01-21213. Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2002 Payment Rates  

  • Start Preamble Start Printed Page 44672

    AGENCY:

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

    ACTION:

    Proposed rule.

    SUMMARY:

    This proposed rule would revise the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements, including relevant provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 and changes arising from our continuing experience with this system. In addition, it would describe proposed changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes would be applicable to services furnished on or after January 1, 2002.

    DATES:

    We will consider comments if we receive them at the appropriate address, as provided below, no later than 5 p.m. on October 3, 2001.

    ADDRESSES:

    In commenting, please refer to file code CMS-1159-P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. Mail written comments (one original and three copies) to the following address only: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1159-P, P.O. Box 8017, Baltimore, MD 21244-8017.

    To ensure that mailed comments are received in time for us to consider them, please allow for possible delays in delivery.

    If you prefer, you may deliver (by hand or courier) your written comments (one original and three copies) to one of the following addresses:

    Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or

    Room C5-16-03, 7500 Security Boulevard, Baltimore, MD 21244-1850.

    Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received too late for us to consider them.

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

    When ordering copies of the Federal Register containing this document, see the SUPPLEMENTARY INFORMATION section.

    Start Further Info

    FOR FURTHER INFORMATION CONTACT:

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

    End Further Info End Preamble Start Supplemental Information

    SUPPLEMENTARY INFORMATION:

    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 the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Blvd., Baltimore, MD 21244-1850 on Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, please call (410) 786-7195 or (410) 786-4668.

    Availability of Copies and Electronic Access

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

    This Federal Register document is also available from the Federal Register online database through GPO Access, a service of the U.S. Government Printing Office. The Website address is: http://www.access.gpo.gov/​nara/​index.html. To assist readers in referencing sections contained in this document, we are providing the following table of contents.

    Outline of Contents

    I. Background

    A. Authority

    B. Summary of Rulemaking

    C. Summary of Relevant Provisions of the Benefits Improvement and Protection Act of 2000 (BIPA 2000)

    1. Accelerated Reduction of Beneficiary Copayment

    2. Revision of Payment Update

    3. Process and Standards for Determining Eligibility of Devices for Transitional Pass-Through Payments

    4. Application of Transitional Corridor Payments to Certain Hospitals That Did Not Submit A 1996 Cost Report

    5. Treatment of Children's Hospitals

    6. Transitional Pass-Through Payment for Temperature Monitored Cryoablation

    7. Contrast Enhanced Diagnostic Procedures

    8. Other Changes

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

    A. Recommendations of the Advisory Panel on APC Groups

    1. Establishment of the Advisory Panel

    2. Specific Recommendations of the Advisory Panel and Our Responses

    B. Additional APC Changes Resulting from BIPA Provisions

    1. Coverage of Glaucoma Screening

    2. APCs for Contrast Enhanced Diagnostic Procedures

    C. Other Changes Affecting the APCs

    1. Changes in Revenue Code Packaging

    2. Special Revenue Code Packaging for Specific Types of Procedures

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

    4. Observation Services

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

    6. Additional New Technology APC Groups

    D. Recalibration of APC Weights for CY 2002

    III. Wage Index Changes

    IV. Copayment Changes

    A. BIPA 2000 Coinsurance Limit

    B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance

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

    V. Outlier Policy Changes

    VI. Other Policy Decisions and Proposed Changes

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

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

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

    D. Hospital Coding for Evaluation and Management Services

    E. Annual Drug Pricing Update

    F. Definition of Single-Use Devices

    G. Criteria for New Technology APCs

    1. Background

    2. Proposed Modifications to the Criteria and Process for Assigning Services to New Technology APCs a. Services Paid Under New Technology APCs b. Criteria for Assignment to New Technology APC c. Revision of Application for New Technology Status d. Length of Time in a New Technology APC

    VII. Transitional Pass-Through Payment Issues Start Printed Page 44673

    A. Background

    B. Discussion of Pro-Rata Reduction

    1. Data and Methodology

    2. Drugs and Biologicals

    3. Radiopharmaceutical Drugs and Biological Products

    4. Medical Devices

    5. Projecting to 2002

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

    1. Background

    2. Proposed Reduction for 2002

    VIII. Conversion Factor Update for CY 2002

    IX. Summary of and Responses to MedPAC Recommendations

    X. Provider-Based Issues

    A. Background and April 7, 2000 Regulations

    B. Provider-Based Issues/Frequently Asked Questions

    C. Benefits Improvement and Protection Act of 2000

    1. Two-Year “Grandfathering'

    2. Geographic Location Criteria

    3.Criteria for Temporary Treatment as Provider—Based

    D. Proposed Changes to Provider-Based Regulations

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

    2. Scope and Definitions

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

    4. Reporting

    5. Geographic Location Criteria

    6. Notice to Beneficiaries of Coinsurance Liability

    7. Clarification of Protocols for Off-Campus Departments

    8. Other Changes

    XI. Summary of Proposed Changes

    A. Changes Required by BIPA

    B. Additional Changes

    C. Technical Corrections

    XII. Collection of Information Requirements

    XIII. Response to Public Comments

    XIV. Regulatory Impact Analysis

    Regulations Text

    Addenda

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

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

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

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

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

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

    Addendum H—Wage Index for Urban Areas

    Addendum I—Wage Index for Rural Areas

    Addendum J—Wage Index for Hospitals That Are Reclassified

    Alphabetical List of Acronyms Appearing in the Proposed Rule

    APC Ambulatory payment classification

    APG Ambulatory patient group

    ASC Ambulatory surgical center

    AWP Average wholesale price

    BBA 1997 Balanced Budget Act of 1997

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

    BBRA 1999 Balanced Budget Refinement Act of 1999

    CAH Critical access hospital

    CAT Computerized axial tomography

    CCI Correct Coding Initiative

    CCR Cost center specific cost-to-charge ratio

    CMHC Community mental health center

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

    CORF Comprehensive outpatient rehabilitation facility

    CPI Consumer Price Index

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

    DME Durable medical equipment

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

    DRG Diagnosis-related group

    EMTALA Emergency Medical Treatment and Active Labor Act

    FDA Food and Drug Administration

    FQHC Federally qualified health center

    HCPCS Healthcare Common Procedure Coding System

    HHA Home health agency

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

    IME Indirect medical education

    JCAHO Joint Commission on Accreditation of Healthcare Organizations

    MRI Magnetic resonance imaging

    MSA Metropolitan statistical area

    NECMA New England County Metropolitan Area

    OPPS Hospital outpatient prospective payment system

    PPS Prospective payment system

    RFA Regulatory Flexibility Act

    RHC Rural health clinic

    RRC Rural referral center

    SCH Sole community hospital

    SNF Skilled nursing facility

    I. Background

    A. Authority

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

    B. Summary of Rulemaking

    • On September 8, 1998, we published a proposed rule (63 FR 47552) to establish in regulations a PPS for hospital outpatient services, to eliminate the formula-driven overpayment for certain hospital outpatient services, and to extend reductions in payment for costs of hospital outpatient services. On June 30, 1999, we published a correction notice (64 FR 35258) to correct a number of technical and typographic errors in the September 1998 proposed rule including the proposed amounts and factors used to determine the payment rates.
    • On April 7, 2000, we published a final rule with comment period (65 FR 18438) that addressed the provisions of the PPS for hospital outpatient services scheduled to be effective for services furnished on or after July 1, 2000. Under this system, Medicare payment for hospital outpatient services included in the PPS is made at a predetermined, specific rate. These outpatient services are classified according to a list of ambulatory payment classifications (APCs). The April 7 final rule with comment period also established requirements for provider departments and provider-based entities and prohibited Medicare payment for non-physician services furnished to a hospital outpatient by a provider or supplier other than a hospital unless the services are furnished under arrangement. In addition, this rule extended reductions in payment for costs of hospital outpatient services as required by the BBA of 1997 and Start Printed Page 44674amended by the BBRA of 1999. Medicare regulations governing the hospital OPPS are set forth at 42 CFR 419.
    • On June 30, 2000, we published a notice (65 FR 40535) announcing a delay in implementation of the OPPS from July 1, 2000 to August 1, 2000.
    • On August 3, 2000, we published an interim final rule with comment period (65 FR 47670) that modified criteria that we use to determine which medical devices are eligible for transitional pass-through payments. The August 3, 2000 rule also corrected and clarified certain provider-based provisions included in the April 7, 2000 rule.
    • On November 13, 2000, we published an interim final rule with comment period (65 FR 67798). This rule provided for the annual update to the amounts and factors for OPPS payment rates effective for services furnished on or after January 1, 2001. We also responded to public comments on those portions of the April 7, 2000 final rule that implemented related provisions of the BBRA and public comments on the August 3, 2000 rule.

    C. Summary of Relevant Provisions of the BIPA

    The BIPA, which was enacted on December 21, 2000, made the following changes to the Act relating to OPPS.

    1. Accelerated Reduction of Beneficiary Copayment

    Section 111 amended section 1833(t)(8)(C) of the Act to limit the national copayment rate for OPPS services to 57 percent of the OPPS payment rate for services furnished in 2001 on or after April 1, 2001; 55 percent for services in 2002 and 2003; 50 percent for services furnished in 2004; 45 percent for services furnished in 2005; and 40 percent for services furnished in 2006 and thereafter.

    Section 111 also specifies that nothing in BIPA 2000 or the Act, shall be viewed as preventing a hospital from waiving the amount of any beneficiary coinsurance for outpatient hospital services that may have been increased as a result of implementation of the OPPS.

    2. Revision of Payment Update

    Section 401 amended section 1833(t)(3)(C) of the Act to provide in 2001 an update equal to the full rate of increase in the market basket index. The 2002 update factor remains as it was under the law before the enactment of BIPA, that is, the market basket index percentage increase minus 1 percentage point.

    3. Process and Standards for Determining Eligibility of Devices for Transitional Pass-Through Payments

    Section 402 amended section 1833(t)(6) of the Act to require that the determination of eligibility for transitional pass-through payments be based on categories of devices (previously, eligibility was determined on a device-specific basis). The establishment of an initial set of categories was required effective for services furnished on or after April 1, 2001. This provision was implemented on March 22, 2001 in Program Memorandum (PM) No. A-01-41, which set forth a list of 96 initial categories.

    Section 402 of the BIPA also provides that the Secretary must establish criteria to use in creating additional device categories. These criteria will be set forth in an interim final rule with comment period that will be published in the Federal Register at a later date.

    Related to this issue is the issue of pro rata reductions of transitional pass through payments for new technology. A discussion of this can be found later in this document in Section VII. B.

    4. Application of Transitional Corridor Payments to Certain Hospitals That Did Not Submit a 1996 Cost Report

    Section 403 amended section 1833(t)(7)(F)(ii)(I) of the Act to allow transitional corridor payments to hospitals subject to the OPPS that did not have a 1996 cost report by authorizing the use of the first available cost reporting period ending after 1996 and before 2001.

    5. Treatment of Children's Hospitals

    Section 405 amended section 1833(t) of the Act to give children's hospitals the same permanent hold harmless protection as cancer hospitals under the OPPS.

    6. Transitional Pass-Through Payment for Temperature Monitored Cryoablation

    Section 406 amended section 1833(t)(6)(A)(ii) of the Act to include devices of temperature monitored cryoablation as eligible for transitional pass-through payments. This provision will be included in the interim final rule concerning changes in eligibility of devices for transitional pass-through payments mentioned above.

    7. Contrast Enhanced Diagnostic Procedures

    Section 430 amended section 1833(t)(2) of the Act to require that procedures that use contrast agents be classified in groups that are separate from those to which procedures not using contrast agents are assigned. We implemented this provision in PM No. A-01-73, issued on June 1, 2001. In addition, section 430 amended section 1861(t)(1) of the Act to expand the definition of drugs to include contrast agents effective for contrast agents furnished on or after July 1, 2001.

    8. Other Changes

    In addition to the provisions directly related to OPPS, BIPA included the following provisions that will require revision in the services assigned to APCs in the OPPS:

    • Section 102 amended section 1861(s)(2) of the Act to allow coverage of glaucoma screening for certain high risk individuals effective for services furnished on or after January 1, 2002.
    • Section 104(d)(2) directed the Secretary to determine if HCPCS codes are appropriate to describe mammography that uses new technology. The Secretary has created these codes for 2002.

    Throughout this proposed rule, we discuss these various provisions and the changes we are proposing to make in the OPPS for them.

    II. Proposed Changes to the APC Groups and Relative Weights

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

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

    Finally, section 1833(t)(2) of the Act provides that, subject to certain exceptions, the items and services within an APC group cannot be considered comparable with respect to Start Printed Page 44675the use of resources if the highest median or mean cost item or service in the group is more than 2 times greater than the lowest median or mean cost item or service within the same group (referred to as the “2 times rule”). We use the median cost of the item or service in implementing this provision. The statute authorizes the Secretary to make exceptions to the 2 times rule “in unusual cases, such as low volume items and services.”

    The APC groups that we are proposing in this rule as the basis for payment in 2002 under the OPPS have been analyzed within this statutory framework.

    A. Recommendations of the Advisory Panel on APC Groups

    1. Establishment of the Advisory Panel

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

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

    2. Specific Recommendations of the Advisory Panel and Our Responses

    In this section of the proposed rule, we summarize the issues considered by the Panel, the Panel's APC recommendations, and our subsequent action with regard to the Panel's recommendations. The data used by the Panel in making its recommendation are the 1996 claims that were used to set the APC weights and payment rates for CY 2000 and 2001.

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

    APC 0016: Level V Debridement & Destruction

    APC 0017: Level VI Debridement & Destruction

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

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

    The Panel rejected the option to split APC 0016 into three different APCs. The members stated that there was no validity in taking that approach because simple versus extensive destruction of lesions had greater significance in relation to physician work than in measuring facility resource use. They believed that many of the procedures assigned to APC 0016 are performed in a procedure room rather than in the operating room. The Panel considered factors such as the use of anesthesia and the method used to destroy the lesions as indicators of differences in facility resource consumption between simple and extensive destruction of lesions. The Panel agreed that the simple destruction of lesions should be assigned to the same APC as the extensive destruction of lesions if a laser is used to remove simple lesions. In this case, the Panel stated that the similarity in resource use is based on the method or technique used to perform the procedure.

    The Panel also noted that CPT code 11042, Debridement; skin, subcutaneous tissue, and muscle, is the most frequently performed procedure in APC 0016, accounting for approximately 85 percent of this APC's total volume. The Panel noted that this code had probably been billed incorrectly because of widespread misunderstanding about its definition.

    The Panel also reviewed procedures assigned to APCs 0014 (Level III Debridement & Destruction) and 0015 (Level IV Debridement & Destruction) and compared similarities and differences among those procedures and the ones assigned to APCs 0016 and 0017. During this comparative review, the Panel compared CPT code 56501 to the following two CPT codes: 46917, Destruction of lesion(s), anus, simple; laser surgery, which is assigned to APC 0014, and 54055, Destruction of lesion(s), penis, simple; electrodesiccation, which is assigned to APC 0016. In reviewing these three procedures, the Panel questioned whether the resources involved supported their current APC assignments. After considerable discussion, the Panel recommended the following:

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

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

    We propose to accept the Panel's recommendation regarding CPT code 56501 and to revise the APC accordingly. However, as shown below in Table 3, we are proposing to make Start Printed Page 44676additional changes to these APCs because of the 2 times rule.

    APC 0024: Level I Skin Repair

    APC 0025: Level II Skin Repair

    APC 0026: Level III Skin Repair

    APC 0027: Level IV Skin Repair

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

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

    The Panel reviewed the various options presented, which were modeled based on the 1996 claims data used in constructing the current APC groups and payment rates. Using these data, the Panel discussed size and complexity of the various repairs, considered the clinical differences in performing the repairs on different anatomical sites, and the clinical differences involved in making skin repairs using flaps and grafts versus layers of skin. As a result of its review, the Panel stated that they found no compelling clinical advantages in the options presented. The Panel also agreed that more current data would be needed to make appropriate recommendations about the actual merits and benefits of the various options. For these reasons, the Panel recommended the following:

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

    We propose to accept the Panel's recommendations. However, as shown in Table 3, we are proposing to make changes to these APCs based on the use of new data and application of the 2 times rule.

    APC 0058: Level I Strapping and Casting Application

    APC 0059: Level II Strapping and Casting Application

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

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

    The Panel discussion revealed that codes grouped in APC 0058 are not always appropriately billed by hospitals. The Panel pointed out that code descriptors such as “strapping of the hip” are not commonly understood by hospital staff. The Panel noted that before implementation of OPPS, hospitals billed the items described by these codes as supplies (without a CPT code) when they were billed as anything other than an emergency room visit. They also stated that the use of these codes has been confused with the use of some codes associated with durable medical equipment. For these reasons, the Panel believed that the procedure costs reflected in our data are skewed. As a result, the Panel recommended that we do the following:

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

    We propose to accept the Panel's recommendations except that we propose to move CPT code 29515 to APC 0059 due to the 2 times rule and the newer data we are using for this proposed rule.

    APC 0079: Ventilation Initiation and Management

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

    The Panel acknowledged that there are major problems associated with appropriately assigning codes to these procedures which results in incorrect billing. The Panel concluded that additional information is necessary to better understand the issues raised. The Panel also advised that CPT code 94660, Continuous positive airway pressure ventilation (CPAP), initiation and management, is a sleep apnea procedure used in the treatment of obesity and is clinically different from all other procedures in APC 0079. For these reasons, the Panel recommended the following:

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

    We propose to accept the Panel's recommendation by creating a new APC 0065, CPAP Initiation.

    APC 0094: Resuscitation and Cardioversion

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

    The Panel considered whether it was clinically appropriate to combine internal and external cardioversion procedures (CPT codes 92960 and 92961, respectively) in the same APC. The Panel also questioned the conditions under which internal cardioversion procedures would be performed on an outpatient basis.Start Printed Page 44677

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

    We propose to accept the APC Panel recommendation.

    APC 0102: Electronic Analysis of Pacemakers/Other Devices

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

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

    One presenter appearing before the Panel stated that APC 0102 involves clinical functions related to four different categories of devices; that is, pacemakers, defibrillators, infusion pumps, and neurostimulators. The presenter, who represented a device manufacturers' association, contended that these four categories of devices differ clinically. The presenter also stated that patients receiving these devices are clinically different and are even treated by different hospital departments. The presenter recommended the following:

    • Split APC 0102 into two APCs: One APC for electronic analysis of pacemakers and other cardiac devices and a separate APC for electronic analysis of infusion pumps and neurostimulators.
    • The APC created for electronic analysis of infusion pumps and neurostimulators would include the following CPT codes:
    CodeDescriptor
    62367Analyze spine infusion pump.
    62368Analyze spine infusion pump.
    95970Analyze neurostim, no prog.
    95971Analyze neurostim, simple.
    95972Analyze neurostim, complex.
    95973Analyze neurostim, complex.
    95974Cranial neurostim, complex.
    95975Cranial neurostim, complex.
    • The APC created for electronic analysis of pacemakers and other cardiac devices would include the following CPT codes:
    CodeDescriptor
    93727Analyze ilr system.
    93731Analyze pacemaker system.
    93732Analyze pacemaker system.
    93733Telephone analy, pacemaker.
    93734Analyze pacemaker system.
    93735Analyze pacemaker system.
    93736Telephone analy, pacemaker.
    93737Analyze cardio/defibrillator.
    93738Analyze cardio/defibrillator.
    93741Analyze ht pace device sngl.
    93742Analyze ht pace device single.
    93743Analyze ht pace device dual.
    93744Analyze ht pace device dual.

    The presenter stated that reorganizing APC 0102 as recommended would establish groups that are more clinically and resource similar than the current grouping. The presenter believes that APC 0102 as currently configured violates the 2 times rule. The median costs for the 21 procedures currently included in APC 0102 vary from $19 to $145. Other presenters clarified clinical aspects of the procedures, identified which practitioners perform them, the time it takes to perform them, and how they are to be billed. Yet another presenter speaking on behalf of a specialty society noted that the society had previously commented on this APC and requested that we remove CPT codes 93737 and 93738 from APC 0102.

    The Panel noted that because most of the codes are new, having been established since 1996 (the base year of data available to the Panel), these newer procedures could not have been included in the data file used to create the current APC payment rates. In the absence of frequency and median cost data for many of these procedures, the Panel was concerned about reorganizing the codes in this APC. Nonetheless, the Panel recommended the following reorganization of APC 0102 to better reflect clinical coherence:

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

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

    APC 0689: Electronic Analysis of Cardioverter-Defibrillator

    APC 0690: Electronic Analysis of Pacemakers and Other Cardiac Devices

    APC 0691: Electronic Analysis of Programmable Shunts/Pumps

    APC 0692: Electronic Analysis of Neurostimulator Pulse Generators.

    APC 0110: Transfusion

    APC 0111: Blood Product Exchange

    APC 0112: Extracorporeal Photopheresis

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

    A presenter representing a device manufacturers' association noted that these issues were examined extensively by several specialty societies that sent considerable data to us on the actual cost of the transfusion procedures before publication of the April 7, 2000 final rule (65 FR 18434). The presenter stated that the median costs for transfusion procedures that we used in calculating the final payment rate for APC 0110 was somewhat lower than the costs submitted by the specialty societies. The presenter believes that our experience under the APC system is too limited for us to make a judgment concerning the validity of the median costs. The presenter also believes that the payment rate for APC 0110 should have been adjusted to include costs for blood safety tests, such as the hepatitis and HIV look-back tests mandated by the FDA over the past several years, because these costs were not included in the 1996 data used to construct the APC rates. The presenter stated that these tests are expensive and that they increase the hospitals' costs to provide the blood. However, it was unclear whether these tests are separately billable under the lab fee schedule.

    In addition, the presenter explained that blood centers do not charge hospitals for blood because it is voluntarily donated, not manufactured. The presenter stated that blood centers charge hospitals what it costs them to provide the blood and that hospitals bill Start Printed Page 44678acquisition and processing charges rather than charges for the blood itself. Based on the information provided, the presenter urged the Panel not to revise APC 0110 until more data become available.

    For APC 0111, another representative of a specialty society recommended that CPT code 36521, Therapeutic apheresis; with extracorporeal affinity column absorption and plasma reinfusion, be moved from APC 0111 to APC 0112. The presenter stated that CPT code 36521 is more similar clinically and in resource use to 36522, Photopheresis, extracorporeal which is in APC 0112. The presenter stated that a major difference between the procedure represented by CPT codes 36521 and 36520, Therapeutic Apheresis; plasma and/or cell exchange, which is also assigned to APC 0111, and the other procedures codes assigned to APC 0111, is that hospitals can bill separately for blood products such as the plasma or albumin used in performing plasma exchange procedures. The presenter described CPT code 36521 as a “self-contained” procedure not requiring the use of albumin or plasma, because the patient's own blood is processed through a machine and returned to the patient. The presenter stated that the materials and equipment used to perform this procedure make it much more costly than the other procedures assigned to APC 0111. The presenter, citing cost data from two medical centers where CPT code 36521 is frequently performed, stated that the total cost of the procedure, including the cost of the adsorption column, is approximately $2000. At this time, the commenter noted, only one of the adsorption columns (Prosorba) used for this procedure is eligible for transitional pass-through payments, which means that payments for this procedure, which are based upon the APC payment alone, are too low when one of the other columns is used and no additional pass-through payment is made. It was stated that the cost of many of the adsorption columns is over $1000 per column. The presenter concluded that moving CPT code 36521 from APC 0111 to APC 0112 would comply with the statutory requirements for clinical coherence and resource similarity among procedures in the same APC.

    The Panel discussed various adsorption devices used in performing CPT code 36521, their eligibility for transitional pass-through payments, as well as the clinical and resource use difference between CPT codes 36520 and 36551. After considerable discussion, the Panel recommended the following:

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

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

    APC 0116: Chemotherapy Administration by Other Technique Except Infusion

    APC 0117: Chemotherapy Administration by Infusion Only

    APC 0118: Chemotherapy Administration by Both Infusion and Other Technique

    We had received several comments requesting that oral delivery of chemotherapy and delivery of chemotherapy by infusion pumps and reservoirs be recognized for payment under the OPPS. We asked the Panel to examine this issue.

    With regard to oral administration of chemotherapy, the Panel heard several presenters discuss the need for extensive beneficiary education prior to administration of oral anticancer agents. The Panel agreed that the beneficiaries actually self-administer the drug and that beneficiary education was appropriately billed as a clinic visit. The Panel stated that this would be true whether the education involved cancer chemotherapy, diabetes management, or congestive heart failure management. Therefore, the Panel recommended that no new codes be created to specifically recognize oral administration of chemotherapy.

    With regard to recognizing chemotherapy administration through infusion pumps and ports, the Panel heard several presentations that this is becoming a common method of administering not only cancer chemotherapy but also for administering other types of pharmaceuticals. It was pointed out that because CPT codes 96520, Refilling and maintenance of portable pump, and 96530, Refilling and maintenance of implantable pump or reservoir, were excluded from the OPPS it was impossible for hospitals to be paid when performing these services. After lengthy discussion, the Panel recommended that refilling and maintenance of pumps and reservoirs be assigned to an APC.

    The Panel also discussed the current HCPCS Q codes for chemotherapy administration and concluded that these codes should continue to be recognized in the OPPS. In addition, the Panel discussed whether a new Q code should be developed for extended chemotherapy infusions.

    In summary, the Panel recommended the following:

    • Hospitals be allowed to bill for patient education under the appropriate clinic codes.
    • CPT codes 96520 and 96530 be assigned to a new APC.
    • The current HCPCS Level II Q codes for chemotherapy administration should continue to be used.
    • There is no need to develop a new HCPCS code for “extended chemotherapy infusions.”
    • CMS should consider developing a new HCPCS code for flushing of ports and reservoirs.

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

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

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

    The Panel noted that these transplant and stem cell harvesting procedures are Start Printed Page 44679being increasingly performed on an outpatient basis. One presenter representing a specialty society stated that 95 percent of these procedures are performed in the hospital outpatient setting. The presenter shared cost data from the bone marrow transplant unit of an academic medical center that showed the cost to harvest bone marrow to be about $1,800. The presenter observed that this cost is significantly higher than the APC payment rate of about $205 for APC 0123. Another presenter representing a group of hospitals stated that the supply costs alone for bone marrow harvesting are more than the current APC payment for the procedure. The presenter suggested that miscoding may have contributed to the low $15 median cost reflected in our database. After discussion, the Panel recommended the following:

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

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

    APC 0142: Small Intestine Endoscopy

    APC 0143: Lower GI Endoscopy

    APC 0145: Therapeutic Anoscopy

    APC 0147: Level II Sigmoidoscopy

    APC 0148: Level I Anal/Rectal Procedures

    APC 0149: Level II Anal/Rectal Procedures

    APC 0150: Level III Anal/Rectal Procedures

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

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

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

    During the Panel discussion, it was noted that the data distributed to the Panel for these APCs indicated that most of the procedures are billed as single procedures only 50 percent of the time. This raised questions as to whether the data include procedures such as flexible sigmoidoscopies that were miscoded as rigid sigmoidoscopies, colonoscopies, and anoscopies. In examining the data, the Panel considered what impact this miscoding would have on the cost data, and discussed the clinical approaches used to perform some of the procedures, what type of practitioners perform them, and other procedures and supplies that would be billed with them. As a result of this discussion, the Panel concluded that the data anomalies were probably attributable to miscoding because hospitals have not received sufficient guidance and information on appropriately coding procedures included in these APCs. The Panel also agreed that it would need more current data before it could consider reconfiguring these APCs. Therefore, the Panel recommended that we do the following:

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

    We propose to accept the Panel's recommendations.

    APC 0151: Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

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

    A presenter speaking on behalf of a specialty society made the following points:

    • ERCP is the most complex endoscopy procedure to perform and is usually performed by gastroenterologists.
    • ERCP is usually performed at large hospitals.
    • The most complex ERCP procedures are usually performed in teaching hospitals.
    • Current payments for ERCP are lower than the costs to perform the procedure (based on cost and frequency data gathered from several teaching hospitals).
    • Single claims should not be used to calculate an APC payment rate for ERCP services because a single ERCP procedure usually consists of several components, each with its own CPT code (e.g., sphincterotomy and stent placement). Therefore, an ERCP billed as a single CPT code would represent aberrant billing and would not accurately reflect the costs of an ERCP.

    The OPPS data distributed to the Panel verified that the vast majority of the ERCP procedures are performed as multiple procedures. The Panel agreed that the use of single claims data could possibly skew the APC payment rate for ERCP services.

    The Panel recommended that we do the following:

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

    We propose to accept the Panel's recommendations. We are currently reviewing the potential for using multiple claims data for determining payment rates for ERCP procedures. As a first step in the process, in this proposed rule, we have determined a payment rate for ERCP procedures based on both single claims for ERCP procedures and, because ERCP procedures are typically done under radiologic guidance, on claims that included both an ERCP procedure and a radiologic supervision or guidance Start Printed Page 44680procedure in this APC. Using these additional claims has resulted in significantly increasing the number of claims used to determine the payment rate for this APC and in a much higher proposed payment rate (about $825).

    APC 0160: Level I Cystourethroscopy and other Genitourinary Procedures

    APC 0161: Level II Cystourethroscopy and other Genitourinary Procedures

    APC 0162: Level III Cystourethroscopy and other Genitourinary Procedures

    APC 0163: Level IV Cystourethroscopy and other Genitourinary Procedures

    APC 0169: Lithotripsy

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

    One presenter representing a device manufacturer discussed the merits of reassigning CPT code 52353 to either APC 0163 or 0169 (APC 0169 contains a single CPT code, 50590, Lithotripsy, extracorporeal shock wave (ESWL)). The presenter was concerned that our decision to assign the cystourethroscopic procedure to APC 0162 rather to APC 0163 was not explained in our April 7, 2000 final rule.

    Furthermore, the presenter noted that this decision resulted in a 40 percent decline in payment for the procedure which will make it difficult for hospitals to provide this service because the capital equipment, probes, and fibers required to perform the procedure are expensive. Moreover, the probes and fibers are ineligible for transitional pass-through payments because they are not single-use items. At the Panel's request, the presenter discussed the clinical differences between CPT codes 52353 and 50590. The presenter stated that code 50590 is a noninvasive procedure that involves breaking up kidney stones using shock waves produced outside the patient while code 52353 is an invasive procedure that requires the urologist to insert different instruments through a cystoscope and a uretheroscope to access stones in the upper urinary tract (the ureter and kidney).

    The presenter also compared the cost of performing CPT code 52353 with that for CPT code 52352, which involves the mechanical removal of stones. The presenter asked the Panel to consider the following two options to resolve this issue:

    • Reassign CPT code 52353 to APC 0169, Lithotripsy. The presenter believes that this would be the most appropriate assignment clinically and from a cost perspective because both involve lithotripsy and require expensive capital equipment, fibers, and probes. Also, other payers using a similar procedure grouping system, ambulatory procedure groups (APGs), have grouped these procedures together.
    • Restore CPT code 52353 to its original APC assignment, APC 0163.

    In addition, the presenter expressed concern that the large number of procedures assigned to APC 0162 makes it difficult to achieve clinical homogeneity within the APC. The presenter asked that we work with appropriate groups to reconfigure APC 0162 because, as constituted, it appears to violate the 2 times rule.

    The Panel had a lengthy discussion regarding whether to move CPT code 52353 to APC 0163 or to APC 0169. The Panel considered the resources used for procedures in APCs 0163 and 0169 and noted that the lithotriptor used for code 50590 may be purchased or leased and that lease rates for lithotriptors have frequently been inflated. Furthermore, it noted that much of the equipment and resource use required for code 52353 is similar to the resource use of other procedures in APC 0163. In spite of these considerations, the Panel voted eight to seven to recommend moving CPT code 52353 from APC 0162 to APC 0169 because both codes 52353 and 50590 are lithotripsy procedures.

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

    APC 0191: Level I Female Reproductive Procedures

    APC 0192: Level II Female Reproductive Procedures

    APC 0193: Level III Female Reproductive Procedures

    APC 0194: Level IV Female Reproductive Procedures

    APC 0195: Level V Female Reproductive Procedures

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

    The Panel discussed the rapid increase in the rate at which CPT code 57288 is performed on an outpatient basis. The Panel stated that this procedure is becoming more routine and replacing many of the older, more complex urinary dysfunctional procedures. Questions were raised about the frequency with which this procedure is performed alone as opposed to being performed as one of several procedures. The Panel was advised that the sling material and the relevant anchors used in performing Start Printed Page 44681CPT code 57288 are eligible for transitional pass-through payments.

    One presenter, speaking on behalf of a device manufacturer, supported our proposal to divide APC 0195 into different clinical groupings. The presenter's testimony was limited to a discussion of CPT code 57288. The presenter concurred with the Panel's assessment of the current utilization trends for CPT code 57288, emphasized the high costs associated with performing this procedure, and highlighted the wide variation in techniques and devices used to perform it. Because of these factors, the presenter believes that the procedure is underpaid and that the 1996 cost data may not fully reflect the actual costs associated with performing CPT code 57288.

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

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

    We propose to accept all of these Panel recommendations. These APCs would be reconfigured and renumbered as APCs 0188 to 0194. We are also proposing to add new APCs for Level VII and Level VIII Female Reproductive Procedures (APCs 0195 and 0202, respectively) based on the 1999-2000 claims data and the 2 times rule.

    APC 0210: Spinal Tap

    APC 0211: Level I Nervous System Injections

    APC 0212: Level II Nervous System Injections

    The Panel heard testimony from two presenters regarding the merits of modifying these three APCs. The first presenter, speaking on behalf of a manufacturer, discussed CPT code 64614, Chemodenervation of muscles; extremities and/or trunk muscles (e.g., for dystonia, cerebral palsy, multiple sclerosis). The presenter advised the Panel that although this is a new code for 2001, the procedure is well established and formerly coded using CPT code 64640, Destruction by neurolytic agent; other peripheral nerve or branch. The new code was created to distinguish chemodenervation of limb and trunk muscles from other chemodenervation procedures. The presenter claimed that this code is similar both clinically and in terms of resource use to the other chemodenervation procedures assigned to APC 0211, so it should be assigned to that APC instead of APC 0971, New Technology—Level II, where it is currently assigned.

    The second presenter, representing a specialty society, proposed regrouping the procedures assigned to APCs 0210, 0211, and 0212 based on similar levels of complexity and median costs. The presenter's proposal also included reassignment to these APCs of interventional pain procedures Start Printed Page 44682currently assigned to APCs 040, Arthrocenteris and Ligament/Tendon Injection, 0105, Revision/Removal of Pacemakers, AICD, or Vascular Device, and 0971. The presenter contended that it was essential to reconfigure these APCs because of disparity in resource use among procedures currently assigned to the same APC. The presenter also claimed that many of these procedures are being underpaid in their current APC and, for that reason, a number of hospitals have chosen not to perform them in the outpatient setting. The presenter proposed establishing the following five levels of interventional pain procedures by regrouping the procedures into new APCs as stated below:

    • Level I Nerve Injections (to include Trigger Point, Joint, Other Injections, and Lower Complexity Nerve Blocks):
    CPT codeReassigned from APC
    20550040
    20600040
    20605040
    20610040
    646120211
    646130211
    646140971
    64400-644180211
    644250211
    644300211
    644350211
    644450211
    644500211
    645050211
    645080211
    • Level II Nerve Injections (to include Moderate Complexity Nerve Blocks and Epidurals):
    CPT codeReassigned from APC
    270960210
    622700210
    622720210
    622730212
    62310-623190212

    Level III Nerve Injections (to include Moderately High Complexity Epidurals, Facet Blocks, and Disk Injections):

    CPT codeReassigned from APC
    62280-622820212
    62290Currently Packaged.
    62291Currently Packaged.
    64420-644210211
    644700211
    644720211
    64475-644760211
    644790211
    644800211
    64483-644840211
    645100211
    645200211
    645300211
    646300211
    646400211
    • Level IV Nerve Injections (to include High Complexity Lysis of Adhesions, Neurolytic Procedures, Removal of Implantable Pumps and Stimulators):
    CPT codeReassigned from APC
    622630212
    646000211
    646050211
    646100211
    646200211
    64622-646230211
    64626-646270211
    646800211
    623550105
    623650105
    • Level V Nerve Injections (to include Highest Complexity Disk and Spinal Endoscopies): CPT code 62287, Aspiration or decompression procedure, percutaneous, of nucleus pulposus of invertebral disk, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous diskectomy, percutaneous laser diskectomy), reassigned from APC 0220, Level I Nerve Procedures.

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

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

    • The Panel recommended that CPT codes 62290 and 62291 not be included in Level III because they are packaged injections and should not be unpackaged and paid separately.
    • The Panel opposed moving CPT codes 62355, Removal of previously implanted intrathecal or epidural catheter, and 62365, Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion, from APC 0105 to Level IV Nerve Injections because they were neither clinically similar nor similar in resource use to the other codes assigned to this proposed APC.
    • The Panel opposed the creation of Level V Nerve Tests as it included only one code and recommended that CPT code 62287 remain in APC 220.

    We propose to accept the Panel's recommendations for these services. We propose to create new APCs 0203, 0204, 0206, and 0207 to accommodate these proposed changes.

    APC 0215: Level I Nerve and Muscle Tests

    APC 0216: Level II Nerve and Muscle Tests

    APC 0217: Level III Nerve and Muscle Tests

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

    The Panel reviewed the cost data for APCs 0215 and 0216 and noted that the median costs for both CPT codes 95863 and 95864 appeared aberrant. Based on the information presented, the Panel recommended that we move CPT code 95863 from APC 0216 to APC 0215.

    We propose to accept the Panel's recommendation with one exception. We are proposing to revise these APCs based on the 1999-2000 cost data and the 2 times rule, and CPT code 95863 would be assigned to a reconfigured APC for Level II Nerve and Muscle Tests (APC 0218). Start Printed Page 44683

    APC 0237: Level III Posterior Segment Eye Procedures

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

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

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

    APC 0251: Level I ENT Procedures

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

    We agree that this APC should be reviewed by the Panel at its next meeting. However, our review of the more recent cost data indicates that significant violations of the 2 times rule still exist. In order to correct this problem, but keep the APC as intact as possible, we propose to move CPT codes 30300, Remove foreign body, intranasal; office type procedure, 40804, Removal of embedded foreign body, vestiblue of mouth; simple, and 42809, Removal of foreign body from pharynx, to APC 0340, Minor Ancillary Procedures. This APC consists of procedures such as removal of earwax that require similar resources.

    APC 0264: Level II Miscellaneous Radiology Procedures

    We asked the panel to review this APC because it violated the 2 times rule and consisted of a wide variety of unrelated procedures. Specifically, we believe that the costs associated with CPT codes 74740, Hysterosalpingography, radiological supervision and interpretation, and 76102, Radiologic examination, complex motion (e.g., hypercycloidal) body section (e.g., mastoid polytomography), other than with urography; bilateral, were aberrant and that we would significantly underpay these procedures if we moved them into a lower paying APC. We also asked the Panel to determine whether this APC and APC 0263, Level I Miscellaneous Radiology Procedures, should be reconfigured by body system. After considerable discussion, the Panel agreed that the procedures in these APCs were not clinically homogeneous; however, it recommended that we leave these APCs intact because the data do not support any more coherent reorganization. The Panel requested that this APC be placed on the agenda for the 2002 meeting.

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

    APC 0269: Echocardiogram except Transesophageal

    APC 0270: Transesophageal Echocardiogram

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

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

    APC 0274: Myelography

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

    We informed the Panel members that we packaged the costs associated with radiologic injection codes into the radiological supervision and interpretation codes with which they were reported. The reason for doing this is that hospitals incur expenses for providing both services and they typically perform both an injection and a supervision and interpretation procedure on the same patient. Therefore, since neither an injection code nor a supervision and interpretation code should be billed alone, it would not be appropriate for us to use single claims data to determine the costs of performing these procedures. However, we are using single claims data in order to accurately Start Printed Page 44684determine the costs of performing procedures. Therefore, in order to accurately determine the costs of a complete radiologic procedure, we had to package the costs of the injection component into the cost of the supervision and interpretation component with which it was billed. The Panel believed that, in 1996, hospitals generally did not bill the injection code when performing myelography. Furthermore, in 1996, some hospitals kept patients overnight after a myelogram. More recently, postmyelogram recovery time has decreased to about 6 hours. For these reasons, the Panel believed that the median costs of $109 and $174 probably do not represent the actual resources used for CPT codes 70010, Myelography, posterior fossa, radiological supervision and interpretation, and 70015, Cisternography, positive contrast, radiological supervision and interpretation. Therefore, the Panel recommended the following:

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

    We propose to accept the Panel's recommendations.

    APC 0279: Level I Diagnostic Angiography and Venography

    APC 0280: Level II Diagnostic Angiography and Venography

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

    The Panel reviewed the clinical coherence of both APCs as well as the resources required to perform all these procedures. The Panel believed that it would be unusual for many of these procedures to be performed separately and that we would need to look at multiple claims to get accurate data. The Panel recommended the following:

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

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

    APC 0300: Level I Radiation Therapy

    APC 0302: Level III Radiation Therapy

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

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

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

    We are proposing to set forth a proposed new coding structure that more accurately reflects the clinical use of these services and the resources required to perform them. Our understanding of these services, based on review of the comments, the testimony before the Panel, the Panel discussion and recommendations, and meetings with knowledgeable stakeholders, is described below.

    Recent developments in the field of radiation oncology include the ability to deliver high doses of radiation to abnormal tissues (e.g., tumors) while minimizing delivery of radiation to adjacent normal tissues. Collectively, these procedures are called stereotactic radiosurgery and IMRT.

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

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

    Although there are several types of equipment, produced by several manufacturers, used to accomplish this treatment, it is the consensus of the commenters and the Panel that the most useful way to categorize stereotactic radiosurgery and IMRT is by the source of radiation used for the treatment and Start Printed Page 44685not by the type of equipment used. One reason for this is that the clinical indications for stereotactic radiosurgery and IMRT overlap. Therefore, a single disease process can be treated by either modality but the cost of treatment varies by source of radiation used for the treatment. Second, while both stereotactic radiosurgery and IMRT can deliver a complete course of treatment in either one or multiple sessions, the cost of treatment delivery per session is relatively fixed, and is closely related to the source of radiation used for the treatment. Therefore, we believe that appropriate APC assignment and payment can be made by creating a small number of HCPCS codes to describe these services. The proposed codes are as follows:

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

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

    It is our understanding that single-source photon stereotactic radiosurgery (or LINAC) planning and delivery are similar to IMRT planning and delivery in terms of clinical use and resource requirements. Therefore, we propose to require coding for single-source photon stereotactic radiosurgery under HCPCS codes G0174 and G0178.

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

    We believe that all activities required to perform stereotactic radiosurgery and IMRT are included in the codes described above. In order to avoid confusion and to optimize tracking of these services in terms of both utilization and cost, we propose to discontinue the use of any other radiation therapy codes for activities involved with planning and delivery of stereotactic radiosurgery and IMRT for purposes of hospital billing in OPPS. Thus, we would continue to not recognize CPT code 61793 for hospital billing purposes.

    We believe the coding requirements set forth above not only simplify the reporting process for hospitals, but appropriately recognize the clinical practice and resource requirements for stereotactic radiosurgery and IMRT.

    We seek comments on our proposal, including the code titles, descriptors, and coding requirements discussed above. We also request information regarding appropriate APC assignment and payment rates to inform our decision-making. In particular, we would like information regarding the costs of treatment delivery including any differences between the cost of a complete treatment in single versus multiple sessions.

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

    We believe that while the APC Panel did not make any specific recommendations regarding these codes, the concerns expressed by the Panel are addressed by our proposal.

    APC 0311: Radiation Physics Services

    APC 0312: Radio Element Application

    APC 0313: Brachytherapy

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

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

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

    We presented APCs 0312 and 0313 to the Panel because commenters were concerned that the payment rates were too low for the procedures assigned to the APCs and that there were insufficient data to set payment rates for these APCs. The Panel agreed that the issue regarding the use of single claim data affected the payment rates for these services. However, there were insufficient data for the Panel to make Start Printed Page 44686any recommendations regarding these APCs. The Panel did request to look at the issue of radiation oncology at its 2002 meeting.

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

    APC 0371: Allergy Injections

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

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

    In order to create clinical and resource homogeneity, the Panel recommended that we create a new APC for codes 95115 and 95117 and that we leave the other services in APC 0371. We propose to accept the Panel recommendation and create a new APC 0353, Level II Allergy Injections, and revise the title of APC 0371 to Level I Allergy Injections.

    Observation Services

    See the discussion on observation services in section II.C.4 of this preamble for a summary of the Panel discussion and recommendations and our proposal.

    Inpatient Procedure List

    See the discussion of the inpatient procedures list in section II.C.5 of this preamble for a summary of the Panel discussion and recommendations and our proposal.

    B. Additional APC Changes Resulting from BIPA Provisions

    1. Coverage of Glaucoma Screening

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

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

    G0117—Glaucoma screening for high risk patients furnished by an ophthalmologist or optometrist.

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

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

    2. APCs for Contrast Enhanced Diagnostic Procedures

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

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

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

    APCSIAPC title
    0282SMiscellaneous Computerized Axial Tomography.
    0283SComputerized Axial Tomography with Contrast.
    0284SMagnetic Resonance Imaging and Angiography with Contrast.
    0332SComputerized Axial Tomography w/o Contrast.
    0333SCT Angio and Computerized Axial Tomography w/o Contrast followed by with Contrast.
    0335SMagnetic Resonance Imaging, Temporomandibular Joint.
    0336SMagnetic Resonance Angiography and Imaging without Contrast.
    0337SMagnetic Resonance Imaging and Angiography w/o Contrast followed by with Contrast.
    0338SMagnetic Resonance Angiography, Chest and Abdomen with or w/o Contrast.

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

    Start Printed Page 44687
    APCHCPCSSIShort descriptor
    028276370SCAT scan for therapy guide.
    76375S3d/holograph reconstr add-on.
    76380SCAT scan for follow-up study.
    G0131SCt scan, bone density study.
    G0132SCt scan, bone density study.
    028370460SCt head/brain w/dye.
    70481SCt orbit/ear/fossa w/dye.
    70487SCt maxillofacial w/dye.
    70491SCt soft tissue neck w/dye.
    71260SCt thorax w/dye.
    72126SCt neck spine w/dye.
    72129SCt chest spine w/dye.
    72132SCt lumbar spine w/dye.
    72193SCt pelvis w/dye.
    73201SCt upper extremity w/dye.
    73701SCt lower extremity w/dye.
    74160SCt abdomen w/dye.
    76355SCAT scan for localization.
    76360SCAT scan for needle biopsy.
    028470542SMRI orbit/face/neck w/dye.
    70545SMr angiography head w/dye.
    70548SMr angiography neck w/dye.
    70552SMRI brain w/dye.
    71551SMRI chest w/dye.
    72142SMRI neck spine w/dye.
    72147SMRI chest spine w/dye.
    72149SMRI lumbar spine w/dye.
    72196SMRI pelvis w/dye.
    73219SMRI upper extremity w/dye.
    73222SMRI joint upr extrem w/dye.
    73719SMRI lower extremity w/dye.
    73722SMRI joint of lwr extr w/dye.
    74182SMRI abdomen w/dye.
    75553SHeart MRI for morph w/dye.
    C8900SMRA w/cont, abd.
    C8903SMRI w/cont, breast, uni.
    C8906SMRI w/cont, breast, bi.
    C8909SMRA w/cont, chest.
    C8912SMRA w/cont, lwr ext.
    033270450SCAT scan of head or brain.
    70480SCt orbit/ear/fossa w/o dye.
    70486SCt maxillofacial w/o dye.
    70490SCt soft tissue neck w/o dye.
    71250SCt thorax w/o dye.
    72125SCt neck spine w/o dye.
    72128SCt chest spine w/o dye.
    72131SCt lumbar spine w/o dye.
    72192SCt pelvis w/o dye.
    73200SCt upper extremity w/o dye.
    73700SCt lower extremity w/o dye.
    74150SCt abdomen w/o dye.
    033370470SCt head/brain w/o&w dye.
    70482SCt orbit/ear/fossa w/o&w dye.
    70488SCt maxillofacial w/o&w dye.
    70492SCt sft tsue nck w/o & w/dye.
    70496SCt angiography, head.
    70498SCt angiography, neck.
    71270SCt thorax w/o&w dye.
    71275SCt angiography, chest.
    72127SCt neck spine w/o&w dye.
    72130SCt chest spine w/o&w dye.
    72133SCt lumbar spine w/o&w dye.
    72191SCt angiograph pelv w/o&w dye.
    72194SCt pelvis w/o&w dye.
    73202SCt uppr extremity w/o&w dye.
    73206SCt angio upr extrm w/o&w dye.
    73702SCt lwr extremity w/o&w dye.
    73706SCt angio lwr extr w/o&w dye.
    74170SCt abdomen w/o&w dye.
    74175SCt angio abdom w/o&w dye.
    75635SCt angio abdominal arteries.
    033570336SMagnetic image, jaw joint.
    75554SCardiac mri/function.
    75555SCardiac mri/limited study.
    Start Printed Page 44688
    76390SMr spectroscopy.
    76400SMagnetic image, bone marrow.
    033670540SMRI orbit/face/neck w/o dye.
    70544SMr angiography head w/o dye.
    70547SMr angiography neck w/o dye.
    70551SMRI brain w/o dye.
    71550SMRI chest w/o dye.
    72141SMRI neck spine w/o dye.
    72146SMRI chest spine w/o dye.
    72148SMRI lumbar spine w/o dye.
    72195SMRI pelvis w/o dye.
    73218SMRI upper extremity w/o dye.
    73221SMRI joint upr extrem w/o dye.
    73718SMRI lower extremity w/o dye.
    73721SMRI joint of lwr extre w/o dye.
    74181SMRI abdomen w/o dye.
    75552SHeart MRI for morph w/o dye.
    C8901SMRA w/o cont, abd.
    C8904SMRI w/o cont, breast, uni.
    C8910SMRA w/o cont, chest.
    C8913SMRA w/o cont, lwr ext.
    033770543SMRI orbt/fac/nck w/o&w dye.
    70546SMr angiograph head w/o&w dye.
    70549SMr angiograph neck w/o&w dye.
    70553SMRI brain w/o&w dye.
    71552SMRI chest w/o&w dye.
    72156SMRI neck spine w/o&w dye.
    72157SMRI chest spine w/o&w dye.
    72158SMRI lumbar spine w/o&w dye.
    72197SMRI pelvis w/o&w dye.
    73220SMRI uppr extremity w/o&w dye.
    73223SMRI joint upr extr w/o&w dye.
    73720SMRI lwr extremity w/o&w dye.
    73723SMRI joint lwr extr w/o&w dye.
    74183SMRI abdomen w/o&w dye.
    C8902SMRA w/o fol w/cont, abd.
    C8905SMRI w/o fol w/cont, brst, uni.
    C8908SMRI w/o fol w/cont, breast, bi.
    C8911SMRA w/o fol w/cont, chest.
    C8914SMRA w/o fol w/cont, lwr ext.

    Refer to Addendum A or Addendum B for the updated weights, payment rates, national unadjusted copayment, and minimum unadjusted copayment that we are proposing for all of the procedures listed above.

    C. Other Changes Affecting the APCs

    1. Changes in Revenue Code Packaging

    In the April 7, 2000 final rule, we described how, in calculating the per procedure and per visit costs to determine the median cost of an APC (and therefore its relative weight), we used the charges billed using the revenue codes that contained items that were integral to performing the procedure or visit (65 FR 18483). For example, in calculating the cost of a surgical procedure, we included charges for revenue codes such as operating room, treatment rooms, recovery, observation, medical and surgical supplies, pharmacy, anesthesia, casts and splints, and donor tissue, bone, and organ. For medical visit costs, we included charges for items such as medical and surgical supplies, drugs, and observation. The complete list of the revenue centers by type of APC group was printed in the April 7, 2000 rule (65 FR 18484).

    In the November 13, 2000 interim final rule, we made some changes to the list of revenue codes to reflect the charges associated with implantable devices (65 FR 67806 and 67825). As we stated in that rule, charges included in revenue codes 274 (prosthetic/orthotic devices), 275 (pacemaker), and 278 (other implants) were not included in the initial APC payment rates because, before enactment of BBRA, we were proposing to pay these devices outside of the OPPS, and, after the enactment of the BBRA, it was not feasible to revise our database to include these revenue codes in developing the April 7, 2000 final rule. As discussed in the November 13, 2000 interim final rule, we were later able to incorporate these revenue codes in our database, and effective January 1, 2001, we updated the APC payment rates to reflect inclusion of this information.

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

    • Package additional revenue centers that may be used to bill for implantable devices (including durable medical equipment (DME) and brachytherapy seeds) with surgical procedures. These additional centers are revenue codes 280 (oncology), 289 (other oncology), 290 (DME), and 624 (investigational devices).
    • Package revenue codes 280, 289, and 624 with other diagnostic and radiology services.
    • Package the revenue codes for medical social services, 560 (medical social services) and 569 (other medical social services). These services are not Start Printed Page 44689paid separately in the hospital outpatient setting but often constitute discharge-planning services if provided with an outpatient service.
    • Package revenue code 637 (self-administered drug (insulin administered in an emergency diabetic coma)) with medical visits. Although this is a self-administrable drug, it is covered when administered as described.
    • Remove revenue code 723 (circumcision) from the list of packaged revenue codes because circumcision is a payable procedure under OPPS and should not be packaged.
    • Package revenue code 942 (education/training) with medical visits and the category of “All Other APC Groups.” Patient training and education are generally not paid as a separate service under Medicare, but may be included as part of an otherwise payable service such as a medical visit. We believe that training and education services generally occur as part of a medical visit or psychiatric service.
    • Remove the revenue codes in the range of 890 through 899 (donor bank), as these are no longer valid revenue codes.

    2. Special Revenue Code Packaging for Specific Types of Procedures

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

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

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

    Table 2.—Packaged Services by Revenue Code

    Surgery

    250 PHARMACY

    251 GENERIC

    252 NONGENERIC

    257 NONPRESCRIPTION DRUGS

    258 IV SOLUTIONS

    259 OTHER PHARMACY

    260 IV THERAPY, GENERAL CLASS

    262 IV THERAPY/PHARMACY SERVICES

    263 IV THERAPY/DRUG SUPPLY/DELIVERY

    264 IV THERAPY/SUPPLIES

    269 OTHER IV THERAPY

    270 M&S SUPPLIES

    271 NONSTERILE SUPPLIES

    272 STERILE SUPPLIES

    274 PROSTHETIC/ORTHOTIC DEVICES

    275 PACEMAKER DRUG

    276 INTRAOCULAR LENS SOURCE DRUG

    278 OTHER IMPLANTS

    279 OTHER M&S SUPPLIES

    280 ONCOLOGY

    289 OTHER ONCOLOGY

    290 DURABLE MEDICAL EQUIPMENT

    370 ANESTHESIA

    379 OTHER ANESTHESIA

    390 BLOOD STORAGE AND PROCESSING

    399 OTHER BLOOD STORAGE AND PROCESSING

    560 MEDICAL SOCIAL SERVICES

    569 OTHER MEDICAL SOCIAL SERVICES

    624 INVESTIGATIONAL DEVICE (IDE)

    630 DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS

    631 SINGLE SOURCE

    632 MULTIPLE

    633 RESTRICTIVE PRESCRIPTION

    700 CAST ROOM

    709 OTHER CAST ROOM

    710 RECOVERY ROOM

    719 OTHER RECOVERY ROOM

    720 LABOR ROOM

    721 LABOR

    762 OBSERVATION ROOM

    810 ORGAN AQUISITION

    819 OTHER ORGAN ACQUISITION

    Medical Visit

    250 PHARMACY

    251 GENERIC

    252 NONGENERIC

    257 NONPRESCRIPTION DRUGS

    258 IV SOLUTIONS

    259 OTHER PHARMACY

    270 M&S SUPPLIES

    271 NONSTERILE SUPPLIES

    272 STERILE SUPPLIES

    279 OTHER M&S SUPPLIES

    560 MEDICAL SOCIAL SERVICES

    569 OTHER MEDICAL SOCIAL SERVICES

    630 DRUGS REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS

    631 SINGLE SOURCE DRUG

    632 MULTIPLE SOURCE DRUG

    633 RESTRICTIVE PRESCRIPTION

    637 SELF-ADMINISTERED DRUG (INSULIN ADMIN. IN EMERGENCY DIABETIC COMA)

    700 CAST ROOM

    709 OTHER CAST ROOM

    762 OBSERVATION ROOM

    942 EDUCATION/TRAINING

    Other Diagnostic

    254 PHARMACY INCIDENT TO OTHER DIAGNOSTIC

    280 ONCOLOGY

    289 OTHER ONCOLOGY

    372 ANESTHESIA INCIDENT TO OTHER DIAGNOSTIC

    560 MEDICAL SOCIAL SERVICES

    569 OTHER MEDICAL SOCIAL SERVICES

    622 SUPPLIES INCIDENT TO OTHER DIAGNOSTIC

    624 INVESTIGATIONAL DEVICE (IDE)

    710 RECOVERY ROOM

    719 OTHER RECOVERY ROOM

    762 OBSERVATION ROOM

    Radiology

    255 PHARMACY INCIDENT TO RADIOLOGY

    280 ONCOLOGY

    289 OTHER ONCOLOGY

    371 ANESTHESIA INCIDENT TO RADIOLOGY

    560 MEDICAL SOCIAL SERVICES

    710 RECOVERY ROOM

    719 OTHER RECOVERY ROOM

    569 OTHER MEDICAL SOCIAL SERVICES

    621 SUPPLIES INCIDENT TO RADIOLOGY

    624 INVESTIGATIONAL DEVICE (IDE)

    762 OBSERVATION ROOM

    All Other APC Groups

    250 PHARMACY

    251 GENERIC

    252 NONGENERIC

    257 NONPRESCRIPTION DRUGS

    258 IV SOLUTIONS

    259 OTHER PHARMACY

    260 IV THERAPY, GENERAL CLASS

    262 IV THERAPY PHARMACY SERVICES

    263 IV THERAPY/DRUG/SUPPLY/DELIVERY

    264 IV THERAPY SUPPLIES

    269 OTHER IV THERAPY

    270 M&S SUPPLIES

    271 NONSTERILE SUPPLIES

    272 STERILE SUPPLIES

    279 OTHER M&S SUPPLIES

    560 MEDICAL SOCIAL SERVICES

    569 OTHER MEDICAL SOCIAL SERVICES

    630 DRUG REQUIRING SPECIFIC IDENTIFICATION, GENERAL CLASS

    631 SINGLE SOURCE DRUG

    632 MULTIPLE SOURCE DRUG

    633 RESTRICTIVE PRESCRIPTION

    762 OBSERVATION ROOM

    942 EDUCATION/TRAINING

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

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

    Based on the proposed APC changes discussed above in this section of this preamble and the use of more current data to calculate the median cost of procedures classified to APCs, we reviewed all the APCs to determine which of them would not meet the 2 times limit. We use the following Start Printed Page 44690criteria when deciding whether to make exceptions to the 2 times rule for affected APCs:

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

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

    The following list contains APCs that we propose to except from the 2 times rule based on the criteria cited above. In cases in which compliance with the 2 times rule appeared to conflict with a recommendation of the APC Advisory Panel, we generally accepted the Panel recommendation. This was because Panel recommendations were based on explicit consideration of resource use, clinical homogeneity, hospital specialization, and the quality of the data used to determine payment rates.

    0001 Photochemotherapy

    0041 Arthroscopy

    0044 Closed Treatment Fracture/Dislocation Except Finger/Toe/Trunk

    0047 Arthroplasty without Prosthesis

    0058 Level I Strapping and Cast Application

    0077 Level I Pulmonary Treatment

    0093 Vascular Repair/Fistula Construction

    0096 Noninvasive Vascular Studies

    0097 Cardiac Monitoring for 30 days

    0115 Cannula/Access Device Procedures

    0121 Level I Tube Changes and Repositioning

    0140 Esophageal Dilation without Endoscopy

    0147 Level II Sigmoidoscopy

    0164 Level I Urinary and Anal Procedures

    0165 Level II Urinary and Anal Procedures

    0182 Insertion of Penile Prosthesis

    0198 Pregnancy and Neonatal Care Procedures

    0203 Level V Nerve Injections

    0204 Level VI Nerve Injections

    0207 Level IV Nerve Injections

    0213 Extended EEG Studies and Sleep Studies

    0215 Level I Nerve and Muscle Tests

    0231 Level II Eye Tests

    0238 Level I Repair and Plastic Eye Procedures

    0251 Level I ENT Procedures

    0260 Level I Plain Film Except Teeth

    0265 Level I Diagnostic Ultrasound Except Vascular

    0279 Level I Angiography and Venography except Extremity

    0285 Positron Emission Tomography (PET)

    0305 Level II Therapeutic Radiation Preparation

    0322 Brief Individual Psychotherapy

    0345 Level I Transfusion Lab Procedures

    0349 Miscellaneous Lab Procedures

    0354 Administration of Influenza/Pneumonia Vaccine

    0356 Level II Immunizations

    0363 Otorhinolaryngologic Function Tests

    0364 Level I Audiometry

    0373 Neuropsychological Testing

    0602 High Level Clinic Visits

    0694 Level III Excision/Biopsy

    0697 Level II Transesophageal Procedures

    4. Observation Services

    Observation services have a long intertwined clinical and payment history. For many years, beneficiaries have been placed in “observation status” in order to receive treatment or be monitored before making a decision concerning their next placement (that is, admit to the hospital or discharge to home). This occurs most frequently after surgery or a visit to the emergency department. Typically, beneficiaries placed in observation have failed to respond to initial emergency department treatment for their condition (for example, exacerbation of asthma), have symptoms placing them at significant risk for mortality (for example, chest pains with the possibility of myocardial infarction), or have received anesthesia for a surgical procedure and need to be monitored postoperatively. Clinically, most beneficiaries do not require more than 24 hours of observation before a decision concerning admission or discharge can be made. Therefore, it is rare that it is clinically justifiable to keep a patient in observation for more than 24 to 48 hours. The location where observation services are provided is facility-specific, and sometimes individual-specific. It is not uncommon for beneficiaries to be observed in the emergency department, in a designated unit near the emergency department, or in an intensive care or other unit in the facility.

    After implementation of the Medicare hospital inpatient PPS in 1983, peer review organizations (PROs) began to review inpatient admissions to determine whether the admission and the length of stay were appropriate. Because “observation care” is considered to be an outpatient service, facilities began using “observation” as an administrative mechanism to care for beneficiaries who, if admitted as inpatients, might have their admission questioned by the PRO. Moreover, before the implementation of the OPPS, the payment for observation care was on a reasonable cost basis, which frequently gave hospitals a financial incentive to keep beneficiaries in “observation status” even though they were clinically being treated as inpatients. Occasionally, beneficiaries were kept in observation for days and weeks resulting in both excessive payments from the Medicare program and excessive copayments from the beneficiary. In response to this practice, Medicare revised its manuals in November 1996, limiting covered observation services to no more than 48 hours (section 456 of the Hospital Manual and section 3663 of the Intermediary Manual).

    The costs for all observation services provided in the outpatient setting, even those provided in excess of 48 hours, were included in the initial APC payment rates. Currently, observation services are not paid separately, that is, they are not assigned to a separate APC. Instead, costs for observation services are packaged into payments for services with which the observation was billed in 1996. Observation was most frequently billed with emergency department visits, clinic visits, and surgical procedures. The payments for all APCs include the costs of observation to the extent that it was billed in 1996. In the 1996 data, we identified and packaged a total of $392 million from revenue codes 760, 761, 762, and 769, which represented observation services.

    In the April 7, 2000 final rule (65 FR 18448), we responded to numerous comments concerning observation services. Even though commenters acknowledged that being paid separately for observation services following a surgical procedure was unnecessary, many commenters requested that we pay separately for observation services following emergency department visits. Among those commenters requesting separate payment for observation, some requested separate payment for specific medical conditions, and others requested payment for all medical conditions. Some commenters provided articles and books containing clinical research on the value and cost effectiveness of observation for certain patients. Although we did not decide to create a separate APC for observation services, we did include this topic in the agenda for our APC Panel, which met from February 27 to March 1, 2001. While individual Panel members agreed that use of observation services had been abused in the past by hospitals seeking to maximize payment, the Panel also agreed that observation services following clinic and emergency room visits should be paid separately. In addition, the Panel believed that observation following surgery should be packaged into the payment for the surgical procedure. The Panel did not dispute that the vast majority of patients are admitted to the hospital or discharged home from observation in less than 24 hours, and Panel members judged that a rule limiting separate payment to 24 hours of observation Start Printed Page 44691would be reasonable. The Panel also noted that because Medicare currently allows hospitals to report observation services up to 48 hours, hospital staff and coders would have to be educated were we to change the current standard.

    Since the Panel meeting, we have reviewed all comments we have received on this issue. In determining whether we should pay separately for observation services, our primary concern is to ensure that Medicare beneficiaries have access to medically necessary observation care. We also want to ensure that payment be made only for beneficiaries actually receiving observation care, and that payment be restricted to clinically appropriate observation care. We paid particular attention to the Qualcare criteria (severity of illness and intensity of service criteria used by some insurance plans to determine whether it is appropriate for a patient to receive observation care) for observation services and to those comments providing medical evidence on the value and cost effectiveness of observation care. We also carefully considered logistical and administrative issues related to delivering observation care such as whether payment for emergency services should be bundled into observation services, the potential for overuse of the services, and the need for treatment guidelines. We also considered how to most appropriately define the starting time, discharge time, and minimum length of stay for observation care.

    Finally, in considering whether to make a separate payment for observation care, we had to balance the issues of access, medical necessity, potential for abuse, and need to ensure appropriate payment. As a threshold requirement for candidate medical conditions, we sought published criteria regarding the following:

    • Risk stratification of patients to determine which patient sub-populations benefit from observation care.
    • Which patients should be admitted to observation.
    • Which patients should be discharged home from observation.
    • When patients should be admitted to the hospital from observation.
    • Patient management.

    We found that these criteria were met for chest pain, asthma, and congestive heart failure.

    The fulfillment of these criteria ensured that, for these conditions, observation care avoided significant morbidity and mortality from inappropriate discharge to home while at the same time avoiding unnecessary inpatient admissions. For example, the use of observation for selected patients with asthma and congestive heart failure can reduce the rate of return emergency visits and subsequent admission. The literature clearly shows that for these patients, observation care requires prolonged physiologic monitoring and intensive treatment to result in the beneficial outcomes.

    After careful consideration, we are proposing—

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

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

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

    We are proposing to make payment for APC 0339 only if the tests described above are billed on the same claim as the observation service.

    (We are not proposing to require telemetry and other ongoing monitoring services as criteria to make separate payment for observation services. Although these services are often medically necessary to ensure prompt diagnosis of cardiac arrhythmias and other disorders, we do not believe they are necessary to support separate payment for observation services.)

    We propose to require that, in order to receive payment for APC 0339, the hospital must include one of the ICD-9-CM diagnosis codes listed below in the diagnosis field of the bill. We propose the following diagnosis codes to indicate a symptom or condition that would require observation:

    For Chest Pain

    411.1 Intermediate coronary syndrome

    411.81 Coronary occlusion without myocardial infarction

    411.0 Postmyocardial infarction syndrome

    411.89 Other acute ischemic heart disease

    413.0 Angina decubitus

    413.1 Prinzmetal angina

    413.9 Other and unspecified angina pectoris

    786.05 Shortness of breath

    786.50 Chest pain, unspecified

    786.51 Precordial pain

    786.52 Painful respiration

    786.59 Other chest pain

    For Asthma

    493.01 Extrinsic asthma with status asthmaticus

    493.02 Extrinsic asthma with acute exacerbation Start Printed Page 44692

    493.11 Intrinsic asthma with status asthmaticus

    493.12 Intrinsic asthma with acute exacerbation

    493.21 Chronic obstructive asthma with status asthmaticus

    493.22 Chronic obstructive asthma with acute exacerbation

    493.91 Asthma, unspecified with status asthmaticus

    493.92 Asthma, unspecified with acute exacerbation

    For Congestive Heart Failure

    428.0 Congestive heart failure

    428.1 Left heart failure

    428.9 Heart failure, unspecified

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

    We appreciate that there are other medical conditions for which selected beneficiaries may benefit from observation care and we are interested in comments on whether we should make separate payment for observation care for other conditions. We will consider medical research submitted to support the benefits of observation services for these conditions. This information will assist us in determining whether these other conditions meet the criteria we used to select the three conditions we have proposed to include in APC 0339.

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

    Before implementation of the OPPS, Medicare paid reasonable costs for services provided in the outpatient department. The claims submitted were subject to medical review by the fiscal intermediaries to determine the appropriateness of providing certain services in the outpatient setting. We did not specify in regulations those services that were appropriate to provide only in the inpatient setting and that, therefore, should be payable only when provided in that setting.

    Section 1833(t)(1)(B)(i) of the Social Security Act gave the Secretary broad authority to determine the services to be covered and paid for under the OPPS. In the September 8, 1998 OPPS proposed rule, we defined a set of services that are typically provided only in an inpatient setting and, hence, would not be paid by Medicare under the OPPS. This set of services is referred to as the “inpatient list.”

    We received numerous comments on the inpatient list. In the April 7, 2000 final rule, we revised the proposed list by removing a number of services and we discussed in greater detail the criteria we will use to define which services will be included on the inpatient list (65 FR 18455). These are services that require inpatient care because of the invasive nature of the procedure, the need for at least 24 hours of postoperative recovery time or monitoring before the patient can be safely discharged, or the underlying physical condition of the patient.

    After publication of the April 7 final rule, we received information from a number of groups demonstrating that certain services are routinely provided safely in the outpatient setting. As a result, in the November 13, 2000 interim final rule, we removed 44 procedures from the list (65 FR 67826). In that rule, we also stated that we would update the list at least quarterly to reflect advances in medical practice that permit procedures to be routinely performed in the outpatient setting. And, on June 1, 2001, we issued Program Memorandum A-01-73 in which we moved an additional 23 procedures from the inpatient list.

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

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

    We would continue to update the list in response to comments as often as quarterly through program memoranda to reflect current advances in medical practice. We believe that the current list addresses the concerns of previous commenters and reflects a general consensus about those services that hospitals and physicians agree are not routinely performed in the outpatient setting. Therefore, at this time, we are proposing no further changes to the inpatient list, which is set forth in Addendum E to this proposed rule.

    6. Additional New Technology APC Groups

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

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

    In section VI.G of this preamble, we describe several modifications and refinements to the criteria and process Start Printed Page 44693for assigning services to new technology APCs that we are proposing in this rule.

    Table 3 below, lists all of the APC groups that we are proposing to change for 2002.

    Table 3.—APC Groups Proposed To Be Changed in 2002

    APCTitleSIAPC panel2 timesOther
    0002Fine needle Biopsy/AspirationTX
    0004Level I Needle Biopsy/Aspiration Except Bone MarrowTX
    0006Level I Incision & DrainageTX
    0007Level II Incision & DrainageTX
    0008Level III Incision & DrainageTX
    0012Level I Debridement & DestructionTX
    0013Level II Debridement & DestructionTX
    0014Level III Debridement and DestructionTX
    0015Level IV Debridement & DestructionTX
    0016Level V Debridement & DestructionTXX
    0017Level VI Debridement & DestructionTXX
    0018Biopsy of Skin/Puncture of LesionTX
    0019Level I Excision/BiopsyTX
    0020Level II Excision/BiopsyTX
    0021Level IV Excision/BiopsyTX
    0022Level V Excision/BiopsyTX
    0026Level III Skin RepairTX
    0027Level IV Skin RepairTX
    0029Level II Incision/Excision BreastTX
    0030Level I Breast ReconstructionTX
    0032Insertion of Central Venous/Arterial CatheterTX
    0035Placement of Arterial/Central Venous CatheterTX
    0043Closed Treatment Fracture Finger/Toe/TrunkTX
    0044Closed Treatment Fracture/Dislocation except Finger/Toe/TrunkTX
    0045Bone/Joint Manipulation Under AnesthesiaTX
    0049Level I Musculoskeletal Procedures Except Hand and FootTX
    0050Level II Musculoskeletal Procedures Except Hand and FootTX
    0058Level I Strapping and Cast ApplicationSX
    0059Level II Strapping and Cast ApplicationSX
    0068CPAP InitiationSX
    0069ThoracoscopyTX
    0074Level IV Endoscopy Upper AirwayTX
    0075Level V Endoscopy Upper AirwayTX
    0076Endoscopy Lower AirwayTX
    0079Ventilation Initiation and ManagementSX
    0082Coronary AtherectomyTX
    0083Coronary AngioplastyTX
    0087Cardiac Electrophysiologic Recording/MappingSX
    0088ThrombectomyTX
    0093Vascular Repair/Fistula ConstructionTX
    0094Resuscitation and CardioversionSX
    0097Cardiac Monitoring for 30 daysTX
    0102Electronic Analysis of Pacemakers/other DevicesSX
    0105Revision/Removal of Pacemakers, AICD, or Vascular DeviceTX
    0111Blood Product ExchangeSX
    0112Apheresis, Photopheresis, and PlasmapheresisSX
    0115Cannula/Access Device ProceduresTX
    0125Refilling of Infusion PumpTX
    0130Level I LaparoscopyTX
    0131Level II LaparoscopyTX
    0148Level I Anal/Rectal ProcedureTX
    0149Level III Anal/Rectal ProcedureTX
    0150Level IV Anal/Rectal ProcedureTX
    0155Level II Anal/Rectal ProcedureTX
    0156Level II Urinary and Anal ProceduresTX
    0160Level I Cystourethroscopy and other Genitourinary ProceduresTX
    0161Level II Cystourethroscopy and other Genitourinary ProceduresTX
    0162Level III Cystourethroscopy and other Genitourinary ProceduresTX
    0163Level IV Cystourethroscopy and other Genitourinary ProceduresTX
    0164Level I Urinary and Anal ProceduresTX
    0165Level III Urinary and Anal ProceduresTX
    0188Level II Female Reproductive ProcTXX
    0189Level III Female Reproductive ProcTXX
    0191Level I Female Reproductive ProcTXX
    0192Level IV Female Reproductive ProcTXX
    0193Level V Female Reproductive ProcTXX
    0194Level VI Female Reproductive ProcTXX
    0195Level VII Female Reproductive ProcTXX
    Start Printed Page 44694
    0196Dilation and CurettageTX
    0203Level V Nerve InjectionsTX
    0204Level VI Nerve InjectionsTX
    0206Level III Nerve InjectionsTX
    0207Level IV Nerve InjectionsTX
    0208Laminotomies and LaminectomiesTX
    0209Level II Extended EEG Studies and Sleep StudiesSX
    0212Level II Nervous System InjectionsTX
    0213Level I Extended EEG Studies and Sleep StudiesSX
    0215Level I Nerve and Muscle TestsSXX
    0216Level III Nerve and Muscle TestsSXX
    0217Level III Nerve and Muscle TestsSX
    0218Level II Nerve and Muscle TestsSX
    0230Level I Eye Tests & TreatmentsSXX
    0231Level III Eye Tests & TreatmentsSX
    0232Level I Anterior Segment EyeSX
    0233Level II Anterior Segment EyeTX
    0234Level III Anterior Segment Eye ProceduresTX
    0235Level I Posterior Segment Eye ProceduresTX
    0236Level II Posterior Segment Eye ProceduresTX
    0237Level III Posterior Segment Eye ProceduresTX
    0238Level I Repair and Plastic Eye ProceduresTX
    0239Level II Repair and Plastic Eye ProceduresTX
    0245Level I Cataract Procedures without IOL InsertTX
    0249Level II Cataract Procedures without IOL InsertTX
    0251Level I ENT ProceduresTX
    0252Level II ENT ProceduresTX
    0253Level III ENT ProceduresTX
    0254Level IV ENT ProceduresTX
    0256Level V ENT ProceduresTX
    0259Level VI ENT ProceduresTX
    0260Level I Plain Film Except TeethXX
    0261Level II Plain Film Except Teeth Including Bone Density MeasurementXX
    0263Level I Miscellaneous Radiology ProceduresXX
    0264Level II Miscellaneous Radiology ProceduresXX
    0265Level I Diagnostic Ultrasound Except VascularXX
    0266Level II Diagnostic Ultrasound Except VascularSX
    0269Level I Echocardiogram Except TransesophagealSX
    0271MammographySX
    0272Level I FluoroscopyXX
    0279Level I Angiography and Venography except ExtremitySX
    0280Level II Angiography and VenographySX
    0282Miscellaneous Computerized Axial TomographySXX
    0283Computerized Axial Tomography with ContrastSX
    0284Magnetic Resonance Imaging and Angiography with ContrastSX
    0287Complex VenographySX
    0288CT, Bone DensitySX
    0289Needle Localization for Breast BiopsyXX
    0291Level I Diagnostic Nuclear Medicine Excluding Myocardial ScansSX
    0292Level II Diagnostic Nuclear Medicine Excluding Myocardial ScansSX
    0300Level I Radiation TherapySX
    0301Level II Radiation TherapySX
    0302Level III Radiation TherapySX
    0304Level I Therapeutic Radiation Treatment PreparationXX
    0305Level II Therapeutic Radiation Treatment PreparationXX
    0312Radioelement ApplicationsSX
    0332Computerized Axial Tomography w/o ContrastSXX
    0333CT Angio and Computerized Axial Tomography w/o Contrast followed by with ContrastSXX
    0335Magnetic Resonance Imaging, Temporomandular JointSX
    0336Magnetic Resonance Angiography and Imaging without ContrastSXX
    0337Magnetic Resonance Imaging and Angiography w/o Contrast followed by with ContrastSX
    0338Magnetic Resonance Angiography, Chest and Abdomen with or w/o ContrastSX
    0339ObservationXX
    0340Minor Ancillary ProceduresXX
    0345Level I Transfusion Laboratory ProceduresXX
    0346Level II Transfusion Laboratory ProceduresXX
    0347Level III Transfusion Laboratory ProceduresXX
    0352Level II InjectionsXX
    0353Level II Allergy InjectionsXX
    0355Level I ImmunizationsKX
    Start Printed Page 44695
    0356Level II ImmunizationsKX
    0359Level I InjectionsKX
    0360Level I Alimentary TestsXX
    0361Level II Alimentary TestsXX
    0364Level I AudiometryXX
    0365Level II AudiometryXX
    0367Level I Pulmonary TestXX
    0368Level II Pulmonary TestsXX
    0369Level III Pulmonary TestsXX
    0371Level I Allergy InjectionsXX
    0689Electronic Analysis of Cardioverter-DefibrillatorsSX
    0690Electronic Analysis of Pacemakers and other Cardiac DevicesSX
    0691Electronic Analysis of Programmable Shunts/PumpsSX
    0692Electronic Analysis of Neurostimulator Pulse GeneratorsSX
    0693Level II Breast ReconstructionTX
    0694Level III Excision/BiopsyTX
    0695Level VII Debridement & DestructionTX
    0696Repair/Replacement of Cardioverter-DefibrillatorsTX
    0697Level II Echocardiogram Except TransesophagealSX
    0698Level II Eye Tests & TreatmentsSX
    0699Level IV Eye Tests & TreatmentTX
    0982New Technology—Level XII ($2500-3000)TX
    0983New Technology—Level XIV ($3000-3500)TX
    0984New Technology—Level XV ($3500-5000)TX
    0985New Technology—Level XVI ($5000-6000)TX

    D. Recalibration of APC Weights for CY 2002

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

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

    The methodology we followed to calculate the APC relative weights proposed for CY 2002 is as follows:

    • We excluded from the data approximately 15.4 million claims for those bill and claim types that would not be paid under the OPPS (for example, bill type 72X for dialysis services for patients with ESRD).
    • Using the most recent available cost report from each hospital, we converted billed charges to costs and aggregated them to the procedure or visit level first by identifying the cost-to-charge ratio specific to each hospital's cost centers (“cost center specific cost-to-charge ratios” or CCRs) and then by matching the CCRs to revenue centers used on the hospital's 1999-2000 outpatient bills. The CCRs included operating and capital costs but excluded costs paid on a reasonable cost basis that are described elsewhere of this preamble.
    • We eliminated from the hospital CCR data 283 hospitals that we identified as having reported charges on their cost reports that were not actual charges (for example, they make uniform charges for all services).
    • We calculated the geometric mean of the total operating CCRs of hospitals remaining in the CCR data. We removed from the CCR data 67 hospitals whose total operating CCR exceeded the geometric mean by more than 3 standard deviations.
    • We excluded from our data approximately 1.8 million claims from the hospitals that we removed or trimmed from the hospital CCR data.
    • We matched revenue centers from the remaining universe of approximately 80.8 million claims to CCRs of 5,653 hospitals.
    • We separated the 80.8 million claims that we had matched with a cost report into two distinct groups: single-procedure claims and multiple-procedure claims. Single-procedure claims were those that included only one HCPCS code (other than laboratory and incidentals such as packaged drugs and venipuncture) that could be grouped to an APC. Multiple-procedure claims included more than one HCPCS code that could be mapped to an APC. There were approximately 36.4 million single-procedure claims and 44.4 million multiple-procedure claims.
    • To calculate median costs for services within an APC, we used only single-procedure bills. We did not use multiple-procedure claims because we are not able to specifically allocate charges or costs for packaged items and services such as anesthesia, recovery room, drugs, or supplies to a particular procedure when more than one significant procedure or medical visit is billed on a claim. Use of the single-procedure bills minimizes the risk of improperly assigning costs to the wrong procedure or visit.
    • For each single-procedure claim, we calculated a cost for every billed line item charge by multiplying each Start Printed Page 44696revenue center charge by the appropriate hospital-specific CCR. If the appropriate cost center did not exist for a given hospital, we crosswalked the revenue center to a secondary cost center when possible, or to the hospital's overall cost-to-charge ratio for outpatient department services. We excluded from this calculation all charges associated with HCPCS codes previously defined as not paid under the OPPS (for example, laboratory, ambulance, and therapy services).
    • To calculate the per-service costs, we used the charges shown in the revenue centers that contained items integral to performing the service. These included those items that we previously discussed as being subject to our proposed packaging provision. For instance, in calculating the surgical procedure cost, we included charges for the operating room, treatment rooms, recovery, observation, medical and surgical supplies, pharmacy, anesthesia, casts and splints, and donor tissue, bone, and organ. For medical visit cost estimates, we included charges for items such as medical and surgical supplies, drugs, and observation in those instances where it is still packaged. See sections II.C.1 and II.C.2 of this preamble for a discussion and complete listing of the revenue centers that we are proposing to use to calculate per-service costs.
    • We standardized costs for geographic wage variation by dividing the labor-related portion of the operating and capital costs for each billed item by the current FY 2001 hospital inpatient prospective payment system wage index published in the Federal Register on August 1, 2000 (65 FR 47054). We used 60 percent to represent our estimate of that portion of costs attributable, on average, to labor. A more detailed discussion of wage index adjustments is found in section III of this preamble.
    • We summed the standardized labor-related cost and the nonlabor-related cost component for each billed item to derive the total standardized cost for each procedure or medical visit.
    • We removed extremely unusual costs that appeared to be errors in the data using a trimming methodology analogous to what we use in calculating the DRG weights for the hospital inpatient PPS. That is, we eliminated any bills with costs outside of 3 standard deviations from the geometric mean.
    • After trimming the procedure and visit level costs, we mapped each procedure or visit cost to its assigned APC, including, to the extent possible, the proposed APC changes described elsewhere in this preamble.
    • We calculated the median cost, weighted by procedure volume, for each APC.
    • Using the weighted median APC costs, we calculated the relative payment weights for each APC. We scaled all the relative payment weights to APC 0601, Mid-level clinic visit, because it is one of the most frequently performed services in the hospital outpatient setting. This approach is consistent with that used in developing relative value units for the Medicare physician fee schedule. We assigned APC 0601 a relative payment weight of 1.00 and divided the median cost for each APC by the median cost for APC 0601, to derive the relative payment weight for each APC. The median cost for APC 0601 is $54.00.

    Section 1833(t)(9)(B) of the Act requires that APC reclassification and recalibration changes and wage index changes be made in a manner that assures that aggregate payments under the OPPS for 2002 are neither greater than nor less than the aggregate payments that would have been made without the changes. To comply with this requirement concerning the APC changes, we compared aggregate payments using the CY 2001 relative weights to aggregate payments using the CY 2002 proposed weights. Based on this comparison, we are proposing to make an adjustment of 1.022 to the weights. The weights that we are proposing for 2002, which incorporate the recalibration adjustments explained in this section, are listed in Addendum A and Addendum B.

    III. Wage Index Changes

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

    We used the proposed Federal fiscal year (FY) 2002 hospital inpatient PPS wage index to make wage adjustments in determining the proposed payment rates set forth in this proposed rule. The proposed FY 2002 hospital inpatient wage index published in the May 4, 2001 Federal Register (66 FR 22821) is reprinted in this proposed rule as Addendum H, Wage Index for Urban Areas; Addendum I, Wage Index for Rural Areas; and Addendum J, Wage Index for Hospitals That Are Reclassified. We propose to use the final FY 2002 hospital inpatient wage index to calculate the payment rates and coinsurance amounts that we will publish in the final rule implementing the OPPS for calendar year (CY) 2002.

    IV. Copayment Changes

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

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

    A. BIPA 2000 Coinsurance Limit

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

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

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

    B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance

    Under the statute as enacted by BBA 1997, APC payment rates for 2001 were to be based on the payment rates for 2000 increased by the inpatient hospital market basket percentage increase minus 1 percentage point; however, section 401 of the BIPA 2000 increased APC payment rates for 2001 to reflect an update based on the full market basket Start Printed Page 44697percentage increase. The Congress intended for the increased payment to be in effect for the entire calendar year 2001; however, to provide us sufficient time to make the change, the Congress adopted a special payment rule for 2001. Under section 401(c) of the BIPA, the payment rates in effect for services furnished on or after January 1, 2001 and before April 1, 2001 are the rates as determined under the statute prior to the enactment of BIPA. For services furnished on or after April 1, 2001 and before January 1, 2002 the payment rates reflect the full market basket update and are further increased by 0.32 percent to account for the timing delay in implementing the full market basket update for 2001. The 0.32 percent increase is a temporary increase that applies only to the period April 1 through December 31, 2001 and is not considered in updating the OPPS conversion factor for 2002. The increase in APC payment rates for 2001 was implemented effective April 1, 2001 through changes to the OPPS PRICER software. We would revise § 419.32 to conform to the statute.

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

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

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

    In developing a proposed approach to be used in determining copayments for new or revised APCs, we took into account the following:

    • One of the Congress's goals in authorizing an OPPS is to reduce beneficiary copayment liability until the copayment for every hospital outpatient service equals 20 percent of the prospectively determined payment rate for that service. Therefore, when given two possible copayment amounts or coinsurance percentages for a service as the result of an APC change, we should opt for the lower value.
    • In general, we should use the coinsurance percentage (that is, the percentage of the total payment rate represented by the copayment amount) as the factor for comparison of the old versus the new copayment amount rather than a copayment dollar amount.
    • Notwithstanding any changes, the coinsurance for an APC cannot be lower than 20 percent of the payment rate for an APC group.
    • Notwithstanding any changes, the coinsurance for an APC cannot exceed 55 percent of the payment rate for an APC in 2002 or the applicable copayment limits under section 1833(t)(8)(C)(ii) of the Act in subsequent years.

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

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

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

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

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

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

    V. Outlier Policy Changes

    For OPPS services furnished before January 1, 2002, section 1833(t)(5)(D) of the Act explicitly authorizes the Secretary to apply the outlier payment provision based upon all of the OPPS services on a bill. We exercised that authority and, since the beginning of the OPPS on August 1, 2000, we have calculated outlier payments in the aggregate for all OPPS services that appear on a bill. Under this proposed rule, beginning January 1, 2002, we will calculate outlier payments based on each individual OPPS service. We propose to revise the aggregate method that we are currently using to calculate outlier payments and begin to determine outliers on a service-by-service basis for Start Printed Page 44698OPPS services furnished on or after January 1, 2002.

    One difficulty we face with calculating outliers based on individual services is how to treat the charges for packaged services (for example, drugs, supplies, anesthesia, and equipment) when more than one OPPS service appears on a bill. These packaged services do not in themselves generate an APC payment but their charges must be taken into account to determine the cost of a service such as a surgical or diagnostic procedure or medical visit that does generate an APC payment. When more than one HCPCS code that will result in an APC payment appears on a bill, it is currently impossible to determine which packaged service is associated with an individual OPPS payable service. For example, when multiple surgical procedures are performed on the same day, we cannot determine how much of the operating room, drug, supply, anesthesia, or recovery room charge is attributable to each procedure. Similarly, if a medical visit and a surgical procedure occur on the same day, we cannot accurately determine how much of the charge for any drug, supply, or other packaged service that appears on the bill is attributable to each individual OPPS service.

    One solution would be to require hospitals to submit separate bills for each OPPS service so that we can be certain that the correct packaged services attributable to the individual OPPS service will be taken into account in determining an outlier payment for that service. We believe, however, such a requirement would be excessively burdensome to hospitals and would greatly increase fiscal intermediary workloads. In addition, billing of individual services for the same day on separate bills would prohibit us from applying the correct coding edits. Finally, we believe that the limit on outlier payments (up to 2.5 percent of the total OPPS payments in each year before 2004 and up to 3 percent for subsequent years) does not justify the burden that would result from requiring separate bills for each OPPS service.

    Another approach we considered is to allocate the charges for any packaged service among the individual OPPS services that appear on the bill. We considered two possible ways to do this. First, we could divide the packaged charges equally among the OPPS services so that if there were three services that generated APC payments, one third of the charges for the packaged services would be assigned to each OPPS service. We also considered dividing the total packaged charges among the OPPS services based on the ratio of the APC payment rate for an individual OPPS service to the total APC payment rates for all services on the bill. Thus, if a service resulted in an APC rate of $200 and the total APC payment rates for all services on the bill were $2,000, that individual APC would be allocated 10 percent of the packaged charges appearing on the bill.

    We prefer using one of the approaches that would allocate packaged charges among the APCs on a bill to avoid disruptive billing changes. Of the two ways to allocate charges for packaged services, we are proposing that charges be allocated to each OPPS service based on the percent the APC payment rate for that service bears to the total APC rates for all OPPS services on the bill. We believe that this allocation method is somewhat more precise than simply dividing evenly the total packaged charges by the number of APCs on the bill.

    We also propose to convert charges to costs for calculating outlier payments by continuing to apply a single overall hospital-specific cost-to-charge ratio instead of applying hospital-specific departmental cost-to-charge ratios. There is no universal crosswalk of revenue codes to cost report cost centers that is used by all hospitals. Although departmental cost-to-charge ratios are more precise for purposes of determining costs of specific services, hospitals have considerable discretion in assigning charges billed under specific revenue codes to specific departments on their cost reports. Therefore, we do not have a way of defining, in a uniform manner that is accurate for all hospitals, which department cost-to-charge ratio to apply to a revenue code billed by a hospital. We considered establishing a basic crosswalk that we would apply uniformly to every hospital, but this could result in a distorted or inaccurate model of how some hospitals actually assign charges. Given the appropriate resources, we could gather data from hospitals upon which to base a crosswalk specific to every hospital paid under the OPPS. But collecting these data would impose significant burden and administrative costs on hospitals and on our contractors. Given that outliers represent only 2 to 3 percent of total OPPS expenditures, we believe that the increased accuracy in calculating outlier payments that we could gain would not be sufficient to justify the significant additional administrative burden and cost that would be required. For this reason, we are proposing to continue to apply a single hospital-specific outpatient cost-to-charge ratio to convert billed charges to costs for calculating outlier payments.

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

    In setting the 2002 outlier threshold and payment percentage, we account for the charge to service level rather than claim level outlier calculation. In this proposed rule, we would again set the target for outlier payment at 2.0 percent. However, because we believe that the claims data we are using to set the 2002 proposed payment rates reflect much better coding of services than did the 1996 data, we would set these parameters to reach a target of 2.0 percent (rather than 2.5 percent). Based on our simulations, the proposed threshold for 2002 is 3 times the service costs and the proposed payment percentage for costs above that threshold is set at 50 percent.

    VI. Other Policy Decisions and Proposed Changes

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

    Section 1833(t)(1)(B) of the Act defines the term “covered OPD services” that are to be paid under the OPPS. “Covered OPD services” are “hospital outpatient services designated by the Secretary” and include “inpatient hospital services designated by the Secretary that are covered under this part and furnished to a hospital inpatient who (i) is entitled to benefits under part A but has exhausted benefits for inpatient hospital services during a spell of illness, or (ii) is not so entitled” (that is, “Part B-only” services). “Part B-only” services are certain ancillary services furnished to inpatients for which the hospital receives payment under Medicare Part B. Section 3110 of the Medicare Intermediary Manual and section 2255C of the Medicare Carriers Manual specify these services as diagnostic tests; X-ray and radioactive isotope therapy; surgical dressings, splints and casts; prosthetic devices; and limb braces and trusses and artificial limbs and eyes. Start Printed Page 44699

    In the April 7, 2000 final rule, we included inpatient “Part B-only” services within the definition of services payable under the OPPS (68 FR 18543). We have subsequently been approached by representatives of some hospitals that do not have outpatient departments and that, therefore, do no billing for Part B services except for a relatively few “Part B-only” services that they furnish to their inpatients. That is, the only bills these hospitals would ever submit for Part B payment are for the ancillary services designated as “Part B-only” services. These hospitals are concerned about the administrative burden and prohibitive costs they would incur if they were to change their billing systems to accommodate OPPS requirements solely to receive payment for “Part B-only” services.

    We recognize that there are certain hospitals that do not have outpatient departments and that do not provide outpatient department services but that do provide inpatient services to Medicare beneficiaries. The only services these hospitals bill under OPPS are services furnished to inpatients. That is, these are special billings under the Part B-only benefit for limited ancillary services provided to beneficiaries who are admitted to the hospital as inpatients and who are not receiving services on an outpatient basis. We further acknowledge that the expense of converting their billing systems to accommodate the OPPS is disproportionate to the Part B revenues that these hospitals receive. Therefore, we are proposing to revise § 419.22 by adding subparagraph (r) to exclude from payment under the OPPS Part B-only services that are furnished to inpatients of hospitals that do no other billing for hospital outpatient services under Part B.

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

    We do not know at this time, and are not sure it would be possible to ascertain, the potential number of hospitals that would be affected by this regulatory change. However, we expect the financial impact on the program to be small, because this revised rule would apply only to the relatively few hospitals that are billing for the very limited range of Part B-only services for a small number of beneficiaries.

    B. Categories of Hospitals Subject to and Excluded From the OPPS

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

    It has been brought to our attention that under the statute, hospitals located in Guam, Saipan, American Samoa, and the Virgin Islands are excluded from the hospital inpatient PPS. These hospitals currently lack a charge structure for billing and, in some cases, are not equipped to prepare a cost report. They furnish very few services that would be subject to the OPPS. In addition, we believe that because of their distant locations, they incur costs that might not be adequately recognized by a PPS. Prior to implementation of the OPPS, each of the hospitals in Guam, American Samoa, Saipan, and the Virgin Islands had its own unique Medicare payment methodology for the outpatient services they furnish. In light of these factors, we are proposing to revise § 419.20 of the regulations by adding paragraph (b)(3) to exclude these hospitals from OPPS consistent with their treatment under inpatient PPS. In addition, we would revise that section to include the hospitals of the IHS so that it is clear that they are excluded until we develop a plan to include them. We would note that it may also be possible to include the hospitals in the territories in the OPPS in the future.

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

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

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

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

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

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

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

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

    g. Organ acquisition costs paid under Part B. Interim payments for these services are made on a biweekly basis and final payments are determined at cost report settlement.

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

    D. Hospital Coding for Evaluation and Management (E/M) Services

    In the April 7, 2000 final rule, we emphasized the importance of each facility accurately assessing the intensity, resource use, and charges for evaluation and management (E/M) services, in order to ensure proper reporting of the service provided. We stated that “the billing information that the hospitals report during the first years of implementation of the hospital outpatient PPS will be vitally important to our revision of weights and other adjustments that affect payment in future years.” (65 FR 18451)

    We went on to state, “We realize that while these HCPCS codes appropriately represent different levels of physician effort, they do not adequately describe nonphysician resources. However, * * * the same concept can be applied to each code in terms of the differences in resource utilization. Therefore, each facility should develop a system for Start Printed Page 44700mapping the provided services or combination of services furnished to the different levels of effort represented by the codes * * *. We will hold each facility accountable for following its own system for assigning the different levels of HCPCS codes. As long as the services furnished are documented and medically necessary and the facility is following its own system, which reasonably relates the intensity of hospital resources to the different levels of HCPCS codes, we will assume that it is in compliance with these reporting requirements as they relate to the clinic/emergency department visit code reported on the bill. Therefore, we would not expect to see a high degree of correlation between the code reported by the physician and that reported by the facility * * *. We will work with the American Hospital Association and the American Medical Association to propose the establishment of appropriate facility-based patient visit codes * * *.”

    We understand that facilities have developed several different systems for determining resource consumption to assign proper E/M codes. Some of these systems are based on clinical (“condition”) criteria, and others are based on weighted scoring criteria. We continue to believe that proper facility coding of E/M services is critical for assuring appropriate payments. In order to achieve this, we are interested in developing and implementing a standardized coding process for facility reporting of E/M services. This process could include the use of current HCPCS codes or the establishment of new HCPCS codes in conjunction with guidelines for facility coding.

    At this time, we are soliciting comments from hospitals and other interested parties on this issue. We will submit these comments to the APC Advisory Panel and ask for the Panel's recommendations regarding the development and implementation of a facility coding process for E/M services. In order to ensure consideration by the Panel, comments must be received by November 1, 2001. Send comments regarding facility coding of E/M services to: OPPS-E/M coding, Centers for Medicare & Medicaid Services, Mailstop C4-05-17, 7500 Security Boulevard, Baltimore, Maryland 21244-1850. CMS will review both the public comments and the recommendations from the Panel and propose a coding process in the proposed rule for 2003.

    E. Annual Drug Pricing Update

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

    1. Packaged Payment

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

    2. Transitional Pass-Through Payments for Eligible Drugs and Biologicals

    As we explain in the April 7, 2000 final rule and in section VII of this preamble, the BBRA 1999 provided for special transitional pass-through payments for a period of 2 to 3 years for the following drugs and biologicals:

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

    In this context, “current” refers to those items for which hospital outpatient payment was being made on August 1, 2000, the date on which the OPPS was implemented. A “new” drug or biological is a product that was not paid as a hospital outpatient service prior to January 1, 1997 and for which the cost is not insignificant in relation to the payment for the APC to which it is assigned.

    Section 1833(t)(6)(D)(i) of the Act sets the payment rate for pass-through eligible drugs as the amount determined under section 1842(o) of the Act, that is, 95 percent of the applicable average wholesale price (AWP). Section 1833(t)(6)(D)(i) of the Act also sets the amount of additional payment for pass-through-eligible drugs and biologicals (the pass-through payment amount). The pass-through payment amount is the difference between 95 percent of the applicable AWP and the portion of the otherwise applicable fee schedule amount (that is, the APC payment rate) that the Secretary determines is associated with the drug or biological. Therefore, as we explain in the April 7 final rule (65 FR 18481), in order to determine the correct pass-through payment amount, we first had to determine the cost that was packaged for the drug or biological within its related APC. In order to determine this amount, we used the following methodology, which we also explain in the April 7 final rule.

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

    Next, in order to establish the applicable beneficiary copayment amount and pass-through payment amount, we had to determine the cost of the pass-through eligible drug or biological that would have been included in the payment rate for its associated APC had the drug or biological been packaged. We used hospital acquisition costs as a proxy for the amount that would have been packaged, based on data taken from an external survey of hospital drug costs. (See the April 7, 2000 final rule (65 FR 18481)).

    We imputed the acquisition cost for the various drugs and biologicals in pass-through APCs by multiplying their applicable AWP by one of the following ratios. The following ratios are based on the survey data, and they represent, on average, hospital drug acquisition cost relative to AWP:

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

    In accordance with section 1833(t)(7) of the Act, we base beneficiary copayment amounts for pass-through drugs only on that portion of the drug's cost that would have been included in the payment amount for an associated APC had the drug been packaged. Therefore, having determined the hospital acquisition cost of the drug based on the ratios described above, we multiply the acquisition cost by 20 Start Printed Page 44701percent to calculate the beneficiary copayment for the pass-through drug or biological APCs. Finally, to calculate the actual pass-through payment amount, we subtract from the applicable 95 percent of AWP the hospital acquisition cost less the beneficiary copayment amount.

    To illustrate this payment methodology, consider a current sole source drug with an average wholesale price (AWP) of $100 per dose. Under section 1842(o) of the Act, the total allowed payment for the drug is $95, that is, 95 percent of AWP. We impute the cost of the drug based on survey data, which indicate hospital acquisition costs for this type of drug on average to be 68 percent of its AWP (or $68). In the absence of the pass-through provisions, this cost would be packaged into the APC payment for the procedure or service with which the drug or biological is furnished. Therefore, we define the beneficiary coinsurance as 20 percent of the imputed cost of $68, resulting in a copayment amount $13.60. The pass-through payment amount is $27 (the difference between 95 percent of AWP ($95) and the portion of the APC payment that is based on the cost of the drug ($68)). The total Medicare program payment in this example equals $81.40 (cost of the drug in the APC ($68) less beneficiary copay ($13.60) plus pass-through payment ($27)).

    In this proposed rule, we are clarifying that, for purposes of calculating transitional pass-through payment amounts, we make no distinction between new and current drugs and biologicals. Rather, we assume that drugs and biologicals defined as “new” under section 1833(t)(6)(A)(iv)(I) of the Act, that is, for which payment was not being made as of December 31, 1996, nonetheless replace or are alternatives to drugs, biologicals, or therapies whose costs would have been reflected in our 1996 claims data and, thus, have been packaged into an associated APC. Therefore, we assume that our imputed acquisition cost, based on the external survey data, represents that portion of the APC payment attributable to new as well as current drugs and biologicals. For that reason, we are discontinuing use of the payment status indicator “J” that we introduced in the November 13, 2000 final rule to designate a “new” drug/biological pass-through. Instead, we would assign payment status indicator “G” to both current and new drugs that are eligible for pass-through payment under the OPPS. (Addendum D lists the definition of the OPPS payment status indicators.)

    3. Separate APCs for Drugs Not Eligible for Transitional Pass-Through Payment

    There are some drugs and biologicals for which we did not have adequate cost data yet that are not eligible for transitional pass-through payments. Beginning with the April 7, 2000 final rule, we created separate APCs for these drugs and biologicals. For example, we did not package into the emergency room visit APCs the various drugs classified as tissue plasminogen activators (tPAs) and other thrombolytic agents, which are used to treat patients with myocardial infarctions. Rather, we created individual APC groups for these drugs to allow separate payment so as not to discourage their use where appropriate.

    We based the payment rate for these APCs on median hospital acquisition costs. To determine the hospital acquisition cost for the drugs, we imputed a cost using the same ratios of drug acquisition cost to AWP that we discuss in section VI.E.2. in connection with calculating acquisition costs for transitional pass-through drug payments. That is, we multiplied the AWP for the drug by the applicable ratio (sole or multi-source drug) based on data collected in an external survey of hospital drug acquisition costs.

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

    4. Annual Drug Pricing Update

    a. Drugs Eligible for Pass-Through Payments. We used the AWPs reported in the Drug Topics Red Book to determine the payment rates for the pass-through drugs and biologicals. In the November 13, 2000 interim final rule (65 FR 67809), in response to a comment that we update the AWPs for pass-through drugs on a quarterly basis, we stated that, due to the complexity of the new payment system, we would be able to update the rates only on an annual basis. We also noted that the new rates would be effective for the quarter following the publication of the updated AWP values in the Red Book. It was our understanding that, although there are quarterly updates to the AWPs in the Red Book, the annual update is published in April of each year. It was our intention to update the AWPs for drugs each July 1, the quarter following the annual publication, and we did use the April 2001 version of the Red Book to update the APC rates for drugs eligible for pass-through payments. The pass-through payment rates for drugs and biologicals updated for 2001 went into effect July 1, 2001 (Program Memorandum A-01-73, issued on June 1, 2001).

    We found that doing an update for all the pass-through drugs and biologicals at mid-year was disruptive to both our computer systems and pricing software. Because it is now our understanding that even though the April publication is the annual printed version of the Red Book, there are quarterly updates available that we can use to update the AWPs. In fact, we have found that since the implementation of the pass-through payments in OPPS, many manufacturers have availed themselves of the Red Book quarterly update system to make frequent and large increases to their AWPs. Therefore, we do not believe it is necessary to wait until publication of the annual Red Book to do an update to the pass-through rates for drugs and biologicals to reflect the most recent AWPs.

    Thus, we are proposing to update the APC rates for drugs that are eligible for pass-through payments in 2002 using the July 2001 or October 2001 version of Red Book (depending upon which is available when we develop the final rule). The updated rates effective January 1, 2002 would remain in effect until we implement the next annual update in 2003, when we would again update the AWPs based on the latest quarterly version of the Red Book. This would place the update of pass-through drug prices on the same calendar year schedule as the other annual OPPS updates.

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

    For 2002, we propose to recalibrate the weights for the APCs for drugs that are not pass-through items and make the other adjustments applicable to the APC groups that we discuss in sections III, IV, and VIII of this proposed rule. Start Printed Page 44702

    F. Definition of Single-Use Devices

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

    Since publishing our November 13, 2000 rule, much has come to our attention regarding reprocessed single-use devices. Reprocessors and professional associations using reprocessed devices commented that, under certain circumstances, the FDA considers reprocessed devices to be single-use devices. The FDA corroborated that it considers previously used single-use devices that have been appropriately reprocessed to be considered to be a single-use device. The reprocessing industry also indicated that reprocessed single use devices are of much lower cost to hospitals than original equipment manufactured single-use devices.

    We have learned that the FDA published guidance for the reprocessing of single-use devices (FDA's “Enforcement Priorities for Single-Use Devices Reprocessed by Third Parties and Hospitals,” issued August 14, 2000). This document presents a phased-in regulatory scheme for reprocessed devices. As such, we are proposing to follow FDA's guidance on reprocessed single-use device. We would consider reprocessed single-use devices that are otherwise eligible for pass-through payment as part of a category of devices to be eligible for that payment if they meet FDA's most recent regulatory criteria on single-use devices. Also, reprocessed devices must meet any FDA guidance or other regulatory requirements in the future regarding single use. Reprocessed devices adhering to these guidelines would be considered as having met our criterion of approval or clearance by the FDA. We have met with and will continue to meet and coordinate with the FDA concerning that Federal agency's definition and regulation of single-use devices.

    Parties advise us that reprocessed devices reduce the costs to hospitals substantially. Therefore, we would expect that the hospital charges on claims submitted for pass-through payments for reprocessed single-use devices would reflect the lower cost of these devices.

    G. Criteria for New Technology APCs

    1. Background

    In the April 7, 2000 final rule (68 FR 18477), we created a set of new technology APCs to pay for certain new technology services under the OPPS. These APCs are intended to pay for new technology services that were not addressed by the transitional pass-through provisions of the BBRA 1999. We indicated that the new technology APCs would be defined on the basis of costs and not the clinical characteristics of a service.

    We initially established groups 0970 through 0984 as the new technology APCs with costs ranging from less than $50 to $6,000. The payment rate for each of these APCs is based on the midpoint of a range of costs. For example, the payment for new technology APC 0974, which includes services that cost from $300 to $500, is set at $400.

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

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

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

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

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

    a. Services Paid Under New Technology APCs. We propose to limit eligibility for placement in new technology APCs to complete services or procedures. That is, the following are not eligible for placement in a new technology APC: items, materials, supplies, apparatuses, instruments, implements, or equipment that are used to accomplish a more comprehensive service or procedure.

    We would continue to exclude devices or any drug, biologic, radiopharmaceutical, product, or commodity for which payment could be made under the transitional pass-through provisions. We believe that the new technology APCs should be reserved for only those comprehensive services or procedures that are truly new. Individual components of a service or procedure that do not meet the transitional pass-through payment criteria should be incorporated into a current APC and as hospitals begin to use the new items, supplies, or equipment the costs will become incorporated into the weight of the APC. To the extent possible, we believe that hospitals should be making the decision on what items, supplies, and equipment on the basis of efficiency and appropriate treatment of the patient. However, we believe it is appropriate to incorporate truly new services and procedures that replace much less Start Printed Page 44703expensive services or procedures into a new technology APC to afford access to our beneficiaries.

    Furthermore, we wish to clarify that we do not consider that merely being a different approach to an existing treatment or procedure qualifies a service for assignment to a new technology APC. As new approaches to existing procedures and services are adopted and performed, we expect the costs associated with these variations and improvements to be reflected in the claims data that we use to annually update the APC relative weights.

    b. Criteria for Assignment to New Technology APC. In light of the experience we have gained over the past year in reviewing requests for new technology and transitional pass-through status, developing criteria to define new medical services and technologies under the inpatient PPS, and determining categories of new devices under the transitional pass-through provisions, we are proposing that the following criteria be used to determine whether a service be assigned to a new technology APC. These modifications are based on changes in data (we are no longer using 1996 data to set payment rates) and our continuing experience with the system of assigning new technology APCs.

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

    We would delete the criterion that the service must have a HCPCS code. In the absence of an appropriate HCPCS code, we would consider creating a HCPCS code that describes the procedure or service. These HCPCS codes would be solely for hospitals to use when billing under the OPPS.

    c. Revision of Application for New Technology Status. We also propose to change the information that interested parties must submit to have a service or procedure considered for assignment to a new technology APC. Based on our experience over the past year in reviewing new technology APC applications, we believe that the criteria would better assist us in determining eligibility for these APCs than do the current criteria. Specifically, to be considered, we propose to require that requests include the following information:

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

    d. Length of Time in a New Technology APC. We are also proposing to change the period of time during which a service may be paid under a new technology APC. Although section 1833(t)(6)(B) of the Act, as amended by section 201 of BBRA 1999, sets a 2 to 3 year period of payment for transitional pass-through payments, this requirement does not extend to new technology APCs. In the April 7, 2000 final rule we stated our intention to adopt the same period of payment for new technology APCs for consistency. However, the experience we have gained during the first year of the OPPS has led us to the conclusion that a more flexible payment period would be preferable. Therefore, we are proposing to modify the time frame that we established for new technology APCs in the April 7, 2000 final rule and to retain a service within a new technology APC group until we have acquired adequate data that allow us to assign the service to a clinically appropriate APC. This would allow us to move a service from a new technology APC in less than 2 years if the data were available and would also allow us to retain a service in a new technology APC for more than 3 years if these data were not available.

    We invite comment on the changes to the definition, criteria, application process, and timeframe that we are proposing for services and procedures that may qualify for assignment to a new technology APC under the OPPS. Start Printed Page 44704

    VII. Transitional Pass-Through Payment Issues

    A. Background

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

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

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

    Section 1833(t)(6)(B)(ii) of the Act also requires us to establish, through rulemaking, criteria that will be used to create additional categories, other than those established initially. The criteria for new categories are the subject of a separate interim final rule with comment period, which will be published at a later date.

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

    B. Discussion of Pro Rata Reduction

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

    In order to prepare for making an estimate, we have constructed an extensive database that includes outpatient claims data submitted by hospitals for services furnished on or after July 1, 1999 and before July 1, 2000. We are also collecting device cost and utilization data that were provided by manufacturers. We are extracting device cost and utilization data from applications for pass-through status submitted by manufacturers, hospitals, specialty societies, and other entities. In their applications for pass-through status, manufacturers have supplied information on the expected cost to hospitals of devices and the procedures with which the devices are commonly used.

    The information that we have collected thus far suggests that a significant pro rata reduction could be required for 2002 in order to meet the statutory limit on the amount of the pass-through payments. Given the potential magnitude of the reductions, we are reviewing our data and methodology to identify any flaws or weaknesses in them and to determine whether a significant reduction would actually be required under the statute. We are also considering the appropriateness of a number of possible alternative approaches to different technical aspects of estimating payments that would have the effect of minimizing the amount of any potential reduction in these payments. Below is a discussion of the methodology that we contemplate employing in developing our estimate.

    We are considering a number of possible approaches to different technical aspects of estimating payments. As is always the case in making these types of estimates, it is necessary to make a number of assumptions in interpreting the data. We are tentatively contemplating using the following assumptions and techniques in developing our methodology:

    1. Data and Methodology

    We plan to base the estimate of 2002 pass-through expenditures on the claims we would use to set payment rates for 2002, 2001 pass-through amounts for drugs and radiopharmaceuticals, and device cost and use data from pass-through applications submitted by manufacturers, hospitals, specialty societies, and other entities. Projections to CY 2002 would employ price, volume, and service-mix inflators consistent with our baseline for OPPS spending. Estimates for drugs, radiopharmaceuticals, and devices would be made separately and combined for the final projection of pass-through spending.

    2. Drugs and Biologicals

    We would identify those drugs eligible for pass-through status that have been separately billed to the Medicare program on the claims that we intend to employ for the estimate. We would multiply the frequency of use for each of these drugs (that is, the number of line items multiplied by the number of units billed as shown in the claims data) by its 2001 pass-through payment amount. If any drugs are not reflected in the claims data, we would make an appropriate adjustment. Such an adjustment might take into account the extent to which the non-coded items are classified as orphan drugs and therefore would likely be used infrequently.

    3. Radiopharmaceutical Drugs and Biological Products

    Similar to the drug estimate, we would identify those Start Printed Page 44705radiopharmaceuticals eligible for pass-through status that were separately billed to Medicare in the claims data file. We would estimate expenditures for these radiopharmaceuticals directly as described above. For radiopharmaceutical drugs, we would multiply the frequency of use for each item by the 2001 pass-through amount. We would estimate expenditures for the remaining items by using the frequency counts for all nuclear medicine procedures not billed with one of these radiopharmaceuticals.

    4. Medical Devices

    We would estimate the transitional pass-through payments attributable to devices by linking the frequencies for all device-related procedures in the claims data file with the cost and use data supplied by the manufacturers or other entities as part of their applications for pass-through status. We would match each device eligible as of January 2001 with the procedures with which it would be used. We would then calculate an average cost for each device or device package associated with a procedure.

    The statute requires that we calculate transitional pass-through payments for devices by adjusting the hospital's charge for the device to cost and then subtracting an amount that reflects the device costs already included in the payment for the associated APC. As we explained in the April 7, 2000 final rule (65 FR 18481) we were not able to implement these subtractions at the time of implementation of the system. For 2001, as we explain in section III.C. of this preamble, we made these deductions for pacemakers and neurostimulators but not other devices because it was not feasible to make the deductions for the other devices at that time. As also explained in section III.C., we are proposing to make these subtractions for most other devices beginning in 2002. For the purpose of doing this estimation, we would deduct these amounts from each device package before multiplying that cost by the procedure frequencies. In total, we project the deductions to be $450 million. (See section III.C. for a discussion of how we calculated the deductions.)

    5. Projecting to 2002

    After making the three estimates as determined above, we plan to project prices and quantities in the estimates to 2002 using actuarial projections of price, volume, and service increase consistent with the OPPS baseline. We would add the three separate results for drugs, radiopharmaceuticals, and devices to determine an estimate of total pass-through spending.

    A. Reducing Transitional Pass-Through Payments to Offset Costs Packaged Into APC Groups

    1. Background

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

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

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

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

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

    For 2002, in this proposed rule we are estimating the portion of each APC rate that could reasonably be attributed to the cost of associated devices that are eligible for pass-through payments. This amount will be deducted from the pass-through payments for those devices as required by the statute. Since the deductions to the pass-through payments for costs included in APCs for 2002 are included in the recalibration of the weights and the fixed pool of dollars for outpatient services, the total payment for the procedure plus device or devices will be reduced rather than remain constant as they did in 2001. Start Printed Page 44706

    2. Proposed Reductions for 2002

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

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

    Table 5.—Proposed Reduction to Pass-Through Payment to Offset Device-Related Costs Packaged in Associated APC Groups

    APCDescriptionPercent differencesDevice-related cost to be subtracted from pass-through payment for eligible device
    00032Insertion of Central Venous/Arterial Catheter20.11$73
    00080Diagnostic Cardiac Catheterization9.99164
    00081Non-Coronary Angioplasty or Atherectomy27.06303
    00082Coronary Atherectomy6.95462
    00083Coronary Angioplasty19.85506
    00088Thrombectomy10.86161
    00089Insertion/Replacement of Permanent Pacemaker and Electrodes72.693,052
    00090Insertion/Replacement of Pacemaker Pulse Generator77.132,877
    00104Transcatheter Placement of Intracoronary Stents11.64422
    00106Insertion/Replacement/Repair of Pacemaker and/or Electrodes79.55640
    00107Insertion of Cardioverter-Defibrillator81.696,449
    0108Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads71.165,768
    0122Level II Tube Changes and Repositioning24.9272
    0151Endoscopic Retrograde Cholangio-Pancreatography (ERCP)7.3561
    0152Percutaneous Biliary Endoscopic Procedures12.05107
    0154Hernia/Hydrocele Procedures8.80108
    0182Insertion of Penile Prosthesis57.222,500
    0185Removal or Repair of Penile Prosthesis56.821,652
    0202Level VIII Female Reproductive Procedures25.02503
    0222Implantation of Neurological Device75.704,330
    0223Implantation of Pain Management Device79.51359
    0225Implantation of Neurotransmitter Electrodes67.251,154
    0227Implantation of Drug Infusion Device80.233,871
    0229Transcatheter Placement of Intravascular Shunts35.461,083
    0246Cataract Procedures with IOL Insert12.87146

    VIII. Conversion Factor Update for CY 2002

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

    The most recent forecast of the hospital market basket increase for FY 2002 is 3.3 percent. To set the proposed OPPS conversion factor for 2002, we increased the 2001 conversion factor of $50.080, which reflects the BIPA provision of the full market basket update, by 2.3 percent, that is, the 3.3 percentage increase minus 1 percentage point.

    In accordance with section 1833(t)(9)(B) of the Act, we further adjusted the proposed conversion factor for 2002 to ensure that the revisions we are proposing to update the wage index are made on a budget-neutral basis. A budget neutrality factor of 0.9924 was calculated for wage index changes by comparing total payments from our simulation model using the proposed FY 2002 hospital inpatient PPS wage Start Printed Page 44707index values to those payments using the current (FY 2001) wage index values.

    The increase factor of 2.3 percent for 2002 and the required wage index budget neutrality adjustment of 0.9924 result in a proposed conversion factor for 2002 of $50.842.

    IX. Summary of and Responses to MedPac Recommendations

    The Medicare Payment Advisory Commission (MedPAC) offered several recommendations dealing with the OPPS in its March 2001 Report to Congress. Below we summarize each recommendation and respond to it.

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

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

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

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

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

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

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

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

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

    • Current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act.
    • Current drugs and biologicals used for the treatment of cancer, and brachytherapy and temperature monitored cryoablation devices used for the treatment of cancer.
    • Current radiopharmaceutical drugs and biologicals.
    • New drugs and biologicals in instances in which the item was not being paid as a hospital outpatient service as of December 31, 1996, and when the cost of the item is “not insignificant” in relation to the OPPS payment amount.
    • Effective April 1, 2001, categories of Medical devices when the cost of the Start Printed Page 44708category is not insignificant” in relation to the OPPS payment amount.

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

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

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

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

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

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

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

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

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

    X. Provider-Based Issues

    A. Background and April 7, 2000 Regulations

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

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

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

    B. Provider-Based Issues/Frequently Asked Questions

    Following publication of the April 7, 2000 final rule, we received many requests for clarification of policies on specific issues related to provider-based status. In response, we published a list of “Frequently Asked Questions” and the answers to them on the CMS web site at www.hcfa.gov/​medlearn/​provqa.htm. (This document can also be obtained by contacting the CMS (Formerly, HCFA) Regional Office.) Start Printed Page 44709These Qs and As did not revise the regulatory criteria, but do provide subregulatory guidance for their implementation.

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

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

    1. Two-Year “Grandfathering”

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

    These provider-based facilities and organizations will not be exempt from the Emergency Medical Treatment and Active Labor Act (EMTALA) requirements for provider-based facilities and organizations (revised § 489.24(b) and new § 489.24(i)) or from the obligations of hospital outpatient departments and hospital-based entities in § 413.65(g), such as the requirement that off-campus facilities provide written notices to Medicare beneficiaries of coinsurance liability. These requirements become effective for hospitals on the first day of the hospital's cost reporting period beginning on or after January 10, 2001.

    We are aware that many hospitals and physicians continue to have significant concerns with our policy on the applicability of EMTALA to provider-based facilities and organizations. We intend to re-examine these regulations and, in particular, reconsider the appropriateness of applying EMTALA to off-campus locations. At the same time, we want to assure that those departments that Medicare pays as hospital-based departments are appropriately integrated with the hospital as a whole. We intend to publish a proposed rule to address these issues more fully.

    2. Geographic Location Criteria

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

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

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

    3. Criteria for Temporary Treatment as Provider-Based

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

    Facilities requesting a provider-based status determination on or after October 1, 2002 will not be covered by the provision concerning temporary treatment as provider-based in section 404(c) of BIPA. Thus, as stated in § 413.65(n), CMS ROs will make provider-based status applicable as of the earliest date on which a request for determination has been made and all requirements for provider-based status in effect as of the date of the request are shown to have been met, not on the date of the formal CMS determination. If a facility or organization does not qualify for provider-based status and CMS learns that the provider has treated the facility or organization as provider-based without having obtained a provider-based determination under applicable regulations, CMS will review all payments and may seek recovery for overpayments in accordance with the regulations at § 413.65(j), including overpayments made for the period of time between submission of the request or application for provider-based status and the issuance of a formal CMS determination. Start Printed Page 44710

    D. Proposed Changes to Provider-Based Regulations

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

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

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

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

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

    This revision is not a change in the policy, but instead is a clarification to the policy set forth in the April 7, 2000 final rule.

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

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

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

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

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

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

    4. Reporting (§ 413.65(c)(1))

    Current regulations at § 413.65(c) state that a main provider that creates or acquires a facility or organization for which it wishes to claim provider-based Start Printed Page 44711status, including any physician offices that a hospital wishes to operate as a hospital outpatient department or clinic, must report its acquisition of the facility or organization to CMS (Formerly, HCFA) if the facility or organization is located off the campus of the provider, or inclusion of the costs of the facility or organization in the provider's cost report would increase the total costs on the provider's cost report by at least 5 percent, and must furnish all information needed for a determination as to whether the facility or organization meets the requirements in paragraph (d) of this section for provider-based status. Concern has been expressed that such reporting would duplicate the requirement for obtaining approval of a facility as provider-based before billing its services that way or including its costs on the cost report of the main provider (current § 413.65(b)(2)). To prevent any unnecessary duplicate reporting, we propose to delete the current requirement from § 413.65(c)(1). We would, however, retain the requirement that a main provider that has had one or more facilities considered provider-based also report to CMS (Formerly, HCFA) any material change in the relationship between it and any provider-based facility, such as a change in ownership of the facility or entry into a new or different management contract that could affect the provider-based status of the facility.

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

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

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

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

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

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

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

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

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

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

    Some concern had been expressed that providing notice of a beneficiary's exact liability might be difficult in cases where the treating physician was in the process of diagnosing the patient's condition and was unsure of exactly what services might be required. In response to this concern we clarified in the preamble to an interim final rule with comment period published on August 3, 2000 (65 FR 47670) that if the exact type and extent of care needed is not known, the hospital may furnish a written notice to the patient that explains the fact that the beneficiary will incur a coinsurance liability to the hospital that they would not incur if the facility were not provider-based. The interim final rule preamble § 413.65(g)(7)) further explained that the hospital may furnish an estimate based on typical or average charges for visits to the facility, while stating that the patient's actual liability will depend upon the actual services furnished by the hospital. If the beneficiary is unconscious, under great duress, or for any other reason unable to read a written notice and understand and act on his or her own rights, the notice must be provided, prior to the delivery of services, to the beneficiary's authorized representative.

    We are proposing to amend § 413.65(g)(7) to include this clarifying language.

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

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

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

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

    We are proposing to amend § 489.24(i)(2)(ii) to include this clarifying language. Start Printed Page 44712

    8. Other Changes

    In addition to the changes cited above, we are proposing to make the following conforming and clarifying changes:

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

    XI. Summary of Proposed Changes for 2002

    A. Changes Required by BIPA 2000

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

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

    B. Additional Changes

    We are proposing the following additional changes to the OPPS:

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

    C. Technical Corrections

    We are proposing to make conforming changes to the regulations in 42 CFR parts 413, 419 and 489.

    In part 413 we would—

    • Revise § 413.24(d)(6) and (d) (7) to clarify requirements for adequate cost data and cost findings and clarify the meaning of the paragraph.
    • Revise § 413.65(a)(1) to clarify the specified types of facilities identified in this section that are not subject to the provider-based requirements and that provider-based determinations will not be made for them.
    • Revise the definition of “Provider-based entity” in § 413.65(a)(2).
    • Revise § 413.65(b) to implement the BIPA provisions on grandfathering and temporary treatment of a facility as provider-based.
    • Delete the existing requirement in § 413.65(c)(1) in order to prevent unnecessary duplicate reporting.
    • Specify in § 413.65(d)(7) that a facility will meet provider-based geographic location criteria if it and the main provider are located on the same campus, or if a facility meets one of the three criteria specified in this paragraph.
    • Clarify in § 413.65(g)(7) that the hospital may furnish an estimate based on typical or average charges for visits to the facility, while stating that the patient's actual liability will depend upon the actual services furnished by the hospital.
    • Correct date references in §§ 413.65(i)(1)(ii) and (i)(2), in order to take into account the effective date of the current regulations.

    In part 419, we would—

    • Revise § 419.2 to clarify the costs that are excluded from the OPPS rates.
    • Revise the reference to the effective date of the OPPS to August 1, 2000 in § 419.20(a).
    • Add new §§ 419.20(b)(3) and (b)(4) to specify that a hospital located outside one of the 50 States, the District of Columbia, or Puerto Rico, or a hospital of the Indian Health Service is excluded from the hospital outpatient prospective payment system.
    • Add a new § 419.22(r) to specify that services defined in § 419.21(b) that are furnished to inpatients of hospitals that do not submit claims for outpatients services under Medicare Part B are not paid for under the hospital OPPS.
    • Revise § 419.32 to reflect the revised update to the payment rates, as required by section 401 of BIPA.
    • Replace the word “coinsurance” each time it appears in §§ 419.40, 419.41, 419.42 and 419.43 with the word “copayment.”
    • Redesignate existing § 419.41(c)(4)(ii) as paragraph (c)(4)(iv), and add paragraphs (c)(4)(ii) and (c)(4)(iii) to include the provisions of section 1833(t)(8)(C)(ii) of the Act. This section would specify that, effective for services furnished from April 1, 2001 through December 31, 2001, the national unadjusted coinsurance rate for an APC cannot exceed 57 percent of the prospective rate for that APC and the national unadjusted coinsurance rate for an APC cannot exceed 55 percent in calendar year 2004, 45 percent in calendar year 2005, and 40 percent in calendar year 2006 and thereafter.
    • Revise § 419.70(d) to give children's hospitals the same permanent hold harmless protection as cancer hospitals under the OPPS, as required by section 405 of BIPA. Start Printed Page 44713
    • Revise § 489.24(i)(2)(ii) to clarify that, for the purposes of arranging an appropriate transfer of a patient from an off-campus department, staff at the off-campus department may delay contacting the emergency personnel at the main hospital campus in the specific cases where doing otherwise would endanger a patient.

    XII. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995, we are required to provide 60-day notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues:

    • The need for the information collection and its usefulness in carrying out the proper functions of our agency.
    • The accuracy of our estimate of the information collection burden.
    • The quality, utility, and clarity of the information to be collected.
    • Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.

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

    XIII. Response to Public Comments

    Because of the large number of items of correspondence we normally receive on a proposed rule, we are not able to acknowledge or respond to them individually. However, in preparing the final rule, we will consider all comments concerning the provisions of this proposed rule that we receive by the date and time specified in the DATES section of this preamble and respond to those comments in the preamble to that rule.

    Modification of 60-day Comment Period

    The highly complex analysis surrounding the possibility of a significant pro rata reduction has caused a delay in the publication of the proposed rule. It is essential for this rule to become effective by January 1, 2002 for hospital outpatient departments to receive appropriate higher payments and to ensure that beneficiaries receive the benefits of further reductions in beneficiary copayments. Congress has directed us to update payment rates annually, at the beginning of each calendar year. If the increased provider payments and reduced beneficiary copayments do not become effective by the statutory effective date of January 1, 2002, enormous uncertainty and administrative difficulties will result for beneficiaries, providers, and intermediaries. In addition, any delay in receiving increased provider payments or reduced beneficiary copayments will cause harm to providers and beneficiaries. Consequently, in order to avoid imposing this uncertainty and harm on beneficiaries, providers, and intermediaries and to meet the January 1, 2002 statutory effective date for the update to the OPPS payment rates, we find we must shorten the comment period to 40 days. For the reasons discussed above, we find there is good cause to modify the 60-day comment period. We further find that this comment cycle will give parties sufficient opportunity to comment adequately on our proposed rule. In addition, we are immediately posting this proposed rule on our website at http://www.hcfa.gov/​regs/​cms1159p.htm pending publication in the Federal Register to ensure the maximum possible opportunity for public comment.

    XIV. Regulatory Impact Analysis

    A. General

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

    The statutory effects of the provisions that would be implemented by this proposed rule result in expenditures exceeding $100 million per year. We estimate the total impact of these changes for CY 2002 payments compared to CY 2001 payments to be approximately a $450 million increase. Therefore, this proposed rule is an economically significant rule under Executive Order 12866, and a major rule under 5 U.S.C. 804(2).

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

    In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 603 of the RFA. With the exception of hospitals located in certain New England counties, for purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area (MSA) and has fewer than 100 beds, or New England County Metropolitan Area (NECMA). Section 601(g) of the Social Security Amendments of 1983 (Pub. L. 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the OPPS, we classify these hospitals as urban hospitals.

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

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

    Executive Order 13132 establishes certain requirements that an agency must meet when it publishes a proposed Start Printed Page 44714rule (and subsequent final rule) that imposes substantial direct costs on State and local governments, preempts State law, or otherwise has Federalism implications.

    We have examined this proposed rule in accordance with Executive Order 13132, Federalism, and have determined that it will not have any negative impact on the rights, roles, and responsibilities of State, local or tribal governments.

    B. Changes in This Proposed Rule

    We are proposing several changes to the OPPS that are required by the statute. We are required under section 1833(t)(3)(C)(ii) of the Act to update annually the conversion factor used to determine the APC payment rates. We are also required under section 1833(t)(8)(A) of the Act to revise, not less often than annually, the wage index and other adjustments. In addition, we must review the clinical integrity of payment groups and weights at least annually. Accordingly, in this proposed rule, we are updating the conversion factor and the wage index adjustment for hospital outpatient services furnished beginning January 1, 2002. We are also proposing revisions to the relative APC payment weights based on claims data from July 1, 1999 through June 30, 2000. Finally, we are proposing to begin calculating outlier payments on an APC-specific basis rather than the current method of calculating outlier payments for each claim.

    The projected aggregate impact of updating the conversion factor is to increase total payments to hospitals by 2.3 percent. As described in the preamble, budget neutrality adjustments are made to the conversion factor and the weights to assure that the revisions in the wage index, APC groups, and relative weights do not affect aggregate payments. In addition, the determination of the parameters for outlier payments have been modified so that projected outlier payments for 2002 are equivalent to the established policy target of 2.0 percent of total payments. Because we are not revising the target percentage, there is no estimated aggregate impact from modifying the method of determining outlier payments.

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

    C. Limitations of Our Analysis

    The distributional impacts represent the projected effects of the proposed policy changes, as well as statutory changes effective for 2002, on various hospital groups. We estimate the effects of individual policy changes by estimating payments per service while holding all other payment policies constant. We use the best data available but do not attempt to predict behavioral responses to our policy changes. In addition, we do not make adjustments for future changes in variables such as service volume, service mix, or number of encounters.

    D. Estimated Impacts of This Proposed Rule

    Column 5 in Table 6 represents the full impact on each hospital group of all the changes for 2002. Columns 2 through 4 in the table reflect the independent effects of the proposed change in the wage index, the APC reclassification and recalibration changes and the change in outlier method, respectively.

    In general, the wage index changes favor rural hospitals, particularly the largest in bed size and volume. The only rural hospitals that would experience a negative impact due to wage index changes are those in the Middle Atlantic and Pacific Regions, a decrease of 0.3 percent for each. Conversely, the urban hospitals are generally negatively affected by these changes, with the largest effect on those with 500 or more beds (0.6 percent decrease) and those in the Middle Atlantic (1.7 percent decrease) and West South Central Regions (1.5 percent decrease).

    We estimate that the APC reclassification and recalibration changes have generally an opposite impact from the wage index, causing increases for all urban hospitals except those with under 200 beds and volumes of fewer than 21,000 services per year and those located in the New England (a 0.1 percent decrease), Middle Atlantic (a 0.7 percent decrease), East North Central (a 0.55 percent decrease), and Puerto Rico (a 5.6 percent decrease) Regions.

    The change in outlier policy to an APC-specific payment has a slight negative effect on rural hospitals as a group (a 0.2 percent decrease), no effect on urban hospitals as a group, and slight negative effects on all smaller hospitals as well as those with lower volumes of services.

    The overall projected increase in payments for urban hospitals is slightly greater (2.4 percent) than the average increase for all hospitals while the increase for rural hospitals is somewhat less than the average increase (1.9 percent). Rural hospitals gain 1.2 percent from the wage index change, but lose a combined 1.7 percent from the APC changes and the change in method of determining outlier payments.

    In both urban and rural areas, hospitals that provide a higher volume of outpatient services are projected to receive a larger increase in payments than lower volume hospitals. In rural areas, hospitals with volumes of fewer than 5000 services are projected to experience a small decline in payments (−0.1 percent). The less favorable impact for the low volume hospitals is attributable to the APC changes and the change in outlier method. For example, rural hospitals providing fewer than 5000 services are projected to lose a combined 3 percent due to these changes.

    Urban hospitals in the Middle Atlantic region are projected to receive no increase in payments, and we estimate a decline of 0.1 percent for rural hospitals in this region. Both the urban and rural hospitals lose 2.4 percent due to the wage index change and APC changes. The urban hospitals are affected more by the wage index change (−1.7 percent), while rural hospitals are affected more by the recalibration (−2.1 percent). Urban hospitals in the East South Central Region are projected to experience the largest increase in payments (5.5 percent).

    Major teaching hospitals are projected to experience a smaller increase in payments (1.3 percent) than the aggregate for all hospitals due to negative impacts of the wage index (−0.7 percent), recalibration (−0.1 percent), and outlier changes (−0.2 percent). Hospitals with less intensive teaching programs are projected to experience an overall increase (3.0 percent) that is larger than the average for all hospitals. This is attributable to the fact that there is no impact on this group for the wage index change and positive impacts for both the APC changes (0.6 percent) and outlier changes (0.1). There is little difference in impact among hospitals with varying shares of low-income patients. Start Printed Page 44715

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

    [Percent changes in total payments (program and beneficiary)]

    Number of hospitals 1New wage index 2APC recalib.3New outlier policy 4All CY 2002 changes 5
    (1)(2)(3)(4)(5)
    ALL HOSPITALS5,0770.00.00.02.3
    NON-TEFRA HOSPITALS4,7010.00.00.02.3
    URBAN HOSPS2,608−0.30.40.02.4
    LARGE URBAN (GT 1 MILL.)1,495−0.50.10.01.9
    OTHER URBAN (LE 1 MILL.)1,113−0.10.70.13.1
    RURAL HOSPS2,0931.2−1.5−0.21.9
    BEDS (URBAN):
    0-99 BEDS6610.0−1.9−0.10.3
    100-199 BEDS918−0.3−0.40.11.8
    200-299 BEDS510−0.30.60.02.6
    300-499 BEDS374−0.31.10.13.2
    500 + BEDS145−0.61.10.02.7
    BEDS (RURAL):
    0—49 BEDS1,2490.4−2.4−0.6−0.2
    50-99 BEDS5060.7−2.2−0.20.6
    100-149 BEDS1981.6−0.70.03.2
    150-199 BEDS741.6−1.0−0.12.8
    200 + BEDS662.6−0.20.14.8
    VOLUME (URBAN):
    LT 5,000363−0.5−0.5−0.31.0
    5,000-10,999496−0.3−1.10.00.9
    11,000-20,999605−0.4−0.40.11.7
    21,000-42,999746−0.40.60.12.6
    GT 42,999398−0.20.60.02.7
    VOLUME (RURAL):
    LT 5,0001,0000.4−2.0−1.0−0.1
    5,000-10,9995690.5−2.3−0.20.2
    11,000-20,9993221.1−1.7−0.11.6
    21,000-42,9991711.7−0.90.03.0
    GT 42,999312.8−0.30.04.8
    REGION (URBAN):
    NEW ENGLAND1361.0−0.1−0.23.0
    MIDDLE ATLANTIC380−1.7−0.70.00.0
    SOUTH ATLANTIC4290.41.30.14.1
    EAST NORTH CENT444−0.4−0.50.11.5
    EAST SOUTH CENT1541.31.80.15.5
    WEST NORTH CENT183−0.10.20.12.5
    WEST SOUTH CENT323−1.51.60.02.3
    MOUNTAIN1290.11.20.03.6
    PACIFIC391−0.20.40.02.5
    PUERTO RICO391.2−5.6−0.2−2.3
    REGION (RURAL):
    NEW ENGLAND510.4−2.3−0.40.0
    MIDDLE ATLANTIC72−0.3−2.10.1−0.1
    SOUTH ATLANTIC2761.8−0.8−0.13.2
    EAST NORTH CENT2751.5−2.5−0.11.2
    EAST SOUTH CENT2501.5−0.9−0.12.8
    WEST NORTH CENT5011.3−2.1−0.31.2
    WEST SOUTH CENT3261.4−0.2−0.23.2
    MOUNTAIN2001.6−1.1−0.52.4
    PACIFIC137−0.3−1.2−0.20.6
    PUERTO RICO54.2−3.1−0.33.0
    TEACHING STATUS:
    NON-TEACHING3,5940.2−0.40.02.1
    MINOR8120.00.60.13.0
    MAJOR294−0.7−0.1−0.21.3
    DSH PATIENT PERCENT:
    0270.0−1.1−0.70.7
    GT 0-0.101,298−0.1−0.30.02.0
    0.10-0.161,0470.2−0.20.12.3
    0.16-0.23822−0.10.30.02.5
    0.23-0.358120.10.20.02.6
    GE 0.35695−0.20.1−0.32.0
    URBAN IME/DSH:
    IME & DSH1,012−0.40.50.02.4
    IME/NO DSH4−0.1−2.2−1.2−1.0
    NO IME/DSH1,578−0.20.20.12.4
    NO IME/NO DSH140.10.90.74.0
    Start Printed Page 44716
    RURAL HOSP. TYPES:
    NO SPECIAL STATUS7970.5−2.0−0.20.6
    RRC1712.3−0.50.14.2
    SCH/EACH6560.7−2.2−0.40.5
    MDH3270.2−2.5−0.5−0.4
    SCH AND RRC702.1−0.9−0.13.4
    TYPE OF OWNERSHIP:
    VOLUNTARY2,808−0.1−0.10.02.2
    PROPRIETARY7610.00.90.23.4
    GOVERNMENT1,1320.4−0.4−0.22.1
    SPECIALTY HOSPITALS:
    EYE AND EAR120.1−8.30.6−5.3
    TRAUMA154−0.2−0.1−0.11.9
    CANCER10−1.72.3−1.61.2
    TEFRA HOSPITALS (NOT INCLUDED ON OTHER LINES):
    REHAB164−1.810.0−1.08.9
    PSYCH88−1.4−0.6−3.5−3.1
    LTC83−0.7−2.3−0.2−1.0
    CHILDREN41−0.6−2.0−2.2−2.2
    1 Some data necessary to classify hospitals by category were missing; thus, the total number of hospitals in each category may not equal the national total.
    2 This column shows the impact of updating the wage index used to calculate payment using the proposed FY 2002 hospital inpatient wage index after geographic reclassification by the Medicare Geographic Classification Review Board. The hospital inpatient proposed rule for FY 2002 was published in the Federal Register on May 4, 2001.
    3 This column shows the impact of recalibrating the APC weights based on 1999-2000 hospital claims data and of the reassignment of some HCPCs to APCs as discussed in this rule.
    4 This column shows the difference in calculating outliers on an APC-specific rather than bill basis.
    5 This column shows changes in total payment from CY 2001 to CY 2002. It incorporates all of the changes reflected in columns 2, 3, and 4. In addition, it shows the impact of the CY 2002 payment update. The sum of the columns may be different from the percentage changes shown here due to rounding.

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

    Start List of Subjects

    List of Subjects

    42 CFR Part 413

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

    42 CFR Part 419

    • Hospitals
    • Medicare
    • Reporting and recordkeeping requirements

    42 CFR Part 489

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

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

    Start Part

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

    A. Part 413 is amended as set forth below:

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

    Start Authority

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

    End Authority

    Subpart B—Accounting Records and Reports

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

    Adequate cost data and cost finding.
    * * * * *

    (d) Cost finding methods. * * *

    (6) Provider-based entities and departments: Preventing duplication of cost. In some situations, the main provider in a provider-based complex may purchase services for a provider-based entity or for a department of the provider through a contract for services (for example, a management contract), directly assigning the costs to the provider-based entity or department and reporting the costs directly in the cost center for that entity or department. In any situation in which costs are directly assigned to a cost center, there is a risk of excess cost in that cost center resulting from the directly assigned costs plus a share of overhead improperly allocated to the cost center which duplicates the directly assigned costs. This duplication could result in improper Medicare payment to the provider. Where a provider has purchased services for a provider-based entity or for a provider department, like general service costs of the provider (for example, like costs in the administrative and general cost center) must be separately identified to ensure that they are not improperly allocated to the entity or the department. If the like costs of the main provider cannot be separately identified, the costs of the services purchased through a contract Start Printed Page 44717must be reclassified to the main provider and allocated among the main provider's benefiting cost centers.

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

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

    * * * * *

    Subpart E—Payments to Providers

    3. Section 413.65 is amended as follows:

    A. Revising paragraph (a)(1).

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

    C. Revising paragraph (b).

    D. Revising paragraph (c).

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

    F. Revising paragraph (d)(7).

    G. Revising paragraph (g)(7).

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

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

    J. Revising paragraph (i)(2).

    The revisions read as follows:

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

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

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

    (A) Ambulatory surgical centers (ASCs).

    (B) Comprehensive outpatient rehabilitation facilities (CORFs).

    (C) Home health agencies (HHAs).

    (D) Skilled nursing facilities (SNFs).

    (E) Hospices.

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

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

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

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

    (2) Definitions. * * *

    * * * * *

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

    * * * * *

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

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

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

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

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

    (c) Reporting. A main provider that has had one or more facilities considered provider-based also must report to CMS any material change in the relationship between it and any Start Printed Page 44718provider-based facility, such as a change in ownership of the facility or entry into a new or different management contract that could affect the provider-based status of the facility.

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

    * * * * *

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

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

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

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

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

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

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

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

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

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

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

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

    * * * * *

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

    * * * * *

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

    * * * * *

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

    * * * * *

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

    * * * * *

    (2) Recovery of overpayments. If CMS finds that payments for services at the facility or organization have been made as if the facility or organization were provider-based, even though CMS had not previously determined that the facility or organization qualified for provider-based status, CMS will recover the difference between the amount of payments that actually were made and the amount of payments that CMS estimates should have been made in the absence of a determination of provider-based status, except that recovery will not be made for any period before the beginning of the hospital's first cost reporting period beginning or or after January 10, 2001 if during all of that period the management of the entity made a good faith effort to operate it as a provider-based facility or organization, as described in paragraph (h)(3) of this section.

    * * * * *
    End Part Start Part

    PART 419—PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

    B. Part 419 is amended as set forth below:

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

    Start Authority

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

    End Authority

    Subpart A—General Provisions

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

    Basis of payment.
    * * * * *
    Start Printed Page 44719

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

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

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

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

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

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

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

    (7) Organ acquisition costs paid under Part B.

    (8) Corneal tissue acquisition costs.

    Subpart B—Categories of Hospitals and Services Subject to and Excluded From the Hospital Outpatient Prospective Payment System

    3. In § 419.20, paragraph (a) is revised, and paragraphs (b)(3) and (b)(4) are added to read as follows:

    Hospitals subject to the hospital outpatient prospective payment system.

    (a) Applicability. The hospital outpatient prospective payment system is applicable to any hospital participating in the Medicare program, except those specified in paragraph (b) of this section, for services furnished on or after August 1, 2000.

    (b) Hospitals excluded from the outpatient prospective payment system.

    * * * * *

    (3) A hospital located outside one of the 50 States, the District of Columbia, and Puerto Rico is excluded from the hospital outpatient prospective payment system.

    (4) A hospital of the Indian Health Service.

    4. In § 419.22, the introductory text is republished, and paragraph (r) is added to read as follows:

    Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system.

    The following services are not paid for under the hospital outpatient prospective payment system:

    * * * * *

    (r) Services defined in § 419.21(b) that are furnished to inpatients of hospitals that do not submit claims for outpatient services under Medicare Part B.

    Subpart C—Basic Methodology for Determining Prospective Payment Rates for Hospital Outpatient Services

    5. In § 419.32, paragraph (b)(1) is revised to read as follows:

    Calculation of prospective payment rates for hospital outpatient services.
    * * * * *

    (b) Conversion factor for calendar year 2000 and subsequent years. (1) Subject to paragraph (b)(2) of this section, the conversion factor for a calendar year is equal to the conversion factor calculated for the previous year adjusted as follows:

    (i) For calendar year 2000, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point.

    (ii) For calendar year 2001—

    (A) For services furnished on or after January 1, 2001 and before April 1, 2001, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point; and

    (B) For services furnished on or after April 1, 2001 and before January 1, 2002, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act, and increased by a transitional percentage allowance equal to 0.32 percent.

    (iii) For calendar year 2002, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point, without taking into account the transitional percentage allowance referenced in § 419.32(b)(ii)(B).

    (iv) For calendar year 2003 and subsequent years, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act.

    * * * * *

    Subpart D—Payments to Hospitals

    6. In § 419.40, the word “coinsurance” is removed and the word “copayment” is added in its place as follows:

    Payment concepts.

    (a) In addition to the payment rate described in § 419.32, for each APC group there is a predetermined beneficiary copayment amount as described in § 419.41(a). The Medicare program payment amount for each APC group is calculated by applying the program payment percentage as described in § 419.41(b).

    (b) For purposes of this section—

    (1) Coinsurance percentage is calculated as the difference between the program payment percentage and 100 percent. The coinsurance percentage in any year is thus defined for each APC group as the greater of the following: the ratio of the APC group unadjusted copayment amount to the annual APC group payment rate, or 20 percent.

    (2) Program payment percentage is calculated as the lower of the following: the ratio of the APC group payment rate minus the APC group unadjusted copayment amount, to the APC group payment rate, or 80 percent.

    (3) Unadjusted copayment amount is calculated as 20 percent of the wage-adjusted national median of charges for services within an APC group furnished during 1996, updated to 1999 using an actuarial projection of charge increases for hospital outpatient department services during the period 1996 to 1999.

    (c) Limitation of copayment amount to inpatient hospital deductible amount. The copayment amount for a procedure performed in a year cannot exceed the amount of the inpatient hospital deductible established under section 1813(b) of the Act for that year.

    7. Amend § 419.41 as follows:

    A. The section heading is revised.

    B. The word “coinsurance” is removed each time it appears, and the word “copayment” is added in its place.

    C. Paragraph (c)(4)(ii) is redesignated as paragraph (c)(4)(iv).

    D. Paragraphs (c)(4)(ii) and (c)(4)(iii) are added as follows:

    Calculation of national beneficiary copayment amounts and national Medicare program payment amounts.

    (c) * * *

    (4) * * *

    (i) Effective for services furnished from April 1, 2001 through December 31, 2001, the national unadjusted coinsurance rate for an APC cannot exceed 57 percent of the prospective payment rate for that APC.

    (ii) The national unadjusted coinsurance rate for an APC cannot exceed 55 percent in calendar years Start Printed Page 447202002 and 2003; 50 percent in calendar year 2004; 45 percent in calendar year 2005; and 40 percent in calendar year 2006 and thereafter.

    * * * * *

    8. In § 419.42 paragraph (a), (c), and (e) are revised as follows:

    Hospital election to reduce coinsurance.

    (a) A hospital may elect to reduce coinsurance for any or all APC groups on a calendar year basis. A hospital may not elect to reduce copayment amounts for some, but not all, services within the same group.

    * * * * *

    (c) The hospital's election must be properly documented. It must specifically identify the APCs to which it applies and the copayment amount (within the limits identified below) that the hospital has selected for each group.

    * * * * *

    (e) In electing reduced coinsurance, a hospital may elect a copayment amount that is less than that year's wage-adjusted copayment amount for the group but not less than 20 percent of the APC payment rate as determined in § 419.32.

    * * * * *
    [Amended]

    9. Section 419.43 is amended by removing the word “coinsurance” from the section heading and from paragraph (a), and adding the word “copayment” in its place.

    Subpart G—Transitional Corridors

    10. In § 419.70, paragraph (d)(2) is revised to read as follows:

    Transitional adjustment to limit decline in payment.
    * * * * *

    (d) Hold harmless provisions * * *

    * * * * *

    (2) Permanent treatment for cancer hospitals and children's hospitals. In the case of a hospital described in § 412.23(d) or § 412.23(f) of this chapter for which the prospective payment system amount is less than the pre-BBA amount for covered hospital outpatient services, the amount of payment under this part is increased by the amount of this difference.

    * * * * *
    End Part Start Part

    PART 489—PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

    C. Part 489 is amended as set forth below:

    1. The authority citation to part 489 continues to read as follows:

    Start Authority

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

    End Authority

    Subpart B—Essentials of Provider Agreements

    2. In § 489.24, paragraph (i)(2)(ii) is revised to read as follows:

    Special responsibilities of Medicare hospitals in emergency cases.
    * * * * *

    (i) Off-campus departments. * * *

    (2) Protocols for off-campus departments. * * *

    * * * * *

    (ii) If the off-campus department is a physical therapy, radiology, or other facility not routinely staffed with physicians, RNs, or LPNs, the department's personnel must be given protocols that direct them to contact emergency personnel at the main hospital campus for direction. Under this direction, and in accordance with protocols established in advance by the hospital, the personnel at the off-campus department must describe patient appearance and report symptoms and, if appropriate, either arrange transportation of the individual to the main hospital campus in accordance with paragraph (i)(3)(i) of this section or assist in an appropriate transfer as described in paragraphs (i)(3)(ii) and (d)(2) of this section. Any contact with emergency personnel at the main hospital campus should either be made after or concurrently with the actions needed to arrange an appropriate transfer under paragraph (i)(3)(ii) of this section if doing otherwise would significantly jeopardize the life or health of the individual.

    * * * * *

    (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

    Start Signature

    Dated: August 3, 2001.

    Thomas A. Scully,

    Administrator, Centers for Medicare & Medicaid Services.

    Approved: August 3, 2001.

    Tommy G. Thompson,

    Secretary.

    End Signature

    Addendum A.—List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment Rates, and Copayment Amounts Calendar Year 2002

    APCGroup TitleStatus IndicatorRelative WeightPayment RateNational Unadjusted CopaymentMinimum Unadjusted Copayment
    0001PhotochemotherapyS0.45$22.88$8.24$4.58
    0002Fine needle Biopsy/AspirationT0.47$23.90$13.14$4.78
    0003Bone Marrow Biopsy/AspirationT1.11$56.43$27.99$11.29
    0004Level I Needle Biopsy/ Aspiration Except Bone MarrowT3.00$152.53$32.57$30.51
    0005Level II Needle Biopsy /Aspiration Except Bone MarrowT6.71$341.15$119.75$68.23
    0006Level I Incision & DrainageT2.36$119.99$33.95$24.00
    0007Level II Incision & DrainageT7.28$370.13$74.03$74.03
    0008Level III Incision and DrainageT11.36$577.57$115.51$115.51
    0009Nail ProceduresT0.68$34.57$8.99$6.91
    0010Level I Destruction of LesionT0.71$36.10$9.86$7.22
    0011Level II Destruction of LesionT1.57$79.82$29.53$15.96
    0012Level I Debridement & DestructionT0.72$36.61$9.18$7.32
    0013Level II Debridement & DestructionT1.51$76.77$17.66$15.35
    0015Level IV Debridement & DestructionT2.29$116.43$31.20$23.29
    0016Level V Debridement & DestructionT3.31$168.29$70.68$33.66
    0017Level VI Debridement & DestructionT10.51$534.35$245.80$106.87
    0018Biopsy of Skin/Puncture of LesionT1.16$58.98$17.66$11.80
    0019Level I Excision/ BiopsyT4.56$231.84$78.91$46.37
    0020Level II Excision/ BiopsyT8.56$435.21$130.53$87.04
    0021Level IV Excision/ BiopsyT12.74$647.73$236.51$129.55
    0022Level V Excision/ BiopsyT15.07$766.19$292.94$153.24
    0023Exploration Penetrating WoundT2.18$110.84$40.37$22.17
    0024Level I Skin RepairT2.48$126.09$44.50$25.22
    0025Level II Skin RepairT3.71$188.62$70.66$37.72
    Start Printed Page 44721
    0026Level III Skin RepairT13.51$686.88$277.92$137.38
    0027Level IV Skin RepairT19.31$981.76$383.10$196.35
    0028Level I Incision/Excision BreastT14.95$760.09$303.74$152.02
    0029Level II Incision/Excision BreastT35.93$1,826.75$820.79$365.35
    0030Level I Breast ReconstructionT25.95$1,319.35$646.48$263.87
    0032Insertion of Central Venous/Arterial CatheterT7.16$364.03$119.52$72.81
    0033Partial HospitalizationP4.17$212.01$42.40
    0035Placement of Arterial or Central Venous CatheterT0.13$6.61$2.18$1.32
    0041ArthroscopyT26.18$1,331.04$592.08$266.21
    0042Arthroscopically-Aided ProceduresT39.39$2,002.67$804.74$400.53
    0043Closed Treatment Fracture Finger/Toe/TrunkT4.13$209.98$42.00$42.00
    0044Closed Treatment Fracture/Dislocation Except Finger/Toe/TrunkT2.73$138.80$38.08$27.76
    0045Bone/Joint Manipulation Under AnesthesiaT12.91$656.37$277.12$131.27
    0046Open/Percutaneous Treatment Fracture or DislocationT25.36$1,289.35$535.76$257.87
    0047Arthroplasty without ProsthesisT28.54$1,451.03$537.03$290.21
    0048Arthroplasty with ProsthesisT32.37$1,645.76$725.94$329.15
    0049Level I Musculoskeletal Procedures Except Hand and FootT17.07$867.87$356.95$173.57
    0050Level II Musculoskeletal Procedures Except Hand and FootT22.31$1,134.29$513.86$226.86
    0051Level III Musculoskeletal Procedures Except Hand and FootT30.94$1,573.05$675.24$314.61
    0052Level IV Musculoskeletal Procedures Except Hand and FootT38.88$1,976.74$930.91$395.35
    0053Level I Hand Musculoskeletal ProceduresT12.67$644.17$253.49$128.83
    0054Level II Hand Musculoskeletal ProceduresT20.84$1,059.55$472.33$211.91
    0055Level I Foot Musculoskeletal ProceduresT16.77$852.62$355.34$170.52
    0056Level II Foot Musculoskeletal ProceduresT19.20$976.17$405.81$195.23
    0057Bunion ProceduresT21.11$1,073.27$496.65$214.65
    0058Level I Strapping and Cast ApplicationS1.36$69.15$19.27$13.83
    0059Level II Strapping and Cast ApplicationS2.34$118.97$29.59$23.79
    0060Manipulation TherapyS0.25$12.71$2.54$2.54
    0068CPAP InitiationS3.33$169.30$93.12$33.86
    0069ThoracoscopyT25.62$1,302.57$612.21$260.51
    0070Thoracentesis/Lavage ProceduresT4.11$208.96$79.60$41.79
    0071Level I Endoscopy Upper AirwayT1.08$54.91$14.22$10.98
    0072Level II Endoscopy Upper AirwayT1.29$65.59$36.08$13.12
    0073Level III Endoscopy Upper AirwayT3.54$179.98$79.19$36.00
    0074Level IV Endoscopy Upper AirwayT14.62$743.31$347.54$148.66
    0075Level V Endoscopy Upper AirwayT19.08$970.07$467.29$194.01
    0076Endoscopy Lower AirwayT8.22$417.92$197.05$83.58
    0077Level I Pulmonary TreatmentS0.42$21.35$11.74$4.27
    0078Level II Pulmonary TreatmentS0.93$47.28$20.33$9.46
    0079Ventilation Initiation and ManagementS0.62$31.52$17.34$6.30
    0080Diagnostic Cardiac CatheterizationT32.20$1,637.11$838.92$327.42
    0081Non-Coronary Angioplasty or AtherectomyT22.04$1,120.56$549.07$224.11
    0082Coronary AtherectomyT130.89$6,654.71$1,351.74$1,330.94
    0083Coronary AngioplastyT50.15$2,549.73$794.30$509.95
    0084Level I Electrophysiologic EvaluationS4.94$251.16$82.88$50.23
    0085Level II Electrophysiologic EvaluationS27.39$1,392.56$654.48$278.51
    0086Ablate Heart Dysrhythm FocusS47.13$2,396.18$1,265.37$479.24
    0087Cardiac Electrophysiologic Recording/MappingS14.89$757.04$214.72$151.41
    0088ThrombectomyT29.11$1,480.01$678.68$296.00
    0089Insertion/Replacement of Permanent Pacemaker and ElectrodesT82.60$4,199.55$2,246.59$839.91
    0090Insertion/Replacement of Pacemaker Pulse GeneratorT73.37$3,730.28$2,014.35$746.06
    0091Level I Vascular LigationT22.17$1,127.17$348.23$225.43
    0092Level II Vascular LigationT21.43$1,089.54$505.37$217.91
    0093Vascular Repair/Fistula ConstructionT15.05$765.17$277.34$153.03
    0094Resuscitation and CardioversionS5.69$289.29$105.29$57.86
    0095Cardiac RehabilitationS0.66$33.56$16.98$6.71
    0096Non-Invasive Vascular StudiesS1.87$95.07$52.29$19.01
    0097Cardiac Monitoring for 30 daysX0.87$44.23$24.33$8.85
    0098Injection of Sclerosing SolutionT1.34$68.13$20.88$13.63
    0099ElectrocardiogramsS0.38$19.32$10.63$3.86
    0100Stress Tests and Continuous ECGX1.63$82.87$45.58$16.57
    0101Tilt Table EvaluationS4.03$204.89$112.69$40.98
    0103Miscellaneous Vascular ProceduresT10.91$554.69$249.61$110.94
    0104Transcatheter Placement of Intracoronary StentsT71.42$3,631.14$726.23$726.23
    0105Revision/Removal of Pacemakers, AICD, or Vascular DeviceT16.56$841.94$372.32$168.39
    0106Insertion/Replacement/Repair of Pacemaker and/or ElectrodesT15.82$804.32$426.29$160.86
    0107Insertion of Cardioverter-DefibrillatorT155.27$7,894.24$4,224.27$1,578.85
    0108Insertion/Replacement/Repair of Cardioverter-Defibrillator LeadsT159.42$8,105.23$4,214.72$1,621.05
    0109Removal of Implanted DevicesT6.57$334.03$133.51$66.81
    0110TransfusionS5.76$292.85$122.70$58.57
    0111Blood Product ExchangeS16.69$848.55$300.74$169.71
    0112Apheresis, Photopheresis, and PlasmapheresisS39.75$2,020.97$663.65$404.19
    0113Excision Lymphatic SystemT16.87$857.70$326.55$171.54
    0114Thyroid/Lymphadenectomy ProceduresT30.50$1,550.68$493.78$310.14
    0115Cannula/Access Device ProceduresT19.06$969.05$503.91$193.81
    0116Chemotherapy Administration by Other Technique Except InfusionS0.98$49.83$9.97$9.97
    0117Chemotherapy Administration by Infusion OnlyS3.48$176.93$52.69$35.39
    0118Chemotherapy Administration by Both Infusion and Other TechniqueS3.52$178.96$72.03$35.79
    Start Printed Page 44722
    0119Implantation of DevicesT14.37$730.60$161.50$146.12
    0120Infusion Therapy Except ChemotherapyT2.35$119.48$42.67$23.90
    0121Level I Tube changes and RepositioningT2.42$123.04$52.53$24.61
    0122Level II Tube changes and RepositioningT5.69$289.29$114.93$57.86
    0123Bone Marrow Harvesting and Bone Marrow/Stem Cell TransplantS10.12$514.52$102.90$102.90
    0124Revision of Implanted Infusion PumpT25.84$1,313.76$722.57$262.75
    0125Refilling of Infusion PumpT3.20$162.69$32.54
    0130Level I LaparoscopyT27.92$1,419.51$659.53$283.90
    0131Level II LaparoscopyT39.80$2,023.51$1,052.23$404.70
    0132Level III LaparoscopyT60.31$3,066.28$1,239.22$613.26
    0140Esophageal Dilation without EndoscopyT5.73$291.32$107.24$58.26
    0141Upper GI ProceduresT7.46$379.28$184.67$75.86
    0142Small Intestine EndoscopyT7.61$386.91$162.42$77.38
    0143Lower GI EndoscopyT7.87$400.13$198.46$80.03
    0144Diagnostic AnoscopyT1.97$100.16$44.07$20.03
    0145Therapeutic AnoscopyT12.11$615.70$179.39$123.14
    0146Level I SigmoidoscopyT2.95$149.98$65.15$30.00
    0147Level II SigmoidoscopyT6.15$312.68$146.96$62.54
    0148Level I Anal/Rectal ProcedureT2.58$131.17$43.59$26.23
    0149Level III Anal/Rectal ProcedureT14.49$736.70$293.06$147.34
    0150Level IV Anal/Rectal ProcedureT19.58$995.49$437.12$199.10
    0151Endoscopic Retrograde Cholangio-Pancreatography (ERCP)T16.22$824.66$245.46$164.93
    0152Percutaneous Biliary Endoscopic ProceduresT17.44$886.68$207.38$177.34
    0153Peritoneal and Abdominal ProceduresT22.44$1,140.89$496.31$228.18
    0154Hernia/Hydrocele ProceduresT24.09$1,224.78$556.98$244.96
    0155Level II Anal/Rectal ProcedureT5.73$291.32$96.14$58.26
    0156Level II Urinary and Anal ProceduresT2.62$133.21$39.96$26.64
    0157Colorectal Cancer Screening: Barium EnemaS2.14$108.80$27.20
    0158Colorectal Cancer Screening: ColonoscopyS7.00$355.89$88.97
    0159Colorectal Cancer Screening: Flexible SigmoidoscopyS2.51$127.61$31.90
    0160Level I Cystourethroscopy and other Genitourinary ProceduresT5.98$304.04$110.11$60.81
    0161Level II Cystourethroscopy and other Genitourinary ProceduresT16.45$836.35$249.36$167.27
    0162Level III Cystourethroscopy and other Genitourinary ProceduresT19.86$1,009.72$427.49$201.94
    0163Level IV Cystourethroscopy and other Genitourinary ProceduresT30.27$1,538.99$792.58$307.80
    0164Level I Urinary and Anal ProceduresT0.98$49.83$14.95$9.97
    0165Level III Urinary and Anal ProceduresT5.36$272.51$91.76$54.50
    0166Level I Urethral ProceduresT13.02$661.96$218.73$132.39
    0167Level II Urethral ProceduresT24.18$1,229.36$555.84$245.87
    0168Level III Urethral ProceduresT31.68$1,610.67$536.11$322.13
    0169LithotripsyT42.65$2,168.41$1,192.63$433.68
    0170Dialysis for Other Than ESRD PatientsS1.08$54.91$12.08$10.98
    0180CircumcisionT16.29$828.22$304.87$165.64
    0181Penile ProceduresT24.07$1,223.77$673.07$244.75
    0182Insertion of Penile ProsthesisT85.94$4,369.36$1,492.28$873.87
    0183Testes/Epididymis ProceduresT20.37$1,035.65$448.94$207.13
    0184Prostate BiopsyT5.23$265.90$122.96$53.18
    0185Removal or Repair of Penile ProsthesisT57.17$2,906.64$906.36$581.33
    0187Placement/Repositioning Misc CathetersT4.54$230.82$113.10$46.16
    0188Level II Female Reproductive ProcT0.83$42.20$12.24$8.44
    0189Level III Female Reproductive ProcT1.38$70.16$17.54$14.03
    0190Surgical HysteroscopyT18.27$928.88$443.89$185.78
    0191Level I Female Reproductive ProcT0.27$13.73$3.98$2.75
    0192Level IV Female Reproductive ProcT2.73$138.80$35.33$27.76
    0193Level V Female Reproductive ProcT12.17$618.75$171.13$123.75
    0194Level VI Female Reproductive ProcT17.18$873.47$395.94$174.69
    0195Level VII Female Reproductive ProcT22.22$1,129.71$483.80$225.94
    0196Dilation and CurettageT14.62$743.31$357.98$148.66
    0197Infertility ProceduresT2.58$131.17$49.55$26.23
    0198Pregnancy and Neonatal Care ProceduresT1.42$72.20$33.03$14.44
    0199Vaginal DeliveryT4.20$213.54$59.79$42.71
    0200Therapeutic AbortionT13.74$698.57$373.23$139.71
    0201Spontaneous AbortionT14.89$757.04$329.65$151.41
    0202Level VIII Female Reproductive ProcT39.56$2,011.31$864.86$402.26
    0203Level V Nerve InjectionsT7.62$387.42$166.59$77.48
    0204Level VI Nerve InjectionsT2.44$124.05$47.14$24.81
    0206Level III Nerve InjectionsT3.88$197.27$82.85$39.45
    0207Level IV Nerve InjectionsT4.13$209.98$94.49$42.00
    0208Laminotomies and LaminectomiesT30.93$1,572.54$314.51$314.51
    0209Extended EEG Studies and Sleep Studies, Level IIS11.73$596.38$310.12$119.28
    0212Level II Nervous System InjectionsT4.17$212.01$88.78$42.40
    0213Extended EEG Studies and Sleep Studies, Level IS2.95$149.98$77.99$30.00
    0214ElectroencephalogramS2.27$115.41$57.71$23.08
    0215Level I Nerve and Muscle TestsS0.66$33.56$17.45$6.71
    0216Level III Nerve and Muscle TestsS2.91$147.95$64.69$29.59
    0218Level II Nerve and Muscle TestsS1.09$55.42$23.83$11.08
    0220Level I Nerve ProceduresT14.76$750.43$326.21$150.09
    0221Level II Nerve ProceduresT22.68$1,153.10$463.62$230.62
    0222Implantation of Neurological DeviceT112.50$5,719.73$2,688.27$1,143.95
    Start Printed Page 44723
    0223Implantation of Pain Management DeviceT8.87$450.97$154.27$90.19
    0224Implantation of Reservoir/Pump/ShuntT29.95$1,522.72$453.41$304.54
    0225Implantation of Neurostimulator ElectrodesT33.75$1,715.92$408.33$343.18
    0226Implantation of Drug Infusion ReservoirT8.91$453.00$109.42$90.60
    0227Implantation of Drug Infusion DeviceT94.89$4,824.40$964.88$964.88
    0228Creation of Lumbar Subarachnoid ShuntT47.98$2,439.40$696.46$487.88
    0229Transcatherter Placement of Intravascular ShuntsT60.07$3,054.08$996.86$610.82
    0230Level I Eye Tests & TreatmentsS0.64$32.54$14.97$6.51
    0231Level III Eye Tests & TreatmentsS2.27$115.41$51.94$23.08
    0232Level I Anterior Segment Eye ProceduresT3.69$187.61$82.55$37.52
    0233Level II Anterior Segment Eye ProceduresT11.78$598.92$287.48$119.78
    0234Level III Anterior Segment Eye ProceduresT20.56$1,045.31$502.16$209.06
    0235Level I Posterior Segment Eye ProceduresT5.39$274.04$78.91$54.81
    0236Level II Posterior Segment Eye ProceduresT17.75$902.45$180.49$180.49
    0237Level III Posterior Segment Eye ProceduresT33.56$1,706.26$852.68$341.25
    0238Level I Repair and Plastic Eye ProceduresT2.84$144.39$58.96$28.88
    0239Level II Repair and Plastic Eye ProceduresT6.25$317.76$123.42$63.55
    0240Level III Repair and Plastic Eye ProceduresT14.86$755.51$315.31$151.10
    0241Level IV Repair and Plastic Eye ProceduresT19.20$976.17$384.47$195.23
    0242Level V Repair and Plastic Eye ProceduresT25.31$1,286.81$597.36$257.36
    0243Strabismus/Muscle ProceduresT19.22$977.18$431.39$195.44
    0244Corneal TransplantT41.43$2,106.38$851.42$421.28
    0245Level I Cataract Procedures without IOL InsertT10.75$546.55$256.88$109.31
    0246Cataract Procedures with IOL InsertT22.36$1,136.83$534.31$227.37
    0247Laser Eye Procedures Except RetinalT4.73$240.48$110.62$48.10
    0248Laser Retinal ProceduresT4.15$210.99$94.05$42.20
    0249Level II Cataract Procedures without IOL InsertT23.51$1,195.30$561.79$239.06
    0250Nasal Cauterization/PackingT2.27$115.41$38.54$23.08
    0251Level I ENT ProceduresT2.71$137.78$27.99$27.56
    0252Level II ENT ProceduresT6.53$332.00$114.24$66.40
    0253Level III ENT ProceduresT13.27$674.67$284.00$134.93
    0254Level IV ENT ProceduresT19.11$971.59$272.41$194.32
    0256Level V ENT ProceduresT28.82$1,465.27$623.05$293.05
    0258Tonsil and Adenoid ProceduresT18.86$958.88$462.81$191.78
    0259Level VI ENT ProceduresT306.15$15,565.28$6,537.42$3,113.06
    0260Level I Plain Film Except TeethX0.76$38.64$21.25$7.73
    0261Level II Plain Film Except Teeth Including Bone Density MeasurementX1.31$66.60$36.63$13.32
    0262Plain Film of TeethX0.66$33.56$10.90$6.71
    0263Level I Miscellaneous Radiology ProceduresX1.74$88.47$45.88$17.69
    0264Level II Miscellaneous Radiology ProceduresX2.51$127.61$70.19$25.52
    0265Level I Diagnostic Ultrasound Except VascularS1.02$51.86$28.52$10.37
    0266Level II Diagnostic Ultrasound Except VascularS1.67$84.91$46.70$16.98
    0267Vascular UltrasoundS2.58$131.17$72.14$26.23
    0269Level I Echocardiogram Except TransesophagealS4.31$219.13$113.95$43.83
    0270Transesophageal EchocardiogramS5.83$296.41$150.26$59.28
    0271MammographyS0.64$32.54$17.90$6.51
    0272Level I FluoroscopyX1.47$74.74$39.00$14.95
    0274MyelographyS5.69$289.29$128.12$57.86
    0275ArthrographyS2.82$143.37$72.26$28.67
    0276Level I Digestive RadiologyS1.63$82.87$45.58$16.57
    0277Level II Digestive RadiologyS2.35$119.48$65.71$23.90
    0278Diagnostic UrographyS2.56$130.16$71.59$26.03
    0279Level I Angiography and Venography except ExtremityS8.37$425.55$174.57$85.11
    0280Level II Angiography and Venography except ExtremityS14.40$732.12$373.38$146.42
    0281Venography of ExtremityS4.64$235.91$115.16$47.18
    0282Miscellaneous Computerized Axial TomographyS1.63$82.87$45.58$16.57
    0283Computerized Axial Tomography with Contrast MaterialS4.89$248.62$136.74$49.72
    0284Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contrast MaterialS7.80$396.57$218.11$79.31
    0285Positron Emission Tomography (PET)S20.07$1,020.40$415.21$204.08
    0286Myocardial ScansS5.85$297.43$163.58$59.49
    0287Complex VenographyS4.33$220.15$90.26$44.03
    0288CT, Bone DensityS1.27$64.57$35.51$12.91
    0289Needle Localization for Breast BiopsyX1.22$62.03$32.25$12.41
    0290Standard Non-Imaging Nuclear MedicineS1.91$97.11$53.41$19.42
    0291Level I Diagnostic Nuclear Medicine Excluding Myocardial ScansS3.78$192.18$90.20$38.44
    0292Level II Diagnostic Nuclear Medicine Excluding Myocardial ScansS4.56$231.84$124.85$46.37
    0294Level I Therapeutic Nuclear MedicineS5.45$277.09$144.06$55.42
    0295Level II Therapeutic Nuclear MedicineS13.97$710.26$390.64$142.05
    0296Level I Therapeutic Radiologic ProceduresS3.52$178.96$98.43$35.79
    0297Level II Therapeutic Radiologic ProceduresS7.80$396.57$172.51$79.31
    0300Level I Radiation TherapyS2.25$114.39$47.72$22.88
    0301Level II Radiation TherapyS5.85$297.43$59.49$59.49
    0302Level III Radiation TherapyS11.96$608.07$216.55$121.61
    0303Treatment Device ConstructionX3.98$202.35$69.28$40.47
    0304Level I Therapeutic Radiation Treatment PreparationX1.80$91.52$41.52$18.30
    0305Level II Therapeutic Radiation Treatment PreparationX4.40$223.70$97.50$44.74
    0310Level III Therapeutic Radiation Treatment PreparationX17.14$871.43$339.05$174.29
    Start Printed Page 44724
    0312Radioelement ApplicationsS7.77$395.04$109.65$79.01
    0313BrachytherapyS16.31$829.23$165.85$165.85
    0314Hyperthermic TherapiesS5.16$262.34$133.80$52.47
    0320Electroconvulsive TherapyS4.20$213.54$80.06$42.71
    0321Biofeedback and Other TrainingS1.02$51.86$23.86$10.37
    0322Brief Individual PsychotherapyS1.25$63.55$13.35$12.71
    0323Extended Individual PsychotherapyS1.89$96.09$22.48$19.22
    0324Family PsychotherapyS3.13$159.14$31.83$31.83
    0325Group PsychotherapyS1.49$75.75$19.70$15.15
    0330Dental ProceduresS7.68$390.47$78.09$78.09
    0332Computerized Axial Tomography and Computerized Angiography without Contrast MaterialS3.51$178.46$98.15$35.69
    0333Computerized Axial Tomography and Computerized Angiography without Contrast Material followed by Contrast MaterialS5.66$287.77$158.27$57.55
    0335Magnetic Resonance Imaging, MiscellaneousS5.91$300.48$165.26$60.10
    0336Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast MaterialS6.85$348.27$191.55$69.65
    0337Magnetic Resonance Imaging and Magnetic Resonance Angiography without Contrast Material followed by Contrast MaterialS9.26$470.80$258.94$94.16
    0339ObservationX7.38$375.21$75.04
    0340Minor Ancillary ProceduresX0.91$46.27$11.57$9.25
    0341Immunology TestsX0.11$5.59$3.08$1.12
    0342Level I PathologyX0.22$11.19$6.15$2.24
    0343Level II PathologyX0.42$21.35$11.53$4.27
    0344Level III PathologyX0.60$30.51$16.78$6.10
    0345Level I Transfusion Laboratory ProceduresX0.29$14.74$5.37$2.95
    0346Level II Transfusion Laboratory ProceduresX0.83$42.20$12.03$8.44
    0347Level III Transfusion Laboratory ProceduresX1.73$87.96$20.13$17.59
    0348Fertility Laboratory ProceduresX0.85$43.22$8.64$8.64
    0349Miscellaneous Laboratory ProceduresX0.34$17.29$3.46$3.46
    0352Level II InjectionsX0.45$22.88$4.58$4.58
    0353Level II Allergy InjectionsX0.27$13.73$2.75$2.75
    0354Administration of Influenza/Pneumonia VaccineK0.11$5.59
    0355Level I ImmunizationsK0.20$10.17$2.03
    0356Level II ImmunizationsK1.20$61.01$12.20
    0359Level II InjectionsX1.91$97.11$19.42$19.42
    0360Level I Alimentary TestsX1.40$71.18$34.75$14.24
    0361Level II Alimentary TestsX3.52$178.96$88.09$35.79
    0362Fitting of Vision AidsX0.83$42.20$9.63$8.44
    0363Otorhinolaryngologic Function TestsX2.06$104.73$38.75$20.95
    0364Level I AudiometryX0.55$27.96$10.91$5.59
    0365Level II AudiometryX1.42$72.20$21.66$14.44
    0367Level I Pulmonary TestX0.76$38.64$19.32$7.73
    0368Level II Pulmonary TestsX1.53$77.79$39.67$15.56
    0369Level III Pulmonary TestsX3.99$202.86$58.50$40.57
    0370Allergy TestsX0.87$44.23$11.81$8.85
    0371Level I Allergy InjectionsX0.76$38.64$7.73$7.73
    0372Therapeutic PhlebotomyX0.57$28.98$10.09$5.80
    0373Neuropsychological TestingX1.11$56.43$15.80$11.29
    0374Monitoring Psychiatric DrugsX0.96$48.81$10.74$9.76
    0600Low Level Clinic VisitsV0.93$47.28$9.46$9.46
    0601Mid Level Clinic VisitsV1.02$51.86$10.37$10.37
    0602High Level Clinic VisitsV1.49$75.75$15.15$15.15
    0610Low Level Emergency VisitsV1.34$68.13$20.65$13.63
    0611Mid Level Emergency VisitsV2.33$118.46$36.47$23.69
    0612High Level Emergency VisitsV3.75$190.66$54.14$38.13
    0620Critical CareS9.13$464.19$152.78$92.84
    0689Electronic Analysis of Cardioverter-defibrillatorsS0.49$24.91$13.70$4.98
    0690Electronic Analysis of Pacemakers and other Cardiac DevicesS0.40$20.34$11.19$4.07
    0691Electronic Analysis of Programmable Shunts/PumpsS3.36$170.83$93.96$34.17
    0692Electronic Analysis of Neurostimulator Pulse GeneratorsS1.73$87.96$48.38$17.59
    0693Level II Breast ReconstructionT33.16$1,685.92$826.10$337.18
    0694Level III Excision/BiopsyT4.28$217.60$65.28$43.52
    0695Level VII Debridement & DestructionT17.06$867.36$398.99$173.47
    0697Level II Echocardiogram Except TransesophagealS2.00$101.68$52.88$20.34
    0698Level II Eye Tests & TreatmentsS1.09$55.42$24.94$11.08
    0699Level IV Eye Tests & TreatmentT6.91$351.32$158.09$70.26
    0701SR 89 chloride, per mCiG$963.42$137.92
    0702SM 153 lexidronam, 50 mCiG$1,020.00$146.02
    0704IN 111 Satumomab pendetide per doseG$831.25$119.00
    0705TC 99M tetrofosmin, per doseG$129.96$18.60
    0725Leucovorin calcium inj, 50 mgG$4.98$.45
    0726Dexrazoxane hcl injection, 250 mgG$194.53$27.85
    0727Etidronate disodium inj 300 mgG$63.65$9.11
    0728Filgrastim 300 mcg injectionG$179.08$25.64
    0730Pamidronate disodium , 30 mgG$253.68$32.58
    0731Sargramostim injection 50 mcgG$29.06$4.16
    0732Mesna injection 200 mgG$40.44$5.79
    Start Printed Page 44725
    0733Non esrd epoetin alpha inj, 1000 uG$11.85$1.52
    0750Dolasetron mesylate, 10 mgG$16.45$2.11
    0754Metoclopramide hcl injection up to 10 mgG$1.55$.20
    0755Thiethylperazine maleate inj up to 10 mgG$5.43$.70
    0762Dronabinol 2.5mg oralG$3.28$.42
    0763Dolasetron mesylate oral, 100 mgG$69.64$8.94
    0764Granisetron hcl injection 10 mcgG$18.54$2.38
    0765Granisetron hcl 1 mg oralG$44.70$5.74
    0768Ondansetron hcl injection 1 mgG$3.92$.50
    0769Ondansetron hcl 8mg oralG$25.15$3.23
    0800Leuprolide acetate, 3.75 mgG$81.60$7.39
    0801Cyclophosphamide oral 25 mgG$2.23$.32
    0802Etoposide oral 50 mgG$50.89$7.29
    0803Melphalan oral 2 mgG$2.18$.31
    0807Aldesleukin/single use vialG$641.25$91.80
    0809Bcg live intravesical vacG$166.44$21.37
    0810Goserelin acetate implant 3.6 mgG$446.49$63.92
    0811Carboplatin injection 50 mgG$111.11$15.91
    0812Carmus bischl nitro inj 100 mgG$114.41$16.38
    0813Cisplatin 10 mg injectionG$47.12$6.75
    0814Asparaginase injection 10,000 uG$59.70$8.55
    0815Cyclophosphamide 100 mg injG$5.98$.77
    0816Cyclophosphamide lyophilized 100 mgG$6.13$.79
    0817Cytarabine hcl 100 mg injG$4.75$.43
    0818Dactinomycin 0.5 mgG$13.23$1.89
    0819Dacarbazine 100 mg injG$11.28$1.02
    0820Daunorubicin 10 mgG$76.62$6.94
    0821Daunorubicin citrate liposom 10 mgG$64.60$9.25
    0822Diethylstilbestrol injection 250 mgG$3.99$.57
    0823Docetaxel, 20 mgG$297.83$42.64
    0824Etoposide 10 mg injG$3.86$.35
    0826Methotrexate Oral 2.5 mgG$2.73$.25
    0827Floxuridine injection 500 mgG$129.56$11.73
    0828Gemcitabine HCL 200 mgG$102.13$14.62
    0830Irinotecan injection 20 mgG$125.47$17.96
    0831Ifosfomide injection 1 gmG$156.65$22.43
    0832Idarubicin hcl injection 5 mgG$412.21$59.01
    0833Interferon alfacon-1, 1 mcgG$4.10$.59
    0834Interferon alfa-2a inj recombinant 3 million uG$34.87$4.99
    0836Interferon alfa-2b inj recombinant, 1 millionG$12.98$1.67
    0838Interferon gamma 1-b inj, 3 million uG$285.64$40.89
    0839Mechlorethamine hcl inj 10 mgG$11.88$1.70
    0840Melphalan hydrochl 50 mgG$381.65$54.64
    0841Methotrexate sodium inj 5 mgG$.41$.04
    0842Fludarabine phosphate inj 50 mgG$258.88$37.06
    0843Pegaspargase, singl dose vialG$1,255.57$179.74
    0844Pentostatin injection, 10 mgG$1,654.14$236.80
    0847Doxorubicin hcl 10 mg vl chemoG$9.00$1.29
    0849Rituximab, 100 mgG$454.55$65.07
    0850Streptozocin injection, 1 gmG$117.64$16.84
    0851Thiotepa injection, 15 mgG$116.97$16.75
    0852Topotecan, 4 mgG$632.56$90.56
    0853Vinblastine sulfate inj, 1 mgG$4.11$.37
    0854Vincristine sulfate 1 mg injG$30.16$2.73
    0855Vinorelbine tartrate, 10 mgG$79.28$11.35
    0856Porfimer sodium, 75 mgG$2,603.67$372.74
    0857Bleomycin sulfate injection 15 uG$289.37$41.43
    0858Cladribine, 1mgG$56.08$8.03
    0859Fluorouracil injection 500 mgG$1.48$.13
    0860Plicamycin (mithramycin) inj 2.5 mgG$93.80$13.43
    0861Leuprolide acetate injection 1 mgG$26.15$2.37
    0862Mitomycin 5 mg injG$121.65$11.01
    0863Paclitaxel injection, 30 mgG$164.08$21.07
    0864Mitoxantrone hcl, 5 mgG$244.20$34.96
    0865Interferon alfa-n3 inj, human leukocyte derived, 250,000 iuG$7.86$1.12
    0884Rho d immune globulin inj, 1 dose pkgG$34.11$4.38
    0886Azathioprine oral 50mgG$1.24$.16
    0887Azathioprine parenteral 100 mgG$.75$.10
    0888Cyclosporine oral 100 mgG$5.23$.47
    0889Cyclosporin parenteral 250mgG$25.08$2.27
    0890Lymphocyte immune globulin 250 mgG$249.47$32.04
    0891Tacrolimus oral per 1 mgG$2.91$.42
    0900Alglucerase injection, per 10 uG$37.53$5.37
    0901Alpha 1 proteinase inhibitor, 10 mgG$2.09$.30
    0902Botulinum toxin a, per unitG$4.39$.56
    0903Cytomegalovirus imm IV, 50 mgG$656.27$84.28
    0905Immune globulin 500 mgG$25.92$3.33
    0906RSV-ivig, 50 mgG$406.34$58.17
    Start Printed Page 44726
    0907Ganciclovir Sodium 500 mg injectionK0.46$23.39$4.51
    0908Tetanus immune globulin inj up to 250 uG$102.60$14.69
    0909Interferon beta-1a, 33 mcgG$225.23$32.24
    0910Interferon beta-1b , .25 mgG$54.15$7.75
    0911Streptokinase per 250,000 iuK1.80$91.52$17.68
    0913Ganciclovir long act implant 4.5 mgG$4,750.00$680.00
    0916Imiglucerase, unitG$3.75$.54
    0917Pharmacologic stressorsK0.37$18.81$3.62
    0925Factor viii per iuG$.87$.11
    0926Factor VIII (porcine) per iuG$2.09$.30
    0927Factor viii recombinant per iuG$1.19$.15
    0928Factor ix complex per iuG$.68$.09
    0929Anti-inhibitor per iuG$1.43$.18
    0930Antithrombin iii injection per iuG$1.05$.15
    0931Factor IX non-recombinant, per iuG$.76$.10
    0932Factor IX recombinant, per iuG$1.12$.16
    0949Plasma, Pooled Multiple Donor, Solvent/Detergent Treated, FrozenK3.00$152.53$30.51
    0950Blood (Whole) For TransfusionK2.13$108.29$21.66
    0952CryoprecipitateK0.72$36.61$7.32
    0954RBC leukocytes reducedK2.89$146.93$29.39
    0955Plasma, Fresh FrozenK2.31$117.45$23.49
    0956Plasma Protein FractionK1.29$65.59$13.12
    0957Platelet ConcentrateK1.00$50.84$10.17
    0958Platelet Rich PlasmaK1.19$60.50$12.10
    0959Red Blood CellsK2.09$106.26$21.25
    0960Washed Red Blood CellsK3.89$197.78$39.56
    0961Infusion, Albumin (Human) 5%, 50 mlK2.24$113.89$22.78
    0962Infusion, Albumin (Human) 25%, 10 mlK1.12$56.94$11.39
    0970New Technology - Level I ($0 - $50)T0.47$23.90$4.78
    0971New Technology - Level II ($50 - $100)S1.42$72.20$14.44
    0972New Technology - Level III ($100 - $200)T2.84$144.39$28.88
    0973New Technology - Level IV ($200 - $300)T4.73$240.48$48.10
    0974New Technology - Level V ($300 - $500)S7.57$384.87$76.97
    0975New Technology - Level VI ($500 - $750)T11.83$601.46$120.29
    0976New Technology - Level VII ($750 - $1000)S16.56$841.94$168.39
    0977New Technology - Level VIII ($1000 - $1250)T21.30$1,082.93$216.59
    0978New Technology - Level IX ($1250 - $1500)T26.03$1,323.42$264.68
    0979New Technology - Level X ($1500 - $1750)T30.76$1,563.90$312.78
    0980New Technology - Level XI ($1750 - $2000)T35.49$1,804.38$360.88
    0981New Technology - Level XII ($2000 - $2500)S42.59$2,165.36$433.07
    0982New Technology - Level XIII ($2500 - $3000)T52.06$2,646.83$529.37
    0983New Technology-Level XIV ($3000- $3500)T61.52$3,127.80
    0984New Technology - Level XV ($3500 - $5000)T80.45$4,090.24$818.05
    0985New Technology - Level XVI ($5000 - $6000)T104.11$5,293.16$1,058.63
    1002Cochlear Implant SystemH
    1009Cryoprecip reduced plasmaK0.88$44.74$8.95
    1010Blood, L/R, CMV-negK2.94$149.48$29.90
    1011Platelets, HLA-m, L/R, unitK12.12$616.21$123.24
    1012Platelet concentrate, L/R, irradiated, unitK1.96$99.65$19.93
    1013Platelet concentrate, L/R, unitK1.20$61.01$12.20
    1014Platelets, aph/pher, L/R, unitK9.13$464.19$92.84
    1016Blood, L/R, froz/deglycerol/washedK7.31$371.66$74.33
    1017Platelets, aph/pher, L/R, CMV-neg, unitK9.53$484.52$96.90
    1018Blood, L/R, irradiatedK3.20$162.69$32.54
    1019Platelets, aph/pher, L/R, irradiated, unitK9.85$500.79$100.16
    1024Quinupristin/dalfopristinG$102.05$14.61
    1045Iobenguane sulfate i-131G$495.65$44.87
    1059Cultured chondrocytes implntG$14,250.00$2,040.00
    1079CO 57/58 0.5 mCiG$253.84$36.34
    1084Denileukin diftitox, 300 MCGG$999.88$143.14
    1086Temozolomide,oral 5 mgG$5.93$.85
    1087I-123 per uci, dx useG$.65$.09
    1089Cyanocobalamin cobalt co57G$97.85$14.01
    1090IN 111 Chloride, per mCiG$152.00$21.76
    1091IN 111 Oxyquinoline, per 5 mCiG$482.84$69.12
    1092IN 111 Pentetate, per 1.5 mCiG$769.50$110.16
    1094TC 99M Albumin aggr, per vialG$33.09$4.74
    1095TC 99M Depreotide, per vialG$760.00$108.80
    1096TC 99M Exametazime, per doseG$423.04$60.56
    1097TC 99M Mebrofenin, per vialG$51.43$7.36
    1098TC 99M Pentetate, per vialG$22.64$2.76
    1099TC 99M Pyrophosphate, per vialG$42.75$6.12
    1122TC 99M arcitumomab, per vialG$1,235.00$176.80
    1166Cytarabine liposomal, 10 mgG$371.45$53.18
    1167Epirubicin hcl, 2 mgG$24.94$3.57
    1178Busulfan IV, 6 mgG$26.49$3.79
    1188I-131 per uci, dx useG$.78$.10
    1200TC 99M Sodium Glucoheptonate, per vialG$107.40$15.37
    Start Printed Page 44727
    1201TC 99M succimer, per vialG$135.66$19.42
    1202TC 99M Sulfur Colloid, per doseG$36.10$3.27
    1203Verteporfin for injectionG$1,458.25$208.76
    1205Technetium tc99m disofeninG$85.50$7.74
    1207Octreotide acetate depot 1mgG$140.37$20.10
    1305ApligrafG$1,157.81$165.75
    1348I-131 per mci sol, rx useG$146.57$20.98
    1400Diphenhydramine hcl 50mgG$.12$.01
    1401Prochlorperazine maleate 5mgG$.57$.05
    1402Promethazine hcl 12.5mg oralG$.03$.00
    1403Chlorpromazine hcl 10mg oralG$.07$.01
    1404Trimethobenzamide hcl 250mgG$.36$.03
    1405Thiethylperazine maleate10mgG$.56$.08
    1406Perphenazine 4mg oralG$.62$.06
    1407Hydroxyzine pamoate 25mgG$.20$.02
    1409Factor viia recombinant, per 1.2 mgG$1,596.00$228.48
    1600TC 99M sestamibi, per syringeG$115.90$16.59
    1601TC 99M medronate, per doseG$36.46$3.30
    1602TC 99M apcitide, per vialG$45.13$6.46
    1603TL 201, mCiG$29.45$3.78
    1604IN 111 capromab pendetide, per doseG$1,128.13$161.50
    1605Abciximab injection, 10 mgG$513.02$73.44
    1606Anistreplase, 30 uG$2,559.11$366.36
    1607Eptifibatide injection, 5 mgG$13.58$1.94
    1608Etanercept injection, 25 mgG$140.98$20.18
    1609Rho(D) immune globulin h, sd, 100 iuG$20.64$2.65
    1611Hylan G-F 20 injection, 16 mgG$213.86$30.62
    1612Daclizumab, parenteral, 25 mgG$397.29$56.88
    1613Trastuzumab, 10 mgG$52.83$7.56
    1614Valrubicin, 200 mgG$423.23$60.59
    1615Basiliximab, 20 mgG$1,348.76$193.09
    1616Histrelin Acetate, 0.5 mgG$14.16$2.03
    1617Lepirdin, 50 mgG$131.96$18.89
    1618Von Willebrand factor, per iuG$.95$.14
    1619Ga 67, per mCiG$24.38$3.13
    1620TC 99M Bicisate, per vialG$384.75$55.08
    1621Xe 133, per mCiG$29.93$3.84
    1622TC 99M Mertiatide, per vialG$176.53$25.27
    1623TC 99M GluceptateG$22.61$3.24
    1624P32 sodium, per mCiG$81.10$11.61
    1625IN 111 Pentetreotide, per mCiG$935.75$133.96
    1626TC 99M Oxidronate, per vialG$36.74$5.26
    1627TC-99 labeled red blood cell, per testG$40.90$5.85
    1628P32 phosphate chromic, per mCiG$150.86$21.60
    1713Anchor/screw bn/bn,tis/bnH
    1714Cath, trans atherectomy, dirH
    1715Brachytherapy needleH
    1716Brachytx seed, Gold 198H
    1717Brachytx seed, HDR Ir-192H
    1718Brachytx seed, Iodine 125H
    1719Brachytxseed, Non-HDR Ir-192H
    1720Brachytx seed, Palladium 103H
    1721AICD, dual chamberH
    1722AICD, single chamberH
    1723Cath, ablation, non-cardiacH
    1724Cath, trans atherec,rotationH
    1725Cath, translumin non-laserH
    1726Cath, bal dil, non-vascularH
    1727Cath, bal tis dis, non-vasH
    1728Cath, brachytx seed admH
    1729Cath, drainageH
    1730Cath, EP, 19 or fewer electH
    1731Cath, EP, 20 or more elecH
    1732Cath, EP, diag/abl, 3D/vectH
    1733Cath, EP, othr than cool-tipH
    1750Cath, hemodialysis,long-termH
    1751Cath, inf, per/cent/midlineH
    1752Cath, hemodialysis,short-termH
    1753Cath, intravas ultrasoundH
    1754Catheter, intradiscalH
    1755Catheter, intraspinalH
    1756Cath, pacing, transesophH
    1757Cath, thrombectomy/embolectH
    1758Cath, ureteralH
    1759Cath, intra echocardiographyH
    1760Closure dev, vasc, imp/insertH
    1762Conn tiss, human (inc fascia)H
    1763Conn tiss, non-humanH
    Start Printed Page 44728
    1764Event recorder, cardiacH
    1765Adhesion barrierH
    1766Intro/sheath,strble,non-peelH
    1767Generator, neurostim, impH
    1768Graft, vascularH
    1769Guide wireH
    1770Imaging coil, MR, insertableH
    1771Rep dev, urinary, w/slingH
    1772Infusion pump, programmableH
    1773Retrieval dev, insertH
    1776Joint device (implantable)H
    1777Lead, AICD, endo single coilH
    1778Lead, neurostimulatorH
    1779Lead, pmkr, transvenous VDDH
    1780Lens, intraocularH
    1781Mesh (implantable)H
    1782MorcellatorH
    1784Ocular dev, intraop, det retH
    1785Pmkr, dual, rate-respH
    1786Pmkr, single, rate-respH
    1787Patient progr, neurostimH
    1788Port, indwelling, impH
    1789Prosthesis, breast, impH
    1813Prosthesis, penile, inflatabH
    1815Pros, urinary sph, impH
    1816Receiver/transmitter, neuroH
    1817Septal defect imp sysH
    1874Stent, coated/cov w/del sysH
    1875Stent, coated/cov w/o del syH
    1876Stent, non-coa/no-cov w/delH
    1877Stent, non-coat/cov w/o delH
    1878Matrl for vocal cordH
    1879Tissue marker, impH
    1880Vena cava filterH
    1881Dialysis access systemH
    1882AICD, other than sing/dualH
    1883Adapt/ext, pacing/neuro leadH
    1885Cath, translumin angio laserH
    1887Catheter, guidingH
    1891Infusion pump,non-prog,permH
    1892Intro/sheath,fixed,peel-awayH
    1893Intro/sheath,fixed,non-peelH
    1894Intro/sheath, non-laserH
    1895Lead, AICD, endo dual coilH
    1896Lead, AICD, non sing/dualH
    1897Lead, neurostim test kitH
    1898Lead, pmkr, other than transH
    1899Lead, pmkr/AICD combinationH
    2615Sealant, pulmonary, liquidH
    2616Brachytx seed, Yttrium-90H
    2617Stent, non-cor, tem w/o delH
    2618Probe, cryoablationH
    2619Pmkr, dual, non rate-respH
    2620Pmkr, single, non rate-respH
    2621Pmkr, other than sing/dualH
    2622Prosthesis, penile, non-infH
    2625Stent, non-cor, tem w/del sysH
    2626Infusion pump, non-prog,tempH
    2627Cath, suprapubic/cystoscopicH
    2628Catheter, occlusionH
    2629Intro/sheath, laserH
    2630Cath, EP, cool-tipH
    2631Rep dev, urinary, w/o slingH
    7000Amifostine, 500 mgG$392.06$56.13
    7001Amphotericin B lipid complex, 50 mgG$109.25$15.64
    7003Epoprostenol injection 0.5 mgG$17.37$2.49
    7005Gonadorelin hydroch, 100 mcgG$38.47$5.51
    7007Milrinone lactate, per 5 ml, injK0.48$24.40$4.88
    7010Morphine sulfate (preservative free) 10 mgG$7.41$.95
    7011Oprelvekin injection, 5 mgG$236.31$33.83
    7014Fentanyl citrate inj up 2 mlG$1.40$.18
    7015Busulfan, oral, 2 mgG$1.81$.23
    7019Aprotinin, 10,000 kiuG$2.06$.30
    7022Elliot's B solution, per mlG$14.25$2.04
    7023Treatment for bladder calculi, per 500 mlG$24.70$3.54
    7024Corticorelin ovine triflutate, per 0.1 mgG$368.03$52.69
    7025Digoxin immune FAB (Ovine), 40 mg vialG$551.66$78.97
    7026Ethanolamine oleate, 100 mgG$39.73$5.69
    Start Printed Page 44729
    7027Fomepizole, 1.5 mgG$1.09$.16
    7028Fosphenytoin, 50 mgG$9.55$1.37
    7029Glatiramer acetate, 20 mgG$30.07$4.30
    7030Hemin, 1 mgG$.99$.14
    7031Octreotide acetate injection 1mgG$125.65$17.99
    7032Sermorelin acetate, 0.5 mgG$15.78$2.26
    7033Somatrem, 5 mgG$209.48$29.99
    7034Somatropin, 1 mg (any derivation)G$39.90$5.12
    7035Teniposide, 50 mgG$216.32$30.97
    7037Urofollitropin, 75 I.U.G$73.29$9.41
    7038Muromonab-CD3, 5 mgG$777.31$111.28
    7039Pegademase bovine inj 25 I.UG$139.33$19.95
    7040Pentastarch 10% inj, 100 mlG$15.11$2.16
    7041Tirofiban hydrochloride 12.5 mgG$435.27$62.31
    7042Capecitabine, oral, 150 mgG$2.43$.35
    7043Infliximab injection 10 mgG$63.23$9.05
    7045Trimetrexate glucoronate 25 mgG$86.09$12.32
    7046Doxorubicin hcl liposome inj 10 mgG$358.95$51.39
    7047Droperidol/fentanyl injG$6.67$.95
    7048Alteplase recombinantK0.39$19.83$3.97
    7049Filgrastim 480 mcg injectionG$285.38$40.85
    7050Prednisone oralG$.07$.01
    7315Sodium hyaluronate, 20 mgG$136.80$19.58
    9000Na chromate Cr51, per 0.25mCiG$.32$.05
    9001Linezolid inj, 200mgG$34.14$4.89
    9002Tenecteplase, 50mg/vialG$2,612.50$374.00
    9003Palivizumab, per 50mgG$664.49$95.13
    9004Gemtuzumab ozogamicin inj,5mgG$1,929.69$276.25
    9005Reteplase injectionG$1,306.25$187.00
    9006Tacrolimus inj, per 5mg (1 amp)G$113.15$16.20
    9007Baclofen Intrathecal kit-1ampG$79.80$11.42
    9008Baclofen Refill Kit--500mcgG$233.70$33.46
    9009Baclofen Refill Kit--2000mcgG$491.15$70.31
    9010Baclofen Refill Kit--4000mcgG$861.65$123.35
    9011Caffeine Citrate, inj, 1mlG$12.22$1.75
    9012Arsenic Trioxide, 1mg/kgG$237.50$34.00
    9013Co 57 Cobaltous Cl, 1 mlG$10.02$1.43
    9015Mycophenolate mofetil oralG$2.40$.34
    9016Echocardiography contrastG$39.58$5.67
    9018Botulinum tox B, per 100 uG$8.79$1.26
    9019Caspofungin acetate, 50 mgG$34.20$4.90
    9020Sirolimus tablet, 1 mgG$6.51$.89
    9100Iodinated I-131 AlbuminG$9.84$1.41
    910251 Na chromate, 50mCiG$.65$.09
    9103Na Iothalamate I-125, 10uCiG$11.66$1.67
    9104Anti-thymocyte globulin,25mgG$251.75$36.04
    9105Hep B imm glob, per 1 mlG$135.43$12.26
    9106Sirolimus, oralG$6.51$.93
    9108Thyrotropin alfa, 1.1 mgG$531.05$76.02
    9109Tirofliban hcl, 6.25 mgG$217.64$31.16
    9217Leuprolide acetate suspnsionG$564.92$51.14
    9500Platelets, irradiatedK1.81$92.02$18.40
    9501Platelets, pheresisK9.91$503.84$100.77
    9502Platelet pheresis irradiatedK10.75$546.55$109.31
    9503Fresh frozen plasma, ea unitK1.69$85.92$17.18
    9504RBC deglycerolizedK4.45$226.25$45.25
    9505RBC irradiatedK2.64$134.22$26.84

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

    IndicatorServiceStatus
    APulmonary Rehabilitation Clinical TrialNot Paid Under Outpatient PPS
    ADurable Medical Equipment, Prosthetics and OrthoticsDMEPOS Fee Schedule
    APhysical, Occupational and Speech TherapyPhysician Fee Schedule
    AAmbulanceAmbulance Fee Schedule
    AEPO for ESRD PatientsNational Rate
    AClinical Diagnostic Laboratory ServicesLaboratory Fee Schedule
    APhysician Services for ESRD PatientsPhysician Fee Schedule
    AScreening MammographyLower of Charges or National Rate
    CInpatient ProceduresAdmit Patient
    ENon-Covered Items and ServicesNot Paid Under Outpatient PPS
    FAcquisition of Corneal TissuePaid at Reasonable Cost
    GDrug/Biological Pass-ThroughAdditional Payment
    HDevice Pass-ThroughAdditional Payment
    KNon Pass-Through Drug/BiologicalPaid Under Outpatient PPS
    NIncidental Services, packaged into APC RatePackaged
    PPartial HospitalizationPaid Per Diem APC
    Start Printed Page 44730
    SSignificant Procedure, Not Discounted When MultiplePaid Under Outpatient PPS
    TSignificant Procedure, Multiple Procedure Reduction AppliesPaid Under Outpatient PPS
    VVisit to Clinic or Emergency DepartmentPaid Under Outpatient PPS
    XAncillary ServicePaid Under Outpatient PPS
    End Part —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. Start Printed Page 44730

    Addendum B.—Payment Status by HCPCS Code and Related Information Calender Year 2002------

    CPT/HCPCSHOPD Status IndicatorDescriptionAPCRelative WeightPayment RateNational Unadjusted CopaymentMinimum Unadjusted Copayment
    00100NAnesth, salivary gland
    00103NAnesth, blepharoplasty
    00104NAnesth, electroshock
    00120NAnesth, ear surgery
    00124NAnesth, ear exam
    00126NAnesth, tympanotomy
    00140NAnesth, procedures on eye
    00142NAnesth, lens surgery
    00144NAnesth, corneal transplant
    00145NAnesth, vitreoretinal surg
    00147NAnesth, iridectomy
    00148NAnesth, eye exam
    00160NAnesth, nose/sinus surgery
    00162NAnesth, nose/sinus surgery
    00164NAnesth, biopsy of nose
    00170NAnesth, procedure on mouth
    00172NAnesth, cleft palate repair
    00174NAnesth, pharyngeal surgery
    00176NAnesth, pharyngeal surgery
    00190NAnesth, face/skull bone surg
    00192NAnesth, facial bone surgery
    00210NAnesth, open head surgery
    00212NAnesth, skull drainage
    00214NAnesth, skull drainage
    00215NAnesth, skull repair/fract
    00216NAnesth, head vessel surgery
    00218NAnesth, special head surgery
    00220NAnesth, spinal fluid shunt
    00222NAnesth, head nerve surgery
    00300NAnesth, head/neck/ptrunk
    00320NAnesth, neck organ surgery
    00322NAnesth, biopsy of thyroid
    00350NAnesth, neck vessel surgery
    00352NAnesth, neck vessel surgery
    00400NAnesth, skin, ext/per/atrunk
    00402NAnesth, surgery of breast
    00404NAnesth, surgery of breast
    00406NAnesth, surgery of breast
    00410NAnesth, correct heart rhythm
    00450NAnesth, surgery of shoulder
    00452NAnesth, surgery of shoulder
    00454NAnesth, collar bone biopsy
    00470NAnesth, removal of rib
    00472NAnesth, chest wall repair
    00474NAnesth, surgery of rib(s)
    00500NAnesth, esophageal surgery
    00520NAnesth, chest procedure
    00522NAnesth, chest lining biopsy
    00524NAnesth, chest drainage
    00528NAnesth, chest partition view
    00530NAnesth, pacemaker insertion
    00532NAnesth, vascular access
    00534NAnesth, cardioverter/defib
    00537NAnesth, cardiac electrophys
    00540NAnesth, chest surgery
    00542NAnesth, release of lung
    00544NAnesth, chest lining removal
    00546NAnesth, lung,chest wall surg
    00548NAnesth, trachea,bronchi surg
    00550NAnesth, sternal debridement
    00560NAnesth, open heart surgery
    00562NAnesth, open heart surgery
    00563NAnesth, heart proc w/pump
    00566NAnesth, cabg w/o pump
    00580NAnesth heart/lung transplant
    Start Printed Page 44731
    00600NAnesth, spine, cord surgery
    00604NAnesth, sitting procedure
    00620NAnesth, spine, cord surgery
    00622NAnesth, removal of nerves
    00630NAnesth, spine, cord surgery
    00632NAnesth, removal of nerves
    00634NAnesth for chemonucleolysis
    00635NAnesth, lumbar puncture
    00670NAnesth, spine, cord surgery
    00700NAnesth, abdominal wall surg
    00702NAnesth, for liver biopsy
    00730NAnesth, abdominal wall surg
    00740NAnesth, upper gi visualize
    00750NAnesth, repair of hernia
    00752NAnesth, repair of hernia
    00754NAnesth, repair of hernia
    00756NAnesth, repair of hernia
    00770NAnesth, blood vessel repair
    00790NAnesth, surg upper abdomen
    00792NAnesth, hemorr/excise liver
    00794NAnesth, pancreas removal
    00796NAnesth, for liver transplant
    00800NAnesth, abdominal wall surg
    00802NAnesth, fat layer removal
    00810NAnesth, low intestine scope
    00820NAnesth, abdominal wall surg
    00830NAnesth, repair of hernia
    00832NAnesth, repair of hernia
    00840NAnesth, surg lower abdomen
    00842NAnesth, amniocentesis
    00844NAnesth, pelvis surgery
    00846NAnesth, hysterectomy
    00848NAnesth, pelvic organ surg
    00850NAnesth, cesarean section
    00855NAnesth, hysterectomy
    00857NAnalgesia, labor & c-section
    00860NAnesth, surgery of abdomen
    00862NAnesth, kidney/ureter surg
    00864NAnesth, removal of bladder
    00865NAnesth, removal of prostate
    00866NAnesth, removal of adrenal
    00868NAnesth, kidney transplant
    00870NAnesth, bladder stone surg
    00872NAnesth kidney stone destruct
    00873NAnesth kidney stone destruct
    00880NAnesth, abdomen vessel surg
    00882NAnesth, major vein ligation
    00884NAnesth, major vein revision
    00902NAnesth, anorectal surgery
    00904NAnesth, perineal surgery
    00906NAnesth, removal of vulva
    00908NAnesth, removal of prostate
    00910NAnesth, bladder surgery
    00912NAnesth, bladder tumor surg
    00914NAnesth, removal of prostate
    00916NAnesth, bleeding control
    00918NAnesth, stone removal
    00920NAnesth, genitalia surgery
    00922NAnesth, sperm duct surgery
    00924NAnesth, testis exploration
    00926NAnesth, removal of testis
    00928NAnesth, removal of testis
    00930NAnesth, testis suspension
    00932NAnesth, amputation of penis
    00934NAnesth, penis, nodes removal
    00936NAnesth, penis, nodes removal
    00938NAnesth, insert penis device
    00940NAnesth, vaginal procedures
    00942NAnesth, surg on vag/urethal
    00944NAnesth, vaginal hysterectomy
    00946NAnesth, vaginal delivery
    00948NAnesth, repair of cervix
    00950NAnesth, vaginal endoscopy
    00952NAnesth, hysteroscope/graph
    00955NAnalgesia, vaginal delivery
    Start Printed Page 44732
    01112NAnesth, bone aspirate/bx
    01120NAnesth, pelvis surgery
    01130NAnesth, body cast procedure
    01140NAnesth, amputation at pelvis
    01150NAnesth, pelvic tumor surgery
    01160NAnesth, pelvis procedure
    01170NAnesth, pelvis surgery
    01180NAnesth, pelvis nerve removal
    01190NAnesth, pelvis nerve removal
    01200NAnesth, hip joint procedure
    01202NAnesth, arthroscopy of hip
    01210NAnesth, hip joint surgery
    01212NAnesth, hip disarticulation
    01214NAnesth, replacement of hip
    01215NAnesth, revise hip repair
    01220NAnesth, procedure on femur
    01230NAnesth, surgery of femur
    01232NAnesth, amputation of femur
    01234NAnesth, radical femur surg
    01250NAnesth, upper leg surgery
    01260NAnesth, upper leg veins surg
    01270NAnesth, thigh arteries surg
    01272NAnesth, femoral artery surg
    01274NAnesth, femoral embolectomy
    01320NAnesth, knee area surgery
    01340NAnesth, knee area procedure
    01360NAnesth, knee area surgery
    01380NAnesth, knee joint procedure
    01382NAnesth, knee arthroscopy
    01390NAnesth, knee area procedure
    01392NAnesth, knee area surgery
    01400NAnesth, knee joint surgery
    01402NAnesth, replacement of knee
    01404NAnesth, amputation at knee
    01420NAnesth, knee joint casting
    01430NAnesth, knee veins surgery
    01432NAnesth, knee vessel surg
    01440NAnesth, knee arteries surg
    01442NAnesth, knee artery surg
    01444NAnesth, knee artery repair
    01462NAnesth, lower leg procedure
    01464NAnesth, ankle arthroscopy
    01470NAnesth, lower leg surgery
    01472NAnesth, achilles tendon surg
    01474NAnesth, lower leg surgery
    01480NAnesth, lower leg bone surg
    01482NAnesth, radical leg surgery
    01484NAnesth, lower leg revision
    01486NAnesth, ankle replacement
    01490NAnesth, lower leg casting
    01500NAnesth, leg arteries surg
    01502NAnesth, lwr leg embolectomy
    01520NAnesth, lower leg vein surg
    01522NAnesth, lower leg vein surg
    01610NAnesth, surgery of shoulder
    01620NAnesth, shoulder procedure
    01622NAnesth, shoulder arthroscopy
    01630NAnesth, surgery of shoulder
    01632NAnesth, surgery of shoulder
    01634NAnesth, shoulder joint amput
    01636NAnesth, forequarter amput
    01638NAnesth, shoulder replacement
    01650NAnesth, shoulder artery surg
    01652NAnesth, shoulder vessel surg
    01654NAnesth, shoulder vessel surg
    01656NAnesth, arm-leg vessel surg
    01670NAnesth, shoulder vein surg
    01680NAnesth, shoulder casting
    01682NAnesth, airplane cast
    01710NAnesth, elbow area surgery
    01712NAnesth, uppr arm tendon surg
    01714NAnesth, uppr arm tendon surg
    01716NAnesth, biceps tendon repair
    01730NAnesth, uppr arm procedure
    01732NAnesth, elbow arthroscopy
    Start Printed Page 44733
    01740NAnesth, upper arm surgery
    01742NAnesth, humerus surgery
    01744NAnesth, humerus repair
    01756NAnesth, radical humerus surg
    01758NAnesth, humeral lesion surg
    01760NAnesth, elbow replacement
    01770NAnesth, uppr arm artery surg
    01772NAnesth, uppr arm embolectomy
    01780NAnesth, upper arm vein surg
    01782NAnesth, uppr arm vein repair
    01810NAnesth, lower arm surgery
    01820NAnesth, lower arm procedure
    01830NAnesth, lower arm surgery
    01832NAnesth, wrist replacement
    01840NAnesth, lwr arm artery surg
    01842NAnesth, lwr arm embolectomy
    01844NAnesth, vascular shunt surg
    01850NAnesth, lower arm vein surg
    01852NAnesth, lwr arm vein repair
    01860NAnesth, lower arm casting
    01904NAnesth, skull x-ray inject
    01906NAnesth, lumbar myelography
    01908NAnesth, cervical myelography
    01910NAnesth, skull myelography
    01912NAnesth, lumbar diskography
    01914NAnesth, cervical diskography
    01916NAnesth, head arteriogram
    01918NAnesth, limb arteriogram
    01920NAnesth, catheterize heart
    01921NAnesth, vessel surgery
    01922NAnesth, cat or MRI scan
    01951NAnesth, burn, less 1 percent
    01952NAnesth, burn, 1-9 percent
    01953NAnesth, burn, each 9 percent
    01990NSupport for organ donor
    01995NRegional anesthesia, limb
    01996NManage daily drug therapy
    01999NUnlisted anesth procedure
    10040TAcne surgery of skin abscess00062.36$119.99$33.95$24.00
    10060TDrainage of skin abscess00062.36$119.99$33.95$24.00
    10061TDrainage of skin abscess00062.36$119.99$33.95$24.00
    10080TDrainage of pilonidal cyst00062.36$119.99$33.95$24.00
    10081TDrainage of pilonidal cyst00077.28$370.13$74.03$74.03
    10120TRemove foreign body00062.36$119.99$33.95$24.00
    10121TRemove foreign body00208.56$435.21$130.53$87.04
    10140TDrainage of hematoma/fluid00077.28$370.13$74.03$74.03
    10160TPuncture drainage of lesion00181.16$58.98$17.66$11.80
    10180TComplex drainage, wound00077.28$370.13$74.03$74.03
    11000TDebride infected skin00152.29$116.43$31.20$23.29
    11001TDebride infected skin add-on00131.51$76.77$17.66$15.35
    11010TDebride skin, fx002215.07$766.19$292.94$153.24
    11011TDebride skin/muscle, fx002215.07$766.19$292.94$153.24
    11012TDebride skin/muscle/bone, fx002215.07$766.19$292.94$153.24
    11040TDebride skin, partial00152.29$116.43$31.20$23.29
    11041TDebride skin, full00152.29$116.43$31.20$23.29
    11042TDebride skin/tissue00163.31$168.29$70.68$33.66
    11043TDebride tissue/muscle00163.31$168.29$70.68$33.66
    11044TDebride tissue/muscle/bone001710.51$534.35$245.80$106.87
    11055TTrim skin lesion00120.72$36.61$9.18$7.32
    11056TTrim skin lesions, 2 to 400120.72$36.61$9.18$7.32
    11057TTrim skin lesions, over 400120.72$36.61$9.18$7.32
    11100TBiopsy of skin lesion00181.16$58.98$17.66$11.80
    11101TBiopsy, skin add-on00181.16$58.98$17.66$11.80
    11200TRemoval of skin tags00131.51$76.77$17.66$15.35
    11201TRemove skin tags add-on00152.29$116.43$31.20$23.29
    11300TShave skin lesion00120.72$36.61$9.18$7.32
    11301TShave skin lesion00120.72$36.61$9.18$7.32
    11302TShave skin lesion00131.51$76.77$17.66$15.35
    11303TShave skin lesion00152.29$116.43$31.20$23.29
    11305TShave skin lesion00131.51$76.77$17.66$15.35
    11306TShave skin lesion00131.51$76.77$17.66$15.35
    11307TShave skin lesion00131.51$76.77$17.66$15.35
    11308TShave skin lesion00131.51$76.77$17.66$15.35
    11310TShave skin lesion00131.51$76.77$17.66$15.35
    11311TShave skin lesion00131.51$76.77$17.66$15.35
    Start Printed Page 44734
    11312TShave skin lesion00131.51$76.77$17.66$15.35
    11313TShave skin lesion00163.31$168.29$70.68$33.66
    11400TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11401TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11402TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11403TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11404TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11406TRemoval of skin lesion002112.74$647.73$236.51$129.55
    11420TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11421TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11422TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11423TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11424TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11426TRemoval of skin lesion002215.07$766.19$292.94$153.24
    11440TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11441TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11442TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11443TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11444TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11446TRemoval of skin lesion002215.07$766.19$292.94$153.24
    11450TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11451TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11462TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11463TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11470TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11471TRemoval, sweat gland lesion002215.07$766.19$292.94$153.24
    11600TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11601TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11602TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11603TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11604TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11606TRemoval of skin lesion002112.74$647.73$236.51$129.55
    11620TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11621TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11622TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11623TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11624TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11626TRemoval of skin lesion002215.07$766.19$292.94$153.24
    11640TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11641TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11642TRemoval of skin lesion00194.56$231.84$78.91$46.37
    11643TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11644TRemoval of skin lesion00208.56$435.21$130.53$87.04
    11646TRemoval of skin lesion002215.07$766.19$292.94$153.24
    11719TTrim nail(s)00090.68$34.57$8.99$6.91
    11720TDebride nail, 1-500090.68$34.57$8.99$6.91
    11721TDebride nail, 6 or more00090.68$34.57$8.99$6.91
    11730TRemoval of nail plate00131.51$76.77$17.66$15.35
    11732TRemove nail plate, add-on00120.72$36.61$9.18$7.32
    11740TDrain blood from under nail00090.68$34.57$8.99$6.91
    11750TRemoval of nail bed00194.56$231.84$78.91$46.37
    11752TRemove nail bed/finger tip002215.07$766.19$292.94$153.24
    11755TBiopsy, nail unit00194.56$231.84$78.91$46.37
    11760TRepair of nail bed00242.48$126.09$44.50$25.22
    11762TReconstruction of nail bed00242.48$126.09$44.50$25.22
    11765TExcision of nail fold, toe00152.29$116.43$31.20$23.29
    11770TRemoval of pilonidal lesion002112.74$647.73$236.51$129.55
    11771TRemoval of pilonidal lesion002215.07$766.19$292.94$153.24
    11772TRemoval of pilonidal lesion002215.07$766.19$292.94$153.24
    11900TInjection into skin lesions00120.72$36.61$9.18$7.32
    11901TAdded skin lesions injection00120.72$36.61$9.18$7.32
    11920TCorrect skin color defects00242.48$126.09$44.50$25.22
    11921TCorrect skin color defects00242.48$126.09$44.50$25.22
    11922TCorrect skin color defects00242.48$126.09$44.50$25.22
    11950TTherapy for contour defects00242.48$126.09$44.50$25.22
    11951TTherapy for contour defects00242.48$126.09$44.50$25.22
    11952TTherapy for contour defects00242.48$126.09$44.50$25.22
    11954TTherapy for contour defects00242.48$126.09$44.50$25.22
    11960TInsert tissue expander(s)002613.51$686.88$277.92$137.38
    11970TReplace tissue expander002613.51$686.88$277.92$137.38
    11971TRemove tissue expander(s)002215.07$766.19$292.94$153.24
    11975EInsert contraceptive cap
    11976TRemoval of contraceptive cap00194.56$231.84$78.91$46.37
    11977ERemoval/reinsert contra cap
    11980XImplant hormone pellet(s)03400.91$46.27$11.57$9.25
    Start Printed Page 44735
    12001TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12002TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12004TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12005TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12006TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12007TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12011TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12013TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12014TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12015TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12016TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12017TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12018TRepair superficial wound(s)00242.48$126.09$44.50$25.22
    12020TClosure of split wound00242.48$126.09$44.50$25.22
    12021TClosure of split wound00242.48$126.09$44.50$25.22
    12031TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12032TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12034TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12035TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12036TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12037TLayer closure of wound(s)002613.51$686.88$277.92$137.38
    12041TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12042TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12044TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12045TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12046TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12047TLayer closure of wound(s)002613.51$686.88$277.92$137.38
    12051TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12052TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12053TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12054TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12055TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12056TLayer closure of wound(s)00242.48$126.09$44.50$25.22
    12057TLayer closure of wound(s)002613.51$686.88$277.92$137.38
    13100TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13101TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13102TRepair wound/lesion add-on00253.71$188.62$70.66$37.72
    13120TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13121TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13122TRepair wound/lesion add-on00253.71$188.62$70.66$37.72
    13131TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13132TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13133TRepair wound/lesion add-on00253.71$188.62$70.66$37.72
    13150TRepair of wound or lesion002613.51$686.88$277.92$137.38
    13151TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13152TRepair of wound or lesion00253.71$188.62$70.66$37.72
    13153TRepair wound/lesion add-on00253.71$188.62$70.66$37.72
    13160TLate closure of wound002613.51$686.88$277.92$137.38
    14000TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14001TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14020TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14021TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14040TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14041TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14060TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14061TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14300TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    14350TSkin tissue rearrangement002613.51$686.88$277.92$137.38
    15000TSkin graft002613.51$686.88$277.92$137.38
    15001TSkin graft add-on002613.51$686.88$277.92$137.38
    15050TSkin pinch graft002613.51$686.88$277.92$137.38
    15100TSkin split graft002613.51$686.88$277.92$137.38
    15101TSkin split graft add-on002613.51$686.88$277.92$137.38
    15120TSkin split graft002613.51$686.88$277.92$137.38
    15121TSkin split graft add-on002613.51$686.88$277.92$137.38
    15200TSkin full graft002613.51$686.88$277.92$137.38
    15201TSkin full graft add-on002613.51$686.88$277.92$137.38
    15220TSkin full graft002613.51$686.88$277.92$137.38
    15221TSkin full graft add-on002613.51$686.88$277.92$137.38
    15240TSkin full graft002613.51$686.88$277.92$137.38
    15241TSkin full graft add-on002613.51$686.88$277.92$137.38
    15260TSkin full graft002613.51$686.88$277.92$137.38
    15261TSkin full graft add-on002613.51$686.88$277.92$137.38
    15342TCultured skin graft, 25 cm00253.71$188.62$70.66$37.72
    15343TCulture skn graft addl 25 cm00253.71$188.62$70.66$37.72
    Start Printed Page 44736
    15350TSkin homograft002613.51$686.88$277.92$137.38
    15351TSkin homograft add-on002613.51$686.88$277.92$137.38
    15400TSkin heterograft002613.51$686.88$277.92$137.38
    15401TSkin heterograft add-on002613.51$686.88$277.92$137.38
    15570TForm skin pedicle flap002613.51$686.88$277.92$137.38
    15572TForm skin pedicle flap002613.51$686.88$277.92$137.38
    15574TForm skin pedicle flap002613.51$686.88$277.92$137.38
    15576TForm skin pedicle flap002613.51$686.88$277.92$137.38
    15600TSkin graft002613.51$686.88$277.92$137.38
    15610TSkin graft002613.51$686.88$277.92$137.38
    15620TSkin graft002613.51$686.88$277.92$137.38
    15630TSkin graft002613.51$686.88$277.92$137.38
    15650TTransfer skin pedicle flap002613.51$686.88$277.92$137.38
    15732TMuscle-skin graft, head/neck002719.31$981.76$383.10$196.35
    15734TMuscle-skin graft, trunk002719.31$981.76$383.10$196.35
    15736TMuscle-skin graft, arm002719.31$981.76$383.10$196.35
    15738TMuscle-skin graft, leg002719.31$981.76$383.10$196.35
    15740TIsland pedicle flap graft002719.31$981.76$383.10$196.35
    15750TNeurovascular pedicle graft002719.31$981.76$383.10$196.35
    15756CFree muscle flap, microvasc
    15757CFree skin flap, microvasc
    15758CFree fascial flap, microvasc
    15760TComposite skin graft002719.31$981.76$383.10$196.35
    15770TDerma-fat-fascia graft002719.31$981.76$383.10$196.35
    15775THair transplant punch grafts002613.51$686.88$277.92$137.38
    15776THair transplant punch grafts002613.51$686.88$277.92$137.38
    15780TAbrasion treatment of skin002215.07$766.19$292.94$153.24
    15781TAbrasion treatment of skin002215.07$766.19$292.94$153.24
    15782TAbrasion treatment of skin002215.07$766.19$292.94$153.24
    15783TAbrasion treatment of skin00163.31$168.29$70.68$33.66
    15786TAbrasion, lesion, single00131.51$76.77$17.66$15.35
    15787TAbrasion, lesions, add-on00131.51$76.77$17.66$15.35
    15788TChemical peel, face, epiderm00120.72$36.61$9.18$7.32
    15789TChemical peel, face, dermal00152.29$116.43$31.20$23.29
    15792TChemical peel, nonfacial00120.72$36.61$9.18$7.32
    15793TChemical peel, nonfacial00131.51$76.77$17.66$15.35
    15810TSalabrasion00163.31$168.29$70.68$33.66
    15811TSalabrasion00163.31$168.29$70.68$33.66
    15819TPlastic surgery, neck002613.51$686.88$277.92$137.38
    15820TRevision of lower eyelid002613.51$686.88$277.92$137.38
    15821TRevision of lower eyelid002613.51$686.88$277.92$137.38
    15822TRevision of upper eyelid002613.51$686.88$277.92$137.38
    15823TRevision of upper eyelid002613.51$686.88$277.92$137.38
    15824TRemoval of forehead wrinkles002719.31$981.76$383.10$196.35
    15825TRemoval of neck wrinkles002613.51$686.88$277.92$137.38
    15826TRemoval of brow wrinkles002613.51$686.88$277.92$137.38
    15828TRemoval of face wrinkles002719.31$981.76$383.10$196.35
    15829TRemoval of skin wrinkles002613.51$686.88$277.92$137.38
    15831TExcise excessive skin tissue002215.07$766.19$292.94$153.24
    15832TExcise excessive skin tissue002215.07$766.19$292.94$153.24
    15833TExcise excessive skin tissue002215.07$766.19$292.94$153.24
    15834TExcise excessive skin tissue002215.07$766.19$292.94$153.24
    15835TExcise excessive skin tissue002613.51$686.88$277.92$137.38
    15836TExcise excessive skin tissue00194.56$231.84$78.91$46.37
    15837TExcise excessive skin tissue00194.56$231.84$78.91$46.37
    15838TExcise excessive skin tissue00194.56$231.84$78.91$46.37
    15839TExcise excessive skin tissue00194.56$231.84$78.91$46.37
    15840TGraft for face nerve palsy002719.31$981.76$383.10$196.35
    15841TGraft for face nerve palsy002719.31$981.76$383.10$196.35
    15842TFlap for face nerve palsy002719.31$981.76$383.10$196.35
    15845TSkin and muscle repair, face002719.31$981.76$383.10$196.35
    15850TRemoval of sutures00163.31$168.29$70.68$33.66
    15851TRemoval of sutures00131.51$76.77$17.66$15.35
    15852TDressing change,not for burn00131.51$76.77$17.66$15.35
    15860NTest for blood flow in graft
    15876TSuction assisted lipectomy002719.31$981.76$383.10$196.35
    15877TSuction assisted lipectomy002719.31$981.76$383.10$196.35
    15878TSuction assisted lipectomy002719.31$981.76$383.10$196.35
    15879TSuction assisted lipectomy002719.31$981.76$383.10$196.35
    15920TRemoval of tail bone ulcer002215.07$766.19$292.94$153.24
    15922TRemoval of tail bone ulcer002719.31$981.76$383.10$196.35
    15931TRemove sacrum pressure sore002215.07$766.19$292.94$153.24
    15933TRemove sacrum pressure sore002215.07$766.19$292.94$153.24
    15934TRemove sacrum pressure sore002719.31$981.76$383.10$196.35
    15935TRemove sacrum pressure sore002719.31$981.76$383.10$196.35
    Start Printed Page 44737
    15936TRemove sacrum pressure sore002719.31$981.76$383.10$196.35
    15937TRemove sacrum pressure sore002719.31$981.76$383.10$196.35
    15940TRemove hip pressure sore002215.07$766.19$292.94$153.24
    15941TRemove hip pressure sore002215.07$766.19$292.94$153.24
    15944TRemove hip pressure sore002719.31$981.76$383.10$196.35
    15945TRemove hip pressure sore002719.31$981.76$383.10$196.35
    15946TRemove hip pressure sore002719.31$981.76$383.10$196.35
    15950TRemove thigh pressure sore002215.07$766.19$292.94$153.24
    15951TRemove thigh pressure sore002215.07$766.19$292.94$153.24
    15952TRemove thigh pressure sore002719.31$981.76$383.10$196.35
    15953TRemove thigh pressure sore002719.31$981.76$383.10$196.35
    15956TRemove thigh pressure sore002719.31$981.76$383.10$196.35
    15958TRemove thigh pressure sore002719.31$981.76$383.10$196.35
    15999TRemoval of pressure sore002215.07$766.19$292.94$153.24
    16000TInitial treatment of burn(s)00131.51$76.77$17.66$15.35
    16010TTreatment of burn(s)00163.31$168.29$70.68$33.66
    16015TTreatment of burn(s)001710.51$534.35$245.80$106.87
    16020TTreatment of burn(s)00131.51$76.77$17.66$15.35
    16025TTreatment of burn(s)00131.51$76.77$17.66$15.35
    16030TTreatment of burn(s)00152.29$116.43$31.20$23.29
    16035CIncision of burn scab, initi
    16036CIncise burn scab, addl incis
    17000TDestroy benign/premal lesion00100.71$36.10$9.86$7.22
    17003TDestroy lesions, 2-1400100.71$36.10$9.86$7.22
    17004TDestroy lesions, 15 or more00111.57$79.82$29.53$15.96
    17106TDestruction of skin lesions00111.57$79.82$29.53$15.96
    17107TDestruction of skin lesions00111.57$79.82$29.53$15.96
    17108TDestruction of skin lesions00111.57$79.82$29.53$15.96
    17110TDestruct lesion, 1-1400100.71$36.10$9.86$7.22
    17111TDestruct lesion, 15 or more00111.57$79.82$29.53$15.96
    17250TChemical cautery, tissue00131.51$76.77$17.66$15.35
    17260TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17261TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17262TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17263TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17264TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17266TDestruction of skin lesions00163.31$168.29$70.68$33.66
    17270TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17271TDestruction of skin lesions00120.72$36.61$9.18$7.32
    17272TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17273TDestruction of skin lesions00152.29$116.43$31.20$23.29
    17274TDestruction of skin lesions00163.31$168.29$70.68$33.66
    17276TDestruction of skin lesions00163.31$168.29$70.68$33.66
    17280TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17281TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17282TDestruction of skin lesions00152.29$116.43$31.20$23.29
    17283TDestruction of skin lesions00152.29$116.43$31.20$23.29
    17284TDestruction of skin lesions00163.31$168.29$70.68$33.66
    17286TDestruction of skin lesions00131.51$76.77$17.66$15.35
    17304TChemosurgery of skin lesion06944.28$217.60$65.28$43.52
    17305T2nd stage chemosurgery06944.28$217.60$65.28$43.52
    17306T3rd stage chemosurgery06944.28$217.60$65.28$43.52
    17307TFollowup skin lesion therapy06944.28$217.60$65.28$43.52
    17310TExtensive skin chemosurgery06944.28$217.60$65.28$43.52
    17340TCryotherapy of skin00120.72$36.61$9.18$7.32
    17360TSkin peel therapy00120.72$36.61$9.18$7.32
    17380THair removal by electrolysis001710.51$534.35$245.80$106.87
    17999TSkin tissue procedure00043.00$152.53$32.57$30.51
    19000TDrainage of breast lesion00043.00$152.53$32.57$30.51
    19001TDrain breast lesion add-on00043.00$152.53$32.57$30.51
    19020TIncision of breast lesion000811.36$577.57$115.51$115.51
    19030NInjection for breast x-ray
    19100TBx breast percut w/o image00056.71$341.15$119.75$68.23
    19101TBiopsy of breast, open002814.95$760.09$303.74$152.02
    19102TBx breast percut w/image00056.71$341.15$119.75$68.23
    19103SBx breast percut w/device09747.57$384.87$76.97
    19110TNipple exploration002814.95$760.09$303.74$152.02
    19112TExcise breast duct fistula002814.95$760.09$303.74$152.02
    19120TRemoval of breast lesion002814.95$760.09$303.74$152.02
    19125TExcision, breast lesion002814.95$760.09$303.74$152.02
    19126TExcision, addl breast lesion002814.95$760.09$303.74$152.02
    19140TRemoval of breast tissue002814.95$760.09$303.74$152.02
    19160TRemoval of breast tissue002814.95$760.09$303.74$152.02
    19162TRemove breast tissue, nodes069333.16$1,685.92$826.10$337.18
    19180TRemoval of breast003025.95$1,319.35$646.48$263.87
    Start Printed Page 44738
    19182TRemoval of breast003025.95$1,319.35$646.48$263.87
    19200CRemoval of breast
    19220CRemoval of breast
    19240TRemoval of breast002935.93$1,826.75$820.79$365.35
    19260TRemoval of chest wall lesion002112.74$647.73$236.51$129.55
    19271CRevision of chest wall
    19272CExtensive chest wall surgery
    19290NPlace needle wire, breast
    19291NPlace needle wire, breast
    19295NPlace breast clip, percut
    19316TSuspension of breast003025.95$1,319.35$646.48$263.87
    19318TReduction of large breast069333.16$1,685.92$826.10$337.18
    19324TEnlarge breast069333.16$1,685.92$826.10$337.18
    19325TEnlarge breast with implant069333.16$1,685.92$826.10$337.18
    19328TRemoval of breast implant003025.95$1,319.35$646.48$263.87
    19330TRemoval of implant material003025.95$1,319.35$646.48$263.87
    19340TImmediate breast prosthesis003025.95$1,319.35$646.48$263.87
    19342TDelayed breast prosthesis069333.16$1,685.92$826.10$337.18
    19350TBreast reconstruction003025.95$1,319.35$646.48$263.87
    19355TCorrect inverted nipple(s)003025.95$1,319.35$646.48$263.87
    19357TBreast reconstruction069333.16$1,685.92$826.10$337.18
    19361CBreast reconstruction
    19364CBreast reconstruction
    19366TBreast reconstruction003025.95$1,319.35$646.48$263.87
    19367CBreast reconstruction
    19368CBreast reconstruction
    19369CBreast reconstruction
    19370TSurgery of breast capsule003025.95$1,319.35$646.48$263.87
    19371TRemoval of breast capsule003025.95$1,319.35$646.48$263.87
    19380TRevise breast reconstruction003025.95$1,319.35$646.48$263.87
    19396TDesign custom breast implant002935.93$1,826.75$820.79$365.35
    19499TBreast surgery procedure002935.93$1,826.75$820.79$365.35
    20000TIncision of abscess00062.36$119.99$33.95$24.00
    20005TIncision of deep abscess004917.07$867.87$356.95$173.57
    20100TExplore wound, neck00232.18$110.84$40.37$22.17
    20101TExplore wound, chest002613.51$686.88$277.92$137.38
    20102TExplore wound, abdomen002613.51$686.88$277.92$137.38
    20103TExplore wound, extremity00232.18$110.84$40.37$22.17
    20150TExcise epiphyseal bar005130.94$1,573.05$675.24$314.61
    20200TMuscle biopsy00208.56$435.21$130.53$87.04
    20205TDeep muscle biopsy002112.74$647.73$236.51$129.55
    20206TNeedle biopsy, muscle00056.71$341.15$119.75$68.23
    20220TBone biopsy, trocar/needle00194.56$231.84$78.91$46.37
    20225TBone biopsy, trocar/needle00208.56$435.21$130.53$87.04
    20240TBone biopsy, excisional002215.07$766.19$292.94$153.24
    20245TBone biopsy, excisional002215.07$766.19$292.94$153.24
    20250TOpen bone biopsy004917.07$867.87$356.95$173.57
    20251TOpen bone biopsy004917.07$867.87$356.95$173.57
    20500TInjection of sinus tract02512.71$137.78$27.99$27.56
    20501NInject sinus tract for x-ray
    20520TRemoval of foreign body00194.56$231.84$78.91$46.37
    20525TRemoval of foreign body002215.07$766.19$292.94$153.24
    20550TInject tendon/ligament/cyst02042.44$124.05$47.14$24.81
    20600TDrain/inject, joint/bursa02042.44$124.05$47.14$24.81
    20605TDrain/inject, joint/bursa02042.44$124.05$47.14$24.81
    20610TDrain/inject, joint/bursa02042.44$124.05$47.14$24.81
    20615TTreatment of bone cyst00043.00$152.53$32.57$30.51
    20650TInsert and remove bone pin004917.07$867.87$356.95$173.57
    20660CApply,remove fixation device
    20661CApplication of head brace
    20662CApplication of pelvis brace
    20663CApplication of thigh brace
    20664CHalo brace application
    20665NRemoval of fixation device
    20670TRemoval of support implant002112.74$647.73$236.51$129.55
    20680TRemoval of support implant002215.07$766.19$292.94$153.24
    20690TApply bone fixation device005022.31$1,134.29$513.86$226.86
    20692TApply bone fixation device005022.31$1,134.29$513.86$226.86
    20693TAdjust bone fixation device004917.07$867.87$356.95$173.57
    20694TRemove bone fixation device004917.07$867.87$356.95$173.57
    20802CReplantation, arm, complete
    20805CReplant, forearm, complete
    20808CReplantation hand, complete
    20816CReplantation digit, complete
    20822CReplantation digit, complete
    Start Printed Page 44739
    20824CReplantation thumb, complete
    20827CReplantation thumb, complete
    20838CReplantation foot, complete
    20900TRemoval of bone for graft005022.31$1,134.29$513.86$226.86
    20902TRemoval of bone for graft005022.31$1,134.29$513.86$226.86
    20910TRemove cartilage for graft002613.51$686.88$277.92$137.38
    20912TRemove cartilage for graft002613.51$686.88$277.92$137.38
    20920TRemoval of fascia for graft002613.51$686.88$277.92$137.38
    20922TRemoval of fascia for graft002613.51$686.88$277.92$137.38
    20924TRemoval of tendon for graft005022.31$1,134.29$513.86$226.86
    20926TRemoval of tissue for graft002613.51$686.88$277.92$137.38
    20930CSpinal bone allograft
    20931CSpinal bone allograft
    20936CSpinal bone autograft
    20937CSpinal bone autograft
    20938CSpinal bone autograft
    20950TFluid pressure, muscle000811.36$577.57$115.51$115.51
    20955CFibula bone graft, microvasc
    20956CIliac bone graft, microvasc
    20957CMt bone graft, microvasc
    20962COther bone graft, microvasc
    20969CBone/skin graft, microvasc
    20970CBone/skin graft, iliac crest
    20972CBone/skin graft, metatarsal
    20973CBone/skin graft, great toe
    20974AElectrical bone stimulation
    20975TElectrical bone stimulation004917.07$867.87$356.95$173.57
    20979EUs bone stimulation
    20999NMusculoskeletal surgery
    21010TIncision of jaw joint025419.11$971.59$272.41$194.32
    21015TResection of facial tumor02526.53$332.00$114.24$66.40
    21025TExcision of bone, lower jaw025628.82$1,465.27$623.05$293.05
    21026TExcision of facial bone(s)025628.82$1,465.27$623.05$293.05
    21029TContour of face bone lesion025628.82$1,465.27$623.05$293.05
    21030TRemoval of face bone lesion025419.11$971.59$272.41$194.32
    21031TRemove exostosis, mandible025419.11$971.59$272.41$194.32
    21032TRemove exostosis, maxilla025419.11$971.59$272.41$194.32
    21034TRemoval of face bone lesion025628.82$1,465.27$623.05$293.05
    21040TRemoval of jaw bone lesion025419.11$971.59$272.41$194.32
    21041TRemoval of jaw bone lesion025628.82$1,465.27$623.05$293.05
    21044TRemoval of jaw bone lesion025628.82$1,465.27$623.05$293.05
    21045CExtensive jaw surgery
    21050TRemoval of jaw joint025628.82$1,465.27$623.05$293.05
    21060TRemove jaw joint cartilage025628.82$1,465.27$623.05$293.05
    21070TRemove coronoid process025628.82$1,465.27$623.05$293.05
    21076TPrepare face/oral prosthesis025419.11$971.59$272.41$194.32
    21077TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21079TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21080TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21081TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21082TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21083TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21084TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21085TPrepare face/oral prosthesis025313.27$674.67$284.00$134.93
    21086TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21087TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21088TPrepare face/oral prosthesis025628.82$1,465.27$623.05$293.05
    21089TPrepare face/oral prosthesis025313.27$674.67$284.00$134.93
    21100TMaxillofacial fixation025628.82$1,465.27$623.05$293.05
    21110TInterdental fixation02526.53$332.00$114.24$66.40
    21116NInjection, jaw joint x-ray
    21120TReconstruction of chin025419.11$971.59$272.41$194.32
    21121TReconstruction of chin025419.11$971.59$272.41$194.32
    21122TReconstruction of chin025419.11$971.59$272.41$194.32
    21123TReconstruction of chin025419.11$971.59$272.41$194.32
    21125TAugmentation, lower jaw bone025419.11$971.59$272.41$194.32
    21127TAugmentation, lower jaw bone025628.82$1,465.27$623.05$293.05
    21137TReduction of forehead025419.11$971.59$272.41$194.32
    21138TReduction of forehead025628.82$1,465.27$623.05$293.05
    21139TReduction of forehead025628.82$1,465.27$623.05$293.05
    21141CReconstruct midface, lefort
    21142CReconstruct midface, lefort
    21143CReconstruct midface, lefort
    21145CReconstruct midface, lefort
    21146CReconstruct midface, lefort
    Start Printed Page 44740
    21147CReconstruct midface, lefort
    21150CReconstruct midface, lefort
    21151CReconstruct midface, lefort
    21154CReconstruct midface, lefort
    21155CReconstruct midface, lefort
    21159CReconstruct midface, lefort
    21160CReconstruct midface, lefort
    21172CReconstruct orbit/forehead
    21175CReconstruct orbit/forehead
    21179CReconstruct entire forehead
    21180CReconstruct entire forehead
    21181TContour cranial bone lesion025419.11$971.59$272.41$194.32
    21182CReconstruct cranial bone
    21183CReconstruct cranial bone
    21184CReconstruct cranial bone
    21188CReconstruction of midface
    21193CReconst lwr jaw w/o graft
    21194CReconst lwr jaw w/graft
    21195CReconst lwr jaw w/o fixation
    21196CReconst lwr jaw w/fixation
    21198TReconstr lwr jaw segment025628.82$1,465.27$623.05$293.05
    21199TReconstr lwr jaw w/advance025628.82$1,465.27$623.05$293.05
    21206TReconstruct upper jaw bone025628.82$1,465.27$623.05$293.05
    21208TAugmentation of facial bones025628.82$1,465.27$623.05$293.05
    21209TReduction of facial bones025628.82$1,465.27$623.05$293.05
    21210TFace bone graft025628.82$1,465.27$623.05$293.05
    21215TLower jaw bone graft025628.82$1,465.27$623.05$293.05
    21230TRib cartilage graft025628.82$1,465.27$623.05$293.05
    21235TEar cartilage graft025419.11$971.59$272.41$194.32
    21240TReconstruction of jaw joint025628.82$1,465.27$623.05$293.05
    21242TReconstruction of jaw joint025628.82$1,465.27$623.05$293.05
    21243TReconstruction of jaw joint025628.82$1,465.27$623.05$293.05
    21244TReconstruction of lower jaw025628.82$1,465.27$623.05$293.05
    21245TReconstruction of jaw025628.82$1,465.27$623.05$293.05
    21246TReconstruction of jaw025628.82$1,465.27$623.05$293.05
    21247CReconstruct lower jaw bone
    21248TReconstruction of jaw025628.82$1,465.27$623.05$293.05
    21249TReconstruction of jaw025628.82$1,465.27$623.05$293.05
    21255CReconstruct lower jaw bone
    21256CReconstruction of orbit
    21260TRevise eye sockets025628.82$1,465.27$623.05$293.05
    21261TRevise eye sockets025628.82$1,465.27$623.05$293.05
    21263TRevise eye sockets025628.82$1,465.27$623.05$293.05
    21267TRevise eye sockets025628.82$1,465.27$623.05$293.05
    21268CRevise eye sockets
    21270TAugmentation, cheek bone025628.82$1,465.27$623.05$293.05
    21275TRevision, orbitofacial bones025628.82$1,465.27$623.05$293.05
    21280TRevision of eyelid025628.82$1,465.27$623.05$293.05
    21282TRevision of eyelid025313.27$674.67$284.00$134.93
    21295TRevision of jaw muscle/bone02526.53$332.00$114.24$66.40
    21296TRevision of jaw muscle/bone025419.11$971.59$272.41$194.32
    21299TCranio/maxillofacial surgery025313.27$674.67$284.00$134.93
    21300TTreatment of skull fracture025313.27$674.67$284.00$134.93
    21310TTreatment of nose fracture025313.27$674.67$284.00$134.93
    21315TTreatment of nose fracture025313.27$674.67$284.00$134.93
    21320TTreatment of nose fracture025313.27$674.67$284.00$134.93
    21325TTreatment of nose fracture025419.11$971.59$272.41$194.32
    21330TTreatment of nose fracture025419.11$971.59$272.41$194.32
    21335TTreatment of nose fracture025419.11$971.59$272.41$194.32
    21336TTreat nasal septal fracture004625.36$1,289.35$535.76$257.87
    21337TTreat nasal septal fracture025313.27$674.67$284.00$134.93
    21338TTreat nasoethmoid fracture025419.11$971.59$272.41$194.32
    21339TTreat nasoethmoid fracture025419.11$971.59$272.41$194.32
    21340TTreatment of nose fracture025628.82$1,465.27$623.05$293.05
    21343CTreatment of sinus fracture
    21344CTreatment of sinus fracture
    21345TTreat nose/jaw fracture025419.11$971.59$272.41$194.32
    21346CTreat nose/jaw fracture
    21347CTreat nose/jaw fracture
    21348CTreat nose/jaw fracture
    21355TTreat cheek bone fracture025628.82$1,465.27$623.05$293.05
    21356CTreat cheek bone fracture
    21360CTreat cheek bone fracture
    21365CTreat cheek bone fracture
    21366CTreat cheek bone fracture
    Start Printed Page 44741
    21385CTreat eye socket fracture
    21386CTreat eye socket fracture
    21387CTreat eye socket fracture
    21390CTreat eye socket fracture
    21395CTreat eye socket fracture
    21400TTreat eye socket fracture02526.53$332.00$114.24$66.40
    21401TTreat eye socket fracture025313.27$674.67$284.00$134.93
    21406TTreat eye socket fracture025628.82$1,465.27$623.05$293.05
    21407TTreat eye socket fracture025628.82$1,465.27$623.05$293.05
    21408CTreat eye socket fracture
    21421TTreat mouth roof fracture025419.11$971.59$272.41$194.32
    21422CTreat mouth roof fracture
    21423CTreat mouth roof fracture
    21431CTreat craniofacial fracture
    21432CTreat craniofacial fracture
    21433CTreat craniofacial fracture
    21435CTreat craniofacial fracture
    21436CTreat craniofacial fracture
    21440TTreat dental ridge fracture025419.11$971.59$272.41$194.32
    21445TTreat dental ridge fracture025419.11$971.59$272.41$194.32
    21450TTreat lower jaw fracture02512.71$137.78$27.99$27.56
    21451TTreat lower jaw fracture02526.53$332.00$114.24$66.40
    21452TTreat lower jaw fracture025313.27$674.67$284.00$134.93
    21453TTreat lower jaw fracture025628.82$1,465.27$623.05$293.05
    21454TTreat lower jaw fracture025419.11$971.59$272.41$194.32
    21461TTreat lower jaw fracture025628.82$1,465.27$623.05$293.05
    21462TTreat lower jaw fracture025628.82$1,465.27$623.05$293.05
    21465TTreat lower jaw fracture025628.82$1,465.27$623.05$293.05
    21470TTreat lower jaw fracture025628.82$1,465.27$623.05$293.05
    21480TReset dislocated jaw02512.71$137.78$27.99$27.56
    21485TReset dislocated jaw025313.27$674.67$284.00$134.93
    21490TRepair dislocated jaw025628.82$1,465.27$623.05$293.05
    21493TTreat hyoid bone fracture02526.53$332.00$114.24$66.40
    21494TTreat hyoid bone fracture02526.53$332.00$114.24$66.40
    21495CTreat hyoid bone fracture
    21497TInterdental wiring025313.27$674.67$284.00$134.93
    21499THead surgery procedure025313.27$674.67$284.00$134.93
    21501TDrain neck/chest lesion000811.36$577.57$115.51$115.51
    21502TDrain chest lesion004917.07$867.87$356.95$173.57
    21510CDrainage of bone lesion
    21550TBiopsy of neck/chest00194.56$231.84$78.91$46.37
    21555TRemove lesion, neck/chest002215.07$766.19$292.94$153.24
    21556TRemove lesion, neck/chest002215.07$766.19$292.94$153.24
    21557CRemove tumor, neck/chest
    21600TPartial removal of rib005022.31$1,134.29$513.86$226.86
    21610TPartial removal of rib005022.31$1,134.29$513.86$226.86
    21615CRemoval of rib
    21616CRemoval of rib and nerves
    21620CPartial removal of sternum
    21627CSternal debridement
    21630CExtensive sternum surgery
    21632CExtensive sternum surgery
    21700TRevision of neck muscle000811.36$577.57$115.51$115.51
    21705CRevision of neck muscle/rib
    21720TRevision of neck muscle000811.36$577.57$115.51$115.51
    21725TRevision of neck muscle000811.36$577.57$115.51$115.51
    21740CReconstruction of sternum
    21750CRepair of sternum separation
    21800TTreatment of rib fracture00434.13$209.98$42.00$42.00
    21805TTreatment of rib fracture004625.36$1,289.35$535.76$257.87
    21810CTreatment of rib fracture(s)
    21820TTreat sternum fracture00442.73$138.80$38.08$27.76
    21825CTreat sternum fracture
    21899TNeck/chest surgery procedure02526.53$332.00$114.24$66.40
    21920TBiopsy soft tissue of back00208.56$435.21$130.53$87.04
    21925TBiopsy soft tissue of back002215.07$766.19$292.94$153.24
    21930TRemove lesion, back or flank002215.07$766.19$292.94$153.24
    21935TRemove tumor, back002215.07$766.19$292.94$153.24
    22100CRemove part of neck vertebra
    22101CRemove part, thorax vertebra
    22102CRemove part, lumbar vertebra
    22103CRemove extra spine segment
    22110CRemove part of neck vertebra
    22112CRemove part, thorax vertebra
    22114CRemove part, lumbar vertebra
    Start Printed Page 44742
    22116CRemove extra spine segment
    22210CRevision of neck spine
    22212CRevision of thorax spine
    22214CRevision of lumbar spine
    22216CRevise, extra spine segment
    22220CRevision of neck spine
    22222CRevision of thorax spine
    22224CRevision of lumbar spine
    22226CRevise, extra spine segment
    22305TTreat spine process fracture00434.13$209.98$42.00$42.00
    22310TTreat spine fracture00434.13$209.98$42.00$42.00
    22315TTreat spine fracture00434.13$209.98$42.00$42.00
    22318CTreat odontoid fx w/o graft
    22319CTreat odontoid fx w/graft
    22325CTreat spine fracture
    22326CTreat neck spine fracture
    22327CTreat thorax spine fracture
    22328CTreat each add spine fx
    22505TManipulation of spine004512.91$656.37$277.12$131.27
    22520TPercut vertebroplasty thor005022.31$1,134.29$513.86$226.86
    22521TPercut vertebroplasty lumb005022.31$1,134.29$513.86$226.86
    22522TPercut vertebroplasty addl005022.31$1,134.29$513.86$226.86
    22548CNeck spine fusion
    22554CNeck spine fusion
    22556CThorax spine fusion
    22558CLumbar spine fusion
    22585CAdditional spinal fusion
    22590CSpine & skull spinal fusion
    22595CNeck spinal fusion
    22600CNeck spine fusion
    22610CThorax spine fusion
    22612CLumbar spine fusion
    22614CSpine fusion, extra segment
    22630CLumbar spine fusion
    22632CSpine fusion, extra segment
    22800CFusion of spine
    22802CFusion of spine
    22804CFusion of spine
    22808CFusion of spine
    22810CFusion of spine
    22812CFusion of spine
    22818CKyphectomy, 1-2 segments
    22819CKyphectomy, 3 or more
    22830CExploration of spinal fusion
    22840CInsert spine fixation device
    22841CInsert spine fixation device
    22842CInsert spine fixation device
    22843CInsert spine fixation device
    22844CInsert spine fixation device
    22845CInsert spine fixation device
    22846CInsert spine fixation device
    22847CInsert spine fixation device
    22848CInsert pelv fixation device
    22849CReinsert spinal fixation
    22850CRemove spine fixation device
    22851CApply spine prosth device
    22852CRemove spine fixation device
    22855CRemove spine fixation device
    22899TSpine surgery procedure00434.13$209.98$42.00$42.00
    22900TRemove abdominal wall lesion002215.07$766.19$292.94$153.24
    22999TAbdomen surgery procedure002215.07$766.19$292.94$153.24
    23000TRemoval of calcium deposits002112.74$647.73$236.51$129.55
    23020TRelease shoulder joint005130.94$1,573.05$675.24$314.61
    23030TDrain shoulder lesion000811.36$577.57$115.51$115.51
    23031TDrain shoulder bursa000811.36$577.57$115.51$115.51
    23035CDrain shoulder bone lesion
    23040TExploratory shoulder surgery005022.31$1,134.29$513.86$226.86
    23044TExploratory shoulder surgery005022.31$1,134.29$513.86$226.86
    23065TBiopsy shoulder tissues002112.74$647.73$236.51$129.55
    23066TBiopsy shoulder tissues002215.07$766.19$292.94$153.24
    23075TRemoval of shoulder lesion002112.74$647.73$236.51$129.55
    23076TRemoval of shoulder lesion002215.07$766.19$292.94$153.24
    23077TRemove tumor of shoulder002215.07$766.19$292.94$153.24
    23100TBiopsy of shoulder joint004917.07$867.87$356.95$173.57
    23101TShoulder joint surgery005022.31$1,134.29$513.86$226.86
    Start Printed Page 44743
    23105TRemove shoulder joint lining005022.31$1,134.29$513.86$226.86
    23106TIncision of collarbone joint005022.31$1,134.29$513.86$226.86
    23107TExplore treat shoulder joint005022.31$1,134.29$513.86$226.86
    23120TPartial removal, collar bone005130.94$1,573.05$675.24$314.61
    23125CRemoval of collar bone
    23130TRemove shoulder bone, part005130.94$1,573.05$675.24$314.61
    23140TRemoval of bone lesion004917.07$867.87$356.95$173.57
    23145TRemoval of bone lesion005022.31$1,134.29$513.86$226.86
    23146TRemoval of bone lesion005022.31$1,134.29$513.86$226.86
    23150TRemoval of humerus lesion005022.31$1,134.29$513.86$226.86
    23155TRemoval of humerus lesion005022.31$1,134.29$513.86$226.86
    23156TRemoval of humerus lesion005022.31$1,134.29$513.86$226.86
    23170TRemove collar bone lesion005022.31$1,134.29$513.86$226.86
    23172TRemove shoulder blade lesion005022.31$1,134.29$513.86$226.86
    23174TRemove humerus lesion005022.31$1,134.29$513.86$226.86
    23180TRemove collar bone lesion005022.31$1,134.29$513.86$226.86
    23182TRemove shoulder blade lesion005022.31$1,134.29$513.86$226.86
    23184TRemove humerus lesion005022.31$1,134.29$513.86$226.86
    23190TPartial removal of scapula005022.31$1,134.29$513.86$226.86
    23195CRemoval of head of humerus
    23200CRemoval of collar bone
    23210CRemoval of shoulder blade
    23220CPartial removal of humerus
    23221CPartial removal of humerus
    23222CPartial removal of humerus
    23330TRemove shoulder foreign body00194.56$231.84$78.91$46.37
    23331TRemove shoulder foreign body002215.07$766.19$292.94$153.24
    23332CRemove shoulder foreign body
    23350NInjection for shoulder x-ray
    23395CMuscle transfer,shoulder/arm
    23397CMuscle transfers
    23400CFixation of shoulder blade
    23405TIncision of tendon & muscle005022.31$1,134.29$513.86$226.86
    23406TIncise tendon(s) & muscle(s)005022.31$1,134.29$513.86$226.86
    23410TRepair of tendon(s)005238.88$1,976.74$930.91$395.35
    23412TRepair of tendon(s)005238.88$1,976.74$930.91$395.35
    23415TRelease of shoulder ligament005130.94$1,573.05$675.24$314.61
    23420TRepair of shoulder005238.88$1,976.74$930.91$395.35
    23430TRepair biceps tendon005238.88$1,976.74$930.91$395.35
    23440CRemove/transplant tendon
    23450TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23455TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23460TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23462TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23465TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23466TRepair shoulder capsule005238.88$1,976.74$930.91$395.35
    23470CReconstruct shoulder joint
    23472CReconstruct shoulder joint
    23480TRevision of collar bone005130.94$1,573.05$675.24$314.61
    23485TRevision of collar bone005130.94$1,573.05$675.24$314.61
    23490TReinforce clavicle005130.94$1,573.05$675.24$314.61
    23491TReinforce shoulder bones005130.94$1,573.05$675.24$314.61
    23500TTreat clavicle fracture00434.13$209.98$42.00$42.00
    23505TTreat clavicle fracture00434.13$209.98$42.00$42.00
    23515TTreat clavicle fracture004625.36$1,289.35$535.76$257.87
    23520TTreat clavicle dislocation00442.73$138.80$38.08$27.76
    23525TTreat clavicle dislocation00434.13$209.98$42.00$42.00
    23530TTreat clavicle dislocation004625.36$1,289.35$535.76$257.87
    23532TTreat clavicle dislocation004625.36$1,289.35$535.76$257.87
    23540TTreat clavicle dislocation00442.73$138.80$38.08$27.76
    23545TTreat clavicle dislocation00434.13$209.98$42.00$42.00
    23550TTreat clavicle dislocation004625.36$1,289.35$535.76$257.87
    23552TTreat clavicle dislocation004625.36$1,289.35$535.76$257.87
    23570TTreat shoulder blade fx00434.13$209.98$42.00$42.00
    23575TTreat shoulder blade fx00442.73$138.80$38.08$27.76
    23585TTreat scapula fracture004625.36$1,289.35$535.76$257.87
    23600TTreat humerus fracture00442.73$138.80$38.08$27.76
    23605TTreat humerus fracture00442.73$138.80$38.08$27.76
    23615TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    23616TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    23620TTreat humerus fracture00442.73$138.80$38.08$27.76
    23625TTreat humerus fracture00442.73$138.80$38.08$27.76
    23630TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    23650TTreat shoulder dislocation00434.13$209.98$42.00$42.00
    23655TTreat shoulder dislocation004512.91$656.37$277.12$131.27
    Start Printed Page 44744
    23660TTreat shoulder dislocation004625.36$1,289.35$535.76$257.87
    23665TTreat dislocation/fracture00442.73$138.80$38.08$27.76
    23670TTreat dislocation/fracture004625.36$1,289.35$535.76$257.87
    23675TTreat dislocation/fracture00442.73$138.80$38.08$27.76
    23680TTreat dislocation/fracture004625.36$1,289.35$535.76$257.87
    23700TFixation of shoulder004512.91$656.37$277.12$131.27
    23800TFusion of shoulder joint005130.94$1,573.05$675.24$314.61
    23802TFusion of shoulder joint005130.94$1,573.05$675.24$314.61
    23900CAmputation of arm & girdle
    23920CAmputation at shoulder joint
    23921TAmputation follow-up surgery002613.51$686.88$277.92$137.38
    23929TShoulder surgery procedure00434.13$209.98$42.00$42.00
    23930TDrainage of arm lesion000811.36$577.57$115.51$115.51
    23931TDrainage of arm bursa000811.36$577.57$115.51$115.51
    23935TDrain arm/elbow bone lesion004917.07$867.87$356.95$173.57
    24000TExploratory elbow surgery005022.31$1,134.29$513.86$226.86
    24006TRelease elbow joint005022.31$1,134.29$513.86$226.86
    24065TBiopsy arm/elbow soft tissue00208.56$435.21$130.53$87.04
    24066TBiopsy arm/elbow soft tissue002112.74$647.73$236.51$129.55
    24075TRemove arm/elbow lesion002112.74$647.73$236.51$129.55
    24076TRemove arm/elbow lesion002215.07$766.19$292.94$153.24
    24077TRemove tumor of arm/elbow002215.07$766.19$292.94$153.24
    24100TBiopsy elbow joint lining004917.07$867.87$356.95$173.57
    24101TExplore/treat elbow joint005022.31$1,134.29$513.86$226.86
    24102TRemove elbow joint lining005022.31$1,134.29$513.86$226.86
    24105TRemoval of elbow bursa004917.07$867.87$356.95$173.57
    24110TRemove humerus lesion004917.07$867.87$356.95$173.57
    24115TRemove/graft bone lesion005022.31$1,134.29$513.86$226.86
    24116TRemove/graft bone lesion005022.31$1,134.29$513.86$226.86
    24120TRemove elbow lesion004917.07$867.87$356.95$173.57
    24125TRemove/graft bone lesion005022.31$1,134.29$513.86$226.86
    24126TRemove/graft bone lesion005022.31$1,134.29$513.86$226.86
    24130TRemoval of head of radius005022.31$1,134.29$513.86$226.86
    24134TRemoval of arm bone lesion005022.31$1,134.29$513.86$226.86
    24136TRemove radius bone lesion005022.31$1,134.29$513.86$226.86
    24138TRemove elbow bone lesion005022.31$1,134.29$513.86$226.86
    24140TPartial removal of arm bone005022.31$1,134.29$513.86$226.86
    24145TPartial removal of radius005022.31$1,134.29$513.86$226.86
    24147TPartial removal of elbow005022.31$1,134.29$513.86$226.86
    24149CRadical resection of elbow
    24150CExtensive humerus surgery
    24151CExtensive humerus surgery
    24152CExtensive radius surgery
    24153CExtensive radius surgery
    24155TRemoval of elbow joint005130.94$1,573.05$675.24$314.61
    24160TRemove elbow joint implant005022.31$1,134.29$513.86$226.86
    24164TRemove radius head implant005022.31$1,134.29$513.86$226.86
    24200TRemoval of arm foreign body00194.56$231.84$78.91$46.37
    24201TRemoval of arm foreign body002112.74$647.73$236.51$129.55
    24220NInjection for elbow x-ray
    24301TMuscle/tendon transfer005022.31$1,134.29$513.86$226.86
    24305TArm tendon lengthening005022.31$1,134.29$513.86$226.86
    24310TRevision of arm tendon004917.07$867.87$356.95$173.57
    24320TRepair of arm tendon005130.94$1,573.05$675.24$314.61
    24330TRevision of arm muscles005130.94$1,573.05$675.24$314.61
    24331TRevision of arm muscles005130.94$1,573.05$675.24$314.61
    24340TRepair of biceps tendon005130.94$1,573.05$675.24$314.61
    24341TRepair arm tendon/muscle005130.94$1,573.05$675.24$314.61
    24342TRepair of ruptured tendon005130.94$1,573.05$675.24$314.61
    24350TRepair of tennis elbow005022.31$1,134.29$513.86$226.86
    24351TRepair of tennis elbow005022.31$1,134.29$513.86$226.86
    24352TRepair of tennis elbow005022.31$1,134.29$513.86$226.86
    24354TRepair of tennis elbow005022.31$1,134.29$513.86$226.86
    24356TRevision of tennis elbow005022.31$1,134.29$513.86$226.86
    24360TReconstruct elbow joint004728.54$1,451.03$537.03$290.21
    24361TReconstruct elbow joint004832.37$1,645.76$725.94$329.15
    24362TReconstruct elbow joint004832.37$1,645.76$725.94$329.15
    24363TReplace elbow joint004832.37$1,645.76$725.94$329.15
    24365TReconstruct head of radius004728.54$1,451.03$537.03$290.21
    24366TReconstruct head of radius004832.37$1,645.76$725.94$329.15
    24400TRevision of humerus005022.31$1,134.29$513.86$226.86
    24410TRevision of humerus005022.31$1,134.29$513.86$226.86
    24420TRevision of humerus005130.94$1,573.05$675.24$314.61
    24430TRepair of humerus005130.94$1,573.05$675.24$314.61
    24435TRepair humerus with graft005130.94$1,573.05$675.24$314.61
    Start Printed Page 44745
    24470TRevision of elbow joint005130.94$1,573.05$675.24$314.61
    24495TDecompression of forearm005022.31$1,134.29$513.86$226.86
    24498TReinforce humerus005130.94$1,573.05$675.24$314.61
    24500TTreat humerus fracture00442.73$138.80$38.08$27.76
    24505TTreat humerus fracture00442.73$138.80$38.08$27.76
    24515TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24516TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24530TTreat humerus fracture00442.73$138.80$38.08$27.76
    24535TTreat humerus fracture00442.73$138.80$38.08$27.76
    24538TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24545TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24546TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24560TTreat humerus fracture00442.73$138.80$38.08$27.76
    24565TTreat humerus fracture00442.73$138.80$38.08$27.76
    24566TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24575TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24576TTreat humerus fracture00442.73$138.80$38.08$27.76
    24577TTreat humerus fracture00442.73$138.80$38.08$27.76
    24579TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24582TTreat humerus fracture004625.36$1,289.35$535.76$257.87
    24586TTreat elbow fracture004625.36$1,289.35$535.76$257.87
    24587TTreat elbow fracture004625.36$1,289.35$535.76$257.87
    24600TTreat elbow dislocation00442.73$138.80$38.08$27.76
    24605TTreat elbow dislocation004512.91$656.37$277.12$131.27
    24615TTreat elbow dislocation004625.36$1,289.35$535.76$257.87
    24620TTreat elbow fracture00442.73$138.80$38.08$27.76
    24635TTreat elbow fracture004625.36$1,289.35$535.76$257.87
    24640TTreat elbow dislocation00442.73$138.80$38.08$27.76
    24650TTreat radius fracture00442.73$138.80$38.08$27.76
    24655TTreat radius fracture00442.73$138.80$38.08$27.76
    24665TTreat radius fracture004625.36$1,289.35$535.76$257.87
    24666TTreat radius fracture004625.36$1,289.35$535.76$257.87
    24670TTreat ulnar fracture00442.73$138.80$38.08$27.76
    24675TTreat ulnar fracture00442.73$138.80$38.08$27.76
    24685TTreat ulnar fracture004625.36$1,289.35$535.76$257.87
    24800TFusion of elbow joint005130.94$1,573.05$675.24$314.61
    24802TFusion/graft of elbow joint005130.94$1,573.05$675.24$314.61
    24900CAmputation of upper arm
    24920CAmputation of upper arm
    24925TAmputation follow-up surgery004917.07$867.87$356.95$173.57
    24930CAmputation follow-up surgery
    24931CAmputate upper arm & implant
    24935TRevision of amputation005238.88$1,976.74$930.91$395.35
    24940CRevision of upper arm
    24999TUpper arm/elbow surgery00442.73$138.80$38.08$27.76
    25000TIncision of tendon sheath004917.07$867.87$356.95$173.57
    25020TDecompression of forearm004917.07$867.87$356.95$173.57
    25023TDecompression of forearm005022.31$1,134.29$513.86$226.86
    25028TDrainage of forearm lesion004917.07$867.87$356.95$173.57
    25031TDrainage of forearm bursa004917.07$867.87$356.95$173.57
    25035TTreat forearm bone lesion004917.07$867.87$356.95$173.57
    25040TExplore/treat wrist joint005022.31$1,134.29$513.86$226.86
    25065TBiopsy forearm soft tissues002112.74$647.73$236.51$129.55
    25066TBiopsy forearm soft tissues002215.07$766.19$292.94$153.24
    25075TRemoval of forearm lesion00208.56$435.21$130.53$87.04
    25076TRemoval of forearm lesion002215.07$766.19$292.94$153.24
    25077TRemove tumor, forearm/wrist002215.07$766.19$292.94$153.24
    25085TIncision of wrist capsule004917.07$867.87$356.95$173.57
    25100TBiopsy of wrist joint004917.07$867.87$356.95$173.57
    25101TExplore/treat wrist joint005022.31$1,134.29$513.86$226.86
    25105TRemove wrist joint lining005022.31$1,134.29$513.86$226.86
    25107TRemove wrist joint cartilage005022.31$1,134.29$513.86$226.86
    25110TRemove wrist tendon lesion004917.07$867.87$356.95$173.57
    25111TRemove wrist tendon lesion005312.67$644.17$253.49$128.83
    25112TReremove wrist tendon lesion005312.67$644.17$253.49$128.83
    25115TRemove wrist/forearm lesion004917.07$867.87$356.95$173.57
    25116TRemove wrist/forearm lesion004917.07$867.87$356.95$173.57
    25118TExcise wrist tendon sheath005022.31$1,134.29$513.86$226.86
    25119TPartial removal of ulna005022.31$1,134.29$513.86$226.86
    25120TRemoval of forearm lesion005022.31$1,134.29$513.86$226.86
    25125TRemove/graft forearm lesion005022.31$1,134.29$513.86$226.86
    25126TRemove/graft forearm lesion005022.31$1,134.29$513.86$226.86
    25130TRemoval of wrist lesion005022.31$1,134.29$513.86$226.86
    25135TRemove & graft wrist lesion005022.31$1,134.29$513.86$226.86
    25136TRemove & graft wrist lesion005022.31$1,134.29$513.86$226.86
    Start Printed Page 44746
    25145TRemove forearm bone lesion005022.31$1,134.29$513.86$226.86
    25150TPartial removal of ulna005022.31$1,134.29$513.86$226.86
    25151TPartial removal of radius005022.31$1,134.29$513.86$226.86
    25170CExtensive forearm surgery
    25210TRemoval of wrist bone005420.84$1,059.55$472.33$211.91
    25215TRemoval of wrist bones005420.84$1,059.55$472.33$211.91
    25230TPartial removal of radius005022.31$1,134.29$513.86$226.86
    25240TPartial removal of ulna005022.31$1,134.29$513.86$226.86
    25246NInjection for wrist x-ray
    25248TRemove forearm foreign body004917.07$867.87$356.95$173.57
    25250TRemoval of wrist prosthesis005022.31$1,134.29$513.86$226.86
    25251TRemoval of wrist prosthesis005022.31$1,134.29$513.86$226.86
    25260TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25263TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25265TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25270TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25272TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25274TRepair forearm tendon/muscle005022.31$1,134.29$513.86$226.86
    25280TRevise wrist/forearm tendon005022.31$1,134.29$513.86$226.86
    25290TIncise wrist/forearm tendon005022.31$1,134.29$513.86$226.86
    25295TRelease wrist/forearm tendon004917.07$867.87$356.95$173.57
    25300TFusion of tendons at wrist005022.31$1,134.29$513.86$226.86
    25301TFusion of tendons at wrist005022.31$1,134.29$513.86$226.86
    25310TTransplant forearm tendon005130.94$1,573.05$675.24$314.61
    25312TTransplant forearm tendon005130.94$1,573.05$675.24$314.61
    25315TRevise palsy hand tendon(s)005130.94$1,573.05$675.24$314.61
    25316TRevise palsy hand tendon(s)005130.94$1,573.05$675.24$314.61
    25320TRepair/revise wrist joint005130.94$1,573.05$675.24$314.61
    25332TRevise wrist joint004728.54$1,451.03$537.03$290.21
    25335TRealignment of hand005130.94$1,573.05$675.24$314.61
    25337TReconstruct ulna/radioulnar005130.94$1,573.05$675.24$314.61
    25350TRevision of radius005130.94$1,573.05$675.24$314.61
    25355TRevision of radius005130.94$1,573.05$675.24$314.61
    25360TRevision of ulna005022.31$1,134.29$513.86$226.86
    25365TRevise radius & ulna005022.31$1,134.29$513.86$226.86
    25370TRevise radius or ulna005130.94$1,573.05$675.24$314.61
    25375TRevise radius & ulna005130.94$1,573.05$675.24$314.61
    25390CShorten radius or ulna
    25391CLengthen radius or ulna
    25392CShorten radius & ulna
    25393CLengthen radius & ulna
    25400TRepair radius or ulna005022.31$1,134.29$513.86$226.86
    25405TRepair/graft radius or ulna005022.31$1,134.29$513.86$226.86
    25415TRepair radius & ulna005022.31$1,134.29$513.86$226.86
    25420CRepair/graft radius & ulna
    25425TRepair/graft radius or ulna005130.94$1,573.05$675.24$314.61
    25426TRepair/graft radius & ulna005130.94$1,573.05$675.24$314.61
    25440TRepair/graft wrist bone005130.94$1,573.05$675.24$314.61
    25441TReconstruct wrist joint004832.37$1,645.76$725.94$329.15
    25442TReconstruct wrist joint004832.37$1,645.76$725.94$329.15
    25443TReconstruct wrist joint004832.37$1,645.76$725.94$329.15
    25444TReconstruct wrist joint004832.37$1,645.76$725.94$329.15
    25445TReconstruct wrist joint004832.37$1,645.76$725.94$329.15
    25446TWrist replacement004832.37$1,645.76$725.94$329.15
    25447TRepair wrist joint(s)004728.54$1,451.03$537.03$290.21
    25449TRemove wrist joint implant004728.54$1,451.03$537.03$290.21
    25450TRevision of wrist joint005130.94$1,573.05$675.24$314.61
    25455TRevision of wrist joint005130.94$1,573.05$675.24$314.61
    25490TReinforce radius005130.94$1,573.05$675.24$314.61
    25491TReinforce ulna005130.94$1,573.05$675.24$314.61
    25492TReinforce radius and ulna005130.94$1,573.05$675.24$314.61
    25500TTreat fracture of radius00442.73$138.80$38.08$27.76
    25505TTreat fracture of radius00442.73$138.80$38.08$27.76
    25515TTreat fracture of radius004625.36$1,289.35$535.76$257.87
    25520TTreat fracture of radius00442.73$138.80$38.08$27.76
    25525TTreat fracture of radius004625.36$1,289.35$535.76$257.87
    25526TTreat fracture of radius004625.36$1,289.35$535.76$257.87
    25530TTreat fracture of ulna00442.73$138.80$38.08$27.76
    25535TTreat fracture of ulna00442.73$138.80$38.08$27.76
    25545TTreat fracture of ulna004625.36$1,289.35$535.76$257.87
    25560TTreat fracture radius & ulna00442.73$138.80$38.08$27.76
    25565TTreat fracture radius & ulna00442.73$138.80$38.08$27.76
    25574TTreat fracture radius & ulna004625.36$1,289.35$535.76$257.87
    25575TTreat fracture radius/ulna004625.36$1,289.35$535.76$257.87
    25600TTreat fracture radius/ulna00442.73$138.80$38.08$27.76
    Start Printed Page 44747
    25605TTreat fracture radius/ulna00442.73$138.80$38.08$27.76
    25611TTreat fracture radius/ulna004625.36$1,289.35$535.76$257.87
    25620TTreat fracture radius/ulna004625.36$1,289.35$535.76$257.87
    25622TTreat wrist bone fracture00442.73$138.80$38.08$27.76
    25624TTreat wrist bone fracture00442.73$138.80$38.08$27.76
    25628TTreat wrist bone fracture004625.36$1,289.35$535.76$257.87
    25630TTreat wrist bone fracture00442.73$138.80$38.08$27.76
    25635TTreat wrist bone fracture00442.73$138.80$38.08$27.76
    25645TTreat wrist bone fracture004625.36$1,289.35$535.76$257.87
    25650TTreat wrist bone fracture00442.73$138.80$38.08$27.76
    25660TTreat wrist dislocation00442.73$138.80$38.08$27.76
    25670TTreat wrist dislocation004625.36$1,289.35$535.76$257.87
    25675TTreat wrist dislocation00442.73$138.80$38.08$27.76
    25676TTreat wrist dislocation004625.36$1,289.35$535.76$257.87
    25680TTreat wrist fracture00442.73$138.80$38.08$27.76
    25685TTreat wrist fracture004625.36$1,289.35$535.76$257.87
    25690TTreat wrist dislocation00442.73$138.80$38.08$27.76
    25695TTreat wrist dislocation004625.36$1,289.35$535.76$257.87
    25800TFusion of wrist joint005130.94$1,573.05$675.24$314.61
    25805TFusion/graft of wrist joint005130.94$1,573.05$675.24$314.61
    25810TFusion/graft of wrist joint005130.94$1,573.05$675.24$314.61
    25820TFusion of hand bones005312.67$644.17$253.49$128.83
    25825TFuse hand bones with graft005420.84$1,059.55$472.33$211.91
    25830TFusion, radioulnar jnt/ulna005130.94$1,573.05$675.24$314.61
    25900CAmputation of forearm
    25905CAmputation of forearm
    25907TAmputation follow-up surgery004917.07$867.87$356.95$173.57
    25909CAmputation follow-up surgery
    25915CAmputation of forearm
    25920CAmputate hand at wrist
    25922TAmputate hand at wrist004917.07$867.87$356.95$173.57
    25924CAmputation follow-up surgery
    25927CAmputation of hand
    25929TAmputation follow-up surgery002613.51$686.88$277.92$137.38
    25931CAmputation follow-up surgery
    25999TForearm or wrist surgery00442.73$138.80$38.08$27.76
    26010TDrainage of finger abscess00062.36$119.99$33.95$24.00
    26011TDrainage of finger abscess00077.28$370.13$74.03$74.03
    26020TDrain hand tendon sheath005312.67$644.17$253.49$128.83
    26025TDrainage of palm bursa005312.67$644.17$253.49$128.83
    26030TDrainage of palm bursa(s)005312.67$644.17$253.49$128.83
    26034TTreat hand bone lesion005312.67$644.17$253.49$128.83
    26035TDecompress fingers/hand005312.67$644.17$253.49$128.83
    26037TDecompress fingers/hand005312.67$644.17$253.49$128.83
    26040TRelease palm contracture005420.84$1,059.55$472.33$211.91
    26045TRelease palm contracture005420.84$1,059.55$472.33$211.91
    26055TIncise finger tendon sheath005312.67$644.17$253.49$128.83
    26060TIncision of finger tendon005312.67$644.17$253.49$128.83
    26070TExplore/treat hand joint005312.67$644.17$253.49$128.83
    26075TExplore/treat finger joint005312.67$644.17$253.49$128.83
    26080TExplore/treat finger joint005312.67$644.17$253.49$128.83
    26100TBiopsy hand joint lining005312.67$644.17$253.49$128.83
    26105TBiopsy finger joint lining005312.67$644.17$253.49$128.83
    26110TBiopsy finger joint lining005312.67$644.17$253.49$128.83
    26115TRemoval of hand lesion002215.07$766.19$292.94$153.24
    26116TRemoval of hand lesion002215.07$766.19$292.94$153.24
    26117TRemove tumor, hand/finger002215.07$766.19$292.94$153.24
    26121TRelease palm contracture005420.84$1,059.55$472.33$211.91
    26123TRelease palm contracture005420.84$1,059.55$472.33$211.91
    26125TRelease palm contracture005420.84$1,059.55$472.33$211.91
    26130TRemove wrist joint lining005312.67$644.17$253.49$128.83
    26135TRevise finger joint, each005420.84$1,059.55$472.33$211.91
    26140TRevise finger joint, each005312.67$644.17$253.49$128.83
    26145TTendon excision, palm/finger005312.67$644.17$253.49$128.83
    26160TRemove tendon sheath lesion005312.67$644.17$253.49$128.83
    26170TRemoval of palm tendon, each005312.67$644.17$253.49$128.83
    26180TRemoval of finger tendon005312.67$644.17$253.49$128.83
    26185TRemove finger bone005312.67$644.17$253.49$128.83
    26200TRemove hand bone lesion005312.67$644.17$253.49$128.83
    26205TRemove/graft bone lesion005420.84$1,059.55$472.33$211.91
    26210TRemoval of finger lesion005312.67$644.17$253.49$128.83
    26215TRemove/graft finger lesion005312.67$644.17$253.49$128.83
    26230TPartial removal of hand bone005312.67$644.17$253.49$128.83
    26235TPartial removal, finger bone005312.67$644.17$253.49$128.83
    26236TPartial removal, finger bone005312.67$644.17$253.49$128.83
    Start Printed Page 44748
    26250TExtensive hand surgery005312.67$644.17$253.49$128.83
    26255TExtensive hand surgery005420.84$1,059.55$472.33$211.91
    26260TExtensive finger surgery005312.67$644.17$253.49$128.83
    26261TExtensive finger surgery005312.67$644.17$253.49$128.83
    26262TPartial removal of finger005312.67$644.17$253.49$128.83
    26320TRemoval of implant from hand00208.56$435.21$130.53$87.04
    26350TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26352TRepair/graft hand tendon005420.84$1,059.55$472.33$211.91
    26356TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26357TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26358TRepair/graft hand tendon005420.84$1,059.55$472.33$211.91
    26370TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26372TRepair/graft hand tendon005420.84$1,059.55$472.33$211.91
    26373TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26390TRevise hand/finger tendon005420.84$1,059.55$472.33$211.91
    26392TRepair/graft hand tendon005420.84$1,059.55$472.33$211.91
    26410TRepair hand tendon005312.67$644.17$253.49$128.83
    26412TRepair/graft hand tendon005420.84$1,059.55$472.33$211.91
    26415TExcision, hand/finger tendon005420.84$1,059.55$472.33$211.91
    26416TGraft hand or finger tendon005420.84$1,059.55$472.33$211.91
    26418TRepair finger tendon005312.67$644.17$253.49$128.83
    26420TRepair/graft finger tendon005420.84$1,059.55$472.33$211.91
    26426TRepair finger/hand tendon005420.84$1,059.55$472.33$211.91
    26428TRepair/graft finger tendon005420.84$1,059.55$472.33$211.91
    26432TRepair finger tendon005312.67$644.17$253.49$128.83
    26433TRepair finger tendon005312.67$644.17$253.49$128.83
    26434TRepair/graft finger tendon005420.84$1,059.55$472.33$211.91
    26437TRealignment of tendons005312.67$644.17$253.49$128.83
    26440TRelease palm/finger tendon005312.67$644.17$253.49$128.83
    26442TRelease palm & finger tendon005420.84$1,059.55$472.33$211.91
    26445TRelease hand/finger tendon005312.67$644.17$253.49$128.83
    26449TRelease forearm/hand tendon005420.84$1,059.55$472.33$211.91
    26450TIncision of palm tendon005312.67$644.17$253.49$128.83
    26455TIncision of finger tendon005312.67$644.17$253.49$128.83
    26460TIncise hand/finger tendon005312.67$644.17$253.49$128.83
    26471TFusion of finger tendons005312.67$644.17$253.49$128.83
    26474TFusion of finger tendons005312.67$644.17$253.49$128.83
    26476TTendon lengthening005312.67$644.17$253.49$128.83
    26477TTendon shortening005312.67$644.17$253.49$128.83
    26478TLengthening of hand tendon005312.67$644.17$253.49$128.83
    26479TShortening of hand tendon005312.67$644.17$253.49$128.83
    26480TTransplant hand tendon005420.84$1,059.55$472.33$211.91
    26483TTransplant/graft hand tendon005420.84$1,059.55$472.33$211.91
    26485TTransplant palm tendon005420.84$1,059.55$472.33$211.91
    26489TTransplant/graft palm tendon005420.84$1,059.55$472.33$211.91
    26490TRevise thumb tendon005420.84$1,059.55$472.33$211.91
    26492TTendon transfer with graft005420.84$1,059.55$472.33$211.91
    26494THand tendon/muscle transfer005420.84$1,059.55$472.33$211.91
    26496TRevise thumb tendon005420.84$1,059.55$472.33$211.91
    26497TFinger tendon transfer005420.84$1,059.55$472.33$211.91
    26498TFinger tendon transfer005420.84$1,059.55$472.33$211.91
    26499TRevision of finger005420.84$1,059.55$472.33$211.91
    26500THand tendon reconstruction005312.67$644.17$253.49$128.83
    26502THand tendon reconstruction005420.84$1,059.55$472.33$211.91
    26504THand tendon reconstruction005420.84$1,059.55$472.33$211.91
    26508TRelease thumb contracture005312.67$644.17$253.49$128.83
    26510TThumb tendon transfer005420.84$1,059.55$472.33$211.91
    26516TFusion of knuckle joint005420.84$1,059.55$472.33$211.91
    26517TFusion of knuckle joints005420.84$1,059.55$472.33$211.91
    26518TFusion of knuckle joints005420.84$1,059.55$472.33$211.91
    26520TRelease knuckle contracture005312.67$644.17$253.49$128.83
    26525TRelease finger contracture005312.67$644.17$253.49$128.83
    26530TRevise knuckle joint004728.54$1,451.03$537.03$290.21
    26531TRevise knuckle with implant004832.37$1,645.76$725.94$329.15
    26535TRevise finger joint004728.54$1,451.03$537.03$290.21
    26536TRevise/implant finger joint004832.37$1,645.76$725.94$329.15
    26540TRepair hand joint005312.67$644.17$253.49$128.83
    26541TRepair hand joint with graft005420.84$1,059.55$472.33$211.91
    26542TRepair hand joint with graft005312.67$644.17$253.49$128.83
    26545TReconstruct finger joint005420.84$1,059.55$472.33$211.91
    26546TRepair nonunion hand005420.84$1,059.55$472.33$211.91
    26548TReconstruct finger joint005420.84$1,059.55$472.33$211.91
    26550TConstruct thumb replacement005420.84$1,059.55$472.33$211.91
    26551CGreat toe-hand transfer
    26553CSingle transfer, toe-hand
    Start Printed Page 44749
    26554CDouble transfer, toe-hand
    26555TPositional change of finger005420.84$1,059.55$472.33$211.91
    26556CToe joint transfer
    26560TRepair of web finger005312.67$644.17$253.49$128.83
    26561TRepair of web finger005420.84$1,059.55$472.33$211.91
    26562TRepair of web finger005420.84$1,059.55$472.33$211.91
    26565TCorrect metacarpal flaw005420.84$1,059.55$472.33$211.91
    26567TCorrect finger deformity005420.84$1,059.55$472.33$211.91
    26568TLengthen metacarpal/finger005420.84$1,059.55$472.33$211.91
    26580TRepair hand deformity005420.84$1,059.55$472.33$211.91
    26585TRepair finger deformity005420.84$1,059.55$472.33$211.91
    26587TReconstruct extra finger005312.67$644.17$253.49$128.83
    26590TRepair finger deformity005420.84$1,059.55$472.33$211.91
    26591TRepair muscles of hand005420.84$1,059.55$472.33$211.91
    26593TRelease muscles of hand005312.67$644.17$253.49$128.83
    26596TExcision constricting tissue005420.84$1,059.55$472.33$211.91
    26597TRelease of scar contracture005420.84$1,059.55$472.33$211.91
    26600TTreat metacarpal fracture00442.73$138.80$38.08$27.76
    26605TTreat metacarpal fracture00442.73$138.80$38.08$27.76
    26607TTreat metacarpal fracture00442.73$138.80$38.08$27.76
    26608TTreat metacarpal fracture004625.36$1,289.35$535.76$257.87
    26615TTreat metacarpal fracture004625.36$1,289.35$535.76$257.87
    26641TTreat thumb dislocation00442.73$138.80$38.08$27.76
    26645TTreat thumb fracture00442.73$138.80$38.08$27.76
    26650TTreat thumb fracture004625.36$1,289.35$535.76$257.87
    26665TTreat thumb fracture004625.36$1,289.35$535.76$257.87
    26670TTreat hand dislocation00442.73$138.80$38.08$27.76
    26675TTreat hand dislocation00442.73$138.80$38.08$27.76
    26676TPin hand dislocation004625.36$1,289.35$535.76$257.87
    26685TTreat hand dislocation004625.36$1,289.35$535.76$257.87
    26686TTreat hand dislocation004625.36$1,289.35$535.76$257.87
    26700TTreat knuckle dislocation00434.13$209.98$42.00$42.00
    26705TTreat knuckle dislocation00442.73$138.80$38.08$27.76
    26706TPin knuckle dislocation00442.73$138.80$38.08$27.76
    26715TTreat knuckle dislocation004625.36$1,289.35$535.76$257.87
    26720TTreat finger fracture, each00434.13$209.98$42.00$42.00
    26725TTreat finger fracture, each00434.13$209.98$42.00$42.00
    26727TTreat finger fracture, each004625.36$1,289.35$535.76$257.87
    26735TTreat finger fracture, each004625.36$1,289.35$535.76$257.87
    26740TTreat finger fracture, each00434.13$209.98$42.00$42.00
    26742TTreat finger fracture, each00442.73$138.80$38.08$27.76
    26746TTreat finger fracture, each004625.36$1,289.35$535.76$257.87
    26750TTreat finger fracture, each00434.13$209.98$42.00$42.00
    26755TTreat finger fracture, each00434.13$209.98$42.00$42.00
    26756TPin finger fracture, each004625.36$1,289.35$535.76$257.87
    26765TTreat finger fracture, each004625.36$1,289.35$535.76$257.87
    26770TTreat finger dislocation00434.13$209.98$42.00$42.00
    26775TTreat finger dislocation004512.91$656.37$277.12$131.27
    26776TPin finger dislocation004625.36$1,289.35$535.76$257.87
    26785TTreat finger dislocation004625.36$1,289.35$535.76$257.87
    26820TThumb fusion with graft005420.84$1,059.55$472.33$211.91
    26841TFusion of thumb005420.84$1,059.55$472.33$211.91
    26842TThumb fusion with graft005420.84$1,059.55$472.33$211.91
    26843TFusion of hand joint005420.84$1,059.55$472.33$211.91
    26844TFusion/graft of hand joint005420.84$1,059.55$472.33$211.91
    26850TFusion of knuckle005420.84$1,059.55$472.33$211.91
    26852TFusion of knuckle with graft005420.84$1,059.55$472.33$211.91
    26860TFusion of finger joint005420.84$1,059.55$472.33$211.91
    26861TFusion of finger jnt, add-on005420.84$1,059.55$472.33$211.91
    26862TFusion/graft of finger joint005420.84$1,059.55$472.33$211.91
    26863TFuse/graft added joint005420.84$1,059.55$472.33$211.91
    26910TAmputate metacarpal bone005420.84$1,059.55$472.33$211.91
    26951TAmputation of finger/thumb005312.67$644.17$253.49$128.83
    26952TAmputation of finger/thumb005312.67$644.17$253.49$128.83
    26989THand/finger surgery00434.13$209.98$42.00$42.00
    26990TDrainage of pelvis lesion004917.07$867.87$356.95$173.57
    26991TDrainage of pelvis bursa004917.07$867.87$356.95$173.57
    26992CDrainage of bone lesion
    27000TIncision of hip tendon004917.07$867.87$356.95$173.57
    27001TIncision of hip tendon005022.31$1,134.29$513.86$226.86
    27003TIncision of hip tendon005022.31$1,134.29$513.86$226.86
    27005CIncision of hip tendon
    27006CIncision of hip tendons
    27025CIncision of hip/thigh fascia
    27030CDrainage of hip joint
    Start Printed Page 44750
    27033TExploration of hip joint005130.94$1,573.05$675.24$314.61
    27035CDenervation of hip joint
    27036CExcision of hip joint/muscle
    27040TBiopsy of soft tissues002112.74$647.73$236.51$129.55
    27041TBiopsy of soft tissues002215.07$766.19$292.94$153.24
    27047TRemove hip/pelvis lesion002215.07$766.19$292.94$153.24
    27048TRemove hip/pelvis lesion002215.07$766.19$292.94$153.24
    27049TRemove tumor, hip/pelvis002215.07$766.19$292.94$153.24
    27050TBiopsy of sacroiliac joint004917.07$867.87$356.95$173.57
    27052TBiopsy of hip joint004917.07$867.87$356.95$173.57
    27054CRemoval of hip joint lining
    27060TRemoval of ischial bursa004917.07$867.87$356.95$173.57
    27062TRemove femur lesion/bursa004917.07$867.87$356.95$173.57
    27065TRemoval of hip bone lesion004917.07$867.87$356.95$173.57
    27066TRemoval of hip bone lesion005022.31$1,134.29$513.86$226.86
    27067TRemove/graft hip bone lesion005022.31$1,134.29$513.86$226.86
    27070CPartial removal of hip bone
    27071CPartial removal of hip bone
    27075CExtensive hip surgery
    27076CExtensive hip surgery
    27077CExtensive hip surgery
    27078CExtensive hip surgery
    27079CExtensive hip surgery
    27080TRemoval of tail bone005022.31$1,134.29$513.86$226.86
    27086TRemove hip foreign body00194.56$231.84$78.91$46.37
    27087TRemove hip foreign body004917.07$867.87$356.95$173.57
    27090CRemoval of hip prosthesis
    27091CRemoval of hip prosthesis
    27093NInjection for hip x-ray
    27095NInjection for hip x-ray
    27096NInject sacroiliac joint
    27097TRevision of hip tendon005022.31$1,134.29$513.86$226.86
    27098TTransfer tendon to pelvis005022.31$1,134.29$513.86$226.86
    27100TTransfer of abdominal muscle005130.94$1,573.05$675.24$314.61
    27105TTransfer of spinal muscle005130.94$1,573.05$675.24$314.61
    27110TTransfer of iliopsoas muscle005130.94$1,573.05$675.24$314.61
    27111TTransfer of iliopsoas muscle005130.94$1,573.05$675.24$314.61
    27120CReconstruction of hip socket
    27122CReconstruction of hip socket
    27125CPartial hip replacement
    27130CTotal hip replacement
    27132CTotal hip replacement
    27134CRevise hip joint replacement
    27137CRevise hip joint replacement
    27138CRevise hip joint replacement
    27140CTransplant femur ridge
    27146CIncision of hip bone
    27147CRevision of hip bone
    27151CIncision of hip bones
    27156CRevision of hip bones
    27158CRevision of pelvis
    27161CIncision of neck of femur
    27165CIncision/fixation of femur
    27170CRepair/graft femur head/neck
    27175CTreat slipped epiphysis
    27176CTreat slipped epiphysis
    27177CTreat slipped epiphysis
    27178CTreat slipped epiphysis
    27179CRevise head/neck of femur
    27181CTreat slipped epiphysis
    27185CRevision of femur epiphysis
    27187CReinforce hip bones
    27193TTreat pelvic ring fracture00442.73$138.80$38.08$27.76
    27194TTreat pelvic ring fracture004512.91$656.37$277.12$131.27
    27200TTreat tail bone fracture00442.73$138.80$38.08$27.76
    27202TTreat tail bone fracture004625.36$1,289.35$535.76$257.87
    27215CTreat pelvic fracture(s)
    27216CTreat pelvic ring fracture
    27217CTreat pelvic ring fracture
    27218CTreat pelvic ring fracture
    27220TTreat hip socket fracture00442.73$138.80$38.08$27.76
    27222CTreat hip socket fracture
    27226CTreat hip wall fracture
    27227CTreat hip fracture(s)
    27228CTreat hip fracture(s)
    Start Printed Page 44751
    27230TTreat thigh fracture00442.73$138.80$38.08$27.76
    27232CTreat thigh fracture
    27235CTreat thigh fracture
    27236CTreat thigh fracture
    27238TTreat thigh fracture00442.73$138.80$38.08$27.76
    27240CTreat thigh fracture
    27244CTreat thigh fracture
    27245CTreat thigh fracture
    27246TTreat thigh fracture00434.13$209.98$42.00$42.00
    27248CTreat thigh fracture
    27250TTreat hip dislocation00442.73$138.80$38.08$27.76
    27252TTreat hip dislocation004512.91$656.37$277.12$131.27
    27253CTreat hip dislocation
    27254CTreat hip dislocation
    27256TTreat hip dislocation00434.13$209.98$42.00$42.00
    27257TTreat hip dislocation004512.91$656.37$277.12$131.27
    27258CTreat hip dislocation
    27259CTreat hip dislocation
    27265TTreat hip dislocation00442.73$138.80$38.08$27.76
    27266TTreat hip dislocation004728.54$1,451.03$537.03$290.21
    27275TManipulation of hip joint004512.91$656.37$277.12$131.27
    27280CFusion of sacroiliac joint
    27282CFusion of pubic bones
    27284CFusion of hip joint
    27286CFusion of hip joint
    27290CAmputation of leg at hip
    27295CAmputation of leg at hip
    27299TPelvis/hip joint surgery00434.13$209.98$42.00$42.00
    27301TDrain thigh/knee lesion000811.36$577.57$115.51$115.51
    27303CDrainage of bone lesion
    27305TIncise thigh tendon & fascia004917.07$867.87$356.95$173.57
    27306TIncision of thigh tendon004917.07$867.87$356.95$173.57
    27307TIncision of thigh tendons004917.07$867.87$356.95$173.57
    27310TExploration of knee joint005022.31$1,134.29$513.86$226.86
    27315TPartial removal, thigh nerve022014.76$750.43$326.21$150.09
    27320TPartial removal, thigh nerve022014.76$750.43$326.21$150.09
    27323TBiopsy, thigh soft tissues002112.74$647.73$236.51$129.55
    27324TBiopsy, thigh soft tissues002215.07$766.19$292.94$153.24
    27327TRemoval of thigh lesion002215.07$766.19$292.94$153.24
    27328TRemoval of thigh lesion002215.07$766.19$292.94$153.24
    27329TRemove tumor, thigh/knee002215.07$766.19$292.94$153.24
    27330TBiopsy, knee joint lining005022.31$1,134.29$513.86$226.86
    27331TExplore/treat knee joint005022.31$1,134.29$513.86$226.86
    27332TRemoval of knee cartilage005022.31$1,134.29$513.86$226.86
    27333TRemoval of knee cartilage005022.31$1,134.29$513.86$226.86
    27334TRemove knee joint lining005022.31$1,134.29$513.86$226.86
    27335TRemove knee joint lining005022.31$1,134.29$513.86$226.86
    27340TRemoval of kneecap bursa004917.07$867.87$356.95$173.57
    27345TRemoval of knee cyst004917.07$867.87$356.95$173.57
    27347TRemove knee cyst004917.07$867.87$356.95$173.57
    27350TRemoval of kneecap005022.31$1,134.29$513.86$226.86
    27355TRemove femur lesion005022.31$1,134.29$513.86$226.86
    27356TRemove femur lesion/graft005022.31$1,134.29$513.86$226.86
    27357TRemove femur lesion/graft005022.31$1,134.29$513.86$226.86
    27358TRemove femur lesion/fixation005022.31$1,134.29$513.86$226.86
    27360TPartial removal, leg bone(s)005022.31$1,134.29$513.86$226.86
    27365CExtensive leg surgery
    27370NInjection for knee x-ray
    27372TRemoval of foreign body002215.07$766.19$292.94$153.24
    27380TRepair of kneecap tendon004917.07$867.87$356.95$173.57
    27381TRepair/graft kneecap tendon004917.07$867.87$356.95$173.57
    27385TRepair of thigh muscle004917.07$867.87$356.95$173.57
    27386TRepair/graft of thigh muscle004917.07$867.87$356.95$173.57
    27390TIncision of thigh tendon004917.07$867.87$356.95$173.57
    27391TIncision of thigh tendons004917.07$867.87$356.95$173.57
    27392TIncision of thigh tendons004917.07$867.87$356.95$173.57
    27393TLengthening of thigh tendon005022.31$1,134.29$513.86$226.86
    27394TLengthening of thigh tendons005022.31$1,134.29$513.86$226.86
    27395TLengthening of thigh tendons005130.94$1,573.05$675.24$314.61
    27396TTransplant of thigh tendon005022.31$1,134.29$513.86$226.86
    27397TTransplants of thigh tendons005130.94$1,573.05$675.24$314.61
    27400TRevise thigh muscles/tendons005130.94$1,573.05$675.24$314.61
    27403TRepair of knee cartilage005022.31$1,134.29$513.86$226.86
    27405TRepair of knee ligament005130.94$1,573.05$675.24$314.61
    27407TRepair of knee ligament005130.94$1,573.05$675.24$314.61
    Start Printed Page 44752
    27409TRepair of knee ligaments005130.94$1,573.05$675.24$314.61
    27418TRepair degenerated kneecap005130.94$1,573.05$675.24$314.61
    27420TRevision of unstable kneecap005130.94$1,573.05$675.24$314.61
    27422TRevision of unstable kneecap005130.94$1,573.05$675.24$314.61
    27424TRevision/removal of kneecap005130.94$1,573.05$675.24$314.61
    27425TLateral retinacular release005022.31$1,134.29$513.86$226.86
    27427TReconstruction, knee005238.88$1,976.74$930.91$395.35
    27428TReconstruction, knee005238.88$1,976.74$930.91$395.35
    27429TReconstruction, knee005238.88$1,976.74$930.91$395.35
    27430TRevision of thigh muscles005130.94$1,573.05$675.24$314.61
    27435TIncision of knee joint005130.94$1,573.05$675.24$314.61
    27437TRevise kneecap004728.54$1,451.03$537.03$290.21
    27438TRevise kneecap with implant004832.37$1,645.76$725.94$329.15
    27440TRevision of knee joint004728.54$1,451.03$537.03$290.21
    27441TRevision of knee joint004728.54$1,451.03$537.03$290.21
    27442TRevision of knee joint004728.54$1,451.03$537.03$290.21
    27443TRevision of knee joint004728.54$1,451.03$537.03$290.21
    27445CRevision of knee joint
    27446TRevision of knee joint004728.54$1,451.03$537.03$290.21
    27447CTotal knee replacement
    27448CIncision of thigh
    27450CIncision of thigh
    27454CRealignment of thigh bone
    27455CRealignment of knee
    27457CRealignment of knee
    27465CShortening of thigh bone
    27466CLengthening of thigh bone
    27468CShorten/lengthen thighs
    27470CRepair of thigh
    27472CRepair/graft of thigh
    27475CSurgery to stop leg growth
    27477CSurgery to stop leg growth
    27479CSurgery to stop leg growth
    27485CSurgery to stop leg growth
    27486CRevise/replace knee joint
    27487CRevise/replace knee joint
    27488CRemoval of knee prosthesis
    27495CReinforce thigh
    27496TDecompression of thigh/knee004917.07$867.87$356.95$173.57
    27497TDecompression of thigh/knee004917.07$867.87$356.95$173.57
    27498TDecompression of thigh/knee004917.07$867.87$356.95$173.57
    27499TDecompression of thigh/knee004917.07$867.87$356.95$173.57
    27500TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27501TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27502TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27503TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27506CTreatment of thigh fracture
    27507CTreatment of thigh fracture
    27508TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27509TTreatment of thigh fracture004625.36$1,289.35$535.76$257.87
    27510TTreatment of thigh fracture00442.73$138.80$38.08$27.76
    27511CTreatment of thigh fracture
    27513CTreatment of thigh fracture
    27514CTreatment of thigh fracture
    27516TTreat thigh fx growth plate00442.73$138.80$38.08$27.76
    27517TTreat thigh fx growth plate00434.13$209.98$42.00$42.00
    27519CTreat thigh fx growth plate
    27520TTreat kneecap fracture00442.73$138.80$38.08$27.76
    27524TTreat kneecap fracture004625.36$1,289.35$535.76$257.87
    27530TTreat knee fracture00442.73$138.80$38.08$27.76
    27532TTreat knee fracture00442.73$138.80$38.08$27.76
    27535CTreat knee fracture
    27536CTreat knee fracture
    27538TTreat knee fracture(s)00434.13$209.98$42.00$42.00
    27540CTreat knee fracture
    27550TTreat knee dislocation00442.73$138.80$38.08$27.76
    27552TTreat knee dislocation004512.91$656.37$277.12$131.27
    27556CTreat knee dislocation
    27557CTreat knee dislocation
    27558CTreat knee dislocation
    27560TTreat kneecap dislocation00442.73$138.80$38.08$27.76
    27562TTreat kneecap dislocation004512.91$656.37$277.12$131.27
    27566TTreat kneecap dislocation004625.36$1,289.35$535.76$257.87
    27570TFixation of knee joint004512.91$656.37$277.12$131.27
    27580CFusion of knee
    Start Printed Page 44753
    27590CAmputate leg at thigh
    27591CAmputate leg at thigh
    27592CAmputate leg at thigh
    27594TAmputation follow-up surgery004917.07$867.87$356.95$173.57
    27596CAmputation follow-up surgery
    27598CAmputate lower leg at knee
    27599TLeg surgery procedure00442.73$138.80$38.08$27.76
    27600TDecompression of lower leg004917.07$867.87$356.95$173.57
    27601TDecompression of lower leg004917.07$867.87$356.95$173.57
    27602TDecompression of lower leg004917.07$867.87$356.95$173.57
    27603TDrain lower leg lesion000811.36$577.57$115.51$115.51
    27604TDrain lower leg bursa004917.07$867.87$356.95$173.57
    27605TIncision of achilles tendon005516.77$852.62$355.34$170.52
    27606TIncision of achilles tendon004917.07$867.87$356.95$173.57
    27607TTreat lower leg bone lesion004917.07$867.87$356.95$173.57
    27610TExplore/treat ankle joint005022.31$1,134.29$513.86$226.86
    27612TExploration of ankle joint005022.31$1,134.29$513.86$226.86
    27613TBiopsy lower leg soft tissue00208.56$435.21$130.53$87.04
    27614TBiopsy lower leg soft tissue002215.07$766.19$292.94$153.24
    27615TRemove tumor, lower leg004625.36$1,289.35$535.76$257.87
    27618TRemove lower leg lesion002112.74$647.73$236.51$129.55
    27619TRemove lower leg lesion002215.07$766.19$292.94$153.24
    27620TExplore/treat ankle joint005022.31$1,134.29$513.86$226.86
    27625TRemove ankle joint lining005022.31$1,134.29$513.86$226.86
    27626TRemove ankle joint lining005022.31$1,134.29$513.86$226.86
    27630TRemoval of tendon lesion004917.07$867.87$356.95$173.57
    27635TRemove lower leg bone lesion005022.31$1,134.29$513.86$226.86
    27637TRemove/graft leg bone lesion005022.31$1,134.29$513.86$226.86
    27638TRemove/graft leg bone lesion005022.31$1,134.29$513.86$226.86
    27640TPartial removal of tibia005130.94$1,573.05$675.24$314.61
    27641TPartial removal of fibula005022.31$1,134.29$513.86$226.86
    27645CExtensive lower leg surgery
    27646CExtensive lower leg surgery
    27647TExtensive ankle/heel surgery005130.94$1,573.05$675.24$314.61
    27648NInjection for ankle x-ray
    27650TRepair achilles tendon005130.94$1,573.05$675.24$314.61
    27652TRepair/graft achilles tendon005130.94$1,573.05$675.24$314.61
    27654TRepair of achilles tendon005130.94$1,573.05$675.24$314.61
    27656TRepair leg fascia defect004917.07$867.87$356.95$173.57
    27658TRepair of leg tendon, each004917.07$867.87$356.95$173.57
    27659TRepair of leg tendon, each004917.07$867.87$356.95$173.57
    27664TRepair of leg tendon, each004917.07$867.87$356.95$173.57
    27665TRepair of leg tendon, each005022.31$1,134.29$513.86$226.86
    27675TRepair lower leg tendons004917.07$867.87$356.95$173.57
    27676TRepair lower leg tendons005022.31$1,134.29$513.86$226.86
    27680TRelease of lower leg tendon005022.31$1,134.29$513.86$226.86
    27681TRelease of lower leg tendons005022.31$1,134.29$513.86$226.86
    27685TRevision of lower leg tendon005022.31$1,134.29$513.86$226.86
    27686TRevise lower leg tendons005022.31$1,134.29$513.86$226.86
    27687TRevision of calf tendon005022.31$1,134.29$513.86$226.86
    27690TRevise lower leg tendon005130.94$1,573.05$675.24$314.61
    27691TRevise lower leg tendon005130.94$1,573.05$675.24$314.61
    27692TRevise additional leg tendon005130.94$1,573.05$675.24$314.61
    27695TRepair of ankle ligament005022.31$1,134.29$513.86$226.86
    27696TRepair of ankle ligaments005022.31$1,134.29$513.86$226.86
    27698TRepair of ankle ligament005022.31$1,134.29$513.86$226.86
    27700TRevision of ankle joint004728.54$1,451.03$537.03$290.21
    27702CReconstruct ankle joint
    27703CReconstruction, ankle joint
    27704TRemoval of ankle implant004917.07$867.87$356.95$173.57
    27705TIncision of tibia005130.94$1,573.05$675.24$314.61
    27707TIncision of fibula004917.07$867.87$356.95$173.57
    27709TIncision of tibia & fibula005022.31$1,134.29$513.86$226.86
    27712CRealignment of lower leg
    27715CRevision of lower leg
    27720CRepair of tibia
    27722CRepair/graft of tibia
    27724CRepair/graft of tibia
    27725CRepair of lower leg
    27727CRepair of lower leg
    27730TRepair of tibia epiphysis005022.31$1,134.29$513.86$226.86
    27732TRepair of fibula epiphysis005022.31$1,134.29$513.86$226.86
    27734TRepair lower leg epiphyses005022.31$1,134.29$513.86$226.86
    27740TRepair of leg epiphyses005022.31$1,134.29$513.86$226.86
    27742TRepair of leg epiphyses005130.94$1,573.05$675.24$314.61
    Start Printed Page 44754
    27745TReinforce tibia005130.94$1,573.05$675.24$314.61
    27750TTreatment of tibia fracture00442.73$138.80$38.08$27.76
    27752TTreatment of tibia fracture00442.73$138.80$38.08$27.76
    27756TTreatment of tibia fracture004625.36$1,289.35$535.76$257.87
    27758TTreatment of tibia fracture004625.36$1,289.35$535.76$257.87
    27759TTreatment of tibia fracture004625.36$1,289.35$535.76$257.87
    27760TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27762TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27766TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    27780TTreatment of fibula fracture00442.73$138.80$38.08$27.76
    27781TTreatment of fibula fracture00442.73$138.80$38.08$27.76
    27784TTreatment of fibula fracture004625.36$1,289.35$535.76$257.87
    27786TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27788TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27792TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    27808TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27810TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27814TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    27816TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27818TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    27822TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    27823TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    27824TTreat lower leg fracture00442.73$138.80$38.08$27.76
    27825TTreat lower leg fracture00442.73$138.80$38.08$27.76
    27826TTreat lower leg fracture004625.36$1,289.35$535.76$257.87
    27827TTreat lower leg fracture004625.36$1,289.35$535.76$257.87
    27828TTreat lower leg fracture004625.36$1,289.35$535.76$257.87
    27829TTreat lower leg joint004625.36$1,289.35$535.76$257.87
    27830TTreat lower leg dislocation00442.73$138.80$38.08$27.76
    27831TTreat lower leg dislocation00442.73$138.80$38.08$27.76
    27832TTreat lower leg dislocation004625.36$1,289.35$535.76$257.87
    27840TTreat ankle dislocation00442.73$138.80$38.08$27.76
    27842TTreat ankle dislocation004512.91$656.37$277.12$131.27
    27846TTreat ankle dislocation004625.36$1,289.35$535.76$257.87
    27848TTreat ankle dislocation004625.36$1,289.35$535.76$257.87
    27860TFixation of ankle joint004512.91$656.37$277.12$131.27
    27870TFusion of ankle joint005130.94$1,573.05$675.24$314.61
    27871TFusion of tibiofibular joint005130.94$1,573.05$675.24$314.61
    27880CAmputation of lower leg
    27881CAmputation of lower leg
    27882CAmputation of lower leg
    27884TAmputation follow-up surgery004917.07$867.87$356.95$173.57
    27886CAmputation follow-up surgery
    27888CAmputation of foot at ankle
    27889TAmputation of foot at ankle005022.31$1,134.29$513.86$226.86
    27892TDecompression of leg004917.07$867.87$356.95$173.57
    27893TDecompression of leg004917.07$867.87$356.95$173.57
    27894TDecompression of leg004917.07$867.87$356.95$173.57
    27899TLeg/ankle surgery procedure00442.73$138.80$38.08$27.76
    28001TDrainage of bursa of foot000811.36$577.57$115.51$115.51
    28002TTreatment of foot infection004917.07$867.87$356.95$173.57
    28003TTreatment of foot infection004917.07$867.87$356.95$173.57
    28005TTreat foot bone lesion005516.77$852.62$355.34$170.52
    28008TIncision of foot fascia005516.77$852.62$355.34$170.52
    28010TIncision of toe tendon005516.77$852.62$355.34$170.52
    28011TIncision of toe tendons005516.77$852.62$355.34$170.52
    28020TExploration of foot joint005516.77$852.62$355.34$170.52
    28022TExploration of foot joint005516.77$852.62$355.34$170.52
    28024TExploration of toe joint005516.77$852.62$355.34$170.52
    28030TRemoval of foot nerve022014.76$750.43$326.21$150.09
    28035TDecompression of tibia nerve022014.76$750.43$326.21$150.09
    28043TExcision of foot lesion002112.74$647.73$236.51$129.55
    28045TExcision of foot lesion005516.77$852.62$355.34$170.52
    28046TResection of tumor, foot005516.77$852.62$355.34$170.52
    28050TBiopsy of foot joint lining005516.77$852.62$355.34$170.52
    28052TBiopsy of foot joint lining005516.77$852.62$355.34$170.52
    28054TBiopsy of toe joint lining005516.77$852.62$355.34$170.52
    28060TPartial removal, foot fascia005619.20$976.17$405.81$195.23
    28062TRemoval of foot fascia005619.20$976.17$405.81$195.23
    28070TRemoval of foot joint lining005619.20$976.17$405.81$195.23
    28072TRemoval of foot joint lining005619.20$976.17$405.81$195.23
    28080TRemoval of foot lesion005516.77$852.62$355.34$170.52
    28086TExcise foot tendon sheath005516.77$852.62$355.34$170.52
    28088TExcise foot tendon sheath005516.77$852.62$355.34$170.52
    28090TRemoval of foot lesion005516.77$852.62$355.34$170.52
    Start Printed Page 44755
    28092TRemoval of toe lesions005516.77$852.62$355.34$170.52
    28100TRemoval of ankle/heel lesion005516.77$852.62$355.34$170.52
    28102TRemove/graft foot lesion005619.20$976.17$405.81$195.23
    28103TRemove/graft foot lesion005619.20$976.17$405.81$195.23
    28104TRemoval of foot lesion005516.77$852.62$355.34$170.52
    28106TRemove/graft foot lesion005619.20$976.17$405.81$195.23
    28107TRemove/graft foot lesion005619.20$976.17$405.81$195.23
    28108TRemoval of toe lesions005516.77$852.62$355.34$170.52
    28110TPart removal of metatarsal005721.11$1,073.27$496.65$214.65
    28111TPart removal of metatarsal005516.77$852.62$355.34$170.52
    28112TPart removal of metatarsal005516.77$852.62$355.34$170.52
    28113TPart removal of metatarsal005516.77$852.62$355.34$170.52
    28114TRemoval of metatarsal heads005516.77$852.62$355.34$170.52
    28116TRevision of foot005516.77$852.62$355.34$170.52
    28118TRemoval of heel bone005516.77$852.62$355.34$170.52
    28119TRemoval of heel spur005516.77$852.62$355.34$170.52
    28120TPart removal of ankle/heel005516.77$852.62$355.34$170.52
    28122TPartial removal of foot bone005516.77$852.62$355.34$170.52
    28124TPartial removal of toe005516.77$852.62$355.34$170.52
    28126TPartial removal of toe005516.77$852.62$355.34$170.52
    28130TRemoval of ankle bone005516.77$852.62$355.34$170.52
    28140TRemoval of metatarsal005516.77$852.62$355.34$170.52
    28150TRemoval of toe005516.77$852.62$355.34$170.52
    28153TPartial removal of toe005516.77$852.62$355.34$170.52
    28160TPartial removal of toe005516.77$852.62$355.34$170.52
    28171TExtensive foot surgery005516.77$852.62$355.34$170.52
    28173TExtensive foot surgery005516.77$852.62$355.34$170.52
    28175TExtensive foot surgery005516.77$852.62$355.34$170.52
    28190TRemoval of foot foreign body00194.56$231.84$78.91$46.37
    28192TRemoval of foot foreign body002112.74$647.73$236.51$129.55
    28193TRemoval of foot foreign body002112.74$647.73$236.51$129.55
    28200TRepair of foot tendon005516.77$852.62$355.34$170.52
    28202TRepair/graft of foot tendon005619.20$976.17$405.81$195.23
    28208TRepair of foot tendon005516.77$852.62$355.34$170.52
    28210TRepair/graft of foot tendon005516.77$852.62$355.34$170.52
    28220TRelease of foot tendon005516.77$852.62$355.34$170.52
    28222TRelease of foot tendons005516.77$852.62$355.34$170.52
    28225TRelease of foot tendon005516.77$852.62$355.34$170.52
    28226TRelease of foot tendons005516.77$852.62$355.34$170.52
    28230TIncision of foot tendon(s)005516.77$852.62$355.34$170.52
    28232TIncision of toe tendon005516.77$852.62$355.34$170.52
    28234TIncision of foot tendon005516.77$852.62$355.34$170.52
    28238TRevision of foot tendon005619.20$976.17$405.81$195.23
    28240TRelease of big toe005516.77$852.62$355.34$170.52
    28250TRevision of foot fascia005619.20$976.17$405.81$195.23
    28260TRelease of midfoot joint005619.20$976.17$405.81$195.23
    28261TRevision of foot tendon005619.20$976.17$405.81$195.23
    28262TRevision of foot and ankle005619.20$976.17$405.81$195.23
    28264TRelease of midfoot joint005619.20$976.17$405.81$195.23
    28270TRelease of foot contracture005516.77$852.62$355.34$170.52
    28272TRelease of toe joint, each005516.77$852.62$355.34$170.52
    28280TFusion of toes005516.77$852.62$355.34$170.52
    28285TRepair of hammertoe005516.77$852.62$355.34$170.52
    28286TRepair of hammertoe005516.77$852.62$355.34$170.52
    28288TPartial removal of foot bone005619.20$976.17$405.81$195.23
    28289TRepair hallux rigidus005619.20$976.17$405.81$195.23
    28290TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28292TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28293TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28294TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28296TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28297TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28298TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28299TCorrection of bunion005721.11$1,073.27$496.65$214.65
    28300TIncision of heel bone005619.20$976.17$405.81$195.23
    28302TIncision of ankle bone005619.20$976.17$405.81$195.23
    28304TIncision of midfoot bones005619.20$976.17$405.81$195.23
    28305TIncise/graft midfoot bones005619.20$976.17$405.81$195.23
    28306TIncision of metatarsal005619.20$976.17$405.81$195.23
    28307TIncision of metatarsal005619.20$976.17$405.81$195.23
    28308TIncision of metatarsal005619.20$976.17$405.81$195.23
    28309TIncision of metatarsals005619.20$976.17$405.81$195.23
    28310TRevision of big toe005516.77$852.62$355.34$170.52
    28312TRevision of toe005516.77$852.62$355.34$170.52
    28313TRepair deformity of toe005516.77$852.62$355.34$170.52
    Start Printed Page 44756
    28315TRemoval of sesamoid bone005516.77$852.62$355.34$170.52
    28320TRepair of foot bones005619.20$976.17$405.81$195.23
    28322TRepair of metatarsals005619.20$976.17$405.81$195.23
    28340TResect enlarged toe tissue005516.77$852.62$355.34$170.52
    28341TResect enlarged toe005516.77$852.62$355.34$170.52
    28344TRepair extra toe(s)005619.20$976.17$405.81$195.23
    28345TRepair webbed toe(s)005619.20$976.17$405.81$195.23
    28360TReconstruct cleft foot005619.20$976.17$405.81$195.23
    28400TTreatment of heel fracture00442.73$138.80$38.08$27.76
    28405TTreatment of heel fracture00442.73$138.80$38.08$27.76
    28406TTreatment of heel fracture004625.36$1,289.35$535.76$257.87
    28415TTreat heel fracture004625.36$1,289.35$535.76$257.87
    28420TTreat/graft heel fracture004625.36$1,289.35$535.76$257.87
    28430TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    28435TTreatment of ankle fracture00442.73$138.80$38.08$27.76
    28436TTreatment of ankle fracture004625.36$1,289.35$535.76$257.87
    28445TTreat ankle fracture004625.36$1,289.35$535.76$257.87
    28450TTreat midfoot fracture, each00442.73$138.80$38.08$27.76
    28455TTreat midfoot fracture, each00442.73$138.80$38.08$27.76
    28456TTreat midfoot fracture004625.36$1,289.35$535.76$257.87
    28465TTreat midfoot fracture, each004625.36$1,289.35$535.76$257.87
    28470TTreat metatarsal fracture00442.73$138.80$38.08$27.76
    28475TTreat metatarsal fracture00442.73$138.80$38.08$27.76
    28476TTreat metatarsal fracture004625.36$1,289.35$535.76$257.87
    28485TTreat metatarsal fracture004625.36$1,289.35$535.76$257.87
    28490TTreat big toe fracture00442.73$138.80$38.08$27.76
    28495TTreat big toe fracture00442.73$138.80$38.08$27.76
    28496TTreat big toe fracture004625.36$1,289.35$535.76$257.87
    28505TTreat big toe fracture004625.36$1,289.35$535.76$257.87
    28510TTreatment of toe fracture00434.13$209.98$42.00$42.00
    28515TTreatment of toe fracture00434.13$209.98$42.00$42.00
    28525TTreat toe fracture004625.36$1,289.35$535.76$257.87
    28530TTreat sesamoid bone fracture00442.73$138.80$38.08$27.76
    28531TTreat sesamoid bone fracture004625.36$1,289.35$535.76$257.87
    28540TTreat foot dislocation00442.73$138.80$38.08$27.76
    28545TTreat foot dislocation004512.91$656.37$277.12$131.27
    28546TTreat foot dislocation004625.36$1,289.35$535.76$257.87
    28555TRepair foot dislocation004625.36$1,289.35$535.76$257.87
    28570TTreat foot dislocation00442.73$138.80$38.08$27.76
    28575TTreat foot dislocation00434.13$209.98$42.00$42.00
    28576TTreat foot dislocation004625.36$1,289.35$535.76$257.87
    28585TRepair foot dislocation004625.36$1,289.35$535.76$257.87
    28600TTreat foot dislocation00442.73$138.80$38.08$27.76
    28605TTreat foot dislocation00434.13$209.98$42.00$42.00
    28606TTreat foot dislocation004625.36$1,289.35$535.76$257.87
    28615TRepair foot dislocation004625.36$1,289.35$535.76$257.87
    28630TTreat toe dislocation00442.73$138.80$38.08$27.76
    28635TTreat toe dislocation004512.91$656.37$277.12$131.27
    28636TTreat toe dislocation004625.36$1,289.35$535.76$257.87
    28645TRepair toe dislocation004625.36$1,289.35$535.76$257.87
    28660TTreat toe dislocation00434.13$209.98$42.00$42.00
    28665TTreat toe dislocation004512.91$656.37$277.12$131.27
    28666TTreat toe dislocation004625.36$1,289.35$535.76$257.87
    28675TRepair of toe dislocation004625.36$1,289.35$535.76$257.87
    28705TFusion of foot bones005619.20$976.17$405.81$195.23
    28715TFusion of foot bones005619.20$976.17$405.81$195.23
    28725TFusion of foot bones005619.20$976.17$405.81$195.23
    28730TFusion of foot bones005619.20$976.17$405.81$195.23
    28735TFusion of foot bones005619.20$976.17$405.81$195.23
    28737TRevision of foot bones005516.77$852.62$355.34$170.52
    28740TFusion of foot bones005619.20$976.17$405.81$195.23
    28750TFusion of big toe joint005516.77$852.62$355.34$170.52
    28755TFusion of big toe joint005516.77$852.62$355.34$170.52
    28760TFusion of big toe joint005619.20$976.17$405.81$195.23
    28800CAmputation of midfoot
    28805CAmputation thru metatarsal
    28810TAmputation toe & metatarsal005516.77$852.62$355.34$170.52
    28820TAmputation of toe005516.77$852.62$355.34$170.52
    28825TPartial amputation of toe005516.77$852.62$355.34$170.52
    28899TFoot/toes surgery procedure00434.13$209.98$42.00$42.00
    29000SApplication of body cast00592.34$118.97$29.59$23.79
    29010SApplication of body cast00592.34$118.97$29.59$23.79
    29015SApplication of body cast00592.34$118.97$29.59$23.79
    29020SApplication of body cast00592.34$118.97$29.59$23.79
    29025SApplication of body cast00592.34$118.97$29.59$23.79
    Start Printed Page 44757
    29035SApplication of body cast00581.36$69.15$19.27$13.83
    29040SApplication of body cast00592.34$118.97$29.59$23.79
    29044SApplication of body cast00592.34$118.97$29.59$23.79
    29046SApplication of body cast00592.34$118.97$29.59$23.79
    29049SApplication of figure eight00592.34$118.97$29.59$23.79
    29055SApplication of shoulder cast00592.34$118.97$29.59$23.79
    29058SApplication of shoulder cast00592.34$118.97$29.59$23.79
    29065SApplication of long arm cast00592.34$118.97$29.59$23.79
    29075SApplication of forearm cast00581.36$69.15$19.27$13.83
    29085SApply hand/wrist cast00581.36$69.15$19.27$13.83
    29105SApply long arm splint00581.36$69.15$19.27$13.83
    29125SApply forearm splint00581.36$69.15$19.27$13.83
    29126SApply forearm splint00581.36$69.15$19.27$13.83
    29130SApplication of finger splint00581.36$69.15$19.27$13.83
    29131SApplication of finger splint00581.36$69.15$19.27$13.83
    29200SStrapping of chest00581.36$69.15$19.27$13.83
    29220SStrapping of low back00592.34$118.97$29.59$23.79
    29240SStrapping of shoulder00581.36$69.15$19.27$13.83
    29260SStrapping of elbow or wrist00581.36$69.15$19.27$13.83
    29280SStrapping of hand or finger00581.36$69.15$19.27$13.83
    29305SApplication of hip cast00581.36$69.15$19.27$13.83
    29325SApplication of hip casts00592.34$118.97$29.59$23.79
    29345SApplication of long leg cast00592.34$118.97$29.59$23.79
    29355SApplication of long leg cast00592.34$118.97$29.59$23.79
    29358SApply long leg cast brace00592.34$118.97$29.59$23.79
    29365SApplication of long leg cast00592.34$118.97$29.59$23.79
    29405SApply short leg cast00581.36$69.15$19.27$13.83
    29425SApply short leg cast00592.34$118.97$29.59$23.79
    29435SApply short leg cast00581.36$69.15$19.27$13.83
    29440SAddition of walker to cast00592.34$118.97$29.59$23.79
    29445SApply rigid leg cast00592.34$118.97$29.59$23.79
    29450SApplication of leg cast00592.34$118.97$29.59$23.79
    29505SApplication, long leg splint00592.34$118.97$29.59$23.79
    29515SApplication lower leg splint00592.34$118.97$29.59$23.79
    29520SStrapping of hip00581.36$69.15$19.27$13.83
    29530SStrapping of knee00581.36$69.15$19.27$13.83
    29540SStrapping of ankle00581.36$69.15$19.27$13.83
    29550SStrapping of toes00581.36$69.15$19.27$13.83
    29580SApplication of paste boot00581.36$69.15$19.27$13.83
    29590SApplication of foot splint00581.36$69.15$19.27$13.83
    29700SRemoval/revision of cast00581.36$69.15$19.27$13.83
    29705SRemoval/revision of cast00581.36$69.15$19.27$13.83
    29710SRemoval/revision of cast00581.36$69.15$19.27$13.83
    29715SRemoval/revision of cast00581.36$69.15$19.27$13.83
    29720SRepair of body cast00581.36$69.15$19.27$13.83
    29730SWindowing of cast00581.36$69.15$19.27$13.83
    29740SWedging of cast00581.36$69.15$19.27$13.83
    29750SWedging of clubfoot cast00581.36$69.15$19.27$13.83
    29799NCasting/strapping procedure
    29800TJaw arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29804TJaw arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29815TShoulder arthroscopy004126.18$1,331.04$592.08$266.21
    29819TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29820TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29821TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29822TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29823TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29825TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29826TShoulder arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29830TElbow arthroscopy004126.18$1,331.04$592.08$266.21
    29834TElbow arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29835TElbow arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29836TElbow arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29837TElbow arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29838TElbow arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29840TWrist arthroscopy004126.18$1,331.04$592.08$266.21
    29843TWrist arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29844TWrist arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29845TWrist arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29846TWrist arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29847TWrist arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29848TWrist endoscopy/surgery004126.18$1,331.04$592.08$266.21
    29850TKnee arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29851TKnee arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29855TTibial arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    Start Printed Page 44758
    29856TTibial arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29860THip arthroscopy, dx004126.18$1,331.04$592.08$266.21
    29861THip arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29862THip arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29863THip arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29870TKnee arthroscopy, dx004126.18$1,331.04$592.08$266.21
    29871TKnee arthroscopy/drainage004126.18$1,331.04$592.08$266.21
    29874TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29875TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29876TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29877TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29879TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29880TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29881TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29882TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29883TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29884TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29885TKnee arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29886TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29887TKnee arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29888TKnee arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29889TKnee arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29891TAnkle arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29892TAnkle arthroscopy/surgery004239.39$2,002.67$804.74$400.53
    29893TScope, plantar fasciotomy005516.77$852.62$355.34$170.52
    29894TAnkle arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29895TAnkle arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29897TAnkle arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29898TAnkle arthroscopy/surgery004126.18$1,331.04$592.08$266.21
    29909TArthroscopy of joint004126.18$1,331.04$592.08$266.21
    30000TDrainage of nose lesion02512.71$137.78$27.99$27.56
    30020TDrainage of nose lesion02512.71$137.78$27.99$27.56
    30100TIntranasal biopsy02526.53$332.00$114.24$66.40
    30110TRemoval of nose polyp(s)025313.27$674.67$284.00$134.93
    30115TRemoval of nose polyp(s)025313.27$674.67$284.00$134.93
    30117TRemoval of intranasal lesion025313.27$674.67$284.00$134.93
    30118TRemoval of intranasal lesion025419.11$971.59$272.41$194.32
    30120TRevision of nose025313.27$674.67$284.00$134.93
    30124TRemoval of nose lesion02526.53$332.00$114.24$66.40
    30125TRemoval of nose lesion025628.82$1,465.27$623.05$293.05
    30130TRemoval of turbinate bones025313.27$674.67$284.00$134.93
    30140TRemoval of turbinate bones025419.11$971.59$272.41$194.32
    30150TPartial removal of nose025628.82$1,465.27$623.05$293.05
    30160TRemoval of nose025628.82$1,465.27$623.05$293.05
    30200TInjection treatment of nose025313.27$674.67$284.00$134.93
    30210TNasal sinus therapy02526.53$332.00$114.24$66.40
    30220TInsert nasal septal button02526.53$332.00$114.24$66.40
    30300XRemove nasal foreign body03400.91$46.27$11.57$9.25
    30310TRemove nasal foreign body025313.27$674.67$284.00$134.93
    30320TRemove nasal foreign body025313.27$674.67$284.00$134.93
    30400TReconstruction of nose025628.82$1,465.27$623.05$293.05
    30410TReconstruction of nose025628.82$1,465.27$623.05$293.05
    30420TReconstruction of nose025628.82$1,465.27$623.05$293.05
    30430TRevision of nose025419.11$971.59$272.41$194.32
    30435TRevision of nose025628.82$1,465.27$623.05$293.05
    30450TRevision of nose025628.82$1,465.27$623.05$293.05
    30460TRevision of nose025628.82$1,465.27$623.05$293.05
    30462TRevision of nose025628.82$1,465.27$623.05$293.05
    30465TRepair nasal stenosis025628.82$1,465.27$623.05$293.05
    30520TRepair of nasal septum025628.82$1,465.27$623.05$293.05
    30540TRepair nasal defect025628.82$1,465.27$623.05$293.05
    30545TRepair nasal defect025628.82$1,465.27$623.05$293.05
    30560TRelease of nasal adhesions02512.71$137.78$27.99$27.56
    30580TRepair upper jaw fistula025628.82$1,465.27$623.05$293.05
    30600TRepair mouth/nose fistula025628.82$1,465.27$623.05$293.05
    30620TIntranasal reconstruction025628.82$1,465.27$623.05$293.05
    30630TRepair nasal septum defect025419.11$971.59$272.41$194.32
    30801TCauterization, inner nose02526.53$332.00$114.24$66.40
    30802TCauterization, inner nose025313.27$674.67$284.00$134.93
    30901TControl of nosebleed02502.27$115.41$38.54$23.08
    30903TControl of nosebleed02502.27$115.41$38.54$23.08
    30905TControl of nosebleed02502.27$115.41$38.54$23.08
    30906TRepeat control of nosebleed02502.27$115.41$38.54$23.08
    30915TLigation, nasal sinus artery009122.17$1,127.17$348.23$225.43
    30920TLigation, upper jaw artery009221.43$1,089.54$505.37$217.91
    Start Printed Page 44759
    30930TTherapy, fracture of nose025313.27$674.67$284.00$134.93
    30999TNasal surgery procedure02512.71$137.78$27.99$27.56
    31000TIrrigation, maxillary sinus02512.71$137.78$27.99$27.56
    31002TIrrigation, sphenoid sinus02526.53$332.00$114.24$66.40
    31020TExploration, maxillary sinus025419.11$971.59$272.41$194.32
    31030TExploration, maxillary sinus025628.82$1,465.27$623.05$293.05
    31032TExplore sinus,remove polyps025628.82$1,465.27$623.05$293.05
    31040TExploration behind upper jaw025419.11$971.59$272.41$194.32
    31050TExploration, sphenoid sinus025628.82$1,465.27$623.05$293.05
    31051TSphenoid sinus surgery025628.82$1,465.27$623.05$293.05
    31070TExploration of frontal sinus025419.11$971.59$272.41$194.32
    31075TExploration of frontal sinus025628.82$1,465.27$623.05$293.05
    31080TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31081TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31084TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31085TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31086TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31087TRemoval of frontal sinus025628.82$1,465.27$623.05$293.05
    31090TExploration of sinuses025628.82$1,465.27$623.05$293.05
    31200TRemoval of ethmoid sinus025628.82$1,465.27$623.05$293.05
    31201TRemoval of ethmoid sinus025628.82$1,465.27$623.05$293.05
    31205TRemoval of ethmoid sinus025628.82$1,465.27$623.05$293.05
    31225CRemoval of upper jaw
    31230CRemoval of upper jaw
    31231TNasal endoscopy, dx00711.08$54.91$14.22$10.98
    31233TNasal/sinus endoscopy, dx00721.29$65.59$36.08$13.12
    31235TNasal/sinus endoscopy, dx007414.62$743.31$347.54$148.66
    31237TNasal/sinus endoscopy, surg007414.62$743.31$347.54$148.66
    31238TNasal/sinus endoscopy, surg007414.62$743.31$347.54$148.66
    31239TNasal/sinus endoscopy, surg007519.08$970.07$467.29$194.01
    31240TNasal/sinus endoscopy, surg007414.62$743.31$347.54$148.66
    31254TRevision of ethmoid sinus007519.08$970.07$467.29$194.01
    31255TRemoval of ethmoid sinus007519.08$970.07$467.29$194.01
    31256TExploration maxillary sinus007519.08$970.07$467.29$194.01
    31267TEndoscopy, maxillary sinus007519.08$970.07$467.29$194.01
    31276TSinus endoscopy, surgical007519.08$970.07$467.29$194.01
    31287TNasal/sinus endoscopy, surg007519.08$970.07$467.29$194.01
    31288TNasal/sinus endoscopy, surg007519.08$970.07$467.29$194.01
    31290CNasal/sinus endoscopy, surg
    31291CNasal/sinus endoscopy, surg
    31292CNasal/sinus endoscopy, surg
    31293CNasal/sinus endoscopy, surg
    31294CNasal/sinus endoscopy, surg
    31299TSinus surgery procedure02526.53$332.00$114.24$66.40
    31300TRemoval of larynx lesion025628.82$1,465.27$623.05$293.05
    31320TDiagnostic incision, larynx025628.82$1,465.27$623.05$293.05
    31360CRemoval of larynx
    31365CRemoval of larynx
    31367CPartial removal of larynx
    31368CPartial removal of larynx
    31370CPartial removal of larynx
    31375CPartial removal of larynx
    31380CPartial removal of larynx
    31382CPartial removal of larynx
    31390CRemoval of larynx & pharynx
    31395CReconstruct larynx & pharynx
    31400TRevision of larynx025628.82$1,465.27$623.05$293.05
    31420TRemoval of epiglottis025628.82$1,465.27$623.05$293.05
    31500SInsert emergency airway00945.69$289.29$105.29$57.86
    31502TChange of windpipe airway01212.42$123.04$52.53$24.61
    31505TDiagnostic laryngoscopy00721.29$65.59$36.08$13.12
    31510TLaryngoscopy with biopsy007414.62$743.31$347.54$148.66
    31511TRemove foreign body, larynx00721.29$65.59$36.08$13.12
    31512TRemoval of larynx lesion007414.62$743.31$347.54$148.66
    31513TInjection into vocal cord00733.54$179.98$79.19$36.00
    31515TLaryngoscopy for aspiration007414.62$743.31$347.54$148.66
    31520TDiagnostic laryngoscopy00721.29$65.59$36.08$13.12
    31525TDiagnostic laryngoscopy007414.62$743.31$347.54$148.66
    31526TDiagnostic laryngoscopy007414.62$743.31$347.54$148.66
    31527TLaryngoscopy for treatment007519.08$970.07$467.29$194.01
    31528TLaryngoscopy and dilatation007414.62$743.31$347.54$148.66
    31529TLaryngoscopy and dilatation007414.62$743.31$347.54$148.66
    31530TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31531TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31535TOperative laryngoscopy007519.08$970.07$467.29$194.01
    Start Printed Page 44760
    31536TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31540TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31541TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31560TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31561TOperative laryngoscopy007519.08$970.07$467.29$194.01
    31570TLaryngoscopy with injection007414.62$743.31$347.54$148.66
    31571TLaryngoscopy with injection007519.08$970.07$467.29$194.01
    31575TDiagnostic laryngoscopy00711.08$54.91$14.22$10.98
    31576TLaryngoscopy with biopsy007414.62$743.31$347.54$148.66
    31577TRemove foreign body, larynx00733.54$179.98$79.19$36.00
    31578TRemoval of larynx lesion007519.08$970.07$467.29$194.01
    31579TDiagnostic laryngoscopy00733.54$179.98$79.19$36.00
    31580TRevision of larynx025628.82$1,465.27$623.05$293.05
    31582CRevision of larynx
    31584CTreat larynx fracture
    31585TTreat larynx fracture025313.27$674.67$284.00$134.93
    31586TTreat larynx fracture025628.82$1,465.27$623.05$293.05
    31587CRevision of larynx
    31588TRevision of larynx025628.82$1,465.27$623.05$293.05
    31590TReinnervate larynx025628.82$1,465.27$623.05$293.05
    31595TLarynx nerve surgery025628.82$1,465.27$623.05$293.05
    31599TLarynx surgery procedure025419.11$971.59$272.41$194.32
    31600TIncision of windpipe025419.11$971.59$272.41$194.32
    31601TIncision of windpipe025419.11$971.59$272.41$194.32
    31603TIncision of windpipe02526.53$332.00$114.24$66.40
    31605TIncision of windpipe025313.27$674.67$284.00$134.93
    31610TIncision of windpipe025419.11$971.59$272.41$194.32
    31611TSurgery/speech prosthesis025419.11$971.59$272.41$194.32
    31612TPuncture/clear windpipe025419.11$971.59$272.41$194.32
    31613TRepair windpipe opening025419.11$971.59$272.41$194.32
    31614TRepair windpipe opening025628.82$1,465.27$623.05$293.05
    31615TVisualization of windpipe00768.22$417.92$197.05$83.58
    31622TDx bronchoscope/wash00768.22$417.92$197.05$83.58
    31623TDx bronchoscope/brush00768.22$417.92$197.05$83.58
    31624TDx bronchoscope/lavage00768.22$417.92$197.05$83.58
    31625TBronchoscopy with biopsy00768.22$417.92$197.05$83.58
    31628TBronchoscopy with biopsy00768.22$417.92$197.05$83.58
    31629TBronchoscopy with biopsy00768.22$417.92$197.05$83.58
    31630TBronchoscopy with repair00768.22$417.92$197.05$83.58
    31631TBronchoscopy with dilation00768.22$417.92$197.05$83.58
    31635TRemove foreign body, airway00768.22$417.92$197.05$83.58
    31640TBronchoscopy & remove lesion00768.22$417.92$197.05$83.58
    31641TBronchoscopy, treat blockage00768.22$417.92$197.05$83.58
    31643TDiag bronchoscope/catheter00768.22$417.92$197.05$83.58
    31645TBronchoscopy, clear airways00768.22$417.92$197.05$83.58
    31646TBronchoscopy, reclear airway00768.22$417.92$197.05$83.58
    31656TBronchoscopy, inj for xray00768.22$417.92$197.05$83.58
    31700TInsertion of airway catheter00721.29$65.59$36.08$13.12
    31708NInstill airway contrast dye
    31710NInsertion of airway catheter
    31715NInjection for bronchus x-ray
    31717TBronchial brush biopsy00733.54$179.98$79.19$36.00
    31720TClearance of airways00721.29$65.59$36.08$13.12
    31725CClearance of airways
    31730TIntro, windpipe wire/tube00733.54$179.98$79.19$36.00
    31750TRepair of windpipe025628.82$1,465.27$623.05$293.05
    31755TRepair of windpipe025628.82$1,465.27$623.05$293.05
    31760CRepair of windpipe
    31766CReconstruction of windpipe
    31770CRepair/graft of bronchus
    31775CReconstruct bronchus
    31780CReconstruct windpipe
    31781CReconstruct windpipe
    31785CRemove windpipe lesion
    31786CRemove windpipe lesion
    31800CRepair of windpipe injury
    31805CRepair of windpipe injury
    31820TClosure of windpipe lesion025313.27$674.67$284.00$134.93
    31825TRepair of windpipe defect025419.11$971.59$272.41$194.32
    31830TRevise windpipe scar025419.11$971.59$272.41$194.32
    31899TAirways surgical procedure00768.22$417.92$197.05$83.58
    32000TDrainage of chest00704.11$208.96$79.60$41.79
    32002TTreatment of collapsed lung00704.11$208.96$79.60$41.79
    32005TTreat lung lining chemically00704.11$208.96$79.60$41.79
    32020TInsertion of chest tube00704.11$208.96$79.60$41.79
    Start Printed Page 44761
    32035CExploration of chest
    32036CExploration of chest
    32095CBiopsy through chest wall
    32100CExploration/biopsy of chest
    32110CExplore/repair chest
    32120CRe-exploration of chest
    32124CExplore chest free adhesions
    32140CRemoval of lung lesion(s)
    32141CRemove/treat lung lesions
    32150CRemoval of lung lesion(s)
    32151CRemove lung foreign body
    32160COpen chest heart massage
    32200CDrain, open, lung lesion
    32201CDrain, percut, lung lesion
    32215CTreat chest lining
    32220CRelease of lung
    32225CPartial release of lung
    32310CRemoval of chest lining
    32320CFree/remove chest lining
    32400TNeedle biopsy chest lining00056.71$341.15$119.75$68.23
    32402COpen biopsy chest lining
    32405TBiopsy, lung or mediastinum00056.71$341.15$119.75$68.23
    32420TPuncture/clear lung00704.11$208.96$79.60$41.79
    32440CRemoval of lung
    32442CSleeve pneumonectomy
    32445CRemoval of lung
    32480CPartial removal of lung
    32482CBilobectomy
    32484CSegmentectomy
    32486CSleeve lobectomy
    32488CCompletion pneumonectomy
    32491CLung volume reduction
    32500CPartial removal of lung
    32501CRepair bronchus add-on
    32520CRemove lung & revise chest
    32522CRemove lung & revise chest
    32525CRemove lung & revise chest
    32540CRemoval of lung lesion
    32601TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32602TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32603TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32604TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32605TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32606TThoracoscopy, diagnostic006925.62$1,302.57$612.21$260.51
    32650CThoracoscopy, surgical
    32651CThoracoscopy, surgical
    32652CThoracoscopy, surgical
    32653CThoracoscopy, surgical
    32654CThoracoscopy, surgical
    32655CThoracoscopy, surgical
    32656CThoracoscopy, surgical
    32657CThoracoscopy, surgical
    32658CThoracoscopy, surgical
    32659CThoracoscopy, surgical
    32660CThoracoscopy, surgical
    32661CThoracoscopy, surgical
    32662CThoracoscopy, surgical
    32663CThoracoscopy, surgical
    32664CThoracoscopy, surgical
    32665CThoracoscopy, surgical
    32800CRepair lung hernia
    32810CClose chest after drainage
    32815CClose bronchial fistula
    32820CReconstruct injured chest
    32850CDonor pneumonectomy
    32851CLung transplant, single
    32852CLung transplant with bypass
    32853CLung transplant, double
    32854CLung transplant with bypass
    32900CRemoval of rib(s)
    32905CRevise & repair chest wall
    32906CRevise & repair chest wall
    32940CRevision of lung
    32960TTherapeutic pneumothorax00704.11$208.96$79.60$41.79
    32997CTotal lung lavage
    Start Printed Page 44762
    32999TChest surgery procedure00704.11$208.96$79.60$41.79
    33010TDrainage of heart sac00704.11$208.96$79.60$41.79
    33011TRepeat drainage of heart sac00704.11$208.96$79.60$41.79
    33015CIncision of heart sac
    33020CIncision of heart sac
    33025CIncision of heart sac
    33030CPartial removal of heart sac
    33031CPartial removal of heart sac
    33050CRemoval of heart sac lesion
    33120CRemoval of heart lesion
    33130CRemoval of heart lesion
    33140CHeart revascularize (tmr)
    33141CHeart tmr w/other procedure
    33200CInsertion of heart pacemaker
    33201CInsertion of heart pacemaker
    33206TInsertion of heart pacemaker008982.60$4,199.55$2,246.59$839.91
    33207TInsertion of heart pacemaker008982.60$4,199.55$2,246.59$839.91
    33208TInsertion of heart pacemaker008982.60$4,199.55$2,246.59$839.91
    33210TInsertion of heart electrode010615.82$804.32$426.29$160.86
    33211TInsertion of heart electrode010615.82$804.32$426.29$160.86
    33212TInsertion of pulse generator009073.37$3,730.28$2,014.35$746.06
    33213TInsertion of pulse generator009073.37$3,730.28$2,014.35$746.06
    33214TUpgrade of pacemaker system008982.60$4,199.55$2,246.59$839.91
    33216TRevise eltrd pacing-defib010615.82$804.32$426.29$160.86
    33217TRevise eltrd pacing-defib010615.82$804.32$426.29$160.86
    33218TRevise eltrd pacing-defib010615.82$804.32$426.29$160.86
    33220TRevise eltrd pacing-defib010615.82$804.32$426.29$160.86
    33222TRevise pocket, pacemaker002613.51$686.88$277.92$137.38
    33223TRevise pocket, pacing-defib002613.51$686.88$277.92$137.38
    33233TRemoval of pacemaker system010516.56$841.94$372.32$168.39
    33234TRemoval of pacemaker system010516.56$841.94$372.32$168.39
    33235TRemoval pacemaker electrode010516.56$841.94$372.32$168.39
    33236CRemove electrode/thoracotomy
    33237CRemove electrode/thoracotomy
    33238CRemove electrode/thoracotomy
    33240TInsert pulse generator0107155.27$7,894.24$4,224.27$1,578.85
    33241TRemove pulse generator010516.56$841.94$372.32$168.39
    33243CRemove eltrd/thoracotomy
    33244TRemove eltrd, transven010516.56$841.94$372.32$168.39
    33245CInsert epic eltrd pace-defib
    33246CInsert epic eltrd/generator
    33249TEltrd/insert pace-defib0108159.42$8,105.23$4,214.72$1,621.05
    33250CAblate heart dysrhythm focus
    33251CAblate heart dysrhythm focus
    33253CReconstruct atria
    33261CAblate heart dysrhythm focus
    33282SImplant pat-active ht record09747.57$384.87$76.97
    33284TRemove pat-active ht record01096.57$334.03$133.51$66.81
    33300CRepair of heart wound
    33305CRepair of heart wound
    33310CExploratory heart surgery
    33315CExploratory heart surgery
    33320CRepair major blood vessel(s)
    33321CRepair major vessel
    33322CRepair major blood vessel(s)
    33330CInsert major vessel graft
    33332CInsert major vessel graft
    33335CInsert major vessel graft
    33400CRepair of aortic valve
    33401CValvuloplasty, open
    33403CValvuloplasty, w/cp bypass
    33404CPrepare heart-aorta conduit
    33405CReplacement of aortic valve
    33406CReplacement of aortic valve
    33410CReplacement of aortic valve
    33411CReplacement of aortic valve
    33412CReplacement of aortic valve
    33413CReplacement of aortic valve
    33414CRepair of aortic valve
    33415CRevision, subvalvular tissue
    33416CRevise ventricle muscle
    33417CRepair of aortic valve
    33420CRevision of mitral valve
    33422CRevision of mitral valve
    33425CRepair of mitral valve
    Start Printed Page 44763
    33426CRepair of mitral valve
    33427CRepair of mitral valve
    33430CReplacement of mitral valve
    33460CRevision of tricuspid valve
    33463CValvuloplasty, tricuspid
    33464CValvuloplasty, tricuspid
    33465CReplace tricuspid valve
    33468CRevision of tricuspid valve
    33470CRevision of pulmonary valve
    33471CValvotomy, pulmonary valve
    33472CRevision of pulmonary valve
    33474CRevision of pulmonary valve
    33475CReplacement, pulmonary valve
    33476CRevision of heart chamber
    33478CRevision of heart chamber
    33496CRepair, prosth valve clot
    33500CRepair heart vessel fistula
    33501CRepair heart vessel fistula
    33502CCoronary artery correction
    33503CCoronary artery graft
    33504CCoronary artery graft
    33505CRepair artery w/tunnel
    33506CRepair artery, translocation
    33510CCABG, vein, single
    33511CCABG, vein, two
    33512CCABG, vein, three
    33513CCABG, vein, four
    33514CCABG, vein, five
    33516CCabg, vein, six or more
    33517CCABG, artery-vein, single
    33518CCABG, artery-vein, two
    33519CCABG, artery-vein, three
    33521CCABG, artery-vein, four
    33522CCABG, artery-vein, five
    33523CCabg, art-vein, six or more
    33530CCoronary artery, bypass/reop
    33533CCABG, arterial, single
    33534CCABG, arterial, two
    33535CCABG, arterial, three
    33536CCabg, arterial, four or more
    33542CRemoval of heart lesion
    33545CRepair of heart damage
    33572COpen coronary endarterectomy
    33600CClosure of valve
    33602CClosure of valve
    33606CAnastomosis/artery-aorta
    33608CRepair anomaly w/conduit
    33610CRepair by enlargement
    33611CRepair double ventricle
    33612CRepair double ventricle
    33615CRepair, modified fontan
    33617CRepair single ventricle
    33619CRepair single ventricle
    33641CRepair heart septum defect
    33645CRevision of heart veins
    33647CRepair heart septum defects
    33660CRepair of heart defects
    33665CRepair of heart defects
    33670CRepair of heart chambers
    33681CRepair heart septum defect
    33684CRepair heart septum defect
    33688CRepair heart septum defect
    33690CReinforce pulmonary artery
    33692CRepair of heart defects
    33694CRepair of heart defects
    33697CRepair of heart defects
    33702CRepair of heart defects
    33710CRepair of heart defects
    33720CRepair of heart defect
    33722CRepair of heart defect
    33730CRepair heart-vein defect(s)
    33732CRepair heart-vein defect
    33735CRevision of heart chamber
    33736CRevision of heart chamber
    33737CRevision of heart chamber
    Start Printed Page 44764
    33750CMajor vessel shunt
    33755CMajor vessel shunt
    33762CMajor vessel shunt
    33764CMajor vessel shunt & graft
    33766CMajor vessel shunt
    33767CMajor vessel shunt
    33770CRepair great vessels defect
    33771CRepair great vessels defect
    33774CRepair great vessels defect
    33775CRepair great vessels defect
    33776CRepair great vessels defect
    33777CRepair great vessels defect
    33778CRepair great vessels defect
    33779CRepair great vessels defect
    33780CRepair great vessels defect
    33781CRepair great vessels defect
    33786CRepair arterial trunk
    33788CRevision of pulmonary artery
    33800CAortic suspension
    33802CRepair vessel defect
    33803CRepair vessel defect
    33813CRepair septal defect
    33814CRepair septal defect
    33820CRevise major vessel
    33822CRevise major vessel
    33824CRevise major vessel
    33840CRemove aorta constriction
    33845CRemove aorta constriction
    33851CRemove aorta constriction
    33852CRepair septal defect
    33853CRepair septal defect
    33860CAscending aortic graft
    33861CAscending aortic graft
    33863CAscending aortic graft
    33870CTransverse aortic arch graft
    33875CThoracic aortic graft
    33877CThoracoabdominal graft
    33910CRemove lung artery emboli
    33915CRemove lung artery emboli
    33916CSurgery of great vessel
    33917CRepair pulmonary artery
    33918CRepair pulmonary atresia
    33919CRepair pulmonary atresia
    33920CRepair pulmonary atresia
    33922CTransect pulmonary artery
    33924CRemove pulmonary shunt
    33930CRemoval of donor heart/lung
    33935CTransplantation, heart/lung
    33940CRemoval of donor heart
    33945CTransplantation of heart
    33960CExternal circulation assist
    33961CExternal circulation assist
    33968CRemove aortic assist device
    33970CAortic circulation assist
    33971CAortic circulation assist
    33973CInsert balloon device
    33974CRemove intra-aortic balloon
    33975CImplant ventricular device
    33976CImplant ventricular device
    33977CRemove ventricular device
    33978CRemove ventricular device
    33999TCardiac surgery procedure00704.11$208.96$79.60$41.79
    34001CRemoval of artery clot
    34051CRemoval of artery clot
    34101TRemoval of artery clot008829.11$1,480.01$678.68$296.00
    34111TRemoval of arm artery clot008829.11$1,480.01$678.68$296.00
    34151CRemoval of artery clot
    34201TRemoval of artery clot008829.11$1,480.01$678.68$296.00
    34203TRemoval of leg artery clot008829.11$1,480.01$678.68$296.00
    34401CRemoval of vein clot
    34421TRemoval of vein clot008829.11$1,480.01$678.68$296.00
    34451CRemoval of vein clot
    34471TRemoval of vein clot008829.11$1,480.01$678.68$296.00
    34490TRemoval of vein clot008829.11$1,480.01$678.68$296.00
    34501TRepair valve, femoral vein008829.11$1,480.01$678.68$296.00
    Start Printed Page 44765
    34502CReconstruct vena cava
    34510TTransposition of vein valve008829.11$1,480.01$678.68$296.00
    34520TCross-over vein graft008829.11$1,480.01$678.68$296.00
    34530TLeg vein fusion008829.11$1,480.01$678.68$296.00
    34800CEndovasc abdo repair w/tube
    34802CEndovasc abdo repr w/device
    34804CEndovasc abdo repr w/device
    34808CEndovasc abdo occlud device
    34812CXpose for endoprosth, aortic
    34813CXpose for endoprosth, femorl
    34820CXpose for endoprosth, iliac
    34825CEndovasc extend prosth, init
    34826CEndovasc exten prosth, addl
    34830COpen aortic tube prosth repr
    34831COpen aortoiliac prosth repr
    34832COpen aortofemor prosth repr
    35001CRepair defect of artery
    35002CRepair artery rupture, neck
    35005CRepair defect of artery
    35011TRepair defect of artery009315.05$765.17$277.34$153.03
    35013CRepair artery rupture, arm
    35021CRepair defect of artery
    35022CRepair artery rupture, chest
    35045CRepair defect of arm artery
    35081CRepair defect of artery
    35082CRepair artery rupture, aorta
    35091CRepair defect of artery
    35092CRepair artery rupture, aorta
    35102CRepair defect of artery
    35103CRepair artery rupture, groin
    35111CRepair defect of artery
    35112CRepair artery rupture,spleen
    35121CRepair defect of artery
    35122CRepair artery rupture, belly
    35131CRepair defect of artery
    35132CRepair artery rupture, groin
    35141CRepair defect of artery
    35142CRepair artery rupture, thigh
    35151CRepair defect of artery
    35152CRepair artery rupture, knee
    35161CRepair defect of artery
    35162CRepair artery rupture
    35180TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35182CRepair blood vessel lesion
    35184TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35188TRepair blood vessel lesion008829.11$1,480.01$678.68$296.00
    35189CRepair blood vessel lesion
    35190TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35201TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35206TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35207TRepair blood vessel lesion008829.11$1,480.01$678.68$296.00
    35211CRepair blood vessel lesion
    35216CRepair blood vessel lesion
    35221CRepair blood vessel lesion
    35226TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35231TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35236TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35241CRepair blood vessel lesion
    35246CRepair blood vessel lesion
    35251CRepair blood vessel lesion
    35256TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35261TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35266TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35271CRepair blood vessel lesion
    35276CRepair blood vessel lesion
    35281CRepair blood vessel lesion
    35286TRepair blood vessel lesion009315.05$765.17$277.34$153.03
    35301CRechanneling of artery
    35311CRechanneling of artery
    35321TRechanneling of artery009315.05$765.17$277.34$153.03
    35331CRechanneling of artery
    35341CRechanneling of artery
    35351CRechanneling of artery
    35355CRechanneling of artery
    35361CRechanneling of artery
    Start Printed Page 44766
    35363CRechanneling of artery
    35371CRechanneling of artery
    35372CRechanneling of artery
    35381CRechanneling of artery
    35390CReoperation, carotid add-on
    35400CAngioscopy
    35450CRepair arterial blockage
    35452CRepair arterial blockage
    35454CRepair arterial blockage
    35456CRepair arterial blockage
    35458TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35459TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35460TRepair venous blockage008122.04$1,120.56$549.07$224.11
    35470TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35471TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35472TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35473TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35474TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35475TRepair arterial blockage008122.04$1,120.56$549.07$224.11
    35476TRepair venous blockage008122.04$1,120.56$549.07$224.11
    35480CAtherectomy, open
    35481TAtherectomy, open008122.04$1,120.56$549.07$224.11
    35482CAtherectomy, open
    35483CAtherectomy, open
    35484TAtherectomy, open008122.04$1,120.56$549.07$224.11
    35485TAtherectomy, open008122.04$1,120.56$549.07$224.11
    35490TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35491TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35492TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35493TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35494TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35495TAtherectomy, percutaneous008122.04$1,120.56$549.07$224.11
    35500THarvest vein for bypass008122.04$1,120.56$549.07$224.11
    35501CArtery bypass graft
    35506CArtery bypass graft
    35507CArtery bypass graft
    35508CArtery bypass graft
    35509CArtery bypass graft
    35511CArtery bypass graft
    35515CArtery bypass graft
    35516CArtery bypass graft
    35518CArtery bypass graft
    35521CArtery bypass graft
    35526CArtery bypass graft
    35531CArtery bypass graft
    35533CArtery bypass graft
    35536CArtery bypass graft
    35541CArtery bypass graft
    35546CArtery bypass graft
    35548CArtery bypass graft
    35549CArtery bypass graft
    35551CArtery bypass graft
    35556CArtery bypass graft
    35558CArtery bypass graft
    35560CArtery bypass graft
    35563CArtery bypass graft
    35565CArtery bypass graft
    35566CArtery bypass graft
    35571CArtery bypass graft
    35582CVein bypass graft
    35583CVein bypass graft
    35585CVein bypass graft
    35587CVein bypass graft
    35600CHarvest artery for cabg
    35601CArtery bypass graft
    35606CArtery bypass graft
    35612CArtery bypass graft
    35616CArtery bypass graft
    35621CArtery bypass graft
    35623CBypass graft, not vein
    35626CArtery bypass graft
    35631CArtery bypass graft
    35636CArtery bypass graft
    35641CArtery bypass graft
    35642CArtery bypass graft
    Start Printed Page 44767
    35645CArtery bypass graft
    35646CArtery bypass graft
    35650CArtery bypass graft
    35651CArtery bypass graft
    35654CArtery bypass graft
    35656CArtery bypass graft
    35661CArtery bypass graft
    35663CArtery bypass graft
    35665CArtery bypass graft
    35666CArtery bypass graft
    35671CArtery bypass graft
    35681CComposite bypass graft
    35682CComposite bypass graft
    35683CComposite bypass graft
    35691CArterial transposition
    35693CArterial transposition
    35694CArterial transposition
    35695CArterial transposition
    35700CReoperation, bypass graft
    35701CExploration, carotid artery
    35721CExploration, femoral artery
    35741CExploration popliteal artery
    35761TExploration of artery/vein011519.06$969.05$503.91$193.81
    35800CExplore neck vessels
    35820CExplore chest vessels
    35840CExplore abdominal vessels
    35860TExplore limb vessels009315.05$765.17$277.34$153.03
    35870CRepair vessel graft defect
    35875TRemoval of clot in graft008829.11$1,480.01$678.68$296.00
    35876TRemoval of clot in graft008829.11$1,480.01$678.68$296.00
    35879TRevise graft w/vein008829.11$1,480.01$678.68$296.00
    35881TRevise graft w/vein008829.11$1,480.01$678.68$296.00
    35901CExcision, graft, neck
    35903TExcision, graft, extremity011519.06$969.05$503.91$193.81
    35905CExcision, graft, thorax
    35907CExcision, graft, abdomen
    36000NPlace needle in vein
    36005NInjection, venography
    36010NPlace catheter in vein
    36011NPlace catheter in vein
    36012NPlace catheter in vein
    36013NPlace catheter in artery
    36014NPlace catheter in artery
    36015NPlace catheter in artery
    36100NEstablish access to artery
    36120NEstablish access to artery
    36140NEstablish access to artery
    36145NArtery to vein shunt
    36160NEstablish access to aorta
    36200NPlace catheter in aorta
    36215NPlace catheter in artery
    36216NPlace catheter in artery
    36217NPlace catheter in artery
    36218NPlace catheter in artery
    36245NPlace catheter in artery
    36246NPlace catheter in artery
    36247NPlace catheter in artery
    36248NPlace catheter in artery
    36260TInsertion of infusion pump011914.37$730.60$161.50$146.12
    36261TRevision of infusion pump012425.84$1,313.76$722.57$262.75
    36262TRemoval of infusion pump01096.57$334.03$133.51$66.81
    36299NVessel injection procedure
    36400NDrawing blood
    36405NDrawing blood
    36406NDrawing blood
    36410NDrawing blood
    36415EDrawing blood
    36420TEstablish access to vein00350.13$6.61$2.18$1.32
    36425TEstablish access to vein00350.13$6.61$2.18$1.32
    36430SBlood transfusion service01105.76$292.85$122.70$58.57
    36440SBlood transfusion service01105.76$292.85$122.70$58.57
    36450SExchange transfusion service01105.76$292.85$122.70$58.57
    36455SExchange transfusion service01105.76$292.85$122.70$58.57
    36460STransfusion service, fetal01105.76$292.85$122.70$58.57
    36468TInjection(s), spider veins00981.34$68.13$20.88$13.63
    Start Printed Page 44768
    36469TInjection(s), spider veins00981.34$68.13$20.88$13.63
    36470TInjection therapy of vein00981.34$68.13$20.88$13.63
    36471TInjection therapy of veins00981.34$68.13$20.88$13.63
    36481NInsertion of catheter, vein
    36488TInsertion of catheter, vein00327.16$364.03$119.52$72.81
    36489TInsertion of catheter, vein00327.16$364.03$119.52$72.81
    36490TInsertion of catheter, vein00327.16$364.03$119.52$72.81
    36491TInsertion of catheter, vein00327.16$364.03$119.52$72.81
    36493TRepositioning of cvc01874.54$230.82$113.10$46.16
    36500NInsertion of catheter, vein
    36510CInsertion of catheter, vein
    36520SPlasma and/or cell exchange011116.69$848.55$300.74$169.71
    36521SApheresis w/ adsorp/reinfuse011239.75$2,020.97$663.65$404.19
    36522SPhotopheresis011239.75$2,020.97$663.65$404.19
    36530TInsertion of infusion pump011914.37$730.60$161.50$146.12
    36531TRevision of infusion pump012425.84$1,313.76$722.57$262.75
    36532TRemoval of infusion pump01096.57$334.03$133.51$66.81
    36533TInsertion of access device011519.06$969.05$503.91$193.81
    36534TRevision of access device010310.91$554.69$249.61$110.94
    36535TRemoval of access device01096.57$334.03$133.51$66.81
    36540NCollect blood venous device
    36550TDeclot vascular device09700.47$23.90$4.78
    36600NWithdrawal of arterial blood
    36620NInsertion catheter, artery
    36625NInsertion catheter, artery
    36640TInsertion catheter, artery00327.16$364.03$119.52$72.81
    36660CInsertion catheter, artery
    36680TInsert needle, bone cavity01202.35$119.48$42.67$23.90
    36800TInsertion of cannula011519.06$969.05$503.91$193.81
    36810TInsertion of cannula011519.06$969.05$503.91$193.81
    36815TInsertion of cannula011519.06$969.05$503.91$193.81
    36819TAv fusion by basilic vein008829.11$1,480.01$678.68$296.00
    36821TAv fusion direct any site008829.11$1,480.01$678.68$296.00
    36822CInsertion of cannula(s)
    36823CInsertion of cannula(s)
    36825TArtery-vein graft008829.11$1,480.01$678.68$296.00
    36830TArtery-vein graft008829.11$1,480.01$678.68$296.00
    36831TAv fistula excision, open008829.11$1,480.01$678.68$296.00
    36832TAv fistula revision, open008829.11$1,480.01$678.68$296.00
    36833TAv fistula revision008829.11$1,480.01$678.68$296.00
    36834TRepair A-V aneurysm008829.11$1,480.01$678.68$296.00
    36835TArtery to vein shunt011519.06$969.05$503.91$193.81
    36860TExternal cannula declotting011519.06$969.05$503.91$193.81
    36861TCannula declotting011519.06$969.05$503.91$193.81
    36870TAv fistula revision, open009315.05$765.17$277.34$153.03
    37140CRevision of circulation
    37145CRevision of circulation
    37160CRevision of circulation
    37180CRevision of circulation
    37181CSplice spleen/kidney veins
    37195CThrombolytic therapy, stroke
    37200TTranscatheter biopsy00056.71$341.15$119.75$68.23
    37201TTranscatheter therapy infuse01202.35$119.48$42.67$23.90
    37202TTranscatheter therapy infuse01202.35$119.48$42.67$23.90
    37203TTranscatheter retrieval010310.91$554.69$249.61$110.94
    37204TTranscatheter occlusion010310.91$554.69$249.61$110.94
    37205TTranscatheter stent022960.07$3,054.08$996.86$610.82
    37206TTranscatheter stent add-on022960.07$3,054.08$996.86$610.82
    37207TTranscatheter stent022960.07$3,054.08$996.86$610.82
    37208TTranscatheter stent add-on022960.07$3,054.08$996.86$610.82
    37209TExchange arterial catheter010310.91$554.69$249.61$110.94
    37250TIv us first vessel add-on010310.91$554.69$249.61$110.94
    37251TIv us each add vessel add-on010310.91$554.69$249.61$110.94
    37565TLigation of neck vein009315.05$765.17$277.34$153.03
    37600TLigation of neck artery009315.05$765.17$277.34$153.03
    37605TLigation of neck artery009122.17$1,127.17$348.23$225.43
    37606TLigation of neck artery009122.17$1,127.17$348.23$225.43
    37607TLigation of a-v fistula009221.43$1,089.54$505.37$217.91
    37609TTemporal artery procedure00208.56$435.21$130.53$87.04
    37615TLigation of neck artery009122.17$1,127.17$348.23$225.43
    37616CLigation of chest artery
    37617CLigation of abdomen artery
    37618CLigation of extremity artery
    37620TRevision of major vein009122.17$1,127.17$348.23$225.43
    37650TRevision of major vein009122.17$1,127.17$348.23$225.43
    Start Printed Page 44769
    37660CRevision of major vein
    37700TRevise leg vein009122.17$1,127.17$348.23$225.43
    37720TRemoval of leg vein009221.43$1,089.54$505.37$217.91
    37730TRemoval of leg veins009221.43$1,089.54$505.37$217.91
    37735TRemoval of leg veins/lesion009221.43$1,089.54$505.37$217.91
    37760TRevision of leg veins009122.17$1,127.17$348.23$225.43
    37780TRevision of leg vein009122.17$1,127.17$348.23$225.43
    37785TRevise secondary varicosity009122.17$1,127.17$348.23$225.43
    37788CRevascularization, penis
    37790TPenile venous occlusion018124.07$1,223.77$673.07$244.75
    37799TVascular surgery procedure00208.56$435.21$130.53$87.04
    38100CRemoval of spleen, total
    38101CRemoval of spleen, partial
    38102CRemoval of spleen, total
    38115CRepair of ruptured spleen
    38120TLaparoscopy, splenectomy013139.80$2,023.51$1,052.23$404.70
    38129TLaparoscope proc, spleen013027.92$1,419.51$659.53$283.90
    38200NInjection for spleen x-ray
    38230SBone marrow collection012310.12$514.52$102.90$102.90
    38231SStem cell collection011116.69$848.55$300.74$169.71
    38240SBone marrow/stem transplant012310.12$514.52$102.90$102.90
    38241SBone marrow/stem transplant012310.12$514.52$102.90$102.90
    38300TDrainage, lymph node lesion000811.36$577.57$115.51$115.51
    38305TDrainage, lymph node lesion000811.36$577.57$115.51$115.51
    38308TIncision of lymph channels011316.87$857.70$326.55$171.54
    38380CThoracic duct procedure
    38381CThoracic duct procedure
    38382CThoracic duct procedure
    38500TBiopsy/removal, lymph nodes011316.87$857.70$326.55$171.54
    38505TNeedle biopsy, lymph nodes00056.71$341.15$119.75$68.23
    38510TBiopsy/removal, lymph nodes011316.87$857.70$326.55$171.54
    38520TBiopsy/removal, lymph nodes011316.87$857.70$326.55$171.54
    38525TBiopsy/removal, lymph nodes011316.87$857.70$326.55$171.54
    38530TBiopsy/removal, lymph nodes011316.87$857.70$326.55$171.54
    38542TExplore deep node(s), neck011430.50$1,550.68$493.78$310.14
    38550TRemoval, neck/armpit lesion011316.87$857.70$326.55$171.54
    38555TRemoval, neck/armpit lesion011430.50$1,550.68$493.78$310.14
    38562CRemoval, pelvic lymph nodes
    38564CRemoval, abdomen lymph nodes
    38570TLaparoscopy, lymph node biop013139.80$2,023.51$1,052.23$404.70
    38571TLaparoscopy, lymphadenectomy013260.31$3,066.28$1,239.22$613.26
    38572TLaparoscopy, lymphadenectomy013139.80$2,023.51$1,052.23$404.70
    38589TLaparoscope proc, lymphatic013027.92$1,419.51$659.53$283.90
    38700CRemoval of lymph nodes, neck
    38720TRemoval of lymph nodes, neck011430.50$1,550.68$493.78$310.14
    38724CRemoval of lymph nodes, neck
    38740TRemove armpit lymph nodes011430.50$1,550.68$493.78$310.14
    38745TRemove armpit lymph nodes011430.50$1,550.68$493.78$310.14
    38746CRemove thoracic lymph nodes
    38747CRemove abdominal lymph nodes
    38760TRemove groin lymph nodes011430.50$1,550.68$493.78$310.14
    38765CRemove groin lymph nodes
    38770CRemove pelvis lymph nodes
    38780CRemove abdomen lymph nodes
    38790NInject for lymphatic x-ray
    38792NIdentify sentinel node
    38794NAccess thoracic lymph duct
    38999TBlood/lymph system procedure000811.36$577.57$115.51$115.51
    39000CExploration of chest
    39010CExploration of chest
    39200CRemoval chest lesion
    39220CRemoval chest lesion
    39400TVisualization of chest006925.62$1,302.57$612.21$260.51
    39499CChest procedure
    39501CRepair diaphragm laceration
    39502CRepair paraesophageal hernia
    39503CRepair of diaphragm hernia
    39520CRepair of diaphragm hernia
    39530CRepair of diaphragm hernia
    39531CRepair of diaphragm hernia
    39540CRepair of diaphragm hernia
    39541CRepair of diaphragm hernia
    39545CRevision of diaphragm
    39560CResect diaphragm, simple
    39561CResect diaphragm, complex
    Start Printed Page 44770
    39599CDiaphragm surgery procedure
    40490TBiopsy of lip02512.71$137.78$27.99$27.56
    40500TPartial excision of lip025313.27$674.67$284.00$134.93
    40510TPartial excision of lip025419.11$971.59$272.41$194.32
    40520TPartial excision of lip025313.27$674.67$284.00$134.93
    40525TReconstruct lip with flap025419.11$971.59$272.41$194.32
    40527TReconstruct lip with flap025419.11$971.59$272.41$194.32
    40530TPartial removal of lip025419.11$971.59$272.41$194.32
    40650TRepair lip02526.53$332.00$114.24$66.40
    40652TRepair lip02526.53$332.00$114.24$66.40
    40654TRepair lip02526.53$332.00$114.24$66.40
    40700TRepair cleft lip/nasal025628.82$1,465.27$623.05$293.05
    40701TRepair cleft lip/nasal025628.82$1,465.27$623.05$293.05
    40702TRepair cleft lip/nasal025628.82$1,465.27$623.05$293.05
    40720TRepair cleft lip/nasal025628.82$1,465.27$623.05$293.05
    40761TRepair cleft lip/nasal025628.82$1,465.27$623.05$293.05
    40799TLip surgery procedure025313.27$674.67$284.00$134.93
    40800TDrainage of mouth lesion02512.71$137.78$27.99$27.56
    40801TDrainage of mouth lesion02526.53$332.00$114.24$66.40
    40804XRemoval, foreign body, mouth03400.91$46.27$11.57$9.25
    40805TRemoval, foreign body, mouth02526.53$332.00$114.24$66.40
    40806TIncision of lip fold02512.71$137.78$27.99$27.56
    40808TBiopsy of mouth lesion02512.71$137.78$27.99$27.56
    40810TExcision of mouth lesion025313.27$674.67$284.00$134.93
    40812TExcise/repair mouth lesion02526.53$332.00$114.24$66.40
    40814TExcise/repair mouth lesion025313.27$674.67$284.00$134.93
    40816TExcision of mouth lesion025419.11$971.59$272.41$194.32
    40818TExcise oral mucosa for graft02512.71$137.78$27.99$27.56
    40819TExcise lip or cheek fold02526.53$332.00$114.24$66.40
    40820TTreatment of mouth lesion025313.27$674.67$284.00$134.93
    40830TRepair mouth laceration02512.71$137.78$27.99$27.56
    40831TRepair mouth laceration02526.53$332.00$114.24$66.40
    40840TReconstruction of mouth025419.11$971.59$272.41$194.32
    40842TReconstruction of mouth025419.11$971.59$272.41$194.32
    40843TReconstruction of mouth025419.11$971.59$272.41$194.32
    40844TReconstruction of mouth025628.82$1,465.27$623.05$293.05
    40845TReconstruction of mouth025628.82$1,465.27$623.05$293.05
    40899TMouth surgery procedure02526.53$332.00$114.24$66.40
    41000TDrainage of mouth lesion025313.27$674.67$284.00$134.93
    41005TDrainage of mouth lesion02512.71$137.78$27.99$27.56
    41006TDrainage of mouth lesion025419.11$971.59$272.41$194.32
    41007TDrainage of mouth lesion025313.27$674.67$284.00$134.93
    41008TDrainage of mouth lesion025313.27$674.67$284.00$134.93
    41009TDrainage of mouth lesion02512.71$137.78$27.99$27.56
    41010TIncision of tongue fold025313.27$674.67$284.00$134.93
    41015TDrainage of mouth lesion02512.71$137.78$27.99$27.56
    41016TDrainage of mouth lesion02526.53$332.00$114.24$66.40
    41017TDrainage of mouth lesion02526.53$332.00$114.24$66.40
    41018TDrainage of mouth lesion02526.53$332.00$114.24$66.40
    41100TBiopsy of tongue02526.53$332.00$114.24$66.40
    41105TBiopsy of tongue025313.27$674.67$284.00$134.93
    41108TBiopsy of floor of mouth02526.53$332.00$114.24$66.40
    41110TExcision of tongue lesion025313.27$674.67$284.00$134.93
    41112TExcision of tongue lesion025313.27$674.67$284.00$134.93
    41113TExcision of tongue lesion025313.27$674.67$284.00$134.93
    41114TExcision of tongue lesion025419.11$971.59$272.41$194.32
    41115TExcision of tongue fold02526.53$332.00$114.24$66.40
    41116TExcision of mouth lesion025313.27$674.67$284.00$134.93
    41120TPartial removal of tongue025628.82$1,465.27$623.05$293.05
    41130CPartial removal of tongue
    41135CTongue and neck surgery
    41140CRemoval of tongue
    41145CTongue removal, neck surgery
    41150CTongue, mouth, jaw surgery
    41153CTongue, mouth, neck surgery
    41155CTongue, jaw, & neck surgery
    41250TRepair tongue laceration02512.71$137.78$27.99$27.56
    41251TRepair tongue laceration02526.53$332.00$114.24$66.40
    41252TRepair tongue laceration02526.53$332.00$114.24$66.40
    41500TFixation of tongue025419.11$971.59$272.41$194.32
    41510TTongue to lip surgery025313.27$674.67$284.00$134.93
    41520TReconstruction, tongue fold02526.53$332.00$114.24$66.40
    41599TTongue and mouth surgery02512.71$137.78$27.99$27.56
    41800TDrainage of gum lesion02512.71$137.78$27.99$27.56
    41805TRemoval foreign body, gum025419.11$971.59$272.41$194.32
    Start Printed Page 44771
    41806TRemoval foreign body,jawbone025313.27$674.67$284.00$134.93
    41820TExcision, gum, each quadrant02526.53$332.00$114.24$66.40
    41821TExcision of gum flap02526.53$332.00$114.24$66.40
    41822TExcision of gum lesion025313.27$674.67$284.00$134.93
    41823TExcision of gum lesion025419.11$971.59$272.41$194.32
    41825TExcision of gum lesion025313.27$674.67$284.00$134.93
    41826TExcision of gum lesion025313.27$674.67$284.00$134.93
    41827TExcision of gum lesion025419.11$971.59$272.41$194.32
    41828TExcision of gum lesion025313.27$674.67$284.00$134.93
    41830TRemoval of gum tissue025313.27$674.67$284.00$134.93
    41850TTreatment of gum lesion025313.27$674.67$284.00$134.93
    41870TGum graft025419.11$971.59$272.41$194.32
    41872TRepair gum025313.27$674.67$284.00$134.93
    41874TRepair tooth socket025419.11$971.59$272.41$194.32
    41899TDental surgery procedure025313.27$674.67$284.00$134.93
    42000TDrainage mouth roof lesion02512.71$137.78$27.99$27.56
    42100TBiopsy roof of mouth02526.53$332.00$114.24$66.40
    42104TExcision lesion, mouth roof025313.27$674.67$284.00$134.93
    42106TExcision lesion, mouth roof025313.27$674.67$284.00$134.93
    42107TExcision lesion, mouth roof025419.11$971.59$272.41$194.32
    42120TRemove palate/lesion025628.82$1,465.27$623.05$293.05
    42140TExcision of uvula02526.53$332.00$114.24$66.40
    42145TRepair palate, pharynx/uvula025419.11$971.59$272.41$194.32
    42160TTreatment mouth roof lesion025313.27$674.67$284.00$134.93
    42180TRepair palate02512.71$137.78$27.99$27.56
    42182TRepair palate025628.82$1,465.27$623.05$293.05
    42200TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42205TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42210TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42215TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42220TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42225TReconstruct cleft palate025628.82$1,465.27$623.05$293.05
    42226TLengthening of palate025628.82$1,465.27$623.05$293.05
    42227TLengthening of palate025628.82$1,465.27$623.05$293.05
    42235TRepair palate025313.27$674.67$284.00$134.93
    42260TRepair nose to lip fistula025419.11$971.59$272.41$194.32
    42280TPreparation, palate mold02512.71$137.78$27.99$27.56
    42281TInsertion, palate prosthesis025313.27$674.67$284.00$134.93
    42299TPalate/uvula surgery02512.71$137.78$27.99$27.56
    42300TDrainage of salivary gland025313.27$674.67$284.00$134.93
    42305TDrainage of salivary gland025313.27$674.67$284.00$134.93
    42310TDrainage of salivary gland02512.71$137.78$27.99$27.56
    42320TDrainage of salivary gland02512.71$137.78$27.99$27.56
    42325TCreate salivary cyst drain02512.71$137.78$27.99$27.56
    42326TCreate salivary cyst drain02526.53$332.00$114.24$66.40
    42330TRemoval of salivary stone02526.53$332.00$114.24$66.40
    42335TRemoval of salivary stone025313.27$674.67$284.00$134.93
    42340TRemoval of salivary stone025313.27$674.67$284.00$134.93
    42400TBiopsy of salivary gland00043.00$152.53$32.57$30.51
    42405TBiopsy of salivary gland025313.27$674.67$284.00$134.93
    42408TExcision of salivary cyst025313.27$674.67$284.00$134.93
    42409TDrainage of salivary cyst025313.27$674.67$284.00$134.93
    42410TExcise parotid gland/lesion025628.82$1,465.27$623.05$293.05
    42415TExcise parotid gland/lesion025628.82$1,465.27$623.05$293.05
    42420TExcise parotid gland/lesion025628.82$1,465.27$623.05$293.05
    42425TExcise parotid gland/lesion025628.82$1,465.27$623.05$293.05
    42426CExcise parotid gland/lesion
    42440TExcise submaxillary gland025628.82$1,465.27$623.05$293.05
    42450TExcise sublingual gland025419.11$971.59$272.41$194.32
    42500TRepair salivary duct025419.11$971.59$272.41$194.32
    42505TRepair salivary duct025628.82$1,465.27$623.05$293.05
    42507TParotid duct diversion025628.82$1,465.27$623.05$293.05
    42508TParotid duct diversion025628.82$1,465.27$623.05$293.05
    42509TParotid duct diversion025628.82$1,465.27$623.05$293.05
    42510TParotid duct diversion025628.82$1,465.27$623.05$293.05
    42550NInjection for salivary x-ray
    42600TClosure of salivary fistula025313.27$674.67$284.00$134.93
    42650TDilation of salivary duct02526.53$332.00$114.24$66.40
    42660TDilation of salivary duct02526.53$332.00$114.24$66.40
    42665TLigation of salivary duct025419.11$971.59$272.41$194.32
    42699TSalivary surgery procedure025313.27$674.67$284.00$134.93
    42700TDrainage of tonsil abscess02512.71$137.78$27.99$27.56
    42720TDrainage of throat abscess025313.27$674.67$284.00$134.93
    42725TDrainage of throat abscess025628.82$1,465.27$623.05$293.05
    42800TBiopsy of throat02526.53$332.00$114.24$66.40
    Start Printed Page 44772
    42802TBiopsy of throat025313.27$674.67$284.00$134.93
    42804TBiopsy of upper nose/throat025313.27$674.67$284.00$134.93
    42806TBiopsy of upper nose/throat025419.11$971.59$272.41$194.32
    42808TExcise pharynx lesion025313.27$674.67$284.00$134.93
    42809XRemove pharynx foreign body03400.91$46.27$11.57$9.25
    42810TExcision of neck cyst025419.11$971.59$272.41$194.32
    42815TExcision of neck cyst025628.82$1,465.27$623.05$293.05
    42820TRemove tonsils and adenoids025818.86$958.88$462.81$191.78
    42821TRemove tonsils and adenoids025818.86$958.88$462.81$191.78
    42825TRemoval of tonsils025818.86$958.88$462.81$191.78
    42826TRemoval of tonsils025818.86$958.88$462.81$191.78
    42830TRemoval of adenoids025818.86$958.88$462.81$191.78
    42831TRemoval of adenoids025818.86$958.88$462.81$191.78
    42835TRemoval of adenoids025818.86$958.88$462.81$191.78
    42836TRemoval of adenoids025818.86$958.88$462.81$191.78
    42842CExtensive surgery of throat
    42844TExtensive surgery of throat025628.82$1,465.27$623.05$293.05
    42845CExtensive surgery of throat
    42860TExcision of tonsil tags025818.86$958.88$462.81$191.78
    42870TExcision of lingual tonsil025818.86$958.88$462.81$191.78
    42890TPartial removal of pharynx025628.82$1,465.27$623.05$293.05
    42892TRevision of pharyngeal walls025628.82$1,465.27$623.05$293.05
    42894CRevision of pharyngeal walls
    42900TRepair throat wound02526.53$332.00$114.24$66.40
    42950TReconstruction of throat025419.11$971.59$272.41$194.32
    42953CRepair throat, esophagus
    42955TSurgical opening of throat025419.11$971.59$272.41$194.32
    42960TControl throat bleeding02502.27$115.41$38.54$23.08
    42961CControl throat bleeding
    42962TControl throat bleeding025628.82$1,465.27$623.05$293.05
    42970TControl nose/throat bleeding02502.27$115.41$38.54$23.08
    42971CControl nose/throat bleeding
    42972TControl nose/throat bleeding025313.27$674.67$284.00$134.93
    42999TThroat surgery procedure02526.53$332.00$114.24$66.40
    43020TIncision of esophagus02526.53$332.00$114.24$66.40
    43030CThroat muscle surgery
    43045CIncision of esophagus
    43100CExcision of esophagus lesion
    43101CExcision of esophagus lesion
    43107CRemoval of esophagus
    43108CRemoval of esophagus
    43112CRemoval of esophagus
    43113CRemoval of esophagus
    43116CPartial removal of esophagus
    43117CPartial removal of esophagus
    43118CPartial removal of esophagus
    43121CPartial removal of esophagus
    43122CParital removal of esophagus
    43123CPartial removal of esophagus
    43124CRemoval of esophagus
    43130TRemoval of esophagus pouch025419.11$971.59$272.41$194.32
    43135CRemoval of esophagus pouch
    43200TEsophagus endoscopy01417.46$379.28$184.67$75.86
    43202TEsophagus endoscopy, biopsy01417.46$379.28$184.67$75.86
    43204TEsophagus endoscopy & inject01417.46$379.28$184.67$75.86
    43205TEsophagus endoscopy/ligation01417.46$379.28$184.67$75.86
    43215TEsophagus endoscopy01417.46$379.28$184.67$75.86
    43216TEsophagus endoscopy/lesion01417.46$379.28$184.67$75.86
    43217TEsophagus endoscopy01417.46$379.28$184.67$75.86
    43219TEsophagus endoscopy01417.46$379.28$184.67$75.86
    43220TEsoph endoscopy, dilation01417.46$379.28$184.67$75.86
    43226TEsoph endoscopy, dilation01417.46$379.28$184.67$75.86
    43227TEsoph endoscopy, repair01417.46$379.28$184.67$75.86
    43228TEsoph endoscopy, ablation01417.46$379.28$184.67$75.86
    43231TEsoph endoscopy w/us exam01417.46$379.28$184.67$75.86
    43232TEsoph endoscopy w/us fn bx01417.46$379.28$184.67$75.86
    43234TUpper GI endoscopy, exam01417.46$379.28$184.67$75.86
    43235TUppr gi endoscopy, diagnosis01417.46$379.28$184.67$75.86
    43239TUpper GI endoscopy, biopsy01417.46$379.28$184.67$75.86
    43240TEsoph endoscope w/drain cyst01417.46$379.28$184.67$75.86
    43241TUpper GI endoscopy with tube01417.46$379.28$184.67$75.86
    43242TUppr gi endoscopy w/us fn bx01417.46$379.28$184.67$75.86
    43243TUpper gi endoscopy & inject01417.46$379.28$184.67$75.86
    43244TUpper GI endoscopy/ligation01417.46$379.28$184.67$75.86
    43245TOperative upper GI endoscopy01417.46$379.28$184.67$75.86
    Start Printed Page 44773
    43246TPlace gastrostomy tube01417.46$379.28$184.67$75.86
    43247TOperative upper GI endoscopy01417.46$379.28$184.67$75.86
    43248TUppr gi endoscopy/guide wire01417.46$379.28$184.67$75.86
    43249TEsoph endoscopy, dilation01417.46$379.28$184.67$75.86
    43250TUpper GI endoscopy/tumor01417.46$379.28$184.67$75.86
    43251TOperative upper GI endoscopy01417.46$379.28$184.67$75.86
    43255TOperative upper GI endoscopy01417.46$379.28$184.67$75.86
    43256TUppr gi endoscopy w stent01417.46$379.28$184.67$75.86
    43258TOperative upper GI endoscopy01417.46$379.28$184.67$75.86
    43259TEndoscopic ultrasound exam01417.46$379.28$184.67$75.86
    43260TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43261TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43262TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43263TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43264TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43265TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43267TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43268TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43269TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43271TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43272TEndo cholangiopancreatograph015116.22$824.66$245.46$164.93
    43280TLaparoscopy, fundoplasty013260.31$3,066.28$1,239.22$613.26
    43289TLaparoscope proc, esoph013027.92$1,419.51$659.53$283.90
    43300CRepair of esophagus
    43305CRepair esophagus and fistula
    43310CRepair of esophagus
    43312CRepair esophagus and fistula
    43320CFuse esophagus & stomach
    43324CRevise esophagus & stomach
    43325CRevise esophagus & stomach
    43326CRevise esophagus & stomach
    43330CRepair of esophagus
    43331CRepair of esophagus
    43340CFuse esophagus & intestine
    43341CFuse esophagus & intestine
    43350CSurgical opening, esophagus
    43351CSurgical opening, esophagus
    43352CSurgical opening, esophagus
    43360CGastrointestinal repair
    43361CGastrointestinal repair
    43400CLigate esophagus veins
    43401CEsophagus surgery for veins
    43405CLigate/staple esophagus
    43410CRepair esophagus wound
    43415CRepair esophagus wound
    43420CRepair esophagus opening
    43425CRepair esophagus opening
    43450TDilate esophagus01405.73$291.32$107.24$58.26
    43453TDilate esophagus01405.73$291.32$107.24$58.26
    43456TDilate esophagus01405.73$291.32$107.24$58.26
    43458TDilate esophagus01405.73$291.32$107.24$58.26
    43460CPressure treatment esophagus
    43496CFree jejunum flap, microvasc
    43499TEsophagus surgery procedure01405.73$291.32$107.24$58.26
    43500CSurgical opening of stomach
    43501CSurgical repair of stomach
    43502CSurgical repair of stomach
    43510CSurgical opening of stomach
    43520CIncision of pyloric muscle
    43600TBiopsy of stomach01417.46$379.28$184.67$75.86
    43605CBiopsy of stomach
    43610CExcision of stomach lesion
    43611CExcision of stomach lesion
    43620CRemoval of stomach
    43621CRemoval of stomach
    43622CRemoval of stomach
    43631CRemoval of stomach, partial
    43632CRemoval of stomach, partial
    43633CRemoval of stomach, partial
    43634CRemoval of stomach, partial
    43635CRemoval of stomach, partial
    43638CRemoval of stomach, partial
    43639CRemoval of stomach, partial
    43640CVagotomy & pylorus repair
    43641CVagotomy & pylorus repair
    Start Printed Page 44774
    43651TLaparoscopy, vagus nerve013260.31$3,066.28$1,239.22$613.26
    43652TLaparoscopy, vagus nerve013260.31$3,066.28$1,239.22$613.26
    43653TLaparoscopy, gastrostomy013139.80$2,023.51$1,052.23$404.70
    43659TLaparoscope proc, stom013027.92$1,419.51$659.53$283.90
    43750TPlace gastrostomy tube01417.46$379.28$184.67$75.86
    43752ENasal/orogastric w/stent
    43760TChange gastrostomy tube01212.42$123.04$52.53$24.61
    43761TReposition gastrostomy tube01212.42$123.04$52.53$24.61
    43800CReconstruction of pylorus
    43810CFusion of stomach and bowel
    43820CFusion of stomach and bowel
    43825CFusion of stomach and bowel
    43830TPlace gastrostomy tube01417.46$379.28$184.67$75.86
    43831TPlace gastrostomy tube01417.46$379.28$184.67$75.86
    43832CPlace gastrostomy tube
    43840CRepair of stomach lesion
    43842CGastroplasty for obesity
    43843CGastroplasty for obesity
    43846CGastric bypass for obesity
    43847CGastric bypass for obesity
    43848CRevision gastroplasty
    43850CRevise stomach-bowel fusion
    43855CRevise stomach-bowel fusion
    43860CRevise stomach-bowel fusion
    43865CRevise stomach-bowel fusion
    43870TRepair stomach opening00253.71$188.62$70.66$37.72
    43880CRepair stomach-bowel fistula
    43999TStomach surgery procedure01212.42$123.04$52.53$24.61
    44005CFreeing of bowel adhesion
    44010CIncision of small bowel
    44015CInsert needle cath bowel
    44020CExploration of small bowel
    44021CDecompress small bowel
    44025CIncision of large bowel
    44050CReduce bowel obstruction
    44055CCorrect malrotation of bowel
    44100TBiopsy of bowel01417.46$379.28$184.67$75.86
    44110CExcision of bowel lesion(s)
    44111CExcision of bowel lesion(s)
    44120CRemoval of small intestine
    44121CRemoval of small intestine
    44125CRemoval of small intestine
    44130CBowel to bowel fusion
    44132CEnterectomy, cadaver donor
    44133CEnterectomy, live donor
    44135CIntestine transplnt, cadaver
    44136CIntestine transplant, live
    44139CMobilization of colon
    44140CPartial removal of colon
    44141CPartial removal of colon
    44143CPartial removal of colon
    44144CPartial removal of colon
    44145CPartial removal of colon
    44146CPartial removal of colon
    44147CPartial removal of colon
    44150CRemoval of colon
    44151CRemoval of colon/ileostomy
    44152CRemoval of colon/ileostomy
    44153CRemoval of colon/ileostomy
    44155CRemoval of colon/ileostomy
    44156CRemoval of colon/ileostomy
    44160CRemoval of colon
    44200TLaparoscopy, enterolysis013139.80$2,023.51$1,052.23$404.70
    44201TLaparoscopy, jejunostomy013139.80$2,023.51$1,052.23$404.70
    44202CLaparo, resect intestine
    44209TLaparoscope proc, intestine013027.92$1,419.51$659.53$283.90
    44300COpen bowel to skin
    44310CIleostomy/jejunostomy
    44312TRevision of ileostomy002613.51$686.88$277.92$137.38
    44314CRevision of ileostomy
    44316CDevise bowel pouch
    44320CColostomy
    44322CColostomy with biopsies
    44340TRevision of colostomy002613.51$686.88$277.92$137.38
    44345CRevision of colostomy
    Start Printed Page 44775
    44346CRevision of colostomy
    44360TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44361TSmall bowel endoscopy/biopsy01427.61$386.91$162.42$77.38
    44363TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44364TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44365TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44366TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44369TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44370TSmall bowel endoscopy/stent01427.61$386.91$162.42$77.38
    44372TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44373TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44376TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44377TSmall bowel endoscopy/biopsy01427.61$386.91$162.42$77.38
    44378TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44379TS bowel endoscope w/stent01427.61$386.91$162.42$77.38
    44380TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44382TSmall bowel endoscopy01427.61$386.91$162.42$77.38
    44383TIleoscopy w/stent01427.61$386.91$162.42$77.38
    44385TEndoscopy of bowel pouch01437.87$400.13$198.46$80.03
    44386TEndoscopy, bowel pouch/biop01437.87$400.13$198.46$80.03
    44388TColon endoscopy01437.87$400.13$198.46$80.03
    44389TColonoscopy with biopsy01437.87$400.13$198.46$80.03
    44390TColonoscopy for foreign body01437.87$400.13$198.46$80.03
    44391TColonoscopy for bleeding01437.87$400.13$198.46$80.03
    44392TColonoscopy & polypectomy01437.87$400.13$198.46$80.03
    44393TColonoscopy, lesion removal01437.87$400.13$198.46$80.03
    44394TColonoscopy w/snare01437.87$400.13$198.46$80.03
    44397TColonoscopy w stent01437.87$400.13$198.46$80.03
    44500TIntro, gastrointestinal tube01212.42$123.04$52.53$24.61
    44602CSuture, small intestine
    44603CSuture, small intestine
    44604CSuture, large intestine
    44605CRepair of bowel lesion
    44615CIntestinal stricturoplasty
    44620CRepair bowel opening
    44625CRepair bowel opening
    44626CRepair bowel opening
    44640CRepair bowel-skin fistula
    44650CRepair bowel fistula
    44660CRepair bowel-bladder fistula
    44661CRepair bowel-bladder fistula
    44680CSurgical revision, intestine
    44700CSuspend bowel w/prosthesis
    44799TIntestine surgery procedure01427.61$386.91$162.42$77.38
    44800CExcision of bowel pouch
    44820CExcision of mesentery lesion
    44850CRepair of mesentery
    44899CBowel surgery procedure
    44900CDrain app abscess, open
    44901CDrain app abscess, percut
    44950CAppendectomy
    44955CAppendectomy add-on
    44960CAppendectomy
    44970TLaparoscopy, appendectomy013027.92$1,419.51$659.53$283.90
    44979TLaparoscope proc, app013027.92$1,419.51$659.53$283.90
    45000TDrainage of pelvic abscess014914.49$736.70$293.06$147.34
    45005TDrainage of rectal abscess01482.58$131.17$43.59$26.23
    45020TDrainage of rectal abscess014914.49$736.70$293.06$147.34
    45100TBiopsy of rectum014914.49$736.70$293.06$147.34
    45108TRemoval of anorectal lesion015019.58$995.49$437.12$199.10
    45110CRemoval of rectum
    45111CPartial removal of rectum
    45112CRemoval of rectum
    45113CPartial proctectomy
    45114CPartial removal of rectum
    45116CPartial removal of rectum
    45119CRemove rectum w/reservoir
    45120CRemoval of rectum
    45121CRemoval of rectum and colon
    45123CPartial proctectomy
    45126CPelvic exenteration
    45130CExcision of rectal prolapse
    45135CExcision of rectal prolapse
    45150TExcision of rectal stricture015019.58$995.49$437.12$199.10
    45160TExcision of rectal lesion015019.58$995.49$437.12$199.10
    Start Printed Page 44776
    45170TExcision of rectal lesion015019.58$995.49$437.12$199.10
    45190TDestruction, rectal tumor015019.58$995.49$437.12$199.10
    45300TProctosigmoidoscopy dx01462.95$149.98$65.15$30.00
    45303TProctosigmoidoscopy dilate01462.95$149.98$65.15$30.00
    45305TProtosigmoidoscopy w/bx01462.95$149.98$65.15$30.00
    45307TProtosigmoidoscopy fb01462.95$149.98$65.15$30.00
    45308TProtosigmoidoscopy removal01476.15$312.68$146.96$62.54
    45309TProtosigmoidoscopy removal01476.15$312.68$146.96$62.54
    45315TProtosigmoidoscopy removal01476.15$312.68$146.96$62.54
    45317TProtosigmoidoscopy bleed01462.95$149.98$65.15$30.00
    45320TProtosigmoidoscopy ablate01476.15$312.68$146.96$62.54
    45321TProtosigmoidoscopy volvul01476.15$312.68$146.96$62.54
    45327TProctosigmoidoscopy w/stent01476.15$312.68$146.96$62.54
    45330TDiagnostic sigmoidoscopy01462.95$149.98$65.15$30.00
    45331TSigmoidoscopy and biopsy01462.95$149.98$65.15$30.00
    45332TSigmoidoscopy w/fb removal01462.95$149.98$65.15$30.00
    45333TSigmoidoscopy & polypectomy01476.15$312.68$146.96$62.54
    45334TSigmoidoscopy for bleeding01476.15$312.68$146.96$62.54
    45337TSigmoidoscopy & decompress01476.15$312.68$146.96$62.54
    45338TSigmoidoscpy w/tumr remove01476.15$312.68$146.96$62.54
    45339TSigmoidoscopy w/ablate tumr01476.15$312.68$146.96$62.54
    45341TSigmoidoscopy w/ultrasound01476.15$312.68$146.96$62.54
    45342TSigmoidoscopy w/us guide bx01476.15$312.68$146.96$62.54
    45345TSigmodoscopy w/stent01476.15$312.68$146.96$62.54
    45355TSurgical colonoscopy01437.87$400.13$198.46$80.03
    45378TDiagnostic colonoscopy01437.87$400.13$198.46$80.03
    45379TColonoscopy w/fb removal01437.87$400.13$198.46$80.03
    45380TColonoscopy and biopsy01437.87$400.13$198.46$80.03
    45382TColonoscopy/control bleeding01437.87$400.13$198.46$80.03
    45383TLesion removal colonoscopy01437.87$400.13$198.46$80.03
    45384TLesion remove colonoscopy01437.87$400.13$198.46$80.03
    45385TLesion removal colonoscopy01437.87$400.13$198.46$80.03
    45387TColonoscopy w/stent01437.87$400.13$198.46$80.03
    45500TRepair of rectum015019.58$995.49$437.12$199.10
    45505TRepair of rectum015019.58$995.49$437.12$199.10
    45520TTreatment of rectal prolapse00981.34$68.13$20.88$13.63
    45540CCorrect rectal prolapse
    45541CCorrect rectal prolapse
    45550CRepair rectum/remove sigmoid
    45560TRepair of rectocele015019.58$995.49$437.12$199.10
    45562CExploration/repair of rectum
    45563CExploration/repair of rectum
    45800CRepair rect/bladder fistula
    45805CRepair fistula w/colostomy
    45820CRepair rectourethral fistula
    45825CRepair fistula w/colostomy
    45900TReduction of rectal prolapse01482.58$131.17$43.59$26.23
    45905TDilation of anal sphincter014914.49$736.70$293.06$147.34
    45910TDilation of rectal narrowing014914.49$736.70$293.06$147.34
    45915TRemove rectal obstruction01482.58$131.17$43.59$26.23
    45999TRectum surgery procedure01482.58$131.17$43.59$26.23
    46030TRemoval of rectal marker014914.49$736.70$293.06$147.34
    46040TIncision of rectal abscess01555.73$291.32$96.14$58.26
    46045TIncision of rectal abscess015019.58$995.49$437.12$199.10
    46050TIncision of anal abscess01482.58$131.17$43.59$26.23
    46060TIncision of rectal abscess015019.58$995.49$437.12$199.10
    46070TIncision of anal septum01555.73$291.32$96.14$58.26
    46080TIncision of anal sphincter014914.49$736.70$293.06$147.34
    46083TIncise external hemorrhoid01482.58$131.17$43.59$26.23
    46200TRemoval of anal fissure015019.58$995.49$437.12$199.10
    46210TRemoval of anal crypt014914.49$736.70$293.06$147.34
    46211TRemoval of anal crypts015019.58$995.49$437.12$199.10
    46220TRemoval of anal tab014914.49$736.70$293.06$147.34
    46221TLigation of hemorrhoid(s)01555.73$291.32$96.14$58.26
    46230TRemoval of anal tabs014914.49$736.70$293.06$147.34
    46250THemorrhoidectomy015019.58$995.49$437.12$199.10
    46255THemorrhoidectomy015019.58$995.49$437.12$199.10
    46257TRemove hemorrhoids & fissure015019.58$995.49$437.12$199.10
    46258TRemove hemorrhoids & fistula015019.58$995.49$437.12$199.10
    46260THemorrhoidectomy015019.58$995.49$437.12$199.10
    46261TRemove hemorrhoids & fissure015019.58$995.49$437.12$199.10
    46262TRemove hemorrhoids & fistula015019.58$995.49$437.12$199.10
    46270TRemoval of anal fistula015019.58$995.49$437.12$199.10
    46275TRemoval of anal fistula015019.58$995.49$437.12$199.10
    46280TRemoval of anal fistula015019.58$995.49$437.12$199.10
    Start Printed Page 44777
    46285TRemoval of anal fistula015019.58$995.49$437.12$199.10
    46288TRepair anal fistula015019.58$995.49$437.12$199.10
    46320TRemoval of hemorrhoid clot01555.73$291.32$96.14$58.26
    46500TInjection into hemorrhoids01555.73$291.32$96.14$58.26
    46600NDiagnostic anoscopy
    46604TAnoscopy and dilation01441.97$100.16$44.07$20.03
    46606TAnoscopy and biopsy014512.11$615.70$179.39$123.14
    46608TAnoscopy/ remove for body01441.97$100.16$44.07$20.03
    46610TAnoscopy/remove lesion014512.11$615.70$179.39$123.14
    46611TAnoscopy014512.11$615.70$179.39$123.14
    46612TAnoscopy/ remove lesions014512.11$615.70$179.39$123.14
    46614TAnoscopy/control bleeding014512.11$615.70$179.39$123.14
    46615TAnoscopy014512.11$615.70$179.39$123.14
    46700TRepair of anal stricture015019.58$995.49$437.12$199.10
    46705CRepair of anal stricture
    46715CRepair of anovaginal fistula
    46716CRepair of anovaginal fistula
    46730CConstruction of absent anus
    46735CConstruction of absent anus
    46740CConstruction of absent anus
    46742CRepair of imperforated anus
    46744CRepair of cloacal anomaly
    46746CRepair of cloacal anomaly
    46748CRepair of cloacal anomaly
    46750TRepair of anal sphincter015019.58$995.49$437.12$199.10
    46751CRepair of anal sphincter
    46753TReconstruction of anus015019.58$995.49$437.12$199.10
    46754TRemoval of suture from anus014914.49$736.70$293.06$147.34
    46760TRepair of anal sphincter015019.58$995.49$437.12$199.10
    46761TRepair of anal sphincter015019.58$995.49$437.12$199.10
    46762TImplant artificial sphincter015019.58$995.49$437.12$199.10
    46900TDestruction, anal lesion(s)00163.31$168.29$70.68$33.66
    46910TDestruction, anal lesion(s)001710.51$534.35$245.80$106.87
    46916TCryosurgery, anal lesion(s)00131.51$76.77$17.66$15.35
    46917TLaser surgery, anal lesions069517.06$867.36$398.99$173.47
    46922TExcision of anal lesion(s)069517.06$867.36$398.99$173.47
    46924TDestruction, anal lesion(s)069517.06$867.36$398.99$173.47
    46934TDestruction of hemorrhoids01555.73$291.32$96.14$58.26
    46935TDestruction of hemorrhoids01555.73$291.32$96.14$58.26
    46936TDestruction of hemorrhoids014914.49$736.70$293.06$147.34
    46937TCryotherapy of rectal lesion014914.49$736.70$293.06$147.34
    46938TCryotherapy of rectal lesion015019.58$995.49$437.12$199.10
    46940TTreatment of anal fissure014914.49$736.70$293.06$147.34
    46942TTreatment of anal fissure014914.49$736.70$293.06$147.34
    46945TLigation of hemorrhoids01555.73$291.32$96.14$58.26
    46946TLigation of hemorrhoids01555.73$291.32$96.14$58.26
    46999TAnus surgery procedure014914.49$736.70$293.06$147.34
    47000TNeedle biopsy of liver00056.71$341.15$119.75$68.23
    47001CNeedle biopsy, liver add-on
    47010COpen drainage, liver lesion
    47011CPercut drain, liver lesion
    47015CInject/aspirate liver cyst
    47100CWedge biopsy of liver
    47120CPartial removal of liver
    47122CExtensive removal of liver
    47125CPartial removal of liver
    47130CPartial removal of liver
    47133CRemoval of donor liver
    47134CPartial removal, donor liver
    47135CTransplantation of liver
    47136CTransplantation of liver
    47300CSurgery for liver lesion
    47350CRepair liver wound
    47360CRepair liver wound
    47361CRepair liver wound
    47362CRepair liver wound
    47379TLaparoscope procedure, liver013027.92$1,419.51$659.53$283.90
    47399TLiver surgery procedure00056.71$341.15$119.75$68.23
    47400CIncision of liver duct
    47420CIncision of bile duct
    47425CIncision of bile duct
    47460CIncise bile duct sphincter
    47480CIncision of gallbladder
    47490CIncision of gallbladder
    47500NInjection for liver x-rays
    Start Printed Page 44778
    47505NInjection for liver x-rays
    47510TInsert catheter, bile duct015217.44$886.68$207.38$177.34
    47511TInsert bile duct drain015217.44$886.68$207.38$177.34
    47525TChange bile duct catheter01225.69$289.29$114.93$57.86
    47530TRevise/reinsert bile tube01212.42$123.04$52.53$24.61
    47550CBile duct endoscopy add-on
    47552TBiliary endoscopy thru skin015217.44$886.68$207.38$177.34
    47553TBiliary endoscopy thru skin015217.44$886.68$207.38$177.34
    47554TBiliary endoscopy thru skin015217.44$886.68$207.38$177.34
    47555TBiliary endoscopy thru skin015217.44$886.68$207.38$177.34
    47556TBiliary endoscopy thru skin015217.44$886.68$207.38$177.34
    47560TLaparoscopy w/cholangio013027.92$1,419.51$659.53$283.90
    47561TLaparo w/cholangio/biopsy013027.92$1,419.51$659.53$283.90
    47562TLaparoscopic cholecystectomy013139.80$2,023.51$1,052.23$404.70
    47563TLaparo cholecystectomy/graph013139.80$2,023.51$1,052.23$404.70
    47564TLaparo cholecystectomy/explr013139.80$2,023.51$1,052.23$404.70
    47570CLaparo cholecystoenterostomy
    47579TLaparoscope proc, biliary013027.92$1,419.51$659.53$283.90
    47600CRemoval of gallbladder
    47605CRemoval of gallbladder
    47610CRemoval of gallbladder
    47612CRemoval of gallbladder
    47620CRemoval of gallbladder
    47630TRemove bile duct stone015217.44$886.68$207.38$177.34
    47700CExploration of bile ducts
    47701CBile duct revision
    47711CExcision of bile duct tumor
    47712CExcision of bile duct tumor
    47715CExcision of bile duct cyst
    47716CFusion of bile duct cyst
    47720CFuse gallbladder & bowel
    47721CFuse upper gi structures
    47740CFuse gallbladder & bowel
    47741CFuse gallbladder & bowel
    47760CFuse bile ducts and bowel
    47765CFuse liver ducts & bowel
    47780CFuse bile ducts and bowel
    47785CFuse bile ducts and bowel
    47800CReconstruction of bile ducts
    47801CPlacement, bile duct support
    47802CFuse liver duct & intestine
    47900CSuture bile duct injury
    47999TBile tract surgery procedure01212.42$123.04$52.53$24.61
    48000CDrainage of abdomen
    48001CPlacement of drain, pancreas
    48005CResect/debride pancreas
    48020CRemoval of pancreatic stone
    48100CBiopsy of pancreas
    48102TNeedle biopsy, pancreas00056.71$341.15$119.75$68.23
    48120CRemoval of pancreas lesion
    48140CPartial removal of pancreas
    48145CPartial removal of pancreas
    48146CPancreatectomy
    48148CRemoval of pancreatic duct
    48150CPartial removal of pancreas
    48152CPancreatectomy
    48153CPancreatectomy
    48154CPancreatectomy
    48155CRemoval of pancreas
    48160EPancreas removal/transplant
    48180CFuse pancreas and bowel
    48400CInjection, intraop add-on
    48500CSurgery of pancreas cyst
    48510CDrain pancreatic pseudocyst
    48511CDrain pancreatic pseudocyst
    48520CFuse pancreas cyst and bowel
    48540CFuse pancreas cyst and bowel
    48545CPancreatorrhaphy
    48547CDuodenal exclusion
    48550EDonor pancreatectomy
    48554ETranspl allograft pancreas
    48556CRemoval, allograft pancreas
    48999TPancreas surgery procedure00056.71$341.15$119.75$68.23
    49000CExploration of abdomen
    49002CReopening of abdomen
    Start Printed Page 44779
    49010CExploration behind abdomen
    49020CDrain abdominal abscess
    49021CDrain abdominal abscess
    49040CDrain, open, abdom abscess
    49041CDrain, percut, abdom abscess
    49060CDrain, open, retrop abscess
    49061CDrain, percut, retroper absc
    49062CDrain to peritoneal cavity
    49080TPuncture, peritoneal cavity00704.11$208.96$79.60$41.79
    49081TRemoval of abdominal fluid00704.11$208.96$79.60$41.79
    49085TRemove abdomen foreign body015322.44$1,140.89$496.31$228.18
    49180TBiopsy, abdominal mass00056.71$341.15$119.75$68.23
    49200CRemoval of abdominal lesion
    49201CRemoval of abdominal lesion
    49215CExcise sacral spine tumor
    49220CMultiple surgery, abdomen
    49250TExcision of umbilicus015322.44$1,140.89$496.31$228.18
    49255CRemoval of omentum
    49320TDiag laparo separate proc013027.92$1,419.51$659.53$283.90
    49321TLaparoscopy, biopsy013027.92$1,419.51$659.53$283.90
    49322TLaparoscopy, aspiration013027.92$1,419.51$659.53$283.90
    49323TLaparo drain lymphocele013027.92$1,419.51$659.53$283.90
    49329TLaparo proc, abdm/per/oment013027.92$1,419.51$659.53$283.90
    49400NAir injection into abdomen
    49420TInsert abdominal drain015322.44$1,140.89$496.31$228.18
    49421TInsert abdominal drain015322.44$1,140.89$496.31$228.18
    49422TRemove perm cannula/catheter010516.56$841.94$372.32$168.39
    49423TExchange drainage catheter015322.44$1,140.89$496.31$228.18
    49424NAssess cyst, contrast inject
    49425CInsert abdomen-venous drain
    49426TRevise abdomen-venous shunt015322.44$1,140.89$496.31$228.18
    49427NInjection, abdominal shunt
    49428CLigation of shunt
    49429TRemoval of shunt010516.56$841.94$372.32$168.39
    49495TRepair inguinal hernia, init015424.09$1,224.78$556.98$244.96
    49496TRepair inguinal hernia, init015424.09$1,224.78$556.98$244.96
    49500TRepair inguinal hernia015424.09$1,224.78$556.98$244.96
    49501TRepair inguinal hernia, init015424.09$1,224.78$556.98$244.96
    49505TRepair inguinal hernia015424.09$1,224.78$556.98$244.96
    49507TRepair inguinal hernia015424.09$1,224.78$556.98$244.96
    49520TRerepair inguinal hernia015424.09$1,224.78$556.98$244.96
    49521TRepair inguinal hernia, rec015424.09$1,224.78$556.98$244.96
    49525TRepair inguinal hernia015424.09$1,224.78$556.98$244.96
    49540TRepair lumbar hernia015424.09$1,224.78$556.98$244.96
    49550TRepair femoral hernia015424.09$1,224.78$556.98$244.96
    49553TRepair femoral hernia, init015424.09$1,224.78$556.98$244.96
    49555TRepair femoral hernia015424.09$1,224.78$556.98$244.96
    49557TRepair femoral hernia, recur015424.09$1,224.78$556.98$244.96
    49560TRepair abdominal hernia015424.09$1,224.78$556.98$244.96
    49561TRepair incisional hernia015424.09$1,224.78$556.98$244.96
    49565TRerepair abdominal hernia015424.09$1,224.78$556.98$244.96
    49566TRepair incisional hernia015424.09$1,224.78$556.98$244.96
    49568THernia repair w/mesh015424.09$1,224.78$556.98$244.96
    49570TRepair epigastric hernia015424.09$1,224.78$556.98$244.96
    49572TRepair epigastric hernia015424.09$1,224.78$556.98$244.96
    49580TRepair umbilical hernia015424.09$1,224.78$556.98$244.96
    49582TRepair umbilical hernia015424.09$1,224.78$556.98$244.96
    49585TRepair umbilical hernia015424.09$1,224.78$556.98$244.96
    49587TRepair umbilical hernia015424.09$1,224.78$556.98$244.96
    49590TRepair abdominal hernia015424.09$1,224.78$556.98$244.96
    49600TRepair umbilical lesion015424.09$1,224.78$556.98$244.96
    49605CRepair umbilical lesion
    49606CRepair umbilical lesion
    49610CRepair umbilical lesion
    49611CRepair umbilical lesion
    49650TLaparo hernia repair initial013139.80$2,023.51$1,052.23$404.70
    49651TLaparo hernia repair recur013139.80$2,023.51$1,052.23$404.70
    49659TLaparo proc, hernia repair013139.80$2,023.51$1,052.23$404.70
    49900CRepair of abdominal wall
    49905COmental flap
    49906CFree omental flap, microvasc
    49999TAbdomen surgery procedure01212.42$123.04$52.53$24.61
    50010CExploration of kidney
    50020CRenal abscess, open drain
    50021CRenal abscess, percut drain
    Start Printed Page 44780
    50040CDrainage of kidney
    50045CExploration of kidney
    50060CRemoval of kidney stone
    50065CIncision of kidney
    50070CIncision of kidney
    50075CRemoval of kidney stone
    50080TRemoval of kidney stone016330.27$1,538.99$792.58$307.80
    50081TRemoval of kidney stone016330.27$1,538.99$792.58$307.80
    50100CRevise kidney blood vessels
    50120CExploration of kidney
    50125CExplore and drain kidney
    50130CRemoval of kidney stone
    50135CExploration of kidney
    50200TBiopsy of kidney00056.71$341.15$119.75$68.23
    50205CBiopsy of kidney
    50220CRemoval of kidney
    50225CRemoval of kidney
    50230CRemoval of kidney
    50234CRemoval of kidney & ureter
    50236CRemoval of kidney & ureter
    50240CPartial removal of kidney
    50280CRemoval of kidney lesion
    50290CRemoval of kidney lesion
    50300CRemoval of donor kidney
    50320CRemoval of donor kidney
    50340CRemoval of kidney
    50360CTransplantation of kidney
    50365CTransplantation of kidney
    50370CRemove transplanted kidney
    50380CReimplantation of kidney
    50390TDrainage of kidney lesion00056.71$341.15$119.75$68.23
    50392TInsert kidney drain016116.45$836.35$249.36$167.27
    50393TInsert ureteral tube01605.98$304.04$110.11$60.81
    50394NInjection for kidney x-ray
    50395TCreate passage to kidney01605.98$304.04$110.11$60.81
    50396TMeasure kidney pressure01640.98$49.83$14.95$9.97
    50398TChange kidney tube01225.69$289.29$114.93$57.86
    50400CRevision of kidney/ureter
    50405CRevision of kidney/ureter
    50500CRepair of kidney wound
    50520CClose kidney-skin fistula
    50525CRepair renal-abdomen fistula
    50526CRepair renal-abdomen fistula
    50540CRevision of horseshoe kidney
    50541TLaparo ablate renal cyst013027.92$1,419.51$659.53$283.90
    50544TLaparoscopy, pyeloplasty013027.92$1,419.51$659.53$283.90
    50545CLaparo radical nephrectomy
    50546CLaparoscopic nephrectomy
    50547CLaparo removal donor kidney
    50548CLaparo remove k/ureter
    50549TLaparoscope proc, renal013027.92$1,419.51$659.53$283.90
    50551TKidney endoscopy016116.45$836.35$249.36$167.27
    50553TKidney endoscopy016116.45$836.35$249.36$167.27
    50555TKidney endoscopy & biopsy016116.45$836.35$249.36$167.27
    50557TKidney endoscopy & treatment016116.45$836.35$249.36$167.27
    50559TRenal endoscopy/radiotracer016116.45$836.35$249.36$167.27
    50561TKidney endoscopy & treatment016116.45$836.35$249.36$167.27
    50570CKidney endoscopy
    50572CKidney endoscopy
    50574CKidney endoscopy & biopsy
    50575CKidney endoscopy
    50576CKidney endoscopy & treatment
    50578CRenal endoscopy/radiotracer
    50580CKidney endoscopy & treatment
    50590TFragmenting of kidney stone016942.65$2,168.41$1,192.63$433.68
    50600CExploration of ureter
    50605CInsert ureteral support
    50610CRemoval of ureter stone
    50620CRemoval of ureter stone
    50630CRemoval of ureter stone
    50650CRemoval of ureter
    50660CRemoval of ureter
    50684NInjection for ureter x-ray
    50686TMeasure ureter pressure01640.98$49.83$14.95$9.97
    50688TChange of ureter tube01212.42$123.04$52.53$24.61
    Start Printed Page 44781
    50690NInjection for ureter x-ray
    50700CRevision of ureter
    50715CRelease of ureter
    50722CRelease of ureter
    50725CRelease/revise ureter
    50727CRevise ureter
    50728CRevise ureter
    50740CFusion of ureter & kidney
    50750CFusion of ureter & kidney
    50760CFusion of ureters
    50770CSplicing of ureters
    50780CReimplant ureter in bladder
    50782CReimplant ureter in bladder
    50783CReimplant ureter in bladder
    50785CReimplant ureter in bladder
    50800CImplant ureter in bowel
    50810CFusion of ureter & bowel
    50815CUrine shunt to bowel
    50820CConstruct bowel bladder
    50825CConstruct bowel bladder
    50830CRevise urine flow
    50840CReplace ureter by bowel
    50845CAppendico-vesicostomy
    50860CTransplant ureter to skin
    50900CRepair of ureter
    50920CClosure ureter/skin fistula
    50930CClosure ureter/bowel fistula
    50940CRelease of ureter
    50945TLaparoscopy ureterolithotomy013139.80$2,023.51$1,052.23$404.70
    50947TLaparo new ureter/bladder013139.80$2,023.51$1,052.23$404.70
    50948TLaparo new ureter/bladder013139.80$2,023.51$1,052.23$404.70
    50949TLaparoscope proc, ureter013027.92$1,419.51$659.53$283.90
    50951TEndoscopy of ureter016219.86$1,009.72$427.49$201.94
    50953TEndoscopy of ureter016219.86$1,009.72$427.49$201.94
    50955TUreter endoscopy & biopsy016219.86$1,009.72$427.49$201.94
    50957TUreter endoscopy & treatment016219.86$1,009.72$427.49$201.94
    50959TUreter endoscopy & tracer016219.86$1,009.72$427.49$201.94
    50961TUreter endoscopy & treatment016219.86$1,009.72$427.49$201.94
    50970TUreter endoscopy016219.86$1,009.72$427.49$201.94
    50972TUreter endoscopy & catheter016219.86$1,009.72$427.49$201.94
    50974TUreter endoscopy & biopsy016219.86$1,009.72$427.49$201.94
    50976TUreter endoscopy & treatment016219.86$1,009.72$427.49$201.94
    50978TUreter endoscopy & tracer016219.86$1,009.72$427.49$201.94
    50980TUreter endoscopy & treatment016219.86$1,009.72$427.49$201.94
    51000TDrainage of bladder01655.36$272.51$91.76$54.50
    51005TDrainage of bladder01562.62$133.21$39.96$26.64
    51010TDrainage of bladder01655.36$272.51$91.76$54.50
    51020TIncise & treat bladder016219.86$1,009.72$427.49$201.94
    51030TIncise & treat bladder016219.86$1,009.72$427.49$201.94
    51040TIncise & drain bladder016219.86$1,009.72$427.49$201.94
    51045TIncise bladder/drain ureter016219.86$1,009.72$427.49$201.94
    51050TRemoval of bladder stone016219.86$1,009.72$427.49$201.94
    51060CRemoval of ureter stone
    51065TRemoval of ureter stone016219.86$1,009.72$427.49$201.94
    51080TDrainage of bladder abscess00077.28$370.13$74.03$74.03
    51500TRemoval of bladder cyst015424.09$1,224.78$556.98$244.96
    51520TRemoval of bladder lesion016219.86$1,009.72$427.49$201.94
    51525CRemoval of bladder lesion
    51530CRemoval of bladder lesion
    51535CRepair of ureter lesion
    51550CPartial removal of bladder
    51555CPartial removal of bladder
    51565CRevise bladder & ureter(s)
    51570CRemoval of bladder
    51575CRemoval of bladder & nodes
    51580CRemove bladder/revise tract
    51585CRemoval of bladder & nodes
    51590CRemove bladder/revise tract
    51595CRemove bladder/revise tract
    51596CRemove bladder/create pouch
    51597CRemoval of pelvic structures
    51600NInjection for bladder x-ray
    51605NPreparation for bladder xray
    51610NInjection for bladder x-ray
    51700TIrrigation of bladder01562.62$133.21$39.96$26.64
    Start Printed Page 44782
    51705TChange of bladder tube01212.42$123.04$52.53$24.61
    51710TChange of bladder tube01212.42$123.04$52.53$24.61
    51715TEndoscopic injection/implant016724.18$1,229.36$555.84$245.87
    51720TTreatment of bladder lesion01562.62$133.21$39.96$26.64
    51725TSimple cystometrogram01655.36$272.51$91.76$54.50
    51726TComplex cystometrogram01655.36$272.51$91.76$54.50
    51736TUrine flow measurement01640.98$49.83$14.95$9.97
    51741TElectro-uroflowmetry, first01640.98$49.83$14.95$9.97
    51772TUrethra pressure profile01655.36$272.51$91.76$54.50
    51784TAnal/urinary muscle study01640.98$49.83$14.95$9.97
    51785TAnal/urinary muscle study01562.62$133.21$39.96$26.64
    51792TUrinary reflex study01562.62$133.21$39.96$26.64
    51795TUrine voiding pressure study01655.36$272.51$91.76$54.50
    51797TIntraabdominal pressure test01655.36$272.51$91.76$54.50
    51800CRevision of bladder/urethra
    51820CRevision of urinary tract
    51840CAttach bladder/urethra
    51841CAttach bladder/urethra
    51845CRepair bladder neck
    51860CRepair of bladder wound
    51865CRepair of bladder wound
    51880TRepair of bladder opening016219.86$1,009.72$427.49$201.94
    51900CRepair bladder/vagina lesion
    51920CClose bladder-uterus fistula
    51925CHysterectomy/bladder repair
    51940CCorrection of bladder defect
    51960CRevision of bladder & bowel
    51980CConstruct bladder opening
    51990TLaparo urethral suspension013139.80$2,023.51$1,052.23$404.70
    51992TLaparo sling operation013260.31$3,066.28$1,239.22$613.26
    52000TCystoscopy01605.98$304.04$110.11$60.81
    52005TCystoscopy & ureter catheter016116.45$836.35$249.36$167.27
    52007TCystoscopy and biopsy016116.45$836.35$249.36$167.27
    52010TCystoscopy & duct catheter01605.98$304.04$110.11$60.81
    52204TCystoscopy016116.45$836.35$249.36$167.27
    52214TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52224TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52234TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52235TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52240TCystoscopy and treatment016330.27$1,538.99$792.58$307.80
    52250TCystoscopy and radiotracer016219.86$1,009.72$427.49$201.94
    52260TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52265TCystoscopy and treatment01605.98$304.04$110.11$60.81
    52270TCystoscopy & revise urethra016116.45$836.35$249.36$167.27
    52275TCystoscopy & revise urethra016116.45$836.35$249.36$167.27
    52276TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52277TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52281TCystoscopy and treatment01605.98$304.04$110.11$60.81
    52282TCystoscopy, implant stent016219.86$1,009.72$427.49$201.94
    52283TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52285TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52290TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52300TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52301TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52305TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52310TCystoscopy and treatment01605.98$304.04$110.11$60.81
    52315TCystoscopy and treatment016116.45$836.35$249.36$167.27
    52317TRemove bladder stone016219.86$1,009.72$427.49$201.94
    52318TRemove bladder stone016219.86$1,009.72$427.49$201.94
    52320TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52325TCystoscopy, stone removal016219.86$1,009.72$427.49$201.94
    52327TCystoscopy, inject material016116.45$836.35$249.36$167.27
    52330TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52332TCystoscopy and treatment016219.86$1,009.72$427.49$201.94
    52334TCreate passage to kidney016219.86$1,009.72$427.49$201.94
    52341TCysto w/ureter stricture tx016219.86$1,009.72$427.49$201.94
    52342TCysto w/up stricture tx016219.86$1,009.72$427.49$201.94
    52343TCysto w/renal stricture tx016219.86$1,009.72$427.49$201.94
    52344TCysto/uretero, stone remove016219.86$1,009.72$427.49$201.94
    52345TCysto/uretero w/up stricture016219.86$1,009.72$427.49$201.94
    52346TCystouretero w/renal strict016219.86$1,009.72$427.49$201.94
    52351TCystouretro & or pyeloscope016116.45$836.35$249.36$167.27
    52352TCystouretro w/stone remove016219.86$1,009.72$427.49$201.94
    52353TCystouretero w/lithotripsy016330.27$1,538.99$792.58$307.80
    52354TCystouretero w/biopsy016219.86$1,009.72$427.49$201.94
    Start Printed Page 44783
    52355TCystouretero w/excise tumor016219.86$1,009.72$427.49$201.94
    52400TCystouretero w/congen repr016219.86$1,009.72$427.49$201.94
    52450TIncision of prostate016219.86$1,009.72$427.49$201.94
    52500TRevision of bladder neck016219.86$1,009.72$427.49$201.94
    52510TDilation prostatic urethra016116.45$836.35$249.36$167.27
    52601TProstatectomy (TURP)016330.27$1,538.99$792.58$307.80
    52606TControl postop bleeding016219.86$1,009.72$427.49$201.94
    52612TProstatectomy, first stage016330.27$1,538.99$792.58$307.80
    52614TProstatectomy, second stage016330.27$1,538.99$792.58$307.80
    52620TRemove residual prostate016330.27$1,538.99$792.58$307.80
    52630TRemove prostate regrowth016330.27$1,538.99$792.58$307.80
    52640TRelieve bladder contracture016219.86$1,009.72$427.49$201.94
    52647TLaser surgery of prostate016330.27$1,538.99$792.58$307.80
    52648TLaser surgery of prostate016330.27$1,538.99$792.58$307.80
    52700TDrainage of prostate abscess016219.86$1,009.72$427.49$201.94
    53000TIncision of urethra016613.02$661.96$218.73$132.39
    53010TIncision of urethra016613.02$661.96$218.73$132.39
    53020TIncision of urethra016613.02$661.96$218.73$132.39
    53025TIncision of urethra016613.02$661.96$218.73$132.39
    53040TDrainage of urethra abscess016613.02$661.96$218.73$132.39
    53060TDrainage of urethra abscess016613.02$661.96$218.73$132.39
    53080TDrainage of urinary leakage016613.02$661.96$218.73$132.39
    53085CDrainage of urinary leakage
    53200TBiopsy of urethra016613.02$661.96$218.73$132.39
    53210TRemoval of urethra016831.68$1,610.67$536.11$322.13
    53215TRemoval of urethra016831.68$1,610.67$536.11$322.13
    53220TTreatment of urethra lesion016831.68$1,610.67$536.11$322.13
    53230TRemoval of urethra lesion016831.68$1,610.67$536.11$322.13
    53235TRemoval of urethra lesion016831.68$1,610.67$536.11$322.13
    53240TSurgery for urethra pouch016831.68$1,610.67$536.11$322.13
    53250TRemoval of urethra gland016613.02$661.96$218.73$132.39
    53260TTreatment of urethra lesion016613.02$661.96$218.73$132.39
    53265TTreatment of urethra lesion016613.02$661.96$218.73$132.39
    53270TRemoval of urethra gland016724.18$1,229.36$555.84$245.87
    53275TRepair of urethra defect016613.02$661.96$218.73$132.39
    53400TRevise urethra, stage 1016831.68$1,610.67$536.11$322.13
    53405TRevise urethra, stage 2016831.68$1,610.67$536.11$322.13
    53410TReconstruction of urethra016831.68$1,610.67$536.11$322.13
    53415CReconstruction of urethra
    53420TReconstruct urethra, stage 1016831.68$1,610.67$536.11$322.13
    53425TReconstruct urethra, stage 2016831.68$1,610.67$536.11$322.13
    53430TReconstruction of urethra016831.68$1,610.67$536.11$322.13
    53440TCorrect bladder function018285.94$4,369.36$1,492.28$873.87
    53442TRemove perineal prosthesis016613.02$661.96$218.73$132.39
    53443CReconstruction of urethra
    53445TCorrect urine flow control018285.94$4,369.36$1,492.28$873.87
    53447TRemove artificial sphincter016831.68$1,610.67$536.11$322.13
    53449TCorrect artificial sphincter016831.68$1,610.67$536.11$322.13
    53450TRevision of urethra016831.68$1,610.67$536.11$322.13
    53460TRevision of urethra016831.68$1,610.67$536.11$322.13
    53502TRepair of urethra injury016613.02$661.96$218.73$132.39
    53505TRepair of urethra injury016724.18$1,229.36$555.84$245.87
    53510TRepair of urethra injury016613.02$661.96$218.73$132.39
    53515TRepair of urethra injury016831.68$1,610.67$536.11$322.13
    53520TRepair of urethra defect016831.68$1,610.67$536.11$322.13
    53600TDilate urethra stricture01562.62$133.21$39.96$26.64
    53601TDilate urethra stricture01640.98$49.83$14.95$9.97
    53605TDilate urethra stricture016116.45$836.35$249.36$167.27
    53620TDilate urethra stricture01655.36$272.51$91.76$54.50
    53621TDilate urethra stricture01640.98$49.83$14.95$9.97
    53660TDilation of urethra01640.98$49.83$14.95$9.97
    53661TDilation of urethra01640.98$49.83$14.95$9.97
    53665TDilation of urethra016613.02$661.96$218.73$132.39
    53670NInsert urinary catheter
    53675TInsert urinary catheter01562.62$133.21$39.96$26.64
    53850TProstatic microwave thermotx098252.06$2,646.83$529.37
    53852TProstatic rf thermotx098252.06$2,646.83$529.37
    53899TUrology surgery procedure01655.36$272.51$91.76$54.50
    54000TSlitting of prepuce016613.02$661.96$218.73$132.39
    54001TSlitting of prepuce016613.02$661.96$218.73$132.39
    54015TDrain penis lesion000811.36$577.57$115.51$115.51
    54050TDestruction, penis lesion(s)00131.51$76.77$17.66$15.35
    54055TDestruction, penis lesion(s)001710.51$534.35$245.80$106.87
    54056TCryosurgery, penis lesion(s)00120.72$36.61$9.18$7.32
    54057TLaser surg, penis lesion(s)001710.51$534.35$245.80$106.87
    Start Printed Page 44784
    54060TExcision of penis lesion(s)001710.51$534.35$245.80$106.87
    54065TDestruction, penis lesion(s)069517.06$867.36$398.99$173.47
    54100TBiopsy of penis00208.56$435.21$130.53$87.04
    54105TBiopsy of penis002112.74$647.73$236.51$129.55
    54110TTreatment of penis lesion018124.07$1,223.77$673.07$244.75
    54111TTreat penis lesion, graft018124.07$1,223.77$673.07$244.75
    54112TTreat penis lesion, graft018124.07$1,223.77$673.07$244.75
    54115TTreatment of penis lesion000811.36$577.57$115.51$115.51
    54120TPartial removal of penis018124.07$1,223.77$673.07$244.75
    54125CRemoval of penis
    54130CRemove penis & nodes
    54135CRemove penis & nodes
    54150TCircumcision018016.29$828.22$304.87$165.64
    54152TCircumcision018016.29$828.22$304.87$165.64
    54160TCircumcision018016.29$828.22$304.87$165.64
    54161TCircumcision018016.29$828.22$304.87$165.64
    54200TTreatment of penis lesion01562.62$133.21$39.96$26.64
    54205TTreatment of penis lesion018124.07$1,223.77$673.07$244.75
    54220TTreatment of penis lesion01562.62$133.21$39.96$26.64
    54230NPrepare penis study
    54231TDynamic cavernosometry01655.36$272.51$91.76$54.50
    54235TPenile injection01640.98$49.83$14.95$9.97
    54240TPenis study01640.98$49.83$14.95$9.97
    54250TPenis study01655.36$272.51$91.76$54.50
    54300TRevision of penis018124.07$1,223.77$673.07$244.75
    54304TRevision of penis018124.07$1,223.77$673.07$244.75
    54308TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54312TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54316TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54318TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54322TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54324TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54326TReconstruction of urethra018124.07$1,223.77$673.07$244.75
    54328TRevise penis/urethra018124.07$1,223.77$673.07$244.75
    54332CRevise penis/urethra
    54336CRevise penis/urethra
    54340TSecondary urethral surgery018124.07$1,223.77$673.07$244.75
    54344TSecondary urethral surgery018124.07$1,223.77$673.07$244.75
    54348TSecondary urethral surgery018124.07$1,223.77$673.07$244.75
    54352TReconstruct urethra/penis018124.07$1,223.77$673.07$244.75
    54360TPenis plastic surgery018124.07$1,223.77$673.07$244.75
    54380TRepair penis018124.07$1,223.77$673.07$244.75
    54385TRepair penis018124.07$1,223.77$673.07$244.75
    54390CRepair penis and bladder
    54400TInsert semi-rigid prosthesis018285.94$4,369.36$1,492.28$873.87
    54401TInsert self-contd prosthesis018285.94$4,369.36$1,492.28$873.87
    54402TRemove penis prosthesis018557.17$2,906.64$906.36$581.33
    54405TInsert multi-comp prosthesis018285.94$4,369.36$1,492.28$873.87
    54407TRemove multi-comp prosthesis018557.17$2,906.64$906.36$581.33
    54409TRevise penis prosthesis018557.17$2,906.64$906.36$581.33
    54420TRevision of penis018124.07$1,223.77$673.07$244.75
    54430CRevision of penis
    54435TRevision of penis018124.07$1,223.77$673.07$244.75
    54440TRepair of penis018124.07$1,223.77$673.07$244.75
    54450TPreputial stretching01562.62$133.21$39.96$26.64
    54500TBiopsy of testis00056.71$341.15$119.75$68.23
    54505TBiopsy of testis018320.37$1,035.65$448.94$207.13
    54510TRemoval of testis lesion018320.37$1,035.65$448.94$207.13
    54512TExcise lesion testis018320.37$1,035.65$448.94$207.13
    54520TRemoval of testis018320.37$1,035.65$448.94$207.13
    54522TOrchiectomy, partial018320.37$1,035.65$448.94$207.13
    54530TRemoval of testis015424.09$1,224.78$556.98$244.96
    54535CExtensive testis surgery
    54550TExploration for testis015424.09$1,224.78$556.98$244.96
    54560CExploration for testis
    54600TReduce testis torsion018320.37$1,035.65$448.94$207.13
    54620TSuspension of testis018320.37$1,035.65$448.94$207.13
    54640TSuspension of testis015424.09$1,224.78$556.98$244.96
    54650COrchiopexy (Fowler-Stephens)
    54660TRevision of testis018320.37$1,035.65$448.94$207.13
    54670TRepair testis injury018320.37$1,035.65$448.94$207.13
    54680TRelocation of testis(es)018320.37$1,035.65$448.94$207.13
    54690TLaparoscopy, orchiectomy013139.80$2,023.51$1,052.23$404.70
    54692TLaparoscopy, orchiopexy013260.31$3,066.28$1,239.22$613.26
    54699TLaparoscope proc, testis013027.92$1,419.51$659.53$283.90
    Start Printed Page 44785
    54700TDrainage of scrotum018320.37$1,035.65$448.94$207.13
    54800TBiopsy of epididymis00043.00$152.53$32.57$30.51
    54820TExploration of epididymis018320.37$1,035.65$448.94$207.13
    54830TRemove epididymis lesion018320.37$1,035.65$448.94$207.13
    54840TRemove epididymis lesion018320.37$1,035.65$448.94$207.13
    54860TRemoval of epididymis018320.37$1,035.65$448.94$207.13
    54861TRemoval of epididymis018320.37$1,035.65$448.94$207.13
    54900TFusion of spermatic ducts018320.37$1,035.65$448.94$207.13
    54901TFusion of spermatic ducts018320.37$1,035.65$448.94$207.13
    55000TDrainage of hydrocele00043.00$152.53$32.57$30.51
    55040TRemoval of hydrocele015424.09$1,224.78$556.98$244.96
    55041TRemoval of hydroceles015424.09$1,224.78$556.98$244.96
    55060TRepair of hydrocele018320.37$1,035.65$448.94$207.13
    55100TDrainage of scrotum abscess00077.28$370.13$74.03$74.03
    55110TExplore scrotum018320.37$1,035.65$448.94$207.13
    55120TRemoval of scrotum lesion018320.37$1,035.65$448.94$207.13
    55150TRemoval of scrotum018320.37$1,035.65$448.94$207.13
    55175TRevision of scrotum018320.37$1,035.65$448.94$207.13
    55180TRevision of scrotum018320.37$1,035.65$448.94$207.13
    55200TIncision of sperm duct018320.37$1,035.65$448.94$207.13
    55250TRemoval of sperm duct(s)018320.37$1,035.65$448.94$207.13
    55300NPrepare, sperm duct x-ray
    55400TRepair of sperm duct018320.37$1,035.65$448.94$207.13
    55450TLigation of sperm duct018320.37$1,035.65$448.94$207.13
    55500TRemoval of hydrocele018320.37$1,035.65$448.94$207.13
    55520TRemoval of sperm cord lesion018320.37$1,035.65$448.94$207.13
    55530TRevise spermatic cord veins018320.37$1,035.65$448.94$207.13
    55535TRevise spermatic cord veins015424.09$1,224.78$556.98$244.96
    55540TRevise hernia & sperm veins015424.09$1,224.78$556.98$244.96
    55550TLaparo ligate spermatic vein013139.80$2,023.51$1,052.23$404.70
    55559TLaparo proc, spermatic cord013027.92$1,419.51$659.53$283.90
    55600CIncise sperm duct pouch
    55605CIncise sperm duct pouch
    55650CRemove sperm duct pouch
    55680TRemove sperm pouch lesion018320.37$1,035.65$448.94$207.13
    55700TBiopsy of prostate01845.23$265.90$122.96$53.18
    55705TBiopsy of prostate01845.23$265.90$122.96$53.18
    55720TDrainage of prostate abscess016219.86$1,009.72$427.49$201.94
    55725TDrainage of prostate abscess016219.86$1,009.72$427.49$201.94
    55801CRemoval of prostate
    55810CExtensive prostate surgery
    55812CExtensive prostate surgery
    55815CExtensive prostate surgery
    55821CRemoval of prostate
    55831CRemoval of prostate
    55840CExtensive prostate surgery
    55842CExtensive prostate surgery
    55845CExtensive prostate surgery
    55859TPercut/needle insert, pros016330.27$1,538.99$792.58$307.80
    55860TSurgical exposure, prostate01655.36$272.51$91.76$54.50
    55862CExtensive prostate surgery
    55865CExtensive prostate surgery
    55870TElectroejaculation01972.58$131.17$49.55$26.23
    55873TCryoablate prostate016330.27$1,538.99$792.58$307.80
    55899TGenital surgery procedure01640.98$49.83$14.95$9.97
    55970ESex transformation, M to F
    55980ESex transformation, F to M
    56405TI & D of vulva/perineum01922.73$138.80$35.33$27.76
    56420TDrainage of gland abscess01922.73$138.80$35.33$27.76
    56440TSurgery for vulva lesion019417.18$873.47$395.94$174.69
    56441TLysis of labial lesion(s)019312.17$618.75$171.13$123.75
    56501TDestruction, vulva lesion(s)001710.51$534.35$245.80$106.87
    56515TDestruction, vulva lesion(s)069517.06$867.36$398.99$173.47
    56605TBiopsy of vulva/perineum00194.56$231.84$78.91$46.37
    56606TBiopsy of vulva/perineum00194.56$231.84$78.91$46.37
    56620TPartial removal of vulva019522.22$1,129.71$483.80$225.94
    56625TComplete removal of vulva019522.22$1,129.71$483.80$225.94
    56630CExtensive vulva surgery
    56631CExtensive vulva surgery
    56632CExtensive vulva surgery
    56633CExtensive vulva surgery
    56634CExtensive vulva surgery
    56637CExtensive vulva surgery
    56640CExtensive vulva surgery
    56700TPartial removal of hymen019417.18$873.47$395.94$174.69
    Start Printed Page 44786
    56720TIncision of hymen019312.17$618.75$171.13$123.75
    56740TRemove vagina gland lesion019417.18$873.47$395.94$174.69
    56800TRepair of vagina019417.18$873.47$395.94$174.69
    56805TRepair clitoris019417.18$873.47$395.94$174.69
    56810TRepair of perineum019417.18$873.47$395.94$174.69
    57000TExploration of vagina019417.18$873.47$395.94$174.69
    57010TDrainage of pelvic abscess019417.18$873.47$395.94$174.69
    57020TDrainage of pelvic fluid019312.17$618.75$171.13$123.75
    57022TI &d vaginal hematoma, ob00077.28$370.13$74.03$74.03
    57023TI &d vag hematoma, trauma00077.28$370.13$74.03$74.03
    57061TDestruction vagina lesion(s)019417.18$873.47$395.94$174.69
    57065TDestruction vagina lesion(s)019417.18$873.47$395.94$174.69
    57100TBiopsy of vagina019312.17$618.75$171.13$123.75
    57105TBiopsy of vagina019417.18$873.47$395.94$174.69
    57106TRemove vagina wall, partial019417.18$873.47$395.94$174.69
    57107TRemove vagina tissue, part019522.22$1,129.71$483.80$225.94
    57109TVaginectomy partial w/nodes020239.56$2,011.31$864.86$402.26
    57110CRemove vagina wall, complete
    57111CRemove vagina tissue, compl
    57112CVaginectomy w/nodes, compl
    57120TClosure of vagina019417.18$873.47$395.94$174.69
    57130TRemove vagina lesion019417.18$873.47$395.94$174.69
    57135TRemove vagina lesion019417.18$873.47$395.94$174.69
    57150TTreat vagina infection01910.27$13.73$3.98$2.75
    57160TInsert pessary/other device01880.83$42.20$12.24$8.44
    57170TFitting of diaphragm/cap01910.27$13.73$3.98$2.75
    57180TTreat vaginal bleeding01922.73$138.80$35.33$27.76
    57200TRepair of vagina019417.18$873.47$395.94$174.69
    57210TRepair vagina/perineum019417.18$873.47$395.94$174.69
    57220TRevision of urethra019522.22$1,129.71$483.80$225.94
    57230TRepair of urethral lesion019417.18$873.47$395.94$174.69
    57240TRepair bladder & vagina019522.22$1,129.71$483.80$225.94
    57250TRepair rectum & vagina019522.22$1,129.71$483.80$225.94
    57260TRepair of vagina019522.22$1,129.71$483.80$225.94
    57265TExtensive repair of vagina019522.22$1,129.71$483.80$225.94
    57268TRepair of bowel bulge019522.22$1,129.71$483.80$225.94
    57270CRepair of bowel pouch
    57280CSuspension of vagina
    57282CRepair of vaginal prolapse
    57284TRepair paravaginal defect019522.22$1,129.71$483.80$225.94
    57287TRevise/remove sling repair020239.56$2,011.31$864.86$402.26
    57288TRepair bladder defect020239.56$2,011.31$864.86$402.26
    57289TRepair bladder & vagina019522.22$1,129.71$483.80$225.94
    57291TConstruction of vagina019522.22$1,129.71$483.80$225.94
    57292CConstruct vagina with graft
    57300TRepair rectum-vagina fistula019522.22$1,129.71$483.80$225.94
    57305CRepair rectum-vagina fistula
    57307CFistula repair & colostomy
    57308CFistula repair, transperine
    57310TRepair urethrovaginal lesion019522.22$1,129.71$483.80$225.94
    57311CRepair urethrovaginal lesion
    57320TRepair bladder-vagina lesion019522.22$1,129.71$483.80$225.94
    57330TRepair bladder-vagina lesion019522.22$1,129.71$483.80$225.94
    57335CRepair vagina
    57400TDilation of vagina019417.18$873.47$395.94$174.69
    57410TPelvic examination019417.18$873.47$395.94$174.69
    57415TRemove vaginal foreign body019417.18$873.47$395.94$174.69
    57452TExamination of vagina01891.38$70.16$17.54$14.03
    57454TVagina examination & biopsy01922.73$138.80$35.33$27.76
    57460TCervix excision019312.17$618.75$171.13$123.75
    57500TBiopsy of cervix01922.73$138.80$35.33$27.76
    57505TEndocervical curettage01922.73$138.80$35.33$27.76
    57510TCauterization of cervix019312.17$618.75$171.13$123.75
    57511TCryocautery of cervix01891.38$70.16$17.54$14.03
    57513TLaser surgery of cervix019312.17$618.75$171.13$123.75
    57520TConization of cervix019417.18$873.47$395.94$174.69
    57522TConization of cervix019522.22$1,129.71$483.80$225.94
    57530TRemoval of cervix019522.22$1,129.71$483.80$225.94
    57531CRemoval of cervix, radical
    57540CRemoval of residual cervix
    57545CRemove cervix/repair pelvis
    57550TRemoval of residual cervix019522.22$1,129.71$483.80$225.94
    57555TRemove cervix/repair vagina019522.22$1,129.71$483.80$225.94
    57556TRemove cervix, repair bowel019522.22$1,129.71$483.80$225.94
    57700TRevision of cervix019417.18$873.47$395.94$174.69
    Start Printed Page 44787
    57720TRevision of cervix019417.18$873.47$395.94$174.69
    57800TDilation of cervical canal01922.73$138.80$35.33$27.76
    57820TD & c of residual cervix019614.62$743.31$357.98$148.66
    58100TBiopsy of uterus lining01880.83$42.20$12.24$8.44
    58120TDilation and curettage019614.62$743.31$357.98$148.66
    58140CRemoval of uterus lesion
    58145TRemoval of uterus lesion019522.22$1,129.71$483.80$225.94
    58150CTotal hysterectomy
    58152CTotal hysterectomy
    58180CPartial hysterectomy
    58200CExtensive hysterectomy
    58210CExtensive hysterectomy
    58240CRemoval of pelvis contents
    58260CVaginal hysterectomy
    58262CVaginal hysterectomy
    58263CVaginal hysterectomy
    58267CHysterectomy & vagina repair
    58270CHysterectomy & vagina repair
    58275CHysterectomy/revise vagina
    58280CHysterectomy/revise vagina
    58285CExtensive hysterectomy
    58300EInsert intrauterine device
    58301TRemove intrauterine device01891.38$70.16$17.54$14.03
    58321TArtificial insemination01972.58$131.17$49.55$26.23
    58322TArtificial insemination01972.58$131.17$49.55$26.23
    58323TSperm washing01972.58$131.17$49.55$26.23
    58340NCatheter for hysterography
    58345TReopen fallopian tube019417.18$873.47$395.94$174.69
    58350TReopen fallopian tube019417.18$873.47$395.94$174.69
    58353TEndometr ablate, thermal019312.17$618.75$171.13$123.75
    58400CSuspension of uterus
    58410CSuspension of uterus
    58520CRepair of ruptured uterus
    58540CRevision of uterus
    58550TLaparo-asst vag hysterectomy013260.31$3,066.28$1,239.22$613.26
    58551TLaparoscopy, remove myoma013139.80$2,023.51$1,052.23$404.70
    58555THysteroscopy, dx, sep proc019417.18$873.47$395.94$174.69
    58558THysteroscopy, biopsy019018.27$928.88$443.89$185.78
    58559THysteroscopy, lysis019018.27$928.88$443.89$185.78
    58560THysteroscopy, resect septum019018.27$928.88$443.89$185.78
    58561THysteroscopy, remove myoma019018.27$928.88$443.89$185.78
    58562THysteroscopy, remove fb019018.27$928.88$443.89$185.78
    58563THysteroscopy, ablation019018.27$928.88$443.89$185.78
    58578TLaparo proc, uterus019018.27$928.88$443.89$185.78
    58579THysteroscope procedure019018.27$928.88$443.89$185.78
    58600TDivision of fallopian tube019417.18$873.47$395.94$174.69
    58605CDivision of fallopian tube
    58611CLigate oviduct(s) add-on
    58615TOcclude fallopian tube(s)019417.18$873.47$395.94$174.69
    58660TLaparoscopy, lysis013139.80$2,023.51$1,052.23$404.70
    58661TLaparoscopy, remove adnexa013139.80$2,023.51$1,052.23$404.70
    58662TLaparoscopy, excise lesions013139.80$2,023.51$1,052.23$404.70
    58670TLaparoscopy, tubal cautery013139.80$2,023.51$1,052.23$404.70
    58671TLaparoscopy, tubal block013139.80$2,023.51$1,052.23$404.70
    58672TLaparoscopy, fimbrioplasty013139.80$2,023.51$1,052.23$404.70
    58673TLaparoscopy, salpingostomy013139.80$2,023.51$1,052.23$404.70
    58679TLaparo proc, oviduct-ovary013027.92$1,419.51$659.53$283.90
    58700CRemoval of fallopian tube
    58720CRemoval of ovary/tube(s)
    58740CRevise fallopian tube(s)
    58750CRepair oviduct
    58752CRevise ovarian tube(s)
    58760CRemove tubal obstruction
    58770CCreate new tubal opening
    58800TDrainage of ovarian cyst(s)019522.22$1,129.71$483.80$225.94
    58805CDrainage of ovarian cyst(s)
    58820TDrain ovary abscess, open019522.22$1,129.71$483.80$225.94
    58822CDrain ovary abscess, percut
    58823CDrain pelvic abscess, percut
    58825CTransposition, ovary(s)
    58900TBiopsy of ovary(s)019522.22$1,129.71$483.80$225.94
    58920TPartial removal of ovary(s)020239.56$2,011.31$864.86$402.26
    58925TRemoval of ovarian cyst(s)020239.56$2,011.31$864.86$402.26
    58940CRemoval of ovary(s)
    58943CRemoval of ovary(s)
    Start Printed Page 44788
    58950CResect ovarian malignancy
    58951CResect ovarian malignancy
    58952CResect ovarian malignancy
    58960CExploration of abdomen
    58970TRetrieval of oocyte019417.18$873.47$395.94$174.69
    58974TTransfer of embryo01972.58$131.17$49.55$26.23
    58976TTransfer of embryo01972.58$131.17$49.55$26.23
    58999TGenital surgery procedure00194.56$231.84$78.91$46.37
    59000TAmniocentesis01981.42$72.20$33.03$14.44
    59012TFetal cord puncture,prenatal01981.42$72.20$33.03$14.44
    59015TChorion biopsy01981.42$72.20$33.03$14.44
    59020TFetal contract stress test01981.42$72.20$33.03$14.44
    59025TFetal non-stress test01981.42$72.20$33.03$14.44
    59030TFetal scalp blood sample01981.42$72.20$33.03$14.44
    59050TFetal monitor w/report01981.42$72.20$33.03$14.44
    59051EFetal monitor/interpret only
    59100CRemove uterus lesion
    59120CTreat ectopic pregnancy
    59121CTreat ectopic pregnancy
    59130CTreat ectopic pregnancy
    59135CTreat ectopic pregnancy
    59136CTreat ectopic pregnancy
    59140CTreat ectopic pregnancy
    59150TTreat ectopic pregnancy013139.80$2,023.51$1,052.23$404.70
    59151TTreat ectopic pregnancy013139.80$2,023.51$1,052.23$404.70
    59160TD & c after delivery019614.62$743.31$357.98$148.66
    59200TInsert cervical dilator01891.38$70.16$17.54$14.03
    59300TEpisiotomy or vaginal repair019312.17$618.75$171.13$123.75
    59320TRevision of cervix019417.18$873.47$395.94$174.69
    59325CRevision of cervix
    59350CRepair of uterus
    59400EObstetrical care
    59409TObstetrical care01994.20$213.54$59.79$42.71
    59410EObstetrical care
    59412TAntepartum manipulation01994.20$213.54$59.79$42.71
    59414TDeliver placenta01994.20$213.54$59.79$42.71
    59425EAntepartum care only
    59426EAntepartum care only
    59430ECare after delivery
    59510ECesarean delivery
    59514CCesarean delivery only
    59515ECesarean delivery
    59525CRemove uterus after cesarean
    59610EVbac delivery
    59612TVbac delivery only01994.20$213.54$59.79$42.71
    59614EVbac care after delivery
    59618EAttempted vbac delivery
    59620CAttempted vbac delivery only
    59622EAttempted vbac after care
    59812TTreatment of miscarriage020114.89$757.04$329.65$151.41
    59820TCare of miscarriage020114.89$757.04$329.65$151.41
    59821TTreatment of miscarriage020114.89$757.04$329.65$151.41
    59830CTreat uterus infection
    59840TAbortion020013.74$698.57$373.23$139.71
    59841TAbortion020013.74$698.57$373.23$139.71
    59850CAbortion
    59851CAbortion
    59852CAbortion
    59855CAbortion
    59856CAbortion
    59857CAbortion
    59866TAbortion (mpr)01981.42$72.20$33.03$14.44
    59870TEvacuate mole of uterus020114.89$757.04$329.65$151.41
    59871TRemove cerclage suture019417.18$873.47$395.94$174.69
    59898TLaparo proc, ob care/deliver013027.92$1,419.51$659.53$283.90
    59899TMaternity care procedure01981.42$72.20$33.03$14.44
    60000TDrain thyroid/tongue cyst02526.53$332.00$114.24$66.40
    60001TAspirate/inject thyriod cyst00043.00$152.53$32.57$30.51
    60100TBiopsy of thyroid00043.00$152.53$32.57$30.51
    60200TRemove thyroid lesion011430.50$1,550.68$493.78$310.14
    60210TPartial thyroid excision011430.50$1,550.68$493.78$310.14
    60212TParital thyroid excision011430.50$1,550.68$493.78$310.14
    60220TPartial removal of thyroid011430.50$1,550.68$493.78$310.14
    60225TPartial removal of thyroid011430.50$1,550.68$493.78$310.14
    60240TRemoval of thyroid011430.50$1,550.68$493.78$310.14
    Start Printed Page 44789
    60252TRemoval of thyroid025628.82$1,465.27$623.05$293.05
    60254CExtensive thyroid surgery
    60260TRepeat thyroid surgery025628.82$1,465.27$623.05$293.05
    60270CRemoval of thyroid
    60271CRemoval of thyroid
    60280TRemove thyroid duct lesion011430.50$1,550.68$493.78$310.14
    60281TRemove thyroid duct lesion011430.50$1,550.68$493.78$310.14
    60500TExplore parathyroid glands025628.82$1,465.27$623.05$293.05
    60502CRe-explore parathyroids
    60505CExplore parathyroid glands
    60512TAutotransplant parathyroid002112.74$647.73$236.51$129.55
    60520CRemoval of thymus gland
    60521CRemoval of thymus gland
    60522CRemoval of thymus gland
    60540CExplore adrenal gland
    60545CExplore adrenal gland
    60600CRemove carotid body lesion
    60605CRemove carotid body lesion
    60650CLaparoscopy adrenalectomy
    60659TLaparo proc, endocrine013027.92$1,419.51$659.53$283.90
    60699TEndocrine surgery procedure00043.00$152.53$32.57$30.51
    61000TRemove cranial cavity fluid02124.17$212.01$88.78$42.40
    61001TRemove cranial cavity fluid02124.17$212.01$88.78$42.40
    61020TRemove brain cavity fluid02124.17$212.01$88.78$42.40
    61026TInjection into brain canal02124.17$212.01$88.78$42.40
    61050TRemove brain canal fluid02124.17$212.01$88.78$42.40
    61055TInjection into brain canal02124.17$212.01$88.78$42.40
    61070TBrain canal shunt procedure02124.17$212.01$88.78$42.40
    61105CTwist drill hole
    61107CDrill skull for implantation
    61108CDrill skull for drainage
    61120CBurr hole for puncture
    61140CPierce skull for biopsy
    61150CPierce skull for drainage
    61151CPierce skull for drainage
    61154CPierce skull & remove clot
    61156CPierce skull for drainage
    61210CPierce skull, implant device
    61215TInsert brain-fluid device022429.95$1,522.72$453.41$304.54
    61250CPierce skull & explore
    61253CPierce skull & explore
    61304COpen skull for exploration
    61305COpen skull for exploration
    61312COpen skull for drainage
    61313COpen skull for drainage
    61314COpen skull for drainage
    61315COpen skull for drainage
    61320COpen skull for drainage
    61321COpen skull for drainage
    61330TDecompress eye socket025628.82$1,465.27$623.05$293.05
    61332CExplore/biopsy eye socket
    61333CExplore orbit/remove lesion
    61334CExplore orbit/remove object
    61340CRelieve cranial pressure
    61343CIncise skull (press relief)
    61345CRelieve cranial pressure
    61440CIncise skull for surgery
    61450CIncise skull for surgery
    61458CIncise skull for brain wound
    61460CIncise skull for surgery
    61470CIncise skull for surgery
    61480CIncise skull for surgery
    61490CIncise skull for surgery
    61500CRemoval of skull lesion
    61501CRemove infected skull bone
    61510CRemoval of brain lesion
    61512CRemove brain lining lesion
    61514CRemoval of brain abscess
    61516CRemoval of brain lesion
    61518CRemoval of brain lesion
    61519CRemove brain lining lesion
    61520CRemoval of brain lesion
    61521CRemoval of brain lesion
    61522CRemoval of brain abscess
    61524CRemoval of brain lesion
    Start Printed Page 44790
    61526CRemoval of brain lesion
    61530CRemoval of brain lesion
    61531CImplant brain electrodes
    61533CImplant brain electrodes
    61534CRemoval of brain lesion
    61535CRemove brain electrodes
    61536CRemoval of brain lesion
    61538CRemoval of brain tissue
    61539CRemoval of brain tissue
    61541CIncision of brain tissue
    61542CRemoval of brain tissue
    61543CRemoval of brain tissue
    61544CRemove & treat brain lesion
    61545CExcision of brain tumor
    61546CRemoval of pituitary gland
    61548CRemoval of pituitary gland
    61550CRelease of skull seams
    61552CRelease of skull seams
    61556CIncise skull/sutures
    61557CIncise skull/sutures
    61558CExcision of skull/sutures
    61559CExcision of skull/sutures
    61563CExcision of skull tumor
    61564CExcision of skull tumor
    61570CRemove foreign body, brain
    61571CIncise skull for brain wound
    61575CSkull base/brainstem surgery
    61576CSkull base/brainstem surgery
    61580CCraniofacial approach, skull
    61581CCraniofacial approach, skull
    61582CCraniofacial approach, skull
    61583CCraniofacial approach, skull
    61584COrbitocranial approach/skull
    61585COrbitocranial approach/skull
    61586CResect nasopharynx, skull
    61590CInfratemporal approach/skull
    61591CInfratemporal approach/skull
    61592COrbitocranial approach/skull
    61595CTranstemporal approach/skull
    61596CTranscochlear approach/skull
    61597CTranscondylar approach/skull
    61598CTranspetrosal approach/skull
    61600CResect/excise cranial lesion
    61601CResect/excise cranial lesion
    61605CResect/excise cranial lesion
    61606CResect/excise cranial lesion
    61607CResect/excise cranial lesion
    61608CResect/excise cranial lesion
    61609CTransect artery, sinus
    61610CTransect artery, sinus
    61611CTransect artery, sinus
    61612CTransect artery, sinus
    61613CRemove aneurysm, sinus
    61615CResect/excise lesion, skull
    61616CResect/excise lesion, skull
    61618CRepair dura
    61619CRepair dura
    61624COcclusion/embolization cath
    61626COcclusion/embolization cath
    61680CIntracranial vessel surgery
    61682CIntracranial vessel surgery
    61684CIntracranial vessel surgery
    61686CIntracranial vessel surgery
    61690CIntracranial vessel surgery
    61692CIntracranial vessel surgery
    61697CBrain aneurysm repr, complx
    61698CBrain aneurysm repr, complx
    61700CBrain aneurysm repr , simple
    61702CInner skull vessel surgery
    61703CClamp neck artery
    61705CRevise circulation to head
    61708CRevise circulation to head
    61710CRevise circulation to head
    61711CFusion of skull arteries
    61720CIncise skull/brain surgery
    Start Printed Page 44791
    61735CIncise skull/brain surgery
    61750CIncise skull/brain biopsy
    61751CBrain biopsy w/ ct/mr guide
    61760CImplant brain electrodes
    61770CIncise skull for treatment
    61790TTreat trigeminal nerve022014.76$750.43$326.21$150.09
    61791CTreat trigeminal tract
    61793SFocus radiation beam030211.96$608.07$216.55$121.61
    61795SBrain surgery using computer030211.96$608.07$216.55$121.61
    61850CImplant neuroelectrodes
    61860CImplant neuroelectrodes
    61862CImplant neurostimul, subcort
    61870CImplant neuroelectrodes
    61875CImplant neuroelectrodes
    61880TRevise/remove neuroelectrode010516.56$841.94$372.32$168.39
    61885TImplant neurostim one array0222112.50$5,719.73$2,688.27$1,143.95
    61886TImplant neurostim arrays0222112.50$5,719.73$2,688.27$1,143.95
    61888TRevise/remove neuroreceiver010516.56$841.94$372.32$168.39
    62000CTreat skull fracture
    62005CTreat skull fracture
    62010CTreatment of head injury
    62100CRepair brain fluid leakage
    62115CReduction of skull defect
    62116CReduction of skull defect
    62117CReduction of skull defect
    62120CRepair skull cavity lesion
    62121CIncise skull repair
    62140CRepair of skull defect
    62141CRepair of skull defect
    62142CRemove skull plate/flap
    62143CReplace skull plate/flap
    62145CRepair of skull & brain
    62146CRepair of skull with graft
    62147CRepair of skull with graft
    62180CEstablish brain cavity shunt
    62190CEstablish brain cavity shunt
    62192CEstablish brain cavity shunt
    62194TReplace/irrigate catheter01212.42$123.04$52.53$24.61
    62200CEstablish brain cavity shunt
    62201CEstablish brain cavity shunt
    62220CEstablish brain cavity shunt
    62223CEstablish brain cavity shunt
    62225TReplace/irrigate catheter01212.42$123.04$52.53$24.61
    62230TReplace/revise brain shunt022429.95$1,522.72$453.41$304.54
    62252SCsf shunt reprogram06913.36$170.83$93.96$34.17
    62256CRemove brain cavity shunt
    62258CReplace brain cavity shunt
    62263TLysis epidural adhesions02037.62$387.42$166.59$77.48
    62268TDrain spinal cord cyst02124.17$212.01$88.78$42.40
    62269TNeedle biopsy, spinal cord00056.71$341.15$119.75$68.23
    62270TSpinal fluid tap, diagnostic02063.88$197.27$82.85$39.45
    62272TDrain spinal fluid02063.88$197.27$82.85$39.45
    62273TTreat epidural spine lesion02063.88$197.27$82.85$39.45
    62280TTreat spinal cord lesion02074.13$209.98$94.49$42.00
    62281TTreat spinal cord lesion02074.13$209.98$94.49$42.00
    62282TTreat spinal canal lesion02074.13$209.98$94.49$42.00
    62284NInjection for myelogram
    62287TPercutaneous diskectomy022014.76$750.43$326.21$150.09
    62290NInject for spine disk x-ray
    62291NInject for spine disk x-ray
    62292TInjection into disk lesion02124.17$212.01$88.78$42.40
    62294TInjection into spinal artery02124.17$212.01$88.78$42.40
    62310TInject spine c/t02063.88$197.27$82.85$39.45
    62311TInject spine l/s (cd)02063.88$197.27$82.85$39.45
    62318TInject spine w/cath, c/t02063.88$197.27$82.85$39.45
    62319TInject spine w/cath l/s (cd)02063.88$197.27$82.85$39.45
    62350TImplant spinal canal cath02238.87$450.97$154.27$90.19
    62351CImplant spinal canal cath
    62355TRemove spinal canal catheter010516.56$841.94$372.32$168.39
    62360TInsert spine infusion device02268.91$453.00$109.42$90.60
    62361TImplant spine infusion pump022794.89$4,824.40$964.88$964.88
    62362TImplant spine infusion pump022794.89$4,824.40$964.88$964.88
    62365TRemove spine infusion device010516.56$841.94$372.32$168.39
    62367SAnalyze spine infusion pump06913.36$170.83$93.96$34.17
    62368SAnalyze spine infusion pump06913.36$170.83$93.96$34.17
    Start Printed Page 44792
    63001TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63003TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63005TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63011TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63012TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63015TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63016TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63017TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63020TNeck spine disk surgery020830.93$1,572.54$314.51$314.51
    63030TLow back disk surgery020830.93$1,572.54$314.51$314.51
    63035TSpinal disk surgery add-on020830.93$1,572.54$314.51$314.51
    63040TLaminotomy, single cervical020830.93$1,572.54$314.51$314.51
    63042TLaminotomy, single lumbar020830.93$1,572.54$314.51$314.51
    63043CLaminotomy, addl cervical
    63044CLaminotomy, addl lumbar
    63045TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63046TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63047TRemoval of spinal lamina020830.93$1,572.54$314.51$314.51
    63048TRemove spinal lamina add-on020830.93$1,572.54$314.51$314.51
    63055TDecompress spinal cord020830.93$1,572.54$314.51$314.51
    63056TDecompress spinal cord020830.93$1,572.54$314.51$314.51
    63057TDecompress spine cord add-on020830.93$1,572.54$314.51$314.51
    63064TDecompress spinal cord020830.93$1,572.54$314.51$314.51
    63066TDecompress spine cord add-on020830.93$1,572.54$314.51$314.51
    63075CNeck spine disk surgery
    63076CNeck spine disk surgery
    63077CSpine disk surgery, thorax
    63078CSpine disk surgery, thorax
    63081CRemoval of vertebral body
    63082CRemove vertebral body add-on
    63085CRemoval of vertebral body
    63086CRemove vertebral body add-on
    63087CRemoval of vertebral body
    63088CRemove vertebral body add-on
    63090CRemoval of vertebral body
    63091CRemove vertebral body add-on
    63170CIncise spinal cord tract(s)
    63172CDrainage of spinal cyst
    63173CDrainage of spinal cyst
    63180CRevise spinal cord ligaments
    63182CRevise spinal cord ligaments
    63185CIncise spinal column/nerves
    63190CIncise spinal column/nerves
    63191CIncise spinal column/nerves
    63194CIncise spinal column & cord
    63195CIncise spinal column & cord
    63196CIncise spinal column & cord
    63197CIncise spinal column & cord
    63198CIncise spinal column & cord
    63199CIncise spinal column & cord
    63200CRelease of spinal cord
    63250CRevise spinal cord vessels
    63251CRevise spinal cord vessels
    63252CRevise spinal cord vessels
    63265CExcise intraspinal lesion
    63266CExcise intraspinal lesion
    63267CExcise intraspinal lesion
    63268CExcise intraspinal lesion
    63270CExcise intraspinal lesion
    63271CExcise intraspinal lesion
    63272CExcise intraspinal lesion
    63273CExcise intraspinal lesion
    63275CBiopsy/excise spinal tumor
    63276CBiopsy/excise spinal tumor
    63277CBiopsy/excise spinal tumor
    63278CBiopsy/excise spinal tumor
    63280CBiopsy/excise spinal tumor
    63281CBiopsy/excise spinal tumor
    63282CBiopsy/excise spinal tumor
    63283CBiopsy/excise spinal tumor
    63285CBiopsy/excise spinal tumor
    63286CBiopsy/excise spinal tumor
    63287CBiopsy/excise spinal tumor
    63290CBiopsy/excise spinal tumor
    63300CRemoval of vertebral body
    Start Printed Page 44793
    63301CRemoval of vertebral body
    63302CRemoval of vertebral body
    63303CRemoval of vertebral body
    63304CRemoval of vertebral body
    63305CRemoval of vertebral body
    63306CRemoval of vertebral body
    63307CRemoval of vertebral body
    63308CRemove vertebral body add-on
    63600TRemove spinal cord lesion022014.76$750.43$326.21$150.09
    63610TStimulation of spinal cord022014.76$750.43$326.21$150.09
    63615TRemove lesion of spinal cord022014.76$750.43$326.21$150.09
    63650TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    63655CImplant neuroelectrodes
    63660TRevise/remove neuroelectrode010516.56$841.94$372.32$168.39
    63685TImplant neuroreceiver0222112.50$5,719.73$2,688.27$1,143.95
    63688TRevise/remove neuroreceiver010516.56$841.94$372.32$168.39
    63700CRepair of spinal herniation
    63702CRepair of spinal herniation
    63704CRepair of spinal herniation
    63706CRepair of spinal herniation
    63707CRepair spinal fluid leakage
    63709CRepair spinal fluid leakage
    63710CGraft repair of spine defect
    63740CInstall spinal shunt
    63741TInstall spinal shunt022847.98$2,439.40$696.46$487.88
    63744TRevision of spinal shunt022847.98$2,439.40$696.46$487.88
    63746TRemoval of spinal shunt01096.57$334.03$133.51$66.81
    64400TInjection for nerve block02042.44$124.05$47.14$24.81
    64402TInjection for nerve block02042.44$124.05$47.14$24.81
    64405TInjection for nerve block02042.44$124.05$47.14$24.81
    64408TInjection for nerve block02042.44$124.05$47.14$24.81
    64410TInjection for nerve block02042.44$124.05$47.14$24.81
    64412TInjection for nerve block02042.44$124.05$47.14$24.81
    64413TInjection for nerve block02042.44$124.05$47.14$24.81
    64415TInjection for nerve block02042.44$124.05$47.14$24.81
    64417TInjection for nerve block02042.44$124.05$47.14$24.81
    64418TInjection for nerve block02042.44$124.05$47.14$24.81
    64420TInjection for nerve block02074.13$209.98$94.49$42.00
    64421TInjection for nerve block02074.13$209.98$94.49$42.00
    64425TInjection for nerve block02042.44$124.05$47.14$24.81
    64430TInjection for nerve block02042.44$124.05$47.14$24.81
    64435TInjection for nerve block02042.44$124.05$47.14$24.81
    64445TInjection for nerve block02042.44$124.05$47.14$24.81
    64450TInjection for nerve block02042.44$124.05$47.14$24.81
    64470TInj paravertebral c/t02074.13$209.98$94.49$42.00
    64472TInj paravertebral c/t add-on02074.13$209.98$94.49$42.00
    64475TInj paravertebral l/s02074.13$209.98$94.49$42.00
    64476TInj paravertebral l/s add-on02074.13$209.98$94.49$42.00
    64479TInj foramen epidural c/t02074.13$209.98$94.49$42.00
    64480TInj foramen epidural add-on02074.13$209.98$94.49$42.00
    64483TInj foramen epidural l/s02074.13$209.98$94.49$42.00
    64484TInj foramen epidural add-on02074.13$209.98$94.49$42.00
    64505TInjection for nerve block02042.44$124.05$47.14$24.81
    64508TInjection for nerve block02042.44$124.05$47.14$24.81
    64510TInjection for nerve block02074.13$209.98$94.49$42.00
    64520TInjection for nerve block02074.13$209.98$94.49$42.00
    64530TInjection for nerve block02074.13$209.98$94.49$42.00
    64550AApply neurostimulator
    64553TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64555TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64560TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64565TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64573TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64575TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64577TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64580TImplant neuroelectrodes022533.75$1,715.92$408.33$343.18
    64585TRevise/remove neuroelectrode010516.56$841.94$372.32$168.39
    64590TImplant neuroreceiver0222112.50$5,719.73$2,688.27$1,143.95
    64595TRevise/remove neuroreceiver010516.56$841.94$372.32$168.39
    64600TInjection treatment of nerve02037.62$387.42$166.59$77.48
    64605TInjection treatment of nerve02037.62$387.42$166.59$77.48
    64610TInjection treatment of nerve02037.62$387.42$166.59$77.48
    64612TDestroy nerve, face muscle02042.44$124.05$47.14$24.81
    64613TDestroy nerve, spine muscle02042.44$124.05$47.14$24.81
    64614TDestroy nerve, extrem musc02063.88$197.27$82.85$39.45
    Start Printed Page 44794
    64620TInjection treatment of nerve02037.62$387.42$166.59$77.48
    64622TDestr paravertebrl nerve l/s02037.62$387.42$166.59$77.48
    64623TDestr paravertebral n add-on02037.62$387.42$166.59$77.48
    64626TDestr paravertebrl nerve c/t02037.62$387.42$166.59$77.48
    64627TDestr paravertebral n add-on02037.62$387.42$166.59$77.48
    64630TInjection treatment of nerve02074.13$209.98$94.49$42.00
    64640TInjection treatment of nerve02074.13$209.98$94.49$42.00
    64680TInjection treatment of nerve02037.62$387.42$166.59$77.48
    64702TRevise finger/toe nerve022014.76$750.43$326.21$150.09
    64704TRevise hand/foot nerve022014.76$750.43$326.21$150.09
    64708TRevise arm/leg nerve022014.76$750.43$326.21$150.09
    64712TRevision of sciatic nerve022014.76$750.43$326.21$150.09
    64713TRevision of arm nerve(s)022014.76$750.43$326.21$150.09
    64714TRevise low back nerve(s)022014.76$750.43$326.21$150.09
    64716TRevision of cranial nerve022014.76$750.43$326.21$150.09
    64718TRevise ulnar nerve at elbow022014.76$750.43$326.21$150.09
    64719TRevise ulnar nerve at wrist022014.76$750.43$326.21$150.09
    64721TCarpal tunnel surgery022014.76$750.43$326.21$150.09
    64722TRelieve pressure on nerve(s)022014.76$750.43$326.21$150.09
    64726TRelease foot/toe nerve022014.76$750.43$326.21$150.09
    64727TInternal nerve revision022014.76$750.43$326.21$150.09
    64732TIncision of brow nerve022014.76$750.43$326.21$150.09
    64734TIncision of cheek nerve022014.76$750.43$326.21$150.09
    64736TIncision of chin nerve022014.76$750.43$326.21$150.09
    64738TIncision of jaw nerve022014.76$750.43$326.21$150.09
    64740TIncision of tongue nerve022014.76$750.43$326.21$150.09
    64742TIncision of facial nerve022014.76$750.43$326.21$150.09
    64744TIncise nerve, back of head022014.76$750.43$326.21$150.09
    64746TIncise diaphragm nerve022014.76$750.43$326.21$150.09
    64752CIncision of vagus nerve
    64755CIncision of stomach nerves
    64760CIncision of vagus nerve
    64761TIncision of pelvis nerve022014.76$750.43$326.21$150.09
    64763CIncise hip/thigh nerve
    64766CIncise hip/thigh nerve
    64771TSever cranial nerve022014.76$750.43$326.21$150.09
    64772TIncision of spinal nerve022014.76$750.43$326.21$150.09
    64774TRemove skin nerve lesion022014.76$750.43$326.21$150.09
    64776TRemove digit nerve lesion022014.76$750.43$326.21$150.09
    64778TDigit nerve surgery add-on022014.76$750.43$326.21$150.09
    64782TRemove limb nerve lesion022014.76$750.43$326.21$150.09
    64783TLimb nerve surgery add-on022014.76$750.43$326.21$150.09
    64784TRemove nerve lesion022014.76$750.43$326.21$150.09
    64786TRemove sciatic nerve lesion022122.68$1,153.10$463.62$230.62
    64787TImplant nerve end022014.76$750.43$326.21$150.09
    64788TRemove skin nerve lesion022014.76$750.43$326.21$150.09
    64790TRemoval of nerve lesion022014.76$750.43$326.21$150.09
    64792TRemoval of nerve lesion022122.68$1,153.10$463.62$230.62
    64795TBiopsy of nerve022014.76$750.43$326.21$150.09
    64802CRemove sympathetic nerves
    64804CRemove sympathetic nerves
    64809CRemove sympathetic nerves
    64818CRemove sympathetic nerves
    64820CRemove sympathetic nerves
    64831TRepair of digit nerve022122.68$1,153.10$463.62$230.62
    64832TRepair nerve add-on022122.68$1,153.10$463.62$230.62
    64834TRepair of hand or foot nerve022122.68$1,153.10$463.62$230.62
    64835TRepair of hand or foot nerve022122.68$1,153.10$463.62$230.62
    64836TRepair of hand or foot nerve022122.68$1,153.10$463.62$230.62
    64837TRepair nerve add-on022122.68$1,153.10$463.62$230.62
    64840TRepair of leg nerve022122.68$1,153.10$463.62$230.62
    64856TRepair/transpose nerve022122.68$1,153.10$463.62$230.62
    64857TRepair arm/leg nerve022122.68$1,153.10$463.62$230.62
    64858TRepair sciatic nerve022122.68$1,153.10$463.62$230.62
    64859TNerve surgery022122.68$1,153.10$463.62$230.62
    64861TRepair of arm nerves022122.68$1,153.10$463.62$230.62
    64862TRepair of low back nerves022122.68$1,153.10$463.62$230.62
    64864TRepair of facial nerve022122.68$1,153.10$463.62$230.62
    64865TRepair of facial nerve022122.68$1,153.10$463.62$230.62
    64866CFusion of facial/other nerve
    64868CFusion of facial/other nerve
    64870TFusion of facial/other nerve022122.68$1,153.10$463.62$230.62
    64872TSubsequent repair of nerve022122.68$1,153.10$463.62$230.62
    64874TRepair & revise nerve add-on022122.68$1,153.10$463.62$230.62
    64876TRepair nerve/shorten bone022122.68$1,153.10$463.62$230.62
    Start Printed Page 44795
    64885TNerve graft, head or neck022122.68$1,153.10$463.62$230.62
    64886TNerve graft, head or neck022122.68$1,153.10$463.62$230.62
    64890TNerve graft, hand or foot022122.68$1,153.10$463.62$230.62
    64891TNerve graft, hand or foot022122.68$1,153.10$463.62$230.62
    64892TNerve graft, arm or leg022122.68$1,153.10$463.62$230.62
    64893TNerve graft, arm or leg022122.68$1,153.10$463.62$230.62
    64895TNerve graft, hand or foot022122.68$1,153.10$463.62$230.62
    64896TNerve graft, hand or foot022122.68$1,153.10$463.62$230.62
    64897TNerve graft, arm or leg022122.68$1,153.10$463.62$230.62
    64898TNerve graft, arm or leg022122.68$1,153.10$463.62$230.62
    64901TNerve graft add-on022122.68$1,153.10$463.62$230.62
    64902TNerve graft add-on022122.68$1,153.10$463.62$230.62
    64905TNerve pedicle transfer022122.68$1,153.10$463.62$230.62
    64907TNerve pedicle transfer022122.68$1,153.10$463.62$230.62
    64999TNervous system surgery02042.44$124.05$47.14$24.81
    65091TRevise eye024225.31$1,286.81$597.36$257.36
    65093TRevise eye with implant024119.20$976.17$384.47$195.23
    65101TRemoval of eye024225.31$1,286.81$597.36$257.36
    65103TRemove eye/insert implant024225.31$1,286.81$597.36$257.36
    65105TRemove eye/attach implant024225.31$1,286.81$597.36$257.36
    65110TRemoval of eye024225.31$1,286.81$597.36$257.36
    65112TRemove eye/revise socket024225.31$1,286.81$597.36$257.36
    65114TRemove eye/revise socket024225.31$1,286.81$597.36$257.36
    65125TRevise ocular implant024014.86$755.51$315.31$151.10
    65130TInsert ocular implant024119.20$976.17$384.47$195.23
    65135TInsert ocular implant024119.20$976.17$384.47$195.23
    65140TAttach ocular implant024225.31$1,286.81$597.36$257.36
    65150TRevise ocular implant024119.20$976.17$384.47$195.23
    65155TReinsert ocular implant024225.31$1,286.81$597.36$257.36
    65175TRemoval of ocular implant024014.86$755.51$315.31$151.10
    65205SRemove foreign body from eye02312.27$115.41$51.94$23.08
    65210SRemove foreign body from eye02312.27$115.41$51.94$23.08
    65220SRemove foreign body from eye02312.27$115.41$51.94$23.08
    65222SRemove foreign body from eye02312.27$115.41$51.94$23.08
    65235TRemove foreign body from eye023311.78$598.92$287.48$119.78
    65260TRemove foreign body from eye023733.56$1,706.26$852.68$341.25
    65265TRemove foreign body from eye023617.75$902.45$180.49$180.49
    65270TRepair of eye wound024014.86$755.51$315.31$151.10
    65272TRepair of eye wound023311.78$598.92$287.48$119.78
    65273CRepair of eye wound
    65275TRepair of eye wound023311.78$598.92$287.48$119.78
    65280TRepair of eye wound023420.56$1,045.31$502.16$209.06
    65285TRepair of eye wound023420.56$1,045.31$502.16$209.06
    65286TRepair of eye wound023311.78$598.92$287.48$119.78
    65290TRepair of eye socket wound024319.22$977.18$431.39$195.44
    65400TRemoval of eye lesion023311.78$598.92$287.48$119.78
    65410TBiopsy of cornea023311.78$598.92$287.48$119.78
    65420TRemoval of eye lesion023311.78$598.92$287.48$119.78
    65426TRemoval of eye lesion023420.56$1,045.31$502.16$209.06
    65430SCorneal smear02300.64$32.54$14.97$6.51
    65435TCurette/treat cornea02396.25$317.76$123.42$63.55
    65436TCurette/treat cornea023311.78$598.92$287.48$119.78
    65450TTreatment of corneal lesion02323.69$187.61$82.55$37.52
    65600TRevision of cornea024014.86$755.51$315.31$151.10
    65710TCorneal transplant024441.43$2,106.38$851.42$421.28
    65730TCorneal transplant024441.43$2,106.38$851.42$421.28
    65750TCorneal transplant024441.43$2,106.38$851.42$421.28
    65755TCorneal transplant024441.43$2,106.38$851.42$421.28
    65760ERevision of cornea
    65765ERevision of cornea
    65767ECorneal tissue transplant
    65770TRevise cornea with implant024441.43$2,106.38$851.42$421.28
    65771ERadial keratotomy
    65772TCorrection of astigmatism023311.78$598.92$287.48$119.78
    65775TCorrection of astigmatism023311.78$598.92$287.48$119.78
    65800TDrainage of eye023311.78$598.92$287.48$119.78
    65805TDrainage of eye023311.78$598.92$287.48$119.78
    65810TDrainage of eye023311.78$598.92$287.48$119.78
    65815TDrainage of eye023420.56$1,045.31$502.16$209.06
    65820TRelieve inner eye pressure02323.69$187.61$82.55$37.52
    65850TIncision of eye023420.56$1,045.31$502.16$209.06
    65855TLaser surgery of eye02474.73$240.48$110.62$48.10
    65860TIncise inner eye adhesions02474.73$240.48$110.62$48.10
    65865TIncise inner eye adhesions023311.78$598.92$287.48$119.78
    65870TIncise inner eye adhesions023420.56$1,045.31$502.16$209.06
    Start Printed Page 44796
    65875TIncise inner eye adhesions023420.56$1,045.31$502.16$209.06
    65880TIncise inner eye adhesions023311.78$598.92$287.48$119.78
    65900TRemove eye lesion023311.78$598.92$287.48$119.78
    65920TRemove implant from eye023311.78$598.92$287.48$119.78
    65930TRemove blood clot from eye023420.56$1,045.31$502.16$209.06
    66020TInjection treatment of eye023311.78$598.92$287.48$119.78
    66030TInjection treatment of eye023311.78$598.92$287.48$119.78
    66130TRemove eye lesion023420.56$1,045.31$502.16$209.06
    66150TGlaucoma surgery023311.78$598.92$287.48$119.78
    66155TGlaucoma surgery023420.56$1,045.31$502.16$209.06
    66160TGlaucoma surgery023420.56$1,045.31$502.16$209.06
    66165TGlaucoma surgery023420.56$1,045.31$502.16$209.06
    66170TGlaucoma surgery023420.56$1,045.31$502.16$209.06
    66172TIncision of eye023420.56$1,045.31$502.16$209.06
    66180TImplant eye shunt023420.56$1,045.31$502.16$209.06
    66185TRevise eye shunt023420.56$1,045.31$502.16$209.06
    66220TRepair eye lesion023617.75$902.45$180.49$180.49
    66225TRepair/graft eye lesion023420.56$1,045.31$502.16$209.06
    66250TFollow-up surgery of eye023311.78$598.92$287.48$119.78
    66500TIncision of iris02323.69$187.61$82.55$37.52
    66505TIncision of iris02323.69$187.61$82.55$37.52
    66600TRemove iris and lesion023311.78$598.92$287.48$119.78
    66605TRemoval of iris023420.56$1,045.31$502.16$209.06
    66625TRemoval of iris023311.78$598.92$287.48$119.78
    66630TRemoval of iris023311.78$598.92$287.48$119.78
    66635TRemoval of iris023420.56$1,045.31$502.16$209.06
    66680TRepair iris & ciliary body023420.56$1,045.31$502.16$209.06
    66682TRepair iris & ciliary body023420.56$1,045.31$502.16$209.06
    66700TDestruction, ciliary body023311.78$598.92$287.48$119.78
    66710TDestruction, ciliary body023311.78$598.92$287.48$119.78
    66720TDestruction, ciliary body023311.78$598.92$287.48$119.78
    66740TDestruction, ciliary body023311.78$598.92$287.48$119.78
    66761TRevision of iris02474.73$240.48$110.62$48.10
    66762TRevision of iris02474.73$240.48$110.62$48.10
    66770TRemoval of inner eye lesion02474.73$240.48$110.62$48.10
    66820TIncision, secondary cataract02323.69$187.61$82.55$37.52
    66821TAfter cataract laser surgery02474.73$240.48$110.62$48.10
    66825TReposition intraocular lens023420.56$1,045.31$502.16$209.06
    66830TRemoval of lens lesion02323.69$187.61$82.55$37.52
    66840TRemoval of lens material024510.75$546.55$256.88$109.31
    66850TRemoval of lens material024923.51$1,195.30$561.79$239.06
    66852TRemoval of lens material024923.51$1,195.30$561.79$239.06
    66920TExtraction of lens024923.51$1,195.30$561.79$239.06
    66930TExtraction of lens024923.51$1,195.30$561.79$239.06
    66940TExtraction of lens024510.75$546.55$256.88$109.31
    66982TCataract surgery, complex024622.36$1,136.83$534.31$227.37
    66983TCataract surg w/iol, 1 stage024622.36$1,136.83$534.31$227.37
    66984TCataract surg w/iol, i stage024622.36$1,136.83$534.31$227.37
    66985TInsert lens prosthesis024622.36$1,136.83$534.31$227.37
    66986TExchange lens prosthesis024622.36$1,136.83$534.31$227.37
    66999TEye surgery procedure02474.73$240.48$110.62$48.10
    67005TPartial removal of eye fluid023733.56$1,706.26$852.68$341.25
    67010TPartial removal of eye fluid023733.56$1,706.26$852.68$341.25
    67015TRelease of eye fluid023733.56$1,706.26$852.68$341.25
    67025TReplace eye fluid023617.75$902.45$180.49$180.49
    67027TImplant eye drug system023733.56$1,706.26$852.68$341.25
    67028TInjection eye drug02355.39$274.04$78.91$54.81
    67030TIncise inner eye strands023617.75$902.45$180.49$180.49
    67031TLaser surgery, eye strands02474.73$240.48$110.62$48.10
    67036TRemoval of inner eye fluid023733.56$1,706.26$852.68$341.25
    67038TStrip retinal membrane023733.56$1,706.26$852.68$341.25
    67039TLaser treatment of retina023733.56$1,706.26$852.68$341.25
    67040TLaser treatment of retina023733.56$1,706.26$852.68$341.25
    67101TRepair detached retina02355.39$274.04$78.91$54.81
    67105TRepair detached retina02484.15$210.99$94.05$42.20
    67107TRepair detached retina023733.56$1,706.26$852.68$341.25
    67108TRepair detached retina023733.56$1,706.26$852.68$341.25
    67110TRepair detached retina02355.39$274.04$78.91$54.81
    67112TRerepair detached retina023733.56$1,706.26$852.68$341.25
    67115TRelease encircling material023617.75$902.45$180.49$180.49
    67120TRemove eye implant material023617.75$902.45$180.49$180.49
    67121TRemove eye implant material023733.56$1,706.26$852.68$341.25
    67141TTreatment of retina02355.39$274.04$78.91$54.81
    67145TTreatment of retina02484.15$210.99$94.05$42.20
    67208STreatment of retinal lesion02312.27$115.41$51.94$23.08
    Start Printed Page 44797
    67210TTreatment of retinal lesion02484.15$210.99$94.05$42.20
    67218TTreatment of retinal lesion023733.56$1,706.26$852.68$341.25
    67220TTreatment of choroid lesion02355.39$274.04$78.91$54.81
    67221TOcular photodynamic ther02355.39$274.04$78.91$54.81
    67227TTreatment of retinal lesion02355.39$274.04$78.91$54.81
    67228TTreatment of retinal lesion02484.15$210.99$94.05$42.20
    67250TReinforce eye wall024014.86$755.51$315.31$151.10
    67255TReinforce/graft eye wall023733.56$1,706.26$852.68$341.25
    67299TEye surgery procedure02484.15$210.99$94.05$42.20
    67311TRevise eye muscle024319.22$977.18$431.39$195.44
    67312TRevise two eye muscles024319.22$977.18$431.39$195.44
    67314TRevise eye muscle024319.22$977.18$431.39$195.44
    67316TRevise two eye muscles024319.22$977.18$431.39$195.44
    67318TRevise eye muscle(s)024319.22$977.18$431.39$195.44
    67320TRevise eye muscle(s) add-on024319.22$977.18$431.39$195.44
    67331TEye surgery follow-up add-on024319.22$977.18$431.39$195.44
    67332TRerevise eye muscles add-on024319.22$977.18$431.39$195.44
    67334TRevise eye muscle w/suture024319.22$977.18$431.39$195.44
    67335TEye suture during surgery024319.22$977.18$431.39$195.44
    67340TRevise eye muscle add-on024319.22$977.18$431.39$195.44
    67343TRelease eye tissue024319.22$977.18$431.39$195.44
    67345TDestroy nerve of eye muscle02382.84$144.39$58.96$28.88
    67350TBiopsy eye muscle06996.91$351.32$158.09$70.26
    67399TEye muscle surgery procedure024319.22$977.18$431.39$195.44
    67400TExplore/biopsy eye socket024119.20$976.17$384.47$195.23
    67405TExplore/drain eye socket024119.20$976.17$384.47$195.23
    67412TExplore/treat eye socket024119.20$976.17$384.47$195.23
    67413TExplore/treat eye socket024119.20$976.17$384.47$195.23
    67414TExplr/decompress eye socket024225.31$1,286.81$597.36$257.36
    67415TAspiration, orbital contents02396.25$317.76$123.42$63.55
    67420TExplore/treat eye socket024225.31$1,286.81$597.36$257.36
    67430TExplore/treat eye socket024225.31$1,286.81$597.36$257.36
    67440TExplore/drain eye socket024225.31$1,286.81$597.36$257.36
    67445TExplr/decompress eye socket024225.31$1,286.81$597.36$257.36
    67450TExplore/biopsy eye socket024225.31$1,286.81$597.36$257.36
    67500SInject/treat eye socket02312.27$115.41$51.94$23.08
    67505TInject/treat eye socket02382.84$144.39$58.96$28.88
    67515TInject/treat eye socket02396.25$317.76$123.42$63.55
    67550TInsert eye socket implant024225.31$1,286.81$597.36$257.36
    67560TRevise eye socket implant024119.20$976.17$384.47$195.23
    67570TDecompress optic nerve024225.31$1,286.81$597.36$257.36
    67599TOrbit surgery procedure02396.25$317.76$123.42$63.55
    67700TDrainage of eyelid abscess02382.84$144.39$58.96$28.88
    67710TIncision of eyelid02396.25$317.76$123.42$63.55
    67715TIncision of eyelid fold024014.86$755.51$315.31$151.10
    67800TRemove eyelid lesion02382.84$144.39$58.96$28.88
    67801TRemove eyelid lesions02396.25$317.76$123.42$63.55
    67805TRemove eyelid lesions02382.84$144.39$58.96$28.88
    67808TRemove eyelid lesion(s)024014.86$755.51$315.31$151.10
    67810TBiopsy of eyelid02382.84$144.39$58.96$28.88
    67820TRevise eyelashes02382.84$144.39$58.96$28.88
    67825TRevise eyelashes02382.84$144.39$58.96$28.88
    67830TRevise eyelashes02396.25$317.76$123.42$63.55
    67835TRevise eyelashes024014.86$755.51$315.31$151.10
    67840TRemove eyelid lesion02396.25$317.76$123.42$63.55
    67850TTreat eyelid lesion02396.25$317.76$123.42$63.55
    67875TClosure of eyelid by suture02396.25$317.76$123.42$63.55
    67880TRevision of eyelid023311.78$598.92$287.48$119.78
    67882TRevision of eyelid024014.86$755.51$315.31$151.10
    67900TRepair brow defect024014.86$755.51$315.31$151.10
    67901TRepair eyelid defect024014.86$755.51$315.31$151.10
    67902TRepair eyelid defect024014.86$755.51$315.31$151.10
    67903TRepair eyelid defect024014.86$755.51$315.31$151.10
    67904TRepair eyelid defect024014.86$755.51$315.31$151.10
    67906TRepair eyelid defect024014.86$755.51$315.31$151.10
    67908TRepair eyelid defect024014.86$755.51$315.31$151.10
    67909TRevise eyelid defect024014.86$755.51$315.31$151.10
    67911TRevise eyelid defect024014.86$755.51$315.31$151.10
    67914TRepair eyelid defect024014.86$755.51$315.31$151.10
    67915TRepair eyelid defect02396.25$317.76$123.42$63.55
    67916TRepair eyelid defect024014.86$755.51$315.31$151.10
    67917TRepair eyelid defect024014.86$755.51$315.31$151.10
    67921TRepair eyelid defect024014.86$755.51$315.31$151.10
    67922TRepair eyelid defect02396.25$317.76$123.42$63.55
    67923TRepair eyelid defect024014.86$755.51$315.31$151.10
    Start Printed Page 44798
    67924TRepair eyelid defect024014.86$755.51$315.31$151.10
    67930TRepair eyelid wound024014.86$755.51$315.31$151.10
    67935TRepair eyelid wound024014.86$755.51$315.31$151.10
    67938TRemove eyelid foreign body02382.84$144.39$58.96$28.88
    67950TRevision of eyelid024014.86$755.51$315.31$151.10
    67961TRevision of eyelid024014.86$755.51$315.31$151.10
    67966TRevision of eyelid024014.86$755.51$315.31$151.10
    67971TReconstruction of eyelid024119.20$976.17$384.47$195.23
    67973TReconstruction of eyelid024119.20$976.17$384.47$195.23
    67974TReconstruction of eyelid024119.20$976.17$384.47$195.23
    67975TReconstruction of eyelid024014.86$755.51$315.31$151.10
    67999TRevision of eyelid024014.86$755.51$315.31$151.10
    68020TIncise/drain eyelid lining024014.86$755.51$315.31$151.10
    68040TTreatment of eyelid lesions02382.84$144.39$58.96$28.88
    68100TBiopsy of eyelid lining023311.78$598.92$287.48$119.78
    68110TRemove eyelid lining lesion06996.91$351.32$158.09$70.26
    68115TRemove eyelid lining lesion02396.25$317.76$123.42$63.55
    68130TRemove eyelid lining lesion023311.78$598.92$287.48$119.78
    68135TRemove eyelid lining lesion02396.25$317.76$123.42$63.55
    68200STreat eyelid by injection02300.64$32.54$14.97$6.51
    68320TRevise/graft eyelid lining024014.86$755.51$315.31$151.10
    68325TRevise/graft eyelid lining024225.31$1,286.81$597.36$257.36
    68326TRevise/graft eyelid lining024119.20$976.17$384.47$195.23
    68328TRevise/graft eyelid lining024119.20$976.17$384.47$195.23
    68330TRevise eyelid lining023311.78$598.92$287.48$119.78
    68335TRevise/graft eyelid lining024119.20$976.17$384.47$195.23
    68340TSeparate eyelid adhesions024014.86$755.51$315.31$151.10
    68360TRevise eyelid lining023420.56$1,045.31$502.16$209.06
    68362TRevise eyelid lining023420.56$1,045.31$502.16$209.06
    68399TEyelid lining surgery02396.25$317.76$123.42$63.55
    68400TIncise/drain tear gland02382.84$144.39$58.96$28.88
    68420TIncise/drain tear sac024014.86$755.51$315.31$151.10
    68440TIncise tear duct opening02382.84$144.39$58.96$28.88
    68500TRemoval of tear gland024119.20$976.17$384.47$195.23
    68505TPartial removal, tear gland024119.20$976.17$384.47$195.23
    68510TBiopsy of tear gland024014.86$755.51$315.31$151.10
    68520TRemoval of tear sac024119.20$976.17$384.47$195.23
    68525TBiopsy of tear sac024014.86$755.51$315.31$151.10
    68530TClearance of tear duct024014.86$755.51$315.31$151.10
    68540TRemove tear gland lesion024119.20$976.17$384.47$195.23
    68550TRemove tear gland lesion024225.31$1,286.81$597.36$257.36
    68700TRepair tear ducts024119.20$976.17$384.47$195.23
    68705TRevise tear duct opening02382.84$144.39$58.96$28.88
    68720TCreate tear sac drain024225.31$1,286.81$597.36$257.36
    68745TCreate tear duct drain024119.20$976.17$384.47$195.23
    68750TCreate tear duct drain024225.31$1,286.81$597.36$257.36
    68760TClose tear duct opening02382.84$144.39$58.96$28.88
    68761SClose tear duct opening02312.27$115.41$51.94$23.08
    68770TClose tear system fistula024014.86$755.51$315.31$151.10
    68801SDilate tear duct opening02312.27$115.41$51.94$23.08
    68810TProbe nasolacrimal duct06996.91$351.32$158.09$70.26
    68811TProbe nasolacrimal duct024014.86$755.51$315.31$151.10
    68815TProbe nasolacrimal duct024014.86$755.51$315.31$151.10
    68840TExplore/irrigate tear ducts06996.91$351.32$158.09$70.26
    68850NInjection for tear sac x-ray
    68899TTear duct system surgery06996.91$351.32$158.09$70.26
    69000TDrain external ear lesion00062.36$119.99$33.95$24.00
    69005TDrain external ear lesion00077.28$370.13$74.03$74.03
    69020TDrain outer ear canal lesion00062.36$119.99$33.95$24.00
    69090EPierce earlobes
    69100TBiopsy of external ear00194.56$231.84$78.91$46.37
    69105TBiopsy of external ear canal025313.27$674.67$284.00$134.93
    69110TRemove external ear, partial00208.56$435.21$130.53$87.04
    69120TRemoval of external ear025419.11$971.59$272.41$194.32
    69140TRemove ear canal lesion(s)025419.11$971.59$272.41$194.32
    69145TRemove ear canal lesion(s)00208.56$435.21$130.53$87.04
    69150CExtensive ear canal surgery
    69155CExtensive ear/neck surgery
    69200XClear outer ear canal03400.91$46.27$11.57$9.25
    69205TClear outer ear canal002215.07$766.19$292.94$153.24
    69210XRemove impacted ear wax03400.91$46.27$11.57$9.25
    69220TClean out mastoid cavity00120.72$36.61$9.18$7.32
    69222TClean out mastoid cavity025313.27$674.67$284.00$134.93
    69300TRevise external ear025419.11$971.59$272.41$194.32
    69310TRebuild outer ear canal025628.82$1,465.27$623.05$293.05
    Start Printed Page 44799
    69320TRebuild outer ear canal025628.82$1,465.27$623.05$293.05
    69399TOuter ear surgery procedure02512.71$137.78$27.99$27.56
    69400TInflate middle ear canal02512.71$137.78$27.99$27.56
    69401NInflate middle ear canal
    69405TCatheterize middle ear canal02526.53$332.00$114.24$66.40
    69410TInset middle ear (baffle)02526.53$332.00$114.24$66.40
    69420TIncision of eardrum02512.71$137.78$27.99$27.56
    69421TIncision of eardrum025313.27$674.67$284.00$134.93
    69424TRemove ventilating tube02526.53$332.00$114.24$66.40
    69433TCreate eardrum opening02526.53$332.00$114.24$66.40
    69436TCreate eardrum opening025313.27$674.67$284.00$134.93
    69440TExploration of middle ear025419.11$971.59$272.41$194.32
    69450TEardrum revision025628.82$1,465.27$623.05$293.05
    69501TMastoidectomy025628.82$1,465.27$623.05$293.05
    69502CMastoidectomy
    69505TRemove mastoid structures025628.82$1,465.27$623.05$293.05
    69511TExtensive mastoid surgery025628.82$1,465.27$623.05$293.05
    69530TExtensive mastoid surgery025628.82$1,465.27$623.05$293.05
    69535CRemove part of temporal bone
    69540TRemove ear lesion025313.27$674.67$284.00$134.93
    69550TRemove ear lesion025628.82$1,465.27$623.05$293.05
    69552TRemove ear lesion025628.82$1,465.27$623.05$293.05
    69554CRemove ear lesion
    69601TMastoid surgery revision025628.82$1,465.27$623.05$293.05
    69602TMastoid surgery revision025628.82$1,465.27$623.05$293.05
    69603TMastoid surgery revision025628.82$1,465.27$623.05$293.05
    69604TMastoid surgery revision025628.82$1,465.27$623.05$293.05
    69605TMastoid surgery revision025628.82$1,465.27$623.05$293.05
    69610TRepair of eardrum025419.11$971.59$272.41$194.32
    69620TRepair of eardrum025419.11$971.59$272.41$194.32
    69631TRepair eardrum structures025628.82$1,465.27$623.05$293.05
    69632TRebuild eardrum structures025628.82$1,465.27$623.05$293.05
    69633TRebuild eardrum structures025628.82$1,465.27$623.05$293.05
    69635TRepair eardrum structures025628.82$1,465.27$623.05$293.05
    69636TRebuild eardrum structures025628.82$1,465.27$623.05$293.05
    69637TRebuild eardrum structures025628.82$1,465.27$623.05$293.05
    69641TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69642TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69643TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69644TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69645TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69646TRevise middle ear & mastoid025628.82$1,465.27$623.05$293.05
    69650TRelease middle ear bone025419.11$971.59$272.41$194.32
    69660TRevise middle ear bone025628.82$1,465.27$623.05$293.05
    69661TRevise middle ear bone025628.82$1,465.27$623.05$293.05
    69662TRevise middle ear bone025628.82$1,465.27$623.05$293.05
    69666TRepair middle ear structures025628.82$1,465.27$623.05$293.05
    69667TRepair middle ear structures025628.82$1,465.27$623.05$293.05
    69670TRemove mastoid air cells025628.82$1,465.27$623.05$293.05
    69676TRemove middle ear nerve025628.82$1,465.27$623.05$293.05
    69700TClose mastoid fistula025628.82$1,465.27$623.05$293.05
    69710EImplant/replace hearing aid
    69711TRemove/repair hearing aid025628.82$1,465.27$623.05$293.05
    69714TImplant temple bone w/stimul025628.82$1,465.27$623.05$293.05
    69715TTemple bne implnt w/stimulat025628.82$1,465.27$623.05$293.05
    69717TTemple bone implant revision025628.82$1,465.27$623.05$293.05
    69718TRevise temple bone implant025628.82$1,465.27$623.05$293.05
    69720TRelease facial nerve025628.82$1,465.27$623.05$293.05
    69725TRelease facial nerve025628.82$1,465.27$623.05$293.05
    69740TRepair facial nerve025628.82$1,465.27$623.05$293.05
    69745TRepair facial nerve025628.82$1,465.27$623.05$293.05
    69799TMiddle ear surgery procedure025313.27$674.67$284.00$134.93
    69801TIncise inner ear025628.82$1,465.27$623.05$293.05
    69802TIncise inner ear025628.82$1,465.27$623.05$293.05
    69805TExplore inner ear025628.82$1,465.27$623.05$293.05
    69806TExplore inner ear025628.82$1,465.27$623.05$293.05
    69820TEstablish inner ear window025628.82$1,465.27$623.05$293.05
    69840TRevise inner ear window025628.82$1,465.27$623.05$293.05
    69905TRemove inner ear025628.82$1,465.27$623.05$293.05
    69910TRemove inner ear & mastoid025628.82$1,465.27$623.05$293.05
    69915TIncise inner ear nerve025628.82$1,465.27$623.05$293.05
    69930TImplant cochlear device0259306.15$15,565.28$6,537.42$3,113.06
    69949TInner ear surgery procedure025313.27$674.67$284.00$134.93
    69950CIncise inner ear nerve
    69955TRelease facial nerve025628.82$1,465.27$623.05$293.05
    Start Printed Page 44800
    69960TRelease inner ear canal025628.82$1,465.27$623.05$293.05
    69970CRemove inner ear lesion
    69979TTemporal bone surgery02512.71$137.78$27.99$27.56
    69990NMicrosurgery add-on
    70010SContrast x-ray of brain02745.69$289.29$128.12$57.86
    70015SContrast x-ray of brain02745.69$289.29$128.12$57.86
    70030XX-ray eye for foreign body02600.76$38.64$21.25$7.73
    70100XX-ray exam of jaw02600.76$38.64$21.25$7.73
    70110XX-ray exam of jaw02600.76$38.64$21.25$7.73
    70120XX-ray exam of mastoids02600.76$38.64$21.25$7.73
    70130XX-ray exam of mastoids02600.76$38.64$21.25$7.73
    70134XX-ray exam of middle ear02611.31$66.60$36.63$13.32
    70140XX-ray exam of facial bones02600.76$38.64$21.25$7.73
    70150XX-ray exam of facial bones02600.76$38.64$21.25$7.73
    70160XX-ray exam of nasal bones02600.76$38.64$21.25$7.73
    70170XX-ray exam of tear duct02631.74$88.47$45.88$17.69
    70190XX-ray exam of eye sockets02600.76$38.64$21.25$7.73
    70200XX-ray exam of eye sockets02600.76$38.64$21.25$7.73
    70210XX-ray exam of sinuses02600.76$38.64$21.25$7.73
    70220XX-ray exam of sinuses02600.76$38.64$21.25$7.73
    70240XX-ray exam, pituitary saddle02600.76$38.64$21.25$7.73
    70250XX-ray exam of skull02600.76$38.64$21.25$7.73
    70260XX-ray exam of skull02611.31$66.60$36.63$13.32
    70300XX-ray exam of teeth02620.66$33.56$10.90$6.71
    70310XX-ray exam of teeth02620.66$33.56$10.90$6.71
    70320XFull mouth x-ray of teeth02620.66$33.56$10.90$6.71
    70328XX-ray exam of jaw joint02600.76$38.64$21.25$7.73
    70330XX-ray exam of jaw joints02600.76$38.64$21.25$7.73
    70332SX-ray exam of jaw joint02752.82$143.37$72.26$28.67
    70336SMagnetic image, jaw joint03355.91$300.48$165.26$60.10
    70350XX-ray head for orthodontia02600.76$38.64$21.25$7.73
    70355XPanoramic x-ray of jaws02600.76$38.64$21.25$7.73
    70360XX-ray exam of neck02600.76$38.64$21.25$7.73
    70370XThroat x-ray & fluoroscopy02721.47$74.74$39.00$14.95
    70371XSpeech evaluation, complex02721.47$74.74$39.00$14.95
    70373XContrast x-ray of larynx02631.74$88.47$45.88$17.69
    70380XX-ray exam of salivary gland02600.76$38.64$21.25$7.73
    70390XX-ray exam of salivary duct02631.74$88.47$45.88$17.69
    70450SCt head/brain w/o dye03323.51$178.46$98.15$35.69
    70460SCt head/brain w/dye02834.89$248.62$136.74$49.72
    70470SCt head/brain w/o&w dye03335.66$287.77$158.27$57.55
    70480SCt orbit/ear/fossa w/o dye03323.51$178.46$98.15$35.69
    70481SCt orbit/ear/fossa w/dye02834.89$248.62$136.74$49.72
    70482SCt orbit/ear/fossa w/o&w dye03335.66$287.77$158.27$57.55
    70486SCt maxillofacial w/o dye03323.51$178.46$98.15$35.69
    70487SCt maxillofacial w/dye02834.89$248.62$136.74$49.72
    70488SCt maxillofacial w/o&w dye03335.66$287.77$158.27$57.55
    70490SCt soft tissue neck w/o dye03323.51$178.46$98.15$35.69
    70491SCt soft tissue neck w/dye02834.89$248.62$136.74$49.72
    70492SCt sft tsue nck w/o & w/dye03335.66$287.77$158.27$57.55
    70496SCt angiography, head03335.66$287.77$158.27$57.55
    70498SCt angiography, neck03335.66$287.77$158.27$57.55
    70540SMri orbit/face/neck w/o dye03366.85$348.27$191.55$69.65
    70542SMri orbit/face/neck w/dye02847.80$396.57$218.11$79.31
    70543SMri orbt/fac/nck w/o&w dye03379.26$470.80$258.94$94.16
    70544SMr angiography head w/o dye03366.85$348.27$191.55$69.65
    70545SMr angiography head w/dye02847.80$396.57$218.11$79.31
    70546SMr angiograph head w/o&w dye03379.26$470.80$258.94$94.16
    70547SMr angiography neck w/o dye03366.85$348.27$191.55$69.65
    70548SMr angiography neck w/dye02847.80$396.57$218.11$79.31
    70549SMr angiograph neck w/o&w dye03379.26$470.80$258.94$94.16
    70551SMri brain w/o dye03366.85$348.27$191.55$69.65
    70552SMri brain w/dye02847.80$396.57$218.11$79.31
    70553SMri brain w/o&w dye03379.26$470.80$258.94$94.16
    71010XChest x-ray02600.76$38.64$21.25$7.73
    71015XChest x-ray02600.76$38.64$21.25$7.73
    71020XChest x-ray02600.76$38.64$21.25$7.73
    71021XChest x-ray02600.76$38.64$21.25$7.73
    71022XChest x-ray02600.76$38.64$21.25$7.73
    71023XChest x-ray and fluoroscopy02721.47$74.74$39.00$14.95
    71030XChest x-ray02600.76$38.64$21.25$7.73
    71034XChest x-ray and fluoroscopy02721.47$74.74$39.00$14.95
    71035XChest x-ray02600.76$38.64$21.25$7.73
    71040XContrast x-ray of bronchi02631.74$88.47$45.88$17.69
    71060XContrast x-ray of bronchi02631.74$88.47$45.88$17.69
    Start Printed Page 44801
    71090XX-ray & pacemaker insertion02721.47$74.74$39.00$14.95
    71100XX-ray exam of ribs02600.76$38.64$21.25$7.73
    71101XX-ray exam of ribs/chest02600.76$38.64$21.25$7.73
    71110XX-ray exam of ribs02600.76$38.64$21.25$7.73
    71111XX-ray exam of ribs/ chest02611.31$66.60$36.63$13.32
    71120XX-ray exam of breastbone02600.76$38.64$21.25$7.73
    71130XX-ray exam of breastbone02600.76$38.64$21.25$7.73
    71250SCt thorax w/o dye03323.51$178.46$98.15$35.69
    71260SCt thorax w/dye02834.89$248.62$136.74$49.72
    71270SCt thorax w/o&w dye03335.66$287.77$158.27$57.55
    71275SCt angiography, chest03335.66$287.77$158.27$57.55
    71550SMri chest w/o dye03366.85$348.27$191.55$69.65
    71551SMri chest w/dye02847.80$396.57$218.11$79.31
    71552SMri chest w/o&w dye03379.26$470.80$258.94$94.16
    71555EMri angio chest w or w/o dye
    72010XX-ray exam of spine02611.31$66.60$36.63$13.32
    72020XX-ray exam of spine02600.76$38.64$21.25$7.73
    72040XX-ray exam of neck spine02600.76$38.64$21.25$7.73
    72050XX-ray exam of neck spine02611.31$66.60$36.63$13.32
    72052XX-ray exam of neck spine02611.31$66.60$36.63$13.32
    72069XX-ray exam of trunk spine02600.76$38.64$21.25$7.73
    72070XX-ray exam of thoracic spine02600.76$38.64$21.25$7.73
    72072XX-ray exam of thoracic spine02600.76$38.64$21.25$7.73
    72074XX-ray exam of thoracic spine02600.76$38.64$21.25$7.73
    72080XX-ray exam of trunk spine02600.76$38.64$21.25$7.73
    72090XX-ray exam of trunk spine02611.31$66.60$36.63$13.32
    72100XX-ray exam of lower spine02600.76$38.64$21.25$7.73
    72110XX-ray exam of lower spine02611.31$66.60$36.63$13.32
    72114XX-ray exam of lower spine02611.31$66.60$36.63$13.32
    72120XX-ray exam of lower spine02600.76$38.64$21.25$7.73
    72125SCt neck spine w/o dye03323.51$178.46$98.15$35.69
    72126SCt neck spine w/dye02834.89$248.62$136.74$49.72
    72127SCt neck spine w/o&w dye03335.66$287.77$158.27$57.55
    72128SCt chest spine w/o dye03323.51$178.46$98.15$35.69
    72129SCt chest spine w/dye02834.89$248.62$136.74$49.72
    72130SCt chest spine w/o&w dye03335.66$287.77$158.27$57.55
    72131SCt lumbar spine w/o dye03323.51$178.46$98.15$35.69
    72132SCt lumbar spine w/dye02834.89$248.62$136.74$49.72
    72133SCt lumbar spine w/o&w dye03335.66$287.77$158.27$57.55
    72141SMri neck spine w/o dye03366.85$348.27$191.55$69.65
    72142SMri neck spine w/dye02847.80$396.57$218.11$79.31
    72146SMri chest spine w/o dye03366.85$348.27$191.55$69.65
    72147SMri chest spine w/dye02847.80$396.57$218.11$79.31
    72148SMri lumbar spine w/o dye03366.85$348.27$191.55$69.65
    72149SMri lumbar spine w/dye02847.80$396.57$218.11$79.31
    72156SMri neck spine w/o&w dye03379.26$470.80$258.94$94.16
    72157SMri chest spine w/o&w dye03379.26$470.80$258.94$94.16
    72158SMri lumbar spine w/o&w dye03379.26$470.80$258.94$94.16
    72159EMr angio spine w/o&w dye
    72170XX-ray exam of pelvis02600.76$38.64$21.25$7.73
    72190XX-ray exam of pelvis02600.76$38.64$21.25$7.73
    72191SCt angiograph pelv w/o&w dye03335.66$287.77$158.27$57.55
    72192SCt pelvis w/o dye03323.51$178.46$98.15$35.69
    72193SCt pelvis w/dye02834.89$248.62$136.74$49.72
    72194SCt pelvis w/o&w dye03335.66$287.77$158.27$57.55
    72195SMri pelvis w/o dye03366.85$348.27$191.55$69.65
    72196SMri pelvis w/dye02847.80$396.57$218.11$79.31
    72197SMri pelvis w/o & w dye03379.26$470.80$258.94$94.16
    72198EMr angio pelvis w/o&w dye
    72200XX-ray exam sacroiliac joints02600.76$38.64$21.25$7.73
    72202XX-ray exam sacroiliac joints02600.76$38.64$21.25$7.73
    72220XX-ray exam of tailbone02600.76$38.64$21.25$7.73
    72240SContrast x-ray of neck spine02745.69$289.29$128.12$57.86
    72255SContrast x-ray, thorax spine02745.69$289.29$128.12$57.86
    72265SContrast x-ray, lower spine02745.69$289.29$128.12$57.86
    72270SContrast x-ray of spine02745.69$289.29$128.12$57.86
    72275SEpidurography02745.69$289.29$128.12$57.86
    72285SX-ray c/t spine disk02745.69$289.29$128.12$57.86
    72295SX-ray of lower spine disk02745.69$289.29$128.12$57.86
    73000XX-ray exam of collar bone02600.76$38.64$21.25$7.73
    73010XX-ray exam of shoulder blade02600.76$38.64$21.25$7.73
    73020XX-ray exam of shoulder02600.76$38.64$21.25$7.73
    73030XX-ray exam of shoulder02600.76$38.64$21.25$7.73
    73040SContrast x-ray of shoulder02752.82$143.37$72.26$28.67
    73050XX-ray exam of shoulders02600.76$38.64$21.25$7.73
    Start Printed Page 44802
    73060XX-ray exam of humerus02600.76$38.64$21.25$7.73
    73070XX-ray exam of elbow02600.76$38.64$21.25$7.73
    73080XX-ray exam of elbow02600.76$38.64$21.25$7.73
    73085SContrast x-ray of elbow02752.82$143.37$72.26$28.67
    73090XX-ray exam of forearm02600.76$38.64$21.25$7.73
    73092XX-ray exam of arm, infant02600.76$38.64$21.25$7.73
    73100XX-ray exam of wrist02600.76$38.64$21.25$7.73
    73110XX-ray exam of wrist02600.76$38.64$21.25$7.73
    73115SContrast x-ray of wrist02752.82$143.37$72.26$28.67
    73120XX-ray exam of hand02600.76$38.64$21.25$7.73
    73130XX-ray exam of hand02600.76$38.64$21.25$7.73
    73140XX-ray exam of finger(s)02600.76$38.64$21.25$7.73
    73200SCt upper extremity w/o dye03323.51$178.46$98.15$35.69
    73201SCt upper extremity w/dye02834.89$248.62$136.74$49.72
    73202SCt uppr extremity w/o&w dye03335.66$287.77$158.27$57.55
    73206SCt angio upr extrm w/o&w dye03335.66$287.77$158.27$57.55
    73218SMri upper extremity w/o dye03366.85$348.27$191.55$69.65
    73219SMri upper extremity w/dye02847.80$396.57$218.11$79.31
    73220SMri uppr extremity w/o&w dye03379.26$470.80$258.94$94.16
    73221SMri joint upr extrem w/o dye03366.85$348.27$191.55$69.65
    73222SMri joint upr extrem w/ dye02847.80$396.57$218.11$79.31
    73223SMri joint upr extr w/o&w dye03379.26$470.80$258.94$94.16
    73225EMr angio upr extr w/o&w dye
    73500XX-ray exam of hip02600.76$38.64$21.25$7.73
    73510XX-ray exam of hip02600.76$38.64$21.25$7.73
    73520XX-ray exam of hips02600.76$38.64$21.25$7.73
    73525SContrast x-ray of hip02752.82$143.37$72.26$28.67
    73530XX-ray exam of hip02611.31$66.60$36.63$13.32
    73540XX-ray exam of pelvis & hips02600.76$38.64$21.25$7.73
    73542SX-ray exam, sacroiliac joint02752.82$143.37$72.26$28.67
    73550XX-ray exam of thigh02600.76$38.64$21.25$7.73
    73560XX-ray exam of knee, 1 or 202600.76$38.64$21.25$7.73
    73562XX-ray exam of knee, 302600.76$38.64$21.25$7.73
    73564XX-ray exam, knee, 4 or more02600.76$38.64$21.25$7.73
    73565XX-ray exam of knees02600.76$38.64$21.25$7.73
    73580SContrast x-ray of knee joint02752.82$143.37$72.26$28.67
    73590XX-ray exam of lower leg02600.76$38.64$21.25$7.73
    73592XX-ray exam of leg, infant02611.31$66.60$36.63$13.32
    73600XX-ray exam of ankle02600.76$38.64$21.25$7.73
    73610XX-ray exam of ankle02600.76$38.64$21.25$7.73
    73615SContrast x-ray of ankle02752.82$143.37$72.26$28.67
    73620XX-ray exam of foot02600.76$38.64$21.25$7.73
    73630XX-ray exam of foot02600.76$38.64$21.25$7.73
    73650XX-ray exam of heel02600.76$38.64$21.25$7.73
    73660XX-ray exam of toe(s)02600.76$38.64$21.25$7.73
    73700SCt lower extremity w/o dye03323.51$178.46$98.15$35.69
    73701SCt lower extremity w/dye02834.89$248.62$136.74$49.72
    73702SCt lwr extremity w/o&w dye03335.66$287.77$158.27$57.55
    73706SCt angio lwr extr w/o&w dye03335.66$287.77$158.27$57.55
    73718SMri lower extremity w/o dye03366.85$348.27$191.55$69.65
    73719SMri lower extremity w/dye02847.80$396.57$218.11$79.31
    73720SMri lwr extremity w/o&w dye03379.26$470.80$258.94$94.16
    73721SMri joint of lwr extre w/o d03366.85$348.27$191.55$69.65
    73722SMri joint of lwr extr w/dye02847.80$396.57$218.11$79.31
    73723SMri joint lwr extr w/o&w dye03379.26$470.80$258.94$94.16
    73725EMr ang lwr ext w or w/o dye
    74000XX-ray exam of abdomen02600.76$38.64$21.25$7.73
    74010XX-ray exam of abdomen02600.76$38.64$21.25$7.73
    74020XX-ray exam of abdomen02600.76$38.64$21.25$7.73
    74022XX-ray exam series, abdomen02611.31$66.60$36.63$13.32
    74150SCt abdomen w/o dye03323.51$178.46$98.15$35.69
    74160SCt abdomen w/dye02834.89$248.62$136.74$49.72
    74170SCt abdomen w/o&w dye03335.66$287.77$158.27$57.55
    74175SCt angio abdom w/o&w dye03335.66$287.77$158.27$57.55
    74181SMri abdomen w/o dye03366.85$348.27$191.55$69.65
    74182SMri abdomen w/dye02847.80$396.57$218.11$79.31
    74183SMri abdomen w/o&w dye03379.26$470.80$258.94$94.16
    74185EMri angio, abdom w or w/o dy
    74190XX-ray exam of peritoneum02631.74$88.47$45.88$17.69
    74210SContrst x-ray exam of throat02761.63$82.87$45.58$16.57
    74220SContrast x-ray, esophagus02761.63$82.87$45.58$16.57
    74230SCinema x-ray, throat/esoph02761.63$82.87$45.58$16.57
    74235SRemove esophagus obstruction02963.52$178.96$98.43$35.79
    74240SX-ray exam, upper gi tract02761.63$82.87$45.58$16.57
    74241SX-ray exam, upper gi tract02761.63$82.87$45.58$16.57
    Start Printed Page 44803
    74245SX-ray exam, upper gi tract02772.35$119.48$65.71$23.90
    74246SContrst x-ray uppr gi tract02761.63$82.87$45.58$16.57
    74247SContrst x-ray uppr gi tract02761.63$82.87$45.58$16.57
    74249SContrst x-ray uppr gi tract02772.35$119.48$65.71$23.90
    74250SX-ray exam of small bowel02761.63$82.87$45.58$16.57
    74251SX-ray exam of small bowel02772.35$119.48$65.71$23.90
    74260SX-ray exam of small bowel02772.35$119.48$65.71$23.90
    74270SContrast x-ray exam of colon02761.63$82.87$45.58$16.57
    74280SContrast x-ray exam of colon02772.35$119.48$65.71$23.90
    74283SContrast x-ray exam of colon02761.63$82.87$45.58$16.57
    74290SContrast x-ray, gallbladder02761.63$82.87$45.58$16.57
    74291SContrast x-rays, gallbladder02761.63$82.87$45.58$16.57
    74300XX-ray bile ducts/pancreas02631.74$88.47$45.88$17.69
    74301XX-rays at surgery add-on02631.74$88.47$45.88$17.69
    74305XX-ray bile ducts/pancreas02631.74$88.47$45.88$17.69
    74320XContrast x-ray of bile ducts02642.51$127.61$70.19$25.52
    74327SX-ray bile stone removal02963.52$178.96$98.43$35.79
    74328NXray bile duct endoscopy
    74329NX-ray for pancreas endoscopy
    74330NX-ray bile/panc endoscopy
    74340XX-ray guide for GI tube02721.47$74.74$39.00$14.95
    74350TX-ray guide, stomach tube01874.54$230.82$113.10$46.16
    74355TX-ray guide, intestinal tube01874.54$230.82$113.10$46.16
    74360SX-ray guide, GI dilation02963.52$178.96$98.43$35.79
    74363SX-ray, bile duct dilation02977.80$396.57$172.51$79.31
    74400SContrst x-ray, urinary tract02782.56$130.16$71.59$26.03
    74410SContrst x-ray, urinary tract02782.56$130.16$71.59$26.03
    74415SContrst x-ray, urinary tract02782.56$130.16$71.59$26.03
    74420SContrst x-ray, urinary tract02782.56$130.16$71.59$26.03
    74425SContrst x-ray, urinary tract02782.56$130.16$71.59$26.03
    74430SContrast x-ray, bladder02782.56$130.16$71.59$26.03
    74440SX-ray, male genital tract02782.56$130.16$71.59$26.03
    74445SX-ray exam of penis02782.56$130.16$71.59$26.03
    74450SX-ray, urethra/bladder02782.56$130.16$71.59$26.03
    74455SX-ray, urethra/bladder02782.56$130.16$71.59$26.03
    74470XX-ray exam of kidney lesion02642.51$127.61$70.19$25.52
    74475SX-ray control, cath insert02977.80$396.57$172.51$79.31
    74480SX-ray control, cath insert02977.80$396.57$172.51$79.31
    74485SX-ray guide, GU dilation02963.52$178.96$98.43$35.79
    74710XX-ray measurement of pelvis02600.76$38.64$21.25$7.73
    74740XX-ray, female genital tract02642.51$127.61$70.19$25.52
    74742TX-ray, fallopian tube01874.54$230.82$113.10$46.16
    74775SX-ray exam of perineum02782.56$130.16$71.59$26.03
    75552SHeart mri for morph w/o dye03366.85$348.27$191.55$69.65
    75553SHeart mri for morph w/dye02847.80$396.57$218.11$79.31
    75554SCardiac MRI/function03355.91$300.48$165.26$60.10
    75555SCardiac MRI/limited study03355.91$300.48$165.26$60.10
    75556ECardiac MRI/flow mapping
    75600SContrast x-ray exam of aorta028014.40$732.12$373.38$146.42
    75605SContrast x-ray exam of aorta028014.40$732.12$373.38$146.42
    75625SContrast x-ray exam of aorta028014.40$732.12$373.38$146.42
    75630SX-ray aorta, leg arteries028014.40$732.12$373.38$146.42
    75635SCt angio abdominal arteries03335.66$287.77$158.27$57.55
    75650SArtery x-rays, head & neck028014.40$732.12$373.38$146.42
    75658SArtery x-rays, arm028014.40$732.12$373.38$146.42
    75660SArtery x-rays, head & neck02798.37$425.55$174.57$85.11
    75662SArtery x-rays, head & neck02798.37$425.55$174.57$85.11
    75665SArtery x-rays, head & neck028014.40$732.12$373.38$146.42
    75671SArtery x-rays, head & neck028014.40$732.12$373.38$146.42
    75676SArtery x-rays, neck028014.40$732.12$373.38$146.42
    75680SArtery x-rays, neck028014.40$732.12$373.38$146.42
    75685SArtery x-rays, spine02798.37$425.55$174.57$85.11
    75705SArtery x-rays, spine02798.37$425.55$174.57$85.11
    75710SArtery x-rays, arm/leg028014.40$732.12$373.38$146.42
    75716SArtery x-rays, arms/legs028014.40$732.12$373.38$146.42
    75722SArtery x-rays, kidney028014.40$732.12$373.38$146.42
    75724SArtery x-rays, kidneys028014.40$732.12$373.38$146.42
    75726SArtery x-rays, abdomen028014.40$732.12$373.38$146.42
    75731SArtery x-rays, adrenal gland028014.40$732.12$373.38$146.42
    75733SArtery x-rays, adrenals028014.40$732.12$373.38$146.42
    75736SArtery x-rays, pelvis028014.40$732.12$373.38$146.42
    75741SArtery x-rays, lung02798.37$425.55$174.57$85.11
    75743SArtery x-rays, lungs028014.40$732.12$373.38$146.42
    75746SArtery x-rays, lung02798.37$425.55$174.57$85.11
    75756SArtery x-rays, chest02798.37$425.55$174.57$85.11
    Start Printed Page 44804
    75774SArtery x-ray, each vessel02798.37$425.55$174.57$85.11
    75790SVisualize A-V shunt02814.64$235.91$115.16$47.18
    75801XLymph vessel x-ray, arm/leg02642.51$127.61$70.19$25.52
    75803XLymph vessel x-ray,arms/legs02642.51$127.61$70.19$25.52
    75805XLymph vessel x-ray, trunk02642.51$127.61$70.19$25.52
    75807XLymph vessel x-ray, trunk02642.51$127.61$70.19$25.52
    75809XNonvascular shunt, x-ray02631.74$88.47$45.88$17.69
    75810SVein x-ray, spleen/liver02798.37$425.55$174.57$85.11
    75820SVein x-ray, arm/leg02814.64$235.91$115.16$47.18
    75822SVein x-ray, arms/legs02814.64$235.91$115.16$47.18
    75825SVein x-ray, trunk02798.37$425.55$174.57$85.11
    75827SVein x-ray, chest02798.37$425.55$174.57$85.11
    75831SVein x-ray, kidney02874.33$220.15$90.26$44.03
    75833SVein x-ray, kidneys02798.37$425.55$174.57$85.11
    75840SVein x-ray, adrenal gland02874.33$220.15$90.26$44.03
    75842SVein x-ray, adrenal glands02874.33$220.15$90.26$44.03
    75860SVein x-ray, neck02874.33$220.15$90.26$44.03
    75870SVein x-ray, skull02874.33$220.15$90.26$44.03
    75872SVein x-ray, skull02874.33$220.15$90.26$44.03
    75880SVein x-ray, eye socket02874.33$220.15$90.26$44.03
    75885SVein x-ray, liver02798.37$425.55$174.57$85.11
    75887SVein x-ray, liver028014.40$732.12$373.38$146.42
    75889SVein x-ray, liver02798.37$425.55$174.57$85.11
    75891SVein x-ray, liver02798.37$425.55$174.57$85.11
    75893NVenous sampling by catheter
    75894SX-rays, transcath therapy02977.80$396.57$172.51$79.31
    75896SX-rays, transcath therapy02977.80$396.57$172.51$79.31
    75898XFollow-up angiogram02642.51$127.61$70.19$25.52
    75900CArterial catheter exchange
    75940TX-ray placement, vein filter01874.54$230.82$113.10$46.16
    75945SIntravascular us02672.58$131.17$72.14$26.23
    75946SIntravascular us add-on02672.58$131.17$72.14$26.23
    75952CEndovasc repair abdom aorta
    75953CAbdom aneurysm endovas rpr
    75960STranscatheter intro, stent028014.40$732.12$373.38$146.42
    75961SRetrieval, broken catheter028014.40$732.12$373.38$146.42
    75962SRepair arterial blockage028014.40$732.12$373.38$146.42
    75964SRepair artery blockage, each028014.40$732.12$373.38$146.42
    75966SRepair arterial blockage028014.40$732.12$373.38$146.42
    75968SRepair artery blockage, each028014.40$732.12$373.38$146.42
    75970SVascular biopsy028014.40$732.12$373.38$146.42
    75978SRepair venous blockage028014.40$732.12$373.38$146.42
    75980SContrast xray exam bile duct02977.80$396.57$172.51$79.31
    75982SContrast xray exam bile duct02977.80$396.57$172.51$79.31
    75984SXray control catheter change02963.52$178.96$98.43$35.79
    75989NAbscess drainage under x-ray
    75992SAtherectomy, x-ray exam028014.40$732.12$373.38$146.42
    75993TAtherectomy, x-ray exam008122.04$1,120.56$549.07$224.11
    75994TAtherectomy, x-ray exam008122.04$1,120.56$549.07$224.11
    75995SAtherectomy, x-ray exam028014.40$732.12$373.38$146.42
    75996TAtherectomy, x-ray exam008122.04$1,120.56$549.07$224.11
    76000XFluoroscope examination02721.47$74.74$39.00$14.95
    76001NFluoroscope exam, extensive
    76003NNeedle localization by x-ray
    76005NFluoroguide for spine inject
    76006XX-ray stress view02611.31$66.60$36.63$13.32
    76010XX-ray, nose to rectum02600.76$38.64$21.25$7.73
    76012SPercut vertebroplasty fluor02745.69$289.29$128.12$57.86
    76013SPercut vertebroplasty, ct02745.69$289.29$128.12$57.86
    76020XX-rays for bone age02611.31$66.60$36.63$13.32
    76040XX-rays, bone evaluation02600.76$38.64$21.25$7.73
    76061XX-rays, bone survey02611.31$66.60$36.63$13.32
    76062XX-rays, bone survey02611.31$66.60$36.63$13.32
    76065XX-rays, bone evaluation02611.31$66.60$36.63$13.32
    76066XJoint(s) survey, single film02600.76$38.64$21.25$7.73
    76070ECT scan, bone density study
    76075SDual energy x-ray study09711.42$72.20$14.44
    76076SDual energy x-ray study09711.42$72.20$14.44
    76078XPhotodensitometry02611.31$66.60$36.63$13.32
    76080XX-ray exam of fistula02631.74$88.47$45.88$17.69
    76086XX-ray of mammary duct02631.74$88.47$45.88$17.69
    76088XX-ray of mammary ducts02631.74$88.47$45.88$17.69
    76090SMammogram, one breast02710.64$32.54$17.90$6.51
    76091SMammogram, both breasts02710.64$32.54$17.90$6.51
    76092AMammogram, screening
    Start Printed Page 44805
    76093EMagnetic image, breast
    76094EMagnetic image, both breasts
    76095TStereotactic breast biopsy01874.54$230.82$113.10$46.16
    76096XX-ray of needle wire, breast02891.22$62.03$32.25$12.41
    76098XX-ray exam, breast specimen02600.76$38.64$21.25$7.73
    76100XX-ray exam of body section02611.31$66.60$36.63$13.32
    76101XComplex body section x-ray02631.74$88.47$45.88$17.69
    76102XComplex body section x-rays02642.51$127.61$70.19$25.52
    76120XCinematic x-rays02611.31$66.60$36.63$13.32
    76125XCinematic x-rays add-on02611.31$66.60$36.63$13.32
    76140EX-ray consultation
    76150XX-ray exam, dry process02600.76$38.64$21.25$7.73
    76350NSpecial x-ray contrast study
    76355SCAT scan for localization02834.89$248.62$136.74$49.72
    76360SCAT scan for needle biopsy02834.89$248.62$136.74$49.72
    76370SCAT scan for therapy guide02821.63$82.87$45.58$16.57
    76375S3d/holograph reconstr add-on02821.63$82.87$45.58$16.57
    76380SCAT scan follow-up study02821.63$82.87$45.58$16.57
    76390SMr spectroscopy03355.91$300.48$165.26$60.10
    76393NMr guidance for needle place
    76400SMagnetic image, bone marrow03355.91$300.48$165.26$60.10
    76499XRadiographic procedure02600.76$38.64$21.25$7.73
    76506SEcho exam of head02661.67$84.91$46.70$16.98
    76511SEcho exam of eye02661.67$84.91$46.70$16.98
    76512SEcho exam of eye02661.67$84.91$46.70$16.98
    76513SEcho exam of eye, water bath02651.02$51.86$28.52$10.37
    76516SEcho exam of eye02661.67$84.91$46.70$16.98
    76519SEcho exam of eye02661.67$84.91$46.70$16.98
    76529SEcho exam of eye02651.02$51.86$28.52$10.37
    76536SEcho exam of head and neck02661.67$84.91$46.70$16.98
    76604SEcho exam of chest02661.67$84.91$46.70$16.98
    76645SEcho exam of breast(s)02651.02$51.86$28.52$10.37
    76700SEcho exam of abdomen02661.67$84.91$46.70$16.98
    76705SEcho exam of abdomen02661.67$84.91$46.70$16.98
    76770SEcho exam abdomen back wall02661.67$84.91$46.70$16.98
    76775SEcho exam abdomen back wall02661.67$84.91$46.70$16.98
    76778SEcho exam kidney transplant02661.67$84.91$46.70$16.98
    76800SEcho exam spinal canal02661.67$84.91$46.70$16.98
    76805SEcho exam of pregnant uterus02661.67$84.91$46.70$16.98
    76810SEcho exam of pregnant uterus02651.02$51.86$28.52$10.37
    76815SEcho exam of pregnant uterus02651.02$51.86$28.52$10.37
    76816SEcho exam follow-up/repeat02651.02$51.86$28.52$10.37
    76818SFetl biophys profil w/stress02661.67$84.91$46.70$16.98
    76819SFetl biophys profil w/o strs02661.67$84.91$46.70$16.98
    76825SEcho exam of fetal heart02694.31$219.13$113.95$43.83
    76826SEcho exam of fetal heart06972.00$101.68$52.88$20.34
    76827SEcho exam of fetal heart02694.31$219.13$113.95$43.83
    76828SEcho exam of fetal heart06972.00$101.68$52.88$20.34
    76830SEcho exam, transvaginal02661.67$84.91$46.70$16.98
    76831SEcho exam, uterus02661.67$84.91$46.70$16.98
    76856SEcho exam of pelvis02661.67$84.91$46.70$16.98
    76857SEcho exam of pelvis02651.02$51.86$28.52$10.37
    76870SEcho exam of scrotum02661.67$84.91$46.70$16.98
    76872SEcho exam, transrectal02661.67$84.91$46.70$16.98
    76873NEchograp trans r, pros study
    76880SEcho exam of extremity02661.67$84.91$46.70$16.98
    76885SEcho exam, infant hips02661.67$84.91$46.70$16.98
    76886SEcho exam, infant hips02661.67$84.91$46.70$16.98
    76930NEcho guide, cardiocentesis
    76932NEcho guide for heart biopsy
    76936NEcho guide for artery repair
    76941NEcho guide for transfusion
    76942NEcho guide for biopsy
    76945NEcho guide, villus sampling
    76946NEcho guide for amniocentesis
    76948NEcho guide, ova aspiration
    76950NEcho guidance radiotherapy
    76965NEcho guidance radiotherapy
    76970SUltrasound exam follow-up02651.02$51.86$28.52$10.37
    76975SGI endoscopic ultrasound02661.67$84.91$46.70$16.98
    76977SUs bone density measure02651.02$51.86$28.52$10.37
    76986SUltrasound guide intraoper02661.67$84.91$46.70$16.98
    76999SEcho examination procedure02661.67$84.91$46.70$16.98
    77261ERadiation therapy planning
    77262ERadiation therapy planning
    Start Printed Page 44806
    77263ERadiation therapy planning
    77280XSet radiation therapy field03041.80$91.52$41.52$18.30
    77285XSet radiation therapy field03054.40$223.70$97.50$44.74
    77290XSet radiation therapy field03054.40$223.70$97.50$44.74
    77295XSet radiation therapy field031017.14$871.43$339.05$174.29
    77299ERadiation therapy planning
    77300XRadiation therapy dose plan03041.80$91.52$41.52$18.30
    77305XRadiation therapy dose plan03041.80$91.52$41.52$18.30
    77310XRadiation therapy dose plan03041.80$91.52$41.52$18.30
    77315XRadiation therapy dose plan03054.40$223.70$97.50$44.74
    77321XRadiation therapy port plan03054.40$223.70$97.50$44.74
    77326XRadiation therapy dose plan03054.40$223.70$97.50$44.74
    77327XRadiation therapy dose plan03054.40$223.70$97.50$44.74
    77328XRadiation therapy dose plan03054.40$223.70$97.50$44.74
    77331XSpecial radiation dosimetry03041.80$91.52$41.52$18.30
    77332XRadiation treatment aid(s)03033.98$202.35$69.28$40.47
    77333XRadiation treatment aid(s)03033.98$202.35$69.28$40.47
    77334XRadiation treatment aid(s)03033.98$202.35$69.28$40.47
    77336XRadiation physics consult03041.80$91.52$41.52$18.30
    77370XRadiation physics consult03054.40$223.70$97.50$44.74
    77399XExternal radiation dosimetry03041.80$91.52$41.52$18.30
    77401SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77402SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77403SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77404SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77406SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77407SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77408SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77409SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77411SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77412SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77413SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77414SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77416SRadiation treatment delivery03002.25$114.39$47.72$22.88
    77417XRadiology port film(s)02600.76$38.64$21.25$7.73
    77427ERadiation tx management, x5
    77431ERadiation therapy management
    77432EStereotactic radiation trmt
    77470SSpecial radiation treatment030211.96$608.07$216.55$121.61
    77499ERadiation therapy management
    77520SProton trmt, simple w/o comp09747.57$384.87$76.97
    77522SProton trmt, simple w/comp09747.57$384.87$76.97
    77523SProton trmt, intermediate097616.56$841.94$168.39
    77525SProton treatment, complex097616.56$841.94$168.39
    77600SHyperthermia treatment03145.16$262.34$133.80$52.47
    77605SHyperthermia treatment03145.16$262.34$133.80$52.47
    77610SHyperthermia treatment03145.16$262.34$133.80$52.47
    77615SHyperthermia treatment03145.16$262.34$133.80$52.47
    77620SHyperthermia treatment03145.16$262.34$133.80$52.47
    77750SInfuse radioactive materials03015.85$297.43$59.49$59.49
    77761SApply intrcav radiat simple03127.77$395.04$109.65$79.01
    77762SApply intrcav radiat interm03127.77$395.04$109.65$79.01
    77763SApply intrcav radiat compl03127.77$395.04$109.65$79.01
    77776SApply interstit radiat simpl03127.77$395.04$109.65$79.01
    77777SApply interstit radiat inter03127.77$395.04$109.65$79.01
    77778SApply iterstit radiat compl03127.77$395.04$109.65$79.01
    77781SHigh intensity brachytherapy031316.31$829.23$165.85$165.85
    77782SHigh intensity brachytherapy031316.31$829.23$165.85$165.85
    77783SHigh intensity brachytherapy031316.31$829.23$165.85$165.85
    77784SHigh intensity brachytherapy031316.31$829.23$165.85$165.85
    77789SApply surface radiation03002.25$114.39$47.72$22.88
    77790NRadiation handling
    77799SRadium/radioisotope therapy031316.31$829.23$165.85$165.85
    78000SThyroid, single uptake02901.91$97.11$53.41$19.42
    78001SThyroid, multiple uptakes02901.91$97.11$53.41$19.42
    78003SThyroid suppress/stimul02901.91$97.11$53.41$19.42
    78006SThyroid imaging with uptake02913.78$192.18$90.20$38.44
    78007SThyroid image, mult uptakes02913.78$192.18$90.20$38.44
    78010SThyroid imaging02901.91$97.11$53.41$19.42
    78011SThyroid imaging with flow02901.91$97.11$53.41$19.42
    78015SThyroid met imaging02913.78$192.18$90.20$38.44
    78016SThyroid met imaging/studies02913.78$192.18$90.20$38.44
    78018SThyroid met imaging, body02924.56$231.84$124.85$46.37
    78020SThyroid met uptake02913.78$192.18$90.20$38.44
    78070SParathyroid nuclear imaging02913.78$192.18$90.20$38.44
    Start Printed Page 44807
    78075SAdrenal nuclear imaging02924.56$231.84$124.85$46.37
    78099SEndocrine nuclear procedure02901.91$97.11$53.41$19.42
    78102SBone marrow imaging, ltd02913.78$192.18$90.20$38.44
    78103SBone marrow imaging, mult02924.56$231.84$124.85$46.37
    78104SBone marrow imaging, body02913.78$192.18$90.20$38.44
    78110SPlasma volume, single02913.78$192.18$90.20$38.44
    78111SPlasma volume, multiple02913.78$192.18$90.20$38.44
    78120SRed cell mass, single02913.78$192.18$90.20$38.44
    78121SRed cell mass, multiple02913.78$192.18$90.20$38.44
    78122SBlood volume02924.56$231.84$124.85$46.37
    78130SRed cell survival study02913.78$192.18$90.20$38.44
    78135SRed cell survival kinetics02924.56$231.84$124.85$46.37
    78140SRed cell sequestration02913.78$192.18$90.20$38.44
    78160SPlasma iron turnover02913.78$192.18$90.20$38.44
    78162SIron absorption exam02913.78$192.18$90.20$38.44
    78170SRed cell iron utilization02913.78$192.18$90.20$38.44
    78172STotal body iron estimation02913.78$192.18$90.20$38.44
    78185SSpleen imaging02913.78$192.18$90.20$38.44
    78190SPlatelet survival, kinetics02913.78$192.18$90.20$38.44
    78191SPlatelet survival02913.78$192.18$90.20$38.44
    78195SLymph system imaging02913.78$192.18$90.20$38.44
    78199SBlood/lymph nuclear exam02901.91$97.11$53.41$19.42
    78201SLiver imaging02913.78$192.18$90.20$38.44
    78202SLiver imaging with flow02913.78$192.18$90.20$38.44
    78205SLiver imaging (3D)02924.56$231.84$124.85$46.37
    78206SLiver image (3d) w/flow02924.56$231.84$124.85$46.37
    78215SLiver and spleen imaging02913.78$192.18$90.20$38.44
    78216SLiver & spleen image/flow02913.78$192.18$90.20$38.44
    78220SLiver function study02913.78$192.18$90.20$38.44
    78223SHepatobiliary imaging02924.56$231.84$124.85$46.37
    78230SSalivary gland imaging02913.78$192.18$90.20$38.44
    78231SSerial salivary imaging02913.78$192.18$90.20$38.44
    78232SSalivary gland function exam02913.78$192.18$90.20$38.44
    78258SEsophageal motility study02913.78$192.18$90.20$38.44
    78261SGastric mucosa imaging02913.78$192.18$90.20$38.44
    78262SGastroesophageal reflux exam02913.78$192.18$90.20$38.44
    78264SGastric emptying study02913.78$192.18$90.20$38.44
    78267ABreath tst attain/anal c-14
    78268ABreath test analysis, c-14
    78270SVit B-12 absorption exam02901.91$97.11$53.41$19.42
    78271SVit B-12 absorp exam, IF02901.91$97.11$53.41$19.42
    78272SVit B-12 absorp, combined02913.78$192.18$90.20$38.44
    78278SAcute GI blood loss imaging02913.78$192.18$90.20$38.44
    78282SGI protein loss exam02901.91$97.11$53.41$19.42
    78290SMeckel's divert exam02913.78$192.18$90.20$38.44
    78291SLeveen/shunt patency exam02913.78$192.18$90.20$38.44
    78299SGI nuclear procedure02901.91$97.11$53.41$19.42
    78300SBone imaging, limited area02913.78$192.18$90.20$38.44
    78305SBone imaging, multiple areas02913.78$192.18$90.20$38.44
    78306SBone imaging, whole body02913.78$192.18$90.20$38.44
    78315SBone imaging, 3 phase02924.56$231.84$124.85$46.37
    78320SBone imaging (3D)02924.56$231.84$124.85$46.37
    78350XBone mineral, single photon02611.31$66.60$36.63$13.32
    78351EBone mineral, dual photon
    78399SMusculoskeletal nuclear exam02901.91$97.11$53.41$19.42
    78414SNon-imaging heart function02924.56$231.84$124.85$46.37
    78428SCardiac shunt imaging02924.56$231.84$124.85$46.37
    78445SVascular flow imaging02913.78$192.18$90.20$38.44
    78455SVenous thrombosis study02913.78$192.18$90.20$38.44
    78456SAcute venous thrombus image02913.78$192.18$90.20$38.44
    78457SVenous thrombosis imaging02913.78$192.18$90.20$38.44
    78458SVen thrombosis images, bilat02913.78$192.18$90.20$38.44
    78459EHeart muscle imaging (PET)
    78460SHeart muscle blood, single02865.85$297.43$163.58$59.49
    78461SHeart muscle blood, multiple02865.85$297.43$163.58$59.49
    78464SHeart image (3d), single02865.85$297.43$163.58$59.49
    78465SHeart image (3d), multiple02865.85$297.43$163.58$59.49
    78466SHeart infarct image02913.78$192.18$90.20$38.44
    78468SHeart infarct image (ef)02924.56$231.84$124.85$46.37
    78469SHeart infarct image (3D)02924.56$231.84$124.85$46.37
    78472SGated heart, planar, single02865.85$297.43$163.58$59.49
    78473SGated heart, multiple02865.85$297.43$163.58$59.49
    78478SHeart wall motion add-on02865.85$297.43$163.58$59.49
    78480SHeart function add-on02865.85$297.43$163.58$59.49
    78481SHeart first pass, single02865.85$297.43$163.58$59.49
    Start Printed Page 44808
    78483SHeart first pass, multiple02865.85$297.43$163.58$59.49
    78491EHeart image (pet), single
    78492EHeart image (pet), multiple
    78494SHeart image, spect02963.52$178.96$98.43$35.79
    78496SHeart first pass add-on02963.52$178.96$98.43$35.79
    78499SCardiovascular nuclear exam02913.78$192.18$90.20$38.44
    78580SLung perfusion imaging02913.78$192.18$90.20$38.44
    78584SLung V/Q image single breath02924.56$231.84$124.85$46.37
    78585SLung V/Q imaging02924.56$231.84$124.85$46.37
    78586SAerosol lung image, single02924.56$231.84$124.85$46.37
    78587SAerosol lung image, multiple02913.78$192.18$90.20$38.44
    78588SPerfusion lung image02924.56$231.84$124.85$46.37
    78591SVent image, 1 breath, 1 proj02913.78$192.18$90.20$38.44
    78593SVent image, 1 proj, gas02924.56$231.84$124.85$46.37
    78594SVent image, mult proj, gas02924.56$231.84$124.85$46.37
    78596SLung differential function02924.56$231.84$124.85$46.37
    78599SRespiratory nuclear exam02913.78$192.18$90.20$38.44
    78600SBrain imaging, ltd static02924.56$231.84$124.85$46.37
    78601SBrain imaging, ltd w/ flow02913.78$192.18$90.20$38.44
    78605SBrain imaging, complete02913.78$192.18$90.20$38.44
    78606SBrain imaging, compl w/flow02924.56$231.84$124.85$46.37
    78607SBrain imaging (3D)02924.56$231.84$124.85$46.37
    78608EBrain imaging (PET)
    78609EBrain imaging (PET)
    78610SBrain flow imaging only02913.78$192.18$90.20$38.44
    78615SCerebral blood flow imaging02913.78$192.18$90.20$38.44
    78630SCerebrospinal fluid scan02924.56$231.84$124.85$46.37
    78635SCSF ventriculography02924.56$231.84$124.85$46.37
    78645SCSF shunt evaluation02913.78$192.18$90.20$38.44
    78647SCerebrospinal fluid scan02924.56$231.84$124.85$46.37
    78650SCSF leakage imaging02924.56$231.84$124.85$46.37
    78660SNuclear exam of tear flow02913.78$192.18$90.20$38.44
    78699SNervous system nuclear exam02913.78$192.18$90.20$38.44
    78700SKidney imaging, static02913.78$192.18$90.20$38.44
    78701SKidney imaging with flow02913.78$192.18$90.20$38.44
    78704SImaging renogram02913.78$192.18$90.20$38.44
    78707SKidney flow/function image02924.56$231.84$124.85$46.37
    78708SKidney flow/function image02924.56$231.84$124.85$46.37
    78709SKidney flow/function image02924.56$231.84$124.85$46.37
    78710SKidney imaging (3D)02913.78$192.18$90.20$38.44
    78715SRenal vascular flow exam02913.78$192.18$90.20$38.44
    78725SKidney function study02913.78$192.18$90.20$38.44
    78730SUrinary bladder retention02913.78$192.18$90.20$38.44
    78740SUreteral reflux study02913.78$192.18$90.20$38.44
    78760STesticular imaging02913.78$192.18$90.20$38.44
    78761STesticular imaging/flow02913.78$192.18$90.20$38.44
    78799SGenitourinary nuclear exam02924.56$231.84$124.85$46.37
    78800STumor imaging, limited area02913.78$192.18$90.20$38.44
    78801STumor imaging, mult areas02924.56$231.84$124.85$46.37
    78802STumor imaging, whole body02924.56$231.84$124.85$46.37
    78803STumor imaging (3D)02924.56$231.84$124.85$46.37
    78805SAbscess imaging, ltd area02924.56$231.84$124.85$46.37
    78806SAbscess imaging, whole body02924.56$231.84$124.85$46.37
    78807SNuclear localization/abscess02924.56$231.84$124.85$46.37
    78810ETumor imaging (PET)
    78890NNuclear medicine data proc
    78891NNuclear med data proc
    78990NProvide diag radionuclide(s)
    78999SNuclear diagnostic exam02913.78$192.18$90.20$38.44
    79000SInit hyperthyroid therapy02945.45$277.09$144.06$55.42
    79001SRepeat hyperthyroid therapy02945.45$277.09$144.06$55.42
    79020SThyroid ablation02945.45$277.09$144.06$55.42
    79030SThyroid ablation, carcinoma02945.45$277.09$144.06$55.42
    79035SThyroid metastatic therapy02945.45$277.09$144.06$55.42
    79100SHematopoetic nuclear therapy02945.45$277.09$144.06$55.42
    79200SIntracavitary nuclear trmt029513.97$710.26$390.64$142.05
    79300SInterstitial nuclear therapy02945.45$277.09$144.06$55.42
    79400SNonhemato nuclear therapy029513.97$710.26$390.64$142.05
    79420SIntravascular nuclear ther029513.97$710.26$390.64$142.05
    79440SNuclear joint therapy02945.45$277.09$144.06$55.42
    79900NProvide ther radiopharm(s)
    79999SNuclear medicine therapy02945.45$277.09$144.06$55.42
    80048ABasic metabolic panel
    80050AGeneral health panel
    80051AElectrolyte panel
    Start Printed Page 44809
    80053AComprehen metabolic panel
    80055AObstetric panel
    80061ALipid panel
    80069ARenal function panel
    80072AArthritis panel
    80074AAcute hepatitis panel
    80076AHepatic function panel
    80090ATorch antibody panel
    80100ADrug screen, qualitate/multi
    80101ADrug screen, single
    80102ADrug confirmation
    80103NDrug analysis, tissue prep
    80150AAssay of amikacin
    80152AAssay of amitriptyline
    80154AAssay of benzodiazepines
    80156AAssay, carbamazepine, total
    80157AAssay, carbamazepine, free
    80158AAssay of cyclosporine
    80160AAssay of desipramine
    80162AAssay of digoxin
    80164AAssay, dipropylacetic acid
    80166AAssay of doxepin
    80168AAssay of ethosuximide
    80170AAssay of gentamicin
    80172AAssay of gold
    80173AAssay of haloperidol
    80174AAssay of imipramine
    80176AAssay of lidocaine
    80178AAssay of lithium
    80182AAssay of nortriptyline
    80184AAssay of phenobarbital
    80185AAssay of phenytoin, total
    80186AAssay of phenytoin, free
    80188AAssay of primidone
    80190AAssay of procainamide
    80192AAssay of procainamide
    80194AAssay of quinidine
    80196AAssay of salicylate
    80197AAssay of tacrolimus
    80198AAssay of theophylline
    80200AAssay of tobramycin
    80201XAssay of topiramate03490.34$17.29$3.46$3.46
    80202AAssay of vancomycin
    80299AQuantitative assay, drug
    80400AActh stimulation panel
    80402AActh stimulation panel
    80406AActh stimulation panel
    80408AAldosterone suppression eval
    80410ACalcitonin stimul panel
    80412ACRH stimulation panel
    80414ATestosterone response
    80415AEstradiol response panel
    80416ARenin stimulation panel
    80417ARenin stimulation panel
    80418APituitary evaluation panel
    80420ADexamethasone panel
    80422AGlucagon tolerance panel
    80424AGlucagon tolerance panel
    80426AGonadotropin hormone panel
    80428AGrowth hormone panel
    80430AGrowth hormone panel
    80432AInsulin suppression panel
    80434AInsulin tolerance panel
    80435AInsulin tolerance panel
    80436AMetyrapone panel
    80438ATRH stimulation panel
    80439ATRH stimulation panel
    80440ATRH stimulation panel
    80500XLab pathology consultation03430.42$21.35$11.53$4.27
    80502XLab pathology consultation03430.42$21.35$11.53$4.27
    81000AUrinalysis, nonauto w/scope
    81001AUrinalysis, auto w/scope
    81002AUrinalysis nonauto w/o scope
    81003AUrinalysis, auto, w/o scope
    81005AUrinalysis
    Start Printed Page 44810
    81007AUrine screen for bacteria
    81015AMicroscopic exam of urine
    81020AUrinalysis, glass test
    81025AUrine pregnancy test
    81050AUrinalysis, volume measure
    81099XUrinalysis test procedure03490.34$17.29$3.46$3.46
    82000AAssay of blood acetaldehyde
    82003AAssay of acetaminophen
    82009ATest for acetone/ketones
    82010AAcetone assay
    82013AAcetylcholinesterase assay
    82016AAcylcarnitines, qual
    82017AAcylcarnitines, quant
    82024AAssay of acth
    82030AAssay of adp & amp
    82040AAssay of serum albumin
    82042AAssay of urine albumin
    82043AMicroalbumin, quantitative
    82044AMicroalbumin, semiquant
    82055AAssay of ethanol
    82075AAssay of breath ethanol
    82085AAssay of aldolase
    82088AAssay of aldosterone
    82101AAssay of urine alkaloids
    82103AAlpha-1-antitrypsin, total
    82104AAlpha-1-antitrypsin, pheno
    82105AAlpha-fetoprotein, serum
    82106AAlpha-fetoprotein, amniotic
    82108AAssay of aluminum
    82120AAmines, vaginal fluid qual
    82127AAmino acid, single qual
    82128AAmino acids, mult qual
    82131AAmino acids, single quant
    82135AAssay, aminolevulinic acid
    82136AAmino acids, quant, 2-5
    82139AAmino acids, quan, 6 or more
    82140AAssay of ammonia
    82143AAmniotic fluid scan
    82145AAssay of amphetamines
    82150AAssay of amylase
    82154AAndrostanediol glucuronide
    82157AAssay of androstenedione
    82160AAssay of androsterone
    82163AAssay of angiotensin II
    82164AAngiotensin I enzyme test
    82172AAssay of apolipoprotein
    82175AAssay of arsenic
    82180AAssay of ascorbic acid
    82190AAtomic absorption
    82205AAssay of barbiturates
    82232AAssay of beta-2 protein
    82239ABile acids, total
    82240ABile acids, cholylglycine
    82247ABilirubin, total
    82248ABilirubin, direct
    82252AFecal bilirubin test
    82261AAssay of biotinidase
    82270ATest for blood, feces
    82273ATest for blood, other source
    82286AAssay of bradykinin
    82300AAssay of cadmium
    82306AAssay of vitamin D
    82307AAssay of vitamin D
    82308AAssay of calcitonin
    82310AAssay of calcium
    82330AAssay of calcium
    82331ACalcium infusion test
    82340AAssay of calcium in urine
    82355ACalculus (stone) analysis
    82360ACalculus (stone) assay
    82365ACalculus (stone) assay
    82370AX-ray assay, calculus
    82373AAssay, c-d transfer measure
    82374AAssay, blood carbon dioxide
    82375AAssay, blood carbon monoxide
    Start Printed Page 44811
    82376ATest for carbon monoxide
    82378ACarcinoembryonic antigen
    82379AAssay of carnitine
    82380AAssay of carotene
    82382AAssay, urine catecholamines
    82383AAssay, blood catecholamines
    82384AAssay, three catecholamines
    82387AAssay of cathepsin-d
    82390AAssay of ceruloplasmin
    82397AChemiluminescent assay
    82415AAssay of chloramphenicol
    82435AAssay of blood chloride
    82436AAssay of urine chloride
    82438AAssay, other fluid chlorides
    82441ATest for chlorohydrocarbons
    82465AAssay, bld/serum cholesterol
    82480AAssay, serum cholinesterase
    82482AAssay, rbc cholinesterase
    82485AAssay, chondroitin sulfate
    82486AGas/liquid chromatography
    82487APaper chromatography
    82488APaper chromatography
    82489AThin layer chromatography
    82491AChromotography, quant, sing
    82492AChromotography, quant, mult
    82495AAssay of chromium
    82507AAssay of citrate
    82520AAssay of cocaine
    82523ACollagen crosslinks
    82525AAssay of copper
    82528AAssay of corticosterone
    82530ACortisol, free
    82533ATotal cortisol
    82540AAssay of creatine
    82541AColumn chromotography, qual
    82542AColumn chromotography, quant
    82543AColumn chromotograph/isotope
    82544AColumn chromotograph/isotope
    82550AAssay of ck (cpk)
    82552AAssay of cpk in blood
    82553ACreatine, MB fraction
    82554ACreatine, isoforms
    82565AAssay of creatinine
    82570AAssay of urine creatinine
    82575ACreatinine clearance test
    82585AAssay of cryofibrinogen
    82595AAssay of cryoglobulin
    82600AAssay of cyanide
    82607AVitamin B-12
    82608AB-12 binding capacity
    82615ATest for urine cystines
    82626ADehydroepiandrosterone
    82627ADehydroepiandrosterone
    82633ADesoxycorticosterone
    82634ADeoxycortisol
    82638AAssay of dibucaine number
    82646AAssay of dihydrocodeinone
    82649AAssay of dihydromorphinone
    82651AAssay of dihydrotestosterone
    82652AAssay of dihydroxyvitamin d
    82654AAssay of dimethadione
    82657AEnzyme cell activity
    82658AEnzyme cell activity, ra
    82664AElectrophoretic test
    82666AAssay of epiandrosterone
    82668AAssay of erythropoietin
    82670AAssay of estradiol
    82671AAssay of estrogens
    82672AAssay of estrogen
    82677AAssay of estriol
    82679AAssay of estrone
    82690AAssay of ethchlorvynol
    82693AAssay of ethylene glycol
    82696AAssay of etiocholanolone
    82705AFats/lipids, feces, qual
    Start Printed Page 44812
    82710AFats/lipids, feces, quant
    82715AAssay of fecal fat
    82725AAssay of blood fatty acids
    82726ALong chain fatty acids
    82728AAssay of ferritin
    82731AAssay of fetal fibronectin
    82735AAssay of fluoride
    82742AAssay of flurazepam
    82746ABlood folic acid serum
    82747AAssay of folic acid, rbc
    82757AAssay of semen fructose
    82759AAssay of rbc galactokinase
    82760AAssay of galactose
    82775AAssay galactose transferase
    82776AGalactose transferase test
    82784AAssay of gammaglobulin igm
    82785AAssay of gammaglobulin ige
    82787AIgg 1, 2, 3 or 4, each
    82800ABlood pH
    82803ABlood gases: pH, pO2 & pCO2
    82805ABlood gases W/02 saturation
    82810ABlood gases, O2 sat only
    82820AHemoglobin-oxygen affinity
    82926AAssay of gastric acid
    82928AAssay of gastric acid
    82938AGastrin test
    82941AAssay of gastrin
    82943AAssay of glucagon
    82945AGlucose other fluid
    82946AGlucagon tolerance test
    82947AAssay, glucose, blood quant
    82948AReagent strip/blood glucose
    82950AGlucose test
    82951AGlucose tolerance test (GTT)
    82952AGTT-added samples
    82953AGlucose-tolbutamide test
    82955AAssay of g6pd enzyme
    82960ATest for G6PD enzyme
    82962AGlucose blood test
    82963AAssay of glucosidase
    82965AAssay of gdh enzyme
    82975AAssay of glutamine
    82977AAssay of GGT
    82978AAssay of glutathione
    82979AAssay, rbc glutathione
    82980AAssay of glutethimide
    82985AGlycated protein
    83001AGonadotropin (FSH)
    83002AGonadotropin (LH)
    83003AAssay, growth hormone (hgh)
    83008AAssay of guanosine
    83010AAssay of haptoglobin, quant
    83012AAssay of haptoglobins
    83013AH pylori analysis
    83014AH pylori drug admin/collect
    83015AHeavy metal screen
    83018AQuantitative screen, metals
    83020AHemoglobin electrophoresis
    83021AHemoglobin chromotography
    83026AHemoglobin, copper sulfate
    83030AFetal hemoglobin, chemical
    83033AFetal hemoglobin assay, qual
    83036AGlycated hemoglobin test
    83045ABlood methemoglobin test
    83050ABlood methemoglobin assay
    83051AAssay of plasma hemoglobin
    83055ABlood sulfhemoglobin test
    83060ABlood sulfhemoglobin assay
    83065AAssay of hemoglobin heat
    83068AHemoglobin stability screen
    83069AAssay of urine hemoglobin
    83070AAssay of hemosiderin, qual
    83071AAssay of hemosiderin, quant
    83080AAssay of b hexosaminidase
    83088AAssay of histamine
    Start Printed Page 44813
    83090AAssay of homocystine
    83150AAssay of for hva
    83491AAssay of corticosteroids
    83497AAssay of 5-hiaa
    83498AAssay of progesterone
    83499AAssay of progesterone
    83500AAssay, free hydroxyproline
    83505AAssay, total hydroxyproline
    83516AImmunoassay, nonantibody
    83518AImmunoassay, dipstick
    83519AImmunoassay, nonantibody
    83520AImmunoassay, RIA
    83525AAssay of insulin
    83527AAssay of insulin
    83528AAssay of intrinsic factor
    83540AAssay of iron
    83550AIron binding test
    83570AAssay of idh enzyme
    83582AAssay of ketogenic steroids
    83586AAssay 17- ketosteroids
    83593AFractionation, ketosteroids
    83605AAssay of lactic acid
    83615ALactate (LD) (LDH) enzyme
    83625AAssay of ldh enzymes
    83632APlacental lactogen
    83633ATest urine for lactose
    83634AAssay of urine for lactose
    83655AAssay of lead
    83661AL/s ratio, fetal lung
    83662AFoam stability, fetal lung
    83663AFluoro polarize, fetal lung
    83664ALamellar bdy, fetal lung
    83670AAssay of lap enzyme
    83690AAssay of lipase
    83715AAssay of blood lipoproteins
    83716AAssay of blood lipoproteins
    83718AAssay of lipoprotein
    83719AAssay of blood lipoprotein
    83721AAssay of blood lipoprotein
    83727AAssay of lrh hormone
    83735AAssay of magnesium
    83775AAssay of md enzyme
    83785AAssay of manganese
    83788AMass spectrometry qual
    83789AMass spectrometry quant
    83805AAssay of meprobamate
    83825AAssay of mercury
    83835AAssay of metanephrines
    83840AAssay of methadone
    83857AAssay of methemalbumin
    83858AAssay of methsuximide
    83864AMucopolysaccharides
    83866AMucopolysaccharides screen
    83872AAssay synovial fluid mucin
    83873AAssay of csf protein
    83874AAssay of myoglobin
    83883AAssay, nephelometry not spec
    83885AAssay of nickel
    83887AAssay of nicotine
    83890AMolecule isolate
    83891AMolecule isolate nucleic
    83892AMolecular diagnostics
    83893AMolecule dot/slot/blot
    83894AMolecule gel electrophor
    83896AMolecular diagnostics
    83897AMolecule nucleic transfer
    83898AMolecule nucleic ampli
    83901AMolecule nucleic ampli
    83902AMolecular diagnostics
    83903AMolecule mutation scan
    83904AMolecule mutation identify
    83905AMolecule mutation identify
    83906AMolecule mutation identify
    83912AGenetic examination
    83915AAssay of nucleotidase
    Start Printed Page 44814
    83916AOligoclonal bands
    83918AOrganic acids, total, quant
    83919AOrganic acids, qual, each
    83921AOrganic acid, single, quant
    83925AAssay of opiates
    83930AAssay of blood osmolality
    83935AAssay of urine osmolality
    83937AAssay of osteocalcin
    83945AAssay of oxalate
    83970AAssay of parathormone
    83986AAssay of body fluid acidity
    83992AAssay for phencyclidine
    84022AAssay of phenothiazine
    84030AAssay of blood pku
    84035AAssay of phenylketones
    84060AAssay acid phosphatase
    84061APhosphatase, forensic exam
    84066AAssay prostate phosphatase
    84075AAssay alkaline phosphatase
    84078AAssay alkaline phosphatase
    84080AAssay alkaline phosphatases
    84081AAmniotic fluid enzyme test
    84085AAssay of rbc pg6d enzyme
    84087AAssay phosphohexose enzymes
    84100AAssay of phosphorus
    84105AAssay of urine phosphorus
    84106ATest for porphobilinogen
    84110AAssay of porphobilinogen
    84119ATest urine for porphyrins
    84120AAssay of urine porphyrins
    84126AAssay of feces porphyrins
    84127AAssay of feces porphyrins
    84132AAssay of serum potassium
    84133AAssay of urine potassium
    84134AAssay of prealbumin
    84135AAssay of pregnanediol
    84138AAssay of pregnanetriol
    84140AAssay of pregnenolone
    84143AAssay of 17-hydroxypregneno
    84144AAssay of progesterone
    84146AAssay of prolactin
    84150AAssay of prostaglandin
    84152AAssay of psa, complexed
    84153AAssay of psa, total
    84154AAssay of psa, free
    84155AAssay of protein
    84160AAssay of serum protein
    84165AAssay of serum proteins
    84181AWestern blot test
    84182AProtein, western blot test
    84202AAssay RBC protoporphyrin
    84203ATest RBC protoporphyrin
    84206AAssay of proinsulin
    84207AAssay of vitamin b-6
    84210AAssay of pyruvate
    84220AAssay of pyruvate kinase
    84228AAssay of quinine
    84233AAssay of estrogen
    84234AAssay of progesterone
    84235AAssay of endocrine hormone
    84238AAssay, nonendocrine receptor
    84244AAssay of renin
    84252AAssay of vitamin b-2
    84255AAssay of selenium
    84260AAssay of serotonin
    84270AAssay of sex hormone globul
    84275AAssay of sialic acid
    84285AAssay of silica
    84295AAssay of serum sodium
    84300AAssay of urine sodium
    84305AAssay of somatomedin
    84307AAssay of somatostatin
    84311ASpectrophotometry
    84315ABody fluid specific gravity
    84375AChromatogram assay, sugars
    Start Printed Page 44815
    84376ASugars, single, qual
    84377ASugars, multiple, qual
    84378ASugars single quant
    84379ASugars multiple quant
    84392AAssay of urine sulfate
    84402AAssay of testosterone
    84403AAssay of total testosterone
    84425AAssay of vitamin b-1
    84430AAssay of thiocyanate
    84432AAssay of thyroglobulin
    84436AAssay of total thyroxine
    84437AAssay of neonatal thyroxine
    84439AAssay of free thyroxine
    84442AAssay of thyroid activity
    84443AAssay thyroid stim hormone
    84445AAssay of tsi
    84446AAssay of vitamin e
    84449AAssay of transcortin
    84450ATransferase (AST) (SGOT)
    84460AAlanine amino (ALT) (SGPT)
    84466AAssay of transferrin
    84478AAssay of triglycerides
    84479AAssay of thyroid (t3 or t4)
    84480AAssay, triiodothyronine (t3)
    84481AFree assay (FT-3)
    84482AT3 reverse
    84484AAssay of troponin, quant
    84485AAssay duodenal fluid trypsin
    84488ATest feces for trypsin
    84490AAssay of feces for trypsin
    84510AAssay of tyrosine
    84512XAssay of troponin, qual03490.34$17.29$3.46$3.46
    84520AAssay of urea nitrogen
    84525AUrea nitrogen semi-quant
    84540AAssay of urine/urea-n
    84545AUrea-N clearance test
    84550AAssay of blood/uric acid
    84560AAssay of urine/uric acid
    84577AAssay of feces/urobilinogen
    84578ATest urine urobilinogen
    84580AAssay of urine urobilinogen
    84583AAssay of urine urobilinogen
    84585AAssay of urine vma
    84586AAssay of vip
    84588AAssay of vasopressin
    84590AAssay of vitamin a
    84591AAssay of nos vitamin
    84597AAssay of vitamin k
    84600AAssay of volatiles
    84620AXylose tolerance test
    84630AAssay of zinc
    84681AAssay of c-peptide
    84702AChorionic gonadotropin test
    84703AChorionic gonadotropin assay
    84830AOvulation tests
    84999XClinical chemistry test03490.34$17.29$3.46$3.46
    85002ABleeding time test
    85007ADifferential WBC count
    85008ANondifferential WBC count
    85009ADifferential WBC count
    85013AHematocrit
    85014AHematocrit
    85018AHemoglobin
    85021AAutomated hemogram
    85022AAutomated hemogram
    85023AAutomated hemogram
    85024AAutomated hemogram
    85025AAutomated hemogram
    85027AAutomated hemogram
    85031AManual hemogram, cbc
    85041ARed blood cell (RBC) count
    85044AReticulocyte count
    85045AReticulocyte count
    85046AReticyte/hgb concentrate
    85048AWhite blood cell (WBC) count
    Start Printed Page 44816
    85060XBlood smear interpretation03420.22$11.19$6.15$2.24
    85095TBone marrow aspiration00031.11$56.43$27.99$11.29
    85097XBone marrow interpretation03440.60$30.51$16.78$6.10
    85102TBone marrow biopsy00031.11$56.43$27.99$11.29
    85130AChromogenic substrate assay
    85170ABlood clot retraction
    85175ABlood clot lysis time
    85210ABlood clot factor II test
    85220ABlood clot factor V test
    85230ABlood clot factor VII test
    85240ABlood clot factor VIII test
    85244ABlood clot factor VIII test
    85245ABlood clot factor VIII test
    85246ABlood clot factor VIII test
    85247ABlood clot factor VIII test
    85250ABlood clot factor IX test
    85260ABlood clot factor X test
    85270ABlood clot factor XI test
    85280ABlood clot factor XII test
    85290ABlood clot factor XIII test
    85291ABlood clot factor XIII test
    85292ABlood clot factor assay
    85293ABlood clot factor assay
    85300AAntithrombin III test
    85301AAntithrombin III test
    85302ABlood clot inhibitor antigen
    85303ABlood clot inhibitor test
    85305ABlood clot inhibitor assay
    85306ABlood clot inhibitor test
    85307AAssay activated protein c
    85335AFactor inhibitor test
    85337AThrombomodulin
    85345ACoagulation time
    85347ACoagulation time
    85348ACoagulation time
    85360AEuglobulin lysis
    85362AFibrin degradation products
    85366AFibrinogen test
    85370AFibrinogen test
    85378AFibrin degradation
    85379AFibrin degradation
    85384AFibrinogen
    85385AFibrinogen
    85390AFibrinolysins screen
    85400AFibrinolytic plasmin
    85410AFibrinolytic antiplasmin
    85415AFibrinolytic plasminogen
    85420AFibrinolytic plasminogen
    85421AFibrinolytic plasminogen
    85441AHeinz bodies, direct
    85445AHeinz bodies, induced
    85460AHemoglobin, fetal
    85461AHemoglobin, fetal
    85475AHemolysin
    85520AHeparin assay
    85525AHeparin
    85530AHeparin-protamine tolerance
    85535AIron stain, blood cells
    85536AIron stain peripheral blood
    85540AWbc alkaline phosphatase
    85547ARBC mechanical fragility
    85549AMuramidase
    85555ARBC osmotic fragility
    85557ARBC osmotic fragility
    85576ABlood platelet aggregation
    85585ABlood platelet estimation
    85590APlatelet count, manual
    85595APlatelet count, automated
    85597APlatelet neutralization
    85610AProthrombin time
    85611AProthrombin test
    85612AViper venom prothrombin time
    85613ARussell viper venom, diluted
    85635AReptilase test
    85651ARbc sed rate, nonautomated
    Start Printed Page 44817
    85652ARbc sed rate, automated
    85660ARBC sickle cell test
    85670AThrombin time, plasma
    85675AThrombin time, titer
    85705AThromboplastin inhibition
    85730AThromboplastin time, partial
    85732AThromboplastin time, partial
    85810ABlood viscosity examination
    85999XHematology procedure03490.34$17.29$3.46$3.46
    86000AAgglutinins, febrile
    86001AAllergen specific igg
    86003AAllergen specific IgE
    86005AAllergen specific IgE
    86021AWBC antibody identification
    86022APlatelet antibodies
    86023AImmunoglobulin assay
    86038AAntinuclear antibodies
    86039AAntinuclear antibodies (ANA)
    86060AAntistreptolysin o, titer
    86063AAntistreptolysin o, screen
    86077XPhysician blood bank service03430.42$21.35$11.53$4.27
    86078XPhysician blood bank service03440.60$30.51$16.78$6.10
    86079XPhysician blood bank service03440.60$30.51$16.78$6.10
    86140AC-reactive protein
    86146AGlycoprotein antibody
    86147ACardiolipin antibody
    86148XPhospholipid antibody03490.34$17.29$3.46$3.46
    86155AChemotaxis assay
    86156ACold agglutinin, screen
    86157ACold agglutinin, titer
    86160AComplement, antigen
    86161AComplement/function activity
    86162AComplement, total (CH50)
    86171AComplement fixation, each
    86185ACounterimmunoelectrophoresis
    86215ADeoxyribonuclease, antibody
    86225ADNA antibody
    86226ADNA antibody, single strand
    86235ANuclear antigen antibody
    86243AFc receptor
    86255AFluorescent antibody, screen
    86256AFluorescent antibody, titer
    86277AGrowth hormone antibody
    86280AHemagglutination inhibition
    86294AImmunoassay, tumor qual
    86300AImmunoassay, tumor ca 15-3
    86301AImmunoassay, tumor, ca 19-9
    86304AImmunoassay, tumor ca 125
    86308AHeterophile antibodies
    86309AHeterophile antibodies
    86310AHeterophile antibodies
    86316AImmunoassay, tumor other
    86317AImmunoassay,infectious agent
    86318AImmunoassay,infectious agent
    86320ASerum immunoelectrophoresis
    86325AOther immunoelectrophoresis
    86327AImmunoelectrophoresis assay
    86329AImmunodiffusion
    86331AImmunodiffusion ouchterlony
    86332AImmune complex assay
    86334AImmunofixation procedure
    86337AInsulin antibodies
    86340AIntrinsic factor antibody
    86341AIslet cell antibody
    86343ALeukocyte histamine release
    86344ALeukocyte phagocytosis
    86353ALymphocyte transformation
    86359AT cells, total count
    86360AT cell, absolute count/ratio
    86361XT cell, absolute count03490.34$17.29$3.46$3.46
    86376AMicrosomal antibody
    86378AMigration inhibitory factor
    86382ANeutralization test, viral
    86384ANitroblue tetrazolium dye
    86403AParticle agglutination test
    Start Printed Page 44818
    86406AParticle agglutination test
    86430ARheumatoid factor test
    86431ARheumatoid factor, quant
    86485XSkin test, candida03410.11$5.59$3.08$1.12
    86490XCoccidioidomycosis skin test03410.11$5.59$3.08$1.12
    86510XHistoplasmosis skin test03410.11$5.59$3.08$1.12
    86580XTB intradermal test03410.11$5.59$3.08$1.12
    86585XTB tine test03410.11$5.59$3.08$1.12
    86586XSkin test, unlisted03410.11$5.59$3.08$1.12
    86590AStreptokinase, antibody
    86592ABlood serology, qualitative
    86593ABlood serology, quantitative
    86602AAntinomyces antibody
    86603AAdenovirus antibody
    86606AAspergillus antibody
    86609ABacterium antibody
    86611ABartonella antibody
    86612ABlastomyces antibody
    86615ABordetella antibody
    86617ALyme disease antibody
    86618ALyme disease antibody
    86619ABorrelia antibody
    86622ABrucella antibody
    86625ACampylobacter antibody
    86628ACandida antibody
    86631AChlamydia antibody
    86632AChlamydia igm antibody
    86635ACoccidioides antibody
    86638AQ fever antibody
    86641ACryptococcus antibody
    86644ACMV antibody
    86645ACMV antibody, IgM
    86648ADiphtheria antibody
    86651AEncephalitis antibody
    86652AEncephalitis antibody
    86653AEncephalitis antibody
    86654AEncephalitis antibody
    86658AEnterovirus antibody
    86663AEpstein-barr antibody
    86664AEpstein-barr antibody
    86665AEpstein-barr antibody
    86666AEhrlichia antibody
    86668AFrancisella tularensis
    86671AFungus antibody
    86674AGiardia lamblia antibody
    86677AHelicobacter pylori
    86682AHelminth antibody
    86683AHemoglobin, fecal antibody
    86684AHemophilus influenza
    86687AHtlv-i antibody
    86688AHtlv-ii antibody
    86689AHTLV/HIV confirmatory test
    86692AHepatitis, delta agent
    86694AHerpes simplex test
    86695AHerpes simplex test
    86696AHerpes simplex type 2
    86698AHistoplasma
    86701AHIV-1
    86702AHIV-2
    86703AHIV-1/HIV-2, single assay
    86704AHep b core antibody, total
    86705AHep b core antibody, igm
    86706AHep b surface antibody
    86707AHep be antibody
    86708AHep a antibody, total
    86709AHep a antibody, igm
    86710AInfluenza virus antibody
    86713ALegionella antibody
    86717ALeishmania antibody
    86720ALeptospira antibody
    86723AListeria monocytogenes ab
    86727ALymph choriomeningitis ab
    86729ALympho venereum antibody
    86732AMucormycosis antibody
    86735AMumps antibody
    Start Printed Page 44819
    86738AMycoplasma antibody
    86741ANeisseria meningitidis
    86744ANocardia antibody
    86747AParvovirus antibody
    86750AMalaria antibody
    86753AProtozoa antibody nos
    86756ARespiratory virus antibody
    86757ARickettsia antibody
    86759ARotavirus antibody
    86762ARubella antibody
    86765ARubeola antibody
    86768ASalmonella antibody
    86771AShigella antibody
    86774ATetanus antibody
    86777AToxoplasma antibody
    86778AToxoplasma antibody, igm
    86781ATreponema pallidum, confirm
    86784ATrichinella antibody
    86787AVaricella-zoster antibody
    86790AVirus antibody nos
    86793AYersinia antibody
    86800AThyroglobulin antibody
    86803AHepatitis c ab test
    86804AHep c ab test, confirm
    86805ALymphocytotoxicity assay
    86806ALymphocytotoxicity assay
    86807ACytotoxic antibody screening
    86808ACytotoxic antibody screening
    86812AHLA typing, A, B, or C
    86813AHLA typing, A, B, or C
    86816AHLA typing, DR/DQ
    86817AHLA typing, DR/DQ
    86821ALymphocyte culture, mixed
    86822ALymphocyte culture, primed
    86849XImmunology procedure03490.34$17.29$3.46$3.46
    86850XRBC antibody screen03450.29$14.74$5.37$2.95
    86860XRBC antibody elution03450.29$14.74$5.37$2.95
    86870XRBC antibody identification03460.83$42.20$12.03$8.44
    86880ACoombs test
    86885ACoombs test
    86886ACoombs test
    86890XAutologous blood process03460.83$42.20$12.03$8.44
    86891XAutologous blood, op salvage03450.29$14.74$5.37$2.95
    86900ABlood typing, ABO
    86901XBlood typing, Rh (D)03450.29$14.74$5.37$2.95
    86903ABlood typing, antigen screen
    86904ABlood typing, patient serum
    86905ABlood typing, RBC antigens
    86906ABlood typing, Rh phenotype
    86910EBlood typing, paternity test
    86911EBlood typing, antigen system
    86915XBone marrow/stem cell prep03460.83$42.20$12.03$8.44
    86920XCompatibility test03460.83$42.20$12.03$8.44
    86921XCompatibility test03450.29$14.74$5.37$2.95
    86922XCompatibility test03460.83$42.20$12.03$8.44
    86927XPlasma, fresh frozen03460.83$42.20$12.03$8.44
    86930XFrozen blood prep03471.73$87.96$20.13$17.59
    86931XFrozen blood thaw03471.73$87.96$20.13$17.59
    86932XFrozen blood freeze/thaw03460.83$42.20$12.03$8.44
    86940AHemolysins/agglutinins, auto
    86941AHemolysins/agglutinins
    86945XBlood product/irradiation03450.29$14.74$5.37$2.95
    86950XLeukacyte transfusion03471.73$87.96$20.13$17.59
    86965XPooling blood platelets03471.73$87.96$20.13$17.59
    86970XRBC pretreatment03450.29$14.74$5.37$2.95
    86971XRBC pretreatment03450.29$14.74$5.37$2.95
    86972XRBC pretreatment03450.29$14.74$5.37$2.95
    86975XRBC pretreatment, serum03450.29$14.74$5.37$2.95
    86976XRBC pretreatment, serum03450.29$14.74$5.37$2.95
    86977XRBC pretreatment, serum03450.29$14.74$5.37$2.95
    86978XRBC pretreatment, serum03450.29$14.74$5.37$2.95
    86985XSplit blood or products03471.73$87.96$20.13$17.59
    86999XTransfusion procedure03460.83$42.20$12.03$8.44
    87001ASmall animal inoculation
    87003ASmall animal inoculation
    Start Printed Page 44820
    87015ASpecimen concentration
    87040ABlood culture for bacteria
    87045AStool culture, bacteria
    87046AStool cultr, bacteria, each
    87070ACulture, bacteria, other
    87071ACulture bacteri aerobic othr
    87073ACulture bacteria anaerobic
    87075ACulture bacteria anaerobic
    87076ACulture anaerobe ident, each
    87077ACulture aerobic identify
    87081ACulture screen only
    87084ACulture of specimen by kit
    87086AUrine culture/colony count
    87088AUrine bacteria culture
    87101ASkin fungi culture
    87102AFungus isolation culture
    87103ABlood fungus culture
    87106AFungi identification, yeast
    87107AFungi identification, mold
    87109AMycoplasma
    87110AChlamydia culture
    87116AMycobacteria culture
    87118AMycobacteric identification
    87140ACultur type immunofluoresc
    87143ACulture typing, glc/hplc
    87147ACulture type, immunologic
    87149ACulture type, nucleic acid
    87152ACulture type pulse field gel
    87158ACulture typing, added method
    87164ADark field examination
    87166ADark field examination
    87168AMacroscopic exam arthropod
    87169AMacacroscopic exam parasite
    87172APinworm exam
    87176ATissue homogenization, cultr
    87177AOva and parasites smears
    87181AMicrobe susceptible, diffuse
    87184AMicrobe susceptible, disk
    87185AMicrobe susceptible, enzyme
    87186AMicrobe susceptible, mic
    87187AMicrobe susceptible, mlc
    87188AMicrobe suscept, macrobroth
    87190AMicrobe suscept, mycobacteri
    87197ABactericidal level, serum
    87205ASmear, gram stain
    87206ASmear, fluorescent/acid stai
    87207ASmear, special stain
    87210ASmear, wet mount, saline/ink
    87220ATissue exam for fungi
    87230AAssay, toxin or antitoxin
    87250AVirus inoculate, eggs/animal
    87252AVirus inoculation, tissue
    87253AVirus inoculate tissue, addl
    87254AVirus inoculation, shell via
    87260AAdenovirus ag, if
    87265APertussis ag, if
    87270AChlamydia trachomatis ag, if
    87272ACryptosporidum/gardia ag, if
    87273AHerpes simplex 2, ag, if
    87274AHerpes simplex 1, ag, if
    87275AInfluenza b, ag, if
    87276AInfluenza a, ag, if
    87277ALegionella micdadei, ag, if
    87278ALegion pneumophilia ag, if
    87279AParainfluenza, ag, if
    87280ARespiratory syncytial ag, if
    87281APneumocystis carinii, ag, if
    87283ARubeola, ag, if
    87285ATreponema pallidum, ag, if
    87290AVaricella zoster, ag, if
    87299AAntibody detection, nos, if
    87300AAg detection, polyval, if
    87301AAdenovirus ag, eia
    87320AChylmd trach ag, eia
    87324AClostridium ag, eia
    Start Printed Page 44821
    87327ACryptococcus neoform ag, eia
    87328ACryptospor ag, eia
    87332ACytomegalovirus ag, eia
    87335AE coli 0157 ag, eia
    87336AEntamoeb hist dispr, ag, eia
    87337AEntamoeb hist group, ag, eia
    87338AHpylori, stool, eia
    87339AHpylori ag, eia
    87340AHepatitis b surface ag, eia
    87341AHepatitis b surface, ag, eia
    87350AHepatitis be ag, eia
    87380AHepatitis delta ag, eia
    87385AHistoplasma capsul ag, eia
    87390AHiv-1 ag, eia
    87391AHiv-2 ag, eia
    87400AInfluenza a/b, ag, eia
    87420AResp syncytial ag, eia
    87425ARotavirus ag, eia
    87427AShiga-like toxin ag, eia
    87430AStrep a ag, eia
    87449AAg detect nos, eia, mult
    87450AAg detect nos, eia, single
    87451AAg detect polyval, eia, mult
    87470ABartonella, dna, dir probe
    87471ABartonella, dna, amp probe
    87472XBartonella, dna, quant03490.34$17.29$3.46$3.46
    87475ALyme dis, dna, dir probe
    87476ALyme dis, dna, amp probe
    87477XLyme dis, dna, quant03490.34$17.29$3.46$3.46
    87480ACandida, dna, dir probe
    87481ACandida, dna, amp probe
    87482XCandida, dna, quant03490.34$17.29$3.46$3.46
    87485AChylmd pneum, dna, dir probe
    87486AChylmd pneum, dna, amp probe
    87487XChylmd pneum, dna, quant03490.34$17.29$3.46$3.46
    87490AChylmd trach, dna, dir probe
    87491AChylmd trach, dna, amp probe
    87492XChylmd trach, dna, quant03490.34$17.29$3.46$3.46
    87495ACytomeg, dna, dir probe
    87496ACytomeg, dna, amp probe
    87497XCytomeg, dna, quant03490.34$17.29$3.46$3.46
    87510AGardner vag, dna, dir probe
    87511AGardner vag, dna, amp probe
    87512XGardner vag, dna, quant03490.34$17.29$3.46$3.46
    87515AHepatitis b, dna, dir probe
    87516AHepatitis b , dna, amp probe
    87517XHepatitis b , dna, quant03490.34$17.29$3.46$3.46
    87520AHepatitis c , rna, dir probe
    87521AHepatitis c , rna, amp probe
    87522XHepatitis c, rna, quant03490.34$17.29$3.46$3.46
    87525AHepatitis g , dna, dir probe
    87526AHepatitis g, dna, amp probe
    87527XHepatitis g, dna, quant03490.34$17.29$3.46$3.46
    87528AHsv, dna, dir probe
    87529AHsv, dna, amp probe
    87530XHsv, dna, quant03490.34$17.29$3.46$3.46
    87531AHhv-6, dna, dir probe
    87532AHhv-6, dna, amp probe
    87533XHhv-6, dna, quant03490.34$17.29$3.46$3.46
    87534AHiv-1, dna, dir probe
    87535AHiv-1, dna, amp probe
    87536XHiv-1, dna, quant03490.34$17.29$3.46$3.46
    87537AHiv-2, dna, dir probe
    87538AHiv-2, dna, amp probe
    87539XHiv-2, dna, quant03490.34$17.29$3.46$3.46
    87540ALegion pneumo, dna, dir prob
    87541ALegion pneumo, dna, amp prob
    87542XLegion pneumo, dna, quant03490.34$17.29$3.46$3.46
    87550AMycobacteria, dna, dir probe
    87551AMycobacteria, dna, amp probe
    87552XMycobacteria, dna, quant03490.34$17.29$3.46$3.46
    87555AM.tuberculo, dna, dir probe
    87556AM.tuberculo, dna, amp probe
    87557XM.tuberculo, dna, quant03490.34$17.29$3.46$3.46
    87560AM.avium-intra, dna, dir prob
    Start Printed Page 44822
    87561AM.avium-intra, dna, amp prob
    87562XM.avium-intra, dna, quant03490.34$17.29$3.46$3.46
    87580AM.pneumon, dna, dir probe
    87581AM.pneumon, dna, amp probe
    87582XM.pneumon, dna, quant03490.34$17.29$3.46$3.46
    87590AN.gonorrhoeae, dna, dir prob
    87591AN.gonorrhoeae, dna, amp prob
    87592XN.gonorrhoeae, dna, quant03490.34$17.29$3.46$3.46
    87620AHpv, dna, dir probe
    87621AHpv, dna, amp probe
    87622XHpv, dna, quant03490.34$17.29$3.46$3.46
    87650AStrep a, dna, dir probe
    87651AStrep a, dna, amp probe
    87652XStrep a, dna, quant03490.34$17.29$3.46$3.46
    87797ADetect agent nos, dna, dir
    87798ADetect agent nos, dna, amp
    87799XDetect agent nos, dna, quant03490.34$17.29$3.46$3.46
    87800ADetect agnt mult, dna, direc
    87801ADetect agnt mult, dna, ampli
    87810AChylmd trach assay w/optic
    87850AN. gonorrhoeae assay w/optic
    87880AStrep a assay w/optic
    87899AAgent nos assay w/optic
    87901AGenotype, dna, hiv reverse t
    87903APhenotype, dna hiv w/culture
    87904APhenotype, dna hiv w/clt add
    87999XMicrobiology procedure03490.34$17.29$3.46$3.46
    88000EAutopsy (necropsy), gross
    88005EAutopsy (necropsy), gross
    88007EAutopsy (necropsy), gross
    88012EAutopsy (necropsy), gross
    88014EAutopsy (necropsy), gross
    88016EAutopsy (necropsy), gross
    88020EAutopsy (necropsy), complete
    88025EAutopsy (necropsy), complete
    88027EAutopsy (necropsy), complete
    88028EAutopsy (necropsy), complete
    88029EAutopsy (necropsy), complete
    88036ELimited autopsy
    88037ELimited autopsy
    88040EForensic autopsy (necropsy)
    88045ECoroner's autopsy (necropsy)
    88099ENecropsy (autopsy) procedure
    88104XCytopathology, fluids03430.42$21.35$11.53$4.27
    88106XCytopathology, fluids03430.42$21.35$11.53$4.27
    88107XCytopathology, fluids03430.42$21.35$11.53$4.27
    88108XCytopath, concentrate tech03430.42$21.35$11.53$4.27
    88125XForensic cytopathology03430.42$21.35$11.53$4.27
    88130ASex chromatin identification
    88140ASex chromatin identification
    88141NCytopath, c/v, interpret
    88142XCytopath, c/v, thin layer03490.34$17.29$3.46$3.46
    88143ACytopath c/v thin layer redo
    88144ACytopath, c/v thin lyr redo
    88145ACytopath, c/v thin lyr sel
    88147ACytopath, c/v, automated
    88148ACytopath, c/v, auto rescreen
    88150ACytopath, c/v, manual
    88152ACytopath, c/v, auto redo
    88153ACytopath, c/v, redo
    88154ACytopath, c/v, select
    88155ACytopath, c/v, index add-on
    88160XCytopath smear, other source03420.22$11.19$6.15$2.24
    88161XCytopath smear, other source03430.42$21.35$11.53$4.27
    88162XCytopath smear, other source03430.42$21.35$11.53$4.27
    88164ACytopath tbs, c/v, manual
    88165ACytopath tbs, c/v, redo
    88166ACytopath tbs, c/v, auto redo
    88167ACytopath tbs, c/v, select
    88170TFine needle aspiration00020.47$23.90$13.14$4.78
    88171TFine needle aspiration00043.00$152.53$32.57$30.51
    88172XCytopathology eval of fna03430.42$21.35$11.53$4.27
    88173XCytopath eval, fna, report03430.42$21.35$11.53$4.27
    88180XCell marker study03440.60$30.51$16.78$6.10
    88182XCell marker study03440.60$30.51$16.78$6.10
    Start Printed Page 44823
    88199XCytopathology procedure03490.34$17.29$3.46$3.46
    88230ATissue culture, lymphocyte
    88233ATissue culture, skin/biopsy
    88235ATissue culture, placenta
    88237ATissue culture, bone marrow
    88239ATissue culture, tumor
    88240ACell cryopreserve/storage
    88241AFrozen cell preparation
    88245AChromosome analysis, 20-25
    88248AChromosome analysis, 50-100
    88249AChromosome analysis, 100
    88261AChromosome analysis, 5
    88262AChromosome analysis, 15-20
    88263AChromosome analysis, 45
    88264AChromosome analysis, 20-25
    88267AChromosome analys, placenta
    88269AChromosome analys, amniotic
    88271ACytogenetics, dna probe
    88272ACytogenetics, 3-5
    88273ACytogenetics, 10-30
    88274ACytogenetics, 25-99
    88275ACytogenetics, 100-300
    88280AChromosome karyotype study
    88283AChromosome banding study
    88285AChromosome count, additional
    88289AChromosome study, additional
    88291ACyto/molecular report
    88299XCytogenetic study03420.22$11.19$6.15$2.24
    88300XSurgical path, gross03420.22$11.19$6.15$2.24
    88302XTissue exam by pathologist03420.22$11.19$6.15$2.24
    88304XTissue exam by pathologist03430.42$21.35$11.53$4.27
    88305XTissue exam by pathologist03430.42$21.35$11.53$4.27
    88307XTissue exam by pathologist03440.60$30.51$16.78$6.10
    88309XTissue exam by pathologist03440.60$30.51$16.78$6.10
    88311XDecalcify tissue03420.22$11.19$6.15$2.24
    88312XSpecial stains03430.42$21.35$11.53$4.27
    88313XSpecial stains03420.22$11.19$6.15$2.24
    88314XHistochemical stain03430.42$21.35$11.53$4.27
    88318XChemical histochemistry03430.42$21.35$11.53$4.27
    88319XEnzyme histochemistry03420.22$11.19$6.15$2.24
    88321XMicroslide consultation03420.22$11.19$6.15$2.24
    88323XMicroslide consultation03430.42$21.35$11.53$4.27
    88325XComprehensive review of data03430.42$21.35$11.53$4.27
    88329XPath consult introp03430.42$21.35$11.53$4.27
    88331XPath consult intraop, 1 bloc03430.42$21.35$11.53$4.27
    88332XPath consult intraop, addl03430.42$21.35$11.53$4.27
    88342XImmunocytochemistry03440.60$30.51$16.78$6.10
    88346XImmunofluorescent study03430.42$21.35$11.53$4.27
    88347XImmunofluorescent study03440.60$30.51$16.78$6.10
    88348XElectron microscopy03440.60$30.51$16.78$6.10
    88349XScanning electron microscopy03440.60$30.51$16.78$6.10
    88355XAnalysis, skeletal muscle03440.60$30.51$16.78$6.10
    88356XAnalysis, nerve03440.60$30.51$16.78$6.10
    88358XAnalysis, tumor03440.60$30.51$16.78$6.10
    88362XNerve teasing preparations03430.42$21.35$11.53$4.27
    88365XTissue hybridization03440.60$30.51$16.78$6.10
    88371AProtein, western blot tissue
    88372AProtein analysis w/probe
    88399XSurgical pathology procedure03490.34$17.29$3.46$3.46
    88400ABilirubin total transcut
    89050ABody fluid cell count
    89051ABody fluid cell count
    89060AExam,synovial fluid crystals
    89100XSample intestinal contents03613.52$178.96$88.09$35.79
    89105XSample intestinal contents03601.40$71.18$34.75$14.24
    89125ASpecimen fat stain
    89130XSample stomach contents03601.40$71.18$34.75$14.24
    89132XSample stomach contents03601.40$71.18$34.75$14.24
    89135XSample stomach contents03601.40$71.18$34.75$14.24
    89136XSample stomach contents03601.40$71.18$34.75$14.24
    89140XSample stomach contents03601.40$71.18$34.75$14.24
    89141XSample stomach contents03601.40$71.18$34.75$14.24
    89160AExam feces for meat fibers
    89190ANasal smear for eosinophils
    89250XFertilization of oocyte03480.85$43.22$8.64$8.64
    Start Printed Page 44824
    89251XCulture oocyte w/embryos03480.85$43.22$8.64$8.64
    89252XAssist oocyte fertilization03480.85$43.22$8.64$8.64
    89253XEmbryo hatching03480.85$43.22$8.64$8.64
    89254XOocyte identification03480.85$43.22$8.64$8.64
    89255XPrepare embryo for transfer03480.85$43.22$8.64$8.64
    89256XPrepare cryopreserved embryo03480.85$43.22$8.64$8.64
    89257XSperm identification03480.85$43.22$8.64$8.64
    89258XCryopreservation, embryo03480.85$43.22$8.64$8.64
    89259XCryopreservation, sperm03480.85$43.22$8.64$8.64
    89260XSperm isolation, simple03480.85$43.22$8.64$8.64
    89261XSperm isolation, complex03480.85$43.22$8.64$8.64
    89264XIdentify sperm tissue03480.85$43.22$8.64$8.64
    89300ASemen analysis
    89310ASemen analysis
    89320ASemen analysis
    89321ASemen analysis
    89325ASperm antibody test
    89329ASperm evaluation test
    89330AEvaluation, cervical mucus
    89350XSputum specimen collection03440.60$30.51$16.78$6.10
    89355AExam feces for starch
    89360XCollect sweat for test03440.60$30.51$16.78$6.10
    89365AWater load test
    89399XPathology lab procedure03490.34$17.29$3.46$3.46
    90281EHuman ig, im
    90283EHuman ig, iv
    90287EBotulinum antitoxin
    90288EBotulism ig, iv
    90291ECmv ig, iv
    90296KDiphtheria antitoxin03561.20$61.01$12.20
    90371KHep b ig, im03561.20$61.01$12.20
    90375KRabies ig, im/sc03561.20$61.01$12.20
    90376KRabies ig, heat treated03561.20$61.01$12.20
    90378KRsv ig, im, 50mg03561.20$61.01$12.20
    90379KRsv ig, iv03561.20$61.01$12.20
    90384ERh ig, full-dose, im
    90385KRh ig, minidose, im03561.20$61.01$12.20
    90386ERh ig, iv
    90389KTetanus ig, im03561.20$61.01$12.20
    90393KVaccina ig, im03561.20$61.01$12.20
    90396KVaricella-zoster ig, im03561.20$61.01$12.20
    90399EImmune globulin
    90471NImmunization admin
    90472NImmunization admin, each add
    90476KAdenovirus vaccine, type 403561.20$61.01$12.20
    90477KAdenovirus vaccine, type 703561.20$61.01$12.20
    90581KAnthrax vaccine, sc03561.20$61.01$12.20
    90585KBcg vaccine, percut03561.20$61.01$12.20
    90586KBcg vaccine, intravesical03561.20$61.01$12.20
    90632KHep a vaccine, adult im03561.20$61.01$12.20
    90633KHep a vacc, ped/adol, 2 dose03561.20$61.01$12.20
    90634KHep a vacc, ped/adol, 3 dose03561.20$61.01$12.20
    90636KHep a/hep b vacc, adult im03550.20$10.17$2.03
    90645KHib vaccine, hboc, im03550.20$10.17$2.03
    90646KHib vaccine, prp-d, im03550.20$10.17$2.03
    90647KHib vaccine, prp-omp, im03550.20$10.17$2.03
    90648KHib vaccine, prp-t, im03550.20$10.17$2.03
    90657KFlu vaccine, 6-35 mo, im03540.11$5.59
    90658KFlu vaccine, 3 yrs, im03540.11$5.59
    90659KFlu vaccine, whole, im03540.11$5.59
    90660EFlu vaccine, nasal
    90665KLyme disease vaccine, im03561.20$61.01$12.20
    90669EPneumococcal vacc, ped<5
    90675KRabies vaccine, im03561.20$61.01$12.20
    90676KRabies vaccine, id03561.20$61.01$12.20
    90680KRotovirus vaccine, oral03561.20$61.01$12.20
    90690KTyphoid vaccine, oral03561.20$61.01$12.20
    90691KTyphoid vaccine, im03561.20$61.01$12.20
    90692KTyphoid vaccine, h-p, sc/id03550.20$10.17$2.03
    90693KTyphoid vaccine, akd, sc03561.20$61.01$12.20
    90700KDtap vaccine, im03550.20$10.17$2.03
    90701KDtp vaccine, im03550.20$10.17$2.03
    90702KDt vaccine < 7, im03550.20$10.17$2.03
    90703KTetanus vaccine, im03550.20$10.17$2.03
    90704KMumps vaccine, sc03550.20$10.17$2.03
    Start Printed Page 44825
    90705KMeasles vaccine, sc03561.20$61.01$12.20
    90706KRubella vaccine, sc03550.20$10.17$2.03
    90707KMmr vaccine, sc03561.20$61.01$12.20
    90708KMeasles-rubella vaccine, sc03561.20$61.01$12.20
    90709KRubella & mumps vaccine, sc03561.20$61.01$12.20
    90710KMmrv vaccine, sc03561.20$61.01$12.20
    90712KOral poliovirus vaccine03550.20$10.17$2.03
    90713KPoliovirus, ipv, sc03550.20$10.17$2.03
    90716KChicken pox vaccine, sc03550.20$10.17$2.03
    90717KYellow fever vaccine, sc03561.20$61.01$12.20
    90718KTd vaccine > 7, im03550.20$10.17$2.03
    90719KDiphtheria vaccine, im03561.20$61.01$12.20
    90720KDtp/hib vaccine, im03550.20$10.17$2.03
    90721KDtap/hib vaccine, im03550.20$10.17$2.03
    90723KDtap-hep b-ipv vaccine, im03561.20$61.01$12.20
    90725KCholera vaccine, injectable03550.20$10.17$2.03
    90727KPlague vaccine, im03550.20$10.17$2.03
    90732KPneumococcal vacc, adult/ill03540.11$5.59
    90733KMeningococcal vaccine, sc03561.20$61.01$12.20
    90735KEncephalitis vaccine, sc03561.20$61.01$12.20
    90740KHepb vacc, ill pat 3 dose im03561.20$61.01$12.20
    90743KHep b vacc, adol, 2 dose, im03561.20$61.01$12.20
    90744KHepb vacc ped/adol 3 dose im03561.20$61.01$12.20
    90746KHep b vaccine, adult, im03561.20$61.01$12.20
    90747KHepb vacc, ill pat 4 dose im03561.20$61.01$12.20
    90748KHep b/hib vaccine, im03550.20$10.17$2.03
    90749KVaccine toxoid03550.20$10.17$2.03
    90780EIV infusion therapy, 1 hour
    90781EIV infusion, additional hour
    90782XInjection, sc/im03520.45$22.88$4.58$4.58
    90783XInjection, ia03591.91$97.11$19.42$19.42
    90784XInjection, iv03591.91$97.11$19.42$19.42
    90788XInjection of antibiotic03591.91$97.11$19.42$19.42
    90799XTher/prophylactic/dx inject03520.45$22.88$4.58$4.58
    90801SPsy dx interview03231.89$96.09$22.48$19.22
    90802SIntac psy dx interview03231.89$96.09$22.48$19.22
    90804SPsytx, office, 20-30 min03221.25$63.55$13.35$12.71
    90805SPsytx, off, 20-30 min w/e&m03221.25$63.55$13.35$12.71
    90806SPsytx, off, 45-50 min03231.89$96.09$22.48$19.22
    90807SPsytx, off, 45-50 min w/e&m03231.89$96.09$22.48$19.22
    90808SPsytx, office, 75-80 min03231.89$96.09$22.48$19.22
    90809SPsytx, off, 75-80, w/e&m03231.89$96.09$22.48$19.22
    90810SIntac psytx, off, 20-30 min03221.25$63.55$13.35$12.71
    90811SIntac psytx, 20-30, w/e&m03221.25$63.55$13.35$12.71
    90812SIntac psytx, off, 45-50 min03231.89$96.09$22.48$19.22
    90813SIntac psytx, 45-50 min w/e&m03231.89$96.09$22.48$19.22
    90814SIntac psytx, off, 75-80 min03231.89$96.09$22.48$19.22
    90815SIntac psytx, 75-80 w/e&m03231.89$96.09$22.48$19.22
    90816SPsytx, hosp, 20-30 min03221.25$63.55$13.35$12.71
    90817SPsytx, hosp, 20-30 min w/e&m03221.25$63.55$13.35$12.71
    90818SPsytx, hosp, 45-50 min03231.89$96.09$22.48$19.22
    90819SPsytx, hosp, 45-50 min w/e&m03231.89$96.09$22.48$19.22
    90821SPsytx, hosp, 75-80 min03231.89$96.09$22.48$19.22
    90822SPsytx, hosp, 75-80 min w/e&m03231.89$96.09$22.48$19.22
    90823SIntac psytx, hosp, 20-30 min03221.25$63.55$13.35$12.71
    90824SIntac psytx, hsp 20-30 w/e&m03221.25$63.55$13.35$12.71
    90826SIntac psytx, hosp, 45-50 min03231.89$96.09$22.48$19.22
    90827SIntac psytx, hsp 45-50 w/e&m03231.89$96.09$22.48$19.22
    90828SIntac psytx, hosp, 75-80 min03231.89$96.09$22.48$19.22
    90829SIntac psytx, hsp 75-80 w/e&m03231.89$96.09$22.48$19.22
    90845SPsychoanalysis03231.89$96.09$22.48$19.22
    90846SFamily psytx w/o patient03243.13$159.14$31.83$31.83
    90847SFamily psytx w/patient03243.13$159.14$31.83$31.83
    90849SMultiple family group psytx03251.49$75.75$19.70$15.15
    90853SGroup psychotherapy03251.49$75.75$19.70$15.15
    90857SIntac group psytx03251.49$75.75$19.70$15.15
    90862XMedication management03740.96$48.81$10.74$9.76
    90865SNarcosynthesis03231.89$96.09$22.48$19.22
    90870SElectroconvulsive therapy03204.20$213.54$80.06$42.71
    90871SElectroconvulsive therapy03204.20$213.54$80.06$42.71
    90875EPsychophysiological therapy
    90876EPsychophysiological therapy
    90880SHypnotherapy03231.89$96.09$22.48$19.22
    90882EEnvironmental manipulation
    90885NPsy evaluation of records
    Start Printed Page 44826
    90887NConsultation with family
    90889NPreparation of report
    90899SPsychiatric service/therapy03221.25$63.55$13.35$12.71
    90901SBiofeedback train, any meth03211.02$51.86$23.86$10.37
    90911SBiofeedback peri/uro/rectal03211.02$51.86$23.86$10.37
    90918AESRD related services, month
    90919AESRD related services, month
    90920AESRD related services, month
    90921AESRD related services, month
    90922AESRD related services, day
    90923AEsrd related services, day
    90924AEsrd related services, day
    90925AEsrd related services, day
    90935SHemodialysis, one evaluation01701.08$54.91$12.08$10.98
    90937EHemodialysis, repeated eval
    90940NHemodialysis access study
    90945SDialysis, one evaluation01701.08$54.91$12.08$10.98
    90947EDialysis, repeated eval
    90989EDialysis training, complete
    90993EDialysis training, incompl
    90997EHemoperfusion
    90999EDialysis procedure
    91000XEsophageal intubation03613.52$178.96$88.09$35.79
    91010XEsophagus motility study03613.52$178.96$88.09$35.79
    91011XEsophagus motility study03613.52$178.96$88.09$35.79
    91012XEsophagus motility study03613.52$178.96$88.09$35.79
    91020XGastric motility03613.52$178.96$88.09$35.79
    91030XAcid perfusion of esophagus03601.40$71.18$34.75$14.24
    91032XEsophagus, acid reflux test03613.52$178.96$88.09$35.79
    91033XProlonged acid reflux test03613.52$178.96$88.09$35.79
    91052XGastric analysis test03613.52$178.96$88.09$35.79
    91055XGastric intubation for smear03601.40$71.18$34.75$14.24
    91060XGastric saline load test03601.40$71.18$34.75$14.24
    91065XBreath hydrogen test03601.40$71.18$34.75$14.24
    91100XPass intestine bleeding tube03601.40$71.18$34.75$14.24
    91105XGastric intubation treatment03613.52$178.96$88.09$35.79
    91122TAnal pressure record01562.62$133.21$39.96$26.64
    91132XElectrogastrography03601.40$71.18$34.75$14.24
    91133XElectrogastrography w/test03601.40$71.18$34.75$14.24
    91299XGastroenterology procedure03601.40$71.18$34.75$14.24
    92002VEye exam, new patient06011.02$51.86$10.37$10.37
    92004VEye exam, new patient06021.49$75.75$15.15$15.15
    92012VEye exam established pat06011.02$51.86$10.37$10.37
    92014VEye exam & treatment06021.49$75.75$15.15$15.15
    92015ERefraction
    92018TNew eye exam & treatment06996.91$351.32$158.09$70.26
    92019SEye exam & treatment06981.09$55.42$24.94$11.08
    92020SSpecial eye evaluation02300.64$32.54$14.97$6.51
    92060SSpecial eye evaluation02300.64$32.54$14.97$6.51
    92065SOrthoptic/pleoptic training02300.64$32.54$14.97$6.51
    92070NFitting of contact lens
    92081SVisual field examination(s)02300.64$32.54$14.97$6.51
    92082SVisual field examination(s)06981.09$55.42$24.94$11.08
    92083SVisual field examination(s)06981.09$55.42$24.94$11.08
    92100NSerial tonometry exam(s)
    92120STonography & eye evaluation02300.64$32.54$14.97$6.51
    92130SWater provocation tonography02300.64$32.54$14.97$6.51
    92135SOpthalmic dx imaging02300.64$32.54$14.97$6.51
    92140SGlaucoma provocative tests02312.27$115.41$51.94$23.08
    92225SSpecial eye exam, initial02300.64$32.54$14.97$6.51
    92226SSpecial eye exam, subsequent02312.27$115.41$51.94$23.08
    92230TEye exam with photos06996.91$351.32$158.09$70.26
    92235SEye exam with photos02312.27$115.41$51.94$23.08
    92240SIcg angiography02312.27$115.41$51.94$23.08
    92250SEye exam with photos02300.64$32.54$14.97$6.51
    92260SOphthalmoscopy/dynamometry02300.64$32.54$14.97$6.51
    92265SEye muscle evaluation02312.27$115.41$51.94$23.08
    92270SElectro-oculography06981.09$55.42$24.94$11.08
    92275SElectroretinography02162.91$147.95$64.69$29.59
    92283SColor vision examination02300.64$32.54$14.97$6.51
    92284SDark adaptation eye exam02312.27$115.41$51.94$23.08
    92285SEye photography02300.64$32.54$14.97$6.51
    92286SInternal eye photography02300.64$32.54$14.97$6.51
    92287SInternal eye photography02312.27$115.41$51.94$23.08
    92310EContact lens fitting
    Start Printed Page 44827
    92311XContact lens fitting03620.83$42.20$9.63$8.44
    92312XContact lens fitting03620.83$42.20$9.63$8.44
    92313XContact lens fitting03620.83$42.20$9.63$8.44
    92314EPrescription of contact lens
    92315XPrescription of contact lens03620.83$42.20$9.63$8.44
    92316XPrescription of contact lens03620.83$42.20$9.63$8.44
    92317XPrescription of contact lens03620.83$42.20$9.63$8.44
    92325XModification of contact lens03620.83$42.20$9.63$8.44
    92326XReplacement of contact lens03620.83$42.20$9.63$8.44
    92330SFitting of artificial eye02300.64$32.54$14.97$6.51
    92335NFitting of artificial eye
    92340EFitting of spectacles
    92341EFitting of spectacles
    92342EFitting of spectacles
    92352XSpecial spectacles fitting03620.83$42.20$9.63$8.44
    92353XSpecial spectacles fitting03620.83$42.20$9.63$8.44
    92354XSpecial spectacles fitting03620.83$42.20$9.63$8.44
    92355XSpecial spectacles fitting03620.83$42.20$9.63$8.44
    92358XEye prosthesis service03620.83$42.20$9.63$8.44
    92370ERepair & adjust spectacles
    92371XRepair & adjust spectacles03620.83$42.20$9.63$8.44
    92390ESupply of spectacles
    92391ESupply of contact lenses
    92392ESupply of low vision aids
    92393ESupply of artificial eye
    92395ESupply of spectacles
    92396ESupply of contact lenses
    92499SEye service or procedure02300.64$32.54$14.97$6.51
    92502TEar and throat examination02512.71$137.78$27.99$27.56
    92504NEar microscopy examination
    92506ASpeech/hearing evaluation
    92507ASpeech/hearing therapy
    92508ASpeech/hearing therapy
    92510ARehab for ear implant
    92511TNasopharyngoscopy00711.08$54.91$14.22$10.98
    92512XNasal function studies03632.06$104.73$38.75$20.95
    92516XFacial nerve function test03632.06$104.73$38.75$20.95
    92520XLaryngeal function studies03632.06$104.73$38.75$20.95
    92525AOral function evaluation
    92526AOral function therapy
    92531NSpontaneous nystagmus study
    92532NPositional nystagmus study
    92533NCaloric vestibular test
    92534NOptokinetic nystagmus
    92541XSpontaneous nystagmus test03632.06$104.73$38.75$20.95
    92542XPositional nystagmus test03632.06$104.73$38.75$20.95
    92543XCaloric vestibular test03632.06$104.73$38.75$20.95
    92544XOptokinetic nystagmus test03632.06$104.73$38.75$20.95
    92545XOscillating tracking test03632.06$104.73$38.75$20.95
    92546XSinusoidal rotational test03632.06$104.73$38.75$20.95
    92547XSupplemental electrical test03632.06$104.73$38.75$20.95
    92548XPosturography03632.06$104.73$38.75$20.95
    92551EPure tone hearing test, air
    92552XPure tone audiometry, air03640.55$27.96$10.91$5.59
    92553XAudiometry, air & bone03651.42$72.20$21.66$14.44
    92555XSpeech threshold audiometry03640.55$27.96$10.91$5.59
    92556XSpeech audiometry, complete03640.55$27.96$10.91$5.59
    92557XComprehensive hearing test03651.42$72.20$21.66$14.44
    92559EGroup audiometric testing
    92560EBekesy audiometry, screen
    92561XBekesy audiometry, diagnosis03651.42$72.20$21.66$14.44
    92562XLoudness balance test03640.55$27.96$10.91$5.59
    92563XTone decay hearing test03640.55$27.96$10.91$5.59
    92564XSisi hearing test03640.55$27.96$10.91$5.59
    92565XStenger test, pure tone03640.55$27.96$10.91$5.59
    92567XTympanometry03640.55$27.96$10.91$5.59
    92568XAcoustic reflex testing03640.55$27.96$10.91$5.59
    92569XAcoustic reflex decay test03640.55$27.96$10.91$5.59
    92571XFiltered speech hearing test03640.55$27.96$10.91$5.59
    92572XStaggered spondaic word test03640.55$27.96$10.91$5.59
    92573XLombard test03640.55$27.96$10.91$5.59
    92575XSensorineural acuity test03651.42$72.20$21.66$14.44
    92576XSynthetic sentence test03640.55$27.96$10.91$5.59
    92577XStenger test, speech03651.42$72.20$21.66$14.44
    92579XVisual audiometry (vra)03651.42$72.20$21.66$14.44
    Start Printed Page 44828
    92582XConditioning play audiometry03651.42$72.20$21.66$14.44
    92583XSelect picture audiometry03640.55$27.96$10.91$5.59
    92584XElectrocochleography03632.06$104.73$38.75$20.95
    92585SAuditor evoke potent, compre02162.91$147.95$64.69$29.59
    92586SAuditor evoke potent, limit09711.42$72.20$14.44
    92587XEvoked auditory test03632.06$104.73$38.75$20.95
    92588XEvoked auditory test03632.06$104.73$38.75$20.95
    92589XAuditory function test(s)03640.55$27.96$10.91$5.59
    92590EHearing aid exam, one ear
    92591EHearing aid exam, both ears
    92592EHearing aid check, one ear
    92593EHearing aid check, both ears
    92594EElectro hearng aid test, one
    92595EElectro hearng aid tst, both
    92596XEar protector evaluation03651.42$72.20$21.66$14.44
    92599XENT procedure/service03640.55$27.96$10.91$5.59
    92950SHeart/lung resuscitation cpr00945.69$289.29$105.29$57.86
    92953STemporary external pacing00945.69$289.29$105.29$57.86
    92960SCardioversion electric, ext00945.69$289.29$105.29$57.86
    92961SCardioversion, electric, int008714.89$757.04$214.72$151.41
    92970CCardioassist, internal
    92971CCardioassist, external
    92975CDissolve clot, heart vessel
    92977TDissolve clot, heart vessel01202.35$119.48$42.67$23.90
    92978SIntravasc us, heart add-on02672.58$131.17$72.14$26.23
    92979SIntravasc us, heart add-on02672.58$131.17$72.14$26.23
    92980TInsert intracoronary stent010471.42$3,631.14$726.23$726.23
    92981TInsert intracoronary stent010471.42$3,631.14$726.23$726.23
    92982TCoronary artery dilation008350.15$2,549.73$794.30$509.95
    92984TCoronary artery dilation008350.15$2,549.73$794.30$509.95
    92986CRevision of aortic valve
    92987CRevision of mitral valve
    92990CRevision of pulmonary valve
    92992CRevision of heart chamber
    92993CRevision of heart chamber
    92995TCoronary atherectomy0082130.89$6,654.71$1,351.74$1,330.94
    92996TCoronary atherectomy add-on0082130.89$6,654.71$1,351.74$1,330.94
    92997CPul art balloon repr, percut
    92998CPul art balloon repr, percut
    93000EElectrocardiogram, complete
    93005SElectrocardiogram, tracing00990.38$19.32$10.63$3.86
    93010SElectrocardiogram report
    93012NTransmission of ecg
    93014EReport on transmitted ecg
    93015ECardiovascular stress test
    93016ECardiovascular stress test
    93017XCardiovascular stress test01001.63$82.87$45.58$16.57
    93018ECardiovascular stress test
    93024XCardiac drug stress test01001.63$82.87$45.58$16.57
    93040ERhythm ECG with report
    93041SRhythm ECG, tracing00990.38$19.32$10.63$3.86
    93042ERhythm ECG, report
    93224EECG monitor/report, 24 hrs
    93225XECG monitor/record, 24 hrs01001.63$82.87$45.58$16.57
    93226XECG monitor/report, 24 hrs01001.63$82.87$45.58$16.57
    93227EECG monitor/review, 24 hrs
    93230EECG monitor/report, 24 hrs
    93231XEcg monitor/record, 24 hrs01001.63$82.87$45.58$16.57
    93232XECG monitor/report, 24 hrs01001.63$82.87$45.58$16.57
    93233EECG monitor/review, 24 hrs
    93235EECG monitor/report, 24 hrs
    93236XECG monitor/report, 24 hrs01001.63$82.87$45.58$16.57
    93237EECG monitor/review, 24 hrs
    93268EECG record/review
    93270XECG recording00970.87$44.23$24.33$8.85
    93271XEcg/monitoring and analysis00970.87$44.23$24.33$8.85
    93272EEcg/review, interpret only
    93278SECG/signal-averaged00990.38$19.32$10.63$3.86
    93303SEcho transthoracic02694.31$219.13$113.95$43.83
    93304SEcho transthoracic06972.00$101.68$52.88$20.34
    93307SEcho exam of heart02694.31$219.13$113.95$43.83
    93308SEcho exam of heart06972.00$101.68$52.88$20.34
    93312SEcho transesophageal02705.83$296.41$150.26$59.28
    93313SEcho transesophageal02705.83$296.41$150.26$59.28
    93314NEcho transesophageal
    Start Printed Page 44829
    93315SEcho transesophageal02705.83$296.41$150.26$59.28
    93316SEcho transesophageal02705.83$296.41$150.26$59.28
    93317NEcho transesophageal
    93318SEcho transesophageal intraop02705.83$296.41$150.26$59.28
    93320SDoppler echo exam, heart02694.31$219.13$113.95$43.83
    93321SDoppler echo exam, heart06972.00$101.68$52.88$20.34
    93325SDoppler color flow add-on06972.00$101.68$52.88$20.34
    93350SEcho transthoracic02694.31$219.13$113.95$43.83
    93501TRight heart catheterization008032.20$1,637.11$838.92$327.42
    93503TInsert/place heart catheter010310.91$554.69$249.61$110.94
    93505TBiopsy of heart lining010310.91$554.69$249.61$110.94
    93508NCath placement, angiography
    93510TLeft heart catheterization008032.20$1,637.11$838.92$327.42
    93511TLeft heart catheterization008032.20$1,637.11$838.92$327.42
    93514TLeft heart catheterization008032.20$1,637.11$838.92$327.42
    93524TLeft heart catheterization008032.20$1,637.11$838.92$327.42
    93526TRt & Lt heart catheters008032.20$1,637.11$838.92$327.42
    93527TRt & Lt heart catheters008032.20$1,637.11$838.92$327.42
    93528TRt & Lt heart catheters008032.20$1,637.11$838.92$327.42
    93529TRt, Lt heart catheterization008032.20$1,637.11$838.92$327.42
    93530TRt heart cath, congenital008032.20$1,637.11$838.92$327.42
    93531TR & l heart cath, congenital008032.20$1,637.11$838.92$327.42
    93532TR & l heart cath, congenital008032.20$1,637.11$838.92$327.42
    93533TR & l heart cath, congenital008032.20$1,637.11$838.92$327.42
    93536TInsert circulation assi010310.91$554.69$249.61$110.94
    93539NInjection, cardiac cath
    93540NInjection, cardiac cath
    93541NInjection for lung angiogram
    93542NInjection for heart x-rays
    93543NInjection for heart x-rays
    93544NInjection for aortography
    93545NInject for coronary x-rays
    93555NImaging, cardiac cath
    93556NImaging, cardiac cath
    93561NCardiac output measurement
    93562NCardiac output measurement
    93571NHeart flow reserve measure
    93572NHeart flow reserve measure
    93600SBundle of His recording008714.89$757.04$214.72$151.41
    93602SIntra-atrial recording008714.89$757.04$214.72$151.41
    93603SRight ventricular recording008714.89$757.04$214.72$151.41
    93607SLeft ventricular recording008714.89$757.04$214.72$151.41
    93609SMapping of tachycardia008714.89$757.04$214.72$151.41
    93610SIntra-atrial pacing008714.89$757.04$214.72$151.41
    93612SIntraventricular pacing008714.89$757.04$214.72$151.41
    93615SEsophageal recording008714.89$757.04$214.72$151.41
    93616SEsophageal recording008714.89$757.04$214.72$151.41
    93618SHeart rhythm pacing008714.89$757.04$214.72$151.41
    93619SElectrophysiology evaluation008527.39$1,392.56$654.48$278.51
    93620SElectrophysiology evaluation008527.39$1,392.56$654.48$278.51
    93621SElectrophysiology evaluation008527.39$1,392.56$654.48$278.51
    93622SElectrophysiology evaluation008527.39$1,392.56$654.48$278.51
    93623SStimulation, pacing heart008714.89$757.04$214.72$151.41
    93624SElectrophysiologic study008714.89$757.04$214.72$151.41
    93631SHeart pacing, mapping008714.89$757.04$214.72$151.41
    93640SEvaluation heart device00844.94$251.16$82.88$50.23
    93641SElectrophysiology evaluation00844.94$251.16$82.88$50.23
    93642SElectrophysiology evaluation00844.94$251.16$82.88$50.23
    93650SAblate heart dysrhythm focus008647.13$2,396.18$1,265.37$479.24
    93651SAblate heart dysrhythm focus008647.13$2,396.18$1,265.37$479.24
    93652SAblate heart dysrhythm focus008647.13$2,396.18$1,265.37$479.24
    93660STilt table evaluation01014.03$204.89$112.69$40.98
    93662SIntracardiac ecg (ice)02705.83$296.41$150.26$59.28
    93668EPeripheral vascular rehab
    93720ETotal body plethysmography
    93721SPlethysmography tracing00961.87$95.07$52.29$19.01
    93722EPlethysmography report
    93724SAnalyze pacemaker system06900.40$20.34$11.19$4.07
    93727SAnalyze ilr system06900.40$20.34$11.19$4.07
    93731SAnalyze pacemaker system06900.40$20.34$11.19$4.07
    93732SAnalyze pacemaker system06900.40$20.34$11.19$4.07
    93733STelephone analy, pacemaker06900.40$20.34$11.19$4.07
    93734SAnalyze pacemaker system06900.40$20.34$11.19$4.07
    93735SAnalyze pacemaker system06900.40$20.34$11.19$4.07
    93736STelephone analy, pacemaker06900.40$20.34$11.19$4.07
    Start Printed Page 44830
    93737SAnalyze cardio/defibrillator06890.49$24.91$13.70$4.98
    93738SAnalyze cardio/defibrillator06890.49$24.91$13.70$4.98
    93740STemperature gradient studies00961.87$95.07$52.29$19.01
    93741SAnalyze ht pace device sngl06890.49$24.91$13.70$4.98
    93742SAnalyze ht pace device sngl06890.49$24.91$13.70$4.98
    93743SAnalyze ht pace device dual06890.49$24.91$13.70$4.98
    93744SAnalyze ht pace device dual06890.49$24.91$13.70$4.98
    93760ECephalic thermogram
    93762EPeripheral thermogram
    93770NMeasure venous pressure
    93784EAmbulatory BP monitoring
    93786EAmbulatory BP recording
    93788EAmbulatory BP analysis
    93790EReview/report BP recording
    93797SCardiac rehab00950.66$33.56$16.98$6.71
    93798SCardiac rehab/monitor00950.66$33.56$16.98$6.71
    93799SCardiovascular procedure00961.87$95.07$52.29$19.01
    93875SExtracranial study00961.87$95.07$52.29$19.01
    93880SExtracranial study02672.58$131.17$72.14$26.23
    93882SExtracranial study02672.58$131.17$72.14$26.23
    93886SIntracranial study02672.58$131.17$72.14$26.23
    93888SIntracranial study02672.58$131.17$72.14$26.23
    93922SExtremity study00961.87$95.07$52.29$19.01
    93923SExtremity study00961.87$95.07$52.29$19.01
    93924SExtremity study00961.87$95.07$52.29$19.01
    93925SLower extremity study02672.58$131.17$72.14$26.23
    93926SLower extremity study02672.58$131.17$72.14$26.23
    93930SUpper extremity study02672.58$131.17$72.14$26.23
    93931SUpper extremity study02672.58$131.17$72.14$26.23
    93965SExtremity study00961.87$95.07$52.29$19.01
    93970SExtremity study02672.58$131.17$72.14$26.23
    93971SExtremity study02672.58$131.17$72.14$26.23
    93975SVascular study02672.58$131.17$72.14$26.23
    93976SVascular study02672.58$131.17$72.14$26.23
    93978SVascular study02672.58$131.17$72.14$26.23
    93979SVascular study02672.58$131.17$72.14$26.23
    93980SPenile vascular study02672.58$131.17$72.14$26.23
    93981SPenile vascular study02672.58$131.17$72.14$26.23
    93990SDoppler flow testing02672.58$131.17$72.14$26.23
    94010XBreathing capacity test03670.76$38.64$19.32$7.73
    94014XPatient recorded spirometry03670.76$38.64$19.32$7.73
    94015XPatient recorded spirometry03670.76$38.64$19.32$7.73
    94016XReview patient spirometry03693.99$202.86$58.50$40.57
    94060XEvaluation of wheezing03681.53$77.79$39.67$15.56
    94070XEvaluation of wheezing03681.53$77.79$39.67$15.56
    94150NVital capacity test
    94200XLung function test (MBC/MVV)03670.76$38.64$19.32$7.73
    94240XResidual lung capacity03681.53$77.79$39.67$15.56
    94250XExpired gas collection03670.76$38.64$19.32$7.73
    94260XThoracic gas volume03681.53$77.79$39.67$15.56
    94350XLung nitrogen washout curve03681.53$77.79$39.67$15.56
    94360XMeasure airflow resistance03681.53$77.79$39.67$15.56
    94370XBreath airway closing volume03681.53$77.79$39.67$15.56
    94375XRespiratory flow volume loop03670.76$38.64$19.32$7.73
    94400XCO2 breathing response curve03681.53$77.79$39.67$15.56
    94450XHypoxia response curve03670.76$38.64$19.32$7.73
    94620XPulmonary stress test/simple03681.53$77.79$39.67$15.56
    94621XPulm stress test/complex03693.99$202.86$58.50$40.57
    94640SAirway inhalation treatment00770.42$21.35$11.74$4.27
    94642SAerosol inhalation treatment00780.93$47.28$20.33$9.46
    94650SPressure breathing (IPPB)00770.42$21.35$11.74$4.27
    94651SPressure breathing (IPPB)00770.42$21.35$11.74$4.27
    94652CPressure breathing (IPPB)
    94656SInitial ventilator mgmt00790.62$31.52$17.34$6.30
    94657SContinued ventilator mgmt00790.62$31.52$17.34$6.30
    94660SPos airway pressure, CPAP00683.33$169.30$93.12$33.86
    94662SNeg press ventilation, cnp00790.62$31.52$17.34$6.30
    94664SAerosol or vapor inhalations00770.42$21.35$11.74$4.27
    94665SAerosol or vapor inhalations00770.42$21.35$11.74$4.27
    94667SChest wall manipulation00770.42$21.35$11.74$4.27
    94668SChest wall manipulation00770.42$21.35$11.74$4.27
    94680XExhaled air analysis, o203681.53$77.79$39.67$15.56
    94681XExhaled air analysis, o2/co203681.53$77.79$39.67$15.56
    94690XExhaled air analysis03670.76$38.64$19.32$7.73
    94720XMonoxide diffusing capacity03670.76$38.64$19.32$7.73
    Start Printed Page 44831
    94725XMembrane diffusion capacity03681.53$77.79$39.67$15.56
    94750XPulmonary compliance study03681.53$77.79$39.67$15.56
    94760NMeasure blood oxygen level
    94761NMeasure blood oxygen level
    94762NMeasure blood oxygen level
    94770XExhaled carbon dioxide test03670.76$38.64$19.32$7.73
    94772XBreath recording, infant03693.99$202.86$58.50$40.57
    94799XPulmonary service/procedure03670.76$38.64$19.32$7.73
    95004XAllergy skin tests03700.87$44.23$11.81$8.85
    95010XSensitivity skin tests03700.87$44.23$11.81$8.85
    95015XSensitivity skin tests03700.87$44.23$11.81$8.85
    95024XAllergy skin tests03700.87$44.23$11.81$8.85
    95027XSkin end point titration03700.87$44.23$11.81$8.85
    95028XAllergy skin tests03700.87$44.23$11.81$8.85
    95044XAllergy patch tests03700.87$44.23$11.81$8.85
    95052XPhoto patch test03700.87$44.23$11.81$8.85
    95056XPhotosensitivity tests03700.87$44.23$11.81$8.85
    95060XEye allergy tests03700.87$44.23$11.81$8.85
    95065XNose allergy test03700.87$44.23$11.81$8.85
    95070XBronchial allergy tests03693.99$202.86$58.50$40.57
    95071XBronchial allergy tests03693.99$202.86$58.50$40.57
    95075XIngestion challenge test03613.52$178.96$88.09$35.79
    95078XProvocative testing03700.87$44.23$11.81$8.85
    95115XImmunotherapy, one injection03530.27$13.73$2.75$2.75
    95117XImmunotherapy injections03530.27$13.73$2.75$2.75
    95120EImmunotherapy, one injection
    95125EImmunotherapy, many antigens
    95130EImmunotherapy, insect venom
    95131EImmunotherapy, insect venoms
    95132EImmunotherapy, insect venoms
    95133EImmunotherapy, insect venoms
    95134EImmunotherapy, insect venoms
    95144XAntigen therapy services03710.76$38.64$7.73$7.73
    95145XAntigen therapy services03710.76$38.64$7.73$7.73
    95146XAntigen therapy services03710.76$38.64$7.73$7.73
    95147XAntigen therapy services03710.76$38.64$7.73$7.73
    95148XAntigen therapy services03710.76$38.64$7.73$7.73
    95149XAntigen therapy services03710.76$38.64$7.73$7.73
    95165XAntigen therapy services03710.76$38.64$7.73$7.73
    95170XAntigen therapy services03710.76$38.64$7.73$7.73
    95180XRapid desensitization03700.87$44.23$11.81$8.85
    95199XAllergy immunology services03700.87$44.23$11.81$8.85
    95805SMultiple sleep latency test020911.73$596.38$310.12$119.28
    95806SSleep study, unattended02132.95$149.98$77.99$30.00
    95807SSleep study, attended020911.73$596.38$310.12$119.28
    95808SPolysomnography, 1-3020911.73$596.38$310.12$119.28
    95810SPolysomnography, 4 or more020911.73$596.38$310.12$119.28
    95811SPolysomnography w/cpap020911.73$596.38$310.12$119.28
    95812SElectroencephalogram (EEG)02132.95$149.98$77.99$30.00
    95813SElectroencephalogram (EEG)02132.95$149.98$77.99$30.00
    95816SElectroencephalogram (EEG)02142.27$115.41$57.71$23.08
    95819SElectroencephalogram (EEG)02142.27$115.41$57.71$23.08
    95822SSleep electroencephalogram02142.27$115.41$57.71$23.08
    95824SElectroencephalography02142.27$115.41$57.71$23.08
    95827SNight electroencephalogram020911.73$596.38$310.12$119.28
    95829SSurgery electrocorticogram02142.27$115.41$57.71$23.08
    95830EInsert electrodes for EEG
    95831NLimb muscle testing, manual
    95832NHand muscle testing, manual
    95833NBody muscle testing, manual
    95834NBody muscle testing, manual
    95851NRange of motion measurements
    95852NRange of motion measurements
    95857STensilon test02181.09$55.42$23.83$11.08
    95858STensilon test & myogram02150.66$33.56$17.45$6.71
    95860SMuscle test, one limb02181.09$55.42$23.83$11.08
    95861SMuscle test, two limbs02181.09$55.42$23.83$11.08
    95863SMuscle test, 3 limbs02181.09$55.42$23.83$11.08
    95864SMuscle test, 4 limbs02181.09$55.42$23.83$11.08
    95867SMuscle test, head or neck02181.09$55.42$23.83$11.08
    95868SMuscle test, head or neck02181.09$55.42$23.83$11.08
    95869SMuscle test, thor paraspinal02150.66$33.56$17.45$6.71
    95870SMuscle test, nonparaspinal02181.09$55.42$23.83$11.08
    95872SMuscle test, one fiber02150.66$33.56$17.45$6.71
    95875SLimb exercise test02150.66$33.56$17.45$6.71
    Start Printed Page 44832
    95900SMotor nerve conduction test02181.09$55.42$23.83$11.08
    95903SMotor nerve conduction test02181.09$55.42$23.83$11.08
    95904SSense/mixed n conduction tst02150.66$33.56$17.45$6.71
    95920SIntraop nerve test add-on02181.09$55.42$23.83$11.08
    95921SAutonomic nerv function test02150.66$33.56$17.45$6.71
    95922SAutonomic nerv function test02150.66$33.56$17.45$6.71
    95923SAutonomic nerv function test02150.66$33.56$17.45$6.71
    95925SSomatosensory testing02162.91$147.95$64.69$29.59
    95926SSomatosensory testing02162.91$147.95$64.69$29.59
    95927SSomatosensory testing02162.91$147.95$64.69$29.59
    95930SVisual evoked potential test02162.91$147.95$64.69$29.59
    95933SBlink reflex test02150.66$33.56$17.45$6.71
    95934SH-reflex test02150.66$33.56$17.45$6.71
    95936SH-reflex test02150.66$33.56$17.45$6.71
    95937SNeuromuscular junction test02181.09$55.42$23.83$11.08
    95950SAmbulatory eeg monitoring02132.95$149.98$77.99$30.00
    95951SEEG monitoring/videorecord020911.73$596.38$310.12$119.28
    95953SEEG monitoring/computer020911.73$596.38$310.12$119.28
    95954SEEG monitoring/giving drugs02132.95$149.98$77.99$30.00
    95955SEEG during surgery02142.27$115.41$57.71$23.08
    95956NEeg monitoring, cable/radio
    95957NEEG digital analysis
    95958SEEG monitoring/function test02132.95$149.98$77.99$30.00
    95961SElectrode stimulation, brain02162.91$147.95$64.69$29.59
    95962SElectrode stim, brain add-on02162.91$147.95$64.69$29.59
    95970SAnalyze neurostim, no prog06921.73$87.96$48.38$17.59
    95971SAnalyze neurostim, simple06921.73$87.96$48.38$17.59
    95972SAnalyze neurostim, complex06921.73$87.96$48.38$17.59
    95973SAnalyze neurostim, complex06921.73$87.96$48.38$17.59
    95974SCranial neurostim, complex06921.73$87.96$48.38$17.59
    95975SCranial neurostim, complex06921.73$87.96$48.38$17.59
    95999NNeurological procedure
    96100XPsychological testing03731.11$56.43$15.80$11.29
    96105XAssessment of aphasia03731.11$56.43$15.80$11.29
    96110XDevelopmental test, lim03731.11$56.43$15.80$11.29
    96111XDevelopmental test, extend03731.11$56.43$15.80$11.29
    96115XNeurobehavior status exam03731.11$56.43$15.80$11.29
    96117XNeuropsych test battery03731.11$56.43$15.80$11.29
    96400EChemotherapy, sc/im
    96405EIntralesional chemo admin
    96406EIntralesional chemo admin
    96408EChemotherapy, push technique
    96410EChemotherapy,infusion method
    96412EChemo, infuse method add-on
    96414EChemo, infuse method add-on
    96420EChemotherapy, push technique
    96422EChemotherapy,infusion method
    96423EChemo, infuse method add-on
    96425EChemotherapy,infusion method
    96440EChemotherapy, intracavitary
    96445EChemotherapy, intracavitary
    96450EChemotherapy, into CNS
    96520TPump refilling, maintenance01253.20$162.69$32.54
    96530TPump refilling, maintenance01253.20$162.69$32.54
    96542EChemotherapy injection
    96545EProvide chemotherapy agent
    96549EChemotherapy, unspecified
    96570TPhotodynamic tx, 30 min09734.73$240.48$48.10
    96571TPhotodynamic tx, addl 15 min09734.73$240.48$48.10
    96900SUltraviolet light therapy00010.45$22.88$8.24$4.58
    96902NTrichogram
    96910SPhotochemotherapy with UV-B00010.45$22.88$8.24$4.58
    96912SPhotochemotherapy with UV-A00010.45$22.88$8.24$4.58
    96913SPhotochemotherapy, UV-A or B00010.45$22.88$8.24$4.58
    96999SDermatological procedure00010.45$22.88$8.24$4.58
    97001APt evaluation
    97002APt re-evaluation
    97003AOt evaluation
    97004AOt re-evaluation
    97010AHot or cold packs therapy
    97012AMechanical traction therapy
    97014AElectric stimulation therapy
    97016AVasopneumatic device therapy
    97018AParaffin bath therapy
    97020AMicrowave therapy
    Start Printed Page 44833
    97022AWhirlpool therapy
    97024ADiathermy treatment
    97026AInfrared therapy
    97028AUltraviolet therapy
    97032AElectrical stimulation
    97033AElectric current therapy
    97034AContrast bath therapy
    97035AUltrasound therapy
    97036AHydrotherapy
    97039APhysical therapy treatment
    97110ATherapeutic exercises
    97112ANeuromuscular reeducation
    97113AAquatic therapy/exercises
    97116AGait training therapy
    97124AMassage therapy
    97139APhysical medicine procedure
    97140AManual therapy
    97150AGroup therapeutic procedures
    97504AOrthotic training
    97520AProsthetic training
    97530ATherapeutic activities
    97532ACognitive skills development
    97533ASensory integration
    97535ASelf care mngment training
    97537ACommunity/work reintegration
    97542AWheelchair mngment training
    97545AWork hardening
    97546AWork hardening add-on
    97601AWound care selective
    97602NWound care non-selective
    97703AProsthetic checkout
    97750APhysical performance test
    97780EAcupuncture w/o stimul
    97781EAcupuncture w/stimul
    97799APhysical medicine procedure
    97802EMedical nutrition, indiv, in
    97803EMed nutrition, indiv, subseq
    97804EMedical nutrition, group
    98925SOsteopathic manipulation00600.25$12.71$2.54$2.54
    98926SOsteopathic manipulation00600.25$12.71$2.54$2.54
    98927SOsteopathic manipulation00600.25$12.71$2.54$2.54
    98928SOsteopathic manipulation00600.25$12.71$2.54$2.54
    98929SOsteopathic manipulation00600.25$12.71$2.54$2.54
    98940SChiropractic manipulation00600.25$12.71$2.54$2.54
    98941SChiropractic manipulation00600.25$12.71$2.54$2.54
    98942SChiropractic manipulation00600.25$12.71$2.54$2.54
    98943EChiropractic manipulation
    99000ESpecimen handling
    99001ESpecimen handling
    99002EDevice handling
    99024EPostop follow-up visit
    99025EInitial surgical evaluation
    99050EMedical services after hrs
    99052EMedical services at night
    99054EMedical servcs, unusual hrs
    99056ENon-office medical services
    99058EOffice emergency care
    99070ESpecial supplies
    99071EPatient education materials
    99075EMedical testimony
    99078EGroup health education
    99080ESpecial reports or forms
    99082EUnusual physician travel
    99090EComputer data analysis
    99100ESpecial anesthesia service
    99116EAnesthesia with hypothermia
    99135ESpecial anesthesia procedure
    99140EEmergency anesthesia
    99141NSedation, iv/im or inhalant
    99142NSedation, oral/rectal/nasal
    99170TAnogenital exam, child01910.27$13.73$3.98$2.75
    99172EOcular function screen
    99173EVisual acuity screen
    99175NInduction of vomiting
    99183EHyperbaric oxygen therapy
    Start Printed Page 44834
    99185NRegional hypothermia
    99186NTotal body hypothermia
    99190CSpecial pump services
    99191CSpecial pump services
    99192CSpecial pump services
    99195XPhlebotomy03720.57$28.98$10.09$5.80
    99199ESpecial service/proc/report
    99201VOffice/outpatient visit, new06000.93$47.28$9.46$9.46
    99202VOffice/outpatient visit, new06000.93$47.28$9.46$9.46
    99203VOffice/outpatient visit, new06011.02$51.86$10.37$10.37
    99204VOffice/outpatient visit, new06021.49$75.75$15.15$15.15
    99205VOffice/outpatient visit, new06021.49$75.75$15.15$15.15
    99211VOffice/outpatient visit, est06000.93$47.28$9.46$9.46
    99212VOffice/outpatient visit, est06000.93$47.28$9.46$9.46
    99213VOffice/outpatient visit, est06011.02$51.86$10.37$10.37
    99214VOffice/outpatient visit, est06021.49$75.75$15.15$15.15
    99215VOffice/outpatient visit, est06021.49$75.75$15.15$15.15
    99217NObservation care discharge
    99218NObservation care
    99219NObservation care
    99220NObservation care
    99221EInitial hospital care
    99222EInitial hospital care
    99223EInitial hospital care
    99231ESubsequent hospital care
    99232ESubsequent hospital care
    99233ESubsequent hospital care
    99234NObserv/hosp same date
    99235NObserv/hosp same date
    99236NObserv/hosp same date
    99238EHospital discharge day
    99239EHospital discharge day
    99241VOffice consultation06000.93$47.28$9.46$9.46
    99242VOffice consultation06000.93$47.28$9.46$9.46
    99243VOffice consultation06011.02$51.86$10.37$10.37
    99244VOffice consultation06021.49$75.75$15.15$15.15
    99245VOffice consultation06021.49$75.75$15.15$15.15
    99251CInitial inpatient consult
    99252CInitial inpatient consult
    99253CInitial inpatient consult
    99254CInitial inpatient consult
    99255CInitial inpatient consult
    99261CFollow-up inpatient consult
    99262CFollow-up inpatient consult
    99263CFollow-up inpatient consult
    99271VConfirmatory consultation06000.93$47.28$9.46$9.46
    99272VConfirmatory consultation06000.93$47.28$9.46$9.46
    99273VConfirmatory consultation06011.02$51.86$10.37$10.37
    99274VConfirmatory consultation06021.49$75.75$15.15$15.15
    99275VConfirmatory consultation06021.49$75.75$15.15$15.15
    99281VEmergency dept visit06101.34$68.13$20.65$13.63
    99282VEmergency dept visit06101.34$68.13$20.65$13.63
    99283VEmergency dept visit06112.33$118.46$36.47$23.69
    99284VEmergency dept visit06123.75$190.66$54.14$38.13
    99285VEmergency dept visit06123.75$190.66$54.14$38.13
    99288EDirect advanced life support
    99291SCritical care, first hour06209.13$464.19$152.78$92.84
    99292NCritical care, addl 30 min
    99295CNeonatal critical care
    99296CNeonatal critical care
    99297CNeonatal critical care
    99298CNeonatal critical care
    99301ENursing facility care
    99302ENursing facility care
    99303ENursing facility care
    99311ENursing fac care, subseq
    99312ENursing fac care, subseq
    99313ENursing fac care, subseq
    99315ENursing fac discharge day
    99316ENursing fac discharge day
    99321ERest home visit, new patient
    99322ERest home visit, new patient
    99323ERest home visit, new patient
    99331ERest home visit, est pat
    99332ERest home visit, est pat
    Start Printed Page 44835
    99333ERest home visit, est pat
    99341EHome visit, new patient
    99342EHome visit, new patient
    99343EHome visit, new patient
    99344EHome visit, new patient
    99345EHome visit, new patient
    99347EHome visit, est patient
    99348EHome visit, est patient
    99349EHome visit, est patient
    99350EHome visit, est patient
    99354NProlonged service, office
    99355NProlonged service, office
    99356CProlonged service, inpatient
    99357CProlonged service, inpatient
    99358NProlonged serv, w/o contact
    99359NProlonged serv, w/o contact
    99360EPhysician standby services
    99361EPhysician/team conference
    99362EPhysician/team conference
    99371EPhysician phone consultation
    99372EPhysician phone consultation
    99373EPhysician phone consultation
    99374EHome health care supervision
    99377EHospice care supervision
    99379ENursing fac care supervision
    99380ENursing fac care supervision
    99381EPrev visit, new, infant
    99382EPrev visit, new, age 1-4
    99383EPrev visit, new, age 5-11
    99384EPrev visit, new, age 12-17
    99385EPrev visit, new, age 18-39
    99386EPrev visit, new, age 40-64
    99387EPrev visit, new, 65 & over
    99391EPrev visit, est, infant
    99392EPrev visit, est, age 1-4
    99393EPrev visit, est, age 5-11
    99394EPrev visit, est, age 12-17
    99395EPrev visit, est, age 18-39
    99396EPrev visit, est, age 40-64
    99397EPrev visit, est, 65 & over
    99401EPreventive counseling, indiv
    99402EPreventive counseling, indiv
    99403EPreventive counseling, indiv
    99404EPreventive counseling, indiv
    99411EPreventive counseling, group
    99412EPreventive counseling, group
    99420EHealth risk assessment test
    99429EUnlisted preventive service
    99431NInitial care, normal newborn
    99432NNewborn care, not in hosp
    99433CNormal newborn care/hospital
    99435ENewborn discharge day hosp
    99436NAttendance, birth
    99440SNewborn resuscitation00945.69$289.29$105.29$57.86
    99450ELife/disability evaluation
    99455EDisability examination
    99456EDisability examination
    99499EUnlisted e&m service
    A0021EOutside state ambulance serv
    A0080ENoninterest escort in non er
    A0090EInterest escort in non er
    A0100ENonemergency transport taxi
    A0110ENonemergency transport bus
    A0120ENoner transport mini-bus
    A0130ENoner transport wheelch van
    A0140ENonemergency transport air
    A0160ENoner transport case worker
    A0170ENoner transport parking fees
    A0180ENoner transport lodgng recip
    A0190ENoner transport meals recip
    A0200ENoner transport lodgng escrt
    A0210ENoner transport meals escort
    A0225ANeonatal emergency transport
    A0382ABasic support routine suppls
    A0384ABls defibrillation supplies
    Start Printed Page 44836
    A0392AAls defibrillation supplies
    A0394AAls IV drug therapy supplies
    A0396AAls esophageal intub suppls
    A0398AAls routine disposble suppls
    A0420AAmbulance waiting 1/2 hr
    A0422AAmbulance 02 life sustaining
    A0424AExtra ambulance attendant
    A0425AGround mileage
    A0426AAls 1
    A0427AALS1-emergency
    A0428Abls
    A0429ABLS-emergency
    A0430AFixed wing air transport
    A0431ARotary wing air transport
    A0432API volunteer ambulance co
    A0433Aals 2
    A0434ASpecialty care transport
    A0435AFixed wing air mileage
    A0436ARotary wing air mileage
    A0888ENoncovered ambulance mileage
    A0999AUnlisted ambulance service
    A4206A1 CC sterile syringe&needle
    A4207A2 CC sterile syringe&needle
    A4208A3 CC sterile syringe&needle
    A4209E5+ CC sterile syringe&needle
    A4210ENonneedle injection device
    A4211ESupp for self-adm injections
    A4212ENon coring needle or stylet
    A4213E20+ CC syringe only
    A4214A30 CC sterile water/saline
    A4215ESterile needle
    A4220AInfusion pump refill kit
    A4221AMaint drug infus cath per wk
    A4222ADrug infusion pump supplies
    A4230AInfus insulin pump non needl
    A4231AInfusion insulin pump needle
    A4232ASyringe w/needle insulin 3cc
    A4244EAlcohol or peroxide per pint
    A4245EAlcohol wipes per box
    A4246EBetadine/phisohex solution
    A4247EBetadine/iodine swabs/wipes
    A4250EUrine reagent strips/tablets
    A4253ABlood glucose/reagent strips
    A4254ABattery for glucose monitor
    A4255AGlucose monitor platforms
    A4256ACalibrator solution/chips
    A4258ALancet device each
    A4259ALancets per box
    A4260ELevonorgestrel implant
    A4261ECervical cap contraceptive
    A4262NTemporary tear duct plug
    A4263NPermanent tear duct plug
    A4265AParaffin
    A4270ADisposable endoscope sheath
    A4280ABrst prsths adhsv attchmnt
    A4290NSacral nerve stim test lead
    A4300ACath impl vasc access portal
    A4301AImplantable access syst perc
    A4305ADrug delivery system >=50 ML
    A4306ADrug delivery system <=5 ML
    A4310AInsert tray w/o bag/cath
    A4311ACatheter w/o bag 2-way latex
    A4312ACath w/o bag 2-way silicone
    A4313ACatheter w/bag 3-way
    A4314ACath w/drainage 2-way latex
    A4315ACath w/drainage 2-way silcne
    A4316ACath w/drainage 3-way
    A4319ASterile H2O irrigation solut
    A4320AIrrigation tray
    A4321ACath therapeutic irrig agent
    A4322AIrrigation syringe
    A4323ASaline irrigation solution
    A4324AMale ext cath w/adh coating
    A4325AMale ext cath w/adh strip
    A4326AMale external catheter
    Start Printed Page 44837
    A4327AFem urinary collect dev cup
    A4328AFem urinary collect pouch
    A4329AExternal catheter start set
    A4330AStool collection pouch
    A4331AExtension drainage tubing
    A4332ALubricant for cath insertion
    A4333AUrinary cath anchor device
    A4334AUrinary cath leg strap
    A4335AIncontinence supply
    A4338AIndwelling catheter latex
    A4340AIndwelling catheter special
    A4344ACath indw foley 2 way silicn
    A4346ACath indw foley 3 way
    A4347AMale external catheter
    A4348AMale ext cath extended wear
    A4351AStraight tip urine catheter
    A4352ACoude tip urinary catheter
    A4353AIntermittent urinary cath
    A4354ACath insertion tray w/bag
    A4355ABladder irrigation tubing
    A4356AExt ureth clmp or compr dvc
    A4357ABedside drainage bag
    A4358AUrinary leg bag
    A4359AUrinary suspensory w/o leg b
    A4361AOstomy face plate
    A4362ASolid skin barrier
    A4364AAdhesive, liquid or equal
    A4365AAdhesive remover wipes
    A4367AOstomy belt
    A4368AOstomy filter
    A4369ASkin barrier liquid per oz
    A4370ASkin barrier paste per oz
    A4371ASkin barrier powder per oz
    A4372ASkin barrier solid 4x4 equiv
    A4373ASkin barrier with flange
    A4374ASkin barrier extended wear
    A4375ADrainable plastic pch w fcpl
    A4376ADrainable rubber pch w fcplt
    A4377ADrainable plstic pch w/o fp
    A4378ADrainable rubber pch w/o fp
    A4379AUrinary plastic pouch w fcpl
    A4380AUrinary rubber pouch w fcplt
    A4381AUrinary plastic pouch w/o fp
    A4382AUrinary hvy plstc pch w/o fp
    A4383AUrinary rubber pouch w/o fp
    A4384AOstomy faceplt/silicone ring
    A4385AOst skn barrier sld ext wear
    A4386AOst skn barrier w flng ex wr
    A4387AOst clsd pouch w att st barr
    A4388ADrainable pch w ex wear barr
    A4389ADrainable pch w st wear barr
    A4390ADrainable pch ex wear convex
    A4391AUrinary pouch w ex wear barr
    A4392AUrinary pouch w st wear barr
    A4393AUrine pch w ex wear bar conv
    A4394AOstomy pouch liq deodorant
    A4395AOstomy pouch solid deodorant
    A4396APeristomal hernia supprt blt
    A4397AIrrigation supply sleeve
    A4398AOstomy irrigation bag
    A4399AOstomy irrig cone/cath w brs
    A4400AOstomy irrigation set
    A4402ALubricant per ounce
    A4404AOstomy ring each
    A4421AOstomy supply misc
    A4454ATape all types all sizes
    A4455AAdhesive remover per ounce
    A4460AElastic compression bandage
    A4462AAbdmnl drssng holder/binder
    A4464AJoint support device/garment
    A4465ANon-elastic extremity binder
    A4470AGravlee jet washer
    A4480AVabra aspirator
    A4481ATracheostoma filter
    A4483AMoisture exchanger
    Start Printed Page 44838
    A4490EAbove knee surgical stocking
    A4495EThigh length surg stocking
    A4500EBelow knee surgical stocking
    A4510EFull length surg stocking
    A4550ESurgical trays
    A4554EDisposable underpads
    A4556AElectrodes, pair
    A4557ALead wires, pair
    A4558AConductive paste or gel
    A4561NPessary rubber, any type
    A4562NPessary, non rubber,any type
    A4565ASlings
    A4570NSplint
    A4572ARib belt
    A4575EHyperbaric o2 chamber disps
    A4580NCast supplies (plaster)
    A4590NSpecial casting material
    A4595ATENS suppl 2 lead per month
    A4608ATranstracheal oxygen cath
    A4611AHeavy duty battery
    A4612ABattery cables
    A4613ABattery charger
    A4614AHand-held PEFR meter
    A4615ACannula nasal
    A4616ATubing (oxygen) per foot
    A4617AMouth piece
    A4618ABreathing circuits
    A4619AFace tent
    A4620AVariable concentration mask
    A4621ATracheotomy mask or collar
    A4622ATracheostomy or larngectomy
    A4623ATracheostomy inner cannula
    A4624ATracheal suction tube
    A4625ATrach care kit for new trach
    A4626ATracheostomy cleaning brush
    A4627ESpacer bag/reservoir
    A4628AOropharyngeal suction cath
    A4629ATracheostomy care kit
    A4630ARepl bat t.e.n.s. own by pt
    A4631AWheelchair battery
    A4635AUnderarm crutch pad
    A4636AHandgrip for cane etc
    A4637ARepl tip cane/crutch/walker
    A4640AAlternating pressure pad
    A4641NDiagnostic imaging agent
    A4642GSatumomab pendetide per dose0704$831.25$119.00
    A4643NHigh dose contrast MRI
    A4644NContrast 100-199 MGs iodine
    A4645NContrast 200-299 MGs iodine
    A4646NContrast 300-399 MGs iodine
    A4647NSupp- paramagnetic contr mat
    A4649ASurgical supplies
    A4650ASupp esrd centrifuge
    A4655AEsrd syringe/needle
    A4660AEsrd blood pressure device
    A4663AEsrd blood pressure cuff
    A4670EAuto blood pressure monitor
    A4680AActivated carbon filters
    A4690ADialyzers
    A4700AStandard dialysate solution
    A4705ABicarb dialysate solution
    A4712ASterile water
    A4714ATreated water for dialysis
    A4730AFistula cannulation set dial
    A4735ALocal/topical anesthetics
    A4740AEsrd shunt accessory
    A4750AArterial or venous tubing
    A4755AArterial and venous tubing
    A4760AStandard testing solution
    A4765ADialysate concentrate
    A4770ABlood testing supplies
    A4771ABlood clotting time tube
    A4772ADextrostick/glucose strips
    A4773AHemostix
    A4774AAmmonia test paper
    Start Printed Page 44839
    A4780AEsrd sterilizing agent
    A4790AEsrd cleansing agents
    A4800AHeparin/antidote dialysis
    A4820ASupplies hemodialysis kit
    A4850ARubber tipped hemostats
    A4860ADisposable catheter caps
    A4870APlumbing/electrical work
    A4880AWater storage tanks
    A4890AContracts/repair/maintenance
    A4900ACapd supply kit
    A4901ACcpd supply kit
    A4905AIpd supply kit
    A4910AEsrd nonmedical supplies
    A4912AGomco drain bottle
    A4913AEsrd supply
    A4914APreparation kit
    A4918AVenous pressure clamp
    A4919ASupp dialysis dialyzer holde
    A4920AHarvard pressure clamp
    A4921AMeasuring cylinder
    A4927AGloves
    A5051APouch clsd w barr attached
    A5052AClsd ostomy pouch w/o barr
    A5053AClsd ostomy pouch faceplate
    A5054AClsd ostomy pouch w/flange
    A5055AStoma cap
    A5061APouch drainable w barrier at
    A5062ADrnble ostomy pouch w/o barr
    A5063ADrain ostomy pouch w/flange
    A5064EDrain ostomy pouch w/fceplte
    A5071AUrinary pouch w/barrier
    A5072AUrinary pouch w/o barrier
    A5073AUrinary pouch on barr w/flng
    A5074EUrinary pouch w/faceplate
    A5075EUrinary pouch on faceplate
    A5081AContinent stoma plug
    A5082AContinent stoma catheter
    A5093AOstomy accessory convex inse
    A5102ABedside drain btl w/wo tube
    A5105AUrinary suspensory
    A5112AUrinary leg bag
    A5113ALatex leg strap
    A5114AFoam/fabric leg strap
    A5119ASkin barrier wipes box pr 50
    A5121ASolid skin barrier 6x6
    A5122ASolid skin barrier 8x8
    A5123ASkin barrier with flange
    A5126ADisk/foam pad +or- adhesive
    A5131AAppliance cleaner
    A5200APercutaneous catheter anchor
    A5500ADiab shoe for density insert
    A5501ADiabetic custom molded shoe
    A5502ADiabetic shoe density insert
    A5503ADiabetic shoe w/roller/rockr
    A5504ADiabetic shoe with wedge
    A5505ADiab shoe w/metatarsal bar
    A5506ADiabetic shoe w/off set heel
    A5507AModification diabetic shoe
    A5508ADiabetic deluxe shoe
    A6021ACollagen dressing <=16 sq in
    A6022ACollagen drsg>6<=48 sq in
    A6023ACollagen dressing >48 sq in
    A6024ACollagen dsg wound filler
    A6025ESilicone gel sheet, each
    A6154AWound pouch each
    A6196AAlginate dressing <=16 sq in
    A6197AAlginate drsg >16 <=48 sq in
    A6198Aalginate dressing > 48 sq in
    A6199AAlginate drsg wound filler
    A6200ACompos drsg <=16 no border
    A6201ACompos drsg >16<=48 no bdr
    A6202ACompos drsg >48 no border
    A6203AComposite drsg <= 16 sq in
    A6204AComposite drsg >16<=48 sq in
    A6205AComposite drsg > 48 sq in
    Start Printed Page 44840
    A6206AContact layer <= 16 sq in
    A6207AContact layer >16<= 48 sq in
    A6208AContact layer > 48 sq in
    A6209AFoam drsg <=16 sq in w/o bdr
    A6210AFoam drg >16<=48 sq in w/o b
    A6211AFoam drg > 48 sq in w/o brdr
    A6212AFoam drg <=16 sq in w/border
    A6213AFoam drg >16<=48 sq in w/bdr
    A6214AFoam drg > 48 sq in w/border
    A6215AFoam dressing wound filler
    A6216ANon-sterile gauze<=16 sq in
    A6217ANon-sterile gauze>16<=48 sq
    A6218ANon-sterile gauze > 48 sq in
    A6219AGauze <= 16 sq in w/border
    A6220AGauze >16 <=48 sq in w/bordr
    A6221AGauze > 48 sq in w/border
    A6222AGauze <=16 in no w/sal w/o b
    A6223AGauze >16<=48 no w/sal w/o b
    A6224AGauze > 48 in no w/sal w/o b
    A6228AGauze <= 16 sq in water/sal
    A6229AGauze >16<=48 sq in watr/sal
    A6230AGauze > 48 sq in water/salne
    A6231AHydrogel dsg<=16 sq in
    A6232AHydrogel dsg>16<=48 sq in
    A6233AHydrogel dressing >48 sq in
    A6234AHydrocolld drg <=16 w/o bdr
    A6235AHydrocolld drg >16<=48 w/o b
    A6236AHydrocolld drg > 48 in w/o b
    A6237AHydrocolld drg <=16 in w/bdr
    A6238AHydrocolld drg >16<=48 w/bdr
    A6239AHydrocolld drg > 48 in w/bdr
    A6240AHydrocolld drg filler paste
    A6241AHydrocolloid drg filler dry
    A6242AHydrogel drg <=16 in w/o bdr
    A6243AHydrogel drg >16<=48 w/o bdr
    A6244AHydrogel drg >48 in w/o bdr
    A6245AHydrogel drg <= 16 in w/bdr
    A6246AHydrogel drg >16<=48 in w/b
    A6247AHydrogel drg > 48 sq in w/b
    A6248AHydrogel drsg gel filler
    A6250ASkin seal protect moisturizr
    A6251AAbsorpt drg <=16 sq in w/o b
    A6252AAbsorpt drg >16 <=48 w/o bdr
    A6253AAbsorpt drg > 48 sq in w/o b
    A6254AAbsorpt drg <=16 sq in w/bdr
    A6255AAbsorpt drg >16<=48 in w/bdr
    A6256AAbsorpt drg > 48 sq in w/bdr
    A6257ATransparent film <= 16 sq in
    A6258ATransparent film >16<=48 in
    A6259ATransparent film > 48 sq in
    A6260AWound cleanser any type/size
    A6261AWound filler gel/paste /oz
    A6262AWound filler dry form / gram
    A6263ANon-sterile elastic gauze/yd
    A6264ANon-sterile no elastic gauze
    A6265ATape per 18 sq inches
    A6266AImpreg gauze no h20/sal/yard
    A6402ASterile gauze <= 16 sq in
    A6403ASterile gauze>16 <= 48 sq in
    A6404ASterile gauze > 48 sq in
    A6405ASterile elastic gauze /yd
    A6406ASterile non-elastic gauze/yd
    A7000ADisposable canister for pump
    A7001ANondisposable pump canister
    A7002ATubing used w suction pump
    A7003ANebulizer administration set
    A7004ADisposable nebulizer sml vol
    A7005ANondisposable nebulizer set
    A7006AFiltered nebulizer admin set
    A7007ALg vol nebulizer disposable
    A7008ADisposable nebulizer prefill
    A7009ANebulizer reservoir bottle
    A7010ADisposable corrugated tubing
    A7011ANondispos corrugated tubing
    A7012ANebulizer water collec devic
    Start Printed Page 44841
    A7013ADisposable compressor filter
    A7014ACompressor nondispos filter
    A7015AAerosol mask used w nebulize
    A7016ANebulizer dome & mouthpiece
    A7017ANebulizer not used w oxygen
    A7018AWater distilled w/nebulizer
    A7019ASaline solution dispenser
    A7020ASterile H2O or NSS w lgv neb
    A7501ATracheostoma valve w diaphra
    A7502AReplacement diaphragm/fplate
    A7503AHMES filter holder or cap
    A7504ATracheostoma HMES filter
    A7505AHMES or trach valve housing
    A7506AHMES/trachvalve adhesivedisk
    A7507AIntegrated filter & holder
    A7508AHousing & Integrated Adhesiv
    A7509AHeat & moisture exchange sys
    A9150EMisc/exper non-prescript dru
    A9160EPodiatrist non-covered servi
    A9170EChiropractor non-covered ser
    A9190EMisc/expe personal comfort i
    A9270ENon-covered item or service
    A9300EExercise equipment
    A9500GTechnetium TC 99m sestamibi1600$115.90$16.59
    A9502GTechnetium TC99M tetrofosmin0705$129.96$18.60
    A9503GTechnetium TC 99m medronate1601$36.46$3.30
    A9504GTechnetium tc 99m apcitide1602$45.13$6.46
    A9505GThallous chloride TL 201/mci1603$29.45$3.78
    A9507GIndium/111 capromab pendetid1604$1,128.13$161.50
    A9508GIobenguane sulfate I-1311045$495.65$44.87
    A9510GTechnetium TC99m Disofenin1205$85.50$7.74
    A9600GStrontium-89 chloride0701$963.42$137.92
    A9605GSamarium sm153 lexidronamm0702$1,020.00$146.02
    A9700GEchocardiography Contrast9016$39.58$5.67
    A9900ASupply/accessory/service
    A9901ADelivery/set up/dispensing
    B4034AEnter feed supkit syr by day
    B4035AEnteral feed supp pump per d
    B4036AEnteral feed sup kit grav by
    B4081AEnteral ng tubing w/ stylet
    B4082AEnteral ng tubing w/o stylet
    B4083AEnteral stomach tube levine
    B4084AGastrostomy/jejunostomy tubi
    B4085AGastrostomy tube w/ring each
    B4150AEnteral formulae category i
    B4151AEnteral formulae cat1natural
    B4152AEnteral formulae category ii
    B4153AEnteral formulae categoryIII
    B4154AEnteral formulae category IV
    B4155AEnteral formulae category v
    B4156AEnteral formulae category vi
    B4164AParenteral 50% dextrose solu
    B4168AParenteral sol amino acid 3.
    B4172AParenteral sol amino acid 5.
    B4176AParenteral sol amino acid 7-
    B4178AParenteral sol amino acid >
    B4180AParenteral sol carb > 50%
    B4184AParenteral sol lipids 10%
    B4186AParenteral sol lipids 20%
    B4189AParenteral sol amino acid &
    B4193AParenteral sol 52-73 gm prot
    B4197AParenteral sol 74-100 gm pro
    B4199AParenteral sol > 100gm prote
    B4216AParenteral nutrition additiv
    B4220AParenteral supply kit premix
    B4222AParenteral supply kit homemi
    B4224AParenteral administration ki
    B5000AParenteral sol renal-amirosy
    B5100AParenteral sol hepatic-fream
    B5200AParenteral sol stres-brnch c
    B9000AEnter infusion pump w/o alrm
    B9002AEnteral infusion pump w/ ala
    B9004AParenteral infus pump portab
    B9006AParenteral infus pump statio
    B9998AEnteral supp not otherwise c
    Start Printed Page 44842
    B9999AParenteral supp not othrws c
    C1010KBlood, L/R, CMV-NEG10102.94$149.48$29.90
    C1011KPlatelets, HLA-m, L/R, unit101112.12$616.21$123.24
    C1012KPLATELET CONC, L/R, Irrad10121.96$99.65$19.93
    C1013KPLATELET CONC, L/R, Unit10131.20$61.01$12.20
    C1014KPlatelet,Aph/Pher, L/R, unit10149.13$464.19$92.84
    C1016KBLOOD,L/R,FROZ/DEGLY/Washed10167.31$371.66$74.33
    C1017KPlt, APH/PHER,L/R,CMV-NEG10179.53$484.52$96.90
    C1018KBlood, L/R, IRRADIATED10183.20$162.69$32.54
    C1019KPlt, APH/PHER, L/R, IRRAD10199.85$500.79$100.16
    C1050SPROSORBA Column097616.56$841.94$168.39
    C1079GCO 57/58 0.5 Mci1079$253.84$36.34
    C1087GI-123 per uci, dx use1087$.65$.09
    C1088TLASER OPTIC TR Sys098035.49$1,804.38$360.88
    C1090GIN 111 chloride, per mCi1090$152.00$21.76
    C1091GIN 111 oxyquinoline,per 5mCi1091$482.84$69.12
    C1092GIN 111 PENETATE, PER 1.5 mci1092$769.50$110.16
    C1094GTC 99M albumin aggr, per via1094$33.09$4.74
    C1095GTC 99M DEPREOTIDE, PER Vial1095$760.00$108.80
    C1096GTC 99M EXAMETAZIME, PER Dose1096$423.04$60.56
    C1097GTC 99M MEBROFENIN, PER Vial1097$51.43$7.36
    C1098GTC 99M PENTETATE, PER Vial1098$22.64$2.76
    C1099GTC 99M PYROPHOSPHATE,PER Via1099$42.75$6.12
    C1122GTc 99M ARCITUMOMAB PER VIAL1122$1,235.00$176.80
    C1166GCYTARABINE LIPOSOMAL, 10 mg1166$371.45$53.18
    C1167GEPIRUBICIN HCL, 2 mg1167$24.94$3.57
    C1178GBUSULFAN IV, 6 Mg1178$26.49$3.79
    C1188GI-131 per uci, dx use1188$.78$.10
    C1200GTC 99M Sodium Glucoheptonat1200$107.40$15.37
    C1201GTC 99M SUCCIMER, PER Vial1201$135.66$19.42
    C1202GTC 99M SULFUR COLLOID, Vial1202$36.10$3.27
    C1207GOCTREOTIDE ACETATE DEPOT 1mg1207$140.37$20.10
    C1300SHYPERBARIC Oxygen09711.42$72.20$14.44
    C1305GApligraf1305$1,157.81$165.75
    C1348GI-131 per mci sol, rx use1348$146.57$20.98
    C1713HAnchor/screw bn/bn,tis/bn1713
    C1714HCath, trans atherectomy, dir1714
    C1715HBrachytherapy needle1715
    C1716HBrachytx seed, Gold 1981716
    C1717HBrachytx seed, HDR Ir-1921717
    C1718HBrachytx seed, Iodine 1251718
    C1719HBrachytx seed,Non-HDR Ir-1921719
    C1720HBrachytx seed, Palladium 1031720
    C1721HAICD, dual chamber1721
    C1722HAICD, single chamber1722
    C1723HCath, ablation, non-cardiac1723
    C1724HCath, trans atherec,rotation1724
    C1725HCath, translumin non-laser1725
    C1726HCath, bal dil, non-vascular1726
    C1727HCath, bal tis dis, non-vas1727
    C1728HCath, brachytx seed adm1728
    C1729HCath, drainage1729
    C1730HCath, EP, 19 or few elect1730
    C1731HCath, EP, 20 or more elec1731
    C1732HCath, EP, diag/abl, 3D/vect1732
    C1733HCath, EP, othr than cool-tip1733
    C1750HCath, hemodialysis,long-term1750
    C1751HCath, inf, per/cent/midline1751
    C1752HCath,hemodialysis,short-term1752
    C1753HCath, intravas ultrasound1753
    C1754HCatheter, intradiscal1754
    C1755HCatheter, intraspinal1755
    C1756HCath, pacing, transesoph1756
    C1757HCath, thrombectomy/embolect1757
    C1758HCatheter, ureteral1758
    C1759HCath, intra echocardiography1759
    C1760HClosure dev, vasc1760
    C1762HConn tiss, human(inc fascia)1762
    C1763HConn tiss, non-human1763
    C1764HEvent recorder, cardiac1764
    C1765HAdhesion barrier1765
    C1766HIntro/sheath,strble,non-peel1766
    C1767HGenerator, neurostim, imp1767
    C1768HGraft, vascular1768
    C1769HGuide wire1769
    Start Printed Page 44843
    C1770HImaging coil, MR, insertable1770
    C1771HRep dev, urinary, w/sling1771
    C1772HInfusion pump, programmable1772
    C1773HRet dev, insertable1773
    C1776HJoint device (implantable)1776
    C1777HLead, AICD, endo single coil1777
    C1778HLead, neurostimulator1778
    C1779HLead, pmkr, transvenous VDD1779
    C1780HLens, intraocular (new tech)1780
    C1781HMesh (implantable)1781
    C1782HMorcellator1782
    C1784HOcular dev, intraop, det ret1784
    C1785HPmkr, dual, rate-resp1785
    C1786HPmkr, single, rate-resp1786
    C1787HPatient progr, neurostim1787
    C1788HPort, indwelling, imp1788
    C1789HProsthesis, breast, imp1789
    C1813HProsthesis, penile, inflatab1813
    C1815HPros, urinary sph, imp1815
    C1816HReceiver/transmitter, neuro1816
    C1817HSeptal defect imp sys1817
    C1874HStent, coated/cov w/del sys1874
    C1875HStent, coated/cov w/o del sy1875
    C1876HStent, non-coa/non-cov w/del1876
    C1877HStent, non-coat/cov w/o del1877
    C1878HMatrl for vocal cord1878
    C1879HTissue marker, implantable1879
    C1880HVena cava filter1880
    C1881HDialysis access system1881
    C1882HAICD, other than sing/dual1882
    C1883HAdapt/ext, pacing/neuro lead1883
    C1885HCath, translumin angio laser1885
    C1887HCatheter, guiding1887
    C1891HInfusion pump,non-prog, perm1891
    C1892HIntro/sheath,fixed,peel-away1892
    C1893HIntro/sheath, fixed,non-peel1893
    C1894HIntro/sheath, non-laser1894
    C1895HLead, AICD, endo dual coil1895
    C1896HLead, AICD, non sing/dual1896
    C1897HLead, neurostim test kit1897
    C1898HLead, pmkr, other than trans1898
    C1899HLead, pmkr/AICD combination1899
    C2615HSealant, pulmonary, liquid2615
    C2616HBrachytx seed, Yttrium-902616
    C2617HStent, non-cor, tem w/o del2617
    C2618HProbe, cryoablation2618
    C2619HPmkr, dual, non rate-resp2619
    C2620HPmkr, single, non rate-resp2620
    C2621HPmkr, other than sing/dual2621
    C2622HProsthesis, penile, non-inf2622
    C2625HStent, non-cor, tem w/del sy2625
    C2626HInfusion pump, non-prog,temp2626
    C2627HCath, suprapubic/cystoscopic2627
    C2628HCatheter, occlusion2628
    C2629HIntro/sheath, laser2629
    C2630HCath, EP, cool-tip2630
    C2631HRep dev, urinary, w/o sling2631
    C8900SMRA w/cont, abd02847.80$396.57$218.11$79.31
    C8901SMRA w/o cont, abd03366.85$348.27$191.55$69.65
    C8902SMRA w/o fol w/cont, abd03379.26$470.80$258.94$94.16
    C8903SMRI w/cont, breast, uni02847.80$396.57$218.11$79.31
    C8904SMRI w/o cont, breast, uni03366.85$348.27$191.55$69.65
    C8905SMRI w/o fol w/cont, brst, un03379.26$470.80$258.94$94.16
    C8906SMRI w/cont, breast, bi02847.80$396.57$218.11$79.31
    C8907SMRI w/o cont, breast, bi03366.85$348.27$191.55$69.65
    C8908SMRI w/o fol w/cont, breast,03379.26$470.80$258.94$94.16
    C8909SMRA w/cont, chest02847.80$396.57$218.11$79.31
    C8910SMRA w/o cont, chest03366.85$348.27$191.55$69.65
    C8911SMRA w/o fol w/cont, chest03379.26$470.80$258.94$94.16
    C8912SMRA w/cont, lwr ext02847.80$396.57$218.11$79.31
    C8913SMRA w/o cont, lwr ext03366.85$348.27$191.55$69.65
    C8914SMRA w/o fol w/cont, lwr ext03379.26$470.80$258.94$94.16
    C9000GNa chromateCr51, per 0.25mCi9000$.32$.05
    C9001GLinezolid inj, 200mg9001$34.14$4.89
    C9002GTenecteplase, 50mg/vial9002$2,612.50$374.00
    Start Printed Page 44844
    C9003GPalivizumab, per 50 mg9003$664.49$95.13
    C9004GGemtuzumab ozogamicin inj,5m9004$1,929.69$276.25
    C9006GTacrolimus inj, per 5 mg9006$113.15$16.20
    C9007GBaclofen Intrathecal kit-1am9007$79.80$11.42
    C9008GBaclofen Refill Kit-500mcg9008$233.70$33.46
    C9009GBaclofen Refill Kit-2000mcg9009$491.15$70.31
    C9010GBaclofen Refill Kit--4000mcg9010$861.65$123.35
    C9011GCaffeine Citrate, inj, 1ml9011$12.22$1.75
    C9012GInjection, arsenic trioxide9012$237.50$34.00
    C9013GCo 57 cobaltous chloride9013$10.02$1.43
    C9017ELomustine, 10 mg
    C9018GBotulinum tox B, per 100 u9018$8.79$1.26
    C9019GCaspofungin acetate, 5 mg9019$34.20$4.90
    C9020GSirolimus tablet, 1 mg9020$6.51$.89
    C9100GIodinated I-131 Albumin9100$9.84$1.41
    C9102G51 Na Chromate, 50mCi9102$.65$.09
    C9103GNa Iothalamate I-125, 10 uCi9103$11.66$1.67
    C9104GAnti-thymocyte globulin,25mg9104$251.75$36.04
    C9105GHep B imm glob, per 1 ml9105$135.43$12.26
    C9108GThyrotropin alfa, 1.1 mg9108$531.05$76.02
    C9109GTirofliban hcl, 6.25 mg9109$217.64$31.16
    C9503KFresh frozen plasma, ea unit95031.69$85.92$17.18
    C9700TWater Induced Thermo097721.30$1,082.93$216.59
    C9701SStretta System097616.56$841.94$168.39
    C9702SChkmate/Novost/Galileo Brach098142.59$2,165.36$433.07
    C9708TPreview Tx Planning Software097511.83$601.46$120.29
    D0120EPeriodic oral evaluation
    D0140ELimit oral eval problm focus
    D0150SComprehensve oral evaluation03307.68$390.47$78.09$78.09
    D0160EExtensv oral eval prob focus
    D0170ERe-eval,est pt,problem focus
    D0210EIntraor complete film series
    D0220EIntraoral periapical first f
    D0230EIntraoral periapical ea add
    D0240SIntraoral occlusal film03307.68$390.47$78.09$78.09
    D0250SExtraoral first film03307.68$390.47$78.09$78.09
    D0260SExtraoral ea additional film03307.68$390.47$78.09$78.09
    D0270SDental bitewing single film03307.68$390.47$78.09$78.09
    D0272SDental bitewings two films03307.68$390.47$78.09$78.09
    D0274SDental bitewings four films03307.68$390.47$78.09$78.09
    D0277SVert bitewings-sev to eight03307.68$390.47$78.09$78.09
    D0290EDental film skull/facial bon
    D0310EDental saliography
    D0320EDental tmj arthrogram incl i
    D0321EDental other tmj films
    D0322EDental tomographic survey
    D0330EDental panoramic film
    D0340EDental cephalometric film
    D0350EOral/facial images
    D0415EBacteriologic study
    D0425ECaries susceptibility test
    D0460SPulp vitality test03307.68$390.47$78.09$78.09
    D0470EDiagnostic casts
    D0472SGross exam, prep & report03307.68$390.47$78.09$78.09
    D0473SMicro exam, prep & report03307.68$390.47$78.09$78.09
    D0474SMicro w exam of surg margins03307.68$390.47$78.09$78.09
    D0480SCytopath smear prep & report03307.68$390.47$78.09$78.09
    D0501SHistopathologic examinations03307.68$390.47$78.09$78.09
    D0502SOther oral pathology procedu03307.68$390.47$78.09$78.09
    D0999SUnspecified diagnostic proce03307.68$390.47$78.09$78.09
    D1110EDental prophylaxis adult
    D1120EDental prophylaxis child
    D1201ETopical fluor w prophy child
    D1203ETopical fluor w/o prophy chi
    D1204ETopical fluor w/o prophy adu
    D1205ETopical fluoride w/ prophy a
    D1310ENutri counsel-control caries
    D1320ETobacco counseling
    D1330EOral hygiene instruction
    D1351EDental sealant per tooth
    D1510SSpace maintainer fxd unilat03307.68$390.47$78.09$78.09
    D1515SFixed bilat space maintainer03307.68$390.47$78.09$78.09
    D1520SRemove unilat space maintain03307.68$390.47$78.09$78.09
    D1525SRemove bilat space maintain03307.68$390.47$78.09$78.09
    D1550SRecement space maintainer03307.68$390.47$78.09$78.09
    Start Printed Page 44845
    D2110EAmalgam one surface primary
    D2120EAmalgam two surfaces primary
    D2130EAmalgam three surfaces prima
    D2131EAmalgam four/more surf prima
    D2140EAmalgam one surface permanen
    D2150EAmalgam two surfaces permane
    D2160EAmalgam three surfaces perma
    D2161EAmalgam 4 or > surfaces perm
    D2330EResin one surface-anterior
    D2331EResin two surfaces-anterior
    D2332EResin three surfaces-anterio
    D2335EResin 4/> surf or w incis an
    D2336EComposite resin crown
    D2337ECompo resin crown ant-perm
    D2380EResin one surf poster primar
    D2381EResin two surf poster primar
    D2382EResin three/more surf post p
    D2385EResin one surf poster perman
    D2386EResin two surf poster perman
    D2387EResin three/more surf post p
    D2388EResin four/more, post perm
    D2410EDental gold foil one surface
    D2420EDental gold foil two surface
    D2430EDental gold foil three surfa
    D2510EDental inlay metalic 1 surf
    D2520EDental inlay metallic 2 surf
    D2530EDental inlay metl 3/more sur
    D2542EDental onlay metallic 2 surf
    D2543EDental onlay metallic 3 surf
    D2544EDental onlay metl 4/more sur
    D2610EInlay porcelain/ceramic 1 su
    D2620EInlay porcelain/ceramic 2 su
    D2630EDental onlay porc 3/more sur
    D2642EDental onlay porcelin 2 surf
    D2643EDental onlay porcelin 3 surf
    D2644EDental onlay porc 4/more sur
    D2650EInlay composite/resin one su
    D2651EInlay composite/resin two su
    D2652EDental inlay resin 3/mre sur
    D2662EDental onlay resin 2 surface
    D2663EDental onlay resin 3 surface
    D2664EDental onlay resin 4/mre sur
    D2710ECrown resin laboratory
    D2720ECrown resin w/ high noble me
    D2721ECrown resin w/ base metal
    D2722ECrown resin w/ noble metal
    D2740ECrown porcelain/ceramic subs
    D2750ECrown porcelain w/ h noble m
    D2751ECrown porcelain fused base m
    D2752ECrown porcelain w/ noble met
    D2780ECrown 3/4 cast hi noble met
    D2781ECrown 3/4 cast base metal
    D2782ECrown 3/4 cast noble metal
    D2783ECrown 3/4 porcelain/ceramic
    D2790ECrown full cast high noble m
    D2791ECrown full cast base metal
    D2792ECrown full cast noble metal
    D2799EProvisional crown
    D2910EDental recement inlay
    D2920EDental recement crown
    D2930EPrefab stnlss steel crwn pri
    D2931EPrefab stnlss steel crown pe
    D2932EPrefabricated resin crown
    D2933EPrefab stainless steel crown
    D2940EDental sedative filling
    D2950ECore build-up incl any pins
    D2951ETooth pin retention
    D2952EPost and core cast + crown
    D2953EEach addtnl cast post
    D2954EPrefab post/core + crown
    D2955EPost removal
    D2957EEach addtnl prefab post
    D2960ELaminate labial veneer
    D2961ELab labial veneer resin
    D2962ELab labial veneer porcelain
    Start Printed Page 44846
    D2970STemporary- fractured tooth03307.68$390.47$78.09$78.09
    D2980ECrown repair
    D2999SDental unspec restorative pr03307.68$390.47$78.09$78.09
    D3110EPulp cap direct
    D3120EPulp cap indirect
    D3220ETherapeutic pulpotomy
    D3221EGross pulpal debridement
    D3230EPulpal therapy anterior prim
    D3240EPulpal therapy posterior pri
    D3310EAnterior
    D3320ERoot canal therapy 2 canals
    D3330ERoot canal therapy 3 canals
    D3331ENon-surg tx root canal obs
    D3332EIncomplete endodontic tx
    D3333EInternal root repair
    D3346ERetreat root canal anterior
    D3347ERetreat root canal bicuspid
    D3348ERetreat root canal molar
    D3351EApexification/recalc initial
    D3352EApexification/recalc interim
    D3353EApexification/recalc final
    D3410EApicoect/perirad surg anter
    D3421ERoot surgery bicuspid
    D3425ERoot surgery molar
    D3426ERoot surgery ea add root
    D3430ERetrograde filling
    D3450ERoot amputation
    D3460SEndodontic endosseous implan03307.68$390.47$78.09$78.09
    D3470EIntentional replantation
    D3910EIsolation- tooth w rubb dam
    D3920ETooth splitting
    D3950ECanal prep/fitting of dowel
    D3999SEndodontic procedure03307.68$390.47$78.09$78.09
    D4210EGingivectomy/plasty per quad
    D4211EGingivectomy/plasty per toot
    D4220EGingival curettage per quadr
    D4240EGingival flap proc w/ planin
    D4245EApically positioned flap
    D4249ECrown lengthen hard tissue
    D4260SOsseous surgery per quadrant03307.68$390.47$78.09$78.09
    D4263SBone replce graft first site03307.68$390.47$78.09$78.09
    D4264SBone replce graft each add03307.68$390.47$78.09$78.09
    D4266EGuided tiss regen resorble
    D4267EGuided tiss regen nonresorb
    D4268SSurgical revision procedure03307.68$390.47$78.09$78.09
    D4270SPedicle soft tissue graft pr03307.68$390.47$78.09$78.09
    D4271SFree soft tissue graft proc03307.68$390.47$78.09$78.09
    D4273SSubepithelial tissue graft03307.68$390.47$78.09$78.09
    D4274EDistal/proximal wedge proc
    D4320EProvision splnt intracoronal
    D4321EProvisional splint extracoro
    D4341EPeriodontal scaling & root
    D4355SFull mouth debridement03307.68$390.47$78.09$78.09
    D4381SLocalized chemo delivery03307.68$390.47$78.09$78.09
    D4910EPeriodontal maint procedures
    D4920EUnscheduled dressing change
    D4999EUnspecified periodontal proc
    D5110EDentures complete maxillary
    D5120EDentures complete mandible
    D5130EDentures immediat maxillary
    D5140EDentures immediat mandible
    D5211EDentures maxill part resin
    D5212EDentures mand part resin
    D5213EDentures maxill part metal
    D5214EDentures mandibl part metal
    D5281ERemovable partial denture
    D5410EDentures adjust cmplt maxil
    D5411EDentures adjust cmplt mand
    D5421EDentures adjust part maxill
    D5422EDentures adjust part mandbl
    D5510EDentur repr broken compl bas
    D5520EReplace denture teeth complt
    D5610EDentures repair resin base
    D5620ERep part denture cast frame
    D5630ERep partial denture clasp
    Start Printed Page 44847
    D5640EReplace part denture teeth
    D5650EAdd tooth to partial denture
    D5660EAdd clasp to partial denture
    D5710EDentures rebase cmplt maxil
    D5711EDentures rebase cmplt mand
    D5720EDentures rebase part maxill
    D5721EDentures rebase part mandbl
    D5730EDenture reln cmplt maxil ch
    D5731EDenture reln cmplt mand chr
    D5740EDenture reln part maxil chr
    D5741EDenture reln part mand chr
    D5750EDenture reln cmplt max lab
    D5751EDenture reln cmplt mand lab
    D5760EDenture reln part maxil lab
    D5761EDenture reln part mand lab
    D5810EDenture interm cmplt maxill
    D5811EDenture interm cmplt mandbl
    D5820EDenture interm part maxill
    D5821EDenture interm part mandbl
    D5850EDenture tiss conditn maxill
    D5851EDenture tiss condtin mandbl
    D5860EOverdenture complete
    D5861EOverdenture partial
    D5862EPrecision attachment
    D5867EReplacement of precision att
    D5875EProsthesis modification
    D5899ERemovable prosthodontic proc
    D5911SFacial moulage sectional03307.68$390.47$78.09$78.09
    D5912SFacial moulage complete03307.68$390.47$78.09$78.09
    D5913ENasal prosthesis
    D5914EAuricular prosthesis
    D5915EOrbital prosthesis
    D5916EOcular prosthesis
    D5919EFacial prosthesis
    D5922ENasal septal prosthesis
    D5923EOcular prosthesis interim
    D5924ECranial prosthesis
    D5925EFacial augmentation implant
    D5926EReplacement nasal prosthesis
    D5927EAuricular replacement
    D5928EOrbital replacement
    D5929EFacial replacement
    D5931ESurgical obturator
    D5932EPostsurgical obturator
    D5933ERefitting of obturator
    D5934EMandibular flange prosthesis
    D5935EMandibular denture prosth
    D5936ETemp obturator prosthesis
    D5937ETrismus appliance
    D5951EFeeding aid
    D5952EPediatric speech aid
    D5953EAdult speech aid
    D5954ESuperimposed prosthesis
    D5955EPalatal lift prosthesis
    D5958EIntraoral con def inter plt
    D5959EIntraoral con def mod palat
    D5960EModify speech aid prosthesis
    D5982ESurgical stent
    D5983SRadiation applicator03307.68$390.47$78.09$78.09
    D5984SRadiation shield03307.68$390.47$78.09$78.09
    D5985SRadiation cone locator03307.68$390.47$78.09$78.09
    D5986EFluoride applicator
    D5987SCommissure splint03307.68$390.47$78.09$78.09
    D5988ESurgical splint
    D5999EMaxillofacial prosthesis
    D6010EOdontics endosteal implant
    D6020EOdontics abutment placement
    D6040EOdontics eposteal implant
    D6050EOdontics transosteal implnt
    D6055EImplant connecting bar
    D6056EPrefabricated abutment
    D6057ECustom abutment
    D6058EAbutment supported crown
    D6059EAbutment supported mtl crown
    D6060EAbutment supported mtl crown
    Start Printed Page 44848
    D6061EAbutment supported mtl crown
    D6062EAbutment supported mtl crown
    D6063EAbutment supported mtl crown
    D6064EAbutment supported mtl crown
    D6065EImplant supported crown
    D6066EImplant supported mtl crown
    D6067EImplant supported mtl crown
    D6068EAbutment supported retainer
    D6069EAbutment supported retainer
    D6070EAbutment supported retainer
    D6071EAbutment supported retainer
    D6072EAbutment supported retainer
    D6073EAbutment supported retainer
    D6074EAbutment supported retainer
    D6075EImplant supported retainer
    D6076EImplant supported retainer
    D6077EImplant supported retainer
    D6078EImplnt/abut suprtd fixd dent
    D6079EImplnt/abut suprtd fixd dent
    D6080EImplant maintenance
    D6090ERepair implant
    D6095EOdontics repr abutment
    D6100ERemoval of implant
    D6199EImplant procedure
    D6210EProsthodont high noble metal
    D6211EBridge base metal cast
    D6212EBridge noble metal cast
    D6240EBridge porcelain high noble
    D6241EBridge porcelain base metal
    D6242EBridge porcelain nobel metal
    D6245EBridge porcelain/ceramic
    D6250EBridge resin w/high noble
    D6251EBridge resin base metal
    D6252EBridge resin w/noble metal
    D6519EInlay/onlay porce/ceramic
    D6520EDental retainer two surfaces
    D6530ERetainer metallic 3+ surface
    D6543EDental retainr onlay 3 surf
    D6544EDental retainr onlay 4/more
    D6545EDental retainr cast metl
    D6548EPorcelain/ceramic retainer
    D6720ERetain crown resin w hi nble
    D6721ECrown resin w/base metal
    D6722ECrown resin w/noble metal
    D6740ECrown porcelain/ceramic
    D6750ECrown porcelain high noble
    D6751ECrown porcelain base metal
    D6752ECrown porcelain noble metal
    D6780ECrown 3/4 high noble metal
    D6781ECrown 3/4 cast based metal
    D6782ECrown 3/4 cast noble metal
    D6783ECrown 3/4 porcelain/ceramic
    D6790ECrown full high noble metal
    D6791ECrown full base metal cast
    D6792ECrown full noble metal cast
    D6920SDental connector bar03307.68$390.47$78.09$78.09
    D6930EDental recement bridge
    D6940EStress breaker
    D6950EPrecision attachment
    D6970EPost & core plus retainer
    D6971ECast post bridge retainer
    D6972EPrefab post & core plus reta
    D6973ECore build up for retainer
    D6975ECoping metal
    D6976EEach addtnl cast post
    D6977EEach addtl prefab post
    D6980EBridge repair
    D6999EFixed prosthodontic proc
    D7110SOral surgery single tooth03307.68$390.47$78.09$78.09
    D7120SEach add tooth extraction03307.68$390.47$78.09$78.09
    D7130STooth root removal03307.68$390.47$78.09$78.09
    D7210SRem imp tooth w mucoper flp03307.68$390.47$78.09$78.09
    D7220SImpact tooth remov soft tiss03307.68$390.47$78.09$78.09
    D7230SImpact tooth remov part bony03307.68$390.47$78.09$78.09
    D7240SImpact tooth remov comp bony03307.68$390.47$78.09$78.09
    Start Printed Page 44849
    D7241SImpact tooth rem bony w/comp03307.68$390.47$78.09$78.09
    D7250STooth root removal03307.68$390.47$78.09$78.09
    D7260SOral antral fistula closure03307.68$390.47$78.09$78.09
    D7270ETooth reimplantation
    D7272ETooth transplantation
    D7280EExposure impact tooth orthod
    D7281EExposure tooth aid eruption
    D7285EBiopsy of oral tissue hard
    D7286EBiopsy of oral tissue soft
    D7290ERepositioning of teeth
    D7291STransseptal fiberotomy03307.68$390.47$78.09$78.09
    D7310EAlveoplasty w/ extraction
    D7320EAlveoplasty w/o extraction
    D7340EVestibuloplasty ridge extens
    D7350EVestibuloplasty exten graft
    D7410ERad exc lesion up to 1.25 cm
    D7420ELesion > 1.25 cm
    D7430EExc benign tumor to 1.25 cm
    D7431EBenign tumor exc > 1.25 cm
    D7440EMalig tumor exc to 1.25 cm
    D7441EMalig tumor > 1.25 cm
    D7450ERem odontogen cyst to 1.25cm
    D7451ERem odontogen cyst > 1.25 cm
    D7460ERem nonodonto cyst to 1.25cm
    D7461ERem nonodonto cyst > 1.25 cm
    D7465ELesion destruction
    D7471ERem exostosis any site
    D7480EPartial ostectomy
    D7490EMandible resection
    D7510EI&d absc intraoral soft tiss
    D7520EI&d abscess extraoral
    D7530ERemoval fb skin/areolar tiss
    D7540ERemoval of fb reaction
    D7550ERemoval of sloughed off bone
    D7560EMaxillary sinusotomy
    D7610EMaxilla open reduct simple
    D7620EClsd reduct simpl maxilla fx
    D7630EOpen red simpl mandible fx
    D7640EClsd red simpl mandible fx
    D7650EOpen red simp malar/zygom fx
    D7660EClsd red simp malar/zygom fx
    D7670EClosd rductn splint alveolus
    D7680EReduct simple facial bone fx
    D7710EMaxilla open reduct compound
    D7720EClsd reduct compd maxilla fx
    D7730EOpen reduct compd mandble fx
    D7740EClsd reduct compd mandble fx
    D7750EOpen red comp malar/zygma fx
    D7760EClsd red comp malar/zygma fx
    D7770EOpen reduc compd alveolus fx
    D7780EReduct compnd facial bone fx
    D7810ETmj open reduct-dislocation
    D7820EClosed tmp manipulation
    D7830ETmj manipulation under anest
    D7840ERemoval of tmj condyle
    D7850ETmj meniscectomy
    D7852ETmj repair of joint disc
    D7854ETmj excisn of joint membrane
    D7856ETmj cutting of a muscle
    D7858ETmj reconstruction
    D7860ETmj cutting into joint
    D7865ETmj reshaping components
    D7870ETmj aspiration joint fluid
    D7871ELysis + lavage w catheters
    D7872ETmj diagnostic arthroscopy
    D7873ETmj arthroscopy lysis adhesn
    D7874ETmj arthroscopy disc reposit
    D7875ETmj arthroscopy synovectomy
    D7876ETmj arthroscopy discectomy
    D7877ETmj arthroscopy debridement
    D7880EOcclusal orthotic appliance
    D7899ETmj unspecified therapy
    D7910EDent sutur recent wnd to 5cm
    D7911EDental suture wound to 5 cm
    D7912ESuture complicate wnd > 5 cm
    Start Printed Page 44850
    D7920EDental skin graft
    D7940SReshaping bone orthognathic03307.68$390.47$78.09$78.09
    D7941EBone cutting ramus closed
    D7943ECutting ramus open w/graft
    D7944EBone cutting segmented
    D7945EBone cutting body mandible
    D7946EReconstruction maxilla total
    D7947EReconstruct maxilla segment
    D7948EReconstruct midface no graft
    D7949EReconstruct midface w/graft
    D7950EMandible graft
    D7955ERepair maxillofacial defects
    D7960EFrenulectomy/frenulotomy
    D7970EExcision hyperplastic tissue
    D7971EExcision pericoronal gingiva
    D7980ESialolithotomy
    D7981EExcision of salivary gland
    D7982ESialodochoplasty
    D7983EClosure of salivary fistula
    D7990EEmergency tracheotomy
    D7991EDental coronoidectomy
    D7995ESynthetic graft facial bones
    D7996EImplant mandible for augment
    D7997EAppliance removal
    D7999EOral surgery procedure
    D8010ELimited dental tx primary
    D8020ELimited dental tx transition
    D8030ELimited dental tx adolescent
    D8040ELimited dental tx adult
    D8050EIntercep dental tx primary
    D8060EIntercep dental tx transitn
    D8070ECompre dental tx transition
    D8080ECompre dental tx adolescent
    D8090ECompre dental tx adult
    D8210EOrthodontic rem appliance tx
    D8220EFixed appliance therapy habt
    D8660EPreorthodontic tx visit
    D8670EPeriodic orthodontc tx visit
    D8680EOrthodontic retention
    D8690EOrthodontic treatment
    D8691ERepair ortho appliance
    D8692EReplacement retainer
    D8999EOrthodontic procedure
    D9110NTx dental pain minor proc
    D9210EDent anesthesia w/o surgery
    D9211ERegional block anesthesia
    D9212ETrigeminal block anesthesia
    D9215ELocal anesthesia
    D9220EGeneral anesthesia
    D9221EGeneral anesthesia ea ad 15m
    D9230NAnalgesia
    D9241EIntravenous sedation
    D9242EIV sedation ea ad 30 m
    D9248NSedation (non-iv)
    D9310EDental consultation
    D9410EDental house call
    D9420EHospital call
    D9430EOffice visit during hours
    D9440EOffice visit after hours
    D9610EDent therapeutic drug inject
    D9630SOther drugs/medicaments03307.68$390.47$78.09$78.09
    D9910EDent appl desensitizing med
    D9911EAppl desensitizing resin
    D9920EBehavior management
    D9930STreatment of complications03307.68$390.47$78.09$78.09
    D9940SDental occlusal guard03307.68$390.47$78.09$78.09
    D9941EFabrication athletic guard
    D9950SOcclusion analysis03307.68$390.47$78.09$78.09
    D9951SLimited occlusal adjustment03307.68$390.47$78.09$78.09
    D9952SComplete occlusal adjustment03307.68$390.47$78.09$78.09
    D9970EEnamel microabrasion
    D9971EOdontoplasty 1-2 teeth
    D9972EExtrnl bleaching per arch
    D9973EExtrnl bleaching per tooth
    D9974EIntrnl bleaching per tooth
    Start Printed Page 44851
    D9999EAdjunctive procedure
    E0100ACane adjust/fixed with tip
    E0105ACane adjust/fixed quad/3 pro
    E0110ACrutch forearm pair
    E0111ACrutch forearm each
    E0112ACrutch underarm pair wood
    E0113ACrutch underarm each wood
    E0114ACrutch underarm pair no wood
    E0116ACrutch underarm each no wood
    E0130AWalker rigid adjust/fixed ht
    E0135AWalker folding adjust/fixed
    E0141ARigid walker wheeled wo seat
    E0142AWalker rigid wheeled with se
    E0143AWalker folding wheeled w/o s
    E0144AEnclosed walker w rear seat
    E0145AWalker whled seat/crutch att
    E0146AFolding walker wheels w seat
    E0147AWalker variable wheel resist
    E0148AHeavyduty walker no wheels
    E0149AHeavy duty wheeled walker
    E0153AForearm crutch platform atta
    E0154AWalker platform attachment
    E0155AWalker wheel attachment,pair
    E0156AWalker seat attachment
    E0157AWalker crutch attachment
    E0158AWalker leg extenders set of4
    E0159ABrake for wheeled walker
    E0160ASitz type bath or equipment
    E0161ASitz bath/equipment w/faucet
    E0162ASitz bath chair
    E0163ACommode chair stationry fxd
    E0164ACommode chair mobile fixed a
    E0165ACommode chair stationry det
    E0166ACommode chair mobile detach
    E0167ACommode chair pail or pan
    E0168AHeavyduty/wide commode chair
    E0175ACommode chair foot rest
    E0176AAir pressre pad/cushion nonp
    E0177AWater press pad/cushion nonp
    E0178AGel pressre pad/cushion nonp
    E0179ADry pressre pad/cushion nonp
    E0180APress pad alternating w pump
    E0181APress pad alternating w/ pum
    E0182APressure pad alternating pum
    E0184ADry pressure mattress
    E0185AGel pressure mattress pad
    E0186AAir pressure mattress
    E0187AWater pressure mattress
    E0188ESynthetic sheepskin pad
    E0189ELambswool sheepskin pad
    E0191AProtector heel or elbow
    E0192APad wheelchr low press/posit
    E0193APowered air flotation bed
    E0194AAir fluidized bed
    E0196AGel pressure mattress
    E0197AAir pressure pad for mattres
    E0198AWater pressure pad for mattr
    E0199ADry pressure pad for mattres
    E0200AHeat lamp without stand
    E0202APhototherapy light w/ photom
    E0205AHeat lamp with stand
    E0210AElectric heat pad standard
    E0215AElectric heat pad moist
    E0217AWater circ heat pad w pump
    E0218EWater circ cold pad w pump
    E0220AHot water bottle
    E0225AHydrocollator unit
    E0230AIce cap or collar
    E0235AParaffin bath unit portable
    E0236APump for water circulating p
    E0238AHeat pad non-electric moist
    E0239AHydrocollator unit portable
    E0241EBath tub wall rail
    E0242EBath tub rail floor
    E0243EToilet rail
    Start Printed Page 44852
    E0244EToilet seat raised
    E0245ETub stool or bench
    E0246ETransfer tub rail attachment
    E0249APad water circulating heat u
    E0250AHosp bed fixed ht w/ mattres
    E0251AHosp bed fixd ht w/o mattres
    E0255AHospital bed var ht w/ mattr
    E0256AHospital bed var ht w/o matt
    E0260AHosp bed semi-electr w/ matt
    E0261AHosp bed semi-electr w/o mat
    E0265AHosp bed total electr w/ mat
    E0266AHosp bed total elec w/o matt
    E0270EHospital bed institutional t
    E0271AMattress innerspring
    E0272AMattress foam rubber
    E0273EBed board
    E0274EOver-bed table
    E0275ABed pan standard
    E0276ABed pan fracture
    E0277APowered pres-redu air mattrs
    E0280ABed cradle
    E0290AHosp bed fx ht w/o rails w/m
    E0291AHosp bed fx ht w/o rail w/o
    E0292AHosp bed var ht w/o rail w/o
    E0293AHosp bed var ht w/o rail w/
    E0294AHosp bed semi-elect w/ mattr
    E0295AHosp bed semi-elect w/o matt
    E0296AHosp bed total elect w/ matt
    E0297AHosp bed total elect w/o mat
    E0298EHeavyduty/xtra wide hosp bed
    E0305ARails bed side half length
    E0310ARails bed side full length
    E0315EBed accessory brd/tbl/supprt
    E0325AUrinal male jug-type
    E0326AUrinal female jug-type
    E0350EControl unit bowel system
    E0352EDisposable pack w/bowel syst
    E0370EAir elevator for heel
    E0371ANonpower mattress overlay
    E0372APowered air mattress overlay
    E0373ANonpowered pressure mattress
    E0424AStationary compressed gas 02
    E0425EGas system stationary compre
    E0430EOxygen system gas portable
    E0431APortable gaseous 02
    E0434APortable liquid 02
    E0435EOxygen system liquid portabl
    E0439AStationary liquid 02
    E0440EOxygen system liquid station
    E0441AOxygen contents, gaseous
    E0442AOxygen contents, liquid
    E0443APortable 02 contents, gas
    E0444APortable 02 contents, liquid
    E0450AVolume vent stationary/porta
    E0455AOxygen tent excl croup/ped t
    E0457AChest shell
    E0459AChest wrap
    E0460ANeg press vent portabl/statn
    E0462ARocking bed w/ or w/o side r
    E0480APercussor elect/pneum home m
    E0500AIppb all types
    E0550AHumidif extens supple w ippb
    E0555AHumidifier for use w/ regula
    E0560AHumidifier supplemental w/ i
    E0565ACompressor air power source
    E0570ANebulizer with compression
    E0571AAerosol compressor for svneb
    E0572AAerosol compressor adjust pr
    E0574AUltrasonic generator w svneb
    E0575ANebulizer ultrasonic
    E0580ANebulizer for use w/ regulat
    E0585ANebulizer w/ compressor & he
    E0590ADispensing fee dme neb drug
    E0600ASuction pump portab hom modl
    E0601ACont airway pressure device
    Start Printed Page 44853
    E0602EBreast pump
    E0605AVaporizer room type
    E0606ADrainage board postural
    E0607ABlood glucose monitor home
    E0608AApnea monitor
    E0609ABlood gluc mon w/special fea
    E0610APacemaker monitr audible/vis
    E0615APacemaker monitr digital/vis
    E0616NCardiac event recorder
    E0617AAutomatic ext defibrillator
    E0621APatient lift sling or seat
    E0625EPatient lift bathroom or toi
    E0627ASeat lift incorp lift-chair
    E0628ASeat lift for pt furn-electr
    E0629ASeat lift for pt furn-non-el
    E0630APatient lift hydraulic
    E0635APatient lift electric
    E0650APneuma compresor non-segment
    E0651APneum compressor segmental
    E0652APneum compres w/cal pressure
    E0655APneumatic appliance half arm
    E0660APneumatic appliance full leg
    E0665APneumatic appliance full arm
    E0666APneumatic appliance half leg
    E0667ASeg pneumatic appl full leg
    E0668ASeg pneumatic appl full arm
    E0669ASeg pneumatic appli half leg
    E0671APressure pneum appl full leg
    E0672APressure pneum appl full arm
    E0673APressure pneum appl half leg
    E0690AUltraviolet cabinet
    E0700ESafety equipment
    E0710ERestraints any type
    E0720ATens two lead
    E0730ATens four lead
    E0731AConductive garment for tens/
    E0740EIncontinence treatment systm
    E0744ANeuromuscular stim for scoli
    E0745ANeuromuscular stim for shock
    E0746EElectromyograph biofeedback
    E0747AElec osteogen stim not spine
    E0748AElec osteogen stim spinal
    E0749NElec osteogen stim implanted
    E0753NNeurostimulator electrodes
    E0755EElectronic salivary reflex s
    E0756AImplantable pulse generator
    E0757AImplantable RF receiver
    E0758AExternal RF transmitter
    E0760EOsteogen ultrasound stimltor
    E0765ENerve stimulator for tx n&v
    E0776AIv pole
    E0779AAmb infusion pump mechanical
    E0780AMech amb infusion pump <8hrs
    E0781AExternal ambulatory infus pu
    E0782NNon-programble infusion pump
    E0783NProgrammable infusion pump
    E0784AExt amb infusn pump insulin
    E0785NReplacement impl pump cathet
    E0786AImplantable pump replacement
    E0791AParenteral infusion pump sta
    E0830NAmbulatory traction device
    E0840ATract frame attach headboard
    E0850ATraction stand free standing
    E0855ACervical traction equipment
    E0860ATract equip cervical tract
    E0870ATract frame attach footboard
    E0880ATrac stand free stand extrem
    E0890ATraction frame attach pelvic
    E0900ATrac stand free stand pelvic
    E0910ATrapeze bar attached to bed
    E0920AFracture frame attached to b
    E0930AFracture frame free standing
    E0935AExercise device passive moti
    E0940ATrapeze bar free standing
    E0941AGravity assisted traction de
    Start Printed Page 44854
    E0942ACervical head harness/halter
    E0943ACervical pillow
    E0944APelvic belt/harness/boot
    E0945ABelt/harness extremity
    E0946AFracture frame dual w cross
    E0947AFracture frame attachmnts pe
    E0948AFracture frame attachmnts ce
    E0950ETray
    E0951ELoop heel
    E0952ELoop tie
    E0953EPneumatic tire
    E0954EWheelchair semi-pneumatic ca
    E0958EWhlchr att- conv 1 arm drive
    E0959EAmputee adapter
    E0961EWheelchair brake extension
    E0962AWheelchair 1 inch cushion
    E0963AWheelchair 2 inch cushion
    E0964AWheelchair 3 inch cushion
    E0965AWheelchair 4 inch cushion
    E0966EWheelchair head rest extensi
    E0967EWheelchair hand rims
    E0968EWheelchair commode seat
    E0969EWheelchair narrowing device
    E0970EWheelchair no. 2 footplates
    E0971EWheelchair anti-tipping devi
    E0972ATransfer board or device
    E0973EWheelchair adjustabl height
    E0974EWheelchair grade-aid
    E0975EWheelchair reinforced seat u
    E0976EWheelchair reinforced back u
    E0977EWheelchair wedge cushion
    E0978EWheelchair belt w/airplane b
    E0979EWheelchair belt with velcro
    E0980EWheelchair safety vest
    E0990EWhellchair elevating leg res
    E0991EWheelchair upholstry seat
    E0992EWheelchair solid seat insert
    E0993EWheelchair back upholstery
    E0994EWheelchair arm rest
    E0995EWheelchair calf rest
    E0996EWheelchair tire solid
    E0997EWheelchair caster w/ a fork
    E0998EWheelchair caster w/o a fork
    E0999EWheelchr pneumatic tire w/wh
    E1000EWheelchair tire pneumatic ca
    E1001EWheelchair wheel
    E1031ARollabout chair with casters
    E1035EPatient transfer system
    E1050EWhelchr fxd full length arms
    E1060EWheelchair detachable arms
    E1065EWheelchair power attachment
    E1066EWheelchair battery charger
    E1069EWheelchair deep cycle batter
    E1070EWheelchair detachable foot r
    E1083EHemi-wheelchair fixed arms
    E1084EHemi-wheelchair detachable a
    E1085EHemi-wheelchair fixed arms
    E1086EHemi-wheelchair detachable a
    E1087EWheelchair lightwt fixed arm
    E1088EWheelchair lightweight det a
    E1089EWheelchair lightwt fixed arm
    E1090EWheelchair lightweight det a
    E1091EWheelchair youth
    E1092EWheelchair wide w/ leg rests
    E1093EWheelchair wide w/ foot rest
    E1100EWhchr s-recl fxd arm leg res
    E1110EWheelchair semi-recl detach
    E1130EWhlchr stand fxd arm ft rest
    E1140EWheelchair standard detach a
    E1150EWheelchair standard w/ leg r
    E1160EWheelchair fixed arms
    E1170EWhlchr ampu fxd arm leg rest
    E1171EWheelchair amputee w/o leg r
    E1172EWheelchair amputee detach ar
    E1180EWheelchair amputee w/ foot r
    Start Printed Page 44855
    E1190EWheelchair amputee w/ leg re
    E1195EWheelchair amputee heavy dut
    E1200EWheelchair amputee fixed arm
    E1210EWhlchr moto ful arm leg rest
    E1211EWheelchair motorized w/ det
    E1212EWheelchair motorized w full
    E1213EWheelchair motorized w/ det
    E1220EWhlchr special size/constrc
    E1221EWheelchair spec size w foot
    E1222EWheelchair spec size w/ leg
    E1223EWheelchair spec size w foot
    E1224EWheelchair spec size w/ leg
    E1225EWheelchair spec sz semi-recl
    E1226EWheelchair spec sz full-recl
    E1227EWheelchair spec sz spec ht a
    E1228EWheelchair spec sz spec ht b
    E1230APower operated vehicle
    E1240EWhchr litwt det arm leg rest
    E1250EWheelchair lightwt fixed arm
    E1260EWheelchair lightwt foot rest
    E1270EWheelchair lightweight leg r
    E1280EWhchr h-duty det arm leg res
    E1285EWheelchair heavy duty fixed
    E1290EWheelchair hvy duty detach a
    E1295EWheelchair heavy duty fixed
    E1296EWheelchair special seat heig
    E1297EWheelchair special seat dept
    E1298EWheelchair spec seat depth/w
    E1300EWhirlpool portable
    E1310AWhirlpool non-portable
    E1340ARepair for DME, per 15 min
    E1353AOxygen supplies regulator
    E1355AOxygen supplies stand/rack
    E1372AOxy suppl heater for nebuliz
    E1390AOxygen concentrator
    E1399ADurable medical equipment mi
    E1405AO2/water vapor enrich w/heat
    E1406AO2/water vapor enrich w/o he
    E1510AKidney dialysate delivry sys
    E1520AHeparin infusion pump for di
    E1530AAir bubble detector for dial
    E1540APressure alarm for dialysis
    E1550ABath conductivity meter
    E1560ABlood leak detector for dial
    E1570AAdjustable chair for esrd pt
    E1575ATransducer protector/fluid b
    E1580AUnipuncture control system
    E1590AHemodialysis machine
    E1592AAuto interm peritoneal dialy
    E1594ACycler dialysis machine
    E1600ADeliv/install equip for dial
    E1610AReverse osmosis water purifi
    E1615ADeionizer water purification
    E1620ABlood pump for dialysis
    E1625AWater softening system
    E1630AReciprocating peritoneal dia
    E1632AWearable artificial kidney
    E1635ACompact travel hemodialyzer
    E1636ASorbent cartridges for dialy
    E1640AReplacement components for d
    E1699ADialysis equipment unspecifi
    E1700AJaw motion rehab system
    E1701ARepl cushions for jaw motion
    E1702ARepl measr scales jaw motion
    E1800AAdjust elbow ext/flex device
    E1805AAdjust wrist ext/flex device
    E1810AAdjust knee ext/flex device
    E1815AAdjust ankle ext/flex device
    E1820ASoft interface material
    E1825AAdjust finger ext/flex devc
    E1830AAdjust toe ext/flex device
    E1900ASpeech communication device
    G0001ADrawing blood for specimen
    G0002NTemporary urinary catheter
    G0004EECG transm phys review & int
    Start Printed Page 44856
    G0005XECG 24 hour recording00970.87$44.23$24.33$8.85
    G0006XECG transmission & analysis00970.87$44.23$24.33$8.85
    G0007NECG phy review & interpret
    G0008KAdmin influenza virus vac03540.11$5.59
    G0009KAdmin pneumococcal vaccine03540.11$5.59
    G0010NAdmin hepatitis b vaccine
    G0015XPost symptom ECG tracing00970.87$44.23$24.33$8.85
    G0016EPost symptom ECG md review
    G0117SGlaucoma screen, md perform02300.64$32.54$14.97$6.51
    G0118SGlaucoma screen, md supr02300.64$32.54$14.97$6.51
    G0025XCollagen skin test kit03430.42$21.35$11.53$4.27
    G0026AFecal leukocyte examination
    G0027ASemen analysis
    G0030SPET imaging prev PET single028520.07$1,020.40$415.21$204.08
    G0031SPET imaging prev PET multple028520.07$1,020.40$415.21$204.08
    G0032SPET follow SPECT 78464 singl028520.07$1,020.40$415.21$204.08
    G0033SPET follow SPECT 78464 mult028520.07$1,020.40$415.21$204.08
    G0034SPET follow SPECT 76865 singl028520.07$1,020.40$415.21$204.08
    G0035SPET follow SPECT 78465 mult028520.07$1,020.40$415.21$204.08
    G0036SPET follow cornry angio sing028520.07$1,020.40$415.21$204.08
    G0037SPET follow cornry angio mult028520.07$1,020.40$415.21$204.08
    G0038SPET follow myocard perf sing028520.07$1,020.40$415.21$204.08
    G0039SPET follow myocard perf mult028520.07$1,020.40$415.21$204.08
    G0040SPET follow stress echo singl028520.07$1,020.40$415.21$204.08
    G0041SPET follow stress echo mult028520.07$1,020.40$415.21$204.08
    G0042SPET follow ventriculogm sing028520.07$1,020.40$415.21$204.08
    G0043SPET follow ventriculogm mult028520.07$1,020.40$415.21$204.08
    G0044SPET following rest ECG singl028520.07$1,020.40$415.21$204.08
    G0045SPET following rest ECG mult028520.07$1,020.40$415.21$204.08
    G0046SPET follow stress ECG singl028520.07$1,020.40$415.21$204.08
    G0047SPET follow stress ECG mult028520.07$1,020.40$415.21$204.08
    G0050SResidual urine by ultrasound02651.02$51.86$28.52$10.37
    G0101VCA screen;pelvic/breast exam06011.02$51.86$10.37$10.37
    G0102NProstate ca screening; dre
    G0103APsa, total screening
    G0104SCA screen;flexi sigmoidscope01592.51$127.61$31.90
    G0105SColorectal scrn; hi risk ind01587.00$355.89$88.97
    G0106SColon CA screen;barium enema01572.14$108.80$27.20
    G0107ACA screen; fecal blood test
    G0108ADiab manage trn per indiv
    G0109ADiab manage trn ind/group
    G0110ANett pulm-rehab educ; ind
    G0111ANett pulm-rehab educ; group
    G0112ANett;nutrition guid, initial
    G0113ANett;nutrition guid,subseqnt
    G0114ANett; psychosocial consult
    G0115ANett; psychological testing
    G0116ANett; psychosocial counsel
    G0120SColon ca scrn; barium enema01572.14$108.80$27.20
    G0121EColon ca scrn not hi rsk ind
    G0122SColon ca scrn; barium enema01572.14$108.80$27.20
    G0123AScreen cerv/vag thin layer
    G0124AScreen c/v thin layer by MD
    G0125SPET image pulmonary nodule097616.56$841.94$168.39
    G0126SLung image (PET) staging097616.56$841.94$168.39
    G0127TTrim nail(s)00090.68$34.57$8.99$6.91
    G0128ECORF skilled nursing service
    G0129PPartial hosp prog service00334.17$212.01$42.40
    G0130XSingle energy x-ray study02611.31$66.60$36.63$13.32
    G0131SCT scan, bone density study02881.27$64.57$35.51$12.91
    G0132SCT scan, bone density study02881.27$64.57$35.51$12.91
    G0141EScr c/v cyto,autosys and md
    G0143AScr c/v cyto,thinlayer,rescr
    G0144AScr c/v cyto,thinlayer,rescr
    G0145AScr c/v cyto,thinlayer,rescr
    G0147AScr c/v cyto, automated sys
    G0148AScr c/v cyto, autosys, rescr
    G0151EHHCP-serv of pt,ea 15 min
    G0152EHHCP-serv of ot,ea 15 min
    G0153EHHCP-svs of s/l path,ea 15mn
    G0154EHHCP-svs of rn,ea 15 min
    G0155EHHCP-svs of csw,ea 15 min
    G0156EHHCP-svs of aide,ea 15 min
    G0163SPet for rec of colorectal ca097616.56$841.94$168.39
    G0164SPet for lymphoma staging097616.56$841.94$168.39
    Start Printed Page 44857
    G0165SPet,rec of melanoma/met ca097616.56$841.94$168.39
    G0166TExtrnl counterpulse, per tx09722.84$144.39$28.88
    G0167EHyperbaric oz tx;no md reqrd
    G0168TWound closure by adhesive09700.47$23.90$4.78
    G0173SStereo radoisurgery,complete030211.96$608.07$216.55$121.61
    G0174SIntensitymodulatedradiation030211.96$608.07$216.55$121.61
    G0175VOPPS Service,sched team conf06021.49$75.75$15.15$15.15
    G0176POPPS/PHP;activity therapy00334.17$212.01$42.40
    G0177POPPS/PHP; train & educ serv00334.17$212.01$42.40
    G0178SIntensitymodulatedradiation030211.96$608.07$216.55$121.61
    G0179EMD recertification HHA PT
    G0180EMD certification HHA patient
    G0181EHome health care supervision
    G0182EHospice care supervision
    G0183TOcular photodynamic therapy02355.39$274.04$78.91$54.81
    G0184TOcular photdynamicTx 2nd eye02355.39$274.04$78.91$54.81
    G0185TTranspuppillary thermotx02355.39$274.04$78.91$54.81
    G0186TDstry eye lesn,fdr vssl tech02355.39$274.04$78.91$54.81
    G0187TDstry mclr drusen,photocoag02355.39$274.04$78.91$54.81
    G0188XXray lwr extrmty-full lngth02611.31$66.60$36.63$13.32
    G0190NImmunization administration
    G0191NImmunization admin,each add
    G0192NImmunization oral/intranasal
    G0193AEndoscopicstudyswallowfunctn
    G0194ASensorytestingendoscopicstud
    G0195AClinicalevalswallowingfunct
    G0196AEvalofswallowingwithradioopa
    G0197AEvalofptforprescipspeechdevi
    G0198APatientadapation&trainforspe
    G0199AReevaluationofpatientusespec
    G0200AEvalofpatientprescipofvoicep
    G0201AModifortraininginusevoicepro
    G0202AScreeningmammographydigital
    G0203AScreenmammographyfilmdigital
    G0204SDiagnosticmammographydigital02710.64$32.54$17.90$6.51
    G0205SDiagnosticmammographyfilmpro02710.64$32.54$17.90$6.51
    G0206SDiagnosticmammographydigital02710.64$32.54$17.90$6.51
    G0207SDiagnostic mammography film02710.64$32.54$17.90$6.51
    G0210SPET img wholebody dxlung ca097616.56$841.94$168.39
    G0211SPET img wholebody init lung097616.56$841.94$168.39
    G0212SPET img wholebod restag lung097616.56$841.94$168.39
    G0213SPET img wholebody dx colorec097616.56$841.94$168.39
    G0214SPET img wholebod init colore097616.56$841.94$168.39
    G0215SPETimg wholebod restag colre097616.56$841.94$168.39
    G0216SPET img wholebod dx melanoma097616.56$841.94$168.39
    G0217SPET img wholebod init melano097616.56$841.94$168.39
    G0218SPET img wholebod restag mela097616.56$841.94$168.39
    G0219SPET img wholbod melano nonco097616.56$841.94$168.39
    G0220SPET img wholebod dx lymphoma097616.56$841.94$168.39
    G0221SPET imag wholbod init lympho097616.56$841.94$168.39
    G0222SPET imag wholbod resta lymph097616.56$841.94$168.39
    G0223SPET imag wholbod reg dx head097616.56$841.94$168.39
    G0224SPET imag wholbod reg ini hea097616.56$841.94$168.39
    G0225SPET whol restag headneck onl097616.56$841.94$168.39
    G0226SPET img wholbody dx esophagl097616.56$841.94$168.39
    G0227SPET img wholbod ini esophage097616.56$841.94$168.39
    G0228SPET img wholbod restg esopha097616.56$841.94$168.39
    G0229SPET img metabolic brain pres097616.56$841.94$168.39
    G0230SPET myocard viability post s097616.56$841.94$168.39
    G9001EMCCD, initial rate
    G9002EMCCD,maintenance rate
    G9003EMCCD, risk adj hi, initial
    G9004EMCCD, risk adj lo, initial
    G9005EMCCD, risk adj, maintenance
    G9006EMCCD, Home monitoring
    G9007EMCCD, sch team conf
    G9008EMccd,phys coor-care ovrsght
    G9016ADemo-smoking cessation coun
    H0001EAlcohol and/or drug assess
    H0002EAlcohol and/or drug screenin
    H0003EAlcohol and/or drug screenin
    H0004EAlcohol and/or drug services
    H0005EAlcohol and/or drug services
    H0006EAlcohol and/or drug services
    H0007EAlcohol and/or drug services
    Start Printed Page 44858
    H0008EAlcohol and/or drug services
    H0009EAlcohol and/or drug services
    H0010EAlcohol and/or drug services
    H0011EAlcohol and/or drug services
    H0012EAlcohol and/or drug services
    H0013EAlcohol and/or drug services
    H0014EAlcohol and/or drug services
    H0015EAlcohol and/or drug services
    H0016EAlcohol and/or drug services
    H0017EAlcohol and/or drug services
    H0018EAlcohol and/or drug services
    H0019EAlcohol and/or drug services
    H0020EAlcohol and/or drug services
    H0021EAlcohol and/or drug training
    H0022EAlcohol and/or drug interven
    H0023EAlcohol and/or drug outreach
    H0024EAlcohol and/or drug preventi
    H0025EAlcohol and/or drug preventi
    H0026EAlcohol and/or drug preventi
    H0027EAlcohol and/or drug preventi
    H0028EAlcohol and/or drug preventi
    H0029EAlcohol and/or drug preventi
    H0030EAlcohol and/or drug hotline
    J0120NTetracyclin injection
    J0130GAbciximab injection1605$513.02$73.44
    J0150KInjection adenosine 6 MG09170.37$18.81$3.62
    J0151EAdenosine injection
    J0170NAdrenalin epinephrin inject
    J0190NInj biperiden lactate/5 mg
    J0200NAlatrofloxacin mesylate
    J0205GAlglucerase injection0900$37.53$5.37
    J0207GAmifostine7000$392.06$56.13
    J0210NMethyldopate hcl injection
    J0256GAlpha 1 proteinase inhibitor0901$2.09$.30
    J0270EAlprostadil for injection
    J0275EAlprostadil urethral suppos
    J0280NAminophyllin 250 MG inj
    J0282NAmiodarone HCl
    J0285NAmphotericin B
    J0286GAmphotericin B lipid complex7001$109.25$15.64
    J0290NAmpicillin 500 MG inj
    J0295NAmpicillin sodium per 1.5 gm
    J0300NAmobarbital 125 MG inj
    J0330NSuccinycholine chloride inj
    J0340NNandrolon phenpropionate inj
    J0350GInjection anistreplase 30 u1606$2,559.11$366.36
    J0360NHydralazine hcl injection
    J0380NInj metaraminol bitartrate
    J0390NChloroquine injection
    J0395NArbutamine HCl injection
    J0400NInj trimethaphan camsylate
    J0456NAzithromycin
    J0460NAtropine sulfate injection
    J0470NDimecaprol injection
    J0475NBaclofen 10 MG injection
    J0476EBaclofen intrathecal trial
    J0500NDicyclomine injection
    J0510NBenzquinamide injection
    J0515NInj benztropine mesylate
    J0520NBethanechol chloride inject
    J0530NPenicillin g benzathine inj
    J0540NPenicillin g benzathine inj
    J0550NPenicillin g benzathine inj
    J0560NPenicillin g benzathine inj
    J0570NPenicillin g benzathine inj
    J0580NPenicillin g benzathine inj
    J0585GBotulinum toxin a per unit0902$4.39$.56
    J0590NEthylnorepinephrine hcl inj
    J0600NEdetate calcium disodium inj
    J0610NCalcium gluconate injection
    J0620NCalcium glycer & lact/10 ML
    J0630NCalcitonin salmon injection
    J0635NCalcitriol injection
    J0640GLeucovorin calcium injection0725$4.98$.45
    J0670NInj mepivacaine HCL/10 ml
    Start Printed Page 44859
    J0690NCefazolin sodium injection
    J0694NCefoxitin sodium injection
    J0695NCefonocid sodium injection
    J0696NCeftriaxone sodium injection
    J0697NSterile cefuroxime injection
    J0698NCefotaxime sodium injection
    J0702NBetamethasone acet&sod phosp
    J0704NBetamethasone sod phosp/4 MG
    J0710NCephapirin sodium injection
    J0713NInj ceftazidime per 500 mg
    J0715NCeftizoxime sodium / 500 MG
    J0720NChloramphenicol sodium injec
    J0725NChorionic gonadotropin/1000u
    J0730NChlorpheniramin maleate inj
    J0735NClonidine hydrochloride
    J0740NCidofovir injection
    J0743NCilastatin sodium injection
    J0745NInj codeine phosphate /30 MG
    J0760NColchicine injection
    J0770NColistimethate sodium inj
    J0780NProchlorperazine injection
    J0800NCorticotropin injection
    J0810NCortisone injection
    J0835NInj cosyntropin per 0.25 MG
    J0850GCytomegalovirus imm IV /vial0903$656.27$84.28
    J0895NDeferoxamine mesylate inj
    J0900NTestosterone enanthate inj
    J0945NBrompheniramine maleate inj
    J0970NEstradiol valerate injection
    J1000NDepo-estradiol cypionate inj
    J1020NMethylprednisolone 20 MG inj
    J1030NMethylprednisolone 40 MG inj
    J1040NMethylprednisolone 80 MG inj
    J1050NMedroxyprogesterone inj
    J1055EMedrxyprogester acetate inj
    J1060NTestosterone cypionate 1 ML
    J1070NTestosterone cypionat 100 MG
    J1080NTestosterone cypionat 200 MG
    J1090NTestosterone cypionate 50 MG
    J1095NInj dexamethasone acetate
    J1100NDexamethasone sodium phos
    J1110NInj dihydroergotamine mesylt
    J1120NAcetazolamid sodium injectio
    J1160NDigoxin injection
    J1165NPhenytoin sodium injection
    J1170NHydromorphone injection
    J1180NDyphylline injection
    J1190GDexrazoxane HCl injection0726$194.53$27.85
    J1200NDiphenhydramine hcl injectio
    J1205NChlorothiazide sodium inj
    J1212NDimethyl sulfoxide 50% 50 ML
    J1230NMethadone injection
    J1240NDimenhydrinate injection
    J1245KDipyridamole injection09170.37$18.81$3.62
    J1250NInj dobutamine HCL/250 mg
    J1260GDolasetron mesylate0750$16.45$2.11
    J1320NAmitriptyline injection
    J1325GEpoprostenol injection7003$17.37$2.49
    J1327GEptifibatide injection1607$13.58$1.94
    J1330NErgonovine maleate injection
    J1362NErythromycin glucep / 250 MG
    J1364NErythro lactobionate /500 MG
    J1380NEstradiol valerate 10 MG inj
    J1390NEstradiol valerate 20 MG inj
    J1410NInj estrogen conjugate 25 MG
    J1435NInjection estrone per 1 MG
    J1436GEtidronate disodium inj0727$63.65$9.11
    J1438GEtanercept injection1608$140.98$20.18
    J1440GFilgrastim 300 mcg injeciton0728$179.08$25.64
    J1441GFilgrastim 480 mcg injection7049$285.38$40.85
    J1450NFluconazole
    J1452NIntraocular Fomivirsen na
    J1455NFoscarnet sodium injection
    J1460NGamma globulin 1 CC inj
    J1470EGamma globulin 2 CC inj
    Start Printed Page 44860
    J1480EGamma globulin 3 CC inj
    J1490EGamma globulin 4 CC inj
    J1500EGamma globulin 5 CC inj
    J1510EGamma globulin 6 CC inj
    J1520EGamma globulin 7 CC inj
    J1530EGamma globulin 8 CC inj
    J1540EGamma globulin 9 CC inj
    J1550EGamma globulin 10 CC inj
    J1560EGamma globulin > 10 CC inj
    J1561GImmune globulin 500 mg0905$25.92$3.33
    J1563NIV immune globulin
    J1565GRSV-ivig0906$406.34$58.17
    J1570KGanciclovir sodium injection09070.46$23.39$4.51
    J1580NGaramycin gentamicin inj
    J1600NGold sodium thiomaleate inj
    J1610NGlucagon hydrochloride/1 MG
    J1620GGonadorelin hydroch/ 100 mcg7005$38.47$5.51
    J1626GGranisetron HCl injection0764$18.54$2.38
    J1630NHaloperidol injection
    J1631NHaloperidol decanoate inj
    J1642NInj heparin sodium per 10 u
    J1644NInj heparin sodium per 1000u
    J1645NDalteparin sodium
    J1650NInj enoxaparin sodium
    J1670GTetanus immune globulin inj0908$102.60$14.69
    J1690NPrednisolone tebutate inj
    J1700NHydrocortisone acetate inj
    J1710NHydrocortisone sodium ph inj
    J1720NHydrocortisone sodium succ i
    J1730NDiazoxide injection
    J1739NHydroxyprogesterone cap 125
    J1741NHydroxyprogesterone cap 250
    J1742NIbutilide fumarate injection
    J1745GInfliximab injection7043$63.23$9.05
    J1750NIron dextran
    J1785GInjection imiglucerase /unit0916$3.75$.54
    J1790NDroperidol injection
    J1800NPropranolol injection
    J1810GDroperidol/fentanyl inj7047$6.67$.95
    J1820NInsulin injection
    J1825GInterferon beta-1a0909$225.23$32.24
    J1830GInterferon beta-1b / .25 MG0910$54.15$7.75
    J1840NKanamycin sulfate 500 MG inj
    J1850NKanamycin sulfate 75 MG inj
    J1885NKetorolac tromethamine inj
    J1890NCephalothin sodium injection
    J1910NKutapressin injection
    J1930NPropiomazine injection
    J1940NFurosemide injection
    J1950GLeuprolide acetate /3.75 MG0800$81.60$7.39
    J1955EInj levocarnitine per 1 gm
    J1956NLevofloxacin injection
    J1960NLevorphanol tartrate inj
    J1970NMethotrimeprazine injection
    J1980NHyoscyamine sulfate inj
    J1990NChlordiazepoxide injection
    J2000NLidocaine injection
    J2010NLincomycin injection
    J2060NLorazepam injection
    J2150NMannitol injection
    J2175NMeperidine hydrochl /100 MG
    J2180NMeperidine/promethazine inj
    J2210NMethylergonovin maleate inj
    J2240NMetocurine iodide injection
    J2250NInj midazolam hydrochloride
    J2260KInj milrinone lactate / 5 ML70070.48$24.40$4.88
    J2270NMorphine sulfate injection
    J2271NMorphine so4 injection 100mg
    J2275GMorphine sulfate injection7010$7.41$.95
    J2300NInj nalbuphine hydrochloride
    J2310NInj naloxone hydrochloride
    J2320NNandrolone decanoate 50 MG
    J2321NNandrolone decanoate 100 MG
    J2322NNandrolone decanoate 200 MG
    J2330NThiothixene injection
    Start Printed Page 44861
    J2350NNiacinamide/niacin injection
    J2352GOctreotide acetate injection7031$125.65$17.99
    J2355GOprelvekin injection7011$236.31$33.83
    J2360NOrphenadrine injection
    J2370NPhenylephrine hcl injection
    J2400NChloroprocaine hcl injection
    J2405GOndansetron hcl injection0768$3.92$.50
    J2410NOxymorphone hcl injection
    J2430GPamidronate disodium /30 MG0730$253.68$32.58
    J2440NPapaverin hcl injection
    J2460NOxytetracycline injection
    J2480NHydrochlorides of opium inj
    J2500NParicalcitol
    J2510NPenicillin g procaine inj
    J2512NInj pentagastrin per 2 ML
    J2515NPentobarbital sodium inj
    J2540NPenicillin g potassium inj
    J2543NPiperacillin/tazobactam
    J2545APentamidine isethionte/300mg
    J2550NPromethazine hcl injection
    J2560NPhenobarbital sodium inj
    J2590NOxytocin injection
    J2597EInj desmopressin acetate
    J2640NPrednisolone sodium ph inj
    J2650NPrednisolone acetate inj
    J2670NTotazoline hcl injection
    J2675NInj progesterone per 50 MG
    J2680NFluphenazine decanoate 25 MG
    J2690NProcainamide hcl injection
    J2700NOxacillin sodium injeciton
    J2710NNeostigmine methylslfte inj
    J2720NInj protamine sulfate/10 MG
    J2725NInj protirelin per 250 mcg
    J2730NPralidoxime chloride inj
    J2760NPhentolaine mesylate inj
    J2765GMetoclopramide hcl injection0754$1.55$.20
    J2770GQuinupristin/dalfopristin1024$102.05$14.61
    J2780NRanitidine hydrochloride inj
    J2790GRho d immune globulin inj0884$34.11$4.38
    J2792GRho(D) immune globulin h, sd1609$20.64$2.65
    J2795NRopivacaine HCl injection
    J2800NMethocarbamol injection
    J2810NInj theophylline per 40 MG
    J2820GSargramostim injection0731$29.06$4.16
    J2860NSecobarbital sodium inj
    J2910NAurothioglucose injeciton
    J2912NSodium chloride injection
    J2915NNA Ferric Gluconate Complex
    J2920NMethylprednisolone injection
    J2930NMethylprednisolone injection
    J2950NPromazine hcl injeciton
    J2970NMethicillin sodium injection
    J2993GReteplase injection9005$1,306.25$187.00
    J2995KInj streptokinase /250000 IU09111.80$91.52$17.68
    J2997KAlteplase recombinant70480.39$19.83$3.97
    J3000NStreptomycin injection
    J3010GFentanyl citrate injeciton7014$1.40$.18
    J3030NSumatriptan succinate / 6 MG
    J3070NPentazocine hcl injeciton
    J3080NChlorprothixene injection
    J3105NTerbutaline sulfate inj
    J3120NTestosterone enanthate inj
    J3130NTestosterone enanthate inj
    J3140NTestosterone suspension inj
    J3150NTestosteron propionate inj
    J3230NChlorpromazine hcl injection
    J3240EThyrotropin injection
    J3245GTirofiban hydrochloride7041$435.27$62.31
    J3250NTrimethobenzamide hcl inj
    J3260NTobramycin sulfate injection
    J3265NInjection torsemide 10 mg/ml
    J3270NImipramine hcl injection
    J3280GThiethylperazine maleate inj0755$5.43$.70
    J3301NTriamcinolone acetonide inj
    J3302NTriamcinolone diacetate inj
    Start Printed Page 44862
    J3303NTriamcinolone hexacetonl inj
    J3305GInj trimetrexate glucoronate7045$86.09$12.32
    J3310NPerphenazine injeciton
    J3320NSpectinomycn di-hcl inj
    J3350NUrea injection
    J3360NDiazepam injection
    J3364NUrokinase 5000 IU injection
    J3365KUrokinase 250,000 IU inj70366.93$352.34$70.47
    J3370NVancomycin hcl injeciton
    J3390NMethoxamine injection
    J3400NTriflupromazine hcl inj
    J3410NHydroxyzine hcl injeciton
    J3420NVitamin b12 injection
    J3430NVitamin k phytonadione inj
    J3450NMephentermine sulfate inj
    J3470NHyaluronidase injection
    J3475NInj magnesium sulfate
    J3480NInj potassium chloride
    J3485NZidovudine
    J3490NDrugs unclassified injection
    J3520EEdetate disodium per 150 mg
    J3530NNasal vaccine inhalation
    J3535EMetered dose inhaler drug
    J3570ELaetrile amygdalin vit B17
    J7030NNormal saline solution infus
    J7040NNormal saline solution infus
    J7042N5% dextrose/normal saline
    J7050NNormal saline solution infus
    J7051NSterile saline/water
    J7060N5% dextrose/water
    J7070ND5w infusion
    J7100NDextran 40 infusion
    J7110NDextran 75 infusion
    J7120NRingers lactate infusion
    J7130NHypertonic saline solution
    J7190GFactor viii0925$.87$.11
    J7191GFactor VIII (porcine)0926$2.09$.30
    J7192GFactor viii recombinant0927$1.19$.15
    J7194GFactor ix complex0928$.68$.09
    J7197GAntithrombin iii injection0930$1.05$.15
    J7198GAnti-inhibitor0929$1.43$.18
    J7199EHemophilia clot factor noc
    J7300EIntraut copper contraceptive
    J7310GGanciclovir long act implant0913$4,750.00$680.00
    J7315GSodium hyaluronate injection7315$136.80$19.58
    J7320GHylan G-F 20 injection1611$213.86$30.62
    J7330GCultured chondrocytes implnt1059$14,250.00$2,040.00
    J7500GAzathioprine oral 50mg0886$1.24$.16
    J7501GAzathioprine parenteral0887$.75$.10
    J7502GCyclosporine oral 100 mg0888$5.23$.47
    J7504GLymphocyte immune globulin0890$249.47$32.04
    J7505GMonoclonal antibodies7038$777.31$111.28
    J7506GPrednisone oral7050$.07$.01
    J7507GTacrolimus oral per 1 MG0891$2.91$.42
    J7508ETacrolimus oral per 5 MG
    J7509NMethylprednisolone oral
    J7510NPrednisolone oral per 5 mg
    J7513GDaclizumab, parenteral1612$397.29$56.88
    J7515NCyclosporine oral 25 mg
    J7516GCyclosporin parenteral 250mg0889$25.08$2.27
    J7517GMycophenolate mofetil oral9015$2.40$.34
    J7520GSirolimus, oral9106$6.51$.93
    J7525ETacrolimus injection
    J7599EImmunosuppressive drug noc
    J7608AAcetylcysteine inh sol u d
    J7618AAlbuterol inh sol con
    J7619AAlbuterol inh sol u d
    J7628ABitolterol mes inhal sol con
    J7629ABitolterol mes inh sol u d
    J7631ACromolyn sodium inh sol u d
    J7635AAtropine inhal sol con
    J7636AAtropine inhal sol unit dose
    J7637ADexamethasone inhal sol con
    J7638ADexamethasone inhal sol u d
    J7639ADornase alpha inhal sol u d
    Start Printed Page 44863
    J7642AGlycopyrrolate inhal sol con
    J7643AGlycopyrrolate inhal sol u d
    J7644AIpratropium brom inh sol u d
    J7648AIsoetharine hcl inh sol con
    J7649AIsoetharine hcl inh sol u d
    J7658AIsoproterenolhcl inh sol con
    J7659AIsoproterenol hcl inh sol ud
    J7668AMetaproterenol inh sol con
    J7669AMetaproterenol inh sol u d
    J7680ATerbutaline so4 inh sol con
    J7681ATerbutaline so4 inh sol u d
    J7682ATobramycin inhalation sol
    J7683ATriamcinolone inh sol con
    J7684ATriamcinolone inh sol u d
    J7699AInhalation solution for DME
    J7799ANon-inhalation drug for DME
    J8499EOral prescrip drug non chemo
    J8510GOral busulfan7015$1.81$.23
    J8520GCapecitabine, oral, 150 mg7042$2.43$.35
    J8521NCapecitabine, oral, 500 mg
    J8530GCyclophosphamide oral 25 MG0801$2.23$.32
    J8560GEtoposide oral 50 MG0802$50.89$7.29
    J8600GMelphalan oral 2 MG0803$2.18$.31
    J8610GMethotrexate oral 2.5 MG0826$2.73$.25
    J8700GTemozolmide1086$5.93$.85
    J8999EOral prescription drug chemo
    J9000GDoxorubic hcl 10 MG vl chemo0847$9.00$1.29
    J9001GDoxorubicin hcl liposome inj7046$358.95$51.39
    J9015GAldesleukin/single use vial0807$641.25$91.80
    J9020GAsparaginase injection0814$59.70$8.55
    J9031GBcg live intravesical vac0809$166.44$21.37
    J9040GBleomycin sulfate injection0857$289.37$41.43
    J9045GCarboplatin injection0811$111.11$15.91
    J9050GCarmus bischl nitro inj0812$114.41$16.38
    J9060GCisplatin 10 MG injeciton0813$47.12$6.75
    J9062ECisplatin 50 MG injeciton
    J9065GInj cladribine per 1 MG0858$56.08$8.03
    J9070GCyclophosphamide 100 MG inj0815$5.98$.77
    J9080ECyclophosphamide 200 MG inj
    J9090ECyclophosphamide 500 MG inj
    J9091ECyclophosphamide 1.0 grm inj
    J9092ECyclophosphamide 2.0 grm inj
    J9093GCyclophosphamide lyophilized0816$6.13$.79
    J9094ECyclophosphamide lyophilized
    J9095ECyclophosphamide lyophilized
    J9096ECyclophosphamide lyophilized
    J9097ECyclophosphamide lyophilized
    J9100GCytarabine hcl 100 MG inj0817$4.75$.43
    J9110ECytarabine hcl 500 MG inj
    J9120GDactinomycin actinomycin d0818$13.23$1.89
    J9130GDacarbazine 10 MG inj0819$11.28$1.02
    J9140EDacarbazine 200 MG inj
    J9150GDaunorubicin0820$76.62$6.94
    J9151GDaunorubicin citrate liposom0821$64.60$9.25
    J9160GDenileukin diftitox, 300 mcg1084$999.88$143.14
    J9165GDiethylstilbestrol injection0822$3.99$.57
    J9170GDocetaxel0823$297.83$42.64
    J9180EEpirubicin HCl injection
    J9181GEtoposide 10 MG inj0824$3.86$.35
    J9182EEtoposide 100 MG inj
    J9185GFludarabine phosphate inj0842$258.88$37.06
    J9190GFluorouracil injection0859$1.48$.13
    J9200GFloxuridine injection0827$129.56$11.73
    J9201GGemcitabine HCl0828$102.13$14.62
    J9202GGoserelin acetate implant0810$446.49$63.92
    J9206GIrinotecan injection0830$125.47$17.96
    J9208GIfosfomide injection0831$156.65$22.43
    J9209GMesna injection0732$40.44$5.79
    J9211GIdarubicin hcl injeciton0832$412.21$59.01
    J9212GInterferon alfacon-10833$4.10$.59
    J9213GInterferon alfa-2a inj0834$34.87$4.99
    J9214GInterferon alfa-2b inj0836$12.98$1.67
    J9215GInterferon alfa-n3 inj0865$7.86$1.12
    J9216GInterferon gamma 1-b inj0838$285.64$40.89
    J9217GLeuprolide acetate suspnsion9217$564.92$51.14
    Start Printed Page 44864
    J9218GLeuprolide acetate injeciton0861$26.15$2.37
    J9219NLeuprolide acetate implant
    J9230GMechlorethamine hcl inj0839$11.88$1.70
    J9245GInj melphalan hydrochl 50 MG0840$381.65$54.64
    J9250GMethotrexate sodium inj0841$.41$.04
    J9260EMethotrexate sodium inj
    J9265GPaclitaxel injection0863$164.08$21.07
    J9266GPegaspargase/singl dose vial0843$1,255.57$179.74
    J9268GPentostatin injection0844$1,654.14$236.80
    J9270GPlicamycin (mithramycin) inj0860$93.80$13.43
    J9280GMitomycin 5 MG inj0862$121.65$11.01
    J9290EMitomycin 20 MG inj
    J9291EMitomycin 40 MG inj
    J9293GMitoxantrone hydrochl / 5 MG0864$244.20$34.96
    J9310GRituximab cancer treatment0849$454.55$65.07
    J9320GStreptozocin injection0850$117.64$16.84
    J9340GThiotepa injection0851$116.97$16.75
    J9350GTopotecan0852$632.56$90.56
    J9355GTrastuzumab1613$52.83$7.56
    J9357GValrubicin, 200 mg1614$423.23$60.59
    J9360GVinblastine sulfate inj0853$4.11$.37
    J9370GVincristine sulfate 1 MG inj0854$30.16$2.73
    J9375EVincristine sulfate 2 MG inj
    J9380EVincristine sulfate 5 MG inj
    J9390GVinorelbine tartrate/10 mg0855$79.28$11.35
    J9600GPorfimer sodium0856$2,603.67$372.74
    J9999EChemotherapy drug
    K0001AStandard wheelchair
    K0002AStnd hemi (low seat) whlchr
    K0003ALightweight wheelchair
    K0004AHigh strength ltwt whlchr
    K0005AUltralightweight wheelchair
    K0006AHeavy duty wheelchair
    K0007AExtra heavy duty wheelchair
    K0008ACstm manual wheelchair/base
    K0009AOther manual wheelchair/base
    K0010AStnd wt frame power whlchr
    K0011AStnd wt pwr whlchr w control
    K0012ALtwt portbl power whlchr
    K0013ACustom power whlchr base
    K0014AOther power whlchr base
    K0015ADetach non-adjus hght armrst
    K0016ADetach adjust armrst cmplete
    K0017ADetach adjust armrest base
    K0018ADetach adjust armrst upper
    K0019AArm pad each
    K0020AFixed adjust armrest pair
    K0021AAnti-tipping device each
    K0022AReinforced back upholstery
    K0023APlanr back insrt foam w/strp
    K0024APlnr back insrt foam w/hrdwr
    K0025AHook-on headrest extension
    K0026ABack upholst lgtwt whlchr
    K0027ABack upholst other whlchr
    K0028AManual fully reclining back
    K0029AReinforced seat upholstery
    K0030ASolid plnr seat sngl dnsfoam
    K0031ASafety belt/pelvic strap
    K0032ASeat uphols lgtwt whlchr
    K0033ASeat upholstery other whlchr
    K0034AHeel loop each
    K0035AHeel loop with ankle strap
    K0036AToe loop each
    K0037AHigh mount flip-up footrest
    K0038ALeg strap each
    K0039ALeg strap h style each
    K0040AAdjustable angle footplate
    K0041ALarge size footplate each
    K0042AStandard size footplate each
    K0043AFtrst lower extension tube
    K0044AFtrst upper hanger bracket
    K0045AFootrest complete assembly
    K0046AElevat legrst low extension
    K0047AElevat legrst up hangr brack
    K0048AElevate legrest complete
    Start Printed Page 44865
    K0049ACalf pad each
    K0050ARatchet assembly
    K0051ACam relese assem ftrst/lgrst
    K0052ASwingaway detach footrest
    K0053AElevate footrest articulate
    K0054ASeat wdth 10-12/15/17/20 wc
    K0055ASeat dpth 15/17/18 ltwt wc
    K0056ASeat ht 17 or =21 ltwt wc
    K0057ASeat wdth 19/20 hvy dty wc
    K0058ASeat dpth 17/18 power wc
    K0059APlastic coated handrim each
    K0060ASteel handrim each
    K0061AAluminum handrim each
    K0062AHandrim 8-10 vert/obliq proj
    K0063AHndrm 12-16 vert/obliq proj
    K0064AZero pressure tube flat free
    K0065ASpoke protectors
    K0066ASolid tire any size each
    K0067APneumatic tire any size each
    K0068APneumatic tire tube each
    K0069ARear whl complete solid tire
    K0070ARear whl compl pneum tire
    K0071AFront castr compl pneum tire
    K0072AFrnt cstr cmpl sem-pneum tir
    K0073ACaster pin lock each
    K0074APneumatic caster tire each
    K0075ASemi-pneumatic caster tire
    K0076ASolid caster tire each
    K0077AFront caster assem complete
    K0078APneumatic caster tire tube
    K0079AWheel lock extension pair
    K0080AAnti-rollback device pair
    K0081AWheel lock assembly complete
    K0082A22 nf deep cycl acid battery
    K0083A22 nf gel cell battery each
    K0084AGrp 24 deep cycl acid battry
    K0085AGroup 24 gel cell battery
    K0086AU-1 lead acid battery each
    K0087AU-1 gel cell battery each
    K0088ABattry chrgr acid/gel cell
    K0089ABattery charger dual mode
    K0090ARear tire power wheelchair
    K0091ARear tire tube power whlchr
    K0092ARear assem cmplt powr whlchr
    K0093ARear zero pressure tire tube
    K0094AWheel tire for power base
    K0095AWheel tire tube each base
    K0096AWheel assem powr base complt
    K0097AWheel zero presure tire tube
    K0098ADrive belt power wheelchair
    K0099APwr wheelchair front caster
    K0100AAmputee adapter pair
    K0101AOne-arm drive attachment
    K0102ACrutch and cane holder
    K0103ATransfer board < 25≧
    K0104ACylinder tank carrier
    K0105AIv hanger
    K0106AArm trough each
    K0107AWheelchair tray
    K0108AW/c component-accessory NOS
    K0112ATrunk vest supprt innr frame
    K0113ATrunk vest suprt w/o inr frm
    K0114AWhlchr back suprt inr frame
    K0115ABack module orthotic system
    K0116ABack & seat modul orthot sys
    K0183ANasal application device
    K0184ANasal pillows/seals pair
    K0185APos airway pressure headgear
    K0186APos airway prssure chinstrap
    K0187APos airway pressure tubing
    K0188APos airway pressure filter
    K0189AFilter nondisposable w PAP
    K0195AElevating whlchair leg rests
    K0268AHumidifier nonheated w PAP
    K0415ERX antiemetic drg, oral NOS
    Start Printed Page 44866
    K0416ERx antiemetic drg,rectal NOS
    K0452AWheelchair bearings
    K0455APump uninterrupted infusion
    K0460AWC power add-on joystick
    K0461AWC power add-on tiller cntrl
    K0462ATemporary replacement eqpmnt
    K0531AHeated humidifier used w pap
    K0532ANoninvasive assist wo backup
    K0533ANoninvasive assist w backup
    K0534AInvasive assist w backup
    K0538ANeg pressure wnd thrpy pump
    K0539ANeg pres wnd thrpy dsg set
    K0540ANeg pres wnd thrp canister
    K0541ASpeech generating device
    K0542ASpeech generating device
    K0543ASpeech generating device
    K0544ASpeech generating device
    K0545ASpeech generating software
    K0546AAccessory for sgd,mntng syst
    K0547AAccessory for sgd,not clasfd
    K0548AInsulin lispro
    K0549AHosp bed hvy dty xtra wide
    K0550AHosp bed xtra hvy dty x wide
    K0551AResidual limb support system
    L0100ACerv craniosten helmet mold
    L0110ACerv craniostenosis hel non-
    L0120ACerv flexible non-adjustable
    L0130AFlex thermoplastic collar mo
    L0140ACervical semi-rigid adjustab
    L0150ACerv semi-rig adj molded chn
    L0160ACerv semi-rig wire occ/mand
    L0170ACervical collar molded to pt
    L0172ACerv col thermplas foam 2 pi
    L0174ACerv col foam 2 piece w thor
    L0180ACer post col occ/man sup adj
    L0190ACerv collar supp adj cerv ba
    L0200ACerv col supp adj bar & thor
    L0210AThoracic rib belt
    L0220AThor rib belt custom fabrica
    L0300ATLSO flex surgical support
    L0310ATlso flexible custom fabrica
    L0315ATlso flex elas rigid post pa
    L0317ATlso flex hypext elas post p
    L0320ATlso a-p contrl w apron frnt
    L0330ATlso ant-pos-lateral control
    L0340ATlso a-p-l-rotary with apron
    L0350ATlso flex compress jacket cu
    L0360ATlso flex compress jacket mo
    L0370ATlso a-p-l-rotary hyperexten
    L0380ATlso a-p-l-rot w/ pos extens
    L0390ATlso a-p-l control molded
    L0400ATlso a-p-l w interface mater
    L0410ATlso a-p-l two piece constr
    L0420ATlso a-p-l 2 piece w interfa
    L0430ATlso a-p-l w interface custm
    L0440ATlso a-p-l overlap frnt cust
    L0500ALso flex surgical support
    L0510ALso flexible custom fabricat
    L0515ALso flex elas w/ rig post pa
    L0520ALso a-p-l control with apron
    L0530ALso ant-pos control w apron
    L0540ALso lumbar flexion a-p-l
    L0550ALso a-p-l control molded
    L0560ALso a-p-l w interface
    L0565ALso a-p-l control custom
    L0600ASacroiliac flex surg support
    L0610ASacroiliac flexible custm fa
    L0620ASacroiliac semi-rig w apron
    L0700ACtlso a-p-l control molded
    L0710ACtlso a-p-l control w/ inter
    L0810AHalo cervical into jckt vest
    L0820AHalo cervical into body jack
    L0830AHalo cerv into milwaukee typ
    L0860AMagnetic resonanc image comp
    L0900ATorso/ptosis support
    Start Printed Page 44867
    L0910ATorso & ptosis supp custm fa
    L0920ATorso/pendulous abd support
    L0930APendulous abdomen supp custm
    L0940ATorso/postsurgical support
    L0950APost surg support custom fab
    L0960APost surgical support pads
    L0970ATlso corset front
    L0972ALso corset front
    L0974ATlso full corset
    L0976ALso full corset
    L0978AAxillary crutch extension
    L0980APeroneal straps pair
    L0982AStocking supp grips set of f
    L0984AProtective body sock each
    L0999AAdd to spinal orthosis NOS
    L1000ACtlso milwauke initial model
    L1010ACtlso axilla sling
    L1020AKyphosis pad
    L1025AKyphosis pad floating
    L1030ALumbar bolster pad
    L1040ALumbar or lumbar rib pad
    L1050ASternal pad
    L1060AThoracic pad
    L1070ATrapezius sling
    L1080AOutrigger
    L1085AOutrigger bil w/ vert extens
    L1090ALumbar sling
    L1100ARing flange plastic/leather
    L1110ARing flange plas/leather mol
    L1120ACovers for upright each
    L1200AFurnsh initial orthosis only
    L1210ALateral thoracic extension
    L1220AAnterior thoracic extension
    L1230AMilwaukee type superstructur
    L1240ALumbar derotation pad
    L1250AAnterior asis pad
    L1260AAnterior thoracic derotation
    L1270AAbdominal pad
    L1280ARib gusset (elastic) each
    L1290ALateral trochanteric pad
    L1300ABody jacket mold to patient
    L1310APost-operative body jacket
    L1499ASpinal orthosis NOS
    L1500AThkao mobility frame
    L1510AThkao standing frame
    L1520AThkao swivel walker
    L1600AAbduct hip flex frejka w cvr
    L1610AAbduct hip flex frejka covr
    L1620AAbduct hip flex pavlik harne
    L1630AAbduct control hip semi-flex
    L1640APelv band/spread bar thigh c
    L1650AHO abduction hip adjustable
    L1660AHO abduction static plastic
    L1680APelvic & hip control thigh c
    L1685APost-op hip abduct custom fa
    L1686AHO post-op hip abduction
    L1690ACombination bilateral HO
    L1700ALeg perthes orth toronto typ
    L1710ALegg perthes orth newington
    L1720ALegg perthes orthosis trilat
    L1730ALegg perthes orth scottish r
    L1750ALegg perthes sling
    L1755ALegg perthes patten bottom t
    L1800AKnee orthoses elas w stays
    L1810AKo elastic with joints
    L1815AElastic with condylar pads
    L1820AKo elas w/ condyle pads & jo
    L1825AKo elastic knee cap
    L1830AKo immobilizer canvas longit
    L1832AKO adj jnt pos rigid support
    L1834AKo w/0 joint rigid molded to
    L1840AKo derot ant cruciate custom
    L1843AKO single upright custom fit
    L1844AKo w/adj jt rot cntrl molded
    L1845AKo w/ adj flex/ext rotat cus
    Start Printed Page 44868
    L1846AKo w adj flex/ext rotat mold
    L1847AKO adjustable w air chambers
    L1850AKo swedish type
    L1855AKo plas doub upright jnt mol
    L1858AKo polycentric pneumatic pad
    L1860AKo supracondylar socket mold
    L1870AKo doub upright lacers molde
    L1880AKo doub upright cuffs/lacers
    L1885AKnee upright w/resistance
    L1900AAfo sprng wir drsflx calf bd
    L1902AAfo ankle gauntlet
    L1904AAfo molded ankle gauntlet
    L1906AAfo multiligamentus ankle su
    L1910AAfo sing bar clasp attach sh
    L1920AAfo sing upright w/ adjust s
    L1930AAfo plastic
    L1940AAfo molded to patient plasti
    L1945AAfo molded plas rig ant tib
    L1950AAfo spiral molded to pt plas
    L1960AAfo pos solid ank plastic mo
    L1970AAfo plastic molded w/ankle j
    L1980AAfo sing solid stirrup calf
    L1990AAfo doub solid stirrup calf
    L2000AKafo sing fre stirr thi/calf
    L2010AKafo sng solid stirrup w/o j
    L2020AKafo dbl solid stirrup band/
    L2030AKafo dbl solid stirrup w/o j
    L2035AKAFO plastic pediatric size
    L2036AKafo plas doub free knee mol
    L2037AKafo plas sing free knee mol
    L2038AKafo w/o joint multi-axis an
    L2039AKAFO,plstic,medlat rotat con
    L2040AHkafo torsion bil rot straps
    L2050AHkafo torsion cable hip pelv
    L2060AHkafo torsion ball bearing j
    L2070AHkafo torsion unilat rot str
    L2080AHkafo unilat torsion cable
    L2090AHkafo unilat torsion ball br
    L2102AAfo tibial fx cast plstr mol
    L2104AAfo tib fx cast synthetic mo
    L2106AAfo tib fx cast plaster mold
    L2108AAfo tib fx cast molded to pt
    L2112AAfo tibial fracture soft
    L2114AAfo tib fx semi-rigid
    L2116AAfo tibial fracture rigid
    L2122AKafo fem fx cast plaster mol
    L2124AKafo fem fx cast synthet mol
    L2126AKafo fem fx cast thermoplas
    L2128AKafo fem fx cast molded to p
    L2132AKafo femoral fx cast soft
    L2134AKafo fem fx cast semi-rigid
    L2136AKafo femoral fx cast rigid
    L2180APlas shoe insert w ank joint
    L2182ADrop lock knee
    L2184ALimited motion knee joint
    L2186AAdj motion knee jnt lerman t
    L2188AQuadrilateral brim
    L2190AWaist belt
    L2192APelvic band & belt thigh fla
    L2200ALimited ankle motion ea jnt
    L2210ADorsiflexion assist each joi
    L2220ADorsi & plantar flex ass/res
    L2230ASplit flat caliper stirr & p
    L2240ARound caliper and plate atta
    L2250AFoot plate molded stirrup at
    L2260AReinforced solid stirrup
    L2265ALong tongue stirrup
    L2270AVarus/valgus strap padded/li
    L2275APlastic mod low ext pad/line
    L2280AMolded inner boot
    L2300AAbduction bar jointed adjust
    L2310AAbduction bar-straight
    L2320ANon-molded lacer
    L2330ALacer molded to patient mode
    L2335AAnterior swing band
    Start Printed Page 44869
    L2340APre-tibial shell molded to p
    L2350AProsthetic type socket molde
    L2360AExtended steel shank
    L2370APatten bottom
    L2375ATorsion ank & half solid sti
    L2380ATorsion straight knee joint
    L2385AStraight knee joint heavy du
    L2390AOffset knee joint each
    L2395AOffset knee joint heavy duty
    L2397ASuspension sleeve lower ext
    L2405AKnee joint drop lock ea jnt
    L2415AKnee joint cam lock each joi
    L2425AKnee disc/dial lock/adj flex
    L2430AKnee jnt ratchet lock ea jnt
    L2435AKnee joint polycentric joint
    L2492AKnee lift loop drop lock rin
    L2500AThi/glut/ischia wgt bearing
    L2510ATh/wght bear quad-lat brim m
    L2520ATh/wght bear quad-lat brim c
    L2525ATh/wght bear nar m-l brim mo
    L2526ATh/wght bear nar m-l brim cu
    L2530AThigh/wght bear lacer non-mo
    L2540AThigh/wght bear lacer molded
    L2550AThigh/wght bear high roll cu
    L2570AHip clevis type 2 posit jnt
    L2580APelvic control pelvic sling
    L2600AHip clevis/thrust bearing fr
    L2610AHip clevis/thrust bearing lo
    L2620APelvic control hip heavy dut
    L2622AHip joint adjustable flexion
    L2624AHip adj flex ext abduct cont
    L2627APlastic mold recipro hip & c
    L2628AMetal frame recipro hip & ca
    L2630APelvic control band & belt u
    L2640APelvic control band & belt b
    L2650APelv & thor control gluteal
    L2660AThoracic control thoracic ba
    L2670AThorac cont paraspinal uprig
    L2680AThorac cont lat support upri
    L2750APlating chrome/nickel pr bar
    L2755ACarbon graphite lamination
    L2760AExtension per extension per
    L2770ALow ext orthosis per bar/jnt
    L2780ANon-corrosive finish
    L2785ADrop lock retainer each
    L2795AKnee control full kneecap
    L2800AKnee cap medial or lateral p
    L2810AKnee control condylar pad
    L2820ASoft interface below knee se
    L2830ASoft interface above knee se
    L2840ATibial length sock fx or equ
    L2850AFemoral lgth sock fx or equa
    L2860ATorsion mechanism knee/ankle
    L2999ALower extremity orthosis NOS
    L3000EFt insert ucb berkeley shell
    L3001EFoot insert remov molded spe
    L3002EFoot insert plastazote or eq
    L3003EFoot insert silicone gel eac
    L3010EFoot longitudinal arch suppo
    L3020EFoot longitud/metatarsal sup
    L3030EFoot arch support remov prem
    L3040EFt arch suprt premold longit
    L3050EFoot arch supp premold metat
    L3060EFoot arch supp longitud/meta
    L3070EArch suprt att to sho longit
    L3080EArch supp att to shoe metata
    L3090EArch supp att to shoe long/m
    L3100EHallus-valgus nght dynamic s
    L3140EAbduction rotation bar shoe
    L3150EAbduct rotation bar w/o shoe
    L3160EShoe styled positioning dev
    L3170EFoot plastic heel stabilizer
    L3201EOxford w supinat/pronat inf
    L3202EOxford w/ supinat/pronator c
    L3203EOxford w/ supinator/pronator
    Start Printed Page 44870
    L3204EHightop w/ supp/pronator inf
    L3206EHightop w/ supp/pronator chi
    L3207EHightop w/ supp/pronator jun
    L3208ESurgical boot each infant
    L3209ESurgical boot each child
    L3211ESurgical boot each junior
    L3212EBenesch boot pair infant
    L3213EBenesch boot pair child
    L3214EBenesch boot pair junior
    L3215EOrthopedic ftwear ladies oxf
    L3216EOrthoped ladies shoes dpth i
    L3217ELadies shoes hightop depth i
    L3218ELadies surgical boot each
    L3219EOrthopedic mens shoes oxford
    L3221EOrthopedic mens shoes dpth i
    L3222EMens shoes hightop depth inl
    L3223EMens surgical boot each
    L3224AWoman's shoe oxford brace
    L3225AMan's shoe oxford brace
    L3230ECustom shoes depth inlay
    L3250ECustom mold shoe remov prost
    L3251EShoe molded to pt silicone s
    L3252EShoe molded plastazote cust
    L3253EShoe molded plastazote cust
    L3254EOrth foot non-stndard size/w
    L3255EOrth foot non-standard size/
    L3257EOrth foot add charge split s
    L3260EAmbulatory surgical boot eac
    L3265EPlastazote sandal each
    L3300ESho lift taper to metatarsal
    L3310EShoe lift elev heel/sole neo
    L3320EShoe lift elev heel/sole cor
    L3330ELifts elevation metal extens
    L3332EShoe lifts tapered to one-ha
    L3334EShoe lifts elevation heel /i
    L3340EShoe wedge sach
    L3350EShoe heel wedge
    L3360EShoe sole wedge outside sole
    L3370EShoe sole wedge between sole
    L3380EShoe clubfoot wedge
    L3390EShoe outflare wedge
    L3400EShoe metatarsal bar wedge ro
    L3410EShoe metatarsal bar between
    L3420EFull sole/heel wedge btween
    L3430ESho heel count plast reinfor
    L3440EHeel leather reinforced
    L3450EShoe heel sach cushion type
    L3455EShoe heel new leather standa
    L3460EShoe heel new rubber standar
    L3465EShoe heel thomas with wedge
    L3470EShoe heel thomas extend to b
    L3480EShoe heel pad & depress for
    L3485EShoe heel pad removable for
    L3500EOrtho shoe add leather insol
    L3510EOrthopedic shoe add rub insl
    L3520EO shoe add felt w leath insl
    L3530EOrtho shoe add half sole
    L3540EOrtho shoe add full sole
    L3550EO shoe add standard toe tap
    L3560EO shoe add horseshoe toe tap
    L3570EO shoe add instep extension
    L3580EO shoe add instep velcro clo
    L3590EO shoe convert to sof counte
    L3595EOrtho shoe add march bar
    L3600ETrans shoe calip plate exist
    L3610ETrans shoe caliper plate new
    L3620ETrans shoe solid stirrup exi
    L3630ETrans shoe solid stirrup new
    L3640EShoe dennis browne splint bo
    L3649EOrthopedic shoe modifica NOS
    L3650AShlder fig 8 abduct restrain
    L3660AAbduct restrainer canvas&web
    L3670AAcromio/clavicular canvas&we
    L3675ACanvas vest SO
    L3700AElbow orthoses elas w stays
    Start Printed Page 44871
    L3710AElbow elastic with metal joi
    L3720AForearm/arm cuffs free motio
    L3730AForearm/arm cuffs ext/flex a
    L3740ACuffs adj lock w/ active con
    L3760EEO withjoint, Prefabricated
    L3800AWhfo short opponen no attach
    L3805AWhfo long opponens no attach
    L3807AWHFO,no joint, prefabricated
    L3810AWhfo thumb abduction bar
    L3815AWhfo second m.p. abduction a
    L3820AWhfo ip ext asst w/ mp ext s
    L3825AWhfo m.p. extension stop
    L3830AWhfo m.p. extension assist
    L3835AWhfo m.p. spring extension a
    L3840AWhfo spring swivel thumb
    L3845AWhfo thumb ip ext ass w/ mp
    L3850AAction wrist w/ dorsiflex as
    L3855AWhfo adj m.p. flexion contro
    L3860AWhfo adj m.p. flex ctrl & i.
    L3890ETorsion mechanism wrist/elbo
    L3900AHinge extension/flex wrist/f
    L3901AHinge ext/flex wrist finger
    L3902AWhfo ext power compress gas
    L3904AWhfo electric custom fitted
    L3906AWrist gauntlet molded to pt
    L3907AWhfo wrst gauntlt thmb spica
    L3908AWrist cock-up non-molded
    L3910AWhfo swanson design
    L3912AFlex glove w/elastic finger
    L3914AWHO wrist extension cock-up
    L3916AWhfo wrist extens w/ outrigg
    L3918AHFO knuckle bender
    L3920AKnuckle bender with outrigge
    L3922AKnuckle bend 2 seg to flex j
    L3923AHFO, no joint, prefabricated
    L3924AOppenheimer
    L3926AThomas suspension
    L3928AFinger extension w/ clock sp
    L3930AFinger extension with wrist
    L3932ASafety pin spring wire
    L3934ASafety pin modified
    L3936APalmer
    L3938ADorsal wrist
    L3940ADorsal wrist w/ outrigger at
    L3942AReverse knuckle bender
    L3944AReverse knuckle bend w/ outr
    L3946AHFO composite elastic
    L3948AFinger knuckle bender
    L3950AOppenheimer w/ knuckle bend
    L3952AOppenheimer w/ rev knuckle 2
    L3954ASpreading hand
    L3956AAdd joint upper ext orthosis
    L3960ASewho airplan desig abdu pos
    L3962ASewho erbs palsey design abd
    L3963AMolded w/ articulating elbow
    L3964ASeo mobile arm sup att to wc
    L3965AArm supp att to wc rancho ty
    L3966AMobile arm supports reclinin
    L3968AFriction dampening arm supp
    L3969AMonosuspension arm/hand supp
    L3970AElevat proximal arm support
    L3972AOffset/lat rocker arm w/ ela
    L3974AMobile arm support supinator
    L3980AUpp ext fx orthosis humeral
    L3982AUpper ext fx orthosis rad/ul
    L3984AUpper ext fx orthosis wrist
    L3985AForearm hand fx orth w/ wr h
    L3986AHumeral rad/ulna wrist fx or
    L3995ASock fracture or equal each
    L3999AUpper limb orthosis NOS
    L4000ARepl girdle milwaukee orth
    L4010AReplace trilateral socket br
    L4020AReplace quadlat socket brim
    L4030AReplace socket brim cust fit
    L4040AReplace molded thigh lacer
    Start Printed Page 44872
    L4045AReplace non-molded thigh lac
    L4050AReplace molded calf lacer
    L4055AReplace non-molded calf lace
    L4060AReplace high roll cuff
    L4070AReplace prox & dist upright
    L4080ARepl met band kafo-afo prox
    L4090ARepl met band kafo-afo calf/
    L4100ARepl leath cuff kafo prox th
    L4110ARepl leath cuff kafo-afo cal
    L4130AReplace pretibial shell
    L4205AOrtho dvc repair per 15 min
    L4210AOrth dev repair/repl minor p
    L4350APneumatic ankle cntrl splint
    L4360APneumatic walking splint
    L4370APneumatic full leg splint
    L4380APneumatic knee splint
    L4392AReplace AFO soft interface
    L4394AReplace foot drop spint
    L4396AStatic AFO
    L4398AFoot drop splint recumbent
    L5000ASho insert w arch toe filler
    L5010AMold socket ank hgt w/ toe f
    L5020ATibial tubercle hgt w/ toe f
    L5050AAnk symes mold sckt sach ft
    L5060ASymes met fr leath socket ar
    L5100AMolded socket shin sach foot
    L5105APlast socket jts/thgh lacer
    L5150AMold sckt ext knee shin sach
    L5160AMold socket bent knee shin s
    L5200AKne sing axis fric shin sach
    L5210ANo knee/ankle joints w/ ft b
    L5220ANo knee joint with artic ali
    L5230AFem focal defic constant fri
    L5250AHip canad sing axi cons fric
    L5270ATilt table locking hip sing
    L5280AHemipelvect canad sing axis
    L5300ABk sach soft cover & finish
    L5310AKnee disart sach soft cv/fin
    L5320AAk open end sach soft cv/fin
    L5330AHip canadian sach sft cv/fin
    L5340AHemipelvectomy canad cv/fin
    L5400APostop dress & 1 cast chg bk
    L5410APostop dsg bk ea add cast ch
    L5420APostop dsg & 1 cast chg ak/d
    L5430APostop dsg ak ea add cast ch
    L5450APostop app non-wgt bear dsg
    L5460APostop app non-wgt bear dsg
    L5500AInit bk ptb plaster direct
    L5505AInit ak ischal plstr direct
    L5510APrep BK ptb plaster molded
    L5520APerp BK ptb thermopls direct
    L5530APrep BK ptb thermopls molded
    L5535APrep BK ptb open end socket
    L5540APrep BK ptb laminated socket
    L5560APrep AK ischial plast molded
    L5570APrep AK ischial direct form
    L5580APrep AK ischial thermo mold
    L5585APrep AK ischial open end
    L5590APrep AK ischial laminated
    L5595AHip disartic sach thermopls
    L5600AHip disart sach laminat mold
    L5610AAbove knee hydracadence
    L5611AAk 4 bar link w/fric swing
    L5613AAk 4 bar ling w/hydraul swig
    L5614A4-bar link above knee w/swng
    L5616AAk univ multiplex sys frict
    L5617AAK/BK self-aligning unit ea
    L5618ATest socket symes
    L5620ATest socket below knee
    L5622ATest socket knee disarticula
    L5624ATest socket above knee
    L5626ATest socket hip disarticulat
    L5628ATest socket hemipelvectomy
    L5629ABelow knee acrylic socket
    L5630ASyme typ expandabl wall sckt
    Start Printed Page 44873
    L5631AAk/knee disartic acrylic soc
    L5632ASymes type ptb brim design s
    L5634ASymes type poster opening so
    L5636ASymes type medial opening so
    L5637ABelow knee total contact
    L5638ABelow knee leather socket
    L5639ABelow knee wood socket
    L5640AKnee disarticulat leather so
    L5642AAbove knee leather socket
    L5643AHip flex inner socket ext fr
    L5644AAbove knee wood socket
    L5645ABk flex inner socket ext fra
    L5646ABelow knee air cushion socke
    L5647ABelow knee suction socket
    L5648AAbove knee air cushion socke
    L5649AIsch containmt/narrow m-l so
    L5650ATot contact ak/knee disart s
    L5651AAk flex inner socket ext fra
    L5652ASuction susp ak/knee disart
    L5653AKnee disart expand wall sock
    L5654ASocket insert symes
    L5655ASocket insert below knee
    L5656ASocket insert knee articulat
    L5658ASocket insert above knee
    L5660ASock insrt syme silicone gel
    L5661AMulti-durometer symes
    L5662ASocket insert bk silicone ge
    L5663ASock knee disartic silicone
    L5664ASocket insert ak silicone ge
    L5665AMulti-durometer below knee
    L5666ABelow knee cuff suspension
    L5667ASocket insert w lock lower
    L5668ASocket insert w/o lock lower
    L5669ABelow knee socket w/o lock
    L5670ABk molded supracondylar susp
    L5672ABk removable medial brim sus
    L5674ABk suspension sleeve
    L5675ABk heavy duty susp sleeve
    L5676ABk knee joints single axis p
    L5677ABk knee joints polycentric p
    L5678ABk joint covers pair
    L5680ABk thigh lacer non-molded
    L5682ABk thigh lacer glut/ischia m
    L5684ABk fork strap
    L5686ABk back check
    L5688ABk waist belt webbing
    L5690ABk waist belt padded and lin
    L5692AAk pelvic control belt light
    L5694AAk pelvic control belt pad/l
    L5695AAk sleeve susp neoprene/equa
    L5696AAk/knee disartic pelvic join
    L5697AAk/knee disartic pelvic band
    L5698AAk/knee disartic silesian ba
    L5699AShoulder harness
    L5700AReplace socket below knee
    L5701AReplace socket above knee
    L5702AReplace socket hip
    L5704ACustom shape covr below knee
    L5705ACustm shape cover above knee
    L5706ACustm shape cvr knee disart
    L5707ACustm shape cover hip disart
    L5710AKne-shin exo sng axi mnl loc
    L5711AKnee-shin exo mnl lock ultra
    L5712AKnee-shin exo frict swg & st
    L5714AKnee-shin exo variable frict
    L5716AKnee-shin exo mech stance ph
    L5718AKnee-shin exo frct swg & sta
    L5722AKnee-shin pneum swg frct exo
    L5724AKnee-shin exo fluid swing ph
    L5726AKnee-shin ext jnts fld swg e
    L5728AKnee-shin fluid swg & stance
    L5780AKnee-shin pneum/hydra pneum
    L5785AExoskeletal bk ultralt mater
    L5790AExoskeletal ak ultra-light m
    L5795AExoskel hip ultra-light mate
    Start Printed Page 44874
    L5810AEndoskel knee-shin mnl lock
    L5811AEndo knee-shin mnl lck ultra
    L5812AEndo knee-shin frct swg & st
    L5814AEndo knee-shin hydral swg ph
    L5816AEndo knee-shin polyc mch sta
    L5818AEndo knee-shin frct swg & st
    L5822AEndo knee-shin pneum swg frc
    L5824AEndo knee-shin fluid swing p
    L5826AMiniature knee joint
    L5828AEndo knee-shin fluid swg/sta
    L5830AEndo knee-shin pneum/swg pha
    L5840AMulti-axial knee/shin system
    L5845AKnee-shin sys stance flexion
    L5846AKnee-shin sys microprocessor
    L5850AEndo ak/hip knee extens assi
    L5855AMech hip extension assist
    L5910AEndo below knee alignable sy
    L5920AEndo ak/hip alignable system
    L5925AAbove knee manual lock
    L5930AHigh activity knee frame
    L5940AEndo bk ultra-light material
    L5950AEndo ak ultra-light material
    L5960AEndo hip ultra-light materia
    L5962ABelow knee flex cover system
    L5964AAbove knee flex cover system
    L5966AHip flexible cover system
    L5968AMultiaxial ankle w dorsiflex
    L5970AFoot external keel sach foot
    L5972AFlexible keel foot
    L5974AFoot single axis ankle/foot
    L5975ACombo ankle/foot prosthesis
    L5976AEnergy storing foot
    L5978AFt prosth multiaxial ankl/ft
    L5979AMulti-axial ankle/ft prosth
    L5980AFlex foot system
    L5981AFlex-walk sys low ext prosth
    L5982AExoskeletal axial rotation u
    L5984AEndoskeletal axial rotation
    L5985ALwr ext dynamic prosth pylon
    L5986AMulti-axial rotation unit
    L5987AShank ft w vert load pylon
    L5988AVertical shock reducing pylo
    L5999ALowr extremity prosthes NOS
    L6000APar hand robin-aids thum rem
    L6010AHand robin-aids little/ring
    L6020APart hand robin-aids no fing
    L6050AWrst MLd sck flx hng tri pad
    L6055AWrst mold sock w/exp interfa
    L6100AElb mold sock flex hinge pad
    L6110AElbow mold sock suspension t
    L6120AElbow mold doub splt soc ste
    L6130AElbow stump activated lock h
    L6200AElbow mold outsid lock hinge
    L6205AElbow molded w/ expand inter
    L6250AElbow inter loc elbow forarm
    L6300AShlder disart int lock elbow
    L6310AShoulder passive restor comp
    L6320AShoulder passive restor cap
    L6350AThoracic intern lock elbow
    L6360AThoracic passive restor comp
    L6370AThoracic passive restor cap
    L6380APostop dsg cast chg wrst/elb
    L6382APostop dsg cast chg elb dis/
    L6384APostop dsg cast chg shlder/t
    L6386APostop ea cast chg & realign
    L6388APostop applicat rigid dsg on
    L6400ABelow elbow prosth tiss shap
    L6450AElb disart prosth tiss shap
    L6500AAbove elbow prosth tiss shap
    L6550AShldr disar prosth tiss shap
    L6570AScap thorac prosth tiss shap
    L6580AWrist/elbow bowden cable mol
    L6582AWrist/elbow bowden cbl dir f
    L6584AElbow fair lead cable molded
    L6586AElbow fair lead cable dir fo
    Start Printed Page 44875
    L6588AShdr fair lead cable molded
    L6590AShdr fair lead cable direct
    L6600APolycentric hinge pair
    L6605ASingle pivot hinge pair
    L6610AFlexible metal hinge pair
    L6615ADisconnect locking wrist uni
    L6616ADisconnect insert locking wr
    L6620AFlexion-friction wrist unit
    L6623ASpring-ass rot wrst w/ latch
    L6625ARotation wrst w/ cable lock
    L6628AQuick disconn hook adapter o
    L6629ALamination collar w/ couplin
    L6630AStainless steel any wrist
    L6632ALatex suspension sleeve each
    L6635ALift assist for elbow
    L6637ANudge control elbow lock
    L6640AShoulder abduction joint pai
    L6641AExcursion amplifier pulley t
    L6642AExcursion amplifier lever ty
    L6645AShoulder flexion-abduction j
    L6650AShoulder universal joint
    L6655AStandard control cable extra
    L6660AHeavy duty control cable
    L6665ATeflon or equal cable lining
    L6670AHook to hand cable adapter
    L6672AHarness chest/shlder saddle
    L6675AHarness figure of 8 sing con
    L6676AHarness figure of 8 dual con
    L6680ATest sock wrist disart/bel e
    L6682ATest sock elbw disart/above
    L6684ATest socket shldr disart/tho
    L6686ASuction socket
    L6687AFrame typ socket bel elbow/w
    L6688AFrame typ sock above elb/dis
    L6689AFrame typ socket shoulder di
    L6690AFrame typ sock interscap-tho
    L6691ARemovable insert each
    L6692ASilicone gel insert or equal
    L6693ALockingelbow forearm cntrbal
    L6700ATerminal device model #3
    L6705ATerminal device model #5
    L6710ATerminal device model #5x
    L6715ATerminal device model #5xa
    L6720ATerminal device model #6
    L6725ATerminal device model #7
    L6730ATerminal device model #7lo
    L6735ATerminal device model #8
    L6740ATerminal device model #8x
    L6745ATerminal device model #88x
    L6750ATerminal device model #10p
    L6755ATerminal device model #10x
    L6765ATerminal device model #12p
    L6770ATerminal device model #99x
    L6775ATerminal device model#555
    L6780ATerminal device model #ss555
    L6790AHooks-accu hook or equal
    L6795AHooks-2 load or equal
    L6800AHooks-aprl vc or equal
    L6805AModifier wrist flexion unit
    L6806ATrs grip vc or equal
    L6807ATerm device grip1/2 or equal
    L6808ATerm device infant or child
    L6809ATrs super sport passive
    L6810APincher tool otto bock or eq
    L6825AHands dorrance vo
    L6830AHand aprl vc
    L6835AHand sierra vo
    L6840AHand becker imperial
    L6845AHand becker lock grip
    L6850ATerm dvc-hand becker plylite
    L6855AHand robin-aids vo
    L6860AHand robin-aids vo soft
    L6865AHand passive hand
    L6867AHand detroit infant hand
    L6868APassive inf hand steeper/hos
    Start Printed Page 44876
    L6870AHand child mitt
    L6872AHand nyu child hand
    L6873AHand mech inf steeper or equ
    L6875AHand bock vc
    L6880AHand bock vo
    L6890AProduction glove
    L6895ACustom glove
    L6900AHand restorat thumb/1 finger
    L6905AHand restoration multiple fi
    L6910AHand restoration no fingers
    L6915AHand restoration replacmnt g
    L6920AWrist disarticul switch ctrl
    L6925AWrist disart myoelectronic c
    L6930ABelow elbow switch control
    L6935ABelow elbow myoelectronic ct
    L6940AElbow disarticulation switch
    L6945AElbow disart myoelectronic c
    L6950AAbove elbow switch control
    L6955AAbove elbow myoelectronic ct
    L6960AShldr disartic switch contro
    L6965AShldr disartic myoelectronic
    L6970AInterscapular-thor switch ct
    L6975AInterscap-thor myoelectronic
    L7010AHand otto back steeper/eq sw
    L7015AHand sys teknik village swit
    L7020AElectronic greifer switch ct
    L7025AElectron hand myoelectronic
    L7030AHand sys teknik vill myoelec
    L7035AElectron greifer myoelectro
    L7040APrehensile actuator hosmer s
    L7045AElectron hook child michigan
    L7170AElectronic elbow hosmer swit
    L7180AElectronic elbow utah myoele
    L7185AElectron elbow adolescent sw
    L7186AElectron elbow child switch
    L7190AElbow adolescent myoelectron
    L7191AElbow child myoelectronic ct
    L7260AElectron wrist rotator otto
    L7261AElectron wrist rotator utah
    L7266AServo control steeper or equ
    L7272AAnalogue control unb or equa
    L7274AProportional ctl 12 volt uta
    L7360ASix volt bat otto bock/eq ea
    L7362ABattery chrgr six volt otto
    L7364ATwelve volt battery utah/equ
    L7366ABattery chrgr 12 volt utah/e
    L7499AUpper extremity prosthes NOS
    L7500AProsthetic dvc repair hourly
    L7510AProsthetic device repair rep
    L7520ARepair prosthesis per 15 min
    L7900AVacuum erection system
    L8000AMastectomy bra
    L8010AMastectomy sleeve
    L8015AExt breastprosthesis garment
    L8020AMastectomy form
    L8030ABreast prosthesis silicone/e
    L8035ACustom breast prosthesis
    L8039ABreast prosthesis NOS
    L8040ANasal prosthesis
    L8041AMidfacial prosthesis
    L8042AOrbital prosthesis
    L8043AUpper facial prosthesis
    L8044AHemi-facial prosthesis
    L8045AAuricular prosthesis
    L8046APartial facial prosthesis
    L8047ANasal septal prosthesis
    L8048AUnspec maxillofacial prosth
    L8049ARepair maxillofacial prosth
    L8100ECompression stocking BK18-30
    L8110ECompression stocking BK30-40
    L8120ECompression stocking BK40-50
    L8130EGc stocking thighlngth 18-30
    L8140EGc stocking thighlngth 30-40
    L8150EGc stocking thighlngth 40-50
    L8160EGc stocking full lngth 18-30
    Start Printed Page 44877
    L8170EGc stocking full lngth 30-40
    L8180EGc stocking full lngth 40-50
    L8190EGc stocking waistlngth 18-30
    L8195EGc stocking waistlngth 30-40
    L8200EGc stocking waistlngth 40-50
    L8210EGc stocking custom made
    L8220EGc stocking lymphedema
    L8230EGc stocking garter belt
    L8239EG compression stocking NOS
    L8300ATruss single w/ standard pad
    L8310ATruss double w/ standard pad
    L8320ATruss addition to std pad wa
    L8330ATruss add to std pad scrotal
    L8400ASheath below knee
    L8410ASheath above knee
    L8415ASheath upper limb
    L8417APros sheath/sock w gel cushn
    L8420AProsthetic sock multi ply BK
    L8430AProsthetic sock multi ply AK
    L8435APros sock multi ply upper lm
    L8440AShrinker below knee
    L8460AShrinker above knee
    L8465AShrinker upper limb
    L8470APros sock single ply BK
    L8480APros sock single ply AK
    L8485APros sock single ply upper l
    L8490AAir seal suction reten systm
    L8499AUnlisted misc prosthetic ser
    L8500AArtificial larynx
    L8501ATracheostomy speaking valve
    L8600NImplant breast silicone/eq
    L8603NCollagen imp urinary 2.5 ml
    L8606ASynthetic implnt urinary 1ml
    L8610NOcular implant
    L8612NAqueous shunt prosthesis
    L8613NOssicular implant
    L8614HCochlear device/system1002
    L8619AReplace cochlear processor
    L8630NMetacarpophalangeal implant
    L8641NMetatarsal joint implant
    L8642NHallux implant
    L8658NInterphalangeal joint implnt
    L8670NVascular graft, synthetic
    L8699NProsthetic implant NOS
    L9900AO&P supply/accessory/service
    M0064XVisit for drug monitoring03740.96$48.81$10.74$9.76
    M0075ECellular therapy
    M0076EProlotherapy
    M0100EIntragastric hypothermia
    M0300EIV chelationtherapy
    M0301EFabric wrapping of aneurysm
    M0302TAssessment of cardiac output09700.47$23.90$4.78
    P2028XCephalin floculation test03490.34$17.29$3.46$3.46
    P2029XCongo red blood test03490.34$17.29$3.46$3.46
    P2031EHair analysis
    P2033XBlood thymol turbidity03490.34$17.29$3.46$3.46
    P2038ABlood mucoprotein
    P3000AScreen pap by tech w md supv
    P3001EScreening pap smear by phys
    P7001ECulture bacterial urine
    P9010KWhole blood for transfusion09502.13$108.29$21.66
    P9011EBlood split unit
    P9012KCryoprecipitate each unit09520.72$36.61$7.32
    P9016KRBC leukocytes reduced09542.89$146.93$29.39
    P9017KOne donor fresh frozn plasma09552.31$117.45$23.49
    P9019KPlatelets, each unit09571.00$50.84$10.17
    P9020KPlaelet rich plasma unit09581.19$60.50$12.10
    P9021KRed blood cells unit09592.09$106.26$21.25
    P9022KWashed red blood cells unit09603.89$197.78$39.56
    P9023KFrozen plasma, pooled, sd09493.00$152.53$30.51
    P9031KPlatelets leukocytes reduced09542.89$146.93$29.39
    P9032KPlatelets, irradiated95001.81$92.02$18.40
    P9033KPlatelets leukoreduced irrad09542.89$146.93$29.39
    P9034KPlatelets, pheresis95019.91$503.84$100.77
    P9035KPlatelet pheres leukoreduced95019.91$503.84$100.77
    Start Printed Page 44878
    P9036KPlatelet pheresis irradiated950210.75$546.55$109.31
    P9037KPlate pheres leukoredu irrad95019.91$503.84$100.77
    P9038KRBC irradiated95052.64$134.22$26.84
    P9039KRBC deglycerolized95044.45$226.25$45.25
    P9040KRBC leukoreduced irradiated95044.45$226.25$45.25
    P9041KAlbumin(human), 5%09612.24$113.89$22.78
    P9042KAlbumin (human), 25%09621.12$56.94$11.39
    P9043KPlasma protein fraction09561.29$65.59$13.12
    P9044KCryoprecipitatereducedplasma10090.88$44.74$8.95
    P9603AOne-way allow prorated miles
    P9604AOne-way allow prorated trip
    P9612NCatheterize for urine spec
    P9615NUrine specimen collect mult
    Q0035XCardiokymography01001.63$82.87$45.58$16.57
    Q0081TInfusion ther other than che01202.35$119.48$42.67$23.90
    Q0083SChemo by other than infusion01160.98$49.83$9.97$9.97
    Q0084SChemotherapy by infusion01173.48$176.93$52.69$35.39
    Q0085SChemo by both infusion and o01183.52$178.96$72.03$35.79
    Q0086APhysical therapy evaluation/
    Q0091TObtaining screen pap smear01910.27$13.73$3.98$2.75
    Q0092NSet up port xray equipment
    Q0111AWet mounts/ w preparations
    Q0112APotassium hydroxide preps
    Q0113APinworm examinations
    Q0114AFern test
    Q0115APost-coital mucous exam
    Q0136GNon esrd epoetin alpha inj0733$11.85$1.52
    Q0144EAzithromycin dihydrate, oral
    Q0160GFactor IX non-recombinant0931$.76$.10
    Q0161GFactor IX recombinant0932$1.12$.16
    Q0163GDiphenhydramine HCl 50mg1400$.12$.01
    Q0164GProchlorperazine maleate 5mg1401$.57$.05
    Q0165EProchlorperazine maleate10mg
    Q0166GGranisetron HCl 1 mg oral0765$44.70$5.74
    Q0167GDronabinol 2.5mg oral0762$3.28$.42
    Q0168EDronabinol 5mg oral
    Q0169GPromethazine HCl 12.5mg oral1402$.03$.00
    Q0170EPromethazine HCl 25 mg oral
    Q0171GChlorpromazine HCl 10mg oral1403$.07$.01
    Q0172EChlorpromazine HCl 25mg oral
    Q0173GTrimethobenzamide HCl 250mg1404$.36$.03
    Q0174GThiethylperazine maleate10mg1405$.56$.08
    Q0175GPerphenazine 4mg oral1406$.62$.06
    Q0176EPerphenazine 8mg oral
    Q0177GHydroxyzine pamoate 25mg1407$.20$.02
    Q0178EHydroxyzine pamoate 50mg
    Q0179GOndansetron HCl 8mg oral0769$25.15$3.23
    Q0180GDolasetron mesylate oral0763$69.64$8.94
    Q0181EUnspecified oral anti-emetic
    Q0183NNonmetabolic active tissue
    Q0184NMetabolically active tissue
    Q0185NMetabolic active D/E tissue
    Q0187GFactor viia recombinant1409$1,596.00$228.48
    Q1001ENtiol category 1
    Q1002ENtiol category 2
    Q1003ENtiol category 3
    Q1004ENtiol category 4
    Q1005ENtiol category 5
    Q2001NOral cabergoline 0.5 mg
    Q2002GElliotts b solution per ml7022$14.25$2.04
    Q2003GAprotinin, 10,000 kiu7019$2.06$.30
    Q2004GBladder calculi irrig sol7023$24.70$3.54
    Q2005GCorticorelin ovine triflutat7024$368.03$52.69
    Q2006GDigoxin immune fab (ovine)7025$551.66$78.97
    Q2007GEthanolamine oleate 100 mg7026$39.73$5.69
    Q2008GFomepizole, 15 mg7027$1.09$.16
    Q2009GFosphenytoin, 50 mg7028$9.55$1.37
    Q2010GGlatiramer acetate, per dose7029$30.07$4.30
    Q2011GHemin, per 1 mg7030$.99$.14
    Q2012GPegademase bovine, 25 iu7039$139.33$19.95
    Q2013GPentastarch 10% solution7040$15.11$2.16
    Q2014GSermorelin acetate, 0.5 mg7032$15.78$2.26
    Q2015GSomatrem, 5 mg7033$209.48$29.99
    Q2016GSomatropin, 1 mg7034$39.90$5.12
    Q2017GTeniposide, 50 mg7035$216.32$30.97
    Start Printed Page 44879
    Q2018GUrofollitropin, 75 iu7037$73.29$9.41
    Q2019GBasiliximab1615$1,348.76$193.09
    Q2020GHistrelin acetate1616$14.16$2.03
    Q2021GLepirudin1617$131.96$18.89
    Q2022GVonWillebrandFactrCmplxperIU1618$.95$.14
    Q3001EBrachytherapy Radioelements0918
    Q3002GGallium ga 671619$24.38$3.13
    Q3003GTechnetium tc99m bicisate1620$384.75$55.08
    Q3004GXenon xe 1331621$29.93$3.84
    Q3005GTechnetium tc99m mertiatide1622$176.53$25.27
    Q3006GTechnetium tc99m glucepatate1623$22.61$3.24
    Q3007GSodium phosphate p321624$81.10$11.61
    Q3008GIndium 111-in pentetreotide1625$935.75$133.96
    Q3009GTechnetium tc99m oxidronate1626$36.74$5.26
    Q3010GTechnetium tc99mlabeledrbcs1627$40.90$5.85
    Q3011GChromic phosphate p321628$150.86$21.60
    Q3012GCyanocobalamin cobalt co571089$97.85$14.01
    Q3013GVerteporfin for injection1203$1,458.25$208.76
    Q4001ACast sup body cast plaster
    Q4002ACast sup body cast fiberglas
    Q4003ACast sup shoulder cast plstr
    Q4004ACast sup shoulder cast fbrgl
    Q4005ACast sup long arm adult plst
    Q4006ACast sup long arm adult fbrg
    Q4007ACast sup long arm ped plster
    Q4008ACast sup long arm ped fbrgls
    Q4009ACast sup sht arm adult plstr
    Q4010ACast sup sht arm adult fbrgl
    Q4011ACast sup sht arm ped plaster
    Q4012ACast sup sht arm ped fbrglas
    Q4013ACast sup gauntlet plaster
    Q4014ACast sup gauntlet fiberglass
    Q4015ACast sup gauntlet ped plster
    Q4016ACast sup gauntlet ped fbrgls
    Q4017ACast sup lng arm splint plst
    Q4018ACast sup lng arm splint fbrg
    Q4019ACast sup lng arm splnt ped p
    Q4020ACast sup lng arm splnt ped f
    Q4021ACast sup sht arm splint plst
    Q4022ACast sup sht arm splint fbrg
    Q4023ACast sup sht arm splnt ped p
    Q4024ACast sup sht arm splnt ped f
    Q4025ACast sup hip spica plaster
    Q4026ACast sup hip spica fiberglas
    Q4027ACast sup hip spica ped plstr
    Q4028ACast sup hip spica ped fbrgl
    Q4029ACast sup long leg plaster
    Q4030ACast sup long leg fiberglass
    Q4031ACast sup lng leg ped plaster
    Q4032ACast sup lng leg ped fbrgls
    Q4033ACast sup lng leg cylinder pl
    Q4034ACast sup lng leg cylinder fb
    Q4035ACast sup lngleg cylndr ped p
    Q4036ACast sup lngleg cylndr ped f
    Q4037ACast sup shrt leg plaster
    Q4038ACast sup shrt leg fiberglass
    Q4039ACast sup shrt leg ped plster
    Q4040ACast sup shrt leg ped fbrgls
    Q4041ACast sup lng leg splnt plstr
    Q4042ACast sup lng leg splnt fbrgl
    Q4043ACast sup lng leg splnt ped p
    Q4044ACast sup lng leg splnt ped f
    Q4045ACast sup sht leg splnt plstr
    Q4046ACast sup sht leg splnt fbrgl
    Q4047ACast sup sht leg splnt ped p
    Q4048ACast sup sht leg splnt ped f
    Q4049AFinger splint, static
    Q4050ACast supplies unlisted
    Q4051ASplint supplies misc
    Q9920AEpoetin with hct <= 20
    Q9921AEpoetin with hct = 21
    Q9922AEpoetin with hct = 22
    Q9923AEpoetin with hct = 23
    Q9924AEpoetin with hct = 24
    Q9925AEpoetin with hct = 25
    Start Printed Page 44880
    Q9926AEpoetin with hct = 26
    Q9927AEpoetin with hct = 27
    Q9928AEpoetin with hct = 28
    Q9929AEpoetin with hct = 29
    Q9930AEpoetin with hct = 30
    Q9931AEpoetin with hct = 31
    Q9932AEpoetin with hct = 32
    Q9933AEpoetin with hct = 33
    Q9934AEpoetin with hct = 34
    Q9935AEpoetin with hct = 35
    Q9936AEpoetin with hct = 36
    Q9937AEpoetin with hct = 37
    Q9938AEpoetin with hct = 38
    Q9939AEpoetin with hct = 39
    Q9940AEpoetin with hct >= 40
    R0070NTransport portable x-ray
    R0075NTransport port x-ray multipl
    R0076NTransport portable EKG
    V2020AVision svcs frames purchases
    V2025EEyeglasses delux frames
    V2100ALens spher single plano 4.00
    V2101ASingle visn sphere 4.12-7.00
    V2102ASingl visn sphere 7.12-20.00
    V2103ASpherocylindr 4.00d/12-2.00d
    V2104ASpherocylindr 4.00d/2.12-4d
    V2105ASpherocylinder 4.00d/4.25-6d
    V2106ASpherocylinder 4.00d/>6.00d
    V2107ASpherocylinder 4.25d/12-2d
    V2108ASpherocylinder 4.25d/2.12-4d
    V2109ASpherocylinder 4.25d/4.25-6d
    V2110ASpherocylinder 4.25d/over 6d
    V2111ASpherocylindr 7.25d/.25-2.25
    V2112ASpherocylindr 7.25d/2.25-4d
    V2113ASpherocylindr 7.25d/4.25-6d
    V2114ASpherocylinder over 12.00d
    V2115ALens lenticular bifocal
    V2116ANonaspheric lens bifocal
    V2117AAspheric lens bifocal
    V2118ALens aniseikonic single
    V2199ALens single vision not oth c
    V2200ALens spher bifoc plano 4.00d
    V2201ALens sphere bifocal 4.12-7.0
    V2202ALens sphere bifocal 7.12-20.
    V2203ALens sphcyl bifocal 4.00d/.1
    V2204ALens sphcy bifocal 4.00d/2.1
    V2205ALens sphcy bifocal 4.00d/4.2
    V2206ALens sphcy bifocal 4.00d/ove
    V2207ALens sphcy bifocal 4.25-7d/.
    V2208ALens sphcy bifocal 4.25-7/2.
    V2209ALens sphcy bifocal 4.25-7/4.
    V2210ALens sphcy bifocal 4.25-7/ov
    V2211ALens sphcy bifo 7.25-12/.25-
    V2212ALens sphcyl bifo 7.25-12/2.2
    V2213ALens sphcyl bifo 7.25-12/4.2
    V2214ALens sphcyl bifocal over 12.
    V2215ALens lenticular bifocal
    V2216ALens lenticular nonaspheric
    V2217ALens lenticular aspheric bif
    V2218ALens aniseikonic bifocal
    V2219ALens bifocal seg width over
    V2220ALens bifocal add over 3.25d
    V2299ALens bifocal speciality
    V2300ALens sphere trifocal 4.00d
    V2301ALens sphere trifocal 4.12-7.
    V2302ALens sphere trifocal 7.12-20
    V2303ALens sphcy trifocal 4.0/.12-
    V2304ALens sphcy trifocal 4.0/2.25
    V2305ALens sphcy trifocal 4.0/4.25
    V2306ALens sphcyl trifocal 4.00/>6
    V2307ALens sphcy trifocal 4.25-7/.
    V2308ALens sphc trifocal 4.25-7/2.
    V2309ALens sphc trifocal 4.25-7/4.
    V2310ALens sphc trifocal 4.25-7/>6
    V2311ALens sphc trifo 7.25-12/.25-
    V2312ALens sphc trifo 7.25-12/2.25
    Start Printed Page 44881
    V2313ALens sphc trifo 7.25-12/4.25
    V2314ALens sphcyl trifocal over 12
    V2315ALens lenticular trifocal
    V2316ALens lenticular nonaspheric
    V2317ALens lenticular aspheric tri
    V2318ALens aniseikonic trifocal
    V2319ALens trifocal seg width > 28
    V2320ALens trifocal add over 3.25d
    V2399ALens trifocal speciality
    V2410ALens variab asphericity sing
    V2430ALens variable asphericity bi
    V2499AVariable asphericity lens
    V2500AContact lens pmma spherical
    V2501ACntct lens pmma-toric/prism
    V2502AContact lens pmma bifocal
    V2503ACntct lens pmma color vision
    V2510ACntct gas permeable sphericl
    V2511ACntct toric prism ballast
    V2512ACntct lens gas permbl bifocl
    V2513AContact lens extended wear
    V2520AContact lens hydrophilic
    V2521ACntct lens hydrophilic toric
    V2522ACntct lens hydrophil bifocl
    V2523ACntct lens hydrophil extend
    V2530AContact lens gas impermeable
    V2531AContact lens gas permeable
    V2599AContact lens/es other type
    V2600AHand held low vision aids
    V2610ASingle lens spectacle mount
    V2615ATelescop/othr compound lens
    V2623APlastic eye prosth custom
    V2624APolishing artifical eye
    V2625AEnlargemnt of eye prosthesis
    V2626AReduction of eye prosthesis
    V2627AScleral cover shell
    V2628AFabrication & fitting
    V2629AProsthetic eye other type
    V2630NAnter chamber intraocul lens
    V2631NIris support intraoclr lens
    V2632NPost chmbr intraocular lens
    V2700ABalance lens
    V2710AGlass/plastic slab off prism
    V2715APrism lens/es
    V2718AFresnell prism press-on lens
    V2730ASpecial base curve
    V2740ARose tint plastic
    V2741ANon-rose tint plastic
    V2742ARose tint glass
    V2743ANon-rose tint glass
    V2744ATint photochromatic lens/es
    V2750AAnti-reflective coating
    V2755AUV lens/es
    V2760AScratch resistant coating
    V2770AOccluder lens/es
    V2780AOversize lens/es
    V2781EProgressive lens per lens
    V2785FCorneal tissue processing
    V2790NAmniotic membrane
    V2799AMiscellaneous vision service
    V5008EHearing screening
    V5010EAssessment for hearing aid
    V5011EHearing aid fitting/checking
    V5014EHearing aid repair/modifying
    V5020EConformity evaluation
    V5030EBody-worn hearing aid air
    V5040EBody-worn hearing aid bone
    V5050EHearing aid monaural in ear
    V5060EBehind ear hearing aid
    V5070EGlasses air conduction
    V5080EGlasses bone conduction
    V5090EHearing aid dispensing fee
    V5100EBody-worn bilat hearing aid
    V5110EHearing aid dispensing fee
    V5120EBody-worn binaur hearing aid
    V5130EIn ear binaural hearing aid
    Start Printed Page 44882
    V5140EBehind ear binaur hearing ai
    V5150EGlasses binaural hearing aid
    V5160EDispensing fee binaural
    V5170EWithin ear cros hearing aid
    V5180EBehind ear cros hearing aid
    V5190EGlasses cros hearing aid
    V5200ECros hearing aid dispens fee
    V5210EIn ear bicros hearing aid
    V5220EBehind ear bicros hearing ai
    V5230EGlasses bicros hearing aid
    V5240EDispensing fee bicros
    V5299EHearing service
    V5336ERepair communication device
    V5362ASpeech screening
    V5363ALanguage screening
    V5364ADysphagia screening
    CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    Copyright American Dental Association. All rights reserved.
          Start Printed Page 44882

    —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. Start Printed Page 44882

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

    CPT/HCPCSHOPD Status IndicatorDescription
    00174CAnesth, pharyngeal surgery
    00176CAnesth, pharyngeal surgery
    00192CAnesth, facial bone surgery
    00214CAnesth, skull drainage
    00215CAnesth, skull repair/fract
    00404CAnesth, surgery of breast
    00406CAnesth, surgery of breast
    00452CAnesth, surgery of shoulder
    00474CAnesth, surgery of rib(s)
    00524CAnesth, chest drainage
    00530CAnesth, pacemaker insertion
    00540CAnesth, chest surgery
    00542CAnesth, release of lung
    00544CAnesth, chest lining removal
    00546CAnesth, lung,chest wall surg
    00560CAnesth, open heart surgery
    00562CAnesth, open heart surgery
    00580CAnesth heart/lung transplant
    00604CAnesth, sitting procedure
    00622CAnesth, removal of nerves
    00632CAnesth, removal of nerves
    00634CAnesth for chemonucleolysis
    00670CAnesth, spine, cord surgery
    00792CAnesth, hemorr/excise liver
    00794CAnesth, pancreas removal
    00796CAnesth, for liver transplant
    00802CAnesth, fat layer removal
    00844CAnesth, pelvis surgery
    00846CAnesth, hysterectomy
    00848CAnesth, pelvic organ surg
    00850CAnesth, cesarean section
    00855CAnesth, hysterectomy
    00857CAnalgesia, labor & c-section
    00864CAnesth, removal of bladder
    00865CAnesth, removal of prostate
    00866CAnesth, removal of adrenal
    00868CAnesth, kidney transplant
    00882CAnesth, major vein ligation
    00884CAnesth, major vein revision
    00904CAnesth, perineal surgery
    00908CAnesth, removal of prostate
    00928CAnesth, removal of testis
    00932CAnesth, amputation of penis
    00934CAnesth, penis, nodes removal
    00936CAnesth, penis, nodes removal
    00944CAnesth, vaginal hysterectomy
    00955CAnalgesia, vaginal delivery
    01140CAnesth, amputation at pelvis
    01150CAnesth, pelvic tumor surgery
    Start Printed Page 44883
    01190CAnesth, pelvis nerve removal
    01212CAnesth, hip disarticulation
    01214CAnesth, replacement of hip
    01232CAnesth, amputation of femur
    01234CAnesth, radical femur surg
    01272CAnesth, femoral artery surg
    01274CAnesth, femoral embolectomy
    01402CAnesth, replacement of knee
    01404CAnesth, amputation at knee
    01442CAnesth, knee artery surg
    01444CAnesth, knee artery repair
    01486CAnesth, ankle replacement
    01502CAnesth, lwr leg embolectomy
    01632CAnesth, surgery of shoulder
    01634CAnesth, shoulder joint amput
    01636CAnesth, forequarter amput
    01638CAnesth, shoulder replacement
    01652CAnesth, shoulder vessel surg
    01654CAnesth, shoulder vessel surg
    01656CAnesth, arm-leg vessel surg
    01756CAnesth, radical humerus surg
    01772CAnesth, uppr arm embolectomy
    01782CAnesth, uppr arm vein repair
    01842CAnesth, lwr arm embolectomy
    01852CAnesth, lwr arm vein repair
    01904CAnesth, skull x-ray inject
    01990CSupport for organ donor
    15756CFree muscle flap, microvasc
    15757CFree skin flap, microvasc
    15758CFree fascial flap, microvasc
    16035CIncision of burn scab, initi
    16036CIncise burn scab, addl incis
    19200CRemoval of breast
    19220CRemoval of breast
    19271CRevision of chest wall
    19272CExtensive chest wall surgery
    19361CBreast reconstruction
    19364CBreast reconstruction
    19367CBreast reconstruction
    19368CBreast reconstruction
    19369CBreast reconstruction
    20660CApply,remove fixation device
    20661CApplication of head brace
    20662CApplication of pelvis brace
    20663CApplication of thigh brace
    20664CHalo brace application
    20802CReplantation, arm, complete
    20805CReplant, forearm, complete
    20808CReplantation hand, complete
    20816CReplantation digit, complete
    20822CReplantation digit, complete
    20824CReplantation thumb, complete
    20827CReplantation thumb, complete
    20838CReplantation foot, complete
    20930CSpinal bone allograft
    20931CSpinal bone allograft
    20936CSpinal bone autograft
    20937CSpinal bone autograft
    20938CSpinal bone autograft
    20955CFibula bone graft, microvasc
    20956CIliac bone graft, microvasc
    20957CMt bone graft, microvasc
    20962COther bone graft, microvasc
    20969CBone/skin graft, microvasc
    20970CBone/skin graft, iliac crest
    20972CBone/skin graft, metatarsal
    20973CBone/skin graft, great toe
    21045CExtensive jaw surgery
    21141CReconstruct midface, lefort
    21142CReconstruct midface, lefort
    21143CReconstruct midface, lefort
    21145CReconstruct midface, lefort
    21146CReconstruct midface, lefort
    21147CReconstruct midface, lefort
    21150CReconstruct midface, lefort
    Start Printed Page 44884
    21151CReconstruct midface, lefort
    21154CReconstruct midface, lefort
    21155CReconstruct midface, lefort
    21159CReconstruct midface, lefort
    21160CReconstruct midface, lefort
    21172CReconstruct orbit/forehead
    21175CReconstruct orbit/forehead
    21179CReconstruct entire forehead
    21180CReconstruct entire forehead
    21182CReconstruct cranial bone
    21183CReconstruct cranial bone
    21184CReconstruct cranial bone
    21188CReconstruction of midface
    21193CReconst lwr jaw w/o graft
    21194CReconst lwr jaw w/graft
    21195CReconst lwr jaw w/o fixation
    21196CReconst lwr jaw w/fixation
    21247CReconstruct lower jaw bone
    21255CReconstruct lower jaw bone
    21256CReconstruction of orbit
    21268CRevise eye sockets
    21343CTreatment of sinus fracture
    21344CTreatment of sinus fracture
    21346CTreat nose/jaw fracture
    21347CTreat nose/jaw fracture
    21348CTreat nose/jaw fracture
    21356CTreat cheek bone fracture
    21360CTreat cheek bone fracture
    21365CTreat cheek bone fracture
    21366CTreat cheek bone fracture
    21385CTreat eye socket fracture
    21386CTreat eye socket fracture
    21387CTreat eye socket fracture
    21390CTreat eye socket fracture
    21395CTreat eye socket fracture
    21408CTreat eye socket fracture
    21422CTreat mouth roof fracture
    21423CTreat mouth roof fracture
    21431CTreat craniofacial fracture
    21432CTreat craniofacial fracture
    21433CTreat craniofacial fracture
    21435CTreat craniofacial fracture
    21436CTreat craniofacial fracture
    21495CTreat hyoid bone fracture
    21510CDrainage of bone lesion
    21557CRemove tumor, neck/chest
    21615CRemoval of rib
    21616CRemoval of rib and nerves
    21620CPartial removal of sternum
    21627CSternal debridement
    21630CExtensive sternum surgery
    21632CExtensive sternum surgery
    21705CRevision of neck muscle/rib
    21740CReconstruction of sternum
    21750CRepair of sternum separation
    21810CTreatment of rib fracture(s)
    21825CTreat sternum fracture
    22100CRemove part of neck vertebra
    22101CRemove part, thorax vertebra
    22102CRemove part, lumbar vertebra
    22103CRemove extra spine segment
    22110CRemove part of neck vertebra
    22112CRemove part, thorax vertebra
    22114CRemove part, lumbar vertebra
    22116CRemove extra spine segment
    22210CRevision of neck spine
    22212CRevision of thorax spine
    22214CRevision of lumbar spine
    22216CRevise, extra spine segment
    22220CRevision of neck spine
    22222CRevision of thorax spine
    22224CRevision of lumbar spine
    22226CRevise, extra spine segment
    22318CTreat odontoid fx w/o graft
    22319CTreat odontoid fx w/graft
    Start Printed Page 44885
    22325CTreat spine fracture
    22326CTreat neck spine fracture
    22327CTreat thorax spine fracture
    22328CTreat each add spine fx
    22548CNeck spine fusion
    22554CNeck spine fusion
    22556CThorax spine fusion
    22558CLumbar spine fusion
    22585CAdditional spinal fusion
    22590CSpine & skull spinal fusion
    22595CNeck spinal fusion
    22600CNeck spine fusion
    22610CThorax spine fusion
    22612CLumbar spine fusion
    22614CSpine fusion, extra segment
    22630CLumbar spine fusion
    22632CSpine fusion, extra segment
    22800CFusion of spine
    22802CFusion of spine
    22804CFusion of spine
    22808CFusion of spine
    22810CFusion of spine
    22812CFusion of spine
    22818CKyphectomy, 1-2 segments
    22819CKyphectomy, 3 or more
    22830CExploration of spinal fusion
    22840CInsert spine fixation device
    22841CInsert spine fixation device
    22842CInsert spine fixation device
    22843CInsert spine fixation device
    22844CInsert spine fixation device
    22845CInsert spine fixation device
    22846CInsert spine fixation device
    22847CInsert spine fixation device
    22848CInsert pelv fixation device
    22849CReinsert spinal fixation
    22850CRemove spine fixation device
    22851CApply spine prosth device
    22852CRemove spine fixation device
    22855CRemove spine fixation device
    23035CDrain shoulder bone lesion
    23125CRemoval of collar bone
    23195CRemoval of head of humerus
    23200CRemoval of collar bone
    23210CRemoval of shoulder blade
    23220CPartial removal of humerus
    23221CPartial removal of humerus
    23222CPartial removal of humerus
    23332CRemove shoulder foreign body
    23395CMuscle transfer,shoulder/arm
    23397CMuscle transfers
    23400CFixation of shoulder blade
    23440CRemove/transplant tendon
    23470CReconstruct shoulder joint
    23472CReconstruct shoulder joint
    23900CAmputation of arm & girdle
    23920CAmputation at shoulder joint
    24149CRadical resection of elbow
    24150CExtensive humerus surgery
    24151CExtensive humerus surgery
    24152CExtensive radius surgery
    24153CExtensive radius surgery
    24900CAmputation of upper arm
    24920CAmputation of upper arm
    24930CAmputation follow-up surgery
    24931CAmputate upper arm & implant
    24940CRevision of upper arm
    25170CExtensive forearm surgery
    25390CShorten radius or ulna
    25391CLengthen radius or ulna
    25392CShorten radius & ulna
    25393CLengthen radius & ulna
    25420CRepair/graft radius & ulna
    25900CAmputation of forearm
    25905CAmputation of forearm
    Start Printed Page 44886
    25909CAmputation follow-up surgery
    25915CAmputation of forearm
    25920CAmputate hand at wrist
    25924CAmputation follow-up surgery
    25927CAmputation of hand
    25931CAmputation follow-up surgery
    26551CGreat toe-hand transfer
    26553CSingle transfer, toe-hand
    26554CDouble transfer, toe-hand
    26556CToe joint transfer
    26992CDrainage of bone lesion
    27005CIncision of hip tendon
    27006CIncision of hip tendons
    27025CIncision of hip/thigh fascia
    27030CDrainage of hip joint
    27035CDenervation of hip joint
    27036CExcision of hip joint/muscle
    27054CRemoval of hip joint lining
    27070CPartial removal of hip bone
    27071CPartial removal of hip bone
    27075CExtensive hip surgery
    27076CExtensive hip surgery
    27077CExtensive hip surgery
    27078CExtensive hip surgery
    27079CExtensive hip surgery
    27090CRemoval of hip prosthesis
    27091CRemoval of hip prosthesis
    27120CReconstruction of hip socket
    27122CReconstruction of hip socket
    27125CPartial hip replacement
    27130CTotal hip replacement
    27132CTotal hip replacement
    27134CRevise hip joint replacement
    27137CRevise hip joint replacement
    27138CRevise hip joint replacement
    27140CTransplant femur ridge
    27146CIncision of hip bone
    27147CRevision of hip bone
    27151CIncision of hip bones
    27156CRevision of hip bones
    27158CRevision of pelvis
    27161CIncision of neck of femur
    27165CIncision/fixation of femur
    27170CRepair/graft femur head/neck
    27175CTreat slipped epiphysis
    27176CTreat slipped epiphysis
    27177CTreat slipped epiphysis
    27178CTreat slipped epiphysis
    27179CRevise head/neck of femur
    27181CTreat slipped epiphysis
    27185CRevision of femur epiphysis
    27187CReinforce hip bones
    27215CTreat pelvic fracture(s)
    27216CTreat pelvic ring fracture
    27217CTreat pelvic ring fracture
    27218CTreat pelvic ring fracture
    27222CTreat hip socket fracture
    27226CTreat hip wall fracture
    27227CTreat hip fracture(s)
    27228CTreat hip fracture(s)
    27232CTreat thigh fracture
    27235CTreat thigh fracture
    27236CTreat thigh fracture
    27240CTreat thigh fracture
    27244CTreat thigh fracture
    27245CTreat thigh fracture
    27248CTreat thigh fracture
    27253CTreat hip dislocation
    27254CTreat hip dislocation
    27258CTreat hip dislocation
    27259CTreat hip dislocation
    27280CFusion of sacroiliac joint
    27282CFusion of pubic bones
    27284CFusion of hip joint
    27286CFusion of hip joint
    Start Printed Page 44887
    27290CAmputation of leg at hip
    27295CAmputation of leg at hip
    27303CDrainage of bone lesion
    27365CExtensive leg surgery
    27445CRevision of knee joint
    27447CTotal knee replacement
    27448CIncision of thigh
    27450CIncision of thigh
    27454CRealignment of thigh bone
    27455CRealignment of knee
    27457CRealignment of knee
    27465CShortening of thigh bone
    27466CLengthening of thigh bone
    27468CShorten/lengthen thighs
    27470CRepair of thigh
    27472CRepair/graft of thigh
    27475CSurgery to stop leg growth
    27477CSurgery to stop leg growth
    27479CSurgery to stop leg growth
    27485CSurgery to stop leg growth
    27486CRevise/replace knee joint
    27487CRevise/replace knee joint
    27488CRemoval of knee prosthesis
    27495CReinforce thigh
    27506CTreatment of thigh fracture
    27507CTreatment of thigh fracture
    27511CTreatment of thigh fracture
    27513CTreatment of thigh fracture
    27514CTreatment of thigh fracture
    27519CTreat thigh fx growth plate
    27535CTreat knee fracture
    27536CTreat knee fracture
    27540CTreat knee fracture
    27556CTreat knee dislocation
    27557CTreat knee dislocation
    27558CTreat knee dislocation
    27580CFusion of knee
    27590CAmputate leg at thigh
    27591CAmputate leg at thigh
    27592CAmputate leg at thigh
    27596CAmputation follow-up surgery
    27598CAmputate lower leg at knee
    27645CExtensive lower leg surgery
    27646CExtensive lower leg surgery
    27702CReconstruct ankle joint
    27703CReconstruction, ankle joint
    27712CRealignment of lower leg
    27715CRevision of lower leg
    27720CRepair of tibia
    27722CRepair/graft of tibia
    27724CRepair/graft of tibia
    27725CRepair of lower leg
    27727CRepair of lower leg
    27880CAmputation of lower leg
    27881CAmputation of lower leg
    27882CAmputation of lower leg
    27886CAmputation follow-up surgery
    27888CAmputation of foot at ankle
    28800CAmputation of midfoot
    28805CAmputation thru metatarsal
    31225CRemoval of upper jaw
    31230CRemoval of upper jaw
    31290CNasal/sinus endoscopy, surg
    31291CNasal/sinus endoscopy, surg
    31292CNasal/sinus endoscopy, surg
    31293CNasal/sinus endoscopy, surg
    31294CNasal/sinus endoscopy, surg
    31360CRemoval of larynx
    31365CRemoval of larynx
    31367CPartial removal of larynx
    31368CPartial removal of larynx
    31370CPartial removal of larynx
    31375CPartial removal of larynx
    31380CPartial removal of larynx
    31382CPartial removal of larynx
    Start Printed Page 44888
    31390CRemoval of larynx & pharynx
    31395CReconstruct larynx & pharynx
    31582CRevision of larynx
    31584CTreat larynx fracture
    31587CRevision of larynx
    31725CClearance of airways
    31760CRepair of windpipe
    31766CReconstruction of windpipe
    31770CRepair/graft of bronchus
    31775CReconstruct bronchus
    31780CReconstruct windpipe
    31781CReconstruct windpipe
    31785CRemove windpipe lesion
    31786CRemove windpipe lesion
    31800CRepair of windpipe injury
    31805CRepair of windpipe injury
    32035CExploration of chest
    32036CExploration of chest
    32095CBiopsy through chest wall
    32100CExploration/biopsy of chest
    32110CExplore/repair chest
    32120CRe-exploration of chest
    32124CExplore chest free adhesions
    32140CRemoval of lung lesion(s)
    32141CRemove/treat lung lesions
    32150CRemoval of lung lesion(s)
    32151CRemove lung foreign body
    32160COpen chest heart massage
    32200CDrain, open, lung lesion
    32201CDrain, percut, lung lesion
    32215CTreat chest lining
    32220CRelease of lung
    32225CPartial release of lung
    32310CRemoval of chest lining
    32320CFree/remove chest lining
    32402COpen biopsy chest lining
    32440CRemoval of lung
    32442CSleeve pneumonectomy
    32445CRemoval of lung
    32480CPartial removal of lung
    32482CBilobectomy
    32484CSegmentectomy
    32486CSleeve lobectomy
    32488CCompletion pneumonectomy
    32491CLung volume reduction
    32500CPartial removal of lung
    32501CRepair bronchus add-on
    32520CRemove lung & revise chest
    32522CRemove lung & revise chest
    32525CRemove lung & revise chest
    32540CRemoval of lung lesion
    32650CThoracoscopy, surgical
    32651CThoracoscopy, surgical
    32652CThoracoscopy, surgical
    32653CThoracoscopy, surgical
    32654CThoracoscopy, surgical
    32655CThoracoscopy, surgical
    32656CThoracoscopy, surgical
    32657CThoracoscopy, surgical
    32658CThoracoscopy, surgical
    32659CThoracoscopy, surgical
    32660CThoracoscopy, surgical
    32661CThoracoscopy, surgical
    32662CThoracoscopy, surgical
    32663CThoracoscopy, surgical
    32664CThoracoscopy, surgical
    32665CThoracoscopy, surgical
    32800CRepair lung hernia
    32810CClose chest after drainage
    32815CClose bronchial fistula
    32820CReconstruct injured chest
    32850CDonor pneumonectomy
    32851CLung transplant, single
    32852CLung transplant with bypass
    32853CLung transplant, double
    Start Printed Page 44889
    32854CLung transplant with bypass
    32900CRemoval of rib(s)
    32905CRevise & repair chest wall
    32906CRevise & repair chest wall
    32940CRevision of lung
    32997CTotal lung lavage
    33015CIncision of heart sac
    33020CIncision of heart sac
    33025CIncision of heart sac
    33030CPartial removal of heart sac
    33031CPartial removal of heart sac
    33050CRemoval of heart sac lesion
    33120CRemoval of heart lesion
    33130CRemoval of heart lesion
    33140CHeart revascularize (tmr)
    33141CHeart tmr w/other procedure
    33200CInsertion of heart pacemaker
    33201CInsertion of heart pacemaker
    33236CRemove electrode/thoracotomy
    33237CRemove electrode/thoracotomy
    33238CRemove electrode/thoracotomy
    33243CRemove eltrd/thoracotomy
    33245CInsert epic eltrd pace-defib
    33246CInsert epic eltrd/generator
    33250CAblate heart dysrhythm focus
    33251CAblate heart dysrhythm focus
    33253CReconstruct atria
    33261CAblate heart dysrhythm focus
    33300CRepair of heart wound
    33305CRepair of heart wound
    33310CExploratory heart surgery
    33315CExploratory heart surgery
    33320CRepair major blood vessel(s)
    33321CRepair major vessel
    33322CRepair major blood vessel(s)
    33330CInsert major vessel graft
    33332CInsert major vessel graft
    33335CInsert major vessel graft
    33400CRepair of aortic valve
    33401CValvuloplasty, open
    33403CValvuloplasty, w/cp bypass
    33404CPrepare heart-aorta conduit
    33405CReplacement of aortic valve
    33406CReplacement of aortic valve
    33410CReplacement of aortic valve
    33411CReplacement of aortic valve
    33412CReplacement of aortic valve
    33413CReplacement of aortic valve
    33414CRepair of aortic valve
    33415CRevision, subvalvular tissue
    33416CRevise ventricle muscle
    33417CRepair of aortic valve
    33420CRevision of mitral valve
    33422CRevision of mitral valve
    33425CRepair of mitral valve
    33426CRepair of mitral valve
    33427CRepair of mitral valve
    33430CReplacement of mitral valve
    33460CRevision of tricuspid valve
    33463CValvuloplasty, tricuspid
    33464CValvuloplasty, tricuspid
    33465CReplace tricuspid valve
    33468CRevision of tricuspid valve
    33470CRevision of pulmonary valve
    33471CValvotomy, pulmonary valve
    33472CRevision of pulmonary valve
    33474CRevision of pulmonary valve
    33475CReplacement, pulmonary valve
    33476CRevision of heart chamber
    33478CRevision of heart chamber
    33496CRepair, prosth valve clot
    33500CRepair heart vessel fistula
    33501CRepair heart vessel fistula
    33502CCoronary artery correction
    33503CCoronary artery graft
    Start Printed Page 44890
    33504CCoronary artery graft
    33505CRepair artery w/tunnel
    33506CRepair artery, translocation
    33510CCabg, vein, single
    33511CCabg, vein, two
    33512CCabg, vein, three
    33513CCabg, vein, four
    33514CCabg, vein, five
    33516CCabg, vein, six or more
    33517CCabg, artery-vein, single
    33518CCabg, artery-vein, two
    33519CCabg, artery-vein, three
    33521CCabg, artery-vein, four
    33522CCabg, artery-vein, five
    33523CCabg, art-vein, six or more
    33530CCoronary artery, bypass/reop
    33533CCabg, arterial, single
    33534CCabg, arterial, two
    33535CCabg, arterial, three
    33536CCabg, arterial, four or more
    33542CRemoval of heart lesion
    33545CRepair of heart damage
    33572COpen coronary endarterectomy
    33600CClosure of valve
    33602CClosure of valve
    33606CAnastomosis/artery-aorta
    33608CRepair anomaly w/conduit
    33610CRepair by enlargement
    33611CRepair double ventricle
    33612CRepair double ventricle
    33615CRepair, modified fontan
    33617CRepair single ventricle
    33619CRepair single ventricle
    33641CRepair heart septum defect
    33645CRevision of heart veins
    33647CRepair heart septum defects
    33660CRepair of heart defects
    33665CRepair of heart defects
    33670CRepair of heart chambers
    33681CRepair heart septum defect
    33684CRepair heart septum defect
    33688CRepair heart septum defect
    33690CReinforce pulmonary artery
    33692CRepair of heart defects
    33694CRepair of heart defects
    33697CRepair of heart defects
    33702CRepair of heart defects
    33710CRepair of heart defects
    33720CRepair of heart defect
    33722CRepair of heart defect
    33730CRepair heart-vein defect(s)
    33732CRepair heart-vein defect
    33735CRevision of heart chamber
    33736CRevision of heart chamber
    33737CRevision of heart chamber
    33750CMajor vessel shunt
    33755CMajor vessel shunt
    33762CMajor vessel shunt
    33764CMajor vessel shunt & graft
    33766CMajor vessel shunt
    33767CMajor vessel shunt
    33770CRepair great vessels defect
    33771CRepair great vessels defect
    33774CRepair great vessels defect
    33775CRepair great vessels defect
    33776CRepair great vessels defect
    33777CRepair great vessels defect
    33778CRepair great vessels defect
    33779CRepair great vessels defect
    33780CRepair great vessels defect
    33781CRepair great vessels defect
    33786CRepair arterial trunk
    33788CRevision of pulmonary artery
    33800CAortic suspension
    33802CRepair vessel defect
    Start Printed Page 44891
    33803CRepair vessel defect
    33813CRepair septal defect
    33814CRepair septal defect
    33820CRevise major vessel
    33822CRevise major vessel
    33824CRevise major vessel
    33840CRemove aorta constriction
    33845CRemove aorta constriction
    33851CRemove aorta constriction
    33852CRepair septal defect
    33853CRepair septal defect
    33860CAscending aortic graft
    33861CAscending aortic graft
    33863CAscending aortic graft
    33870CTransverse aortic arch graft
    33875CThoracic aortic graft
    33877CThoracoabdominal graft
    33910CRemove lung artery emboli
    33915CRemove lung artery emboli
    33916CSurgery of great vessel
    33917CRepair pulmonary artery
    33918CRepair pulmonary atresia
    33919CRepair pulmonary atresia
    33920CRepair pulmonary atresia
    33922CTransect pulmonary artery
    33924CRemove pulmonary shunt
    33930CRemoval of donor heart/lung
    33935CTransplantation, heart/lung
    33940CRemoval of donor heart
    33945CTransplantation of heart
    33960CExternal circulation assist
    33961CExternal circulation assist
    33968CRemove aortic assist device
    33970CAortic circulation assist
    33971CAortic circulation assist
    33973CInsert balloon device
    33974CRemove intra-aortic balloon
    33975CImplant ventricular device
    33976CImplant ventricular device
    33977CRemove ventricular device
    33978CRemove ventricular device
    34001CRemoval of artery clot
    34051CRemoval of artery clot
    34151CRemoval of artery clot
    34401CRemoval of vein clot
    34451CRemoval of vein clot
    34502CReconstruct vena cava
    34800CEndovasc abdo repair w/tube
    34802CEndovasc abdo repr w/device
    34804CEndovasc abdo repr w/device
    34808CEndovasc abdo occlud device
    34812CXpose for endoprosth, aortic
    34813CXpose for endoprosth, femorl
    34820CXpose for endoprosth, iliac
    34825CEndovasc extend prosth, init
    34826CEndovasc exten prosth, addl
    34830COpen aortic tube prosth repr
    34831COpen aortoiliac prosth repr
    34832COpen aortofemor prosth repr
    35001CRepair defect of artery
    35002CRepair artery rupture, neck
    35005CRepair defect of artery
    35013CRepair artery rupture, arm
    35021CRepair defect of artery
    35022CRepair artery rupture, chest
    35045CRepair defect of arm artery
    35081CRepair defect of artery
    35082CRepair artery rupture, aorta
    35091CRepair defect of artery
    35092CRepair artery rupture, aorta
    35102CRepair defect of artery
    35103CRepair artery rupture, groin
    35111CRepair defect of artery
    35112CRepair artery rupture,spleen
    35121CRepair defect of artery
    Start Printed Page 44892
    35122CRepair artery rupture, belly
    35131CRepair defect of artery
    35132CRepair artery rupture, groin
    35141CRepair defect of artery
    35142CRepair artery rupture, thigh
    35151CRepair defect of artery
    35152CRepair artery rupture, knee
    35161CRepair defect of artery
    35162CRepair artery rupture
    35182CRepair blood vessel lesion
    35189CRepair blood vessel lesion
    35211CRepair blood vessel lesion
    35216CRepair blood vessel lesion
    35221CRepair blood vessel lesion
    35241CRepair blood vessel lesion
    35246CRepair blood vessel lesion
    35251CRepair blood vessel lesion
    35271CRepair blood vessel lesion
    35276CRepair blood vessel lesion
    35281CRepair blood vessel lesion
    35301CRechanneling of artery
    35311CRechanneling of artery
    35331CRechanneling of artery
    35341CRechanneling of artery
    35351CRechanneling of artery
    35355CRechanneling of artery
    35361CRechanneling of artery
    35363CRechanneling of artery
    35371CRechanneling of artery
    35372CRechanneling of artery
    35381CRechanneling of artery
    35390CReoperation, carotid add-on
    35400CAngioscopy
    35450CRepair arterial blockage
    35452CRepair arterial blockage
    35454CRepair arterial blockage
    35456CRepair arterial blockage
    35480CAtherectomy, open
    35482CAtherectomy, open
    35483CAtherectomy, open
    35501CArtery bypass graft
    35506CArtery bypass graft
    35507CArtery bypass graft
    35508CArtery bypass graft
    35509CArtery bypass graft
    35511CArtery bypass graft
    35515CArtery bypass graft
    35516CArtery bypass graft
    35518CArtery bypass graft
    35521CArtery bypass graft
    35526CArtery bypass graft
    35531CArtery bypass graft
    35533CArtery bypass graft
    35536CArtery bypass graft
    35541CArtery bypass graft
    35546CArtery bypass graft
    35548CArtery bypass graft
    35549CArtery bypass graft
    35551CArtery bypass graft
    35556CArtery bypass graft
    35558CArtery bypass graft
    35560CArtery bypass graft
    35563CArtery bypass graft
    35565CArtery bypass graft
    35566CArtery bypass graft
    35571CArtery bypass graft
    35582CVein bypass graft
    35583CVein bypass graft
    35585CVein bypass graft
    35587CVein bypass graft
    35600CHarvest artery for cabg
    35601CArtery bypass graft
    35606CArtery bypass graft
    35612CArtery bypass graft
    35616CArtery bypass graft
    Start Printed Page 44893
    35621CArtery bypass graft
    35623CBypass graft, not vein
    35626CArtery bypass graft
    35631CArtery bypass graft
    35636CArtery bypass graft
    35641CArtery bypass graft
    35642CArtery bypass graft
    35645CArtery bypass graft
    35646CArtery bypass graft
    35650CArtery bypass graft
    35651CArtery bypass graft
    35654CArtery bypass graft
    35656CArtery bypass graft
    35661CArtery bypass graft
    35663CArtery bypass graft
    35665CArtery bypass graft
    35666CArtery bypass graft
    35671CArtery bypass graft
    35681CComposite bypass graft
    35682CComposite bypass graft
    35683CComposite bypass graft
    35691CArterial transposition
    35693CArterial transposition
    35694CArterial transposition
    35695CArterial transposition
    35700CReoperation, bypass graft
    35701CExploration, carotid artery
    35721CExploration, femoral artery
    35741CExploration popliteal artery
    35800CExplore neck vessels
    35820CExplore chest vessels
    35840CExplore abdominal vessels
    35870CRepair vessel graft defect
    35901CExcision, graft, neck
    35905CExcision, graft, thorax
    35907CExcision, graft, abdomen
    36510CInsertion of catheter, vein
    36660CInsertion catheter, artery
    36822CInsertion of cannula(s)
    36823CInsertion of cannula(s)
    37140CRevision of circulation
    37145CRevision of circulation
    37160CRevision of circulation
    37180CRevision of circulation
    37181CSplice spleen/kidney veins
    37195CThrombolytic therapy, stroke
    37616CLigation of chest artery
    37617CLigation of abdomen artery
    37618CLigation of extremity artery
    37660CRevision of major vein
    37788CRevascularization, penis
    38100CRemoval of spleen, total
    38101CRemoval of spleen, partial
    38102CRemoval of spleen, total
    38115CRepair of ruptured spleen
    38380CThoracic duct procedure
    38381CThoracic duct procedure
    38382CThoracic duct procedure
    38562CRemoval, pelvic lymph nodes
    38564CRemoval, abdomen lymph nodes
    38700CRemoval of lymph nodes, neck
    38724CRemoval of lymph nodes, neck
    38746CRemove thoracic lymph nodes
    38747CRemove abdominal lymph nodes
    38765CRemove groin lymph nodes
    38770CRemove pelvis lymph nodes
    38780CRemove abdomen lymph nodes
    39000CExploration of chest
    39010CExploration of chest
    39200CRemoval chest lesion
    39220CRemoval chest lesion
    39499CChest procedure
    39501CRepair diaphragm laceration
    39502CRepair paraesophageal hernia
    39503CRepair of diaphragm hernia
    Start Printed Page 44894
    39520CRepair of diaphragm hernia
    39530CRepair of diaphragm hernia
    39531CRepair of diaphragm hernia
    39540CRepair of diaphragm hernia
    39541CRepair of diaphragm hernia
    39545CRevision of diaphragm
    39560CResect diaphragm, simple
    39561CResect diaphragm, complex
    39599CDiaphragm surgery procedure
    41130CPartial removal of tongue
    41135CTongue and neck surgery
    41140CRemoval of tongue
    41145CTongue removal, neck surgery
    41150CTongue, mouth, jaw surgery
    41153CTongue, mouth, neck surgery
    41155CTongue, jaw, & neck surgery
    42426CExcise parotid gland/lesion
    42842CExtensive surgery of throat
    42845CExtensive surgery of throat
    42894CRevision of pharyngeal walls
    42953CRepair throat, esophagus
    42961CControl throat bleeding
    42971CControl nose/throat bleeding
    43030CThroat muscle surgery
    43045CIncision of esophagus
    43100CExcision of esophagus lesion
    43101CExcision of esophagus lesion
    43107CRemoval of esophagus
    43108CRemoval of esophagus
    43112CRemoval of esophagus
    43113CRemoval of esophagus
    43116CPartial removal of esophagus
    43117CPartial removal of esophagus
    43118CPartial removal of esophagus
    43121CPartial removal of esophagus
    43122CParital removal of esophagus
    43123CPartial removal of esophagus
    43124CRemoval of esophagus
    43135CRemoval of esophagus pouch
    43300CRepair of esophagus
    43305CRepair esophagus and fistula
    43310CRepair of esophagus
    43312CRepair esophagus and fistula
    43320CFuse esophagus & stomach
    43324CRevise esophagus & stomach
    43325CRevise esophagus & stomach
    43326CRevise esophagus & stomach
    43330CRepair of esophagus
    43331CRepair of esophagus
    43340CFuse esophagus & intestine
    43341CFuse esophagus & intestine
    43350CSurgical opening, esophagus
    43351CSurgical opening, esophagus
    43352CSurgical opening, esophagus
    43360CGastrointestinal repair
    43361CGastrointestinal repair
    43400CLigate esophagus veins
    43401CEsophagus surgery for veins
    43405CLigate/staple esophagus
    43410CRepair esophagus wound
    43415CRepair esophagus wound
    43420CRepair esophagus opening
    43425CRepair esophagus opening
    43460CPressure treatment esophagus
    43496CFree jejunum flap, microvasc
    43500CSurgical opening of stomach
    43501CSurgical repair of stomach
    43502CSurgical repair of stomach
    43510CSurgical opening of stomach
    43520CIncision of pyloric muscle
    43605CBiopsy of stomach
    43610CExcision of stomach lesion
    43611CExcision of stomach lesion
    43620CRemoval of stomach
    43621CRemoval of stomach
    Start Printed Page 44895
    43622CRemoval of stomach
    43631CRemoval of stomach, partial
    43632CRemoval of stomach, partial
    43633CRemoval of stomach, partial
    43634CRemoval of stomach, partial
    43635CRemoval of stomach, partial
    43638CRemoval of stomach, partial
    43639CRemoval of stomach, partial
    43640CVagotomy & pylorus repair
    43641CVagotomy & pylorus repair
    43800CReconstruction of pylorus
    43810CFusion of stomach and bowel
    43820CFusion of stomach and bowel
    43825CFusion of stomach and bowel
    43832CPlace gastrostomy tube
    43840CRepair of stomach lesion
    43842CGastroplasty for obesity
    43843CGastroplasty for obesity
    43846CGastric bypass for obesity
    43847CGastric bypass for obesity
    43848CRevision gastroplasty
    43850CRevise stomach-bowel fusion
    43855CRevise stomach-bowel fusion
    43860CRevise stomach-bowel fusion
    43865CRevise stomach-bowel fusion
    43880CRepair stomach-bowel fistula
    44005CFreeing of bowel adhesion
    44010CIncision of small bowel
    44015CInsert needle cath bowel
    44020CExploration of small bowel
    44021CDecompress small bowel
    44025CIncision of large bowel
    44050CReduce bowel obstruction
    44055CCorrect malrotation of bowel
    44110CExcision of bowel lesion(s)
    44111CExcision of bowel lesion(s)
    44120CRemoval of small intestine
    44121CRemoval of small intestine
    44125CRemoval of small intestine
    44130CBowel to bowel fusion
    44139CMobilization of colon
    44140CPartial removal of colon
    44141CPartial removal of colon
    44143CPartial removal of colon
    44144CPartial removal of colon
    44145CPartial removal of colon
    44146CPartial removal of colon
    44147CPartial removal of colon
    44150CRemoval of colon
    44151CRemoval of colon/ileostomy
    44152CRemoval of colon/ileostomy
    44153CRemoval of colon/ileostomy
    44155CRemoval of colon/ileostomy
    44156CRemoval of colon/ileostomy
    44160CRemoval of colon
    44202CLaparo, resect intestine
    44300COpen bowel to skin
    44310CIleostomy/jejunostomy
    44314CRevision of ileostomy
    44316CDevise bowel pouch
    44320CColostomy
    44322CColostomy with biopsies
    44345CRevision of colostomy
    44346CRevision of colostomy
    44602CSuture, small intestine
    44603CSuture, small intestine
    44604CSuture, large intestine
    44605CRepair of bowel lesion
    44615CIntestinal stricturoplasty
    44620CRepair bowel opening
    44625CRepair bowel opening
    44626CRepair bowel opening
    44640CRepair bowel-skin fistula
    44650CRepair bowel fistula
    44660CRepair bowel-bladder fistula
    Start Printed Page 44896
    44661CRepair bowel-bladder fistula
    44680CSurgical revision, intestine
    44700CSuspend bowel w/prosthesis
    44800CExcision of bowel pouch
    44820CExcision of mesentery lesion
    44850CRepair of mesentery
    44899CBowel surgery procedure
    44900CDrain app abscess, open
    44901CDrain app abscess, percut
    44950CAppendectomy
    44955CAppendectomy add-on
    44960CAppendectomy
    45110CRemoval of rectum
    45111CPartial removal of rectum
    45112CRemoval of rectum
    45113CPartial proctectomy
    45114CPartial removal of rectum
    45116CPartial removal of rectum
    45119CRemove rectum w/reservoir
    45120CRemoval of rectum
    45121CRemoval of rectum and colon
    45123CPartial proctectomy
    45126CPelvic exenteration
    45130CExcision of rectal prolapse
    45135CExcision of rectal prolapse
    45540CCorrect rectal prolapse
    45541CCorrect rectal prolapse
    45550CRepair rectum/remove sigmoid
    45562CExploration/repair of rectum
    45563CExploration/repair of rectum
    45800CRepair rect/bladder fistula
    45805CRepair fistula w/colostomy
    45820CRepair rectourethral fistula
    45825CRepair fistula w/colostomy
    46705CRepair of anal stricture
    46715CRepair of anovaginal fistula
    46716CRepair of anovaginal fistula
    46730CConstruction of absent anus
    46735CConstruction of absent anus
    46740CConstruction of absent anus
    46742CRepair of imperforated anus
    46744CRepair of cloacal anomaly
    46746CRepair of cloacal anomaly
    46748CRepair of cloacal anomaly
    46751CRepair of anal sphincter
    47001CNeedle biopsy, liver add-on
    47010COpen drainage, liver lesion
    47011CPercut drain, liver lesion
    47015CInject/aspirate liver cyst
    47100CWedge biopsy of liver
    47120CPartial removal of liver
    47122CExtensive removal of liver
    47125CPartial removal of liver
    47130CPartial removal of liver
    47133CRemoval of donor liver
    47134CPartial removal, donor liver
    47135CTransplantation of liver
    47136CTransplantation of liver
    47300CSurgery for liver lesion
    47350CRepair liver wound
    47360CRepair liver wound
    47361CRepair liver wound
    47362CRepair liver wound
    47400CIncision of liver duct
    47420CIncision of bile duct
    47425CIncision of bile duct
    47460CIncise bile duct sphincter
    47480CIncision of gallbladder
    47490CIncision of gallbladder
    47550CBile duct endoscopy add-on
    47570CLaparo cholecystoenterostomy
    47600CRemoval of gallbladder
    47605CRemoval of gallbladder
    47610CRemoval of gallbladder
    47612CRemoval of gallbladder
    Start Printed Page 44897
    47620CRemoval of gallbladder
    47700CExploration of bile ducts
    47701CBile duct revision
    47711CExcision of bile duct tumor
    47712CExcision of bile duct tumor
    47715CExcision of bile duct cyst
    47716CFusion of bile duct cyst
    47720CFuse gallbladder & bowel
    47721CFuse upper GI structures
    47740CFuse gallbladder & bowel
    47741CFuse gallbladder & bowel
    47760CFuse bile ducts and bowel
    47765CFuse liver ducts & bowel
    47780CFuse bile ducts and bowel
    47785CFuse bile ducts and bowel
    47800CReconstruction of bile ducts
    47801CPlacement, bile duct support
    47802CFuse liver duct & intestine
    47900CSuture bile duct injury
    48000CDrainage of abdomen
    48001CPlacement of drain, pancreas
    48005CResect/debride pancreas
    48020CRemoval of pancreatic stone
    48100CBiopsy of pancreas
    48120CRemoval of pancreas lesion
    48140CPartial removal of pancreas
    48145CPartial removal of pancreas
    48146CPancreatectomy
    48148CRemoval of pancreatic duct
    48150CPartial removal of pancreas
    48152CPancreatectomy
    48153CPancreatectomy
    48154CPancreatectomy
    48155CRemoval of pancreas
    48180CFuse pancreas and bowel
    48400CInjection, intraop add-on
    48500CSurgery of pancreas cyst
    48510CDrain pancreatic pseudocyst
    48511CDrain pancreatic pseudocyst
    48520CFuse pancreas cyst and bowel
    48540CFuse pancreas cyst and bowel
    48545CPancreatorrhaphy
    48547CDuodenal exclusion
    48556CRemoval, allograft pancreas
    49000CExploration of abdomen
    49002CReopening of abdomen
    49010CExploration behind abdomen
    49020CDrain abdominal abscess
    49021CDrain abdominal abscess
    49040CDrain, open, abdom abscess
    49041CDrain, percut, abdom abscess
    49060CDrain, open, retrop abscess
    49061CDrain, percut, retroper absc
    49062CDrain to peritoneal cavity
    49200CRemoval of abdominal lesion
    49201CRemoval of abdominal lesion
    49215CExcise sacral spine tumor
    49220CMultiple surgery, abdomen
    49255CRemoval of omentum
    49425CInsert abdomen-venous drain
    49428CLigation of shunt
    49605CRepair umbilical lesion
    49606CRepair umbilical lesion
    49610CRepair umbilical lesion
    49611CRepair umbilical lesion
    49900CRepair of abdominal wall
    49905COmental flap
    49906CFree omental flap, microvasc
    50010CExploration of kidney
    50020CRenal abscess, open drain
    50021CRenal abscess, percut drain
    50040CDrainage of kidney
    50045CExploration of kidney
    50060CRemoval of kidney stone
    50065CIncision of kidney
    Start Printed Page 44898
    50070CIncision of kidney
    50075CRemoval of kidney stone
    50100CRevise kidney blood vessels
    50120CExploration of kidney
    50125CExplore and drain kidney
    50130CRemoval of kidney stone
    50135CExploration of kidney
    50205CBiopsy of kidney
    50220CRemoval of kidney
    50225CRemoval of kidney
    50230CRemoval of kidney
    50234CRemoval of kidney & ureter
    50236CRemoval of kidney & ureter
    50240CPartial removal of kidney
    50280CRemoval of kidney lesion
    50290CRemoval of kidney lesion
    50300CRemoval of donor kidney
    50320CRemoval of donor kidney
    50340CRemoval of kidney
    50360CTransplantation of kidney
    50365CTransplantation of kidney
    50370CRemove transplanted kidney
    50380CReimplantation of kidney
    50400CRevision of kidney/ureter
    50405CRevision of kidney/ureter
    50500CRepair of kidney wound
    50520CClose kidney-skin fistula
    50525CRepair renal-abdomen fistula
    50526CRepair renal-abdomen fistula
    50540CRevision of horseshoe kidney
    50545CLaparo radical nephrectomy
    50546CLaparoscopic nephrectomy
    50547CLaparo removal donor kidney
    50548CLaparo remove k/ureter
    50570CKidney endoscopy
    50572CKidney endoscopy
    50574CKidney endoscopy & biopsy
    50575CKidney endoscopy
    50576CKidney endoscopy & treatment
    50578CRenal endoscopy/radiotracer
    50580CKidney endoscopy & treatment
    50600CExploration of ureter
    50605CInsert ureteral support
    50610CRemoval of ureter stone
    50620CRemoval of ureter stone
    50630CRemoval of ureter stone
    50650CRemoval of ureter
    50660CRemoval of ureter
    50700CRevision of ureter
    50715CRelease of ureter
    50722CRelease of ureter
    50725CRelease/revise ureter
    50727CRevise ureter
    50728CRevise ureter
    50740CFusion of ureter & kidney
    50750CFusion of ureter & kidney
    50760CFusion of ureters
    50770CSplicing of ureters
    50780CReimplant ureter in bladder
    50782CReimplant ureter in bladder
    50783CReimplant ureter in bladder
    50785CReimplant ureter in bladder
    50800CImplant ureter in bowel
    50810CFusion of ureter & bowel
    50815CUrine shunt to bowel
    50820CConstruct bowel bladder
    50825CConstruct bowel bladder
    50830CRevise urine flow
    50840CReplace ureter by bowel
    50845CAppendico-vesicostomy
    50860CTransplant ureter to skin
    50900CRepair of ureter
    50920CClosure ureter/skin fistula
    50930CClosure ureter/bowel fistula
    50940CRelease of ureter
    Start Printed Page 44899
    51060CRemoval of ureter stone
    51525CRemoval of bladder lesion
    51530CRemoval of bladder lesion
    51535CRepair of ureter lesion
    51550CPartial removal of bladder
    51555CPartial removal of bladder
    51565CRevise bladder & ureter(s)
    51570CRemoval of bladder
    51575CRemoval of bladder & nodes
    51580CRemove bladder/revise tract
    51585CRemoval of bladder & nodes
    51590CRemove bladder/revise tract
    51595CRemove bladder/revise tract
    51596CRemove bladder/create pouch
    51597CRemoval of pelvic structures
    51800CRevision of bladder/urethra
    51820CRevision of urinary tract
    51840CAttach bladder/urethra
    51841CAttach bladder/urethra
    51845CRepair bladder neck
    51860CRepair of bladder wound
    51865CRepair of bladder wound
    51900CRepair bladder/vagina lesion
    51920CClose bladder-uterus fistula
    51925CHysterectomy/bladder repair
    51940CCorrection of bladder defect
    51960CRevision of bladder & bowel
    51980CConstruct bladder opening
    53085CDrainage of urinary leakage
    53415CReconstruction of urethra
    53443CReconstruction of urethra
    54125CRemoval of penis
    54130CRemove penis & nodes
    54135CRemove penis & nodes
    54332CRevise penis/urethra
    54336CRevise penis/urethra
    54390CRepair penis and bladder
    54430CRevision of penis
    54535CExtensive testis surgery
    54560CExploration for testis
    54650COrchiopexy (fowler-stephens)
    55600CIncise sperm duct pouch
    55605CIncise sperm duct pouch
    55650CRemove sperm duct pouch
    55801CRemoval of prostate
    55810CExtensive prostate surgery
    55812CExtensive prostate surgery
    55815CExtensive prostate surgery
    55821CRemoval of prostate
    55831CRemoval of prostate
    55840CExtensive prostate surgery
    55842CExtensive prostate surgery
    55845CExtensive prostate surgery
    55862CExtensive prostate surgery
    55865CExtensive prostate surgery
    56630CExtensive vulva surgery
    56631CExtensive vulva surgery
    56632CExtensive vulva surgery
    56633CExtensive vulva surgery
    56634CExtensive vulva surgery
    56637CExtensive vulva surgery
    56640CExtensive vulva surgery
    57110CRemove vagina wall, complete
    57111CRemove vagina tissue, compl
    57112CVaginectomy w/nodes, compl
    57270CRepair of bowel pouch
    57280CSuspension of vagina
    57282CRepair of vaginal prolapse
    57292CConstruct vagina with graft
    57305CRepair rectum-vagina fistula
    57307CFistula repair & colostomy
    57308CFistula repair, transperine
    57311CRepair urethrovaginal lesion
    57335CRepair vagina
    57531CRemoval of cervix, radical
    Start Printed Page 44900
    57540CRemoval of residual cervix
    57545CRemove cervix/repair pelvis
    58140CRemoval of uterus lesion
    58150CTotal hysterectomy
    58152CTotal hysterectomy
    58180CPartial hysterectomy
    58200CExtensive hysterectomy
    58210CExtensive hysterectomy
    58240CRemoval of pelvis contents
    58260CVaginal hysterectomy
    58262CVaginal hysterectomy
    58263CVaginal hysterectomy
    58267CHysterectomy & vagina repair
    58270CHysterectomy & vagina repair
    58275CHysterectomy/revise vagina
    58280CHysterectomy/revise vagina
    58285CExtensive hysterectomy
    58400CSuspension of uterus
    58410CSuspension of uterus
    58520CRepair of ruptured uterus
    58540CRevision of uterus
    58605CDivision of fallopian tube
    58611CLigate oviduct(s) add-on
    58700CRemoval of fallopian tube
    58720CRemoval of ovary/tube(s)
    58740CRevise fallopian tube(s)
    58750CRepair oviduct
    58752CRevise ovarian tube(s)
    58760CRemove tubal obstruction
    58770CCreate new tubal opening
    58805CDrainage of ovarian cyst(s)
    58822CDrain ovary abscess, percut
    58823CDrain pelvic abscess, percut
    58825CTransposition, ovary(s)
    58940CRemoval of ovary(s)
    58943CRemoval of ovary(s)
    58950CResect ovarian malignancy
    58951CResect ovarian malignancy
    58952CResect ovarian malignancy
    58960CExploration of abdomen
    59100CRemove uterus lesion
    59120CTreat ectopic pregnancy
    59121CTreat ectopic pregnancy
    59130CTreat ectopic pregnancy
    59135CTreat ectopic pregnancy
    59136CTreat ectopic pregnancy
    59140CTreat ectopic pregnancy
    59325CRevision of cervix
    59350CRepair of uterus
    59514CCesarean delivery only
    59525CRemove uterus after cesarean
    59620CAttempted vbac delivery only
    59830CTreat uterus infection
    59850CAbortion
    59851CAbortion
    59852CAbortion
    59855CAbortion
    59856CAbortion
    59857CAbortion
    60254CExtensive thyroid surgery
    60270CRemoval of thyroid
    60271CRemoval of thyroid
    60502CRe-explore parathyroids
    60505CExplore parathyroid glands
    60520CRemoval of thymus gland
    60521CRemoval of thymus gland
    60522CRemoval of thymus gland
    60540CExplore adrenal gland
    60545CExplore adrenal gland
    60600CRemove carotid body lesion
    60605CRemove carotid body lesion
    60650CLaparoscopy adrenalectomy
    61105CTwist drill hole
    61107CDrill skull for implantation
    61108CDrill skull for drainage
    Start Printed Page 44901
    61120CBurr hole for puncture
    61140CPierce skull for biopsy
    61150CPierce skull for drainage
    61151CPierce skull for drainage
    61154CPierce skull & remove clot
    61156CPierce skull for drainage
    61210CPierce skull, implant device
    61250CPierce skull & explore
    61253CPierce skull & explore
    61304COpen skull for exploration
    61305COpen skull for exploration
    61312COpen skull for drainage
    61313COpen skull for drainage
    61314COpen skull for drainage
    61315COpen skull for drainage
    61320COpen skull for drainage
    61321COpen skull for drainage
    61332CExplore/biopsy eye socket
    61333CExplore orbit/remove lesion
    61334CExplore orbit/remove object
    61340CRelieve cranial pressure
    61343CIncise skull (press relief)
    61345CRelieve cranial pressure
    61440CIncise skull for surgery
    61450CIncise skull for surgery
    61458CIncise skull for brain wound
    61460CIncise skull for surgery
    61470CIncise skull for surgery
    61480CIncise skull for surgery
    61490CIncise skull for surgery
    61500CRemoval of skull lesion
    61501CRemove infected skull bone
    61510CRemoval of brain lesion
    61512CRemove brain lining lesion
    61514CRemoval of brain abscess
    61516CRemoval of brain lesion
    61518CRemoval of brain lesion
    61519CRemove brain lining lesion
    61520CRemoval of brain lesion
    61521CRemoval of brain lesion
    61522CRemoval of brain abscess
    61524CRemoval of brain lesion
    61526CRemoval of brain lesion
    61530CRemoval of brain lesion
    61531CImplant brain electrodes
    61533CImplant brain electrodes
    61534CRemoval of brain lesion
    61535CRemove brain electrodes
    61536CRemoval of brain lesion
    61538CRemoval of brain tissue
    61539CRemoval of brain tissue
    61541CIncision of brain tissue
    61542CRemoval of brain tissue
    61543CRemoval of brain tissue
    61544CRemove & treat brain lesion
    61545CExcision of brain tumor
    61546CRemoval of pituitary gland
    61548CRemoval of pituitary gland
    61550CRelease of skull seams
    61552CRelease of skull seams
    61556CIncise skull/sutures
    61557CIncise skull/sutures
    61558CExcision of skull/sutures
    61559CExcision of skull/sutures
    61563CExcision of skull tumor
    61564CExcision of skull tumor
    61570CRemove foreign body, brain
    61571CIncise skull for brain wound
    61575CSkull base/brainstem surgery
    61576CSkull base/brainstem surgery
    61580CCraniofacial approach, skull
    61581CCraniofacial approach, skull
    61582CCraniofacial approach, skull
    61583CCraniofacial approach, skull
    61584COrbitocranial approach/skull
    Start Printed Page 44902
    61585COrbitocranial approach/skull
    61586CResect nasopharynx, skull
    61590CInfratemporal approach/skull
    61591CInfratemporal approach/skull
    61592COrbitocranial approach/skull
    61595CTranstemporal approach/skull
    61596CTranscochlear approach/skull
    61597CTranscondylar approach/skull
    61598CTranspetrosal approach/skull
    61600CResect/excise cranial lesion
    61601CResect/excise cranial lesion
    61605CResect/excise cranial lesion
    61606CResect/excise cranial lesion
    61607CResect/excise cranial lesion
    61608CResect/excise cranial lesion
    61609CTransect artery, sinus
    61610CTransect artery, sinus
    61611CTransect artery, sinus
    61612CTransect artery, sinus
    61613CRemove aneurysm, sinus
    61615CResect/excise lesion, skull
    61616CResect/excise lesion, skull
    61618CRepair dura
    61619CRepair dura
    61624COcclusion/embolization cath
    61626COcclusion/embolization cath
    61680CIntracranial vessel surgery
    61682CIntracranial vessel surgery
    61684CIntracranial vessel surgery
    61686CIntracranial vessel surgery
    61690CIntracranial vessel surgery
    61692CIntracranial vessel surgery
    61697CBrain aneurysm repr, complx
    61698CBrain aneurysm repr, complx
    61700CBrain aneurysm repr , simple
    61702CInner skull vessel surgery
    61703CClamp neck artery
    61705CRevise circulation to head
    61708CRevise circulation to head
    61710CRevise circulation to head
    61711CFusion of skull arteries
    61720CIncise skull/brain surgery
    61735CIncise skull/brain surgery
    61750CIncise skull/brain biopsy
    61751CBrain biopsy w/ ct/mr guide
    61760CImplant brain electrodes
    61770CIncise skull for treatment
    61791CTreat trigeminal tract
    61850CImplant neuroelectrodes
    61860CImplant neuroelectrodes
    61862CImplant neurostimul, subcort
    61870CImplant neuroelectrodes
    61875CImplant neuroelectrodes
    62000CTreat skull fracture
    62005CTreat skull fracture
    62010CTreatment of head injury
    62100CRepair brain fluid leakage
    62115CReduction of skull defect
    62116CReduction of skull defect
    62117CReduction of skull defect
    62120CRepair skull cavity lesion
    62121CIncise skull repair
    62140CRepair of skull defect
    62141CRepair of skull defect
    62142CRemove skull plate/flap
    62143CReplace skull plate/flap
    62145CRepair of skull & brain
    62146CRepair of skull with graft
    62147CRepair of skull with graft
    62180CEstablish brain cavity shunt
    62190CEstablish brain cavity shunt
    62192CEstablish brain cavity shunt
    62200CEstablish brain cavity shunt
    62201CEstablish brain cavity shunt
    62220CEstablish brain cavity shunt
    Start Printed Page 44903
    62223CEstablish brain cavity shunt
    62256CRemove brain cavity shunt
    62258CReplace brain cavity shunt
    62351CImplant spinal canal cath
    63043CLaminotomy, addl cervical
    63044CLaminotomy, addl lumbar
    63075CNeck spine disk surgery
    63076CNeck spine disk surgery
    63077CSpine disk surgery, thorax
    63078CSpine disk surgery, thorax
    63081CRemoval of vertebral body
    63082CRemove vertebral body add-on
    63085CRemoval of vertebral body
    63086CRemove vertebral body add-on
    63087CRemoval of vertebral body
    63088CRemove vertebral body add-on
    63090CRemoval of vertebral body
    63091CRemove vertebral body add-on
    63170CIncise spinal cord tract(s)
    63172CDrainage of spinal cyst
    63173CDrainage of spinal cyst
    63180CRevise spinal cord ligaments
    63182CRevise spinal cord ligaments
    63185CIncise spinal column/nerves
    63190CIncise spinal column/nerves
    63191CIncise spinal column/nerves
    63194CIncise spinal column & cord
    63195CIncise spinal column & cord
    63196CIncise spinal column & cord
    63197CIncise spinal column & cord
    63198CIncise spinal column & cord
    63199CIncise spinal column & cord
    63200CRelease of spinal cord
    63250CRevise spinal cord vessels
    63251CRevise spinal cord vessels
    63252CRevise spinal cord vessels
    63265CExcise intraspinal lesion
    63266CExcise intraspinal lesion
    63267CExcise intraspinal lesion
    63268CExcise intraspinal lesion
    63270CExcise intraspinal lesion
    63271CExcise intraspinal lesion
    63272CExcise intraspinal lesion
    63273CExcise intraspinal lesion
    63275CBiopsy/excise spinal tumor
    63276CBiopsy/excise spinal tumor
    63277CBiopsy/excise spinal tumor
    63278CBiopsy/excise spinal tumor
    63280CBiopsy/excise spinal tumor
    63281CBiopsy/excise spinal tumor
    63282CBiopsy/excise spinal tumor
    63283CBiopsy/excise spinal tumor
    63285CBiopsy/excise spinal tumor
    63286CBiopsy/excise spinal tumor
    63287CBiopsy/excise spinal tumor
    63290CBiopsy/excise spinal tumor
    63300CRemoval of vertebral body
    63301CRemoval of vertebral body
    63302CRemoval of vertebral body
    63303CRemoval of vertebral body
    63304CRemoval of vertebral body
    63305CRemoval of vertebral body
    63306CRemoval of vertebral body
    63307CRemoval of vertebral body
    63308CRemove vertebral body add-on
    63655CImplant neuroelectrodes
    63700CRepair of spinal herniation
    63702CRepair of spinal herniation
    63704CRepair of spinal herniation
    63706CRepair of spinal herniation
    63707CRepair spinal fluid leakage
    63709CRepair spinal fluid leakage
    63710CGraft repair of spine defect
    63740CInstall spinal shunt
    64752CIncision of vagus nerve
    Start Printed Page 44904
    64755CIncision of stomach nerves
    64760CIncision of vagus nerve
    64763CIncise hip/thigh nerve
    64766CIncise hip/thigh nerve
    64802CRemove sympathetic nerves
    64804CRemove sympathetic nerves
    64809CRemove sympathetic nerves
    64818CRemove sympathetic nerves
    64820CRemove sympathetic nerves
    64866CFusion of facial/other nerve
    64868CFusion of facial/other nerve
    65273CRepair of eye wound
    69150CExtensive ear canal surgery
    69155CExtensive ear/neck surgery
    69502CMastoidectomy
    69535CRemove part of temporal bone
    69554CRemove ear lesion
    69950CIncise inner ear nerve
    69970CRemove inner ear lesion
    75900CArterial catheter exchange
    75952CEndovasc repair abdom aorta
    75953CAbdom aneurysm endovas rpr
    92970CCardioassist, internal
    92971CCardioassist, external
    92975CDissolve clot, heart vessel
    92986CRevision of aortic valve
    92987CRevision of mitral valve
    92990CRevision of pulmonary valve
    92992CRevision of heart chamber
    92993CRevision of heart chamber
    92997CPul art balloon repr, percut
    92998CPul art balloon repr, percut
    94652CPressure breathing (ippb)
    99190CSpecial pump services
    99191CSpecial pump services
    99192CSpecial pump services
    99251CInitial inpatient consult
    99252CInitial inpatient consult
    99253CInitial inpatient consult
    99254CInitial inpatient consult
    99255CInitial inpatient consult
    99261CFollow-up inpatient consult
    99262CFollow-up inpatient consult
    99263CFollow-up inpatient consult
    99295CNeonatal critical care
    99296CNeonatal critical care
    99297CNeonatal critical care
    99298CNeonatal critical care
    99356CProlonged service, inpatient
    99357CProlonged service, inpatient
    99433CNormal newborn care/hospital
    CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    Copyright American Dental Association. All rights reserved.
          Start Printed Page 44904

    Addendum H.—Wage Index for Urban Areas

    Urban area (constituent counties)Wage index
    0040 Abilene, TX0.8118
    Taylor, TX
    0060 Aguadilla, PR0.4738
    Aguada, PR
    Aguadilla, PR
    Moca, PR
    0080 Akron, OH0.9924
    Portage, OH
    Summit, OH
    0120 Albany, GA1.0675
    Dougherty, GA
    Lee, GA
    0160 Albany-Schenectady-Troy, NY0.8597
    Albany, NY
    Montgomery, NY
    Rensselaer, NY
    Saratoga, NY
    Schenectady, NY
    Schoharie, NY
    0200 Albuquerque, NM0.9855
    Bernalillo, NM
    Sandoval, NM
    Valencia, NM
    0220 Alexandria, LA0.8137
    Rapides, LA
    0240 Allentown-Bethlehem-Easton, PA0.9443
    Carbon, PA
    Lehigh, PA
    Northampton, PA
    0280 Altoona, PA0.9225
    Blair, PA
    0320 Amarillo, TX0.8706
    Potter, TX
    Randall, TX
    0380 Anchorage, AK1.2605
    Anchorage, AK
    0440 Ann Arbor, MI1.1220
    Lenawee, MI
    Livingston, MI
    Start Printed Page 44905
    Washtenaw, MI
    0450 Anniston, AL0.8360
    Calhoun, AL
    0460 Appleton-Oshkosh-Neenah, WI0.9203
    Calumet, WI
    Outagamie, WI
    Winnebago, WI
    0470 Arecibo, PR0.4683
    Arecibo, PR
    Camuy, PR
    Hatillo, PR
    0480 Asheville, NC0.9307
    Buncombe, NC
    Madison, NC
    0500 Athens, GA0.9956
    Clarke, GA
    Madison, GA
    Oconee, GA
    0520 1 Atlanta, GA1.0176
    Barrow, GA
    Bartow, GA
    Carroll, GA
    Cherokee, GA
    Clayton, GA
    Cobb, GA
    Coweta, GA
    DeKalb, GA
    Douglas, GA
    Fayette, GA
    Forsyth, GA
    Fulton, GA
    Gwinnett, GA
    Henry, GA
    Newton, GA
    Paulding, GA
    Pickens, GA
    Rockdale, GA
    Spalding, GA
    Walton, GA
    0560 Atlantic-Cape May, NJ1.1349
    Atlantic, NJ
    Cape May, NJ
    0580 Auburn-Opelika, AL0.8325
    Lee, AL
    0600 Augusta-Aiken, GA-SC1.0090
    Columbia, GA
    McDuffie, GA
    Richmond, GA
    Aiken, SC
    Edgefield, SC
    0640 1 Austin-San Marcos, TX0.9327
    Bastrop, TX
    Caldwell, TX
    Hays, TX
    Travis, TX
    Williamson, TX
    0680 2 Bakersfield, CA0.9870
    Kern, CA
    0720 1 Baltimore, MD0.9723
    Anne Arundel, MD
    Baltimore, MD
    Baltimore City, MD
    Carroll, MD
    Harford, MD
    Howard, MD
    Queen Anne's, MD
    0733 Bangor, ME0.9559
    Penobscot, ME
    0743 Barnstable-Yarmouth, MA1.3539
    Barnstable, MA
    0760 Baton Rouge, LA0.8258
    Ascension, LA
    East Baton Rouge, LA
    Livingston, LA
    West Baton Rouge, LA
    0840 Beaumont-Port Arthur, TX0.8508
    Hardin, TX
    Jefferson, TX
    Orange, TX
    0860 Bellingham, WA1.1963
    Whatcom, WA
    0870 2 Benton Harbor, MI0.9115
    Berrien, MI
    0875 1 Bergen-Passaic, NJ1.1669
    Bergen, NJ
    Passaic, NJ
    0880 Billings, MT0.9623
    Yellowstone, MT
    0920 Biloxi-Gulfport-Pascagoula, MS0.8538
    Hancock, MS
    Harrison, MS
    Jackson, MS
    0960 Binghamton, NY0.8595
    Broome, NY
    Tioga, NY
    1000 Birmingham, AL0.8648
    Blount, AL
    Jefferson, AL
    St. Clair, AL
    Shelby, AL
    1010 2 Bismarck, ND0.7965
    Burleigh, ND
    Morton, ND
    1020 2 Bloomington, IN0.8757
    Monroe, IN
    1040 Bloomington-Normal, IL0.8545
    McLean, IL
    1080 Boise City, ID0.9190
    Ada, ID
    Canyon, ID
    1123 1,2 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (MA Hospitals)1.1586
    Bristol, MA
    Essex, MA
    Middlesex, MA
    Norfolk, MA
    Plymouth, MA
    Suffolk, MA
    Worcester, MA
    Hillsborough, NH
    Merrimack, NH
    Rockingham, NH
    Strafford, NH
    1123 1 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH Hospitals)1.1483
    Bristol, MA
    Essex, MA
    Middlesex, MA
    Norfolk, MA
    Plymouth, MA
    Suffolk, MA
    Worcester, MA
    Hillsborough, NH
    Merrimack, NH
    Rockingham, NH
    Strafford, NH
    1125 Boulder-Longmont, CO0.9836
    Boulder, CO
    1145 Brazoria, TX0.8299
    Brazoria, TX
    1150 Bremerton, WA1.0882
    Kitsap, WA
    1240 Brownsville-Harlingen-San Benito, TX0.8783
    Cameron, TX
    1260 Bryan-College Station, TX0.9296
    Brazos, TX
    1280 1 Buffalo-Niagara Falls, NY0.9405
    Erie, NY
    Niagara, NY
    1303 Burlington, VT0.9826
    Chittenden, VT
    Franklin, VT
    Grand Isle, VT
    1310 Caguas, PR0.5158
    Caguas, PR
    Cayey, PR
    Cidra, PR
    Gurabo, PR
    San Lorenzo, PR
    1320 Canton-Massillon, OH0.9059
    Carroll, OH
    Stark, OH
    1350 Casper, WY0.9606
    Natrona, WY
    1360 Cedar Rapids, IA0.8711
    Linn, IA
    1400 Champaign-Urbana, IL0.9264
    Champaign, IL
    1440 Charleston-North Charleston, SC0.9293
    Berkeley, SC
    Charleston, SC
    Dorchester, SC
    1480 Charleston, WV0.9369
    Kanawha, WV
    Putnam, WV
    1520 1 Charlotte-Gastonia-Rock Hill, NC-SC0.9469
    Cabarrus, NC
    Gaston, NC
    Lincoln, NC
    Mecklenburg, NC
    Rowan, NC
    Stanly, NC
    Union, NC
    York, SC
    1540 Charlottesville, VA1.0688
    Albemarle, VA
    Charlottesville City, VA
    Fluvanna, VA
    Greene, VA
    1560 Chattanooga, TN-GA0.9446
    Catoosa, GA
    Dade, GA
    Walker, GA
    Hamilton, TN
    Marion, TN
    1580 2 Cheyenne, WY0.8855
    Laramie, WY
    1600 1 Chicago, IL1.1011
    Cook, IL
    DeKalb, IL
    DuPage, IL
    Grundy, IL
    Kane, IL
    Start Printed Page 44906
    Kendall, IL
    Lake, IL
    McHenry, IL
    Will, IL
    1620 Chico-Paradise, CA0.9909
    Butte, CA
    1640 1 Cincinnati, OH-KY-IN0.9574
    Dearborn, IN
    Ohio, IN
    Boone, KY
    Campbell, KY
    Gallatin, KY
    Grant, KY
    Kenton, KY
    Pendleton, KY
    Brown, OH
    Clermont, OH
    Hamilton, OH
    Warren, OH
    1660 Clarksville-Hopkinsville, TN-KY0.8481
    Christian, KY
    Montgomery, TN
    1680 1 Cleveland-Lorain-Elyria, OH0.9496
    Ashtabula, OH
    Cuyahoga, OH
    Geauga, OH
    Lake, OH
    Lorain, OH
    Medina, OH
    1720 Colorado Springs, CO0.9754
    El Paso, CO
    1740 Columbia, MO0.8787
    Boone, MO
    1760 Columbia, SC0.9589
    Lexington, SC
    Richland, SC
    1800 Columbus, GA-AL Russell, AL0.8471
    Chattahoochee, GA
    Harris, GA
    Muscogee, GA
    1840 1 Columbus, OH0.9724
    Delaware, OH
    Fairfield, OH
    Franklin, OH
    Licking, OH
    Madison, OH
    Pickaway, OH
    1880 Corpus Christi, TX0.8203
    Nueces, TX
    San Patricio, TX
    1890 Corvallis, OR1.1781
    Benton, OR
    1900 2 Cumberland, MD-WV (MD Hospitals)0.8962
    Allegany, MD
    Mineral, WV
    1900 Cumberland, MD-WV (WV Hospital)0.8402
    Allegany, MD
    Mineral, WV
    1920 1 Dallas, TX0.9506
    Collin, TX
    Dallas, TX
    Denton, TX
    Ellis, TX
    Henderson, TX
    Hunt, TX
    Kaufman, TX
    Rockwall, TX
    1950 Danville, VA0.8641
    Danville City, VA
    Pittsylvania, VA
    1960 Davenport-Moline-Rock Island, IA-IL0.8790
    Scott, IA
    Henry, IL
    Rock Island, IL
    2000 Dayton-Springfield, OH0.9323
    Clark, OH
    Greene, OH
    Miami, OH
    Montgomery, OH
    2020 Daytona Beach, FL0.9069
    Flagler, FL
    Volusia, FL
    2030 Decatur, AL0.8817
    Lawrence, AL
    Morgan, AL
    2040 2 Decatur, IL0.8140
    Macon, IL
    2080 1 Denver, CO1.0289
    Adams, CO
    Arapahoe, CO
    Denver, CO
    Douglas, CO
    Jefferson, CO
    2120 Des Moines, IA0.8881
    Dallas, IA
    Polk, IA
    Warren, IA
    2160 1 Detroit, MI1.0478
    Lapeer, MI
    Macomb, MI
    Monroe, MI
    Oakland, MI
    St. Clair, MI
    Wayne, MI
    2180 Dothan, AL0.8005
    Dale, AL
    Houston, AL
    2190 Dover, DE1.0453
    Kent, DE
    2200 Dubuque, IA0.8617
    Dubuque, IA
    2240 Duluth-Superior, MN-WI1.0401
    St. Louis, MN
    Douglas, WI
    2281 Dutchess County, NY1.0639
    Dutchess, NY
    2290 2 Eau Claire, WI0.9121
    Chippewa, WI
    Eau Claire, WI
    2320 El Paso, TX0.9162
    El Paso, TX
    2330 Elkhart-Goshen, IN0.9646
    Elkhart, IN
    2335 Elmira, NY0.8530
    Chemung, NY
    2340 Enid, OK0.8454
    Garfield, OK
    2360 Erie, PA0.8911
    Erie, PA
    2400 Eugene-Springfield, OR1.1485
    Lane, OR
    2440 2 Evansville-Henderson, IN-KY (IN Hospitals)0.8757
    Posey, IN
    Vanderburgh, IN
    Warrick, IN
    Henderson, KY
    2440 2 Evansville-Henderson, IN-KY (KY Hospitals)0.8019
    Posey, IN
    Vanderburgh, IN
    Warrick, IN
    Henderson, KY
    2520 Fargo-Moorhead, ND-MN0.9374
    Clay, MN
    Cass, ND
    2560 Fayetteville, NC0.9132
    Cumberland, NC
    2580 Fayetteville-Springdale-Rogers, AR0.7587
    Benton, AR
    Washington, AR
    2620 Flagstaff, AZ-UT1.0678
    Coconino, AZ
    Kane, UT
    2640 Flint, MI1.0920
    Genesee, MI
    2650 Florence, AL0.7927
    Colbert, AL
    Lauderdale, AL
    2655 Florence, SC0.8843
    Florence, SC
    2670 Fort Collins-Loveland, CO1.0161
    Larimer, CO
    2680 1 Ft. Lauderdale, FL1.0906
    Broward, FL
    2700 Fort Myers-Cape Coral, FL0.9380
    Lee, FL
    2710 Fort Pierce-Port St. Lucie, FL1.0067
    Martin, FL
    St. Lucie, FL
    2720 Fort Smith, AR-OK0.8076
    Crawford, AR
    Sebastian, AR
    Sequoyah, OK
    2750 2 Fort Walton Beach, FL0.8733
    Okaloosa, FL
    2760 Fort Wayne, IN0.9186
    Adams, IN
    Allen, IN
    De Kalb, IN
    Huntington, IN
    Wells, IN
    Whitley, IN
    2800 1 Fort Worth-Arlington, TX0.9452
    Hood, TX
    Johnson, TX
    Parker, TX
    Tarrant, TX
    2840 Fresno, CA0.9972
    Fresno, CA
    Madera, CA
    2880 Gadsden, AL0.8845
    Etowah, AL
    2900 Gainesville, FL1.2133
    Alachua, FL
    2920 Galveston-Texas City, TX1.0271
    Galveston, TX
    2960 Gary, IN0.9571
    Lake, IN
    Porter, IN
    2975 2 Glens Falls, NY0.8530
    Warren, NY
    Start Printed Page 44907
    Washington, NY
    2980 Goldsboro, NC0.8810
    Wayne, NC
    2985 Grand Forks, ND-MN0.9173
    Polk, MN
    Grand Forks, ND
    2995 Grand Junction, CO0.9816
    Mesa, CO
    3000 1 Grand Rapids-Muskegon-Holland, MI1.0161
    Allegan, MI
    Kent, MI
    Muskegon, MI
    Ottawa, MI
    3040 Great Falls, MT0.9301
    Cascade, MT
    3060 Greeley, CO0.9604
    Weld, CO
    3080 Green Bay, WI0.9440
    Brown, WI
    3120 1 Greensboro-Winston-Salem-High Point, NC0.9616
    Alamance, NC
    Davidson, NC
    Davie, NC
    Forsyth, NC
    Guilford, NC
    Randolph, NC
    Stokes, NC
    Yadkin, NC
    3150 Greenville, NC0.9963
    Pitt, NC
    3160 Greenville-Spartanburg-Anderson, SC0.9110
    Anderson, SC
    Cherokee, SC
    Greenville, SC
    Pickens, SC
    Spartanburg, SC
    3180 2 Hagerstown, MD0.8962
    Washington, MD
    3200 Hamilton-Middletown, OH0.9269
    Butler, OH
    3240 Harrisburg-Lebanon-Carlisle, PA0.9311
    Cumberland, PA
    Dauphin, PA
    Lebanon, PA
    Perry, PA
    3283 1,2 Hartford, CT1.2357
    Hartford, CT
    Litchfield, CT
    Middlesex, CT
    Tolland, CT
    3285 2 Hattiesburg, MS0.7612
    Forrest, MS
    Lamar, MS
    3290 Hickory-Morganton-Lenoir, NC0.9517
    Alexander, NC
    Burke, NC
    Caldwell, NC
    Catawba, NC
    3320 Honolulu, HI1.1658
    Honolulu, HI
    3350 Houma, LA0.8043
    Lafourche, LA
    Terrebonne, LA
    3360 1 Houston, TX0.9604
    Chambers, TX
    Fort Bend, TX
    Harris, TX
    Liberty, TX
    Montgomery, TX
    Waller, TX
    3400 Huntington-Ashland, WV-KY-OH0.9700
    Boyd, KY
    Carter, KY
    Greenup, KY
    Lawrence, OH
    Cabell, WV
    Wayne, WV
    3440 Huntsville, AL0.8854
    Limestone, AL
    Madison, AL
    3480 1 Indianapolis, IN0.9771
    Boone, IN
    Hamilton, IN
    Hancock, IN
    Hendricks, IN
    Johnson, IN
    Madison, IN
    Marion, IN
    Morgan, IN
    Shelby, IN
    3500 Iowa City, IA0.9973
    Johnson, IA
    3520 Jackson, MI0.9387
    Jackson, MI
    3560 Jackson, MS0.8589
    Hinds, MS
    Madison, MS
    Rankin, MS
    3580 Jackson, TN0.9117
    Madison, TN
    Chester, TN
    3600 1 Jacksonville, FL0.9040
    Clay, FL
    Duval, FL
    Nassau, FL
    St. Johns, FL
    3605 2 Jacksonville, NC0.8632
    Onslow, NC
    3610 2 Jamestown, NY0.8530
    Chautauqua, NY
    3620 Janesville-Beloit, WI0.9840
    Rock, WI
    3640 Jersey City, NJ1.1216
    Hudson, NJ
    3660 Johnson City-Kingsport-Bristol, TN-VA0.8540
    Carter, TN
    Hawkins, TN
    Sullivan, TN
    Unicoi, TN
    Washington, TN
    Bristol City, VA
    Scott, VA
    Washington, VA
    3680 Johnstown, PA0.8959
    Cambria, PA
    Somerset, PA
    3700 Jonesboro, AR0.8523
    Craighead, AR
    3710 Joplin, MO0.8736
    Jasper, MO
    Newton, MO
    3720 Kalamazoo-Battlecreek, MI1.0696
    Calhoun, MI
    Kalamazoo, MI
    Van Buren, MI
    3740 Kankakee, IL0.9268
    Kankakee, IL
    3760 1 Kansas City, KS-MO0.9430
    Johnson, KS
    Leavenworth, KS
    Miami, KS
    Wyandotte, KS
    Cass, MO
    Clay, MO
    Clinton, MO
    Jackson, MO
    Lafayette, MO
    Platte, MO
    Ray, MO
    3800 Kenosha, WI0.9678
    Kenosha, WI
    3810 2 Killeen-Temple, TX0.7673
    Bell, TX
    Coryell, TX
    3840 Knoxville, TN0.8904
    Anderson, TN
    Blount, TN
    Knox, TN
    Loudon, TN
    Sevier, TN
    Union, TN
    3850 Kokomo, IN0.9290
    Howard, IN
    Tipton, IN
    3870 La Crosse, WI-MN0.9328
    Houston, MN
    La Crosse, WI
    3880 Lafayette, LA0.8600
    Acadia, LA
    Lafayette, LA
    St. Landry, LA
    St. Martin, LA
    3920 Lafayette, IN0.9165
    Clinton, IN
    Tippecanoe, IN
    3960 Lake Charles, LA0.7810
    Calcasieu, LA
    3980 Lakeland-Winter Haven, FL0.9167
    Polk, FL
    4000 Lancaster, PA0.9413
    Lancaster, PA
    4040 Lansing-East Lansing, MI0.9653
    Clinton, MI
    Eaton, MI
    Ingham, MI
    4080 Laredo, TX0.7877
    Webb, TX
    4100 2 Las Cruces, NM0.8835
    Dona Ana, NM
    4120 1 Las Vegas, NV-AZ1.1238
    Mohave, AZ
    Clark, NV
    Nye, NV
    4150 Lawrence, KS0.8756
    Douglas, KS
    4200 Lawton, OK0.8783
    Comanche, OK
    4243 Lewiston-Auburn, ME0.9451
    Androscoggin, ME
    4280 Lexington, KY0.8850
    Bourbon, KY
    Clark, KY
    Fayette, KY
    Start Printed Page 44908
    Jessamine, KY
    Madison, KY
    Scott, KY
    Woodford, KY
    4320 Lima, OH0.9558
    Allen, OH
    Auglaize, OH
    4360 Lincoln, NE1.0272
    Lancaster, NE
    4400 Little Rock-North Little Rock, AR0.9053
    Faulkner, AR
    Lonoke, AR
    Pulaski, AR
    Saline, AR
    4420 Longview-Marshall, TX0.8439
    Gregg, TX
    Harrison, TX
    Upshur, TX
    4480 1 Los Angeles-Long Beach, CA1.2071
    Los Angeles, CA
    4520 1 Louisville, KY-IN0.9596
    Clark, IN
    Floyd, IN
    Harrison, IN
    Scott, IN
    Bullitt, KY
    Jefferson, KY
    Oldham, KY
    4600 Lubbock, TX0.8547
    Lubbock, TX
    4640 Lynchburg, VA0.9208
    Amherst, VA
    Bedford, VA
    Bedford City, VA
    Campbell, VA
    Lynchburg City, VA
    4680 Macon, GA0.9077
    Bibb, GA
    Houston, GA
    Jones, GA
    Peach, GA
    Twiggs, GA
    4720 Madison, WI1.0462
    Dane, WI
    4800 Mansfield, OH0.8827
    Crawford, OH
    Richland, OH
    4840 Mayaguez, PR0.4917
    Anasco, PR
    Cabo Rojo, PR
    Hormigueros, PR
    Mayaguez, PR
    Sabana Grande, PR
    San German, PR
    4880 McAllen-Edinburg-Mission, TX0.8433
    Hidalgo, TX
    4890 Medford-Ashland, OR1.0433
    Jackson, OR
    4900 Melbourne-Titusville-Palm Bay, FL0.9883
    Brevard, FL
    4920 1 Memphis, TN-AR-MS0.9435
    Crittenden, AR
    DeSoto, MS
    Fayette, TN
    Shelby, TN
    Tipton, TN
    4940 Merced, CA0.9870
    Merced, CA
    5000 1 Miami, FL0.9934
    Dade, FL
    5015 1 Middlesex-Somerset-Hunterdon, NJ1.1952
    Hunterdon, NJ
    Middlesex, NJ
    Somerset, NJ
    5080 1 Milwaukee-Waukesha, WI0.9898
    Milwaukee, WI
    Ozaukee, WI
    Washington, WI
    Waukesha, WI
    5120 1 Minneapolis-St. Paul, MN-WI1.1000
    Anoka, MN
    Carver, MN
    Chisago, MN
    Dakota, MN
    Hennepin, MN
    Isanti, MN
    Ramsey, MN
    Scott, MN
    Sherburne, MN
    Washington, MN
    Wright, MN
    Pierce, WI
    St. Croix, WI
    5140 Missoula, MT0.9453
    Missoula, MT
    5160 Mobile, AL0.7766
    Baldwin, AL
    Mobile, AL
    5170 Modesto, CA1.0945
    Stanislaus, CA
    5190 1 Monmouth-Ocean, NJ1.1514
    Monmouth, NJ
    Ocean, NJ
    5200 Monroe, LA0.8296
    Ouachita, LA
    5240 Montgomery, AL0.7502
    Autauga, AL
    Elmore, AL
    Montgomery, AL
    5280 Muncie, IN0.9689
    Delaware, IN
    5330 Myrtle Beach, SC0.8855
    Horry, SC
    5345 Naples, FL0.9566
    Collier, FL
    5360 1 Nashville, TN0.9602
    Cheatham, TN
    Davidson, TN
    Dickson, TN
    Robertson, TN
    Rutherford, TN
    Sumner, TN
    Williamson, TN
    Wilson, TN
    5380 1 Nassau-Suffolk, NY1.3841
    Nassau, NY
    Suffolk, NY
    5483 1,2 New Haven-Bridgeport-Stamford-Waterbury1.2357
    Danbury, CT
    Fairfield, CT
    New Haven, CT
    5523 2 New London-Norwich, CT1.2357
    New London, CT
    5560 1 New Orleans, LA0.9054
    Jefferson, LA
    Orleans, LA
    Plaquemines, LA
    St. Bernard, LA
    St. Charles, LA
    St. James, LA
    St. John The Baptist, LA
    St. Tammany, LA
    5600 1 New York, NY1.3923
    Bronx, NY
    Kings, NY
    New York, NY
    Putnam, NY
    Queens, NY
    Richmond, NY
    Rockland, NY
    Westchester, NY
    5640 1 Newark, NJ1.2004
    Essex, NJ
    Morris, NJ
    Sussex, NJ
    Union, NJ
    Warren, NJ
    5660 Newburgh, NY-PA1.1235
    Orange, NY
    Pike, PA
    5720 1 Norfolk-Virginia Beach-Newport News, VA-NC0.8630
    Currituck, NC
    Chesapeake City, VA
    Gloucester, VA
    Hampton City, VA
    Isle of Wight, VA
    James City, VA
    Mathews, VA
    Newport News City, VA
    Norfolk City, VA
    Poquoson City, VA
    Portsmouth City, VA
    Suffolk City, VA
    Virginia Beach City, VA
    Williamsburg City, VA
    York, VA
    5775 1 Oakland, CA1.5416
    Alameda, CA
    Contra Costa, CA
    5790 Ocala, FL0.9579
    Marion, FL
    5800 Odessa-Midland, TX0.9017
    Ector, TX
    Midland, TX
    5880 1 Oklahoma City, OK0.8728
    Canadian, OK
    Cleveland, OK
    Logan, OK
    McClain, OK
    Oklahoma, OK
    Pottawatomie, OK
    5910 Olympia, WA1.1481
    Thurston, WA
    5920 Omaha, NE-IA0.9696
    Pottawattamie, IA
    Cass, NE
    Douglas, NE
    Sarpy, NE
    Washington, NE
    5945 1 Orange County, CA1.1354
    Orange, CA
    5960 1 Orlando, FL0.9464
    Start Printed Page 44909
    Lake, FL
    Orange, FL
    Osceola, FL
    Seminole, FL
    5990 Owensboro, KY0.8346
    Daviess, KY
    6015 Panama City, FL0.9166
    Bay, FL
    6020 Parkersburg-Marietta, WV-OH (WV Hospitals)0.8192
    Washington, OH
    Wood, WV
    6020 2 Parkersburg-Marietta, WV-OH (OH Hospitals)0.8761
    Washington, OH
    Wood, WV
    6080 2 Pensacola, FL0.8733
    Escambia, FL
    Santa Rosa, FL
    6120 Peoria-Pekin, IL0.8883
    Peoria, IL
    Tazewell, IL
    Woodford, IL
    6160 1 Philadelphia, PA-NJ1.0626
    Burlington, NJ
    Camden, NJ
    Gloucester, NJ
    Salem, NJ
    Bucks, PA
    Chester, PA
    Delaware, PA
    Montgomery, PA
    Philadelphia, PA
    6200 1 Phoenix-Mesa, AZ0.9654
    Maricopa, AZ
    Pinal, AZ
    6240 Pine Bluff, AR0.7837
    Jefferson, AR
    6280 1 Pittsburgh, PA0.9714
    Allegheny, PA
    Beaver, PA
    Butler, PA
    Fayette, PA
    Washington, PA
    Westmoreland, PA
    6323 2 Pittsfield, MA1.1586
    Berkshire, MA
    6340 Pocatello, ID0.9557
    Bannock, ID
    6360 Ponce, PR0.5278
    Guayanilla, PR
    Juana Diaz, PR
    Penuelas, PR
    Ponce, PR
    Villalba, PR
    Yauco, PR
    6403 Portland, ME0.9501
    Cumberland, ME
    Sagadahoc, ME
    York, ME
    6440 1 Portland-Vancouver, OR-WA1.1291
    Clackamas, OR
    Columbia, OR
    Multnomah, OR
    Washington, OR
    Yamhill, OR
    Clark, WA
    6483 1 Providence-Warwick-Pawtucket, RI1.0781
    Bristol, RI
    Kent, RI
    Newport, RI
    Providence, RI
    Washington, RI
    6520 Provo-Orem, UT0.9967
    Utah, UT
    6560 2 Pueblo, CO0.8909
    Pueblo, CO
    6580 Punta Gorda, FL0.8818
    Charlotte, FL
    6600 Racine, WI0.9441
    Racine, WI
    6640 1 Raleigh-Durham-Chapel Hill, NC0.9901
    Chatham, NC
    Durham, NC
    Franklin, NC
    Johnston, NC
    Orange, NC
    Wake, NC
    6660 Rapid City, SD0.8971
    Pennington, SD
    6680 2 Reading, PA0.8473
    Berks, PA
    6690 Redding, CA1.1222
    Shasta, CA
    6720 Reno, NV1.0456
    Washoe, NV
    6740 Richland-Kennewick-Pasco, WA1.1086
    Benton, WA
    Franklin, WA
    6760 Richmond-Petersburg, VA0.9712
    Charles City County, VA
    Chesterfield, VA
    Colonial Heights City, VA
    Dinwiddie, VA
    Goochland, VA
    Hanover, VA
    Henrico, VA
    Hopewell City, VA
    New Kent, VA
    Petersburg City, VA
    Powhatan, VA
    Prince George, VA
    Richmond City, VA
    6780 1 Riverside-San Bernardino, CA1.1012
    Riverside, CA
    San Bernardino, CA
    6800 2 Roanoke, VA0.8473
    Botetourt, VA
    Roanoke, VA
    Roanoke City, VA
    Salem City, VA
    6820 Rochester, MN1.1595
    Olmsted, MN
    6840 1 Rochester, NY0.9238
    Genesee, NY
    Livingston, NY
    Monroe, NY
    Ontario, NY
    Orleans, NY
    Wayne, NY
    6880 Rockford, IL0.9194
    Boone, IL
    Ogle, IL
    Winnebago, IL
    6895 Rocky Mount, NC0.9197
    Edgecombe, NC
    Nash, NC
    6920 1 Sacramento, CA1.1809
    El Dorado, CA
    Placer, CA
    Sacramento, CA
    6960 Saginaw-Bay City-Midland, MI0.9662
    Bay, MI
    Midland, MI
    Saginaw, MI
    6980 St. Cloud, MN1.0040
    Benton, MN
    Stearns, MN
    7000 St. Joseph, MO0.9113
    Andrew, MO
    Buchanan, MO
    7040 1 St. Louis, MO-IL0.9024
    Clinton, IL
    Jersey, IL
    Madison, IL
    Monroe, IL
    St. Clair, IL
    Franklin, MO
    Jefferson, MO
    Lincoln, MO
    St. Charles, MO
    St. Louis, MO
    St. Louis City, MO
    Warren, MO
    7080 2 Salem, OR1.0156
    Marion, OR
    Polk, OR
    7120 Salinas, CA1.4854
    Monterey, CA
    7160 1 Salt Lake City-Ogden, UT0.9976
    Davis, UT
    Salt Lake, UT
    Weber, UT
    7200 San Angelo, TX0.8288
    Tom Green, TX
    7240 1 San Antonio, TX0.8333
    Bexar, TX
    Comal, TX
    Guadalupe, TX
    Wilson, TX
    7320 1 San Diego, CA1.1480
    San Diego, CA
    7360 1 San Francisco, CA1.4319
    Marin, CA
    San Francisco, CA
    San Mateo, CA
    7400 1 San Jose, CA1.4249
    Santa Clara, CA
    7440 1 San Juan-Bayamon, PR0.4812
    Aguas Buenas, PR
    Barceloneta, PR
    Bayamon, PR
    Canovanas, PR
    Carolina, PR
    Catano, PR
    Ceiba, PR
    Comerio, PR
    Corozal, PR
    Dorado, PR
    Fajardo, PR
    Florida, PR
    Guaynabo, PR
    Humacao, PR
    Juncos, PR
    Start Printed Page 44910
    Los Piedras, PR
    Loiza, PR
    Luguillo, PR
    Manati, PR
    Morovis, PR
    Naguabo, PR
    Naranjito, PR
    Rio Grande, PR
    San Juan, PR
    Toa Alta, PR
    Toa Baja, PR
    Trujillo Alto, PR
    Vega Alta, PR
    Vega Baja, PR
    Yabucoa, PR
    7460 San Luis Obispo-Atascadero-Paso Robles, CA1.1117
    San Luis Obispo, CA
    7480 Santa Barbara-Santa Maria-Lompoc, CA1.0927
    Santa Barbara, CA
    7485 Santa Cruz-Watsonville, CA1.4049
    Santa Cruz, CA
    7490 Santa Fe, NM1.0312
    Los Alamos, NM
    Santa Fe, NM
    7500 Santa Rosa, CA1.2727
    Sonoma, CA
    7510 Sarasota-Bradenton, FL1.0118
    Manatee, FL
    Sarasota, FL
    7520 Savannah, GA0.9349
    Bryan, GA
    Chatham, GA
    Effingham, GA
    7560 2 Scranton-Wilkes-Barre-Hazleton, PA0.8473
    Columbia, PA
    Lackawanna, PA
    Luzerne, PA
    Wyoming, PA
    7600 1 Seattle-Bellevue-Everett, WA1.1056
    Island, WA
    King, WA
    Snohomish, WA
    7610 2 Sharon, PA0.8473
    Mercer, PA
    7620 2 Sheboygan, WI0.9121
    Sheboygan, WI
    7640 Sherman-Denison, TX0.9163
    Grayson, TX
    7680 Shreveport-Bossier City, LA0.9165
    Bossier, LA
    Caddo, LA
    Webster, LA
    7720 Sioux City, IA-NE0.8868
    Woodbury, IA
    Dakota, NE
    7760 Sioux Falls, SD0.9245
    Lincoln, SD
    Minnehaha, SD
    7800 South Bend, IN1.0303
    St. Joseph, IN
    7840 Spokane, WA1.0791
    Spokane, WA
    7880 Springfield, IL0.8502
    Menard, IL
    Sangamon, IL
    7920 Springfield, MO0.8666
    Christian, MO
    Greene, MO
    Webster, MO
    8003 2 Springfield, MA1.1586
    Hampden, MA
    Hampshire, MA
    8050 State College, PA0.9239
    Centre, PA
    8080 2 Steubenville-Weirton, OH-WV (OH Hospitals)0.8761
    Jefferson, OH
    Brooke, WV
    Hancock, WV
    8080 Steubenville-Weirton, OH-WV (WV Hospitals)0.8737
    Jefferson, OH
    Brooke, WV
    Hancock, WV
    8120 Stockton-Lodi, CA1.1114
    San Joaquin, CA
    8140 2 Sumter, SC0.8606
    Sumter, SC
    8160 Syracuse, NY0.9247
    Cayuga, NY
    Madison, NY
    Onondaga, NY
    Oswego, NY
    8200 Tacoma, WA1.1751
    Pierce, WA
    8240 2 Tallahassee, FL0.8733
    Gadsden, FL
    Leon, FL
    8280 1 Tampa-St. Petersburg-Clearwater, FL0.9095
    Hernando, FL
    Hillsborough, FL
    Pasco, FL
    Pinellas, FL
    8320 2 Terre Haute, IN0.8757
    Clay, IN
    Vermillion, IN
    Vigo, IN
    8360 Texarkana, AR—Texarkana, TX0.8414
    Miller, AR
    Bowie, TX
    8400 Toledo, OH0.9815
    Fulton, OH
    Lucas, OH
    Wood, OH
    8440 Topeka, KS0.9015
    Shawnee, KS
    8480 Trenton, NJ1.0172
    Mercer, NJ
    8520 Tucson, AZ0.9002
    Pima, AZ
    8560 Tulsa, OK0.8949
    Creek, OK
    Osage, OK
    Rogers, OK
    Tulsa, OK
    Wagoner, OK
    8600 Tuscaloosa, AL0.8265
    Tuscaloosa, AL
    8640 Tyler, TX0.9109
    Smith, TX
    8680 2 Utica-Rome, NY0.8530
    Herkimer, NY
    Oneida, NY
    8720 Vallejo-Fairfield-Napa, CA1.3535
    Napa, CA
    Solano, CA
    8735 Ventura, CA1.1088
    Ventura, CA
    8750 Victoria, TX0.8354
    Victoria, TX
    8760 Vineland-Millville-Bridgeton, NJ1.0473
    Cumberland, NJ
    8780 2 Visalia-Tulare-Porterville, CA0.9870
    Tulare, CA
    8800 Waco, TX0.8268
    McLennan, TX
    8840 1 Washington, DC-MD-VA-WV1.1176
    District of Columbia, DC
    Calvert, MD
    Charles, MD
    Frederick, MD
    Montgomery, MD
    Prince Georges, MD
    Alexandria City, VA
    Arlington, VA
    Clarke, VA
    Culpeper, VA
    Fairfax, VA
    Fairfax City, VA
    Falls Church City, VA
    Fauquier, VA
    Fredericksburg City, VA
    King George, VA
    Loudoun, VA
    Manassas City, VA
    Manassas Park City, VA
    Prince William, VA
    Spotsylvania, VA
    Stafford, VA
    Warren, VA
    Berkeley, WV
    Jefferson, WV
    8920 Waterloo-Cedar Falls, IA0.8608
    Black Hawk, IA
    8940 Wausau, WI0.9516
    Marathon, WI
    8960 1 West Palm Beach-Boca Raton, FL0.9785
    Palm Beach, FL
    9000 2 Wheeling, WV-OH (WV Hospitals)0.8145
    Belmont, OH
    Marshall, WV
    Ohio, WV
    9000 2 Wheeling, WV-OH (OH Hospitals)0.8761
    Belmont, OH
    Marshall, WV
    Ohio, WV
    9040 Wichita, KS0.9541
    Butler, KS
    Harvey, KS
    Sedgwick, KS
    9080 Wichita Falls, TX0.8015
    Archer, TX
    Wichita, TX
    9140 Williamsport, PA0.8503
    Lycoming, PA
    9160 Wilmington-Newark, DE-MD1.0757
    New Castle, DE
    Start Printed Page 44911
    Cecil, MD
    9200 Wilmington, NC0.9971
    New Hanover, NC
    Brunswick, NC
    9260 Yakima, WA1.0690
    Yakima, WA
    9270 2 Yolo, CA0.9870
    Yolo, CA
    9280 2 York, PA0.8473
    York, PA
    9320 Youngstown-Warren, OH0.9480
    Columbiana, OH
    Mahoning, OH
    Trumbull, OH
    9340 Yuba City, CA1.0479
    Sutter, CA
    Yuba, CA
    9360 Yuma, AZ0.8904
    Yuma, AZ
    1 Large Urban Area.
    2 Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2002.

    Addendum I.—Wage Index for Rural Areas

    Nonurban areaWage index
    Alabama0.7483
    Alaska1.2006
    Arizona0.8747
    Arkansas0.7561
    California0.9870
    Colorado0.8909
    Connecticut1.2357
    Delaware0.9487
    Florida0.8733
    Georgia0.8341
    Hawaii1.1235
    Idaho0.8820
    Illinois0.8140
    Indiana0.8757
    Iowa0.8194
    Kansas0.7850
    Kentucky0.8019
    Louisiana0.7755
    Maine0.8714
    Maryland0.8962
    Massachusetts1.1586
    Michigan0.9115
    Minnesota0.9109
    Mississippi0.7612
    Missouri0.7838
    Montana0.8642
    Nebraska0.8233
    Nevada0.9785
    New Hampshire0.9914
    New Jersey 1
    New Mexico0.8835
    New York0.8530
    North Carolina0.8632
    North Dakota0.7965
    Ohio0.8761
    Oklahoma0.7646
    Oregon1.0156
    Pennsylvania0.8473
    Puerto Rico0.4654
    Rhode Island 1
    South Carolina0.8606
    South Dakota0.7934
    Tennessee0.7901
    Texas0.7673
    Utah0.9156
    Vermont0.9576
    Virginia0.8473
    Washington1.0301
    West Virginia0.8145
    Wisconsin0.9121
    Wyoming0.8855
    1 All counties within the State are classified as urban.

    Addendum J.—Wage Index for Hospitals That Are Reclassified

    AreaWage index
    Abilene, TX0.8118
    Akron, OH0.9924
    Albany, GA1.0675
    Albuquerque, NM0.9748
    Alexandria, LA0.8137
    Allentown-Bethlehem-Easton, PA0.9443
    Altoona, PA0.9225
    Amarillo, TX0.8485
    Anchorage, AK1.2605
    Ann Arbor, MI1.1220
    Anniston, AL0.7922
    Asheville, NC0.9307
    Athens, GA0.9818
    Atlanta, GA1.0066
    Augusta-Aiken, GA-SC1.0090
    Austin-San Marcos, TX0.9327
    Barnstable-Yarmouth, MA1.3415
    Baton Rouge, LA0.8258
    Bellingham, WA1.1427
    Benton Harbor, MI0.9115
    Bergen-Passaic, NJ1.1669
    Billings, MT0.9623
    Biloxi-Gulfport-Pascagoula, MS0.8198
    Binghamton, NY0.8595
    Birmingham, AL0.8648
    Bismarck, ND0.7965
    Bloomington-Normal, IL0.8545
    Boise City, ID0.9190
    Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH1.1483
    Burlington, VT0.9606
    Caguas, PR0.4993
    Casper, WY0.9454
    Champaign-Urbana, IL0.9264
    Charleston-North Charleston, SC0.9293
    Charleston, WV0.8991
    Charlotte-Gastonia-Rock Hill, NC-SC0.9469
    Chattanooga, TN-GA0.9207
    Chicago, IL1.0887
    Cincinnati, OH-KY-IN0.9574
    Clarksville-Hopkinsville, TN-KY0.8481
    Cleveland-Lorain-Elyria, OH0.9496
    Columbia, MO0.8787
    Columbia, SC0.9264
    Columbus, GA-AL0.8471
    Columbus, OH0.9724
    Corpus Christi, TX0.8203
    Dallas, TX0.9506
    Davenport-Moline-Rock Island, IA-IL0.8790
    Dayton-Springfield, OH0.9323
    Denver, CO1.0289
    Des Moines, IA0.8881
    Dothan, AL0.8005
    Dover, DE0.9957
    Duluth-Superior, MN-WI1.0299
    Eau Claire, WI0.9121
    Elkhart-Goshen, IN0.9516
    Erie, PA0.8780
    Eugene-Springfield, OR1.1073
    Fargo-Moorhead, ND-MN0.9247
    Fayetteville, NC0.8970
    Flagstaff, AZ-UT1.0222
    Flint, MI1.0920
    Florence, AL0.7927
    Florence, SC0.8843
    Fort Collins-Loveland, CO1.0161
    Ft. Lauderdale, FL1.0906
    Fort Pierce-Port St. Lucie, FL1.0067
    Fort Smith, AR-OK0.7889
    Fort Walton Beach, FL0.8547
    Fort Wayne, IN0.9059
    Forth Worth-Arlington, TX0.9452
    Gadsden, AL0.8446
    Gainesville, FL1.1855
    Grand Forks, ND-MN (ND Hospitals)0.9022
    Grand Forks, ND-MN (MN Hospital)0.9109
    Grand Junction, CO0.9816
    Grand Rapids-Muskegon-Holland, MI1.0052
    Great Falls, MT0.9301
    Greeley, CO0.9604
    Green Bay, WI0.9440
    Greensboro-Winston-Salem-High Point, NC0.9474
    Greenville, NC0.9751
    Greenville-Spartanburg-Anderson, SC0.9110
    Harrisburg-Lebanon-Carlisle, PA0.9068
    Hartford, CT1.1586
    Hattiesburg, MS0.7612
    Hickory-Morganton-Lenoir, NC0.9517
    Honolulu, HI1.1658
    Houston, TX0.9604
    Huntington-Ashland, WV-KY-OH0.9286
    Huntsville, AL0.8657
    Indianapolis, IN0.9666
    Iowa City, IA0.9820
    Jackson, MS0.8589
    Jackson, TN0.8945
    Jacksonville, FL0.9040
    Johnson City-Kingsport-Bristol, TN-VA0.8540
    Jonesboro, AR0.8093
    Joplin, MO0.8560
    Kalamazoo-Battlecreek, MI1.0537
    Kansas City, KS-MO0.9430
    Knoxville, TN0.8904
    Kokomo, IN0.9290
    Lafayette, LA0.8430
    Lansing-East Lansing, MI0.9653
    Las Vegas, NV-AZ1.1238
    Lawton, OK0.8372
    Lexington, KY0.8675
    Start Printed Page 44912
    Lima, OH0.9558
    Lincoln, NE0.9945
    Little Rock-North Little Rock, AR0.8938
    Longview-Marshall, TX0.8439
    Los Angeles-Long Beach, CA1.2071
    Louisville, KY-IN0.9481
    Lubbock, TX0.8547
    Lynchburg, VA0.8897
    Macon, GA0.9077
    Madison, WI1.0462
    Mansfield, OH0.8827
    Medford-Ashland, OR1.0156
    Melbourne-Titusville-Palm Bay, FL0.9883
    Memphis, TN-AR-MS0.9152
    Miami, FL0.9934
    Milwaukee-Waukesha, WI0.9898
    Minneapolis-St. Paul, MN-WI1.1000
    Missoula, MT0.9273
    Mobile, AL0.7766
    Modesto, CA1.0945
    Monmouth-Ocean, NJ1.1514
    Monroe, LA0.8191
    Montgomery, AL0.7502
    Myrtle Beach, SC0.8663
    Nashville, TN0.9433
    New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT1.2357
    New London-Norwich, CT1.1578
    New Orleans, LA0.9054
    New York, NY1.3923
    Newark, NJ1.2004
    Newburgh, NY-PA1.0838
    Norfolk-Virginia Beach-Newport News, VA-NC0.8632
    Oakland, CA1.5313
    Odessa-Midland, TX (TX Hospitals)0.8769
    Odessa-Midland, TX (NM Hospitals)0.8835
    Oklahoma City, OK0.8728
    Omaha, NE-IA0.9696
    Orange County, CA1.1354
    Orlando, FL0.9464
    Peoria-Pekin, IL0.8883
    Philadelphia, PA-NJ1.0626
    Pine Bluff, AR0.7837
    Pittsburgh, PA0.9550
    Pittsfield, MA1.0018
    Pocatello, ID0.9264
    Portland, ME0.9501
    Portland-Vancouver, OR-WA1.1291
    Provo-Orem, UT0.9840
    Raleigh-Durham-Chapel Hill, NC0.9901
    Rapid City, SD0.8849
    Reading, PA0.8473
    Redding, CA1.1222
    Reno, NV1.0456
    Richland-Kennewick-Pasco, WA1.0478
    Richmond-Petersburg, VA0.9712
    Roanoke, VA0.8468
    Rochester, MN1.1595
    Rockford, IL0.9080
    Sacramento, CA1.1809
    Saginaw-Bay City-Midland, MI0.9662
    St. Cloud, MN1.0040
    St. Joseph, MO0.8953
    St. Louis, MO-IL0.8911
    Salinas, CA1.4738
    Salt Lake City-Ogden, UT0.9976
    San Diego, CA1.1480
    Santa Fe, NM1.0013
    Santa Rosa, CA1.2408
    Sarasota-Bradenton, FL1.0118
    Savannah, GA0.9349
    Seattle-Bellevue-Everett, WA1.1056
    Sherman-Denison, TX0.8899
    Shreveport-Bossier City, LA0.9165
    Sioux City, IA-NE0.8868
    Sioux Falls, SD0.9037
    South Bend, IN1.0176
    Spokane, WA1.0663
    Springfield, IL0.8502
    Springfield, MO0.8454
    Stockton-Lodi, CA1.1114
    Syracuse, NY0.9247
    Tampa-St. Petersburg-Clearwater, FL0.9095
    Texarkana, AR—Texarkana, TX0.8414
    Toledo, OH0.9815
    Topeka, KS0.8850
    Tucson, AZ0.9002
    Tulsa, OK0.8815
    Tuscaloosa, AL0.8265
    Tyler, TX0.8905
    Victoria, TX0.8212
    Waco, TX0.8268
    Washington, DC-MD-VA-WV1.1024
    Waterloo-Cedar Falls, IA0.8608
    Wausau, WI0.9516
    West Palm Beach-Boca Raton, FL0.9785
    Wichita, KS0.9218
    Wichita Falls, TX0.8015
    Wilmington-Newark, DE-MD1.0757
    Rural Alabama0.7483
    Rural Florida0.8733
    Rural Illinois (IA Hospital)0.8194
    Rural Illinois (MO Hospital)0.8140
    Rural Kentucky0.8019
    Rural Louisiana0.7755
    Rural Michigan0.9115
    Rural Minnesota0.9109
    Rural Missouri (AK Hospital)0.7838
    Rural Missouri (KS Hospital)0.7850
    Rural Montana0.8642
    Rural Nebraska0.8233
    Rural Nevada0.9219
    Rural Oregon1.0156
    Rural Texas0.7673
    Rural Washington1.0301
    Rural Wisconsin0.9121
    Rural Wyoming0.8855
    End Supplemental Information

    [FR Doc. 01-21213 Filed 8-20-01; 10:08 am]

    BILLING CODE 4120-01-P

Document Information

Published:
08/24/2001
Department:
Centers for Medicare & Medicaid Services
Entry Type:
Proposed Rule
Action:
Proposed rule.
Document Number:
01-21213
Dates:
We will consider comments if we receive them at the appropriate
Pages:
44671-44912 (242 pages)
Docket Numbers:
CMS-1159-P
RINs:
0938-AK54
Topics:
Health facilities, Hospitals, Kidney diseases, Medicare, Puerto Rico, Reporting and recordkeeping requirements
PDF File:
01-21213.pdf
CFR: (12)
42 CFR 413.24
42 CFR 413.65
42 CFR 419.2
42 CFR 419.20
42 CFR 419.22
More ...