5.43NA14.180.71NA20.32090
    26516AFusion of knuckle joint7.15NA15.060.90NA23.11090
    26517AFusion of knuckle joints8.83NA15.890.96NA25.68090
    26518AFusion of knuckle joints9.02NA15.911.13NA26.06090
    26520ARelease knuckle contracture5.30NA18.590.65NA24.54090
    26525ARelease finger contracture5.33NA18.670.66NA24.66090
    26530ARevise knuckle joint6.69NA19.350.86NA26.90090
    26531ARevise knuckle with implant7.91NA19.411.01NA28.33090
    26535ARevise finger joint5.24NA11.100.66NA17.00090
    26536ARevise/implant finger joint6.37NA17.970.80NA25.14090
    26540ARepair hand joint6.43NA14.540.81NA21.78090
    26541ARepair hand joint with graft8.62NA16.361.12NA26.10090
    26542ARepair hand joint with graft6.78NA14.510.87NA22.16090
    26545AReconstruct finger joint6.92NA16.160.79NA23.87090
    26546ARepair nonunion hand8.92NA15.951.14NA26.01090
    26548AReconstruct finger joint8.03NA16.130.98NA25.14090
    26550AConstruct thumb replacement21.24NA30.361.80NA53.40090
    26551AGreat toe-hand transfer46.58NA29.356.57NA82.50090Start Printed Page 55351
    26553ASingle transfer, toe-hand46.27NA29.231.99NA77.49090
    26554ADouble transfer, toe-hand54.95NA32.697.76NA95.40090
    26555APositional change of finger16.63NA24.002.13NA42.76090
    26556AToe joint transfer47.26NA29.626.67NA83.55090
    26560ARepair of web finger5.38NA12.550.60NA18.53090
    26561ARepair of web finger10.92NA18.610.69NA30.22090
    26562ARepair of web finger15.00NA13.440.98NA29.42090
    26565ACorrect metacarpal flaw6.74NA14.770.84NA22.35090
    26567ACorrect finger deformity6.82NA15.100.84NA22.76090
    26568ALengthen metacarpal/finger9.08NA19.481.10NA29.66090
    26580ARepair hand deformity18.18NA17.221.46NA36.86090
    26585DRepair finger deformity0.00NA0.000.00NA0.00090
    26587AReconstruct extra finger14.054.67NA1.0819.80NA090
    26590ARepair finger deformity17.96NA14.621.32NA33.90090
    26591ARepair muscles of hand3.25NA14.220.37NA17.84090
    26593ARelease muscles of hand5.31NA13.330.64NA19.28090
    26596AExcision constricting tissue8.95NA10.260.87NA20.08090
    26597DRelease of scar contracture0.00NA0.000.00NA0.00090
    26600ATreat metacarpal fracture1.964.152.830.256.365.04090
    26605ATreat metacarpal fracture2.856.054.290.389.287.52090
    26607ATreat metacarpal fracture5.36NA8.330.70NA14.39090
    26608ATreat metacarpal fracture5.36NA8.850.73NA14.94090
    26615ATreat metacarpal fracture5.33NA8.430.70NA14.46090
    26641ATreat thumb dislocation3.946.584.990.4210.949.35090
    26645ATreat thumb fracture4.417.335.300.5412.2810.25090
    26650ATreat thumb fracture5.72NA9.020.77NA15.51090
    26665ATreat thumb fracture7.60NA9.240.97NA17.81090
    26670ATreat hand dislocation3.696.464.930.3610.518.98090
    26675ATreat hand dislocation4.646.824.710.5612.029.91090
    26676APin hand dislocation5.52NA9.360.76NA15.64090
    26685ATreat hand dislocation6.98NA8.880.95NA16.81090
    26686ATreat hand dislocation7.94NA9.841.05NA18.83090
    26700ATreat knuckle dislocation3.695.013.020.359.057.06090
    26705ATreat knuckle dislocation4.196.264.330.5010.959.02090
    26706APin knuckle dislocation5.12NA5.870.64NA11.63090
    26715ATreat knuckle dislocation5.74NA8.620.75NA15.11090
    26720ATreat finger fracture, each1.663.061.720.204.923.58090
    26725ATreat finger fracture, each3.335.273.260.439.037.02090
    26727ATreat finger fracture, each5.23NA8.880.69NA14.80090
    26735ATreat finger fracture, each5.98NA8.990.77NA15.74090
    26740ATreat finger fracture, each1.943.862.670.246.044.85090
    26742ATreat finger fracture, each3.857.215.130.4911.559.47090
    26746ATreat finger fracture, each5.81NA8.930.74NA15.48090
    26750ATreat finger fracture, each1.703.662.470.195.554.36090
    26755ATreat finger fracture, each3.105.083.270.378.556.74090
    26756APin finger fracture, each4.39NA8.740.56NA13.69090
    26765ATreat finger fracture, each4.17NA8.020.51NA12.70090
    26770ATreat finger dislocation3.024.872.800.278.166.09090
    26775ATreat finger dislocation3.716.074.090.4310.218.23090
    26776APin finger dislocation4.80NA8.610.63NA14.04090
    26785ATreat finger dislocation4.21NA7.950.54NA12.70090
    26820AThumb fusion with graft8.26NA15.801.11NA25.17090
    26841AFusion of thumb7.13NA15.370.97NA23.47090
    26842AThumb fusion with graft8.24NA15.491.10NA24.83090
    26843AFusion of hand joint7.61NA13.910.99NA22.51090
    26844AFusion/graft of hand joint8.73NA15.631.12NA25.48090
    26850AFusion of knuckle6.97NA14.630.89NA22.49090
    26852AFusion of knuckle with graft8.46NA15.191.05NA24.70090
    26860AFusion of finger joint4.69NA13.450.60NA18.74090
    26861AFusion of finger jnt, add-on1.74NA0.990.22NA2.95ZZZ
    26862AFusion/graft of finger joint7.37NA15.180.92NA23.47090
    26863AFuse/graft added joint3.90NA2.250.51NA6.66ZZZ
    26910AAmputate metacarpal bone7.60NA13.980.90NA22.48090
    26951AAmputation of finger/thumb4.59NA13.060.56NA18.21090
    26952AAmputation of finger/thumb6.31NA14.470.74NA21.52090
    26989CHand/finger surgery0.000.000.000.000.000.00YYY
    26990ADrainage of pelvis lesion7.48NA15.920.92NA24.32090
    26991ADrainage of pelvis bursa6.6811.329.390.8518.8516.92090
    26992ADrainage of bone lesion13.02NA19.951.75NA34.72090
    27000AIncision of hip tendon5.62NA7.480.76NA13.86090
    27001AIncision of hip tendon6.94NA8.420.95NA16.31090
    27003AIncision of hip tendon7.34NA9.010.93NA17.28090
    27005AIncision of hip tendon9.66NA10.501.36NA21.52090Start Printed Page 55352
    27006AIncision of hip tendons9.68NA10.591.33NA21.60090
    27025AIncision of hip/thigh fascia11.16NA10.531.38NA23.07090
    27030ADrainage of hip joint13.01NA12.451.81NA27.27090
    27033AExploration of hip joint13.39NA12.621.87NA27.88090
    27035ADenervation of hip joint16.69NA19.671.70NA38.06090
    27036AExcision of hip joint/muscle12.88NA14.031.80NA28.71090
    27040ABiopsy of soft tissues2.876.234.000.219.317.08010
    27041ABiopsy of soft tissues9.89NA8.601.01NA19.50090
    27047ARemove hip/pelvis lesion7.459.267.030.7917.5015.27090
    27048ARemove hip/pelvis lesion6.25NA7.940.73NA14.92090
    27049ARemove tumor, hip/pelvis13.66NA13.771.60NA29.03090
    27050ABiopsy of sacroiliac joint4.36NA7.520.53NA12.41090
    27052ABiopsy of hip joint6.23NA8.240.85NA15.32090
    27054ARemoval of hip joint lining8.54NA10.671.17NA20.38090
    27060ARemoval of ischial bursa5.43NA7.210.60NA13.24090
    27062ARemove femur lesion/bursa5.37NA7.320.74NA13.43090
    27065ARemoval of hip bone lesion5.90NA8.650.76NA15.31090
    27066ARemoval of hip bone lesion10.33NA12.531.42NA24.28090
    27067ARemove/graft hip bone lesion13.83NA14.541.95NA30.32090
    27070APartial removal of hip bone10.72NA17.711.36NA29.79090
    27071APartial removal of hip bone11.46NA18.671.51NA31.64090
    27075AExtensive hip surgery35.00NA25.752.22NA62.97090
    27076AExtensive hip surgery22.12NA20.082.86NA45.06090
    27077AExtensive hip surgery40.00NA30.553.18NA73.73090
    27078AExtensive hip surgery13.44NA16.301.67NA31.41090
    27079AExtensive hip surgery13.75NA13.431.86NA29.04090
    27080ARemoval of tail bone6.39NA7.640.80NA14.83090
    27086ARemove hip foreign body1.875.853.700.177.895.74010
    27087ARemove hip foreign body8.54NA9.041.09NA18.67090
    27090ARemoval of hip prosthesis11.15NA11.371.55NA24.07090
    27091ARemoval of hip prosthesis22.14NA15.143.11NA40.39090
    27093AInjection for hip x-ray1.3013.590.530.0914.981.92000
    27095AInjection for hip x-ray1.5011.000.600.1012.602.20000
    27096AInject sacroiliac joint1.408.860.350.0810.341.83000
    27097ARevision of hip tendon8.80NA8.131.22NA18.15090
    27098ATransfer tendon to pelvis8.83NA9.181.24NA19.25090
    27100ATransfer of abdominal muscle11.08NA13.031.57NA25.68090
    27105ATransfer of spinal muscle11.77NA12.141.66NA25.57090
    27110ATransfer of iliopsoas muscle13.26NA12.991.38NA27.63090
    27111ATransfer of iliopsoas muscle12.15NA11.771.48NA25.40090
    27120AReconstruction of hip socket18.01NA14.282.45NA34.74090
    27122AReconstruction of hip socket14.98NA14.482.08NA31.54090
    27125APartial hip replacement14.69NA14.022.05NA30.76090
    27130ATotal hip arthroplasty20.12NA17.182.82NA40.12090
    27132ATotal hip arthroplasty23.30NA19.003.26NA45.56090
    27134ARevise hip joint replacement28.52NA21.823.97NA54.31090
    27137ARevise hip joint replacement21.17NA17.542.97NA41.68090
    27138ARevise hip joint replacement22.17NA17.943.11NA43.22090
    27140ATransplant femur ridge12.24NA11.981.67NA25.89090
    27146AIncision of hip bone17.43NA15.872.27NA35.57090
    27147ARevision of hip bone20.58NA17.872.61NA41.06090
    27151AIncision of hip bones22.51NA18.973.12NA44.60090
    27156ARevision of hip bones24.63NA19.843.48NA47.95090
    27158ARevision of pelvis19.74NA15.582.60NA37.92090
    27161AIncision of neck of femur16.71NA14.472.32NA33.50090
    27165AIncision/fixation of femur17.91NA14.922.51NA35.34090
    27170ARepair/graft femur head/neck16.07NA14.162.20NA32.43090
    27175ATreat slipped epiphysis8.46NA7.261.19NA16.91090
    27176ATreat slipped epiphysis12.05NA10.231.68NA23.96090
    27177ATreat slipped epiphysis15.08NA12.222.11NA29.41090
    27178ATreat slipped epiphysis11.99NA10.131.68NA23.80090
    27179ARevise head/neck of femur12.98NA10.901.84NA25.72090
    27181ATreat slipped epiphysis14.68NA11.921.74NA28.34090
    27185ARevision of femur epiphysis9.18NA10.041.29NA20.51090
    27187AReinforce hip bones13.54NA13.531.89NA28.96090
    27193ATreat pelvic ring fracture5.567.145.360.7713.4711.69090
    27194ATreat pelvic ring fracture9.659.207.691.3220.1718.66090
    27200ATreat tail bone fracture1.843.131.840.225.193.90090
    27202ATreat tail bone fracture7.04NA21.620.69NA29.35090
    27215ATreat pelvic fracture(s)10.05NA10.601.37NA22.02090
    27216ATreat pelvic ring fracture15.19NA15.512.15NA32.85090
    27217ATreat pelvic ring fracture14.11NA12.831.95NA28.89090
    27218ATreat pelvic ring fracture20.15NA16.682.85NA39.68090Start Printed Page 55353
    27220ATreat hip socket fracture6.187.485.720.8514.5112.75090
    27222ATreat hip socket fracture12.70NA10.371.77NA24.84090
    27226ATreat hip wall fracture14.91NA10.362.07NA27.34090
    27227ATreat hip fracture(s)23.45NA17.223.24NA43.91090
    27228ATreat hip fracture(s)27.16NA19.673.77NA50.60090
    27230ATreat thigh fracture5.507.626.300.7313.8512.53090
    27232ATreat thigh fracture10.68NA9.311.45NA21.44090
    27235ATreat thigh fracture12.16NA11.241.71NA25.11090
    27236ATreat thigh fracture15.60NA12.992.18NA30.77090
    27238ATreat thigh fracture5.52NA6.360.76NA12.64090
    27240ATreat thigh fracture12.50NA10.381.69NA24.57090
    27244ATreat thigh fracture15.94NA13.252.23NA31.42090
    27245ATreat thigh fracture20.31NA15.612.85NA38.77090
    27246ATreat thigh fracture4.717.315.930.6612.6811.30090
    27248ATreat thigh fracture10.45NA10.201.45NA22.10090
    27250ATreat hip dislocation6.95NA6.550.68NA14.18090
    27252ATreat hip dislocation10.39NA8.311.37NA20.07090
    27253ATreat hip dislocation12.92NA11.101.81NA25.83090
    27254ATreat hip dislocation18.26NA14.292.52NA35.07090
    27256ATreat hip dislocation4.12NA4.310.49NA8.92010
    27257ATreat hip dislocation5.22NA4.590.56NA10.37010
    27258ATreat hip dislocation15.43NA13.932.06NA31.42090
    27259ATreat hip dislocation21.55NA18.022.99NA42.56090
    27265ATreat hip dislocation5.05NA6.090.65NA11.79090
    27266ATreat hip dislocation7.49NA7.501.04NA16.03090
    27275AManipulation of hip joint2.27NA3.620.31NA6.20010
    27280AFusion of sacroiliac joint13.39NA13.951.98NA29.32090
    27282AFusion of pubic bones11.34NA12.331.14NA24.81090
    27284AFusion of hip joint23.45NA18.862.36NA44.67090
    27286AFusion of hip joint23.45NA19.132.37NA44.95090
    27290AAmputation of leg at hip23.28NA17.372.94NA43.59090
    27295AAmputation of leg at hip18.65NA14.652.35NA35.65090
    27299CPelvis/hip joint surgery0.000.000.000.000.000.00YYY
    27301ADrain thigh/knee lesion6.4915.3014.040.8022.5921.33090
    27303ADrainage of bone lesion8.28NA14.631.14NA24.05090
    27305AIncise thigh tendon & fascia5.92NA8.880.77NA15.57090
    27306AIncision of thigh tendon4.62NA7.540.62NA12.78090
    27307AIncision of thigh tendons5.80NA8.150.78NA14.73090
    27310AExploration of knee joint9.27NA10.141.29NA20.70090
    27315APartial removal, thigh nerve6.97NA4.040.79NA11.80090
    27320APartial removal, thigh nerve6.30NA5.070.78NA12.15090
    27323ABiopsy, thigh soft tissues2.285.573.490.178.025.94010
    27324ABiopsy, thigh soft tissues4.90NA6.790.59NA12.28090
    27327ARemoval of thigh lesion4.478.476.350.5013.4411.32090
    27328ARemoval of thigh lesion5.57NA7.190.66NA13.42090
    27329ARemove tumor, thigh/knee14.14NA15.021.68NA30.84090
    27330ABiopsy, knee joint lining4.97NA6.420.66NA12.05090
    27331AExplore/treat knee joint5.88NA7.560.81NA14.25090
    27332ARemoval of knee cartilage8.27NA8.841.15NA18.26090
    27333ARemoval of knee cartilage7.30NA8.491.03NA16.82090
    27334ARemove knee joint lining8.70NA9.801.21NA19.71090
    27335ARemove knee joint lining10.00NA10.581.41NA21.99090
    27340ARemoval of kneecap bursa4.18NA6.030.58NA10.79090
    27345ARemoval of knee cyst5.92NA7.490.81NA14.22090
    27347ARemove knee cyst5.782.642.640.769.189.18090
    27350ARemoval of kneecap8.17NA8.951.15NA18.27090
    27355ARemove femur lesion7.65NA10.361.07NA19.08090
    27356ARemove femur lesion/graft9.48NA11.321.29NA22.09090
    27357ARemove femur lesion/graft10.53NA11.751.48NA23.76090
    27358ARemove femur lesion/fixation4.74NA2.690.67NA8.10ZZZ
    27360APartial removal, leg bone(s)10.50NA18.431.42NA30.35090
    27365AExtensive leg surgery16.27NA14.692.26NA33.22090
    27370AInjection for knee x-ray0.9611.100.350.0612.121.37000
    27372ARemoval of foreign body5.078.666.280.6214.3511.97090
    27380ARepair of kneecap tendon7.16NA8.571.00NA16.73090
    27381ARepair/graft kneecap tendon10.34NA10.341.44NA22.12090
    27385ARepair of thigh muscle7.76NA8.931.09NA17.78090
    27386ARepair/graft of thigh muscle10.56NA11.121.49NA23.17090
    27390AIncision of thigh tendon5.33NA8.220.69NA14.24090
    27391AIncision of thigh tendons7.20NA9.080.99NA17.27090
    27392AIncision of thigh tendons9.20NA11.151.23NA21.58090
    27393ALengthening of thigh tendon6.39NA8.450.90NA15.74090
    27394ALengthening of thigh tendons8.50NA10.511.17NA20.18090Start Printed Page 55354
    27395ALengthening of thigh tendons11.73NA13.191.63NA26.55090
    27396ATransplant of thigh tendon7.86NA9.651.11NA18.62090
    27397ATransplants of thigh tendons11.28NA11.711.58NA24.57090
    27400ARevise thigh muscles/tendons9.02NA10.671.18NA20.87090
    27403ARepair of knee cartilage8.33NA8.881.16NA18.37090
    27405ARepair of knee ligament8.65NA9.811.21NA19.67090
    27407ARepair of knee ligament10.28NA10.671.38NA22.33090
    27409ARepair of knee ligaments12.90NA12.111.75NA26.76090
    27418ARepair degenerated kneecap10.85NA10.991.51NA23.35090
    27420ARevision of unstable kneecap9.83NA9.871.38NA21.08090
    27422ARevision of unstable kneecap9.78NA9.831.37NA20.98090
    27424ARevision/removal of kneecap9.81NA9.751.38NA20.94090
    27425ALateral retinacular release5.22NA7.290.73NA13.24090
    27427AReconstruction, knee9.36NA9.571.29NA20.22090
    27428AReconstruction, knee14.00NA12.851.95NA28.80090
    27429AReconstruction, knee15.52NA13.692.18NA31.39090
    27430ARevision of thigh muscles9.67NA9.901.35NA20.92090
    27435AIncision of knee joint9.49NA9.681.33NA20.50090
    27437ARevise kneecap8.46NA10.061.18NA19.70090
    27438ARevise kneecap with implant11.23NA11.341.56NA24.13090
    27440ARevision of knee joint10.43NA10.921.42NA22.77090
    27441ARevision of knee joint10.82NA11.241.49NA23.55090
    27442ARevision of knee joint11.89NA11.771.68NA25.34090
    27443ARevision of knee joint10.93NA11.561.52NA24.01090
    27445ARevision of knee joint17.68NA14.982.49NA35.15090
    27446ARevision of knee joint15.84NA14.262.22NA32.32090
    27447ATotal knee arthroplasty21.48NA17.353.00NA41.83090
    27448AIncision of thigh11.06NA11.981.51NA24.55090
    27450AIncision of thigh13.98NA13.831.96NA29.77090
    27454ARealignment of thigh bone17.56NA15.832.46NA35.85090
    27455ARealignment of knee12.82NA12.571.78NA27.17090
    27457ARealignment of knee13.45NA11.731.88NA27.06090
    27465AShortening of thigh bone13.87NA14.091.86NA29.82090
    27466ALengthening of thigh bone16.33NA16.191.92NA34.44090
    27468AShorten/lengthen thighs18.97NA14.572.68NA36.22090
    27470ARepair of thigh16.07NA16.072.24NA34.38090
    27472ARepair/graft of thigh17.72NA16.982.49NA37.19090
    27475ASurgery to stop leg growth8.64NA9.511.13NA19.28090
    27477ASurgery to stop leg growth9.85NA10.101.31NA21.26090
    27479ASurgery to stop leg growth12.80NA12.091.81NA26.70090
    27485ASurgery to stop leg growth8.84NA9.401.24NA19.48090
    27486ARevise/replace knee joint19.27NA16.132.70NA38.10090
    27487ARevise/replace knee joint25.27NA19.263.54NA48.07090
    27488ARemoval of knee prosthesis15.74NA14.212.21NA32.16090
    27495AReinforce thigh15.55NA15.782.18NA33.51090
    27496ADecompression of thigh/knee6.11NA7.960.77NA14.84090
    27497ADecompression of thigh/knee7.17NA8.160.84NA16.17090
    27498ADecompression of thigh/knee7.99NA8.370.97NA17.33090
    27499ADecompression of thigh/knee9.00NA9.421.18NA19.60090
    27500ATreatment of thigh fracture5.929.847.570.8016.5614.29090
    27501ATreatment of thigh fracture5.9210.928.620.8317.6715.37090
    27502ATreatment of thigh fracture10.58NA11.271.49NA23.34090
    27503ATreatment of thigh fracture10.58NA11.261.49NA23.33090
    27506ATreatment of thigh fracture17.45NA14.572.33NA34.35090
    27507ATreatment of thigh fracture13.99NA12.581.95NA28.52090
    27508ATreatment of thigh fracture5.837.175.430.8013.8012.06090
    27509ATreatment of thigh fracture7.71NA9.441.08NA18.23090
    27510ATreatment of thigh fracture9.13NA7.371.26NA17.76090
    27511ATreatment of thigh fracture13.64NA13.381.91NA28.93090
    27513ATreatment of thigh fracture17.92NA15.802.51NA36.23090
    27514ATreatment of thigh fracture17.30NA14.552.41NA34.26090
    27516ATreat thigh fx growth plate5.377.985.850.7414.0911.96090
    27517ATreat thigh fx growth plate8.789.947.901.2219.9417.90090
    27519ATreat thigh fx growth plate15.02NA13.112.09NA30.22090
    27520ATreat kneecap fracture2.865.483.820.388.727.06090
    27524ATreat kneecap fracture10.00NA8.981.40NA20.38090
    27530ATreat knee fracture3.786.004.330.5110.298.62090
    27532ATreat knee fracture7.307.655.841.0215.9714.16090
    27535ATreat knee fracture11.50NA12.151.61NA25.26090
    27536ATreat knee fracture15.65NA12.162.19NA30.00090
    27538ATreat knee fracture(s)4.877.645.600.6713.1811.14090
    27540ATreat knee fracture13.10NA10.751.80NA25.65090
    27550ATreat knee dislocation5.767.605.790.6814.0412.23090Start Printed Page 55355
    27552ATreat knee dislocation7.90NA8.041.10NA17.04090
    27556ATreat knee dislocation14.41NA14.452.01NA30.87090
    27557ATreat knee dislocation16.77NA15.782.37NA34.92090
    27558ATreat knee dislocation17.72NA15.912.51NA36.14090
    27560ATreat kneecap dislocation3.825.894.040.4010.118.26090
    27562ATreat kneecap dislocation5.79NA5.670.69NA12.15090
    27566ATreat kneecap dislocation12.23NA10.091.73NA24.05090
    27570AFixation of knee joint1.74NA3.240.24NA5.22010
    27580AFusion of knee19.37NA16.632.70NA38.70090
    27590AAmputate leg at thigh12.03NA12.671.35NA26.05090
    27591AAmputate leg at thigh12.68NA14.011.63NA28.32090
    27592AAmputate leg at thigh10.02NA12.551.17NA23.74090
    27594AAmputation follow-up surgery6.92NA9.050.82NA16.79090
    27596AAmputation follow-up surgery10.60NA12.641.24NA24.48090
    27598AAmputate lower leg at knee10.53NA11.691.24NA23.46090
    27599CLeg surgery procedure0.000.000.000.000.000.00YYY
    27600ADecompression of lower leg5.65NA7.670.68NA14.00090
    27601ADecompression of lower leg5.64NA7.680.69NA14.01090
    27602ADecompression of lower leg7.35NA8.080.85NA16.28090
    27603ADrain lower leg lesion4.9416.0310.540.5621.5316.04090
    27604ADrain lower leg bursa4.4711.018.470.5416.0213.48090
    27605AIncision of achilles tendon2.879.813.670.3813.066.92010
    27606AIncision of achilles tendon4.1413.195.080.5717.909.79010
    27607ATreat lower leg bone lesion7.97NA12.781.08NA21.83090
    27610AExplore/treat ankle joint8.34NA10.431.15NA19.92090
    27612AExploration of ankle joint7.33NA8.321.01NA16.66090
    27613ABiopsy lower leg soft tissue2.175.382.960.167.715.29010
    27614ABiopsy lower leg soft tissue5.6610.887.170.6217.1613.45090
    27615ARemove tumor, lower leg12.56NA17.071.39NA31.02090
    27618ARemove lower leg lesion5.0911.726.720.5417.3512.35090
    27619ARemove lower leg lesion8.4012.639.551.0122.0418.96090
    27620AExplore/treat ankle joint5.98NA8.200.83NA15.01090
    27625ARemove ankle joint lining8.30NA9.571.16NA19.03090
    27626ARemove ankle joint lining8.91NA10.391.23NA20.53090
    27630ARemoval of tendon lesion4.8010.706.870.6016.1012.27090
    27635ARemove lower leg bone lesion7.78NA11.131.06NA19.97090
    27637ARemove/graft leg bone lesion9.85NA12.361.38NA23.59090
    27638ARemove/graft leg bone lesion10.57NA12.551.47NA24.59090
    27640APartial removal of tibia11.37NA18.461.54NA31.37090
    27641APartial removal of fibula9.24NA16.521.22NA26.98090
    27645AExtensive lower leg surgery14.17NA18.781.98NA34.93090
    27646AExtensive lower leg surgery12.66NA18.501.55NA32.71090
    27647AExtensive ankle/heel surgery12.24NA11.311.64NA25.19090
    27648AInjection for ankle x-ray0.969.490.360.0510.501.37000
    27650ARepair achilles tendon9.69NA9.601.35NA20.64090
    27652ARepair/graft achilles tendon10.33NA9.901.45NA21.68090
    27654ARepair of achilles tendon10.02NA10.341.41NA21.77090
    27656ARepair leg fascia defect4.5711.387.060.4816.4312.11090
    27658ARepair of leg tendon, each4.9810.639.140.6816.2914.80090
    27659ARepair of leg tendon, each6.8112.779.970.9620.5417.74090
    27664ARepair of leg tendon, each4.5917.859.170.6323.0714.39090
    27665ARepair of leg tendon, each5.408.958.950.7515.1015.10090
    27675ARepair lower leg tendons7.18NA8.481.01NA16.67090
    27676ARepair lower leg tendons8.42NA9.721.15NA19.29090
    27680ARelease of lower leg tendon5.74NA8.270.80NA14.81090
    27681ARelease of lower leg tendons6.82NA8.880.92NA16.62090
    27685ARevision of lower leg tendon6.5010.378.450.9117.7815.86090
    27686ARevise lower leg tendons7.4615.309.891.0523.8118.40090
    27687ARevision of calf tendon6.24NA8.700.88NA15.82090
    27690ARevise lower leg tendon8.71NA9.611.22NA19.54090
    27691ARevise lower leg tendon9.96NA11.101.40NA22.46090
    27692ARevise additional leg tendon1.87NA0.990.26NA3.12ZZZ
    27695ARepair of ankle ligament6.51NA9.200.90NA16.61090
    27696ARepair of ankle ligaments8.27NA9.541.16NA18.97090
    27698ARepair of ankle ligament9.36NA9.721.31NA20.39090
    27700ARevision of ankle joint9.29NA7.951.24NA18.48090
    27702AReconstruct ankle joint13.67NA13.021.92NA28.61090
    27703AReconstruction, ankle joint15.87NA13.312.24NA31.42090
    27704ARemoval of ankle implant7.62NA9.400.61NA17.63090
    27705AIncision of tibia10.38NA11.551.44NA23.37090
    27707AIncision of fibula4.37NA8.480.60NA13.45090
    27709AIncision of tibia & fibula9.95NA11.481.39NA22.82090
    27712ARealignment of lower leg14.25NA13.922.00NA30.17090Start Printed Page 55356
    27715ARevision of lower leg14.39NA15.222.00NA31.61090
    27720ARepair of tibia11.79NA13.671.66NA27.12090
    27722ARepair/graft of tibia11.82NA13.461.65NA26.93090
    27724ARepair/graft of tibia18.20NA17.282.10NA37.58090
    27725ARepair of lower leg15.59NA15.622.20NA33.41090
    27727ARepair of lower leg14.01NA14.431.84NA30.28090
    27730ARepair of tibia epiphysis7.4121.5410.220.7529.7018.38090
    27732ARepair of fibula epiphysis5.3214.457.220.6320.4013.17090
    27734ARepair lower leg epiphyses8.48NA10.840.85NA20.17090
    27740ARepair of leg epiphyses9.3016.049.721.3126.6520.33090
    27742ARepair of leg epiphyses10.3016.449.271.5528.2921.12090
    27745AReinforce tibia10.07NA11.601.38NA23.05090
    27750ATreatment of tibia fracture3.195.654.000.439.277.62090
    27752ATreatment of tibia fracture5.848.206.170.8214.8612.83090
    27756ATreatment of tibia fracture6.78NA10.840.94NA18.56090
    27758ATreatment of tibia fracture11.67NA12.221.52NA25.41090
    27759ATreatment of tibia fracture13.76NA13.461.93NA29.15090
    27760ATreatment of ankle fracture3.015.423.870.398.827.27090
    27762ATreatment of ankle fracture5.257.575.750.7113.5311.71090
    27766ATreatment of ankle fracture8.36NA8.261.17NA17.79090
    27780ATreatment of fibula fracture2.655.373.690.338.356.67090
    27781ATreatment of fibula fracture4.406.384.620.5711.359.59090
    27784ATreatment of fibula fracture7.11NA8.630.98NA16.72090
    27786ATreatment of ankle fracture2.845.383.780.378.596.99090
    27788ATreatment of ankle fracture4.456.654.620.6111.719.68090
    27792ATreatment of ankle fracture7.66NA8.181.07NA16.91090
    27808ATreatment of ankle fracture2.836.444.500.389.657.71090
    27810ATreatment of ankle fracture5.137.775.710.7113.6111.55090
    27814ATreatment of ankle fracture10.68NA10.931.50NA23.11090
    27816ATreatment of ankle fracture2.895.974.550.379.237.81090
    27818ATreatment of ankle fracture5.507.895.880.7414.1312.12090
    27822ATreatment of ankle fracture11.00NA13.181.29NA25.47090
    27823ATreatment of ankle fracture13.00NA14.391.65NA29.04090
    27824ATreat lower leg fracture2.896.434.500.399.717.78090
    27825ATreat lower leg fracture6.198.306.320.8515.3413.36090
    27826ATreat lower leg fracture8.54NA11.881.19NA21.61090
    27827ATreat lower leg fracture14.06NA15.001.96NA31.02090
    27828ATreat lower leg fracture16.23NA15.032.27NA33.53090
    27829ATreat lower leg joint5.49NA8.670.77NA14.93090
    27830ATreat lower leg dislocation3.795.824.360.4410.058.59090
    27831ATreat lower leg dislocation4.56NA4.940.61NA10.11090
    27832ATreat lower leg dislocation6.49NA8.060.91NA15.46090
    27840ATreat ankle dislocation4.58NA6.210.47NA11.26090
    27842ATreat ankle dislocation6.21NA5.250.76NA12.22090
    27846ATreat ankle dislocation9.79NA10.461.36NA21.61090
    27848ATreat ankle dislocation11.20NA11.701.55NA24.45090
    27860AFixation of ankle joint2.34NA3.780.31NA6.43010
    27870AFusion of ankle joint13.91NA13.761.95NA29.62090
    27871AFusion of tibiofibular joint9.17NA11.031.29NA21.49090
    27880AAmputation of lower leg11.85NA11.951.38NA25.18090
    27881AAmputation of lower leg12.34NA13.441.59NA27.37090
    27882AAmputation of lower leg8.94NA13.131.03NA23.10090
    27884AAmputation follow-up surgery8.21NA10.780.95NA19.94090
    27886AAmputation follow-up surgery9.32NA11.261.13NA21.71090
    27888AAmputation of foot at ankle9.67NA11.111.26NA22.04090
    27889AAmputation of foot at ankle9.98NA10.451.19NA21.62090
    27892ADecompression of leg7.39NA8.410.86NA16.66090
    27893ADecompression of leg7.35NA8.580.90NA16.83090
    27894ADecompression of leg10.49NA10.091.25NA21.83090
    27899CLeg/ankle surgery procedure0.000.000.000.000.000.00YYY
    28001ADrainage of bursa of foot2.735.623.090.318.666.13010
    28002ATreatment of foot infection4.626.784.220.5611.969.40010
    28003ATreatment of foot infection8.4111.4010.631.0320.8420.07090
    28005ATreat foot bone lesion8.68NA10.261.14NA20.08090
    28008AIncision of foot fascia4.458.176.380.5613.1811.39090
    28010AIncision of toe tendon2.847.645.370.3910.878.60090
    28011AIncision of toe tendons4.149.366.790.5814.0811.51090
    28020AExploration of foot joint5.018.126.810.6413.7712.46090
    28022AExploration of foot joint4.677.906.260.6213.1911.55090
    28024AExploration of toe joint4.388.556.640.5013.4311.52090
    28030ARemoval of foot nerve6.15NA3.500.85NA10.50090
    28035ADecompression of tibia nerve5.098.805.350.7114.6011.15090
    28043AExcision of foot lesion3.547.474.960.4511.468.95090Start Printed Page 55357
    28045AExcision of foot lesion4.728.185.810.6213.5211.15090
    28046AResection of tumor, foot10.1813.5811.381.1324.8922.69090
    28050ABiopsy of foot joint lining4.259.526.110.5514.3210.91090
    28052ABiopsy of foot joint lining3.948.015.760.5112.4610.21090
    28054ABiopsy of toe joint lining3.457.705.500.4511.609.40090
    28060APartial removal, foot fascia5.238.726.510.6914.6412.43090
    28062ARemoval of foot fascia6.529.276.870.8516.6414.24090
    28070ARemoval of foot joint lining5.107.986.120.6813.7611.90090
    28072ARemoval of foot joint lining4.588.846.670.6414.0611.89090
    28080ARemoval of foot lesion3.587.825.510.5011.909.59090
    28086AExcise foot tendon sheath4.7811.877.110.6617.3112.55090
    28088AExcise foot tendon sheath3.869.976.620.5214.3511.00090
    28090ARemoval of foot lesion4.418.125.640.5713.1010.62090
    28092ARemoval of toe lesions3.648.176.080.4612.2710.18090
    28100ARemoval of ankle/heel lesion5.6613.077.700.7619.4914.12090
    28102ARemove/graft foot lesion7.73NA9.000.97NA17.70090
    28103ARemove/graft foot lesion6.508.766.930.8916.1514.32090
    28104ARemoval of foot lesion5.128.496.760.6914.3012.57090
    28106ARemove/graft foot lesion7.16NA6.971.01NA15.14090
    28107ARemove/graft foot lesion5.569.967.130.7416.2613.43090
    28108ARemoval of toe lesions4.167.495.360.5212.1710.04090
    28110APart removal of metatarsal4.088.806.870.4913.3711.44090
    28111APart removal of metatarsal5.019.097.690.6314.7313.33090
    28112APart removal of metatarsal4.498.897.470.6013.9812.56090
    28113APart removal of metatarsal4.798.927.130.6314.3412.55090
    28114ARemoval of metatarsal heads9.7912.3610.851.3623.5122.00090
    28116ARevision of foot7.759.276.381.0318.0515.16090
    28118ARemoval of heel bone5.969.377.240.7916.1213.99090
    28119ARemoval of heel spur5.398.586.150.7414.7112.28090
    28120APart removal of ankle/heel5.4011.289.830.6917.3715.92090
    28122APartial removal of foot bone7.2910.949.500.9619.1917.75090
    28124APartial removal of toe4.819.617.610.6515.0713.07090
    28126APartial removal of toe3.528.376.760.4912.3810.77090
    28130ARemoval of ankle bone8.11NA8.771.11NA17.99090
    28140ARemoval of metatarsal6.9110.407.920.8418.1515.67090
    28150ARemoval of toe4.098.757.070.5213.3611.68090
    28153APartial removal of toe3.668.396.220.4912.5410.37090
    28160APartial removal of toe3.748.557.220.5112.8011.47090
    28171AExtensive foot surgery9.60NA8.271.13NA19.00090
    28173AExtensive foot surgery8.8010.838.881.0420.6718.72090
    28175AExtensive foot surgery6.059.546.990.7516.3413.79090
    28190ARemoval of foot foreign body1.966.543.530.168.665.65010
    28192ARemoval of foot foreign body4.648.205.440.5213.3610.60090
    28193ARemoval of foot foreign body5.738.946.670.6315.3013.03090
    28200ARepair of foot tendon4.608.476.320.5913.6611.51090
    28202ARepair/graft of foot tendon6.8412.636.830.8620.3314.53090
    28208ARepair of foot tendon4.378.176.030.5913.1310.99090
    28210ARepair/graft of foot tendon6.359.836.380.7716.9513.50090
    28220ARelease of foot tendon4.538.126.410.6313.2811.57090
    28222ARelease of foot tendons5.628.406.770.7714.7913.16090
    28225ARelease of foot tendon3.667.765.570.5011.929.73090
    28226ARelease of foot tendons4.538.306.660.6213.4511.81090
    28230AIncision of foot tendon(s)4.248.266.830.5913.0911.66090
    28232AIncision of toe tendon3.398.126.530.4811.9910.40090
    28234AIncision of foot tendon3.377.986.110.4611.819.94090
    28238ARevision of foot tendon7.739.777.601.0818.5816.41090
    28240ARelease of big toe4.368.176.400.6113.1411.37090
    28250ARevision of foot fascia5.929.057.120.8115.7813.85090
    28260ARelease of midfoot joint7.9611.048.081.0820.0817.12090
    28261ARevision of foot tendon11.7311.169.641.6624.5523.03090
    28262ARevision of foot and ankle15.8315.6615.092.2233.7133.14090
    28264ARelease of midfoot joint10.3510.9810.981.4622.7922.79090
    28270ARelease of foot contracture4.768.757.430.6714.1812.86090
    28272ARelease of toe joint, each3.807.705.500.5212.029.82090
    28280AFusion of toes5.198.396.770.7214.3012.68090
    28285ARepair of hammertoe4.598.796.760.6414.0211.99090
    28286ARepair of hammertoe4.568.786.750.6413.9811.95090
    28288APartial removal of foot bone4.749.008.020.6514.3913.41090
    28289ARepair hallux rigidus7.0410.549.750.9618.5417.75090
    28290ACorrection of bunion5.669.558.810.7916.0015.26090
    28292ACorrection of bunion7.049.827.690.9817.8415.71090
    28293ACorrection of bunion9.1510.678.021.2821.1018.45090
    28294ACorrection of bunion8.5610.528.301.1620.2418.02090Start Printed Page 55358
    28296ACorrection of bunion9.1810.848.651.2821.3019.11090
    28297ACorrection of bunion9.1812.8010.251.3123.2920.74090
    28298ACorrection of bunion7.9410.108.481.1219.1617.54090
    28299ACorrection of bunion10.5811.559.211.2423.3721.03090
    28300AIncision of heel bone9.5414.159.431.3125.0020.28090
    28302AIncision of ankle bone9.559.559.221.1520.2519.92090
    28304AIncision of midfoot bones9.169.537.881.0019.6918.04090
    28305AIncise/graft midfoot bones10.5014.5210.070.5525.5721.12090
    28306AIncision of metatarsal5.868.846.510.8115.5113.18090
    28307AIncision of metatarsal6.3313.707.740.7120.7414.78090
    28308AIncision of metatarsal5.297.975.600.7414.0011.63090
    28309AIncision of metatarsals12.78NA11.081.64NA25.50090
    28310ARevision of big toe5.439.006.930.7615.1913.12090
    28312ARevision of toe4.558.667.870.6213.8313.04090
    28313ARepair deformity of toe5.019.069.060.6814.7514.75090
    28315ARemoval of sesamoid bone4.867.955.820.6613.4711.34090
    28320ARepair of foot bones9.18NA9.021.27NA19.47090
    28322ARepair of metatarsals8.3411.718.381.1721.2217.89090
    28340AResect enlarged toe tissue6.988.966.280.9816.9214.24090
    28341AResect enlarged toe8.419.556.881.1819.1416.47090
    28344ARepair extra toe(s)4.267.384.860.6012.249.72090
    28345ARepair webbed toe(s)5.929.487.580.8416.2414.34090
    28360AReconstruct cleft foot13.34NA12.221.88NA27.44090
    28400ATreatment of heel fracture2.165.764.740.298.217.19090
    28405ATreatment of heel fracture4.576.665.870.6311.8611.07090
    28406ATreatment of heel fracture6.31NA8.690.87NA15.87090
    28415ATreat heel fracture15.97NA15.722.24NA33.93090
    28420ATreat/graft heel fracture16.64NA15.952.29NA34.88090
    28430ATreatment of ankle fracture2.095.254.260.277.616.62090
    28435ATreatment of ankle fracture3.405.414.570.479.288.44090
    28436ATreatment of ankle fracture4.71NA7.860.66NA13.23090
    28445ATreat ankle fracture15.62NA13.941.29NA30.85090
    28450ATreat midfoot fracture, each1.905.284.070.257.436.22090
    28455ATreat midfoot fracture, each3.095.514.940.439.038.46090
    28456ATreat midfoot fracture2.68NA6.270.36NA9.31090
    28465ATreat midfoot fracture, each7.01NA8.250.87NA16.13090
    28470ATreat metatarsal fracture1.994.523.410.266.775.66090
    28475ATreat metatarsal fracture2.975.184.380.418.567.76090
    28476ATreat metatarsal fracture3.38NA6.710.46NA10.55090
    28485ATreat metatarsal fracture5.71NA8.160.80NA14.67090
    28490ATreat big toe fracture1.092.762.210.133.983.43090
    28495ATreat big toe fracture1.582.822.310.194.594.08090
    28496ATreat big toe fracture2.3311.104.580.3213.757.23090
    28505ATreat big toe fracture3.8111.466.740.5015.7711.05090
    28510ATreatment of toe fracture1.092.512.230.133.733.45090
    28515ATreatment of toe fracture1.462.832.300.174.463.93090
    28525ATreat toe fracture3.3210.826.160.4414.589.92090
    28530ATreat sesamoid bone fracture1.062.912.910.134.104.10090
    28531ATreat sesamoid bone fracture2.3511.914.730.3314.597.41090
    28540ATreat foot dislocation2.043.753.750.246.036.03090
    28545ATreat foot dislocation2.454.764.760.337.547.54090
    28546ATreat foot dislocation3.2012.556.310.4616.219.97090
    28555ARepair foot dislocation6.3013.498.360.8820.6715.54090
    28570ATreat foot dislocation1.663.673.670.225.555.55090
    28575ATreat foot dislocation3.315.195.190.458.958.95090
    28576ATreat foot dislocation4.1712.066.850.5616.7911.58090
    28585ARepair foot dislocation7.998.758.321.1317.8717.44090
    28600ATreat foot dislocation1.894.323.890.246.456.02090
    28605ATreat foot dislocation2.714.404.400.357.467.46090
    28606ATreat foot dislocation4.9016.147.090.6821.7212.67090
    28615ARepair foot dislocation7.77NA9.451.09NA18.31090
    28630ATreat toe dislocation1.702.352.350.174.224.22010
    28635ATreat toe dislocation1.912.492.490.244.644.64010
    28636ATreat toe dislocation2.774.813.220.397.976.38010
    28645ARepair toe dislocation4.226.694.340.5811.499.14090
    28660ATreat toe dislocation1.233.112.600.114.453.94010
    28665ATreat toe dislocation1.922.472.470.244.634.63010
    28666ATreat toe dislocation2.6613.303.000.3816.346.04010
    28675ARepair of toe dislocation2.929.484.900.4112.818.23090
    28705AFusion of foot bones18.80NA15.672.13NA36.60090
    28715AFusion of foot bones13.10NA12.571.84NA27.51090
    28725AFusion of foot bones11.61NA11.481.63NA24.72090
    28730AFusion of foot bones10.76NA10.761.51NA23.03090Start Printed Page 55359
    28735AFusion of foot bones10.85NA10.451.51NA22.81090
    28737ARevision of foot bones9.64NA9.041.36NA20.04090
    28740AFusion of foot bones8.0213.038.941.1322.1818.09090
    28750AFusion of big toe joint7.3012.489.131.0320.8117.46090
    28755AFusion of big toe joint4.748.526.420.6613.9211.82090
    28760AFusion of big toe joint7.7510.397.821.0719.2116.64090
    28800AAmputation of midfoot8.21NA8.900.98NA18.09090
    28805AAmputation thru metatarsal8.39NA9.000.97NA18.36090
    28810AAmputation toe & metatarsal6.21NA7.970.70NA14.88090
    28820AAmputation of toe4.419.917.160.5114.8312.08090
    28825APartial amputation of toe3.5910.126.950.4314.1410.97090
    28899CFoot/toes surgery procedure0.000.000.000.000.000.00YYY
    29000AApplication of body cast2.252.711.670.305.264.22000
    29010AApplication of body cast2.062.981.720.275.314.05000
    29015AApplication of body cast2.413.171.930.215.794.55000
    29020AApplication of body cast2.113.331.470.165.603.74000
    29025AApplication of body cast2.403.321.860.265.984.52000
    29035AApplication of body cast1.773.051.560.245.063.57000
    29040AApplication of body cast2.222.541.490.355.114.06000
    29044AApplication of body cast2.123.201.810.295.614.22000
    29046AApplication of body cast2.413.312.040.346.064.79000
    29049AApplication of figure eight0.891.070.570.122.081.58000
    29055AApplication of shoulder cast1.782.401.420.244.423.44000
    29058AApplication of shoulder cast1.311.330.730.142.782.18000
    29065AApplication of long arm cast0.871.100.690.122.091.68000
    29075AApplication of forearm cast0.771.050.630.111.931.51000
    29085AApply hand/wrist cast0.871.100.620.112.081.60000
    29086AApply finger cast0.620.810.500.071.501.19000
    29105AApply long arm splint0.871.050.520.112.031.50000
    29125AApply forearm splint0.590.880.410.061.531.06000
    29126AApply forearm splint0.771.210.470.062.041.30000
    29130AApplication of finger splint0.500.440.180.050.990.73000
    29131AApplication of finger splint0.550.710.230.031.290.81000
    29200AStrapping of chest0.650.850.370.041.541.06000
    29220AStrapping of low back0.640.960.410.071.671.12000
    29240AStrapping of shoulder0.710.920.390.051.681.15000
    29260AStrapping of elbow or wrist0.550.850.350.041.440.94000
    29280AStrapping of hand or finger0.510.910.390.041.460.94000
    29305AApplication of hip cast2.032.741.600.295.063.92000
    29325AApplication of hip casts2.323.051.790.315.684.42000
    29345AApplication of long leg cast1.401.511.020.193.102.61000
    29355AApplication of long leg cast1.531.471.110.203.202.84000
    29358AApply long leg cast brace1.431.721.070.193.342.69000
    29365AApplication of long leg cast1.181.380.900.172.732.25000
    29405AApply short leg cast0.861.030.660.122.011.64000
    29425AApply short leg cast1.011.050.680.142.201.83000
    29435AApply short leg cast1.181.350.880.172.702.23000
    29440AAddition of walker to cast0.570.610.260.071.250.90000
    29445AApply rigid leg cast1.781.580.960.243.602.98000
    29450AApplication of leg cast2.081.401.110.133.613.32000
    29505AApplication, long leg splint0.691.100.480.061.851.23000
    29515AApplication lower leg splint0.730.780.480.071.581.28000
    29520AStrapping of hip0.540.930.440.021.491.00000
    29530AStrapping of knee0.570.830.360.041.440.97000
    29540AStrapping of ankle0.510.400.320.040.950.87000
    29550AStrapping of toes0.470.400.290.050.920.81000
    29580AApplication of paste boot0.570.610.360.051.230.98000
    29590AApplication of foot splint0.760.500.300.061.321.12000
    29700ARemoval/revision of cast0.570.810.280.071.450.92000
    29705ARemoval/revision of cast0.760.730.390.101.591.25000
    29710ARemoval/revision of cast1.341.500.660.173.012.17000
    29715ARemoval/revision of cast0.940.980.290.082.001.31000
    29720ARepair of body cast0.680.950.360.101.731.14000
    29730AWindowing of cast0.750.710.360.101.561.21000
    29740AWedging of cast1.121.020.460.152.291.73000
    29750AWedging of clubfoot cast1.261.130.620.162.552.04000
    29799CCasting/strapping procedure0.000.000.000.000.000.00YYY
    29800AJaw arthroscopy/surgery6.43NA9.150.84NA16.42090
    29804AJaw arthroscopy/surgery8.14NA8.730.66NA17.53090
    29805AShoulder arthroscopy, dx5.893.233.230.839.959.95090
    29806AShoulder arthroscopy/surgery14.37NA11.332.01NA27.71090
    29807AShoulder arthroscopy/surgery13.90NA11.062.01NA26.97090
    29815DShoulder arthroscopy0.00NA0.000.00NA0.00090Start Printed Page 55360
    29819AShoulder arthroscopy/surgery7.62NA9.821.07NA18.51090
    29820AShoulder arthroscopy/surgery7.07NA9.550.99NA17.61090
    29821AShoulder arthroscopy/surgery7.72NA9.841.08NA18.64090
    29822AShoulder arthroscopy/surgery7.43NA9.751.04NA18.22090
    29823AShoulder arthroscopy/surgery8.17NA10.141.15NA19.46090
    29824AShoulder arthroscopy/surgery8.25NA7.481.16NA16.89090
    29825AShoulder arthroscopy/surgery7.62NA9.801.06NA18.48090
    29826AShoulder arthroscopy/surgery8.99NA10.651.26NA20.90090
    29830AElbow arthroscopy5.76NA6.140.79NA12.69090
    29834AElbow arthroscopy/surgery6.28NA6.940.86NA14.08090
    29835AElbow arthroscopy/surgery6.48NA6.950.88NA14.31090
    29836AElbow arthroscopy/surgery7.55NA7.621.06NA16.23090
    29837AElbow arthroscopy/surgery6.87NA7.300.96NA15.13090
    29838AElbow arthroscopy/surgery7.71NA7.731.07NA16.51090
    29840AWrist arthroscopy5.54NA8.380.69NA14.61090
    29843AWrist arthroscopy/surgery6.01NA8.700.82NA15.53090
    29844AWrist arthroscopy/surgery6.37NA8.960.86NA16.19090
    29845AWrist arthroscopy/surgery7.52NA9.560.84NA17.92090
    29846AWrist arthroscopy/surgery6.75NA11.670.89NA19.31090
    29847AWrist arthroscopy/surgery7.08NA11.850.91NA19.84090
    29848AWrist endoscopy/surgery5.44NA8.460.72NA14.62090
    29850AKnee arthroscopy/surgery8.19NA7.490.74NA16.42090
    29851AKnee arthroscopy/surgery13.10NA12.001.81NA26.91090
    29855ATibial arthroscopy/surgery10.62NA10.551.50NA22.67090
    29856ATibial arthroscopy/surgery14.14NA12.492.00NA28.63090
    29860AHip arthroscopy, dx8.05NA8.051.14NA17.24090
    29861AHip arthroscopy/surgery9.15NA8.711.29NA19.15090
    29862AHip arthroscopy/surgery9.90NA9.751.39NA21.04090
    29863AHip arthroscopy/surgery9.90NA10.311.40NA21.61090
    29870AKnee arthroscopy, dx5.07NA6.270.67NA12.01090
    29871AKnee arthroscopy/drainage6.55NA8.380.88NA15.81090
    29874AKnee arthroscopy/surgery7.05NA8.150.87NA16.07090
    29875AKnee arthroscopy/surgery6.31NA7.690.88NA14.88090
    29876AKnee arthroscopy/surgery7.92NA9.191.11NA18.22090
    29877AKnee arthroscopy/surgery7.35NA8.291.03NA16.67090
    29879AKnee arthroscopy/surgery8.04NA8.681.13NA17.85090
    29880AKnee arthroscopy/surgery8.50NA8.951.19NA18.64090
    29881AKnee arthroscopy/surgery7.76NA8.531.09NA17.38090
    29882AKnee arthroscopy/surgery8.65NA9.011.09NA18.75090
    29883AKnee arthroscopy/surgery11.05NA10.411.33NA22.79090
    29884AKnee arthroscopy/surgery7.33NA8.871.03NA17.23090
    29885AKnee arthroscopy/surgery9.09NA9.851.27NA20.21090
    29886AKnee arthroscopy/surgery7.54NA8.991.06NA17.59090
    29887AKnee arthroscopy/surgery9.04NA9.831.27NA20.14090
    29888AKnee arthroscopy/surgery13.90NA12.501.95NA28.35090
    29889AKnee arthroscopy/surgery16.00NA13.712.11NA31.82090
    29891AAnkle arthroscopy/surgery8.40NA8.921.17NA18.49090
    29892AAnkle arthroscopy/surgery9.00NA9.041.26NA19.30090
    29893AScope, plantar fasciotomy5.22NA5.560.74NA11.52090
    29894AAnkle arthroscopy/surgery7.21NA8.041.01NA16.26090
    29895AAnkle arthroscopy/surgery6.99NA8.010.97NA15.97090
    29897AAnkle arthroscopy/surgery7.18NA8.731.01NA16.92090
    29898AAnkle arthroscopy/surgery8.32NA8.791.14NA18.25090
    29900AMcp joint arthroscopy, dx5.42NA5.880.69NA11.99090
    29901AMcp joint arthroscopy, surg6.13NA6.280.81NA13.22090
    29902AMcp joint arthroscopy, surg6.70NA6.600.89NA14.19090
    29909DArthroscopy of joint0.000.000.000.000.000.00YYY
    29999CArthroscopy of joint0.000.000.000.000.000.00YYY
    30000ADrainage of nose lesion1.432.531.510.104.063.04010
    30020ADrainage of nose lesion1.432.641.570.084.153.08010
    30100AIntranasal biopsy0.941.340.530.062.341.53000
    30110ARemoval of nose polyp(s)1.632.800.880.124.552.63010
    30115ARemoval of nose polyp(s)4.35NA4.540.31NA9.20090
    30117ARemoval of intranasal lesion3.164.953.200.228.336.58090
    30118ARemoval of intranasal lesion9.69NA8.550.66NA18.90090
    30120ARevision of nose5.275.715.710.4111.3911.39090
    30124ARemoval of nose lesion3.10NA3.310.20NA6.61090
    30125ARemoval of nose lesion7.16NA6.610.54NA14.31090
    30130ARemoval of turbinate bones3.38NA3.990.22NA7.59090
    30140ARemoval of turbinate bones3.43NA4.610.24NA8.28090
    30150APartial removal of nose9.14NA8.830.76NA18.73090
    30160ARemoval of nose9.58NA8.790.78NA19.15090
    30200AInjection treatment of nose0.781.230.460.062.071.30000Start Printed Page 55361
    30210ANasal sinus therapy1.082.150.610.083.311.77010
    30220AInsert nasal septal button1.542.520.840.114.172.49010
    30300ARemove nasal foreign body1.042.620.370.073.731.48010
    30310ARemove nasal foreign body1.96NA1.920.14NA4.02010
    30320ARemove nasal foreign body4.52NA5.260.36NA10.14090
    30400RReconstruction of nose9.83NA8.950.80NA19.58090
    30410RReconstruction of nose12.98NA10.451.08NA24.51090
    30420RReconstruction of nose15.88NA12.501.24NA29.62090
    30430RRevision of nose7.21NA7.400.62NA15.23090
    30435RRevision of nose11.71NA10.681.10NA23.49090
    30450RRevision of nose18.65NA14.371.53NA34.55090
    30460ARevision of nose9.96NA9.160.85NA19.97090
    30462ARevision of nose19.57NA14.301.92NA35.79090
    30465ARepair nasal stenosis11.64NA9.580.97NA22.19090
    30520ARepair of nasal septum5.70NA5.930.41NA12.04090
    30540ARepair nasal defect7.75NA6.710.53NA14.99090
    30545ARepair nasal defect11.38NA9.190.80NA21.37090
    30560ARelease of nasal adhesions1.262.371.520.093.722.87010
    30580ARepair upper jaw fistula6.695.005.000.5012.1912.19090
    30600ARepair mouth/nose fistula6.024.904.900.7011.6211.62090
    30620AIntranasal reconstruction5.97NA6.690.45NA13.11090
    30630ARepair nasal septum defect7.12NA7.230.51NA14.86090
    30801ACauterization, inner nose1.092.572.310.083.743.48010
    30802ACauterization, inner nose2.033.142.870.155.325.05010
    30901AControl of nosebleed1.211.430.340.092.731.64000
    30903AControl of nosebleed1.543.200.530.124.862.19000
    30905AControl of nosebleed1.973.850.800.155.972.92000
    30906ARepeat control of nosebleed2.454.271.270.176.893.89000
    30915ALigation, nasal sinus artery7.20NA7.130.50NA14.83090
    30920ALigation, upper jaw artery9.83NA8.640.69NA19.16090
    30930ATherapy, fracture of nose1.26NA2.170.09NA3.52010
    30999CNasal surgery procedure0.000.000.000.000.000.00YYY
    31000AIrrigation, maxillary sinus1.152.430.660.083.661.89010
    31002AIrrigation, sphenoid sinus1.91NA2.070.14NA4.12010
    31020AExploration, maxillary sinus2.944.203.680.207.346.82090
    31030AExploration, maxillary sinus5.924.854.680.4211.1911.02090
    31032AExplore sinus,remove polyps6.57NA6.160.47NA13.20090
    31040AExploration behind upper jaw9.42NA7.340.71NA17.47090
    31050AExploration, sphenoid sinus5.28NA5.120.39NA10.79090
    31051ASphenoid sinus surgery7.11NA6.660.55NA14.32090
    31070AExploration of frontal sinus4.28NA5.040.30NA9.62090
    31075AExploration of frontal sinus9.16NA8.380.64NA18.18090
    31080ARemoval of frontal sinus11.42NA9.130.78NA21.33090
    31081ARemoval of frontal sinus12.75NA9.971.84NA24.56090
    31084ARemoval of frontal sinus13.51NA10.760.96NA25.23090
    31085ARemoval of frontal sinus14.20NA11.121.18NA26.50090
    31086ARemoval of frontal sinus12.86NA10.500.90NA24.26090
    31087ARemoval of frontal sinus13.10NA10.321.15NA24.57090
    31090AExploration of sinuses9.53NA9.050.66NA19.24090
    31200ARemoval of ethmoid sinus4.97NA5.860.25NA11.08090
    31201ARemoval of ethmoid sinus8.37NA7.910.58NA16.86090
    31205ARemoval of ethmoid sinus10.24NA8.660.58NA19.48090
    31225ARemoval of upper jaw19.23NA15.421.38NA36.03090
    31230ARemoval of upper jaw21.94NA17.211.57NA40.72090
    31231ANasal endoscopy, dx1.102.010.610.083.191.79000
    31233ANasal/sinus endoscopy, dx2.182.661.240.165.003.58000
    31235ANasal/sinus endoscopy, dx2.642.931.490.185.754.31000
    31237ANasal/sinus endoscopy, surg2.983.221.660.216.414.85000
    31238ANasal/sinus endoscopy, surg3.263.751.890.237.245.38000
    31239ANasal/sinus endoscopy, surg8.70NA6.720.46NA15.88010
    31240ANasal/sinus endoscopy, surg2.61NA1.620.18NA4.41000
    31254ARevision of ethmoid sinus4.65NA2.790.32NA7.76000
    31255ARemoval of ethmoid sinus6.96NA4.140.49NA11.59000
    31256AExploration maxillary sinus3.29NA2.010.23NA5.53000
    31267AEndoscopy, maxillary sinus5.46NA3.270.38NA9.11000
    31276ASinus endoscopy, surgical8.85NA5.240.62NA14.71000
    31287ANasal/sinus endoscopy, surg3.92NA2.370.27NA6.56000
    31288ANasal/sinus endoscopy, surg4.58NA2.750.32NA7.65000
    31290ANasal/sinus endoscopy, surg17.24NA11.861.20NA30.30010
    31291ANasal/sinus endoscopy, surg18.19NA12.281.73NA32.20010
    31292ANasal/sinus endoscopy, surg14.76NA10.360.99NA26.11010
    31293ANasal/sinus endoscopy, surg16.21NA11.160.97NA28.34010
    31294ANasal/sinus endoscopy, surg19.06NA12.461.04NA32.56010Start Printed Page 55362
    31299CSinus surgery procedure0.000.000.000.000.000.00YYY
    31300ARemoval of larynx lesion14.29NA17.460.99NA32.74090
    31320ADiagnostic incision, larynx5.26NA12.540.40NA18.20090
    31360ARemoval of larynx17.08NA19.241.20NA37.52090
    31365ARemoval of larynx24.16NA23.201.72NA49.08090
    31367APartial removal of larynx21.86NA23.921.57NA47.35090
    31368APartial removal of larynx27.09NA28.641.90NA57.63090
    31370APartial removal of larynx21.38NA23.461.51NA46.35090
    31375APartial removal of larynx20.21NA21.161.43NA42.80090
    31380APartial removal of larynx20.21NA21.411.40NA43.02090
    31382APartial removal of larynx20.52NA23.061.44NA45.02090
    31390ARemoval of larynx & pharynx27.53NA28.901.95NA58.38090
    31395AReconstruct larynx & pharynx31.09NA35.022.27NA68.38090
    31400ARevision of larynx10.31NA15.750.72NA26.78090
    31420ARemoval of epiglottis10.22NA15.600.71NA26.53090
    31500AInsert emergency airway2.33NA0.690.15NA3.17000
    31502AChange of windpipe airway0.651.970.270.042.660.96000
    31505ADiagnostic laryngoscopy0.611.850.350.042.501.00000
    31510ALaryngoscopy with biopsy1.922.861.040.154.933.11000
    31511ARemove foreign body, larynx2.163.150.750.165.473.07000
    31512ARemoval of larynx lesion2.073.001.100.165.233.33000
    31513AInjection into vocal cord2.10NA1.320.15NA3.57000
    31515ALaryngoscopy for aspiration1.802.300.900.124.222.82000
    31520ADiagnostic laryngoscopy2.56NA1.410.17NA4.14000
    31525ADiagnostic laryngoscopy2.632.941.530.185.754.34000
    31526ADiagnostic laryngoscopy2.57NA1.590.18NA4.34000
    31527ALaryngoscopy for treatment3.27NA1.770.21NA5.25000
    31528ALaryngoscopy and dilation2.37NA1.240.16NA3.77000
    31529ALaryngoscopy and dilation2.68NA1.620.18NA4.48000
    31530AOperative laryngoscopy3.39NA1.890.24NA5.52000
    31531AOperative laryngoscopy3.59NA2.180.25NA6.02000
    31535AOperative laryngoscopy3.16NA1.880.22NA5.26000
    31536AOperative laryngoscopy3.56NA2.160.25NA5.97000
    31540AOperative laryngoscopy4.13NA2.480.29NA6.90000
    31541AOperative laryngoscopy4.53NA2.720.32NA7.57000
    31560AOperative laryngoscopy5.46NA3.110.38NA8.95000
    31561AOperative laryngoscopy6.00NA2.960.42NA9.38000
    31570ALaryngoscopy with injection3.873.972.310.248.086.42000
    31571ALaryngoscopy with injection4.27NA2.460.30NA7.03000
    31575ADiagnostic laryngoscopy1.102.080.590.083.261.77000
    31576ALaryngoscopy with biopsy1.972.261.080.134.363.18000
    31577ARemove foreign body, larynx2.472.901.310.175.543.95000
    31578ARemoval of larynx lesion2.843.131.620.206.174.66000
    31579ADiagnostic laryngoscopy2.262.971.270.165.393.69000
    31580ARevision of larynx12.38NA16.850.87NA30.10090
    31582ARevision of larynx21.62NA22.061.52NA45.20090
    31584ATreat larynx fracture19.64NA19.051.42NA40.11090
    31585ATreat larynx fracture4.64NA8.920.30NA13.86090
    31586ATreat larynx fracture8.03NA12.710.56NA21.30090
    31587ARevision of larynx11.99NA14.770.88NA27.64090
    31588ARevision of larynx13.11NA17.210.92NA31.24090
    31590AReinnervate larynx6.97NA12.630.50NA20.10090
    31595ALarynx nerve surgery8.34NA11.900.62NA20.86090
    31599CLarynx surgery procedure0.000.000.000.000.000.00YYY
    31600AIncision of windpipe7.18NA3.150.34NA10.67000
    31601AIncision of windpipe4.45NA2.200.39NA7.04000
    31603AIncision of windpipe4.15NA1.880.35NA6.38000
    31605AIncision of windpipe3.58NA1.240.33NA5.15000
    31610AIncision of windpipe8.76NA10.980.69NA20.43090
    31611ASurgery/speech prosthesis5.64NA10.280.40NA16.32090
    31612APuncture/clear windpipe0.911.530.480.062.501.45000
    31613ARepair windpipe opening4.59NA8.940.37NA13.90090
    31614ARepair windpipe opening7.12NA12.470.51NA20.10090
    31615AVisualization of windpipe2.093.761.200.145.993.43000
    31622ADx bronchoscope/wash2.783.691.200.146.614.12000
    31623ADx bronchoscope/brush2.882.971.170.145.994.19000
    31624ADx bronchoscope/lavage2.882.751.170.135.764.18000
    31625ABronchoscopy with biopsy3.372.961.340.166.494.87000
    31628ABronchoscopy with biopsy3.813.381.450.147.335.40000
    31629ABronchoscopy with biopsy3.37NA1.320.13NA4.82000
    31630ABronchoscopy with repair3.82NA1.990.30NA6.11000
    31631ABronchoscopy with dilation4.37NA2.040.31NA6.72000
    31635ARemove foreign body, airway3.68NA1.700.21NA5.59000Start Printed Page 55363
    31640ABronchoscopy & remove lesion4.94NA2.360.37NA7.67000
    31641ABronchoscopy, treat blockage5.03NA2.200.30NA7.53000
    31643ADiag bronchoscope/catheter3.501.171.170.154.824.82000
    31645ABronchoscopy, clear airways3.16NA1.270.13NA4.56000
    31646ABronchoscopy, reclear airway2.72NA1.120.12NA3.96000
    31656ABronchoscopy, inj for xray2.17NA1.050.10NA3.32000
    31700AInsertion of airway catheter1.343.440.680.074.852.09000
    31708AInstill airway contrast dye1.41NA0.640.06NA2.11000
    31710AInsertion of airway catheter1.30NA0.750.06NA2.11000
    31715AInjection for bronchus x-ray1.11NA0.730.06NA1.90000
    31717ABronchial brush biopsy2.123.250.890.095.463.10000
    31720AClearance of airways1.061.900.350.063.021.47000
    31725AClearance of airways1.96NA0.610.10NA2.67000
    31730AIntro, windpipe wire/tube2.852.541.130.155.544.13000
    31750ARepair of windpipe13.02NA16.221.02NA30.26090
    31755ARepair of windpipe15.93NA19.271.15NA36.35090
    31760ARepair of windpipe22.35NA12.791.48NA36.62090
    31766AReconstruction of windpipe30.43NA15.033.16NA48.62090
    31770ARepair/graft of bronchus22.51NA15.672.27NA40.45090
    31775AReconstruct bronchus23.54NA15.142.91NA41.59090
    31780AReconstruct windpipe17.72NA12.971.55NA32.24090
    31781AReconstruct windpipe23.53NA15.492.04NA41.06090
    31785ARemove windpipe lesion17.23NA13.051.36NA31.64090
    31786ARemove windpipe lesion23.98NA14.412.20NA40.59090
    31800ARepair of windpipe injury7.43NA6.810.67NA14.91090
    31805ARepair of windpipe injury13.13NA10.721.45NA25.30090
    31820AClosure of windpipe lesion4.498.248.070.3513.0812.91090
    31825ARepair of windpipe defect6.8110.8610.860.5018.1718.17090
    31830ARevise windpipe scar4.507.827.820.3612.6812.68090
    31899CAirways surgical procedure0.000.000.000.000.000.00YYY
    32000ADrainage of chest1.543.100.510.074.712.12000
    32002ATreatment of collapsed lung2.19NA0.870.11NA3.17000
    32005ATreat lung lining chemically2.19NA0.880.17NA3.24000
    32020AInsertion of chest tube3.98NA1.480.36NA5.82000
    32035AExploration of chest8.67NA7.831.02NA17.52090
    32036AExploration of chest9.68NA8.391.20NA19.27090
    32095ABiopsy through chest wall8.36NA8.050.99NA17.40090
    32100AExploration/biopsy of chest15.24NA10.301.45NA26.99090
    32110AExplore/repair chest23.00NA12.721.63NA37.35090
    32120ARe-exploration of chest11.54NA9.341.42NA22.30090
    32124AExplore chest free adhesions12.72NA9.531.51NA23.76090
    32140ARemoval of lung lesion(s)13.93NA9.791.68NA25.40090
    32141ARemove/treat lung lesions14.00NA9.981.72NA25.70090
    32150ARemoval of lung lesion(s)14.15NA9.701.60NA25.45090
    32151ARemove lung foreign body14.21NA10.201.49NA25.90090
    32160AOpen chest heart massage9.30NA6.341.01NA16.65090
    32200ADrain, open, lung lesion15.29NA10.081.46NA26.83090
    32201ADrain, percut, lung lesion4.00NA5.670.18NA9.85000
    32215ATreat chest lining11.33NA9.161.34NA21.83090
    32220ARelease of lung24.00NA13.562.39NA39.95090
    32225APartial release of lung13.96NA9.951.70NA25.61090
    32310ARemoval of chest lining13.44NA9.861.65NA24.95090
    32320AFree/remove chest lining24.00NA13.212.50NA39.71090
    32400ANeedle biopsy chest lining1.761.890.590.073.722.42000
    32402AOpen biopsy chest lining7.56NA7.760.91NA16.23090
    32405ABiopsy, lung or mediastinum1.932.330.670.094.352.69000
    32420APuncture/clear lung2.18NA0.880.11NA3.17000
    32440ARemoval of lung25.00NA13.572.56NA41.13090
    32442ASleeve pneumonectomy26.24NA14.353.12NA43.71090
    32445ARemoval of lung25.09NA13.833.11NA42.03090
    32480APartial removal of lung23.75NA12.782.24NA38.77090
    32482ABilobectomy25.00NA13.392.35NA40.74090
    32484ASegmentectomy20.69NA11.972.54NA35.20090
    32486ASleeve lobectomy23.92NA13.323.00NA40.24090
    32488ACompletion pneumonectomy25.71NA13.893.18NA42.78090
    32491RLung volume reduction21.25NA12.672.66NA36.58090
    32500APartial removal of lung22.00NA12.701.77NA36.47090
    32501ARepair bronchus add-on4.69NA1.590.56NA6.84ZZZ
    32520ARemove lung & revise chest21.68NA12.562.71NA36.95090
    32522ARemove lung & revise chest24.20NA13.632.84NA40.67090
    32525ARemove lung & revise chest26.50NA14.223.25NA43.97090
    32540ARemoval of lung lesion14.64NA9.991.84NA26.47090
    32601AThoracoscopy, diagnostic5.46NA3.600.63NA9.69000Start Printed Page 55364
    32602AThoracoscopy, diagnostic5.96NA3.720.70NA10.38000
    32603AThoracoscopy, diagnostic7.81NA4.330.76NA12.90000
    32604AThoracoscopy, diagnostic8.78NA4.790.97NA14.54000
    32605AThoracoscopy, diagnostic6.93NA4.190.86NA11.98000
    32606AThoracoscopy, diagnostic8.40NA4.550.99NA13.94000
    32650AThoracoscopy, surgical10.75NA8.471.25NA20.47090
    32651AThoracoscopy, surgical12.91NA8.841.50NA23.25090
    32652AThoracoscopy, surgical18.66NA11.162.30NA32.12090
    32653AThoracoscopy, surgical12.87NA9.151.55NA23.57090
    32654AThoracoscopy, surgical12.44NA7.531.51NA21.48090
    32655AThoracoscopy, surgical13.10NA8.861.53NA23.49090
    32656AThoracoscopy, surgical12.91NA9.531.61NA24.05090
    32657AThoracoscopy, surgical13.65NA9.361.64NA24.65090
    32658AThoracoscopy, surgical11.63NA9.051.47NA22.15090
    32659AThoracoscopy, surgical11.59NA9.101.39NA22.08090
    32660AThoracoscopy, surgical17.43NA10.532.09NA30.05090
    32661AThoracoscopy, surgical13.25NA9.151.66NA24.06090
    32662AThoracoscopy, surgical16.44NA10.592.01NA29.04090
    32663AThoracoscopy, surgical18.47NA11.222.28NA31.97090
    32664AThoracoscopy, surgical14.20NA9.431.70NA25.33090
    32665AThoracoscopy, surgical15.54NA9.181.79NA26.51090
    32800ARepair lung hernia13.69NA10.051.51NA25.25090
    32810AClose chest after drainage13.05NA10.051.55NA24.65090
    32815AClose bronchial fistula23.15NA13.322.84NA39.31090
    32820AReconstruct injured chest21.48NA13.992.31NA37.78090
    32850XDonor pneumonectomy0.000.000.000.000.000.00XXX
    32851ALung transplant, single38.63NA19.944.90NA63.47090
    32852ALung transplant with bypass41.80NA21.405.17NA68.37090
    32853ALung transplant, double47.81NA23.496.13NA77.43090
    32854ALung transplant with bypass50.98NA24.356.41NA81.74090
    32900ARemoval of rib(s)20.27NA12.272.42NA34.96090
    32905ARevise & repair chest wall20.75NA12.772.54NA36.06090
    32906ARevise & repair chest wall26.77NA14.123.30NA44.19090
    32940ARevision of lung19.43NA11.962.47NA33.86090
    32960ATherapeutic pneumothorax1.842.160.700.124.122.66000
    32997ATotal lung lavage6.00NA2.000.55NA8.55000
    32999CChest surgery procedure0.000.000.000.000.000.00YYY
    33010ADrainage of heart sac2.24NA1.010.13NA3.38000
    33011ARepeat drainage of heart sac2.24NA1.050.13NA3.42000
    33015AIncision of heart sac6.80NA4.410.64NA11.85090
    33020AIncision of heart sac12.61NA7.911.50NA22.02090
    33025AIncision of heart sac12.09NA7.771.50NA21.36090
    33030APartial removal of heart sac18.71NA12.122.40NA33.23090
    33031APartial removal of heart sac21.79NA13.202.78NA37.77090
    33050ARemoval of heart sac lesion14.36NA10.241.73NA26.33090
    33120ARemoval of heart lesion24.56NA15.683.06NA43.30090
    33130ARemoval of heart lesion21.39NA12.402.51NA36.30090
    33140AHeart revascularize (tmr)20.00NA10.572.27NA32.84090
    33141AHeart tmr w/other procedure4.84NA1.630.55NA7.02ZZZ
    33200AInsertion of heart pacemaker12.48NA9.591.17NA23.24090
    33201AInsertion of heart pacemaker10.18NA9.391.21NA20.78090
    33206AInsertion of heart pacemaker6.67NA5.350.50NA12.52090
    33207AInsertion of heart pacemaker8.04NA6.000.57NA14.61090
    33208AInsertion of heart pacemaker8.13NA6.140.54NA14.81090
    33210AInsertion of heart electrode3.30NA1.340.17NA4.81000
    33211AInsertion of heart electrode3.40NA1.410.17NA4.98000
    33212AInsertion of pulse generator5.52NA4.440.44NA10.40090
    33213AInsertion of pulse generator6.37NA4.850.46NA11.68090
    33214AUpgrade of pacemaker system7.75NA5.950.52NA14.22090
    33216ARevise eltrd pacing-defib5.39NA4.950.36NA10.70090
    33217ARevise eltrd pacing-defib5.75NA5.260.36NA11.37090
    33218ARevise eltrd pacing-defib5.44NA4.510.40NA10.35090
    33220ARevise eltrd pacing-defib5.52NA4.450.39NA10.36090
    33222ARevise pocket, pacemaker4.96NA3.930.39NA9.28090
    33223ARevise pocket, pacing-defib6.46NA5.060.44NA11.96090
    33233ARemoval of pacemaker system3.29NA3.800.22NA7.31090
    33234ARemoval of pacemaker system7.82NA5.030.56NA13.41090
    33235ARemoval pacemaker electrode9.40NA6.260.68NA16.34090
    33236ARemove electrode/thoracotomy12.60NA9.351.49NA23.44090
    33237ARemove electrode/thoracotomy13.71NA9.511.57NA24.79090
    33238ARemove electrode/thoracotomy15.22NA9.241.56NA26.02090
    33240AInsert pulse generator7.60NA5.490.53NA13.62090
    33241ARemove pulse generator3.24NA3.390.21NA6.84090Start Printed Page 55365
    33243ARemove eltrd/thoracotomy22.64NA10.882.53NA36.05090
    33244ARemove eltrd, transven13.76NA8.221.05NA23.03090
    33245AInsert epic eltrd pace-defib14.30NA10.791.28NA26.37090
    33246AInsert epic eltrd/generator20.71NA14.162.22NA37.09090
    33249AEltrd/insert pace-defib14.23NA8.980.80NA24.01090
    33250AAblate heart dysrhythm focus21.85NA13.651.01NA36.51090
    33251AAblate heart dysrhythm focus24.88NA14.062.41NA41.35090
    33253AReconstruct atria31.06NA16.583.68NA51.32090
    33261AAblate heart dysrhythm focus24.88NA14.472.82NA42.17090
    33282AImplant pat-active ht record4.17NA4.420.39NA8.98090
    33284ARemove pat-active ht record2.50NA3.940.23NA6.67090
    33300ARepair of heart wound17.92NA11.561.91NA31.39090
    33305ARepair of heart wound21.44NA13.242.68NA37.36090
    33310AExploratory heart surgery18.51NA11.852.26NA32.62090
    33315AExploratory heart surgery22.37NA13.432.90NA38.70090
    33320ARepair major blood vessel(s)16.79NA11.061.66NA29.51090
    33321ARepair major vessel20.20NA13.152.70NA36.05090
    33322ARepair major blood vessel(s)20.62NA13.022.51NA36.15090
    33330AInsert major vessel graft21.43NA12.352.49NA36.27090
    33332AInsert major vessel graft23.96NA12.942.45NA39.35090
    33335AInsert major vessel graft30.01NA16.153.79NA49.95090
    33400ARepair of aortic valve28.50NA17.043.09NA48.63090
    33401AValvuloplasty, open23.91NA14.852.71NA41.47090
    33403AValvuloplasty, w/cp bypass24.89NA15.992.48NA43.36090
    33404APrepare heart-aorta conduit28.54NA17.223.31NA49.07090
    33405AReplacement of aortic valve35.00NA17.693.86NA56.55090
    33406AReplacement of aortic valve37.50NA18.534.07NA60.10090
    33410AReplacement of aortic valve32.46NA16.934.11NA53.50090
    33411AReplacement of aortic valve36.25NA18.074.16NA58.48090
    33412AReplacement of aortic valve42.00NA21.904.66NA68.56090
    33413AReplacement of aortic valve43.50NA23.054.26NA70.81090
    33414ARepair of aortic valve30.35NA17.673.79NA51.81090
    33415ARevision, subvalvular tissue27.15NA16.533.25NA46.93090
    33416ARevise ventricle muscle30.35NA16.063.85NA50.26090
    33417ARepair of aortic valve28.53NA17.093.58NA49.20090
    33420ARevision of mitral valve22.70NA11.771.48NA35.95090
    33422ARevision of mitral valve25.94NA14.743.30NA43.98090
    33425ARepair of mitral valve27.00NA14.983.00NA44.98090
    33426ARepair of mitral valve33.00NA17.143.87NA54.01090
    33427ARepair of mitral valve40.00NA19.424.30NA63.72090
    33430AReplacement of mitral valve33.50NA17.263.95NA54.71090
    33460ARevision of tricuspid valve23.60NA13.833.02NA40.45090
    33463AValvuloplasty, tricuspid25.62NA14.603.17NA43.39090
    33464AValvuloplasty, tricuspid27.33NA15.223.47NA46.02090
    33465AReplace tricuspid valve28.79NA15.673.61NA48.07090
    33468ARevision of tricuspid valve30.12NA19.064.00NA53.18090
    33470ARevision of pulmonary valve20.81NA14.202.81NA37.82090
    33471AValvotomy, pulmonary valve22.25NA13.133.00NA38.38090
    33472ARevision of pulmonary valve22.25NA13.132.92NA38.30090
    33474ARevision of pulmonary valve23.04NA13.452.84NA39.33090
    33475AReplacement, pulmonary valve33.00NA18.282.64NA53.92090
    33476ARevision of heart chamber25.77NA14.232.40NA42.40090
    33478ARevision of heart chamber26.74NA14.433.56NA44.73090
    33496ARepair, prosth valve clot27.25NA16.843.44NA47.53090
    33500ARepair heart vessel fistula25.55NA13.992.80NA42.34090
    33501ARepair heart vessel fistula17.78NA10.242.05NA30.07090
    33502ACoronary artery correction21.04NA16.642.51NA40.19090
    33503ACoronary artery graft21.78NA13.901.42NA37.10090
    33504ACoronary artery graft24.66NA16.553.04NA44.25090
    33505ARepair artery w/tunnel26.84NA18.161.52NA46.52090
    33506ARepair artery, translocation35.50NA19.273.19NA57.96090
    33510ACABG, vein, single29.00NA15.533.13NA47.66090
    33511ACABG, vein, two30.00NA16.053.34NA49.39090
    33512ACABG, vein, three31.80NA16.653.70NA52.15090
    33513ACABG, vein, four32.00NA16.773.99NA52.76090
    33514ACABG, vein, five32.75NA17.004.37NA54.12090
    33516ACabg, vein, six or more35.00NA17.744.62NA57.36090
    33517ACABG, artery-vein, single2.57NA0.860.32NA3.75ZZZ
    33518ACABG, artery-vein, two4.85NA1.620.61NA7.08ZZZ
    33519ACABG, artery-vein, three7.12NA2.380.89NA10.39ZZZ
    33521ACABG, artery-vein, four9.40NA3.151.18NA13.73ZZZ
    33522ACABG, artery-vein, five11.67NA3.911.48NA17.06ZZZ
    33523ACabg, art-vein, six or more13.95NA4.631.78NA20.36ZZZStart Printed Page 55366
    33533ACABG, arterial, single30.00NA17.243.24NA50.48090
    33534ACABG, arterial, two32.20NA17.453.63NA53.28090
    33535ACABG, arterial, three34.50NA17.773.97NA56.24090
    33536ACabg, arterial, four or more37.50NA19.273.29NA60.06090
    33542ARemoval of heart lesion28.85NA17.053.61NA49.51090
    33545ARepair of heart damage36.78NA19.794.40NA60.97090
    33572AOpen coronary endarterectomy4.45NA1.480.55NA6.48ZZZ
    33600AClosure of valve29.51NA17.792.30NA49.60090
    33602AClosure of valve28.54NA16.652.90NA48.09090
    33606AAnastomosis/artery-aorta30.74NA17.533.59NA51.86090
    33608ARepair anomaly w/conduit31.09NA16.384.17NA51.64090
    33610ARepair by enlargement30.61NA18.894.02NA53.52090
    33611ARepair double ventricle34.00NA19.083.28NA56.36090
    33612ARepair double ventricle35.00NA20.174.44NA59.61090
    33615ARepair, modified fontan34.00NA19.333.15NA56.48090
    33617ARepair single ventricle37.00NA21.254.09NA62.34090
    33619ARepair single ventricle45.00NA26.494.71NA76.20090
    33641ARepair heart septum defect21.39NA11.822.67NA35.88090
    33645ARevision of heart veins24.82NA13.923.27NA42.01090
    33647ARepair heart septum defects28.73NA17.083.37NA49.18090
    33660ARepair of heart defects30.00NA17.092.82NA49.91090
    33665ARepair of heart defects28.60NA16.873.81NA49.28090
    33670ARepair of heart chambers35.00NA16.682.18NA53.86090
    33681ARepair heart septum defect30.61NA17.833.53NA51.97090
    33684ARepair heart septum defect29.65NA17.823.77NA51.24090
    33688ARepair heart septum defect30.62NA16.703.89NA51.21090
    33690AReinforce pulmonary artery19.55NA13.552.56NA35.66090
    33692ARepair of heart defects30.75NA17.523.77NA52.04090
    33694ARepair of heart defects34.00NA17.824.27NA56.09090
    33697ARepair of heart defects36.00NA18.624.54NA59.16090
    33702ARepair of heart defects26.54NA16.533.45NA46.52090
    33710ARepair of heart defects29.71NA16.823.85NA50.38090
    33720ARepair of heart defect26.56NA16.513.21NA46.28090
    33722ARepair of heart defect28.41NA17.053.80NA49.26090
    33730ARepair heart-vein defect(s)34.25NA18.352.85NA55.45090
    33732ARepair heart-vein defect28.16NA17.952.78NA48.89090
    33735ARevision of heart chamber21.39NA13.001.12NA35.51090
    33736ARevision of heart chamber23.52NA14.062.70NA40.28090
    33737ARevision of heart chamber21.76NA15.222.93NA39.91090
    33750AMajor vessel shunt21.41NA12.831.74NA35.98090
    33755AMajor vessel shunt21.79NA12.942.93NA37.66090
    33762AMajor vessel shunt21.79NA13.321.59NA36.70090
    33764AMajor vessel shunt & graft21.79NA14.221.93NA37.94090
    33766AMajor vessel shunt22.76NA15.163.04NA40.96090
    33767AMajor vessel shunt24.50NA14.923.14NA42.56090
    33770ARepair great vessels defect37.00NA19.014.49NA60.50090
    33771ARepair great vessels defect34.65NA18.084.67NA57.40090
    33774ARepair great vessels defect30.98NA16.614.18NA51.77090
    33775ARepair great vessels defect32.20NA17.104.34NA53.64090
    33776ARepair great vessels defect34.04NA17.834.58NA56.45090
    33777ARepair great vessels defect33.46NA17.604.51NA55.57090
    33778ARepair great vessels defect40.00NA20.214.83NA65.04090
    33779ARepair great vessels defect36.21NA17.932.40NA56.54090
    33780ARepair great vessels defect41.75NA20.985.21NA67.94090
    33781ARepair great vessels defect36.45NA18.804.91NA60.16090
    33786ARepair arterial trunk39.00NA19.814.69NA63.50090
    33788ARevision of pulmonary artery26.62NA14.873.32NA44.81090
    33800AAortic suspension16.24NA13.121.11NA30.47090
    33802ARepair vessel defect17.66NA12.221.56NA31.44090
    33803ARepair vessel defect19.60NA13.532.63NA35.76090
    33813ARepair septal defect20.65NA14.122.78NA37.55090
    33814ARepair septal defect25.77NA15.612.52NA43.90090
    33820ARevise major vessel16.29NA10.952.10NA29.34090
    33822ARevise major vessel17.32NA11.162.33NA30.81090
    33824ARevise major vessel19.52NA11.972.61NA34.10090
    33840ARemove aorta constriction20.63NA14.112.36NA37.10090
    33845ARemove aorta constriction22.12NA14.852.90NA39.87090
    33851ARemove aorta constriction21.27NA12.982.86NA37.11090
    33852ARepair septal defect23.71NA14.143.19NA41.04090
    33853ARepair septal defect31.72NA18.254.23NA54.20090
    33860AAscending aortic graft38.00NA18.744.30NA61.04090
    33861AAscending aortic graft42.00NA20.154.24NA66.39090Start Printed Page 55367
    33863AAscending aortic graft45.00NA21.104.60NA70.70090
    33870ATransverse aortic arch graft44.00NA20.695.09NA69.78090
    33875AThoracic aortic graft33.06NA17.014.08NA54.15090
    33877AThoracoabdominal graft42.60NA19.965.07NA67.63090
    33910ARemove lung artery emboli24.59NA14.163.06NA41.81090
    33915ARemove lung artery emboli21.02NA12.311.20NA34.53090
    33916ASurgery of great vessel25.83NA15.493.04NA44.36090
    33917ARepair pulmonary artery24.50NA15.363.17NA43.03090
    33918ARepair pulmonary atresia26.45NA14.803.42NA44.67090
    33919ARepair pulmonary atresia40.00NA21.023.48NA64.50090
    33920ARepair pulmonary atresia31.95NA17.283.61NA52.84090
    33922ATransect pulmonary artery23.52NA13.792.30NA39.61090
    33924ARemove pulmonary shunt5.50NA2.050.74NA8.29ZZZ
    33930XRemoval of donor heart/lung0.000.000.000.000.000.00XXX
    33935RTransplantation, heart/lung60.96NA27.938.15NA97.04090
    33940XRemoval of donor heart0.000.000.000.000.000.00XXX
    33945RTransplantation of heart42.10NA21.675.42NA69.19090
    33960AExternal circulation assist19.36NA6.062.14NA27.56000
    33961AExternal circulation assist10.93NA3.791.47NA16.19ZZZ
    33967AInsert ia percut device4.852.011.960.277.137.08000
    33968ARemove aortic assist device0.64NA0.240.07NA0.95000
    33970AAortic circulation assist6.75NA2.370.70NA9.82000
    33971AAortic circulation assist9.69NA7.820.97NA18.48090
    33973AInsert balloon device9.76NA3.441.01NA14.21000
    33974ARemove intra-aortic balloon14.41NA10.691.48NA26.58090
    33975AImplant ventricular device21.00NA7.041.72NA29.76XXX
    33976AImplant ventricular device23.00NA7.782.82NA33.60XXX
    33977ARemove ventricular device19.29NA10.462.44NA32.19090
    33978ARemove ventricular device21.73NA11.272.66NA35.66090
    33979CInsert intracorporeal device0.000.000.000.000.000.00XXX
    33980CRemove intracorporeal device0.000.000.000.000.000.00090
    33999CCardiac surgery procedure0.000.000.000.000.000.00YYY
    34001ARemoval of artery clot12.91NA5.971.46NA20.34090
    34051ARemoval of artery clot15.21NA7.071.90NA24.18090
    34101ARemoval of artery clot10.00NA4.841.11NA15.95090
    34111ARemoval of arm artery clot10.00NA4.880.85NA15.73090
    34151ARemoval of artery clot25.00NA10.541.84NA37.38090
    34201ARemoval of artery clot10.03NA5.121.02NA16.17090
    34203ARemoval of leg artery clot16.50NA7.651.37NA25.52090
    34401ARemoval of vein clot25.00NA10.471.20NA36.67090
    34421ARemoval of vein clot12.00NA6.010.95NA18.96090
    34451ARemoval of vein clot27.00NA11.081.59NA39.67090
    34471ARemoval of vein clot10.18NA5.180.90NA16.26090
    34490ARemoval of vein clot9.86NA6.260.73NA16.85090
    34501ARepair valve, femoral vein16.00NA8.981.37NA26.35090
    34502AReconstruct vena cava26.95NA11.342.99NA41.28090
    34510ATransposition of vein valve18.95NA10.231.60NA30.78090
    34520ACross-over vein graft17.95NA9.591.41NA28.95090
    34530ALeg vein fusion16.64NA8.482.06NA27.18090
    34800AEndovasc abdo repair w/tube20.75NA9.791.49NA32.03090
    34802AEndovasc abdo repr w/device23.00NA10.691.65NA35.34090
    34804AEndovasc abdo repr w/device23.00NA10.691.65NA35.34090
    34808AEndovasc abdo occlud device4.13NA1.650.29NA6.07ZZZ
    34812AXpose for endoprosth, aortic6.75NA2.690.49NA9.93000
    34813AXpose for endoprosth, femorl4.80NA1.920.34NA7.06ZZZ
    34820AXpose for endoprosth, iliac9.75NA3.890.70NA14.34000
    34825AEndovasc extend prosth, init12.00NA6.300.86NA19.16090
    34826AEndovasc exten prosth, addl4.13NA1.650.29NA6.07ZZZ
    34830AOpen aortic tube prosth repr32.59NA14.892.34NA49.82090
    34831AOpen aortoiliac prosth repr35.34NA15.992.53NA53.86090
    34832AOpen aortofemor prosth repr35.34NA15.992.53NA53.86090
    35001ARepair defect of artery19.64NA8.412.44NA30.49090
    35002ARepair artery rupture, neck21.00NA9.121.82NA31.94090
    35005ARepair defect of artery18.12NA8.041.35NA27.51090
    35011ARepair defect of artery18.00NA7.591.30NA26.89090
    35013ARepair artery rupture, arm22.00NA8.981.91NA32.89090
    35021ARepair defect of artery19.65NA8.641.93NA30.22090
    35022ARepair artery rupture, chest23.18NA9.571.99NA34.74090
    35045ARepair defect of arm artery17.57NA7.991.25NA26.81090
    35081ARepair defect of artery28.01NA11.693.20NA42.90090
    35082ARepair artery rupture, aorta38.50NA15.084.07NA57.65090
    35091ARepair defect of artery35.40NA14.224.09NA53.71090
    35092ARepair artery rupture, aorta45.00NA17.354.31NA66.66090Start Printed Page 55368
    35102ARepair defect of artery30.76NA12.673.44NA46.87090
    35103ARepair artery rupture, groin40.50NA15.813.79NA60.10090
    35111ARepair defect of artery25.00NA10.431.81NA37.24090
    35112ARepair artery rupture,spleen30.00NA12.061.95NA44.01090
    35121ARepair defect of artery30.00NA12.392.93NA45.32090
    35122ARepair artery rupture, belly35.00NA13.733.54NA52.27090
    35131ARepair defect of artery25.00NA10.642.11NA37.75090
    35132ARepair artery rupture, groin30.00NA12.142.48NA44.62090
    35141ARepair defect of artery20.00NA8.661.65NA30.31090
    35142ARepair artery rupture, thigh23.30NA9.761.75NA34.81090
    35151ARepair defect of artery22.64NA9.721.93NA34.29090
    35152ARepair artery rupture, knee25.62NA10.501.93NA38.05090
    35161ARepair defect of artery18.76NA8.962.21NA29.93090
    35162ARepair artery rupture19.78NA9.052.21NA31.04090
    35180ARepair blood vessel lesion13.62NA6.491.44NA21.55090
    35182ARepair blood vessel lesion30.00NA12.391.88NA44.27090
    35184ARepair blood vessel lesion18.00NA7.921.34NA27.26090
    35188ARepair blood vessel lesion14.28NA6.701.53NA22.51090
    35189ARepair blood vessel lesion28.00NA11.712.12NA41.83090
    35190ARepair blood vessel lesion12.75NA6.031.33NA20.11090
    35201ARepair blood vessel lesion16.14NA7.181.17NA24.49090
    35206ARepair blood vessel lesion13.25NA7.601.04NA21.89090
    35207ARepair blood vessel lesion10.15NA9.911.15NA21.21090
    35211ARepair blood vessel lesion22.12NA13.552.83NA38.50090
    35216ARepair blood vessel lesion18.75NA11.832.17NA32.75090
    35221ARepair blood vessel lesion24.39NA10.311.79NA36.49090
    35226ARepair blood vessel lesion14.50NA8.540.84NA23.88090
    35231ARepair blood vessel lesion20.00NA9.451.32NA30.77090
    35236ARepair blood vessel lesion17.11NA8.971.19NA27.27090
    35241ARepair blood vessel lesion23.12NA14.092.90NA40.11090
    35246ARepair blood vessel lesion26.45NA14.322.22NA42.99090
    35251ARepair blood vessel lesion30.20NA12.391.87NA44.46090
    35256ARepair blood vessel lesion18.36NA9.631.32NA29.31090
    35261ARepair blood vessel lesion17.80NA7.561.34NA26.70090
    35266ARepair blood vessel lesion14.91NA8.121.16NA24.19090
    35271ARepair blood vessel lesion22.12NA13.432.77NA38.32090
    35276ARepair blood vessel lesion24.25NA13.562.37NA40.18090
    35281ARepair blood vessel lesion28.00NA11.661.82NA41.48090
    35286ARepair blood vessel lesion16.16NA8.881.36NA26.40090
    35301ARechanneling of artery18.70NA8.392.23NA29.32090
    35311ARechanneling of artery27.00NA11.102.75NA40.85090
    35321ARechanneling of artery16.00NA6.871.36NA24.23090
    35331ARechanneling of artery26.20NA11.112.71NA40.02090
    35341ARechanneling of artery25.11NA10.702.87NA38.68090
    35351ARechanneling of artery23.00NA9.842.29NA35.13090
    35355ARechanneling of artery18.50NA8.331.80NA28.63090
    35361ARechanneling of artery28.20NA11.602.66NA42.46090
    35363ARechanneling of artery30.20NA12.542.77NA45.51090
    35371ARechanneling of artery14.72NA6.751.32NA22.79090
    35372ARechanneling of artery18.00NA7.911.53NA27.44090
    35381ARechanneling of artery15.81NA7.351.80NA24.96090
    35390AReoperation, carotid add-on3.19NA1.110.38NA4.68ZZZ
    35400AAngioscopy3.00NA1.050.34NA4.39ZZZ
    35450ARepair arterial blockage10.07NA4.220.84NA15.13000
    35452ARepair arterial blockage6.91NA3.110.76NA10.78000
    35454ARepair arterial blockage6.04NA2.830.67NA9.54000
    35456ARepair arterial blockage7.35NA3.270.82NA11.44000
    35458ARepair arterial blockage9.49NA4.031.09NA14.61000
    35459ARepair arterial blockage8.63NA3.690.96NA13.28000
    35460ARepair venous blockage6.04NA2.700.66NA9.40000
    35470ARepair arterial blockage8.63NA3.980.50NA13.11000
    35471ARepair arterial blockage10.07NA4.670.50NA15.24000
    35472ARepair arterial blockage6.91NA3.320.39NA10.62000
    35473ARepair arterial blockage6.04NA3.010.34NA9.39000
    35474ARepair arterial blockage7.36NA3.520.40NA11.28000
    35475RRepair arterial blockage9.49NA4.230.47NA14.19000
    35476ARepair venous blockage6.04NA2.940.27NA9.25000
    35480AAtherectomy, open11.08NA4.581.13NA16.79000
    35481AAtherectomy, open7.61NA3.540.84NA11.99000
    35482AAtherectomy, open6.65NA3.160.75NA10.56000
    35483AAtherectomy, open8.10NA3.520.81NA12.43000
    35484AAtherectomy, open10.44NA4.211.13NA15.78000
    35485AAtherectomy, open9.49NA4.051.06NA14.60000Start Printed Page 55369
    35490AAtherectomy, percutaneous11.08NA4.830.55NA16.46000
    35491AAtherectomy, percutaneous7.61NA3.590.49NA11.69000
    35492AAtherectomy, percutaneous6.65NA3.220.43NA10.30000
    35493AAtherectomy, percutaneous8.10NA3.900.47NA12.47000
    35494AAtherectomy, percutaneous10.44NA4.570.48NA15.49000
    35495AAtherectomy, percutaneous9.49NA4.520.51NA14.52000
    35500AHarvest vein for bypass6.45NA2.250.63NA9.33ZZZ
    35501AArtery bypass graft19.19NA8.142.33NA29.66090
    35506AArtery bypass graft19.67NA8.322.33NA30.32090
    35507AArtery bypass graft19.67NA8.292.27NA30.23090
    35508AArtery bypass graft18.65NA7.912.34NA28.90090
    35509AArtery bypass graft18.07NA7.702.12NA27.89090
    35511AArtery bypass graft21.20NA8.801.74NA31.74090
    35515AArtery bypass graft18.65NA7.802.26NA28.71090
    35516AArtery bypass graft16.32NA4.941.88NA23.14090
    35518AArtery bypass graft21.20NA8.801.78NA31.78090
    35521AArtery bypass graft22.20NA9.531.82NA33.55090
    35526AArtery bypass graft29.95NA12.192.18NA44.32090
    35531AArtery bypass graft36.20NA14.532.91NA53.64090
    35533AArtery bypass graft28.00NA11.742.35NA42.09090
    35536AArtery bypass graft31.70NA12.852.62NA47.17090
    35541AArtery bypass graft25.80NA10.982.74NA39.52090
    35546AArtery bypass graft25.54NA10.752.84NA39.13090
    35548AArtery bypass graft21.57NA9.452.45NA33.47090
    35549AArtery bypass graft23.35NA9.882.77NA36.00090
    35551AArtery bypass graft26.67NA11.203.19NA41.06090
    35556AArtery bypass graft21.76NA9.452.48NA33.69090
    35558AArtery bypass graft21.20NA9.111.58NA31.89090
    35560AArtery bypass graft32.00NA13.122.73NA47.85090
    35563AArtery bypass graft24.20NA10.421.68NA36.30090
    35565AArtery bypass graft23.20NA9.991.71NA34.90090
    35566AArtery bypass graft26.92NA11.773.02NA41.71090
    35571AArtery bypass graft24.06NA12.132.14NA38.33090
    35582AVein bypass graft27.13NA11.353.11NA41.59090
    35583AVein bypass graft22.37NA10.622.53NA35.52090
    35585AVein bypass graft28.39NA14.533.21NA46.13090
    35587AVein bypass graft24.75NA12.792.17NA39.71090
    35600AHarvest artery for cabg4.95NA1.980.60NA7.53ZZZ
    35601AArtery bypass graft17.50NA7.492.08NA27.07090
    35606AArtery bypass graft18.71NA7.932.17NA28.81090
    35612AArtery bypass graft15.76NA6.701.72NA24.18090
    35616AArtery bypass graft15.70NA7.051.84NA24.59090
    35621AArtery bypass graft20.00NA8.791.68NA30.47090
    35623ABypass graft, not vein24.00NA10.221.91NA36.13090
    35626AArtery bypass graft27.75NA11.082.89NA41.72090
    35631AArtery bypass graft34.00NA13.742.83NA50.57090
    35636AArtery bypass graft29.50NA12.262.37NA44.13090
    35641AArtery bypass graft24.57NA10.472.83NA37.87090
    35642AArtery bypass graft17.98NA7.921.84NA27.74090
    35645AArtery bypass graft17.47NA8.361.91NA27.74090
    35646AArtery bypass graft31.00NA13.262.98NA47.24090
    35647AArtery bypass graft28.00NA11.972.98NA42.95090
    35650AArtery bypass graft19.00NA7.931.64NA28.57090
    35651AArtery bypass graft25.04NA10.702.53NA38.27090
    35654AArtery bypass graft25.00NA10.602.10NA37.70090
    35656AArtery bypass graft19.53NA8.442.21NA30.18090
    35661AArtery bypass graft19.00NA8.261.50NA28.76090
    35663AArtery bypass graft22.00NA9.651.55NA33.20090
    35665AArtery bypass graft21.00NA9.181.76NA31.94090
    35666AArtery bypass graft22.19NA11.932.19NA36.31090
    35671AArtery bypass graft19.33NA10.531.68NA31.54090
    35681AComposite bypass graft1.60NA0.560.18NA2.34ZZZ
    35682AComposite bypass graft7.20NA2.510.83NA10.54ZZZ
    35683AComposite bypass graft8.50NA2.990.98NA12.47ZZZ
    35685ABypass graft patency/patch4.05NA1.500.41NA5.96ZZZ
    35686ABypass graft/av fist patency3.35NA1.240.34NA4.93ZZZ
    35691AArterial transposition18.05NA7.652.06NA27.76090
    35693AArterial transposition15.36NA6.661.80NA23.82090
    35694AArterial transposition19.16NA8.022.13NA29.31090
    35695AArterial transposition19.16NA7.922.19NA29.27090
    35700AReoperation, bypass graft3.08NA1.070.36NA4.51ZZZ
    35701AExploration, carotid artery8.50NA4.700.64NA13.84090
    35721AExploration, femoral artery7.18NA5.100.59NA12.87090Start Printed Page 55370
    35741AExploration popliteal artery8.00NA5.470.60NA14.07090
    35761AExploration of artery/vein5.37NA4.470.60NA10.44090
    35800AExplore neck vessels7.02NA3.950.79NA11.76090
    35820AExplore chest vessels12.88NA4.321.61NA18.81090
    35840AExplore abdominal vessels9.77NA5.211.06NA16.04090
    35860AExplore limb vessels5.55NA3.620.63NA9.80090
    35870ARepair vessel graft defect22.17NA10.212.47NA34.85090
    35875ARemoval of clot in graft10.13NA6.630.97NA17.73090
    35876ARemoval of clot in graft17.00NA9.161.88NA28.04090
    35879ARevise graft w/vein16.00NA7.771.35NA25.12090
    35881ARevise graft w/vein18.00NA8.651.44NA28.09090
    35901AExcision, graft, neck8.19NA5.850.90NA14.94090
    35903AExcision, graft, extremity9.39NA8.201.03NA18.62090
    35905AExcision, graft, thorax31.25NA15.392.15NA48.79090
    35907AExcision, graft, abdomen35.00NA14.972.17NA52.14090
    36000APlace needle in vein0.180.650.050.010.840.24XXX
    36002APseudoaneurysm injection trt1.962.951.030.084.993.07000
    36005AInjection ext venography0.957.290.340.048.281.33000
    36010APlace catheter in vein2.43NA0.840.16NA3.43XXX
    36011APlace catheter in vein3.14NA1.100.17NA4.41XXX
    36012APlace catheter in vein3.52NA1.230.17NA4.92XXX
    36013APlace catheter in artery2.52NA0.610.17NA3.30XXX
    36014APlace catheter in artery3.02NA1.060.14NA4.22XXX
    36015APlace catheter in artery3.52NA1.240.16NA4.92XXX
    36100AEstablish access to artery3.02NA1.160.18NA4.36XXX
    36120AEstablish access to artery2.01NA0.690.11NA2.81XXX
    36140AEstablish access to artery2.01NA0.690.12NA2.82XXX
    36145AArtery to vein shunt2.01NA0.700.10NA2.81XXX
    36160AEstablish access to aorta2.52NA0.900.20NA3.62XXX
    36200APlace catheter in aorta3.02NA1.090.15NA4.26XXX
    36215APlace catheter in artery4.68NA1.680.22NA6.58XXX
    36216APlace catheter in artery5.28NA1.890.24NA7.41XXX
    36217APlace catheter in artery6.30NA2.290.32NA8.91XXX
    36218APlace catheter in artery1.01NA0.370.05NA1.43ZZZ
    36245APlace catheter in artery4.68NA1.780.23NA6.69XXX
    36246APlace catheter in artery5.28NA1.910.26NA7.45XXX
    36247APlace catheter in artery6.30NA2.250.32NA8.87XXX
    36248APlace catheter in artery1.01NA0.370.06NA1.44ZZZ
    36260AInsertion of infusion pump9.71NA5.631.00NA16.34090
    36261ARevision of infusion pump5.45NA3.470.50NA9.42090
    36262ARemoval of infusion pump4.02NA2.590.43NA7.04090
    36299CVessel injection procedure0.000.000.000.000.000.00YYY
    36400ADrawing blood0.380.720.100.011.110.49XXX
    36405ADrawing blood0.310.580.090.010.900.41XXX
    36406ADrawing blood0.180.940.060.011.130.25XXX
    36410ADrawing blood0.180.500.050.010.690.24XXX
    36415IDrawing blood0.000.000.000.000.000.00XXX
    36420AEstablish access to vein1.01NA0.330.09NA1.43XXX
    36425AEstablish access to vein0.763.440.170.054.250.98XXX
    36430ABlood transfusion service0.000.95NA0.051.00NAXXX
    36440ABlood transfusion service1.03NA0.310.08NA1.42XXX
    36450AExchange transfusion service2.23NA0.710.16NA3.10XXX
    36455AExchange transfusion service2.43NA0.970.10NA3.50XXX
    36460ATransfusion service, fetal6.59NA2.550.56NA9.70XXX
    36468RInjection(s), spider veins0.000.000.000.000.000.00000
    36469RInjection(s), spider veins0.000.000.000.000.000.00000
    36470AInjection therapy of vein1.092.600.400.103.791.59010
    36471AInjection therapy of veins1.572.650.580.154.372.30010
    36481AInsertion of catheter, vein6.99NA2.860.40NA10.25000
    36488AInsertion of catheter, vein1.35NA0.760.09NA2.20000
    36489AInsertion of catheter, vein2.504.701.080.087.283.66000
    36490AInsertion of catheter, vein1.67NA0.860.17NA2.70000
    36491AInsertion of catheter, vein1.43NA0.750.13NA2.31000
    36493ARepositioning of cvc1.21NA0.880.06NA2.15000
    36500AInsertion of catheter, vein3.52NA1.310.14NA4.97000
    36510AInsertion of catheter, vein1.09NA0.730.06NA1.88000
    36520APlasma and/or cell exchange1.74NA1.070.06NA2.87000
    36521AApheresis w/ adsorp/reinfuse1.74NA1.070.06NA2.87000
    36522APhotopheresis1.676.031.160.077.772.90000
    36530RInsertion of infusion pump6.20NA4.170.56NA10.93010
    36531RRevision of infusion pump4.87NA3.320.44NA8.63010
    36532RRemoval of infusion pump3.30NA1.570.34NA5.21010
    36533AInsertion of access device5.324.673.500.4910.489.31010Start Printed Page 55371
    36534ARevision of access device2.80NA1.550.19NA4.54010
    36535ARemoval of access device2.272.951.890.215.434.37010
    36540BCollect blood venous device0.000.000.000.000.000.00XXX
    36550ADeclot vascular device0.000.38NA0.310.69NAXXX
    36600AWithdrawal of arterial blood0.320.430.090.020.770.43XXX
    36620AInsertion catheter, artery1.15NA0.250.06NA1.46000
    36625AInsertion catheter, artery2.11NA0.610.16NA2.88000
    36640AInsertion catheter, artery2.10NA0.750.18NA3.03000
    36660AInsertion catheter, artery1.40NA0.380.08NA1.86000
    36680AInsert needle, bone cavity1.20NA0.660.08NA1.94000
    36800AInsertion of cannula2.43NA1.590.17NA4.19000
    36810AInsertion of cannula3.97NA2.220.40NA6.59000
    36815AInsertion of cannula2.62NA1.280.26NA4.16000
    36819AAv fusion/uppr arm vein14.00NA6.561.53NA22.09090
    36820AAv fusion/forearm vein14.00NA6.561.53NA22.09090
    36821AAv fusion direct any site8.93NA5.030.97NA14.93090
    36822AInsertion of cannula(s)5.42NA6.810.63NA12.86090
    36823AInsertion of cannula(s)21.00NA10.632.18NA33.81090
    36825AArtery-vein graft9.84NA5.581.09NA16.51090
    36830AArtery-vein graft12.00NA6.141.32NA19.46090
    36831AOpen thrombect av fistula8.00NA3.990.79NA12.78090
    36832AAv fistula revision, open10.50NA5.591.13NA17.22090
    36833AAv fistula revision11.95NA6.111.29NA19.35090
    36834ARepair A-V aneurysm9.93NA3.931.06NA14.92090
    36835AArtery to vein shunt7.15NA4.500.80NA12.45090
    36860AExternal cannula declotting2.012.521.330.104.633.44000
    36861ACannula declotting2.52NA1.500.14NA4.16000
    36870APercut thrombect av fistula5.1641.632.450.2347.027.84090
    37140ARevision of circulation23.60NA10.561.21NA35.37090
    37145ARevision of circulation24.61NA12.972.48NA40.06090
    37160ARevision of circulation21.60NA9.432.16NA33.19090
    37180ARevision of circulation24.61NA10.662.63NA37.90090
    37181ASplice spleen/kidney veins26.68NA11.022.67NA40.37090
    37195AThrombolytic therapy, stroke0.007.65NA0.388.03NAXXX
    37200ATranscatheter biopsy4.56NA1.600.19NA6.35000
    37201ATranscatheter therapy infuse5.00NA2.590.24NA7.83000
    37202ATranscatheter therapy infuse5.68NA3.330.38NA9.39000
    37203ATranscatheter retrieval5.03NA2.620.23NA7.88000
    37204ATranscatheter occlusion18.14NA6.360.85NA25.35000
    37205ATranscatheter stent8.28NA3.900.43NA12.61000
    37206ATranscatheter stent add-on4.13NA1.540.22NA5.89ZZZ
    37207ATranscatheter stent8.28NA3.610.89NA12.78000
    37208ATranscatheter stent add-on4.13NA1.450.44NA6.02ZZZ
    37209AExchange arterial catheter2.27NA0.800.11NA3.18000
    37250AIv us first vessel add-on2.10NA0.790.17NA3.06ZZZ
    37251AIv us each add vessel add-on1.60NA0.580.14NA2.32ZZZ
    37565ALigation of neck vein10.88NA5.340.45NA16.67090
    37600ALigation of neck artery11.25NA6.510.40NA18.16090
    37605ALigation of neck artery13.11NA6.630.77NA20.51090
    37606ALigation of neck artery6.28NA3.850.79NA10.92090
    37607ALigation of a-v fistula6.16NA3.710.67NA10.54090
    37609ATemporal artery procedure3.007.252.580.2110.465.79010
    37615ALigation of neck artery5.73NA3.610.57NA9.91090
    37616ALigation of chest artery16.49NA10.541.93NA28.96090
    37617ALigation of abdomen artery22.06NA9.811.69NA33.56090
    37618ALigation of extremity artery4.84NA3.560.54NA8.94090
    37620ARevision of major vein10.56NA5.530.75NA16.84090
    37650ARevision of major vein7.80NA4.640.56NA13.00090
    37660ARevision of major vein21.00NA9.441.17NA31.61090
    37700ARevise leg vein3.73NA3.200.40NA7.33090
    37720ARemoval of leg vein5.66NA3.720.61NA9.99090
    37730ARemoval of leg veins7.33NA4.590.77NA12.69090
    37735ARemoval of leg veins/lesion10.53NA5.941.17NA17.64090
    37760ARevision of leg veins10.47NA5.781.11NA17.36090
    37780ARevision of leg vein3.84NA2.890.41NA7.14090
    37785ARevise secondary varicosity3.847.182.910.4111.437.16090
    37788ARevascularization, penis22.01NA14.081.35NA37.44090
    37790APenile venous occlusion8.34NA6.780.63NA15.75090
    37799CVascular surgery procedure0.000.000.000.000.000.00YYY
    38100ARemoval of spleen, total14.50NA6.731.30NA22.53090
    38101ARemoval of spleen, partial15.31NA7.271.38NA23.96090
    38102ARemoval of spleen, total4.80NA1.730.49NA7.02ZZZ
    38115ARepair of ruptured spleen15.82NA7.231.40NA24.45090Start Printed Page 55372
    38120ALaparoscopy, splenectomy17.00NA7.581.73NA26.31090
    38129CLaparoscope proc, spleen0.000.000.000.000.000.00YYY
    38200AInjection for spleen x-ray2.64NA0.930.12NA3.69000
    38220ABone marrow aspiration1.084.640.440.035.751.55XXX
    38221ABone marrow biopsy1.374.740.560.046.151.97XXX
    38230RBone marrow collection4.54NA2.450.25NA7.24010
    38231RStem cell collection1.50NA0.610.05NA2.16000
    38240RBone marrow/stem transplant2.24NA0.880.08NA3.20XXX
    38241RBone marrow/stem transplant2.24NA0.860.08NA3.18XXX
    38300ADrainage, lymph node lesion1.994.882.650.157.024.79010
    38305ADrainage, lymph node lesion6.007.996.410.3614.3512.77090
    38308AIncision of lymph channels6.45NA5.400.51NA12.36090
    38380AThoracic duct procedure7.46NA7.610.68NA15.75090
    38381AThoracic duct procedure12.88NA9.721.58NA24.18090
    38382AThoracic duct procedure10.08NA8.811.08NA19.97090
    38500ABiopsy/removal, lymph nodes3.753.152.630.287.186.66010
    38505ANeedle biopsy, lymph nodes1.143.211.130.094.442.36000
    38510ABiopsy/removal, lymph nodes6.43NA5.550.38NA12.36010
    38520ABiopsy/removal, lymph nodes6.67NA5.670.52NA12.86090
    38525ABiopsy/removal, lymph nodes6.07NA4.510.48NA11.06090
    38530ABiopsy/removal, lymph nodes7.98NA5.780.63NA14.39090
    38542AExplore deep node(s), neck5.91NA6.090.50NA12.50090
    38550ARemoval, neck/armpit lesion6.92NA5.010.69NA12.62090
    38555ARemoval, neck/armpit lesion14.14NA9.471.46NA25.07090
    38562ARemoval, pelvic lymph nodes10.49NA6.790.97NA18.25090
    38564ARemoval, abdomen lymph nodes10.83NA6.541.06NA18.43090
    38570ALaparoscopy, lymph node biop9.25NA4.630.89NA14.77010
    38571ALaparoscopy, lymphadenectomy14.68NA6.500.80NA21.98010
    38572ALaparoscopy, lymphadenectomy16.59NA7.711.32NA25.62010
    38589CLaparoscope proc, lymphatic0.000.000.000.000.000.00YYY
    38700ARemoval of lymph nodes, neck8.24NA13.610.60NA22.45090
    38720ARemoval of lymph nodes, neck13.61NA16.251.03NA30.89090
    38724ARemoval of lymph nodes, neck14.54NA16.821.10NA32.46090
    38740ARemove armpit lymph nodes10.03NA5.890.69NA16.61090
    38745ARemove armpit lymph nodes13.10NA8.470.90NA22.47090
    38746ARemove thoracic lymph nodes4.89NA1.650.55NA7.09ZZZ
    38747ARemove abdominal lymph nodes4.89NA1.750.50NA7.14ZZZ
    38760ARemove groin lymph nodes12.95NA7.360.88NA21.19090
    38765ARemove groin lymph nodes19.98NA11.571.50NA33.05090
    38770ARemove pelvis lymph nodes13.23NA7.180.94NA21.35090
    38780ARemove abdomen lymph nodes16.59NA9.671.60NA27.86090
    38790AInject for lymphatic x-ray1.2914.770.460.0916.151.84000
    38792AIdentify sentinel node0.52NA0.190.04NA0.75000
    38794AAccess thoracic lymph duct4.45NA1.570.17NA6.19090
    38999CBlood/lymph system procedure0.000.000.000.000.000.00YYY
    39000AExploration of chest6.10NA7.410.73NA14.24090
    39010AExploration of chest11.79NA9.311.46NA22.56090
    39200ARemoval chest lesion13.62NA10.101.65NA25.37090
    39220ARemoval chest lesion17.42NA11.292.10NA30.81090
    39400AVisualization of chest5.61NA7.010.69NA13.31010
    39499CChest procedure0.000.000.000.000.000.00YYY
    39501ARepair diaphragm laceration13.19NA7.821.38NA22.39090
    39502ARepair paraesophageal hernia16.33NA8.411.68NA26.42090
    39503ARepair of diaphragm hernia95.00NA37.243.52NA135.76090
    39520ARepair of diaphragm hernia16.10NA9.591.83NA27.52090
    39530ARepair of diaphragm hernia15.41NA8.691.66NA25.76090
    39531ARepair of diaphragm hernia16.42NA8.451.83NA26.70090
    39540ARepair of diaphragm hernia13.32NA7.791.38NA22.49090
    39541ARepair of diaphragm hernia14.41NA7.971.52NA23.90090
    39545ARevision of diaphragm13.37NA9.321.55NA24.24090
    39560AResect diaphragm, simple12.00NA7.621.35NA20.97090
    39561AResect diaphragm, complex17.50NA9.841.97NA29.31090
    39599CDiaphragm surgery procedure0.000.000.000.000.000.00YYY
    40490ABiopsy of lip1.221.630.630.062.911.91000
    40500APartial excision of lip4.285.725.720.3110.3110.31090
    40510APartial excision of lip4.706.756.520.3811.8311.60090
    40520APartial excision of lip4.677.977.150.4213.0612.24090
    40525AReconstruct lip with flap7.55NA8.840.68NA17.07090
    40527AReconstruct lip with flap9.13NA9.600.82NA19.55090
    40530APartial removal of lip5.407.356.560.4713.2212.43090
    40650ARepair lip3.645.785.180.319.739.13090
    40652ARepair lip4.267.087.040.3911.7311.69090
    40654ARepair lip5.317.957.950.4813.7413.74090Start Printed Page 55373
    40700ARepair cleft lip/nasal12.79NA10.880.93NA24.60090
    40701ARepair cleft lip/nasal15.85NA14.661.36NA31.87090
    40702ARepair cleft lip/nasal13.04NA8.991.01NA23.04090
    40720ARepair cleft lip/nasal13.55NA12.891.31NA27.75090
    40761ARepair cleft lip/nasal14.72NA12.761.41NA28.89090
    40799CLip surgery procedure0.000.000.000.000.000.00YYY
    40800ADrainage of mouth lesion1.172.010.480.093.271.74010
    40801ADrainage of mouth lesion2.532.521.980.185.234.69010
    40804ARemoval, foreign body, mouth1.242.592.030.093.923.36010
    40805ARemoval, foreign body, mouth2.693.272.850.176.135.71010
    40806AIncision of lip fold0.310.890.890.021.221.22000
    40808ABiopsy of mouth lesion0.962.112.110.073.143.14010
    40810AExcision of mouth lesion1.312.702.470.094.103.87010
    40812AExcise/repair mouth lesion2.312.952.930.175.435.41010
    40814AExcise/repair mouth lesion3.424.084.080.267.767.76090
    40816AExcision of mouth lesion3.674.324.320.278.268.26090
    40818AExcise oral mucosa for graft2.414.054.050.146.606.60090
    40819AExcise lip or cheek fold2.413.673.480.176.256.06090
    40820ATreatment of mouth lesion1.282.382.300.083.743.66010
    40830ARepair mouth laceration1.762.482.480.144.384.38010
    40831ARepair mouth laceration2.462.722.720.215.395.39010
    40840RReconstruction of mouth8.735.935.930.7915.4515.45090
    40842RReconstruction of mouth8.735.905.900.6515.2815.28090
    40843RReconstruction of mouth12.107.357.350.8420.2920.29090
    40844RReconstruction of mouth16.019.019.011.6326.6526.65090
    40845RReconstruction of mouth18.5812.2512.251.4732.3032.30090
    40899CMouth surgery procedure0.000.000.000.000.000.00YYY
    41000ADrainage of mouth lesion1.302.401.550.093.792.94010
    41005ADrainage of mouth lesion1.262.331.620.093.682.97010
    41006ADrainage of mouth lesion3.243.583.280.257.076.77090
    41007ADrainage of mouth lesion3.103.783.330.227.106.65090
    41008ADrainage of mouth lesion3.373.693.220.247.306.83090
    41009ADrainage of mouth lesion3.593.653.420.257.497.26090
    41010AIncision of tongue fold1.063.573.570.064.694.69010
    41015ADrainage of mouth lesion3.964.053.390.298.307.64090
    41016ADrainage of mouth lesion4.074.313.610.288.667.96090
    41017ADrainage of mouth lesion4.074.263.460.328.657.85090
    41018ADrainage of mouth lesion5.104.393.870.359.849.32090
    41100ABiopsy of tongue1.632.672.640.124.424.39010
    41105ABiopsy of tongue1.422.422.420.103.943.94010
    41108ABiopsy of floor of mouth1.052.382.380.083.513.51010
    41110AExcision of tongue lesion1.513.192.630.114.814.25010
    41112AExcision of tongue lesion2.733.563.560.206.496.49090
    41113AExcision of tongue lesion3.193.503.500.236.926.92090
    41114AExcision of tongue lesion8.47NA6.590.64NA15.70090
    41115AExcision of tongue fold1.742.692.530.134.564.40010
    41116AExcision of mouth lesion2.443.373.370.175.985.98090
    41120APartial removal of tongue9.77NA9.120.70NA19.59090
    41130APartial removal of tongue11.15NA9.760.81NA21.72090
    41135ATongue and neck surgery23.09NA16.631.66NA41.38090
    41140ARemoval of tongue25.50NA17.391.85NA44.74090
    41145ATongue removal, neck surgery30.06NA21.362.11NA53.53090
    41150ATongue, mouth, jaw surgery23.04NA17.641.67NA42.35090
    41153ATongue, mouth, neck surgery23.77NA18.041.71NA43.52090
    41155ATongue, jaw, & neck surgery27.72NA20.442.02NA50.18090
    41250ARepair tongue laceration1.912.981.770.155.043.83010
    41251ARepair tongue laceration2.273.121.880.185.574.33010
    41252ARepair tongue laceration2.973.232.330.236.435.53010
    41500AFixation of tongue3.71NA4.430.26NA8.40090
    41510ATongue to lip surgery3.42NA5.390.24NA9.05090
    41520AReconstruction, tongue fold2.733.063.060.195.985.98090
    41599CTongue and mouth surgery0.000.000.000.000.000.00YYY
    41800ADrainage of gum lesion1.171.961.430.093.222.69010
    41805ARemoval foreign body, gum1.242.082.080.093.413.41010
    41806ARemoval foreign body, jawbone2.692.542.540.225.455.45010
    41820RExcision, gum, each quadrant0.000.000.000.000.000.00000
    41821RExcision of gum flap0.000.000.000.000.000.00000
    41822RExcision of gum lesion2.312.820.980.245.373.53010
    41823RExcision of gum lesion3.303.543.230.297.136.82090
    41825AExcision of gum lesion1.312.432.410.103.843.82010
    41826AExcision of gum lesion2.312.662.660.175.145.14010
    41827AExcision of gum lesion3.423.633.630.257.307.30090
    41828RExcision of gum lesion3.093.072.470.226.385.78010Start Printed Page 55374
    41830RRemoval of gum tissue3.353.392.980.236.976.56010
    41850RTreatment of gum lesion0.000.000.000.000.000.00000
    41870RGum graft0.000.000.000.000.000.00000
    41872RRepair gum2.592.932.930.185.705.70090
    41874RRepair tooth socket3.092.862.450.236.185.77090
    41899CDental surgery procedure0.000.000.000.000.000.00YYY
    42000ADrainage mouth roof lesion1.232.521.510.103.852.84010
    42100ABiopsy roof of mouth1.312.472.470.103.883.88010
    42104AExcision lesion, mouth roof1.642.582.580.124.344.34010
    42106AExcision lesion, mouth roof2.102.662.660.164.924.92010
    42107AExcision lesion, mouth roof4.444.264.260.329.029.02090
    42120ARemove palate/lesion6.17NA6.190.44NA12.80090
    42140AExcision of uvula1.623.913.360.125.655.10090
    42145ARepair palate, pharynx/uvula8.05NA7.590.56NA16.20090
    42160ATreatment mouth roof lesion1.803.252.720.135.184.65010
    42180ARepair palate2.503.292.250.195.984.94010
    42182ARepair palate3.833.103.100.277.207.20010
    42200AReconstruct cleft palate12.00NA9.780.97NA22.75090
    42205AReconstruct cleft palate13.29NA9.760.82NA23.87090
    42210AReconstruct cleft palate14.50NA11.471.24NA27.21090
    42215AReconstruct cleft palate8.82NA9.720.96NA19.50090
    42220AReconstruct cleft palate7.02NA6.850.41NA14.28090
    42225AReconstruct cleft palate9.54NA9.160.75NA19.45090
    42226ALengthening of palate10.01NA9.960.73NA20.70090
    42227ALengthening of palate9.52NA9.090.70NA19.31090
    42235ARepair palate7.87NA5.930.49NA14.29090
    42260ARepair nose to lip fistula9.806.436.430.8517.0817.08090
    42280APreparation, palate mold1.541.440.600.123.102.26010
    42281AInsertion, palate prosthesis1.931.570.920.143.642.99010
    42299CPalate/uvula surgery0.000.000.000.000.000.00YYY
    42300ADrainage of salivary gland1.932.651.980.154.734.06010
    42305ADrainage of salivary gland6.07NA5.380.46NA11.91090
    42310ADrainage of salivary gland1.562.321.820.113.993.49010
    42320ADrainage of salivary gland2.352.792.150.175.314.67010
    42325ACreate salivary cyst drain2.753.851.260.176.774.18090
    42326ACreate salivary cyst drain3.783.331.510.347.455.63090
    42330ARemoval of salivary stone2.212.811.200.165.183.57010
    42335ARemoval of salivary stone3.313.713.710.237.257.25090
    42340ARemoval of salivary stone4.605.075.070.3410.0110.01090
    42400ABiopsy of salivary gland0.782.520.400.063.361.24000
    42405ABiopsy of salivary gland3.293.443.440.246.976.97010
    42408AExcision of salivary cyst4.544.714.710.349.599.59090
    42409ADrainage of salivary cyst2.813.343.340.206.356.35090
    42410AExcise parotid gland/lesion9.34NA8.200.77NA18.31090
    42415AExcise parotid gland/lesion16.89NA12.821.26NA30.97090
    42420AExcise parotid gland/lesion19.59NA14.461.45NA35.50090
    42425AExcise parotid gland/lesion13.02NA10.700.98NA24.70090
    42426AExcise parotid gland/lesion21.26NA15.441.57NA38.27090
    42440AExcise submaxillary gland6.97NA6.130.51NA13.61090
    42450AExcise sublingual gland4.624.384.380.349.349.34090
    42500ARepair salivary duct4.305.145.100.309.749.70090
    42505ARepair salivary duct6.186.026.020.4412.6412.64090
    42507AParotid duct diversion6.11NA5.440.66NA12.21090
    42508AParotid duct diversion9.10NA8.400.64NA18.14090
    42509AParotid duct diversion11.54NA9.251.24NA22.03090
    42510AParotid duct diversion8.15NA7.270.57NA15.99090
    42550AInjection for salivary x-ray1.2512.450.440.0613.761.75000
    42600AClosure of salivary fistula4.827.895.610.3413.0510.77090
    42650ADilation of salivary duct0.771.130.410.061.961.24000
    42660ADilation of salivary duct1.131.151.150.072.352.35000
    42665ALigation of salivary duct2.533.033.030.175.735.73090
    42699CSalivary surgery procedure0.000.000.000.000.000.00YYY
    42700ADrainage of tonsil abscess1.623.301.930.125.043.67010
    42720ADrainage of throat abscess5.424.774.770.3910.5810.58010
    42725ADrainage of throat abscess10.72NA8.700.80NA20.22090
    42800ABiopsy of throat1.393.092.630.104.584.12010
    42802ABiopsy of throat1.543.242.720.114.894.37010
    42804ABiopsy of upper nose/throat1.243.042.560.094.373.89010
    42806ABiopsy of upper nose/throat1.583.532.760.125.234.46010
    42808AExcise pharynx lesion2.305.003.170.177.475.64010
    42809ARemove pharynx foreign body1.813.481.770.135.423.71010
    42810AExcision of neck cyst3.255.664.610.259.168.11090
    42815AExcision of neck cyst7.07NA6.670.53NA14.27090Start Printed Page 55375
    42820ARemove tonsils and adenoids3.91NA4.020.28NA8.21090
    42821ARemove tonsils and adenoids4.29NA4.300.30NA8.89090
    42825ARemoval of tonsils3.42NA3.740.24NA7.40090
    42826ARemoval of tonsils3.38NA3.810.23NA7.42090
    42830ARemoval of adenoids2.57NA2.510.18NA5.26090
    42831ARemoval of adenoids2.71NA2.590.19NA5.49090
    42835ARemoval of adenoids2.30NA3.200.17NA5.67090
    42836ARemoval of adenoids3.18NA3.690.22NA7.09090
    42842AExtensive surgery of throat8.76NA7.960.61NA17.33090
    42844AExtensive surgery of throat14.31NA11.571.04NA26.92090
    42845AExtensive surgery of throat24.29NA18.001.76NA44.05090
    42860AExcision of tonsil tags2.22NA3.080.16NA5.46090
    42870AExcision of lingual tonsil5.40NA6.180.38NA11.96090
    42890APartial removal of pharynx12.94NA11.030.91NA24.88090
    42892ARevision of pharyngeal walls15.83NA12.681.14NA29.65090
    42894ARevision of pharyngeal walls22.88NA17.381.64NA41.90090
    42900ARepair throat wound5.25NA3.930.39NA9.57010
    42950AReconstruction of throat8.10NA7.600.58NA16.28090
    42953ARepair throat, esophagus8.96NA9.140.73NA18.83090
    42955ASurgical opening of throat7.39NA6.550.63NA14.57090
    42960AControl throat bleeding2.33NA2.130.17NA4.63010
    42961AControl throat bleeding5.59NA5.300.40NA11.29090
    42962AControl throat bleeding7.14NA6.350.51NA14.00090
    42970AControl nose/throat bleeding5.43NA3.990.37NA9.79090
    42971AControl nose/throat bleeding6.21NA5.990.45NA12.65090
    42972AControl nose/throat bleeding7.20NA5.730.54NA13.47090
    42999CThroat surgery procedure0.000.000.000.000.000.00YYY
    43020AIncision of esophagus8.09NA6.770.70NA15.56090
    43030AThroat muscle surgery7.69NA7.000.60NA15.29090
    43045AIncision of esophagus20.12NA11.142.15NA33.41090
    43100AExcision of esophagus lesion9.19NA7.580.79NA17.56090
    43101AExcision of esophagus lesion16.24NA8.841.81NA26.89090
    43107ARemoval of esophagus40.00NA18.493.29NA61.78090
    43108ARemoval of esophagus34.19NA16.393.78NA54.36090
    43112ARemoval of esophagus43.50NA20.063.67NA67.23090
    43113ARemoval of esophagus35.27NA16.384.33NA55.98090
    43116APartial removal of esophagus31.22NA18.492.62NA52.33090
    43117APartial removal of esophagus40.00NA18.513.51NA62.02090
    43118APartial removal of esophagus33.20NA15.763.56NA52.52090
    43121APartial removal of esophagus29.19NA15.083.44NA47.71090
    43122AParital removal of esophagus40.00NA18.053.27NA61.32090
    43123APartial removal of esophagus33.20NA15.583.96NA52.74090
    43124ARemoval of esophagus27.32NA15.152.95NA45.42090
    43130ARemoval of esophagus pouch11.75NA9.051.06NA21.86090
    43135ARemoval of esophagus pouch16.10NA10.091.85NA28.04090
    43200AEsophagus endoscopy1.597.921.220.119.622.92000
    43202AEsophagus endoscopy, biopsy1.896.461.150.128.473.16000
    43204AEsophagus endoscopy & inject3.77NA1.710.18NA5.66000
    43205AEsophagus endoscopy/ligation3.79NA1.710.17NA5.67000
    43215AEsophagus endoscopy2.60NA1.260.17NA4.03000
    43216AEsophagus endoscopy/lesion2.40NA1.200.15NA3.75000
    43217AEsophagus endoscopy2.90NA1.350.17NA4.42000
    43219AEsophagus endoscopy2.80NA1.430.16NA4.39000
    43220AEsoph endoscopy, dilation2.10NA1.140.12NA3.36000
    43226AEsoph endoscopy, dilation2.34NA1.210.12NA3.67000
    43227AEsoph endoscopy, repair3.60NA1.640.18NA5.42000
    43228AEsoph endoscopy, ablation3.77NA1.770.25NA5.79000
    43231AEsoph endoscopy w/us exam3.19NA1.600.20NA4.99000
    43232AEsoph endoscopy w/us fn bx4.48NA2.150.26NA6.89000
    43234AUpper GI endoscopy, exam2.014.581.060.136.723.20000
    43235AUppr GI endoscopy, diagnosis2.396.381.230.138.903.75000
    43239AUpper GI endoscopy, biopsy2.876.791.270.149.804.28000
    43240AEsoph endoscope w/drain cyst6.86NA2.970.36NA10.19000
    43241AUpper GI endoscopy with tube2.59NA1.270.14NA4.00000
    43242AUppr GI endoscopy w/us fn bx7.312.642.640.2910.2410.24000
    43243AUpper GI endoscopy & inject4.57NA2.000.21NA6.78000
    43244AUpper GI endoscopy/ligation5.05NA2.180.21NA7.44000
    43245AOperative upper GI endoscopy3.39NA1.550.18NA5.12000
    43246APlace gastrostomy tube4.33NA1.840.24NA6.41000
    43247AOperative upper GI endoscopy3.39NA1.560.17NA5.12000
    43248AUppr GI endoscopy/guide wire3.15NA1.490.15NA4.79000
    43249AEsoph endoscopy, dilation2.90NA1.390.15NA4.44000
    43250AUpper GI endoscopy/tumor3.20NA1.480.17NA4.85000Start Printed Page 55376
    43251AOperative upper GI endoscopy3.70NA1.670.19NA5.56000
    43255AOperative upper GI endoscopy4.82NA1.970.20NA6.99000
    43256AUppr GI endoscopy w stent4.601.661.660.236.496.49000
    43258AOperative upper GI endoscopy4.55NA1.990.22NA6.76000
    43259AEndoscopic ultrasound exam4.89NA2.220.22NA7.33000
    43260AEndo cholangiopancreatograph5.96NA2.500.27NA8.73000
    43261AEndo cholangiopancreatograph6.27NA2.620.29NA9.18000
    43262AEndo cholangiopancreatograph7.39NA3.030.34NA10.76000
    43263AEndo cholangiopancreatograph7.29NA3.000.28NA10.57000
    43264AEndo cholangiopancreatograph8.90NA3.580.41NA12.89000
    43265AEndo cholangiopancreatograph10.02NA3.990.42NA14.43000
    43267AEndo cholangiopancreatograph7.39NA3.040.34NA10.77000
    43268AEndo cholangiopancreatograph7.39NA3.030.34NA10.76000
    43269AEndo cholangiopancreatograph8.21NA3.330.28NA11.82000
    43271AEndo cholangiopancreatograph7.39NA3.020.34NA10.75000
    43272AEndo cholangiopancreatograph7.39NA3.040.34NA10.77000
    43280ALaparoscopy, fundoplasty17.25NA8.431.76NA27.44090
    43289CLaparoscope proc, esoph0.000.000.000.000.000.00YYY
    43300ARepair of esophagus9.14NA7.310.85NA17.30090
    43305ARepair esophagus and fistula17.39NA12.841.36NA31.59090
    43310ARepair of esophagus25.39NA14.513.18NA43.08090
    43312ARepair esophagus and fistula28.42NA17.453.38NA49.25090
    43313AEsophagoplasty congential45.28NA22.015.43NA72.72090
    43314ATracheo-esophagoplasty cong50.27NA24.075.53NA79.87090
    43320AFuse esophagus & stomach19.93NA10.671.59NA32.19090
    43324ARevise esophagus & stomach20.57NA9.791.72NA32.08090
    43325ARevise esophagus & stomach20.06NA10.081.65NA31.79090
    43326ARevise esophagus & stomach19.74NA10.331.84NA31.91090
    43330ARepair of esophagus19.77NA9.781.52NA31.07090
    43331ARepair of esophagus20.13NA11.411.93NA33.47090
    43340AFuse esophagus & intestine19.61NA10.311.53NA31.45090
    43341AFuse esophagus & intestine20.85NA11.172.14NA34.16090
    43350ASurgical opening, esophagus15.78NA10.501.15NA27.43090
    43351ASurgical opening, esophagus18.35NA10.911.51NA30.77090
    43352ASurgical opening, esophagus15.26NA9.591.28NA26.13090
    43360AGastrointestinal repair35.70NA17.433.00NA56.13090
    43361AGastrointestinal repair40.50NA17.933.52NA61.95090
    43400ALigate esophagus veins21.20NA10.460.99NA32.65090
    43401AEsophagus surgery for veins22.09NA10.341.73NA34.16090
    43405ALigate/staple esophagus20.01NA9.451.63NA31.09090
    43410ARepair esophagus wound13.47NA9.351.15NA23.97090
    43415ARepair esophagus wound25.00NA12.501.92NA39.42090
    43420ARepair esophagus opening14.35NA9.150.86NA24.36090
    43425ARepair esophagus opening21.03NA11.002.03NA34.06090
    43450ADilate esophagus1.381.470.630.072.922.08000
    43453ADilate esophagus1.51NA0.680.08NA2.27000
    43456ADilate esophagus2.57NA1.070.14NA3.78000
    43458ADilate esophagus3.06NA1.260.17NA4.49000
    43460APressure treatment esophagus3.80NA1.540.21NA5.55000
    43496CFree jejunum flap, microvasc0.000.000.000.000.000.00090
    43499CEsophagus surgery procedure0.000.000.000.000.000.00YYY
    43500ASurgical opening of stomach11.05NA5.230.84NA17.12090
    43501ASurgical repair of stomach20.04NA8.861.55NA30.45090
    43502ASurgical repair of stomach23.13NA10.161.83NA35.12090
    43510ASurgical opening of stomach13.08NA7.500.90NA21.48090
    43520AIncision of pyloric muscle9.99NA5.730.84NA16.56090
    43600ABiopsy of stomach1.91NA1.050.11NA3.07000
    43605ABiopsy of stomach11.98NA5.550.93NA18.46090
    43610AExcision of stomach lesion14.60NA6.851.14NA22.59090
    43611AExcision of stomach lesion17.84NA8.121.38NA27.34090
    43620ARemoval of stomach30.04NA12.892.29NA45.22090
    43621ARemoval of stomach30.73NA13.212.36NA46.30090
    43622ARemoval of stomach32.53NA13.792.48NA48.80090
    43631ARemoval of stomach, partial22.59NA9.721.99NA34.30090
    43632ARemoval of stomach, partial22.59NA9.732.00NA34.32090
    43633ARemoval of stomach, partial23.10NA9.872.05NA35.02090
    43634ARemoval of stomach, partial25.12NA10.842.18NA38.14090
    43635ARemoval of stomach, partial2.06NA0.740.21NA3.01ZZZ
    43638ARemoval of stomach, partial29.00NA12.132.24NA43.37090
    43639ARemoval of stomach, partial29.65NA12.302.31NA44.26090
    43640AVagotomy & pylorus repair17.02NA7.721.51NA26.25090
    43641AVagotomy & pylorus repair17.27NA7.821.53NA26.62090
    43651ALaparoscopy, vagus nerve10.15NA4.711.03NA15.89090Start Printed Page 55377
    43652ALaparoscopy, vagus nerve12.15NA5.531.25NA18.93090
    43653ALaparoscopy, gastrostomy7.73NA4.370.78NA12.88090
    43659CLaparoscope proc, stom0.000.000.000.000.000.00YYY
    43750APlace gastrostomy tube4.49NA2.720.33NA7.54010
    43752BNasal/orogastric w/stent0.000.000.000.000.000.00XXX
    43760AChange gastrostomy tube1.101.470.460.072.641.63000
    43761AReposition gastrostomy tube2.01NA0.830.10NA2.94000
    43800AReconstruction of pylorus13.69NA6.601.07NA21.36090
    43810AFusion of stomach and bowel14.65NA6.941.10NA22.69090
    43820AFusion of stomach and bowel15.37NA7.151.18NA23.70090
    43825AFusion of stomach and bowel19.22NA8.561.50NA29.28090
    43830APlace gastrostomy tube9.53NA5.060.69NA15.28090
    43831APlace gastrostomy tube7.84NA4.670.81NA13.32090
    43832APlace gastrostomy tube15.60NA7.661.13NA24.39090
    43840ARepair of stomach lesion15.56NA7.211.20NA23.97090
    43842AGastroplasty for obesity18.47NA11.241.51NA31.22090
    43843AGastroplasty for obesity18.65NA11.251.53NA31.43090
    43846AGastric bypass for obesity24.05NA13.681.96NA39.69090
    43847AGastric bypass for obesity26.92NA15.282.14NA44.34090
    43848ARevision gastroplasty29.39NA16.542.39NA48.32090
    43850ARevise stomach-bowel fusion24.72NA10.421.97NA37.11090
    43855ARevise stomach-bowel fusion26.16NA11.122.01NA39.29090
    43860ARevise stomach-bowel fusion25.00NA10.582.03NA37.61090
    43865ARevise stomach-bowel fusion26.52NA11.212.15NA39.88090
    43870ARepair stomach opening9.69NA5.220.71NA15.62090
    43880ARepair stomach-bowel fistula24.65NA10.871.94NA37.46090
    43999CStomach surgery procedure0.000.000.000.000.000.00YYY
    44005AFreeing of bowel adhesion16.23NA7.401.39NA25.02090
    44010AIncision of small bowel12.52NA6.481.05NA20.05090
    44015AInsert needle cath bowel2.62NA0.930.25NA3.80ZZZ
    44020AExplore small intestine13.99NA6.561.20NA21.75090
    44021ADecompress small bowel14.08NA7.021.18NA22.28090
    44025AIncision of large bowel14.28NA6.651.21NA22.14090
    44050AReduce bowel obstruction14.03NA6.601.15NA21.78090
    44055ACorrect malrotation of bowel22.00NA9.511.32NA32.83090
    44100ABiopsy of bowel2.01NA1.090.12NA3.22000
    44110AExcise intestine lesion(s)11.81NA5.841.00NA18.65090
    44111AExcision of bowel lesion(s)14.29NA7.101.22NA22.61090
    44120ARemoval of small intestine17.00NA7.671.46NA26.13090
    44121ARemoval of small intestine4.45NA1.600.45NA6.50ZZZ
    44125ARemoval of small intestine17.54NA7.861.49NA26.89090
    44126AEnterectomy w/taper, cong35.50NA18.030.36NA53.89090
    44127AEnterectomy w/o taper, cong41.00NA20.560.41NA61.97090
    44128AEnterectomy cong, add-on4.45NA1.780.45NA6.68ZZZ
    44130ABowel to bowel fusion14.49NA6.781.23NA22.50090
    44132REnterectomy, cadaver donor0.000.000.000.000.000.00XXX
    44133REnterectomy, live donor0.000.000.000.000.000.00XXX
    44135RIntestine transplant, cadaver0.000.000.000.000.000.00XXX
    44136RIntestine transplant, live0.000.000.000.000.000.00XXX
    44139AMobilization of colon2.23NA0.800.21NA3.24ZZZ
    44140APartial removal of colon21.00NA9.531.83NA32.36090
    44141APartial removal of colon19.51NA11.931.95NA33.39090
    44143APartial removal of colon22.99NA13.142.02NA38.15090
    44144APartial removal of colon21.53NA11.751.89NA35.17090
    44145APartial removal of colon26.42NA11.902.22NA40.54090
    44146APartial removal of colon27.54NA15.412.20NA45.15090
    44147APartial removal of colon20.71NA10.151.74NA32.60090
    44150ARemoval of colon23.95NA14.082.05NA40.08090
    44151ARemoval of colon/ileostomy26.88NA15.741.97NA44.59090
    44152ARemoval of colon/ileostomy27.83NA17.012.36NA47.20090
    44153ARemoval of colon/ileostomy30.59NA16.642.33NA49.56090
    44155ARemoval of colon/ileostomy27.86NA15.282.26NA45.40090
    44156ARemoval of colon/ileostomy30.79NA17.862.19NA50.84090
    44160ARemoval of colon18.62NA8.651.55NA28.82090
    44200ALaparoscopy, enterolysis14.44NA6.791.46NA22.69090
    44201ALaparoscopy, jejunostomy9.78NA5.160.97NA15.91090
    44202ALap resect s/intestine singl22.04NA9.822.16NA34.02090
    44203ALap resect s/intestine, addl4.45NA1.600.45NA6.50ZZZ
    44204ALaparo partial colectomy25.08NA10.461.83NA37.37090
    44205ALap colectomy part w/ileum22.23NA9.311.55NA33.09090
    44209CLaparoscope proc, intestine0.000.000.000.000.000.00YYY
    44300AOpen bowel to skin12.11NA6.790.88NA19.78090
    44310AIleostomy/jejunostomy15.95NA10.501.13NA27.58090Start Printed Page 55378
    44312ARevision of ileostomy8.02NA5.250.54NA13.81090
    44314ARevision of ileostomy15.05NA10.370.99NA26.41090
    44316ADevise bowel pouch21.09NA13.771.41NA36.27090
    44320AColostomy17.64NA12.131.28NA31.05090
    44322AColostomy with biopsies11.98NA10.411.18NA23.57090
    44340ARevision of colostomy7.72NA4.860.56NA13.14090
    44345ARevision of colostomy15.43NA8.341.11NA24.88090
    44346ARevision of colostomy16.99NA8.911.20NA27.10090
    44360ASmall bowel endoscopy2.59NA1.390.14NA4.12000
    44361ASmall bowel endoscopy/biopsy2.87NA1.500.15NA4.52000
    44363ASmall bowel endoscopy3.50NA1.710.19NA5.40000
    44364ASmall bowel endoscopy3.74NA1.800.21NA5.75000
    44365ASmall bowel endoscopy3.31NA1.680.18NA5.17000
    44366ASmall bowel endoscopy4.41NA2.050.22NA6.68000
    44369ASmall bowel endoscopy4.52NA2.050.23NA6.80000
    44370ASmall bowel endoscopy/stent4.801.741.740.216.756.75000
    44372ASmall bowel endoscopy4.41NA2.040.27NA6.72000
    44373ASmall bowel endoscopy3.50NA1.800.19NA5.49000
    44376ASmall bowel endoscopy5.26NA2.360.29NA7.91000
    44377ASmall bowel endoscopy/biopsy5.53NA2.470.28NA8.28000
    44378ASmall bowel endoscopy7.13NA3.060.37NA10.56000
    44379AS bowel endoscope w/stent7.472.672.670.3810.5210.52000
    44380ASmall bowel endoscopy1.05NA0.790.08NA1.92000
    44382ASmall bowel endoscopy1.27NA0.900.09NA2.26000
    44383AIleoscopy w/stent3.261.161.160.134.554.55000
    44385AEndoscopy of bowel pouch1.825.260.950.127.202.89000
    44386AEndoscopy, bowel pouch/biop2.126.981.090.159.253.36000
    44388AColon endoscopy2.826.911.420.189.914.42000
    44389AColonoscopy with biopsy3.137.621.550.1810.934.86000
    44390AColonoscopy for foreign body3.836.681.800.2210.735.85000
    44391AColonoscopy for bleeding4.326.041.780.2310.596.33000
    44392AColonoscopy & polypectomy3.828.211.790.2312.265.84000
    44393AColonoscopy, lesion removal4.848.452.190.2713.567.30000
    44394AColonoscopy w/snare4.437.712.040.2612.406.73000
    44397AColonoscopy w stent4.71NA2.100.28NA7.09000
    44500AIntro, gastrointestinal tube0.49NA0.370.02NA0.88000
    44602ASuture, small intestine16.03NA7.341.07NA24.44090
    44603ASuture, small intestine18.66NA8.251.39NA28.30090
    44604ASuture, large intestine16.03NA7.351.42NA24.80090
    44605ARepair of bowel lesion19.53NA8.941.54NA30.01090
    44615AIntestinal stricturoplasty15.93NA7.321.39NA24.64090
    44620ARepair bowel opening12.20NA5.811.05NA19.06090
    44625ARepair bowel opening15.05NA6.861.30NA23.21090
    44626ARepair bowel opening25.36NA10.602.19NA38.15090
    44640ARepair bowel-skin fistula21.65NA9.701.46NA32.81090
    44650ARepair bowel fistula22.57NA10.011.49NA34.07090
    44660ARepair bowel-bladder fistula21.36NA9.511.14NA32.01090
    44661ARepair bowel-bladder fistula24.81NA10.731.53NA37.07090
    44680ASurgical revision, intestine15.40NA7.471.37NA24.24090
    44700ASuspend bowel w/prosthesis16.11NA7.571.21NA24.89090
    44799CIntestine surgery procedure0.000.000.000.000.000.00YYY
    44800AExcision of bowel pouch11.23NA5.611.11NA17.95090
    44820AExcision of mesentery lesion12.09NA5.981.03NA19.10090
    44850ARepair of mesentery10.74NA5.410.99NA17.14090
    44899CBowel surgery procedure0.000.000.000.000.000.00YYY
    44900ADrain app abscess, open10.14NA5.960.84NA16.94090
    44901ADrain app abscess, percut3.38NA5.010.17NA8.56000
    44950AAppendectomy10.00NA5.310.88NA16.19090
    44955AAppendectomy add-on1.53NA0.570.16NA2.26ZZZ
    44960AAppendectomy12.34NA6.501.09NA19.93090
    44970ALaparoscopy, appendectomy8.70NA4.210.88NA13.79090
    44979CLaparoscope proc, app0.000.000.000.000.000.00YYY
    45000ADrainage of pelvic abscess4.52NA3.800.37NA8.69090
    45005ADrainage of rectal abscess1.994.581.620.186.753.79010
    45020ADrainage of rectal abscess4.72NA4.210.41NA9.34090
    45100ABiopsy of rectum3.684.862.120.338.876.13090
    45108ARemoval of anorectal lesion4.766.402.950.4611.628.17090
    45110ARemoval of rectum28.00NA13.262.26NA43.52090
    45111APartial removal of rectum16.48NA8.781.60NA26.86090
    45112ARemoval of rectum30.54NA13.702.35NA46.59090
    45113APartial proctectomy30.58NA13.392.13NA46.10090
    45114APartial removal of rectum27.32NA12.612.28NA42.21090
    45116APartial removal of rectum24.58NA11.582.00NA38.16090Start Printed Page 55379
    45119ARemove rectum w/reservoir30.84NA13.252.13NA46.22090
    45120ARemoval of rectum24.60NA11.632.28NA38.51090
    45121ARemoval of rectum and colon27.04NA12.532.66NA42.23090
    45123APartial proctectomy16.71NA8.211.04NA25.96090
    45126APelvic exenteration45.16NA19.123.23NA67.51090
    45130AExcision of rectal prolapse16.44NA7.801.12NA25.36090
    45135AExcision of rectal prolapse19.28NA9.101.52NA29.90090
    45136AExcise ileoanal reservoir27.30NA12.662.19NA42.15090
    45150AExcision of rectal stricture5.675.893.190.4612.029.32090
    45160AExcision of rectal lesion15.32NA7.141.07NA23.53090
    45170AExcision of rectal lesion11.49NA5.890.89NA18.27090
    45190ADestruction, rectal tumor9.74NA5.330.76NA15.83090
    45300AProctosigmoidoscopy dx0.381.340.230.051.770.66000
    45303AProctosigmoidoscopy dilate0.441.550.270.062.050.77000
    45305AProtosigmoidoscopy w/bx1.011.640.460.092.741.56000
    45307AProtosigmoidoscopy fb0.942.680.440.153.771.53000
    45308AProtosigmoidoscopy removal0.831.590.390.132.551.35000
    45309AProtosigmoidoscopy removal2.012.430.810.174.612.99000
    45315AProtosigmoidoscopy removal1.402.840.600.204.442.20000
    45317AProtosigmoidoscopy bleed1.501.940.630.203.642.33000
    45320AProtosigmoidoscopy ablate1.581.880.680.203.662.46000
    45321AProtosigmoidoscopy volvul1.17NA0.520.17NA1.86000
    45327AProctosigmoidoscopy w/stent1.65NA0.890.10NA2.64000
    45330ADiagnostic sigmoidoscopy0.961.920.530.052.931.54000
    45331ASigmoidoscopy and biopsy1.152.380.540.073.601.76000
    45332ASigmoidoscopy w/fb removal1.794.360.760.116.262.66000
    45333ASigmoidoscopy & polypectomy1.793.930.770.125.842.68000
    45334ASigmoidoscopy for bleeding2.73NA1.120.16NA4.01000
    45337ASigmoidoscopy & decompress2.36NA0.970.15NA3.48000
    45338ASigmoidoscpy w/tumr remove2.344.750.970.157.243.46000
    45339ASigmoidoscopy w/ablate tumr3.143.621.270.176.934.58000
    45341ASigmoidoscopy w/ultrasound2.60NA1.400.20NA4.20000
    45342ASigmoidoscopy w/us guide bx4.06NA1.850.23NA6.14000
    45345ASigmodoscopy w/stent2.92NA1.440.15NA4.51000
    45355ASurgical colonoscopy3.52NA1.280.26NA5.06000
    45378ADiagnostic colonoscopy3.708.791.770.2012.695.67000
    4537853ADiagnostic colonoscopy0.961.920.530.052.931.54000
    45379AColonoscopy w/fb removal4.698.252.130.2513.197.07000
    45380AColonoscopy and biopsy4.449.282.050.2113.936.70000
    45382AColonoscopy/control bleeding5.6910.322.290.2716.288.25000
    45383ALesion removal colonoscopy5.8710.012.560.3216.208.75000
    45384ALesion remove colonoscopy4.709.742.140.2414.687.08000
    45385ALesion removal colonoscopy5.3110.192.360.2815.787.95000
    45387AColonoscopy w/stent5.91NA2.570.33NA8.81000
    45500ARepair of rectum7.29NA4.240.56NA12.09090
    45505ARepair of rectum7.58NA3.860.50NA11.94090
    45520ATreatment of rectal prolapse0.550.770.200.041.360.79000
    45540ACorrect rectal prolapse16.27NA8.181.17NA25.62090
    45541ACorrect rectal prolapse13.40NA7.030.88NA21.31090
    45550ARepair rectum/remove sigmoid23.00NA10.401.58NA34.98090
    45560ARepair of rectocele10.58NA6.120.73NA17.43090
    45562AExploration/repair of rectum15.38NA7.521.15NA24.05090
    45563AExploration/repair of rectum23.47NA11.341.84NA36.65090
    45800ARepair rect/bladder fistula17.77NA8.231.14NA27.14090
    45805ARepair fistula w/colostomy20.78NA10.721.47NA32.97090
    45820ARepair rectourethral fistula18.48NA8.551.17NA28.20090
    45825ARepair fistula w/colostomy21.25NA10.570.97NA32.79090
    45900AReduction of rectal prolapse2.61NA1.040.17NA3.82010
    45905ADilation of anal sphincter2.3012.190.960.1414.633.40010
    45910ADilation of rectal narrowing2.8017.621.150.1420.564.09010
    45915ARemove rectal obstruction3.144.891.160.178.204.47010
    45999CRectum surgery procedure0.000.000.000.000.000.00YYY
    46020APlacement of seton2.903.092.360.226.215.48010
    46030ARemoval of rectal marker1.232.901.220.114.242.56010
    46040AIncision of rectal abscess4.965.573.150.4811.018.59090
    46045AIncision of rectal abscess4.32NA2.880.40NA7.60090
    46050AIncision of anal abscess1.193.681.370.114.982.67010
    46060AIncision of rectal abscess5.69NA3.830.52NA10.04090
    46070AIncision of anal septum2.71NA2.540.27NA5.52090
    46080AIncision of anal sphincter2.493.811.650.236.534.37010
    46083AIncise external hemorrhoid1.404.781.590.126.303.11010
    46200ARemoval of anal fissure3.424.012.420.307.736.14090
    46210ARemoval of anal crypt2.675.122.170.268.055.10090Start Printed Page 55380
    46211ARemoval of anal crypts4.254.973.100.379.597.72090
    46220ARemoval of anal tab1.561.320.560.143.022.26010
    46221ALigation of hemorrhoid(s)2.041.801.120.123.963.28010
    46230ARemoval of anal tabs2.574.381.690.227.174.48010
    46250AHemorrhoidectomy3.895.592.710.439.917.03090
    46255AHemorrhoidectomy4.606.452.960.5111.568.07090
    46257ARemove hemorrhoids & fissure5.40NA3.120.59NA9.11090
    46258ARemove hemorrhoids & fistula5.73NA3.300.64NA9.67090
    46260AHemorrhoidectomy6.37NA4.040.68NA11.09090
    46261ARemove hemorrhoids & fissure7.08NA4.190.70NA11.97090
    46262ARemove hemorrhoids & fistula7.50NA4.350.76NA12.61090
    46270ARemoval of anal fistula3.725.232.650.369.316.73090
    46275ARemoval of anal fistula4.564.652.850.409.617.81090
    46280ARemoval of anal fistula5.98NA3.830.50NA10.31090
    46285ARemoval of anal fistula4.094.282.690.348.717.12090
    46288ARepair anal fistula7.13NA4.250.60NA11.98090
    46320ARemoval of hemorrhoid clot1.614.001.570.145.753.32010
    46500AInjection into hemorrhoid(s)1.612.890.580.124.622.31010
    46600ADiagnostic anoscopy0.500.820.150.041.360.69000
    46604AAnoscopy and dilation1.310.990.470.092.391.87000
    46606AAnoscopy and biopsy0.810.870.290.071.751.17000
    46608AAnoscopy/remove for body1.511.810.490.133.452.13000
    46610AAnoscopy/remove lesion1.321.460.480.122.901.92000
    46611AAnoscopy1.812.070.650.154.032.61000
    46612AAnoscopy/ remove lesions2.342.650.850.185.173.37000
    46614AAnoscopy/control bleeding2.011.900.710.144.052.86000
    46615AAnoscopy2.681.760.960.234.673.87000
    46700ARepair of anal stricture9.13NA4.780.56NA14.47090
    46705ARepair of anal stricture6.90NA4.530.73NA12.16090
    46715ARepair of anovaginal fistula7.20NA4.460.76NA12.42090
    46716ARepair of anovaginal fistula15.07NA8.051.30NA24.42090
    46730AConstruction of absent anus26.75NA12.252.03NA41.03090
    46735AConstruction of absent anus32.17NA15.492.64NA50.30090
    46740AConstruction of absent anus30.00NA14.611.99NA46.60090
    46742ARepair of imperforated anus35.80NA18.312.63NA56.74090
    46744ARepair of cloacal anomaly52.63NA22.782.27NA77.68090
    46746ARepair of cloacal anomaly58.22NA27.192.51NA87.92090
    46748ARepair of cloacal anomaly64.21NA29.582.77NA96.56090
    46750ARepair of anal sphincter10.25NA5.790.69NA16.73090
    46751ARepair of anal sphincter8.77NA6.140.78NA15.69090
    46753AReconstruction of anus8.29NA4.130.58NA13.00090
    46754ARemoval of suture from anus2.205.361.430.127.683.75010
    46760ARepair of anal sphincter14.43NA7.070.86NA22.36090
    46761ARepair of anal sphincter13.84NA6.870.84NA21.55090
    46762AImplant artificial sphincter12.71NA6.080.71NA19.50090
    46900ADestruction, anal lesion(s)1.913.520.740.135.562.78010
    46910ADestruction, anal lesion(s)1.863.811.480.145.813.48010
    46916ACryosurgery, anal lesion(s)1.863.241.680.095.193.63010
    46917ALaser surgery, anal lesions1.865.321.620.167.343.64010
    46922AExcision of anal lesion(s)1.863.961.460.175.993.49010
    46924ADestruction, anal lesion(s)2.764.811.770.207.774.73010
    46934ADestruction of hemorrhoids3.516.623.770.2610.397.54090
    46935ADestruction of hemorrhoids2.434.600.870.177.203.47010
    46936ADestruction of hemorrhoids3.696.673.580.3010.667.57090
    46937ACryotherapy of rectal lesion2.694.511.720.127.324.53010
    46938ACryotherapy of rectal lesion4.666.223.270.4011.288.33090
    46940ATreatment of anal fissure2.323.470.830.175.963.32010
    46942ATreatment of anal fissure2.042.840.710.145.022.89010
    46945ALigation of hemorrhoids1.844.042.290.176.054.30090
    46946ALigation of hemorrhoids2.585.402.610.228.205.41090
    46999CAnus surgery procedure0.000.000.000.000.000.00YYY
    47000ANeedle biopsy of liver1.908.360.670.0910.352.66000
    47001ANeedle biopsy, liver add-on1.90NA0.680.18NA2.76ZZZ
    47010AOpen drainage, liver lesion16.01NA9.600.65NA26.26090
    47011APercut drain, liver lesion3.70NA4.610.17NA8.48000
    47015AInject/aspirate liver cyst15.11NA8.230.86NA24.20090
    47100AWedge biopsy of liver11.67NA6.500.75NA18.92090
    47120APartial removal of liver35.50NA17.022.29NA54.81090
    47122AExtensive removal of liver55.13NA24.113.60NA82.84090
    47125APartial removal of liver49.19NA22.123.18NA74.49090
    47130APartial removal of liver53.35NA23.493.47NA80.31090
    47133XRemoval of donor liver0.000.000.000.000.000.00XXX
    47134RPartial removal, donor liver39.15NA13.913.98NA57.04XXXStart Printed Page 55381
    47135RTransplantation of liver81.52NA43.288.13NA132.93090
    47136RTransplantation of liver68.60NA47.006.93NA122.53090
    47300ASurgery for liver lesion15.08NA7.750.97NA23.80090
    47350ARepair liver wound19.56NA9.451.25NA30.26090
    47360ARepair liver wound26.92NA12.961.71NA41.59090
    47361ARepair liver wound47.12NA19.943.11NA70.17090
    47362ARepair liver wound18.51NA9.771.22NA29.50090
    47370ALaparo ablate liver tumor rf18.007.197.190.8526.0426.04090
    47371ALaparo ablate liver cryosug16.946.766.760.8524.5524.55090
    47379CLaparoscope procedure, liver0.000.000.000.000.000.00YYY
    47380AOpen ablate liver tumor rf21.258.488.480.8530.5830.58090
    47381AOpen ablate liver tumor cryo21.008.388.380.8530.2330.23090
    47382APercut ablate liver rf12.00NA5.370.85NA18.22010
    47399CLiver surgery procedure0.000.000.000.000.000.00YYY
    47400AIncision of liver duct32.49NA14.991.82NA49.30090
    47420AIncision of bile duct19.88NA9.461.70NA31.04090
    47425AIncision of bile duct19.83NA9.381.60NA30.81090
    47460AIncise bile duct sphincter18.04NA9.261.24NA28.54090
    47480AIncision of gallbladder10.82NA6.800.85NA18.47090
    47490AIncision of gallbladder7.23NA7.670.33NA15.23090
    47500AInjection for liver x-rays1.96NA0.680.09NA2.73000
    47505AInjection for liver x-rays0.762.880.260.033.671.05000
    47510AInsert catheter, bile duct7.83NA9.460.36NA17.65090
    47511AInsert bile duct drain10.50NA10.570.47NA21.54090
    47525AChange bile duct catheter5.55NA3.340.24NA9.13010
    47530ARevise/reinsert bile tube5.85NA5.070.29NA11.21090
    47550ABile duct endoscopy add-on3.02NA1.080.30NA4.40ZZZ
    47552ABiliary endoscopy thru skin6.04NA2.520.42NA8.98000
    47553ABiliary endoscopy thru skin6.35NA2.700.30NA9.35000
    47554ABiliary endoscopy thru skin9.06NA3.550.74NA13.35000
    47555ABiliary endoscopy thru skin7.56NA3.150.35NA11.06000
    47556ABiliary endoscopy thru skin8.56NA3.490.38NA12.43000
    47560ALaparoscopy w/cholangio4.89NA1.890.49NA7.27000
    47561ALaparo w/cholangio/biopsy5.18NA2.190.49NA7.86000
    47562ALaparoscopic cholecystectomy11.09NA5.151.13NA17.37090
    47563ALaparo cholecystectomy/graph11.94NA5.431.21NA18.58090
    47564ALaparo cholecystectomy/explr14.23NA6.261.44NA21.93090
    47570ALaparo cholecystoenterostomy12.58NA5.671.28NA19.53090
    47579CLaparoscope proc, biliary0.000.000.000.000.000.00YYY
    47600ARemoval of gallbladder13.58NA6.861.16NA21.60090
    47605ARemoval of gallbladder14.69NA7.231.25NA23.17090
    47610ARemoval of gallbladder18.82NA8.801.61NA29.23090
    47612ARemoval of gallbladder18.78NA8.701.60NA29.08090
    47620ARemoval of gallbladder20.64NA9.351.77NA31.76090
    47630ARemove bile duct stone9.11NA3.200.46NA12.77090
    47700AExploration of bile ducts15.62NA8.791.40NA25.81090
    47701ABile duct revision27.81NA13.603.00NA44.41090
    47711AExcision of bile duct tumor23.03NA11.341.98NA36.35090
    47712AExcision of bile duct tumor30.24NA14.002.67NA46.91090
    47715AExcision of bile duct cyst18.80NA8.951.59NA29.34090
    47716AFusion of bile duct cyst16.44NA8.191.41NA26.04090
    47720AFuse gallbladder & bowel15.91NA8.661.37NA25.94090
    47721AFuse upper gi structures19.12NA9.901.63NA30.65090
    47740AFuse gallbladder & bowel18.48NA9.641.59NA29.71090
    47741AFuse gallbladder & bowel21.34NA10.621.82NA33.78090
    47760AFuse bile ducts and bowel25.85NA12.282.21NA40.34090
    47765AFuse liver ducts & bowel24.88NA12.732.18NA39.79090
    47780AFuse bile ducts and bowel26.50NA12.492.27NA41.26090
    47785AFuse bile ducts and bowel31.18NA14.972.69NA48.84090
    47800AReconstruction of bile ducts23.30NA11.571.95NA36.82090
    47801APlacement, bile duct support15.17NA10.210.69NA26.07090
    47802AFuse liver duct & intestine21.55NA11.601.84NA34.99090
    47900ASuture bile duct injury19.90NA10.251.65NA31.80090
    47999CBile tract surgery procedure0.000.000.000.000.000.00YYY
    48000ADrainage of abdomen28.07NA12.591.32NA41.98090
    48001APlacement of drain, pancreas35.45NA15.041.90NA52.39090
    48005AResect/debride pancreas42.17NA17.392.26NA61.82090
    48020ARemoval of pancreatic stone15.70NA7.441.36NA24.50090
    48100ABiopsy of pancreas, open12.23NA7.031.08NA20.34090
    48102ANeedle biopsy, pancreas4.688.962.450.2013.847.33010
    48120ARemoval of pancreas lesion15.85NA7.691.35NA24.89090
    48140APartial removal of pancreas22.94NA10.782.12NA35.84090
    48145APartial removal of pancreas24.02NA11.482.25NA37.75090Start Printed Page 55382
    48146APancreatectomy26.40NA13.962.43NA42.79090
    48148ARemoval of pancreatic duct17.34NA9.151.61NA28.10090
    48150APartial removal of pancreas48.00NA21.294.43NA73.72090
    48152APancreatectomy43.75NA20.744.07NA68.56090
    48153APancreatectomy47.89NA22.184.40NA74.47090
    48154APancreatectomy44.10NA20.824.10NA69.02090
    48155ARemoval of pancreas24.64NA13.892.30NA40.83090
    48160NPancreas removal/transplant0.000.000.000.000.000.00XXX
    48180AFuse pancreas and bowel24.72NA11.162.24NA38.12090
    48400AInjection, intraop add-on1.95NA0.690.10NA2.74ZZZ
    48500ASurgery of pancreatic cyst15.28NA7.741.35NA24.37090
    48510ADrain pancreatic pseudocyst14.31NA7.451.07NA22.83090
    48511ADrain pancreatic pseudocyst4.00NA3.950.17NA8.12000
    48520AFuse pancreas cyst and bowel15.59NA7.491.41NA24.49090
    48540AFuse pancreas cyst and bowel19.72NA8.841.82NA30.38090
    48545APancreatorrhaphy18.18NA8.881.61NA28.67090
    48547ADuodenal exclusion25.83NA11.042.30NA39.17090
    48550XDonor pancreatectomy0.000.000.000.000.000.00XXX
    48554RTranspl allograft pancreas34.17NA12.273.30NA49.74090
    48556ARemoval, allograft pancreas15.71NA8.711.52NA25.94090
    48999CPancreas surgery procedure0.000.000.000.000.000.00YYY
    49000AExploration of abdomen11.68NA6.221.17NA19.07090
    49002AReopening of abdomen10.49NA6.101.06NA17.65090
    49010AExploration behind abdomen12.28NA7.051.22NA20.55090
    49020ADrain abdominal abscess22.84NA11.411.31NA35.56090
    49021ADrain abdominal abscess3.38NA5.840.16NA9.38000
    49040ADrain, open, abdom abscess13.52NA8.020.84NA22.38090
    49041ADrain, percut, abdom abscess4.00NA6.070.18NA10.25000
    49060ADrain, open, retrop abscess15.86NA9.620.77NA26.25090
    49061ADrain, percut, retroper absc3.70NA5.990.17NA9.86000
    49062ADrain to peritoneal cavity11.36NA7.061.08NA19.50090
    49080APuncture, peritoneal cavity1.354.560.480.075.981.90000
    49081ARemoval of abdominal fluid1.263.140.600.064.461.92000
    49085ARemove abdomen foreign body12.14NA6.720.88NA19.74090
    49180ABiopsy, abdominal mass1.738.500.600.0810.312.41000
    49200ARemoval of abdominal lesion10.25NA6.590.89NA17.73090
    49201ARemoval of abdominal lesion14.84NA8.901.44NA25.18090
    49215AExcise sacral spine tumor33.50NA15.522.48NA51.50090
    49220AMultiple surgery, abdomen14.88NA7.941.51NA24.33090
    49250AExcision of umbilicus8.35NA5.260.84NA14.45090
    49255ARemoval of omentum11.14NA6.661.12NA18.92090
    49320ADiag laparo separate proc5.10NA3.080.50NA8.68010
    49321ALaparoscopy, biopsy5.40NA3.070.53NA9.00010
    49322ALaparoscopy, aspiration5.70NA3.530.57NA9.80010
    49323ALaparo drain lymphocele9.48NA4.180.88NA14.54090
    49329CLaparo proc, abdm/per/oment0.000.000.000.000.000.00YYY
    49400AAir injection into abdomen1.88NA0.820.11NA2.81000
    49420AInsert abdominal drain2.22NA0.980.13NA3.33000
    49421AInsert abdominal drain5.54NA4.080.55NA10.17090
    49422ARemove perm cannula/catheter6.25NA3.010.63NA9.89010
    49423AExchange drainage catheter1.46NA0.700.07NA2.23000
    49424AAssess cyst, contrast inject0.76NA0.450.03NA1.24000
    49425AInsert abdomen-venous drain11.37NA6.791.21NA19.37090
    49426ARevise abdomen-venous shunt9.63NA6.170.93NA16.73090
    49427AInjection, abdominal shunt0.89NA0.500.05NA1.44000
    49428ALigation of shunt6.06NA3.190.31NA9.56010
    49429ARemoval of shunt7.40NA3.550.81NA11.76010
    49491ARepairing hern premie reduc11.13NA5.651.00NA17.78090
    49492ARpr ing hern premie, blocked14.03NA6.401.42NA21.85090
    49495ARpr ing hernia baby, reduc5.89NA3.720.55NA10.16090
    49496ARpr ing hernia baby, blocked8.79NA5.940.89NA15.62090
    49500ARpr ing hernia, init, reduce5.48NA3.480.46NA9.42090
    49501ARpr ing hernia, init blocked8.88NA4.620.76NA14.26090
    49505ARpr i/hern init reduc>5 yr7.604.584.130.6512.8312.38090
    49507ARpr i/hern init block>5 yr9.57NA6.170.83NA16.57090
    49520ARerepair ing hernia, reduce9.63NA5.490.84NA15.96090
    49521ARerepair ing hernia, blocked11.97NA5.851.04NA18.86090
    49525ARepair ing hernia, sliding8.57NA4.970.74NA14.28090
    49540ARepair lumbar hernia10.39NA5.650.90NA16.94090
    49550ARpr fem hernia, init, reduce8.63NA4.550.75NA13.93090
    49553ARpr fem hernia, init blocked9.44NA4.950.83NA15.22090
    49555ARerepair fem hernia, reduce9.03NA5.300.79NA15.12090
    49557ARerepair fem hernia, blocked11.15NA5.590.97NA17.71090Start Printed Page 55383
    49560ARpr ventral hern init, reduc11.57NA6.111.00NA18.68090
    49561ARpr ventral hern init, block14.25NA6.711.23NA22.19090
    49565ARerepair ventrl hern, reduce11.57NA6.271.00NA18.84090
    49566ARerepair ventrl hern, block14.40NA6.791.24NA22.43090
    49568AHernia repair w/mesh4.89NA1.760.50NA7.15ZZZ
    49570ARpr epigastric hern, reduce5.69NA3.540.50NA9.73090
    49572ARpr epigastric hern, blocked6.73NA4.000.58NA11.31090
    49580ARpr umbil hern, reduc <5 yr4.11NA3.030.34NA7.48090
    49582ARpr umbil hern, block < 5 yr6.65NA5.020.57NA12.24090
    49585ARpr umbil hern, reduc > 5 yr6.23NA4.150.53NA10.91090
    49587ARpr umbil hern, block > 5 yr7.56NA4.270.65NA12.48090
    49590ARepair spigelian hernia8.54NA4.960.74NA14.24090
    49600ARepair umbilical lesion10.96NA6.301.13NA18.39090
    49605ARepair umbilical lesion76.00NA30.792.57NA109.36090
    49606ARepair umbilical lesion18.60NA9.612.22NA30.43090
    49610ARepair umbilical lesion10.50NA6.870.77NA18.14090
    49611ARepair umbilical lesion8.92NA6.560.65NA16.13090
    49650ALaparo hernia repair initial6.27NA3.330.64NA10.24090
    49651ALaparo hernia repair recur8.24NA4.400.84NA13.48090
    49659CLaparo proc, hernia repair0.000.000.000.000.000.00YYY
    49900ARepair of abdominal wall12.28NA6.801.23NA20.31090
    49905AOmental flap6.55NA2.440.61NA9.60ZZZ
    49906CFree omental flap, microvasc0.000.000.000.000.000.00090
    49999CAbdomen surgery procedure0.000.000.000.000.000.00YYY
    50010AExploration of kidney10.98NA7.070.79NA18.84090
    50020ARenal abscess, open drain14.66NA13.720.80NA29.18090
    50021ARenal abscess, percut drain3.38NA10.460.15NA13.99000
    50040ADrainage of kidney14.94NA11.560.82NA27.32090
    50045AExploration of kidney15.46NA8.551.06NA25.07090
    50060ARemoval of kidney stone19.30NA10.031.14NA30.47090
    50065AIncision of kidney20.79NA10.561.13NA32.48090
    50070AIncision of kidney20.32NA10.701.20NA32.22090
    50075ARemoval of kidney stone25.34NA12.651.51NA39.50090
    50080ARemoval of kidney stone14.71NA11.030.86NA26.60090
    50081ARemoval of kidney stone21.80NA13.271.30NA36.37090
    50100ARevise kidney blood vessels16.09NA9.341.64NA27.07090
    50120AExploration of kidney15.91NA8.931.04NA25.88090
    50125AExplore and drain kidney16.52NA9.481.07NA27.07090
    50130ARemoval of kidney stone17.29NA9.241.04NA27.57090
    50135AExploration of kidney19.18NA9.931.18NA30.29090
    50200ABiopsy of kidney2.63NA0.960.12NA3.71000
    50205ABiopsy of kidney11.31NA6.520.94NA18.77090
    50220ARemove kidney, open17.15NA9.291.16NA27.60090
    50225ARemoval kidney open, complex20.23NA10.301.26NA31.79090
    50230ARemoval kidney open, radical22.07NA10.921.35NA34.34090
    50234ARemoval of kidney & ureter22.40NA11.051.37NA34.82090
    50236ARemoval of kidney & ureter24.86NA14.271.50NA40.63090
    50240APartial removal of kidney22.00NA13.321.36NA36.68090
    50280ARemoval of kidney lesion15.67NA8.690.99NA25.35090
    50290ARemoval of kidney lesion14.73NA8.491.11NA24.33090
    50300XRemoval of donor kidney0.000.000.000.000.000.00XXX
    50320ARemoval of donor kidney22.21NA10.981.78NA34.97090
    50340ARemoval of kidney12.15NA9.311.15NA22.61090
    50360ATransplantation of kidney31.53NA17.872.97NA52.37090
    50365ATransplantation of kidney36.81NA21.293.51NA61.61090
    50370ARemove transplanted kidney13.72NA9.881.26NA24.86090
    50380AReimplantation of kidney20.76NA13.521.80NA36.08090
    50390ADrainage of kidney lesion1.96NA0.680.09NA2.73000
    50392AInsert kidney drain3.38NA1.180.15NA4.71000
    50393AInsert ureteral tube4.16NA1.440.18NA5.78000
    50394AInjection for kidney x-ray0.762.600.260.043.401.06000
    50395ACreate passage to kidney3.38NA1.170.16NA4.71000
    50396AMeasure kidney pressure2.09NA0.890.10NA3.08000
    50398AChange kidney tube1.461.060.510.072.592.04000
    50400ARevision of kidney/ureter19.50NA10.061.21NA30.77090
    50405ARevision of kidney/ureter23.93NA11.841.45NA37.22090
    50500ARepair of kidney wound19.57NA11.371.45NA32.39090
    50520AClose kidney-skin fistula17.23NA11.801.26NA30.29090
    50525ARepair renal-abdomen fistula22.27NA13.301.51NA37.08090
    50526ARepair renal-abdomen fistula24.02NA14.861.62NA40.50090
    50540ARevision of horseshoe kidney19.93NA10.421.28NA31.63090
    50541ALaparo ablate renal cyst16.00NA6.790.99NA23.78090
    50544ALaparoscopy, pyeloplasty22.40NA9.041.41NA32.85090Start Printed Page 55384
    50545ALaparo radical nephrectomy24.00NA9.651.53NA35.18090
    50546ALaparoscopic nephrectomy20.48NA8.401.37NA30.25090
    50547ALaparo removal donor kidney25.50NA11.272.04NA38.81090
    50548ALaparo remove k/ureter24.40NA9.701.49NA35.59090
    50549CLaparoscope proc, renal0.000.000.000.000.000.00YYY
    50551AKidney endoscopy5.604.931.900.3310.867.83000
    50553AKidney endoscopy5.9916.252.050.3522.598.39000
    50555AKidney endoscopy & biopsy6.5320.112.250.3827.029.16000
    50557AKidney endoscopy & treatment6.6220.232.250.3927.249.26000
    50559ARenal endoscopy/radiotracer6.78NA2.420.27NA9.47000
    50561AKidney endoscopy & treatment7.5918.312.580.4426.3410.61000
    50570AKidney endoscopy9.54NA3.240.56NA13.34000
    50572AKidney endoscopy10.35NA3.520.64NA14.51000
    50574AKidney endoscopy & biopsy11.02NA3.870.65NA15.54000
    50575AKidney endoscopy13.98NA4.730.84NA19.55000
    50576AKidney endoscopy & treatment10.99NA3.740.66NA15.39000
    50578ARenal endoscopy/radiotracer11.35NA4.010.67NA16.03000
    50580AKidney endoscopy & treatment11.86NA4.030.70NA16.59000
    50590AFragmenting of kidney stone9.0910.785.350.5420.4114.98090
    50600AExploration of ureter15.84NA9.070.99NA25.90090
    50605AInsert ureteral support15.46NA8.881.13NA25.47090
    50610ARemoval of ureter stone15.92NA9.091.08NA26.09090
    50620ARemoval of ureter stone15.16NA8.550.91NA24.62090
    50630ARemoval of ureter stone14.94NA8.480.90NA24.32090
    50650ARemoval of ureter17.41NA9.711.07NA28.19090
    50660ARemoval of ureter19.55NA10.431.19NA31.17090
    50684AInjection for ureter x-ray0.7615.020.260.0415.821.06000
    50686AMeasure ureter pressure1.515.080.650.096.682.25000
    50688AChange of ureter tube1.17NA1.760.06NA2.99010
    50690AInjection for ureter x-ray1.1615.400.400.0616.621.62000
    50700ARevision of ureter15.21NA9.090.86NA25.16090
    50715ARelease of ureter18.90NA12.371.68NA32.95090
    50722ARelease of ureter16.35NA10.421.41NA28.18090
    50725ARelease/revise ureter18.49NA10.611.44NA30.54090
    50727ARevise ureter8.18NA6.540.51NA15.23090
    50728ARevise ureter12.02NA8.180.88NA21.08090
    50740AFusion of ureter & kidney18.42NA9.661.49NA29.57090
    50750AFusion of ureter & kidney19.51NA10.481.24NA31.23090
    50760AFusion of ureters18.42NA10.111.25NA29.78090
    50770ASplicing of ureters19.51NA10.431.25NA31.19090
    50780AReimplant ureter in bladder18.36NA10.011.20NA29.57090
    50782AReimplant ureter in bladder19.54NA11.911.13NA32.58090
    50783AReimplant ureter in bladder20.55NA11.221.35NA33.12090
    50785AReimplant ureter in bladder20.52NA10.831.30NA32.65090
    50800AImplant ureter in bowel14.52NA10.020.92NA25.46090
    50810AFusion of ureter & bowel20.05NA12.231.78NA34.06090
    50815AUrine shunt to intestine19.93NA11.711.31NA32.95090
    50820AConstruct bowel bladder21.89NA12.381.38NA35.65090
    50825AConstruct bowel bladder28.18NA15.301.81NA45.29090
    50830ARevise urine flow31.28NA15.962.20NA49.44090
    50840AReplace ureter by bowel20.00NA11.831.26NA33.09090
    50845AAppendico-vesicostomy20.89NA10.201.26NA32.35090
    50860ATransplant ureter to skin15.36NA8.931.01NA25.30090
    50900ARepair of ureter13.62NA8.080.98NA22.68090
    50920AClosure ureter/skin fistula14.33NA8.370.84NA23.54090
    50930AClosure ureter/bowel fistula18.72NA10.801.57NA31.09090
    50940ARelease of ureter14.51NA8.441.04NA23.99090
    50945ALaparoscopy ureterolithotomy17.00NA7.421.15NA25.57090
    50947ALaparo new ureter/bladder24.50NA11.741.99NA38.23090
    50948ALaparo new ureter/bladder22.50NA10.611.83NA34.94090
    50949CLaparoscope proc, ureter0.000.000.000.000.000.00YYY
    50951AEndoscopy of ureter5.845.281.980.3511.478.17000
    50953AEndoscopy of ureter6.2416.552.120.3723.168.73000
    50955AUreter endoscopy & biopsy6.7521.112.380.3828.249.51000
    50957AUreter endoscopy & treatment6.7919.642.280.4026.839.47000
    50959AUreter endoscopy & tracer4.40NA1.580.18NA6.16000
    50961AUreter endoscopy & treatment6.0523.382.040.3529.788.44000
    50970AUreter endoscopy7.14NA2.430.43NA10.00000
    50972AUreter endoscopy & catheter6.89NA2.520.39NA9.80000
    50974AUreter endoscopy & biopsy9.17NA3.160.53NA12.86000
    50976AUreter endoscopy & treatment9.04NA3.090.53NA12.66000
    50978AUreter endoscopy & tracer5.10NA1.880.30NA7.28000
    50980AUreter endoscopy & treatment6.85NA2.340.41NA9.60000Start Printed Page 55385
    51000ADrainage of bladder0.782.030.250.052.861.08000
    51005ADrainage of bladder1.023.370.350.084.471.45000
    51010ADrainage of bladder3.534.422.370.238.186.13010
    51020AIncise & treat bladder6.71NA5.720.42NA12.85090
    51030AIncise & treat bladder6.77NA6.010.42NA13.20090
    51040AIncise & drain bladder4.40NA4.470.27NA9.14090
    51045AIncise bladder/drain ureter6.77NA6.010.47NA13.25090
    51050ARemoval of bladder stone6.92NA5.270.42NA12.61090
    51060ARemoval of ureter stone8.85NA6.530.54NA15.92090
    51065ARemove ureter calculus8.85NA6.060.53NA15.44090
    51080ADrainage of bladder abscess5.96NA5.670.35NA11.98090
    51500ARemoval of bladder cyst10.14NA6.130.88NA17.15090
    51520ARemoval of bladder lesion9.29NA6.660.58NA16.53090
    51525ARemoval of bladder lesion13.97NA8.150.85NA22.97090
    51530ARemoval of bladder lesion12.38NA7.810.82NA21.01090
    51535ARepair of ureter lesion12.57NA8.230.90NA21.70090
    51550APartial removal of bladder15.66NA8.681.05NA25.39090
    51555APartial removal of bladder21.23NA11.001.37NA33.60090
    51565ARevise bladder & ureter(s)21.62NA11.621.40NA34.64090
    51570ARemoval of bladder24.24NA12.601.59NA38.43090
    51575ARemoval of bladder & nodes30.45NA15.351.88NA47.68090
    51580ARemove bladder/revise tract31.08NA16.011.94NA49.03090
    51585ARemoval of bladder & nodes35.23NA17.342.18NA54.75090
    51590ARemove bladder/revise tract32.66NA16.012.01NA50.68090
    51595ARemove bladder/revise tract37.14NA17.552.23NA56.92090
    51596ARemove bladder/create pouch39.52NA18.942.39NA60.85090
    51597ARemoval of pelvic structures38.35NA18.062.49NA58.90090
    51600AInjection for bladder x-ray0.885.510.300.046.431.22000
    51605APreparation for bladder x-ray0.6416.730.220.0417.410.90000
    51610AInjection for bladder x-ray1.0516.200.360.0517.301.46000
    51700AIrrigation of bladder0.881.320.300.052.251.23000
    51705AChange of bladder tube1.022.150.650.063.231.73010
    51710AChange of bladder tube1.495.111.470.096.693.05010
    51715AEndoscopic injection/implant3.744.441.290.248.425.27000
    51720ATreatment of bladder lesion1.961.680.740.123.762.82000
    51725ASimple cystometrogram1.515.92NA0.137.56NA000
    5172526ASimple cystometrogram1.510.520.520.102.132.13000
    51725TCASimple cystometrogram0.005.40NA0.035.43NA000
    51726AComplex cystometrogram1.714.65NA0.156.51NA000
    5172626AComplex cystometrogram1.710.590.590.112.412.41000
    51726TCAComplex cystometrogram0.004.06NA0.044.10NA000
    51736AUrine flow measurement0.611.07NA0.051.73NA000
    5173626AUrine flow measurement0.610.210.210.040.860.86000
    51736TCAUrine flow measurement0.000.86NA0.010.87NA000
    51741AElectro-uroflowmetry, first1.141.93NA0.093.16NA000
    5174126AElectro-uroflowmetry, first1.140.400.400.071.611.61000
    51741TCAElectro-uroflowmetry, first0.001.53NA0.021.55NA000
    51772AUrethra pressure profile1.614.73NA0.166.50NA000
    5177226AUrethra pressure profile1.610.590.590.122.322.32000
    51772TCAUrethra pressure profile0.004.14NA0.044.18NA000
    51784AAnal/urinary muscle study1.533.36NA0.135.02NA000
    5178426AAnal/urinary muscle study1.530.530.530.102.162.16000
    51784TCAAnal/urinary muscle study0.002.83NA0.032.86NA000
    51785AAnal/urinary muscle study1.533.46NA0.125.11NA000
    5178526AAnal/urinary muscle study1.530.530.530.092.152.15000
    51785TCAAnal/urinary muscle study0.002.93NA0.032.96NA000
    51792AUrinary reflex study1.103.33NA0.204.63NA000
    5179226AUrinary reflex study1.100.430.430.091.621.62000
    51792TCAUrinary reflex study0.002.90NA0.113.01NA000
    51795AUrine voiding pressure study1.534.84NA0.186.55NA000
    5179526AUrine voiding pressure study1.530.530.530.102.162.16000
    51795TCAUrine voiding pressure study0.004.31NA0.084.39NA000
    51797AIntraabdominal pressure test1.604.87NA0.146.61NA000
    5179726AIntraabdominal pressure test1.600.560.560.102.262.26000
    51797TCAIntraabdominal pressure test0.004.31NA0.044.35NA000
    51800ARevision of bladder/urethra17.42NA9.591.17NA28.18090
    51820ARevision of urinary tract17.89NA10.911.45NA30.25090
    51840AAttach bladder/urethra10.71NA6.880.87NA18.46090
    51841AAttach bladder/urethra13.03NA8.571.04NA22.64090
    51845ARepair bladder neck9.73NA6.900.62NA17.25090
    51860ARepair of bladder wound12.02NA7.900.89NA20.81090
    51865ARepair of bladder wound15.04NA8.931.01NA24.98090
    51880ARepair of bladder opening7.66NA5.980.54NA14.18090Start Printed Page 55386
    51900ARepair bladder/vagina lesion12.97NA8.290.87NA22.13090
    51920AClose bladder-uterus fistula11.81NA7.650.86NA20.32090
    51925AHysterectomy/bladder repair15.58NA9.651.48NA26.71090
    51940ACorrection of bladder defect28.43NA16.411.97NA46.81090
    51960ARevision of bladder & bowel23.01NA13.391.41NA37.81090
    51980AConstruct bladder opening11.36NA7.300.74NA19.40090
    51990ALaparo urethral suspension12.50NA6.791.02NA20.31090
    51992ALaparo sling operation14.01NA6.810.93NA21.75090
    52000ACystoscopy2.013.450.690.125.582.82000
    52001ACystoscopy, removal of clots2.37NA0.980.32NA3.67000
    52005ACystoscopy & ureter catheter2.3713.400.910.1515.923.43000
    52007ACystoscopy and biopsy3.02NA1.020.18NA4.22000
    52010ACystoscopy & duct catheter3.025.911.020.189.114.22000
    52204ACystoscopy2.376.170.800.158.693.32000
    52214ACystoscopy and treatment3.716.531.260.2210.465.19000
    52224ACystoscopy and treatment3.146.411.070.189.734.39000
    52234ACystoscopy and treatment4.63NA1.680.27NA6.58000
    52235ACystoscopy and treatment5.45NA1.970.32NA7.74000
    52240ACystoscopy and treatment9.72NA3.430.58NA13.73000
    52250ACystoscopy and radiotracer4.50NA1.530.27NA6.30000
    52260ACystoscopy and treatment3.92NA1.340.23NA5.49000
    52265ACystoscopy and treatment2.943.771.000.186.894.12000
    52270ACystoscopy & revise urethra3.376.881.140.2010.454.71000
    52275ACystoscopy & revise urethra4.707.421.590.2812.406.57000
    52276ACystoscopy and treatment5.007.551.700.3012.857.00000
    52277ACystoscopy and treatment6.17NA2.120.38NA8.67000
    52281ACystoscopy and treatment2.8014.541.080.1717.514.05000
    52282ACystoscopy, implant stent6.4015.362.180.3822.148.96000
    52283ACystoscopy and treatment3.746.581.270.2210.545.23000
    52285ACystoscopy and treatment3.617.061.230.2210.895.06000
    52290ACystoscopy and treatment4.59NA1.560.27NA6.42000
    52300ACystoscopy and treatment5.31NA1.800.32NA7.43000
    52301ACystoscopy and treatment5.51NA1.820.39NA7.72000
    52305ACystoscopy and treatment5.31NA1.800.31NA7.42000
    52310ACystoscopy and treatment2.813.851.020.176.834.00000
    52315ACystoscopy and treatment5.2116.431.760.3121.957.28000
    52317ARemove bladder stone6.7226.092.280.4033.219.40000
    52318ARemove bladder stone9.19NA3.110.54NA12.84000
    52320ACystoscopy and treatment4.70NA1.590.28NA6.57000
    52325ACystoscopy, stone removal6.16NA2.080.37NA8.61000
    52327ACystoscopy, inject material5.19NA1.770.32NA7.28000
    52330ACystoscopy and treatment5.0420.791.710.3026.137.05000
    52332ACystoscopy and treatment2.8318.841.070.1721.844.07000
    52334ACreate passage to kidney4.83NA1.630.28NA6.74000
    52341ACysto w/ureter stricture tx6.00NA2.400.37NA8.77000
    52342ACysto w/up stricture tx6.50NA2.590.40NA9.49000
    52343ACysto w/renal stricture tx7.20NA2.870.44NA10.51000
    52344ACysto/uretero, stone remove7.70NA3.070.47NA11.24000
    52345ACysto/uretero w/up stricture8.20NA3.270.50NA11.97000
    52346ACystouretero w/renal strict9.23NA3.680.57NA13.48000
    52347ACystoscopy, resect ducts5.28NA2.140.33NA7.75000
    52351ACystouretro & or pyeloscope5.86NA1.990.36NA8.21000
    52352ACystouretro w/stone remove6.88NA2.330.42NA9.63000
    52353ACystouretero w/lithotripsy7.97NA2.690.49NA11.15000
    52354ACystouretero w/biopsy7.34NA2.490.45NA10.28000
    52355ACystouretero w/excise tumor8.82NA2.990.55NA12.36000
    52400ACystouretero w/congen repr9.68NA5.750.60NA16.03090
    52450AIncision of prostate7.64NA6.560.46NA14.66090
    52500ARevision of bladder neck8.47NA6.810.50NA15.78090
    52510ADilation prostatic urethra6.72NA5.800.40NA12.92090
    52601AProstatectomy (TURP)12.37NA8.160.74NA21.27090
    52606AControl postop bleeding8.13NA6.270.49NA14.89090
    52612AProstatectomy, first stage7.98NA6.720.48NA15.18090
    52614AProstatectomy, second stage6.84NA6.300.41NA13.55090
    52620ARemove residual prostate6.61NA6.220.39NA13.22090
    52630ARemove prostate regrowth7.26NA6.440.43NA14.13090
    52640ARelieve bladder contracture6.62NA5.730.39NA12.74090
    52647ALaser surgery of prostate10.3659.334.850.6170.3015.82090
    52648ALaser surgery of prostate11.21NA7.630.66NA19.50090
    52700ADrainage of prostate abscess6.80NA6.320.41NA13.53090
    53000AIncision of urethra2.287.472.630.139.885.04010
    53010AIncision of urethra3.64NA4.120.20NA7.96090
    53020AIncision of urethra1.774.430.670.116.312.55000Start Printed Page 55387
    53025AIncision of urethra1.134.810.450.076.011.65000
    53040ADrainage of urethra abscess6.4014.748.330.4121.5515.14090
    53060ADrainage of urethra abscess2.636.212.910.239.075.77010
    53080ADrainage of urinary leakage6.29NA8.370.42NA15.08090
    53085ADrainage of urinary leakage10.27NA10.290.67NA21.23090
    53200ABiopsy of urethra2.595.630.970.178.393.73000
    53210ARemoval of urethra12.57NA8.000.81NA21.38090
    53215ARemoval of urethra15.58NA8.810.93NA25.32090
    53220ATreatment of urethra lesion7.00NA5.710.44NA13.15090
    53230ARemoval of urethra lesion9.58NA6.360.60NA16.54090
    53235ARemoval of urethra lesion10.14NA6.490.60NA17.23090
    53240ASurgery for urethra pouch6.45NA5.320.42NA12.19090
    53250ARemoval of urethra gland5.89NA4.740.35NA10.98090
    53260ATreatment of urethra lesion2.986.112.440.239.325.65010
    53265ATreatment of urethra lesion3.126.602.420.209.925.74010
    53270ARemoval of urethra gland3.097.032.830.2110.336.13010
    53275ARepair of urethra defect4.53NA3.430.28NA8.24010
    53400ARevise urethra, stage 112.77NA8.310.85NA21.93090
    53405ARevise urethra, stage 214.48NA8.610.91NA24.00090
    53410AReconstruction of urethra16.44NA9.210.99NA26.64090
    53415AReconstruction of urethra19.41NA10.161.16NA30.73090
    53420AReconstruct urethra, stage 114.08NA8.820.90NA23.80090
    53425AReconstruct urethra, stage 215.98NA9.020.97NA25.97090
    53430AReconstruction of urethra16.34NA9.341.01NA26.69090
    53431AReconstruct urethra/bladder19.897.947.941.2529.0829.08090
    53440ACorrect bladder function12.34NA8.090.73NA21.16090
    53442ARemove perineal prosthesis8.27NA6.080.55NA14.90090
    53443DReconstruction of urethra0.00NA0.000.00NA0.00090
    53444AInsert tandem cuff13.40NA6.660.79NA20.85090
    53445AInsert uro/ves nck sphincter14.06NA8.720.84NA23.62090
    53446ARemove uro sphincter10.23NA8.460.61NA19.30090
    53447ARemove/replace ur sphincter13.49NA7.900.79NA22.18090
    53448ARemov/replc ur sphinctr comp21.15NA12.351.27NA34.77090
    53449ARepair uro sphincter9.70NA6.730.57NA17.00090
    53450ARevision of urethra6.14NA5.160.37NA11.67090
    53460ARevision of urethra7.12NA5.500.43NA13.05090
    53502ARepair of urethra injury7.63NA5.800.50NA13.93090
    53505ARepair of urethra injury7.63NA5.620.46NA13.71090
    53510ARepair of urethra injury10.11NA6.580.60NA17.29090
    53515ARepair of urethra injury13.31NA7.810.83NA21.95090
    53520ARepair of urethra defect8.68NA6.120.53NA15.33090
    53600ADilate urethra stricture1.211.190.460.072.471.74000
    53601ADilate urethra stricture0.981.310.400.062.351.44000
    53605ADilate urethra stricture1.28NA0.440.08NA1.80000
    53620ADilate urethra stricture1.621.910.630.103.632.35000
    53621ADilate urethra stricture1.352.000.520.083.431.95000
    53660ADilation of urethra0.711.220.330.041.971.08000
    53661ADilation of urethra0.721.210.310.041.971.07000
    53665ADilation of urethra0.76NA0.270.05NA1.08000
    53670AInsert urinary catheter0.501.740.180.032.270.71000
    53675AInsert urinary catheter1.472.630.580.094.192.14000
    53850AProstatic microwave thermotx9.4587.544.500.5697.5514.51090
    53852AProstatic rf thermotx9.8875.534.680.5885.9915.14090
    53853AProstatic water thermother4.1452.752.550.3857.277.07090
    53899CUrology surgery procedure0.000.000.000.000.000.00YYY
    54000ASlitting of prepuce1.545.661.510.107.303.15010
    54001ASlitting of prepuce2.196.562.150.148.894.48010
    54015ADrain penis lesion5.327.953.210.3313.608.86010
    54050ADestruction, penis lesion(s)1.242.850.470.074.161.78010
    54055ADestruction, penis lesion(s)1.226.641.420.077.932.71010
    54056ACryosurgery, penis lesion(s)1.242.960.580.064.261.88010
    54057ALaser surg, penis lesion(s)1.242.971.410.084.292.73010
    54060AExcision of penis lesion(s)1.935.651.660.127.703.71010
    54065ADestruction, penis lesion(s)2.425.382.240.137.934.79010
    54100ABiopsy of penis1.903.540.770.105.542.77000
    54105ABiopsy of penis3.506.752.190.2110.465.90010
    54110ATreatment of penis lesion10.13NA8.200.60NA18.93090
    54111ATreat penis lesion, graft13.57NA9.370.79NA23.73090
    54112ATreat penis lesion, graft15.86NA10.080.94NA26.88090
    54115ATreatment of penis lesion6.1511.636.770.3918.1713.31090
    54120APartial removal of penis9.97NA8.140.60NA18.71090
    54125ARemoval of penis13.53NA9.370.81NA23.71090
    54130ARemove penis & nodes20.14NA12.001.19NA33.33090Start Printed Page 55388
    54135ARemove penis & nodes26.36NA14.681.58NA42.62090
    54150ACircumcision1.816.041.870.178.023.85010
    54152ACircumcision2.31NA1.760.16NA4.23010
    54160ACircumcision2.485.041.820.167.684.46010
    54161ACircumcision3.27NA2.100.20NA5.57010
    54162ALysis penil circumcis lesion3.00NA2.910.18NA6.09010
    54163ARepair of circumcision3.00NA2.540.18NA5.72010
    54164AFrenulotomy of penis2.50NA2.370.15NA5.02010
    54200ATreatment of penis lesion1.062.870.380.063.991.50010
    54205ATreatment of penis lesion7.93NA7.500.47NA15.90090
    54220ATreatment of penis lesion2.422.081.040.154.653.61000
    54230APrepare penis study1.34NA0.460.08NA1.88000
    54231ADynamic cavernosometry2.042.260.830.144.443.01000
    54235APenile injection1.191.190.410.072.451.67000
    54240APenis study1.311.59NA0.133.03NA000
    5424026APenis study1.310.450.450.081.841.84000
    54240TCAPenis study0.001.14NA0.051.19NA000
    54250APenis study2.222.90NA0.165.28NA000
    5425026APenis study2.220.750.750.143.113.11000
    54250TCAPenis study0.002.15NA0.022.17NA000
    54300ARevision of penis10.41NA8.890.64NA19.94090
    54304ARevision of penis12.49NA10.040.74NA23.27090
    54308AReconstruction of urethra11.83NA9.940.70NA22.47090
    54312AReconstruction of urethra13.57NA10.730.81NA25.11090
    54316AReconstruction of urethra16.82NA11.671.00NA29.49090
    54318AReconstruction of urethra11.25NA10.061.15NA22.46090
    54322AReconstruction of urethra13.01NA9.560.77NA23.34090
    54324AReconstruction of urethra16.31NA12.021.03NA29.36090
    54326AReconstruction of urethra15.72NA11.170.93NA27.82090
    54328ARevise penis/urethra15.65NA11.590.92NA28.16090
    54332ARevise penis/urethra17.08NA11.871.01NA29.96090
    54336ARevise penis/urethra20.04NA13.591.90NA35.53090
    54340ASecondary urethral surgery8.91NA9.800.72NA19.43090
    54344ASecondary urethral surgery15.94NA10.911.10NA27.95090
    54348ASecondary urethral surgery17.15NA12.101.02NA30.27090
    54352AReconstruct urethra/penis24.74NA16.531.62NA42.89090
    54360APenis plastic surgery11.93NA8.820.72NA21.47090
    54380ARepair penis13.18NA10.791.16NA25.13090
    54385ARepair penis15.39NA12.200.71NA28.30090
    54390ARepair penis and bladder21.61NA14.691.28NA37.58090
    54400AInsert semi-rigid prosthesis8.99NA6.530.53NA16.05090
    54401AInsert self-contd prosthesis10.28NA7.370.61NA18.26090
    54402DRemove penis prosthesis0.00NA0.000.00NA0.00090
    54405AInsert multi-comp penis pros13.43NA8.450.80NA22.68090
    54406ARemove multi-comp penis pros12.10NA6.090.80NA18.99090
    54407DRemove multi-comp prosthesis0.00NA0.000.00NA0.00090
    54408ARepair multi-comp penis pros12.75NA6.460.80NA20.01090
    54409DRevise penis prosthesis0.00NA0.000.00NA0.00090
    54410ARemove/replace penis prosth15.50NA7.360.80NA23.66090
    54411ARemv/replc penis pros, comp16.00NA8.980.80NA25.78090
    54415ARemove self-contd penis pros8.20NA5.350.55NA14.10090
    54416ARemv/repl penis contain pros10.87NA6.940.55NA18.36090
    54417ARemv/replc penis pros, compl14.19NA7.890.55NA22.63090
    54420ARevision of penis11.42NA8.700.72NA20.84090
    54430ARevision of penis10.15NA8.170.60NA18.92090
    54435ARevision of penis6.12NA6.300.36NA12.78090
    54440CRepair of penis0.000.000.000.000.000.00090
    54450APreputial stretching1.121.100.490.072.291.68000
    54500ABiopsy of testis1.316.260.450.087.651.84000
    54505ABiopsy of testis3.46NA2.750.21NA6.42010
    54510DRemoval of testis lesion0.00NA0.000.00NA0.00090
    54512AExcise lesion testis8.58NA5.190.56NA14.33090
    54520ARemoval of testis5.23NA3.750.33NA9.31090
    54522AOrchiectomy, partial9.50NA6.150.62NA16.27090
    54530ARemoval of testis8.58NA5.460.53NA14.57090
    54535AExtensive testis surgery12.16NA7.620.83NA20.61090
    54550AExploration for testis7.78NA4.970.49NA13.24090
    54560AExploration for testis11.13NA7.100.79NA19.02090
    54600AReduce testis torsion7.01NA4.380.45NA11.84090
    54620ASuspension of testis4.90NA3.260.31NA8.47010
    54640ASuspension of testis6.90NA4.400.49NA11.79090
    54650AOrchiopexy (Fowler-Stephens)11.45NA7.290.81NA19.55090
    54660ARevision of testis5.11NA3.650.35NA9.11090Start Printed Page 55389
    54670ARepair testis injury6.41NA4.300.41NA11.12090
    54680ARelocation of testis(es)12.65NA7.650.94NA21.24090
    54690ALaparoscopy, orchiectomy10.96NA7.080.99NA19.03090
    54692ALaparoscopy, orchiopexy12.88NA5.840.87NA19.59090
    54699CLaparoscope proc, testis0.000.000.000.000.000.00YYY
    54700ADrainage of scrotum3.438.803.530.2312.467.19010
    54800ABiopsy of epididymis2.336.450.790.148.923.26000
    54820AExploration of epididymis5.14NA3.610.33NA9.08090
    54830ARemove epididymis lesion5.38NA3.850.34NA9.57090
    54840ARemove epididymis lesion5.20NA3.790.31NA9.30090
    54860ARemoval of epididymis6.32NA4.400.38NA11.10090
    54861ARemoval of epididymis8.90NA5.280.52NA14.70090
    54900AFusion of spermatic ducts13.20NA6.991.34NA21.53090
    54901AFusion of spermatic ducts17.94NA9.271.83NA29.04090
    55000ADrainage of hydrocele1.432.240.490.103.772.02000
    55040ARemoval of hydrocele5.36NA3.560.35NA9.27090
    55041ARemoval of hydroceles7.74NA4.630.50NA12.87090
    55060ARepair of hydrocele5.52NA3.640.37NA9.53090
    55100ADrainage of scrotum abscess2.1310.063.630.1512.345.91010
    55110AExplore scrotum5.70NA3.710.36NA9.77090
    55120ARemoval of scrotum lesion5.09NA3.520.33NA8.94090
    55150ARemoval of scrotum7.22NA4.760.47NA12.45090
    55175ARevision of scrotum5.24NA3.880.33NA9.45090
    55180ARevision of scrotum10.72NA6.380.72NA17.82090
    55200AIncision of sperm duct4.24NA3.100.25NA7.59090
    55250ARemoval of sperm duct(s)3.299.723.280.2113.226.78090
    55300APrepare, sperm duct x-ray3.51NA1.560.20NA5.27000
    55400ARepair of sperm duct8.49NA5.320.50NA14.31090
    55450ALigation of sperm duct4.128.082.620.2412.446.98010
    55500ARemoval of hydrocele5.59NA3.760.43NA9.78090
    55520ARemoval of sperm cord lesion6.03NA3.820.56NA10.41090
    55530ARevise spermatic cord veins5.66NA3.920.36NA9.94090
    55535ARevise spermatic cord veins6.56NA4.230.42NA11.21090
    55540ARevise hernia & sperm veins7.67NA4.370.74NA12.78090
    55550ALaparo ligate spermatic vein6.57NA3.670.47NA10.71090
    55559CLaparo proc, spermatic cord0.000.000.000.000.000.00YYY
    55600AIncise sperm duct pouch6.38NA4.410.38NA11.17090
    55605AIncise sperm duct pouch7.96NA5.390.54NA13.89090
    55650ARemove sperm duct pouch11.80NA6.440.72NA18.96090
    55680ARemove sperm pouch lesion5.19NA3.770.31NA9.27090
    55700ABiopsy of prostate1.574.680.730.106.352.40000
    55705ABiopsy of prostate4.57NA3.920.26NA8.75010
    55720ADrainage of prostate abscess7.64NA5.880.44NA13.96090
    55725ADrainage of prostate abscess8.68NA6.580.51NA15.77090
    55801ARemoval of prostate17.80NA9.781.08NA28.66090
    55810AExtensive prostate surgery22.58NA11.851.35NA35.78090
    55812AExtensive prostate surgery27.51NA13.911.69NA43.11090
    55815AExtensive prostate surgery30.46NA15.011.84NA47.31090
    55821ARemoval of prostate14.25NA8.200.85NA23.30090
    55831ARemoval of prostate15.62NA8.670.94NA25.23090
    55840AExtensive prostate surgery22.69NA12.321.37NA36.38090
    55842AExtensive prostate surgery24.38NA12.861.48NA38.72090
    55845AExtensive prostate surgery28.55NA14.261.71NA44.52090
    55859APercut/needle insert, pros12.52NA7.710.74NA20.97090
    55860ASurgical exposure, prostate14.45NA7.930.82NA23.20090
    55862AExtensive prostate surgery18.39NA9.691.14NA29.22090
    55865AExtensive prostate surgery22.87NA11.491.37NA35.73090
    55870AElectroejaculation2.581.960.980.144.683.70000
    55873ACryoablate prostate19.47NA10.651.02NA31.14090
    55899CGenital surgery procedure0.000.000.000.000.000.00YYY
    55970NSex transformation, M to F0.000.000.000.000.000.00XXX
    55980NSex transformation, F to M0.000.000.000.000.000.00XXX
    56405AI & D of vulva/perineum1.442.501.330.144.082.91010
    56420ADrainage of gland abscess1.392.481.330.134.002.85010
    56440ASurgery for vulva lesion2.843.832.400.286.955.52010
    56441ALysis of labial lesion(s)1.972.742.110.174.884.25010
    56501ADestroy, vulva lesions, simp1.532.421.420.154.103.10010
    56515ADestroy vulva lesion/s compl2.763.202.460.186.145.40010
    56605ABiopsy of vulva/perineum1.101.900.500.113.111.71000
    56606ABiopsy of vulva/perineum0.551.690.230.062.300.84ZZZ
    56620APartial removal of vulva7.47NA5.130.76NA13.36090
    56625AComplete removal of vulva8.40NA6.200.84NA15.44090
    56630AExtensive vulva surgery12.36NA7.931.23NA21.52090Start Printed Page 55390
    56631AExtensive vulva surgery16.20NA10.801.63NA28.63090
    56632AExtensive vulva surgery20.29NA12.422.03NA34.74090
    56633AExtensive vulva surgery16.47NA9.701.66NA27.83090
    56634AExtensive vulva surgery17.88NA11.251.78NA30.91090
    56637AExtensive vulva surgery21.97NA13.162.18NA37.31090
    56640AExtensive vulva surgery22.17NA12.582.26NA37.01090
    56700APartial removal of hymen2.523.182.160.245.944.92010
    56720AIncision of hymen0.681.790.570.072.541.32000
    56740ARemove vagina gland lesion4.574.083.080.379.028.02010
    56800ARepair of vagina3.89NA2.860.37NA7.12010
    56805ARepair clitoris18.86NA9.691.82NA30.37090
    56810ARepair of perineum4.13NA2.910.41NA7.45010
    57000AExploration of vagina2.97NA2.490.28NA5.74010
    57010ADrainage of pelvic abscess6.03NA4.080.57NA10.68090
    57020ADrainage of pelvic fluid1.501.630.660.153.282.31000
    57022AI & d vaginal hematoma, pp2.56NA2.140.24NA4.94010
    57023AI & d vag hematoma, non-ob4.75NA3.010.24NA8.00010
    57061ADestroy vag lesions, simple1.252.371.330.133.752.71010
    57065ADestroy vag lesions, complex2.613.092.410.265.965.28010
    57100ABiopsy of vagina1.201.640.530.102.941.83000
    57105ABiopsy of vagina1.692.352.340.174.214.20010
    57106ARemove vagina wall, partial6.362.672.670.589.619.61090
    57107ARemove vagina tissue, part23.00NA10.652.17NA35.82090
    57109AVaginectomy partial w/nodes27.00NA13.891.97NA42.86090
    57110ARemove vagina wall, complete14.29NA7.561.43NA23.28090
    57111ARemove vagina tissue, compl27.00NA12.852.71NA42.56090
    57112AVaginectomy w/nodes, compl29.00NA14.382.19NA45.57090
    57120AClosure of vagina7.41NA4.850.75NA13.01090
    57130ARemove vagina lesion2.43NA2.250.23NA4.91010
    57135ARemove vagina lesion2.673.092.350.266.025.28010
    57150ATreat vagina infection0.551.040.220.061.650.83000
    57155AInsert uteri tandems/ovoids6.27NA3.670.63NA10.57090
    57160AInsert pessary/other device0.891.120.410.092.101.39000
    57170AFitting of diaphragm/cap0.911.460.360.092.461.36000
    57180ATreat vaginal bleeding1.582.371.550.164.113.29010
    57200ARepair of vagina3.94NA3.140.38NA7.46090
    57210ARepair vagina/perineum5.17NA3.690.50NA9.36090
    57220ARevision of urethra4.31NA3.520.42NA8.25090
    57230ARepair of urethral lesion5.64NA4.490.50NA10.63090
    57240ARepair bladder & vagina6.07NA4.620.53NA11.22090
    57250ARepair rectum & vagina5.53NA4.010.54NA10.08090
    57260ARepair of vagina8.27NA5.170.83NA14.27090
    57265AExtensive repair of vagina11.34NA7.221.14NA19.70090
    57268ARepair of bowel bulge6.76NA4.540.66NA11.96090
    57270ARepair of bowel pouch12.11NA6.581.17NA19.86090
    57280ASuspension of vagina15.04NA7.741.44NA24.22090
    57282ARepair of vaginal prolapse8.86NA5.440.86NA15.16090
    57284ARepair paravaginal defect12.70NA7.451.17NA21.32090
    57287ARevise/remove sling repair10.71NA7.470.74NA18.92090
    57288ARepair bladder defect13.02NA7.240.86NA21.12090
    57289ARepair bladder & vagina11.58NA7.120.95NA19.65090
    57291AConstruction of vagina7.95NA5.930.78NA14.66090
    57292AConstruct vagina with graft13.09NA7.201.29NA21.58090
    57300ARepair rectum-vagina fistula7.61NA4.820.70NA13.13090
    57305ARepair rectum-vagina fistula13.77NA7.001.33NA22.10090
    57307AFistula repair & colostomy15.93NA7.721.59NA25.24090
    57308AFistula repair, transperine9.94NA5.960.91NA16.81090
    57310ARepair urethrovaginal lesion6.78NA4.950.45NA12.18090
    57311ARepair urethrovaginal lesion7.98NA5.450.51NA13.94090
    57320ARepair bladder-vagina lesion8.01NA5.680.60NA14.29090
    57330ARepair bladder-vagina lesion12.35NA6.960.86NA20.17090
    57335ARepair vagina18.73NA9.841.66NA30.23090
    57400ADilation of vagina2.27NA1.180.22NA3.67000
    57410APelvic examination1.752.751.120.144.643.01000
    57415ARemove vaginal foreign body2.173.712.180.196.074.54010
    57452AExamination of vagina0.991.690.460.102.781.55000
    57454AVagina examination & biopsy1.271.880.620.133.282.02000
    57460ACervix excision2.832.171.190.285.284.30000
    57500ABiopsy of cervix0.972.290.500.103.361.57000
    57505AEndocervical curettage1.142.051.360.123.312.62010
    57510ACauterization of cervix1.903.391.660.185.473.74010
    57511ACryocautery of cervix1.902.540.770.184.622.85010
    57513ALaser surgery of cervix1.902.721.660.194.813.75010Start Printed Page 55391
    57520AConization of cervix4.044.432.930.418.887.38090
    57522AConization of cervix3.364.022.680.347.726.38090
    57530ARemoval of cervix4.79NA3.780.48NA9.05090
    57531ARemoval of cervix, radical28.00NA14.442.46NA44.90090
    57540ARemoval of residual cervix12.22NA6.491.21NA19.92090
    57545ARemove cervix/repair pelvis13.03NA6.951.30NA21.28090
    57550ARemoval of residual cervix5.53NA3.980.55NA10.06090
    57555ARemove cervix/repair vagina8.95NA5.900.89NA15.74090
    57556ARemove cervix, repair bowel8.37NA5.140.80NA14.31090
    57700ARevision of cervix3.55NA2.710.33NA6.59090
    57720ARevision of cervix4.13NA3.410.41NA7.95090
    57800ADilation of cervical canal0.771.220.360.082.071.21000
    57820AD & C of residual cervix1.672.702.400.174.544.24010
    58100ABiopsy of uterus lining1.531.560.760.073.162.36000
    58120ADilation and curettage3.274.012.550.337.616.15010
    58140ARemoval of uterus lesion14.60NA7.381.46NA23.44090
    58145ARemoval of uterus lesion8.04NA5.110.80NA13.95090
    58150ATotal hysterectomy15.24NA7.901.53NA24.67090
    58152ATotal hysterectomy20.60NA10.171.52NA32.29090
    58180APartial hysterectomy15.29NA7.901.54NA24.73090
    58200AExtensive hysterectomy21.59NA11.622.15NA35.36090
    58210AExtensive hysterectomy28.85NA14.672.91NA46.43090
    58240ARemoval of pelvis contents38.39NA19.713.76NA61.86090
    58260AVaginal hysterectomy12.98NA6.901.23NA21.11090
    58262AVaginal hysterectomy14.77NA7.661.42NA23.85090
    58263AVaginal hysterectomy16.06NA8.221.55NA25.83090
    58267AHysterectomy & vagina repair17.04NA8.811.51NA27.36090
    58270AHysterectomy & vagina repair14.26NA7.431.37NA23.06090
    58275AHysterectomy/revise vagina15.76NA7.941.51NA25.21090
    58280AHysterectomy/revise vagina17.01NA8.461.54NA27.01090
    58285AExtensive hysterectomy22.26NA11.151.88NA35.29090
    58300NInsert intrauterine device+1.011.420.400.102.531.51XXX
    58301ARemove intrauterine device1.271.620.510.133.021.91000
    58321AArtificial insemination0.921.030.370.102.051.39000
    58322AArtificial insemination1.101.050.420.112.261.63000
    58323ASperm washing0.230.530.100.020.780.35000
    58340ACatheter for hysterography0.8812.420.330.0813.381.29000
    58345AReopen fallopian tube4.66NA1.730.36NA6.75010
    58346AInsert heyman uteri capsule6.75NA3.840.68NA11.27090
    58350AReopen fallopian tube1.012.151.170.103.262.28010
    58353AEndometr ablate, thermal3.56NA2.280.37NA6.21010
    58400ASuspension of uterus6.36NA4.170.62NA11.15090
    58410ASuspension of uterus12.73NA6.841.09NA20.66090
    58520ARepair of ruptured uterus11.92NA6.241.17NA19.33090
    58540ARevision of uterus14.64NA6.961.28NA22.88090
    58550ALaparo-asst vag hysterectomy14.19NA7.111.44NA22.74010
    58551ALaparoscopy, remove myoma14.21NA7.091.45NA22.75010
    58555AHysteroscopy, dx, sep proc3.332.951.490.346.625.16000
    58558AHysteroscopy, biopsy4.753.552.130.498.797.37000
    58559AHysteroscopy, lysis6.172.592.590.629.389.38000
    58560AHysteroscopy, resect septum7.003.013.010.7110.7210.72000
    58561AHysteroscopy, remove myoma10.003.783.781.0214.8014.80000
    58562AHysteroscopy, remove fb5.21NA2.340.52NA8.07000
    58563AHysteroscopy, ablation6.172.622.620.629.419.41000
    58578CLaparo proc, uterus0.000.000.000.000.000.00YYY
    58579CHysteroscope procedure0.000.000.000.000.000.00YYY
    58600ADivision of fallopian tube5.60NA3.510.39NA9.50090
    58605ADivision of fallopian tube5.00NA3.320.33NA8.65090
    58611ALigate oviduct(s) add-on1.45NA0.610.07NA2.13ZZZ
    58615AOcclude fallopian tube(s)3.90NA3.350.40NA7.65010
    58660ALaparoscopy, lysis11.29NA5.781.14NA18.21090
    58661ALaparoscopy, remove adnexa11.05NA5.471.12NA17.64010
    58662ALaparoscopy, excise lesions11.79NA5.751.18NA18.72090
    58670ALaparoscopy, tubal cautery5.60NA3.730.55NA9.88090
    58671ALaparoscopy, tubal block5.60NA3.740.56NA9.90090
    58672ALaparoscopy, fimbrioplasty12.88NA6.811.22NA20.91090
    58673ALaparoscopy, salpingostomy13.74NA7.161.40NA22.30090
    58679CLaparo proc, oviduct-ovary0.000.000.000.000.000.00YYY
    58700ARemoval of fallopian tube12.05NA6.050.64NA18.74090
    58720ARemoval of ovary/tube(s)11.36NA6.051.14NA18.55090
    58740ARevise fallopian tube(s)14.00NA7.340.59NA21.93090
    58750ARepair oviduct14.84NA7.601.52NA23.96090
    58752ARevise ovarian tube(s)14.84NA7.921.51NA24.27090Start Printed Page 55392
    58760ARemove tubal obstruction13.13NA7.001.34NA21.47090
    58770ACreate new tubal opening13.97NA7.241.42NA22.63090
    58800ADrainage of ovarian cyst(s)4.144.434.360.368.938.86090
    58805ADrainage of ovarian cyst(s)5.88NA3.660.56NA10.10090
    58820ADrain ovary abscess, open4.22NA3.380.29NA7.89090
    58822ADrain ovary abscess, percut10.13NA5.200.92NA16.25090
    58823ADrain pelvic abscess, percut3.38NA2.380.18NA5.94000
    58825ATransposition, ovary(s)10.98NA5.950.62NA17.55090
    58900ABiopsy of ovary(s)5.99NA3.640.56NA10.19090
    58920APartial removal of ovary(s)11.36NA5.850.68NA17.89090
    58925ARemoval of ovarian cyst(s)11.36NA5.791.14NA18.29090
    58940ARemoval of ovary(s)7.29NA4.180.73NA12.20090
    58943ARemoval of ovary(s)18.43NA9.921.86NA30.21090
    58950AResect ovarian malignancy16.93NA9.411.55NA27.89090
    58951AResect ovarian malignancy22.38NA11.812.20NA36.39090
    58952AResect ovarian malignancy25.01NA12.992.50NA40.50090
    58953ATah, rad dissect for debulk32.00NA15.593.20NA50.79090
    58954ATah rad debulk/lymph remove35.00NA16.713.50NA55.21090
    58960AExploration of abdomen14.65NA8.521.47NA24.64090
    58970ARetrieval of oocyte3.538.561.920.3612.455.81000
    58974CTransfer of embryo0.000.000.000.000.000.00000
    58976ATransfer of embryo3.832.301.530.396.525.75000
    58999CGenital surgery procedure0.000.000.000.000.000.00YYY
    59000AAmniocentesis, diagnostic1.302.050.720.233.582.25000
    59001AAmniocentesis, therapeutic3.00NA1.370.23NA4.60000
    59012AFetal cord puncture, prenatal3.45NA1.710.62NA5.78000
    59015AChorion biopsy2.201.641.110.404.243.71000
    59020AFetal contract stress test0.660.78NA0.201.64NA000
    5902026AFetal contract stress test0.660.280.280.121.061.06000
    59020TCAFetal contract stress test0.000.50NA0.080.58NA000
    59025AFetal non-stress test0.530.44NA0.121.09NA000
    5902526AFetal non-stress test0.530.220.220.100.850.85000
    59025TCAFetal non-stress test0.000.22NA0.020.24NA000
    59030AFetal scalp blood sample1.99NA1.140.36NA3.49000
    59050AFetal monitor w/report0.89NA0.380.16NA1.43XXX
    59051AFetal monitor/interpret only0.74NA0.310.14NA1.19XXX
    59100ARemove uterus lesion12.35NA6.612.21NA21.17090
    59120ATreat ectopic pregnancy11.49NA6.352.06NA19.90090
    59121ATreat ectopic pregnancy11.67NA6.392.09NA20.15090
    59130ATreat ectopic pregnancy14.22NA7.162.54NA23.92090
    59135ATreat ectopic pregnancy13.88NA7.272.49NA23.64090
    59136ATreat ectopic pregnancy13.18NA6.362.36NA21.90090
    59140ATreat ectopic pregnancy5.46NA3.700.98NA10.14090
    59150ATreat ectopic pregnancy11.67NA6.691.23NA19.59090
    59151ATreat ectopic pregnancy11.49NA6.121.41NA19.02090
    59160AD & C after delivery2.713.732.290.496.935.49010
    59200AInsert cervical dilator0.791.410.320.152.351.26000
    59300AEpisiotomy or vaginal repair2.412.011.010.434.853.85000
    59320ARevision of cervix2.48NA1.310.45NA4.24000
    59325ARevision of cervix4.07NA1.970.73NA6.77000
    59350ARepair of uterus4.95NA2.190.88NA8.02000
    59400AObstetrical care23.06NA15.414.14NA42.61MMM
    59409AObstetrical care13.50NA5.572.42NA21.49MMM
    59410AObstetrical care14.78NA6.982.65NA24.41MMM
    59412AAntepartum manipulation1.711.380.720.313.402.74MMM
    59414ADeliver placenta1.61NA1.340.29NA3.24MMM
    59425AAntepartum care only4.815.365.320.8611.0310.99MMM
    59426AAntepartum care only8.289.149.141.4918.9118.91MMM
    59430ACare after delivery2.131.291.290.383.803.80MMM
    59510ACesarean delivery26.22NA17.614.70NA48.53MMM
    59514ACesarean delivery only15.97NA6.572.86NA25.40MMM
    59515ACesarean delivery17.37NA8.523.12NA29.01MMM
    59525ARemove uterus after cesarean8.54NA3.521.53NA13.59ZZZ
    59610AVbac delivery24.62NA16.294.41NA45.32MMM
    59612AVbac delivery only15.06NA6.432.70NA24.19MMM
    59614AVbac care after delivery16.34NA7.702.93NA26.97MMM
    59618AAttempted vbac delivery27.78NA18.384.98NA51.14MMM
    59620AAttempted vbac delivery only17.53NA6.873.15NA27.55MMM
    59622AAttempted vbac after care18.93NA8.913.39NA31.23MMM
    59812ATreatment of miscarriage4.013.752.510.588.347.10090
    59820ACare of miscarriage4.013.792.850.728.527.58090
    59821ATreatment of miscarriage4.473.793.010.809.068.28090
    59830ATreat uterus infection6.11NA3.851.10NA11.06090Start Printed Page 55393
    59840RAbortion3.014.012.470.547.566.02010
    59841RAbortion5.245.783.720.9411.969.90010
    59850RAbortion5.91NA2.751.06NA9.72090
    59851RAbortion5.93NA3.221.06NA10.21090
    59852RAbortion8.24NA4.581.48NA14.30090
    59855RAbortion6.12NA3.381.10NA10.60090
    59856RAbortion7.48NA3.741.34NA12.56090
    59857RAbortion9.29NA4.461.66NA15.41090
    59866RAbortion (mpr)4.00NA1.600.72NA6.32000
    59870AEvacuate mole of uterus6.01NA3.830.77NA10.61090
    59871ARemove cerclage suture2.132.190.930.384.703.44000
    59898CLaparo proc, ob care/deliver0.000.000.000.000.000.00YYY
    59899CMaternity care procedure0.000.000.000.000.000.00YYY
    60000ADrain thyroid/tongue cyst1.762.402.220.144.304.12010
    60001AAspirate/inject thyriod cyst0.971.770.350.062.801.38000
    60100ABiopsy of thyroid1.562.700.560.054.312.17000
    60200ARemove thyroid lesion9.55NA6.880.84NA17.27090
    60210APartial thyroid excision10.88NA6.631.01NA18.52090
    60212AParital thyroid excision16.03NA8.621.51NA26.16090
    60220APartial removal of thyroid11.90NA7.270.97NA20.14090
    60225APartial removal of thyroid14.19NA8.051.31NA23.55090
    60240ARemoval of thyroid16.06NA9.321.50NA26.88090
    60252ARemoval of thyroid20.57NA11.641.63NA33.84090
    60254AExtensive thyroid surgery26.99NA16.391.96NA45.34090
    60260ARepeat thyroid surgery17.47NA10.661.39NA29.52090
    60270ARemoval of thyroid20.27NA11.541.78NA33.59090
    60271ARemoval of thyroid16.83NA10.201.35NA28.38090
    60280ARemove thyroid duct lesion5.87NA5.290.45NA11.61090
    60281ARemove thyroid duct lesion8.53NA6.270.67NA15.47090
    60500AExplore parathyroid glands16.23NA7.991.61NA25.83090
    60502ARe-explore parathyroids20.35NA9.972.00NA32.32090
    60505AExplore parathyroid glands21.49NA11.532.14NA35.16090
    60512AAutotransplant parathyroid4.45NA1.720.44NA6.61ZZZ
    60520ARemoval of thymus gland16.81NA9.551.84NA28.20090
    60521ARemoval of thymus gland18.87NA11.572.34NA32.78090
    60522ARemoval of thymus gland23.09NA12.882.83NA38.80090
    60540AExplore adrenal gland17.03NA8.091.42NA26.54090
    60545AExplore adrenal gland19.88NA9.731.75NA31.36090
    60600ARemove carotid body lesion17.93NA13.431.87NA33.23090
    60605ARemove carotid body lesion20.24NA18.122.28NA40.64090
    60650ALaparoscopy adrenalectomy20.00NA8.341.98NA30.32090
    60659CLaparo proc, endocrine0.000.000.000.000.000.00YYY
    60699CEndocrine surgery procedure0.000.000.000.000.000.00YYY
    61000ARemove cranial cavity fluid1.581.791.530.133.503.24000
    61001ARemove cranial cavity fluid1.492.081.470.153.723.11000
    61020ARemove brain cavity fluid1.512.521.510.264.293.28000
    61026AInjection into brain canal1.692.281.730.214.183.63000
    61050ARemove brain canal fluid1.51NA1.560.13NA3.20000
    61055AInjection into brain canal2.10NA1.800.13NA4.03000
    61070ABrain canal shunt procedure0.897.331.220.098.312.20000
    61105ATwist drill hole5.14NA3.671.05NA9.86090
    61107ADrill skull for implantation5.00NA3.121.02NA9.14000
    61108ADrill skull for drainage10.19NA7.092.04NA19.32090
    61120ABurr hole for puncture8.76NA5.881.81NA16.45090
    61140APierce skull for biopsy15.90NA10.003.15NA29.05090
    61150APierce skull for drainage17.57NA10.743.52NA31.83090
    61151APierce skull for drainage12.42NA8.162.45NA23.03090
    61154APierce skull & remove clot14.99NA9.433.05NA27.47090
    61156APierce skull for drainage16.32NA10.303.42NA30.04090
    61210APierce skull, implant device5.84NA3.531.16NA10.53000
    61215AInsert brain-fluid device4.89NA4.240.99NA10.12090
    61250APierce skull & explore10.42NA6.732.02NA19.17090
    61253APierce skull & explore12.36NA7.652.26NA22.27090
    61304AOpen skull for exploration21.96NA12.854.33NA39.14090
    61305AOpen skull for exploration26.61NA15.315.25NA47.17090
    61312AOpen skull for drainage24.57NA14.574.99NA44.13090
    61313AOpen skull for drainage24.93NA14.765.07NA44.76090
    61314AOpen skull for drainage24.23NA11.554.00NA39.78090
    61315AOpen skull for drainage27.68NA16.225.62NA49.52090
    61320AOpen skull for drainage25.62NA15.205.20NA46.02090
    61321AOpen skull for drainage28.50NA16.095.35NA49.94090
    61330ADecompress eye socket23.32NA19.432.58NA45.33090
    61332AExplore/biopsy eye socket27.28NA20.434.15NA51.86090Start Printed Page 55394
    61333AExplore orbit/remove lesion27.95NA16.452.24NA46.64090
    61334AExplore orbit/remove object18.27NA10.083.02NA31.37090
    61340ARelieve cranial pressure18.66NA11.753.66NA34.07090
    61343AIncise skull (press relief)29.77NA17.966.04NA53.77090
    61345ARelieve cranial pressure27.20NA16.175.23NA48.60090
    61440AIncise skull for surgery26.63NA12.145.57NA44.34090
    61450AIncise skull for surgery25.95NA14.465.11NA45.52090
    61458AIncise skull for brain wound27.29NA15.895.28NA48.46090
    61460AIncise skull for surgery28.39NA16.775.13NA50.29090
    61470AIncise skull for surgery26.06NA13.744.65NA44.45090
    61480AIncise skull for surgery26.49NA12.345.54NA44.37090
    61490AIncise skull for surgery25.66NA15.185.37NA46.21090
    61500ARemoval of skull lesion17.92NA11.033.26NA32.21090
    61501ARemove infected skull bone14.84NA9.622.63NA27.09090
    61510ARemoval of brain lesion28.45NA16.605.77NA50.82090
    61512ARemove brain lining lesion35.09NA20.187.14NA62.41090
    61514ARemoval of brain abscess25.26NA14.915.12NA45.29090
    61516ARemoval of brain lesion24.61NA15.014.94NA44.56090
    61518ARemoval of brain lesion37.32NA22.347.53NA67.19090
    61519ARemove brain lining lesion41.39NA24.428.15NA73.96090
    61520ARemoval of brain lesion54.84NA31.9310.10NA96.87090
    61521ARemoval of brain lesion44.48NA26.228.85NA79.55090
    61522ARemoval of brain abscess29.45NA17.205.30NA51.95090
    61524ARemoval of brain lesion27.86NA16.835.01NA49.70090
    61526ARemoval of brain lesion52.17NA31.556.72NA90.44090
    61530ARemoval of brain lesion43.86NA27.436.17NA77.46090
    61531AImplant brain electrodes14.63NA9.562.84NA27.03090
    61533AImplant brain electrodes19.71NA12.213.80NA35.72090
    61534ARemoval of brain lesion20.97NA13.304.15NA38.42090
    61535ARemove brain electrodes11.63NA8.162.29NA22.08090
    61536ARemoval of brain lesion35.52NA21.186.68NA63.38090
    61538ARemoval of brain tissue26.81NA16.305.38NA48.49090
    61539ARemoval of brain tissue32.08NA18.916.62NA57.61090
    61541AIncision of brain tissue28.85NA16.895.50NA51.24090
    61542ARemoval of brain tissue31.02NA18.006.49NA55.51090
    61543ARemoval of brain tissue29.22NA17.426.11NA52.75090
    61544ARemove & treat brain lesion25.50NA15.214.91NA45.62090
    61545AExcision of brain tumor43.80NA25.098.88NA77.77090
    61546ARemoval of pituitary gland31.30NA18.746.06NA56.10090
    61548ARemoval of pituitary gland21.53NA13.743.63NA38.90090
    61550ARelease of skull seams14.65NA4.891.14NA20.68090
    61552ARelease of skull seams19.56NA9.870.88NA30.31090
    61556AIncise skull/sutures22.26NA11.743.57NA37.57090
    61557AIncise skull/sutures22.38NA13.414.68NA40.47090
    61558AExcision of skull/sutures25.58NA12.672.61NA40.86090
    61559AExcision of skull/sutures32.79NA18.896.86NA58.54090
    61563AExcision of skull tumor26.83NA16.254.46NA47.54090
    61564AExcision of skull tumor33.83NA18.737.08NA59.64090
    61570ARemove foreign body, brain24.60NA13.804.60NA43.00090
    61571AIncise skull for brain wound26.39NA15.435.23NA47.05090
    61575ASkull base/brainstem surgery34.36NA21.385.02NA60.76090
    61576ASkull base/brainstem surgery52.43NA28.894.68NA86.00090
    61580ACraniofacial approach, skull30.35NA19.962.75NA53.06090
    61581ACraniofacial approach, skull34.60NA22.573.37NA60.54090
    61582ACraniofacial approach, skull31.66NA19.566.30NA57.52090
    61583ACraniofacial approach, skull36.21NA22.716.94NA65.86090
    61584AOrbitocranial approach/skull34.65NA20.996.53NA62.17090
    61585AOrbitocranial approach/skull38.61NA22.216.19NA67.01090
    61586AResect nasopharynx, skull25.10NA16.393.52NA45.01090
    61590AInfratemporal approach/skull41.78NA26.124.28NA72.18090
    61591AInfratemporal approach/skull43.68NA26.895.26NA75.83090
    61592AOrbitocranial approach/skull39.64NA23.597.55NA70.78090
    61595ATranstemporal approach/skull29.57NA19.743.05NA52.36090
    61596ATranscochlear approach/skull35.63NA21.884.25NA61.76090
    61597ATranscondylar approach/skull37.96NA22.416.65NA67.02090
    61598ATranspetrosal approach/skull33.41NA20.924.60NA58.93090
    61600AResect/excise cranial lesion25.85NA15.013.12NA43.98090
    61601AResect/excise cranial lesion27.89NA17.345.29NA50.52090
    61605AResect/excise cranial lesion29.33NA18.972.51NA50.81090
    61606AResect/excise cranial lesion38.83NA23.176.81NA68.81090
    61607AResect/excise cranial lesion36.27NA22.175.69NA64.13090
    61608AResect/excise cranial lesion42.10NA24.898.31NA75.30090
    61609ATransect artery, sinus9.89NA5.112.07NA17.07ZZZStart Printed Page 55395
    61610ATransect artery, sinus29.67NA14.383.52NA47.57ZZZ
    61611ATransect artery, sinus7.42NA2.961.55NA11.93ZZZ
    61612ATransect artery, sinus27.88NA14.303.55NA45.73ZZZ
    61613ARemove aneurysm, sinus40.86NA23.348.32NA72.52090
    61615AResect/excise lesion, skull32.07NA20.814.64NA57.52090
    61616AResect/excise lesion, skull43.33NA26.977.02NA77.32090
    61618ARepair dura16.99NA11.432.92NA31.34090
    61619ARepair dura20.71NA13.673.42NA37.80090
    61624AOcclusion/embolization cath20.15NA7.461.15NA28.76000
    61626AOcclusion/embolization cath16.62NA5.880.84NA23.34000
    61680AIntracranial vessel surgery30.71NA18.386.04NA55.13090
    61682AIntracranial vessel surgery61.57NA34.6512.69NA108.91090
    61684AIntracranial vessel surgery39.81NA22.607.87NA70.28090
    61686AIntracranial vessel surgery64.49NA36.7013.20NA114.39090
    61690AIntracranial vessel surgery29.31NA17.645.51NA52.46090
    61692AIntracranial vessel surgery51.87NA29.5110.17NA91.55090
    61697ABrain aneurysm repr, complx50.52NA28.4210.31NA89.25090
    61698ABrain aneurysm repr, complx48.41NA27.319.99NA85.71090
    61700ABrain aneurysm repr , simple50.52NA28.4210.18NA89.12090
    61702AInner skull vessel surgery48.41NA27.319.75NA85.47090
    61703AClamp neck artery17.47NA11.133.62NA32.22090
    61705ARevise circulation to head36.20NA19.896.67NA62.76090
    61708ARevise circulation to head35.30NA16.522.18NA54.00090
    61710ARevise circulation to head29.67NA14.682.42NA46.77090
    61711AFusion of skull arteries36.33NA20.687.39NA64.40090
    61720AIncise skull/brain surgery16.77NA10.903.51NA31.18090
    61735AIncise skull/brain surgery20.43NA12.774.16NA37.36090
    61750AIncise skull/brain biopsy18.20NA11.083.71NA32.99090
    61751ABrain biopsy w/ ct/mr guide17.62NA10.923.57NA32.11090
    61760AImplant brain electrodes22.27NA12.854.59NA39.71090
    61770AIncise skull for treatment21.44NA13.264.09NA38.79090
    61790ATreat trigeminal nerve10.86NA6.921.82NA19.60090
    61791ATreat trigeminal tract14.61NA9.393.03NA27.03090
    61793AFocus radiation beam17.24NA11.073.51NA31.82090
    61795ABrain surgery using computer4.04NA2.140.81NA6.99ZZZ
    61850AImplant neuroelectrodes12.39NA8.132.23NA22.75090
    61860AImplant neuroelectrodes20.87NA12.594.04NA37.50090
    61862AImplant neurostimul, subcort19.34NA12.163.97NA35.47090
    61870AImplant neuroelectrodes14.94NA9.971.70NA26.61090
    61875AImplant neuroelectrodes15.06NA7.392.42NA24.87090
    61880ARevise/remove neuroelectrode6.29NA5.261.31NA12.86090
    61885AImplant neurostim one array5.85NA4.361.22NA11.43090
    61886AImplant neurostim arrays8.00NA6.131.64NA15.77090
    61888ARevise/remove neuroreceiver5.07NA3.901.04NA10.01010
    62000ATreat skull fracture12.53NA6.190.87NA19.59090
    62005ATreat skull fracture16.17NA9.352.33NA27.85090
    62010ATreatment of head injury19.81NA11.834.05NA35.69090
    62100ARepair brain fluid leakage22.03NA13.974.07NA40.07090
    62115AReduction of skull defect21.66NA11.034.53NA37.22090
    62116AReduction of skull defect23.59NA14.044.85NA42.48090
    62117AReduction of skull defect26.60NA12.685.56NA44.84090
    62120ARepair skull cavity lesion23.35NA15.143.07NA41.56090
    62121AIncise skull repair21.58NA13.522.47NA37.57090
    62140ARepair of skull defect13.51NA8.722.60NA24.83090
    62141ARepair of skull defect14.91NA9.892.85NA27.65090
    62142ARemove skull plate/flap10.79NA7.312.10NA20.20090
    62143AReplace skull plate/flap13.05NA8.812.55NA24.41090
    62145ARepair of skull & brain18.82NA11.773.81NA34.40090
    62146ARepair of skull with graft16.12NA10.632.94NA29.69090
    62147ARepair of skull with graft19.34NA12.383.64NA35.36090
    62180AEstablish brain cavity shunt21.06NA13.084.32NA38.46090
    62190AEstablish brain cavity shunt11.07NA7.772.18NA21.02090
    62192AEstablish brain cavity shunt12.25NA8.252.46NA22.96090
    62194AReplace/irrigate catheter5.03NA2.250.50NA7.78010
    62200AEstablish brain cavity shunt18.32NA11.723.70NA33.74090
    62201AEstablish brain cavity shunt14.86NA9.762.52NA27.14090
    62220AEstablish brain cavity shunt13.00NA8.602.53NA24.13090
    62223AEstablish brain cavity shunt12.87NA8.542.58NA23.99090
    62225AReplace/irrigate catheter5.41NA4.111.09NA10.61090
    62230AReplace/revise brain shunt10.54NA6.422.10NA19.06090
    62252ACsf shunt reprogram0.741.35NA0.182.27NAXXX
    6225226ACsf shunt reprogram0.740.300.300.161.201.20XXX
    62252TCACsf shunt reprogram0.001.05NA0.021.07NAXXXStart Printed Page 55396
    62256ARemove brain cavity shunt6.60NA5.401.34NA13.34090
    62258AReplace brain cavity shunt14.54NA8.822.91NA26.27090
    62263ALysis epidural adhesions6.145.152.070.4211.718.63010
    62268ADrain spinal cord cyst4.74NA2.740.29NA7.77000
    62269ANeedle biopsy, spinal cord5.02NA2.400.29NA7.71000
    62270ASpinal fluid tap, diagnostic1.134.080.480.065.271.67000
    62272ADrain cerebro spinal fluid1.353.380.620.134.862.10000
    62273ATreat epidural spine lesion2.151.571.270.143.863.56000
    62280ATreat spinal cord lesion2.633.790.700.176.593.50010
    62281ATreat spinal cord lesion2.664.500.620.167.323.44010
    62282ATreat spinal canal lesion2.335.570.620.148.043.09010
    62284AInjection for myelogram1.545.530.550.107.172.19000
    62287APercutaneous diskectomy8.08NA5.050.66NA13.79090
    62290AInject for spine disk x-ray3.005.681.300.208.884.50000
    62291AInject for spine disk x-ray2.916.241.200.179.324.28000
    62292AInjection into disk lesion7.86NA5.340.65NA13.85090
    62294AInjection into spinal artery11.83NA7.370.85NA20.05090
    62310AInject spine c/t1.913.710.430.115.732.45000
    62311AInject spine l/s (cd)1.544.220.370.095.852.00000
    62318AInject spine w/cath, c/t2.043.830.440.125.992.60000
    62319AInject spine w/cath l/s (cd)1.873.670.400.115.652.38000
    62350AImplant spinal canal cath6.87NA3.790.64NA11.30090
    62351AImplant spinal canal cath10.00NA6.901.79NA18.69090
    62355ARemove spinal canal catheter5.45NA3.020.47NA8.94090
    62360AInsert spine infusion device2.62NA2.460.21NA5.29090
    62361AImplant spine infusion pump5.42NA3.670.50NA9.59090
    62362AImplant spine infusion pump7.04NA4.060.86NA11.96090
    62365ARemove spine infusion device5.42NA3.990.58NA9.99090
    62367CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236726AAnalyze spine infusion pump0.480.140.140.030.650.65XXX
    62367TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    62368CAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    6236826AAnalyze spine infusion pump0.750.200.200.051.001.00XXX
    62368TCCAnalyze spine infusion pump0.000.000.000.000.000.00XXX
    63001ARemoval of spinal lamina15.82NA11.683.03NA30.53090
    63003ARemoval of spinal lamina15.95NA11.952.98NA30.88090
    63005ARemoval of spinal lamina14.92NA11.492.62NA29.03090
    63011ARemoval of spinal lamina14.52NA11.291.43NA27.24090
    63012ARemoval of spinal lamina15.40NA10.342.71NA28.45090
    63015ARemoval of spinal lamina19.35NA13.683.84NA36.87090
    63016ARemoval of spinal lamina19.20NA13.663.62NA36.48090
    63017ARemoval of spinal lamina15.94NA12.002.91NA30.85090
    63020ANeck spine disk surgery14.81NA11.332.89NA29.03090
    63030ALow back disk surgery12.00NA9.922.21NA24.13090
    63035ASpinal disk surgery add-on3.15NA1.670.57NA5.39ZZZ
    63040ALaminotomy, single cervical18.81NA13.393.36NA35.56090
    63042ALaminotomy, single lumbar17.47NA12.953.11NA33.53090
    63043CLaminotomy, addl cervical0.000.000.000.000.000.00ZZZ
    63044CLaminotomy, addl lumbar0.000.000.000.000.000.00ZZZ
    63045ARemoval of spinal lamina16.50NA12.223.19NA31.91090
    63046ARemoval of spinal lamina15.80NA12.022.89NA30.71090
    63047ARemoval of spinal lamina14.61NA11.422.61NA28.64090
    63048ARemove spinal lamina add-on3.26NA1.750.58NA5.59ZZZ
    63055ADecompress spinal cord21.99NA15.114.09NA41.19090
    63056ADecompress spinal cord20.36NA14.443.34NA38.14090
    63057ADecompress spine cord add-on5.26NA2.820.81NA8.89ZZZ
    63064ADecompress spinal cord24.61NA17.124.72NA46.45090
    63066ADecompress spine cord add-on3.26NA1.760.63NA5.65ZZZ
    63075ANeck spine disk surgery19.41NA13.833.73NA36.97090
    63076ANeck spine disk surgery4.05NA2.160.78NA6.99ZZZ
    63077ASpine disk surgery, thorax21.44NA15.473.44NA40.35090
    63078ASpine disk surgery, thorax3.28NA1.720.50NA5.50ZZZ
    63081ARemoval of vertebral body23.73NA16.684.46NA44.87090
    63082ARemove vertebral body add-on4.37NA2.340.82NA7.53ZZZ
    63085ARemoval of vertebral body26.92NA17.894.70NA49.51090
    63086ARemove vertebral body add-on3.19NA1.660.55NA5.40ZZZ
    63087ARemoval of vertebral body35.57NA22.455.87NA63.89090
    63088ARemove vertebral body add-on4.33NA2.300.77NA7.40ZZZ
    63090ARemoval of vertebral body28.16NA18.124.27NA50.55090
    63091ARemove vertebral body add-on3.03NA1.480.45NA4.96ZZZ
    63170AIncise spinal cord tract(s)19.83NA13.543.89NA37.26090
    63172ADrainage of spinal cyst17.66NA13.373.46NA34.49090
    63173ADrainage of spinal cyst21.99NA15.544.14NA41.67090Start Printed Page 55397
    63180ARevise spinal cord ligaments18.27NA13.043.83NA35.14090
    63182ARevise spinal cord ligaments20.50NA13.613.48NA37.59090
    63185AIncise spinal column/nerves15.04NA9.702.08NA26.82090
    63190AIncise spinal column/nerves17.45NA11.682.88NA32.01090
    63191AIncise spinal column/nerves17.54NA10.653.50NA31.69090
    63194AIncise spinal column & cord19.19NA13.484.01NA36.68090
    63195AIncise spinal column & cord18.84NA13.023.44NA35.30090
    63196AIncise spinal column & cord22.30NA14.034.66NA40.99090
    63197AIncise spinal column & cord21.11NA13.494.42NA39.02090
    63198AIncise spinal column & cord25.38NA12.705.31NA43.39090
    63199AIncise spinal column & cord26.89NA14.385.62NA46.89090
    63200ARelease of spinal cord19.18NA13.423.61NA36.21090
    63250ARevise spinal cord vessels40.76NA23.157.65NA71.56090
    63251ARevise spinal cord vessels41.20NA23.517.98NA72.69090
    63252ARevise spinal cord vessels41.19NA23.367.75NA72.30090
    63265AExcise intraspinal lesion21.56NA13.214.29NA39.06090
    63266AExcise intraspinal lesion22.30NA13.704.47NA40.47090
    63267AExcise intraspinal lesion17.95NA11.483.50NA32.93090
    63268AExcise intraspinal lesion18.52NA10.973.18NA32.67090
    63270AExcise intraspinal lesion26.80NA16.105.41NA48.31090
    63271AExcise intraspinal lesion26.92NA16.175.56NA48.65090
    63272AExcise intraspinal lesion25.32NA15.315.07NA45.70090
    63273AExcise intraspinal lesion24.29NA14.845.08NA44.21090
    63275ABiopsy/excise spinal tumor23.68NA14.474.68NA42.83090
    63276ABiopsy/excise spinal tumor23.45NA14.274.63NA42.35090
    63277ABiopsy/excise spinal tumor20.83NA12.994.03NA37.85090
    63278ABiopsy/excise spinal tumor20.56NA13.084.02NA37.66090
    63280ABiopsy/excise spinal tumor28.35NA16.765.80NA50.91090
    63281ABiopsy/excise spinal tumor28.05NA16.735.67NA50.45090
    63282ABiopsy/excise spinal tumor26.39NA15.795.33NA47.51090
    63283ABiopsy/excise spinal tumor25.00NA15.075.12NA45.19090
    63285ABiopsy/excise spinal tumor36.00NA20.827.31NA64.13090
    63286ABiopsy/excise spinal tumor35.63NA20.517.07NA63.21090
    63287ABiopsy/excise spinal tumor36.70NA21.037.48NA65.21090
    63290ABiopsy/excise spinal tumor37.38NA21.587.65NA66.61090
    63300ARemoval of vertebral body24.43NA14.634.78NA43.84090
    63301ARemoval of vertebral body27.60NA15.655.03NA48.28090
    63302ARemoval of vertebral body27.81NA16.455.25NA49.51090
    63303ARemoval of vertebral body30.50NA17.715.21NA53.42090
    63304ARemoval of vertebral body30.33NA17.804.72NA52.85090
    63305ARemoval of vertebral body32.03NA19.245.39NA56.66090
    63306ARemoval of vertebral body32.22NA18.192.39NA52.80090
    63307ARemoval of vertebral body31.63NA17.294.23NA53.15090
    63308ARemove vertebral body add-on5.25NA2.741.01NA9.00ZZZ
    63600ARemove spinal cord lesion14.02NA6.381.22NA21.62090
    63610AStimulation of spinal cord8.73NA3.900.43NA13.06000
    63615ARemove lesion of spinal cord16.28NA9.502.85NA28.63090
    63650AImplant neuroelectrodes6.74NA2.970.48NA10.19090
    63655AImplant neuroelectrodes10.29NA7.261.85NA19.40090
    63660ARevise/remove neuroelectrode6.16NA3.670.65NA10.48090
    63685AImplant neuroreceiver7.04NA4.150.96NA12.15090
    63688ARevise/remove neuroreceiver5.39NA3.690.70NA9.78090
    63700ARepair of spinal herniation16.53NA10.472.69NA29.69090
    63702ARepair of spinal herniation18.48NA9.901.36NA29.74090
    63704ARepair of spinal herniation21.18NA12.373.84NA37.39090
    63706ARepair of spinal herniation24.11NA13.604.73NA42.44090
    63707ARepair spinal fluid leakage11.26NA8.061.96NA21.28090
    63709ARepair spinal fluid leakage14.32NA9.792.49NA26.60090
    63710AGraft repair of spine defect14.07NA9.542.61NA26.22090
    63740AInstall spinal shunt11.36NA7.792.15NA21.30090
    63741AInstall spinal shunt8.25NA4.721.05NA14.02090
    63744ARevision of spinal shunt8.10NA5.721.51NA15.33090
    63746ARemoval of spinal shunt6.43NA4.961.15NA12.54090
    64400AInjection for nerve block1.112.700.290.063.871.46000
    64402AInjection for nerve block1.254.380.450.075.701.77000
    64405AInjection for nerve block1.321.340.370.082.741.77000
    64408AInjection for nerve block1.412.950.620.094.452.12000
    64410AInjection for nerve block1.433.270.350.084.781.86000
    64412AInjection for nerve block1.182.490.370.083.751.63000
    64413AInjection for nerve block1.402.810.340.094.301.83000
    64415AInjection for nerve block1.482.650.320.084.211.88000
    64417AInjection for nerve block1.443.210.380.094.741.91000
    64418AInjection for nerve block1.322.490.290.073.881.68000Start Printed Page 55398
    64420AInjection for nerve block1.182.370.270.073.621.52000
    64421AInjection for nerve block1.682.910.380.104.692.16000
    64425AInjection for nerve block1.752.330.410.114.192.27000
    64430AInjection for nerve block1.462.890.470.114.462.04000
    64435AInjection for nerve block1.452.960.600.154.562.20000
    64445AInjection for nerve block1.481.600.420.083.161.98000
    64450AInjection for nerve block1.271.790.330.083.141.68000
    64470AInj paravertebral c/t1.854.020.480.125.992.45000
    64472AInj paravertebral c/t add-on1.293.900.330.095.281.71ZZZ
    64475AInj paravertebral l/s1.413.820.390.095.321.89000
    64476AInj paravertebral l/s add-on0.983.860.260.064.901.30ZZZ
    64479AInj foramen epidural c/t2.204.400.640.146.742.98000
    64480AInj foramen epidural add-on1.544.070.500.095.702.13ZZZ
    64483AInj foramen epidural l/s1.904.440.560.126.462.58000
    64484AInj foramen epidural add-on1.334.050.400.085.461.81ZZZ
    64505AInjection for nerve block1.362.410.350.083.851.79000
    64508AInjection for nerve block1.122.320.480.063.501.66000
    64510AInjection for nerve block1.222.530.260.073.821.55000
    64520AInjection for nerve block1.353.490.310.084.921.74000
    64530AInjection for nerve block1.583.070.370.094.742.04000
    64550AApply neurostimulator0.180.560.070.010.750.26000
    64553AImplant neuroelectrodes2.314.251.330.176.733.81010
    64555AImplant neuroelectrodes2.272.380.770.114.763.15010
    64560AImplant neuroelectrodes2.362.300.940.174.833.47010
    64561AImplant neuroelectrodes6.7415.283.830.1122.1310.68010
    64565AImplant neuroelectrodes1.763.410.690.085.252.53010
    64573AImplant neuroelectrodes7.50NA5.401.48NA14.38090
    64575AImplant neuroelectrodes4.35NA3.030.37NA7.75090
    64577AImplant neuroelectrodes4.62NA3.440.50NA8.56090
    64580AImplant neuroelectrodes4.12NA3.940.21NA8.27090
    64581AImplant neuroelectrodes13.50NA6.720.37NA20.59090
    64585ARevise/remove neuroelectrode2.062.822.200.295.174.55010
    64590AImplant neuroreceiver2.40NA2.170.40NA4.97010
    64595ARevise/remove neuroreceiver1.73NA2.080.22NA4.03010
    64600AInjection treatment of nerve3.452.982.060.286.715.79010
    64605AInjection treatment of nerve5.613.622.900.539.769.04010
    64610AInjection treatment of nerve7.16NA4.181.12NA12.46010
    64612ADestroy nerve, face muscle1.963.001.650.095.053.70010
    64613ADestroy nerve, spine muscle1.961.821.480.103.883.54010
    64614ADestroy nerve, extrem musc2.203.230.820.095.523.11010
    64620AInjection treatment of nerve2.842.980.670.175.993.68010
    64622ADestr paravertebrl nerve l/s3.004.770.740.177.943.91010
    64623ADestr paravertebral n add-on0.993.850.240.064.901.29ZZZ
    64626ADestr paravertebrl nerve c/t3.284.340.800.227.844.30010
    64627ADestr paravertebral n add-on1.163.740.290.084.981.53ZZZ
    64630AInjection treatment of nerve3.003.660.880.166.824.04010
    64640AInjection treatment of nerve2.763.671.720.116.544.59010
    64680AInjection treatment of nerve2.622.890.760.155.663.53010
    64702ARevise finger/toe nerve4.23NA4.050.51NA8.79090
    64704ARevise hand/foot nerve4.57NA3.230.59NA8.39090
    64708ARevise arm/leg nerve6.12NA5.190.82NA12.13090
    64712ARevision of sciatic nerve7.75NA5.610.54NA13.90090
    64713ARevision of arm nerve(s)11.00NA6.661.01NA18.67090
    64714ARevise low back nerve(s)10.33NA4.250.64NA15.22090
    64716ARevision of cranial nerve6.31NA5.180.59NA12.08090
    64718ARevise ulnar nerve at elbow5.99NA5.290.87NA12.15090
    64719ARevise ulnar nerve at wrist4.85NA4.780.63NA10.26090
    64721ACarpal tunnel surgery4.296.596.140.5911.4711.02090
    64722ARelieve pressure on nerve(s)4.70NA3.490.32NA8.51090
    64726ARelease foot/toe nerve4.18NA3.140.57NA7.89090
    64727AInternal nerve revision3.10NA1.680.40NA5.18ZZZ
    64732AIncision of brow nerve4.41NA3.690.77NA8.87090
    64734AIncision of cheek nerve4.92NA3.800.83NA9.55090
    64736AIncision of chin nerve4.60NA2.980.71NA8.29090
    64738AIncision of jaw nerve5.73NA3.920.84NA10.49090
    64740AIncision of tongue nerve5.59NA4.110.43NA10.13090
    64742AIncision of facial nerve6.22NA4.960.69NA11.87090
    64744AIncise nerve, back of head5.24NA3.940.98NA10.16090
    64746AIncise diaphragm nerve5.93NA4.580.75NA11.26090
    64752AIncision of vagus nerve7.06NA4.960.83NA12.85090
    64755AIncision of stomach nerves13.52NA6.401.16NA21.08090
    64760AIncision of vagus nerve6.96NA4.050.51NA11.52090
    64761AIncision of pelvis nerve6.41NA3.480.26NA10.15090Start Printed Page 55399
    64763AIncise hip/thigh nerve6.93NA6.210.77NA13.91090
    64766AIncise hip/thigh nerve8.67NA4.730.99NA14.39090
    64771ASever cranial nerve7.35NA5.441.32NA14.11090
    64772AIncision of spinal nerve7.21NA4.881.20NA13.29090
    64774ARemove skin nerve lesion5.17NA3.920.60NA9.69090
    64776ARemove digit nerve lesion5.12NA3.890.63NA9.64090
    64778ADigit nerve surgery add-on3.11NA1.640.38NA5.13ZZZ
    64782ARemove limb nerve lesion6.23NA3.930.79NA10.95090
    64783ALimb nerve surgery add-on3.72NA1.950.48NA6.15ZZZ
    64784ARemove nerve lesion9.82NA6.991.17NA17.98090
    64786ARemove sciatic nerve lesion15.46NA10.412.22NA28.09090
    64787AImplant nerve end4.30NA2.280.56NA7.14ZZZ
    64788ARemove skin nerve lesion4.61NA3.500.54NA8.65090
    64790ARemoval of nerve lesion11.31NA7.531.68NA20.52090
    64792ARemoval of nerve lesion14.92NA9.131.88NA25.93090
    64795ABiopsy of nerve3.01NA1.810.40NA5.22000
    64802ARemove sympathetic nerves9.15NA5.170.87NA15.19090
    64804ARemove sympathetic nerves14.64NA6.831.79NA23.26090
    64809ARemove sympathetic nerves13.67NA6.040.96NA20.67090
    64818ARemove sympathetic nerves10.30NA5.761.08NA17.14090
    64820ARemove sympathetic nerves10.37NA6.481.17NA18.02090
    64821ARemove sympathetic nerves8.75NA7.090.99NA16.83090
    64822ARemove sympathetic nerves8.75NA7.090.99NA16.83090
    64823ARemove sympathetic nerves10.37NA7.891.17NA19.43090
    64831ARepair of digit nerve9.44NA7.441.14NA18.02090
    64832ARepair nerve add-on5.66NA3.110.68NA9.45ZZZ
    64834ARepair of hand or foot nerve10.19NA7.401.23NA18.82090
    64835ARepair of hand or foot nerve10.94NA8.061.36NA20.36090
    64836ARepair of hand or foot nerve10.94NA7.941.32NA20.20090
    64837ARepair nerve add-on6.26NA3.470.80NA10.53ZZZ
    64840ARepair of leg nerve13.02NA7.790.86NA21.67090
    64856ARepair/transpose nerve13.80NA9.661.71NA25.17090
    64857ARepair arm/leg nerve14.49NA10.211.76NA26.46090
    64858ARepair sciatic nerve16.49NA11.042.78NA30.31090
    64859ANerve surgery4.26NA2.240.50NA7.00ZZZ
    64861ARepair of arm nerves19.24NA13.022.45NA34.71090
    64862ARepair of low back nerves19.44NA12.292.47NA34.20090
    64864ARepair of facial nerve12.55NA8.631.13NA22.31090
    64865ARepair of facial nerve15.24NA10.461.37NA27.07090
    64866AFusion of facial/other nerve15.74NA9.841.06NA26.64090
    64868AFusion of facial/other nerve14.04NA9.571.40NA25.01090
    64870AFusion of facial/other nerve15.99NA9.651.08NA26.72090
    64872ASubsequent repair of nerve1.99NA1.080.24NA3.31ZZZ
    64874ARepair & revise nerve add-on2.98NA1.640.34NA4.96ZZZ
    64876ARepair nerve/shorten bone3.38NA1.350.39NA5.12ZZZ
    64885ANerve graft, head or neck17.53NA11.661.51NA30.70090
    64886ANerve graft, head or neck20.75NA13.601.73NA36.08090
    64890ANerve graft, hand or foot15.15NA10.271.74NA27.16090
    64891ANerve graft, hand or foot16.14NA5.751.38NA23.27090
    64892ANerve graft, arm or leg14.65NA8.961.65NA25.26090
    64893ANerve graft, arm or leg15.60NA10.751.77NA28.12090
    64895ANerve graft, hand or foot19.25NA8.622.04NA29.91090
    64896ANerve graft, hand or foot20.49NA11.751.85NA34.09090
    64897ANerve graft, arm or leg18.24NA10.922.64NA31.80090
    64898ANerve graft, arm or leg19.50NA10.752.71NA32.96090
    64901ANerve graft add-on10.22NA5.750.99NA16.96ZZZ
    64902ANerve graft add-on11.83NA6.321.10NA19.25ZZZ
    64905ANerve pedicle transfer14.02NA8.931.52NA24.47090
    64907ANerve pedicle transfer18.83NA12.071.79NA32.69090
    64999CNervous system surgery0.000.000.000.000.000.00YYY
    65091ARevise eye6.46NA11.590.26NA18.31090
    65093ARevise eye with implant6.87NA11.830.28NA18.98090
    65101ARemoval of eye7.03NA12.040.28NA19.35090
    65103ARemove eye/insert implant7.57NA12.170.30NA20.04090
    65105ARemove eye/attach implant8.49NA12.670.34NA21.50090
    65110ARemoval of eye13.95NA15.900.68NA30.53090
    65112ARemove eye/revise socket16.38NA17.260.96NA34.60090
    65114ARemove eye/revise socket17.53NA18.540.94NA37.01090
    65125ARevise ocular implant3.126.231.480.159.504.75090
    65130AInsert ocular implant7.15NA11.460.28NA18.89090
    65135AInsert ocular implant7.33NA12.370.29NA19.99090
    65140AAttach ocular implant8.02NA12.360.31NA20.69090
    65150ARevise ocular implant6.26NA10.940.25NA17.45090Start Printed Page 55400
    65155AReinsert ocular implant8.66NA12.590.40NA21.65090
    65175ARemoval of ocular implant6.28NA11.350.26NA17.89090
    65205ARemove foreign body from eye0.710.630.200.031.370.94000
    65210ARemove foreign body from eye0.840.780.320.031.651.19000
    65220ARemove foreign body from eye0.718.230.190.058.990.95000
    65222ARemove foreign body from eye0.930.800.290.041.771.26000
    65235ARemove foreign body from eye7.57NA7.040.30NA14.91090
    65260ARemove foreign body from eye10.96NA12.660.43NA24.05090
    65265ARemove foreign body from eye12.59NA14.380.50NA27.47090
    65270ARepair of eye wound1.904.072.440.086.054.42010
    65272ARepair of eye wound3.825.764.750.169.748.73090
    65273ARepair of eye wound4.36NA5.150.17NA9.68090
    65275ARepair of eye wound5.345.505.320.2711.1110.93090
    65280ARepair of eye wound7.66NA7.880.30NA15.84090
    65285ARepair of eye wound12.90NA13.860.51NA27.27090
    65286ARepair of eye wound5.519.127.850.2114.8413.57090
    65290ARepair of eye socket wound5.41NA6.600.26NA12.27090
    65400ARemoval of eye lesion6.068.617.130.2414.9113.43090
    65410ABiopsy of cornea1.471.760.710.063.292.24000
    65420ARemoval of eye lesion4.178.367.220.1712.7011.56090
    65426ARemoval of eye lesion5.258.016.750.2013.4612.20090
    65430ACorneal smear1.478.680.710.0610.212.24000
    65435ACurette/treat cornea0.921.370.410.042.331.37000
    65436ACurette/treat cornea4.196.025.030.1710.389.39090
    65450ATreatment of corneal lesion3.277.976.800.1311.3710.20090
    65600ARevision of cornea3.405.541.540.149.085.08090
    65710ACorneal transplant12.35NA13.250.49NA26.09090
    65730ACorneal transplant14.25NA12.160.56NA26.97090
    65750ACorneal transplant15.00NA14.540.59NA30.13090
    65755ACorneal transplant14.89NA14.480.58NA29.95090
    65760NRevision of cornea0.000.000.000.000.000.00XXX
    65765NRevision of cornea0.000.000.000.000.000.00XXX
    65767NCorneal tissue transplant0.000.000.000.000.000.00XXX
    65770ARevise cornea with implant17.56NA15.480.69NA33.73090
    65771NRadial keratotomy0.000.000.000.000.000.00XXX
    65772ACorrection of astigmatism4.297.516.470.1711.9710.93090
    65775ACorrection of astigmatism5.79NA8.630.22NA14.64090
    65800ADrainage of eye1.912.331.450.084.323.44000
    65805ADrainage of eye1.912.341.460.084.333.45000
    65810ADrainage of eye4.87NA8.950.19NA14.01090
    65815ADrainage of eye5.059.408.160.2014.6513.41090
    65820ARelieve inner eye pressure8.13NA10.990.32NA19.44090
    65850AIncision of eye10.52NA10.350.41NA21.28090
    65855ALaser surgery of eye3.855.173.700.179.197.72010
    65860AIncise inner eye adhesions3.554.153.180.147.846.87090
    65865AIncise inner eye adhesions5.60NA6.920.22NA12.74090
    65870AIncise inner eye adhesions6.27NA7.250.24NA13.76090
    65875AIncise inner eye adhesions6.54NA7.370.25NA14.16090
    65880AIncise inner eye adhesions7.09NA7.640.28NA15.01090
    65900ARemove eye lesion10.93NA12.750.46NA24.14090
    65920ARemove implant of eye8.40NA8.260.33NA16.99090
    65930ARemove blood clot from eye7.44NA8.830.29NA16.56090
    66020AInjection treatment of eye1.592.431.570.074.093.23010
    66030AInjection treatment of eye1.252.251.400.053.552.70010
    66130ARemove eye lesion7.697.636.710.3115.6314.71090
    66150AGlaucoma surgery8.30NA10.980.33NA19.61090
    66155AGlaucoma surgery8.29NA10.940.32NA19.55090
    66160AGlaucoma surgery10.17NA11.840.41NA22.42090
    66165AGlaucoma surgery8.01NA10.720.31NA19.04090
    66170AGlaucoma surgery12.16NA17.110.48NA29.75090
    66172AIncision of eye15.04NA15.670.59NA31.30090
    66180AImplant eye shunt14.55NA12.440.57NA27.56090
    66185ARevise eye shunt8.14NA8.470.32NA16.93090
    66220ARepair eye lesion7.77NA9.990.32NA18.08090
    66225ARepair/graft eye lesion11.05NA9.650.44NA21.14090
    66250AFollow-up surgery of eye5.988.086.480.2314.2912.69090
    66500AIncision of iris3.71NA4.820.15NA8.68090
    66505AIncision of iris4.08NA5.010.17NA9.26090
    66600ARemove iris and lesion8.68NA8.900.34NA17.92090
    66605ARemoval of iris12.79NA12.540.61NA25.94090
    66625ARemoval of iris5.137.906.810.2013.2312.14090
    66630ARemoval of iris6.16NA7.760.24NA14.16090
    66635ARemoval of iris6.25NA6.650.24NA13.14090Start Printed Page 55401
    66680ARepair iris & ciliary body5.44NA6.300.21NA11.95090
    66682ARepair iris & ciliary body6.21NA7.750.24NA14.20090
    66700ADestruction, ciliary body4.787.177.170.1912.1412.14090
    66710ADestruction, ciliary body4.788.927.530.1813.8812.49090
    66720ADestruction, ciliary body4.788.407.530.1913.3712.50090
    66740ADestruction, ciliary body4.78NA6.530.18NA11.49090
    66761ARevision of iris4.075.664.380.169.898.61090
    66762ARevision of iris4.585.654.450.1810.419.21090
    66770ARemoval of inner eye lesion5.185.944.680.2011.3210.06090
    66820AIncision, secondary cataract3.89NA8.500.16NA12.55090
    66821AAfter cataract laser surgery2.353.893.460.106.345.91090
    66825AReposition intraocular lens8.23NA10.560.32NA19.11090
    66830ARemoval of lens lesion8.20NA7.060.32NA15.58090
    66840ARemoval of lens material7.91NA6.920.31NA15.14090
    66850ARemoval of lens material9.11NA7.520.36NA16.99090
    66852ARemoval of lens material9.97NA7.990.39NA18.35090
    66920AExtraction of lens8.86NA7.420.35NA16.63090
    66930AExtraction of lens10.18NA8.940.41NA19.53090
    66940AExtraction of lens8.93NA8.390.35NA17.67090
    66982ACataract surgery, complex13.50NA9.310.56NA23.37090
    66983ACataract surg w/iol, 1 stage8.99NA6.340.37NA15.70090
    66984ACataract surg w/iol, 1 stage10.23NA7.850.41NA18.49090
    66985AInsert lens prosthesis8.39NA7.050.33NA15.77090
    66986AExchange lens prosthesis12.28NA8.860.49NA21.63090
    66999CEye surgery procedure0.000.000.000.000.000.00YYY
    67005APartial removal of eye fluid5.70NA2.750.22NA8.67090
    67010APartial removal of eye fluid6.87NA3.320.27NA10.46090
    67015ARelease of eye fluid6.92NA8.380.27NA15.57090
    67025AReplace eye fluid6.8418.237.770.2725.3414.88090
    67027AImplant eye drug system10.8515.129.260.4626.4320.57090
    67028AInjection eye drug2.5211.921.210.1114.553.84000
    67030AIncise inner eye strands4.84NA6.960.19NA11.99090
    67031ALaser surgery, eye strands3.674.223.240.158.047.06090
    67036ARemoval of inner eye fluid11.89NA9.300.47NA21.66090
    67038AStrip retinal membrane21.24NA16.010.84NA38.09090
    67039ALaser treatment of retina14.52NA12.740.57NA27.83090
    67040ALaser treatment of retina17.23NA14.080.68NA31.99090
    67101ARepair detached retina7.5311.299.120.2919.1116.94090
    67105ARepair detached retina7.417.805.700.2915.5013.40090
    67107ARepair detached retina14.84NA13.630.58NA29.05090
    67108ARepair detached retina20.82NA18.300.82NA39.94090
    67110ARepair detached retina8.8121.7410.560.3530.9019.72090
    67112ARerepair detached retina16.86NA15.660.66NA33.18090
    67115ARelease encircling material4.99NA7.020.19NA12.20090
    67120ARemove eye implant material5.9817.577.360.2323.7813.57090
    67121ARemove eye implant material10.67NA12.470.42NA23.56090
    67141ATreatment of retina5.208.297.160.2013.6912.56090
    67145ATreatment of retina5.375.434.280.2111.019.86090
    67208ATreatment of retinal lesion6.708.627.260.2615.5814.22090
    67210ATreatment of retinal lesion8.827.495.930.3516.6615.10090
    67218ATreatment of retinal lesion18.53NA16.360.53NA35.42090
    67220ATreatment of choroid lesion13.1311.189.940.5124.8223.58090
    67221AOcular photodynamic ther4.014.801.950.168.976.12000
    67225AEye photodynamic ther add-on0.470.240.190.501.211.16ZZZ
    67227ATreatment of retinal lesion6.589.297.400.2616.1314.24090
    67228ATreatment of retinal lesion12.7410.177.470.5023.4120.71090
    67250AReinforce eye wall8.66NA12.100.36NA21.12090
    67255AReinforce/graft eye wall8.90NA12.110.35NA21.36090
    67299CEye surgery procedure0.000.000.000.000.000.00YYY
    67311ARevise eye muscle6.65NA6.360.27NA13.28090
    67312ARevise two eye muscles8.54NA7.460.35NA16.35090
    67314ARevise eye muscle7.52NA6.940.30NA14.76090
    67316ARevise two eye muscles9.66NA7.990.40NA18.05090
    67318ARevise eye muscle(s)7.85NA7.370.31NA15.53090
    67320ARevise eye muscle(s) add-on4.33NA2.090.17NA6.59ZZZ
    67331AEye surgery follow-up add-on4.06NA2.020.17NA6.25ZZZ
    67332ARerevise eye muscles add-on4.49NA2.160.18NA6.83ZZZ
    67334ARevise eye muscle w/suture3.98NA1.900.16NA6.04ZZZ
    67335AEye suture during surgery2.49NA1.200.10NA3.79ZZZ
    67340ARevise eye muscle add-on4.93NA2.410.19NA7.53ZZZ
    67343ARelease eye tissue7.35NA7.260.30NA14.91090
    67345ADestroy nerve of eye muscle2.964.461.360.137.554.45010
    67350ABiopsy eye muscle2.87NA1.990.13NA4.99000Start Printed Page 55402
    67399CEye muscle surgery procedure0.000.000.000.000.000.00YYY
    67400AExplore/biopsy eye socket9.76NA13.850.43NA24.04090
    67405AExplore/drain eye socket7.93NA12.560.36NA20.85090
    67412AExplore/treat eye socket9.50NA16.020.41NA25.93090
    67413AExplore/treat eye socket10.00NA13.800.43NA24.23090
    67414AExplr/decompress eye socket11.13NA16.900.48NA28.51090
    67415AAspiration, orbital contents1.76NA0.800.09NA2.65000
    67420AExplore/treat eye socket20.06NA20.790.84NA41.69090
    67430AExplore/treat eye socket13.39NA18.380.97NA32.74090
    67440AExplore/drain eye socket13.09NA18.430.58NA32.10090
    67445AExplr/decompress eye socket14.42NA18.190.63NA33.24090
    67450AExplore/biopsy eye socket13.51NA17.510.56NA31.58090
    67500AInject/treat eye socket0.790.950.200.041.781.03000
    67505AInject/treat eye socket0.820.950.210.041.811.07000
    67515AInject/treat eye socket0.610.860.290.021.490.92000
    67550AInsert eye socket implant10.19NA13.570.50NA24.26090
    67560ARevise eye socket implant10.60NA13.500.47NA24.57090
    67570ADecompress optic nerve13.58NA17.660.69NA31.93090
    67599COrbit surgery procedure0.000.000.000.000.000.00YYY
    67700ADrainage of eyelid abscess1.357.800.600.069.212.01010
    67710AIncision of eyelid1.027.920.490.048.981.55010
    67715AIncision of eyelid fold1.22NA0.590.05NA1.86010
    67800ARemove eyelid lesion1.382.670.660.064.112.10010
    67801ARemove eyelid lesions1.888.230.910.0810.192.87010
    67805ARemove eyelid lesions2.228.411.060.0910.723.37010
    67808ARemove eyelid lesion(s)3.80NA4.340.17NA8.31090
    67810ABiopsy of eyelid1.485.260.720.066.802.26000
    67820ARevise eyelashes0.892.020.390.042.951.32000
    67825ARevise eyelashes1.385.701.070.067.142.51010
    67830ARevise eyelashes1.7011.552.200.0713.323.97010
    67835ARevise eyelashes5.56NA4.900.22NA10.68090
    67840ARemove eyelid lesion2.048.190.990.0810.313.11010
    67850ATreat eyelid lesion1.698.792.070.0710.553.83010
    67875AClosure of eyelid by suture1.3511.622.160.0613.033.57000
    67880ARevision of eyelid3.8012.773.240.1616.737.20090
    67882ARevision of eyelid5.0715.424.840.2120.7010.12090
    67900ARepair brow defect6.1411.296.690.3017.7313.13090
    67901ARepair eyelid defect6.97NA7.220.32NA14.51090
    67902ARepair eyelid defect7.03NA7.170.34NA14.54090
    67903ARepair eyelid defect6.3710.726.800.3917.4813.56090
    67904ARepair eyelid defect6.2614.978.570.2621.4915.09090
    67906ARepair eyelid defect6.799.916.300.4217.1213.51090
    67908ARepair eyelid defect5.139.656.360.2014.9811.69090
    67909ARevise eyelid defect5.4010.206.870.2515.8512.52090
    67911ARevise eyelid defect5.27NA6.920.23NA12.42090
    67914ARepair eyelid defect3.6813.223.700.1617.067.54090
    67915ARepair eyelid defect3.1811.731.520.1315.044.83090
    67916ARepair eyelid defect5.3117.265.520.2222.7911.05090
    67917ARepair eyelid defect6.0210.636.860.2516.9013.13090
    67921ARepair eyelid defect3.4012.943.470.1416.487.01090
    67922ARepair eyelid defect3.0611.733.310.1314.926.50090
    67923ARepair eyelid defect5.8816.335.620.2422.4511.74090
    67924ARepair eyelid defect5.799.976.200.2315.9912.22090
    67930ARepair eyelid wound3.6112.503.150.1716.286.93010
    67935ARepair eyelid wound6.2216.125.600.2922.6312.11090
    67938ARemove eyelid foreign body1.339.650.530.0611.041.92010
    67950ARevision of eyelid5.829.017.670.3015.1313.79090
    67961ARevision of eyelid5.699.396.030.2615.3411.98090
    67966ARevision of eyelid6.579.016.250.3315.9113.15090
    67971AReconstruction of eyelid9.79NA7.850.42NA18.06090
    67973AReconstruction of eyelid12.87NA9.950.59NA23.41090
    67974AReconstruction of eyelid12.84NA9.870.54NA23.25090
    67975AReconstruction of eyelid9.13NA7.510.38NA17.02090
    67999CRevision of eyelid0.000.000.000.000.000.00YYY
    68020AIncise/drain eyelid lining1.377.790.650.069.222.08010
    68040ATreatment of eyelid lesions0.857.680.410.038.561.29000
    68100ABiopsy of eyelid lining1.357.930.650.069.342.06000
    68110ARemove eyelid lining lesion1.778.981.410.0710.823.25010
    68115ARemove eyelid lining lesion2.368.471.140.1010.933.60010
    68130ARemove eyelid lining lesion4.93NA2.380.19NA7.50090
    68135ARemove eyelid lining lesion1.848.230.890.0710.142.80010
    68200ATreat eyelid by injection0.490.760.240.021.270.75000
    68320ARevise/graft eyelid lining5.375.755.340.2111.3310.92090Start Printed Page 55403
    68325ARevise/graft eyelid lining7.36NA6.330.30NA13.99090
    68326ARevise/graft eyelid lining7.15NA6.260.30NA13.71090
    68328ARevise/graft eyelid lining8.18NA7.070.40NA15.65090
    68330ARevise eyelid lining4.837.345.820.1912.3610.84090
    68335ARevise/graft eyelid lining7.19NA5.680.29NA13.16090
    68340ASeparate eyelid adhesions4.1715.874.330.1720.218.67090
    68360ARevise eyelid lining4.376.775.420.1711.319.96090
    68362ARevise eyelid lining7.34NA8.020.29NA15.65090
    68399CEyelid lining surgery0.000.000.000.000.000.00YYY
    68400AIncise/drain tear gland1.6911.482.180.0713.243.94010
    68420AIncise/drain tear sac2.3011.892.520.1014.294.92010
    68440AIncise tear duct opening0.947.860.450.048.841.43010
    68500ARemoval of tear gland11.02NA9.130.60NA20.75090
    68505APartial removal, tear gland10.94NA10.310.57NA21.82090
    68510ABiopsy of tear gland4.6113.092.220.1917.897.02000
    68520ARemoval of tear sac7.51NA7.470.33NA15.31090
    68525ABiopsy of tear sac4.43NA2.150.18NA6.76000
    68530AClearance of tear duct3.6615.333.180.1619.157.00010
    68540ARemove tear gland lesion10.60NA9.730.46NA20.79090
    68550ARemove tear gland lesion13.26NA10.500.66NA24.42090
    68700ARepair tear ducts6.60NA6.870.27NA13.74090
    68705ARevise tear duct opening2.068.331.000.0810.473.14010
    68720ACreate tear sac drain8.96NA8.040.38NA17.38090
    68745ACreate tear duct drain8.63NA7.820.38NA16.83090
    68750ACreate tear duct drain8.66NA8.460.37NA17.49090
    68760AClose tear duct opening1.736.771.250.078.573.05010
    68761AClose tear duct opening1.363.091.030.064.512.45010
    68770AClose tear system fistula7.0217.746.150.2825.0413.45090
    68801ADilate tear duct opening0.940.880.570.041.861.55010
    68810AProbe nasolacrimal duct1.902.480.910.084.462.89010
    68811AProbe nasolacrimal duct2.35NA2.460.10NA4.91010
    68815AProbe nasolacrimal duct3.2014.082.920.1417.426.26010
    68840AExplore/irrigate tear ducts1.251.621.000.052.922.30010
    68850AInjection for tear sac x-ray0.8015.290.320.0316.121.15000
    68899CTear duct system surgery0.000.000.000.000.000.00YYY
    69000ADrain external ear lesion1.452.140.590.103.692.14010
    69005ADrain external ear lesion2.112.552.110.164.824.38010
    69020ADrain outer ear canal lesion1.482.250.710.113.842.30010
    69090NPierce earlobes0.000.000.000.000.000.00XXX
    69100ABiopsy of external ear0.811.440.410.042.291.26000
    69105ABiopsy of external ear canal0.851.511.020.062.421.93000
    69110ARemove external ear, partial3.443.482.850.247.166.53090
    69120ARemoval of external ear4.05NA4.680.31NA9.04090
    69140ARemove ear canal lesion(s)7.97NA8.240.56NA16.77090
    69145ARemove ear canal lesion(s)2.623.412.540.186.215.34090
    69150AExtensive ear canal surgery13.43NA11.381.07NA25.88090
    69155AExtensive ear/neck surgery20.80NA16.261.51NA38.57090
    69200AClear outer ear canal0.771.450.770.052.271.59000
    69205AClear outer ear canal1.20NA1.580.09NA2.87010
    69210ARemove impacted ear wax0.610.590.250.041.240.90000
    69220AClean out mastoid cavity0.831.530.440.062.421.33000
    69222AClean out mastoid cavity1.402.241.710.103.743.21010
    69300RRevise external ear6.36NA4.380.43NA11.17YYY
    69310ARebuild outer ear canal10.79NA9.860.77NA21.42090
    69320ARebuild outer ear canal16.96NA13.771.17NA31.90090
    69399COuter ear surgery procedure0.000.000.000.000.000.00YYY
    69400AInflate middle ear canal0.831.510.490.062.401.38000
    69401AInflate middle ear canal0.631.410.340.042.081.01000
    69405ACatheterize middle ear canal2.633.091.500.185.904.31010
    69410AInset middle ear (baffle)0.331.390.170.021.740.52000
    69420AIncision of eardrum1.332.350.750.103.782.18010
    69421AIncision of eardrum1.732.581.920.134.443.78010
    69424ARemove ventilating tube0.851.680.940.062.591.85000
    69433ACreate eardrum opening1.522.320.880.113.952.51010
    69436ACreate eardrum opening1.96NA2.050.14NA4.15010
    69440AExploration of middle ear7.57NA7.410.53NA15.51090
    69450AEardrum revision5.57NA6.180.39NA12.14090
    69501AMastoidectomy9.07NA8.220.65NA17.94090
    69502AMastoidectomy12.38NA10.800.86NA24.04090
    69505ARemove mastoid structures12.99NA10.940.92NA24.85090
    69511AExtensive mastoid surgery13.52NA11.450.96NA25.93090
    69530AExtensive mastoid surgery19.19NA15.061.32NA35.57090
    69535ARemove part of temporal bone36.14NA25.132.59NA63.86090Start Printed Page 55404
    69540ARemove ear lesion1.202.271.610.093.562.90010
    69550ARemove ear lesion10.99NA9.970.80NA21.76090
    69552ARemove ear lesion19.46NA14.811.36NA35.63090
    69554ARemove ear lesion33.16NA21.792.32NA57.27090
    69601AMastoid surgery revision13.24NA11.970.92NA26.13090
    69602AMastoid surgery revision13.58NA11.550.94NA26.07090
    69603AMastoid surgery revision14.02NA11.801.00NA26.82090
    69604AMastoid surgery revision14.02NA11.760.98NA26.76090
    69605AMastoid surgery revision18.49NA14.371.29NA34.15090
    69610ARepair of eardrum4.434.273.470.319.018.21010
    69620ARepair of eardrum5.896.903.400.4013.199.69090
    69631ARepair eardrum structures9.86NA9.380.69NA19.93090
    69632ARebuild eardrum structures12.75NA11.730.89NA25.37090
    69633ARebuild eardrum structures12.10NA11.360.84NA24.30090
    69635ARepair eardrum structures13.33NA11.410.87NA25.61090
    69636ARebuild eardrum structures15.22NA13.231.07NA29.52090
    69637ARebuild eardrum structures15.11NA13.161.06NA29.33090
    69641ARevise middle ear & mastoid12.71NA11.060.89NA24.66090
    69642ARevise middle ear & mastoid16.84NA14.161.18NA32.18090
    69643ARevise middle ear & mastoid15.32NA13.241.08NA29.64090
    69644ARevise middle ear & mastoid16.97NA14.221.19NA32.38090
    69645ARevise middle ear & mastoid16.38NA13.771.16NA31.31090
    69646ARevise middle ear & mastoid17.99NA14.831.26NA34.08090
    69650ARelease middle ear bone9.66NA8.530.68NA18.87090
    69660ARevise middle ear bone11.90NA9.860.84NA22.60090
    69661ARevise middle ear bone15.74NA12.631.10NA29.47090
    69662ARevise middle ear bone15.44NA12.561.08NA29.08090
    69666ARepair middle ear structures9.75NA8.650.68NA19.08090
    69667ARepair middle ear structures9.76NA8.580.72NA19.06090
    69670ARemove mastoid air cells11.51NA10.360.78NA22.65090
    69676ARemove middle ear nerve9.52NA9.140.69NA19.35090
    69700AClose mastoid fistula8.23NA5.770.55NA14.55090
    69710NImplant/replace hearing aid0.000.000.000.000.000.00XXX
    69711ARemove/repair hearing aid10.44NA9.620.62NA20.68090
    69714AImplant temple bone w/stimul14.00NA11.531.01NA26.54090
    69715ATemple bone implnt w/stimulat18.25NA14.051.32NA33.62090
    69717ATemple bone implant revision14.98NA11.461.08NA27.52090
    69718ARevise temple bone implant18.50NA14.201.34NA34.04090
    69720ARelease facial nerve14.38NA12.851.03NA28.26090
    69725ARelease facial nerve25.38NA17.971.78NA45.13090
    69740ARepair facial nerve15.96NA10.901.13NA27.99090
    69745ARepair facial nerve16.69NA12.801.00NA30.49090
    69799CMiddle ear surgery procedure0.000.000.000.000.000.00YYY
    69801AIncise inner ear8.56NA7.960.60NA17.12090
    69802AIncise inner ear13.10NA11.370.91NA25.38090
    69805AExplore inner ear13.82NA10.910.97NA25.70090
    69806AExplore inner ear12.35NA10.820.86NA24.03090
    69820AEstablish inner ear window10.34NA8.780.66NA19.78090
    69840ARevise inner ear window10.26NA9.000.64NA19.90090
    69905ARemove inner ear11.10NA9.940.77NA21.81090
    69910ARemove inner ear & mastoid13.63NA11.420.94NA25.99090
    69915AIncise inner ear nerve21.23NA15.881.54NA38.65090
    69930AImplant cochlear device16.81NA12.941.19NA30.94090
    69949CInner ear surgery procedure0.000.000.000.000.000.00YYY
    69950AIncise inner ear nerve25.64NA16.712.90NA45.25090
    69955ARelease facial nerve27.04NA18.391.89NA47.32090
    69960ARelease inner ear canal27.04NA18.402.43NA47.87090
    69970ARemove inner ear lesion30.04NA19.122.34NA51.50090
    69979CTemporal bone surgery0.000.000.000.000.000.00YYY
    69990RMicrosurgery add-on3.47NA1.870.56NA5.90ZZZ
    70010AContrast x-ray of brain1.194.53NA0.245.96NAXXX
    7001026AContrast x-ray of brain1.190.420.420.061.671.67XXX
    70010TCAContrast x-ray of brain0.004.11NA0.184.29NAXXX
    70015AContrast x-ray of brain1.191.71NA0.123.02NAXXX
    7001526AContrast x-ray of brain1.190.420.420.051.661.66XXX
    70015TCAContrast x-ray of brain0.001.29NA0.071.36NAXXX
    70030AX-ray eye for foreign body0.170.45NA0.030.65NAXXX
    7003026AX-ray eye for foreign body0.170.060.060.010.240.24XXX
    70030TCAX-ray eye for foreign body0.000.39NA0.020.41NAXXX
    70100AX-ray exam of jaw0.180.56NA0.030.77NAXXX
    7010026AX-ray exam of jaw0.180.060.060.010.250.25XXX
    70100TCAX-ray exam of jaw0.000.50NA0.020.52NAXXX
    70110AX-ray exam of jaw0.250.68NA0.040.97NAXXXStart Printed Page 55405
    7011026AX-ray exam of jaw0.250.090.090.010.350.35XXX
    70110TCAX-ray exam of jaw0.000.59NA0.030.62NAXXX
    70120AX-ray exam of mastoids0.180.65NA0.040.87NAXXX
    7012026AX-ray exam of mastoids0.180.060.060.010.250.25XXX
    70120TCAX-ray exam of mastoids0.000.59NA0.030.62NAXXX
    70130AX-ray exam of mastoids0.340.86NA0.051.25NAXXX
    7013026AX-ray exam of mastoids0.340.120.120.010.470.47XXX
    70130TCAX-ray exam of mastoids0.000.74NA0.040.78NAXXX
    70134AX-ray exam of middle ear0.340.82NA0.051.21NAXXX
    7013426AX-ray exam of middle ear0.340.120.120.010.470.47XXX
    70134TCAX-ray exam of middle ear0.000.70NA0.040.74NAXXX
    70140AX-ray exam of facial bones0.190.66NA0.040.89NAXXX
    7014026AX-ray exam of facial bones0.190.070.070.010.270.27XXX
    70140TCAX-ray exam of facial bones0.000.59NA0.030.62NAXXX
    70150AX-ray exam of facial bones0.260.83NA0.051.14NAXXX
    7015026AX-ray exam of facial bones0.260.090.090.010.360.36XXX
    70150TCAX-ray exam of facial bones0.000.74NA0.040.78NAXXX
    70160AX-ray exam of nasal bones0.170.56NA0.030.76NAXXX
    7016026AX-ray exam of nasal bones0.170.060.060.010.240.24XXX
    70160TCAX-ray exam of nasal bones0.000.50NA0.020.52NAXXX
    70170AX-ray exam of tear duct0.301.01NA0.061.37NAXXX
    7017026AX-ray exam of tear duct0.300.110.110.010.420.42XXX
    70170TCAX-ray exam of tear duct0.000.90NA0.050.95NAXXX
    70190AX-ray exam of eye sockets0.210.66NA0.040.91NAXXX
    7019026AX-ray exam of eye sockets0.210.070.070.010.290.29XXX
    70190TCAX-ray exam of eye sockets0.000.59NA0.030.62NAXXX
    70200AX-ray exam of eye sockets0.280.84NA0.051.17NAXXX
    7020026AX-ray exam of eye sockets0.280.100.100.010.390.39XXX
    70200TCAX-ray exam of eye sockets0.000.74NA0.040.78NAXXX
    70210AX-ray exam of sinuses0.170.65NA0.040.86NAXXX
    7021026AX-ray exam of sinuses0.170.060.060.010.240.24XXX
    70210TCAX-ray exam of sinuses0.000.59NA0.030.62NAXXX
    70220AX-ray exam of sinuses0.250.83NA0.051.13NAXXX
    7022026AX-ray exam of sinuses0.250.090.090.010.350.35XXX
    70220TCAX-ray exam of sinuses0.000.74NA0.040.78NAXXX
    70240AX-ray exam, pituitary saddle0.190.46NA0.030.68NAXXX
    7024026AX-ray exam, pituitary saddle0.190.070.070.010.270.27XXX
    70240TCAX-ray exam, pituitary saddle0.000.39NA0.020.41NAXXX
    70250AX-ray exam of skull0.240.67NA0.040.95NAXXX
    7025026AX-ray exam of skull0.240.080.080.010.330.33XXX
    70250TCAX-ray exam of skull0.000.59NA0.030.62NAXXX
    70260AX-ray exam of skull0.340.96NA0.061.36NAXXX
    7026026AX-ray exam of skull0.340.120.120.010.470.47XXX
    70260TCAX-ray exam of skull0.000.84NA0.050.89NAXXX
    70300AX-ray exam of teeth0.100.29NA0.030.42NAXXX
    7030026AX-ray exam of teeth0.100.040.040.010.150.15XXX
    70300TCAX-ray exam of teeth0.000.25NA0.020.27NAXXX
    70310AX-ray exam of teeth0.160.46NA0.030.65NAXXX
    7031026AX-ray exam of teeth0.160.070.070.010.240.24XXX
    70310TCAX-ray exam of teeth0.000.39NA0.020.41NAXXX
    70320AFull mouth x-ray of teeth0.220.82NA0.051.09NAXXX
    7032026AFull mouth x-ray of teeth0.220.080.080.010.310.31XXX
    70320TCAFull mouth x-ray of teeth0.000.74NA0.040.78NAXXX
    70328AX-ray exam of jaw joint0.180.53NA0.030.74NAXXX
    7032826AX-ray exam of jaw joint0.180.060.060.010.250.25XXX
    70328TCAX-ray exam of jaw joint0.000.47NA0.020.49NAXXX
    70330AX-ray exam of jaw joints0.240.88NA0.051.17NAXXX
    7033026AX-ray exam of jaw joints0.240.080.080.010.330.33XXX
    70330TCAX-ray exam of jaw joints0.000.80NA0.040.84NAXXX
    70332AX-ray exam of jaw joint0.542.18NA0.122.84NAXXX
    7033226AX-ray exam of jaw joint0.540.190.190.020.750.75XXX
    70332TCAX-ray exam of jaw joint0.001.99NA0.102.09NAXXX
    70336AMagnetic image, jaw joint1.4811.16NA0.5613.20NAXXX
    7033626AMagnetic image, jaw joint1.480.520.520.072.072.07XXX
    70336TCAMagnetic image, jaw joint0.0010.64NA0.4911.13NAXXX
    70350AX-ray head for orthodontia0.170.42NA0.030.62NAXXX
    7035026AX-ray head for orthodontia0.170.060.060.010.240.24XXX
    70350TCAX-ray head for orthodontia0.000.36NA0.020.38NAXXX
    70355APanoramic x-ray of jaws0.200.61NA0.040.85NAXXX
    7035526APanoramic x-ray of jaws0.200.070.070.010.280.28XXX
    70355TCAPanoramic x-ray of jaws0.000.54NA0.030.57NAXXX
    70360AX-ray exam of neck0.170.45NA0.030.65NAXXX
    7036026AX-ray exam of neck0.170.060.060.010.240.24XXXStart Printed Page 55406
    70360TCAX-ray exam of neck0.000.39NA0.020.41NAXXX
    70370AThroat x-ray & fluoroscopy0.321.35NA0.071.74NAXXX
    7037026AThroat x-ray & fluoroscopy0.320.110.110.010.440.44XXX
    70370TCAThroat x-ray & fluoroscopy0.001.24NA0.061.30NAXXX
    70371ASpeech evaluation, complex0.842.29NA0.143.27NAXXX
    7037126ASpeech evaluation, complex0.840.300.300.041.181.18XXX
    70371TCASpeech evaluation, complex0.001.99NA0.102.09NAXXX
    70373AContrast x-ray of larynx0.441.84NA0.112.39NAXXX
    7037326AContrast x-ray of larynx0.440.150.150.020.610.61XXX
    70373TCAContrast x-ray of larynx0.001.69NA0.091.78NAXXX
    70380AX-ray exam of salivary gland0.170.69NA0.040.90NAXXX
    7038026AX-ray exam of salivary gland0.170.060.060.010.240.24XXX
    70380TCAX-ray exam of salivary gland0.000.63NA0.030.66NAXXX
    70390AX-ray exam of salivary duct0.381.82NA0.112.31NAXXX
    7039026AX-ray exam of salivary duct0.380.130.130.020.530.53XXX
    70390TCAX-ray exam of salivary duct0.001.69NA0.091.78NAXXX
    70450ACt head/brain w/o dye0.854.78NA0.255.88NAXXX
    7045026ACt head/brain w/o dye0.850.300.300.041.191.19XXX
    70450TCACt head/brain w/o dye0.004.48NA0.214.69NAXXX
    70460ACt head/brain w/dye1.135.77NA0.307.20NAXXX
    7046026ACt head/brain w/dye1.130.400.400.051.581.58XXX
    70460TCACt head/brain w/dye0.005.37NA0.255.62NAXXX
    70470ACt head/brain w/o&w dye1.277.16NA0.378.80NAXXX
    7047026ACt head/brain w/o&w dye1.270.450.450.061.781.78XXX
    70470TCACt head/brain w/o&w dye0.006.71NA0.317.02NAXXX
    70480ACt orbit/ear/fossa w/o dye1.284.93NA0.276.48NAXXX
    7048026ACt orbit/ear/fossa w/o dye1.280.450.450.061.791.79XXX
    70480TCACt orbit/ear/fossa w/o dye0.004.48NA0.214.69NAXXX
    70481ACt orbit/ear/fossa w/dye1.385.85NA0.317.54NAXXX
    7048126ACt orbit/ear/fossa w/dye1.380.480.480.061.921.92XXX
    70481TCACt orbit/ear/fossa w/dye0.005.37NA0.255.62NAXXX
    70482ACt orbit/ear/fossa w/o&w dye1.457.22NA0.379.04NAXXX
    7048226ACt orbit/ear/fossa w/o&w dye1.450.510.510.062.022.02XXX
    70482TCACt orbit/ear/fossa w/o&w dye0.006.71NA0.317.02NAXXX
    70486ACt maxillofacial w/o dye1.144.88NA0.266.28NAXXX
    7048626ACt maxillofacial w/o dye1.140.400.400.051.591.59XXX
    70486TCACt maxillofacial w/o dye0.004.48NA0.214.69NAXXX
    70487ACt maxillofacial w/dye1.305.83NA0.317.44NAXXX
    7048726ACt maxillofacial w/dye1.300.460.460.061.821.82XXX
    70487TCACt maxillofacial w/dye0.005.37NA0.255.62NAXXX
    70488ACt maxillofacial w/o&w dye1.427.21NA0.379.00NAXXX
    7048826ACt maxillofacial w/o&w dye1.420.500.500.061.981.98XXX
    70488TCACt maxillofacial w/o&w dye0.006.71NA0.317.02NAXXX
    70490ACt soft tissue neck w/o dye1.284.93NA0.276.48NAXXX
    7049026ACt soft tissue neck w/o dye1.280.450.450.061.791.79XXX
    70490TCACt soft tissue neck w/o dye0.004.48NA0.214.69NAXXX
    70491ACt soft tissue neck w/dye1.385.85NA0.317.54NAXXX
    7049126ACt soft tissue neck w/dye1.380.480.480.061.921.92XXX
    70491TCACt soft tissue neck w/dye0.005.37NA0.255.62NAXXX
    70492ACt sft tsue nck w/o & w/dye1.457.22NA0.379.04NAXXX
    7049226ACt sft tsue nck w/o & w/dye1.450.510.510.062.022.02XXX
    70492TCACt sft tsue nck w/o & w/dye0.006.71NA0.317.02NAXXX
    70496ACt angiography, head1.757.41NA0.569.72NAXXX
    7049626ACt angiography, head1.750.700.700.082.532.53XXX
    70496TCACt angiography, head0.006.71NA0.487.19NAXXX
    70498ACt angiography, neck1.757.41NA0.569.72NAXXX
    7049826ACt angiography, neck1.750.700.700.082.532.53XXX
    70498TCACt angiography, neck0.006.71NA0.487.19NAXXX
    70540AMri orbit/face/neck w/o dye1.3511.11NA0.3612.82NAXXX
    7054026AMri orbit/face/neck w/o dye1.350.470.470.041.861.86XXX
    70540TCAMri orbit/face/neck w/o dye0.0010.64NA0.3210.96NAXXX
    70542AMri orbit/face/neck w/dye1.6213.33NA0.4415.39NAXXX
    7054226AMri orbit/face/neck w/dye1.620.570.570.052.242.24XXX
    70542TCAMri orbit/face/neck w/dye0.0012.76NA0.3913.15NAXXX
    70543AMri orbt/fac/nck w/o&w dye2.1524.39NA0.7727.31NAXXX
    7054326AMri orbt/fac/nck w/o&w dye2.150.750.750.072.972.97XXX
    70543TCAMri orbt/fac/nck w/o&w dye0.0023.64NA0.7024.34NAXXX
    70544AMr angiography head w/o dye1.2011.06NA0.5412.80NAXXX
    7054426AMr angiography head w/o dye1.200.420.420.051.671.67XXX
    70544TCAMr angiography head w/o dye0.0010.64NA0.4911.13NAXXX
    70545AMr angiography head w/dye1.2011.06NA0.5412.80NAXXX
    7054526AMr angiography head w/dye1.200.420.420.051.671.67XXX
    70545TCAMr angiography head w/dye0.0010.64NA0.4911.13NAXXXStart Printed Page 55407
    70546AMr angiograph head w/o&w dye1.8021.92NA0.5724.29NAXXX
    7054626AMr angiograph head w/o&w dye1.800.630.630.082.512.51XXX
    70546TCAMr angiograph head w/o&w dye0.0021.29NA0.4921.78NAXXX
    70547AMr angiography neck w/o dye1.2011.06NA0.5412.80NAXXX
    7054726AMr angiography neck w/o dye1.200.420.420.051.671.67XXX
    70547TCAMr angiography neck w/o dye0.0010.64NA0.4911.13NAXXX
    70548AMr angiography neck w/dye1.2011.06NA0.5412.80NAXXX
    7054826AMr angiography neck w/dye1.200.420.420.051.671.67XXX
    70548TCAMr angiography neck w/dye0.0010.64NA0.4911.13NAXXX
    70549AMr angiograph neck w/o&w dye1.8021.92NA0.5724.29NAXXX
    7054926AMr angiograph neck w/o&w dye1.800.630.630.082.512.51XXX
    70549TCAMr angiograph neck w/o&w dye0.0021.29NA0.4921.78NAXXX
    70551AMri brain w/o dye1.4811.16NA0.5613.20NAXXX
    7055126AMri brain w/o dye1.480.520.520.072.072.07XXX
    70551TCAMri brain w/o dye0.0010.64NA0.4911.13NAXXX
    70552AMri brain w/dye1.7813.40NA0.6615.84NAXXX
    7055226AMri brain w/dye1.780.640.640.082.502.50XXX
    70552TCAMri brain w/dye0.0012.76NA0.5813.34NAXXX
    70553AMri brain w/o&w dye2.3624.47NA1.1928.02NAXXX
    7055326AMri brain w/o&w dye2.360.830.830.103.293.29XXX
    70553TCAMri brain w/o&w dye0.0023.64NA1.0924.73NAXXX
    71010AChest x-ray0.180.51NA0.030.72NAXXX
    7101026AChest x-ray0.180.060.060.010.250.25XXX
    71010TCAChest x-ray0.000.45NA0.020.47NAXXX
    71015AChest x-ray0.210.57NA0.030.81NAXXX
    7101526AChest x-ray0.210.070.070.010.290.29XXX
    71015TCAChest x-ray0.000.50NA0.020.52NAXXX
    71020AChest x-ray0.220.67NA0.040.93NAXXX
    7102026AChest x-ray0.220.080.080.010.310.31XXX
    71020TCAChest x-ray0.000.59NA0.030.62NAXXX
    71021AChest x-ray0.270.79NA0.051.11NAXXX
    7102126AChest x-ray0.270.090.090.010.370.37XXX
    71021TCAChest x-ray0.000.70NA0.040.74NAXXX
    71022AChest x-ray0.310.81NA0.061.18NAXXX
    7102226AChest x-ray0.310.110.110.020.440.44XXX
    71022TCAChest x-ray0.000.70NA0.040.74NAXXX
    71023AChest x-ray and fluoroscopy0.380.88NA0.061.32NAXXX
    7102326AChest x-ray and fluoroscopy0.380.140.140.020.540.54XXX
    71023TCAChest x-ray and fluoroscopy0.000.74NA0.040.78NAXXX
    71030AChest x-ray0.310.85NA0.051.21NAXXX
    7103026AChest x-ray0.310.110.110.010.430.43XXX
    71030TCAChest x-ray0.000.74NA0.040.78NAXXX
    71034AChest x-ray and fluoroscopy0.461.54NA0.092.09NAXXX
    7103426AChest x-ray and fluoroscopy0.460.170.170.020.650.65XXX
    71034TCAChest x-ray and fluoroscopy0.001.37NA0.071.44NAXXX
    71035AChest x-ray0.180.56NA0.030.77NAXXX
    7103526AChest x-ray0.180.060.060.010.250.25XXX
    71035TCAChest x-ray0.000.50NA0.020.52NAXXX
    71040AContrast x-ray of bronchi0.581.59NA0.102.27NAXXX
    7104026AContrast x-ray of bronchi0.580.200.200.030.810.81XXX
    71040TCAContrast x-ray of bronchi0.001.39NA0.071.46NAXXX
    71060AContrast x-ray of bronchi0.742.35NA0.143.23NAXXX
    7106026AContrast x-ray of bronchi0.740.260.260.031.031.03XXX
    71060TCAContrast x-ray of bronchi0.002.09NA0.112.20NAXXX
    71090AX-ray & pacemaker insertion0.541.82NA0.112.47NAXXX
    7109026AX-ray & pacemaker insertion0.540.220.220.020.780.78XXX
    71090TCAX-ray & pacemaker insertion0.001.60NA0.091.69NAXXX
    71100AX-ray exam of ribs0.220.62NA0.040.88NAXXX
    7110026AX-ray exam of ribs0.220.080.080.010.310.31XXX
    71100TCAX-ray exam of ribs0.000.54NA0.030.57NAXXX
    71101AX-ray exam of ribs/chest0.270.72NA0.041.03NAXXX
    7110126AX-ray exam of ribs/chest0.270.090.090.010.370.37XXX
    71101TCAX-ray exam of ribs/chest0.000.63NA0.030.66NAXXX
    71110AX-ray exam of ribs0.270.83NA0.051.15NAXXX
    7111026AX-ray exam of ribs0.270.090.090.010.370.37XXX
    71110TCAX-ray exam of ribs0.000.74NA0.040.78NAXXX
    71111AX-ray exam of ribs/chest0.320.95NA0.061.33NAXXX
    7111126AX-ray exam of ribs/chest0.320.110.110.010.440.44XXX
    71111TCAX-ray exam of ribs/chest0.000.84NA0.050.89NAXXX
    71120AX-ray exam of breastbone0.200.69NA0.040.93NAXXX
    7112026AX-ray exam of breastbone0.200.070.070.010.280.28XXX
    71120TCAX-ray exam of breastbone0.000.62NA0.030.65NAXXX
    71130AX-ray exam of breastbone0.220.75NA0.041.01NAXXXStart Printed Page 55408
    7113026AX-ray exam of breastbone0.220.080.080.010.310.31XXX
    71130TCAX-ray exam of breastbone0.000.67NA0.030.70NAXXX
    71250ACt thorax w/o dye1.166.02NA0.317.49NAXXX
    7125026ACt thorax w/o dye1.160.410.410.051.621.62XXX
    71250TCACt thorax w/o dye0.005.61NA0.265.87NAXXX
    71260ACt thorax w/dye1.247.14NA0.368.74NAXXX
    7126026ACt thorax w/dye1.240.430.430.051.721.72XXX
    71260TCACt thorax w/dye0.006.71NA0.317.02NAXXX
    71270ACt thorax w/o&w dye1.388.88NA0.4410.70NAXXX
    7127026ACt thorax w/o&w dye1.380.480.480.061.921.92XXX
    71270TCACt thorax w/o&w dye0.008.40NA0.388.78NAXXX
    71275ACt angiography, chest1.929.17NA0.3811.47NAXXX
    7127526ACt angiography, chest1.920.770.770.062.752.75XXX
    71275TCACt angiography, chest0.008.40NA0.328.72NAXXX
    71550AMri chest w/o dye1.4611.15NA0.4113.02NAXXX
    7155026AMri chest w/o dye1.460.510.510.042.012.01XXX
    71550TCAMri chest w/o dye0.0010.64NA0.3711.01NAXXX
    71551AMri chest w/dye1.7313.36NA0.4915.58NAXXX
    7155126AMri chest w/dye1.730.600.600.062.392.39XXX
    71551TCAMri chest w/dye0.0012.76NA0.4313.19NAXXX
    71552AMri chest w/o&w dye2.2624.43NA0.6427.33NAXXX
    7155226AMri chest w/o&w dye2.260.790.790.083.133.13XXX
    71552TCAMri chest w/o&w dye0.0023.64NA0.5624.20NAXXX
    71555RMri angio chest w or w/o dye1.8111.28NA0.5713.66NAXXX
    7155526RMri angio chest w or w/o dye1.810.640.640.082.532.53XXX
    71555TCRMri angio chest w or w/o dye0.0010.64NA0.4911.13NAXXX
    72010AX-ray exam of spine0.451.13NA0.081.66NAXXX
    7201026AX-ray exam of spine0.450.160.160.030.640.64XXX
    72010TCAX-ray exam of spine0.000.97NA0.051.02NAXXX
    72020AX-ray exam of spine0.150.44NA0.030.62NAXXX
    7202026AX-ray exam of spine0.150.050.050.010.210.21XXX
    72020TCAX-ray exam of spine0.000.39NA0.020.41NAXXX
    72040AX-ray exam of neck spine0.220.65NA0.040.91NAXXX
    7204026AX-ray exam of neck spine0.220.080.080.010.310.31XXX
    72040TCAX-ray exam of neck spine0.000.57NA0.030.60NAXXX
    72050AX-ray exam of neck spine0.310.95NA0.071.33NAXXX
    7205026AX-ray exam of neck spine0.310.110.110.020.440.44XXX
    72050TCAX-ray exam of neck spine0.000.84NA0.050.89NAXXX
    72052AX-ray exam of neck spine0.361.20NA0.071.63NAXXX
    7205226AX-ray exam of neck spine0.360.130.130.020.510.51XXX
    72052TCAX-ray exam of neck spine0.001.07NA0.051.12NAXXX
    72069AX-ray exam of trunk spine0.220.56NA0.040.82NAXXX
    7206926AX-ray exam of trunk spine0.220.090.090.020.330.33XXX
    72069TCAX-ray exam of trunk spine0.000.47NA0.020.49NAXXX
    72070AX-ray exam of thoracic spine0.220.70NA0.040.96NAXXX
    7207026AX-ray exam of thoracic spine0.220.080.080.010.310.31XXX
    72070TCAX-ray exam of thoracic spine0.000.62NA0.030.65NAXXX
    72072AX-ray exam of thoracic spine0.220.78NA0.051.05NAXXX
    7207226AX-ray exam of thoracic spine0.220.080.080.010.310.31XXX
    72072TCAX-ray exam of thoracic spine0.000.70NA0.040.74NAXXX
    72074AX-ray exam of thoracic spine0.220.94NA0.061.22NAXXX
    7207426AX-ray exam of thoracic spine0.220.080.080.010.310.31XXX
    72074TCAX-ray exam of thoracic spine0.000.86NA0.050.91NAXXX
    72080AX-ray exam of trunk spine0.220.71NA0.050.98NAXXX
    7208026AX-ray exam of trunk spine0.220.080.080.020.320.32XXX
    72080TCAX-ray exam of trunk spine0.000.63NA0.030.66NAXXX
    72090AX-ray exam of trunk spine0.280.73NA0.051.06NAXXX
    7209026AX-ray exam of trunk spine0.280.100.100.020.400.40XXX
    72090TCAX-ray exam of trunk spine0.000.63NA0.030.66NAXXX
    72100AX-ray exam of lower spine0.220.71NA0.050.98NAXXX
    7210026AX-ray exam of lower spine0.220.080.080.020.320.32XXX
    72100TCAX-ray exam of lower spine0.000.63NA0.030.66NAXXX
    72110AX-ray exam of lower spine0.310.97NA0.071.35NAXXX
    7211026AX-ray exam of lower spine0.310.110.110.020.440.44XXX
    72110TCAX-ray exam of lower spine0.000.86NA0.050.91NAXXX
    72114AX-ray exam of lower spine0.361.26NA0.081.70NAXXX
    7211426AX-ray exam of lower spine0.360.130.130.030.520.52XXX
    72114TCAX-ray exam of lower spine0.001.13NA0.051.18NAXXX
    72120AX-ray exam of lower spine0.220.92NA0.071.21NAXXX
    7212026AX-ray exam of lower spine0.220.080.080.020.320.32XXX
    72120TCAX-ray exam of lower spine0.000.84NA0.050.89NAXXX
    72125ACt neck spine w/o dye1.166.02NA0.317.49NAXXX
    7212526ACt neck spine w/o dye1.160.410.410.051.621.62XXXStart Printed Page 55409
    72125TCACt neck spine w/o dye0.005.61NA0.265.87NAXXX
    72126ACt neck spine w/dye1.227.14NA0.368.72NAXXX
    7212626ACt neck spine w/dye1.220.430.430.051.701.70XXX
    72126TCACt neck spine w/dye0.006.71NA0.317.02NAXXX
    72127ACt neck spine w/o&w dye1.278.85NA0.4410.56NAXXX
    7212726ACt neck spine w/o&w dye1.270.450.450.061.781.78XXX
    72127TCACt neck spine w/o&w dye0.008.40NA0.388.78NAXXX
    72128ACt chest spine w/o dye1.166.02NA0.317.49NAXXX
    7212826ACt chest spine w/o dye1.160.410.410.051.621.62XXX
    72128TCACt chest spine w/o dye0.005.61NA0.265.87NAXXX
    72129ACt chest spine w/dye1.227.14NA0.368.72NAXXX
    7212926ACt chest spine w/dye1.220.430.430.051.701.70XXX
    72129TCACt chest spine w/dye0.006.71NA0.317.02NAXXX
    72130ACt chest spine w/o&w dye1.278.85NA0.4410.56NAXXX
    7213026ACt chest spine w/o&w dye1.270.450.450.061.781.78XXX
    72130TCACt chest spine w/o&w dye0.008.40NA0.388.78NAXXX
    72131ACt lumbar spine w/o dye1.166.02NA0.317.49NAXXX
    7213126ACt lumbar spine w/o dye1.160.410.410.051.621.62XXX
    72131TCACt lumbar spine w/o dye0.005.61NA0.265.87NAXXX
    72132ACt lumbar spine w/dye1.227.14NA0.378.73NAXXX
    7213226ACt lumbar spine w/dye1.220.430.430.061.711.71XXX
    72132TCACt lumbar spine w/dye0.006.71NA0.317.02NAXXX
    72133ACt lumbar spine w/o&w dye1.278.85NA0.4410.56NAXXX
    7213326ACt lumbar spine w/o&w dye1.270.450.450.061.781.78XXX
    72133TCACt lumbar spine w/o&w dye0.008.40NA0.388.78NAXXX
    72141AMri neck spine w/o dye1.6011.20NA0.5613.36NAXXX
    7214126AMri neck spine w/o dye1.600.560.560.072.232.23XXX
    72141TCAMri neck spine w/o dye0.0010.64NA0.4911.13NAXXX
    72142AMri neck spine w/dye1.9213.45NA0.6716.04NAXXX
    7214226AMri neck spine w/dye1.920.690.690.092.702.70XXX
    72142TCAMri neck spine w/dye0.0012.76NA0.5813.34NAXXX
    72146AMri chest spine w/o dye1.6012.38NA0.6014.58NAXXX
    7214626AMri chest spine w/o dye1.600.560.560.072.232.23XXX
    72146TCAMri chest spine w/o dye0.0011.82NA0.5312.35NAXXX
    72147AMri chest spine w/dye1.9213.44NA0.6716.03NAXXX
    7214726AMri chest spine w/dye1.920.680.680.092.692.69XXX
    72147TCAMri chest spine w/dye0.0012.76NA0.5813.34NAXXX
    72148AMri lumbar spine w/o dye1.4812.34NA0.6014.42NAXXX
    7214826AMri lumbar spine w/o dye1.480.520.520.072.072.07XXX
    72148TCAMri lumbar spine w/o dye0.0011.82NA0.5312.35NAXXX
    72149AMri lumbar spine w/dye1.7813.40NA0.6715.85NAXXX
    7214926AMri lumbar spine w/dye1.780.640.640.092.512.51XXX
    72149TCAMri lumbar spine w/dye0.0012.76NA0.5813.34NAXXX
    72156AMri neck spine w/o&w dye2.5724.55NA1.2028.32NAXXX
    7215626AMri neck spine w/o&w dye2.570.910.910.113.593.59XXX
    72156TCAMri neck spine w/o&w dye0.0023.64NA1.0924.73NAXXX
    72157AMri chest spine w/o&w dye2.5724.54NA1.2028.31NAXXX
    7215726AMri chest spine w/o&w dye2.570.900.900.113.583.58XXX
    72157TCAMri chest spine w/o&w dye0.0023.64NA1.0924.73NAXXX
    72158AMri lumbar spine w/o&w dye2.3624.47NA1.2028.03NAXXX
    7215826AMri lumbar spine w/o&w dye2.360.830.830.113.303.30XXX
    72158TCAMri lumbar spine w/o&w dye0.0023.64NA1.0924.73NAXXX
    72159NMr angio spine w/o&w dye+1.8012.54NA0.6114.95NAXXX
    7215926NMr angio spine w/o&w dye+1.800.720.720.082.602.60XXX
    72159TCNMr angio spine w/o&w dye+0.0011.82NA0.5312.35NAXXX
    72170AX-ray exam of pelvis0.170.56NA0.030.76NAXXX
    7217026AX-ray exam of pelvis0.170.060.060.010.240.24XXX
    72170TCAX-ray exam of pelvis0.000.50NA0.020.52NAXXX
    72190AX-ray exam of pelvis0.210.70NA0.040.95NAXXX
    7219026AX-ray exam of pelvis0.210.070.070.010.290.29XXX
    72190TCAX-ray exam of pelvis0.000.63NA0.030.66NAXXX
    72191ACt angiograph pelv w/o&w dye1.818.78NA0.3810.97NAXXX
    7219126ACt angiograph pelv w/o&w dye1.810.720.720.062.592.59XXX
    72191TCACt angiograph pelv w/o&w dye0.008.06NA0.328.38NAXXX
    72192ACt pelvis w/o dye1.095.99NA0.317.39NAXXX
    7219226ACt pelvis w/o dye1.090.380.380.051.521.52XXX
    72192TCACt pelvis w/o dye0.005.61NA0.265.87NAXXX
    72193ACt pelvis w/dye1.166.91NA0.358.42NAXXX
    7219326ACt pelvis w/dye1.160.410.410.051.621.62XXX
    72193TCACt pelvis w/dye0.006.50NA0.306.80NAXXX
    72194ACt pelvis w/o&w dye1.228.49NA0.4110.12NAXXX
    7219426ACt pelvis w/o&w dye1.220.430.430.051.701.70XXX
    72194TCACt pelvis w/o&w dye0.008.06NA0.368.42NAXXXStart Printed Page 55410
    72195AMri pelvis w/o dye1.4611.15NA0.4213.03NAXXX
    7219526AMri pelvis w/o dye1.460.510.510.052.022.02XXX
    72195TCAMri pelvis w/o dye0.0010.64NA0.3711.01NAXXX
    72196AMri pelvis w/dye1.7313.36NA0.4815.57NAXXX
    7219626AMri pelvis w/dye1.730.600.600.052.382.38XXX
    72196TCAMri pelvis w/dye0.0012.76NA0.4313.19NAXXX
    72197AMri pelvis w/o&w dye2.2624.43NA0.8427.53NAXXX
    7219726AMri pelvis w/o&w dye2.260.790.790.083.133.13XXX
    72197TCAMri pelvis w/o&w dye0.0023.64NA0.7624.40NAXXX
    72198NMr angio pelvis w/o&w dye+1.8011.36NA0.5713.73NAXXX
    7219826NMr angio pelvis w/o&w dye+1.800.720.720.082.602.60XXX
    72198TCNMr angio pelvis w/o&w dye+0.0010.64NA0.4911.13NAXXX
    72200AX-ray exam sacroiliac joints0.170.56NA0.030.76NAXXX
    7220026AX-ray exam sacroiliac joints0.170.060.060.010.240.24XXX
    72200TCAX-ray exam sacroiliac joints0.000.50NA0.020.52NAXXX
    72202AX-ray exam sacroiliac joints0.190.66NA0.040.89NAXXX
    7220226AX-ray exam sacroiliac joints0.190.070.070.010.270.27XXX
    72202TCAX-ray exam sacroiliac joints0.000.59NA0.030.62NAXXX
    72220AX-ray exam of tailbone0.170.60NA0.040.81NAXXX
    7222026AX-ray exam of tailbone0.170.060.060.010.240.24XXX
    72220TCAX-ray exam of tailbone0.000.54NA0.030.57NAXXX
    72240AContrast x-ray of neck spine0.914.82NA0.255.98NAXXX
    7224026AContrast x-ray of neck spine0.910.310.310.041.261.26XXX
    72240TCAContrast x-ray of neck spine0.004.51NA0.214.72NAXXX
    72255AContrast x-ray, thorax spine0.914.41NA0.225.54NAXXX
    7225526AContrast x-ray, thorax spine0.910.300.300.041.251.25XXX
    72255TCAContrast x-ray, thorax spine0.004.11NA0.184.29NAXXX
    72265AContrast x-ray, lower spine0.834.15NA0.225.20NAXXX
    7226526AContrast x-ray, lower spine0.830.280.280.041.151.15XXX
    72265TCAContrast x-ray, lower spine0.003.87NA0.184.05NAXXX
    72270AContrast x-ray of spine1.336.25NA0.347.92NAXXX
    7227026AContrast x-ray of spine1.330.460.460.071.861.86XXX
    72270TCAContrast x-ray of spine0.005.79NA0.276.06NAXXX
    72275AEpidurography0.762.20NA0.213.17NAXXX
    7227526AEpidurography0.760.210.210.031.001.00XXX
    72275TCAEpidurography0.001.99NA0.182.17NAXXX
    72285AX-ray c/t spine disk1.168.35NA0.429.93NAXXX
    7228526AX-ray c/t spine disk1.160.390.390.061.611.61XXX
    72285TCAX-ray c/t spine disk0.007.96NA0.368.32NAXXX
    72295AX-ray of lower spine disk0.837.76NA0.378.96NAXXX
    7229526AX-ray of lower spine disk0.830.290.290.041.161.16XXX
    72295TCAX-ray of lower spine disk0.007.47NA0.337.80NAXXX
    73000AX-ray exam of collar bone0.160.56NA0.030.75NAXXX
    7300026AX-ray exam of collar bone0.160.060.060.010.230.23XXX
    73000TCAX-ray exam of collar bone0.000.50NA0.020.52NAXXX
    73010AX-ray exam of shoulder blade0.170.56NA0.030.76NAXXX
    7301026AX-ray exam of shoulder blade0.170.060.060.010.240.24XXX
    73010TCAX-ray exam of shoulder blade0.000.50NA0.020.52NAXXX
    73020AX-ray exam of shoulder0.150.50NA0.030.68NAXXX
    7302026AX-ray exam of shoulder0.150.050.050.010.210.21XXX
    73020TCAX-ray exam of shoulder0.000.45NA0.020.47NAXXX
    73030AX-ray exam of shoulder0.180.60NA0.040.82NAXXX
    7303026AX-ray exam of shoulder0.180.060.060.010.250.25XXX
    73030TCAX-ray exam of shoulder0.000.54NA0.030.57NAXXX
    73040AContrast x-ray of shoulder0.542.18NA0.132.85NAXXX
    7304026AContrast x-ray of shoulder0.540.190.190.030.760.76XXX
    73040TCAContrast x-ray of shoulder0.001.99NA0.102.09NAXXX
    73050AX-ray exam of shoulders0.200.70NA0.050.95NAXXX
    7305026AX-ray exam of shoulders0.200.070.070.020.290.29XXX
    73050TCAX-ray exam of shoulders0.000.63NA0.030.66NAXXX
    73060AX-ray exam of humerus0.170.60NA0.040.81NAXXX
    7306026AX-ray exam of humerus0.170.060.060.010.240.24XXX
    73060TCAX-ray exam of humerus0.000.54NA0.030.57NAXXX
    73070AX-ray exam of elbow0.150.55NA0.030.73NAXXX
    7307026AX-ray exam of elbow0.150.050.050.010.210.21XXX
    73070TCAX-ray exam of elbow0.000.50NA0.020.52NAXXX
    73080AX-ray exam of elbow0.170.60NA0.040.81NAXXX
    7308026AX-ray exam of elbow0.170.060.060.010.240.24XXX
    73080TCAX-ray exam of elbow0.000.54NA0.030.57NAXXX
    73085AContrast x-ray of elbow0.542.19NA0.132.86NAXXX
    7308526AContrast x-ray of elbow0.540.200.200.030.770.77XXX
    73085TCAContrast x-ray of elbow0.001.99NA0.102.09NAXXX
    73090AX-ray exam of forearm0.160.56NA0.030.75NAXXXStart Printed Page 55411
    7309026AX-ray exam of forearm0.160.060.060.010.230.23XXX
    73090TCAX-ray exam of forearm0.000.50NA0.020.52NAXXX
    73092AX-ray exam of arm, infant0.160.53NA0.030.72NAXXX
    7309226AX-ray exam of arm, infant0.160.060.060.010.230.23XXX
    73092TCAX-ray exam of arm, infant0.000.47NA0.020.49NAXXX
    73100AX-ray exam of wrist0.160.53NA0.040.73NAXXX
    7310026AX-ray exam of wrist0.160.060.060.020.240.24XXX
    73100TCAX-ray exam of wrist0.000.47NA0.020.49NAXXX
    73110AX-ray exam of wrist0.170.57NA0.030.77NAXXX
    7311026AX-ray exam of wrist0.170.060.060.010.240.24XXX
    73110TCAX-ray exam of wrist0.000.51NA0.020.53NAXXX
    73115AContrast x-ray of wrist0.541.70NA0.112.35NAXXX
    7311526AContrast x-ray of wrist0.540.200.200.030.770.77XXX
    73115TCAContrast x-ray of wrist0.001.50NA0.081.58NAXXX
    73120AX-ray exam of hand0.160.53NA0.030.72NAXXX
    7312026AX-ray exam of hand0.160.060.060.010.230.23XXX
    73120TCAX-ray exam of hand0.000.47NA0.020.49NAXXX
    73130AX-ray exam of hand0.170.57NA0.030.77NAXXX
    7313026AX-ray exam of hand0.170.060.060.010.240.24XXX
    73130TCAX-ray exam of hand0.000.51NA0.020.53NAXXX
    73140AX-ray exam of finger(s)0.130.44NA0.030.60NAXXX
    7314026AX-ray exam of finger(s)0.130.050.050.010.190.19XXX
    73140TCAX-ray exam of finger(s)0.000.39NA0.020.41NAXXX
    73200ACt upper extremity w/o dye1.095.09NA0.266.44NAXXX
    7320026ACt upper extremity w/o dye1.090.380.380.051.521.52XXX
    73200TCACt upper extremity w/o dye0.004.71NA0.214.92NAXXX
    73201ACt upper extremity w/dye1.166.02NA0.317.49NAXXX
    7320126ACt upper extremity w/dye1.160.410.410.051.621.62XXX
    73201TCACt upper extremity w/dye0.005.61NA0.265.87NAXXX
    73202ACt uppr extremity w/o&w dye1.227.48NA0.389.08NAXXX
    7320226ACt uppr extremity w/o&w dye1.220.430.430.061.711.71XXX
    73202TCACt uppr extremity w/o&w dye0.007.05NA0.327.37NAXXX
    73206ACt angio upr extrm w/o&w dye1.817.77NA0.389.96NAXXX
    7320626ACt angio upr extrm w/o&w dye1.810.720.720.062.592.59XXX
    73206TCACt angio upr extrm w/o&w dye0.007.05NA0.327.37NAXXX
    73218AMri upper extremity w/o dye1.3511.11NA0.3612.82NAXXX
    7321826AMri upper extremity w/o dye1.350.470.470.041.861.86XXX
    73218TCAMri upper extremity w/o dye0.0010.64NA0.3210.96NAXXX
    73219AMri upper extremity w/dye1.6213.33NA0.4415.39NAXXX
    7321926AMri upper extremity w/dye1.620.570.570.052.242.24XXX
    73219TCAMri upper extremity w/dye0.0012.76NA0.3913.15NAXXX
    73220AMri uppr extremity w/o&w dye2.1524.39NA0.7827.32NAXXX
    7322026AMri uppr extremity w/o&w dye2.150.750.750.082.982.98XXX
    73220TCAMri uppr extremity w/o&w dye0.0023.64NA0.7024.34NAXXX
    73221AMri joint upr extrem w/o dye1.3511.11NA0.3612.82NAXXX
    7322126AMri joint upr extrem w/o dye1.350.470.470.041.861.86XXX
    73221TCAMri joint upr extrem w/o dye0.0010.64NA0.3210.96NAXXX
    73222AMri joint upr extrem w/dye1.6213.33NA0.4415.39NAXXX
    7322226AMri joint upr extrem w/dye1.620.570.570.052.242.24XXX
    73222TCAMri joint upr extrem w/dye0.0012.76NA0.3913.15NAXXX
    73223AMri joint upr extr w/o&w dye2.1524.39NA0.7727.31NAXXX
    7322326AMri joint upr extr w/o&w dye2.150.750.750.072.972.97XXX
    73223TCAMri joint upr extr w/o&w dye0.0023.64NA0.7024.34NAXXX
    73225NMr angio upr extr w/o&w dye+1.7311.33NA0.5713.63NAXXX
    7322526NMr angio upr extr w/o&w dye+1.730.690.690.082.502.50XXX
    73225TCNMr angio upr extr w/o&w dye+0.0010.64NA0.4911.13NAXXX
    73500AX-ray exam of hip0.170.51NA0.030.71NAXXX
    7350026AX-ray exam of hip0.170.060.060.010.240.24XXX
    73500TCAX-ray exam of hip0.000.45NA0.020.47NAXXX
    73510AX-ray exam of hip0.210.61NA0.050.87NAXXX
    7351026AX-ray exam of hip0.210.070.070.020.300.30XXX
    73510TCAX-ray exam of hip0.000.54NA0.030.57NAXXX
    73520AX-ray exam of hips0.260.72NA0.051.03NAXXX
    7352026AX-ray exam of hips0.260.090.090.020.370.37XXX
    73520TCAX-ray exam of hips0.000.63NA0.030.66NAXXX
    73525AContrast x-ray of hip0.542.19NA0.132.86NAXXX
    7352526AContrast x-ray of hip0.540.200.200.030.770.77XXX
    73525TCAContrast x-ray of hip0.001.99NA0.102.09NAXXX
    73530AX-ray exam of hip0.290.60NA0.030.92NAXXX
    7353026AX-ray exam of hip0.290.100.100.010.400.40XXX
    73530TCAX-ray exam of hip0.000.50NA0.020.52NAXXX
    73540AX-ray exam of pelvis & hips0.200.61NA0.050.86NAXXX
    7354026AX-ray exam of pelvis & hips0.200.070.070.020.290.29XXXStart Printed Page 55412
    73540TCAX-ray exam of pelvis & hips0.000.54NA0.030.57NAXXX
    73542AX-ray exam, sacroiliac joint0.592.16NA0.132.88NAXXX
    7354226AX-ray exam, sacroiliac joint0.590.170.170.030.790.79XXX
    73542TCAX-ray exam, sacroiliac joint0.001.99NA0.102.09NAXXX
    73550AX-ray exam of thigh0.170.60NA0.040.81NAXXX
    7355026AX-ray exam of thigh0.170.060.060.010.240.24XXX
    73550TCAX-ray exam of thigh0.000.54NA0.030.57NAXXX
    73560AX-ray exam of knee, 1 or 20.170.56NA0.040.77NAXXX
    7356026AX-ray exam of knee, 1 or 20.170.060.060.020.250.25XXX
    73560TCAX-ray exam of knee, 1 or 20.000.50NA0.020.52NAXXX
    73562AX-ray exam of knee, 30.180.60NA0.050.83NAXXX
    7356226AX-ray exam of knee, 30.180.060.060.020.260.26XXX
    73562TCAX-ray exam of knee, 30.000.54NA0.030.57NAXXX
    73564AX-ray exam, knee, 4 or more0.220.67NA0.050.94NAXXX
    7356426AX-ray exam, knee, 4 or more0.220.080.080.020.320.32XXX
    73564TCAX-ray exam, knee, 4 or more0.000.59NA0.030.62NAXXX
    73565AX-ray exam of knees0.170.54NA0.040.75NAXXX
    7356526AX-ray exam of knees0.170.070.070.020.260.26XXX
    73565TCAX-ray exam of knees0.000.47NA0.020.49NAXXX
    73580AContrast x-ray of knee joint0.542.68NA0.153.37NAXXX
    7358026AContrast x-ray of knee joint0.540.190.190.030.760.76XXX
    73580TCAContrast x-ray of knee joint0.002.49NA0.122.61NAXXX
    73590AX-ray exam of lower leg0.170.56NA0.030.76NAXXX
    7359026AX-ray exam of lower leg0.170.060.060.010.240.24XXX
    73590TCAX-ray exam of lower leg0.000.50NA0.020.52NAXXX
    73592AX-ray exam of leg, infant0.160.53NA0.030.72NAXXX
    7359226AX-ray exam of leg, infant0.160.060.060.010.230.23XXX
    73592TCAX-ray exam of leg, infant0.000.47NA0.020.49NAXXX
    73600AX-ray exam of ankle0.160.53NA0.030.72NAXXX
    7360026AX-ray exam of ankle0.160.060.060.010.230.23XXX
    73600TCAX-ray exam of ankle0.000.47NA0.020.49NAXXX
    73610AX-ray exam of ankle0.170.57NA0.030.77NAXXX
    7361026AX-ray exam of ankle0.170.060.060.010.240.24XXX
    73610TCAX-ray exam of ankle0.000.51NA0.020.53NAXXX
    73615AContrast x-ray of ankle0.542.18NA0.132.85NAXXX
    7361526AContrast x-ray of ankle0.540.190.190.030.760.76XXX
    73615TCAContrast x-ray of ankle0.001.99NA0.102.09NAXXX
    73620AX-ray exam of foot0.160.53NA0.030.72NAXXX
    7362026AX-ray exam of foot0.160.060.060.010.230.23XXX
    73620TCAX-ray exam of foot0.000.47NA0.020.49NAXXX
    73630AX-ray exam of foot0.170.57NA0.030.77NAXXX
    7363026AX-ray exam of foot0.170.060.060.010.240.24XXX
    73630TCAX-ray exam of foot0.000.51NA0.020.53NAXXX
    73650AX-ray exam of heel0.160.51NA0.030.70NAXXX
    7365026AX-ray exam of heel0.160.060.060.010.230.23XXX
    73650TCAX-ray exam of heel0.000.45NA0.020.47NAXXX
    73660AX-ray exam of toe(s)0.130.44NA0.030.60NAXXX
    7366026AX-ray exam of toe(s)0.130.050.050.010.190.19XXX
    73660TCAX-ray exam of toe(s)0.000.39NA0.020.41NAXXX
    73700ACt lower extremity w/o dye1.095.09NA0.266.44NAXXX
    7370026ACt lower extremity w/o dye1.090.380.380.051.521.52XXX
    73700TCACt lower extremity w/o dye0.004.71NA0.214.92NAXXX
    73701ACt lower extremity w/dye1.166.02NA0.317.49NAXXX
    7370126ACt lower extremity w/dye1.160.410.410.051.621.62XXX
    73701TCACt lower extremity w/dye0.005.61NA0.265.87NAXXX
    73702ACt lwr extremity w/o&w dye1.227.48NA0.379.07NAXXX
    7370226ACt lwr extremity w/o&w dye1.220.430.430.051.701.70XXX
    73702TCACt lwr extremity w/o&w dye0.007.05NA0.327.37NAXXX
    73706ACt angio lwr extr w/o&w dye1.907.81NA0.3810.09NAXXX
    7370626ACt angio lwr extr w/o&w dye1.900.760.760.062.722.72XXX
    73706TCACt angio lwr extr w/o&w dye0.007.05NA0.327.37NAXXX
    73718AMri lower extremity w/o dye1.3511.11NA0.3612.82NAXXX
    7371826AMri lower extremity w/o dye1.350.470.470.041.861.86XXX
    73718TCAMri lower extremity w/o dye0.0010.64NA0.3210.96NAXXX
    73719AMri lower extremity w/dye1.6213.32NA0.4415.38NAXXX
    7371926AMri lower extremity w/dye1.620.560.560.052.232.23XXX
    73719TCAMri lower extremity w/dye0.0012.76NA0.3913.15NAXXX
    73720AMri lwr extremity w/o&w dye2.1524.39NA0.7827.32NAXXX
    7372026AMri lwr extremity w/o&w dye2.150.750.750.082.982.98XXX
    73720TCAMri lwr extremity w/o&w dye0.0023.64NA0.7024.34NAXXX
    73721AMri joint of lwr extre w/o d1.3511.11NA0.3612.82NAXXX
    7372126AMri joint of lwr extre w/o d1.350.470.470.041.861.86XXX
    73721TCAMri joint of lwr extre w/o d0.0010.64NA0.3210.96NAXXX
    Start Printed Page 55413
    73722AMri joint of lwr extr w/dye1.6213.33NA0.4515.40NAXXX
    7372226AMri joint of lwr extr w/dye1.620.570.570.062.252.25XXX
    73722TCAMri joint of lwr extr w/dye0.0012.76NA0.3913.15NAXXX
    73723AMri joint lwr extr w/o&w dye2.1524.39NA0.7727.31NAXXX
    7372326AMri joint lwr extr w/o&w dye2.150.750.750.072.972.97XXX
    73723TCAMri joint lwr extr w/o&w dye0.0023.64NA0.7024.34NAXXX
    73725RMr ang lwr ext w or w/o dye1.8211.28NA0.5713.67NAXXX
    7372526RMr ang lwr ext w or w/o dye1.820.640.640.082.542.54XXX
    73725TCRMr ang lwr ext w or w/o dye0.0010.64NA0.4911.13NAXXX
    74000AX-ray exam of abdomen0.180.56NA0.030.77NAXXX
    7400026AX-ray exam of abdomen0.180.060.060.010.250.25XXX
    74000TCAX-ray exam of abdomen0.000.50NA0.020.52NAXXX
    74010AX-ray exam of abdomen0.230.62NA0.040.89NAXXX
    7401026AX-ray exam of abdomen0.230.080.080.010.320.32XXX
    74010TCAX-ray exam of abdomen0.000.54NA0.030.57NAXXX
    74020AX-ray exam of abdomen0.270.68NA0.040.99NAXXX
    7402026AX-ray exam of abdomen0.270.090.090.010.370.37XXX
    74020TCAX-ray exam of abdomen0.000.59NA0.030.62NAXXX
    74022AX-ray exam series, abdomen0.320.81NA0.051.18NAXXX
    7402226AX-ray exam series, abdomen0.320.110.110.010.440.44XXX
    74022TCAX-ray exam series, abdomen0.000.70NA0.040.74NAXXX
    74150ACt abdomen w/o dye1.195.79NA0.307.28NAXXX
    7415026ACt abdomen w/o dye1.190.420.420.051.661.66XXX
    74150TCACt abdomen w/o dye0.005.37NA0.255.62NAXXX
    74160ACt abdomen w/dye1.276.94NA0.368.57NAXXX
    7416026ACt abdomen w/dye1.270.440.440.061.771.77XXX
    74160TCACt abdomen w/dye0.006.50NA0.306.80NAXXX
    74170ACt abdomen w/o&w dye1.408.55NA0.4210.37NAXXX
    7417026ACt abdomen w/o&w dye1.400.490.490.061.951.95XXX
    74170TCACt abdomen w/o&w dye0.008.06NA0.368.42NAXXX
    74175ACt angio abdom w/o&w dye1.908.82NA0.3811.10NAXXX
    7417526ACt angio abdom w/o&w dye1.900.760.760.062.722.72XXX
    74175TCACt angio abdom w/o&w dye0.008.06NA0.328.38NAXXX
    74181AMri abdomen w/o dye1.4611.15NA0.4113.02NAXXX
    7418126AMri abdomen w/o dye1.460.510.510.042.012.01XXX
    74181TCAMri abdomen w/o dye0.0010.64NA0.3711.01NAXXX
    74182AMri abdomen w/dye1.7313.36NA0.4915.58NAXXX
    7418226AMri abdomen w/dye1.730.600.600.062.392.39XXX
    74182TCAMri abdomen w/dye0.0012.76NA0.4313.19NAXXX
    74183AMri abdomen w/o&w dye2.2624.43NA0.8427.53NAXXX
    7418326AMri abdomen w/o&w dye2.260.790.790.083.133.13XXX
    74183TCAMri abdomen w/o&w dye0.0023.64NA0.7624.40NAXXX
    74185RMri angio, abdom w or w/o dy1.8011.27NA0.5713.64NAXXX
    7418526RMri angio, abdom w or w/o dy1.800.630.630.082.512.51XXX
    74185TCRMri angio, abdom w or w/o dy0.0010.64NA0.4911.13NAXXX
    74190AX-ray exam of peritoneum0.481.41NA0.081.97NAXXX
    7419026AX-ray exam of peritoneum0.480.170.170.020.670.67XXX
    74190TCAX-ray exam of peritoneum0.001.24NA0.061.30NAXXX
    74210AContrst x-ray exam of throat0.361.26NA0.071.69NAXXX
    7421026AContrst x-ray exam of throat0.360.130.130.020.510.51XXX
    74210TCAContrst x-ray exam of throat0.001.13NA0.051.18NAXXX
    74220AContrast x-ray, esophagus0.461.29NA0.071.82NAXXX
    7422026AContrast x-ray, esophagus0.460.160.160.020.640.64XXX
    74220TCAContrast x-ray, esophagus0.001.13NA0.051.18NAXXX
    74230ACine/video x-ray, throat/eso0.531.43NA0.082.04NAXXX
    7423026ACine/video x-ray, throat/eso0.530.190.190.020.740.74XXX
    74230TCACine/video x-ray, throat/eso0.001.24NA0.061.30NAXXX
    74235ARemove esophagus obstruction1.192.90NA0.174.26NAXXX
    7423526ARemove esophagus obstruction1.190.410.410.051.651.65XXX
    74235TCARemove esophagus obstruction0.002.49NA0.122.61NAXXX
    74240AX-ray exam, upper gi tract0.691.63NA0.102.42NAXXX
    7424026AX-ray exam, upper gi tract0.690.240.240.030.960.96XXX
    74240TCAX-ray exam, upper gi tract0.001.39NA0.071.46NAXXX
    74241AX-ray exam, upper gi tract0.691.65NA0.102.44NAXXX
    7424126AX-ray exam, upper gi tract0.690.240.240.030.960.96XXX
    74241TCAX-ray exam, upper gi tract0.001.41NA0.071.48NAXXX
    74245AX-ray exam, upper gi tract0.912.58NA0.153.64NAXXX
    7424526AX-ray exam, upper gi tract0.910.320.320.041.271.27XXX
    74245TCAX-ray exam, upper gi tract0.002.26NA0.112.37NAXXX
    74246AContrst x-ray uppr gi tract0.691.80NA0.112.60NAXXX
    7424626AContrst x-ray uppr gi tract0.690.240.240.030.960.96XXX
    74246TCAContrst x-ray uppr gi tract0.001.56NA0.081.64NAXXX
    74247AContrst x-ray uppr gi tract0.691.84NA0.122.65NAXXX
    Start Printed Page 55414
    7424726AContrst x-ray uppr gi tract0.690.240.240.030.960.96XXX
    74247TCAContrst x-ray uppr gi tract0.001.60NA0.091.69NAXXX
    74249AContrst x-ray uppr gi tract0.912.76NA0.163.83NAXXX
    7424926AContrst x-ray uppr gi tract0.910.320.320.041.271.27XXX
    74249TCAContrst x-ray uppr gi tract0.002.44NA0.122.56NAXXX
    74250AX-ray exam of small bowel0.471.40NA0.081.95NAXXX
    7425026AX-ray exam of small bowel0.470.160.160.020.650.65XXX
    74250TCAX-ray exam of small bowel0.001.24NA0.061.30NAXXX
    74251AX-ray exam of small bowel0.691.48NA0.092.26NAXXX
    7425126AX-ray exam of small bowel0.690.240.240.030.960.96XXX
    74251TCAX-ray exam of small bowel0.001.24NA0.061.30NAXXX
    74260AX-ray exam of small bowel0.501.58NA0.092.17NAXXX
    7426026AX-ray exam of small bowel0.500.170.170.020.690.69XXX
    74260TCAX-ray exam of small bowel0.001.41NA0.071.48NAXXX
    74270AContrast x-ray exam of colon0.691.86NA0.122.67NAXXX
    7427026AContrast x-ray exam of colon0.690.240.240.030.960.96XXX
    74270TCAContrast x-ray exam of colon0.001.62NA0.091.71NAXXX
    74280AContrast x-ray exam of colon0.992.47NA0.153.61NAXXX
    7428026AContrast x-ray exam of colon0.990.350.350.041.381.38XXX
    74280TCAContrast x-ray exam of colon0.002.12NA0.112.23NAXXX
    74283AContrast x-ray exam of colon2.023.14NA0.215.37NAXXX
    7428326AContrast x-ray exam of colon2.020.710.710.092.822.82XXX
    74283TCAContrast x-ray exam of colon0.002.43NA0.122.55NAXXX
    74290AContrast x-ray, gallbladder0.320.81NA0.051.18NAXXX
    7429026AContrast x-ray, gallbladder0.320.110.110.010.440.44XXX
    74290TCAContrast x-ray, gallbladder0.000.70NA0.040.74NAXXX
    74291AContrast x-rays, gallbladder0.200.46NA0.030.69NAXXX
    7429126AContrast x-rays, gallbladder0.200.070.070.010.280.28XXX
    74291TCAContrast x-rays, gallbladder0.000.39NA0.020.41NAXXX
    74300CX-ray bile ducts/pancreas0.000.000.000.000.000.00XXX
    7430026AX-ray bile ducts/pancreas0.360.130.130.020.510.51XXX
    74300TCCX-ray bile ducts/pancreas0.000.000.000.000.000.00XXX
    74301CX-rays at surgery add-on0.000.000.000.000.000.00ZZZ
    7430126AX-rays at surgery add-on0.210.070.070.010.290.29ZZZ
    74301TCCX-rays at surgery add-on0.000.000.000.000.000.00ZZZ
    74305AX-ray bile ducts/pancreas0.420.89NA0.061.37NAXXX
    7430526AX-ray bile ducts/pancreas0.420.150.150.020.590.59XXX
    74305TCAX-ray bile ducts/pancreas0.000.74NA0.040.78NAXXX
    74320AContrast x-ray of bile ducts0.543.18NA0.163.88NAXXX
    7432026AContrast x-ray of bile ducts0.540.190.190.020.750.75XXX
    74320TCAContrast x-ray of bile ducts0.002.99NA0.143.13NAXXX
    74327AX-ray bile stone removal0.701.91NA0.122.73NAXXX
    7432726AX-ray bile stone removal0.700.240.240.030.970.97XXX
    74327TCAX-ray bile stone removal0.001.67NA0.091.76NAXXX
    74328AXray bile duct endoscopy0.703.24NA0.174.11NAXXX
    7432826AXray bile duct endoscopy0.700.250.250.030.980.98XXX
    74328TCAXray bile duct endoscopy0.002.99NA0.143.13NAXXX
    74329AX-ray for pancreas endoscopy0.703.24NA0.174.11NAXXX
    7432926AX-ray for pancreas endoscopy0.700.250.250.030.980.98XXX
    74329TCAX-ray for pancreas endoscopy0.002.99NA0.143.13NAXXX
    74330AX-ray bile/panc endoscopy0.903.31NA0.184.39NAXXX
    7433026AX-ray bile/panc endoscopy0.900.320.320.041.261.26XXX
    74330TCAX-ray bile/panc endoscopy0.002.99NA0.143.13NAXXX
    74340AX-ray guide for GI tube0.542.68NA0.143.36NAXXX
    7434026AX-ray guide for GI tube0.540.190.190.020.750.75XXX
    74340TCAX-ray guide for GI tube0.002.49NA0.122.61NAXXX
    74350AX-ray guide, stomach tube0.763.26NA0.174.19NAXXX
    7435026AX-ray guide, stomach tube0.760.270.270.031.061.06XXX
    74350TCAX-ray guide, stomach tube0.002.99NA0.143.13NAXXX
    74355AX-ray guide, intestinal tube0.762.75NA0.153.66NAXXX
    7435526AX-ray guide, intestinal tube0.760.260.260.031.051.05XXX
    74355TCAX-ray guide, intestinal tube0.002.49NA0.122.61NAXXX
    74360AX-ray guide, GI dilation0.543.18NA0.163.88NAXXX
    7436026AX-ray guide, GI dilation0.540.190.190.020.750.75XXX
    74360TCAX-ray guide, GI dilation0.002.99NA0.143.13NAXXX
    74363AX-ray, bile duct dilation0.886.10NA0.317.29NAXXX
    7436326AX-ray, bile duct dilation0.880.310.310.041.231.23XXX
    74363TCAX-ray, bile duct dilation0.005.79NA0.276.06NAXXX
    74400AContrst x-ray, urinary tract0.491.77NA0.112.37NAXXX
    7440026AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    74400TCAContrst x-ray, urinary tract0.001.60NA0.091.69NAXXX
    74410AContrst x-ray, urinary tract0.492.02NA0.112.62NAXXX
    7441026AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    Start Printed Page 55415
    74410TCAContrst x-ray, urinary tract0.001.85NA0.091.94NAXXX
    74415AContrst x-ray, urinary tract0.492.18NA0.122.79NAXXX
    7441526AContrst x-ray, urinary tract0.490.170.170.020.680.68XXX
    74415TCAContrst x-ray, urinary tract0.002.01NA0.102.11NAXXX
    74420AContrst x-ray, urinary tract0.362.62NA0.143.12NAXXX
    7442026AContrst x-ray, urinary tract0.360.130.130.020.510.51XXX
    74420TCAContrst x-ray, urinary tract0.002.49NA0.122.61NAXXX
    74425AContrst x-ray, urinary tract0.361.37NA0.081.81NAXXX
    7442526AContrst x-ray, urinary tract0.360.130.130.020.510.51XXX
    74425TCAContrst x-ray, urinary tract0.001.24NA0.061.30NAXXX
    74430AContrast x-ray, bladder0.321.11NA0.071.50NAXXX
    7443026AContrast x-ray, bladder0.320.110.110.020.450.45XXX
    74430TCAContrast x-ray, bladder0.001.00NA0.051.05NAXXX
    74440AX-ray, male genital tract0.381.20NA0.071.65NAXXX
    7444026AX-ray, male genital tract0.380.130.130.020.530.53XXX
    74440TCAX-ray, male genital tract0.001.07NA0.051.12NAXXX
    74445AX-ray exam of penis1.141.46NA0.102.70NAXXX
    7444526AX-ray exam of penis1.140.390.390.051.581.58XXX
    74445TCAX-ray exam of penis0.001.07NA0.051.12NAXXX
    74450AX-ray, urethra/bladder0.331.51NA0.091.93NAXXX
    7445026AX-ray, urethra/bladder0.330.120.120.020.470.47XXX
    74450TCAX-ray, urethra/bladder0.001.39NA0.071.46NAXXX
    74455AX-ray, urethra/bladder0.331.61NA0.102.04NAXXX
    7445526AX-ray, urethra/bladder0.330.110.110.020.460.46XXX
    74455TCAX-ray, urethra/bladder0.001.50NA0.081.58NAXXX
    74470AX-ray exam of kidney lesion0.541.37NA0.081.99NAXXX
    7447026AX-ray exam of kidney lesion0.540.190.190.020.750.75XXX
    74470TCAX-ray exam of kidney lesion0.001.18NA0.061.24NAXXX
    74475AX-ray control, cath insert0.544.06NA0.204.80NAXXX
    7447526AX-ray control, cath insert0.540.190.190.020.750.75XXX
    74475TCAX-ray control, cath insert0.003.87NA0.184.05NAXXX
    74480AX-ray control, cath insert0.544.06NA0.204.80NAXXX
    7448026AX-ray control, cath insert0.540.190.190.020.750.75XXX
    74480TCAX-ray control, cath insert0.003.87NA0.184.05NAXXX
    74485AX-ray guide, GU dilation0.543.18NA0.173.89NAXXX
    7448526AX-ray guide, GU dilation0.540.190.190.030.760.76XXX
    74485TCAX-ray guide, GU dilation0.002.99NA0.143.13NAXXX
    74710AX-ray measurement of pelvis0.341.12NA0.071.53NAXXX
    7471026AX-ray measurement of pelvis0.340.120.120.020.480.48XXX
    74710TCAX-ray measurement of pelvis0.001.00NA0.051.05NAXXX
    74740AX-ray, female genital tract0.381.37NA0.081.83NAXXX
    7474026AX-ray, female genital tract0.380.130.130.020.530.53XXX
    74740TCAX-ray, female genital tract0.001.24NA0.061.30NAXXX
    74742AX-ray, fallopian tube0.613.23NA0.164.00NAXXX
    7474226AX-ray, fallopian tube0.610.240.240.020.870.87XXX
    74742TCAX-ray, fallopian tube0.002.99NA0.143.13NAXXX
    74775AX-ray exam of perineum0.621.62NA0.102.34NAXXX
    7477526AX-ray exam of perineum0.620.230.230.030.880.88XXX
    74775TCAX-ray exam of perineum0.001.39NA0.071.46NAXXX
    75552AHeart mri for morph w/o dye1.6011.20NA0.5613.36NAXXX
    7555226AHeart mri for morph w/o dye1.600.560.560.072.232.23XXX
    75552TCAHeart mri for morph w/o dye0.0010.64NA0.4911.13NAXXX
    75553AHeart mri for morph w/dye2.0011.35NA0.5813.93NAXXX
    7555326AHeart mri for morph w/dye2.000.710.710.092.802.80XXX
    75553TCAHeart mri for morph w/dye0.0010.64NA0.4911.13NAXXX
    75554ACardiac MRI/function1.8311.33NA0.5613.72NAXXX
    7555426ACardiac MRI/function1.830.690.690.072.592.59XXX
    75554TCACardiac MRI/function0.0010.64NA0.4911.13NAXXX
    75555ACardiac MRI/limited study1.7411.32NA0.5613.62NAXXX
    7555526ACardiac MRI/limited study1.740.680.680.072.492.49XXX
    75555TCACardiac MRI/limited study0.0010.64NA0.4911.13NAXXX
    75556NCardiac MRI/flow mapping0.000.000.000.000.000.00XXX
    75600AContrast x-ray exam of aorta0.4912.16NA0.5613.21NAXXX
    7560026AContrast x-ray exam of aorta0.490.200.200.020.710.71XXX
    75600TCAContrast x-ray exam of aorta0.0011.96NA0.5412.50NAXXX
    75605AContrast x-ray exam of aorta1.1412.39NA0.5914.12NAXXX
    7560526AContrast x-ray exam of aorta1.140.430.430.051.621.62XXX
    75605TCAContrast x-ray exam of aorta0.0011.96NA0.5412.50NAXXX
    75625AContrast x-ray exam of aorta1.1412.37NA0.5914.10NAXXX
    7562526AContrast x-ray exam of aorta1.140.410.410.051.601.60XXX
    75625TCAContrast x-ray exam of aorta0.0011.96NA0.5412.50NAXXX
    75630AX-ray aorta, leg arteries1.7913.14NA0.6515.58NAXXX
    7563026AX-ray aorta, leg arteries1.790.670.670.082.542.54XXX
    Start Printed Page 55416
    75630TCAX-ray aorta, leg arteries0.0012.47NA0.5713.04NAXXX
    75635ACt angio abdominal arteries2.409.02NA0.4111.83NAXXX
    7563526ACt angio abdominal arteries2.400.960.960.093.453.45XXX
    75635TCACt angio abdominal arteries0.008.06NA0.328.38NAXXX
    75650AArtery x-rays, head & neck1.4912.49NA0.6114.59NAXXX
    7565026AArtery x-rays, head & neck1.490.530.530.072.092.09XXX
    75650TCAArtery x-rays, head & neck0.0011.96NA0.5412.50NAXXX
    75658AArtery x-rays, arm1.3112.44NA0.6014.35NAXXX
    7565826AArtery x-rays, arm1.310.480.480.061.851.85XXX
    75658TCAArtery x-rays, arm0.0011.96NA0.5412.50NAXXX
    75660AArtery x-rays, head & neck1.3112.44NA0.6014.35NAXXX
    7566026AArtery x-rays, head & neck1.310.480.480.061.851.85XXX
    75660TCAArtery x-rays, head & neck0.0011.96NA0.5412.50NAXXX
    75662AArtery x-rays, head & neck1.6612.60NA0.6214.88NAXXX
    7566226AArtery x-rays, head & neck1.660.640.640.082.382.38XXX
    75662TCAArtery x-rays, head & neck0.0011.96NA0.5412.50NAXXX
    75665AArtery x-rays, head & neck1.3112.43NA0.6114.35NAXXX
    7566526AArtery x-rays, head & neck1.310.470.470.071.851.85XXX
    75665TCAArtery x-rays, head & neck0.0011.96NA0.5412.50NAXXX
    75671AArtery x-rays, head & neck1.6612.55NA0.6214.83NAXXX
    7567126AArtery x-rays, head & neck1.660.590.590.082.332.33XXX
    75671TCAArtery x-rays, head & neck0.0011.96NA0.5412.50NAXXX
    75676AArtery x-rays, neck1.3112.43NA0.6114.35NAXXX
    7567626AArtery x-rays, neck1.310.470.470.071.851.85XXX
    75676TCAArtery x-rays, neck0.0011.96NA0.5412.50NAXXX
    75680AArtery x-rays, neck1.6612.55NA0.6214.83NAXXX
    7568026AArtery x-rays, neck1.660.590.590.082.332.33XXX
    75680TCAArtery x-rays, neck0.0011.96NA0.5412.50NAXXX
    75685AArtery x-rays, spine1.3112.43NA0.6014.34NAXXX
    7568526AArtery x-rays, spine1.310.470.470.061.841.84XXX
    75685TCAArtery x-rays, spine0.0011.96NA0.5412.50NAXXX
    75705AArtery x-rays, spine2.1812.75NA0.6515.58NAXXX
    7570526AArtery x-rays, spine2.180.790.790.113.083.08XXX
    75705TCAArtery x-rays, spine0.0011.96NA0.5412.50NAXXX
    75710AArtery x-rays, arm/leg1.1412.38NA0.6014.12NAXXX
    7571026AArtery x-rays, arm/leg1.140.420.420.061.621.62XXX
    75710TCAArtery x-rays, arm/leg0.0011.96NA0.5412.50NAXXX
    75716AArtery x-rays, arms/legs1.3112.43NA0.6014.34NAXXX
    7571626AArtery x-rays, arms/legs1.310.470.470.061.841.84XXX
    75716TCAArtery x-rays, arms/legs0.0011.96NA0.5412.50NAXXX
    75722AArtery x-rays, kidney1.1412.39NA0.5914.12NAXXX
    7572226AArtery x-rays, kidney1.140.430.430.051.621.62XXX
    75722TCAArtery x-rays, kidney0.0011.96NA0.5412.50NAXXX
    75724AArtery x-rays, kidneys1.4912.56NA0.5914.64NAXXX
    7572426AArtery x-rays, kidneys1.490.600.600.052.142.14XXX
    75724TCAArtery x-rays, kidneys0.0011.96NA0.5412.50NAXXX
    75726AArtery x-rays, abdomen1.1412.36NA0.5914.09NAXXX
    7572626AArtery x-rays, abdomen1.140.400.400.051.591.59XXX
    75726TCAArtery x-rays, abdomen0.0011.96NA0.5412.50NAXXX
    75731AArtery x-rays, adrenal gland1.1412.36NA0.5914.09NAXXX
    7573126AArtery x-rays, adrenal gland1.140.400.400.051.591.59XXX
    75731TCAArtery x-rays, adrenal gland0.0011.96NA0.5412.50NAXXX
    75733AArtery x-rays, adrenals1.3112.43NA0.6014.34NAXXX
    7573326AArtery x-rays, adrenals1.310.470.470.061.841.84XXX
    75733TCAArtery x-rays, adrenals0.0011.96NA0.5412.50NAXXX
    75736AArtery x-rays, pelvis1.1412.37NA0.5914.10NAXXX
    7573626AArtery x-rays, pelvis1.140.410.410.051.601.60XXX
    75736TCAArtery x-rays, pelvis0.0011.96NA0.5412.50NAXXX
    75741AArtery x-rays, lung1.3112.42NA0.6014.33NAXXX
    7574126AArtery x-rays, lung1.310.460.460.061.831.83XXX
    75741TCAArtery x-rays, lung0.0011.96NA0.5412.50NAXXX
    75743AArtery x-rays, lungs1.6612.54NA0.6114.81NAXXX
    7574326AArtery x-rays, lungs1.660.580.580.072.312.31XXX
    75743TCAArtery x-rays, lungs0.0011.96NA0.5412.50NAXXX
    75746AArtery x-rays, lung1.1412.36NA0.5914.09NAXXX
    7574626AArtery x-rays, lung1.140.400.400.051.591.59XXX
    75746TCAArtery x-rays, lung0.0011.96NA0.5412.50NAXXX
    75756AArtery x-rays, chest1.1412.44NA0.5814.16NAXXX
    7575626AArtery x-rays, chest1.140.480.480.041.661.66XXX
    75756TCAArtery x-rays, chest0.0011.96NA0.5412.50NAXXX
    75774AArtery x-ray, each vessel0.3612.09NA0.5613.01NAZZZ
    7577426AArtery x-ray, each vessel0.360.130.130.020.510.51ZZZ
    75774TCAArtery x-ray, each vessel0.0011.96NA0.5412.50NAZZZ
    Start Printed Page 55417
    75790AVisualize A-V shunt1.841.93NA0.163.93NAXXX
    7579026AVisualize A-V shunt1.840.640.640.092.572.57XXX
    75790TCAVisualize A-V shunt0.001.29NA0.071.36NAXXX
    75801ALymph vessel x-ray, arm/leg0.815.42NA0.296.52NAXXX
    7580126ALymph vessel x-ray, arm/leg0.810.280.280.051.141.14XXX
    75801TCALymph vessel x-ray, arm/leg0.005.14NA0.245.38NAXXX
    75803ALymph vessel x-ray,arms/legs1.175.55NA0.297.01NAXXX
    7580326ALymph vessel x-ray,arms/legs1.170.410.410.051.631.63XXX
    75803TCALymph vessel x-ray,arms/legs0.005.14NA0.245.38NAXXX
    75805ALymph vessel x-ray, trunk0.816.08NA0.317.20NAXXX
    7580526ALymph vessel x-ray, trunk0.810.290.290.041.141.14XXX
    75805TCALymph vessel x-ray, trunk0.005.79NA0.276.06NAXXX
    75807ALymph vessel x-ray, trunk1.176.20NA0.327.69NAXXX
    7580726ALymph vessel x-ray, trunk1.170.410.410.051.631.63XXX
    75807TCALymph vessel x-ray, trunk0.005.79NA0.276.06NAXXX
    75809ANonvascular shunt, x-ray0.470.91NA0.061.44NAXXX
    7580926ANonvascular shunt, x-ray0.470.170.170.020.660.66XXX
    75809TCANonvascular shunt, x-ray0.000.74NA0.040.78NAXXX
    75810AVein x-ray, spleen/liver1.1412.36NA0.6014.10NAXXX
    7581026AVein x-ray, spleen/liver1.140.400.400.061.601.60XXX
    75810TCAVein x-ray, spleen/liver0.0011.96NA0.5412.50NAXXX
    75820AVein x-ray, arm/leg0.701.15NA0.081.93NAXXX
    7582026AVein x-ray, arm/leg0.700.250.250.030.980.98XXX
    75820TCAVein x-ray, arm/leg0.000.90NA0.050.95NAXXX
    75822AVein x-ray, arms/legs1.061.77NA0.122.95NAXXX
    7582226AVein x-ray, arms/legs1.060.370.370.051.481.48XXX
    75822TCAVein x-ray, arms/legs0.001.40NA0.071.47NAXXX
    75825AVein x-ray, trunk1.1412.36NA0.6014.10NAXXX
    7582526AVein x-ray, trunk1.140.400.400.061.601.60XXX
    75825TCAVein x-ray, trunk0.0011.96NA0.5412.50NAXXX
    75827AVein x-ray, chest1.1412.36NA0.5914.09NAXXX
    7582726AVein x-ray, chest1.140.400.400.051.591.59XXX
    75827TCAVein x-ray, chest0.0011.96NA0.5412.50NAXXX
    75831AVein x-ray, kidney1.1412.36NA0.5914.09NAXXX
    7583126AVein x-ray, kidney1.140.400.400.051.591.59XXX
    75831TCAVein x-ray, kidney0.0011.96NA0.5412.50NAXXX
    75833AVein x-ray, kidneys1.4912.49NA0.6114.59NAXXX
    7583326AVein x-ray, kidneys1.490.530.530.072.092.09XXX
    75833TCAVein x-ray, kidneys0.0011.96NA0.5412.50NAXXX
    75840AVein x-ray, adrenal gland1.1412.38NA0.6114.13NAXXX
    7584026AVein x-ray, adrenal gland1.140.420.420.071.631.63XXX
    75840TCAVein x-ray, adrenal gland0.0011.96NA0.5412.50NAXXX
    75842AVein x-ray, adrenal glands1.4912.48NA0.6114.58NAXXX
    7584226AVein x-ray, adrenal glands1.490.520.520.072.082.08XXX
    75842TCAVein x-ray, adrenal glands0.0011.96NA0.5412.50NAXXX
    75860AVein x-ray, neck1.1412.39NA0.6014.13NAXXX
    7586026AVein x-ray, neck1.140.430.430.061.631.63XXX
    75860TCAVein x-ray, neck0.0011.96NA0.5412.50NAXXX
    75870AVein x-ray, skull1.1412.38NA0.6014.12NAXXX
    7587026AVein x-ray, skull1.140.420.420.061.621.62XXX
    75870TCAVein x-ray, skull0.0011.96NA0.5412.50NAXXX
    75872AVein x-ray, skull1.1412.36NA0.5914.09NAXXX
    7587226AVein x-ray, skull1.140.400.400.051.591.59XXX
    75872TCAVein x-ray, skull0.0011.96NA0.5412.50NAXXX
    75880AVein x-ray, eye socket0.701.17NA0.081.95NAXXX
    7588026AVein x-ray, eye socket0.700.270.270.031.001.00XXX
    75880TCAVein x-ray, eye socket0.000.90NA0.050.95NAXXX
    75885AVein x-ray, liver1.4412.46NA0.6014.50NAXXX
    7588526AVein x-ray, liver1.440.500.500.062.002.00XXX
    75885TCAVein x-ray, liver0.0011.96NA0.5412.50NAXXX
    75887AVein x-ray, liver1.4412.46NA0.6014.50NAXXX
    7588726AVein x-ray, liver1.440.500.500.062.002.00XXX
    75887TCAVein x-ray, liver0.0011.96NA0.5412.50NAXXX
    75889AVein x-ray, liver1.1412.36NA0.5914.09NAXXX
    7588926AVein x-ray, liver1.140.400.400.051.591.59XXX
    75889TCAVein x-ray, liver0.0011.96NA0.5412.50NAXXX
    75891AVein x-ray, liver1.1412.36NA0.5914.09NAXXX
    7589126AVein x-ray, liver1.140.400.400.051.591.59XXX
    75891TCAVein x-ray, liver0.0011.96NA0.5412.50NAXXX
    75893AVenous sampling by catheter0.5412.15NA0.5613.25NAXXX
    7589326AVenous sampling by catheter0.540.190.190.020.750.75XXX
    75893TCAVenous sampling by catheter0.0011.96NA0.5412.50NAXXX
    75894AX-rays, transcath therapy1.3123.38NA1.1225.81NAXXX
    Start Printed Page 55418
    7589426AX-rays, transcath therapy1.310.460.460.071.841.84XXX
    75894TCAX-rays, transcath therapy0.0022.92NA1.0523.97NAXXX
    75896AX-rays, transcath therapy1.3120.42NA0.9722.70NAXXX
    7589626AX-rays, transcath therapy1.310.480.480.061.851.85XXX
    75896TCAX-rays, transcath therapy0.0019.94NA0.9120.85NAXXX
    75898AFollow-up angiography1.651.60NA0.123.37NAXXX
    7589826AFollow-up angiography1.650.600.600.072.322.32XXX
    75898TCAFollow-up angiography0.001.00NA0.051.05NAXXX
    75900AArterial catheter exchange0.4920.09NA0.9421.52NAXXX
    7590026AArterial catheter exchange0.490.170.170.020.680.68XXX
    75900TCAArterial catheter exchange0.0019.92NA0.9220.84NAXXX
    75940AX-ray placement, vein filter0.5412.15NA0.5713.26NAXXX
    7594026AX-ray placement, vein filter0.540.190.190.030.760.76XXX
    75940TCAX-ray placement, vein filter0.0011.96NA0.5412.50NAXXX
    75945AIntravascular us0.404.48NA0.235.11NAXXX
    7594526AIntravascular us0.400.150.150.030.580.58XXX
    75945TCAIntravascular us0.004.33NA0.204.53NAXXX
    75946AIntravascular us add-on0.402.32NA0.142.86NAZZZ
    7594626AIntravascular us add-on0.400.140.140.030.570.57ZZZ
    75946TCAIntravascular us add-on0.002.18NA0.112.29NAZZZ
    75952CEndovasc repair abdom aorta+0.000.000.000.000.000.00XXX
    7595226AEndovasc repair abdom aorta4.501.801.800.686.986.98XXX
    75952TCCEndovasc repair abdom aorta0.000.000.000.000.000.00XXX
    75953CAbdom aneurysm endovas rpr+0.000.000.000.000.000.00XXX
    7595326AAbdom aneurysm endovas rpr1.360.540.540.682.582.58XXX
    75953TCCAbdom aneurysm endovas rpr0.000.000.000.000.000.00XXX
    75960ATranscatheter intro, stent0.8214.45NA0.6815.95NAXXX
    7596026ATranscatheter intro, stent0.820.300.300.041.161.16XXX
    75960TCATranscatheter intro, stent0.0014.15NA0.6414.79NAXXX
    75961ARetrieval, broken catheter4.2511.46NA0.6416.35NAXXX
    7596126ARetrieval, broken catheter4.251.491.490.185.925.92XXX
    75961TCARetrieval, broken catheter0.009.97NA0.4610.43NAXXX
    75962ARepair arterial blockage0.5415.15NA0.7216.41NAXXX
    7596226ARepair arterial blockage0.540.200.200.030.770.77XXX
    75962TCARepair arterial blockage0.0014.95NA0.6915.64NAXXX
    75964ARepair artery blockage, each0.368.10NA0.388.84NAZZZ
    7596426ARepair artery blockage, each0.360.130.130.020.510.51ZZZ
    75964TCARepair artery blockage, each0.007.97NA0.368.33NAZZZ
    75966ARepair arterial blockage1.3115.45NA0.7517.51NAXXX
    7596626ARepair arterial blockage1.310.500.500.061.871.87XXX
    75966TCARepair arterial blockage0.0014.95NA0.6915.64NAXXX
    75968ARepair artery blockage, each0.368.11NA0.378.84NAZZZ
    7596826ARepair artery blockage, each0.360.140.140.010.510.51ZZZ
    75968TCARepair artery blockage, each0.007.97NA0.368.33NAZZZ
    75970AVascular biopsy0.8311.26NA0.5412.63NAXXX
    7597026AVascular biopsy0.830.300.300.041.171.17XXX
    75970TCAVascular biopsy0.0010.96NA0.5011.46NAXXX
    75978ARepair venous blockage0.5415.14NA0.7116.39NAXXX
    7597826ARepair venous blockage0.540.190.190.020.750.75XXX
    75978TCARepair venous blockage0.0014.95NA0.6915.64NAXXX
    75980AContrast xray exam bile duct1.445.64NA0.307.38NAXXX
    7598026AContrast xray exam bile duct1.440.500.500.062.002.00XXX
    75980TCAContrast xray exam bile duct0.005.14NA0.245.38NAXXX
    75982AContrast xray exam bile duct1.446.29NA0.338.06NAXXX
    7598226AContrast xray exam bile duct1.440.500.500.062.002.00XXX
    75982TCAContrast xray exam bile duct0.005.79NA0.276.06NAXXX
    75984AXray control catheter change0.722.10NA0.122.94NAXXX
    7598426AXray control catheter change0.720.250.250.031.001.00XXX
    75984TCAXray control catheter change0.001.85NA0.091.94NAXXX
    75989AAbscess drainage under x-ray1.193.41NA0.194.79NAXXX
    7598926AAbscess drainage under x-ray1.190.420.420.051.661.66XXX
    75989TCAAbscess drainage under x-ray0.002.99NA0.143.13NAXXX
    75992AAtherectomy, x-ray exam0.5415.15NA0.7116.40NAXXX
    7599226AAtherectomy, x-ray exam0.540.200.200.020.760.76XXX
    75992TCAAtherectomy, x-ray exam0.0014.95NA0.6915.64NAXXX
    75993AAtherectomy, x-ray exam0.368.11NA0.378.84NAZZZ
    7599326AAtherectomy, x-ray exam0.360.140.140.010.510.51ZZZ
    75993TCAAtherectomy, x-ray exam0.007.97NA0.368.33NAZZZ
    75994AAtherectomy, x-ray exam1.3115.45NA0.7517.51NAXXX
    7599426AAtherectomy, x-ray exam1.310.500.500.061.871.87XXX
    75994TCAAtherectomy, x-ray exam0.0014.95NA0.6915.64NAXXX
    75995AAtherectomy, x-ray exam1.3115.42NA0.7517.48NAXXX
    7599526AAtherectomy, x-ray exam1.310.470.470.061.841.84XXX
    Start Printed Page 55419
    75995TCAAtherectomy, x-ray exam0.0014.95NA0.6915.64NAXXX
    75996AAtherectomy, x-ray exam0.368.09NA0.378.82NAZZZ
    7599626AAtherectomy, x-ray exam0.360.120.120.010.490.49ZZZ
    75996TCAAtherectomy, x-ray exam0.007.97NA0.368.33NAZZZ
    76000AFluoroscope examination0.171.31NA0.071.55NAXXX
    7600026AFluoroscope examination0.170.070.070.010.250.25XXX
    76000TCAFluoroscope examination0.001.24NA0.061.30NAXXX
    76001AFluoroscope exam, extensive0.672.73NA0.153.55NAXXX
    7600126AFluoroscope exam, extensive0.670.240.240.030.940.94XXX
    76001TCAFluoroscope exam, extensive0.002.49NA0.122.61NAXXX
    76003ANeedle localization by x-ray0.541.43NA0.092.06NAXXX
    7600326ANeedle localization by x-ray0.540.190.190.030.760.76XXX
    76003TCANeedle localization by x-ray0.001.24NA0.061.30NAXXX
    76005AFluoroguide for spine inject0.601.41NA0.092.10NAXXX
    7600526AFluoroguide for spine inject0.600.170.170.030.800.80XXX
    76005TCAFluoroguide for spine inject0.001.24NA0.061.30NAXXX
    76006AX-ray stress view0.410.200.200.040.650.65XXX
    76010AX-ray, nose to rectum0.180.56NA0.030.77NAXXX
    7601026AX-ray, nose to rectum0.180.060.060.010.250.25XXX
    76010TCAX-ray, nose to rectum0.000.50NA0.020.52NAXXX
    76012CPercut vertebroplasty fluor+0.000.000.000.000.000.00XXX
    7601226APercut vertebroplasty fluor1.310.520.520.232.062.06XXX
    76012TCCPercut vertebroplasty fluor0.000.000.000.000.000.00XXX
    76013CPercut vertebroplasty, ct+0.000.000.000.000.000.00XXX
    7601326APercut vertebroplasty, ct1.380.550.550.482.412.41XXX
    76013TCCPercut vertebroplasty, ct0.000.000.000.000.000.00XXX
    76020AX-rays for bone age0.190.57NA0.030.79NAXXX
    7602026AX-rays for bone age0.190.070.070.010.270.27XXX
    76020TCAX-rays for bone age0.000.50NA0.020.52NAXXX
    76040AX-rays, bone evaluation0.270.84NA0.071.18NAXXX
    7604026AX-rays, bone evaluation0.270.100.100.030.400.40XXX
    76040TCAX-rays, bone evaluation0.000.74NA0.040.78NAXXX
    76061AX-rays, bone survey0.451.11NA0.071.63NAXXX
    7606126AX-rays, bone survey0.450.160.160.020.630.63XXX
    76061TCAX-rays, bone survey0.000.95NA0.051.00NAXXX
    76062AX-rays, bone survey0.541.56NA0.092.19NAXXX
    7606226AX-rays, bone survey0.540.190.190.020.750.75XXX
    76062TCAX-rays, bone survey0.001.37NA0.071.44NAXXX
    76065AX-rays, bone evaluation0.700.95NA0.051.70NAXXX
    7606526AX-rays, bone evaluation0.700.250.250.010.960.96XXX
    76065TCAX-rays, bone evaluation0.000.70NA0.040.74NAXXX
    76066AJoint survey, single view0.311.17NA0.071.55NAXXX
    7606626AJoint survey, single view0.310.110.110.020.440.44XXX
    76066TCAJoint survey, single view0.001.06NA0.051.11NAXXX
    76070ICT scan, bone density study+0.252.90NA0.143.29NAXXX
    7607026ICT scan, bone density study+0.250.100.100.010.360.36XXX
    76070TCICT scan, bone density study+0.002.80NA0.132.93NAXXX
    76075AUs exam, abdom, limited0.303.05NA0.153.50NAXXX
    7607526AUs exam, abdom, limited0.300.110.110.010.420.42XXX
    76075TCAUs exam, abdom, limited0.002.94NA0.143.08NAXXX
    76076ADual energy x-ray study0.220.80NA0.051.07NAXXX
    7607626ADual energy x-ray study0.220.080.080.010.310.31XXX
    76076TCADual energy x-ray study0.000.72NA0.040.76NAXXX
    76078ARadiographic absorptiometry0.200.80NA0.051.05NAXXX
    7607826ARadiographic absorptiometry0.200.080.080.010.290.29XXX
    76078TCARadiographic absorptiometry0.000.72NA0.040.76NAXXX
    76080AX-ray exam of fistula0.541.19NA0.071.80NAXXX
    7608026AX-ray exam of fistula0.540.190.190.020.750.75XXX
    76080TCAX-ray exam of fistula0.001.00NA0.051.05NAXXX
    76085AComputer mammogram add-on0.060.31NA0.020.39NAZZZ
    7608526AComputer mammogram add-on0.060.020.020.010.090.09ZZZ
    76085TCAComputer mammogram add-on0.000.29NA0.010.30NAXXX
    76086AX-ray of mammary duct0.362.62NA0.143.12NAXXX
    7608626AX-ray of mammary duct0.360.130.130.020.510.51XXX
    76086TCAX-ray of mammary duct0.002.49NA0.122.61NAXXX
    76088AX-ray of mammary ducts0.453.64NA0.184.27NAXXX
    7608826AX-ray of mammary ducts0.450.160.160.020.630.63XXX
    76088TCAX-ray of mammary ducts0.003.48NA0.163.64NAXXX
    76090AMammogram, one breast0.701.25NA0.082.03NAXXX
    7609026AMammogram, one breast0.700.250.250.030.980.98XXX
    76090TCAMammogram, one breast0.001.00NA0.051.05NAXXX
    76091AMammogram, both breasts0.871.54NA0.092.50NAXXX
    7609126AMammogram, both breasts0.870.300.300.031.201.20XXX
    Start Printed Page 55420
    76091TCAMammogram, both breasts0.001.24NA0.061.30NAXXX
    76092AMammogram, screening0.701.44NA0.092.23NAXXX
    7609226AMammogram, screening0.700.250.250.030.980.98XXX
    76092TCAMammogram, screening0.001.19NA0.061.25NAXXX
    76093AMagnetic image, breast1.6317.31NA0.8319.77NAXXX
    7609326AMagnetic image, breast1.630.570.570.072.272.27XXX
    76093TCAMagnetic image, breast0.0016.74NA0.7617.50NAXXX
    76094AMagnetic image, both breasts1.6323.28NA1.1026.01NAXXX
    7609426AMagnetic image, both breasts1.630.570.570.072.272.27XXX
    76094TCAMagnetic image, both breasts0.0022.71NA1.0323.74NAXXX
    76095AStereotactic breast biopsy1.597.36NA0.409.35NAXXX
    7609526AStereotactic breast biopsy1.590.560.560.092.242.24XXX
    76095TCAStereotactic breast biopsy0.006.80NA0.317.11NAXXX
    76096AX-ray of needle wire, breast0.561.44NA0.092.09NAXXX
    7609626AX-ray of needle wire, breast0.560.200.200.030.790.79XXX
    76096TCAX-ray of needle wire, breast0.001.24NA0.061.30NAXXX
    76098AX-ray exam, breast specimen0.160.45NA0.030.64NAXXX
    7609826AX-ray exam, breast specimen0.160.060.060.010.230.23XXX
    76098TCAX-ray exam, breast specimen0.000.39NA0.020.41NAXXX
    76100AX-ray exam of body section0.581.38NA0.092.05NAXXX
    7610026AX-ray exam of body section0.580.200.200.030.810.81XXX
    76100TCAX-ray exam of body section0.001.18NA0.061.24NAXXX
    76101AComplex body section x-ray0.581.55NA0.102.23NAXXX
    7610126AComplex body section x-ray0.580.200.200.030.810.81XXX
    76101TCAComplex body section x-ray0.001.35NA0.071.42NAXXX
    76102AComplex body section x-rays0.581.84NA0.122.54NAXXX
    7610226AComplex body section x-rays0.580.200.200.030.810.81XXX
    76102TCAComplex body section x-rays0.001.64NA0.091.73NAXXX
    76120ACine/video x-rays0.381.14NA0.071.59NAXXX
    7612026ACine/video x-rays0.380.140.140.020.540.54XXX
    76120TCACine/video x-rays0.001.00NA0.051.05NAXXX
    76125ACine/ video x-rays add-on0.270.84NA0.051.16NAZZZ
    7612526ACine/ video x-rays add-on0.270.100.100.010.380.38ZZZ
    76125TCACine/ video x-rays add-on0.000.74NA0.040.78NAZZZ
    76140IX-ray consultation0.000.000.000.000.000.00XXX
    76150AX-ray exam, dry process0.000.39NA0.020.41NAXXX
    76350CSpecial x-ray contrast study0.000.000.000.000.000.00XXX
    76355ACAT scan for localization1.218.28NA0.419.90NAXXX
    7635526ACAT scan for localization1.210.440.440.061.711.71XXX
    76355TCACAT scan for localization0.007.84NA0.358.19NAXXX
    76360ACAT scan for needle biopsy1.168.24NA0.409.80NAXXX
    7636026ACAT scan for needle biopsy1.160.400.400.051.611.61XXX
    76360TCACAT scan for needle biopsy0.007.84NA0.358.19NAXXX
    76362ACat scan for tissue ablation4.009.24NA1.3814.62NAXXX
    7636226ACat scan for tissue ablation4.001.401.400.175.575.57XXX
    76362TCACat scan for tissue ablation0.007.84NA1.219.05NAXXX
    76370ACAT scan for therapy guide0.853.10NA0.174.12NAXXX
    7637026ACAT scan for therapy guide0.850.300.300.041.191.19XXX
    76370TCACAT scan for therapy guide0.002.80NA0.132.93NAXXX
    76375A3d/holograph reconstr add-on0.163.42NA0.163.74NAXXX
    7637526A3d/holograph reconstr add-on0.160.060.060.010.230.23XXX
    76375TCA3d/holograph reconstr add-on0.003.36NA0.153.51NAXXX
    76380ACAT scan follow-up study0.983.66NA0.194.83NAXXX
    7638026ACAT scan follow-up study0.980.340.340.041.361.36XXX
    76380TCACAT scan follow-up study0.003.32NA0.153.47NAXXX
    76390AMr spectroscopy1.4011.14NA0.5513.09NAXXX
    7639026AMr spectroscopy1.400.500.500.061.961.96XXX
    76390TCAMr spectroscopy0.0010.64NA0.4911.13NAXXX
    76393AMr guidance for needle place1.5011.16NA0.5313.19NAXXX
    7639326AMr guidance for needle place1.500.520.520.072.092.09XXX
    76393TCAMr guidance for needle place0.0010.64NA0.4611.10NAXXX
    76394AMri for tissue ablation4.2512.13NA1.4317.81NAXXX
    7639426AMri for tissue ablation4.251.491.490.145.885.88XXX
    76394TCAMri for tissue ablation0.0010.64NA1.2911.93NAXXX
    76400AMagnetic image, bone marrow1.6011.20NA0.5613.36NAXXX
    7640026AMagnetic image, bone marrow1.600.560.560.072.232.23XXX
    76400TCAMagnetic image, bone marrow0.0010.64NA0.4911.13NAXXX
    76490AUs for tissue ablation2.002.13NA0.364.49NAXXX
    7649026AUs for tissue ablation2.000.690.690.122.812.81XXX
    76490TCAUs for tissue ablation0.001.44NA0.241.68NAXXX
    76499CRadiographic procedure0.000.000.000.000.000.00XXX
    7649926CRadiographic procedure0.000.000.000.000.000.00XXX
    76499TCCRadiographic procedure0.000.000.000.000.000.00XXX
    Start Printed Page 55421
    76506AEcho exam of head0.631.61NA0.102.34NAXXX
    7650626AEcho exam of head0.630.260.260.030.920.92XXX
    76506TCAEcho exam of head0.001.35NA0.071.42NAXXX
    76511AEcho exam of eye0.942.37NA0.083.39NAXXX
    7651126AEcho exam of eye0.940.450.450.021.411.41XXX
    76511TCAEcho exam of eye0.001.92NA0.061.98NAXXX
    76512AEcho exam of eye0.662.49NA0.093.24NAXXX
    7651226AEcho exam of eye0.660.310.310.010.980.98XXX
    76512TCAEcho exam of eye0.002.18NA0.082.26NAXXX
    76513AEcho exam of eye, water bath0.662.90NA0.093.65NAXXX
    7651326AEcho exam of eye, water bath0.660.320.320.010.990.99XXX
    76513TCAEcho exam of eye, water bath0.002.58NA0.082.66NAXXX
    76516AEcho exam of eye0.542.04NA0.072.65NAXXX
    7651626AEcho exam of eye0.540.260.260.010.810.81XXX
    76516TCAEcho exam of eye0.001.78NA0.061.84NAXXX
    76519AEcho exam of eye0.541.91NA0.072.52NAXXX
    7651926AEcho exam of eye0.540.260.260.010.810.81XXX
    76519TCAEcho exam of eye0.001.65NA0.061.71NAXXX
    76529AEcho exam of eye0.572.70NA0.083.35NAXXX
    7652926AEcho exam of eye0.570.270.270.010.850.85XXX
    76529TCAEcho exam of eye0.002.43NA0.072.50NAXXX
    76536AUs exam of head and neck0.561.55NA0.092.20NAXXX
    7653626AUs exam of head and neck0.560.200.200.020.780.78XXX
    76536TCAUs exam of head and neck0.001.35NA0.071.42NAXXX
    76604AUs exam, chest, b-scan0.551.43NA0.082.06NAXXX
    7660426AUs exam, chest, b-scan0.550.190.190.020.760.76XXX
    76604TCAUs exam, chest, b-scan0.001.24NA0.061.30NAXXX
    76645AUs exam, breast(s)0.541.19NA0.081.81NAXXX
    7664526AUs exam, breast(s)0.540.190.190.030.760.76XXX
    76645TCAUs exam, breast(s)0.001.00NA0.051.05NAXXX
    76700AUs exam, abdom, complete0.812.15NA0.133.09NAXXX
    7670026AUs exam, abdom, complete0.810.280.280.041.131.13XXX
    76700TCAUs exam, abdom, complete0.001.87NA0.091.96NAXXX
    76705AUs exam, abdom, limited0.591.56NA0.102.25NAXXX
    7670526AUs exam, abdom, limited0.590.210.210.030.830.83XXX
    76705TCAUs exam, abdom, limited0.001.35NA0.071.42NAXXX
    76770AUs exam abdo back wall, comp0.742.13NA0.122.99NAXXX
    7677026AUs exam abdo back wall, comp0.740.260.260.031.031.03XXX
    76770TCAUs exam abdo back wall, comp0.001.87NA0.091.96NAXXX
    76775AUs exam abdo back wall, lim0.581.55NA0.102.23NAXXX
    7677526AUs exam abdo back wall, lim0.580.200.200.030.810.81XXX
    76775TCAUs exam abdo back wall, lim0.001.35NA0.071.42NAXXX
    76778AUs exam kidney transplant0.742.13NA0.122.99NAXXX
    7677826AUs exam kidney transplant0.740.260.260.031.031.03XXX
    76778TCAUs exam kidney transplant0.001.87NA0.091.96NAXXX
    76800AUs exam, spinal canal1.131.73NA0.112.97NAXXX
    7680026AUs exam, spinal canal1.130.380.380.041.551.55XXX
    76800TCAUs exam, spinal canal0.001.35NA0.071.42NAXXX
    76805AUs exam, pg uterus, compl0.992.35NA0.143.48NAXXX
    7680526AUs exam, pg uterus, compl0.990.360.360.041.391.39XXX
    76805TCAUs exam, pg uterus, compl0.001.99NA0.102.09NAXXX
    76810AUs exam, pg uterus, mult1.974.74NA0.256.96NAXXX
    7681026AUs exam, pg uterus, mult1.970.750.750.072.792.79XXX
    76810TCAUs exam, pg uterus, mult0.003.99NA0.184.17NAXXX
    76815AUs exam, pg uterus limit0.651.60NA0.092.34NAXXX
    7681526AUs exam, pg uterus limit0.650.250.250.020.920.92XXX
    76815TCAUs exam, pg uterus limit0.001.35NA0.071.42NAXXX
    76816AUs exam pg uterus repeat0.571.28NA0.071.92NAXXX
    7681626AUs exam pg uterus repeat0.570.220.220.020.810.81XXX
    76816TCAUs exam pg uterus repeat0.001.06NA0.051.11NAXXX
    76818AFetal biophy profile w/nst1.051.94NA0.123.11NAXXX
    7681826AFetal biophy profile w/nst1.050.410.410.041.501.50XXX
    76818TCAFetal biophy profile w/nst0.001.53NA0.081.61NAXXX
    76819AFetal biophys profil w/o nst0.771.83NA0.102.70NAXXX
    7681926AFetal biophys profil w/o nst0.770.300.300.021.091.09XXX
    76819TCAFetal biophys profil w/o nst0.001.53NA0.081.61NAXXX
    76825AEcho exam of fetal heart1.672.50NA0.154.32NAXXX
    7682526AEcho exam of fetal heart1.670.630.630.062.362.36XXX
    76825TCAEcho exam of fetal heart0.001.87NA0.091.96NAXXX
    76826AEcho exam of fetal heart0.830.97NA0.071.87NAXXX
    7682626AEcho exam of fetal heart0.830.300.300.031.161.16XXX
    76826TCAEcho exam of fetal heart0.000.67NA0.040.71NAXXX
    76827AEcho exam of fetal heart0.581.85NA0.122.55NAXXX
    Start Printed Page 55422
    7682726AEcho exam of fetal heart0.580.220.220.020.820.82XXX
    76827TCAEcho exam of fetal heart0.001.63NA0.101.73NAXXX
    76828AEcho exam of fetal heart0.561.29NA0.091.94NAXXX
    7682826AEcho exam of fetal heart0.560.230.230.020.810.81XXX
    76828TCAEcho exam of fetal heart0.001.06NA0.071.13NAXXX
    76830AUs exam, transvaginal0.691.68NA0.112.48NAXXX
    7683026AUs exam, transvaginal0.690.240.240.030.960.96XXX
    76830TCAUs exam, transvaginal0.001.44NA0.081.52NAXXX
    76831AEcho exam, uterus0.721.71NA0.102.53NAXXX
    7683126AEcho exam, uterus0.720.270.270.021.011.01XXX
    76831TCAEcho exam, uterus0.001.44NA0.081.52NAXXX
    76856AUs exam, pelvic, complete0.691.68NA0.112.48NAXXX
    7685626AUs exam, pelvic, complete0.690.240.240.030.960.96XXX
    76856TCAUs exam, pelvic, complete0.001.44NA0.081.52NAXXX
    76857AUs exam, pelvic, limited0.381.13NA0.071.58NAXXX
    7685726AUs exam, pelvic, limited0.380.130.130.020.530.53XXX
    76857TCAUs exam, pelvic, limited0.001.00NA0.051.05NAXXX
    76870AUs exam, scrotum0.641.66NA0.112.41NAXXX
    7687026AUs exam, scrotum0.640.220.220.030.890.89XXX
    76870TCAUs exam, scrotum0.001.44NA0.081.52NAXXX
    76872AEcho exam, transrectal0.691.68NA0.122.49NAXXX
    7687226AEcho exam, transrectal0.690.240.240.040.970.97XXX
    76872TCAEcho exam, transrectal0.001.44NA0.081.52NAXXX
    76873AEchograp trans r, pros study1.552.53NA0.214.29NAXXX
    7687326AEchograp trans r, pros study1.550.540.540.082.172.17XXX
    76873TCAEchograp trans r, pros study0.001.99NA0.132.12NAXXX
    76880AUs exam, extremity0.591.56NA0.102.25NAXXX
    7688026AUs exam, extremity0.590.210.210.030.830.83XXX
    76880TCAUs exam, extremity0.001.35NA0.071.42NAXXX
    76885AUs exam infant hips, dynamic0.741.70NA0.112.55NAXXX
    688526AUs exam infant hips, dynamic0.740.260.260.031.031.03XXX
    76885TCAUs exam infant hips, dynamic0.001.44NA0.081.52NAXXX
    76886AUs exam infant hips, static0.621.57NA0.102.29NAXXX
    7688626AUs exam infant hips, static0.620.220.220.030.870.87XXX
    76886TCAUs exam infant hips, static0.001.35NA0.071.42NAXXX
    76930AEcho guide, cardiocentesis0.671.71NA0.102.48NAXXX
    7693026AEcho guide, cardiocentesis0.670.270.270.020.960.96XXX
    76930TCAEcho guide, cardiocentesis0.001.44NA0.081.52NAXXX
    76932AEcho guide for heart biopsy0.671.71NA0.102.48NAXXX
    7693226AEcho guide for heart biopsy0.670.270.270.020.960.96XXX
    76932TCAEcho guide for heart biopsy0.001.44NA0.081.52NAXXX
    76936AEcho guide for artery repair1.996.68NA0.399.06NAXXX
    7693626AEcho guide for artery repair1.990.700.700.112.802.80XXX
    76936TCAEcho guide for artery repair0.005.98NA0.286.26NAXXX
    76941AEcho guide for transfusion1.341.98NA0.133.45NAXXX
    7694126AEcho guide for transfusion1.340.530.530.061.931.93XXX
    76941TCAEcho guide for transfusion0.001.45NA0.071.52NAXXX
    76942AEcho guide for biopsy0.671.67NA0.122.46NAXXX
    7694226AEcho guide for biopsy0.670.230.230.040.940.94XXX
    76942TCAEcho guide for biopsy0.001.44NA0.081.52NAXXX
    76945AEcho guide, villus sampling0.671.69NA0.102.46NAXXX
    7694526AEcho guide, villus sampling0.670.240.240.030.940.94XXX
    76945TCAEcho guide, villus sampling0.001.45NA0.071.52NAXXX
    76946AEcho guide for amniocentesis0.381.59NA0.092.06NAXXX
    7694626AEcho guide for amniocentesis0.380.150.150.010.540.54XXX
    76946TCAEcho guide for amniocentesis0.001.44NA0.081.52NAXXX
    76948AEcho guide, ova aspiration0.381.57NA0.102.05NAXXX
    7694826AEcho guide, ova aspiration0.380.130.130.020.530.53XXX
    76948TCAEcho guide, ova aspiration0.001.44NA0.081.52NAXXX
    76950AEcho guidance radiotherapy0.581.45NA0.092.12NAXXX
    7695026AEcho guidance radiotherapy0.580.210.210.030.820.82XXX
    76950TCAEcho guidance radiotherapy0.001.24NA0.061.30NAXXX
    76965AEcho guidance radiotherapy1.345.75NA0.317.40NAXXX
    7696526AEcho guidance radiotherapy1.340.460.460.071.871.87XXX
    76965TCAEcho guidance radiotherapy0.005.29NA0.245.53NAXXX
    76970AUltrasound exam follow-up0.401.14NA0.071.61NAXXX
    7697026AUltrasound exam follow-up0.400.140.140.020.560.56XXX
    76970TCAUltrasound exam follow-up0.001.00NA0.051.05NAXXX
    76975AGI endoscopic ultrasound0.811.73NA0.112.65NAXXX
    7697526AGI endoscopic ultrasound0.810.290.290.031.131.13XXX
    76975TCAGI endoscopic ultrasound0.001.44NA0.081.52NAXXX
    76977AUs bone density measure0.050.80NA0.050.90NAXXX
    7697726AUs bone density measure0.050.020.020.010.080.08XXX
    Start Printed Page 55423
    76977TCAUs bone density measure0.000.78NA0.040.82NAXXX
    76986AUltrasound guide intraoper1.202.91NA0.194.30NAXXX
    7698626AUltrasound guide intraoper1.200.420.420.071.691.69XXX
    76986TCAUltrasound guide intraoper0.002.49NA0.122.61NAXXX
    76999CEcho examination procedure0.000.000.000.000.000.00XXX
    7699926CEcho examination procedure0.000.000.000.000.000.00XXX
    76999TCCEcho examination procedure0.000.000.000.000.000.00XXX
    77261ARadiation therapy planning1.390.560.560.062.012.01XXX
    77262ARadiation therapy planning2.110.820.820.093.023.02XXX
    77263ARadiation therapy planning3.141.231.230.134.504.50XXX
    77280ASet radiation therapy field0.703.55NA0.184.43NAXXX
    7728026ASet radiation therapy field0.700.250.250.030.980.98XXX
    77280TCASet radiation therapy field0.003.30NA0.153.45NAXXX
    77285ASet radiation therapy field1.055.67NA0.297.01NAXXX
    7728526ASet radiation therapy field1.050.380.380.041.471.47XXX
    77285TCASet radiation therapy field0.005.29NA0.255.54NAXXX
    77290ASet radiation therapy field1.566.74NA0.358.65NAXXX
    7729026ASet radiation therapy field1.560.560.560.062.182.18XXX
    77290TCASet radiation therapy field0.006.18NA0.296.47NAXXX
    77295ASet radiation therapy field4.5728.18NA1.4134.16NAXXX
    7729526ASet radiation therapy field4.571.651.650.186.406.40XXX
    77295TCASet radiation therapy field0.0026.53NA1.2327.76NAXXX
    77299CRadiation therapy planning0.000.000.000.000.000.00XXX
    7729926CRadiation therapy planning0.000.000.000.000.000.00XXX
    77299TCCRadiation therapy planning0.000.000.000.000.000.00XXX
    77300ARadiation therapy dose plan0.621.50NA0.092.21NAXXX
    7730026ARadiation therapy dose plan0.620.220.220.030.870.87XXX
    77300TCARadiation therapy dose plan0.001.28NA0.061.34NAXXX
    77301ARadioltherapy dos plan, imrt8.0029.72NA1.4139.13NAXXX
    7730126ARadioltherapy dos plan, imrt8.003.193.190.1811.3711.37XXX
    77301TCARadioltherapy dos plan, imrt0.0026.53NA1.2327.76NAXXX
    77305ARadiation therapy dose plan0.702.01NA0.122.83NAXXX
    7730526ARadiation therapy dose plan0.700.250.250.030.980.98XXX
    77305TCARadiation therapy dose plan0.001.76NA0.091.85NAXXX
    77310ARadiation therapy dose plan1.052.59NA0.153.79NAXXX
    7731026ARadiation therapy dose plan1.050.380.380.041.471.47XXX
    77310TCARadiation therapy dose plan0.002.21NA0.112.32NAXXX
    77315ARadiation therapy dose plan1.563.09NA0.184.83NAXXX
    7731526ARadiation therapy dose plan1.560.560.560.062.182.18XXX
    77315TCARadiation therapy dose plan0.002.53NA0.122.65NAXXX
    77321ARadiation therapy port plan0.954.18NA0.215.34NAXXX
    7732126ARadiation therapy port plan0.950.340.340.041.331.33XXX
    77321TCARadiation therapy port plan0.003.84NA0.174.01NAXXX
    77326ARadiation therapy dose plan0.932.58NA0.153.66NAXXX
    7732626ARadiation therapy dose plan0.930.340.340.041.311.31XXX
    77326TCARadiation therapy dose plan0.002.24NA0.112.35NAXXX
    77327ARadiation therapy dose plan1.393.80NA0.215.40NAXXX
    7732726ARadiation therapy dose plan1.390.500.500.061.951.95XXX
    77327TCARadiation therapy dose plan0.003.30NA0.153.45NAXXX
    77328ARadiation therapy dose plan2.095.46NA0.307.85NAXXX
    7732826ARadiation therapy dose plan2.090.750.750.092.932.93XXX
    77328TCARadiation therapy dose plan0.004.71NA0.214.92NAXXX
    77331ASpecial radiation dosimetry0.870.79NA0.061.72NAXXX
    7733126ASpecial radiation dosimetry0.870.310.310.041.221.22XXX
    77331TCASpecial radiation dosimetry0.000.48NA0.020.50NAXXX
    77332ARadiation treatment aid(s)0.541.47NA0.082.09NAXXX
    7733226ARadiation treatment aid(s)0.540.190.190.020.750.75XXX
    77332TCARadiation treatment aid(s)0.001.28NA0.061.34NAXXX
    77333ARadiation treatment aid(s)0.842.10NA0.133.07NAXXX
    7733326ARadiation treatment aid(s)0.840.300.300.041.181.18XXX
    77333TCARadiation treatment aid(s)0.001.80NA0.091.89NAXXX
    77334ARadiation treatment aid(s)1.243.54NA0.194.97NAXXX
    7733426ARadiation treatment aid(s)1.240.450.450.051.741.74XXX
    77334TCARadiation treatment aid(s)0.003.09NA0.143.23NAXXX
    77336ARadiation physics consult0.002.83NA0.132.96NAXXX
    77370ARadiation physics consult0.003.31NA0.153.46NAXXX
    77399CExternal radiation dosimetry0.000.000.000.000.000.00XXX
    7739926CExternal radiation dosimetry0.000.000.000.000.000.00XXX
    77399TCCExternal radiation dosimetry0.000.000.000.000.000.00XXX
    77401ARadiation treatment delivery0.001.68NA0.091.77NAXXX
    77402ARadiation treatment delivery0.001.68NA0.091.77NAXXX
    77403ARadiation treatment delivery0.001.68NA0.091.77NAXXX
    77404ARadiation treatment delivery0.001.68NA0.091.77NAXXX
    Start Printed Page 55424
    77406ARadiation treatment delivery0.001.68NA0.091.77NAXXX
    77407ARadiation treatment delivery0.001.98NA0.102.08NAXXX
    77408ARadiation treatment delivery0.001.98NA0.102.08NAXXX
    77409ARadiation treatment delivery0.001.98NA0.102.08NAXXX
    77411ARadiation treatment delivery0.001.98NA0.102.08NAXXX
    77412ARadiation treatment delivery0.002.21NA0.112.32NAXXX
    77413ARadiation treatment delivery0.002.21NA0.112.32NAXXX
    77414ARadiation treatment delivery0.002.21NA0.112.32NAXXX
    77416ARadiation treatment delivery0.002.21NA0.112.32NAXXX
    77417ARadiology port film(s)0.000.56NA0.030.59NAXXX
    77418ARadiation tx delivery, imrt0.0016.07NA0.1116.18NAXXX
    77427ARadiation tx management, x53.311.191.190.144.644.64XXX
    77431ARadiation therapy management1.810.730.730.072.612.61XXX
    77432AStereotactic radiation trmt7.933.253.250.3311.5111.51XXX
    77470ASpecial radiation treatment2.0911.34NA0.5814.01NAXXX
    7747026ASpecial radiation treatment2.090.750.750.092.932.93XXX
    77470TCASpecial radiation treatment0.0010.59NA0.4911.08NAXXX
    77499CRadiation therapy management0.000.000.000.000.000.00XXX
    7749926CRadiation therapy management0.000.000.000.000.000.00XXX
    77499TCCRadiation therapy management0.000.000.000.000.000.00XXX
    77520CProton trmt, simple w/o comp0.000.000.000.000.000.00XXX
    77522CProton trmt, simple w/comp0.000.000.000.000.000.00XXX
    77523CProton trmt, intermediate0.000.000.000.000.000.00XXX
    77525CProton treatment, complex0.000.000.000.000.000.00XXX
    77600RHyperthermia treatment1.563.44NA0.215.21NAXXX
    7760026RHyperthermia treatment1.560.550.550.082.192.19XXX
    77600TCRHyperthermia treatment0.002.89NA0.133.02NAXXX
    77605RHyperthermia treatment2.094.62NA0.317.02NAXXX
    7760526RHyperthermia treatment2.090.760.760.132.982.98XXX
    77605TCRHyperthermia treatment0.003.86NA0.184.04NAXXX
    77610RHyperthermia treatment1.563.44NA0.205.20NAXXX
    7761026RHyperthermia treatment1.560.550.550.072.182.18XXX
    77610TCRHyperthermia treatment0.002.89NA0.133.02NAXXX
    77615RHyperthermia treatment2.094.60NA0.276.96NAXXX
    7761526RHyperthermia treatment2.090.740.740.092.922.92XXX
    77615TCRHyperthermia treatment0.003.86NA0.184.04NAXXX
    77620RHyperthermia treatment1.563.47NA0.195.22NAXXX
    7762026RHyperthermia treatment1.560.580.580.062.202.20XXX
    77620TCRHyperthermia treatment0.002.89NA0.133.02NAXXX
    77750AInfuse radioactive materials4.913.04NA0.238.18NA090
    7775026AInfuse radioactive materials4.911.771.770.176.856.85090
    77750TCAInfuse radioactive materials0.001.27NA0.061.33NA090
    77761AApply intrcav radiat simple3.813.51NA0.287.60NA090
    7776126AApply intrcav radiat simple3.811.131.130.165.105.10090
    77761TCAApply intrcav radiat simple0.002.38NA0.122.50NA090
    77762AApply intrcav radiat interm5.725.42NA0.3811.52NA090
    7776226AApply intrcav radiat interm5.721.991.990.227.937.93090
    77762TCAApply intrcav radiat interm0.003.43NA0.163.59NA090
    77763AApply intrcav radiat compl8.577.38NA0.5316.48NA090
    7776326AApply intrcav radiat compl8.573.123.120.3412.0312.03090
    77763TCAApply intrcav radiat compl0.004.26NA0.194.45NA090
    77776AApply interstit radiat simpl4.663.72NA0.358.73NA090
    7777626AApply interstit radiat simpl4.661.651.650.246.556.55090
    77776TCAApply interstit radiat simpl0.002.07NA0.112.18NA090
    77777AApply interstit radiat inter7.486.37NA0.5014.35NA090
    7777726AApply interstit radiat inter7.482.352.350.3210.1510.15090
    77777TCAApply interstit radiat inter0.004.02NA0.184.20NA090
    77778AApply iterstit radiat compl11.198.90NA0.6920.78NA090
    7777826AApply iterstit radiat compl11.194.024.020.4715.6815.68090
    77778TCAApply iterstit radiat compl0.004.88NA0.225.10NA090
    77781AHigh intensity brachytherapy1.6619.88NA0.9522.49NA090
    7778126AHigh intensity brachytherapy1.660.600.600.072.332.33090
    77781TCAHigh intensity brachytherapy0.0019.28NA0.8820.16NA090
    77782AHigh intensity brachytherapy2.4920.18NA0.9823.65NA090
    7778226AHigh intensity brachytherapy2.490.900.900.103.493.49090
    77782TCAHigh intensity brachytherapy0.0019.28NA0.8820.16NA090
    77783AHigh intensity brachytherapy3.7320.62NA1.0325.38NA090
    7778326AHigh intensity brachytherapy3.731.341.340.155.225.22090
    77783TCAHigh intensity brachytherapy0.0019.28NA0.8820.16NA090
    77784AHigh intensity brachytherapy5.6121.30NA1.1028.01NA090
    7778426AHigh intensity brachytherapy5.612.022.020.227.857.85090
    77784TCAHigh intensity brachytherapy0.0019.28NA0.8820.16NA090
    77789AApply surface radiation1.120.84NA0.052.01NA090
    Start Printed Page 55425
    7778926AApply surface radiation1.120.410.410.031.561.56090
    77789TCAApply surface radiation0.000.43NA0.020.45NA090
    77790ARadiation handling1.050.86NA0.061.97NAXXX
    7779026ARadiation handling1.050.380.380.041.471.47XXX
    77790TCARadiation handling0.000.48NA0.020.50NAXXX
    77799CRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    7779926CRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    77799TCCRadium/radioisotope therapy0.000.000.000.000.000.00XXX
    78000AThyroid, single uptake0.190.99NA0.061.24NAXXX
    7800026AThyroid, single uptake0.190.070.070.010.270.27XXX
    78000TCAThyroid, single uptake0.000.92NA0.050.97NAXXX
    78001AThyroid, multiple uptakes0.261.33NA0.071.66NAXXX
    7800126AThyroid, multiple uptakes0.260.090.090.010.360.36XXX
    78001TCAThyroid, multiple uptakes0.001.24NA0.061.30NAXXX
    78003AThyroid suppress/stimul0.331.04NA0.061.43NAXXX
    7800326AThyroid suppress/stimul0.330.120.120.010.460.46XXX
    78003TCAThyroid suppress/stimul0.000.92NA0.050.97NAXXX
    78006AThyroid imaging with uptake0.492.44NA0.133.06NAXXX
    7800626AThyroid imaging with uptake0.490.180.180.020.690.69XXX
    78006TCAThyroid imaging with uptake0.002.26NA0.112.37NAXXX
    78007AThyroid image, mult uptakes0.502.62NA0.143.26NAXXX
    7800726AThyroid image, mult uptakes0.500.180.180.020.700.70XXX
    78007TCAThyroid image, mult uptakes0.002.44NA0.122.56NAXXX
    78010AThyroid imaging0.391.87NA0.112.37NAXXX
    7801026AThyroid imaging0.390.140.140.020.550.55XXX
    78010TCAThyroid imaging0.001.73NA0.091.82NAXXX
    78011AThyroid imaging with flow0.452.45NA0.133.03NAXXX
    7801126AThyroid imaging with flow0.450.160.160.020.630.63XXX
    78011TCAThyroid imaging with flow0.002.29NA0.112.40NAXXX
    78015AThyroid met imaging0.672.68NA0.153.50NAXXX
    7801526AThyroid met imaging0.670.240.240.030.940.94XXX
    78015TCAThyroid met imaging0.002.44NA0.122.56NAXXX
    78016AThyroid met imaging/studies0.823.62NA0.184.62NAXXX
    7801626AThyroid met imaging/studies0.820.310.310.031.161.16XXX
    78016TCAThyroid met imaging/studies0.003.31NA0.153.46NAXXX
    78018AThyroid met imaging, body0.865.47NA0.276.60NAXXX
    7801826AThyroid met imaging, body0.860.320.320.031.211.21XXX
    78018TCAThyroid met imaging, body0.005.15NA0.245.39NAXXX
    78020AThyroid met uptake0.601.47NA0.142.21NAZZZ
    7802026AThyroid met uptake0.600.230.230.020.850.85ZZZ
    78020TCAThyroid met uptake0.001.24NA0.121.36NAZZZ
    78070AParathyroid nuclear imaging0.822.03NA0.122.97NAXXX
    7807026AParathyroid nuclear imaging0.820.300.300.031.151.15XXX
    78070TCAParathyroid nuclear imaging0.001.73NA0.091.82NAXXX
    78075AAdrenal nuclear imaging0.745.44NA0.276.45NAXXX
    7807526AAdrenal nuclear imaging0.740.290.290.031.061.06XXX
    78075TCAAdrenal nuclear imaging0.005.15NA0.245.39NAXXX
    78099CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    7809926CEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78099TCCEndocrine nuclear procedure0.000.000.000.000.000.00XXX
    78102ABone marrow imaging, ltd0.552.15NA0.122.82NAXXX
    7810226ABone marrow imaging, ltd0.550.210.210.020.780.78XXX
    78102TCABone marrow imaging, ltd0.001.94NA0.102.04NAXXX
    78103ABone marrow imaging, mult0.753.28NA0.174.20NAXXX
    7810326ABone marrow imaging, mult0.750.270.270.031.051.05XXX
    78103TCABone marrow imaging, mult0.003.01NA0.143.15NAXXX
    78104ABone marrow imaging, body0.804.16NA0.215.17NAXXX
    7810426ABone marrow imaging, body0.800.290.290.031.121.12XXX
    78104TCABone marrow imaging, body0.003.87NA0.184.05NAXXX
    78110APlasma volume, single0.190.97NA0.061.22NAXXX
    7811026APlasma volume, single0.190.070.070.010.270.27XXX
    78110TCAPlasma volume, single0.000.90NA0.050.95NAXXX
    78111APlasma volume, multiple0.222.52NA0.132.87NAXXX
    7811126APlasma volume, multiple0.220.080.080.010.310.31XXX
    78111TCAPlasma volume, multiple0.002.44NA0.122.56NAXXX
    78120ARed cell mass, single0.231.73NA0.102.06NAXXX
    7812026ARed cell mass, single0.230.090.090.010.330.33XXX
    78120TCARed cell mass, single0.001.64NA0.091.73NAXXX
    78121ARed cell mass, multiple0.322.88NA0.133.33NAXXX
    7812126ARed cell mass, multiple0.320.120.120.010.450.45XXX
    78121TCARed cell mass, multiple0.002.76NA0.122.88NAXXX
    78122ABlood volume0.454.54NA0.225.21NAXXX
    7812226ABlood volume0.450.170.170.020.640.64XXX
    Start Printed Page 55426
    78122TCABlood volume0.004.37NA0.204.57NAXXX
    78130ARed cell survival study0.612.93NA0.153.69NAXXX
    7813026ARed cell survival study0.610.220.220.030.860.86XXX
    78130TCARed cell survival study0.002.71NA0.122.83NAXXX
    78135ARed cell survival kinetics0.644.86NA0.245.74NAXXX
    7813526ARed cell survival kinetics0.640.230.230.030.900.90XXX
    78135TCARed cell survival kinetics0.004.63NA0.214.84NAXXX
    78140ARed cell sequestration0.613.95NA0.204.76NAXXX
    7814026ARed cell sequestration0.610.210.210.030.850.85XXX
    78140TCARed cell sequestration0.003.74NA0.173.91NAXXX
    78160APlasma iron turnover0.333.60NA0.194.12NAXXX
    7816026APlasma iron turnover0.330.120.120.030.480.48XXX
    78160TCAPlasma iron turnover0.003.48NA0.163.64NAXXX
    78162AIron absorption exam0.453.22NA0.153.82NAXXX
    7816226AIron absorption exam0.450.180.180.010.640.64XXX
    78162TCAIron absorption exam0.003.04NA0.143.18NAXXX
    78170ARed cell iron utilization0.415.19NA0.275.87NAXXX
    7817026ARed cell iron utilization0.410.150.150.040.600.60XXX
    78170TCARed cell iron utilization0.005.04NA0.235.27NAXXX
    78172CTotal body iron estimation0.000.000.000.000.000.00XXX
    7817226ATotal body iron estimation0.530.200.200.020.750.75XXX
    78172TCCTotal body iron estimation0.000.000.000.000.000.00XXX
    78185ASpleen imaging0.402.39NA0.132.92NAXXX
    7818526ASpleen imaging0.400.150.150.020.570.57XXX
    78185TCASpleen imaging0.002.24NA0.112.35NAXXX
    78190APlatelet survival, kinetics1.095.83NA0.317.23NAXXX
    7819026APlatelet survival, kinetics1.090.400.400.061.551.55XXX
    78190TCAPlatelet survival, kinetics0.005.43NA0.255.68NAXXX
    78191APlatelet survival0.617.19NA0.348.14NAXXX
    7819126APlatelet survival0.610.220.220.030.860.86XXX
    78191TCAPlatelet survival0.006.97NA0.317.28NAXXX
    78195ALymph system imaging1.204.31NA0.235.74NAXXX
    7819526ALymph system imaging1.200.440.440.051.691.69XXX
    78195TCALymph system imaging0.003.87NA0.184.05NAXXX
    78199CBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    7819926CBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    78199TCCBlood/lymph nuclear exam0.000.000.000.000.000.00XXX
    78201ALiver imaging0.442.40NA0.132.97NAXXX
    7820126ALiver imaging0.440.160.160.020.620.62XXX
    78201TCALiver imaging0.002.24NA0.112.35NAXXX
    78202ALiver imaging with flow0.512.93NA0.143.58NAXXX
    7820226ALiver imaging with flow0.510.190.190.020.720.72XXX
    78202TCALiver imaging with flow0.002.74NA0.122.86NAXXX
    78205ALiver imaging (3D)0.715.87NA0.296.87NAXXX
    7820526ALiver imaging (3D)0.710.260.260.031.001.00XXX
    78205TCALiver imaging (3D)0.005.61NA0.265.87NAXXX
    78206ALiver image (3d) w/flow0.965.96NA0.137.05NAXXX
    7820626ALiver image (3d) w/flow0.960.350.350.041.351.35XXX
    78206TCALiver image (3d) w/flow0.005.61NA0.095.70NAXXX
    78215ALiver and spleen imaging0.492.97NA0.143.60NAXXX
    7821526ALiver and spleen imaging0.490.180.180.020.690.69XXX
    78215TCALiver and spleen imaging0.002.79NA0.122.91NAXXX
    78216ALiver & spleen image/flow0.573.52NA0.174.26NAXXX
    7821626ALiver & spleen image/flow0.570.210.210.020.800.80XXX
    78216TCALiver & spleen image/flow0.003.31NA0.153.46NAXXX
    78220ALiver function study0.493.72NA0.184.39NAXXX
    7822026ALiver function study0.490.180.180.020.690.69XXX
    78220TCALiver function study0.003.54NA0.163.70NAXXX
    78223AHepatobiliary imaging0.843.78NA0.204.82NAXXX
    7822326AHepatobiliary imaging0.840.300.300.041.181.18XXX
    78223TCAHepatobiliary imaging0.003.48NA0.163.64NAXXX
    78230ASalivary gland imaging0.452.23NA0.132.81NAXXX
    7823026ASalivary gland imaging0.450.160.160.020.630.63XXX
    78230TCASalivary gland imaging0.002.07NA0.112.18NAXXX
    78231ASerial salivary imaging0.523.21NA0.163.89NAXXX
    7823126ASerial salivary imaging0.520.200.200.020.740.74XXX
    78231TCASerial salivary imaging0.003.01NA0.143.15NAXXX
    78232ASalivary gland function exam0.473.54NA0.164.17NAXXX
    7823226ASalivary gland function exam0.470.180.180.010.660.66XXX
    78232TCASalivary gland function exam0.003.36NA0.153.51NAXXX
    78258AEsophageal motility study0.743.01NA0.153.90NAXXX
    7825826AEsophageal motility study0.740.270.270.031.041.04XXX
    78258TCAEsophageal motility study0.002.74NA0.122.86NAXXX
    Start Printed Page 55427
    78261AGastric mucosa imaging0.694.15NA0.215.05NAXXX
    7826126AGastric mucosa imaging0.690.260.260.030.980.98XXX
    78261TCAGastric mucosa imaging0.003.89NA0.184.07NAXXX
    78262AGastroesophageal reflux exam0.684.29NA0.215.18NAXXX
    7826226AGastroesophageal reflux exam0.680.250.250.030.960.96XXX
    78262TCAGastroesophageal reflux exam0.004.04NA0.184.22NAXXX
    78264AGastric emptying study0.784.20NA0.215.19NAXXX
    7826426AGastric emptying study0.780.280.280.031.091.09XXX
    78264TCAGastric emptying study0.003.92NA0.184.10NAXXX
    78267XBreath tst attain/anal c-140.000.000.000.000.000.00XXX
    78268XBreath test analysis, c-140.000.000.000.000.000.00XXX
    78270AVit B-12 absorption exam0.201.54NA0.091.83NAXXX
    7827026AVit B-12 absorption exam0.200.070.070.010.280.28XXX
    78270TCAVit B-12 absorption exam0.001.47NA0.081.55NAXXX
    78271AVit B-12 absorp exam, IF0.201.63NA0.091.92NAXXX
    7827126AVit B-12 absorp exam, IF0.200.070.070.010.280.28XXX
    78271TCAVit B-12 absorp exam, IF0.001.56NA0.081.64NAXXX
    78272AVit B-12 absorp, combined0.272.30NA0.122.69NAXXX
    7827226AVit B-12 absorp, combined0.270.100.100.010.380.38XXX
    78272TCAVit B-12 absorp, combined0.002.20NA0.112.31NAXXX
    78278AAcute GI blood loss imaging0.994.98NA0.256.22NAXXX
    7827826AAcute GI blood loss imaging0.990.350.350.041.381.38XXX
    78278TCAAcute GI blood loss imaging0.004.63NA0.214.84NAXXX
    78282CGI protein loss exam0.000.000.000.000.000.00XXX
    7828226AGI protein loss exam0.380.130.130.020.530.53XXX
    78282TCCGI protein loss exam0.000.000.000.000.000.00XXX
    78290AMeckel's divert exam0.683.13NA0.163.97NAXXX
    7829026AMeckel's divert exam0.680.240.240.030.950.95XXX
    78290TCAMeckel's divert exam0.002.89NA0.133.02NAXXX
    78291ALeveen/shunt patency exam0.883.23NA0.174.28NAXXX
    7829126ALeveen/shunt patency exam0.880.320.320.041.241.24XXX
    78291TCALeveen/shunt patency exam0.002.91NA0.133.04NAXXX
    78299CGI nuclear procedure0.000.000.000.000.000.00XXX
    7829926CGI nuclear procedure0.000.000.000.000.000.00XXX
    78299TCCGI nuclear procedure0.000.000.000.000.000.00XXX
    78300ABone imaging, limited area0.622.58NA0.153.35NAXXX
    7830026ABone imaging, limited area0.620.220.220.030.870.87XXX
    78300TCABone imaging, limited area0.002.36NA0.122.48NAXXX
    78305ABone imaging, multiple areas0.833.78NA0.194.80NAXXX
    7830526ABone imaging, multiple areas0.830.300.300.031.161.16XXX
    78305TCABone imaging, multiple areas0.003.48NA0.163.64NAXXX
    78306ABone imaging, whole body0.864.37NA0.225.45NAXXX
    7830626ABone imaging, whole body0.860.310.310.041.211.21XXX
    78306TCABone imaging, whole body0.004.06NA0.184.24NAXXX
    78315ABone imaging, 3 phase1.024.91NA0.256.18NAXXX
    7831526ABone imaging, 3 phase1.020.370.370.041.431.43XXX
    78315TCABone imaging, 3 phase0.004.54NA0.214.75NAXXX
    78320ABone imaging (3D)1.046.00NA0.307.34NAXXX
    7832026ABone imaging (3D)1.040.390.390.041.471.47XXX
    78320TCABone imaging (3D)0.005.61NA0.265.87NAXXX
    78350ABone mineral, single photon0.220.80NA0.051.07NAXXX
    7835026ABone mineral, single photon0.220.080.080.010.310.31XXX
    78350TCABone mineral, single photon0.000.72NA0.040.76NAXXX
    78351NBone mineral, dual photon+0.301.640.120.011.950.43XXX
    78399CMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    7839926CMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    78399TCCMusculoskeletal nuclear exam0.000.000.000.000.000.00XXX
    78414CNon-imaging heart function0.000.000.000.000.000.00XXX
    7841426ANon-imaging heart function0.450.160.160.020.630.63XXX
    78414TCCNon-imaging heart function0.000.000.000.000.000.00XXX
    78428ACardiac shunt imaging0.782.46NA0.143.38NAXXX
    7842826ACardiac shunt imaging0.780.320.320.031.131.13XXX
    78428TCACardiac shunt imaging0.002.14NA0.112.25NAXXX
    78445AVascular flow imaging0.491.94NA0.112.54NAXXX
    7844526AVascular flow imaging0.490.180.180.020.690.69XXX
    78445TCAVascular flow imaging0.001.76NA0.091.85NAXXX
    78455AVenous thrombosis study0.734.04NA0.204.97NAXXX
    7845526AVenous thrombosis study0.730.260.260.031.021.02XXX
    78455TCAVenous thrombosis study0.003.78NA0.173.95NAXXX
    78456AAcute venous thrombus image1.004.15NA0.285.43NAXXX
    7845626AAcute venous thrombus image1.000.370.370.041.411.41XXX
    78456TCAAcute venous thrombus image0.003.78NA0.244.02NAXXX
    78457AVenous thrombosis imaging0.772.81NA0.153.73NAXXX
    Start Printed Page 55428
    7845726AVenous thrombosis imaging0.770.280.280.031.081.08XXX
    78457TCAVenous thrombosis imaging0.002.53NA0.122.65NAXXX
    78458AVen thrombosis images, bilat0.904.17NA0.205.27NAXXX
    7845826AVen thrombosis images, bilat0.900.350.350.031.281.28XXX
    78458TCAVen thrombosis images, bilat0.003.82NA0.173.99NAXXX
    78459IHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    7845926IHeart muscle imaging (PET)+1.880.750.750.082.712.71XXX
    78459TCIHeart muscle imaging (PET)0.000.000.000.000.000.00XXX
    78460AHeart muscle blood, single0.862.55NA0.143.55NAXXX
    7846026AHeart muscle blood, single0.860.310.310.031.201.20XXX
    78460TCAHeart muscle blood, single0.002.24NA0.112.35NAXXX
    78461AHeart muscle blood, multiple1.234.94NA0.266.43NAXXX
    7846126AHeart muscle blood, multiple1.230.460.460.051.741.74XXX
    78461TCAHeart muscle blood, multiple0.004.48NA0.214.69NAXXX
    78464AHeart image (3d), single1.097.12NA0.358.56NAXXX
    7846426AHeart image (3d), single1.090.410.410.041.541.54XXX
    78464TCAHeart image (3d), single0.006.71NA0.317.02NAXXX
    78465AHeart image (3d), multiple1.4611.76NA0.5613.78NAXXX
    7846526AHeart image (3d), multiple1.460.560.560.052.072.07XXX
    78465TCAHeart image (3d), multiple0.0011.20NA0.5111.71NAXXX
    78466AHeart infarct image0.692.75NA0.153.59NAXXX
    7846626AHeart infarct image0.690.260.260.030.980.98XXX
    78466TCAHeart infarct image0.002.49NA0.122.61NAXXX
    78468AHeart infarct image (ef)0.803.78NA0.194.77NAXXX
    7846826AHeart infarct image (ef)0.800.300.300.031.131.13XXX
    78468TCAHeart infarct image (ef)0.003.48NA0.163.64NAXXX
    78469AHeart infarct image (3D)0.925.31NA0.266.49NAXXX
    7846926AHeart infarct image (3D)0.920.350.350.031.301.30XXX
    78469TCAHeart infarct image (3D)0.004.96NA0.235.19NAXXX
    78472AGated heart, planar, single0.985.60NA0.296.87NAXXX
    7847226AGated heart, planar, single0.980.370.370.041.391.39XXX
    78472TCAGated heart, planar, single0.005.23NA0.255.48NAXXX
    78473AGated heart, multiple1.478.40NA0.4010.27NAXXX
    7847326AGated heart, multiple1.470.560.560.052.082.08XXX
    78473TCAGated heart, multiple0.007.84NA0.358.19NAXXX
    78478AHeart wall motion add-on0.621.72NA0.102.44NAZZZ
    7847826AHeart wall motion add-on0.620.240.240.020.880.88ZZZ
    78478TCAHeart wall motion add-on0.001.48NA0.081.56NAZZZ
    78480AHeart function add-on0.621.72NA0.102.44NAZZZ
    7848026AHeart function add-on0.620.240.240.020.880.88ZZZ
    78480TCAHeart function add-on0.001.48NA0.081.56NAZZZ
    78481AHeart first pass, single0.985.35NA0.266.59NAXXX
    7848126AHeart first pass, single0.980.390.390.031.401.40XXX
    78481TCAHeart first pass, single0.004.96NA0.235.19NAXXX
    78483AHeart first pass, multiple1.478.05NA0.399.91NAXXX
    7848326AHeart first pass, multiple1.470.580.580.052.102.10XXX
    78483TCAHeart first pass, multiple0.007.47NA0.347.81NAXXX
    78491IHeart image (pet), single0.000.000.000.000.000.00XXX
    7849126IHeart image (pet), single+1.500.600.600.052.152.15XXX
    78491TCIHeart image (pet), single0.000.000.000.000.000.00XXX
    78492IHeart image (pet), multiple0.000.000.000.000.000.00XXX
    7849226IHeart image (pet), multiple+1.870.750.750.062.682.68XXX
    78492TCIHeart image (pet), multiple0.000.000.000.000.000.00XXX
    78494AHeart image, spect1.197.15NA0.298.63NAXXX
    7849426AHeart image, spect1.190.440.440.041.671.67XXX
    78494TCAHeart image, spect0.006.71NA0.256.96NAXXX
    78496AHeart first pass add-on0.506.91NA0.277.68NAZZZ
    7849626AHeart first pass add-on0.500.200.200.020.720.72ZZZ
    78496TCAHeart first pass add-on0.006.71NA0.256.96NAZZZ
    78499CCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    7849926CCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    78499TCCCardiovascular nuclear exam0.000.000.000.000.000.00XXX
    78580ALung perfusion imaging0.743.53NA0.184.45NAXXX
    7858026ALung perfusion imaging0.740.270.270.031.041.04XXX
    78580TCALung perfusion imaging0.003.26NA0.153.41NAXXX
    78584ALung V/Q image single breath0.993.39NA0.184.56NAXXX
    7858426ALung V/Q image single breath0.990.350.350.041.381.38XXX
    78584TCALung V/Q image single breath0.003.04NA0.143.18NAXXX
    78585ALung V/Q imaging1.095.74NA0.307.13NAXXX
    7858526ALung V/Q imaging1.090.390.390.051.531.53XXX
    78585TCALung V/Q imaging0.005.35NA0.255.60NAXXX
    78586AAerosol lung image, single0.402.60NA0.143.14NAXXX
    7858626AAerosol lung image, single0.400.140.140.020.560.56XXX
    Start Printed Page 55429
    78586TCAAerosol lung image, single0.002.46NA0.122.58NAXXX
    78587AAerosol lung image, multiple0.492.84NA0.143.47NAXXX
    7858726AAerosol lung image, multiple0.490.180.180.020.690.69XXX
    78587TCAAerosol lung image, multiple0.002.66NA0.122.78NAXXX
    78588APerfusion lung image1.093.43NA0.204.72NAXXX
    7858826APerfusion lung image1.090.390.390.051.531.53XXX
    78588TCAPerfusion lung image0.003.04NA0.153.19NAXXX
    78591AVent image, 1 breath, 1 proj0.402.86NA0.143.40NAXXX
    7859126AVent image, 1 breath, 1 proj0.400.150.150.020.570.57XXX
    78591TCAVent image, 1 breath, 1 proj0.002.71NA0.122.83NAXXX
    78593AVent image, 1 proj, gas0.493.46NA0.174.12NAXXX
    7859326AVent image, 1 proj, gas0.490.180.180.020.690.69XXX
    78593TCAVent image, 1 proj, gas0.003.28NA0.153.43NAXXX
    78594AVent image, mult proj, gas0.534.92NA0.235.68NAXXX
    7859426AVent image, mult proj, gas0.530.190.190.020.740.74XXX
    78594TCAVent image, mult proj, gas0.004.73NA0.214.94NAXXX
    78596ALung differential function1.277.17NA0.368.80NAXXX
    7859626ALung differential function1.270.460.460.051.781.78XXX
    78596TCALung differential function0.006.71NA0.317.02NAXXX
    78599CRespiratory nuclear exam0.000.000.000.000.000.00XXX
    7859926CRespiratory nuclear exam0.000.000.000.000.000.00XXX
    78599TCCRespiratory nuclear exam0.000.000.000.000.000.00XXX
    78600ABrain imaging, ltd static0.442.90NA0.143.48NAXXX
    7860026ABrain imaging, ltd static0.440.160.160.020.620.62XXX
    78600TCABrain imaging, ltd static0.002.74NA0.122.86NAXXX
    78601ABrain imaging, ltd w/flow0.513.41NA0.174.09NAXXX
    7860126ABrain imaging, ltd w/flow0.510.180.180.020.710.71XXX
    78601TCABrain imaging, ltd w/flow0.003.23NA0.153.38NAXXX
    78605ABrain imaging, complete0.533.42NA0.174.12NAXXX
    7860526ABrain imaging, complete0.530.190.190.020.740.74XXX
    78605TCABrain imaging, complete0.003.23NA0.153.38NAXXX
    78606ABrain imaging, compl w/flow0.643.90NA0.204.74NAXXX
    7860626ABrain imaging, compl w/flow0.640.230.230.030.900.90XXX
    78606TCABrain imaging, compl w/flow0.003.67NA0.173.84NAXXX
    78607ABrain imaging (3D)1.236.70NA0.348.27NAXXX
    7860726ABrain imaging (3D)1.230.470.470.051.751.75XXX
    78607TCABrain imaging (3D)0.006.23NA0.296.52NAXXX
    78608NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78609NBrain imaging (PET)0.000.000.000.000.000.00XXX
    78610ABrain flow imaging only0.301.61NA0.092.00NAXXX
    7861026ABrain flow imaging only0.300.110.110.010.420.42XXX
    78610TCABrain flow imaging only0.001.50NA0.081.58NAXXX
    78615ACerebral vascular flow image0.423.81NA0.194.42NAXXX
    7861526ACerebral vascular flow image0.420.160.160.020.600.60XXX
    78615TCACerebral vascular flow image0.003.65NA0.173.82NAXXX
    78630ACerebrospinal fluid scan0.685.02NA0.255.95NAXXX
    7863026ACerebrospinal fluid scan0.680.240.240.030.950.95XXX
    78630TCACerebrospinal fluid scan0.004.78NA0.225.00NAXXX
    78635ACSF ventriculography0.612.67NA0.143.42NAXXX
    7863526ACSF ventriculography0.610.250.250.020.880.88XXX
    78635TCACSF ventriculography0.002.42NA0.122.54NAXXX
    78645ACSF shunt evaluation0.573.47NA0.174.21NAXXX
    7864526ACSF shunt evaluation0.570.210.210.020.800.80XXX
    78645TCACSF shunt evaluation0.003.26NA0.153.41NAXXX
    78647ACerebrospinal fluid scan0.905.94NA0.297.13NAXXX
    7864726ACerebrospinal fluid scan0.900.330.330.031.261.26XXX
    78647TCACerebrospinal fluid scan0.005.61NA0.265.87NAXXX
    78650ACSF leakage imaging0.614.63NA0.225.46NAXXX
    7865026ACSF leakage imaging0.610.220.220.020.850.85XXX
    78650TCACSF leakage imaging0.004.41NA0.204.61NAXXX
    78660ANuclear exam of tear flow0.532.20NA0.122.85NAXXX
    7866026ANuclear exam of tear flow0.530.190.190.020.740.74XXX
    78660TCANuclear exam of tear flow0.002.01NA0.102.11NAXXX
    78699CNervous system nuclear exam0.000.000.000.000.000.00XXX
    7869926CNervous system nuclear exam0.000.000.000.000.000.00XXX
    78699TCCNervous system nuclear exam0.000.000.000.000.000.00XXX
    78700AKidney imaging, static0.453.05NA0.153.65NAXXX
    7870026AKidney imaging, static0.450.160.160.020.630.63XXX
    78700TCAKidney imaging, static0.002.89NA0.133.02NAXXX
    78701AKidney imaging with flow0.493.55NA0.174.21NAXXX
    7870126AKidney imaging with flow0.490.170.170.020.680.68XXX
    78701TCAKidney imaging with flow0.003.38NA0.153.53NAXXX
    78704AImaging renogram0.744.03NA0.204.97NAXXX
    Start Printed Page 55430
    7870426AImaging renogram0.740.270.270.031.041.04XXX
    78704TCAImaging renogram0.003.76NA0.173.93NAXXX
    78707AKidney flow/function image0.964.59NA0.235.78NAXXX
    7870726AKidney flow/function image0.960.350.350.041.351.35XXX
    78707TCAKidney flow/function image0.004.24NA0.194.43NAXXX
    78708AKidney flow/function image1.214.68NA0.246.13NAXXX
    7870826AKidney flow/function image1.210.440.440.051.701.70XXX
    78708TCAKidney flow/function image0.004.24NA0.194.43NAXXX
    78709AKidney flow/function image1.414.75NA0.256.41NAXXX
    7870926AKidney flow/function image1.410.510.510.061.981.98XXX
    78709TCAKidney flow/function image0.004.24NA0.194.43NAXXX
    78710AKidney imaging (3D)0.665.84NA0.296.79NAXXX
    7871026AKidney imaging (3D)0.660.230.230.030.920.92XXX
    78710TCAKidney imaging (3D)0.005.61NA0.265.87NAXXX
    78715ARenal vascular flow exam0.301.61NA0.092.00NAXXX
    7871526ARenal vascular flow exam0.300.110.110.010.420.42XXX
    78715TCARenal vascular flow exam0.001.50NA0.081.58NAXXX
    78725AKidney function study0.381.83NA0.102.31NAXXX
    7872526AKidney function study0.380.140.140.010.530.53XXX
    78725TCAKidney function study0.001.69NA0.091.78NAXXX
    78730AUrinary bladder retention0.361.52NA0.091.97NAXXX
    7873026AUrinary bladder retention0.360.130.130.020.510.51XXX
    78730TCAUrinary bladder retention0.001.39NA0.071.46NAXXX
    78740AUreteral reflux study0.572.22NA0.122.91NAXXX
    7874026AUreteral reflux study0.570.210.210.020.800.80XXX
    78740TCAUreteral reflux study0.002.01NA0.102.11NAXXX
    78760ATesticular imaging0.662.77NA0.153.58NAXXX
    7876026ATesticular imaging0.660.230.230.030.920.92XXX
    78760TCATesticular imaging0.002.54NA0.122.66NAXXX
    78761ATesticular imaging/flow0.713.30NA0.174.18NAXXX
    7876126ATesticular imaging/flow0.710.260.260.031.001.00XXX
    78761TCATesticular imaging/flow0.003.04NA0.143.18NAXXX
    78799CGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    7879926CGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    78799TCCGenitourinary nuclear exam0.000.000.000.000.000.00XXX
    78800ATumor imaging, limited area0.663.46NA0.184.30NAXXX
    7880026ATumor imaging, limited area0.660.230.230.030.920.92XXX
    78800TCATumor imaging, limited area0.003.23NA0.153.38NAXXX
    78801ATumor imaging, mult areas0.794.30NA0.215.30NAXXX
    7880126ATumor imaging, mult areas0.790.290.290.031.111.11XXX
    78801TCATumor imaging, mult areas0.004.01NA0.184.19NAXXX
    78802ATumor imaging, whole body0.865.57NA0.286.71NAXXX
    7880226ATumor imaging, whole body0.860.320.320.031.211.21XXX
    78802TCATumor imaging, whole body0.005.25NA0.255.50NAXXX
    78803ATumor imaging (3D)1.096.64NA0.338.06NAXXX
    7880326ATumor imaging (3D)1.090.410.410.041.541.54XXX
    78803TCATumor imaging (3D)0.006.23NA0.296.52NAXXX
    78805AAbscess imaging, ltd area0.733.50NA0.184.41NAXXX
    7880526AAbscess imaging, ltd area0.730.270.270.031.031.03XXX
    78805TCAAbscess imaging, ltd area0.003.23NA0.153.38NAXXX
    78806AAbscess imaging, whole body0.866.43NA0.327.61NAXXX
    7880626AAbscess imaging, whole body0.860.320.320.031.211.21XXX
    78806TCAAbscess imaging, whole body0.006.11NA0.296.40NAXXX
    78807ANuclear localization/abscess1.096.66NA0.338.08NAXXX
    7880726ANuclear localization/abscess1.090.430.430.041.561.56XXX
    78807TCANuclear localization/abscess0.006.23NA0.296.52NAXXX
    78810NTumor imaging (PET)0.000.000.000.000.000.00XXX
    7881026NTumor imaging (PET)+1.930.770.770.092.792.79XXX
    78810TCNTumor imaging (PET)0.000.000.000.000.000.00XXX
    78890BNuclear medicine data proc+0.051.26NA0.061.37NAXXX
    7889026BNuclear medicine data proc+0.050.020.020.010.080.08XXX
    78890TCBNuclear medicine data proc+0.001.24NA0.051.29NAXXX
    78891BNuclear med data proc+0.102.53NA0.122.75NAXXX
    7889126BNuclear med data proc+0.100.040.040.010.150.15XXX
    78891TCBNuclear med data proc+0.002.49NA0.112.60NAXXX
    78990IProvide diag radionuclide(s)0.000.000.000.000.000.00XXX
    78999CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    7899926CNuclear diagnostic exam0.000.000.000.000.000.00XXX
    78999TCCNuclear diagnostic exam0.000.000.000.000.000.00XXX
    79000AInit hyperthyroid therapy1.803.14NA0.195.13NAXXX
    7900026AInit hyperthyroid therapy1.800.650.650.072.522.52XXX
    79000TCAInit hyperthyroid therapy0.002.49NA0.122.61NAXXX
    79001ARepeat hyperthyroid therapy1.051.63NA0.102.78NAXXX
    Start Printed Page 55431
    7900126ARepeat hyperthyroid therapy1.050.390.390.041.481.48XXX
    79001TCARepeat hyperthyroid therapy0.001.24NA0.061.30NAXXX
    79020AThyroid ablation1.813.13NA0.195.13NAXXX
    7902026AThyroid ablation1.810.640.640.072.522.52XXX
    79020TCAThyroid ablation0.002.49NA0.122.61NAXXX
    79030AThyroid ablation, carcinoma2.103.26NA0.205.56NAXXX
    7903026AThyroid ablation, carcinoma2.100.770.770.082.952.95XXX
    79030TCAThyroid ablation, carcinoma0.002.49NA0.122.61NAXXX
    79035AThyroid metastatic therapy2.523.43NA0.216.16NAXXX
    7903526AThyroid metastatic therapy2.520.940.940.093.553.55XXX
    79035TCAThyroid metastatic therapy0.002.49NA0.122.61NAXXX
    79100AHematopoetic nuclear therapy1.323.00NA0.174.49NAXXX
    7910026AHematopoetic nuclear therapy1.320.510.510.051.881.88XXX
    79100TCAHematopoetic nuclear therapy0.002.49NA0.122.61NAXXX
    79200AIntracavitary nuclear trmt1.993.23NA0.195.41NAXXX
    7920026AIntracavitary nuclear trmt1.990.740.740.072.802.80XXX
    79200TCAIntracavitary nuclear trmt0.002.49NA0.122.61NAXXX
    79300CInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    7930026AInterstitial nuclear therapy1.600.680.680.072.352.35XXX
    79300TCCInterstitial nuclear therapy0.000.000.000.000.000.00XXX
    79400ANonhemato nuclear therapy1.963.22NA0.205.38NAXXX
    7940026ANonhemato nuclear therapy1.960.730.730.082.772.77XXX
    79400TCANonhemato nuclear therapy0.002.49NA0.122.61NAXXX
    79420CIntravascular nuclear ther0.000.000.000.000.000.00XXX
    7942026AIntravascular nuclear ther1.510.540.540.062.112.11XXX
    79420TCCIntravascular nuclear ther0.000.000.000.000.000.00XXX
    79440ANuclear joint therapy1.993.29NA0.205.48NAXXX
    7944026ANuclear joint therapy1.990.800.800.082.872.87XXX
    79440TCANuclear joint therapy0.002.49NA0.122.61NAXXX
    79900CProvide ther radiopharm(s)0.000.000.000.000.000.00XXX
    79999CNuclear medicine therapy0.000.000.000.000.000.00XXX
    7999926CNuclear medicine therapy0.000.000.000.000.000.00XXX
    79999TCCNuclear medicine therapy0.000.000.000.000.000.00XXX
    80048XBasic metabolic panel0.000.000.000.000.000.00XXX
    80050NGeneral health panel0.000.000.000.000.000.00XXX
    80051XElectrolyte panel0.000.000.000.000.000.00XXX
    80053XComprehen metabolic panel0.000.000.000.000.000.00XXX
    80055IObstetric panel0.000.000.000.000.000.00XXX
    80061XLipid panel0.000.000.000.000.000.00XXX
    80069XRenal function panel0.000.000.000.000.000.00XXX
    80072DArthritis panel0.000.000.000.000.000.00XXX
    80074XAcute hepatitis panel0.000.000.000.000.000.00XXX
    80076XHepatic function panel0.000.000.000.000.000.00XXX
    80090XTorch antibody panel0.000.000.000.000.000.00XXX
    80100XDrug screen, qualitate/multi0.000.000.000.000.000.00XXX
    80101XDrug screen, single0.000.000.000.000.000.00XXX
    80102XDrug confirmation0.000.000.000.000.000.00XXX
    80103XDrug analysis, tissue prep0.000.000.000.000.000.00XXX
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    80152XAssay of amitriptyline0.000.000.000.000.000.00XXX
    80154XAssay of benzodiazepines0.000.000.000.000.000.00XXX
    80156XAssay, carbamazepine, total0.000.000.000.000.000.00XXX
    80157XAssay, carbamazepine, free0.000.000.000.000.000.00XXX
    80158XAssay of cyclosporine0.000.000.000.000.000.00XXX
    80160XAssay of desipramine0.000.000.000.000.000.00XXX
    80162XAssay of digoxin0.000.000.000.000.000.00XXX
    80164XAssay, dipropylacetic acid0.000.000.000.000.000.00XXX
    80166XAssay of doxepin0.000.000.000.000.000.00XXX
    80168XAssay of ethosuximide0.000.000.000.000.000.00XXX
    80170XAssay of gentamicin0.000.000.000.000.000.00XXX
    80172XAssay of gold0.000.000.000.000.000.00XXX
    80173XAssay of haloperidol0.000.000.000.000.000.00XXX
    80174XAssay of imipramine0.000.000.000.000.000.00XXX
    80176XAssay of lidocaine0.000.000.000.000.000.00XXX
    80178XAssay of lithium0.000.000.000.000.000.00XXX
    80182XAssay of nortriptyline0.000.000.000.000.000.00XXX
    80184XAssay of phenobarbital0.000.000.000.000.000.00XXX
    80185XAssay of phenytoin, total0.000.000.000.000.000.00XXX
    80186XAssay of phenytoin, free0.000.000.000.000.000.00XXX
    80188XAssay of primidone0.000.000.000.000.000.00XXX
    80190XAssay of procainamide0.000.000.000.000.000.00XXX
    80192XAssay of procainamide0.000.000.000.000.000.00XXX
    80194XAssay of quinidine0.000.000.000.000.000.00XXX
    Start Printed Page 55432
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    80198XAssay of theophylline0.000.000.000.000.000.00XXX
    80200XAssay of tobramycin0.000.000.000.000.000.00XXX
    80201XAssay of topiramate0.000.000.000.000.000.00XXX
    80202XAssay of vancomycin0.000.000.000.000.000.00XXX
    80299XQuantitative assay, drug0.000.000.000.000.000.00XXX
    80400XActh stimulation panel0.000.000.000.000.000.00XXX
    80402XActh stimulation panel0.000.000.000.000.000.00XXX
    80406XActh stimulation panel0.000.000.000.000.000.00XXX
    80408XAldosterone suppression eval0.000.000.000.000.000.00XXX
    80410XCalcitonin stimul panel0.000.000.000.000.000.00XXX
    80412XCRH stimulation panel0.000.000.000.000.000.00XXX
    80414XTestosterone response0.000.000.000.000.000.00XXX
    80415XEstradiol response panel0.000.000.000.000.000.00XXX
    80416XRenin stimulation panel0.000.000.000.000.000.00XXX
    80417XRenin stimulation panel0.000.000.000.000.000.00XXX
    80418XPituitary evaluation panel0.000.000.000.000.000.00XXX
    80420XDexamethasone panel0.000.000.000.000.000.00XXX
    80422XGlucagon tolerance panel0.000.000.000.000.000.00XXX
    80424XGlucagon tolerance panel0.000.000.000.000.000.00XXX
    80426XGonadotropin hormone panel0.000.000.000.000.000.00XXX
    80428XGrowth hormone panel0.000.000.000.000.000.00XXX
    80430XGrowth hormone panel0.000.000.000.000.000.00XXX
    80432XInsulin suppression panel0.000.000.000.000.000.00XXX
    80434XInsulin tolerance panel0.000.000.000.000.000.00XXX
    80435XInsulin tolerance panel0.000.000.000.000.000.00XXX
    80436XMetyrapone panel0.000.000.000.000.000.00XXX
    80438XTRH stimulation panel0.000.000.000.000.000.00XXX
    80439XTRH stimulation panel0.000.000.000.000.000.00XXX
    80440XTRH stimulation panel0.000.000.000.000.000.00XXX
    80500ALab pathology consultation0.370.210.170.010.590.55XXX
    80502ALab pathology consultation1.330.630.610.052.011.99XXX
    81000XUrinalysis, nonauto w/scope0.000.000.000.000.000.00XXX
    81001XUrinalysis, auto w/scope0.000.000.000.000.000.00XXX
    81002XUrinalysis nonauto w/o scope0.000.000.000.000.000.00XXX
    81003XUrinalysis, auto, w/o scope0.000.000.000.000.000.00XXX
    81005XUrinalysis0.000.000.000.000.000.00XXX
    81007XUrine screen for bacteria0.000.000.000.000.000.00XXX
    81015XMicroscopic exam of urine0.000.000.000.000.000.00XXX
    81020XUrinalysis, glass test0.000.000.000.000.000.00XXX
    81025XUrine pregnancy test0.000.000.000.000.000.00XXX
    81050XUrinalysis, volume measure0.000.000.000.000.000.00XXX
    81099XUrinalysis test procedure0.000.000.000.000.000.00XXX
    82000XAssay of blood acetaldehyde0.000.000.000.000.000.00XXX
    82003XAssay of acetaminophen0.000.000.000.000.000.00XXX
    82009XTest for acetone/ketones0.000.000.000.000.000.00XXX
    82010XAcetone assay0.000.000.000.000.000.00XXX
    82013XAcetylcholinesterase assay0.000.000.000.000.000.00XXX
    82016XAcylcarnitines, qual0.000.000.000.000.000.00XXX
    82017XAcylcarnitines, quant0.000.000.000.000.000.00XXX
    82024XAssay of acth0.000.000.000.000.000.00XXX
    82030XAssay of adp & amp0.000.000.000.000.000.00XXX
    82040XAssay of serum albumin0.000.000.000.000.000.00XXX
    82042XAssay of urine albumin0.000.000.000.000.000.00XXX
    82043XMicroalbumin, quantitative0.000.000.000.000.000.00XXX
    82044XMicroalbumin, semiquant0.000.000.000.000.000.00XXX
    82055XAssay of ethanol0.000.000.000.000.000.00XXX
    82075XAssay of breath ethanol0.000.000.000.000.000.00XXX
    82085XAssay of aldolase0.000.000.000.000.000.00XXX
    82088XAssay of aldosterone0.000.000.000.000.000.00XXX
    82101XAssay of urine alkaloids0.000.000.000.000.000.00XXX
    82103XAlpha-1-antitrypsin, total0.000.000.000.000.000.00XXX
    82104XAlpha-1-antitrypsin, pheno0.000.000.000.000.000.00XXX
    82105XAlpha-fetoprotein, serum0.000.000.000.000.000.00XXX
    82106XAlpha-fetoprotein, amniotic0.000.000.000.000.000.00XXX
    82108XAssay of aluminum0.000.000.000.000.000.00XXX
    82120XAmines, vaginal fluid qual0.000.000.000.000.000.00XXX
    82127XAmino acid, single qual0.000.000.000.000.000.00XXX
    82128XAmino acids, mult qual0.000.000.000.000.000.00XXX
    82131XAmino acids, single quant0.000.000.000.000.000.00XXX
    82135XAssay, aminolevulinic acid0.000.000.000.000.000.00XXX
    82136XAmino acids, quant, 2-50.000.000.000.000.000.00XXX
    Start Printed Page 55433
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    82143XAmniotic fluid scan0.000.000.000.000.000.00XXX
    82145XAssay of amphetamines0.000.000.000.000.000.00XXX
    82150XAssay of amylase0.000.000.000.000.000.00XXX
    82154XAndrostanediol glucuronide0.000.000.000.000.000.00XXX
    82157XAssay of androstenedione0.000.000.000.000.000.00XXX
    82160XAssay of androsterone0.000.000.000.000.000.00XXX
    82163XAssay of angiotensin II0.000.000.000.000.000.00XXX
    82164XAngiotensin I enzyme test0.000.000.000.000.000.00XXX
    82172XAssay of apolipoprotein0.000.000.000.000.000.00XXX
    82175XAssay of arsenic0.000.000.000.000.000.00XXX
    82180XAssay of ascorbic acid0.000.000.000.000.000.00XXX
    82190XAtomic absorption0.000.000.000.000.000.00XXX
    82205XAssay of barbiturates0.000.000.000.000.000.00XXX
    82232XAssay of beta-2 protein0.000.000.000.000.000.00XXX
    82239XBile acids, total0.000.000.000.000.000.00XXX
    82240XBile acids, cholylglycine0.000.000.000.000.000.00XXX
    82247XBilirubin, total0.000.000.000.000.000.00XXX
    82248XBilirubin, direct0.000.000.000.000.000.00XXX
    82252XFecal bilirubin test0.000.000.000.000.000.00XXX
    82261XAssay of biotinidase0.000.000.000.000.000.00XXX
    82270XTest for blood, feces0.000.000.000.000.000.00XXX
    82273XTest for blood, other source0.000.000.000.000.000.00XXX
    82274XAssay test for blood, fecal0.000.000.000.000.000.00XXX
    82286XAssay of bradykinin0.000.000.000.000.000.00XXX
    82300XAssay of cadmium0.000.000.000.000.000.00XXX
    82306XAssay of vitamin D0.000.000.000.000.000.00XXX
    82307XAssay of vitamin D0.000.000.000.000.000.00XXX
    82308XAssay of calcitonin0.000.000.000.000.000.00XXX
    82310XAssay of calcium0.000.000.000.000.000.00XXX
    82330XAssay of calcium0.000.000.000.000.000.00XXX
    82331XCalcium infusion test0.000.000.000.000.000.00XXX
    82340XAssay of calcium in urine0.000.000.000.000.000.00XXX
    82355XCalculus analysis, qual0.000.000.000.000.000.00XXX
    82360XCalculus assay, quant0.000.000.000.000.000.00XXX
    82365XCalculus spectroscopy0.000.000.000.000.000.00XXX
    82370XX-ray assay, calculus0.000.000.000.000.000.00XXX
    82373XAssay, c-d transfer measure0.000.000.000.000.000.00XXX
    82374XAssay, blood carbon dioxide0.000.000.000.000.000.00XXX
    82375XAssay, blood carbon monoxide0.000.000.000.000.000.00XXX
    82376XTest for carbon monoxide0.000.000.000.000.000.00XXX
    82378XCarcinoembryonic antigen0.000.000.000.000.000.00XXX
    82379XAssay of carnitine0.000.000.000.000.000.00XXX
    82380XAssay of carotene0.000.000.000.000.000.00XXX
    82382XAssay, urine catecholamines0.000.000.000.000.000.00XXX
    82383XAssay, blood catecholamines0.000.000.000.000.000.00XXX
    82384XAssay, three catecholamines0.000.000.000.000.000.00XXX
    82387XAssay of cathepsin-d0.000.000.000.000.000.00XXX
    82390XAssay of ceruloplasmin0.000.000.000.000.000.00XXX
    82397XChemiluminescent assay0.000.000.000.000.000.00XXX
    82415XAssay of chloramphenicol0.000.000.000.000.000.00XXX
    82435XAssay of blood chloride0.000.000.000.000.000.00XXX
    82436XAssay of urine chloride0.000.000.000.000.000.00XXX
    82438XAssay, other fluid chlorides0.000.000.000.000.000.00XXX
    82441XTest for chlorohydrocarbons0.000.000.000.000.000.00XXX
    82465XAssay, bld/serum cholesterol0.000.000.000.000.000.00XXX
    82480XAssay, serum cholinesterase0.000.000.000.000.000.00XXX
    82482XAssay, rbc cholinesterase0.000.000.000.000.000.00XXX
    82485XAssay, chondroitin sulfate0.000.000.000.000.000.00XXX
    82486XGas/liquid chromatography0.000.000.000.000.000.00XXX
    82487XPaper chromatography0.000.000.000.000.000.00XXX
    82488XPaper chromatography0.000.000.000.000.000.00XXX
    82489XThin layer chromatography0.000.000.000.000.000.00XXX
    82491XChromotography, quant, sing0.000.000.000.000.000.00XXX
    82492XChromotography, quant, mult0.000.000.000.000.000.00XXX
    82495XAssay of chromium0.000.000.000.000.000.00XXX
    82507XAssay of citrate0.000.000.000.000.000.00XXX
    82520XAssay of cocaine0.000.000.000.000.000.00XXX
    82523XCollagen crosslinks0.000.000.000.000.000.00XXX
    82525XAssay of copper0.000.000.000.000.000.00XXX
    82528XAssay of corticosterone0.000.000.000.000.000.00XXX
    82530XCortisol, free0.000.000.000.000.000.00XXX
    Start Printed Page 55434
    82533XTotal cortisol0.000.000.000.000.000.00XXX
    82540XAssay of creatine0.000.000.000.000.000.00XXX
    82541XColumn chromotography, qual0.000.000.000.000.000.00XXX
    82542XColumn chromotography, quant0.000.000.000.000.000.00XXX
    82543XColumn chromotograph/isotope0.000.000.000.000.000.00XXX
    82544XColumn chromotograph/isotope0.000.000.000.000.000.00XXX
    82550XAssay of ck (cpk)0.000.000.000.000.000.00XXX
    82552XAssay of cpk in blood0.000.000.000.000.000.00XXX
    82553XCreatine, MB fraction0.000.000.000.000.000.00XXX
    82554XCreatine, isoforms0.000.000.000.000.000.00XXX
    82565XAssay of creatinine0.000.000.000.000.000.00XXX
    82570XAssay of urine creatinine0.000.000.000.000.000.00XXX
    82575XCreatinine clearance test0.000.000.000.000.000.00XXX
    82585XAssay of cryofibrinogen0.000.000.000.000.000.00XXX
    82595XAssay of cryoglobulin0.000.000.000.000.000.00XXX
    82600XAssay of cyanide0.000.000.000.000.000.00XXX
    82607XVitamin B-120.000.000.000.000.000.00XXX
    82608XB-12 binding capacity0.000.000.000.000.000.00XXX
    82615XTest for urine cystines0.000.000.000.000.000.00XXX
    82626XDehydroepiandrosterone0.000.000.000.000.000.00XXX
    82627XDehydroepiandrosterone0.000.000.000.000.000.00XXX
    82633XDesoxycorticosterone0.000.000.000.000.000.00XXX
    82634XDeoxycortisol0.000.000.000.000.000.00XXX
    82638XAssay of dibucaine number0.000.000.000.000.000.00XXX
    82646XAssay of dihydrocodeinone0.000.000.000.000.000.00XXX
    82649XAssay of dihydromorphinone0.000.000.000.000.000.00XXX
    82651XAssay of dihydrotestosterone0.000.000.000.000.000.00XXX
    82652XAssay of dihydroxyvitamin d0.000.000.000.000.000.00XXX
    82654XAssay of dimethadione0.000.000.000.000.000.00XXX
    82657XEnzyme cell activity0.000.000.000.000.000.00XXX
    82658XEnzyme cell activity, ra0.000.000.000.000.000.00XXX
    82664XElectrophoretic test0.000.000.000.000.000.00XXX
    82666XAssay of epiandrosterone0.000.000.000.000.000.00XXX
    82668XAssay of erythropoietin0.000.000.000.000.000.00XXX
    82670XAssay of estradiol0.000.000.000.000.000.00XXX
    82671XAssay of estrogens0.000.000.000.000.000.00XXX
    82672XAssay of estrogen0.000.000.000.000.000.00XXX
    82677XAssay of estriol0.000.000.000.000.000.00XXX
    82679XAssay of estrone0.000.000.000.000.000.00XXX
    82690XAssay of ethchlorvynol0.000.000.000.000.000.00XXX
    82693XAssay of ethylene glycol0.000.000.000.000.000.00XXX
    82696XAssay of etiocholanolone0.000.000.000.000.000.00XXX
    82705XFats/lipids, feces, qual0.000.000.000.000.000.00XXX
    82710XFats/lipids, feces, quant0.000.000.000.000.000.00XXX
    82715XAssay of fecal fat0.000.000.000.000.000.00XXX
    82725XAssay of blood fatty acids0.000.000.000.000.000.00XXX
    82726XLong chain fatty acids0.000.000.000.000.000.00XXX
    82728XAssay of ferritin0.000.000.000.000.000.00XXX
    82731XAssay of fetal fibronectin0.000.000.000.000.000.00XXX
    82735XAssay of fluoride0.000.000.000.000.000.00XXX
    82742XAssay of flurazepam0.000.000.000.000.000.00XXX
    82746XBlood folic acid serum0.000.000.000.000.000.00XXX
    82747XAssay of folic acid, rbc0.000.000.000.000.000.00XXX
    82757XAssay of semen fructose0.000.000.000.000.000.00XXX
    82759XAssay of rbc galactokinase0.000.000.000.000.000.00XXX
    82760XAssay of galactose0.000.000.000.000.000.00XXX
    82775XAssay galactose transferase0.000.000.000.000.000.00XXX
    82776XGalactose transferase test0.000.000.000.000.000.00XXX
    82784XAssay of gammaglobulin igm0.000.000.000.000.000.00XXX
    82785XAssay of gammaglobulin ige0.000.000.000.000.000.00XXX
    82787XIgg 1, 2, 3 or 4, each0.000.000.000.000.000.00XXX
    82800XBlood pH0.000.000.000.000.000.00XXX
    82803XBlood gases: pH, pO2 & pCO20.000.000.000.000.000.00XXX
    82805XBlood gases W/02 saturation0.000.000.000.000.000.00XXX
    82810XBlood gases, O2 sat only0.000.000.000.000.000.00XXX
    82820XHemoglobin-oxygen affinity0.000.000.000.000.000.00XXX
    82926XAssay of gastric acid0.000.000.000.000.000.00XXX
    82928XAssay of gastric acid0.000.000.000.000.000.00XXX
    82938XGastrin test0.000.000.000.000.000.00XXX
    82941XAssay of gastrin0.000.000.000.000.000.00XXX
    82943XAssay of glucagon0.000.000.000.000.000.00XXX
    82945XGlucose other fluid0.000.000.000.000.000.00XXX
    82946XGlucagon tolerance test0.000.000.000.000.000.00XXX
    Start Printed Page 55435
    82947XAssay, glucose, blood quant0.000.000.000.000.000.00XXX
    82948XReagent strip/blood glucose0.000.000.000.000.000.00XXX
    82950XGlucose test0.000.000.000.000.000.00XXX
    82951XGlucose tolerance test (GTT)0.000.000.000.000.000.00XXX
    82952XGTT-added samples0.000.000.000.000.000.00XXX
    82953XGlucose-tolbutamide test0.000.000.000.000.000.00XXX
    82955XAssay of g6pd enzyme0.000.000.000.000.000.00XXX
    82960XTest for G6PD enzyme0.000.000.000.000.000.00XXX
    82962XGlucose blood test0.000.000.000.000.000.00XXX
    82963XAssay of glucosidase0.000.000.000.000.000.00XXX
    82965XAssay of gdh enzyme0.000.000.000.000.000.00XXX
    82975XAssay of glutamine0.000.000.000.000.000.00XXX
    82977XAssay of GGT0.000.000.000.000.000.00XXX
    82978XAssay of glutathione0.000.000.000.000.000.00XXX
    82979XAssay, rbc glutathione0.000.000.000.000.000.00XXX
    82980XAssay of glutethimide0.000.000.000.000.000.00XXX
    82985XGlycated protein0.000.000.000.000.000.00XXX
    83001XGonadotropin (FSH)0.000.000.000.000.000.00XXX
    83002XGonadotropin (LH)0.000.000.000.000.000.00XXX
    83003XAssay, growth hormone (hgh)0.000.000.000.000.000.00XXX
    83008XAssay of guanosine0.000.000.000.000.000.00XXX
    83010XAssay of haptoglobin, quant0.000.000.000.000.000.00XXX
    83012XAssay of haptoglobins0.000.000.000.000.000.00XXX
    83013XH pylori analysis0.000.000.000.000.000.00XXX
    83014XH pylori drug admin/collect0.000.000.000.000.000.00XXX
    83015XHeavy metal screen0.000.000.000.000.000.00XXX
    83018XQuantitative screen, metals0.000.000.000.000.000.00XXX
    83020XHemoglobin electrophoresis0.000.000.000.000.000.00XXX
    8302026AHemoglobin electrophoresis0.370.170.170.010.550.55XXX
    83021XHemoglobin chromotography0.000.000.000.000.000.00XXX
    83026XHemoglobin, copper sulfate0.000.000.000.000.000.00XXX
    83030XFetal hemoglobin, chemical0.000.000.000.000.000.00XXX
    83033XFetal hemoglobin assay, qual0.000.000.000.000.000.00XXX
    83036XGlycated hemoglobin test0.000.000.000.000.000.00XXX
    83045XBlood methemoglobin test0.000.000.000.000.000.00XXX
    83050XBlood methemoglobin assay0.000.000.000.000.000.00XXX
    83051XAssay of plasma hemoglobin0.000.000.000.000.000.00XXX
    83055XBlood sulfhemoglobin test0.000.000.000.000.000.00XXX
    83060XBlood sulfhemoglobin assay0.000.000.000.000.000.00XXX
    83065XAssay of hemoglobin heat0.000.000.000.000.000.00XXX
    83068XHemoglobin stability screen0.000.000.000.000.000.00XXX
    83069XAssay of urine hemoglobin0.000.000.000.000.000.00XXX
    83070XAssay of hemosiderin, qual0.000.000.000.000.000.00XXX
    83071XAssay of hemosiderin, quant0.000.000.000.000.000.00XXX
    83080XAssay of b hexosaminidase0.000.000.000.000.000.00XXX
    83088XAssay of histamine0.000.000.000.000.000.00XXX
    83090XAssay of homocystine0.000.000.000.000.000.00XXX
    83150XAssay of for hva0.000.000.000.000.000.00XXX
    83491XAssay of corticosteroids0.000.000.000.000.000.00XXX
    83497XAssay of 5-hiaa0.000.000.000.000.000.00XXX
    83498XAssay of progesterone0.000.000.000.000.000.00XXX
    83499XAssay of progesterone0.000.000.000.000.000.00XXX
    83500XAssay, free hydroxyproline0.000.000.000.000.000.00XXX
    83505XAssay, total hydroxyproline0.000.000.000.000.000.00XXX
    83516XImmunoassay, nonantibody0.000.000.000.000.000.00XXX
    83518XImmunoassay, dipstick0.000.000.000.000.000.00XXX
    83519XImmunoassay, nonantibody0.000.000.000.000.000.00XXX
    83520XImmunoassay, RIA0.000.000.000.000.000.00XXX
    83525XAssay of insulin0.000.000.000.000.000.00XXX
    83527XAssay of insulin0.000.000.000.000.000.00XXX
    83528XAssay of intrinsic factor0.000.000.000.000.000.00XXX
    83540XAssay of iron0.000.000.000.000.000.00XXX
    83550XIron binding test0.000.000.000.000.000.00XXX
    83570XAssay of idh enzyme0.000.000.000.000.000.00XXX
    83582XAssay of ketogenic steroids0.000.000.000.000.000.00XXX
    83586XAssay 17- ketosteroids0.000.000.000.000.000.00XXX
    83593XFractionation, ketosteroids0.000.000.000.000.000.00XXX
    83605XAssay of lactic acid0.000.000.000.000.000.00XXX
    83615XLactate (LD) (LDH) enzyme0.000.000.000.000.000.00XXX
    83625XAssay of ldh enzymes0.000.000.000.000.000.00XXX
    83632XPlacental lactogen0.000.000.000.000.000.00XXX
    83633XTest urine for lactose0.000.000.000.000.000.00XXX
    83634XAssay of urine for lactose0.000.000.000.000.000.00XXXStart Printed Page 55436
    83655XAssay of lead0.000.000.000.000.000.00XXX
    83661XL/s ratio, fetal lung0.000.000.000.000.000.00XXX
    83662XFoam stability, fetal lung0.000.000.000.000.000.00XXX
    83663XFluoro polarize, fetal lung0.000.000.000.000.000.00XXX
    83664XLamellar bdy, fetal lung0.000.000.000.000.000.00XXX
    83670XAssay of lap enzyme0.000.000.000.000.000.00XXX
    83690XAssay of lipase0.000.000.000.000.000.00XXX
    83715XAssay of blood lipoproteins0.000.000.000.000.000.00XXX
    83716XAssay of blood lipoproteins0.000.000.000.000.000.00XXX
    83718XAssay of lipoprotein0.000.000.000.000.000.00XXX
    83719XAssay of blood lipoprotein0.000.000.000.000.000.00XXX
    83721XAssay of blood lipoprotein0.000.000.000.000.000.00XXX
    83727XAssay of lrh hormone0.000.000.000.000.000.00XXX
    83735XAssay of magnesium0.000.000.000.000.000.00XXX
    83775XAssay of md enzyme0.000.000.000.000.000.00XXX
    83785XAssay of manganese0.000.000.000.000.000.00XXX
    83788XMass spectrometry qual0.000.000.000.000.000.00XXX
    83789XMass spectrometry quant0.000.000.000.000.000.00XXX
    83805XAssay of meprobamate0.000.000.000.000.000.00XXX
    83825XAssay of mercury0.000.000.000.000.000.00XXX
    83835XAssay of metanephrines0.000.000.000.000.000.00XXX
    83840XAssay of methadone0.000.000.000.000.000.00XXX
    83857XAssay of methemalbumin0.000.000.000.000.000.00XXX
    83858XAssay of methsuximide0.000.000.000.000.000.00XXX
    83864XMucopolysaccharides0.000.000.000.000.000.00XXX
    83866XMucopolysaccharides screen0.000.000.000.000.000.00XXX
    83872XAssay synovial fluid mucin0.000.000.000.000.000.00XXX
    83873XAssay of csf protein0.000.000.000.000.000.00XXX
    83874XAssay of myoglobin0.000.000.000.000.000.00XXX
    83883XAssay, nephelometry not spec0.000.000.000.000.000.00XXX
    83885XAssay of nickel0.000.000.000.000.000.00XXX
    83887XAssay of nicotine0.000.000.000.000.000.00XXX
    83890XMolecule isolate0.000.000.000.000.000.00XXX
    83891XMolecule isolate nucleic0.000.000.000.000.000.00XXX
    83892XMolecular diagnostics0.000.000.000.000.000.00XXX
    83893XMolecule dot/slot/blot0.000.000.000.000.000.00XXX
    83894XMolecule gel electrophor0.000.000.000.000.000.00XXX
    83896XMolecular diagnostics0.000.000.000.000.000.00XXX
    83897XMolecule nucleic transfer0.000.000.000.000.000.00XXX
    83898XMolecule nucleic ampli0.000.000.000.000.000.00XXX
    83901XMolecule nucleic ampli0.000.000.000.000.000.00XXX
    83902XMolecular diagnostics0.000.000.000.000.000.00XXX
    83903XMolecule mutation scan0.000.000.000.000.000.00XXX
    83904XMolecule mutation identify0.000.000.000.000.000.00XXX
    83905XMolecule mutation identify0.000.000.000.000.000.00XXX
    83906XMolecule mutation identify0.000.000.000.000.000.00XXX
    83912XGenetic examination0.000.000.000.000.000.00XXX
    8391226AGenetic examination0.370.170.170.010.550.55XXX
    83915XAssay of nucleotidase0.000.000.000.000.000.00XXX
    83916XOligoclonal bands0.000.000.000.000.000.00XXX
    83918XOrganic acids, total, quant0.000.000.000.000.000.00XXX
    83919XOrganic acids, qual, each0.000.000.000.000.000.00XXX
    83921XOrganic acid, single, quant0.000.000.000.000.000.00XXX
    83925XAssay of opiates0.000.000.000.000.000.00XXX
    83930XAssay of blood osmolality0.000.000.000.000.000.00XXX
    83935XAssay of urine osmolality0.000.000.000.000.000.00XXX
    83937XAssay of osteocalcin0.000.000.000.000.000.00XXX
    83945XAssay of oxalate0.000.000.000.000.000.00XXX
    83950XOncorprotein, her-2/neu0.000.000.000.000.000.00XXX
    83970XAssay of parathormone0.000.000.000.000.000.00XXX
    83986XAssay of body fluid acidity0.000.000.000.000.000.00XXX
    83992XAssay for phencyclidine0.000.000.000.000.000.00XXX
    84022XAssay of phenothiazine0.000.000.000.000.000.00XXX
    84030XAssay of blood pku0.000.000.000.000.000.00XXX
    84035XAssay of phenylketones0.000.000.000.000.000.00XXX
    84060XAssay acid phosphatase0.000.000.000.000.000.00XXX
    84061XPhosphatase, forensic exam0.000.000.000.000.000.00XXX
    84066XAssay prostate phosphatase0.000.000.000.000.000.00XXX
    84075XAssay alkaline phosphatase0.000.000.000.000.000.00XXX
    84078XAssay alkaline phosphatase0.000.000.000.000.000.00XXX
    84080XAssay alkaline phosphatases0.000.000.000.000.000.00XXX
    84081XAmniotic fluid enzyme test0.000.000.000.000.000.00XXX
    84085XAssay of rbc pg6d enzyme0.000.000.000.000.000.00XXX
    Start Printed Page 55437
    84087XAssay phosphohexose enzymes0.000.000.000.000.000.00XXX
    84100XAssay of phosphorus0.000.000.000.000.000.00XXX
    84105XAssay of urine phosphorus0.000.000.000.000.000.00XXX
    84106XTest for porphobilinogen0.000.000.000.000.000.00XXX
    84110XAssay of porphobilinogen0.000.000.000.000.000.00XXX
    84119XTest urine for porphyrins0.000.000.000.000.000.00XXX
    84120XAssay of urine porphyrins0.000.000.000.000.000.00XXX
    84126XAssay of feces porphyrins0.000.000.000.000.000.00XXX
    84127XAssay of feces porphyrins0.000.000.000.000.000.00XXX
    84132XAssay of serum potassium0.000.000.000.000.000.00XXX
    84133XAssay of urine potassium0.000.000.000.000.000.00XXX
    84134XAssay of prealbumin0.000.000.000.000.000.00XXX
    84135XAssay of pregnanediol0.000.000.000.000.000.00XXX
    84138XAssay of pregnanetriol0.000.000.000.000.000.00XXX
    84140XAssay of pregnenolone0.000.000.000.000.000.00XXX
    84143XAssay of 17-hydroxypregneno0.000.000.000.000.000.00XXX
    84144XAssay of progesterone0.000.000.000.000.000.00XXX
    84146XAssay of prolactin0.000.000.000.000.000.00XXX
    84150XAssay of prostaglandin0.000.000.000.000.000.00XXX
    84152XAssay of psa, complexed0.000.000.000.000.000.00XXX
    84153XAssay of psa, total0.000.000.000.000.000.00XXX
    84154XAssay of psa, free0.000.000.000.000.000.00XXX
    84155XAssay of protein0.000.000.000.000.000.00XXX
    84160XAssay of serum protein0.000.000.000.000.000.00XXX
    84165XAssay of serum proteins0.000.000.000.000.000.00XXX
    8416526AAssay of serum proteins0.370.170.170.010.550.55XXX
    84181XWestern blot test0.000.000.000.000.000.00XXX
    8418126AWestern blot test0.370.150.150.010.530.53XXX
    84182XProtein, western blot test0.000.000.000.000.000.00XXX
    8418226AProtein, western blot test0.370.150.150.010.530.53XXX
    84202XAssay RBC protoporphyrin0.000.000.000.000.000.00XXX
    84203XTest RBC protoporphyrin0.000.000.000.000.000.00XXX
    84206XAssay of proinsulin0.000.000.000.000.000.00XXX
    84207XAssay of vitamin b-60.000.000.000.000.000.00XXX
    84210XAssay of pyruvate0.000.000.000.000.000.00XXX
    84220XAssay of pyruvate kinase0.000.000.000.000.000.00XXX
    84228XAssay of quinine0.000.000.000.000.000.00XXX
    84233XAssay of estrogen0.000.000.000.000.000.00XXX
    84234XAssay of progesterone0.000.000.000.000.000.00XXX
    84235XAssay of endocrine hormone0.000.000.000.000.000.00XXX
    84238XAssay, nonendocrine receptor0.000.000.000.000.000.00XXX
    84244XAssay of renin0.000.000.000.000.000.00XXX
    84252XAssay of vitamin b-20.000.000.000.000.000.00XXX
    84255XAssay of selenium0.000.000.000.000.000.00XXX
    84260XAssay of serotonin0.000.000.000.000.000.00XXX
    84270XAssay of sex hormone globul0.000.000.000.000.000.00XXX
    84275XAssay of sialic acid0.000.000.000.000.000.00XXX
    84285XAssay of silica0.000.000.000.000.000.00XXX
    84295XAssay of serum sodium0.000.000.000.000.000.00XXX
    84300XAssay of urine sodium0.000.000.000.000.000.00XXX
    84305XAssay of somatomedin0.000.000.000.000.000.00XXX
    84307XAssay of somatostatin0.000.000.000.000.000.00XXX
    84311XSpectrophotometry0.000.000.000.000.000.00XXX
    84315XBody fluid specific gravity0.000.000.000.000.000.00XXX
    84375XChromatogram assay, sugars0.000.000.000.000.000.00XXX
    84376XSugars, single, qual0.000.000.000.000.000.00XXX
    84377XSugars, multiple, qual0.000.000.000.000.000.00XXX
    84378XSugars single quant0.000.000.000.000.000.00XXX
    84379XSugars multiple quant0.000.000.000.000.000.00XXX
    84392XAssay of urine sulfate0.000.000.000.000.000.00XXX
    84402XAssay of testosterone0.000.000.000.000.000.00XXX
    84403XAssay of total testosterone0.000.000.000.000.000.00XXX
    84425XAssay of vitamin b-10.000.000.000.000.000.00XXX
    84430XAssay of thiocyanate0.000.000.000.000.000.00XXX
    84432XAssay of thyroglobulin0.000.000.000.000.000.00XXX
    84436XAssay of total thyroxine0.000.000.000.000.000.00XXX
    84437XAssay of neonatal thyroxine0.000.000.000.000.000.00XXX
    84439XAssay of free thyroxine0.000.000.000.000.000.00XXX
    84442XAssay of thyroid activity0.000.000.000.000.000.00XXX
    84443XAssay thyroid stim hormone0.000.000.000.000.000.00XXX
    84445XAssay of tsi0.000.000.000.000.000.00XXX
    84446XAssay of vitamin e0.000.000.000.000.000.00XXX
    84449XAssay of transcortin0.000.000.000.000.000.00XXX
    Start Printed Page 55438
    84450XTransferase (AST) (SGOT)0.000.000.000.000.000.00XXX
    84460XAlanine amino (ALT) (SGPT)0.000.000.000.000.000.00XXX
    84466XAssay of transferrin0.000.000.000.000.000.00XXX
    84478XAssay of triglycerides0.000.000.000.000.000.00XXX
    84479XAssay of thyroid (t3 or t4)0.000.000.000.000.000.00XXX
    84480XAssay, triiodothyronine (t3)0.000.000.000.000.000.00XXX
    84481XFree assay (FT-3)0.000.000.000.000.000.00XXX
    84482XReverse assay (t3)0.000.000.000.000.000.00XXX
    84484XAssay of troponin, quant0.000.000.000.000.000.00XXX
    84485XAssay duodenal fluid trypsin0.000.000.000.000.000.00XXX
    84488XTest feces for trypsin0.000.000.000.000.000.00XXX
    84490XAssay of feces for trypsin0.000.000.000.000.000.00XXX
    84510XAssay of tyrosine0.000.000.000.000.000.00XXX
    84512XAssay of troponin, qual0.000.000.000.000.000.00XXX
    84520XAssay of urea nitrogen0.000.000.000.000.000.00XXX
    84525XUrea nitrogen semi-quant0.000.000.000.000.000.00XXX
    84540XAssay of urine/urea-n0.000.000.000.000.000.00XXX
    84545XUrea-N clearance test0.000.000.000.000.000.00XXX
    84550XAssay of blood/uric acid0.000.000.000.000.000.00XXX
    84560XAssay of urine/uric acid0.000.000.000.000.000.00XXX
    84577XAssay of feces/urobilinogen0.000.000.000.000.000.00XXX
    84578XTest urine urobilinogen0.000.000.000.000.000.00XXX
    84580XAssay of urine urobilinogen0.000.000.000.000.000.00XXX
    84583XAssay of urine urobilinogen0.000.000.000.000.000.00XXX
    84585XAssay of urine vma0.000.000.000.000.000.00XXX
    84586XAssay of vip0.000.000.000.000.000.00XXX
    84588XAssay of vasopressin0.000.000.000.000.000.00XXX
    84590XAssay of vitamin a0.000.000.000.000.000.00XXX
    84591XAssay of nos vitamin0.000.000.000.000.000.00XXX
    84597XAssay of vitamin k0.000.000.000.000.000.00XXX
    84600XAssay of volatiles0.000.000.000.000.000.00XXX
    84620XXylose tolerance test0.000.000.000.000.000.00XXX
    84630XAssay of zinc0.000.000.000.000.000.00XXX
    84681XAssay of c-peptide0.000.000.000.000.000.00XXX
    84702XChorionic gonadotropin test0.000.000.000.000.000.00XXX
    84703XChorionic gonadotropin assay0.000.000.000.000.000.00XXX
    84830XOvulation tests0.000.000.000.000.000.00XXX
    84999XClinical chemistry test0.000.000.000.000.000.00XXX
    85002XBleeding time test0.000.000.000.000.000.00XXX
    85007XDifferential WBC count0.000.000.000.000.000.00XXX
    85008XNondifferential WBC count0.000.000.000.000.000.00XXX
    85009XDifferential WBC count0.000.000.000.000.000.00XXX
    85013XHematocrit0.000.000.000.000.000.00XXX
    85014XHematocrit0.000.000.000.000.000.00XXX
    85018XHemoglobin0.000.000.000.000.000.00XXX
    85021XAutomated hemogram0.000.000.000.000.000.00XXX
    85022XAutomated hemogram0.000.000.000.000.000.00XXX
    85023XAutomated hemogram0.000.000.000.000.000.00XXX
    85024XAutomated hemogram0.000.000.000.000.000.00XXX
    85025XAutomated hemogram0.000.000.000.000.000.00XXX
    85027XAutomated hemogram0.000.000.000.000.000.00XXX
    85031XManual hemogram, cbc0.000.000.000.000.000.00XXX
    85041XRed blood cell (RBC) count0.000.000.000.000.000.00XXX
    85044XReticulocyte count0.000.000.000.000.000.00XXX
    85045XReticulocyte count0.000.000.000.000.000.00XXX
    85046XReticyte/hgb concentrate0.000.000.000.000.000.00XXX
    85048XWhite blood cell (WBC) count0.000.000.000.000.000.00XXX
    85060ABlood smear interpretation0.450.190.190.020.660.66XXX
    85095DBone marrow aspiration0.000.000.000.000.000.00XXX
    85097ABone marrow interpretation0.941.750.430.032.721.40XXX
    85102DBone marrow biopsy0.000.000.000.000.000.00XXX
    85130XChromogenic substrate assay0.000.000.000.000.000.00XXX
    85170XBlood clot retraction0.000.000.000.000.000.00XXX
    85175XBlood clot lysis time0.000.000.000.000.000.00XXX
    85210XBlood clot factor II test0.000.000.000.000.000.00XXX
    85220XBlood clot factor V test0.000.000.000.000.000.00XXX
    85230XBlood clot factor VII test0.000.000.000.000.000.00XXX
    85240XBlood clot factor VIII test0.000.000.000.000.000.00XXX
    85244XBlood clot factor VIII test0.000.000.000.000.000.00XXX
    85245XBlood clot factor VIII test0.000.000.000.000.000.00XXX
    85246XBlood clot factor VIII test0.000.000.000.000.000.00XXX
    85247XBlood clot factor VIII test0.000.000.000.000.000.00XXX
    85250XBlood clot factor IX test0.000.000.000.000.000.00XXX
    Start Printed Page 55439
    85260XBlood clot factor X test0.000.000.000.000.000.00XXX
    85270XBlood clot factor XI test0.000.000.000.000.000.00XXX
    85280XBlood clot factor XII test0.000.000.000.000.000.00XXX
    85290XBlood clot factor XIII test0.000.000.000.000.000.00XXX
    85291XBlood clot factor XIII test0.000.000.000.000.000.00XXX
    85292XBlood clot factor assay0.000.000.000.000.000.00XXX
    85293XBlood clot factor assay0.000.000.000.000.000.00XXX
    85300XAntithrombin III test0.000.000.000.000.000.00XXX
    85301XAntithrombin III test0.000.000.000.000.000.00XXX
    85302XBlood clot inhibitor antigen0.000.000.000.000.000.00XXX
    85303XBlood clot inhibitor test0.000.000.000.000.000.00XXX
    85305XBlood clot inhibitor assay0.000.000.000.000.000.00XXX
    85306XBlood clot inhibitor test0.000.000.000.000.000.00XXX
    85307XAssay activated protein c0.000.000.000.000.000.00XXX
    85335XFactor inhibitor test0.000.000.000.000.000.00XXX
    85337XThrombomodulin0.000.000.000.000.000.00XXX
    85345XCoagulation time0.000.000.000.000.000.00XXX
    85347XCoagulation time0.000.000.000.000.000.00XXX
    85348XCoagulation time0.000.000.000.000.000.00XXX
    85360XEuglobulin lysis0.000.000.000.000.000.00XXX
    85362XFibrin degradation products0.000.000.000.000.000.00XXX
    85366XFibrinogen test0.000.000.000.000.000.00XXX
    85370XFibrinogen test0.000.000.000.000.000.00XXX
    85378XFibrin degradation0.000.000.000.000.000.00XXX
    85379XFibrin degradation0.000.000.000.000.000.00XXX
    85384XFibrinogen0.000.000.000.000.000.00XXX
    85385XFibrinogen0.000.000.000.000.000.00XXX
    85390XFibrinolysins screen0.000.000.000.000.000.00XXX
    8539026AFibrinolysins screen0.370.120.120.010.500.50XXX
    85400XFibrinolytic plasmin0.000.000.000.000.000.00XXX
    85410XFibrinolytic antiplasmin0.000.000.000.000.000.00XXX
    85415XFibrinolytic plasminogen0.000.000.000.000.000.00XXX
    85420XFibrinolytic plasminogen0.000.000.000.000.000.00XXX
    85421XFibrinolytic plasminogen0.000.000.000.000.000.00XXX
    85441XHeinz bodies, direct0.000.000.000.000.000.00XXX
    85445XHeinz bodies, induced0.000.000.000.000.000.00XXX
    85460XHemoglobin, fetal0.000.000.000.000.000.00XXX
    85461XHemoglobin, fetal0.000.000.000.000.000.00XXX
    85475XHemolysin0.000.000.000.000.000.00XXX
    85520XHeparin assay0.000.000.000.000.000.00XXX
    85525XHeparin0.000.000.000.000.000.00XXX
    85530XHeparin-protamine tolerance0.000.000.000.000.000.00XXX
    85535DIron stain, blood cells0.000.000.000.000.000.00XXX
    85536XIron stain peripheral blood0.000.000.000.000.000.00XXX
    85540XWbc alkaline phosphatase0.000.000.000.000.000.00XXX
    85547XRBC mechanical fragility0.000.000.000.000.000.00XXX
    85549XMuramidase0.000.000.000.000.000.00XXX
    85555XRBC osmotic fragility0.000.000.000.000.000.00XXX
    85557XRBC osmotic fragility0.000.000.000.000.000.00XXX
    85576XBlood platelet aggregation0.000.000.000.000.000.00XXX
    8557626ABlood platelet aggregation0.370.160.160.010.540.54XXX
    85585XBlood platelet estimation0.000.000.000.000.000.00XXX
    85590XPlatelet count, manual0.000.000.000.000.000.00XXX
    85595XPlatelet count, automated0.000.000.000.000.000.00XXX
    85597XPlatelet neutralization0.000.000.000.000.000.00XXX
    85610XProthrombin time0.000.000.000.000.000.00XXX
    85611XProthrombin test0.000.000.000.000.000.00XXX
    85612XViper venom prothrombin time0.000.000.000.000.000.00XXX
    85613XRussell viper venom, diluted0.000.000.000.000.000.00XXX
    85635XReptilase test0.000.000.000.000.000.00XXX
    85651XRbc sed rate, nonautomated0.000.000.000.000.000.00XXX
    85652XRbc sed rate, automated0.000.000.000.000.000.00XXX
    85660XRBC sickle cell test0.000.000.000.000.000.00XXX
    85670XThrombin time, plasma0.000.000.000.000.000.00XXX
    85675XThrombin time, titer0.000.000.000.000.000.00XXX
    85705XThromboplastin inhibition0.000.000.000.000.000.00XXX
    85730XThromboplastin time, partial0.000.000.000.000.000.00XXX
    85732XThromboplastin time, partial0.000.000.000.000.000.00XXX
    85810XBlood viscosity examination0.000.000.000.000.000.00XXX
    85999XHematology procedure0.000.000.000.000.000.00XXX
    86000XAgglutinins, febrile0.000.000.000.000.000.00XXX
    86001XAllergen specific igg0.000.000.000.000.000.00XXX
    86003XAllergen specific IgE0.000.000.000.000.000.00XXX
    Start Printed Page 55440
    86005XAllergen specific IgE0.000.000.000.000.000.00XXX
    86021XWBC antibody identification0.000.000.000.000.000.00XXX
    86022XPlatelet antibodies0.000.000.000.000.000.00XXX
    86023XImmunoglobulin assay0.000.000.000.000.000.00XXX
    86038XAntinuclear antibodies0.000.000.000.000.000.00XXX
    86039XAntinuclear antibodies (ANA)0.000.000.000.000.000.00XXX
    86060XAntistreptolysin o, titer0.000.000.000.000.000.00XXX
    86063XAntistreptolysin o, screen0.000.000.000.000.000.00XXX
    86077APhysician blood bank service0.940.480.430.031.451.40XXX
    86078APhysician blood bank service0.940.510.430.031.481.40XXX
    86079APhysician blood bank service0.940.500.440.031.471.41XXX
    86140XC-reactive protein0.000.000.000.000.000.00XXX
    86141XC-reactive protein, hs0.000.000.000.000.000.00XXX
    86146XGlycoprotein antibody0.000.000.000.000.000.00XXX
    86147XCardiolipin antibody0.000.000.000.000.000.00XXX
    86148XPhospholipid antibody0.000.000.000.000.000.00XXX
    86155XChemotaxis assay0.000.000.000.000.000.00XXX
    86156XCold agglutinin, screen0.000.000.000.000.000.00XXX
    86157XCold agglutinin, titer0.000.000.000.000.000.00XXX
    86160XComplement, antigen0.000.000.000.000.000.00XXX
    86161XComplement/function activity0.000.000.000.000.000.00XXX
    86162XComplement, total (CH50)0.000.000.000.000.000.00XXX
    86171XComplement fixation, each0.000.000.000.000.000.00XXX
    86185XCounterimmunoelectrophoresis0.000.000.000.000.000.00XXX
    86215XDeoxyribonuclease, antibody0.000.000.000.000.000.00XXX
    86225XDNA antibody0.000.000.000.000.000.00XXX
    86226XDNA antibody, single strand0.000.000.000.000.000.00XXX
    86235XNuclear antigen antibody0.000.000.000.000.000.00XXX
    86243XFc receptor0.000.000.000.000.000.00XXX
    86255XFluorescent antibody, screen0.000.000.000.000.000.00XXX
    8625526AFluorescent antibody, screen0.370.170.170.010.550.55XXX
    86256XFluorescent antibody, titer0.000.000.000.000.000.00XXX
    8625626AFluorescent antibody, titer0.370.170.170.010.550.55XXX
    86277XGrowth hormone antibody0.000.000.000.000.000.00XXX
    86280XHemagglutination inhibition0.000.000.000.000.000.00XXX
    86294XImmunoassay, tumor qual0.000.000.000.000.000.00XXX
    86300XImmunoassay, tumor ca 15-30.000.000.000.000.000.00XXX
    86301XImmunoassay, tumor ca 19-90.000.000.000.000.000.00XXX
    86304XImmunoassay, tumor, ca 1250.000.000.000.000.000.00XXX
    86308XHeterophile antibodies0.000.000.000.000.000.00XXX
    86309XHeterophile antibodies0.000.000.000.000.000.00XXX
    86310XHeterophile antibodies0.000.000.000.000.000.00XXX
    86316XImmunoassay, tumor other0.000.000.000.000.000.00XXX
    86317XImmunoassay, infectious agent0.000.000.000.000.000.00XXX
    86318XImmunoassay, infectious agent0.000.000.000.000.000.00XXX
    86320XSerum immunoelectrophoresis0.000.000.000.000.000.00XXX
    8632026ASerum immunoelectrophoresis0.370.170.170.010.550.55XXX
    86325XOther immunoelectrophoresis0.000.000.000.000.000.00XXX
    8632526AOther immunoelectrophoresis0.370.170.170.010.550.55XXX
    86327XImmunoelectrophoresis assay0.000.000.000.000.000.00XXX
    8632726AImmunoelectrophoresis assay0.420.200.200.010.630.63XXX
    86329XImmunodiffusion0.000.000.000.000.000.00XXX
    86331XImmunodiffusion ouchterlony0.000.000.000.000.000.00XXX
    86332XImmune complex assay0.000.000.000.000.000.00XXX
    86334XImmunofixation procedure0.000.000.000.000.000.00XXX
    8633426AImmunofixation procedure0.370.170.170.010.550.55XXX
    86336XInhibin A0.000.000.000.000.000.00XXX
    86337XInsulin antibodies0.000.000.000.000.000.00XXX
    86340XIntrinsic factor antibody0.000.000.000.000.000.00XXX
    86341XIslet cell antibody0.000.000.000.000.000.00XXX
    86343XLeukocyte histamine release0.000.000.000.000.000.00XXX
    86344XLeukocyte phagocytosis0.000.000.000.000.000.00XXX
    86353XLymphocyte transformation0.000.000.000.000.000.00XXX
    86359XT cells, total count0.000.000.000.000.000.00XXX
    86360XT cell, absolute count/ratio0.000.000.000.000.000.00XXX
    86361XT cell, absolute count0.000.000.000.000.000.00XXX
    86376XMicrosomal antibody0.000.000.000.000.000.00XXX
    86378XMigration inhibitory factor0.000.000.000.000.000.00XXX
    86382XNeutralization test, viral0.000.000.000.000.000.00XXX
    86384XNitroblue tetrazolium dye0.000.000.000.000.000.00XXX
    86403XParticle agglutination test0.000.000.000.000.000.00XXX
    86406XParticle agglutination test0.000.000.000.000.000.00XXX
    86430XRheumatoid factor test0.000.000.000.000.000.00XXX
    Start Printed Page 55441
    86431XRheumatoid factor, quant0.000.000.000.000.000.00XXX
    86485CSkin test, candida0.000.000.000.000.000.00XXX
    86490ACoccidioidomycosis skin test0.000.28NA0.020.30NAXXX
    86510AHistoplasmosis skin test0.000.30NA0.020.32NAXXX
    86580ATB intradermal test0.000.24NA0.020.26NAXXX
    86585ATB tine test0.000.19NA0.010.20NAXXX
    86586CSkin test, unlisted0.000.000.000.000.000.00XXX
    86590XStreptokinase, antibody0.000.000.000.000.000.00XXX
    86592XBlood serology, qualitative0.000.000.000.000.000.00XXX
    86593XBlood serology, quantitative0.000.000.000.000.000.00XXX
    86602XAntinomyces antibody0.000.000.000.000.000.00XXX
    86603XAdenovirus antibody0.000.000.000.000.000.00XXX
    86606XAspergillus antibody0.000.000.000.000.000.00XXX
    86609XBacterium antibody0.000.000.000.000.000.00XXX
    86611XBartonella antibody0.000.000.000.000.000.00XXX
    86612XBlastomyces antibody0.000.000.000.000.000.00XXX
    86615XBordetella antibody0.000.000.000.000.000.00XXX
    86617XLyme disease antibody0.000.000.000.000.000.00XXX
    86618XLyme disease antibody0.000.000.000.000.000.00XXX
    86619XBorrelia antibody0.000.000.000.000.000.00XXX
    86622XBrucella antibody0.000.000.000.000.000.00XXX
    86625XCampylobacter antibody0.000.000.000.000.000.00XXX
    86628XCandida antibody0.000.000.000.000.000.00XXX
    86631XChlamydia antibody0.000.000.000.000.000.00XXX
    86632XChlamydia igm antibody0.000.000.000.000.000.00XXX
    86635XCoccidioides antibody0.000.000.000.000.000.00XXX
    86638XQ fever antibody0.000.000.000.000.000.00XXX
    86641XCryptococcus antibody0.000.000.000.000.000.00XXX
    86644XCMV antibody0.000.000.000.000.000.00XXX
    86645XCMV antibody, IgM0.000.000.000.000.000.00XXX
    86648XDiphtheria antibody0.000.000.000.000.000.00XXX
    86651XEncephalitis antibody0.000.000.000.000.000.00XXX
    86652XEncephalitis antibody0.000.000.000.000.000.00XXX
    86653XEncephalitis antibody0.000.000.000.000.000.00XXX
    86654XEncephalitis antibody0.000.000.000.000.000.00XXX
    86658XEnterovirus antibody0.000.000.000.000.000.00XXX
    86663XEpstein-barr antibody0.000.000.000.000.000.00XXX
    86664XEpstein-barr antibody0.000.000.000.000.000.00XXX
    86665XEpstein-barr antibody0.000.000.000.000.000.00XXX
    86666XEhrlichia antibody0.000.000.000.000.000.00XXX
    86668XFrancisella tularensis0.000.000.000.000.000.00XXX
    86671XFungus antibody0.000.000.000.000.000.00XXX
    86674XGiardia lamblia antibody0.000.000.000.000.000.00XXX
    86677XHelicobacter pylori0.000.000.000.000.000.00XXX
    86682XHelminth antibody0.000.000.000.000.000.00XXX
    86683DHemoglobin, fecal antibody0.000.000.000.000.000.00XXX
    86684XHemophilus influenza0.000.000.000.000.000.00XXX
    86687XHtlv-i antibody0.000.000.000.000.000.00XXX
    86688XHtlv-ii antibody0.000.000.000.000.000.00XXX
    86689XHTLV/HIV confirmatory test0.000.000.000.000.000.00XXX
    86692XHepatitis, delta agent0.000.000.000.000.000.00XXX
    86694XHerpes simplex test0.000.000.000.000.000.00XXX
    86695XHerpes simplex test0.000.000.000.000.000.00XXX
    86696XHerpes simplex type 20.000.000.000.000.000.00XXX
    86698XHistoplasma0.000.000.000.000.000.00XXX
    86701XHIV-10.000.000.000.000.000.00XXX
    86702XHIV-20.000.000.000.000.000.00XXX
    86703XHIV-1/HIV-2, single assay0.000.000.000.000.000.00XXX
    86704XHep b core antibody, total0.000.000.000.000.000.00XXX
    86705XHep b core antibody, igm0.000.000.000.000.000.00XXX
    86706XHep b surface antibody0.000.000.000.000.000.00XXX
    86707XHep be antibody0.000.000.000.000.000.00XXX
    86708XHep a antibody, total0.000.000.000.000.000.00XXX
    86709XHep a antibody, igm0.000.000.000.000.000.00XXX
    86710XInfluenza virus antibody0.000.000.000.000.000.00XXX
    86713XLegionella antibody0.000.000.000.000.000.00XXX
    86717XLeishmania antibody0.000.000.000.000.000.00XXX
    86720XLeptospira antibody0.000.000.000.000.000.00XXX
    86723XListeria monocytogenes ab0.000.000.000.000.000.00XXX
    86727XLymph choriomeningitis ab0.000.000.000.000.000.00XXX
    86729XLympho venereum antibody0.000.000.000.000.000.00XXX
    86732XMucormycosis antibody0.000.000.000.000.000.00XXX
    86735XMumps antibody0.000.000.000.000.000.00XXX
    Start Printed Page 55442
    86738XMycoplasma antibody0.000.000.000.000.000.00XXX
    86741XNeisseria meningitidis0.000.000.000.000.000.00XXX
    86744XNocardia antibody0.000.000.000.000.000.00XXX
    86747XParvovirus antibody0.000.000.000.000.000.00XXX
    86750XMalaria antibody0.000.000.000.000.000.00XXX
    86753XProtozoa antibody nos0.000.000.000.000.000.00XXX
    86756XRespiratory virus antibody0.000.000.000.000.000.00XXX
    86757XRickettsia antibody0.000.000.000.000.000.00XXX
    86759XRotavirus antibody0.000.000.000.000.000.00XXX
    86762XRubella antibody0.000.000.000.000.000.00XXX
    86765XRubeola antibody0.000.000.000.000.000.00XXX
    86768XSalmonella antibody0.000.000.000.000.000.00XXX
    86771XShigella antibody0.000.000.000.000.000.00XXX
    86774XTetanus antibody0.000.000.000.000.000.00XXX
    86777XToxoplasma antibody0.000.000.000.000.000.00XXX
    86778XToxoplasma antibody, igm0.000.000.000.000.000.00XXX
    86781XTreponema pallidum, confirm0.000.000.000.000.000.00XXX
    86784XTrichinella antibody0.000.000.000.000.000.00XXX
    86787XVaricella-zoster antibody0.000.000.000.000.000.00XXX
    86790XVirus antibody nos0.000.000.000.000.000.00XXX
    86793XYersinia antibody0.000.000.000.000.000.00XXX
    86800XThyroglobulin antibody0.000.000.000.000.000.00XXX
    86803XHepatitis c ab test0.000.000.000.000.000.00XXX
    86804XHep c ab test, confirm0.000.000.000.000.000.00XXX
    86805XLymphocytotoxicity assay0.000.000.000.000.000.00XXX
    86806XLymphocytotoxicity assay0.000.000.000.000.000.00XXX
    86807XCytotoxic antibody screening0.000.000.000.000.000.00XXX
    86808XCytotoxic antibody screening0.000.000.000.000.000.00XXX
    86812XHLA typing, A, B, or C0.000.000.000.000.000.00XXX
    86813XHLA typing, A, B, or C0.000.000.000.000.000.00XXX
    86816XHLA typing, DR/DQ0.000.000.000.000.000.00XXX
    86817XHLA typing, DR/DQ0.000.000.000.000.000.00XXX
    86821XLymphocyte culture, mixed0.000.000.000.000.000.00XXX
    86822XLymphocyte culture, primed0.000.000.000.000.000.00XXX
    86849XImmunology procedure0.000.000.000.000.000.00XXX
    86850XRBC antibody screen0.000.000.000.000.000.00XXX
    86860XRBC antibody elution0.000.000.000.000.000.00XXX
    86870XRBC antibody identification0.000.000.000.000.000.00XXX
    86880XCoombs test0.000.000.000.000.000.00XXX
    86885XCoombs test0.000.000.000.000.000.00XXX
    86886XCoombs test0.000.000.000.000.000.00XXX
    86890XAutologous blood process0.000.000.000.000.000.00XXX
    86891XAutologous blood, op salvage0.000.000.000.000.000.00XXX
    86900XBlood typing, ABO0.000.000.000.000.000.00XXX
    86901XBlood typing, Rh (D)0.000.000.000.000.000.00XXX
    86903XBlood typing, antigen screen0.000.000.000.000.000.00XXX
    86904XBlood typing, patient serum0.000.000.000.000.000.00XXX
    86905XBlood typing, RBC antigens0.000.000.000.000.000.00XXX
    86906XBlood typing, Rh phenotype0.000.000.000.000.000.00XXX
    86910NBlood typing, paternity test0.000.000.000.000.000.00XXX
    86911NBlood typing, antigen system0.000.000.000.000.000.00XXX
    86915XBone marrow/stem cell prep0.000.000.000.000.000.00XXX
    86920XCompatibility test0.000.000.000.000.000.00XXX
    86921XCompatibility test0.000.000.000.000.000.00XXX
    86922XCompatibility test0.000.000.000.000.000.00XXX
    86927XPlasma, fresh frozen0.000.000.000.000.000.00XXX
    86930XFrozen blood prep0.000.000.000.000.000.00XXX
    86931XFrozen blood thaw0.000.000.000.000.000.00XXX
    86932XFrozen blood freeze/thaw0.000.000.000.000.000.00XXX
    86940XHemolysins/agglutinins, auto0.000.000.000.000.000.00XXX
    86941XHemolysins/agglutinins0.000.000.000.000.000.00XXX
    86945XBlood product/irradiation0.000.000.000.000.000.00XXX
    86950XLeukacyte transfusion0.000.000.000.000.000.00XXX
    86965XPooling blood platelets0.000.000.000.000.000.00XXX
    86970XRBC pretreatment0.000.000.000.000.000.00XXX
    86971XRBC pretreatment0.000.000.000.000.000.00XXX
    86972XRBC pretreatment0.000.000.000.000.000.00XXX
    86975XRBC pretreatment, serum0.000.000.000.000.000.00XXX
    86976XRBC pretreatment, serum0.000.000.000.000.000.00XXX
    86977XRBC pretreatment, serum0.000.000.000.000.000.00XXX
    86978XRBC pretreatment, serum0.000.000.000.000.000.00XXX
    86985XSplit blood or products0.000.000.000.000.000.00XXX
    86999XTransfusion procedure0.000.000.000.000.000.00XXX
    Start Printed Page 55443
    87001XSmall animal inoculation0.000.000.000.000.000.00XXX
    87003XSmall animal inoculation0.000.000.000.000.000.00XXX
    87015XSpecimen concentration0.000.000.000.000.000.00XXX
    87040XBlood culture for bacteria0.000.000.000.000.000.00XXX
    87045XFeces culture, bacteria0.000.000.000.000.000.00XXX
    87046XStool cultr, bacteria, each0.000.000.000.000.000.00XXX
    87070XCulture, bacteria, other0.000.000.000.000.000.00XXX
    87071XCulture bacteri aerobic othr0.000.000.000.000.000.00XXX
    87073XCulture bacteria anaerobic0.000.000.000.000.000.00XXX
    87075XCulture bacteria anaerobic0.000.000.000.000.000.00XXX
    87076XCulture anaerobe ident, each0.000.000.000.000.000.00XXX
    87077XCulture aerobic identify0.000.000.000.000.000.00XXX
    87081XCulture screen only0.000.000.000.000.000.00XXX
    87084XCulture of specimen by kit0.000.000.000.000.000.00XXX
    87086XUrine culture/colony count0.000.000.000.000.000.00XXX
    87088XUrine bacteria culture0.000.000.000.000.000.00XXX
    87101XSkin fungi culture0.000.000.000.000.000.00XXX
    87102XFungus isolation culture0.000.000.000.000.000.00XXX
    87103XBlood fungus culture0.000.000.000.000.000.00XXX
    87106XFungi identification, yeast0.000.000.000.000.000.00XXX
    87107XFungi identification, mold0.000.000.000.000.000.00XXX
    87109XMycoplasma0.000.000.000.000.000.00XXX
    87110XChlamydia culture0.000.000.000.000.000.00XXX
    87116XMycobacteria culture0.000.000.000.000.000.00XXX
    87118XMycobacteric identification0.000.000.000.000.000.00XXX
    87140XCulture type immunofluoresc0.000.000.000.000.000.00XXX
    87143XCulture typing, glc/hplc0.000.000.000.000.000.00XXX
    87147XCulture type, immunologic0.000.000.000.000.000.00XXX
    87149XCulture type, nucleic acid0.000.000.000.000.000.00XXX
    87152XCulture type pulse field gel0.000.000.000.000.000.00XXX
    87158XCulture typing, added method0.000.000.000.000.000.00XXX
    87164XDark field examination0.000.000.000.000.000.00XXX
    8716426ADark field examination0.370.120.110.010.500.49XXX
    87166XDark field examination0.000.000.000.000.000.00XXX
    87168XMacroscopic exam arthropod0.000.000.000.000.000.00XXX
    87169XMacacroscopic exam parasite0.000.000.000.000.000.00XXX
    87172XPinworm exam0.000.000.000.000.000.00XXX
    87176XTissue homogenization, cultr0.000.000.000.000.000.00XXX
    87177XOva and parasites smears0.000.000.000.000.000.00XXX
    87181XMicrobe susceptible, diffuse0.000.000.000.000.000.00XXX
    87184XMicrobe susceptible, disk0.000.000.000.000.000.00XXX
    87185XMicrobe susceptible, enzyme0.000.000.000.000.000.00XXX
    87186XMicrobe susceptible, mic0.000.000.000.000.000.00XXX
    87187XMicrobe susceptible, mlc0.000.000.000.000.000.00XXX
    87188XMicrobe suscept, macrobroth0.000.000.000.000.000.00XXX
    87190XMicrobe suscept, mycobacteri0.000.000.000.000.000.00XXX
    87197XBactericidal level, serum0.000.000.000.000.000.00XXX
    87198XCytomegalovirus antibody dfa0.000.000.000.000.000.00XXX
    87199XEnterovirus antibody, dfa0.000.000.000.000.000.00XXX
    87205XSmear, gram stain0.000.000.000.000.000.00XXX
    87206XSmear, fluorescent/acid stai0.000.000.000.000.000.00XXX
    87207XSmear, special stain0.000.000.000.000.000.00XXX
    8720726ASmear, special stain0.370.180.170.010.560.55XXX
    87210XSmear, wet mount, saline/ink0.000.000.000.000.000.00XXX
    87220XTissue exam for fungi0.000.000.000.000.000.00XXX
    87230XAssay, toxin or antitoxin0.000.000.000.000.000.00XXX
    87250XVirus inoculate, eggs/animal0.000.000.000.000.000.00XXX
    87252XVirus inoculation, tissue0.000.000.000.000.000.00XXX
    87253XVirus inoculate tissue, addl0.000.000.000.000.000.00XXX
    87254XVirus inoculation, shell via0.000.000.000.000.000.00XXX
    87260XAdenovirus ag, if0.000.000.000.000.000.00XXX
    87265XPertussis ag, if0.000.000.000.000.000.00XXX
    87270XChlamydia trachomatis ag, if0.000.000.000.000.000.00XXX
    87272XCryptosporidum/gardia ag, if0.000.000.000.000.000.00XXX
    87273XHerpes simplex 2, ag, if0.000.000.000.000.000.00XXX
    87274XHerpes simplex 1, ag, if0.000.000.000.000.000.00XXX
    87275XInfluenza b, ag, if0.000.000.000.000.000.00XXX
    87276XInfluenza a, ag, if0.000.000.000.000.000.00XXX
    87277XLegionella micdadei, ag, if0.000.000.000.000.000.00XXX
    87278XLegion pneumophilia ag, if0.000.000.000.000.000.00XXX
    87279XParainfluenza, ag, if0.000.000.000.000.000.00XXX
    87280XRespiratory syncytial ag, if0.000.000.000.000.000.00XXX
    87281XPneumocystis carinii, ag, if0.000.000.000.000.000.00XXX
    Start Printed Page 55444
    87283XRubeola, ag, if0.000.000.000.000.000.00XXX
    87285XTreponema pallidum, ag, if0.000.000.000.000.000.00XXX
    87290XVaricella zoster, ag, if0.000.000.000.000.000.00XXX
    87299XAntibody detection, nos, if0.000.000.000.000.000.00XXX
    87300XAg detection, polyval, if0.000.000.000.000.000.00XXX
    87301XAdenovirus ag, eia0.000.000.000.000.000.00XXX
    87320XChylmd trach ag, eia0.000.000.000.000.000.00XXX
    87324XClostridium ag, eia0.000.000.000.000.000.00XXX
    87327XCryptococcus neoform ag, eia0.000.000.000.000.000.00XXX
    87328XCryptospor ag, eia0.000.000.000.000.000.00XXX
    87332XCytomegalovirus ag, eia0.000.000.000.000.000.00XXX
    87335XE coli 0157 ag, eia0.000.000.000.000.000.00XXX
    87336XEntamoeb hist dispr, ag, eia0.000.000.000.000.000.00XXX
    87337XEntamoeb hist group, ag, eia0.000.000.000.000.000.00XXX
    87338XHpylori, stool, eia0.000.000.000.000.000.00XXX
    87339XH pylori ag, eia0.000.000.000.000.000.00XXX
    87340XHepatitis b surface ag, eia0.000.000.000.000.000.00XXX
    87341XHepatitis b surface, ag, eia0.000.000.000.000.000.00XXX
    87350XHepatitis be ag, eia0.000.000.000.000.000.00XXX
    87380XHepatitis delta ag, eia0.000.000.000.000.000.00XXX
    87385XHistoplasma capsul ag, eia0.000.000.000.000.000.00XXX
    87390XHiv-1 ag, eia0.000.000.000.000.000.00XXX
    87391XHiv-2 ag, eia0.000.000.000.000.000.00XXX
    87400XInfluenza a/b, ag, eia0.000.000.000.000.000.00XXX
    87420XResp syncytial ag, eia0.000.000.000.000.000.00XXX
    87425XRotavirus ag, eia0.000.000.000.000.000.00XXX
    87427XShiga-like toxin ag, eia0.000.000.000.000.000.00XXX
    87430XStrep a ag, eia0.000.000.000.000.000.00XXX
    87449XAg detect nos, eia, mult0.000.000.000.000.000.00XXX
    87450XAg detect nos, eia, single0.000.000.000.000.000.00XXX
    87451XAg detect polyval, eia, mult0.000.000.000.000.000.00XXX
    87470XBartonella, dna, dir probe0.000.000.000.000.000.00XXX
    87471XBartonella, dna, amp probe0.000.000.000.000.000.00XXX
    87472XBartonella, dna, quant0.000.000.000.000.000.00XXX
    87475XLyme dis, dna, dir probe0.000.000.000.000.000.00XXX
    87476XLyme dis, dna, amp probe0.000.000.000.000.000.00XXX
    87477XLyme dis, dna, quant0.000.000.000.000.000.00XXX
    87480XCandida, dna, dir probe0.000.000.000.000.000.00XXX
    87481XCandida, dna, amp probe0.000.000.000.000.000.00XXX
    87482XCandida, dna, quant0.000.000.000.000.000.00XXX
    87485XChylmd pneum, dna, dir probe0.000.000.000.000.000.00XXX
    87486XChylmd pneum, dna, amp probe0.000.000.000.000.000.00XXX
    87487XChylmd pneum, dna, quant0.000.000.000.000.000.00XXX
    87490XChylmd trach, dna, dir probe0.000.000.000.000.000.00XXX
    87491XChylmd trach, dna, amp probe0.000.000.000.000.000.00XXX
    87492XChylmd trach, dna, quant0.000.000.000.000.000.00XXX
    87495XCytomeg, dna, dir probe0.000.000.000.000.000.00XXX
    87496XCytomeg, dna, amp probe0.000.000.000.000.000.00XXX
    87497XCytomeg, dna, quant0.000.000.000.000.000.00XXX
    87510XGardner vag, dna, dir probe0.000.000.000.000.000.00XXX
    87511XGardner vag, dna, amp probe0.000.000.000.000.000.00XXX
    87512XGardner vag, dna, quant0.000.000.000.000.000.00XXX
    87515XHepatitis b, dna, dir probe0.000.000.000.000.000.00XXX
    87516XHepatitis b, dna, amp probe0.000.000.000.000.000.00XXX
    87517XHepatitis b, dna, quant0.000.000.000.000.000.00XXX
    87520XHepatitis c, rna, dir probe0.000.000.000.000.000.00XXX
    87521XHepatitis c, rna, amp probe0.000.000.000.000.000.00XXX
    87522XHepatitis c, rna, quant0.000.000.000.000.000.00XXX
    87525XHepatitis g, dna, dir probe0.000.000.000.000.000.00XXX
    87526XHepatitis g, dna, amp probe0.000.000.000.000.000.00XXX
    87527XHepatitis g, dna, quant0.000.000.000.000.000.00XXX
    87528XHsv, dna, dir probe0.000.000.000.000.000.00XXX
    87529XHsv, dna, amp probe0.000.000.000.000.000.00XXX
    87530XHsv, dna, quant0.000.000.000.000.000.00XXX
    87531XHhv-6, dna, dir probe0.000.000.000.000.000.00XXX
    87532XHhv-6, dna, amp probe0.000.000.000.000.000.00XXX
    87533XHhv-6, dna, quant0.000.000.000.000.000.00XXX
    87534XHiv-1, dna, dir probe0.000.000.000.000.000.00XXX
    87535XHiv-1, dna, amp probe0.000.000.000.000.000.00XXX
    87536XHiv-1, dna, quant0.000.000.000.000.000.00XXX
    87537XHiv-2, dna, dir probe0.000.000.000.000.000.00XXX
    87538XHiv-2, dna, amp probe0.000.000.000.000.000.00XXX
    87539XHiv-2, dna, quant0.000.000.000.000.000.00XXX
    Start Printed Page 55445
    87540XLegion pneumo, dna, dir prob0.000.000.000.000.000.00XXX
    87541XLegion pneumo, dna, amp prob0.000.000.000.000.000.00XXX
    87542XLegion pneumo, dna, quant0.000.000.000.000.000.00XXX
    87550XMycobacteria, dna, dir probe0.000.000.000.000.000.00XXX
    87551XMycobacteria, dna, amp probe0.000.000.000.000.000.00XXX
    87552XMycobacteria, dna, quant0.000.000.000.000.000.00XXX
    87555XM.tuberculo, dna, dir probe0.000.000.000.000.000.00XXX
    87556XM.tuberculo, dna, amp probe0.000.000.000.000.000.00XXX
    87557XM.tuberculo, dna, quant0.000.000.000.000.000.00XXX
    87560XM.avium-intra, dna, dir prob0.000.000.000.000.000.00XXX
    87561XM.avium-intra, dna, amp prob0.000.000.000.000.000.00XXX
    87562XM.avium-intra, dna, quant0.000.000.000.000.000.00XXX
    87580XM.pneumon, dna, dir probe0.000.000.000.000.000.00XXX
    87581XM.pneumon, dna, amp probe0.000.000.000.000.000.00XXX
    87582XM.pneumon, dna, quant0.000.000.000.000.000.00XXX
    87590XN.gonorrhoeae, dna, dir prob0.000.000.000.000.000.00XXX
    87591XN.gonorrhoeae, dna, amp prob0.000.000.000.000.000.00XXX
    87592XN.gonorrhoeae, dna, quant0.000.000.000.000.000.00XXX
    87620XHpv, dna, dir probe0.000.000.000.000.000.00XXX
    87621XHpv, dna, amp probe0.000.000.000.000.000.00XXX
    87622XHpv, dna, quant0.000.000.000.000.000.00XXX
    87650XStrep a, dna, dir probe0.000.000.000.000.000.00XXX
    87651XStrep a, dna, amp probe0.000.000.000.000.000.00XXX
    87652XStrep a, dna, quant0.000.000.000.000.000.00XXX
    87797XDetect agent nos, dna, dir0.000.000.000.000.000.00XXX
    87798XDetect agent nos, dna, amp0.000.000.000.000.000.00XXX
    87799XDetect agent nos, dna, quant0.000.000.000.000.000.00XXX
    87800XDetect agnt mult, dna, direc0.000.000.000.000.000.00XXX
    87801XDetect agnt mult, dna, ampli0.000.000.000.000.000.00XXX
    87802XStrep b assay w/optic0.000.000.000.000.000.00XXX
    87803XClostridium toxin a w/optic0.000.000.000.000.000.00XXX
    87804XInfluenza assay w/optic0.000.000.000.000.000.00XXX
    87810XChylmd trach assay w/optic0.000.000.000.000.000.00XXX
    87850XN. gonorrhoeae assay w/optic0.000.000.000.000.000.00XXX
    87880XStrep a assay w/optic0.000.000.000.000.000.00XXX
    87899XAgent nos assay w/optic0.000.000.000.000.000.00XXX
    87901XGenotype, dna, hiv reverse t0.000.000.000.000.000.00XXX
    87902XGenotype, dna, hepatitis C0.000.000.000.000.000.00XXX
    87903XPhenotype, dna hiv w/culture0.000.000.000.000.000.00XXX
    87904XPhenotype, dna hiv w/clt add0.000.000.000.000.000.00XXX
    87999XMicrobiology procedure0.000.000.000.000.000.00XXX
    88000NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88005NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88007NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88012NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88014NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88016NAutopsy (necropsy), gross0.000.000.000.000.000.00XXX
    88020NAutopsy (necropsy), complete0.000.000.000.000.000.00XXX
    88025NAutopsy (necropsy), complete0.000.000.000.000.000.00XXX
    88027NAutopsy (necropsy), complete0.000.000.000.000.000.00XXX
    88028NAutopsy (necropsy), complete0.000.000.000.000.000.00XXX
    88029NAutopsy (necropsy), complete0.000.000.000.000.000.00XXX
    88036NLimited autopsy0.000.000.000.000.000.00XXX
    88037NLimited autopsy0.000.000.000.000.000.00XXX
    88040NForensic autopsy (necropsy)0.000.000.000.000.000.00XXX
    88045NCoroner's autopsy (necropsy)0.000.000.000.000.000.00XXX
    88099NNecropsy (autopsy) procedure0.000.000.000.000.000.00XXX
    88104ACytopathology, fluids0.560.72NA0.041.32NAXXX
    8810426ACytopathology, fluids0.560.260.260.020.840.84XXX
    88104TCACytopathology, fluids0.000.46NA0.020.48NAXXX
    88106ACytopathology, fluids0.560.72NA0.041.32NAXXX
    8810626ACytopathology, fluids0.560.260.260.020.840.84XXX
    88106TCACytopathology, fluids0.000.46NA0.020.48NAXXX
    88107ACytopathology, fluids0.761.01NA0.051.82NAXXX
    8810726ACytopathology, fluids0.760.350.350.031.141.14XXX
    88107TCACytopathology, fluids0.000.66NA0.020.68NAXXX
    88108ACytopath, concentrate tech0.560.94NA0.041.54NAXXX
    8810826ACytopath, concentrate tech0.560.260.260.020.840.84XXX
    88108TCACytopath, concentrate tech0.000.68NA0.020.70NAXXX
    88125AForensic cytopathology0.260.30NA0.020.58NAXXX
    8812526AForensic cytopathology0.260.120.120.010.390.39XXX
    88125TCAForensic cytopathology0.000.18NA0.010.19NAXXX
    88130XSex chromatin identification0.000.000.000.000.000.00XXX
    Start Printed Page 55446
    88140XSex chromatin identification0.000.000.000.000.000.00XXX
    88141ACytopath, c/v, interpret0.420.190.190.010.620.62XXX
    88142XCytopath, c/v, thin layer0.000.000.000.000.000.00XXX
    88143XCytopath, c/v, thin lyr redo0.000.000.000.000.000.00XXX
    88144XCytopath, c/v, thin lyr redo0.000.000.000.000.000.00XXX
    88145XCytopath, c/v, thin lyr sel0.000.000.000.000.000.00XXX
    88147XCytopath, c/v, automated0.000.000.000.000.000.00XXX
    88148XCytopath, c/v, auto rescreen0.000.000.000.000.000.00XXX
    88150XCytopath, c/v, manual0.000.000.000.000.000.00XXX
    88152XCytopath, c/v, auto redo0.000.000.000.000.000.00XXX
    88153XCytopath, c/v, redo0.000.000.000.000.000.00XXX
    88154XCytopath, c/v, select0.000.000.000.000.000.00XXX
    88155XCytopath, c/v, index add-on0.000.000.000.000.000.00XXX
    88160ACytopath smear, other source0.501.01NA0.041.55NAXXX
    8816026ACytopath smear, other source0.500.230.230.020.750.75XXX
    88160TCACytopath smear, other source0.000.78NA0.020.80NAXXX
    88161ACytopath smear, other source0.501.22NA0.041.76NAXXX
    8816126ACytopath smear, other source0.500.230.230.020.750.75XXX
    88161TCACytopath smear, other source0.000.99NA0.021.01NAXXX
    88162ACytopath smear, other source0.760.73NA0.051.54NAXXX
    8816226ACytopath smear, other source0.760.350.350.031.141.14XXX
    88162TCACytopath smear, other source0.000.38NA0.020.40NAXXX
    88164XCytopath tbs, c/v, manual0.000.000.000.000.000.00XXX
    88165XCytopath tbs, c/v, redo0.000.000.000.000.000.00XXX
    88166XCytopath tbs, c/v, auto redo0.000.000.000.000.000.00XXX
    88167XCytopath tbs, c/v, select0.000.000.000.000.000.00XXX
    88170DFine needle aspiration0.000.00NA0.000.00NAXXX
    8817026DFine needle aspiration0.000.000.000.000.000.00XXX
    88170TCDFine needle aspiration0.000.00NA0.000.00NAXXX
    88171DFine needle aspiration0.000.00NA0.000.00NAXXX
    8817126DFine needle aspiration0.000.000.000.000.000.00XXX
    88171TCDFine needle aspiration0.000.00NA0.000.00NAXXX
    88172ACytopathology eval of fna0.600.68NA0.041.32NAXXX
    8817226ACytopathology eval of fna0.600.280.280.020.900.90XXX
    88172TCACytopathology eval of fna0.000.40NA0.020.42NAXXX
    88173ACytopath eval, fna, report1.391.80NA0.073.26NAXXX
    8817326ACytopath eval, fna, report1.390.640.640.052.082.08XXX
    88173TCACytopath eval, fna, report0.001.16NA0.021.18NAXXX
    88180ACell marker study0.360.60NA0.030.99NAXXX
    8818026ACell marker study0.360.170.170.010.540.54XXX
    88180TCACell marker study0.000.43NA0.020.45NAXXX
    88182ACell marker study0.771.81NA0.062.64NAXXX
    8818226ACell marker study0.770.360.360.031.161.16XXX
    88182TCACell marker study0.001.45NA0.031.48NAXXX
    88199CCytopathology procedure0.000.000.000.000.000.00XXX
    8819926CCytopathology procedure0.000.000.000.000.000.00XXX
    88199TCCCytopathology procedure0.000.000.000.000.000.00XXX
    88230XTissue culture, lymphocyte0.000.000.000.000.000.00XXX
    88233XTissue culture, skin/biopsy0.000.000.000.000.000.00XXX
    88235XTissue culture, placenta0.000.000.000.000.000.00XXX
    88237XTissue culture, bone marrow0.000.000.000.000.000.00XXX
    88239XTissue culture, tumor0.000.000.000.000.000.00XXX
    88240XCell cryopreserve/storage0.000.000.000.000.000.00XXX
    88241XFrozen cell preparation0.000.000.000.000.000.00XXX
    88245XChromosome analysis, 20-250.000.000.000.000.000.00XXX
    88248XChromosome analysis, 50-1000.000.000.000.000.000.00XXX
    88249XChromosome analysis, 1000.000.000.000.000.000.00XXX
    88261XChromosome analysis, 50.000.000.000.000.000.00XXX
    88262XChromosome analysis, 15-200.000.000.000.000.000.00XXX
    88263XChromosome analysis, 450.000.000.000.000.000.00XXX
    88264XChromosome analysis, 20-250.000.000.000.000.000.00XXX
    88267XChromosome analys, placenta0.000.000.000.000.000.00XXX
    88269XChromosome analys, amniotic0.000.000.000.000.000.00XXX
    88271XCytogenetics, dna probe0.000.000.000.000.000.00XXX
    88272XCytogenetics, 3-50.000.000.000.000.000.00XXX
    88273XCytogenetics, 10-300.000.000.000.000.000.00XXX
    88274XCytogenetics, 25-990.000.000.000.000.000.00XXX
    88275XCytogenetics, 100-3000.000.000.000.000.000.00XXX
    88280XChromosome karyotype study0.000.000.000.000.000.00XXX
    88283XChromosome banding study0.000.000.000.000.000.00XXX
    88285XChromosome count, additional0.000.000.000.000.000.00XXX
    88289XChromosome study, additional0.000.000.000.000.000.00XXX
    88291ACyto/molecular report0.520.230.230.020.770.77XXX
    Start Printed Page 55447
    88299CCytogenetic study0.000.000.000.000.000.00XXX
    88300ASurgical path, gross0.080.34NA0.020.44NAXXX
    8830026ASurgical path, gross0.080.040.040.010.130.13XXX
    88300TCASurgical path, gross0.000.30NA0.010.31NAXXX
    88302ATissue exam by pathologist0.130.73NA0.030.89NAXXX
    8830226ATissue exam by pathologist0.130.060.060.010.200.20XXX
    88302TCATissue exam by pathologist0.000.67NA0.020.69NAXXX
    88304ATissue exam by pathologist0.220.95NA0.031.20NAXXX
    8830426ATissue exam by pathologist0.220.100.100.010.330.33XXX
    88304TCATissue exam by pathologist0.000.85NA0.020.87NAXXX
    88305ATissue exam by pathologist0.751.78NA0.052.58NAXXX
    8830526ATissue exam by pathologist0.750.350.350.021.121.12XXX
    88305TCATissue exam by pathologist0.001.43NA0.031.46NAXXX
    88307ATissue exam by pathologist1.592.71NA0.114.41NAXXX
    8830726ATissue exam by pathologist1.590.740.740.062.392.39XXX
    88307TCATissue exam by pathologist0.001.97NA0.052.02NAXXX
    88309ATissue exam by pathologist2.283.40NA0.135.81NAXXX
    8830926ATissue exam by pathologist2.281.051.050.083.413.41XXX
    88309TCATissue exam by pathologist0.002.35NA0.052.40NAXXX
    88311ADecalcify tissue0.240.21NA0.020.47NAXXX
    8831126ADecalcify tissue0.240.110.110.010.360.36XXX
    88311TCADecalcify tissue0.000.10NA0.010.11NAXXX
    88312ASpecial stains0.541.69NA0.032.26NAXXX
    8831226ASpecial stains0.540.250.250.020.810.81XXX
    88312TCASpecial stains0.001.44NA0.011.45NAXXX
    88313ASpecial stains0.241.47NA0.021.73NAXXX
    8831326ASpecial stains0.240.110.110.010.360.36XXX
    88313TCASpecial stains0.001.36NA0.011.37NAXXX
    88314AHistochemical stain0.450.86NA0.041.35NAXXX
    8831426AHistochemical stain0.450.200.200.020.670.67XXX
    88314TCAHistochemical stain0.000.66NA0.020.68NAXXX
    88318AChemical histochemistry0.420.59NA0.021.03NAXXX
    8831826AChemical histochemistry0.420.200.200.010.630.63XXX
    88318TCAChemical histochemistry0.000.39NA0.010.40NAXXX
    88319AEnzyme histochemistry0.532.45NA0.043.02NAXXX
    8831926AEnzyme histochemistry0.530.240.240.020.790.79XXX
    88319TCAEnzyme histochemistry0.002.21NA0.022.23NAXXX
    88321AMicroslide consultation1.300.620.600.041.961.94XXX
    88323AMicroslide consultation1.351.37NA0.072.79NAXXX
    8832326AMicroslide consultation1.350.630.630.052.032.03XXX
    88323TCAMicroslide consultation0.000.74NA0.020.76NAXXX
    88325AComprehensive review of data2.220.980.980.083.283.28XXX
    88329APath consult introp0.670.390.310.021.081.00XXX
    88331APath consult intraop, 1 bloc1.190.87NA0.072.13NAXXX
    8833126APath consult intraop, 1 bloc1.190.550.550.041.781.78XXX
    88331TCAPath consult intraop, 1 bloc0.000.32NA0.030.35NAXXX
    88332APath consult intraop, addl0.590.47NA0.041.10NAXXX
    8833226APath consult intraop, addl0.590.270.270.020.880.88XXX
    88332TCAPath consult intraop, addl0.000.20NA0.020.22NAXXX
    88342AImmunocytochemistry0.851.43NA0.052.33NAXXX
    8834226AImmunocytochemistry0.850.390.390.031.271.27XXX
    88342TCAImmunocytochemistry0.001.04NA0.021.06NAXXX
    88346AImmunofluorescent study0.861.20NA0.052.11NAXXX
    8834626AImmunofluorescent study0.860.390.390.031.281.28XXX
    88346TCAImmunofluorescent study0.000.81NA0.020.83NAXXX
    88347AImmunofluorescent study0.861.90NA0.052.81NAXXX
    8834726AImmunofluorescent study0.860.380.380.031.271.27XXX
    88347TCAImmunofluorescent study0.001.52NA0.021.54NAXXX
    88348AElectron microscopy1.516.96NA0.118.58NAXXX
    8834826AElectron microscopy1.510.690.690.052.252.25XXX
    88348TCAElectron microscopy0.006.27NA0.066.33NAXXX
    88349AScanning electron microscopy0.768.51NA0.089.35NAXXX
    8834926AScanning electron microscopy0.760.350.350.031.141.14XXX
    88349TCAScanning electron microscopy0.008.16NA0.058.21NAXXX
    88355AAnalysis, skeletal muscle1.852.41NA0.124.38NAXXX
    8835526AAnalysis, skeletal muscle1.850.860.860.072.782.78XXX
    88355TCAAnalysis, skeletal muscle0.001.55NA0.051.60NAXXX
    88356AAnalysis, nerve3.024.96NA0.168.14NAXXX
    8835626AAnalysis, nerve3.021.371.370.104.494.49XXX
    88356TCAAnalysis, nerve0.003.59NA0.063.65NAXXX
    88358AAnalysis, tumor2.821.76NA0.164.74NAXXX
    8835826AAnalysis, tumor2.821.301.300.104.224.22XXX
    88358TCAAnalysis, tumor0.000.46NA0.060.52NAXXX
    Start Printed Page 55448
    88362ANerve teasing preparations2.173.36NA0.125.65NAXXX
    8836226ANerve teasing preparations2.170.990.990.073.233.23XXX
    88362TCANerve teasing preparations0.002.37NA0.052.42NAXXX
    88365ATissue hybridization0.932.03NA0.053.01NAXXX
    8836526ATissue hybridization0.930.430.430.031.391.39XXX
    88365TCATissue hybridization0.001.60NA0.021.62NAXXX
    88371XProtein, western blot tissue0.000.000.000.000.000.00XXX
    8837126AProtein, western blot tissue0.370.150.140.010.530.52XXX
    88372XProtein analysis w/probe0.000.000.000.000.000.00XXX
    8837226AProtein analysis w/probe0.370.170.170.010.550.55XXX
    88380CMicrodissection0.000.000.000.000.000.00XXX
    8838026CMicrodissection0.000.000.000.000.000.00XXX
    88380TCCMicrodissection0.000.000.000.000.000.00XXX
    88399CSurgical pathology procedure0.000.000.000.000.000.00XXX
    8839926CSurgical pathology procedure0.000.000.000.000.000.00XXX
    88399TCCSurgical pathology procedure0.000.000.000.000.000.00XXX
    88400XBilirubin total transcut0.000.000.000.000.000.00XXX
    89050XBody fluid cell count0.000.000.000.000.000.00XXX
    89051XBody fluid cell count0.000.000.000.000.000.00XXX
    89060XExam synovial fluid crystals0.000.000.000.000.000.00XXX
    8906026AExam synovial fluid crystals0.370.180.170.010.560.55XXX
    89100ASample intestinal contents0.602.290.230.022.910.85XXX
    89105ASample intestinal contents0.502.250.180.022.770.70XXX
    89125XSpecimen fat stain0.000.000.000.000.000.00XXX
    89130ASample stomach contents0.452.210.130.022.680.60XXX
    89132ASample stomach contents0.191.150.050.011.350.25XXX
    89135ASample stomach contents0.792.530.250.033.351.07XXX
    89136ASample stomach contents0.212.050.080.012.270.30XXX
    89140ASample stomach contents0.942.360.190.033.331.16XXX
    89141ASample stomach contents0.853.140.400.034.021.28XXX
    89160XExam feces for meat fibers0.000.000.000.000.000.00XXX
    89190XNasal smear for eosinophils0.000.000.000.000.000.00XXX
    89250XFertilization of oocyte0.000.000.000.000.000.00XXX
    89251XCulture oocyte w/embryos0.000.000.000.000.000.00XXX
    89252XAssist oocyte fertilization0.000.000.000.000.000.00XXX
    89253XEmbryo hatching0.000.000.000.000.000.00XXX
    89254XOocyte identification0.000.000.000.000.000.00XXX
    89255XPrepare embryo for transfer0.000.000.000.000.000.00XXX
    89256XPrepare cryopreserved embryo0.000.000.000.000.000.00XXX
    89257XSperm identification0.000.000.000.000.000.00XXX
    89258XCryopreservation, embryo0.000.000.000.000.000.00XXX
    89259XCryopreservation, sperm0.000.000.000.000.000.00XXX
    89260XSperm isolation, simple0.000.000.000.000.000.00XXX
    89261XSperm isolation, complex0.000.000.000.000.000.00XXX
    89264XIdentify sperm tissue0.000.000.000.000.000.00XXX
    89300XSemen analysis0.000.000.000.000.000.00XXX
    89310XSemen analysis0.000.000.000.000.000.00XXX
    89320XSemen analysis0.000.000.000.000.000.00XXX
    89321XSemen analysis0.000.000.000.000.000.00XXX
    89325XSperm antibody test0.000.000.000.000.000.00XXX
    89329XSperm evaluation test0.000.000.000.000.000.00XXX
    89330XEvaluation, cervical mucus0.000.000.000.000.000.00XXX
    89350ASputum specimen collection0.000.39NA0.020.41NAXXX
    89355XExam feces for starch0.000.000.000.000.000.00XXX
    89360ACollect sweat for test0.000.43NA0.020.45NAXXX
    89365XWater load test0.000.000.000.000.000.00XXX
    89399CPathology lab procedure0.000.000.000.000.000.00XXX
    8939926CPathology lab procedure0.000.000.000.000.000.00XXX
    89399TCCPathology lab procedure0.000.000.000.000.000.00XXX
    90281IHuman ig, im0.000.000.000.000.000.00XXX
    90283IHuman ig, iv0.000.000.000.000.000.00XXX
    90287IBotulinum antitoxin0.000.000.000.000.000.00XXX
    90288IBotulism ig, iv0.000.000.000.000.000.00XXX
    90291ICmv ig, iv0.000.000.000.000.000.00XXX
    90296EDiphtheria antitoxin0.000.000.000.000.000.00XXX
    90371EHep b ig, im0.000.000.000.000.000.00XXX
    90375ERabies ig, im/sc0.000.000.000.000.000.00XXX
    90376ERabies ig, heat treated0.000.000.000.000.000.00XXX
    90378XRsv ig, im, 50mg0.000.000.000.000.000.00XXX
    90379IRsv ig, iv0.000.000.000.000.000.00XXX
    90384IRh ig, full-dose, im0.000.000.000.000.000.00XXX
    90385ERh ig, minidose, im0.000.000.000.000.000.00XXX
    90386IRh ig, iv0.000.000.000.000.000.00XXX
    Start Printed Page 55449
    90389ITetanus ig, im0.000.000.000.000.000.00XXX
    90393EVaccina ig, im0.000.000.000.000.000.00XXX
    90396EVaricella-zoster ig, im0.000.000.000.000.000.00XXX
    90399IImmune globulin0.000.000.000.000.000.00XXX
    90471AImmunization admin0.000.10NA0.010.11NAXXX
    90472AImmunization admin, each add0.000.10NA0.010.11NAZZZ
    90473NImmune admin oral/nasal0.000.000.000.000.000.00XXX
    90474NImmune admin oral/nasal addl0.000.000.000.000.000.00ZZZ
    90476EAdenovirus vaccine, type 40.000.000.000.000.000.00XXX
    90477EAdenovirus vaccine, type 70.000.000.000.000.000.00XXX
    90581EAnthrax vaccine, sc0.000.000.000.000.000.00XXX
    90585EBcg vaccine, percut0.000.000.000.000.000.00XXX
    90586EBcg vaccine, intravesical0.000.000.000.000.000.00XXX
    90632EHep a vaccine, adult im0.000.000.000.000.000.00XXX
    90633EHep a vacc, ped/adol, 2 dose0.000.000.000.000.000.00XXX
    90634EHep a vacc, ped/adol, 3 dose0.000.000.000.000.000.00XXX
    90636EHep a/hep b vacc, adult im0.000.000.000.000.000.00XXX
    90645EHib vaccine, hboc, im0.000.000.000.000.000.00XXX
    90646EHib vaccine, prp-d, im0.000.000.000.000.000.00XXX
    90647EHib vaccine, prp-omp, im0.000.000.000.000.000.00XXX
    90648EHib vaccine, prp-t, im0.000.000.000.000.000.00XXX
    90657XFlu vaccine, 6-35 mo, im0.000.000.000.000.000.00XXX
    90658XFlu vaccine, 3 yrs, im0.000.000.000.000.000.00XXX
    90659XFlu vaccine, whole, im0.000.000.000.000.000.00XXX
    90660XFlu vaccine, nasal0.000.000.000.000.000.00XXX
    90665ELyme disease vaccine, im0.000.000.000.000.000.00XXX
    90669NPneumococcal vacc, ped<50.000.000.000.000.000.00XXX
    90675ERabies vaccine, im0.000.000.000.000.000.00XXX
    90676ERabies vaccine, id0.000.000.000.000.000.00XXX
    90680ERotovirus vaccine, oral0.000.000.000.000.000.00XXX
    90690ETyphoid vaccine, oral0.000.000.000.000.000.00XXX
    90691ETyphoid vaccine, im0.000.000.000.000.000.00XXX
    90692ETyphoid vaccine, h-p, sc/id0.000.000.000.000.000.00XXX
    90693ETyphoid vaccine, akd, sc0.000.000.000.000.000.00XXX
    90700EDtap vaccine, im0.000.000.000.000.000.00XXX
    90701EDtp vaccine, im0.000.000.000.000.000.00XXX
    90702EDt vaccine < 7, im0.000.000.000.000.000.00XXX
    90703ETetanus vaccine, im0.000.000.000.000.000.00XXX
    90704EMumps vaccine, sc0.000.000.000.000.000.00XXX
    90705EMeasles vaccine, sc0.000.000.000.000.000.00XXX
    90706ERubella vaccine, sc0.000.000.000.000.000.00XXX
    90707EMmr vaccine, sc0.000.000.000.000.000.00XXX
    90708EMeasles-rubella vaccine, sc0.000.000.000.000.000.00XXX
    90709ERubella & mumps vaccine, sc0.000.000.000.000.000.00XXX
    90710EMmrv vaccine, sc0.000.000.000.000.000.00XXX
    90712EOral poliovirus vaccine0.000.000.000.000.000.00XXX
    90713EPoliovirus, ipv, sc0.000.000.000.000.000.00XXX
    90716EChicken pox vaccine, sc0.000.000.000.000.000.00XXX
    90717EYellow fever vaccine, sc0.000.000.000.000.000.00XXX
    90718ETd vaccine > 7, im0.000.000.000.000.000.00XXX
    90719EDiphtheria vaccine, im0.000.000.000.000.000.00XXX
    90720EDtp/hib vaccine, im0.000.000.000.000.000.00XXX
    90721EDtap/hib vaccine, im0.000.000.000.000.000.00XXX
    90723XDtap-hep b-ipv vaccine, im0.000.000.000.000.000.00XXX
    90725ECholera vaccine, injectable0.000.000.000.000.000.00XXX
    90727EPlague vaccine, im0.000.000.000.000.000.00XXX
    90732XPneumococcal vaccine0.000.000.000.000.000.00XXX
    90733EMeningococcal vaccine, sc0.000.000.000.000.000.00XXX
    90735EEncephalitis vaccine, sc0.000.000.000.000.000.00XXX
    90740XHepb vacc, ill pat 3 dose im0.000.000.000.000.000.00XXX
    90743XHep b vacc, adol, 2 dose, im0.000.000.000.000.000.00XXX
    90744XHepb vacc ped/adol 3 dose im0.000.000.000.000.000.00XXX
    90746XHep b vaccine, adult, im0.000.000.000.000.000.00XXX
    90747XHepb vacc, ill pat 4 dose im0.000.000.000.000.000.00XXX
    90748EHep b/hib vaccine, im0.000.000.000.000.000.00XXX
    90749EVaccine toxoid0.000.000.000.000.000.00XXX
    90780AIV infusion therapy, 1 hour0.001.06NA0.061.12NAXXX
    90781AIV infusion, additional hour0.000.53NA0.030.56NAZZZ
    90782TInjection, sc/im0.000.10NA0.010.11NAXXX
    90783TInjection, ia0.000.39NA0.020.41NAXXX
    90784TInjection, iv0.000.45NA0.030.48NAXXX
    90788TInjection of antibiotic0.000.11NA0.010.12NAXXX
    90799CTher/prophylactic/dx inject0.000.000.000.000.000.00XXX
    Start Printed Page 55450
    90801APsy dx interview2.801.140.930.064.003.79XXX
    90802AIntac psy dx interview3.011.170.990.074.254.07XXX
    90804APsytx, office, 20-30 min1.210.530.400.031.771.64XXX
    90805APsytx, off, 20-30 min w/e&m1.370.590.440.031.991.84XXX
    90806APsytx, off, 45-50 min1.860.750.620.042.652.52XXX
    90807APsytx, off, 45-50 min w/e&m2.020.790.660.052.862.73XXX
    90808APsytx, office, 75-80 min2.791.060.930.073.923.79XXX
    90809APsytx, off, 75-80, w/e&m2.951.110.970.074.133.99XXX
    90810AIntac psytx, off, 20-30 min1.320.560.440.031.911.79XXX
    90811AIntac psytx, 20-30, w/e&m1.480.630.480.032.141.99XXX
    90812AIntac psytx, off, 45-50 min1.970.800.690.052.822.71XXX
    90813AIntac psytx, 45-50 min w/e&m2.130.870.710.053.052.89XXX
    90814AIntac psytx, off, 75-80 min2.901.151.010.074.123.98XXX
    90815AIntac psytx, 75-80 w/e&m3.061.151.020.074.284.15XXX
    90816APsytx, hosp, 20-30 min1.250.570.430.031.851.71XXX
    90817APsytx, hosp, 20-30 min w/e&m1.410.620.450.032.061.89XXX
    90818APsytx, hosp, 45-50 min1.890.800.650.042.732.58XXX
    90819APsytx, hosp, 45-50 min w/e&m2.050.830.660.052.932.76XXX
    90821APsytx, hosp, 75-80 min2.831.110.970.064.003.86XXX
    90822APsytx, hosp, 75-80 min w/e&m2.991.300.970.074.364.03XXX
    90823AIntac psytx, hosp, 20-30 min1.360.650.450.032.041.84XXX
    90824AIntac psytx, hsp 20-30 w/e&m1.520.700.500.032.252.05XXX
    90826AIntac psytx, hosp, 45-50 min2.010.890.680.042.942.73XXX
    90827AIntac psytx, hsp 45-50 w/e&m2.160.910.700.053.122.91XXX
    90828AIntac psytx, hosp, 75-80 min2.941.901.020.074.914.03XXX
    90829AIntac psytx, hsp 75-80 w/e&m3.101.231.020.074.404.19XXX
    90845APsychoanalysis1.790.710.570.042.542.40XXX
    90846RFamily psytx w/o patient1.830.730.620.042.602.49XXX
    90847RFamily psytx w/patient2.210.860.750.053.123.01XXX
    90849RMultiple family group psytx0.590.310.200.010.910.80XXX
    90853AGroup psychotherapy0.590.350.200.010.950.80XXX
    90857AIntac group psytx0.630.370.210.021.020.86XXX
    90862AMedication management0.950.440.310.021.411.28XXX
    90865ANarcosynthesis2.841.700.940.074.613.85XXX
    90870AElectroconvulsive therapy1.880.740.740.042.662.66000
    90871AElectroconvulsive therapy2.72NA1.040.06NA3.82000
    90875NPsychophysiological therapy+1.200.900.480.032.131.71XXX
    90876NPsychophysiological therapy+1.901.180.760.043.122.70XXX
    90880AHypnotherapy2.190.910.710.053.152.95XXX
    90882NEnvironmental manipulation0.000.000.000.000.000.00XXX
    90885BPsy evaluation of records+0.970.390.390.021.381.38XXX
    90887BConsultation with family+1.480.830.590.032.342.10XXX
    90889BPreparation of report0.000.000.000.000.000.00XXX
    90899CPsychiatric service/therapy0.000.000.000.000.000.00XXX
    90901ABiofeedback train, any meth0.410.820.170.021.250.60000
    90911ABiofeedback peri/uro/rectal0.890.870.390.041.801.32000
    90918AESRD related services, month11.185.535.530.3017.0117.01XXX
    90919AESRD related services, month8.544.534.530.2413.3113.31XXX
    90920AESRD related services, month7.274.024.020.1911.4811.48XXX
    90921AESRD related services, month4.472.962.960.127.557.55XXX
    90922AESRD related services, day0.370.170.170.010.550.55XXX
    90923AESRD related services, day0.280.150.150.010.440.44XXX
    90924AESRD related services, day0.240.130.130.010.380.38XXX
    90925AESRD related services, day0.150.100.100.010.260.26XXX
    90935AHemodialysis, one evaluation1.22NA0.860.03NA2.11000
    90937AHemodialysis, repeated eval2.11NA1.200.06NA3.37000
    90939XHemodialysis study, transcut0.000.000.000.000.000.00XXX
    90940XHemodialysis access study0.000.000.000.000.000.00XXX
    90945ADialysis, one evaluation1.28NA0.890.04NA2.21000
    90947ADialysis, repeated eval2.16NA1.240.06NA3.46000
    90989XDialysis training, complete0.000.000.000.000.000.00XXX
    90993XDialysis training, incompl0.000.000.000.000.000.00XXX
    90997AHemoperfusion1.84NA1.100.05NA2.99000
    90999CDialysis procedure0.000.000.000.000.000.00XXX
    91000AEsophageal intubation0.730.32NA0.041.09NA000
    9100026AEsophageal intubation0.730.250.250.031.011.01000
    91000TCAEsophageal intubation0.000.07NA0.010.08NA000
    91010AEsophagus motility study1.252.60NA0.103.95NA000
    9101026AEsophagus motility study1.250.460.460.051.761.76000
    91010TCAEsophagus motility study0.002.14NA0.052.19NA000
    91011AEsophagus motility study1.502.71NA0.104.31NA000
    9101126AEsophagus motility study1.500.550.550.052.102.10000
    91011TCAEsophagus motility study0.002.16NA0.052.21NA000
    Start Printed Page 55451
    91012AEsophagus motility study1.462.35NA0.123.93NA000
    9101226AEsophagus motility study1.460.540.540.062.062.06000
    91012TCAEsophagus motility study0.001.81NA0.061.87NA000
    91020AGastric motility1.442.96NA0.114.51NA000
    9102026AGastric motility1.440.510.510.062.012.01000
    91020TCAGastric motility0.002.45NA0.052.50NA000
    91030AAcid perfusion of esophagus0.912.27NA0.053.23NA000
    9103026AAcid perfusion of esophagus0.910.340.340.031.281.28000
    91030TCAAcid perfusion of esophagus0.001.93NA0.021.95NA000
    91032AEsophagus, acid reflux test1.212.26NA0.103.57NA000
    9103226AEsophagus, acid reflux test1.210.440.440.051.701.70000
    91032TCAEsophagus, acid reflux test0.001.82NA0.051.87NA000
    91033AProlonged acid reflux test1.302.64NA0.144.08NA000
    9103326AProlonged acid reflux test1.300.480.480.051.831.83000
    91033TCAProlonged acid reflux test0.002.16NA0.092.25NA000
    91052AGastric analysis test0.792.19NA0.053.03NA000
    9105226AGastric analysis test0.790.290.290.031.111.11000
    91052TCAGastric analysis test0.001.90NA0.021.92NA000
    91055AGastric intubation for smear0.942.22NA0.063.22NA000
    9105526AGastric intubation for smear0.940.280.280.041.261.26000
    91055TCAGastric intubation for smear0.001.94NA0.021.96NA000
    91060AGastric saline load test0.450.28NA0.040.77NA000
    9106026AGastric saline load test0.450.150.150.020.620.62000
    91060TCAGastric saline load test0.000.13NA0.020.15NA000
    91065ABreath hydrogen test0.204.55NA0.034.78NA000
    9106526ABreath hydrogen test0.200.070.070.010.280.28000
    91065TCABreath hydrogen test0.004.48NA0.024.50NA000
    91100APass intestine bleeding tube1.08NA0.480.06NA1.62000
    91105AGastric intubation treatment0.37NA0.210.02NA0.60000
    91122AAnal pressure record1.772.77NA0.174.71NA000
    9112226AAnal pressure record1.770.630.630.102.502.50000
    91122TCAAnal pressure record0.002.14NA0.072.21NA000
    91123BIrrigate fecal impaction0.000.000.000.000.000.00XXX
    91132CElectrogastrography0.000.000.000.000.000.00XXX
    9113226AElectrogastrography0.520.21NA0.030.76NAXXX
    91132TCCElectrogastrography0.000.000.000.000.000.00XXX
    91133CElectrogastrography w/test0.000.000.000.000.000.00XXX
    9113326AElectrogastrography w/test0.660.26NA0.030.95NAXXX
    91133TCCElectrogastrography w/test0.000.000.000.000.000.00XXX
    91299CGastroenterology procedure0.000.000.000.000.000.00XXX
    9129926CGastroenterology procedure0.000.000.000.000.000.00XXX
    91299TCCGastroenterology procedure0.000.000.000.000.000.00XXX
    92002AEye exam, new patient0.880.960.380.021.861.28XXX
    92004AEye exam, new patient1.671.710.730.033.412.43XXX
    92012AEye exam established pat0.671.010.310.011.690.99XXX
    92014AEye exam & treatment1.101.400.500.022.521.62XXX
    92015NRefraction+0.381.510.150.011.900.54XXX
    92018ANew eye exam & treatment2.50NA1.140.03NA3.67XXX
    92019AEye exam & treatment1.31NA0.610.03NA1.95XXX
    92020ASpecial eye evaluation0.370.950.170.011.330.55XXX
    92060ASpecial eye evaluation0.690.74NA0.021.45NAXXX
    9206026ASpecial eye evaluation0.690.310.310.011.011.01XXX
    92060TCASpecial eye evaluation0.000.43NA0.010.44NAXXX
    92065AOrthoptic/pleoptic training0.371.19NA0.021.58NAXXX
    9206526AOrthoptic/pleoptic training0.370.150.150.010.530.53XXX
    92065TCAOrthoptic/pleoptic training0.001.04NA0.011.05NAXXX
    92070AFitting of contact lens0.701.120.340.011.831.05XXX
    92081AVisual field examination(s)0.361.84NA0.022.22NAXXX
    9208126AVisual field examination(s)0.360.160.160.010.530.53XXX
    92081TCAVisual field examination(s)0.001.68NA0.011.69NAXXX
    92082AVisual field examination(s)0.440.85NA0.021.31NAXXX
    9208226AVisual field examination(s)0.440.200.200.010.650.65XXX
    92082TCAVisual field examination(s)0.000.65NA0.010.66NAXXX
    92083AVisual field examination(s)0.501.51NA0.022.03NAXXX
    9208326AVisual field examination(s)0.500.230.230.010.740.74XXX
    92083TCAVisual field examination(s)0.001.28NA0.011.29NAXXX
    92100ASerial tonometry exam(s)0.920.750.400.021.691.34XXX
    92120ATonography & eye evaluation0.810.810.310.021.641.14XXX
    92130AWater provocation tonography0.810.920.320.021.751.15XXX
    92135AOphthalmic dx imaging0.351.48NA0.021.85NAXXX
    9213526AOphthalmic dx imaging0.350.170.170.010.530.53XXX
    92135TCAOphthalmic dx imaging0.001.31NA0.011.32NAXXX
    92136AOphthalmic biometry0.541.52NA0.072.13NAXXX
    Start Printed Page 55452
    9213626AOphthalmic biometry0.540.220.220.010.770.77XXX
    92136TCAOphthalmic biometry0.001.30NA0.061.36NAXXX
    92140AGlaucoma provocative tests0.501.010.220.011.520.73XXX
    92225ASpecial eye exam, initial0.380.230.170.010.620.56XXX
    92226ASpecial eye exam, subsequent0.330.220.150.010.560.49XXX
    92230AEye exam with photos0.601.730.210.022.350.83XXX
    92235AEye exam with photos0.812.62NA0.073.50NAXXX
    9223526AEye exam with photos0.810.390.390.021.221.22XXX
    92235TCAEye exam with photos0.002.23NA0.052.28NAXXX
    92240AIcg angiography1.105.24NA0.076.41NAXXX
    9224026AIcg angiography1.100.530.530.021.651.65XXX
    92240TCAIcg angiography0.004.71NA0.054.76NAXXX
    92250AEye exam with photos0.441.37NA0.021.83NAXXX
    9225026AEye exam with photos0.440.200.200.010.650.65XXX
    92250TCAEye exam with photos0.001.17NA0.011.18NAXXX
    92260AOphthalmoscopy/dynamometry0.200.240.100.010.450.31XXX
    92265AEye muscle evaluation0.811.23NA0.042.08NAXXX
    9226526AEye muscle evaluation0.810.380.380.021.211.21XXX
    92265TCAEye muscle evaluation0.000.85NA0.020.87NAXXX
    92270AElectro-oculography0.811.15NA0.052.01NAXXX
    9227026AElectro-oculography0.810.370.370.031.211.21XXX
    92270TCAElectro-oculography0.000.78NA0.020.80NAXXX
    92275AElectroretinography1.011.25NA0.042.30NAXXX
    9227526AElectroretinography1.010.460.460.021.491.49XXX
    92275TCAElectroretinography0.000.79NA0.020.81NAXXX
    92283AColor vision examination0.170.74NA0.020.93NAXXX
    9228326AColor vision examination0.170.070.070.010.250.25XXX
    92283TCAColor vision examination0.000.67NA0.010.68NAXXX
    92284ADark adaptation eye exam0.241.75NA0.022.01NAXXX
    9228426ADark adaptation eye exam0.240.090.090.010.340.34XXX
    92284TCADark adaptation eye exam0.001.66NA0.011.67NAXXX
    92285AEye photography0.200.80NA0.021.02NAXXX
    9228526AEye photography0.200.090.090.010.300.30XXX
    92285TCAEye photography0.000.71NA0.010.72NAXXX
    92286AInternal eye photography0.663.00NA0.033.69NAXXX
    9228626AInternal eye photography0.660.320.320.010.990.99XXX
    92286TCAInternal eye photography0.002.68NA0.022.70NAXXX
    92287AInternal eye photography0.813.160.310.023.991.14XXX
    92310NContact lens fitting+1.171.100.470.032.301.67XXX
    92311AContact lens fitting1.081.170.310.032.281.42XXX
    92312AContact lens fitting1.261.170.450.032.461.74XXX
    92313AContact lens fitting0.921.210.330.022.151.27XXX
    92314NPrescription of contact lens+0.690.910.280.011.610.98XXX
    92315APrescription of contact lens0.450.950.170.011.410.63XXX
    92316APrescription of contact lens0.681.030.300.011.720.99XXX
    92317APrescription of contact lens0.450.970.180.011.430.64XXX
    92325AModification of contact lens0.000.38NA0.010.39NAXXX
    92326AReplacement of contact lens0.001.55NA0.051.60NAXXX
    92330AFitting of artificial eye1.081.010.380.042.131.50XXX
    92335AFitting of artificial eye0.450.990.170.011.450.63XXX
    92340NFitting of spectacles+0.370.680.150.011.060.53XXX
    92341NFitting of spectacles+0.470.720.190.011.200.67XXX
    92342NFitting of spectacles+0.530.740.210.011.280.75XXX
    92352BSpecial spectacles fitting+0.370.680.150.011.060.53XXX
    92353BSpecial spectacles fitting+0.500.730.200.021.250.72XXX
    92354BSpecial spectacles fitting+0.008.41NA0.088.49NAXXX
    92355BSpecial spectacles fitting+0.004.11NA0.014.12NAXXX
    92358BEye prosthesis service+0.000.92NA0.040.96NAXXX
    92370NRepair & adjust spectacles+0.320.540.130.020.880.47XXX
    92371BRepair & adjust spectacles+0.000.59NA0.020.61NAXXX
    92390NSupply of spectacles0.000.000.000.000.000.00XXX
    92391NSupply of contact lenses0.000.000.000.000.000.00XXX
    92392ISupply of low vision aids+0.003.84NA0.023.86NAXXX
    92393ISupply of artificial eye+0.0011.92NA0.4712.39NAXXX
    92395ISupply of spectacles+0.001.30NA0.081.38NAXXX
    92396ISupply of contact lenses+0.002.19NA0.062.25NAXXX
    92499CEye service or procedure0.000.000.000.000.000.00XXX
    9249926CEye service or procedure0.000.000.000.000.000.00XXX
    92499TCCEye service or procedure0.000.000.000.000.000.00XXX
    92502AEar and throat examination1.51NA1.280.06NA2.85000
    92504AEar microscopy examination0.181.100.090.011.290.28XXX
    92506ASpeech/hearing evaluation0.861.720.430.042.621.33XXX
    92507ASpeech/hearing therapy0.521.540.280.022.080.82XXX
    Start Printed Page 55453
    92508ASpeech/hearing therapy0.261.770.150.012.040.42XXX
    92510ARehab for ear implant1.502.110.830.063.672.39XXX
    92511ANasopharyngoscopy0.841.360.420.032.231.29000
    92512ANasal function studies0.551.130.170.021.700.74XXX
    92516AFacial nerve function test0.430.940.240.021.390.69XXX
    92520ALaryngeal function studies0.760.520.430.031.311.22XXX
    92525IOral function evaluation+1.501.690.600.073.262.17XXX
    92526AOral function therapy0.551.550.270.022.120.84XXX
    92531BSpontaneous nystagmus study0.000.000.000.000.000.00XXX
    92532BPositional nystagmus test0.000.000.000.000.000.00XXX
    92533BCaloric vestibular test0.000.000.000.000.000.00XXX
    92534BOptokinetic nystagmus test0.000.000.000.000.000.00XXX
    92541ASpontaneous nystagmus test0.401.45NA0.041.89NAXXX
    9254126ASpontaneous nystagmus test0.400.200.200.020.620.62XXX
    92541TCASpontaneous nystagmus test0.001.25NA0.021.27NAXXX
    92542APositional nystagmus test0.331.39NA0.031.75NAXXX
    9254226APositional nystagmus test0.330.170.170.010.510.51XXX
    92542TCAPositional nystagmus test0.001.22NA0.021.24NAXXX
    92543ACaloric vestibular test0.100.39NA0.020.51NAXXX
    9254326ACaloric vestibular test0.100.050.050.010.160.16XXX
    92543TCACaloric vestibular test0.000.34NA0.010.35NAXXX
    92544AOptokinetic nystagmus test0.261.35NA0.031.64NAXXX
    9254426AOptokinetic nystagmus test0.260.130.130.010.400.40XXX
    92544TCAOptokinetic nystagmus test0.001.22NA0.021.24NAXXX
    92545AOscillating tracking test0.231.32NA0.031.58NAXXX
    9254526AOscillating tracking test0.230.120.120.010.360.36XXX
    92545TCAOscillating tracking test0.001.20NA0.021.22NAXXX
    92546ASinusoidal rotational test0.292.22NA0.032.54NAXXX
    9254626ASinusoidal rotational test0.290.140.140.010.440.44XXX
    92546TCASinusoidal rotational test0.002.08NA0.022.10NAXXX
    92547ASupplemental electrical test0.001.21NA0.051.26NAZZZ
    92548APosturography0.502.09NA0.132.72NAXXX
    9254826APosturography0.500.280.280.020.800.80XXX
    92548TCAPosturography0.001.81NA0.111.92NAXXX
    92551NPure tone hearing test, air0.000.000.000.000.000.00XXX
    92552APure tone audiometry, air0.000.42NA0.030.45NAXXX
    92553AAudiometry, air & bone0.000.62NA0.050.67NAXXX
    92555ASpeech threshold audiometry0.000.36NA0.030.39NAXXX
    92556ASpeech audiometry, complete0.000.54NA0.050.59NAXXX
    92557AComprehensive hearing test0.001.13NA0.101.23NAXXX
    92559NGroup audiometric testing0.000.000.000.000.000.00XXX
    92560NBekesy audiometry, screen0.000.000.000.000.000.00XXX
    92561ABekesy audiometry, diagnosis0.000.68NA0.050.73NAXXX
    92562ALoudness balance test0.000.39NA0.030.42NAXXX
    92563ATone decay hearing test0.000.36NA0.030.39NAXXX
    92564ASisi hearing test0.000.45NA0.040.49NAXXX
    92565AStenger test, pure tone0.000.38NA0.030.41NAXXX
    92567ATympanometry0.000.50NA0.050.55NAXXX
    92568AAcoustic reflex testing0.000.36NA0.030.39NAXXX
    92569AAcoustic reflex decay test0.000.39NA0.030.42NAXXX
    92571AFiltered speech hearing test0.000.37NA0.030.40NAXXX
    92572AStaggered spondaic word test0.000.08NA0.010.09NAXXX
    92573ALombard test0.000.33NA0.030.36NAXXX
    92575ASensorineural acuity test0.000.28NA0.020.30NAXXX
    92576ASynthetic sentence test0.000.42NA0.040.46NAXXX
    92577AStenger test, speech0.000.68NA0.060.74NAXXX
    92579AVisual audiometry (vra)0.000.69NA0.050.74NAXXX
    92582AConditioning play audiometry0.000.69NA0.050.74NAXXX
    92583ASelect picture audiometry0.000.84NA0.070.91NAXXX
    92584AElectrocochleography0.002.35NA0.172.52NAXXX
    92585AAuditor evoke potent, compre0.501.98NA0.142.62NAXXX
    9258526AAuditor evoke potent, compre0.500.230.230.020.750.75XXX
    92585TCAAuditor evoke potent, compre0.001.75NA0.121.87NAXXX
    92586AAuditor evoke potent, limit0.001.75NA0.121.87NAXXX
    92587AEvoked auditory test0.131.31NA0.101.54NAXXX
    9258726AEvoked auditory test0.130.070.070.010.210.21XXX
    92587TCAEvoked auditory test0.001.24NA0.091.33NAXXX
    92588AEvoked auditory test0.361.58NA0.122.06NAXXX
    9258826AEvoked auditory test0.360.180.180.010.550.55XXX
    92588TCAEvoked auditory test0.001.40NA0.111.51NAXXX
    92589AAuditory function test(s)0.000.51NA0.050.56NAXXX
    92590NHearing aid exam, one ear0.000.000.000.000.000.00XXX
    92591NHearing aid exam, both ears0.000.000.000.000.000.00XXX
    Start Printed Page 55454
    92592NHearing aid check, one ear0.000.000.000.000.000.00XXX
    92593NHearing aid check, both ears0.000.000.000.000.000.00XXX
    92594NElectro hearng aid test, one0.000.000.000.000.000.00XXX
    92595NElectro hearng aid tst, both0.000.000.000.000.000.00XXX
    92596AEar protector evaluation0.000.56NA0.050.61NAXXX
    92599CENT procedure/service0.000.000.000.000.000.00XXX
    9259926CENT procedure/service0.000.000.000.000.000.00XXX
    92599TCCENT procedure/service0.000.000.000.000.000.00XXX
    92950AHeart/lung resuscitation cpr3.801.591.180.215.605.19000
    92953ATemporary external pacing0.23NA0.230.01NA0.47000
    92960ACardioversion electric, ext2.252.230.910.084.563.24000
    92961ACardioversion, electric, int4.60NA1.850.17NA6.62000
    92970ACardioassist, internal3.52NA1.270.17NA4.96000
    92971ACardioassist, external1.77NA0.860.06NA2.69000
    92973APercut coronary thrombectomy3.28NA1.370.17NA4.82ZZZ
    92974ACath place, cardio brachytx3.00NA1.261.18NA5.44ZZZ
    92975ADissolve clot, heart vessel7.25NA3.010.22NA10.48000
    92977ADissolve clot, heart vessel0.007.65NA0.388.03NAXXX
    92978AIntravasc us, heart add-on1.805.09NA0.267.15NAZZZ
    9297826AIntravasc us, heart add-on1.800.760.760.062.622.62ZZZ
    92978TCAIntravasc us, heart add-on0.004.33NA0.204.53NAZZZ
    92979AIntravasc us, heart add-on1.442.76NA0.154.35NAZZZ
    9297926AIntravasc us, heart add-on1.440.580.580.042.062.06ZZZ
    92979TCAIntravasc us, heart add-on0.002.18NA0.112.29NAZZZ
    92980AInsert intracoronary stent14.84NA6.220.78NA21.84000
    92981AInsert intracoronary stent4.17NA1.750.21NA6.13ZZZ
    92982ACoronary artery dilation10.98NA4.590.57NA16.14000
    92984ACoronary artery dilation2.97NA1.240.16NA4.37ZZZ
    92986ARevision of aortic valve21.80NA10.431.14NA33.37090
    92987ARevision of mitral valve22.70NA10.851.18NA34.73090
    92990ARevision of pulmonary valve17.34NA8.410.90NA26.65090
    92992CRevision of heart chamber0.000.000.000.000.000.00090
    92993CRevision of heart chamber0.000.000.000.000.000.00090
    92995ACoronary atherectomy12.09NA5.060.63NA17.78000
    92996ACoronary atherectomy add-on3.26NA1.370.17NA4.80ZZZ
    92997APul art balloon repr, percut12.00NA4.550.63NA17.18000
    92998APul art balloon repr, percut6.00NA2.060.31NA8.37ZZZ
    93000AElectrocardiogram, complete0.170.50NA0.030.70NAXXX
    93005AElectrocardiogram, tracing0.000.43NA0.020.45NAXXX
    93010AElectrocardiogram report0.170.070.070.010.250.25XXX
    93012ATransmission of ecg0.002.24NA0.152.39NAXXX
    93014AReport on transmitted ecg0.520.190.190.020.730.73XXX
    93015ACardiovascular stress test0.751.90NA0.112.76NAXXX
    93016ACardiovascular stress test0.450.180.180.010.640.64XXX
    93017ACardiovascular stress test0.001.60NA0.091.69NAXXX
    93018ACardiovascular stress test0.300.120.120.010.430.43XXX
    93024ACardiac drug stress test1.171.55NA0.112.83NAXXX
    9302426ACardiac drug stress test1.170.480.480.041.691.69XXX
    93024TCACardiac drug stress test0.001.07NA0.071.14NAXXX
    93025AMicrovolt t-wave assess0.756.42NA0.117.28NAXXX
    93040ARhythm ECG with report0.160.19NA0.020.37NAXXX
    93041ARhythm ECG, tracing0.000.14NA0.010.15NAXXX
    93042ARhythm ECG, report0.160.050.050.010.220.22XXX
    93224AECG monitor/report, 24 hrs0.523.47NA0.214.20NAXXX
    93225AECG monitor/record, 24 hrs0.001.18NA0.071.25NAXXX
    93226AECG monitor/report, 24 hrs0.002.08NA0.122.20NAXXX
    93227AECG monitor/review, 24 hrs0.520.210.210.020.750.75XXX
    93230AECG monitor/report, 24 hrs0.523.72NA0.224.46NAXXX
    93231AEcg monitor/record, 24 hrs0.001.44NA0.091.53NAXXX
    93232AECG monitor/report, 24 hrs0.002.07NA0.112.18NAXXX
    93233AECG monitor/review, 24 hrs0.520.210.210.020.750.75XXX
    93235AECG monitor/report, 24 hrs0.452.66NA0.133.24NAXXX
    93236AECG monitor/report, 24 hrs0.002.49NA0.122.61NAXXX
    93237AECG monitor/review, 24 hrs0.450.170.170.010.630.63XXX
    93268AECG record/review0.523.62NA0.244.38NAXXX
    93270AECG recording0.001.18NA0.071.25NAXXX
    93271AEcg/monitoring and analysis0.002.24NA0.152.39NAXXX
    93272AEcg/review, interpret only0.520.200.200.020.740.74XXX
    93278AECG/signal-averaged0.251.19NA0.101.54NAXXX
    9327826AECG/signal-averaged0.250.100.100.010.360.36XXX
    93278TCAECG/signal-averaged0.001.09NA0.091.18NAXXX
    93303AEcho transthoracic1.304.16NA0.235.69NAXXX
    9330326AEcho transthoracic1.300.500.500.041.841.84XXX
    Start Printed Page 55455
    93303TCAEcho transthoracic0.003.66NA0.193.85NAXXX
    93304AEcho transthoracic0.752.15NA0.133.03NAXXX
    9330426AEcho transthoracic0.750.300.300.021.071.07XXX
    93304TCAEcho transthoracic0.001.85NA0.111.96NAXXX
    93307AEcho exam of heart0.924.04NA0.225.18NAXXX
    9330726AEcho exam of heart0.920.380.380.031.331.33XXX
    93307TCAEcho exam of heart0.003.66NA0.193.85NAXXX
    93308AEcho exam of heart0.532.07NA0.132.73NAXXX
    9330826AEcho exam of heart0.530.220.220.020.770.77XXX
    93308TCAEcho exam of heart0.001.85NA0.111.96NAXXX
    93312AEcho transesophageal2.204.45NA0.326.97NAXXX
    9331226AEcho transesophageal2.200.860.860.083.143.14XXX
    93312TCAEcho transesophageal0.003.59NA0.243.83NAXXX
    93313AEcho transesophageal0.955.290.220.056.291.22XXX
    93314AEcho transesophageal1.254.10NA0.285.63NAXXX
    9331426AEcho transesophageal1.250.510.510.041.801.80XXX
    93314TCAEcho transesophageal0.003.59NA0.243.83NAXXX
    93315AEcho transesophageal2.784.70NA0.347.82NAXXX
    9331526AEcho transesophageal2.781.111.110.103.993.99XXX
    93315TCAEcho transesophageal0.003.59NA0.243.83NAXXX
    93316AEcho transesophageal0.956.390.250.057.391.25XXX
    93317AEcho transesophageal1.834.31NA0.306.44NAXXX
    9331726AEcho transesophageal1.830.720.720.062.612.61XXX
    93317TCAEcho transesophageal0.003.59NA0.243.83NAXXX
    93318CEcho transesophageal intraop0.000.000.000.000.000.00XXX
    9331826AEcho transesophageal intraop2.200.88NA0.063.14NAXXX
    93318TCCEcho transesophageal intraop0.000.000.000.000.000.00XXX
    93320ADoppler echo exam, heart0.381.79NA0.112.28NAZZZ
    9332026ADoppler echo exam, heart0.380.160.160.010.550.55ZZZ
    93320TCADoppler echo exam, heart0.001.63NA0.101.73NAZZZ
    93321ADoppler echo exam, heart0.151.12NA0.081.35NAZZZ
    9332126ADoppler echo exam, heart0.150.060.060.010.220.22ZZZ
    93321TCADoppler echo exam, heart0.001.06NA0.071.13NAZZZ
    93325ADoppler color flow add-on0.072.78NA0.183.03NAZZZ
    9332526ADoppler color flow add-on0.070.030.030.010.110.11ZZZ
    93325TCADoppler color flow add-on0.002.75NA0.172.92NAZZZ
    93350AEcho transthoracic1.482.28NA0.133.89NAXXX
    9335026AEcho transthoracic1.480.610.610.022.112.11XXX
    93350TCAEcho transthoracic0.001.67NA0.111.78NAXXX
    93501ARight heart catheterization3.0217.23NA1.0321.28NA000
    9350126ARight heart catheterization3.021.241.240.164.424.42000
    93501TCARight heart catheterization0.0015.99NA0.8716.86NA000
    93503AInsert/place heart catheter2.91NA0.710.16NA3.78000
    93505ABiopsy of heart lining4.383.67NA0.368.41NA000
    9350526ABiopsy of heart lining4.381.801.800.236.416.41000
    93505TCABiopsy of heart lining0.001.87NA0.132.00NA000
    93508ACath placement, angiography4.1013.64NA0.7518.49NA000
    9350826ACath placement, angiography4.101.711.710.216.026.02000
    93508TCACath placement, angiography0.0011.93NA0.5412.47NA000
    93510ALeft heart catheterization4.3336.77NA2.1343.23NA000
    9351026ALeft heart catheterization4.331.821.820.226.376.37000
    93510TCALeft heart catheterization0.0034.95NA1.9136.86NA000
    93511ALeft heart catheterization5.0336.12NA2.1143.26NA000
    9351126ALeft heart catheterization5.032.102.100.267.397.39000
    93511TCALeft heart catheterization0.0034.02NA1.8535.87NA000
    93514ALeft heart catheterization7.0536.79NA2.2246.06NA000
    9351426ALeft heart catheterization7.052.772.770.3710.1910.19000
    93514TCALeft heart catheterization0.0034.02NA1.8535.87NA000
    93524ALeft heart catheterization6.9547.32NA2.7957.06NA000
    9352426ALeft heart catheterization6.952.862.860.3610.1710.17000
    93524TCALeft heart catheterization0.0044.46NA2.4346.89NA000
    93526ARt & Lt heart catheters5.9948.18NA2.8156.98NA000
    9352626ARt & Lt heart catheters5.992.502.500.318.808.80000
    93526TCARt & Lt heart catheters0.0045.68NA2.5048.18NA000
    93527ARt & Lt heart catheters7.2847.49NA2.8157.58NA000
    9352726ARt & Lt heart catheters7.283.033.030.3810.6910.69000
    93527TCARt & Lt heart catheters0.0044.46NA2.4346.89NA000
    93528ARt & Lt heart catheters9.0048.27NA2.9060.17NA000
    9352826ARt & Lt heart catheters9.003.813.810.4713.2813.28000
    93528TCARt & Lt heart catheters0.0044.46NA2.4346.89NA000
    93529ARt&lt heart catheterization4.8046.46NA2.6853.94NA000
    9352926ARt&lt heart catheterization4.802.002.000.257.057.05000
    93529TCARt&lt heart catheterization0.0044.46NA2.4346.89NA000
    Start Printed Page 55456
    93530ARt heart cath, congenital4.2317.59NA1.1122.93NA000
    9353026ARt heart cath, congenital4.231.601.600.246.076.07000
    93530TCARt heart cath, congenital0.0015.99NA0.8716.86NA000
    93531AR & l heart cath, congenital8.3548.92NA2.9660.23NA000
    9353126AR & l heart cath, congenital8.353.243.240.4612.0512.05000
    93531TCAR & l heart cath, congenital0.0045.68NA2.5048.18NA000
    93532AR & l heart cath, congenital10.0048.58NA2.9561.53NA000
    9353226AR & l heart cath, congenital10.004.124.120.5214.6414.64000
    93532TCAR & l heart cath, congenital0.0044.46NA2.4346.89NA000
    93533AR & l heart cath, congenital6.7047.01NA2.8656.57NA000
    9353326AR & l heart cath, congenital6.702.552.550.439.689.68000
    93533TCAR & l heart cath, congenital0.0044.46NA2.4346.89NA000
    93536DInsert circulation assi0.00NA0.000.00NA0.00000
    93539AInjection, cardiac cath0.400.840.170.011.250.58000
    93540AInjection, cardiac cath0.430.860.180.011.300.62000
    93541AInjection for lung angiogram0.29NA0.120.01NA0.42000
    93542AInjection for heart x-rays0.29NA0.120.01NA0.42000
    93543AInjection for heart x-rays0.290.550.120.010.850.42000
    93544AInjection for aortography0.250.530.100.010.790.36000
    93545AInject for coronary x-rays0.400.850.170.011.260.58000
    93555AImaging, cardiac cath0.816.27NA0.317.39NAXXX
    9355526AImaging, cardiac cath0.810.340.340.031.181.18XXX
    93555TCAImaging, cardiac cath0.005.93NA0.286.21NAXXX
    93556AImaging, cardiac cath0.839.71NA0.4510.99NAXXX
    9355626AImaging, cardiac cath0.830.350.350.031.211.21XXX
    93556TCAImaging, cardiac cath0.009.36NA0.429.78NAXXX
    93561ACardiac output measurement0.500.67NA0.071.24NA000
    9356126ACardiac output measurement0.500.160.160.020.680.68000
    93561TCACardiac output measurement0.000.51NA0.050.56NA000
    93562ACardiac output measurement0.160.34NA0.040.54NA000
    9356226ACardiac output measurement0.160.050.050.010.220.22000
    93562TCACardiac output measurement0.000.29NA0.030.32NA000
    93571AHeart flow reserve measure1.805.06NA0.317.17NAZZZ
    9357126AHeart flow reserve measure1.800.730.730.112.642.64ZZZ
    93571TCAHeart flow reserve measure0.004.33NA0.204.53NAZZZ
    93572AHeart flow reserve measure1.442.70NA0.284.42NAZZZ
    9357226AHeart flow reserve measure1.440.520.520.172.132.13ZZZ
    93572TCAHeart flow reserve measure0.002.18NA0.112.29NAZZZ
    93600ABundle of His recording2.122.74NA0.225.08NA000
    9360026ABundle of His recording2.120.890.890.113.123.12000
    93600TCABundle of His recording0.001.85NA0.111.96NA000
    93602AIntra-atrial recording2.121.94NA0.184.24NA000
    9360226AIntra-atrial recording2.120.880.880.123.123.12000
    93602TCAIntra-atrial recording0.001.06NA0.061.12NA000
    93603ARight ventricular recording2.122.46NA0.204.78NA000
    9360326ARight ventricular recording2.120.860.860.113.093.09000
    93603TCARight ventricular recording0.001.60NA0.091.69NA000
    93607DLeft ventricular recording0.000.000.000.000.000.00000
    9360726DLeft ventricular recording0.000.000.000.000.000.00000
    93607TCDLeft ventricular recording0.000.000.000.000.000.00000
    93609AMap tachycardia, add-on4.814.59NA0.6610.06NAZZZ
    9360926AMap tachycardia, add-on4.812.012.010.527.347.34ZZZ
    93609TCAMap tachycardia, add-on0.002.58NA0.142.72NAZZZ
    93610AIntra-atrial pacing3.022.52NA0.255.79NA000
    9361026AIntra-atrial pacing3.021.231.230.174.424.42000
    93610TCAIntra-atrial pacing0.001.29NA0.081.37NA000
    93612AIntraventricular pacing3.022.76NA0.266.04NA000
    9361226AIntraventricular pacing3.021.231.230.174.424.42000
    93612TCAIntraventricular pacing0.001.53NA0.091.62NA000
    93613CElectrophys map, 3d, add-on0.000.000.000.000.000.00XXX
    9361326AElectrophys map, 3d, add-on7.002.792.790.5210.3110.31XXX
    93613TCCElectrophys map, 3d, add-on0.000.000.000.000.000.00XXX
    93615AEsophageal recording0.990.66NA0.051.70NA000
    9361526AEsophageal recording0.990.360.360.031.381.38000
    93615TCAEsophageal recording0.000.30NA0.020.32NA000
    93616AEsophageal recording1.490.80NA0.082.37NA000
    9361626AEsophageal recording1.490.500.500.062.052.05000
    93616TCAEsophageal recording0.000.30NA0.020.32NA000
    93618AHeart rhythm pacing4.265.54NA0.4210.22NA000
    9361826AHeart rhythm pacing4.261.781.780.226.266.26000
    93618TCAHeart rhythm pacing0.003.76NA0.203.96NA000
    93619AElectrophysiology evaluation7.3210.32NA0.7718.41NA000
    9361926AElectrophysiology evaluation7.323.003.000.3810.7010.70000
    Start Printed Page 55457
    93619TCAElectrophysiology evaluation0.007.32NA0.397.71NA000
    93620AElectrophysiology evaluation11.5913.33NA1.0425.96NA000
    9362026AElectrophysiology evaluation11.594.824.820.6017.0117.01000
    93620TCAElectrophysiology evaluation0.008.51NA0.448.95NA000
    93621CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362126AElectrophysiology evaluation2.100.880.880.153.133.13ZZZ
    93621TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93622CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    9362226AElectrophysiology evaluation3.101.301.300.675.075.07ZZZ
    93622TCCElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93623CStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    9362326AStimulation, pacing heart2.851.191.190.154.194.19ZZZ
    93623TCCStimulation, pacing heart0.000.000.000.000.000.00ZZZ
    93624AElectrophysiologic study4.813.87NA0.369.04NA000
    9362426AElectrophysiologic study4.811.991.990.257.057.05000
    93624TCAElectrophysiologic study0.001.88NA0.111.99NA000
    93631AHeart pacing, mapping7.608.65NA1.1717.42NA000
    9363126AHeart pacing, mapping7.602.812.810.6611.0711.07000
    93631TCAHeart pacing, mapping0.005.84NA0.516.35NA000
    93640AEvaluation heart device3.528.27NA0.5312.32NA000
    9364026AEvaluation heart device3.521.461.460.185.165.16000
    93640TCAEvaluation heart device0.006.81NA0.357.16NA000
    93641AElectrophysiology evaluation5.939.28NA0.6615.87NA000
    9364126AElectrophysiology evaluation5.932.472.470.318.718.71000
    93641TCAElectrophysiology evaluation0.006.81NA0.357.16NA000
    93642AElectrophysiology evaluation4.898.85NA0.5114.25NA000
    9364226AElectrophysiology evaluation4.892.042.040.167.097.09000
    93642TCAElectrophysiology evaluation0.006.81NA0.357.16NA000
    93650AAblate heart dysrhythm focus10.51NA4.320.55NA15.38000
    93651AAblate heart dysrhythm focus16.25NA6.780.85NA23.88000
    93652AAblate heart dysrhythm focus17.68NA7.360.92NA25.96000
    93660ATilt table evaluation1.892.39NA0.084.36NA000
    9366026ATilt table evaluation1.890.790.790.062.742.74000
    93660TCATilt table evaluation0.001.60NA0.021.62NA000
    93662CIntracardiac ecg (ice)+0.000.000.000.000.000.00ZZZ
    9366226AIntracardiac ecg (ice)2.801.121.120.414.334.33ZZZ
    93662TCCIntracardiac ecg (ice)+0.000.00NA0.000.00NAXXX
    93668NPeripheral vascular rehab0.000.000.000.000.000.00XXX
    93701ABioimpedance, thoracic0.170.78NA0.020.97NAXXX
    9370126ABioimpedance, thoracic0.170.070.070.010.250.25XXX
    93701TCABioimpedance, thoracic0.000.71NA0.010.72NAXXX
    93720ATotal body plethysmography0.170.73NA0.060.96NAXXX
    93721APlethysmography tracing0.000.67NA0.050.72NAXXX
    93722APlethysmography report0.170.060.060.010.240.24XXX
    93724AAnalyze pacemaker system4.895.80NA0.3811.07NA000
    9372426AAnalyze pacemaker system4.892.042.040.187.117.11000
    93724TCAAnalyze pacemaker system0.003.76NA0.203.96NA000
    93727AAnalyze ilr system0.520.210.210.050.780.78XXX
    93731AAnalyze pacemaker system0.450.66NA0.051.16NAXXX
    9373126AAnalyze pacemaker system0.450.190.190.020.660.66XXX
    93731TCAAnalyze pacemaker system0.000.47NA0.030.50NAXXX
    93732AAnalyze pacemaker system0.920.87NA0.061.85NAXXX
    9373226AAnalyze pacemaker system0.920.380.380.031.331.33XXX
    93732TCAAnalyze pacemaker system0.000.49NA0.030.52NAXXX
    93733ATelephone analy, pacemaker0.170.76NA0.060.99NAXXX
    9373326ATelephone analy, pacemaker0.170.070.070.010.250.25XXX
    93733TCATelephone analy, pacemaker0.000.69NA0.050.74NAXXX
    93734AAnalyze pacemaker system0.380.49NA0.030.90NAXXX
    9373426AAnalyze pacemaker system0.380.160.160.010.550.55XXX
    93734TCAAnalyze pacemaker system0.000.33NA0.020.35NAXXX
    93735AAnalyze pacemaker system0.740.72NA0.061.52NAXXX
    9373526AAnalyze pacemaker system0.740.300.300.031.071.07XXX
    93735TCAAnalyze pacemaker system0.000.42NA0.030.45NAXXX
    93736ATelephone analy, pacemaker0.150.66NA0.060.87NAXXX
    9373626ATelephone analy, pacemaker0.150.060.060.010.220.22XXX
    93736TCATelephone analy, pacemaker0.000.60NA0.050.65NAXXX
    93737DAnalyze cardio/defibrillator0.000.00NA0.000.00NAXXX
    9373726DAnalyze cardio/defibrillator0.000.000.000.000.000.00XXX
    93737TCDAnalyze cardio/defibrillator0.000.00NA0.000.00NAXXX
    93738DAnalyze cardio/defibrillator0.000.00NA0.000.00NAXXX
    9373826DAnalyze cardio/defibrillator0.000.000.000.000.000.00XXX
    93738TCDAnalyze cardio/defibrillator0.000.00NA0.000.00NAXXX
    93740BTemperature gradient studies+0.160.21NA0.020.39NAXXX
    Start Printed Page 55458
    9374026BTemperature gradient studies+0.160.060.060.010.230.23XXX
    93740TCBTemperature gradient studies+0.000.15NA0.010.16NAXXX
    93741AAnalyze ht pace device sngl0.800.96NA0.051.81NAXXX
    9374126AAnalyze ht pace device sngl0.800.330.330.021.151.15XXX
    93741TCAAnalyze ht pace device sngl0.000.63NA0.030.66NAXXX
    93742AAnalyze ht pace device sngl0.911.01NA0.051.97NAXXX
    9374226AAnalyze ht pace device sngl0.910.380.380.021.311.31XXX
    93742TCAAnalyze ht pace device sngl0.000.63NA0.030.66NAXXX
    93743AAnalyze ht pace device dual1.031.13NA0.062.22NAXXX
    9374326AAnalyze ht pace device dual1.030.430.430.031.491.49XXX
    93743TCAAnalyze ht pace device dual0.000.70NA0.030.73NAXXX
    93744AAnalyze ht pace device dual1.181.12NA0.062.36NAXXX
    9374426AAnalyze ht pace device dual1.180.490.490.031.701.70XXX
    93744TCAAnalyze ht pace device dual0.000.63NA0.030.66NAXXX
    93760NCephalic thermogram0.000.000.000.000.000.00XXX
    93762NPeripheral thermogram0.000.000.000.000.000.00XXX
    93770BMeasure venous pressure+0.160.09NA0.020.27NAXXX
    9377026BMeasure venous pressure+0.160.060.060.010.230.23XXX
    93770TCBMeasure venous pressure+0.000.03NA0.010.04NAXXX
    93784NAmbulatory BP monitoring0.000.000.000.000.000.00XXX
    93786NAmbulatory BP recording0.000.000.000.000.000.00XXX
    93788NAmbulatory BP analysis0.000.000.000.000.000.00XXX
    93790NReview/report BP recording0.000.000.000.000.000.00XXX
    93797ACardiac rehab0.180.330.070.010.520.26000
    93798ACardiac rehab/monitor0.280.440.110.010.730.40000
    93799CCardiovascular procedure0.000.000.000.000.000.00XXX
    9379926CCardiovascular procedure0.000.000.000.000.000.00XXX
    93799TCCCardiovascular procedure0.000.000.000.000.000.00XXX
    93875AExtracranial study0.221.13NA0.101.45NAXXX
    9387526AExtracranial study0.220.080.080.010.310.31XXX
    93875TCAExtracranial study0.001.05NA0.091.14NAXXX
    93880AExtracranial study0.603.76NA0.334.69NAXXX
    9388026AExtracranial study0.600.220.220.040.860.86XXX
    93880TCAExtracranial study0.003.54NA0.293.83NAXXX
    93882AExtracranial study0.402.50NA0.223.12NAXXX
    9388226AExtracranial study0.400.150.150.040.590.59XXX
    93882TCAExtracranial study0.002.35NA0.182.53NAXXX
    93886AIntracranial study0.944.40NA0.375.71NAXXX
    9388626AIntracranial study0.940.400.400.051.391.39XXX
    93886TCAIntracranial study0.004.00NA0.324.32NAXXX
    93888AIntracranial study0.622.91NA0.263.79NAXXX
    9388826AIntracranial study0.620.240.240.040.900.90XXX
    93888TCAIntracranial study0.002.67NA0.222.89NAXXX
    93922AExtremity study0.251.18NA0.131.56NAXXX
    9392226AExtremity study0.250.090.090.020.360.36XXX
    93922TCAExtremity study0.001.09NA0.111.20NAXXX
    93923AExtremity study0.452.24NA0.222.91NAXXX
    9392326AExtremity study0.450.160.160.040.650.65XXX
    93923TCAExtremity study0.002.08NA0.182.26NAXXX
    93924AExtremity study0.502.43NA0.263.19NAXXX
    9392426AExtremity study0.500.180.180.050.730.73XXX
    93924TCAExtremity study0.002.25NA0.212.46NAXXX
    93925ALower extremity study0.583.76NA0.334.67NAXXX
    9392526ALower extremity study0.580.210.210.040.830.83XXX
    93925TCALower extremity study0.003.55NA0.293.84NAXXX
    93926ALower extremity study0.392.51NA0.223.12NAXXX
    9392626ALower extremity study0.390.140.140.030.560.56XXX
    93926TCALower extremity study0.002.37NA0.192.56NAXXX
    93930AUpper extremity study0.463.93NA0.344.73NAXXX
    9393026AUpper extremity study0.460.160.160.030.650.65XXX
    93930TCAUpper extremity study0.003.77NA0.314.08NAXXX
    93931AUpper extremity study0.312.62NA0.223.15NAXXX
    9393126AUpper extremity study0.310.110.110.020.440.44XXX
    93931TCAUpper extremity study0.002.51NA0.202.71NAXXX
    93965AExtremity study0.351.17NA0.121.64NAXXX
    9396526AExtremity study0.350.130.130.020.500.50XXX
    93965TCAExtremity study0.001.04NA0.101.14NAXXX
    93970AExtremity study0.684.16NA0.385.22NAXXX
    9397026AExtremity study0.680.240.240.050.970.97XXX
    93970TCAExtremity study0.003.92NA0.334.25NAXXX
    93971AExtremity study0.452.77NA0.253.47NAXXX
    9397126AExtremity study0.450.160.160.030.640.64XXX
    93971TCAExtremity study0.002.61NA0.222.83NAXXX
    Start Printed Page 55459
    93975AVascular study1.805.10NA0.477.37NAXXX
    9397526AVascular study1.800.640.640.112.552.55XXX
    93975TCAVascular study0.004.46NA0.364.82NAXXX
    93976AVascular study1.213.41NA0.314.93NAXXX
    9397626AVascular study1.210.430.430.061.701.70XXX
    93976TCAVascular study0.002.98NA0.253.23NAXXX
    93978AVascular study0.653.88NA0.364.89NAXXX
    9397826AVascular study0.650.230.230.050.930.93XXX
    93978TCAVascular study0.003.65NA0.313.96NAXXX
    93979AVascular study0.442.59NA0.243.27NAXXX
    9397926AVascular study0.440.160.160.040.640.64XXX
    93979TCAVascular study0.002.43NA0.202.63NAXXX
    93980APenile vascular study1.253.75NA0.355.35NAXXX
    9398026APenile vascular study1.250.440.440.071.761.76XXX
    93980TCAPenile vascular study0.003.31NA0.283.59NAXXX
    93981APenile vascular study0.443.21NA0.283.93NAXXX
    9398126APenile vascular study0.440.150.150.020.610.61XXX
    93981TCAPenile vascular study0.003.06NA0.263.32NAXXX
    93990ADoppler flow testing0.252.46NA0.212.92NAXXX
    9399026ADoppler flow testing0.250.090.090.020.360.36XXX
    93990TCADoppler flow testing0.002.37NA0.192.56NAXXX
    94010ABreathing capacity test0.170.82NA0.031.02NAXXX
    9401026ABreathing capacity test0.170.060.060.010.240.24XXX
    94010TCABreathing capacity test0.000.76NA0.020.78NAXXX
    94014APatient recorded spirometry0.520.46NA0.031.01NAXXX
    94015APatient recorded spirometry0.000.29NA0.010.30NAXXX
    94016AReview patient spirometry0.520.170.170.020.710.71XXX
    94060AEvaluation of wheezing0.311.36NA0.061.73NAXXX
    9406026AEvaluation of wheezing0.310.100.100.010.420.42XXX
    94060TCAEvaluation of wheezing0.001.26NA0.051.31NAXXX
    94070AEvaluation of wheezing0.603.38NA0.104.08NAXXX
    9407026AEvaluation of wheezing0.600.190.190.020.810.81XXX
    94070TCAEvaluation of wheezing0.003.19NA0.083.27NAXXX
    94150BVital capacity test+0.070.63NA0.020.72NAXXX
    9415026BVital capacity test+0.070.030.030.010.110.11XXX
    94150TCBVital capacity test+0.000.60NA0.010.61NAXXX
    94200ALung function test (MBC/MVV)0.110.33NA0.030.47NAXXX
    9420026ALung function test (MBC/MVV)0.110.040.040.010.160.16XXX
    94200TCALung function test (MBC/MVV)0.000.29NA0.020.31NAXXX
    94240AResidual lung capacity0.261.26NA0.051.57NAXXX
    9424026AResidual lung capacity0.260.080.080.010.350.35XXX
    94240TCAResidual lung capacity0.001.18NA0.041.22NAXXX
    94250AExpired gas collection0.110.61NA0.020.74NAXXX
    9425026AExpired gas collection0.110.040.040.010.160.16XXX
    94250TCAExpired gas collection0.000.57NA0.010.58NAXXX
    94260AThoracic gas volume0.130.38NA0.040.55NAXXX
    9426026AThoracic gas volume0.130.040.040.010.180.18XXX
    94260TCAThoracic gas volume0.000.34NA0.030.37NAXXX
    94350ALung nitrogen washout curve0.261.01NA0.041.31NAXXX
    9435026ALung nitrogen washout curve0.260.080.080.010.350.35XXX
    94350TCALung nitrogen washout curve0.000.93NA0.030.96NAXXX
    94360AMeasure airflow resistance0.260.50NA0.060.82NAXXX
    9436026AMeasure airflow resistance0.260.080.080.010.350.35XXX
    94360TCAMeasure airflow resistance0.000.42NA0.050.47NAXXX
    94370ABreath airway closing volume0.262.03NA0.032.32NAXXX
    9437026ABreath airway closing volume0.260.080.080.010.350.35XXX
    94370TCABreath airway closing volume0.001.95NA0.021.97NAXXX
    94375ARespiratory flow volume loop0.310.46NA0.030.80NAXXX
    9437526ARespiratory flow volume loop0.310.100.100.010.420.42XXX
    94375TCARespiratory flow volume loop0.000.36NA0.020.38NAXXX
    94400ACO2 breathing response curve0.400.70NA0.061.16NAXXX
    9440026ACO2 breathing response curve0.400.130.130.010.540.54XXX
    94400TCACO2 breathing response curve0.000.57NA0.050.62NAXXX
    94450AHypoxia response curve0.400.85NA0.041.29NAXXX
    9445026AHypoxia response curve0.400.120.120.020.540.54XXX
    94450TCAHypoxia response curve0.000.73NA0.020.75NAXXX
    94620APulmonary stress test/simple0.641.66NA0.102.40NAXXX
    9462026APulmonary stress test/simple0.640.210.210.020.870.87XXX
    94620TCAPulmonary stress test/simple0.001.45NA0.081.53NAXXX
    94621APulm stress test/complex1.421.25NA0.132.80NAXXX
    9462126APulm stress test/complex1.420.470.470.051.941.94XXX
    94621TCAPulm stress test/complex0.000.78NA0.080.86NAXXX
    94640AAirway inhalation treatment0.000.74NA0.020.76NAXXX
    Start Printed Page 55460
    94642CAerosol inhalation treatment0.000.000.000.000.000.00XXX
    94650APressure breathing (IPPB)0.000.67NA0.020.69NAXXX
    94651APressure breathing (IPPB)0.000.62NA0.020.64NAXXX
    94652APressure breathing (IPPB)0.000.77NA0.060.83NAXXX
    94656AInitial ventilator mgmt1.22NA0.330.06NA1.61XXX
    94657AContinued ventilator mgmt0.83NA0.260.03NA1.12XXX
    94660APos airway pressure, CPAP0.760.670.240.031.461.03XXX
    94662ANeg press ventilation, cnp0.76NA0.240.02NA1.02XXX
    94664AAerosol or vapor inhalations0.000.53NA0.030.56NAXXX
    94665AAerosol or vapor inhalations0.000.53NA0.040.57NAXXX
    94667AChest wall manipulation0.001.01NA0.041.05NAXXX
    94668AChest wall manipulation0.000.75NA0.020.77NAXXX
    94680AExhaled air analysis, o20.261.17NA0.061.49NAXXX
    9468026AExhaled air analysis, o20.260.090.090.010.360.36XXX
    94680TCAExhaled air analysis, o20.001.08NA0.051.13NAXXX
    94681AExhaled air analysis, o2/co20.201.32NA0.111.63NAXXX
    9468126AExhaled air analysis, o2/co20.200.070.070.010.280.28XXX
    94681TCAExhaled air analysis, o2/co20.001.25NA0.101.35NAXXX
    94690AExhaled air analysis0.071.59NA0.041.70NAXXX
    9469026AExhaled air analysis0.070.020.020.010.100.10XXX
    94690TCAExhaled air analysis0.001.57NA0.031.60NAXXX
    94720AMonoxide diffusing capacity0.261.32NA0.061.64NAXXX
    9472026AMonoxide diffusing capacity0.260.080.080.010.350.35XXX
    94720TCAMonoxide diffusing capacity0.001.24NA0.051.29NAXXX
    94725AMembrane diffusion capacity0.260.71NA0.111.08NAXXX
    9472526AMembrane diffusion capacity0.260.080.080.010.350.35XXX
    94725TCAMembrane diffusion capacity0.000.63NA0.100.73NAXXX
    94750APulmonary compliance study0.231.06NA0.041.33NAXXX
    9475026APulmonary compliance study0.230.070.070.010.310.31XXX
    94750TCAPulmonary compliance study0.000.99NA0.031.02NAXXX
    94760TMeasure blood oxygen level0.000.10NA0.020.12NAXXX
    94761TMeasure blood oxygen level0.000.14NA0.050.19NAXXX
    94762AMeasure blood oxygen level0.000.74NA0.080.82NAXXX
    94770AExhaled carbon dioxide test0.150.91NA0.071.13NAXXX
    9477026AExhaled carbon dioxide test0.150.040.040.010.200.20XXX
    94770TCAExhaled carbon dioxide test0.000.87NA0.060.93NAXXX
    94772CBreath recording, infant0.000.000.000.000.000.00XXX
    9477226CBreath recording, infant0.000.000.000.000.000.00XXX
    94772TCCBreath recording, infant0.000.000.000.000.000.00XXX
    94799CPulmonary service/procedure0.000.000.000.000.000.00XXX
    9479926CPulmonary service/procedure0.000.000.000.000.000.00XXX
    94799TCCPulmonary service/procedure0.000.000.000.000.000.00XXX
    95004AAllergy skin tests0.000.09NA0.010.10NAXXX
    95010ASensitivity skin tests0.150.450.070.010.610.23XXX
    95015ASensitivity skin tests0.150.390.060.010.550.22XXX
    95024AAllergy skin tests0.000.14NA0.010.15NAXXX
    95027ASkin end point titration0.000.14NA0.010.15NAXXX
    95028AAllergy skin tests0.000.22NA0.010.23NAXXX
    95044AAllergy patch tests0.000.19NA0.010.20NAXXX
    95052APhoto patch test0.000.24NA0.010.25NAXXX
    95056APhotosensitivity tests0.000.17NA0.010.18NAXXX
    95060AEye allergy tests0.000.33NA0.020.35NAXXX
    95065ANose allergy test0.000.19NA0.010.20NAXXX
    95070ABronchial allergy tests0.002.17NA0.022.19NAXXX
    95071ABronchial allergy tests0.002.77NA0.022.79NAXXX
    95075AIngestion challenge test0.950.800.430.031.781.41XXX
    95078AProvocative testing0.000.24NA0.020.26NAXXX
    95115AImmunotherapy, one injection0.000.37NA0.020.39NA000
    95117AImmunotherapy injections0.000.48NA0.020.50NA000
    95120IImmunotherapy, one injection0.000.000.000.000.000.00XXX
    95125IImmunotherapy, many antigens0.000.000.000.000.000.00XXX
    95130IImmunotherapy, insect venom0.000.000.000.000.000.00XXX
    95131IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95132IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95133IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95134IImmunotherapy, insect venoms0.000.000.000.000.000.00XXX
    95144AAntigen therapy services0.060.250.030.010.320.10000
    95145AAntigen therapy services0.060.470.030.010.540.10000
    95146AAntigen therapy services0.060.620.030.010.690.10000
    95147AAntigen therapy services0.060.910.030.010.980.10000
    95148AAntigen therapy services0.060.810.030.010.880.10000
    95149AAntigen therapy services0.061.040.030.011.110.10000
    95165AAntigen therapy services0.060.210.020.010.280.09000
    Start Printed Page 55461
    95170AAntigen therapy services0.060.260.020.010.330.09000
    95180ARapid desensitization2.011.660.850.043.712.90000
    95199CAllergy immunology services0.000.000.000.000.000.00000
    95250AGlucose monitoring, cont0.001.44NA0.011.45NAXXX
    95805AMultiple sleep latency test1.885.89NA0.348.11NAXXX
    9580526AMultiple sleep latency test1.880.700.700.062.642.64XXX
    95805TCAMultiple sleep latency test0.005.19NA0.285.47NAXXX
    95806ASleep study, unattended1.664.31NA0.326.29NAXXX
    9580626ASleep study, unattended1.660.570.570.062.292.29XXX
    95806TCASleep study, unattended0.003.74NA0.264.00NAXXX
    95807ASleep study, attended1.6610.70NA0.4012.76NAXXX
    9580726ASleep study, attended1.660.560.560.052.272.27XXX
    95807TCASleep study, attended0.0010.14NA0.3510.49NAXXX
    95808APolysomnography, 1-32.653.86NA0.446.95NAXXX
    9580826APolysomnography, 1-32.650.990.990.093.733.73XXX
    95808TCAPolysomnography, 1-30.002.87NA0.353.22NAXXX
    95810APolysomnography, 4 or more3.5315.66NA0.4719.66NAXXX
    9581026APolysomnography, 4 or more3.531.261.260.124.914.91XXX
    95810TCAPolysomnography, 4 or more0.0014.40NA0.3514.75NAXXX
    95811APolysomnography w/cpap3.8013.63NA0.4917.92NAXXX
    9581126APolysomnography w/cpap3.801.341.340.135.275.27XXX
    95811TCAPolysomnography w/cpap0.0012.29NA0.3612.65NAXXX
    95812AElectroencephalogram (EEG)1.083.96NA0.135.17NAXXX
    9581226AElectroencephalogram (EEG)1.080.480.480.041.601.60XXX
    95812TCAElectroencephalogram (EEG)0.003.48NA0.093.57NAXXX
    95813AElectroencephalogram (EEG)1.735.53NA0.157.41NAXXX
    9581326AElectroencephalogram (EEG)1.730.730.730.062.522.52XXX
    95813TCAElectroencephalogram (EEG)0.004.80NA0.094.89NAXXX
    95816AElectroencephalogram (EEG)1.083.42NA0.124.62NAXXX
    9581626AElectroencephalogram (EEG)1.080.490.490.041.611.61XXX
    95816TCAElectroencephalogram (EEG)0.002.93NA0.083.01NAXXX
    95819AElectroencephalogram (EEG)1.084.34NA0.125.54NAXXX
    9581926AElectroencephalogram (EEG)1.080.490.490.041.611.61XXX
    95819TCAElectroencephalogram (EEG)0.003.85NA0.083.93NAXXX
    95822ASleep electroencephalogram1.081.78NA0.153.01NAXXX
    9582226ASleep electroencephalogram1.080.490.490.041.611.61XXX
    95822TCASleep electroencephalogram0.001.29NA0.111.40NAXXX
    95824CElectroencephalography+0.000.000.000.000.000.00XXX
    9582426AElectroencephalography0.740.300.300.051.091.09ZZZ
    95824TCCElectroencephalography+0.000.00NA0.000.00NAXXX
    95827ANight electroencephalogram1.082.64NA0.153.87NAXXX
    9582726ANight electroencephalogram1.080.460.460.031.571.57XXX
    95827TCANight electroencephalogram0.002.18NA0.122.30NAXXX
    95829ASurgery electrocorticogram6.2131.39NA0.3337.93NAXXX
    9582926ASurgery electrocorticogram6.212.902.900.319.429.42XXX
    95829TCASurgery electrocorticogram0.0028.49NA0.0228.51NAXXX
    95830AInsert electrodes for EEG1.703.760.780.075.532.55XXX
    95831ALimb muscle testing, manual0.280.520.120.010.810.41XXX
    95832AHand muscle testing, manual0.290.480.110.010.780.41XXX
    95833ABody muscle testing, manual0.470.540.240.011.020.72XXX
    95834ABody muscle testing, manual0.600.590.280.021.210.90XXX
    95851ARange of motion measurements0.160.550.080.010.720.25XXX
    95852ARange of motion measurements0.110.490.050.010.610.17XXX
    95857ATensilon test0.530.660.240.021.210.79XXX
    95858ATensilon test & myogram1.561.10NA0.072.73NAXXX
    9585826ATensilon test & myogram1.560.720.720.042.322.32XXX
    95858TCATensilon test & myogram0.000.38NA0.030.41NAXXX
    95860AMuscle test, one limb0.961.18NA0.052.19NAXXX
    9586026AMuscle test, one limb0.960.450.450.031.441.44XXX
    95860TCAMuscle test, one limb0.000.73NA0.020.75NAXXX
    95861AMuscle test, two limbs1.541.42NA0.103.06NAXXX
    9586126AMuscle test, two limbs1.540.720.720.052.312.31XXX
    95861TCAMuscle test, two limbs0.000.70NA0.050.75NAXXX
    95863AMuscle test, 3 limbs1.871.76NA0.113.74NAXXX
    9586326AMuscle test, 3 limbs1.870.870.870.062.802.80XXX
    95863TCAMuscle test, 3 limbs0.000.89NA0.050.94NAXXX
    95864AMuscle test, 4 limbs1.992.62NA0.164.77NAXXX
    9586426AMuscle test, 4 limbs1.990.930.930.062.982.98XXX
    95864TCAMuscle test, 4 limbs0.001.69NA0.101.79NAXXX
    95867AMuscle test, head or neck0.790.92NA0.061.77NAXXX
    9586726AMuscle test, head or neck0.790.370.370.031.191.19XXX
    95867TCAMuscle test, head or neck0.000.55NA0.030.58NAXXX
    95868AMuscle test, head or neck1.181.23NA0.082.49NAXXX
    Start Printed Page 55462
    9586826AMuscle test, head or neck1.180.570.570.041.791.79XXX
    95868TCAMuscle test, head or neck0.000.66NA0.040.70NAXXX
    95869AMuscle test, thor paraspinal0.370.37NA0.030.77NAXXX
    9586926AMuscle test, thor paraspinal0.370.170.170.010.550.55XXX
    95869TCAMuscle test, thor paraspinal0.000.20NA0.020.22NAXXX
    95870AMuscle test, nonparaspinal0.370.37NA0.030.77NAXXX
    9587026AMuscle test, nonparaspinal0.370.170.170.010.550.55XXX
    95870TCAMuscle test, nonparaspinal0.000.20NA0.020.22NAXXX
    95872AMuscle test, one fiber1.501.25NA0.082.83NAXXX
    9587226AMuscle test, one fiber1.500.680.680.042.222.22XXX
    95872TCAMuscle test, one fiber0.000.57NA0.040.61NAXXX
    95875ALimb exercise test1.101.38NA0.092.57NAXXX
    9587526ALimb exercise test1.100.490.490.041.631.63XXX
    95875TCALimb exercise test0.000.89NA0.050.94NAXXX
    95900AMotor nerve conduction test0.420.73NA0.031.18NAXXX
    9590026AMotor nerve conduction test0.420.200.200.010.630.63XXX
    95900TCAMotor nerve conduction test0.000.53NA0.020.55NAXXX
    95903AMotor nerve conduction test0.600.51NA0.041.15NAXXX
    9590326AMotor nerve conduction test0.600.270.270.020.890.89XXX
    95903TCAMotor nerve conduction test0.000.24NA0.020.26NAXXX
    95904ASense nerve conduction test0.340.64NA0.031.01NAXXX
    9590426ASense nerve conduction test0.340.160.160.010.510.51XXX
    95904TCASense nerve conduction test0.000.48NA0.020.50NAXXX
    95920AIntraop nerve test add-on2.112.23NA0.204.54NAZZZ
    9592026AIntraop nerve test add-on2.110.990.990.143.243.24ZZZ
    95920TCAIntraop nerve test add-on0.001.24NA0.061.30NAZZZ
    95921AAutonomic nerv function test0.900.70NA0.051.65NAXXX
    9592126AAutonomic nerv function test0.900.340.340.031.271.27XXX
    95921TCAAutonomic nerv function test0.000.36NA0.020.38NAXXX
    95922AAutonomic nerv function test0.960.79NA0.051.80NAXXX
    9592226AAutonomic nerv function test0.960.430.430.031.421.42XXX
    95922TCAAutonomic nerv function test0.000.36NA0.020.38NAXXX
    95923AAutonomic nerv function test0.902.57NA0.053.52NAXXX
    9592326AAutonomic nerv function test0.900.400.400.031.331.33XXX
    95923TCAAutonomic nerv function test0.002.17NA0.022.19NAXXX
    95925ASomatosensory testing0.541.10NA0.071.71NAXXX
    9592526ASomatosensory testing0.540.240.240.020.800.80XXX
    95925TCASomatosensory testing0.000.86NA0.050.91NAXXX
    95926ASomatosensory testing0.541.11NA0.071.72NAXXX
    9592626ASomatosensory testing0.540.250.250.020.810.81XXX
    95926TCASomatosensory testing0.000.86NA0.050.91NAXXX
    95927ASomatosensory testing0.541.13NA0.081.75NAXXX
    9592726ASomatosensory testing0.540.270.270.030.840.84XXX
    95927TCASomatosensory testing0.000.86NA0.050.91NAXXX
    95930AVisual evoked potential test0.350.84NA0.021.21NAXXX
    9593026AVisual evoked potential test0.350.160.160.010.520.52XXX
    95930TCAVisual evoked potential test0.000.68NA0.010.69NAXXX
    95933ABlink reflex test0.591.01NA0.071.67NAXXX
    9593326ABlink reflex test0.590.270.270.020.880.88XXX
    95933TCABlink reflex test0.000.74NA0.050.79NAXXX
    95934AH-reflex test0.510.44NA0.040.99NAXXX
    9593426AH-reflex test0.510.240.240.020.770.77XXX
    95934TCAH-reflex test0.000.20NA0.020.22NAXXX
    95936AH-reflex test0.550.45NA0.041.04NAXXX
    9593626AH-reflex test0.550.250.250.020.820.82XXX
    95936TCAH-reflex test0.000.20NA0.020.22NAXXX
    95937ANeuromuscular junction test0.650.60NA0.041.29NAXXX
    9593726ANeuromuscular junction test0.650.280.280.020.950.95XXX
    95937TCANeuromuscular junction test0.000.32NA0.020.34NAXXX
    95950AAmbulatory eeg monitoring1.514.93NA0.446.88NAXXX
    9595026AAmbulatory eeg monitoring1.510.700.700.082.292.29XXX
    95950TCAAmbulatory eeg monitoring0.004.23NA0.364.59NAXXX
    95951AEEG monitoring/videorecord6.0016.38NA0.5822.96NAXXX
    9595126AEEG monitoring/videorecord6.002.722.720.208.928.92XXX
    95951TCAEEG monitoring/videorecord0.0013.66NA0.3814.04NAXXX
    95953AEEG monitoring/computer3.087.39NA0.4610.93NAXXX
    9595326AEEG monitoring/computer3.081.381.380.104.564.56XXX
    95953TCAEEG monitoring/computer0.006.01NA0.366.37NAXXX
    95954AEEG monitoring/giving drugs2.454.43NA0.157.03NAXXX
    9595426AEEG monitoring/giving drugs2.451.071.070.103.623.62XXX
    95954TCAEEG monitoring/giving drugs0.003.36NA0.053.41NAXXX
    95955AEEG during surgery1.012.26NA0.193.46NAXXX
    9595526AEEG during surgery1.010.400.400.051.461.46XXX
    Start Printed Page 55463
    95955TCAEEG during surgery0.001.86NA0.142.00NAXXX
    95956AEeg monitoring, cable/radio3.087.43NA0.4710.98NAXXX
    9595626AEeg monitoring, cable/radio3.081.351.350.114.544.54XXX
    95956TCAEeg monitoring, cable/radio0.006.08NA0.366.44NAXXX
    95957AEEG digital analysis1.982.52NA0.174.67NAXXX
    9595726AEEG digital analysis1.980.900.900.072.952.95XXX
    95957TCAEEG digital analysis0.001.62NA0.101.72NAXXX
    95958AEEG monitoring/function test4.253.51NA0.298.05NAXXX
    9595826AEEG monitoring/function test4.251.861.860.186.296.29XXX
    95958TCAEEG monitoring/function test0.001.65NA0.111.76NAXXX
    95961AElectrode stimulation, brain2.972.67NA0.245.88NAXXX
    9596126AElectrode stimulation, brain2.971.431.430.184.584.58XXX
    95961TCAElectrode stimulation, brain0.001.24NA0.061.30NAXXX
    95962AElectrode stim, brain add-on3.212.72NA0.236.16NAZZZ
    9596226AElectrode stim, brain add-on3.211.481.480.174.864.86ZZZ
    95962TCAElectrode stim, brain add-on0.001.24NA0.061.30NAZZZ
    95965CMeg, spontaneous0.000.000.000.000.000.00XXX
    9596526AMeg, spontaneous8.003.193.190.2011.3911.39XXX
    95965TCCMeg, spontaneous0.000.000.000.000.000.00XXX
    95966CMeg, evoked, single0.000.000.000.000.000.00XXX
    9596626AMeg, evoked, single4.001.601.600.185.785.78XXX
    95966TCCMeg, evoked, single0.000.000.000.000.000.00XXX
    95967CMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    9596726AMeg, evoked, each addl3.501.401.400.175.075.07ZZZ
    95967TCCMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    95970AAnalyze neurostim, no prog0.450.180.160.030.660.64XXX
    95971AAnalyze neurostim, simple0.780.280.240.061.121.08XXX
    95972AAnalyze neurostim, complex1.500.620.510.172.292.18XXX
    95973AAnalyze neurostim, complex0.920.420.360.071.411.35ZZZ
    95974ACranial neurostim, complex3.001.371.370.154.524.52XXX
    95975ACranial neurostim, complex1.700.780.780.072.552.55ZZZ
    95999CNeurological procedure0.000.000.000.000.000.00XXX
    96000AMotion analysis, video/3d1.80NA0.720.02NA2.54XXX
    96001AMotion test w/ft press meas2.15NA0.860.02NA3.03XXX
    96002ADynamic surface emg0.41NA0.160.02NA0.59XXX
    96003ADynamic fine wire emg0.37NA0.150.03NA0.55XXX
    96004APhys review of motion tests1.800.720.720.082.602.60XXX
    96100APsychological testing0.001.67NA0.151.82NAXXX
    96105AAssessment of aphasia0.001.67NA0.151.82NAXXX
    96110CDevelopmental test, lim0.000.000.000.000.000.00XXX
    96111ADevelopmental test, extend0.001.67NA0.151.82NAXXX
    96115ANeurobehavior status exam0.001.67NA0.151.82NAXXX
    96117ANeuropsych test battery0.001.67NA0.151.82NAXXX
    96150AAssess hlth/behave, init0.500.210.200.020.730.72XXX
    96151AAssess hlth/behave, subseq0.480.210.190.020.710.69XXX
    96152AIntervene hlth/behave, indiv0.460.200.180.020.680.66XXX
    96153AIntervene hlth/behave, group0.100.040.040.010.150.15XXX
    96154AInterv hlth/behav, fam w/pt0.450.190.180.020.660.65XXX
    96155AInterv hlth/behav fam no pt0.440.180.180.020.640.64XXX
    96400AChemotherapy, sc/im0.000.13NA0.010.14NAXXX
    96405AIntralesional chemo admin0.521.880.240.022.420.78000
    96406AIntralesional chemo admin0.802.940.410.023.761.23000
    96408AChemotherapy, push technique0.000.92NA0.050.97NAXXX
    96410AChemotherapy infusion method0.001.47NA0.071.54NAXXX
    96412AChemo, infuse method add-on0.001.09NA0.061.15NAZZZ
    96414AChemo, infuse method add-on0.001.27NA0.071.34NAXXX
    96420AChemotherapy, push technique0.001.18NA0.071.25NAXXX
    96422AChemotherapy infusion method0.001.17NA0.071.24NAXXX
    96423AChemo, infuse method add-on0.000.46NA0.020.48NAZZZ
    96425AChemotherapy infusion method0.001.36NA0.071.43NAXXX
    96440AChemotherapy, intracavitary2.377.991.060.1210.483.55000
    96445AChemotherapy, intracavitary2.208.741.080.0711.013.35000
    96450AChemotherapy, into CNS1.896.790.950.068.742.90000
    96520APump refilling, maintenance0.000.84NA0.050.89NAXXX
    96530APump refilling, maintenance0.001.01NA0.051.06NAXXX
    96542AChemotherapy injection1.424.700.550.056.172.02XXX
    96545BProvide chemotherapy agent0.000.000.000.000.000.00XXX
    96549CChemotherapy, unspecified0.000.000.000.000.000.00XXX
    96567APhotodynamic tx, skin0.001.63NA0.031.66NAXXX
    96570APhotodynamic tx, 30 min1.100.460.380.041.601.52ZZZ
    96571APhotodynamic tx, addl 15 min0.550.220.200.020.790.77ZZZ
    96900AUltraviolet light therapy0.000.45NA0.020.47NAXXX
    96902BTrichogram+0.410.250.160.010.670.58XXX
    Start Printed Page 55464
    96910APhotochemotherapy with UV-B0.001.37NA0.031.40NAXXX
    96912APhotochemotherapy with UV-A0.001.54NA0.041.58NAXXX
    96913APhotochemotherapy, UV-A or B0.002.26NA0.082.34NAXXX
    96999CDermatological procedure0.000.000.000.000.000.00XXX
    97001APt evaluation1.200.560.370.101.861.67XXX
    97002APt re-evaluation0.600.350.270.040.990.91XXX
    97003AOt evaluation1.200.690.320.051.941.57XXX
    97004AOt re-evaluation0.600.690.120.021.310.74XXX
    97005IAthletic train eval0.000.000.000.000.000.00XXX
    97006IAthletic train reeval0.000.000.000.000.000.00XXX
    97010BHot or cold packs therapy+0.060.040.040.010.110.11XXX
    97012AMechanical traction therapy0.250.110.110.010.370.37XXX
    97014AElectric stimulation therapy0.180.190.190.010.380.38XXX
    97016AVasopneumatic device therapy0.180.140.140.010.330.33XXX
    97018AParaffin bath therapy0.060.120.120.010.190.19XXX
    97020AMicrowave therapy0.060.050.050.010.120.12XXX
    97022AWhirlpool therapy0.170.260.260.010.440.44XXX
    97024ADiathermy treatment0.060.050.050.010.120.12XXX
    97026AInfrared therapy0.060.050.050.010.120.12XXX
    97028AUltraviolet therapy0.080.060.060.010.150.15XXX
    97032AElectrical stimulation0.250.210.210.010.470.47XXX
    97033AElectric current therapy0.260.120.120.020.400.40XXX
    97034AContrast bath therapy0.210.140.140.010.360.36XXX
    97035AUltrasound therapy0.210.080.080.010.300.30XXX
    97036AHydrotherapy0.280.340.340.010.630.63XXX
    97039APhysical therapy treatment0.200.070.070.010.280.28XXX
    97110ATherapeutic exercises0.450.250.250.030.730.73XXX
    97112ANeuromuscular reeducation0.450.290.290.020.760.76XXX
    97113AAquatic therapy/exercises0.440.330.330.030.800.80XXX
    97116AGait training therapy0.400.210.210.020.630.63XXX
    97124AMassage therapy0.350.210.210.010.570.57XXX
    97139APhysical medicine procedure0.210.210.210.010.430.43XXX
    97140AManual therapy0.430.230.230.020.680.68XXX
    97150AGroup therapeutic procedures0.270.200.200.020.490.49XXX
    97504AOrthotic training0.450.250.250.030.730.73XXX
    97520AProsthetic training0.450.210.210.020.680.68XXX
    97530ATherapeutic activities0.440.450.450.020.910.91XXX
    97532ACognitive skills development0.440.170.170.010.620.62XXX
    97533ASensory integration0.440.210.210.010.660.66XXX
    97535ASelf care mngment training0.450.350.350.020.820.82XXX
    97537ACommunity/work reintegration0.450.200.200.010.660.66XXX
    97542AWheelchair mngment training0.450.220.220.010.680.68XXX
    97545RWork hardening0.000.000.000.000.000.00XXX
    97546RWork hardening add-on0.000.000.000.000.000.00ZZZ
    97601AWound(s) care, selective0.501.901.900.042.442.44XXX
    97602BWound(s) care non-selective0.000.000.000.000.000.00XXX
    97703AProsthetic checkout0.250.440.440.020.710.71XXX
    97750APhysical performance test0.450.240.240.020.710.71XXX
    97780NAcupuncture w/o stimul0.000.000.000.000.000.00XXX
    97781NAcupuncture w/stimul0.000.000.000.000.000.00XXX
    97799CPhysical medicine procedure0.000.000.000.000.000.00XXX
    97802AMedical nutrition, indiv, in0.000.450.450.010.460.46XXX
    97803AMed nutrition, indiv, subseq0.000.450.450.010.460.46XXX
    97804AMedical nutrition, group0.000.170.170.010.180.18XXX
    98925AOsteopathic manipulation0.450.380.140.010.840.60000
    98926AOsteopathic manipulation0.650.440.250.021.110.92000
    98927AOsteopathic manipulation0.870.520.310.031.421.21000
    98928AOsteopathic manipulation1.030.590.380.031.651.44000
    98929AOsteopathic manipulation1.190.650.390.041.881.62000
    98940AChiropractic manipulation0.450.250.130.010.710.59000
    98941AChiropractic manipulation0.650.310.190.020.980.86000
    98942AChiropractic manipulation0.870.370.250.031.271.15000
    98943NChiropractic manipulation+0.400.340.160.010.750.57XXX
    99000BSpecimen handling0.000.000.000.000.000.00XXX
    99001BSpecimen handling0.000.000.000.000.000.00XXX
    99002BDevice handling0.000.000.000.000.000.00XXX
    99024BPostop follow-up visit0.000.000.000.000.000.00XXX
    99025BInitial surgical evaluation0.000.000.000.000.000.00XXX
    99050BMedical services after hrs0.000.000.000.000.000.00XXX
    99052BMedical services at night0.000.000.000.000.000.00XXX
    99054BMedical servcs, unusual hrs0.000.000.000.000.000.00XXX
    99056BNon-office medical services0.000.000.000.000.000.00XXX
    99058BOffice emergency care0.000.000.000.000.000.00XXX
    Start Printed Page 55465
    99070BSpecial supplies0.000.000.000.000.000.00XXX
    99071BPatient education materials0.000.000.000.000.000.00XXX
    99075NMedical testimony0.000.000.000.000.000.00XXX
    99078BGroup health education0.000.000.000.000.000.00XXX
    99080BSpecial reports or forms0.000.000.000.000.000.00XXX
    99082CUnusual physician travel0.000.000.000.000.000.00XXX
    99090BComputer data analysis0.000.000.000.000.000.00XXX
    99091BCollect/review data from pt0.000.000.000.000.000.00XXX
    99100BSpecial anesthesia service0.000.000.000.000.000.00ZZZ
    99116BAnesthesia with hypothermia0.000.000.000.000.000.00ZZZ
    99135BSpecial anesthesia procedure0.000.000.000.000.000.00ZZZ
    99140BEmergency anesthesia0.000.000.000.000.000.00ZZZ
    99141BSedation, iv/im or inhalant+0.802.120.390.042.961.23XXX
    99142BSedation, oral/rectal/nasal+0.601.240.310.031.870.94XXX
    99170AAnogenital exam, child1.752.020.550.073.842.37000
    99172NOcular function screen0.000.000.000.000.000.00XXX
    99173NVisual acuity screen0.000.000.000.000.000.00XXX
    99175AInduction of vomiting0.001.32NA0.081.40NAXXX
    99183AHyperbaric oxygen therapy2.34NA0.770.12NA3.23XXX
    99185ARegional hypothermia0.000.61NA0.030.64NAXXX
    99186ATotal body hypothermia0.001.69NA0.372.06NAXXX
    99190XSpecial pump services0.000.000.000.000.000.00XXX
    99191XSpecial pump services0.000.000.000.000.000.00XXX
    99192XSpecial pump services0.000.000.000.000.000.00XXX
    99195APhlebotomy0.000.42NA0.020.44NAXXX
    99199CSpecial service/proc/report0.000.000.000.000.000.00XXX
    99201AOffice/outpatient visit, new0.450.470.160.020.940.63XXX
    99202AOffice/outpatient visit, new0.880.770.330.051.701.26XXX
    99203AOffice/outpatient visit, new1.341.120.500.082.541.92XXX
    99204AOffice/outpatient visit, new2.001.510.740.103.612.84XXX
    99205AOffice/outpatient visit, new2.671.800.980.124.593.77XXX
    99211AOffice/outpatient visit, est0.170.380.060.010.560.24XXX
    99212AOffice/outpatient visit, est0.450.530.170.021.000.64XXX
    99213AOffice/outpatient visit, est0.670.690.240.031.390.94XXX
    99214AOffice/outpatient visit, est1.101.040.410.042.181.55XXX
    99215AOffice/outpatient visit, est1.771.360.660.073.202.50XXX
    99217AObservation care discharge1.28NA0.450.05NA1.78XXX
    99218AObservation care1.28NA0.450.05NA1.78XXX
    99219AObservation care2.14NA0.750.08NA2.97XXX
    99220AObservation care2.99NA1.060.11NA4.16XXX
    99221AInitial hospital care1.28NA0.470.05NA1.80XXX
    99222AInitial hospital care2.14NA0.770.08NA2.99XXX
    99223AInitial hospital care2.99NA1.080.10NA4.17XXX
    99231ASubsequent hospital care0.64NA0.240.02NA0.90XXX
    99232ASubsequent hospital care1.06NA0.390.03NA1.48XXX
    99233ASubsequent hospital care1.51NA0.550.05NA2.11XXX
    99234AObserv/hosp same date2.56NA0.930.11NA3.60XXX
    99235AObserv/hosp same date3.42NA1.210.13NA4.76XXX
    99236AObserv/hosp same date4.27NA1.490.17NA5.93XXX
    99238AHospital discharge day1.28NA0.510.04NA1.83XXX
    99239AHospital discharge day1.75NA0.710.05NA2.51XXX
    99241AOffice consultation0.640.620.240.041.300.92XXX
    99242AOffice consultation1.291.030.500.092.411.88XXX
    99243AOffice consultation1.721.380.670.103.202.49XXX
    99244AOffice consultation2.581.830.980.134.543.69XXX
    99245AOffice consultation3.432.291.300.165.884.89XXX
    99251AInitial inpatient consult0.66NA0.260.04NA0.96XXX
    99252AInitial inpatient consult1.32NA0.530.08NA1.93XXX
    99253AInitial inpatient consult1.82NA0.720.09NA2.63XXX
    99254AInitial inpatient consult2.64NA1.030.11NA3.78XXX
    99255AInitial inpatient consult3.65NA1.410.15NA5.21XXX
    99261AFollow-up inpatient consult0.42NA0.160.02NA0.60XXX
    99262AFollow-up inpatient consult0.85NA0.320.03NA1.20XXX
    99263AFollow-up inpatient consult1.27NA0.480.04NA1.79XXX
    99271AConfirmatory consultation0.450.670.170.031.150.65XXX
    99272AConfirmatory consultation0.840.890.320.061.791.22XXX
    99273AConfirmatory consultation1.191.130.470.072.391.73XXX
    99274AConfirmatory consultation1.731.410.680.093.232.50XXX
    99275AConfirmatory consultation2.311.680.880.104.093.29XXX
    99281AEmergency dept visit0.33NA0.090.02NA0.44XXX
    99282AEmergency dept visit0.55NA0.150.03NA0.73XXX
    99283AEmergency dept visit1.24NA0.320.08NA1.64XXX
    99284AEmergency dept visit1.95NA0.490.12NA2.56XXX
    Start Printed Page 55466
    99285AEmergency dept visit3.06NA0.750.19NA4.00XXX
    99288BDirect advanced life support0.000.000.000.000.000.00XXX
    99289IPt transport, 30-74 min0.000.000.000.000.000.00XXX
    99290IPt transport, addl 30 min0.000.000.000.000.000.00ZZZ
    99291ACritical care, first hour4.001.631.340.145.775.48XXX
    99292ACritical care, addl 30 min2.000.920.660.072.992.73ZZZ
    99295ANeonatal critical care16.00NA4.530.70NA21.23XXX
    99296ANeonatal critical care8.00NA2.580.23NA10.81XXX
    99297ANeonatal critical care4.00NA1.320.12NA5.44XXX
    99298ANeonatal critical care2.75NA0.970.10NA3.82XXX
    99301ANursing facility care1.200.700.420.041.941.66XXX
    99302ANursing facility care1.610.980.570.052.642.23XXX
    99303ANursing facility care2.011.210.700.063.282.77XXX
    99311ANursing fac care, subseq0.600.490.210.021.110.83XXX
    99312ANursing fac care, subseq1.000.680.350.031.711.38XXX
    99313ANursing fac care, subseq1.420.870.500.042.331.96XXX
    99315ANursing fac discharge day1.130.740.400.041.911.57XXX
    99316ANursing fac discharge day1.500.950.530.052.502.08XXX
    99321ARest home visit, new patient0.710.49NA0.021.22NAXXX
    99322ARest home visit, new patient1.010.70NA0.031.74NAXXX
    99323ARest home visit, new patient1.280.93NA0.042.25NAXXX
    99331ARest home visit, est pat0.600.47NA0.021.09NAXXX
    99332ARest home visit, est pat0.800.59NA0.031.42NAXXX
    99333ARest home visit, est pat1.000.73NA0.031.76NAXXX
    99341AHome visit, new patient1.010.56NA0.051.62NAXXX
    99342AHome visit, new patient1.520.87NA0.052.44NAXXX
    99343AHome visit, new patient2.271.29NA0.073.63NAXXX
    99344AHome visit, new patient3.031.57NA0.104.70NAXXX
    99345AHome visit, new patient3.791.86NA0.125.77NAXXX
    99347AHome visit, est patient0.760.49NA0.031.28NAXXX
    99348AHome visit, est patient1.260.74NA0.042.04NAXXX
    99349AHome visit, est patient2.021.08NA0.063.16NAXXX
    99350AHome visit, est patient3.031.47NA0.104.60NAXXX
    99354AProlonged service, office1.771.460.660.063.292.49ZZZ
    99355AProlonged service, office1.771.240.650.063.072.48ZZZ
    99356AProlonged service, inpatient1.71NA0.610.06NA2.38ZZZ
    99357AProlonged service, inpatient1.71NA0.630.06NA2.40ZZZ
    99358BProlonged serv, w/o contact0.000.000.000.000.000.00ZZZ
    99359BProlonged serv, w/o contact0.000.000.000.000.000.00ZZZ
    99360XPhysician standby services0.000.000.000.000.000.00XXX
    99361BPhysician/team conference0.000.000.000.000.000.00XXX
    99362BPhysician/team conference0.000.000.000.000.000.00XXX
    99371BPhysician phone consultation0.000.000.000.000.000.00XXX
    99372BPhysician phone consultation0.000.000.000.000.000.00XXX
    99373BPhysician phone consultation0.000.000.000.000.000.00XXX
    99374BHome health care supervision+1.101.470.440.042.611.58XXX
    99377BHospice care supervision+1.101.470.440.042.611.58XXX
    99379BNursing fac care supervision+1.101.470.440.032.601.57XXX
    99380BNursing fac care supervision+1.731.720.690.053.502.47XXX
    99381NPrev visit, new, infant+1.191.500.480.042.731.71XXX
    99382NPrev visit, new, age 1-4+1.361.540.540.042.941.94XXX
    99383NPrev visit, new, age 5-11+1.361.480.540.042.881.94XXX
    99384NPrev visit, new, age 12-17+1.531.550.610.053.132.19XXX
    99385NPrev visit, new, age 18-39+1.531.550.610.053.132.19XXX
    99386NPrev visit, new, age 40-64+1.881.740.750.063.682.69XXX
    99387NPrev visit, new, 65 & over+2.061.870.820.063.992.94XXX
    99391NPrev visit, est, infant+1.021.020.410.032.071.46XXX
    99392NPrev visit, est, age 1-4+1.191.090.480.042.321.71XXX
    99393NPrev visit, est, age 5-11+1.191.060.480.042.291.71XXX
    99394NPrev visit, est, age 12-17+1.361.150.540.042.551.94XXX
    99395NPrev visit, est, age 18-39+1.361.180.540.042.581.94XXX
    99396NPrev visit, est, age 40-64+1.531.270.610.052.852.19XXX
    99397NPrev visit, est, 65 & over+1.711.370.680.053.132.44XXX
    99401NPreventive counseling, indiv+0.480.620.190.011.110.68XXX
    99402NPreventive counseling, indiv+0.980.860.390.021.861.39XXX
    99403NPreventive counseling, indiv+1.461.100.580.032.592.07XXX
    99404NPreventive counseling, indiv+1.951.350.780.043.342.77XXX
    99411NPreventive counseling, group+0.150.180.060.010.340.22XXX
    99412NPreventive counseling, group+0.250.240.100.010.500.36XXX
    99420NHealth risk assessment test0.000.000.000.000.000.00XXX
    99429NUnlisted preventive service0.000.000.000.000.000.00XXX
    99431AInitial care, normal newborn1.17NA0.390.04NA1.60XXX
    99432ANewborn care, not in hosp1.261.120.500.062.441.82XXX
    Start Printed Page 55467
    99433ANormal newborn care/hospital0.62NA0.210.02NA0.85XXX
    99435ANewborn discharge day hosp1.50NA0.540.05NA2.09XXX
    99436AAttendance, birth1.500.500.500.052.052.05XXX
    99440ANewborn resuscitation2.93NA1.170.11NA4.21XXX
    99450NLife/disability evaluation0.000.000.000.000.000.00XXX
    99455RDisability examination0.000.000.000.000.000.00XXX
    99456RDisability examination0.000.000.000.000.000.00XXX
    99499CUnlisted e&m service0.000.000.000.000.000.00XXX
    99500IHome visit, prenatal0.000.000.000.000.000.00XXX
    99501IHome visit, postnatal0.000.000.000.000.000.00XXX
    99502IHome visit, nb care0.000.000.000.000.000.00XXX
    99503IHome visit, resp therapy0.000.000.000.000.000.00XXX
    99504IHome visit, mech ventilator0.000.000.000.000.000.00XXX
    99505IHome visit, stoma care0.000.000.000.000.000.00XXX
    99506IHome visit, im injection0.000.000.000.000.000.00XXX
    99507IHome visit, cath maintain0.000.000.000.000.000.00XXX
    99508IHome visit, sleep studies0.000.000.000.000.000.00XXX
    99509IHome visit, day life activity0.000.000.000.000.000.00XXX
    99510IHome visit, sing/m/fam couns0.000.000.000.000.000.00XXX
    99511IHome visit, fecal/enema mgmt0.000.000.000.000.000.00XXX
    99512IHome visit, hemodialysis0.000.000.000.000.000.00XXX
    99539IHome visit, nos0.000.000.000.000.000.00XXX
    99551IHome infuse, pain mgmt, iv/sc0.000.000.000.000.000.00XXX
    99552IHome infuse pain mgmt, epid/ith0.000.000.000.000.000.00XXX
    99553IHome infuse, tocolytic tx0.000.000.000.000.000.00XXX
    99554IHome infuse, hormone/platelet0.000.000.000.000.000.00XXX
    99555IHome infuse, chemotheraphy0.000.000.000.000.000.00XXX
    99556IHome infuse, antibio/fung/vir0.000.000.000.000.000.00XXX
    99557IHome infuse, anticoagulant0.000.000.000.000.000.00XXX
    99558IHome infuse, immunotherapy0.000.000.000.000.000.00XXX
    99559IHome infuse, periton dialysis0.000.000.000.000.000.00XXX
    99560IHome infuse, entero nutrition0.000.000.000.000.000.00XXX
    99561IHome infuse, hydration tx0.000.000.000.000.000.00XXX
    99562IHome infuse, parent nutrition0.000.000.000.000.000.00XXX
    99563IHome admin, pentamidine0.000.000.000.000.000.00XXX
    99564IHome infuse, antihemophil agnt0.000.000.000.000.000.00XXX
    99565IHome infuse, proteinase inhib0.000.000.000.000.000.00XXX
    99566IHome infuse, iv therapy0.000.000.000.000.000.00XXX
    99567IHome infuse, sympath agent0.000.000.000.000.000.00XXX
    99568IHome infuse, misc drug, daily0.000.000.000.000.000.00XXX
    99569IHome infuse, each addl tx0.000.000.000.000.000.00XXX
    A0021IOutside state ambulance serv0.000.000.000.000.000.00XXX
    A0080INoninterest escort in non er0.000.000.000.000.000.00XXX
    A0090IInterest escort in non er0.000.000.000.000.000.00XXX
    A0100INonemergency transport taxi0.000.000.000.000.000.00XXX
    A0110INonemergency transport bus0.000.000.000.000.000.00XXX
    A0120INoner transport mini-bus0.000.000.000.000.000.00XXX
    A0130INoner transport wheelch van0.000.000.000.000.000.00XXX
    A0140INonemergency transport air0.000.000.000.000.000.00XXX
    A0160INoner transport case worker0.000.000.000.000.000.00XXX
    A0170INoner transport parking fees0.000.000.000.000.000.00XXX
    A0180INoner transport lodgng recip0.000.000.000.000.000.00XXX
    A0190INoner transport meals recip0.000.000.000.000.000.00XXX
    A0200INoner transport lodgng escrt0.000.000.000.000.000.00XXX
    A0210INoner transport meals escort0.000.000.000.000.000.00XXX
    A0380XBasic life support mileage0.000.000.000.000.000.00XXX
    A0382XBasic support routine suppls0.000.000.000.000.000.00XXX
    A0384XBls defibrillation supplies0.000.000.000.000.000.00XXX
    A0390XAdvanced life support mileag0.000.000.000.000.000.00XXX
    A0392XAls defibrillation supplies0.000.000.000.000.000.00XXX
    A0394XAls IV drug therapy supplies0.000.000.000.000.000.00XXX
    A0396XAls esophageal intub suppls0.000.000.000.000.000.00XXX
    A0398XAls routine disposble suppls0.000.000.000.000.000.00XXX
    A0420XAmbulance waiting 1/2 hr0.000.000.000.000.000.00XXX
    A0422XAmbulance 02 life sustaining0.000.000.000.000.000.00XXX
    A0424XExtra ambulance attendant0.000.000.000.000.000.00XXX
    A0425XGround mileage0.000.000.000.000.000.00XXX
    A0426XAls 10.000.000.000.000.000.00XXX
    A0427XALS1-emergency0.000.000.000.000.000.00XXX
    A0428Xbls0.000.000.000.000.000.00XXX
    A0429XBLS-emergency0.000.000.000.000.000.00XXX
    A0430XFixed wing air transport0.000.000.000.000.000.00XXX
    A0431XRotary wing air transport0.000.000.000.000.000.00XXX
    Start Printed Page 55468
    A0432XPI volunteer ambulance co0.000.000.000.000.000.00XXX
    A0433Xals 20.000.000.000.000.000.00XXX
    A0434XSpecialty care transport0.000.000.000.000.000.00XXX
    A0435XFixed wing air mileage0.000.000.000.000.000.00XXX
    A0436XRotary wing air mileage0.000.000.000.000.000.00XXX
    A0888NNoncovered ambulance mileage0.000.000.000.000.000.00XXX
    A0999XUnlisted ambulance service0.000.000.000.000.000.00XXX
    A4206I1 CC sterile syringe&needle0.000.000.000.000.000.00XXX
    A4207I2 CC sterile syringe&needle0.000.000.000.000.000.00XXX
    A4208I3 CC sterile syringe&needle0.000.000.000.000.000.00XXX
    A4209I5+ CC sterile syringe&needle0.000.000.000.000.000.00XXX
    A4210NNonneedle injection device0.000.000.000.000.000.00XXX
    A4211PSupp for self-adm injections0.000.000.000.000.000.00XXX
    A4212PNon coring needle or stylet0.000.000.000.000.000.00XXX
    A4213I20+ CC syringe only0.000.000.000.000.000.00XXX
    A4214P30 CC sterile water/saline0.000.000.000.000.000.00XXX
    A4215ISterile needle0.000.000.000.000.000.00XXX
    A4220PInfusion pump refill kit0.000.000.000.000.000.00XXX
    A4221XMaint drug infus cath per wk0.000.000.000.000.000.00XXX
    A4222XDrug infusion pump supplies0.000.000.000.000.000.00XXX
    A4230XInfus insulin pump non needl0.000.000.000.000.000.00XXX
    A4231XInfusion insulin pump needle0.000.000.000.000.000.00XXX
    A4232XSyringe w/needle insulin 3cc0.000.000.000.000.000.00XXX
    A4244IAlcohol or peroxide per pint0.000.000.000.000.000.00XXX
    A4245IAlcohol wipes per box0.000.000.000.000.000.00XXX
    A4246IBetadine/phisohex solution0.000.000.000.000.000.00XXX
    A4247IBetadine/iodine swabs/wipes0.000.000.000.000.000.00XXX
    A4250NUrine reagent strips/tablets0.000.000.000.000.000.00XXX
    A4253PBlood glucose/reagent strips0.000.000.000.000.000.00XXX
    A4254XBattery for glucose monitor0.000.000.000.000.000.00XXX
    A4255XGlucose monitor platforms0.000.000.000.000.000.00XXX
    A4256PCalibrator solution/chips0.000.000.000.000.000.00XXX
    A4257XReplace Lensshield Cartridge0.000.000.000.000.000.00XXX
    A4258PLancet device each0.000.000.000.000.000.00XXX
    A4259PLancets per box0.000.000.000.000.000.00XXX
    A4260NLevonorgestrel implant0.000.000.000.000.000.00XXX
    A4261NCervical cap contraceptive0.000.000.000.000.000.00XXX
    A4262BTemporary tear duct plug0.000.000.000.000.000.00XXX
    A4263IPermanent tear duct plug0.000.000.000.000.000.00XXX
    A4265PParaffin0.000.000.000.000.000.00XXX
    A4270BDisposable endoscope sheath0.000.000.000.000.000.00XXX
    A4280XBrst prsths adhsv attchmnt0.000.000.000.000.000.00XXX
    A4290XSacral nerve stim test lead0.000.000.000.000.000.00XXX
    A4300BCath impl vasc access portal0.000.000.000.000.000.00XXX
    A4301PImplantable access syst perc0.000.000.000.000.000.00XXX
    A4305PDrug delivery system >=50 ML0.000.000.000.000.000.00XXX
    A4306PDrug delivery system <=5 ML0.000.000.000.000.000.00XXX
    A4310PInsert tray w/o bag/cath0.000.000.000.000.000.00XXX
    A4311PCatheter w/o bag 2-way latex0.000.000.000.000.000.00XXX
    A4312PCath w/o bag 2-way silicone0.000.000.000.000.000.00XXX
    A4313PCatheter w/bag 3-way0.000.000.000.000.000.00XXX
    A4314PCath w/drainage 2-way latex0.000.000.000.000.000.00XXX
    A4315PCath w/drainage 2-way silcne0.000.000.000.000.000.00XXX
    A4316PCath w/drainage 3-way0.000.000.000.000.000.00XXX
    A4319XSterile H2 O irrigation solut0.000.000.000.000.000.00XXX
    A4320PIrrigation tray0.000.000.000.000.000.00XXX
    A4321XCath therapeutic irrig agent0.000.000.000.000.000.00XXX
    A4322PIrrigation syringe0.000.000.000.000.000.00XXX
    A4323PSaline irrigation solution0.000.000.000.000.000.00XXX
    A4324XMale ext cath w/adh coating0.000.000.000.000.000.00XXX
    A4325XMale ext cath w/adh strip0.000.000.000.000.000.00XXX
    A4326PMale external catheter0.000.000.000.000.000.00XXX
    A4327PFem urinary collect dev cup0.000.000.000.000.000.00XXX
    A4328PFem urinary collect pouch0.000.000.000.000.000.00XXX
    A4329DExternal catheter start set0.000.000.000.000.000.00XXX
    A4330PStool collection pouch0.000.000.000.000.000.00XXX
    A4331XExtension drainage tubing0.000.000.000.000.000.00XXX
    A4332XLubricant for cath insertion0.000.000.000.000.000.00XXX
    A4333XUrinary cath anchor device0.000.000.000.000.000.00XXX
    A4334XUrinary cath leg strap0.000.000.000.000.000.00XXX
    A4335PIncontinence supply0.000.000.000.000.000.00XXX
    A4338PIndwelling catheter latex0.000.000.000.000.000.00XXX
    A4340PIndwelling catheter special0.000.000.000.000.000.00XXX
    Start Printed Page 55469
    A4344PCath indw foley 2 way silicn0.000.000.000.000.000.00XXX
    A4346PCath indw foley 3 way0.000.000.000.000.000.00XXX
    A4347PMale external catheter0.000.000.000.000.000.00XXX
    A4348XMale ext cath extended wear0.000.000.000.000.000.00XXX
    A4351PStraight tip urine catheter0.000.000.000.000.000.00XXX
    A4352PCoude tip urinary catheter0.000.000.000.000.000.00XXX
    A4353XIntermittent urinary cath0.000.000.000.000.000.00XXX
    A4354PCath insertion tray w/bag0.000.000.000.000.000.00XXX
    A4355PBladder irrigation tubing0.000.000.000.000.000.00XXX
    A4356PExt ureth clmp or compr dvc0.000.000.000.000.000.00XXX
    A4357PBedside drainage bag0.000.000.000.000.000.00XXX
    A4358PUrinary leg or abdomen bag0.000.000.000.000.000.00XXX
    A4359PUrinary suspensory w/o leg b0.000.000.000.000.000.00XXX
    A4360NAdult incontinence garment0.000.000.000.000.000.00XXX
    A4361POstomy face plate0.000.000.000.000.000.00XXX
    A4362PSolid skin barrier0.000.000.000.000.000.00XXX
    A4364PAdhesive, liquid or equal0.000.000.000.000.000.00XXX
    A4365XAdhesive remover wipes0.000.000.000.000.000.00XXX
    A4367POstomy belt0.000.000.000.000.000.00XXX
    A4368XOstomy filter0.000.000.000.000.000.00XXX
    A4369XSkin barrier liquid per oz0.000.000.000.000.000.00XXX
    A4370XSkin barrier paste per oz0.000.000.000.000.000.00XXX
    A4371XSkin barrier powder per oz0.000.000.000.000.000.00XXX
    A4372XSkin barrier solid 4x4 equiv0.000.000.000.000.000.00XXX
    A4373XSkin barrier with flange0.000.000.000.000.000.00XXX
    A4374XSkin barrier extended wear0.000.000.000.000.000.00XXX
    A4375XDrainable plastic pch w fcpl0.000.000.000.000.000.00XXX
    A4376XDrainable rubber pch w fcplt0.000.000.000.000.000.00XXX
    A4377XDrainable plstic pch w/o fp0.000.000.000.000.000.00XXX
    A4378XDrainable rubber pch w/o fp0.000.000.000.000.000.00XXX
    A4379XUrinary plastic pouch w fcpl0.000.000.000.000.000.00XXX
    A4380XUrinary rubber pouch w fcplt0.000.000.000.000.000.00XXX
    A4381XUrinary plastic pouch w/o fp0.000.000.000.000.000.00XXX
    A4382XUrinary hvy plstc pch w/o fp0.000.000.000.000.000.00XXX
    A4383XUrinary rubber pouch w/o fp0.000.000.000.000.000.00XXX
    A4384XOstomy faceplt/silicone ring0.000.000.000.000.000.00XXX
    A4385XOst skn barrier sld ext wear0.000.000.000.000.000.00XXX
    A4386XOst skn barrier w flng ex wr0.000.000.000.000.000.00XXX
    A4387XOst clsd pouch w att st barr0.000.000.000.000.000.00XXX
    A4388XDrainable pch w ex wear barr0.000.000.000.000.000.00XXX
    A4389XDrainable pch w st wear barr0.000.000.000.000.000.00XXX
    A4390XDrainable pch ex wear convex0.000.000.000.000.000.00XXX
    A4391XUrinary pouch w ex wear barr0.000.000.000.000.000.00XXX
    A4392XUrinary pouch w st wear barr0.000.000.000.000.000.00XXX
    A4393XUrine pch w ex wear bar conv0.000.000.000.000.000.00XXX
    A4394XOstomy pouch liq deodorant0.000.000.000.000.000.00XXX
    A4395XOstomy pouch solid deodorant0.000.000.000.000.000.00XXX
    A4396XPeristomal hernia supprt blt0.000.000.000.000.000.00XXX
    A4397PIrrigation supply sleeve0.000.000.000.000.000.00XXX
    A4398POstomy irrigation bag0.000.000.000.000.000.00XXX
    A4399POstomy irrig cone/cath w brs0.000.000.000.000.000.00XXX
    A4400POstomy irrigation set0.000.000.000.000.000.00XXX
    A4402PLubricant per ounce0.000.000.000.000.000.00XXX
    A4404POstomy ring each0.000.000.000.000.000.00XXX
    A4421POstomy supply misc0.000.000.000.000.000.00XXX
    A4454PTape all types all sizes0.000.000.000.000.000.00XXX
    A4455PAdhesive remover per ounce0.000.000.000.000.000.00XXX
    A4460PElastic compression bandage0.000.000.000.000.000.00XXX
    A4462XAbdmnl drssng holder/binder0.000.000.000.000.000.00XXX
    A4464NJoint support device/garment0.000.000.000.000.000.00XXX
    A4465PNon-elastic extremity binder0.000.000.000.000.000.00XXX
    A4470PGravlee jet washer0.000.000.000.000.000.00XXX
    A4480PVabra aspirator0.000.000.000.000.000.00XXX
    A4481XTracheostoma filter0.000.000.000.000.000.00XXX
    A4483XMoisture exchanger0.000.000.000.000.000.00XXX
    A4490NAbove knee surgical stocking0.000.000.000.000.000.00XXX
    A4495NThigh length surg stocking0.000.000.000.000.000.00XXX
    A4500NBelow knee surgical stocking0.000.000.000.000.000.00XXX
    A4510NFull length surg stocking0.000.000.000.000.000.00XXX
    A4550ISurgical trays0.000.000.000.000.000.00XXX
    A4554NDisposable underpads0.000.000.000.000.000.00XXX
    A4556PElectrodes, pair0.000.000.000.000.000.00XXX
    A4557PLead wires, pair0.000.000.000.000.000.00XXX
    Start Printed Page 55470
    A4558PConductive paste or gel0.000.000.000.000.000.00XXX
    A4561XPessary rubber, any type0.000.000.000.000.000.00XXX
    A4562XPessary, non rubber, any type0.000.000.000.000.000.00XXX
    A4565XSlings0.000.000.000.000.000.00XXX
    A4570ISplint0.000.000.000.000.000.00XXX
    A4572XRib belt0.000.000.000.000.000.00XXX
    A4575NHyperbaric o2 chamber disps0.000.000.000.000.000.00XXX
    A4580ICast supplies (plaster)0.000.000.000.000.000.00XXX
    A4590ISpecial casting material0.000.000.000.000.000.00XXX
    A4595XTENS suppl 2 lead per month0.000.000.000.000.000.00XXX
    A4608XTranstracheal oxygen cath0.000.000.000.000.000.00XXX
    A4611XHeavy duty battery0.000.000.000.000.000.00XXX
    A4612XBattery cables0.000.000.000.000.000.00XXX
    A4613XBattery charger0.000.000.000.000.000.00XXX
    A4614XHand-held PEFR meter0.000.000.000.000.000.00XXX
    A4615XCannula nasal0.000.000.000.000.000.00XXX
    A4616XTubing (oxygen) per foot0.000.000.000.000.000.00XXX
    A4617XMouth piece0.000.000.000.000.000.00XXX
    A4618XBreathing circuits0.000.000.000.000.000.00XXX
    A4619XFace tent0.000.000.000.000.000.00XXX
    A4620XVariable concentration mask0.000.000.000.000.000.00XXX
    A4621XTracheotomy mask or collar0.000.000.000.000.000.00XXX
    A4622XTracheostomy or larngectomy0.000.000.000.000.000.00XXX
    A4623XTracheostomy inner cannula0.000.000.000.000.000.00XXX
    A4624XTracheal suction tube0.000.000.000.000.000.00XXX
    A4625XTrach care kit for new trach0.000.000.000.000.000.00XXX
    A4626XTracheostomy cleaning brush0.000.000.000.000.000.00XXX
    A4627NSpacer bag/reservoir0.000.000.000.000.000.00XXX
    A4628XOropharyngeal suction cath0.000.000.000.000.000.00XXX
    A4629XTracheostomy care kit0.000.000.000.000.000.00XXX
    A4630XRepl bat t.e.n.s. own by pt0.000.000.000.000.000.00XXX
    A4631XWheelchair battery0.000.000.000.000.000.00XXX
    A4635XUnderarm crutch pad0.000.000.000.000.000.00XXX
    A4636XHandgrip for cane etc0.000.000.000.000.000.00XXX
    A4637XRepl tip cane/crutch/walker0.000.000.000.000.000.00XXX
    A4640XAlternating pressure pad0.000.000.000.000.000.00XXX
    A4641EDiagnostic imaging agent0.000.000.000.000.000.00XXX
    A4642ESatumomab pendetide per dose0.000.000.000.000.000.00XXX
    A4643EHigh dose contrast MRI0.000.000.000.000.000.00XXX
    A4644EContrast 100-199 MGs iodine0.000.000.000.000.000.00XXX
    A4645EContrast 200-299 MGs iodine0.000.000.000.000.000.00XXX
    A4646EContrast 300-399 MGs iodine0.000.000.000.000.000.00XXX
    A4647BSupp- paramagnetic contr mat0.000.000.000.000.000.00XXX
    A4649PSurgical supplies0.000.000.000.000.000.00XXX
    A4650DSupp esrd centrifuge0.000.000.000.000.000.00XXX
    A4651XCalibrated microcap tube0.000.000.000.000.000.00XXX
    A4652XMicrocapillary tube sealant0.000.000.000.000.000.00XXX
    A4655DEsrd syringe/needle0.000.000.000.000.000.00XXX
    A4656XDialysis needle0.000.000.000.000.000.00XXX
    A4657XDialysis syringe w/wo needle0.000.000.000.000.000.00XXX
    A4660XSphyg/bp app w cuff and stet0.000.000.000.000.000.00XXX
    A4663XDialysis blood pressure cuff0.000.000.000.000.000.00XXX
    A4670NAutomatic bp monitor, dial0.000.000.000.000.000.00XXX
    A4680XActificial carbon filter, ea0.000.000.000.000.000.00XXX
    A4690XDialyzer, each0.000.000.000.000.000.00XXX
    A4700DStandard dialysate solution0.000.000.000.000.000.00XXX
    A4705DBicarb dialysate solution0.000.000.000.000.000.00XXX
    A4706XBicarbonate conc sol per gal0.000.000.000.000.000.00XXX
    A4707XBicarbonate conc pow per pac0.000.000.000.000.000.00XXX
    A4708XAcetate conc sol per gallon0.000.000.000.000.000.00XXX
    A4709XAcid conc sol per gallon0.000.000.000.000.000.00XXX
    A4712XSterile water inj per 10 ml0.000.000.000.000.000.00XXX
    A4714XTreated water per gallon0.000.000.000.000.000.00XXX
    A4719X“Y set” tubing0.000.000.000.000.000.00XXX
    A4720XDialysat sol fld vol > 249cc0.000.000.000.000.000.00XXX
    A4721XDialysat sol fld vol > 999cc0.000.000.000.000.000.00XXX
    A4722XDialys sol fld vol > 1999cc0.000.000.000.000.000.00XXX
    A4723XDialys sol fld vol > 2999cc0.000.000.000.000.000.00XXX
    A4724XDialys sol fld vol > 3999cc0.000.000.000.000.000.00XXX
    A4725XDialys sol fld vol > 4999cc0.000.000.000.000.000.00XXX
    A4726XDialys sol fld vol > 5999cc0.000.000.000.000.000.00XXX
    A4730XFistula cannulation set, ea0.000.000.000.000.000.00XXX
    A4735DLocal/topical anesthetics0.000.000.000.000.000.00XXX
    Start Printed Page 55471
    A4736XTopical anesthetic, per gram0.000.000.000.000.000.00XXX
    A4737XInj anesthetic per 10 ml0.000.000.000.000.000.00XXX
    A4740XShunt accessory0.000.000.000.000.000.00XXX
    A4750XArt or venous blood tubing0.000.000.000.000.000.00XXX
    A4755XComb art/venous blood tubing0.000.000.000.000.000.00XXX
    A4760XDialysate sol test kit, each0.000.000.000.000.000.00XXX
    A4765XDialysate conc pow per pack0.000.000.000.000.000.00XXX
    A4766XDialysate conc sol add 10 ml0.000.000.000.000.000.00XXX
    A4770XBlood collection tube/vacuum0.000.000.000.000.000.00XXX
    A4771XSerum clotting time tube0.000.000.000.000.000.00XXX
    A4772XBlood glucose test strips0.000.000.000.000.000.00XXX
    A4773XOccult blood test strips0.000.000.000.000.000.00XXX
    A4774XAmmonia test strips0.000.000.000.000.000.00XXX
    A4780DEsrd sterilizing agent0.000.000.000.000.000.00XXX
    A4790DEsrd cleansing agents0.000.000.000.000.000.00XXX
    A4800DHeparin/antidote dialysis0.000.000.000.000.000.00XXX
    A4801XHeparin per 1000 units0.000.000.000.000.000.00XXX
    A4802XProtamine sulfate per 50 mg0.000.000.000.000.000.00XXX
    A4820DSupplies hemodialysis kit0.000.000.000.000.000.00XXX
    A4850DRubber tipped hemostats0.000.000.000.000.000.00XXX
    A4860XDisposable catheter tips0.000.000.000.000.000.00XXX
    A4870XPlumb/elec wk hm hemo equip0.000.000.000.000.000.00XXX
    A4880DWater storage tanks0.000.000.000.000.000.00XXX
    A4890RRepair/maint cont hemo equip0.000.000.000.000.000.00XXX
    A4900DCapd supply kit0.000.000.000.000.000.00XXX
    A4901DCcpd supply kit0.000.000.000.000.000.00XXX
    A4905DIpd supply kit0.000.000.000.000.000.00XXX
    A4910DEsrd nonmedical supplies0.000.000.000.000.000.00XXX
    A4911XDrain bag/bottle0.000.000.000.000.000.00XXX
    A4912DGomco drain bottle0.000.000.000.000.000.00XXX
    A4913XMisc dialysis supplies noc0.000.000.000.000.000.00XXX
    A4914DPreparation kit0.000.000.000.000.000.00XXX
    A4918XVenous pressure clamp0.000.000.000.000.000.00XXX
    A4919DSupp dialysis dialyzer holde0.000.000.000.000.000.00XXX
    A4920DHarvard pressure clamp0.000.000.000.000.000.00XXX
    A4921DMeasuring cylinder0.000.000.000.000.000.00XXX
    A4927XNon-sterile gloves0.000.000.000.000.000.00XXX
    A4928XSurgical mask0.000.000.000.000.000.00XXX
    A4929XTourniquet for dialysis, ea0.000.000.000.000.000.00XXX
    A5051PPouch clsd w barr attached0.000.000.000.000.000.00XXX
    A5052PClsd ostomy pouch w/o barr0.000.000.000.000.000.00XXX
    A5053PClsd ostomy pouch faceplate0.000.000.000.000.000.00XXX
    A5054PClsd ostomy pouch w/flange0.000.000.000.000.000.00XXX
    A5055PStoma cap0.000.000.000.000.000.00XXX
    A5061PPouch drainable w barrier at0.000.000.000.000.000.00XXX
    A5062PDrnble ostomy pouch w/o barr0.000.000.000.000.000.00XXX
    A5063PDrain ostomy pouch w/flange0.000.000.000.000.000.00XXX
    A5064DDrain ostomy pouch w/fceplte0.000.000.000.000.000.00XXX
    A5071PUrinary pouch w/barrier0.000.000.000.000.000.00XXX
    A5072PUrinary pouch w/o barrier0.000.000.000.000.000.00XXX
    A5073PUrinary pouch on barr w/flng0.000.000.000.000.000.00XXX
    A5074DUrinary pouch w/faceplate0.000.000.000.000.000.00XXX
    A5075DUrinary pouch on faceplate0.000.000.000.000.000.00XXX
    A5081PContinent stoma plug0.000.000.000.000.000.00XXX
    A5082PContinent stoma catheter0.000.000.000.000.000.00XXX
    A5093POstomy accessory convex inse0.000.000.000.000.000.00XXX
    A5102PBedside drain btl w/wo tube0.000.000.000.000.000.00XXX
    A5105PUrinary suspensory0.000.000.000.000.000.00XXX
    A5112PUrinary leg bag0.000.000.000.000.000.00XXX
    A5113PLatex leg strap0.000.000.000.000.000.00XXX
    A5114PFoam/fabric leg strap0.000.000.000.000.000.00XXX
    A5119PSkin barrier wipes box pr 500.000.000.000.000.000.00XXX
    A5121PSolid skin barrier 6x60.000.000.000.000.000.00XXX
    A5122PSolid skin barrier 8x80.000.000.000.000.000.00XXX
    A5123PSkin barrier with flange0.000.000.000.000.000.00XXX
    A5126PDisk/foam pad + or − adhesive0.000.000.000.000.000.00XXX
    A5131PAppliance cleaner0.000.000.000.000.000.00XXX
    A5200XPercutaneous catheter anchor0.000.000.000.000.000.00XXX
    A5500XDiab shoe for density insert0.000.000.000.000.000.00XXX
    A5501XDiabetic custom molded shoe0.000.000.000.000.000.00XXX
    A5502DDiabetic shoe density insert0.000.000.000.000.000.00XXX
    A5503XDiabetic shoe w/roller/rockr0.000.000.000.000.000.00XXX
    A5504XDiabetic shoe with wedge0.000.000.000.000.000.00XXX
    Start Printed Page 55472
    A5505XDiab shoe w/metatarsal bar0.000.000.000.000.000.00XXX
    A5506XDiabetic shoe w/off set heel0.000.000.000.000.000.00XXX
    A5507XModification diabetic shoe0.000.000.000.000.000.00XXX
    A5508XDiabetic deluxe shoe0.000.000.000.000.000.00XXX
    A5509XDirect heat form shoe insert0.000.000.000.000.000.00XXX
    A5510XCompression form shoe insert0.000.000.000.000.000.00XXX
    A5511XCustom fab molded shoe inser0.000.000.000.000.000.00XXX
    A6000XWound warming wound cover0.000.000.000.000.000.00XXX
    A6010XCollagen based wound filler0.000.000.000.000.000.00XXX
    A6020DCollagen wound dressing0.000.000.000.000.000.00XXX
    A6021XCollagen dressing <=16 sq in0.000.000.000.000.000.00XXX
    A6022XCollagen drsg>6<=48 sq in0.000.000.000.000.000.00XXX
    A6023XCollagen dressing >48 sq in0.000.000.000.000.000.00XXX
    A6024XCollagen dsg wound filler0.000.000.000.000.000.00XXX
    A6025ISilicone gel sheet, each0.000.000.000.000.000.00XXX
    A6154PWound pouch each0.000.000.000.000.000.00XXX
    A6196PAlginate dressing <=16 sq in0.000.000.000.000.000.00XXX
    A6197PAlginate drsg >16 <=48 sq in0.000.000.000.000.000.00XXX
    A6198Palginate dressing >48 sq in0.000.000.000.000.000.00XXX
    A6199PAlginate drsg wound filler0.000.000.000.000.000.00XXX
    A6200XCompos drsg <=16 no border0.000.000.000.000.000.00XXX
    A6201XCompos drsg >16<=48 no bdr0.000.000.000.000.000.00XXX
    A6202XCompos drsg >48 no border0.000.000.000.000.000.00XXX
    A6203PComposite drsg <=16 sq in0.000.000.000.000.000.00XXX
    A6204PComposite drsg >16<=48 sq in0.000.000.000.000.000.00XXX
    A6205PComposite drsg >48 sq in0.000.000.000.000.000.00XXX
    A6206PContact layer <=16 sq in0.000.000.000.000.000.00XXX
    A6207PContact layer >16<=48 sq in0.000.000.000.000.000.00XXX
    A6208PContact layer >48 sq in0.000.000.000.000.000.00XXX
    A6209PFoam drsg <=16 sq in w/o bdr0.000.000.000.000.000.00XXX
    A6210PFoam drg >16<=48 sq in w/o b0.000.000.000.000.000.00XXX
    A6211PFoam drg >48 sq in w/o brdr0.000.000.000.000.000.00XXX
    A6212PFoam drg <=16 sq in w/border0.000.000.000.000.000.00XXX
    A6213PFoam drg >16<=48 sq in w/bdr0.000.000.000.000.000.00XXX
    A6214PFoam drg >48 sq in w/border0.000.000.000.000.000.00XXX
    A6215PFoam dressing wound filler0.000.000.000.000.000.00XXX
    A6216PNon-sterile gauze <=16 sq in0.000.000.000.000.000.00XXX
    A6217PNon-sterile gauze >16<=48 sq0.000.000.000.000.000.00XXX
    A6218PNon-sterile gauze >48 sq in0.000.000.000.000.000.00XXX
    A6219PGauze <=16 sq in w/border0.000.000.000.000.000.00XXX
    A6220PGauze >16 <=48 sq in w/bordr0.000.000.000.000.000.00XXX
    A6221PGauze >48 sq in w/border0.000.000.000.000.000.00XXX
    A6222PGauze <=16 in no w/sal w/o b0.000.000.000.000.000.00XXX
    A6223PGauze >16<=48 no w/sal w/o b0.000.000.000.000.000.00XXX
    A6224PGauze >48 in no w/sal w/o b0.000.000.000.000.000.00XXX
    A6228PGauze <=16 sq in water/sal0.000.000.000.000.000.00XXX
    A6229PGauze >16<=48 sq in watr/sal0.000.000.000.000.000.00XXX
    A6230PGauze >48 sq in water/salne0.000.000.000.000.000.00XXX
    A6231XHydrogel dsg <=16 sq in0.000.000.000.000.000.00XXX
    A6232XHydrogel dsg >16<=48 sq in0.000.000.000.000.000.00XXX
    A6233XHydrogel dressing >48 sq in0.000.000.000.000.000.00XXX
    A6234PHydrocolld drg <=16 w/o bdr0.000.000.000.000.000.00XXX
    A6235PHydrocolld drg >16<=48 w/o b0.000.000.000.000.000.00XXX
    A6236PHydrocolld drg >48 in w/o b0.000.000.000.000.000.00XXX
    A6237PHydrocolld drg <=16 in w/bdr0.000.000.000.000.000.00XXX
    A6238PHydrocolld drg >16<=48 w/bdr0.000.000.000.000.000.00XXX
    A6239PHydrocolld drg >48 in w/bdr0.000.000.000.000.000.00XXX
    A6240PHydrocolld drg filler paste0.000.000.000.000.000.00XXX
    A6241PHydrocolloid drg filler dry0.000.000.000.000.000.00XXX
    A6242PHydrogel drg <=16 in w/o bdr0.000.000.000.000.000.00XXX
    A6243PHydrogel drg >16<=48 w/o bdr0.000.000.000.000.000.00XXX
    A6244PHydrogel drg >48 in w/o bdr0.000.000.000.000.000.00XXX
    A6245PHydrogel drg <=16 in w/bdr0.000.000.000.000.000.00XXX
    A6246PHydrogel drg >16<=48 in w/b0.000.000.000.000.000.00XXX
    A6247PHydrogel drg >48 sq in w/b0.000.000.000.000.000.00XXX
    A6248PHydrogel drsg gel filler0.000.000.000.000.000.00XXX
    A6250PSkin seal protect moisturizr0.000.000.000.000.000.00XXX
    A6251PAbsorpt drg <=16 sq in w/o b0.000.000.000.000.000.00XXX
    A6252PAbsorpt drg >16<=48 w/o bdr0.000.000.000.000.000.00XXX
    A6253PAbsorpt drg >48 sq in w/o b0.000.000.000.000.000.00XXX
    A6254PAbsorpt drg <=16 sq in w/bdr0.000.000.000.000.000.00XXX
    A6255PAbsorpt drg >16<=48 in w/bdr0.000.000.000.000.000.00XXX
    A6256PAbsorpt drg >48 sq in w/bdr0.000.000.000.000.000.00XXX
    Start Printed Page 55473
    A6257PTransparent film <=16 sq in0.000.000.000.000.000.00XXX
    A6258PTransparent film >16<=48 in0.000.000.000.000.000.00XXX
    A6259PTransparent film >48 sq in0.000.000.000.000.000.00XXX
    A6260PWound cleanser any type/size0.000.000.000.000.000.00XXX
    A6261PWound filler gel/paste/oz0.000.000.000.000.000.00XXX
    A6262PWound filler dry form/gram0.000.000.000.000.000.00XXX
    A6263PNon-sterile elastic gauze/yd0.000.000.000.000.000.00XXX
    A6264PNon-sterile no elastic gauze0.000.000.000.000.000.00XXX
    A6265PTape per 18 sq inches0.000.000.000.000.000.00XXX
    A6266PImpreg gauze no h20/sal/yard0.000.000.000.000.000.00XXX
    A6402PSterile gauze <=16 sq in0.000.000.000.000.000.00XXX
    A6403PSterile gauze >16<=48 sq in0.000.000.000.000.000.00XXX
    A6404PSterile gauze >48 sq in0.000.000.000.000.000.00XXX
    A6405PSterile elastic gauze/yd0.000.000.000.000.000.00XXX
    A6406PSterile non-elastic gauze/yd0.000.000.000.000.000.00XXX
    A7000XDisposable canister for pump0.000.000.000.000.000.00XXX
    A7001XNondisposable pump canister0.000.000.000.000.000.00XXX
    A7002XTubing used w suction pump0.000.000.000.000.000.00XXX
    A7003XNebulizer administration set0.000.000.000.000.000.00XXX
    A7004XDisposable nebulizer sml vol0.000.000.000.000.000.00XXX
    A7005XNondisposable nebulizer set0.000.000.000.000.000.00XXX
    A7006XFiltered nebulizer admin set0.000.000.000.000.000.00XXX
    A7007XLg vol nebulizer disposable0.000.000.000.000.000.00XXX
    A7008XDisposable nebulizer prefill0.000.000.000.000.000.00XXX
    A7009XNebulizer reservoir bottle0.000.000.000.000.000.00XXX
    A7010XDisposable corrugated tubing0.000.000.000.000.000.00XXX
    A7011XNondispos corrugated tubing0.000.000.000.000.000.00XXX
    A7012XNebulizer water collec devic0.000.000.000.000.000.00XXX
    A7013XDisposable compressor filter0.000.000.000.000.000.00XXX
    A7014XCompressor nondispos filter0.000.000.000.000.000.00XXX
    A7015XAerosol mask used w nebulize0.000.000.000.000.000.00XXX
    A7016XNebulizer dome & mouthpiece0.000.000.000.000.000.00XXX
    A7017XNebulizer not used w oxygen0.000.000.000.000.000.00XXX
    A7018XWater distilled w/nebulizer0.000.000.000.000.000.00XXX
    A7019XSaline solution dispenser0.000.000.000.000.000.00XXX
    A7020XSterile H2 O or NSS w lgv neb0.000.000.000.000.000.00XXX
    A7501XTracheostoma valve w diaphra0.000.000.000.000.000.00XXX
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    Start Printed Page 55474
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    Start Printed Page 55475
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    Start Printed Page 55477
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    D6056NPrefabricated abutment0.000.000.000.000.000.00XXX
    D6057NCustom abutment0.000.000.000.000.000.00XXX
    D6058NAbutment supported crown0.000.000.000.000.000.00XXX
    D6059NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6060NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6061NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6062NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6063NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6064NAbutment supported mtl crown0.000.000.000.000.000.00XXX
    D6065NImplant supported crown0.000.000.000.000.000.00XXX
    D6066NImplant supported mtl crown0.000.000.000.000.000.00XXX
    D6067NImplant supported mtl crown0.000.000.000.000.000.00XXX
    D6068NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6069NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6070NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6071NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6072NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6073NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6074NAbutment supported retainer0.000.000.000.000.000.00XXX
    D6075NImplant supported retainer0.000.000.000.000.000.00XXX
    D6076NImplant supported retainer0.000.000.000.000.000.00XXX
    D6077NImplant supported retainer0.000.000.000.000.000.00XXX
    D6078NImplnt/abut suprtd fixd dent0.000.000.000.000.000.00XXX
    D6079NImplnt/abut suprtd fixd dent0.000.000.000.000.000.00XXX
    D6080IImplant maintenance0.000.000.000.000.000.00XXX
    D6090IRepair implant0.000.000.000.000.000.00XXX
    D6095IOdontics repr abutment0.000.000.000.000.000.00XXX
    D6100IRemoval of implant0.000.000.000.000.000.00XXX
    D6199IImplant procedure0.000.000.000.000.000.00XXX
    D6210NProsthodont high noble metal0.000.000.000.000.000.00XXX
    D6211NBridge base metal cast0.000.000.000.000.000.00XXX
    Start Printed Page 55478
    D6212NBridge noble metal cast0.000.000.000.000.000.00XXX
    D6240NBridge porcelain high noble0.000.000.000.000.000.00XXX
    D6241NBridge porcelain base metal0.000.000.000.000.000.00XXX
    D6242NBridge porcelain nobel metal0.000.000.000.000.000.00XXX
    D6245NBridge porcelain/ceramic0.000.000.000.000.000.00XXX
    D6250NBridge resin w/high noble0.000.000.000.000.000.00XXX
    D6251NBridge resin base metal0.000.000.000.000.000.00XXX
    D6252NBridge resin w/noble metal0.000.000.000.000.000.00XXX
    D6519NInlay/onlay porce/ceramic0.000.000.000.000.000.00XXX
    D6520NDental retainer two surfaces0.000.000.000.000.000.00XXX
    D6530NRetainer metallic 3+ surface0.000.000.000.000.000.00XXX
    D6543NDental retainr onlay 3 surf0.000.000.000.000.000.00XXX
    D6544NDental retainr onlay 4/more0.000.000.000.000.000.00XXX
    D6545NDental retainr cast metl0.000.000.000.000.000.00XXX
    D6548NPorcelain/ceramic retainer0.000.000.000.000.000.00XXX
    D6720NRetain crown resin w/hi nble0.000.000.000.000.000.00XXX
    D6721NCrown resin w/base metal0.000.000.000.000.000.00XXX
    D6722NCrown resin w/noble metal0.000.000.000.000.000.00XXX
    D6740NCrown porcelain/ceramic0.000.000.000.000.000.00XXX
    D6750NCrown porcelain high noble0.000.000.000.000.000.00XXX
    D6751NCrown porcelain base metal0.000.000.000.000.000.00XXX
    D6752NCrown porcelain noble metal0.000.000.000.000.000.00XXX
    D6780NCrown 3/4 high noble metal0.000.000.000.000.000.00XXX
    D6781NCrown 3/4 cast based metal0.000.000.000.000.000.00XXX
    D6782NCrown 3/4 cast noble metal0.000.000.000.000.000.00XXX
    D6783NCrown 3/4 porcelain/ceramic0.000.000.000.000.000.00XXX
    D6790NCrown full high noble metal0.000.000.000.000.000.00XXX
    D6791NCrown full base metal cast0.000.000.000.000.000.00XXX
    D6792NCrown full noble metal cast0.000.000.000.000.000.00XXX
    D6920RDental connector bar0.000.000.000.000.000.00YYY
    D6930NDental recement bridge0.000.000.000.000.000.00XXX
    D6940NStress breaker0.000.000.000.000.000.00XXX
    D6950NPrecision attachment0.000.000.000.000.000.00XXX
    D6970NPost & core plus retainer0.000.000.000.000.000.00XXX
    D6971NCast post bridge retainer0.000.000.000.000.000.00XXX
    D6972NPrefab post & core plus reta0.000.000.000.000.000.00XXX
    D6973NCore build up for retainer0.000.000.000.000.000.00XXX
    D6975NCoping metal0.000.000.000.000.000.00XXX
    D6976NEach addtnl cast post0.000.000.000.000.000.00XXX
    D6977NEach addtl prefab post0.000.000.000.000.000.00XXX
    D6980NBridge repair0.000.000.000.000.000.00XXX
    D6999NFixed prosthodontic proc0.000.000.000.000.000.00XXX
    D7110ROral surgery single tooth0.000.000.000.000.000.00YYY
    D7120REach add tooth extraction0.000.000.000.000.000.00YYY
    D7130RTooth root removal0.000.000.000.000.000.00YYY
    D7210RRem imp tooth w/mucoper flp0.000.000.000.000.000.00YYY
    D7220RImpact tooth remov soft tiss0.000.000.000.000.000.00YYY
    D7230RImpact tooth remov part bony0.000.000.000.000.000.00YYY
    D7240RImpact tooth remov comp bony0.000.000.000.000.000.00YYY
    D7241RImpact tooth rem bony w/comp0.000.000.000.000.000.00YYY
    D7250RTooth root removal0.000.000.000.000.000.00YYY
    D7260ROral antral fistula closure0.000.000.000.000.000.00YYY
    D7270NTooth reimplantation0.000.000.000.000.000.00XXX
    D7272NTooth transplantation0.000.000.000.000.000.00XXX
    D7280NExposure impact tooth orthod0.000.000.000.000.000.00XXX
    D7281NExposure tooth aid eruption0.000.000.000.000.000.00XXX
    D7285IBiopsy of oral tissue hard0.000.000.000.000.000.00XXX
    D7286IBiopsy of oral tissue soft0.000.000.000.000.000.00XXX
    D7290NRepositioning of teeth0.000.000.000.000.000.00XXX
    D7291RTransseptal fiberotomy0.000.000.000.000.000.00YYY
    D7310IAlveoplasty w/ extraction0.000.000.000.000.000.00XXX
    D7320IAlveoplasty w/o extraction0.000.000.000.000.000.00XXX
    D7340IVestibuloplasty ridge extens0.000.000.000.000.000.00XXX
    D7350IVestibuloplasty exten graft0.000.000.000.000.000.00XXX
    D7410IRad exc lesion up to 1.25 cm0.000.000.000.000.000.00XXX
    D7420ILesion > 1.25 cm0.000.000.000.000.000.00XXX
    D7430IExc benign tumor to 1.25 cm0.000.000.000.000.000.00XXX
    D7431IBenign tumor exc > 1.25 cm0.000.000.000.000.000.00XXX
    D7440IMalig tumor exc to 1.25 cm0.000.000.000.000.000.00XXX
    D7441IMalig tumor > 1.25 cm0.000.000.000.000.000.00XXX
    D7450IRem odontogen cyst to 1.25 cm0.000.000.000.000.000.00XXX
    D7451IRem odontogen cyst > 1.25 cm0.000.000.000.000.000.00XXX
    D7460IRem nonodonto cyst to 1.25 cm0.000.000.000.000.000.00XXX
    Start Printed Page 55479
    D7461IRem nonodonto cyst > 1.25 cm0.000.000.000.000.000.00XXX
    D7465ILesion destruction0.000.000.000.000.000.00XXX
    D7471IRem exostosis any site0.000.000.000.000.000.00XXX
    D7480IPartial ostectomy0.000.000.000.000.000.00XXX
    D7490IMandible resection0.000.000.000.000.000.00XXX
    D7510II&d absc intraoral soft tiss0.000.000.000.000.000.00XXX
    D7520II&d abscess extraoral0.000.000.000.000.000.00XXX
    D7530IRemoval fb skin/areolar tiss0.000.000.000.000.000.00XXX
    D7540IRemoval of fb reaction0.000.000.000.000.000.00XXX
    D7550IRemoval of sloughed off bone0.000.000.000.000.000.00XXX
    D7560IMaxillary sinusotomy0.000.000.000.000.000.00XXX
    D7610IMaxilla open reduct simple0.000.000.000.000.000.00XXX
    D7620IClsd reduct simpl maxilla fx0.000.000.000.000.000.00XXX
    D7630IOpen red simpl mandible fx0.000.000.000.000.000.00XXX
    D7640IClsd red simpl mandible fx0.000.000.000.000.000.00XXX
    D7650IOpen red simp malar/zygom fx0.000.000.000.000.000.00XXX
    D7660IClsd red simp malar/zygom fx0.000.000.000.000.000.00XXX
    D7670IClosd rductn splint alveolus0.000.000.000.000.000.00XXX
    D7680IReduct simple facial bone fx0.000.000.000.000.000.00XXX
    D7710IMaxilla open reduct compound0.000.000.000.000.000.00XXX
    D7720IClsd reduct compd maxilla fx0.000.000.000.000.000.00XXX
    D7730IOpen reduct compd mandble fx0.000.000.000.000.000.00XXX
    D7740IClsd reduct compd mandble fx0.000.000.000.000.000.00XXX
    D7750IOpen red comp malar/zygma fx0.000.000.000.000.000.00XXX
    D7760IClsd red comp malar/zygma fx0.000.000.000.000.000.00XXX
    D7770IOpen reduc compd alveolus fx0.000.000.000.000.000.00XXX
    D7780IReduct compnd facial bone fx0.000.000.000.000.000.00XXX
    D7810ITmj open reduct-dislocation0.000.000.000.000.000.00XXX
    D7820IClosed tmp manipulation0.000.000.000.000.000.00XXX
    D7830ITmj manipulation under anest0.000.000.000.000.000.00XXX
    D7840IRemoval of tmj condyle0.000.000.000.000.000.00XXX
    D7850ITmj meniscectomy0.000.000.000.000.000.00XXX
    D7852ITmj repair of joint disc0.000.000.000.000.000.00XXX
    D7854ITmj excisn of joint membrane0.000.000.000.000.000.00XXX
    D7856ITmj cutting of a muscle0.000.000.000.000.000.00XXX
    D7858ITmj reconstruction0.000.000.000.000.000.00XXX
    D7860ITmj cutting into joint0.000.000.000.000.000.00XXX
    D7865ITmj reshaping components0.000.000.000.000.000.00XXX
    D7870ITmj aspiration joint fluid0.000.000.000.000.000.00XXX
    D7871NLysis + lavage w catheters0.000.000.000.000.000.00XXX
    D7872ITmj diagnostic arthroscopy0.000.000.000.000.000.00XXX
    D7873ITmj arthroscopy lysis adhesn0.000.000.000.000.000.00XXX
    D7874ITmj arthroscopy disc reposit0.000.000.000.000.000.00XXX
    D7875ITmj arthroscopy synovectomy0.000.000.000.000.000.00XXX
    D7876ITmj arthroscopy discectomy0.000.000.000.000.000.00XXX
    D7877ITmj arthroscopy debridement0.000.000.000.000.000.00XXX
    D7880IOcclusal orthotic appliance0.000.000.000.000.000.00XXX
    D7899ITmj unspecified therapy0.000.000.000.000.000.00XXX
    D7910IDent sutur recent wnd to 5 cm0.000.000.000.000.000.00XXX
    D7911IDental suture wound to 5 cm0.000.000.000.000.000.00XXX
    D7912ISuture complicate wnd > 5 cm0.000.000.000.000.000.00XXX
    D7920IDental skin graft0.000.000.000.000.000.00XXX
    D7940RReshaping bone orthognathic0.000.000.000.000.000.00YYY
    D7941IBone cutting ramus closed0.000.000.000.000.000.00XXX
    D7943ICutting ramus open w/graft0.000.000.000.000.000.00XXX
    D7944IBone cutting segmented0.000.000.000.000.000.00XXX
    D7945IBone cutting body mandible0.000.000.000.000.000.00XXX
    D7946IReconstruction maxilla total0.000.000.000.000.000.00XXX
    D7947IReconstruct maxilla segment0.000.000.000.000.000.00XXX
    D7948IReconstruct midface no graft0.000.000.000.000.000.00XXX
    D7949IReconstruct midface w/graft0.000.000.000.000.000.00XXX
    D7950IMandible graft0.000.000.000.000.000.00XXX
    D7955IRepair maxillofacial defects0.000.000.000.000.000.00XXX
    D7960IFrenulectomy/frenulotomy0.000.000.000.000.000.00XXX
    D7970IExcision hyperplastic tissue0.000.000.000.000.000.00XXX
    D7971IExcision pericoronal gingiva0.000.000.000.000.000.00XXX
    D7980ISialolithotomy0.000.000.000.000.000.00XXX
    D7981IExcision of salivary gland0.000.000.000.000.000.00XXX
    D7982ISialodochoplasty0.000.000.000.000.000.00XXX
    D7983IClosure of salivary fistula0.000.000.000.000.000.00XXX
    D7990IEmergency tracheotomy0.000.000.000.000.000.00XXX
    D7991IDental coronoidectomy0.000.000.000.000.000.00XXX
    D7995ISynthetic graft facial bones0.000.000.000.000.000.00XXX
    Start Printed Page 55480
    D7996IImplant mandible for augment0.000.000.000.000.000.00XXX
    D7997NAppliance removal0.000.000.000.000.000.00XXX
    D7999IOral surgery procedure0.000.000.000.000.000.00XXX
    D8010NLimited dental tx primary0.000.000.000.000.000.00XXX
    D8020NLimited dental tx transition0.000.000.000.000.000.00XXX
    D8030NLimited dental tx adolescent0.000.000.000.000.000.00XXX
    D8040NLimited dental tx adult0.000.000.000.000.000.00XXX
    D8050NIntercep dental tx primary0.000.000.000.000.000.00XXX
    D8060NIntercep dental tx transitn0.000.000.000.000.000.00XXX
    D8070NCompre dental tx transition0.000.000.000.000.000.00XXX
    D8080NCompre dental tx adolescent0.000.000.000.000.000.00XXX
    D8090NCompre dental tx adult0.000.000.000.000.000.00XXX
    D8210NOrthodontic rem appliance tx0.000.000.000.000.000.00XXX
    D8220NFixed appliance therapy habt0.000.000.000.000.000.00XXX
    D8660NPreorthodontic tx visit0.000.000.000.000.000.00XXX
    D8670NPeriodic orthodontc tx visit0.000.000.000.000.000.00XXX
    D8680NOrthodontic retention0.000.000.000.000.000.00XXX
    D8690NOrthodontic treatment0.000.000.000.000.000.00XXX
    D8691NRepair ortho appliance0.000.000.000.000.000.00XXX
    D8692NReplacement retainer0.000.000.000.000.000.00XXX
    D8999NOrthodontic procedure0.000.000.000.000.000.00XXX
    D9110RTx dental pain minor proc0.000.000.000.000.000.00YYY
    D9210IDent anesthesia w/o surgery0.000.000.000.000.000.00XXX
    D9211IRegional block anesthesia0.000.000.000.000.000.00XXX
    D9212ITrigeminal block anesthesia0.000.000.000.000.000.00XXX
    D9215ILocal anesthesia0.000.000.000.000.000.00XXX
    D9220IGeneral anesthesia0.000.000.000.000.000.00XXX
    D9221IGeneral anesthesia ea ad 15m0.000.000.000.000.000.00XXX
    D9230RAnalgesia0.000.000.000.000.000.00YYY
    D9241IIntravenous sedation0.000.000.000.000.000.00XXX
    D9242IIV sedation ea ad 30 m0.000.000.000.000.000.00XXX
    D9248RSedation (non-iv)0.000.000.000.000.000.00XXX
    D9310IDental consultation0.000.000.000.000.000.00XXX
    D9410IDental house call0.000.000.000.000.000.00XXX
    D9420IHospital call0.000.000.000.000.000.00XXX
    D9430IOffice visit during hours0.000.000.000.000.000.00XXX
    D9440IOffice visit after hours0.000.000.000.000.000.00XXX
    D9610IDent therapeutic drug inject0.000.000.000.000.000.00XXX
    D9630ROther drugs/medicaments0.000.000.000.000.000.00YYY
    D9910NDent appl desensitizing med0.000.000.000.000.000.00XXX
    D9911NAppl desensitizing resin0.000.000.000.000.000.00XXX
    D9920NBehavior management0.000.000.000.000.000.00XXX
    D9930RTreatment of complications0.000.000.000.000.000.00YYY
    D9940RDental occlusal guard0.000.000.000.000.000.00YYY
    D9941NFabrication athletic guard0.000.000.000.000.000.00XXX
    D9950ROcclusion analysis0.000.000.000.000.000.00YYY
    D9951RLimited occlusal adjustment0.000.000.000.000.000.00YYY
    D9952RComplete occlusal adjustment0.000.000.000.000.000.00YYY
    D9970NEnamel microabrasion0.000.000.000.000.000.00XXX
    D9971NOdontoplasty 1-2 teeth0.000.000.000.000.000.00XXX
    D9972NExtrnl bleaching per arch0.000.000.000.000.000.00XXX
    D9973NExtrnl bleaching per tooth0.000.000.000.000.000.00XXX
    D9974NIntrnl bleaching per tooth0.000.000.000.000.000.00XXX
    D9999IAdjunctive procedure0.000.000.000.000.000.00XXX
    G0001XDrawing blood for specimen0.000.000.000.000.000.00XXX
    G0002ATemporary urinary catheter0.503.320.170.033.850.70000
    G0004AECG transm phys review & int0.527.10NA0.458.07NAXXX
    G0005AECG 24 hour recording0.001.18NA0.071.25NAXXX
    G0006AECG transmission & analysis0.005.71NA0.366.07NAXXX
    G0007AECG phy review & interpret0.520.210.210.020.750.75XXX
    G0008XAdmin influenza virus vac0.000.000.000.000.000.00XXX
    G0009XAdmin pneumococcal vaccine0.000.000.000.000.000.00XXX
    G0010XAdmin hepatitis b vaccine0.000.000.000.000.000.00XXX
    G0015APost symptom ECG tracing0.005.71NA0.366.07NAXXX
    G0016DPost symptom ECG md review0.000.000.000.000.000.00XXX
    G0025ICollagen skin test kit0.000.000.000.000.000.00XXX
    G0026XFecal leukocyte examination0.000.000.000.000.000.00XXX
    G0027XSemen analysis0.000.000.000.000.000.00XXX
    G0030CPET imaging prev PET single0.000.000.000.000.000.00XXX
    G003026APET imaging prev PET single1.500.520.520.042.062.06XXX
    G0030TCCPET imaging prev PET single0.000.000.000.000.000.00XXX
    G0031CPET imaging prev PET multple0.000.000.000.000.000.00XXX
    G003126APET imaging prev PET multple1.870.700.700.062.632.63XXX
    Start Printed Page 55481
    G0031TCCPET imaging prev PET multple0.000.000.000.000.000.00XXX
    G0032CPET follow SPECT 78464 singl0.000.000.000.000.000.00XXX
    G003226APET follow SPECT 78464 singl1.500.520.520.052.072.07XXX
    G0032TCCPET follow SPECT 78464 singl0.000.000.000.000.000.00XXX
    G0033CPET follow SPECT 78464 mult0.000.000.000.000.000.00XXX
    G003326APET follow SPECT 78464 mult1.870.700.700.062.632.63XXX
    G0033TCCPET follow SPECT 78464 mult0.000.000.000.000.000.00XXX
    G0034CPET follow SPECT 76865 singl0.000.000.000.000.000.00XXX
    G003426APET follow SPECT 76865 singl1.500.520.520.052.072.07XXX
    G0034TCCPET follow SPECT 76865 singl0.000.000.000.000.000.00XXX
    G0035CPET follow SPECT 78465 mult0.000.000.000.000.000.00XXX
    G003526APET follow SPECT 78465 mult1.870.700.700.062.632.63XXX
    G0035TCCPET follow SPECT 78465 mult0.000.000.000.000.000.00XXX
    G0036CPET follow cornry angio sing0.000.000.000.000.000.00XXX
    G003626APET follow cornry angio sing1.500.520.520.042.062.06XXX
    G0036TCCPET follow cornry angio sing0.000.000.000.000.000.00XXX
    G0037CPET follow cornry angio mult0.000.000.000.000.000.00XXX
    G003726APET follow cornry angio mult1.870.700.700.062.632.63XXX
    G0037TCCPET follow cornry angio mult0.000.000.000.000.000.00XXX
    G0038CPET follow myocard perf sing0.000.000.000.000.000.00XXX
    G003826APET follow myocard perf sing1.500.520.520.042.062.06XXX
    G0038TCCPET follow myocard perf sing0.000.000.000.000.000.00XXX
    G0039CPET follow myocard perf mult0.000.000.000.000.000.00XXX
    G003926APET follow myocard perf mult1.870.700.700.072.642.64XXX
    G0039TCCPET follow myocard perf mult0.000.000.000.000.000.00XXX
    G0040CPET follow stress echo singl0.000.000.000.000.000.00XXX
    G004026APET follow stress echo singl1.500.520.520.042.062.06XXX
    G0040TCCPET follow stress echo singl0.000.000.000.000.000.00XXX
    G0041CPET follow stress echo mult0.000.000.000.000.000.00XXX
    G004126APET follow stress echo mult1.870.700.700.052.622.62XXX
    G0041TCCPET follow stress echo mult0.000.000.000.000.000.00XXX
    G0042CPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G004226APET follow ventriculogm sing1.500.520.520.042.062.06XXX
    G0042TCCPET follow ventriculogm sing0.000.000.000.000.000.00XXX
    G0043CPET follow ventriculogm mult0.000.000.000.000.000.00XXX
    G004326APET follow ventriculogm mult1.870.700.700.062.632.63XXX
    G0043TCCPET follow ventriculogm mult0.000.000.000.000.000.00XXX
    G0044CPET following rest ECG singl0.000.000.000.000.000.00XXX
    G004426APET following rest ECG singl1.500.520.520.042.062.06XXX
    G0044TCCPET following rest ECG singl0.000.000.000.000.000.00XXX
    G0045CPET following rest ECG mult0.000.000.000.000.000.00XXX
    G004526APET following rest ECG mult1.870.700.700.062.632.63XXX
    G0045TCCPET following rest ECG mult0.000.000.000.000.000.00XXX
    G0046CPET follow stress ECG singl0.000.000.000.000.000.00XXX
    G004626APET follow stress ECG singl1.500.520.520.042.062.06XXX
    G0046TCCPET follow stress ECG singl0.000.000.000.000.000.00XXX
    G0047CPET follow stress ECG mult0.000.000.000.000.000.00XXX
    G004726APET follow stress ECG mult1.870.700.700.062.632.63XXX
    G0047TCCPET follow stress ECG mult0.000.000.000.000.000.00XXX
    G0050AResidual urine by ultrasound0.000.81NA0.040.85NAXXX
    G0101ACA screen; pelvic/breast exam0.450.520.180.010.980.64XXX
    G0102AProstate ca screening; dre0.170.380.060.010.560.24XXX
    G0103XPsa, total screening0.000.000.000.000.000.00XXX
    G0104ACA screen; flexi sigmoidscope0.961.920.530.052.931.54000
    G0105AColorectal scrn; hi risk ind3.708.791.770.2012.695.67000
    G0106AColon CA screen; barium enema0.992.47NA0.153.61NAXXX
    G010626AColon CA screen; barium enema0.990.350.350.041.381.38XXX
    G0106TCAColon CA screen; barium enema0.002.12NA0.112.23NAXXX
    G0107XCA screen; fecal blood test0.000.000.000.000.000.00XXX
    G0108ADiab manage trn per indiv0.001.64NA0.011.65NAXXX
    G0109ADiab manage trn ind/group0.000.96NA0.010.97NAXXX
    G0110RNett pulm-rehab educ; ind0.900.670.360.031.601.29XXX
    G0111RNett pulm-rehab educ; group0.270.290.110.010.570.39XXX
    G0112RNett; nutrition guid, initial1.721.240.690.053.012.46XXX
    G0113RNett; nutrition guid, subseqnt1.290.970.510.042.301.84XXX
    G0114RNett; psychosocial consult1.200.490.480.031.721.71XXX
    G0115RNett; psychological testing1.200.570.480.041.811.72XXX
    G0116RNett; psychosocial counsel1.110.690.440.041.841.59XXX
    G0117TGlaucoma scrn hgh risk direc0.450.970.220.021.440.69XXX
    G0118TGlaucoma scrn hgh risk direc0.170.840.080.011.020.26XXX
    G0120AColon ca scrn; barium enema0.992.47NA0.153.61NAXXX
    G012026AColon ca scrn; barium enema0.990.350.350.041.381.38XXX
    G0120TCAColon ca scrn; barium enema0.002.12NA0.112.23NAXXX
    Start Printed Page 55482
    G0121AColon ca scrn not hi rsk ind3.708.791.770.2012.695.67000
    G0122NColon ca scrn; barium enema+0.992.52NA0.153.66NAXXX
    G012226NColon ca scrn; barium enema+0.990.400.400.041.431.43XXX
    G0122TCNColon ca scrn; barium enema+0.002.12NA0.112.23NAXXX
    G0123XScreen cerv/vag thin layer0.000.000.000.000.000.00XXX
    G0124AScreen c/v thin layer by MD0.420.190.190.010.620.62XXX
    G0125APET img WhBD sgl pulm ring1.5056.10NA2.0059.60NAXXX
    G012526APET img WhBD sgl pulm ring1.500.520.520.052.072.07XXX
    G0125TCAPET img WhBD sgl pulm ring0.0055.58NA1.9557.53NAXXX
    G0126DLung image (PET) staging0.000.00NA0.000.00NAXXX
    G012626DLung image (PET) staging0.000.000.000.000.000.00XXX
    G0126TCDLung image (PET) staging0.000.00NA0.000.00NAXXX
    G0127RTrim nail(s)0.170.260.070.010.440.25000
    G0128RCORF skilled nursing service0.080.030.030.010.120.12XXX
    G0130ASingle energy x-ray study0.220.90NA0.051.17NAXXX
    G013026ASingle energy x-ray study0.220.110.110.010.340.34XXX
    G0130TCASingle energy x-ray study0.000.79NA0.040.83NAXXX
    G0131ACT scan, bone density study0.253.18NA0.143.57NAXXX
    G013126ACT scan, bone density study0.250.130.130.010.390.39XXX
    G0131TCACT scan, bone density study0.003.05NA0.133.18NAXXX
    G0132ACT scan, bone density study0.220.90NA0.051.17NAXXX
    G013226ACT scan, bone density study0.220.110.110.010.340.34XXX
    G0132TCACT scan, bone density study0.000.79NA0.040.83NAXXX
    G0141AScr c/v cyto, autosys and md0.420.190.190.010.620.62XXX
    G0143XScr c/v cyto, thinlayer,rescr0.000.000.000.000.000.00XXX
    G0144XScr c/v cyto, thinlayer,rescr0.000.000.000.000.000.00XXX
    G0145XScr c/v cyto, thinlayer,rescr0.000.000.000.000.000.00XXX
    G0147XScr c/v cyto, automated sys0.000.000.000.000.000.00XXX
    G0148XScr c/v cyto, autosys, rescr0.000.000.000.000.000.00XXX
    G0163DPet for rec of colorectal ca0.000.00NA0.000.00NAXXX
    G016326DPet for rec of colorectal ca0.000.000.000.000.000.00XXX
    G0163TCDPet for rec of colorectal ca0.000.00NA0.000.00NAXXX
    G0164DPet for lymphoma staging0.000.00NA0.000.00NAXXX
    G016426DPet for lymphoma staging0.000.000.000.000.000.00XXX
    G0164TCDPet for lymphoma staging0.000.00NA0.000.00NAXXX
    G0165DPet, rec of melanoma/met ca0.000.00NA0.000.00NAXXX
    G016526DPet, rec of melanoma/met ca0.000.000.000.000.000.00XXX
    G0165TCDPet, rec of melanoma/met ca0.000.00NA0.000.00NAXXX
    G0166AExtrnl counterpulse, per tx0.074.170.030.014.250.11XXX
    G0167CHyperbaric oz tx; no md reqrd0.000.000.000.000.000.00XXX
    G0168AWound closure by adhesive0.452.330.190.012.790.65000
    G0173XStereo radoisurgery, complete0.000.000.000.000.000.00XXX
    G0174DIntensitymodulatedradiation0.000.000.000.000.000.00XXX
    G0175XOPPS Service, sched team conf0.000.000.000.000.000.00XXX
    G0176XOPPS/PHP; activity therapy0.000.000.000.000.000.00XXX
    G0177XOPPS/PHP; train & educ serv0.000.000.000.000.000.00XXX
    G0178DIntensitymodulatedradiation0.000.000.000.000.000.00XXX
    G0179AMD recertification HHA PT0.451.21NA0.011.67NAXXX
    G0180AMD certification HHA patient0.671.29NA0.021.98NAXXX
    G0181AHome health care supervision1.731.57NA0.063.36NAXXX
    G0182AHospice care supervision1.731.97NA0.063.76NAXXX
    G0184DOcular photdynamicTx 2nd eye0.000.000.000.000.000.00ZZZ
    G0185CTranspuppillary thermotx0.000.000.000.000.000.00YYY
    G0186CDstry eye lesn, fdr vssl tech0.000.000.000.000.000.00YYY
    G0187CDstry mclr drusen, photocoag0.000.000.000.000.000.00YYY
    G0188DXray lwr extrmty-full lngth0.000.000.000.000.000.00XXX
    G018826DXray lwr extrmty-full lngth0.000.000.000.000.000.00XXX
    G0188TCDXray lwr extrmty-full lngth0.000.000.000.000.000.00XXX
    G0190DImmunization administration0.000.000.000.000.000.00XXX
    G0191DImmunization admin, each add0.000.000.000.000.000.00XXX
    G0192NImmunization oral/intranasal0.000.000.000.000.000.00XXX
    G0193CEndoscopicstudyswallowfunctn0.000.000.000.000.000.00XXX
    G0194CSensorytestingendoscopicstud0.000.000.000.000.000.00XXX
    G0195AClinicalevalswallowingfunct1.501.950.760.073.522.33XXX
    G0196AEval of swallowing with radio opa1.501.950.760.073.522.33XXX
    G0197AEval of pt for prescip speech devi1.352.110.750.043.502.14XXX
    G0198APatient adapation & train for spe0.991.140.580.032.161.60XXX
    G0199AReevaluation of patient uses pec1.011.920.560.032.961.60XXX
    G0200AEval of patient prescip of voice p1.352.110.750.043.502.14XXX
    G0201AModi for training in use voice pro0.991.140.580.032.161.60XXX
    G0202AScreening mammographydigital0.702.70NA0.093.49NAXXX
    G020226AScreening mammographydigital0.700.280.280.031.011.01XXX
    G0202TCAScreening mammographydigital0.002.42NA0.062.48NAXXX
    Start Printed Page 55483
    G0203DScreen mammographyfilmdigital0.000.000.000.000.000.00XXX
    G0204ADiagnostic mammographydigital0.872.73NA0.093.69NAXXX
    G020426ADiagnostic mammographydigital0.870.350.350.031.251.25XXX
    G0204TCADiagnostic mammographydigital0.002.38NA0.062.44NAXXX
    G0205DDiagnostic mammographyfilmpro0.000.000.000.000.000.00XXX
    G020526DDiagnostic mammographyfilmpro0.000.000.000.000.000.00XXX
    G0205TCDDiagnostic mammographyfilmpro0.000.000.000.000.000.00XXX
    G0206ADiagnostic mammographydigital0.702.20NA0.082.98NAXXX
    G020626ADiagnostic mammographydigital0.700.280.280.031.011.01XXX
    G0206TCADiagnostic mammographydigital0.001.92NA0.051.97NAXXX
    G0207DDiagnostic mammography film0.000.000.000.000.000.00XXX
    G020726DDiagnostic mammography film0.000.000.000.000.000.00XXX
    G0207TCDDiagnostic mammography film0.000.000.000.000.000.00XXX
    G0210CPET img WhBD ring dxlung ca0.000.000.000.000.000.00XXX
    G021026APET img WhBD ring dxlung ca1.500.600.600.042.142.14XXX
    G0210TCCPET img WhBD ring dxlung ca0.000.000.000.000.000.00XXX
    G0211CPET img WhBD ring init lung0.000.000.000.000.000.00XXX
    G021126APET img WhBD ring init lung1.500.600.600.042.142.14XXX
    G0211TCCPET img WhBD ring init lung0.000.000.000.000.000.00XXX
    G0212CPET img WhBD ring restag lun0.000.000.000.000.000.00XXX
    G021226APET img WhBD ring restag lun1.500.600.600.042.142.14XXX
    G0212TCCPET img WhBD ring restag lun0.000.000.000.000.000.00XXX
    G0213CPET img WhBD ring dx colorec0.000.000.000.000.000.00XXX
    G021326APET img WhBD ring dx colorec1.500.600.600.042.142.14XXX
    G0213TCCPET img WhBD ring dx colorec0.000.000.000.000.000.00XXX
    G0214CPET img WhBD ring init colre0.000.000.000.000.000.00XXX
    G021426APET img WhBD ring init colre1.500.600.600.042.142.14XXX
    G0214TCCPET img WhBD ring init colre0.000.000.000.000.000.00XXX
    G0215CPET img WhBD restag col0.000.000.000.000.000.00XXX
    G021526APET img WhBD restag col1.500.600.600.042.142.14XXX
    G0215TCCPET img WhBD restag col0.000.000.000.000.000.00XXX
    G0216CPET img WhBD ring dx melanom0.000.000.000.000.000.00XXX
    G021626APET img WhBD ring dx melanom1.500.600.600.042.142.14XXX
    G0216TCCPET img WhBD ring dx melanom0.000.000.000.000.000.00XXX
    G0217CPET img WhBD ring init melan0.000.000.000.000.000.00XXX
    G021726APET img WhBD ring init melan1.500.600.600.042.142.14XXX
    G0217TCCPET img WhBD ring init melan0.000.000.000.000.000.00XXX
    G0218CPET img WhBD ring restag mel0.000.000.000.000.000.00XXX
    G021826APET img WhBD ring restag mel1.500.600.600.042.142.14XXX
    G0218TCCPET img WhBD ring restag mel0.000.000.000.000.000.00XXX
    G0219NPET img WhBD ring noncov ind+1.500.600.600.042.142.14XXX
    G021926NPET img WhBD ring noncov ind+1.500.600.600.042.142.14XXX
    G0219TCNPET img WhBD ring noncov ind0.000.000.000.000.000.00XXX
    G0220CPET img WhBD ring dx lymphom0.000.000.000.000.000.00XXX
    G022026APET img WhBD ring dx lymphom1.500.600.600.042.142.14XXX
    G0220TCCPET img WhBD ring dx lymphom0.000.000.000.000.000.00XXX
    G0221CPET img WhBD ring init lymph0.000.000.000.000.000.00XXX
    G022126APET img WhBD ring init lymph1.500.600.600.042.142.14XXX
    G0221TCCPET img WhBD ring init lymph0.000.000.000.000.000.00XXX
    G0222CPET img WhBD ring resta lymp0.000.000.000.000.000.00XXX
    G022226APET img WhBD ring resta lymp1.500.600.600.042.142.14XXX
    G0222TCCPET img WhBD ring resta lymp0.000.000.000.000.000.00XXX
    G0223CPET img WhBD reg ring dx hea0.000.000.000.000.000.00XXX
    G022326APET img WhBD reg ring dx hea1.500.600.600.042.142.14XXX
    G0223TCCPET img WhBD reg ring dx hea0.000.000.000.000.000.00XXX
    G0224CPET img WhBD reg ring ini hea0.000.000.000.000.000.00XXX
    G022426APET img WhBD reg ring ini hea1.500.600.600.042.142.14XXX
    G0224TCCPET img WhBD reg ring ini hea0.000.000.000.000.000.00XXX
    G0225CPET img WhBD ring restag hea0.000.000.000.000.000.00XXX
    G022526APET img WhBD ring restag hea1.500.600.600.042.142.14XXX
    G0225TCCPET img WhBD ring restag hea0.000.000.000.000.000.00XXX
    G0226CPET img WhBD dx esophag0.000.000.000.000.000.00XXX
    G022626APET img WhBD dx esophag1.500.600.600.042.142.14XXX
    G0226TCCPET img WhBD dx esophag0.000.000.000.000.000.00XXX
    G0227CPET img WhBD ini esopha0.000.000.000.000.000.00XXX
    G022726APET img WhBD ini esopha1.500.600.600.042.142.14XXX
    G0227TCCPET img WhBD ini esopha0.000.000.000.000.000.00XXX
    G0228CPET img WhBD ring restg esop0.000.000.000.000.000.00XXX
    G022826APET img WhBD ring restg esop1.500.600.600.042.142.14XXX
    G0228TCCPET img WhBD ring restg esop0.000.000.000.000.000.00XXX
    G0229CPET img metabolic brain ring0.000.000.000.000.000.00XXX
    G022926APET img metabolic brain ring1.500.600.600.042.142.14XXX
    G0229TCCPET img metabolic brain ring0.000.000.000.000.000.00XXX
    Start Printed Page 55484
    G0230CPET myocard viability ring0.000.000.000.000.000.00XXX
    G023026APET myocard viability ring1.500.600.600.042.142.14XXX
    G0230TCCPET myocard viability ring0.000.000.000.000.000.00XXX
    G0231CPET WhBD colorec; gamma cam0.000.000.000.000.000.00XXX
    G023126APET WhBD colorec; gamma cam1.500.600.600.042.142.14XXX
    G0231TCCPET WhBD colorec; gamma cam0.000.000.000.000.000.00XXX
    G0232CPET WhBD lymphoma; gamma cam0.000.000.000.000.000.00XXX
    G023226APET WhBD lymphoma; gamma cam1.500.600.600.042.142.14XXX
    G0232TCCPET WhBD lymphoma; gamma cam0.000.000.000.000.000.00XXX
    G0233CPET WhBD melanoma; gamma cam0.000.000.000.000.000.00XXX
    G023326APET WhBD melanoma; gamma cam1.500.600.600.042.142.14XXX
    G0233TCCPET WhBD melanoma; gamma cam0.000.000.000.000.000.00XXX
    G0234CPET WhBD pulm nod; gamma cam0.000.000.000.000.000.00XXX
    G023426APET WhBD pulm nod; gamma cam1.500.600.600.042.142.14XXX
    G0234TCCPET WhBD pulm nod; gamma cam0.000.000.000.000.000.00XXX
    G0236Adigital film convert diag ma0.060.31NA0.020.39NAZZZ
    G023626Adigital film convert diag ma0.060.020.020.010.090.09ZZZ
    G0236TCAdigital film convert diag ma0.000.29NA0.010.30NAZZZ
    G0237ATherapeutic procd strg endur0.000.45NA0.020.47NAXXX
    G0238COth resp proc, indiv0.000.000.000.000.000.00XXX
    G0239COth resp proc, group0.000.000.000.000.000.00XXX
    G0240ACritic care by MD transport4.001.601.600.145.745.74XXX
    G0241AEach additional 30 minutes2.000.800.800.072.872.87ZZZ
    G0242XMultisource photon ster plan0.000.000.000.000.000.00XXX
    G0243XMultisour photon stero treat0.000.000.000.000.000.00XXX
    G0244XObserv care by facility topt0.000.000.000.000.000.00XXX
    G9001XMCCD, initial rate0.000.000.000.000.000.00XXX
    G9002XMCCD, maintenance rate0.000.000.000.000.000.00XXX
    G9003XMCCD, risk adj hi, initial0.000.000.000.000.000.00XXX
    G9004XMCCD, risk adj lo, initial0.000.000.000.000.000.00XXX
    G9005XMCCD, risk adj, maintenance0.000.000.000.000.000.00XXX
    G9006XMCCD, Home monitoring0.000.000.000.000.000.00XXX
    G9007XMCCD, sch team conf0.000.000.000.000.000.00XXX
    G9008XMCCD, phys coor-care ovrsght0.000.000.000.000.000.00XXX
    G9009XMCCD, risk adj, level 30.000.000.000.000.000.00XXX
    G9010XMCCD, risk adj, level 40.000.000.000.000.000.00XXX
    G9011XMCCD, risk adj, level 50.000.000.000.000.000.00XXX
    G9012XOther Specified Case Mgmt0.000.000.000.000.000.00XXX
    G9016NDemo-smoking cessation coun0.000.000.000.000.000.00XXX
    H0001IAlcohol and/or drug assess0.000.000.000.000.000.00XXX
    H0002IAlcohol and/or drug screenin0.000.000.000.000.000.00XXX
    H0003IAlcohol and/or drug screenin0.000.000.000.000.000.00XXX
    H0004IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0005IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0006IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0007IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0008IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0009IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0010IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0011IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0012IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0013IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0014IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0015IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0016IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0017IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0018IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0019IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0020IAlcohol and/or drug services0.000.000.000.000.000.00XXX
    H0021IAlcohol and/or drug training0.000.000.000.000.000.00XXX
    H0022IAlcohol and/or drug interven0.000.000.000.000.000.00XXX
    H0023IAlcohol and/or drug outreach0.000.000.000.000.000.00XXX
    H0024IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0025IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0026IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0027IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0028IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0029IAlcohol and/or drug preventi0.000.000.000.000.000.00XXX
    H0030IAlcohol and/or drug hotline0.000.000.000.000.000.00XXX
    H1000IPrenatal care atrisk assessm0.000.000.000.000.000.00XXX
    H1001IAntepartum management0.000.000.000.000.000.00XXX
    H1002ICare coordination prenatal0.000.000.000.000.000.00XXX
    H1003IPrenatal at risk education0.000.000.000.000.000.00XXX
    Start Printed Page 55485
    H1004IFollow up home visit/prental0.000.000.000.000.000.00XXX
    H1005IPrenatal care enhanced srv pk0.000.000.000.000.000.00XXX
    J0120ETetracyclin injection0.000.000.000.000.000.00XXX
    J0130EAbciximab injection0.000.000.000.000.000.00XXX
    J0150EInjection adenosine 6 MG0.000.000.000.000.000.00XXX
    J0151EAdenosine injection0.000.000.000.000.000.00XXX
    J0170EAdrenalin epinephrin inject0.000.000.000.000.000.00XXX
    J0190EInj biperiden lactate/5 mg0.000.000.000.000.000.00XXX
    J0200EAlatrofloxacin mesylate0.000.000.000.000.000.00XXX
    J0205EAlglucerase injection0.000.000.000.000.000.00XXX
    J0207EAmifostine0.000.000.000.000.000.00XXX
    J0210EMethyldopate hcl injection0.000.000.000.000.000.00XXX
    J0256EAlpha 1 proteinase inhibitor0.000.000.000.000.000.00XXX
    J0270EAlprostadil for injection0.000.000.000.000.000.00XXX
    J0275EAlprostadil urethral suppos0.000.000.000.000.000.00XXX
    J0280EAminophyllin 250 MG inj0.000.000.000.000.000.00XXX
    J0282EAmiodarone HCl0.000.000.000.000.000.00XXX
    J0285EAmphotericin B0.000.000.000.000.000.00XXX
    J0286EAmphotericin B lipid complex0.000.000.000.000.000.00XXX
    J0290EAmpicillin 500 MG inj0.000.000.000.000.000.00XXX
    J0295EAmpicillin sodium per 1.5 gm0.000.000.000.000.000.00XXX
    J0300EAmobarbital 125 MG inj0.000.000.000.000.000.00XXX
    J0330ESuccinycholine chloride inj0.000.000.000.000.000.00XXX
    J0340DNandrolon phenpropionate inj0.000.000.000.000.000.00XXX
    J0350EInjection anistreplase 30 u0.000.000.000.000.000.00XXX
    J0360EHydralazine hcl injection0.000.000.000.000.000.00XXX
    J0380EInj metaraminol bitartrate0.000.000.000.000.000.00XXX
    J0390EChloroquine injection0.000.000.000.000.000.00XXX
    J0395EArbutamine HCl injection0.000.000.000.000.000.00XXX
    J0400DInj trimethaphan camsylate0.000.000.000.000.000.00XXX
    J0456EAzithromycin0.000.000.000.000.000.00XXX
    J0460EAtropine sulfate injection0.000.000.000.000.000.00XXX
    J0470EDimecaprol injection0.000.000.000.000.000.00XXX
    J0475EBaclofen 10 MG injection0.000.000.000.000.000.00XXX
    J0476EBaclofen intrathecal trial0.000.000.000.000.000.00XXX
    J0500EDicyclomine injection0.000.000.000.000.000.00XXX
    J0510DBenzquinamide injection0.000.000.000.000.000.00XXX
    J0515EInj benztropine mesylate0.000.000.000.000.000.00XXX
    J0520EBethanechol chloride inject0.000.000.000.000.000.00XXX
    J0530EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0540EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0550EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0560EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0570EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0580EPenicillin g benzathine inj0.000.000.000.000.000.00XXX
    J0585EBotulinum toxin a per unit0.000.000.000.000.000.00XXX
    J0587EBotulinum toxin type B0.000.000.000.000.000.00XXX
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    Start Printed Page 55486
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    Start Printed Page 55491
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    Start Printed Page 55493
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    Q4024XCast sup sht arm splnt ped f0.000.000.000.000.000.00XXX
    Q4025XCast sup hip spica plaster0.000.000.000.000.000.00XXX
    Q4026XCast sup hip spica fiberglas0.000.000.000.000.000.00XXX
    Q4027XCast sup hip spica ped plstr0.000.000.000.000.000.00XXX
    Q4028XCast sup hip spica ped fbrgl0.000.000.000.000.000.00XXX
    Q4029XCast sup long leg plaster0.000.000.000.000.000.00XXX
    Q4030XCast sup long leg fiberglass0.000.000.000.000.000.00XXX
    Q4031XCast sup lng leg ped plaster0.000.000.000.000.000.00XXX
    Q4032XCast sup lng leg ped fbrgls0.000.000.000.000.000.00XXX
    Q4033XCast sup lng leg cylinder pl0.000.000.000.000.000.00XXX
    Q4034XCast sup lng leg cylinder fb0.000.000.000.000.000.00XXX
    Q4035XCast sup lng leg cylndr ped p0.000.000.000.000.000.00XXX
    Q4036XCast sup lng leg cylndr ped f0.000.000.000.000.000.00XXX
    Q4037XCast sup shrt leg plaster0.000.000.000.000.000.00XXX
    Q4038XCast sup shrt leg fiberglass0.000.000.000.000.000.00XXX
    Q4039XCast sup shrt leg ped plster0.000.000.000.000.000.00XXX
    Q4040XCast sup shrt leg ped fbrgls0.000.000.000.000.000.00XXX
    Q4041XCast sup lng leg splnt plstr0.000.000.000.000.000.00XXX
    Q4042XCast sup lng leg splnt fbrgl0.000.000.000.000.000.00XXX
    Q4043XCast sup lng leg splnt ped p0.000.000.000.000.000.00XXX
    Q4044XCast sup lng leg splnt ped f0.000.000.000.000.000.00XXX
    Start Printed Page 55494
    Q4045XCast sup sht leg splnt plstr0.000.000.000.000.000.00XXX
    Q4046XCast sup sht leg splnt fbrgl0.000.000.000.000.000.00XXX
    Q4047XCast sup sht leg splnt ped p0.000.000.000.000.000.00XXX
    Q4048XCast sup sht leg splnt ped f0.000.000.000.000.000.00XXX
    Q4049XFinger splint, static0.000.000.000.000.000.00XXX
    Q4050XCast supplies unlisted0.000.000.000.000.000.00XXX
    Q4051XSplint supplies misc0.000.000.000.000.000.00XXX
    Q9920EEpoetin with hct <= 200.000.000.000.000.000.00XXX
    Q9921EEpoetin with hct = 210.000.000.000.000.000.00XXX
    Q9922EEpoetin with hct = 220.000.000.000.000.000.00XXX
    Q9923EEpoetin with hct = 230.000.000.000.000.000.00XXX
    Q9924EEpoetin with hct = 240.000.000.000.000.000.00XXX
    Q9925EEpoetin with hct = 250.000.000.000.000.000.00XXX
    Q9926EEpoetin with hct = 260.000.000.000.000.000.00XXX
    Q9927EEpoetin with hct = 270.000.000.000.000.000.00XXX
    Q9928EEpoetin with hct = 280.000.000.000.000.000.00XXX
    Q9929EEpoetin with hct = 290.000.000.000.000.000.00XXX
    Q9930EEpoetin with hct = 300.000.000.000.000.000.00XXX
    Q9931EEpoetin with hct = 310.000.000.000.000.000.00XXX
    Q9932EEpoetin with hct = 320.000.000.000.000.000.00XXX
    Q9933EEpoetin with hct = 330.000.000.000.000.000.00XXX
    Q9934EEpoetin with hct = 340.000.000.000.000.000.00XXX
    Q9935EEpoetin with hct = 350.000.000.000.000.000.00XXX
    Q9936EEpoetin with hct = 360.000.000.000.000.000.00XXX
    Q9937EEpoetin with hct = 370.000.000.000.000.000.00XXX
    Q9938EEpoetin with hct = 380.000.000.000.000.000.00XXX
    Q9939EEpoetin with hct = 390.000.000.000.000.000.00XXX
    Q9940EEpoetin with hct >= 400.000.000.000.000.000.00XXX
    R0070CTransport portable x-ray0.000.000.000.000.000.00XXX
    R0075CTransport port x-ray multipl0.000.000.000.000.000.00XXX
    R0076BTransport portable EKG0.000.000.000.000.000.00XXX
    T1000IPrivate duty/independent nsg0.000.000.000.000.000.00XXX
    T1001INursing assessment/evaluatn0.000.000.000.000.000.00XXX
    T1002IRN services up to 15 minutes0.000.000.000.000.000.00XXX
    T1003ILPN/LVN services up to 15 min0.000.000.000.000.000.00XXX
    T1004INsg aide service up to 15 min0.000.000.000.000.000.00XXX
    T1005IRespite care service 15 min0.000.000.000.000.000.00XXX
    T1006IFamily/Couple Counseling0.000.000.000.000.000.00XXX
    T1007ITreatment Plan Development0.000.000.000.000.000.00XXX
    T1008IDay Treatment for Individual0.000.000.000.000.000.00XXX
    T1009IChild Sitting Services0.000.000.000.000.000.00XXX
    T1010IMeals when Receive Services0.000.000.000.000.000.00XXX
    T1011IAlcohol/Substance Abuse NOC0.000.000.000.000.000.00XXX
    T1012IAlcohol/Substance Abuse Skil0.000.000.000.000.000.00XXX
    T1013ISign Lang/Oral Interpreter0.000.000.000.000.000.00XXX
    T1014ITelehealth transmit, per min0.000.000.000.000.000.00XXX
    T1015IClinic service0.000.000.000.000.000.00XXX
    V2020XVision svcs frames purchases0.000.000.000.000.000.00XXX
    V2025NEyeglasses delux frames0.000.000.000.000.000.00XXX
    V2100XLens spher single plano 4.000.000.000.000.000.000.00XXX
    V2101XSingle visn sphere 4.12-7.000.000.000.000.000.000.00XXX
    V2102XSingl visn sphere 7.12-20.000.000.000.000.000.000.00XXX
    V2103XSpherocylindr 4.00d/12-2.00d0.000.000.000.000.000.00XXX
    V2104XSpherocylindr 4.00d/2.12-4d0.000.000.000.000.000.00XXX
    V2105XSpherocylinder 4.00d/4.25-6d0.000.000.000.000.000.00XXX
    V2106XSpherocylinder 4.00d/>6.00d0.000.000.000.000.000.00XXX
    V2107XSpherocylinder 4.25d/12-2d0.000.000.000.000.000.00XXX
    V2108XSpherocylinder 4.25d/2.12-4d0.000.000.000.000.000.00XXX
    V2109XSpherocylinder 4.25d/4.25-6d0.000.000.000.000.000.00XXX
    V2110XSpherocylinder 4.25d/over 6d0.000.000.000.000.000.00XXX
    V2111XSpherocylindr 7.25d/.25-2.250.000.000.000.000.000.00XXX
    V2112XSpherocylindr 7.25d/2.25-4d0.000.000.000.000.000.00XXX
    V2113XSpherocylindr 7.25d/4.25-6d0.000.000.000.000.000.00XXX
    V2114XSpherocylinder over 12.00d0.000.000.000.000.000.00XXX
    V2115XLens lenticular bifocal0.000.000.000.000.000.00XXX
    V2116XNonaspheric lens bifocal0.000.000.000.000.000.00XXX
    V2117XAspheric lens bifocal0.000.000.000.000.000.00XXX
    V2118XLens aniseikonic single0.000.000.000.000.000.00XXX
    V2199XLens single vision not oth c0.000.000.000.000.000.00XXX
    V2200XLens spher bifoc plano 4.00d0.000.000.000.000.000.00XXX
    V2201XLens sphere bifocal 4.12-7.00.000.000.000.000.000.00XXX
    V2202XLens sphere bifocal 7.12-200.000.000.000.000.000.00XXX
    V2203XLens sphcyl bifocal 4.00d/.10.000.000.000.000.000.00XXX
    Start Printed Page 55495
    V2204XLens sphcy bifocal 4.00d/2.10.000.000.000.000.000.00XXX
    V2205XLens sphcy bifocal 4.00d/4.20.000.000.000.000.000.00XXX
    V2206XLens sphcy bifocal 4.00d/ove0.000.000.000.000.000.00XXX
    V2207XLens sphcy bifocal 4.25-7d/0.000.000.000.000.000.00XXX
    V2208XLens sphcy bifocal 4.25-7/20.000.000.000.000.000.00XXX
    V2209XLens sphcy bifocal 4.25-7/40.000.000.000.000.000.00XXX
    V2210XLens sphcy bifocal 4.25-7/ov0.000.000.000.000.000.00XXX
    V2211XLens sphcy bifo 7.25-12/.25-0.000.000.000.000.000.00XXX
    V2212XLens sphcyl bifo 7.25-12/2.20.000.000.000.000.000.00XXX
    V2213XLens sphcyl bifo 7.25-12/4.20.000.000.000.000.000.00XXX
    V2214XLens sphcyl bifocal over 120.000.000.000.000.000.00XXX
    V2215XLens lenticular bifocal0.000.000.000.000.000.00XXX
    V2216XLens lenticular nonaspheric0.000.000.000.000.000.00XXX
    V2217XLens lenticular aspheric bif0.000.000.000.000.000.00XXX
    V2218XLens aniseikonic bifocal0.000.000.000.000.000.00XXX
    V2219XLens bifocal seg width over0.000.000.000.000.000.00XXX
    V2220XLens bifocal add over 3.25d0.000.000.000.000.000.00XXX
    V2299XLens bifocal speciality0.000.000.000.000.000.00XXX
    V2300XLens sphere trifocal 4.00d0.000.000.000.000.000.00XXX
    V2301XLens sphere trifocal 4.12-70.000.000.000.000.000.00XXX
    V2302XLens sphere trifocal 7.12-200.000.000.000.000.000.00XXX
    V2303XLens sphcy trifocal 4.0/.12-0.000.000.000.000.000.00XXX
    V2304XLens sphcy trifocal 4.0/2.250.000.000.000.000.000.00XXX
    V2305XLens sphcy trifocal 4.0/4.250.000.000.000.000.000.00XXX
    V2306XLens sphcyl trifocal 4.00/>60.000.000.000.000.000.00XXX
    V2307XLens sphcy trifocal 4.25-7/0.000.000.000.000.000.00XXX
    V2308XLens sphc trifocal 4.25-7/20.000.000.000.000.000.00XXX
    V2309XLens sphc trifocal 4.25-7/40.000.000.000.000.000.00XXX
    V2310XLens sphc trifocal 4.25-7/>60.000.000.000.000.000.00XXX
    V2311XLens sphc trifo 7.25-12/.25-0.000.000.000.000.000.00XXX
    V2312XLens sphc trifo 7.25-12/2.250.000.000.000.000.000.00XXX
    V2313XLens sphc trifo 7.25-12/4.250.000.000.000.000.000.00XXX
    V2314XLens sphcyl trifocal over 120.000.000.000.000.000.00XXX
    V2315XLens lenticular trifocal0.000.000.000.000.000.00XXX
    V2316XLens lenticular nonaspheric0.000.000.000.000.000.00XXX
    V2317XLens lenticular aspheric tri0.000.000.000.000.000.00XXX
    V2318XLens aniseikonic trifocal0.000.000.000.000.000.00XXX
    V2319XLens trifocal seg width > 280.000.000.000.000.000.00XXX
    V2320XLens trifocal add over 3.25d0.000.000.000.000.000.00XXX
    V2399XLens trifocal speciality0.000.000.000.000.000.00XXX
    V2410XLens variab asphericity sing0.000.000.000.000.000.00XXX
    V2430XLens variable asphericity bi0.000.000.000.000.000.00XXX
    V2499XVariable asphericity lens0.000.000.000.000.000.00XXX
    V2500XContact lens pmma spherical0.000.000.000.000.000.00XXX
    V2501XCntct lens pmma-toric/prism0.000.000.000.000.000.00XXX
    V2502XContact lens pmma bifocal0.000.000.000.000.000.00XXX
    V2503XCntct lens pmma color vision0.000.000.000.000.000.00XXX
    V2510XCntct gas permeable sphericl0.000.000.000.000.000.00XXX
    V2511XCntct toric prism ballast0.000.000.000.000.000.00XXX
    V2512XCntct lens gas permbl bifocl0.000.000.000.000.000.00XXX
    V2513XContact lens extended wear0.000.000.000.000.000.00XXX
    V2520PContact lens hydrophilic0.000.000.000.000.000.00XXX
    V2521XCntct lens hydrophilic toric0.000.000.000.000.000.00XXX
    V2522XCntct lens hydrophil bifocl0.000.000.000.000.000.00XXX
    V2523XCntct lens hydrophil extend0.000.000.000.000.000.00XXX
    V2530XContact lens gas impermeable0.000.000.000.000.000.00XXX
    V2531XContact lens gas permeable0.000.000.000.000.000.00XXX
    V2599XContact lens/es other type0.000.000.000.000.000.00XXX
    V2600XHand held low vision aids0.000.000.000.000.000.00XXX
    V2610XSingle lens spectacle mount0.000.000.000.000.000.00XXX
    V2615XTelescop/othr compound lens0.000.000.000.000.000.00XXX
    V2623XPlastic eye prosth custom0.000.000.000.000.000.00XXX
    V2624XPolishing artifical eye0.000.000.000.000.000.00XXX
    V2625XEnlargemnt of eye prosthesis0.000.000.000.000.000.00XXX
    V2626XReduction of eye prosthesis0.000.000.000.000.000.00XXX
    V2627XScleral cover shell0.000.000.000.000.000.00XXX
    V2628XFabrication & fitting0.000.000.000.000.000.00XXX
    V2629XProsthetic eye other type0.000.000.000.000.000.00XXX
    V2630XAnter chamber intraocul lens0.000.000.000.000.000.00XXX
    V2631XIris support intraoclr lens0.000.000.000.000.000.00XXX
    V2632XPost chmbr intraocular lens0.000.000.000.000.000.00XXX
    V2700XBalance lens0.000.000.000.000.000.00XXX
    V2710XGlass/plastic slab off prism0.000.000.000.000.000.00XXX
    Start Printed Page 55496
    V2715XPrism lens/es0.000.000.000.000.000.00XXX
    V2718XFresnell prism press-on lens0.000.000.000.000.000.00XXX
    V2730XSpecial base curve0.000.000.000.000.000.00XXX
    V2740XRose tint plastic0.000.000.000.000.000.00XXX
    V2741XNon-rose tint plastic0.000.000.000.000.000.00XXX
    V2742XRose tint glass0.000.000.000.000.000.00XXX
    V2743XNon-rose tint glass0.000.000.000.000.000.00XXX
    V2744XTint photochromatic lens/es0.000.000.000.000.000.00XXX
    V2750XAnti-reflective coating0.000.000.000.000.000.00XXX
    V2755XUV lens/es0.000.000.000.000.000.00XXX
    V2760XScratch resistant coating0.000.000.000.000.000.00XXX
    V2770XOccluder lens/es0.000.000.000.000.000.00XXX
    V2780XOversize lens/es0.000.000.000.000.000.00XXX
    V2781XProgressive lens per lens0.000.000.000.000.000.00XXX
    V2785XCorneal tissue processing0.000.000.000.000.000.00XXX
    V2790XAmniotic membrane0.000.000.000.000.000.00XXX
    V2799XMiscellaneous vision service0.000.000.000.000.000.00XXX
    V5008NHearing screening0.000.000.000.000.000.00XXX
    V5010NAssessment for hearing aid0.000.000.000.000.000.00XXX
    V5011NHearing aid fitting/checking0.000.000.000.000.000.00XXX
    V5014NHearing aid repair/modifying0.000.000.000.000.000.00XXX
    V5020NConformity evaluation0.000.000.000.000.000.00XXX
    V5030NBody-worn hearing aid air0.000.000.000.000.000.00XXX
    V5040NBody-worn hearing aid bone0.000.000.000.000.000.00XXX
    V5050NHearing aid monaural in ear0.000.000.000.000.000.00XXX
    V5060NBehind ear hearing aid0.000.000.000.000.000.00XXX
    V5070NGlasses air conduction0.000.000.000.000.000.00XXX
    V5080NGlasses bone conduction0.000.000.000.000.000.00XXX
    V5090NHearing aid dispensing fee0.000.000.000.000.000.00XXX
    V5100NBody-worn bilat hearing aid0.000.000.000.000.000.00XXX
    V5110NHearing aid dispensing fee0.000.000.000.000.000.00XXX
    V5120NBody-worn binaur hearing aid0.000.000.000.000.000.00XXX
    V5130NIn ear binaural hearing aid0.000.000.000.000.000.00XXX
    V5140NBehind ear binaur hearing ai0.000.000.000.000.000.00XXX
    V5150NGlasses binaural hearing aid0.000.000.000.000.000.00XXX
    V5160NDispensing fee binaural0.000.000.000.000.000.00XXX
    V5170NWithin ear cros hearing aid0.000.000.000.000.000.00XXX
    V5180NBehind ear cros hearing aid0.000.000.000.000.000.00XXX
    V5190NGlasses cros hearing aid0.000.000.000.000.000.00XXX
    V5200NCros hearing aid dispens fee0.000.000.000.000.000.00XXX
    V5210NIn ear bicros hearing aid0.000.000.000.000.000.00XXX
    V5220NBehind ear bicros hearing ai0.000.000.000.000.000.00XXX
    V5230NGlasses bicros hearing aid0.000.000.000.000.000.00XXX
    V5240NDispensing fee bicros0.000.000.000.000.000.00XXX
    V5241NDispensing fee, monaural0.000.000.000.000.000.00XXX
    V5242NHearing aid, monaural, cic0.000.000.000.000.000.00XXX
    V5243NHearing aid, monaural, itc0.000.000.000.000.000.00XXX
    V5244NHearing aid, prog, mon, cic0.000.000.000.000.000.00XXX
    V5245NHearing aid, prog, mon, itc0.000.000.000.000.000.00XXX
    V5246NHearing aid, prog, mon, ite0.000.000.000.000.000.00XXX
    V5247NHearing aid, prog, mon, bte0.000.000.000.000.000.00XXX
    V5248NHearing aid, binaural, cic0.000.000.000.000.000.00XXX
    V5249NHearing aid, binaural, itc0.000.000.000.000.000.00XXX
    V5250NHearing aid, prog, bin, cic0.000.000.000.000.000.00XXX
    V5251NHearing aid, prog, bin, itc0.000.000.000.000.000.00XXX
    V5252NHearing aid, prog, bin, ite0.000.000.000.000.000.00XXX
    V5253NHearing aid, prog, bin, bte0.000.000.000.000.000.00XXX
    V5254NHearing aid, digit, mon, cic0.000.000.000.000.000.00XXX
    V5255NHearing aid, digit, mon, itc0.000.000.000.000.000.00XXX
    V5256NHearing aid, digit, mon, ite0.000.000.000.000.000.00XXX
    V5257NHearing aid, digit, mon, bte0.000.000.000.000.000.00XXX
    V5258NHearing aid, digit, bin, cic0.000.000.000.000.000.00XXX
    V5259NHearing aid, digit, bin, itc0.000.000.000.000.000.00XXX
    V5260NHearing aid, digit, bin, ite0.000.000.000.000.000.00XXX
    V5261NHearing aid, digit, bin, bte0.000.000.000.000.000.00XXX
    V5262NHearing aid, disp, monaural0.000.000.000.000.000.00XXX
    V5263NHearing aid, disp, binaural0.000.000.000.000.000.00XXX
    V5264NEar mold/insert0.000.000.000.000.000.00XXX
    V5265NEar mold/insert, disp0.000.000.000.000.000.00XXX
    V5266NBattery for hearing device0.000.000.000.000.000.00XXX
    V5267NHearing aid supply/accessory0.000.000.000.000.000.00XXX
    V5268NALD Telephone Amplifier0.000.000.000.000.000.00XXX
    V5269NAlerting device, any type0.000.000.000.000.000.00XXX
    Start Printed Page 55497
    V5270NALD, TV amplifier, any type0.000.000.000.000.000.00XXX
    V5271NALD, TV caption decoder0.000.000.000.000.000.00XXX
    V5272NTdd0.000.000.000.000.000.00XXX
    V5273NALD for cochlear implant0.000.000.000.000.000.00XXX
    V5274NALD unspecified0.000.000.000.000.000.00XXX
    V5275NEar impression0.000.000.000.000.000.00XXX
    V5299RHearing service0.000.000.000.000.000.00XXX
    V5336NRepair communication device0.000.000.000.000.000.00XXX
    V5362RSpeech screening0.000.000.000.000.000.00XXX
    V5363RLanguage screening0.000.000.000.000.000.00XXX
    V5364RDysphagia screening0.000.000.000.000.000.00XXX
    1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 1994 American Dental Association. All rights reserved.
    3 +Indicates RVUs are not used for Medicare payment.
            Start Printed Page 55497

    Addendum C.—Codes With Interim RVUs

    CPT 1/HCPCS 2MODStatusDescriptionPhysician Work RVUs 3Fully implemented non-facility PE RVUsFully implemented facility PE RVUsMal- practice RVUsFully implemented non-facility totalFully implemented facility totalGlobal
    11981AInsert drug implant device1.481.580.590.143.202.21XXX
    11982ARemove drug implant device1.781.700.710.173.652.66XXX
    11983ARemove/insert drug implant3.302.311.320.315.924.93XXX
    20526ATher injection carpal tunnel0.860.780.390.061.701.31000
    20551AInject tendon origin/insert0.860.780.390.061.701.31000
    20552AInject trigger point, 1 or 20.860.780.390.061.701.31000
    20553AInject trigger points, > 30.860.780.390.061.701.31000
    24300AManipulate elbow w/anesth3.75NA5.460.52NA9.73090
    24332ATenolysis, triceps7.45NA5.230.77NA13.45090
    24343ARepr elbow lat ligmnt w/tiss8.65NA7.911.21NA17.77090
    24344AReconstruct elbow lat ligmnt14.00NA10.871.95NA26.82090
    24345ARepr elbw med ligmnt w/tiss8.65NA7.911.21NA17.77090
    24346AReconstruct elbow med ligmnt14.00NA10.871.95NA26.82090
    25001AIncise flexor carpi radialis3.38NA4.300.45NA8.13090
    25024ADecompress forearm 2 spaces9.50NA8.171.20NA18.87090
    25025ADecompress forearm 2 spaces16.54NA12.051.91NA30.50090
    25259AManipulate wrist w/anesthes3.75NA5.350.52NA9.62090
    25275ARepair forearm tendon sheath8.50NA7.531.11NA17.14090
    25394ARepair carpal bone, shorten10.40NA8.431.15NA19.98090
    25430AVasc graft into carpal bone9.25NA7.820.56NA17.63090
    25431ARepair nonunion carpal bone10.44NA6.420.56NA17.42090
    25651APin ulnar styloid fracture5.36NA4.390.73NA10.48090
    25652ATreat fracture ulnar styloid7.60NA6.900.97NA15.47090
    25671APin radioulnar dislocation6.00NA6.020.75NA12.77090
    26340AManipulate finger w/anesth2.50NA4.530.32NA7.35090
    26587AReconstruct extra finger14.054.67NA1.0819.80NA090
    28299ACorrection of bunion10.5811.559.211.2423.3721.03090
    29086AApply finger cast0.620.810.500.071.501.19000
    29805AShoulder arthroscopy, dx5.893.233.230.839.959.95090
    29806AShoulder arthroscopy/surgery14.37NA11.332.01NA27.71090
    29807AShoulder arthroscopy/surgery13.90NA11.062.01NA26.97090
    29824AShoulder arthroscopy/surgery8.25NA7.481.16NA16.89090
    29900AMcp joint arthroscopy, dx5.42NA5.880.69NA11.99090
    29901AMcp joint arthroscopy, surg6.13NA6.280.81NA13.22090
    29902AMcp joint arthroscopy, surg6.70NA6.600.89NA14.19090
    33967AInsert ia percut device4.852.011.960.277.137.08000
    33979CInsert intracorporeal device0.000.000.000.000.000.00XXX
    33980CRemove intracorporeal device0.000.000.000.000.000.00090
    35646AArtery bypass graft31.00NA13.262.98NA47.24090
    35647AArtery bypass graft28.00NA11.972.98NA42.95090
    35685ABypass graft patency/patch4.05NA1.500.41NA5.96ZZZ
    35686ABypass graft/av fist patency3.35NA1.240.34NA4.93ZZZ
    36002APseudoaneurysm injection trt1.962.951.030.084.993.07000
    36400ADrawing blood0.380.720.100.011.110.49XXX
    36820AAv fusion/forearm vein14.00NA6.561.53NA22.09090
    43239AUpper GI endoscopy, biopsy2.876.791.270.149.804.28000
    43313AEsophagoplasty congential45.28NA22.015.43NA72.72090
    43314ATracheo-esophagoplasty cong50.27NA24.075.53NA79.87090
    44120ARemoval of small intestine17.00NA7.671.46NA26.13090
    44126AEnterectomy w/taper, cong35.50NA18.030.36NA53.89090
    44127AEnterectomy w/o taper, cong41.00NA20.560.41NA61.97090
    44128AEnterectomy cong, add-on4.45NA1.780.45NA6.68ZZZ
    Start Printed Page 55498
    44160ARemoval of colon18.62NA8.651.55NA28.82090
    44203ALap resect s/intestine, addl4.45NA1.600.45NA6.50ZZZ
    44204ALaparo partial colectomy25.08NA10.461.83NA37.37090
    44205ALap colectomy part w/ileum22.23NA9.311.55NA33.09090
    45136AExcise ileoanal reservoir27.30NA12.662.19NA42.15090
    45380AColonoscopy and biopsy4.449.282.050.2113.936.70000
    46020APlacement of seton2.903.092.360.226.215.48010
    47370ALaparo ablate liver tumor rf18.007.197.190.8526.0426.04090
    47371ALaparo ablate liver cryosug16.946.766.760.8524.5524.55090
    47380AOpen ablate liver tumor rf21.258.488.480.8530.5830.58090
    47381AOpen ablate liver tumor cryo21.008.388.380.8530.2330.23090
    47382APercut ablate liver rf12.00NA5.370.85NA18.22010
    49491ARepairing hern premie reduc11.13NA5.651.00NA17.78090
    49492ARpr ing hern premie, blocked14.03NA6.401.42NA21.85090
    52001ACystoscopy, removal of clots2.37NA0.980.32NA3.67000
    52347ACystoscopy, resect ducts5.28NA2.140.33NA7.75000
    53431AReconstruct urethra/bladder19.897.947.941.2529.0829.08090
    53444AInsert tandem cuff13.40NA6.660.79NA20.85090
    53446ARemove uro sphincter10.23NA8.460.61NA19.30090
    53447ARemove/replace ur sphincter13.49NA7.900.79NA22.18090
    53448ARemov/replc ur sphinctr comp21.15NA12.351.27NA34.77090
    53853AProstatic water thermother4.1452.752.550.3857.277.07090
    54162ALysis penil circumcis lesion3.00NA2.910.18NA6.09010
    54163ARepair of circumcision3.00NA2.540.18NA5.72010
    54164AFrenulotomy of penis2.50NA2.370.15NA5.02010
    54406ARemove multi-comp penis pros12.10NA6.090.80NA18.99090
    54408ARepair multi-comp penis pros12.75NA6.460.80NA20.01090
    54410ARemove/replace penis prosth15.50NA7.360.80NA23.66090
    54411ARemv/replc penis pros, comp16.00NA8.980.80NA25.78090
    54415ARemove self-contd penis pros8.20NA5.350.55NA14.10090
    54416ARemv/repl penis contain pros10.87NA6.940.55NA18.36090
    54417ARemv/replc penis pros, compl14.19NA7.890.55NA22.63090
    56605ABiopsy of vulva/perineum1.101.900.500.113.111.71000
    56810ARepair of perineum4.13NA2.910.41NA7.45010
    57155AInsert uteri tandems/ovoids6.27NA3.670.63NA10.57090
    58100ABiopsy of uterus lining1.531.560.760.073.162.36000
    58346AInsert heyman uteri capsule6.75NA3.840.68NA11.27090
    58953ATah, rad dissect for debulk32.00NA15.593.20NA50.79090
    58954ATah, rad debulk/lymph remove35.00NA16.713.50NA55.21090
    59001AAmniocentesis, therapeutic3.00NA1.370.23NA4.60000
    64561AImplant neuroelectrodes6.7415.283.830.1122.1310.68010
    64581AImplant neuroelectrodes13.50NA6.720.37NA20.59090
    64821ARemove sympathetic nerves8.75NA7.090.99NA16.83090
    64822ARemove sympathetic nerves8.75NA7.090.99NA16.83090
    64823ARemove sympathetic nerves10.37NA7.891.17NA19.43090
    67225AEye photodynamic ther add-on0.470.240.190.501.211.16ZZZ
    76085AComputer mammogram add-on0.060.31NA0.020.39NAZZZ
    76092AMammogram, screening0.701.44NA0.092.23NAXXX
    76362ACat scan for tissue ablation4.009.24NA1.3814.62NAXXX
    76394AMri for tissue ablation4.2512.13NA1.4317.81NAXXX
    76490AUs for tissue ablation2.002.13NA0.364.49NAXXX
    76819AFetal biophys profil w/o nst0.771.83NA0.102.70NAXXX
    77301ARadioltherapy dos plan, imrt8.0029.72NA1.4139.13NAXXX
    77418ARadiation tx delivery, imrt0.0016.07NA0.1116.18NAXXX
    88380CMicrodissection0.000.000.000.000.000.00XXX
    90471AImmunization admin0.000.10NA0.010.11NAXXX
    90472AImmunization admin, each add0.000.10NA0.010.11NAZZZ
    90473NImmune admin oral/nasal0.000.000.000.000.000.00XXX
    90474NImmune admin oral/nasal addl0.000.000.000.000.000.00ZZZ
    90939XHemodialysis study, transcut0.000.000.000.000.000.00XXX
    91123BIrrigate fecal impaction0.000.000.000.000.000.00XXX
    92136AOphthalmic biometry0.541.52NA0.072.13NAXXX
    92973APercut coronary thrombectomy3.28NA1.370.17NA4.82ZZZ
    92974ACath place, cardio brachytx3.00NA1.261.18NA5.44ZZZ
    93025AMicrovolt t-wave assess0.756.42NA0.117.28NAXXX
    93609AMap tachycardia, add-on4.814.59NA0.6610.06NAZZZ
    93613CElectrophys map, 3d, add-on0.000.000.000.000.000.00XXX
    93621CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93622CElectrophysiology evaluation0.000.000.000.000.000.00ZZZ
    93701ABioimpedance, thoracic0.170.78NA0.020.97NAXXX
    95250AGlucose monitoring, cont0.001.44NA0.011.45NAXXX
    95875ALimb exercise test1.101.38NA0.092.57NAXXX
    95965CMeg, spontaneous0.000.000.000.000.000.00XXX
    95966CMeg, evoked, single0.000.000.000.000.000.00XXX
    95967CMeg, evoked, each addl0.000.000.000.000.000.00ZZZ
    96000AMotion analysis, video/3d1.80NA0.720.02NA2.54XXX
    96001AMotion test w/ft press meas2.15NA0.860.02NA3.03XXX
    96002ADynamic surface emg0.41NA0.160.02NA0.59XXX
    Start Printed Page 55499
    96003ADynamic fine wire emg0.37NA0.150.03NA0.55XXX
    96004APhys review of motion tests1.800.720.720.082.602.60XXX
    96150AAssess hlth/behave, init0.500.210.200.020.730.72XXX
    96151AAssess hlth/behave, subseq0.480.210.190.020.710.69XXX
    96152AIntervene hlth/behave, indiv0.460.200.180.020.680.66XXX
    96153AIntervene hlth/behave, group0.100.040.040.010.150.15XXX
    96154AInterv hlth/behav, fam w/pt0.450.190.180.020.660.65XXX
    96155AInterv hlth/behav fam no pt0.440.180.180.020.640.64XXX
    96567APhotodynamic tx, skin0.001.63NA0.031.66NAXXX
    97602BWound(s) care non-selective0.000.000.000.000.000.00XXX
    97802AMedical nutrition, indiv, in0.000.450.450.010.460.46XXX
    97803AMed nutrition, indiv, subseq0.000.450.450.010.460.46XXX
    97804AMedical nutrition, group0.000.170.170.010.180.18XXX
    99091BCollect/review data from pt0.000.000.000.000.000.00XXX
    99289IPt transport, 30-74 min0.000.000.000.000.000.00XXX
    99290IPt transport, addl 30 min0.000.000.000.000.000.00ZZZ
    G0117TGlaucoma scrn hgh risk direc0.450.970.220.021.440.69XXX
    G0118TGlaucoma scrn hgh risk direc0.170.840.080.011.020.26XXX
    G020226AScreeningmammographydigital0.700.280.280.031.011.01XXX
    G020426ADiagnosticmammographydigital0.870.350.350.031.251.25XXX
    G020626ADiagnosticmammographydigital0.700.280.280.031.011.01XXX
    G023626Adigital film convert diag ma0.060.020.020.010.090.09ZZZ
    1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    2 Copyright 1994 American Dental Association. All rights reserved.
    3+ Indicates RVUs are not used for Medicare payment.

    Addendum D.—2002 Geographic Practice Cost Indices by Medicare Carrier and Locality

    Carrier No.Locality No.Locality nameWorkPractice expenseMalpractice
    0051000ALABAMA0.9780.8700.807
    0083101ALASKA1.0641.1721.223
    0083200ARIZONA0.9940.9781.111
    0052013ARKANSAS0.9530.8470.340
    3114626ANAHEIM/SANTA ANA, CA1.0371.1840.955
    3114618LOS ANGELES, CA1.0561.1390.955
    3114003MARIN/NAPA/SOLANO, CA1.0151.2480.687
    3114007OAKLAND/BERKELEY, CA1.0411.2350.687
    3114005SAN FRANCISCO, CA1.0681.4580.687
    3114006SAN MATEO, CA1.0481.4320.687
    3114009SANTA CLARA, CA1.0631.3800.639
    3114617VENTURA, CA1.0281.1250.783
    3114699REST OF CALIFORNIA*1.0071.0340.748
    3114099REST OF CALIFORNIA*1.0071.0340.748
    0082401COLORADO0.9850.9920.840
    0059100CONNECTICUT1.0501.1560.966
    0090201DELAWARE1.0191.0350.712
    0090301DC + MD/VA SUBURBS1.0501.1660.909
    0059003FORT LAUDERDALE, FL0.9961.0181.877
    0059004MIAMI, FL1.0151.0522.528
    0059099REST OF FLORIDA0.9750.9461.265
    0051101ATLANTA, GA1.0061.0590.935
    0051199REST OF GEORGIA0.9700.8920.935
    0083301HAWAII/GUAM0.9971.1240.834
    0513000IDAHO0.9600.8810.497
    0095216CHICAGO, IL1.0281.0921.797
    0095212EAST ST. LOUIS, IL0.9880.9241.691
    0095215SUBURBAN CHICAGO, IL1.0061.0711.645
    0095299REST OF ILLINOIS0.9640.8891.157
    0063000INDIANA0.9810.9220.481
    0082600IOWA0.9590.8760.596
    0065000KANSAS*0.9630.8950.756
    0074004KANSAS*0.9630.8950.756
    0066000KENTUCKY0.9700.8660.877
    0052801NEW ORLEANS, LA0.9980.9451.283
    0052899REST OF LOUISIANA0.9680.8701.073
    3114203SOUTHERN MAINE0.9790.9990.666
    3114299REST OF MAINE0.9610.9100.666
    0090101BALTIMORE/SURR. CNTYS, MD1.0211.0380.916
    0090199REST OF MARYLAND0.9840.9720.774
    3114301METROPOLITAN BOSTON1.0411.2390.784
    3114399REST OF MASSACHUSETTS1.0101.1290.784
    0095301DETROIT, MI1.0431.0382.738
    0095399REST OF MICHIGAN0.9970.9381.571
    0095400MINNESOTA0.9900.9740.452
    0051200MISSISSIPPI0.9570.8370.779
    Start Printed Page 55500
    0074002METROPOLITAN KANSAS CITY, MO0.9880.9670.846
    0052301METROPOLITAN ST. LOUIS, MO0.9940.9380.846
    0074099REST OF MISSOURI*0.9460.8250.793
    0052399REST OF MISSOURI*0.9460.8250.793
    0075101MONTANA0.9500.8760.727
    0065500NEBRASKA0.9480.8770.430
    0083400NEVADA1.0051.0391.209
    3114440NEW HAMPSHIRE0.9861.0300.825
    0080501NORTHERN NJ1.0581.1930.860
    0080599REST OF NEW JERSEY1.0291.1100.860
    0052105NEW MEXICO0.9730.9000.902
    0080301MANHATTAN, NY1.0941.3511.668
    0080302NYC SUBURBS/LONG I., NY1.0681.2511.952
    0080303POUGHKPSIE/N NYC SUBURBS, NY1.0111.0751.275
    1433004QUEENS, NY1.0581.2281.871
    0080199REST OF NEW YORK0.9980.9440.764
    0553500NORTH CAROLINA0.9700.9310.595
    0082001NORTH DAKOTA0.9500.8800.657
    1636000OHIO0.9880.9440.957
    0052200OKLAHOMA0.9680.8760.444
    0083501PORTLAND, OR0.9961.0490.436
    0083599REST OF OREGON0.9610.9330.436
    0086501METROPOLITAN PHILADELPHIA, PA1.0231.0921.413
    0086599REST OF PENNSYLVANIA0.9890.9290.774
    0097320PUERTO RICO0.8810.7120.275
    0087001RHODE ISLAND1.0171.0650.883
    0088001SOUTH CAROLINA0.9740.9040.279
    0082002SOUTH DAKOTA0.9350.8780.406
    0544035TENNESSEE0.9750.9000.592
    0090031AUSTIN, TX0.9860.9960.859
    0090020BEAUMONT, TX0.9920.8901.338
    0090009BRAZORIA, TX0.9920.9781.338
    0090011DALLAS, TX1.0101.0650.931
    0090028FORT WORTH, TX0.9870.9810.931
    0090015GALVESTON, TX0.9880.9691.338
    0090018HOUSTON, TX1.0201.0071.336
    0090099REST OF TEXAS0.9660.8800.956
    0091009UTAH0.9760.9410.644
    3114550VERMONT0.9730.9860.539
    0097350VIRGIN ISLANDS0.9651.0231.002
    0090400VIRGINIA0.9840.9380.500
    0083602SEATTLE (KING CNTY), WA1.0051.1000.788
    0083699REST OF WASHINGTON0.9810.9720.788
    1651016WEST VIRGINIA0.9630.8501.378
    0095100WISCONSIN0.9810.9290.939
    0082521WYOMING0.9670.8951.005
    * Payment locality is serviced by two carriers.
    Note: Work GPCI reflects only 1/4 work GPCI in accordance with section 1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the following factors for budget neutrality: Work = 0.99699; Practice Expense = 0.99235; Malpractice Expense = 1.00215.

    Addendum E.—Updated List of CPT 1/HCPCS Codes Used To Describe Certain Designated Health Services Under the Physician Referral Provisions

    [Section 1877 of the Social Security Act]

    CLINICAL LABORATORY SERVICES
    INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services:
    86890Autologous blood process
    86891Autologous blood, op salvage
    86915Bone marrow/stem cell prep
    86927Plasma, fresh frozen
    86930Frozen blood prep
    86931Frozen blood thaw
    86932Frozen blood freeze/thaw
    86945Blood product/irradiation
    86950Leukacyte transfusion
    86965Pooling blood platelets
    86985Split blood or products
    INCLUDE the following HCPCS level 2 codes for other clinical laboratory services:
    G0001Drawing blood for specimen
    G0026Fecal leukocyte examination
    G0027Semen analysis
    G0103Psa, total screening
    G0107CA screen; fecal blood test
    G0123Screen cerv/vag thin layer
    G0124Screen c/v thin layer by MD
    G0141Scr c/v cyto,autosys and md
    G0143-G0145Scr c/v cyto,thinlayer, rescr
    G0147Scr c/v cyto, automated sys
    G0148Scr c/v cyto, autosys, rescr
    P2028Cephalin floculation test
    P2029Congo red blood test
    P2031Hair analysis
    P2033Blood thymol turbidity
    P2038Blood mucoprotein
    P3000Screen pap by tech w md supv
    P3001Screening pap smear by phys
    P7001Culture bacterial urine
    P9612Catheterize for urine spec
    P9615Urine specimen collect mult
    Q0111Wet mounts/w preparations
    Q0112Potassium hydroxide preps
    Q0113Pinworm examinations
    Q0114Fern test
    Q0115Post-coital mucous exam
    PHYSICAL THERAPY/OCCUPATIONAL THERAPY/SPEECH-LANGUAGE PATHOLOGY
    INCLUDE the following CPT codes for the physical therapy/occupational therapy/speech-language pathology services in the 97000 series:
    97001Pt evaluation
    97002Pt re-evaluation
    97003Ot evaluation
    97004Ot re-evaluation
    97010Hot or cold packs therapy
    97012Mechanical traction therapy
    97014Electric stimulation therapy
    97016Vasopneumatic device therapy
    97018Paraffin bath therapy
    Start Printed Page 55501
    97020Microwave therapy
    97022Whirlpool therapy
    97024Diathermy treatment
    97026Infrared therapy
    97028Ultraviolet therapy
    97032Electrical stimulation
    97033Electric current therapy
    97034Contrast bath therapy
    97035Ultrasound therapy
    97036Hydrotherapy
    97039Physical therapy treatment
    97110Therapeutic exercises
    97112Neuromuscular reeducation
    97113Aquatic therapy/exercises
    97116Gait training therapy
    97124Massage therapy
    97139Physical medicine procedure
    97140Manual therapy
    97150Group therapeutic procedures
    97504Orthotic training
    97520Prosthetic training
    97530Therapeutic activities
    97532Cognitive skills development
    97533Sensory integration
    97535Self care mngment training
    97537Community/work reintegration
    97542Wheelchair mngment training
    97545Work hardening
    97546Work hardening add-on
    97703Prosthetic checkout
    97750Physical performance test
    97799Physical medicine procedure
    INCLUDE CPT codes for physical therapy/occupational therapy/speech-language pathology services not in the 97000 series:
    64550Apply neurostimulator
    90901Biofeedback train, any meth
    90911Biofeedback peri/uro/rectal
    92506Speech/hearing evaluation
    92507-92508Speech/hearing therapy
    92510Rehab for ear implant
    92526Oral function therapy
    93797Cardiac rehab
    93798Cardiac rehab/monitor
    94667-94668Chest wall manipulation
    94762Measure blood oxygen level
    95831Limb muscle testing, manual
    95832Hand muscle testing, manual
    95833-95834Body muscle testing, manual
    95851-95852Range of motion measurements
    96000Motion analysis, video/3d
    96001Motion test w/ft press meas
    96002Dynamic surface emg
    96003Dynamic fine wire emg
    96105Assessment of aphasia
    96110Developmental test, lim
    96111Developmental test, extend
    96115Neurobehavior status exam
    INCLUDE HCPCS level 2 codes for the following physical therapy/occupational therapy/speech-language pathology services:
    G0193Endoscopic study swallow functn
    G0194Sensory testing endoscopic stud
    G0195Clinical eval swallowing funct
    G0196Eval of swallowing with radioopa
    G0197Eval of pt for prescip speech devi
    G0198Patient adapation & train for spe
    G0199Reevaluation of patient use spec
    G0200Eval of patient prescip of voice p
    G0201Modi for training in use voice pro
    Q0086Physical therapy evaluation/
    RADIOLOGY
    INCLUDE the following radiology and certain other imaging services in the CPT 70000 series:
    70100-70110X-ray exam of jaw
    70120-70130X-ray exam of mastoids
    70134X-ray exam of middle ear
    70140-70150X-ray exam of facial bones
    70160X-ray exam of nasal bones
    70190-70200X-ray exam of eye sockets
    70210-70220X-ray exam of sinuses
    70240X-ray exam, pituitary saddle
    70250-70260X-ray exam of skull
    70300-70310X-ray exam of teeth
    70320Full mouth x-ray of teeth
    70328X-ray exam of jaw joint
    70330X-ray exam of jaw joints
    70336Magnetic image, jaw joint
    70350X-ray head for orthodontia
    70355Panoramic x-ray of jaws
    70360X-ray exam of neck
    70370Throat x-ray & fluoroscopy
    70371Speech evaluation, complex
    70380X-ray exam of salivary gland
    70450Ct head/brain w/o dye
    70460Ct head/brain w/dye
    70470Ct head/brain w/o&w dye
    70480Ct orbit/ear/fossa w/o dye
    70481Ct orbit/ear/fossa w/dye
    70482Ct orbit/ear/fossa w/o&w dye
    70486Ct maxillofacial w/o dye
    70487Ct maxillofacial w/dye
    70488Ct maxillofacial w/o&w dye
    70490Ct soft tissue neck w/o dye
    70491Ct soft tissue neck w/dye
    70492Ct sft tsue nck w/o & w/dye
    70496Ct angiography, head
    70498Ct angiography, neck
    70540Mri orbit/face/neck w/o dye
    70542Mri orbit/face/neck w/dye
    70543Mri orbt/fac/nck w/o&w dye
    70544Mr angiography head w/o dye
    70545Mr angiography head w/dye
    70546Mr angiograph head w/o&w dye
    70547Mr angiography neck w/o dye
    70548Mr angiography neck w/dye
    70549Mr angiograph neck w/o&w dye
    70551Mri brain w/o dye
    70552Mri brain w/dye
    70553Mri brain w/o&w dye
    71010-71022Chest x-ray
    71023Chest x-ray and fluoroscopy
    71030Chest x-ray
    71034Chest x-ray and fluoroscopy
    71035Chest x-ray
    71100X-ray exam of ribs
    71101X-ray exam of ribs/chest
    71110X-ray exam of ribs
    71111X-ray exam of ribs/ chest
    71120-71130X-ray exam of breastbone
    71250Ct thorax w/o dye
    71260Ct thorax w/dye
    71270Ct thorax w/o&w dye
    71275Ct angiography, chest
    71550Mri chest w/o dye
    71551Mri chest w/dye
    71552Mri chest w/o&w dye
    71555Mri angio chest w or w/o dye
    72010-72020X-ray exam of spine
    72040-72052X-ray exam of neck spine
    72069X-ray exam of trunk spine
    72070-72074X-ray exam of thoracic spine
    72080-72090X-ray exam of trunk spine
    72100-72120X-ray exam of lower spine
    72125Ct neck spine w/o dye
    72126Ct neck spine w/dye
    72127Ct neck spine w/o&w dye
    72128Ct chest spine w/o dye
    72129Ct chest spine w/dye
    72130Ct chest spine w/o&w dye
    72131Ct lumbar spine w/o dye
    72132Ct lumbar spine w/dye
    72133Ct lumbar spine w/o&w dye
    72141Mri neck spine w/o dye
    72142Mri neck spine w/dye
    72146Mri chest spine w/o dye
    72147Mri chest spine w/dye
    72148Mri lumbar spine w/o dye
    72149Mri lumbar spine w/dye
    72156Mri neck spine w/o&w dye
    72157Mri chest spine w/o&w dye
    72158Mri lumbar spine w/o&w dye
    72170-72190X-ray exam of pelvis
    72191Ct angiograph pelv w/o&w dye
    72192Ct pelvis w/o dye
    72193Ct pelvis w/dye
    72194Ct pelvis w/o&w dye
    72195Mri pelvis w/o dye
    72196Mri pelvis w/dye
    72197Mri pelvis w/o & w dye
    72200-72202X-ray exam sacroiliac joints
    72220X-ray exam of tailbone
    73000X-ray exam of collar bone
    73010X-ray exam of shoulder blade
    73020-73030X-ray exam of shoulder
    73050X-ray exam of shoulders
    73060X-ray exam of humerus
    73070-73080X-ray exam of elbow
    73090X-ray exam of forearm
    73092X-ray exam of arm, infant
    73100-73110X-ray exam of wrist
    73120-73130X-ray exam of hand
    73140X-ray exam of finger(s)
    73200Ct upper extremity w/o dye
    73201Ct upper extremity w/dye
    73202Ct uppr extremity w/o&w dye
    73206Ct angio upr extrm w/o&w dye
    73218Mri upper extremity w/o dye
    73219Mri upper extremity w/dye
    73220Mri uppr extremity w/o&w dye
    73221Mri joint upr extrem w/o dye
    73222Mri joint upr extrem w/ dye
    73223Mri joint upr extr w/o&w dye
    73500-73510X-ray exam of hip
    73520X-ray exam of hips
    73540X-ray exam of pelvis & hips
    73550X-ray exam of thigh
    73560X-ray exam of knee, 1 or 2
    73562X-ray exam of knee, 3
    73564X-ray exam, knee, 4 or more
    73565X-ray exam of knees
    73590X-ray exam of lower leg
    73592X-ray exam of leg, infant
    73600-73610X-ray exam of ankle
    73620-73630X-ray exam of foot
    73650X-ray exam of heel
    73660X-ray exam of toe(s)
    73700Ct lower extremity w/o dye
    73701Ct lower extremity w/dye
    73702Ct lwr extremity w/o&w dye
    73706Ct angio lwr extr w/o&w dye
    73718Mri lower extremity w/o dye
    73719Mri lower extremity w/dye
    73720Mri lwr extremity w/o&w dye
    73721Mri joint of lwr extre w/o d
    73722Mri joint of lwr extr w/dye
    Start Printed Page 55502
    73723Mri joint lwr extr w/o&w dye
    73725Mr ang lwr ext w or w/o dye
    74000-74020X-ray exam of abdomen
    74022X-ray exam series, abdomen
    74150Ct abdomen w/o dye
    74160Ct abdomen w/dye
    74170Ct abdomen w/o&w dye
    74175Ct angio abdom w/o&w dye
    74181Mri abdomen w/o dye
    74182Mri abdomen w/dye
    74183Mri abdomen w/o&w dye
    74185Mri angio, abdom w or w/o dy
    74210Contrst x-ray exam of throat
    74220Contrast x-ray, esophagus
    74230Cine/video x-ray, throat/eso
    74240-74245X-ray exam, upper gi tract
    74246-74249Contrst x-ray uppr gi tract
    74250X-ray exam of small bowel
    74290Contrast x-ray, gallbladder
    74291Contrast x-rays, gallbladder
    74710X-ray measurement of pelvis
    75552Heart mri for morph w/o dye
    75553Heart mri for morph w/dye
    75554Cardiac MRI/function
    75555Cardiac MRI/limited study
    75635Ct angio abdominal arteries
    76000Fluoroscope examination
    76006X-ray stress view
    76010X-ray, nose to rectum
    76020X-rays for bone age
    76040X-rays, bone evaluation
    76061-76062X-rays, bone survey
    76065X-rays, bone evaluation
    76066Joint survey, single view
    76085Computer mammogram add-on
    76090Mammogram, one breast
    76091Mammogram, both breasts
    76092Mammogram, screening
    76093Magnetic image, breast
    76094Magnetic image, both breasts
    76100X-ray exam of body section
    76101Complex body section x-ray
    76102Complex body section x-rays
    76120Cine/video x-rays
    76125Cine/ video x-rays add-on
    76150X-ray exam, dry process
    76370CAT scan for therapy guide
    763753d/holograph reconstr add-on
    76380CAT scan follow-up study
    76390Mr spectroscopy
    76400Magnetic image, bone marrow
    76499Radiographic procedure
    76506Echo exam of head
    76511-76512Echo exam of eye
    76513Echo exam of eye, water bath
    76516-76519Echo exam of eye
    76536Us exam of head and neck
    76604Us exam, chest, b-scan
    76645Us exam, breast(s)
    76700Us exam, abdom, complete
    76705Us exam, abdom, limited
    76770Us exam abdo back wall, comp
    76775Us exam abdo back wall, lim
    76778Us exam kidney transplant
    76800Us exam, spinal canal
    76805Us exam, pg uterus, compl
    76810Us exam, pg uterus, mult
    76815Us exam, pg uterus limit
    76816Us exam pg uterus repeat
    76818Fetal biophy profile w/nst
    76819Fetal biophys profil w/o nst
    76825-76828Echo exam of fetal heart
    76830Us exam, transvaginal
    76831Echo exam, uterus
    76856Us exam, pelvic, complete
    76857Us exam, pelvic, limited
    76870Us exam, scrotum
    76872Echo exam, transrectal
    76873Echograp trans r, pros study
    76880Us exam, extremity
    76885Us exam infant hips, dynamic
    76886Us exam infant hips, static
    76970Ultrasound exam follow-up
    76977Us bone density measure
    76999Echo examination procedure
    INCLUDE the following CPT codes for echocardiography and vascular ultrasound:
    93303-93304Echo transthoracic
    93307-93308Echo exam of heart
    93320-93321Doppler echo exam, heart, if used in conjunction with 93303-93308
    93325Doppler color flow add-on, if used in conjunction with 93303-93308
    93875-93882Extracranial study
    93886-93888Intracranial study
    93922-93924Extremity study
    93925-93926Lower extremity study
    93930-93931Upper extremity study
    93965-93971Extremity study
    93975-93979Vascular study
    93980-93981Penile vascular study
    93990Doppler flow testing
    INCLUDE miscellaneous other HCPCS level 2 codes for radiology and certain other imaging services:
    G0050Residual urine by ultrasound
    G0131-132CT scan, bone density study
    G0188Xray lwr extrmty-full lngth
    G0202Screening mammography digital
    G0204Diagnostic mammography digital
    G0206Diagnostic mammography digital
    G0236digital film convert diag ma
    R0070Transport portable x-ray
    R0075Transport port x-ray multipl
    RADIATION THERAPY SERVICES AND SUPPLIES
    INCLUDE CPT codes for all radiation therapy services and supplies in the CPT 70000 series:
    77261-77263Radiation therapy planning
    77280-77295Set radiation therapy field
    77299Radiation therapy planning
    77300Radiation therapy dose plan
    77301Radioltherapy dos plan, imrt
    77305-77315Radiation therapy dose plan
    77321Radiation therapy port plan
    77326-77328Radiation therapy dose plan
    77331Special radiation dosimetry
    77332-77334Radiation treatment aid(s)
    77336-77370Radiation physics consult
    77399External radiation dosimetry
    77401-77416Radiation treatment delivery
    77417Radiology port film(s)
    77418Radiation tx delivery, imrt
    77427Radiation tx management, x5
    77431Radiation therapy management
    77432Stereotactic radiation trmt
    77470Special radiation treatment
    77499Radiation therapy management
    77520Proton trmt, simple w/o comp
    77522Proton trmt, simple w/comp
    77523Proton trmt, intermediate
    77525Proton treatment, complex
    77600-77620Hyperthermia treatment
    77750Infuse radioactive materials
    77761Apply intrcav radiat simple
    77762Apply intrcav radiat interm
    77763Apply intrcav radiat compl
    77776Apply interstit radiat simpl
    77777Apply interstit radiat inter
    77778Apply iterstit radiat compl
    77781-77784High intensity brachytherapy
    77789Apply surface radiation
    77790Radiation handling
    77799Radium/radioisotope therapy
    INCLUDE CPT codes for radiation therapy classified elsewhere:
    31643Diag bronchoscope/catheter
    50559Renal endoscopy/radiotracer
    55859Percut/needle insert, pros
    61770Incise skull for treatment
    61793Focus radiation beam
    92974Cath place, cardio brachytx
    PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES
    The following CPT and HCPCS codes are excluded under § 411.355(h) as screening tests:
    76085Computer mammogram add-on
    76092Mammogram, screening
    76977Us bone density measure
    G0103Psa, total screening
    G0107CA screen; fecal blood test
    G0123Screen cerv/vag thin layer
    G0124Screen c/v thin layer by MD
    G0141Scr c/v cyto, autosys and md
    G0143-G0145Scr c/v cyto, thinlayer, rescr
    G0147Scr c/v cyto, automated sys
    G0148Scr c/v cyto, autosys, rescr
    G0202Screening mammography digital
    P3000Screen pap by tech w md supv
    P3001Screening pap smear by phys
    The following CPT and HCPCS codes are excluded under § 411.355(h) as vaccines:
    90657Flu vaccine, 6-35 mo, im
    90658Flu vaccine, 3 yrs, im
    90659Flu vacine, whole, im
    90732Pneumococcal vaccine
    90748Hep b/hib vaccine, im
    Q3018Hepatitis B vaccine
    DRUGS USED BY PATIENTS UNDERGOING DIALYSIS
    The following HCPCS codes are excluded under § 411.355(g) as EPO and other dialysis related outpatient prescription drugs furnished in or by an ESRD facility:
    J0635Calcitriol injection
    J0895Deferoxamine mesylate inj
    J1270Injection, doxercalciferol
    J1750Iron dextran
    J1755Iron sucrose injection
    J2915NA Ferric Gluconate Complex
    J2997Alteplase recombinant
    Q9920Epoetin with hct <=20
    Q9921Epoetin with hct = 21
    Q9922Epoetin with hct = 22
    Q9923Epoetin with hct = 23
    Q9924Epoetin with hct = 24
    Q9925Epoetin with hct = 25
    Q9926Epoetin with hct = 26
    Q9927Epoetin with hct = 27
    Q9928Epoetin with hct = 28
    Q9929Epoetin with hct = 29
    Q9930Epoetin with hct = 30
    Q9931Epoetin with hct = 31
    Q9932Epoetin with hct = 32
    Q9933Epoetin with hct = 33
    Q9934Epoetin with hct = 34
    Q9935Epoetin with hct = 35
    Start Printed Page 55503
    Q9936Epoetin with hct = 36
    Q9937Epoetin with hct = 37
    Q9938Epoetin with hct = 38
    Q9939Epoetin with hct = 39
    Q9940Epoetin with hct >= 40
    1 CPT codes and descriptions only are copyright 2001 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply.
    End Supplemental Information

    [FR Doc. 01-27275 Filed 10-31-01; 8:45 am]

    BILLING CODE 4120-01-P

Document Information

Published:
11/01/2001
Department:
Centers for Medicare & Medicaid Services
Entry Type:
Rule
Action:
Final rule with comment period.
Document Number:
01-27275
Pages:
55245-55503 (259 pages)
Docket Numbers:
CMS-1169-FC
RINs:
0938-AK57
Topics:
Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays
PDF File:
01-27275.pdf
CFR: (18)
42 CFR 405.534
42 CFR 405.535
42 CFR 410.3
42 CFR 410.10
42 CFR 410.23
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