01-18951. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2002
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AGENCY:
Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION:
Proposed rule.
SUMMARY:
This proposed rule would refine the resource-based practice expense relative value units and make several changes to Medicare Part B payment. The policy changes concern services and supplies incident to a physician's professional service; anesthesia base unit variations; recognition of CPT tracking codes; and nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies. We are proposing these refinements and changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We are soliciting comments on the proposed policy changes as well as comments on the payment policy for CPT modifier 62 that is used to report the work of co-surgeons.
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 modernizes the mammography screening benefit and authorizes payment under the physician fee schedule effective January 1, 2002; provides for biennial screening pelvic examinations for certain beneficiaries effective July 1, 2001; provides for annual glaucoma screenings for high-risk beneficiaries effective January 1, 2002; expands coverage for screening colonoscopies to all beneficiaries effective July 1, 2001; establishes coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002; expands payment for telehealth services effective October 1, 2001; requires certain Indian Health Service providers to be paid for some services under the physician fee schedule effective July 1, 2001; and revises the payment for certain physician pathology services effective January 1, 2001. This proposed rule would conform our regulations to reflect the statutory provisions.
DATES:
We will consider comments if we receive them at the appropriate address, as provided below, no later than 5 p.m. on October 1, 2001.
ADDRESSES:
Mail written comments (1 original and 3 copies) to the following address:
Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1169-P, P.O. Box 8013, Baltimore, MD 21244-8013.
To insure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them. If you prefer, you may deliver your written comments (1 original and 3 copies) to one of the following addresses: Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013.
Comments mailed to the above addresses may be delayed and received too late for us to consider them.
Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code CMS-1169-P.
For information on viewing public comments, please see the beginning of the Supplementary Information section.
Start Further InfoFOR FURTHER INFORMATION CONTACT:
Carolyn Mullen, (410) 786-4589 or Marc Hartstein, (410) 786-4539 (for issues related to resource-based practice expense relative value units).
Carlos Cano, (410) 786-0245 (for issues related to screenings for sigmoidoscopies).
Paul W. Kim, (410) 786-7410 (for issues related to incident to services).
Rick Ensor, (410) 786-5617 (for issues related to mammography screenings).
Bill Larson, (410) 786-4639 (for issues related to screening pelvic examinations, screenings for glaucoma, and coverage for screening colonoscopies).
Bob Ulikowski, (410) 786-5721 (for issues related to the payment for screening colonoscopies).
Mary Stojak, (410) 786-6939 (for issues related to medical nutrition therapy).
Joan Mitchell, (410) 786-4508 (for issues related to the payment for medical nutrition therapy).
Craig Dobyski, (410) 786-4584 (for issues related to telehealth).
Terri Harris, (410) 786-6830 (for issues related to Indian Health Service providers).
Jim Menas, (410) 786-4507 (for issues related to anesthesia and pathology services).
Diane Milstead, (410) 786-3355 (for all other issues).
End Further Info End Preamble Start Supplemental InformationSUPPLEMENTARY INFORMATION:
Inspection of Public Comments: Comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at 7500 Security Blvd, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 5 p.m. Please call (410) 786-7197 to make an appointment to view the public comments.
Copies: To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250. The cost for each copy is $9. As an alternative, you can view and photocopy the Federal Register 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.
Information on the physician fee schedule can be found on our homepage. You can access this data by using the following directions:
1. Go to the CMS homepage (http://www.cms.hhs.gov).
2. Click on “Medicare.”
3. Click on “Professional/Technical Information.”
4. Select Medicare Payment Systems.
5. Select Physician Fee Schedule.
Or, you can go directly to the Physician Fee Schedule page by typing the following: http://www.cms.hhs.gov/medicare/pfsmain.htm.
To assist readers in referencing sections contained in this preamble, we are providing the following table of contents. Some of the issues discussed in this preamble affect the payment policies but do not require changes to the regulations in the Code of Federal Regulations. Information on the regulation's impact appears throughout the preamble and is not exclusively in section VI.
Table of Contents
I. Background Start Printed Page 40373
A. Legislative History
B. Published Changes to the Fee Schedule
II. Specific Proposals for Calendar Year 2002
A. Resource-Based Practice Expense Relative Value Units
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
C. Services and Supplies Incident to a Physician's Professional Services: Conditions
D. Anesthesia Services
E. Performance Measurement and Emerging Technology Codes
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
III. Implementation of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
A. Screening Mammography
B. Screening Pelvic Examinations
C. Screening for Glaucoma
D. Screening Colonoscopy
E. Medical Nutrition Therapy
F. Telehealth Services
G. Indian Health Service
H. Pathology Services
IV. Collection of Information Requirements
V.Response to Comments
VI. Regulatory Impact Analysis
Addendum A—Explanation and Use of Addendum B
Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002
In addition, because of the many organizations and terms to which we refer by acronym in this proposed rule, we are listing these acronyms and their corresponding terms in alphabetical order below:
AMA American Medical Association
BBA Balanced Budget Act of 1997
BBRA Balanced Budget Refinement Act of 1999
CF Conversion factor
CFR Code of Federal Regulations
CPT [Physicians'] Current Procedural Terminology [4th Edition, 1997, copyrighted by the American Medical Association]
CPEP Clinical Practice Expert Panel
CRNA Certified Registered Nurse Anesthetist
E/M Evaluation and management
EB Electrical bioimpedance
FMR Fair market rental
GAF Geographic adjustment factor
GPCI Geographic practice cost index
CMS Centers for Medicare & Medicaid Services
HCPCS Healthcare Common Procedure Coding System
HHA Home health agency
HHS [Department of] Health and Human Services
IDTFs Independent Diagnostic Testing Facilities
MCM Medicare Carrier Manual
MedPAC Medicare Payment Advisory Commission
MEI Medicare Economic Index
MGMA Medical Group Management Association
MSA Metropolitan Statistical Area
NAMCS National Ambulatory Medical Care Survey
PC Professional component
PEAC Practice Expense Advisory Committee
PPAC Practicing Physicians Advisory Council
PPS Prospective payment system
RUC [AMA's Specialty Society] Relative [Value] Update Committee
RVU Relative value unit
SGR Sustainable growth rate
SMS [AMA's] Socioeconomic Monitoring System
TC Technical component
I. Background
A. Legislative History
Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), “Payment for Physicians” Services.” This section provides for three major elements: (1) A fee schedule for the payment of physicians' services; (2) a sustainable growth rate for the rates of increase in Medicare expenditures for physicians' services; and (3) limits on the amounts that nonparticipating physicians can charge beneficiaries. The Act requires that payments under the fee schedule be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense, and malpractice expense. Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may not cause total physician fee schedule payments to differ by more than $20 million from what they would have been had the adjustments not been made. If adjustments to RVUs cause expenditures to change by more than $20 million, we must make adjustments to preserve budget neutrality.
B. Published Changes to the Fee Schedule
In the July 2000 proposed rule (65 FR 44177), we listed all of the final rules published through November 1999, relating to the updates to the RVUs and revisions to payment policies under the physician fee schedule.
In the November 2000 final rule with comment period (65 FR 65376), we revised the policy for resource-based practice expense relative value units (RVUs); the geographic practice cost indices; resource-based malpractice RVUs; critical care RVUs; care plan oversight, physician certification and recertification for home health services; observation care codes; ocular photodynamic therapy and other ophthalmologic treatments; electrical bioimpedance; antigen supply, and the implantation of ventricular assist devices. This rule also addressed the comments received on the May 3, 2000 interim final rule (65 FR 25664) on the supplemental survey criteria and made modifications to the criteria for data submitted in 2001. Based on public comments, we withdrew our proposals related to the global period for insertion, removal, and replacement of pacemakers and cardioverter defibrillators, and to the removal of RVUs for low intensity ultrasound. The November 2000 final rule also discussed or clarified the payment policy for incomplete medical direction, pulse oximetry services, outpatient therapy supervision, outpatient therapy caps, HCPCS “G” Codes, and the second 5-year refinement of work RVUs for services furnished beginning January 1, 2002. In addition, we finalized the calendar year (CY) 2000 interim physician work RVUs and issued interim RVUs for new and revised codes for CY 2001. We made these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule also announced the CY 2001 Medicare physician fee schedule conversion factor under the Medicare Supplementary Medical Insurance (Part B) program as required by section 1848(d) of the Act. The 2001 Medicare physician fee schedule conversion factor was $38.2581.
II. Specific Proposals for Calendar Year 2002
This proposed rule would affect the regulations set forth at Part 405, Federal health insurance for the aged and disabled, Part 410, Supplementary medical insurance (SMI) benefits; Part 411, Exclusions from Medicare and limitations on Medicare payment; Part 414, Payment for Part B medical and other health services; and Part 415, Services furnished by physicians in providers, supervising physicians in teaching settings, and residents in certain settings.
A. Resource-Based Practice Expense Relative Value Units
1. Resource-Based Practice Expense Legislation
Section 121 of the Social Security Act Amendments of 1994 (Public Law 103-432), enacted on October 31, 1994, required us to develop a methodology for a resource-based system for determining practice expense RVUs for each physician's service beginning in Start Printed Page 403741998. In developing the methodology, we were to consider the staff, equipment, and supplies used in providing medical and surgical services in various settings. The legislation specifically required that, in implementing the new system of practice expense RVUs, we apply the same budget-neutrality provisions that we apply to other adjustments under the physician fee schedule.
Section 4505(a) of the BBA amended section 1848(c)(2)(ii) of the Act and delayed the effective date of the resource-based practice expense RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based practice expense RVUs to resource-based RVUs. The practice expense RVUs for CY 1999 were the product of 75 percent of charge-based RVUs and 25 percent of the resource-based RVUs. For CY 2000, the RVUs were 50 percent charge-based RVUs and 50 percent resource-based RVUs. For CY 2001, the RVUs are 25 percent charge-based and 75 percent resource-based. After CY 2001, the RVUs will be totally resource-based.
Section 4505(e) of the BBA amended section 1848(c)(2) of the Act by providing that 1998 practice expense RVUs be adjusted for certain services in anticipation of implementation of resource-based practice expenses beginning in 1999. As a result, the statute required us to increase practice expense RVUs for office visits. For other services in which practice expense RVUs exceeded 110 percent of the work RVUs and were furnished less than 75 percent of the time in an office setting, the statute required us to reduce the 1998 practice expense RVUs to a number equal to 110 percent of the work RVUs. This reduction did not apply to services that had proposed resource-based practice expense RVUs that increased from their 1997 practice expense RVUs as reflected in the June 18, 1997 proposed rule (62 FR 33196). The services affected and the final RVUs for 1998 were published in the October 1997 final rule (62 FR 59103).
Further legislation affecting resource-based practice expense RVUs was included in the Balanced Budget Refinement Act of 1999 (BBRA) (Public Law 106-113). Section 212 of the BBRA amended section 1848(c)(2)(ii) of the Act by directing us to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations. These data would supplement the data we normally collect in determining the practice expense component of the physician fee schedule for payments in CY 2001 and CY 2002.
2. Current Methodology for Computing the Practice Expense Relative Value Unit System
Effective with services furnished on or after January 1, 1999, we established a new methodology for computing resource-based practice expense RVUs that used the two significant sources of actual practice expense data we have available—the Clinical Practice Expert Panel (CPEP) data and the American Medical Association's (AMA) Socioeconomic Monitoring System (SMS) data. The methodology was based on an assumption that current aggregate specialty practice costs are a reasonable way to establish initial estimates of relative resource costs for physicians' services across specialties. The methodology allocated these aggregate specialty practice costs to specific procedures and, thus, can be seen as a “top-down” approach. Discussion of the various elements of the methodology and their application follow.
a. Practice Expense Cost Pools. We used actual practice expense data by specialty, derived from the 1995 through 1998 SMS survey data, to create six cost pools—administrative labor, clinical labor, medical supplies, medical equipment, office supplies, and all other expenses. There were three steps in the creation of the cost pools. (Please note that use of the 1998 data was incorporated for CY 2001.)
- Step (1) We used the AMA's SMS survey of actual cost data to determine practice expenses per hour by cost category. The practice expenses per hour for each physician respondent's practice was calculated as the practice expenses for the practice divided by the total number of hours spent in patient care activities. The practice expenses per hour for the specialty were an average of the practice expenses per hour for the respondent physicians in that specialty. For the CY 2000 physician fee schedule, we also used data from a survey submitted by the Society of Thoracic Surgeons (STS) in calculating thoracic and cardiac surgeons' practice expense per hour. (Please see the November 1999 final rule (64 FR 59391) for additional information concerning acceptance of these data.) For CY 2001 we used these STS data, as well as survey data submitted by the American Society of Vascular Surgery and the Society of Vascular Surgery. (Please see the November 2000 final rule (65 FR 65385) for additional information on acceptance of these data.)
- Step (2) We determined the total number of physician hours (by specialty) spent treating Medicare patients. This was calculated from physician time data for each procedure code and from Medicare claims data.
- Step (3) We calculated the practice expense pools by specialty and by cost category by multiplying the specialty practice expenses per hour for each category by the total physician hours.
For services with work RVUs equal to zero (including the technical component (TC) of services with a TC and professional component (PC)), we created a separate practice expense pool using the average clinical staff time from the CPEP data (since these codes by definition do not have physician time) and the “all physicians” practice expense per hour.
b. Cost Allocation Methodology. For each specialty, we divided the six practice expense pools into two groups, based on whether direct or indirect costs were involved, and used a different allocation basis for each group. The first group included clinical labor, medical supplies, and medical equipment. The second group included administrative labor, office expenses, and all other expenses.
(i) Direct Costs. For direct costs (including clinical labor, medical supplies, and medical equipment), we used the CPEP data as the allocation basis. The CPEP data for clinical labor, medical supplies, and medical equipment were used to allocate the costs for each of the respective cost pools.
For the separate practice expense pool for services with work RVUs equal to zero, we used adjusted 1998 practice expense RVUs as an interim measure to allocate the direct cost pools. (Please see the November 1998 final rule (63 FR 58891) for further information related to this adjustment.) Also, for all radiology services that are assigned work RVUs, we used the adjusted 1998 practice expense RVUs for radiology services as an interim measure to allocate the direct practice expense cost pool for radiology. For all other specialties that perform radiology services, we used the CPEP data for radiology services in the allocation of that specialty's direct practice expense cost pools.
(ii) Indirect Costs. To allocate the cost pools for indirect costs, including administrative labor, office expenses, and all other expenses, we used the total direct costs, as described above, in combination with the physician fee schedule work RVUs. We converted the work RVUs to dollars using the Medicare CF (expressed in 1995 dollars Start Printed Page 40375for consistency with the SMS survey years).
The SMS pool was divided by the CPEP pool for each specialty to produce a scaling factor that was applied to the CPEP direct cost inputs. This was intended to match costs counted as practice expenses in the SMS survey with items counted as practice expenses in the CPEP process. When the specialty-specific scaling factor exceeded the average scaling factor by more than 3 standard deviations, we used the average scaling factor. (Please see the November 1999 final rule (64 FR 59390) for further discussion of this issue.)
For procedures performed by more than one specialty, the final procedure code allocation was a weighted average of allocations for the specialties that perform the procedure, with the weights being the frequency with which each specialty performs the procedure on Medicare patients.
c. Other Methodological Issues. (i) Global Practice Expense Relative Value Units. For services with the PC and TC paid under the physician fee schedule, the global practice expense RVUs were set equal to the sum of the PC and TC.
(ii) Practice Expenses per Hour Adjustments and Specialty Crosswalks. Since many specialties identified in our claims data did not correspond exactly to the specialties included in the practice expense tables from the SMS survey data, it was necessary to crosswalk these specialties to the most appropriate SMS specialty category. We also made the following adjustments to the practice expense per hour data. (For the rationale for these adjustments to the practice expense per hour, see the November 1998 final rule (63 FR 58841).)
- We set the medical materials and supplies practice expenses per hour for the specialty of “oncology” equal to the “all physician” medical materials and supplies practice expenses per hour.
- We based the administrative payroll, office, and other practice expenses per hour for the specialties of “physical therapy” and “occupational therapy” on data used to develop the salary equivalency guidelines for these specialties. We set the remaining practice expense per hour categories equal to the “all physician” practice expenses per hour from the SMS survey data. (Note that in the November 2000 final rule (65 FR 65403), we increased the space allotment for therapy services to 750 square feet.)
- Due to uncertainty concerning the appropriate crosswalk and time data for the nonphysician specialty “audiologist,” we derived the resource-based practice expense RVUs for codes performed by audiologists from the practice expenses per hour of the other specialties that perform these services.
- For the specialty of “emergency medicine,” we used the “all physician” practice expense per hour to create practice expense cost pools for the categories “clerical payroll” and “other expenses.”
- For the specialty of “podiatry,” we used the “all physician” practice expense per hour to create the practice expense pool.
- For the specialty of “pathology,” we removed the supervision and autopsy hours reimbursed through Part A of the Medicare program from the practice expense per hour calculation.
- For the specialty “maxillofacial prosthetics,” we used the “all physician” practice expense per hour to create practice expense cost pools and, as an interim measure, allocated these pools using the adjusted 1998 practice expense RVUs.
- We split the practice expenses per hour for the specialty “radiology” into “radiation oncology” and “radiology other than radiation oncology” and used this split practice expense per hour to create practice expense cost pools for these specialties.
(iii) Time Associated with the Work RVUs. The time data resulting from the refinement of the work RVUs have been, on average, 25 percent greater than the time data obtained by the Harvard study for the same services. We increased the Harvard study's time data to ensure consistency between these data sources.
For services with no assigned physician time, such as dialysis, physical therapy, psychology, and many radiology and other diagnostic services, we calculated estimated total physician time based on work RVUs, maximum clinical staff time for each service as shown in the CPEP data, or the judgment of our clinical staff.
We calculated the time for CPT codes (hereafter referred to as “codes”) 00100 through 01996 using the base and time units from the anesthesia fee schedule and the Medicare allowed claims data.
3. Refinement
a. Background. Section 4505(d)(1)(C) of the BBA amended section 1848(c)(2)(C)(ii) of the Act by directing us to develop a refinement process to be used during each of the 4 years of the transition period. We did not propose a specific long-term refinement process in the June 1998 proposed rule (63 FR 30835). Rather, we set out the parameters for an acceptable refinement process for practice expense RVUs and solicited comments on our proposal. We received a variety of comments about broad methodology issues, practice expense per-hour data, and detailed code-level data. We made adjustments to our proposal based on comments we received. We also indicated that we would consider other comments for possible refinement and that the RVUs for all codes would be considered interim for 1999 and for future years during the transition period.
We outlined in the November 1998 final rule (63 FR 58832) the steps we were undertaking as part of the initial refinement process. These steps included the following:
- Establishment of a mechanism to receive independent advice for dealing with broad practice expense RVU technical and methodological issues.
- Evaluation of any additional recommendations from the General Accounting Office, the Medicare Payment Advisory Commission (MedPAC), and the Practicing Physicians Advisory Council (PPAC).
- Consultation with physician and other groups about these issues.
We also discussed a proposal submitted by the AMA's Specialty Society Relative Value Update Committee (RUC) for development of a new advisory committee, the Practice Expense Advisory Committee (PEAC), to review comments and recommendations on the code-specific CPEP data during the refinement period. In addition, we solicited comments and suggestions about our practice expense methodology from organizations that have a broad range of interests and expertise in practice expense and survey issues.
b. Current Status of Refinement Activities. In the 1999 and 2000 proposed and final rules, we provided further information on refinement activities underway, including the AMA's formation of the PEAC and the support contract that we awarded to the Lewin Group to focus on methodologic issues. In addition, in these rules we announced actions taken and decisions made in response to the hundreds of comments received on our resource-based physician practice expense initiative. Because the transition will be completed in CY 2002 and the practice expense RVUs will then be totally resource-based, it is appropriate to recap the specific achievements reached and decisions implemented during this refinement effort to date.
(i) Use of the Top-Down Approach. Most of the physician organizations commenting agreed that this methodology was preferred for computing resource-based practice expense RVUs and that it was in accordance with the requirements of the Start Printed Page 40376BBA. KPMG Peat Marwick, under contract to us, reviewed the top-down methodology in which aggregate specialty costs are applied to specific procedures and concluded that it followed reasonable cost accounting principles. A 1999 GAO report concludes, “HCFA's new approach represents a reasonable starting point for creating resource-based practice expense RVUs. It uses the best available data for this purpose and explicitly recognizes specialty differences in practice expense.” Based on these comments and assessments, we made the decision to continue to use the top-down methodology to calculate the resource-based practice expense RVUs.
(ii) Use of the SMS Survey. The supplemental non-SMS survey data submitted by several specialties in response to the 1998 proposed rule, with the exception of the survey data from the thoracic surgeons, were not compatible with the format or methodology of the SMS. We awarded a contract to the Lewin Group to recommend criteria for the acceptance of specialty-specific practice expense data so that we could supplement the SMS data as appropriate. These recommended criteria are contained in the final report, “An Evaluation of the Health Care Financing Administration's Resource-Based Practice Expense Methodology.” This report is available on our web page under the same title. (Access to our web site is discussed under the SUPPLEMENTARY INFORMATION section above.)
The report also contains recommendations for revisions to the SMS or other surveys to efficiently meet the needs of our practice expense methodology. We augmented these recommendations and forwarded our suggestions for revisions to any future surveys to the AMA. For example, we developed supplementary survey questions that would allow us to distinguish both costs and direct patient care hours for all midlevel practitioners. We also suggested revisions that would capture the necessary information on separately billable supplies and services so that we could eliminate these costs from the specialty-specific practice expense per-hour calculations.
To obtain supplementary specialty-specific practice expense data that could be used in computing practice expense RVUs beginning January 1, 2001, we published an interim final rule on May 3, 2000 (65 FR 25664) that set forth the criteria applicable to supplemental survey data submitted to us by August 1, 2000.
We also provided a 60-day period for submission of public comments on our criteria for survey data submitted between August 2, 2000 and August 1, 2001 for use in computing the practice expense RVUs for the CY 2002 physician fee schedule.
In the November 1, 2000 final rule (65 FR 65385), we responded to comments received on the interim final rule and made modifications to the criteria for supplemental survey data that will be considered in computing practice expense RVUs for the CY 2002 physician fee schedule. These data can then be used to supplement the SMS survey data currently used to estimate each specialty's aggregate practice costs or to replace the crosswalks used for specialties not represented in the SMS.
In our November 1999 final rule, we accepted supplementary data submitted by the thoracic surgeons and, in our November 2000 rule, we accepted survey data from the vascular surgeons that replaced the previously crosswalked practice expense per hour data for that specialty. If we receive additional specialty-specific survey data before August 1, 2001 that meets the criteria outlined in the November 1, 2000 final rule, we will use this supplementary data in calculating the CY 2002 practice expense RVUs.
We accepted our contractor's recommendation to incorporate the latest SMS data into our practice-expense-per-hour calculations. For CY 2001, we incorporated the 1998 SMS data into a 4-year average and are proposing to incorporate the 1999 SMS data into a 5-year average to calculate the CY 2002 practice expense RVUs.
We also accepted the contractor's recommendation to standardize the survey practice expense data to a common year. We adjusted the data to reflect a 1995 cost year.
We received comments that urged us to use the median SMS specialty-specific data instead of the mean, as well as comments supporting our use of the mean values. We made a decision to continue to use the mean in calculating the specialty-specific practice expense per hour. We believe that, in a small sample, using the median could eliminate outlying data from the calculation that represent real costs and thus should be considered.
(iii) CPEP Data. The AMA has formed a multispecialty sub-committee of their Relative Value Update Committee (RUC), the Practice Expense Advisory Committee (PEAC), to review the CPEP clinical staff, equipment, and supply data for all physician services. This multispecialty committee, which includes representatives from all major specialty societies, would then make recommendations on suggested refinements to this data. We indicated in our November 1998 final rule (63 FR 58833) that we would work with the PEAC and RUC to refine the practice expense direct cost inputs. This refinement process was supported in comments we received from almost every major physician specialty society.
In our 1999 physician fee schedule final rule, we implemented most CPEP refinements recommended by the RUC. For the 2000 final rule, the RUC forwarded to us significant additional refinement recommendations that reflected multispecialty agreement on the typical resources for many important services, including visit codes, that account for approximately 24 percent of Medicare spending for physician services. Again we received and accepted almost all of these RUC recommendations. In addition, at its October 2000, February 2001, and April 2001 meetings, the PEAC focused on high-volume services and on standardizing inputs across wide ranges of services. We, therefore, anticipate that the pace of refinement of the CPEP inputs will continue to accelerate.
In addition to implementing most of the RUC-recommended refinements, we responded to comments on errors and anomalies in the CPEP data in both the November 1999 and November 2000 final rules. For example, we removed separately billable casting supplies and drugs from all services, we adjusted the prices of certain supplies that were clearly in error, we removed duplicated equipment from the direct inputs of the nuclear medicine codes, we added clearly essential equipment that was missing from the lithotripsy and photochemotherapy codes, we corrected anomalies in inputs within several families of codes, and we changed the crosswalks for the CPEP inputs of several codes not valued by the CPEP panels when a commenter suggested more appropriate crosswalks.
We simplified the refinement of equipment inputs by combining both the procedure-specific and overhead equipment into a single equipment category. We also deleted stand-by equipment and equipment used for multiple services at one time from the direct cost inputs because of the difficulty of allocating these costs at the code-specific level.
We are resolving issues related to averaging input costs for codes that were valued by more than one CPEP panel. While we have received comments agreeing and disagreeing with our use of mean costs, the issue is moot because we are substituting refined data for the data previously produced by multiple CPEPs. Start Printed Page 40377
(iv) Physician Time Data. In the November 1999 rule (64 FR 59404), we stated that, in general, requests for revisions for the procedure-specific physician times should be deferred to either the RUC process or the 5-year review process. However, we did adopt the newer data to correct the physician time for the pediatric surgery codes and made the requested revisions to correct anomalies in the times of certain psychotherapy codes.
In response to comments on the times associated with physical and occupational therapy services, we added preservice and postservice times to all of these codes.
(v) Crosswalk Issues. In response to concerns expressed by specialty societies representing emergency medicine that the SMS data did not capture the costs of uncompensated care, we crosswalked emergency medicine's administrative labor and other expenses cost pools to the practice expense per hour for “all physicians.”
We resolved issues related to the specialty crosswalk for nursing specialties by eliminating the separate practice expense pools for midlevel practitioners.
(vi) Calculation of Practice Expense Pools—Other Issues. We addressed concerns that potential errors in our specialty utilization data will have an effect on the calculation of practice expense RVUs. In the July 2000 proposed rule (65 FR 44178), we discussed our simulations that demonstrated that the small percentage of potential errors in our very large database have no adverse effect on specialty-specific practice expense RVUs.
We have created the zero-work pool for services with no physician work to ensure that these services are not inappropriately disadvantaged by our methodology. We have also agreed with the request of all the specialty societies that commented that their services should be moved out of the zero-work pool and into the specialty-specific pool. The specialties whose services remain in the zero-work pool have indicated that they wish their services to remain there. We plan to eliminate this separate pool for services with no physician work only when we have determined what revisions to our methodology are required so that we can value these services appropriately outside of the zero-work pool.
(vii) Calculation of Indirect Cost. We requested that our contractor evaluate various options for calculating indirect costs. The final report, referenced above, contains an analysis of the impacts of six alternative allocation methodologies. In confirming the suitability of our allocation methodology, the report concludes that “HCFA's approach is broadly consistent with most of the alternative methods. This consistency suggests that, from a broad perspective, no other allocation methodology offers a compelling reason to abandon the current HCFA approach.”
(viii) Site-of-Service. The practice expense RVUs would be expected to be higher in the non-facility setting, where the practitioner bears the costs of the necessary staff, supplies, and equipment, than in the facility setting. To prevent potential anomalies in our calculations due to the different mix of specialties performing a given service in different settings, we capped the facility practice expense RVUs at the non-facility level for each specific service.
In the November 1999 final rule (64 FR 59407), in response to a comment from the Renal Physicians Association, we agreed that the monthly capitated service codes should always be reported using the non-facility designation. The site of service designations are not meaningful for a monthly service that may be provided in different settings for the same patient during a given month.
Although we need to do additional work to complete the refinement of all practice expense RVUs, we believe that the above description of our actions to date shows that much has been accomplished. We also believe that it demonstrates that we have been responsive to comments from the medical community and have established a process that enables this community to participate fully in the refinement of both the specialty-specific practice expense per hour and the CPEP code-specific inputs.
Practice Expense Proposals for Calendar Year 2002
(1) Use of 1999 SMS Survey Data
We are currently using data from the 1995 through the 1998 SMS surveys (1994 through 1997 practice expense data) in order to calculate the specialty-specific practice expense per hour. The 1999 SMS survey data is now available. Because we want to incorporate the most recent survey data into our methodology during the transition period, we are proposing to add this 1999 data to the 4 years of data we are currently using.
We are proposing to use these 5 years of data in addition to any supplemental specialty-specific data that meet our criteria as the basis of the practice expense per hour calculations until the first 5-year review of practice expense RVUs in 2007. At that time, we anticipate that newer practice expense survey data might be available.
The proposed specialty-specific practice-expense per hour calculations are shown in Table 1. The specialty level impact of using the additional SMS data is shown in Table 5 of the regulatory impact statement. As indicated, Table 5 shows the impact of this change only relative to the current estimated fully-implemented practice expense RVUs.
Table 1.—Specialty-Specific Practice Expense Per Hour Calculations
Specialty Clinical payroll per hour Clerical payroll per hour Office expense per hour Supplies expense per hour Equipment expense per hour Other expense per hour Total expense per hour ALL PHYSICIANS 12.3 15.4 19.4 7.4 3.2 11.5 69 GENERAL/FAMILY PRACTICE 14.8 14.9 17.7 7.9 3.1 8.8 67.1 GENERAL INTERNAL MEDICINE 9.4 14.4 17.9 6.1 2.1 6.6 56.5 CARDIOVASCULAR DISEASE 15.8 15.2 20.7 6.2 5.9 17.8 81.6 GASTROENTEROLOGY 8.9 17 18 3.6 2.1 12.3 61.8 ALLERGY/IMMUNOLOGY 36.3 25.3 31.4 16 2 15.8 128.8 PULMONARY DISEASE 6.9 12.4 15.7 2.6 1.6 6.9 46.1 ONCOLOGY (with supplies adjustment) 27.4 24.1 26.5 7.4 4.6 9.3 99.3 GENERAL SURGERY 7.2 15.6 16.8 3.4 2 9.9 54.9 OTOLARYNGOLOGY 17.2 25.2 32.9 7.5 5.6 17.2 105.7 ORTHOPEDIC SURGERY 16.6 28.5 29.7 10.3 3.8 19.1 108 OPHTHALMOLOGY 25.1 25.8 34.1 10.8 8.4 21.1 125.3 UROLOGICAL SURGERY 12.4 18.5 23.2 25.5 5.3 11.3 96.2 PLASTIC SURGERY 15 20.3 32.4 18.5 5.7 25.2 117.2 NEUROLOGICAL SURGERY 8.6 25.6 28.6 1.8 1.4 16.1 82.2 CARDIAC/THORACIC SURGERY 18.1 16.8 16.8 1.8 2.2 13.1 68.8 Start Printed Page 40378 PEDIATRICS 12.4 12.9 18.9 10.2 1.7 8.6 64.8 OBSTETRICS/GYNECOLOGY 16.4 18.8 24.7 7.3 3.2 11.2 81.7 RADIATION ONCOLOGY 14 9.2 12.1 5.4 9.7 16.4 66.8 RADIOLOGY 9.3 10.8 14.8 4.8 7.4 20.9 68 PSYCHIATRY 1.7 5.1 10.5 0.4 0.4 7.2 25.3 ANESTHESIOLOGY 11.3 3.7 5.9 0.4 0.4 5.9 27.6 PATHOLOGY (adjusted to remove Part A Hrs) 11.2 14 11.9 6.8 2 21 66.9 DERMATOLOGY 22.5 28.4 33.4 12.6 5.4 17.2 119.4 EMERGENCY MEDICINE (adjusted for admin/other) 3.3 15.4 2 0.7 0.1 11.5 33 NEUROLOGY 8.3 23 19.5 5.2 4.4 9.3 69.7 PHYS MED/RHEUMATOLOGY 14.9 23.7 30.7 6.5 6.2 12.2 94.2 OTHER SPECIALTY 9.3 13 19.3 4.9 1.9 8.8 57.3 VASCULAR SURGERY (supplemental data) 20.2 18.1 17.7 3.2 4.5 11.4 75.1 PHYSICAL AND OCCUPATIONAL THERAPY (see 12.3 5.9 7.5 7.4 3.2 4.4 40.7 * Total expenses exclude professional liability insurance premiums and employee physician payroll. Notes: —Only self-employed non-federal non-resident patient care physicians who responded to all relevant expense questions are included. Self-employed physician respondents with no practice expenses for the year are excluded. —Physicians whose typical number of hours worked in patient care activities per week is missing, less than 20, or equal to 168 are excluded. Physicians whose number of weeks worked the previous year is missing or less than 26 are excluded. —For each respondent, total practice expense and expense components per hour are calculated as (4)/(5) below. —Expenses adjusted for practice size = self-employed respondent expenses X # physician owners —Hours adjusted for practice size =(respondent hours * # physician owners) + (employee physician hours (see (6) below) * # employee physicians) —The typical number of hours worked in patient care activities for the employee physician(s) of a self-employed physician's practice is not known. Mean hours worked in patient care activities for employee physicians of each specialty are used as an estimate of employee physician hours. —As described earlier in this proposed rule, the practice expense per hour shown above reflect: —the “All Physician” supplies expense per hour for Oncology —use of supplemental SMS practice expense data for Cardiac and Thoracic Surgery in addition to regular SMS data collection. —removal of hours spent in Part A activities for Pathology. —Using the “All Physician” administration and other practice expense data for Emergency Medicine. —Vascular Surgery data is based on supplemental survey not the SMS. —Physical and occupational therapy data is based on “All Physician” for clinical, staff, supplies and equipment. It is based on salary equivalency guidelines assuming 750 square feet of office space for clerical, office and other. Supplemental Practice Expense Survey Data
To ensure the maximum opportunity for specialties to submit supplementary practice expense data, we are proposing to accept survey data that meets the criteria set forth in the November 2000 final rule for an additional 2 years. The deadlines for submission of such supplemental data to be considered in CY 2003 and CY 2004 are August 1, 2002 and August 1, 2003, respectively.
Repricing of CPEP Inputs
The cost of the original CPEP inputs for staff, supplies, and equipment were assigned by our contractor, Abt Associates, based primarily on 1994 and 1995 pricing data. In addition, for many items on the equipment and supply list, the associated costs were based on the recommendation of a CPEP panel member, rather than on actual catalog prices. Several equipment and supply items and clinical staff types also have been added subsequent to the CPEP panels. In general, the costs of these inputs have been provided by the relevant specialty society, with and without documentation of the costs.
We are proposing to revise the salary and cost estimates by using the most current pricing data available. We contracted with a consultant to help us in this endeavor and the contractor also solicited advice and information from the major medical specialty societies. We appreciate the time and effort given to this project by the staff of many of the specialty societies. We have at this time completed our proposals for the update of clinical staff salary data and discuss these proposals below. However, we have not yet completed the pricing update for all of the hundreds of supplies and pieces of equipment that are in our CPEP database. We have had difficulty in identifying some of these inputs because many of the original descriptions are too general to price (for example, “laser” or “antibody”) or because the item cannot be found in any supplier's catalog. In addition, several of the pieces of equipment are now obsolete and we need input regarding the appropriate equipment to price. Therefore, we need to work closely with the specialty societies in the coming months so that we can propose accurate prices for all the supply and equipment inputs in next year's proposed rule.
Staff Types and Wages
For the original CPEP wage data, Abt Associates used three primary external data sets: The Bureau of Labor Statistics' (BLS) Occupation Compensation Survey, 1993; The University of Texas Medical Branch (UTMB) Survey of Hospital and Medical School Salaries, 1994; and the Current Population Survey, 1993. Abt's report on the CPEP cost estimation stated that, “* * * the BLS data were considered to be the preferred data set. The BLS’ reputation for publishing valid estimates that are nationally representative led to the choice of the BLS data as the main source. If more than one data set provided an exact mapping for a receptionist, then the BLS wage was chosen over any other mapping.”
We agreed with this assessment and directed our current contractor to use the most current BLS survey (1999) as the main source of wage data. The two other data sets used by Abt were not useful in this pricing update. The UTMB survey has apparently not been repeated and the Current Population Survey was used mainly for administrative staff types that are no longer treated as a direct cost.
It should also be noted that the BLS discontinued the Occupational Compensation Survey used in 1995 and now conducts the National Compensation Survey that has a different breakdown of staff types than the earlier survey. This survey also does not cover all the staff types contained in the CPEP data. Therefore, it has been necessary for us to crosswalk or extrapolate the wages for several staff types using supplementary data sources for verification whenever possible.
We used three other data sources to price wages of staff types that were not referenced in the BLS data—the American Society of Clinical Start Printed Page 40379Pathologists' survey of laboratory staff salaries (found at www.ascp.org); the survey done by the American Academy of Health Physics and the American Board of Health Physics (found at www.hps1.org); and national salary data from the Salary Expert, an Internet site that develops national and local salary ranges and averages for thousands of job titles using mainly government sources. (A detailed explanation of the methodology used to determine the specific job salaries can be found at www.salaryexpert.com.)
We welcome comments and input on both our proposed wage rates and our proposed crosswalks. We are particularly seeking any additional sources of reliable national pricing for the wages of staff types not included in the BLS. Anecdotal information regarding individual pay scales will not be particularly helpful for setting national rates, though such information could help with verification of other data. For those staff types that are included in the BLS, we would require data that is equally representative and valid in order to consider revising our proposed salaries.
The table below lists the clinical staff types whose input has been priced, the source for the data, the staff type crosswalk used, the proposed annual salary in 2001 dollars (using the Medicare Economic Index to convert 1999 salaries to 2001 dollars), the proposed cost per minute (including benefits) and the current cost per minute (including benefits) for comparison purposes. The proposed cost per minute was derived by dividing the annual salary by 2080 to arrive at the hourly wage rate and then again by 60 to arrive at the per minute cost. To account for the employers' cost of providing fringe benefits, such as sick leave, we used the same benefits multiplier of 1.366 used by Abt. The last column in the table refers to the numbered notes following the table that contain proposals regarding the pricing of the staff types and additional information as needed.
Table 2.—Proposed Wage Rates for CPEP Clinical Staff Types
Description Source Crosswalk Mean yrly 2001 Proposed per minute Current per minute Note # Physical Therapy Aide BLS Physical Therapist Aides 21,077.36 0.226 0.232 Medical Assistant BLS Medical Assistants 23,680.67 0.254 0.162 1 Technical Aide BLS Medical Assistants 23,680.67 0.254 0.225 1 Medical Technician BLS Medical Assistants 23,680.67 0.254 0.225 1 EKG Technician BLS Medical Assistants 23,680.67 0.254 0.204 1 Anesthesia Technician BLS Medical Assistants 23,680.67 0.254 0.225 1 Technician BLS Medical Assistants 23,680.67 0.254 0.225 1 Cast Technician BLS Medical Assistants 23,680.67 0.254 0.177 1 LPN BLS Licensed Practical Nurses 30,340.53 0.325 0.267 RN BLS Registered Nurses 46,493.56 0.498 0.422 RN Cardiology BLS Registered Nurses 46,493.56 0.498 0.574 2 RN Oncology BLS Registered Nurses plus adjustment 54,862.40 0.587 0.497 2 Surgery Assistant BLS Surgical Technologists 28,814.09 0.308 0.326 3 Certified Surgical Technician BLS Surgical Technologists 28,814.09 0.308 0.262 Lab Technician BLS Medical and Clinical Laboratory Technicians 29,723.68 0.318 0.288 Histotechnician ASCP Histologic Technologist 33,924.51 0.363 0.306 4 Electron Microscopy Technician ASCP Histologic Technologist 33,924.51 0.363 0.312 5 Cytotechnologist BLS Medical and Clinical Laboratory Technologists 41,098.76 0.440 0.415 EEG Technician Salary Expert Electroencephalographic Technician 29,150.74 0.312 0.283 6 Electrodiagnostic Technologist BLS Electroneurodiagnostic Technologists 33,529.31 0.359 0.302 6 Registered EEG Technologist Current Rate Registered EEG Technologist 37,645.00 0.403 0.403 6 Vascular Technician BLS Cardiovascular Technologists and Technicians 34,794.37 0.372 0.351 7 Cardiovascular Technician BLS Cardiovascular Technologists and Technicians 34,794.37 0.372 0.351 Radiation Technologist BLS Radiologic Technologists and Technicians 37,125.85 0.397 0.319 8 X-Ray Technologist BLS Radiologic Technologists and Technicians 37,125.85 0.397 0.319 8 Angiographic Technician BLS Radiologic Technologists and Technicians 37,125.85 0.397 0.351 9 CAT Scan Technician BLS Radiologic Technologists and Technicians 37,125.85 0.397 0.319 9 MRI Technician BLS Radiologic Technologists and Technicians 37,125.85 0.397 0.319 9 Nuclear Medicine Technician BLS Nuclear Medicine Technologists 44,360.73 0.475 0.392 Nuclear Cardiology Technician BLS Nuclear Medicine Technologists 44,360.73 0.475 0.392 10 Ultrasound Technician BLS Diagnostic Medical Sonographers 45,751.26 0.490 0.389 11 Sonographer BLS Diagnostic Medical Sonographers 45,751.26 0.490 0.389 11 Cardiac Sonographer BLS Diagnostic Medical Sonographers 45,751.26 0.490 0.389 11 Radiation Technical Therapist BLS Radiation Therapists 45,333.05 0.485 0.404 Dosimetrist BLS Radiation Therapists 45,333.05 0.485 0.500 Physicist AAHP Certified Health Physicists 84,495.54 0.905 0.968 12 COT X-WALK Lab Technician 29,723.68 0.318 0.256 13 COMT X-WALK Histotechnician 33,924.51 0.363 0.278 13 Optician BLS Opticians, Dispensing 26,336.25 0.282 0.278 Start Printed Page 40380 Certified Retinal Angiographer Salary Expert Ophthalmic Photographer 35,453.04 0.380 0.351 14 Orthoptist X-WALK COMT 33,924.51 0.363 0.315 15 Respiratory Therapist BLS Respiratory Therapists 38,537.28 0.413 0.421 Speech Pathologist BLS Speech-Language Pathologists 49,996.00 0.535 0.419 Audiologist BLS Audiologists 47,748.17 0.511 0.411 Registered Dietician BLS Dieticians and Nutritionists 39,049.57 0.418 0.365 Counselor BLS Mental Health Counselors 30,769.18 0.329 0.422 (1) We are proposing to collapse the medical assistant, technical aide, medical technician, EKG technician, anesthesia technician, technician, and cast technician staff types into a new staff type called, “medical or technical assistant” that will be priced at the medical assistant proposed wage rate per minute. This will represent an increased per minute rate for all the bundled staff types.
(2) We are proposing to bundle the staff type “RN-cardiology” into the staff type “RN.” RN-cardiology is used as the staff type for the pre- and post-service time of only three percutaneous valvuloplasty services, codes 92986, 92987 and 92990. We were unable to find any national salary data for the oncology certified nurse (OCN). In the absence of other information, we are adjusting the proposed wage rate to be 18 percent higher than the RN; this is the same differential that currently exists between these two staff types.
(3) We are proposing to bundle the staff type “surgery assistant”, which is assigned to only 19 surgical services, into the staff type “certified surgical technologist (CST)”, which is assigned to 133 services. It also appears that Abt mapped the averaged costs from a first assistant and certified scrub technician to the surgery assistant staff type, which does not appear to be the most appropriate crosswalk for the office setting.
(4) We used the average hourly rate for histologic technologists from the 1998 American Society of Clinical Pathologists' survey to propose a wage for the histotechnician staff type. This survey's average hourly rate of $12.90 for laboratory technician generally corresponds to our proposed rate of $13.67 and its average hourly rate of $19.00 for cytotechnologists almost matches our proposed rate of $18.90. Therefore, we believe that the $15.60 hourly rate we are proposing for the histotechnician maintains the current relativity between these laboratory staff types.
(5) We were unable to find any national salary data for the electron microscopy technician and, in the absence of such data, are crosswalking the salary from the wage rate for the histotechnician. This does represent an increase in the per minute cost for this staff type. However, we would welcome reliable national survey data from the specialty that we could use in pricing this staff type.
(6) We were only able to find direct BLS salary data for the electroneurodiagnostic technologist staff type. This information was contained in the BLS Occupational Outlook Handbook rather than in the listing of Occupational Employment Statistics where we found all other BLS data. We are proposing to crosswalk the corresponding salary from the Handbook to the electrodiagnostic technologist staff type. Data for the EEG technician came from the Salary Expert. We were unable to find any national salary data for registered EEG technologist (REEGT) and are proposing to maintain the current rate, since the speciality society recently recommended this rate of pay. However, we would also welcome reliable national survey data from the specialty that we could use in pricing these three levels of neurodiagnostic staff.
(7) We are proposing to bundle the vascular technician in with the cardiovascular technology staff type. Currently both are priced at the same rate.
(8) We are proposing to merge the x-ray technician and radiation technologist staff types, which are currently priced at the same rate, into a staff type called “Radiologic Technologist.”
(9) Because we were unable to find any national survey data regarding the salaries for CAT scan technician, MRI technician, or angiographic technician, we are proposing to crosswalk these staff types to the BLS radiologic technologist pay scale. If there is a generally applied differential for these specialized radiologic technologists, we would welcome any reliable national survey data that would allow us to separately price these staff types.
(10) We are proposing to merge the nuclear cardiology technician in with the nuclear medicine technician staff type. Currently, both are priced at the same rate.
(11) We are proposing to merge the cardiac sonographer and the ultrasound technician into the sonographer staff type. Currently, all three are priced at the same rate.
(12) We are proposing to use the average salary data for all certified health physicists from the 1999 survey done by the American Academy of Health Physics and the American Board of Health Physics.
(13) We were unable to find representative national salary data for either the certified ophthalmic technician (COT) or the certified ophthalmic medical technologist (COMT). Until we can obtain such data, we are proposing to crosswalk the COT and COMT to the lab technician and histotechnician, respectively, since we believe that the skill and responsibility of these staff types would generally correspond. Again, we would welcome reliable and representative national salary data for these staff types.
(14) Data for our proposed salary for the certified retinal angiographer came from the Salary Expert. The position description for the ophthalmic photographer appeared to match the duties of a retinal angiographer: “Photographs medical phenomena of eye to document diseases, surgeries, treatment and congenital problems * * * Injects contrast medium into vein of patient and photographs fluorescent dye as it flows through retina or iris vessels to obtain angiogram of eye * * *”
(15) In the absence of any national salary data for the orthoptist, we crosswalked the salary from that of the COMT, the highest level of ophthalmic medical personnel.
We are also proposing to delete those clinical staff that can bill separately from the list of CPEP staff types. We believe that these staff types are used as physician extenders and thus their salaries should not be considered as Start Printed Page 40381practice expense. Therefore, we are proposing to substitute physical therapy aide for physical therapist, registered nurse for physician assistant, nurse practitioner and psychologist, and counselor for social worker. We are also proposing to delete as redundant the ophthalmic medical personnel (OMP) staff type and are substituting the COMT/COT/RN/CST blend that was suggested by the American Academy of Ophthalmology and recommended by the AMA's Relative Value Update Committee.
The CPEP clinical staff inputs also include blends of staff types that are used for those services where more than one type of clinical staff may be used in the performance of the service. We are proposing to establish the payment rates for these blends by calculating a simple average of the wage rates of the staff types included. The table below shows the blended staff types, the proposed cost per minute and the current cost per minute.
Table 3.—Proposed Wage Rates for CPEP Blended Clinical Staff Types
Current description Proposed description Proposed per minute Current per minute COMT/COT/RN/CST Same 0.372 0.307 EKG Tech/MA Medical or Technical Assistant (MTA) 0.254 0.183 EKG Tech/Med Tech Medical or Technical Assistant (MTA) 0.254 0.214 Lab Tech/Histotech Same 0.341 0.297 Lab Tech/Med Tech Lab Tech/MTA 0.286 0.257 Optician/COMT Same 0.323 0.278 RN/LPN Same 0.412 0.389 RN/LPN/MA RN/LPN/MTA 0.359 0.317 RN/LPN/MA/Tech RN/LPN/MTA 0.359 0.269 RN/Med Tech/MA RN/LPN/MTA 0.359 0.269 RN/OCN Same 0.543 0.497 RN/PA/Cast Tech RN/LPN/MTA 0.359 0.402 RN/Respiratory Therapist Same 0.456 0.421 RN/Tech RN/LPN/MTA 0.359 0.323 RN/Ultrasound Tech RN/Sonographer 0.494 0.405 RN//MA RN/LPN/MTA 0.359 0.326 Note: The proposed descriptions are based on our proposals on staff types from the previous table. We have eliminated the staff types we have proposed deleting from the above blends. We are also proposing to add LPN to the blend of an RN and a medical or technical assistant because we believe that if an RN and an assistant can perform a service, it is reasonable to assume that an LPN could as well. Revision of the Ophthalmology Visit Supply Package
In its May 2000 submission to us, the RUC recommended the use of an ophthalmology visit supply package that would contain the routine supplies typically used in each 90-day global postsurgical visit for ophthalmology services. We accepted this recommendation. However, upon further review, we noted that two of the supplies—rev eyes and post myd spectacles—were not used in many of the postsurgical office visits. Therefore, after consulting with the ophthalmology specialty society, we are proposing to remove these two items from the ophthalmology visit package. Instead, we propose to include these items as appropriate on a code-by-code basis.
Deletion of Contrast Agents From the Practice Expense Inputs
Section 430(b) of BIPA amends section 1861(t)(1) of the Act to include contrast agents in the definition of drugs and biologicals. Previously, contrast agents were defined as supplies and were included in the list of CPEP supplies for the appropriate services. Therefore, we are proposing to delete the costs of the following contrast agents from our CPEP data—hypaque, methylene blue, high density barium, polibar, telopaque tablets, barium paste contrast, effervescent sparkies (fizzies) and renographin-60 iodinated contrast.
Physician Time
RUC Time Database
The primary sources for the physician time data used in creating the specialty-specific practice expense pools are the surveys performed for the initial establishment of the work RVUs and the surveys submitted to the AMA RUC. The AMA informed us that some of the times used for the November 1998 final rule (63 FR 58823) differed from the official RUC database, and we agreed to use the RUC-verified physician time database when we received it from the AMA. Subsequently, the AMA notified us that there were gaps in its own database for certain global surgery codes and that a revised time database would be sent to us once all the times were verified. We have now received this revised database and are proposing to use it in the calculation of the specialty-specific practice expense pools. It should be noted that the RUC database reflects the proposed physician times for those codes that were surveyed as part of the 5-year review of physician work.
c. Site-of-Service: Comments on Site of Service. In the November 2, 1998 final rule (63 FR 58830) and the November 2, 1999 final rule (64 FR 59407), we indicated the circumstances under which either the facility or the non-facility RVUs are used to calculate payment for a service. Specifically, we indicated that the lower facility practice expense RVUs apply when the service is performed in an Ambulatory Service Center (ASC) and the procedure is on the ASC-approved procedures list. The higher non-facility practice expense RVUs apply to procedures performed in an ASC that are not on the ASC-approved list because there will be no separate facility payment for these services. We have recently received a number of inquiries asking about the place-of-service that should be used on the Medicare claim when a service not on the ASC-approved procedures list is provided in an ASC. In these circumstances, physicians should indicate ASC as the place-of-service on the Medicare claim. Other questions have arisen as to whether a beneficiary can be billed the ASC facility fee when Medicare does not pay a facility fee because a procedure not on the ASC list is performed in a certified ASC. In this situation, Medicare pays the higher non-facility practice expense RVUs because the ASC is effectively serving as a physician's office, and Medicare's payment for the physician's service Start Printed Page 40382includes payment for all practice expenses incurred in furnishing the service. The ASC benefit does not apply since the services do not meet the provisions of section 1833(i) of the Act. The services are covered as physicians' services and paid under the physician fee schedule. Therefore, payment to the physician reflects payment for the whole service, and the beneficiary cannot be charged in excess of the limiting charge for the physician fee schedule service.
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
On January 1, 1998, we implemented regulations at § 410.37(d) (Conditions for coverage of screening flexible sigmoidoscopies) requiring that screening flexible sigmoidoscopies be performed by a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act). Based on our review of current medical literature, we believe that there are other practitioners whose services are covered under Medicare who have been trained and are qualified to perform these procedures safely and accurately, such as nurse practitioners, clinical nurse specialists, and physician assistants.
A growing body of literature has shown that certain non-physician health care professionals can carry out screening by flexible sigmoidoscopy as accurately and safely as physicians when properly trained. This procedure requires fewer supervised examinations to attain objective measures of technical competency than other endoscopic procedures, does not require sedation, and has a low rate of related complications. In the studies reviewed, physician and non-physician endoscopists achieved similar polyp detection rates and depth of insertion in screenings performed independently. No significant complications from sigmoidoscopy were reported in any of these studies. The level of satisfaction with the procedure was similar for all practitioners.
Therefore, we are proposing to revise § 410.37(d) to provide that, in addition to medical doctors and doctors of osteopathy, physician assistants, nurse practitioners, and clinical nurse specialists also be allowed to perform screening flexible sigmoidoscopies for beneficiaries if they meet the applicable Medicare qualification requirements in §§ 410.74, 410.75, and 410.76, and if they are authorized to perform these services under State law.
C. Services and Supplies Incident to a Physician's Professional Services: Conditions
Section 1861(s)(2)(A) of the Act authorizes coverage of services and supplies (including drugs and biologicals that cannot, as determined in accordance with regulations, be self-administered) furnished as an incident to a physician's service, of kinds which are commonly furnished in physicians' offices and are commonly either furnished without charge or included in the physician's bills. This statutory “incident to” benefit differs from the “incident to” benefit in the hospital setting as set forth in section 1861(s)(2)(B) of the Act, which authorizes coverage of hospital services (including drugs and biologicals which cannot, as determined in accordance with regulations, be self-administered) incident to a physician's service furnished to outpatients and partial hospitalization services furnished to outpatients incident to a physician's service. This proposal only addresses the “incident to” benefit set forth in section 1861(s)(2)(A) of the Act.
In addition, the statute provides Medicare coverage of services incident to practitioners other than physicians. For example, section 1861(s)(2)(K) of the Act authorizes Medicare to pay for services incident to a service of a nurse practitioner or a physician assistant.
Section 2050 of the Medicare Carriers Manual (the manual) clarifies the coverage of services “incident to” physician services as described in section 1861(s)(2)(A) of the Act. Specifically, services incident to a physician service may be furnished by an employee of the physician. Alternatively, both the physician and the individual furnishing the “incident to” service must be employed by a common employer. Furthermore, the individual furnishing the “incident to” service may be any staff member working with the physician and not just one of the non-physician practitioners listed in section 1842(b)(18)(C) of the Act. We shall refer to these staff members as auxiliary personnel, a term which includes registered nurses and medical assistants.
Currently, our manual requires that the physician be either the employer of the auxiliary personnel or be an employee of the same entity that employs the auxiliary personnel. We note that, under our manual, auxiliary personnel may be either employees, leased employees, or independent contractors. An independent contractor relationship appears to be common current practice because it affords the auxiliary personnel the flexibility to work with various physicians or practitioners on a part-time basis. We do not believe that the nature of the employment relationship is critical for purposes of payment for services incident to the services of physicians and practitioners, so long as the auxiliary personnel reports to a physician or practitioner under the required level of supervision. We see no clinical reason to exclude independent contractor physicians and practitioners from the class of practitioners who can receive Medicare payment for services incident to their own services based solely on their status as independent contractors. Accordingly, we propose to allow auxiliary personnel to provide services incident to the services of physicians or practitioners who supervise them, regardless of the employment relationship. Thus, auxiliary personnel may be employees, leased employees, or independent contractors, and may provide services incident to the services of physicians and practitioners who employ or contract with them or who are employees or independent contractors of the same entity, provided that the other requirements for payment for “incident to” services are met. We note, however, that the employment relationship remains relevant under our rules prohibiting reassignment of Medicare benefits. (§§ 424.73 and 424.80) We also propose to codify the following definitions:
- Auxiliary personnel means any individual who is acting under the supervision of a physician, regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner).
- Direct supervision means the level of supervision by the physician (or other practitioner) of auxiliary personnel as defined in § 410.32(b)(3)(ii).
- Independent contractor means an individual who performs part-time or full-time work for which the individual receives an IRS-1099 form.
- Leased employment means an employment relationship that is recognized by applicable State law and that is established by two employers by a contract such that one employer hires the services of an employee of the other employer.
- Noninstitutional setting means all settings other than a hospital or skilled nursing facility.
- Practitioner means a non-physician practitioner who is authorized by the Start Printed Page 40383Act to receive payment for services incident to his or her own services.
- Services and supplies means any service or supply (including any drug and biological that cannot be self-administered) that is included in section 1861(s)(2)(A) of the Act and is not specifically listed in the Act as a separate benefit included in the Medicare program.
We also propose to codify the provisions in section 2050 of the manual by revising § 410.26 to clarify the requirements for “incident to” services. Section 410.26 would be revised as follows:
- Services and supplies must be furnished in a noninstitutional setting to noninstitutional patients.
- Services and supplies must be an integral, although incidental, part of the service of a physician (or other practitioner) in the course of diagnosis or treatment of an injury or illness.
- Services and supplies must be commonly furnished without charge or included in the bill of a physician (or other practitioner).
- Services and supplies must be of a type that are commonly furnished in the office or clinic of a physician (or other practitioner).
- Services and supplies must be furnished under the direct supervision of the physician (or other practitioner).
- Services and supplies must be furnished by the physician, practitioner with an incident to benefit, or by auxiliary personnel.
- A physician (or other practitioner) may be an employee or an independent contractor.
- Drugs and biologicals are also subject to the limitations specified in § 410.29.
D. Anesthesia Services
Section 4048(b) of the Omnibus Budget Reconciliation Act of 1987 amended section 1842(b) of the Act and required us to establish a uniform relative value guide for use in all carrier localities in determining payment for anesthesia services furnished by physicians under Medicare Part B. In accordance with the law, the uniform relative value guide was designed so that Medicare payment for anesthesia services would not exceed the amount that would have occurred under the then-existing system of payment.
We implemented the uniform relative value guide in March 1989 and selected the 1988 American Society of Anesthesiologists' (ASA) Relative Value Guide as the basis for the uniform relative value guide. (For a discussion of this issue, please see the August 7, 1990 final rule (55 FR 32078).)
To determine base unit values, we used the 1988 ASA base unit values for each anesthesia code, except for codes 00142 (lens surgery) and 00147 (iridectomy). The base unit values for each of these codes were set at 4 units instead of the ASA values of 6 and 5 units, respectively.
The ASA has requested that we ensure that the anesthesia base units under our uniform relative value guide are the same as those listed in the ASA's most current guide. Standardization of base units between Medicare and the ASA guide will simplify billing by anesthesiologists. The ASA's base unit values for the following 8 codes are different than CMS's values:
Code CMS ASA 0081 6 5 00902 4 5 01150 8 10 01214 10 8 01432 5 6 01440 5 8 01770 8 6 01921 7 8 We are proposing to use the ASA base unit values from the 1999 guide beginning in CY 2002 for the above codes. However, the base unit values for codes 00142 and 00147 would remain at 4 units. The values for these codes were established by us under the “inherent reasonableness” process in 1987.
We would make an adjustment to the anesthesia conversion factor in 2001 so that payments would not exceed payments that would have been made using the current values. We currently estimate that this adjustment will be less than 0.5 percent.
E. Performance Measurement and Emerging Technology Codes
In modernizing the CPT, the AMA has developed two new categories of codes. In addition to the traditional codes for physicians' and other practitioners' services, referred to as Category I CPT codes, which are coded by five digit numbers, the new codes describe Performance Measures and Emerging Technologies and are coded with four digits followed by a letter.
The Performance Measure codes, referred to as Category II CPT codes, are intended to facilitate data collection. These codes are designed to decrease the need for review of medical records to document when services were performed. They allow practitioners to indicate in their billing records that the visit addressed issues that need to be tracked for quality and outcome measurement. For example, there is likely to be a code to indicate that a diabetic patient received a retinal examination. The visit that contained that specific service might have been reported with an evaluation and management code or with a more general ophthalmological service code and paid for based on the code selected. Thus, the performance measurement code is used only to assist the practitioner to specify that the performance measurement service was furnished. The syntax of this code will be four digits followed by the letter “F.” We are proposing that no values are placed on the Performance Measure codes and no additional payment is made for the use of these codes. Practitioners will, however, be able to list them on their Medicare bills, to facilitate the tracking of these services.
The Emerging Technology codes, referred to as Category III CPT codes, are intended to track new and emerging technologies. These codes were developed to facilitate data collection on and assessment of new services and procedures. These data could be used to document the use of services and procedures in the Food and Drug Administration approval process or while the efficacy of a procedure is being demonstrated. The syntax of these codes is four digits followed by the letter “T.” In general, these codes represent services that are still experimental or have unverified effectiveness and would not be covered services. Although we were concerned that codes with a “T” designation might be needed for use by some Medicaid programs, we now believe that we would be able to process claims with the “T” in the fifth digit. However, we propose not to provide payment for all of the Emerging Technology Codes. Rather, we would provide payment on a case-by-case basis only in specific situations when we determine that the codes represent services that are not, in fact, experimental, but have been shown to be safe and effective. If the coverage policy is not consistent with the existing tracking codes, a Medicare-specific code may need to be developed to allow payment for the service. Thus, we propose that only specific emerging technology codes will be recognized for Medicare payment.
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
The CPT modifier code 62 is used to report the work of co-surgeons. Currently, if we pay for co-surgery, we pay a total of 125 percent of the fee schedule amount to the co-surgeons who each receive half of this total payment. This policy was established at the beginning of the fee schedule and Start Printed Page 40384the level of payment reflected the predominant payment rate used by Medicare carriers at that time. Unlike other components of the fee schedule, this payment policy was not based on an analysis of the relative physician work effort for surgical services involving co-surgeons.
In addition, surgical practice has changed significantly over the past 10 years. For example, there is increasing use of noninvasive, minimally invasive, percutaneous, and endoscopic approaches to performing surgical procedures that were formerly performed as open procedures. Therefore, we are reviewing our payment policies for co-surgery to consider possible ways to ensure that they reflect current clinical practices and properly reflect the relative resources and work effort required to perform these services.
Among the issues we are considering are:
(1) Whether it would be possible to establish criteria for distinguishing the roles of a co-surgeon (when both surgeons are paid at 125 percent of the surgery amount) and assistant at surgery (when the total payment is 116 percent of the surgery amount);
(2) Whether any such criteria should vary by type of procedure (that is, open surgical, minimally invasive (including interventional procedures), and endoscopic procedures);
(3) Which procedures require a co-surgeon and under what circumstances should documentation be required for payment; and
(4) How to value the work performed by a co-surgeon.
While we are not making a specific proposal at this time, we will consider any information we receive to assist us in deciding whether to make a future proposal affecting payments for co-surgery.
III. Implementation of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) (Public Law 106-554), enacted on December 21, 2000, provides for revisions to policies applicable to the physician fee schedule. These revisions are presented below.
A. Screening Mammography
Medicare has paid for screening mammography since January 1, 1991. Section 1834(c) of the Act governing these screenings did not include screening mammography under the physician fee schedule and required payment using a different methodology. As stated in § 405.534, Medicare payment for screening mammography currently equals the lesser of the following: the actual charge for the service; the applicable amount under the physician fee schedule in an area for a bilateral diagnostic mammogram; or $55, a figure specified in section 1834(c)(3) of the Act, updated since 1991 by the Medicare Economic Index (MEI). In 2001, the statutory payment limit for screening mammography is $69.23. In most cases, payment for screening mammography is made at the national limit with no differences among geographical areas.
Section 104 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) amends section 1848(j)(3) of the Act to include screening mammography as a physician service for which payment is made under the physician fee schedule beginning January 1, 2002. We are proposing to amend §§ 405.534 and 405.535 to reflect the inclusion of screening mammography as a physician service which will be payable under the physician fee schedule. In addition, we are amending § 414.2 to include screening mammography under the definition for physicians' services. In accordance with part 414, payments for screening mammography will be resource-based and will have geographic adjustments that reflect cost differences among areas as do all other services under the physician fee schedule, including diagnostic mammography. The following is a discussion of our proposed RVUs for the professional and technical components (PC and TC) of a screening mammography, code 76092, under the physician fee schedule.
Professional Component
We are proposing to establish physician work RVUs=0.70. This value is equal to the proposed work RVUs from the 5-year review of physician work for code 76090, unilateral diagnostic mammogram. Due to the comparable number of views taken in both a unilateral diagnostic mammography and a screening mammography, we believe the physician work associated with the performance of screening mammography is similar to the physician work associated with unilateral diagnostic mammography.
We note that in the June 8, 2001 proposed notice on the 5-year review of work RVUs (66 FR 31028), we proposed to increase the work RVUs for unilateral diagnostic mammography from 0.58 to 0.70 RVUs, an increase of 21 percent. Additionally, we are proposing to increase the work RVUs for bilateral diagnostic mammography from 0.69 to 0.87 RVUs, an increase of 26 percent. Both of these increases would be effective for services performed on or after January 1, 2002. Our proposal to establish physician work RVUs for screening mammography equal to the physician work RVUs for unilateral diagnostic mammography, since both involve a four view film study, incorporates the increases we have proposed in the June 8, 2001 proposed notice.
We also believe that the practice expense and malpractice expense for the professional component of screening mammography is similar to the professional component of unilateral diagnostic mammography. As a result, we are proposing 0.25 practice expense RVUs and 0.03 malpractice RVUs for the PC of screening mammography. These proposed RVUs reflect changes to the practice expense RVUs for code 76090.
Technical Component
We propose valuing the technical component of screening mammography using a methodology that updates the original statutory limit for the technical component of screening mammography of $37.40, by the cumulative increase in physician fee schedule rates between 1992 and 2001. While screening mammography payments increased through application of the MEI between 1992 and 2001, resulting in a cumulative increase of 25.9 percent, physician fee schedule payments increased by 35.6 percent during this period. As a result, increasing payment for screening mammography by the statutory limit led to lower payment than if payment for the procedure had increased at the same rate as physician fee schedule services.
We propose updating the technical component of the initial screening mammography statutory limit of $37.40 by the same update factor that would have applied if screening mammography had received the same increases as physician fee schedule services. Currently, payment for the technical component of a screening mammography is equal to 68 percent of the statutory payment limit. To update the current value, we took 68 percent of the original $55 payment limit and increased it by 35.6 percent ($55 × 0.68 × 1.356 = $50.70). We divided this figure by the 2001 physician fee schedule CF of $38.2581 to determine total RVUs of 1.33. Since the TC is comprised only of practice and malpractice RVUs, we then used the Start Printed Page 40385practice expense and malpractice expense percentages for the TC of unilateral diagnostic mammography (95.3 and 4.7 percent, respectively) to determine the practice expense and malpractice RVUs for the technical component of screening mammography. We multiplied the total RVUs of 1.33 by 0.953 to determine the proposed practice expense RVUs of 1.27 and by 0.047 to determine the proposed malpractice expense RVUs of 0.06.
Overall, the proposed total RVUs associated with the combined PC and TC of code 76092 are 2.31 (0.70 work RVUs, 1.52 practice expense RVUs, and 0.09 malpractice expense RVUs). These proposed RVUs would result in a payment for CY 2002 of approximately $88.50, before application of any geographic adjustments.
New Technology Mammography
The BIPA requires us to determine whether the assignment of new HCPCS codes is appropriate for both screening and diagnostic mammography using new technologies. If new codes are appropriate, the provision requires us to provide for their use beginning January 1, 2002. The provision defines new technology mammography to be an advance in technology with respect to the test or equipment that results in: (a) A significant increase or decrease in the resources used in the test or in the manufacture of the equipment; (b) a significant improvement in the performance of the test or equipment; or (c) a significant advance in medical technology that is expected to significantly improve the treatment of Medicare beneficiaries.
Before January 1, 2002, the BIPA provides for temporary payment amounts during the period April 1, 2001 to December 31, 2001 for two types of new technology mammography used in both diagnostic and screening procedures. The BIPA specifies that payment for technologies that directly take digital images would equal 150 percent of the amount that would otherwise be paid for bilateral diagnostic mammography. The BIPA also specifies that for technologies that convert standard film to a digital form which is then analyzed, payment would be equal to the statutory screening mammography limit for CY 2001, plus an additional payment of $15.00. Moreover, the BIPA specifies that the same payment amount be used for a screening or diagnostic procedure for each of the new technologies. We have implemented the temporary payment provisions via a Program Memorandum sent to Medicare carriers on February 1, 2000.
We believe that new HCPCS codes are appropriate for new technology mammography beginning with January 1, 2002 and propose codes to be used with the associated RVUs described below. We propose to establish three separate codes for directly taking a digital image (one for screening and one each for unilateral and bilateral diagnostic). Our approach would establish a single add-on code for computer-aided diagnosis with conversion of standard film images to digital images. At the present time, the FDA has approved computer-aided diagnosis only for use in conjunction with standard film screening mammography. Thus, at the present time, our proposal would only allow Gxxx4 to be billed as an add-on to 76090 if medically necessary. In the section that follows, we discuss the proposed coding and payment methodologies for new technology mammography.
Screening mammography, direct digital image (Gxxx1). We propose to use HCPCS code Gxxx1 to report screening mammography performed using direct digital images as opposed to mammography that is performed using the standard film images associated with code 76092, or conversion of a standard film image to a digital image. (Note: Gxxx is used as a placeholder; the actual “G” code designation for payment will be included in the final rule.)
We believe that the physician work and malpractice expense associated with both the PC and TC of HCPCS code Gxxx1 are analogous to the professional and technical components of CPT code 76092. (Note: Proposed work RVUs for code 76092, discussed above, are being increased to 0.70.) However, because the equipment involved with direct digital images is different from the equipment involved with standard film images, we believe that the practice expense RVUs are different than the practice expense RVUs for code 76092. Thus, we are proposing to value the practice expense for the PC of this service using the methodology for determining resource-based practice expense RVUs. We are proposing to value the practice expense RVUs for the TC of the service using the practice expense methodology for the “zero work pool.” (For more information about the practice expense methodology for PC and TC services, see the November 2, 1998 final rule (63 FR 58817).
For the PC of HCPCS code Gxxx1, we propose 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx1, for which there is no physician work associated, we propose 2.50 practice expense RVUs and 0.06 malpractice RVUs. Please see Table 4 below for a summary of all component RVUs associated with this and other mammography services.
Diagnostic mammography, unilateral, direct digital image (Gxxx2). We propose to use HCPCS code Gxxx2 to report unilateral diagnostic mammography performed using direct digital images as opposed to mammography performed using the standard film images associated with code 76090, or conversion of a standard film image to a digital image.
We believe that the physician work and malpractice expense associated with both the PC and TC of HCPCS code Gxxx2 are analogous to the PC and TC of code 76090. (Note: Proposed work RVUs for code 76090, discussed above, are being increased to 0.70). However, because the equipment involved with direct digital images is different from the equipment involved with standard film images, we believe that the practice expense RVUs are different than those for code 76090. Thus, we are proposing to value the practice expense for the PC of this service using the methodology for determining resource-based practice expense RVUs. We are proposing to value the practice expense RVUs for the TC of the service using the practice expense methodology for the “zero work pool.”
For the professional component of HCPCS code Gxxx2, we propose 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx2, for which there is no physician work associated, we propose 1.99 practice expense RVUs and 0.05 malpractice expense RVUs. Please see Table 4 below for a summary of all component RVUs associated with this and other mammography services.
Diagnostic mammography, bilateral, direct digital image (Gxxx3). We propose to use HCPCS code Gxxx3 to report bilateral diagnostic mammography that is performed using direct digital images as opposed to mammography performed using the standard film images associated with code 76091, or conversion of a standard film image to a digital image.
We believe that the physician work and malpractice expenses associated with both the PC and TC of HCPCS code Gxxx3 are analogous to the PC and TC of code 76091. (Note: Proposed work RVUs for code 76091, discussed above, are being increased to 0.87). However, because the equipment involved with direct digital images is different from the equipment involved with standard Start Printed Page 40386film images, we believe that the practice expense RVUs are different than those for code 76091. Thus, we are proposing to value the practice expense for the PC of this service using the methodology for determining resource-based practice expense RVUs. The practice expense RVUs for the TC of the service are being valued using the practice expense methodology for the “zero work pool.”
For the PC of HCPCS code Gxxx3, we propose 0.87 work RVUs, 0.34 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx3, with which there is no physician work associated, we propose 2.47 practice expense RVUs and 0.06 malpractice expense RVUs. Please see Table 4 below for a summary of all component relative values associated with this and other mammography services.
Computer-aided detection, conversion of standard film images to digital images (HCPCS Code Gxxx4). We propose to use HCPCS code Gxxx4 to report conversion of standard film images to digital images when used in conjunction with computer-aided diagnosis software.
We propose establishing HCPCS code Gxxx4 as an add-on code that can be billed only in conjunction with the primary service, code 76092. At this time, we understand that the only FDA-approved use of the computer-aided diagnosis mammography software is with screening film images. If there are other FDA-approved uses of computer-aided diagnosis, we allow for use of Gxxx4 as an add-on to other mammography services. We believe that the physician work associated with CPT code 76375, Coronal, sagittal, multiplanar, oblique, 3-dimensional and/or holographic reconstruction of computerized tomography, magnetic resonance imaging, or other tomographic modality, is comparable, per unit of time, to the physician work of Gxxx4. We have determined that the physician time associated with HCPCS code Gxxx4 is approximately 1/3 of the physician time associated with CPT code 76375. Using this relationship, we propose 0.06 work relative value units for HCPCS code Gxxx4. Additionally, we believe the malpractice expense RVUs for HCPCS code Gxxx4 are analogous to a level two established office visit, CPT code 99212. However, we believe that the practice expense RVUs for HCPCS code Gxxx4 are markedly different from either of the two aforementioned services; therefore, we are valuing the PC of this service using the methodology for determining resource-based practice expense RVUs. The TC of the service is being valued using the practice expense methodology for the “zero work pool.”
For the PC of code Gxxx4, we propose 0.06 work RVUs, 0.02 practice expense RVUs, and 0.01 malpractice expense RVUs. For the TC of HCPCS code Gxxx4, with which there is no physician work associated, we propose 0.41 practice expense RVUs and 0.01 malpractice expense RVUs. Table 4 below summarizes all component RVUs associated with this and other mammography services.
Table 4.—Proposed RVUs for Mammography Services
Code Modifier Work Practice expense Malpractice Total 76090 0.70 1.28 0.08 2.06 76090 26 0.70 0.24 0.03 0.97 76090 TC 0.00 1.04 0.05 1.09 76091 0.87 1.59 0.09 2.55 76091 26 0.87 0.30 0.03 1.20 76091 TC 0.00 1.29 0.06 1.35 76092 0.70 1.52 0.09 2.31 76092 26 0.70 0.25 0.03 0.98 76092 TC 0.00 1.27 0.06 1.33 Gxxx1 0.70 2.78 0.09 3.57 Gxxx1 26 0.70 0.28 0.03 1.01 Gxxx1 TC 0.00 2.50 0.06 2.56 Gxxx2 0.70 2.27 0.08 3.05 Gxxx2 26 0.70 0.28 0.03 1.01 Gxxx2 TC 0.00 1.99 0.05 2.04 Gxxx3 0.87 2.81 0.09 3.77 Gxxx3 26 0.87 0.34 0.03 1.24 Gxxx3 TC 0.00 2.47 0.06 2.53 Gxxx4 0.06 0.43 0.02 0.51 Gxxx4 26 0.06 0.02 0.01 0.09 Gxxx4 TC 0.00 0.41 0.01 0.42 B. Screening Pelvic Examinations
Before the enactment of the BIPA, section 1861(nn)(2) of the Act authorized Medicare coverage for a screening pelvic examination (including a clinical breast examination) furnished to a woman for the purpose of early detection of cervical or vaginal cancer once every 3 years, or once every year for a woman who is at high risk for one of these conditions, or who is of childbearing age and meets certain other requirements.
Section 101 of the BIPA amends section 1861(nn)(2) of the Act (effective July 1, 2001) to provide that a woman who does not qualify for annual coverage of a screening pelvic examination under one of the statutory exceptions, qualifies for coverage of a screening pelvic examination (including a clinical breast examination) once every 2 years rather than once every 3 years.
We are conforming § 410.56 (Screening Pelvic Examinations) of the regulations to the new statutory provision that has been implemented through sections 4603, 3628.1 and 4731 of the Medicare Carrier Manual, the Medicare Intermediary Manual, and the Medicare Hospital Manual, respectively.
C. Screening for Glaucoma
Section 102 of BIPA provides for Medicare coverage under Part B for screening for glaucoma for individuals with diabetes, a family history of glaucoma, or others determined to be at “high risk” for glaucoma effective for services furnished on or after January 1, Start Printed Page 403872002. The statute provides for coverage of glaucoma screening, including (1) a dilated eye examination with an intraocular pressure measurement, and (2) a direct ophthalmoscopy or a slit-lamp biomicroscopic examination, subject to certain frequency and other limitations.
Currently, Medicare coverage policy allows for payment for examinations to diagnose glaucoma and related medically necessary services that are furnished to beneficiaries. Under this policy, diagnostic glaucoma tests are covered if they are medically necessary to evaluate a specific complaint or symptom that might indicate glaucoma or to monitor an existing medical condition of an individual who has had a history of elevated intraocular pressure or other signs of possible glaucoma. This coverage is based on sections 1861(s)(1) and (s)(3) of the Act. Section 1861(s)(1) of the Act provides for general Medicare coverage of physicians' services, including a physician's interpretation of the results of tests performed. Section 1861(s)(3) of the Act provides for general Medicare coverage of diagnostic x-ray, clinical laboratory, and other diagnostic tests. Before the enactment of the BIPA, screening for glaucoma was excluded from coverage based on § 411.15 (Particular services excluded from coverage), paragraphs (a) and (k).
To conform our regulations to the statutory requirements of the BIPA, we are specifying an exception to the list of examples of routine physical checkups excluded from coverage in §§ 411.15(a)(1) and 411.15(k)(9) for glaucoma screening examinations that meet the frequency limitation and the conditions for coverage that we are specifying under new § 410.23 (Screening for Glaucoma: Conditions for and Limitations on Coverage). Coverage of glaucoma screening is provided under Medicare Part B only. As provided in the statute, this new coverage allows payment for one glaucoma screening examination every year. We are proposing to add new § 410.23 (Screening for Glaucoma: Conditions for and Limitations on Coverage), to provide for coverage of the various types of glaucoma screening examinations specified in the statute. We are proposing several definitions of terms that would be included to implement the statutory provisions and to help the reader in understanding the provisions of the regulation. These include definitions of the following terms: (1) Screening for glaucoma, (2) eligible beneficiaries, and (3) direct supervision.
Section 102(b) of the BIPA defines the term “screening for glaucoma” to mean a dilated eye examination with an intraocular pressure measurement and a direct ophthalmoscopy or a slit-lamp biomicroscopic examination for the early detection of glaucoma. This section also provides that the screening examinations that are to be covered under Medicare are to be furnished by or under the direct supervision of an optometrist or ophthalmologist who is legally authorized to furnish these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished. These are services that would otherwise be covered if furnished by a physician or as incident to a physician's professional service.
Section 102(a) of BIPA also provides that coverage of screening for glaucoma services will be available only for individuals determined to be at high risk for glaucoma, individuals with a family history of glaucoma and individuals with diabetes. Based on our review of the medical literature, and consultation with staff of the National Eye Institute and representatives of the American Academy of Ophthalmology and the American Optometric Association, we are proposing to interpret the statutory language, “individuals determined to be at high risk for glaucoma” to include Medicare beneficiaries who are African-Americans age 50 and over. While the National Eye Institute and others have provided us with information indicating that age and other factors may place a Medicare beneficiary at increased risk for glaucoma, we believe that the medical evidence available at this time is only sufficient to support inclusion of African-Americans age 50 and over in the statutory “high risk” category, in addition to individuals with diabetes and those with a family history of glaucoma who are covered separately under the new screening benefit. Studies have shown that the prevalence of glaucoma increases with age and is four to five times more likely to occur in African-Americans than in Caucasians. (Tielsch et al. JAMA 1991; Quigley. NEJM 1997) For African-Americans, the evidence indicates that the onset of the disease comes at an earlier age, and that the damage is more severe at the time of diagnosis. In view of the possibility that it may be appropriate to include other individuals in the statutory definition of those at “high risk” for glaucoma, however, we are requesting public comments on this issue. Specifically, we ask that anyone providing us with specific recommendations on this issue should provide documentation in support of them from the medical literature. In addition, we are proposing to use the term “eligible beneficiaries” to indicate who may qualify for the new screening glaucoma benefit, and we are proposing to define that term to include: (1) Individuals with diabetes mellitus, (2) individuals with a family history of glaucoma, and (3) African-Americans age 50 and over.
Section 102(b) of the BIPA also provides that the glaucoma screening examination is to be furnished by or under the direct supervision of an ophthalmologist or optometrist who is legally authorized to furnish such services under State law or regulation in which the services are furnished. We are proposing to define the term “direct supervision” as that term is defined in § 410.32(b)(3)(ii) for purposes of the oversight of covered diagnostic laboratory services as they are performed in the office setting. Specifically, we are proposing that the term “direct supervision” be defined to mean that the ophthalmologist or optometrist must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. The proposed definition states that the term “direct supervision” does not mean the physician must be present in the room when the procedure is performed.
Payment for Glaucoma Screening
We believe that services provided as part of glaucoma screening will often overlap other services a physician provides during a patient encounter as part of basic ophthalmological services and will result in no additional work or practice expense. Therefore, we propose bundling payment for glaucoma screening when it is provided on the same day as an evaluation and management (E/M) service, or when it is provided as part of any ophthalmology service. When glaucoma screening is the only service provided, or when it is provided as part of an otherwise noncovered service (for example, CPT 99397, preventive services visit), we propose to establish the following HCPCS codes and payments:
Gxxx5, Glaucoma Screening Furnished by a Physician for High Risk Patients
For physician work and for malpractice, we propose crosswalking this new HCPCS code to a level II E/M code, CPT 99212, which we believe represents a comparable level of work. The proposed work and malpractice RVUs are 0.45 and 0.02, respectively.
Start Printed Page 40388Gxxx6, Glaucoma Screening Furnished Under the Direct Supervision of a Physician for High Risk Patients
For physician work and for malpractice, we propose crosswalking this new HCPCS code to the lowest level E/M code, CPT 99211, which we believe represents a comparable level of work. The proposed work and malpractice RVUs are 0.17 and 0.01, respectively.
For non-facility settings, we propose the following practice expense inputs for both of the above HCPCS Codes:
clinical staff time-certified ophthalmic medical technologist/certified ophthalmic technician/registered
nurse: five minutes;
equipment: screening lane; and
supplies: ophthalmology visit supply package.
D. Screening Colonoscopy
Before the enactment of the BIPA, sections 1861(pp)(1)(C) and 1834(d)(3)(E) of the Act authorized Medicare coverage of screening colonoscopies once every 2 years for individuals at high risk for colorectal cancer. Individuals not at high risk for colorectal cancer did not qualify for coverage of screening colonoscopies under the colorectal cancer screening benefit, but they did qualify for coverage of other colorectal cancer screening examinations specified in the statute. These other examinations that were covered for individuals not at high risk for colorectal cancer included screening fecal-occult blood tests, screening flexible sigmoidoscopies, and screening barium enema examinations at certain frequency intervals specified in the statute and the regulations at § 410.37 (Colorectal cancer screening tests).
Section 103 of the BIPA amended sections 1861(pp)(1)(C), 1834(d)(2)(E)(ii), and 1834(d)(3)(F) of the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. However, in the case of an individual who is not at high risk for colorectal cancer, but who has had a screening flexible sigmoidoscopy within the last 4 years, the statute provides that payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed. In addition, the statute provides that in the case of an individual who is not at high risk for colorectal cancer but who does have a screening colonoscopy performed on or after July 1, 2001, payment may be made for a screening flexible sigmoidoscopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
In view of the statutory changes, we are conforming §§ 410.37(e) and 410.37(g) (related to limitations on coverage of screening colonoscopies and screening flexible sigmoidoscopies) to make them consistent with the new provisions of the statute that have been implemented through manual provisions of the Medicare Carriers Manual, the Medicare Intermediary Manual Part III, and the Medicare Hospital Manual in transmittal numbers 6097, 1824, and 7069, respectively, in February 2001.
Payment for Screening Colonoscopy
Payment for screening colonoscopy will be made under HCPCS code G0121: colorectal screening; colonoscopy for an individual not meeting criteria for high risk. As with current code G0105, screening colonoscopy for an individual at high risk, payment will be made at the level for a diagnostic colonoscopy, CPT code 45378, because the work is the same whether a procedure is screening or diagnostic. As the statute requires for both individuals who are or are not at high risk, if, during the course of the screening colonoscopy, a lesion or growth is detected that results in a biopsy or removal of the growth, the appropriate diagnostic procedure classified as colonoscopy with biopsy or removal should be billed and paid rather than HCPCS code G0105 or G0121.
E. Medical Nutrition Therapy
1. Legislation
Section 105 of the BIPA amended section 1861(s)(2) of the Act to authorize Medicare Part B coverage under Part B of medical nutrition therapy (MNT) for beneficiaries who have diabetes or renal disease, effective for services furnished on or after January 1, 2002. The legislation also:
- Authorizes dietitians and nutritionists who meet certain qualifications to be reimbursed directly by Medicare.
- Excludes from coverage beneficiaries who are receiving maintenance dialysis for which payment is made under section 1881 of the Act.
- Requires coordination of medical nutrition therapy benefits with the existing benefit for diabetes outpatient self-management training services.
- Defines a registered dietitian or other nutrition professional, and grandfathers dietitians or nutrition professionals who were licensed or certified in their States as of December 21, 2000, but would not otherwise meet the new requirements.
- Specifies that Medicare payment for MNT services must equal 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the physician fee schedule for the same services if furnished by a physician.
- Requires that we submit a report to the Congress by July 1, 2003, that contains recommendations with respect to expansion of the MNT benefit for other medical conditions.
This new benefit, while related, differs from the diabetes outpatient self-management training (DSMT) benefit, which was established by the BBA in section 1861(s)(2)(S) of the Act and described at section 1861(qq). The DSMT benefit is a comprehensive diabetes training program, of which nutrition training is only one component. Most of the available research (Diabetes Control and Complication Trial Research Group, 1993; UK Prospective Diabetes Study Group, 1995; and UK Prospective Diabetes Study Group, 1998) supports the use of a multi-disciplinary approach to diabetes, which includes nutrition training. As a result, nutrition training is considered to be an essential element of the DSMT benefit. Section 1861(qq) of the Act mandates the use of quality standards for DSMT and allows certified individuals or entities designated by the Secretary that meet such standards to receive Medicare payment for the service, provided that the physician managing the patient certified that DSMT is needed.
The approach in the BIPA with regard to MNT is different. The statute mandates specific qualifications regarding who may provide MNT services, but does not require that we establish quality standards. We are also instructed by the Congress to establish criteria for recognition of individuals in States that do not have licensure or certification requirements for registered dietitians or nutrition professionals.
We set specific duration and frequency limits for DSMT, consistent with the statutory authority granted by the BBA. In accordance with our regulations in § 410.141(c), all beneficiaries receiving the DSMT benefit may have up to 10 hours of initial training within a continuous 12-month period. For most beneficiaries, 9 of these 10 hours of training must be in a group setting. One hour of training may be on an individual basis for purposes of conducting an individual assessment and providing specialized training. Once a beneficiary has completed the 10 hours of initial Start Printed Page 40389training, the benefit provides for up to 2 hours of follow-up training each subsequent year. As with the DSMT benefit the duration and frequency of the MNT benefit was not prescribed by the Congress. However, since the Congress has indicated that beneficiaries who have received DSMT within a designated time period (to be specified by the Secretary) are not eligible for MNT, the two benefits must be coordinated.
2. Proposed Policy
Consistent with section 105(a)(3) of the BIPA, we considered the protocols of the American Dietetic Association and the National Kidney Foundation regarding nutrition training for both diabetes and renal disease. Because the protocols were inconclusive with respect to the duration and frequency issues, we are proposing to determine the duration and frequency of the benefit through the National Coverage Determination (NCD) process rather than through the rulemaking process. We will solicit the opinions of all interested parties as a part of the NCD process.
We propose to set forth the provisions regarding medical nutrition therapy at Part 410, subpart G and at § 414.64. The MNT provisions of the proposed rule are as follows:
Definitions (§ 410.130). We propose to define “renal disease” for the purpose of this benefit as only chronic renal insufficiency and post-transplant care provided after discharge from the hospital. The exclusion of patients receiving maintenance dialysis under section 1881 of the Act is consistent with section 1861(s)(2) of the Act, as amended by section 105(a)(3) of the BIPA. We propose to limit post-transplant care to care furnished within 6 months after discharge from the hospital, if the transplant is viable and effective, because under such conditions we believe the beneficiary would no longer have renal disease and would not be eligible to receive the benefit under the statutory provision. We propose a 6-month time period based on expert opinions. We specifically request comments on this proposed time period and request that commenters submit articles from clinical journals to support their comments. We do not make separate payments for MNT while the beneficiary is an inpatient in the hospital because the statute only authorizes payment for this service under Part B. We are proposing definitions of “diabetes” and “chronic renal insufficiency” for the purpose of this benefit using definitions from the Institute of Medicine report, “The Role of Nutrition in Maintaining Health in the Nation's Elderly,” published in 2000.
We propose to define “episode of care” as a time period that may not exceed 12 months, starting with the assessment (based on a referral from a physician), and including all covered interventions. The number of episodes of care covered during the lifetime of an individual beneficiary is unlimited. We chose a 12-month period to allow for the coordination of the MNT and DSMT benefits, as authorized by section 105(a)(3) of the BIPA.
Finally, in accordance with the statute, we define MNT services as nutritional diagnostic, therapy, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing disease. This definition tracks the language of the statute.
Medical Nutrition Therapy (§ 410.132).
At proposed § 410.132(a), we set forth conditions for coverage of MNT services. Specifically, we provide that Medicare Part B pays for MNT services furnished by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the beneficiary's treating physician. We limit the definition of physician to “treating physician” to ensure that the physician establishing the need for MNT is actually treating the beneficiary for the chronic disease and the therapy is coordinated with the care being provided by the treating physician. Referrals by a non-treating physician might also be interpreted as an indication that a fraudulent situation exists.
We are proposing that the services covered will consist of nutritional assessment, interventions, reassessment, and follow-up interventions. We chose not to define the specific components of the benefit in more detail because we anticipate that registered dietitians and nutritionists will use nationally recognized protocols, such as those developed by the American Dietetic Association (ADA) as they normally would in their business practice. We also chose not to specify the number of hours of MNT that will be covered. Rather, we will develop these frequency limits using the NCD process. After we complete a literature review, we will solicit input from interested parties as part of the NCD process.
At § 410.132(b), we set forth proposed coverage limitations for MNT services. In accordance with section 1861(s)(2)(V)(ii) of the Act, we would provide that MNT services are not covered for beneficiaries on dialysis for end-stage renal disease. We do not exclude all beneficiaries who are diagnosed with end-stage renal disease because a few individuals with end-stage renal disease do not receive maintenance dialysis and the statute specifically excludes beneficiaries receiving maintenance dialysis under section 1881 of the Act. The other provisions of this section would coordinate the referrals for MNT for diabetes and renal disease, and coordinate MNT services with DSMT services as follows:
- If a beneficiary has both diabetes and a renal disease as defined in this subpart, the beneficiary may receive both MNT and DSMT, but coverage in any 12-month period would be limited to the number of hours the beneficiary would receive under either the MNT benefit or the DSMT benefit for that period, whichever is greater.
- MNT would only be covered if the beneficiary had not started initial training under the diabetes self-management training benefit (as described in § 410.141) within the past 12 months, unless: (1) the need for a reassessment had been documented by the referring physician; or (2) the beneficiary had been diagnosed with both diabetes and renal disease.
- If a beneficiary diagnosed with diabetes was referred for both follow-up DSMT services and MNT, the beneficiary would only receive the total amount of hours covered under either follow-up DSMT services or MNT, whichever was greater.
If DSMT and MNT benefits overlapped, we would not allow the number of hours covered under the MNT benefit to exceed the hours Medicare would cover if the beneficiary was only receiving DSMT, except if a beneficiary receiving initial DSMT subsequently was diagnosed with renal disease or if there was a change in diagnosis or medical condition that occurred during an episode of care. We would allow additional hours of coverage for patients with renal disease and diabetes because MNT for renal disease is more complex than MNT for diabetes alone.
Eligibility for MNT services would be dependent upon diagnoses and referrals made by the treating physician. At proposed § 410.132(c), we provide that referral may only be made by the treating physician when the beneficiary has been diagnosed with diabetes or renal disease, with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care. We note that the statute Start Printed Page 40390specifies that a physician, as defined in section 1861(r)(1) of the Act, must refer the beneficiary in order for the therapy to be covered. We are proposing to limit referrals to those made by the treating physician as noted earlier.
At proposed § 410.132(d), we set forth requirements regarding reassessment and follow-up interventions. Specifically, we provide that reassessments and follow-up interventions would only be covered when the referring physician determines that there was a change of diagnosis or medical condition within an episode of care that made a change in diet necessary.
Provider Qualifications (§ 410.134). BIPA specifies how we must define “registered dietitian or nutrition professional” for the purposes of this benefit and allows for the grandfathering of nutrition professionals licensed or certified by States at the time of BIPA's enactment. Pursuant to BIPA, a registered dietitian or nutrition professional means an individual who meets the following criteria:
- Holds a bachelor's or higher degree granted by a regionally accredited ollege or university in the United States (or an equivalent foreign degree) with completion of the academic requirements of a program in nutrition or dietetics, as accredited by an appropriate national accreditation organization we have recognized for this purpose.
- Has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional.
- Is licensed or certified as a dietitian or nutrition professional by the State in which the services are performed, or, if a State does not provide for licensure or certification, meets other criteria established by the Secretary.
We propose to exercise our statutory discretion, with respect to such alternative criteria, by providing that in States that do not provide licensure or certification requirements, we would use the designation of “registered dietitian” as certified by the Commission on Dietetic Registration, the credentialing agency for the American Dietetic Association; or require compliance with the statutory educational and experience requirements alone. The Commission on Dietetic Registration is currently considered to be the recognized standard in certification programs for registered dietitians. If an individual can supply documentation to us that he/she is a “registered dietitian,” we would not require that individual to also supply documentation that he/she meets the minimum statutory educational and experience requirements, because these latter requirements are also requirements an individual must currently meet to become a “registered dietitian.” Likewise, if an individual supplies documentation to us that he/she meets the minimum statutory educational and experience requirements, that individual would not need to supply documentation to us that he/she is a “registered dietitian.”
The statute also requires that an individual who, as of December 21, 2000 (BIPA's date of enactment), is licensed or certified under the law of the State in which the services are performed as a dietitian or nutrition professional, qualifies as a “registered dietitian or nutrition professional” even if he or she does not meet the other education and experience requirements. There is no provision in the law to allow grandfathering of dietitian or nutrition professionals in States with no licensure or certification requirements, or of individuals who did not choose to be licensed or credentialed as of the date of enactment of section 1861(vv)(3) of the Act. Therefore, we only provide for “grandfathering” of individuals who do meet the specific criteria of section 1861(vv)(3) of the Act.
Payment for Medical Nutrition Therapy (§ 414.64). Section 105(c) of the BIPA requires that we pay for medical nutrition therapy services at 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the physician fee schedule for the same services if such services had been furnished by a physician. Section 1848 of the Act requires that payments under the physician fee schedule be established on national uniform RVUs based on the resources used in furnishing a service. We have consulted with the ADA to assess the types of resource inputs that are used to furnish a 15-minute medical nutrition therapy session by a Registered Dietitian or Professional Nutritionist.
As stated above, these services would be paid under the physician fee schedule. Malpractice RVUs for medical nutrition therapy services have been extrapolated based on analogous service procedures. The statute specifically provides that medical nutrition therapy services may only be provided by registered dietitians or nutrition professionals. We do not believe that physicians will be able to satisfy the qualification requirements and therefore will not be able to provide this service themselves. Therefore, we are not establishing physician work RVUs for this service. We interpret section 105(c)(2) of BIPA to mean that if a physician were to furnish this service, that the service was performed “incident to” the physicians treatment plan and provided by a registered dietitian or nutrition professional. Since we are not proposing work RVUs for medical nutrition therapy, we propose to determine practice expense RVUs using the practice expense methodology for the “zero work pool.” (For more information about the practice expense methodology for services that have no physician work, see the November 2, 1998 final rule (63 FR 58814)). The proposed RVUs for individuals and individuals in a group are found in Table 5 as follows:
Table 5.—RVUs for Individuals and Individuals in a Group
Code Description Work RVUs Practice expense RVUs Malpractice RVUs Total 97802 Medical nutrition, individual, initial 0.00 0.47 0.01 0.48 97803 Medical nutrition, individual, subseq 0.00 0.34 0.01 0.35 97804 Medical nutrition, group 0.00 0.14 0.01 0.15 Much like diabetes education, the number of MNT beneficiaries attending a group session would vary. As defined in the CPT's Physical Medicine Rehabilitation codes, a group is considered to be two or more individuals.
We would refine the medical nutritional therapy services payment amounts in the future by including the services into the refinement process Start Printed Page 40391used for other Medicare services payable under the physician fee schedule.
Medicare co-payments and deductibles would apply for medical nutritional therapy services. We are proposing to pay for this service under the physician fee schedule using the following codes:
CPT 97802—Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes.
CPT 97803—reassessments and intervention, individual, face-to-face with the patient, each 15 minutes.
CPT 97804—Group, 2 or more individuals, each 30 minutes.
Since payment for MNT will be included in our payment for facility services, separate payment will not be made for hospital inpatients or skilled nursing facility patients. Section 105(c) of BIPA amends section 1833(a)(1) to add subparagraph (T), requiring Medicare payment to equal 80 percent of the of the lesser of the actual charge for the service or 85 percent of the amount determined under the physician fee schedule. Thus, we will make payment in the hospital outpatient department, Federally Qualified Health Centers and Rural Health Clinics at the lesser of 80 percent of the actual charge or 85 percent of the physician fee schedule amount. The RVUs shown above do not reflect this 85 percent adjustment. To determine payment, the RVUs shown above will need to be multiplied by the physician fee schedule conversion factor and 0.85. We expect to provide the Medicare carriers with a payment file that includes this 85 percent adjustment. That is, we expect to determine the payment amount using the RVUs shown and apply the 85 percent adjustment to the product of the geographically adjusted RVUs and conversion factor. The Medicare carriers will not need to make any additional adjustment to the payments we provide.
F. Telehealth Services
1. Background
a. History. Before January 1, 1999, payment for services delivered via a telecommunications system was limited to services that do not require a face-to-face, “hands-on” encounter under the traditional delivery of medical care. Examples of these services include interpretation of an x-ray, electrocardiogram and electroencephalogram tracings, and cardiac pacemaker analysis.
The BBA provided for coverage of and payment for consultation services delivered via a telecommunications system to Medicare beneficiaries residing in rural health professional shortage areas (HPSA) as defined by section 332(a)(1)(A) of the Public Health Services Act. Additionally, a Medicare practitioner was required to be with the patient at the time of a teleconsultation.
The BBA specified that payment for a teleconsultation had to be shared between the consulting physician or practitioner and the referring physician or practitioner and could not exceed the fee schedule payment which would have been made to the consultant for the service provided. The BBA prohibited payment for any line charges or facility fees associated with the teleconsultation and clarified that the beneficiary may not be billed for these charges or fees.
These provisions became effective January 1, 1999. The November 2, 1998 final rule on “Revisions to Payment Policies Under the Physicians Fee Schedule for Calendar Year 1999” (63 FR 58879) implemented these provisions.
b. Legislative Summary. In section 223 of the BIPA, the Congress provided for a “Revision of Medicare Reimbursement for Telehealth Services” and specified a “sunset” date for the current statutory teleconsultation provisions. The current teleconsultation provisions contained in section 4206(a) and (b) of the BBA and implemented in §§ 410.78 and 414.65 apply only to teleconsultations provided on or after January 1, 1999 and before October 1, 2001.
Beginning October 1, 2001, the BIPA amends section 1834 of the Act to provide for a new subsection (m) “Payment for Telehealth Services.” This amendment provides for an expansion of Medicare payment for telehealth services. A summary of the expansion appears below.
The BIPA specifies that we pay for telehealth services that are furnished via a telecommunications system by a physician (as defined in section 1861(r) of the Act) or a practitioner (described in section 1842(b)(18)(C) of the Act). Telehealth services may be provided only to an eligible telehealth individual enrolled under Medicare, notwithstanding the fact that the individual physician or practitioner providing the telehealth service is not at the same location as the beneficiary.
The BIPA defines Medicare telehealth services as professional consultations, office or other outpatient visits, and office psychiatry services identified as of July 1, 2000, by CPT codes 99241 through 99275; 99201 through 99215, 90804 through 90809 and 90862 (and as we may subsequently modify) and any additional service we specify.
The statute requires us to establish a process that provides, on an annual basis, for the addition or deletion of services (and HCPCS codes) as appropriate, to the services specified above, for authorized payment under Medicare.
Section 1834(m)(4)(B) of the Act, as added by the BIPA, specifies that an eligible telehealth individual means an individual enrolled under Part B who receives a telehealth service furnished at an originating site. Originating sites are defined only as specified medical facilities located in specific geographic areas. Section 1834(m)(4)(C) of the Act, as added by the BIPA, limits originating sites to the following types of facilities:
- The office of a physician or practitioner.
- A critical access hospital (as defined in section 1861(mm)(1) of the Act).
- A rural health clinic (as defined in section 1861(aa)(s) of the Act).
- A Federally qualified health center (as defined in section 1861(aa)(4) of the Act).
- A hospital (as defined in section 1861(e) of the Act).
The BIPA specifies that the originating site must be located in one of the following geographic areas:
- In an area that is designated as a rural health professional shortage area under section 332(a)(1)(A) of the Public Health Service Act.
- In a county that is not included in a Metropolitan Statistical Area.
- From an entity that participates in a Federal telemedicine demonstration project that has been approved by (or receives funding from) the Secretary of Health and Human Services as of December 31, 2000.
The BIPA relaxes some of the conditions for payment imposed by the BBA. Section 1834(m)(2)(C) of the Act, as added by the BIPA, specifies that a telepresenter is not required and specifically states that nothing in section 1834(m)(2)(C) of the Act shall be construed as requiring an eligible telehealth beneficiary to be presented by a physician or practitioner at the originating site for the furnishing of a service via a telecommunications system, unless it is medically necessary (as determined by the physician or practitioner at the distant site).
Additionally, section 1834(m)(1) of the Act, as added by the BIPA, specifies that, for purposes of defining a telecommunications system, in the case of any Federal telemedicine demonstration program conducted in Alaska or Hawaii, the term “telecommunications system” includes store and forward technologies that Start Printed Page 40392provide for the asynchronous transmission of health care information in single or multimedia formats.
Section 1834(m)(2) of the Act, as added by the BIPA, states that we pay a physician or practitioner located at a distant site that furnishes a telehealth service to an eligible telehealth beneficiary an amount equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.
This section also provides for a facility fee payment to the originating site. It specifies that for the period beginning October 1, 2001 through December 31, 2002, the originating site facility fee is equal to $20. For each subsequent year, the facility fee for the preceding year is increased by the percentage increase in the MEI as defined in section 1842(i)(3) of the Act.
The BIPA amended section 1833(a)(1) of the Act by adding subparagraph (U), specifying that with respect to the originating site facility fees, the amount paid is 80 percent of the lesser of the actual charge or the amounts specified in new section 1834(m)(2) of the Act.
Section 1834(m)(3) of the Act requires that the provisions of sections 1848(g) and 1842(b)(18)(A) and (B) of the Act apply to physicians and practitioners. The provisions of section 1842(b)(18) of the Act apply to originating sites receiving a facility payment as the provisions apply to practitioners under section 1834(m) of the Act.
Section 1848(g) of the Act provides a limitation of charges to beneficiaries and provides sanctions if a physician, supplier, or other person knowingly and willfully bills or collects for services in violation of the limitation. It also provides for sanctions if a physician, supplier, or other person fails—(1) to timely correct excess charges by reducing the actual charge billed for the service to an amount that does not exceed the limiting charge for the service, or (2) to timely refund excess collections. In addition, it requires that physicians and suppliers submit claims for services they furnished to a beneficiary to a carrier on behalf of the beneficiary using a standard Medicare claim form. The statute imposes a penalty for failure to submit the claim. In addition, section 1848(g) of the Act prohibits imposing any charge relating to completing and submitting the claim. Section 1842(b)(18) of the Act provides that services furnished by a physician assistant, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, anesthesiologist's assistant, certified nurse-midwife, clinical social worker, or clinical psychologist for which payment may be made on a reasonable charge or fee schedule basis may be made only on an assignment-related basis. It also limits the beneficiary's liability to any applicable deductible and coinsurance amounts. It further provides for sanctions against a practitioner who knowingly and willfully bills (or collects an amount) in violation of the limitation.
c. Implementation. Section 223 of the BIPA limits the application of the existing telehealth provision to services furnished before October 1, 2001 and mandates that the expanded benefit be effective for services furnished on or after October 1, 2001. Therefore, this benefit expansion is being implemented via program memorandum. The program memorandum is effective October 1, 2001 when the telehealth benefit supercedes the teleconsultation benefit authorized by section 4206 of the BBA and existing regulations at § 410.78 and § 414.65. Any regulatory changes resulting from this rulemaking process will be effective January 1, 2002.
d. Proposed Policies. This rule proposes to establish policies for implementing the provisions of section 1834(m) of the Act, as added by the BIPA, that change Medicare payment for telehealth services.
(i) Scope of telehealth benefit. Section 1834(m)(4)(B) of the Act, as added by the BIPA, defines an eligible telehealth individual as a Medicare beneficiary who receives a telehealth service furnished at an originating site. As discussed earlier, originating sites are limited to certain facilities within specifically identified geographic areas.
We would revise § 410.78 to specify that Medicare beneficiaries are eligible for telehealth services only if they receive services from an originating site located in either a rural HPSA as defined by section 332(a)(1)(A) of the Public Health Services Act or in a county outside of a MSA as defined by section 1886(d)(2)(D) of the Act. Additionally, we would provide for an exception if an entity participates in a Federal telemedicine demonstration project that has been approved by, or receives funding from, us as of December 31, 2000. That entity would not be required to be in a rural HPSA or non-MSA as described above.
We would also specify that, providing the geographic criteria are met, the following sites qualify as originating sites under this provision:
- The office of a physician or practitioner.
- A hospital as defined in section 1861(e) of the Act.
- A critical access hospital as defined in section 1861(mm)(1).
- A rural health clinic as defined in section 1861(aa)(2) of the Act.
- A Federally qualified health center as defined in section 1861(aa)(4) of the Act.
Covered Services. Section 1834(m)(4)(F) of the Act, as added by the BIPA, defines telehealth services as professional consultations, office and other outpatient visits, individual psychotherapy, pharmacologic management and any additional service we specify. Additionally, this provision identifies covered services by HCPCS codes identified as of July 1, 2000. We propose to revise § 410.78 to implement this coverage expansion. The services and corresponding CPT codes are listed below:
- Consultations (codes 99241 through 99275).
- Office and other outpatient visits (codes 99201 through 99215).
- Individual Psychotherapy (codes 90804 through 90809).
- Pharmacologic management (code 90862).
The BIPA provision is effective for services beginning on October 1, 2001. Payment for the statutorily specified codes, as listed above, will be implemented beginning with that date. We propose to make any additions or deletions to the services defined as telehealth effective on a January 1st basis. We plan to use the annual physician fee schedule proposed rule published in the summer and the final rule (published by November 1) each year as the vehicle to make these changes. Since the statutory provision will be implemented on October 1, 2001, and there is limited published data on telehealth in clinical settings, we will not make any recommendations on additional services until we have had time to ensure we have a process for redefining covered services in place.
We are soliciting suggestions and comments from the public regarding the guidelines that we should use to make additions or deletions of services. We also solicit suggestions and comments about specific services that may be appropriate to be covered under the Medicare telehealth benefit. Once we complete our review of these suggestions and comments, we will propose a more detailed approach as to how we would make modifications to the existing telehealth benefit.
(ii) Conditions of Payment: Technology. The Congress defines the term “telecommunications system” with respect to demonstration projects conducted in Alaska or Hawaii; however, the BIPA does not define a Start Printed Page 40393telecommunications system in any other case. In a non-telehealth setting, Medicare pays for these codes only if there is a face-to-face encounter between the patient and attending physician or practitioner. We believe that the patient's presence and use of an interactive audio and video telecommunications system permitting the distant site practitioner to interact with the patient provides a reasonable substitute for a face-to-face encounter.
Limited exception to the interactive telecommunications requirement. For purposes of defining a telecommunications system, section 1834(m)(1) of the Act includes the use of store and forward technology in very limited circumstances. This provision specifies that, in the case of a Federal telemedicine demonstration program conducted in Alaska or Hawaii, Medicare payment is permitted when asynchronous, store and forward technologies, in single or multimedia formats is used to deliver the service.
Store and forward technology substitutes for an interactive, patient-present encounter in these limited circumstances. The patient is not present or available to interact with the distant site physician or practitioner in real-time.
We believe that when store and forward technologies are used to substitute for an interactive patient encounter, the technology must permit the distant site practitioner adequate medical information for recommending or confirming a diagnosis or treatment plan. A patient's medical information may typically include various combinations of the following items—video clips, still images, x-rays, magnetic resonance images, electrocardiogram and electroencephalogram tracings, tissue samples, laboratory results, and audio clips of heart or lungs.
We propose to specify at § 410.78 that, except for the statutory provision noted above, an interactive telecommunications system must be used and that the medical examination of the patient is at the control of the physician or practitioner at the distant site. We would define interactive telecommunications system as multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and physician or practitioner at the distant site. We would also specify that telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.
Additionally, we would provide an exception to the interactive requirements where the patient must be present for a Federal telemedicine demonstration program conducted in Alaska or Hawaii. We would specify that for Federal telemedicine demonstration programs conducted in Alaska or Hawaii, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system. Additionally, we would specify that the physician or practitioner at the distant site must be affiliated with the demonstration program.
This exception would be permitted for Federal telemedicine demonstration projects conducted in Alaska or Hawaii only. Interactive telecommunications system with the real-time presence of the patient is required as a condition of payment in all other circumstances.
We would define asynchronous, store and forward technologies, as the transmission of the patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. Asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines, and text messages without visualization of the patient (electronic mail). Photographs must be specific to the patient's medical condition and adequate for rendering or confirming a diagnosis or treatment plan. Dermatological photographs, for example, a photograph of a skin lesion may be considered to meet the requirement of a single media format under this provision.
Additionally, we would define the originating site as the location of an eligible Medicare beneficiary at the time the service being furnished via a telecommunications system occurs. For asynchronous, store and forward telecommunications technologies, an originating site is a Federal telemedicine demonstration program conducted in Alaska or Hawaii.
Telepresenter. As mentioned earlier, the BIPA changed the telepresenter requirements. In accordance with section 1834(m)(2)(C) of the Act, a telepresenter is not required to be present. Therefore, we would not require a telepresenter as a condition of Medicare payment.
Practitioners eligible to receive payment for Medicare Telehealth Services. Section 1834(m)(1) of the Act requires that Medicare make payments for telehealth services furnished via a telecommunications system by a physician or a practitioner (described in section 1842(b)(18)(C) of the Act). Non-physician practitioners described in this section of the Act include nurse practitioners, physician assistants, clinical nurse specialists, certified nurse midwives, clinical psychologists, clinical social workers, and certified registered nurse anesthetists or anesthesiologists' assistants. Section 1834(m)(2) of the Act specifies that the payment amount to the physician or practitioner at the distant site who furnishes a telehealth service be equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.
As discussed earlier in this document, covered telehealth services include office visits (codes 99201 through 99215), consultation (codes 99241 through 99275), individual psychotherapy (codes 90804 through 90809), and pharmacologic management (code 90862). If a physician, clinical nurse specialist, nurse practitioner, physician assistant, nurse midwife, clinical psychologist, or clinical social worker is licensed under State law to provide a service listed above, then these practitioners may bill for and receive payment for this service when delivered via a telecommunications system.
Clinical psychologists and clinical social workers cannot bill or receive payment for psychotherapy involving evaluation and management services under Medicare when the service is delivered face-to-face (that is, without the use of a telecommunications system). Therefore, clinical psychologists and clinical social workers cannot receive payment for these services under the telehealth benefit.
Certified registered nurse anesthetists and anesthesiologists' assistants are not eligible. Certified registered nurse anesthetists and anesthesiologists' assistants would not be permitted to bill for and receive payment for a telehealth service under this provision. Section 1861(bb) of the Act defines services provided by these practitioners as anesthesia services and related care only. Under the Medicare program, these practitioners do not receive payment for office visits, consultation, individual psychotherapy, or pharmacologic management when these services are furnished without the use of a telecommunications system. Section 1834(m)(2) of the Act specifies that the Start Printed Page 40394payment amount made to the distant site physician or practitioner must be equal to what would have been paid for the service without the use of a telecommunications system. Therefore, certified registered nurse anesthetists and anesthesiologists' assistants would not receive payment for telehealth services.
Proposed regulatory provisions. Based on the law, we would state at § 410.78 that, as a condition of Part B payment for telehealth services, the physician or practitioner at the distant site must be licensed to provide the service under State law. When the physician or practitioner at the distant site is licensed under State law to provide a covered telehealth service (that is, professional consultations, office and other outpatient visits, individual psychotherapy, and pharmacologic management), then he or she may bill for and receive payment for this service when delivered via a telecommunications system.
We would specify that the physician or practitioner at the distant site may be any of the following (provided that the physician or practitioner is licensed to bill for the service being furnished via a telecommunications system):
- A physician as described in § 410.20.
- A physician assistant as defined in § 410.74.
- A nurse practitioner as defined in § 410.75.
- A clinical nurse specialist as described in § 410.76.
- A nurse midwife as defined in § 410.77.
- A clinical psychologist as described in § 410.71.
- A clinical social worker as defined in § 410.73.
However, we would further specify that a clinical psychologist and clinical social worker may bill for individual psychotherapy furnished via a telecommunications system, but may not seek payment for medical evaluation and management services.
Documentation. Documentation requirements as specified in our most recent documentation guidelines are applicable to services delivered via a telecommunications system. At this time, we will not require additional documentation under this provision beyond what is already required for medical services delivered without the use of a telecommunications system. Medicare documentation guidelines are available from our web site. You may access our documentation guidelines by using the following directions:
1. Go to the CMS Homepage (http://www.cms.gov).
2. Click on “Medicare” (Top left hand column).
3. Click on “Professional/Technical Information”
4. Click on “Documentation Guidelines for Evaluation and Management Services:”
5. You may choose the 1995 version or the 1997 version whichever best fits your needs.
(iii) Payment provisions. Professional Services: General—Section 1834(m)(2)(A) of the Act, specifies that the payment amount for the professional service is equal to the amount that would have been paid without the use of a telecommunications system. Medicare payment for physicians' services is generally based, under section 1848 of the Act, on the resource-based physician fee schedule. Payment to other health care practitioners listed earlier, authorized under section 1833 of the Act, is based on a percentage of the physician fee schedule payment amount. Therefore, we would pay for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management services furnished by physicians at 80 percent of the lower of the actual charge or the fee schedule amount for physicians' services. We would also pay for services furnished by other practitioners at 80 percent of the lower of the actual charge or that practitioner's respective percentage of the physician fee schedule (for example, the fee schedule amount for clinical psychologists would be 100 percent of the physician fee schedule; for clinical social workers, the payment would be made at 75 percent of the clinical psychologist fee schedule; for certified nurse midwives, the payment would be made at 65 percent of the physicians fee schedule; and for all other eligible health care practitioners, payment would be made at 85 percent of the physician fee schedule). Assuming the beneficiary has met his or her Part B deductible, the beneficiary would be responsible for 20 percent of the appropriate payment amount.
Payment for Telepresenter. Section 1834(m)(2) of the Act, provides for a professional fee for the physician or practitioner at the distant site (equal to the applicable Part B fee schedule amount) and a $20 facility fee for the originating site. Telepresenters are not required, unless one is deemed medically necessary by the physician or practitioner at the distant site. BIPA does not address the issue of payment for the telepresenter. The Office of the Inspector General has advised us that permitting the physician or practitioner at the distant site to pay the telepresenter creates a significant risk under the anti-kickback statute and may also violate many State fee-splitting laws. Therefore, we would propose in § 414.65 that payments made to the distant site physician or practitioner for professional fees, including deductible and coinsurance (for the professional service), are not to be shared with the referring practitioner or telepresenter.
However, the telepresenter could bill and receive payment for services that are not telehealth services that a telepresenter would otherwise be allowed to provide under the Medicare statute, including services furnished on the same day as the telehealth service.
Facility Fee for the Originating Site. The BBA prohibited any payment for line charges or facility fees associated with a professional consultation via a telecommunications system. Section 1834(m)(2)(B) of the Act, as added by the BIPA, provides for a facility fee payment to the originating site, specifying that the amount of payment is 80 percent of the lesser of the actual charge or a facility fee of $20.00. The BIPA further specifies that, beginning January 1, 2003, the originating facility fee be increased annually by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act. Additionally, we clarify that the Geographic Practice Cost Index (GPCI) would not apply to the facility fee for the originating site. This fee is statutorily set and is not subject to the geographic payment adjustments authorized under the physician's fee schedule. The beneficiary is responsible for any unmet deductible amount and Medicare coinsurance. We would revise § 414.65 to provide for payment of a facility fee to the originating site.
Coding. For office and other outpatient visits, consultation, individual psychotherapy, and pharmacologic management delivered via a telecommunications system, we would use modifiers in conjunction with existing CPT codes to indicate the use of a telecommunications system in delivering the service.
A new HCPCS code for the facility fee for the originating site will be used to identify this fee. Since this is a new occasion of payment under Medicare, a separate and distinct code for the facility fee is necessary for contractors to make the appropriate payment.
G. Indian Health Service
The Indian health care system provides primary health care to many American Indian and Alaska Native Medicare beneficiaries. This system consists of programs operated by a Start Printed Page 40395Federal agency, the Indian Health Service (IHS), and Federally funded programs operated by Indian tribes, tribal organizations, and urban Indian organizations (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These programs deliver a range of clinical and preventive health services to their beneficiaries through a network of facilities including hospitals and outpatient clinics. Programs operated in IHS-owned or leased facilities, by IHS or by tribes or tribal organizations, are considered “Federal providers” by Medicare. Sections 1814(c) and 1835(d) of the Act generally prohibit payment to Federal providers, subject to exceptions contained in section 1880 of the Act for these IHS facilities. Prior to enactment of the BIPA, the exception in section 1880 of the Act was applicable only to IHS hospitals including provider-based clinics (IHS hospital outpatient clinics) and skilled nursing facilities. The exception did not permit Medicare to pay for services furnished by IHS free-standing outpatient clinics or to pay any IHS facilities for services by physicians and other practitioners paid under a fee schedule.
Effective July 1, 2001, section 432 of the BIPA extends the exception in section 1880 of the Act to permit Medicare payments to hospitals and outpatient clinics (provider-based or free-standing), operated by the IHS or by a tribe or tribal organization, for services furnished by physicians and specified non-physician practitioners in or at the direction of an IHS hospital or outpatient clinic. Payments for these services are made to the IHS or tribal hospital or outpatient clinic, not to the physician or other practitioner. These payments are subject to the same situations, terms, and conditions as would apply if the services were furnished in or at the direction of a hospital or outpatient clinic that is not operated by the IHS or by a tribe or tribal organization. The payments include incentive payments for physicians furnishing covered physicians' services in rural or urban HPSAs if the usual HPSA criteria are met. (For further information see section 1833 of the Act and § 414.42 of our regulations.) Payments will not be made under these provisions to the extent that Medicare is otherwise paying for the same services under other provisions (for example, as part of a bundled payment, or if a tribal hospital outpatient clinic continues to bill as a Federally qualified health center (FQHC)).
We are adding a new § 410.46 to our regulations to reflect this new statutory provision. Due to the statutory effective date of July 1, 2001, we will implement this BIPA provision through program memorandum instructions.
H. Pathology Services
Background
The November 2, 1999 final rule (64 FR 59380) provided that, for services furnished on or after January, 1, 2001, carriers would no longer pay claims to independent laboratories under the physician fee schedule for the technical component (TC) of physician pathology services for hospital inpatients. Before this rule, independent laboratories could bill the carrier under the physician fee schedule for the TC of a physician pathology service furnished to a hospital inpatient. Under the rule, independent labs would still have been able to bill and receive payment for TC physician pathology services furnished to patients who are not hospital inpatients. (The TC of physicians' pathology services includes the TC of cytopathology and surgical pathology physicians' services as described in the Medicare Carrier Manual, section 15020 B and C.) This change was to take effect for services furnished on or after January 1, 2001. The delay between publication and effective date was intended to allow independent laboratories and hospitals sufficient time to negotiate new arrangements, if necessary.
BIPA Provision
Section 542 of the BIPA requires the Medicare carrier to continue to pay for the TC of physician pathology services when an independent laboratory furnishes these services to an inpatient or outpatient of a covered hospital. The BIPA provisions apply to TC services furnished during the 2-year period beginning January 1, 2001 and continuing through December 31, 2002. We informed the carriers and the intermediaries of this provision through program memorandum AB-01-47 which was issued in March 2001. This program memorandum requested the carriers to notify independent laboratories of this provision in their next regularly scheduled bulletin and to place this bulletin on their Internet web site.
In the absence of further legislation, the policy of the November 1999 final rule will take effect for the TC of physician pathology services furnished to hospital patients after December 31, 2002.
Definitions
For this provision, “covered hospital” means a hospital that had an arrangement with an independent laboratory that was in effect as of July 22, 1999, under which a laboratory furnished the TC of physician pathology services to fee-for-service Medicare beneficiaries who were hospital inpatients or outpatients and submitted claims for payment for the TC to a carrier. The TC could have been submitted separately or combined with the professional component and reported as a combined service.
The term “fee-for-service Medicare beneficiary” means an individual who—(1) Is entitled to benefits under Part A or enrolled under Part B of Title XVIII or both, and; (2) Is not enrolled in any of the following:
- A Medicare+Choice plan under Part C of that title.
- A plan offered by an eligible organization under section 1876 of the Act.
- A program of all-inclusive care for the elderly (PACE) under section 1894 of the Act.
- A social health maintenance organization (SHMO) demonstration project established under section 4018(b) of the Omnibus Budget Reconciliation Act of 1987.
V. Collection of Information Requirements
Under the Paperwork Reduction Act (PRA) 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.
We are soliciting public comment on each of these issues for the following sections of this document that contain information collection requirements:
§ 410.132—Medical Nutrition Therapy
Paragraph (c) of this section requires a referring physician or practitioner to Start Printed Page 40396maintain referral documentation in the beneficiary's medical record for each referral. Paragraph (b)(3)(i) requires that the referring physician or qualified non-physician practitioner document a reassessment in the beneficiary's medical record. Paragraph (e) of this section requires the medical nutrition therapy care plan to be sent to the referring physician initially and each time the medical nutrition therapy care plan is updated. If the physician makes recommendations regarding the medical nutrition therapy care plan, the registered dietitian or nutrition professional must integrate the requirements into the medical nutrition therapy care plan.
We believe the burden associated with these provisions is exempt in accordance with 5 CFR 1320.3(b)(2) because the time, effort, and financial resources necessary to comply with these requirements would be incurred by certified providers in the normal course of business activities.
If you comment on these information collection and recordkeeping requirements, please mail copies directly to the following:
Health Care Financing Administration, Office of Information Services, Information Technology Investment Management Group, Attn.: John Burke, CMS-1169-P, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Allison Eydt, CMS Desk Officer.
VI. Response to Comments
Because of the large number of items of correspondence we normally receive on Federal Register documents published for comment, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the “DATES” section of this preamble, and, if we proceed with a subsequent document, we will respond to the major comments in the preamble to that document.
VII. Regulatory Impact Analysis
We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review) and the Regulatory Flexibility Act (RFA) (Public Law 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared for proposed rules with economically significant effects (that is, a proposed rule that would have an annual effect on the economy of $100 million or more or would adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities). We estimate the changes to the practice expense RVUs (not including earlier proposed changes to the work RVUs) may result in a redistribution of payments among physician specialties of approximately $100 million. We estimate the benefit changes in this proposed rule resulting from the BIPA will likely result in additional Medicare expenditures of $210 to $360 million or more for any single FY through FY 2006. Therefore, this proposed rule is considered economically significant, and, thus, we have prepared a regulatory impact analysis.
The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations and government agencies. Most hospitals, and most other providers, physicians, and health care suppliers are small entities, either by nonprofit status or by having revenues of $7.5 million or less annually for physicians and $5 million or less for other practitioners. For purposes of the RFA and based on small business administration data for 1997, we estimate that there are 162,000 physician organizations that meet the definition of a small entity. There are about 700,000 physicians and other practitioners who receive Medicare payment under the physician fee schedule. Individuals and States are not included in the definition of a small entity.
Section 1102(b) of the Social Security Act requires us to prepare a regulatory impact analysis for any proposed rule that may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 603 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside a Metropolitan Statistical Area and has fewer than 100 beds.
Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. We have determined that this proposed rule will have no consequential effect on State, local, or tribal governments. We believe the private sector cost of this rule falls below the above-stated threshold as well.
Thus, we have prepared the following analysis, which together with the rest of this preamble, meets all assessment requirements. It explains the rationale for, and purposes of, the rule, details the costs and benefits of the rule, analyzes alternatives, and presents the measures we propose to use to minimize the burden on small entities.
A. Resource-Based Practice Expense Relative Value Units and 5-Year Review Changes
Under section 1848(c)(2) of the Act, adjustments to relative value units may not cause the amount of expenditures to differ by more than $20 million from the amount expenditures would have been without such adjustments. We are proposing several changes that would result in a change of expenditures exceeding $20 million without offsetting adjustments to either the conversion factor or relative value units. In the June 8, 2001 Five-Year Review of Relative Value Units Under the Physician Fee Schedule, (66 FR 31028), we described the specialty level impact on payments of proposed changes in work RVUs. We estimated that the increase in physician work RVUs would increase expenditures by more than $20 million without an offsetting adjustment to either the relative value units or conversion factor. We proposed to meet the budget neutrality requirements in the statute by reducing the physician fee schedule conversion factor by an estimated 0.3 percent. Since the changes to the physician work RVUs included in our earlier proposed notice will affect payments in 2002, we are repeating those impacts in Table 6. In addition, we are also showing the impact of proposed changes that will affect the practice expense relative value units.
With respect to practice expense, our policy has been to meet the budget neutrality requirements in the statute by incorporating a rescaling adjustment in the practice expense methodology. That is, we determined the aggregate number of practice expense relative values that will be paid under current and proposed policy in 2002. We apply a uniform adjustment factor to all proposed practice expense relative value units to make them equal to the aggregate Start Printed Page 40397number of practice expense relative values that we estimate will be paid under current policy. Table 6 shows the specialty level impact on payment of changes being proposed for 2002.
The three columns under the label “5-Year Review of Work” show the estimated change in payments that will result from our earlier notice on the 5-Year Review of Work Relative Value Units. The column labeled “Work” shows the impact on total payments that will result from increases in physician work relative value units. Since the practice expense relative value units are based, in part, on the physician work, the 5-year review will also result in a change to the practice expense relative value units. The column labeled “Practice Expense” shows this impact and includes the effect of the rescaling adjustment discussed above to make the practice expense relative value units budget neutral. The column labeled “Total” reflects the total impact on payments resulting from proposed changes in work and practice expense from the 5-year review of physician work. This column includes the effect of a 0.3 percent reduction to the physician fee schedule conversion factor to meet the budget neutrality requirements in the statute.
The column labeled “New Time” reflects the estimated specialty level impact on payments that will result from using new physician times in the practice expense methodology. As described earlier in section II.A., physician time is used in conjunction with information on practice expense per hour and Medicare utilization to create specialty practice expense pools that are used to allocate practice expenses to different services. The RUC earlier indicated to us that some of the times we were using in the practice expense methodology differed from the times included in the RUC database. We understand that the RUC has made substantial efforts to validate the time in its database with physician specialty societies and to supply us with times that were missing for some services. The RUC recently forwarded the results of this effort to us and is recommending that we use the new times in the practice expense methodology. In addition, several physician specialty societies obtained new and more recent survey times as a result of the five-year review of physician work. The RUC has reviewed and forwarded these times to us as well and is also recommending that we use them in the practice expense methodology. We believe the times supplied to us by the RUC are more likely to be reflective of the actual time it takes to perform a procedure. For this reason, we are proposing to use these new times in the practice expense methodology. As indicated in our June 8, 2001 proposed notice, our expectation was that the substitution of new times would reduce payments to cardiac and thoracic surgeons because the new times for many heart and chest procedures are shorter than those we have been using in the practice expense methodology. We estimate that substitution of new physician times will reduce payments to cardiac and thoracic surgeons by an estimated 5 and 4 percent, respectively. Combining this reduction with the change in work relative value units will result in a total estimated increase in payments from between 0 and 1 percent for cardiac and thoracic surgeons. We estimate change in payments to other specialties from using new time data will be one percent or less.
The column labeled “New SMS” refers to our proposal to recalculate the practice expense per hour data based on the 1995 through 1999 SMS. (We refer to the SMS based on its publication year. The practice expense data is actually from surveys performed the year prior to publication. For example, the 1998 SMS includes 1997 cost data.) The proposed changes in practice expense per hour from incorporating the latest SMS data are modest. Payments to pathologists are estimated to increase by 2 percent. Specialty 69—Independent Laboratory, the largest specialty included in the supplier category, bills for many of the same services as pathologists, producing our estimated 2 percent increase in Medicare payments to suppliers.
The column labeled “Clinical Labor Repricing” reflects our proposal to use 1999 information from the Bureau of Labor Statistics to update the wage rate information that is used to price clinical labor inputs in the practice expense methodology. We estimate that this proposal will result in less than a 1 percent change in payments to any physician specialty.
The column labeled “Other” refers to our proposal to make minor modifications to the specialty utilization. As discussed earlier, we are proposing to recode the specialty for several very low volume physician specialties that likely have practice expenses that are similar to other larger physician specialties. In addition, this policy reflects our proposal to drop the utilization for a number of specialties from the practice expense methodology because a very small percentage (one percent or less) of their allowed charges are from physician fee schedule services. The modifications to the utilization data that we are proposing have virtually no specialty level impact on any specialty.
Table 6.—Impact of Proposed Work and Practice Expense Changes Total Allowed Charges by Specialty
Specialty Allowed charges $ Billions 5 year review of work practice New time New SMS Clinical labor repricing Other Total Work Expense Total ANESTHESIOLOGY 1.5 1% 0% 1% 0% 0% 0% 0% 1% CARDIAC SURGERY 0.3 5% 1% 6% 5% 0% 0% 0% 0% CARDIOLOGY 4.2 0% 0% 0% 0% 0% 0% 0% 0% CHIROPRACTOR 0.4 0% 0% 0% 0% 0% 0% 0% 0% CLINICS 1.6 0% 0% 0% 0% 0% 0% 0% 0% DERMATOLOGY 1.4 0% 0% 0% 0% 1% 0% 0% 1% EMERGENCY MEDICINE 1.0 0% 0% 0% 0% 0% 0% 0% 0% FAMILY PRACTICE 3.3 0% 0% 0% 0% 0% 0% 0% 0% GASTROENTEROLOGY 1.2 0% 0% 0% 1% 0% 0% 0% 1% GENERAL PRACTICE 1.0 0% 0% 0% 0% 0% 0% 0% 0% GENERAL SURGERY 2.0 3% 1% 4% 0% 0% 0% 0% 4% HEMATOLOGY ONCOLOGY 0.6 0% −1% −1% 0% 0% 0% 0% 0% INTERNAL MEDICINE 7.1 0% 0% 0% 0% 0% 0% 0% 0% NEPHROLOGY 1.0 0% 0% 0% 0% 0% 0% 0% 0% NEUROLOGY 0.9 0% 0% 0% 0% 0% 0% 0% 0% NEUROSURGERY 0.4 0% 0% 0% 0% 0% 0% 0% 0% NONPHYSICIAN PRACTITIONER 1.2 0% 0% 0% 0% 0% 0% 0% 0% OBSTETRICS/GYNECOLOGY 0.4 0% 0% 1% 0% 1% 0% 0% 1% OPHTHALMOLOGY 3.9 0% 0% 0% 0% −1% 0% 0% −1% OPTOMETRIST 0.5 0% 0% 0% 0% −1% 1% 0% 0% Start Printed Page 40398 ORTHOPEDIC SURGERY 2.3 0% 0% 0% 0% 0% 0% 0% 0% OTHER PHYSICIAN 1.6 0% 0% 0% 0% 0% 0% 0% 1% OTOLARYNGOLOGY 0.6 0% 0% 0% 1% 0% 0% 0% 0% PATHOLOGY 0.6 0% 0% 0% 0% 2% 0% 0% 3% PLASTIC SURGERY 0.2 0% 0% 0% 0% 0% 0% 0% 0% PODIATRY 1.1 0% 0% 0% 1% 0% 0% 0% 1% PSYCHIATRY 1.1 0% 0% 0% 0% 0% 0% 0% 0% PULMONARY 1.1 0% 0% 0% 0% 0% 0% 0% 0% RADIATION ONCOLOGY 0.7 0% −1% −1% 0% 0% 0% 0% 0% RADIOLOGY 3.3 0% −1% 0% 0% 0% 0% 0% 0% RHEUMATOLOGY 0.3 0% 0% 0% 0% 0% 0% 0% 0% SUPPLIERS 0.5 0% −1% −1% −1% 2% 0% 1% 2% THORACIC SURGERY 0.5 4% 1% 5% −4% 0% 0% 0% 1% UROLOGY 1.3 0% 0% 0% 0% 0% 0% 0% 1% VASCULAR SURGERY 0.3 2% 0% 2% −1% 0% 0% 0% 2% Table 7 shows the impact on payments for selected high volume procedures of all of the changes previously discussed. This table shows the combined impact of the change in physician work and the fully implemented practice expense relative value units on total payment for the procedure. There are separate columns that show the change in the old and new facility rates and the old and new nonfacility rates. The table does not show the actual change in payments from 2001 to 2002 for the procedures because the “old” payments do not take into account that the practice expense relative value units in 2001 are a blend of the old charge-based relative value units and the new resource-based practice expense relative value determined under current policy. We show the amounts in this way to isolate the impact of new proposals on the change in payment without including the effect of continuing to transition resource-based practice expense relative value units that will occur regardless of whether we publish this proposed rule. For an explanation of facility and non-facility practice expense refer to § 414.22(b)(5)(i).
Table 7.—Impact of 5 Year Review and Proposed Rule on Medicare Payment for Selected Procedures
HCPCS MOD Desc Old non-facility New non-facility Percent change Old facility New facility Percent change 11721 Debride nail, 6 or more $42.47 $42.47 0% $30.61 $30.61 0% 17000 Destroy benign/premal lesion $63.89 $65.80 3% $34.43 $34.43 0% 27130 Total hip replacement NA NA NA $1,499.72 $1,502.40 0% 27236 Treat thigh fracture NA NA NA $1,150.80 $1,152.72 0% 27244 Treat thigh fracture NA NA NA $1,174.91 $1,177.20 0% 27447 Total knee replacement NA NA NA $1,567.43 $1,570.50 0% 33533 CABG, arterial, single NA NA NA $1,855.90 $1,900.28 2% 35301 Rechanneling of artery NA NA NA $1,170.32 $1,141.24 −2% 43239 Upper GI endoscopy, biopsy $298.03 $318.31 7% $157.24 $158.39 1% 45385 Lesion removal colonoscopy $501.95 $534.47 6% $299.56 $303.00 1% 66821 After cataract laser surgery $229.93 $228.02 −1% $215.01 $212.72 −1% 66984 Cataract surg w/iol, i stage NA NA NA $697.83 $691.71 −1% 67210 Treatment of retinal lesion $627.82 $620.55 −1% $575.40 $569.66 −1% 71010 26 Chest x-ray $9.56 $9.56 0% $9.56 $9.56 0% 71020 26 Chest x-ray $11.86 $11.86 0% $11.86 $11.86 0% 77427 Radiation tx management, x5 $176.75 $177.52 0% $176.75 $177.52 0% 78465 26 Heart image (3d), multiple $79.58 $78.81 −1% $79.58 $78.81 −1% 88305 26 Tissue exam by pathologist $42.08 $42.85 2% $42.08 $42.85 2% 90801 Psy dx interview $153.80 $152.65 −1% $145.00 $144.62 0% 90806 Psytx, off, 45-50 min $102.15 $101.38 −1% $96.41 $96.41 0% 90807 Psytx, off, 45-50 min w/e&m $109.80 $109.42 0% $104.44 $104.44 0% 90862 Medication management $53.94 $53.94 0% $48.97 $48.97 0% 90921 ESRD related services, month $278.90 $279.28 0% $278.90 $279.28 0% 90935 Hemodialysis, one evaluation NA NA NA $77.66 $78.05 1% 92004 Eye exam, new patient $131.23 $130.84 0% $92.58 $92.20 0% 92012 Eye exam established pat $66.19 $65.80 −1% $37.88 $37.49 −1% 92014 Eye exam & treatment $94.88 $94.50 0% $62.36 $61.60 −1% 92980 Insert intracoronary stent NA NA NA $845.12 $832.88 1% 92982 Coronary artery dilation NA NA NA $625.90 $616.34 −2% 93000 Electrocardiogram, complete $27.55 $27.16 −1% NA NA NA 93010 Electrocardiogram report $9.56 $9.18 −4% $9.56 $9.18 −4% 93015 Cardiovascular stress test $108.65 $107.51 −1% NA NA NA 93307 26 Echo exam of heart $51.27 $50.50 −2% $51.27 $50.50 −2% 93510 26 Left heart catheterization $246.00 $242.17 −2% $246.00 $242.17 −2% 98941 Chiropractic manipulation $37.49 $37.49 0% $32.52 $32.52 0% 99202 Office/outpatient visit, new $63.89 $63.89 0% $48.21 $48.21 0% 99203 Office/outpatient visit, new $95.65 $95.26 0% $73.46 $73.46 0% 99204 Office/outpatient visit, new $137.73 $136.96 −1% $108.65 $108.65 0% 99205 Office/outpatient visit, new $174.46 $174.46 0% $143.85 $143.47 0% 99211 Office/outpatient visit, est $21.04 $21.04 0% $9.18 $9.18 0% 99212 Office/outpatient visit, est $37.49 $37.49 0% $24.49 $24.49 0% Start Printed Page 40399 99213 Office/outpatient visit, est $52.41 $52.41 0% $35.96 $35.96 0% 99214 Office/outpatient visit, est $82.64 $82.64 0% $58.92 $58.92 0% 99215 Office/outpatient visit, est $120.90 $121.28 0% $95.26 $95.26 0% 99221 Initial hospital care NA NA NA $68.86 $68.86 0% 99222 Initial hospital care NA NA NA $114.01 $114.01 0% 99223 Initial hospital care NA NA NA $159.15 $159.15 0% 99231 Subsequent hospital care NA NA NA $34.43 $34.43 0% 99232 Subsequent hospital care NA NA NA $56.24 $56.24 0% 99233 Subsequent hospital care NA NA NA $80.34 $80.34 0% 99236 Observ/hosp same date NA NA NA $225.72 $225.34 0% 99238 Hospital discharge day NA NA NA $67.72 $67.72 0% 99239 Hospital discharge day NA NA NA $92.58 $92.58 0% 99241 Office consultation $48.97 $48.97 0% $34.81 $34.81 0% 99242 Office consultation $91.05 $90.67 0% $71.54 $71.54 0% 99243 Office consultation $120.90 $120.51 0% $95.26 $94.88 0% 99244 Office consultation $171.78 $171.78 0% $140.79 $140.79 0% 99245 Office consultation $223.04 $223.43 0% $186.70 $186.32 0% 99251 Initial inpatient consult NA NA NA $38.26 $38.26 0% 99252 Initial inpatient consult NA NA NA $75.37 $75.37 0% 99253 Initial inpatient consult NA NA NA $102.15 $102.15 0% 99254 Initial inpatient consult NA NA NA $146.15 $146.15 0% 99255 Initial inpatient consult NA NA NA $200.47 $200.47 0% 99261 Follow-up inpatient consult NA NA NA $24.87 $24.87 0% 99262 Follow-up inpatient consult NA NA NA $47.82 $47.82 0% 99263 Follow-up inpatient consult NA NA NA $70.01 $70.01 0% 99282 Emergency dept visit NA NA NA $27.93 $27.93 0% 99283 Emergency dept visit NA NA NA $62.74 $62.74 0% 99284 Emergency dept visit NA NA NA $97.94 $98.32 0% 99285 Emergency dept visit NA NA NA $152.65 $153.03 0% 99291 Critical care, first hour $218.45 $219.22 0% $208.89 $209.27 0% 99292 Critical care, addl 30 min $111.71 $112.10 0% $104.06 $104.44 0% 99301 Nursing facility care NA NA NA $63.51 $63.51 0% 99302 Nursing facility care NA NA NA $84.93 $84.93 0% 99303 Nursing facility care NA NA NA $105.59 $105.59 0% 99311 Nursing fac care, subseq NA NA NA $31.75 $31.75 0% 99312 Nursing fac care, subseq NA NA NA $52.41 $52.41 0% 99313 Nursing fac care, subseq NA NA NA $74.60 $74.60 0% 99348 Home visit, est patient $77.28 $76.90 0% $70.01 $70.01 0% 99350 Home visit, est patient $176.37 $175.60 0% $164.13 $164.13 0% B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
As discussed in section II.B. of the preamble, this proposed regulation would expand the scope of who is allowed to perform screening flexible sigmoidoscopies for Medicare coverage and payment purposes to include nurse practitioners, physician assistants, and clinical nurse specialists, as long as those practitioners meet applicable Medicare qualification requirements, and they are authorized to perform those screening services under State law. At present, the Medicare condition of coverage for screening flexible sigmoidoscopies limits coverage of those services to those that are performed by either a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act) who is authorized under State law to perform the examination.
We estimate that this expansion in the scope of who is allowed to perform screening flexible sigmoidoscopies will increase beneficiary access to these screening services and will result in an increase in the number of covered exams that are performed. At the same time, we estimate that this proposed rule will result in a decrease in payments that are made for certain screening flexible sigmoidoscopies because they will be performed by nurse practitioners, physician assistants, and clinical nurse specialists who are paid at 85 percent of the amount of payment that is made to physicians for the same screening service. Taking these factors into account, we estimate that this proposal will result in negligible additional Medicare program costs. For a more detailed discussion of this provision see section II.B. of this preamble.
C. Services and Supplies Incident to a Physician's Professional Services—Conditions
We are proposing to allow auxiliary personnel to provide services incident to the services of physicians or practitioners who supervise them, regardless of the employment relationship. There are no costs or savings to the Medicare program associated with this proposal because the same physicians and practitioners would have performed these services before publication of this proposed rule. For a more detailed discussion of this provision see section II.C. of this preamble.
D. Anesthesia Services—Anesthesia Base Units
As previously discussed in section II.D. of the preamble, with the exception of codes 00142 and 00147, we propose to use the same anesthesia base unit per anesthesia code as the ASA provides in its uniform relative value guide. There are eight codes for which the base unit values would be different under our proposed rule.
Under this proposal, the estimated total number of base units would decrease. This is due primarily to the fact that code 001214 is the dominant code in terms of allowed services and the base unit for this code would decrease from 10 to 8 units.
To maintain neutrality in the anesthesia conversion factor, we would provide for a slight increase in the Start Printed Page 40400anesthesia conversion factor, less than 0.5 percent. For a more detailed discussion of this provision see section II.D. of this preamble.
E. Performance Measurement and Emerging Technology Codes
As previously discussed in section II.E. of the preamble, the AMA has developed two new categories of codes: performance codes and emerging technology. Allowing the performance measurement code to be referenced on Medicare billing forms will have no budgetary impact since we are not proposing payment for these codes. We are proposing to allow for carrier pricing of the emerging technology codes.
We expect that the emerging technology codes will be used infrequently and may be used in place of “unlisted” procedure codes that are also carrier priced. There would be few, if any, no Medicare program costs associated with this proposal. For a more detailed discussion of this provision see section II.E. of this preamble.
F. BIPA Provisions Included in This Proposed Rule
The following provisions of the BIPA are discussed in detail in section III of this preamble. This proposed rule would conform the regulations text to the BIPA provisions. Table 8 provides the estimated costs (in millions of dollars) for the Medicare program for these provisions for the fiscal years shown:
Table 8.—Medicare Cost Estimates for BIPA 2000 Provisions
[In millions]
BIPA provisions FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 Sec. 101 Biennial Pelvic Examinations 10 20 20 20 20 Sec. 102 Screening Glaucoma 30 50 50 60 60 Sec. 103 Screening Colonoscopy 40 40 30 10 10 Sec. 104 Screening Mammography 30 40 40 40 50 Sec. 105 Medical Nutrition 20 50 60 70 70 Sec. 223 Telehealth Services 20 30 40 50 60 Sec. 432 Indian Health 60 70 80 80 90 1. Screening Mammography
As discussed in section III.A. of the preamble, the BIPA eliminates the statutorily prescribed payment rate for screening mammography and specifies that it will be paid under the physician fee schedule beginning January 1, 2002. To pay for the professional component of the screening mammography, we propose to use the work and malpractice RVUs that have been established for unilateral diagnostic mammography. We are establishing the practice expense RVUs for the professional component under the resource-based methodology. To establish practice expense RVUs for the technical component, we propose using the statutory payment limit and the applicable physician fee schedule update factor used each year. Currently, we pay for screening mammography under section 1834(c) of the Act. Payment for screening mammography is not subject to the budget neutrality requirements that apply to physician fee schedule services under section 1848(c)(2)(B)(ii)(II) of the Act. Effective January 1, 2002, screening mammography will be subject to the budget neutrality requirements that apply to physician fee schedule services. We will include the current payment amounts for screening mammography in aggregate physician fee schedule payments subject to the budget neutrality requirements. As a result, the BIPA requirement to pay for screening mammography under the physician fee schedule will not result in an increase in Medicare program expenditures. However, the increase in payment for screening mammography under the physician fee schedule will be included in the budget neutrality adjustments that apply to physician fee schedule services. The BIPA also establishes a methodology for determining payment for certain types of new technology that are used in providing both diagnostic and screening mammography services. The statutory provisions are in effect from April 1, 2001 to December 31, 2001. The statute gives us the authority to determine whether separate codes and payment amounts are appropriate for screening and diagnostic mammography services that involve use of a new technology on or after January 1, 2002. We are proposing several new codes and fee schedule amounts for screening and diagnostic mammography services that involve use of a new technology. The BIPA provisions related to new technology mammography will result in the Medicare program costs shown in Table 8. The BIPA makes no changes to provisions for Medicare coverage of screening mammography.
2. Screening Pelvic Examinations
As discussed in section III.B. of the preamble, section 101 of the BIPA provides for expanded coverage for screening pelvic examinations (including a clinical breast examination) furnished on or after July 1, 2001. Specifically, the revised benefit will allow for biennial coverage of screening pelvic examination for all women who do not qualify under the law for annual coverage of such tests. We estimate that this change in the frequency of coverage for certain beneficiaries will result in an increase in Medicare payments. These payments will be made to a large number of physicians and other practitioners who provide these tests, any medically necessary follow-up tests, or treatment that may be required as a result of the increased frequency of coverage of these tests. Medicare program expenditures associated with screening pelvic examinations have been included in the budget. The impact of this provision is shown in Table 8.
3. Screening for Glaucoma
As discussed in section III.C. of the preamble, section 102 of the BIPA authorizes coverage of glaucoma screening examinations effective January 1, 2002, subject to certain frequency and other limitations. We believe services provided as part of glaucoma screening will often overlap with other services a physician provides during a patient encounter that is associated with a higher payment amount. We believe that physicians will more commonly provide glaucoma tests in conjunction with other services and will rarely provide only glaucoma screening to Medicare patients. Based on the projected utilization of these screening services and related medically necessary follow-up tests and treatment that may be required for the beneficiaries screened, we estimate that this new benefit will result in an Start Printed Page 40401increase in Medicare payments. These payments will be made to ophthalmologists or optometrists who will provide these screening tests and related follow-up tests and treatment that may be required. Medicare program expenditures associated with the BIPA provision that establishes coverage for screening glaucoma are shown in Table 8.
4. Screening Colonoscopy
As discussed in section III.D. of the preamble, section 103 of the BIPA amended the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to practitioners who will provide these screening tests and related follow-up tests and treatment that may be required. The impact of this provision is shown in Table 8.
5. Medical Nutrition Therapy
As discussed in section III.E. of the preamble, section 105 of the BIPA amended the Act to authorize Medicare coverage under Part B of medical nutrition therapy (MNT) for beneficiaries who have diabetes or renal disease, effective for services furnished on or after January 1, 2002. We propose to implement this provision at part 410, subpart G. Specifically, the proposed rule discusses the education, experience, and licensing requirements for dietitians or nutritionists furnishing the service. In addition, the proposed rule discusses the payment provisions, a referral requirement, and the manner by which the medical nutrition therapy and diabetes outpatient self-management training benefits will be coordinated to avoid duplicate payment. We also propose to establish payment amounts for these services under the physician fee schedule.
We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to dietitians and nutrition professionals who will provide these diagnostic therapy and counseling services. Costs to the Medicare program associated with this provision are shown in Table 8.
6. Telehealth
We estimate that the cost of providing office or other outpatient visits, consultation services, individual psychotherapy, and pharmacologic management in accordance with section 223 of the BIPA will be approximately $20 million in FY 2002 and approximately $60 million by FY 2006, as indicated above in Table 8.
This rule does not mandate that entities provide consultation, office or other outpatient visits, individual psychotherapy or pharmacological management services via a telecommunications system. Thus, this rule would not require entities to purchase telehealth equipment or to acquire the telecommunications infrastructure necessary to deliver these services via a telecommunications system. Therefore, this rule does not impose costs associated with starting and operating a telehealth network.
7. Indian Health Services
As discussed in section III.G. of the preamble, in addition to payment for Medicare services in hospitals and skilled nursing facilities, section 432 of the BIPA authorizes payment under the physician fee schedule to physicians and certain practitioners for services furnished in a hospital and an ambulatory care clinic, whether provider-based or free-standing, of the Indian Health Service effective for services furnished on or after July 1, 2001. We propose to add a new § 410.46 to conform our regulations to the statute. Costs to the Medicare program for this BIPA provision are shown in Table 8.
8. Pathology Services
As discussed in section III.H. of the preamble, in the November 2, 1999 physician fee schedule final rule (64 FR 59381), we stated that we would implement a policy to pay only hospitals for the TC of physician pathology services furnished to hospital inpatients. Before the effective date of this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology to a hospital inpatient. The regulation provided that for services furnished on or after January 1, 2001, the carriers would no longer pay claims to an independent laboratory under the physician fee schedule for the TC of physician pathology services furnished for hospital inpatients. Similar treatment was provided under the hospital outpatient prospective payment system for the TC of physician pathology services to hospital outpatients. We delayed implementation of this provision for one year; it was to take effect for services furnished on or after January 1, 2001. The delay was intended to allow independent laboratories and hospitals sufficient time to negotiate arrangements.
Section 542 of the BIPA requires Medicare to continue to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital. This provision applies to TC services furnished during the 2-year period beginning on January 1, 2001.
In the November 2, 1999 final rule, we estimated that payment under the physician fee schedule for TC billings by independent laboratories would decrease by $6 million per year if the original proposal had been implemented on January 1, 2001. As a result of the BIPA, these savings are not realized for two years.
G. Budget Neutrality
Each year since the fee schedule has been implemented, our actuaries have determined any adjustments needed to meet the budget neutrality requirement of the statute. A component of the actuarial determination of budget-neutrality involves estimating the impact of changes in the volume and intensity of physicians' services provided to Medicare beneficiaries as a result of the proposed changes. Since the November 1998 final rule (63 FR 58891), we have used a model that assumes 30 percent of anticipated payment reductions will be offset through an increase in the volume and intensity of services. We will continue to use the same assumption in this year's final rule.
H. Impact on Beneficiaries
Although changes in physicians' payments were large when the physician fee schedule was implemented in 1992, we detected no problems with beneficiary access to care. Furthermore, since beginning our transition to a resource-based practice expense system in 1999, we have not found that there are problems with beneficiary access to care. In addition, the implementation of the BIPA proposals that are contained in this rule will improve beneficiary access to health care under the Medicare program since certain preventative services, such as screening glaucoma, will now be covered for the first time and coverage of several existing services is being expanded.
I. Federalism
We have examined this proposed rule in accordance with Executive Order 13132 and have determined that this regulation would not have any negative impact on the rights, roles, or responsibilities of State, local, or tribal governments.
In accordance with the provisions of Executive Order 12866, this regulation Start Printed Page 40402was reviewed by the Office of Management and Budget.
Start List of SubjectsList of Subjects
42 CFR Part 405
- Administrative practice and procedure
- Health facilities
- Health professions
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
- Rural areas
- X-rays
42 CFR Part 410
- Health facilities
- Health professions
- Kidney diseases
- Laboratories
- Medicare
- Rural areas
- X-rays
42 CFR Part 411
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
42 CFR Part 414
- Administrative practice and procedure
- Health facilities
- Health professions
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
- Rural areas
- X-rays
42 CFR Part 415
- Health facilities
- Health professions
- Medicare
- Reporting and recordkeeping requirements
For the reasons set forth in the preamble, the Health Care Financing Administration proposes to amend 42 CFR chapter IV as follows:
Start PartPART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
1. The authority citation for part 405 continues to read as follows:
2. In § 405.534, an introductory paragraph is added to read as follows:
Limitation on payment for screening mammography services.The provisions in paragraphs (a), (b), and (c) of this section apply for services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are paid under the physician fee schedule in accordance with § 414.2 of this chapter.
* * * * *3. In § 405.535, the section heading is revised and the introductory text is amended by adding two sentences to the beginning to read as follows:
Special rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.The provisions in this section apply for screening mammography services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are paid under the physician fee schedule in accordance with § 414.2 of this chapter. * * *
* * * * *PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
1. The authority citation for part 410 continues to read as follows:
2. Section 410.3 is amended by revising paragraph (a)(1) to read as follows:
Scope of benefits.(a) * * *
(1) Medical and other health services such as physicians' services, outpatient services furnished by a hospital or a CAH, diagnostic tests, outpatient physical therapy and speech pathology services, rural health clinic services, Federally qualified health center services, IHS, Indian tribe, or tribal organization facility services, and outpatient renal dialysis services.
* * * * *3. Section 410.10 is amended by adding paragraph (x) to read as follows:
Medical and other health services: Included services.* * * * *(x) IHS, Indian tribe, or tribal organization facility services.
4. Section 410.22 is redesignated as § 410.21, § 410.23 is redesignated as § 410.22, and a new § 410.23 is added to read as follows:
Screening for glaucoma: Conditions for and limitations on coverage.(a) Definitions: As used in this section, the following definitions apply:
(1) Direct supervision in the office setting means the optometrist or the ophthalmologist must be present in the office suite and be immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed.
(2) Eligible beneficiary means:
(i) Individual with diabetes mellitus;
(ii) Individual with a family history of glaucoma; or
(iii) African-Americans age 50 and over.
(3) Screening for glaucoma means the following procedures furnished to an individual for the early detection of glaucoma:
(i) A dilated eye examination with an intraocular pressure measurement.
(ii) A direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination.
(b) Condition for coverage of screening for glaucoma.
Medicare Part B pays for glaucoma screening examinations provided to eligible beneficiaries as described in paragraph (a)(2) of this section if they are furnished by or under the direct supervision in the office setting of an optometrist or ophthalmologist who is legally authorized to perform these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished, as would otherwise be covered if furnished by a physician or incident to a physician's professional service.
(c) Limitations on coverage of glaucoma screening examinations.
(1) Payment may not be made for a glaucoma screening examination that is performed for an individual who is not an eligible beneficiary as described in paragraph (a)(2) of this section.
(2) Payment may be made for a glaucoma screening examination that is performed on an individual who is an eligible beneficiary as described in paragraph (a)(2) of this section, after at least 11 months have passed following the month in which the last glaucoma screening examination was performed.
5. In § 410.26, paragraph (b) is redesignated as paragraph (c), paragraph (a) is redesignated as paragraph (b) and revised, a new paragraph (a) is added, and newly designated paragraph (c) is amended by adding a paragraph heading:
Services and supplies incident to a physician's professional service: Conditions.(a) Definitions. For purposes of this section, the following definitions apply:
(1) Auxiliary personnel means any individual who is acting under the supervision of a physician, regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner).
(2) Direct supervision means the level of supervision by the physician (or other practitioner) of auxiliary personnel as defined in § 410.32(b)(3)(ii).
(3) Independent contractor means an individual who performs part-time or full-time work for which the individual receives an IRS-1099 form.
(4) Leased employment means an employment relationship that is Start Printed Page 40403recognized by applicable State law and that is established by two employers by a contract such that one employer hires the services of an employee of the other employer.
(5) Noninstitutional setting means all settings other than a hospital or skilled nursing facility.
(6) Practitioner means a non-physician practitioner who is authorized by the Act to receive payment for services incident to his or her own services.
(7) Services and supplies means any service or supply (including any drug or biological that cannot be self-administered) that is included in section 1861(s)(2)(A) of the Act and is not specifically listed in the Act as a separate benefit included in the Medicare program.
(b) Medicare Part B pays for services and supplies incident to the service of a physician (or other practitioner).
(1) Services and supplies must be furnished in a noninstitutional setting to noninstitutional patients.
(2) Services and supplies must be an integral, though incidental, part of the service of a physician (or other practitioner) in the course of diagnosis or treatment of an injury or illness.
(3) Services and supplies must be commonly furnished without charge or included in the bill of a physician (or other practitioner).
(4) Services and supplies must be of a type that are commonly furnished in the office or clinic of a physician (or other practitioner).
(5) Services and supplies must be furnished under the supervision of the physician (or other practitioner).
(6) Services and supplies must be furnished by the physician, practitioner with an incident to benefit, or auxiliary personnel.
(7) A physician (or other practitioner) may be an employee or an independent contractor.
(c) Limitation. * * *
6. In § 410.37, paragraphs (d), (e)(2), and (g) are revised and paragraph (e)(3) is added to read as follows:
Colorectal cancer screening tests: Conditions for and limitations on coverage.* * * * *(d) Condition for coverage of flexible sigmoidoscopy screening. Medicare Part B pays for a flexible sigmoidoscopy screening service if it is performed by a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act), or by a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5) of the Act and §§ 410.74, 410.75, and 410.76) who is authorized under State law to perform the examination.
(e) Limitations on coverage of screening flexible sigmoidoscopies. * * *
(2) For an individual 50 years of age or over, except as described in paragraph (e)(3) of this section, payment may be made for screening flexible sigmoidoscopy after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.
(3) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening colonoscopy performed, payment may be made for a screening flexible sigmoidosocopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
* * * * *(g) Limitations on coverage of screening colonoscopies. (1) Effective for services furnished on or after January 1, 1998 through June 30, 2001, payment may not be made for a screening colonoscopy for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section.
(2) Effective for services furnished on or after July 1, 2001, except as described in paragraph (g)(4) of this section, payment may be made for a screening colonoscopy performed for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
(3) Payment may be made for a screening colonoscopy performed for an individual who is at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 23 months have passed following the month in which the last screening colonoscopy was performed, or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.
(4) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening flexible sigmoidoscopy performed, payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed.
* * * * *7. Section 410.46 is added to read as follows:
Physician and other practitioner services furnished in or at the direction of an IHS or Indian tribal hospital or clinic: Scope and conditions.(a) Medicare Part B pays, in accordance with the physician fee schedule, for services furnished in or at the direction of a hospital or outpatient clinic (provider-based or free-standing) that is operated by the Indian Health Service (IHS) or by an Indian tribe or tribal organization (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These services are subject to the same situations, terms, and conditions that would apply if the services were furnished in or at the direction of a hospital or clinic that is not operated by IHS or by an Indian tribe or tribal organization. Payments include health professional shortage areas incentive payments when the requirements for these incentive payments in § 414.42 of this chapter are met.
(b) Payment is not made under this section to the extent that Medicare otherwise pays for the same services under other provisions.
(c) Payment is made under these provisions for the following services:
(1) Services for which payment is made under the physician fee schedule in accordance with part 414 of this chapter.
(2) Services furnished by non-physician practitioners for which payment under Part B is made under the physician fee schedule.
(3) Services furnished by a physical therapist or occupational therapist, for which payment under Part B is made under the physician fee schedule.
(d) Payments under these provisions will be paid to the IHS or tribal hospital or clinic.
8. In § 410.56, paragraphs (b)(1), the introductory text of (b)(2), and (b)(3) are revised to read as follows:
Screening pelvic examinations.* * * * *(b) * * *
(1) General rule. Except as specified in paragraphs (b)(2) and (b)(3) of this section, payment may be made for a pelvic examination performed on an asymptomatic woman only if the individual has not had a pelvic examination paid for by Medicare during the preceding 23 months following the month in which her last Medicare-covered screening pelvic examination was performed. Start Printed Page 40404
(2) More frequent screening based on high-risk factors. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner specified in paragraph (a) of this section, and there is evidence that the woman is at high risk (on the basis of her medical history or other findings) of developing cervical cancer or vaginal cancer, as determined in accordance with the following risk factors:
* * * * *(3) More frequent screening for women of childbearing age. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner as specified in paragraph (a) of this section for a woman of childbearing age who has had an examination that indicated the presence of cervical or vaginal cancer or other abnormality during any of the preceding 3 years. The term “woman of childbearing age” means a woman who is premenopausal, and has been determined by a physician, or a qualified practitioner, as specified in paragraph (a) of this section, to be of childbearing age, based on her medical history or other findings.
* * * * *9. Section 410.78 is revised to read as follows:
Office and other outpatient visits, consultation, individual psychotherapy and pharmacologic management via an interactive telecommunications system.(a) Definitions. For the purposes of this section the following definitions apply:
(1) Asynchronous store and forward technologies means the transmission of a patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. An asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines and text messages without visualization of the patient (electronic mail). Photographs visualized by a telecommunications system must be specific to the patient's medical condition and adequate for furnishing or confirming a diagnosis and or treatment plan. Dermatological photographs, for example, a photograph of a skin lesion, may be considered to meet the requirement of a single media format under this provision.
(2) Distant site means the site at which the physician or practitioner delivering the service is located at the time the service is provided via a telecommunications system.
(3) Interactive telecommunications system means multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.
(4) Originating site means, for purposes of a consultation, office or other outpatient visit, individual psychotherapy, or pharmacologic management via an interactive telecommunications system, the location of an eligible Medicare beneficiary at the time the service being furnished via a telecommunications system occurs. For asynchronous store and forward telecommunications technologies, the only originating sites are Federal telemedicine demonstration programs conducted in Alaska or Hawaii.
(b) General rule. Medicare Part B pays for office and other outpatient visits, professional consultation, individual psychotherapy, and pharmacologic management furnished by means of an interactive telecommunications system if the following conditions are met:
(1) The physician or practitioner at the distant site must be licensed to provide the service under State law. When the physician or practitioner at the distant site is licensed under State law to provide a covered telehealth service (that is, professional consultations, office and other outpatient visits, individual psychotherapy, and pharmacologic management), he or she may bill for, and receive payment for, this service when delivered via a telecommunications system.
(2) The practitioner at the distant site is one of the following:
(i) A physician as described in § 410.20.
(ii) A physician assistant as described § 410.74.
(iii) A nurse practitioner as described in § 410.75.
(iv) A clinical nurse specialist as described in § 410.76.
(v) A nurse-midwife as described in § 410.77.
(vi) A clinical psychologist as described in § 410.71.
(vii) A clinical social worker as described in § 410.73.
(3) The services are furnished to a beneficiary at an originating site, which is one of the following:
(i) The office of a physician or practitioner.
(ii) A critical access hospital (as described in section 1861(mm)(1) of the Act).
(iii) A rural health clinic (as described in section 1861(aa)(2) of the Act).
(iv) A Federally qualified health center (as defined in section 1861(aa)(4) of the Act).
(v) A hospital (as defined in section 1861(e) of the Act).
(4) Originating sites must be located in either a rural health professional shortage area as defined under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in section 1886(d)(2)(D) of the Act. Entities participating in a Federal telemedicine demonstration project that have been approved by, or receive funding from, the Secretary as of December 31, 2000 qualify as an eligible originating site regardless of geographic location.
(5) The medical examination of the patient is under the control of the physician or practitioner at the distant site.
(c) Telepresenter not required. A telepresenter is not required as a condition of payment unless a telepresenter is medically necessary as determined by the physician or practitioner at the distant site.
(d) Exception to the interactive telecommunications system requirement. For Federal telemedicine demonstration programs conducted in Alaska or Hawaii only, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system.
(e) Limitation. A clinical psychologist and a clinical social worker may bill and receive payment for individual psychotherapy via a telecommunications system, but may not seek payment for medical evaluation and management services.
10. A new subpart G is added to read as follows:
Subpart G—Medical Nutrition Therapy
Definitions.For the purposes of this subpart, the following definitions apply:
Chronic renal insufficiency is defined as the stage of renal disease associated with a reduction in renal function not severe enough to require dialysis or transplantation (glomerular filtration rate [GFR] 13-50 ml/min/1.73m2).
Diabetes is diabetes mellitus consisting of two types. Type 1 is an autoimmune disease that destroys the beta cells of the pancreas, leading to insulin deficiency. Type 2 is familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. The diagnostic criterion for a diagnosis of diabetes for a fasting glucose tolerance test is greater than or equal to 126 mg/dL.
Episode of care means a time period not exceeding 12 months, starting with the assessment and including all covered interventions based on a referral from a physician as specified in § 410.132(c).
Medical nutrition therapy services means nutritional diagnostic, therapy, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing diabetes or renal disease.
Physician means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action (including a physician within the meaning of section of 1101(a)(7) of the Act).
Renal disease means chronic renal insufficiency and the medical condition of a beneficiary who has been discharged from the hospital within the last six months after a successful renal transplant.
Medical nutrition therapy.(a) Conditions for coverage of medical nutrition therapy services. Medicare Part B pays for medical nutrition therapy services provided by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the treating physician. Services covered consist of nutritional assessment, interventions, and reassessment and follow-up interventions in accordance with nationally accepted dietary or nutritional protocols.
(b) Limitations on coverage of medical nutrition therapy services.
(1) Medical nutrition therapy services are not covered for beneficiaries receiving maintenance dialysis for which payment is made under section 1881 of the Act.
(2) If a beneficiary has both diabetes and renal disease, the beneficiary may receive both MNT and DSMT, but coverage is limited to the number of hours the beneficiary would receive under either the MNT benefit or the DSMT benefit for the episode of care, whichever is greater.
(3) Medical nutrition therapy is only covered if the beneficiary has not started initial training under the diabetes self-management training benefit as described in § 410.141 within the 12 months previous to initial referral for MNT, unless—
(i) The need for a reassessment and additional therapy has been documented by the referring physician as a result of a change in diagnosis or medical condition; or
(ii) The beneficiary is diagnosed with both diabetes and renal disease.
(4) If a beneficiary diagnosed with diabetes has been referred for both follow-up diabetes self-management training services and medical nutrition therapy, the number of hours the beneficiary may receive is limited to the number of hours under either follow-up diabetes self-management training services or medical nutrition therapy for any 12 month period.
(c) Referrals. Referral may only be made by the treating physician when the beneficiary has been diagnosed with diabetes or renal disease as defined in this subpart with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care and any reassessments or follow-up interventions during an episode of care.
(d) Reassessments and follow-up interventions. Reassessments and follow-up interventions are only covered within an episode of care when the referring physician determines there is a change of diagnosis or medical condition within such episode of care that makes a change in diet necessary.
Provider qualifications.For Medicare Part B coverage of medical nutrition therapy, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who on or after December 22, 2000—
(a) Holds a bachelor's or higher degree granted by a regionally accredited college or university in the United States (or an equivalent foreign degree) with completion of the academic requirements of a program in nutrition or dietetics, as accredited by an appropriate national accreditation organization recognized for this purpose;
(b) Has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional; and
(c) Is licensed or certified as a dietitian or nutrition professional by the State in which the services are performed. In a State that does not provide for licensure or certification, the individual will be deemed to have met this requirement if he or she is recognized as a “registered dietitian” by the Commission on Dietetic Registration or its successor organization, or meets the requirements of paragraphs (a) and (b) of this section; or a dietitian or nutritionist licensed or certified in a State as of December 21, 2000.
PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT
1. The authority citation for part 411 continues to read as follows:
2. In § 411.15, paragraph (a)(1) is revised, and a new paragraph (k)(10) is added to read as follows:
Particular services excluded from coverage.* * * * *(a) * * *
(1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic examinations, prostate cancer screening tests, or glaucoma screening exams that meet the criteria specified in paragraphs (k)(6) through (k)(10) of this section.
* * * * *(k) * * *
(10) In the case of screening exams for glaucoma, for the purpose of early detection of glaucoma, subject to the conditions and limitations specified in § 410.23 of this chapter.
* * * * *PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
1. The authority citation for part 414 continues to read as follows:
2. In 414.2, the definition of “Physician services” is amended by Start Printed Page 40406adding a new paragraph (8) to read as follows:
Definitions.* * * * *Physician Services * * *
(8) Screening mammography services.
* * * * *3. A new § 414.64 is added to read as follows:
Payment for medical nutrition therapy.(a) Payment under the physician fee schedule. Medicare payment for medical nutrition therapy is made under the physician fee schedule in accordance with subpart B of this part.
(b) To whom payment may be made. Payment may be made to a supplier (registered dietitian or nutrition professional) approved by CMS to furnish medical nutrition therapy in accordance with part 410, subpart G of this chapter.
(c) Effective date of payment. Medicare pays suppliers of medical nutrition therapy on or after the effective date of enrollment of the supplier at the carrier.
(d) Limitation on payment. Payment is made only for nutritional therapy sessions actually attended by the beneficiary and documented for payment purposes.
(e) Other conditions for fee-for-service payment. Payment is made only if the beneficiary:
(1) Is not an inpatient of a hospital, SNF, nursing home, or hospice.
(2) Is not receiving services in an RHC, FQHC or ESRD dialysis facility.
4. Section 414.65 is revised to read as follows:
Payment for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via interactive telecommunications systems.(a) Professional service. Medicare payment for the professional service via an interactive telecommunications system is made according to the following limitations:
(1) The Medicare payment amount for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via an interactive telecommunications system is equal to the current fee schedule amount applicable to services of the physician or practitioner.
(2) Only the physician or practitioner at the distant site may bill and receive payment for the professional service via an interactive telecommunications system.
(3) Payments made to the physician or practitioner at the distant site, including deductible and coinsurance, for the professional service may not be shared with the referring practitioner or telepresenter.
(b) Originating site facility fee. For office or other outpatient visits, consultation, individual psychotherapy, or pharmacologic management services delivered via an interactive telecommunications system furnished on or after October 1, 2001.
(1) Payment amount. For services furnished on or after October 1, 2001 through December 31, 2002, the payment amount to the originating site is the lesser of the actual charge or the originating site facility fee of $20. For services furnished on or after January 1 of each subsequent year, the facility fee for the originating site will be updated by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act.
(2) Who may bill for the originating site facility fee. Only the originating site may bill for the originating site facility fee and only on an assignment-related basis. The distant site physician or practitioner may not bill for or receive payment for facility fees associated with the professional service furnished via an interactive telecommunications system.
(c) Deductible and coinsurance apply. The payment for the professional service and originating site facility fee is subject to the coinsurance and deductible requirements of sections 1833(a)(1) and (b) of the Act.
(d) Sanctions. A distant site practitioner or originating site facility may be subject to the applicable sanctions provided for in chapter IV, part 402 and chapter V, parts 1001, 1002, and 1003 of this title if he or she does any of the following:
(1) Knowingly and willfully bills or collects for services in violation of the limitation of this section.
(2) Fails to timely correct excess charges by reducing the actual charge billed for the service in an amount that does not exceed the limiting charge for the service or fails to timely refund excess collections.
(3) Fails to submit a claim on a standard form for services provided for which payment is made on a fee schedule basis; or
(4) Imposes a charge for completing and submitting the standard claims form.
PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS
1. The authority citation for part 415 continues to read as follows:
2. Section 415.130 is amended by:
A. Redesignating paragraphs (a), (b), and (c) as paragraphs (b), (c), and (d).
B. Adding a new paragraph (a).
C. Amending newly designated paragraph (b)(3) by removing the reference “paragraph (b)” and adding “paragraph (c)” in its place.
D. Amending newly designated paragraph (b)(4) by removing the reference “paragraphs (b)(1), (b)(3), and (b)(4)” and adding “paragraphs (c)(1), (c)(3), and (c)(4)” in their place.
E. Revising newly designated paragraph (d).
Conditions for payment: Physician pathology services.(a) Definitions. The following definitions are used in this section.
(1) Covered hospital means, with respect to an inpatient or an outpatient, a hospital that had an arrangement with an independent laboratory that was in effect as of July 22, 1999, under which a laboratory furnished the technical component of physician pathology services to fee-for-service Medicare beneficiaries who were hospital inpatients or outpatients, and submitted claims for payment for this technical component to a Medicare carrier and not to the hospital.
(2) Fee-for-service Medicare beneficiaries means those beneficiaries who are entitled to benefits under Part A or are enrolled under Part B of Title XVIII of the Act or both and are not enrolled in any of the following:
(i) A Medicare+Choice plan under Part C of Title XVIII of the Act.
(ii) A plan offered by an eligible organization under section 1876 of the Act;
(iii) A program of all-inclusive care for the elderly (PACE) under 1894 of the Act; or
(iv) A social health maintenance organization (SHMO) demonstration project established under section 4018(b) of the Omnibus Budget Reconciliation Act of 1987.
* * * * *(d) Physician pathology services furnished by an independent laboratory. The technical component of physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient before January 1, 2001 may be paid on a fee schedule basis. After December 31, 2001 but before January 1, 2003, if an independent laboratory furnishes the technical component of a physician pathology service to a fee-for-service Medicare beneficiary who is an Start Printed Page 40407inpatient or outpatient of a covered hospital, the carrier will treat the technical component as a service for which payment will be made to the laboratory under the physician fee schedule. The service will not be treated as an inpatient hospital service for which payment is made to the hospital under section 1886(d) of the Act or as an outpatient hospital service for which payment is made to the hospital under section 1833(t) of the Act. After December 31, 2002, the technical component for physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient is paid only to the hospital.
(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)
Dated: June 19, 2001.
Thomas A. Scully,
Administrator, Health Care Financing Administration.
Approved: July 12, 2001.
Tommy G. Thompson,
Secretary.
Note:
These addenda will not appear in the Code of Federal Regulations.
Addendum A—Explanation and Use of Addenda B
The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians' services furnished in 2002. Addendum B contains the RVUs for work, non-facility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.
Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002
This addendum contains the following information for each CPT code and alphanumeric HCPCS code, except for alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for nonphysicians' services or items), or L (orthotics), and codes for anesthesiology.
1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum.
2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier -26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code: One for the global values (both professional and technical); one for modifier -26 (PC); and one for modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service.
Modifier -53 is shown for a discontinued procedure. There will be RVUs for the code (CPT code 45378) with this modifier.
3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the physician fee schedule and whether it is separately payable if the service is covered.
A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an “A” indicator does not mean that Medicare has made a national decision regarding the coverage of the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.
B = Bundled code. Payment for covered services is always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient.)
C = Carrier-priced code. Carriers will establish RVUs and payment amounts for these services, generally on a case-by-case basis following review of documentation, such as an operative report.
D = Deleted code. These codes are deleted effective with the beginning of the calendar year.
E = Excluded from physician fee schedule by regulation. These codes are for items or services that we chose to exclude from the physician fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the physician fee schedule for these codes. Payment for them, if they are covered, continues under reasonable charge or other payment procedures.
G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services.
N = Noncovered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.
P = Bundled or excluded code. There are no RVUs for these services. No separate payment should be made for them under the physician fee schedule.
End Part—If the item or service is covered as incident to a physician's service and is furnished on the same day as a physician's service, payment for it is bundled into the payment for the physician's service to which it is incident (an example is an elastic bandage furnished by a physician incident to a physician's service).
—If the item or service is covered as other than incident to a physician's service, it is excluded from the physician fee schedule (for example, colostomy supplies) and is paid under the other payment provisions of the Act.
R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced.
T = Injections. There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the service(s) for which payment is made.
X = Exclusion by law. These codes represent an item or service that is not within the definition of “physicians” services” for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)
4. Description of code. This is an abbreviated version of the narrative description of the code.
5. Physician work RVUs. These are the RVUs for the physician work for this service in 2000. Codes that are not used for Medicare payment are identified with a “+.”
6. Facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for facility settings.
7. Non-facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for non-facility settings.
8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2000.
9. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.
10. Non-facility total. This is the sum of the work, fully implemented non-facility practice expense, and malpractice expense RVUs.Start Printed Page 40408
11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows:
MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians' Current Procedural Terminology for specific definitions.
XXX = The global concept does not apply.
YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).
ZZZ = The code is part of another service and falls within the global period for the other service.
—————————— 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved. 3 + Indicates RVUs are not used for Medicare payments. 4 PE RVUs = Practice Expense Relative Value Units.Start Printed Page 40408Start Printed Page 40566Addendum B.—Relative Value Units (RVUs) and Related Information
CPT 1/HCPCS 2 MOD Status Description Physician Work RVUs 3 Facility PE RVUs Non- Facility PE RVUs Mal- Practice RVUs Facility Total Non- Facility Total Global 10040 A Acne surgery of skin abscess 1.18 0.52 1.63 0.05 1.75 2.86 010 10060 A Drainage of skin abscess 1.17 0.66 1.35 0.08 1.91 2.60 010 10061 A Drainage of skin abscess 2.40 1.15 2.07 0.17 3.72 4.64 010 10080 A Drainage of pilonidal cyst 1.17 0.71 2.11 0.09 1.97 3.37 010 10081 A Drainage of pilonidal cyst 2.45 1.55 2.89 0.19 4.19 5.53 010 10120 A Remove foreign body 1.22 0.73 1.83 0.10 2.05 3.15 010 10121 A Remove foreign body 2.69 1.77 2.83 0.25 4.71 5.77 010 10140 A Drainage of hematoma/fluid 1.53 0.87 1.42 0.15 2.55 3.10 010 10160 A Puncture drainage of lesion 1.20 0.77 1.56 0.11 2.08 2.87 010 10180 A Complex drainage, wound 2.25 1.25 1.51 0.25 3.75 4.01 010 11000 A Debride infected skin 0.60 0.24 0.58 0.05 0.89 1.23 000 11001 A Debride infected skin add-on 0.30 0.11 0.34 0.02 0.43 0.66 ZZZ 11010 A Debride skin, fx 4.20 2.00 2.51 0.45 6.65 7.16 010 11011 A Debride skin/muscle, fx 4.95 2.59 3.87 0.53 8.07 9.35 000 11012 A Debride skin/muscle/bone, fx 6.88 4.21 5.67 0.89 11.98 13.44 000 11040 A Debride skin, partial 0.50 0.21 0.50 0.05 0.76 1.05 000 11041 A Debride skin, full 0.82 0.34 0.67 0.08 1.24 1.57 000 11042 A Debride skin/tissue 1.12 0.46 0.95 0.11 1.69 2.18 000 11043 A Debride tissue/muscle 2.38 1.38 2.60 0.24 4.00 5.22 010 11044 A Debride tissue/muscle/bone 3.06 1.80 3.11 0.34 5.20 6.51 010 11055 R Trim skin lesion 0.27 0.12 0.38 0.02 0.41 0.67 000 11056 R Trim skin lesion, 2 to 4 0.39 0.17 0.42 0.03 0.59 0.84 000 11057 R Trim skin lesions, over 4 0.50 0.22 0.46 0.04 0.76 1.00 000 11100 A Biopsy of skin lesion 0.81 0.38 1.49 0.04 1.23 2.34 000 11101 A Biopsy, skin add-on 0.41 0.20 0.70 0.02 0.63 1.13 ZZZ 11200 A Removal of skin tags 0.77 0.31 1.17 0.04 1.12 1.98 010 11201 A Remove skin tags add-on 0.29 0.12 0.52 0.02 0.43 0.83 ZZZ 11300 A Shave skin lesion 0.51 0.22 1.02 0.03 0.76 1.56 000 11301 A Shave skin lesion 0.85 0.38 1.11 0.04 1.27 2.00 000 11302 A Shave skin lesion 1.05 0.48 1.21 0.05 1.58 2.31 000 11303 A Shave skin lesion 1.24 0.54 1.34 0.06 1.84 2.64 000 11305 A Shave skin lesion 0.67 0.29 0.81 0.04 1.00 1.52 000 11306 A Shave skin lesion 0.99 0.43 1.06 0.05 1.47 2.10 000 11307 A Shave skin lesion 1.14 0.51 1.18 0.05 1.70 2.37 000 11308 A Shave skin lesion 1.41 0.63 1.27 0.07 2.11 2.75 000 11310 A Shave skin lesion 0.73 0.33 1.12 0.04 1.10 1.89 000 11311 A Shave skin lesion 1.05 0.50 1.23 0.05 1.60 2.33 000 11312 A Shave skin lesion 1.20 0.57 1.30 0.06 1.83 2.56 000 11313 A Shave skin lesion 1.62 0.75 1.58 0.09 2.46 3.29 000 11400 A Removal of skin lesion 0.91 0.73 2.42 0.06 1.70 3.39 010 11401 A Removal of skin lesion 1.32 0.88 2.43 0.09 2.29 3.84 010 11402 A Removal of skin lesion 1.61 0.96 2.52 0.12 2.69 4.25 010 11403 A Removal of skin lesion 1.92 1.07 2.76 0.16 3.15 4.84 010 11404 A Removal of skin lesion 2.20 1.17 2.92 0.18 3.55 5.30 010 11406 A Removal of skin lesion 2.76 1.38 3.20 0.25 4.39 6.21 010 11420 A Removal of skin lesion 1.06 0.77 2.03 0.08 1.91 3.17 010 11421 A Removal of skin lesion 1.53 0.99 2.36 0.11 2.63 4.00 010 11422 A Removal of skin lesion 1.76 1.06 2.51 0.14 2.96 4.41 010 11423 A Removal of skin lesion 2.17 1.22 2.94 0.17 3.56 5.28 010 11424 A Removal of skin lesion 2.62 1.41 3.09 0.21 4.24 5.92 010 11426 A Removal of skin lesion 3.78 1.85 3.74 0.34 5.97 7.86 010 11440 A Removal of skin lesion 1.15 0.92 2.54 0.08 2.15 3.77 010 11441 A Removal of skin lesion 1.61 1.16 2.70 0.11 2.88 4.42 010 11442 A Removal of skin lesion 1.87 1.25 2.77 0.14 3.26 4.78 010 11443 A Removal of skin lesion 2.49 1.59 3.32 0.18 4.26 5.99 010 11444 A Removal of skin lesion 3.42 2.00 3.74 0.25 5.67 7.41 010 11446 A Removal of skin lesion 4.49 2.49 4.18 0.30 7.28 8.97 010 11450 A Removal, sweat gland lesion 2.73 1.05 4.02 0.26 4.04 7.01 090 11451 A Removal, sweat gland lesion 3.95 1.59 4.83 0.39 5.93 9.17 090 11462 A Removal, sweat gland lesion 2.51 0.98 4.14 0.23 3.72 6.88 090 11463 A Removal, sweat gland lesion 3.95 1.62 5.63 0.40 5.97 9.98 090 11470 A Removal, sweat gland lesion 3.25 1.28 4.41 0.30 4.83 7.96 090 11471 A Removal, sweat gland lesion 4.41 1.77 5.42 0.40 6.58 10.23 090 Start Printed Page 40409 11600 A Removal of skin lesion 1.41 0.94 2.57 0.09 2.44 4.07 010 11601 A Removal of skin lesion 1.93 1.08 2.63 0.12 3.13 4.68 010 11602 A Removal of skin lesion 2.09 1.32 2.69 0.13 3.54 4.91 010 11603 A Removal of skin lesion 2.35 1.39 2.88 0.16 3.90 5.39 010 11604 A Removal of skin lesion 2.58 1.46 3.07 0.18 4.22 5.83 010 11606 A Removal of skin lesion 3.43 1.75 3.63 0.28 5.46 7.34 010 11620 A Removal of skin lesion 1.34 0.89 2.53 0.09 2.32 3.96 010 11621 A Removal of skin lesion 1.97 1.35 2.67 0.12 3.44 4.76 010 11622 A Removal of skin lesion 2.34 1.50 2.84 0.15 3.99 5.33 010 11623 A Removal of skin lesion 2.93 1.71 2.79 0.20 4.84 5.92 010 11624 A Removal of skin lesion 3.43 1.93 3.16 0.25 5.61 6.84 010 11626 A Removal of skin lesion 4.30 2.34 4.18 0.35 6.99 8.83 010 11640 A Removal of skin lesion 1.53 1.11 2.62 0.10 2.74 4.25 010 11641 A Removal of skin lesion 2.44 1.66 2.96 0.15 4.25 5.55 010 11642 A Removal of skin lesion 2.93 1.88 2.89 0.18 4.99 6.00 010 11643 A Removal of skin lesion 3.50 2.17 3.25 0.24 5.91 6.99 010 11644 A Removal of skin lesion 4.55 2.68 3.91 0.33 7.56 8.79 010 11646 A Removal of skin lesion 5.95 3.38 5.19 0.46 9.79 11.60 010 11719 R Trim nail(s) 0.11 0.07 0.54 0.01 0.19 0.66 000 11720 A Debride nail, 1-5 0.32 0.13 0.42 0.02 0.47 0.76 000 11721 A Debride nail, 6 or more 0.54 0.22 0.53 0.04 0.80 1.11 000 11730 A Removal of nail plate 1.13 0.46 0.74 0.09 1.68 1.96 000 11732 A Remove nail plate, add-on 0.57 0.24 0.29 0.05 0.86 0.91 ZZZ 11740 A Drain blood from under nail 0.37 0.14 0.68 0.03 0.54 1.08 000 11750 A Removal of nail bed 1.86 0.79 1.55 0.16 2.81 3.57 010 11752 A Remove nail bed/finger tip 2.67 1.75 1.99 0.33 4.75 4.99 010 11755 A Biopsy, nail unit 1.31 0.59 1.03 0.06 1.96 2.40 000 11760 A Repair of nail bed 1.58 1.19 1.70 0.17 2.94 3.45 010 11762 A Reconstruction of nail bed 2.89 1.87 2.15 0.32 5.08 5.36 010 11765 A Excision of nail fold, toe 0.69 0.45 0.97 0.05 1.19 1.71 010 11770 A Removal of pilonidal lesion 2.61 1.26 2.97 0.24 4.11 5.82 010 11771 A Removal of pilonidal lesion 5.74 3.92 5.34 0.56 10.22 11.64 090 11772 A Removal of pilonidal lesion 6.98 4.36 6.12 0.68 12.02 13.78 090 11900 A Injection into skin lesions 0.52 0.23 0.76 0.02 0.77 1.30 000 11901 A Added skin lesions injection 0.80 0.37 0.89 0.03 1.20 1.72 000 11920 R Correct skin color defects 1.61 0.83 2.24 0.17 2.61 4.02 000 11921 R Correct skin color defects 1.93 1.04 2.63 0.21 3.18 4.77 000 11922 R Correct skin color defects 0.49 0.26 0.39 0.05 0.80 0.93 ZZZ 11950 R Therapy for contour defects 0.84 0.47 1.28 0.06 1.37 2.18 000 11951 R Therapy for contour defects 1.19 0.54 1.71 0.10 1.83 3.00 000 11952 R Therapy for contour defects 1.69 0.89 2.15 0.17 2.75 4.01 000 11954 R Therapy for contour defects 1.85 0.94 2.85 0.19 2.98 4.89 000 11960 A Insert tissue expander(s) 9.08 10.76 NA 0.88 20.72 NA 090 11970 A Replace tissue expander 7.06 5.06 NA 0.77 12.89 NA 090 11971 A Remove tissue expander(s) 2.13 3.86 6.15 0.21 6.20 8.49 090 11975 N Insert contraceptive cap +1.48 0.59 1.54 0.14 2.21 3.16 XXX 11976 R Removal of contraceptive cap 1.78 0.77 1.58 0.17 2.72 3.53 XXX 11977 N Removal/reinsert contra cap +3.30 1.30 2.25 0.31 4.91 5.86 XXX 11980 A Implant hormone pellet(s) 1.48 0.63 1.13 0.10 2.21 2.71 000 12001 A Repair superficial wound(s) 1.70 0.83 2.31 0.13 2.66 4.14 010 12002 A Repair superficial wound(s) 1.86 0.86 2.41 0.15 2.87 4.42 010 12004 A Repair superficial wound(s) 2.24 0.98 2.59 0.17 3.39 5.00 010 12005 A Repair superficial wound(s) 2.86 1.23 3.05 0.23 4.32 6.14 010 12006 A Repair superficial wound(s) 3.67 1.92 4.15 0.31 5.90 8.13 010 12007 A Repair superficial wound(s) 4.12 2.24 4.63 0.37 6.73 9.12 010 12011 A Repair superficial wound(s) 1.76 0.83 2.37 0.14 2.73 4.27 010 12013 A Repair superficial wound(s) 1.99 0.89 2.53 0.16 3.04 4.68 010 12014 A Repair superficial wound(s) 2.46 1.06 2.83 0.18 3.70 5.47 010 12015 A Repair superficial wound(s) 3.19 1.26 3.26 0.24 4.69 6.69 010 12016 A Repair superficial wound(s) 3.93 1.50 3.79 0.32 5.75 8.04 010 12017 A Repair superficial wound(s) 4.71 2.44 5.41 0.39 7.54 10.51 010 12018 A Repair superficial wound(s) 5.53 2.69 6.31 0.46 8.68 12.30 010 12020 A Closure of split wound 2.62 1.45 2.60 0.24 4.31 5.46 010 12021 A Closure of split wound 1.84 1.12 2.11 0.19 3.15 4.14 010 12031 A Layer closure of wound(s) 2.15 1.19 2.74 0.15 3.49 5.04 010 12032 A Layer closure of wound(s) 2.47 1.27 2.80 0.15 3.89 5.42 010 12034 A Layer closure of wound(s) 2.92 1.44 3.06 0.21 4.57 6.19 010 12035 A Layer closure of wound(s) 3.43 1.65 3.03 0.30 5.38 6.76 010 12036 A Layer closure of wound(s) 4.05 2.47 5.20 0.41 6.93 9.66 010 12037 A Layer closure of wound(s) 4.67 2.82 5.61 0.49 7.98 10.77 010 12041 A Layer closure of wound(s) 2.37 1.26 3.03 0.17 3.80 5.57 010 12042 A Layer closure of wound(s) 2.74 1.41 3.01 0.17 4.32 5.92 010 12044 A Layer closure of wound(s) 3.14 1.61 3.17 0.24 4.99 6.55 010 12045 A Layer closure of wound(s) 3.64 1.84 3.58 0.34 5.82 7.56 010 Start Printed Page 40410 12046 A Layer closure of wound(s) 4.25 2.53 5.31 0.40 7.18 9.96 010 12047 A Layer closure of wound(s) 4.65 2.90 5.94 0.41 7.96 11.00 010 12051 A Layer closure of wound(s) 2.47 1.41 3.00 0.16 4.04 5.63 010 12052 A Layer closure of wound(s) 2.77 1.37 2.97 0.17 4.31 5.91 010 12053 A Layer closure of wound(s) 3.12 1.51 3.11 0.20 4.83 6.43 010 12054 A Layer closure of wound(s) 3.46 1.63 3.43 0.25 5.34 7.14 010 12055 A Layer closure of wound(s) 4.43 2.14 4.67 0.35 6.92 9.45 010 12056 A Layer closure of wound(s) 5.24 2.86 6.76 0.43 8.53 12.43 010 12057 A Layer closure of wound(s) 5.96 3.88 6.67 0.50 10.34 13.13 010 13100 A Repair of wound or lesion 3.12 1.85 3.38 0.21 5.18 6.71 010 13101 A Repair of wound or lesion 3.92 2.31 3.61 0.22 6.45 7.75 010 13102 A Repair wound/lesion add-on 1.24 0.58 0.74 0.10 1.92 2.08 ZZZ 13120 A Repair of wound or lesion 3.30 1.92 3.49 0.23 5.45 7.02 010 13121 A Repair of wound or lesion 4.33 2.40 3.82 0.25 6.98 8.40 010 13122 A Repair wound/lesion add-on 1.44 0.67 0.86 0.12 2.23 2.42 ZZZ 13131 A Repair of wound or lesion 3.79 2.22 3.73 0.25 6.26 7.77 010 13132 A Repair of wound or lesion 5.95 3.28 4.56 0.32 9.55 10.83 010 13133 A Repair wound/lesion add-on 2.19 1.02 1.21 0.17 3.38 3.57 ZZZ 13150 A Repair of wound or lesion 3.81 2.68 5.27 0.29 6.78 9.37 010 13151 A Repair of wound or lesion 4.45 3.13 5.18 0.28 7.86 9.91 010 13152 A Repair of wound or lesion 6.33 4.03 5.89 0.38 10.74 12.60 010 13153 A Repair wound/lesion add-on 2.38 1.11 1.34 0.18 3.67 3.90 ZZZ 13160 A Late closure of wound 10.48 6.24 NA 1.19 17.91 NA 090 14000 A Skin tissue rearrangement 5.89 4.63 7.50 0.46 10.98 13.85 090 14001 A Skin tissue rearrangement 8.47 5.99 8.93 0.65 15.11 18.05 090 14020 A Skin tissue rearrangement 6.59 5.36 8.11 0.50 12.45 15.20 090 14021 A Skin tissue rearrangement 10.06 7.16 9.38 0.69 17.91 20.13 090 14040 A Skin tissue rearrangement 7.87 6.12 8.33 0.53 14.52 16.73 090 14041 A Skin tissue rearrangement 11.49 7.98 10.13 0.68 20.15 22.30 090 14060 A Skin tissue rearrangement 8.50 6.97 8.82 0.59 16.06 17.91 090 14061 A Skin tissue rearrangement 12.29 8.92 10.97 0.75 21.96 24.01 090 14300 A Skin tissue rearrangement 11.76 8.50 10.37 0.88 21.14 23.01 090 14350 A Skin tissue rearrangement 9.61 6.41 NA 1.09 17.11 NA 090 15000 A Skin graft 4.00 1.92 2.52 0.37 6.29 6.89 000 15001 A Skin graft add-on 1.00 0.43 0.56 0.11 1.54 1.67 ZZZ 15050 A Skin pinch graft 4.30 3.94 4.91 0.46 8.70 9.67 090 15100 A Skin split graft 9.05 6.17 6.26 0.94 16.16 16.25 090 15101 A Skin split graft add-on 1.72 0.75 1.21 0.18 2.65 3.11 ZZZ 15120 A Skin split graft 9.83 6.67 8.99 0.87 17.37 19.69 090 15121 A Skin split graft add-on 2.67 1.25 1.57 0.27 4.19 4.51 ZZZ 15200 A Skin full graft 8.03 5.64 9.59 0.73 14.40 18.35 090 15201 A Skin full graft add-on 1.32 0.65 1.00 0.14 2.11 2.46 ZZZ 15220 A Skin full graft 7.87 6.23 9.66 0.68 14.78 18.21 090 15221 A Skin full graft add-on 1.19 0.58 1.00 0.12 1.89 2.31 ZZZ 15240 A Skin full graft 9.04 7.12 9.28 0.77 16.93 19.09 090 15241 A Skin full graft add-on 1.86 0.96 1.53 0.17 2.99 3.56 ZZZ 15260 A Skin full graft 10.06 7.53 9.16 0.63 18.22 19.85 090 15261 A Skin full graft add-on 2.23 1.16 1.63 0.17 3.56 4.03 ZZZ 15342 A Cultured skin graft, 25 cm 1.00 0.79 2.18 0.39 2.18 3.57 010 15343 A Culture skn graft addl 25 cm 0.25 0.10 0.27 0.09 0.44 0.61 ZZZ 15350 A Skin homograft 4.00 4.37 7.37 0.42 8.79 11.79 090 15351 A Skin homograft add-on 1.00 0.42 0.94 0.11 1.53 2.05 ZZZ 15400 A Skin heterograft 4.00 4.96 4.96 0.40 9.36 9.36 090 15401 A Skin heterograft add-on 1.00 0.46 1.14 0.11 1.57 2.25 ZZZ 15570 A Form skin pedicle flap 9.21 6.27 8.42 0.96 16.44 18.59 090 15572 A Form skin pedicle flap 9.27 6.18 7.54 0.93 16.38 17.74 090 15574 A Form skin pedicle flap 9.88 6.94 8.53 0.92 17.74 19.33 090 15576 A Form skin pedicle flap 8.69 6.35 8.97 0.72 15.76 18.38 090 15600 A Skin graft 1.91 2.34 6.62 0.19 4.44 8.72 090 15610 A Skin graft 2.42 2.70 4.56 0.25 5.37 7.23 090 15620 A Skin graft 2.94 3.29 6.92 0.28 6.51 10.14 090 15630 A Skin graft 3.27 3.73 6.19 0.28 7.28 9.74 090 15650 A Transfer skin pedicle flap 3.97 3.84 6.26 0.36 8.17 10.59 090 15732 A Muscle-skin graft, head/neck 17.84 11.39 NA 1.50 30.73 NA 090 15734 A Muscle-skin graft, trunk 17.79 11.31 NA 1.91 31.01 NA 090 15736 A Muscle-skin graft, arm 16.27 10.77 NA 1.78 28.82 NA 090 15738 A Muscle-skin graft, leg 17.92 11.27 NA 1.95 31.14 NA 090 15740 A Island pedicle flap graft 10.25 7.12 8.87 0.62 17.99 19.74 090 15750 A Neurovascular pedicle graft 11.41 8.05 NA 1.12 20.58 NA 090 15756 A Free muscle flap, microvasc 35.23 18.80 NA 3.11 57.14 NA 090 15757 A Free skin flap, microvasc 35.23 22.15 NA 3.37 60.75 NA 090 15758 A Free fascial flap, microvasc 35.10 22.48 NA 3.52 61.10 NA 090 15760 A Composite skin graft 8.74 6.79 9.31 0.72 16.25 18.77 090 15770 A Derma-fat-fascia graft 7.52 6.02 NA 0.78 14.32 NA 090 Start Printed Page 40411 15775 R Hair transplant punch grafts 3.96 1.58 3.04 0.43 5.97 7.43 000 15776 R Hair transplant punch grafts 5.54 2.94 3.88 0.60 9.08 10.02 000 15780 A Abrasion treatment of skin 7.29 6.30 6.30 0.41 14.00 14.00 090 15781 A Abrasion treatment of skin 4.85 4.76 4.76 0.27 9.88 9.88 090 15782 A Abrasion treatment of skin 4.32 4.10 4.10 0.21 8.63 8.63 090 15783 A Abrasion treatment of skin 4.29 3.46 4.45 0.26 8.01 9.00 090 15786 A Abrasion, lesion, single 2.03 1.27 1.69 0.11 3.41 3.83 010 15787 A Abrasion, lesions, add-on 0.33 0.17 0.37 0.02 0.52 0.72 ZZZ 15788 R Chemical peel, face, epiderm 2.09 1.05 3.00 0.11 3.25 5.20 090 15789 R Chemical peel, face, dermal 4.92 3.67 5.59 0.27 8.86 10.78 090 15792 R Chemical peel, nonfacial 1.86 1.81 2.77 0.10 3.77 4.73 090 15793 A Chemical peel, nonfacial 3.74 3.34 NA 0.17 7.25 NA 090 15810 A Salabrasion 4.74 3.85 3.85 0.42 9.01 9.01 090 15811 A Salabrasion 5.39 4.03 4.03 0.52 9.94 9.94 090 15819 A Plastic surgery, neck 9.38 6.82 NA 0.77 16.97 NA 090 15820 A Revision of lower eyelid 5.15 6.55 10.91 0.30 12.00 16.36 090 15821 A Revision of lower eyelid 5.72 6.67 11.61 0.31 12.70 17.64 090 15822 A Revision of upper eyelid 4.45 5.86 8.92 0.22 10.53 13.59 090 15823 A Revision of upper eyelid 7.05 6.95 10.06 0.32 14.32 17.43 090 15824 R Removal of forehead wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15825 R Removal of neck wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15826 R Removal of brow wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15828 R Removal of face wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15829 R Removal of skin wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15831 A Excise excessive skin tissue 12.40 8.14 NA 1.30 21.84 NA 090 15832 A Excise excessive skin tissue 11.59 7.81 NA 1.21 20.61 NA 090 15833 A Excise excessive skin tissue 10.64 7.55 NA 1.17 19.36 NA 090 15834 A Excise excessive skin tissue 10.85 6.03 NA 1.18 18.06 NA 090 15835 A Excise excessive skin tissue 11.67 5.70 NA 1.13 18.50 NA 090 15836 A Excise excessive skin tissue 9.34 6.16 NA 0.95 16.45 NA 090 15837 A Excise excessive skin tissue 8.43 6.10 7.85 0.78 15.31 17.06 090 15838 A Excise excessive skin tissue 7.13 5.70 NA 0.58 13.41 NA 090 15839 A Excise excessive skin tissue 9.38 5.95 7.60 0.88 16.21 17.86 090 15840 A Graft for face nerve palsy 13.26 9.84 NA 1.15 24.25 NA 090 15841 A Graft for face nerve palsy 23.26 15.24 NA 2.65 41.15 NA 090 15842 A Flap for face nerve palsy 37.96 21.68 NA 3.99 63.63 NA 090 15845 A Skin and muscle repair, face 12.57 8.65 NA 0.80 22.02 NA 090 15850 B Removal of sutures +0.78 0.31 1.37 0.04 1.13 2.19 XXX 15851 A Removal of sutures 0.86 0.35 1.56 0.05 1.26 2.47 000 15852 A Dressing change,not for burn 0.86 0.36 1.76 0.07 1.29 2.69 000 15860 A Test for blood flow in graft 1.95 0.80 1.31 0.13 2.88 3.39 000 15876 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15877 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15878 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15879 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 15920 A Removal of tail bone ulcer 7.95 5.38 NA 0.83 14.16 NA 090 15922 A Removal of tail bone ulcer 9.90 7.27 NA 1.06 18.23 NA 090 15931 A Remove sacrum pressure sore 9.24 5.59 NA 0.95 15.78 NA 090 15933 A Remove sacrum pressure sore 10.85 7.74 NA 1.14 19.73 NA 090 15934 A Remove sacrum pressure sore 12.69 8.36 NA 1.35 22.40 NA 090 15935 A Remove sacrum pressure sore 14.57 10.35 NA 1.56 26.48 NA 090 15936 A Remove sacrum pressure sore 12.38 8.98 NA 1.32 22.68 NA 090 15937 A Remove sacrum pressure sore 14.21 10.45 NA 1.51 26.17 NA 090 15940 A Remove hip pressure sore 9.34 5.94 NA 0.98 16.26 NA 090 15941 A Remove hip pressure sore 11.43 9.77 NA 1.23 22.43 NA 090 15944 A Remove hip pressure sore 11.46 8.68 NA 1.21 21.35 NA 090 15945 A Remove hip pressure sore 12.69 9.83 NA 1.38 23.90 NA 090 15946 A Remove hip pressure sore 21.57 14.57 NA 2.32 38.46 NA 090 15950 A Remove thigh pressure sore 7.54 5.17 NA 0.80 13.51 NA 090 15951 A Remove thigh pressure sore 10.72 7.67 NA 1.14 19.53 NA 090 15952 A Remove thigh pressure sore 11.39 7.38 NA 1.19 19.96 NA 090 15953 A Remove thigh pressure sore 12.63 8.89 NA 1.38 22.90 NA 090 15956 A Remove thigh pressure sore 15.52 10.60 NA 1.64 27.76 NA 090 15958 A Remove thigh pressure sore 15.48 10.97 NA 1.66 28.11 NA 090 15999 C Removal of pressure sore 0.00 0.00 0.00 0.00 0.00 0.00 YYY 16000 A Initial treatment of burn(s) 0.89 0.27 1.06 0.06 1.22 2.01 000 16010 A Treatment of burn(s) 0.87 0.38 1.17 0.07 1.32 2.11 000 16015 A Treatment of burn(s) 2.35 0.97 1.93 0.22 3.54 4.50 000 16020 A Treatment of burn(s) 0.80 0.26 1.17 0.06 1.12 2.03 000 16025 A Treatment of burn(s) 1.85 0.68 1.87 0.16 2.69 3.88 000 16030 A Treatment of burn(s) 2.08 0.93 3.03 0.18 3.19 5.29 000 16035 A Incision of burn scab, initi 3.75 1.53 NA 0.36 5.64 NA 090 16036 A Incise burn scab, addl incis 1.50 0.61 NA 0.18 2.29 NA ZZZ 17000 A Destroy benign/premal lesion 0.60 0.27 1.09 0.03 0.90 1.72 010 Start Printed Page 40412 17003 A Destroy lesions, 2-14 0.15 0.07 0.24 0.01 0.23 0.40 ZZZ 17004 A Destroy lesions, 15 or more 2.79 1.29 2.56 0.12 4.20 5.47 010 17106 A Destruction of skin lesions 4.59 2.68 4.68 0.28 7.55 9.55 090 17107 A Destruction of skin lesions 9.16 4.75 6.80 0.53 14.44 16.49 090 17108 A Destruction of skin lesions 13.20 7.27 8.63 0.89 21.36 22.72 090 17110 A Destruct lesion, 1-14 0.65 0.26 1.07 0.04 0.95 1.76 010 17111 A Destruct lesion, 15 or more 0.92 0.40 1.13 0.04 1.36 2.09 010 17250 A Chemical cautery, tissue 0.50 0.21 0.71 0.04 0.75 1.25 000 17260 A Destruction of skin lesions 0.91 0.42 1.37 0.04 1.37 2.32 010 17261 A Destruction of skin lesions 1.17 0.55 1.48 0.05 1.77 2.70 010 17262 A Destruction of skin lesions 1.58 0.75 1.68 0.07 2.40 3.33 010 17263 A Destruction of skin lesions 1.79 0.82 1.79 0.08 2.69 3.66 010 17264 A Destruction of skin lesions 1.94 0.84 1.87 0.08 2.86 3.89 010 17266 A Destruction of skin lesions 2.34 0.94 2.08 0.11 3.39 4.53 010 17270 A Destruction of skin lesions 1.32 0.62 1.57 0.06 2.00 2.95 010 17271 A Destruction of skin lesions 1.49 0.72 1.64 0.06 2.27 3.19 010 17272 A Destruction of skin lesions 1.77 0.85 1.78 0.07 2.69 3.62 010 17273 A Destruction of skin lesions 2.05 0.98 1.93 0.09 3.12 4.07 010 17274 A Destruction of skin lesions 2.59 1.19 2.19 0.11 3.89 4.89 010 17276 A Destruction of skin lesions 3.20 1.71 2.50 0.15 5.06 5.85 010 17280 A Destruction of skin lesions 1.17 0.54 1.40 0.05 1.76 2.62 010 17281 A Destruction of skin lesions 1.72 0.83 1.76 0.07 2.62 3.55 010 17282 A Destruction of skin lesions 2.04 0.99 1.92 0.09 3.12 4.05 010 17283 A Destruction of skin lesions 2.64 1.24 2.23 0.11 3.99 4.98 010 17284 A Destruction of skin lesions 3.21 1.50 2.52 0.14 4.85 5.87 010 17286 A Destruction of skin lesions 4.44 2.48 3.15 0.22 7.14 7.81 010 17304 A Chemosurgery of skin lesion 7.60 3.67 7.75 0.31 11.58 15.66 000 17305 A 2nd stage chemosurgery 2.85 1.38 3.60 0.12 4.35 6.57 000 17306 A 3rd stage chemosurgery 2.85 1.39 3.64 0.12 4.36 6.61 000 17307 A Followup skin lesion therapy 2.85 1.41 3.16 0.12 4.38 6.13 000 17310 A Extensive skin chemosurgery 0.95 0.48 1.49 0.05 1.48 2.49 000 17340 A Cryotherapy of skin 0.76 0.27 1.36 0.04 1.07 2.16 010 17360 A Skin peel therapy 1.43 0.70 1.48 0.06 2.19 2.97 010 17380 R Hair removal by electrolysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 17999 C Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 19000 A Drainage of breast lesion 0.84 0.29 1.23 0.07 1.20 2.14 000 19001 A Drain breast lesion add-on 0.42 0.15 0.83 0.03 0.60 1.28 ZZZ 19020 A Incision of breast lesion 3.57 3.41 6.96 0.35 7.33 10.88 090 19030 A Injection for breast x-ray 1.53 0.53 11.25 0.07 2.13 12.85 000 19100 A Biopsy of breast 1.27 0.45 3.56 0.10 1.82 4.93 000 19101 A Biopsy of breast, open 3.18 3.09 10.62 0.20 6.47 14.00 010 19102 A Bx breast percut w/image 2.00 0.71 4.88 0.08 2.79 6.96 000 19103 A Bx breast percut w/device 2.37 0.84 11.46 0.08 3.29 13.91 000 19110 A Nipple exploration 4.30 4.40 8.43 0.44 9.14 13.17 090 19112 A Excise breast duct fistula 3.67 3.09 7.24 0.38 7.14 11.29 090 19120 A Removal of breast lesion 5.56 3.55 4.41 0.56 9.67 10.53 090 19125 A Excision, breast lesion 6.06 3.70 5.02 0.61 10.37 11.69 090 19126 A Excision, addl breast lesion 2.93 1.05 NA 0.30 4.28 NA ZZZ 19140 A Removal of breast tissue 5.14 3.72 9.03 0.52 9.38 14.69 090 19160 A Removal of breast tissue 5.99 4.52 NA 0.61 11.12 NA 090 19162 A Remove breast tissue, nodes 13.53 7.94 NA 1.38 22.85 NA 090 19180 A Removal of breast 8.80 5.97 NA 0.88 15.65 NA 090 19182 A Removal of breast 7.73 5.01 NA 0.79 13.53 NA 090 19200 A Removal of breast 15.49 9.24 NA 1.51 26.24 NA 090 19220 A Removal of breast 15.72 9.22 NA 1.56 26.50 NA 090 19240 A Removal of breast 16.00 8.82 NA 1.62 26.44 NA 090 19260 A Removal of chest wall lesion 15.44 9.35 NA 1.64 26.43 NA 090 19271 A Revision of chest wall 18.90 11.61 NA 2.27 32.78 NA 090 19272 A Extensive chest wall surgery 21.55 12.54 NA 2.54 36.63 NA 090 19290 A Place needle wire, breast 1.27 0.44 5.08 0.06 1.77 6.41 000 19291 A Place needle wire, breast 0.63 0.22 1.72 0.03 0.88 2.38 ZZZ 19295 A Place breast clip, percut 0.00 NA 2.65 0.01 NA 2.66 ZZZ 19316 A Suspension of breast 10.69 7.65 NA 1.15 19.49 NA 090 19318 A Reduction of large breast 15.62 10.47 NA 1.69 27.78 NA 090 19324 A Enlarge breast 5.85 4.64 NA 0.63 11.12 NA 090 19325 A Enlarge breast with implant 8.45 6.82 NA 0.90 16.17 NA 090 19328 A Removal of breast implant 5.68 4.63 NA 0.61 10.92 NA 090 19330 A Removal of implant material 7.59 5.35 NA 0.81 13.75 NA 090 19340 A Immediate breast prosthesis 6.33 3.25 NA 0.68 10.26 NA ZZZ 19342 A Delayed breast prosthesis 11.20 8.01 NA 1.21 20.42 NA 090 19350 A Breast reconstruction 8.92 6.92 14.29 0.95 16.79 24.16 090 19355 A Correct inverted nipple(s) 7.57 6.10 12.05 0.80 14.47 20.42 090 19357 A Breast reconstruction 18.16 14.04 NA 1.96 34.16 NA 090 19361 A Breast reconstruction 19.26 12.20 NA 2.08 33.54 NA 090 Start Printed Page 40413 19364 A Breast reconstruction 41.00 22.78 NA 3.91 67.69 NA 090 19366 A Breast reconstruction 21.28 12.20 NA 2.27 35.75 NA 090 19367 A Breast reconstruction 25.73 15.53 NA 2.78 44.04 NA 090 19368 A Breast reconstruction 32.42 19.28 NA 3.51 55.21 NA 090 19369 A Breast reconstruction 29.82 18.49 NA 3.24 51.55 NA 090 19370 A Surgery of breast capsule 8.05 6.21 NA 0.86 15.12 NA 090 19371 A Removal of breast capsule 9.35 7.32 NA 1.01 17.68 NA 090 19380 A Revise breast reconstruction 9.14 7.21 NA 0.98 17.33 NA 090 19396 A Design custom breast implant 2.17 0.80 5.35 0.23 3.20 7.75 000 19499 C Breast surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 20000 A Incision of abscess 2.12 1.19 2.01 0.17 3.48 4.30 010 20005 A Incision of deep abscess 3.42 2.20 2.92 0.34 5.96 6.68 010 20100 A Explore wound, neck 10.08 4.47 5.92 0.99 15.54 16.99 010 20101 A Explore wound, chest 3.22 1.30 3.00 0.24 4.76 6.46 010 20102 A Explore wound, abdomen 3.94 1.67 3.34 0.35 5.96 7.63 010 20103 A Explore wound, extremity 5.30 2.98 4.10 0.57 8.85 9.97 010 20150 A Excise epiphyseal bar 13.69 7.83 NA 0.96 22.48 NA 090 20200 A Muscle biopsy 1.46 0.62 1.72 0.17 2.25 3.35 000 20205 A Deep muscle biopsy 2.35 0.98 3.72 0.23 3.56 6.30 000 20206 A Needle biopsy, muscle 0.99 0.36 3.15 0.06 1.41 4.20 000 20220 A Bone biopsy, trocar/needle 1.27 3.02 4.98 0.06 4.35 6.31 000 20225 A Bone biopsy, trocar/needle 1.87 3.03 4.52 0.11 5.01 6.50 000 20240 A Bone biopsy, excisional 3.23 4.07 NA 0.33 7.63 NA 010 20245 A Bone biopsy, excisional 7.78 6.69 NA 0.44 14.91 NA 010 20250 A Open bone biopsy 5.03 4.30 NA 0.50 9.83 NA 010 20251 A Open bone biopsy 5.56 4.74 NA 0.79 11.09 NA 010 20500 A Injection of sinus tract 1.23 4.03 5.37 0.10 5.36 6.70 010 20501 A Inject sinus tract for x-ray 0.76 0.26 13.46 0.03 1.05 14.25 000 20520 A Removal of foreign body 1.85 3.37 5.40 0.17 5.39 7.42 010 20525 A Removal of foreign body 3.50 4.15 6.66 0.40 8.05 10.56 010 20550 A Inject tendon/ligament/cyst 0.86 0.22 2.05 0.06 1.14 2.97 000 20600 A Drain/inject, joint/bursa 0.66 0.27 1.38 0.06 0.99 2.10 000 20605 A Drain/inject, joint/bursa 0.68 0.27 1.71 0.06 1.01 2.45 000 20610 A Drain/inject, joint/bursa 0.79 0.56 2.11 0.08 1.43 2.98 000 20615 A Treatment of bone cyst 2.28 2.51 4.52 0.19 4.98 6.99 010 20650 A Insert and remove bone pin 2.23 2.90 4.38 0.28 5.41 6.89 010 20660 A Apply,remove fixation device 2.51 1.49 NA 0.48 4.48 NA 000 20661 A Application of head brace 4.89 6.47 NA 0.92 12.28 NA 090 20662 A Application of pelvis brace 6.07 5.15 NA 0.81 12.03 NA 090 20663 A Application of thigh brace 5.43 4.78 NA 0.77 10.98 NA 090 20664 A Halo brace application 8.06 8.21 NA 1.49 17.76 NA 090 20665 A Removal of fixation device 1.31 1.23 2.34 0.17 2.71 3.82 010 20670 A Removal of support implant 1.74 3.37 5.51 0.23 5.34 7.48 010 20680 A Removal of support implant 3.35 4.98 4.98 0.46 8.79 8.79 090 20690 A Apply bone fixation device 3.52 1.89 NA 0.47 5.88 NA 090 20692 A Apply bone fixation device 6.41 2.50 NA 0.60 9.51 NA 090 20693 A Adjust bone fixation device 5.86 11.53 NA 0.85 18.24 NA 090 20694 A Remove bone fixation device 4.16 5.77 8.18 0.57 10.50 12.91 090 20802 A Replantation, arm, complete 41.15 31.17 NA 5.81 78.13 NA 090 20805 A Replant, forearm, complete 50.00 49.91 NA 3.95 103.86 NA 090 20808 A Replantation hand, complete 61.65 43.88 NA 6.49 112.02 NA 090 20816 A Replantation digit, complete 30.94 43.13 NA 3.01 77.08 NA 090 20822 A Replantation digit, complete 25.59 39.51 NA 3.07 68.17 NA 090 20824 A Replantation thumb, complete 30.94 36.86 NA 3.48 71.28 NA 090 20827 A Replantation thumb, complete 26.41 45.96 NA 3.21 75.58 NA 090 20838 A Replantation foot, complete 41.41 28.52 NA 5.85 75.78 NA 090 20900 A Removal of bone for graft 5.58 5.83 6.77 0.77 12.18 13.12 090 20902 A Removal of bone for graft 7.55 8.29 NA 1.06 16.90 NA 090 20910 A Remove cartilage for graft 5.34 6.69 8.21 0.50 12.53 14.05 090 20912 A Remove cartilage for graft 6.35 7.51 NA 0.55 14.41 NA 090 20920 A Removal of fascia for graft 5.31 5.57 NA 0.54 11.42 NA 090 20922 A Removal of fascia for graft 6.61 6.25 8.76 0.88 13.74 16.25 090 20924 A Removal of tendon for graft 6.48 6.73 NA 0.82 14.03 NA 090 20926 A Removal of tissue for graft 5.53 6.23 NA 0.73 12.49 NA 090 20930 B Spinal bone allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20931 A Spinal bone allograft 1.81 0.97 NA 0.34 3.12 NA ZZZ 20936 B Spinal bone autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20937 A Spinal bone autograft 2.79 1.53 NA 0.43 4.75 NA ZZZ 20938 A Spinal bone autograft 3.02 1.63 NA 0.52 5.17 NA ZZZ 20950 A Fluid pressure, muscle 1.26 2.10 NA 0.16 3.52 NA 000 20955 A Fibula bone graft, microvasc 39.21 30.01 NA 4.35 73.57 NA 090 20956 A Iliac bone graft, microvasc 39.27 28.48 NA 5.77 73.52 NA 090 20957 A Mt bone graft, microvasc 40.65 24.37 NA 5.74 70.76 NA 090 20962 A Other bone graft, microvasc 39.27 28.18 NA 5.19 72.64 NA 090 Start Printed Page 40414 20969 A Bone/skin graft, microvasc 43.92 32.94 NA 4.34 81.20 NA 090 20970 A Bone/skin graft, iliac crest 43.06 30.40 NA 4.64 78.10 NA 090 20972 A Bone/skin graft, metatarsal 42.99 18.86 NA 6.07 67.92 NA 090 20973 A Bone/skin graft, great toe 45.76 22.15 NA 4.65 72.56 NA 090 20974 A Electrical bone stimulation 0.62 0.34 0.39 0.09 1.05 1.10 000 20975 A Electrical bone stimulation 2.60 1.42 NA 0.42 4.44 NA 000 20979 A Us bone stimulation 0.62 0.25 0.56 0.04 0.91 1.22 000 20999 C Musculoskeletal surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21010 A Incision of jaw joint 10.14 7.05 NA 0.54 17.73 NA 090 21015 A Resection of facial tumor 5.29 7.20 NA 0.52 13.01 NA 090 21025 A Excision of bone, lower jaw 10.06 6.86 7.38 0.79 17.71 18.23 090 21026 A Excision of facial bone(s) 4.85 4.83 5.49 0.40 10.08 10.74 090 21029 A Contour of face bone lesion 7.71 6.11 6.87 0.74 14.56 15.32 090 21030 A Removal of face bone lesion 6.46 4.88 5.39 0.60 11.94 12.45 090 21031 A Remove exostosis, mandible 3.24 2.11 3.34 0.28 5.63 6.86 090 21032 A Remove exostosis, maxilla 3.24 2.15 3.30 0.27 5.66 6.81 090 21034 A Removal of face bone lesion 16.17 10.67 12.00 1.37 28.21 29.54 090 21040 A Removal of jaw bone lesion 2.11 1.85 2.98 0.19 4.15 5.28 090 21041 A Removal of jaw bone lesion 6.71 4.34 5.61 0.56 11.61 12.88 090 21044 A Removal of jaw bone lesion 11.86 7.92 NA 0.87 20.65 NA 090 21045 A Extensive jaw surgery 16.17 10.27 NA 1.20 27.64 NA 090 21050 A Removal of jaw joint 10.77 11.32 NA 0.84 22.93 NA 090 21060 A Remove jaw joint cartilage 10.23 10.11 NA 1.16 21.50 NA 090 21070 A Remove coronoid process 8.20 6.09 NA 0.67 14.96 NA 090 21076 A Prepare face/oral prosthesis 13.42 7.29 9.70 1.36 22.07 24.48 010 21077 A Prepare face/oral prosthesis 33.75 18.34 24.39 3.43 55.52 61.57 090 21079 A Prepare face/oral prosthesis 22.34 12.68 17.23 1.59 36.61 41.16 090 21080 A Prepare face/oral prosthesis 25.10 14.25 19.36 2.55 41.90 47.01 090 21081 A Prepare face/oral prosthesis 22.88 12.99 17.65 1.87 37.74 42.40 090 21082 A Prepare face/oral prosthesis 20.87 11.34 15.08 1.46 33.67 37.41 090 21083 A Prepare face/oral prosthesis 19.30 10.96 14.89 1.96 32.22 36.15 090 21084 A Prepare face/oral prosthesis 22.51 12.78 17.36 1.57 36.86 41.44 090 21085 A Prepare face/oral prosthesis 9.00 4.89 6.50 0.65 14.54 16.15 010 21086 A Prepare face/oral prosthesis 24.92 14.15 19.22 1.86 40.93 46.00 090 21087 A Prepare face/oral prosthesis 24.92 13.54 18.00 2.22 40.68 45.14 090 21088 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21089 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21100 A Maxillofacial fixation 4.22 4.06 5.89 0.18 8.46 10.29 090 21110 A Interdental fixation 5.21 4.57 5.23 0.28 10.06 10.72 090 21116 A Injection, jaw joint x-ray 0.81 0.30 8.08 0.05 1.16 8.94 000 21120 A Reconstruction of chin 4.93 6.32 10.45 0.29 11.54 15.67 090 21121 A Reconstruction of chin 7.64 5.82 8.09 0.56 14.02 16.29 090 21122 A Reconstruction of chin 8.52 7.36 NA 0.59 16.47 NA 090 21123 A Reconstruction of chin 11.16 8.54 NA 1.16 20.86 NA 090 21125 A Augmentation, lower jaw bone 10.62 8.72 9.17 0.72 20.06 20.51 090 21127 A Augmentation, lower jaw bone 11.12 6.69 9.64 0.76 18.57 21.52 090 21137 A Reduction of forehead 9.82 6.95 NA 0.53 17.30 NA 090 21138 A Reduction of forehead 12.19 9.93 NA 1.47 23.59 NA 090 21139 A Reduction of forehead 14.61 9.39 NA 1.02 25.02 NA 090 21141 A Reconstruct midface, lefort 18.10 11.14 NA 1.63 30.87 NA 090 21142 A Reconstruct midface, lefort 18.81 11.26 NA 1.16 31.23 NA 090 21143 A Reconstruct midface, lefort 19.58 11.74 NA 0.90 32.22 NA 090 21145 A Reconstruct midface, lefort 19.94 11.43 NA 2.09 33.46 NA 090 21146 A Reconstruct midface, lefort 20.71 12.11 NA 2.13 34.95 NA 090 21147 A Reconstruct midface, lefort 21.77 13.27 NA 1.52 36.56 NA 090 21150 A Reconstruct midface, lefort 25.24 14.91 NA 1.09 41.24 NA 090 21151 A Reconstruct midface, lefort 28.30 18.38 NA 1.98 48.66 NA 090 21154 A Reconstruct midface, lefort 30.52 18.49 NA 4.86 53.87 NA 090 21155 A Reconstruct midface, lefort 34.45 18.24 NA 5.48 58.17 NA 090 21159 A Reconstruct midface, lefort 42.38 21.37 NA 6.74 70.49 NA 090 21160 A Reconstruct midface, lefort 46.44 24.49 NA 4.39 75.32 NA 090 21172 A Reconstruct orbit/forehead 27.80 18.30 NA 1.91 48.01 NA 090 21175 A Reconstruct orbit/forehead 33.17 18.70 NA 5.16 57.03 NA 090 21179 A Reconstruct entire forehead 22.25 18.90 NA 2.48 43.63 NA 090 21180 A Reconstruct entire forehead 25.19 19.28 NA 2.15 46.62 NA 090 21181 A Contour cranial bone lesion 9.90 8.90 NA 0.97 19.77 NA 090 21182 A Reconstruct cranial bone 32.19 22.36 NA 2.53 57.08 NA 090 21183 A Reconstruct cranial bone 35.31 23.10 NA 2.75 61.16 NA 090 21184 A Reconstruct cranial bone 38.24 21.38 NA 4.12 63.74 NA 090 21188 A Reconstruction of midface 22.46 15.78 NA 1.85 40.09 NA 090 21193 A Reconst lwr jaw w/o graft 17.15 11.03 NA 1.53 29.71 NA 090 21194 A Reconst lwr jaw w/graft 19.84 12.07 NA 1.39 33.30 NA 090 21195 A Reconst lwr jaw w/o fixation 17.24 12.94 NA 1.20 31.38 NA 090 21196 A Reconst lwr jaw w/fixation 18.91 12.88 NA 1.62 33.41 NA 090 Start Printed Page 40415 21198 A Reconstr lwr jaw segment 14.16 11.84 NA 1.05 27.05 NA 090 21199 A Reconstr lwr jaw w/advance 16.00 10.56 NA 1.00 27.56 NA 090 21206 A Reconstruct upper jaw bone 14.10 10.13 NA 1.01 25.24 NA 090 21208 A Augmentation of facial bones 10.23 8.46 10.12 0.92 19.61 21.27 090 21209 A Reduction of facial bones 6.72 5.69 8.96 0.60 13.01 16.28 090 21210 A Face bone graft 10.23 8.02 8.95 0.88 19.13 20.06 090 21215 A Lower jaw bone graft 10.77 6.88 8.75 1.04 18.69 20.56 090 21230 A Rib cartilage graft 10.77 10.27 NA 0.96 22.00 NA 090 21235 A Ear cartilage graft 6.72 8.03 11.81 0.52 15.27 19.05 090 21240 A Reconstruction of jaw joint 14.05 11.49 NA 1.15 26.69 NA 090 21242 A Reconstruction of jaw joint 12.95 11.53 NA 1.40 25.88 NA 090 21243 A Reconstruction of jaw joint 20.79 14.75 NA 1.85 37.39 NA 090 21244 A Reconstruction of lower jaw 11.86 9.03 NA 0.95 21.84 NA 090 21245 A Reconstruction of jaw 11.86 10.15 16.56 0.88 22.89 29.30 090 21246 A Reconstruction of jaw 12.47 10.98 12.51 1.21 24.66 26.19 090 21247 A Reconstruct lower jaw bone 22.63 18.84 NA 2.21 43.68 NA 090 21248 A Reconstruction of jaw 11.48 8.01 8.86 1.01 20.50 21.35 090 21249 A Reconstruction of jaw 17.52 10.16 11.38 1.39 29.07 30.29 090 21255 A Reconstruct lower jaw bone 16.72 10.96 NA 1.13 28.81 NA 090 21256 A Reconstruction of orbit 16.19 13.20 NA 1.04 30.43 NA 090 21260 A Revise eye sockets 16.52 11.65 NA 1.25 29.42 NA 090 21261 A Revise eye sockets 31.49 19.12 NA 2.20 52.81 NA 090 21263 A Revise eye sockets 28.42 14.84 NA 2.16 45.42 NA 090 21267 A Revise eye sockets 18.90 14.43 NA 1.35 34.68 NA 090 21268 A Revise eye sockets 24.48 11.93 NA 0.79 37.20 NA 090 21270 A Augmentation, cheek bone 10.23 9.10 10.49 0.73 20.06 21.45 090 21275 A Revision, orbitofacial bones 11.24 11.24 NA 1.03 23.51 NA 090 21280 A Revision of eyelid 6.03 5.88 NA 0.27 12.18 NA 090 21282 A Revision of eyelid 3.49 5.04 NA 0.21 8.74 NA 090 21295 A Revision of jaw muscle/bone 1.53 3.55 NA 0.13 5.21 NA 090 21296 A Revision of jaw muscle/bone 4.25 5.17 NA 0.30 9.72 NA 090 21299 C Cranio/maxillofacial surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21300 A Treatment of skull fracture 0.72 0.27 2.37 0.09 1.08 3.18 000 21310 A Treatment of nose fracture 0.58 0.15 2.54 0.05 0.78 3.17 000 21315 A Treatment of nose fracture 1.51 1.24 3.30 0.12 2.87 4.93 010 21320 A Treatment of nose fracture 1.85 1.99 4.85 0.15 3.99 6.85 010 21325 A Treatment of nose fracture 3.77 3.71 NA 0.31 7.79 NA 090 21330 A Treatment of nose fracture 5.38 5.50 NA 0.48 11.36 NA 090 21335 A Treatment of nose fracture 8.61 7.10 NA 0.64 16.35 NA 090 21336 A Treat nasal septal fracture 5.72 5.50 NA 0.45 11.67 NA 090 21337 A Treat nasal septal fracture 2.70 3.17 5.02 0.22 6.09 7.94 090 21338 A Treat nasoethmoid fracture 6.46 5.94 NA 0.53 12.93 NA 090 21339 A Treat nasoethmoid fracture 8.09 6.95 NA 0.76 15.80 NA 090 21340 A Treatment of nose fracture 10.77 9.36 NA 0.85 20.98 NA 090 21343 A Treatment of sinus fracture 12.95 9.99 NA 1.06 24.00 NA 090 21344 A Treatment of sinus fracture 19.72 13.42 NA 1.72 34.86 NA 090 21345 A Treat nose/jaw fracture 8.16 7.44 8.86 0.60 16.20 17.62 090 21346 A Treat nose/jaw fracture 10.61 10.35 NA 0.85 21.81 NA 090 21347 A Treat nose/jaw fracture 12.69 9.36 NA 1.14 23.19 NA 090 21348 A Treat nose/jaw fracture 16.69 10.37 NA 1.50 28.56 NA 090 21355 A Treat cheek bone fracture 3.77 2.41 4.84 0.29 6.47 8.90 010 21356 A Treat cheek bone fracture 4.15 3.25 NA 0.36 7.76 NA 010 21360 A Treat cheek bone fracture 6.46 5.77 NA 0.52 12.75 NA 090 21365 A Treat cheek bone fracture 14.95 11.37 NA 1.30 27.62 NA 090 21366 A Treat cheek bone fracture 17.77 12.08 NA 1.41 31.26 NA 090 21385 A Treat eye socket fracture 9.16 7.63 NA 0.64 17.43 NA 090 21386 A Treat eye socket fracture 9.16 8.03 NA 0.76 17.95 NA 090 21387 A Treat eye socket fracture 9.70 8.16 NA 0.78 18.64 NA 090 21390 A Treat eye socket fracture 10.13 8.38 NA 0.70 19.21 NA 090 21395 A Treat eye socket fracture 12.68 10.07 NA 1.09 23.84 NA 090 21400 A Treat eye socket fracture 1.40 1.08 2.93 0.12 2.60 4.45 090 21401 A Treat eye socket fracture 3.26 3.25 5.59 0.34 6.85 9.19 090 21406 A Treat eye socket fracture 7.01 6.60 NA 0.59 14.20 NA 090 21407 A Treat eye socket fracture 8.61 7.71 NA 0.67 16.99 NA 090 21408 A Treat eye socket fracture 12.38 9.70 NA 1.24 23.32 NA 090 21421 A Treat mouth roof fracture 5.14 6.35 7.45 0.42 11.91 13.01 090 21422 A Treat mouth roof fracture 8.32 7.21 NA 0.69 16.22 NA 090 21423 A Treat mouth roof fracture 10.40 8.19 NA 0.95 19.54 NA 090 21431 A Treat craniofacial fracture 7.05 5.25 NA 0.58 12.88 NA 090 21432 A Treat craniofacial fracture 8.61 7.40 NA 0.55 16.56 NA 090 21433 A Treat craniofacial fracture 25.35 17.86 NA 2.46 45.67 NA 090 21435 A Treat craniofacial fracture 17.25 11.71 NA 1.66 30.62 NA 090 21436 A Treat craniofacial fracture 28.04 18.98 NA 2.32 49.34 NA 090 21440 A Treat dental ridge fracture 2.70 3.38 5.43 0.22 6.30 8.35 090 Start Printed Page 40416 21445 A Treat dental ridge fracture 5.38 5.37 7.07 0.55 11.30 13.00 090 21450 A Treat lower jaw fracture 2.97 2.67 6.70 0.23 5.87 9.90 090 21451 A Treat lower jaw fracture 4.87 5.49 6.58 0.39 10.75 11.84 090 21452 A Treat lower jaw fracture 1.98 3.84 9.04 0.14 5.96 11.16 090 21453 A Treat lower jaw fracture 5.54 6.28 7.56 0.49 12.31 13.59 090 21454 A Treat lower jaw fracture 6.46 6.01 NA 0.55 13.02 NA 090 21461 A Treat lower jaw fracture 8.09 7.83 9.74 0.73 16.65 18.56 090 21462 A Treat lower jaw fracture 9.79 7.91 11.11 0.80 18.50 21.70 090 21465 A Treat lower jaw fracture 11.91 7.37 NA 0.84 20.12 NA 090 21470 A Treat lower jaw fracture 15.34 9.83 NA 1.36 26.53 NA 090 21480 A Reset dislocated jaw 0.61 0.18 1.59 0.05 0.84 2.25 000 21485 A Reset dislocated jaw 3.99 3.49 3.80 0.31 7.79 8.10 090 21490 A Repair dislocated jaw 11.86 7.50 NA 1.31 20.67 NA 090 21493 A Treat hyoid bone fracture 1.27 3.05 NA 0.10 4.42 NA 090 21494 A Treat hyoid bone fracture 6.28 5.28 NA 0.44 12.00 NA 090 21495 A Treat hyoid bone fracture 5.69 4.83 NA 0.41 10.93 NA 090 21497 A Interdental wiring 3.86 3.78 4.72 0.31 7.95 8.89 090 21499 C Head surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21501 A Drain neck/chest lesion 3.81 3.57 4.31 0.36 7.74 8.48 090 21502 A Drain chest lesion 7.12 7.71 NA 0.79 15.62 NA 090 21510 A Drainage of bone lesion 5.74 6.86 NA 0.67 13.27 NA 090 21550 A Biopsy of neck/chest 2.06 1.22 2.24 0.13 3.41 4.43 010 21555 A Remove lesion, neck/chest 4.35 2.47 4.15 0.41 7.23 8.91 090 21556 A Remove lesion, neck/chest 5.57 3.24 NA 0.51 9.32 NA 090 21557 A Remove tumor, neck/chest 8.88 7.74 NA 0.85 17.47 NA 090 21600 A Partial removal of rib 6.89 7.59 NA 0.81 15.29 NA 090 21610 A Partial removal of rib 14.61 10.68 NA 1.85 27.14 NA 090 21615 A Removal of rib 9.87 8.29 NA 1.20 19.36 NA 090 21616 A Removal of rib and nerves 12.04 8.18 NA 1.31 21.53 NA 090 21620 A Partial removal of sternum 6.79 8.03 NA 0.77 15.59 NA 090 21627 A Sternal debridement 6.81 12.78 NA 0.82 20.41 NA 090 21630 A Extensive sternum surgery 17.38 13.87 NA 1.95 33.20 NA 090 21632 A Extensive sternum surgery 18.14 12.62 NA 2.16 32.92 NA 090 21700 A Revision of neck muscle 6.19 7.11 8.71 0.31 13.61 15.21 090 21705 A Revision of neck muscle/rib 9.60 7.18 NA 0.92 17.70 NA 090 21720 A Revision of neck muscle 5.68 7.01 7.61 0.80 13.49 14.09 090 21725 A Revision of neck muscle 6.99 6.89 NA 0.90 14.78 NA 090 21740 A Reconstruction of sternum 16.50 12.24 NA 2.03 30.77 NA 090 21750 A Repair of sternum separation 10.77 9.98 NA 1.35 22.10 NA 090 21800 A Treatment of rib fracture 0.96 1.01 2.21 0.09 2.06 3.26 090 21805 A Treatment of rib fracture 2.75 4.06 NA 0.29 7.10 NA 090 21810 A Treatment of rib fracture(s) 6.86 6.27 NA 0.60 13.73 NA 090 21820 A Treat sternum fracture 1.28 1.46 2.61 0.15 2.89 4.04 090 21825 A Treat sternum fracture 7.41 10.09 NA 0.84 18.34 NA 090 21899 C Neck/chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21920 A Biopsy soft tissue of back 2.06 0.75 2.32 0.12 2.93 4.50 010 21925 A Biopsy soft tissue of back 4.49 4.47 10.95 0.44 9.40 15.88 090 21930 A Remove lesion, back or flank 5.00 2.65 4.56 0.49 8.14 10.05 090 21935 A Remove tumor, back 17.96 13.26 NA 1.87 33.09 NA 090 22100 A Remove part of neck vertebra 9.73 8.67 NA 1.55 19.95 NA 090 22101 A Remove part, thorax vertebra 9.81 8.49 NA 1.51 19.81 NA 090 22102 A Remove part, lumbar vertebra 9.81 8.70 NA 1.46 19.97 NA 090 22103 A Remove extra spine segment 2.34 1.30 NA 0.37 4.01 NA ZZZ 22110 A Remove part of neck vertebra 12.74 10.53 NA 2.20 25.47 NA 090 22112 A Remove part, thorax vertebra 12.81 10.60 NA 1.96 25.37 NA 090 22114 A Remove part, lumbar vertebra 12.81 10.34 NA 1.98 25.13 NA 090 22116 A Remove extra spine segment 2.32 1.19 NA 0.40 3.91 NA ZZZ 22210 A Revision of neck spine 23.82 16.94 NA 4.23 44.99 NA 090 22212 A Revision of thorax spine 19.42 14.35 NA 2.78 36.55 NA 090 22214 A Revision of lumbar spine 19.45 14.92 NA 2.78 37.15 NA 090 22216 A Revise, extra spine segment 6.04 3.31 NA 0.98 10.33 NA ZZZ 22220 A Revision of neck spine 21.37 15.46 NA 3.65 40.48 NA 090 22222 A Revision of thorax spine 21.52 13.62 NA 3.08 38.22 NA 090 22224 A Revision of lumbar spine 21.52 15.68 NA 3.20 40.40 NA 090 22226 A Revise, extra spine segment 6.04 3.30 NA 1.01 10.35 NA ZZZ 22305 A Treat spine process fracture 2.05 1.87 3.03 0.29 4.21 5.37 090 22310 A Treat spine fracture 2.61 3.28 4.38 0.37 6.26 7.36 090 22315 A Treat spine fracture 8.84 8.89 NA 1.37 19.10 NA 090 22318 A Treat odontoid fx w/o graft 21.50 14.60 NA 4.26 40.36 NA 090 22319 A Treat odontoid fx w/graft 24.00 16.89 NA 4.76 45.65 NA 090 22325 A Treat spine fracture 18.30 14.45 NA 2.61 35.36 NA 090 22326 A Treat neck spine fracture 19.59 15.28 NA 3.54 38.41 NA 090 22327 A Treat thorax spine fracture 19.20 14.83 NA 2.75 36.78 NA 090 22328 A Treat each add spine fx 4.61 2.30 NA 0.66 7.57 NA ZZZ Start Printed Page 40417 22505 A Manipulation of spine 1.87 3.01 4.59 0.27 5.15 6.73 010 22520 A Percut vertebroplasty thor 8.91 3.91 NA 0.89 13.71 NA 010 22521 A Percut vertebroplasty lumb 8.34 3.68 NA 0.84 12.86 NA 010 22522 A Percut vertebroplasty addl 3.00 1.19 NA 0.30 4.49 NA ZZZ 22548 A Neck spine fusion 25.82 17.74 NA 4.98 48.54 NA 090 22554 A Neck spine fusion 18.62 13.65 NA 3.51 35.78 NA 090 22556 A Thorax spine fusion 23.46 16.42 NA 3.78 43.66 NA 090 22558 A Lumbar spine fusion 22.28 14.36 NA 3.18 39.82 NA 090 22585 A Additional spinal fusion 5.53 2.92 NA 0.98 9.43 NA ZZZ 22590 A Spine & skull spinal fusion 20.51 15.33 NA 3.81 39.65 NA 090 22595 A Neck spinal fusion 19.39 14.31 NA 3.62 37.32 NA 090 22600 A Neck spine fusion 16.14 12.58 NA 2.89 31.61 NA 090 22610 A Thorax spine fusion 16.02 12.54 NA 2.66 31.22 NA 090 22612 A Lumbar spine fusion 21.00 15.36 NA 3.28 39.64 NA 090 22614 A Spine fusion, extra segment 6.44 3.53 NA 1.04 11.01 NA ZZZ 22630 A Lumbar spine fusion 20.84 15.57 NA 3.79 40.20 NA 090 22632 A Spine fusion, extra segment 5.23 2.82 NA 0.90 8.95 NA ZZZ 22800 A Fusion of spine 18.25 13.64 NA 2.71 34.60 NA 090 22802 A Fusion of spine 30.88 21.30 NA 4.42 56.60 NA 090 22804 A Fusion of spine 36.27 24.04 NA 5.23 65.54 NA 090 22808 A Fusion of spine 26.27 18.18 NA 4.36 48.81 NA 090 22810 A Fusion of spine 30.27 19.81 NA 4.49 54.57 NA 090 22812 A Fusion of spine 32.70 21.83 NA 4.67 59.20 NA 090 22818 A Kyphectomy, 1-2 segments 31.83 21.14 NA 5.01 57.98 NA 090 22819 A Kyphectomy, 3 or more 36.44 20.86 NA 5.20 62.50 NA 090 22830 A Exploration of spinal fusion 10.85 9.57 NA 1.73 22.15 NA 090 22840 A Insert spine fixation device 12.54 8.37 NA 2.03 22.94 NA ZZZ 22841 B Insert spine fixation device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 22842 A Insert spine fixation device 12.58 6.87 NA 2.04 21.49 NA ZZZ 22843 A Insert spine fixation device 13.46 8.86 NA 2.10 24.42 NA ZZZ 22844 A Insert spine fixation device 16.44 10.54 NA 2.42 29.40 NA ZZZ 22845 A Insert spine fixation device 11.96 7.95 NA 2.22 22.13 NA ZZZ 22846 A Insert spine fixation device 12.42 8.21 NA 2.26 22.89 NA ZZZ 22847 A Insert spine fixation device 13.80 8.97 NA 2.36 25.13 NA ZZZ 22848 A Insert pelv fixation device 6.00 4.75 NA 0.88 11.63 NA ZZZ 22849 A Reinsert spinal fixation 18.51 13.72 NA 2.87 35.10 NA 090 22850 A Remove spine fixation device 9.52 8.41 NA 1.51 19.44 NA 090 22851 A Apply spine prosth device 6.71 5.08 NA 1.11 12.90 NA ZZZ 22852 A Remove spine fixation device 9.01 8.18 NA 1.40 18.59 NA 090 22855 A Remove spine fixation device 15.13 11.28 NA 2.74 29.15 NA 090 22899 C Spine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 22900 A Remove abdominal wall lesion 5.80 4.29 NA 0.58 10.67 NA 090 22999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23000 A Removal of calcium deposits 4.36 6.59 8.98 0.50 11.45 13.84 090 23020 A Release shoulder joint 8.93 10.02 NA 1.23 20.18 NA 090 23030 A Drain shoulder lesion 3.43 4.18 5.88 0.42 8.03 9.73 010 23031 A Drain shoulder bursa 2.74 3.82 5.81 0.33 6.89 8.88 010 23035 A Drain shoulder bone lesion 8.61 14.53 NA 1.19 24.33 NA 090 23040 A Exploratory shoulder surgery 9.20 10.87 NA 1.28 21.35 NA 090 23044 A Exploratory shoulder surgery 7.12 9.79 NA 0.97 17.88 NA 090 23065 A Biopsy shoulder tissues 2.27 1.29 2.53 0.14 3.70 4.94 010 23066 A Biopsy shoulder tissues 4.16 6.04 7.42 0.50 10.70 12.08 090 23075 A Removal of shoulder lesion 2.39 3.08 5.25 0.25 5.72 7.89 010 23076 A Removal of shoulder lesion 7.63 8.03 NA 0.87 16.53 NA 090 23077 A Remove tumor of shoulder 16.09 14.40 NA 1.81 32.30 NA 090 23100 A Biopsy of shoulder joint 6.03 8.01 NA 0.81 14.85 NA 090 23101 A Shoulder joint surgery 5.58 8.10 NA 0.77 14.45 NA 090 23105 A Remove shoulder joint lining 8.23 9.64 NA 1.13 19.00 NA 090 23106 A Incision of collarbone joint 5.96 8.29 NA 0.82 15.07 NA 090 23107 A Explore treat shoulder joint 8.62 9.61 NA 1.19 19.42 NA 090 23120 A Partial removal, collar bone 7.11 8.86 NA 0.99 16.96 NA 090 23125 A Removal of collar bone 9.39 10.24 NA 1.27 20.90 NA 090 23130 A Remove shoulder bone, part 7.55 9.11 NA 1.06 17.72 NA 090 23140 A Removal of bone lesion 6.89 8.21 NA 0.82 15.92 NA 090 23145 A Removal of bone lesion 9.09 11.52 NA 1.24 21.85 NA 090 23146 A Removal of bone lesion 7.83 9.97 NA 1.11 18.91 NA 090 23150 A Removal of humerus lesion 8.48 9.44 NA 1.14 19.06 NA 090 23155 A Removal of humerus lesion 10.35 10.88 NA 1.20 22.43 NA 090 23156 A Removal of humerus lesion 8.68 9.69 NA 1.18 19.55 NA 090 23170 A Remove collar bone lesion 6.86 10.32 NA 0.84 18.02 NA 090 23172 A Remove shoulder blade lesion 6.90 10.73 NA 0.95 18.58 NA 090 23174 A Remove humerus lesion 9.51 10.99 NA 1.30 21.80 NA 090 23180 A Remove collar bone lesion 8.53 14.68 NA 1.18 24.39 NA 090 23182 A Remove shoulder blade lesion 8.15 15.09 NA 1.08 24.32 NA 090 Start Printed Page 40418 23184 A Remove humerus lesion 9.38 14.91 NA 1.24 25.53 NA 090 23190 A Partial removal of scapula 7.24 8.12 NA 0.97 16.33 NA 090 23195 A Removal of head of humerus 9.81 10.47 NA 1.38 21.66 NA 090 23200 A Removal of collar bone 12.08 13.34 NA 1.48 26.90 NA 090 23210 A Removal of shoulder blade 12.49 13.73 NA 1.61 27.83 NA 090 23220 A Partial removal of humerus 14.56 14.41 NA 2.03 31.00 NA 090 23221 A Partial removal of humerus 17.74 16.13 NA 2.51 36.38 NA 090 23222 A Partial removal of humerus 23.92 19.80 NA 3.37 47.09 NA 090 23330 A Remove shoulder foreign body 1.85 4.11 5.58 0.18 6.14 7.61 010 23331 A Remove shoulder foreign body 7.38 8.97 NA 1.02 17.37 NA 090 23332 A Remove shoulder foreign body 11.62 11.35 NA 1.62 24.59 NA 090 23350 A Injection for shoulder x-ray 1.00 0.35 9.72 0.05 1.40 10.77 000 23395 A Muscle transfer,shoulder/arm 16.85 13.51 NA 2.29 32.65 NA 090 23397 A Muscle transfers 16.13 14.01 NA 2.24 32.38 NA 090 23400 A Fixation of shoulder blade 13.54 12.98 NA 1.91 28.43 NA 090 23405 A Incision of tendon & muscle 8.37 8.93 NA 1.12 18.42 NA 090 23406 A Incise tendon(s) & muscle(s) 10.79 10.89 NA 1.48 23.16 NA 090 23410 A Repair of tendon(s) 12.45 11.71 NA 1.72 25.88 NA 090 23412 A Repair of tendon(s) 13.31 12.29 NA 1.86 27.46 NA 090 23415 A Release of shoulder ligament 9.97 9.62 NA 1.39 20.98 NA 090 23420 A Repair of shoulder 13.30 13.10 NA 1.86 28.26 NA 090 23430 A Repair biceps tendon 9.98 10.45 NA 1.40 21.83 NA 090 23440 A Remove/transplant tendon 10.48 10.69 NA 1.47 22.64 NA 090 23450 A Repair shoulder capsule 13.40 12.40 NA 1.86 27.66 NA 090 23455 A Repair shoulder capsule 14.37 12.91 NA 2.01 29.29 NA 090 23460 A Repair shoulder capsule 15.37 13.57 NA 2.17 31.11 NA 090 23462 A Repair shoulder capsule 15.30 13.41 NA 2.16 30.87 NA 090 23465 A Repair shoulder capsule 15.85 12.40 NA 1.61 29.86 NA 090 23466 A Repair shoulder capsule 14.22 12.83 NA 2.00 29.05 NA 090 23470 A Reconstruct shoulder joint 17.15 14.42 NA 2.40 33.97 NA 090 23472 A Reconstruct shoulder joint 21.10 16.66 NA 2.37 40.13 NA 090 23480 A Revision of collar bone 11.18 11.16 NA 1.56 23.90 NA 090 23485 A Revision of collar bone 13.43 12.42 NA 1.84 27.69 NA 090 23490 A Reinforce clavicle 11.86 10.64 NA 1.11 23.61 NA 090 23491 A Reinforce shoulder bones 14.21 12.60 NA 2.00 28.81 NA 090 23500 A Treat clavicle fracture 2.08 2.38 3.55 0.26 4.72 5.89 090 23505 A Treat clavicle fracture 3.69 3.78 5.48 0.50 7.97 9.67 090 23515 A Treat clavicle fracture 7.41 7.70 NA 1.03 16.14 NA 090 23520 A Treat clavicle dislocation 2.16 2.42 3.49 0.26 4.84 5.91 090 23525 A Treat clavicle dislocation 3.60 3.65 5.36 0.44 7.69 9.40 090 23530 A Treat clavicle dislocation 7.31 8.24 NA 0.85 16.40 NA 090 23532 A Treat clavicle dislocation 8.01 8.09 NA 1.13 17.23 NA 090 23540 A Treat clavicle dislocation 2.23 2.40 4.13 0.24 4.87 6.60 090 23545 A Treat clavicle dislocation 3.25 3.46 4.74 0.39 7.10 8.38 090 23550 A Treat clavicle dislocation 7.24 7.74 NA 0.94 15.92 NA 090 23552 A Treat clavicle dislocation 8.45 8.31 NA 1.18 17.94 NA 090 23570 A Treat shoulder blade fx 2.23 2.49 3.53 0.29 5.01 6.05 090 23575 A Treat shoulder blade fx 4.06 4.00 5.61 0.53 8.59 10.20 090 23585 A Treat scapula fracture 8.96 8.85 NA 1.25 19.06 NA 090 23600 A Treat humerus fracture 2.93 3.37 5.09 0.39 6.69 8.41 090 23605 A Treat humerus fracture 4.87 6.04 7.59 0.67 11.58 13.13 090 23615 A Treat humerus fracture 9.35 9.54 NA 1.31 20.20 NA 090 23616 A Treat humerus fracture 21.27 15.63 NA 2.98 39.88 NA 090 23620 A Treat humerus fracture 2.40 3.11 4.79 0.32 5.83 7.51 090 23625 A Treat humerus fracture 3.93 5.07 6.64 0.53 9.53 11.10 090 23630 A Treat humerus fracture 7.35 7.69 NA 1.03 16.07 NA 090 23650 A Treat shoulder dislocation 3.39 3.37 5.22 0.31 7.07 8.92 090 23655 A Treat shoulder dislocation 4.57 4.06 NA 0.52 9.15 NA 090 23660 A Treat shoulder dislocation 7.49 7.67 NA 1.01 16.17 NA 090 23665 A Treat dislocation/fracture 4.47 5.35 6.96 0.60 10.42 12.03 090 23670 A Treat dislocation/fracture 7.90 8.14 NA 1.10 17.14 NA 090 23675 A Treat dislocation/fracture 6.05 6.26 7.75 0.83 13.14 14.63 090 23680 A Treat dislocation/fracture 10.06 9.35 NA 1.39 20.80 NA 090 23700 A Fixation of shoulder 2.52 3.22 NA 0.35 6.09 NA 010 23800 A Fusion of shoulder joint 14.16 13.57 NA 1.97 29.70 NA 090 23802 A Fusion of shoulder joint 16.60 15.04 NA 2.34 33.98 NA 090 23900 A Amputation of arm & girdle 19.72 14.75 NA 2.47 36.94 NA 090 23920 A Amputation at shoulder joint 14.61 13.93 NA 1.92 30.46 NA 090 23921 A Amputation follow-up surgery 5.49 6.54 NA 0.78 12.81 NA 090 23929 C Shoulder surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23930 A Drainage of arm lesion 2.94 3.86 5.96 0.32 7.12 9.22 010 23931 A Drainage of arm bursa 1.79 3.38 5.50 0.21 5.38 7.50 010 23935 A Drain arm/elbow bone lesion 6.09 11.98 NA 0.84 18.91 NA 090 24000 A Exploratory elbow surgery 5.82 5.71 NA 0.77 12.30 NA 090 Start Printed Page 40419 24006 A Release elbow joint 9.31 8.16 NA 1.27 18.74 NA 090 24065 A Biopsy arm/elbow soft tissue 2.08 3.25 5.41 0.14 5.47 7.63 010 24066 A Biopsy arm/elbow soft tissue 5.21 6.39 8.70 0.61 12.21 14.52 090 24075 A Remove arm/elbow lesion 3.92 5.87 8.10 0.43 10.22 12.45 090 24076 A Remove arm/elbow lesion 6.30 6.92 NA 0.70 13.92 NA 090 24077 A Remove tumor of arm/elbow 11.76 13.74 NA 1.32 26.82 NA 090 24100 A Biopsy elbow joint lining 4.93 5.51 NA 0.62 11.06 NA 090 24101 A Explore/treat elbow joint 6.13 6.33 NA 0.84 13.30 NA 090 24102 A Remove elbow joint lining 8.03 7.45 NA 1.09 16.57 NA 090 24105 A Removal of elbow bursa 3.61 4.84 NA 0.49 8.94 NA 090 24110 A Remove humerus lesion 7.39 9.03 NA 0.99 17.41 NA 090 24115 A Remove/graft bone lesion 9.63 9.42 NA 1.15 20.20 NA 090 24116 A Remove/graft bone lesion 11.81 11.23 NA 1.66 24.70 NA 090 24120 A Remove elbow lesion 6.65 6.33 NA 0.87 13.85 NA 090 24125 A Remove/graft bone lesion 7.89 6.60 NA 0.88 15.37 NA 090 24126 A Remove/graft bone lesion 8.31 7.22 NA 0.90 16.43 NA 090 24130 A Removal of head of radius 6.25 6.43 NA 0.87 13.55 NA 090 24134 A Removal of arm bone lesion 9.73 15.45 NA 1.31 26.49 NA 090 24136 A Remove radius bone lesion 7.99 6.71 NA 0.85 15.55 NA 090 24138 A Remove elbow bone lesion 8.05 7.37 NA 1.12 16.54 NA 090 24140 A Partial removal of arm bone 9.18 15.93 NA 1.23 26.34 NA 090 24145 A Partial removal of radius 7.58 10.30 NA 1.01 18.89 NA 090 24147 A Partial removal of elbow 7.54 10.34 NA 1.04 18.92 NA 090 24149 A Radical resection of elbow 14.20 10.85 NA 1.90 26.95 NA 090 24150 A Extensive humerus surgery 13.27 13.78 NA 1.81 28.86 NA 090 24151 A Extensive humerus surgery 15.58 15.36 NA 2.19 33.13 NA 090 24152 A Extensive radius surgery 10.06 8.95 NA 1.19 20.20 NA 090 24153 A Extensive radius surgery 11.54 7.34 NA 0.64 19.52 NA 090 24155 A Removal of elbow joint 11.73 8.81 NA 1.42 21.96 NA 090 24160 A Remove elbow joint implant 7.83 7.33 NA 1.07 16.23 NA 090 24164 A Remove radius head implant 6.23 6.36 NA 0.84 13.43 NA 090 24200 A Removal of arm foreign body 1.76 3.16 5.90 0.15 5.07 7.81 010 24201 A Removal of arm foreign body 4.56 6.75 8.45 0.56 11.87 13.57 090 24220 A Injection for elbow x-ray 1.31 0.47 10.76 0.07 1.85 12.14 000 24301 A Muscle/tendon transfer 10.20 8.94 NA 1.30 20.44 NA 090 24305 A Arm tendon lengthening 7.45 7.15 NA 0.98 15.58 NA 090 24310 A Revision of arm tendon 5.98 7.77 NA 0.74 14.49 NA 090 24320 A Repair of arm tendon 10.56 10.12 NA 1.00 21.68 NA 090 24330 A Revision of arm muscles 9.60 8.44 NA 1.21 19.25 NA 090 24331 A Revision of arm muscles 10.65 8.80 NA 1.41 20.86 NA 090 24340 A Repair of biceps tendon 7.89 7.23 NA 1.08 16.20 NA 090 24341 A Repair arm tendon/muscle 7.90 7.30 NA 1.08 16.28 NA 090 24342 A Repair of ruptured tendon 10.62 8.91 NA 1.48 21.01 NA 090 24350 A Repair of tennis elbow 5.25 5.91 NA 0.72 11.88 NA 090 24351 A Repair of tennis elbow 5.91 6.34 NA 0.82 13.07 NA 090 24352 A Repair of tennis elbow 6.43 6.61 NA 0.90 13.94 NA 090 24354 A Repair of tennis elbow 6.48 6.55 NA 0.88 13.91 NA 090 24356 A Revision of tennis elbow 6.68 6.74 NA 0.90 14.32 NA 090 24360 A Reconstruct elbow joint 12.34 9.65 NA 1.69 23.68 NA 090 24361 A Reconstruct elbow joint 14.08 10.36 NA 1.95 26.39 NA 090 24362 A Reconstruct elbow joint 14.99 10.93 NA 1.92 27.84 NA 090 24363 A Replace elbow joint 18.49 13.26 NA 2.52 34.27 NA 090 24365 A Reconstruct head of radius 8.39 7.62 NA 1.11 17.12 NA 090 24366 A Reconstruct head of radius 9.13 8.06 NA 1.28 18.47 NA 090 24400 A Revision of humerus 11.06 11.89 NA 1.53 24.48 NA 090 24410 A Revision of humerus 14.82 13.84 NA 1.89 30.55 NA 090 24420 A Revision of humerus 13.44 15.43 NA 1.82 30.69 NA 090 24430 A Repair of humerus 12.81 12.15 NA 1.80 26.76 NA 090 24435 A Repair humerus with graft 13.17 13.11 NA 1.84 28.12 NA 090 24470 A Revision of elbow joint 8.74 7.17 NA 1.23 17.14 NA 090 24495 A Decompression of forearm 8.12 9.47 NA 0.92 18.51 NA 090 24498 A Reinforce humerus 11.92 11.60 NA 1.67 25.19 NA 090 24500 A Treat humerus fracture 3.21 3.11 4.67 0.41 6.73 8.29 090 24505 A Treat humerus fracture 5.17 6.31 8.09 0.72 12.20 13.98 090 24515 A Treat humerus fracture 11.65 10.79 NA 1.63 24.07 NA 090 24516 A Treat humerus fracture 11.65 11.17 NA 1.63 24.45 NA 090 24530 A Treat humerus fracture 3.50 4.44 5.64 0.47 8.41 9.61 090 24535 A Treat humerus fracture 6.87 6.38 8.13 0.96 14.21 15.96 090 24538 A Treat humerus fracture 9.43 9.79 NA 1.25 20.47 NA 090 24545 A Treat humerus fracture 10.46 9.60 NA 1.47 21.53 NA 090 24546 A Treat humerus fracture 15.69 13.03 NA 2.18 30.90 NA 090 24560 A Treat humerus fracture 2.80 2.89 4.48 0.35 6.04 7.63 090 24565 A Treat humerus fracture 5.56 5.62 7.40 0.74 11.92 13.70 090 24566 A Treat humerus fracture 7.79 9.23 NA 1.10 18.12 NA 090 Start Printed Page 40420 24575 A Treat humerus fracture 10.66 8.03 NA 1.44 20.13 NA 090 24576 A Treat humerus fracture 2.86 3.01 4.25 0.38 6.25 7.49 090 24577 A Treat humerus fracture 5.79 5.75 7.51 0.81 12.35 14.11 090 24579 A Treat humerus fracture 11.60 10.69 NA 1.62 23.91 NA 090 24582 A Treat humerus fracture 8.55 9.72 NA 1.20 19.47 NA 090 24586 A Treat elbow fracture 15.21 10.77 NA 2.12 28.10 NA 090 24587 A Treat elbow fracture 15.16 10.55 NA 2.14 27.85 NA 090 24600 A Treat elbow dislocation 4.23 4.70 6.32 0.49 9.42 11.04 090 24605 A Treat elbow dislocation 5.42 4.75 NA 0.72 10.89 NA 090 24615 A Treat elbow dislocation 9.42 7.58 NA 1.31 18.31 NA 090 24620 A Treat elbow fracture 6.98 6.21 NA 0.90 14.09 NA 090 24635 A Treat elbow fracture 13.19 15.10 NA 1.84 30.13 NA 090 24640 A Treat elbow dislocation 1.20 1.70 3.24 0.11 3.01 4.55 010 24650 A Treat radius fracture 2.16 2.65 4.13 0.28 5.09 6.57 090 24655 A Treat radius fracture 4.40 4.90 6.70 0.58 9.88 11.68 090 24665 A Treat radius fracture 8.14 8.79 NA 1.13 18.06 NA 090 24666 A Treat radius fracture 9.49 9.53 NA 1.32 20.34 NA 090 24670 A Treat ulnar fracture 2.54 2.85 4.10 0.33 5.72 6.97 090 24675 A Treat ulnar fracture 4.72 5.12 6.84 0.65 10.49 12.21 090 24685 A Treat ulnar fracture 8.80 9.15 NA 1.23 19.18 NA 090 24800 A Fusion of elbow joint 11.20 9.43 NA 1.41 22.04 NA 090 24802 A Fusion/graft of elbow joint 13.69 11.22 NA 1.89 26.80 NA 090 24900 A Amputation of upper arm 9.60 10.69 NA 1.18 21.47 NA 090 24920 A Amputation of upper arm 9.54 12.12 NA 1.22 22.88 NA 090 24925 A Amputation follow-up surgery 7.07 8.94 NA 0.95 16.96 NA 090 24930 A Amputation follow-up surgery 10.25 11.17 NA 1.23 22.65 NA 090 24931 A Amputate upper arm & implant 12.72 11.41 NA 1.56 25.69 NA 090 24935 A Revision of amputation 15.56 11.97 NA 1.58 29.11 NA 090 24940 C Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.00 090 24999 C Upper arm/elbow surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 25000 A Incision of tendon sheath 3.38 6.63 NA 0.45 10.46 NA 090 25020 A Decompression of forearm 5.92 10.41 NA 0.75 17.08 NA 090 25023 A Decompression of forearm 12.96 16.09 NA 1.50 30.55 NA 090 25028 A Drainage of forearm lesion 5.25 9.40 NA 0.61 15.26 NA 090 25031 A Drainage of forearm bursa 4.14 9.13 NA 0.50 13.77 NA 090 25035 A Treat forearm bone lesion 7.36 15.24 NA 0.98 23.58 NA 090 25040 A Explore/treat wrist joint 7.18 8.62 NA 0.96 16.76 NA 090 25065 A Biopsy forearm soft tissues 1.99 2.42 2.42 0.12 4.53 4.53 010 25066 A Biopsy forearm soft tissues 4.13 7.44 NA 0.49 12.06 NA 090 25075 A Removal of forearm lesion 3.74 6.93 NA 0.40 11.07 NA 090 25076 A Removal of forearm lesion 4.92 11.70 NA 0.59 17.21 NA 090 25077 A Remove tumor, forearm/wrist 9.76 15.47 NA 1.10 26.33 NA 090 25085 A Incision of wrist capsule 5.50 9.97 NA 0.71 16.18 NA 090 25100 A Biopsy of wrist joint 3.90 6.70 NA 0.50 11.10 NA 090 25101 A Explore/treat wrist joint 4.69 7.29 NA 0.60 12.58 NA 090 25105 A Remove wrist joint lining 5.85 10.15 NA 0.77 16.77 NA 090 25107 A Remove wrist joint cartilage 6.43 10.29 NA 0.82 17.54 NA 090 25110 A Remove wrist tendon lesion 3.92 7.83 NA 0.48 12.23 NA 090 25111 A Remove wrist tendon lesion 3.39 6.12 NA 0.42 9.93 NA 090 25112 A Reremove wrist tendon lesion 4.53 7.02 NA 0.54 12.09 NA 090 25115 A Remove wrist/forearm lesion 8.82 15.64 NA 1.11 25.57 NA 090 25116 A Remove wrist/forearm lesion 7.11 14.57 NA 0.90 22.58 NA 090 25118 A Excise wrist tendon sheath 4.37 7.29 NA 0.55 12.21 NA 090 25119 A Partial removal of ulna 6.04 10.04 NA 0.80 16.88 NA 090 25120 A Removal of forearm lesion 6.10 13.32 NA 0.81 20.23 NA 090 25125 A Remove/graft forearm lesion 7.48 14.60 NA 1.02 23.10 NA 090 25126 A Remove/graft forearm lesion 7.55 13.98 NA 1.00 22.53 NA 090 25130 A Removal of wrist lesion 5.26 7.58 NA 0.66 13.50 NA 090 25135 A Remove & graft wrist lesion 6.89 8.35 NA 0.89 16.13 NA 090 25136 A Remove & graft wrist lesion 5.97 6.45 NA 0.58 13.00 NA 090 25145 A Remove forearm bone lesion 6.37 14.15 NA 0.82 21.34 NA 090 25150 A Partial removal of ulna 7.09 11.10 NA 0.96 19.15 NA 090 25151 A Partial removal of radius 7.39 13.87 NA 0.93 22.19 NA 090 25170 A Extensive forearm surgery 11.09 16.11 NA 1.52 28.72 NA 090 25210 A Removal of wrist bone 5.95 8.13 NA 0.73 14.81 NA 090 25215 A Removal of wrist bones 7.89 11.22 NA 1.02 20.13 NA 090 25230 A Partial removal of radius 5.23 7.50 NA 0.66 13.39 NA 090 25240 A Partial removal of ulna 5.17 9.65 NA 0.69 15.51 NA 090 25246 A Injection for wrist x-ray 1.45 0.51 10.21 0.07 2.03 11.73 000 25248 A Remove forearm foreign body 5.14 9.18 NA 0.54 14.86 NA 090 25250 A Removal of wrist prosthesis 6.60 8.22 NA 0.84 15.66 NA 090 25251 A Removal of wrist prosthesis 9.57 11.59 NA 1.15 22.31 NA 090 25260 A Repair forearm tendon/muscle 7.80 15.87 NA 0.97 24.64 NA 090 25263 A Repair forearm tendon/muscle 7.82 15.18 NA 0.94 23.94 NA 090 Start Printed Page 40421 25265 A Repair forearm tendon/muscle 9.88 15.91 NA 1.19 26.98 NA 090 25270 A Repair forearm tendon/muscle 6.00 14.75 NA 0.76 21.51 NA 090 25272 A Repair forearm tendon/muscle 7.04 15.38 NA 0.89 23.31 NA 090 25274 A Repair forearm tendon/muscle 8.75 15.08 NA 1.11 24.94 NA 090 25280 A Revise wrist/forearm tendon 7.22 14.41 NA 0.91 22.54 NA 090 25290 A Incise wrist/forearm tendon 5.29 16.27 NA 0.66 22.22 NA 090 25295 A Release wrist/forearm tendon 6.55 14.17 NA 0.84 21.56 NA 090 25300 A Fusion of tendons at wrist 8.80 9.65 NA 1.07 19.52 NA 090 25301 A Fusion of tendons at wrist 8.40 9.34 NA 1.08 18.82 NA 090 25310 A Transplant forearm tendon 8.14 14.69 NA 1.01 23.84 NA 090 25312 A Transplant forearm tendon 9.57 15.68 NA 1.22 26.47 NA 090 25315 A Revise palsy hand tendon(s) 10.20 16.52 NA 1.26 27.98 NA 090 25316 A Revise palsy hand tendon(s) 12.33 17.21 NA 1.74 31.28 NA 090 25320 A Repair/revise wrist joint 10.77 10.80 NA 1.32 22.89 NA 090 25332 A Revise wrist joint 11.41 11.30 NA 1.46 24.17 NA 090 25335 A Realignment of hand 12.88 13.40 NA 1.66 27.94 NA 090 25337 A Reconstruct ulna/radioulnar 10.17 12.46 NA 1.31 23.94 NA 090 25350 A Revision of radius 8.78 14.90 NA 1.17 24.85 NA 090 25355 A Revision of radius 10.17 15.98 NA 1.44 27.59 NA 090 25360 A Revision of ulna 8.43 15.02 NA 1.17 24.62 NA 090 25365 A Revise radius & ulna 12.40 16.38 NA 1.67 30.45 NA 090 25370 A Revise radius or ulna 13.36 17.87 NA 1.88 33.11 NA 090 25375 A Revise radius & ulna 13.04 17.69 NA 1.84 32.57 NA 090 25390 A Shorten radius or ulna 10.40 15.98 NA 1.38 27.76 NA 090 25391 A Lengthen radius or ulna 13.65 17.30 NA 1.73 32.68 NA 090 25392 A Shorten radius & ulna 13.95 16.70 NA 1.73 32.38 NA 090 25393 A Lengthen radius & ulna 15.87 16.87 NA 1.87 34.61 NA 090 25400 A Repair radius or ulna 10.92 16.14 NA 1.50 28.56 NA 090 25405 A Repair/graft radius or ulna 14.38 18.44 NA 1.95 34.77 NA 090 25415 A Repair radius & ulna 13.35 17.54 NA 1.87 32.76 NA 090 25420 A Repair/graft radius & ulna 16.33 19.34 NA 2.20 37.87 NA 090 25425 A Repair/graft radius or ulna 13.21 24.49 NA 1.61 39.31 NA 090 25426 A Repair/graft radius & ulna 15.82 19.57 NA 2.23 37.62 NA 090 25440 A Repair/graft wrist bone 10.44 10.49 NA 1.41 22.34 NA 090 25441 A Reconstruct wrist joint 12.90 11.56 NA 1.83 26.29 NA 090 25442 A Reconstruct wrist joint 10.85 10.66 NA 1.24 22.75 NA 090 25443 A Reconstruct wrist joint 10.39 14.76 NA 1.30 26.45 NA 090 25444 A Reconstruct wrist joint 11.15 12.37 NA 1.43 24.95 NA 090 25445 A Reconstruct wrist joint 9.69 12.45 NA 1.26 23.40 NA 090 25446 A Wrist replacement 16.55 13.94 NA 2.20 32.69 NA 090 25447 A Repair wrist joint(s) 10.37 10.50 NA 1.34 22.21 NA 090 25449 A Remove wrist joint implant 14.49 14.77 NA 1.77 31.03 NA 090 25450 A Revision of wrist joint 7.87 11.88 NA 0.88 20.63 NA 090 25455 A Revision of wrist joint 9.49 11.30 NA 1.07 21.86 NA 090 25490 A Reinforce radius 9.54 15.04 NA 1.19 25.77 NA 090 25491 A Reinforce ulna 9.96 15.44 NA 1.41 26.81 NA 090 25492 A Reinforce radius and ulna 12.33 14.22 NA 1.62 28.17 NA 090 25500 A Treat fracture of radius 2.45 2.73 3.94 0.28 5.46 6.67 090 25505 A Treat fracture of radius 5.21 5.33 7.08 0.69 11.23 12.98 090 25515 A Treat fracture of radius 9.18 9.26 NA 1.22 19.66 NA 090 25520 A Treat fracture of radius 6.26 6.01 7.39 0.85 13.12 14.50 090 25525 A Treat fracture of radius 12.24 11.02 NA 1.68 24.94 NA 090 25526 A Treat fracture of radius 12.98 14.20 NA 1.80 28.98 NA 090 25530 A Treat fracture of ulna 2.09 2.64 3.82 0.27 5.00 6.18 090 25535 A Treat fracture of ulna 5.14 5.29 7.08 0.68 11.11 12.90 090 25545 A Treat fracture of ulna 8.90 9.22 NA 1.23 19.35 NA 090 25560 A Treat fracture radius & ulna 2.44 2.69 3.94 0.27 5.40 6.65 090 25565 A Treat fracture radius & ulna 5.63 5.55 7.34 0.76 11.94 13.73 090 25574 A Treat fracture radius & ulna 7.01 8.12 NA 0.96 16.09 NA 090 25575 A Treat fracture radius/ulna 10.45 10.09 NA 1.46 22.00 NA 090 25600 A Treat fracture radius/ulna 2.63 2.85 4.13 0.34 5.82 7.10 090 25605 A Treat fracture radius/ulna 5.81 5.73 7.51 0.81 12.35 14.13 090 25611 A Treat fracture radius/ulna 7.77 9.27 NA 1.08 18.12 NA 090 5620 A Treat fracture radius/ulna 8.55 9.03 NA 1.17 18.75 NA 090 25622 A Treat wrist bone fracture 2.61 2.83 4.11 0.33 5.77 7.05 090 25624 A Treat wrist bone fracture 4.53 4.98 6.72 0.61 10.12 11.86 090 25628 A Treat wrist bone fracture 8.43 9.15 NA 1.14 18.72 NA 090 25630 A Treat wrist bone fracture 2.88 2.93 4.26 0.37 6.18 7.51 090 25635 A Treat wrist bone fracture 4.39 4.05 6.78 0.39 8.83 11.56 090 25645 A Treat wrist bone fracture 7.25 9.29 NA 0.93 17.47 NA 090 25650 A Treat wrist bone fracture 3.05 2.96 4.36 0.37 6.38 7.78 090 25660 A Treat wrist dislocation 4.76 5.14 NA 0.59 10.49 NA 090 25670 A Treat wrist dislocation 7.92 8.94 NA 1.07 17.93 NA 090 25675 A Treat wrist dislocation 4.67 4.90 6.75 0.57 10.14 11.99 090 Start Printed Page 40422 25676 A Treat wrist dislocation 8.04 8.99 NA 1.10 18.13 NA 090 25680 A Treat wrist fracture 5.99 6.13 NA 0.61 12.73 NA 090 25685 A Treat wrist fracture 9.78 9.62 NA 1.25 20.65 NA 090 25690 A Treat wrist dislocation 5.50 6.50 NA 0.78 12.78 NA 090 25695 A Treat wrist dislocation 8.34 8.92 NA 1.07 18.33 NA 090 25800 A Fusion of wrist joint 9.76 10.06 NA 1.30 21.12 NA 090 25805 A Fusion/graft of wrist joint 11.28 11.01 NA 1.51 23.80 NA 090 25810 A Fusion/graft of wrist joint 10.57 10.56 NA 1.37 22.50 NA 090 25820 A Fusion of hand bones 7.45 8.83 NA 0.96 17.24 NA 090 25825 A Fuse hand bones with graft 9.27 9.90 NA 1.20 20.37 NA 090 25830 A Fusion, radioulnar jnt/ulna 10.06 15.03 NA 1.27 26.36 NA 090 25900 A Amputation of forearm 9.01 13.44 NA 1.08 23.53 NA 090 25905 A Amputation of forearm 9.12 15.44 NA 1.06 25.62 NA 090 25907 A Amputation follow-up surgery 7.80 13.37 NA 1.01 22.18 NA 090 25909 A Amputation follow-up surgery 8.96 15.46 NA 1.07 25.49 NA 090 25915 A Amputation of forearm 17.08 20.29 NA 2.41 39.78 NA 090 25920 A Amputate hand at wrist 8.68 9.45 NA 1.06 19.19 NA 090 25922 A Amputate hand at wrist 7.42 8.61 NA 0.93 16.96 NA 090 25924 A Amputation follow-up surgery 8.46 9.25 NA 1.07 18.78 NA 090 25927 A Amputation of hand 8.80 13.77 NA 1.02 23.59 NA 090 25929 A Amputation follow-up surgery 7.59 6.66 NA 0.89 15.14 NA 090 25931 A Amputation follow-up surgery 7.81 13.86 NA 0.88 22.55 NA 090 25999 C Forearm or wrist surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26010 A Drainage of finger abscess 1.54 3.50 4.85 0.14 5.18 6.53 010 26011 A Drainage of finger abscess 2.19 5.80 6.86 0.25 8.24 9.30 010 26020 A Drain hand tendon sheath 4.67 11.73 NA 0.59 16.99 NA 090 26025 A Drainage of palm bursa 4.82 11.93 NA 0.60 17.35 NA 090 26030 A Drainage of palm bursa(s) 5.93 12.37 NA 0.72 19.02 NA 090 26034 A Treat hand bone lesion 6.23 13.53 NA 0.79 20.55 NA 090 26035 A Decompress fingers/hand 9.51 15.47 NA 1.12 26.10 NA 090 26037 A Decompress fingers/hand 7.25 11.90 NA 0.87 20.02 NA 090 26040 A Release palm contracture 3.33 11.30 NA 0.45 15.08 NA 090 26045 A Release palm contracture 5.56 12.48 NA 0.74 18.78 NA 090 26055 A Incise finger tendon sheath 2.69 6.82 7.13 0.36 9.87 10.18 090 26060 A Incision of finger tendon 2.81 6.75 NA 0.35 9.91 NA 090 26070 A Explore/treat hand joint 3.69 10.47 NA 0.35 14.51 NA 090 26075 A Explore/treat finger joint 3.79 11.05 NA 0.40 15.24 NA 090 26080 A Explore/treat finger joint 4.24 11.75 NA 0.52 16.51 NA 090 26100 A Biopsy hand joint lining 3.67 7.53 NA 0.45 11.65 NA 090 26105 A Biopsy finger joint lining 3.71 10.82 NA 0.45 14.98 NA 090 26110 A Biopsy finger joint lining 3.53 10.83 NA 0.44 14.80 NA 090 26115 A Removal of hand lesion 3.86 7.37 7.37 0.48 11.71 11.71 090 26116 A Removal of hand lesion 5.53 12.40 NA 0.69 18.62 NA 090 26117 A Remove tumor, hand/finger 8.55 14.68 NA 1.01 24.24 NA 090 26121 A Release palm contracture 7.54 14.45 NA 0.94 22.93 NA 090 26123 A Release palm contracture 9.29 15.42 NA 1.17 25.88 NA 090 26125 A Release palm contracture 4.61 2.58 NA 0.57 7.76 NA ZZZ 26130 A Remove wrist joint lining 5.42 15.08 NA 0.65 21.15 NA 090 26135 A Revise finger joint, each 6.96 15.66 NA 0.87 23.49 NA 090 26140 A Revise finger joint, each 6.17 14.55 NA 0.76 21.48 NA 090 26145 A Tendon excision, palm/finger 6.32 14.53 NA 0.77 21.62 NA 090 26160 A Remove tendon sheath lesion 3.15 7.07 7.42 0.39 10.61 10.96 090 26170 A Removal of palm tendon, each 4.77 8.10 NA 0.60 13.47 NA 090 26180 A Removal of finger tendon 5.18 7.90 NA 0.64 13.72 NA 090 26185 A Remove finger bone 5.25 8.47 NA 0.67 14.39 NA 090 26200 A Remove hand bone lesion 5.51 12.49 NA 0.71 18.71 NA 090 26205 A Remove/graft bone lesion 7.70 14.21 NA 0.95 22.86 NA 090 26210 A Removal of finger lesion 5.15 13.15 NA 0.64 18.94 NA 090 26215 A Remove/graft finger lesion 7.10 13.64 NA 0.77 21.51 NA 090 26230 A Partial removal of hand bone 6.33 11.95 NA 0.84 19.12 NA 090 26235 A Partial removal, finger bone 6.19 11.60 NA 0.78 18.57 NA 090 26236 A Partial removal, finger bone 5.32 11.50 NA 0.66 17.48 NA 090 26250 A Extensive hand surgery 7.55 16.17 NA 0.92 24.64 NA 090 26255 A Extensive hand surgery 12.43 17.40 NA 1.05 30.88 NA 090 26260 A Extensive finger surgery 7.03 16.10 NA 0.83 23.96 NA 090 26261 A Extensive finger surgery 9.09 17.27 NA 0.84 27.20 NA 090 26262 A Partial removal of finger 5.67 13.02 NA 0.70 19.39 NA 090 26320 A Removal of implant from hand 3.98 11.90 NA 0.49 16.37 NA 090 26350 A Repair finger/hand tendon 5.99 18.44 NA 0.73 25.16 NA 090 26352 A Repair/graft hand tendon 7.68 17.73 NA 0.93 26.34 NA 090 26356 A Repair finger/hand tendon 8.07 19.76 NA 0.99 28.82 NA 090 26357 A Repair finger/hand tendon 8.58 19.18 NA 1.02 28.78 NA 090 26358 A Repair/graft hand tendon 9.14 18.83 NA 1.07 29.04 NA 090 26370 A Repair finger/hand tendon 7.11 18.97 NA 0.90 26.98 NA 090 Start Printed Page 40423 26372 A Repair/graft hand tendon 8.76 19.04 NA 1.06 28.86 NA 090 26373 A Repair finger/hand tendon 8.16 21.85 NA 0.98 30.99 NA 090 26390 A Revise hand/finger tendon 9.19 14.73 NA 1.09 25.01 NA 090 26392 A Repair/graft hand tendon 10.26 20.11 NA 1.26 31.63 NA 090 26410 A Repair hand tendon 4.63 14.73 NA 0.57 19.93 NA 090 26412 A Repair/graft hand tendon 6.31 15.14 NA 0.80 22.25 NA 090 26415 A Excision, hand/finger tendon 8.34 14.78 NA 0.77 23.89 NA 090 26416 A Graft hand or finger tendon 9.37 15.98 NA 1.20 26.55 NA 090 26418 A Repair finger tendon 4.25 14.47 NA 0.50 19.22 NA 090 26420 A Repair/graft finger tendon 6.77 15.94 NA 0.83 23.54 NA 090 26426 A Repair finger/hand tendon 6.15 15.25 NA 0.77 22.17 NA 090 26428 A Repair/graft finger tendon 7.21 15.88 NA 0.84 23.93 NA 090 26432 A Repair finger tendon 4.02 11.21 NA 0.48 15.71 NA 090 26433 A Repair finger tendon 4.56 12.90 NA 0.56 18.02 NA 090 26434 A Repair/graft finger tendon 6.09 12.26 NA 0.71 19.06 NA 090 26437 A Realignment of tendons 5.82 12.65 NA 0.74 19.21 NA 090 26440 A Release palm/finger tendon 5.02 16.29 NA 0.62 21.93 NA 090 26442 A Release palm & finger tendon 8.16 18.65 NA 0.94 27.75 NA 090 26445 A Release hand/finger tendon 4.31 16.15 NA 0.54 21.00 NA 090 26449 A Release forearm/hand tendon 7.00 16.93 NA 0.84 24.77 NA 090 26450 A Incision of palm tendon 3.67 7.35 NA 0.46 11.48 NA 090 26455 A Incision of finger tendon 3.64 7.62 NA 0.47 11.73 NA 090 26460 A Incise hand/finger tendon 3.46 7.16 NA 0.44 11.06 NA 090 26471 A Fusion of finger tendons 5.73 12.60 NA 0.73 19.06 NA 090 26474 A Fusion of finger tendons 5.32 12.98 NA 0.69 18.99 NA 090 26476 A Tendon lengthening 5.18 13.01 NA 0.62 18.81 NA 090 26477 A Tendon shortening 5.15 12.42 NA 0.60 18.17 NA 090 26478 A Lengthening of hand tendon 5.80 12.68 NA 0.77 19.25 NA 090 26479 A Shortening of hand tendon 5.74 12.93 NA 0.76 19.43 NA 090 26480 A Transplant hand tendon 6.69 17.38 NA 0.84 24.91 NA 090 26483 A Transplant/graft hand tendon 8.29 18.21 NA 1.03 27.53 NA 090 26485 A Transplant palm tendon 7.70 17.29 NA 0.94 25.93 NA 090 26489 A Transplant/graft palm tendon 9.55 16.81 NA 0.98 27.34 NA 090 26490 A Revise thumb tendon 8.41 13.89 NA 1.05 23.35 NA 090 26492 A Tendon transfer with graft 9.62 15.06 NA 1.19 25.87 NA 090 26494 A Hand tendon/muscle transfer 8.47 14.39 NA 1.13 23.99 NA 090 26496 A Revise thumb tendon 9.59 14.31 NA 1.17 25.07 NA 090 26497 A Finger tendon transfer 9.57 14.56 NA 1.17 25.30 NA 090 26498 A Finger tendon transfer 14.00 16.84 NA 1.74 32.58 NA 090 26499 A Revision of finger 8.98 16.21 NA 0.94 26.13 NA 090 26500 A Hand tendon reconstruction 5.96 13.54 NA 0.66 20.16 NA 090 26502 A Hand tendon reconstruction 7.14 14.64 NA 0.87 22.65 NA 090 26504 A Hand tendon reconstruction 7.47 10.07 NA 0.84 18.38 NA 090 26508 A Release thumb contracture 6.01 13.31 NA 0.76 20.08 NA 090 26510 A Thumb tendon transfer 5.43 12.63 NA 0.71 18.77 NA 090 26516 A Fusion of knuckle joint 7.15 13.37 NA 0.90 21.42 NA 090 26517 A Fusion of knuckle joints 8.83 13.80 NA 0.96 23.59 NA 090 26518 A Fusion of knuckle joints 9.02 13.39 NA 1.13 23.54 NA 090 26520 A Release knuckle contracture 5.30 16.60 NA 0.65 22.55 NA 090 26525 A Release finger contracture 5.33 17.02 NA 0.66 23.01 NA 090 26530 A Revise knuckle joint 6.69 17.06 NA 0.86 24.61 NA 090 26531 A Revise knuckle with implant 7.91 17.47 NA 1.01 26.39 NA 090 26535 A Revise finger joint 5.24 9.35 NA 0.66 15.25 NA 090 26536 A Revise/implant finger joint 6.37 16.17 NA 0.80 23.34 NA 090 26540 A Repair hand joint 6.43 13.61 NA 0.81 20.85 NA 090 26541 A Repair hand joint with graft 8.62 14.98 NA 1.12 24.72 NA 090 26542 A Repair hand joint with graft 6.78 12.89 NA 0.87 20.54 NA 090 26545 A Reconstruct finger joint 6.92 14.40 NA 0.79 22.11 NA 090 26546 A Repair nonunion hand 8.92 14.17 NA 1.14 24.23 NA 090 26548 A Reconstruct finger joint 8.03 14.48 NA 0.98 23.49 NA 090 26550 A Construct thumb replacement 21.24 20.44 NA 1.80 43.48 NA 090 26551 A Great toe-hand transfer 46.58 28.68 NA 6.57 81.83 NA 090 26553 A Single transfer, toe-hand 46.27 29.02 NA 1.99 77.28 NA 090 26554 A Double transfer, toe-hand 54.95 34.09 NA 7.76 96.80 NA 090 26555 A Positional change of finger 16.63 22.63 NA 2.13 41.39 NA 090 26556 A Toe joint transfer 47.26 28.95 NA 6.67 82.88 NA 090 26560 A Repair of web finger 5.38 13.36 NA 0.60 19.34 NA 090 26561 A Repair of web finger 10.92 14.12 NA 0.69 25.73 NA 090 26562 A Repair of web finger 15.00 10.53 NA 0.98 26.51 NA 090 26565 A Correct metacarpal flaw 6.74 13.32 NA 0.84 20.90 NA 090 26567 A Correct finger deformity 6.82 13.21 NA 0.84 20.87 NA 090 26568 A Lengthen metacarpal/finger 9.08 17.70 NA 1.10 27.88 NA 090 26580 A Repair hand deformity 18.18 16.51 NA 1.46 36.15 NA 090 26585 A Repair finger deformity 14.05 14.32 NA 1.08 29.45 NA 090 Start Printed Page 40424 26587 C Reconstruct extra finger 0.00 0.00 0.00 0.00 0.00 0.00 090 26590 A Repair finger deformity 17.96 14.17 NA 1.32 33.45 NA 090 26591 A Repair muscles of hand 3.25 13.02 NA 0.37 16.64 NA 090 26593 A Release muscles of hand 5.31 11.86 NA 0.64 17.81 NA 090 26596 A Excision constricting tissue 8.95 9.21 NA 0.87 19.03 NA 090 26597 A Release of scar contracture 9.82 15.51 NA 1.20 26.53 NA 090 26600 A Treat metacarpal fracture 1.96 2.58 3.76 0.25 4.79 5.97 090 26605 A Treat metacarpal fracture 2.85 3.98 5.45 0.38 7.21 8.68 090 26607 A Treat metacarpal fracture 5.36 7.74 NA 0.70 13.80 NA 090 26608 A Treat metacarpal fracture 5.36 8.10 NA 0.73 14.19 NA 090 26615 A Treat metacarpal fracture 5.33 7.86 NA 0.70 13.89 NA 090 26641 A Treat thumb dislocation 3.94 4.53 6.22 0.42 8.89 10.58 090 26645 A Treat thumb fracture 4.41 4.91 6.61 0.54 9.86 11.56 090 26650 A Treat thumb fracture 5.72 8.28 NA 0.77 14.77 NA 090 26665 A Treat thumb fracture 7.60 8.80 NA 0.97 17.37 NA 090 26670 A Treat hand dislocation 3.69 4.38 5.78 0.36 8.43 9.83 090 26675 A Treat hand dislocation 4.64 4.49 5.64 0.56 9.69 10.84 090 26676 A Pin hand dislocation 5.52 8.12 NA 0.76 14.40 NA 090 26685 A Treat hand dislocation 6.98 8.29 NA 0.95 16.22 NA 090 26686 A Treat hand dislocation 7.94 9.26 NA 1.05 18.25 NA 090 26700 A Treat knuckle dislocation 3.69 2.84 4.80 0.35 6.88 8.84 090 26705 A Treat knuckle dislocation 4.19 4.12 5.79 0.50 8.81 10.48 090 26706 A Pin knuckle dislocation 5.12 5.54 NA 0.64 11.30 NA 090 26715 A Treat knuckle dislocation 5.74 7.97 NA 0.75 14.46 NA 090 26720 A Treat finger fracture, each 1.66 1.58 2.83 0.20 3.44 4.69 090 26725 A Treat finger fracture, each 3.33 3.05 4.83 0.43 6.81 8.59 090 26727 A Treat finger fracture, each 5.23 8.38 NA 0.69 14.30 NA 090 26735 A Treat finger fracture, each 5.98 8.36 NA 0.77 15.11 NA 090 26740 A Treat finger fracture, each 1.94 2.43 3.54 0.24 4.61 5.72 090 26742 A Treat finger fracture, each 3.85 4.93 6.64 0.49 9.27 10.98 090 26746 A Treat finger fracture, each 5.81 8.51 NA 0.74 15.06 NA 090 26750 A Treat finger fracture, each 1.70 2.24 3.37 0.19 4.13 5.26 090 26755 A Treat finger fracture, each 3.10 2.94 4.75 0.37 6.41 8.22 090 26756 A Pin finger fracture, each 4.39 8.31 NA 0.56 13.26 NA 090 26765 A Treat finger fracture, each 4.17 7.47 NA 0.51 12.15 NA 090 26770 A Treat finger dislocation 3.02 2.57 4.52 0.27 5.86 7.81 090 26775 A Treat finger dislocation 3.71 3.79 5.62 0.43 7.93 9.76 090 26776 A Pin finger dislocation 4.80 8.34 NA 0.63 13.77 NA 090 26785 A Treat finger dislocation 4.21 7.36 NA 0.54 12.11 NA 090 26820 A Thumb fusion with graft 8.26 14.74 NA 1.11 24.11 NA 090 26841 A Fusion of thumb 7.13 13.62 NA 0.97 21.72 NA 090 26842 A Thumb fusion with graft 8.24 14.38 NA 1.10 23.72 NA 090 26843 A Fusion of hand joint 7.61 13.54 NA 0.99 22.14 NA 090 26844 A Fusion/graft of hand joint 8.73 13.97 NA 1.12 23.82 NA 090 26850 A Fusion of knuckle 6.97 13.04 NA 0.89 20.90 NA 090 26852 A Fusion of knuckle with graft 8.46 13.95 NA 1.05 23.46 NA 090 26860 A Fusion of finger joint 4.69 12.02 NA 0.60 17.31 NA 090 26861 A Fusion of finger jnt, add-on 1.74 0.98 NA 0.22 2.94 NA ZZZ 26862 A Fusion/graft of finger joint 7.37 13.58 NA 0.92 21.87 NA 090 26863 A Fuse/graft added joint 3.90 2.21 NA 0.51 6.62 NA ZZZ 26910 A Amputate metacarpal bone 7.60 13.34 NA 0.90 21.84 NA 090 26951 A Amputation of finger/thumb 4.59 11.90 NA 0.56 17.05 NA 090 26952 A Amputation of finger/thumb 6.31 13.26 NA 0.74 20.31 NA 090 26989 C Hand/finger surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26990 A Drainage of pelvis lesion 7.48 14.75 NA 0.92 23.15 NA 090 26991 A Drainage of pelvis bursa 6.68 9.26 10.55 0.85 16.79 18.08 090 26992 A Drainage of bone lesion 13.02 18.66 NA 1.75 33.43 NA 090 27000 A Incision of hip tendon 5.62 6.95 NA 0.76 13.33 NA 090 27001 A Incision of hip tendon 6.94 7.86 NA 0.95 15.75 NA 090 27003 A Incision of hip tendon 7.34 8.49 NA 0.93 16.76 NA 090 27005 A Incision of hip tendon 9.66 9.91 NA 1.36 20.93 NA 090 27006 A Incision of hip tendons 9.68 9.86 NA 1.33 20.87 NA 090 27025 A Incision of hip/thigh fascia 11.16 9.72 NA 1.38 22.26 NA 090 27030 A Drainage of hip joint 13.01 11.78 NA 1.81 26.60 NA 090 27033 A Exploration of hip joint 13.39 11.95 NA 1.87 27.21 NA 090 27035 A Denervation of hip joint 16.69 16.51 NA 1.70 34.90 NA 090 27036 A Excision of hip joint/muscle 12.88 13.14 NA 1.80 27.82 NA 090 27040 A Biopsy of soft tissues 2.87 3.82 5.89 0.21 6.90 8.97 010 27041 A Biopsy of soft tissues 9.89 8.34 NA 1.01 19.24 NA 090 27047 A Remove hip/pelvis lesion 7.45 6.95 9.43 0.79 15.19 17.67 090 27048 A Remove hip/pelvis lesion 6.25 7.67 NA 0.73 14.65 NA 090 27049 A Remove tumor, hip/pelvis 13.66 12.98 NA 1.60 28.24 NA 090 27050 A Biopsy of sacroiliac joint 4.36 6.53 NA 0.53 11.42 NA 090 27052 A Biopsy of hip joint 6.23 7.72 NA 0.85 14.80 NA 090 Start Printed Page 40425 27054 A Removal of hip joint lining 8.54 10.02 NA 1.17 19.73 NA 090 27060 A Removal of ischial bursa 5.43 7.97 NA 0.60 14.00 NA 090 27062 A Remove femur lesion/bursa 5.37 6.79 NA 0.74 12.90 NA 090 27065 A Removal of hip bone lesion 5.90 8.03 NA 0.76 14.69 NA 090 27066 A Removal of hip bone lesion 10.33 11.61 NA 1.42 23.36 NA 090 27067 A Remove/graft hip bone lesion 13.83 13.58 NA 1.95 29.36 NA 090 27070 A Partial removal of hip bone 10.72 16.17 NA 1.36 28.25 NA 090 27071 A Partial removal of hip bone 11.46 17.22 NA 1.51 30.19 NA 090 27075 A Extensive hip surgery 35.00 25.69 NA 2.22 62.91 NA 090 27076 A Extensive hip surgery 22.12 19.75 NA 2.86 44.73 NA 090 27077 A Extensive hip surgery 40.00 27.07 NA 3.18 70.25 NA 090 27078 A Extensive hip surgery 13.44 14.69 NA 1.67 29.80 NA 090 27079 A Extensive hip surgery 13.75 14.34 NA 1.86 29.95 NA 090 27080 A Removal of tail bone 6.39 7.60 NA 0.80 14.79 NA 090 27086 A Remove hip foreign body 1.87 3.74 5.20 0.17 5.78 7.24 010 27087 A Remove hip foreign body 8.54 8.42 NA 1.09 18.05 NA 090 27090 A Removal of hip prosthesis 11.15 10.67 NA 1.55 23.37 NA 090 27091 A Removal of hip prosthesis 22.14 16.83 NA 3.11 42.08 NA 090 27093 A Injection for hip x-ray 1.30 0.51 12.12 0.09 1.90 13.51 000 27095 A Injection for hip x-ray 1.50 0.52 10.61 0.10 2.12 12.21 000 27096 A Inject sacroiliac joint 1.40 0.53 11.75 0.08 2.01 13.23 000 27097 A Revision of hip tendon 8.80 9.30 NA 1.22 19.32 NA 090 27098 A Transfer tendon to pelvis 8.83 9.47 NA 1.24 19.54 NA 090 27100 A Transfer of abdominal muscle 11.08 11.75 NA 1.57 24.40 NA 090 27105 A Transfer of spinal muscle 11.77 11.80 NA 1.66 25.23 NA 090 27110 A Transfer of iliopsoas muscle 13.26 11.37 NA 1.38 26.01 NA 090 27111 A Transfer of iliopsoas muscle 12.15 10.72 NA 1.48 24.35 NA 090 27120 A Reconstruction of hip socket 18.01 13.97 NA 2.45 34.43 NA 090 27122 A Reconstruction of hip socket 14.98 13.58 NA 2.08 30.64 NA 090 27125 A Partial hip replacement 14.69 13.17 NA 2.05 29.91 NA 090 27130 A Total hip replacement 20.12 16.33 NA 2.82 39.27 NA 090 27132 A Total hip replacement 23.30 18.15 NA 3.26 44.71 NA 090 27134 A Revise hip joint replacement 28.52 20.90 NA 3.97 53.39 NA 090 27137 A Revise hip joint replacement 21.17 17.00 NA 2.97 41.14 NA 090 27138 A Revise hip joint replacement 22.17 17.56 NA 3.11 42.84 NA 090 27140 A Transplant femur ridge 12.24 11.37 NA 1.67 25.28 NA 090 27146 A Incision of hip bone 17.43 15.10 NA 2.27 34.80 NA 090 27147 A Revision of hip bone 20.58 17.18 NA 2.61 40.37 NA 090 27151 A Incision of hip bones 22.51 18.88 NA 3.12 44.51 NA 090 27156 A Revision of hip bones 24.63 19.71 NA 3.48 47.82 NA 090 27158 A Revision of pelvis 19.74 17.31 NA 2.60 39.65 NA 090 27161 A Incision of neck of femur 16.71 13.78 NA 2.32 32.81 NA 090 27165 A Incision/fixation of femur 17.91 14.34 NA 2.51 34.76 NA 090 27170 A Repair/graft femur head/neck 16.07 13.42 NA 2.20 31.69 NA 090 27175 A Treat slipped epiphysis 8.46 6.96 NA 1.19 16.61 NA 090 27176 A Treat slipped epiphysis 12.05 9.79 NA 1.68 23.52 NA 090 27177 A Treat slipped epiphysis 15.08 11.34 NA 2.11 28.53 NA 090 27178 A Treat slipped epiphysis 11.99 9.32 NA 1.68 22.99 NA 090 27179 A Revise head/neck of femur 12.98 9.67 NA 1.84 24.49 NA 090 27181 A Treat slipped epiphysis 14.68 10.55 NA 1.74 26.97 NA 090 27185 A Revision of femur epiphysis 9.18 9.67 NA 1.29 20.14 NA 090 27187 A Reinforce hip bones 13.54 12.78 NA 1.89 28.21 NA 090 27193 A Treat pelvic ring fracture 5.56 5.05 6.60 0.77 11.38 12.93 090 27194 A Treat pelvic ring fracture 9.65 7.32 8.78 1.32 18.29 19.75 090 27200 A Treat tail bone fracture 1.84 1.71 2.87 0.22 3.77 4.93 090 27202 A Treat tail bone fracture 7.04 18.71 NA 0.69 26.44 NA 090 27215 A Treat pelvic fracture(s) 10.05 9.89 NA 1.37 21.31 NA 090 27216 A Treat pelvic ring fracture 15.19 14.74 NA 2.15 32.08 NA 090 27217 A Treat pelvic ring fracture 14.11 12.25 NA 1.95 28.31 NA 090 27218 A Treat pelvic ring fracture 20.15 15.81 NA 2.85 38.81 NA 090 27220 A Treat hip socket fracture 6.18 5.40 6.94 0.85 12.43 13.97 090 27222 A Treat hip socket fracture 12.70 9.90 NA 1.77 24.37 NA 090 27226 A Treat hip wall fracture 14.91 12.77 NA 2.07 29.75 NA 090 27227 A Treat hip fracture(s) 23.45 16.93 NA 3.24 43.62 NA 090 27228 A Treat hip fracture(s) 27.16 19.17 NA 3.77 50.10 NA 090 27230 A Treat thigh fracture 5.50 5.85 7.09 0.73 12.08 13.32 090 27232 A Treat thigh fracture 10.68 8.85 NA 1.45 20.98 NA 090 27235 A Treat thigh fracture 12.16 10.62 NA 1.71 24.49 NA 090 27236 A Treat thigh fracture 15.60 12.35 NA 2.18 30.13 NA 090 27238 A Treat thigh fracture 5.52 5.92 NA 0.76 12.20 NA 090 27240 A Treat thigh fracture 12.50 9.90 NA 1.69 24.09 NA 090 27244 A Treat thigh fracture 15.94 12.60 NA 2.23 30.77 NA 090 27245 A Treat thigh fracture 20.31 15.07 NA 2.85 38.23 NA 090 27246 A Treat thigh fracture 4.71 5.51 6.73 0.66 10.88 12.10 090 Start Printed Page 40426 27248 A Treat thigh fracture 10.45 9.54 NA 1.45 21.44 NA 090 27250 A Treat hip dislocation 6.95 6.09 NA 0.68 13.72 NA 090 27252 A Treat hip dislocation 10.39 7.92 NA 1.37 19.68 NA 090 27253 A Treat hip dislocation 12.92 10.54 NA 1.81 25.27 NA 090 27254 A Treat hip dislocation 18.26 13.72 NA 2.52 34.50 NA 090 27256 A Treat hip dislocation 4.12 4.17 NA 0.49 8.78 NA 010 27257 A Treat hip dislocation 5.22 4.55 NA 0.56 10.33 NA 010 27258 A Treat hip dislocation 15.43 13.02 NA 2.06 30.51 NA 090 27259 A Treat hip dislocation 21.55 16.30 NA 2.99 40.84 NA 090 27265 A Treat hip dislocation 5.05 5.64 NA 0.65 11.34 NA 090 27266 A Treat hip dislocation 7.49 7.06 NA 1.04 15.59 NA 090 27275 A Manipulation of hip joint 2.27 3.29 NA 0.31 5.87 NA 010 27280 A Fusion of sacroiliac joint 13.39 13.42 NA 1.98 28.79 NA 090 27282 A Fusion of pubic bones 11.34 12.51 NA 1.14 24.99 NA 090 27284 A Fusion of hip joint 23.45 18.36 NA 2.36 44.17 NA 090 27286 A Fusion of hip joint 16.79 14.57 NA 2.37 33.73 NA 090 27290 A Amputation of leg at hip 23.28 16.85 NA 2.94 43.07 NA 090 27295 A Amputation of leg at hip 18.65 13.93 NA 2.35 34.93 NA 090 27299 C Pelvis/hip joint surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27301 A Drain thigh/knee lesion 6.49 13.35 15.31 0.80 20.64 22.60 090 27303 A Drainage of bone lesion 8.28 13.63 NA 1.14 23.05 NA 090 27305 A Incise thigh tendon & fascia 5.92 8.77 NA 0.77 15.46 NA 090 27306 A Incision of thigh tendon 4.62 7.05 NA 0.62 12.29 NA 090 27307 A Incision of thigh tendons 5.80 7.75 NA 0.78 14.33 NA 090 27310 A Exploration of knee joint 9.27 9.49 NA 1.29 20.05 NA 090 27315 A Partial removal, thigh nerve 6.97 4.58 NA 0.79 12.34 NA 090 27320 A Partial removal, thigh nerve 6.30 4.28 NA 0.78 11.36 NA 090 27323 A Biopsy, thigh soft tissues 2.28 3.34 5.64 0.17 5.79 8.09 010 27324 A Biopsy, thigh soft tissues 4.90 6.53 NA 0.59 12.02 NA 090 27327 A Removal of thigh lesion 4.47 6.19 8.40 0.50 11.16 13.37 090 27328 A Removal of thigh lesion 5.57 6.79 NA 0.66 13.02 NA 090 27329 A Remove tumor, thigh/knee 14.14 13.97 NA 1.68 29.79 NA 090 27330 A Biopsy, knee joint lining 4.97 5.95 NA 0.66 11.58 NA 090 27331 A Explore/treat knee joint 5.88 7.00 NA 0.81 13.69 NA 090 27332 A Removal of knee cartilage 8.27 8.37 NA 1.15 17.79 NA 090 27333 A Removal of knee cartilage 7.30 7.88 NA 1.03 16.21 NA 090 27334 A Remove knee joint lining 8.70 9.16 NA 1.21 19.07 NA 090 27335 A Remove knee joint lining 10.00 9.92 NA 1.41 21.33 NA 090 27340 A Removal of kneecap bursa 4.18 5.59 NA 0.58 10.35 NA 090 27345 A Removal of knee cyst 5.92 6.92 NA 0.81 13.65 NA 090 27347 A Remove knee cyst 5.78 2.82 2.82 0.76 9.36 9.36 090 27350 A Removal of kneecap 8.17 8.36 NA 1.15 17.68 NA 090 27355 A Remove femur lesion 7.65 9.58 NA 1.07 18.30 NA 090 27356 A Remove femur lesion/graft 9.48 10.60 NA 1.29 21.37 NA 090 27357 A Remove femur lesion/graft 10.53 11.14 NA 1.48 23.15 NA 090 27358 A Remove femur lesion/fixation 4.74 2.67 NA 0.67 8.08 NA ZZZ 27360 A Partial removal, leg bone(s) 10.50 16.98 NA 1.42 28.90 NA 090 27365 A Extensive leg surgery 16.27 13.73 NA 2.26 32.26 NA 090 27370 A Injection for knee x-ray 0.96 0.34 12.03 0.06 1.36 13.05 000 27372 A Removal of foreign body 5.07 6.07 8.36 0.62 11.76 14.05 090 27380 A Repair of kneecap tendon 7.16 7.87 NA 1.00 16.03 NA 090 27381 A Repair/graft kneecap tendon 10.34 9.66 NA 1.44 21.44 NA 090 27385 A Repair of thigh muscle 7.76 8.22 NA 1.09 17.07 NA 090 27386 A Repair/graft of thigh muscle 10.56 10.34 NA 1.49 22.39 NA 090 27390 A Incision of thigh tendon 5.33 7.26 NA 0.69 13.28 NA 090 27391 A Incision of thigh tendons 7.20 8.37 NA 0.99 16.56 NA 090 27392 A Incision of thigh tendons 9.20 10.37 NA 1.23 20.80 NA 090 27393 A Lengthening of thigh tendon 6.39 7.77 NA 0.90 15.06 NA 090 27394 A Lengthening of thigh tendons 8.50 10.05 NA 1.17 19.72 NA 090 27395 A Lengthening of thigh tendons 11.73 12.75 NA 1.63 26.11 NA 090 27396 A Transplant of thigh tendon 7.86 9.69 NA 1.11 18.66 NA 090 27397 A Transplants of thigh tendons 11.28 11.12 NA 1.58 23.98 NA 090 27400 A Revise thigh muscles/tendons 9.02 10.67 NA 1.18 20.87 NA 090 27403 A Repair of knee cartilage 8.33 8.41 NA 1.16 17.90 NA 090 27405 A Repair of knee ligament 8.65 9.10 NA 1.21 18.96 NA 090 27407 A Repair of knee ligament 10.28 9.88 NA 1.38 21.54 NA 090 27409 A Repair of knee ligaments 12.90 11.31 NA 1.75 25.96 NA 090 27418 A Repair degenerated kneecap 10.85 10.40 NA 1.51 22.76 NA 090 27420 A Revision of unstable kneecap 9.83 9.29 NA 1.38 20.50 NA 090 27422 A Revision of unstable kneecap 9.78 9.30 NA 1.37 20.45 NA 090 27424 A Revision/removal of kneecap 9.81 9.28 NA 1.38 20.47 NA 090 27425 A Lateral retinacular release 5.22 6.72 NA 0.73 12.67 NA 090 27427 A Reconstruction, knee 9.36 8.94 NA 1.29 19.59 NA 090 27428 A Reconstruction, knee 14.00 11.95 NA 1.95 27.90 NA 090 Start Printed Page 40427 27429 A Reconstruction, knee 15.52 12.95 NA 2.18 30.65 NA 090 27430 A Revision of thigh muscles 9.67 9.29 NA 1.35 20.31 NA 090 27435 A Incision of knee joint 9.49 9.21 NA 1.33 20.03 NA 090 27437 A Revise kneecap 8.46 9.35 NA 1.18 18.99 NA 090 27438 A Revise kneecap with implant 11.23 10.55 NA 1.56 23.34 NA 090 27440 A Revision of knee joint 10.43 10.22 NA 1.42 22.07 NA 090 27441 A Revision of knee joint 10.82 10.58 NA 1.49 22.89 NA 090 27442 A Revision of knee joint 11.89 11.16 NA 1.68 24.73 NA 090 27443 A Revision of knee joint 10.93 10.82 NA 1.52 23.27 NA 090 27445 A Revision of knee joint 17.68 14.44 NA 2.49 34.61 NA 090 27446 A Revision of knee joint 15.84 13.51 NA 2.22 31.57 NA 090 27447 A Total knee replacement 21.48 16.57 NA 3.00 41.05 NA 090 27448 A Incision of thigh 11.06 11.43 NA 1.51 24.00 NA 090 27450 A Incision of thigh 13.98 13.10 NA 1.96 29.04 NA 090 27454 A Realignment of thigh bone 17.56 15.15 NA 2.46 35.17 NA 090 27455 A Realignment of knee 12.82 11.89 NA 1.78 26.49 NA 090 27457 A Realignment of knee 13.45 11.16 NA 1.88 26.49 NA 090 27465 A Shortening of thigh bone 13.87 13.49 NA 1.86 29.22 NA 090 27466 A Lengthening of thigh bone 16.33 14.79 NA 1.92 33.04 NA 090 27468 A Shorten/lengthen thighs 18.97 16.66 NA 2.68 38.31 NA 090 27470 A Repair of thigh 16.07 15.10 NA 2.24 33.41 NA 090 27472 A Repair/graft of thigh 17.72 16.03 NA 2.49 36.24 NA 090 27475 A Surgery to stop leg growth 8.64 9.39 NA 1.13 19.16 NA 090 27477 A Surgery to stop leg growth 9.85 9.25 NA 1.31 20.41 NA 090 27479 A Surgery to stop leg growth 12.80 10.30 NA 1.81 24.91 NA 090 27485 A Surgery to stop leg growth 8.84 8.75 NA 1.24 18.83 NA 090 27486 A Revise/replace knee joint 19.27 15.41 NA 2.70 37.38 NA 090 27487 A Revise/replace knee joint 25.27 18.75 NA 3.54 47.56 NA 090 27488 A Removal of knee prosthesis 15.74 13.51 NA 2.21 31.46 NA 090 27495 A Reinforce thigh 15.55 14.86 NA 2.18 32.59 NA 090 27496 A Decompression of thigh/knee 6.11 7.28 NA 0.77 14.16 NA 090 27497 A Decompression of thigh/knee 7.17 7.52 NA 0.84 15.53 NA 090 27498 A Decompression of thigh/knee 7.99 8.72 NA 0.97 17.68 NA 090 27499 A Decompression of thigh/knee 9.00 9.01 NA 1.18 19.19 NA 090 27500 A Treatment of thigh fracture 5.92 7.03 9.03 0.80 13.75 15.75 090 27501 A Treatment of thigh fracture 5.92 7.95 10.01 0.83 14.70 16.76 090 27502 A Treatment of thigh fracture 10.58 10.59 NA 1.49 22.66 NA 090 27503 A Treatment of thigh fracture 10.58 10.58 NA 1.49 22.65 NA 090 27506 A Treatment of thigh fracture 17.45 13.54 NA 2.33 33.32 NA 090 27507 A Treatment of thigh fracture 13.99 11.92 NA 1.95 27.86 NA 090 27508 A Treatment of thigh fracture 5.83 5.13 6.64 0.80 11.76 13.27 090 27509 A Treatment of thigh fracture 7.71 8.62 NA 1.08 17.41 NA 090 27510 A Treatment of thigh fracture 9.13 7.02 NA 1.26 17.41 NA 090 27511 A Treatment of thigh fracture 13.64 12.45 NA 1.91 28.00 NA 090 27513 A Treatment of thigh fracture 17.92 14.85 NA 2.51 35.28 NA 090 27514 A Treatment of thigh fracture 17.30 14.31 NA 2.41 34.02 NA 090 27516 A Treat thigh fx growth plate 5.37 5.53 7.10 0.74 11.64 13.21 090 27517 A Treat thigh fx growth plate 8.78 7.49 9.23 1.22 17.49 19.23 090 27519 A Treat thigh fx growth plate 15.02 12.72 NA 2.09 29.83 NA 090 27520 A Treat kneecap fracture 2.86 3.50 4.97 0.38 6.74 8.21 090 27524 A Treat kneecap fracture 10.00 8.48 NA 1.40 19.88 NA 090 27530 A Treat knee fracture 3.78 4.03 5.49 0.51 8.32 9.78 090 27532 A Treat knee fracture 7.30 5.58 7.16 1.02 13.90 15.48 090 27535 A Treat knee fracture 11.50 11.30 NA 1.61 24.41 NA 090 27536 A Treat knee fracture 15.65 11.62 NA 2.19 29.46 NA 090 27538 A Treat knee fracture(s) 4.87 5.15 6.98 0.67 10.69 12.52 090 27540 A Treat knee fracture 13.10 10.02 NA 1.80 24.92 NA 090 27550 A Treat knee dislocation 5.76 5.39 6.99 0.68 11.83 13.43 090 27552 A Treat knee dislocation 7.90 7.56 NA 1.10 16.56 NA 090 27556 A Treat knee dislocation 14.41 13.70 NA 2.01 30.12 NA 090 27557 A Treat knee dislocation 16.77 14.90 NA 2.37 34.04 NA 090 27558 A Treat knee dislocation 17.72 15.15 NA 2.51 35.38 NA 090 27560 A Treat kneecap dislocation 3.82 3.73 5.48 0.40 7.95 9.70 090 27562 A Treat kneecap dislocation 5.79 5.40 NA 0.69 11.88 NA 090 27566 A Treat kneecap dislocation 12.23 9.85 NA 1.73 23.81 NA 090 27570 A Fixation of knee joint 1.74 2.97 NA 0.24 4.95 NA 010 27580 A Fusion of knee 19.37 15.82 NA 2.70 37.89 NA 090 27590 A Amputate leg at thigh 12.03 12.40 NA 1.35 25.78 NA 090 27591 A Amputate leg at thigh 12.68 13.36 NA 1.63 27.67 NA 090 27592 A Amputate leg at thigh 10.02 11.90 NA 1.17 23.09 NA 090 27594 A Amputation follow-up surgery 6.92 8.82 NA 0.82 16.56 NA 090 27596 A Amputation follow-up surgery 10.60 12.19 NA 1.24 24.03 NA 090 27598 A Amputate lower leg at knee 10.53 10.97 NA 1.24 22.74 NA 090 27599 C Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY Start Printed Page 40428 27600 A Decompression of lower leg 5.65 7.81 NA 0.68 14.14 NA 090 27601 A Decompression of lower leg 5.64 7.17 NA 0.69 13.50 NA 090 27602 A Decompression of lower leg 7.35 8.12 NA 0.85 16.32 NA 090 27603 A Drain lower leg lesion 4.94 10.08 15.62 0.56 15.58 21.12 090 27604 A Drain lower leg bursa 4.47 7.81 10.69 0.54 12.82 15.70 090 27605 A Incision of achilles tendon 2.87 3.67 9.73 0.38 6.92 12.98 010 27606 A Incision of achilles tendon 4.14 4.76 11.66 0.57 9.47 16.37 010 27607 A Treat lower leg bone lesion 7.97 12.93 NA 1.08 21.98 NA 090 27610 A Explore/treat ankle joint 8.34 9.84 NA 1.15 19.33 NA 090 27612 A Exploration of ankle joint 7.33 7.59 NA 1.01 15.93 NA 090 27613 A Biopsy lower leg soft tissue 2.17 3.13 5.62 0.16 5.46 7.95 010 27614 A Biopsy lower leg soft tissue 5.66 6.91 11.43 0.62 13.19 17.71 090 27615 A Remove tumor, lower leg 12.56 17.04 NA 1.39 30.99 NA 090 27618 A Remove lower leg lesion 5.09 6.46 11.09 0.54 12.09 16.72 090 27619 A Remove lower leg lesion 8.40 8.95 13.47 1.01 18.36 22.88 090 27620 A Explore/treat ankle joint 5.98 7.31 NA 0.83 14.12 NA 090 27625 A Remove ankle joint lining 8.30 9.15 NA 1.16 18.61 NA 090 27626 A Remove ankle joint lining 8.91 9.83 NA 1.23 19.97 NA 090 27630 A Removal of tendon lesion 4.80 6.58 11.43 0.60 11.98 16.83 090 27635 A Remove lower leg bone lesion 7.78 10.35 NA 1.06 19.19 NA 090 27637 A Remove/graft leg bone lesion 9.85 11.58 NA 1.38 22.81 NA 090 27638 A Remove/graft leg bone lesion 10.57 12.14 NA 1.47 24.18 NA 090 27640 A Partial removal of tibia 11.37 17.11 NA 1.54 30.02 NA 090 27641 A Partial removal of fibula 9.24 14.98 NA 1.22 25.44 NA 090 27645 A Extensive lower leg surgery 14.17 16.93 NA 1.98 33.08 NA 090 27646 A Extensive lower leg surgery 12.66 15.65 NA 1.55 29.86 NA 090 27647 A Extensive ankle/heel surgery 12.24 10.62 NA 1.64 24.50 NA 090 27648 A Injection for ankle x-ray 0.96 0.34 9.37 0.05 1.35 10.38 000 27650 A Repair achilles tendon 9.69 8.97 NA 1.35 20.01 NA 090 27652 A Repair/graft achilles tendon 10.33 9.31 NA 1.45 21.09 NA 090 27654 A Repair of achilles tendon 10.02 9.60 NA 1.41 21.03 NA 090 27656 A Repair leg fascia defect 4.57 6.11 12.80 0.48 11.16 17.85 090 27658 A Repair of leg tendon, each 4.98 8.27 14.26 0.68 13.93 19.92 090 27659 A Repair of leg tendon, each 6.81 9.22 16.82 0.96 16.99 24.59 090 27664 A Repair of leg tendon, each 4.59 8.23 12.05 0.63 13.45 17.27 090 27665 A Repair of leg tendon, each 5.40 8.39 13.42 0.75 14.54 19.57 090 27675 A Repair lower leg tendons 7.18 7.46 NA 1.01 15.65 NA 090 27676 A Repair lower leg tendons 8.42 8.74 NA 1.15 18.31 NA 090 27680 A Release of lower leg tendon 5.74 7.47 NA 0.80 14.01 NA 090 27681 A Release of lower leg tendons 6.82 7.51 NA 0.92 15.25 NA 090 27685 A Revision of lower leg tendon 6.50 7.69 10.30 0.91 15.10 17.71 090 27686 A Revise lower leg tendons 7.46 9.22 16.33 1.05 17.73 24.84 090 27687 A Revision of calf tendon 6.24 7.78 NA 0.88 14.90 NA 090 27690 A Revise lower leg tendon 8.71 8.75 NA 1.22 18.68 NA 090 27691 A Revise lower leg tendon 9.96 10.31 NA 1.40 21.67 NA 090 27692 A Revise additional leg tendon 1.87 0.99 NA 0.26 3.12 NA ZZZ 27695 A Repair of ankle ligament 6.51 8.47 NA 0.90 15.88 NA 090 27696 A Repair of ankle ligaments 8.27 8.96 NA 1.16 18.39 NA 090 27698 A Repair of ankle ligament 9.36 8.70 NA 1.31 19.37 NA 090 27700 A Revision of ankle joint 9.29 7.42 NA 1.24 17.95 NA 090 27702 A Reconstruct ankle joint 13.67 12.31 NA 1.92 27.90 NA 090 27703 A Reconstruction, ankle joint 15.87 13.65 NA 2.24 31.76 NA 090 27704 A Removal of ankle implant 7.62 7.54 NA 0.61 15.77 NA 090 27705 A Incision of tibia 10.38 10.88 NA 1.44 22.70 NA 090 27707 A Incision of fibula 4.37 7.73 NA 0.60 12.70 NA 090 27709 A Incision of tibia & fibula 9.95 10.81 NA 1.39 22.15 NA 090 27712 A Realignment of lower leg 14.25 12.96 NA 2.00 29.21 NA 090 27715 A Revision of lower leg 14.39 14.20 NA 2.00 30.59 NA 090 27720 A Repair of tibia 11.79 12.75 NA 1.66 26.20 NA 090 27722 A Repair/graft of tibia 11.82 12.39 NA 1.65 25.86 NA 090 27724 A Repair/graft of tibia 18.20 16.34 NA 2.10 36.64 NA 090 27725 A Repair of lower leg 15.59 14.94 NA 2.20 32.73 NA 090 27727 A Repair of lower leg 14.01 12.62 NA 1.84 28.47 NA 090 27730 A Repair of tibia epiphysis 7.41 10.05 14.78 0.75 18.21 22.94 090 27732 A Repair of fibula epiphysis 5.32 8.24 11.97 0.63 14.19 17.92 090 27734 A Repair lower leg epiphyses 8.48 9.20 NA 0.85 18.53 NA 090 27740 A Repair of leg epiphyses 9.30 10.50 15.53 1.31 21.11 26.14 090 27742 A Repair of leg epiphyses 10.30 11.08 15.92 1.55 22.93 27.77 090 27745 A Reinforce tibia 10.07 10.86 NA 1.38 22.31 NA 090 27750 A Treatment of tibia fracture 3.19 3.69 5.14 0.43 7.31 8.76 090 27752 A Treatment of tibia fracture 5.84 5.76 7.54 0.82 12.42 14.20 090 27756 A Treatment of tibia fracture 6.78 9.98 NA 0.94 17.70 NA 090 27758 A Treatment of tibia fracture 11.67 11.15 NA 1.52 24.34 NA 090 27759 A Treatment of tibia fracture 13.76 12.70 NA 1.93 28.39 NA 090 Start Printed Page 40429 27760 A Treatment of ankle fracture 3.01 3.54 4.93 0.39 6.94 8.33 090 27762 A Treatment of ankle fracture 5.25 5.34 7.10 0.71 11.30 13.06 090 27766 A Treatment of ankle fracture 8.36 8.07 NA 1.17 17.60 NA 090 27780 A Treatment of fibula fracture 2.65 3.36 4.88 0.33 6.34 7.86 090 27781 A Treatment of fibula fracture 4.40 4.29 6.07 0.57 9.26 11.04 090 27784 A Treatment of fibula fracture 7.11 8.00 NA 0.98 16.09 NA 090 27786 A Treatment of ankle fracture 2.84 3.47 4.90 0.37 6.68 8.11 090 27788 A Treatment of ankle fracture 4.45 4.34 6.06 0.61 9.40 11.12 090 27792 A Treatment of ankle fracture 7.66 7.65 NA 1.07 16.38 NA 090 27808 A Treatment of ankle fracture 2.83 4.08 5.79 0.38 7.29 9.00 090 27810 A Treatment of ankle fracture 5.13 5.31 7.06 0.71 11.15 12.90 090 27814 A Treatment of ankle fracture 10.68 10.27 NA 1.50 22.45 NA 090 27816 A Treatment of ankle fracture 2.89 4.11 5.43 0.37 7.37 8.69 090 27818 A Treatment of ankle fracture 5.50 5.48 7.27 0.74 11.72 13.51 090 27822 A Treatment of ankle fracture 11.00 12.26 NA 1.29 24.55 NA 090 27823 A Treatment of ankle fracture 13.00 13.32 NA 1.65 27.97 NA 090 27824 A Treat lower leg fracture 2.89 4.09 5.83 0.39 7.37 9.11 090 27825 A Treat lower leg fracture 6.19 5.94 7.66 0.85 12.98 14.70 090 27826 A Treat lower leg fracture 8.54 10.89 NA 1.19 20.62 NA 090 27827 A Treat lower leg fracture 14.06 14.00 NA 1.96 30.02 NA 090 27828 A Treat lower leg fracture 16.23 15.15 NA 2.27 33.65 NA 090 27829 A Treat lower leg joint 5.49 7.89 NA 0.77 14.15 NA 090 27830 A Treat lower leg dislocation 3.79 4.05 4.53 0.44 8.28 8.76 090 27831 A Treat lower leg dislocation 4.56 4.97 NA 0.61 10.14 NA 090 27832 A Treat lower leg dislocation 6.49 7.75 NA 0.91 15.15 NA 090 27840 A Treat ankle dislocation 4.58 5.60 NA 0.47 10.65 NA 090 27842 A Treat ankle dislocation 6.21 4.91 NA 0.76 11.88 NA 090 27846 A Treat ankle dislocation 9.79 9.79 NA 1.36 20.94 NA 090 27848 A Treat ankle dislocation 11.20 10.93 NA 1.55 23.68 NA 090 27860 A Fixation of ankle joint 2.34 3.59 NA 0.31 6.24 NA 010 27870 A Fusion of ankle joint 13.91 12.94 NA 1.95 28.80 NA 090 27871 A Fusion of tibiofibular joint 9.17 10.24 NA 1.29 20.70 NA 090 27880 A Amputation of lower leg 11.85 11.64 NA 1.38 24.87 NA 090 27881 A Amputation of lower leg 12.34 12.77 NA 1.59 26.70 NA 090 27882 A Amputation of lower leg 8.94 13.04 NA 1.03 23.01 NA 090 27884 A Amputation follow-up surgery 8.21 10.30 NA 0.95 19.46 NA 090 27886 A Amputation follow-up surgery 9.32 11.00 NA 1.13 21.45 NA 090 27888 A Amputation of foot at ankle 9.67 10.31 NA 1.26 21.24 NA 090 27889 A Amputation of foot at ankle 9.98 10.64 NA 1.19 21.81 NA 090 27892 A Decompression of leg 7.39 8.15 NA 0.86 16.40 NA 090 27893 A Decompression of leg 7.35 8.37 NA 0.90 16.62 NA 090 27894 A Decompression of leg 10.49 9.47 NA 1.25 21.21 NA 090 27899 C Leg/ankle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 28001 A Drainage of bursa of foot 2.73 2.87 4.72 0.31 5.91 7.76 010 28002 A Treatment of foot infection 4.62 4.11 6.34 0.56 9.29 11.52 010 28003 A Treatment of foot infection 8.41 10.05 10.23 1.03 19.49 19.67 090 28005 A Treat foot bone lesion 8.68 9.63 NA 1.14 19.45 NA 090 28008 A Incision of foot fascia 4.45 5.83 7.00 0.56 10.84 12.01 090 28010 A Incision of toe tendon 2.84 4.54 6.37 0.39 7.77 9.60 090 28011 A Incision of toe tendons 4.14 6.04 8.32 0.58 10.76 13.04 090 28020 A Exploration of foot joint 5.01 5.81 8.48 0.64 11.46 14.13 090 28022 A Exploration of foot joint 4.67 5.62 7.68 0.62 10.91 12.97 090 28024 A Exploration of toe joint 4.38 5.92 7.41 0.50 10.80 12.29 090 28030 A Removal of foot nerve 6.15 3.44 NA 0.85 10.44 NA 090 28035 A Decompression of tibia nerve 5.09 4.97 8.95 0.71 10.77 14.75 090 28043 A Excision of foot lesion 3.54 4.63 6.68 0.45 8.62 10.67 090 28045 A Excision of foot lesion 4.72 5.24 7.06 0.62 10.58 12.40 090 28046 A Resection of tumor, foot 10.18 10.69 12.22 1.13 22.00 23.53 090 28050 A Biopsy of foot joint lining 4.25 5.23 6.13 0.55 10.03 10.93 090 28052 A Biopsy of foot joint lining 3.94 5.33 7.61 0.51 9.78 12.06 090 28054 A Biopsy of toe joint lining 3.45 5.04 7.21 0.45 8.94 11.11 090 28060 A Partial removal, foot fascia 5.23 5.91 7.83 0.69 11.83 13.75 090 28062 A Removal of foot fascia 6.52 5.97 8.74 0.85 13.34 16.11 090 28070 A Removal of foot joint lining 5.10 5.45 7.97 0.68 11.23 13.75 090 28072 A Removal of foot joint lining 4.58 6.10 7.45 0.64 11.32 12.67 090 28080 A Removal of foot lesion 3.58 4.88 6.86 0.50 8.96 10.94 090 28086 A Excise foot tendon sheath 4.78 6.69 10.90 0.66 12.13 16.34 090 28088 A Excise foot tendon sheath 3.86 5.84 8.17 0.52 10.22 12.55 090 28090 A Removal of foot lesion 4.41 5.10 7.15 0.57 10.08 12.13 090 28092 A Removal of toe lesions 3.64 5.38 7.61 0.46 9.48 11.71 090 28100 A Removal of ankle/heel lesion 5.66 7.00 10.92 0.76 13.42 17.34 090 28102 A Remove/graft foot lesion 7.73 7.99 NA 0.97 16.69 NA 090 28103 A Remove/graft foot lesion 6.50 7.04 10.80 0.89 14.43 18.19 090 28104 A Removal of foot lesion 5.12 6.22 8.21 0.69 12.03 14.02 090 Start Printed Page 40430 28106 A Remove/graft foot lesion 7.16 5.93 NA 1.01 14.10 NA 090 28107 A Remove/graft foot lesion 5.56 6.31 8.70 0.74 12.61 15.00 090 28108 A Removal of toe lesions 4.16 4.80 6.43 0.52 9.48 11.11 090 28110 A Part removal of metatarsal 4.08 6.11 7.87 0.49 10.68 12.44 090 28111 A Part removal of metatarsal 5.01 7.11 10.56 0.63 12.75 16.20 090 28112 A Part removal of metatarsal 4.49 6.71 9.19 0.60 11.80 14.28 090 28113 A Part removal of metatarsal 4.79 6.47 8.43 0.63 11.89 13.85 090 28114 A Removal of metatarsal heads 9.79 10.01 14.52 1.36 21.16 25.67 090 28116 A Revision of foot 7.75 6.47 8.21 1.03 15.25 16.99 090 28118 A Removal of heel bone 5.96 6.43 9.35 0.79 13.18 16.10 090 28119 A Removal of heel spur 5.39 5.47 7.52 0.74 11.60 13.65 090 28120 A Part removal of ankle/heel 5.40 8.96 11.93 0.69 15.05 18.02 090 28122 A Partial removal of foot bone 7.29 8.55 10.38 0.96 16.80 18.63 090 28124 A Partial removal of toe 4.81 6.76 8.04 0.65 12.22 13.50 090 28126 A Partial removal of toe 3.52 6.19 6.89 0.49 10.20 10.90 090 28130 A Removal of ankle bone 8.11 7.90 NA 1.11 17.12 NA 090 28140 A Removal of metatarsal 6.91 7.63 10.94 0.84 15.38 18.69 090 28150 A Removal of toe 4.09 6.43 7.98 0.52 11.04 12.59 090 28153 A Partial removal of toe 3.66 5.33 6.97 0.49 9.48 11.12 090 28160 A Partial removal of toe 3.74 6.36 7.45 0.51 10.61 11.70 090 28171 A Extensive foot surgery 9.60 8.77 NA 1.13 19.50 NA 090 28173 A Extensive foot surgery 8.80 8.07 11.16 1.04 17.91 21.00 090 28175 A Extensive foot surgery 6.05 6.25 8.19 0.75 13.05 14.99 090 28190 A Removal of foot foreign body 1.96 3.19 5.55 0.16 5.31 7.67 010 28192 A Removal of foot foreign body 4.64 5.11 7.06 0.52 10.27 12.22 090 28193 A Removal of foot foreign body 5.73 5.94 7.46 0.63 12.30 13.82 090 28200 A Repair of foot tendon 4.60 5.54 7.61 0.59 10.73 12.80 090 28202 A Repair/graft of foot tendon 6.84 6.42 11.03 0.86 14.12 18.73 090 28208 A Repair of foot tendon 4.37 5.63 7.34 0.59 10.59 12.30 090 28210 A Repair/graft of foot tendon 6.35 5.84 8.55 0.77 12.96 15.67 090 28220 A Release of foot tendon 4.53 5.56 6.68 0.63 10.72 11.84 090 28222 A Release of foot tendons 5.62 6.54 7.17 0.77 12.93 13.56 090 28225 A Release of foot tendon 3.66 5.11 6.57 0.50 9.27 10.73 090 28226 A Release of foot tendons 4.53 6.61 6.61 0.62 11.76 11.76 090 28230 A Incision of foot tendon(s) 4.24 6.20 6.88 0.59 11.03 11.71 090 28232 A Incision of toe tendon 3.39 5.81 6.84 0.48 9.68 10.71 090 28234 A Incision of foot tendon 3.37 5.33 6.91 0.46 9.16 10.74 090 28238 A Revision of foot tendon 7.73 6.95 10.42 1.08 15.76 19.23 090 28240 A Release of big toe 4.36 5.72 6.85 0.61 10.69 11.82 090 28250 A Revision of foot fascia 5.92 6.62 8.40 0.81 13.35 15.13 090 28260 A Release of midfoot joint 7.96 6.88 8.02 1.08 15.92 17.06 090 28261 A Revision of foot tendon 11.73 8.86 9.82 1.66 22.25 23.21 090 28262 A Revision of foot and ankle 15.83 14.52 17.21 2.22 32.57 35.26 090 28264 A Release of midfoot joint 10.35 11.05 11.16 1.46 22.86 22.97 090 28270 A Release of foot contracture 4.76 6.39 7.38 0.67 11.82 12.81 090 28272 A Release of toe joint, each 3.80 4.79 6.35 0.52 9.11 10.67 090 28280 A Fusion of toes 5.19 6.27 8.82 0.72 12.18 14.73 090 28285 A Repair of hammertoe 4.59 5.87 7.57 0.64 11.10 12.80 090 28286 A Repair of hammertoe 4.56 5.93 7.24 0.64 11.13 12.44 090 28288 A Partial removal of foot bone 4.74 7.27 8.26 0.65 12.66 13.65 090 28289 A Repair hallux rigidus 7.04 7.97 9.66 0.96 15.97 17.66 090 28290 A Correction of bunion 5.66 8.02 9.17 0.79 14.47 15.62 090 28292 A Correction of bunion 7.04 6.89 8.87 0.98 14.91 16.89 090 28293 A Correction of bunion 9.15 7.21 9.98 1.28 17.64 20.41 090 28294 A Correction of bunion 8.56 7.19 9.33 1.16 16.91 19.05 090 28296 A Correction of bunion 9.18 7.83 10.01 1.28 18.29 20.47 090 28297 A Correction of bunion 9.18 9.47 12.30 1.31 19.96 22.79 090 28298 A Correction of bunion 7.94 7.52 8.91 1.12 16.58 17.97 090 28299 A Correction of bunion 9.18 7.81 9.97 1.24 18.23 20.39 090 28300 A Incision of heel bone 9.54 8.93 14.62 1.31 19.78 25.47 090 28302 A Incision of ankle bone 9.55 8.75 18.58 1.15 19.45 29.28 090 28304 A Incision of midfoot bones 9.16 7.19 9.35 1.00 17.35 19.51 090 28305 A Incise/graft midfoot bones 10.50 9.21 14.83 0.55 20.26 25.88 090 28306 A Incision of metatarsal 5.86 5.80 9.30 0.81 12.47 15.97 090 28307 A Incision of metatarsal 6.33 7.76 15.35 0.71 14.80 22.39 090 28308 A Incision of metatarsal 5.29 4.92 6.95 0.74 10.95 12.98 090 28309 A Incision of metatarsals 12.78 10.50 NA 1.64 24.92 NA 090 28310 A Revision of big toe 5.43 6.14 8.17 0.76 12.33 14.36 090 28312 A Revision of toe 4.55 6.72 7.78 0.62 11.89 12.95 090 28313 A Repair deformity of toe 5.01 8.16 8.16 0.68 13.85 13.85 090 28315 A Removal of sesamoid bone 4.86 5.06 6.81 0.66 10.58 12.33 090 28320 A Repair of foot bones 9.18 8.11 NA 1.27 18.56 NA 090 28322 A Repair of metatarsals 8.34 8.17 11.63 1.17 17.68 21.14 090 28340 A Resect enlarged toe tissue 6.98 5.73 8.90 0.98 13.69 16.86 090 Start Printed Page 40431 28341 A Resect enlarged toe 8.41 6.57 8.21 1.18 16.16 17.80 090 28344 A Repair extra toe(s) 4.26 5.02 12.54 0.60 9.88 17.40 090 28345 A Repair webbed toe(s) 5.92 6.43 8.86 0.84 13.19 15.62 090 28360 A Reconstruct cleft foot 13.34 12.22 NA 1.88 27.44 NA 090 28400 A Treatment of heel fracture 2.16 4.28 5.15 0.29 6.73 7.60 090 28405 A Treatment of heel fracture 4.57 5.42 6.19 0.63 10.62 11.39 090 28406 A Treatment of heel fracture 6.31 8.08 NA 0.87 15.26 NA 090 28415 A Treat heel fracture 15.97 14.55 NA 2.24 32.76 NA 090 28420 A Treat/graft heel fracture 16.64 14.62 NA 2.29 33.55 NA 090 28430 A Treatment of ankle fracture 2.09 3.84 4.79 0.27 6.20 7.15 090 28435 A Treatment of ankle fracture 3.40 4.34 5.43 0.47 8.21 9.30 090 28436 A Treatment of ankle fracture 4.71 7.27 NA 0.66 12.64 NA 090 28445 A Treat ankle fracture 15.62 12.97 NA 1.29 29.88 NA 090 28450 A Treat midfoot fracture, each 1.90 3.69 4.69 0.25 5.84 6.84 090 28455 A Treat midfoot fracture, each 3.09 4.56 5.17 0.43 8.08 8.69 090 28456 A Treat midfoot fracture 2.68 5.64 NA 0.36 8.68 NA 090 28465 A Treat midfoot fracture, each 7.01 7.32 NA 0.87 15.20 NA 090 28470 A Treat metatarsal fracture 1.99 3.08 4.07 0.26 5.33 6.32 090 28475 A Treat metatarsal fracture 2.97 4.02 4.75 0.41 7.40 8.13 090 28476 A Treat metatarsal fracture 3.38 5.92 NA 0.46 9.76 NA 090 28485 A Treat metatarsal fracture 5.71 7.13 NA 0.80 13.64 NA 090 28490 A Treat big toe fracture 1.09 2.01 2.46 0.13 3.23 3.68 090 28495 A Treat big toe fracture 1.58 2.06 2.59 0.19 3.83 4.36 090 28496 A Treat big toe fracture 2.33 4.26 10.08 0.32 6.91 12.73 090 28505 A Treat big toe fracture 3.81 5.99 10.51 0.50 10.30 14.82 090 28510 A Treatment of toe fracture 1.09 1.99 2.20 0.13 3.21 3.42 090 28515 A Treatment of toe fracture 1.46 2.01 2.43 0.17 3.64 4.06 090 28525 A Treat toe fracture 3.32 5.79 10.05 0.44 9.55 13.81 090 28530 A Treat sesamoid bone fracture 1.06 2.18 2.52 0.13 3.37 3.71 090 28531 A Treat sesamoid bone fracture 2.35 3.40 11.43 0.33 6.08 14.11 090 28540 A Treat foot dislocation 2.04 3.13 3.13 0.24 5.41 5.41 090 28545 A Treat foot dislocation 2.45 3.56 3.56 0.33 6.34 6.34 090 28546 A Treat foot dislocation 3.20 5.31 5.31 0.46 8.97 8.97 090 28555 A Repair foot dislocation 6.30 7.85 13.60 0.88 15.03 20.78 090 28570 A Treat foot dislocation 1.66 3.35 3.36 0.22 5.23 5.24 090 28575 A Treat foot dislocation 3.31 4.90 5.89 0.45 8.66 9.65 090 28576 A Treat foot dislocation 4.17 6.04 13.73 0.56 10.77 18.46 090 28585 A Repair foot dislocation 7.99 7.63 8.63 1.13 16.75 17.75 090 28600 A Treat foot dislocation 1.89 3.67 3.83 0.24 5.80 5.96 090 28605 A Treat foot dislocation 2.71 4.42 4.42 0.35 7.48 7.48 090 28606 A Treat foot dislocation 4.90 6.59 15.56 0.68 12.17 21.14 090 28615 A Repair foot dislocation 7.77 8.82 NA 1.09 17.68 NA 090 28630 A Treat toe dislocation 1.70 2.09 2.09 0.17 3.96 3.96 010 28635 A Treat toe dislocation 1.91 2.32 2.32 0.24 4.47 4.47 010 28636 A Treat toe dislocation 2.77 3.12 6.60 0.39 6.28 9.76 010 28645 A Repair toe dislocation 4.22 4.01 6.01 0.58 8.81 10.81 090 28660 A Treat toe dislocation 1.23 2.27 2.92 0.11 3.61 4.26 010 28665 A Treat toe dislocation 1.92 2.44 2.44 0.24 4.60 4.60 010 28666 A Treat toe dislocation 2.66 2.31 6.55 0.38 5.35 9.59 010 28675 A Repair of toe dislocation 2.92 4.47 8.80 0.41 7.80 12.13 090 28705 A Fusion of foot bones 18.80 14.55 NA 2.13 35.48 NA 090 28715 A Fusion of foot bones 13.10 11.82 NA 1.84 26.76 NA 090 28725 A Fusion of foot bones 11.61 10.68 NA 1.63 23.92 NA 090 28730 A Fusion of foot bones 10.76 9.98 NA 1.51 22.25 NA 090 28735 A Fusion of foot bones 10.85 10.28 NA 1.51 22.64 NA 090 28737 A Revision of foot bones 9.64 8.18 NA 1.36 19.18 NA 090 28740 A Fusion of foot bones 8.02 8.30 13.40 1.13 17.45 22.55 090 28750 A Fusion of big toe joint 7.30 8.51 14.60 1.03 16.84 22.93 090 28755 A Fusion of big toe joint 4.74 5.98 8.64 0.66 11.38 14.04 090 28760 A Fusion of big toe joint 7.75 7.09 9.78 1.07 15.91 18.60 090 28800 A Amputation of midfoot 8.21 8.68 NA 0.98 17.87 NA 090 28805 A Amputation thru metatarsal 8.39 8.86 NA 0.97 18.22 NA 090 28810 A Amputation toe & metatarsal 6.21 7.75 NA 0.70 14.66 NA 090 28820 A Amputation of toe 4.41 6.86 11.18 0.51 11.78 16.10 090 28825 A Partial amputation of toe 3.59 6.70 10.28 0.43 10.72 14.30 090 28899 C Foot/toes surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29000 A Application of body cast 2.25 1.33 2.75 0.30 3.88 5.30 000 29010 A Application of body cast 2.06 1.27 2.56 0.27 3.60 4.89 000 29015 A Application of body cast 2.41 1.17 2.50 0.21 3.79 5.12 000 29020 A Application of body cast 2.11 0.98 2.48 0.16 3.25 4.75 000 29025 A Application of body cast 2.40 1.46 2.92 0.26 4.12 5.58 000 29035 A Application of body cast 1.77 1.09 2.49 0.24 3.10 4.50 000 29040 A Application of body cast 2.22 1.39 1.60 0.35 3.96 4.17 000 29044 A Application of body cast 2.12 1.32 2.72 0.29 3.73 5.13 000 Start Printed Page 40432 29046 A Application of body cast 2.41 1.38 2.86 0.34 4.13 5.61 000 29049 A Application of figure eight 0.89 0.51 1.54 0.12 1.52 2.55 000 29055 A Application of shoulder cast 1.78 1.07 2.16 0.24 3.09 4.18 000 29058 A Application of shoulder cast 1.31 0.64 1.81 0.14 2.09 3.26 000 29065 A Application of long arm cast 0.87 0.54 1.27 0.12 1.53 2.26 000 29075 A Application of forearm cast 0.77 0.47 1.22 0.11 1.35 2.10 000 29085 A Apply hand/wrist cast 0.87 0.47 1.27 0.11 1.45 2.25 000 29105 A Apply long arm splint 0.87 0.40 1.27 0.11 1.38 2.25 000 29125 A Apply forearm splint 0.59 0.29 1.13 0.06 0.94 1.78 000 29126 A Apply forearm splint 0.77 0.45 1.93 0.06 1.28 2.76 000 29130 A Application of finger splint 0.50 0.27 0.92 0.05 0.82 1.47 000 29131 A Application of finger splint 0.55 0.38 1.82 0.03 0.96 2.40 000 29200 A Strapping of chest 0.65 0.30 1.40 0.04 0.99 2.09 000 29220 A Strapping of low back 0.64 0.33 1.05 0.07 1.04 1.76 000 29240 A Strapping of shoulder 0.71 0.32 1.43 0.05 1.08 2.19 000 29260 A Strapping of elbow or wrist 0.55 0.27 1.16 0.04 0.86 1.75 000 29280 A Strapping of hand or finger 0.51 0.27 1.30 0.04 0.82 1.85 000 29305 A Application of hip cast 2.03 1.28 2.44 0.29 3.60 4.76 000 29325 A Application of hip casts 2.32 1.44 2.59 0.31 4.07 5.22 000 29345 A Application of long leg cast 1.40 0.85 1.65 0.19 2.44 3.24 000 29355 A Application of long leg cast 1.53 0.87 1.67 0.20 2.60 3.40 000 29358 A Apply long leg cast brace 1.43 0.93 1.86 0.19 2.55 3.48 000 29365 A Application of long leg cast 1.18 0.72 1.50 0.17 2.07 2.85 000 29405 A Apply short leg cast 0.86 0.52 1.18 0.12 1.50 2.16 000 29425 A Apply short leg cast 1.01 0.56 1.13 0.14 1.71 2.28 000 29435 A Apply short leg cast 1.18 0.79 1.79 0.17 2.14 3.14 000 29440 A Addition of walker to cast 0.57 0.32 0.90 0.07 0.96 1.54 000 29445 A Apply rigid leg cast 1.78 0.86 2.01 0.24 2.88 4.03 000 29450 A Application of leg cast 2.08 1.01 1.69 0.13 3.22 3.90 000 29505 A Application, long leg splint 0.69 0.42 1.61 0.06 1.17 2.36 000 29515 A Application lower leg splint 0.73 0.43 1.17 0.07 1.23 1.97 000 29520 A Strapping of hip 0.54 0.38 1.54 0.02 0.94 2.10 000 29530 A Strapping of knee 0.57 0.28 1.22 0.04 0.89 1.83 000 29540 A Strapping of ankle 0.51 0.26 0.51 0.04 0.81 1.06 000 29550 A Strapping of toes 0.47 0.24 0.50 0.05 0.76 1.02 000 29580 A Application of paste boot 0.57 0.31 0.85 0.05 0.93 1.47 000 29590 A Application of foot splint 0.76 0.41 0.79 0.06 1.23 1.61 000 29700 A Removal/revision of cast 0.57 0.31 0.81 0.07 0.95 1.45 000 29705 A Removal/revision of cast 0.76 0.41 0.97 0.10 1.27 1.83 000 29710 A Removal/revision of cast 1.34 0.85 1.78 0.17 2.36 3.29 000 29715 A Removal/revision of cast 0.94 0.72 3.90 0.08 1.74 4.92 000 29720 A Repair of body cast 0.68 0.50 1.45 0.10 1.28 2.23 000 29730 A Windowing of cast 0.75 0.39 0.92 0.10 1.24 1.77 000 29740 A Wedging of cast 1.12 0.53 1.35 0.15 1.80 2.62 000 29750 A Wedging of clubfoot cast 1.26 0.59 1.58 0.16 2.01 3.00 000 29799 C Casting/strapping procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 A Jaw arthroscopy/surgery 6.43 8.44 NA 0.84 15.71 NA 090 29804 A Jaw arthroscopy/surgery 8.14 8.83 NA 0.66 17.63 NA 090 29815 A Shoulder arthroscopy 5.89 7.31 NA 0.83 14.03 NA 090 29819 A Shoulder arthroscopy/surgery 7.62 9.18 NA 1.07 17.87 NA 090 29820 A Shoulder arthroscopy/surgery 7.07 8.81 NA 0.99 16.87 NA 090 29821 A Shoulder arthroscopy/surgery 7.72 9.18 NA 1.08 17.98 NA 090 29822 A Shoulder arthroscopy/surgery 7.43 9.06 NA 1.04 17.53 NA 090 29823 A Shoulder arthroscopy/surgery 8.17 9.43 NA 1.15 18.75 NA 090 29825 A Shoulder arthroscopy/surgery 7.62 9.19 NA 1.06 17.87 NA 090 29826 A Shoulder arthroscopy/surgery 8.99 9.92 NA 1.26 20.17 NA 090 29830 A Elbow arthroscopy 5.76 5.72 NA 0.79 12.27 NA 090 29834 A Elbow arthroscopy/surgery 6.28 6.51 NA 0.86 13.65 NA 090 29835 A Elbow arthroscopy/surgery 6.48 6.50 NA 0.88 13.86 NA 090 29836 A Elbow arthroscopy/surgery 7.55 7.24 NA 1.06 15.85 NA 090 29837 A Elbow arthroscopy/surgery 6.87 6.80 NA 0.96 14.63 NA 090 29838 A Elbow arthroscopy/surgery 7.71 7.31 NA 1.07 16.09 NA 090 29840 A Wrist arthroscopy 5.54 8.36 NA 0.69 14.59 NA 090 29843 A Wrist arthroscopy/surgery 6.01 7.95 NA 0.82 14.78 NA 090 29844 A Wrist arthroscopy/surgery 6.37 8.11 NA 0.86 15.34 NA 090 29845 A Wrist arthroscopy/surgery 7.52 8.57 NA 0.84 16.93 NA 090 29846 A Wrist arthroscopy/surgery 6.75 10.62 NA 0.89 18.26 NA 090 29847 A Wrist arthroscopy/surgery 7.08 10.57 NA 0.91 18.56 NA 090 29848 A Wrist endoscopy/surgery 5.44 7.82 NA 0.72 13.98 NA 090 29850 A Knee arthroscopy/surgery 8.19 7.05 NA 0.74 15.98 NA 090 29851 A Knee arthroscopy/surgery 13.10 11.36 NA 1.81 26.27 NA 090 29855 A Tibial arthroscopy/surgery 10.62 10.01 NA 1.50 22.13 NA 090 29856 A Tibial arthroscopy/surgery 14.14 11.98 NA 2.00 28.12 NA 090 29860 A Hip arthroscopy, dx 8.05 7.61 NA 1.14 16.80 NA 090 Start Printed Page 40433 29861 A Hip arthroscopy/surgery 9.15 8.76 NA 1.29 19.20 NA 090 29862 A Hip arthroscopy/surgery 9.90 9.09 NA 1.39 20.38 NA 090 29863 A Hip arthroscopy/surgery 9.90 9.71 NA 1.40 21.01 NA 090 29870 A Knee arthroscopy, dx 5.07 5.81 NA 0.67 11.55 NA 090 29871 A Knee arthroscopy/drainage 6.55 7.74 NA 0.88 15.17 NA 090 29874 A Knee arthroscopy/surgery 7.05 7.42 NA 0.87 15.34 NA 090 29875 A Knee arthroscopy/surgery 6.31 7.15 NA 0.88 14.34 NA 090 29876 A Knee arthroscopy/surgery 7.92 8.57 NA 1.11 17.60 NA 090 29877 A Knee arthroscopy/surgery 7.35 7.74 NA 1.03 16.12 NA 090 29879 A Knee arthroscopy/surgery 8.04 8.13 NA 1.13 17.30 NA 090 29880 A Knee arthroscopy/surgery 8.50 8.39 NA 1.19 18.08 NA 090 29881 A Knee arthroscopy/surgery 7.76 7.97 NA 1.09 16.82 NA 090 29882 A Knee arthroscopy/surgery 8.65 8.02 NA 1.09 17.76 NA 090 29883 A Knee arthroscopy/surgery 11.05 9.82 NA 1.33 22.20 NA 090 29884 A Knee arthroscopy/surgery 7.33 8.25 NA 1.03 16.61 NA 090 29885 A Knee arthroscopy/surgery 9.09 9.19 NA 1.27 19.55 NA 090 29886 A Knee arthroscopy/surgery 7.54 8.36 NA 1.06 16.96 NA 090 29887 A Knee arthroscopy/surgery 9.04 9.19 NA 1.27 19.50 NA 090 29888 A Knee arthroscopy/surgery 13.90 11.89 NA 1.95 27.74 NA 090 29889 A Knee arthroscopy/surgery 16.00 12.98 NA 2.11 31.09 NA 090 29891 A Ankle arthroscopy/surgery 8.40 8.76 NA 1.17 18.33 NA 090 29892 A Ankle arthroscopy/surgery 9.00 8.60 NA 1.26 18.86 NA 090 29893 A Scope, plantar fasciotomy 5.22 4.81 NA 0.74 10.77 NA 090 29894 A Ankle arthroscopy/surgery 7.21 7.40 NA 1.01 15.62 NA 090 29895 A Ankle arthroscopy/surgery 6.99 7.69 NA 0.97 15.65 NA 090 29897 A Ankle arthroscopy/surgery 7.18 8.29 NA 1.01 16.48 NA 090 29898 A Ankle arthroscopy/surgery 8.32 8.15 NA 1.14 17.61 NA 090 29909 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 A Drainage of nose lesion 1.43 1.45 2.41 0.10 2.98 3.94 010 30020 A Drainage of nose lesion 1.43 1.54 2.62 0.08 3.05 4.13 010 30100 A Intranasal biopsy 0.94 0.53 1.28 0.06 1.53 2.28 000 30110 A Removal of nose polyp(s) 1.63 0.90 2.66 0.12 2.65 4.41 010 30115 A Removal of nose polyp(s) 4.35 4.37 NA 0.31 9.03 NA 090 30117 A Removal of intranasal lesion 3.16 3.10 4.66 0.22 6.48 8.04 090 30118 A Removal of intranasal lesion 9.69 7.48 NA 0.66 17.83 NA 090 30120 A Revision of nose 5.27 5.93 5.93 0.41 11.61 11.61 090 30124 A Removal of nose lesion 3.10 3.27 NA 0.20 6.57 NA 090 30125 A Removal of nose lesion 7.16 6.29 NA 0.54 13.99 NA 090 30130 A Removal of turbinate bones 3.38 3.81 NA 0.22 7.41 NA 090 30140 A Removal of turbinate bones 3.43 4.40 NA 0.24 8.07 NA 090 30150 A Partial removal of nose 9.14 8.58 NA 0.76 18.48 NA 090 30160 A Removal of nose 9.58 8.39 NA 0.78 18.75 NA 090 30200 A Injection treatment of nose 0.78 0.45 1.16 0.06 1.29 2.00 000 30210 A Nasal sinus therapy 1.08 0.61 2.04 0.08 1.77 3.20 010 30220 A Insert nasal septal button 1.54 0.87 2.36 0.11 2.52 4.01 010 30300 A Remove nasal foreign body 1.04 0.38 2.43 0.07 1.49 3.54 010 30310 A Remove nasal foreign body 1.96 1.84 NA 0.14 3.94 NA 010 30320 A Remove nasal foreign body 4.52 5.40 NA 0.36 10.28 NA 090 30400 R Reconstruction of nose 9.83 8.68 NA 0.80 19.31 NA 090 30410 R Reconstruction of nose 12.98 10.55 NA 1.08 24.61 NA 090 30420 R Reconstruction of nose 15.88 12.25 NA 1.24 29.37 NA 090 30430 R Revision of nose 7.21 7.15 NA 0.62 14.98 NA 090 30435 R Revision of nose 11.71 10.47 NA 1.10 23.28 NA 090 30450 R Revision of nose 18.65 14.05 NA 1.53 34.23 NA 090 30460 A Revision of nose 9.96 9.51 NA 0.85 20.32 NA 090 30462 A Revision of nose 19.57 14.96 NA 1.92 36.45 NA 090 30465 A Repair nasal stenosis 11.64 9.21 NA 0.82 21.67 NA 090 30520 A Repair of nasal septum 5.70 5.71 NA 0.41 11.82 NA 090 30540 A Repair nasal defect 7.75 6.46 NA 0.53 14.74 NA 090 30545 A Repair nasal defect 11.38 8.20 NA 0.80 20.38 NA 090 30560 A Release of nasal adhesions 1.26 1.46 2.25 0.09 2.81 3.60 010 30580 A Repair upper jaw fistula 6.69 4.94 4.94 0.50 12.13 12.13 090 30600 A Repair mouth/nose fistula 6.02 5.17 5.17 0.70 11.89 11.89 090 30620 A Intranasal reconstruction 5.97 6.44 NA 0.45 12.86 NA 090 30630 A Repair nasal septum defect 7.12 6.89 NA 0.51 14.52 NA 090 30801 A Cauterization, inner nose 1.09 2.17 2.45 0.08 3.34 3.62 010 30802 A Cauterization, inner nose 2.03 2.72 2.99 0.15 4.90 5.17 010 30901 A Control of nosebleed 1.21 0.44 2.05 0.09 1.74 3.35 000 30903 A Control of nosebleed 1.54 0.63 2.46 0.12 2.29 4.12 000 30905 A Control of nosebleed 1.97 0.89 4.32 0.15 3.01 6.44 000 30906 A Repeat control of nosebleed 2.45 1.35 4.56 0.17 3.97 7.18 000 30915 A Ligation, nasal sinus artery 7.20 6.84 NA 0.50 14.54 NA 090 30920 A Ligation, upper jaw artery 9.83 8.33 NA 0.69 18.85 NA 090 30930 A Therapy, fracture of nose 1.26 2.05 NA 0.09 3.40 NA 010 Start Printed Page 40434 30999 C Nasal surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31000 A Irrigation, maxillary sinus 1.15 0.64 2.33 0.08 1.87 3.56 010 31002 A Irrigation, sphenoid sinus 1.91 1.98 NA 0.14 4.03 NA 010 31020 A Exploration, maxillary sinus 2.94 3.53 4.22 0.20 6.67 7.36 090 31030 A Exploration, maxillary sinus 5.92 4.54 4.79 0.42 10.88 11.13 090 31032 A Explore sinus,remove polyps 6.57 5.91 NA 0.47 12.95 NA 090 31040 A Exploration behind upper jaw 9.42 6.80 NA 0.71 16.93 NA 090 31050 A Exploration, sphenoid sinus 5.28 4.93 NA 0.39 10.60 NA 090 31051 A Sphenoid sinus surgery 7.11 6.35 NA 0.55 14.01 NA 090 31070 A Exploration of frontal sinus 4.28 4.85 NA 0.30 9.43 NA 090 31075 A Exploration of frontal sinus 9.16 8.02 NA 0.64 17.82 NA 090 31080 A Removal of frontal sinus 11.42 8.69 NA 0.78 20.89 NA 090 31081 A Removal of frontal sinus 12.75 9.38 NA 1.84 23.97 NA 090 31084 A Removal of frontal sinus 13.51 10.41 NA 0.96 24.88 NA 090 31085 A Removal of frontal sinus 14.20 10.67 NA 1.18 26.05 NA 090 31086 A Removal of frontal sinus 12.86 9.97 NA 0.90 23.73 NA 090 31087 A Removal of frontal sinus 13.10 10.51 NA 1.15 24.76 NA 090 31090 A Exploration of sinuses 9.53 8.66 NA 0.66 18.85 NA 090 31200 A Removal of ethmoid sinus 4.97 5.52 NA 0.25 10.74 NA 090 31201 A Removal of ethmoid sinus 8.37 7.61 NA 0.58 16.56 NA 090 31205 A Removal of ethmoid sinus 10.24 8.20 NA 0.58 19.02 NA 090 31225 A Removal of upper jaw 19.23 14.89 NA 1.38 35.50 NA 090 31230 A Removal of upper jaw 21.94 16.19 NA 1.57 39.70 NA 090 31231 A Nasal endoscopy, dx 1.10 0.59 1.91 0.08 1.77 3.09 000 31233 A Nasal/sinus endoscopy, dx 2.18 1.19 2.55 0.16 3.53 4.89 000 31235 A Nasal/sinus endoscopy, dx 2.64 1.49 2.82 0.18 4.31 5.64 000 31237 A Nasal/sinus endoscopy, surg 2.98 1.65 3.10 0.21 4.84 6.29 000 31238 A Nasal/sinus endoscopy, surg 3.26 1.86 3.59 0.23 5.35 7.08 000 31239 A Nasal/sinus endoscopy, surg 8.70 6.37 NA 0.46 15.53 NA 010 31240 A Nasal/sinus endoscopy, surg 2.61 1.59 NA 0.18 4.38 NA 000 31254 A Revision of ethmoid sinus 4.65 2.75 NA 0.32 7.72 NA 000 31255 A Removal of ethmoid sinus 6.96 4.07 NA 0.49 11.52 NA 000 31256 A Exploration maxillary sinus 3.29 1.98 NA 0.23 5.50 NA 000 31267 A Endoscopy, maxillary sinus 5.46 3.22 NA 0.38 9.06 NA 000 31276 A Sinus endoscopy, surgical 8.85 5.16 NA 0.62 14.63 NA 000 31287 A Nasal/sinus endoscopy, surg 3.92 2.34 NA 0.27 6.53 NA 000 31288 A Nasal/sinus endoscopy, surg 4.58 2.71 NA 0.32 7.61 NA 000 31290 A Nasal/sinus endoscopy, surg 17.24 11.70 NA 1.20 30.14 NA 010 31291 A Nasal/sinus endoscopy, surg 18.19 11.90 NA 1.73 31.82 NA 010 31292 A Nasal/sinus endoscopy, surg 14.76 10.04 NA 0.99 25.79 NA 010 31293 A Nasal/sinus endoscopy, surg 16.21 10.71 NA 0.97 27.89 NA 010 31294 A Nasal/sinus endoscopy, surg 19.06 11.48 NA 1.04 31.58 NA 010 31299 C Sinus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31300 A Removal of larynx lesion 14.29 16.71 NA 0.99 31.99 NA 090 31320 A Diagnostic incision, larynx 5.26 13.00 NA 0.40 18.66 NA 090 31360 A Removal of larynx 17.08 18.54 NA 1.20 36.82 NA 090 31365 A Removal of larynx 24.16 22.21 NA 1.72 48.09 NA 090 31367 A Partial removal of larynx 21.86 22.87 NA 1.57 46.30 NA 090 31368 A Partial removal of larynx 27.09 27.69 NA 1.90 56.68 NA 090 31370 A Partial removal of larynx 21.38 22.65 NA 1.51 45.54 NA 090 31375 A Partial removal of larynx 20.21 20.63 NA 1.43 42.27 NA 090 31380 A Partial removal of larynx 20.21 20.16 NA 1.40 41.77 NA 090 31382 A Partial removal of larynx 20.52 22.33 NA 1.44 44.29 NA 090 31390 A Removal of larynx & pharynx 27.53 28.12 NA 1.95 57.60 NA 090 31395 A Reconstruct larynx & pharynx 31.09 33.15 NA 2.27 66.51 NA 090 31400 A Revision of larynx 10.31 15.09 NA 0.72 26.12 NA 090 31420 A Removal of epiglottis 10.22 14.89 NA 0.71 25.82 NA 090 31500 A Insert emergency airway 2.33 0.68 NA 0.15 3.16 NA 000 31502 A Change of windpipe airway 0.65 0.27 1.85 0.04 0.96 2.54 000 31505 A Diagnostic laryngoscopy 0.61 0.34 1.74 0.04 0.99 2.39 000 31510 A Laryngoscopy with biopsy 1.92 1.01 2.70 0.15 3.08 4.77 000 31511 A Remove foreign body, larynx 2.16 0.77 2.94 0.16 3.09 5.26 000 31512 A Removal of larynx lesion 2.07 1.14 2.89 0.16 3.37 5.12 000 31513 A Injection into vocal cord 2.10 1.29 NA 0.15 3.54 NA 000 31515 A Laryngoscopy for aspiration 1.80 0.85 2.40 0.12 2.77 4.32 000 31520 A Diagnostic laryngoscopy 2.56 1.41 NA 0.17 4.14 NA 000 31525 A Diagnostic laryngoscopy 2.63 1.50 2.82 0.18 4.31 5.63 000 31526 A Diagnostic laryngoscopy 2.57 1.56 NA 0.18 4.31 NA 000 31527 A Laryngoscopy for treatment 3.27 1.72 NA 0.21 5.20 NA 000 31528 A Laryngoscopy and dilatation 2.37 1.31 NA 0.16 3.84 NA 000 31529 A Laryngoscopy and dilatation 2.68 1.59 NA 0.18 4.45 NA 000 31530 A Operative laryngoscopy 3.39 1.83 NA 0.24 5.46 NA 000 31531 A Operative laryngoscopy 3.59 2.15 NA 0.25 5.99 NA 000 31535 A Operative laryngoscopy 3.16 1.86 NA 0.22 5.24 NA 000 Start Printed Page 40435 31536 A Operative laryngoscopy 3.56 2.12 NA 0.25 5.93 NA 000 31540 A Operative laryngoscopy 4.13 2.43 NA 0.29 6.85 NA 000 31541 A Operative laryngoscopy 4.53 2.68 NA 0.32 7.53 NA 000 31560 A Operative laryngoscopy 5.46 3.06 NA 0.38 8.90 NA 000 31561 A Operative laryngoscopy 6.00 3.53 NA 0.42 9.95 NA 000 31570 A Laryngoscopy with injection 3.87 2.28 4.21 0.24 6.39 8.32 000 31571 A Laryngoscopy with injection 4.27 2.53 NA 0.30 7.10 NA 000 31575 A Diagnostic laryngoscopy 1.10 0.62 2.10 0.08 1.80 3.28 000 31576 A Laryngoscopy with biopsy 1.97 0.98 2.36 0.13 3.08 4.46 000 31577 A Remove foreign body, larynx 2.47 1.34 2.79 0.17 3.98 5.43 000 31578 A Removal of larynx lesion 2.84 1.59 3.00 0.20 4.63 6.04 000 31579 A Diagnostic laryngoscopy 2.26 1.22 2.84 0.16 3.64 5.26 000 31580 A Revision of larynx 12.38 15.82 NA 0.87 29.07 NA 090 31582 A Revision of larynx 21.62 21.18 NA 1.52 44.32 NA 090 31584 A Treat larynx fracture 19.64 18.51 NA 1.42 39.57 NA 090 31585 A Treat larynx fracture 4.64 8.67 NA 0.30 13.61 NA 090 31586 A Treat larynx fracture 8.03 12.02 NA 0.56 20.61 NA 090 31587 A Revision of larynx 11.99 13.39 NA 0.88 26.26 NA 090 31588 A Revision of larynx 13.11 16.53 NA 0.92 30.56 NA 090 31590 A Reinnervate larynx 6.97 11.67 NA 0.50 19.14 NA 090 31595 A Larynx nerve surgery 8.34 10.54 NA 0.62 19.50 NA 090 31599 C Larynx surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31600 A Incision of windpipe 7.18 3.12 NA 0.34 10.64 NA 000 31601 A Incision of windpipe 4.45 2.11 NA 0.39 6.95 NA 000 31603 A Incision of windpipe 4.15 1.67 NA 0.35 6.17 NA 000 31605 A Incision of windpipe 3.58 1.24 NA 0.33 5.15 NA 000 31610 A Incision of windpipe 8.76 10.50 NA 0.69 19.95 NA 090 31611 A Surgery/speech prosthesis 5.64 9.78 NA 0.40 15.82 NA 090 31612 A Puncture/clear windpipe 0.91 0.43 1.49 0.06 1.40 2.46 000 31613 A Repair windpipe opening 4.59 8.57 NA 0.37 13.53 NA 090 31614 A Repair windpipe opening 7.12 11.72 NA 0.51 19.35 NA 090 31615 A Visualization of windpipe 2.09 1.20 3.54 0.14 3.43 5.77 000 31622 A Dx bronchoscope/wash 2.78 1.19 3.30 0.14 4.11 6.22 000 31623 A Dx bronchoscope/brush 2.88 1.20 3.23 0.14 4.22 6.25 000 31624 A Dx bronchoscope/lavage 2.88 1.20 2.90 0.13 4.21 5.91 000 31625 A Bronchoscopy with biopsy 3.37 1.34 2.93 0.16 4.87 6.46 000 31628 A Bronchoscopy with biopsy 3.81 1.45 3.36 0.14 5.40 7.31 000 31629 A Bronchoscopy with biopsy 3.37 1.32 NA 0.13 4.82 NA 000 31630 A Bronchoscopy with repair 3.82 2.03 NA 0.30 6.15 NA 000 31631 A Bronchoscopy with dilation 4.37 2.06 NA 0.31 6.74 NA 000 31635 A Remove foreign body, airway 3.68 1.73 NA 0.21 5.62 NA 000 31640 A Bronchoscopy & remove lesion 4.94 2.37 NA 0.37 7.68 NA 000 31641 A Bronchoscopy, treat blockage 5.03 2.20 NA 0.30 7.53 NA 000 31643 A Diag bronchoscope/catheter 3.50 1.17 1.17 0.15 4.82 4.82 000 31645 A Bronchoscopy, clear airways 3.16 1.26 NA 0.13 4.55 NA 000 31646 A Bronchoscopy, reclear airway 2.72 1.12 NA 0.12 3.96 NA 000 31656 A Bronchoscopy, inj for xray 2.17 0.94 NA 0.10 3.21 NA 000 31700 A Insertion of airway catheter 1.34 0.75 2.53 0.07 2.16 3.94 000 31708 A Instill airway contrast dye 1.41 0.63 NA 0.06 2.10 NA 000 31710 A Insertion of airway catheter 1.30 0.74 NA 0.06 2.10 NA 000 31715 A Injection for bronchus x-ray 1.11 0.66 NA 0.06 1.83 NA 000 31717 A Bronchial brush biopsy 2.12 0.92 2.79 0.09 3.13 5.00 000 31720 A Clearance of airways 1.06 0.34 1.88 0.06 1.46 3.00 000 31725 A Clearance of airways 1.96 0.62 NA 0.10 2.68 NA 000 31730 A Intro, windpipe wire/tube 2.85 1.13 2.43 0.15 4.13 5.43 000 31750 A Repair of windpipe 13.02 15.46 NA 1.02 29.50 NA 090 31755 A Repair of windpipe 15.93 18.50 NA 1.15 35.58 NA 090 31760 A Repair of windpipe 22.35 11.89 NA 1.48 35.72 NA 090 31766 A Reconstruction of windpipe 30.43 17.60 NA 3.16 51.19 NA 090 31770 A Repair/graft of bronchus 22.51 14.69 NA 2.27 39.47 NA 090 31775 A Reconstruct bronchus 23.54 14.06 NA 2.91 40.51 NA 090 31780 A Reconstruct windpipe 17.72 12.93 NA 1.55 32.20 NA 090 31781 A Reconstruct windpipe 23.53 13.82 NA 2.04 39.39 NA 090 31785 A Remove windpipe lesion 17.23 12.69 NA 1.36 31.28 NA 090 31786 A Remove windpipe lesion 23.98 14.62 NA 2.20 40.80 NA 090 31800 A Repair of windpipe injury 7.43 6.95 NA 0.67 15.05 NA 090 31805 A Repair of windpipe injury 13.13 10.09 NA 1.45 24.67 NA 090 31820 A Closure of windpipe lesion 4.49 7.70 7.74 0.35 12.54 12.58 090 31825 A Repair of windpipe defect 6.81 10.92 11.15 0.50 18.23 18.46 090 31830 A Revise windpipe scar 4.50 7.84 7.84 0.36 12.70 12.70 090 31899 C Airways surgical procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 32000 A Drainage of chest 1.54 0.51 3.04 0.07 2.12 4.65 000 32002 A Treatment of collapsed lung 2.19 0.87 NA 0.11 3.17 NA 000 32005 A Treat lung lining chemically 2.19 0.88 NA 0.17 3.24 NA 000 Start Printed Page 40436 32020 A Insertion of chest tube 3.98 1.48 NA 0.36 5.82 NA 000 32035 A Exploration of chest 8.67 7.78 NA 1.02 17.47 NA 090 32036 A Exploration of chest 9.68 8.82 NA 1.20 19.70 NA 090 32095 A Biopsy through chest wall 8.36 8.17 NA 0.99 17.52 NA 090 32100 A Exploration/biopsy of chest 15.24 10.45 NA 1.45 27.14 NA 090 32110 A Explore/repair chest 23.00 13.15 NA 1.63 37.78 NA 090 32120 A Re-exploration of chest 11.54 9.57 NA 1.42 22.53 NA 090 32124 A Explore chest free adhesions 12.72 9.38 NA 1.51 23.61 NA 090 32140 A Removal of lung lesion(s) 13.93 10.02 NA 1.68 25.63 NA 090 32141 A Remove/treat lung lesions 14.00 10.20 NA 1.72 25.92 NA 090 32150 A Removal of lung lesion(s) 14.15 9.78 NA 1.60 25.53 NA 090 32151 A Remove lung foreign body 14.21 10.46 NA 1.49 26.16 NA 090 32160 A Open chest heart massage 9.30 6.29 NA 1.01 16.60 NA 090 32200 A Drain, open, lung lesion 15.29 10.30 NA 1.46 27.05 NA 090 32201 A Drain, percut, lung lesion 4.00 6.49 NA 0.18 10.67 NA 000 32215 A Treat chest lining 11.33 9.64 NA 1.34 22.31 NA 090 32220 A Release of lung 24.00 13.70 NA 2.39 40.09 NA 090 32225 A Partial release of lung 13.96 10.10 NA 1.70 25.76 NA 090 32310 A Removal of chest lining 13.44 9.86 NA 1.65 24.95 NA 090 32320 A Free/remove chest lining 24.00 13.32 NA 2.50 39.82 NA 090 32400 A Needle biopsy chest lining 1.76 0.58 1.94 0.07 2.41 3.77 000 32402 A Open biopsy chest lining 7.56 8.16 NA 0.91 16.63 NA 090 32405 A Biopsy, lung or mediastinum 1.93 0.67 2.34 0.09 2.69 4.36 000 32420 A Puncture/clear lung 2.18 0.86 NA 0.11 3.15 NA 000 32440 A Removal of lung 25.00 13.83 NA 2.56 41.39 NA 090 32442 A Sleeve pneumonectomy 26.24 15.04 NA 3.12 44.40 NA 090 32445 A Removal of lung 25.09 13.71 NA 3.11 41.91 NA 090 32480 A Partial removal of lung 23.75 12.95 NA 2.24 38.94 NA 090 32482 A Bilobectomy 25.00 13.65 NA 2.35 41.00 NA 090 32484 A Segmentectomy 20.69 12.09 NA 2.54 35.32 NA 090 32486 A Sleeve lobectomy 23.92 13.44 NA 3.00 40.36 NA 090 32488 A Completion pneumonectomy 25.71 14.22 NA 3.18 43.11 NA 090 32491 R Lung volume reduction 21.25 13.52 NA 2.66 37.43 NA 090 32500 A Partial removal of lung 22.00 12.94 NA 1.77 36.71 NA 090 32501 A Repair bronchus add-on 4.69 1.59 NA 0.56 6.84 NA ZZZ 32520 A Remove lung & revise chest 21.68 12.88 NA 2.71 37.27 NA 090 32522 A Remove lung & revise chest 24.20 13.48 NA 2.84 40.52 NA 090 32525 A Remove lung & revise chest 26.50 14.29 NA 3.25 44.04 NA 090 32540 A Removal of lung lesion 14.64 10.51 NA 1.84 26.99 NA 090 32601 A Thoracoscopy, diagnostic 5.46 3.67 NA 0.63 9.76 NA 000 32602 A Thoracoscopy, diagnostic 5.96 3.85 NA 0.70 10.51 NA 000 32603 A Thoracoscopy, diagnostic 7.81 4.29 NA 0.76 12.86 NA 000 32604 A Thoracoscopy, diagnostic 8.78 4.83 NA 0.97 14.58 NA 000 32605 A Thoracoscopy, diagnostic 6.93 4.36 NA 0.86 12.15 NA 000 32606 A Thoracoscopy, diagnostic 8.40 4.65 NA 0.99 14.04 NA 000 32650 A Thoracoscopy, surgical 10.75 8.63 NA 1.25 20.63 NA 090 32651 A Thoracoscopy, surgical 12.91 8.87 NA 1.50 23.28 NA 090 32652 A Thoracoscopy, surgical 18.66 11.51 NA 2.30 32.47 NA 090 32653 A Thoracoscopy, surgical 12.87 9.30 NA 1.55 23.72 NA 090 32654 A Thoracoscopy, surgical 12.44 7.38 NA 1.51 21.33 NA 090 32655 A Thoracoscopy, surgical 13.10 8.99 NA 1.53 23.62 NA 090 32656 A Thoracoscopy, surgical 12.91 9.71 NA 1.61 24.23 NA 090 32657 A Thoracoscopy, surgical 13.65 9.51 NA 1.64 24.80 NA 090 32658 A Thoracoscopy, surgical 11.63 9.85 NA 1.47 22.95 NA 090 32659 A Thoracoscopy, surgical 11.59 8.96 NA 1.39 21.94 NA 090 32660 A Thoracoscopy, surgical 17.43 10.64 NA 2.09 30.16 NA 090 32661 A Thoracoscopy, surgical 13.25 9.75 NA 1.66 24.66 NA 090 32662 A Thoracoscopy, surgical 16.44 10.73 NA 2.01 29.18 NA 090 32663 A Thoracoscopy, surgical 18.47 11.44 NA 2.28 32.19 NA 090 32664 A Thoracoscopy, surgical 14.20 9.22 NA 1.70 25.12 NA 090 32665 A Thoracoscopy, surgical 15.54 9.49 NA 1.79 26.82 NA 090 32800 A Repair lung hernia 13.69 9.70 NA 1.51 24.90 NA 090 32810 A Close chest after drainage 13.05 9.65 NA 1.55 24.25 NA 090 32815 A Close bronchial fistula 23.15 13.57 NA 2.84 39.56 NA 090 32820 A Reconstruct injured chest 21.48 13.85 NA 2.31 37.64 NA 090 32850 X Donor pneumonectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32851 A Lung transplant, single 38.63 20.37 NA 4.90 63.90 NA 090 32852 A Lung transplant with bypass 41.80 22.29 NA 5.17 69.26 NA 090 32853 A Lung transplant, double 47.81 23.87 NA 6.13 77.81 NA 090 32854 A Lung transplant with bypass 50.98 24.28 NA 6.41 81.67 NA 090 32900 A Removal of rib(s) 20.27 12.21 NA 2.42 34.90 NA 090 32905 A Revise & repair chest wall 20.75 12.70 NA 2.54 35.99 NA 090 32906 A Revise & repair chest wall 26.77 15.56 NA 3.30 45.63 NA 090 32940 A Revision of lung 19.43 12.41 NA 2.47 34.31 NA 090 Start Printed Page 40437 32960 A Therapeutic pneumothorax 1.84 0.60 1.58 0.12 2.56 3.54 000 32997 A Total lung lavage 6.00 2.12 NA 0.55 8.67 NA 000 32999 C Chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 A Drainage of heart sac 2.24 1.00 NA 0.13 3.37 NA 000 33011 A Repeat drainage of heart sac 2.24 1.04 NA 0.13 3.41 NA 000 33015 A Incision of heart sac 6.80 4.48 NA 0.64 11.92 NA 090 33020 A Incision of heart sac 12.61 7.93 NA 1.50 22.04 NA 090 33025 A Incision of heart sac 12.09 7.94 NA 1.50 21.53 NA 090 33030 A Partial removal of heart sac 18.71 12.50 NA 2.40 33.61 NA 090 33031 A Partial removal of heart sac 21.79 13.63 NA 2.78 38.20 NA 090 33050 A Removal of heart sac lesion 14.36 10.20 NA 1.73 26.29 NA 090 33120 A Removal of heart lesion 24.56 16.06 NA 3.06 43.68 NA 090 33130 A Removal of heart lesion 21.39 13.11 NA 2.51 37.01 NA 090 33140 A Heart revascularize (tmr) 20.00 10.59 NA 2.27 32.86 NA 090 33141 A Heart tmr w/other procedure 4.84 1.69 NA 0.60 7.13 NA ZZZ 33200 A Insertion of heart pacemaker 12.48 9.74 NA 1.17 23.39 NA 090 33201 A Insertion of heart pacemaker 10.18 9.67 NA 1.21 21.06 NA 090 33206 A Insertion of heart pacemaker 6.67 5.54 NA 0.50 12.71 NA 090 33207 A Insertion of heart pacemaker 8.04 6.05 NA 0.57 14.66 NA 090 33208 A Insertion of heart pacemaker 8.13 6.20 NA 0.54 14.87 NA 090 33210 A Insertion of heart electrode 3.30 1.32 NA 0.17 4.79 NA 000 33211 A Insertion of heart electrode 3.40 1.39 NA 0.17 4.96 NA 000 33212 A Insertion of pulse generator 5.52 4.48 NA 0.44 10.44 NA 090 33213 A Insertion of pulse generator 6.37 4.86 NA 0.46 11.69 NA 090 33214 A Upgrade of pacemaker system 7.75 6.00 NA 0.52 14.27 NA 090 33216 A Revise eltrd pacing-defib 5.39 4.96 NA 0.36 10.71 NA 090 33217 A Revise eltrd pacing-defib 5.75 5.30 NA 0.36 11.41 NA 090 33218 A Revise eltrd pacing-defib 5.44 4.53 NA 0.40 10.37 NA 090 33220 A Revise eltrd pacing-defib 5.52 4.59 NA 0.39 10.50 NA 090 33222 A Revise pocket, pacemaker 4.96 3.97 NA 0.39 9.32 NA 090 33223 A Revise pocket, pacing-defib 6.46 5.19 NA 0.44 12.09 NA 090 33233 A Removal of pacemaker system 3.29 3.86 NA 0.22 7.37 NA 090 33234 A Removal of pacemaker system 7.82 5.67 NA 0.56 14.05 NA 090 33235 A Removal of pacemaker electro 9.40 6.33 NA 0.68 16.41 NA 090 33236 A Remove electrode/thoracotomy 12.60 9.27 NA 1.49 23.36 NA 090 33237 A Remove electrode/thoracotomy 13.71 9.90 NA 1.57 25.18 NA 090 33238 A Remove electrode/thoracotomy 15.22 9.86 NA 1.56 26.64 NA 090 33240 A Insert pulse generator 7.60 5.57 NA 0.53 13.70 NA 090 33241 A Remove pulse generator 3.24 3.47 NA 0.21 6.92 NA 090 33243 A Remove eltrd/thoracotomy 22.64 10.96 NA 2.53 36.13 NA 090 33244 A Remove eltrd, transven 13.76 8.29 NA 1.05 23.10 NA 090 33245 A Insert epic eltrd pace-defib 14.30 10.98 NA 1.28 26.56 NA 090 33246 A Insert epic eltrd/generator 20.71 14.37 NA 2.22 37.30 NA 090 33249 A Eltrd/insert pace-defib 14.23 9.00 NA 0.80 24.03 NA 090 33250 A Ablate heart dysrhythm focus 21.85 13.79 NA 1.01 36.65 NA 090 33251 A Ablate heart dysrhythm focus 24.88 14.75 NA 2.41 42.04 NA 090 33253 A Reconstruct atria 31.06 17.03 NA 3.68 51.77 NA 090 33261 A Ablate heart dysrhythm focus 24.88 14.70 NA 2.82 42.40 NA 090 33282 A Implant pat-active ht record 4.17 4.64 NA 0.39 9.20 NA 090 33284 A Remove pat-active ht record 2.50 4.16 NA 0.23 6.89 NA 090 33300 A Repair of heart wound 17.92 12.15 NA 1.91 31.98 NA 090 33305 A Repair of heart wound 21.44 13.61 NA 2.68 37.73 NA 090 33310 A Exploratory heart surgery 18.51 12.35 NA 2.26 33.12 NA 090 33315 A Exploratory heart surgery 22.37 13.84 NA 2.90 39.11 NA 090 33320 A Repair major blood vessel(s) 16.79 11.30 NA 1.66 29.75 NA 090 33321 A Repair major vessel 20.20 13.19 NA 2.70 36.09 NA 090 33322 A Repair major blood vessel(s) 20.62 13.29 NA 2.51 36.42 NA 090 33330 A Insert major vessel graft 21.43 13.08 NA 2.49 37.00 NA 090 33332 A Insert major vessel graft 23.96 13.61 NA 2.45 40.02 NA 090 33335 A Insert major vessel graft 30.01 16.34 NA 3.79 50.14 NA 090 33400 A Repair of aortic valve 28.50 17.31 NA 3.09 48.90 NA 090 33401 A Valvuloplasty, open 23.91 15.66 NA 2.71 42.28 NA 090 33403 A Valvuloplasty, w/cp bypass 24.89 15.61 NA 2.48 42.98 NA 090 33404 A Prepare heart-aorta conduit 28.54 17.27 NA 3.31 49.12 NA 090 33405 A Replacement of aortic valve 35.00 18.13 NA 3.86 56.99 NA 090 33406 A Replacement of aortic valve 37.50 18.83 NA 4.07 60.40 NA 090 33410 A Replacement of aortic valve 32.46 17.28 NA 4.11 53.85 NA 090 33411 A Replacement of aortic valve 36.25 18.61 NA 4.16 59.02 NA 090 33412 A Replacement of aortic valve 42.00 22.33 NA 4.66 68.99 NA 090 33413 A Replacement of aortic valve 43.50 23.30 NA 4.26 71.06 NA 090 33414 A Repair of aortic valve 30.35 18.26 NA 3.79 52.40 NA 090 33415 A Revision, subvalvular tissue 27.15 17.07 NA 3.25 47.47 NA 090 33416 A Revise ventricle muscle 30.35 16.61 NA 3.85 50.81 NA 090 33417 A Repair of aortic valve 28.53 17.74 NA 3.58 49.85 NA 090 Start Printed Page 40438 33420 A Revision of mitral valve 22.70 11.82 NA 1.48 36.00 NA 090 33422 A Revision of mitral valve 25.94 15.09 NA 3.30 44.33 NA 090 33425 A Repair of mitral valve 27.00 14.50 NA 3.00 44.50 NA 090 33426 A Repair of mitral valve 33.00 17.51 NA 3.87 54.38 NA 090 33427 A Repair of mitral valve 40.00 19.71 NA 4.30 64.01 NA 090 33430 A Replacement of mitral valve 33.50 17.65 NA 3.95 55.10 NA 090 33460 A Revision of tricuspid valve 23.60 14.40 NA 3.02 41.02 NA 090 33463 A Valvuloplasty, tricuspid 25.62 15.07 NA 3.17 43.86 NA 090 33464 A Valvuloplasty, tricuspid 27.33 15.63 NA 3.47 46.43 NA 090 33465 A Replace tricuspid valve 28.79 15.92 NA 3.61 48.32 NA 090 33468 A Revision of tricuspid valve 30.12 20.51 NA 4.00 54.63 NA 090 33470 A Revision of pulmonary valve 20.81 13.69 NA 2.81 37.31 NA 090 33471 A Valvotomy, pulmonary valve 22.25 14.65 NA 3.00 39.90 NA 090 33472 A Revision of pulmonary valve 22.25 14.77 NA 2.92 39.94 NA 090 33474 A Revision of pulmonary valve 23.04 13.61 NA 2.84 39.49 NA 090 33475 A Replacement, pulmonary valve 33.00 19.81 NA 2.64 55.45 NA 090 33476 A Revision of heart chamber 25.77 14.43 NA 2.40 42.60 NA 090 33478 A Revision of heart chamber 26.74 15.00 NA 3.56 45.30 NA 090 33496 A Repair, prosth valve clot 27.25 17.25 NA 3.44 47.94 NA 090 33500 A Repair heart vessel fistula 25.55 13.93 NA 2.80 42.28 NA 090 33501 A Repair heart vessel fistula 17.78 10.63 NA 2.05 30.46 NA 090 33502 A Coronary artery correction 21.04 16.64 NA 2.51 40.19 NA 090 33503 A Coronary artery graft 21.78 12.32 NA 1.42 35.52 NA 090 33504 A Coronary artery graft 24.66 17.34 NA 3.04 45.04 NA 090 33505 A Repair artery w/tunnel 26.84 18.35 NA 1.52 46.71 NA 090 33506 A Repair artery, translocation 35.50 19.13 NA 3.19 57.82 NA 090 33510 A CABG, vein, single 29.00 16.12 NA 3.13 48.25 NA 090 33511 A CABG, vein, two 30.00 16.25 NA 3.34 49.59 NA 090 33512 A CABG, vein, three 31.80 17.01 NA 3.70 52.51 NA 090 33513 A CABG, vein, four 32.00 17.09 NA 3.99 53.08 NA 090 33514 A CABG, vein, five 32.75 17.36 NA 4.37 54.48 NA 090 33516 A Cabg, vein, six or more 35.00 18.13 NA 4.62 57.75 NA 090 33517 A CABG, artery-vein, single 2.57 0.86 NA 0.32 3.75 NA ZZZ 33518 A CABG, artery-vein, two 4.85 1.63 NA 0.61 7.09 NA ZZZ 33519 A CABG, artery-vein, three 7.12 2.39 NA 0.89 10.40 NA ZZZ 33521 A CABG, artery-vein, four 9.40 3.15 NA 1.18 13.73 NA ZZZ 33522 A CABG, artery-vein, five 11.67 3.91 NA 1.48 17.06 NA ZZZ 33523 A Cabg, art-vein, six or more 13.95 4.62 NA 1.78 20.35 NA ZZZ 33530 A Coronary artery, bypass/reop 5.86 1.95 NA 0.73 8.54 NA ZZZ 33533 A CABG, arterial, single 30.00 16.43 NA 3.24 49.67 NA 090 33534 A CABG, arterial, two 32.20 16.71 NA 3.63 52.54 NA 090 33535 A CABG, arterial, three 34.50 17.46 NA 3.97 55.93 NA 090 33536 A Cabg, arterial, four or more 37.50 15.94 NA 3.29 56.73 NA 090 33542 A Removal of heart lesion 28.85 17.56 NA 3.61 50.02 NA 090 33545 A Repair of heart damage 36.78 20.21 NA 4.40 61.39 NA 090 33572 A Open coronary endarterectomy 4.45 1.50 NA 0.55 6.50 NA ZZZ 33600 A Closure of valve 29.51 16.62 NA 2.30 48.43 NA 090 33602 A Closure of valve 28.54 14.97 NA 2.90 46.41 NA 090 33606 A Anastomosis/artery-aorta 30.74 15.77 NA 3.59 50.10 NA 090 33608 A Repair anomaly w/conduit 31.09 18.69 NA 4.17 53.95 NA 090 33610 A Repair by enlargement 30.61 19.41 NA 4.02 54.04 NA 090 33611 A Repair double ventricle 34.00 18.98 NA 3.28 56.26 NA 090 33612 A Repair double ventricle 35.00 20.65 NA 4.44 60.09 NA 090 33615 A Repair, simple fontan 34.00 21.46 NA 3.15 58.61 NA 090 33617 A Repair, modified fontan 37.00 21.51 NA 4.09 62.60 NA 090 33619 A Repair single ventricle 45.00 25.91 NA 4.71 75.62 NA 090 33641 A Repair heart septum defect 21.39 12.07 NA 2.67 36.13 NA 090 33645 A Revision of heart veins 24.82 14.37 NA 3.27 42.46 NA 090 33647 A Repair heart septum defects 28.73 17.60 NA 3.37 49.70 NA 090 33660 A Repair of heart defects 30.00 17.54 NA 2.82 50.36 NA 090 33665 A Repair of heart defects 28.60 17.59 NA 3.81 50.00 NA 090 33670 A Repair of heart chambers 35.00 16.14 NA 2.18 53.32 NA 090 33681 A Repair heart septum defect 30.61 18.11 NA 3.53 52.25 NA 090 33684 A Repair heart septum defect 29.65 17.18 NA 3.77 50.60 NA 090 33688 A Repair heart septum defect 30.62 16.22 NA 3.89 50.73 NA 090 33690 A Reinforce pulmonary artery 19.55 14.09 NA 2.56 36.20 NA 090 33692 A Repair of heart defects 30.75 16.68 NA 3.77 51.20 NA 090 33694 A Repair of heart defects 34.00 18.48 NA 4.27 56.75 NA 090 33697 A Repair of heart defects 36.00 19.78 NA 4.54 60.32 NA 090 33702 A Repair of heart defects 26.54 15.95 NA 3.45 45.94 NA 090 33710 A Repair of heart defects 29.71 15.86 NA 3.85 49.42 NA 090 33720 A Repair of heart defect 26.56 16.35 NA 3.21 46.12 NA 090 33722 A Repair of heart defect 28.41 17.16 NA 3.80 49.37 NA 090 33730 A Repair heart-vein defect(s) 34.25 17.77 NA 2.85 54.87 NA 090 Start Printed Page 40439 33732 A Repair heart-vein defect 28.16 15.96 NA 2.78 46.90 NA 090 33735 A Revision of heart chamber 21.39 13.10 NA 1.12 35.61 NA 090 33736 A Revision of heart chamber 23.52 15.44 NA 2.70 41.66 NA 090 33737 A Revision of heart chamber 21.76 14.04 NA 2.93 38.73 NA 090 33750 A Major vessel shunt 21.41 14.61 NA 1.74 37.76 NA 090 33755 A Major vessel shunt 21.79 14.05 NA 2.93 38.77 NA 090 33762 A Major vessel shunt 21.79 11.09 NA 1.59 34.47 NA 090 33764 A Major vessel shunt & graft 21.79 12.21 NA 1.93 35.93 NA 090 33766 A Major vessel shunt 22.76 15.50 NA 3.04 41.30 NA 090 33767 A Major vessel shunt 24.50 15.24 NA 3.14 42.88 NA 090 33770 A Repair great vessels defect 37.00 19.57 NA 4.49 61.06 NA 090 33771 A Repair great vessels defect 34.65 17.81 NA 4.67 57.13 NA 090 33774 A Repair great vessels defect 30.98 16.36 NA 4.18 51.52 NA 090 33775 A Repair great vessels defect 32.20 16.84 NA 4.34 53.38 NA 090 33776 A Repair great vessels defect 34.04 17.57 NA 4.58 56.19 NA 090 33777 A Repair great vessels defect 33.46 17.34 NA 4.51 55.31 NA 090 33778 A Repair great vessels defect 40.00 19.93 NA 4.83 64.76 NA 090 33779 A Repair great vessels defect 36.21 18.50 NA 2.40 57.11 NA 090 33780 A Repair great vessels defect 41.75 24.12 NA 5.21 71.08 NA 090 33781 A Repair great vessels defect 36.45 18.52 NA 4.91 59.88 NA 090 33786 A Repair arterial trunk 39.00 20.29 NA 4.69 63.98 NA 090 33788 A Revision of pulmonary artery 26.62 15.90 NA 3.32 45.84 NA 090 33800 A Aortic suspension 16.24 10.41 NA 1.11 27.76 NA 090 33802 A Repair vessel defect 17.66 9.73 NA 1.56 28.95 NA 090 33803 A Repair vessel defect 19.60 13.91 NA 2.63 36.14 NA 090 33813 A Repair septal defect 20.65 13.64 NA 2.78 37.07 NA 090 33814 A Repair septal defect 25.77 17.46 NA 2.52 45.75 NA 090 33820 A Revise major vessel 16.29 11.56 NA 2.10 29.95 NA 090 33822 A Revise major vessel 17.32 13.89 NA 2.33 33.54 NA 090 33824 A Revise major vessel 19.52 12.77 NA 2.61 34.90 NA 090 33840 A Remove aorta constriction 20.63 12.98 NA 2.36 35.97 NA 090 33845 A Remove aorta constriction 22.12 14.93 NA 2.90 39.95 NA 090 33851 A Remove aorta constriction 21.27 13.86 NA 2.86 37.99 NA 090 33852 A Repair septal defect 23.71 15.17 NA 3.19 42.07 NA 090 33853 A Repair septal defect 31.72 18.40 NA 4.23 54.35 NA 090 33860 A Ascending aortic graft 38.00 19.11 NA 4.30 61.41 NA 090 33861 A Ascending aortic graft 42.00 20.36 NA 4.24 66.60 NA 090 33863 A Ascending aortic graft 45.00 21.45 NA 4.60 71.05 NA 090 33870 A Transverse aortic arch graft 44.00 21.05 NA 5.09 70.14 NA 090 33875 A Thoracic aortic graft 33.06 17.33 NA 4.08 54.47 NA 090 33877 A Thoracoabdominal graft 42.60 22.98 NA 5.07 70.65 NA 090 33910 A Remove lung artery emboli 24.59 14.45 NA 3.06 42.10 NA 090 33915 A Remove lung artery emboli 21.02 12.55 NA 1.20 34.77 NA 090 33916 A Surgery of great vessel 25.83 14.01 NA 3.04 42.88 NA 090 33917 A Repair pulmonary artery 24.50 16.12 NA 3.17 43.79 NA 090 33918 A Repair pulmonary atresia 26.45 14.57 NA 3.42 44.44 NA 090 33919 A Repair pulmonary atresia 40.00 21.39 NA 3.48 64.87 NA 090 33920 A Repair pulmonary atresia 31.95 15.83 NA 3.61 51.39 NA 090 33922 A Transect pulmonary artery 23.52 14.54 NA 2.30 40.36 NA 090 33924 A Remove pulmonary shunt 5.50 1.86 NA 0.74 8.10 NA ZZZ 33930 X Removal of donor heart/lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33935 R Transplantation, heart/lung 60.96 28.42 NA 8.15 97.53 NA 090 33940 X Removal of donor heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33945 R Transplantation of heart 42.10 21.97 NA 5.42 69.49 NA 090 33960 A External circulation assist 19.36 6.32 NA 2.14 27.82 NA XXX 33961 A External circulation assist 10.93 3.64 NA 1.47 16.04 NA ZZZ 33968 A Remove aortic assist device 0.64 0.25 NA 0.07 0.96 NA 000 33970 A Aortic circulation assist 6.75 2.36 NA 0.70 9.81 NA 000 33971 A Aortic circulation assist 9.69 7.99 NA 0.97 18.65 NA 090 33973 A Insert balloon device 9.76 3.40 NA 1.01 14.17 NA 000 33974 A Remove intra-aortic balloon 14.41 10.78 NA 1.48 26.67 NA 090 33975 A Implant ventricular device 21.00 5.63 NA 1.72 28.35 NA XXX 33976 A Implant ventricular device 23.00 7.71 NA 2.82 33.53 NA XXX 33977 A Remove ventricular device 19.29 10.57 NA 2.44 32.30 NA 090 33978 A Remove ventricular device 21.73 11.51 NA 2.66 35.90 NA 090 33999 C Cardiac surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 34001 A Removal of artery clot 12.91 5.88 NA 1.46 20.25 NA 090 34051 A Removal of artery clot 15.21 7.04 NA 1.90 24.15 NA 090 34101 A Removal of artery clot 10.00 4.82 NA 1.11 15.93 NA 090 34111 A Removal of arm artery clot 10.00 4.84 NA 0.85 15.69 NA 090 34151 A Removal of artery clot 25.00 10.43 NA 1.84 37.27 NA 090 34201 A Removal of artery clot 10.03 5.12 NA 1.02 16.17 NA 090 34203 A Removal of leg artery clot 16.50 7.61 NA 1.37 25.48 NA 090 34401 A Removal of vein clot 25.00 10.42 NA 1.20 36.62 NA 090 Start Printed Page 40440 34421 A Removal of vein clot 12.00 5.96 NA 0.95 18.91 NA 090 34451 A Removal of vein clot 27.00 11.13 NA 1.59 39.72 NA 090 34471 A Removal of vein clot 10.18 5.02 NA 0.90 16.10 NA 090 34490 A Removal of vein clot 9.86 6.22 NA 0.73 16.81 NA 090 34501 A Repair valve, femoral vein 16.00 9.41 NA 1.37 26.78 NA 090 34502 A Reconstruct vena cava 26.95 11.22 NA 2.99 41.16 NA 090 34510 A Transposition of vein valve 18.95 10.16 NA 1.60 30.71 NA 090 34520 A Cross-over vein graft 17.95 9.27 NA 1.41 28.63 NA 090 34530 A Leg vein fusion 16.64 9.12 NA 2.06 27.82 NA 090 34800 A Endovasc abdo repair w/tube 20.75 9.65 NA 1.49 31.89 NA 090 34802 A Endovasc abdo repr w/device 23.00 10.54 NA 1.65 35.19 NA 090 34804 A Endovasc abdo repr w/device 23.00 10.54 NA 1.65 35.19 NA 090 34808 A Endovasc abdo occlud device 4.13 1.63 NA 0.29 6.05 NA ZZZ 34812 A Xpose for endoprosth, aortic 6.75 2.67 NA 0.49 9.91 NA 000 34813 A Xpose for endoprosth, femorl 4.80 1.90 NA 0.34 7.04 NA ZZZ 34820 A Xpose for endoprosth, iliac 9.75 3.85 NA 0.70 14.30 NA 000 34825 A Endovasc extend prosth, init 12.00 6.19 NA 0.86 19.05 NA 090 34826 A Endovasc exten prosth, addl 4.13 1.63 NA 0.29 6.05 NA ZZZ 34830 A Open aortic tube prosth repr 32.59 14.68 NA 2.34 49.61 NA 090 34831 A Open aortoiliac prosth repr 35.34 15.77 NA 2.53 53.64 NA 090 34832 A Open aortofemor prosth repr 35.34 15.77 NA 2.53 53.64 NA 090 35001 A Repair defect of artery 19.64 8.49 NA 2.44 30.57 NA 090 35002 A Repair artery rupture, neck 21.00 9.60 NA 1.82 32.42 NA 090 35005 A Repair defect of artery 18.12 8.12 NA 1.35 27.59 NA 090 35011 A Repair defect of artery 18.00 7.55 NA 1.30 26.85 NA 090 35013 A Repair artery rupture, arm 22.00 8.94 NA 1.91 32.85 NA 090 35021 A Repair defect of artery 19.65 8.91 NA 1.93 30.49 NA 090 35022 A Repair artery rupture, chest 23.18 9.48 NA 1.99 34.65 NA 090 35045 A Repair defect of arm artery 17.57 9.04 NA 1.25 27.86 NA 090 35081 A Repair defect of artery 28.01 11.65 NA 3.20 42.86 NA 090 35082 A Repair artery rupture, aorta 38.50 15.04 NA 4.07 57.61 NA 090 35091 A Repair defect of artery 35.40 14.28 NA 4.09 53.77 NA 090 35092 A Repair artery rupture, aorta 45.00 17.41 NA 4.31 66.72 NA 090 35102 A Repair defect of artery 30.76 12.58 NA 3.44 46.78 NA 090 35103 A Repair artery rupture, groin 40.50 15.75 NA 3.79 60.04 NA 090 35111 A Repair defect of artery 25.00 10.36 NA 1.81 37.17 NA 090 35112 A Repair artery rupture,spleen 30.00 11.97 NA 1.95 43.92 NA 090 35121 A Repair defect of artery 30.00 12.29 NA 2.93 45.22 NA 090 35122 A Repair artery rupture, belly 35.00 13.81 NA 3.54 52.35 NA 090 35131 A Repair defect of artery 25.00 10.62 NA 2.11 37.73 NA 090 35132 A Repair artery rupture, groin 30.00 12.05 NA 2.48 44.53 NA 090 35141 A Repair defect of artery 20.00 8.67 NA 1.65 30.32 NA 090 35142 A Repair artery rupture, thigh 23.30 9.81 NA 1.75 34.86 NA 090 35151 A Repair defect of artery 22.64 9.75 NA 1.93 34.32 NA 090 35152 A Repair artery rupture, knee 25.62 10.60 NA 1.93 38.15 NA 090 35161 A Repair defect of artery 18.76 8.92 NA 2.21 29.89 NA 090 35162 A Repair artery rupture 19.78 9.44 NA 2.21 31.43 NA 090 35180 A Repair blood vessel lesion 13.62 6.05 NA 1.44 21.11 NA 090 35182 A Repair blood vessel lesion 30.00 12.49 NA 1.88 44.37 NA 090 35184 A Repair blood vessel lesion 18.00 7.83 NA 1.34 27.17 NA 090 35188 A Repair blood vessel lesion 14.28 6.49 NA 1.53 22.30 NA 090 35189 A Repair blood vessel lesion 28.00 11.66 NA 2.12 41.78 NA 090 35190 A Repair blood vessel lesion 12.75 5.81 NA 1.33 19.89 NA 090 35201 A Repair blood vessel lesion 16.14 7.14 NA 1.17 24.45 NA 090 35206 A Repair blood vessel lesion 13.25 7.64 NA 1.04 21.93 NA 090 35207 A Repair blood vessel lesion 10.15 9.54 NA 1.15 20.84 NA 090 35211 A Repair blood vessel lesion 22.12 13.89 NA 2.83 38.84 NA 090 35216 A Repair blood vessel lesion 18.75 11.66 NA 2.17 32.58 NA 090 35221 A Repair blood vessel lesion 24.39 10.30 NA 1.79 36.48 NA 090 35226 A Repair blood vessel lesion 14.50 8.72 NA 0.84 24.06 NA 090 35231 A Repair blood vessel lesion 20.00 9.35 NA 1.32 30.67 NA 090 35236 A Repair blood vessel lesion 17.11 9.07 NA 1.19 27.37 NA 090 35241 A Repair blood vessel lesion 23.12 14.48 NA 2.90 40.50 NA 090 35246 A Repair blood vessel lesion 26.45 14.54 NA 2.22 43.21 NA 090 35251 A Repair blood vessel lesion 30.20 12.23 NA 1.87 44.30 NA 090 35256 A Repair blood vessel lesion 18.36 9.67 NA 1.32 29.35 NA 090 35261 A Repair blood vessel lesion 17.80 7.57 NA 1.34 26.71 NA 090 35266 A Repair blood vessel lesion 14.91 8.23 NA 1.16 24.30 NA 090 35271 A Repair blood vessel lesion 22.12 13.34 NA 2.77 38.23 NA 090 35276 A Repair blood vessel lesion 24.25 13.98 NA 2.37 40.60 NA 090 35281 A Repair blood vessel lesion 28.00 11.70 NA 1.82 41.52 NA 090 35286 A Repair blood vessel lesion 16.16 8.76 NA 1.36 26.28 NA 090 35301 A Rechanneling of artery 18.70 8.90 NA 2.23 29.83 NA 090 35311 A Rechanneling of artery 27.00 11.11 NA 2.75 40.86 NA 090 Start Printed Page 40441 35321 A Rechanneling of artery 16.00 6.86 NA 1.36 24.22 NA 090 35331 A Rechanneling of artery 26.20 11.03 NA 2.71 39.94 NA 090 35341 A Rechanneling of artery 25.11 10.64 NA 2.87 38.62 NA 090 35351 A Rechanneling of artery 23.00 9.86 NA 2.29 35.15 NA 090 35355 A Rechanneling of artery 18.50 8.29 NA 1.80 28.59 NA 090 35361 A Rechanneling of artery 28.20 11.63 NA 2.66 42.49 NA 090 35363 A Rechanneling of artery 30.20 12.17 NA 2.77 45.14 NA 090 35371 A Rechanneling of artery 14.72 6.75 NA 1.32 22.79 NA 090 35372 A Rechanneling of artery 18.00 7.91 NA 1.53 27.44 NA 090 35381 A Rechanneling of artery 15.81 7.38 NA 1.80 24.99 NA 090 35390 A Reoperation, carotid add-on 3.19 1.11 NA 0.38 4.68 NA ZZZ 35400 A Angioscopy 3.00 1.05 NA 0.34 4.39 NA ZZZ 35450 A Repair arterial blockage 10.07 3.76 NA 0.84 14.67 NA 000 35452 A Repair arterial blockage 6.91 3.20 NA 0.76 10.87 NA 000 35454 A Repair arterial blockage 6.04 2.85 NA 0.67 9.56 NA 000 35456 A Repair arterial blockage 7.35 3.30 NA 0.82 11.47 NA 000 35458 A Repair arterial blockage 9.49 4.01 NA 1.09 14.59 NA 000 35459 A Repair arterial blockage 8.63 3.68 NA 0.96 13.27 NA 000 35460 A Repair venous blockage 6.04 2.71 NA 0.66 9.41 NA 000 35470 A Repair arterial blockage 8.63 4.00 NA 0.50 13.13 NA 000 35471 A Repair arterial blockage 10.07 4.67 NA 0.50 15.24 NA 000 35472 A Repair arterial blockage 6.91 3.39 NA 0.39 10.69 NA 000 35473 A Repair arterial blockage 6.04 3.05 NA 0.34 9.43 NA 000 35474 A Repair arterial blockage 7.36 3.54 NA 0.40 11.30 NA 000 35475 R Repair arterial blockage 9.49 4.23 NA 0.47 14.19 NA 000 35476 A Repair venous blockage 6.04 2.97 NA 0.27 9.28 NA 000 35480 A Atherectomy, open 11.08 4.61 NA 1.13 16.82 NA 000 35481 A Atherectomy, open 7.61 3.48 NA 0.84 11.93 NA 000 35482 A Atherectomy, open 6.65 3.04 NA 0.75 10.44 NA 000 35483 A Atherectomy, open 8.10 3.61 NA 0.81 12.52 NA 000 35484 A Atherectomy, open 10.44 4.32 NA 1.13 15.89 NA 000 35485 A Atherectomy, open 9.49 4.22 NA 1.06 14.77 NA 000 35490 A Atherectomy, percutaneous 11.08 4.95 NA 0.55 16.58 NA 000 35491 A Atherectomy, percutaneous 7.61 3.54 NA 0.49 11.64 NA 000 35492 A Atherectomy, percutaneous 6.65 3.30 NA 0.43 10.38 NA 000 35493 A Atherectomy, percutaneous 8.10 3.93 NA 0.47 12.50 NA 000 35494 A Atherectomy, percutaneous 10.44 4.63 NA 0.48 15.55 NA 000 35495 A Atherectomy, percutaneous 9.49 4.58 NA 0.51 14.58 NA 000 35500 A Harvest vein for bypass 6.45 2.03 NA 0.63 9.11 NA ZZZ 35501 A Artery bypass graft 19.19 8.17 NA 2.33 29.69 NA 090 35506 A Artery bypass graft 19.67 8.29 NA 2.33 30.29 NA 090 35507 A Artery bypass graft 19.67 8.27 NA 2.27 30.21 NA 090 35508 A Artery bypass graft 18.65 7.99 NA 2.34 28.98 NA 090 35509 A Artery bypass graft 18.07 7.75 NA 2.12 27.94 NA 090 35511 A Artery bypass graft 21.20 8.89 NA 1.74 31.83 NA 090 35515 A Artery bypass graft 18.65 8.01 NA 2.26 28.92 NA 090 35516 A Artery bypass graft 16.32 7.05 NA 1.88 25.25 NA 090 35518 A Artery bypass graft 21.20 8.71 NA 1.78 31.69 NA 090 35521 A Artery bypass graft 22.20 9.51 NA 1.82 33.53 NA 090 35526 A Artery bypass graft 29.95 12.21 NA 2.18 44.34 NA 090 35531 A Artery bypass graft 36.20 14.49 NA 2.91 53.60 NA 090 35533 A Artery bypass graft 28.00 11.56 NA 2.35 41.91 NA 090 35536 A Artery bypass graft 31.70 12.90 NA 2.62 47.22 NA 090 35541 A Artery bypass graft 25.80 10.99 NA 2.74 39.53 NA 090 35546 A Artery bypass graft 25.54 10.67 NA 2.84 39.05 NA 090 35548 A Artery bypass graft 21.57 9.21 NA 2.45 33.23 NA 090 35549 A Artery bypass graft 23.35 9.97 NA 2.77 36.09 NA 090 35551 A Artery bypass graft 26.67 11.21 NA 3.19 41.07 NA 090 35556 A Artery bypass graft 21.76 9.44 NA 2.48 33.68 NA 090 35558 A Artery bypass graft 21.20 9.20 NA 1.58 31.98 NA 090 35560 A Artery bypass graft 32.00 13.04 NA 2.73 47.77 NA 090 35563 A Artery bypass graft 24.20 10.33 NA 1.68 36.21 NA 090 35565 A Artery bypass graft 23.20 9.88 NA 1.71 34.79 NA 090 35566 A Artery bypass graft 26.92 13.89 NA 3.02 43.83 NA 090 35571 A Artery bypass graft 24.06 12.17 NA 2.14 38.37 NA 090 35582 A Vein bypass graft 27.13 11.40 NA 3.11 41.64 NA 090 35583 A Vein bypass graft 22.37 10.60 NA 2.53 35.50 NA 090 35585 A Vein bypass graft 28.39 14.59 NA 3.21 46.19 NA 090 35587 A Vein bypass graft 24.75 12.80 NA 2.17 39.72 NA 090 35600 A Harvest artery for cabg 4.95 1.96 NA 0.54 7.45 NA ZZZ 35601 A Artery bypass graft 17.50 7.50 NA 2.08 27.08 NA 090 35606 A Artery bypass graft 18.71 7.91 NA 2.17 28.79 NA 090 35612 A Artery bypass graft 15.76 6.84 NA 1.72 24.32 NA 090 35616 A Artery bypass graft 15.70 7.02 NA 1.84 24.56 NA 090 Start Printed Page 40442 35621 A Artery bypass graft 20.00 8.87 NA 1.68 30.55 NA 090 35623 A Bypass graft, not vein 24.00 10.22 NA 1.91 36.13 NA 090 35626 A Artery bypass graft 27.75 11.13 NA 2.89 41.77 NA 090 35631 A Artery bypass graft 34.00 13.77 NA 2.83 50.60 NA 090 35636 A Artery bypass graft 29.50 12.31 NA 2.37 44.18 NA 090 35641 A Artery bypass graft 24.57 10.47 NA 2.83 37.87 NA 090 35642 A Artery bypass graft 17.98 8.52 NA 1.84 28.34 NA 090 35645 A Artery bypass graft 17.47 7.98 NA 1.91 27.36 NA 090 35646 A Artery bypass graft 25.81 10.89 NA 2.98 39.68 NA 090 35650 A Artery bypass graft 19.00 7.91 NA 1.64 28.55 NA 090 35651 A Artery bypass graft 25.04 10.68 NA 2.53 38.25 NA 090 35654 A Artery bypass graft 25.00 10.57 NA 2.10 37.67 NA 090 35656 A Artery bypass graft 19.53 8.44 NA 2.21 30.18 NA 090 35661 A Artery bypass graft 19.00 8.26 NA 1.50 28.76 NA 090 35663 A Artery bypass graft 22.00 9.64 NA 1.55 33.19 NA 090 35665 A Artery bypass graft 21.00 9.17 NA 1.76 31.93 NA 090 35666 A Artery bypass graft 22.19 11.95 NA 2.19 36.33 NA 090 35671 A Artery bypass graft 19.33 10.48 NA 1.68 31.49 NA 090 35681 A Composite bypass graft 1.60 2.34 NA 0.18 4.12 NA ZZZ 35682 A Composite bypass graft 7.20 2.51 NA 0.83 10.54 NA ZZZ 35683 A Composite bypass graft 8.50 2.96 NA 0.98 12.44 NA ZZZ 35691 A Arterial transposition 18.05 7.66 NA 2.06 27.77 NA 090 35693 A Arterial transposition 15.36 6.82 NA 1.80 23.98 NA 090 35694 A Arterial transposition 19.16 8.12 NA 2.13 29.41 NA 090 35695 A Arterial transposition 19.16 8.01 NA 2.19 29.36 NA 090 35700 A Reoperation, bypass graft 3.08 2.96 NA 0.36 6.40 NA ZZZ 35701 A Exploration, carotid artery 8.50 4.61 NA 0.64 13.75 NA 090 35721 A Exploration, femoral artery 7.18 5.16 NA 0.59 12.93 NA 090 35741 A Exploration popliteal artery 8.00 5.37 NA 0.60 13.97 NA 090 35761 A Exploration of artery/vein 5.37 4.46 NA 0.60 10.43 NA 090 35800 A Explore neck vessels 7.02 3.96 NA 0.79 11.77 NA 090 35820 A Explore chest vessels 12.88 4.33 NA 1.61 18.82 NA 090 35840 A Explore abdominal vessels 9.77 5.19 NA 1.06 16.02 NA 090 35860 A Explore limb vessels 5.55 3.59 NA 0.63 9.77 NA 090 35870 A Repair vessel graft defect 22.17 10.21 NA 2.47 34.85 NA 090 35875 A Removal of clot in graft 10.13 6.55 NA 0.97 17.65 NA 090 35876 A Removal of clot in graft 17.00 9.07 NA 1.88 27.95 NA 090 35879 A Revise graft w/vein 16.00 8.23 NA 1.35 25.58 NA 090 35881 A Revise graft w/vein 18.00 9.21 NA 1.44 28.65 NA 090 35901 A Excision, graft, neck 8.19 5.68 NA 0.90 14.77 NA 090 35903 A Excision, graft, extremity 9.39 8.15 NA 1.03 18.57 NA 090 35905 A Excision, graft, thorax 31.25 15.71 NA 2.15 49.11 NA 090 35907 A Excision, graft, abdomen 35.00 14.91 NA 2.17 52.08 NA 090 36000 A Place needle in vein 0.18 0.05 0.64 0.01 0.24 0.83 XXX 36005 A Injection, venography 0.95 0.33 15.92 0.04 1.32 16.91 000 36010 A Place catheter in vein 2.43 0.87 NA 0.16 3.46 NA XXX 36011 A Place catheter in vein 3.14 1.13 NA 0.17 4.44 NA XXX 36012 A Place catheter in vein 3.52 1.26 NA 0.17 4.95 NA XXX 36013 A Place catheter in artery 2.52 0.77 NA 0.17 3.46 NA XXX 36014 A Place catheter in artery 3.02 1.09 NA 0.14 4.25 NA XXX 36015 A Place catheter in artery 3.52 1.26 NA 0.16 4.94 NA XXX 36100 A Establish access to artery 3.02 1.20 NA 0.18 4.40 NA XXX 36120 A Establish access to artery 2.01 0.71 NA 0.11 2.83 NA XXX 36140 A Establish access to artery 2.01 0.71 NA 0.12 2.84 NA XXX 36145 A Artery to vein shunt 2.01 0.73 NA 0.10 2.84 NA XXX 36160 A Establish access to aorta 2.52 0.93 NA 0.20 3.65 NA XXX 36200 A Place catheter in aorta 3.02 1.08 NA 0.15 4.25 NA XXX 36215 A Place catheter in artery 4.68 1.69 NA 0.22 6.59 NA XXX 36216 A Place catheter in artery 5.28 1.90 NA 0.24 7.42 NA XXX 36217 A Place catheter in artery 6.30 2.31 NA 0.32 8.93 NA XXX 36218 A Place catheter in artery 1.01 0.40 NA 0.05 1.46 NA ZZZ 36245 A Place catheter in artery 4.68 1.79 NA 0.23 6.70 NA XXX 36246 A Place catheter in artery 5.28 1.92 NA 0.26 7.46 NA XXX 36247 A Place catheter in artery 6.30 2.26 NA 0.32 8.88 NA XXX 36248 A Place catheter in artery 1.01 0.40 NA 0.06 1.47 NA ZZZ 36260 A Insertion of infusion pump 9.71 5.58 NA 1.00 16.29 NA 090 36261 A Revision of infusion pump 5.45 3.47 NA 0.50 9.42 NA 090 36262 A Removal of infusion pump 4.02 2.52 NA 0.43 6.97 NA 090 36299 C Vessel injection procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 36400 A Drawing blood 0.18 0.05 0.64 0.01 0.24 0.83 XXX 36405 A Drawing blood 0.18 0.06 0.57 0.01 0.25 0.76 XXX 36406 A Drawing blood 0.18 0.05 0.80 0.01 0.24 0.99 XXX 36410 A Drawing blood 0.18 0.05 0.49 0.01 0.24 0.68 XXX 36415 I Drawing blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40443 36420 A Establish access to vein 1.01 0.31 NA 0.09 1.41 NA XXX 36425 A Establish access to vein 0.76 0.17 3.39 0.05 0.98 4.20 XXX 36430 A Blood transfusion service 0.00 NA 0.99 0.05 NA 1.04 XXX 36440 A Blood transfusion service 1.03 0.29 NA 0.08 1.40 NA XXX 36450 A Exchange transfusion service 2.23 0.74 NA 0.16 3.13 NA XXX 36455 A Exchange transfusion service 2.43 0.96 NA 0.10 3.49 NA XXX 36460 A Transfusion service, fetal 6.59 2.38 NA 0.56 9.53 NA XXX 36468 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36469 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36470 A Injection therapy of vein 1.09 0.39 2.64 0.10 1.58 3.83 010 36471 A Injection therapy of veins 1.57 0.58 3.25 0.15 2.30 4.97 010 36481 A Insertion of catheter, vein 6.99 2.85 NA 0.40 10.24 NA 000 36488 A Insertion of catheter, vein 1.35 0.74 NA 0.09 2.18 NA 000 36489 A Insertion of catheter, vein 2.50 1.06 3.84 0.08 3.64 6.42 000 36490 A Insertion of catheter, vein 1.67 0.85 NA 0.17 2.69 NA 000 36491 A Insertion of catheter, vein 1.43 0.76 NA 0.13 2.32 NA 000 36493 A Repositioning of cvc 1.21 0.87 NA 0.06 2.14 NA 000 36500 A Insertion of catheter, vein 3.52 1.30 NA 0.14 4.96 NA 000 36510 A Insertion of catheter, vein 1.09 0.63 NA 0.06 1.78 NA 000 36520 A Plasma and/or cell exchange 1.74 1.00 NA 0.06 2.80 NA 000 36521 A Apheresis w/ adsorp/reinfuse 1.74 1.00 NA 0.06 2.80 NA 000 36522 A Photopheresis 1.67 1.13 6.29 0.07 2.87 8.03 000 36530 R Insertion of infusion pump 6.20 3.70 NA 0.56 10.46 NA 010 36531 R Revision of infusion pump 4.87 3.26 NA 0.44 8.57 NA 010 36532 R Removal of infusion pump 3.30 1.56 NA 0.34 5.20 NA 010 36533 A Insertion of access device 5.32 3.45 4.31 0.49 9.26 10.12 010 36534 A Revision of access device 2.80 1.50 NA 0.19 4.49 NA 010 36535 A Removal of access device 2.27 1.85 2.84 0.21 4.33 5.32 010 36540 B Collect blood venous device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36550 A Declot vascular device 0.00 NA 0.37 0.31 NA 0.68 XXX 36600 A Withdrawal of arterial blood 0.32 0.09 0.43 0.02 0.43 0.77 XXX 36620 A Insertion catheter, artery 1.15 0.25 NA 0.06 1.46 NA 000 36625 A Insertion catheter, artery 2.11 0.57 NA 0.16 2.84 NA 000 36640 A Insertion catheter, artery 2.10 0.74 NA 0.18 3.02 NA 000 36660 A Insertion catheter, artery 1.40 0.47 NA 0.08 1.95 NA 000 36680 A Insert needle, bone cavity 1.20 0.60 NA 0.08 1.88 NA 000 36800 A Insertion of cannula 2.43 1.62 NA 0.17 4.22 NA 000 36810 A Insertion of cannula 3.97 2.34 NA 0.40 6.71 NA 000 36815 A Insertion of cannula 2.62 1.73 NA 0.26 4.61 NA 000 36819 A Av fusion by basilic vein 14.00 6.55 NA 1.53 22.08 NA 090 36821 A Av fusion direct any site 8.93 5.04 NA 0.97 14.94 NA 090 36822 A Insertion of cannula(s) 5.42 6.99 NA 0.63 13.04 NA 090 36823 A Insertion of cannula(s) 21.00 10.55 NA 2.18 33.73 NA 090 36825 A Artery-vein graft 9.84 5.61 NA 1.09 16.54 NA 090 36830 A Artery-vein graft 12.00 6.16 NA 1.32 19.48 NA 090 36831 A Av fistula excision, open 8.00 4.02 NA 0.79 12.81 NA 090 36832 A Av fistula revision, open 10.50 5.62 NA 1.13 17.25 NA 090 36833 A Av fistula revision 11.95 6.10 NA 1.29 19.34 NA 090 36834 A Repair A-V aneurysm 9.93 3.84 NA 1.06 14.83 NA 090 36835 A Artery to vein shunt 7.15 4.47 NA 0.80 12.42 NA 090 36860 A External cannula declotting 2.01 1.68 2.36 0.10 3.79 4.47 000 36861 A Cannula declotting 2.52 1.84 NA 0.14 4.50 NA 000 36870 A Av fistula revision, open 5.16 2.49 31.10 0.40 8.05 36.66 090 37140 A Revision of circulation 23.60 10.54 NA 1.21 35.35 NA 090 37145 A Revision of circulation 24.61 10.87 NA 2.48 37.96 NA 090 37160 A Revision of circulation 21.60 9.42 NA 2.16 33.18 NA 090 37180 A Revision of circulation 24.61 10.79 NA 2.63 38.03 NA 090 37181 A Splice spleen/kidney veins 26.68 11.10 NA 2.67 40.45 NA 090 37195 A Thrombolytic therapy, stroke 0.00 NA 7.93 0.38 NA 8.31 XXX 37200 A Transcatheter biopsy 4.56 1.62 NA 0.19 6.37 NA 000 37201 A Transcatheter therapy infuse 5.00 2.62 NA 0.24 7.86 NA 000 37202 A Transcatheter therapy infuse 5.68 3.23 NA 0.38 9.29 NA 000 37203 A Transcatheter retrieval 5.03 2.65 NA 0.23 7.91 NA 000 37204 A Transcatheter occlusion 18.14 6.20 NA 0.85 25.19 NA 000 37205 A Transcatheter stent 8.28 3.92 NA 0.43 12.63 NA 000 37206 A Transcatheter stent add-on 4.13 1.56 NA 0.22 5.91 NA ZZZ 37207 A Transcatheter stent 8.28 3.62 NA 0.89 12.79 NA 000 37208 A Transcatheter stent add-on 4.13 1.47 NA 0.44 6.04 NA ZZZ 37209 A Exchange arterial catheter 2.27 0.83 NA 0.11 3.21 NA 000 37250 A Iv us first vessel add-on 2.10 0.81 NA 0.17 3.08 NA ZZZ 37251 A Iv us each add vessel add-on 1.60 0.61 NA 0.14 2.35 NA ZZZ 37565 A Ligation of neck vein 10.88 5.13 NA 0.45 16.46 NA 090 37600 A Ligation of neck artery 11.25 6.41 NA 0.40 18.06 NA 090 37605 A Ligation of neck artery 13.11 6.61 NA 0.77 20.49 NA 090 Start Printed Page 40444 37606 A Ligation of neck artery 6.28 3.72 NA 0.79 10.79 NA 090 37607 A Ligation of a-v fistula 6.16 3.71 NA 0.67 10.54 NA 090 37609 A Temporal artery procedure 3.00 2.53 6.59 0.21 5.74 9.80 010 37615 A Ligation of neck artery 5.73 3.65 NA 0.57 9.95 NA 090 37616 A Ligation of chest artery 16.49 10.83 NA 1.93 29.25 NA 090 37617 A Ligation of abdomen artery 22.06 9.60 NA 1.69 33.35 NA 090 37618 A Ligation of extremity artery 4.84 3.55 NA 0.54 8.93 NA 090 37620 A Revision of major vein 10.56 5.50 NA 0.75 16.81 NA 090 37650 A Revision of major vein 7.80 4.66 NA 0.56 13.02 NA 090 37660 A Revision of major vein 21.00 9.33 NA 1.17 31.50 NA 090 37700 A Revise leg vein 3.73 3.20 NA 0.40 7.33 NA 090 37720 A Removal of leg vein 5.66 3.71 NA 0.61 9.98 NA 090 37730 A Removal of leg veins 7.33 4.59 NA 0.77 12.69 NA 090 37735 A Removal of leg veins/lesion 10.53 5.84 NA 1.17 17.54 NA 090 37760 A Revision of leg veins 10.47 5.79 NA 1.11 17.37 NA 090 37780 A Revision of leg vein 3.84 2.93 NA 0.41 7.18 NA 090 37785 A Revision secondary varicosit 3.84 2.89 6.94 0.41 7.14 11.19 090 37788 A Revascularization, penis 22.01 12.79 NA 1.35 36.15 NA 090 37790 A Penile venous occlusion 8.34 7.01 NA 0.63 15.98 NA 090 37799 C Vascular surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38100 A Removal of spleen, total 14.50 6.64 NA 1.30 22.44 NA 090 38101 A Removal of spleen, partial 15.31 7.00 NA 1.38 23.69 NA 090 38102 A Removal of spleen, total 4.80 1.72 NA 0.49 7.01 NA ZZZ 38115 A Repair of ruptured spleen 15.82 7.14 NA 1.40 24.36 NA 090 38120 A Laparoscopy, splenectomy 17.00 7.48 NA 1.73 26.21 NA 090 38129 C Laparoscope proc, spleen 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38200 A Injection for spleen x-ray 2.64 0.96 NA 0.12 3.72 NA 000 38230 R Bone marrow collection 4.54 2.34 NA 0.25 7.13 NA 010 38231 R Stem cell collection 1.50 0.60 NA 0.05 2.15 NA 000 38240 R Bone marrow/stem transplant 2.24 0.85 NA 0.08 3.17 NA XXX 38241 R Bone marrow/stem transplant 2.24 0.84 NA 0.08 3.16 NA XXX 38300 A Drainage, lymph node lesion 1.99 2.63 4.62 0.15 4.77 6.76 010 38305 A Drainage, lymph node lesion 6.00 6.37 8.67 0.36 12.73 15.03 090 38308 A Incision of lymph channels 6.45 5.65 NA 0.51 12.61 NA 090 38380 A Thoracic duct procedure 7.46 7.38 NA 0.68 15.52 NA 090 38381 A Thoracic duct procedure 12.88 9.76 NA 1.58 24.22 NA 090 38382 A Thoracic duct procedure 10.08 9.46 NA 1.08 20.62 NA 090 38500 A Biopsy/removal, lymph nodes 3.75 2.57 2.98 0.28 6.60 7.01 010 38505 A Needle biopsy, lymph nodes 1.14 1.16 3.06 0.09 2.39 4.29 000 38510 A Biopsy/removal, lymph nodes 6.43 5.38 NA 0.38 12.19 NA 090 38520 A Biopsy/removal, lymph nodes 6.67 5.56 NA 0.52 12.75 NA 090 38525 A Biopsy/removal, lymph nodes 6.07 4.44 NA 0.48 10.99 NA 090 38530 A Biopsy/removal, lymph nodes 7.98 5.69 NA 0.63 14.30 NA 090 38542 A Explore deep node(s), neck 5.91 5.90 NA 0.50 12.31 NA 090 38550 A Removal, neck/armpit lesion 6.92 4.92 NA 0.69 12.53 NA 090 38555 A Removal, neck/armpit lesion 14.14 10.70 NA 1.46 26.30 NA 090 38562 A Removal, pelvic lymph nodes 10.49 6.59 NA 0.97 18.05 NA 090 38564 A Removal, abdomen lymph nodes 10.83 6.42 NA 1.06 18.31 NA 090 38570 A Laparoscopy, lymph node biop 9.25 4.53 NA 0.89 14.67 NA 010 38571 A Laparoscopy, lymphadenectomy 12.38 5.53 NA 0.80 18.71 NA 010 38572 A Laparoscopy, lymphadenectomy 16.59 7.58 NA 1.32 25.49 NA 010 38589 C Laparoscope proc, lymphatic 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38700 A Removal of lymph nodes, neck 8.24 13.31 NA 0.60 22.15 NA 090 38720 A Removal of lymph nodes, neck 13.61 15.74 NA 1.03 30.38 NA 090 38724 A Removal of lymph nodes, neck 14.54 16.21 NA 1.10 31.85 NA 090 38740 A Remove armpit lymph nodes 10.02 5.87 NA 0.69 16.58 NA 090 38745 A Remove armpit lymph nodes 13.00 8.24 NA 0.90 22.14 NA 090 38746 A Remove thoracic lymph nodes 4.89 1.65 NA 0.55 7.09 NA ZZZ 38747 A Remove abdominal lymph nodes 4.89 1.75 NA 0.50 7.14 NA ZZZ 38760 A Remove groin lymph nodes 12.94 7.26 NA 0.88 21.08 NA 090 38765 A Remove groin lymph nodes 19.98 11.36 NA 1.50 32.84 NA 090 38770 A Remove pelvis lymph nodes 13.23 6.94 NA 0.94 21.11 NA 090 38780 A Remove abdomen lymph nodes 16.59 9.49 NA 1.60 27.68 NA 090 38790 A Inject for lymphatic x-ray 1.29 0.46 37.13 0.09 1.84 38.51 000 38792 A Identify sentinel node 0.52 0.19 NA 0.04 0.75 NA 000 38794 A Access thoracic lymph duct 4.45 1.67 NA 0.17 6.29 NA 090 38999 C Blood/lymph system procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39000 A Exploration of chest 6.10 7.52 NA 0.73 14.35 NA 090 39010 A Exploration of chest 11.79 9.80 NA 1.46 23.05 NA 090 39200 A Removal chest lesion 13.62 10.17 NA 1.65 25.44 NA 090 39220 A Removal chest lesion 17.42 11.54 NA 2.10 31.06 NA 090 39400 A Visualization of chest 5.61 7.22 NA 0.69 13.52 NA 010 39499 C Chest procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39501 A Repair diaphragm laceration 13.19 7.76 NA 1.38 22.33 NA 090 Start Printed Page 40445 39502 A Repair paraesophageal hernia 16.33 8.38 NA 1.68 26.39 NA 090 39503 A Repair of diaphragm hernia 34.85 15.15 NA 3.52 53.52 NA 090 39520 A Repair of diaphragm hernia 16.10 9.81 NA 1.83 27.74 NA 090 39530 A Repair of diaphragm hernia 15.41 8.61 NA 1.66 25.68 NA 090 39531 A Repair of diaphragm hernia 16.42 9.33 NA 1.83 27.58 NA 090 39540 A Repair of diaphragm hernia 13.32 7.83 NA 1.38 22.53 NA 090 39541 A Repair of diaphragm hernia 14.41 8.06 NA 1.52 23.99 NA 090 39545 A Revision of diaphragm 13.37 9.52 NA 1.55 24.44 NA 090 39560 A Resect diaphragm, simple 12.00 7.91 NA 1.35 21.26 NA 090 39561 A Resect diaphragm, complex 17.50 9.85 NA 1.97 29.32 NA 090 39599 C Diaphragm surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40490 A Biopsy of lip 1.22 0.62 1.61 0.06 1.90 2.89 000 40500 A Partial excision of lip 4.28 5.61 5.65 0.31 10.20 10.24 090 40510 A Partial excision of lip 4.70 6.46 6.70 0.38 11.54 11.78 090 40520 A Partial excision of lip 4.67 6.93 7.81 0.42 12.02 12.90 090 40525 A Reconstruct lip with flap 7.55 8.40 NA 0.68 16.63 NA 090 40527 A Reconstruct lip with flap 9.13 9.25 NA 0.82 19.20 NA 090 40530 A Partial removal of lip 5.40 6.34 6.49 0.47 12.21 12.36 090 40650 A Repair lip 3.64 4.55 5.53 0.31 8.50 9.48 090 40652 A Repair lip 4.26 6.53 6.53 0.39 11.18 11.18 090 40654 A Repair lip 5.31 7.67 7.86 0.48 13.46 13.65 090 40700 A Repair cleft lip/nasal 12.79 10.51 NA 0.93 24.23 NA 090 40701 A Repair cleft lip/nasal 15.85 10.01 NA 1.36 27.22 NA 090 40702 A Repair cleft lip/nasal 13.04 9.40 NA 1.01 23.45 NA 090 40720 A Repair cleft lip/nasal 13.55 12.69 NA 1.31 27.55 NA 090 40761 A Repair cleft lip/nasal 14.72 11.77 NA 1.41 27.90 NA 090 40799 C Lip surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40800 A Drainage of mouth lesion 1.17 0.46 1.93 0.09 1.72 3.19 010 40801 A Drainage of mouth lesion 2.53 1.90 2.45 0.18 4.61 5.16 010 40804 A Removal, foreign body, mouth 1.24 2.15 2.58 0.09 3.48 3.91 010 40805 A Removal, foreign body, mouth 2.69 2.70 3.10 0.17 5.56 5.96 010 40806 A Incision of lip fold 0.31 0.88 0.88 0.02 1.21 1.21 000 40808 A Biopsy of mouth lesion 0.96 2.05 2.05 0.07 3.08 3.08 010 40810 A Excision of mouth lesion 1.31 2.34 2.67 0.09 3.74 4.07 010 40812 A Excise/repair mouth lesion 2.31 2.86 2.89 0.17 5.34 5.37 010 40814 A Excise/repair mouth lesion 3.42 4.07 4.07 0.26 7.75 7.75 090 40816 A Excision of mouth lesion 3.67 4.39 4.39 0.27 8.33 8.33 090 40818 A Excise oral mucosa for graft 2.41 4.03 4.03 0.14 6.58 6.58 090 40819 A Excise lip or cheek fold 2.41 3.54 3.54 0.17 6.12 6.12 090 40820 A Treatment of mouth lesion 1.28 2.15 2.33 0.08 3.51 3.69 010 40830 A Repair mouth laceration 1.76 2.39 2.50 0.14 4.29 4.40 010 40831 A Repair mouth laceration 2.46 2.84 2.84 0.21 5.51 5.51 010 40840 R Reconstruction of mouth 8.73 6.22 6.22 0.79 15.74 15.74 090 40842 R Reconstruction of mouth 8.73 5.98 5.98 0.65 15.36 15.36 090 40843 R Reconstruction of mouth 12.10 8.48 8.48 0.84 21.42 21.42 090 40844 R Reconstruction of mouth 16.01 8.37 8.93 1.63 26.01 26.57 090 40845 R Reconstruction of mouth 18.58 10.56 10.56 1.47 30.61 30.61 090 40899 C Mouth surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41000 A Drainage of mouth lesion 1.30 1.53 2.36 0.09 2.92 3.75 010 41005 A Drainage of mouth lesion 1.26 1.24 2.11 0.09 2.59 3.46 010 41006 A Drainage of mouth lesion 3.24 3.40 3.51 0.25 6.89 7.00 090 41007 A Drainage of mouth lesion 3.10 3.03 3.34 0.22 6.35 6.66 090 41008 A Drainage of mouth lesion 3.37 3.18 3.59 0.24 6.79 7.20 090 41009 A Drainage of mouth lesion 3.59 3.19 3.60 0.25 7.03 7.44 090 41010 A Incision of tongue fold 1.06 2.97 2.97 0.06 4.09 4.09 010 41015 A Drainage of mouth lesion 3.96 3.17 4.36 0.29 7.42 8.61 090 41016 A Drainage of mouth lesion 4.07 3.39 4.17 0.28 7.74 8.52 090 41017 A Drainage of mouth lesion 4.07 3.30 4.04 0.32 7.69 8.43 090 41018 A Drainage of mouth lesion 5.10 3.88 4.55 0.35 9.33 10.00 090 41100 A Biopsy of tongue 1.63 2.54 2.59 0.12 4.29 4.34 010 41105 A Biopsy of tongue 1.42 2.43 2.43 0.10 3.95 3.95 010 41108 A Biopsy of floor of mouth 1.05 2.20 2.29 0.08 3.33 3.42 010 41110 A Excision of tongue lesion 1.51 2.47 3.04 0.11 4.09 4.66 010 41112 A Excision of tongue lesion 2.73 3.50 3.50 0.20 6.43 6.43 090 41113 A Excision of tongue lesion 3.19 3.48 3.48 0.23 6.90 6.90 090 41114 A Excision of tongue lesion 8.47 6.36 NA 0.64 15.47 NA 090 41115 A Excision of tongue fold 1.74 2.33 2.33 0.13 4.20 4.20 010 41116 A Excision of mouth lesion 2.44 3.38 3.38 0.17 5.99 5.99 090 41120 A Partial removal of tongue 9.77 8.68 NA 0.70 19.15 NA 090 41130 A Partial removal of tongue 11.15 9.53 NA 0.81 21.49 NA 090 41135 A Tongue and neck surgery 23.09 15.92 NA 1.66 40.67 NA 090 41140 A Removal of tongue 25.50 18.11 NA 1.85 45.46 NA 090 41145 A Tongue removal, neck surgery 30.06 21.54 NA 2.11 53.71 NA 090 41150 A Tongue, mouth, jaw surgery 23.04 17.08 NA 1.67 41.79 NA 090 Start Printed Page 40446 41153 A Tongue, mouth, neck surgery 23.77 17.84 NA 1.71 43.32 NA 090 41155 A Tongue, jaw, & neck surgery 27.72 19.87 NA 2.02 49.61 NA 090 41250 A Repair tongue laceration 1.91 1.63 2.82 0.15 3.69 4.88 010 41251 A Repair tongue laceration 2.27 2.27 2.80 0.18 4.72 5.25 010 41252 A Repair tongue laceration 2.97 2.32 3.63 0.23 5.52 6.83 010 41500 A Fixation of tongue 3.71 4.25 NA 0.26 8.22 NA 090 41510 A Tongue to lip surgery 3.42 4.51 NA 0.24 8.17 NA 090 41520 A Reconstruction, tongue fold 2.73 3.17 3.17 0.19 6.09 6.09 090 41599 C Tongue and mouth surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41800 A Drainage of gum lesion 1.17 1.31 1.90 0.09 2.57 3.16 010 41805 A Removal foreign body, gum 1.24 1.93 1.93 0.09 3.26 3.26 010 41806 A Removal foreign body,jawbone 2.69 2.38 2.58 0.22 5.29 5.49 010 41820 R Excision, gum, each quadrant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 41821 R Excision of gum flap 0.00 0.00 0.00 0.00 0.00 0.00 XXX 41822 R Excision of gum lesion 2.31 0.89 2.89 0.24 3.44 5.44 010 41823 R Excision of gum lesion 3.30 2.75 3.77 0.29 6.34 7.36 090 41825 A Excision of gum lesion 1.31 2.25 2.36 0.10 3.66 3.77 010 41826 A Excision of gum lesion 2.31 2.57 2.62 0.17 5.05 5.10 010 41827 A Excision of gum lesion 3.42 3.58 3.58 0.25 7.25 7.25 090 41828 R Excision of gum lesion 3.09 2.29 3.03 0.22 5.60 6.34 010 41830 R Removal of gum tissue 3.35 3.14 3.18 0.23 6.72 6.76 010 41850 R Treatment of gum lesion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 41870 R Gum graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 41872 R Repair gum 2.59 2.69 2.69 0.18 5.46 5.46 090 41874 R Repair tooth socket 3.09 2.33 2.83 0.23 5.65 6.15 090 41899 C Dental surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42000 A Drainage mouth roof lesion 1.23 1.59 2.42 0.10 2.92 3.75 010 42100 A Biopsy roof of mouth 1.31 2.36 2.36 0.10 3.77 3.77 010 42104 A Excision lesion, mouth roof 1.64 2.44 2.44 0.12 4.20 4.20 010 42106 A Excision lesion, mouth roof 2.10 2.63 2.63 0.16 4.89 4.89 010 42107 A Excision lesion, mouth roof 4.44 4.05 4.05 0.32 8.81 8.81 090 42120 A Remove palate/lesion 6.17 5.99 NA 0.44 12.60 NA 090 42140 A Excision of uvula 1.62 3.18 3.65 0.12 4.92 5.39 090 42145 A Repair palate, pharynx/uvula 8.05 7.31 NA 0.56 15.92 NA 090 42160 A Treatment mouth roof lesion 1.80 2.60 3.16 0.13 4.53 5.09 010 42180 A Repair palate 2.50 2.10 2.75 0.19 4.79 5.44 010 42182 A Repair palate 3.83 2.99 3.95 0.27 7.09 8.05 010 42200 A Reconstruct cleft palate 12.00 10.00 NA 0.97 22.97 NA 090 42205 A Reconstruct cleft palate 13.29 9.62 NA 0.82 23.73 NA 090 42210 A Reconstruct cleft palate 14.50 7.95 NA 1.24 23.69 NA 090 42215 A Reconstruct cleft palate 8.82 7.48 NA 0.96 17.26 NA 090 42220 A Reconstruct cleft palate 7.02 5.82 NA 0.41 13.25 NA 090 42225 A Reconstruct cleft palate 9.54 8.92 NA 0.75 19.21 NA 090 42226 A Lengthening of palate 10.01 9.14 NA 0.73 19.88 NA 090 42227 A Lengthening of palate 9.52 6.67 NA 0.70 16.89 NA 090 42235 A Repair palate 7.87 5.92 NA 0.49 14.28 NA 090 42260 A Repair nose to lip fistula 9.80 7.33 7.33 0.85 17.98 17.98 090 42280 A Preparation, palate mold 1.54 0.81 1.41 0.12 2.47 3.07 010 42281 A Insertion, palate prosthesis 1.93 1.04 2.00 0.14 3.11 4.07 010 42299 C Palate/uvula surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42300 A Drainage of salivary gland 1.93 1.77 2.55 0.15 3.85 4.63 010 42305 A Drainage of salivary gland 6.07 5.16 NA 0.46 11.69 NA 090 42310 A Drainage of salivary gland 1.56 1.67 2.25 0.11 3.34 3.92 010 42320 A Drainage of salivary gland 2.35 2.12 2.79 0.17 4.64 5.31 010 42325 A Create salivary cyst drain 2.75 1.21 3.32 0.17 4.13 6.24 090 42326 A Create salivary cyst drain 3.78 2.10 3.29 0.34 6.22 7.41 090 42330 A Removal of salivary stone 2.21 1.22 2.70 0.16 3.59 5.07 010 42335 A Removal of salivary stone 3.31 3.56 3.56 0.23 7.10 7.10 090 42340 A Removal of salivary stone 4.60 4.57 4.57 0.34 9.51 9.51 090 42400 A Biopsy of salivary gland 0.78 0.40 2.37 0.06 1.24 3.21 000 42405 A Biopsy of salivary gland 3.29 3.27 3.36 0.24 6.80 6.89 010 42408 A Excision of salivary cyst 4.54 4.62 4.62 0.34 9.50 9.50 090 42409 A Drainage of salivary cyst 2.81 3.44 3.44 0.20 6.45 6.45 090 42410 A Excise parotid gland/lesion 9.34 7.76 NA 0.77 17.87 NA 090 42415 A Excise parotid gland/lesion 16.89 12.43 NA 1.26 30.58 NA 090 42420 A Excise parotid gland/lesion 19.59 14.02 NA 1.45 35.06 NA 090 42425 A Excise parotid gland/lesion 13.02 10.29 NA 0.98 24.29 NA 090 42426 A Excise parotid gland/lesion 21.26 14.84 NA 1.57 37.67 NA 090 42440 A Excise submaxillary gland 6.97 5.87 NA 0.51 13.35 NA 090 42450 A Excise sublingual gland 4.62 4.91 4.99 0.34 9.87 9.95 090 42500 A Repair salivary duct 4.30 4.69 4.69 0.30 9.29 9.29 090 42505 A Repair salivary duct 6.18 5.36 5.36 0.44 11.98 11.98 090 42507 A Parotid duct diversion 6.11 5.84 NA 0.66 12.61 NA 090 42508 A Parotid duct diversion 9.10 7.95 NA 0.64 17.69 NA 090 Start Printed Page 40447 42509 A Parotid duct diversion 11.54 7.62 NA 1.24 20.40 NA 090 42510 A Parotid duct diversion 8.15 7.45 NA 0.57 16.17 NA 090 42550 A Injection for salivary x-ray 1.25 0.44 12.88 0.06 1.75 14.19 000 42600 A Closure of salivary fistula 4.82 5.54 6.03 0.34 10.70 11.19 090 42650 A Dilation of salivary duct 0.77 0.43 1.06 0.06 1.26 1.89 000 42660 A Dilation of salivary duct 1.13 1.15 1.15 0.07 2.35 2.35 000 42665 A Ligation of salivary duct 2.53 3.65 3.72 0.17 6.35 6.42 090 42699 C Salivary surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42700 A Drainage of tonsil abscess 1.62 1.79 3.08 0.12 3.53 4.82 010 42720 A Drainage of throat abscess 5.42 4.66 4.75 0.39 10.47 10.56 010 42725 A Drainage of throat abscess 10.72 8.30 NA 0.80 19.82 NA 090 42800 A Biopsy of throat 1.39 2.46 2.90 0.10 3.95 4.39 010 42802 A Biopsy of throat 1.54 2.58 3.00 0.11 4.23 4.65 010 42804 A Biopsy of upper nose/throat 1.24 2.42 2.85 0.09 3.75 4.18 010 42806 A Biopsy of upper nose/throat 1.58 2.60 3.27 0.12 4.30 4.97 010 42808 A Excise pharynx lesion 2.30 3.01 4.67 0.17 5.48 7.14 010 42809 A Remove pharynx foreign body 1.81 1.66 3.33 0.13 3.60 5.27 010 42810 A Excision of neck cyst 3.25 4.42 5.33 0.25 7.92 8.83 090 42815 A Excision of neck cyst 7.07 6.44 NA 0.53 14.04 NA 090 42820 A Remove tonsils and adenoids 3.91 3.87 NA 0.28 8.06 NA 090 42821 A Remove tonsils and adenoids 4.29 4.12 NA 0.30 8.71 NA 090 42825 A Removal of tonsils 3.42 3.55 NA 0.24 7.21 NA 090 42826 A Removal of tonsils 3.38 3.59 NA 0.23 7.20 NA 090 42830 A Removal of adenoids 2.57 2.25 NA 0.18 5.00 NA 090 42831 A Removal of adenoids 2.71 2.50 NA 0.19 5.40 NA 090 42835 A Removal of adenoids 2.30 2.44 NA 0.17 4.91 NA 090 42836 A Removal of adenoids 3.18 3.55 NA 0.22 6.95 NA 090 42842 A Extensive surgery of throat 8.76 7.71 NA 0.61 17.08 NA 090 42844 A Extensive surgery of throat 14.31 11.33 NA 1.04 26.68 NA 090 42845 A Extensive surgery of throat 24.29 17.53 NA 1.76 43.58 NA 090 42860 A Excision of tonsil tags 2.22 2.98 NA 0.16 5.36 NA 090 42870 A Excision of lingual tonsil 5.40 5.80 NA 0.38 11.58 NA 090 42890 A Partial removal of pharynx 12.94 10.63 NA 0.91 24.48 NA 090 42892 A Revision of pharyngeal walls 15.83 12.19 NA 1.14 29.16 NA 090 42894 A Revision of pharyngeal walls 22.88 16.90 NA 1.64 41.42 NA 090 42900 A Repair throat wound 5.25 3.75 NA 0.39 9.39 NA 010 42950 A Reconstruction of throat 8.10 7.42 NA 0.58 16.10 NA 090 42953 A Repair throat, esophagus 8.96 8.98 NA 0.73 18.67 NA 090 42955 A Surgical opening of throat 7.39 6.27 NA 0.63 14.29 NA 090 42960 A Control throat bleeding 2.33 2.08 NA 0.17 4.58 NA 010 42961 A Control throat bleeding 5.59 5.22 NA 0.40 11.21 NA 090 42962 A Control throat bleeding 7.14 6.27 NA 0.51 13.92 NA 090 42970 A Control nose/throat bleeding 5.43 3.79 NA 0.37 9.59 NA 090 42971 A Control nose/throat bleeding 6.21 5.70 NA 0.45 12.36 NA 090 42972 A Control nose/throat bleeding 7.20 5.31 NA 0.54 13.05 NA 090 42999 C Throat surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43020 A Incision of esophagus 8.09 6.30 NA 0.70 15.09 NA 090 43030 A Throat muscle surgery 7.69 6.79 NA 0.60 15.08 NA 090 43045 A Incision of esophagus 20.12 10.99 NA 2.15 33.26 NA 090 43100 A Excision of esophagus lesion 9.19 7.27 NA 0.79 17.25 NA 090 43101 A Excision of esophagus lesion 16.24 8.55 NA 1.81 26.60 NA 090 43107 A Removal of esophagus 40.00 18.57 NA 3.29 61.86 NA 090 43108 A Removal of esophagus 34.19 15.74 NA 3.78 53.71 NA 090 43112 A Removal of esophagus 43.50 20.06 NA 3.67 67.23 NA 090 43113 A Removal of esophagus 35.27 16.69 NA 4.33 56.29 NA 090 43116 A Partial removal of esophagus 31.22 20.19 NA 2.62 54.03 NA 090 43117 A Partial removal of esophagus 40.00 18.55 NA 3.51 62.06 NA 090 43118 A Partial removal of esophagus 33.20 15.82 NA 3.56 52.58 NA 090 43121 A Partial removal of esophagus 29.19 14.85 NA 3.44 47.48 NA 090 43122 A Parital removal of esophagus 40.00 18.10 NA 3.27 61.37 NA 090 43123 A Partial removal of esophagus 33.20 16.59 NA 3.96 53.75 NA 090 43124 A Removal of esophagus 27.32 15.10 NA 2.95 45.37 NA 090 43130 A Removal of esophagus pouch 11.75 8.80 NA 1.06 21.61 NA 090 43135 A Removal of esophagus pouch 16.10 9.86 NA 1.85 27.81 NA 090 43200 A Esophagus endoscopy 1.59 1.18 6.85 0.11 2.88 8.55 000 43202 A Esophagus endoscopy, biopsy 1.89 1.13 5.67 0.12 3.14 7.68 000 43204 A Esophagus endoscopy & inject 3.77 1.69 NA 0.18 5.64 NA 000 43205 A Esophagus endoscopy/ligation 3.79 1.70 NA 0.17 5.66 NA 000 43215 A Esophagus endoscopy 2.60 1.25 NA 0.17 4.02 NA 000 43216 A Esophagus endoscopy/lesion 2.40 1.19 NA 0.15 3.74 NA 000 43217 A Esophagus endoscopy 2.90 1.35 NA 0.17 4.42 NA 000 43219 A Esophagus endoscopy 2.80 1.40 NA 0.16 4.36 NA 000 43220 A Esoph endoscopy, dilation 2.10 1.11 NA 0.12 3.33 NA 000 43226 A Esoph endoscopy, dilation 2.34 1.18 NA 0.12 3.64 NA 000 Start Printed Page 40448 43227 A Esoph endoscopy, repair 3.60 1.62 NA 0.18 5.40 NA 000 43228 A Esoph endoscopy, ablation 3.77 1.73 NA 0.25 5.75 NA 000 43231 A Esoph endoscopy w/us exam 4.09 1.89 NA 0.24 6.22 NA 000 43232 A Esoph endoscopy w/us fn bx 4.71 2.22 NA 0.28 7.21 NA 000 43234 A Upper GI endoscopy, exam 2.01 1.04 3.89 0.13 3.18 6.03 000 43235 A Uppr gi endoscopy, diagnosis 2.39 1.20 5.27 0.13 3.72 7.79 000 43239 A Upper GI endoscopy, biopsy 2.69 1.31 5.49 0.14 4.14 8.32 000 43240 A Esoph endoscope w/drain cyst 7.39 3.14 NA 0.45 10.98 NA 000 43241 A Upper GI endoscopy with tube 2.59 1.25 NA 0.14 3.98 NA 000 43242 A Uppr gi endoscopy w/us fn bx 5.51 2.00 2.00 0.34 7.85 7.85 000 43243 A Upper gi endoscopy & inject 4.57 1.98 NA 0.21 6.76 NA 000 43244 A Upper GI endoscopy/ligation 4.59 1.99 NA 0.21 6.79 NA 000 43245 A Operative upper GI endoscopy 3.39 1.53 NA 0.18 5.10 NA 000 43246 A Place gastrostomy tube 4.33 1.82 NA 0.24 6.39 NA 000 43247 A Operative upper GI endoscopy 3.39 1.53 NA 0.17 5.09 NA 000 43248 A Uppr gi endoscopy/guide wire 3.15 1.46 NA 0.15 4.76 NA 000 43249 A Esoph endoscopy, dilation 2.90 1.36 NA 0.15 4.41 NA 000 43250 A Upper GI endoscopy/tumor 3.20 1.46 NA 0.17 4.83 NA 000 43251 A Operative upper GI endoscopy 3.70 1.65 NA 0.19 5.54 NA 000 43255 A Operative upper GI endoscopy 4.40 1.80 NA 0.20 6.40 NA 000 43256 A Uppr gi endoscopy w stent 4.35 1.58 1.58 0.26 6.19 6.19 000 43258 A Operative upper GI endoscopy 4.55 1.97 NA 0.22 6.74 NA 000 43259 A Endoscopic ultrasound exam 4.89 2.19 NA 0.22 7.30 NA 000 43260 A Endo cholangiopancreatograph 5.96 2.48 NA 0.27 8.71 NA 000 43261 A Endo cholangiopancreatograph 6.27 2.59 NA 0.29 9.15 NA 000 43262 A Endo cholangiopancreatograph 7.39 3.01 NA 0.34 10.74 NA 000 43263 A Endo cholangiopancreatograph 6.19 2.58 NA 0.28 9.05 NA 000 43264 A Endo cholangiopancreatograph 8.90 3.57 NA 0.41 12.88 NA 000 43265 A Endo cholangiopancreatograph 8.90 3.56 NA 0.42 12.88 NA 000 43267 A Endo cholangiopancreatograph 7.39 3.01 NA 0.34 10.74 NA 000 43268 A Endo cholangiopancreatograph 7.39 3.01 NA 0.34 10.74 NA 000 43269 A Endo cholangiopancreatograph 6.04 2.51 NA 0.28 8.83 NA 000 43271 A Endo cholangiopancreatograph 7.39 3.00 NA 0.34 10.73 NA 000 43272 A Endo cholangiopancreatograph 7.39 3.01 NA 0.34 10.74 NA 000 43280 A Laparoscopy, fundoplasty 17.25 8.37 NA 1.76 27.38 NA 090 43289 C Laparoscope proc, esoph 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43300 A Repair of esophagus 9.14 7.43 NA 0.85 17.42 NA 090 43305 A Repair esophagus and fistula 17.39 12.48 NA 1.36 31.23 NA 090 43310 A Repair of esophagus 25.39 14.68 NA 3.18 43.25 NA 090 43312 A Repair esophagus and fistula 28.42 18.43 NA 3.38 50.23 NA 090 43320 A Fuse esophagus & stomach 19.93 10.60 NA 1.59 32.12 NA 090 43324 A Revise esophagus & stomach 20.57 9.71 NA 1.72 32.00 NA 090 43325 A Revise esophagus & stomach 20.06 9.97 NA 1.65 31.68 NA 090 43326 A Revise esophagus & stomach 19.74 10.75 NA 1.84 32.33 NA 090 43330 A Repair of esophagus 19.77 9.69 NA 1.52 30.98 NA 090 43331 A Repair of esophagus 20.13 11.46 NA 1.93 33.52 NA 090 43340 A Fuse esophagus & intestine 19.61 10.60 NA 1.53 31.74 NA 090 43341 A Fuse esophagus & intestine 20.85 13.19 NA 2.14 36.18 NA 090 43350 A Surgical opening, esophagus 15.78 10.59 NA 1.15 27.52 NA 090 43351 A Surgical opening, esophagus 18.35 9.93 NA 1.51 29.79 NA 090 43352 A Surgical opening, esophagus 15.26 9.64 NA 1.28 26.18 NA 090 43360 A Gastrointestinal repair 35.70 16.95 NA 3.00 55.65 NA 090 43361 A Gastrointestinal repair 40.50 19.13 NA 3.52 63.15 NA 090 43400 A Ligate esophagus veins 21.20 10.43 NA 0.99 32.62 NA 090 43401 A Esophagus surgery for veins 22.09 10.05 NA 1.73 33.87 NA 090 43405 A Ligate/staple esophagus 20.01 9.83 NA 1.63 31.47 NA 090 43410 A Repair esophagus wound 13.47 8.91 NA 1.15 23.53 NA 090 43415 A Repair esophagus wound 25.00 12.50 NA 1.92 39.42 NA 090 43420 A Repair esophagus opening 14.35 9.56 NA 0.86 24.77 NA 090 43425 A Repair esophagus opening 21.03 11.55 NA 2.03 34.61 NA 090 43450 A Dilate esophagus 1.38 0.62 1.34 0.07 2.07 2.79 000 43453 A Dilate esophagus 1.51 0.67 NA 0.08 2.26 NA 000 43456 A Dilate esophagus 2.57 1.06 NA 0.14 3.77 NA 000 43458 A Dilate esophagus 3.06 1.25 NA 0.17 4.48 NA 000 43460 A Pressure treatment esophagus 3.80 1.53 NA 0.21 5.54 NA 000 43496 C Free jejunum flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 43499 C Esophagus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43500 A Surgical opening of stomach 11.05 5.16 NA 0.84 17.05 NA 090 43501 A Surgical repair of stomach 20.04 8.75 NA 1.55 30.34 NA 090 43502 A Surgical repair of stomach 23.13 9.96 NA 1.83 34.92 NA 090 43510 A Surgical opening of stomach 13.08 7.42 NA 0.90 21.40 NA 090 43520 A Incision of pyloric muscle 9.99 5.92 NA 0.84 16.75 NA 090 43600 A Biopsy of stomach 1.91 1.02 NA 0.11 3.04 NA 000 43605 A Biopsy of stomach 11.98 5.44 NA 0.93 18.35 NA 090 Start Printed Page 40449 43610 A Excision of stomach lesion 14.60 6.79 NA 1.14 22.53 NA 090 43611 A Excision of stomach lesion 17.84 8.06 NA 1.38 27.28 NA 090 43620 A Removal of stomach 30.04 12.99 NA 2.29 45.32 NA 090 43621 A Removal of stomach 30.73 13.14 NA 2.36 46.23 NA 090 43622 A Removal of stomach 32.53 13.74 NA 2.48 48.75 NA 090 43631 A Removal of stomach, partial 22.59 9.65 NA 1.99 34.23 NA 090 43632 A Removal of stomach, partial 22.59 9.65 NA 2.00 34.24 NA 090 43633 A Removal of stomach, partial 23.10 9.84 NA 2.05 34.99 NA 090 43634 A Removal of stomach, partial 25.12 10.50 NA 2.18 37.80 NA 090 43635 A Removal of stomach, partial 2.06 0.74 NA 0.21 3.01 NA ZZZ 43638 A Removal of stomach, partial 29.00 12.03 NA 2.24 43.27 NA 090 43639 A Removal of stomach, partial 29.65 12.28 NA 2.31 44.24 NA 090 43640 A Vagotomy & pylorus repair 17.02 7.66 NA 1.51 26.19 NA 090 43641 A Vagotomy & pylorus repair 17.27 7.79 NA 1.53 26.59 NA 090 43651 A Laparoscopy, vagus nerve 10.15 4.72 NA 1.03 15.90 NA 090 43652 A Laparoscopy, vagus nerve 12.15 5.37 NA 1.25 18.77 NA 090 43653 A Laparoscopy, gastrostomy 7.73 4.27 NA 0.78 12.78 NA 090 43659 C Laparoscope proc, stom 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43750 A Place gastrostomy tube 4.49 2.63 NA 0.33 7.45 NA 010 43752 B Nasal/orogastric w/stent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 43760 A Change gastrostomy tube 1.10 0.46 1.41 0.07 1.63 2.58 000 43761 A Reposition gastrostomy tube 2.01 0.82 NA 0.10 2.93 NA 000 43800 A Reconstruction of pylorus 13.69 6.56 NA 1.07 21.32 NA 090 43810 A Fusion of stomach and bowel 14.65 6.86 NA 1.10 22.61 NA 090 43820 A Fusion of stomach and bowel 15.37 7.07 NA 1.18 23.62 NA 090 43825 A Fusion of stomach and bowel 19.22 8.39 NA 1.50 29.11 NA 090 43830 A Place gastrostomy tube 9.53 4.98 NA 0.69 15.20 NA 090 43831 A Place gastrostomy tube 7.84 4.26 NA 0.81 12.91 NA 090 43832 A Place gastrostomy tube 15.60 7.56 NA 1.13 24.29 NA 090 43840 A Repair of stomach lesion 15.56 7.12 NA 1.20 23.88 NA 090 43842 A Gastroplasty for obesity 18.47 11.14 NA 1.51 31.12 NA 090 43843 A Gastroplasty for obesity 18.65 11.01 NA 1.53 31.19 NA 090 43846 A Gastric bypass for obesity 24.05 13.28 NA 1.96 39.29 NA 090 43847 A Gastric bypass for obesity 26.92 14.88 NA 2.14 43.94 NA 090 43848 A Revision gastroplasty 29.39 15.95 NA 2.39 47.73 NA 090 43850 A Revise stomach-bowel fusion 24.72 10.34 NA 1.97 37.03 NA 090 43855 A Revise stomach-bowel fusion 26.16 11.24 NA 2.01 39.41 NA 090 43860 A Revise stomach-bowel fusion 25.00 10.52 NA 2.03 37.55 NA 090 43865 A Revise stomach-bowel fusion 26.52 11.05 NA 2.15 39.72 NA 090 43870 A Repair stomach opening 9.69 5.08 NA 0.71 15.48 NA 090 43880 A Repair stomach-bowel fistula 24.65 10.86 NA 1.94 37.45 NA 090 43999 C Stomach surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44005 A Freeing of bowel adhesion 16.23 7.34 NA 1.39 24.96 NA 090 44010 A Incision of small bowel 12.52 6.42 NA 1.05 19.99 NA 090 44015 A Insert needle cath bowel 2.62 0.93 NA 0.25 3.80 NA ZZZ 44020 A Exploration of small bowel 13.99 6.50 NA 1.20 21.69 NA 090 44021 A Decompress small bowel 14.08 6.90 NA 1.18 22.16 NA 090 44025 A Incision of large bowel 14.28 6.61 NA 1.21 22.10 NA 090 44050 A Reduce bowel obstruction 14.03 6.52 NA 1.15 21.70 NA 090 44055 A Correct malrotation of bowel 22.00 9.38 NA 1.32 32.70 NA 090 44100 A Biopsy of bowel 2.01 1.07 NA 0.12 3.20 NA 000 44110 A Excision of bowel lesion(s) 11.81 5.78 NA 1.00 18.59 NA 090 44111 A Excision of bowel lesion(s) 14.29 7.20 NA 1.22 22.71 NA 090 44120 A Removal of small intestine 17.00 7.59 NA 1.46 26.05 NA 090 44121 A Removal of small intestine 4.45 1.60 NA 0.45 6.50 NA ZZZ 44125 A Removal of small intestine 17.54 7.77 NA 1.49 26.80 NA 090 44130 A Bowel to bowel fusion 14.49 6.69 NA 1.23 22.41 NA 090 44132 R Enterectomy, cadaver donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44133 R Enterectomy, live donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44135 R Intestine transplnt, cadaver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44136 R Intestine transplant, live 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44139 A Mobilization of colon 2.23 0.80 NA 0.21 3.24 NA ZZZ 44140 A Partial removal of colon 21.00 9.46 NA 1.83 32.29 NA 090 44141 A Partial removal of colon 19.51 11.66 NA 1.95 33.12 NA 090 44143 A Partial removal of colon 22.99 12.88 NA 2.02 37.89 NA 090 44144 A Partial removal of colon 21.53 11.57 NA 1.89 34.99 NA 090 44145 A Partial removal of colon 26.42 11.77 NA 2.22 40.41 NA 090 44146 A Partial removal of colon 27.54 14.77 NA 2.20 44.51 NA 090 44147 A Partial removal of colon 20.71 10.09 NA 1.74 32.54 NA 090 44150 A Removal of colon 23.95 13.79 NA 2.05 39.79 NA 090 44151 A Removal of colon/ileostomy 26.88 14.74 NA 1.97 43.59 NA 090 44152 A Removal of colon/ileostomy 27.83 16.60 NA 2.36 46.79 NA 090 44153 A Removal of colon/ileostomy 30.59 16.26 NA 2.33 49.18 NA 090 44155 A Removal of colon/ileostomy 27.86 15.02 NA 2.26 45.14 NA 090 Start Printed Page 40450 44156 A Removal of colon/ileostomy 30.79 16.48 NA 2.19 49.46 NA 090 44160 A Removal of colon 18.62 8.56 NA 1.55 28.73 NA 090 44200 A Laparoscopy, enterolysis 14.44 6.78 NA 1.46 22.68 NA 090 44201 A Laparoscopy, jejunostomy 9.78 5.11 NA 0.97 15.86 NA 090 44202 A Laparo, resect intestine 22.04 9.78 NA 2.16 33.98 NA 090 44209 C Laparoscope proc, intestine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44300 A Open bowel to skin 12.11 6.62 NA 0.88 19.61 NA 090 44310 A Ileostomy/jejunostomy 15.95 10.29 NA 1.13 27.37 NA 090 44312 A Revision of ileostomy 8.02 5.02 NA 0.54 13.58 NA 090 44314 A Revision of ileostomy 15.05 10.19 NA 0.99 26.23 NA 090 44316 A Devise bowel pouch 21.09 14.20 NA 1.41 36.70 NA 090 44320 A Colostomy 17.64 11.80 NA 1.28 30.72 NA 090 44322 A Colostomy with biopsies 11.98 9.91 NA 1.18 23.07 NA 090 44340 A Revision of colostomy 7.72 4.71 NA 0.56 12.99 NA 090 44345 A Revision of colostomy 15.43 8.19 NA 1.11 24.73 NA 090 44346 A Revision of colostomy 16.99 8.74 NA 1.20 26.93 NA 090 44360 A Small bowel endoscopy 2.59 1.36 NA 0.14 4.09 NA 000 44361 A Small bowel endoscopy/biopsy 2.87 1.46 NA 0.15 4.48 NA 000 44363 A Small bowel endoscopy 3.50 1.65 NA 0.19 5.34 NA 000 44364 A Small bowel endoscopy 3.74 1.78 NA 0.21 5.73 NA 000 44365 A Small bowel endoscopy 3.31 1.63 NA 0.18 5.12 NA 000 44366 A Small bowel endoscopy 4.41 2.02 NA 0.22 6.65 NA 000 44369 A Small bowel endoscopy 4.52 2.00 NA 0.23 6.75 NA 000 44370 A Small bowel endoscopy/stent 4.33 1.59 1.59 0.26 6.18 6.18 000 44372 A Small bowel endoscopy 4.41 2.02 NA 0.27 6.70 NA 000 44373 A Small bowel endoscopy 3.50 1.74 NA 0.19 5.43 NA 000 44376 A Small bowel endoscopy 5.26 2.32 NA 0.29 7.87 NA 000 44377 A Small bowel endoscopy/biopsy 5.53 2.45 NA 0.28 8.26 NA 000 44378 A Small bowel endoscopy 7.13 3.02 NA 0.37 10.52 NA 000 44379 A S bowel endoscope w/stent 7.07 2.55 2.55 0.45 10.07 10.07 000 44380 A Small bowel endoscopy 1.05 0.77 NA 0.08 1.90 NA 000 44382 A Small bowel endoscopy 1.27 0.86 NA 0.09 2.22 NA 000 44383 A Ileoscopy w/stent 2.41 0.87 0.87 0.15 3.43 3.43 000 44385 A Endoscopy of bowel pouch 1.82 0.94 4.40 0.12 2.88 6.34 000 44386 A Endoscopy, bowel pouch/biop 2.12 1.09 5.56 0.15 3.36 7.83 000 44388 A Colon endoscopy 2.82 1.39 6.06 0.18 4.39 9.06 000 44389 A Colonoscopy with biopsy 3.13 1.52 6.65 0.18 4.83 9.96 000 44390 A Colonoscopy for foreign body 3.83 1.80 7.38 0.22 5.85 11.43 000 44391 A Colonoscopy for bleeding 4.32 1.76 6.17 0.23 6.31 10.72 000 44392 A Colonoscopy and polypectomy 3.82 1.76 6.74 0.23 5.81 10.79 000 44393 A Colonoscopy, lesion removal 4.84 2.15 7.45 0.27 7.26 12.56 000 44394 A Colonoscopy w/snare 4.43 1.99 7.40 0.26 6.68 12.09 000 44397 A Colonoscopy w stent 4.23 1.90 NA 0.30 6.43 NA 000 44500 A Intro, gastrointestinal tube 0.49 0.36 NA 0.02 0.87 NA 000 44602 A Suture, small intestine 16.03 7.26 NA 1.07 24.36 NA 090 44603 A Suture, small intestine 18.66 8.18 NA 1.39 28.23 NA 090 44604 A Suture, large intestine 16.03 7.26 NA 1.42 24.71 NA 090 44605 A Repair of bowel lesion 19.53 8.92 NA 1.54 29.99 NA 090 44615 A Intestinal stricturoplasty 15.93 7.20 NA 1.39 24.52 NA 090 44620 A Repair bowel opening 12.20 5.79 NA 1.05 19.04 NA 090 44625 A Repair bowel opening 15.05 6.83 NA 1.30 23.18 NA 090 44626 A Repair bowel opening 25.36 10.52 NA 2.19 38.07 NA 090 44640 A Repair bowel-skin fistula 21.65 9.57 NA 1.46 32.68 NA 090 44650 A Repair bowel fistula 22.57 9.80 NA 1.49 33.86 NA 090 44660 A Repair bowel-bladder fistula 21.36 9.40 NA 1.14 31.90 NA 090 44661 A Repair bowel-bladder fistula 24.81 10.56 NA 1.53 36.90 NA 090 44680 A Surgical revision, intestine 15.40 7.38 NA 1.37 24.15 NA 090 44700 A Suspend bowel w/prosthesis 16.11 7.43 NA 1.21 24.75 NA 090 44799 C Intestine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44800 A Excision of bowel pouch 11.23 5.51 NA 1.11 17.85 NA 090 44820 A Excision of mesentery lesion 12.09 5.89 NA 1.03 19.01 NA 090 44850 A Repair of mesentery 10.74 5.55 NA 0.99 17.28 NA 090 44899 C Bowel surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44900 A Drain app abscess, open 10.14 5.83 NA 0.84 16.81 NA 090 44901 A Drain app abscess, percut 3.38 5.25 NA 0.17 8.80 NA 000 44950 A Appendectomy 10.00 5.25 NA 0.88 16.13 NA 090 44955 A Appendectomy add-on 1.53 0.57 NA 0.16 2.26 NA ZZZ 44960 A Appendectomy 12.34 6.41 NA 1.09 19.84 NA 090 44970 A Laparoscopy, appendectomy 8.70 4.16 NA 0.88 13.74 NA 090 44979 C Laparoscope proc, app 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45000 A Drainage of pelvic abscess 4.52 3.86 NA 0.37 8.75 NA 090 45005 A Drainage of rectal abscess 1.99 1.57 4.41 0.18 3.74 6.58 010 45020 A Drainage of rectal abscess 4.72 3.89 NA 0.41 9.02 NA 090 45100 A Biopsy of rectum 3.68 2.08 4.75 0.33 6.09 8.76 090 Start Printed Page 40451 45108 A Removal of anorectal lesion 4.76 3.06 5.90 0.46 8.28 11.12 090 45110 A Removal of rectum 28.00 13.10 NA 2.26 43.36 NA 090 45111 A Partial removal of rectum 16.48 8.62 NA 1.60 26.70 NA 090 45112 A Removal of rectum 30.54 13.57 NA 2.35 46.46 NA 090 45113 A Partial proctectomy 30.58 12.85 NA 2.13 45.56 NA 090 45114 A Partial removal of rectum 27.32 12.41 NA 2.28 42.01 NA 090 45116 A Partial removal of rectum 24.58 11.19 NA 2.00 37.77 NA 090 45119 A Remove rectum w/reservoir 30.84 13.31 NA 2.13 46.28 NA 090 45120 A Removal of rectum 24.60 11.41 NA 2.28 38.29 NA 090 45121 A Removal of rectum and colon 27.04 12.37 NA 2.66 42.07 NA 090 45123 A Partial proctectomy 16.71 7.62 NA 1.04 25.37 NA 090 45126 A Pelvic exenteration 45.16 19.69 NA 3.23 68.08 NA 090 45130 A Excision of rectal prolapse 16.44 7.66 NA 1.12 25.22 NA 090 45135 A Excision of rectal prolapse 19.28 9.16 NA 1.52 29.96 NA 090 45150 A Excision of rectal stricture 5.67 3.08 5.08 0.46 9.21 11.21 090 45160 A Excision of rectal lesion 15.32 6.97 NA 1.07 23.36 NA 090 45170 A Excision of rectal lesion 11.49 5.80 NA 0.89 18.18 NA 090 45190 A Destruction, rectal tumor 9.74 5.19 NA 0.76 15.69 NA 090 45300 A Proctosigmoidoscopy dx 0.38 0.23 1.28 0.05 0.66 1.71 000 45303 A Proctosigmoidoscopy dilate 0.44 0.26 1.47 0.06 0.76 1.97 000 45305 A Proctosigmoidoscopy & biopsy 1.01 0.45 1.55 0.09 1.55 2.65 000 45307 A Protosigmoidoscopy fb 0.94 0.42 2.35 0.15 1.51 3.44 000 45308 A Protosigmoidoscopy removal 0.83 0.39 1.53 0.13 1.35 2.49 000 45309 A Proctosigmoidoscopy 2.01 0.80 2.46 0.17 2.98 4.64 000 45315 A Protosigmoidoscopy removal 1.40 0.60 2.42 0.20 2.20 4.02 000 45317 A Protosigmoidoscopy bleed 1.50 0.63 1.79 0.20 2.33 3.49 000 45320 A Protosigmoidoscopy ablate 1.58 0.67 1.74 0.20 2.45 3.52 000 45321 A Protosigmoidoscopy volvul 1.17 0.52 NA 0.17 1.86 NA 000 45327 A Proctosigmoidoscopy w/stent 1.46 0.81 NA 0.12 2.39 NA 000 45330 A Diagnostic sigmoidoscopy 0.88 0.45 1.88 0.05 1.38 2.81 000 45331 A Sigmoidoscopy and biopsy 1.15 0.53 2.13 0.07 1.75 3.35 000 45332 A Sigmoidoscopy w/fb removal 1.79 0.76 3.73 0.11 2.66 5.63 000 45333 A Sigmoidoscopy & polypectomy 1.79 0.76 3.37 0.12 2.67 5.28 000 45334 A Sigmoidoscopy for bleeding 2.73 1.11 NA 0.16 4.00 NA 000 45337 A Sigmoidoscopy & decompress 2.36 0.97 NA 0.15 3.48 NA 000 45338 A Sigmoidoscpy w/tumr remove 2.34 0.96 4.01 0.15 3.45 6.50 000 45339 A Sigmoidoscopy 3.14 1.26 3.05 0.17 4.57 6.36 000 45341 A Sigmoidoscopy w/ultrasound 3.46 1.68 NA 0.24 5.38 NA 000 45342 A Sigmoidoscopy w/us guide bx 4.08 1.83 NA 0.29 6.20 NA 000 45345 A Sigmodoscopy w/stent 2.66 1.32 NA 0.18 4.16 NA 000 45355 A Surgical colonoscopy 3.52 1.27 NA 0.26 5.05 NA 000 45378 A Diagnostic colonoscopy 3.68 1.74 7.30 0.20 5.62 11.18 000 45378 53 A Diagnostic colonoscopy 0.88 0.45 1.88 0.05 1.38 2.81 000 45379 A Colonoscopy w/fb removal 4.69 2.09 7.87 0.25 7.03 12.81 000 45380 A Colonoscopy and biopsy 4.01 1.86 7.53 0.21 6.08 11.75 000 45382 A Colonoscopy/control bleeding 5.69 2.28 8.80 0.27 8.24 14.76 000 45383 A Lesion removal colonoscopy 5.87 2.52 8.59 0.32 8.71 14.78 000 45384 A Colonoscopy 4.70 2.11 8.21 0.24 7.05 13.15 000 45385 A Lesion removal colonoscopy 5.31 2.33 8.38 0.28 7.92 13.97 000 45387 A Colonoscopy w/stent 5.62 2.44 NA 0.36 8.42 NA 000 45500 A Repair of rectum 7.29 4.19 NA 0.56 12.04 NA 090 45505 A Repair of rectum 7.58 3.73 NA 0.50 11.81 NA 090 45520 A Treatment of rectal prolapse 0.55 0.19 0.75 0.04 0.78 1.34 000 45540 A Correct rectal prolapse 16.27 7.98 NA 1.17 25.42 NA 090 45541 A Correct rectal prolapse 13.40 6.83 NA 0.88 21.11 NA 090 45550 A Repair rectum/remove sigmoid 23.00 10.25 NA 1.58 34.83 NA 090 45560 A Repair of rectocele 10.58 5.99 NA 0.73 17.30 NA 090 45562 A Exploration/repair of rectum 15.38 7.40 NA 1.15 23.93 NA 090 45563 A Exploration/repair of rectum 23.47 11.08 NA 1.84 36.39 NA 090 45800 A Repair rect/bladder fistula 17.77 8.10 NA 1.14 27.01 NA 090 45805 A Repair fistula w/colostomy 20.78 9.94 NA 1.47 32.19 NA 090 45820 A Repair rectourethral fistula 18.48 8.48 NA 1.17 28.13 NA 090 45825 A Repair fistula w/colostomy 21.25 10.11 NA 0.97 32.33 NA 090 45900 A Reduction of rectal prolapse 2.61 1.03 NA 0.17 3.81 NA 010 45905 A Dilation of anal sphincter 2.30 0.95 3.50 0.14 3.39 5.94 010 45910 A Dilation of rectal narrowing 2.80 1.15 4.78 0.14 4.09 7.72 010 45915 A Remove rectal obstruction 3.14 1.11 4.59 0.17 4.42 7.90 010 45999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46030 A Removal of rectal marker 1.23 1.20 3.35 0.11 2.54 4.69 010 46040 A Incision of rectal abscess 4.96 3.06 5.40 0.48 8.50 10.84 090 46045 A Incision of rectal abscess 4.32 2.77 NA 0.40 7.49 NA 090 46050 A Incision of anal abscess 1.19 1.30 3.53 0.11 2.60 4.83 010 46060 A Incision of rectal abscess 5.69 3.75 NA 0.52 9.96 NA 090 46070 A Incision of anal septum 2.71 2.48 NA 0.27 5.46 NA 090 Start Printed Page 40452 46080 A Incision of anal sphincter 2.49 1.61 3.81 0.23 4.33 6.53 010 46083 A Incise external hemorrhoid 1.40 1.47 4.60 0.12 2.99 6.12 010 46200 A Removal of anal fissure 3.42 2.35 3.90 0.30 6.07 7.62 090 46210 A Removal of anal crypt 2.67 2.15 5.01 0.26 5.08 7.94 090 46211 A Removal of anal crypts 4.25 2.94 5.48 0.37 7.56 10.10 090 46220 A Removal of anal tab 1.56 0.56 1.24 0.14 2.26 2.94 010 46221 A Ligation of hemorrhoid(s) 2.04 0.73 3.40 0.12 2.89 5.56 010 46230 A Removal of anal tabs 2.57 1.68 4.18 0.22 4.47 6.97 010 46250 A Hemorrhoidectomy 3.89 2.67 5.25 0.43 6.99 9.57 090 46255 A Hemorrhoidectomy 4.60 2.88 5.87 0.51 7.99 10.98 090 46257 A Remove hemorrhoids & fissure 5.40 3.06 NA 0.59 9.05 NA 090 46258 A Remove hemorrhoids & fistula 5.73 3.27 NA 0.64 9.64 NA 090 46260 A Hemorrhoidectomy 6.37 3.94 NA 0.68 10.99 NA 090 46261 A Remove hemorrhoids & fissure 7.08 4.05 NA 0.70 11.83 NA 090 46262 A Remove hemorrhoids & fistula 7.50 4.31 NA 0.76 12.57 NA 090 46270 A Removal of anal fistula 3.72 2.55 4.91 0.36 6.63 8.99 090 46275 A Removal of anal fistula 4.56 2.78 4.70 0.40 7.74 9.66 090 46280 A Removal of anal fistula 5.98 3.69 NA 0.50 10.17 NA 090 46285 A Removal of anal fistula 4.09 2.60 3.91 0.34 7.03 8.34 090 46288 A Repair anal fistula 7.13 4.16 NA 0.60 11.89 NA 090 46320 A Removal of hemorrhoid clot 1.61 1.50 3.79 0.14 3.25 5.54 010 46500 A Injection into hemorrhoids 1.61 0.59 2.63 0.12 2.32 4.36 010 46600 A Diagnostic anoscopy 0.50 0.15 0.79 0.04 0.69 1.33 000 46604 A Anoscopy and dilation 1.31 0.47 0.95 0.09 1.87 2.35 000 46606 A Anoscopy and biopsy 0.81 0.29 0.88 0.07 1.17 1.76 000 46608 A Anoscopy/ remove for body 1.51 0.46 1.82 0.13 2.10 3.46 000 46610 A Anoscopy/remove lesion 1.32 0.48 1.44 0.12 1.92 2.88 000 46611 A Anoscopy 1.81 0.65 2.00 0.15 2.61 3.96 000 46612 A Anoscopy/ remove lesions 2.34 0.85 2.46 0.18 3.37 4.98 000 46614 A Anoscopy/control bleeding 2.01 0.71 1.68 0.14 2.86 3.83 000 46615 A Anoscopy 2.68 0.96 1.72 0.23 3.87 4.63 000 46700 A Repair of anal stricture 9.13 4.68 NA 0.56 14.37 NA 090 46705 A Repair of anal stricture 6.90 4.73 NA 0.73 12.36 NA 090 46715 A Repair of anovaginal fistula 7.20 4.50 NA 0.76 12.46 NA 090 46716 A Repair of anovaginal fistula 15.07 7.81 NA 1.30 24.18 NA 090 46730 A Construction of absent anus 26.75 12.10 NA 2.03 40.88 NA 090 46735 A Construction of absent anus 32.17 14.90 NA 2.64 49.71 NA 090 46740 A Construction of absent anus 30.00 12.81 NA 1.99 44.80 NA 090 46742 A Repair of imperforated anus 35.80 17.97 NA 2.63 56.40 NA 090 46744 A Repair of cloacal anomaly 52.63 20.67 NA 2.27 75.57 NA 090 46746 A Repair of cloacal anomaly 58.22 26.84 NA 2.51 87.57 NA 090 46748 A Repair of cloacal anomaly 64.21 29.21 NA 2.77 96.19 NA 090 46750 A Repair of anal sphincter 10.25 5.65 NA 0.69 16.59 NA 090 46751 A Repair of anal sphincter 8.77 6.30 NA 0.78 15.85 NA 090 46753 A Reconstruction of anus 8.29 4.04 NA 0.58 12.91 NA 090 46754 A Removal of suture from anus 2.20 1.32 5.40 0.12 3.64 7.72 010 46760 A Repair of anal sphincter 14.43 6.74 NA 0.86 22.03 NA 090 46761 A Repair of anal sphincter 13.84 6.62 NA 0.84 21.30 NA 090 46762 A Implant artificial sphincter 12.71 5.67 NA 0.71 19.09 NA 090 46900 A Destruction, anal lesion(s) 1.91 0.77 3.28 0.13 2.81 5.32 010 46910 A Destruction, anal lesion(s) 1.86 1.49 3.52 0.14 3.49 5.52 010 46916 A Cryosurgery, anal lesion(s) 1.86 1.60 3.44 0.09 3.55 5.39 010 46917 A Laser surgery, anal lesions 1.86 1.57 4.61 0.16 3.59 6.63 010 46922 A Excision of anal lesion(s) 1.86 1.43 3.81 0.17 3.46 5.84 010 46924 A Destruction, anal lesion(s) 2.76 1.70 5.01 0.20 4.66 7.97 010 46934 A Destruction of hemorrhoids 3.51 3.49 5.92 0.26 7.26 9.69 090 46935 A Destruction of hemorrhoids 2.43 0.87 4.07 0.17 3.47 6.67 010 46936 A Destruction of hemorrhoids 3.69 3.34 5.73 0.30 7.33 9.72 090 46937 A Cryotherapy of rectal lesion 2.69 2.44 4.03 0.12 5.25 6.84 010 46938 A Cryotherapy of rectal lesion 4.66 3.48 3.99 0.40 8.54 9.05 090 46940 A Treatment of anal fissure 2.32 0.83 3.08 0.17 3.32 5.57 010 46942 A Treatment of anal fissure 2.04 0.71 3.21 0.14 2.89 5.39 010 46945 A Ligation of hemorrhoids 1.84 2.13 3.83 0.17 4.14 5.84 090 46946 A Ligation of hemorrhoids 2.58 2.44 5.05 0.22 5.24 7.85 090 46999 C Anus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47000 A Needle biopsy of liver 1.90 0.67 9.17 0.09 2.66 11.16 000 47001 A Needle biopsy, liver add-on 1.90 0.68 NA 0.18 2.76 NA ZZZ 47010 A Open drainage, liver lesion 16.01 9.58 NA 0.65 26.24 NA 090 47011 A Percut drain, liver lesion 3.70 6.24 NA 0.17 10.11 NA 000 47015 A Inject/aspirate liver cyst 15.11 7.96 NA 0.86 23.93 NA 090 47100 A Wedge biopsy of liver 11.67 6.37 NA 0.75 18.79 NA 090 47120 A Partial removal of liver 35.50 16.79 NA 2.29 54.58 NA 090 47122 A Extensive removal of liver 55.13 23.83 NA 3.60 82.56 NA 090 47125 A Partial removal of liver 49.19 21.66 NA 3.18 74.03 NA 090 Start Printed Page 40453 47130 A Partial removal of liver 53.35 23.34 NA 3.47 80.16 NA 090 47133 X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47134 R Partial removal, donor liver 39.15 14.22 NA 3.98 57.35 NA XXX 47135 R Transplantation of liver 81.52 42.54 NA 8.13 132.19 NA 090 47136 R Transplantation of liver 68.60 46.19 NA 6.93 121.72 NA 090 47300 A Surgery for liver lesion 15.08 7.62 NA 0.97 23.67 NA 090 47350 A Repair liver wound 19.56 9.32 NA 1.25 30.13 NA 090 47360 A Repair liver wound 26.92 12.57 NA 1.71 41.20 NA 090 47361 A Repair liver wound 47.12 20.03 NA 3.11 70.26 NA 090 47362 A Repair liver wound 18.51 10.17 NA 1.22 29.90 NA 090 47379 C Laparoscope procedure, liver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47399 C Liver surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47400 A Incision of liver duct 32.49 14.82 NA 1.82 49.13 NA 090 47420 A Incision of bile duct 19.88 9.28 NA 1.70 30.86 NA 090 47425 A Incision of bile duct 19.83 9.54 NA 1.60 30.97 NA 090 47460 A Incise bile duct sphincter 18.04 8.90 NA 1.24 28.18 NA 090 47480 A Incision of gallbladder 10.82 6.52 NA 0.85 18.19 NA 090 47490 A Incision of gallbladder 7.23 7.60 NA 0.33 15.16 NA 090 47500 A Injection for liver x-rays 1.96 0.68 NA 0.09 2.73 NA 000 47505 A Injection for liver x-rays 0.76 0.26 15.72 0.03 1.05 16.51 000 47510 A Insert catheter, bile duct 7.83 9.35 NA 0.36 17.54 NA 090 47511 A Insert bile duct drain 10.50 10.59 NA 0.47 21.56 NA 090 47525 A Change bile duct catheter 5.55 3.33 NA 0.24 9.12 NA 010 47530 A Revise/reinsert bile tube 5.85 5.02 NA 0.29 11.16 NA 090 47550 A Bile duct endoscopy add-on 3.02 1.08 NA 0.30 4.40 NA ZZZ 47552 A Biliary endoscopy thru skin 6.04 2.51 NA 0.42 8.97 NA 000 47553 A Biliary endoscopy thru skin 6.35 2.70 NA 0.30 9.35 NA 000 47554 A Biliary endoscopy thru skin 9.06 3.52 NA 0.74 13.32 NA 000 47555 A Biliary endoscopy thru skin 7.56 3.13 NA 0.35 11.04 NA 000 47556 A Biliary endoscopy thru skin 8.56 3.48 NA 0.38 12.42 NA 000 47560 A Laparoscopy w/cholangio 4.89 1.90 NA 0.49 7.28 NA 000 47561 A Laparo w/cholangio/biopsy 5.18 2.22 NA 0.49 7.89 NA 000 47562 A Laparoscopic cholecystectomy 11.09 4.82 NA 1.13 17.04 NA 090 47563 A Laparoscopic cholecystectomy 11.94 5.32 NA 1.21 18.47 NA 090 47564 A Laparo cholecystectomy/explr 14.23 6.94 NA 1.44 22.61 NA 090 47570 A Laparo cholecystoenterostomy 12.58 5.93 NA 1.28 19.79 NA 090 47579 C Laparoscope proc, biliary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47600 A Removal of gallbladder 13.58 6.75 NA 1.16 21.49 NA 090 47605 A Removal of gallbladder 14.69 7.14 NA 1.25 23.08 NA 090 47610 A Removal of gallbladder 18.82 8.75 NA 1.61 29.18 NA 090 47612 A Removal of gallbladder 18.78 8.59 NA 1.60 28.97 NA 090 47620 A Removal of gallbladder 20.64 9.25 NA 1.77 31.66 NA 090 47630 A Remove bile duct stone 9.11 3.17 NA 0.46 12.74 NA 090 47700 A Exploration of bile ducts 15.62 8.73 NA 1.40 25.75 NA 090 47701 A Bile duct revision 27.81 13.42 NA 3.00 44.23 NA 090 47711 A Excision of bile duct tumor 23.03 11.21 NA 1.98 36.22 NA 090 47712 A Excision of bile duct tumor 30.24 14.20 NA 2.67 47.11 NA 090 47715 A Excision of bile duct cyst 18.80 8.85 NA 1.59 29.24 NA 090 47716 A Fusion of bile duct cyst 16.44 9.46 NA 1.41 27.31 NA 090 47720 A Fuse gallbladder & bowel 15.91 8.67 NA 1.37 25.95 NA 090 47721 A Fuse upper gi structures 19.12 9.77 NA 1.63 30.52 NA 090 47740 A Fuse gallbladder & bowel 18.48 9.61 NA 1.59 29.68 NA 090 47741 A Fuse gallbladder & bowel 21.34 10.50 NA 1.82 33.66 NA 090 47760 A Fuse bile ducts and bowel 25.85 12.12 NA 2.21 40.18 NA 090 47765 A Fuse liver ducts & bowel 24.88 12.79 NA 2.18 39.85 NA 090 47780 A Fuse bile ducts and bowel 26.50 12.37 NA 2.27 41.14 NA 090 47785 A Fuse bile ducts and bowel 31.18 14.72 NA 2.69 48.59 NA 090 47800 A Reconstruction of bile ducts 23.30 11.22 NA 1.95 36.47 NA 090 47801 A Placement, bile duct support 15.17 10.25 NA 0.69 26.11 NA 090 47802 A Fuse liver duct & intestine 21.55 11.28 NA 1.84 34.67 NA 090 47900 A Suture bile duct injury 19.90 10.04 NA 1.65 31.59 NA 090 47999 C Bile tract surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 48000 A Drainage of abdomen 28.07 12.79 NA 1.32 42.18 NA 090 48001 A Placement of drain, pancreas 35.45 14.98 NA 1.90 52.33 NA 090 48005 A Resect/debride pancreas 42.17 17.36 NA 2.26 61.79 NA 090 48020 A Removal of pancreatic stone 15.70 7.61 NA 1.36 24.67 NA 090 48100 A Biopsy of pancreas 12.23 6.89 NA 1.08 20.20 NA 090 48102 A Needle biopsy, pancreas 4.68 2.44 8.98 0.20 7.32 13.86 010 48120 A Removal of pancreas lesion 15.85 7.51 NA 1.35 24.71 NA 090 48140 A Partial removal of pancreas 22.94 10.69 NA 2.12 35.75 NA 090 48145 A Partial removal of pancreas 24.02 11.58 NA 2.25 37.85 NA 090 48146 A Pancreatectomy 26.40 13.53 NA 2.43 42.36 NA 090 48148 A Removal of pancreatic duct 17.34 9.25 NA 1.61 28.20 NA 090 48150 A Partial removal of pancreas 48.00 21.99 NA 4.43 74.42 NA 090 Start Printed Page 40454 48152 A Pancreatectomy 43.75 20.61 NA 4.07 68.43 NA 090 48153 A Pancreatectomy 47.89 21.97 NA 4.40 74.26 NA 090 48154 A Pancreatectomy 44.10 20.71 NA 4.10 68.91 NA 090 48155 A Removal of pancreas 24.64 13.79 NA 2.30 40.73 NA 090 48160 N Pancreas removal/transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48180 A Fuse pancreas and bowel 24.72 11.10 NA 2.24 38.06 NA 090 48400 A Injection, intraop add-on 1.95 0.68 NA 0.10 2.73 NA ZZZ 48500 A Surgery of pancreas cyst 15.28 7.53 NA 1.35 24.16 NA 090 48510 A Drain pancreatic pseudocyst 14.31 7.48 NA 1.07 22.86 NA 090 48511 A Drain pancreatic pseudocyst 4.00 4.71 NA 0.17 8.88 NA 000 48520 A Fuse pancreas cyst and bowel 15.59 7.29 NA 1.41 24.29 NA 090 48540 A Fuse pancreas cyst and bowel 19.72 8.81 NA 1.82 30.35 NA 090 48545 A Pancreatorrhaphy 18.18 8.74 NA 1.61 28.53 NA 090 48547 A Duodenal exclusion 25.83 10.89 NA 2.30 39.02 NA 090 48550 X Donor pancreatectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48554 R Transpl allograft pancreas 34.17 12.27 NA 3.30 49.74 NA 090 48556 A Removal, allograft pancreas 15.71 8.56 NA 1.52 25.79 NA 090 48999 C Pancreas surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49000 A Exploration of abdomen 11.68 6.14 NA 1.17 18.99 NA 090 49002 A Reopening of abdomen 10.49 6.02 NA 1.06 17.57 NA 090 49010 A Exploration behind abdomen 12.28 6.94 NA 1.22 20.44 NA 090 49020 A Drain abdominal abscess 22.84 11.55 NA 1.31 35.70 NA 090 49021 A Drain abdominal abscess 3.38 6.31 NA 0.16 9.85 NA 000 49040 A Drain, open, abdom abscess 13.52 8.00 NA 0.84 22.36 NA 090 49041 A Drain, percut, abdom abscess 4.00 6.50 NA 0.18 10.68 NA 000 49060 A Drain, open, retrop abscess 15.86 9.58 NA 0.77 26.21 NA 090 49061 A Drain, percut, retroper absc 3.70 6.44 NA 0.17 10.31 NA 000 49062 A Drain to peritoneal cavity 11.36 7.15 NA 1.08 19.59 NA 090 49080 A Puncture, peritoneal cavity 1.35 0.62 3.08 0.07 2.04 4.50 000 49081 A Removal of abdominal fluid 1.26 0.59 2.93 0.06 1.91 4.25 000 49085 A Remove abdomen foreign body 12.14 6.59 NA 0.88 19.61 NA 090 49180 A Biopsy, abdominal mass 1.73 0.60 7.64 0.08 2.41 9.45 000 49200 A Removal of abdominal lesion 10.25 6.43 NA 0.89 17.57 NA 090 49201 A Removal of abdominal lesion 14.84 8.71 NA 1.44 24.99 NA 090 49215 A Excise sacral spine tumor 33.50 14.97 NA 2.48 50.95 NA 090 49220 A Multiple surgery, abdomen 14.88 7.71 NA 1.51 24.10 NA 090 49250 A Excision of umbilicus 8.35 5.10 NA 0.84 14.29 NA 090 49255 A Removal of omentum 11.14 6.63 NA 1.12 18.89 NA 090 49320 A Diag laparo separate proc 5.10 3.04 NA 0.50 8.64 NA 010 49321 A Laparoscopy; biopsy 5.40 3.08 NA 0.53 9.01 NA 010 49322 A Laparoscopy; aspiration 5.70 3.47 NA 0.57 9.74 NA 010 49323 A Laparo drain lymphocele 9.48 4.01 NA 0.88 14.37 NA 090 49329 C Laparo proc, abdm/per/oment 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49400 A Air injection into abdomen 1.88 0.81 NA 0.11 2.80 NA 000 49420 A Insert abdominal drain 2.22 0.98 NA 0.13 3.33 NA 000 49421 A Insert abdominal drain 5.54 4.03 NA 0.55 10.12 NA 090 49422 A Remove perm cannula/catheter 6.25 2.96 NA 0.63 9.84 NA 010 49423 A Exchange drainage catheter 1.46 0.69 NA 0.07 2.22 NA 000 49424 A Assess cyst, contrast inject 0.76 0.45 NA 0.03 1.24 NA 000 49425 A Insert abdomen-venous drain 11.37 6.70 NA 1.21 19.28 NA 090 49426 A Revise abdomen-venous shunt 9.63 6.06 NA 0.93 16.62 NA 090 49427 A Injection, abdominal shunt 0.89 0.49 NA 0.05 1.43 NA 000 49428 A Ligation of shunt 6.06 3.22 NA 0.31 9.59 NA 010 49429 A Removal of shunt 7.40 3.49 NA 0.81 11.70 NA 010 49495 A Repair inguinal hernia, init 5.89 3.49 NA 0.55 9.93 NA 090 49496 A Repair inguinal hernia, init 8.79 6.44 NA 0.89 16.12 NA 090 49500 A Repair inguinal hernia 5.48 3.38 NA 0.46 9.32 NA 090 49501 A Repair inguinal hernia, init 8.88 4.48 NA 0.76 14.12 NA 090 49505 A Repair inguinal hernia 7.60 4.07 4.53 0.65 12.32 12.78 090 49507 A Repair inguinal hernia 9.57 6.05 NA 0.83 16.45 NA 090 49520 A Rerepair inguinal hernia 9.63 5.41 NA 0.84 15.88 NA 090 49521 A Repair inguinal hernia, rec 11.97 5.78 NA 1.04 18.79 NA 090 49525 A Repair inguinal hernia 8.57 4.90 NA 0.74 14.21 NA 090 49540 A Repair lumbar hernia 10.39 5.62 NA 0.90 16.91 NA 090 49550 A Repair femoral hernia 8.63 4.48 NA 0.75 13.86 NA 090 49553 A Repair femoral hernia, init 9.44 4.91 NA 0.83 15.18 NA 090 49555 A Repair femoral hernia 9.03 5.21 NA 0.79 15.03 NA 090 49557 A Repair femoral hernia, recur 11.15 5.51 NA 0.97 17.63 NA 090 49560 A Repair abdominal hernia 11.57 6.03 NA 1.00 18.60 NA 090 49561 A Repair incisional hernia 14.25 6.64 NA 1.23 22.12 NA 090 49565 A Rerepair abdominal hernia 11.57 6.21 NA 1.00 18.78 NA 090 49566 A Repair incisional hernia 14.40 6.69 NA 1.24 22.33 NA 090 49568 A Hernia repair w/mesh 4.89 1.76 NA 0.50 7.15 NA ZZZ 49570 A Repair epigastric hernia 5.69 3.44 NA 0.50 9.63 NA 090 Start Printed Page 40455 49572 A Repair epigastric hernia 6.73 3.95 NA 0.58 11.26 NA 090 49580 A Repair umbilical hernia 4.11 2.92 NA 0.34 7.37 NA 090 49582 A Repair umbilical hernia 6.65 4.82 NA 0.57 12.04 NA 090 49585 A Repair umbilical hernia 6.23 4.07 NA 0.53 10.83 NA 090 49587 A Repair umbilical hernia 7.56 4.21 NA 0.65 12.42 NA 090 49590 A Repair abdominal hernia 8.54 4.89 NA 0.74 14.17 NA 090 49600 A Repair umbilical lesion 10.96 6.30 NA 1.13 18.39 NA 090 49605 A Repair umbilical lesion 22.66 10.94 NA 2.57 36.17 NA 090 49606 A Repair umbilical lesion 18.60 9.23 NA 2.22 30.05 NA 090 49610 A Repair umbilical lesion 10.50 6.73 NA 0.77 18.00 NA 090 49611 A Repair umbilical lesion 8.92 6.42 NA 0.65 15.99 NA 090 49650 A Laparo hernia repair initial 6.27 3.29 NA 0.64 10.20 NA 090 49651 A Laparo hernia repair recur 8.24 4.34 NA 0.84 13.42 NA 090 49659 C Laparo proc, hernia repair 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49900 A Repair of abdominal wall 12.28 6.72 NA 1.23 20.23 NA 090 49905 A Omental flap 6.55 2.30 NA 0.61 9.46 NA ZZZ 49906 C Free omental flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 49999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50010 A Exploration of kidney 10.98 6.80 NA 0.79 18.57 NA 090 50020 A Renal abscess, open drain 14.66 13.73 NA 0.80 29.19 NA 090 50021 A Renal abscess, percut drain 3.38 12.63 NA 0.15 16.16 NA 000 50040 A Drainage of kidney 14.94 11.46 NA 0.82 27.22 NA 090 50045 A Exploration of kidney 15.46 8.23 NA 1.06 24.75 NA 090 50060 A Removal of kidney stone 19.30 9.60 NA 1.14 30.04 NA 090 50065 A Incision of kidney 20.79 7.79 NA 1.13 29.71 NA 090 50070 A Incision of kidney 20.32 10.48 NA 1.20 32.00 NA 090 50075 A Removal of kidney stone 25.34 12.28 NA 1.51 39.13 NA 090 50080 A Removal of kidney stone 14.71 10.56 NA 0.86 26.13 NA 090 50081 A Removal of kidney stone 21.80 12.63 NA 1.30 35.73 NA 090 50100 A Revise kidney blood vessels 16.09 9.39 NA 1.64 27.12 NA 090 50120 A Exploration of kidney 15.91 8.65 NA 1.04 25.60 NA 090 50125 A Explore and drain kidney 16.52 8.73 NA 1.07 26.32 NA 090 50130 A Removal of kidney stone 17.29 8.89 NA 1.04 27.22 NA 090 50135 A Exploration of kidney 19.18 9.49 NA 1.18 29.85 NA 090 50200 A Biopsy of kidney 2.63 0.93 NA 0.12 3.68 NA 000 50205 A Biopsy of kidney 11.31 6.38 NA 0.94 18.63 NA 090 50220 A Removal of kidney 17.15 8.98 NA 1.16 27.29 NA 090 50225 A Removal of kidney 20.23 9.94 NA 1.26 31.43 NA 090 50230 A Removal of kidney 22.07 10.54 NA 1.35 33.96 NA 090 50234 A Removal of kidney & ureter 22.40 10.62 NA 1.37 34.39 NA 090 50236 A Removal of kidney & ureter 24.86 13.67 NA 1.50 40.03 NA 090 50240 A Partial removal of kidney 22.00 12.71 NA 1.36 36.07 NA 090 50280 A Removal of kidney lesion 15.67 8.38 NA 0.99 25.04 NA 090 50290 A Removal of kidney lesion 14.73 8.15 NA 1.11 23.99 NA 090 50300 X Removal of donor kidney 0.00 0.00 0.00 0.00 0.00 0.00 XXX 50320 A Removal of donor kidney 22.21 10.41 NA 1.78 34.40 NA 090 50340 A Removal of kidney 12.15 8.83 NA 1.15 22.13 NA 090 50360 A Transplantation of kidney 31.53 17.54 NA 2.97 52.04 NA 090 50365 A Transplantation of kidney 36.81 21.31 NA 3.51 61.63 NA 090 50370 A Remove transplanted kidney 13.72 9.67 NA 1.26 24.65 NA 090 50380 A Reimplantation of kidney 20.76 13.56 NA 1.80 36.12 NA 090 50390 A Drainage of kidney lesion 1.96 0.68 NA 0.09 2.73 NA 000 50392 A Insert kidney drain 3.38 1.17 NA 0.15 4.70 NA 000 50393 A Insert ureteral tube 4.16 1.44 NA 0.18 5.78 NA 000 50394 A Injection for kidney x-ray 0.76 0.26 13.83 0.04 1.06 14.63 000 50395 A Create passage to kidney 3.38 1.16 NA 0.16 4.70 NA 000 50396 A Measure kidney pressure 2.09 0.88 NA 0.10 3.07 NA 000 50398 A Change kidney tube 1.46 0.50 1.36 0.07 2.03 2.89 000 50400 A Revision of kidney/ureter 19.50 9.69 NA 1.21 30.40 NA 090 50405 A Revision of kidney/ureter 23.93 12.83 NA 1.45 38.21 NA 090 50500 A Repair of kidney wound 19.57 11.22 NA 1.45 32.24 NA 090 50520 A Close kidney-skin fistula 17.23 10.54 NA 1.26 29.03 NA 090 50525 A Repair renal-abdomen fistula 22.27 12.65 NA 1.51 36.43 NA 090 50526 A Repair renal-abdomen fistula 24.02 15.49 NA 1.62 41.13 NA 090 50540 A Revision of horseshoe kidney 19.93 10.96 NA 1.28 32.17 NA 090 50541 A Laparo ablate renal cyst 16.00 6.63 NA 0.99 23.62 NA 090 50544 A Laparoscopy, pyeloplasty 22.40 8.83 NA 1.41 32.64 NA 090 50545 A Laparo radical nephrectomy 24.00 9.44 NA 1.81 35.25 NA 090 50546 A Laparoscopic nephrectomy 20.48 8.27 NA 1.37 30.12 NA 090 50547 A Laparo removal donor kidney 25.50 10.71 NA 2.04 38.25 NA 090 50548 A Laparo remove k/ureter 24.40 9.47 NA 1.49 35.36 NA 090 50549 C Laparoscope proc, renal 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50551 A Kidney endoscopy 5.60 1.87 4.62 0.33 7.80 10.55 000 50553 A Kidney endoscopy 5.99 2.05 16.02 0.35 8.39 22.36 000 Start Printed Page 40456 50555 A Kidney endoscopy & biopsy 6.53 2.20 18.71 0.38 9.11 25.62 000 50557 A Kidney endoscopy & treatment 6.62 2.22 18.82 0.39 9.23 25.83 000 50559 A Renal endoscopy/radiotracer 6.78 2.43 NA 0.27 9.48 NA 000 50561 A Kidney endoscopy & treatment 7.59 2.56 16.87 0.44 10.59 24.90 000 50570 A Kidney endoscopy 9.54 3.20 NA 0.56 13.30 NA 000 50572 A Kidney endoscopy 10.35 3.47 NA 0.64 14.46 NA 000 50574 A Kidney endoscopy & biopsy 11.02 3.69 NA 0.65 15.36 NA 000 50575 A Kidney endoscopy 13.98 4.69 NA 0.84 19.51 NA 000 50576 A Kidney endoscopy & treatment 10.99 3.65 NA 0.66 15.30 NA 000 50578 A Renal endoscopy/radiotracer 11.35 3.80 NA 0.67 15.82 NA 000 50580 A Kidney endoscopy & treatment 11.86 3.99 NA 0.70 16.55 NA 000 50590 A Fragmenting of kidney stone 9.09 5.07 10.10 0.54 14.70 19.73 090 50600 A Exploration of ureter 15.84 8.51 NA 0.99 25.34 NA 090 50605 A Insert ureteral support 15.46 8.71 NA 1.13 25.30 NA 090 50610 A Removal of ureter stone 15.92 8.96 NA 1.08 25.96 NA 090 50620 A Removal of ureter stone 15.16 8.09 NA 0.91 24.16 NA 090 50630 A Removal of ureter stone 14.94 8.16 NA 0.90 24.00 NA 090 50650 A Removal of ureter 17.41 9.25 NA 1.07 27.73 NA 090 50660 A Removal of ureter 19.55 10.03 NA 1.19 30.77 NA 090 50684 A Injection for ureter x-ray 0.76 0.26 14.20 0.04 1.06 15.00 000 50686 A Measure ureter pressure 1.51 0.71 4.77 0.09 2.31 6.37 000 50688 A Change of ureter tube 1.17 1.75 NA 0.06 2.98 NA 010 50690 A Injection for ureter x-ray 1.16 0.40 14.48 0.06 1.62 15.70 000 50700 A Revision of ureter 15.21 8.97 NA 0.86 25.04 NA 090 50715 A Release of ureter 18.90 12.10 NA 1.68 32.68 NA 090 50722 A Release of ureter 16.35 9.40 NA 1.41 27.16 NA 090 50725 A Release/revise ureter 18.49 10.26 NA 1.44 30.19 NA 090 50727 A Revise ureter 8.18 6.23 NA 0.51 14.92 NA 090 50728 A Revise ureter 12.02 7.80 NA 0.88 20.70 NA 090 50740 A Fusion of ureter & kidney 18.42 9.33 NA 1.49 29.24 NA 090 50750 A Fusion of ureter & kidney 19.51 10.28 NA 1.24 31.03 NA 090 50760 A Fusion of ureters 18.42 9.70 NA 1.25 29.37 NA 090 50770 A Splicing of ureters 19.51 9.93 NA 1.25 30.69 NA 090 50780 A Reimplant ureter in bladder 18.36 9.65 NA 1.20 29.21 NA 090 50782 A Reimplant ureter in bladder 19.54 11.18 NA 1.13 31.85 NA 090 50783 A Reimplant ureter in bladder 20.55 10.62 NA 1.35 32.52 NA 090 50785 A Reimplant ureter in bladder 20.52 10.37 NA 1.30 32.19 NA 090 50800 A Implant ureter in bowel 14.52 9.38 NA 0.92 24.82 NA 090 50810 A Fusion of ureter & bowel 20.05 12.91 NA 1.78 34.74 NA 090 50815 A Urine shunt to bowel 19.93 11.47 NA 1.31 32.71 NA 090 50820 A Construct bowel bladder 21.89 11.33 NA 1.38 34.60 NA 090 50825 A Construct bowel bladder 28.18 14.68 NA 1.81 44.67 NA 090 50830 A Revise urine flow 31.28 15.36 NA 2.20 48.84 NA 090 50840 A Replace ureter by bowel 20.00 11.53 NA 1.26 32.79 NA 090 50845 A Appendico-vesicostomy 20.89 9.67 NA 1.26 31.82 NA 090 50860 A Transplant ureter to skin 15.36 8.67 NA 1.01 25.04 NA 090 50900 A Repair of ureter 13.62 7.77 NA 0.98 22.37 NA 090 50920 A Closure ureter/skin fistula 14.33 8.72 NA 0.84 23.89 NA 090 50930 A Closure ureter/bowel fistula 18.72 9.73 NA 1.57 30.02 NA 090 50940 A Release of ureter 14.51 8.17 NA 1.04 23.72 NA 090 50945 A Laparoscopy ureterolithotomy 17.00 7.41 NA 1.15 25.56 NA 090 50947 A Laparo new ureter/bladder 24.50 11.58 NA 1.84 37.92 NA 090 50948 A Laparo new ureter/bladder 22.50 10.47 NA 1.70 34.67 NA 090 50949 C Laparoscope proc, ureter 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50951 A Endoscopy of ureter 5.84 1.96 5.01 0.35 8.15 11.20 000 50953 A Endoscopy of ureter 6.24 2.09 17.98 0.37 8.70 24.59 000 50955 A Ureter endoscopy & biopsy 6.75 2.30 18.69 0.38 9.43 25.82 000 50957 A Ureter endoscopy & treatment 6.79 2.28 18.28 0.40 9.47 25.47 000 50959 A Ureter endoscopy & tracer 4.40 1.59 NA 0.18 6.17 NA 000 50961 A Ureter endoscopy & treatment 6.05 2.04 22.48 0.35 8.44 28.88 000 50970 A Ureter endoscopy 7.14 2.40 NA 0.43 9.97 NA 000 50972 A Ureter endoscopy & catheter 6.89 2.37 NA 0.39 9.65 NA 000 50974 A Ureter endoscopy & biopsy 9.17 3.01 NA 0.53 12.71 NA 000 50976 A Ureter endoscopy & treatment 9.04 3.03 NA 0.53 12.60 NA 000 50978 A Ureter endoscopy & tracer 5.10 1.75 NA 0.30 7.15 NA 000 50980 A Ureter endoscopy & treatment 6.85 2.31 NA 0.41 9.57 NA 000 51000 A Drainage of bladder 0.78 0.25 1.95 0.05 1.08 2.78 000 51005 A Drainage of bladder 1.02 0.35 3.25 0.08 1.45 4.35 000 51010 A Drainage of bladder 3.53 1.86 6.96 0.23 5.62 10.72 010 51020 A Incise & treat bladder 6.71 5.42 NA 0.42 12.55 NA 090 51030 A Incise & treat bladder 6.77 5.46 NA 0.42 12.65 NA 090 51040 A Incise & drain bladder 4.40 4.19 NA 0.27 8.86 NA 090 51045 A Incise bladder/drain ureter 6.77 5.73 NA 0.47 12.97 NA 090 51050 A Removal of bladder stone 6.92 4.98 NA 0.42 12.32 NA 090 Start Printed Page 40457 51060 A Removal of ureter stone 8.85 6.16 NA 0.54 15.55 NA 090 51065 A Removal of ureter stone 8.85 5.99 NA 0.53 15.37 NA 090 51080 A Drainage of bladder abscess 5.96 5.51 NA 0.35 11.82 NA 090 51500 A Removal of bladder cyst 10.14 5.99 NA 0.88 17.01 NA 090 51520 A Removal of bladder lesion 9.29 6.21 NA 0.58 16.08 NA 090 51525 A Removal of bladder lesion 13.97 7.78 NA 0.85 22.60 NA 090 51530 A Removal of bladder lesion 12.38 7.37 NA 0.82 20.57 NA 090 51535 A Repair of ureter lesion 12.57 7.80 NA 0.90 21.27 NA 090 51550 A Partial removal of bladder 15.66 8.38 NA 1.05 25.09 NA 090 51555 A Partial removal of bladder 21.23 10.64 NA 1.37 33.24 NA 090 51565 A Revise bladder & ureter(s) 21.62 11.17 NA 1.40 34.19 NA 090 51570 A Removal of bladder 24.24 12.39 NA 1.59 38.22 NA 090 51575 A Removal of bladder & nodes 30.45 14.82 NA 1.88 47.15 NA 090 51580 A Remove bladder/revise tract 31.08 15.33 NA 1.94 48.35 NA 090 51585 A Removal of bladder & nodes 35.23 16.59 NA 2.18 54.00 NA 090 51590 A Remove bladder/revise tract 32.66 15.48 NA 2.01 50.15 NA 090 51595 A Remove bladder/revise tract 37.14 16.93 NA 2.23 56.30 NA 090 51596 A Remove bladder/create pouch 39.52 18.20 NA 2.39 60.11 NA 090 51597 A Removal of pelvic structures 38.35 17.93 NA 2.49 58.77 NA 090 51600 A Injection for bladder x-ray 0.88 0.30 14.75 0.04 1.22 15.67 000 51605 A Preparation for bladder xray 0.64 0.22 15.45 0.04 0.90 16.13 000 51610 A Injection for bladder x-ray 1.05 0.36 15.23 0.05 1.46 16.33 000 51700 A Irrigation of bladder 0.88 0.33 3.74 0.05 1.26 4.67 000 51705 A Change of bladder tube 1.02 1.25 2.50 0.06 2.33 3.58 010 51710 A Change of bladder tube 1.49 1.39 4.72 0.09 2.97 6.30 010 51715 A Endoscopic injection/implant 3.74 1.28 4.20 0.24 5.26 8.18 000 51720 A Treatment of bladder lesion 1.96 0.66 4.03 0.12 2.74 6.11 000 51725 A Simple cystometrogram 1.51 NA 5.50 0.13 NA 7.14 000 51725 26 A Simple cystometrogram 1.51 0.52 0.52 0.10 2.13 2.13 000 51725 TC A Simple cystometrogram 0.00 NA 4.98 0.03 NA 5.01 000 51726 A Complex cystometrogram 1.71 NA 4.33 0.15 NA 6.19 000 51726 26 A Complex cystometrogram 1.71 0.59 0.59 0.11 2.41 2.41 000 51726 TC A Complex cystometrogram 0.00 NA 3.74 0.04 NA 3.78 000 51736 A Urine flow measurement 0.61 NA 0.99 0.05 NA 1.65 000 51736 26 A Urine flow measurement 0.61 0.21 0.21 0.04 0.86 0.86 000 51736 TC A Urine flow measurement 0.00 NA 0.78 0.01 NA 0.79 000 51741 A Electro-uroflowmetry, first 1.14 NA 1.75 0.09 NA 2.98 000 51741 26 A Electro-uroflowmetry, first 1.14 0.39 0.39 0.07 1.60 1.60 000 51741 TC A Electro-uroflowmetry, first 0.00 NA 1.36 0.02 NA 1.38 000 51772 A Urethra pressure profile 1.61 NA 4.42 0.16 NA 6.19 000 51772 26 A Urethra pressure profile 1.61 0.58 0.58 0.12 2.31 2.31 000 51772 TC A Urethra pressure profile 0.00 NA 3.84 0.04 NA 3.88 000 51784 A Anal/urinary muscle study 1.53 NA 3.08 0.13 NA 4.74 000 51784 26 A Anal/urinary muscle study 1.53 0.53 0.53 0.10 2.16 2.16 000 51784 TC A Anal/urinary muscle study 0.00 NA 2.55 0.03 NA 2.58 000 51785 A Anal/urinary muscle study 1.53 NA 3.12 0.12 NA 4.77 000 51785 26 A Anal/urinary muscle study 1.53 0.53 0.53 0.09 2.15 2.15 000 51785 TC A Anal/urinary muscle study 0.00 NA 2.59 0.03 NA 2.62 000 51792 A Urinary reflex study 1.10 NA 3.18 0.20 NA 4.48 000 51792 26 A Urinary reflex study 1.10 0.44 0.44 0.09 1.63 1.63 000 51792 TC A Urinary reflex study 0.00 NA 2.74 0.11 NA 2.85 000 51795 A Urine voiding pressure study 1.53 NA 4.53 0.18 NA 6.24 000 51795 26 A Urine voiding pressure study 1.53 0.53 0.53 0.10 2.16 2.16 000 51795 TC A Urine voiding pressure study 0.00 NA 4.00 0.08 NA 4.08 000 51797 A Intraabdominal pressure test 1.60 NA 4.48 0.14 NA 6.22 000 51797 26 A Intraabdominal pressure test 1.60 0.55 0.55 0.10 2.25 2.25 000 51797 TC A Intraabdominal pressure test 0.00 NA 3.93 0.04 NA 3.97 000 51800 A Revision of bladder/urethra 17.42 9.26 NA 1.17 27.85 NA 090 51820 A Revision of urinary tract 17.89 10.78 NA 1.45 30.12 NA 090 51840 A Attach bladder/urethra 10.71 6.65 NA 0.87 18.23 NA 090 51841 A Attach bladder/urethra 13.03 8.36 NA 1.04 22.43 NA 090 51845 A Repair bladder neck 9.73 6.56 NA 0.62 16.91 NA 090 51860 A Repair of bladder wound 12.02 7.66 NA 0.89 20.57 NA 090 51865 A Repair of bladder wound 15.04 8.55 NA 1.01 24.60 NA 090 51880 A Repair of bladder opening 7.66 5.56 NA 0.54 13.76 NA 090 51900 A Repair bladder/vagina lesion 12.97 7.93 NA 0.87 21.77 NA 090 51920 A Close bladder-uterus fistula 11.81 7.67 NA 0.86 20.34 NA 090 51925 A Hysterectomy/bladder repair 15.58 9.17 NA 1.48 26.23 NA 090 51940 A Correction of bladder defect 28.43 14.31 NA 1.97 44.71 NA 090 51960 A Revision of bladder & bowel 23.01 12.58 NA 1.41 37.00 NA 090 51980 A Construct bladder opening 11.36 7.01 NA 0.74 19.11 NA 090 51990 A Laparo urethral suspension 12.50 6.53 NA 1.02 20.05 NA 090 51992 A Laparo sling operation 14.01 6.54 NA 0.93 21.48 NA 090 52000 A Cystoscopy 2.01 0.68 3.20 0.12 2.81 5.33 000 Start Printed Page 40458 52005 A Cystoscopy & ureter catheter 2.37 0.79 4.97 0.15 3.31 7.49 000 52007 A Cystoscopy and biopsy 3.02 1.01 NA 0.18 4.21 NA 000 52010 A Cystoscopy & duct catheter 3.02 1.02 5.34 0.18 4.22 8.54 000 52204 A Cystoscopy 2.37 0.80 5.72 0.15 3.32 8.24 000 52214 A Cystoscopy and treatment 3.71 1.24 6.08 0.22 5.17 10.01 000 52224 A Cystoscopy and treatment 3.14 1.05 5.94 0.18 4.37 9.26 000 52234 A Cystoscopy and treatment 4.63 1.55 6.86 0.27 6.45 11.76 000 52235 A Cystoscopy and treatment 5.45 1.83 7.15 0.32 7.60 12.92 000 52240 A Cystoscopy and treatment 9.72 3.26 8.58 0.58 13.56 18.88 000 52250 A Cystoscopy and radiotracer 4.50 1.51 NA 0.27 6.28 NA 000 52260 A Cystoscopy and treatment 3.92 1.32 NA 0.23 5.47 NA 000 52265 A Cystoscopy and treatment 2.94 0.99 3.62 0.18 4.11 6.74 000 52270 A Cystoscopy & revise urethra 3.37 1.13 6.47 0.20 4.70 10.04 000 52275 A Cystoscopy & revise urethra 4.70 1.57 6.96 0.28 6.55 11.94 000 52276 A Cystoscopy and treatment 5.00 1.67 7.06 0.30 6.97 12.36 000 52277 A Cystoscopy and treatment 6.17 2.10 NA 0.38 8.65 NA 000 52281 A Cystoscopy and treatment 2.80 0.94 3.62 0.17 3.91 6.59 000 52282 A Cystoscopy, implant stent 6.40 2.15 7.23 0.38 8.93 14.01 000 52283 A Cystoscopy and treatment 3.74 1.26 6.37 0.22 5.22 10.33 000 52285 A Cystoscopy and treatment 3.61 1.21 6.58 0.22 5.04 10.41 000 52290 A Cystoscopy and treatment 4.59 1.55 NA 0.27 6.41 NA 000 52300 A Cystoscopy and treatment 5.31 1.78 NA 0.32 7.41 NA 000 52301 A Cystoscopy and treatment 5.51 1.79 NA 0.39 7.69 NA 000 52305 A Cystoscopy and treatment 5.31 1.78 NA 0.31 7.40 NA 000 52310 A Cystoscopy and treatment 2.81 0.94 14.32 0.17 3.92 17.30 000 52315 A Cystoscopy and treatment 5.21 1.75 15.30 0.31 7.27 20.82 000 52317 A Remove bladder stone 6.72 2.25 24.35 0.40 9.37 31.47 000 52318 A Remove bladder stone 9.19 3.08 NA 0.54 12.81 NA 000 52320 A Cystoscopy and treatment 4.70 1.58 NA 0.28 6.56 NA 000 52325 A Cystoscopy, stone removal 6.16 2.06 NA 0.37 8.59 NA 000 52327 A Cystoscopy, inject material 5.19 1.77 NA 0.32 7.28 NA 000 52330 A Cystoscopy and treatment 5.04 1.69 19.35 0.30 7.03 24.69 000 52332 A Cystoscopy and treatment 2.83 0.95 29.05 0.17 3.95 32.05 000 52334 A Create passage to kidney 4.83 1.62 NA 0.28 6.73 NA 000 52341 A Cysto w/ureter stricture tx 6.00 2.37 NA 0.34 8.71 NA 000 52342 A Cysto w/up stricture tx 6.50 2.57 NA 0.36 9.43 NA 000 52343 A Cysto w/renal stricture tx 7.20 2.85 NA 0.40 10.45 NA 000 52344 A Cysto/uretero, stone remove 7.70 3.04 NA 0.42 11.16 NA 000 52345 A Cysto/uretero w/up stricture 8.20 3.24 NA 0.46 11.90 NA 000 52346 A Cystouretero w/renal strict 9.23 3.65 NA 0.51 13.39 NA 000 52351 A Cystouretro & or pyeloscope 5.86 1.97 NA 0.32 8.15 NA 000 52352 A Cystouretro w/stone remove 6.88 2.31 NA 0.38 9.57 NA 000 52353 A Cystouretero w/lithotripsy 7.97 2.67 NA 0.44 11.08 NA 000 52354 A Cystouretero w/biopsy 7.34 2.46 NA 0.41 10.21 NA 000 52355 A Cystouretero w/excise tumor 8.82 2.96 NA 0.50 12.28 NA 000 52400 A Cystouretero w/congen repr 9.68 5.45 NA 0.53 15.66 NA 090 52450 A Incision of prostate 7.64 6.17 NA 0.46 14.27 NA 090 52500 A Revision of bladder neck 8.47 6.44 NA 0.50 15.41 NA 090 52510 A Dilation prostatic urethra 6.72 5.50 NA 0.40 12.62 NA 090 52601 A Prostatectomy (TURP) 12.37 7.76 NA 0.74 20.87 NA 090 52606 A Control postop bleeding 8.13 5.93 NA 0.49 14.55 NA 090 52612 A Prostatectomy, first stage 7.98 6.29 NA 0.48 14.75 NA 090 52614 A Prostatectomy, second stage 6.84 5.89 NA 0.41 13.14 NA 090 52620 A Remove residual prostate 6.61 5.83 NA 0.39 12.83 NA 090 52630 A Remove prostate regrowth 7.26 6.05 NA 0.43 13.74 NA 090 52640 A Relieve bladder contracture 6.62 5.40 NA 0.39 12.41 NA 090 52647 A Laser surgery of prostate 10.36 5.33 57.84 0.61 16.30 68.81 090 52648 A Laser surgery of prostate 11.21 7.39 NA 0.66 19.26 NA 090 52700 A Drainage of prostate abscess 6.80 5.98 NA 0.41 13.19 NA 090 53000 A Incision of urethra 2.28 2.46 7.27 0.13 4.87 9.68 010 53010 A Incision of urethra 3.64 3.97 NA 0.20 7.81 NA 090 53020 A Incision of urethra 1.77 0.66 3.91 0.11 2.54 5.79 000 53025 A Incision of urethra 1.13 0.44 4.44 0.07 1.64 5.64 000 53040 A Drainage of urethra abscess 6.40 7.92 12.82 0.41 14.73 19.63 090 53060 A Drainage of urethra abscess 2.63 3.03 6.22 0.23 5.89 9.08 010 53080 A Drainage of urinary leakage 6.29 7.84 NA 0.42 14.55 NA 090 53085 A Drainage of urinary leakage 10.27 9.30 NA 0.67 20.24 NA 090 53200 A Biopsy of urethra 2.59 0.96 5.28 0.17 3.72 8.04 000 53210 A Removal of urethra 12.57 7.75 NA 0.81 21.13 NA 090 53215 A Removal of urethra 15.58 8.41 NA 0.93 24.92 NA 090 53220 A Treatment of urethra lesion 7.00 5.35 NA 0.44 12.79 NA 090 53230 A Removal of urethra lesion 9.58 6.09 NA 0.60 16.27 NA 090 53235 A Removal of urethra lesion 10.14 6.33 NA 0.60 17.07 NA 090 53240 A Surgery for urethra pouch 6.45 4.92 NA 0.42 11.79 NA 090 Start Printed Page 40459 53250 A Removal of urethra gland 5.89 4.21 NA 0.35 10.45 NA 090 53260 A Treatment of urethra lesion 2.98 2.33 5.88 0.23 5.54 9.09 010 53265 A Treatment of urethra lesion 3.12 2.28 6.20 0.20 5.60 9.52 010 53270 A Removal of urethra gland 3.09 2.41 5.55 0.21 5.71 8.85 010 53275 A Repair of urethra defect 4.53 3.22 NA 0.28 8.03 NA 010 53400 A Revise urethra, stage 1 12.77 7.82 NA 0.85 21.44 NA 090 53405 A Revise urethra, stage 2 14.48 8.12 NA 0.91 23.51 NA 090 53410 A Reconstruction of urethra 16.44 8.72 NA 0.99 26.15 NA 090 53415 A Reconstruction of urethra 19.41 9.63 NA 1.16 30.20 NA 090 53420 A Reconstruct urethra, stage 1 14.08 8.41 NA 0.90 23.39 NA 090 53425 A Reconstruct urethra, stage 2 15.98 8.93 NA 0.97 25.88 NA 090 53430 A Reconstruction of urethra 16.34 8.88 NA 1.01 26.23 NA 090 53440 A Correct bladder function 12.34 7.66 NA 0.73 20.73 NA 090 53442 A Remove perineal prosthesis 8.27 5.81 NA 0.55 14.63 NA 090 53443 A Reconstruction of urethra 19.89 9.44 NA 1.25 30.58 NA 090 53445 A Correct urine flow control 14.06 8.26 NA 0.84 23.16 NA 090 53447 A Remove artificial sphincter 13.17 7.55 NA 0.79 21.51 NA 090 53449 A Correct artificial sphincter 9.70 6.38 NA 0.57 16.65 NA 090 53450 A Revision of urethra 6.14 4.84 NA 0.37 11.35 NA 090 53460 A Revision of urethra 7.12 5.21 NA 0.43 12.76 NA 090 53502 A Repair of urethra injury 7.63 5.42 NA 0.50 13.55 NA 090 53505 A Repair of urethra injury 7.63 5.35 NA 0.46 13.44 NA 090 53510 A Repair of urethra injury 10.11 6.41 NA 0.60 17.12 NA 090 53515 A Repair of urethra injury 13.31 7.29 NA 0.83 21.43 NA 090 53520 A Repair of urethra defect 8.68 5.82 NA 0.53 15.03 NA 090 53600 A Dilate urethra stricture 1.21 0.50 3.94 0.07 1.78 5.22 000 53601 A Dilate urethra stricture 0.98 0.43 3.87 0.06 1.47 4.91 000 53605 A Dilate urethra stricture 1.28 0.43 NA 0.08 1.79 NA 000 53620 A Dilate urethra stricture 1.62 0.54 5.85 0.10 2.26 7.57 000 53621 A Dilate urethra stricture 1.35 0.45 5.87 0.08 1.88 7.30 000 53660 A Dilation of urethra 0.71 0.34 3.72 0.04 1.09 4.47 000 53661 A Dilation of urethra 0.72 0.24 3.77 0.04 1.00 4.53 000 53665 A Dilation of urethra 0.76 0.26 NA 0.05 1.07 NA 000 53670 A Insert urinary catheter 0.50 0.21 3.48 0.03 0.74 4.01 000 53675 A Insert urinary catheter 1.47 0.48 4.70 0.09 2.04 6.26 000 53850 A Prostatic microwave thermotx 9.45 4.98 82.83 0.56 14.99 92.84 090 53852 A Prostatic rf thermotx 9.88 5.23 71.16 0.58 15.69 81.62 090 53899 C Urology surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54000 A Slitting of prepuce 1.54 1.39 5.42 0.10 3.03 7.06 010 54001 A Slitting of prepuce 2.19 2.01 6.02 0.14 4.34 8.35 010 54015 A Drain penis lesion 5.32 3.07 6.85 0.33 8.72 12.50 010 54050 A Destruction, penis lesion(s) 1.24 0.50 2.64 0.07 1.81 3.95 010 54055 A Destruction, penis lesion(s) 1.22 1.40 6.48 0.07 2.69 7.77 010 54056 A Cryosurgery, penis lesion(s) 1.24 0.53 2.92 0.06 1.83 4.22 010 54057 A Laser surg, penis lesion(s) 1.24 1.30 2.92 0.08 2.62 4.24 010 54060 A Excision of penis lesion(s) 1.93 1.56 5.37 0.12 3.61 7.42 010 54065 A Destruction, penis lesion(s) 2.42 2.08 5.28 0.13 4.63 7.83 010 54100 A Biopsy of penis 1.90 0.74 3.57 0.10 2.74 5.57 000 54105 A Biopsy of penis 3.50 2.09 6.24 0.21 5.80 9.95 010 54110 A Treatment of penis lesion 10.13 7.76 NA 0.60 18.49 NA 090 54111 A Treat penis lesion, graft 13.57 8.81 NA 0.79 23.17 NA 090 54112 A Treat penis lesion, graft 15.86 9.64 NA 0.94 26.44 NA 090 54115 A Treatment of penis lesion 6.15 6.49 10.30 0.39 13.03 16.84 090 54120 A Partial removal of penis 9.97 7.69 NA 0.60 18.26 NA 090 54125 A Removal of penis 13.53 8.86 NA 0.81 23.20 NA 090 54130 A Remove penis & nodes 20.14 11.35 NA 1.19 32.68 NA 090 54135 A Remove penis & nodes 26.36 13.47 NA 1.58 41.41 NA 090 54150 A Circumcision 1.81 1.91 7.90 0.17 3.89 9.88 010 54152 A Circumcision 2.31 1.71 NA 0.16 4.18 NA 010 54160 A Circumcision 2.48 1.71 5.89 0.16 4.35 8.53 010 54161 A Circumcision 3.27 1.99 NA 0.20 5.46 NA 010 54200 A Treatment of penis lesion 1.06 0.37 2.62 0.06 1.49 3.74 010 54205 A Treatment of penis lesion 7.93 7.15 NA 0.47 15.55 NA 090 54220 A Treatment of penis lesion 2.42 1.00 1.94 0.15 3.57 4.51 000 54230 A Prepare penis study 1.34 0.45 NA 0.08 1.87 NA 000 54231 A Dynamic cavernosometry 2.04 0.80 2.19 0.14 2.98 4.37 000 54235 A Penile injection 1.19 0.40 1.11 0.07 1.66 2.37 000 54240 A Penis study 1.31 NA 1.19 0.13 NA 2.63 000 54240 26 A Penis study 1.31 0.45 0.45 0.08 1.84 1.84 000 54240 TC A Penis study 0.00 NA 0.74 0.05 NA 0.79 000 54250 A Penis study 2.22 NA 3.37 0.16 NA 5.75 000 54250 26 A Penis study 2.22 0.74 0.74 0.14 3.10 3.10 000 54250 TC A Penis study 0.00 NA 2.63 0.02 NA 2.65 000 54300 A Revision of penis 10.41 8.42 NA 0.64 19.47 NA 090 Start Printed Page 40460 54304 A Revision of penis 12.49 9.50 NA 0.74 22.73 NA 090 54308 A Reconstruction of urethra 11.83 9.16 NA 0.70 21.69 NA 090 54312 A Reconstruction of urethra 13.57 10.23 NA 0.81 24.61 NA 090 54316 A Reconstruction of urethra 16.82 11.67 NA 1.00 29.49 NA 090 54318 A Reconstruction of urethra 11.25 9.18 NA 1.15 21.58 NA 090 54322 A Reconstruction of urethra 13.01 8.75 NA 0.77 22.53 NA 090 54324 A Reconstruction of urethra 16.31 11.64 NA 1.03 28.98 NA 090 54326 A Reconstruction of urethra 15.72 10.09 NA 0.93 26.74 NA 090 54328 A Revise penis/urethra 15.65 10.43 NA 0.92 27.00 NA 090 54332 A Revise penis/urethra 17.08 11.76 NA 1.01 29.85 NA 090 54336 A Revise penis/urethra 20.04 16.59 NA 1.90 38.53 NA 090 54340 A Secondary urethral surgery 8.91 7.79 NA 0.72 17.42 NA 090 54344 A Secondary urethral surgery 15.94 11.73 NA 1.10 28.77 NA 090 54348 A Secondary urethral surgery 17.15 12.66 NA 1.02 30.83 NA 090 54352 A Reconstruct urethra/penis 24.74 15.36 NA 1.62 41.72 NA 090 54360 A Penis plastic surgery 11.93 8.27 NA 0.72 20.92 NA 090 54380 A Repair penis 13.18 9.18 NA 1.16 23.52 NA 090 54385 A Repair penis 15.39 11.82 NA 0.71 27.92 NA 090 54390 A Repair penis and bladder 21.61 13.41 NA 1.28 36.30 NA 090 54400 A Insert semi-rigid prosthesis 8.99 6.12 NA 0.53 15.64 NA 090 54401 A Insert self-contd prosthesis 10.28 6.93 NA 0.61 17.82 NA 090 54402 A Remove penis prosthesis 9.21 6.23 NA 0.55 15.99 NA 090 54405 A Insert multi-comp prosthesis 13.43 8.03 NA 0.80 22.26 NA 090 54407 A Remove multi-comp prosthesis 13.34 7.62 NA 0.80 21.76 NA 090 54409 A Revise penis prosthesis 12.20 7.37 NA 0.73 20.30 NA 090 54420 A Revision of penis 11.42 8.18 NA 0.72 20.32 NA 090 54430 A Revision of penis 10.15 7.71 NA 0.60 18.46 NA 090 54435 A Revision of penis 6.12 5.81 NA 0.36 12.29 NA 090 54440 C Repair of penis 0.00 0.00 0.00 0.00 0.00 0.00 090 54450 A Preputial stretching 1.12 0.47 1.01 0.07 1.66 2.20 000 54500 A Biopsy of testis 1.31 0.45 6.11 0.08 1.84 7.50 000 54505 A Biopsy of testis 3.46 2.57 NA 0.21 6.24 NA 010 54510 A Removal of testis lesion 5.45 3.43 NA 0.35 9.23 NA 090 54512 A Excise lesion testis 8.58 4.92 NA 0.51 14.01 NA 090 54520 A Removal of testis 5.23 3.55 NA 0.33 9.11 NA 090 54522 A Orchiectomy, partial 9.50 5.88 NA 0.57 15.95 NA 090 54530 A Removal of testis 8.58 5.18 NA 0.53 14.29 NA 090 54535 A Extensive testis surgery 12.16 7.07 NA 0.83 20.06 NA 090 54550 A Exploration for testis 7.78 4.70 NA 0.49 12.97 NA 090 54560 A Exploration for testis 11.13 6.79 NA 0.79 18.71 NA 090 54600 A Reduce testis torsion 7.01 4.21 NA 0.45 11.67 NA 090 54620 A Suspension of testis 4.90 3.05 NA 0.31 8.26 NA 010 54640 A Suspension of testis 6.90 4.21 NA 0.49 11.60 NA 090 54650 A Orchiopexy (Fowler-Stephens) 11.45 7.11 NA 0.81 19.37 NA 090 54660 A Revision of testis 5.11 3.26 NA 0.35 8.72 NA 090 54670 A Repair testis injury 6.41 4.16 NA 0.41 10.98 NA 090 54680 A Relocation of testis(es) 12.65 7.47 NA 0.94 21.06 NA 090 54690 A Laparoscopy, orchiectomy 10.96 6.42 NA 0.99 18.37 NA 090 54692 A Laparoscopy, orchiopexy 12.88 5.68 NA 0.87 19.43 NA 090 54699 C Laparoscope proc, testis 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54700 A Drainage of scrotum 3.43 3.32 8.16 0.23 6.98 11.82 010 54800 A Biopsy of epididymis 2.33 0.81 6.31 0.14 3.28 8.78 000 54820 A Exploration of epididymis 5.14 3.55 NA 0.33 9.02 NA 090 54830 A Remove epididymis lesion 5.38 3.64 NA 0.34 9.36 NA 090 54840 A Remove epididymis lesion 5.20 3.57 NA 0.31 9.08 NA 090 54860 A Removal of epididymis 6.32 4.14 NA 0.38 10.84 NA 090 54861 A Removal of epididymis 8.90 5.01 NA 0.52 14.43 NA 090 54900 A Fusion of spermatic ducts 13.20 7.06 NA 1.34 21.60 NA 090 54901 A Fusion of spermatic ducts 17.94 9.80 NA 1.83 29.57 NA 090 55000 A Drainage of hydrocele 1.43 0.49 2.10 0.10 2.02 3.63 000 55040 A Removal of hydrocele 5.36 3.40 NA 0.35 9.11 NA 090 55041 A Removal of hydroceles 7.74 4.43 NA 0.50 12.67 NA 090 55060 A Repair of hydrocele 5.52 3.44 NA 0.37 9.33 NA 090 55100 A Drainage of scrotum abscess 2.13 3.56 9.32 0.15 5.84 11.60 010 55110 A Explore scrotum 5.70 3.55 NA 0.36 9.61 NA 090 55120 A Removal of scrotum lesion 5.09 3.32 NA 0.33 8.74 NA 090 55150 A Removal of scrotum 7.22 4.52 NA 0.47 12.21 NA 090 55175 A Revision of scrotum 5.24 3.66 NA 0.33 9.23 NA 090 55180 A Revision of scrotum 10.72 6.39 NA 0.72 17.83 NA 090 55200 A Incision of sperm duct 4.24 3.06 NA 0.25 7.55 NA 090 55250 A Removal of sperm duct(s) 3.29 3.00 9.03 0.21 6.50 12.53 090 55300 A Prepare, sperm duct x-ray 3.51 1.45 NA 0.20 5.16 NA 000 55400 A Repair of sperm duct 8.49 5.17 NA 0.50 14.16 NA 090 55450 A Ligation of sperm duct 4.12 2.42 7.52 0.24 6.78 11.88 010 Start Printed Page 40461 55500 A Removal of hydrocele 5.59 3.61 NA 0.43 9.63 NA 090 55520 A Removal of sperm cord lesion 6.03 3.72 NA 0.56 10.31 NA 090 55530 A Revise spermatic cord veins 5.66 3.74 NA 0.36 9.76 NA 090 55535 A Revise spermatic cord veins 6.56 4.05 NA 0.42 11.03 NA 090 55540 A Revise hernia & sperm veins 7.67 4.30 NA 0.74 12.71 NA 090 55550 A Laparo ligate spermatic vein 6.57 3.34 NA 0.47 10.38 NA 090 55559 C Laparo proc, spermatic cord 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55600 A Incise sperm duct pouch 6.38 4.18 NA 0.38 10.94 NA 090 55605 A Incise sperm duct pouch 7.96 5.13 NA 0.54 13.63 NA 090 55650 A Remove sperm duct pouch 11.80 6.17 NA 0.72 18.69 NA 090 55680 A Remove sperm pouch lesion 5.19 3.84 NA 0.31 9.34 NA 090 55700 A Biopsy of prostate 1.57 0.53 3.75 0.10 2.20 5.42 000 55705 A Biopsy of prostate 4.57 3.71 NA 0.26 8.54 NA 010 55720 A Drainage of prostate abscess 7.64 5.92 NA 0.44 14.00 NA 090 55725 A Drainage of prostate abscess 8.68 6.48 NA 0.51 15.67 NA 090 55801 A Removal of prostate 17.80 9.33 NA 1.08 28.21 NA 090 55810 A Extensive prostate surgery 22.58 11.34 NA 1.35 35.27 NA 090 55812 A Extensive prostate surgery 27.51 13.82 NA 1.69 43.02 NA 090 55815 A Extensive prostate surgery 30.46 14.38 NA 1.84 46.68 NA 090 55821 A Removal of prostate 14.25 7.83 NA 0.85 22.93 NA 090 55831 A Removal of prostate 15.62 8.32 NA 0.94 24.88 NA 090 55840 A Extensive prostate surgery 22.69 11.76 NA 1.37 35.82 NA 090 55842 A Extensive prostate surgery 24.38 12.37 NA 1.48 38.23 NA 090 55845 A Extensive prostate surgery 28.55 13.70 NA 1.71 43.96 NA 090 55859 A Percut/needle insert, pros 12.52 7.41 NA 0.74 20.67 NA 090 55860 A Surgical exposure, prostate 14.45 8.41 NA 0.82 23.68 NA 090 55862 A Extensive prostate surgery 18.39 9.45 NA 1.14 28.98 NA 090 55865 A Extensive prostate surgery 22.87 11.07 NA 1.37 35.31 NA 090 55870 A Electroejaculation 2.58 1.15 1.84 0.14 3.87 4.56 000 55873 A Cryoablate prostate 17.80 9.99 NA 1.01 28.80 NA 090 55899 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55970 N Sex transformation, M to F 0.00 0.00 0.00 0.00 0.00 0.00 XXX 55980 N Sex transformation, F to M 0.00 0.00 0.00 0.00 0.00 0.00 XXX 56405 A I & D of vulva/perineum 1.44 1.26 2.35 0.14 2.84 3.93 010 56420 A Drainage of gland abscess 1.39 1.19 2.33 0.13 2.71 3.85 010 56440 A Surgery for vulva lesion 2.84 2.32 3.58 0.28 5.44 6.70 010 56441 A Lysis of labial lesion(s) 1.97 2.02 2.56 0.17 4.16 4.70 010 56501 A Destruction, vulva lesion(s) 1.53 1.35 2.31 0.15 3.03 3.99 010 56515 A Destruction, vulva lesion(s) 2.76 2.35 3.11 0.18 5.29 6.05 010 56605 A Biopsy of vulva/perineum 1.10 0.50 1.79 0.11 1.71 3.00 000 56606 A Biopsy of vulva/perineum 0.55 0.23 1.56 0.06 0.84 2.17 ZZZ 56620 A Partial removal of vulva 7.47 5.00 NA 0.76 13.23 NA 090 56625 A Complete removal of vulva 8.40 5.92 NA 0.84 15.16 NA 090 56630 A Extensive vulva surgery 12.36 7.84 NA 1.23 21.43 NA 090 56631 A Extensive vulva surgery 16.20 10.53 NA 1.63 28.36 NA 090 56632 A Extensive vulva surgery 20.29 12.33 NA 2.03 34.65 NA 090 56633 A Extensive vulva surgery 16.47 9.51 NA 1.66 27.64 NA 090 56634 A Extensive vulva surgery 17.88 11.26 NA 1.78 30.92 NA 090 56637 A Extensive vulva surgery 21.97 13.02 NA 2.18 37.17 NA 090 56640 A Extensive vulva surgery 22.17 12.70 NA 2.26 37.13 NA 090 56700 A Partial removal of hymen 2.52 2.06 2.90 0.24 4.82 5.66 010 56720 A Incision of hymen 0.68 0.70 1.67 0.07 1.45 2.42 000 56740 A Remove vagina gland lesion 4.57 3.00 3.91 0.37 7.94 8.85 010 56800 A Repair of vagina 3.89 2.73 NA 0.37 6.99 NA 010 56805 A Repair clitoris 18.86 9.64 NA 1.82 30.32 NA 090 56810 A Repair of perineum 4.13 2.83 NA 0.41 7.37 NA 010 57000 A Exploration of vagina 2.97 2.35 NA 0.28 5.60 NA 010 57010 A Drainage of pelvic abscess 6.03 3.86 NA 0.57 10.46 NA 090 57020 A Drainage of pelvic fluid 1.50 0.65 1.61 0.15 2.30 3.26 000 57022 A I &d vaginal hematoma, ob 2.56 1.58 NA 0.14 4.28 NA 010 57023 A I &d vag hematoma, trauma 2.56 1.58 NA 0.14 4.28 NA 010 57061 A Destruction vagina lesion(s) 1.25 1.24 2.25 0.13 2.62 3.63 010 57065 A Destruction vagina lesion(s) 2.61 2.32 2.97 0.26 5.19 5.84 010 57100 A Biopsy of vagina 1.20 0.52 1.56 0.10 1.82 2.86 000 57105 A Biopsy of vagina 1.69 2.23 2.25 0.17 4.09 4.11 010 57106 A Remove vagina wall, partial 6.36 2.55 2.55 0.58 9.49 9.49 090 57107 A Remove vagina tissue, part 23.00 10.63 NA 2.17 35.80 NA 090 57109 A Vaginectomy partial w/nodes 27.00 12.01 NA 1.97 40.98 NA 090 57110 A Remove vagina wall, complete 14.29 7.53 NA 1.43 23.25 NA 090 57111 A Remove vagina tissue, compl 27.00 12.71 NA 2.71 42.42 NA 090 57112 A Vaginectomy w/nodes, compl 29.00 12.95 NA 2.19 44.14 NA 090 57120 A Closure of vagina 7.41 4.75 NA 0.75 12.91 NA 090 57130 A Remove vagina lesion 2.43 2.15 NA 0.23 4.81 NA 010 57135 A Remove vagina lesion 2.67 2.25 2.95 0.26 5.18 5.88 010 Start Printed Page 40462 57150 A Treat vagina infection 0.55 0.22 1.00 0.06 0.83 1.61 000 57160 A Insert pessary/other device 0.89 0.37 1.38 0.09 1.35 2.36 000 57170 A Fitting of diaphragm/cap 0.91 0.35 1.42 0.09 1.35 2.42 000 57180 A Treat vaginal bleeding 1.58 1.47 2.28 0.16 3.21 4.02 010 57200 A Repair of vagina 3.94 3.03 NA 0.38 7.35 NA 090 57210 A Repair vagina/perineum 5.17 3.54 NA 0.50 9.21 NA 090 57220 A Revision of urethra 4.31 3.43 NA 0.42 8.16 NA 090 57230 A Repair of urethral lesion 5.64 4.34 NA 0.50 10.48 NA 090 57240 A Repair bladder & vagina 6.07 4.46 NA 0.53 11.06 NA 090 57250 A Repair rectum & vagina 5.53 3.89 NA 0.54 9.96 NA 090 57260 A Repair of vagina 8.27 5.06 NA 0.83 14.16 NA 090 57265 A Extensive repair of vagina 11.34 7.10 NA 1.14 19.58 NA 090 57268 A Repair of bowel bulge 6.76 4.40 NA 0.66 11.82 NA 090 57270 A Repair of bowel pouch 12.11 6.45 NA 1.17 19.73 NA 090 57280 A Suspension of vagina 15.04 7.62 NA 1.44 24.10 NA 090 57282 A Repair of vaginal prolapse 8.86 5.31 NA 0.86 15.03 NA 090 57284 A Repair paravaginal defect 12.70 7.28 NA 1.17 21.15 NA 090 57287 A Revise/remove sling repair 10.71 7.13 NA 0.64 18.48 NA 090 57288 A Repair bladder defect 13.02 6.95 NA 0.86 20.83 NA 090 57289 A Repair bladder & vagina 11.58 6.89 NA 0.95 19.42 NA 090 57291 A Construction of vagina 7.95 6.21 NA 0.78 14.94 NA 090 57292 A Construct vagina with graft 13.09 7.45 NA 1.29 21.83 NA 090 57300 A Repair rectum-vagina fistula 7.61 4.72 NA 0.70 13.03 NA 090 57305 A Repair rectum-vagina fistula 13.77 6.94 NA 1.33 22.04 NA 090 57307 A Fistula repair & colostomy 15.93 7.63 NA 1.59 25.15 NA 090 57308 A Fistula repair, transperine 9.94 5.85 NA 0.91 16.70 NA 090 57310 A Repair urethrovaginal lesion 6.78 4.69 NA 0.45 11.92 NA 090 57311 A Repair urethrovaginal lesion 7.98 5.30 NA 0.51 13.79 NA 090 57320 A Repair bladder-vagina lesion 8.01 5.38 NA 0.60 13.99 NA 090 57330 A Repair bladder-vagina lesion 12.35 6.72 NA 0.86 19.93 NA 090 57335 A Repair vagina 18.73 9.43 NA 1.66 29.82 NA 090 57400 A Dilation of vagina 2.27 1.33 NA 0.22 3.82 NA 000 57410 A Pelvic examination 1.75 1.09 2.64 0.14 2.98 4.53 000 57415 A Remove vaginal foreign body 2.17 2.06 3.48 0.19 4.42 5.84 010 57452 A Examination of vagina 0.99 0.46 1.60 0.10 1.55 2.69 000 57454 A Vagina examination & biopsy 1.27 0.62 1.79 0.13 2.02 3.19 000 57460 A Cervix excision 2.83 1.20 2.13 0.28 4.31 5.24 000 57500 A Biopsy of cervix 0.97 0.50 2.12 0.10 1.57 3.19 000 57505 A Endocervical curettage 1.14 1.27 1.95 0.12 2.53 3.21 010 57510 A Cauterization of cervix 1.90 1.58 3.18 0.18 3.66 5.26 010 57511 A Cryocautery of cervix 1.90 0.78 2.43 0.18 2.86 4.51 010 57513 A Laser surgery of cervix 1.90 1.57 2.60 0.19 3.66 4.69 010 57520 A Conization of cervix 4.04 2.87 4.28 0.41 7.32 8.73 090 57522 A Conization of cervix 3.36 2.58 3.81 0.34 6.28 7.51 090 57530 A Removal of cervix 4.79 3.65 NA 0.48 8.92 NA 090 57531 A Removal of cervix, radical 28.00 13.63 NA 2.46 44.09 NA 090 57540 A Removal of residual cervix 12.22 6.32 NA 1.21 19.75 NA 090 57545 A Remove cervix/repair pelvis 13.03 6.90 NA 1.30 21.23 NA 090 57550 A Removal of residual cervix 5.53 3.91 NA 0.55 9.99 NA 090 57555 A Remove cervix/repair vagina 8.95 5.73 NA 0.89 15.57 NA 090 57556 A Remove cervix, repair bowel 8.37 5.05 NA 0.80 14.22 NA 090 57700 A Revision of cervix 3.55 2.53 NA 0.33 6.41 NA 090 57720 A Revision of cervix 4.13 3.34 NA 0.41 7.88 NA 090 57800 A Dilation of cervical canal 0.77 0.36 1.18 0.08 1.21 2.03 000 57820 A D & c of residual cervix 1.67 2.24 2.53 0.17 4.08 4.37 010 58100 A Biopsy of uterus lining 0.71 0.29 2.06 0.07 1.07 2.84 000 58120 A Dilation and curettage 3.27 2.46 3.86 0.33 6.06 7.46 010 58140 A Removal of uterus lesion 14.60 7.26 NA 1.46 23.32 NA 090 58145 A Removal of uterus lesion 8.04 4.99 NA 0.80 13.83 NA 090 58150 A Total hysterectomy 15.24 7.77 NA 1.53 24.54 NA 090 58152 A Total hysterectomy 20.60 10.05 NA 1.52 32.17 NA 090 58180 A Partial hysterectomy 15.29 7.72 NA 1.54 24.55 NA 090 58200 A Extensive hysterectomy 21.59 11.52 NA 2.15 35.26 NA 090 58210 A Extensive hysterectomy 28.85 14.52 NA 2.91 46.28 NA 090 58240 A Removal of pelvis contents 38.39 19.57 NA 3.76 61.72 NA 090 58260 A Vaginal hysterectomy 12.98 6.54 NA 1.23 20.75 NA 090 58262 A Vaginal hysterectomy 14.77 7.32 NA 1.42 23.51 NA 090 58263 A Vaginal hysterectomy 16.06 7.85 NA 1.55 25.46 NA 090 58267 A Hysterectomy & vagina repair 17.04 8.25 NA 1.51 26.80 NA 090 58270 A Hysterectomy & vagina repair 14.26 7.09 NA 1.37 22.72 NA 090 58275 A Hysterectomy/revise vagina 15.76 7.64 NA 1.51 24.91 NA 090 58280 A Hysterectomy/revise vagina 17.01 8.11 NA 1.54 26.66 NA 090 58285 A Extensive hysterectomy 22.26 11.76 NA 1.88 35.90 NA 090 58300 N Insert intrauterine device +1.01 0.40 1.37 0.10 1.51 2.48 XXX Start Printed Page 40463 58301 A Remove intrauterine device 1.27 0.52 1.57 0.13 1.92 2.97 000 58321 A Artificial insemination 0.92 0.36 0.92 0.10 1.38 1.94 000 58322 A Artificial insemination 1.10 0.44 1.04 0.11 1.65 2.25 000 58323 A Sperm washing 0.23 0.10 0.53 0.02 0.35 0.78 000 58340 A Catheter for hysterography 0.88 0.34 11.96 0.08 1.30 12.92 000 58345 A Reopen fallopian tube 4.66 1.87 NA 0.36 6.89 NA 010 58350 A Reopen fallopian tube 1.01 1.11 2.06 0.10 2.22 3.17 010 58353 A Endometr ablate, thermal 3.56 2.26 NA 0.19 6.01 NA 010 58400 A Suspension of uterus 6.36 4.09 NA 0.62 11.07 NA 090 58410 A Suspension of uterus 12.73 6.75 NA 1.09 20.57 NA 090 58520 A Repair of ruptured uterus 11.92 6.04 NA 1.17 19.13 NA 090 58540 A Revision of uterus 14.64 7.29 NA 1.28 23.21 NA 090 58550 A Laparo-asst vag hysterectomy 14.19 7.04 NA 1.44 22.67 NA 010 58551 A Laparoscopy, remove myoma 14.21 6.95 NA 1.45 22.61 NA 010 58555 A Hysteroscopy, dx, sep proc 3.33 1.52 2.90 0.34 5.19 6.57 000 58558 A Hysteroscopy, biopsy 4.75 2.14 3.50 0.49 7.38 8.74 000 58559 A Hysteroscopy, lysis 6.17 2.54 2.54 0.62 9.33 9.33 000 58560 A Hysteroscopy, resect septum 7.00 3.02 3.02 0.71 10.73 10.73 000 58561 A Hysteroscopy, remove myoma 10.00 4.27 4.27 1.02 15.29 15.29 000 58562 A Hysteroscopy, remove fb 5.21 2.30 NA 0.52 8.03 NA 000 58563 A Hysteroscopy, ablation 6.17 2.62 2.62 0.62 9.41 9.41 000 58578 C Laparo proc, uterus 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58579 C Hysteroscope procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58600 A Division of fallopian tube 5.60 3.43 NA 0.39 9.42 NA 090 58605 A Division of fallopian tube 5.00 3.19 NA 0.33 8.52 NA 090 58611 A Ligate oviduct(s) add-on 1.45 0.61 NA 0.07 2.13 NA ZZZ 58615 A Occlude fallopian tube(s) 3.90 2.62 NA 0.40 6.92 NA 010 58660 A Laparoscopy, lysis 11.29 5.48 NA 1.14 17.91 NA 090 58661 A Laparoscopy, remove adnexa 11.05 5.42 NA 1.12 17.59 NA 010 58662 A Laparoscopy, excise lesions 11.79 5.68 NA 1.18 18.65 NA 090 58670 A Laparoscopy, tubal cautery 5.60 3.65 NA 0.55 9.80 NA 090 58671 A Laparoscopy, tubal block 5.60 3.72 NA 0.56 9.88 NA 090 58672 A Laparoscopy, fimbrioplasty 12.88 6.09 NA 1.22 20.19 NA 090 58673 A Laparoscopy, salpingostomy 13.74 7.12 NA 1.40 22.26 NA 090 58679 C Laparo proc, oviduct-ovary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58700 A Removal of fallopian tube 12.05 6.05 NA 0.64 18.74 NA 090 58720 A Removal of ovary/tube(s) 11.36 5.92 NA 1.14 18.42 NA 090 58740 A Revise fallopian tube(s) 14.00 7.22 NA 0.59 21.81 NA 090 58750 A Repair oviduct 14.84 7.52 NA 1.52 23.88 NA 090 58752 A Revise ovarian tube(s) 14.84 7.91 NA 1.51 24.26 NA 090 58760 A Remove tubal obstruction 13.13 6.58 NA 1.34 21.05 NA 090 58770 A Create new tubal opening 13.97 7.24 NA 1.42 22.63 NA 090 58800 A Drainage of ovarian cyst(s) 4.14 4.40 4.55 0.36 8.90 9.05 090 58805 A Drainage of ovarian cyst(s) 5.88 3.53 NA 0.56 9.97 NA 090 58820 A Drain ovary abscess, open 4.22 3.30 NA 0.29 7.81 NA 090 58822 A Drain ovary abscess, percut 10.13 5.16 NA 0.92 16.21 NA 090 58823 A Drain pelvic abscess, percut 3.38 3.18 NA 0.18 6.74 NA 000 58825 A Transposition, ovary(s) 10.98 5.96 NA 0.62 17.56 NA 090 58900 A Biopsy of ovary(s) 5.99 3.62 NA 0.56 10.17 NA 090 58920 A Partial removal of ovary(s) 11.36 5.62 NA 0.68 17.66 NA 090 58925 A Removal of ovarian cyst(s) 11.36 5.70 NA 1.14 18.20 NA 090 58940 A Removal of ovary(s) 7.29 4.06 NA 0.73 12.08 NA 090 58943 A Removal of ovary(s) 18.43 9.79 NA 1.86 30.08 NA 090 58950 A Resect ovarian malignancy 16.93 9.26 NA 1.55 27.74 NA 090 58951 A Resect ovarian malignancy 22.38 11.66 NA 2.20 36.24 NA 090 58952 A Resect ovarian malignancy 25.01 12.80 NA 2.50 40.31 NA 090 58960 A Exploration of abdomen 14.65 8.39 NA 1.47 24.51 NA 090 58970 A Retrieval of oocyte 3.53 1.81 8.66 0.36 5.70 12.55 000 58974 C Transfer of embryo 0.00 0.00 0.00 0.00 0.00 0.00 000 58976 A Transfer of embryo 3.83 1.51 2.25 0.39 5.73 6.47 000 58999 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59000 A Amniocentesis 1.30 0.64 1.95 0.23 2.17 3.48 000 59012 A Fetal cord puncture,prenatal 3.45 1.70 NA 0.62 5.77 NA 000 59015 A Chorion biopsy 2.20 0.95 1.39 0.40 3.55 3.99 000 59020 A Fetal contract stress test 0.66 NA 0.79 0.20 NA 1.65 000 59020 26 A Fetal contract stress test 0.66 0.28 0.28 0.12 1.06 1.06 000 59020 TC A Fetal contract stress test 0.00 NA 0.51 0.08 NA 0.59 000 59025 A Fetal non-stress test 0.53 NA 0.45 0.12 NA 1.10 000 59025 26 A Fetal non-stress test 0.53 0.22 0.22 0.10 0.85 0.85 000 59025 TC A Fetal non-stress test 0.00 NA 0.23 0.02 NA 0.25 000 59030 A Fetal scalp blood sample 1.99 0.97 NA 0.36 3.32 NA 000 59050 A Fetal monitor w/report 0.89 0.36 NA 0.16 1.41 NA XXX 59051 A Fetal monitor/interpret only 0.74 0.29 NA 0.14 1.17 NA XXX 59100 A Remove uterus lesion 12.35 6.34 NA 2.21 20.90 NA 090 Start Printed Page 40464 59120 A Treat ectopic pregnancy 11.49 6.28 NA 2.06 19.83 NA 090 59121 A Treat ectopic pregnancy 11.67 6.31 NA 2.09 20.07 NA 090 59130 A Treat ectopic pregnancy 14.22 7.04 NA 2.54 23.80 NA 090 59135 A Treat ectopic pregnancy 13.88 6.90 NA 2.49 23.27 NA 090 59136 A Treat ectopic pregnancy 13.18 6.99 NA 2.36 22.53 NA 090 59140 A Treat ectopic pregnancy 5.46 3.28 NA 0.98 9.72 NA 090 59150 A Treat ectopic pregnancy 11.67 6.57 NA 1.23 19.47 NA 090 59151 A Treat ectopic pregnancy 11.49 6.03 NA 1.41 18.93 NA 090 59160 A D & c after delivery 2.71 2.26 3.60 0.49 5.46 6.80 010 59200 A Insert cervical dilator 0.79 0.33 1.35 0.15 1.27 2.29 000 59300 A Episiotomy or vaginal repair 2.41 1.01 2.10 0.43 3.85 4.94 000 59320 A Revision of cervix 2.48 1.46 NA 0.45 4.39 NA 000 59325 A Revision of cervix 4.07 2.11 NA 0.73 6.91 NA 000 59350 A Repair of uterus 4.95 2.03 NA 0.88 7.86 NA 000 59400 A Obstetrical care 23.06 15.19 NA 4.14 42.39 NA MMM 59409 A Obstetrical care 13.50 5.58 NA 2.42 21.50 NA MMM 59410 A Obstetrical care 14.78 6.67 NA 2.65 24.10 NA MMM 59412 A Antepartum manipulation 1.71 0.73 1.34 0.31 2.75 3.36 MMM 59414 A Deliver placenta 1.61 1.31 NA 0.29 3.21 NA MMM 59425 A Antepartum care only 4.81 5.18 5.23 0.86 10.85 10.90 MMM 59426 A Antepartum care only 8.28 8.95 8.95 1.49 18.72 18.72 MMM 59430 A Care after delivery 2.13 1.26 1.27 0.38 3.77 3.78 MMM 59510 A Cesarean delivery 26.22 17.34 NA 4.70 48.26 NA MMM 59514 A Cesarean delivery only 15.97 6.53 NA 2.86 25.36 NA MMM 59515 A Cesarean delivery 17.37 8.42 NA 3.12 28.91 NA MMM 59525 A Remove uterus after cesarean 8.54 3.51 NA 1.53 13.58 NA ZZZ 59610 A Vbac delivery 24.62 15.74 NA 4.41 44.77 NA MMM 59612 A Vbac delivery only 15.06 6.38 NA 2.70 24.14 NA MMM 59614 A Vbac care after delivery 16.34 7.64 NA 2.93 26.91 NA MMM 59618 A Attempted vbac delivery 27.78 18.17 NA 4.98 50.93 NA MMM 59620 A Attempted vbac delivery only 17.53 6.91 NA 3.15 27.59 NA MMM 59622 A Attempted vbac after care 18.93 8.88 NA 3.39 31.20 NA MMM 59812 A Treatment of miscarriage 4.01 2.50 3.68 0.58 7.09 8.27 090 59820 A Care of miscarriage 4.01 2.75 3.70 0.72 7.48 8.43 090 59821 A Treatment of miscarriage 4.47 2.96 3.86 0.80 8.23 9.13 090 59830 A Treat uterus infection 6.11 3.88 NA 1.10 11.09 NA 090 59840 R Abortion 3.01 2.27 3.96 0.54 5.82 7.51 010 59841 R Abortion 5.24 3.63 5.70 0.94 9.81 11.88 010 59850 R Abortion 5.91 2.85 NA 1.06 9.82 NA 090 59851 R Abortion 5.93 3.20 NA 1.06 10.19 NA 090 59852 R Abortion 8.24 4.45 NA 1.48 14.17 NA 090 59855 R Abortion 6.12 3.35 NA 1.10 10.57 NA 090 59856 R Abortion 7.48 3.68 NA 1.34 12.50 NA 090 59857 R Abortion 9.29 4.40 NA 1.66 15.35 NA 090 59866 R Abortion (mpr) 4.00 1.58 NA 0.72 6.30 NA 000 59870 A Evacuate mole of uterus 6.01 3.90 NA 0.77 10.68 NA 090 59871 A Remove cerclage suture 2.13 0.92 1.99 0.38 3.43 4.50 000 59898 C Laparo proc, ob care/deliver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59899 C Maternity care procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60000 A Drain thyroid/tongue cyst 1.76 2.26 2.38 0.14 4.16 4.28 010 60001 A Aspirate/inject thyriod cyst 0.97 0.36 1.58 0.06 1.39 2.61 000 60100 A Biopsy of thyroid 1.56 0.56 2.63 0.05 2.17 4.24 000 60200 A Remove thyroid lesion 9.55 6.63 NA 0.84 17.02 NA 090 60210 A Partial thyroid excision 10.88 6.54 NA 1.01 18.43 NA 090 60212 A Parital thyroid excision 16.03 8.59 NA 1.51 26.13 NA 090 60220 A Partial removal of thyroid 11.90 7.05 NA 0.97 19.92 NA 090 60225 A Partial removal of thyroid 14.19 7.96 NA 1.31 23.46 NA 090 60240 A Removal of thyroid 16.06 9.11 NA 1.50 26.67 NA 090 60252 A Removal of thyroid 20.57 11.58 NA 1.63 33.78 NA 090 60254 A Extensive thyroid surgery 26.99 15.89 NA 1.96 44.84 NA 090 60260 A Repeat thyroid surgery 17.47 10.39 NA 1.39 29.25 NA 090 60270 A Removal of thyroid 20.27 11.95 NA 1.78 34.00 NA 090 60271 A Removal of thyroid 16.83 9.80 NA 1.35 27.98 NA 090 60280 A Remove thyroid duct lesion 5.87 5.19 NA 0.45 11.51 NA 090 60281 A Remove thyroid duct lesion 8.53 6.43 NA 0.67 15.63 NA 090 60500 A Explore parathyroid glands 16.23 7.84 NA 1.61 25.68 NA 090 60502 A Re-explore parathyroids 20.35 9.63 NA 2.00 31.98 NA 090 60505 A Explore parathyroid glands 21.49 11.03 NA 2.14 34.66 NA 090 60512 A Autotransplant parathyroid 4.45 1.70 NA 0.44 6.59 NA ZZZ 60520 A Removal of thymus gland 16.81 9.87 NA 1.84 28.52 NA 090 60521 A Removal of thymus gland 18.87 11.73 NA 2.34 32.94 NA 090 60522 A Removal of thymus gland 23.09 13.10 NA 2.83 39.02 NA 090 60540 A Explore adrenal gland 17.03 7.85 NA 1.42 26.30 NA 090 60545 A Explore adrenal gland 19.88 9.55 NA 1.75 31.18 NA 090 Start Printed Page 40465 60600 A Remove carotid body lesion 17.93 13.45 NA 1.87 33.25 NA 090 60605 A Remove carotid body lesion 20.24 18.32 NA 2.28 40.84 NA 090 60650 A Laparoscopy adrenalectomy 20.00 8.26 NA 1.98 30.24 NA 090 60659 C Laparo proc, endocrine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60699 C Endocrine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 61000 A Remove cranial cavity fluid 1.58 1.56 1.72 0.13 3.27 3.43 000 61001 A Remove cranial cavity fluid 1.49 1.37 1.86 0.15 3.01 3.50 000 61020 A Remove brain cavity fluid 1.51 1.46 2.26 0.26 3.23 4.03 000 61026 A Injection into brain canal 1.69 1.68 2.19 0.21 3.58 4.09 000 61050 A Remove brain canal fluid 1.51 1.59 NA 0.13 3.23 NA 000 61055 A Injection into brain canal 2.10 1.76 NA 0.13 3.99 NA 000 61070 A Brain canal shunt procedure 0.89 1.17 6.75 0.09 2.15 7.73 000 61105 A Twist drill hole 5.14 3.63 NA 1.05 9.82 NA 090 61107 A Drill skull for implantation 5.00 3.13 NA 1.02 9.15 NA 000 61108 A Drill skull for drainage 10.19 6.95 NA 2.04 19.18 NA 090 61120 A Burr hole for puncture 8.76 5.81 NA 1.81 16.38 NA 090 61140 A Pierce skull for biopsy 15.90 9.91 NA 3.15 28.96 NA 090 61150 A Pierce skull for drainage 17.57 10.63 NA 3.52 31.72 NA 090 61151 A Pierce skull for drainage 12.42 8.26 NA 2.45 23.13 NA 090 61154 A Pierce skull & remove clot 14.99 9.48 NA 3.05 27.52 NA 090 61156 A Pierce skull for drainage 16.32 10.33 NA 3.42 30.07 NA 090 61210 A Pierce skull, implant device 5.84 3.52 NA 1.16 10.52 NA 000 61215 A Insert brain-fluid device 4.89 4.17 NA 0.99 10.05 NA 090 61250 A Pierce skull & explore 10.42 6.70 NA 2.02 19.14 NA 090 61253 A Pierce skull & explore 12.36 7.36 NA 2.26 21.98 NA 090 61304 A Open skull for exploration 21.96 12.68 NA 4.33 38.97 NA 090 61305 A Open skull for exploration 26.61 15.06 NA 5.25 46.92 NA 090 61312 A Open skull for drainage 24.57 14.43 NA 4.99 43.99 NA 090 61313 A Open skull for drainage 24.93 14.66 NA 5.07 44.66 NA 090 61314 A Open skull for drainage 24.23 12.45 NA 4.00 40.68 NA 090 61315 A Open skull for drainage 27.68 16.13 NA 5.62 49.43 NA 090 61320 A Open skull for drainage 25.62 15.03 NA 5.20 45.85 NA 090 61321 A Open skull for drainage 28.50 16.15 NA 5.35 50.00 NA 090 61330 A Decompress eye socket 23.32 17.12 NA 2.58 43.02 NA 090 61332 A Explore/biopsy eye socket 27.28 19.52 NA 4.15 50.95 NA 090 61333 A Explore orbit/remove lesion 27.95 16.03 NA 2.24 46.22 NA 090 61334 A Explore orbit/remove object 18.27 11.86 NA 3.02 33.15 NA 090 61340 A Relieve cranial pressure 18.66 11.56 NA 3.66 33.88 NA 090 61343 A Incise skull (press relief) 29.77 17.82 NA 6.04 53.63 NA 090 61345 A Relieve cranial pressure 27.20 16.42 NA 5.23 48.85 NA 090 61440 A Incise skull for surgery 26.63 16.16 NA 5.57 48.36 NA 090 61450 A Incise skull for surgery 25.95 14.71 NA 5.11 45.77 NA 090 61458 A Incise skull for brain wound 27.29 15.81 NA 5.28 48.38 NA 090 61460 A Incise skull for surgery 28.39 16.82 NA 5.13 50.34 NA 090 61470 A Incise skull for surgery 26.06 14.19 NA 4.65 44.90 NA 090 61480 A Incise skull for surgery 26.49 14.00 NA 5.54 46.03 NA 090 61490 A Incise skull for surgery 25.66 15.05 NA 5.37 46.08 NA 090 61500 A Removal of skull lesion 17.92 10.99 NA 3.26 32.17 NA 090 61501 A Remove infected skull bone 14.84 9.17 NA 2.63 26.64 NA 090 61510 A Removal of brain lesion 28.45 16.46 NA 5.77 50.68 NA 090 61512 A Remove brain lining lesion 35.09 20.04 NA 7.14 62.27 NA 090 61514 A Removal of brain abscess 25.26 14.64 NA 5.12 45.02 NA 090 61516 A Removal of brain lesion 24.61 14.81 NA 4.94 44.36 NA 090 61518 A Removal of brain lesion 37.32 22.11 NA 7.53 66.96 NA 090 61519 A Remove brain lining lesion 41.39 24.02 NA 8.15 73.56 NA 090 61520 A Removal of brain lesion 54.84 31.79 NA 10.10 96.73 NA 090 61521 A Removal of brain lesion 44.48 26.00 NA 8.85 79.33 NA 090 61522 A Removal of brain abscess 29.45 17.12 NA 5.30 51.87 NA 090 61524 A Removal of brain lesion 27.86 16.60 NA 5.01 49.47 NA 090 61526 A Removal of brain lesion 52.17 30.36 NA 6.72 89.25 NA 090 61530 A Removal of brain lesion 43.86 27.22 NA 6.17 77.25 NA 090 61531 A Implant brain electrodes 14.63 9.23 NA 2.84 26.70 NA 090 61533 A Implant brain electrodes 19.71 12.05 NA 3.80 35.56 NA 090 61534 A Removal of brain lesion 20.97 12.99 NA 4.15 38.11 NA 090 61535 A Remove brain electrodes 11.63 7.73 NA 2.29 21.65 NA 090 61536 A Removal of brain lesion 35.52 20.53 NA 6.68 62.73 NA 090 61538 A Removal of brain tissue 26.81 16.08 NA 5.38 48.27 NA 090 61539 A Removal of brain tissue 32.08 19.01 NA 6.62 57.71 NA 090 61541 A Incision of brain tissue 28.85 16.37 NA 5.50 50.72 NA 090 61542 A Removal of brain tissue 31.02 18.89 NA 6.49 56.40 NA 090 61543 A Removal of brain tissue 29.22 17.92 NA 6.11 53.25 NA 090 61544 A Remove & treat brain lesion 25.50 12.06 NA 4.91 42.47 NA 090 61545 A Excision of brain tumor 43.80 24.74 NA 8.88 77.42 NA 090 61546 A Removal of pituitary gland 31.30 18.26 NA 6.06 55.62 NA 090 Start Printed Page 40466 61548 A Removal of pituitary gland 21.53 13.57 NA 3.63 38.73 NA 090 61550 A Release of skull seams 14.65 7.59 NA 1.14 23.38 NA 090 61552 A Release of skull seams 19.56 10.42 NA 0.88 30.86 NA 090 61556 A Incise skull/sutures 22.26 12.47 NA 3.57 38.30 NA 090 61557 A Incise skull/sutures 22.38 12.86 NA 4.68 39.92 NA 090 61558 A Excision of skull/sutures 25.58 13.34 NA 2.61 41.53 NA 090 61559 A Excision of skull/sutures 32.79 19.09 NA 6.86 58.74 NA 090 61563 A Excision of skull tumor 26.83 16.05 NA 4.46 47.34 NA 090 61564 A Excision of skull tumor 33.83 19.37 NA 7.08 60.28 NA 090 61570 A Remove foreign body, brain 24.60 13.42 NA 4.60 42.62 NA 090 61571 A Incise skull for brain wound 26.39 15.08 NA 5.23 46.70 NA 090 61575 A Skull base/brainstem surgery 34.36 21.06 NA 5.02 60.44 NA 090 61576 A Skull base/brainstem surgery 52.43 29.82 NA 4.68 86.93 NA 090 61580 A Craniofacial approach, skull 30.35 19.50 NA 2.75 52.60 NA 090 61581 A Craniofacial approach, skull 34.60 21.70 NA 3.37 59.67 NA 090 61582 A Craniofacial approach, skull 31.66 19.38 NA 6.30 57.34 NA 090 61583 A Craniofacial approach, skull 36.21 22.33 NA 6.94 65.48 NA 090 61584 A Orbitocranial approach/skull 34.65 20.92 NA 6.53 62.10 NA 090 61585 A Orbitocranial approach/skull 38.61 22.75 NA 6.19 67.55 NA 090 61586 A Resect nasopharynx, skull 25.10 16.18 NA 3.52 44.80 NA 090 61590 A Infratemporal approach/skull 41.78 25.75 NA 4.28 71.81 NA 090 61591 A Infratemporal approach/skull 43.68 26.81 NA 5.26 75.75 NA 090 61592 A Orbitocranial approach/skull 39.64 23.45 NA 7.55 70.64 NA 090 61595 A Transtemporal approach/skull 29.57 19.37 NA 3.05 51.99 NA 090 61596 A Transcochlear approach/skull 35.63 22.22 NA 4.25 62.10 NA 090 61597 A Transcondylar approach/skull 37.96 21.94 NA 6.65 66.55 NA 090 61598 A Transpetrosal approach/skull 33.41 20.82 NA 4.60 58.83 NA 090 61600 A Resect/excise cranial lesion 25.85 16.64 NA 3.12 45.61 NA 090 61601 A Resect/excise cranial lesion 27.89 17.15 NA 5.29 50.33 NA 090 61605 A Resect/excise cranial lesion 29.33 18.58 NA 2.51 50.42 NA 090 61606 A Resect/excise cranial lesion 38.83 23.30 NA 6.81 68.94 NA 090 61607 A Resect/excise cranial lesion 36.27 21.90 NA 5.69 63.86 NA 090 61608 A Resect/excise cranial lesion 42.10 24.57 NA 8.31 74.98 NA 090 61609 A Transect artery, sinus 9.89 4.61 NA 2.07 16.57 NA ZZZ 61610 A Transect artery, sinus 29.67 12.80 NA 3.52 45.99 NA ZZZ 61611 A Transect artery, sinus 7.42 2.93 NA 1.55 11.90 NA ZZZ 61612 A Transect artery, sinus 27.88 14.33 NA 3.55 45.76 NA ZZZ 61613 A Remove aneurysm, sinus 40.86 24.08 NA 8.32 73.26 NA 090 61615 A Resect/excise lesion, skull 32.07 20.45 NA 4.64 57.16 NA 090 61616 A Resect/excise lesion, skull 43.33 27.05 NA 7.02 77.40 NA 090 61618 A Repair dura 16.99 11.22 NA 2.92 31.13 NA 090 61619 A Repair dura 20.71 13.26 NA 3.42 37.39 NA 090 61624 A Occlusion/embolization cath 20.15 7.28 NA 1.15 28.58 NA 000 61626 A Occlusion/embolization cath 16.62 5.88 NA 0.84 23.34 NA 000 61680 A Intracranial vessel surgery 30.71 18.55 NA 6.04 55.30 NA 090 61682 A Intracranial vessel surgery 61.57 34.03 NA 12.69 108.29 NA 090 61684 A Intracranial vessel surgery 39.81 22.06 NA 7.87 69.74 NA 090 61686 A Intracranial vessel surgery 64.49 36.32 NA 13.20 114.01 NA 090 61690 A Intracranial vessel surgery 29.31 17.73 NA 5.51 52.55 NA 090 61692 A Intracranial vessel surgery 51.87 29.41 NA 10.17 91.45 NA 090 61697 A Brain aneurysm repr, complx 50.52 28.07 NA 9.57 88.16 NA 090 61698 A Brain aneurysm repr, complx 48.41 27.18 NA 9.28 84.87 NA 090 61700 A Brain aneurysm repr , simple 50.52 28.07 NA 10.18 88.77 NA 090 61702 A Inner skull vessel surgery 48.41 27.18 NA 9.75 85.34 NA 090 61703 A Clamp neck artery 17.47 11.04 NA 3.62 32.13 NA 090 61705 A Revise circulation to head 36.20 20.39 NA 6.67 63.26 NA 090 61708 A Revise circulation to head 35.30 16.07 NA 2.18 53.55 NA 090 61710 A Revise circulation to head 29.67 14.41 NA 2.42 46.50 NA 090 61711 A Fusion of skull arteries 36.33 20.11 NA 7.39 63.83 NA 090 61720 A Incise skull/brain surgery 16.77 10.75 NA 3.51 31.03 NA 090 61735 A Incise skull/brain surgery 20.43 12.67 NA 4.16 37.26 NA 090 61750 A Incise skull/brain biopsy 18.20 11.09 NA 3.71 33.00 NA 090 61751 A Brain biopsy w/ ct/mr guide 17.62 10.82 NA 3.57 32.01 NA 090 61760 A Implant brain electrodes 22.27 13.25 NA 4.59 40.11 NA 090 61770 A Incise skull for treatment 21.44 12.86 NA 4.09 38.39 NA 090 61790 A Treat trigeminal nerve 10.86 6.17 NA 1.82 18.85 NA 090 61791 A Treat trigeminal tract 14.61 9.33 NA 3.03 26.97 NA 090 61793 A Focus radiation beam 17.24 10.92 NA 3.51 31.67 NA 090 61795 A Brain surgery using computer 4.04 2.12 NA 0.81 6.97 NA ZZZ 61850 A Implant neuroelectrodes 12.39 8.00 NA 2.23 22.62 NA 090 61860 A Implant neuroelectrodes 20.87 12.80 NA 4.04 37.71 NA 090 61862 A Implant neurostimul, subcort 19.34 12.05 NA 3.97 35.36 NA 090 61870 A Implant neuroelectrodes 14.94 11.37 NA 1.70 28.01 NA 090 61875 A Implant neuroelectrodes 15.06 9.86 NA 2.42 27.34 NA 090 Start Printed Page 40467 61880 A Revise/remove neuroelectrode 6.29 5.20 NA 1.31 12.80 NA 090 61885 A Implant neurostim one array 5.85 4.26 NA 1.22 11.33 NA 090 61886 A Implant neurostim arrays 8.00 6.07 NA 1.64 15.71 NA 090 61888 A Revise/remove neuroreceiver 5.07 3.86 NA 1.04 9.97 NA 010 62000 A Treat skull fracture 12.53 5.48 NA 0.87 18.88 NA 090 62005 A Treat skull fracture 16.17 9.04 NA 2.33 27.54 NA 090 62010 A Treatment of head injury 19.81 11.71 NA 4.05 35.57 NA 090 62100 A Repair brain fluid leakage 22.03 13.99 NA 4.07 40.09 NA 090 62115 A Reduction of skull defect 21.66 10.54 NA 4.53 36.73 NA 090 62116 A Reduction of skull defect 23.59 13.81 NA 4.85 42.25 NA 090 62117 A Reduction of skull defect 26.60 15.24 NA 5.56 47.40 NA 090 62120 A Repair skull cavity lesion 23.35 14.11 NA 3.07 40.53 NA 090 62121 A Incise skull repair 21.58 13.89 NA 2.47 37.94 NA 090 62140 A Repair of skull defect 13.51 8.60 NA 2.60 24.71 NA 090 62141 A Repair of skull defect 14.91 9.74 NA 2.85 27.50 NA 090 62142 A Remove skull plate/flap 10.79 7.22 NA 2.10 20.11 NA 090 62143 A Replace skull plate/flap 13.05 8.70 NA 2.55 24.30 NA 090 62145 A Repair of skull & brain 18.82 11.37 NA 3.81 34.00 NA 090 62146 A Repair of skull with graft 16.12 10.46 NA 2.94 29.52 NA 090 62147 A Repair of skull with graft 19.34 12.26 NA 3.64 35.24 NA 090 62180 A Establish brain cavity shunt 21.06 12.91 NA 4.32 38.29 NA 090 62190 A Establish brain cavity shunt 11.07 7.68 NA 2.18 20.93 NA 090 62192 A Establish brain cavity shunt 12.25 8.21 NA 2.46 22.92 NA 090 62194 A Replace/irrigate catheter 5.03 2.11 NA 0.50 7.64 NA 010 62200 A Establish brain cavity shunt 18.32 11.46 NA 3.70 33.48 NA 090 62201 A Establish brain cavity shunt 14.86 9.19 NA 2.52 26.57 NA 090 62220 A Establish brain cavity shunt 13.00 8.63 NA 2.53 24.16 NA 090 62223 A Establish brain cavity shunt 12.87 8.45 NA 2.58 23.90 NA 090 62225 A Replace/irrigate catheter 5.41 4.05 NA 1.09 10.55 NA 090 62230 A Replace/revise brain shunt 10.54 6.61 NA 2.10 19.25 NA 090 62252 A Csf shunt reprogram 0.74 NA 1.38 0.04 NA 2.16 XXX 62252 26 A Csf shunt reprogram 0.74 0.29 0.29 0.02 1.05 1.05 XXX 62252 TC A Csf shunt reprogram 0.00 NA 1.09 0.02 NA 1.11 XXX 62256 A Remove brain cavity shunt 6.60 5.30 NA 1.34 13.24 NA 090 62258 A Replace brain cavity shunt 14.54 8.70 NA 2.91 26.15 NA 090 62263 A Lysis epidural adhesions 6.14 2.27 5.65 0.42 8.83 12.21 010 62268 A Drain spinal cord cyst 4.74 2.74 NA 0.29 7.77 NA 000 62269 A Needle biopsy, spinal cord 5.02 2.35 NA 0.29 7.66 NA 000 62270 A Spinal fluid tap, diagnostic 1.13 0.48 3.78 0.06 1.67 4.97 000 62272 A Drain spinal fluid 1.35 0.62 3.26 0.13 2.10 4.74 000 62273 A Treat epidural spine lesion 2.15 1.27 1.31 0.14 3.56 3.60 000 62280 A Treat spinal cord lesion 2.63 0.70 3.38 0.17 3.50 6.18 010 62281 A Treat spinal cord lesion 2.66 0.61 3.81 0.16 3.43 6.63 010 62282 A Treat spinal canal lesion 2.33 0.61 5.23 0.14 3.08 7.70 010 62284 A Injection for myelogram 1.54 0.71 4.39 0.10 2.35 6.03 000 62287 A Percutaneous diskectomy 8.08 4.74 NA 0.66 13.48 NA 090 62290 A Inject for spine disk x-ray 3.00 1.27 5.68 0.20 4.47 8.88 000 62291 A Inject for spine disk x-ray 2.91 1.16 5.74 0.17 4.24 8.82 000 62292 A Injection into disk lesion 7.86 4.76 NA 0.65 13.27 NA 090 62294 A Injection into spinal artery 11.83 6.17 NA 0.85 18.85 NA 090 62310 A Inject spine c/t 1.94 0.42 3.61 0.11 2.47 5.66 000 62311 A Inject spine l/s (cd) 1.57 0.36 3.87 0.09 2.02 5.53 000 62318 A Inject spine w/cath, c/t 2.08 0.46 3.70 0.12 2.66 5.90 000 62319 A Inject spine w/cath l/s (cd) 1.90 0.39 3.18 0.11 2.40 5.19 000 62350 A Implant spinal canal cath 6.87 3.70 NA 0.64 11.21 NA 090 62351 A Implant spinal canal cath 10.00 6.77 NA 1.79 18.56 NA 090 62355 A Remove spinal canal catheter 5.45 2.80 NA 0.47 8.72 NA 090 62360 A Insert spine infusion device 2.62 2.22 NA 0.21 5.05 NA 090 62361 A Implant spine infusion pump 5.42 3.54 NA 0.50 9.46 NA 090 62362 A Implant spine infusion pump 7.04 4.08 NA 0.86 11.98 NA 090 62365 A Remove spine infusion device 5.42 3.06 NA 0.58 9.06 NA 090 62367 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62367 26 A Analyze spine infusion pump 0.48 0.14 0.14 0.03 0.65 0.65 XXX 62367 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 26 A Analyze spine infusion pump 0.75 0.20 0.20 0.05 1.00 1.00 XXX 62368 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 63001 A Removal of spinal lamina 15.82 11.55 NA 3.03 30.40 NA 090 63003 A Removal of spinal lamina 15.95 11.68 NA 2.98 30.61 NA 090 63005 A Removal of spinal lamina 14.92 11.16 NA 2.62 28.70 NA 090 63011 A Removal of spinal lamina 14.52 9.38 NA 1.43 25.33 NA 090 63012 A Removal of spinal lamina 15.40 10.10 NA 2.71 28.21 NA 090 63015 A Removal of spinal lamina 19.35 13.43 NA 3.84 36.62 NA 090 63016 A Removal of spinal lamina 19.20 13.38 NA 3.62 36.20 NA 090 Start Printed Page 40468 63017 A Removal of spinal lamina 15.94 11.68 NA 2.91 30.53 NA 090 63020 A Neck spine disk surgery 14.81 11.10 NA 2.89 28.80 NA 090 63030 A Low back disk surgery 12.00 9.64 NA 2.21 23.85 NA 090 63035 A Spinal disk surgery add-on 3.15 1.66 NA 0.57 5.38 NA ZZZ 63040 A Laminotomy, single cervical 18.81 13.04 NA 3.36 35.21 NA 090 63042 A Laminotomy, single lumbar 17.47 12.65 NA 3.11 33.23 NA 090 63043 C Laminotomy, addl cervical 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63044 C Laminotomy, addl lumbar 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63045 A Removal of spinal lamina 16.50 11.99 NA 3.19 31.68 NA 090 63046 A Removal of spinal lamina 15.80 11.64 NA 2.89 30.33 NA 090 63047 A Removal of spinal lamina 14.61 11.09 NA 2.61 28.31 NA 090 63048 A Remove spinal lamina add-on 3.26 1.75 NA 0.58 5.59 NA ZZZ 63055 A Decompress spinal cord 21.99 14.82 NA 4.09 40.90 NA 090 63056 A Decompress spinal cord 20.36 14.12 NA 3.34 37.82 NA 090 63057 A Decompress spine cord add-on 5.26 2.69 NA 0.81 8.76 NA ZZZ 63064 A Decompress spinal cord 24.61 16.74 NA 4.72 46.07 NA 090 63066 A Decompress spine cord add-on 3.26 1.76 NA 0.63 5.65 NA ZZZ 63075 A Neck spine disk surgery 19.41 13.57 NA 3.73 36.71 NA 090 63076 A Neck spine disk surgery 4.05 2.16 NA 0.78 6.99 NA ZZZ 63077 A Spine disk surgery, thorax 21.44 14.91 NA 3.44 39.79 NA 090 63078 A Spine disk surgery, thorax 3.28 1.70 NA 0.50 5.48 NA ZZZ 63081 A Removal of vertebral body 23.73 16.42 NA 4.46 44.61 NA 090 63082 A Remove vertebral body add-on 4.37 2.34 NA 0.82 7.53 NA ZZZ 63085 A Removal of vertebral body 26.92 17.85 NA 4.70 49.47 NA 090 63086 A Remove vertebral body add-on 3.19 1.66 NA 0.55 5.40 NA ZZZ 63087 A Removal of vertebral body 35.57 21.93 NA 5.87 63.37 NA 090 63088 A Remove vertebral body add-on 4.33 2.28 NA 0.77 7.38 NA ZZZ 63090 A Removal of vertebral body 28.16 17.88 NA 4.27 50.31 NA 090 63091 A Remove vertebral body add-on 3.03 1.52 NA 0.45 5.00 NA ZZZ 63170 A Incise spinal cord tract(s) 19.83 13.68 NA 3.89 37.40 NA 090 63172 A Drainage of spinal cyst 17.66 13.11 NA 3.46 34.23 NA 090 63173 A Drainage of spinal cyst 21.99 14.91 NA 4.14 41.04 NA 090 63180 A Revise spinal cord ligaments 18.27 12.45 NA 3.83 34.55 NA 090 63182 A Revise spinal cord ligaments 20.50 12.80 NA 3.48 36.78 NA 090 63185 A Incise spinal column/nerves 15.04 9.84 NA 2.08 26.96 NA 090 63190 A Incise spinal column/nerves 17.45 12.01 NA 2.88 32.34 NA 090 63191 A Incise spinal column/nerves 17.54 12.40 NA 3.50 33.44 NA 090 63194 A Incise spinal column & cord 19.19 13.15 NA 4.01 36.35 NA 090 63195 A Incise spinal column & cord 18.84 12.11 NA 3.44 34.39 NA 090 63196 A Incise spinal column & cord 22.30 12.35 NA 4.66 39.31 NA 090 63197 A Incise spinal column & cord 21.11 13.76 NA 4.42 39.29 NA 090 63198 A Incise spinal column & cord 25.38 13.57 NA 5.31 44.26 NA 090 63199 A Incise spinal column & cord 26.89 14.17 NA 5.62 46.68 NA 090 63200 A Release of spinal cord 19.18 13.16 NA 3.61 35.95 NA 090 63250 A Revise spinal cord vessels 40.76 20.99 NA 7.65 69.40 NA 090 63251 A Revise spinal cord vessels 41.20 23.28 NA 7.98 72.46 NA 090 63252 A Revise spinal cord vessels 41.19 22.61 NA 7.75 71.55 NA 090 63265 A Excise intraspinal lesion 21.56 13.21 NA 4.29 39.06 NA 090 63266 A Excise intraspinal lesion 22.30 13.55 NA 4.47 40.32 NA 090 63267 A Excise intraspinal lesion 17.95 11.36 NA 3.50 32.81 NA 090 63268 A Excise intraspinal lesion 18.52 10.91 NA 3.18 32.61 NA 090 63270 A Excise intraspinal lesion 26.80 16.01 NA 5.41 48.22 NA 090 63271 A Excise intraspinal lesion 26.92 16.14 NA 5.56 48.62 NA 090 63272 A Excise intraspinal lesion 25.32 15.26 NA 5.07 45.65 NA 090 63273 A Excise intraspinal lesion 24.29 14.68 NA 5.08 44.05 NA 090 63275 A Biopsy/excise spinal tumor 23.68 14.18 NA 4.68 42.54 NA 090 63276 A Biopsy/excise spinal tumor 23.45 14.11 NA 4.63 42.19 NA 090 63277 A Biopsy/excise spinal tumor 20.83 12.87 NA 4.03 37.73 NA 090 63278 A Biopsy/excise spinal tumor 20.56 12.49 NA 4.02 37.07 NA 090 63280 A Biopsy/excise spinal tumor 28.35 16.74 NA 5.80 50.89 NA 090 63281 A Biopsy/excise spinal tumor 28.05 16.50 NA 5.67 50.22 NA 090 63282 A Biopsy/excise spinal tumor 26.39 15.69 NA 5.33 47.41 NA 090 63283 A Biopsy/excise spinal tumor 25.00 14.89 NA 5.12 45.01 NA 090 63285 A Biopsy/excise spinal tumor 36.00 20.43 NA 7.31 63.74 NA 090 63286 A Biopsy/excise spinal tumor 35.63 20.55 NA 7.07 63.25 NA 090 63287 A Biopsy/excise spinal tumor 36.70 20.93 NA 7.48 65.11 NA 090 63290 A Biopsy/excise spinal tumor 37.38 21.51 NA 7.65 66.54 NA 090 63300 A Removal of vertebral body 24.43 14.89 NA 4.78 44.10 NA 090 63301 A Removal of vertebral body 27.60 15.85 NA 5.03 48.48 NA 090 63302 A Removal of vertebral body 27.81 15.89 NA 5.25 48.95 NA 090 63303 A Removal of vertebral body 30.50 17.46 NA 5.21 53.17 NA 090 63304 A Removal of vertebral body 30.33 16.32 NA 4.72 51.37 NA 090 63305 A Removal of vertebral body 32.03 18.86 NA 5.39 56.28 NA 090 63306 A Removal of vertebral body 32.22 17.06 NA 2.39 51.67 NA 090 Start Printed Page 40469 63307 A Removal of vertebral body 31.63 18.18 NA 4.23 54.04 NA 090 63308 A Remove vertebral body add-on 5.25 2.77 NA 1.01 9.03 NA ZZZ 63600 A Remove spinal cord lesion 14.02 5.95 NA 1.22 21.19 NA 090 63610 A Stimulation of spinal cord 8.73 5.07 NA 0.43 14.23 NA 000 63615 A Remove lesion of spinal cord 16.28 10.42 NA 2.85 29.55 NA 090 63650 A Implant neuroelectrodes 6.74 3.03 NA 0.48 10.25 NA 090 63655 A Implant neuroelectrodes 10.29 7.11 NA 1.85 19.25 NA 090 63660 A Revise/remove neuroelectrode 6.16 3.66 NA 0.65 10.47 NA 090 63685 A Implant neuroreceiver 7.04 4.40 NA 0.96 12.40 NA 090 63688 A Revise/remove neuroreceiver 5.39 3.68 NA 0.70 9.77 NA 090 63700 A Repair of spinal herniation 16.53 10.39 NA 2.69 29.61 NA 090 63702 A Repair of spinal herniation 18.48 10.70 NA 1.36 30.54 NA 090 63704 A Repair of spinal herniation 21.18 12.18 NA 3.84 37.20 NA 090 63706 A Repair of spinal herniation 24.11 14.00 NA 4.73 42.84 NA 090 63707 A Repair spinal fluid leakage 11.26 7.85 NA 1.96 21.07 NA 090 63709 A Repair spinal fluid leakage 14.32 9.62 NA 2.49 26.43 NA 090 63710 A Graft repair of spine defect 14.07 9.36 NA 2.61 26.04 NA 090 63740 A Install spinal shunt 11.36 7.56 NA 2.15 21.07 NA 090 63741 A Install spinal shunt 8.25 4.72 NA 1.05 14.02 NA 090 63744 A Revision of spinal shunt 8.10 5.49 NA 1.51 15.10 NA 090 63746 A Removal of spinal shunt 6.43 4.53 NA 1.15 12.11 NA 090 64400 A Injection for nerve block 1.11 0.27 2.55 0.06 1.44 3.72 000 64402 A Injection for nerve block 1.25 0.44 4.03 0.07 1.76 5.35 000 64405 A Injection for nerve block 1.32 0.31 2.53 0.08 1.71 3.93 000 64408 A Injection for nerve block 1.41 0.70 2.77 0.09 2.20 4.27 000 64410 A Injection for nerve block 1.43 0.30 2.45 0.08 1.81 3.96 000 64412 A Injection for nerve block 1.18 0.27 2.56 0.08 1.53 3.82 000 64413 A Injection for nerve block 1.40 0.36 2.79 0.09 1.85 4.28 000 64415 A Injection for nerve block 1.48 0.31 2.62 0.08 1.87 4.18 000 64417 A Injection for nerve block 1.44 0.33 2.57 0.09 1.86 4.10 000 64418 A Injection for nerve block 1.32 0.29 2.34 0.07 1.68 3.73 000 64420 A Injection for nerve block 1.18 0.27 2.33 0.07 1.52 3.58 000 64421 A Injection for nerve block 1.68 0.38 2.74 0.10 2.16 4.52 000 64425 A Injection for nerve block 1.75 0.40 2.30 0.11 2.26 4.16 000 64430 A Injection for nerve block 1.46 0.43 2.60 0.11 2.00 4.17 000 64435 A Injection for nerve block 1.45 0.57 2.88 0.15 2.17 4.48 000 64445 A Injection for nerve block 1.48 0.34 3.25 0.08 1.90 4.81 000 64450 A Injection for nerve block 1.27 0.33 1.60 0.08 1.68 2.95 000 64470 A Inj paravertebral c/t 1.85 0.50 3.84 0.12 2.47 5.81 000 64472 A Inj paravertebral c/t add-on 1.29 0.35 3.50 0.09 1.73 4.88 ZZZ 64475 A Inj paravertebral l/s 1.41 0.38 3.67 0.09 1.88 5.17 000 64476 A Inj paravertebral l/s add-on 0.98 0.26 4.03 0.06 1.30 5.07 ZZZ 64479 A Inj foramen epidural c/t 2.20 0.62 3.97 0.14 2.96 6.31 000 64480 A Inj foramen epidural add-on 1.54 0.42 4.11 0.09 2.05 5.74 ZZZ 64483 A Inj foramen epidural l/s 1.90 0.53 3.85 0.12 2.55 5.87 000 64484 A Inj foramen epidural add-on 1.33 0.36 4.02 0.08 1.77 5.43 ZZZ 64505 A Injection for nerve block 1.36 0.35 2.23 0.08 1.79 3.67 000 64508 A Injection for nerve block 1.12 0.37 2.82 0.06 1.55 4.00 000 64510 A Injection for nerve block 1.22 0.26 2.54 0.07 1.55 3.83 000 64520 A Injection for nerve block 1.35 0.29 3.48 0.08 1.72 4.91 000 64530 A Injection for nerve block 1.58 0.36 3.14 0.09 2.03 4.81 000 64550 A Apply neurostimulator 0.18 0.05 0.51 0.01 0.24 0.70 000 64553 A Implant neuroelectrodes 2.31 1.29 4.86 0.17 3.77 7.34 010 64555 A Implant neuroelectrodes 2.27 0.71 2.41 0.11 3.09 4.79 010 64560 A Implant neuroelectrodes 2.36 0.87 2.44 0.17 3.40 4.97 010 64565 A Implant neuroelectrodes 1.76 0.62 3.16 0.08 2.46 5.00 010 64573 A Implant neuroelectrodes 7.50 5.42 NA 1.48 14.40 NA 090 64575 A Implant neuroelectrodes 4.35 3.19 NA 0.37 7.91 NA 090 64577 A Implant neuroelectrodes 4.62 3.58 NA 0.50 8.70 NA 090 64580 A Implant neuroelectrodes 4.12 4.22 NA 0.21 8.55 NA 090 64585 A Revise/remove neuroelectrode 2.06 2.17 2.75 0.29 4.52 5.10 010 64590 A Implant neuroreceiver 2.40 2.36 NA 0.40 5.16 NA 010 64595 A Revise/remove neuroreceiver 1.73 2.07 NA 0.22 4.02 NA 010 64600 A Injection treatment of nerve 3.45 2.07 3.11 0.28 5.80 6.84 010 64605 A Injection treatment of nerve 5.61 2.80 4.14 0.53 8.94 10.28 010 64610 A Injection treatment of nerve 7.16 3.79 NA 1.12 12.07 NA 010 64612 A Destroy nerve, face muscle 1.96 1.60 2.84 0.09 3.65 4.89 010 64613 A Destroy nerve, spine muscle 1.96 1.46 1.77 0.10 3.52 3.83 010 64614 A Destroy nerve, extrem musc 2.20 0.80 3.56 0.16 3.16 5.92 010 64620 A Injection treatment of nerve 2.84 0.68 2.94 0.17 3.69 5.95 010 64622 A Destr paravertebrl nerve l/s 3.00 0.73 4.38 0.17 3.90 7.55 010 64623 A Destr paravertebral n add-on 0.99 0.24 3.46 0.06 1.29 4.51 ZZZ 64626 A Destr paravertebrl nerve c/t 3.28 0.88 3.84 0.22 4.38 7.34 010 64627 A Destr paravertebral n add-on 1.16 0.31 3.19 0.08 1.55 4.43 ZZZ Start Printed Page 40470 64630 A Injection treatment of nerve 3.00 0.79 3.61 0.16 3.95 6.77 010 64640 A Injection treatment of nerve 2.76 1.01 5.49 0.11 3.88 8.36 010 64680 A Injection treatment of nerve 2.62 0.65 2.82 0.15 3.42 5.59 010 64702 A Revise finger/toe nerve 4.23 3.78 NA 0.51 8.52 NA 090 64704 A Revise hand/foot nerve 4.57 3.14 NA 0.59 8.30 NA 090 64708 A Revise arm/leg nerve 6.12 4.90 NA 0.82 11.84 NA 090 64712 A Revision of sciatic nerve 7.75 5.01 NA 0.54 13.30 NA 090 64713 A Revision of arm nerve(s) 11.00 5.85 NA 1.01 17.86 NA 090 64714 A Revise low back nerve(s) 10.33 3.99 NA 0.64 14.96 NA 090 64716 A Revision of cranial nerve 6.31 5.01 NA 0.59 11.91 NA 090 64718 A Revise ulnar nerve at elbow 5.99 5.00 NA 0.87 11.86 NA 090 64719 A Revise ulnar nerve at wrist 4.85 4.51 NA 0.63 9.99 NA 090 64721 A Carpal tunnel surgery 4.29 5.65 5.97 0.59 10.53 10.85 090 64722 A Relieve pressure on nerve(s) 4.70 3.02 NA 0.32 8.04 NA 090 64726 A Release foot/toe nerve 4.18 3.03 NA 0.57 7.78 NA 090 64727 A Internal nerve revision 3.10 1.62 NA 0.40 5.12 NA ZZZ 64732 A Incision of brow nerve 4.41 3.46 NA 0.77 8.64 NA 090 64734 A Incision of cheek nerve 4.92 3.53 NA 0.83 9.28 NA 090 64736 A Incision of chin nerve 4.60 2.98 NA 0.71 8.29 NA 090 64738 A Incision of jaw nerve 5.73 3.64 NA 0.84 10.21 NA 090 64740 A Incision of tongue nerve 5.59 4.08 NA 0.43 10.10 NA 090 64742 A Incision of facial nerve 6.22 4.84 NA 0.69 11.75 NA 090 64744 A Incise nerve, back of head 5.24 3.92 NA 0.98 10.14 NA 090 64746 A Incise diaphragm nerve 5.93 4.64 NA 0.75 11.32 NA 090 64752 A Incision of vagus nerve 7.06 4.71 NA 0.83 12.60 NA 090 64755 A Incision of stomach nerves 13.52 6.22 NA 1.16 20.90 NA 090 64760 A Incision of vagus nerve 6.96 4.02 NA 0.51 11.49 NA 090 64761 A Incision of pelvis nerve 6.41 3.31 NA 0.26 9.98 NA 090 64763 A Incise hip/thigh nerve 6.93 6.37 NA 0.77 14.07 NA 090 64766 A Incise hip/thigh nerve 8.67 6.18 NA 0.99 15.84 NA 090 64771 A Sever cranial nerve 7.35 5.56 NA 1.32 14.23 NA 090 64772 A Incision of spinal nerve 7.21 4.96 NA 1.20 13.37 NA 090 64774 A Remove skin nerve lesion 5.17 3.66 NA 0.60 9.43 NA 090 64776 A Remove digit nerve lesion 5.12 3.81 NA 0.63 9.56 NA 090 64778 A Digit nerve surgery add-on 3.11 1.52 NA 0.38 5.01 NA ZZZ 64782 A Remove limb nerve lesion 6.23 3.65 NA 0.79 10.67 NA 090 64783 A Limb nerve surgery add-on 3.72 2.02 NA 0.48 6.22 NA ZZZ 64784 A Remove nerve lesion 9.82 6.39 NA 1.17 17.38 NA 090 64786 A Remove sciatic nerve lesion 15.46 10.25 NA 2.22 27.93 NA 090 64787 A Implant nerve end 4.30 2.21 NA 0.56 7.07 NA ZZZ 64788 A Remove skin nerve lesion 4.61 3.31 NA 0.54 8.46 NA 090 64790 A Removal of nerve lesion 11.31 7.17 NA 1.68 20.16 NA 090 64792 A Removal of nerve lesion 14.92 9.04 NA 1.88 25.84 NA 090 64795 A Biopsy of nerve 3.01 1.85 NA 0.40 5.26 NA 000 64802 A Remove sympathetic nerves 9.15 5.53 NA 0.87 15.55 NA 090 64804 A Remove sympathetic nerves 14.64 7.82 NA 1.79 24.25 NA 090 64809 A Remove sympathetic nerves 13.67 5.32 NA 0.96 19.95 NA 090 64818 A Remove sympathetic nerves 10.30 5.79 NA 1.08 17.17 NA 090 64820 A Remove sympathetic nerves 10.37 7.88 NA 1.17 19.42 NA 090 64831 A Repair of digit nerve 9.44 7.17 NA 1.14 17.75 NA 090 64832 A Repair nerve add-on 5.66 3.12 NA 0.68 9.46 NA ZZZ 64834 A Repair of hand or foot nerve 10.19 7.18 NA 1.23 18.60 NA 090 64835 A Repair of hand or foot nerve 10.94 7.82 NA 1.36 20.12 NA 090 64836 A Repair of hand or foot nerve 10.94 7.67 NA 1.32 19.93 NA 090 64837 A Repair nerve add-on 6.26 3.40 NA 0.80 10.46 NA ZZZ 64840 A Repair of leg nerve 13.02 9.23 NA 0.86 23.11 NA 090 64856 A Repair/transpose nerve 13.80 9.39 NA 1.71 24.90 NA 090 64857 A Repair arm/leg nerve 14.49 9.76 NA 1.76 26.01 NA 090 64858 A Repair sciatic nerve 16.49 10.31 NA 2.78 29.58 NA 090 64859 A Nerve surgery 4.26 2.30 NA 0.50 7.06 NA ZZZ 64861 A Repair of arm nerves 19.24 12.91 NA 2.45 34.60 NA 090 64862 A Repair of low back nerves 19.44 9.63 NA 2.47 31.54 NA 090 64864 A Repair of facial nerve 12.55 8.72 NA 1.13 22.40 NA 090 64865 A Repair of facial nerve 15.24 10.03 NA 1.37 26.64 NA 090 64866 A Fusion of facial/other nerve 15.74 9.73 NA 1.06 26.53 NA 090 64868 A Fusion of facial/other nerve 14.04 9.38 NA 1.40 24.82 NA 090 64870 A Fusion of facial/other nerve 15.99 7.98 NA 1.08 25.05 NA 090 64872 A Subsequent repair of nerve 1.99 1.11 NA 0.24 3.34 NA ZZZ 64874 A Repair & revise nerve add-on 2.98 1.58 NA 0.34 4.90 NA ZZZ 64876 A Repair nerve/shorten bone 3.38 1.34 NA 0.39 5.11 NA ZZZ 64885 A Nerve graft, head or neck 17.53 11.25 NA 1.51 30.29 NA 090 64886 A Nerve graft, head or neck 20.75 13.10 NA 1.73 35.58 NA 090 64890 A Nerve graft, hand or foot 15.15 10.14 NA 1.74 27.03 NA 090 64891 A Nerve graft, hand or foot 16.14 7.59 NA 1.38 25.11 NA 090 Start Printed Page 40471 64892 A Nerve graft, arm or leg 14.65 8.73 NA 1.65 25.03 NA 090 64893 A Nerve graft, arm or leg 15.60 10.34 NA 1.77 27.71 NA 090 64895 A Nerve graft, hand or foot 19.25 11.12 NA 2.04 32.41 NA 090 64896 A Nerve graft, hand or foot 20.49 9.36 NA 1.85 31.70 NA 090 64897 A Nerve graft, arm or leg 18.24 10.73 NA 2.64 31.61 NA 090 64898 A Nerve graft, arm or leg 19.50 12.30 NA 2.71 34.51 NA 090 64901 A Nerve graft add-on 10.22 5.29 NA 0.99 16.50 NA ZZZ 64902 A Nerve graft add-on 11.83 6.03 NA 1.10 18.96 NA ZZZ 64905 A Nerve pedicle transfer 14.02 8.63 NA 1.52 24.17 NA 090 64907 A Nerve pedicle transfer 18.83 11.68 NA 1.79 32.30 NA 090 64999 C Nervous system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 65091 A Revise eye 6.46 9.45 NA 0.26 16.17 NA 090 65093 A Revise eye with implant 6.87 9.65 NA 0.28 16.80 NA 090 65101 A Removal of eye 7.03 9.48 NA 0.28 16.79 NA 090 65103 A Remove eye/insert implant 7.57 9.82 NA 0.30 17.69 NA 090 65105 A Remove eye/attach implant 8.49 10.37 NA 0.34 19.20 NA 090 65110 A Removal of eye 13.95 14.03 NA 0.68 28.66 NA 090 65112 A Remove eye/revise socket 16.38 17.35 NA 0.96 34.69 NA 090 65114 A Remove eye/revise socket 17.53 16.37 NA 0.94 34.84 NA 090 65125 A Revise ocular implant 3.12 1.47 4.85 0.15 4.74 8.12 090 65130 A Insert ocular implant 7.15 9.56 NA 0.28 16.99 NA 090 65135 A Insert ocular implant 7.33 9.30 NA 0.29 16.92 NA 090 65140 A Attach ocular implant 8.02 9.73 NA 0.31 18.06 NA 090 65150 A Revise ocular implant 6.26 9.01 NA 0.25 15.52 NA 090 65155 A Reinsert ocular implant 8.66 11.15 NA 0.40 20.21 NA 090 65175 A Removal of ocular implant 6.28 9.03 NA 0.26 15.57 NA 090 65205 A Remove foreign body from eye 0.71 0.20 5.14 0.03 0.94 5.88 000 65210 A Remove foreign body from eye 0.84 0.31 5.30 0.03 1.18 6.17 000 65220 A Remove foreign body from eye 0.71 0.19 6.66 0.05 0.95 7.42 000 65222 A Remove foreign body from eye 0.93 0.28 5.24 0.04 1.25 6.21 000 65235 A Remove foreign body from eye 7.57 6.67 NA 0.30 14.54 NA 090 65260 A Remove foreign body from eye 10.96 11.53 NA 0.43 22.92 NA 090 65265 A Remove foreign body from eye 12.59 13.08 NA 0.50 26.17 NA 090 65270 A Repair of eye wound 1.90 1.98 3.59 0.08 3.96 5.57 010 65272 A Repair of eye wound 3.82 3.81 4.88 0.16 7.79 8.86 090 65273 A Repair of eye wound 4.36 4.26 NA 0.17 8.79 NA 090 65275 A Repair of eye wound 5.34 4.60 5.03 0.27 10.21 10.64 090 65280 A Repair of eye wound 7.66 7.12 NA 0.30 15.08 NA 090 65285 A Repair of eye wound 12.90 12.78 NA 0.51 26.19 NA 090 65286 A Repair of eye wound 5.51 6.63 7.74 0.21 12.35 13.46 090 65290 A Repair of eye socket wound 5.41 6.69 NA 0.26 12.36 NA 090 65400 A Removal of eye lesion 6.06 6.38 7.70 0.24 12.68 14.00 090 65410 A Biopsy of cornea 1.47 0.65 1.61 0.06 2.18 3.14 000 65420 A Removal of eye lesion 4.17 5.95 6.92 0.17 10.29 11.26 090 65426 A Removal of eye lesion 5.25 5.99 7.12 0.20 11.44 12.57 090 65430 A Corneal smear 1.47 0.69 5.79 0.06 2.22 7.32 000 65435 A Curette/treat cornea 0.92 0.41 1.27 0.04 1.37 2.23 000 65436 A Curette/treat cornea 4.19 4.24 5.10 0.17 8.60 9.46 090 65450 A Treatment of corneal lesion 3.27 5.55 6.68 0.13 8.95 10.08 090 65600 A Revision of cornea 3.40 1.45 4.65 0.14 4.99 8.19 090 65710 A Corneal transplant 12.35 12.27 NA 0.49 25.11 NA 090 65730 A Corneal transplant 14.25 11.75 NA 0.56 26.56 NA 090 65750 A Corneal transplant 15.00 13.52 NA 0.59 29.11 NA 090 65755 A Corneal transplant 14.89 13.44 NA 0.58 28.91 NA 090 65760 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65765 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65767 N Corneal tissue transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65770 A Revise cornea with implant 17.56 14.45 NA 0.69 32.70 NA 090 65771 N Radial keratotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65772 A Correction of astigmatism 4.29 5.26 6.16 0.17 9.72 10.62 090 65775 A Correction of astigmatism 5.79 7.87 NA 0.22 13.88 NA 090 65800 A Drainage of eye 1.91 1.36 2.13 0.08 3.35 4.12 000 65805 A Drainage of eye 1.91 1.37 2.13 0.08 3.36 4.12 000 65810 A Drainage of eye 4.87 7.32 NA 0.19 12.38 NA 090 65815 A Drainage of eye 5.05 6.86 7.93 0.20 12.11 13.18 090 65820 A Relieve inner eye pressure 8.13 9.12 NA 0.32 17.57 NA 090 65850 A Incision of eye 10.52 9.40 NA 0.41 20.33 NA 090 65855 A Laser surgery of eye 3.85 3.56 4.83 0.17 7.58 8.85 090 65860 A Incise inner eye adhesions 3.55 2.93 3.71 0.14 6.62 7.40 090 65865 A Incise inner eye adhesions 5.60 6.14 NA 0.22 11.96 NA 090 65870 A Incise inner eye adhesions 6.27 6.47 NA 0.24 12.98 NA 090 65875 A Incise inner eye adhesions 6.54 6.59 NA 0.25 13.38 NA 090 65880 A Incise inner eye adhesions 7.09 6.82 NA 0.28 14.19 NA 090 65900 A Remove eye lesion 10.93 11.71 NA 0.46 23.10 NA 090 Start Printed Page 40472 65920 A Remove implant from eye 8.40 7.47 NA 0.33 16.20 NA 090 65930 A Remove blood clot from eye 7.44 7.92 NA 0.29 15.65 NA 090 66020 A Injection treatment of eye 1.59 1.45 2.20 0.07 3.11 3.86 010 66030 A Injection treatment of eye 1.25 1.29 2.05 0.05 2.59 3.35 010 66130 A Remove eye lesion 7.69 5.91 6.73 0.31 13.91 14.73 090 66150 A Glaucoma surgery 8.30 10.08 NA 0.33 18.71 NA 090 66155 A Glaucoma surgery 8.29 10.06 NA 0.32 18.67 NA 090 66160 A Glaucoma surgery 10.17 10.94 NA 0.41 21.52 NA 090 66165 A Glaucoma surgery 8.01 9.97 NA 0.31 18.29 NA 090 66170 A Glaucoma surgery 12.16 11.90 NA 0.48 24.54 NA 090 66172 A Incision of eye 15.04 14.75 NA 0.59 30.38 NA 090 66180 A Implant eye shunt 14.55 11.76 NA 0.57 26.88 NA 090 66185 A Revise eye shunt 8.14 8.25 NA 0.32 16.71 NA 090 66220 A Repair eye lesion 7.77 9.97 NA 0.32 18.06 NA 090 66225 A Repair/graft eye lesion 11.05 9.28 NA 0.44 20.77 NA 090 66250 A Follow-up surgery of eye 5.98 6.35 7.71 0.23 12.56 13.92 090 66500 A Incision of iris 3.71 4.00 NA 0.15 7.86 NA 090 66505 A Incision of iris 4.08 4.20 NA 0.17 8.45 NA 090 66600 A Remove iris and lesion 8.68 9.14 NA 0.34 18.16 NA 090 66605 A Removal of iris 12.79 12.23 NA 0.61 25.63 NA 090 66625 A Removal of iris 5.13 6.88 7.80 0.20 12.21 13.13 090 66630 A Removal of iris 6.16 7.91 NA 0.24 14.31 NA 090 66635 A Removal of iris 6.25 6.45 NA 0.24 12.94 NA 090 66680 A Repair iris & ciliary body 5.44 6.06 NA 0.21 11.71 NA 090 66682 A Repair iris & ciliary body 6.21 7.95 NA 0.24 14.40 NA 090 66700 A Destruction, ciliary body 4.78 6.25 7.59 0.19 11.22 12.56 090 66710 A Destruction, ciliary body 4.78 6.28 7.47 0.18 11.24 12.43 090 66720 A Destruction, ciliary body 4.78 6.24 7.37 0.19 11.21 12.34 090 66740 A Destruction, ciliary body 4.78 5.75 NA 0.18 10.71 NA 090 66761 A Revision of iris 4.07 4.03 5.13 0.16 8.26 9.36 090 66762 A Revision of iris 4.58 4.19 5.26 0.18 8.95 10.02 090 66770 A Removal of inner eye lesion 5.18 4.45 5.56 0.20 9.83 10.94 090 66820 A Incision, secondary cataract 3.89 6.91 NA 0.16 10.96 NA 090 66821 A After cataract laser surgery 2.35 3.11 3.51 0.10 5.56 5.96 090 66825 A Reposition intraocular lens 8.23 8.88 NA 0.32 17.43 NA 090 66830 A Removal of lens lesion 8.20 6.65 NA 0.32 15.17 NA 090 66840 A Removal of lens material 7.91 6.59 NA 0.31 14.81 NA 090 66850 A Removal of lens material 9.11 7.13 NA 0.36 16.60 NA 090 66852 A Removal of lens material 9.97 7.59 NA 0.39 17.95 NA 090 66920 A Extraction of lens 8.86 7.06 NA 0.35 16.27 NA 090 66930 A Extraction of lens 10.18 8.53 NA 0.41 19.12 NA 090 66940 A Extraction of lens 8.93 7.93 NA 0.35 17.21 NA 090 66982 A Cataract surgery, complex 13.50 8.88 NA 0.55 22.93 NA 090 66983 A Cataract surg w/iol, 1 stage 8.99 5.74 NA 0.37 15.10 NA 090 66984 A Cataract surg w/iol, i stage 10.23 7.44 NA 0.41 18.08 NA 090 66985 A Insert lens prosthesis 8.39 6.61 NA 0.33 15.33 NA 090 66986 A Exchange lens prosthesis 12.28 8.65 NA 0.49 21.42 NA 090 66999 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67005 A Partial removal of eye fluid 5.70 2.70 NA 0.22 8.62 NA 090 67010 A Partial removal of eye fluid 6.87 3.28 NA 0.27 10.42 NA 090 67015 A Release of eye fluid 6.92 7.62 NA 0.27 14.81 NA 090 67025 A Replace eye fluid 6.84 7.10 14.50 0.27 14.21 21.61 090 67027 A Implant eye drug system 10.85 8.45 16.16 0.46 19.76 27.47 090 67028 A Injection eye drug 2.52 1.20 8.03 0.11 3.83 10.66 000 67030 A Incise inner eye strands 4.84 6.21 NA 0.19 11.24 NA 090 67031 A Laser surgery, eye strands 3.67 3.00 3.80 0.15 6.82 7.62 090 67036 A Removal of inner eye fluid 11.89 8.81 NA 0.47 21.17 NA 090 67038 A Strip retinal membrane 21.24 15.12 NA 0.84 37.20 NA 090 67039 A Laser treatment of retina 14.52 11.91 NA 0.57 27.00 NA 090 67040 A Laser treatment of retina 17.23 13.22 NA 0.68 31.13 NA 090 67101 A Repair detached retina 7.53 8.49 10.38 0.29 16.31 18.20 090 67105 A Repair detached retina 7.41 5.48 7.24 0.29 13.18 14.94 090 67107 A Repair detached retina 14.84 12.77 NA 0.58 28.19 NA 090 67108 A Repair detached retina 20.82 17.00 NA 0.82 38.64 NA 090 67110 A Repair detached retina 8.81 9.89 17.89 0.35 19.05 27.05 090 67112 A Rerepair detached retina 16.86 15.09 NA 0.66 32.61 NA 090 67115 A Release encircling material 4.99 6.30 NA 0.19 11.48 NA 090 67120 A Remove eye implant material 5.98 6.69 13.93 0.23 12.90 20.14 090 67121 A Remove eye implant material 10.67 11.36 NA 0.42 22.45 NA 090 67141 A Treatment of retina 5.20 6.47 7.44 0.20 11.87 12.84 090 67145 A Treatment of retina 5.37 4.10 5.09 0.21 9.68 10.67 090 67208 A Treatment of retinal lesion 6.70 6.61 7.81 0.26 13.57 14.77 090 67210 A Treatment of retinal lesion 8.82 5.72 7.05 0.35 14.89 16.22 090 67218 A Treatment of retinal lesion 18.53 15.13 NA 0.53 34.19 NA 090 Start Printed Page 40473 67220 A Treatment of choroid lesion 13.13 9.81 10.88 0.51 23.45 24.52 090 67221 A Ocular photodynamic ther 4.01 1.92 4.19 0.50 6.43 8.70 000 67227 A Treatment of retinal lesion 6.58 6.72 8.39 0.26 13.56 15.23 090 67228 A Treatment of retinal lesion 12.74 7.25 9.63 0.50 20.49 22.87 090 67250 A Reinforce eye wall 8.66 10.21 NA 0.36 19.23 NA 090 67255 A Reinforce/graft eye wall 8.90 10.14 NA 0.35 19.39 NA 090 67299 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67311 A Revise eye muscle 6.65 6.09 NA 0.27 13.01 NA 090 67312 A Revise two eye muscles 8.54 7.06 NA 0.35 15.95 NA 090 67314 A Revise eye muscle 7.52 6.57 NA 0.30 14.39 NA 090 67316 A Revise two eye muscles 9.66 7.55 NA 0.40 17.61 NA 090 67318 A Revise eye muscle(s) 7.85 6.96 NA 0.31 15.12 NA 090 67320 A Revise eye muscle(s) add-on 4.33 6.56 NA 0.17 11.06 NA ZZZ 67331 A Eye surgery follow-up add-on 4.06 5.01 NA 0.17 9.24 NA ZZZ 67332 A Rerevise eye muscles add-on 4.49 5.66 NA 0.18 10.33 NA ZZZ 67334 A Revise eye muscle w/suture 3.98 5.15 NA 0.16 9.29 NA ZZZ 67335 A Eye suture during surgery 2.49 1.18 NA 0.10 3.77 NA ZZZ 67340 A Revise eye muscle add-on 4.93 6.82 NA 0.19 11.94 NA ZZZ 67343 A Release eye tissue 7.35 6.94 NA 0.30 14.59 NA 090 67345 A Destroy nerve of eye muscle 2.96 1.38 4.19 0.13 4.47 7.28 010 67350 A Biopsy eye muscle 2.87 2.37 NA 0.13 5.37 NA 000 67399 C Eye muscle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67400 A Explore/biopsy eye socket 9.76 11.78 NA 0.43 21.97 NA 090 67405 A Explore/drain eye socket 7.93 10.62 NA 0.36 18.91 NA 090 67412 A Explore/treat eye socket 9.50 12.91 NA 0.41 22.82 NA 090 67413 A Explore/treat eye socket 10.00 11.35 NA 0.43 21.78 NA 090 67414 A Explr/decompress eye socket 11.13 13.53 NA 0.48 25.14 NA 090 67415 A Aspiration, orbital contents 1.76 0.83 NA 0.09 2.68 NA 000 67420 A Explore/treat eye socket 20.06 17.23 NA 0.84 38.13 NA 090 67430 A Explore/treat eye socket 13.39 19.03 NA 0.97 33.39 NA 090 67440 A Explore/drain eye socket 13.09 14.28 NA 0.58 27.95 NA 090 67445 A Explr/decompress eye socket 14.42 15.52 NA 0.63 30.57 NA 090 67450 A Explore/biopsy eye socket 13.51 14.00 NA 0.56 28.07 NA 090 67500 A Inject/treat eye socket 0.79 0.20 1.93 0.04 1.03 2.76 000 67505 A Inject/treat eye socket 0.82 0.21 0.90 0.04 1.07 1.76 000 67515 A Inject/treat eye socket 0.61 0.29 0.79 0.02 0.92 1.42 000 67550 A Insert eye socket implant 10.19 11.87 NA 0.50 22.56 NA 090 67560 A Revise eye socket implant 10.60 11.46 NA 0.47 22.53 NA 090 67570 A Decompress optic nerve 13.58 14.77 NA 0.69 29.04 NA 090 67599 C Orbit surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67700 A Drainage of eyelid abscess 1.35 0.60 5.34 0.06 2.01 6.75 010 67710 A Incision of eyelid 1.02 0.49 5.48 0.04 1.55 6.54 010 67715 A Incision of eyelid fold 1.22 0.59 NA 0.05 1.86 NA 010 67800 A Remove eyelid lesion 1.38 0.66 2.18 0.06 2.10 3.62 010 67801 A Remove eyelid lesions 1.88 0.90 5.68 0.08 2.86 7.64 010 67805 A Remove eyelid lesions 2.22 1.06 5.88 0.09 3.37 8.19 010 67808 A Remove eyelid lesion(s) 3.80 3.79 NA 0.17 7.76 NA 090 67810 A Biopsy of eyelid 1.48 0.71 4.45 0.06 2.25 5.99 000 67820 A Revise eyelashes 0.89 0.38 1.56 0.04 1.31 2.49 000 67825 A Revise eyelashes 1.38 1.66 6.95 0.06 3.10 8.39 010 67830 A Revise eyelashes 1.70 1.87 8.18 0.07 3.64 9.95 010 67835 A Revise eyelashes 5.56 4.53 NA 0.22 10.31 NA 090 67840 A Remove eyelid lesion 2.04 0.97 5.75 0.08 3.09 7.87 010 67850 A Treat eyelid lesion 1.69 1.76 7.12 0.07 3.52 8.88 010 67875 A Closure of eyelid by suture 1.35 1.84 8.34 0.06 3.25 9.75 000 67880 A Revision of eyelid 3.80 2.90 9.21 0.16 6.86 13.17 090 67882 A Revision of eyelid 5.07 4.36 11.96 0.21 9.64 17.24 090 67900 A Repair brow defect 6.14 6.16 10.03 0.30 12.60 16.47 090 67901 A Repair eyelid defect 6.97 6.35 NA 0.32 13.64 NA 090 67902 A Repair eyelid defect 7.03 6.44 NA 0.34 13.81 NA 090 67903 A Repair eyelid defect 6.37 7.12 11.86 0.39 13.88 18.62 090 67904 A Repair eyelid defect 6.26 7.21 12.42 0.26 13.73 18.94 090 67906 A Repair eyelid defect 6.79 6.29 7.52 0.42 13.50 14.73 090 67908 A Repair eyelid defect 5.13 5.67 8.20 0.20 11.00 13.53 090 67909 A Revise eyelid defect 5.40 6.37 9.33 0.25 12.02 14.98 090 67911 A Revise eyelid defect 5.27 6.15 NA 0.23 11.65 NA 090 67914 A Repair eyelid defect 3.68 3.31 9.72 0.16 7.15 13.56 090 67915 A Repair eyelid defect 3.18 1.54 8.46 0.13 4.85 11.77 090 67916 A Repair eyelid defect 5.31 5.00 12.94 0.22 10.53 18.47 090 67917 A Repair eyelid defect 6.02 6.18 9.20 0.25 12.45 15.47 090 67921 A Repair eyelid defect 3.40 3.05 9.35 0.14 6.59 12.89 090 67922 A Repair eyelid defect 3.06 2.89 8.41 0.13 6.08 11.60 090 67923 A Repair eyelid defect 5.88 5.14 12.91 0.24 11.26 19.03 090 67924 A Repair eyelid defect 5.79 5.55 8.55 0.23 11.57 14.57 090 Start Printed Page 40474 67930 A Repair eyelid wound 3.61 2.88 9.23 0.17 6.66 13.01 010 67935 A Repair eyelid wound 6.22 5.19 13.75 0.29 11.70 20.26 090 67938 A Remove eyelid foreign body 1.33 0.53 6.62 0.06 1.92 8.01 010 67950 A Revision of eyelid 5.82 6.94 8.40 0.30 13.06 14.52 090 67961 A Revision of eyelid 5.69 5.86 8.54 0.26 11.81 14.49 090 67966 A Revision of eyelid 6.57 6.05 8.43 0.33 12.95 15.33 090 67971 A Reconstruction of eyelid 9.79 7.56 NA 0.42 17.77 NA 090 67973 A Reconstruction of eyelid 12.87 9.70 NA 0.59 23.16 NA 090 67974 A Reconstruction of eyelid 12.84 9.61 NA 0.54 22.99 NA 090 67975 A Reconstruction of eyelid 9.13 7.20 NA 0.38 16.71 NA 090 67999 C Revision of eyelid 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68020 A Incise/drain eyelid lining 1.37 0.65 5.28 0.06 2.08 6.71 010 68040 A Treatment of eyelid lesions 0.85 0.41 5.13 0.03 1.29 6.01 000 68100 A Biopsy of eyelid lining 1.35 0.64 5.64 0.06 2.05 7.05 000 68110 A Remove eyelid lining lesion 1.77 1.35 6.35 0.07 3.19 8.19 010 68115 A Remove eyelid lining lesion 2.36 1.12 5.90 0.10 3.58 8.36 010 68130 A Remove eyelid lining lesion 4.93 2.35 NA 0.19 7.47 NA 090 68135 A Remove eyelid lining lesion 1.84 0.87 5.65 0.07 2.78 7.56 010 68200 A Treat eyelid by injection 0.49 0.23 5.25 0.02 0.74 5.76 000 68320 A Revise/graft eyelid lining 5.37 5.05 5.14 0.21 10.63 10.72 090 68325 A Revise/graft eyelid lining 7.36 6.07 NA 0.30 13.73 NA 090 68326 A Revise/graft eyelid lining 7.15 5.96 NA 0.30 13.41 NA 090 68328 A Revise/graft eyelid lining 8.18 6.81 NA 0.40 15.39 NA 090 68330 A Revise eyelid lining 4.83 5.00 6.69 0.19 10.02 11.71 090 68335 A Revise/graft eyelid lining 7.19 5.16 NA 0.29 12.64 NA 090 68340 A Separate eyelid adhesions 4.17 3.89 11.78 0.17 8.23 16.12 090 68360 A Revise eyelid lining 4.37 4.78 5.92 0.17 9.32 10.46 090 68362 A Revise eyelid lining 7.34 7.43 NA 0.29 15.06 NA 090 68399 C Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68400 A Incise/drain tear gland 1.69 1.88 8.24 0.07 3.64 10.00 010 68420 A Incise/drain tear sac 2.30 2.17 8.38 0.10 4.57 10.78 010 68440 A Incise tear duct opening 0.94 0.45 5.27 0.04 1.43 6.25 010 68500 A Removal of tear gland 11.02 10.17 NA 0.60 21.79 NA 090 68505 A Partial removal, tear gland 10.94 10.38 NA 0.57 21.89 NA 090 68510 A Biopsy of tear gland 4.61 2.16 9.87 0.19 6.96 14.67 000 68520 A Removal of tear sac 7.51 6.72 NA 0.33 14.56 NA 090 68525 A Biopsy of tear sac 4.43 2.11 NA 0.18 6.72 NA 000 68530 A Clearance of tear duct 3.66 2.76 11.01 0.16 6.58 14.83 010 68540 A Remove tear gland lesion 10.60 8.32 NA 0.46 19.38 NA 090 68550 A Remove tear gland lesion 13.26 10.39 NA 0.66 24.31 NA 090 68700 A Repair tear ducts 6.60 6.10 NA 0.27 12.97 NA 090 68705 A Revise tear duct opening 2.06 0.98 5.90 0.08 3.12 8.04 010 68720 A Create tear sac drain 8.96 7.26 NA 0.38 16.60 NA 090 68745 A Create tear duct drain 8.63 7.26 NA 0.38 16.27 NA 090 68750 A Create tear duct drain 8.66 7.68 NA 0.37 16.71 NA 090 68760 A Close tear duct opening 1.73 0.82 5.54 0.07 2.62 7.34 010 68761 A Close tear duct opening 1.36 0.63 6.39 0.06 2.05 7.81 010 68770 A Close tear system fistula 7.02 5.56 13.49 0.28 12.86 20.79 090 68801 A Dilate tear duct opening 0.94 0.44 6.44 0.04 1.42 7.42 010 68810 A Probe nasolacrimal duct 1.90 1.89 8.09 0.08 3.87 10.07 010 68811 A Probe nasolacrimal duct 2.35 2.14 NA 0.10 4.59 NA 010 68815 A Probe nasolacrimal duct 3.20 2.61 9.93 0.14 5.95 13.27 010 68840 A Explore/irrigate tear ducts 1.25 0.59 7.01 0.05 1.89 8.31 010 68850 A Injection for tear sac x-ray 0.80 0.31 12.26 0.03 1.14 13.09 000 68899 C Tear duct system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69000 A Drain external ear lesion 1.45 0.58 2.03 0.10 2.13 3.58 010 69005 A Drain external ear lesion 2.11 2.06 2.46 0.16 4.33 4.73 010 69020 A Drain outer ear canal lesion 1.48 0.75 2.13 0.11 2.34 3.72 010 69090 N Pierce earlobes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69100 A Biopsy of external ear 0.81 0.41 1.44 0.04 1.26 2.29 000 69105 A Biopsy of external ear canal 0.85 0.96 1.45 0.06 1.87 2.36 000 69110 A Remove external ear, partial 3.44 2.79 3.43 0.24 6.47 7.11 090 69120 A Removal of external ear 4.05 4.42 NA 0.31 8.78 NA 090 69140 A Remove ear canal lesion(s) 7.97 7.89 NA 0.56 16.42 NA 090 69145 A Remove ear canal lesion(s) 2.62 2.44 3.26 0.18 5.24 6.06 090 69150 A Extensive ear canal surgery 13.43 11.19 NA 1.07 25.69 NA 090 69155 A Extensive ear/neck surgery 20.80 15.24 NA 1.51 37.55 NA 090 69200 A Clear outer ear canal 0.77 0.72 1.38 0.05 1.54 2.20 000 69205 A Clear outer ear canal 1.20 1.50 NA 0.09 2.79 NA 010 69210 A Remove impacted ear wax 0.61 0.25 1.27 0.04 0.90 1.92 000 69220 A Clean out mastoid cavity 0.83 0.43 1.44 0.06 1.32 2.33 000 69222 A Clean out mastoid cavity 1.40 1.63 2.12 0.10 3.13 3.62 010 69300 R Revise external ear 6.36 4.35 NA 0.43 11.14 NA YYY 69310 A Rebuild outer ear canal 10.79 9.48 NA 0.77 21.04 NA 090 Start Printed Page 40475 69320 A Rebuild outer ear canal 16.96 13.66 NA 1.17 31.79 NA 090 69399 C Outer ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69400 A Inflate middle ear canal 0.83 0.46 1.44 0.06 1.35 2.33 000 69401 A Inflate middle ear canal 0.63 0.37 1.34 0.04 1.04 2.01 000 69405 A Catheterize middle ear canal 2.63 1.48 2.97 0.18 4.29 5.78 010 69410 A Inset middle ear (baffle) 0.33 0.16 1.38 0.02 0.51 1.73 000 69420 A Incision of eardrum 1.33 0.72 2.22 0.10 2.15 3.65 010 69421 A Incision of eardrum 1.73 1.83 2.46 0.13 3.69 4.32 010 69424 A Remove ventilating tube 0.85 0.89 1.59 0.06 1.80 2.50 000 69433 A Create eardrum opening 1.52 0.86 2.20 0.11 2.49 3.83 010 69436 A Create eardrum opening 1.96 1.97 NA 0.14 4.07 NA 010 69440 A Exploration of middle ear 7.57 7.11 NA 0.53 15.21 NA 090 69450 A Eardrum revision 5.57 5.90 NA 0.39 11.86 NA 090 69501 A Mastoidectomy 9.07 7.91 NA 0.65 17.63 NA 090 69502 A Mastoidectomy 12.38 10.47 NA 0.86 23.71 NA 090 69505 A Remove mastoid structures 12.99 10.66 NA 0.92 24.57 NA 090 69511 A Extensive mastoid surgery 13.52 11.04 NA 0.96 25.52 NA 090 69530 A Extensive mastoid surgery 19.19 14.65 NA 1.32 35.16 NA 090 69535 A Remove part of temporal bone 36.14 24.24 NA 2.59 62.97 NA 090 69540 A Remove ear lesion 1.20 1.52 2.13 0.09 2.81 3.42 010 69550 A Remove ear lesion 10.99 9.68 NA 0.80 21.47 NA 090 69552 A Remove ear lesion 19.46 14.31 NA 1.36 35.13 NA 090 69554 A Remove ear lesion 33.16 21.82 NA 2.32 57.30 NA 090 69601 A Mastoid surgery revision 13.24 11.61 NA 0.92 25.77 NA 090 69602 A Mastoid surgery revision 13.58 11.19 NA 0.94 25.71 NA 090 69603 A Mastoid surgery revision 14.02 11.48 NA 1.00 26.50 NA 090 69604 A Mastoid surgery revision 14.02 11.26 NA 0.98 26.26 NA 090 69605 A Mastoid surgery revision 18.49 13.94 NA 1.29 33.72 NA 090 69610 A Repair of eardrum 4.43 3.37 4.09 0.31 8.11 8.83 010 69620 A Repair of eardrum 5.89 2.95 6.61 0.40 9.24 12.90 090 69631 A Repair eardrum structures 9.86 9.04 NA 0.69 19.59 NA 090 69632 A Rebuild eardrum structures 12.75 11.27 NA 0.89 24.91 NA 090 69633 A Rebuild eardrum structures 12.10 10.91 NA 0.84 23.85 NA 090 69635 A Repair eardrum structures 13.33 9.46 NA 0.87 23.66 NA 090 69636 A Rebuild eardrum structures 15.22 12.80 NA 1.07 29.09 NA 090 69637 A Rebuild eardrum structures 15.11 12.73 NA 1.06 28.90 NA 090 69641 A Revise middle ear & mastoid 12.71 10.63 NA 0.89 24.23 NA 090 69642 A Revise middle ear & mastoid 16.84 13.65 NA 1.18 31.67 NA 090 69643 A Revise middle ear & mastoid 15.32 12.78 NA 1.08 29.18 NA 090 69644 A Revise middle ear & mastoid 16.97 13.73 NA 1.19 31.89 NA 090 69645 A Revise middle ear & mastoid 16.38 13.36 NA 1.16 30.90 NA 090 69646 A Revise middle ear & mastoid 17.99 14.33 NA 1.26 33.58 NA 090 69650 A Release middle ear bone 9.66 8.30 NA 0.68 18.64 NA 090 69660 A Revise middle ear bone 11.90 9.53 NA 0.84 22.27 NA 090 69661 A Revise middle ear bone 15.74 12.32 NA 1.10 29.16 NA 090 69662 A Revise middle ear bone 15.44 12.17 NA 1.08 28.69 NA 090 69666 A Repair middle ear structures 9.75 8.34 NA 0.68 18.77 NA 090 69667 A Repair middle ear structures 9.76 8.29 NA 0.72 18.77 NA 090 69670 A Remove mastoid air cells 11.51 9.91 NA 0.78 22.20 NA 090 69676 A Remove middle ear nerve 9.52 8.62 NA 0.69 18.83 NA 090 69700 A Close mastoid fistula 8.23 5.24 NA 0.55 14.02 NA 090 69710 N Implant/replace hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69711 A Remove/repair hearing aid 10.44 9.18 NA 0.62 20.24 NA 090 69714 A Implant temple bone w/stimul 14.00 8.65 NA 0.97 23.62 NA 090 69715 A Temple bne implnt w/stimulat 18.25 10.42 NA 1.25 29.92 NA 090 69717 A Temple bone implant revision 14.98 8.31 NA 1.04 24.33 NA 090 69718 A Revise temple bone implant 18.50 10.51 NA 1.27 30.28 NA 090 69720 A Release facial nerve 14.38 12.04 NA 1.03 27.45 NA 090 69725 A Release facial nerve 25.38 18.21 NA 1.78 45.37 NA 090 69740 A Repair facial nerve 15.96 11.55 NA 1.13 28.64 NA 090 69745 A Repair facial nerve 16.69 11.91 NA 1.00 29.60 NA 090 69799 C Middle ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69801 A Incise inner ear 8.56 7.68 NA 0.60 16.84 NA 090 69802 A Incise inner ear 13.10 10.97 NA 0.91 24.98 NA 090 69805 A Explore inner ear 13.82 10.74 NA 0.97 25.53 NA 090 69806 A Explore inner ear 12.35 10.50 NA 0.86 23.71 NA 090 69820 A Establish inner ear window 10.34 9.02 NA 0.66 20.02 NA 090 69840 A Revise inner ear window 10.26 9.90 NA 0.64 20.80 NA 090 69905 A Remove inner ear 11.10 9.34 NA 0.77 21.21 NA 090 69910 A Remove inner ear & mastoid 13.63 10.98 NA 0.94 25.55 NA 090 69915 A Incise inner ear nerve 21.23 15.31 NA 1.54 38.08 NA 090 69930 A Implant cochlear device 16.81 12.66 NA 1.19 30.66 NA 090 69949 C Inner ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69950 A Incise inner ear nerve 25.64 16.14 NA 2.90 44.68 NA 090 Start Printed Page 40476 69955 A Release facial nerve 27.04 18.47 NA 1.89 47.40 NA 090 69960 A Release inner ear canal 27.04 17.99 NA 2.43 47.46 NA 090 69970 A Remove inner ear lesion 30.04 19.13 NA 2.34 51.51 NA 090 69979 C Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69990 R Microsurgery add-on 3.47 1.88 NA 0.56 5.91 NA ZZZ 70010 A Contrast x-ray of brain 1.19 NA 4.69 0.24 NA 6.12 XXX 70010 26 A Contrast x-ray of brain 1.19 0.42 0.42 0.06 1.67 1.67 XXX 70010 TC A Contrast x-ray of brain 0.00 NA 4.27 0.18 NA 4.45 XXX 70015 A Contrast x-ray of brain 1.19 NA 1.76 0.12 NA 3.07 XXX 70015 26 A Contrast x-ray of brain 1.19 0.43 0.43 0.05 1.67 1.67 XXX 70015 TC A Contrast x-ray of brain 0.00 NA 1.33 0.07 NA 1.40 XXX 70030 A X-ray eye for foreign body 0.17 NA 0.47 0.03 NA 0.67 XXX 70030 26 A X-ray eye for foreign body 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70030 TC A X-ray eye for foreign body 0.00 NA 0.41 0.02 NA 0.43 XXX 70100 A X-ray exam of jaw 0.18 NA 0.57 0.03 NA 0.78 XXX 70100 26 A X-ray exam of jaw 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70100 TC A X-ray exam of jaw 0.00 NA 0.51 0.02 NA 0.53 XXX 70110 A X-ray exam of jaw 0.25 NA 0.70 0.04 NA 0.99 XXX 70110 26 A X-ray exam of jaw 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70110 TC A X-ray exam of jaw 0.00 NA 0.61 0.03 NA 0.64 XXX 70120 A X-ray exam of mastoids 0.18 NA 0.67 0.04 NA 0.89 XXX 70120 26 A X-ray exam of mastoids 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70120 TC A X-ray exam of mastoids 0.00 NA 0.61 0.03 NA 0.64 XXX 70130 A X-ray exam of mastoids 0.34 NA 0.89 0.05 NA 1.28 XXX 70130 26 A X-ray exam of mastoids 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70130 TC A X-ray exam of mastoids 0.00 NA 0.77 0.04 NA 0.81 XXX 70134 A X-ray exam of middle ear 0.34 NA 0.84 0.05 NA 1.23 XXX 70134 26 A X-ray exam of middle ear 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70134 TC A X-ray exam of middle ear 0.00 NA 0.72 0.04 NA 0.76 XXX 70140 A X-ray exam of facial bones 0.19 NA 0.68 0.04 NA 0.91 XXX 70140 26 A X-ray exam of facial bones 0.19 0.07 0.07 0.01 0.27 0.27 XXX 70140 TC A X-ray exam of facial bones 0.00 NA 0.61 0.03 NA 0.64 XXX 70150 A X-ray exam of facial bones 0.26 NA 0.86 0.05 NA 1.17 XXX 70150 26 A X-ray exam of facial bones 0.26 0.09 0.09 0.01 0.36 0.36 XXX 70150 TC A X-ray exam of facial bones 0.00 NA 0.77 0.04 NA 0.81 XXX 70160 A X-ray exam of nasal bones 0.17 NA 0.57 0.03 NA 0.77 XXX 70160 26 A X-ray exam of nasal bones 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70160 TC A X-ray exam of nasal bones 0.00 NA 0.51 0.02 NA 0.53 XXX 70170 A X-ray exam of tear duct 0.30 NA 1.04 0.06 NA 1.40 XXX 70170 26 A X-ray exam of tear duct 0.30 0.11 0.11 0.01 0.42 0.42 XXX 70170 TC A X-ray exam of tear duct 0.00 NA 0.93 0.05 NA 0.98 XXX 70190 A X-ray exam of eye sockets 0.21 NA 0.68 0.04 NA 0.93 XXX 70190 26 A X-ray exam of eye sockets 0.21 0.07 0.07 0.01 0.29 0.29 XXX 70190 TC A X-ray exam of eye sockets 0.00 NA 0.61 0.03 NA 0.64 XXX 70200 A X-ray exam of eye sockets 0.28 NA 0.87 0.05 NA 1.20 XXX 70200 26 A X-ray exam of eye sockets 0.28 0.10 0.10 0.01 0.39 0.39 XXX 70200 TC A X-ray exam of eye sockets 0.00 NA 0.77 0.04 NA 0.81 XXX 70210 A X-ray exam of sinuses 0.17 NA 0.67 0.04 NA 0.88 XXX 70210 26 A X-ray exam of sinuses 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70210 TC A X-ray exam of sinuses 0.00 NA 0.61 0.03 NA 0.64 XXX 70220 A X-ray exam of sinuses 0.25 NA 0.86 0.05 NA 1.16 XXX 70220 26 A X-ray exam of sinuses 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70220 TC A X-ray exam of sinuses 0.00 NA 0.77 0.04 NA 0.81 XXX 70240 A X-ray exam, pituitary saddle 0.19 NA 0.48 0.03 NA 0.70 XXX 70240 26 A X-ray exam, pituitary saddle 0.19 0.07 0.07 0.01 0.27 0.27 XXX 70240 TC A X-ray exam, pituitary saddle 0.00 NA 0.41 0.02 NA 0.43 XXX 70250 A X-ray exam of skull 0.24 NA 0.69 0.04 NA 0.97 XXX 70250 26 A X-ray exam of skull 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70250 TC A X-ray exam of skull 0.00 NA 0.61 0.03 NA 0.64 XXX 70260 A X-ray exam of skull 0.34 NA 1.00 0.06 NA 1.40 XXX 70260 26 A X-ray exam of skull 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70260 TC A X-ray exam of skull 0.00 NA 0.88 0.05 NA 0.93 XXX 70300 A X-ray exam of teeth 0.10 NA 0.30 0.03 NA 0.43 XXX 70300 26 A X-ray exam of teeth 0.10 0.04 0.04 0.01 0.15 0.15 XXX 70300 TC A X-ray exam of teeth 0.00 NA 0.26 0.02 NA 0.28 XXX 70310 A X-ray exam of teeth 0.16 NA 0.47 0.03 NA 0.66 XXX 70310 26 A X-ray exam of teeth 0.16 0.06 0.06 0.01 0.23 0.23 XXX 70310 TC A X-ray exam of teeth 0.00 NA 0.41 0.02 NA 0.43 XXX 70320 A Full mouth x-ray of teeth 0.22 NA 0.85 0.05 NA 1.12 XXX 70320 26 A Full mouth x-ray of teeth 0.22 0.08 0.08 0.01 0.31 0.31 XXX 70320 TC A Full mouth x-ray of teeth 0.00 NA 0.77 0.04 NA 0.81 XXX 70328 A X-ray exam of jaw joint 0.18 NA 0.55 0.03 NA 0.76 XXX 70328 26 A X-ray exam of jaw joint 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70328 TC A X-ray exam of jaw joint 0.00 NA 0.49 0.02 NA 0.51 XXX Start Printed Page 40477 70330 A X-ray exam of jaw joints 0.24 NA 0.91 0.05 NA 1.20 XXX 70330 26 A X-ray exam of jaw joints 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70330 TC A X-ray exam of jaw joints 0.00 NA 0.83 0.04 NA 0.87 XXX 70332 A X-ray exam of jaw joint 0.54 NA 2.26 0.12 NA 2.92 XXX 70332 26 A X-ray exam of jaw joint 0.54 0.19 0.19 0.02 0.75 0.75 XXX 70332 TC A X-ray exam of jaw joint 0.00 NA 2.07 0.10 NA 2.17 XXX 70336 A Magnetic image, jaw joint 1.48 NA 11.55 0.56 NA 13.59 XXX 70336 26 A Magnetic image, jaw joint 1.48 0.52 0.52 0.07 2.07 2.07 XXX 70336 TC A Magnetic image, jaw joint 0.00 NA 11.03 0.49 NA 11.52 XXX 70350 A X-ray head for orthodontia 0.17 NA 0.43 0.03 NA 0.63 XXX 70350 26 A X-ray head for orthodontia 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70350 TC A X-ray head for orthodontia 0.00 NA 0.37 0.02 NA 0.39 XXX 70355 A Panoramic x-ray of jaws 0.20 NA 0.63 0.04 NA 0.87 XXX 70355 26 A Panoramic x-ray of jaws 0.20 0.07 0.07 0.01 0.28 0.28 XXX 70355 TC A Panoramic x-ray of jaws 0.00 NA 0.56 0.03 NA 0.59 XXX 70360 A X-ray exam of neck 0.17 NA 0.47 0.03 NA 0.67 XXX 70360 26 A X-ray exam of neck 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70360 TC A X-ray exam of neck 0.00 NA 0.41 0.02 NA 0.43 XXX 70370 A Throat x-ray & fluoroscopy 0.32 NA 1.40 0.07 NA 1.79 XXX 70370 26 A Throat x-ray & fluoroscopy 0.32 0.11 0.11 0.01 0.44 0.44 XXX 70370 TC A Throat x-ray & fluoroscopy 0.00 NA 1.29 0.06 NA 1.35 XXX 70371 A Speech evaluation, complex 0.84 NA 2.36 0.14 NA 3.34 XXX 70371 26 A Speech evaluation, complex 0.84 0.29 0.29 0.04 1.17 1.17 XXX 70371 TC A Speech evaluation, complex 0.00 NA 2.07 0.10 NA 2.17 XXX 70373 A Contrast x-ray of larynx 0.44 NA 1.90 0.11 NA 2.45 XXX 70373 26 A Contrast x-ray of larynx 0.44 0.15 0.15 0.02 0.61 0.61 XXX 70373 TC A Contrast x-ray of larynx 0.00 NA 1.75 0.09 NA 1.84 XXX 70380 A X-ray exam of salivary gland 0.17 NA 0.72 0.04 NA 0.93 XXX 70380 26 A X-ray exam of salivary gland 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70380 TC A X-ray exam of salivary gland 0.00 NA 0.66 0.03 NA 0.69 XXX 70390 A X-ray exam of salivary duct 0.38 NA 1.88 0.11 NA 2.37 XXX 70390 26 A X-ray exam of salivary duct 0.38 0.13 0.13 0.02 0.53 0.53 XXX 70390 TC A X-ray exam of salivary duct 0.00 NA 1.75 0.09 NA 1.84 XXX 70450 A Ct head/brain w/o dye 0.85 NA 4.95 0.25 NA 6.05 XXX 70450 26 A Ct head/brain w/o dye 0.85 0.30 0.30 0.04 1.19 1.19 XXX 70450 TC A Ct head/brain w/o dye 0.00 NA 4.65 0.21 NA 4.86 XXX 70460 A Ct head/brain w/dye 1.13 NA 5.97 0.30 NA 7.40 XXX 70460 26 A Ct head/brain w/dye 1.13 0.40 0.40 0.05 1.58 1.58 XXX 70460 TC A Ct head/brain w/dye 0.00 NA 5.57 0.25 NA 5.82 XXX 70470 A Ct head/brain w/o&w dye 1.27 NA 7.40 0.37 NA 9.04 XXX 70470 26 A Ct head/brain w/o&w dye 1.27 0.44 0.44 0.06 1.77 1.77 XXX 70470 TC A Ct head/brain w/o&w dye 0.00 NA 6.96 0.31 NA 7.27 XXX 70480 A Ct orbit/ear/fossa w/o dye 1.28 NA 5.10 0.27 NA 6.65 XXX 70480 26 A Ct orbit/ear/fossa w/o dye 1.28 0.45 0.45 0.06 1.79 1.79 XXX 70480 TC A Ct orbit/ear/fossa w/o dye 0.00 NA 4.65 0.21 NA 4.86 XXX 70481 A Ct orbit/ear/fossa w/dye 1.38 NA 6.05 0.31 NA 7.74 XXX 70481 26 A Ct orbit/ear/fossa w/dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 70481 TC A Ct orbit/ear/fossa w/dye 0.00 NA 5.57 0.25 NA 5.82 XXX 70482 A Ct orbit/ear/fossa w/o&w dye 1.45 NA 7.47 0.37 NA 9.29 XXX 70482 26 A Ct orbit/ear/fossa w/o&w dye 1.45 0.51 0.51 0.06 2.02 2.02 XXX 70482 TC A Ct orbit/ear/fossa w/o&w dye 0.00 NA 6.96 0.31 NA 7.27 XXX 70486 A Ct maxillofacial w/o dye 1.14 NA 5.05 0.26 NA 6.45 XXX 70486 26 A Ct maxillofacial w/o dye 1.14 0.40 0.40 0.05 1.59 1.59 XXX 70486 TC A Ct maxillofacial w/o dye 0.00 NA 4.65 0.21 NA 4.86 XXX 70487 A Ct maxillofacial w/dye 1.30 NA 6.02 0.31 NA 7.63 XXX 70487 26 A Ct maxillofacial w/dye 1.30 0.45 0.45 0.06 1.81 1.81 XXX 70487 TC A Ct maxillofacial w/dye 0.00 NA 5.57 0.25 NA 5.82 XXX 70488 A Ct maxillofacial w/o&w dye 1.42 NA 7.45 0.37 NA 9.24 XXX 70488 26 A Ct maxillofacial w/o&w dye 1.42 0.49 0.49 0.06 1.97 1.97 XXX 70488 TC A Ct maxillofacial w/o&w dye 0.00 NA 6.96 0.31 NA 7.27 XXX 70490 A Ct soft tissue neck w/o dye 1.28 NA 5.10 0.27 NA 6.65 XXX 70490 26 A Ct soft tissue neck w/o dye 1.28 0.45 0.45 0.06 1.79 1.79 XXX 70490 TC A Ct soft tissue neck w/o dye 0.00 NA 4.65 0.21 NA 4.86 XXX 70491 A Ct soft tissue neck w/dye 1.38 NA 6.05 0.31 NA 7.74 XXX 70491 26 A Ct soft tissue neck w/dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 70491 TC A Ct soft tissue neck w/dye 0.00 NA 5.57 0.25 NA 5.82 XXX 70492 A Ct sft tsue nck w/o & w/dye 1.45 NA 7.47 0.37 NA 9.29 XXX 70492 26 A Ct sft tsue nck w/o & w/dye 1.45 0.51 0.51 0.06 2.02 2.02 XXX 70492 TC A Ct sft tsue nck w/o & w/dye 0.00 NA 6.96 0.31 NA 7.27 XXX 70496 A Ct angiography, head 1.75 NA 7.65 0.54 NA 9.94 XXX 70496 26 A Ct angiography, head 1.75 0.69 0.69 0.06 2.50 2.50 XXX 70496 TC A Ct angiography, head 0.00 NA 6.96 0.48 NA 7.44 XXX 70498 A Ct angiography, neck 1.75 NA 7.65 0.54 NA 9.94 XXX 70498 26 A Ct angiography, neck 1.75 0.69 0.69 0.06 2.50 2.50 XXX Start Printed Page 40478 70498 TC A Ct angiography, neck 0.00 NA 6.96 0.48 NA 7.44 XXX 70540 A Mri orbit/face/neck w/o dye 1.10 NA 11.41 0.36 NA 12.87 XXX 70540 26 A Mri orbit/face/neck w/o dye 1.10 0.38 0.38 0.04 1.52 1.52 XXX 70540 TC A Mri orbit/face/neck w/o dye 0.00 NA 11.03 0.32 NA 11.35 XXX 70542 A Mri orbit/face/neck w/dye 1.33 NA 13.69 0.43 NA 15.45 XXX 70542 26 A Mri orbit/face/neck w/dye 1.33 0.46 0.46 0.04 1.83 1.83 XXX 70542 TC A Mri orbit/face/neck w/dye 0.00 NA 13.23 0.39 NA 13.62 XXX 70543 A Mri orbt/fac/nck w/o&w dye 1.76 NA 25.13 0.78 NA 27.67 XXX 70543 26 A Mri orbt/fac/nck w/o&w dye 1.76 0.62 0.62 0.08 2.46 2.46 XXX 70543 TC A Mri orbt/fac/nck w/o&w dye 0.00 NA 24.51 0.70 NA 25.21 XXX 70544 A Mr angiography head w/o dye 1.20 NA 11.45 0.56 NA 13.21 XXX 70544 26 A Mr angiography head w/o dye 1.20 0.42 0.42 0.07 1.69 1.69 XXX 70544 TC A Mr angiography head w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 70545 A Mr angiography head w/dye 1.20 NA 11.45 0.56 NA 13.21 XXX 70545 26 A Mr angiography head w/dye 1.20 0.42 0.42 0.07 1.69 1.69 XXX 70545 TC A Mr angiography head w/dye 0.00 NA 11.03 0.49 NA 11.52 XXX 70546 A Mr angiograph head w/o&w dye 1.80 NA 22.70 0.56 NA 25.06 XXX 70546 26 A Mr angiograph head w/o&w dye 1.80 0.63 0.63 0.07 2.50 2.50 XXX 70546 TC A Mr angiograph head w/o&w dye 0.00 NA 22.07 0.49 NA 22.56 XXX 70547 A Mr angiography neck w/o dye 1.20 NA 11.45 0.56 NA 13.21 XXX 70547 26 A Mr angiography neck w/o dye 1.20 0.42 0.42 0.07 1.69 1.69 XXX 70547 TC A Mr angiography neck w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 70548 A Mr angiography neck w/dye 1.20 NA 11.45 0.56 NA 13.21 XXX 70548 26 A Mr angiography neck w/dye 1.20 0.42 0.42 0.07 1.69 1.69 XXX 70548 TC A Mr angiography neck w/dye 0.00 NA 11.03 0.49 NA 11.52 XXX 70549 A Mr angiograph neck w/o&w dye 1.80 NA 22.70 0.56 NA 25.06 XXX 70549 26 A Mr angiograph neck w/o&w dye 1.80 0.63 0.63 0.07 2.50 2.50 XXX 70549 TC A Mr angiograph neck w/o&w dye 0.00 NA 22.07 0.49 NA 22.56 XXX 70551 A Mri brain w/o dye 1.48 NA 11.55 0.56 NA 13.59 XXX 70551 26 A Mri brain w/o dye 1.48 0.52 0.52 0.07 2.07 2.07 XXX 70551 TC A Mri brain w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 70552 A Mri brain w/dye 1.78 NA 13.86 0.66 NA 16.30 XXX 70552 26 A Mri brain w/dye 1.78 0.63 0.63 0.08 2.49 2.49 XXX 70552 TC A Mri brain w/dye 0.00 NA 13.23 0.58 NA 13.81 XXX 70553 A Mri brain w/o&w dye 2.36 NA 25.34 1.19 NA 28.89 XXX 70553 26 A Mri brain w/o&w dye 2.36 0.83 0.83 0.10 3.29 3.29 XXX 70553 TC A Mri brain w/o&w dye 0.00 NA 24.51 1.09 NA 25.60 XXX 71010 A Chest x-ray 0.18 NA 0.53 0.03 NA 0.74 XXX 71010 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71010 TC A Chest x-ray 0.00 NA 0.47 0.02 NA 0.49 XXX 71015 A Chest x-ray 0.21 NA 0.58 0.03 NA 0.82 XXX 71015 26 A Chest x-ray 0.21 0.07 0.07 0.01 0.29 0.29 XXX 71015 TC A Chest x-ray 0.00 NA 0.51 0.02 NA 0.53 XXX 71020 A Chest x-ray 0.22 NA 0.69 0.04 NA 0.95 XXX 71020 26 A Chest x-ray 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71020 TC A Chest x-ray 0.00 NA 0.61 0.03 NA 0.64 XXX 71021 A Chest x-ray 0.27 NA 0.81 0.05 NA 1.13 XXX 71021 26 A Chest x-ray 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71021 TC A Chest x-ray 0.00 NA 0.72 0.04 NA 0.76 XXX 71022 A Chest x-ray 0.31 NA 0.83 0.06 NA 1.20 XXX 71022 26 A Chest x-ray 0.31 0.11 0.11 0.02 0.44 0.44 XXX 71022 TC A Chest x-ray 0.00 NA 0.72 0.04 NA 0.76 XXX 71023 A Chest x-ray and fluoroscopy 0.38 NA 0.91 0.06 NA 1.35 XXX 71023 26 A Chest x-ray and fluoroscopy 0.38 0.14 0.14 0.02 0.54 0.54 XXX 71023 TC A Chest x-ray and fluoroscopy 0.00 NA 0.77 0.04 NA 0.81 XXX 71030 A Chest x-ray 0.31 NA 0.88 0.05 NA 1.24 XXX 71030 26 A Chest x-ray 0.31 0.11 0.11 0.01 0.43 0.43 XXX 71030 TC A Chest x-ray 0.00 NA 0.77 0.04 NA 0.81 XXX 71034 A Chest x-ray and fluoroscopy 0.46 NA 1.59 0.09 NA 2.14 XXX 71034 26 A Chest x-ray and fluoroscopy 0.46 0.17 0.17 0.02 0.65 0.65 XXX 71034 TC A Chest x-ray and fluoroscopy 0.00 NA 1.42 0.07 NA 1.49 XXX 71035 A Chest x-ray 0.18 NA 0.57 0.03 NA 0.78 XXX 71035 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71035 TC A Chest x-ray 0.00 NA 0.51 0.02 NA 0.53 XXX 71040 A Contrast x-ray of bronchi 0.58 NA 1.64 0.10 NA 2.32 XXX 71040 26 A Contrast x-ray of bronchi 0.58 0.20 0.20 0.03 0.81 0.81 XXX 71040 TC A Contrast x-ray of bronchi 0.00 NA 1.44 0.07 NA 1.51 XXX 71060 A Contrast x-ray of bronchi 0.74 NA 2.43 0.14 NA 3.31 XXX 71060 26 A Contrast x-ray of bronchi 0.74 0.26 0.26 0.03 1.03 1.03 XXX 71060 TC A Contrast x-ray of bronchi 0.00 NA 2.17 0.11 NA 2.28 XXX 71090 A X-ray & pacemaker insertion 0.54 NA 1.88 0.11 NA 2.53 XXX 71090 26 A X-ray & pacemaker insertion 0.54 0.22 0.22 0.02 0.78 0.78 XXX 71090 TC A X-ray & pacemaker insertion 0.00 NA 1.66 0.09 NA 1.75 XXX 71100 A X-ray exam of ribs 0.22 NA 0.64 0.04 NA 0.90 XXX Start Printed Page 40479 71100 26 A X-ray exam of ribs 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71100 TC A X-ray exam of ribs 0.00 NA 0.56 0.03 NA 0.59 XXX 71101 A X-ray exam of ribs/chest 0.27 NA 0.75 0.04 NA 1.06 XXX 71101 26 A X-ray exam of ribs/chest 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71101 TC A X-ray exam of ribs/chest 0.00 NA 0.66 0.03 NA 0.69 XXX 71110 A X-ray exam of ribs 0.27 NA 0.86 0.05 NA 1.18 XXX 71110 26 A X-ray exam of ribs 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71110 TC A X-ray exam of ribs 0.00 NA 0.77 0.04 NA 0.81 XXX 71111 A X-ray exam of ribs/ chest 0.32 NA 0.99 0.06 NA 1.37 XXX 71111 26 A X-ray exam of ribs/ chest 0.32 0.11 0.11 0.01 0.44 0.44 XXX 71111 TC A X-ray exam of ribs/ chest 0.00 NA 0.88 0.05 NA 0.93 XXX 71120 A X-ray exam of breastbone 0.20 NA 0.71 0.04 NA 0.95 XXX 71120 26 A X-ray exam of breastbone 0.20 0.07 0.07 0.01 0.28 0.28 XXX 71120 TC A X-ray exam of breastbone 0.00 NA 0.64 0.03 NA 0.67 XXX 71130 A X-ray exam of breastbone 0.22 NA 0.78 0.04 NA 1.04 XXX 71130 26 A X-ray exam of breastbone 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71130 TC A X-ray exam of breastbone 0.00 NA 0.70 0.03 NA 0.73 XXX 71250 A Ct thorax w/o dye 1.16 NA 6.22 0.31 NA 7.69 XXX 71250 26 A Ct thorax w/o dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 71250 TC A Ct thorax w/o dye 0.00 NA 5.82 0.26 NA 6.08 XXX 71260 A Ct thorax w/dye 1.24 NA 7.39 0.36 NA 8.99 XXX 71260 26 A Ct thorax w/dye 1.24 0.43 0.43 0.05 1.72 1.72 XXX 71260 TC A Ct thorax w/dye 0.00 NA 6.96 0.31 NA 7.27 XXX 71270 A Ct thorax w/o&w dye 1.38 NA 9.19 0.44 NA 11.01 XXX 71270 26 A Ct thorax w/o&w dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 71270 TC A Ct thorax w/o&w dye 0.00 NA 8.71 0.38 NA 9.09 XXX 71275 A Ct angiography, chest 1.20 NA 9.18 0.37 NA 10.75 XXX 71275 26 A Ct angiography, chest 1.20 0.47 0.47 0.05 1.72 1.72 XXX 71275 TC A Ct angiography, chest 0.00 NA 8.71 0.32 NA 9.03 XXX 71550 A Mri chest w/o dye 1.22 NA 11.46 0.41 NA 13.09 XXX 71550 26 A Mri chest w/o dye 1.22 0.43 0.43 0.04 1.69 1.69 XXX 71550 TC A Mri chest w/o dye 0.00 NA 11.03 0.37 NA 11.40 XXX 71551 A Mri chest w/dye 1.44 NA 13.73 0.48 NA 15.65 XXX 71551 26 A Mri chest w/dye 1.44 0.50 0.50 0.05 1.99 1.99 XXX 71551 TC A Mri chest w/dye 0.00 NA 13.23 0.43 NA 13.66 XXX 71552 A Mri chest w/o&w dye 1.89 NA 25.17 0.63 NA 27.69 XXX 71552 26 A Mri chest w/o&w dye 1.89 0.66 0.66 0.07 2.62 2.62 XXX 71552 TC A Mri chest w/o&w dye 0.00 NA 24.51 0.56 NA 25.07 XXX 71555 R Mri angio chest w or w/o dye 1.81 NA 11.66 0.57 NA 14.04 XXX 71555 26 R Mri angio chest w or w/o dye 1.81 0.63 0.63 0.08 2.52 2.52 XXX 71555 TC R Mri angio chest w or w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 72010 A X-ray exam of spine 0.45 NA 1.17 0.08 NA 1.70 XXX 72010 26 A X-ray exam of spine 0.45 0.16 0.16 0.03 0.64 0.64 XXX 72010 TC A X-ray exam of spine 0.00 NA 1.01 0.05 NA 1.06 XXX 72020 A X-ray exam of spine 0.15 NA 0.46 0.03 NA 0.64 XXX 72020 26 A X-ray exam of spine 0.15 0.05 0.05 0.01 0.21 0.21 XXX 72020 TC A X-ray exam of spine 0.00 NA 0.41 0.02 NA 0.43 XXX 72040 A X-ray exam of neck spine 0.22 NA 0.67 0.04 NA 0.93 XXX 72040 26 A X-ray exam of neck spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72040 TC A X-ray exam of neck spine 0.00 NA 0.59 0.03 NA 0.62 XXX 72050 A X-ray exam of neck spine 0.31 NA 0.99 0.07 NA 1.37 XXX 72050 26 A X-ray exam of neck spine 0.31 0.11 0.11 0.02 0.44 0.44 XXX 72050 TC A X-ray exam of neck spine 0.00 NA 0.88 0.05 NA 0.93 XXX 72052 A X-ray exam of neck spine 0.36 NA 1.24 0.07 NA 1.67 XXX 72052 26 A X-ray exam of neck spine 0.36 0.13 0.13 0.02 0.51 0.51 XXX 72052 TC A X-ray exam of neck spine 0.00 NA 1.11 0.05 NA 1.16 XXX 72069 A X-ray exam of trunk spine 0.22 NA 0.57 0.04 NA 0.83 XXX 72069 26 A X-ray exam of trunk spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72069 TC A X-ray exam of trunk spine 0.00 NA 0.49 0.02 NA 0.51 XXX 72070 A X-ray exam of thoracic spine 0.22 NA 0.72 0.04 NA 0.98 XXX 72070 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72070 TC A X-ray exam of thoracic spine 0.00 NA 0.64 0.03 NA 0.67 XXX 72072 A X-ray exam of thoracic spine 0.22 NA 0.80 0.05 NA 1.07 XXX 72072 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72072 TC A X-ray exam of thoracic spine 0.00 NA 0.72 0.04 NA 0.76 XXX 72074 A X-ray exam of thoracic spine 0.22 NA 0.97 0.06 NA 1.25 XXX 72074 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72074 TC A X-ray exam of thoracic spine 0.00 NA 0.89 0.05 NA 0.94 XXX 72080 A X-ray exam of trunk spine 0.22 NA 0.74 0.05 NA 1.01 XXX 72080 26 A X-ray exam of trunk spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72080 TC A X-ray exam of trunk spine 0.00 NA 0.66 0.03 NA 0.69 XXX 72090 A X-ray exam of trunk spine 0.28 NA 0.76 0.05 NA 1.09 XXX 72090 26 A X-ray exam of trunk spine 0.28 0.10 0.10 0.02 0.40 0.40 XXX 72090 TC A X-ray exam of trunk spine 0.00 NA 0.66 0.03 NA 0.69 XXX Start Printed Page 40480 72100 A X-ray exam of lower spine 0.22 NA 0.74 0.05 NA 1.01 XXX 72100 26 A X-ray exam of lower spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72100 TC A X-ray exam of lower spine 0.00 NA 0.66 0.03 NA 0.69 XXX 72110 A X-ray exam of lower spine 0.31 NA 1.00 0.07 NA 1.38 XXX 72110 26 A X-ray exam of lower spine 0.31 0.11 0.11 0.02 0.44 0.44 XXX 72110 TC A X-ray exam of lower spine 0.00 NA 0.89 0.05 NA 0.94 XXX 72114 A X-ray exam of lower spine 0.36 NA 1.30 0.08 NA 1.74 XXX 72114 26 A X-ray exam of lower spine 0.36 0.13 0.13 0.03 0.52 0.52 XXX 72114 TC A X-ray exam of lower spine 0.00 NA 1.17 0.05 NA 1.22 XXX 72120 A X-ray exam of lower spine 0.22 NA 0.96 0.07 NA 1.25 XXX 72120 26 A X-ray exam of lower spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72120 TC A X-ray exam of lower spine 0.00 NA 0.88 0.05 NA 0.93 XXX 72125 A Ct neck spine w/o dye 1.16 NA 6.22 0.31 NA 7.69 XXX 72125 26 A Ct neck spine w/o dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72125 TC A Ct neck spine w/o dye 0.00 NA 5.82 0.26 NA 6.08 XXX 72126 A Ct neck spine w/dye 1.22 NA 7.38 0.36 NA 8.96 XXX 72126 26 A Ct neck spine w/dye 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72126 TC A Ct neck spine w/dye 0.00 NA 6.96 0.31 NA 7.27 XXX 72127 A Ct neck spine w/o&w dye 1.27 NA 9.16 0.44 NA 10.87 XXX 72127 26 A Ct neck spine w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 72127 TC A Ct neck spine w/o&w dye 0.00 NA 8.71 0.38 NA 9.09 XXX 72128 A Ct chest spine w/o dye 1.16 NA 6.22 0.31 NA 7.69 XXX 72128 26 A Ct chest spine w/o dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72128 TC A Ct chest spine w/o dye 0.00 NA 5.82 0.26 NA 6.08 XXX 72129 A Ct chest spine w/dye 1.22 NA 7.38 0.36 NA 8.96 XXX 72129 26 A Ct chest spine w/dye 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72129 TC A Ct chest spine w/dye 0.00 NA 6.96 0.31 NA 7.27 XXX 72130 A Ct chest spine w/o&w dye 1.27 NA 9.15 0.44 NA 10.86 XXX 72130 26 A Ct chest spine w/o&w dye 1.27 0.44 0.44 0.06 1.77 1.77 XXX 72130 TC A Ct chest spine w/o&w dye 0.00 NA 8.71 0.38 NA 9.09 XXX 72131 A Ct lumbar spine w/o dye 1.16 NA 6.22 0.31 NA 7.69 XXX 72131 26 A Ct lumbar spine w/o dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72131 TC A Ct lumbar spine w/o dye 0.00 NA 5.82 0.26 NA 6.08 XXX 72132 A Ct lumbar spine w/dye 1.22 NA 7.38 0.37 NA 8.97 XXX 72132 26 A Ct lumbar spine w/dye 1.22 0.42 0.42 0.06 1.70 1.70 XXX 72132 TC A Ct lumbar spine w/dye 0.00 NA 6.96 0.31 NA 7.27 XXX 72133 A Ct lumbar spine w/o&w dye 1.27 NA 9.16 0.44 NA 10.87 XXX 72133 26 A Ct lumbar spine w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 72133 TC A Ct lumbar spine w/o&w dye 0.00 NA 8.71 0.38 NA 9.09 XXX 72141 A Mri neck spine w/o dye 1.60 NA 11.59 0.56 NA 13.75 XXX 72141 26 A Mri neck spine w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72141 TC A Mri neck spine w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 72142 A Mri neck spine w/dye 1.92 NA 13.92 0.67 NA 16.51 XXX 72142 26 A Mri neck spine w/dye 1.92 0.69 0.69 0.09 2.70 2.70 XXX 72142 TC A Mri neck spine w/dye 0.00 NA 13.23 0.58 NA 13.81 XXX 72146 A Mri chest spine w/o dye 1.60 NA 12.81 0.60 NA 15.01 XXX 72146 26 A Mri chest spine w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72146 TC A Mri chest spine w/o dye 0.00 NA 12.25 0.53 NA 12.78 XXX 72147 A Mri chest spine w/dye 1.92 NA 13.91 0.67 NA 16.50 XXX 72147 26 A Mri chest spine w/dye 1.92 0.68 0.68 0.09 2.69 2.69 XXX 72147 TC A Mri chest spine w/dye 0.00 NA 13.23 0.58 NA 13.81 XXX 72148 A Mri lumbar spine w/o dye 1.48 NA 12.77 0.60 NA 14.85 XXX 72148 26 A Mri lumbar spine w/o dye 1.48 0.52 0.52 0.07 2.07 2.07 XXX 72148 TC A Mri lumbar spine w/o dye 0.00 NA 12.25 0.53 NA 12.78 XXX 72149 A Mri lumbar spine w/dye 1.78 NA 13.87 0.67 NA 16.32 XXX 72149 26 A Mri lumbar spine w/dye 1.78 0.64 0.64 0.09 2.51 2.51 XXX 72149 TC A Mri lumbar spine w/dye 0.00 NA 13.23 0.58 NA 13.81 XXX 72156 A Mri neck spine w/o&w dye 2.57 NA 25.41 1.20 NA 29.18 XXX 72156 26 A Mri neck spine w/o&w dye 2.57 0.90 0.90 0.11 3.58 3.58 XXX 72156 TC A Mri neck spine w/o&w dye 0.00 NA 24.51 1.09 NA 25.60 XXX 72157 A Mri chest spine w/o&w dye 2.57 NA 25.41 1.20 NA 29.18 XXX 72157 26 A Mri chest spine w/o&w dye 2.57 0.90 0.90 0.11 3.58 3.58 XXX 72157 TC A Mri chest spine w/o&w dye 0.00 NA 24.51 1.09 NA 25.60 XXX 72158 A Mri lumbar spine w/o&w dye 2.36 NA 25.34 1.20 NA 28.90 XXX 72158 26 A Mri lumbar spine w/o&w dye 2.36 0.83 0.83 0.11 3.30 3.30 XXX 72158 TC A Mri lumbar spine w/o&w dye 0.00 NA 24.51 1.09 NA 25.60 XXX 72159 N Mr angio spine w/o&w dye +1.80 NA 12.96 0.61 NA 15.37 XXX 72159 26 N Mr angio spine w/o&w dye +1.80 0.71 0.71 0.08 2.59 2.59 XXX 72159 TC N Mr angio spine w/o&w dye +0.00 NA 12.25 0.53 NA 12.78 XXX 72170 A X-ray exam of pelvis 0.17 NA 0.57 0.03 NA 0.77 XXX 72170 26 A X-ray exam of pelvis 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72170 TC A X-ray exam of pelvis 0.00 NA 0.51 0.02 NA 0.53 XXX 72190 A X-ray exam of pelvis 0.21 NA 0.73 0.04 NA 0.98 XXX 72190 26 A X-ray exam of pelvis 0.21 0.07 0.07 0.01 0.29 0.29 XXX Start Printed Page 40481 72190 TC A X-ray exam of pelvis 0.00 NA 0.66 0.03 NA 0.69 XXX 72191 A Ct angiograph pelv w/o&w dye 1.20 NA 8.83 0.37 NA 10.40 XXX 72191 26 A Ct angiograph pelv w/o&w dye 1.20 0.47 0.47 0.05 1.72 1.72 XXX 72191 TC A Ct angiograph pelv w/o&w dye 0.00 NA 8.36 0.32 NA 8.68 XXX 72192 A Ct pelvis w/o dye 1.09 NA 6.20 0.31 NA 7.60 XXX 72192 26 A Ct pelvis w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 72192 TC A Ct pelvis w/o dye 0.00 NA 5.82 0.26 NA 6.08 XXX 72193 A Ct pelvis w/dye 1.16 NA 7.14 0.35 NA 8.65 XXX 72193 26 A Ct pelvis w/dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72193 TC A Ct pelvis w/dye 0.00 NA 6.74 0.30 NA 7.04 XXX 72194 A Ct pelvis w/o&w dye 1.22 NA 8.78 0.41 NA 10.41 XXX 72194 26 A Ct pelvis w/o&w dye 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72194 TC A Ct pelvis w/o&w dye 0.00 NA 8.36 0.36 NA 8.72 XXX 72195 A Mri pelvis w/o dye 1.22 NA 11.46 0.41 NA 13.09 XXX 72195 26 A Mri pelvis w/o dye 1.22 0.43 0.43 0.04 1.69 1.69 XXX 72195 TC A Mri pelvis w/o dye 0.00 NA 11.03 0.37 NA 11.40 XXX 72196 A Mri pelvis w/dye 1.44 NA 13.73 0.48 NA 15.65 XXX 72196 26 A Mri pelvis w/dye 1.44 0.50 0.50 0.05 1.99 1.99 XXX 72196 TC A Mri pelvis w/dye 0.00 NA 13.23 0.43 NA 13.66 XXX 72197 A Mri pelvis w/o & w dye 1.89 NA 25.17 0.85 NA 27.91 XXX 72197 26 A Mri pelvis w/o & w dye 1.89 0.66 0.66 0.09 2.64 2.64 XXX 72197 TC A Mri pelvis w/o & w dye 0.00 NA 24.51 0.76 NA 25.27 XXX 72198 N Mr angio pelvis w/o&w dye +1.80 NA 11.74 0.57 NA 14.11 XXX 72198 26 N Mr angio pelvis w/o&w dye +1.80 0.71 0.71 0.08 2.59 2.59 XXX 72198 TC N Mr angio pelvis w/o&w dye +0.00 NA 11.03 0.49 NA 11.52 XXX 72200 A X-ray exam sacroiliac joints 0.17 NA 0.57 0.03 NA 0.77 XXX 72200 26 A X-ray exam sacroiliac joints 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72200 TC A X-ray exam sacroiliac joints 0.00 NA 0.51 0.02 NA 0.53 XXX 72202 A X-ray exam sacroiliac joints 0.19 NA 0.68 0.04 NA 0.91 XXX 72202 26 A X-ray exam sacroiliac joints 0.19 0.07 0.07 0.01 0.27 0.27 XXX 72202 TC A X-ray exam sacroiliac joints 0.00 NA 0.61 0.03 NA 0.64 XXX 72220 A X-ray exam of tailbone 0.17 NA 0.62 0.04 NA 0.83 XXX 72220 26 A X-ray exam of tailbone 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72220 TC A X-ray exam of tailbone 0.00 NA 0.56 0.03 NA 0.59 XXX 72240 A Contrast x-ray of neck spine 0.91 NA 4.97 0.25 NA 6.13 XXX 72240 26 A Contrast x-ray of neck spine 0.91 0.30 0.30 0.04 1.25 1.25 XXX 72240 TC A Contrast x-ray of neck spine 0.00 NA 4.67 0.21 NA 4.88 XXX 72255 A Contrast x-ray, thorax spine 0.91 NA 4.56 0.22 NA 5.69 XXX 72255 26 A Contrast x-ray, thorax spine 0.91 0.29 0.29 0.04 1.24 1.24 XXX 72255 TC A Contrast x-ray, thorax spine 0.00 NA 4.27 0.18 NA 4.45 XXX 72265 A Contrast x-ray, lower spine 0.83 NA 4.28 0.22 NA 5.33 XXX 72265 26 A Contrast x-ray, lower spine 0.83 0.27 0.27 0.04 1.14 1.14 XXX 72265 TC A Contrast x-ray, lower spine 0.00 NA 4.01 0.18 NA 4.19 XXX 72270 A Contrast x-ray of spine 1.33 NA 6.44 0.34 NA 8.11 XXX 72270 26 A Contrast x-ray of spine 1.33 0.43 0.43 0.07 1.83 1.83 XXX 72270 TC A Contrast x-ray of spine 0.00 NA 6.01 0.27 NA 6.28 XXX 72275 A Epidurography 0.76 NA 2.32 0.21 NA 3.29 XXX 72275 26 A Epidurography 0.76 0.25 0.25 0.03 1.04 1.04 XXX 72275 TC A Epidurography 0.00 NA 2.07 0.18 NA 2.25 XXX 72285 A X-ray c/t spine disk 1.16 NA 8.64 0.42 NA 10.22 XXX 72285 26 A X-ray c/t spine disk 1.16 0.39 0.39 0.06 1.61 1.61 XXX 72285 TC A X-ray c/t spine disk 0.00 NA 8.25 0.36 NA 8.61 XXX 72295 A X-ray of lower spine disk 0.83 NA 8.02 0.37 NA 9.22 XXX 72295 26 A X-ray of lower spine disk 0.83 0.28 0.28 0.04 1.15 1.15 XXX 72295 TC A X-ray of lower spine disk 0.00 NA 7.74 0.33 NA 8.07 XXX 73000 A X-ray exam of collar bone 0.16 NA 0.57 0.03 NA 0.76 XXX 73000 26 A X-ray exam of collar bone 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73000 TC A X-ray exam of collar bone 0.00 NA 0.51 0.02 NA 0.53 XXX 73010 A X-ray exam of shoulder blade 0.17 NA 0.57 0.03 NA 0.77 XXX 73010 26 A X-ray exam of shoulder blade 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73010 TC A X-ray exam of shoulder blade 0.00 NA 0.51 0.02 NA 0.53 XXX 73020 A X-ray exam of shoulder 0.15 NA 0.52 0.03 NA 0.70 XXX 73020 26 A X-ray exam of shoulder 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73020 TC A X-ray exam of shoulder 0.00 NA 0.47 0.02 NA 0.49 XXX 73030 A X-ray exam of shoulder 0.18 NA 0.62 0.04 NA 0.84 XXX 73030 26 A X-ray exam of shoulder 0.18 0.06 0.06 0.01 0.25 0.25 XXX 73030 TC A X-ray exam of shoulder 0.00 NA 0.56 0.03 NA 0.59 XXX 73040 A Contrast x-ray of shoulder 0.54 NA 2.26 0.13 NA 2.93 XXX 73040 26 A Contrast x-ray of shoulder 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73040 TC A Contrast x-ray of shoulder 0.00 NA 2.07 0.10 NA 2.17 XXX 73050 A X-ray exam of shoulders 0.20 NA 0.73 0.05 NA 0.98 XXX 73050 26 A X-ray exam of shoulders 0.20 0.07 0.07 0.02 0.29 0.29 XXX 73050 TC A X-ray exam of shoulders 0.00 NA 0.66 0.03 NA 0.69 XXX 73060 A X-ray exam of humerus 0.17 NA 0.62 0.04 NA 0.83 XXX Start Printed Page 40482 73060 26 A X-ray exam of humerus 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73060 TC A X-ray exam of humerus 0.00 NA 0.56 0.03 NA 0.59 XXX 73070 A X-ray exam of elbow 0.15 NA 0.56 0.03 NA 0.74 XXX 73070 26 A X-ray exam of elbow 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73070 TC A X-ray exam of elbow 0.00 NA 0.51 0.02 NA 0.53 XXX 73080 A X-ray exam of elbow 0.17 NA 0.62 0.04 NA 0.83 XXX 73080 26 A X-ray exam of elbow 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73080 TC A X-ray exam of elbow 0.00 NA 0.56 0.03 NA 0.59 XXX 73085 A Contrast x-ray of elbow 0.54 NA 2.27 0.13 NA 2.94 XXX 73085 26 A Contrast x-ray of elbow 0.54 0.20 0.20 0.03 0.77 0.77 XXX 73085 TC A Contrast x-ray of elbow 0.00 NA 2.07 0.10 NA 2.17 XXX 73090 A X-ray exam of forearm 0.16 NA 0.57 0.03 NA 0.76 XXX 73090 26 A X-ray exam of forearm 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73090 TC A X-ray exam of forearm 0.00 NA 0.51 0.02 NA 0.53 XXX 73092 A X-ray exam of arm, infant 0.16 NA 0.55 0.03 NA 0.74 XXX 73092 26 A X-ray exam of arm, infant 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73092 TC A X-ray exam of arm, infant 0.00 NA 0.49 0.02 NA 0.51 XXX 73100 A X-ray exam of wrist 0.16 NA 0.55 0.04 NA 0.75 XXX 73100 26 A X-ray exam of wrist 0.16 0.06 0.06 0.02 0.24 0.24 XXX 73100 TC A X-ray exam of wrist 0.00 NA 0.49 0.02 NA 0.51 XXX 73110 A X-ray exam of wrist 0.17 NA 0.58 0.03 NA 0.78 XXX 73110 26 A X-ray exam of wrist 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73110 TC A X-ray exam of wrist 0.00 NA 0.52 0.02 NA 0.54 XXX 73115 A Contrast x-ray of wrist 0.54 NA 1.74 0.11 NA 2.39 XXX 73115 26 A Contrast x-ray of wrist 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73115 TC A Contrast x-ray of wrist 0.00 NA 1.55 0.08 NA 1.63 XXX 73120 A X-ray exam of hand 0.16 NA 0.55 0.03 NA 0.74 XXX 73120 26 A X-ray exam of hand 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73120 TC A X-ray exam of hand 0.00 NA 0.49 0.02 NA 0.51 XXX 73130 A X-ray exam of hand 0.17 NA 0.58 0.03 NA 0.78 XXX 73130 26 A X-ray exam of hand 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73130 TC A X-ray exam of hand 0.00 NA 0.52 0.02 NA 0.54 XXX 73140 A X-ray exam of finger(s) 0.13 NA 0.46 0.03 NA 0.62 XXX 73140 26 A X-ray exam of finger(s) 0.13 0.05 0.05 0.01 0.19 0.19 XXX 73140 TC A X-ray exam of finger(s) 0.00 NA 0.41 0.02 NA 0.43 XXX 73200 A Ct upper extremity w/o dye 1.09 NA 5.26 0.26 NA 6.61 XXX 73200 26 A Ct upper extremity w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73200 TC A Ct upper extremity w/o dye 0.00 NA 4.88 0.21 NA 5.09 XXX 73201 A Ct upper extremity w/dye 1.16 NA 6.23 0.31 NA 7.70 XXX 73201 26 A Ct upper extremity w/dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 73201 TC A Ct upper extremity w/dye 0.00 NA 5.82 0.26 NA 6.08 XXX 73202 A Ct uppr extremity w/o&w dye 1.22 NA 7.74 0.38 NA 9.34 XXX 73202 26 A Ct uppr extremity w/o&w dye 1.22 0.43 0.43 0.06 1.71 1.71 XXX 73202 TC A Ct uppr extremity w/o&w dye 0.00 NA 7.31 0.32 NA 7.63 XXX 73206 A Ct angio upr extrm w/o&w dye 1.20 NA 7.78 0.37 NA 9.35 XXX 73206 26 A Ct angio upr extrm w/o&w dye 1.20 0.47 0.47 0.05 1.72 1.72 XXX 73206 TC A Ct angio upr extrm w/o&w dye 0.00 NA 7.31 0.32 NA 7.63 XXX 73218 A Mri upper extremity w/o dye 1.10 NA 11.42 0.36 NA 12.88 XXX 73218 26 A Mri upper extremity w/o dye 1.10 0.39 0.39 0.04 1.53 1.53 XXX 73218 TC A Mri upper extremity w/o dye 0.00 NA 11.03 0.32 NA 11.35 XXX 73219 A Mri upper extremity w/dye 1.33 NA 13.70 0.43 NA 15.46 XXX 73219 26 A Mri upper extremity w/dye 1.33 0.47 0.47 0.04 1.84 1.84 XXX 73219 TC A Mri upper extremity w/dye 0.00 NA 13.23 0.39 NA 13.62 XXX 73220 A Mri uppr extremity w/o&w dye 1.76 NA 25.13 0.78 NA 27.67 XXX 73220 26 A Mri uppr extremity w/o&w dye 1.76 0.62 0.62 0.08 2.46 2.46 XXX 73220 TC A Mri uppr extremity w/o&w dye 0.00 NA 24.51 0.70 NA 25.21 XXX 73221 A Mri joint upr extrem w/o dye 1.10 NA 11.42 0.36 NA 12.88 XXX 73221 26 A Mri joint upr extrem w/o dye 1.10 0.39 0.39 0.04 1.53 1.53 XXX 73221 TC A Mri joint upr extrem w/o dye 0.00 NA 11.03 0.32 NA 11.35 XXX 73222 A Mri joint upr extrem w/ dye 1.33 NA 13.70 0.43 NA 15.46 XXX 73222 26 A Mri joint upr extrem w/ dye 1.33 0.47 0.47 0.04 1.84 1.84 XXX 73222 TC A Mri joint upr extrem w/ dye 0.00 NA 13.23 0.39 NA 13.62 XXX 73223 A Mri joint upr extr w/o&w dye 1.76 NA 25.13 0.78 NA 27.67 XXX 73223 26 A Mri joint upr extr w/o&w dye 1.76 0.62 0.62 0.08 2.46 2.46 XXX 73223 TC A Mri joint upr extr w/o&w dye 0.00 NA 24.51 0.70 NA 25.21 XXX 73225 N Mr angio upr extr w/o&w dye +1.73 NA 11.71 0.57 NA 14.01 XXX 73225 26 N Mr angio upr extr w/o&w dye +1.73 0.68 0.68 0.08 2.49 2.49 XXX 73225 TC N Mr angio upr extr w/o&w dye +0.00 NA 11.03 0.49 NA 11.52 XXX 73500 A X-ray exam of hip 0.17 NA 0.53 0.03 NA 0.73 XXX 73500 26 A X-ray exam of hip 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73500 TC A X-ray exam of hip 0.00 NA 0.47 0.02 NA 0.49 XXX 73510 A X-ray exam of hip 0.21 NA 0.63 0.05 NA 0.89 XXX 73510 26 A X-ray exam of hip 0.21 0.07 0.07 0.02 0.30 0.30 XXX 73510 TC A X-ray exam of hip 0.00 NA 0.56 0.03 NA 0.59 XXX Start Printed Page 40483 73520 A X-ray exam of hips 0.26 NA 0.75 0.05 NA 1.06 XXX 73520 26 A X-ray exam of hips 0.26 0.09 0.09 0.02 0.37 0.37 XXX 73520 TC A X-ray exam of hips 0.00 NA 0.66 0.03 NA 0.69 XXX 73525 A Contrast x-ray of hip 0.54 NA 2.26 0.13 NA 2.93 XXX 73525 26 A Contrast x-ray of hip 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73525 TC A Contrast x-ray of hip 0.00 NA 2.07 0.10 NA 2.17 XXX 73530 A X-ray exam of hip 0.29 NA 0.61 0.03 NA 0.93 XXX 73530 26 A X-ray exam of hip 0.29 0.10 0.10 0.01 0.40 0.40 XXX 73530 TC A X-ray exam of hip 0.00 NA 0.51 0.02 NA 0.53 XXX 73540 A X-ray exam of pelvis & hips 0.20 NA 0.63 0.05 NA 0.88 XXX 73540 26 A X-ray exam of pelvis & hips 0.20 0.07 0.07 0.02 0.29 0.29 XXX 73540 TC A X-ray exam of pelvis & hips 0.00 NA 0.56 0.03 NA 0.59 XXX 73542 A X-ray exam, sacroiliac joint 0.59 NA 2.28 0.13 NA 3.00 XXX 73542 26 A X-ray exam, sacroiliac joint 0.59 0.21 0.21 0.03 0.83 0.83 XXX 73542 TC A X-ray exam, sacroiliac joint 0.00 NA 2.07 0.10 NA 2.17 XXX 73550 A X-ray exam of thigh 0.17 NA 0.62 0.04 NA 0.83 XXX 73550 26 A X-ray exam of thigh 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73550 TC A X-ray exam of thigh 0.00 NA 0.56 0.03 NA 0.59 XXX 73560 A X-ray exam of knee, 1 or 2 0.17 NA 0.57 0.04 NA 0.78 XXX 73560 26 A X-ray exam of knee, 1 or 2 0.17 0.06 0.06 0.02 0.25 0.25 XXX 73560 TC A X-ray exam of knee, 1 or 2 0.00 NA 0.51 0.02 NA 0.53 XXX 73562 A X-ray exam of knee, 3 0.18 NA 0.62 0.05 NA 0.85 XXX 73562 26 A X-ray exam of knee, 3 0.18 0.06 0.06 0.02 0.26 0.26 XXX 73562 TC A X-ray exam of knee, 3 0.00 NA 0.56 0.03 NA 0.59 XXX 73564 A X-ray exam, knee, 4 or more 0.22 NA 0.69 0.05 NA 0.96 XXX 73564 26 A X-ray exam, knee, 4 or more 0.22 0.08 0.08 0.02 0.32 0.32 XXX 73564 TC A X-ray exam, knee, 4 or more 0.00 NA 0.61 0.03 NA 0.64 XXX 73565 A X-ray exam of knees 0.17 NA 0.56 0.04 NA 0.77 XXX 73565 26 A X-ray exam of knees 0.17 0.07 0.07 0.02 0.26 0.26 XXX 73565 TC A X-ray exam of knees 0.00 NA 0.49 0.02 NA 0.51 XXX 73580 A Contrast x-ray of knee joint 0.54 NA 2.77 0.15 NA 3.46 XXX 73580 26 A Contrast x-ray of knee joint 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73580 TC A Contrast x-ray of knee joint 0.00 NA 2.58 0.12 NA 2.70 XXX 73590 A X-ray exam of lower leg 0.17 NA 0.57 0.03 NA 0.77 XXX 73590 26 A X-ray exam of lower leg 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73590 TC A X-ray exam of lower leg 0.00 NA 0.51 0.02 NA 0.53 XXX 73592 A X-ray exam of leg, infant 0.16 NA 0.55 0.03 NA 0.74 XXX 73592 26 A X-ray exam of leg, infant 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73592 TC A X-ray exam of leg, infant 0.00 NA 0.49 0.02 NA 0.51 XXX 73600 A X-ray exam of ankle 0.16 NA 0.55 0.03 NA 0.74 XXX 73600 26 A X-ray exam of ankle 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73600 TC A X-ray exam of ankle 0.00 NA 0.49 0.02 NA 0.51 XXX 73610 A X-ray exam of ankle 0.17 NA 0.58 0.03 NA 0.78 XXX 73610 26 A X-ray exam of ankle 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73610 TC A X-ray exam of ankle 0.00 NA 0.52 0.02 NA 0.54 XXX 73615 A Contrast x-ray of ankle 0.54 NA 2.27 0.13 NA 2.94 XXX 73615 26 A Contrast x-ray of ankle 0.54 0.20 0.20 0.03 0.77 0.77 XXX 73615 TC A Contrast x-ray of ankle 0.00 NA 2.07 0.10 NA 2.17 XXX 73620 A X-ray exam of foot 0.16 NA 0.55 0.03 NA 0.74 XXX 73620 26 A X-ray exam of foot 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73620 TC A X-ray exam of foot 0.00 NA 0.49 0.02 NA 0.51 XXX 73630 A X-ray exam of foot 0.17 NA 0.58 0.03 NA 0.78 XXX 73630 26 A X-ray exam of foot 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73630 TC A X-ray exam of foot 0.00 NA 0.52 0.02 NA 0.54 XXX 73650 A X-ray exam of heel 0.16 NA 0.53 0.03 NA 0.72 XXX 73650 26 A X-ray exam of heel 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73650 TC A X-ray exam of heel 0.00 NA 0.47 0.02 NA 0.49 XXX 73660 A X-ray exam of toe(s) 0.13 NA 0.46 0.03 NA 0.62 XXX 73660 26 A X-ray exam of toe(s) 0.13 0.05 0.05 0.01 0.19 0.19 XXX 73660 TC A X-ray exam of toe(s) 0.00 NA 0.41 0.02 NA 0.43 XXX 73700 A Ct lower extremity w/o dye 1.09 NA 5.26 0.26 NA 6.61 XXX 73700 26 A Ct lower extremity w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73700 TC A Ct lower extremity w/o dye 0.00 NA 4.88 0.21 NA 5.09 XXX 73701 A Ct lower extremity w/dye 1.16 NA 6.22 0.31 NA 7.69 XXX 73701 26 A Ct lower extremity w/dye 1.16 0.40 0.40 0.05 1.61 1.61 XXX 73701 TC A Ct lower extremity w/dye 0.00 NA 5.82 0.26 NA 6.08 XXX 73702 A Ct lwr extremity w/o&w dye 1.22 NA 7.74 0.37 NA 9.33 XXX 73702 26 A Ct lwr extremity w/o&w dye 1.22 0.43 0.43 0.05 1.70 1.70 XXX 73702 TC A Ct lwr extremity w/o&w dye 0.00 NA 7.31 0.32 NA 7.63 XXX 73706 A Ct angio lwr extr w/o&w dye 1.20 NA 7.78 0.37 NA 9.35 XXX 73706 26 A Ct angio lwr extr w/o&w dye 1.20 0.47 0.47 0.05 1.72 1.72 XXX 73706 TC A Ct angio lwr extr w/o&w dye 0.00 NA 7.31 0.32 NA 7.63 XXX 73718 A Mri lower extremity w/o dye 1.10 NA 11.41 0.36 NA 12.87 XXX 73718 26 A Mri lower extremity w/o dye 1.10 0.38 0.38 0.04 1.52 1.52 XXX Start Printed Page 40484 73718 TC A Mri lower extremity w/o dye 0.00 NA 11.03 0.32 NA 11.35 XXX 73719 A Mri lower extremity w/dye 1.33 NA 13.69 0.43 NA 15.45 XXX 73719 26 A Mri lower extremity w/dye 1.33 0.46 0.46 0.04 1.83 1.83 XXX 73719 TC A Mri lower extremity w/dye 0.00 NA 13.23 0.39 NA 13.62 XXX 73720 A Mri lwr extremity w/o&w dye 1.76 NA 25.12 0.78 NA 27.66 XXX 73720 26 A Mri lwr extremity w/o&w dye 1.76 0.61 0.61 0.08 2.45 2.45 XXX 73720 TC A Mri lwr extremity w/o&w dye 0.00 NA 24.51 0.70 NA 25.21 XXX 73721 A Mri joint of lwr extre w/o d 1.10 NA 11.42 0.36 NA 12.88 XXX 73721 26 A Mri joint of lwr extre w/o d 1.10 0.39 0.39 0.04 1.53 1.53 XXX 73721 TC A Mri joint of lwr extre w/o d 0.00 NA 11.03 0.32 NA 11.35 XXX 73722 A Mri joint of lwr extr w/dye 1.33 NA 13.70 0.43 NA 15.46 XXX 73722 26 A Mri joint of lwr extr w/dye 1.33 0.47 0.47 0.04 1.84 1.84 XXX 73722 TC A Mri joint of lwr extr w/dye 0.00 NA 13.23 0.39 NA 13.62 XXX 73723 A Mri joint lwr extr w/o&w dye 1.76 NA 25.13 0.78 NA 27.67 XXX 73723 26 A Mri joint lwr extr w/o&w dye 1.76 0.62 0.62 0.08 2.46 2.46 XXX 73723 TC A Mri joint lwr extr w/o&w dye 0.00 NA 24.51 0.70 NA 25.21 XXX 73725 R Mr ang lwr ext w or w/o dye 1.82 NA 11.67 0.57 NA 14.06 XXX 73725 26 R Mr ang lwr ext w or w/o dye 1.82 0.64 0.64 0.08 2.54 2.54 XXX 73725 TC R Mr ang lwr ext w or w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 74000 A X-ray exam of abdomen 0.18 NA 0.57 0.03 NA 0.78 XXX 74000 26 A X-ray exam of abdomen 0.18 0.06 0.06 0.01 0.25 0.25 XXX 74000 TC A X-ray exam of abdomen 0.00 NA 0.51 0.02 NA 0.53 XXX 74010 A X-ray exam of abdomen 0.23 NA 0.64 0.04 NA 0.91 XXX 74010 26 A X-ray exam of abdomen 0.23 0.08 0.08 0.01 0.32 0.32 XXX 74010 TC A X-ray exam of abdomen 0.00 NA 0.56 0.03 NA 0.59 XXX 74020 A X-ray exam of abdomen 0.27 NA 0.70 0.04 NA 1.01 XXX 74020 26 A X-ray exam of abdomen 0.27 0.09 0.09 0.01 0.37 0.37 XXX 74020 TC A X-ray exam of abdomen 0.00 NA 0.61 0.03 NA 0.64 XXX 74022 A X-ray exam series, abdomen 0.32 NA 0.83 0.05 NA 1.20 XXX 74022 26 A X-ray exam series, abdomen 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74022 TC A X-ray exam series, abdomen 0.00 NA 0.72 0.04 NA 0.76 XXX 74150 A Ct abdomen w/o dye 1.19 NA 5.98 0.30 NA 7.47 XXX 74150 26 A Ct abdomen w/o dye 1.19 0.41 0.41 0.05 1.65 1.65 XXX 74150 TC A Ct abdomen w/o dye 0.00 NA 5.57 0.25 NA 5.82 XXX 74160 A Ct abdomen w/dye 1.27 NA 7.18 0.36 NA 8.81 XXX 74160 26 A Ct abdomen w/dye 1.27 0.44 0.44 0.06 1.77 1.77 XXX 74160 TC A Ct abdomen w/dye 0.00 NA 6.74 0.30 NA 7.04 XXX 74170 A Ct abdomen w/o&w dye 1.40 NA 8.85 0.42 NA 10.67 XXX 74170 26 A Ct abdomen w/o&w dye 1.40 0.49 0.49 0.06 1.95 1.95 XXX 74170 TC A Ct abdomen w/o&w dye 0.00 NA 8.36 0.36 NA 8.72 XXX 74175 A Ct angio abdom w/o&w dye 1.20 NA 8.83 0.37 NA 10.40 XXX 74175 26 A Ct angio abdom w/o&w dye 1.20 0.47 0.47 0.05 1.72 1.72 XXX 74175 TC A Ct angio abdom w/o&w dye 0.00 NA 8.36 0.32 NA 8.68 XXX 74181 A Mri abdomen w/o dye 1.22 NA 11.46 0.41 NA 13.09 XXX 74181 26 A Mri abdomen w/o dye 1.22 0.43 0.43 0.04 1.69 1.69 XXX 74181 TC A Mri abdomen w/o dye 0.00 NA 11.03 0.37 NA 11.40 XXX 74182 A Mri abdomen w/dye 1.44 NA 13.73 0.48 NA 15.65 XXX 74182 26 A Mri abdomen w/dye 1.44 0.50 0.50 0.05 1.99 1.99 XXX 74182 TC A Mri abdomen w/dye 0.00 NA 13.23 0.43 NA 13.66 XXX 74183 A Mri abdomen w/o&w dye 1.89 NA 25.17 0.85 NA 27.91 XXX 74183 26 A Mri abdomen w/o&w dye 1.89 0.66 0.66 0.09 2.64 2.64 XXX 74183 TC A Mri abdomen w/o&w dye 0.00 NA 24.51 0.76 NA 25.27 XXX 74185 R Mri angio, abdom w or w/o dy 1.80 NA 11.66 0.57 NA 14.03 XXX 74185 26 R Mri angio, abdom w or w/o dy 1.80 0.63 0.63 0.08 2.51 2.51 XXX 74185 TC R Mri angio, abdom w or w/o dy 0.00 NA 11.03 0.49 NA 11.52 XXX 74190 A X-ray exam of peritoneum 0.48 NA 1.46 0.08 NA 2.02 XXX 74190 26 A X-ray exam of peritoneum 0.48 0.17 0.17 0.02 0.67 0.67 XXX 74190 TC A X-ray exam of peritoneum 0.00 NA 1.29 0.06 NA 1.35 XXX 74210 A Contrst x-ray exam of throat 0.36 NA 1.30 0.07 NA 1.73 XXX 74210 26 A Contrst x-ray exam of throat 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74210 TC A Contrst x-ray exam of throat 0.00 NA 1.17 0.05 NA 1.22 XXX 74220 A Contrast x-ray, esophagus 0.46 NA 1.33 0.07 NA 1.86 XXX 74220 26 A Contrast x-ray, esophagus 0.46 0.16 0.16 0.02 0.64 0.64 XXX 74220 TC A Contrast x-ray, esophagus 0.00 NA 1.17 0.05 NA 1.22 XXX 74230 A Cinema x-ray, throat/esoph 0.53 NA 1.48 0.08 NA 2.09 XXX 74230 26 A Cinema x-ray, throat/esoph 0.53 0.19 0.19 0.02 0.74 0.74 XXX 74230 TC A Cinema x-ray, throat/esoph 0.00 NA 1.29 0.06 NA 1.35 XXX 74235 A Remove esophagus obstruction 1.19 NA 3.00 0.17 NA 4.36 XXX 74235 26 A Remove esophagus obstruction 1.19 0.42 0.42 0.05 1.66 1.66 XXX 74235 TC A Remove esophagus obstruction 0.00 NA 2.58 0.12 NA 2.70 XXX 74240 A X-ray exam, upper gi tract 0.69 NA 1.68 0.10 NA 2.47 XXX 74240 26 A X-ray exam, upper gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74240 TC A X-ray exam, upper gi tract 0.00 NA 1.44 0.07 NA 1.51 XXX 74241 A X-ray exam, upper gi tract 0.69 NA 1.71 0.10 NA 2.50 XXX Start Printed Page 40485 74241 26 A X-ray exam, upper gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74241 TC A X-ray exam, upper gi tract 0.00 NA 1.47 0.07 NA 1.54 XXX 74245 A X-ray exam, upper gi tract 0.91 NA 2.66 0.15 NA 3.72 XXX 74245 26 A X-ray exam, upper gi tract 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74245 TC A X-ray exam, upper gi tract 0.00 NA 2.34 0.11 NA 2.45 XXX 74246 A Contrst x-ray uppr gi tract 0.69 NA 1.86 0.11 NA 2.66 XXX 74246 26 A Contrst x-ray uppr gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74246 TC A Contrst x-ray uppr gi tract 0.00 NA 1.62 0.08 NA 1.70 XXX 74247 A Contrst x-ray uppr gi tract 0.69 NA 1.90 0.12 NA 2.71 XXX 74247 26 A Contrst x-ray uppr gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74247 TC A Contrst x-ray uppr gi tract 0.00 NA 1.66 0.09 NA 1.75 XXX 74249 A Contrst x-ray uppr gi tract 0.91 NA 2.85 0.16 NA 3.92 XXX 74249 26 A Contrst x-ray uppr gi tract 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74249 TC A Contrst x-ray uppr gi tract 0.00 NA 2.53 0.12 NA 2.65 XXX 74250 A X-ray exam of small bowel 0.47 NA 1.45 0.08 NA 2.00 XXX 74250 26 A X-ray exam of small bowel 0.47 0.16 0.16 0.02 0.65 0.65 XXX 74250 TC A X-ray exam of small bowel 0.00 NA 1.29 0.06 NA 1.35 XXX 74251 A X-ray exam of small bowel 0.69 NA 1.53 0.09 NA 2.31 XXX 74251 26 A X-ray exam of small bowel 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74251 TC A X-ray exam of small bowel 0.00 NA 1.29 0.06 NA 1.35 XXX 74260 A X-ray exam of small bowel 0.50 NA 1.64 0.09 NA 2.23 XXX 74260 26 A X-ray exam of small bowel 0.50 0.17 0.17 0.02 0.69 0.69 XXX 74260 TC A X-ray exam of small bowel 0.00 NA 1.47 0.07 NA 1.54 XXX 74270 A Contrast x-ray exam of colon 0.69 NA 1.92 0.12 NA 2.73 XXX 74270 26 A Contrast x-ray exam of colon 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74270 TC A Contrast x-ray exam of colon 0.00 NA 1.68 0.09 NA 1.77 XXX 74280 A Contrast x-ray exam of colon 0.99 NA 2.55 0.15 NA 3.69 XXX 74280 26 A Contrast x-ray exam of colon 0.99 0.35 0.35 0.04 1.38 1.38 XXX 74280 TC A Contrast x-ray exam of colon 0.00 NA 2.20 0.11 NA 2.31 XXX 74283 A Contrast x-ray exam of colon 2.02 NA 3.22 0.21 NA 5.45 XXX 74283 26 A Contrast x-ray exam of colon 2.02 0.70 0.70 0.09 2.81 2.81 XXX 74283 TC A Contrast x-ray exam of colon 0.00 NA 2.52 0.12 NA 2.64 XXX 74290 A Contrast x-ray, gallbladder 0.32 NA 0.83 0.05 NA 1.20 XXX 74290 26 A Contrast x-ray, gallbladder 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74290 TC A Contrast x-ray, gallbladder 0.00 NA 0.72 0.04 NA 0.76 XXX 74291 A Contrast x-rays, gallbladder 0.20 NA 0.48 0.03 NA 0.71 XXX 74291 26 A Contrast x-rays, gallbladder 0.20 0.07 0.07 0.01 0.28 0.28 XXX 74291 TC A Contrast x-rays, gallbladder 0.00 NA 0.41 0.02 NA 0.43 XXX 74300 C X-ray bile ducts/pancreas 0.00 NA 0.00 0.00 NA 0.00 XXX 74300 26 A X-ray bile ducts/pancreas 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74300 TC C X-ray bile ducts/pancreas 0.00 NA 0.00 0.00 NA 0.00 XXX 74301 C X-rays at surgery add-on 0.00 NA 0.00 0.00 NA 0.00 ZZZ 74301 26 A X-rays at surgery add-on 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ 74301 TC C X-rays at surgery add-on 0.00 NA 0.00 0.00 NA 0.00 ZZZ 74305 A X-ray bile ducts/pancreas 0.42 NA 0.92 0.06 NA 1.40 XXX 74305 26 A X-ray bile ducts/pancreas 0.42 0.15 0.15 0.02 0.59 0.59 XXX 74305 TC A X-ray bile ducts/pancreas 0.00 NA 0.77 0.04 NA 0.81 XXX 74320 A Contrast x-ray of bile ducts 0.54 NA 3.29 0.16 NA 3.99 XXX 74320 26 A Contrast x-ray of bile ducts 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74320 TC A Contrast x-ray of bile ducts 0.00 NA 3.10 0.14 NA 3.24 XXX 74327 A X-ray bile stone removal 0.70 NA 1.97 0.12 NA 2.79 XXX 74327 26 A X-ray bile stone removal 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74327 TC A X-ray bile stone removal 0.00 NA 1.73 0.09 NA 1.82 XXX 74328 A Xray bile duct endoscopy 0.70 NA 3.34 0.17 NA 4.21 XXX 74328 26 A Xray bile duct endoscopy 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74328 TC A Xray bile duct endoscopy 0.00 NA 3.10 0.14 NA 3.24 XXX 74329 A X-ray for pancreas endoscopy 0.70 NA 3.34 0.17 NA 4.21 XXX 74329 26 A X-ray for pancreas endoscopy 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74329 TC A X-ray for pancreas endoscopy 0.00 NA 3.10 0.14 NA 3.24 XXX 74330 A X-ray bile/panc endoscopy 0.90 NA 3.41 0.18 NA 4.49 XXX 74330 26 A X-ray bile/panc endoscopy 0.90 0.31 0.31 0.04 1.25 1.25 XXX 74330 TC A X-ray bile/panc endoscopy 0.00 NA 3.10 0.14 NA 3.24 XXX 74340 A X-ray guide for GI tube 0.54 NA 2.77 0.14 NA 3.45 XXX 74340 26 A X-ray guide for GI tube 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74340 TC A X-ray guide for GI tube 0.00 NA 2.58 0.12 NA 2.70 XXX 74350 A X-ray guide, stomach tube 0.76 NA 3.36 0.17 NA 4.29 XXX 74350 26 A X-ray guide, stomach tube 0.76 0.26 0.26 0.03 1.05 1.05 XXX 74350 TC A X-ray guide, stomach tube 0.00 NA 3.10 0.14 NA 3.24 XXX 74355 A X-ray guide, intestinal tube 0.76 NA 2.84 0.15 NA 3.75 XXX 74355 26 A X-ray guide, intestinal tube 0.76 0.26 0.26 0.03 1.05 1.05 XXX 74355 TC A X-ray guide, intestinal tube 0.00 NA 2.58 0.12 NA 2.70 XXX 74360 A X-ray guide, GI dilation 0.54 NA 3.29 0.16 NA 3.99 XXX 74360 26 A X-ray guide, GI dilation 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74360 TC A X-ray guide, GI dilation 0.00 NA 3.10 0.14 NA 3.24 XXX Start Printed Page 40486 74363 A X-ray, bile duct dilation 0.88 NA 6.31 0.31 NA 7.50 XXX 74363 26 A X-ray, bile duct dilation 0.88 0.30 0.30 0.04 1.22 1.22 XXX 74363 TC A X-ray, bile duct dilation 0.00 NA 6.01 0.27 NA 6.28 XXX 74400 A Contrst x-ray, urinary tract 0.49 NA 1.83 0.11 NA 2.43 XXX 74400 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74400 TC A Contrst x-ray, urinary tract 0.00 NA 1.66 0.09 NA 1.75 XXX 74410 A Contrst x-ray, urinary tract 0.49 NA 2.09 0.11 NA 2.69 XXX 74410 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74410 TC A Contrst x-ray, urinary tract 0.00 NA 1.92 0.09 NA 2.01 XXX 74415 A Contrst x-ray, urinary tract 0.49 NA 2.26 0.12 NA 2.87 XXX 74415 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74415 TC A Contrst x-ray, urinary tract 0.00 NA 2.09 0.10 NA 2.19 XXX 74420 A Contrst x-ray, urinary tract 0.36 NA 2.70 0.14 NA 3.20 XXX 74420 26 A Contrst x-ray, urinary tract 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74420 TC A Contrst x-ray, urinary tract 0.00 NA 2.58 0.12 NA 2.70 XXX 74425 A Contrst x-ray, urinary tract 0.36 NA 1.41 0.08 NA 1.85 XXX 74425 26 A Contrst x-ray, urinary tract 0.36 0.12 0.12 0.02 0.50 0.50 XXX 74425 TC A Contrst x-ray, urinary tract 0.00 NA 1.29 0.06 NA 1.35 XXX 74430 A Contrast x-ray, bladder 0.32 NA 1.15 0.07 NA 1.54 XXX 74430 26 A Contrast x-ray, bladder 0.32 0.11 0.11 0.02 0.45 0.45 XXX 74430 TC A Contrast x-ray, bladder 0.00 NA 1.04 0.05 NA 1.09 XXX 74440 A X-ray, male genital tract 0.38 NA 1.24 0.07 NA 1.69 XXX 74440 26 A X-ray, male genital tract 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74440 TC A X-ray, male genital tract 0.00 NA 1.11 0.05 NA 1.16 XXX 74445 A X-ray exam of penis 1.14 NA 1.51 0.10 NA 2.75 XXX 74445 26 A X-ray exam of penis 1.14 0.40 0.40 0.05 1.59 1.59 XXX 74445 TC A X-ray exam of penis 0.00 NA 1.11 0.05 NA 1.16 XXX 74450 A X-ray, urethra/bladder 0.33 NA 1.55 0.09 NA 1.97 XXX 74450 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX 74450 TC A X-ray, urethra/bladder 0.00 NA 1.44 0.07 NA 1.51 XXX 74455 A X-ray, urethra/bladder 0.33 NA 1.66 0.10 NA 2.09 XXX 74455 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX 74455 TC A X-ray, urethra/bladder 0.00 NA 1.55 0.08 NA 1.63 XXX 74470 A X-ray exam of kidney lesion 0.54 NA 1.42 0.08 NA 2.04 XXX 74470 26 A X-ray exam of kidney lesion 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74470 TC A X-ray exam of kidney lesion 0.00 NA 1.23 0.06 NA 1.29 XXX 74475 A X-ray control, cath insert 0.54 NA 4.20 0.20 NA 4.94 XXX 74475 26 A X-ray control, cath insert 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74475 TC A X-ray control, cath insert 0.00 NA 4.01 0.18 NA 4.19 XXX 74480 A X-ray control, cath insert 0.54 NA 4.20 0.20 NA 4.94 XXX 74480 26 A X-ray control, cath insert 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74480 TC A X-ray control, cath insert 0.00 NA 4.01 0.18 NA 4.19 XXX 74485 A X-ray guide, GU dilation 0.54 NA 3.29 0.17 NA 4.00 XXX 74485 26 A X-ray guide, GU dilation 0.54 0.19 0.19 0.03 0.76 0.76 XXX 74485 TC A X-ray guide, GU dilation 0.00 NA 3.10 0.14 NA 3.24 XXX 74710 A X-ray measurement of pelvis 0.34 NA 1.16 0.07 NA 1.57 XXX 74710 26 A X-ray measurement of pelvis 0.34 0.12 0.12 0.02 0.48 0.48 XXX 74710 TC A X-ray measurement of pelvis 0.00 NA 1.04 0.05 NA 1.09 XXX 74740 A X-ray, female genital tract 0.38 NA 1.42 0.08 NA 1.88 XXX 74740 26 A X-ray, female genital tract 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74740 TC A X-ray, female genital tract 0.00 NA 1.29 0.06 NA 1.35 XXX 74742 A X-ray, fallopian tube 0.61 NA 3.32 0.16 NA 4.09 XXX 74742 26 A X-ray, fallopian tube 0.61 0.22 0.22 0.02 0.85 0.85 XXX 74742 TC A X-ray, fallopian tube 0.00 NA 3.10 0.14 NA 3.24 XXX 74775 A X-ray exam of perineum 0.62 NA 1.66 0.10 NA 2.38 XXX 74775 26 A X-ray exam of perineum 0.62 0.22 0.22 0.03 0.87 0.87 XXX 74775 TC A X-ray exam of perineum 0.00 NA 1.44 0.07 NA 1.51 XXX 75552 A Heart mri for morph w/o dye 1.60 NA 11.59 0.56 NA 13.75 XXX 75552 26 A Heart mri for morph w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 75552 TC A Heart mri for morph w/o dye 0.00 NA 11.03 0.49 NA 11.52 XXX 75553 A Heart mri for morph w/dye 2.00 NA 11.73 0.58 NA 14.31 XXX 75553 26 A Heart mri for morph w/dye 2.00 0.70 0.70 0.09 2.79 2.79 XXX 75553 TC A Heart mri for morph w/dye 0.00 NA 11.03 0.49 NA 11.52 XXX 75554 A Cardiac MRI/function 1.83 NA 11.72 0.56 NA 14.11 XXX 75554 26 A Cardiac MRI/function 1.83 0.69 0.69 0.07 2.59 2.59 XXX 75554 TC A Cardiac MRI/function 0.00 NA 11.03 0.49 NA 11.52 XXX 75555 A Cardiac MRI/limited study 1.74 NA 11.70 0.56 NA 14.00 XXX 75555 26 A Cardiac MRI/limited study 1.74 0.67 0.67 0.07 2.48 2.48 XXX 75555 TC A Cardiac MRI/limited study 0.00 NA 11.03 0.49 NA 11.52 XXX 75556 N Cardiac MRI/flow mapping 0.00 NA 0.00 0.00 NA 0.00 XXX 75600 A Contrast x-ray exam of aorta 0.49 NA 12.61 0.56 NA 13.66 XXX 75600 26 A Contrast x-ray exam of aorta 0.49 0.20 0.20 0.02 0.71 0.71 XXX 75600 TC A Contrast x-ray exam of aorta 0.00 NA 12.41 0.54 NA 12.95 XXX 75605 A Contrast x-ray exam of aorta 1.14 NA 12.83 0.59 NA 14.56 XXX Start Printed Page 40487 75605 26 A Contrast x-ray exam of aorta 1.14 0.42 0.42 0.05 1.61 1.61 XXX 75605 TC A Contrast x-ray exam of aorta 0.00 NA 12.41 0.54 NA 12.95 XXX 75625 A Contrast x-ray exam of aorta 1.14 NA 12.81 0.59 NA 14.54 XXX 75625 26 A Contrast x-ray exam of aorta 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75625 TC A Contrast x-ray exam of aorta 0.00 NA 12.41 0.54 NA 12.95 XXX 75630 A X-ray aorta, leg arteries 1.79 NA 13.58 0.65 NA 16.02 XXX 75630 26 A X-ray aorta, leg arteries 1.79 0.65 0.65 0.08 2.52 2.52 XXX 75630 TC A X-ray aorta, leg arteries 0.00 NA 12.93 0.57 NA 13.50 XXX 75635 A Ct angio abdominal arteries 1.89 NA 9.11 0.37 NA 11.37 XXX 75635 26 A Ct angio abdominal arteries 1.89 0.75 0.75 0.05 2.69 2.69 XXX 75635 TC A Ct angio abdominal arteries 0.00 NA 8.36 0.32 NA 8.68 XXX 75650 A Artery x-rays, head & neck 1.49 NA 12.93 0.61 NA 15.03 XXX 75650 26 A Artery x-rays, head & neck 1.49 0.52 0.52 0.07 2.08 2.08 XXX 75650 TC A Artery x-rays, head & neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75658 A Artery x-rays, arm 1.31 NA 12.92 0.60 NA 14.83 XXX 75658 26 A Artery x-rays, arm 1.31 0.51 0.51 0.06 1.88 1.88 XXX 75658 TC A Artery x-rays, arm 0.00 NA 12.41 0.54 NA 12.95 XXX 75660 A Artery x-rays, head & neck 1.31 NA 12.88 0.60 NA 14.79 XXX 75660 26 A Artery x-rays, head & neck 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75660 TC A Artery x-rays, head & neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75662 A Artery x-rays, head & neck 1.66 NA 13.04 0.62 NA 15.32 XXX 75662 26 A Artery x-rays, head & neck 1.66 0.63 0.63 0.08 2.37 2.37 XXX 75662 TC A Artery x-rays, head & neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75665 A Artery x-rays, head & neck 1.31 NA 12.87 0.61 NA 14.79 XXX 75665 26 A Artery x-rays, head & neck 1.31 0.46 0.46 0.07 1.84 1.84 XXX 75665 TC A Artery x-rays, head & neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75671 A Artery x-rays, head & neck 1.66 NA 12.99 0.62 NA 15.27 XXX 75671 26 A Artery x-rays, head & neck 1.66 0.58 0.58 0.08 2.32 2.32 XXX 75671 TC A Artery x-rays, head & neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75676 A Artery x-rays, neck 1.31 NA 12.88 0.61 NA 14.80 XXX 75676 26 A Artery x-rays, neck 1.31 0.47 0.47 0.07 1.85 1.85 XXX 75676 TC A Artery x-rays, neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75680 A Artery x-rays, neck 1.66 NA 12.99 0.62 NA 15.27 XXX 75680 26 A Artery x-rays, neck 1.66 0.58 0.58 0.08 2.32 2.32 XXX 75680 TC A Artery x-rays, neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75685 A Artery x-rays, spine 1.31 NA 12.87 0.60 NA 14.78 XXX 75685 26 A Artery x-rays, spine 1.31 0.46 0.46 0.06 1.83 1.83 XXX 75685 TC A Artery x-rays, spine 0.00 NA 12.41 0.54 NA 12.95 XXX 75705 A Artery x-rays, spine 2.18 NA 13.18 0.65 NA 16.01 XXX 75705 26 A Artery x-rays, spine 2.18 0.77 0.77 0.11 3.06 3.06 XXX 75705 TC A Artery x-rays, spine 0.00 NA 12.41 0.54 NA 12.95 XXX 75710 A Artery x-rays, arm/leg 1.14 NA 12.82 0.60 NA 14.56 XXX 75710 26 A Artery x-rays, arm/leg 1.14 0.41 0.41 0.06 1.61 1.61 XXX 75710 TC A Artery x-rays, arm/leg 0.00 NA 12.41 0.54 NA 12.95 XXX 75716 A Artery x-rays, arms/legs 1.31 NA 12.87 0.60 NA 14.78 XXX 75716 26 A Artery x-rays, arms/legs 1.31 0.46 0.46 0.06 1.83 1.83 XXX 75716 TC A Artery x-rays, arms/legs 0.00 NA 12.41 0.54 NA 12.95 XXX 75722 A Artery x-rays, kidney 1.14 NA 12.83 0.59 NA 14.56 XXX 75722 26 A Artery x-rays, kidney 1.14 0.42 0.42 0.05 1.61 1.61 XXX 75722 TC A Artery x-rays, kidney 0.00 NA 12.41 0.54 NA 12.95 XXX 75724 A Artery x-rays, kidneys 1.49 NA 13.00 0.59 NA 15.08 XXX 75724 26 A Artery x-rays, kidneys 1.49 0.59 0.59 0.05 2.13 2.13 XXX 75724 TC A Artery x-rays, kidneys 0.00 NA 12.41 0.54 NA 12.95 XXX 75726 A Artery x-rays, abdomen 1.14 NA 12.81 0.59 NA 14.54 XXX 75726 26 A Artery x-rays, abdomen 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75726 TC A Artery x-rays, abdomen 0.00 NA 12.41 0.54 NA 12.95 XXX 75731 A Artery x-rays, adrenal gland 1.14 NA 12.81 0.59 NA 14.54 XXX 75731 26 A Artery x-rays, adrenal gland 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75731 TC A Artery x-rays, adrenal gland 0.00 NA 12.41 0.54 NA 12.95 XXX 75733 A Artery x-rays, adrenals 1.31 NA 12.88 0.60 NA 14.79 XXX 75733 26 A Artery x-rays, adrenals 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75733 TC A Artery x-rays, adrenals 0.00 NA 12.41 0.54 NA 12.95 XXX 75736 A Artery x-rays, pelvis 1.14 NA 12.81 0.59 NA 14.54 XXX 75736 26 A Artery x-rays, pelvis 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75736 TC A Artery x-rays, pelvis 0.00 NA 12.41 0.54 NA 12.95 XXX 75741 A Artery x-rays, lung 1.31 NA 12.87 0.60 NA 14.78 XXX 75741 26 A Artery x-rays, lung 1.31 0.46 0.46 0.06 1.83 1.83 XXX 75741 TC A Artery x-rays, lung 0.00 NA 12.41 0.54 NA 12.95 XXX 75743 A Artery x-rays, lungs 1.66 NA 12.99 0.61 NA 15.26 XXX 75743 26 A Artery x-rays, lungs 1.66 0.58 0.58 0.07 2.31 2.31 XXX 75743 TC A Artery x-rays, lungs 0.00 NA 12.41 0.54 NA 12.95 XXX 75746 A Artery x-rays, lung 1.14 NA 12.81 0.59 NA 14.54 XXX 75746 26 A Artery x-rays, lung 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75746 TC A Artery x-rays, lung 0.00 NA 12.41 0.54 NA 12.95 XXX Start Printed Page 40488 75756 A Artery x-rays, chest 1.14 NA 12.88 0.58 NA 14.60 XXX 75756 26 A Artery x-rays, chest 1.14 0.47 0.47 0.04 1.65 1.65 XXX 75756 TC A Artery x-rays, chest 0.00 NA 12.41 0.54 NA 12.95 XXX 75774 A Artery x-ray, each vessel 0.36 NA 12.54 0.56 NA 13.46 ZZZ 75774 26 A Artery x-ray, each vessel 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75774 TC A Artery x-ray, each vessel 0.00 NA 12.41 0.54 NA 12.95 ZZZ 75790 A Visualize A-V shunt 1.84 NA 1.97 0.16 NA 3.97 XXX 75790 26 A Visualize A-V shunt 1.84 0.64 0.64 0.09 2.57 2.57 XXX 75790 TC A Visualize A-V shunt 0.00 NA 1.33 0.07 NA 1.40 XXX 75801 A Lymph vessel x-ray, arm/leg 0.81 NA 5.61 0.29 NA 6.71 XXX 75801 26 A Lymph vessel x-ray, arm/leg 0.81 0.28 0.28 0.05 1.14 1.14 XXX 75801 TC A Lymph vessel x-ray, arm/leg 0.00 NA 5.33 0.24 NA 5.57 XXX 75803 A Lymph vessel x-ray,arms/legs 1.17 NA 5.74 0.29 NA 7.20 XXX 75803 26 A Lymph vessel x-ray,arms/legs 1.17 0.41 0.41 0.05 1.63 1.63 XXX 75803 TC A Lymph vessel x-ray,arms/legs 0.00 NA 5.33 0.24 NA 5.57 XXX 75805 A Lymph vessel x-ray, trunk 0.81 NA 6.30 0.31 NA 7.42 XXX 75805 26 A Lymph vessel x-ray, trunk 0.81 0.29 0.29 0.04 1.14 1.14 XXX 75805 TC A Lymph vessel x-ray, trunk 0.00 NA 6.01 0.27 NA 6.28 XXX 75807 A Lymph vessel x-ray, trunk 1.17 NA 6.42 0.32 NA 7.91 XXX 75807 26 A Lymph vessel x-ray, trunk 1.17 0.41 0.41 0.05 1.63 1.63 XXX 75807 TC A Lymph vessel x-ray, trunk 0.00 NA 6.01 0.27 NA 6.28 XXX 75809 A Nonvascular shunt, x-ray 0.47 NA 0.94 0.06 NA 1.47 XXX 75809 26 A Nonvascular shunt, x-ray 0.47 0.17 0.17 0.02 0.66 0.66 XXX 75809 TC A Nonvascular shunt, x-ray 0.00 NA 0.77 0.04 NA 0.81 XXX 75810 A Vein x-ray, spleen/liver 1.14 NA 12.81 0.60 NA 14.55 XXX 75810 26 A Vein x-ray, spleen/liver 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75810 TC A Vein x-ray, spleen/liver 0.00 NA 12.41 0.54 NA 12.95 XXX 75820 A Vein x-ray, arm/leg 0.70 NA 1.17 0.08 NA 1.95 XXX 75820 26 A Vein x-ray, arm/leg 0.70 0.24 0.24 0.03 0.97 0.97 XXX 75820 TC A Vein x-ray, arm/leg 0.00 NA 0.93 0.05 NA 0.98 XXX 75822 A Vein x-ray, arms/legs 1.06 NA 1.83 0.12 NA 3.01 XXX 75822 26 A Vein x-ray, arms/legs 1.06 0.37 0.37 0.05 1.48 1.48 XXX 75822 TC A Vein x-ray, arms/legs 0.00 NA 1.46 0.07 NA 1.53 XXX 75825 A Vein x-ray, trunk 1.14 NA 12.81 0.60 NA 14.55 XXX 75825 26 A Vein x-ray, trunk 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75825 TC A Vein x-ray, trunk 0.00 NA 12.41 0.54 NA 12.95 XXX 75827 A Vein x-ray, chest 1.14 NA 12.80 0.59 NA 14.53 XXX 75827 26 A Vein x-ray, chest 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75827 TC A Vein x-ray, chest 0.00 NA 12.41 0.54 NA 12.95 XXX 75831 A Vein x-ray, kidney 1.14 NA 12.81 0.59 NA 14.54 XXX 75831 26 A Vein x-ray, kidney 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75831 TC A Vein x-ray, kidney 0.00 NA 12.41 0.54 NA 12.95 XXX 75833 A Vein x-ray, kidneys 1.49 NA 12.93 0.61 NA 15.03 XXX 75833 26 A Vein x-ray, kidneys 1.49 0.52 0.52 0.07 2.08 2.08 XXX 75833 TC A Vein x-ray, kidneys 0.00 NA 12.41 0.54 NA 12.95 XXX 75840 A Vein x-ray, adrenal gland 1.14 NA 12.81 0.61 NA 14.56 XXX 75840 26 A Vein x-ray, adrenal gland 1.14 0.40 0.40 0.07 1.61 1.61 XXX 75840 TC A Vein x-ray, adrenal gland 0.00 NA 12.41 0.54 NA 12.95 XXX 75842 A Vein x-ray, adrenal glands 1.49 NA 12.92 0.61 NA 15.02 XXX 75842 26 A Vein x-ray, adrenal glands 1.49 0.51 0.51 0.07 2.07 2.07 XXX 75842 TC A Vein x-ray, adrenal glands 0.00 NA 12.41 0.54 NA 12.95 XXX 75860 A Vein x-ray, neck 1.14 NA 12.82 0.60 NA 14.56 XXX 75860 26 A Vein x-ray, neck 1.14 0.41 0.41 0.06 1.61 1.61 XXX 75860 TC A Vein x-ray, neck 0.00 NA 12.41 0.54 NA 12.95 XXX 75870 A Vein x-ray, skull 1.14 NA 12.83 0.60 NA 14.57 XXX 75870 26 A Vein x-ray, skull 1.14 0.42 0.42 0.06 1.62 1.62 XXX 75870 TC A Vein x-ray, skull 0.00 NA 12.41 0.54 NA 12.95 XXX 75872 A Vein x-ray, skull 1.14 NA 12.81 0.59 NA 14.54 XXX 75872 26 A Vein x-ray, skull 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75872 TC A Vein x-ray, skull 0.00 NA 12.41 0.54 NA 12.95 XXX 75880 A Vein x-ray, eye socket 0.70 NA 1.18 0.08 NA 1.96 XXX 75880 26 A Vein x-ray, eye socket 0.70 0.25 0.25 0.03 0.98 0.98 XXX 75880 TC A Vein x-ray, eye socket 0.00 NA 0.93 0.05 NA 0.98 XXX 75885 A Vein x-ray, liver 1.44 NA 12.91 0.60 NA 14.95 XXX 75885 26 A Vein x-ray, liver 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75885 TC A Vein x-ray, liver 0.00 NA 12.41 0.54 NA 12.95 XXX 75887 A Vein x-ray, liver 1.44 NA 12.91 0.60 NA 14.95 XXX 75887 26 A Vein x-ray, liver 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75887 TC A Vein x-ray, liver 0.00 NA 12.41 0.54 NA 12.95 XXX 75889 A Vein x-ray, liver 1.14 NA 12.80 0.59 NA 14.53 XXX 75889 26 A Vein x-ray, liver 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75889 TC A Vein x-ray, liver 0.00 NA 12.41 0.54 NA 12.95 XXX 75891 A Vein x-ray, liver 1.14 NA 12.80 0.59 NA 14.53 XXX 75891 26 A Vein x-ray, liver 1.14 0.39 0.39 0.05 1.58 1.58 XXX Start Printed Page 40489 75891 TC A Vein x-ray, liver 0.00 NA 12.41 0.54 NA 12.95 XXX 75893 A Venous sampling by catheter 0.54 NA 12.60 0.56 NA 13.70 XXX 75893 26 A Venous sampling by catheter 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75893 TC A Venous sampling by catheter 0.00 NA 12.41 0.54 NA 12.95 XXX 75894 A X-rays, transcath therapy 1.31 NA 24.22 1.12 NA 26.65 XXX 75894 26 A X-rays, transcath therapy 1.31 0.46 0.46 0.07 1.84 1.84 XXX 75894 TC A X-rays, transcath therapy 0.00 NA 23.76 1.05 NA 24.81 XXX 75896 A X-rays, transcath therapy 1.31 NA 21.14 0.97 NA 23.42 XXX 75896 26 A X-rays, transcath therapy 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75896 TC A X-rays, transcath therapy 0.00 NA 20.67 0.91 NA 21.58 XXX 75898 A Follow-up angiogram 1.65 NA 1.62 0.12 NA 3.39 XXX 75898 26 A Follow-up angiogram 1.65 0.58 0.58 0.07 2.30 2.30 XXX 75898 TC A Follow-up angiogram 0.00 NA 1.04 0.05 NA 1.09 XXX 75900 A Arterial catheter exchange 0.49 NA 20.82 0.94 NA 22.25 XXX 75900 26 A Arterial catheter exchange 0.49 0.17 0.17 0.02 0.68 0.68 XXX 75900 TC A Arterial catheter exchange 0.00 NA 20.65 0.92 NA 21.57 XXX 75940 A X-ray placement, vein filter 0.54 NA 12.60 0.57 NA 13.71 XXX 75940 26 A X-ray placement, vein filter 0.54 0.19 0.19 0.03 0.76 0.76 XXX 75940 TC A X-ray placement, vein filter 0.00 NA 12.41 0.54 NA 12.95 XXX 75945 A Intravascular us 0.40 NA 4.64 0.23 NA 5.27 XXX 75945 26 A Intravascular us 0.40 0.15 0.15 0.03 0.58 0.58 XXX 75945 TC A Intravascular us 0.00 NA 4.49 0.20 NA 4.69 XXX 75946 A Intravascular us add-on 0.40 NA 2.40 0.14 NA 2.94 ZZZ 75946 26 A Intravascular us add-on 0.40 0.14 0.14 0.03 0.57 0.57 ZZZ 75946 TC A Intravascular us add-on 0.00 NA 2.26 0.11 NA 2.37 ZZZ 75952 A Endovasc repair abdom aorta 4.00 1.58 1.58 0.68 6.26 6.26 XXX 75953 A Abdom aneurysm endovas rpr 1.36 0.54 0.54 0.68 2.58 2.58 XXX 75960 A Transcatheter intro, stent 0.82 NA 14.97 0.68 NA 16.47 XXX 75960 26 A Transcatheter intro, stent 0.82 0.30 0.30 0.04 1.16 1.16 XXX 75960 TC A Transcatheter intro, stent 0.00 NA 14.67 0.64 NA 15.31 XXX 75961 A Retrieval, broken catheter 4.25 NA 11.83 0.64 NA 16.72 XXX 75961 26 A Retrieval, broken catheter 4.25 1.49 1.49 0.18 5.92 5.92 XXX 75961 TC A Retrieval, broken catheter 0.00 NA 10.34 0.46 NA 10.80 XXX 75962 A Repair arterial blockage 0.54 NA 15.69 0.72 NA 16.95 XXX 75962 26 A Repair arterial blockage 0.54 0.19 0.19 0.03 0.76 0.76 XXX 75962 TC A Repair arterial blockage 0.00 NA 15.50 0.69 NA 16.19 XXX 75964 A Repair artery blockage, each 0.36 NA 8.39 0.38 NA 9.13 ZZZ 75964 26 A Repair artery blockage, each 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75964 TC A Repair artery blockage, each 0.00 NA 8.26 0.36 NA 8.62 ZZZ 75966 A Repair arterial blockage 1.31 NA 15.99 0.75 NA 18.05 XXX 75966 26 A Repair arterial blockage 1.31 0.49 0.49 0.06 1.86 1.86 XXX 75966 TC A Repair arterial blockage 0.00 NA 15.50 0.69 NA 16.19 XXX 75968 A Repair artery blockage, each 0.36 NA 8.40 0.37 NA 9.13 ZZZ 75968 26 A Repair artery blockage, each 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ 75968 TC A Repair artery blockage, each 0.00 NA 8.26 0.36 NA 8.62 ZZZ 75970 A Vascular biopsy 0.83 NA 11.67 0.54 NA 13.04 XXX 75970 26 A Vascular biopsy 0.83 0.30 0.30 0.04 1.17 1.17 XXX 75970 TC A Vascular biopsy 0.00 NA 11.37 0.50 NA 11.87 XXX 75978 A Repair venous blockage 0.54 NA 15.69 0.71 NA 16.94 XXX 75978 26 A Repair venous blockage 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75978 TC A Repair venous blockage 0.00 NA 15.50 0.69 NA 16.19 XXX 75980 A Contrast xray exam bile duct 1.44 NA 5.83 0.30 NA 7.57 XXX 75980 26 A Contrast xray exam bile duct 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75980 TC A Contrast xray exam bile duct 0.00 NA 5.33 0.24 NA 5.57 XXX 75982 A Contrast xray exam bile duct 1.44 NA 6.51 0.33 NA 8.28 XXX 75982 26 A Contrast xray exam bile duct 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75982 TC A Contrast xray exam bile duct 0.00 NA 6.01 0.27 NA 6.28 XXX 75984 A Xray control catheter change 0.72 NA 2.17 0.12 NA 3.01 XXX 75984 26 A Xray control catheter change 0.72 0.25 0.25 0.03 1.00 1.00 XXX 75984 TC A Xray control catheter change 0.00 NA 1.92 0.09 NA 2.01 XXX 75989 A Abscess drainage under x-ray 1.19 NA 3.51 0.19 NA 4.89 XXX 75989 26 A Abscess drainage under x-ray 1.19 0.41 0.41 0.05 1.65 1.65 XXX 75989 TC A Abscess drainage under x-ray 0.00 NA 3.10 0.14 NA 3.24 XXX 75992 A Atherectomy, x-ray exam 0.54 NA 15.70 0.71 NA 16.95 XXX 75992 26 A Atherectomy, x-ray exam 0.54 0.20 0.20 0.02 0.76 0.76 XXX 75992 TC A Atherectomy, x-ray exam 0.00 NA 15.50 0.69 NA 16.19 XXX 75993 A Atherectomy, x-ray exam 0.36 NA 8.40 0.37 NA 9.13 ZZZ 75993 26 A Atherectomy, x-ray exam 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ 75993 TC A Atherectomy, x-ray exam 0.00 NA 8.26 0.36 NA 8.62 ZZZ 75994 A Atherectomy, x-ray exam 1.31 NA 15.99 0.75 NA 18.05 XXX 75994 26 A Atherectomy, x-ray exam 1.31 0.49 0.49 0.06 1.86 1.86 XXX 75994 TC A Atherectomy, x-ray exam 0.00 NA 15.50 0.69 NA 16.19 XXX 75995 A Atherectomy, x-ray exam 1.31 NA 15.95 0.75 NA 18.01 XXX 75995 26 A Atherectomy, x-ray exam 1.31 0.45 0.45 0.06 1.82 1.82 XXX Start Printed Page 40490 75995 TC A Atherectomy, x-ray exam 0.00 NA 15.50 0.69 NA 16.19 XXX 75996 A Atherectomy, x-ray exam 0.36 NA 8.39 0.37 NA 9.12 ZZZ 75996 26 A Atherectomy, x-ray exam 0.36 0.13 0.13 0.01 0.50 0.50 ZZZ 75996 TC A Atherectomy, x-ray exam 0.00 NA 8.26 0.36 NA 8.62 ZZZ 76000 A Fluoroscope examination 0.17 NA 1.34 0.01 NA 1.52 XXX 76001 A Fluoroscope exam, extensive 0.67 NA 2.81 0.15 NA 3.63 XXX 76001 26 A Fluoroscope exam, extensive 0.67 0.23 0.23 0.03 0.93 0.93 XXX 76001 TC A Fluoroscope exam, extensive 0.00 NA 2.58 0.12 NA 2.70 XXX 76003 A Needle localization by x-ray 0.54 NA 1.47 0.09 NA 2.10 XXX 76003 26 A Needle localization by x-ray 0.54 0.18 0.18 0.03 0.75 0.75 XXX 76003 TC A Needle localization by x-ray 0.00 NA 1.29 0.06 NA 1.35 XXX 76005 A Fluoroguide for spine inject 0.60 NA 1.48 0.09 NA 2.17 XXX 76005 26 A Fluoroguide for spine inject 0.60 0.19 0.19 0.03 0.82 0.82 XXX 76005 TC A Fluoroguide for spine inject 0.00 NA 1.29 0.06 NA 1.35 XXX 76006 A X-ray stress view 0.41 0.19 0.19 0.04 0.64 0.64 XXX 76010 A X-ray, nose to rectum 0.18 NA 0.57 0.03 NA 0.78 XXX 76010 26 A X-ray, nose to rectum 0.18 0.06 0.06 0.01 0.25 0.25 XXX 76010 TC A X-ray, nose to rectum 0.00 NA 0.51 0.02 NA 0.53 XXX 76012 A Percut vertebroplasty fluor 1.31 0.49 0.49 0.23 2.03 2.03 XXX 76013 A Percut vertebroplasty, ct 1.38 0.51 0.51 0.48 2.37 2.37 XXX 76020 A X-rays for bone age 0.19 NA 0.58 0.03 NA 0.80 XXX 76020 26 A X-rays for bone age 0.19 0.07 0.07 0.01 0.27 0.27 XXX 76020 TC A X-rays for bone age 0.00 NA 0.51 0.02 NA 0.53 XXX 76040 A X-rays, bone evaluation 0.27 NA 0.87 0.07 NA 1.21 XXX 76040 26 A X-rays, bone evaluation 0.27 0.10 0.10 0.03 0.40 0.40 XXX 76040 TC A X-rays, bone evaluation 0.00 NA 0.77 0.04 NA 0.81 XXX 76061 A X-rays, bone survey 0.45 NA 1.14 0.07 NA 1.66 XXX 76061 26 A X-rays, bone survey 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76061 TC A X-rays, bone survey 0.00 NA 0.98 0.05 NA 1.03 XXX 76062 A X-rays, bone survey 0.54 NA 1.61 0.09 NA 2.24 XXX 76062 26 A X-rays, bone survey 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76062 TC A X-rays, bone survey 0.00 NA 1.42 0.07 NA 1.49 XXX 76065 A X-rays, bone evaluation 0.70 NA 0.96 0.05 NA 1.71 XXX 76065 26 A X-rays, bone evaluation 0.70 0.24 0.24 0.01 0.95 0.95 XXX 76065 TC A X-rays, bone evaluation 0.00 NA 0.72 0.04 NA 0.76 XXX 76066 A Joint(s) survey, single film 0.31 NA 1.20 0.07 NA 1.58 XXX 76066 26 A Joint(s) survey, single film 0.31 0.11 0.11 0.02 0.44 0.44 XXX 76066 TC A Joint(s) survey, single film 0.00 NA 1.09 0.05 NA 1.14 XXX 76070 I CT scan, bone density study 0.25 NA 3.00 0.14 NA 3.39 XXX 76070 26 I CT scan, bone density study 0.25 0.10 0.10 0.01 0.36 0.36 XXX 76070 TC I CT scan, bone density study 0.00 NA 2.90 0.13 NA 3.03 XXX 76075 A Dual energy x-ray study 0.30 NA 3.16 0.15 NA 3.61 XXX 76075 26 A Dual energy x-ray study 0.30 0.11 0.11 0.01 0.42 0.42 XXX 76075 TC A Dual energy x-ray study 0.00 NA 3.05 0.14 NA 3.19 XXX 76076 A Dual energy x-ray study 0.22 NA 0.82 0.05 NA 1.09 XXX 76076 26 A Dual energy x-ray study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 76076 TC A Dual energy x-ray study 0.00 NA 0.74 0.04 NA 0.78 XXX 76078 A Photodensitometry 0.20 NA 0.82 0.05 NA 1.07 XXX 76078 26 A Photodensitometry 0.20 0.08 0.08 0.01 0.29 0.29 XXX 76078 TC A Photodensitometry 0.00 NA 0.74 0.04 NA 0.78 XXX 76080 A X-ray exam of fistula 0.54 NA 1.23 0.07 NA 1.84 XXX 76080 26 A X-ray exam of fistula 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76080 TC A X-ray exam of fistula 0.00 NA 1.04 0.05 NA 1.09 XXX 76086 A X-ray of mammary duct 0.36 NA 2.71 0.14 NA 3.21 XXX 76086 26 A X-ray of mammary duct 0.36 0.13 0.13 0.02 0.51 0.51 XXX 76086 TC A X-ray of mammary duct 0.00 NA 2.58 0.12 NA 2.70 XXX 76088 A X-ray of mammary ducts 0.45 NA 3.77 0.18 NA 4.40 XXX 76088 26 A X-ray of mammary ducts 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76088 TC A X-ray of mammary ducts 0.00 NA 3.61 0.16 NA 3.77 XXX 76090 A Mammogram, one breast 0.70 NA 1.28 0.08 NA 2.06 XXX 76090 26 A Mammogram, one breast 0.70 0.24 0.24 0.03 0.97 0.97 XXX 76090 TC A Mammogram, one breast 0.00 NA 1.04 0.05 NA 1.09 XXX 76091 A Mammogram, both breasts 0.87 NA 1.59 0.09 NA 2.55 XXX 76091 26 A Mammogram, both breasts 0.87 0.30 0.30 0.03 1.20 1.20 XXX 76091 TC A Mammogram, both breasts 0.00 NA 1.29 0.06 NA 1.35 XXX 76092 A Mammogram, screening 0.70 NA 1.52 0.09 NA 2.31 XXX 76092 26 A Mammogram, screening 0.70 0.25 0.25 0.03 0.98 0.98 XXX 76092 TC A Mammogram, screening 0.00 NA 1.27 0.06 NA 1.33 XXX 76093 A Magnetic image, breast 1.63 NA 17.93 0.83 NA 20.39 XXX 76093 26 A Magnetic image, breast 1.63 0.57 0.57 0.07 2.27 2.27 XXX 76093 TC A Magnetic image, breast 0.00 NA 17.36 0.76 NA 18.12 XXX 76094 A Magnetic image, both breasts 1.63 NA 24.12 1.10 NA 26.85 XXX 76094 26 A Magnetic image, both breasts 1.63 0.57 0.57 0.07 2.27 2.27 XXX 76094 TC A Magnetic image, both breasts 0.00 NA 23.55 1.03 NA 24.58 XXX Start Printed Page 40491 76095 A Stereotactic breast biopsy 1.59 NA 7.62 0.40 NA 9.61 XXX 76095 26 A Stereotactic breast biopsy 1.59 0.56 0.56 0.09 2.24 2.24 XXX 76095 TC A Stereotactic breast biopsy 0.00 NA 7.06 0.31 NA 7.37 XXX 76096 A X-ray of needle wire, breast 0.56 NA 1.49 0.09 NA 2.14 XXX 76096 26 A X-ray of needle wire, breast 0.56 0.20 0.20 0.03 0.79 0.79 XXX 76096 TC A X-ray of needle wire, breast 0.00 NA 1.29 0.06 NA 1.35 XXX 76098 A X-ray exam, breast specimen 0.16 NA 0.47 0.03 NA 0.66 XXX 76098 26 A X-ray exam, breast specimen 0.16 0.06 0.06 0.01 0.23 0.23 XXX 76098 TC A X-ray exam, breast specimen 0.00 NA 0.41 0.02 NA 0.43 XXX 76100 A X-ray exam of body section 0.58 NA 1.43 0.09 NA 2.10 XXX 76100 26 A X-ray exam of body section 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76100 TC A X-ray exam of body section 0.00 NA 1.23 0.06 NA 1.29 XXX 76101 A Complex body section x-ray 0.58 NA 1.60 0.10 NA 2.28 XXX 76101 26 A Complex body section x-ray 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76101 TC A Complex body section x-ray 0.00 NA 1.40 0.07 NA 1.47 XXX 76102 A Complex body section x-rays 0.58 NA 1.90 0.12 NA 2.60 XXX 76102 26 A Complex body section x-rays 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76102 TC A Complex body section x-rays 0.00 NA 1.70 0.09 NA 1.79 XXX 76120 A Cinematic x-rays 0.38 NA 1.17 0.07 NA 1.62 XXX 76120 26 A Cinematic x-rays 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76120 TC A Cinematic x-rays 0.00 NA 1.04 0.05 NA 1.09 XXX 76125 A Cinematic x-rays add-on 0.27 NA 0.87 0.05 NA 1.19 ZZZ 76125 26 A Cinematic x-rays add-on 0.27 0.10 0.10 0.01 0.38 0.38 ZZZ 76125 TC A Cinematic x-rays add-on 0.00 NA 0.77 0.04 NA 0.81 ZZZ 76140 I X-ray consultation 0.00 NA 0.00 0.00 NA 0.00 XXX 76150 A X-ray exam, dry process 0.00 NA 0.41 0.02 NA 0.43 XXX 76350 C Special x-ray contrast study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76355 A CAT scan for localization 1.21 NA 8.56 0.41 NA 10.18 XXX 76355 26 A CAT scan for localization 1.21 0.43 0.43 0.06 1.70 1.70 XXX 76355 TC A CAT scan for localization 0.00 NA 8.13 0.35 NA 8.48 XXX 76360 A CAT scan for needle biopsy 1.16 NA 8.53 0.40 NA 10.09 XXX 76360 26 A CAT scan for needle biopsy 1.16 0.40 0.40 0.05 1.61 1.61 XXX 76360 TC A CAT scan for needle biopsy 0.00 NA 8.13 0.35 NA 8.48 XXX 76370 A CAT scan for therapy guide 0.85 NA 3.20 0.17 NA 4.22 XXX 76370 26 A CAT scan for therapy guide 0.85 0.30 0.30 0.04 1.19 1.19 XXX 76370 TC A CAT scan for therapy guide 0.00 NA 2.90 0.13 NA 3.03 XXX 76375 A 3d/holograph reconstr add-on 0.16 NA 3.54 0.16 NA 3.86 XXX 76375 26 A 3d/holograph reconstr add-on 0.16 0.06 0.06 0.01 0.23 0.23 XXX 76375 TC A 3d/holograph reconstr add-on 0.00 NA 3.48 0.15 NA 3.63 XXX 76380 A CAT scan follow-up study 0.98 NA 3.79 0.19 NA 4.96 XXX 76380 26 A CAT scan follow-up study 0.98 0.34 0.34 0.04 1.36 1.36 XXX 76380 TC A CAT scan follow-up study 0.00 NA 3.45 0.15 NA 3.60 XXX 76390 A Mr spectroscopy 1.40 NA 11.52 0.55 NA 13.47 XXX 76390 26 A Mr spectroscopy 1.40 0.49 0.49 0.06 1.95 1.95 XXX 76390 TC A Mr spectroscopy 0.00 NA 11.03 0.49 NA 11.52 XXX 76393 A Mr guidance for needle place 1.50 NA 11.55 0.52 NA 13.57 XXX 76393 26 A Mr guidance for needle place 1.50 0.52 0.52 0.06 2.08 2.08 XXX 76393 TC A Mr guidance for needle place 0.00 NA 11.03 0.46 NA 11.49 XXX 76400 A Magnetic image, bone marrow 1.60 NA 11.59 0.56 NA 13.75 XXX 76400 26 A Magnetic image, bone marrow 1.60 0.56 0.56 0.07 2.23 2.23 XXX 76400 TC A Magnetic image, bone marrow 0.00 NA 11.03 0.49 NA 11.52 XXX 76499 C Radiographic procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 76499 26 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 TC C Radiographic procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 76506 A Echo exam of head 0.63 NA 1.66 0.10 NA 2.39 XXX 76506 26 A Echo exam of head 0.63 0.26 0.26 0.03 0.92 0.92 XXX 76506 TC A Echo exam of head 0.00 NA 1.40 0.07 NA 1.47 XXX 76511 A Echo exam of eye 0.94 NA 1.75 0.08 NA 2.77 XXX 76511 26 A Echo exam of eye 0.94 0.42 0.42 0.02 1.38 1.38 XXX 76511 TC A Echo exam of eye 0.00 NA 1.33 0.06 NA 1.39 XXX 76512 A Echo exam of eye 0.66 NA 1.85 0.09 NA 2.60 XXX 76512 26 A Echo exam of eye 0.66 0.31 0.31 0.01 0.98 0.98 XXX 76512 TC A Echo exam of eye 0.00 NA 1.54 0.08 NA 1.62 XXX 76513 A Echo exam of eye, water bath 0.66 NA 2.25 0.09 NA 3.00 XXX 76513 26 A Echo exam of eye, water bath 0.66 0.31 0.31 0.01 0.98 0.98 XXX 76513 TC A Echo exam of eye, water bath 0.00 NA 1.94 0.08 NA 2.02 XXX 76516 A Echo exam of eye 0.54 NA 1.35 0.07 NA 1.96 XXX 76516 26 A Echo exam of eye 0.54 0.26 0.26 0.01 0.81 0.81 XXX 76516 TC A Echo exam of eye 0.00 NA 1.09 0.06 NA 1.15 XXX 76519 A Echo exam of eye 0.54 NA 1.49 0.07 NA 2.10 XXX 76519 26 A Echo exam of eye 0.54 0.26 0.26 0.01 0.81 0.81 XXX 76519 TC A Echo exam of eye 0.00 NA 1.23 0.06 NA 1.29 XXX 76529 A Echo exam of eye 0.57 NA 2.03 0.08 NA 2.68 XXX 76529 26 A Echo exam of eye 0.57 0.26 0.26 0.01 0.84 0.84 XXX Start Printed Page 40492 76529 TC A Echo exam of eye 0.00 NA 1.77 0.07 NA 1.84 XXX 76536 A Echo exam of head and neck 0.56 NA 1.60 0.09 NA 2.25 XXX 76536 26 A Echo exam of head and neck 0.56 0.20 0.20 0.02 0.78 0.78 XXX 76536 TC A Echo exam of head and neck 0.00 NA 1.40 0.07 NA 1.47 XXX 76604 A Echo exam of chest 0.55 NA 1.48 0.08 NA 2.11 XXX 76604 26 A Echo exam of chest 0.55 0.19 0.19 0.02 0.76 0.76 XXX 76604 TC A Echo exam of chest 0.00 NA 1.29 0.06 NA 1.35 XXX 76645 A Echo exam of breast(s) 0.54 NA 1.23 0.08 NA 1.85 XXX 76645 26 A Echo exam of breast(s) 0.54 0.19 0.19 0.03 0.76 0.76 XXX 76645 TC A Echo exam of breast(s) 0.00 NA 1.04 0.05 NA 1.09 XXX 76700 A Echo exam of abdomen 0.81 NA 2.22 0.13 NA 3.16 XXX 76700 26 A Echo exam of abdomen 0.81 0.28 0.28 0.04 1.13 1.13 XXX 76700 TC A Echo exam of abdomen 0.00 NA 1.94 0.09 NA 2.03 XXX 76705 A Echo exam of abdomen 0.59 NA 1.61 0.10 NA 2.30 XXX 76705 26 A Echo exam of abdomen 0.59 0.21 0.21 0.03 0.83 0.83 XXX 76705 TC A Echo exam of abdomen 0.00 NA 1.40 0.07 NA 1.47 XXX 76770 A Echo exam abdomen back wall 0.74 NA 2.20 0.12 NA 3.06 XXX 76770 26 A Echo exam abdomen back wall 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76770 TC A Echo exam abdomen back wall 0.00 NA 1.94 0.09 NA 2.03 XXX 76775 A Echo exam abdomen back wall 0.58 NA 1.60 0.10 NA 2.28 XXX 76775 26 A Echo exam abdomen back wall 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76775 TC A Echo exam abdomen back wall 0.00 NA 1.40 0.07 NA 1.47 XXX 76778 A Echo exam kidney transplant 0.74 NA 2.20 0.12 NA 3.06 XXX 76778 26 A Echo exam kidney transplant 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76778 TC A Echo exam kidney transplant 0.00 NA 1.94 0.09 NA 2.03 XXX 76800 A Echo exam spinal canal 1.13 NA 1.73 0.11 NA 2.97 XXX 76800 26 A Echo exam spinal canal 1.13 0.33 0.33 0.04 1.50 1.50 XXX 76800 TC A Echo exam spinal canal 0.00 NA 1.40 0.07 NA 1.47 XXX 76805 A Echo exam of pregnant uterus 0.99 NA 2.43 0.14 NA 3.56 XXX 76805 26 A Echo exam of pregnant uterus 0.99 0.36 0.36 0.04 1.39 1.39 XXX 76805 TC A Echo exam of pregnant uterus 0.00 NA 2.07 0.10 NA 2.17 XXX 76810 A Echo exam of pregnant uterus 1.97 NA 4.87 0.25 NA 7.09 XXX 76810 26 A Echo exam of pregnant uterus 1.97 0.74 0.74 0.07 2.78 2.78 XXX 76810 TC A Echo exam of pregnant uterus 0.00 NA 4.13 0.18 NA 4.31 XXX 76815 A Echo exam of pregnant uterus 0.65 NA 1.65 0.09 NA 2.39 XXX 76815 26 A Echo exam of pregnant uterus 0.65 0.25 0.25 0.02 0.92 0.92 XXX 76815 TC A Echo exam of pregnant uterus 0.00 NA 1.40 0.07 NA 1.47 XXX 76816 A Echo exam follow-up/repeat 0.57 NA 1.32 0.07 NA 1.96 XXX 76816 26 A Echo exam follow-up/repeat 0.57 0.23 0.23 0.02 0.82 0.82 XXX 76816 TC A Echo exam follow-up/repeat 0.00 NA 1.09 0.05 NA 1.14 XXX 76818 A Fetl biophys profil w/stress 0.86 NA 1.93 0.12 NA 2.91 XXX 76818 26 A Fetl biophys profil w/stress 0.86 0.34 0.34 0.04 1.24 1.24 XXX 76818 TC A Fetl biophys profil w/stress 0.00 NA 1.59 0.08 NA 1.67 XXX 76819 A Fetl biophys profil w/o strs 0.63 NA 1.84 0.11 NA 2.58 XXX 76819 26 A Fetl biophys profil w/o strs 0.63 0.25 0.25 0.03 0.91 0.91 XXX 76819 TC A Fetl biophys profil w/o strs 0.00 NA 1.59 0.08 NA 1.67 XXX 76825 A Echo exam of fetal heart 1.67 NA 2.57 0.15 NA 4.39 XXX 76825 26 A Echo exam of fetal heart 1.67 0.63 0.63 0.06 2.36 2.36 XXX 76825 TC A Echo exam of fetal heart 0.00 NA 1.94 0.09 NA 2.03 XXX 76826 A Echo exam of fetal heart 0.83 NA 1.00 0.07 NA 1.90 XXX 76826 26 A Echo exam of fetal heart 0.83 0.30 0.30 0.03 1.16 1.16 XXX 76826 TC A Echo exam of fetal heart 0.00 NA 0.70 0.04 NA 0.74 XXX 76827 A Echo exam of fetal heart 0.58 NA 1.91 0.12 NA 2.61 XXX 76827 26 A Echo exam of fetal heart 0.58 0.22 0.22 0.02 0.82 0.82 XXX 76827 TC A Echo exam of fetal heart 0.00 NA 1.69 0.10 NA 1.79 XXX 76828 A Echo exam of fetal heart 0.56 NA 1.32 0.09 NA 1.97 XXX 76828 26 A Echo exam of fetal heart 0.56 0.23 0.23 0.02 0.81 0.81 XXX 76828 TC A Echo exam of fetal heart 0.00 NA 1.09 0.07 NA 1.16 XXX 76830 A Echo exam, transvaginal 0.69 NA 1.73 0.11 NA 2.53 XXX 76830 26 A Echo exam, transvaginal 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76830 TC A Echo exam, transvaginal 0.00 NA 1.49 0.08 NA 1.57 XXX 76831 A Echo exam, uterus 0.72 NA 1.76 0.10 NA 2.58 XXX 76831 26 A Echo exam, uterus 0.72 0.27 0.27 0.02 1.01 1.01 XXX 76831 TC A Echo exam, uterus 0.00 NA 1.49 0.08 NA 1.57 XXX 76856 A Echo exam of pelvis 0.69 NA 1.73 0.11 NA 2.53 XXX 76856 26 A Echo exam of pelvis 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76856 TC A Echo exam of pelvis 0.00 NA 1.49 0.08 NA 1.57 XXX 76857 A Echo exam of pelvis 0.38 NA 1.17 0.07 NA 1.62 XXX 76857 26 A Echo exam of pelvis 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76857 TC A Echo exam of pelvis 0.00 NA 1.04 0.05 NA 1.09 XXX 76870 A Echo exam of scrotum 0.64 NA 1.71 0.11 NA 2.46 XXX 76870 26 A Echo exam of scrotum 0.64 0.22 0.22 0.03 0.89 0.89 XXX 76870 TC A Echo exam of scrotum 0.00 NA 1.49 0.08 NA 1.57 XXX 76872 A Echo exam, transrectal 0.69 NA 1.73 0.12 NA 2.54 XXX Start Printed Page 40493 76872 26 A Echo exam, transrectal 0.69 0.24 0.24 0.04 0.97 0.97 XXX 76872 TC A Echo exam, transrectal 0.00 NA 1.49 0.08 NA 1.57 XXX 76873 A Echograp trans r, pros study 1.55 NA 2.60 0.21 NA 4.36 XXX 76873 26 A Echograp trans r, pros study 1.55 0.53 0.53 0.08 2.16 2.16 XXX 76873 TC A Echograp trans r, pros study 0.00 NA 2.07 0.13 NA 2.20 XXX 76880 A Echo exam of extremity 0.59 NA 1.61 0.10 NA 2.30 XXX 76880 26 A Echo exam of extremity 0.59 0.21 0.21 0.03 0.83 0.83 XXX 76880 TC A Echo exam of extremity 0.00 NA 1.40 0.07 NA 1.47 XXX 76885 A Echo exam, infant hips 0.74 NA 1.75 0.11 NA 2.60 XXX 76885 26 A Echo exam, infant hips 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76885 TC A Echo exam, infant hips 0.00 NA 1.49 0.08 NA 1.57 XXX 76886 A Echo exam, infant hips 0.62 NA 1.61 0.10 NA 2.33 XXX 76886 26 A Echo exam, infant hips 0.62 0.21 0.21 0.03 0.86 0.86 XXX 76886 TC A Echo exam, infant hips 0.00 NA 1.40 0.07 NA 1.47 XXX 76930 A Echo guide, cardiocentesis 0.67 NA 1.76 0.10 NA 2.53 XXX 76930 26 A Echo guide, cardiocentesis 0.67 0.27 0.27 0.02 0.96 0.96 XXX 76930 TC A Echo guide, cardiocentesis 0.00 NA 1.49 0.08 NA 1.57 XXX 76932 A Echo guide for heart biopsy 0.67 NA 1.76 0.10 NA 2.53 XXX 76932 26 A Echo guide for heart biopsy 0.67 0.27 0.27 0.02 0.96 0.96 XXX 76932 TC A Echo guide for heart biopsy 0.00 NA 1.49 0.08 NA 1.57 XXX 76936 A Echo guide for artery repair 1.99 NA 6.90 0.39 NA 9.28 XXX 76936 26 A Echo guide for artery repair 1.99 0.70 0.70 0.11 2.80 2.80 XXX 76936 TC A Echo guide for artery repair 0.00 NA 6.20 0.28 NA 6.48 XXX 76941 A Echo guide for transfusion 1.34 NA 2.00 0.13 NA 3.47 XXX 76941 26 A Echo guide for transfusion 1.34 0.50 0.50 0.06 1.90 1.90 XXX 76941 TC A Echo guide for transfusion 0.00 NA 1.50 0.07 NA 1.57 XXX 76942 A Echo guide for biopsy 0.67 NA 1.72 0.12 NA 2.51 XXX 76942 26 A Echo guide for biopsy 0.67 0.23 0.23 0.04 0.94 0.94 XXX 76942 TC A Echo guide for biopsy 0.00 NA 1.49 0.08 NA 1.57 XXX 76945 A Echo guide, villus sampling 0.67 NA 1.74 0.10 NA 2.51 XXX 76945 26 A Echo guide, villus sampling 0.67 0.24 0.24 0.03 0.94 0.94 XXX 76945 TC A Echo guide, villus sampling 0.00 NA 1.50 0.07 NA 1.57 XXX 76946 A Echo guide for amniocentesis 0.38 NA 1.64 0.09 NA 2.11 XXX 76946 26 A Echo guide for amniocentesis 0.38 0.15 0.15 0.01 0.54 0.54 XXX 76946 TC A Echo guide for amniocentesis 0.00 NA 1.49 0.08 NA 1.57 XXX 76948 A Echo guide, ova aspiration 0.38 NA 1.63 0.10 NA 2.11 XXX 76948 26 A Echo guide, ova aspiration 0.38 0.14 0.14 0.02 0.54 0.54 XXX 76948 TC A Echo guide, ova aspiration 0.00 NA 1.49 0.08 NA 1.57 XXX 76950 A Echo guidance radiotherapy 0.58 NA 1.49 0.09 NA 2.16 XXX 76950 26 A Echo guidance radiotherapy 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76950 TC A Echo guidance radiotherapy 0.00 NA 1.29 0.06 NA 1.35 XXX 76965 A Echo guidance radiotherapy 1.34 NA 5.94 0.31 NA 7.59 XXX 76965 26 A Echo guidance radiotherapy 1.34 0.46 0.46 0.07 1.87 1.87 XXX 76965 TC A Echo guidance radiotherapy 0.00 NA 5.48 0.24 NA 5.72 XXX 76970 A Ultrasound exam follow-up 0.40 NA 1.18 0.07 NA 1.65 XXX 76970 26 A Ultrasound exam follow-up 0.40 0.14 0.14 0.02 0.56 0.56 XXX 76970 TC A Ultrasound exam follow-up 0.00 NA 1.04 0.05 NA 1.09 XXX 76975 A GI endoscopic ultrasound 0.81 NA 1.78 0.11 NA 2.70 XXX 76975 26 A GI endoscopic ultrasound 0.81 0.29 0.29 0.03 1.13 1.13 XXX 76975 TC A GI endoscopic ultrasound 0.00 NA 1.49 0.08 NA 1.57 XXX 76977 A Us bone density measure 0.05 NA 1.42 0.05 NA 1.52 XXX 76977 26 A Us bone density measure 0.05 0.02 0.02 0.01 0.08 0.08 XXX 76977 TC A Us bone density measure 0.00 NA 1.40 0.04 NA 1.44 XXX 76986 A Ultrasound guide intraoper 1.20 NA 3.00 0.19 NA 4.39 XXX 76986 26 A Ultrasound guide intraoper 1.20 0.42 0.42 0.07 1.69 1.69 XXX 76986 TC A Ultrasound guide intraoper 0.00 NA 2.58 0.12 NA 2.70 XXX 76999 C Echo examination procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 76999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 TC C Echo examination procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 77261 A Radiation therapy planning 1.39 0.56 0.56 0.06 2.01 2.01 XXX 77262 A Radiation therapy planning 2.11 0.83 0.83 0.09 3.03 3.03 XXX 77263 A Radiation therapy planning 3.14 1.24 1.24 0.13 4.51 4.51 XXX 77280 A Set radiation therapy field 0.70 NA 3.67 0.18 NA 4.55 XXX 77280 26 A Set radiation therapy field 0.70 0.25 0.25 0.03 0.98 0.98 XXX 77280 TC A Set radiation therapy field 0.00 NA 3.42 0.15 NA 3.57 XXX 77285 A Set radiation therapy field 1.05 NA 5.86 0.29 NA 7.20 XXX 77285 26 A Set radiation therapy field 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77285 TC A Set radiation therapy field 0.00 NA 5.48 0.25 NA 5.73 XXX 77290 A Set radiation therapy field 1.56 NA 6.97 0.35 NA 8.88 XXX 77290 26 A Set radiation therapy field 1.56 0.56 0.56 0.06 2.18 2.18 XXX 77290 TC A Set radiation therapy field 0.00 NA 6.41 0.29 NA 6.70 XXX 77295 A Set radiation therapy field 4.57 NA 29.15 1.41 NA 35.13 XXX 77295 26 A Set radiation therapy field 4.57 1.64 1.64 0.18 6.39 6.39 XXX 77295 TC A Set radiation therapy field 0.00 NA 27.51 1.23 NA 28.74 XXX Start Printed Page 40494 77299 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 26 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 TC C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77300 A Radiation therapy dose plan 0.62 NA 1.54 0.09 NA 2.25 XXX 77300 26 A Radiation therapy dose plan 0.62 0.22 0.22 0.03 0.87 0.87 XXX 77300 TC A Radiation therapy dose plan 0.00 NA 1.32 0.06 NA 1.38 XXX 77305 A Radiation therapy dose plan 0.70 NA 2.08 0.12 NA 2.90 XXX 77305 26 A Radiation therapy dose plan 0.70 0.25 0.25 0.03 0.98 0.98 XXX 77305 TC A Radiation therapy dose plan 0.00 NA 1.83 0.09 NA 1.92 XXX 77310 A Radiation therapy dose plan 1.05 NA 2.67 0.15 NA 3.87 XXX 77310 26 A Radiation therapy dose plan 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77310 TC A Radiation therapy dose plan 0.00 NA 2.29 0.11 NA 2.40 XXX 77315 A Radiation therapy dose plan 1.56 NA 3.18 0.18 NA 4.92 XXX 77315 26 A Radiation therapy dose plan 1.56 0.56 0.56 0.06 2.18 2.18 XXX 77315 TC A Radiation therapy dose plan 0.00 NA 2.62 0.12 NA 2.74 XXX 77321 A Radiation therapy port plan 0.95 NA 4.32 0.21 NA 5.48 XXX 77321 26 A Radiation therapy port plan 0.95 0.34 0.34 0.04 1.33 1.33 XXX 77321 TC A Radiation therapy port plan 0.00 NA 3.98 0.17 NA 4.15 XXX 77326 A Radiation therapy dose plan 0.93 NA 2.65 0.15 NA 3.73 XXX 77326 26 A Radiation therapy dose plan 0.93 0.33 0.33 0.04 1.30 1.30 XXX 77326 TC A Radiation therapy dose plan 0.00 NA 2.32 0.11 NA 2.43 XXX 77327 A Radiation therapy dose plan 1.39 NA 3.92 0.21 NA 5.52 XXX 77327 26 A Radiation therapy dose plan 1.39 0.50 0.50 0.06 1.95 1.95 XXX 77327 TC A Radiation therapy dose plan 0.00 NA 3.42 0.15 NA 3.57 XXX 77328 A Radiation therapy dose plan 2.09 NA 5.63 0.30 NA 8.02 XXX 77328 26 A Radiation therapy dose plan 2.09 0.75 0.75 0.09 2.93 2.93 XXX 77328 TC A Radiation therapy dose plan 0.00 NA 4.88 0.21 NA 5.09 XXX 77331 A Special radiation dosimetry 0.87 NA 0.81 0.06 NA 1.74 XXX 77331 26 A Special radiation dosimetry 0.87 0.31 0.31 0.04 1.22 1.22 XXX 77331 TC A Special radiation dosimetry 0.00 NA 0.50 0.02 NA 0.52 XXX 77332 A Radiation treatment aid(s) 0.54 NA 1.51 0.08 NA 2.13 XXX 77332 26 A Radiation treatment aid(s) 0.54 0.19 0.19 0.02 0.75 0.75 XXX 77332 TC A Radiation treatment aid(s) 0.00 NA 1.32 0.06 NA 1.38 XXX 77333 A Radiation treatment aid(s) 0.84 NA 2.17 0.13 NA 3.14 XXX 77333 26 A Radiation treatment aid(s) 0.84 0.30 0.30 0.04 1.18 1.18 XXX 77333 TC A Radiation treatment aid(s) 0.00 NA 1.87 0.09 NA 1.96 XXX 77334 A Radiation treatment aid(s) 1.24 NA 3.64 0.19 NA 5.07 XXX 77334 26 A Radiation treatment aid(s) 1.24 0.44 0.44 0.05 1.73 1.73 XXX 77334 TC A Radiation treatment aid(s) 0.00 NA 3.20 0.14 NA 3.34 XXX 77336 A Radiation physics consult 0.00 NA 2.93 0.13 NA 3.06 XXX 77370 A Radiation physics consult 0.00 NA 3.44 0.15 NA 3.59 XXX 77399 C External radiation dosimetry 0.00 NA 0.00 0.00 NA 0.00 XXX 77399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 TC C External radiation dosimetry 0.00 NA 0.00 0.00 NA 0.00 XXX 77401 A Radiation treatment delivery 0.00 NA 1.74 0.09 NA 1.83 XXX 77402 A Radiation treatment delivery 0.00 NA 1.74 0.09 NA 1.83 XXX 77403 A Radiation treatment delivery 0.00 NA 1.74 0.09 NA 1.83 XXX 77404 A Radiation treatment delivery 0.00 NA 1.74 0.09 NA 1.83 XXX 77406 A Radiation treatment delivery 0.00 NA 1.74 0.09 NA 1.83 XXX 77407 A Radiation treatment delivery 0.00 NA 2.06 0.10 NA 2.16 XXX 77408 A Radiation treatment delivery 0.00 NA 2.06 0.10 NA 2.16 XXX 77409 A Radiation treatment delivery 0.00 NA 2.06 0.10 NA 2.16 XXX 77411 A Radiation treatment delivery 0.00 NA 2.06 0.10 NA 2.16 XXX 77412 A Radiation treatment delivery 0.00 NA 2.29 0.11 NA 2.40 XXX 77413 A Radiation treatment delivery 0.00 NA 2.29 0.11 NA 2.40 XXX 77414 A Radiation treatment delivery 0.00 NA 2.29 0.11 NA 2.40 XXX 77416 A Radiation treatment delivery 0.00 NA 2.29 0.11 NA 2.40 XXX 77417 A Radiology port film(s) 0.00 NA 0.58 0.03 NA 0.61 XXX 77427 A Radiation tx management, x5 3.31 1.19 1.19 0.14 4.64 4.64 XXX 77431 A Radiation therapy management 1.81 0.75 0.75 0.07 2.63 2.63 XXX 77432 A Stereotactic radiation trmt 7.93 3.26 3.26 0.33 11.52 11.52 XXX 77470 A Special radiation treatment 2.09 NA 11.73 0.58 NA 14.40 XXX 77470 26 A Special radiation treatment 2.09 0.75 0.75 0.09 2.93 2.93 XXX 77470 TC A Special radiation treatment 0.00 NA 10.98 0.49 NA 11.47 XXX 77499 C Radiation therapy management 0.00 NA 0.00 0.00 NA 0.00 XXX 77499 26 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 TC C Radiation therapy management 0.00 NA 0.00 0.00 NA 0.00 XXX 77520 C Proton trmt, simple w/o comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77522 C Proton trmt, simple w/comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77523 C Proton trmt, intermediate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77525 C Proton treatment, complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77600 R Hyperthermia treatment 1.56 NA 3.55 0.21 NA 5.32 XXX 77600 26 R Hyperthermia treatment 1.56 0.55 0.55 0.08 2.19 2.19 XXX 77600 TC R Hyperthermia treatment 0.00 NA 3.00 0.13 NA 3.13 XXX Start Printed Page 40495 77605 R Hyperthermia treatment 2.09 NA 4.75 0.31 NA 7.15 XXX 77605 26 R Hyperthermia treatment 2.09 0.75 0.75 0.13 2.97 2.97 XXX 77605 TC R Hyperthermia treatment 0.00 NA 4.00 0.18 NA 4.18 XXX 77610 R Hyperthermia treatment 1.56 NA 3.55 0.20 NA 5.31 XXX 77610 26 R Hyperthermia treatment 1.56 0.55 0.55 0.07 2.18 2.18 XXX 77610 TC R Hyperthermia treatment 0.00 NA 3.00 0.13 NA 3.13 XXX 77615 R Hyperthermia treatment 2.09 NA 4.75 0.27 NA 7.11 XXX 77615 26 R Hyperthermia treatment 2.09 0.75 0.75 0.09 2.93 2.93 XXX 77615 TC R Hyperthermia treatment 0.00 NA 4.00 0.18 NA 4.18 XXX 77620 R Hyperthermia treatment 1.56 NA 3.57 0.19 NA 5.32 XXX 77620 26 R Hyperthermia treatment 1.56 0.57 0.57 0.06 2.19 2.19 XXX 77620 TC R Hyperthermia treatment 0.00 NA 3.00 0.13 NA 3.13 XXX 77750 A Infuse radioactive materials 4.91 NA 3.08 0.23 NA 8.22 090 77750 26 A Infuse radioactive materials 4.91 1.77 1.77 0.17 6.85 6.85 090 77750 TC A Infuse radioactive materials 0.00 NA 1.31 0.06 NA 1.37 090 77761 A Apply intrcav radiat simple 3.81 NA 3.75 0.28 NA 7.84 090 77761 26 A Apply intrcav radiat simple 3.81 1.28 1.28 0.16 5.25 5.25 090 77761 TC A Apply intrcav radiat simple 0.00 NA 2.47 0.12 NA 2.59 090 77762 A Apply intrcav radiat interm 5.72 NA 5.65 0.38 NA 11.75 090 77762 26 A Apply intrcav radiat interm 5.72 2.10 2.10 0.22 8.04 8.04 090 77762 TC A Apply intrcav radiat interm 0.00 NA 3.55 0.16 NA 3.71 090 77763 A Apply intrcav radiat compl 8.57 NA 7.52 0.53 NA 16.62 090 77763 26 A Apply intrcav radiat compl 8.57 3.10 3.10 0.34 12.01 12.01 090 77763 TC A Apply intrcav radiat compl 0.00 NA 4.42 0.19 NA 4.61 090 77776 A Apply interstit radiat simpl 4.66 NA 3.28 0.35 NA 8.29 090 77776 26 A Apply interstit radiat simpl 4.66 1.14 1.14 0.24 6.04 6.04 090 77776 TC A Apply interstit radiat simpl 0.00 NA 2.14 0.11 NA 2.25 090 77777 A Apply interstit radiat inter 7.48 NA 6.85 0.50 NA 14.83 090 77777 26 A Apply interstit radiat inter 7.48 2.68 2.68 0.32 10.48 10.48 090 77777 TC A Apply interstit radiat inter 0.00 NA 4.17 0.18 NA 4.35 090 77778 A Apply iterstit radiat compl 11.19 NA 9.03 0.69 NA 20.91 090 77778 26 A Apply iterstit radiat compl 11.19 3.97 3.97 0.47 15.63 15.63 090 77778 TC A Apply iterstit radiat compl 0.00 NA 5.06 0.22 NA 5.28 090 77781 A High intensity brachytherapy 1.66 NA 20.59 0.95 NA 23.20 090 77781 26 A High intensity brachytherapy 1.66 0.60 0.60 0.07 2.33 2.33 090 77781 TC A High intensity brachytherapy 0.00 NA 19.99 0.88 NA 20.87 090 77782 A High intensity brachytherapy 2.49 NA 20.89 0.98 NA 24.36 090 77782 26 A High intensity brachytherapy 2.49 0.90 0.90 0.10 3.49 3.49 090 77782 TC A High intensity brachytherapy 0.00 NA 19.99 0.88 NA 20.87 090 77783 A High intensity brachytherapy 3.73 NA 21.32 1.03 NA 26.08 090 77783 26 A High intensity brachytherapy 3.73 1.33 1.33 0.15 5.21 5.21 090 77783 TC A High intensity brachytherapy 0.00 NA 19.99 0.88 NA 20.87 090 77784 A High intensity brachytherapy 5.61 NA 22.00 1.10 NA 28.71 090 77784 26 A High intensity brachytherapy 5.61 2.01 2.01 0.22 7.84 7.84 090 77784 TC A High intensity brachytherapy 0.00 NA 19.99 0.88 NA 20.87 090 77789 A Apply surface radiation 1.12 NA 0.86 0.05 NA 2.03 090 77789 26 A Apply surface radiation 1.12 0.41 0.41 0.03 1.56 1.56 090 77789 TC A Apply surface radiation 0.00 NA 0.45 0.02 NA 0.47 090 77790 A Radiation handling 1.05 NA 0.88 0.06 NA 1.99 XXX 77790 26 A Radiation handling 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77790 TC A Radiation handling 0.00 NA 0.50 0.02 NA 0.52 XXX 77799 C Radium/radioisotope therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 77799 26 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 TC C Radium/radioisotope therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 78000 A Thyroid, single uptake 0.19 NA 1.02 0.06 NA 1.27 XXX 78000 26 A Thyroid, single uptake 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78000 TC A Thyroid, single uptake 0.00 NA 0.95 0.05 NA 1.00 XXX 78001 A Thyroid, multiple uptakes 0.26 NA 1.38 0.07 NA 1.71 XXX 78001 26 A Thyroid, multiple uptakes 0.26 0.09 0.09 0.01 0.36 0.36 XXX 78001 TC A Thyroid, multiple uptakes 0.00 NA 1.29 0.06 NA 1.35 XXX 78003 A Thyroid suppress/stimul 0.33 NA 1.07 0.06 NA 1.46 XXX 78003 26 A Thyroid suppress/stimul 0.33 0.12 0.12 0.01 0.46 0.46 XXX 78003 TC A Thyroid suppress/stimul 0.00 NA 0.95 0.05 NA 1.00 XXX 78006 A Thyroid imaging with uptake 0.49 NA 2.51 0.13 NA 3.13 XXX 78006 26 A Thyroid imaging with uptake 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78006 TC A Thyroid imaging with uptake 0.00 NA 2.34 0.11 NA 2.45 XXX 78007 A Thyroid image, mult uptakes 0.50 NA 2.71 0.14 NA 3.35 XXX 78007 26 A Thyroid image, mult uptakes 0.50 0.18 0.18 0.02 0.70 0.70 XXX 78007 TC A Thyroid image, mult uptakes 0.00 NA 2.53 0.12 NA 2.65 XXX 78010 A Thyroid imaging 0.39 NA 1.93 0.11 NA 2.43 XXX 78010 26 A Thyroid imaging 0.39 0.14 0.14 0.02 0.55 0.55 XXX 78010 TC A Thyroid imaging 0.00 NA 1.79 0.09 NA 1.88 XXX 78011 A Thyroid imaging with flow 0.45 NA 2.53 0.13 NA 3.11 XXX 78011 26 A Thyroid imaging with flow 0.45 0.16 0.16 0.02 0.63 0.63 XXX Start Printed Page 40496 78011 TC A Thyroid imaging with flow 0.00 NA 2.37 0.11 NA 2.48 XXX 78015 A Thyroid met imaging 0.67 NA 2.77 0.15 NA 3.59 XXX 78015 26 A Thyroid met imaging 0.67 0.24 0.24 0.03 0.94 0.94 XXX 78015 TC A Thyroid met imaging 0.00 NA 2.53 0.12 NA 2.65 XXX 78016 A Thyroid met imaging/studies 0.82 NA 3.73 0.18 NA 4.73 XXX 78016 26 A Thyroid met imaging/studies 0.82 0.30 0.30 0.03 1.15 1.15 XXX 78016 TC A Thyroid met imaging/studies 0.00 NA 3.43 0.15 NA 3.58 XXX 78018 A Thyroid met imaging, body 0.86 NA 5.66 0.27 NA 6.79 XXX 78018 26 A Thyroid met imaging, body 0.86 0.32 0.32 0.03 1.21 1.21 XXX 78018 TC A Thyroid met imaging, body 0.00 NA 5.34 0.24 NA 5.58 XXX 78020 A Thyroid met uptake 0.60 NA 1.52 0.14 NA 2.26 ZZZ 78020 26 A Thyroid met uptake 0.60 0.23 0.23 0.02 0.85 0.85 ZZZ 78020 TC A Thyroid met uptake 0.00 NA 1.29 0.12 NA 1.41 ZZZ 78070 A Parathyroid nuclear imaging 0.82 NA 2.09 0.12 NA 3.03 XXX 78070 26 A Parathyroid nuclear imaging 0.82 0.30 0.30 0.03 1.15 1.15 XXX 78070 TC A Parathyroid nuclear imaging 0.00 NA 1.79 0.09 NA 1.88 XXX 78075 A Adrenal nuclear imaging 0.74 NA 5.62 0.27 NA 6.63 XXX 78075 26 A Adrenal nuclear imaging 0.74 0.28 0.28 0.03 1.05 1.05 XXX 78075 TC A Adrenal nuclear imaging 0.00 NA 5.34 0.24 NA 5.58 XXX 78099 C Endocrine nuclear procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 78099 26 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 TC C Endocrine nuclear procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 78102 A Bone marrow imaging, ltd 0.55 NA 2.22 0.12 NA 2.89 XXX 78102 26 A Bone marrow imaging, ltd 0.55 0.21 0.21 0.02 0.78 0.78 XXX 78102 TC A Bone marrow imaging, ltd 0.00 NA 2.01 0.10 NA 2.11 XXX 78103 A Bone marrow imaging, mult 0.75 NA 3.40 0.17 NA 4.32 XXX 78103 26 A Bone marrow imaging, mult 0.75 0.28 0.28 0.03 1.06 1.06 XXX 78103 TC A Bone marrow imaging, mult 0.00 NA 3.12 0.14 NA 3.26 XXX 78104 A Bone marrow imaging, body 0.80 NA 4.30 0.21 NA 5.31 XXX 78104 26 A Bone marrow imaging, body 0.80 0.29 0.29 0.03 1.12 1.12 XXX 78104 TC A Bone marrow imaging, body 0.00 NA 4.01 0.18 NA 4.19 XXX 78110 A Plasma volume, single 0.19 NA 1.00 0.06 NA 1.25 XXX 78110 26 A Plasma volume, single 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78110 TC A Plasma volume, single 0.00 NA 0.93 0.05 NA 0.98 XXX 78111 A Plasma volume, multiple 0.22 NA 2.61 0.13 NA 2.96 XXX 78111 26 A Plasma volume, multiple 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78111 TC A Plasma volume, multiple 0.00 NA 2.53 0.12 NA 2.65 XXX 78120 A Red cell mass, single 0.23 NA 1.79 0.10 NA 2.12 XXX 78120 26 A Red cell mass, single 0.23 0.09 0.09 0.01 0.33 0.33 XXX 78120 TC A Red cell mass, single 0.00 NA 1.70 0.09 NA 1.79 XXX 78121 A Red cell mass, multiple 0.32 NA 2.99 0.13 NA 3.44 XXX 78121 26 A Red cell mass, multiple 0.32 0.12 0.12 0.01 0.45 0.45 XXX 78121 TC A Red cell mass, multiple 0.00 NA 2.87 0.12 NA 2.99 XXX 78122 A Blood volume 0.45 NA 4.70 0.22 NA 5.37 XXX 78122 26 A Blood volume 0.45 0.17 0.17 0.02 0.64 0.64 XXX 78122 TC A Blood volume 0.00 NA 4.53 0.20 NA 4.73 XXX 78130 A Red cell survival study 0.61 NA 3.04 0.15 NA 3.80 XXX 78130 26 A Red cell survival study 0.61 0.23 0.23 0.03 0.87 0.87 XXX 78130 TC A Red cell survival study 0.00 NA 2.81 0.12 NA 2.93 XXX 78135 A Red cell survival kinetics 0.64 NA 5.03 0.24 NA 5.91 XXX 78135 26 A Red cell survival kinetics 0.64 0.23 0.23 0.03 0.90 0.90 XXX 78135 TC A Red cell survival kinetics 0.00 NA 4.80 0.21 NA 5.01 XXX 78140 A Red cell sequestration 0.61 NA 4.09 0.20 NA 4.90 XXX 78140 26 A Red cell sequestration 0.61 0.21 0.21 0.03 0.85 0.85 XXX 78140 TC A Red cell sequestration 0.00 NA 3.88 0.17 NA 4.05 XXX 78160 A Plasma iron turnover 0.33 NA 3.75 0.19 NA 4.27 XXX 78160 26 A Plasma iron turnover 0.33 0.14 0.14 0.03 0.50 0.50 XXX 78160 TC A Plasma iron turnover 0.00 NA 3.61 0.16 NA 3.77 XXX 78162 A Iron absorption exam 0.45 NA 3.33 0.15 NA 3.93 XXX 78162 26 A Iron absorption exam 0.45 0.18 0.18 0.01 0.64 0.64 XXX 78162 TC A Iron absorption exam 0.00 NA 3.15 0.14 NA 3.29 XXX 78170 A Red cell iron utilization 0.41 NA 5.37 0.27 NA 6.05 XXX 78170 26 A Red cell iron utilization 0.41 0.14 0.14 0.04 0.59 0.59 XXX 78170 TC A Red cell iron utilization 0.00 NA 5.23 0.23 NA 5.46 XXX 78172 C Total body iron estimation 0.00 NA 0.00 0.00 NA 0.00 XXX 78172 26 A Total body iron estimation 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78172 TC C Total body iron estimation 0.00 NA 0.00 0.00 NA 0.00 XXX 78185 A Spleen imaging 0.40 NA 2.46 0.13 NA 2.99 XXX 78185 26 A Spleen imaging 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78185 TC A Spleen imaging 0.00 NA 2.32 0.11 NA 2.43 XXX 78190 A Platelet survival, kinetics 1.09 NA 6.02 0.31 NA 7.42 XXX 78190 26 A Platelet survival, kinetics 1.09 0.39 0.39 0.06 1.54 1.54 XXX 78190 TC A Platelet survival, kinetics 0.00 NA 5.63 0.25 NA 5.88 XXX 78191 A Platelet survival 0.61 NA 7.45 0.34 NA 8.40 XXX Start Printed Page 40497 78191 26 A Platelet survival 0.61 0.22 0.22 0.03 0.86 0.86 XXX 78191 TC A Platelet survival 0.00 NA 7.23 0.31 NA 7.54 XXX 78195 A Lymph system imaging 1.20 NA 4.45 0.23 NA 5.88 XXX 78195 26 A Lymph system imaging 1.20 0.44 0.44 0.05 1.69 1.69 XXX 78195 TC A Lymph system imaging 0.00 NA 4.01 0.18 NA 4.19 XXX 78199 C Blood/lymph nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78199 26 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 TC C Blood/lymph nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78201 A Liver imaging 0.44 NA 2.48 0.13 NA 3.05 XXX 78201 26 A Liver imaging 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78201 TC A Liver imaging 0.00 NA 2.32 0.11 NA 2.43 XXX 78202 A Liver imaging with flow 0.51 NA 3.03 0.14 NA 3.68 XXX 78202 26 A Liver imaging with flow 0.51 0.19 0.19 0.02 0.72 0.72 XXX 78202 TC A Liver imaging with flow 0.00 NA 2.84 0.12 NA 2.96 XXX 78205 A Liver imaging (3D) 0.71 NA 6.08 0.29 NA 7.08 XXX 78205 26 A Liver imaging (3D) 0.71 0.26 0.26 0.03 1.00 1.00 XXX 78205 TC A Liver imaging (3D) 0.00 NA 5.82 0.26 NA 6.08 XXX 78206 A Liver image (3d) w/flow 0.96 NA 6.17 0.13 NA 7.26 XXX 78206 26 A Liver image (3d) w/flow 0.96 0.35 0.35 0.04 1.35 1.35 XXX 78206 TC A Liver image (3d) w/flow 0.00 NA 5.82 0.09 NA 5.91 XXX 78215 A Liver and spleen imaging 0.49 NA 3.06 0.14 NA 3.69 XXX 78215 26 A Liver and spleen imaging 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78215 TC A Liver and spleen imaging 0.00 NA 2.89 0.12 NA 3.01 XXX 78216 A Liver & spleen image/flow 0.57 NA 3.63 0.17 NA 4.37 XXX 78216 26 A Liver & spleen image/flow 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78216 TC A Liver & spleen image/flow 0.00 NA 3.43 0.15 NA 3.58 XXX 78220 A Liver function study 0.49 NA 3.84 0.18 NA 4.51 XXX 78220 26 A Liver function study 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78220 TC A Liver function study 0.00 NA 3.67 0.16 NA 3.83 XXX 78223 A Hepatobiliary imaging 0.84 NA 3.91 0.20 NA 4.95 XXX 78223 26 A Hepatobiliary imaging 0.84 0.30 0.30 0.04 1.18 1.18 XXX 78223 TC A Hepatobiliary imaging 0.00 NA 3.61 0.16 NA 3.77 XXX 78230 A Salivary gland imaging 0.45 NA 2.30 0.13 NA 2.88 XXX 78230 26 A Salivary gland imaging 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78230 TC A Salivary gland imaging 0.00 NA 2.14 0.11 NA 2.25 XXX 78231 A Serial salivary imaging 0.52 NA 3.32 0.16 NA 4.00 XXX 78231 26 A Serial salivary imaging 0.52 0.20 0.20 0.02 0.74 0.74 XXX 78231 TC A Serial salivary imaging 0.00 NA 3.12 0.14 NA 3.26 XXX 78232 A Salivary gland function exam 0.47 NA 3.66 0.16 NA 4.29 XXX 78232 26 A Salivary gland function exam 0.47 0.18 0.18 0.01 0.66 0.66 XXX 78232 TC A Salivary gland function exam 0.00 NA 3.48 0.15 NA 3.63 XXX 78258 A Esophageal motility study 0.74 NA 3.10 0.15 NA 3.99 XXX 78258 26 A Esophageal motility study 0.74 0.26 0.26 0.03 1.03 1.03 XXX 78258 TC A Esophageal motility study 0.00 NA 2.84 0.12 NA 2.96 XXX 78261 A Gastric mucosa imaging 0.69 NA 4.30 0.21 NA 5.20 XXX 78261 26 A Gastric mucosa imaging 0.69 0.26 0.26 0.03 0.98 0.98 XXX 78261 TC A Gastric mucosa imaging 0.00 NA 4.04 0.18 NA 4.22 XXX 78262 A Gastroesophageal reflux exam 0.68 NA 4.44 0.21 NA 5.33 XXX 78262 26 A Gastroesophageal reflux exam 0.68 0.25 0.25 0.03 0.96 0.96 XXX 78262 TC A Gastroesophageal reflux exam 0.00 NA 4.19 0.18 NA 4.37 XXX 78264 A Gastric emptying study 0.78 NA 4.35 0.21 NA 5.34 XXX 78264 26 A Gastric emptying study 0.78 0.28 0.28 0.03 1.09 1.09 XXX 78264 TC A Gastric emptying study 0.00 NA 4.07 0.18 NA 4.25 XXX 78267 X Breath tst attain/anal c-14 0.00 NA 0.00 0.00 NA 0.00 XXX 78268 X Breath test analysis, c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78270 A Vit B-12 absorption exam 0.20 NA 1.59 0.09 NA 1.88 XXX 78270 26 A Vit B-12 absorption exam 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78270 TC A Vit B-12 absorption exam 0.00 NA 1.52 0.08 NA 1.60 XXX 78271 A Vit B-12 absorp exam, IF 0.20 NA 1.69 0.09 NA 1.98 XXX 78271 26 A Vit B-12 absorp exam, IF 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78271 TC A Vit B-12 absorp exam, IF 0.00 NA 1.62 0.08 NA 1.70 XXX 78272 A Vit B-12 absorp, combined 0.27 NA 2.39 0.12 NA 2.78 XXX 78272 26 A Vit B-12 absorp, combined 0.27 0.10 0.10 0.01 0.38 0.38 XXX 78272 TC A Vit B-12 absorp, combined 0.00 NA 2.29 0.11 NA 2.40 XXX 78278 A Acute GI blood loss imaging 0.99 NA 5.15 0.25 NA 6.39 XXX 78278 26 A Acute GI blood loss imaging 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78278 TC A Acute GI blood loss imaging 0.00 NA 4.80 0.21 NA 5.01 XXX 78282 C GI protein loss exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78282 26 A GI protein loss exam 0.38 0.14 0.14 0.02 0.54 0.54 XXX 78282 TC C GI protein loss exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78290 A Meckel's divert exam 0.68 NA 3.24 0.16 NA 4.08 XXX 78290 26 A Meckel's divert exam 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78290 TC A Meckel's divert exam 0.00 NA 3.00 0.13 NA 3.13 XXX 78291 A Leveen/shunt patency exam 0.88 NA 3.34 0.17 NA 4.39 XXX Start Printed Page 40498 78291 26 A Leveen/shunt patency exam 0.88 0.32 0.32 0.04 1.24 1.24 XXX 78291 TC A Leveen/shunt patency exam 0.00 NA 3.02 0.13 NA 3.15 XXX 78299 C GI nuclear procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 78299 26 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 TC C GI nuclear procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 78300 A Bone imaging, limited area 0.62 NA 2.67 0.15 NA 3.44 XXX 78300 26 A Bone imaging, limited area 0.62 0.22 0.22 0.03 0.87 0.87 XXX 78300 TC A Bone imaging, limited area 0.00 NA 2.45 0.12 NA 2.57 XXX 78305 A Bone imaging, multiple areas 0.83 NA 3.90 0.19 NA 4.92 XXX 78305 26 A Bone imaging, multiple areas 0.83 0.29 0.29 0.03 1.15 1.15 XXX 78305 TC A Bone imaging, multiple areas 0.00 NA 3.61 0.16 NA 3.77 XXX 78306 A Bone imaging, whole body 0.86 NA 4.52 0.22 NA 5.60 XXX 78306 26 A Bone imaging, whole body 0.86 0.31 0.31 0.04 1.21 1.21 XXX 78306 TC A Bone imaging, whole body 0.00 NA 4.21 0.18 NA 4.39 XXX 78315 A Bone imaging, 3 phase 1.02 NA 5.07 0.25 NA 6.34 XXX 78315 26 A Bone imaging, 3 phase 1.02 0.37 0.37 0.04 1.43 1.43 XXX 78315 TC A Bone imaging, 3 phase 0.00 NA 4.70 0.21 NA 4.91 XXX 78320 A Bone imaging (3D) 1.04 NA 6.20 0.30 NA 7.54 XXX 78320 26 A Bone imaging (3D) 1.04 0.38 0.38 0.04 1.46 1.46 XXX 78320 TC A Bone imaging (3D) 0.00 NA 5.82 0.26 NA 6.08 XXX 78350 A Bone mineral, single photon 0.22 NA 0.82 0.05 NA 1.09 XXX 78350 26 A Bone mineral, single photon 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78350 TC A Bone mineral, single photon 0.00 NA 0.74 0.04 NA 0.78 XXX 78351 N Bone mineral, dual photon +0.30 0.12 1.60 0.01 0.43 1.91 XXX 78399 C Musculoskeletal nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78399 26 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 TC C Musculoskeletal nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78414 C Non-imaging heart function 0.00 NA 0.00 0.00 NA 0.00 XXX 78414 26 A Non-imaging heart function 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78414 TC C Non-imaging heart function 0.00 NA 0.00 0.00 NA 0.00 XXX 78428 A Cardiac shunt imaging 0.78 NA 2.53 0.14 NA 3.45 XXX 78428 26 A Cardiac shunt imaging 0.78 0.31 0.31 0.03 1.12 1.12 XXX 78428 TC A Cardiac shunt imaging 0.00 NA 2.22 0.11 NA 2.33 XXX 78445 A Vascular flow imaging 0.49 NA 2.01 0.11 NA 2.61 XXX 78445 26 A Vascular flow imaging 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78445 TC A Vascular flow imaging 0.00 NA 1.83 0.09 NA 1.92 XXX 78455 A Venous thrombosis study 0.73 NA 4.18 0.20 NA 5.11 XXX 78455 26 A Venous thrombosis study 0.73 0.26 0.26 0.03 1.02 1.02 XXX 78455 TC A Venous thrombosis study 0.00 NA 3.92 0.17 NA 4.09 XXX 78456 A Acute venous thrombus image 1.00 NA 4.29 0.28 NA 5.57 XXX 78456 26 A Acute venous thrombus image 1.00 0.37 0.37 0.04 1.41 1.41 XXX 78456 TC A Acute venous thrombus image 0.00 NA 3.92 0.24 NA 4.16 XXX 78457 A Venous thrombosis imaging 0.77 NA 2.90 0.15 NA 3.82 XXX 78457 26 A Venous thrombosis imaging 0.77 0.28 0.28 0.03 1.08 1.08 XXX 78457 TC A Venous thrombosis imaging 0.00 NA 2.62 0.12 NA 2.74 XXX 78458 A Ven thrombosis images, bilat 0.90 NA 4.30 0.20 NA 5.40 XXX 78458 26 A Ven thrombosis images, bilat 0.90 0.34 0.34 0.03 1.27 1.27 XXX 78458 TC A Ven thrombosis images, bilat 0.00 NA 3.96 0.17 NA 4.13 XXX 78459 I Heart muscle imaging (PET) 0.00 0.74 0.74 0.00 0.74 0.74 XXX 78459 26 I Heart muscle imaging (PET) 1.88 0.74 0.74 0.08 2.70 2.70 XXX 78459 TC I Heart muscle imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78460 A Heart muscle blood, single 0.86 NA 2.63 0.14 NA 3.63 XXX 78460 26 A Heart muscle blood, single 0.86 0.31 0.31 0.03 1.20 1.20 XXX 78460 TC A Heart muscle blood, single 0.00 NA 2.32 0.11 NA 2.43 XXX 78461 A Heart muscle blood, multiple 1.23 NA 5.11 0.26 NA 6.60 XXX 78461 26 A Heart muscle blood, multiple 1.23 0.46 0.46 0.05 1.74 1.74 XXX 78461 TC A Heart muscle blood, multiple 0.00 NA 4.65 0.21 NA 4.86 XXX 78464 A Heart image (3d), single 1.09 NA 7.36 0.35 NA 8.80 XXX 78464 26 A Heart image (3d), single 1.09 0.40 0.40 0.04 1.53 1.53 XXX 78464 TC A Heart image (3d), single 0.00 NA 6.96 0.31 NA 7.27 XXX 78465 A Heart image (3d), multiple 1.46 NA 12.17 0.56 NA 14.19 XXX 78465 26 A Heart image (3d), multiple 1.46 0.55 0.55 0.05 2.06 2.06 XXX 78465 TC A Heart image (3d), multiple 0.00 NA 11.62 0.51 NA 12.13 XXX 78466 A Heart infarct image 0.69 NA 2.84 0.15 NA 3.68 XXX 78466 26 A Heart infarct image 0.69 0.26 0.26 0.03 0.98 0.98 XXX 78466 TC A Heart infarct image 0.00 NA 2.58 0.12 NA 2.70 XXX 78468 A Heart infarct image (ef) 0.80 NA 3.90 0.19 NA 4.89 XXX 78468 26 A Heart infarct image (ef) 0.80 0.29 0.29 0.03 1.12 1.12 XXX 78468 TC A Heart infarct image (ef) 0.00 NA 3.61 0.16 NA 3.77 XXX 78469 A Heart infarct image (3D) 0.92 NA 5.47 0.26 NA 6.65 XXX 78469 26 A Heart infarct image (3D) 0.92 0.33 0.33 0.03 1.28 1.28 XXX 78469 TC A Heart infarct image (3D) 0.00 NA 5.14 0.23 NA 5.37 XXX 78472 A Gated heart, planar, single 0.98 NA 5.79 0.29 NA 7.06 XXX 78472 26 A Gated heart, planar, single 0.98 0.36 0.36 0.04 1.38 1.38 XXX Start Printed Page 40499 78472 TC A Gated heart, planar, single 0.00 NA 5.43 0.25 NA 5.68 XXX 78473 A Gated heart, multiple 1.47 NA 8.67 0.40 NA 10.54 XXX 78473 26 A Gated heart, multiple 1.47 0.54 0.54 0.05 2.06 2.06 XXX 78473 TC A Gated heart, multiple 0.00 NA 8.13 0.35 NA 8.48 XXX 78478 A Heart wall motion add-on 0.62 NA 1.77 0.10 NA 2.49 ZZZ 78478 26 A Heart wall motion add-on 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ 78478 TC A Heart wall motion add-on 0.00 NA 1.53 0.08 NA 1.61 ZZZ 78480 A Heart function add-on 0.62 NA 1.77 0.10 NA 2.49 ZZZ 78480 26 A Heart function add-on 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ 78480 TC A Heart function add-on 0.00 NA 1.53 0.08 NA 1.61 ZZZ 78481 A Heart first pass, single 0.98 NA 5.52 0.26 NA 6.76 XXX 78481 26 A Heart first pass, single 0.98 0.38 0.38 0.03 1.39 1.39 XXX 78481 TC A Heart first pass, single 0.00 NA 5.14 0.23 NA 5.37 XXX 78483 A Heart first pass, multiple 1.47 NA 8.32 0.39 NA 10.18 XXX 78483 26 A Heart first pass, multiple 1.47 0.57 0.57 0.05 2.09 2.09 XXX 78483 TC A Heart first pass, multiple 0.00 NA 7.75 0.34 NA 8.09 XXX 78491 I Heart image (pet), single 0.00 NA 0.59 0.00 NA 0.59 XXX 78491 26 I Heart image (pet), single 1.50 0.59 0.59 0.05 2.14 2.14 XXX 78491 TC I Heart image (pet), single 0.00 NA 0.00 0.00 NA 0.00 XXX 78492 I Heart image (pet), multiple +0.00 NA 0.74 0.00 NA 0.74 XXX 78492 26 I Heart image (pet), multiple +1.87 0.74 0.74 0.06 2.67 2.67 XXX 78492 TC I Heart image (pet), multiple 0.00 NA 0.00 0.00 NA 0.00 XXX 78494 A Heart image, spect 1.19 NA 7.40 0.29 NA 8.88 XXX 78494 26 A Heart image, spect 1.19 0.44 0.44 0.04 1.67 1.67 XXX 78494 TC A Heart image, spect 0.00 NA 6.96 0.25 NA 7.21 XXX 78496 A Heart first pass add-on 0.50 NA 7.15 0.27 NA 7.92 ZZZ 78496 26 A Heart first pass add-on 0.50 0.19 0.19 0.02 0.71 0.71 ZZZ 78496 TC A Heart first pass add-on 0.00 NA 6.96 0.25 NA 7.21 ZZZ 78499 C Cardiovascular nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78499 26 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 TC C Cardiovascular nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78580 A Lung perfusion imaging 0.74 NA 3.65 0.18 NA 4.57 XXX 78580 26 A Lung perfusion imaging 0.74 0.27 0.27 0.03 1.04 1.04 XXX 78580 TC A Lung perfusion imaging 0.00 NA 3.38 0.15 NA 3.53 XXX 78584 A Lung V/Q image single breath 0.99 NA 3.50 0.18 NA 4.67 XXX 78584 26 A Lung V/Q image single breath 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78584 TC A Lung V/Q image single breath 0.00 NA 3.15 0.14 NA 3.29 XXX 78585 A Lung V/Q imaging 1.09 NA 5.94 0.30 NA 7.33 XXX 78585 26 A Lung V/Q imaging 1.09 0.39 0.39 0.05 1.53 1.53 XXX 78585 TC A Lung V/Q imaging 0.00 NA 5.55 0.25 NA 5.80 XXX 78586 A Aerosol lung image, single 0.40 NA 2.69 0.14 NA 3.23 XXX 78586 26 A Aerosol lung image, single 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78586 TC A Aerosol lung image, single 0.00 NA 2.55 0.12 NA 2.67 XXX 78587 A Aerosol lung image, multiple 0.49 NA 2.94 0.14 NA 3.57 XXX 78587 26 A Aerosol lung image, multiple 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78587 TC A Aerosol lung image, multiple 0.00 NA 2.76 0.12 NA 2.88 XXX 78588 A Perfusion lung image 1.09 NA 3.54 0.20 NA 4.83 XXX 78588 26 A Perfusion lung image 1.09 0.39 0.39 0.05 1.53 1.53 XXX 78588 TC A Perfusion lung image 0.00 NA 3.15 0.15 NA 3.30 XXX 78591 A Vent image, 1 breath, 1 proj 0.40 NA 2.95 0.14 NA 3.49 XXX 78591 26 A Vent image, 1 breath, 1 proj 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78591 TC A Vent image, 1 breath, 1 proj 0.00 NA 2.81 0.12 NA 2.93 XXX 78593 A Vent image, 1 proj, gas 0.49 NA 3.57 0.17 NA 4.23 XXX 78593 26 A Vent image, 1 proj, gas 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78593 TC A Vent image, 1 proj, gas 0.00 NA 3.40 0.15 NA 3.55 XXX 78594 A Vent image, mult proj, gas 0.53 NA 5.09 0.23 NA 5.85 XXX 78594 26 A Vent image, mult proj, gas 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78594 TC A Vent image, mult proj, gas 0.00 NA 4.90 0.21 NA 5.11 XXX 78596 A Lung differential function 1.27 NA 7.41 0.36 NA 9.04 XXX 78596 26 A Lung differential function 1.27 0.45 0.45 0.05 1.77 1.77 XXX 78596 TC A Lung differential function 0.00 NA 6.96 0.31 NA 7.27 XXX 78599 C Respiratory nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78599 26 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 TC C Respiratory nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78600 A Brain imaging, ltd static 0.44 NA 3.05 0.14 NA 3.63 XXX 78600 26 A Brain imaging, ltd static 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78600 TC A Brain imaging, ltd static 0.00 NA 2.89 0.12 NA 3.01 XXX 78601 A Brain imaging, ltd w/ flow 0.51 NA 3.53 0.17 NA 4.21 XXX 78601 26 A Brain imaging, ltd w/ flow 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78601 TC A Brain imaging, ltd w/ flow 0.00 NA 3.35 0.15 NA 3.50 XXX 78605 A Brain imaging, complete 0.53 NA 3.55 0.17 NA 4.25 XXX 78605 26 A Brain imaging, complete 0.53 0.20 0.20 0.02 0.75 0.75 XXX 78605 TC A Brain imaging, complete 0.00 NA 3.35 0.15 NA 3.50 XXX 78606 A Brain imaging, compl w/flow 0.64 NA 4.04 0.20 NA 4.88 XXX Start Printed Page 40500 78606 26 A Brain imaging, compl w/flow 0.64 0.23 0.23 0.03 0.90 0.90 XXX 78606 TC A Brain imaging, compl w/flow 0.00 NA 3.81 0.17 NA 3.98 XXX 78607 A Brain imaging (3D) 1.23 NA 6.92 0.34 NA 8.49 XXX 78607 26 A Brain imaging (3D) 1.23 0.46 0.46 0.05 1.74 1.74 XXX 78607 TC A Brain imaging (3D) 0.00 NA 6.46 0.29 NA 6.75 XXX 78608 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78609 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78610 A Brain flow imaging only 0.30 NA 1.66 0.09 NA 2.05 XXX 78610 26 A Brain flow imaging only 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78610 TC A Brain flow imaging only 0.00 NA 1.55 0.08 NA 1.63 XXX 78615 A Cerebral blood flow imaging 0.42 NA 3.95 0.19 NA 4.56 XXX 78615 26 A Cerebral blood flow imaging 0.42 0.16 0.16 0.02 0.60 0.60 XXX 78615 TC A Cerebral blood flow imaging 0.00 NA 3.79 0.17 NA 3.96 XXX 78630 A Cerebrospinal fluid scan 0.68 NA 5.20 0.25 NA 6.13 XXX 78630 26 A Cerebrospinal fluid scan 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78630 TC A Cerebrospinal fluid scan 0.00 NA 4.96 0.22 NA 5.18 XXX 78635 A CSF ventriculography 0.61 NA 2.74 0.14 NA 3.49 XXX 78635 26 A CSF ventriculography 0.61 0.24 0.24 0.02 0.87 0.87 XXX 78635 TC A CSF ventriculography 0.00 NA 2.50 0.12 NA 2.62 XXX 78645 A CSF shunt evaluation 0.57 NA 3.59 0.17 NA 4.33 XXX 78645 26 A CSF shunt evaluation 0.57 0.21 0.21 0.02 0.80 0.80 XXX 78645 TC A CSF shunt evaluation 0.00 NA 3.38 0.15 NA 3.53 XXX 78647 A Cerebrospinal fluid scan 0.90 NA 6.16 0.29 NA 7.35 XXX 78647 26 A Cerebrospinal fluid scan 0.90 0.34 0.34 0.03 1.27 1.27 XXX 78647 TC A Cerebrospinal fluid scan 0.00 NA 5.82 0.26 NA 6.08 XXX 78650 A CSF leakage imaging 0.61 NA 4.79 0.22 NA 5.62 XXX 78650 26 A CSF leakage imaging 0.61 0.22 0.22 0.02 0.85 0.85 XXX 78650 TC A CSF leakage imaging 0.00 NA 4.57 0.20 NA 4.77 XXX 78660 A Nuclear exam of tear flow 0.53 NA 2.28 0.12 NA 2.93 XXX 78660 26 A Nuclear exam of tear flow 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78660 TC A Nuclear exam of tear flow 0.00 NA 2.09 0.10 NA 2.19 XXX 78699 C Nervous system nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78699 26 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 TC C Nervous system nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78700 A Kidney imaging, static 0.45 NA 3.16 0.15 NA 3.76 XXX 78700 26 A Kidney imaging, static 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78700 TC A Kidney imaging, static 0.00 NA 3.00 0.13 NA 3.13 XXX 78701 A Kidney imaging with flow 0.49 NA 3.67 0.17 NA 4.33 XXX 78701 26 A Kidney imaging with flow 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78701 TC A Kidney imaging with flow 0.00 NA 3.50 0.15 NA 3.65 XXX 78704 A Imaging renogram 0.74 NA 4.15 0.20 NA 5.09 XXX 78704 26 A Imaging renogram 0.74 0.26 0.26 0.03 1.03 1.03 XXX 78704 TC A Imaging renogram 0.00 NA 3.89 0.17 NA 4.06 XXX 78707 A Kidney flow/function image 0.96 NA 4.75 0.23 NA 5.94 XXX 78707 26 A Kidney flow/function image 0.96 0.35 0.35 0.04 1.35 1.35 XXX 78707 TC A Kidney flow/function image 0.00 NA 4.40 0.19 NA 4.59 XXX 78708 A Kidney flow/function image 1.21 NA 4.84 0.24 NA 6.29 XXX 78708 26 A Kidney flow/function image 1.21 0.44 0.44 0.05 1.70 1.70 XXX 78708 TC A Kidney flow/function image 0.00 NA 4.40 0.19 NA 4.59 XXX 78709 A Kidney flow/function image 1.41 NA 4.90 0.25 NA 6.56 XXX 78709 26 A Kidney flow/function image 1.41 0.50 0.50 0.06 1.97 1.97 XXX 78709 TC A Kidney flow/function image 0.00 NA 4.40 0.19 NA 4.59 XXX 78710 A Kidney imaging (3D) 0.66 NA 6.05 0.29 NA 7.00 XXX 78710 26 A Kidney imaging (3D) 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78710 TC A Kidney imaging (3D) 0.00 NA 5.82 0.26 NA 6.08 XXX 78715 A Renal vascular flow exam 0.30 NA 1.66 0.09 NA 2.05 XXX 78715 26 A Renal vascular flow exam 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78715 TC A Renal vascular flow exam 0.00 NA 1.55 0.08 NA 1.63 XXX 78725 A Kidney function study 0.38 NA 1.89 0.10 NA 2.37 XXX 78725 26 A Kidney function study 0.38 0.14 0.14 0.01 0.53 0.53 XXX 78725 TC A Kidney function study 0.00 NA 1.75 0.09 NA 1.84 XXX 78730 A Urinary bladder retention 0.36 NA 1.57 0.09 NA 2.02 XXX 78730 26 A Urinary bladder retention 0.36 0.13 0.13 0.02 0.51 0.51 XXX 78730 TC A Urinary bladder retention 0.00 NA 1.44 0.07 NA 1.51 XXX 78740 A Ureteral reflux study 0.57 NA 2.29 0.12 NA 2.98 XXX 78740 26 A Ureteral reflux study 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78740 TC A Ureteral reflux study 0.00 NA 2.09 0.10 NA 2.19 XXX 78760 A Testicular imaging 0.66 NA 2.87 0.15 NA 3.68 XXX 78760 26 A Testicular imaging 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78760 TC A Testicular imaging 0.00 NA 2.64 0.12 NA 2.76 XXX 78761 A Testicular imaging/flow 0.71 NA 3.40 0.17 NA 4.28 XXX 78761 26 A Testicular imaging/flow 0.71 0.25 0.25 0.03 0.99 0.99 XXX 78761 TC A Testicular imaging/flow 0.00 NA 3.15 0.14 NA 3.29 XXX 78799 C Genitourinary nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX Start Printed Page 40501 78799 26 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 TC C Genitourinary nuclear exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78800 A Tumor imaging, limited area 0.66 NA 3.58 0.18 NA 4.42 XXX 78800 26 A Tumor imaging, limited area 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78800 TC A Tumor imaging, limited area 0.00 NA 3.35 0.15 NA 3.50 XXX 78801 A Tumor imaging, mult areas 0.79 NA 4.44 0.21 NA 5.44 XXX 78801 26 A Tumor imaging, mult areas 0.79 0.28 0.28 0.03 1.10 1.10 XXX 78801 TC A Tumor imaging, mult areas 0.00 NA 4.16 0.18 NA 4.34 XXX 78802 A Tumor imaging, whole body 0.86 NA 5.76 0.28 NA 6.90 XXX 78802 26 A Tumor imaging, whole body 0.86 0.31 0.31 0.03 1.20 1.20 XXX 78802 TC A Tumor imaging, whole body 0.00 NA 5.45 0.25 NA 5.70 XXX 78803 A Tumor imaging (3D) 1.09 NA 6.87 0.33 NA 8.29 XXX 78803 26 A Tumor imaging (3D) 1.09 0.41 0.41 0.04 1.54 1.54 XXX 78803 TC A Tumor imaging (3D) 0.00 NA 6.46 0.29 NA 6.75 XXX 78805 A Abscess imaging, ltd area 0.73 NA 3.62 0.18 NA 4.53 XXX 78805 26 A Abscess imaging, ltd area 0.73 0.27 0.27 0.03 1.03 1.03 XXX 78805 TC A Abscess imaging, ltd area 0.00 NA 3.35 0.15 NA 3.50 XXX 78806 A Abscess imaging, whole body 0.86 NA 6.64 0.32 NA 7.82 XXX 78806 26 A Abscess imaging, whole body 0.86 0.31 0.31 0.03 1.20 1.20 XXX 78806 TC A Abscess imaging, whole body 0.00 NA 6.33 0.29 NA 6.62 XXX 78807 A Nuclear localization/abscess 1.09 NA 6.87 0.33 NA 8.29 XXX 78807 26 A Nuclear localization/abscess 1.09 0.41 0.41 0.04 1.54 1.54 XXX 78807 TC A Nuclear localization/abscess 0.00 NA 6.46 0.29 NA 6.75 XXX 78810 N Tumor imaging (PET) +0.00 NA 0.76 0.00 NA 0.76 XXX 78810 26 N Tumor imaging (PET) +1.93 0.76 0.76 0.09 2.78 2.78 XXX 78810 TC N Tumor imaging (PET) 0.00 NA 0.00 0.00 NA 0.00 XXX 78890 B Nuclear medicine data proc +0.05 NA 1.31 0.06 NA 1.42 XXX 78890 26 B Nuclear medicine data proc +0.05 0.02 0.02 0.01 0.08 0.08 XXX 78890 TC B Nuclear medicine data proc +0.00 NA 1.29 0.05 NA 1.34 XXX 78891 B Nuclear med data proc +0.10 NA 2.62 0.12 NA 2.84 XXX 78891 26 B Nuclear med data proc +0.10 0.04 0.04 0.01 0.15 0.15 XXX 78891 TC B Nuclear med data proc +0.00 NA 2.58 0.11 NA 2.69 XXX 78990 I Provide diag radionuclide(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 C Nuclear diagnostic exam 0.00 NA 0.00 0.00 NA 0.00 XXX 78999 26 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 TC C Nuclear diagnostic exam 0.00 NA 0.00 0.00 NA 0.00 XXX 79000 A Init hyperthyroid therapy 1.80 NA 3.22 0.19 NA 5.21 XXX 79000 26 A Init hyperthyroid therapy 1.80 0.64 0.64 0.07 2.51 2.51 XXX 79000 TC A Init hyperthyroid therapy 0.00 NA 2.58 0.12 NA 2.70 XXX 79001 A Repeat hyperthyroid therapy 1.05 NA 1.67 0.10 NA 2.82 XXX 79001 26 A Repeat hyperthyroid therapy 1.05 0.38 0.38 0.04 1.47 1.47 XXX 79001 TC A Repeat hyperthyroid therapy 0.00 NA 1.29 0.06 NA 1.35 XXX 79020 A Thyroid ablation 1.81 NA 3.22 0.19 NA 5.22 XXX 79020 26 A Thyroid ablation 1.81 0.64 0.64 0.07 2.52 2.52 XXX 79020 TC A Thyroid ablation 0.00 NA 2.58 0.12 NA 2.70 XXX 79030 A Thyroid ablation, carcinoma 2.10 NA 3.34 0.20 NA 5.64 XXX 79030 26 A Thyroid ablation, carcinoma 2.10 0.76 0.76 0.08 2.94 2.94 XXX 79030 TC A Thyroid ablation, carcinoma 0.00 NA 2.58 0.12 NA 2.70 XXX 79035 A Thyroid metastatic therapy 2.52 NA 3.52 0.21 NA 6.25 XXX 79035 26 A Thyroid metastatic therapy 2.52 0.94 0.94 0.09 3.55 3.55 XXX 79035 TC A Thyroid metastatic therapy 0.00 NA 2.58 0.12 NA 2.70 XXX 79100 A Hematopoetic nuclear therapy 1.32 NA 3.07 0.17 NA 4.56 XXX 79100 26 A Hematopoetic nuclear therapy 1.32 0.49 0.49 0.05 1.86 1.86 XXX 79100 TC A Hematopoetic nuclear therapy 0.00 NA 2.58 0.12 NA 2.70 XXX 79200 A Intracavitary nuclear trmt 1.99 NA 3.32 0.19 NA 5.50 XXX 79200 26 A Intracavitary nuclear trmt 1.99 0.74 0.74 0.07 2.80 2.80 XXX 79200 TC A Intracavitary nuclear trmt 0.00 NA 2.58 0.12 NA 2.70 XXX 79300 C Interstitial nuclear therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 79300 26 A Interstitial nuclear therapy 1.60 0.57 0.57 0.07 2.24 2.24 XXX 79300 TC C Interstitial nuclear therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 79400 A Nonhemato nuclear therapy 1.96 NA 3.30 0.20 NA 5.46 XXX 79400 26 A Nonhemato nuclear therapy 1.96 0.72 0.72 0.08 2.76 2.76 XXX 79400 TC A Nonhemato nuclear therapy 0.00 NA 2.58 0.12 NA 2.70 XXX 79420 C Intravascular nuclear ther 0.00 NA 0.00 0.00 NA 0.00 XXX 79420 26 A Intravascular nuclear ther 1.51 0.53 0.53 0.06 2.10 2.10 XXX 79420 TC C Intravascular nuclear ther 0.00 NA 0.00 0.00 NA 0.00 XXX 79440 A Nuclear joint therapy 1.99 NA 3.38 0.20 NA 5.57 XXX 79440 26 A Nuclear joint therapy 1.99 0.80 0.80 0.08 2.87 2.87 XXX 79440 TC A Nuclear joint therapy 0.00 NA 2.58 0.12 NA 2.70 XXX 79900 C Provide ther radiopharm(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 C Nuclear medicine therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 79999 26 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 TC C Nuclear medicine therapy 0.00 NA 0.00 0.00 NA 0.00 XXX 80048 X Basic metabolic panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40502 80050 N General health panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80051 X Electrolyte panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80053 X Comprehen metabolic panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80055 I Obstetric panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80061 X Lipid panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80069 X Renal function panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80072 X Arthritis panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80074 X Acute hepatitis panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80076 X Hepatic function panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80090 X Torch antibody panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80100 X Drug screen, qualitate/multi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80101 X Drug screen, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80102 X Drug confirmation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80103 X Drug analysis, tissue prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80150 X Assay of amikacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80152 X Assay of amitriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80154 X Assay of benzodiazepines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80156 X Assay, carbamazepine, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80157 X Assay, carbamazepine, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80158 X Assay of cyclosporine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80160 X Assay of desipramine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80162 X Assay of digoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80164 X Assay, dipropylacetic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80166 X Assay of doxepin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80168 X Assay of ethosuximide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80170 X Assay of gentamicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80172 X Assay of gold 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80173 X Assay of haloperidol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80174 X Assay of imipramine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80176 X Assay of lidocaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80178 X Assay of lithium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80182 X Assay of nortriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80184 X Assay of phenobarbital 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80185 X Assay of phenytoin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80186 X Assay of phenytoin, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80188 X Assay of primidone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80190 X Assay of procainamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80192 X Assay of procainamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80194 X Assay of quinidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80196 X Assay of salicylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80197 X Assay of tacrolimus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80198 X Assay of theophylline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80200 X Assay of tobramycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80201 X Assay of topiramate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80202 X Assay of vancomycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80299 X Quantitative assay, drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80400 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80402 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80406 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80408 X Aldosterone suppression eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80410 X Calcitonin stimul panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80412 X CRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80414 X Testosterone response 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80415 X Estradiol response panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80416 X Renin stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80417 X Renin stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80418 X Pituitary evaluation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80420 X Dexamethasone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80422 X Glucagon tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80424 X Glucagon tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80426 X Gonadotropin hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80428 X Growth hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80430 X Growth hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80432 X Insulin suppression panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80434 X Insulin tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80435 X Insulin tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80436 X Metyrapone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80438 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80439 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80440 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80500 A Lab pathology consultation 0.37 0.17 0.19 0.01 0.55 0.57 XXX 80502 A Lab pathology consultation 1.33 0.61 0.64 0.05 1.99 2.02 XXX 81000 X Urinalysis, nonauto w/scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81001 X Urinalysis, auto w/scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40503 81002 X Urinalysis nonauto w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81003 X Urinalysis, auto, w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81005 X Urinalysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81007 X Urine screen for bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81015 X Microscopic exam of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81020 X Urinalysis, glass test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81025 X Urine pregnancy test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81050 X Urinalysis, volume measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81099 X Urinalysis test procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82000 X Assay of blood acetaldehyde 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82003 X Assay of acetaminophen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82009 X Test for acetone/ketones 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82010 X Acetone assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82013 X Acetylcholinesterase assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82016 X Acylcarnitines, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82017 X Acylcarnitines, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82024 X Assay of acth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82030 X Assay of adp & amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82040 X Assay of serum albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82042 X Assay of urine albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82043 X Microalbumin, quantitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82044 X Microalbumin, semiquant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82055 X Assay of ethanol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82075 X Assay of breath ethanol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82085 X Assay of aldolase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82088 X Assay of aldosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82101 X Assay of urine alkaloids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82103 X Alpha-1-antitrypsin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82104 X Alpha-1-antitrypsin, pheno 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82105 X Alpha-fetoprotein, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82106 X Alpha-fetoprotein, amniotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82108 X Assay of aluminum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82120 X Amines, vaginal fluid qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82127 X Amino acid, single qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82128 X Amino acids, mult qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82131 X Amino acids, single quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82135 X Assay, aminolevulinic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82136 X Amino acids, quant, 2-5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82139 X Amino acids, quan, 6 or more 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82140 X Assay of ammonia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82143 X Amniotic fluid scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82145 X Assay of amphetamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82150 X Assay of amylase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82154 X Androstanediol glucuronide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82157 X Assay of androstenedione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82160 X Assay of androsterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82163 X Assay of angiotensin II 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82164 X Angiotensin I enzyme test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82172 X Assay of apolipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82175 X Assay of arsenic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82180 X Assay of ascorbic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82190 X Atomic absorption 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82205 X Assay of barbiturates 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82232 X Assay of beta-2 protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82239 X Bile acids, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82240 X Bile acids, cholylglycine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82247 X Bilirubin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82248 X Bilirubin, direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82252 X Fecal bilirubin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82261 X Assay of biotinidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82270 X Test for blood, feces 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82273 X Test for blood, other source 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82286 X Assay of bradykinin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82300 X Assay of cadmium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82306 X Assay of vitamin D 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82307 X Assay of vitamin D 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82308 X Assay of calcitonin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82310 X Assay of calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82330 X Assay of calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82331 X Calcium infusion test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82340 X Assay of calcium in urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82355 X Calculus (stone) analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82360 X Calculus (stone) assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82365 X Calculus (stone) assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40504 82370 X X-ray assay, calculus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82373 X Assay, c-d transfer measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82374 X Assay, blood carbon dioxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82375 X Assay, blood carbon monoxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82376 X Test for carbon monoxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82378 X Carcinoembryonic antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82379 X Assay of carnitine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82380 X Assay of carotene 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82382 X Assay, urine catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82383 X Assay, blood catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82384 X Assay, three catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82387 X Assay of cathepsin-d 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82390 X Assay of ceruloplasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82397 X Chemiluminescent assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82415 X Assay of chloramphenicol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82435 X Assay of blood chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82436 X Assay of urine chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82438 X Assay, other fluid chlorides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82441 X Test for chlorohydrocarbons 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82465 X Assay, bld/serum cholesterol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82480 X Assay, serum cholinesterase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82482 X Assay, rbc cholinesterase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82485 X Assay, chondroitin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82486 X Gas/liquid chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82487 X Paper chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82488 X Paper chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82489 X Thin layer chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82491 X Chromotography, quant, sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82492 X Chromotography, quant, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82495 X Assay of chromium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82507 X Assay of citrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82520 X Assay of cocaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82523 X Collagen crosslinks 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82525 X Assay of copper 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82528 X Assay of corticosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82530 X Cortisol, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82533 X Total cortisol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82540 X Assay of creatine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82541 X Column chromotography, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82542 X Column chromotography, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82543 X Column chromotograph/isotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82544 X Column chromotograph/isotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82550 X Assay of ck (cpk) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82552 X Assay of cpk in blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82553 X Creatine, MB fraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82554 X Creatine, isoforms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82565 X Assay of creatinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82570 X Assay of urine creatinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82575 X Creatinine clearance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82585 X Assay of cryofibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82595 X Assay of cryoglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82600 X Assay of cyanide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82607 X Vitamin B-12 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82608 X B-12 binding capacity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82615 X Test for urine cystines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82626 X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82627 X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82633 X Desoxycorticosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82634 X Deoxycortisol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82638 X Assay of dibucaine number 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82646 X Assay of dihydrocodeinone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82649 X Assay of dihydromorphinone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82651 X Assay of dihydrotestosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82652 X Assay of dihydroxyvitamin d 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82654 X Assay of dimethadione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82657 X Enzyme cell activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82658 X Enzyme cell activity, ra 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82664 X Electrophoretic test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82666 X Assay of epiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82668 X Assay of erythropoietin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82670 X Assay of estradiol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82671 X Assay of estrogens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82672 X Assay of estrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82677 X Assay of estriol 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40505 82679 X Assay of estrone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82690 X Assay of ethchlorvynol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82693 X Assay of ethylene glycol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82696 X Assay of etiocholanolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82705 X Fats/lipids, feces, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82710 X Fats/lipids, feces, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82715 X Assay of fecal fat 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82725 X Assay of blood fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82726 X Long chain fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82728 X Assay of ferritin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82731 X Assay of fetal fibronectin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82735 X Assay of fluoride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82742 X Assay of flurazepam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82746 X Blood folic acid serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82747 X Assay of folic acid, rbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82757 X Assay of semen fructose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82759 X Assay of rbc galactokinase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82760 X Assay of galactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82775 X Assay galactose transferase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82776 X Galactose transferase test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82784 X Assay of gammaglobulin igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82785 X Assay of gammaglobulin ige 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82787 X Igg 1, 2, 3 or 4, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82800 X Blood pH 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82803 X Blood gases: pH, pO2 & pCO2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82805 X Blood gases W/02 saturation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82810 X Blood gases, O2 sat only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82820 X Hemoglobin-oxygen affinity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82926 X Assay of gastric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82928 X Assay of gastric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82938 X Gastrin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82941 X Assay of gastrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82943 X Assay of glucagon 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82945 X Glucose other fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82946 X Glucagon tolerance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82947 X Assay, glucose, blood quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82948 X Reagent strip/blood glucose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82950 X Glucose test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82951 X Glucose tolerance test (GTT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82952 X GTT-added samples 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82953 X Glucose-tolbutamide test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82955 X Assay of g6pd enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82960 X Test for G6PD enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82962 X Glucose blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82963 X Assay of glucosidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82965 X Assay of gdh enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82975 X Assay of glutamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82977 X Assay of GGT 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82978 X Assay of glutathione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82979 X Assay, rbc glutathione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82980 X Assay of glutethimide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82985 X Glycated protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83001 X Gonadotropin (FSH) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83002 X Gonadotropin (LH) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83003 X Assay, growth hormone (hgh) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83008 X Assay of guanosine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83010 X Assay of haptoglobin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83012 X Assay of haptoglobins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83013 X H pylori analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83014 X H pylori drug admin/collect 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83015 X Heavy metal screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83018 X Quantitative screen, metals 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83020 X Hemoglobin electrophoresis +0.00 0.16 0.16 0.00 0.16 0.16 XXX 83020 26 A Hemoglobin electrophoresis 0.37 0.16 0.16 0.01 0.54 0.54 XXX 83021 X Hemoglobin chromotography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83026 X Hemoglobin, copper sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83030 X Fetal hemoglobin, chemical 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83033 X Fetal hemoglobin assay, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83036 X Glycated hemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83045 X Blood methemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83050 X Blood methemoglobin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83051 X Assay of plasma hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83055 X Blood sulfhemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83060 X Blood sulfhemoglobin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40506 83065 X Assay of hemoglobin heat 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83068 X Hemoglobin stability screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83069 X Assay of urine hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83070 X Assay of hemosiderin, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83071 X Assay of hemosiderin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83080 X Assay of b hexosaminidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83088 X Assay of histamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83090 X Assay of homocystine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83150 X Assay of for hva 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83491 X Assay of corticosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83497 X Assay of 5-hiaa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83498 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83499 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83500 X Assay, free hydroxyproline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83505 X Assay, total hydroxyproline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83516 X Immunoassay, nonantibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83518 X Immunoassay, dipstick 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83519 X Immunoassay, nonantibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83520 X Immunoassay, RIA 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83525 X Assay of insulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83527 X Assay of insulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83528 X Assay of intrinsic factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83540 X Assay of iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83550 X Iron binding test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83570 X Assay of idh enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83582 X Assay of ketogenic steroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83586 X Assay 17- ketosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83593 X Fractionation, ketosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83605 X Assay of lactic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83615 X Lactate (LD) (LDH) enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83625 X Assay of ldh enzymes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83632 X Placental lactogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83633 X Test urine for lactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83634 X Assay of urine for lactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83655 X Assay of lead 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83661 X L/s ratio, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83662 X Foam stability, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83663 X Fluoro polarize, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83664 X Lamellar bdy, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83670 X Assay of lap enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83690 X Assay of lipase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83715 X Assay of blood lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83716 X Assay of blood lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83718 X Assay of lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83719 X Assay of blood lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83721 X Assay of blood lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83727 X Assay of lrh hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83735 X Assay of magnesium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83775 X Assay of md enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83785 X Assay of manganese 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83788 X Mass spectrometry qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83789 X Mass spectrometry quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83805 X Assay of meprobamate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83825 X Assay of mercury 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83835 X Assay of metanephrines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83840 X Assay of methadone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83857 X Assay of methemalbumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83858 X Assay of methsuximide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83864 X Mucopolysaccharides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83866 X Mucopolysaccharides screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83872 X Assay synovial fluid mucin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83873 X Assay of csf protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83874 X Assay of myoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83883 X Assay, nephelometry not spec 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83885 X Assay of nickel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83887 X Assay of nicotine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83890 X Molecule isolate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83891 X Molecule isolate nucleic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83892 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83893 X Molecule dot/slot/blot 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83894 X Molecule gel electrophor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83896 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83897 X Molecule nucleic transfer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83898 X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40507 83901 X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83902 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83903 X Molecule mutation scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83904 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83905 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83906 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83912 X Genetic examination +0.00 0.16 0.16 0.00 0.16 0.16 XXX 83912 26 A Genetic examination 0.37 0.16 0.16 0.01 0.54 0.54 XXX 83915 X Assay of nucleotidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83916 X Oligoclonal bands 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83918 X Organic acids, total, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83919 X Organic acids, qual, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83921 X Organic acid, single, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83925 X Assay of opiates 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83930 X Assay of blood osmolality 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83935 X Assay of urine osmolality 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83937 X Assay of osteocalcin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83945 X Assay of oxalate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83970 X Assay of parathormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83986 X Assay of body fluid acidity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83992 X Assay for phencyclidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84022 X Assay of phenothiazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84030 X Assay of blood pku 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84035 X Assay of phenylketones 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84060 X Assay acid phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84061 X Phosphatase, forensic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84066 X Assay prostate phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84075 X Assay alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84078 X Assay alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84080 X Assay alkaline phosphatases 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84081 X Amniotic fluid enzyme test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84085 X Assay of rbc pg6d enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84087 X Assay phosphohexose enzymes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84100 X Assay of phosphorus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84105 X Assay of urine phosphorus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84106 X Test for porphobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84110 X Assay of porphobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84119 X Test urine for porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84120 X Assay of urine porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84126 X Assay of feces porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84127 X Assay of feces porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84132 X Assay of serum potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84133 X Assay of urine potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84134 X Assay of prealbumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84135 X Assay of pregnanediol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84138 X Assay of pregnanetriol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84140 X Assay of pregnenolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84143 X Assay of 17-hydroxypregneno 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84144 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84146 X Assay of prolactin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84150 X Assay of prostaglandin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84152 X Assay of psa, complexed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84153 X Assay of psa, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84154 X Assay of psa, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84155 X Assay of protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84160 X Assay of serum protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84165 X Assay of serum proteins +0.00 0.17 0.17 0.00 0.17 0.17 XXX 84165 26 A Assay of serum proteins 0.37 0.17 0.17 0.01 0.55 0.55 XXX 84181 X Western blot test +0.00 0.15 0.15 0.00 0.15 0.15 XXX 84181 26 A Western blot test 0.37 0.15 0.15 0.01 0.53 0.53 XXX 84182 X Protein, western blot test +0.00 0.17 0.17 0.00 0.17 0.17 XXX 84182 26 A Protein, western blot test 0.37 0.17 0.17 0.01 0.55 0.55 XXX 84202 X Assay RBC protoporphyrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84203 X Test RBC protoporphyrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84206 X Assay of proinsulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84207 X Assay of vitamin b-6 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84210 X Assay of pyruvate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84220 X Assay of pyruvate kinase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84228 X Assay of quinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84233 X Assay of estrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84234 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84235 X Assay of endocrine hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84238 X Assay, nonendocrine receptor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84244 X Assay of renin 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40508 84252 X Assay of vitamin b-2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84255 X Assay of selenium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84260 X Assay of serotonin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84270 X Assay of sex hormone globul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84275 X Assay of sialic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84285 X Assay of silica 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84295 X Assay of serum sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84300 X Assay of urine sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84305 X Assay of somatomedin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84307 X Assay of somatostatin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84311 X Spectrophotometry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84315 X Body fluid specific gravity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84375 X Chromatogram assay, sugars 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84376 X Sugars, single, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84377 X Sugars, multiple, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84378 X Sugars single quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84379 X Sugars multiple quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84392 X Assay of urine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84402 X Assay of testosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84403 X Assay of total testosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84425 X Assay of vitamin b-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84430 X Assay of thiocyanate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84432 X Assay of thyroglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84436 X Assay of total thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84437 X Assay of neonatal thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84439 X Assay of free thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84442 X Assay of thyroid activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84443 X Assay thyroid stim hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84445 X Assay of tsi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84446 X Assay of vitamin e 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84449 X Assay of transcortin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84450 X Transferase (AST) (SGOT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84460 X Alanine amino (ALT) (SGPT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84466 X Assay of transferrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84478 X Assay of triglycerides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84479 X Assay of thyroid (t3 or t4) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84480 X Assay, triiodothyronine (t3) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84481 X Free assay (FT-3) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84482 X T3 reverse 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84484 X Assay of troponin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84485 X Assay duodenal fluid trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84488 X Test feces for trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84490 X Assay of feces for trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84510 X Assay of tyrosine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84512 X Assay of troponin, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84520 X Assay of urea nitrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84525 X Urea nitrogen semi-quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84540 X Assay of urine/urea-n 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84545 X Urea-N clearance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84550 X Assay of blood/uric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84560 X Assay of urine/uric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84577 X Assay of feces/urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84578 X Test urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84580 X Assay of urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84583 X Assay of urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84585 X Assay of urine vma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84586 X Assay of vip 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84588 X Assay of vasopressin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84590 X Assay of vitamin a 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84591 X Assay of nos vitamin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84597 X Assay of vitamin k 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84600 X Assay of volatiles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84620 X Xylose tolerance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84630 X Assay of zinc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84681 X Assay of c-peptide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84702 X Chorionic gonadotropin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84703 X Chorionic gonadotropin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84830 X Ovulation tests 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84999 X Clinical chemistry test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85002 X Bleeding time test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85007 X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85008 X Nondifferential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85009 X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85013 X Hematocrit 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40509 85014 X Hematocrit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85018 X Hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85021 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85022 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85023 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85024 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85025 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85027 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85031 X Manual hemogram, cbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85041 X Red blood cell (RBC) count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85044 X Reticulocyte count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85045 X Reticulocyte count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85046 X Reticyte/hgb concentrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85048 X White blood cell (WBC) count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85060 A Blood smear interpretation 0.45 0.20 0.20 0.02 0.67 0.67 XXX 85095 A Bone marrow aspiration 1.08 0.44 4.57 0.03 1.55 5.68 XXX 85097 A Bone marrow interpretation 0.94 0.42 1.81 0.03 1.39 2.78 XXX 85102 A Bone marrow biopsy 1.37 0.55 4.70 0.04 1.96 6.11 XXX 85130 X Chromogenic substrate assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85170 X Blood clot retraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85175 X Blood clot lysis time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85210 X Blood clot factor II test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85220 X Blood clot factor V test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85230 X Blood clot factor VII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85240 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85244 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85245 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85246 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85247 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85250 X Blood clot factor IX test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85260 X Blood clot factor X test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85270 X Blood clot factor XI test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85280 X Blood clot factor XII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85290 X Blood clot factor XIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85291 X Blood clot factor XIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85292 X Blood clot factor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85293 X Blood clot factor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85300 X Antithrombin III test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85301 X Antithrombin III test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85302 X Blood clot inhibitor antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85303 X Blood clot inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85305 X Blood clot inhibitor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85306 X Blood clot inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85307 X Assay activated protein c 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85335 X Factor inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85337 X Thrombomodulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85345 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85347 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85348 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85360 X Euglobulin lysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85362 X Fibrin degradation products 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85366 X Fibrinogen test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85370 X Fibrinogen test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85378 X Fibrin degradation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85379 X Fibrin degradation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85384 X Fibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85385 X Fibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85390 X Fibrinolysins screen +0.00 0.13 0.13 0.00 0.13 0.13 XXX 85390 26 A Fibrinolysins screen 0.37 0.13 0.13 0.01 0.51 0.51 XXX 85400 X Fibrinolytic plasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85410 X Fibrinolytic antiplasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85415 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85420 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85421 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85441 X Heinz bodies, direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85445 X Heinz bodies, induced 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85460 X Hemoglobin, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85461 X Hemoglobin, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85475 X Hemolysin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85520 X Heparin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85525 X Heparin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85530 X Heparin-protamine tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85535 X Iron stain, blood cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85536 X Iron stain peripheral blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40510 85540 X Wbc alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85547 X RBC mechanical fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85549 X Muramidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85555 X RBC osmotic fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85557 X RBC osmotic fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85576 X Blood platelet aggregation +0.00 0.16 0.16 0.00 0.16 0.16 XXX 85576 26 A Blood platelet aggregation 0.37 0.16 0.16 0.01 0.54 0.54 XXX 85585 X Blood platelet estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85590 X Platelet count, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85595 X Platelet count, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85597 X Platelet neutralization 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85610 X Prothrombin time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85611 X Prothrombin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85612 X Viper venom prothrombin time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85613 X Russell viper venom, diluted 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85635 X Reptilase test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85651 X Rbc sed rate, nonautomated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85652 X Rbc sed rate, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85660 X RBC sickle cell test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85670 X Thrombin time, plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85675 X Thrombin time, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85705 X Thromboplastin inhibition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85730 X Thromboplastin time, partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85732 X Thromboplastin time, partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85810 X Blood viscosity examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85999 X Hematology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86000 X Agglutinins, febrile 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86001 X Allergen specific igg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86003 X Allergen specific IgE 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86005 X Allergen specific IgE 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86021 X WBC antibody identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86022 X Platelet antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86023 X Immunoglobulin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86038 X Antinuclear antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86039 X Antinuclear antibodies (ANA) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86060 X Antistreptolysin o, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86063 X Antistreptolysin o, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86077 A Physician blood bank service 0.94 0.42 0.49 0.03 1.39 1.46 XXX 86078 A Physician blood bank service 0.94 0.43 0.52 0.03 1.40 1.49 XXX 86079 A Physician blood bank service 0.94 0.43 0.52 0.03 1.40 1.49 XXX 86140 X C-reactive protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86146 X Glycoprotein antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86147 X Cardiolipin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86148 X Phospholipid antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86155 X Chemotaxis assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86156 X Cold agglutinin, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86157 X Cold agglutinin, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86160 X Complement, antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86161 X Complement/function activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86162 X Complement, total (CH50) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86171 X Complement fixation, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86185 X Counterimmunoelectrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86215 X Deoxyribonuclease, antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86225 X DNA antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86226 X DNA antibody, single strand 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86235 X Nuclear antigen antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86243 X Fc receptor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86255 X Fluorescent antibody, screen +0.00 0.17 0.17 0.00 0.17 0.17 XXX 86255 26 A Fluorescent antibody, screen 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86256 X Fluorescent antibody, titer +0.00 0.17 0.17 0.00 0.17 0.17 XXX 86256 26 A Fluorescent antibody, titer 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86277 X Growth hormone antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86280 X Hemagglutination inhibition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86294 X Immunoassay, tumor qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86300 X Immunoassay, tumor ca 15-3 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86301 X Immunoassay, tumor, ca 19-9 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86304 X Immunoassay, tumor ca 125 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86308 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86309 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86310 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86316 X Immunoassay, tumor other 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86317 X Immunoassay,infectious agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86318 X Immunoassay,infectious agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86320 X Serum immunoelectrophoresis +0.00 0.16 0.17 0.00 0.16 0.17 XXX Start Printed Page 40511 86320 26 A Serum immunoelectrophoresis 0.37 0.16 0.17 0.01 0.54 0.55 XXX 86325 X Other immunoelectrophoresis +0.00 0.16 0.16 0.00 0.16 0.16 XXX 86325 26 A Other immunoelectrophoresis 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86327 X Immunoelectrophoresis assay +0.00 0.19 0.19 0.00 0.19 0.19 XXX 86327 26 A Immunoelectrophoresis assay 0.42 0.19 0.19 0.01 0.62 0.62 XXX 86329 X Immunodiffusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86331 X Immunodiffusion ouchterlony 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86332 X Immune complex assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86334 X Immunofixation procedure +0.00 0.17 0.17 0.00 0.17 0.17 XXX 86334 26 A Immunofixation procedure 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86337 X Insulin antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86340 X Intrinsic factor antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86341 X Islet cell antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86343 X Leukocyte histamine release 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86344 X Leukocyte phagocytosis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86353 X Lymphocyte transformation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86359 X T cells, total count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86360 X T cell, absolute count/ratio 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86361 X T cell, absolute count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86376 X Microsomal antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86378 X Migration inhibitory factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86382 X Neutralization test, viral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86384 X Nitroblue tetrazolium dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86403 X Particle agglutination test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86406 X Particle agglutination test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86430 X Rheumatoid factor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86431 X Rheumatoid factor, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86485 C Skin test, candida 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86490 A Coccidioidomycosis skin test 0.00 NA 0.29 0.02 NA 0.31 XXX 86510 A Histoplasmosis skin test 0.00 NA 0.31 0.02 NA 0.33 XXX 86580 A TB intradermal test 0.00 NA 0.25 0.02 NA 0.27 XXX 86585 A TB tine test 0.00 NA 0.20 0.01 NA 0.21 XXX 86586 C Skin test, unlisted 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86590 X Streptokinase, antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86592 X Blood serology, qualitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86593 X Blood serology, quantitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86602 X Antinomyces antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86603 X Adenovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86606 X Aspergillus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86609 X Bacterium antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86611 X Bartonella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86612 X Blastomyces antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86615 X Bordetella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86617 X Lyme disease antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86618 X Lyme disease antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86619 X Borrelia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86622 X Brucella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86625 X Campylobacter antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86628 X Candida antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86631 X Chlamydia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86632 X Chlamydia igm antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86635 X Coccidioides antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86638 X Q fever antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86641 X Cryptococcus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86644 X CMV antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86645 X CMV antibody, IgM 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86648 X Diphtheria antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86651 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86652 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86653 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86654 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86658 X Enterovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86663 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86664 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86665 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86666 X Ehrlichia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86668 X Francisella tularensis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86671 X Fungus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86674 X Giardia lamblia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86677 X Helicobacter pylori 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86682 X Helminth antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86683 X Hemoglobin, fecal antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86684 X Hemophilus influenza 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86687 X Htlv-i antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40512 86688 X Htlv-ii antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86689 X HTLV/HIV confirmatory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86692 X Hepatitis, delta agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86694 X Herpes simplex test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86695 X Herpes simplex test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86696 X Herpes simplex type 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86698 X Histoplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86701 X HIV-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86702 X HIV-2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86703 X HIV-1/HIV-2, single assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86704 X Hep b core antibody, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86705 X Hep b core antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86706 X Hep b surface antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86707 X Hep be antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86708 X Hep a antibody, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86709 X Hep a antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86710 X Influenza virus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86713 X Legionella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86717 X Leishmania antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86720 X Leptospira antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86723 X Listeria monocytogenes ab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86727 X Lymph choriomeningitis ab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86729 X Lympho venereum antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86732 X Mucormycosis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86735 X Mumps antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86738 X Mycoplasma antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86741 X Neisseria meningitidis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86744 X Nocardia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86747 X Parvovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86750 X Malaria antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86753 X Protozoa antibody nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86756 X Respiratory virus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86757 X Rickettsia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86759 X Rotavirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86762 X Rubella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86765 X Rubeola antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86768 X Salmonella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86771 X Shigella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86774 X Tetanus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86777 X Toxoplasma antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86778 X Toxoplasma antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86781 X Treponema pallidum, confirm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86784 X Trichinella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86787 X Varicella-zoster antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86790 X Virus antibody nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86793 X Yersinia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86800 X Thyroglobulin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86803 X Hepatitis c ab test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86804 X Hep c ab test, confirm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86805 X Lymphocytotoxicity assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86806 X Lymphocytotoxicity assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86807 X Cytotoxic antibody screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86808 X Cytotoxic antibody screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86812 X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86813 X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86816 X HLA typing, DR/DQ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86817 X HLA typing, DR/DQ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86821 X Lymphocyte culture, mixed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86822 X Lymphocyte culture, primed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86849 X Immunology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86850 X RBC antibody screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86860 X RBC antibody elution 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86870 X RBC antibody identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86880 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86885 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86886 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86890 X Autologous blood process 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86891 X Autologous blood, op salvage 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86900 X Blood typing, ABO 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86901 X Blood typing, Rh (D) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86903 X Blood typing, antigen screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86904 X Blood typing, patient serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86905 X Blood typing, RBC antigens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86906 X Blood typing, Rh phenotype 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40513 86910 N Blood typing, paternity test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86911 N Blood typing, antigen system 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86915 X Bone marrow/stem cell prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86920 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86921 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86922 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86927 X Plasma, fresh frozen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86930 X Frozen blood prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86931 X Frozen blood thaw 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86932 X Frozen blood freeze/thaw 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86940 X Hemolysins/agglutinins, auto 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86941 X Hemolysins/agglutinins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86945 X Blood product/irradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86950 X Leukacyte transfusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86965 X Pooling blood platelets 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86970 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86971 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86972 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86975 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86976 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86977 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86978 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86985 X Split blood or products 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86999 X Transfusion procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87001 X Small animal inoculation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87003 X Small animal inoculation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87015 X Specimen concentration 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87040 X Blood culture for bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87045 X Stool culture, bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87046 X Stool cultr, bacteria, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87070 X Culture, bacteria, other 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87071 X Culture bacteri aerobic othr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87073 X Culture bacteria anaerobic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87075 X Culture bacteria anaerobic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87076 X Culture anaerobe ident, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87077 X Culture aerobic identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87081 X Culture screen only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87084 X Culture of specimen by kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87086 X Urine culture/colony count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87088 X Urine bacteria culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87101 X Skin fungi culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87102 X Fungus isolation culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87103 X Blood fungus culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87106 X Fungi identification, yeast 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87107 X Fungi identification, mold 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87109 X Mycoplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87110 X Chlamydia culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87116 X Mycobacteria culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87118 X Mycobacteric identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87140 X Cultur type immunofluoresc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87143 X Culture typing, glc/hplc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87147 X Culture type, immunologic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87149 X Culture type, nucleic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87152 X Culture type pulse field gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87158 X Culture typing, added method 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87164 X Dark field examination +0.00 0.17 0.18 0.00 0.17 0.18 XXX 87164 26 A Dark field examination 0.37 0.17 0.18 0.01 0.55 0.56 XXX 87166 X Dark field examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87168 X Macroscopic exam arthropod 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87169 X Macacroscopic exam parasite 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87172 X Pinworm exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87176 X Tissue homogenization, cultr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87177 X Ova and parasites smears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87181 X Microbe susceptible, diffuse 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87184 X Microbe susceptible, disk 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87185 X Microbe susceptible, enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87186 X Microbe susceptible, mic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87187 X Microbe susceptible, mlc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87188 X Microbe suscept, macrobroth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87190 X Microbe suscept, mycobacteri 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87197 X Bactericidal level, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87205 X Smear, gram stain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87206 X Smear, fluorescent/acid stai 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87207 X Smear, special stain +0.00 0.17 0.17 0.00 0.17 0.17 XXX Start Printed Page 40514 87207 26 A Smear, special stain 0.37 0.17 0.17 0.01 0.55 0.55 XXX 87210 X Smear, wet mount, saline/ink 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87220 X Tissue exam for fungi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87230 X Assay, toxin or antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87250 X Virus inoculate, eggs/animal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87252 X Virus inoculation, tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87253 X Virus inoculate tissue, addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87254 X Virus inoculation, shell via 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87260 X Adenovirus ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87265 X Pertussis ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87270 X Chlamydia trachomatis ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87272 X Cryptosporidum/gardia ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87273 X Herpes simplex 2, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87274 X Herpes simplex 1, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87275 X Influenza b, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87276 X Influenza a, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87277 X Legionella micdadei, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87278 X Legion pneumophilia ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87279 X Parainfluenza, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87280 X Respiratory syncytial ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87281 X Pneumocystis carinii, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87283 X Rubeola, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87285 X Treponema pallidum, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87290 X Varicella zoster, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87299 X Antibody detection, nos, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87300 X Ag detection, polyval, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87301 X Adenovirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87320 X Chylmd trach ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87324 X Clostridium ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87327 X Cryptococcus neoform ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87328 X Cryptospor ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87332 X Cytomegalovirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87335 X E coli 0157 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87336 X Entamoeb hist dispr, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87337 X Entamoeb hist group, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87338 X Hpylori, stool, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87339 X Hpylori ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87340 X Hepatitis b surface ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87341 X Hepatitis b surface, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87350 X Hepatitis be ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87380 X Hepatitis delta ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87385 X Histoplasma capsul ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87390 X Hiv-1 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87391 X Hiv-2 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87400 X Influenza a/b, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87420 X Resp syncytial ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87425 X Rotavirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87427 X Shiga-like toxin ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87430 X Strep a ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87449 X Ag detect nos, eia, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87450 X Ag detect nos, eia, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87451 X Ag detect polyval, eia, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87470 X Bartonella, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87471 X Bartonella, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87472 X Bartonella, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87475 X Lyme dis, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87476 X Lyme dis, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87477 X Lyme dis, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87480 X Candida, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87481 X Candida, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87482 X Candida, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87485 X Chylmd pneum, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87486 X Chylmd pneum, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87487 X Chylmd pneum, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87490 X Chylmd trach, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87491 X Chylmd trach, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87492 X Chylmd trach, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87495 X Cytomeg, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87496 X Cytomeg, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87497 X Cytomeg, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87510 X Gardner vag, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87511 X Gardner vag, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87512 X Gardner vag, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87515 X Hepatitis b, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40515 87516 X Hepatitis b , dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87517 X Hepatitis b , dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87520 X Hepatitis c , rna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87521 X Hepatitis c , rna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87522 X Hepatitis c, rna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87525 X Hepatitis g , dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87526 X Hepatitis g, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87527 X Hepatitis g, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87528 X Hsv, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87529 X Hsv, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87530 X Hsv, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87531 X Hhv-6, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87532 X Hhv-6, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87533 X Hhv-6, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87534 X Hiv-1, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87535 X Hiv-1, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87536 X Hiv-1, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87537 X Hiv-2, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87538 X Hiv-2, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87539 X Hiv-2, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87540 X Legion pneumo, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87541 X Legion pneumo, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87542 X Legion pneumo, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87550 X Mycobacteria, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87551 X Mycobacteria, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87552 X Mycobacteria, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87555 X M.tuberculo, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87556 X M.tuberculo, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87557 X M.tuberculo, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87560 X M.avium-intra, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87561 X M.avium-intra, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87562 X M.avium-intra, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87580 X M.pneumon, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87581 X M.pneumon, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87582 X M.pneumon, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87590 X N.gonorrhoeae, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87591 X N.gonorrhoeae, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87592 X N.gonorrhoeae, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87620 X Hpv, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87621 X Hpv, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87622 X Hpv, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87650 X Strep a, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87651 X Strep a, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87652 X Strep a, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87797 X Detect agent nos, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87798 X Detect agent nos, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87799 X Detect agent nos, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87800 X Detect agnt mult, dna, direc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87801 X Detect agnt mult, dna, ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87810 X Chylmd trach assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87850 X N. gonorrhoeae assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87880 X Strep a assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87899 X Agent nos assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87901 X Genotype, dna, hiv reverse t 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87903 X Phenotype, dna hiv w/culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87904 X Phenotype, dna hiv w/clt add 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87999 X Microbiology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88000 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88005 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88007 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88012 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88014 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88016 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88020 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88025 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88027 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88028 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88029 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88036 N Limited autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88037 N Limited autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88040 N Forensic autopsy (necropsy) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88045 N Coroner's autopsy (necropsy) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88099 N Necropsy (autopsy) procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88104 A Cytopathology, fluids 0.56 NA 0.81 0.04 NA 1.41 XXX Start Printed Page 40516 88104 26 A Cytopathology, fluids 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88104 TC A Cytopathology, fluids 0.00 NA 0.55 0.02 NA 0.57 XXX 88106 A Cytopathology, fluids 0.56 NA 0.55 0.04 NA 1.15 XXX 88106 26 A Cytopathology, fluids 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88106 TC A Cytopathology, fluids 0.00 NA 0.29 0.02 NA 0.31 XXX 88107 A Cytopathology, fluids 0.76 NA 0.89 0.05 NA 1.70 XXX 88107 26 A Cytopathology, fluids 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88107 TC A Cytopathology, fluids 0.00 NA 0.54 0.02 NA 0.56 XXX 88108 A Cytopath, concentrate tech 0.56 NA 0.72 0.04 NA 1.32 XXX 88108 26 A Cytopath, concentrate tech 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88108 TC A Cytopath, concentrate tech 0.00 NA 0.46 0.02 NA 0.48 XXX 88125 A Forensic cytopathology 0.26 NA 0.33 0.02 NA 0.61 XXX 88125 26 A Forensic cytopathology 0.26 0.12 0.12 0.01 0.39 0.39 XXX 88125 TC A Forensic cytopathology 0.00 NA 0.21 0.01 NA 0.22 XXX 88130 X Sex chromatin identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88140 X Sex chromatin identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88141 A Cytopath, c/v, interpret 0.42 0.19 0.19 0.01 0.62 0.62 XXX 88142 X Cytopath, c/v, thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88143 X Cytopath c/v thin layer redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88144 X Cytopath, c/v thin lyr redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88145 X Cytopath, c/v thin lyr sel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88147 X Cytopath, c/v, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88148 X Cytopath, c/v, auto rescreen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88150 X Cytopath, c/v, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88152 X Cytopath, c/v, auto redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88153 X Cytopath, c/v, redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88154 X Cytopath, c/v, select 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88155 X Cytopath, c/v, index add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88160 A Cytopath smear, other source 0.50 NA 0.98 0.04 NA 1.52 XXX 88160 26 A Cytopath smear, other source 0.50 0.23 0.23 0.02 0.75 0.75 XXX 88160 TC A Cytopath smear, other source 0.00 NA 0.75 0.02 NA 0.77 XXX 88161 A Cytopath smear, other source 0.50 NA 0.99 0.04 NA 1.53 XXX 88161 26 A Cytopath smear, other source 0.50 0.23 0.23 0.02 0.75 0.75 XXX 88161 TC A Cytopath smear, other source 0.00 NA 0.76 0.02 NA 0.78 XXX 88162 A Cytopath smear, other source 0.76 NA 0.84 0.05 NA 1.65 XXX 88162 26 A Cytopath smear, other source 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88162 TC A Cytopath smear, other source 0.00 NA 0.49 0.02 NA 0.51 XXX 88164 X Cytopath tbs, c/v, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88165 X Cytopath tbs, c/v, redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88166 X Cytopath tbs, c/v, auto redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88167 X Cytopath tbs, c/v, select 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88170 A Fine needle aspiration 1.27 NA 0.89 0.10 NA 2.26 XXX 88170 26 A Fine needle aspiration 1.27 0.55 0.55 0.07 1.89 1.89 XXX 88170 TC A Fine needle aspiration 0.00 NA 0.34 0.03 NA 0.37 XXX 88171 A Fine needle aspiration 1.27 NA 0.73 0.08 NA 2.08 XXX 88171 26 A Fine needle aspiration 1.27 0.50 0.50 0.05 1.82 1.82 XXX 88171 TC A Fine needle aspiration 0.00 NA 0.23 0.03 NA 0.26 XXX 88172 A Cytopathology eval of fna 0.60 NA 1.12 0.04 NA 1.76 XXX 88172 26 A Cytopathology eval of fna 0.60 0.27 0.27 0.02 0.89 0.89 XXX 88172 TC A Cytopathology eval of fna 0.00 NA 0.85 0.02 NA 0.87 XXX 88173 A Cytopath eval, fna, report 1.39 NA 1.35 0.07 NA 2.81 XXX 88173 26 A Cytopath eval, fna, report 1.39 0.63 0.63 0.05 2.07 2.07 XXX 88173 TC A Cytopath eval, fna, report 0.00 NA 0.72 0.02 NA 0.74 XXX 88180 A Cell marker study 0.36 NA 0.67 0.03 NA 1.06 XXX 88180 26 A Cell marker study 0.36 0.16 0.16 0.01 0.53 0.53 XXX 88180 TC A Cell marker study 0.00 NA 0.51 0.02 NA 0.53 XXX 88182 A Cell marker study 0.77 NA 1.74 0.06 NA 2.57 XXX 88182 26 A Cell marker study 0.77 0.35 0.35 0.03 1.15 1.15 XXX 88182 TC A Cell marker study 0.00 NA 1.39 0.03 NA 1.42 XXX 88199 C Cytopathology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 88199 26 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 TC C Cytopathology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 88230 X Tissue culture, lymphocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88233 X Tissue culture, skin/biopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88235 X Tissue culture, placenta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88237 X Tissue culture, bone marrow 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88239 X Tissue culture, tumor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88240 X Cell cryopreserve/storage 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88241 X Frozen cell preparation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88245 X Chromosome analysis, 20-25 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88248 X Chromosome analysis, 50-100 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88249 X Chromosome analysis, 100 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88261 X Chromosome analysis, 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88262 X Chromosome analysis, 15-20 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40517 88263 X Chromosome analysis, 45 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88264 X Chromosome analysis, 20-25 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88267 X Chromosome analys, placenta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88269 X Chromosome analys, amniotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88271 X Cytogenetics, dna probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88272 X Cytogenetics, 3-5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88273 X Cytogenetics, 10-30 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88274 X Cytogenetics, 25-99 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88275 X Cytogenetics, 100-300 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88280 X Chromosome karyotype study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88283 X Chromosome banding study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88285 X Chromosome count, additional 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88289 X Chromosome study, additional 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88291 A Cyto/molecular report 0.52 0.23 0.23 0.02 0.77 0.77 XXX 88299 C Cytogenetic study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88300 A Surgical path, gross 0.08 NA 0.44 0.02 NA 0.54 XXX 88300 26 A Surgical path, gross 0.08 0.04 0.04 0.01 0.13 0.13 XXX 88300 TC A Surgical path, gross 0.00 NA 0.40 0.01 NA 0.41 XXX 88302 A Tissue exam by pathologist 0.13 NA 1.12 0.03 NA 1.28 XXX 88302 26 A Tissue exam by pathologist 0.13 0.06 0.06 0.01 0.20 0.20 XXX 88302 TC A Tissue exam by pathologist 0.00 NA 1.06 0.02 NA 1.08 XXX 88304 A Tissue exam by pathologist 0.22 NA 0.93 0.03 NA 1.18 XXX 88304 26 A Tissue exam by pathologist 0.22 0.10 0.10 0.01 0.33 0.33 XXX 88304 TC A Tissue exam by pathologist 0.00 NA 0.83 0.02 NA 0.85 XXX 88305 A Tissue exam by pathologist 0.75 NA 1.77 0.05 NA 2.57 XXX 88305 26 A Tissue exam by pathologist 0.75 0.35 0.35 0.02 1.12 1.12 XXX 88305 TC A Tissue exam by pathologist 0.00 NA 1.42 0.03 NA 1.45 XXX 88307 A Tissue exam by pathologist 1.59 NA 2.56 0.11 NA 4.26 XXX 88307 26 A Tissue exam by pathologist 1.59 0.73 0.73 0.06 2.38 2.38 XXX 88307 TC A Tissue exam by pathologist 0.00 NA 1.83 0.05 NA 1.88 XXX 88309 A Tissue exam by pathologist 2.28 NA 3.57 0.13 NA 5.98 XXX 88309 26 A Tissue exam by pathologist 2.28 1.04 1.04 0.08 3.40 3.40 XXX 88309 TC A Tissue exam by pathologist 0.00 NA 2.53 0.05 NA 2.58 XXX 88311 A Decalcify tissue 0.24 NA 0.19 0.02 NA 0.45 XXX 88311 26 A Decalcify tissue 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88311 TC A Decalcify tissue 0.00 NA 0.08 0.01 NA 0.09 XXX 88312 A Special stains 0.54 NA 1.69 0.03 NA 2.26 XXX 88312 26 A Special stains 0.54 0.25 0.25 0.02 0.81 0.81 XXX 88312 TC A Special stains 0.00 NA 1.44 0.01 NA 1.45 XXX 88313 A Special stains 0.24 NA 1.16 0.02 NA 1.42 XXX 88313 26 A Special stains 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88313 TC A Special stains 0.00 NA 1.05 0.01 NA 1.06 XXX 88314 A Histochemical stain 0.45 NA 1.05 0.04 NA 1.54 XXX 88314 26 A Histochemical stain 0.45 0.20 0.20 0.02 0.67 0.67 XXX 88314 TC A Histochemical stain 0.00 NA 0.85 0.02 NA 0.87 XXX 88318 A Chemical histochemistry 0.42 NA 1.78 0.02 NA 2.22 XXX 88318 26 A Chemical histochemistry 0.42 0.19 0.19 0.01 0.62 0.62 XXX 88318 TC A Chemical histochemistry 0.00 NA 1.59 0.01 NA 1.60 XXX 88319 A Enzyme histochemistry 0.53 NA 1.75 0.04 NA 2.32 XXX 88319 26 A Enzyme histochemistry 0.53 0.24 0.24 0.02 0.79 0.79 XXX 88319 TC A Enzyme histochemistry 0.00 NA 1.51 0.02 NA 1.53 XXX 88321 A Microslide consultation 1.30 0.59 0.62 0.04 1.93 1.96 XXX 88323 A Microslide consultation 1.35 NA 2.28 0.07 NA 3.70 XXX 88323 26 A Microslide consultation 1.35 0.62 0.62 0.05 2.02 2.02 XXX 88323 TC A Microslide consultation 0.00 NA 1.66 0.02 NA 1.68 XXX 88325 A Comprehensive review of data 2.22 0.96 0.96 0.08 3.26 3.26 XXX 88329 A Path consult introp 0.67 0.31 0.41 0.02 1.00 1.10 XXX 88331 A Path consult intraop, 1 bloc 1.19 NA 0.84 0.07 NA 2.10 XXX 88331 26 A Path consult intraop, 1 bloc 1.19 0.54 0.54 0.04 1.77 1.77 XXX 88331 TC A Path consult intraop, 1 bloc 0.00 NA 0.30 0.03 NA 0.33 XXX 88332 A Path consult intraop, addl 0.59 NA 0.46 0.04 NA 1.09 XXX 88332 26 A Path consult intraop, addl 0.59 0.27 0.27 0.02 0.88 0.88 XXX 88332 TC A Path consult intraop, addl 0.00 NA 0.19 0.02 NA 0.21 XXX 88342 A Immunocytochemistry 0.85 NA 1.37 0.05 NA 2.27 XXX 88342 26 A Immunocytochemistry 0.85 0.39 0.39 0.03 1.27 1.27 XXX 88342 TC A Immunocytochemistry 0.00 NA 0.98 0.02 NA 1.00 XXX 88346 A Immunofluorescent study 0.86 NA 1.38 0.05 NA 2.29 XXX 88346 26 A Immunofluorescent study 0.86 0.39 0.39 0.03 1.28 1.28 XXX 88346 TC A Immunofluorescent study 0.00 NA 0.99 0.02 NA 1.01 XXX 88347 A Immunofluorescent study 0.86 NA 1.92 0.05 NA 2.83 XXX 88347 26 A Immunofluorescent study 0.86 0.38 0.38 0.03 1.27 1.27 XXX 88347 TC A Immunofluorescent study 0.00 NA 1.54 0.02 NA 1.56 XXX 88348 A Electron microscopy 1.51 NA 6.42 0.11 NA 8.04 XXX 88348 26 A Electron microscopy 1.51 0.68 0.68 0.05 2.24 2.24 XXX Start Printed Page 40518 88348 TC A Electron microscopy 0.00 NA 5.74 0.06 NA 5.80 XXX 88349 A Scanning electron microscopy 0.76 NA 7.92 0.08 NA 8.76 XXX 88349 26 A Scanning electron microscopy 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88349 TC A Scanning electron microscopy 0.00 NA 7.57 0.05 NA 7.62 XXX 88355 A Analysis, skeletal muscle 1.85 NA 3.96 0.12 NA 5.93 XXX 88355 26 A Analysis, skeletal muscle 1.85 0.85 0.85 0.07 2.77 2.77 XXX 88355 TC A Analysis, skeletal muscle 0.00 NA 3.11 0.05 NA 3.16 XXX 88356 A Analysis, nerve 3.02 NA 4.47 0.16 NA 7.65 XXX 88356 26 A Analysis, nerve 3.02 1.36 1.36 0.10 4.48 4.48 XXX 88356 TC A Analysis, nerve 0.00 NA 3.11 0.06 NA 3.17 XXX 88358 A Analysis, tumor 2.82 NA 1.71 0.16 NA 4.69 XXX 88358 26 A Analysis, tumor 2.82 1.28 1.28 0.10 4.20 4.20 XXX 88358 TC A Analysis, tumor 0.00 NA 0.43 0.06 NA 0.49 XXX 88362 A Nerve teasing preparations 2.17 NA 1.39 0.12 NA 3.68 XXX 88362 26 A Nerve teasing preparations 2.17 0.97 0.97 0.07 3.21 3.21 XXX 88362 TC A Nerve teasing preparations 0.00 NA 0.42 0.05 NA 0.47 XXX 88365 A Tissue hybridization 0.93 NA 1.43 0.05 NA 2.41 XXX 88365 26 A Tissue hybridization 0.93 0.41 0.41 0.03 1.37 1.37 XXX 88365 TC A Tissue hybridization 0.00 NA 1.02 0.02 NA 1.04 XXX 88371 X Protein, western blot tissue +0.00 0.14 0.14 0.00 0.14 0.14 XXX 88371 26 A Protein, western blot tissue 0.37 0.14 0.14 0.01 0.52 0.52 XXX 88372 X Protein analysis w/probe +0.00 0.15 0.15 0.00 0.15 0.15 XXX 88372 26 A Protein analysis w/probe 0.37 0.15 0.15 0.01 0.53 0.53 XXX 88399 C Surgical pathology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 88399 26 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 TC C Surgical pathology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 88400 X Bilirubin total transcut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89050 X Body fluid cell count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89051 X Body fluid cell count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89060 X Exam,synovial fluid crystals +0.00 0.17 0.17 0.00 0.17 0.17 XXX 89060 26 A Exam,synovial fluid crystals 0.37 0.17 0.17 0.01 0.55 0.55 XXX 89100 A Sample intestinal contents 0.60 0.23 2.07 0.02 0.85 2.69 XXX 89105 A Sample intestinal contents 0.50 0.18 2.25 0.02 0.70 2.77 XXX 89125 X Specimen fat stain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89130 A Sample stomach contents 0.45 0.13 1.92 0.02 0.60 2.39 XXX 89132 A Sample stomach contents 0.19 0.08 1.82 0.01 0.28 2.02 XXX 89135 A Sample stomach contents 0.79 0.28 2.11 0.03 1.10 2.93 XXX 89136 A Sample stomach contents 0.21 0.08 1.39 0.01 0.30 1.61 XXX 89140 A Sample stomach contents 0.94 0.27 2.24 0.03 1.24 3.21 XXX 89141 A Sample stomach contents 0.85 0.35 2.76 0.03 1.23 3.64 XXX 89160 X Exam feces for meat fibers 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89190 X Nasal smear for eosinophils 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89250 X Fertilization of oocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89251 X Culture oocyte w/embryos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89252 X Assist oocyte fertilization 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89253 X Embryo hatching 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89254 X Oocyte identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89255 X Prepare embryo for transfer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89256 X Prepare cryopreserved embryo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89257 X Sperm identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89258 X Cryopreservation, embryo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89259 X Cryopreservation, sperm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89260 X Sperm isolation, simple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89261 X Sperm isolation, complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89264 X Identify sperm tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89300 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89310 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89320 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89321 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89325 X Sperm antibody test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89329 X Sperm evaluation test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89330 X Evaluation, cervical mucus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89350 A Sputum specimen collection 0.00 NA 0.40 0.02 NA 0.42 XXX 89355 X Exam feces for starch 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89360 A Collect sweat for test 0.00 NA 0.45 0.02 NA 0.47 XXX 89365 X Water load test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89399 C Pathology lab procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 89399 26 C Pathology lab procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89399 TC C Pathology lab procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 90281 I Human ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90283 I Human ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90287 I Botulinum antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90288 I Botulism ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90291 I Cmv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40519 90296 E Diphtheria antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90371 E Hep b ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90375 E Rabies ig, im/sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90376 E Rabies ig, heat treated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90378 X Rsv ig, im, 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90379 E Rsv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90384 I Rh ig, full-dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90385 E Rh ig, minidose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90386 I Rh ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90389 E Tetanus ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90393 E Vaccina ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90396 E Varicella-zoster ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90399 I Immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90471 N Immunization admin 0.00 NA 0.00 0.00 NA 0.00 XXX 90472 N Immunization admin, each add 0.00 NA 0.00 0.00 NA 0.00 XXX 90476 E Adenovirus vaccine, type 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90477 E Adenovirus vaccine, type 7 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90581 E Anthrax vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90585 E Bcg vaccine, percut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90586 E Bcg vaccine, intravesical 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90632 E Hep a vaccine, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90633 E Hep a vacc, ped/adol, 2 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90634 E Hep a vacc, ped/adol, 3 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90636 E Hep a/hep b vacc, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90645 E Hib vaccine, hboc, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90646 E Hib vaccine, prp-d, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90647 E Hib vaccine, prp-omp, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90648 E Hib vaccine, prp-t, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90657 X Flu vaccine, 6-35 mo, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90658 X Flu vaccine, 3 yrs, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90659 X Flu vaccine, whole, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90660 X Flu vaccine, nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90665 E Lyme disease vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90669 N Pneumococcal vacc, ped<5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90675 E Rabies vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90676 E Rabies vaccine, id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90680 E Rotovirus vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90690 E Typhoid vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90691 E Typhoid vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90692 E Typhoid vaccine, h-p, sc/id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90693 E Typhoid vaccine, akd, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90700 E Dtap vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90701 E Dtp vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90702 E Dt vaccine < 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90703 E Tetanus vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90704 E Mumps vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90705 E Measles vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90706 E Rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90707 E Mmr vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90708 E Measles-rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90709 E Rubella & mumps vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90710 E Mmrv vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90712 E Oral poliovirus vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90713 E Poliovirus, ipv, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90716 E Chicken pox vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90717 E Yellow fever vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90718 E Td vaccine > 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90719 E Diphtheria vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90720 E Dtp/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90721 E Dtap/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90723 X Dtap-hep b-ipv vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90725 E Cholera vaccine, injectable 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90727 E Plague vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90732 X Pneumococcal vacc, adult/ill 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90733 E Meningococcal vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90735 E Encephalitis vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90740 X Hepb vacc, ill pat 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90743 X Hep b vacc, adol, 2 dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90744 X Hepb vacc ped/adol 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90746 X Hep b vaccine, adult, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90747 X Hepb vacc, ill pat 4 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90748 E Hep b/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90749 E Vaccine toxoid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90780 A IV infusion therapy, 1 hour 0.00 NA 1.09 0.06 NA 1.15 XXX Start Printed Page 40520 90781 A IV infusion, additional hour 0.00 NA 0.55 0.03 NA 0.58 ZZZ 90782 T Injection, sc/im 0.00 NA 0.10 0.01 NA 0.11 XXX 90783 T Injection, ia 0.00 NA 0.40 0.02 NA 0.42 XXX 90784 T Injection, iv 0.00 NA 0.47 0.03 NA 0.50 XXX 90788 T Injection of antibiotic 0.00 NA 0.11 0.01 NA 0.12 XXX 90799 C Ther/prophylactic/dx inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90801 A Psy dx interview 2.80 0.92 1.13 0.06 3.78 3.99 XXX 90802 A Intac psy dx interview 3.01 0.98 1.16 0.07 4.06 4.24 XXX 90804 A Psytx, office, 20-30 min 1.21 0.39 0.53 0.03 1.63 1.77 XXX 90805 A Psytx, off, 20-30 min w/e&m 1.37 0.44 0.59 0.03 1.84 1.99 XXX 90806 A Psytx, off, 45-50 min 1.86 0.62 0.75 0.04 2.52 2.65 XXX 90807 A Psytx, off, 45-50 min w/e&m 2.02 0.66 0.79 0.05 2.73 2.86 XXX 90808 A Psytx, office, 75-80 min 2.79 0.92 1.07 0.07 3.78 3.93 XXX 90809 A Psytx, off, 75-80, w/e&m 2.95 0.95 1.11 0.07 3.97 4.13 XXX 90810 A Intac psytx, off, 20-30 min 1.32 0.43 0.55 0.03 1.78 1.90 XXX 90811 A Intac psytx, 20-30, w/e&m 1.48 0.48 0.64 0.03 1.99 2.15 XXX 90812 A Intac psytx, off, 45-50 min 1.97 0.65 0.81 0.05 2.67 2.83 XXX 90813 A Intac psytx, 45-50 min w/e&m 2.13 0.70 0.87 0.05 2.88 3.05 XXX 90814 A Intac psytx, off, 75-80 min 2.90 0.95 1.17 0.07 3.92 4.14 XXX 90815 A Intac psytx, 75-80 w/e&m 3.06 0.98 1.19 0.07 4.11 4.32 XXX 90816 A Psytx, hosp, 20-30 min 1.25 0.42 0.57 0.03 1.70 1.85 XXX 90817 A Psytx, hosp, 20-30 min w/e&m 1.41 0.45 0.62 0.03 1.89 2.06 XXX 90818 A Psytx, hosp, 45-50 min 1.89 0.64 0.79 0.04 2.57 2.72 XXX 90819 A Psytx, hosp, 45-50 min w/e&m 2.05 0.65 0.82 0.05 2.75 2.92 XXX 90821 A Psytx, hosp, 75-80 min 2.83 0.95 1.11 0.06 3.84 4.00 XXX 90822 A Psytx, hosp, 75-80 min w/e&m 2.99 0.96 1.12 0.07 4.02 4.18 XXX 90823 A Intac psytx, hosp, 20-30 min 1.36 0.45 0.66 0.03 1.84 2.05 XXX 90824 A Intac psytx, hsp 20-30 w/e&m 1.52 0.49 0.71 0.03 2.04 2.26 XXX 90826 A Intac psytx, hosp, 45-50 min 2.01 0.68 0.89 0.04 2.73 2.94 XXX 90827 A Intac psytx, hsp 45-50 w/e&m 2.16 0.69 0.92 0.05 2.90 3.13 XXX 90828 A Intac psytx, hosp, 75-80 min 2.94 1.00 1.21 0.07 4.01 4.22 XXX 90829 A Intac psytx, hsp 75-80 w/e&m 3.10 1.00 1.24 0.07 4.17 4.41 XXX 90845 A Psychoanalysis 1.79 0.58 0.69 0.04 2.41 2.52 XXX 90846 R Family psytx w/o patient 1.83 0.61 0.73 0.04 2.48 2.60 XXX 90847 R Family psytx w/patient 2.21 0.74 0.86 0.05 3.00 3.12 XXX 90849 R Multiple family group psytx 0.59 0.20 0.37 0.01 0.80 0.97 XXX 90853 A Group psychotherapy 0.59 0.20 0.35 0.01 0.80 0.95 XXX 90857 A Intac group psytx 0.63 0.21 0.36 0.02 0.86 1.01 XXX 90862 A Medication management 0.95 0.31 0.44 0.02 1.28 1.41 XXX 90865 A Narcosynthesis 2.84 0.93 1.65 0.07 3.84 4.56 XXX 90870 A Electroconvulsive therapy 1.88 0.74 0.74 0.04 2.66 2.66 000 90871 A Electroconvulsive therapy 2.72 1.02 NA 0.06 3.80 NA 000 90875 N Psychophysiological therapy +1.20 0.47 0.89 0.03 1.70 2.12 XXX 90876 N Psychophysiological therapy +1.90 0.75 1.17 0.04 2.69 3.11 XXX 90880 A Hypnotherapy 2.19 0.70 0.88 0.05 2.94 3.12 XXX 90882 N Environmental manipulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90885 B Psy evaluation of records +0.97 0.38 0.38 0.02 1.37 1.37 XXX 90887 B Consultation with family +1.48 0.59 0.82 0.03 2.10 2.33 XXX 90889 B Preparation of report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90899 C Psychiatric service/therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90901 A Biofeedback train, any meth 0.41 0.18 0.76 0.02 0.61 1.19 000 90911 A Biofeedback peri/uro/rectal 0.89 0.37 0.89 0.04 1.30 1.82 000 90918 A ESRD related services, month 11.18 5.35 5.35 0.30 16.83 16.83 XXX 90919 A ESRD related services, month 8.54 4.40 4.40 0.24 13.18 13.18 XXX 90920 A ESRD related services, month 7.27 3.81 3.81 0.19 11.27 11.27 XXX 90921 A ESRD related services, month 4.47 2.71 2.71 0.12 7.30 7.30 XXX 90922 A ESRD related services, day 0.37 0.16 0.16 0.01 0.54 0.54 XXX 90923 A Esrd related services, day 0.28 0.14 0.14 0.01 0.43 0.43 XXX 90924 A Esrd related services, day 0.24 0.13 0.13 0.01 0.38 0.38 XXX 90925 A Esrd related services, day 0.15 0.09 0.09 0.01 0.25 0.25 XXX 90935 A Hemodialysis, one evaluation 1.22 0.79 NA 0.03 2.04 NA 000 90937 A Hemodialysis, repeated eval 2.11 1.11 NA 0.06 3.28 NA 000 90940 X Hemodialysis access study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90945 A Dialysis, one evaluation 1.28 0.81 NA 0.04 2.13 NA 000 90947 A Dialysis, repeated eval 2.16 1.13 NA 0.06 3.35 NA 000 90989 X Dialysis training, complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90993 X Dialysis training, incompl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90997 A Hemoperfusion 1.84 1.00 NA 0.05 2.89 NA 000 90999 C Dialysis procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91000 A Esophageal intubation 0.73 NA 0.34 0.04 NA 1.11 000 91000 26 A Esophageal intubation 0.73 0.26 0.26 0.03 1.02 1.02 000 91000 TC A Esophageal intubation 0.00 NA 0.08 0.01 NA 0.09 000 91010 A Esophagus motility study 1.25 NA 1.27 0.10 NA 2.62 000 91010 26 A Esophagus motility study 1.25 0.46 0.46 0.05 1.76 1.76 000 Start Printed Page 40521 91010 TC A Esophagus motility study 0.00 NA 0.81 0.05 NA 0.86 000 91011 A Esophagus motility study 1.50 NA 1.57 0.10 NA 3.17 000 91011 26 A Esophagus motility study 1.50 0.56 0.56 0.05 2.11 2.11 000 91011 TC A Esophagus motility study 0.00 NA 1.01 0.05 NA 1.06 000 91012 A Esophagus motility study 1.46 NA 1.67 0.12 NA 3.25 000 91012 26 A Esophagus motility study 1.46 0.54 0.54 0.06 2.06 2.06 000 91012 TC A Esophagus motility study 0.00 NA 1.13 0.06 NA 1.19 000 91020 A Gastric motility 1.44 NA 1.26 0.11 NA 2.81 000 91020 26 A Gastric motility 1.44 0.51 0.51 0.06 2.01 2.01 000 91020 TC A Gastric motility 0.00 NA 0.75 0.05 NA 0.80 000 91030 A Acid perfusion of esophagus 0.91 NA 0.56 0.05 NA 1.52 000 91030 26 A Acid perfusion of esophagus 0.91 0.34 0.34 0.03 1.28 1.28 000 91030 TC A Acid perfusion of esophagus 0.00 NA 0.22 0.02 NA 0.24 000 91032 A Esophagus, acid reflux test 1.21 NA 1.17 0.10 NA 2.48 000 91032 26 A Esophagus, acid reflux test 1.21 0.44 0.44 0.05 1.70 1.70 000 91032 TC A Esophagus, acid reflux test 0.00 NA 0.73 0.05 NA 0.78 000 91033 A Prolonged acid reflux test 1.30 NA 1.80 0.14 NA 3.24 000 91033 26 A Prolonged acid reflux test 1.30 0.48 0.48 0.05 1.83 1.83 000 91033 TC A Prolonged acid reflux test 0.00 NA 1.32 0.09 NA 1.41 000 91052 A Gastric analysis test 0.79 NA 0.62 0.05 NA 1.46 000 91052 26 A Gastric analysis test 0.79 0.29 0.29 0.03 1.11 1.11 000 91052 TC A Gastric analysis test 0.00 NA 0.33 0.02 NA 0.35 000 91055 A Gastric intubation for smear 0.94 NA 0.58 0.06 NA 1.58 000 91055 26 A Gastric intubation for smear 0.94 0.28 0.28 0.04 1.26 1.26 000 91055 TC A Gastric intubation for smear 0.00 NA 0.30 0.02 NA 0.32 000 91060 A Gastric saline load test 0.45 NA 0.36 0.04 NA 0.85 000 91060 26 A Gastric saline load test 0.45 0.14 0.14 0.02 0.61 0.61 000 91060 TC A Gastric saline load test 0.00 NA 0.22 0.02 NA 0.24 000 91065 A Breath hydrogen test 0.20 NA 0.42 0.03 NA 0.65 000 91065 26 A Breath hydrogen test 0.20 0.07 0.07 0.01 0.28 0.28 000 91065 TC A Breath hydrogen test 0.00 NA 0.35 0.02 NA 0.37 000 91100 A Pass intestine bleeding tube 1.08 0.46 NA 0.06 1.60 NA 000 91105 A Gastric intubation treatment 0.37 0.20 NA 0.02 0.59 NA 000 91122 A Anal pressure record 1.77 NA 1.34 0.17 NA 3.28 000 91122 26 A Anal pressure record 1.77 0.64 0.64 0.10 2.51 2.51 000 91122 TC A Anal pressure record 0.00 NA 0.70 0.07 NA 0.77 000 91132 C Electrogastrography 0.00 NA 0.00 0.00 NA 0.00 XXX 91132 26 C Electrogastrography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 TC C Electrogastrography 0.00 NA 0.00 0.00 NA 0.00 XXX 91133 C Electrogastrography w/test 0.00 NA 0.00 0.00 NA 0.00 XXX 91133 26 C Electrogastrography w/test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 TC C Electrogastrography w/test 0.00 NA 0.00 0.00 NA 0.00 XXX 91299 C Gastroenterology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 91299 26 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 TC C Gastroenterology procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 92002 A Eye exam, new patient 0.88 0.36 1.12 0.02 1.26 2.02 XXX 92004 A Eye exam, new patient 1.67 0.71 1.72 0.03 2.41 3.42 XXX 92012 A Eye exam established pat 0.67 0.30 1.04 0.01 0.98 1.72 XXX 92014 A Eye exam & treatment 1.10 0.49 1.35 0.02 1.61 2.47 XXX 92015 N Refraction +0.38 0.15 1.43 0.01 0.54 1.82 XXX 92018 A New eye exam & treatment 2.50 1.15 NA 0.03 3.68 NA XXX 92019 A Eye exam & treatment 1.31 0.60 NA 0.03 1.94 NA XXX 92020 A Special eye evaluation 0.37 0.17 0.70 0.01 0.55 1.08 XXX 92060 A Special eye evaluation 0.69 NA 1.54 0.02 NA 2.25 XXX 92060 26 A Special eye evaluation 0.69 0.30 0.30 0.01 1.00 1.00 XXX 92060 TC A Special eye evaluation 0.00 NA 1.24 0.01 NA 1.25 XXX 92065 A Orthoptic/pleoptic training 0.37 NA 0.83 0.02 NA 1.22 XXX 92065 26 A Orthoptic/pleoptic training 0.37 0.16 0.16 0.01 0.54 0.54 XXX 92065 TC A Orthoptic/pleoptic training 0.00 NA 0.67 0.01 NA 0.68 XXX 92070 A Fitting of contact lens 0.70 0.33 0.98 0.01 1.04 1.69 XXX 92081 A Visual field examination(s) 0.36 NA 1.43 0.02 NA 1.81 XXX 92081 26 A Visual field examination(s) 0.36 0.16 0.16 0.01 0.53 0.53 XXX 92081 TC A Visual field examination(s) 0.00 NA 1.27 0.01 NA 1.28 XXX 92082 A Visual field examination(s) 0.44 NA 1.28 0.02 NA 1.74 XXX 92082 26 A Visual field examination(s) 0.44 0.20 0.20 0.01 0.65 0.65 XXX 92082 TC A Visual field examination(s) 0.00 NA 1.08 0.01 NA 1.09 XXX 92083 A Visual field examination(s) 0.50 NA 1.24 0.02 NA 1.76 XXX 92083 26 A Visual field examination(s) 0.50 0.23 0.23 0.01 0.74 0.74 XXX 92083 TC A Visual field examination(s) 0.00 NA 1.01 0.01 NA 1.02 XXX 92100 A Serial tonometry exam(s) 0.92 0.40 0.78 0.02 1.34 1.72 XXX 92120 A Tonography & eye evaluation 0.81 0.32 0.76 0.02 1.15 1.59 XXX 92130 A Water provocation tonography 0.81 0.39 0.86 0.02 1.22 1.69 XXX 92135 A Opthalmic dx imaging 0.35 NA 1.20 0.02 NA 1.57 XXX 92135 26 A Opthalmic dx imaging 0.35 0.16 0.16 0.01 0.52 0.52 XXX Start Printed Page 40522 92135 TC A Opthalmic dx imaging 0.00 NA 1.04 0.01 NA 1.05 XXX 92140 A Glaucoma provocative tests 0.50 0.22 0.95 0.01 0.73 1.46 XXX 92225 A Special eye exam, initial 0.38 0.16 1.66 0.01 0.55 2.05 XXX 92226 A Special eye exam, subsequent 0.33 0.15 1.74 0.01 0.49 2.08 XXX 92230 A Eye exam with photos 0.60 0.18 1.28 0.02 0.80 1.90 XXX 92235 A Eye exam with photos 0.81 NA 2.11 0.07 NA 2.99 XXX 92235 26 A Eye exam with photos 0.81 0.38 0.38 0.02 1.21 1.21 XXX 92235 TC A Eye exam with photos 0.00 NA 1.73 0.05 NA 1.78 XXX 92240 A Icg angiography 1.10 NA 2.55 0.07 NA 3.72 XXX 92240 26 A Icg angiography 1.10 0.51 0.51 0.02 1.63 1.63 XXX 92240 TC A Icg angiography 0.00 NA 2.04 0.05 NA 2.09 XXX 92250 A Eye exam with photos 0.44 NA 1.69 0.02 NA 2.15 XXX 92250 26 A Eye exam with photos 0.44 0.20 0.20 0.01 0.65 0.65 XXX 92250 TC A Eye exam with photos 0.00 NA 1.49 0.01 NA 1.50 XXX 92260 A Ophthalmoscopy/dynamometry 0.20 0.09 0.22 0.01 0.30 0.43 XXX 92265 A Eye muscle evaluation 0.81 NA 1.35 0.04 NA 2.20 XXX 92265 26 A Eye muscle evaluation 0.81 0.33 0.33 0.02 1.16 1.16 XXX 92265 TC A Eye muscle evaluation 0.00 NA 1.02 0.02 NA 1.04 XXX 92270 A Electro-oculography 0.81 NA 1.17 0.05 NA 2.03 XXX 92270 26 A Electro-oculography 0.81 0.36 0.36 0.03 1.20 1.20 XXX 92270 TC A Electro-oculography 0.00 NA 0.81 0.02 NA 0.83 XXX 92275 A Electroretinography 1.01 NA 1.19 0.04 NA 2.24 XXX 92275 26 A Electroretinography 1.01 0.45 0.45 0.02 1.48 1.48 XXX 92275 TC A Electroretinography 0.00 NA 0.74 0.02 NA 0.76 XXX 92283 A Color vision examination 0.17 NA 0.67 0.02 NA 0.86 XXX 92283 26 A Color vision examination 0.17 0.07 0.07 0.01 0.25 0.25 XXX 92283 TC A Color vision examination 0.00 NA 0.60 0.01 NA 0.61 XXX 92284 A Dark adaptation eye exam 0.24 NA 2.15 0.02 NA 2.41 XXX 92284 26 A Dark adaptation eye exam 0.24 0.08 0.08 0.01 0.33 0.33 XXX 92284 TC A Dark adaptation eye exam 0.00 NA 2.07 0.01 NA 2.08 XXX 92285 A Eye photography 0.20 NA 1.82 0.02 NA 2.04 XXX 92285 26 A Eye photography 0.20 0.09 0.09 0.01 0.30 0.30 XXX 92285 TC A Eye photography 0.00 NA 1.73 0.01 NA 1.74 XXX 92286 A Internal eye photography 0.66 NA 1.98 0.03 NA 2.67 XXX 92286 26 A Internal eye photography 0.66 0.31 0.31 0.01 0.98 0.98 XXX 92286 TC A Internal eye photography 0.00 NA 1.67 0.02 NA 1.69 XXX 92287 A Internal eye photography 0.81 0.30 1.89 0.02 1.13 2.72 XXX 92310 N Contact lens fitting +1.17 0.46 1.08 0.00 1.63 2.25 XXX 92311 A Contact lens fitting 1.08 0.40 1.02 0.03 1.51 2.13 XXX 92312 A Contact lens fitting 1.26 0.46 1.01 0.03 1.75 2.30 XXX 92313 A Contact lens fitting 0.92 0.31 1.02 0.02 1.25 1.96 XXX 92314 N Prescription of contact lens +0.69 0.27 0.89 0.00 0.96 1.58 XXX 92315 A Prescription of contact lens 0.45 0.18 0.74 0.01 0.64 1.20 XXX 92316 A Prescription of contact lens 0.68 0.27 0.82 0.01 0.96 1.51 XXX 92317 A Prescription of contact lens 0.45 0.15 0.88 0.01 0.61 1.34 XXX 92325 A Modification of contact lens 0.00 NA 0.39 0.01 NA 0.40 XXX 92326 A Replacement of contact lens 0.00 NA 1.61 0.05 NA 1.66 XXX 92330 A Fitting of artificial eye 1.08 0.43 0.98 0.04 1.55 2.10 XXX 92335 A Fitting of artificial eye 0.45 0.18 0.80 0.01 0.64 1.26 XXX 92340 N Fitting of spectacles +0.37 0.15 0.66 0.00 0.52 1.03 XXX 92341 N Fitting of spectacles +0.47 0.19 0.70 0.00 0.66 1.17 XXX 92342 N Fitting of spectacles +0.53 0.21 0.73 0.00 0.74 1.26 XXX 92352 B Special spectacles fitting +0.37 0.15 0.66 0.01 0.53 1.04 XXX 92353 B Special spectacles fitting +0.50 0.20 0.71 0.02 0.72 1.23 XXX 92354 B Special spectacles fitting +0.00 NA 8.72 0.08 NA 8.80 XXX 92355 B Special spectacles fitting +0.00 NA 4.27 0.01 NA 4.28 XXX 92358 B Eye prosthesis service +0.00 NA 0.95 0.04 NA 0.99 XXX 92370 N Repair & adjust spectacles +0.32 0.13 0.52 0.00 0.45 0.84 XXX 92371 B Repair & adjust spectacles +0.00 NA 0.61 0.02 NA 0.63 XXX 92390 N Supply of spectacles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92391 N Supply of contact lenses 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92392 I Supply of low vision aids +0.00 NA 3.98 0.02 NA 4.00 XXX 92393 I Supply of artificial eye +0.00 NA 12.36 0.47 NA 12.83 XXX 92395 I Supply of spectacles +0.00 NA 1.35 0.08 NA 1.43 XXX 92396 I Supply of contact lenses +0.00 NA 2.27 0.06 NA 2.33 XXX 92499 C Eye service or procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 92499 26 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 TC C Eye service or procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 92502 A Ear and throat examination 1.51 1.32 NA 0.06 2.89 NA 000 92504 A Ear microscopy examination 0.18 0.09 1.02 0.01 0.28 1.21 XXX 92506 A Speech/hearing evaluation 0.86 0.46 1.60 0.04 1.36 2.50 XXX 92507 A Speech/hearing therapy 0.52 0.28 1.47 0.02 0.82 2.01 XXX 92508 A Speech/hearing therapy 0.26 0.15 1.03 0.01 0.42 1.30 XXX 92510 A Rehab for ear implant 1.50 0.86 2.02 0.06 2.42 3.58 XXX Start Printed Page 40523 92511 A Nasopharyngoscopy 0.84 0.43 1.28 0.03 1.30 2.15 000 92512 A Nasal function studies 0.55 0.19 1.08 0.02 0.76 1.65 XXX 92516 A Facial nerve function test 0.43 0.24 0.89 0.02 0.69 1.34 XXX 92520 A Laryngeal function studies 0.76 0.37 0.57 0.03 1.16 1.36 XXX 92525 G Oral function evaluation 1.50 0.59 1.66 0.07 2.16 3.23 XXX 92526 A Oral function therapy 0.55 0.26 1.72 0.02 0.83 2.29 XXX 92531 B Spontaneous nystagmus study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92532 B Positional nystagmus study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92533 B Caloric vestibular test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92534 B Optokinetic nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92541 A Spontaneous nystagmus test 0.40 NA 0.43 0.04 NA 0.87 XXX 92541 26 A Spontaneous nystagmus test 0.40 0.20 0.20 0.02 0.62 0.62 XXX 92541 TC A Spontaneous nystagmus test 0.00 NA 0.23 0.02 NA 0.25 XXX 92542 A Positional nystagmus test 0.33 NA 0.43 0.03 NA 0.79 XXX 92542 26 A Positional nystagmus test 0.33 0.17 0.17 0.01 0.51 0.51 XXX 92542 TC A Positional nystagmus test 0.00 NA 0.26 0.02 NA 0.28 XXX 92543 A Caloric vestibular test 0.10 NA 0.15 0.02 NA 0.27 XXX 92543 26 A Caloric vestibular test 0.10 0.05 0.05 0.01 0.16 0.16 XXX 92543 TC A Caloric vestibular test 0.00 NA 0.10 0.01 NA 0.11 XXX 92544 A Optokinetic nystagmus test 0.26 NA 0.34 0.03 NA 0.63 XXX 92544 26 A Optokinetic nystagmus test 0.26 0.13 0.13 0.01 0.40 0.40 XXX 92544 TC A Optokinetic nystagmus test 0.00 NA 0.21 0.02 NA 0.23 XXX 92545 A Oscillating tracking test 0.23 NA 0.32 0.03 NA 0.58 XXX 92545 26 A Oscillating tracking test 0.23 0.11 0.11 0.01 0.35 0.35 XXX 92545 TC A Oscillating tracking test 0.00 NA 0.21 0.02 NA 0.23 XXX 92546 A Sinusoidal rotational test 0.29 NA 0.38 0.03 NA 0.70 XXX 92546 26 A Sinusoidal rotational test 0.29 0.14 0.14 0.01 0.44 0.44 XXX 92546 TC A Sinusoidal rotational test 0.00 NA 0.24 0.02 NA 0.26 XXX 92547 A Supplemental electrical test 0.00 NA 0.55 0.05 NA 0.60 ZZZ 92548 A Posturography 0.50 NA 1.72 0.13 NA 2.35 XXX 92548 26 A Posturography 0.50 0.27 0.27 0.02 0.79 0.79 XXX 92548 TC A Posturography 0.00 NA 1.45 0.11 NA 1.56 XXX 92551 N Pure tone hearing test, air 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92552 A Pure tone audiometry, air 0.00 NA 0.44 0.03 NA 0.47 XXX 92553 A Audiometry, air & bone 0.00 NA 0.65 0.05 NA 0.70 XXX 92555 A Speech threshold audiometry 0.00 NA 0.37 0.03 NA 0.40 XXX 92556 A Speech audiometry, complete 0.00 NA 0.56 0.05 NA 0.61 XXX 92557 A Comprehensive hearing test 0.00 NA 1.17 0.10 NA 1.27 XXX 92559 N Group audiometric testing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92560 N Bekesy audiometry, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92561 A Bekesy audiometry, diagnosis 0.00 NA 0.70 0.05 NA 0.75 XXX 92562 A Loudness balance test 0.00 NA 0.40 0.03 NA 0.43 XXX 92563 A Tone decay hearing test 0.00 NA 0.37 0.03 NA 0.40 XXX 92564 A Sisi hearing test 0.00 NA 0.47 0.04 NA 0.51 XXX 92565 A Stenger test, pure tone 0.00 NA 0.39 0.03 NA 0.42 XXX 92567 A Tympanometry 0.00 NA 0.51 0.05 NA 0.56 XXX 92568 A Acoustic reflex testing 0.00 NA 0.37 0.03 NA 0.40 XXX 92569 A Acoustic reflex decay test 0.00 NA 0.40 0.03 NA 0.43 XXX 92571 A Filtered speech hearing test 0.00 NA 0.38 0.03 NA 0.41 XXX 92572 A Staggered spondaic word test 0.00 NA 0.09 0.01 NA 0.10 XXX 92573 A Lombard test 0.00 NA 0.34 0.03 NA 0.37 XXX 92575 A Sensorineural acuity test 0.00 NA 0.30 0.02 NA 0.32 XXX 92576 A Synthetic sentence test 0.00 NA 0.44 0.04 NA 0.48 XXX 92577 A Stenger test, speech 0.00 NA 0.70 0.06 NA 0.76 XXX 92579 A Visual audiometry (vra) 0.00 NA 0.71 0.05 NA 0.76 XXX 92582 A Conditioning play audiometry 0.00 NA 0.71 0.05 NA 0.76 XXX 92583 A Select picture audiometry 0.00 NA 0.88 0.07 NA 0.95 XXX 92584 A Electrocochleography 0.00 NA 2.44 0.17 NA 2.61 XXX 92585 A Auditor evoke potent, compre 0.50 NA 2.05 0.14 NA 2.69 XXX 92585 26 A Auditor evoke potent, compre 0.50 0.23 0.23 0.02 0.75 0.75 XXX 92585 TC A Auditor evoke potent, compre 0.00 NA 1.82 0.12 NA 1.94 XXX 92586 A Auditor evoke potent, limit 0.00 NA 1.82 0.12 NA 1.94 XXX 92587 A Evoked auditory test 0.13 NA 1.36 0.10 NA 1.59 XXX 92587 26 A Evoked auditory test 0.13 0.07 0.07 0.01 0.21 0.21 XXX 92587 TC A Evoked auditory test 0.00 NA 1.29 0.09 NA 1.38 XXX 92588 A Evoked auditory test 0.36 NA 1.62 0.12 NA 2.10 XXX 92588 26 A Evoked auditory test 0.36 0.17 0.17 0.01 0.54 0.54 XXX 92588 TC A Evoked auditory test 0.00 NA 1.45 0.11 NA 1.56 XXX 92589 A Auditory function test(s) 0.00 NA 0.52 0.05 NA 0.57 XXX 92590 N Hearing aid exam, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92591 N Hearing aid exam, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92592 N Hearing aid check, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92593 N Hearing aid check, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92594 N Electro hearng aid test, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40524 92595 N Electro hearng aid tst, both 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92596 A Ear protector evaluation 0.00 NA 0.58 0.05 NA 0.63 XXX 92597 G Oral speech device eval 1.35 0.53 1.60 0.05 1.93 3.00 XXX 92598 G Modify oral speech device 0.99 0.39 0.80 0.04 1.42 1.83 XXX 92599 C ENT procedure/service 0.00 NA 0.00 0.00 NA 0.00 XXX 92599 26 C ENT procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92599 TC C ENT procedure/service 0.00 NA 0.00 0.00 NA 0.00 XXX 92950 A Heart/lung resuscitation cpr 3.80 1.16 1.37 0.21 5.17 5.38 000 92953 A Temporary external pacing 0.23 0.23 NA 0.01 0.47 NA 000 92960 A Cardioversion electric, ext 2.25 0.88 2.22 0.08 3.21 4.55 000 92961 A Cardioversion, electric, int 4.60 1.85 NA 0.17 6.62 NA 000 92970 A Cardioassist, internal 3.52 1.03 NA 0.17 4.72 NA 000 92971 A Cardioassist, external 1.77 0.88 NA 0.06 2.71 NA 000 92975 A Dissolve clot, heart vessel 7.25 3.00 NA 0.22 10.47 NA 000 92977 A Dissolve clot, heart vessel 0.00 NA 7.93 0.38 NA 8.31 XXX 92978 A Intravasc us, heart add-on 1.80 NA 5.23 0.26 NA 7.29 ZZZ 92978 26 A Intravasc us, heart add-on 1.80 0.74 0.74 0.06 2.60 2.60 ZZZ 92978 TC A Intravasc us, heart add-on 0.00 NA 4.49 0.20 NA 4.69 ZZZ 92979 A Intravasc us, heart add-on 1.44 NA 2.85 0.15 NA 4.44 ZZZ 92979 26 A Intravasc us, heart add-on 1.44 0.59 0.59 0.04 2.07 2.07 ZZZ 92979 TC A Intravasc us, heart add-on 0.00 NA 2.26 0.11 NA 2.37 ZZZ 92980 A Insert intracoronary stent 14.84 6.15 NA 0.78 21.77 NA 000 92981 A Insert intracoronary stent 4.17 1.72 NA 0.21 6.10 NA ZZZ 92982 A Coronary artery dilation 10.98 4.56 NA 0.57 16.11 NA 000 92984 A Coronary artery dilation 2.97 1.22 NA 0.16 4.35 NA ZZZ 92986 A Revision of aortic valve 21.80 10.37 NA 1.14 33.31 NA 090 92987 A Revision of mitral valve 22.70 10.75 NA 1.18 34.63 NA 090 92990 A Revision of pulmonary valve 17.34 8.54 NA 0.90 26.78 NA 090 92992 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92993 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92995 A Coronary atherectomy 12.09 5.01 NA 0.63 17.73 NA 000 92996 A Coronary atherectomy add-on 3.26 1.38 NA 0.17 4.81 NA ZZZ 92997 A Pul art balloon repr, percut 12.00 4.84 NA 0.63 17.47 NA 000 92998 A Pul art balloon repr, percut 6.00 2.38 NA 0.31 8.69 NA ZZZ 93000 A Electrocardiogram, complete 0.17 NA 0.51 0.03 NA 0.71 XXX 93005 A Electrocardiogram, tracing 0.00 NA 0.45 0.02 NA 0.47 XXX 93010 A Electrocardiogram report 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93012 A Transmission of ecg 0.00 NA 2.32 0.15 NA 2.47 XXX 93014 A Report on transmitted ecg 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93015 A Cardiovascular stress test 0.75 NA 1.95 0.11 NA 2.81 XXX 93016 A Cardiovascular stress test 0.45 0.18 0.18 0.01 0.64 0.64 XXX 93017 A Cardiovascular stress test 0.00 NA 1.66 0.09 NA 1.75 XXX 93018 A Cardiovascular stress test 0.30 0.12 0.12 0.01 0.43 0.43 XXX 93024 A Cardiac drug stress test 1.17 NA 1.57 0.11 NA 2.85 XXX 93024 26 A Cardiac drug stress test 1.17 0.47 0.47 0.04 1.68 1.68 XXX 93024 TC A Cardiac drug stress test 0.00 NA 1.10 0.07 NA 1.17 XXX 93040 A Rhythm ECG with report 0.16 NA 0.19 0.02 NA 0.37 XXX 93041 A Rhythm ECG, tracing 0.00 NA 0.14 0.01 NA 0.15 XXX 93042 A Rhythm ECG, report 0.16 0.05 0.05 0.01 0.22 0.22 XXX 93224 A ECG monitor/report, 24 hrs 0.52 NA 3.57 0.21 NA 4.30 XXX 93225 A ECG monitor/record, 24 hrs 0.00 NA 1.22 0.07 NA 1.29 XXX 93226 A ECG monitor/report, 24 hrs 0.00 NA 2.15 0.12 NA 2.27 XXX 93227 A ECG monitor/review, 24 hrs 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93230 A ECG monitor/report, 24 hrs 0.52 NA 3.84 0.22 NA 4.58 XXX 93231 A Ecg monitor/record, 24 hrs 0.00 NA 1.49 0.09 NA 1.58 XXX 93232 A ECG monitor/report, 24 hrs 0.00 NA 2.14 0.11 NA 2.25 XXX 93233 A ECG monitor/review, 24 hrs 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93235 A ECG monitor/report, 24 hrs 0.45 NA 2.75 0.13 NA 3.33 XXX 93236 A ECG monitor/report, 24 hrs 0.00 NA 2.58 0.12 NA 2.70 XXX 93237 A ECG monitor/review, 24 hrs 0.45 0.17 0.17 0.01 0.63 0.63 XXX 93268 A ECG record/review 0.52 NA 3.74 0.24 NA 4.50 XXX 93270 A ECG recording 0.00 NA 1.22 0.07 NA 1.29 XXX 93271 A Ecg/monitoring and analysis 0.00 NA 2.32 0.15 NA 2.47 XXX 93272 A Ecg/review, interpret only 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93278 A ECG/signal-averaged 0.25 NA 1.23 0.10 NA 1.58 XXX 93278 26 A ECG/signal-averaged 0.25 0.10 0.10 0.01 0.36 0.36 XXX 93278 TC A ECG/signal-averaged 0.00 NA 1.13 0.09 NA 1.22 XXX 93303 A Echo transthoracic 1.30 NA 4.28 0.23 NA 5.81 XXX 93303 26 A Echo transthoracic 1.30 0.48 0.48 0.04 1.82 1.82 XXX 93303 TC A Echo transthoracic 0.00 NA 3.80 0.19 NA 3.99 XXX 93304 A Echo transthoracic 0.75 NA 2.21 0.13 NA 3.09 XXX 93304 26 A Echo transthoracic 0.75 0.30 0.30 0.02 1.07 1.07 XXX 93304 TC A Echo transthoracic 0.00 NA 1.91 0.11 NA 2.02 XXX 93307 A Echo exam of heart 0.92 NA 4.17 0.22 NA 5.31 XXX Start Printed Page 40525 93307 26 A Echo exam of heart 0.92 0.37 0.37 0.03 1.32 1.32 XXX 93307 TC A Echo exam of heart 0.00 NA 3.80 0.19 NA 3.99 XXX 93308 A Echo exam of heart 0.53 NA 2.12 0.13 NA 2.78 XXX 93308 26 A Echo exam of heart 0.53 0.21 0.21 0.02 0.76 0.76 XXX 93308 TC A Echo exam of heart 0.00 NA 1.91 0.11 NA 2.02 XXX 93312 A Echo transesophageal 2.20 NA 4.57 0.32 NA 7.09 XXX 93312 26 A Echo transesophageal 2.20 0.85 0.85 0.08 3.13 3.13 XXX 93312 TC A Echo transesophageal 0.00 NA 3.72 0.24 NA 3.96 XXX 93313 A Echo transesophageal 0.95 0.21 4.70 0.05 1.21 5.70 XXX 93314 A Echo transesophageal 1.25 NA 4.21 0.28 NA 5.74 XXX 93314 26 A Echo transesophageal 1.25 0.49 0.49 0.04 1.78 1.78 XXX 93314 TC A Echo transesophageal 0.00 NA 3.72 0.24 NA 3.96 XXX 93315 A Echo transesophageal 2.78 NA 4.78 0.34 NA 7.90 XXX 93315 26 A Echo transesophageal 2.78 1.06 1.06 0.10 3.94 3.94 XXX 93315 TC A Echo transesophageal 0.00 NA 3.72 0.24 NA 3.96 XXX 93316 A Echo transesophageal 0.95 0.23 3.35 0.05 1.23 4.35 XXX 93317 A Echo transesophageal 1.83 NA 4.45 0.30 NA 6.58 XXX 93317 26 A Echo transesophageal 1.83 0.73 0.73 0.06 2.62 2.62 XXX 93317 TC A Echo transesophageal 0.00 NA 3.72 0.24 NA 3.96 XXX 93318 C Echo transesophageal intraop 0.00 NA 0.00 0.00 NA 0.00 XXX 93318 26 C Echo transesophageal intraop 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93318 TC C Echo transesophageal intraop 0.00 NA 0.00 0.00 NA 0.00 XXX 93320 A Doppler echo exam, heart 0.38 NA 1.84 0.11 NA 2.33 ZZZ 93320 26 A Doppler echo exam, heart 0.38 0.15 0.15 0.01 0.54 0.54 ZZZ 93320 TC A Doppler echo exam, heart 0.00 NA 1.69 0.10 NA 1.79 ZZZ 93321 A Doppler echo exam, heart 0.15 NA 1.15 0.08 NA 1.38 ZZZ 93321 26 A Doppler echo exam, heart 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ 93321 TC A Doppler echo exam, heart 0.00 NA 1.09 0.07 NA 1.16 ZZZ 93325 A Doppler color flow add-on 0.07 NA 2.89 0.18 NA 3.14 ZZZ 93325 26 A Doppler color flow add-on 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ 93325 TC A Doppler color flow add-on 0.00 NA 2.86 0.17 NA 3.03 ZZZ 93350 A Echo transthoracic 1.48 NA 2.33 0.13 NA 3.94 XXX 93350 26 A Echo transthoracic 1.48 0.60 0.60 0.02 2.10 2.10 XXX 93350 TC A Echo transthoracic 0.00 NA 1.73 0.11 NA 1.84 XXX 93501 A Right heart catheterization 3.02 NA 17.20 1.03 NA 21.25 000 93501 26 A Right heart catheterization 3.02 1.21 1.21 0.16 4.39 4.39 000 93501 TC A Right heart catheterization 0.00 NA 15.99 0.87 NA 16.86 000 93503 A Insert/place heart catheter 2.91 0.74 NA 0.16 3.81 NA 000 93505 A Biopsy of heart lining 4.38 NA 3.64 0.36 NA 8.38 000 93505 26 A Biopsy of heart lining 4.38 1.77 1.77 0.23 6.38 6.38 000 93505 TC A Biopsy of heart lining 0.00 NA 1.87 0.13 NA 2.00 000 93508 A Cath placement, angiography 4.10 NA 13.61 0.75 NA 18.46 000 93508 26 A Cath placement, angiography 4.10 1.68 1.68 0.21 5.99 5.99 000 93508 TC A Cath placement, angiography 0.00 NA 11.93 0.54 NA 12.47 000 93510 A Left heart catheterization 4.33 NA 36.72 2.13 NA 43.18 000 93510 26 A Left heart catheterization 4.33 1.78 1.78 0.22 6.33 6.33 000 93510 TC A Left heart catheterization 0.00 NA 34.94 1.91 NA 36.85 000 93511 A Left heart catheterization 5.03 NA 36.08 2.11 NA 43.22 000 93511 26 A Left heart catheterization 5.03 2.07 2.07 0.26 7.36 7.36 000 93511 TC A Left heart catheterization 0.00 NA 34.01 1.85 NA 35.86 000 93514 A Left heart catheterization 7.05 NA 36.71 2.22 NA 45.98 000 93514 26 A Left heart catheterization 7.05 2.70 2.70 0.37 10.12 10.12 000 93514 TC A Left heart catheterization 0.00 NA 34.01 1.85 NA 35.86 000 93524 A Left heart catheterization 6.95 NA 47.26 2.79 NA 57.00 000 93524 26 A Left heart catheterization 6.95 2.81 2.81 0.36 10.12 10.12 000 93524 TC A Left heart catheterization 0.00 NA 44.45 2.43 NA 46.88 000 93526 A Rt & Lt heart catheters 5.99 NA 48.13 2.81 NA 56.93 000 93526 26 A Rt & Lt heart catheters 5.99 2.46 2.46 0.31 8.76 8.76 000 93526 TC A Rt & Lt heart catheters 0.00 NA 45.67 2.50 NA 48.17 000 93527 A Rt & Lt heart catheters 7.28 NA 47.43 2.81 NA 57.52 000 93527 26 A Rt & Lt heart catheters 7.28 2.98 2.98 0.38 10.64 10.64 000 93527 TC A Rt & Lt heart catheters 0.00 NA 44.45 2.43 NA 46.88 000 93528 A Rt & Lt heart catheters 9.00 NA 48.19 2.90 NA 60.09 000 93528 26 A Rt & Lt heart catheters 9.00 3.74 3.74 0.47 13.21 13.21 000 93528 TC A Rt & Lt heart catheters 0.00 NA 44.45 2.43 NA 46.88 000 93529 A Rt, Lt heart catheterization 4.80 NA 46.41 2.68 NA 53.89 000 93529 26 A Rt, Lt heart catheterization 4.80 1.96 1.96 0.25 7.01 7.01 000 93529 TC A Rt, Lt heart catheterization 0.00 NA 44.45 2.43 NA 46.88 000 93530 A Rt heart cath, congenital 4.23 NA 17.53 1.11 NA 22.87 000 93530 26 A Rt heart cath, congenital 4.23 1.54 1.54 0.24 6.01 6.01 000 93530 TC A Rt heart cath, congenital 0.00 NA 15.99 0.87 NA 16.86 000 93531 A R & l heart cath, congenital 8.35 NA 48.92 2.96 NA 60.23 000 93531 26 A R & l heart cath, congenital 8.35 3.25 3.25 0.46 12.06 12.06 000 93531 TC A R & l heart cath, congenital 0.00 NA 45.67 2.50 NA 48.17 000 Start Printed Page 40526 93532 A R & l heart cath, congenital 10.00 NA 48.33 2.95 NA 61.28 000 93532 26 A R & l heart cath, congenital 10.00 3.88 3.88 0.52 14.40 14.40 000 93532 TC A R & l heart cath, congenital 0.00 NA 44.45 2.43 NA 46.88 000 93533 A R & l heart cath, congenital 6.70 NA 46.91 2.86 NA 56.47 000 93533 26 A R & l heart cath, congenital 6.70 2.46 2.46 0.43 9.59 9.59 000 93533 TC A R & l heart cath, congenital 0.00 NA 44.45 2.43 NA 46.88 000 93536 A Insert circulation assi 4.85 1.97 NA 0.27 7.09 NA 000 93539 A Injection, cardiac cath 0.40 0.16 0.85 0.01 0.57 1.26 000 93540 A Injection, cardiac cath 0.43 0.18 0.86 0.01 0.62 1.30 000 93541 A Injection for lung angiogram 0.29 0.12 NA 0.01 0.42 NA 000 93542 A Injection for heart x-rays 0.29 0.12 NA 0.01 0.42 NA 000 93543 A Injection for heart x-rays 0.29 0.12 0.55 0.01 0.42 0.85 000 93544 A Injection for aortography 0.25 0.10 0.53 0.01 0.36 0.79 000 93545 A Inject for coronary x-rays 0.40 0.16 0.85 0.01 0.57 1.26 000 93555 A Imaging, cardiac cath 0.81 NA 6.26 0.31 NA 7.38 XXX 93555 26 A Imaging, cardiac cath 0.81 0.33 0.33 0.03 1.17 1.17 XXX 93555 TC A Imaging, cardiac cath 0.00 NA 5.93 0.28 NA 6.21 XXX 93556 A Imaging, cardiac cath 0.83 NA 9.70 0.45 NA 10.98 XXX 93556 26 A Imaging, cardiac cath 0.83 0.34 0.34 0.03 1.20 1.20 XXX 93556 TC A Imaging, cardiac cath 0.00 NA 9.36 0.42 NA 9.78 XXX 93561 A Cardiac output measurement 0.50 NA 0.67 0.07 NA 1.24 000 93561 26 A Cardiac output measurement 0.50 0.16 0.16 0.02 0.68 0.68 000 93561 TC A Cardiac output measurement 0.00 NA 0.51 0.05 NA 0.56 000 93562 A Cardiac output measurement 0.16 NA 0.34 0.04 NA 0.54 000 93562 26 A Cardiac output measurement 0.16 0.05 0.05 0.01 0.22 0.22 000 93562 TC A Cardiac output measurement 0.00 NA 0.29 0.03 NA 0.32 000 93571 A Heart flow reserve measure 1.80 NA 5.19 0.31 NA 7.30 ZZZ 93571 26 A Heart flow reserve measure 1.80 0.70 0.70 0.11 2.61 2.61 ZZZ 93571 TC A Heart flow reserve measure 0.00 NA 4.49 0.20 NA 4.69 ZZZ 93572 A Heart flow reserve measure 1.44 NA 2.76 0.28 NA 4.48 ZZZ 93572 26 A Heart flow reserve measure 1.44 0.50 0.50 0.17 2.11 2.11 ZZZ 93572 TC A Heart flow reserve measure 0.00 NA 2.26 0.11 NA 2.37 ZZZ 93600 A Bundle of His recording 2.12 NA 2.79 0.22 NA 5.13 000 93600 26 A Bundle of His recording 2.12 0.87 0.87 0.11 3.10 3.10 000 93600 TC A Bundle of His recording 0.00 NA 1.92 0.11 NA 2.03 000 93602 A Intra-atrial recording 2.12 NA 1.95 0.18 NA 4.25 000 93602 26 A Intra-atrial recording 2.12 0.86 0.86 0.12 3.10 3.10 000 93602 TC A Intra-atrial recording 0.00 NA 1.09 0.06 NA 1.15 000 93603 A Right ventricular recording 2.12 NA 2.51 0.20 NA 4.83 000 93603 26 A Right ventricular recording 2.12 0.85 0.85 0.11 3.08 3.08 000 93603 TC A Right ventricular recording 0.00 NA 1.66 0.09 NA 1.75 000 93607 A Left ventricular recording 3.26 NA 2.83 0.26 NA 6.35 000 93607 26 A Left ventricular recording 3.26 1.36 1.36 0.17 4.79 4.79 000 93607 TC A Left ventricular recording 0.00 NA 1.47 0.09 NA 1.56 000 93609 A Mapping of tachycardia 10.07 NA 6.79 0.66 NA 17.52 000 93609 26 A Mapping of tachycardia 10.07 4.11 4.11 0.52 14.70 14.70 000 93609 TC A Mapping of tachycardia 0.00 NA 2.68 0.14 NA 2.82 000 93610 A Intra-atrial pacing 3.02 NA 2.54 0.25 NA 5.81 000 93610 26 A Intra-atrial pacing 3.02 1.21 1.21 0.17 4.40 4.40 000 93610 TC A Intra-atrial pacing 0.00 NA 1.33 0.08 NA 1.41 000 93612 A Intraventricular pacing 3.02 NA 2.80 0.26 NA 6.08 000 93612 26 A Intraventricular pacing 3.02 1.21 1.21 0.17 4.40 4.40 000 93612 TC A Intraventricular pacing 0.00 NA 1.59 0.09 NA 1.68 000 93615 A Esophageal recording 0.99 NA 0.70 0.05 NA 1.74 000 93615 26 A Esophageal recording 0.99 0.39 0.39 0.03 1.41 1.41 000 93615 TC A Esophageal recording 0.00 NA 0.31 0.02 NA 0.33 000 93616 A Esophageal recording 1.49 NA 0.79 0.08 NA 2.36 000 93616 26 A Esophageal recording 1.49 0.48 0.48 0.06 2.03 2.03 000 93616 TC A Esophageal recording 0.00 NA 0.31 0.02 NA 0.33 000 93618 A Heart rhythm pacing 4.26 NA 5.65 0.42 NA 10.33 000 93618 26 A Heart rhythm pacing 4.26 1.75 1.75 0.22 6.23 6.23 000 93618 TC A Heart rhythm pacing 0.00 NA 3.90 0.20 NA 4.10 000 93619 A Electrophysiology evaluation 7.32 NA 10.57 0.77 NA 18.66 000 93619 26 A Electrophysiology evaluation 7.32 2.98 2.98 0.38 10.68 10.68 000 93619 TC A Electrophysiology evaluation 0.00 NA 7.59 0.39 NA 7.98 000 93620 A Electrophysiology evaluation 11.59 NA 13.58 1.04 NA 26.21 000 93620 26 A Electrophysiology evaluation 11.59 4.75 4.75 0.60 16.94 16.94 000 93620 TC A Electrophysiology evaluation 0.00 NA 8.83 0.44 NA 9.27 000 93621 C Electrophysiology evaluation 0.00 NA 0.00 0.00 NA 0.00 000 93621 26 A Electrophysiology evaluation 12.66 5.19 5.19 0.66 18.51 18.51 000 93621 TC C Electrophysiology evaluation 0.00 NA 0.00 0.00 NA 0.00 000 93622 C Electrophysiology evaluation 0.00 NA 0.00 0.00 NA 0.00 000 93622 26 A Electrophysiology evaluation 12.74 5.22 5.22 0.67 18.63 18.63 000 93622 TC C Electrophysiology evaluation 0.00 NA 0.00 0.00 NA 0.00 000 Start Printed Page 40527 93623 C Stimulation, pacing heart 0.00 NA 0.00 0.00 NA 0.00 ZZZ 93623 26 A Stimulation, pacing heart 2.85 1.16 1.16 0.15 4.16 4.16 ZZZ 93623 TC C Stimulation, pacing heart 0.00 NA 0.00 0.00 NA 0.00 ZZZ 93624 A Electrophysiologic study 4.81 NA 3.91 0.36 NA 9.08 000 93624 26 A Electrophysiologic study 4.81 1.96 1.96 0.25 7.02 7.02 000 93624 TC A Electrophysiologic study 0.00 NA 1.95 0.11 NA 2.06 000 93631 A Heart pacing, mapping 7.60 NA 8.89 1.17 NA 17.66 000 93631 26 A Heart pacing, mapping 7.60 2.83 2.83 0.66 11.09 11.09 000 93631 TC A Heart pacing, mapping 0.00 NA 6.06 0.51 NA 6.57 000 93640 A Evaluation heart device 3.52 NA 8.46 0.53 NA 12.51 000 93640 26 A Evaluation heart device 3.52 1.40 1.40 0.18 5.10 5.10 000 93640 TC A Evaluation heart device 0.00 NA 7.06 0.35 NA 7.41 000 93641 A Electrophysiology evaluation 5.93 NA 9.49 0.66 NA 16.08 000 93641 26 A Electrophysiology evaluation 5.93 2.43 2.43 0.31 8.67 8.67 000 93641 TC A Electrophysiology evaluation 0.00 NA 7.06 0.35 NA 7.41 000 93642 A Electrophysiology evaluation 4.89 NA 9.00 0.51 NA 14.40 000 93642 26 A Electrophysiology evaluation 4.89 1.94 1.94 0.16 6.99 6.99 000 93642 TC A Electrophysiology evaluation 0.00 NA 7.06 0.35 NA 7.41 000 93650 A Ablate heart dysrhythm focus 10.51 4.36 NA 0.55 15.42 NA 000 93651 A Ablate heart dysrhythm focus 16.25 6.70 NA 0.85 23.80 NA 000 93652 A Ablate heart dysrhythm focus 17.68 7.27 NA 0.92 25.87 NA 000 93660 A Tilt table evaluation 1.89 NA 2.44 0.08 NA 4.41 000 93660 26 A Tilt table evaluation 1.89 0.78 0.78 0.06 2.73 2.73 000 93660 TC A Tilt table evaluation 0.00 NA 1.66 0.02 NA 1.68 000 93662 A Intracardiac ecg (ice) 2.80 1.16 NA 0.41 4.37 NA ZZZ 93668 N Peripheral vascular rehab 0.00 NA 0.00 0.00 NA 0.00 XXX 93720 A Total body plethysmography 0.17 NA 0.75 0.06 NA 0.98 XXX 93721 A Plethysmography tracing 0.00 NA 0.70 0.05 NA 0.75 XXX 93722 A Plethysmography report 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93724 A Analyze pacemaker system 4.89 NA 5.90 0.38 NA 11.17 000 93724 26 A Analyze pacemaker system 4.89 2.00 2.00 0.18 7.07 7.07 000 93724 TC A Analyze pacemaker system 0.00 NA 3.90 0.20 NA 4.10 000 93727 A Analyze ilr system 0.52 0.19 0.19 0.05 0.76 0.76 XXX 93731 A Analyze pacemaker system 0.45 NA 0.67 0.05 NA 1.17 XXX 93731 26 A Analyze pacemaker system 0.45 0.18 0.18 0.02 0.65 0.65 XXX 93731 TC A Analyze pacemaker system 0.00 NA 0.49 0.03 NA 0.52 XXX 93732 A Analyze pacemaker system 0.92 NA 0.87 0.06 NA 1.85 XXX 93732 26 A Analyze pacemaker system 0.92 0.37 0.37 0.03 1.32 1.32 XXX 93732 TC A Analyze pacemaker system 0.00 NA 0.50 0.03 NA 0.53 XXX 93733 A Telephone analy, pacemaker 0.17 NA 0.78 0.06 NA 1.01 XXX 93733 26 A Telephone analy, pacemaker 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93733 TC A Telephone analy, pacemaker 0.00 NA 0.71 0.05 NA 0.76 XXX 93734 A Analyze pacemaker system 0.38 NA 0.49 0.03 NA 0.90 XXX 93734 26 A Analyze pacemaker system 0.38 0.15 0.15 0.01 0.54 0.54 XXX 93734 TC A Analyze pacemaker system 0.00 NA 0.34 0.02 NA 0.36 XXX 93735 A Analyze pacemaker system 0.74 NA 0.74 0.06 NA 1.54 XXX 93735 26 A Analyze pacemaker system 0.74 0.30 0.30 0.03 1.07 1.07 XXX 93735 TC A Analyze pacemaker system 0.00 NA 0.44 0.03 NA 0.47 XXX 93736 A Telephone analy, pacemaker 0.15 NA 0.68 0.06 NA 0.89 XXX 93736 26 A Telephone analy, pacemaker 0.15 0.06 0.06 0.01 0.22 0.22 XXX 93736 TC A Telephone analy, pacemaker 0.00 NA 0.62 0.05 NA 0.67 XXX 93737 A Analyze cardio/defibrillator 0.45 NA 0.67 0.04 NA 1.16 XXX 93737 26 A Analyze cardio/defibrillator 0.45 0.18 0.18 0.01 0.64 0.64 XXX 93737 TC A Analyze cardio/defibrillator 0.00 NA 0.49 0.03 NA 0.52 XXX 93738 A Analyze cardio/defibrillator 0.92 NA 0.88 0.06 NA 1.86 XXX 93738 26 A Analyze cardio/defibrillator 0.92 0.38 0.38 0.03 1.33 1.33 XXX 93738 TC A Analyze cardio/defibrillator 0.00 NA 0.50 0.03 NA 0.53 XXX 93740 B Temperature gradient studies +0.16 NA 0.21 0.02 NA 0.39 XXX 93740 26 B Temperature gradient studies +0.16 0.06 0.06 0.01 0.23 0.23 XXX 93740 TC B Temperature gradient studies +0.00 NA 0.15 0.01 NA 0.16 XXX 93741 A Analyze ht pace device sngl 0.80 NA 0.98 0.05 NA 1.83 XXX 93741 26 A Analyze ht pace device sngl 0.80 0.32 0.32 0.02 1.14 1.14 XXX 93741 TC A Analyze ht pace device sngl 0.00 NA 0.66 0.03 NA 0.69 XXX 93742 A Analyze ht pace device sngl 0.91 NA 1.02 0.05 NA 1.98 XXX 93742 26 A Analyze ht pace device sngl 0.91 0.36 0.36 0.02 1.29 1.29 XXX 93742 TC A Analyze ht pace device sngl 0.00 NA 0.66 0.03 NA 0.69 XXX 93743 A Analyze ht pace device dual 1.03 NA 1.13 0.06 NA 2.22 XXX 93743 26 A Analyze ht pace device dual 1.03 0.41 0.41 0.03 1.47 1.47 XXX 93743 TC A Analyze ht pace device dual 0.00 NA 0.72 0.03 NA 0.75 XXX 93744 A Analyze ht pace device dual 1.18 NA 1.13 0.06 NA 2.37 XXX 93744 26 A Analyze ht pace device dual 1.18 0.47 0.47 0.03 1.68 1.68 XXX 93744 TC A Analyze ht pace device dual 0.00 NA 0.66 0.03 NA 0.69 XXX 93760 N Cephalic thermogram 0.00 NA 0.00 0.00 NA 0.00 XXX 93762 N Peripheral thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40528 93770 B Measure venous pressure +0.16 NA 0.09 0.02 NA 0.27 XXX 93770 26 B Measure venous pressure +0.16 0.06 0.06 0.01 0.23 0.23 XXX 93770 TC B Measure venous pressure +0.00 NA 0.03 0.01 NA 0.04 XXX 93784 N Ambulatory BP monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93786 N Ambulatory BP recording 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93788 N Ambulatory BP analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93790 N Review/report BP recording 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93797 A Cardiac rehab 0.18 0.07 0.37 0.01 0.26 0.56 000 93798 A Cardiac rehab/monitor 0.28 0.11 0.45 0.01 0.40 0.74 000 93799 C Cardiovascular procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 93799 26 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 TC C Cardiovascular procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 93875 A Extracranial study 0.22 NA 1.17 0.10 NA 1.49 XXX 93875 26 A Extracranial study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 93875 TC A Extracranial study 0.00 NA 1.09 0.09 NA 1.18 XXX 93880 A Extracranial study 0.60 NA 3.89 0.33 NA 4.82 XXX 93880 26 A Extracranial study 0.60 0.22 0.22 0.04 0.86 0.86 XXX 93880 TC A Extracranial study 0.00 NA 3.67 0.29 NA 3.96 XXX 93882 A Extracranial study 0.40 NA 2.59 0.22 NA 3.21 XXX 93882 26 A Extracranial study 0.40 0.15 0.15 0.04 0.59 0.59 XXX 93882 TC A Extracranial study 0.00 NA 2.44 0.18 NA 2.62 XXX 93886 A Intracranial study 0.94 NA 4.54 0.37 NA 5.85 XXX 93886 26 A Intracranial study 0.94 0.39 0.39 0.05 1.38 1.38 XXX 93886 TC A Intracranial study 0.00 NA 4.15 0.32 NA 4.47 XXX 93888 A Intracranial study 0.62 NA 3.01 0.26 NA 3.89 XXX 93888 26 A Intracranial study 0.62 0.24 0.24 0.04 0.90 0.90 XXX 93888 TC A Intracranial study 0.00 NA 2.77 0.22 NA 2.99 XXX 93922 A Extremity study 0.25 NA 1.22 0.13 NA 1.60 XXX 93922 26 A Extremity study 0.25 0.09 0.09 0.02 0.36 0.36 XXX 93922 TC A Extremity study 0.00 NA 1.13 0.11 NA 1.24 XXX 93923 A Extremity study 0.45 NA 2.31 0.22 NA 2.98 XXX 93923 26 A Extremity study 0.45 0.16 0.16 0.04 0.65 0.65 XXX 93923 TC A Extremity study 0.00 NA 2.15 0.18 NA 2.33 XXX 93924 A Extremity study 0.50 NA 2.51 0.26 NA 3.27 XXX 93924 26 A Extremity study 0.50 0.18 0.18 0.05 0.73 0.73 XXX 93924 TC A Extremity study 0.00 NA 2.33 0.21 NA 2.54 XXX 93925 A Lower extremity study 0.58 NA 3.89 0.33 NA 4.80 XXX 93925 26 A Lower extremity study 0.58 0.21 0.21 0.04 0.83 0.83 XXX 93925 TC A Lower extremity study 0.00 NA 3.68 0.29 NA 3.97 XXX 93926 A Lower extremity study 0.39 NA 2.60 0.22 NA 3.21 XXX 93926 26 A Lower extremity study 0.39 0.14 0.14 0.03 0.56 0.56 XXX 93926 TC A Lower extremity study 0.00 NA 2.46 0.19 NA 2.65 XXX 93930 A Upper extremity study 0.46 NA 4.08 0.34 NA 4.88 XXX 93930 26 A Upper extremity study 0.46 0.17 0.17 0.03 0.66 0.66 XXX 93930 TC A Upper extremity study 0.00 NA 3.91 0.31 NA 4.22 XXX 93931 A Upper extremity study 0.31 NA 2.71 0.22 NA 3.24 XXX 93931 26 A Upper extremity study 0.31 0.11 0.11 0.02 0.44 0.44 XXX 93931 TC A Upper extremity study 0.00 NA 2.60 0.20 NA 2.80 XXX 93965 A Extremity study 0.35 NA 1.21 0.12 NA 1.68 XXX 93965 26 A Extremity study 0.35 0.13 0.13 0.02 0.50 0.50 XXX 93965 TC A Extremity study 0.00 NA 1.08 0.10 NA 1.18 XXX 93970 A Extremity study 0.68 NA 4.31 0.38 NA 5.37 XXX 93970 26 A Extremity study 0.68 0.24 0.24 0.05 0.97 0.97 XXX 93970 TC A Extremity study 0.00 NA 4.07 0.33 NA 4.40 XXX 93971 A Extremity study 0.45 NA 2.86 0.25 NA 3.56 XXX 93971 26 A Extremity study 0.45 0.16 0.16 0.03 0.64 0.64 XXX 93971 TC A Extremity study 0.00 NA 2.70 0.22 NA 2.92 XXX 93975 A Vascular study 1.80 NA 5.26 0.47 NA 7.53 XXX 93975 26 A Vascular study 1.80 0.63 0.63 0.11 2.54 2.54 XXX 93975 TC A Vascular study 0.00 NA 4.63 0.36 NA 4.99 XXX 93976 A Vascular study 1.21 NA 3.50 0.31 NA 5.02 XXX 93976 26 A Vascular study 1.21 0.42 0.42 0.06 1.69 1.69 XXX 93976 TC A Vascular study 0.00 NA 3.08 0.25 NA 3.33 XXX 93978 A Vascular study 0.65 NA 4.02 0.36 NA 5.03 XXX 93978 26 A Vascular study 0.65 0.23 0.23 0.05 0.93 0.93 XXX 93978 TC A Vascular study 0.00 NA 3.79 0.31 NA 4.10 XXX 93979 A Vascular study 0.44 NA 2.68 0.24 NA 3.36 XXX 93979 26 A Vascular study 0.44 0.16 0.16 0.04 0.64 0.64 XXX 93979 TC A Vascular study 0.00 NA 2.52 0.20 NA 2.72 XXX 93980 A Penile vascular study 1.25 NA 3.88 0.35 NA 5.48 XXX 93980 26 A Penile vascular study 1.25 0.44 0.44 0.07 1.76 1.76 XXX 93980 TC A Penile vascular study 0.00 NA 3.44 0.28 NA 3.72 XXX 93981 A Penile vascular study 0.44 NA 3.32 0.28 NA 4.04 XXX 93981 26 A Penile vascular study 0.44 0.15 0.15 0.02 0.61 0.61 XXX Start Printed Page 40529 93981 TC A Penile vascular study 0.00 NA 3.17 0.26 NA 3.43 XXX 93990 A Doppler flow testing 0.25 NA 2.56 0.21 NA 3.02 XXX 93990 26 A Doppler flow testing 0.25 0.10 0.10 0.02 0.37 0.37 XXX 93990 TC A Doppler flow testing 0.00 NA 2.46 0.19 NA 2.65 XXX 94010 A Breathing capacity test 0.17 NA 0.81 0.03 NA 1.01 XXX 94010 26 A Breathing capacity test 0.17 0.05 0.05 0.01 0.23 0.23 XXX 94010 TC A Breathing capacity test 0.00 NA 0.76 0.02 NA 0.78 XXX 94014 A Patient recorded spirometry 0.52 NA 0.50 0.03 NA 1.05 XXX 94015 A Patient recorded spirometry 0.00 NA 0.33 0.01 NA 0.34 XXX 94016 A Review patient spirometry 0.52 0.17 0.17 0.02 0.71 0.71 XXX 94060 A Evaluation of wheezing 0.31 NA 1.22 0.06 NA 1.59 XXX 94060 26 A Evaluation of wheezing 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94060 TC A Evaluation of wheezing 0.00 NA 1.12 0.05 NA 1.17 XXX 94070 A Evaluation of wheezing 0.60 NA 3.83 0.10 NA 4.53 XXX 94070 26 A Evaluation of wheezing 0.60 0.19 0.19 0.02 0.81 0.81 XXX 94070 TC A Evaluation of wheezing 0.00 NA 3.64 0.08 NA 3.72 XXX 94150 B Vital capacity test +0.07 NA 0.61 0.02 NA 0.70 XXX 94150 26 B Vital capacity test +0.07 0.03 0.03 0.01 0.11 0.11 XXX 94150 TC B Vital capacity test +0.00 NA 0.58 0.01 NA 0.59 XXX 94200 A Lung function test (MBC/MVV) 0.11 NA 0.32 0.03 NA 0.46 XXX 94200 26 A Lung function test (MBC/MVV) 0.11 0.04 0.04 0.01 0.16 0.16 XXX 94200 TC A Lung function test (MBC/MVV) 0.00 NA 0.28 0.02 NA 0.30 XXX 94240 A Residual lung capacity 0.26 NA 1.42 0.05 NA 1.73 XXX 94240 26 A Residual lung capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94240 TC A Residual lung capacity 0.00 NA 1.34 0.04 NA 1.38 XXX 94250 A Expired gas collection 0.11 NA 0.66 0.02 NA 0.79 XXX 94250 26 A Expired gas collection 0.11 0.04 0.04 0.01 0.16 0.16 XXX 94250 TC A Expired gas collection 0.00 NA 0.62 0.01 NA 0.63 XXX 94260 A Thoracic gas volume 0.13 NA 0.40 0.04 NA 0.57 XXX 94260 26 A Thoracic gas volume 0.13 0.04 0.04 0.01 0.18 0.18 XXX 94260 TC A Thoracic gas volume 0.00 NA 0.36 0.03 NA 0.39 XXX 94350 A Lung nitrogen washout curve 0.26 NA 1.21 0.04 NA 1.51 XXX 94350 26 A Lung nitrogen washout curve 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94350 TC A Lung nitrogen washout curve 0.00 NA 1.13 0.03 NA 1.16 XXX 94360 A Measure airflow resistance 0.26 NA 0.65 0.06 NA 0.97 XXX 94360 26 A Measure airflow resistance 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94360 TC A Measure airflow resistance 0.00 NA 0.57 0.05 NA 0.62 XXX 94370 A Breath airway closing volume 0.26 NA 2.53 0.03 NA 2.82 XXX 94370 26 A Breath airway closing volume 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94370 TC A Breath airway closing volume 0.00 NA 2.45 0.02 NA 2.47 XXX 94375 A Respiratory flow volume loop 0.31 NA 0.48 0.03 NA 0.82 XXX 94375 26 A Respiratory flow volume loop 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94375 TC A Respiratory flow volume loop 0.00 NA 0.38 0.02 NA 0.40 XXX 94400 A CO2 breathing response curve 0.40 NA 0.84 0.06 NA 1.30 XXX 94400 26 A CO2 breathing response curve 0.40 0.13 0.13 0.01 0.54 0.54 XXX 94400 TC A CO2 breathing response curve 0.00 NA 0.71 0.05 NA 0.76 XXX 94450 A Hypoxia response curve 0.40 NA 0.82 0.04 NA 1.26 XXX 94450 26 A Hypoxia response curve 0.40 0.11 0.11 0.02 0.53 0.53 XXX 94450 TC A Hypoxia response curve 0.00 NA 0.71 0.02 NA 0.73 XXX 94620 A Pulmonary stress test/simple 0.64 NA 2.36 0.10 NA 3.10 XXX 94620 26 A Pulmonary stress test/simple 0.64 0.21 0.21 0.02 0.87 0.87 XXX 94620 TC A Pulmonary stress test/simple 0.00 NA 2.15 0.08 NA 2.23 XXX 94621 A Pulm stress test/complex 1.42 NA 2.11 0.13 NA 3.66 XXX 94621 26 A Pulm stress test/complex 1.42 0.46 0.46 0.05 1.93 1.93 XXX 94621 TC A Pulm stress test/complex 0.00 NA 1.65 0.08 NA 1.73 XXX 94640 A Airway inhalation treatment 0.00 NA 0.69 0.02 NA 0.71 XXX 94642 C Aerosol inhalation treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94650 A Pressure breathing (IPPB) 0.00 NA 0.65 0.02 NA 0.67 XXX 94651 A Pressure breathing (IPPB) 0.00 NA 0.60 0.02 NA 0.62 XXX 94652 A Pressure breathing (IPPB) 0.00 NA 0.75 0.06 NA 0.81 XXX 94656 A Initial ventilator mgmt 1.22 0.33 NA 0.06 1.61 NA XXX 94657 A Continued ventilator mgmt 0.83 0.26 NA 0.03 1.12 NA XXX 94660 A Pos airway pressure, CPAP 0.76 0.24 0.68 0.03 1.03 1.47 XXX 94662 A Neg press ventilation, cnp 0.76 0.25 NA 0.02 1.03 NA XXX 94664 A Aerosol or vapor inhalations 0.00 NA 0.52 0.03 NA 0.55 XXX 94665 A Aerosol or vapor inhalations 0.00 NA 0.53 0.04 NA 0.57 XXX 94667 A Chest wall manipulation 0.00 NA 0.83 0.04 NA 0.87 XXX 94668 A Chest wall manipulation 0.00 NA 0.71 0.02 NA 0.73 XXX 94680 A Exhaled air analysis, o2 0.26 NA 0.84 0.06 NA 1.16 XXX 94680 26 A Exhaled air analysis, o2 0.26 0.09 0.09 0.01 0.36 0.36 XXX 94680 TC A Exhaled air analysis, o2 0.00 NA 0.75 0.05 NA 0.80 XXX 94681 A Exhaled air analysis, o2/co2 0.20 NA 1.70 0.11 NA 2.01 XXX 94681 26 A Exhaled air analysis, o2/co2 0.20 0.07 0.07 0.01 0.28 0.28 XXX 94681 TC A Exhaled air analysis, o2/co2 0.00 NA 1.63 0.10 NA 1.73 XXX Start Printed Page 40530 94690 A Exhaled air analysis 0.07 NA 0.55 0.04 NA 0.66 XXX 94690 26 A Exhaled air analysis 0.07 0.02 0.02 0.01 0.10 0.10 XXX 94690 TC A Exhaled air analysis 0.00 NA 0.53 0.03 NA 0.56 XXX 94720 A Monoxide diffusing capacity 0.26 NA 1.44 0.06 NA 1.76 XXX 94720 26 A Monoxide diffusing capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94720 TC A Monoxide diffusing capacity 0.00 NA 1.36 0.05 NA 1.41 XXX 94725 A Membrane diffusion capacity 0.26 NA 0.81 0.11 NA 1.18 XXX 94725 26 A Membrane diffusion capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94725 TC A Membrane diffusion capacity 0.00 NA 0.73 0.10 NA 0.83 XXX 94750 A Pulmonary compliance study 0.23 NA 3.64 0.04 NA 3.91 XXX 94750 26 A Pulmonary compliance study 0.23 0.07 0.07 0.01 0.31 0.31 XXX 94750 TC A Pulmonary compliance study 0.00 NA 3.57 0.03 NA 3.60 XXX 94760 T Measure blood oxygen level 0.00 NA 0.09 0.02 NA 0.11 XXX 94761 T Measure blood oxygen level 0.00 NA 0.18 0.05 NA 0.23 XXX 94762 A Measure blood oxygen level 0.00 NA 0.11 0.08 NA 0.19 XXX 94770 A Exhaled carbon dioxide test 0.15 NA 0.76 0.07 NA 0.98 XXX 94770 26 A Exhaled carbon dioxide test 0.15 0.04 0.04 0.01 0.20 0.20 XXX 94770 TC A Exhaled carbon dioxide test 0.00 NA 0.72 0.06 NA 0.78 XXX 94772 C Breath recording, infant 0.00 NA 0.00 0.00 NA 0.00 XXX 94772 26 C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 TC C Breath recording, infant 0.00 NA 0.00 0.00 NA 0.00 XXX 94799 C Pulmonary service/procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 94799 26 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 TC C Pulmonary service/procedure 0.00 NA 0.00 0.00 NA 0.00 XXX 95004 A Allergy skin tests 0.00 NA 0.10 0.01 NA 0.11 XXX 95010 A Sensitivity skin tests 0.15 0.07 0.44 0.01 0.23 0.60 XXX 95015 A Sensitivity skin tests 0.15 0.06 0.48 0.01 0.22 0.64 XXX 95024 A Allergy skin tests 0.00 NA 0.14 0.01 NA 0.15 XXX 95027 A Skin end point titration 0.00 NA 0.14 0.01 NA 0.15 XXX 95028 A Allergy skin tests 0.00 NA 0.23 0.01 NA 0.24 XXX 95044 A Allergy patch tests 0.00 NA 0.20 0.01 NA 0.21 XXX 95052 A Photo patch test 0.00 NA 0.25 0.01 NA 0.26 XXX 95056 A Photosensitivity tests 0.00 NA 0.17 0.01 NA 0.18 XXX 95060 A Eye allergy tests 0.00 NA 0.34 0.02 NA 0.36 XXX 95065 A Nose allergy test 0.00 NA 0.20 0.01 NA 0.21 XXX 95070 A Bronchial allergy tests 0.00 NA 2.25 0.02 NA 2.27 XXX 95071 A Bronchial allergy tests 0.00 NA 2.88 0.02 NA 2.90 XXX 95075 A Ingestion challenge test 0.95 0.42 0.88 0.03 1.40 1.86 XXX 95078 A Provocative testing 0.00 NA 0.25 0.02 NA 0.27 XXX 95115 A Immunotherapy, one injection 0.00 NA 0.38 0.02 NA 0.40 000 95117 A Immunotherapy injections 0.00 NA 0.50 0.02 NA 0.52 000 95120 I Immunotherapy, one injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95125 I Immunotherapy, many antigens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95130 I Immunotherapy, insect venom 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95131 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95132 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95133 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95134 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95144 A Antigen therapy services 0.06 0.03 0.25 0.01 0.10 0.32 000 95145 A Antigen therapy services 0.06 0.02 0.50 0.01 0.09 0.57 000 95146 A Antigen therapy services 0.06 0.02 0.58 0.01 0.09 0.65 000 95147 A Antigen therapy services 0.06 0.02 0.84 0.01 0.09 0.91 000 95148 A Antigen therapy services 0.06 0.03 0.81 0.01 0.10 0.88 000 95149 A Antigen therapy services 0.06 0.02 1.00 0.01 0.09 1.07 000 95165 A Antigen therapy services 0.06 0.02 0.20 0.01 0.09 0.27 000 95170 A Antigen therapy services 0.06 0.02 0.26 0.01 0.09 0.33 000 95180 A Rapid desensitization 2.01 0.84 1.66 0.04 2.89 3.71 000 95199 C Allergy immunology services 0.00 0.00 0.00 0.00 0.00 0.00 000 95805 A Multiple sleep latency test 1.88 NA 7.82 0.34 NA 10.04 XXX 95805 26 A Multiple sleep latency test 1.88 0.69 0.69 0.06 2.63 2.63 XXX 95805 TC A Multiple sleep latency test 0.00 NA 7.13 0.28 NA 7.41 XXX 95806 A Sleep study, unattended 1.66 NA 1.74 0.32 NA 3.72 XXX 95806 26 A Sleep study, unattended 1.66 0.56 0.56 0.06 2.28 2.28 XXX 95806 TC A Sleep study, unattended 0.00 NA 1.18 0.26 NA 1.44 XXX 95807 A Sleep study, attended 1.66 NA 10.85 0.40 NA 12.91 XXX 95807 26 A Sleep study, attended 1.66 0.55 0.55 0.05 2.26 2.26 XXX 95807 TC A Sleep study, attended 0.00 NA 10.30 0.35 NA 10.65 XXX 95808 A Polysomnography, 1-3 2.65 NA 19.34 0.44 NA 22.43 XXX 95808 26 A Polysomnography, 1-3 2.65 0.97 0.97 0.09 3.71 3.71 XXX 95808 TC A Polysomnography, 1-3 0.00 NA 18.37 0.35 NA 18.72 XXX 95810 A Polysomnography, 4 or more 3.53 NA 16.46 0.47 NA 20.46 XXX 95810 26 A Polysomnography, 4 or more 3.53 1.25 1.25 0.12 4.90 4.90 XXX 95810 TC A Polysomnography, 4 or more 0.00 NA 15.21 0.35 NA 15.56 XXX 95811 A Polysomnography w/cpap 3.80 NA 14.73 0.49 NA 19.02 XXX Start Printed Page 40531 95811 26 A Polysomnography w/cpap 3.80 1.33 1.33 0.13 5.26 5.26 XXX 95811 TC A Polysomnography w/cpap 0.00 NA 13.40 0.36 NA 13.76 XXX 95812 A Electroencephalogram (EEG) 1.08 NA 3.68 0.13 NA 4.89 XXX 95812 26 A Electroencephalogram (EEG) 1.08 0.47 0.47 0.04 1.59 1.59 XXX 95812 TC A Electroencephalogram (EEG) 0.00 NA 3.21 0.09 NA 3.30 XXX 95813 A Electroencephalogram (EEG) 1.73 NA 4.96 0.15 NA 6.84 XXX 95813 26 A Electroencephalogram (EEG) 1.73 0.73 0.73 0.06 2.52 2.52 XXX 95813 TC A Electroencephalogram (EEG) 0.00 NA 4.23 0.09 NA 4.32 XXX 95816 A Electroencephalogram (EEG) 1.08 NA 3.33 0.12 NA 4.53 XXX 95816 26 A Electroencephalogram (EEG) 1.08 0.48 0.48 0.04 1.60 1.60 XXX 95816 TC A Electroencephalogram (EEG) 0.00 NA 2.85 0.08 NA 2.93 XXX 95819 A Electroencephalogram (EEG) 1.08 NA 3.93 0.12 NA 5.13 XXX 95819 26 A Electroencephalogram (EEG) 1.08 0.48 0.48 0.04 1.60 1.60 XXX 95819 TC A Electroencephalogram (EEG) 0.00 NA 3.45 0.08 NA 3.53 XXX 95822 A Sleep electroencephalogram 1.08 NA 2.43 0.15 NA 3.66 XXX 95822 26 A Sleep electroencephalogram 1.08 0.48 0.48 0.04 1.60 1.60 XXX 95822 TC A Sleep electroencephalogram 0.00 NA 1.95 0.11 NA 2.06 XXX 95824 A Electroencephalography 0.74 0.29 0.70 0.05 1.08 1.49 XXX 95827 A Night electroencephalogram 1.08 NA 2.69 0.15 NA 3.92 XXX 95827 26 A Night electroencephalogram 1.08 0.43 0.43 0.03 1.54 1.54 XXX 95827 TC A Night electroencephalogram 0.00 NA 2.26 0.12 NA 2.38 XXX 95829 A Surgery electrocorticogram 6.21 NA 28.49 0.33 NA 35.03 XXX 95829 26 A Surgery electrocorticogram 6.21 2.04 2.04 0.31 8.56 8.56 XXX 95829 TC A Surgery electrocorticogram 0.00 NA 26.45 0.02 NA 26.47 XXX 95830 A Insert electrodes for EEG 1.70 0.77 3.40 0.07 2.54 5.17 XXX 95831 A Limb muscle testing, manual 0.28 0.13 0.49 0.01 0.42 0.78 XXX 95832 A Hand muscle testing, manual 0.29 0.11 0.43 0.01 0.41 0.73 XXX 95833 A Body muscle testing, manual 0.47 0.24 0.56 0.01 0.72 1.04 XXX 95834 A Body muscle testing, manual 0.60 0.29 0.57 0.02 0.91 1.19 XXX 95851 A Range of motion measurements 0.16 0.08 0.55 0.01 0.25 0.72 XXX 95852 A Range of motion measurements 0.11 0.05 0.45 0.01 0.17 0.57 XXX 95857 A Tensilon test 0.53 0.24 0.63 0.02 0.79 1.18 XXX 95858 A Tensilon test & myogram 1.56 NA 1.10 0.07 NA 2.73 XXX 95858 26 A Tensilon test & myogram 1.56 0.71 0.71 0.04 2.31 2.31 XXX 95858 TC A Tensilon test & myogram 0.00 NA 0.39 0.03 NA 0.42 XXX 95860 A Muscle test, one limb 0.96 NA 1.22 0.05 NA 2.23 XXX 95860 26 A Muscle test, one limb 0.96 0.44 0.44 0.03 1.43 1.43 XXX 95860 TC A Muscle test, one limb 0.00 NA 0.78 0.02 NA 0.80 XXX 95861 A Muscle test, two limbs 1.54 NA 1.43 0.10 NA 3.07 XXX 95861 26 A Muscle test, two limbs 1.54 0.71 0.71 0.05 2.30 2.30 XXX 95861 TC A Muscle test, two limbs 0.00 NA 0.72 0.05 NA 0.77 XXX 95863 A Muscle test, 3 limbs 1.87 NA 1.77 0.11 NA 3.75 XXX 95863 26 A Muscle test, 3 limbs 1.87 0.85 0.85 0.06 2.78 2.78 XXX 95863 TC A Muscle test, 3 limbs 0.00 NA 0.92 0.05 NA 0.97 XXX 95864 A Muscle test, 4 limbs 1.99 NA 2.67 0.16 NA 4.82 XXX 95864 26 A Muscle test, 4 limbs 1.99 0.92 0.92 0.06 2.97 2.97 XXX 95864 TC A Muscle test, 4 limbs 0.00 NA 1.75 0.10 NA 1.85 XXX 95867 A Muscle test, head or neck 0.79 NA 0.94 0.06 NA 1.79 XXX 95867 26 A Muscle test, head or neck 0.79 0.37 0.37 0.03 1.19 1.19 XXX 95867 TC A Muscle test, head or neck 0.00 NA 0.57 0.03 NA 0.60 XXX 95868 A Muscle test, head or neck 1.18 NA 1.23 0.08 NA 2.49 XXX 95868 26 A Muscle test, head or neck 1.18 0.54 0.54 0.04 1.76 1.76 XXX 95868 TC A Muscle test, head or neck 0.00 NA 0.69 0.04 NA 0.73 XXX 95869 A Muscle test, thor paraspinal 0.37 NA 0.38 0.03 NA 0.78 XXX 95869 26 A Muscle test, thor paraspinal 0.37 0.17 0.17 0.01 0.55 0.55 XXX 95869 TC A Muscle test, thor paraspinal 0.00 NA 0.21 0.02 NA 0.23 XXX 95870 A Muscle test, nonparaspinal 0.37 NA 0.37 0.03 NA 0.77 XXX 95870 26 A Muscle test, nonparaspinal 0.37 0.16 0.16 0.01 0.54 0.54 XXX 95870 TC A Muscle test, nonparaspinal 0.00 NA 0.21 0.02 NA 0.23 XXX 95872 A Muscle test, one fiber 1.50 NA 1.26 0.08 NA 2.84 XXX 95872 26 A Muscle test, one fiber 1.50 0.67 0.67 0.04 2.21 2.21 XXX 95872 TC A Muscle test, one fiber 0.00 NA 0.59 0.04 NA 0.63 XXX 95875 A Limb exercise test 1.34 NA 1.30 0.09 NA 2.73 XXX 95875 26 A Limb exercise test 1.34 0.56 0.56 0.04 1.94 1.94 XXX 95875 TC A Limb exercise test 0.00 NA 0.74 0.05 NA 0.79 XXX 95900 A Motor nerve conduction test 0.42 NA 0.75 0.03 NA 1.20 XXX 95900 26 A Motor nerve conduction test 0.42 0.19 0.19 0.01 0.62 0.62 XXX 95900 TC A Motor nerve conduction test 0.00 NA 0.56 0.02 NA 0.58 XXX 95903 A Motor nerve conduction test 0.60 NA 0.52 0.04 NA 1.16 XXX 95903 26 A Motor nerve conduction test 0.60 0.27 0.27 0.02 0.89 0.89 XXX 95903 TC A Motor nerve conduction test 0.00 NA 0.25 0.02 NA 0.27 XXX 95904 A Sense/mixed n conduction tst 0.34 NA 0.68 0.03 NA 1.05 XXX 95904 26 A Sense/mixed n conduction tst 0.34 0.16 0.16 0.01 0.51 0.51 XXX 95904 TC A Sense/mixed n conduction tst 0.00 NA 0.52 0.02 NA 0.54 XXX Start Printed Page 40532 95920 A Intraop nerve test add-on 2.11 NA 2.27 0.20 NA 4.58 ZZZ 95920 26 A Intraop nerve test add-on 2.11 0.98 0.98 0.14 3.23 3.23 ZZZ 95920 TC A Intraop nerve test add-on 0.00 NA 1.29 0.06 NA 1.35 ZZZ 95921 A Autonomic nerv function test 0.90 NA 0.71 0.05 NA 1.66 XXX 95921 26 A Autonomic nerv function test 0.90 0.34 0.34 0.03 1.27 1.27 XXX 95921 TC A Autonomic nerv function test 0.00 NA 0.37 0.02 NA 0.39 XXX 95922 A Autonomic nerv function test 0.96 NA 0.79 0.05 NA 1.80 XXX 95922 26 A Autonomic nerv function test 0.96 0.42 0.42 0.03 1.41 1.41 XXX 95922 TC A Autonomic nerv function test 0.00 NA 0.37 0.02 NA 0.39 XXX 95923 A Autonomic nerv function test 0.90 NA 2.91 0.05 NA 3.86 XXX 95923 26 A Autonomic nerv function test 0.90 0.40 0.40 0.03 1.33 1.33 XXX 95923 TC A Autonomic nerv function test 0.00 NA 2.51 0.02 NA 2.53 XXX 95925 A Somatosensory testing 0.54 NA 1.12 0.07 NA 1.73 XXX 95925 26 A Somatosensory testing 0.54 0.23 0.23 0.02 0.79 0.79 XXX 95925 TC A Somatosensory testing 0.00 NA 0.89 0.05 NA 0.94 XXX 95926 A Somatosensory testing 0.54 NA 1.14 0.07 NA 1.75 XXX 95926 26 A Somatosensory testing 0.54 0.25 0.25 0.02 0.81 0.81 XXX 95926 TC A Somatosensory testing 0.00 NA 0.89 0.05 NA 0.94 XXX 95927 A Somatosensory testing 0.54 NA 1.16 0.08 NA 1.78 XXX 95927 26 A Somatosensory testing 0.54 0.27 0.27 0.03 0.84 0.84 XXX 95927 TC A Somatosensory testing 0.00 NA 0.89 0.05 NA 0.94 XXX 95930 A Visual evoked potential test 0.35 NA 0.67 0.02 NA 1.04 XXX 95930 26 A Visual evoked potential test 0.35 0.15 0.15 0.01 0.51 0.51 XXX 95930 TC A Visual evoked potential test 0.00 NA 0.52 0.01 NA 0.53 XXX 95933 A Blink reflex test 0.59 NA 1.02 0.07 NA 1.68 XXX 95933 26 A Blink reflex test 0.59 0.25 0.25 0.02 0.86 0.86 XXX 95933 TC A Blink reflex test 0.00 NA 0.77 0.05 NA 0.82 XXX 95934 A H-reflex test 0.51 NA 0.44 0.04 NA 0.99 XXX 95934 26 A H-reflex test 0.51 0.23 0.23 0.02 0.76 0.76 XXX 95934 TC A H-reflex test 0.00 NA 0.21 0.02 NA 0.23 XXX 95936 A H-reflex test 0.55 NA 0.46 0.04 NA 1.05 XXX 95936 26 A H-reflex test 0.55 0.25 0.25 0.02 0.82 0.82 XXX 95936 TC A H-reflex test 0.00 NA 0.21 0.02 NA 0.23 XXX 95937 A Neuromuscular junction test 0.65 NA 0.61 0.04 NA 1.30 XXX 95937 26 A Neuromuscular junction test 0.65 0.28 0.28 0.02 0.95 0.95 XXX 95937 TC A Neuromuscular junction test 0.00 NA 0.33 0.02 NA 0.35 XXX 95950 A Ambulatory eeg monitoring 1.51 NA 4.05 0.44 NA 6.00 XXX 95950 26 A Ambulatory eeg monitoring 1.51 0.68 0.68 0.08 2.27 2.27 XXX 95950 TC A Ambulatory eeg monitoring 0.00 NA 3.37 0.36 NA 3.73 XXX 95951 A EEG monitoring/videorecord 6.00 NA 22.95 0.58 NA 29.53 XXX 95951 26 A EEG monitoring/videorecord 6.00 2.67 2.67 0.20 8.87 8.87 XXX 95951 TC A EEG monitoring/videorecord 0.00 NA 20.28 0.38 NA 20.66 XXX 95953 A EEG monitoring/computer 3.08 NA 7.60 0.46 NA 11.14 XXX 95953 26 A EEG monitoring/computer 3.08 1.36 1.36 0.10 4.54 4.54 XXX 95953 TC A EEG monitoring/computer 0.00 NA 6.24 0.36 NA 6.60 XXX 95954 A EEG monitoring/giving drugs 2.45 NA 4.34 0.15 NA 6.94 XXX 95954 26 A EEG monitoring/giving drugs 2.45 1.08 1.08 0.10 3.63 3.63 XXX 95954 TC A EEG monitoring/giving drugs 0.00 NA 3.26 0.05 NA 3.31 XXX 95955 A EEG during surgery 1.01 NA 2.28 0.19 NA 3.48 XXX 95955 26 A EEG during surgery 1.01 0.35 0.35 0.05 1.41 1.41 XXX 95955 TC A EEG during surgery 0.00 NA 1.93 0.14 NA 2.07 XXX 95956 A Eeg monitoring, cable/radio 3.08 NA 31.21 0.47 NA 34.76 XXX 95956 26 A Eeg monitoring, cable/radio 3.08 1.38 1.38 0.11 4.57 4.57 XXX 95956 TC A Eeg monitoring, cable/radio 0.00 NA 29.83 0.36 NA 30.19 XXX 95957 A EEG digital analysis 1.98 NA 2.57 0.17 NA 4.72 XXX 95957 26 A EEG digital analysis 1.98 0.89 0.89 0.07 2.94 2.94 XXX 95957 TC A EEG digital analysis 0.00 NA 1.68 0.10 NA 1.78 XXX 95958 A EEG monitoring/function test 4.25 NA 3.53 0.29 NA 8.07 XXX 95958 26 A EEG monitoring/function test 4.25 1.82 1.82 0.18 6.25 6.25 XXX 95958 TC A EEG monitoring/function test 0.00 NA 1.71 0.11 NA 1.82 XXX 95961 A Electrode stimulation, brain 2.97 NA 2.65 0.24 NA 5.86 XXX 95961 26 A Electrode stimulation, brain 2.97 1.36 1.36 0.18 4.51 4.51 XXX 95961 TC A Electrode stimulation, brain 0.00 NA 1.29 0.06 NA 1.35 XXX 95962 A Electrode stim, brain add-on 3.21 NA 2.73 0.23 NA 6.17 ZZZ 95962 26 A Electrode stim, brain add-on 3.21 1.44 1.44 0.17 4.82 4.82 ZZZ 95962 TC A Electrode stim, brain add-on 0.00 NA 1.29 0.06 NA 1.35 ZZZ 95970 A Analyze neurostim, no prog 0.45 0.14 0.17 0.03 0.62 0.65 XXX 95971 A Analyze neurostim, simple 0.78 0.23 0.29 0.06 1.07 1.13 XXX 95972 A Analyze neurostim, complex 1.50 0.56 0.64 0.17 2.23 2.31 XXX 95973 A Analyze neurostim, complex 0.92 0.37 0.41 0.07 1.36 1.40 ZZZ 95974 A Cranial neurostim, complex 3.00 1.35 1.35 0.15 4.50 4.50 XXX 95975 A Cranial neurostim, complex 1.70 0.75 0.76 0.07 2.52 2.53 ZZZ 95999 C Neurological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96100 A Psychological testing 0.00 NA 1.73 0.15 NA 1.88 XXX Start Printed Page 40533 96105 A Assessment of aphasia 0.00 NA 1.73 0.15 NA 1.88 XXX 96110 C Developmental test, lim 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96111 A Developmental test, extend 0.00 NA 1.73 0.15 NA 1.88 XXX 96115 A Neurobehavior status exam 0.00 NA 1.73 0.15 NA 1.88 XXX 96117 A Neuropsych test battery 0.00 NA 1.73 0.15 NA 1.88 XXX 96400 A Chemotherapy, sc/im 0.00 NA 0.13 0.01 NA 0.14 XXX 96405 A Intralesional chemo admin 0.52 0.24 1.78 0.02 0.78 2.32 000 96406 A Intralesional chemo admin 0.80 0.32 2.44 0.02 1.14 3.26 000 96408 A Chemotherapy, push technique 0.00 NA 0.95 0.05 NA 1.00 XXX 96410 A Chemotherapy,infusion method 0.00 NA 1.52 0.07 NA 1.59 XXX 96412 A Chemo, infuse method add-on 0.00 NA 1.13 0.06 NA 1.19 ZZZ 96414 A Chemo, infuse method add-on 0.00 NA 1.31 0.07 NA 1.38 XXX 96420 A Chemotherapy, push technique 0.00 NA 1.23 0.07 NA 1.30 XXX 96422 A Chemotherapy,infusion method 0.00 NA 1.21 0.07 NA 1.28 XXX 96423 A Chemo, infuse method add-on 0.00 NA 0.48 0.02 NA 0.50 ZZZ 96425 A Chemotherapy,infusion method 0.00 NA 1.41 0.07 NA 1.48 XXX 96440 A Chemotherapy, intracavitary 2.37 1.07 8.00 0.12 3.56 10.49 000 96445 A Chemotherapy, intracavitary 2.20 1.05 8.36 0.07 3.32 10.63 000 96450 A Chemotherapy, into CNS 1.89 0.90 6.74 0.06 2.85 8.69 000 96520 A Pump refilling, maintenance 0.00 NA 0.88 0.05 NA 0.93 XXX 96530 A Pump refilling, maintenance 0.00 NA 1.05 0.05 NA 1.10 XXX 96542 A Chemotherapy injection 1.42 0.57 4.01 0.05 2.04 5.48 XXX 96545 B Provide chemotherapy agent +0.00 0.00 0.00 0.00 0.00 0.00 XXX 96549 C Chemotherapy, unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96570 A Photodynamic tx, 30 min 1.10 0.43 0.43 0.04 1.57 1.57 ZZZ 96571 A Photodynamic tx, addl 15 min 0.55 0.22 0.22 0.02 0.79 0.79 ZZZ 96900 A Ultraviolet light therapy 0.00 NA 0.39 0.02 NA 0.41 XXX 96902 B Trichogram +0.41 0.16 0.24 0.01 0.58 0.66 XXX 96910 A Photochemotherapy with UV-B 0.00 NA 0.57 0.03 NA 0.60 XXX 96912 A Photochemotherapy with UV-A 0.00 NA 0.65 0.04 NA 0.69 XXX 96913 A Photochemotherapy, UV-A or B 0.00 NA 1.33 0.08 NA 1.41 XXX 96999 C Dermatological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97001 A Pt evaluation 1.20 0.47 0.56 0.10 1.77 1.86 XXX 97002 A Pt re-evaluation 0.60 0.26 0.35 0.04 0.90 0.99 XXX 97003 A Ot evaluation 1.20 0.32 0.66 0.05 1.57 1.91 XXX 97004 A Ot re-evaluation 0.60 0.13 0.42 0.02 0.75 1.04 XXX 97010 B Hot or cold packs therapy +0.06 NA 0.24 0.01 NA 0.31 XXX 97012 A Mechanical traction therapy 0.25 NA 0.27 0.01 NA 0.53 XXX 97014 A Electric stimulation therapy 0.18 NA 0.25 0.01 NA 0.44 XXX 97016 A Vasopneumatic device therapy 0.18 NA 0.25 0.01 NA 0.44 XXX 97018 A Paraffin bath therapy 0.06 NA 0.22 0.01 NA 0.29 XXX 97020 A Microwave therapy 0.06 NA 0.23 0.01 NA 0.30 XXX 97022 A Whirlpool therapy 0.17 NA 0.44 0.01 NA 0.62 XXX 97024 A Diathermy treatment 0.06 NA 0.24 0.01 NA 0.31 XXX 97026 A Infrared therapy 0.06 NA 0.22 0.01 NA 0.29 XXX 97028 A Ultraviolet therapy 0.08 NA 0.23 0.01 NA 0.32 XXX 97032 A Electrical stimulation 0.25 NA 0.29 0.01 NA 0.55 XXX 97033 A Electric current therapy 0.26 NA 0.31 0.02 NA 0.59 XXX 97034 A Contrast bath therapy 0.21 NA 0.28 0.01 NA 0.50 XXX 97035 A Ultrasound therapy 0.21 NA 0.17 0.01 NA 0.39 XXX 97036 A Hydrotherapy 0.28 NA 0.37 0.01 NA 0.66 XXX 97039 A Physical therapy treatment 0.20 NA 0.28 0.01 NA 0.49 XXX 97110 A Therapeutic exercises 0.45 NA 0.19 0.03 NA 0.67 XXX 97112 A Neuromuscular reeducation 0.45 NA 0.30 0.02 NA 0.77 XXX 97113 A Aquatic therapy/exercises 0.44 NA 0.32 0.03 NA 0.79 XXX 97116 A Gait training therapy 0.40 NA 0.30 0.02 NA 0.72 XXX 97124 A Massage therapy 0.35 NA 0.29 0.01 NA 0.65 XXX 97139 A Physical medicine procedure 0.21 NA 0.26 0.01 NA 0.48 XXX 97140 A Manual therapy 0.43 NA 0.32 0.02 NA 0.77 XXX 97150 A Group therapeutic procedures 0.27 NA 0.27 0.02 NA 0.56 XXX 97504 A Orthotic training 0.45 NA 0.30 0.03 NA 0.78 XXX 97520 A Prosthetic training 0.45 NA 0.31 0.02 NA 0.78 XXX 97530 A Therapeutic activities 0.44 NA 0.18 0.02 NA 0.64 XXX 97532 A Cognitive skills development 0.44 NA 0.24 0.01 NA 0.69 XXX 97533 A Sensory integration 0.44 NA 0.30 0.01 NA 0.75 XXX 97535 A Self care mngment training 0.45 NA 0.30 0.02 NA 0.77 XXX 97537 A Community/work reintegration 0.45 NA 0.30 0.01 NA 0.76 XXX 97542 A Wheelchair mngmnt training 0.45 NA 0.30 0.01 NA 0.76 XXX 97545 R Work hardening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97546 R Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 97601 A Wound care selective 0.50 NA 0.50 0.04 NA 1.04 XXX 97602 B Wound care non-selective 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97703 A Prosthetic checkout 0.25 NA 0.15 0.02 NA 0.42 XXX 97750 A Physical performance test 0.45 NA 0.25 0.02 NA 0.72 XXX Start Printed Page 40534 97780 N Acupuncture w/o stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97781 N Acupuncture w/stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97799 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 N Medical nutrition, indiv, in +0.00 NA 0.47 0.01 NA 0.48 XXX 97803 N Med nutrition, indiv, subseq +0.00 NA 0.34 0.01 NA 0.35 XXX 97804 N Medical nutrition, group +0.00 NA 0.14 0.01 NA 0.15 XXX 98925 A Osteopathic manipulation 0.45 0.15 0.37 0.01 0.61 0.83 000 98926 A Osteopathic manipulation 0.65 0.26 0.43 0.02 0.93 1.10 000 98927 A Osteopathic manipulation 0.87 0.31 0.51 0.03 1.21 1.41 000 98928 A Osteopathic manipulation 1.03 0.36 0.59 0.03 1.42 1.65 000 98929 A Osteopathic manipulation 1.19 0.38 0.65 0.04 1.61 1.88 000 98940 A Chiropractic manipulation 0.45 0.13 0.25 0.01 0.59 0.71 000 98941 A Chiropractic manipulation 0.65 0.18 0.31 0.02 0.85 0.98 000 98942 A Chiropractic manipulation 0.87 0.24 0.37 0.03 1.14 1.27 000 98943 N Chiropractic manipulation +0.40 0.16 0.34 0.01 0.57 0.75 XXX 99000 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99001 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99002 B Device handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99024 B Postop follow-up visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99025 B Initial surgical evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99050 B Medical services after hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99052 B Medical services at night 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99054 B Medical servcs, unusual hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99056 B Non-office medical services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99058 B Office emergency care 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99070 B Special supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99071 B Patient education materials 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99075 N Medical testimony 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99078 B Group health education 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99080 B Special reports or forms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99082 C Unusual physician travel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99090 B Computer data analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99100 B Special anesthesia service 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99116 B Anesthesia with hypothermia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99135 B Special anesthesia procedure 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99140 B Emergency anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99141 B Sedation, iv/im or inhalant +0.80 0.39 2.04 0.04 1.23 2.88 XXX 99142 B Sedation, oral/rectal/nasal +0.60 0.31 1.19 0.03 0.94 1.82 XXX 99170 A Anogenital exam, child 1.75 0.69 1.85 0.07 2.51 3.67 000 99172 N Ocular function screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99173 N Visual acuity screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99175 A Induction of vomiting 0.00 NA 1.37 0.08 NA 1.45 XXX 99183 A Hyperbaric oxygen therapy 2.34 0.76 NA 0.12 3.22 NA XXX 99185 A Regional hypothermia 0.00 NA 0.63 0.03 NA 0.66 XXX 99186 A Total body hypothermia 0.00 NA 1.75 0.37 NA 2.12 XXX 99190 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99191 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99192 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99195 A Phlebotomy 0.00 NA 0.44 0.02 NA 0.46 XXX 99199 C Special service/proc/report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99201 A Office/outpatient visit, new 0.45 0.16 0.45 0.02 0.63 0.92 XXX 99202 A Office/outpatient visit, new 0.88 0.33 0.74 0.05 1.26 1.67 XXX 99203 A Office/outpatient visit, new 1.34 0.50 1.07 0.08 1.92 2.49 XXX 99204 A Office/outpatient visit, new 2.00 0.74 1.48 0.10 2.84 3.58 XXX 99205 A Office/outpatient visit, new 2.67 0.96 1.77 0.12 3.75 4.56 XXX 99211 A Office/outpatient visit, est 0.17 0.06 0.37 0.01 0.24 0.55 XXX 99212 A Office/outpatient visit, est 0.45 0.17 0.51 0.02 0.64 0.98 XXX 99213 A Office/outpatient visit, est 0.67 0.24 0.67 0.03 0.94 1.37 XXX 99214 A Office/outpatient visit, est 1.10 0.40 1.02 0.04 1.54 2.16 XXX 99215 A Office/outpatient visit, est 1.77 0.65 1.33 0.07 2.49 3.17 XXX 99217 A Observation care discharge 1.28 0.45 NA 0.05 1.78 NA XXX 99218 A Observation care 1.28 0.45 NA 0.05 1.78 NA XXX 99219 A Observation care 2.14 0.74 NA 0.08 2.96 NA XXX 99220 A Observation care 2.99 1.05 NA 0.11 4.15 NA XXX 99221 A Initial hospital care 1.28 0.47 NA 0.05 1.80 NA XXX 99222 A Initial hospital care 2.14 0.76 NA 0.08 2.98 NA XXX 99223 A Initial hospital care 2.99 1.07 NA 0.10 4.16 NA XXX 99231 A Subsequent hospital care 0.64 0.24 NA 0.02 0.90 NA XXX 99232 A Subsequent hospital care 1.06 0.38 NA 0.03 1.47 NA XXX 99233 A Subsequent hospital care 1.51 0.54 NA 0.05 2.10 NA XXX 99234 A Observ/hosp same date 2.56 0.92 NA 0.11 3.59 NA XXX 99235 A Observ/hosp same date 3.42 1.19 NA 0.13 4.74 NA XXX 99236 A Observ/hosp same date 4.27 1.45 NA 0.17 5.89 NA XXX 99238 A Hospital discharge day 1.28 0.45 NA 0.04 1.77 NA XXX Start Printed Page 40535 99239 A Hospital discharge day 1.75 0.62 NA 0.05 2.42 NA XXX 99241 A Office consultation 0.64 0.23 0.60 0.04 0.91 1.28 XXX 99242 A Office consultation 1.29 0.49 0.99 0.09 1.87 2.37 XXX 99243 A Office consultation 1.72 0.66 1.33 0.10 2.48 3.15 XXX 99244 A Office consultation 2.58 0.97 1.78 0.13 3.68 4.49 XXX 99245 A Office consultation 3.43 1.28 2.25 0.16 4.87 5.84 XXX 99251 A Initial inpatient consult 0.66 0.30 NA 0.04 1.00 NA XXX 99252 A Initial inpatient consult 1.32 0.57 NA 0.08 1.97 NA XXX 99253 A Initial inpatient consult 1.82 0.76 NA 0.09 2.67 NA XXX 99254 A Initial inpatient consult 2.64 1.07 NA 0.11 3.82 NA XXX 99255 A Initial inpatient consult 3.65 1.44 NA 0.15 5.24 NA XXX 99261 A Follow-up inpatient consult 0.42 0.21 NA 0.02 0.65 NA XXX 99262 A Follow-up inpatient consult 0.85 0.37 NA 0.03 1.25 NA XXX 99263 A Follow-up inpatient consult 1.27 0.52 NA 0.04 1.83 NA XXX 99271 A Confirmatory consultation 0.45 0.21 0.64 0.03 0.69 1.12 XXX 99272 A Confirmatory consultation 0.84 0.36 0.88 0.06 1.26 1.78 XXX 99273 A Confirmatory consultation 1.19 0.50 1.07 0.07 1.76 2.33 XXX 99274 A Confirmatory consultation 1.73 0.71 1.38 0.09 2.53 3.20 XXX 99275 A Confirmatory consultation 2.31 0.90 1.63 0.10 3.31 4.04 XXX 99281 A Emergency dept visit 0.33 0.09 NA 0.02 0.44 NA XXX 99282 A Emergency dept visit 0.55 0.15 NA 0.03 0.73 NA XXX 99283 A Emergency dept visit 1.24 0.32 NA 0.08 1.64 NA XXX 99284 A Emergency dept visit 1.95 0.50 NA 0.12 2.57 NA XXX 99285 A Emergency dept visit 3.06 0.75 NA 0.19 4.00 NA XXX 99288 B Direct advanced life support 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99291 A Critical care, first hour 4.00 1.33 1.59 0.14 5.47 5.73 XXX 99292 A Critical care, addl 30 min 2.00 0.66 0.86 0.07 2.73 2.93 ZZZ 99295 A Neonatal critical care 16.00 4.91 NA 0.70 21.61 NA XXX 99296 A Neonatal critical care 8.00 2.63 NA 0.23 10.86 NA XXX 99297 A Neonatal critical care 4.00 1.34 NA 0.12 5.46 NA XXX 99298 A Neonatal critical care 2.75 0.96 NA 0.10 3.81 NA XXX 99301 A Nursing facility care 1.20 0.42 NA 0.04 1.66 NA XXX 99302 A Nursing facility care 1.61 0.56 NA 0.05 2.22 NA XXX 99303 A Nursing facility care 2.01 0.69 NA 0.06 2.76 NA XXX 99311 A Nursing fac care, subseq 0.60 0.21 NA 0.02 0.83 NA XXX 99312 A Nursing fac care, subseq 1.00 0.34 NA 0.03 1.37 NA XXX 99313 A Nursing fac care, subseq 1.42 0.49 NA 0.04 1.95 NA XXX 99315 A Nursing fac discharge day 1.13 0.39 NA 0.04 1.56 NA XXX 99316 A Nursing fac discharge day 1.50 0.53 NA 0.05 2.08 NA XXX 99321 A Rest home visit, new patient 0.71 0.35 0.43 0.02 1.08 1.16 XXX 99322 A Rest home visit, new patient 1.01 0.45 0.68 0.03 1.49 1.72 XXX 99323 A Rest home visit, new patient 1.28 0.56 0.92 0.04 1.88 2.24 XXX 99331 A Rest home visit, est pat 0.60 0.31 0.46 0.02 0.93 1.08 XXX 99332 A Rest home visit, est pat 0.80 0.38 0.58 0.03 1.21 1.41 XXX 99333 A Rest home visit, est pat 1.00 0.45 0.71 0.03 1.48 1.74 XXX 99341 A Home visit, new patient 1.01 0.48 0.54 0.05 1.54 1.60 XXX 99342 A Home visit, new patient 1.52 0.69 0.84 0.05 2.26 2.41 XXX 99343 A Home visit, new patient 2.27 1.28 1.28 0.07 3.62 3.62 XXX 99344 A Home visit, new patient 3.03 1.31 1.59 0.10 4.44 4.72 XXX 99345 A Home visit, new patient 3.79 1.36 1.83 0.12 5.27 5.74 XXX 99347 A Home visit, est patient 0.76 0.36 0.47 0.03 1.15 1.26 XXX 99348 A Home visit, est patient 1.26 0.53 0.71 0.04 1.83 2.01 XXX 99349 A Home visit, est patient 2.02 0.81 1.07 0.06 2.89 3.15 XXX 99350 A Home visit, est patient 3.03 1.16 1.46 0.10 4.29 4.59 XXX 99354 A Prolonged service, office 1.77 0.63 1.46 0.06 2.46 3.29 ZZZ 99355 A Prolonged service, office 1.77 0.63 1.25 0.06 2.46 3.08 ZZZ 99356 A Prolonged service, inpatient 1.71 0.60 NA 0.06 2.37 NA ZZZ 99357 A Prolonged service, inpatient 1.71 0.62 NA 0.06 2.39 NA ZZZ 99358 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99359 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99360 X Physician standby services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99361 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99362 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99371 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99372 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99373 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99374 B Home health care supervision +1.10 0.43 1.43 0.04 1.57 2.57 XXX 99375 G Home health care supervision 1.73 1.68 1.68 0.06 3.47 3.47 XXX 99377 B Hospice care supervision +1.10 0.43 1.43 0.04 1.57 2.57 XXX 99378 G Hospice care supervision 1.73 1.68 1.68 0.06 3.47 3.47 XXX 99379 B Nursing fac care supervision +1.10 0.43 1.43 0.03 1.56 2.56 XXX 99380 B Nursing fac care supervision +1.73 0.68 1.68 0.05 2.46 3.46 XXX 99381 N Prev visit, new, infant +1.19 0.47 1.46 0.04 1.70 2.69 XXX 99382 N Prev visit, new, age 1-4 +1.36 0.54 1.50 0.04 1.94 2.90 XXX Start Printed Page 40536 99383 N Prev visit, new, age 5-11 +1.36 0.54 1.44 0.04 1.94 2.84 XXX 99384 N Prev visit, new, age 12-17 +1.53 0.60 1.52 0.05 2.18 3.10 XXX 99385 N Prev visit, new, age 18-39 +1.53 0.60 1.52 0.05 2.18 3.10 XXX 99386 N Prev visit, new, age 40-64 +1.88 0.74 1.70 0.06 2.68 3.64 XXX 99387 N Prev visit, new, 65 & over +2.06 0.81 1.83 0.06 2.93 3.95 XXX 99391 N Prev visit, est, infant +1.02 0.40 1.00 0.03 1.45 2.05 XXX 99392 N Prev visit, est, age 1-4 +1.19 0.47 1.07 0.04 1.70 2.30 XXX 99393 N Prev visit, est, age 5-11 +1.19 0.47 1.04 0.04 1.70 2.27 XXX 99394 N Prev visit, est, age 12-17 +1.36 0.54 1.12 0.04 1.94 2.52 XXX 99395 N Prev visit, est, age 18-39 +1.36 0.54 1.15 0.04 1.94 2.55 XXX 99396 N Prev visit, est, age 40-64 +1.53 0.60 1.24 0.05 2.18 2.82 XXX 99397 N Prev visit, est, 65 & over +1.71 0.68 1.34 0.05 2.44 3.10 XXX 99401 N Preventive counseling, indiv +0.48 0.19 0.60 0.01 0.68 1.09 XXX 99402 N Preventive counseling, indiv +0.98 0.39 0.85 0.02 1.39 1.85 XXX 99403 N Preventive counseling, indiv +1.46 0.58 1.08 0.03 2.07 2.57 XXX 99404 N Preventive counseling, indiv +1.95 0.77 1.32 0.04 2.76 3.31 XXX 99411 N Preventive counseling, group +0.15 0.06 0.18 0.01 0.22 0.34 XXX 99412 N Preventive counseling, group +0.25 0.10 0.24 0.01 0.36 0.50 XXX 99420 N Health risk assessment test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99429 N Unlisted preventive service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99431 A Initial care, normal newborn 1.17 0.36 NA 0.04 1.57 NA XXX 99432 A Newborn care, not in hosp 1.26 0.34 1.10 0.06 1.66 2.42 XXX 99433 A Normal newborn care/hospital 0.62 0.20 NA 0.02 0.84 NA XXX 99435 A Newborn discharge day hosp 1.50 0.56 NA 0.05 2.11 NA XXX 99436 A Attendance, birth 1.50 0.47 0.59 0.05 2.02 2.14 XXX 99440 A Newborn resuscitation 2.93 0.88 NA 0.11 3.92 NA XXX 99450 N Life/disability evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99455 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99456 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99499 C Unlisted e&m service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0021 I Outside state ambulance serv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0030 I Air ambulance service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0040 I Helicopter ambulance service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0050 I Water amb service emergency 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0080 I Noninterest escort in non er 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0090 I Interest escort in non er 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0100 I Nonemergency transport taxi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0110 I Nonemergency transport bus 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0120 I Noner transport mini-bus 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0130 I Noner transport wheelch van 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0140 I Nonemergency transport air 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0160 I Noner transport case worker 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0170 I Noner transport parking fees 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0180 I Noner transport lodgng recip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0190 I Noner transport meals recip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0200 I Noner transport lodgng escrt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0210 I Noner transport meals escort 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0300 I Ambulance basic non-emer all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0302 I Ambulance basic emergeny all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0304 I Amb adv non-er no serv all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0306 I Amb adv non-er spec serv all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0308 I Amb adv er no spec serv all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0310 I Amb adv er spec serv all 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0320 I Amb basic non-er + supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0322 I Amb basic emerg + supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0324 I Adv non-er serv sep mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0326 I Adv non-er no serv sep mile 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0328 I Adv er no serv sep mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0330 I Adv er spec serv sep mile 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0340 I Amb basic non-er + mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0342 I Ambul basic emer + mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0344 I Amb adv non-er no serv +mile 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0346 I Amb adv non-er serv + mile 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0348 I Adv emer no spec serv + mile 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0350 I Adv emer spec serv + mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0360 I Basic non-er sep mile & supp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0362 I Basic emer sep mile & supply 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0364 I Adv non-er no serv sep mi&su 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0366 I Adv non-er serv sep mil&supp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0368 I Adv er no serv sep mile&supp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0370 I Adv er spec serv sep mi&supp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0380 X Basic life support mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0382 X Basic support routine suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0384 X Bls defibrillation supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40537 A0390 X Advanced life support mileag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0392 X Als defibrillation supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0394 X Als IV drug therapy supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0396 X Als esophageal intub suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0398 X Als routine disposble suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0420 X Ambulance waiting 1/2 hr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0422 X Ambulance 02 life sustaining 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0424 X Extra ambulance attendant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0425 X Ground mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0426 X Als 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0427 X ALS1-emergency 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0428 X bls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0429 X BLS-emergency 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0430 X Fixed wing air transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0431 X Rotary wing air transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0432 X PI volunteer ambulance co 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0433 X als 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0434 X Specialty care transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0435 X Fixed wing air mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0436 X Rotary wing air mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0888 N Noncovered ambulance mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0999 X Unlisted ambulance service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4206 I 1 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4207 I 2 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4208 I 3 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4209 I 5+ CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4210 N Nonneedle injection device 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4211 P Supp for self-adm injections 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4212 P Non coring needle or stylet 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4213 I 20+ CC syringe only 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4214 P 30 CC sterile water/saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4215 I Sterile needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4220 P Infusion pump refill kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4221 X Maint drug infus cath per wk 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4222 X Drug infusion pump supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4230 X Infus insulin pump non needl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4231 X Infusion insulin pump needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4232 X Syringe w/needle insulin 3cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4244 I Alcohol or peroxide per pint 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4245 I Alcohol wipes per box 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4246 I Betadine/phisohex solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4247 I Betadine/iodine swabs/wipes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4250 N Urine reagent strips/tablets 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4253 P Blood glucose/reagent strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4254 X Battery for glucose monitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4255 X Glucose monitor platforms 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4256 P Calibrator solution/chips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4258 P Lancet device each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4259 P Lancets per box 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4260 N Levonorgestrel implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4261 N Cervical cap contraceptive 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4262 B Temporary tear duct plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4263 B Permanent tear duct plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4265 P Paraffin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4270 B Disposable endoscope sheath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4280 X Brst prsths adhsv attchmnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4290 X Sacral nerve stim test lead 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4300 B Cath impl vasc access portal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4301 P Implantable access syst perc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4305 P Drug delivery system >=50 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4306 P Drug delivery system <=5 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4310 P Insert tray w/o bag/cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4311 P Catheter w/o bag 2-way latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4312 P Cath w/o bag 2-way silicone 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4313 P Catheter w/bag 3-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4314 P Cath w/drainage 2-way latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4315 P Cath w/drainage 2-way silcne 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4316 P Cath w/drainage 3-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4319 X Sterile H2O irrigation solut 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4320 P Irrigation tray 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4321 X Cath therapeutic irrig agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4322 P Irrigation syringe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4323 P Saline irrigation solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4324 X Male ext cath w/adh coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40538 A4325 X Male ext cath w/adh strip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4326 P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4327 P Fem urinary collect dev cup 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4328 P Fem urinary collect pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4329 P External catheter start set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4330 P Stool collection pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4331 X Extension drainage tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4332 X Lubricant for cath insertion 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4333 X Urinary cath anchor device 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4334 X Urinary cath leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4335 P Incontinence supply 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4338 P Indwelling catheter latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4340 P Indwelling catheter special 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4344 P Cath indw foley 2 way silicn 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4346 P Cath indw foley 3 way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4347 P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4348 X Male ext cath extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4351 P Straight tip urine catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4352 P Coude tip urinary catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4353 X Intermittent urinary cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4354 P Cath insertion tray w/bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4355 P Bladder irrigation tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4356 P Ext ureth clmp or compr dvc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4357 P Bedside drainage bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4358 P Urinary leg bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4359 P Urinary suspensory w/o leg b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4361 P Ostomy face plate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4362 P Solid skin barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4364 P Liq adhes for facial prosth 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4365 X Adhesive remover wipes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4367 P Ostomy belt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4368 X Ostomy filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4369 X Skin barrier liquid per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4370 X Skin barrier paste per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4371 X Skin barrier powder per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4372 X Skin barrier solid 4x4 equiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4373 X Skin barrier with flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4374 X Skin barrier extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4375 X Drainable plastic pch w fcpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4376 X Drainable rubber pch w fcplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4377 X Drainable plstic pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4378 X Drainable rubber pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4379 X Urinary plastic pouch w fcpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4380 X Urinary rubber pouch w fcplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4381 X Urinary plastic pouch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4382 X Urinary hvy plstc pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4383 X Urinary rubber pouch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4384 X Ostomy faceplt/silicone ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4385 X Ost skn barrier sld ext wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4386 X Ost skn barrier w flng ex wr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4387 X Ost clsd pouch w att st barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4388 X Drainable pch w ex wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4389 X Drainable pch w st wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4390 X Drainable pch ex wear convex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4391 X Urinary pouch w ex wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4392 X Urinary pouch w st wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4393 X Urine pch w ex wear bar conv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4394 X Ostomy pouch liq deodorant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4395 X Ostomy pouch solid deodorant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4396 X Peristomal hernia supprt blt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4397 P Irrigation supply sleeve 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4398 P Ostomy irrigation bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4399 P Ostomy irrig cone/cath w brs 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4400 P Ostomy irrigation set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4402 P Lubricant per ounce 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4404 P Ostomy ring each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4421 P Ostomy supply misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4454 P Tape all types all sizes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4455 P Adhesive remover per ounce 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4460 P Elastic compression bandage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4462 X Abdmnl drssng holder/binder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4464 N Joint support device/garment 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4465 P Non-elastic extremity binder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4470 P Gravlee jet washer 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40539 A4480 P Vabra aspirator 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4481 X Tracheostoma filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4483 X Moisture exchanger 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4490 N Above knee surgical stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4495 N Thigh length surg stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4500 N Below knee surgical stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4510 N Full length surg stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4550 B Surgical trays 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4554 N Disposable underpads 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4556 P Electrodes, pair 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4557 P Lead wires, pair 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4558 P Conductive paste or gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4561 X Pessary rubber, any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4562 X Pessary, non rubber,any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4565 X Slings 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4570 I Splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4572 X Rib belt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4575 N Hyperbaric o2 chamber disps 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4580 I Cast supplies (plaster) 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4590 I Special casting material 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4595 X TENS suppl 2 lead per month 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4608 X Transtracheal oxygen cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4611 X Heavy duty battery 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4612 X Battery cables 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4613 X Battery charger 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4614 X Hand-held PEFR meter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4615 X Cannula nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4616 X Tubing (oxygen) per foot 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4617 X Mouth piece 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4618 X Breathing circuits 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4619 X Face tent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4620 X Variable concentration mask 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4621 X Tracheotomy mask or collar 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4622 X Tracheostomy or larngectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4623 X Tracheostomy inner cannula 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4624 X Tracheal suction tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4625 X Trach care kit for new trach 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4626 X Tracheostomy cleaning brush 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4627 N Spacer bag/reservoir 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4628 X Oropharyngeal suction cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4629 X Tracheostomy care kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4630 X Repl bat t.e.n.s. own by pt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4631 X Wheelchair battery 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4635 X Underarm crutch pad 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4636 X Handgrip for cane etc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4637 X Repl tip cane/crutch/walker 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4640 X Alternating pressure pad 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4641 E Diagnostic imaging agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4642 E Satumomab pendetide per dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4643 E High dose contrast MRI 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4644 E Contrast 100-199 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4645 E Contrast 200-299 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4646 E Contrast 300-399 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4647 B Supp- paramagnetic contr mat 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4649 P Surgical supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4650 X Supp esrd centrifuge 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4655 X Esrd syringe/needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4660 X Esrd blood pressure device 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4663 X Esrd blood pressure cuff 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4670 N Auto blood pressure monitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4680 X Activated carbon filters 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4690 X Dialyzers 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4700 X Standard dialysate solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4705 X Bicarb dialysate solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4712 X Sterile water 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4714 X Treated water for dialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4730 X Fistula cannulation set dial 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4735 X Local/topical anesthetics 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4740 X Esrd shunt accessory 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4750 X Arterial or venous tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4755 X Arterial and venous tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4760 X Standard testing solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4765 X Dialysate concentrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4770 X Blood testing supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40540 A4771 X Blood clotting time tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4772 X Dextrostick/glucose strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4773 X Hemostix 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4774 X Ammonia test paper 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4780 X Esrd sterilizing agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4790 X Esrd cleansing agents 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4800 X Heparin/antidote dialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4820 X Supplies hemodialysis kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4850 X Rubber tipped hemostats 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4860 X Disposable catheter caps 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4870 X Plumbing/electrical work 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4880 X Water storage tanks 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4890 R Contracts/repair/maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4900 X Capd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4901 X Ccpd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4905 X Ipd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4910 X Esrd nonmedical supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4912 X Gomco drain bottle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4913 X Esrd supply 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4914 X Preparation kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4918 X Venous pressure clamp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4919 X Supp dialysis dialyzer holde 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4920 X Harvard pressure clamp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4921 X Measuring cylinder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4927 X Gloves 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5051 P Pouch clsd w barr attached 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5052 P Clsd ostomy pouch w/o barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5053 P Clsd ostomy pouch faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5054 P Clsd ostomy pouch w/flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5055 P Stoma cap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5061 P Pouch drainable w barrier at 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5062 P Drnble ostomy pouch w/o barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5063 P Drain ostomy pouch w/flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5064 I Drain ostomy pouch w/fceplte 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5071 P Urinary pouch w/barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5072 P Urinary pouch w/o barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5073 P Urinary pouch on barr w/flng 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5074 I Urinary pouch w/faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5075 I Urinary pouch on faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5081 P Continent stoma plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5082 P Continent stoma catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5093 P Ostomy accessory convex inse 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5102 P Bedside drain btl w/wo tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5105 P Urinary suspensory 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5112 P Urinary leg bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5113 P Latex leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5114 P Foam/fabric leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5119 P Skin barrier wipes box pr 50 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5121 P Solid skin barrier 6x6 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5122 P Solid skin barrier 8x8 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5123 P Skin barrier with flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5126 P Disk/foam pad +or- adhesive 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5131 P Appliance cleaner 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5200 X Percutaneous catheter anchor 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5500 X Diab shoe for density insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5501 X Diabetic custom molded shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5502 X Diabetic shoe density insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5503 X Diabetic shoe w/roller/rockr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5504 X Diabetic shoe with wedge 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5505 X Diab shoe w/metatarsal bar 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5506 X Diabetic shoe w/off set heel 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5507 X Modification diabetic shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5508 X Diabetic deluxe shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6020 P Collagen wound dressing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6021 X Collagen dressing <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6022 X Collagen drsg>6<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6023 X Collagen dressing >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6024 X Collagen dsg wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6025 I Silicone gel sheet, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6154 P Wound pouch each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6196 P Alginate dressing <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6197 P Alginate drsg >16 <=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6198 P alginate dressing > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6199 P Alginate drsg wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40541 A6200 X Compos drsg <=16 no border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6201 X Compos drsg >16<=48 no bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6202 X Compos drsg >48 no border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6203 P Composite drsg <= 16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6204 P Composite drsg >16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6205 P Composite drsg > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6206 P Contact layer <= 16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6207 P Contact layer >16<= 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6208 P Contact layer > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6209 P Foam drsg <=16 sq in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6210 P Foam drg >16<=48 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6211 P Foam drg > 48 sq in w/o brdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6212 P Foam drg <=16 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6213 P Foam drg >16<=48 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6214 P Foam drg > 48 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6215 P Foam dressing wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6216 P Non-sterile gauze<=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6217 P Non-sterile gauze>16<=48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6218 P Non-sterile gauze > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6219 P Gauze <= 16 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6220 P Gauze >16 <=48 sq in w/bordr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6221 P Gauze > 48 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6222 P Gauze <=16 in no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6223 P Gauze >16<=48 no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6224 P Gauze > 48 in no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6228 P Gauze <= 16 sq in water/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6229 P Gauze >16<=48 sq in watr/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6230 P Gauze > 48 sq in water/salne 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6231 X Hydrogel dsg<=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6232 X Hydrogel dsg>16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6233 X Hydrogel dressing >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6234 P Hydrocolld drg <=16 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6235 P Hydrocolld drg >16<=48 w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6236 P Hydrocolld drg > 48 in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6237 P Hydrocolld drg <=16 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6238 P Hydrocolld drg >16<=48 w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6239 P Hydrocolld drg > 48 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6240 P Hydrocolld drg filler paste 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6241 P Hydrocolloid drg filler dry 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6242 P Hydrogel drg <=16 in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6243 P Hydrogel drg >16<=48 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6244 P Hydrogel drg >48 in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6245 P Hydrogel drg <= 16 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6246 P Hydrogel drg >16<=48 in w/b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6247 P Hydrogel drg > 48 sq in w/b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6248 P Hydrogel drsg gel filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6250 P Skin seal protect moisturizr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6251 P Absorpt drg <=16 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6252 P Absorpt drg >16 <=48 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6253 P Absorpt drg > 48 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6254 P Absorpt drg <=16 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6255 P Absorpt drg >16<=48 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6256 P Absorpt drg > 48 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6257 P Transparent film <= 16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6258 P Transparent film >16<=48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6259 P Transparent film > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6260 P Wound cleanser any type/size 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6261 P Wound filler gel/paste /oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6262 P Wound filler dry form / gram 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6263 P Non-sterile elastic gauze/yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6264 P Non-sterile no elastic gauze 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6265 P Tape per 18 sq inches 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6266 P Impreg gauze no h20/sal/yard 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6402 P Sterile gauze <= 16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6403 P Sterile gauze>16 <= 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6404 P Sterile gauze > 48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6405 P Sterile elastic gauze /yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6406 P Sterile non-elastic gauze/yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7000 X Disposable canister for pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7001 X Nondisposable pump canister 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7002 X Tubing used w suction pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7003 X Nebulizer administration set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7004 X Disposable nebulizer sml vol 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7005 X Nondisposable nebulizer set 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40542 A7006 X Filtered nebulizer admin set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7007 X Lg vol nebulizer disposable 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7008 X Disposable nebulizer prefill 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7009 X Nebulizer reservoir bottle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7010 X Disposable corrugated tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7011 X Nondispos corrugated tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7012 X Nebulizer water collec devic 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7013 X Disposable compressor filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7014 X Compressor nondispos filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7015 X Aerosol mask used w nebulize 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7016 X Nebulizer dome & mouthpiece 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7017 X Nebulizer not used w oxygen 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7018 X Water distilled w/nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7019 X Saline solution dispenser 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7020 X Sterile H2O or NSS w lgv neb 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7501 X Tracheostoma valve w diaphra 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7502 X Replacement diaphragm/fplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7503 X HMES filter holder or cap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7504 X Tracheostoma HMES filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7505 X HMES or trach valve housing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7506 X HMES/trachvalve adhesivedisk 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7507 X Integrated filter & holder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7508 X Housing & Integrated Adhesiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7509 X Heat & moisture exchange sys 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9150 E Misc/exper non-prescript dru 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9160 N Podiatrist non-covered servi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9170 N Chiropractor non-covered ser 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9190 N Misc/expe personal comfort i 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9270 N Non-covered item or service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9300 N Exercise equipment 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9500 E Technetium TC 99m sestamibi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9502 X Technetium TC99M tetrofosmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9503 E Technetium TC 99m medronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9504 X Technetium tc 99m apcitide 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9505 E Thallous chloride TL 201/mci 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9507 X Indium/111 capromab pendetid 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9508 X Iobenguane sulfate I-131 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9510 X Technetium TC99m Disofenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9600 X Strontium-89 chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9605 X Samarium sm153 lexidronamm 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9700 X Echocardiography Contrast 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9900 X Supply/accessory/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9901 X Delivery/set up/dispensing 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0120 N Periodic oral evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0140 N Limit oral eval problm focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0150 R Comprehensve oral evaluation 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0160 N Extensv oral eval prob focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0170 N Re-eval,est pt,problem focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0210 I Intraor complete film series 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0220 I Intraoral periapical first f 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0230 I Intraoral periapical ea add 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0240 R Intraoral occlusal film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0250 R Extraoral first film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0260 R Extraoral ea additional film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0270 R Dental bitewing single film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0272 R Dental bitewings two films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0274 R Dental bitewings four films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0277 R Vert bitewings-sev to eight 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0290 I Dental film skull/facial bon 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0310 I Dental saliography 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0320 I Dental tmj arthrogram incl i 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0321 I Dental other tmj films 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0322 I Dental tomographic survey 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0330 I Dental panoramic film 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0340 I Dental cephalometric film 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0350 I Oral/facial images 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0415 N Bacteriologic study 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0425 N Caries susceptibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0460 R Pulp vitality test 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0470 N Diagnostic casts 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0472 R Gross exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0473 R Micro exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0474 R Micro w exam of surg margins 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0480 R Cytopath smear prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40543 D0501 R Histopathologic examinations 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0502 R Other oral pathology procedu 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0999 R Unspecified diagnostic proce 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1110 N Dental prophylaxis adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1120 N Dental prophylaxis child 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1201 N Topical fluor w prophy child 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1203 N Topical fluor w/o prophy chi 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1204 N Topical fluor w/o prophy adu 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1205 N Topical fluoride w/ prophy a 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1310 N Nutri counsel-control caries 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1320 N Tobacco counseling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1330 N Oral hygiene instruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1351 N Dental sealant per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1510 R Space maintainer fxd unilat 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1515 R Fixed bilat space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1520 R Remove unilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1525 R Remove bilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1550 R Recement space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2110 N Amalgam one surface primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2120 N Amalgam two surfaces primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2130 N Amalgam three surfaces prima 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2131 N Amalgam four/more surf prima 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2140 N Amalgam one surface permanen 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2150 N Amalgam two surfaces permane 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2160 N Amalgam three surfaces perma 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2161 N Amalgam 4 or > surfaces perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2330 N Resin one surface-anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2331 N Resin two surfaces-anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2332 N Resin three surfaces-anterio 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2335 N Resin 4/> surf or w incis an 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2336 N Composite resin crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2337 N Compo resin crown ant-perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2380 N Resin one surf poster primar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2381 N Resin two surf poster primar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2382 N Resin three/more surf post p 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2385 N Resin one surf poster perman 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2386 N Resin two surf poster perman 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2387 N Resin three/more surf post p 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2388 N Resin four/more, post perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2410 N Dental gold foil one surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2420 N Dental gold foil two surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2430 N Dental gold foil three surfa 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2510 N Dental inlay metalic 1 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2520 N Dental inlay metallic 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2530 N Dental inlay metl 3/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2542 N Dental onlay metallic 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2543 N Dental onlay metallic 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2544 N Dental onlay metl 4/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2610 N Inlay porcelain/ceramic 1 su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2620 N Inlay porcelain/ceramic 2 su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2630 N Dental onlay porc 3/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2642 N Dental onlay porcelin 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2643 N Dental onlay porcelin 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2644 N Dental onlay porc 4/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2650 N Inlay composite/resin one su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2651 N Inlay composite/resin two su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2652 N Dental inlay resin 3/mre sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2662 N Dental onlay resin 2 surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2663 N Dental onlay resin 3 surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2664 N Dental onlay resin 4/mre sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2710 N Crown resin laboratory 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2720 N Crown resin w/ high noble me 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2721 N Crown resin w/ base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2722 N Crown resin w/ noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2740 N Crown porcelain/ceramic subs 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2750 N Crown porcelain w/ h noble m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2751 N Crown porcelain fused base m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2752 N Crown porcelain w/ noble met 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2780 N Crown 3/4 cast hi noble met 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2781 N Crown 3/4 cast base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2782 N Crown 3/4 cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2783 N Crown 3/4 porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2790 N Crown full cast high noble m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2791 N Crown full cast base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40544 D2792 N Crown full cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2799 N Provisional crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2910 N Dental recement inlay 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2920 N Dental recement crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2930 N Prefab stnlss steel crwn pri 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2931 N Prefab stnlss steel crown pe 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2932 N Prefabricated resin crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2933 N Prefab stainless steel crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2940 N Dental sedative filling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2950 N Core build-up incl any pins 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2951 N Tooth pin retention 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2952 N Post and core cast + crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2953 N Each addtnl cast post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2954 N Prefab post/core + crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2955 N Post removal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2957 N Each addtnl prefab post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2960 N Laminate labial veneer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2961 N Lab labial veneer resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2962 N Lab labial veneer porcelain 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2970 R Temporary- fractured tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2980 N Crown repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2999 R Dental unspec restorative pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3110 N Pulp cap direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3120 N Pulp cap indirect 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3220 N Therapeutic pulpotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3221 N Gross pulpal debridement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3230 N Pulpal therapy anterior prim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3240 N Pulpal therapy posterior pri 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3310 N Anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3320 N Root canal therapy 2 canals 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3330 N Root canal therapy 3 canals 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3331 N Non-surg tx root canal obs 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3332 N Incomplete endodontic tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3333 N Internal root repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3346 N Retreat root canal anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3347 N Retreat root canal bicuspid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3348 N Retreat root canal molar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3351 N Apexification/recalc initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3352 N Apexification/recalc interim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3353 N Apexification/recalc final 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3410 N Apicoect/perirad surg anter 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3421 N Root surgery bicuspid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3425 N Root surgery molar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3426 N Root surgery ea add root 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3430 N Retrograde filling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3450 N Root amputation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3460 R Endodontic endosseous implan 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3470 N Intentional replantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3910 N Isolation- tooth w rubb dam 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3920 N Tooth splitting 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3950 N Canal prep/fitting of dowel 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3999 R Endodontic procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4210 I Gingivectomy/plasty per quad 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4211 I Gingivectomy/plasty per toot 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4220 N Gingival curettage per quadr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4240 N Gingival flap proc w/ planin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4245 N Apically positioned flap 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4249 N Crown lengthen hard tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4260 R Osseous surgery per quadrant 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4263 R Bone replce graft first site 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4264 R Bone replce graft each add 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4266 N Guided tiss regen resorble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4267 N Guided tiss regen nonresorb 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4268 R Surgical revision procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4270 R Pedicle soft tissue graft pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4271 R Free soft tissue graft proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4273 R Subepithelial tissue graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4274 N Distal/proximal wedge proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4320 N Provision splnt intracoronal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4321 N Provisional splint extracoro 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4341 N Periodontal scaling & root 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4355 R Full mouth debridement 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4381 R Localized chemo delivery 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4910 N Periodontal maint procedures 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40545 D4920 N Unscheduled dressing change 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4999 N Unspecified periodontal proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5110 N Dentures complete maxillary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5120 N Dentures complete mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5130 N Dentures immediat maxillary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5140 N Dentures immediat mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5211 N Dentures maxill part resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5212 N Dentures mand part resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5213 N Dentures maxill part metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5214 N Dentures mandibl part metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5281 N Removable partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5410 N Dentures adjust cmplt maxil 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5411 N Dentures adjust cmplt mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5421 N Dentures adjust part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5422 N Dentures adjust part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5510 N Dentur repr broken compl bas 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5520 N Replace denture teeth complt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5610 N Dentures repair resin base 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5620 N Rep part denture cast frame 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5630 N Rep partial denture clasp 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5640 N Replace part denture teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5650 N Add tooth to partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5660 N Add clasp to partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5710 N Dentures rebase cmplt maxil 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5711 N Dentures rebase cmplt mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5720 N Dentures rebase part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5721 N Dentures rebase part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5730 N Denture reln cmplt maxil ch 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5731 N Denture reln cmplt mand chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5740 N Denture reln part maxil chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5741 N Denture reln part mand chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5750 N Denture reln cmplt max lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5751 N Denture reln cmplt mand lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5760 N Denture reln part maxil lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5761 N Denture reln part mand lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5810 N Denture interm cmplt maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5811 N Denture interm cmplt mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5820 N Denture interm part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5821 N Denture interm part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5850 N Denture tiss conditn maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5851 N Denture tiss condtin mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5860 N Overdenture complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5861 N Overdenture partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5862 N Precision attachment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5867 N Replacement of precision att 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5875 N Prosthesis modification 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5899 N Removable prosthodontic proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5911 R Facial moulage sectional 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5912 R Facial moulage complete 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5913 I Nasal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5914 I Auricular prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5915 I Orbital prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5916 I Ocular prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5919 I Facial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5922 I Nasal septal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5923 I Ocular prosthesis interim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5924 I Cranial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5925 I Facial augmentation implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5926 I Replacement nasal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5927 I Auricular replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5928 I Orbital replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5929 I Facial replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5931 I Surgical obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5932 I Postsurgical obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5933 I Refitting of obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5934 I Mandibular flange prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5935 I Mandibular denture prosth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5936 I Temp obturator prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5937 I Trismus appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5951 R Feeding aid 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5952 I Pediatric speech aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5953 I Adult speech aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5954 I Superimposed prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5955 I Palatal lift prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40546 D5958 I Intraoral con def inter plt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5959 I Intraoral con def mod palat 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5960 I Modify speech aid prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5982 I Surgical stent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5983 R Radiation applicator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5984 R Radiation shield 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5985 R Radiation cone locator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5986 N Fluoride applicator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5987 R Commissure splint 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5988 I Surgical splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5999 I Maxillofacial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6010 I Odontics endosteal implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6020 I Odontics abutment placement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6040 I Odontics eposteal implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6050 I Odontics transosteal implnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6055 I Implant connecting bar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6056 N Prefabricated abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6057 N Custom abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6058 N Abutment supported crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6059 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6060 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6061 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6062 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6063 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6064 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6065 N Implant supported crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6066 N Implant supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6067 N Implant supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6068 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6069 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6070 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6071 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6072 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6073 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6074 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6075 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6076 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6077 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6078 N Implnt/abut suprtd fixd dent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6079 N Implnt/abut suprtd fixd dent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6080 I Implant maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6090 I Repair implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6095 I Odontics repr abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6100 I Removal of implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6199 I Implant procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6210 N Prosthodont high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6211 N Bridge base metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6212 N Bridge noble metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6240 N Bridge porcelain high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6241 N Bridge porcelain base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6242 N Bridge porcelain nobel metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6245 N Bridge porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6250 N Bridge resin w/high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6251 N Bridge resin base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6252 N Bridge resin w/noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6519 N Inlay/onlay porce/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6520 N Dental retainer two surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6530 N Retainer metallic 3+ surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6543 N Dental retainr onlay 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6544 N Dental retainr onlay 4/more 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6545 N Dental retainr cast metl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6548 N Porcelain/ceramic retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6720 N Retain crown resin w hi nble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6721 N Crown resin w/base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6722 N Crown resin w/noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6740 N Crown porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6750 N Crown porcelain high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6751 N Crown porcelain base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6752 N Crown porcelain noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6780 N Crown 3/4 high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6781 N Crown 3/4 cast based metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6782 N Crown 3/4 cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6783 N Crown 3/4 porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6790 N Crown full high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40547 D6791 N Crown full base metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6792 N Crown full noble metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6920 R Dental connector bar 0.00 0.00 0.00 0.00 0.00 0.00 YYY D6930 N Dental recement bridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6940 N Stress breaker 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6950 N Precision attachment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6970 N Post & core plus retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6971 N Cast post bridge retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6972 N Prefab post & core plus reta 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6973 N Core build up for retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6975 N Coping metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6976 N Each addtnl cast post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6977 N Each addtl prefab post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6980 N Bridge repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6999 N Fixed prosthodontic proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7110 R Oral surgery single tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7120 R Each add tooth extraction 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7130 R Tooth root removal 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7210 R Rem imp tooth w mucoper flp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7220 R Impact tooth remov soft tiss 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7230 R Impact tooth remov part bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7240 R Impact tooth remov comp bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7241 R Impact tooth rem bony w/comp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7250 R Tooth root removal 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7260 R Oral antral fistula closure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7270 N Tooth reimplantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7272 N Tooth transplantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7280 N Exposure impact tooth orthod 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7281 N Exposure tooth aid eruption 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7285 I Biopsy of oral tissue hard 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7286 I Biopsy of oral tissue soft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7290 N Repositioning of teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7291 R Transseptal fiberotomy 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7310 I Alveoplasty w/ extraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7320 I Alveoplasty w/o extraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7340 I Vestibuloplasty ridge extens 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7350 I Vestibuloplasty exten graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7410 I Rad exc lesion up to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7420 I Lesion > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7430 I Exc benign tumor to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7431 I Benign tumor exc > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7440 I Malig tumor exc to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7441 I Malig tumor > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7450 I Rem odontogen cyst to 1.25cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7451 I Rem odontogen cyst > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7460 I Rem nonodonto cyst to 1.25cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7461 I Rem nonodonto cyst > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7465 I Lesion destruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7471 I Rem exostosis any site 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7480 I Partial ostectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7490 I Mandible resection 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7510 I I&d absc intraoral soft tiss 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7520 I I&d abscess extraoral 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7530 I Removal fb skin/areolar tiss 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7540 I Removal of fb reaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7550 I Removal of sloughed off bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7560 I Maxillary sinusotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7610 I Maxilla open reduct simple 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7620 I Clsd reduct simpl maxilla fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7630 I Open red simpl mandible fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7640 I Clsd red simpl mandible fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7650 I Open red simp malar/zygom fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7660 I Clsd red simp malar/zygom fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7670 I Closd rductn splint alveolus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7680 I Reduct simple facial bone fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7710 I Maxilla open reduct compound 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7720 I Clsd reduct compd maxilla fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7730 I Open reduct compd mandble fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7740 I Clsd reduct compd mandble fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7750 I Open red comp malar/zygma fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7760 I Clsd red comp malar/zygma fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7770 I Open reduc compd alveolus fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7780 I Reduct compnd facial bone fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7810 I Tmj open reduct-dislocation 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40548 D7820 I Closed tmp manipulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7830 I Tmj manipulation under anest 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7840 I Removal of tmj condyle 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7850 I Tmj meniscectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7852 I Tmj repair of joint disc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7854 I Tmj excisn of joint membrane 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7856 I Tmj cutting of a muscle 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7858 I Tmj reconstruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7860 I Tmj cutting into joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7865 I Tmj reshaping components 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7870 I Tmj aspiration joint fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7871 N Lysis + lavage w catheters 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7872 I Tmj diagnostic arthroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7873 I Tmj arthroscopy lysis adhesn 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7874 I Tmj arthroscopy disc reposit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7875 I Tmj arthroscopy synovectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7876 I Tmj arthroscopy discectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7877 I Tmj arthroscopy debridement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7880 I Occlusal orthotic appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7899 I Tmj unspecified therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7910 I Dent sutur recent wnd to 5cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7911 I Dental suture wound to 5 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7912 I Suture complicate wnd > 5 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7920 I Dental skin graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7940 R Reshaping bone orthognathic 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7941 I Bone cutting ramus closed 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7943 I Cutting ramus open w/graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7944 I Bone cutting segmented 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7945 I Bone cutting body mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7946 I Reconstruction maxilla total 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7947 I Reconstruct maxilla segment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7948 I Reconstruct midface no graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7949 I Reconstruct midface w/graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7950 I Mandible graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7955 I Repair maxillofacial defects 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7960 I Frenulectomy/frenulotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7970 I Excision hyperplastic tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7971 I Excision pericoronal gingiva 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7980 I Sialolithotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7981 I Excision of salivary gland 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7982 I Sialodochoplasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7983 I Closure of salivary fistula 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7990 I Emergency tracheotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7991 I Dental coronoidectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7995 I Synthetic graft facial bones 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7996 I Implant mandible for augment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7997 N Appliance removal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7999 I Oral surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8010 N Limited dental tx primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8020 N Limited dental tx transition 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8030 N Limited dental tx adolescent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8040 N Limited dental tx adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8050 N Intercep dental tx primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8060 N Intercep dental tx transitn 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8070 N Compre dental tx transition 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8080 N Compre dental tx adolescent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8090 N Compre dental tx adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8210 N Orthodontic rem appliance tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8220 N Fixed appliance therapy habt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8660 N Preorthodontic tx visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8670 N Periodic orthodontc tx visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8680 N Orthodontic retention 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8690 N Orthodontic treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8691 N Repair ortho appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8692 N Replacement retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8999 N Orthodontic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9110 R Tx dental pain minor proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9210 I Dent anesthesia w/o surgery 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9211 I Regional block anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9212 I Trigeminal block anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9215 I Local anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9220 I General anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9221 I General anesthesia ea ad 15m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9230 R Analgesia 0.00 0.00 0.00 0.00 0.00 0.00 YYY Start Printed Page 40549 D9241 I Intravenous sedation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9242 I IV sedation ea ad 30 m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9248 R Sedation (non-iv) 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9310 I Dental consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9410 I Dental house call 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9420 I Hospital call 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9430 I Office visit during hours 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9440 I Office visit after hours 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9610 I Dent therapeutic drug inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9630 R Other drugs/medicaments 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9910 N Dent appl desensitizing med 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9911 N Appl desensitizing resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9920 N Behavior management 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9930 R Treatment of complications 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9940 R Dental occlusal guard 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9941 N Fabrication athletic guard 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9950 R Occlusion analysis 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9951 R Limited occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9952 R Complete occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9970 N Enamel microabrasion 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9971 N Odontoplasty 1-2 teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9972 N Extrnl bleaching per arch 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9973 N Extrnl bleaching per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9974 N Intrnl bleaching per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9999 I Adjunctive procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0001 X Drawing blood for specimen 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0002 A Temporary urinary catheter 0.50 0.17 3.10 0.03 0.70 3.63 000 G0004 A ECG transm phys review & int 0.52 NA 7.35 0.45 NA 8.32 XXX G0005 A ECG 24 hour recording 0.00 NA 1.22 0.07 NA 1.29 XXX G0006 A ECG transmission & analysis 0.00 NA 5.92 0.36 NA 6.28 XXX G0007 A ECG phy review & interpret 0.52 0.21 0.21 0.02 0.75 0.75 XXX G0008 X Admin influenza virus vac 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0009 X Admin pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0010 X Admin hepatitis b vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0015 A Post symptom ECG tracing 0.00 NA 5.92 0.36 NA 6.28 XXX G0016 A Post symptom ECG md review 0.52 0.23 0.23 0.02 0.77 0.77 XXX G0025 B Collagen skin test kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0026 X Fecal leukocyte examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0027 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 C PET imaging prev PET single 0.00 NA 0.00 0.00 NA 0.00 XXX G0030 26 A PET imaging prev PET single 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0030 TC C PET imaging prev PET single 0.00 NA 0.00 0.00 NA 0.00 XXX G0031 C PET imaging prev PET multple 0.00 NA 0.00 0.00 NA 0.00 XXX G0031 26 A PET imaging prev PET multple 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0031 TC C PET imaging prev PET multple 0.00 NA 0.00 0.00 NA 0.00 XXX G0032 C PET follow SPECT 78464 singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0032 26 A PET follow SPECT 78464 singl 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0032 TC C PET follow SPECT 78464 singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0033 C PET follow SPECT 78464 mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0033 26 A PET follow SPECT 78464 mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0033 TC C PET follow SPECT 78464 mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0034 C PET follow SPECT 76865 singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0034 26 A PET follow SPECT 76865 singl 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0034 TC C PET follow SPECT 76865 singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0035 C PET follow SPECT 78465 mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0035 26 A PET follow SPECT 78465 mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0035 TC C PET follow SPECT 78465 mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0036 C PET follow cornry angio sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0036 26 A PET follow cornry angio sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0036 TC C PET follow cornry angio sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0037 C PET follow cornry angio mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0037 26 A PET follow cornry angio mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0037 TC C PET follow cornry angio mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0038 C PET follow myocard perf sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0038 26 A PET follow myocard perf sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0038 TC C PET follow myocard perf sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0039 C PET follow myocard perf mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0039 26 A PET follow myocard perf mult 1.87 0.70 0.70 0.07 2.64 2.64 XXX G0039 TC C PET follow myocard perf mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0040 C PET follow stress echo singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0040 26 A PET follow stress echo singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0040 TC C PET follow stress echo singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0041 C PET follow stress echo mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0041 26 A PET follow stress echo mult 1.87 0.70 0.70 0.05 2.62 2.62 XXX Start Printed Page 40550 G0041 TC C PET follow stress echo mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0042 C PET follow ventriculogm sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0042 26 A PET follow ventriculogm sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0042 TC C PET follow ventriculogm sing 0.00 NA 0.00 0.00 NA 0.00 XXX G0043 C PET follow ventriculogm mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0043 26 A PET follow ventriculogm mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0043 TC C PET follow ventriculogm mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0044 C PET following rest ECG singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0044 26 A PET following rest ECG singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0044 TC C PET following rest ECG singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0045 C PET following rest ECG mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0045 26 A PET following rest ECG mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0045 TC C PET following rest ECG mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0046 C PET follow stress ECG singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0046 26 A PET follow stress ECG singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0046 TC C PET follow stress ECG singl 0.00 NA 0.00 0.00 NA 0.00 XXX G0047 C PET follow stress ECG mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0047 26 A PET follow stress ECG mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0047 TC C PET follow stress ECG mult 0.00 NA 0.00 0.00 NA 0.00 XXX G0050 A Residual urine by ultrasound 0.00 NA 0.84 0.04 NA 0.88 XXX G0101 A CA screen;pelvic/breast exam 0.45 0.18 0.69 0.01 0.64 1.15 XXX G0102 A Prostate ca screening; dre 0.17 0.06 0.37 0.01 0.24 0.55 XXX G0103 X Psa, total screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0104 A CA screen;flexi sigmoidscope 0.88 0.45 1.88 0.05 1.38 2.81 000 G0105 A Colorectal scrn; hi risk ind 3.68 1.74 7.30 0.20 5.62 11.18 000 G0106 A Colon CA screen;barium enema 0.99 NA 2.55 0.15 NA 3.69 XXX G0106 26 A Colon CA screen;barium enema 0.99 0.35 0.35 0.04 1.38 1.38 XXX G0106 TC A Colon CA screen;barium enema 0.00 NA 2.20 0.11 NA 2.31 XXX G0107 X CA screen; fecal blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0108 A Diab manage trn per indiv 0.00 NA 1.64 0.01 NA 1.65 XXX G0109 A Diab manage trn ind/group 0.00 NA 0.96 0.01 NA 0.97 XXX G0110 R Nett pulm-rehab educ; ind 0.90 0.36 0.75 0.03 1.29 1.68 XXX G0111 R Nett pulm-rehab educ; group 0.27 0.11 0.29 0.01 0.39 0.57 XXX G0112 R Nett;nutrition guid, initial 1.72 0.68 1.48 0.05 2.45 3.25 XXX G0113 R Nett;nutrition guid,subseqnt 1.29 0.51 1.15 0.04 1.84 2.48 XXX G0114 R Nett; psychosocial consult 1.20 0.47 0.49 0.03 1.70 1.72 XXX G0115 R Nett; psychological testing 1.20 0.38 0.71 0.04 1.62 1.95 XXX G0116 R Nett; psychosocial counsel 1.11 0.44 1.24 0.04 1.59 2.39 XXX G0120 A Colon ca scrn; barium enema 0.99 NA 2.55 0.15 NA 3.69 XXX G0120 26 A Colon ca scrn; barium enema 0.99 0.35 0.35 0.04 1.38 1.38 XXX G0120 TC A Colon ca scrn; barium enema 0.00 NA 2.20 0.11 NA 2.31 XXX G0121 A Colon ca scrn not hi rsk ind 3.68 1.74 7.30 0.20 5.62 11.18 000 G0122 N Colon ca scrn; barium enema +0.99 NA 2.59 0.15 NA 3.73 XXX G0122 26 N Colon ca scrn; barium enema +0.99 0.39 0.39 0.04 1.42 1.42 XXX G0122 TC N Colon ca scrn; barium enema +0.00 NA 2.20 0.11 NA 2.31 XXX G0123 X Screen cerv/vag thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0124 A Screen c/v thin layer by MD 0.42 0.19 0.19 0.01 0.62 0.62 XXX G0125 A Lung image (PET) 1.50 0.52 56.08 2.00 4.02 59.58 XXX G0125 26 A Lung image (PET) 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0125 TC A Lung image (PET) 0.00 NA 55.56 1.95 NA 57.51 XXX G0126 A Lung image (PET) staging 1.87 0.70 56.26 2.01 4.58 60.14 XXX G0126 26 A Lung image (PET) staging 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0126 TC A Lung image (PET) staging 0.00 NA 55.56 1.95 NA 57.51 XXX G0127 R Trim nail(s) 0.11 0.05 0.52 0.01 0.17 0.64 000 G0128 R CORF skilled nursing service 0.08 0.03 0.03 0.01 0.12 0.12 XXX G0130 A Single energy x-ray study 0.22 NA 0.90 0.05 NA 1.17 XXX G0130 26 A Single energy x-ray study 0.22 0.11 0.11 0.01 0.34 0.34 XXX G0130 TC A Single energy x-ray study 0.00 NA 0.79 0.04 NA 0.83 XXX G0131 A CT scan, bone density study 0.25 NA 3.18 0.14 NA 3.57 XXX G0131 26 A CT scan, bone density study 0.25 0.13 0.13 0.01 0.39 0.39 XXX G0131 TC A CT scan, bone density study 0.00 NA 3.05 0.13 NA 3.18 XXX G0132 A CT scan, bone density study 0.22 NA 0.90 0.05 NA 1.17 XXX G0132 26 A CT scan, bone density study 0.22 0.11 0.11 0.01 0.34 0.34 XXX G0132 TC A CT scan, bone density study 0.00 NA 0.79 0.04 NA 0.83 XXX G0141 A Scr c/v cyto,autosys and md 0.42 0.19 0.19 0.01 0.62 0.62 XXX G0143 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0144 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0145 X Scr c/v cyto,thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0147 X Scr c/v cyto, automated sys 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0148 X Scr c/v cyto, autosys, rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0163 A Pet for rec of colorectal ca 1.50 0.56 56.12 2.00 4.06 59.62 XXX G0163 26 A Pet for rec of colorectal ca 1.50 0.56 0.56 0.05 2.11 2.11 XXX G0163 TC A Pet for rec of colorectal ca 0.00 NA 55.56 1.95 NA 57.51 XXX G0164 A Pet for lymphoma staging 1.87 0.69 56.25 2.01 4.57 60.13 XXX Start Printed Page 40551 G0164 26 A Pet for lymphoma staging 1.87 0.69 0.69 0.06 2.62 2.62 XXX G0164 TC A Pet for lymphoma staging 0.00 NA 55.56 1.95 NA 57.51 XXX G0165 A Pet,rec of melanoma/met ca 1.50 0.59 56.15 2.00 4.09 59.65 XXX G0165 26 A Pet,rec of melanoma/met ca 1.50 0.59 0.59 0.05 2.14 2.14 XXX G0165 TC A Pet,rec of melanoma/met ca 0.00 NA 55.56 1.95 NA 57.51 XXX G0166 A Extrnl counterpulse, per tx 0.07 0.03 3.75 0.01 0.11 3.83 XXX G0167 C Hyperbaric oz tx;no md reqrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0168 A Wound closure by adhesive 0.45 0.25 1.80 0.01 0.71 2.26 000 G0173 X Stereo radoisurgery,complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0174 X Intensitymodulatedradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0175 X OPPS Service,sched team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0176 X OPPS/PHP;activity therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0177 X OPPS/PHP; train & educ serv 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0178 X Intensitymodulatedradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0179 A MD recertification HHA patie 0.45 NA 1.11 0.06 NA 1.62 XXX G0180 A MD certification HHA patient 0.67 NA 1.19 0.06 NA 1.92 XXX G0181 A Home health care supervision 1.73 NA 1.45 0.06 NA 3.24 XXX G0182 A Hospice care supervision 1.73 NA 1.78 0.06 NA 3.57 XXX G0183 X Ocular photodynamic therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0184 A Ocular photodynamic tx, 2nd 0.47 0.23 0.23 0.50 1.20 1.20 ZZZ G0185 C Transpuppillary thermotx 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0186 C Dstry eye lesn,fdr vssl tech 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0187 C Dstry mclr drusen,photocoag 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0188 C Xray lwr extrmty-full lngth 0.00 NA 0.00 0.00 NA 0.00 XXX G0188 26 C Xray lwr extrmty-full lngth 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0188 TC C Xray lwr extrmty-full lngth 0.00 NA 0.00 0.00 NA 0.00 XXX G0190 X Immunization administration 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0191 X Immunization admin,each add 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0192 N Immunization oral/intranasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0193 C Endoscopicstudyswallowfunctn 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0194 C Sensorytestingendoscopicstud 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0195 A Clinicalevalswallowingfunct 1.50 0.77 2.06 0.07 2.34 3.63 XXX G0196 A Evalofswallowingwithradioopa 1.50 0.77 2.06 0.07 2.34 3.63 XXX G0197 A Evalofptforprescipspeechdevi 1.35 0.78 1.99 0.04 2.17 3.38 XXX G0198 A Patientadapation&trainforspe 0.99 0.58 1.08 0.03 1.60 2.10 XXX G0199 A Reevaluationofpatientusespec 1.01 0.59 1.80 0.03 1.63 2.84 XXX G0200 A Evalofpatientprescipofvoicep 1.35 0.78 1.99 0.04 2.17 3.38 XXX G0201 A Modifortraininginusevoicepro 0.99 0.58 1.08 0.03 1.60 2.10 XXX G0202 G Screen Mammogram, digital 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0203 G Scr Mamm, film to digital 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0204 G Diag Mamm, digital, bilat 0.69 NA 1.56 0.09 NA 2.34 XXX G0204 26 G Diag Mamm, digital, bilat 0.69 0.27 0.27 0.03 0.99 0.99 XXX G0204 TC G Diag Mamm, digital, bilat 0.00 NA 1.29 0.06 NA 1.35 XXX G0205 G Diag Mamm, film/digit/bil 0.69 NA 1.56 0.09 NA 2.34 XXX G0205 26 G Diag Mamm, film/digit/bil 0.69 0.27 0.27 0.03 0.99 0.99 XXX G0205 TC G Diag Mamm, film/digit/bil 0.00 NA 1.29 0.06 NA 1.35 XXX G0206 G Diag Mamm, digital, uni 0.58 NA 1.27 0.08 NA 1.93 XXX G0206 26 G Diag Mamm, digital, uni 0.58 0.23 0.23 0.03 0.84 0.84 XXX G0206 TC G Diag Mamm, digital, uni 0.00 NA 1.04 0.05 NA 1.09 XXX G0207 G Diag Mamm, film/digit/uni 0.58 NA 1.27 0.08 NA 1.93 XXX G0207 26 G Diag Mamm, film/digit/uni 0.58 0.23 0.23 0.03 0.84 0.84 XXX G0207 TC G Diag Mamm, film/digit/uni 0.00 NA 1.04 0.05 NA 1.09 XXX G0210 C PET img wholebody dxlung ca 0.00 NA 0.00 0.00 NA 0.00 XXX G0210 26 A PET img wholebody dxlung ca 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0210 TC C PET img wholebody dxlung ca 0.00 NA 0.00 0.00 NA 0.00 XXX G0211 C PET img wholebody init lung 0.00 NA 0.00 0.00 NA 0.00 XXX G0211 26 A PET img wholebody init lung 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0211 TC C PET img wholebody init lung 0.00 NA 0.00 0.00 NA 0.00 XXX G0212 C PET img wholebod restag lung 0.00 NA 0.00 0.00 NA 0.00 XXX G0212 26 A PET img wholebod restag lung 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0212 TC C PET img wholebod restag lung 0.00 NA 0.00 0.00 NA 0.00 XXX G0213 C PET img wholebody dx colorec 0.00 NA 0.00 0.00 NA 0.00 XXX G0213 26 A PET img wholebody dx colorec 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0213 TC C PET img wholebody dx colorec 0.00 NA 0.00 0.00 NA 0.00 XXX G0214 C PET img wholebody init color 0.00 NA 0.00 0.00 NA 0.00 XXX G0214 26 A PET img wholebody init color 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0214 TC C PET img wholebody init color 0.00 NA 0.00 0.00 NA 0.00 XXX G0215 C PET img wholebod restag colr 0.00 NA 0.00 0.00 NA 0.00 XXX G0215 26 A PET img wholebod restag colr 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0215 TC C PET img wholebod restag colr 0.00 NA 0.00 0.00 NA 0.00 XXX G0216 C PET img wholebod dx melanoma 0.00 NA 0.00 0.00 NA 0.00 XXX G0216 26 A PET img wholebod dx melanoma 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0216 TC C PET img wholebod dx melanoma 0.00 NA 0.00 0.00 NA 0.00 XXX G0217 C PET img wholbod init melano 0.00 NA 0.00 0.00 NA 0.00 XXX Start Printed Page 40552 G0217 26 A PET img wholbod init melano 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0217 TC C PET img wholbod init melano 0.00 NA 0.00 0.00 NA 0.00 XXX G0218 C PET img wholebod restag mela 0.00 NA 0.00 0.00 NA 0.00 XXX G0218 26 A PET img wholebod restag mela 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0218 TC C PET img wholebod restag mela 0.00 NA 0.00 0.00 NA 0.00 XXX G0219 C PET img wholbod melano non-c 0.00 NA 0.00 0.00 NA 0.00 XXX G0219 26 A PET img wholbod melano non-c 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0219 TC C PET img wholbod melano non-c 0.00 NA 0.00 0.00 NA 0.00 XXX G0220 C PET img wholebod dx lymphoma 0.00 NA 0.00 0.00 NA 0.00 XXX G0220 26 A PET img wholebod dx lymphoma 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0220 TC C PET img wholebod dx lymphoma 0.00 NA 0.00 0.00 NA 0.00 XXX G0221 C PET img wholbod init lympho 0.00 NA 0.00 0.00 NA 0.00 XXX G0221 26 A PET img wholbod init lympho 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0221 TC C PET img wholbod init lympho 0.00 NA 0.00 0.00 NA 0.00 XXX G0222 C PET img wholbod resta lymph 0.00 NA 0.00 0.00 NA 0.00 XXX G0222 26 A PET img wholbod resta lymph 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0222 TC C PET img wholbod resta lymph 0.00 NA 0.00 0.00 NA 0.00 XXX G0223 C PET imag wholbod reg dx head 0.00 NA 0.00 0.00 NA 0.00 XXX G0223 26 A PET imag wholbod reg dx head 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0223 TC C PET imag wholbod reg dx head 0.00 NA 0.00 0.00 NA 0.00 XXX G0224 C PET imag wholbod req ini hea 0.00 NA 0.00 0.00 NA 0.00 XXX G0224 26 A PET imag wholbod req ini hea 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0224 TC C PET imag wholbod reg ini hea 0.00 NA 0.00 0.00 NA 0.00 XXX G0225 C PET whol restag headneck onl 0.00 NA 0.00 0.00 NA 0.00 XXX G0225 26 A PET whol restag headneck onl 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0225 TC C PET whol restag headneck onl 0.00 NA 0.00 0.00 NA 0.00 XXX G0226 C PET img wholbod dx esophagl 0.00 NA 0.00 0.00 NA 0.00 XXX G0226 26 A PET img wholbod dx esophagl 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0226 TC C PET img wholbod dx esophagl 0.00 NA 0.00 0.00 NA 0.00 XXX G0227 C PET img wholbod ini esophage 0.00 NA 0.00 0.00 NA 0.00 XXX G0227 26 A PET img wholbod ini esophage 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0227 TC C PET img wholbod ini esophage 0.00 NA 0.00 0.00 NA 0.00 XXX G0228 C PET img wholbod restg esopha 0.00 NA 0.00 0.00 NA 0.00 XXX G0228 26 A PET img wholbod restg esopha 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0228 TC C PET img wholbod restg esopha 0.00 NA 0.00 0.00 NA 0.00 XXX G0229 C PET img metabolic brain pres 0.00 NA 0.00 0.00 NA 0.00 XXX G0229 26 A PET img metabolic brain pres 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0229 TC C PET img metabolic brain pres 0.00 NA 0.00 0.00 NA 0.00 XXX G0230 C PET mycard viability post s 0.00 NA 0.00 0.00 NA 0.00 XXX G0230 26 A PET mycard viability post s 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0230 TC C PET mycard viability post s 0.00 NA 0.00 0.00 NA 0.00 XXX G9001 X MCCD, initial rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9002 X MCCD,maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9003 X MCCD, risk adj hi, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9004 X MCCD, risk adj lo, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9005 X MCCD, risk adj, maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9006 X MCCD, Home monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9007 X MCCD, sch team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9008 X Mccd,phys coor-care ovrsght 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9016 N Demo-smoking cessation coun 0.00 0.00 0.00 0.00 0.00 0.00 XXX Gxxx1 A Mammogram, screen, dir dig 0.70 NA 2.78 0.09 NA 3.57 XXX Gxxx1 26 A Mammogram, screen, dir dig 0.70 0.28 0.28 0.03 1.01 1.01 XXX Gxxx1 TC A Mammogram, screen, dir dig 0.00 NA 2.50 0.06 NA 2.56 XXX Gxxx2 A Diag mammo, unilat, dir dig 0.70 NA 2.27 0.08 NA 3.05 XXX Gxxx2 26 A Diag mammo, unilat, dir dig 0.70 0.28 0.28 0.03 1.01 1.01 XXX Gxxx2 TC A Diag mammo, unilat, dir dig 0.00 NA 1.99 0.05 NA 2.04 XXX Gxxx3 A Diag mammo, bilat, dir dig 0.87 NA 2.81 0.09 NA 3.77 XXX Gxxx3 26 A Diag mammo, bilat, dir dig 0.87 0.34 0.34 0.03 1.24 1.24 XXX Gxxx3 TC A Diag mammo, bilat, dir dig 0.00 NA 2.47 0.06 NA 2.53 XXX Gxxx4 A Computer aided detection 0.06 NA 0.43 0.02 NA 0.51 XXX Gxxx4 26 A Computer aided detection 0.06 0.02 0.02 0.01 0.09 0.09 XXX Gxxx4 TC A Computer aided detection 0.00 NA 0.41 0.01 NA 0.42 XXX Gxxx5 A Glaucoma screen, md perform 0.45 0.22 0.39 0.02 0.69 0.86 XXX Gxxx6 A Glaucoma screen, md supv. 0.17 0.08 0.25 0.01 0.26 0.43 XXX H0001 I Alcohol and/or drug assess 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0002 I Alcohol and/or drug screenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0003 I Alcohol and/or drug screenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0004 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0005 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0006 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0007 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0008 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0009 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0010 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40553 H0011 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0012 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0013 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0014 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0015 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0016 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0017 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0018 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0019 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0020 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0021 I Alcohol and/or drug training 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0022 I Alcohol and/or drug interven 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0023 I Alcohol and/or drug outreach 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0024 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0025 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0026 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0027 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0028 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0029 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0030 I Alcohol and/or drug hotline 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0120 E Tetracyclin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0130 E Abciximab injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0150 E Injection adenosine 6 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0151 E Adenosine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0170 E Adrenalin epinephrin inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0190 E Inj biperiden lactate/5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0200 E Alatrofloxacin mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0205 E Alglucerase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0207 E Amifostine 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0210 E Methyldopate hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0256 E Alpha 1 proteinase inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0270 E Alprostadil for injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0275 E Alprostadil urethral suppos 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0280 E Aminophyllin 250 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0282 E Amiodarone HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0285 E Amphotericin B 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0286 E Amphotericin B lipid complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0290 E Ampicillin 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0295 E Ampicillin sodium per 1.5 gm 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0300 E Amobarbital 125 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0330 E Succinycholine chloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0340 E Nandrolon phenpropionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0350 E Injection anistreplase 30 u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0360 E Hydralazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0380 E Inj metaraminol bitartrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0390 E Chloroquine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0395 E Arbutamine HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0400 E Inj trimethaphan camsylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0456 E Azithromycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0460 E Atropine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0470 E Dimecaprol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0475 E Baclofen 10 MG injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0476 E Baclofen intrathecal trial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0500 E Dicyclomine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0510 E Benzquinamide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0515 E Inj benztropine mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0520 E Bethanechol chloride inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0530 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0540 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0550 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0560 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0570 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0580 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0585 E Botulinum toxin a per unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0590 E Ethylnorepinephrine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0600 E Edetate calcium disodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0610 E Calcium gluconate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0620 E Calcium glycer & lact/10 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0630 E Calcitonin salmon injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0635 E Calcitriol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0640 E Leucovorin calcium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0670 E Inj mepivacaine HCL/10 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0690 E Cefazolin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0694 E Cefoxitin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40554 J0695 E Cefonocid sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0696 E Ceftriaxone sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0697 E Sterile cefuroxime injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0698 E Cefotaxime sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0702 E Betamethasone acet&sod phosp 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0704 E Betamethasone sod phosp/4 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0710 E Cephapirin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0713 E Inj ceftazidime per 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0715 E Ceftizoxime sodium / 500 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0720 E Chloramphenicol sodium injec 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0725 E Chorionic gonadotropin/1000u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0730 E Chlorpheniramin maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0735 E Clonidine hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0740 E Cidofovir injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0743 E Cilastatin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0745 E Inj codeine phosphate /30 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0760 E Colchicine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0770 E Colistimethate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0780 E Prochlorperazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0800 E Corticotropin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0810 E Cortisone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0835 E Inj cosyntropin per 0.25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0850 E Cytomegalovirus imm IV /vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0895 E Deferoxamine mesylate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0900 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0945 E Brompheniramine maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0970 E Estradiol valerate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1000 E Depo-estradiol cypionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1020 E Methylprednisolone 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1030 E Methylprednisolone 40 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1040 E Methylprednisolone 80 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1050 E Medroxyprogesterone inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1055 N Medrxyprogester acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1060 E Testosterone cypionate 1 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1070 E Testosterone cypionat 100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1080 E Testosterone cypionat 200 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1090 E Testosterone cypionate 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1095 E Inj dexamethasone acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1100 E Dexamethasone sodium phos 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1110 E Inj dihydroergotamine mesylt 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1120 E Acetazolamid sodium injectio 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1160 E Digoxin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1165 E Phenytoin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1170 E Hydromorphone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1180 E Dyphylline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1190 E Dexrazoxane HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1200 E Diphenhydramine hcl injectio 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1205 E Chlorothiazide sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1212 E Dimethyl sulfoxide 50% 50 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1230 E Methadone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1240 E Dimenhydrinate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1245 E Dipyridamole injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1250 E Inj dobutamine HCL/250 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1260 E Dolasetron mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1320 E Amitriptyline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1325 E Epoprostenol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1327 E Eptifibatide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1330 E Ergonovine maleate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1362 E Erythromycin glucep / 250 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1364 E Erythro lactobionate /500 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1380 E Estradiol valerate 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1390 E Estradiol valerate 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1410 E Inj estrogen conjugate 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1435 E Injection estrone per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1436 E Etidronate disodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1438 E Etanercept injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1440 E Filgrastim 300 mcg injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1441 E Filgrastim 480 mcg injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1450 E Fluconazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1452 E Intraocular Fomivirsen na 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1455 E Foscarnet sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1460 E Gamma globulin 1 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1470 E Gamma globulin 2 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1480 E Gamma globulin 3 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40555 J1490 E Gamma globulin 4 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1500 E Gamma globulin 5 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1510 E Gamma globulin 6 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1520 E Gamma globulin 7 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1530 E Gamma globulin 8 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1540 E Gamma globulin 9 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1550 E Gamma globulin 10 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1560 E Gamma globulin > 10 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1561 E Immune globulin 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1563 E IV immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1565 E RSV-ivig 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1570 E Ganciclovir sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1580 E Garamycin gentamicin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1600 E Gold sodium thiomaleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1610 E Glucagon hydrochloride/1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1620 E Gonadorelin hydroch/ 100 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1626 E Granisetron HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1630 E Haloperidol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1631 E Haloperidol decanoate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1642 E Inj heparin sodium per 10 u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1644 E Inj heparin sodium per 1000u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1645 E Dalteparin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1650 E Inj enoxaparin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1670 E Tetanus immune globulin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1690 E Prednisolone tebutate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1700 E Hydrocortisone acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1710 E Hydrocortisone sodium ph inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1720 E Hydrocortisone sodium succ i 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1730 E Diazoxide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1739 E Hydroxyprogesterone cap 125 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1741 E Hydroxyprogesterone cap 250 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1742 E Ibutilide fumarate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1745 E Infliximab injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1750 E Iron dextran 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1785 E Injection imiglucerase /unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1790 E Droperidol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1800 E Propranolol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1810 E Droperidol/fentanyl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1820 E Insulin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1825 E Interferon beta-1a 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1830 E Interferon beta-1b / .25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1840 E Kanamycin sulfate 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1850 E Kanamycin sulfate 75 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1885 E Ketorolac tromethamine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1890 E Cephalothin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1910 E Kutapressin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1930 E Propiomazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1940 E Furosemide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1950 E Leuprolide acetate /3.75 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1955 E Inj levocarnitine per 1 gm 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1956 E Levofloxacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1960 E Levorphanol tartrate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1970 E Methotrimeprazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1980 E Hyoscyamine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1990 E Chlordiazepoxide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2000 E Lidocaine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2010 E Lincomycin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2060 E Lorazepam injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2150 E Mannitol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2175 E Meperidine hydrochl /100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2180 E Meperidine/promethazine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2210 E Methylergonovin maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2240 E Metocurine iodide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2250 E Inj midazolam hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2260 E Inj milrinone lactate / 5 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2270 E Morphine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2271 E Morphine so4 injection 100mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2275 E Morphine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2300 E Inj nalbuphine hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2310 E Inj naloxone hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2320 E Nandrolone decanoate 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2321 E Nandrolone decanoate 100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2322 E Nandrolone decanoate 200 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2330 E Thiothixene injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40556 J2350 E Niacinamide/niacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2352 E Octreotide acetate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2355 E Oprelvekin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2360 E Orphenadrine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2370 E Phenylephrine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2400 E Chloroprocaine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2405 E Ondansetron hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2410 E Oxymorphone hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2430 E Pamidronate disodium /30 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2440 E Papaverin hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2460 E Oxytetracycline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2480 E Hydrochlorides of opium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2500 E Paricalcitol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2510 E Penicillin g procaine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2512 E Inj pentagastrin per 2 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2515 E Pentobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2540 E Penicillin g potassium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2543 E Piperacillin/tazobactam 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2545 E Pentamidine isethionte/300mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2550 E Promethazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2560 E Phenobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2590 E Oxytocin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2597 E Inj desmopressin acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2640 E Prednisolone sodium ph inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2650 E Prednisolone acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2670 E Totazoline hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2675 E Inj progesterone per 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2680 E Fluphenazine decanoate 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2690 E Procainamide hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2700 E Oxacillin sodium injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2710 E Neostigmine methylslfte inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2720 E Inj protamine sulfate/10 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2725 E Inj protirelin per 250 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2730 E Pralidoxime chloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2760 E Phentolaine mesylate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2765 E Metoclopramide hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2770 E Quinupristin/dalfopristin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2780 E Ranitidine hydrochloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2790 E Rho d immune globulin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2792 E Rho(D) immune globulin h, sd 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2795 E Ropivacaine HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2800 E Methocarbamol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2810 E Inj theophylline per 40 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2820 E Sargramostim injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2860 E Secobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2910 E Aurothioglucose injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2912 E Sodium chloride injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2915 E NA Ferric Gluconate Complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2920 E Methylprednisolone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2930 E Methylprednisolone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2950 E Promazine hcl injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2970 E Methicillin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2993 E Reteplase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2995 E Inj streptokinase /250000 IU 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2997 E Alteplase recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3000 E Streptomycin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3010 E Fentanyl citrate injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3030 E Sumatriptan succinate / 6 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3070 E Pentazocine hcl injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3080 E Chlorprothixene injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3105 E Terbutaline sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3120 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3130 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3140 E Testosterone suspension inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3150 E Testosteron propionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3230 E Chlorpromazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3240 E Thyrotropin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3245 E Tirofiban hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3250 E Trimethobenzamide hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3260 E Tobramycin sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3265 E Injection torsemide 10 mg/ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3270 E Imipramine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3280 E Thiethylperazine maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3301 E Triamcinolone acetonide inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40557 J3302 E Triamcinolone diacetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3303 E Triamcinolone hexacetonl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3305 E Inj trimetrexate glucoronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3310 E Perphenazine injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3320 E Spectinomycn di-hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3350 E Urea injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3360 E Diazepam injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3364 E Urokinase 5000 IU injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3365 E Urokinase 250,000 IU inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3370 R Vancomycin hcl injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3390 E Methoxamine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3400 E Triflupromazine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3410 E Hydroxyzine hcl injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3420 E Vitamin b12 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3430 E Vitamin k phytonadione inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3450 E Mephentermine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3470 E Hyaluronidase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3475 E Inj magnesium sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3480 E Inj potassium chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3485 E Zidovudine 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3490 E Drugs unclassified injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3520 N Edetate disodium per 150 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3530 E Nasal vaccine inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3535 N Metered dose inhaler drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3570 N Laetrile amygdalin vit B17 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7030 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7040 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7042 E 5% dextrose/normal saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7050 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7051 E Sterile saline/water 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7060 E 5% dextrose/water 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7070 E D5w infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7100 E Dextran 40 infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7110 E Dextran 75 infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7120 E Ringers lactate infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7130 E Hypertonic saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7190 X Factor viii 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7191 X Factor VIII (porcine) 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7192 X Factor viii recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7194 X Factor ix complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7197 X Antithrombin iii injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7198 E Anti-inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7199 E Hemophilia clot factor noc 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7300 N Intraut copper contraceptive 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7310 E Ganciclovir long act implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7315 E Sodium hyaluronate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7320 E Hylan G-F 20 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7330 E Cultured chondrocytes implnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7500 X Azathioprine oral 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7501 X Azathioprine parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7502 E Cyclosporine oral 100 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7504 X Lymphocyte immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7505 X Monoclonal antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7506 X Prednisone oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7507 E Tacrolimus oral per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7508 E Tacrolimus oral per 5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7509 X Methylprednisolone oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7510 X Prednisolone oral per 5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7513 E Daclizumab, parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7515 E Cyclosporine oral 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7516 E Cyclosporin parenteral 250mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7517 E Mycophenolate mofetil oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7520 E Sirolimus, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7525 E Tacrolimus injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7599 X Immunosuppressive drug noc 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7608 E Acetylcysteine inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7618 E Albuterol inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7619 E Albuterol inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7628 E Bitolterol mes inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7629 E Bitolterol mes inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7631 E Cromolyn sodium inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7635 E Atropine inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7636 E Atropine inhal sol unit dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7637 E Dexamethasone inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40558 J7638 E Dexamethasone inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7639 E Dornase alpha inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7642 E Glycopyrrolate inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7643 E Glycopyrrolate inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7644 E Ipratropium brom inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7648 E Isoetharine hcl inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7649 E Isoetharine hcl inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7658 E Isoproterenolhcl inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7659 E Isoproterenol hcl inh sol ud 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7668 E Metaproterenol inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7669 E Metaproterenol inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7680 E Terbutaline so4 inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7681 E Terbutaline so4 inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7682 E Tobramycin inhalation sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7683 E Triamcinolone inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7684 E Triamcinolone inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7699 E Inhalation solution for DME 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7799 E Non-inhalation drug for DME 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8499 N Oral prescrip drug non chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8510 E Oral busulfan 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8520 E Capecitabine, oral, 150 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8521 E Capecitabine, oral, 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8530 E Cyclophosphamide oral 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8560 E Etoposide oral 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8600 E Melphalan oral 2 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8610 E Methotrexate oral 2.5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8700 E Temozolmide 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8999 E Oral prescription drug chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9000 E Doxorubic hcl 10 MG vl chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9001 E Doxorubicin hcl liposome inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9015 E Aldesleukin/single use vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9020 E Asparaginase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9031 E Bcg live intravesical vac 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9040 E Bleomycin sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9045 E Carboplatin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9050 E Carmus bischl nitro inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9060 E Cisplatin 10 MG injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9062 E Cisplatin 50 MG injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9065 E Inj cladribine per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9070 E Cyclophosphamide 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9080 E Cyclophosphamide 200 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9090 E Cyclophosphamide 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9091 E Cyclophosphamide 1.0 grm inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9092 E Cyclophosphamide 2.0 grm inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9093 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9094 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9095 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9096 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9097 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9100 E Cytarabine hcl 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9110 E Cytarabine hcl 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9120 E Dactinomycin actinomycin d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9130 E Dacarbazine 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9140 E Dacarbazine 200 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9150 E Daunorubicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9151 E Daunorubicin citrate liposom 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9160 E Denileukin diftitox, 300 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9165 E Diethylstilbestrol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9170 E Docetaxel 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9180 E Epirubicin HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9181 E Etoposide 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9182 E Etoposide 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9185 E Fludarabine phosphate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9190 E Fluorouracil injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9200 E Floxuridine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9201 E Gemcitabine HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9202 E Goserelin acetate implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9206 E Irinotecan injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9208 E Ifosfomide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9209 E Mesna injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9211 E Idarubicin hcl injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9212 E Interferon alfacon-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9213 E Interferon alfa-2a inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9214 E Interferon alfa-2b inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40559 J9215 E Interferon alfa-n3 inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9216 E Interferon gamma 1-b inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9217 E Leuprolide acetate suspnsion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9218 E Leuprolide acetate injeciton 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9219 E Leuprolide acetate implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9230 E Mechlorethamine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9245 E Inj melphalan hydrochl 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9250 E Methotrexate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9260 E Methotrexate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9265 E Paclitaxel injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9266 E Pegaspargase/singl dose vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9268 E Pentostatin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9270 E Plicamycin (mithramycin) inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9280 E Mitomycin 5 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9290 E Mitomycin 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9291 E Mitomycin 40 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9293 E Mitoxantrone hydrochl / 5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9310 E Rituximab cancer treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9320 E Streptozocin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9340 E Thiotepa injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9350 E Topotecan 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9355 E Trastuzumab 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9357 E Valrubicin, 200 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9360 E Vinblastine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9370 E Vincristine sulfate 1 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9375 E Vincristine sulfate 2 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9380 E Vincristine sulfate 5 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9390 E Vinorelbine tartrate/10 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9600 E Porfimer sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9999 E Chemotherapy drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0064 A Visit for drug monitoring 0.37 0.12 0.26 0.01 0.50 0.64 XXX M0075 N Cellular therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0076 N Prolotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0100 N Intragastric hypothermia 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0300 N IV chelationtherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0301 N Fabric wrapping of aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0302 A Assessment of cardiac output 0.17 NA 0.85 0.02 NA 1.04 XXX M0302 26 A Assessment of cardiac output 0.17 0.07 0.07 0.01 0.25 0.25 XXX M0302 TC A Assessment of cardiac output 0.00 NA 0.78 0.01 NA 0.79 XXX P2028 X Cephalin floculation test 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2029 X Congo red blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2031 N Hair analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2033 X Blood thymol turbidity 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2038 X Blood mucoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX P3000 X Screen pap by tech w md supv 0.00 0.00 0.00 0.00 0.00 0.00 XXX P3001 A Screening pap smear by phys 0.42 0.19 0.19 0.01 0.62 0.62 XXX P7001 I Culture bacterial urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9010 E Whole blood for transfusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9011 E Blood split unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9012 E Cryoprecipitate each unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9016 E RBC leukocytes reduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9017 E One donor fresh frozn plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9019 E Platelets, each unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9020 E Plaelet rich plasma unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9021 E Red blood cells unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9022 E Washed red blood cells unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9023 X Frozen plasma, pooled, sd 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9031 X Platelets leukocytes reduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9032 X Platelets, irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9033 X Platelets leukoreduced irrad 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9034 X Platelets, pheresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9035 X Platelet pheres leukoreduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9036 X Platelet pheresis irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9037 X Plate pheres leukoredu irrad 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9038 X RBC irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9039 X RBC deglycerolized 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9040 X RBC leukoreduced irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9041 X Albumin(human), 5% 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9042 X Albumin (human), 25% 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9043 X Plasma protein fraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9044 X Cryoprecipitatereducedplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9603 X One-way allow prorated miles 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9604 X One-way allow prorated trip 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9612 X Catheterize for urine spec 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40560 P9615 X Urine specimen collect mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0035 A Cardiokymography 0.17 NA 0.45 0.03 NA 0.65 XXX Q0035 26 A Cardiokymography 0.17 0.07 0.07 0.01 0.25 0.25 XXX Q0035 TC A Cardiokymography 0.00 NA 0.38 0.02 NA 0.40 XXX Q0091 A Obtaining screen pap smear 0.37 0.15 0.72 0.01 0.53 1.10 XXX Q0092 A Set up port xray equipment 0.00 NA 0.31 0.01 NA 0.32 XXX Q0111 X Wet mounts/ w preparations 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0112 X Potassium hydroxide preps 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0113 X Pinworm examinations 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0114 X Fern test 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0115 X Post-coital mucous exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0136 X Non esrd epoetin alpha inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0144 N Azithromycin dihydrate, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0160 X Factor IX non-recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0161 X Factor IX recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0163 X Diphenhydramine HCl 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0164 X Prochlorperazine maleate 5mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0165 X Prochlorperazine maleate10mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0166 X Granisetron HCl 1 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0167 X Dronabinol 2.5mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0168 X Dronabinol 5mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0169 X Promethazine HCl 12.5mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0170 X Promethazine HCl 25 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0171 X Chlorpromazine HCl 10mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0172 X Chlorpromazine HCl 25mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0173 X Trimethobenzamide HCl 250mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0174 X Thiethylperazine maleate10mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0175 X Perphenazine 4mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0176 X Perphenazine 8mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0177 X Hydroxyzine pamoate 25mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0178 X Hydroxyzine pamoate 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0179 X Ondansetron HCl 8mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0180 X Dolasetron mesylate oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0181 X Unspecified oral anti-emetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0183 X Nonmetabolic active tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0184 X Metabolically active tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0185 X Metabolic active D/E tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0186 I Paramedic intercept, rural 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0187 E Factor viia recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1001 X Ntiol category 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1002 X Ntiol category 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1003 X Ntiol category 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1004 X Ntiol category 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1005 X Ntiol category 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2001 N Oral cabergoline 0.5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2002 E Elliotts b solution per ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2003 E Aprotinin, 10,000 kiu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2004 E Bladder calculi irrig sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2005 E Corticorelin ovine triflutat 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2006 E Digoxin immune fab (ovine) 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2007 E Ethanolamine oleate 100 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2008 E Fomepizole, 1.5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2009 E Fosphenytoin, 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2010 E Glatiramer acetate, per dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2011 E Hemin, per 1 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2012 E Pegademase bovine, 25 iu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2013 E Pentastarch 10% solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2014 E Sermorelin acetate, 0.5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2015 E Somatrem, 5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2016 E Somatropin, 1 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2017 E Teniposide, 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2018 E Urofollitropin, 75 iu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2019 E Basiliximab 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2020 E Histrelin acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2021 E Lepirudin 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2022 E VonWillebrandFactrCmplxperIU 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3001 E Brachytherapy Radioelements 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3002 E Gallium ga 67 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3003 E Technetium tc99m bicisate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3004 E Xenon xe 133 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3005 E Technetium tc99m mertiatide 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3006 E Technetium tc99m glucepatate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3007 E Sodium phosphate p32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3008 E Indium 111-in pentetreotide 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40561 Q3009 E Technetium tc99m oxidronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3010 E Technetium tc99mlabeledrbcs 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3011 E Chromic phosphate p32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3012 E Cyanocobalamin cobalt co57 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3013 E Injection, verteporfin, 15mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4001 X Cast sup body cast, plas 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4002 X Cast sup body cast, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4003 X Cast sup shoulder cast, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4004 X Cast sup shoulder cast, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4005 X Cast sup long arm, ad, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4006 X Cast sup long arm, ad, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4007 X Cast sup long arm ped, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4008 X Cast sup, long arm ped, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4009 X Cast sup sh arm, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4010 X Cast sup sh arm, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4011 X Cast sup sh arm ped, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4012 X Cast sup sh arm ped, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4013 X Cast sup gauntlet, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4014 X Cast sup gauntlet, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4015 X Cast sup gauntlet ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4016 X Cast sup gauntlet ped, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4017 X Cast sup l arm splint, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4018 X Cast sup l arm splint, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4019 X Cast sup l arm splint ped, p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4020 X Cast sup l arm splint ped, f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4021 X Cast sup sh arm splint, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4022 X Cast sup sh arm splint, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4023 X Cast sup sh arm splint ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4024 X Cast sup sh arm splint ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4025 X Cast sup, hip spica, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4026 X Cast sup hip spica, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4027 X Cast sup hip spica, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4028 X Cast sup, hip spica, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4029 X Cast sup long leg, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4030 X Cast sup, long leg, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4031 X Cast sup, long leg ped, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4032 X Cast sup, long leg ped, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4033 X Cast sup, leg cylinder, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4034 X Cast sup, leg cylinder, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4035 X Cast sup, leg cylinder ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4036 X Cast sup, leg cylinder ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4037 X Cast sup, sh leg, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4038 X Cast sup, sh leg, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4039 X Cast sup, sh leg ped, pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4040 X Cast sup, sh leg ped, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4041 X Cast sup, l leg splint , pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4042 X Cast sup, l leg splint , fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4043 X Cast sup, l leg splintped, p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4044 X Cast sup, l leg splint ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4045 X Cast sup, sh leg splint , pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4046 X Cast sup, sh leg splint, fib 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4047 X Cast sup, sh leg splint ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4048 X Cast sup, sh leg splint ped, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4049 X Finger splint, static 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4050 X Cast sup, unlisted casts 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4051 X Splint sup, misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9920 E Epoetin with hct <= 20 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9921 E Epoetin with hct = 21 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9922 E Epoetin with hct = 22 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9923 E Epoetin with hct = 23 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9924 E Epoetin with hct = 24 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9925 E Epoetin with hct = 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9926 E Epoetin with hct = 26 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9927 E Epoetin with hct = 27 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9928 E Epoetin with hct = 28 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9929 E Epoetin with hct = 29 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9930 E Epoetin with hct = 30 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9931 E Epoetin with hct = 31 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9932 E Epoetin with hct = 32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9933 E Epoetin with hct = 33 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9934 E Epoetin with hct = 34 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9935 E Epoetin with hct = 35 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9936 E Epoetin with hct = 36 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9937 E Epoetin with hct = 37 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40562 Q9938 E Epoetin with hct = 38 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9939 E Epoetin with hct = 39 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9940 E Epoetin with hct >= 40 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0076 B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0009 I Injection, butorphanol tartr 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0012 I Butorphanol tartrate, nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0014 I Tacrine hydrochloride, 10 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0016 I Injection, amikacin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0017 I Injection, aminocaproic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0020 I Injection, bupivicaine hydro 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0021 I Injection, cefoperazone sod 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0023 I Injection, cimetidine hydroc 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0024 I Injection, ciprofloxacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0028 I Injection, famotidine, 20 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0029 I Injection, fluconazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0030 I Injection, metronidazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0032 I Injection, nafcillin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0034 I Injection, ofloxacin, 400 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0039 I Injection, sulfamethoxazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0040 I Injection, ticarcillin disod 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0071 I Injection, acyclovir sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0072 I Injection, amikacin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0073 I Injection, aztreonam, 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0074 I Injection, cefotetan disodiu 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0077 I Injection, clindamycin phosp 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0078 I Injection, fosphenytoin sodi 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0080 I Injection, pentamidine iseth 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0081 I Injection, piperacillin sodi 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0085 I injection, gatifloxacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0086 I Injection, verteporfin, 15mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0090 I Sildenafil citrate, 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0096 I Injection, itraconazole, 200 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0156 I Exemestane, 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0157 I Becaplermin gel 1%, 0.5 gm 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0220 I Medical conference by physic 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0221 I Medical conference, 60 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0601 I Screening proctoscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0605 I Digital rectal examination, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0610 I Annual gynecological examina 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0612 I Annual gynecological examina 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0620 I Routine ophthalmological exa 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0621 I Routine ophthalmological exa 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0630 I Removal of sutures 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0800 I Laser in situ keratomileusis 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0810 I Photorefractive keratectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0820 I Computerized corneal topogra 0.00 0.00 0.00 0.00 0.00 0.00 XXX S0830 I Ultrasound pachymetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX S1015 I IV tubing extension set 0.00 0.00 0.00 0.00 0.00 0.00 XXX S1016 I Non-pvc intravenous administ 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2052 I Transplantation of small int 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2053 I Transplantation of small int 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2054 I Transplantation of multivisc 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2055 I Harvesting of donor multivis 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2060 I Lobar lung transplantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2061 I Donor lobectomy (lung) 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2102 I Islet cell tissue transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2103 I Adrenal tissue transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2120 I Low density lipoprotein(LDL) 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2140 I Cord blood harvesting 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2142 I Cord blood-derived stem-cell 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2180 I Donor leukocyte infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2202 I Echosclerotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2205 I Minimally invasive direct co 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2206 I Minimally invasive direct co 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2207 I Minimally invasive direct co 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2208 I Minimally invasive direct co 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2209 I Minimally invasive direct co 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2210 I Cryosurgical ablation (in si 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2220 I Thrombectomy, coronary 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2300 I Arthroscopy, shoulder, surgi 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2340 I Chemodenervation of abductor 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2350 I Diskectomy, anterior, with d 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40563 S2351 I Diskectomy, anterior, with d 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2370 I Intradiscal electrothermal 0.00 0.00 0.00 0.00 0.00 0.00 XXX S2371 I Each additional interspace 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3620 X Newborn metabolic screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3645 I HIV-1 antibody testing of or 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3650 I Saliva test, hormone level; 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3652 I Saliva test, hormone level; 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3700 I Bladder tumor-associated 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3708 I Gastrointestinal fat absorpt 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3902 I Ballistocardiogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3904 I Masters two step 0.00 0.00 0.00 0.00 0.00 0.00 XXX S3906 I Transfusion, direct, blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5000 I Prescription drug, generic 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5001 I Prescription drug,brand name 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5002 I Fat emulsion 10% in 250 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5003 I Fat emulsion 20% in 250 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5010 I 5% dextrose and 45% saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5011 I 5% dextrose in lactated ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5012 I 5% dextrose with potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5013 I 5% dextrose/45%saline,1000ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5014 I 5% dextrose/45%saline,1500ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5016 I Antibiotic admin supplies w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5017 I Antibiotic adminsupplies w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5018 I Pain therapy admin supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5019 I Chemotherapy admin supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5020 I Chemotherapy admin supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5021 I Hydration therapy admin supp 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5022 I Growth hormone therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5025 I Infusion pump rental,perdiem 0.00 0.00 0.00 0.00 0.00 0.00 XXX S5503 I Maintenance of implanted vas 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8001 I Radiofrequency stimulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8035 I Magnetic source imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8040 I Topographic brain mapping 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8049 I Intraoperative radiation the 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8080 I Scintimammography 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8085 I Fluorine-18 fluorodeoxygluco 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8092 I Electron beam computed tomog 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8095 I Wig (for medically-induced h 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8096 I Portable peak flow meter 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8105 I Oximeter for measuring blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8110 I Peak expiratory flow rate (p 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8200 I Chest compression vest 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8205 I Chest compression system gen 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8210 I Mucus trap 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8260 I Oral orthotic for treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8400 I Incontinence pants, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8402 I Diapers, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8405 I Incontinence liners, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8950 I Complex lymphedema therapy, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S8999 I Resuscitation bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9001 I Home uterine monitor with or 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9007 I Ultrafiltration monitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9015 I Automated EEG monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9022 I Digital subtraction angiogra 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9023 I Xenon regional cerebral bloo 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9024 I Paranasal sinus ultrasound 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9025 I Omnicardiogram/cardiointegra 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9035 I Medical equipment or supplie 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9055 I Procuren or other growth fac 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9056 I Coma stimulation per diem 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9061 I Medical supplies and equipme 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9075 I Smoking cessation treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9085 I Meniscal allograft transplan 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9088 I Services provided in urgent 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9090 I Vertebral axial decompressio 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9122 I Home health aide or certifie 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9123 I Nursing care, in the home; b 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9124 I Nursing care, in the home; b 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9125 I Respite care, in the home, p 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9126 I Hospice care, in the home, p 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9127 I Social work visit, in the ho 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9128 I Speech therapy, in the home, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9129 I Occupational therapy, in the 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9140 I Diabetic Management Program, 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40564 S9141 I Diabetic Management Program, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9200 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9210 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9220 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9225 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9230 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9300 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9308 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9310 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9395 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9420 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9423 I Nursing services, patient as 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9425 I Nursing services and all nec 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9435 I Medical foods for inborn err 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9455 I Diabetic Management Program, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9460 I Diabetic Management Program, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9465 I Diabetic Management Program, 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9470 I Nutritional counseling, diet 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9472 I Cardiac rehabilitation progr 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9473 I Pulmonary rehabilitation pro 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9474 I Enterostomal therapy by a re 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9475 I Ambulatory setting substance 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9480 I Intensive outpatient psychia 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9485 I Crisis intervention mental h 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9524 I Nursing services related to 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9526 I Skilled nursing visits for 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9527 I Insertion of a peripherally 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9528 I Insertion of midline central 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9533 I Pain management, intravenous 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9535 I Administration of hematopoie 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9539 I Administration of antibiotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9543 I Administration of medication 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9545 I Administration of immune glo 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9550 I Home IV therapy, hydration 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9555 I Additional home infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9990 I Services provided as part of 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9991 I Services provided as part of 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9992 I Transportation costs to and 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9994 I Lodging costs (e.g. hotel ch 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9996 I Meals for clinical trial par 0.00 0.00 0.00 0.00 0.00 0.00 XXX S9999 I Sales tax 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2020 X Vision svcs frames purchases 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2025 N Eyeglasses delux frames 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2100 X Lens spher single plano 4.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2101 X Single visn sphere 4.12-7.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2102 X Singl visn sphere 7.12-20.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2103 X Spherocylindr 4.00d/12-2.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2104 X Spherocylindr 4.00d/2.12-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2105 X Spherocylinder 4.00d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2106 X Spherocylinder 4.00d/>6.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2107 X Spherocylinder 4.25d/12-2d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2108 X Spherocylinder 4.25d/2.12-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2109 X Spherocylinder 4.25d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2110 X Spherocylinder 4.25d/over 6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2111 X Spherocylindr 7.25d/.25-2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2112 X Spherocylindr 7.25d/2.25-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2113 X Spherocylindr 7.25d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2114 X Spherocylinder over 12.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2115 X Lens lenticular bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2116 X Nonaspheric lens bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2117 X Aspheric lens bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2118 X Lens aniseikonic single 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2199 X Lens single vision not oth c 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2200 X Lens spher bifoc plano 4.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2201 X Lens sphere bifocal 4.12-7.0 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2202 X Lens sphere bifocal 7.12-20. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2203 X Lens sphcyl bifocal 4.00d/.1 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2204 X Lens sphcy bifocal 4.00d/2.1 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2205 X Lens sphcy bifocal 4.00d/4.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2206 X Lens sphcy bifocal 4.00d/ove 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2207 X Lens sphcy bifocal 4.25-7d/. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2208 X Lens sphcy bifocal 4.25-7/2. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2209 X Lens sphcy bifocal 4.25-7/4. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2210 X Lens sphcy bifocal 4.25-7/ov 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40565 V2211 X Lens sphcy bifo 7.25-12/.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2212 X Lens sphcyl bifo 7.25-12/2.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2213 X Lens sphcyl bifo 7.25-12/4.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2214 X Lens sphcyl bifocal over 12. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2215 X Lens lenticular bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2216 X Lens lenticular nonaspheric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2217 X Lens lenticular aspheric bif 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2218 X Lens aniseikonic bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2219 X Lens bifocal seg width over 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2220 X Lens bifocal add over 3.25d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2299 X Lens bifocal speciality 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2300 X Lens sphere trifocal 4.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2301 X Lens sphere trifocal 4.12-7. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2302 X Lens sphere trifocal 7.12-20 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2303 X Lens sphcy trifocal 4.0/.12- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2304 X Lens sphcy trifocal 4.0/2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2305 X Lens sphcy trifocal 4.0/4.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2306 X Lens sphcyl trifocal 4.00/>6 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2307 X Lens sphcy trifocal 4.25-7/. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2308 X Lens sphc trifocal 4.25-7/2. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2309 X Lens sphc trifocal 4.25-7/4. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2310 X Lens sphc trifocal 4.25-7/>6 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2311 X Lens sphc trifo 7.25-12/.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2312 X Lens sphc trifo 7.25-12/2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2313 X Lens sphc trifo 7.25-12/4.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2314 X Lens sphcyl trifocal over 12 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2315 X Lens lenticular trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2316 X Lens lenticular nonaspheric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2317 X Lens lenticular aspheric tri 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2318 X Lens aniseikonic trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2319 X Lens trifocal seg width > 28 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2320 X Lens trifocal add over 3.25d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2399 X Lens trifocal speciality 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2410 X Lens variab asphericity sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2430 X Lens variable asphericity bi 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2499 X Variable asphericity lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2500 X Contact lens pmma spherical 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2501 X Cntct lens pmma-toric/prism 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2502 X Contact lens pmma bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2503 X Cntct lens pmma color vision 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2510 X Cntct gas permeable sphericl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2511 X Cntct toric prism ballast 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2512 X Cntct lens gas permbl bifocl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2513 X Contact lens extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2520 P Contact lens hydrophilic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2521 X Cntct lens hydrophilic toric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2522 X Cntct lens hydrophil bifocl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2523 X Cntct lens hydrophil extend 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2530 X Contact lens gas impermeable 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2531 X Contact lens gas permeable 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2599 X Contact lens/es other type 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2600 X Hand held low vision aids 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2610 X Single lens spectacle mount 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2615 X Telescop/othr compound lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2623 X Plastic eye prosth custom 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2624 X Polishing artifical eye 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2625 X Enlargemnt of eye prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2626 X Reduction of eye prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2627 X Scleral cover shell 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2628 X Fabrication & fitting 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2629 X Prosthetic eye other type 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2630 X Anter chamber intraocul lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2631 X Iris support intraoclr lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2632 X Post chmbr intraocular lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2700 X Balance lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2710 X Glass/plastic slab off prism 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2715 X Prism lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2718 X Fresnell prism press-on lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2730 X Special base curve 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2740 X Rose tint plastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2741 X Non-rose tint plastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2742 X Rose tint glass 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2743 X Non-rose tint glass 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2744 X Tint photochromatic lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 40566 V2750 X Anti-reflective coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2755 X UV lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2760 X Scratch resistant coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2770 X Occluder lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2780 X Oversize lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2781 X Progressive lens per lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2785 X Corneal tissue processing 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2790 X Amniotic membrane 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2799 X Miscellaneous vision service 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5008 N Hearing screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5010 N Assessment for hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5011 N Hearing aid fitting/checking 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5014 N Hearing aid repair/modifying 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5020 N Conformity evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5030 N Body-worn hearing aid air 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5040 N Body-worn hearing aid bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5050 N Hearing aid monaural in ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5060 N Behind ear hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5070 N Glasses air conduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5080 N Glasses bone conduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5090 N Hearing aid dispensing fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5100 N Body-worn bilat hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5110 N Hearing aid dispensing fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5120 N Body-worn binaur hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5130 N In ear binaural hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5140 N Behind ear binaur hearing ai 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5150 N Glasses binaural hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5160 N Dispensing fee binaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5170 N Within ear cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5180 N Behind ear cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5190 N Glasses cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5200 N Cros hearing aid dispens fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5210 N In ear bicros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5220 N Behind ear bicros hearing ai 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5230 N Glasses bicros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5240 N Dispensing fee bicros 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5336 N Repair communication device 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5362 R Speech screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5363 R Language screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5364 R Dysphagia screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved(D0110-D9999). 3 + Indicates RVUs are not use for Medicate payments. 4 PE RVUs = Practice Expense Relative Value Units. [FR Doc. 01-18951 Filed 8-1-01; 8:45 am]
BILLING CODE 4120-01-P
Document Information
- Published:
- 08/02/2001
- Department:
- Centers for Medicare & Medicaid Services
- Entry Type:
- Proposed Rule
- Action:
- Proposed rule.
- Document Number:
- 01-18951
- Dates:
- We will consider comments if we receive them at the appropriate
- Pages:
- 40371-40566 (196 pages)
- Docket Numbers:
- CMS-1169-P
- RINs:
- 0938-AK57
- Topics:
- Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays
- PDF File:
- 01-18951.pdf
- CFR: (18)
- 42 CFR 405.534
- 42 CFR 405.535
- 42 CFR 410.3
- 42 CFR 410.10
- 42 CFR 410.23
- More ...