Part IX

[Federal Register: January 7, 2004 (Volume 69, Number 4)]

[Rules and Regulations]

[Page 1083-1267]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr07ja04-18]

[[Page 1083]]

Part IX

Department of Health and Human Services

Centers for Medicare & Medicaid Services

42 CFR Parts 405 and 414

Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004; Interim Final Rule

[[Page 1084]]

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405 and 414

[CMS-1372-IFC]

RIN 0938-AM97

Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004

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

ACTION: Interim final rule with comment period.

SUMMARY: This interim final rule implements the provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MPDIMA) of 2003, Pub. L. 108-173, which are applicable in 2004 to Medicare payment for covered drugs and physician fee schedule services. These provisions revise the current payment methodology for Part B covered drugs and biologicals that are not paid on a cost or prospective payment basis; make changes to Medicare payment for furnishing or administering drugs and biologicals; revise the geographic practice cost indices and change the physician fee schedule conversion factor. The 2004 physician fee schedule conversion factor will be $37.3374. The 2004 national anesthesia conversion factor (prior to making adjustment for the geographic practice cost indices) will be $17.4969. The information contained in this final rule related to payment under the physician fee schedule supercedes the information contained in the November 7, 2003, final rule to the extent that the two are inconsistent. All other provisions of the November 7, 2003, final rule are unchanged unless otherwise noted. This rule also extends the ``opt- out'' provisions of 1802(b)(5)(3) of the Social Security Act to dentists, podiatrists, and optometrists.

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

Comment date: We will consider comments if we receive them at the appropriate address, as provided in the addresses section, no later than 5 p.m. on March 8, 2004.

ADDRESSES: In commenting, please refer to file code CMS-1372-FC. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission.

Mail written comments (one original and two copies) to the following address only: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1372-FC, P.O. Box 8013, Baltimore, MD 21244-8013.

Please allow sufficient time for us to receive mailed comments on time in the event of delivery delays.

If you prefer, you may deliver (by hand or courier) your written comments (one original and two copies) to one of the following addresses: Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201, or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013.

(Because access to the interior of the HHH Building is not readily available to persons without Federal government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available if you wish to retain proof of filing by stamping in and retaining an extra copy of the comments being filed.)

Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and could be considered late.

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

FOR FURTHER INFORMATION CONTACT: Jennifer Fan, (410) 786-0548 regarding Medicare payment for Part B covered drugs and biologicals.

Rick Ensor, (410) 786-5617 regarding provisions related to geographic practice cost indices.

Diane Milstead, (410) 786-3355 for provisions related to the physician fee schedule.

Gaysha Brooks, (410) 786-9649 for questions related to obtaining Medicare physician fee schedule information from the CMS Web site.

SUPPLEMENTARY INFORMATION:

Inspection of Public Comments: Comments received timely will be available for public inspection as they are processed, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone (410) 786-7197.

Copies: To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512- 2250. The cost for each copy is $10. As an alternative, you can view and photocopy the Federal Register document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the Federal Register.

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

Accessing Physician Fee Schedule Web Site and Pricing Information

Information on the physician fee schedule and pricing files can be found on our home page. You can access this data at the following Web site: http://cms.hhs.gov/physicians/pfs or you can access this data by

using the following directions:

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

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

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

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

(1) National Physician Fee Schedule Relative Value File--This file contains all CPT/HCPCS (excluding codes beginning with B, E, L, K, and 0), their short descriptions and a status indicator, which denotes whether or not the service is priced under the physician fee schedule. The file also contains the components used in the calculation of the annual pricing amount (that is, the RVUs, GPCIs, and conversion factor), anesthesia conversion factors, and the payment policy indicators used to price the claims with surgical modifiers. This file does not contain the calculated pricing amounts.

(2) Physician Fee Schedule Payment Amount File National/Carrier-- This file contains the CPT code and the Medicare price for all services priced under the Physician Fee Schedule. These data can be downloaded for the entire country, or for a selected carrier (in most cases

[[Page 1085]]

carriers correlate with States). There is no option of requesting data for selected HCPCS codes. The zip file, which is downloaded, contains a file named ``PF04pc'', which explains the data contained in each column. This file also contains a description of pricing localities used in the Physician Fee Schedule. Due to the size of the national file (as well as many of the carrier-specific files), these data are provided in a comma-delimited format, which can be used to populate database applications. Generally speaking, these data are too large for Excel, however if a carrier specific file has 3 or fewer localities, Excel can be used.

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

the following directions:

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

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

3. Scroll down and under ``Payment/Billing'' select ``Medicare Payment Systems.''

4. Scroll down and under Coding Files select ``Zip Code to Carrier Locality File.''

Table of Contents

I. Background

A. Medicare Payment for Part B Covered Drugs and the Furnishing or Administration of Drugs

B. Geographic Practice Cost Indices and Physician Fee Schedule Conversion Factor II. Provisions of the Final Rule

A. Application of Market-Based Systems of Medicare Payment for Part B Drugs

B. Payment for Inhalation Drugs

C. Pharmacy Supplying Fee for Certain Drugs and Biologicals

D. Physician Fee Schedule Provisions Related to the Administration of Drugs

1. Provisions Related to Budget Neutrality

2. Adjustments in Practice Expense Relative Value Units for Certain Drug Administration Services beginning with 2004

3. Pricing of Clinical Oncology Nurses in the Practice Expense Methodology

4. Work Relative Value Units for Certain Drug Administration Services

5. Adjustments in the Practice Expense Relative Value Units for Certain Drug Administration Services Beginning with 2005

6. Provisions for Appropriate Reporting and Billing for Physicians' Services Associated with the Administration of Covered Outpatient Drugs and Biologicals

7. Treatment of Other Services Currently in the Nonphysician Work Pool

8. Payment for Multiple Chemotherapy Agents Furnished on a Single Day through the Push Technique

9. Transitional Adjustment to Medicare Payment for Certain Drug Administration Services

E. Geographic Practice Cost Indices

F. Adjustments to the Work, Practice Expense and Malpractice Relative Value Units

G. Anesthesia and Physician Fee Schedule Conversion Factors for 2004

H. Publication of Addenda III. Private Contracting with Medicare Beneficiaries IV. Waiver of Proposed Rulemaking and Delay in Effective Date V. Collection of Information Requirements VI. Response to Comments VII. Regulatory Impact Analysis Addendum A--Explanation and Use of Addendum B Addendum B--Relative Value Units and Related Information Used in Determining Medicare Payments for 2004 Addendum C--Codes with Interim Relative Value Units Addendum D--2004 Geographic Practice Cost Indices by Medicare Carrier and Locality Addendum E--2005 Geographic Practice Cost Indices by Medicare Carrier and Locality Addendum F--List of Medicare Covered Part B Drugs Under Payment Reform

I. Background

A. Medicare Payment for Part B Covered Drugs and the Furnishing or Administration of Drugs

Medicare Part B covers a limited number of prescription drugs and biologicals. For the purposes of this final rule, the term ``drugs'' will hereafter refer to both drugs and biologicals. Currently, covered Medicare drugs generally fall into three categories: drugs furnished incident to a physician's service, durable medical equipment (DME) drugs, and drugs specifically covered by statute (for example, oral immunosuppressive drugs). Prior to January 1, 2004, drugs not paid on a cost or prospective payment basis are paid based on the lower of the actual charge or 95 percent of the average wholesale price (AWP) (section 1842(o)(1) of the Social Security Act (the Act), as added by section 4556 of the Balanced Budget Act of 1997 (Pub. L. 105-33)). In December 2000, the Congress passed the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA). Section 429(a) of BIPA required the GAO to conduct a study of the current payment methodology. Section 429(b) of BIPA requires the Secretary, notwithstanding any other provision of law, to revise the Medicare payment methodology for drugs based on the GAO study. In September 2001, the GAO presented its study to the Congress in a report titled, ``Medicare: Payments for Covered Outpatient Drugs Exceed Providers' Costs'' (GAO-01-1118). Consistent with the recommendations in the report, we published four options for revising the current drug payment system in a proposed rule published August 20, 2003 (68 FR 50428), in the Federal Register. This proposed rule also discussed changes to Medicare payment under the physician fee schedule for furnishing or administering certain drugs and biologicals. However, as discussed in the November 7, 2003, final rule (68 FR 63196), ``Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2004'', since the Congress was considering legislation to address these issues, we were reluctant to proceed with finalizing the proposals contained in the August 20, 2003, proposed rule. On November 25, 2003, the Congress enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MPDIMA) of 2003, Pub L. 108-173. The President signed Pub. L. 108-173 into law on December 8, 2003. Sections 303 through 305 of MPDIMA make revisions to payment methodology for Part B covered drugs that are not paid on a cost or prospective payment basis. Sections 303 and 304 also require the Secretary of Health and Human Services to revise Medicare payments for the administration of drugs made using the physician fee schedule. We are using this final rule to implement those sections of MPDIMA that are effective January 1, 2004, and prior to January 1, 2006, and affect Medicare payment for covered Part B drugs and their administration.

B. Geographic Practice Cost Indices (GPCIs) and Physician Fee Schedule Conversion Factor

Section 1848(e) of the Act requires that payments vary among Medicare physician fee schedule areas according to the extent resource costs vary, as measured by Geographic Practice Cost Indices (GPCIs) for each of the three fee schedule components--work, practice expense and malpractice. As explained later in this document, for services provided on or after January 1, 2004, and prior to January 1, 2007, section 412 of MPDIMA requires that the work GPCI cannot be less than 1.00. Section 602 of MPDIMA requires that work, practice

[[Page 1086]]

expense and malpractice GPCIs otherwise calculated cannot be less than 1.67 for services furnished in Alaska on or after January 1, 2004, or prior to January 1, 2006.

Sections 1848(d) and (f) of the Act establish a formula for determining the physician fee schedule update and conversion factor (CF). As indicated in the November 7, 2003, final rule (68 FR 63239), the application of the formula in the statute resulted in a 2004 physician fee CF of $35.1339, a reduction of 4.5 percent. However, section 601 of MPDIMA requires that the update to the physician fee schedule CF for 2004 cannot be less than 1.5 percent. We are using this final rule to announce the CF and GPCIs that will be used to determine physician fee schedule rates in 2004.

II. Provisions of the Final Rule

A. Application of Market-Based Systems of Medicare Payment for Part B Drugs

1. General Rule

Subject to the other provisions of MPDIMA, section 303(b) of MPDIMA specifies that drugs not paid on a cost or prospective payment basis will be paid at 85 percent of the average wholesale price (AWP) determined as of April 1, 2003. 2. Specific Provisions

Section 303(b)(1) of MPDIMA specifies that for CY 2004 the following drugs will be paid at 95 percent of the AWP:

[sbull] Blood clotting factors;

[sbull] A drug or biological furnished during 2004 that was not available for Medicare payment as of April 1, 2003;

[sbull] Pneumococcal and influenza vaccines as well as hepatitis B vaccine that is furnished to individuals at high or intermediate risk of contracting hepatitis B (as determined by the Secretary); and

[sbull] A drug or biological furnished during 2004 in connection with the furnishing of renal dialysis services if separately billed by renal dialysis facilities.

Section 303(b)(1) of MPDIMA also specifies that infusion drugs will be paid at 95 percent of the AWP in effect on October 1, 2003, when furnished through a covered item of durable medical equipment.

Section 303(b)(2) of MPDIMA specifies that the payment for a drug contained in the table entitled ``Table 3--Medicare Part B Drugs in the Most Recent GAO and OIG Studies'' published in the August 20, 2003, proposed rule (68 FR 50445) will be the percentage of the AWP indicated in the column entitled ``Average of the GAO and OIG data (percent)''. This percentage will be applied to the AWP determined as of April 1, 2003. However, in the event that the percentage from Table 3 is less than 80 percent, the percentage applied to the AWP determined as of April 1, 2003, will be 80 percent. Table 1 below is a reprint of Table 3 from the August 20, 2003, proposed rule. Table 2 highlights the relevant column from the August 20, 2003, proposed rule table and applies the 80 percent limit where applicable.

We note that there was a typographical error in Table 3 as published on August 20, 2003, for J1642 ``Heparin Sodium Lock Flush''. The percentage in the column specified in MPDIMA is missing for J1642. Given that this column is calculated as the average of the values in the preceding two columns for the drugs in this table, we will treat the missing value as the average of the values in the prior two columns for J1642, namely 66 percent. This is the percentage that would have been in that column in the table in the absence of the typographical error. We believe that this correction is consistent with Congress' intent to revise the percentage based on the average of accurate GAO and OIG data. This percentage will be subject to the 80 percent limitation described above.

We also note that there was another typographical error in Table 3 as published on August 20, 2003, for J9390 ``Vinorelbine Tartrate (Navelbine).'' The percentage listed under the column titled ``GAO Average Widely Available Price as a Percent of AWP (2001)'' for J9390 in Table 3 is incorrect and should not have been listed at all since GAO did not include this drug in its study. The percentage under the column titled ``OIG Median Catalogue Price as a Percent of AWP (2000)'' is correct. Since the column specified in MPDIMA is calculated as the average of the values in the preceding two columns for the drugs in this table, the correct percentage listed for J9390 under this column will be 81 percent based on the data from OIG. We believe that this correction is also consistent with Congress' intent to revise rates based on the average of accurate GAO and OIG data. This is the percentage that would have been in that column in the table in the absence of the typographical error.

BILLING CODE 4120-01-P

[[Page 1087]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.000

[[Page 1088]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.001

[[Page 1089]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.002

[[Page 1090]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.003

BILLING CODE 4120-01-C

[[Page 1091]]

Section 303(b)(2) of MPDIMA also provides an opportunity for the manufacturer of a drug to submit data and information requesting a different percentage from the percentage indicated in Table 1A or the 85 percent general rule. The Secretary may adjust the percentage based on this data and information beginning April 1, 2004. Section 303(b) of MPDIMA specifies that this data and information can be submitted after October 15, 2003, and before January 1, 2004. As required by the statute, manufacturers need to submit this data and information before January 1, 2004. Manufacturers may supplement this data and information; however, any additional supplemental information should be received by CMS before 5 p.m. e.s.t. on January 16, 2004. We will use the supplemental information to help us evaluate the initial submission of data and information.

We expect that the data and information submitted by a manufacturer would include the manufacturer's average sales price for the drug for the most recent quarter available. For the purposes of the exceptions process, the manufacturer's average sales price is calculated as the manufacturer's sales to all purchasers in the United States (excluding sales exempted below) for the quarter divided by the total number of units of such drug or biological sold by the manufacturer in that quarter. The submission should also specify the units used in the calculation (for example, micrograms).

In the calculation of the manufacturer's average sales price, a manufacturer should include volume discounts, prompt pay discounts, cash discounts, free goods that are contingent on any purchase requirement, chargebacks, and rebates (other than rebates under the Medicaid program). To the extent that there is a lag in the availability of this information applicable to the quarter, the manufacturer should apply a methodology based on the most recent 12- month period available to estimate costs attributable to these price concessions. The manufacturer should submit a description of the methodology used to estimate these costs.

In the calculation of the manufacturer's average sales price, a manufacturer should exclude the following sales as defined for the Medicaid best price calculation under section 1827(c)(1)(C)(i) of the Act:

1. Sales to the Indian Health Service, the Department of Veterans Affairs, a state home as defined for the purposes of the Medicaid best price calculation, the Department of Defense, the Public Health Service and entities described in section 340(B)(a)(4) of the Public Health Act;

2. Sales under the Federal Supply Schedule of the General Services Administration;

3. Sales under a State pharmaceutical assistance program; and

4. Any depot sales and single award contract sales as defined for the purposes of the Medicaid best price calculation.

A manufacturer should also exclude sales at a nominal charge. Sales at a nominal charge are defined as sales below 10 percent of the average calculated as described above. In other words, after following the methodology described above, sales below 10 percent of the resulting average should be excluded and the average recalculated. The result of this final calculation is the manufacturer's average sales price for the purpose of the exceptions process.

Note that we would base any changes to the percentage indicated in Table 1 or the 85 percent general rule only on data that we could make available to the public.

Section 303(b)(2) of MPDIMA also specifies that we may adjust the percentage effective January 1, 2004, based on data and information that a manufacturer submitted by October 15, 2003. We accepted data from the manufacturer of two biologicals: imiglucerase and alglucerase. The data and information submitted by the manufacturer indicated that the manufacturer's average sales price was 94 percent of the average wholesale price. Based on this data, we will pay for these two biologicals when furnished in 2004 at 94 percent of the average wholesale price determined as of April 1, 2003.

B. Payment for Inhalation Drugs

Section 305(a) of MPDIMA specifies that inhalation drugs furnished through durable medical equipment covered under 1861(n) of the Act will be paid in accordance with section 1842(o)(4) of the Act, as added by section 303(b)(2) of MPDIMA. The methodology for determining the payment for a drug under section 303(b)(2) of MPDIMA is described above in section II.A.2 of this rule.

C. Pharmacy Supplying Fee for Certain Drugs and Biologicals

Section 303(e)(2) of MPDIMA provides that the Secretary shall pay a pharmacy supplying fee, less applicable deductible and coinsurance, for immunosuppressive drugs described in section 1861(s)(2)(J) and oral anti-cancer and anti-nausea drugs described in subparagraph (Q) and (T) of the same section as determined appropriate by the Secretary. We believe that the payment of this fee should be bundled into the current payment for these drugs and the 2004 payment amounts specified in section 303(b) of MPDIMA. We do not have data indicating that the 85% figure is insufficient to cover the cost of supplying these drugs. However, for 2005, we will re-examine this issue in light of the average sales price (ASP) data that will be submitted by manufacturers.

D. Physician Fee Schedule Provisions Related to the Administration of Drugs

As indicated above, sections 303 and 304 of MPDIMA amend section 1848 of the Act for physician fee schedule payments made beginning January 1, 2004. We are describing our implementation of the parts of sections 303 and 304 which have a January 1, 2004, effective date. 1. Provisions Related to Budget Neutrality

Section 303(a)(1) of MPDIMA amends section 1848(c) of the Act to require changes to the practice expense and physician work relative value units (RVUs) used to determine payment for drug administration services. In general, section 1848(c)(2)(B)(ii)(II) provides that the Secretary shall review and may make adjustments to the RVUs if the changes do not cause the amount of expenditures to increase or decrease by more than $20 million. Section 303(a) of MPDIMA amends section 1848(c)(2)(B) of the Act to add a new clause (iv) that exempts from this limitation, any additional expenditures in 2004 attributable to:

(1) The increase in practice expense RVUs for drug administration services resulting from the use of a practice expense survey meeting specific criteria described in the statute;

(2) The increase in practice expense RVUs resulting from using survey data on the compensation of clinical oncology nurses; and

(3) New physician work RVUs that we are adding to the drug administration services consistent with the new statutory provisions.

In addition, section 303(a)(1) of MPDIMA also modifies section 1848(c)(2)(B) of the Act to provide an exemption from the budget neutrality requirements in 2005 or 2006 for further increases in practice expense RVUs for drug administration services that may result from using additional survey data from physician specialties meeting specific criteria that we will discuss in

[[Page 1092]]

more detail later in this document. Furthermore, any increase in spending associated with any coding or policy changes resulting from the Secretary's review of existing drug administration codes is also exempted from budget neutrality requirements of section 1848 (c)(2)(B) by section 303 of MPDIMA. Section 303(a)(3) also requires the Secretary to review the policy in effect for the administration of more than one drug administered by the push technique. This change is also exempt from budget neutrality.

In general, we have met the budget neutrality requirements in the statute by either applying an adjustment to the physician fee schedule CF or to the RVUs themselves. However, section 303(a) of MPDIMA specifically amends the statute to exempt the additional expenditures that result from changes to the RVUs for drug administration services from the budget neutrality requirements. Therefore, we will make no changes to the physician fee schedule CF or physician work RVUs to account for physician work RVUs being added to drug administration services. We will add the additional expenditures as a result of these provisions to the expenditure base in applying our practice expense methodology. 2. Adjustments in Practice Expense Relative Value Units for Certain Drug Administration Services Beginning with 2004

Section 303(a)(1)(B) of MPDIMA amends section 1848(c)(2) of the Act by adding new subparagraph (H), ``Adjustments in Practice Expense Relative Value Units for Certain Drug Administration Services beginning in 2004''. Subparagraph (H)(i) requires the Secretary to determine the practice expense RVUs for 2004 using practice expense surveys submitted to the Secretary as of January 1, 2003, by a physician specialty organization in accordance with section 212 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act (BBRA) of 1999 if the survey: (1) Covers practice expenses for oncology drug administration services; and (2) meets criteria established by the Secretary for acceptance of such surveys.

Section 212 of the BBRA directed the Secretary to establish a process under which we would accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations. In an interim final rule with comment published in the Federal Register on May 3, 2000 (65 FR 25664), we established the criteria under which we would accept supplemental data for use in computing the practice expense RVUs. We subsequently modified those criteria in the November 1, 2000, physician fee schedule final rule (65 FR 65383) and the December 31, 2002, final rule (67 FR 79971).

The American Society of Clinical Oncology (ASCO) provided us with a supplemental survey prior to January 1, 2003, that includes expenses associated with the administration of chemotherapy drugs. While the survey meets the criteria we established, we initially decided not to use the information because of concerns about the data (for more information, see the December 31, 2003, final rule (67 FR 79973)). In a proposed rule published in the Federal Register on August 20, 2003 (68 FR 50437), we described subsequent discussions held with ASCO that resolved our concerns about the data.

Consistent with section 1848(c)(2)(H)(i) of the Act, we are using the ASCO survey to determine the practice expense RVUs for physician fee schedule services furnished on or after January 1, 2004, because it: (1) Was submitted prior to January 1, 2003; (2) includes expenses for drug administration services; and (3) meets criteria we have established for use of surveys.

Section 303(j) of MPDIMA applies the amendments made by section 303 for payments for drugs or biologicals and drug administrative services to physicians in the specialties of hematology, hematology/oncology and medical oncology. Section 304 indicates that: ``Notwithstanding section 303(j), the amendments made by section 303 shall also apply to payments for drugs or biologicals and drug administration services furnished by physicians in specialties other than the specialties of hematology, hematology/oncology and medical oncology.''

Because the section 303 (a)(1) provisions apply to hematology, hematology/oncology and medical oncology, we will use the supplemental survey submitted by ASCO for CMS specialty codes 82 (hematology), 83 (hematology/oncology) and 90 (medical oncology).

The Conference Report indicates that section 304 requires the Secretary to disregard the (section 303) exemption and apply the adjustments in section 303 to these other specialties. The Conference report further indicates the intent in drafting the provisions in this fashion: ``The intent in drafting the two sections in this manner is to segregate the savings achieved from adjustments to payments to oncologists from savings derived from other physician specialties. The specialties to which the provisions apply are the specialties as used by the carriers in administering Medicare.''

The purpose of the separation is only to display the budget scoring effects separately for oncologists from other physician specialties. There is no substantive policy effect at all from the enactment of the amendments in this manner. The combined effect of the amendments made by both section 303(j) and section 304 is that the substantive changes in both payments for drugs and biologicals as well as drug administration services apply to physicians of all specialties.

When we use supplemental survey data, we have generally blended the supplemental survey data with prior survey data from the American Medical Association's Socioeconomic Monitoring Survey (SMS). However, section 1848(c)(2)(H)(i) of the Act indicates that the Secretary should use survey data that meets the specific criteria specified in the statute. We are using the ASCO survey data and are not blending it with the prior SMS data.

Because we are not blending the ASCO survey with the SMS data, we are adopting a consistent policy in 2004 for survey data received in 1999 from the Society for Thoracic Surgery (STS). That is, we will use the STS supplemental survey data without blending it with the SMS data. However, we have not made a final decision and will continue to consider the issue of whether to blend supplemental survey with prior SMS data or to use specialty submitted supplemental surveys without blending. At this time, we are not using the ASCO and STS cases as precedent for our consideration of future survey data. While some may argue that the inclusion of newer, more specific survey data will improve the precision of the data underlying the calculation of the practice expense resource based RVUs, and lead to more stability in the practice expense methodology, it can also be argued that a specialty society would only undertake a survey (arguing that existing SMS data were not sufficiently representative of the specialty's practice expenses) if it believed that higher practice expense payments for that specialty could be achieved by submitting additional data. We do not believe that it would be prudent for the program to commit to the use of supplemental survey data without blending it with the SMS data for any and all future supplementary surveys. We will continue to consider this issue in 2004 when we make proposals for the 2005 physician fee schedule. At this time, we suggest that supplemental

[[Page 1093]]

survey data should be used without blending only under certain conditions that would be specified in a future rule. (Note that this issue does not affect specialties that are not included in the SMS sample, and for which we have no other previous survey data. In such cases there would obviously be no SMS survey data to blend.)

We invite comments on this issue and on appropriate criteria for determining when to employ specialty submitted supplemental surveys without blending.

Table 2 shows the revised practice expense per hour for each cost pool for the specialties of cardiac and thoracic surgery and oncology, hematology/oncology and hematology.

Table 2

Clin Admin. Office Med. Med. Specialty

Staff Staff Expense Supplies Equip Other Total

Cardiac/Thoracic Surgery........... 19.5 18.0 17.2

2.1

2.1 14.2 73.1 Oncology........................... 53.4 34.7 34.4 16.9

7.4 42.2 189.0

3. Pricing of Clinical Oncology Nurses in the Practice Expense Methodology

Section 1848(c)(2)(H)(ii) of the Act (as added by section 303(a)(1) of MPDIMA) specifies that if a survey meets the criteria described above (that is, the survey that is submitted prior to January 1, 2003, meets criteria established by the Secretary, etc.) and includes data on wages, salaries and compensation of clinical oncology nurses, the Secretary will use the data in the methodology for determining the practice expense RVUs. The ASCO survey meets the criteria specified in the statute and also includes data on oncology nursing compensation. For this reason, we are using information from the survey to determine the wage rate per minute for oncology certified nurses (OCN). The OCN is included as a practice expense input for the nonchemotherapy infusion codes (90780 through 90781) and the chemotherapy administration codes (96400 through 96549). Using information from the ASCO survey, we determined a wage rate of 0.79 per minute (increase from the 0.56 per minute we are currently using) for the OCN. We used this revised wage rate to determine the practice expense RVUs for the drug administration services shown in Addendum B. 4. Work Relative Value Units for Certain Drug Administration Services

For services furnished on or after January 1, 2004, section 1848(c)(2)(H)(iii) of the Act (as added by section 303(a)(1) of MPDIMA) requires the Secretary to establish work RVUs for drug administration services equal to the work RVUs for a level 1 office medical visit for an established patient (CPT code 99211). Section 1848(c)(2)(H)(iv) of the Act defines drug administration services as those classified as of October 1, 2003, within any of the following groups: therapeutic or diagnostic infusions (excluding chemotherapy); chemotherapy administration services; and therapeutic, prophylactic, or diagnostic injections for which there are no work RVUs assigned and for which national RVUs have been assigned.

CPT code 99211 is a level 1 established patient office visit with physician work RVUs of 0.17. Consistent with the statute we are adding physician work RVUs of 0.17 to the following drug administration services: CPT codes 90780 through 90781, 90782 through 90788, 96400, 96408 through 96425, 96520, and 96530.

Currently, section 15010 of the Medicare Carriers Manual (MCM) does not allow payment for CPT codes 90782, 90783, 90784 and 90788 unless these are the only physician fee schedule services provided on that day. We do pay separately for cancer chemotherapy injections (CPT codes 96400-96549) in addition to an office visit (CPT codes 99211-99215) furnished on the same day by the same physician. CPT code 99211 does not require a face-to-face encounter between the physician and the patient like other office visit services (CPT codes 99212-99215) and can be used be physicians supervising a nurse performing chemotherapy administration. Currently, physicians typically bill for CPT code 99211 approximately 34 percent of the time that they are also providing a drug administration service. We believe that adding physician work to the drug administration services will subsume the supervision that physicians billing for a 99211 on the same day are typically providing. Therefore, we will no longer allow for 99211 to be billed on the same day as a chemotherapy administration service.

Although less common than CPT 99211, physicians also bill for other office visit (CPT codes 99212-99215) provided on the same day as chemotherapy administration. We will continue to allow other office visits to be billed on the same day as a drug administration service with modifier 25 indicating that a separately identifiable evaluation and management service was provided. This policy will make our practice with chemotherapy administration consistent with all other physician fee schedule services where we require use of modifier 25 if a separately identifiable evaluation and management service is provided on the day as a procedure. Section 15400(D) of the Medicare Carrier Manual (MCM) describes Medicare payment policy with respect to chemotherapy administration and ``incident to'' services provided on the same day. We will be revising section 15400 of the MCM (in addition to section 15010 that describes ``bundled services'') to reflect that CPT code 99211 and a chemotherapy administration service cannot be billed for the same patient on a single day. 5. Adjustments in the Practice Expense Relative Value Units for Certain Drug Administration Services Beginning with 2005

Section 303(a)(1) of MPDIMA also modifies section 1848(c)(2)(B) of the Act to provide an exemption from the budget neutrality requirements in 2005 or 2006 for further increases in practice expense RVUs for drug administration services that may result from using additional survey data from physician specialties meeting specific criteria. Section 1848(c)(2)(I) of the Act specifies that the exemption from budget neutrality will apply for any survey (other than the ASCO survey that meets the exemption requirement specified by another provision of the statute) submitted by a specialty group where 40 percent or more of its payments for Part B services are attributable to the administration of drugs in 2002 as determined by the Secretary. The statute indicates that the survey must include expenses for the administration of drugs and must be received by the Secretary prior to March 1, 2004, to determine the 2005 practice expense RVUs and prior to March 1, 2005, to determine the 2006 practice expense RVUs.

[[Page 1094]]

We have reviewed Medicare allowed charge data for 2002. Based on the 2002 data, we found that the specialties of gynecology/oncology (specialty code 98) rheumatology (specialty code 66) and urology (specialty code 30) received more than 40 percent of total Part B revenues from drugs. We will apply the exemption from budget neutrality specified in section 1848(c)(2)(I) of the Act for additional expenditures that result from the increases in drug administration practice expense RVUs in 2005 or 2006 resulting from use of a survey that is submitted timely by any of these specialties and otherwise meets criteria we have established for use of supplemental surveys. Hematology (specialty 82), hematology/oncology (specialty 83) and medical oncology (specialty 90) also receive more than 40 percent of their Medicare revenues from drugs. However, we are already using the ASCO survey for these specialties and the increase in payment for drug administration is exempt from budget neutrality by another provision of the statute. 6. Provisions for Appropriate Reporting and Billing for Physicians' Services Associated with the Administration of Covered Outpatient Drugs

Section 1848(c)(2)(J) of the Act requires the Secretary to promptly evaluate existing drug administration codes for physicians' services to ensure accurate reporting and billing for such services, taking into account levels of complexity of the administration and resource consumption. The statute further specifies that the Secretary will use existing processes for the consideration of coding changes and, to the extent changes are made, will use the processes to establish relative values for these services. The Secretary is also required to consult with physician specialties affected by the provisions that change Medicare payments for drugs.

We expect to review this issue in the context of all the payment changes being made by the statute to Medicare payment for drug administration in order to assure accurate reporting and billing for such services taking into account levels of complexity of the administration and resource consumption. The existing processes we plan to use include review by our Physician's Regulatory Issues Team (PRIT) and consultation with the AMA's CPT Editorial Committee and physician specialties affected by changes in payment for drugs and drug administration. The PRIT, an internal CMS group that is working to eliminate unnecessary regulations, is reviewing the issue of coding for drug administration services including section 15400 of the Medicare Carriers Manual (MCM) that currently governs Medicare policy with respect to use of CPT codes in the 96400 through 96549 series for chemotherapy administration. 7. Treatment of Other Services Currently in the Nonphysician Work Pool

The nonphysician work pool is a special interim methodology that we use to determine practice expense RVUs for many services that do not have physician work RVUs. The drug administration codes listed above are currently valued using the nonphysician work pool methodology. Because we are now assigning work RVUs to these drug administration codes, they will no longer be included in the nonphysician work pool. Practice expense RVUs for these services will be computed using the standard practice expense methodology that applies to all other physicians' services.

Section 303(a)(2) of MPDIMA requires the Secretary to make adjustments to the nonphysician work pool methodology for the determination of practice expense RVUs under the physician fee schedule so that the practice expense RVUs for services determined under such methodology are not affected relative to the practice expense RVUs of services not determined under such methodology as a result of the amendments made by section 303(a)(2) of MPDIMA. If we made no other changes, removing drug administration codes from the nonphysician work pool would result in a reduction to the practice expense RVUs for services remaining in the nonphysician work pool. Consistent with section 303(a)(1) of MPDIMA, we are making two changes to the nonphysician work pool methodology so that the practice expense RVUs for nonphysician work pool services are not affected relative to other services.

First, we are changing the practice expense per hour assigned to the nonphysician work pool. In place of the ``all physician'' average, we are using a weighted average practice expense per hour of the specialties that perform the services affected by its calculations. Specifically, we will use the following revised data in the practice expense methodology for services remaining in the nonphysician work pool:

Table 3

Clin Admin. Office Med. Med. Specialty

Staff Staff Expense Supplies Equip Other Total

Nonphysician Work pool............. 15.8 17.4 21.5

7.9

4.9 15.0 82.6

Second, we are adjusting the clinical staff times used in the creation of the pool. By definition, nonphysician work pool services do not involve the physician and have no physician time. To create the nonphysician work pool, we have used clinical staff time per procedure in the computation. We will now use the total staff time rather than the previously utilized maximum staff time for developing the 2004 physician fee schedule. Consistent with section 303(a)(2) of MPDIMA, the change to the practice expense per hour and staff time will result in no reduction to the practice expense RVUs for the services remaining in the nonphysician work pool once drug administration services are removed. By using the maximum staff time, we are assuming that clinical staff are working concurrently. However, it is possible that clinical staff are working sequentially and it would be appropriate to use the total staff time for each service. We are proposing to use the total staff in place of the maximum staff for developing the 2004 physician fee schedule since each are equally likely to address staff time arrangements for non-physician work pool services and the latter approach will assist in meeting the statutory directive that payment for non-physician work pool services not be affected by the changes we are making to drug administration services. 8. Payment for Multiple Chemotherapy Agents Furnished on a Single Day Through the Push Technique

Section 303(a)(3) of MPDIMA requires the Secretary to review the policy as in effect October 1, 2003, for section 1848 of the Act for the administration of more than one drug or biological to an individual on a single day through the push technique. Subsequent to that review, the Secretary will modify the

[[Page 1095]]

payment policy as determined to be appropriate. Section 303(a)(3)(C) of MPDIMA indicates that any change in policy resulting from this review will be treated as additional expenditures attributable to section 1848(c)(2)(H). (This section relates to the additional expenditures that result from use of survey data that includes expenses for drug administration and clinical oncology nurses and requires that we establish work RVUs equal to a level 1 office visit for drug administration services. Currently, a level 1 office has 0.17 work RVUs)

In the November 25, 1991, Federal Register (56 FR 59541), we specified that Medicare will allow CPT code 96408 (Chemotherapy administration, intravenous; push technique) to be reported only once per day even if the physician administers multiple drugs and this policy is contained in Section 15400 of MCM. In the August 20, 2003, proposed rule (68 FR 50439) concerning payment reform for part B drugs under Medicare, we had proposed revising this policy to allow for CPT code 96408 to be reported once per day for each drug administered. This revision was supported by commenters.

Upon review of this issue and in acknowledgement that there are additional resources involved in administering each subsequent drug which should be considered in a resource-based payment system, we are changing our policy and will allow for CPT code 96408 to be reported once per day for each drug administered. The effective date for this change is for services furnished on or after January 1, 2004. We will modify section 15400 of the manual consistent with this change. In addition, as previously mentioned, the PRIT will be reviewing the issue of use of the chemotherapy administration codes in the 96400 CPT code series and Medicare's manual provisions on their use. 9. Transitional Adjustment to Medicare Payment for Certain Drug Administration Services

Section 303(a)(4) of MPDIMA provides for a transitional adjustment to Medicare payment for drug administration services to reflect implementation of the amendments made by section 303 of MPDIMA affecting Medicare's payments for drugs. Specifically, section 303(a)(4) of MPDIMA requires Medicare to increase the physician fee schedule amounts otherwise determined by 32 percent for 2004 and 3 percent for 2005. Thus, we will determine the payment for CPT codes 90780 through 90781, 90782 through 90788, 96400, 96408 through 96425, 96520, and 96530 based on the work, practice expense and malpractice RVUs shown in Addendum B and the 2004 CF of $37.3374. Consistent with section 303(a)(4) of MPDIMA, we will increase the physician fee schedule amount by an additional 32 percent for 2004. (The physician fee schedule amounts applicable in 2005 will be increased by 3 percent.)

C. Geographic Practice Cost Indices (GPCIs)

The Act requires that payments vary among physician fee schedule areas according to the extent that resource costs vary as measured by the Geographic Practice Cost Indices (GPCIs) for each of the three fee schedule components: work, practice expense, and malpractice.

Section 412 of MPDIMA amended section 1848(e)(1) of the Act and establishes a floor of 1.0 for the work geographic index for any locality to be used for purposes of payment for services furnished on or after January 1, 2004, and before January 1, 2007. In addition, section 602 of MPDIMA further amended section 1848(e)(1) of the Act for purposes of payment for services furnished in Alaska under the physician fee schedule on or after January 1, 2004, and before January 1, 2006, and sets the practice expense, malpractice and work indices at 1.67 if the index would otherwise be less than 1.67.

Based on these changes to the Act, we are revising the addenda published in the November 7, 2003, final rule concerning the transitional 2004 and full 2005 GPCIs (Addendum D and Addendum E, respectively). No locality will have a work GPCI of less than 1.00 and the work, practice expense and malpractice GPCIs for Alaska are set at 1.67. Addendum D in the November 7, 2003, final rule listed 58 localities having work GPCIs of less than 1.00. Of these, the range was from 0.881 for Puerto Rico to 0.998 for ``Rest of New York'' and New Orleans, Louisiana. Addendum D and E that are included in this final rule will replace the addenda previously published November 7, 2003.

D. Adjustments to the Work, Practice Expense and Malpractice Relative Value Units

In the August 15, 2003, proposed rule (68 FR 49058), we proposed to adjust the work, practice expense and malpractice RVUs to match the rebased MEI weights. In the November 7, 2003, final rule (68 FR 63245), we responded to public comments and applied adjustments of -0.57 percent (0.9943) to the physician work RVUs, -0.77 percent (0.9923) to the practice expense RVUs and 19.86 percent (1.1986) to the malpractice RVUs. These adjustments were intended to make the aggregate work, practice expense and malpractice RVUs used to determine payments in 2004 consistent with their respective weights in the rebased MEI.

However, the changes required by MPDIMA change the 2004 work, practice expense and malpractice RVUs. Provisions that require changes to the work and practice expense RVUs and exempt them from budget neutrality will increase the number of work and practice expense RVUs.

As we indicated in the November 7, 2003, final rule, we believe Medicare payment policy will be improved by adjusting the work, practice expense and malpractice RVUs to match the revised MEI weights. By matching the aggregate pools of RVUs to the rebased MEI weights, Medicare's payments for physician work, practice expense and malpractice will more closely match the proportion of expenses incurred by physicians in these categories. Therefore, we are revising the adjustments applied to the RVUs in the November 7, 2003, final rule consistent with our goal of making the work, practice expense and malpractice RVUs match the rebased MEI weights. The revised adjustments are -0.15 percent (0.9985) for physician work, -1.320 percent (0.9868) for practice expense, and 20.61 percent (1.2061) for malpractice. We have incorporated these adjustments into the RVUs shown in Addenda B and C of this final rule.

E. Anesthesia and Physician Fee Schedule Conversion Factors for 2004

The physician fee schedule update is determined under a methodology specified by statute. In the November 7, 2003, final rule (68 FR 63251), we used the formula specified in section 1848(d)(4) of the Act to determine a 4.5 percent reduction to the physician fee schedule CF. However, section 601 of MPDIMA amended section 1848(d) of the Act to specify that the update to the single CF for 2004 and 2005 will not be less than 1.5 percent. Because the statutory formula will yield a 4.5 percent reduction to the physician fee schedule CF and the amendments to the statute indicate that the update for 2004 cannot be less than 1.5 percent, we will increase the physician fee schedule CF by 1.5 percent for 2004.

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

[[Page 1096]]

[sbull] Physician Fee Schedule Conversion Factor

Under section 1848(d)(1)(A) of the Act, the physician fee schedule CF is equal to the CF for the previous year multiplied by the update determined under section 1848(d)(4) of the Act.

We illustrate the calculation for the 2004 physician fee schedule CF in table 4:

Table 4

2003 Conversion Factor..................................

$36.7856 2004 Update............................................. 1.5% (1.015) 2004 Conversion Factor..................................

$37.3374

[sbull] Anesthesia Fee Schedule Conversion Factor

As described in the November 7, 2003, final rule (68 FR 63252), anesthesia services do not have RVUs like other physician fee schedule services. For this reason, we are accounting for the adjustments to match the revised MEI weights and changes to anesthesia work and practice expenses through a 1.09 percent 1.0109 adjustment to the anesthesia fee schedule CF. The 1.09 percent increase reflects a 0.15 percent reduction on the work portion (79 percent), a 2.0 percent reduction on the practice expense portion (13.7 percent) and a 20.61 percent increase on the malpractice portion (7.2 percent) of the anesthesia conversion factor. (The adjustment to the practice expense portion is comprised of 1.3 percent for the MEI weights and 0.7 percent for the revisions in the practice expense methodology). To determine the anesthesia fee schedule CF for 2004, we used the following figures:

Table 5

2003 Conversion Factor...............................

$17.0522 Adjustments for Work and Practice Expense............ 1.09% (1.0109) 2004 Update.......................................... 1.5% (1.0150) 2004 Conversion Factor...............................

$17.4969

F. Publication of Addenda

The addenda included in this final rule concerning RVUs and Related Information Used in Determining Medicare Payments for 2004 (Addenda A, B and C) and GPCIs by Medicare Carrier and Locality (Addenda D and E) replace the addenda published November 7, 2003 (68 FR 63261). The revised addenda reflect changes required by MPDIMA as well as corrections to minor errors contained in the addenda published November 7, 2003.

III. Private Contracting With Medicare Beneficiaries

Section 4507 of the Balanced Budget Act of 1997 added section 1802(b) to the Act. This section provides that physicians and certain nonphysician practitioners may opt out of Medicare and enter into private contracts with Medicare beneficiaries. Under these contracts, no limits apply to what physicians or nonphysician practitioners can charge beneficiaries. Physicians opting out of Medicare file an affidavit with the Medicare carrier in which they agree to opt out of Medicare for a period of 2 years and to meet certain other criteria. In general, the statute requires that during that two-year period, physicians and nonphysician practitioners who have filed affidavits opting out of Medicare have private contracts with all Medicare beneficiaries to whom they furnish Medicare covered services. These contracts may not be entered into at a time when a beneficiary needs emergency or urgent care services.

Moreover, the statute requires that the private contract be in writing and be signed by the Medicare beneficiary before any item or service is provided in accordance with the contract and that:

[sbull] The beneficiary agrees not to submit a claim (or to request that the physician or practitioner submit a claim) with Medicare for Medicare covered services.

[sbull] The beneficiary agrees to be responsible, whether through insurance or otherwise, for services furnished under a private contract.

[sbull] The beneficiary acknowledges that no limits (including the limits under section 1848(g) of the Social Security Act) apply to amounts that are charged under the private contract.

[sbull] The beneficiary acknowledges that no payment will be made under a Medigap plan, and other insurers may elect not to make payment for services furnished under the private contract.

[sbull] The beneficiary acknowledges that Medicare may make payment for covered services if the service was received from a physician or non-physician practitioner with whom the beneficiary has not signed a private contract.

Prior to enactment of MPDIMA, section 1802(b)(5)(B) of the Act limited the types of physicians who could choose to opt out of Medicare to doctors of medicine and doctors of osteopathy. Section 603 of MPDIMA amends section 1802(b)(5)(B) of the Act to include dentists, podiatrists, and optometrists, in certain circumstances, in the definition of physicians who may opt out of Medicare. We are making conforming changes to our regulations to reflect this change in the statute.

IV. Waiver of Proposed Rulemaking and Delay in Effective Date

We ordinarily publish a notice of proposed rulemaking in the Federal Register and invite public comment on a proposed rule. The notice of proposed rulemaking includes a reference to the legal authority under which the rule is proposed, and the terms and substance of the proposed rule or a description of the subjects and issues involved. This procedure can be waived, however, if an agency finds good cause that notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule issued. In addition, the Administrative Procedure Act (APA) normally requires a 30-day delay in the effective date of a final rule. Furthermore, the Congressional Review Act (CRA) generally requires an agency to delay the effective date of a major rule by 60-days in order to allow for congressional review of the agency action.

Section 1871 of the Act provides for publication of a notice of proposed rulemaking and opportunity for public comment before CMS issues a final rule. However, section 1871(b)(2)(B) provides an exception when a law establishes a specific deadline for implementation of a provision and the deadline is less than 150 days after the law's date of enactment. MPDIMA was enacted by Congress on November 25, 2003, and signed into law by the President on December 8, 2003. The provisions of this rule that amend the physician fee schedule and drug payment rate are required to be implemented January 1, 2004. Therefore, these provisions are subject to waiver of proposed rulemaking and public comment in accordance with section 1871(b)(2)(B) of the Act.

Even if section 1871(b)(2)(B) of the Act were not directly applicable here, we would find good cause to waive the requirement for publication of an notice of proposed rulemaking and public comment on the grounds that it is impracticable, unnecessary, and contrary to the public interest. This final rule, with the exception of implementation of billing for a level 1 office visit and pharmacy supplying fee and the technical correction of minor errors in the November rule, merely sets out the non-discretionary provisions of MPDIMA with respect to payment under the physician fee schedule and drug AWP methodology. Because the rule is generally ministerial, we believe that pursuing notice and comment is

[[Page 1097]]

unnecessary. Moreover, because such process would prevent congressionally-mandated revisions, updates, and increases in payment under the physician fee schedule for 2004, we find that pursuing such process would be both impracticable and contrary to the public interest.

For these same reasons, we are waiving the 30-day delay in effective date contained in 5 U.S.C. section 553(d).

With respect to the requirement of a 60-day delay in the effective date of any final rule pursuant to the CRA, see 5 U.S.C. section 801, the CRA provides that the 60-day delayed effective date shall not apply to any rule ``which an agency for good cause finds . . . that notice and public procedure thereon are impracticable, unnecessary, or contrary to the public interest'' (5 U.S.C. section 808(2)). For the reasons set forth above, we believe that additional notice-and-comment rulemaking on this subject would be impracticable, unnecessary, or contrary to the public interest. Therefore, we do not believe that the CRA requires a 60-day delay in the effective date of this final rule.

V. 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.

VI. 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 PRA 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.

[sbull] The accuracy of our estimate of the information collection burden.

[sbull] The quality, utility, and clarity of the information to be collected.

[sbull] Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.

Therefore, we are soliciting public comments on each of these issues for the information collection requirement discussed below.

The following information collection requirement and associated burden are subject to the PRA.

Sec. 414.707 Basis of payment

Under paragraph (a)(7) of this section, a manufacturer requesting a drug payment exception to the default 85 percent used in the general rule or the percentage specified in Table 1 will have to submit data and information including the manufacturer's average sales price for the drug. The burden associated with this requirement is the time involved in providing us the information for the submission due before January 1, 2004, and the optional supplemental submission due by January 16, 2004. We believe that it would take an average of one hour to submit the request and the necessary data and information. Given the universe of approximately 450 Medicare drug codes and assuming an average of 10 manufacturers per drug code, the maximum aggregate burden associated with this activity would be 4500 hours.

We are soliciting public comment on this requirement in conjunction with a request for emergency approval of this information collection so that manufacturers may submit their requests during the statutorily prescribed timeframe. These requirements were submitted to OMB for review and are approved by OMB under OMB control number 0938-0913.

If you comment on any of these information collection and record keeping requirements, please mail copies directly to the following: Centers for Medicare & Medicaid Services, Office of Strategic Operations and Regulatory Affairs, Regulations Development and Issuances Group, Attn: Julie Brown, CMS-1372-FC, Room C5-16-03, 7500 Security Boulevard, Baltimore, MD 21244-1850; and Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Brenda Aguilar, CMS Desk Officer.

Comments submitted to OMB may also be emailed to the following address: email: baguilar@omb.eop.gov; or faxed to OMB at (202) 395- 6974.

VII. Regulatory Impact Analysis

We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 16, 1980, Pub. L. 96-354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132. Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared for final rules with economically significant effects (that is, a final rule that would have an annual effect on the economy of $100 million or more in any 1 year, or would adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities). We estimate that the combined effect of the physician fee schedule update and GPCI provisions included in this final rule will increase Medicare spending by $1.0 billion in FY 2004. We have simulated the effect of both the drug payment and physician fee schedule changes that we are adopting in this final rule. We are making several changes to the physician fee schedule RVUs in this final rule. In general, section 1848(c)(2)(B)(ii)(II) of the Act requires that changes to RVUs cannot increase or decrease expenditures more than $20 million from the amount of expenditures that would have resulted with such adjustments. However, section 303(a)(1) of the MPDIMA specifically exempts the changes we are making to the RVUs in this final rule from the budget neutrality requirements of section 1848(c)(2)(B)(ii)(II) of the Act. Thus, the changes that we are making to the physician fee schedule RVUs will increase aggregate spending for Medicare physician fee schedule services. Because the changes in this final rule will increase Medicare spending by more than $1.0 billion in FY 2004, we are considering this final rule to be economically significant. Therefore, this final rule is a major rule and we have prepared a regulatory impact analysis. The table 6 below shows our estimates of the fiscal year 2004 impact of specific MPDIMA provisions we are implementing in this final rule (rounded to the nearest $0.1 billion).

[[Page 1098]]

Table 6

FY 2004 Section

Description

impact ($ in billions)

303............................ Competitive Acquisition

$0.0 of Covered Outpatient Drugs. 304............................ Application to Certain

-0.1 Specialties. 305............................ Payment for Inhalation

-0.1 Drugs. 412............................ Work GPCI Floor for

0.2 Physicians. 601............................ Update Revisions.......

0.8 602............................ Services in Alaska.....

0.0

The RFA requires that we analyze regulatory options for small businesses and other entities. We prepare a Regulatory Flexibility Analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives and less significant adverse economic impact on the small entities.

Section 1102(b) of the Act requires us to prepare a regulatory impact analysis for any 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.

For purposes of the RFA, physicians, non-physician practitioners, and suppliers are considered small businesses if they generate revenues of $6 million or less. Approximately 95 percent of physicians (except mental health specialists) are considered to be small entities. There are about 875,000 physicians, other practitioners and medical suppliers that receive Medicare payment under the physician fee schedule. There are in excess of 20,000 physicians and other practitioners that receive Medicare payment for drugs. These physicians are concentrated in the specialties of oncology, urology and rheumatology. Of the physicians in these specialties, approximately 40 percent are in oncology and 45 percent in urology.

For purposes of the RFA, approximately 98 percent of suppliers of DME and prosthetic devices are considered small businesses according to the Small Business Administration's (SBA) size standards. We estimate that 106,000 entities bill Medicare for DME, prosthetics, orthotics, surgical dressings, and other equipment and supplies each year. Total Medicare expenditures for DME are approximately $7.7 billion per year, of which approximately $1.4 billion are for DME drugs.

The analysis and discussion provided in this section as well as elsewhere in this final rule complies with the RFA requirements. Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. This final rule would not impose unfunded mandates on State, local, or tribal governments, or on the private sector of more than $110 million.

We have examined this final rule in accordance with Executive Order 13132 and have determined that this regulation would not have any significant impact on the rights, roles, or responsibilities of State, local, or tribal governments.

We have prepared the following analysis, which together with the rest of this preamble meets all assessment requirements. It explains the rationale for, and purposes of, the rule, details the costs and benefits of the rule, analyzes alternatives, and presents the measures we propose to use to minimize the burden on small entities. This final rule changes Medicare payment rates for drugs and their administration as well as other physician fee schedule services. We are providing information for each of the policy changes in the relevant sections of this final rule. We are unaware of any relevant Federal rules that duplicate, overlap or conflict with this final rule. The relevant sections of this final rule contain a description of significant alternatives if applicable.

A. Application of Market-Based Systems of Medicare Payment for Part B Drugs

As described in more detail earlier in this final rule, effective January 1, 2004, with some exceptions, section 303(b) of MPDIMA specifies that drugs not paid on a cost or prospective payment basis will be paid at 85 percent of the average wholesale price determined as of April 1, 2003. Section 303(a) directs the Secretary to make changes to the physician fee schedule that will increase Medicare spending for physicians' services. Section 303 applies only to oncology payments while section 304 indicates that identical provisions to those in section 303 apply to other physicians. We have estimated that section 303 of MPDIMA would have no cost in FY 2004 and that section 304 would save $0.1 billion in FY 2004.

B. Payment for Inhalation Drugs

Section 305(a) of MPDIMA specifies that inhalation drugs furnished through durable medical equipment covered under 1861(n) of the Act will be paid at 80 percent of the average wholesale price determined as of April 1, 2003. We estimated savings associated with implementing section 305(a) of the MPDIMA is $0.1 billion in FY 2004.

C. Pharmacy Supplying Fee for Certain Drugs and Biologicals

Section 303(e)(2) provides for payment of a pharmacy supplying fee, less applicable deductible and coinsurance, for immunosuppressive drugs described in subparagraph (J) of section 1861(s)(2) and oral anti- cancer and anti-nausea drugs described in subparagraphs (Q) and (T) of such section. The payment of this fee is bundled into the current payment for these drugs and the 2004 payment amounts specified in section 303(b). This provision has no impact on Medicare expenditures in 2004.

D. Physician Fee Schedule Provisions Related to the Administration of Drugs

As indicated above, we are making changes to the work and practice expense RVUs under the provisions of section 1848(c)(2) of the Act as amended by section 303 of MPDIMA. In general, under section 1848(c)(2) of the Act, adjustments to RVUs may not cause the amount of expenditures to differ by more than $20 million from the amount of expenditures that would have

[[Page 1099]]

resulted without such adjustments. However, section 303(a)(1) of the MPDIMA specifically exempts the changes we are making to the RVUs in this final rule from the budget neutrality requirements of section 1848(c)(2)(B)(ii)(II). As described above, consistent with section 303(a)(1), we are making several changes to the physician fee schedule work and practice expense RVUs.

Table 6A shows the specialty level impact on payment of changes being made for CY 2004. The payment impacts reflect averages for each specialty based on Medicare utilization. The payment impact for an individual physician would be different from the average, based on the mix of services the physician provides. The average change in total revenues would be less than the impact displayed here since physicians furnish services to both Medicare and non-Medicare patients and specialties may receive substantial Medicare revenues for services that are not paid under the physician fee schedule. For instance, oncologists receive approximately 20 percent of their Medicare revenues from physician fee schedule services and approximately 77 percent of their Medicare revenues from drugs. Table 6A shows only the payment impact on physician fee schedule services. Table 11 below shows the combined impact of the physician fee schedule and drug payment changes for selected specialties and suppliers that receive a high percentage of their Medicare revenues from drugs.

We modeled the impact of all changes to the relative value units and illustrated their effect in table 6A. The column labeled ``Impact 11/7/2003 Final Rule Pre-MEI Weight Adjustments'' shows the combined effect of all of the relative value unit changes contained in the August 15, 2003, proposed rule and the November 7, 2003, final rule other than the adjustments to make the aggregate work, practice expense and malpractice RVUs match the MEI weights. (For a description of the impact of the provisions of the August 15, 2003, proposed rule see 68 FR 49060-49065. For a description of the impact of additional impacts resulting from the November 7, 2003, final rule, see 68 FR 63252- 63253). As described below, we have revised the MEI weight adjustments and will illustrate their impact once we show the effect of all other provisions that change RVUs.

The column labeled ``Section 303 and 304 Changes without Transition Payments'' shows the impact of changes made in this final rule implementing section 303 and 304 of MPDIMA other than section 303(a)(4) that requires a ``transitional adjustment'' that increases payments for specific drug administration services by an additional 32 percent in 2004. This column shows the effect of increases in payments for drug administration services resulting from the higher work and practice expense RVUs required by section 303 and 304 of MPDIMA as well allowing oncologists to bill for multiple drug administrations by the ``push'' technique on a single day. In addition, because there will be no same day billing of a level 1 office visit and a drug administration service, the impacts shown include the effect of fewer office visit billings by the minority of oncologists who billed for such services. Taken together, these provisions will increase payments to oncologists by an estimated 27 percent. We estimate that payments to other physicians that provide drug administration services (rheumatology, infectious disease, obstetrics/gynecology) will increase by 1 to 2 percent. The revision to the practice expense per hour for cardiac and thoracic surgeons will increase their payments by an estimated 1 percent. All of the other increases shown in the table are a result of changes that we are making to the non-physician work pool. These changes will increase payments to physicians, practitioners and suppliers (Allergy/Immunology, Radiation Oncology, Radiology, Audiology, Diagnostic Testing Facility and Portable X-Ray suppliers) that provide services affected by the non-physician work pool calculations by approximately 1 percent. There will be little or no change in payments for all other specialties from the changes we are making in this interim final rule because the changes to the RVUs resulting from MPDIMA are exempt from the budget neutrality requirements of section 1848(c)(2)(ii)(II) of the Act.

The column labeled ``Transition Payments'' shows the impact on payment from the 32 percent increase in payment for drug administration services required by section 303(a)(4) of MPDIMA. This provision will have an effect on only those specialties that provide drug administration services and is estimated to increase payments to oncologists by an additional 14 percent. We estimate that payments to other physicians that provide drug administration services (infectious disease, obstetrics/gynecology rheumatology and urology) will increase by 1 to 2 percent.

We also modeled the effect of adjusting the RVUs to match the new MEI weights. Because we are increasing the malpractice RVUs by more than 20 percent, adjusting the RVUs to match the new MEI weights will result in an increase in payment for those specialties that perform services with high malpractice RVUs. Payments to anesthesiology, cardiac surgery, emergency medicine, neurosurgery, orthopedic surgery, thoracic surgery and vascular surgery will increase by approximately 1 percent. There will be a small impact on payment to all other physicians, practitioners and suppliers from the adjustments that reduce physician work and practice expense RVUs to match the new MEI weights. The total change in payment from provisions of the November 7, 2003, final rule and this final rule are shown in the total column.

BILLING CODE 4120-01-P

[[Page 1100]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.004

[[Page 1101]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.005

In general, the statutory methodology for updating the physician fee schedule conversion factor is specified in section 1848(d)(4) of the Act. However, section 1848(d)(5) specifies that the update to the conversion factor for 2004 and 2005 shall not be less than 1.5 percent. Application of the statutory methodology of section 1848(d)(4) of the Act would reduce the physician fee schedule conversion factor by 4.5 percent. However, because section 1848(d)(5) of the Act indicates that the update can be no less than 1.5 percent, we are increasing the 2004 physician fee schedule conversion factor by 1.5 percent. In table 7, we are showing the estimated change in average payments by specialty based on provisions of this final rule and the estimated physician fee schedule update.

[[Page 1102]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.006

[[Page 1103]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.007

In the November 7, 2003, final rule, we showed the impact of all RVUs changes and a 4.5 percent reduction in the physician fee schedule conversion factor. In the table below, we are showing the effect of MPDIMA on payment for physician fee schedule services relative to the changes that would have occurred in 2004 under current law had MPDIMA not been enacted. That is, because the physician fee schedule conversion factor would have been reduced by 4.5 percent to $35.1339 and MPDIMA requires that it be increased by 1.5 percent to $37.3374, MPDIMA provisions affecting the update increased average physician fee schedule rates by 6.3 percent ($37.3374/$35.339 - 1 = 1.063 or 6.3 percent). Furthermore, MPDIMA required changes to relative value units that also resulted in further average increases in Medicare payment for physician fee schedule services. The following table also includes the impact of the GPCI provision that does not allow a work GPCI to be less than 1.0 and another one that increases the Alaska GPCI to 1.67. However, the impact on any specific physician, practitioner or supplier will be different than the average depending upon on whether the individual is located in Alaska or an area that would have had a GPCI that is less than 1.0.

The column labeled ``Impact 11/7/2003'' final rule shows the impacts from table 27 of the November 7, 2003, final rule (68 FR 63256). The next column shows the impacts from table 7 and an estimate of the increase in payments due to the GPCI provisions. The percentage difference between these columns isolates the impact of the MPDIMA provisions we are adopting in this final rule and are shown in the last column.

[[Page 1104]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.008

[[Page 1105]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.009

Table 9 shows the impact on payments for selected high volume procedures of all of the changes previously discussed. This table shows the combined impact of the change in the work, practice expense and malpractice RVUs and the estimated physician fee schedule update on total payment for the procedure. There are separate columns that show the change in the facility rates and the non-facility rates. For an explanation of facility and non-facility practice expense refer to Sec. 414.22(b)(5)(i). The figures in tables 9 and 10 show the impact of the RVU changes and the physician fee schedule update but do not include the impact of the GPCI changes.

[[Page 1106]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.011

[[Page 1107]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.012

[[Page 1108]]

The next table shows the change in payments from 2003 to 2004 for selected high volume drug administration services. This table shows the impact of the increases in the physician work and practice expense RVUs, the 1.5 percent increase in the physician fee schedule conversion factor and the additional 32 percent ``transition adjustment'' required by section 303(a)(4) of MPDIMA in 2004.

[GRAPHIC] [TIFF OMITTED] TR06JA04.013

Table 11 shows the combined impact of changes we are making to Medicare drug and physician fee schedule payments on selected specialties/medical suppliers that receive a significant portion of their total Medicare revenues from drugs. These figures do not include the impact of the legislated increases in the GPCI. The table shows the amount and proportion of total Medicare revenues received from drugs and physician fee schedule services (DME fee schedule services for DME/ Other Medical Suppliers). We note that these impacts and percentages represent averages for each specialty or supplier. The percentages and impacts for any individual physician or DME supplier are dependent on the mix of drugs and physician fee schedule services they provide to Medicare beneficiaries. These tables are intended to illustrate the combined payment impact in a single year across all of the services that these specialties or suppliers perform using the most recent data available to us. The first two columns of table 11 list the specialty and its combined Medicare revenues from all sources. The next three columns show estimated total Medicare drug revenues, the proportion of total revenues represented by drugs and the percent change in Medicare drug payments estimated in the first year. The revenue reduction shown includes the effect of limiting decreases in drug payments to 15 percent, the maximum reduction allowed in 2004 consistent with section 1842(o)(4)(D) of the Act (as added by section 303(b) of MPDIMA). The following three columns show analogous information for physician fee schedule services. The last column shows the combined percentage change across all Medicare revenues. For example, as indicated in the table, approximately 77 percent of total Medicare revenues for oncologists are attributed to drugs. As indicated in the next column, we estimate that Medicare revenues from drugs will decline by approximately 12 percent for oncologists as a result of policies adopted in this interim final rule or about $510 million. We are increasing oncology physician fee schedule payments by 47 percent in this interim final rule or about $510 million. We estimated that the one-year decrease in drug payments and increase in physician fee schedule payments resulting from this final rule will produce virtually no net change in total Medicare payments for oncologists.

For DME/Other Medical Suppliers, 42 and 58 percent of Medicare revenues respectively are received from drugs and DME fee schedule services. These suppliers will receive an approximate reduction of 13 percent in their Medicare drug revenues the first year. The total reduction in payment in one year across all of the services they provide will be approximately 6 percent.

In general, the other physician specialties receive a smaller share of their total Medicare revenues from drugs than oncologists. However, they are also less affected by the payment increases for drug administration services. Taken together, we estimate a net change in revenues from the drug and drug administration payment changes for urology (-4 percent), rheumatology (-2 percent), obstetrics/gynecology (+1 percent) and infectious disease (+4 percent).

[[Page 1109]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.014

[[Page 1110]]

C. Geographic Practice Cost Indices (GPCIs) Changes

Section 412 of MPDIMA amended section 1848(e)(1) of the Act and establishes a floor of 1.0 for the work geographic index for any locality to be used for purposes of payment for services furnished on or after January 1, 2004, and before January 1, 2007. In addition, section 602 of MPDIMA further amended 1848 (e)(1) of the Act for purposes of payment for services furnished in Alaska under the physician fee schedule on or after January 1, 2004, and before January 1, 2006, and sets the practice expense, malpractice and work indices at 1.67 if such index would otherwise be less than 1.67. The impact of the MPDIMA provisions on the work GPCI is illustrated in Table 12.

An impact of these legislative changes to the GPCI can also be demonstrated by a comparison of area geographic adjustment factors (GAFs). The GAFs are a weighted composite of each area's work, practice expense, and malpractice expense GPCIs using the national GPCI cost share weights. While we do not actually use the GAFs in computing the fee schedule payment for a specific service, they are useful in comparing overall area costs and payments. The actual effect on payment for any specific service will deviate from the GAF to the extent that the service's proportions of work, practice expenses, and malpractice expense RVUs differ from those of the GAF. Table 13 shows the effects of the legislative revisions to the GPCIs on area GAFs for 2004. As directed by the legislation no locality will have a work GPCI of less than 1.00 and the work, practice expense and malpractice GPCIs for Alaska are set at 1.67. Tables 12 and 13 are sorted by decreasing percent change in work GPCI and GAF respectively.

[[Page 1111]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.015

[[Page 1112]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.016

[[Page 1113]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.017

[[Page 1114]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.018

[[Page 1115]]

[GRAPHIC] [TIFF OMITTED] TR06JA04.019

BILLING CODE 4120-01-C

We estimate the cost of the provisions affecting the GPCI will increase Medicare spending by 0.2 billion in FY 2004.

E. Alternatives Considered

For the most part, this interim final implements prescriptive provisions of MPDIMA and the statute does not permit us to exercise our discretion. Nevertheless, the preamble identifies ancillary policies and rationale for our decisions.

For instance, the statutory provisions requiring changes to Medicare's payments for drugs were prescriptive. We did not consider any alternatives because of the clear direction in the statute to determine Medicare prices for drugs in 2004. Similarly, the provisions of the statute with respect to the GPCI were also prescriptive and did not allow for us to consider any alternatives. While we considered using the formula contained in section 1848(d)(4) of the Act to update the physician fee schedule conversion factor, its application would result in a reduction of 4.5 percent and would be inconsistent with the MPDIMA provision requiring an update to the physician fee schedule conversion factor for 2004 of not less than 1.5 percent. With respect to the provisions of this final rule that require changes to Medicare payments for the administration of drugs, we generally did not find that the statute permitted discretion. Nevertheless, earlier in the preamble of this final rule, we provided detailed descriptions of the statutory provisions and its requirements and, where possible, of the alternatives we considered.

F. 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. We do not believe that there would be any problem with access to care as a result of the changes in this rule. For the most part, we are increasing payments for physicians fee schedule services that otherwise would be reduced. We don't believe the drug payment changes will have an impact on beneficiary access to services but we will continue to monitor this issue.

We estimate that beneficiary liability will increase in CY 2004 by $1.0 billion for the physician fee schedule provisions relative to current law. Payment changes we are making in this final rule for drug administration will increase beneficiary liability. However, we estimate that the provisions that change Medicare's drug payments to oncologists (section 303 of MPDIMA), other physicians (section 304 of MPDIMA) and inhalation drugs (section 305 of MPDIMA) will offset the additional beneficiary liability for drug administration. We estimate that the net effect of changes to payment for drugs and drug administration will result in savings to beneficiaries of approximately $100 million in CY 2004.

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

List of Subjects

42 CFR Part 405

Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medical devices, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays.

42 CFR Part 414

Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays.

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

[[Page 1116]]

Dated: December 15, 2003. Thomas A Scully, Administrator, Centers for Medicare & Medicaid Services.

Approved: December 24, 2003. Tommy G. Thompson, Secretary.

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

PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED

0 1. The authority citation for part 405 continues to read as follows:

Authority: Secs. 1102, 1802, and 1871 of the Social Security Act (42 U.S.C. 1302, 1395a, and 1395hh).

0 2. Section 405.400 is amended by revising the definition of ``physician'' to read as follows:

Sec. 405.400 Definitions.

* * * * *

Physician means a doctor of medicine; doctor of osteopathy; doctor of dental surgery or of dental medicine; doctor of podiatric medicine; or doctor of optometry who is legally authorized to practice medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, or optometry by the State in which he performs such function and who is acting within the scope of his license when he performs such functions. * * * * *

0 3. Section 405.517 is amended by-- 0 A. Redesignating the text of paragraph (a) as paragraph (a)(1) and adding a heading; 0 B. Adding a new paragraph (a)(2).

Sec. 405.517 Payment for drugs and biologicals that are not paid on a cost or prospective payment basis.

(a) Applicability. (1) Payment for drugs and biologicals before January 1, 2004. * * *

(2) Payment for drugs and biologicals on or after January 1, 2004. Effective January 1, 2004, payment for drugs and biologicals that are not paid on a cost or prospective payment basis are paid in accordance with Part 414, subpart I of this chapter. * * * * *

PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES

0 4. The authority citation for part 414 continues to read as follows:

Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).

0 5. The list in Sec. 414.1 is amended by adding a new entry in numerical order as follows:

Sec. 414.1 Basis and scope.

* * * * *

1842(o)--Rules for payment of certain drugs and biologicals. * * * * *

0 6. A new subpart I is added to read as follows: Subpart I--Payment for Drugs and Biologicals Sec. 414.701 Purpose. 414.704 Definitions. 414.707 Basis of payment.

Sec. 414.701 Purpose.

This subpart implements section 1842(o) of the Social Security Act by specifying the methodology for determining the payment allowance limit for drugs and biologicals covered under Part B of Title XVIII of the Act (hereafter in this subpart referred to as the ``program'') that are not paid on a cost or prospective payment system basis. Examples of drugs that are subject to the rules contained in this subpart are: drugs furnished incident to a physician's service; durable medical equipment (DME) drugs; separately billable drugs at independent dialysis facilities not under the ESRD composite rate; statutorily covered drugs, for example, influenza, pneumococcal and hepatitis vaccines, antigens, hemophilia blood clotting factor, immunosuppressive drugs and certain oral anti-cancer drugs.

Sec. 414.704 Definitions.

As used in this subpart, the following definition applies. Drug refers to both drugs and biologicals.

Sec. 414.707 Basis of payment.

(a) Method of payment. (1) Payment for a drug in calendar year 2004 is based on the lesser of--

(i) The actual charge on the claim for program benefits; or

(ii) 85 percent of the average wholesale price determined as of April 1, 2003, subject to the exceptions as specified in paragraphs (a)(2) through (a)(8) of this section.

(2) The payment limits for the following drugs are calculated using 95 percent of the average wholesale price:

(i) Blood clotting factors.

(ii) A drug or biological furnished during 2004 that was not available for Medicare payment as of April 1, 2003.

(iii) Pneumococcal and influenza vaccines as well as hepatitis B vaccine that is furnished to individuals at high or intermediate risk of contracting hepatitis B (as determined by the Secretary).

(iv) A drug or biological furnished during 2004 in connection with the furnishing of renal dialysis services if separately billed by renal dialysis facilities.

(3) The payment limits for infusion drugs furnished through a covered item of durable medical equipment are calculated using 95 percent of the average wholesale price in effect on October 1, 2003.

(4) The payments limits for drugs contained in the following table are calculated based on the percentages of the average wholesale price determined as of April 1, 2003 that are specified in the table.

Percentage used to calculate Drug

2004 payment limit

EPOETIN ALFA...............................................

87 LEUPROLIDE ACETATE.........................................

81 GOSERELIN ACETATE..........................................

80 RITUXIMAB..................................................

81 PACLITAXEL.................................................

81 DOCETAXEL..................................................

80 CARBOPLATIN................................................

81 IRINOTECAN.................................................

80 GEMCITABINE HCL............................................

80 PAMIDRONATE DISODIUM.......................................

85 DOLASETRON MESYLATE........................................

80 FILGRASTIM.................................................

81 HYLAN G-F 20...............................................

82 MYCOPHENOLATE MOFETIL......................................

86 GRANISETRON HCL............................................

80 ONDANSETRON................................................

87 VINORELBINE TARTATE........................................

81 SARGRAMOSTIM...............................................

80 TOPOTECAN..................................................

84 IPRATROPIUM BROMIDE........................................

80 ALBUTEROL SULFATE..........................................

80 IMMUNE GLOBULIN............................................

80 LEUCOVORIN CALCIUM.........................................

80 DOXORUBICIN HCL............................................

80 DEXAMETHOSONE SODIUM PHOSPHATE.............................

86 HEPARIN SODIUM LOCK-FLUSH..................................

80 CROMOLYN SODIUM............................................

80 ACETYLCYSTEINE.............................................

80

(5) The payment limits for imiglucerase and alglucerase are calculated using 94 percent of the average wholesale price determined as of April 1, 2003.

(6) Exception. The payment limit for a drug otherwise subject to paragraph (a)(1)(ii) or paragraph (a)(4) of this section may be calculated using the percentage of the average wholesale price as the Secretary deems appropriate based on data and information submitted by the drug manufacturer.

(i) The manufacturer must submit data after October 15, 2003 and before January 1, 2004.

(ii) The percentage only applies for drugs furnished on or after April 1, 2004.

[[Page 1117]]

(7) In the case of blood and blood products (other than blood clotting factors), the payment limits shall be determined in the same manner as such payment limit was determined on October 1, 2003.

(b) Mandatory assignment. Effective with services furnished on or after February 1, 2001, payment for any drug covered under Part B of Medicare may be made on an assignment-related basis only. All billers must accept the program allowed charge as payment in full and may not bill nor collect from the beneficiary any amount other than the unmet Part B deductible and Part B coinsurance amounts, if applicable. Violations of this requirement may subject the supplier to sanctions, as provided by the statute (See Sec. 402 of this chapter).

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 2004. Addendum B contains the RVUs for work, non- facility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.

In previous years, we have listed many services in Addendum B that are not paid under the physician fee schedule. To avoid publishing as many pages of codes for these services, we are not including clinical laboratory codes and most alpha-numeric codes (Healthcare Common Procedure Coding System (HCPCS) codes not included in CPT) in Addendum B.

Addendum B--2004 Relative Value Units and Related Information Used in Determining Medicare Payments for 2004

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.

F = Deleted/discontinued codes. Code not subject to a 90-day grace period.

G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services.

H = Deleted modifier. Either the TC or PC component shown for the code has been deleted, and the deleted component is shown in the data base with the H status indicator. (Code subject to a 90-day grace period.)

I = Not valid for Medicare purposes. Medicare uses another code for the reporting of, and the payment for these services. (Code NOT subject to a 90-day grace period.)

N = 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.

[sbull] 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).

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

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

T = Injections. There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the service(s) for which payment is made.

X = Exclusion by law. These codes represent an item or service that is not within the definition of ``physicians' services'' for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)

4. Description of code. This is an abbreviated version of the narrative description of the code.

5. Physician work RVUs. These are the RVUs for the physician work for this service in 2003. Codes that are not used for Medicare payment are identified with a ``+.''

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

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

8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2004.

9. Non-facility total. This is the sum of the work, fully implemented non-facility practice expense, and malpractice expense RVUs.

10. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.

11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows:

MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians' Current Procedural Terminology for specific definitions.

XXX = The global concept does not apply.

YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).

ZZZ = Code related to another service that is always included in the global period of the other service. (Note: Physician work and practice expense are associated with intra service time and in some instances the post service time.)

\1\ CPT codes and descriptions only are copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.

\2\ Copyright 2003 American Dental Association. All rights reserved.

\3\ + Indicates RVUs are not used for Medicare payment.

[[Page 1118]]

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

Physician Non-

Mal- Non- CPT\1\ HCPCS\2\

MOD

Status

Description

work facility Facility practice facility Facility Global RVUs\3\ PE RVUs PE RVUs RVUs total total

0001F............... .............. I

Blood pressure,

0.00 0.00 0.00 0.00 0.00 0.00

XXX measured. 0001T............... .............. C

Endovas repr abdo ao

0.00 0.00 0.00 0.00 0.00 0.00

XXX aneurys. 0002F............... .............. I

Tobacco use, smoking, 0.00 0.00 0.00 0.00 0.00 0.00

XXX assess. 0002T............... .............. D

endo repair abd aa

0.00 0.00 0.00 0.00 0.00 0.00

XXX aorto uni. 0003F............... .............. I

Tobacco use, non-

0.00 0.00 0.00 0.00 0.00 0.00

XXX smoking. 0003T............... .............. C

Cervicography........ 0.00 0.00 0.00 0.00 0.00 0.00

XXX 0004F............... .............. I

Tobacco use txmnt

0.00 0.00 0.00 0.00 0.00 0.00

XXX counseling. 0005F............... .............. I

Tobacco use txmnt,

0.00 0.00 0.00 0.00 0.00 0.00

XXX pharmacol. 0005T............... .............. C

Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00

XXX cv art. 0006F............... .............. I

Statin therapy,

0.00 0.00 0.00 0.00 0.00 0.00

XXX prescribed. 0006T............... .............. C

Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00

XXX cv art. 0007F............... .............. I

Beta-blocker thx

0.00 0.00 0.00 0.00 0.00 0.00

XXX prescribed. 0007T............... .............. C

Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00

XXX cv art. 0008F............... .............. I

Ace inhibitor thx

0.00 0.00 0.00 0.00 0.00 0.00

XXX prescribed. 0008T............... .............. C

Upper gi endoscopy w/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX suture. 0009F............... .............. I

Assess anginal

0.00 0.00 0.00 0.00 0.00 0.00

XXX symptom/level. 0009T............... .............. C

Endometrial

0.00 0.00 0.00 0.00 0.00 0.00

XXX cryoablation. 0010F............... .............. I

Assess anginal

0.00 0.00 0.00 0.00 0.00 0.00

XXX symptom/level. 0010T............... .............. C

Tb test, gamma

0.00 0.00 0.00 0.00 0.00 0.00

XXX interferon. 0011F............... .............. I

Oral antiplat thx

0.00 0.00 0.00 0.00 0.00 0.00

XXX prescribed. 0012T............... .............. C

Osteochondral knee

0.00 0.00 0.00 0.00 0.00 0.00

XXX autograft. 0013T............... .............. C

Osteochondral knee

0.00 0.00 0.00 0.00 0.00 0.00

XXX allograft. 0014T............... .............. C

Meniscal transplant,

0.00 0.00 0.00 0.00 0.00 0.00

XXX knee. 0016T............... .............. C

Thermotx choroid vasc 0.00 0.00 0.00 0.00 0.00 0.00

XXX lesion. 0017T............... .............. C

Photocoagulat macular 0.00 0.00 0.00 0.00 0.00 0.00

XXX drusen. 0018T............... .............. C

Transcranial magnetic 0.00 0.00 0.00 0.00 0.00 0.00

XXX stimul. 0019T............... .............. I

Extracorp shock wave

0.00 0.00 0.00 0.00 0.00 0.00

XXX tx, ms. 0020T............... .............. C

Extracorp shock wave

0.00 0.00 0.00 0.00 0.00 0.00

XXX tx, ft. 0021T............... .............. C

Fetal oximetry,

0.00 0.00 0.00 0.00 0.00 0.00

XXX trnsvag/cerv. 0023T............... .............. C

Phenotype drug test,

0.00 0.00 0.00 0.00 0.00 0.00

XXX hiv 1. 0024T............... .............. C

Transcath cardiac

0.00 0.00 0.00 0.00 0.00 0.00

XXX reduction. 0025T............... .............. D

Ultrasonic pachymetry 0.00 0.00 0.00 0.00 0.00 0.00

XXX 0026T............... .............. C

Measure remnant

0.00 0.00 0.00 0.00 0.00 0.00

XXX lipoproteins. 0027T............... .............. C

Endoscopic epidural

0.00 0.00 0.00 0.00 0.00 0.00

XXX lysis. 0028T............... .............. C

Dexa body composition 0.00 0.00 0.00 0.00 0.00 0.00

XXX study. 0029T............... .............. C

Magnetic tx for

0.00 0.00 0.00 0.00 0.00 0.00

XXX incontinence. 0030T............... .............. C

Antiprothrombin

0.00 0.00 0.00 0.00 0.00 0.00

XXX antibody. 0031T............... .............. C

Speculoscopy......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 0032T............... .............. C

Speculoscopy w/direct 0.00 0.00 0.00 0.00 0.00 0.00

XXX sample. 0033T............... .............. C

Endovasc taa repr

0.00 0.00 0.00 0.00 0.00 0.00

XXX incl subcl. 0034T............... .............. C

Endovasc taa repr w/o 0.00 0.00 0.00 0.00 0.00 0.00

XXX subcl. 0035T............... .............. C

Insert endovasc

0.00 0.00 0.00 0.00 0.00 0.00

XXX prosth, taa. 0036T............... .............. C

Endovasc prosth, taa, 0.00 0.00 0.00 0.00 0.00 0.00

XXX add-on. 0037T............... .............. C

Artery transpose/

0.00 0.00 0.00 0.00 0.00 0.00

XXX endovas taa. 0038T............... .............. C

Rad endovasc taa rpr

0.00 0.00 0.00 0.00 0.00 0.00

XXX w/cover. 0039T............... .............. C

Rad s/i, endovasc taa 0.00 0.00 0.00 0.00 0.00 0.00

XXX repair. 0040T............... .............. C

Rad s/i, endovasc taa 0.00 0.00 0.00 0.00 0.00 0.00

XXX prosth. 0041T............... .............. C

Detect ur infect agnt 0.00 0.00 0.00 0.00 0.00 0.00

XXX w/cpas. 0042T............... .............. C

Ct perfusion w/

0.00 0.00 0.00 0.00 0.00 0.00

XXX contrast, cbf. 0043T............... .............. C

Co expired gas

0.00 0.00 0.00 0.00 0.00 0.00

XXX analysis. 0044T............... .............. C

Whole body

0.00 0.00 0.00 0.00 0.00 0.00

XXX photography. 0045T............... .............. C

Whole body

0.00 0.00 0.00 0.00 0.00 0.00

XXX photography. 0046T............... .............. C

Cath lavage, mammary

0.00 0.00 0.00 0.00 0.00 0.00

XXX duct(s. 0047T............... .............. C

Cath lavage, mammary

0.00 0.00 0.00 0.00 0.00 0.00

XXX duct(s). 0048T............... .............. C

Implant ventricular

0.00 0.00 0.00 0.00 0.00 0.00

XXX device. 0049T............... .............. C

External circulation

0.00 0.00 0.00 0.00 0.00 0.00

XXX assist. 0050T............... .............. C

Removal circulation

0.00 0.00 0.00 0.00 0.00 0.00

XXX assist. 0051T............... .............. C

Implant total heart

0.00 0.00 0.00 0.00 0.00 0.00

XXX system. 0052T............... .............. C

Replace component

0.00 0.00 0.00 0.00 0.00 0.00

XXX heart syst. 0053T............... .............. C

Replace component

0.00 0.00 0.00 0.00 0.00 0.00

XXX heart syst. 0054T............... .............. C

Bone surgery using

0.00 0.00 0.00 0.00 0.00 0.00

XXX computer. 0055T............... .............. C

Bone surgery using

0.00 0.00 0.00 0.00 0.00 0.00

XXX computer. 0056T............... .............. C

Bone surgery using

0.00 0.00 0.00 0.00 0.00 0.00

XXX computer. 0057T............... .............. C

Uppr gi scope w/

0.00 0.00 0.00 0.00 0.00 0.00

XXX thrml txmnt. 0058T............... .............. C

Cryopreservation,

0.00 0.00 0.00 0.00 0.00 0.00

XXX ovary tiss. 0059T............... .............. C

Cryopreservation,

0.00 0.00 0.00 0.00 0.00 0.00

XXX oocyte. 0060T............... .............. C

Electrical impedance

0.00 0.00 0.00 0.00 0.00 0.00

XXX scan. 0061T............... .............. C

Destruction of tumor, 0.00 0.00 0.00 0.00 0.00 0.00

XXX breast. 10021............... .............. A

Fna w/o image........ 1.27 2.20 0.54 0.08 3.55 1.89

XXX 10022............... .............. A

Fna w/image.......... 1.27 2.61 0.42 0.06 3.94 1.75

XXX 10040............... .............. A

Acne surgery......... 1.18 1.02 0.68 0.06 2.26 1.92

010 10060............... .............. A

Drainage of skin

1.17 1.20 0.94 0.10 2.47 2.21

010 abscess. 10061............... .............. A

Drainage of skin

2.40 1.81 1.51 0.21 4.42 4.12

010 abscess. 10080............... .............. A

Drainage of pilonidal 1.17 3.13 1.14 0.11 4.41 2.42

010 cyst. 10081............... .............. A

Drainage of pilonidal 2.45 4.11 1.51 0.23 6.79 4.19

010 cyst.

[[Page 1119]]

10120............... .............. A

Remove foreign body.. 1.22 1.46 0.41 0.12 2.80 1.75

010 10121............... .............. A

Remove foreign body.. 2.69 3.33 1.88 0.30 6.32 4.87

010 10140............... .............. A

Drainage of hematoma/ 1.53 1.51 0.91 0.18 3.22 2.62

010 fluid. 10160............... .............. A

Puncture drainage of

1.20 0.73 0.46 0.13 2.06 1.79

010 lesion. 10180............... .............. A

Complex drainage,

2.25 3.25 2.08 0.30 5.80 4.63

010 wound. 11000............... .............. A

Debride infected skin 0.60 0.57 0.22 0.06 1.23 0.88

000 11001............... .............. A

Debride infected skin 0.30 0.23 0.11 0.02 0.55 0.43

ZZZ add-on. 11010............... .............. A

Debride skin, fx..... 4.19 6.74 2.33 0.54 11.47 7.06

010 11011............... .............. A

Debride skin/muscle,

4.94 8.03 2.37 0.64 13.61 7.95

000 fx. 11012............... .............. A

Debride skin/muscle/

6.87 12.01 3.86 1.07 19.95 11.80

000 bone, fx. 11040............... .............. A

Debride skin, partial 0.50 0.51 0.21 0.06 1.07 0.77

000 11041............... .............. A

Debride skin, full... 0.82 0.65 0.33 0.07 1.54 1.22

000 11042............... .............. A

Debride skin/tissue.. 1.12 0.97 0.45 0.11 2.20 1.68

000 11043............... .............. A

Debride tissue/muscle 2.38 3.41 2.61 0.29 6.08 5.28

010 11044............... .............. A

Debride tissue/muscle/ 3.06 4.50 3.77 0.41 7.97 7.24

010 bone. 11055............... .............. R

Trim skin lesion..... 0.43 0.55 0.17 0.02 1.00 0.62

000 11056............... .............. R

Trim skin lesions, 2

0.61 0.63 0.24 0.04 1.28 0.89

000 to 4. 11057............... .............. R

Trim skin lesions,

0.79 0.73 0.31 0.05 1.57 1.15

000 over 4. 11100............... .............. A

Biopsy, skin lesion.. 0.81 1.26 0.37 0.05 2.12 1.23

000 11101............... .............. A

Biopsy, skin add-on.. 0.41 0.34 0.19 0.02 0.77 0.62

ZZZ 11200............... .............. A

Removal of skin tags. 0.77 1.06 0.77 0.05 1.88 1.59

010 11201............... .............. A

Remove skin tags add- 0.29 0.16 0.12 0.02 0.47 0.43

ZZZ on. 11300............... .............. A

Shave skin lesion.... 0.51 1.00 0.22 0.04 1.55 0.77

000 11301............... .............. A

Shave skin lesion.... 0.85 1.12 0.37 0.05 2.02 1.27

000 11302............... .............. A

Shave skin lesion.... 1.05 1.31 0.46 0.06 2.42 1.57

000 11303............... .............. A

Shave skin lesion.... 1.24 1.59 0.52 0.07 2.90 1.83

000 11305............... .............. A

Shave skin lesion.... 0.67 0.84 0.27 0.05 1.56 0.99

000 11306............... .............. A

Shave skin lesion.... 0.99 1.11 0.41 0.06 2.16 1.46

000 11307............... .............. A

Shave skin lesion.... 1.14 1.29 0.49 0.06 2.49 1.69

000 11308............... .............. A

Shave skin lesion.... 1.41 1.45 0.59 0.08 2.94 2.08

000 11310............... .............. A

Shave skin lesion.... 0.73 1.12 0.33 0.05 1.90 1.11

000 11311............... .............. A

Shave skin lesion.... 1.05 1.24 0.48 0.06 2.35 1.59

000 11312............... .............. A

Shave skin lesion.... 1.20 1.44 0.55 0.07 2.71 1.82

000 11313............... .............. A

Shave skin lesion.... 1.62 1.82 0.72 0.11 3.55 2.45

000 11400............... .............. A

Exc tr-ext b9+marg

0.85 2.00 0.89 0.07 2.92 1.81

010 0.5 4.0 cm. 11420............... .............. A

Exc h-f-nk-sp b9+marg 0.98 1.77 0.94 0.10 2.85 2.02

010 0.5 4 cm. 11440............... .............. A

Exc face-mm b9+marg

1.06 2.28 1.33 0.10 3.44 2.49

010 0.5 4 cm. 11450............... .............. A

Removal, sweat gland

2.73 5.11 2.03 0.31 8.15 5.07

090 lesion. 11451............... .............. A

Removal, sweat gland

3.94 6.74 2.56 0.47 11.15 6.97

090 lesion. 11462............... .............. A

Removal, sweat gland

2.51 5.20 2.02 0.28 7.99 4.81

090 lesion. 11463............... .............. A

Removal, sweat gland

3.94 6.96 2.69 0.48 11.38 7.11

090 lesion. 11470............... .............. A

Removal, sweat gland

3.25 5.14 2.27 0.36 8.75 5.88

090 lesion. 11471............... .............. A

Removal, sweat gland

4.40 6.85 2.78 0.48 11.73 7.66

090 lesion. 11600............... .............. A

Exc tr-ext mlg+marg

1.31 2.65 0.98 0.11 4.07 2.40

010 0.5 4 cm. 11620............... .............. A

Exc h-f-nk-sp

1.19 2.62 0.96 0.11 3.92 2.26

010 mlg+marg 0.5 4 cm. 11640............... .............. A

Exc face-mm

1.35 2.69 1.12 0.12 4.16 2.59

010 malig+marg 0.5 4 cm. 11719............... .............. R

Trim nail(s)......... 0.17 0.25 0.07 0.01 0.43 0.25

000 11720............... .............. A

Debride nail, 1-5.... 0.32 0.34 0.13 0.02 0.68 0.47

000 11721............... .............. A

Debride nail, 6 or

0.54 0.43 0.21 0.05 1.02 0.80

000 more. 11730............... .............. A

Removal of nail plate 1.13 1.02 0.43 0.11 2.26 1.67

000 11732............... .............. A

Remove nail plate,

0.57 0.43 0.22 0.06 1.06 0.85

ZZZ add-on. 11740............... .............. A

Drain blood from

0.37 0.85 0.14 0.04 1.26 0.55

000 under nail. 11750............... .............. A

Removal of nail bed.. 1.86 2.13 1.72 0.19 4.18 3.77

010 11752............... .............. A

Remove nail bed/

2.67 2.95 2.95 0.40 6.02 6.02

010 finger tip. 11755............... .............. A

Biopsy, nail unit.... 1.31 1.10 0.54 0.07 2.48 1.92

000 11760............... .............. A

Repair of nail bed... 1.58 1.84 1.21 0.21 3.63 3.00

010 11762............... .............. A

Reconstruction of

2.89 2.27 1.83 0.39 5.55 5.11

010 nail bed. 11765............... .............. A

Excision of nail

0.69 1.14 0.52 0.06 1.89 1.27

010 fold, toe. 11770............... .............. A

Removal of pilonidal

2.61 3.52 1.51 0.29 6.42 4.41

010 lesion. 11771............... .............. A

Removal of pilonidal

5.73 5.70 3.33 0.68 12.11 9.74

090 lesion. 11772............... .............. A

Removal of pilonidal

6.97 7.17 3.87 0.82 14.96 11.66

090 lesion. 11900............... .............. A

Injection into skin

0.52 0.65 0.22 0.02 1.19 0.76

000 lesions. 11901............... .............. A

Added skin lesions

0.80 0.66 0.36 0.04 1.50 1.20

000 injection. 11920............... .............. R

Correct skin color

1.61 1.99 0.78 0.21 3.81 2.60

000 defects. 11921............... .............. R

Correct skin color

1.93 2.36 0.98 0.25 4.54 3.16

000 defects. 11922............... .............. R

Correct skin color

0.49 0.37 0.25 0.06 0.92 0.80

ZZZ defects. 11950............... .............. R

Therapy for contour

0.84 1.15 0.40 0.07 2.06 1.31

000 defects. 11951............... .............. R

Therapy for contour

1.19 1.50 0.51 0.12 2.81 1.82

000 defects. 11952............... .............. R

Therapy for contour

1.69 1.87 0.68 0.21 3.77 2.58

000 defects. 11954............... .............. R

Therapy for contour

1.85 2.44 0.91 0.23 4.52 2.99

000 defects. 11960............... .............. A

Insert tissue

9.07

NA 10.52 1.06

NA 20.65

090 expander(s). 11970............... .............. A

Replace tissue

7.05

NA 6.10 0.93

NA 14.08

090 expander. 11971............... .............. A

Remove tissue

2.13 7.10 4.76 0.25 9.48 7.14

090 expander(s). 11975............... .............. N

Insert contraceptive +1.48 1.42 0.57 0.17 3.07 2.22

XXX cap. 11976............... .............. R

Removal of

1.78 1.70 0.68 0.21 3.69 2.67

000 contraceptive cap. 11977............... .............. N

Removal/reinsert

+3.30 2.27 1.26 0.37 5.94 4.93

XXX contra cap. 11980............... .............. A

Implant hormone

1.48 1.10 0.54 0.12 2.70 2.14

000 pellet(s). 11981............... .............. A

Insert drug implant

1.48 1.74 0.68 0.17 3.39 2.33

XXX device. 11982............... .............. A

Remove drug implant

1.78 1.97 0.84 0.21 3.96 2.83

XXX device. 11983............... .............. A

Remove/insert drug

3.30 2.32 1.47 0.37 5.99 5.14

XXX implant. 12001............... .............. A

Repair superficial

1.70 2.00 0.49 0.16 3.86 2.35

010 wound(s). 12002............... .............. A

Repair superficial

1.86 2.06 0.93 0.18 4.10 2.97

010 wound(s). 12004............... .............. A

Repair superficial

2.24 2.36 1.05 0.21 4.81 3.50

010 wound(s). 12005............... .............. A

Repair superficial

2.86 2.85 1.23 0.28 5.99 4.37

010 wound(s). 12006............... .............. A

Repair superficial

3.66 3.43 1.54 0.37 7.46 5.57

010 wound(s). 12007............... .............. A

Repair superficial

4.11 3.86 1.84 0.45 8.42 6.40

010 wound(s). 12011............... .............. A

Repair superficial

1.76 2.16 0.50 0.17 4.09 2.43

010 wound(s). 12013............... .............. A

Repair superficial

1.99 2.31 0.97 0.19 4.49 3.15

010 wound(s). 12014............... .............. A

Repair superficial

2.46 2.61 1.09 0.22 5.29 3.77

010 wound(s). 12015............... .............. A

Repair superficial

3.19 3.19 1.28 0.29 6.67 4.76

010 wound(s). 12016............... .............. A

Repair superficial

3.92 3.60 1.56 0.39 7.91 5.87

010 wound(s). 12017............... .............. A

Repair superficial

4.70

NA 1.91 0.47

NA 7.08

010 wound(s). 12018............... .............. A

Repair superficial

5.52

NA 2.27 0.55

NA 8.34

010 wound(s). 12020............... .............. A

Closure of split

2.62 2.65 1.75 0.29 5.56 4.66

010 wound. 12021............... .............. A

Closure of split

1.84 1.74 1.41 0.23 3.81 3.48

010 wound. 12031............... .............. A

Layer closure of

2.15 2.31 0.81 0.18 4.64 3.14

010 wound(s). 12032............... .............. A

Layer closure of

2.47 3.88 1.84 0.18 6.53 4.49

010 wound(s). 12034............... .............. A

Layer closure of

2.92 3.17 1.41 0.25 6.34 4.58

010 wound(s). 12035............... .............. A

Layer closure of

3.42 5.26 2.18 0.36 9.04 5.96

010 wound(s). 12036............... .............. A

Layer closure of

4.04 5.36 2.38 0.49 9.89 6.91

010 wound(s). 12037............... .............. A

Layer closure of

4.66 6.41 2.78 0.59 11.66 8.03

010 wound(s). 12041............... .............. A

Layer closure of

2.37 2.47 0.87 0.21 5.05 3.45

010 wound(s). 12042............... .............. A

Layer closure of

2.74 3.21 1.37 0.21 6.16 4.32

010 wound(s). 12044............... .............. A

Layer closure of

3.14 3.20 1.56 0.29 6.63 4.99

010 wound(s). 12045............... .............. A

Layer closure of

3.63 3.67 2.17 0.41 7.71 6.21

010 wound(s). 12046............... .............. A

Layer closure of

4.24 6.57 2.76 0.48 11.29 7.48

010 wound(s). 12047............... .............. A

Layer closure of

4.64 6.42 3.10 0.49 11.55 8.23

010 wound(s). 12051............... .............. A

Layer closure of

2.47 3.23 1.36 0.19 5.89 4.02

010 wound(s). 12052............... .............. A

Layer closure of

2.77 3.17 1.34 0.21 6.15 4.32

010 wound(s). 12053............... .............. A

Layer closure of

3.12 3.22 1.50 0.24 6.58 4.86

010 wound(s). 12054............... .............. A

Layer closure of

3.45 3.54 1.60 0.30 7.29 5.35

010 wound(s). 12055............... .............. A

Layer closure of

4.42 4.54 2.14 0.42 9.38 6.98

010 wound(s). 12056............... .............. A

Layer closure of

5.23 6.76 3.07 0.52 12.51 8.82

010 wound(s). 12057............... .............. A

Layer closure of

5.95 6.10 3.76 0.60 12.65 10.31

010 wound(s). 13100............... .............. A

Repair of wound or

3.12 3.51 1.78 0.25 6.88 5.15

010 lesion. 13101............... .............. A

Repair of wound or

3.91 3.75 2.22 0.27 7.93 6.40

010 lesion. 13102............... .............. A

Repair wound/lesion

1.24 0.74 0.57 0.12 2.10 1.93

ZZZ add-on. 13120............... .............. A

Repair of wound or

3.30 3.61 1.82 0.28 7.19 5.40

010 lesion. 13121............... .............. A

Repair of wound or

4.32 3.97 2.32 0.30 8.59 6.94

010 lesion. 13122............... .............. A

Repair wound/lesion

1.44 0.87 0.63 0.14 2.45 2.21

ZZZ add-on.

[[Page 1121]]

13131............... .............. A

Repair of wound or

3.78 3.88 2.14 0.30 7.96 6.22

010 lesion. 13132............... .............. A

Repair of wound or

5.94 4.68 3.17 0.39 11.01 9.50

010 lesion. 13133............... .............. A

Repair wound/lesion

2.19 1.19 1.03 0.21 3.59 3.43

ZZZ add-on. 13150............... .............. A

Repair of wound or

3.80 5.50 2.61 0.35 9.65 6.76

010 lesion. 13151............... .............. A

Repair of wound or

4.44 5.40 3.03 0.34 10.18 7.81

010 lesion. 13152............... .............. A

Repair of wound or

6.32 6.08 3.93 0.46 12.86 10.71

010 lesion. 13153............... .............. A

Repair wound/lesion

2.38 1.34 1.14 0.22 3.94 3.74

ZZZ add-on. 13160............... .............. A

Late closure of wound 10.46

NA 7.14 1.44

NA 19.04

090 14000............... .............. A

Skin tissue

5.88 8.52 5.12 0.55 14.95 11.55

090 rearrangement. 14001............... .............. A

Skin tissue

8.46 9.94 6.59 0.78 19.18 15.83

090 rearrangement. 14020............... .............. A

Skin tissue

6.58 9.17 5.99 0.60 16.35 13.17

090 rearrangement. 14021............... .............. A

Skin tissue

10.04 10.45 7.74 0.83 21.32 18.61

090 rearrangement. 14040............... .............. A

Skin tissue

7.86 8.25 6.86 0.66 16.77 15.38

090 rearrangement. 14041............... .............. A

Skin tissue

11.47 10.64 8.68 0.86 22.97 21.01

090 rearrangement. 14060............... .............. A

Skin tissue

8.49 9.08 7.69 0.71 18.28 16.89

090 rearrangement. 14061............... .............. A

Skin tissue

12.27 11.66 9.51 0.90 24.83 22.68

090 rearrangement. 14300............... .............. A

Skin tissue

11.74 11.19 9.17 1.06 23.99 21.97

090 rearrangement. 14350............... .............. A

Skin tissue

9.60

NA 7.12 1.31

NA 18.03

090 rearrangement. 15000............... .............. A

Skin graft........... 3.99 3.81 2.20 0.45 8.25 6.64

000 15001............... .............. A

Skin graft add-on.... 1.00 1.36 0.41 0.13 2.49 1.54

ZZZ 15050............... .............. A

Skin pinch graft..... 4.29 5.97 4.74 0.55 10.81 9.58

090 15100............... .............. A

Skin split graft..... 9.04 12.63 7.80 1.13 22.80 17.97

090 15101............... .............. A

Skin split graft add- 1.72 3.83 1.66 0.22 5.77 3.60

ZZZ on. 15120............... .............. A

Skin split graft..... 9.82 10.78 7.77 1.09 21.69 18.68

090 15121............... .............. A

Skin split graft add- 2.67 4.58 1.87 0.33 7.58 4.87

ZZZ on. 15200............... .............. A

Skin full graft...... 8.02 10.71 6.00 0.88 19.61 14.90

090 15201............... .............. A

Skin full graft add-

1.32 1.04 0.62 0.17 2.53 2.11

ZZZ on. 15220............... .............. A

Skin full graft...... 7.86 10.59 6.43 0.82 19.27 15.11

090 15221............... .............. A

Skin full graft add-

1.19 0.91 0.56 0.14 2.24 1.89

ZZZ on. 15240............... .............. A

Skin full graft...... 9.03 10.15 7.65 0.96 20.14 17.64

090 15241............... .............. A

Skin full graft add-

1.86 1.45 0.92 0.21 3.52 2.99

ZZZ on. 15260............... .............. A

Skin full graft...... 10.04 9.88 8.60 0.76 20.68 19.40

090 15261............... .............. A

Skin full graft add-

2.23 2.72 1.42 0.21 5.16 3.86

ZZZ on. 15342............... .............. A

Cultured skin graft,

1.00 1.83 0.55 0.11 2.94 1.66

010 25 cm. 15343............... .............. A

Culture skn graft

0.25 0.27 0.10 0.02 0.54 0.37

ZZZ addl 25 cm. 15350............... .............. A

Skin homograft....... 3.99 8.22 4.83 0.51 12.72 9.33

090 15351............... .............. A

Skin homograft add-on 1.00 0.94 0.39 0.13 2.07 1.52

ZZZ 15400............... .............. A

Skin heterograft..... 3.99 4.18 4.10 0.48 8.65 8.57

090 15401............... .............. A

Skin heterograft add- 1.00 1.22 0.44 0.13 2.35 1.57

ZZZ on. 15570............... .............. A

Form skin pedicle

9.20 9.17 6.68 1.16 19.53 17.04

090 flap. 15572............... .............. A

Form skin pedicle

9.26 8.38 6.25 1.12 18.76 16.63

090 flap. 15574............... .............. A

Form skin pedicle

9.87 8.79 6.95 1.11 19.77 17.93

090 flap. 15576............... .............. A

Form skin pedicle

8.68 9.39 6.42 0.87 18.94 15.97

090 flap. 15600............... .............. A

Skin graft........... 1.91 7.04 2.70 0.23 9.18 4.84

090 15610............... .............. A

Skin graft........... 2.42 3.73 3.03 0.30 6.45 5.75

090 15620............... .............. A

Skin graft........... 2.94 7.46 3.67 0.34 10.74 6.95

090 15630............... .............. A

Skin graft........... 3.27 6.84 3.93 0.34 10.45 7.54

090 15650............... .............. A

Transfer skin pedicle 3.96 6.70 4.02 0.43 11.09 8.41

090 flap. 15732............... .............. A

Muscle-skin graft,

17.81 18.05 12.22 1.81 37.67 31.84

090 head/neck. 15734............... .............. A

Muscle-skin graft,

17.76 17.84 12.34 2.30 37.90 32.40

090 trunk. 15736............... .............. A

Muscle-skin graft,

16.25 18.16 11.22 2.15 36.56 29.62

090 arm. 15738............... .............. A

Muscle-skin graft,

17.89 17.93 11.74 2.35 38.17 31.98

090 leg. 15740............... .............. A

Island pedicle flap

10.23 9.81 7.88 0.75 20.79 18.86

090 graft. 15750............... .............. A

Neurovascular pedicle 11.39

NA 9.04 1.40

NA 21.83

090 graft. 15756............... .............. A

Free myo/skin flap

35.18

NA 20.69 3.75

NA 59.62

090 microvasc. 15757............... .............. A

Free skin flap,

35.18

NA 21.73 4.06

NA 60.97

090 microvasc. 15758............... .............. A

Free fascial flap,

35.05

NA 21.72 4.25

NA 61.02

090 microvasc. 15760............... .............. A

Composite skin graft. 8.73 9.71 7.02 0.87 19.31 16.62

090 15770............... .............. A

Derma-fat-fascia

7.51

NA 6.69 0.94

NA 15.14

090 graft. 15775............... .............. R

Hair transplant punch 3.95 2.78 1.32 0.52 7.25 5.79

000 grafts. 15776............... .............. R

Hair transplant punch 5.53 5.39 2.81 0.72 11.64 9.06

000 grafts. 15780............... .............. A

Abrasion treatment of 7.28 7.07 7.07 0.49 14.84 14.84

090 skin. 15781............... .............. A

Abrasion treatment of 4.84 5.35 5.35 0.33 10.52 10.52

090 skin. 15782............... .............. A

Abrasion treatment of 4.31 4.30 4.30 0.25 8.86 8.86

090 skin. 15783............... .............. A

Abrasion treatment of 4.28 4.92 4.17 0.31 9.51 8.76

090 skin. 15786............... .............. A

Abrasion, lesion,

2.03 1.63 1.27 0.13 3.79 3.43

010 single. 15787............... .............. A

Abrasion, lesions,

0.33 0.32 0.16 0.02 0.67 0.51

ZZZ add-on. 15788............... .............. R

Chemical peel, face,

2.09 3.34 2.27 0.13 5.56 4.49

090 epiderm. 15789............... .............. R

Chemical peel, face,

4.91 6.39 4.91 0.33 11.63 10.15

090 dermal. 15792............... .............. R

Chemical peel,

1.86 3.16 2.76 0.12 5.14 4.74

090 nonfacial. 15793............... .............. A

Chemical peel,

3.73

NA 4.14 0.21

NA 8.08

090 nonfacial. 15810............... .............. A

Salabrasion.......... 4.73 3.87 3.87 0.51 9.11 9.11

090 15811............... .............. A

Salabrasion.......... 5.38 6.31 5.52 0.63 12.32 11.53

090 15819............... .............. A

Plastic surgery, neck 9.37

NA 7.20 0.93

NA 17.50

090 15820............... .............. A

Revision of lower

5.14 6.85 5.34 0.36 12.35 10.84

090 eyelid.

[[Page 1122]]

15821............... .............. A

Revision of lower

5.71 7.23 5.52 0.37 13.31 11.60

090 eyelid. 15822............... .............. A

Revision of upper

4.44 5.80 4.36 0.27 10.51 9.07

090 eyelid. 15823............... .............. A

Revision of upper

7.04 7.79 6.24 0.39 15.22 13.67

090 eyelid. 15824............... .............. R

Removal of forehead

0.00 0.00 0.00 0.00 0.00 0.00

000 wrinkles. 15825............... .............. R

Removal of neck

0.00 0.00 0.00 0.00 0.00 0.00

000 wrinkles. 15826............... .............. R

Removal of brow

0.00 0.00 0.00 0.00 0.00 0.00

000 wrinkles. 15828............... .............. R

Removal of face

0.00 0.00 0.00 0.00 0.00 0.00

000 wrinkles. 15829............... .............. R

Removal of skin

0.00 0.00 0.00 0.00 0.00 0.00

000 wrinkles. 15831............... .............. A

Excise excessive skin 12.38

NA 8.22 1.57

NA 22.17

090 tissue. 15832............... .............. A

Excise excessive skin 11.57

NA 8.38 1.46

NA 21.41

090 tissue. 15833............... .............. A

Excise excessive skin 10.62

NA 8.24 1.41

NA 20.27

090 tissue. 15834............... .............. A

Excise excessive skin 10.83

NA 7.71 1.42

NA 19.96

090 tissue. 15835............... .............. A

Excise excessive skin 11.65 11.40 7.63 1.36 24.41 20.64

090 tissue. 15836............... .............. A

Excise excessive skin 9.33

NA 6.81 1.15

NA 17.29

090 tissue. 15837............... .............. A

Excise excessive skin 8.42 7.90 7.00 0.94 17.26 16.36

090 tissue. 15838............... .............. A

Excise excessive skin 7.12

NA 6.09 0.70

NA 13.91

090 tissue. 15839............... .............. A

Excise excessive skin 9.37 7.84 6.21 1.06 18.27 16.64

090 tissue. 15840............... .............. A

Graft for face nerve 13.24

NA 10.05 1.39

NA 24.68

090 palsy. 15841............... .............. A

Graft for face nerve 23.23

NA 15.08 3.20

NA 41.51

090 palsy. 15842............... .............. A

Flap for face nerve

37.90

NA 23.01 4.81

NA 65.72

090 palsy. 15845............... .............. A

Skin and muscle

12.55

NA 9.36 0.96

NA 22.87

090 repair, face. 15850............... .............. B

Removal of sutures... +0.78 1.58 0.30 0.05 2.41 1.13

XXX 15851............... .............. A

Removal of sutures... 0.86 1.72 0.34 0.06 2.64 1.26

000 15852............... .............. A

Dressing change not

0.86 1.87 0.36 0.08 2.81 1.30

000 for burn. 15860............... .............. A

Test for blood flow

1.95 1.28 0.79 0.16 3.39 2.90

000 in graft. 15876............... .............. R

Suction assisted

0.00 0.00 0.00 0.00 0.00 0.00

000 lipectomy. 15877............... .............. R

Suction assisted

0.00 0.00 0.00 0.00 0.00 0.00

000 lipectomy. 15878............... .............. R

Suction assisted

0.00 0.00 0.00 0.00 0.00 0.00

000 lipectomy. 15879............... .............. R

Suction assisted

0.00 0.00 0.00 0.00 0.00 0.00

000 lipectomy. 15920............... .............. A

Removal of tail bone

7.94

NA 5.61 1.00

NA 14.55

090 ulcer. 15922............... .............. A

Removal of tail bone

9.89

NA 7.31 1.28

NA 18.48

090 ulcer. 15931............... .............. A

Remove sacrum

9.23

NA 5.75 1.15

NA 16.13

090 pressure sore. 15933............... .............. A

Remove sacrum

10.83

NA 7.94 1.37

NA 20.14

090 pressure sore. 15934............... .............. A

Remove sacrum

12.67

NA 8.15 1.63

NA 22.45

090 pressure sore. 15935............... .............. A

Remove sacrum

14.55

NA 10.40 1.88

NA 26.83

090 pressure sore. 15936............... .............. A

Remove sacrum

12.36

NA 8.36 1.59

NA 22.31

090 pressure sore. 15937............... .............. A

Remove sacrum

14.19

NA 9.96 1.82

NA 25.97

090 pressure sore. 15940............... .............. A

Remove hip pressure

9.33

NA 6.23 1.18

NA 16.74

090 sore. 15941............... .............. A

Remove hip pressure

11.41

NA 9.58 1.48

NA 22.47

090 sore. 15944............... .............. A

Remove hip pressure

11.44

NA 8.70 1.46

NA 21.60

090 sore. 15945............... .............. A

Remove hip pressure

12.67

NA 9.74 1.66

NA 24.07

090 sore. 15946............... .............. A

Remove hip pressure

21.54

NA 14.41 2.80

NA 38.75

090 sore. 15950............... .............. A

Remove thigh pressure 7.53

NA 5.47 0.96

NA 13.96

090 sore. 15951............... .............. A

Remove thigh pressure 10.70

NA 7.95 1.37

NA 20.02

090 sore. 15952............... .............. A

Remove thigh pressure 11.37

NA 7.83 1.44

NA 20.64

090 sore. 15953............... .............. A

Remove thigh pressure 12.61

NA 9.07 1.66

NA 23.34

090 sore. 15956............... .............. A

Remove thigh pressure 15.50

NA 10.85 1.98

NA 28.33

090 sore. 15958............... .............. A

Remove thigh pressure 15.46

NA 11.13 2.00

NA 28.59

090 sore. 15999............... .............. C

Removal of pressure

0.00 0.00 0.00 0.00 0.00 0.00

YYY sore. 16000............... .............. A

Initial treatment of

0.89 0.86 0.27 0.07 1.82 1.23

000 burn(s). 16010............... .............. A

Treatment of burn(s). 0.87 0.66 0.63 0.08 1.61 1.58

000 16015............... .............. A

Treatment of burn(s). 2.35

NA 1.15 0.27

NA 3.77

000 16020............... .............. A

Treatment of burn(s). 0.80 1.31 0.61 0.07 2.18 1.48

000 16025............... .............. A

Treatment of burn(s). 1.85 1.79 0.97 0.19 3.83 3.01

000 16030............... .............. A

Treatment of burn(s). 2.08 2.20 1.12 0.22 4.50 3.42

000 16035............... .............. A

Incision of burn

3.74

NA 1.47 0.43

NA 5.64

090 scab, initi. 16036............... .............. A

Escharotomy; add'l

1.50

NA 0.60 0.13

NA 2.23

ZZZ incision. 17000............... .............. A

Destroy benign/premlg 0.60 0.98 0.32 0.04 1.62 0.96

010 lesion. 17003............... .............. A

Destroy lesions, 2-14 0.15 0.11 0.07 0.01 0.27 0.23

ZZZ 17004............... .............. A

Destroy lesions, 15

2.79 2.32 1.29 0.14 5.25 4.22

010 or more. 17106............... .............. A

Destruction of skin

4.58 4.87 3.34 0.34 9.79 8.26

090 lesions. 17107............... .............. A

Destruction of skin

9.15 7.52 5.45 0.64 17.31 15.24

090 lesions. 17108............... .............. A

Destruction of skin

13.18 9.68 7.68 1.07 23.93 21.93

090 lesions. 17110............... .............. A

Destruct lesion, 1-14 0.65 1.63 0.49 0.05 2.33 1.19

010 17111............... .............. A

Destruct lesion, 15

0.92 1.68 0.59 0.05 2.65 1.56

010 or more. 17250............... .............. A

Chemical cautery,

0.50 1.23 0.35 0.05 1.78 0.90

000 tissue. 17260............... .............. A

Destruction of skin

0.91 1.28 0.44 0.05 2.24 1.40

010 lesions. 17261............... .............. A

Destruction of skin

1.17 1.62 0.59 0.06 2.85 1.82

010 lesions. 17262............... .............. A

Destruction of skin

1.58 1.89 0.78 0.08 3.55 2.44

010 lesions. 17263............... .............. A

Destruction of skin

1.79 2.07 0.86 0.10 3.96 2.75

010 lesions. 17264............... .............. A

Destruction of skin

1.94 2.23 0.89 0.10 4.27 2.93

010 lesions. 17266............... .............. A

Destruction of skin

2.34 2.53 0.99 0.13 5.00 3.46

010 lesions. 17270............... .............. A

Destruction of skin

1.32 1.71 0.64 0.07 3.10 2.03

010 lesions. 17271............... .............. A

Destruction of skin

1.49 1.79 0.74 0.07 3.35 2.30

010 lesions. 17272............... .............. A

Destruction of skin

1.77 2.00 0.88 0.08 3.85 2.73

010 lesions.

[[Page 1123]]

17273............... .............. A

Destruction of skin

2.05 2.21 0.99 0.11 4.37 3.15

010 lesions. 17274............... .............. A

Destruction of skin

2.59 2.58 1.20 0.13 5.30 3.92

010 lesions. 17276............... .............. A

Destruction of skin

3.20 2.97 1.44 0.18 6.35 4.82

010 lesions. 17280............... .............. A

Destruction of skin

1.17 1.62 0.57 0.06 2.85 1.80

010 lesions. 17281............... .............. A

Destruction of skin

1.72 1.91 0.86 0.08 3.71 2.66

010 lesions. 17282............... .............. A

Destruction of skin

2.04 2.17 1.01 0.11 4.32 3.16

010 lesions. 17283............... .............. A

Destruction of skin

2.64 2.56 1.25 0.13 5.33 4.02

010 lesions. 17284............... .............. A

Destruction of skin

3.21 2.94 1.52 0.17 6.32 4.90

010 lesions. 17286............... .............. A

Destruction of skin

4.43 3.71 2.19 0.27 8.41 6.89

010 lesions. 17304............... .............. A

1 stage mohs, up to 5 7.59 8.09 3.57 0.37 16.05 11.53

000 spec. 17305............... .............. A

2 stage mohs, up to 5 2.85 3.81 1.34 0.14 6.80 4.33

000 spec. 17306............... .............. A

3 stage mohs, up to 5 2.85 3.83 1.35 0.14 6.82 4.34

000 spec. 17307............... .............. A

Mohs addl stage up to 2.85 3.78 1.37 0.14 6.77 4.36

000 5 spec. 17310............... .............. A

Mohs any stage 5 spec each. 17340............... .............. A

Cryotherapy of skin.. 0.76 0.37 0.31 0.05 1.18 1.12

010 17360............... .............. A

Skin peel therapy.... 1.43 1.46 0.75 0.07 2.96 2.25

010 17380............... .............. R

Hair removal by

0.00 0.00 0.00 0.00 0.00 0.00

000 electrolysis. 17999............... .............. C

Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.00

YYY 19000............... .............. A

Drainage of breast

0.84 2.03 0.36 0.08 2.95 1.28

000 lesion. 19001............... .............. A

Drain breast lesion

0.42 0.79 0.14 0.04 1.25 0.60

ZZZ add-on. 19020............... .............. A

Incision of breast

3.56 6.00 2.77 0.42 9.98 6.75

090 lesion. 19030............... .............. A

Injection for breast

1.53 3.37 0.50 0.08 4.98 2.11

000 x-ray. 19100............... .............. A

Bx breast percut w/o

1.27 2.15 0.42 0.12 3.54 1.81

000 image. 19101............... .............. A

Biopsy of breast,

3.18 4.69 1.68 0.24 8.11 5.10

010 open. 19102............... .............. A

Bx breast percut w/

2.00 3.98 0.66 0.16 6.14 2.82

000 image. 19103............... .............. A

Bx breast percut w/

3.69 12.07 1.23 0.19 15.95 5.11

000 device. 19110............... .............. A

Nipple exploration... 4.29 5.82 3.06 0.53 10.64 7.88

090 19112............... .............. A

Excise breast duct

3.66 5.80 2.68 0.46 9.92 6.80

090 fistula. 19120............... .............. A

Removal of breast

5.55 4.58 3.08 0.68 10.81 9.31

090 lesion. 19125............... .............. A

Excision, breast

6.05 4.83 3.30 0.74 11.62 10.09

090 lesion. 19126............... .............. A

Excision, addl breast 2.93

NA 1.01 0.36

NA 4.30

ZZZ lesion. 19140............... .............. A

Removal of breast

5.13 7.29 3.42 0.63 13.05 9.18

090 tissue. 19160............... .............. A

Removal of breast

5.98

NA 3.45 0.74

NA 10.17

090 tissue. 19162............... .............. A

Remove breast tissue, 13.51

NA 6.38 1.66

NA 21.55

090 nodes. 19180............... .............. A

Removal of breast.... 8.79

NA 5.06 1.06

NA 14.91

090 19182............... .............. A

Removal of breast.... 7.72

NA 4.81 0.95

NA 13.48

090 19200............... .............. A

Removal of breast.... 15.47

NA 8.04 1.82

NA 25.33

090 19220............... .............. A

Removal of breast.... 15.70

NA 8.30 1.88

NA 25.88

090 19240............... .............. A

Removal of breast.... 15.98

NA 8.28 1.95

NA 26.21

090 19260............... .............. A

Removal of chest wall 15.42

NA 11.30 1.98

NA 28.70

090 lesion. 19271............... .............. A

Revision of chest

18.87

NA 18.23 2.74

NA 39.84

090 wall. 19272............... .............. A

Extensive chest wall 21.52

NA 19.18 3.06

NA 43.76

090 surgery. 19290............... .............. A

Place needle wire,

1.27 3.01 0.41 0.07 4.35 1.75

000 breast. 19291............... .............. A

Place needle wire,

0.63 1.75 0.21 0.04 2.42 0.88

ZZZ breast. 19295............... .............. A

Place breast clip,

0.00 2.77

NA 0.01 2.78

NA

ZZZ percut. 19316............... .............. A

Suspension of breast. 10.67

NA 7.59 1.39

NA 19.65

090 19318............... .............. A

Reduction of large

15.60

NA 11.20 2.04

NA 28.84

090 breast. 19324............... .............. A

Enlarge breast....... 5.84

NA 4.92 0.76

NA 11.52

090 19325............... .............. A

Enlarge breast with

8.44

NA 6.59 1.09

NA 16.12

090 implant. 19328............... .............. A

Removal of breast

5.67

NA 5.07 0.74

NA 11.48

090 implant. 19330............... .............. A

Removal of implant

7.58

NA 6.07 0.98

NA 14.63

090 material. 19340............... .............. A

Immediate breast

6.32

NA 3.12 0.82

NA 10.26

ZZZ prosthesis. 19342............... .............. A

Delayed breast

11.18

NA 8.97 1.46

NA 21.61

090 prosthesis. 19350............... .............. A

Breast reconstruction 8.91 14.20 7.11 1.15 24.26 17.17

090 19355............... .............. A

Correct inverted

7.56 12.80 5.00 0.96 21.32 13.52

090 nipple(s). 19357............... .............. A

Breast reconstruction 18.13

NA 13.85 2.36

NA 34.34

090 19361............... .............. A

Breast reconstruction 19.23

NA 11.78 2.51

NA 33.52

090 19364............... .............. A

Breast reconstruction 40.94

NA 23.64 4.72

NA 69.30

090 19366............... .............. A

Breast reconstruction 21.25

NA 11.23 2.74

NA 35.22

090 19367............... .............. A

Breast reconstruction 25.69

NA 16.57 3.35

NA 45.61

090 19368............... .............. A

Breast reconstruction 32.37

NA 20.26 4.23

NA 56.86

090 19369............... .............. A

Breast reconstruction 29.78

NA 19.79 3.91

NA 53.48

090 19370............... .............. A

Surgery of breast

8.04

NA 6.95 1.04

NA 16.03

090 capsule. 19371............... .............. A

Removal of breast

9.34

NA 7.87 1.22

NA 18.43

090 capsule. 19380............... .............. A

Revise breast

9.13

NA 7.76 1.18

NA 18.07

090 reconstruction. 19396............... .............. A

Design custom breast

2.17 5.78 0.99 0.28 8.23 3.44

000 implant. 19499............... .............. C

Breast surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 20000............... .............. A

Incision of abscess.. 2.12 2.36 1.61 0.21 4.69 3.94

010 20005............... .............. A

Incision of deep

3.41 3.34 2.12 0.41 7.16 5.94

010 abscess. 20100............... .............. A

Explore wound, neck.. 10.06 5.79 4.38 1.19 17.04 15.63

010 20101............... .............. A

Explore wound, chest. 3.22 2.96 1.61 0.29 6.47 5.12

010 20102............... .............. A

Explore wound,

3.93 3.51 1.80 0.42 7.86 6.15

010 abdomen. 20103............... .............. A

Explore wound,

5.29 4.14 3.23 0.69 10.12 9.21

010 extremity. 20150............... .............. A

Excise epiphyseal bar 13.67

NA 7.21 1.16

NA 22.04

090 20200............... .............. A

Muscle biopsy........ 1.46 3.19 0.78 0.21 4.86 2.45

000

[[Page 1124]]

20205............... .............. A

Deep muscle biopsy... 2.35 4.14 1.21 0.28 6.77 3.84

000 20206............... .............. A

Needle biopsy, muscle 0.99 3.17 0.35 0.07 4.23 1.41

000 20220............... .............. A

Bone biopsy, trocar/

1.27 4.73 2.69 0.07 6.07 4.03

000 needle. 20225............... .............. A

Bone biopsy, trocar/

1.87 4.92 2.96 0.13 6.92 4.96

000 needle. 20240............... .............. A

Bone biopsy,

3.23

NA 2.60 0.40

NA 6.23

010 excisional. 20245............... .............. A

Bone biopsy,

7.77

NA 6.36 0.53

NA 14.66

010 excisional. 20250............... .............. A

Open bone biopsy..... 5.02

NA 4.54 0.60

NA 10.16

010 20251............... .............. A

Open bone biopsy..... 5.55

NA 5.17 0.95

NA 11.67

010 20500............... .............. A

Injection of sinus

1.23 5.88 3.89 0.12 7.23 5.24

010 tract. 20501............... .............. A

Inject sinus tract

0.76 3.03 0.25 0.04 3.83 1.05

000 for x-ray. 20520............... .............. A

Removal of foreign

1.85 2.25 1.81 0.21 4.31 3.87

010 body. 20525............... .............. A

Removal of foreign

3.49 3.43 2.66 0.48 7.40 6.63

010 body. 20526............... .............. A

Ther injection, carp

0.94 0.97 0.51 0.07 1.98 1.52

000 tunnel. 20550............... .............. A

Inj tendon sheath/

0.75 0.71 0.24 0.07 1.53 1.06

000 ligament. 20551............... .............. A

Inj tendon origin/

0.75 0.68 0.34 0.07 1.50 1.16

000 insertion. 20552............... .............. A

Inj trigger point, 1/ 0.66 0.73 0.21 0.07 1.46 0.94

000 2 muscl. 20553............... .............. A

Inject trigger

0.75 0.84 0.23 0.07 1.66 1.05

000 points, =/3. 20600............... .............. A

Drain/inject, joint/

0.66 0.64 0.36 0.07 1.37 1.09

000 bursa. 20605............... .............. A

Drain/inject, joint/

0.68 0.75 0.37 0.07 1.50 1.12

000 bursa. 20610............... .............. A

Drain/inject, joint/

0.79 0.94 0.41 0.10 1.83 1.30

000 bursa. 20612............... .............. A

Aspirate/inj ganglion 0.70 0.71 0.34 0.07 1.48 1.11

000 cyst. 20615............... .............. A

Treatment of bone

2.28 2.54 1.83 0.23 5.05 4.34

010 cyst. 20650............... .............. A

Insert and remove

2.23 2.42 1.94 0.34 4.99 4.51

010 bone pin. 20660............... .............. A

Apply, rem fixation

2.51 3.07 1.70 0.58 6.16 4.79

000 device. 20661............... .............. A

Application of head

4.88

NA 4.95 1.11

NA 10.94

090 brace. 20662............... .............. A

Application of pelvis 6.06

NA 5.43 0.98

NA 12.47

090 brace. 20663............... .............. A

Application of thigh

5.42

NA 4.76 0.93

NA 11.11

090 brace. 20664............... .............. A

Halo brace

8.05

NA 7.03 1.80

NA 16.88

090 application. 20665............... .............. A

Removal of fixation

1.31 2.05 1.30 0.21 3.57 2.82

010 device. 20670............... .............. A

Removal of support

1.74 6.69 3.93 0.28 8.71 5.95

010 implant. 20680............... .............. A

Removal of support

3.34 3.22 3.22 0.55 7.11 7.11

090 implant. 20690............... .............. A

Apply bone fixation

3.51

NA 2.47 0.57

NA 6.55

090 device. 20692............... .............. A

Apply bone fixation

6.40

NA 3.73 0.72

NA 10.85

090 device. 20693............... .............. A

Adjust bone fixation

5.85

NA 5.54 1.03

NA 12.42

090 device. 20694............... .............. A

Remove bone fixation

4.15 6.86 4.49 0.69 11.70 9.33

090 device. 20802............... .............. A

Replantation, arm,

41.09

NA 21.40 7.01

NA 69.50

090 complete. 20805............... .............. A

Replant forearm,

49.93

NA 35.06 4.76

NA 89.75

090 complete. 20808............... .............. A

Replantation hand,

61.56

NA 43.43 7.83

NA 112.82

090 complete. 20816............... .............. A

Replantation digit,

30.89

NA 39.17 3.63

NA 73.69

090 complete. 20822............... .............. A

Replantation digit,

25.55

NA 35.90 3.70

NA 65.15

090 complete. 20824............... .............. A

Replantation thumb,

30.89

NA 38.12 4.20

NA 73.21

090 complete. 20827............... .............. A

Replantation thumb,

26.37

NA 37.95 3.87

NA 68.19

090 complete. 20838............... .............. A

Replantation foot,

41.35

NA 22.70 7.06

NA 71.11

090 complete. 20900............... .............. A

Removal of bone for

5.57 7.31 5.79 0.93 13.81 12.29

090 graft. 20902............... .............. A

Removal of bone for

7.54

NA 6.86 1.28

NA 15.68

090 graft. 20910............... .............. A

Remove cartilage for

5.33 7.11 5.44 0.60 13.04 11.37

090 graft. 20912............... .............. A

Remove cartilage for

6.34

NA 6.09 0.66

NA 13.09

090 graft. 20920............... .............. A

Removal of fascia for 5.30

NA 4.37 0.65

NA 10.32

090 graft. 20922............... .............. A

Removal of fascia for 6.60 6.73 5.06 1.06 14.39 12.72

090 graft. 20924............... .............. A

Removal of tendon for 6.47

NA 5.92 0.99

NA 13.38

090 graft. 20926............... .............. A

Removal of tissue for 5.52

NA 4.93 0.88

NA 11.33

090 graft. 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

NA 0.93 0.41

NA 3.15

ZZZ 20936............... .............. B

Spinal bone autograft 0.00 0.00 0.00 0.00 0.00 0.00

XXX 20937............... .............. A

Spinal bone autograft 2.79

NA 1.46 0.52

NA 4.77

ZZZ 20938............... .............. A

Spinal bone autograft 3.02

NA 1.56 0.63

NA 5.21

ZZZ 20950............... .............. A

Fluid pressure,

1.26 1.36 1.01 0.19 2.81 2.46

000 muscle. 20955............... .............. A

Fibula bone graft,

39.15

NA 25.01 5.25

NA 69.41

090 microvasc. 20956............... .............. A

Iliac bone graft,

39.21

NA 24.86 6.96

NA 71.03

090 microvasc. 20957............... .............. A

Mt bone graft,

40.59

NA 19.08 6.92

NA 66.59

090 microvasc. 20962............... .............. A

Other bone graft,

39.21

NA 26.41 6.26

NA 71.88

090 microvasc. 20969............... .............. A

Bone/skin graft,

43.85

NA 27.48 5.23

NA 76.56

090 microvasc. 20970............... .............. A

Bone/skin graft,

43.00

NA 25.84 5.60

NA 74.44

090 iliac crest. 20972............... .............. A

Bone/skin graft,

42.93 21.79 20.14 7.32 72.04 70.39

090 metatarsal. 20973............... .............. A

Bone/skin graft,

45.69

NA 25.29 5.61

NA 76.59

090 great toe. 20974............... .............. A

Electrical bone

0.62 0.62 0.55 0.11 1.35 1.28

000 stimulation. 20975............... .............. A

Electrical bone

2.60

NA 1.73 0.51

NA 4.84

000 stimulation. 20979............... .............. A

Us bone stimulation.. 0.62 0.77 0.34 0.05 1.44 1.01

000 20982............... .............. A

Ablate, bone tumor(s) 7.27 105.35 2.99 0.69 113.31 10.95

000 perq. 20999............... .............. C

Musculoskeletal

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 21010............... .............. A

Incision of jaw joint 10.12

NA 7.25 0.65

NA 18.02

090 21015............... .............. A

Resection of facial

5.28

NA 5.53 0.63

NA 11.44

090 tumor. 21025............... .............. A

Excision of bone,

10.04 10.20 8.21 0.95 21.19 19.20

090 lower jaw. 21026............... .............. A

Excision of facial

4.84 6.94 5.53 0.48 12.26 10.85

090 bone(s). 21029............... .............. A

Contour of face bone

7.70 8.60 6.27 0.89 17.19 14.86

090 lesion.

[[Page 1125]]

21030............... .............. A

Excise max/zygoma b9

4.49 6.84 4.31 0.72 12.05 9.52

090 tumor. 21031............... .............. A

Remove exostosis,

3.24 4.58 3.14 0.34 8.16 6.72

090 mandible. 21032............... .............. A

Remove exostosis,

3.24 4.63 3.25 0.33 8.20 6.82

090 maxilla. 21034............... .............. A

Excise max/zygoma mlg 16.15 13.56 11.32 1.65 31.36 29.12

090 tumor. 21040............... .............. A

Excise mandible

4.49 6.87 4.14 0.23 11.59 8.86

090 lesion. 21044............... .............. A

Removal of jaw bone

11.84

NA 8.68 1.05

NA 21.57

090 lesion. 21045............... .............. A

Extensive jaw surgery 16.15

NA 11.43 1.45

NA 29.03

090 21046............... .............. A

Remove mandible cyst 12.98

NA 12.69 1.22

NA 26.89

090 complex. 21047............... .............. A

Excise lwr jaw cyst w/ 18.72

NA 13.44 1.85

NA 34.01

090 repair. 21048............... .............. A

Remove maxilla cyst

13.48

NA 12.97 1.22

NA 27.67

090 complex. 21049............... .............. A

Excis uppr jaw cyst w/ 17.97

NA 13.03 1.22

NA 32.22

090 repair. 21050............... .............. A

Removal of jaw joint. 10.75

NA 10.26 1.01

NA 22.02

090 21060............... .............. A

Remove jaw joint

10.21

NA 9.80 1.40

NA 21.41

090 cartilage. 21070............... .............. A

Remove coronoid

8.19

NA 7.03 0.81

NA 16.03

090 process. 21076............... .............. A

Prepare face/oral

13.40 12.71 10.17 1.64 27.75 25.21

010 prosthesis. 21077............... .............. A

Prepare face/oral

33.70 32.20 26.20 4.14 70.04 64.04

090 prosthesis. 21079............... .............. A

Prepare face/oral

22.31 22.21 17.49 1.92 46.44 41.72

090 prosthesis. 21080............... .............. A

Prepare face/oral

25.06 25.22 19.77 3.08 53.36 47.91

090 prosthesis. 21081............... .............. A

Prepare face/oral

22.85 22.95 17.79 2.26 48.06 42.90

090 prosthesis. 21082............... .............. A

Prepare face/oral

20.84 19.88 15.99 1.76 42.48 38.59

090 prosthesis. 21083............... .............. A

Prepare face/oral

19.27 19.35 14.73 2.36 40.98 36.36

090 prosthesis. 21084............... .............. A

Prepare face/oral

22.48 22.71 17.68 1.89 47.08 42.05

090 prosthesis. 21085............... .............. A

Prepare face/oral

8.99 8.52 6.88 0.78 18.29 16.65

010 prosthesis. 21086............... .............. A

Prepare face/oral

24.88 24.30 19.60 2.24 51.42 46.72

090 prosthesis. 21087............... .............. A

Prepare face/oral

24.88 23.89 19.41 2.68 51.45 46.97

090 prosthesis. 21088............... .............. C

Prepare face/oral

0.00 0.00 0.00 0.00 0.00 0.00

090 prosthesis. 21089............... .............. C

Prepare face/oral

0.00 0.00 0.00 0.00 0.00 0.00

090 prosthesis. 21100............... .............. A

Maxillofacial

4.21 5.62 4.62 0.22 10.05 9.05

090 fixation. 21110............... .............. A

Interdental fixation. 5.20 7.02 5.66 0.34 12.56 11.20

090 21116............... .............. A

Injection, jaw joint

0.81 7.32 0.34 0.06 8.19 1.21

000 x-ray. 21120............... .............. A

Reconstruction of

4.92 8.83 5.30 0.35 14.10 10.57

090 chin. 21121............... .............. A

Reconstruction of

7.63 10.43 6.65 0.68 18.74 14.96

090 chin. 21122............... .............. A

Reconstruction of

8.51

NA 7.08 0.71

NA 16.30

090 chin. 21123............... .............. A

Reconstruction of

11.14

NA 8.26 1.40

NA 20.80

090 chin. 21125............... .............. A

Augmentation, lower

10.60 11.82 8.28 0.87 23.29 19.75

090 jaw bone. 21127............... .............. A

Augmentation, lower

11.10 14.52 9.11 0.92 26.54 21.13

090 jaw bone. 21137............... .............. A

Reduction of forehead 9.81

NA 7.44 0.64

NA 17.89

090 21138............... .............. A

Reduction of forehead 12.17

NA 9.31 1.77

NA 23.25

090 21139............... .............. A

Reduction of forehead 14.59

NA 9.78 1.23

NA 25.60

090 21141............... .............. A

Reconstruct midface, 18.07

NA 13.88 1.97

NA 33.92

090 lefort. 21142............... .............. A

Reconstruct midface, 18.78

NA 13.08 1.40

NA 33.26

090 lefort. 21143............... .............. A

Reconstruct midface, 19.55

NA 14.09 1.09

NA 34.73

090 lefort. 21145............... .............. A

Reconstruct midface, 19.91

NA 14.15 2.52

NA 36.58

090 lefort. 21146............... .............. A

Reconstruct midface, 20.68

NA 15.59 2.57

NA 38.84

090 lefort. 21147............... .............. A

Reconstruct midface, 21.74

NA 15.29 1.83

NA 38.86

090 lefort. 21150............... .............. A

Reconstruct midface, 25.20

NA 14.12 1.31

NA 40.63

090 lefort. 21151............... .............. A

Reconstruct midface, 28.26

NA 17.92 2.39

NA 48.57

090 lefort. 21154............... .............. A

Reconstruct midface, 30.47

NA 20.18 5.86

NA 56.51

090 lefort. 21155............... .............. A

Reconstruct midface, 34.40

NA 22.30 6.61

NA 63.31

090 lefort. 21159............... .............. A

Reconstruct midface, 42.32

NA 24.47 8.13

NA 74.92

090 lefort. 21160............... .............. A

Reconstruct midface, 46.37

NA 24.41 5.29

NA 76.07

090 lefort. 21172............... .............. A

Reconstruct orbit/

27.76

NA 14.07 2.30

NA 44.13

090 forehead. 21175............... .............. A

Reconstruct orbit/

33.12

NA 18.31 6.22

NA 57.65

090 forehead. 21179............... .............. A

Reconstruct entire

22.22

NA 14.86 2.99

NA 40.07

090 forehead. 21180............... .............. A

Reconstruct entire

25.15

NA 16.07 2.59

NA 43.81

090 forehead. 21181............... .............. A

Contour cranial bone

9.89

NA 7.81 1.17

NA 18.87

090 lesion. 21182............... .............. A

Reconstruct cranial

32.14

NA 19.66 3.05

NA 54.85

090 bone. 21183............... .............. A

Reconstruct cranial

35.26

NA 21.36 3.32

NA 59.94

090 bone. 21184............... .............. A

Reconstruct cranial

38.18

NA 22.55 4.97

NA 65.70

090 bone. 21188............... .............. A

Reconstruction of

22.43

NA 15.18 2.23

NA 39.84

090 midface. 21193............... .............. A

Reconst lwr jaw w/o

17.12

NA 12.97 1.85

NA 31.94

090 graft. 21194............... .............. A

Reconst lwr jaw w/

19.81

NA 14.06 1.68

NA 35.55

090 graft. 21195............... .............. A

Reconst lwr jaw w/o

17.21

NA 13.26 1.45

NA 31.92

090 fixation. 21196............... .............. A

Reconst lwr jaw w/

18.88

NA 13.88 1.95

NA 34.71

090 fixation. 21198............... .............. A

Reconstr lwr jaw

14.14

NA 10.90 1.27

NA 26.31

090 segment. 21199............... .............. A

Reconstr lwr jaw w/

15.98

NA 9.19 1.52

NA 26.69

090 advance. 21206............... .............. A

Reconstruct upper jaw 14.08

NA 10.81 1.22

NA 26.11

090 bone. 21208............... .............. A

Augmentation of

10.21 14.49 9.28 1.11 25.81 20.60

090 facial bones. 21209............... .............. A

Reduction of facial

6.71 11.89 7.23 0.72 19.32 14.66

090 bones. 21210............... .............. A

Face bone graft...... 10.21 13.69 9.41 1.06 24.96 20.68

090 21215............... .............. A

Lower jaw bone graft. 10.75 13.48 9.61 1.25 25.48 21.61

090 21230............... .............. A

Rib cartilage graft.. 10.75

NA 8.57 1.16

NA 20.48

090 21235............... .............. A

Ear cartilage graft.. 6.71 11.37 7.10 0.63 18.71 14.44

090 21240............... .............. A

Reconstruction of jaw 14.03

NA 12.70 1.39

NA 28.12

090 joint. 21242............... .............. A

Reconstruction of jaw 12.93

NA 12.21 1.69

NA 26.83

090 joint.

[[Page 1126]]

21243............... .............. A

Reconstruction of jaw 20.76

NA 17.87 2.23

NA 40.86

090 joint. 21244............... .............. A

Reconstruction of

11.84

NA 10.06 1.15

NA 23.05

090 lower jaw. 21245............... .............. A

Reconstruction of jaw 11.84 16.10 9.73 1.06 29.00 22.63

090 21246............... .............. A

Reconstruction of jaw 12.45 14.55 9.85 1.46 28.46 23.76

090 21247............... .............. A

Reconstruct lower jaw 22.60

NA 17.93 2.67

NA 43.20

090 bone. 21248............... .............. A

Reconstruction of jaw 11.46 13.02 9.31 1.22 25.70 21.99

090 21249............... .............. A

Reconstruction of jaw 17.49 16.58 12.66 1.68 35.75 31.83

090 21255............... .............. A

Reconstruct lower jaw 16.69

NA 12.78 1.36

NA 30.83

090 bone. 21256............... .............. A

Reconstruction of

16.17

NA 12.17 1.25

NA 29.59

090 orbit. 21260............... .............. A

Revise eye sockets... 16.50

NA 8.96 1.51

NA 26.97

090 21261............... .............. A

Revise eye sockets... 31.44

NA 19.21 2.65

NA 53.30

090 21263............... .............. A

Revise eye sockets... 28.38

NA 12.86 2.61

NA 43.85

090 21267............... .............. A

Revise eye sockets... 18.87

NA 13.22 1.63

NA 33.72

090 21268............... .............. A

Revise eye sockets... 24.44

NA 15.32 0.95

NA 40.71

090 21270............... .............. A

Augmentation, cheek

10.21 11.90 8.10 0.88 22.99 19.19

090 bone. 21275............... .............. A

Revision,

11.22

NA 8.74 1.24

NA 21.20

090 orbitofacial bones. 21280............... .............. A

Revision of eyelid... 6.02

NA 6.07 0.33

NA 12.42

090 21282............... .............. A

Revision of eyelid... 3.48

NA 4.68 0.25

NA 8.41

090 21295............... .............. A

Revision of jaw

1.53

NA 2.82 0.16

NA 4.51

090 muscle/bone. 21296............... .............. A

Revision of jaw

4.24

NA 4.43 0.36

NA 9.03

090 muscle/bone. 21299............... .............. C

Cranio/maxillofacial

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 21300............... .............. A

Treatment of skull

0.72 2.38 0.26 0.11 3.21 1.09

000 fracture. 21310............... .............. A

Treatment of nose

0.58 2.34 0.15 0.06 2.98 0.79

000 fracture. 21315............... .............. A

Treatment of nose

1.51 3.03 1.27 0.14 4.68 2.92

010 fracture. 21320............... .............. A

Treatment of nose

1.85 4.25 1.84 0.18 6.28 3.87

010 fracture. 21325............... .............. A

Treatment of nose

3.76

NA 3.75 0.37

NA 7.88

090 fracture. 21330............... .............. A

Treatment of nose

5.37

NA 5.28 0.58

NA 11.23

090 fracture. 21335............... .............. A

Treatment of nose

8.60

NA 6.81 0.77

NA 16.18

090 fracture. 21336............... .............. A

Treat nasal septal

5.71

NA 6.07 0.54

NA 12.32

090 fracture. 21337............... .............. A

Treat nasal septal

2.70 5.11 3.69 0.27 8.08 6.66

090 fracture. 21338............... .............. A

Treat nasoethmoid

6.45

NA 5.99 0.64

NA 13.08

090 fracture. 21339............... .............. A

Treat nasoethmoid

8.08

NA 6.75 0.92

NA 15.75

090 fracture. 21340............... .............. A

Treatment of nose

10.75

NA 8.70 1.03

NA 20.48

090 fracture. 21343............... .............. A

Treatment of sinus

12.93

NA 10.14 1.28

NA 24.35

090 fracture. 21344............... .............. A

Treatment of sinus

19.69

NA 13.71 2.07

NA 35.47

090 fracture. 21345............... .............. A

Treat nose/jaw

8.15 11.54 7.90 0.72 20.41 16.77

090 fracture. 21346............... .............. A

Treat nose/jaw

10.59 13.18 9.03 1.03 24.80 20.65

090 fracture. 21347............... .............. A

Treat nose/jaw

12.67

NA 9.77 1.37

NA 23.81

090 fracture. 21348............... .............. A

Treat nose/jaw

16.66

NA 11.31 1.81

NA 29.78

090 fracture. 21355............... .............. A

Treat cheek bone

3.76 4.70 2.37 0.35 8.81 6.48

010 fracture. 21356............... .............. A

Treat cheek bone

4.14 11.67 3.22 0.43 16.24 7.79

010 fracture. 21360............... .............. A

Treat cheek bone

6.45 13.89 6.19 0.63 20.97 13.27

090 fracture. 21365............... .............. A

Treat cheek bone

14.93

NA 11.77 1.57

NA 28.27

090 fracture. 21366............... .............. A

Treat cheek bone

17.74

NA 11.64 1.70

NA 31.08

090 fracture. 21385............... .............. A

Treat eye socket

9.15

NA 7.07 0.77

NA 16.99

090 fracture. 21386............... .............. A

Treat eye socket

9.15

NA 7.48 0.92

NA 17.55

090 fracture. 21387............... .............. A

Treat eye socket

9.69

NA 7.54 0.94

NA 18.17

090 fracture. 21390............... .............. A

Treat eye socket

10.11

NA 8.01 0.84

NA 18.96

090 fracture. 21395............... .............. A

Treat eye socket

12.66

NA 9.32 1.31

NA 23.29

090 fracture. 21400............... .............. A

Treat eye socket

1.40 3.72 2.10 0.14 5.26 3.64

090 fracture. 21401............... .............. A

Treat eye socket

3.26 5.05 3.87 0.41 8.72 7.54

090 fracture. 21406............... .............. A

Treat eye socket

7.00

NA 6.35 0.71

NA 14.06

090 fracture. 21407............... .............. A

Treat eye socket

8.60

NA 7.14 0.81

NA 16.55

090 fracture. 21408............... .............. A

Treat eye socket

12.36

NA 9.21 1.50

NA 23.07

090 fracture. 21421............... .............. A

Treat mouth roof

5.13 9.92 6.16 0.51 15.56 11.80

090 fracture. 21422............... .............. A

Treat mouth roof

8.31 11.28 7.10 0.83 20.42 16.24

090 fracture. 21423............... .............. A

Treat mouth roof

10.38

NA 8.49 1.15

NA 20.02

090 fracture. 21431............... .............. A

Treat craniofacial

7.04 10.66 6.84 0.70 18.40 14.58

090 fracture. 21432............... .............. A

Treat craniofacial

8.60

NA 6.19 0.66

NA 15.45

090 fracture. 21433............... .............. A

Treat craniofacial

25.31

NA 16.83 2.97

NA 45.11

090 fracture. 21435............... .............. A

Treat craniofacial

17.22

NA 12.96 2.00

NA 32.18

090 fracture. 21436............... .............. A

Treat craniofacial

28.00

NA 18.42 2.80

NA 49.22

090 fracture. 21440............... .............. A

Treat dental ridge

2.70 8.05 4.11 0.27 11.02 7.08

090 fracture. 21445............... .............. A

Treat dental ridge

5.37 10.45 6.28 0.66 16.48 12.31

090 fracture. 21450............... .............. A

Treat lower jaw

2.97 10.65 3.76 0.28 13.90 7.01

090 fracture. 21451............... .............. A

Treat lower jaw

4.86 8.77 5.76 0.47 14.10 11.09

090 fracture. 21452............... .............. A

Treat lower jaw

1.98 7.85 3.56 0.17 10.00 5.71

090 fracture. 21453............... .............. A

Treat lower jaw

5.53 10.50 6.83 0.59 16.62 12.95

090 fracture. 21454............... .............. A

Treat lower jaw

6.45

NA 6.54 0.66

NA 13.65

090 fracture. 21461............... .............. A

Treat lower jaw

8.08 12.52 8.30 0.88 21.48 17.26

090 fracture. 21462............... .............. A

Treat lower jaw

9.78 14.06 9.02 0.96 24.80 19.76

090 fracture. 21465............... .............. A

Treat lower jaw

11.89

NA 10.05 1.01

NA 22.95

090 fracture. 21470............... .............. A

Treat lower jaw

15.32

NA 12.24 1.64

NA 29.20

090 fracture. 21480............... .............. A

Reset dislocated jaw. 0.61 1.95 0.19 0.06 2.62 0.86

000 21485............... .............. A

Reset dislocated jaw. 3.98 5.94 4.80 0.37 10.29 9.15

090

[[Page 1127]]

21490............... .............. A

Repair dislocated jaw 11.84

NA 9.90 1.58

NA 23.32

090 21493............... .............. A

Treat hyoid bone

1.27

NA 2.84 0.12

NA 4.23

090 fracture. 21494............... .............. A

Treat hyoid bone

6.27

NA 5.70 0.53

NA 12.50

090 fracture. 21495............... .............. A

Treat hyoid bone

5.68

NA 5.99 0.49

NA 12.16

090 fracture. 21497............... .............. A

Interdental wiring... 3.85 6.54 5.01 0.37 10.76 9.23

090 21499............... .............. C

Head surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 21501............... .............. A

Drain neck/chest

3.80 4.70 3.95 0.43 8.93 8.18

090 lesion. 21502............... .............. A

Drain chest lesion... 7.11

NA 5.70 0.95

NA 13.76

090 21510............... .............. A

Drainage of bone

5.73

NA 5.72 0.81

NA 12.26

090 lesion. 21550............... .............. A

Biopsy of neck/chest. 2.06 3.64 1.74 0.16 5.86 3.96

010 21555............... .............. A

Remove lesion, neck/

4.34 5.06 3.17 0.49 9.89 8.00

090 chest. 21556............... .............. A

Remove lesion, neck/

5.56

NA 4.11 0.62

NA 10.29

090 chest. 21557............... .............. A

Remove tumor, neck/

8.87

NA 5.44 1.03

NA 15.34

090 chest. 21600............... .............. A

Partial removal of

6.88

NA 5.80 0.98

NA 13.66

090 rib. 21610............... .............. A

Partial removal of

14.59

NA 9.04 2.23

NA 25.86

090 rib. 21615............... .............. A

Removal of rib....... 9.86

NA 6.73 1.45

NA 18.04

090 21616............... .............. A

Removal of rib and

12.02

NA 8.05 1.58

NA 21.65

090 nerves. 21620............... .............. A

Partial removal of

6.78

NA 6.07 0.93

NA 13.78

090 sternum. 21627............... .............. A

Sternal debridement.. 6.80

NA 6.46 0.99

NA 14.25

090 21630............... .............. A

Extensive sternum

17.35

NA 11.99 2.35

NA 31.69

090 surgery. 21632............... .............. A

Extensive sternum

18.11

NA 11.18 2.61

NA 31.90

090 surgery. 21685............... .............. A

Hyoid myotomy &

12.98

NA 10.09 1.52

NA 24.59

090 suspension. 21700............... .............. A

Revision of neck

6.18 6.08 4.86 0.37 12.63 11.41

090 muscle. 21705............... .............. A

Revision of neck

9.59

NA 5.63 1.11

NA 16.33

090 muscle/rib. 21720............... .............. A

Revision of neck

5.67 5.47 4.64 0.96 12.10 11.27

090 muscle. 21725............... .............. A

Revision of neck

6.98

NA 5.52 1.09

NA 13.59

090 muscle. 21740............... .............. A

Reconstruction of

16.48

NA 8.60 2.45

NA 27.53

090 sternum. 21742............... .............. C

Repair stern/nuss w/o 0.00 0.00 0.00 0.00 0.00 0.00

090 scope. 21743............... .............. C

Repair sternum/nuss w/ 0.00 0.00 0.00 0.00 0.00 0.00

090 scope. 21750............... .............. A

Repair of sternum

10.75

NA 6.14 1.63

NA 18.52

090 separation. 21800............... .............. A

Treatment of rib

0.96 2.10 1.40 0.11 3.17 2.47

090 fracture. 21805............... .............. A

Treatment of rib

2.75

NA 3.35 0.35

NA 6.45

090 fracture. 21810............... .............. A

Treatment of rib

6.85

NA 5.03 0.72

NA 12.60

090 fracture(s). 21820............... .............. A

Treat sternum

1.28 2.63 1.83 0.18 4.09 3.29

090 fracture. 21825............... .............. A

Treat sternum

7.40

NA 6.69 1.01

NA 15.10

090 fracture. 21899............... .............. C

Neck/chest surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 21920............... .............. A

Biopsy soft tissue of 2.06 3.28 1.49 0.14 5.48 3.69

010 back. 21925............... .............. A

Biopsy soft tissue of 4.48 6.63 3.35 0.53 11.64 8.36

090 back. 21930............... .............. A

Remove lesion, back

4.99 5.48 3.46 0.59 11.06 9.04

090 or flank. 21935............... .............. A

Remove tumor, back... 17.93

NA 10.20 2.26

NA 30.39

090 22100............... .............. A

Remove part of neck

9.72

NA 7.63 1.87

NA 19.22

090 vertebra. 22101............... .............. A

Remove part, thorax

9.80

NA 7.87 1.82

NA 19.49

090 vertebra. 22102............... .............. A

Remove part, lumbar

9.80

NA 8.08 1.76

NA 19.64

090 vertebra. 22103............... .............. A

Remove extra spine

2.34

NA 1.21 0.45

NA 4.00

ZZZ segment. 22110............... .............. A

Remove part of neck

12.72

NA 9.27 2.65

NA 24.64

090 vertebra. 22112............... .............. A

Remove part, thorax

12.79

NA 9.33 2.36

NA 24.48

090 vertebra. 22114............... .............. A

Remove part, lumbar

12.79

NA 9.31 2.39

NA 24.49

090 vertebra. 22116............... .............. A

Remove extra spine

2.32

NA 1.17 0.48

NA 3.97

ZZZ segment. 22210............... .............. A

Revision of neck

23.78

NA 15.51 5.10

NA 44.39

090 spine. 22212............... .............. A

Revision of thorax

19.39

NA 13.27 3.35

NA 36.01

090 spine. 22214............... .............. A

Revision of lumbar

19.42

NA 13.78 3.35

NA 36.55

090 spine. 22216............... .............. A

Revise, extra spine

6.03

NA 3.14 1.18

NA 10.35

ZZZ segment. 22220............... .............. A

Revision of neck

21.34

NA 13.79 4.40

NA 39.53

090 spine. 22222............... .............. A

Revision of thorax

21.49

NA 11.61 3.71

NA 36.81

090 spine. 22224............... .............. A

Revision of lumbar

21.49

NA 14.24 3.86

NA 39.59

090 spine. 22226............... .............. A

Revise, extra spine

6.03

NA 3.11 1.22

NA 10.36

ZZZ segment. 22305............... .............. A

Treat spine process

2.05 3.19 2.39 0.35 5.59 4.79

090 fracture. 22310............... .............. A

Treat spine fracture. 2.61 4.88 4.11 0.45 7.94 7.17

090 22315............... .............. A

Treat spine fracture. 8.83 13.42 7.53 1.65 23.90 18.01

090 22318............... .............. A

Treat odontoid fx w/o 21.47

NA 13.52 5.14

NA 40.13

090 graft. 22319............... .............. A

Treat odontoid fx w/ 23.96

NA 14.90 5.74

NA 44.60

090 graft. 22325............... .............. A

Treat spine fracture. 18.27

NA 12.15 3.15

NA 33.57

090 22326............... .............. A

Treat neck spine

19.56

NA 12.83 4.27

NA 36.66

090 fracture. 22327............... .............. A

Treat thorax spine

19.17

NA 12.44 3.32

NA 34.93

090 fracture. 22328............... .............. A

Treat each add spine

4.60

NA 2.28 0.80

NA 7.68

ZZZ fx. 22505............... .............. A

Manipulation of spine 1.87

NA 0.94 0.33

NA 3.14

010 22520............... .............. A

Percut vertebroplasty 8.90 101.62 4.34 1.19 111.71 14.43

010 thor. 22521............... .............. A

Percut vertebroplasty 8.33 89.47 4.18 1.12 98.92 13.63

010 lumb. 22522............... .............. A

Percut vertebroplasty 4.30

NA 1.69 0.40

NA 6.39

ZZZ add'l. 22532............... .............. A

Lat thorax spine

23.96

NA 14.82 4.56

NA 43.34

090 fusion. 22533............... .............. A

Lat lumbar spine

23.09

NA 13.48 3.84

NA 40.41

090 fusion. 22534............... .............. A

Lat thor/lumb, add'l

5.99

NA 3.04 1.18

NA 10.21

ZZZ seg. 22548............... .............. A

Neck spine fusion.... 25.78

NA 15.83 6.01

NA 47.62

090 22554............... .............. A

Neck spine fusion.... 18.59

NA 12.32 4.23

NA 35.14

090 22556............... .............. A

Thorax spine fusion.. 23.42

NA 14.68 4.56

NA 42.66

090

[[Page 1128]]

22558............... .............. A

Lumbar spine fusion.. 22.25

NA 13.24 3.84

NA 39.33

090 22585............... .............. A

Additional spinal

5.52

NA 2.80 1.18

NA 9.50

ZZZ fusion. 22590............... .............. A

Spine & skull spinal 20.48

NA 13.29 4.60

NA 38.37

090 fusion. 22595............... .............. A

Neck spinal fusion... 19.36

NA 12.80 4.37

NA 36.53

090 22600............... .............. A

Neck spine fusion.... 16.12

NA 11.14 3.49

NA 30.75

090 22610............... .............. A

Thorax spine fusion.. 16.00

NA 11.32 3.21

NA 30.53

090 22612............... .............. A

Lumbar spine fusion.. 20.97

NA 14.09 3.96

NA 39.02

090 22614............... .............. A

Spine fusion, extra

6.43

NA 3.36 1.25

NA 11.04

ZZZ segment. 22630............... .............. A

Lumbar spine fusion.. 20.81

NA 13.55 4.57

NA 38.93

090 22632............... .............. A

Spine fusion, extra

5.22

NA 2.67 1.09

NA 8.98

ZZZ segment. 22800............... .............. A

Fusion of spine...... 18.22

NA 12.64 3.27

NA 34.13

090 22802............... .............. A

Fusion of spine...... 30.83

NA 19.48 5.33

NA 55.64

090 22804............... .............. A

Fusion of spine...... 36.22

NA 22.58 6.31

NA 65.11

090 22808............... .............. A

Fusion of spine...... 26.23

NA 16.25 5.26

NA 47.74

090 22810............... .............. A

Fusion of spine...... 30.22

NA 18.29 5.42

NA 53.93

090 22812............... .............. A

Fusion of spine...... 32.65

NA 19.95 5.63

NA 58.23

090 22818............... .............. A

Kyphectomy, 1-2

31.78

NA 18.86 6.04

NA 56.68

090 segments. 22819............... .............. A

Kyphectomy, 3 or more 36.39

NA 20.03 6.27

NA 62.69

090 22830............... .............. A

Exploration of spinal 10.83

NA 7.89 2.09

NA 20.81

090 fusion. 22840............... .............. A

Insert spine fixation 12.52

NA 6.51 2.45

NA 21.48

ZZZ device. 22841............... .............. B

Insert spine fixation 0.00 0.00 0.00 0.00 0.00 0.00

XXX device. 22842............... .............. A

Insert spine fixation 12.56

NA 6.53 2.46

NA 21.55

ZZZ device. 22843............... .............. A

Insert spine fixation 13.44

NA 6.63 2.53

NA 22.60

ZZZ device. 22844............... .............. A

Insert spine fixation 16.42

NA 8.78 2.92

NA 28.12

ZZZ device. 22845............... .............. A

Insert spine fixation 11.94

NA 6.11 2.68

NA 20.73

ZZZ device. 22846............... .............. A

Insert spine fixation 12.40

NA 6.36 2.73

NA 21.49

ZZZ device. 22847............... .............. A

Insert spine fixation 13.78

NA 7.06 2.85

NA 23.69

ZZZ device. 22848............... .............. A

Insert pelv fixation

5.99

NA 3.20 1.06

NA 10.25

ZZZ device. 22849............... .............. A

Reinsert spinal

18.48

NA 11.76 3.46

NA 33.70

090 fixation. 22850............... .............. A

Remove spine fixation 9.51

NA 7.00 1.82

NA 18.33

090 device. 22851............... .............. A

Apply spine prosth

6.70

NA 3.37 1.34

NA 11.41

ZZZ device. 22852............... .............. A

Remove spine fixation 9.00

NA 6.79 1.69

NA 17.48

090 device. 22855............... .............. A

Remove spine fixation 15.11

NA 9.72 3.30

NA 28.13

090 device. 22899............... .............. C

Spine surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 22900............... .............. A

Remove abdominal wall 5.79

NA 3.28 0.70

NA 9.77

090 lesion. 22999............... .............. C

Abdomen surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 23000............... .............. A

Removal of calcium

4.35 5.18 4.16 0.60 10.13 9.11

090 deposits. 23020............... .............. A

Release shoulder

8.92

NA 7.58 1.48

NA 17.98

090 joint. 23030............... .............. A

Drain shoulder lesion 3.42 3.01 2.93 0.51 6.94 6.86

010 23031............... .............. A

Drain shoulder bursa. 2.74 2.69 2.69 0.40 5.83 5.83

010 23035............... .............. A

Drain shoulder bone

8.60

NA 8.51 1.44

NA 18.55

090 lesion. 23040............... .............. A

Exploratory shoulder

9.19

NA 7.85 1.54

NA 18.58

090 surgery. 23044............... .............. A

Exploratory shoulder

7.11

NA 6.50 1.17

NA 14.78

090 surgery. 23065............... .............. A

Biopsy shoulder

2.27 2.81 1.54 0.17 5.25 3.98

010 tissues. 23066............... .............. A

Biopsy shoulder

4.15 5.10 4.07 0.60 9.85 8.82

090 tissues. 23075............... .............. A

Removal of shoulder

2.39 2.24 1.82 0.30 4.93 4.51

010 lesion. 23076............... .............. A

Removal of shoulder

7.62

NA 5.78 1.05

NA 14.45

090 lesion. 23077............... .............. A

Remove tumor of

16.07

NA 10.76 2.18

NA 29.01

090 shoulder. 23100............... .............. A

Biopsy of shoulder

6.02

NA 5.69 0.98

NA 12.69

090 joint. 23101............... .............. A

Shoulder joint

5.57

NA 5.39 0.93

NA 11.89

090 surgery. 23105............... .............. A

Remove shoulder joint 8.22

NA 7.17 1.36

NA 16.75

090 lining. 23106............... .............. A

Incision of

5.95

NA 5.77 0.99

NA 12.71

090 collarbone joint. 23107............... .............. A

Explore treat

8.61

NA 7.39 1.44

NA 17.44

090 shoulder joint. 23120............... .............. A

Partial removal,

7.10

NA 6.48 1.19

NA 14.77

090 collar bone. 23125............... .............. A

Removal of collar

9.38

NA 7.63 1.53

NA 18.54

090 bone. 23130............... .............. A

Remove shoulder bone, 7.54

NA 7.10 1.28

NA 15.92

090 part. 23140............... .............. A

Removal of bone

6.88

NA 5.41 0.99

NA 13.28

090 lesion. 23145............... .............. A

Removal of bone

9.08

NA 7.58 1.50

NA 18.16

090 lesion. 23146............... .............. A

Removal of bone

7.82

NA 7.13 1.34

NA 16.29

090 lesion. 23150............... .............. A

Removal of humerus

8.47

NA 6.97 1.37

NA 16.81

090 lesion. 23155............... .............. A

Removal of humerus

10.33

NA 8.46 1.45

NA 20.24

090 lesion. 23156............... .............. A

Removal of humerus

8.67

NA 7.38 1.42

NA 17.47

090 lesion. 23170............... .............. A

Remove collar bone

6.85

NA 6.36 1.01

NA 14.22

090 lesion. 23172............... .............. A

Remove shoulder blade 6.89

NA 6.41 1.15

NA 14.45

090 lesion. 23174............... .............. A

Remove humerus lesion 9.50

NA 8.37 1.57

NA 19.44

090 23180............... .............. A

Remove collar bone

8.52

NA 9.21 1.42

NA 19.15

090 lesion. 23182............... .............. A

Remove shoulder blade 8.14

NA 8.89 1.30

NA 18.33

090 lesion. 23184............... .............. A

Remove humerus lesion 9.37

NA 9.54 1.50

NA 20.41

090 23190............... .............. A

Partial removal of

7.23

NA 6.23 1.17

NA 14.63

090 scapula. 23195............... .............. A

Removal of head of

9.80

NA 7.76 1.66

NA 19.22

090 humerus. 23200............... .............. A

Removal of collar

12.06

NA 8.97 1.79

NA 22.82

090 bone. 23210............... .............. A

Removal of shoulder

12.47

NA 9.30 1.94

NA 23.71

090 blade. 23220............... .............. A

Partial removal of

14.54

NA 10.87 2.45

NA 27.86

090 humerus. 23221............... .............. A

Partial removal of

17.71

NA 11.84 3.03

NA 32.58

090 humerus. 23222............... .............. A

Partial removal of

23.88

NA 15.85 4.06

NA 43.79

090 humerus.

[[Page 1129]]

23330............... .............. A

Remove shoulder

1.85 1.98 1.91 0.22 4.05 3.98

010 foreign body. 23331............... .............. A

Remove shoulder

7.37

NA 6.79 1.23

NA 15.39

090 foreign body. 23332............... .............. A

Remove shoulder

11.60

NA 9.31 1.95

NA 22.86

090 foreign body. 23350............... .............. A

Injection for

1.00 3.85 0.33 0.06 4.91 1.39

000 shoulder x-ray. 23395............... .............. A

Muscle

16.82

NA 12.74 2.76

NA 32.32

090 transfer,shoulder/ arm. 23397............... .............. A

Muscle transfers..... 16.11

NA 11.40 2.70

NA 30.21

090 23400............... .............. A

Fixation of shoulder 13.52

NA 10.16 2.30

NA 25.98

090 blade. 23405............... .............. A

Incision of tendon &

8.36

NA 7.01 1.35

NA 16.72

090 muscle. 23406............... .............. A

Incise tendon(s) &

10.77

NA 8.41 1.79

NA 20.97

090 muscle(s). 23410............... .............. A

Repair rotator cuff, 12.43

NA 9.40 2.07

NA 23.90

090 acute. 23412............... .............. A

Repair rotator cuff, 13.29

NA 9.90 2.24

NA 25.43

090 chronic. 23415............... .............. A

Release of shoulder

9.96

NA 7.97 1.68

NA 19.61

090 ligament. 23420............... .............. A

Repair of shoulder... 13.28

NA 10.78 2.24

NA 26.30

090 23430............... .............. A

Repair biceps tendon. 9.97

NA 8.11 1.69

NA 19.77

090 23440............... .............. A

Remove/transplant

10.46

NA 8.29 1.77

NA 20.52

090 tendon. 23450............... .............. A

Repair shoulder

13.38

NA 9.87 2.24

NA 25.49

090 capsule. 23455............... .............. A

Repair shoulder

14.35

NA 10.45 2.42

NA 27.22

090 capsule. 23460............... .............. A

Repair shoulder

15.35

NA 11.37 2.62

NA 29.34

090 capsule. 23462............... .............. A

Repair shoulder

15.28

NA 10.78 2.61

NA 28.67

090 capsule. 23465............... .............. A

Repair shoulder

15.83

NA 11.30 1.94

NA 29.07

090 capsule. 23466............... .............. A

Repair shoulder

14.20

NA 11.27 2.41

NA 27.88

090 capsule. 23470............... .............. A

Reconstruct shoulder 17.12

NA 12.13 2.89

NA 32.14

090 joint. 23472............... .............. A

Reconstruct shoulder 21.07

NA 14.27 2.86

NA 38.20

090 joint. 23480............... .............. A

Revision of collar

11.16

NA 8.77 1.88

NA 21.81

090 bone. 23485............... .............. A

Revision of collar

13.41

NA 9.91 2.22

NA 25.54

090 bone. 23490............... .............. A

Reinforce clavicle... 11.84

NA 8.81 1.34

NA 21.99

090 23491............... .............. A

Reinforce shoulder

14.19

NA 10.70 2.41

NA 27.30

090 bones. 23500............... .............. A

Treat clavicle

2.08 3.66 2.57 0.31 6.05 4.96

090 fracture. 23505............... .............. A

Treat clavicle

3.68 5.33 3.76 0.60 9.61 8.04

090 fracture. 23515............... .............. A

Treat clavicle

7.40

NA 6.52 1.24

NA 15.16

090 fracture. 23520............... .............. A

Treat clavicle

2.16 3.65 2.71 0.31 6.12 5.18

090 dislocation. 23525............... .............. A

Treat clavicle

3.59 5.27 3.88 0.53 9.39 8.00

090 dislocation. 23530............... .............. A

Treat clavicle

7.30

NA 6.03 1.03

NA 14.36

090 dislocation. 23532............... .............. A

Treat clavicle

8.00

NA 6.92 1.36

NA 16.28

090 dislocation. 23540............... .............. A

Treat clavicle

2.23 4.26 2.46 0.29 6.78 4.98

090 dislocation. 23545............... .............. A

Treat clavicle

3.25 4.50 3.38 0.47 8.22 7.10

090 dislocation. 23550............... .............. A

Treat clavicle

7.23

NA 6.38 1.13

NA 14.74

090 dislocation. 23552............... .............. A

Treat clavicle

8.44

NA 7.26 1.42

NA 17.12

090 dislocation. 23570............... .............. A

Treat shoulder blade

2.23 3.67 2.87 0.35 6.25 5.45

090 fx. 23575............... .............. A

Treat shoulder blade

4.05 5.76 4.24 0.64 10.45 8.93

090 fx. 23585............... .............. A

Treat scapula

8.95

NA 7.60 1.51

NA 18.06

090 fracture. 23600............... .............. A

Treat humerus

2.93 5.73 3.82 0.47 9.13 7.22

090 fracture. 23605............... .............. A

Treat humerus

4.86 6.59 4.96 0.81 12.26 10.63

090 fracture. 23615............... .............. A

Treat humerus

9.34

NA 8.69 1.58

NA 19.61

090 fracture. 23616............... .............. A

Treat humerus

21.24

NA 14.13 3.59

NA 38.96

090 fracture. 23620............... .............. A

Treat humerus

2.40 5.20 3.23 0.39 7.99 6.02

090 fracture. 23625............... .............. A

Treat humerus

3.92 6.33 4.56 0.64 10.89 9.12

090 fracture. 23630............... .............. A

Treat humerus

7.34

NA 6.59 1.24

NA 15.17

090 fracture. 23650............... .............. A

Treat shoulder

3.38 4.69 2.88 0.37 8.44 6.63

090 dislocation. 23655............... .............. A

Treat shoulder

4.56

NA 4.16 0.63

NA 9.35

090 dislocation. 23660............... .............. A

Treat shoulder

7.48

NA 6.36 1.22

NA 15.06

090 dislocation. 23665............... .............. A

Treat islocation/

4.46 6.58 4.93 0.72 11.76 10.11

090 fracture. 23670............... .............. A

Treat dislocation/

7.89

NA 6.82 1.33

NA 16.04

090 fracture. 23675............... .............. A

Treat dislocation/

6.04 7.56 6.06 1.00 14.60 13.10

090 fracture. 23680............... .............. A

Treat dislocation/

10.04

NA 8.09 1.68

NA 19.81

090 fracture. 23700............... .............. A

Fixation of shoulder. 2.52

NA 2.30 0.42

NA 5.24

010 23800............... .............. A

Fusion of shoulder

14.14

NA 10.46 2.38

NA 26.98

090 joint. 23802............... .............. A

Fusion of shoulder

16.58

NA 10.23 2.82

NA 29.63

090 joint. 23900............... .............. A

Amputation of arm &

19.69

NA 11.91 2.98

NA 34.58

090 girdle. 23920............... .............. A

Amputation at

14.59

NA 10.09 2.32

NA 27.00

090 shoulder joint. 23921............... .............. A

Amputation follow-up

5.48 5.16 5.16 0.94 11.58 11.58

090 surgery. 23929............... .............. C

Shoulder surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 23930............... .............. A

Drainage of arm

2.94 2.71 2.35 0.39 6.04 5.68

010 lesion. 23931............... .............. A

Drainage of arm bursa 1.79 2.43 2.19 0.25 4.47 4.23

010 23935............... .............. A

Drain arm/elbow bone

6.08

NA 6.13 1.01

NA 13.22

090 lesion. 24000............... .............. A

Exploratory elbow

5.81

NA 5.36 0.93

NA 12.10

090 surgery. 24006............... .............. A

Release elbow joint.. 9.30

NA 7.69 1.53

NA 18.52

090 24065............... .............. A

Biopsy arm/elbow soft 2.08 2.10 1.78 0.17 4.35 4.03

010 tissue. 24066............... .............. A

Biopsy arm/elbow soft 5.20 5.76 4.27 0.74 11.70 10.21

090 tissue. 24075............... .............. A

Remove arm/elbow

3.91 5.05 3.67 0.52 9.48 8.10

090 lesion. 24076............... .............. A

Remove arm/elbow

6.29

NA 5.09 0.84

NA 12.22

090 lesion. 24077............... .............. A

Remove tumor of arm/ 11.74

NA 8.65 1.59

NA 21.98

090 elbow. 24100............... .............. A

Biopsy elbow joint

4.92

NA 4.49 0.75

NA 10.16

090 lining. 24101............... .............. A

Explore/treat elbow

6.12

NA 5.86 1.01

NA 12.99

090 joint. 24102............... .............. A

Remove elbow joint

8.02

NA 6.83 1.31

NA 16.16

090 lining.

[[Page 1130]]

24105............... .............. A

Removal of elbow

3.60

NA 4.35 0.59

NA 8.54

090 bursa. 24110............... .............. A

Remove humerus lesion 7.38

NA 6.71 1.19

NA 15.28

090 24115............... .............. A

Remove/graft bone

9.62

NA 7.35 1.39

NA 18.36

090 lesion. 24116............... .............. A

Remove/graft bone

11.79

NA 9.11 2.00

NA 22.90

090 lesion. 24120............... .............. A

Remove elbow lesion.. 6.64

NA 5.88 1.05

NA 13.57

090 24125............... .............. A

Remove/graft bone

7.88

NA 6.18 1.06

NA 15.12

090 lesion. 24126............... .............. A

Remove/graft bone

8.30

NA 6.97 1.09

NA 16.36

090 lesion. 24130............... .............. A

Removal of head of

6.24

NA 5.95 1.05

NA 13.24

090 radius. 24134............... .............. A

Removal of arm bone

9.72

NA 9.18 1.58

NA 20.48

090 lesion. 24136............... .............. A

Remove radius bone

7.98

NA 7.41 1.03

NA 16.42

090 lesion. 24138............... .............. A

Remove elbow bone

8.04

NA 7.67 1.35

NA 17.06

090 lesion. 24140............... .............. A

Partial removal of

9.17

NA 9.49 1.48

NA 20.14

090 arm bone. 24145............... .............. A

Partial removal of

7.57

NA 8.15 1.22

NA 16.94

090 radius. 24147............... .............. A

Partial removal of

7.53

NA 8.64 1.25

NA 17.42

090 elbow. 24149............... .............. A

Radical resection of 14.18

NA 11.41 2.29

NA 27.88

090 elbow. 24150............... .............. A

Extensive humerus

13.25

NA 10.10 2.18

NA 25.53

090 surgery. 24151............... .............. A

Extensive humerus

15.56

NA 11.67 2.64

NA 29.87

090 surgery. 24152............... .............. A

Extensive radius

10.04

NA 7.85 1.44

NA 19.33

090 surgery. 24153............... .............. A

Extensive radius

11.52

NA 5.83 0.77

NA 18.12

090 surgery. 24155............... .............. A

Removal of elbow

11.71

NA 8.41 1.71

NA 21.83

090 joint. 24160............... .............. A

Remove elbow joint

7.82

NA 6.77 1.29

NA 15.88

090 implant. 24164............... .............. A

Remove radius head

6.22

NA 5.66 1.01

NA 12.89

090 implant. 24200............... .............. A

Removal of arm

1.76 1.97 1.67 0.18 3.91 3.61

010 foreign body. 24201............... .............. A

Removal of arm

4.55 5.68 4.34 0.68 10.91 9.57

090 foreign body. 24220............... .............. A

Injection for elbow x- 1.31 10.32 0.44 0.08 11.71 1.83

000 ray. 24300............... .............. A

Manipulate elbow w/

3.74

NA 5.48 0.59

NA 9.81

090 anesth. 24301............... .............. A

Muscle/tendon

10.18

NA 8.18 1.57

NA 19.93

090 transfer. 24305............... .............. A

Arm tendon

7.44

NA 6.68 1.18

NA 15.30

090 lengthening. 24310............... .............. A

Revision of arm

5.97

NA 5.72 0.89

NA 12.58

090 tendon. 24320............... .............. A

Repair of arm tendon. 10.54

NA 7.74 1.21

NA 19.49

090 24330............... .............. A

Revision of arm

9.59

NA 7.86 1.46

NA 18.91

090 muscles. 24331............... .............. A

Revision of arm

10.63

NA 8.60 1.70

NA 20.93

090 muscles. 24332............... .............. A

Tenolysis, triceps... 7.44

NA 6.58 0.93

NA 14.95

090 24340............... .............. A

Repair of biceps

7.88

NA 6.91 1.30

NA 16.09

090 tendon. 24341............... .............. A

Repair arm tendon/

7.89

NA 7.75 1.30

NA 16.94

090 muscle. 24342............... .............. A

Repair of ruptured

10.60

NA 8.46 1.79

NA 20.85

090 tendon. 24343............... .............. A

Repr elbow lat ligmnt 8.64

NA 7.93 1.36

NA 17.93

090 w/tiss. 24344............... .............. A

Reconstruct elbow lat 13.98

NA 11.31 2.21

NA 27.50

090 ligmnt. 24345............... .............. A

Repr elbw med ligmnt

8.64

NA 7.83 1.36

NA 17.83

090 w/tissu. 24346............... .............. A

Reconstruct elbow med 13.98

NA 11.17 2.21

NA 27.36

090 ligmnt. 24350............... .............. A

Repair of tennis

5.24

NA 5.52 0.87

NA 11.63

090 elbow. 24351............... .............. A

Repair of tennis

5.90

NA 5.86 0.99

NA 12.75

090 elbow. 24352............... .............. A

Repair of tennis

6.42

NA 6.12 1.09

NA 13.63

090 elbow. 24354............... .............. A

Repair of tennis

6.47

NA 6.08 1.06

NA 13.61

090 elbow. 24356............... .............. A

Revision of tennis

6.67

NA 6.26 1.09

NA 14.02

090 elbow. 24360............... .............. A

Reconstruct elbow

12.32

NA 9.35 2.04

NA 23.71

090 joint. 24361............... .............. A

Reconstruct elbow

14.06

NA 10.44 2.35

NA 26.85

090 joint. 24362............... .............. A

Reconstruct elbow

14.97

NA 9.97 2.32

NA 27.26

090 joint. 24363............... .............. A

Replace elbow joint.. 18.46

NA 13.53 3.04

NA 35.03

090 24365............... .............. A

Reconstruct head of

8.38

NA 7.09 1.34

NA 16.81

090 radius. 24366............... .............. A

Reconstruct head of

9.12

NA 7.43 1.54

NA 18.09

090 radius. 24400............... .............. A

Revision of humerus.. 11.04

NA 8.91 1.85

NA 21.80

090 24410............... .............. A

Revision of humerus.. 14.80

NA 10.43 2.28

NA 27.51

090 24420............... .............. A

Revision of humerus.. 13.42

NA 10.66 2.20

NA 26.28

090 24430............... .............. A

Repair of humerus.... 12.79

NA 9.75 2.17

NA 24.71

090 24435............... .............. A

Repair humerus with

13.15

NA 10.83 2.22

NA 26.20

090 graft. 24470............... .............. A

Revision of elbow

8.73

NA 7.62 1.48

NA 17.83

090 joint. 24495............... .............. A

Decompression of

8.11

NA 9.05 1.11

NA 18.27

090 forearm. 24498............... .............. A

Reinforce humerus.... 11.90

NA 9.28 2.01

NA 23.19

090 24500............... .............. A

Treat humerus

3.21 5.40 3.61 0.49 9.10 7.31

090 fracture. 24505............... .............. A

Treat humerus

5.16 7.29 5.28 0.87 13.32 11.31

090 fracture. 24515............... .............. A

Treat humerus

11.63

NA 9.34 1.97

NA 22.94

090 fracture. 24516............... .............. A

Treat humerus

11.63

NA 9.11 1.97

NA 22.71

090 fracture. 24530............... .............. A

Treat humerus

3.49 5.39 3.94 0.57 9.45 8.00

090 fracture. 24535............... .............. A

Treat humerus

6.86 8.39 6.40 1.16 16.41 14.42

090 fracture. 24538............... .............. A

Treat humerus

9.42

NA 8.69 1.51

NA 19.62

090 fracture. 24545............... .............. A

Treat humerus

10.44

NA 8.42 1.77

NA 20.63

090 fracture. 24546............... .............. A

Treat humerus

15.67

NA 11.31 2.63

NA 29.61

090 fracture. 24560............... .............. A

Treat humerus

2.80 5.07 3.21 0.42 8.29 6.43

090 fracture. 24565............... .............. A

Treat humerus

5.55 7.28 5.40 0.89 13.72 11.84

090 fracture. 24566............... .............. A

Treat humerus

7.78

NA 8.11 1.33

NA 17.22

090 fracture. 24575............... .............. A

Treat humerus

10.64

NA 8.30 1.74

NA 20.68

090 fracture. 24576............... .............. A

Treat humerus

2.86 4.94 3.59 0.46 8.26 6.91

090 fracture. 24577............... .............. A

Treat humerus

5.78 7.56 5.69 0.98 14.32 12.45

090 fracture. 24579............... .............. A

Treat humerus

11.58

NA 8.83 1.95

NA 22.36

090 fracture.

[[Page 1131]]

24582............... .............. A

Treat humerus

8.54

NA 9.01 1.45

NA 19.00

090 fracture. 24586............... .............. A

Treat elbow fracture. 15.19

NA 11.11 2.56

NA 28.86

090 24587............... .............. A

Treat elbow fracture. 15.14

NA 10.91 2.58

NA 28.63

090 24600............... .............. A

Treat elbow

4.22 5.57 3.52 0.59 10.38 8.33

090 dislocation. 24605............... .............. A

Treat elbow

5.41

NA 5.25 0.87

NA 11.53

090 dislocation. 24615............... .............. A

Treat elbow

9.41

NA 7.73 1.58

NA 18.72

090 dislocation. 24620............... .............. A

Treat elbow fracture. 6.97

NA 6.11 1.09

NA 14.17

090 24635............... .............. A

Treat elbow fracture. 13.17

NA 14.21 2.22

NA 29.60

090 24640............... .............. A

Treat elbow

1.20 1.93 0.87 0.13 3.26 2.20

010 dislocation. 24650............... .............. A

Treat radius fracture 2.16 4.55 2.73 0.34 7.05 5.23

090 24655............... .............. A

Treat radius fracture 4.39 6.76 4.69 0.70 11.85 9.78

090 24665............... .............. A

Treat radius fracture 8.13

NA 7.48 1.36

NA 16.97

090 24666............... .............. A

Treat radius fracture 9.48

NA 8.05 1.59

NA 19.12

090 24670............... .............. A

Treat ulnar fracture. 2.54 4.44 3.01 0.40 7.38 5.95

090 24675............... .............. A

Treat ulnar fracture. 4.71 6.72 4.82 0.78 12.21 10.31

090 24685............... .............. A

Treat ulnar fracture. 8.79

NA 7.52 1.48

NA 17.79

090 24800............... .............. A

Fusion of elbow joint 11.18

NA 8.71 1.70

NA 21.59

090 24802............... .............. A

Fusion/graft of elbow 13.67

NA 10.32 2.28

NA 26.27

090 joint. 24900............... .............. A

Amputation of upper

9.59

NA 7.35 1.42

NA 18.36

090 arm. 24920............... .............. A

Amputation of upper

9.53

NA 7.52 1.47

NA 18.52

090 arm. 24925............... .............. A

Amputation follow-up

7.06

NA 6.27 1.15

NA 14.48

090 surgery. 24930............... .............. A

Amputation follow-up 10.23

NA 7.52 1.48

NA 19.23

090 surgery. 24931............... .............. A

Amputate upper arm & 12.70

NA 6.11 1.88

NA 20.69

090 implant. 24935............... .............. A

Revision of

15.54

NA 8.42 1.91

NA 25.87

090 amputation. 24940............... .............. C

Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.00

090 24999............... .............. C

Upper arm/elbow

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 25000............... .............. A

Incision of tendon

3.37

NA 6.95 0.54

NA 10.86

090 sheath. 25001............... .............. A

Incise flexor carpi

3.37

NA 4.09 0.54

NA 8.00

090 radialis. 25020............... .............. A

Decompress forearm 1

5.91

NA 9.94 0.92

NA 16.77

090 space. 25023............... .............. A

Decompress forearm 1 12.94

NA 15.45 1.83

NA 30.22

090 space. 25024............... .............. A

Decompress forearm 2

9.49

NA 7.52 1.50

NA 18.51

090 spaces. 25025............... .............. A

Decompress forearm 2 16.52

NA 10.00 2.63

NA 29.15

090 spaces. 25028............... .............. A

Drainage of forearm

5.24

NA 8.48 0.74

NA 14.46

090 lesion. 25031............... .............. A

Drainage of forearm

4.13

NA 8.25 0.60

NA 12.98

090 bursa. 25035............... .............. A

Treat forearm bone

7.35

NA 14.03 1.18

NA 22.56

090 lesion. 25040............... .............. A

Explore/treat wrist

7.17

NA 7.34 1.16

NA 15.67

090 joint. 25065............... .............. A

Biopsy forearm soft

1.99 2.79 2.79 0.14 4.92 4.92

010 tissues. 25066............... .............. A

Biopsy forearm soft

4.12

NA 7.24 0.59

NA 11.95

090 tissues. 25075............... .............. A

Removel forearm

3.73

NA 6.13 0.48

NA 10.34

090 lesion subcu. 25076............... .............. A

Removel forearm

4.91

NA 9.98 0.71

NA 15.60

090 lesion deep. 25077............... .............. A

Remove tumor, forearm/ 9.75

NA 12.68 1.33

NA 23.76

090 wrist. 25085............... .............. A

Incision of wrist

5.49

NA 7.30 0.86

NA 13.65

090 capsule. 25100............... .............. A

Biopsy of wrist joint 3.89

NA 5.41 0.60

NA 9.90

090 25101............... .............. A

Explore/treat wrist

4.68

NA 5.96 0.72

NA 11.36

090 joint. 25105............... .............. A

Remove wrist joint

5.84

NA 7.48 0.93

NA 14.25

090 lining. 25107............... .............. A

Remove wrist joint

6.42

NA 8.41 0.99

NA 15.82

090 cartilage. 25110............... .............. A

Remove wrist tendon

3.91

NA 7.26 0.58

NA 11.75

090 lesion. 25111............... .............. A

Remove wrist tendon

3.38

NA 4.83 0.51

NA 8.72

090 lesion. 25112............... .............. A

Reremove wrist tendon 4.52

NA 5.43 0.65

NA 10.60

090 lesion. 25115............... .............. A

Remove wrist/forearm

8.81

NA 14.44 1.34

NA 24.59

090 lesion. 25116............... .............. A

Remove wrist/forearm

7.10

NA 13.53 1.09

NA 21.72

090 lesion. 25118............... .............. A

Excise wrist tendon

4.36

NA 5.88 0.66

NA 10.90

090 sheath. 25119............... .............. A

Partial removal of

6.03

NA 7.77 0.96

NA 14.76

090 ulna. 25120............... .............. A

Removal of forearm

6.09

NA 12.44 0.98

NA 19.51

090 lesion. 25125............... .............. A

Remove/graft forearm

7.47

NA 13.21 1.23

NA 21.91

090 lesion. 25126............... .............. A

Remove/graft forearm

7.54

NA 13.31 1.21

NA 22.06

090 lesion. 25130............... .............. A

Removal of wrist

5.25

NA 6.51 0.80

NA 12.56

090 lesion. 25135............... .............. A

Remove & graft wrist

6.88

NA 7.53 1.07

NA 15.48

090 lesion. 25136............... .............. A

Remove & graft wrist

5.96

NA 6.68 0.70

NA 13.34

090 lesion. 25145............... .............. A

Remove forearm bone

6.36

NA 12.47 0.99

NA 19.82

090 lesion. 25150............... .............. A

Partial removal of

7.08

NA 8.41 1.16

NA 16.65

090 ulna. 25151............... .............. A

Partial removal of

7.38

NA 13.08 1.12

NA 21.58

090 radius. 25170............... .............. A

Extensive forearm

11.07

NA 15.46 1.83

NA 28.36

090 surgery. 25210............... .............. A

Removal of wrist bone 5.94

NA 6.90 0.88

NA 13.72

090 25215............... .............. A

Removal of wrist

7.88

NA 8.89 1.23

NA 18.00

090 bones. 25230............... .............. A

Partial removal of

5.22

NA 6.22 0.80

NA 12.24

090 radius. 25240............... .............. A

Partial removal of

5.16

NA 7.09 0.83

NA 13.08

090 ulna. 25246............... .............. A

Injection for wrist x- 1.45 10.05 0.48 0.08 11.58 2.01

000 ray. 25248............... .............. A

Remove forearm

5.13

NA 8.75 0.65

NA 14.53

090 foreign body. 25250............... .............. A

Removal of wrist

6.59

NA 6.00 1.01

NA 13.60

090 prosthesis. 25251............... .............. A

Removal of wrist

9.56

NA 7.82 1.39

NA 18.77

090 prosthesis. 25259............... .............. A

Manipulate wrist w/

3.74

NA 5.48 0.60

NA 9.82

090 anesthes. 25260............... .............. A

Repair forearm tendon/ 7.79

NA 13.90 1.17

NA 22.86

090 muscle. 25263............... .............. A

Repair forearm tendon/ 7.81

NA 13.81 1.13

NA 22.75

090 muscle. 25265............... .............. A

Repair forearm tendon/ 9.87

NA 14.70 1.44

NA 26.01

090 muscle.

[[Page 1132]]

25270............... .............. A

Repair forearm tendon/ 5.99

NA 12.60 0.92

NA 19.51

090 muscle. 25272............... .............. A

Repair forearm tendon/ 7.03

NA 13.30 1.07

NA 21.40

090 muscle. 25274............... .............. A

Repair forearm tendon/ 8.74

NA 14.02 1.37

NA 24.13

090 muscle. 25275............... .............. A

Repair forearm tendon 8.49

NA 7.47 1.36

NA 17.32

090 sheath. 25280............... .............. A

Revise wrist/forearm

7.21

NA 13.03 1.10

NA 21.34

090 tendon. 25290............... .............. A

Incise wrist/forearm

5.28

NA 15.53 0.80

NA 21.61

090 tendon. 25295............... .............. A

Release wrist/forearm 6.54

NA 12.59 1.04

NA 20.17

090 tendon. 25300............... .............. A

Fusion of tendons at

8.79

NA 8.52 1.29

NA 18.60

090 wrist. 25301............... .............. A

Fusion of tendons at

8.39

NA 8.16 1.30

NA 17.85

090 wrist. 25310............... .............. A

Transplant forearm

8.13

NA 13.44 1.22

NA 22.79

090 tendon. 25312............... .............. A

Transplant forearm

9.56

NA 14.32 1.47

NA 25.35

090 tendon. 25315............... .............. A

Revise palsy hand

10.18

NA 14.89 1.52

NA 26.59

090 tendon(s). 25316............... .............. A

Revise palsy hand

12.31

NA 16.66 2.10

NA 31.07

090 tendon(s). 25320............... .............. A

Repair/revise wrist

10.75

NA 11.21 1.59

NA 23.55

090 joint. 25332............... .............. A

Revise wrist joint... 11.39

NA 9.06 1.76

NA 22.21

090 25335............... .............. A

Realignment of hand.. 12.86

NA 11.72 2.00

NA 26.58

090 25337............... .............. A

Reconstruct ulna/

10.15

NA 11.07 1.58

NA 22.80

090 radioulnar. 25350............... .............. A

Revision of radius... 8.77

NA 14.28 1.41

NA 24.46

090 25355............... .............. A

Revision of radius... 10.15

NA 14.90 1.74

NA 26.79

090 25360............... .............. A

Revision of ulna..... 8.42

NA 14.17 1.41

NA 24.00

090 25365............... .............. A

Revise radius & ulna. 12.38

NA 15.93 2.01

NA 30.32

090 25370............... .............. A

Revise radius or ulna 13.34

NA 16.30 2.27

NA 31.91

090 25375............... .............. A

Revise radius & ulna. 13.02

NA 16.72 2.22

NA 31.96

090 25390............... .............. A

Shorten radius or

10.38

NA 14.91 1.66

NA 26.95

090 ulna. 25391............... .............. A

Lengthen radius or

13.63

NA 16.87 2.09

NA 32.59

090 ulna. 25392............... .............. A

Shorten radius & ulna 13.93

NA 16.24 2.09

NA 32.26

090 25393............... .............. A

Lengthen radius &

15.85

NA 17.88 2.26

NA 35.99

090 ulna. 25394............... .............. A

Repair carpal bone,

10.38

NA 8.23 1.69

NA 20.30

090 shorten. 25400............... .............. A

Repair radius or ulna 10.90

NA 15.49 1.81

NA 28.20

090 25405............... .............. A

Repair/graft radius

14.36

NA 17.58 2.35

NA 34.29

090 or ulna. 25415............... .............. A

Repair radius & ulna. 13.33

NA 16.81 2.26

NA 32.40

090 25420............... .............. A

Repair/graft radius & 16.31

NA 18.56 2.65

NA 37.52

090 ulna. 25425............... .............. A

Repair/graft radius

13.19

NA 22.08 1.94

NA 37.21

090 or ulna. 25426............... .............. A

Repair/graft radius & 15.80

NA 17.29 2.69

NA 35.78

090 ulna. 25430............... .............. A

Vasc graft into

9.24

NA 7.28 1.29

NA 17.81

090 carpal bone. 25431............... .............. A

Repair nonunion

10.42

NA 8.23 0.68

NA 19.33

090 carpal bone. 25440............... .............. A

Repair/graft wrist

10.42

NA 9.41 1.70

NA 21.53

090 bone. 25441............... .............. A

Reconstruct wrist

12.88

NA 9.88 2.21

NA 24.97

090 joint. 25442............... .............. A

Reconstruct wrist

10.83

NA 8.77 1.50

NA 21.10

090 joint. 25443............... .............. A

Reconstruct wrist

10.37

NA 8.65 1.57

NA 20.59

090 joint. 25444............... .............. A

Reconstruct wrist

11.13

NA 9.07 1.72

NA 21.92

090 joint. 25445............... .............. A

Reconstruct wrist

9.68

NA 7.87 1.52

NA 19.07

090 joint. 25446............... .............. A

Wrist replacement.... 16.53

NA 11.81 2.65

NA 30.99

090 25447............... .............. A

Repair wrist joint(s) 10.35

NA 8.54 1.62

NA 20.51

090 25449............... .............. A

Remove wrist joint

14.47

NA 10.57 2.13

NA 27.17

090 implant. 25450............... .............. A

Revision of wrist

7.86

NA 10.41 1.06

NA 19.33

090 joint. 25455............... .............. A

Revision of wrist

9.48

NA 11.33 1.29

NA 22.10

090 joint. 25490............... .............. A

Reinforce radius..... 9.53

NA 14.03 1.44

NA 25.00

090 25491............... .............. A

Reinforce ulna....... 9.95

NA 14.79 1.70

NA 26.44

090 25492............... .............. A

Reinforce radius and 12.31

NA 15.58 1.95

NA 29.84

090 ulna. 25500............... .............. A

Treat fracture of

2.45 3.99 2.71 0.34 6.78 5.50

090 radius. 25505............... .............. A

Treat fracture of

5.20 7.22 5.25 0.83 13.25 11.28

090 radius. 25515............... .............. A

Treat fracture of

9.17

NA 7.47 1.47

NA 18.11

090 radius. 25520............... .............. A

Treat fracture of

6.25 7.44 5.87 1.03 14.72 13.15

090 radius. 25525............... .............. A

Treat fracture of

12.22

NA 9.94 2.03

NA 24.19

090 radius. 25526............... .............. A

Treat fracture of

12.96

NA 13.59 2.17

NA 28.72

090 radius. 25530............... .............. A

Treat fracture of

2.09 4.14 2.80 0.33 6.56 5.22

090 ulna. 25535............... .............. A

Treat fracture of

5.13 6.85 5.17 0.82 12.80 11.12

090 ulna. 25545............... .............. A

Treat fracture of

8.89

NA 7.65 1.48

NA 18.02

090 ulna. 25560............... .............. A

Treat fracture radius 2.44 4.04 2.64 0.33 6.81 5.41

090 & ulna. 25565............... .............. A

Treat fracture radius 5.62 7.35 5.32 0.92 13.89 11.86

090 & ulna. 25574............... .............. A

Treat fracture radius 7.00

NA 7.13 1.16

NA 15.29

090 & ulna. 25575............... .............. A

Treat fracture radius/ 10.43

NA 9.39 1.76

NA 21.58

090 ulna. 25600............... .............. A

Treat fracture radius/ 2.63 4.47 2.94 0.41 7.51 5.98

090 ulna. 25605............... .............. A

Treat fracture radius/ 5.80 8.03 6.01 0.98 14.81 12.79

090 ulna. 25611............... .............. A

Treat fracture radius/ 7.76

NA 8.84 1.30

NA 17.90

090 ulna. 25620............... .............. A

Treat fracture radius/ 8.54

NA 7.28 1.41

NA 17.23

090 ulna. 25622............... .............. A

Treat wrist bone

2.61 4.64 3.12 0.40 7.65 6.13

090 fracture. 25624............... .............. A

Treat wrist bone

4.52 6.98 4.90 0.74 12.24 10.16

090 fracture. 25628............... .............. A

Treat wrist bone

8.42

NA 7.81 1.37

NA 17.60

090 fracture. 25630............... .............. A

Treat wrist bone

2.88 4.57 2.94 0.45 7.90 6.27

090 fracture. 25635............... .............. A

Treat wrist bone

4.38 6.75 3.89 0.47 11.60 8.74

090 fracture. 25645............... .............. A

Treat wrist bone

7.24

NA 6.79 1.12

NA 15.15

090 fracture. 25650............... .............. A

Treat wrist bone

3.05 4.83 3.22 0.45 8.33 6.72

090 fracture. 25651............... .............. A

Pin ulnar styloid

5.35

NA 5.39 0.87

NA 11.61

090 fracture.

[[Continued on page 1133]]

From the Federal Register Online via GPO Access [wais.access.gpo.gov] ]

[[pp. 1133-1182]] Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004

[[Continued from page 1132]]

[[Page 1133]]

25652............... .............. A

Treat fracture ulnar

7.59

NA 6.85 1.23

NA 15.67

090 styloid. 25660............... .............. A

Treat wrist

4.75

NA 4.66 0.71

NA 10.12

090 dislocation. 25670............... .............. A

Treat wrist

7.91

NA 7.08 1.29

NA 16.28

090 dislocation. 25671............... .............. A

Pin radioulnar

5.99

NA 5.98 0.98

NA 12.95

090 dislocation. 25675............... .............. A

Treat wrist

4.66 6.49 4.61 0.69 11.84 9.96

090 dislocation. 25676............... .............. A

Treat wrist

8.03

NA 7.32 1.33

NA 16.68

090 dislocation. 25680............... .............. A

Treat wrist fracture. 5.98

NA 4.75 0.74

NA 11.47

090 25685............... .............. A

Treat wrist fracture. 9.77

NA 7.87 1.51

NA 19.15

090 25690............... .............. A

Treat wrist

5.49

NA 5.39 0.94

NA 11.82

090 dislocation. 25695............... .............. A

Treat wrist

8.33

NA 7.19 1.29

NA 16.81

090 dislocation. 25800............... .............. A

Fusion of wrist joint 9.75

NA 9.10 1.57

NA 20.42

090 25805............... .............. A

Fusion/graft of wrist 11.26

NA 10.24 1.82

NA 23.32

090 joint. 25810............... .............. A

Fusion/graft of wrist 10.55

NA 9.88 1.65

NA 22.08

090 joint. 25820............... .............. A

Fusion of hand bones. 7.44

NA 7.88 1.16

NA 16.48

090 25825............... .............. A

Fuse hand bones with

9.26

NA 9.22 1.45

NA 19.93

090 graft. 25830............... .............. A

Fusion, radioulnar

10.04

NA 14.69 1.53

NA 26.26

090 jnt/ulna. 25900............... .............. A

Amputation of forearm 9.00

NA 12.89 1.30

NA 23.19

090 25905............... .............. A

Amputation of forearm 9.11

NA 12.82 1.28

NA 23.21

090 25907............... .............. A

Amputation follow-up

7.79

NA 12.21 1.22

NA 21.22

090 surgery. 25909............... .............. A

Amputation follow-up

8.95

NA 12.76 1.29

NA 23.00

090 surgery. 25915............... .............. A

Amputation of forearm 17.05

NA 19.51 2.91

NA 39.47

090 25920............... .............. A

Amputate hand at

8.67

NA 8.00 1.28

NA 17.95

090 wrist. 25922............... .............. A

Amputate hand at

7.41

NA 7.25 1.12

NA 15.78

090 wrist. 25924............... .............. A

Amputation follow-up

8.45

NA 8.22 1.29

NA 17.96

090 surgery. 25927............... .............. A

Amputation of hand... 8.79

NA 12.15 1.23

NA 22.17

090 25929............... .............. A

Amputation follow-up

7.58

NA 6.06 1.07

NA 14.71

090 surgery. 25931............... .............. A

Amputation follow-up

7.80

NA 12.06 1.06

NA 20.92

090 surgery. 25999............... .............. C

Forearm or wrist

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 26010............... .............. A

Drainage of finger

1.54 5.67 1.66 0.17 7.38 3.37

010 abscess. 26011............... .............. A

Drainage of finger

2.19 9.08 2.31 0.30 11.57 4.80

010 abscess. 26020............... .............. A

Drain hand tendon

4.66

NA 5.57 0.71

NA 10.94

090 sheath. 26025............... .............. A

Drainage of palm

4.81

NA 5.36 0.72

NA 10.89

090 bursa. 26030............... .............. A

Drainage of palm

5.92

NA 6.00 0.87

NA 12.79

090 bursa(s). 26034............... .............. A

Treat hand bone

6.22

NA 6.27 0.95

NA 13.44

090 lesion. 26035............... .............. A

Decompress fingers/

9.50

NA 8.10 1.35

NA 18.95

090 hand. 26037............... .............. A

Decompress fingers/

7.24

NA 6.60 1.05

NA 14.89

090 hand. 26040............... .............. A

Release palm

3.33

NA 3.99 0.54

NA 7.86

090 contracture. 26045............... .............. A

Release palm

5.55

NA 5.56 0.89

NA 12.00

090 contracture. 26055............... .............. A

Incise finger tendon

2.69 14.54 3.85 0.43 17.66 6.97

090 sheath. 26060............... .............. A

Incision of finger

2.81

NA 3.45 0.42

NA 6.68

090 tendon. 26070............... .............. A

Explore/treat hand

3.68

NA 3.36 0.42

NA 7.46

090 joint. 26075............... .............. A

Explore/treat finger

3.78

NA 3.76 0.48

NA 8.02

090 joint. 26080............... .............. A

Explore/treat finger

4.23

NA 4.78 0.63

NA 9.64

090 joint. 26100............... .............. A

Biopsy hand joint

3.66

NA 4.10 0.54

NA 8.30

090 lining. 26105............... .............. A

Biopsy finger joint

3.70

NA 4.17 0.54

NA 8.41

090 lining. 26110............... .............. A

Biopsy finger joint

3.52

NA 3.98 0.53

NA 8.03

090 lining. 26115............... .............. A

Removel hand lesion

3.85 13.33 4.67 0.58 17.76 9.10

090 subcut. 26116............... .............. A

Removel hand lesion,

5.52

NA 5.92 0.83

NA 12.27

090 deep. 26117............... .............. A

Remove tumor, hand/

8.54

NA 7.03 1.22

NA 16.79

090 finger. 26121............... .............. A

Release palm

7.53

NA 6.90 1.13

NA 15.56

090 contracture. 26123............... .............. A

Release palm

9.28

NA 8.74 1.41

NA 19.43

090 contracture. 26125............... .............. A

Release palm

4.60

NA 2.46 0.69

NA 7.75

ZZZ contracture. 26130............... .............. A

Remove wrist joint

5.41

NA 5.30 0.78

NA 11.49

090 lining. 26135............... .............. A

Revise finger joint,

6.95

NA 6.39 1.05

NA 14.39

090 each. 26140............... .............. A

Revise finger joint,

6.16

NA 5.97 0.92

NA 13.05

090 each. 26145............... .............. A

Tendon excision, palm/ 6.31

NA 5.98 0.93

NA 13.22

090 finger. 26160............... .............. A

Remove tendon sheath

3.15 12.69 4.04 0.47 16.31 7.66

090 lesion. 26170............... .............. A

Removal of palm

4.76

NA 4.88 0.72

NA 10.36

090 tendon, each. 26180............... .............. A

Removal of finger

5.17

NA 5.35 0.77

NA 11.29

090 tendon. 26185............... .............. A

Remove finger bone... 5.24

NA 5.91 0.81

NA 11.96

090 26200............... .............. A

Remove hand bone

5.50

NA 5.29 0.86

NA 11.65

090 lesion. 26205............... .............. A

Remove/graft bone

7.69

NA 6.84 1.15

NA 15.68

090 lesion. 26210............... .............. A

Removal of finger

5.14

NA 5.36 0.77

NA 11.27

090 lesion. 26215............... .............. A

Remove/graft finger

7.09

NA 6.26 0.93

NA 14.28

090 lesion. 26230............... .............. A

Partial removal of

6.32

NA 5.85 1.01

NA 13.18

090 hand bone. 26235............... .............. A

Partial removal,

6.18

NA 5.75 0.94

NA 12.87

090 finger bone. 26236............... .............. A

Partial removal,

5.31

NA 5.28 0.80

NA 11.39

090 finger bone. 26250............... .............. A

Extensive hand

7.54

NA 6.38 1.11

NA 15.03

090 surgery. 26255............... .............. A

Extensive hand

12.41

NA 9.35 1.27

NA 23.03

090 surgery. 26260............... .............. A

Extensive finger

7.02

NA 6.14 1.00

NA 14.16

090 surgery. 26261............... .............. A

Extensive finger

9.08

NA 6.23 1.01

NA 16.32

090 surgery. 26262............... .............. A

Partial removal of

5.66

NA 5.29 0.84

NA 11.79

090 finger. 26320............... .............. A

Removal of implant

3.97

NA 4.25 0.59

NA 8.81

090 from hand. 26340............... .............. A

Manipulate finger w/

2.50

NA 4.74 0.36

NA 7.60

090 anesth. 26350............... .............. A

Repair finger/hand

5.98

NA 15.49 0.88

NA 22.35

090 tendon.

[[Page 1134]]

26352............... .............. A

Repair/graft hand

7.67

NA 16.08 1.12

NA 24.87

090 tendon. 26356............... .............. A

Repair finger/hand

8.06

NA 18.91 1.19

NA 28.16

090 tendon. 26357............... .............. A

Repair finger/hand

8.57

NA 16.53 1.23

NA 26.33

090 tendon. 26358............... .............. A

Repair/graft hand

9.13

NA 17.43 1.29

NA 27.85

090 tendon. 26370............... .............. A

Repair finger/hand

7.10

NA 15.95 1.09

NA 24.14

090 tendon. 26372............... .............. A

Repair/graft hand

8.75

NA 17.32 1.28

NA 27.35

090 tendon. 26373............... .............. A

Repair finger/hand

8.15

NA 16.87 1.18

NA 26.20

090 tendon. 26390............... .............. A

Revise hand/finger

9.18

NA 13.92 1.31

NA 24.41

090 tendon. 26392............... .............. A

Repair/graft hand

10.24

NA 17.66 1.52

NA 29.42

090 tendon. 26410............... .............. A

Repair hand tendon... 4.62

NA 12.59 0.69

NA 17.90

090 26412............... .............. A

Repair/graft hand

6.30

NA 13.92 0.96

NA 21.18

090 tendon. 26415............... .............. A

Excision, hand/finger 8.33

NA 12.28 0.93

NA 21.54

090 tendon. 26416............... .............. A

Graft hand or finger

9.36

NA 15.21 1.45

NA 26.02

090 tendon. 26418............... .............. A

Repair finger tendon. 4.24

NA 12.95 0.60

NA 17.79

090 26420............... .............. A

Repair/graft finger

6.76

NA 14.26 1.00

NA 22.02

090 tendon. 26426............... .............. A

Repair finger/hand

6.14

NA 13.78 0.93

NA 20.85

090 tendon. 26428............... .............. A

Repair/graft finger

7.20

NA 14.58 1.01

NA 22.79

090 tendon. 26432............... .............. A

Repair finger tendon. 4.01

NA 10.69 0.58

NA 15.28

090 26433............... .............. A

Repair finger tendon. 4.55

NA 11.37 0.68

NA 16.60

090 26434............... .............. A

Repair/graft finger

6.08

NA 12.06 0.86

NA 19.00

090 tendon. 26437............... .............. A

Realignment of

5.81

NA 11.98 0.89

NA 18.68

090 tendons. 26440............... .............. A

Release palm/finger

5.01

NA 14.18 0.75

NA 19.94

090 tendon. 26442............... .............. A

Release palm & finger 8.15

NA 16.61 1.13

NA 25.89

090 tendon. 26445............... .............. A

Release hand/finger

4.30

NA 13.93 0.65

NA 18.88

090 tendon. 26449............... .............. A

Release forearm/hand

6.99

NA 16.39 1.01

NA 24.39

090 tendon. 26450............... .............. A

Incision of palm

3.66

NA 7.58 0.55

NA 11.79

090 tendon. 26455............... .............. A

Incision of finger

3.63

NA 7.50 0.57

NA 11.70

090 tendon. 26460............... .............. A

Incise hand/finger

3.45

NA 7.32 0.53

NA 11.30

090 tendon. 26471............... .............. A

Fusion of finger

5.72

NA 11.65 0.88

NA 18.25

090 tendons. 26474............... .............. A

Fusion of finger

5.31

NA 11.84 0.83

NA 17.98

090 tendons. 26476............... .............. A

Tendon lengthening... 5.17

NA 11.37 0.75

NA 17.29

090 26477............... .............. A

Tendon shortening.... 5.14

NA 11.54 0.72

NA 17.40

090 26478............... .............. A

Lengthening of hand

5.79

NA 12.24 0.93

NA 18.96

090 tendon. 26479............... .............. A

Shortening of hand

5.73

NA 12.08 0.92

NA 18.73

090 tendon. 26480............... .............. A

Transplant hand

6.68

NA 15.68 1.01

NA 23.37

090 tendon. 26483............... .............. A

Transplant/graft hand 8.28

NA 16.12 1.24

NA 25.64

090 tendon. 26485............... .............. A

Transplant palm

7.69

NA 16.01 1.13

NA 24.83

090 tendon. 26489............... .............. A

Transplant/graft palm 9.54

NA 12.54 1.18

NA 23.26

090 tendon. 26490............... .............. A

Revise thumb tendon.. 8.40

NA 13.16 1.27

NA 22.83

090 26492............... .............. A

Tendon transfer with

9.61

NA 13.97 1.44

NA 25.02

090 graft. 26494............... .............. A

Hand tendon/muscle

8.46

NA 13.61 1.36

NA 23.43

090 transfer. 26496............... .............. A

Revise thumb tendon.. 9.58

NA 13.61 1.41

NA 24.60

090 26497............... .............. A

Finger tendon

9.56

NA 13.96 1.41

NA 24.93

090 transfer. 26498............... .............. A

Finger tendon

13.98

NA 16.55 2.10

NA 32.63

090 transfer. 26499............... .............. A

Revision of finger... 8.97

NA 13.50 1.13

NA 23.60

090 26500............... .............. A

Hand tendon

5.95

NA 12.12 0.80

NA 18.87

090 reconstruction. 26502............... .............. A

Hand tendon

7.13

NA 12.58 1.05

NA 20.76

090 reconstruction. 26504............... .............. A

Hand tendon

7.46

NA 13.01 1.01

NA 21.48

090 reconstruction. 26508............... .............. A

Release thumb

6.00

NA 12.11 0.92

NA 19.03

090 contracture. 26510............... .............. A

Thumb tendon transfer 5.42

NA 11.79 0.86

NA 18.07

090 26516............... .............. A

Fusion of knuckle

7.14

NA 12.65 1.09

NA 20.88

090 joint. 26517............... .............. A

Fusion of knuckle

8.82

NA 13.96 1.16

NA 23.94

090 joints. 26518............... .............. A

Fusion of knuckle

9.01

NA 13.77 1.36

NA 24.14

090 joints. 26520............... .............. A

Release knuckle

5.29

NA 14.63 0.78

NA 20.70

090 contracture. 26525............... .............. A

Release finger

5.32

NA 14.74 0.80

NA 20.86

090 contracture. 26530............... .............. A

Revise knuckle joint. 6.68

NA 6.02 1.04

NA 13.74

090 26531............... .............. A

Revise knuckle with

7.90

NA 6.99 1.22

NA 16.11

090 implant. 26535............... .............. A

Revise finger joint.. 5.23

NA 3.69 0.80

NA 9.72

090 26536............... .............. A

Revise/implant finger 6.36

NA 9.74 0.96

NA 17.06

090 joint. 26540............... .............. A

Repair hand joint.... 6.42

NA 12.35 0.98

NA 19.75

090 26541............... .............. A

Repair hand joint

8.61

NA 13.83 1.35

NA 23.79

090 with graft. 26542............... .............. A

Repair hand joint

6.77

NA 12.39 1.05

NA 20.21

090 with graft. 26545............... .............. A

Reconstruct finger

6.91

NA 12.79 0.95

NA 20.65

090 joint. 26546............... .............. A

Repair nonunion hand. 8.91

NA 15.20 1.37

NA 25.48

090 26548............... .............. A

Reconstruct finger

8.02

NA 13.39 1.18

NA 22.59

090 joint. 26550............... .............. A

Construct thumb

21.21

NA 18.16 2.17

NA 41.54

090 replacement. 26551............... .............. A

Great toe-hand

46.51

NA 33.71 7.92

NA 88.14

090 transfer. 26553............... .............. A

Single transfer, toe- 46.20

NA 23.22 2.40

NA 71.82

090 hand. 26554............... .............. A

Double transfer, toe- 54.87

NA 38.02 9.36

NA 102.25

090 hand. 26555............... .............. A

Positional change of 16.61

NA 18.67 2.57

NA 37.85

090 finger. 26556............... .............. A

Toe joint transfer... 47.19

NA 34.50 8.04

NA 89.73

090 26560............... .............. A

Repair of web finger. 5.37

NA 10.28 0.72

NA 16.37

090 26561............... .............. A

Repair of web finger. 10.90

NA 12.93 0.83

NA 24.66

090 26562............... .............. A

Repair of web finger. 14.98

NA 17.59 1.18

NA 33.75

090 26565............... .............. A

Correct metacarpal

6.73

NA 12.46 1.01

NA 20.20

090 flaw.

[[Page 1135]]

26567............... .............. A

Correct finger

6.81

NA 12.39 1.01

NA 20.21

090 deformity. 26568............... .............. A

Lengthen metacarpal/

9.07

NA 16.09 1.33

NA 26.49

090 finger. 26580............... .............. A

Repair hand deformity 18.15

NA 13.98 1.76

NA 33.89

090 26587............... .............. A

Reconstruct extra

14.03

NA 9.05 1.35

NA 24.43

090 finger. 26590............... .............. A

Repair finger

17.93

NA 14.40 1.59

NA 33.92

090 deformity. 26591............... .............. A

Repair muscles of

3.25

NA 10.44 0.45

NA 14.14

090 hand. 26593............... .............. A

Release muscles of

5.30

NA 11.51 0.77

NA 17.58

090 hand. 26596............... .............. A

Excision constricting 8.94

NA 9.01 1.05

NA 19.00

090 tissue. 26600............... .............. A

Treat metacarpal

1.96 4.08 2.64 0.30 6.34 4.90

090 fracture. 26605............... .............. A

Treat metacarpal

2.85 5.25 3.58 0.46 8.56 6.89

090 fracture. 26607............... .............. A

Treat metacarpal

5.35

NA 6.35 0.84

NA 12.54

090 fracture. 26608............... .............. A

Treat metacarpal

5.35

NA 6.35 0.88

NA 12.58

090 fracture. 26615............... .............. A

Treat metacarpal

5.32

NA 5.53 0.84

NA 11.69

090 fracture. 26641............... .............. A

Treat thumb

3.93 5.40 3.58 0.51 9.84 8.02

090 dislocation. 26645............... .............. A

Treat thumb fracture. 4.40 6.10 4.17 0.65 11.15 9.22

090 26650............... .............. A

Treat thumb fracture. 5.71

NA 6.76 0.93

NA 13.40

090 26665............... .............. A

Treat thumb fracture. 7.59

NA 6.80 1.17

NA 15.56

090 26670............... .............. A

Treat hand

3.68 4.89 3.03 0.43 9.00 7.14

090 dislocation. 26675............... .............. A

Treat hand

4.63 6.23 4.41 0.68 11.54 9.72

090 dislocation. 26676............... .............. A

Pin hand dislocation. 5.51

NA 6.79 0.92

NA 13.22

090 26685............... .............. A

Treat hand

6.97

NA 6.26 1.15

NA 14.38

090 dislocation. 26686............... .............. A

Treat hand

7.93

NA 7.03 1.27

NA 16.23

090 dislocation. 26700............... .............. A

Treat knuckle

3.68 4.65 2.96 0.42 8.75 7.06

090 dislocation. 26705............... .............. A

Treat knuckle

4.18 6.03 4.24 0.60 10.81 9.02

090 dislocation. 26706............... .............. A

Pin knuckle

5.11

NA 5.09 0.77

NA 10.97

090 dislocation. 26715............... .............. A

Treat knuckle

5.73

NA 5.71 0.90

NA 12.34

090 dislocation. 26720............... .............. A

Treat finger

1.66 3.89 2.60 0.24 5.79 4.50

090 fracture, each. 26725............... .............. A

Treat finger

3.33 6.09 4.04 0.52 9.94 7.89

090 fracture, each. 26727............... .............. A

Treat finger

5.22

NA 6.40 0.83

NA 12.45

090 fracture, each. 26735............... .............. A

Treat finger

5.97

NA 5.86 0.93

NA 12.76

090 fracture, each. 26740............... .............. A

Treat finger

1.94 3.56 2.69 0.29 5.79 4.92

090 fracture, each. 26742............... .............. A

Treat finger

3.84 5.81 3.85 0.59 10.24 8.28

090 fracture, each. 26746............... .............. A

Treat finger

5.80

NA 5.91 0.89

NA 12.60

090 fracture, each. 26750............... .............. A

Treat finger

1.70 3.14 2.08 0.23 5.07 4.01

090 fracture, each. 26755............... .............. A

Treat finger

3.10 4.81 3.05 0.45 8.36 6.60

090 fracture, each. 26756............... .............. A

Pin finger fracture,

4.38

NA 6.04 0.68

NA 11.10

090 each. 26765............... .............. A

Treat finger

4.16

NA 4.78 0.62

NA 9.56

090 fracture, each. 26770............... .............. A

Treat finger

3.02 4.40 2.55 0.33 7.75 5.90

090 dislocation. 26775............... .............. A

Treat finger

3.70 5.85 3.82 0.52 10.07 8.04

090 dislocation. 26776............... .............. A

Pin finger

4.79

NA 6.21 0.76

NA 11.76

090 dislocation. 26785............... .............. A

Treat finger

4.20

NA 4.81 0.65

NA 9.66

090 dislocation. 26820............... .............. A

Thumb fusion with

8.25

NA 13.63 1.34

NA 23.22

090 graft. 26841............... .............. A

Fusion of thumb...... 7.12

NA 13.53 1.17

NA 21.82

090 26842............... .............. A

Thumb fusion with

8.23

NA 13.71 1.33

NA 23.27

090 graft. 26843............... .............. A

Fusion of hand joint. 7.60

NA 12.68 1.19

NA 21.47

090 26844............... .............. A

Fusion/graft of hand

8.72

NA 13.68 1.35

NA 23.75

090 joint. 26850............... .............. A

Fusion of knuckle.... 6.96

NA 12.56 1.07

NA 20.59

090 26852............... .............. A

Fusion of knuckle

8.45

NA 13.25 1.27

NA 22.97

090 with graft. 26860............... .............. A

Fusion of finger

4.68

NA 11.55 0.72

NA 16.95

090 joint. 26861............... .............. A

Fusion of finger jnt, 1.74

NA 0.93 0.27

NA 2.94

ZZZ add-on. 26862............... .............. A

Fusion/graft of

7.36

NA 12.75 1.11

NA 21.22

090 finger joint. 26863............... .............. A

Fuse/graft added

3.89

NA 2.12 0.62

NA 6.63

ZZZ joint. 26910............... .............. A

Amputate metacarpal

7.59

NA 11.70 1.09

NA 20.38

090 bone. 26951............... .............. A

Amputation of finger/ 4.58

NA 10.62 0.68

NA 15.88

090 thumb. 26952............... .............. A

Amputation of finger/ 6.30

NA 12.23 0.89

NA 19.42

090 thumb. 26989............... .............. C

Hand/finger surgery.. 0.00 0.00 0.00 0.00 0.00 0.00

YYY 26990............... .............. A

Drainage of pelvis

7.47

NA 7.63 1.11

NA 16.21

090 lesion. 26991............... .............. A

Drainage of pelvis

6.67 7.47 5.94 1.03 15.17 13.64

090 bursa. 26992............... .............. A

Drainage of bone

13.00

NA 10.86 2.11

NA 25.97

090 lesion. 27000............... .............. A

Incision of hip

5.61

NA 5.29 0.92

NA 11.82

090 tendon. 27001............... .............. A

Incision of hip

6.93

NA 6.15 1.15

NA 14.23

090 tendon. 27003............... .............. A

Incision of hip

7.33

NA 6.55 1.12

NA 15.00

090 tendon. 27005............... .............. A

Incision of hip

9.65

NA 7.85 1.64

NA 19.14

090 tendon. 27006............... .............. A

Incision of hip

9.67

NA 7.99 1.60

NA 19.26

090 tendons. 27025............... .............. A

Incision of hip/thigh 11.14

NA 8.60 1.66

NA 21.40

090 fascia. 27030............... .............. A

Drainage of hip joint 12.99

NA 9.66 2.18

NA 24.83

090 27033............... .............. A

Exploration of hip

13.37

NA 9.93 2.26

NA 25.56

090 joint. 27035............... .............. A

Denervation of hip

16.66

NA 12.33 2.05

NA 31.04

090 joint. 27036............... .............. A

Excision of hip joint/ 12.86

NA 10.03 2.17

NA 25.06

090 muscle. 27040............... .............. A

Biopsy of soft

2.87 2.62 2.05 0.25 5.74 5.17

010 tissues. 27041............... .............. A

Biopsy of soft

9.88

NA 6.73 1.22

NA 17.83

090 tissues. 27047............... .............. A

Remove hip/pelvis

7.44 6.55 4.99 0.95 14.94 13.38

090 lesion. 27048............... .............. A

Remove hip/pelvis

6.24

NA 5.04 0.88

NA 12.16

090 lesion. 27049............... .............. A

Remove tumor, hip/

13.64

NA 8.81 1.93

NA 24.38

090 pelvis. 27050............... .............. A

Biopsy of sacroiliac

4.35

NA 4.48 0.64

NA 9.47

090 joint.

[[Page 1136]]

27052............... .............. A

Biopsy of hip joint.. 6.22

NA 5.89 1.03

NA 13.14

090 27054............... .............. A

Removal of hip joint

8.53

NA 7.36 1.41

NA 17.30

090 lining. 27060............... .............. A

Removal of ischial

5.42

NA 4.84 0.72

NA 10.98

090 bursa. 27062............... .............. A

Remove femur lesion/

5.36

NA 5.22 0.89

NA 11.47

090 bursa. 27065............... .............. A

Removal of hip bone

5.89

NA 5.54 0.92

NA 12.35

090 lesion. 27066............... .............. A

Removal of hip bone

10.31

NA 8.51 1.71

NA 20.53

090 lesion. 27067............... .............. A

Remove/graft hip bone 13.81

NA 10.67 2.35

NA 26.83

090 lesion. 27070............... .............. A

Partial removal of

10.70

NA 9.78 1.64

NA 22.12

090 hip bone. 27071............... .............. A

Partial removal of

11.44

NA 10.75 1.82

NA 24.01

090 hip bone. 27075............... .............. A

Extensive hip surgery 34.95

NA 19.68 2.68

NA 57.31

090 27076............... .............. A

Extensive hip surgery 22.09

NA 14.79 3.45

NA 40.33

090 27077............... .............. A

Extensive hip surgery 39.94

NA 23.10 3.84

NA 66.88

090 27078............... .............. A

Extensive hip surgery 13.42

NA 10.43 2.01

NA 25.86

090 27079............... .............. A

Extensive hip surgery 13.73

NA 10.09 2.24

NA 26.06

090 27080............... .............. A

Removal of tail bone. 6.38

NA 5.08 0.96

NA 12.42

090 27086............... .............. A

Remove hip foreign

1.87 2.01 1.87 0.21 4.09 3.95

010 body. 27087............... .............. A

Remove hip foreign

8.53

NA 6.71 1.31

NA 16.55

090 body. 27090............... .............. A

Removal of hip

11.13

NA 8.65 1.87

NA 21.65

090 prosthesis. 27091............... .............. A

Removal of hip

22.11

NA 13.86 3.75

NA 39.72

090 prosthesis. 27093............... .............. A

Injection for hip x-

1.30 12.21 0.48 0.11 13.62 1.89

000 ray. 27095............... .............. A

Injection for hip x-

1.50 10.76 0.52 0.12 12.38 2.14

000 ray. 27096............... .............. A

Inject sacroiliac

1.40 9.35 0.33 0.10 10.85 1.83

000 joint. 27097............... .............. A

Revision of hip

8.79

NA 6.47 1.47

NA 16.73

090 tendon. 27098............... .............. A

Transfer tendon to

8.82

NA 7.10 1.50

NA 17.42

090 pelvis. 27100............... .............. A

Transfer of abdominal 11.06

NA 8.73 1.89

NA 21.68

090 muscle. 27105............... .............. A

Transfer of spinal

11.75

NA 9.20 2.00

NA 22.95

090 muscle. 27110............... .............. A

Transfer of iliopsoas 13.24

NA 9.33 1.66

NA 24.23

090 muscle. 27111............... .............. A

Transfer of iliopsoas 12.13

NA 9.18 1.79

NA 23.10

090 muscle. 27120............... .............. A

Reconstruction of hip 17.98

NA 11.74 2.95

NA 32.67

090 socket. 27122............... .............. A

Reconstruction of hip 14.96

NA 10.91 2.51

NA 28.38

090 socket. 27125............... .............. A

Partial hip

14.67

NA 10.49 2.47

NA 27.63

090 replacement. 27130............... .............. A

Total hip

20.09

NA 13.21 3.40

NA 36.70

090 arthroplasty. 27132............... .............. A

Total hip

23.27

NA 15.48 3.93

NA 42.68

090 arthroplasty. 27134............... .............. A

Revise hip joint

28.48

NA 17.69 4.79

NA 50.96

090 replacement. 27137............... .............. A

Revise hip joint

21.14

NA 13.82 3.58

NA 38.54

090 replacement. 27138............... .............. A

Revise hip joint

22.14

NA 14.28 3.75

NA 40.17

090 replacement. 27140............... .............. A

Transplant femur

12.22

NA 9.41 2.01

NA 23.64

090 ridge. 27146............... .............. A

Incision of hip bone. 17.40

NA 12.27 2.74

NA 32.41

090 27147............... .............. A

Revision of hip bone. 20.55

NA 13.34 3.15

NA 37.04

090 27151............... .............. A

Incision of hip bones 22.48

NA 8.21 3.76

NA 34.45

090 27156............... .............. A

Revision of hip bones 24.59

NA 16.10 4.20

NA 44.89

090 27158............... .............. A

Revision of pelvis... 19.71

NA 11.24 3.14

NA 34.09

090 27161............... .............. A

Incision of neck of

16.68

NA 12.09 2.80

NA 31.57

090 femur. 27165............... .............. A

Incision/fixation of 17.88

NA 12.85 3.03

NA 33.76

090 femur. 27170............... .............. A

Repair/graft femur

16.05

NA 11.30 2.65

NA 30.00

090 head/neck. 27175............... .............. A

Treat slipped

8.45

NA 6.58 1.44

NA 16.47

090 epiphysis. 27176............... .............. A

Treat slipped

12.03

NA 8.98 2.03

NA 23.04

090 epiphysis. 27177............... .............. A

Treat slipped

15.06

NA 10.83 2.54

NA 28.43

090 epiphysis. 27178............... .............. A

Treat slipped

11.97

NA 8.40 2.03

NA 22.40

090 epiphysis. 27179............... .............. A

Revise head/neck of

12.96

NA 9.92 2.22

NA 25.10

090 femur. 27181............... .............. A

Treat slipped

14.66

NA 10.15 2.10

NA 26.91

090 epiphysis. 27185............... .............. A

Revision of femur

9.17

NA 7.58 1.56

NA 18.31

090 epiphysis. 27187............... .............. A

Reinforce hip bones.. 13.52

NA 10.33 2.28

NA 26.13

090 27193............... .............. A

Treat pelvic ring

5.55 7.10 5.74 0.93 13.58 12.22

090 fracture. 27194............... .............. A

Treat pelvic ring

9.64 8.75 7.50 1.59 19.98 18.73

090 fracture. 27200............... .............. A

Treat tail bone

1.84 3.04 2.17 0.27 5.15 4.28

090 fracture. 27202............... .............. A

Treat tail bone

7.03

NA 17.65 0.83

NA 25.51

090 fracture. 27215............... .............. A

Treat pelvic

10.03

NA 7.17 1.65

NA 18.85

090 fracture(s). 27216............... .............. A

Treat pelvic ring

15.17

NA 9.72 2.59

NA 27.48

090 fracture. 27217............... .............. A

Treat pelvic ring

14.09

NA 10.15 2.35

NA 26.59

090 fracture. 27218............... .............. A

Treat pelvic ring

20.12

NA 11.50 3.44

NA 35.06

090 fracture. 27220............... .............. A

Treat hip socket

6.17 7.06 5.51 1.03 14.26 12.71

090 fracture. 27222............... .............. A

Treat hip socket

12.68

NA 9.88 2.13

NA 24.69

090 fracture. 27226............... .............. A

Treat hip wall

14.89

NA 7.92 2.50

NA 25.31

090 fracture. 27227............... .............. A

Treat hip fracture(s) 23.41

NA 15.35 3.91

NA 42.67

090 27228............... .............. A

Treat hip fracture(s) 27.12

NA 17.57 4.55

NA 49.24

090 27230............... .............. A

Treat thigh fracture. 5.49 6.51 5.04 0.88 12.88 11.41

090 27232............... .............. A

Treat thigh fracture. 10.66

NA 7.18 1.75

NA 19.59

090 27235............... .............. A

Treat thigh fracture. 12.14

NA 9.39 2.06

NA 23.59

090 27236............... .............. A

Treat thigh fracture. 15.58

NA 10.93 2.63

NA 29.14

090 27238............... .............. A

Treat thigh fracture. 5.51

NA 5.09 0.92

NA 11.52

090 27240............... .............. A

Treat thigh fracture. 12.48

NA 9.37 2.04

NA 23.89

090 27244............... .............. A

Treat thigh fracture. 15.92

NA 11.26 2.69

NA 29.87

090 27245............... .............. A

Treat thigh fracture. 20.28

NA 13.70 3.44

NA 37.42

090 27246............... .............. A

Treat thigh fracture. 4.70 5.66 4.41 0.80 11.16 9.91

090

[[Page 1137]]

27248............... .............. A

Treat thigh fracture. 10.43

NA 8.19 1.75

NA 20.37

090 27250............... .............. A

Treat hip dislocation 6.94

NA 4.77 0.82

NA 12.53

090 27252............... .............. A

Treat hip dislocation 10.37

NA 7.39 1.65

NA 19.41

090 27253............... .............. A

Treat hip dislocation 12.90

NA 9.72 2.18

NA 24.80

090 27254............... .............. A

Treat hip dislocation 18.23

NA 12.03 3.04

NA 33.30

090 27256............... .............. A

Treat hip dislocation 4.11 3.43 2.09 0.59 8.13 6.79

010 27257............... .............. A

Treat hip dislocation 5.21

NA 2.88 0.68

NA 8.77

010 27258............... .............. A

Treat hip dislocation 15.41

NA 10.91 2.48

NA 28.80

090 27259............... .............. A

Treat hip dislocation 21.52

NA 14.16 3.61

NA 39.29

090 27265............... .............. A

Treat hip dislocation 5.04

NA 4.76 0.78

NA 10.58

090 27266............... .............. A

Treat hip dislocation 7.48

NA 6.27 1.25

NA 15.00

090 27275............... .............. A

Manipulation of hip

2.27

NA 2.13 0.37

NA 4.77

010 joint. 27280............... .............. A

Fusion of sacroiliac 13.37

NA 10.30 2.39

NA 26.06

090 joint. 27282............... .............. A

Fusion of pubic bones 11.32

NA 8.23 1.37

NA 20.92

090 27284............... .............. A

Fusion of hip joint.. 23.41

NA 14.83 2.85

NA 41.09

090 27286............... .............. A

Fusion of hip joint.. 23.41

NA 15.81 2.86

NA 42.08

090 27290............... .............. A

Amputation of leg at 23.25

NA 14.16 3.55

NA 40.96

090 hip. 27295............... .............. A

Amputation of leg at 18.62

NA 11.54 2.83

NA 32.99

090 hip. 27299............... .............. C

Pelvis/hip joint

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 27301............... .............. A

Drain thigh/knee

6.48 7.34 5.88 0.96 14.78 13.32

090 lesion. 27303............... .............. A

Drainage of bone

8.27

NA 7.24 1.37

NA 16.88

090 lesion. 27305............... .............. A

Incise thigh tendon & 5.91

NA 5.36 0.93

NA 12.20

090 fascia. 27306............... .............. A

Incision of thigh

4.61

NA 4.80 0.75

NA 10.16

090 tendon. 27307............... .............. A

Incision of thigh

5.79

NA 5.52 0.94

NA 12.25

090 tendons. 27310............... .............. A

Exploration of knee

9.26

NA 7.54 1.56

NA 18.36

090 joint. 27315............... .............. A

Partial removal,

6.96

NA 4.83 0.95

NA 12.74

090 thigh nerve. 27320............... .............. A

Partial removal,

6.29

NA 5.12 0.94

NA 12.35

090 thigh nerve. 27323............... .............. A

Biopsy, thigh soft

2.28 2.19 1.92 0.21 4.68 4.41

010 tissues. 27324............... .............. A

Biopsy, thigh soft

4.89

NA 4.35 0.71

NA 9.95

090 tissues. 27327............... .............. A

Removal of thigh

4.46 5.34 3.91 0.60 10.40 8.97

090 lesion. 27328............... .............. A

Removal of thigh

5.56

NA 4.57 0.80

NA 10.93

090 lesion. 27329............... .............. A

Remove tumor, thigh/ 14.12

NA 9.51 2.03

NA 25.66

090 knee. 27330............... .............. A

Biopsy, knee joint

4.96

NA 4.61 0.80

NA 10.37

090 lining. 27331............... .............. A

Explore/treat knee

5.87

NA 5.51 0.98

NA 12.36

090 joint. 27332............... .............. A

Removal of knee

8.26

NA 7.08 1.39

NA 16.73

090 cartilage. 27333............... .............. A

Removal of knee

7.29

NA 6.60 1.24

NA 15.13

090 cartilage. 27334............... .............. A

Remove knee joint

8.69

NA 7.38 1.46

NA 17.53

090 lining. 27335............... .............. A

Remove knee joint

9.99

NA 8.18 1.70

NA 19.87

090 lining. 27340............... .............. A

Removal of kneecap

4.17

NA 4.53 0.70

NA 9.40

090 bursa. 27345............... .............. A

Removal of knee cyst. 5.91

NA 5.61 0.98

NA 12.50

090 27347............... .............. A

Remove knee cyst..... 5.77

NA 5.42 0.92

NA 12.11

090 27350............... .............. A

Removal of kneecap... 8.16

NA 7.19 1.39

NA 16.74

090 27355............... .............. A

Remove femur lesion.. 7.64

NA 6.81 1.29

NA 15.74

090 27356............... .............. A

Remove femur lesion/

9.47

NA 7.88 1.56

NA 18.91

090 graft. 27357............... .............. A

Remove femur lesion/ 10.51

NA 8.70 1.79

NA 21.00

090 graft. 27358............... .............. A

Remove femur lesion/

4.73

NA 2.54 0.81

NA 8.08

ZZZ fixation. 27360............... .............. A

Partial removal, leg 10.48

NA 9.95 1.71

NA 22.14

090 bone(s). 27365............... .............. A

Extensive leg surgery 16.25

NA 11.67 2.73

NA 30.65

090 27370............... .............. A

Injection for knee x- 0.96 12.01 0.32 0.07 13.04 1.35

000 ray. 27372............... .............. A

Removal of foreign

5.06 6.00 4.69 0.75 11.81 10.50

090 body. 27380............... .............. A

Repair of kneecap

7.15

NA 7.25 1.21

NA 15.61

090 tendon. 27381............... .............. A

Repair/graft kneecap 10.32

NA 9.05 1.74

NA 21.11

090 tendon. 27385............... .............. A

Repair of thigh

7.75

NA 7.59 1.31

NA 16.65

090 muscle. 27386............... .............. A

Repair/graft of thigh 10.54

NA 9.46 1.80

NA 21.80

090 muscle. 27390............... .............. A

Incision of thigh

5.32

NA 5.26 0.83

NA 11.41

090 tendon. 27391............... .............. A

Incision of thigh

7.19

NA 6.63 1.19

NA 15.01

090 tendons. 27392............... .............. A

Incision of thigh

9.19

NA 7.72 1.48

NA 18.39

090 tendons. 27393............... .............. A

Lengthening of thigh

6.38

NA 5.85 1.09

NA 13.32

090 tendon. 27394............... .............. A

Lengthening of thigh

8.49

NA 7.28 1.41

NA 17.18

090 tendons. 27395............... .............. A

Lengthening of thigh 11.71

NA 9.38 1.97

NA 23.06

090 tendons. 27396............... .............. A

Transplant of thigh

7.85

NA 7.07 1.34

NA 16.26

090 tendon. 27397............... .............. A

Transplants of thigh 11.26

NA 9.03 1.91

NA 22.20

090 tendons. 27400............... .............. A

Revise thigh muscles/ 9.01

NA 7.34 1.42

NA 17.77

090 tendons. 27403............... .............. A

Repair of knee

8.32

NA 7.14 1.40

NA 16.86

090 cartilage. 27405............... .............. A

Repair of knee

8.64

NA 7.46 1.46

NA 17.56

090 ligament. 27407............... .............. A

Repair of knee

10.26

NA 8.30 1.66

NA 20.22

090 ligament. 27409............... .............. A

Repair of knee

12.88

NA 9.91 2.11

NA 24.90

090 ligaments. 27418............... .............. A

Repair degenerated

10.83

NA 8.85 1.82

NA 21.50

090 kneecap. 27420............... .............. A

Revision of unstable

9.82

NA 8.05 1.66

NA 19.53

090 kneecap. 27422............... .............. A

Revision of unstable

9.77

NA 8.07 1.65

NA 19.49

090 kneecap. 27424............... .............. A

Revision/removal of

9.80

NA 8.04 1.66

NA 19.50

090 kneecap. 27425............... .............. A

Lat retinacular

5.21

NA 5.49 0.88

NA 11.58

090 release open. 27427............... .............. A

Reconstruction, knee. 9.35

NA 7.74 1.56

NA 18.65

090 27428............... .............. A

Reconstruction, knee. 13.98

NA 11.10 2.35

NA 27.43

090 27429............... .............. A

Reconstruction, knee. 15.50

NA 12.34 2.63

NA 30.47

090

[[Page 1138]]

27430............... .............. A

Revision of thigh

9.66

NA 7.96 1.63

NA 19.25

090 muscles. 27435............... .............. A

Incision of knee

9.48

NA 8.36 1.60

NA 19.44

090 joint. 27437............... .............. A

Revise kneecap....... 8.45

NA 7.11 1.42

NA 16.98

090 27438............... .............. A

Revise kneecap with

11.21

NA 8.43 1.88

NA 21.52

090 implant. 27440............... .............. A

Revision of knee

10.41

NA 5.97 1.71

NA 18.09

090 joint. 27441............... .............. A

Revision of knee

10.80

NA 6.65 1.80

NA 19.25

090 joint. 27442............... .............. A

Revision of knee

11.87

NA 8.80 2.03

NA 22.70

090 joint. 27443............... .............. A

Revision of knee

10.91

NA 8.59 1.83

NA 21.33

090 joint. 27445............... .............. A

Revision of knee

17.65

NA 12.23 3.00

NA 32.88

090 joint. 27446............... .............. A

Revision of knee

15.82

NA 11.15 2.68

NA 29.65

090 joint. 27447............... .............. A

Total knee

21.45

NA 14.46 3.62

NA 39.53

090 arthroplasty. 27448............... .............. A

Incision of thigh.... 11.04

NA 8.65 1.82

NA 21.51

090 27450............... .............. A

Incision of thigh.... 13.96

NA 10.59 2.36

NA 26.91

090 27454............... .............. A

Realignment of thigh 17.53

NA 12.50 2.97

NA 33.00

090 bone. 27455............... .............. A

Realignment of knee.. 12.80

NA 9.87 2.15

NA 24.82

090 27457............... .............. A

Realignment of knee.. 13.43

NA 9.91 2.27

NA 25.61

090 27465............... .............. A

Shortening of thigh

13.85

NA 10.34 2.24

NA 26.43

090 bone. 27466............... .............. A

Lengthening of thigh 16.31

NA 11.87 2.32

NA 30.50

090 bone. 27468............... .............. A

Shorten/lengthen

18.94

NA 12.45 3.23

NA 34.62

090 thighs. 27470............... .............. A

Repair of thigh...... 16.05

NA 11.83 2.70

NA 30.58

090 27472............... .............. A

Repair/graft of thigh 17.69

NA 12.72 3.00

NA 33.41

090 27475............... .............. A

Surgery to stop leg

8.63

NA 7.22 1.36

NA 17.21

090 growth. 27477............... .............. A

Surgery to stop leg

9.84

NA 7.73 1.58

NA 19.15

090 growth. 27479............... .............. A

Surgery to stop leg

12.78

NA 9.86 2.18

NA 24.82

090 growth. 27485............... .............. A

Surgery to stop leg

8.83

NA 7.38 1.50

NA 17.71

090 growth. 27486............... .............. A

Revise/replace knee

19.24

NA 13.34 3.26

NA 35.84

090 joint. 27487............... .............. A

Revise/replace knee

25.23

NA 16.41 4.27

NA 45.91

090 joint. 27488............... .............. A

Removal of knee

15.72

NA 11.54 2.67

NA 29.93

090 prosthesis. 27495............... .............. A

Reinforce thigh...... 15.53

NA 11.47 2.63

NA 29.63

090 27496............... .............. A

Decompression of

6.10

NA 5.72 0.93

NA 12.75

090 thigh/knee. 27497............... .............. A

Decompression of

7.16

NA 5.66 1.01

NA 13.83

090 thigh/knee. 27498............... .............. A

Decompression of

7.98

NA 6.11 1.17

NA 15.26

090 thigh/knee. 27499............... .............. A

Decompression of

8.99

NA 6.99 1.42

NA 17.40

090 thigh/knee. 27500............... .............. A

Treatment of thigh

5.91 7.01 4.99 0.96 13.88 11.86

090 fracture. 27501............... .............. A

Treatment of thigh

5.91 7.57 5.66 1.00 14.48 12.57

090 fracture. 27502............... .............. A

Treatment of thigh

10.56

NA 8.10 1.80

NA 20.46

090 fracture. 27503............... .............. A

Treatment of thigh

10.56

NA 8.26 1.80

NA 20.62

090 fracture. 27506............... .............. A

Treatment of thigh

17.42

NA 12.70 2.81

NA 32.93

090 fracture. 27507............... .............. A

Treatment of thigh

13.97

NA 9.88 2.35

NA 26.20

090 fracture. 27508............... .............. A

Treatment of thigh

5.82 6.97 5.32 0.96 13.75 12.10

090 fracture. 27509............... .............. A

Treatment of thigh

7.70

NA 7.90 1.30

NA 16.90

090 fracture. 27510............... .............. A

Treatment of thigh

9.12

NA 7.17 1.52

NA 17.81

090 fracture. 27511............... .............. A

Treatment of thigh

13.62

NA 11.19 2.30

NA 27.11

090 fracture. 27513............... .............. A

Treatment of thigh

17.89

NA 13.83 3.03

NA 34.75

090 fracture. 27514............... .............. A

Treatment of thigh

17.27

NA 13.29 2.91

NA 33.47

090 fracture. 27516............... .............. A

Treat thigh fx growth 5.36 7.27 5.38 0.89 13.52 11.63

090 plate. 27517............... .............. A

Treat thigh fx growth 8.77 8.89 7.35 1.47 19.13 17.59

090 plate. 27519............... .............. A

Treat thigh fx growth 15.00

NA 11.61 2.52

NA 29.13

090 plate. 27520............... .............. A

Treat kneecap

2.86 5.22 3.41 0.46 8.54 6.73

090 fracture. 27524............... .............. A

Treat kneecap

9.99

NA 8.14 1.69

NA 19.82

090 fracture. 27530............... .............. A

Treat knee fracture.. 3.77 5.88 4.26 0.62 10.27 8.65

090 27532............... .............. A

Treat knee fracture.. 7.29 7.82 6.26 1.23 16.34 14.78

090 27535............... .............. A

Treat knee fracture.. 11.48

NA 10.09 1.94

NA 23.51

090 27536............... .............. A

Treat knee fracture.. 15.63

NA 11.48 2.64

NA 29.75

090 27538............... .............. A

Treat knee

4.86 7.07 5.08 0.81 12.74 10.75

090 fracture(s). 27540............... .............. A

Treat knee fracture.. 13.08

NA 9.46 2.17

NA 24.71

090 27550............... .............. A

Treat knee

5.75 6.57 4.92 0.82 13.14 11.49

090 dislocation. 27552............... .............. A

Treat knee

7.89

NA 6.86 1.33

NA 16.08

090 dislocation. 27556............... .............. A

Treat knee

14.39

NA 11.66 2.42

NA 28.47

090 dislocation. 27557............... .............. A

Treat knee

16.74

NA 13.12 2.86

NA 32.72

090 dislocation. 27558............... .............. A

Treat knee

17.69

NA 13.08 3.03

NA 33.80

090 dislocation. 27560............... .............. A

Treat kneecap

3.81 5.58 3.29 0.48 9.87 7.58

090 dislocation. 27562............... .............. A

Treat kneecap

5.78

NA 4.79 0.83

NA 11.40

090 dislocation. 27566............... .............. A

Treat kneecap

12.21

NA 9.26 2.09

NA 23.56

090 dislocation. 27570............... .............. A

Fixation of knee

1.74

NA 1.81 0.29

NA 3.84

010 joint. 27580............... .............. A

Fusion of knee....... 19.34

NA 14.75 3.26

NA 37.35

090 27590............... .............. A

Amputate leg at thigh 12.01

NA 7.10 1.63

NA 20.74

090 27591............... .............. A

Amputate leg at thigh 12.66

NA 8.87 1.97

NA 23.50

090 27592............... .............. A

Amputate leg at thigh 10.00

NA 6.59 1.41

NA 18.00

090 27594............... .............. A

Amputation follow-up

6.91

NA 5.45 0.99

NA 13.35

090 surgery. 27596............... .............. A

Amputation follow-up 10.58

NA 7.22 1.50

NA 19.30

090 surgery. 27598............... .............. A

Amputate lower leg at 10.51

NA 7.32 1.50

NA 19.33

090 knee. 27599............... .............. C

Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00

YYY 27600............... .............. A

Decompression of

5.64

NA 4.75 0.82

NA 11.21

090 lower leg. 27601............... .............. A

Decompression of

5.63

NA 5.04 0.83

NA 11.50

090 lower leg.

[[Page 1139]]

27602............... .............. A

Decompression of

7.34

NA 5.33 1.03

NA 13.70

090 lower leg. 27603............... .............. A

Drain lower leg

4.93 10.64 4.85 0.68 16.25 10.46

090 lesion. 27604............... .............. A

Drain lower leg bursa 4.46 8.58 4.53 0.65 13.69 9.64

090 27605............... .............. A

Incision of achilles

2.87 8.80 2.34 0.46 12.13 5.67

010 tendon. 27606............... .............. A

Incision of achilles

4.13 10.03 3.40 0.69 14.85 8.22

010 tendon. 27607............... .............. A

Treat lower leg bone

7.96

NA 6.58 1.30

NA 15.84

090 lesion. 27610............... .............. A

Explore/treat ankle

8.33

NA 7.06 1.39

NA 16.78

090 joint. 27612............... .............. A

Exploration of ankle

7.32

NA 6.12 1.22

NA 14.66

090 joint. 27613............... .............. A

Biopsy lower leg soft 2.17 3.77 1.76 0.19 6.13 4.12

010 tissue. 27614............... .............. A

Biopsy lower leg soft 5.65 8.78 4.63 0.75 15.18 11.03

090 tissue. 27615............... .............. A

Remove tumor, lower

12.54

NA 10.56 1.68

NA 24.78

090 leg. 27618............... .............. A

Remove lower leg

5.08 9.10 4.21 0.65 14.83 9.94

090 lesion. 27619............... .............. A

Remove lower leg

8.39 10.62 6.17 1.22 20.23 15.78

090 lesion. 27620............... .............. A

Explore/treat ankle

5.97

NA 5.50 1.00

NA 12.47

090 joint. 27625............... .............. A

Remove ankle joint

8.29

NA 6.54 1.40

NA 16.23

090 lining. 27626............... .............. A

Remove ankle joint

8.90

NA 7.00 1.48

NA 17.38

090 lining. 27630............... .............. A

Removal of tendon

4.79 8.99 4.46 0.72 14.50 9.97

090 lesion. 27635............... .............. A

Remove lower leg bone 7.77

NA 6.84 1.28

NA 15.89

090 lesion. 27637............... .............. A

Remove/graft leg bone 9.84

NA 8.35 1.66

NA 19.85

090 lesion. 27638............... .............. A

Remove/graft leg bone 10.55

NA 8.39 1.77

NA 20.71

090 lesion. 27640............... .............. A

Partial removal of

11.35

NA 10.81 1.86

NA 24.02

090 tibia. 27641............... .............. A

Partial removal of

9.23

NA 8.83 1.47

NA 19.53

090 fibula. 27645............... .............. A

Extensive lower leg

14.15

NA 12.34 2.39

NA 28.88

090 surgery. 27646............... .............. A

Extensive lower leg

12.64

NA 11.34 1.87

NA 25.85

090 surgery. 27647............... .............. A

Extensive ankle/heel 12.22

NA 7.85 1.98

NA 22.05

090 surgery. 27648............... .............. A

Injection for ankle x- 0.96 9.45 0.33 0.06 10.47 1.35

000 ray. 27650............... .............. A

Repair achilles

9.68

NA 7.51 1.63

NA 18.82

090 tendon. 27652............... .............. A

Repair/graft achilles 10.31

NA 8.01 1.75

NA 20.07

090 tendon. 27654............... .............. A

Repair of achilles

10.00

NA 7.23 1.70

NA 18.93

090 tendon. 27656............... .............. A

Repair leg fascia

4.56 9.93 4.01 0.58 15.07 9.15

090 defect. 27658............... .............. A

Repair of leg tendon, 4.97 9.18 4.77 0.82 14.97 10.56

090 each. 27659............... .............. A

Repair of leg tendon, 6.80 11.30 5.80 1.16 19.26 13.76

090 each. 27664............... .............. A

Repair of leg tendon, 4.58 11.26 4.74 0.76 16.60 10.08

090 each. 27665............... .............. A

Repair of leg tendon, 5.39 11.05 5.18 0.90 17.34 11.47

090 each. 27675............... .............. A

Repair lower leg

7.17

NA 5.79 1.22

NA 14.18

090 tendons. 27676............... .............. A

Repair lower leg

8.41

NA 6.77 1.39

NA 16.57

090 tendons. 27680............... .............. A

Release of lower leg

5.73

NA 5.19 0.96

NA 11.88

090 tendon. 27681............... .............. A

Release of lower leg

6.81

NA 5.96 1.11

NA 13.88

090 tendons. 27685............... .............. A

Revision of lower leg 6.49 8.11 5.51 1.10 15.70 13.10

090 tendon. 27686............... .............. A

Revise lower leg

7.45 12.57 6.59 1.27 21.29 15.31

090 tendons. 27687............... .............. A

Revision of calf

6.23

NA 5.42 1.06

NA 12.71

090 tendon. 27690............... .............. A

Revise lower leg

8.70

NA 6.45 1.47

NA 16.62

090 tendon. 27691............... .............. A

Revise lower leg

9.95

NA 7.81 1.69

NA 19.45

090 tendon. 27692............... .............. A

Revise additional leg 1.87

NA 0.93 0.31

NA 3.11

ZZZ tendon. 27695............... .............. A

Repair of ankle

6.50

NA 5.92 1.09

NA 13.51

090 ligament. 27696............... .............. A

Repair of ankle

8.26

NA 6.50 1.40

NA 16.16

090 ligaments. 27698............... .............. A

Repair of ankle

9.35

NA 6.98 1.58

NA 17.91

090 ligament. 27700............... .............. A

Revision of ankle

9.28

NA 5.62 1.50

NA 16.40

090 joint. 27702............... .............. A

Reconstruct ankle

13.65

NA 10.32 2.32

NA 26.29

090 joint. 27703............... .............. A

Reconstruction, ankle 15.85

NA 11.09 2.70

NA 29.64

090 joint. 27704............... .............. A

Removal of ankle

7.61

NA 5.52 0.74

NA 13.87

090 implant. 27705............... .............. A

Incision of tibia.... 10.36

NA 8.23 1.74

NA 20.33

090 27707............... .............. A

Incision of fibula... 4.36

NA 5.01 0.72

NA 10.09

090 27709............... .............. A

Incision of tibia &

9.94

NA 8.16 1.68

NA 19.78

090 fibula. 27712............... .............. A

Realignment of lower 14.23

NA 10.72 2.41

NA 27.36

090 leg. 27715............... .............. A

Revision of lower leg 14.37

NA 10.84 2.41

NA 27.62

090 27720............... .............. A

Repair of tibia...... 11.77

NA 9.45 2.00

NA 23.22

090 27722............... .............. A

Repair/graft of tibia 11.80

NA 9.21 1.99

NA 23.00

090 27724............... .............. A

Repair/graft of tibia 18.17

NA 12.45 2.53

NA 33.15

090 27725............... .............. A

Repair of lower leg.. 15.57

NA 11.88 2.65

NA 30.10

090 27727............... .............. A

Repair of lower leg.. 13.99

NA 10.41 2.22

NA 26.62

090 27730............... .............. A

Repair of tibia

7.40 17.74 6.45 0.90 26.04 14.75

090 epiphysis. 27732............... .............. A

Repair of fibula

5.31 11.60 5.00 0.76 17.67 11.07

090 epiphysis. 27734............... .............. A

Repair lower leg

8.47

NA 6.42 1.03

NA 15.92

090 epiphyses. 27740............... .............. A

Repair of leg

9.29 20.61 7.93 1.58 31.48 18.80

090 epiphyses. 27742............... .............. A

Repair of leg

10.28 12.50 7.26 1.87 24.65 19.41

090 epiphyses. 27745............... .............. A

Reinforce tibia...... 10.05

NA 8.21 1.66

NA 19.92

090 27750............... .............. A

Treatment of tibia

3.19 5.37 3.77 0.52 9.08 7.48

090 fracture. 27752............... .............. A

Treatment of tibia

5.83 7.38 5.49 0.99 14.20 12.31

090 fracture. 27756............... .............. A

Treatment of tibia

6.77

NA 6.52 1.13

NA 14.42

090 fracture. 27758............... .............. A

Treatment of tibia

11.65

NA 9.19 1.83

NA 22.67

090 fracture. 27759............... .............. A

Treatment of tibia

13.74

NA 10.32 2.33

NA 26.39

090 fracture. 27760............... .............. A

Treatment of ankle

3.01 5.25 3.53 0.47 8.73 7.01

090 fracture. 27762............... .............. A

Treatment of ankle

5.24 7.12 5.16 0.86 13.22 11.26

090 fracture. 27766............... .............. A

Treatment of ankle

8.35

NA 7.16 1.41

NA 16.92

090 fracture.

[[Page 1140]]

27780............... .............. A

Treatment of fibula

2.65 4.92 3.21 0.40 7.97 6.26

090 fracture. 27781............... .............. A

Treatment of fibula

4.39 6.35 4.49 0.69 11.43 9.57

090 fracture. 27784............... .............. A

Treatment of fibula

7.10

NA 6.45 1.18

NA 14.73

090 fracture. 27786............... .............. A

Treatment of ankle

2.84 5.09 3.33 0.45 8.38 6.62

090 fracture. 27788............... .............. A

Treatment of ankle

4.44 6.46 4.50 0.74 11.64 9.68

090 fracture. 27792............... .............. A

Treatment of ankle

7.65

NA 6.90 1.29

NA 15.84

090 fracture. 27808............... .............. A

Treatment of ankle

2.83 5.68 3.60 0.46 8.97 6.89

090 fracture. 27810............... .............. A

Treatment of ankle

5.12 6.95 4.99 0.86 12.93 10.97

090 fracture. 27814............... .............. A

Treatment of ankle

10.66

NA 8.55 1.81

NA 21.02

090 fracture. 27816............... .............. A

Treatment of ankle

2.89 4.99 3.40 0.45 8.33 6.74

090 fracture. 27818............... .............. A

Treatment of ankle

5.49 7.06 5.04 0.89 13.44 11.42

090 fracture. 27822............... .............. A

Treatment of ankle

10.98

NA 10.63 1.56

NA 23.17

090 fracture. 27823............... .............. A

Treatment of ankle

12.98

NA 11.49 1.99

NA 26.46

090 fracture. 27824............... .............. A

Treat lower leg

2.89 5.56 3.74 0.47 8.92 7.10

090 fracture. 27825............... .............. A

Treat lower leg

6.18 8.19 5.86 1.03 15.40 13.07

090 fracture. 27826............... .............. A

Treat lower leg

8.53

NA 8.87 1.44

NA 18.84

090 fracture. 27827............... .............. A

Treat lower leg

14.04

NA 12.71 2.36

NA 29.11

090 fracture. 27828............... .............. A

Treat lower leg

16.21

NA 13.85 2.74

NA 32.80

090 fracture. 27829............... .............. A

Treat lower leg joint 5.48

NA 6.77 0.93

NA 13.18

090 27830............... .............. A

Treat lower leg

3.78 5.12 3.83 0.53 9.43 8.14

090 dislocation. 27831............... .............. A

Treat lower leg

4.55

NA 4.43 0.74

NA 9.72

090 dislocation. 27832............... .............. A

Treat lower leg

6.48

NA 6.16 1.10

NA 13.74

090 dislocation. 27840............... .............. A

Treat ankle

4.57

NA 3.89 0.57

NA 9.03

090 dislocation. 27842............... .............. A

Treat ankle

6.20

NA 5.08 0.92

NA 12.20

090 dislocation. 27846............... .............. A

Treat ankle

9.78

NA 7.91 1.64

NA 19.33

090 dislocation. 27848............... .............. A

Treat ankle

11.18

NA 9.71 1.87

NA 22.76

090 dislocation. 27860............... .............. A

Fixation of ankle

2.34

NA 2.01 0.37

NA 4.72

010 joint. 27870............... .............. A

Fusion of ankle

13.89

NA 10.50 2.35

NA 26.74

090 joint, open. 27871............... .............. A

Fusion of

9.16

NA 7.62 1.56

NA 18.34

090 tibiofibular joint. 27880............... .............. A

Amputation of lower

11.83

NA 7.46 1.66

NA 20.95

090 leg. 27881............... .............. A

Amputation of lower

12.32

NA 9.01 1.92

NA 23.25

090 leg. 27882............... .............. A

Amputation of lower

8.93

NA 6.93 1.24

NA 17.10

090 leg. 27884............... .............. A

Amputation follow-up

8.20

NA 6.10 1.15

NA 15.45

090 surgery. 27886............... .............. A

Amputation follow-up

9.31

NA 6.82 1.36

NA 17.49

090 surgery. 27888............... .............. A

Amputation of foot at 9.66

NA 7.60 1.52

NA 18.78

090 ankle. 27889............... .............. A

Amputation of foot at 9.97

NA 6.74 1.44

NA 18.15

090 ankle. 27892............... .............. A

Decompression of leg. 7.38

NA 5.85 1.04

NA 14.27

090 27893............... .............. A

Decompression of leg. 7.34

NA 5.74 1.09

NA 14.17

090 27894............... .............. A

Decompression of leg. 10.47

NA 7.93 1.51

NA 19.91

090 27899............... .............. C

Leg/ankle surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 28001............... .............. A

Drainage of bursa of

2.73 5.82 3.51 0.37 8.92 6.61

010 foot. 28002............... .............. A

Treatment of foot

4.61 7.22 4.64 0.68 12.51 9.93

010 infection. 28003............... .............. A

Treatment of foot

8.40 7.68 6.04 1.24 17.32 15.68

090 infection. 28005............... .............. A

Treat foot bone

8.67

NA 6.36 1.37

NA 16.40

090 lesion. 28008............... .............. A

Incision of foot

4.44 5.68 3.55 0.68 10.80 8.67

090 fascia. 28010............... .............. A

Incision of toe

2.84 5.53 2.91 0.47 8.84 6.22

090 tendon. 28011............... .............. A

Incision of toe

4.13 7.42 4.24 0.70 12.25 9.07

090 tendons. 28020............... .............. A

Exploration of foot

5.00 7.07 4.20 0.77 12.84 9.97

090 joint. 28022............... .............. A

Exploration of foot

4.66 6.09 3.93 0.75 11.50 9.34

090 joint. 28024............... .............. A

Exploration of toe

4.37 6.20 3.99 0.60 11.17 8.96

090 joint. 28030............... .............. A

Removal of foot nerve 6.14

NA 3.58 1.03

NA 10.75

090 28035............... .............. A

Decompression of

5.08 5.54 4.03 0.86 11.48 9.97

090 tibia nerve. 28043............... .............. A

Excision of foot

3.53 5.79 3.28 0.54 9.86 7.35

090 lesion. 28045............... .............. A

Excision of foot

4.71 6.12 3.71 0.75 11.58 9.17

090 lesion. 28046............... .............. A

Resection of tumor,

10.16 9.42 7.34 1.36 20.94 18.86

090 foot. 28050............... .............. A

Biopsy of foot joint

4.24 5.78 3.66 0.66 10.68 8.56

090 lining. 28052............... .............. A

Biopsy of foot joint

3.93 5.97 3.56 0.62 10.52 8.11

090 lining. 28054............... .............. A

Biopsy of toe joint

3.44 5.82 3.36 0.54 9.80 7.34

090 lining. 28060............... .............. A

Partial removal, foot 5.22 6.39 4.03 0.83 12.44 10.08

090 fascia. 28062............... .............. A

Removal of foot

6.51 7.13 4.19 1.03 14.67 11.73

090 fascia. 28070............... .............. A

Removal of foot joint 5.09 5.96 3.89 0.82 11.87 9.80

090 lining. 28072............... .............. A

Removal of foot joint 4.57 6.43 4.32 0.77 11.77 9.66

090 lining. 28080............... .............. A

Removal of foot

3.57 5.93 3.70 0.60 10.10 7.87

090 lesion. 28086............... .............. A

Excise foot tendon

4.77 9.50 4.69 0.80 15.07 10.26

090 sheath. 28088............... .............. A

Excise foot tendon

3.85 7.04 4.00 0.63 11.52 8.48

090 sheath. 28090............... .............. A

Removal of foot

4.40 6.02 3.55 0.69 11.11 8.64

090 lesion. 28092............... .............. A

Removal of toe

3.63 6.33 3.61 0.55 10.51 7.79

090 lesions. 28100............... .............. A

Removal of ankle/heel 5.65 9.21 4.81 0.92 15.78 11.38

090 lesion. 28102............... .............. A

Remove/graft foot

7.72

NA 6.05 1.17

NA 14.94

090 lesion. 28103............... .............. A

Remove/graft foot

6.49 8.41 4.76 1.07 15.97 12.32

090 lesion. 28104............... .............. A

Removal of foot

5.11 6.35 4.05 0.83 12.29 9.99

090 lesion. 28106............... .............. A

Remove/graft foot

7.15

NA 4.59 1.22

NA 12.96

090 lesion. 28107............... .............. A

Remove/graft foot

5.55 7.24 4.32 0.89 13.68 10.76

090 lesion. 28108............... .............. A

Removal of toe

4.15 5.44 3.36 0.63 10.22 8.14

090 lesions. 28110............... .............. A

Part removal of

4.07 6.03 3.68 0.59 10.69 8.34

090 metatarsal.

[[Page 1141]]

28111............... .............. A

Part removal of

5.00 7.18 4.18 0.76 12.94 9.94

090 metatarsal. 28112............... .............. A

Part removal of

4.48 6.69 4.06 0.72 11.89 9.26

090 metatarsal. 28113............... .............. A

Part removal of

4.78 6.81 4.66 0.76 12.35 10.20

090 metatarsal. 28114............... .............. A

Removal of metatarsal 9.78 11.93 8.52 1.64 23.35 19.94

090 heads. 28116............... .............. A

Revision of foot..... 7.74 7.20 5.22 1.24 16.18 14.20

090 28118............... .............. A

Removal of heel bone. 5.95 7.13 4.53 0.95 14.03 11.43

090 28119............... .............. A

Removal of heel spur. 5.38 6.21 3.87 0.89 12.48 10.14

090 28120............... .............. A

Part removal of ankle/ 5.39 8.67 5.07 0.83 14.89 11.29

090 heel. 28122............... .............. A

Partial removal of

7.28 7.89 5.69 1.16 16.33 14.13

090 foot bone. 28124............... .............. A

Partial removal of

4.80 6.08 4.06 0.78 11.66 9.64

090 toe. 28126............... .............. A

Partial removal of

3.51 5.34 3.51 0.59 9.44 7.61

090 toe. 28130............... .............. A

Removal of ankle bone 8.10

NA 6.70 1.34

NA 16.14

090 28140............... .............. A

Removal of metatarsal 6.90 8.26 5.00 1.01 16.17 12.91

090 28150............... .............. A

Removal of toe....... 4.08 5.98 3.78 0.63 10.69 8.49

090 28153............... .............. A

Partial removal of

3.65 5.40 3.08 0.59 9.64 7.32

090 toe. 28160............... .............. A

Partial removal of

3.73 5.68 3.83 0.62 10.03 8.18

090 toe. 28171............... .............. A

Extensive foot

9.59

NA 5.69 1.36

NA 16.64

090 surgery. 28173............... .............. A

Extensive foot

8.79 8.26 5.64 1.25 18.30 15.68

090 surgery. 28175............... .............. A

Extensive foot

6.04 6.68 4.10 0.90 13.62 11.04

090 surgery. 28190............... .............. A

Removal of foot

1.96 6.51 3.47 0.19 8.66 5.62

010 foreign body. 28192............... .............. A

Removal of foot

4.63 6.43 3.72 0.63 11.69 8.98

090 foreign body. 28193............... .............. A

Removal of foot

5.72 6.35 4.11 0.76 12.83 10.59

090 foreign body. 28200............... .............. A

Repair of foot tendon 4.59 5.94 3.71 0.71 11.24 9.01

090 28202............... .............. A

Repair/graft of foot

6.83 8.16 4.63 1.04 16.03 12.50

090 tendon. 28208............... .............. A

Repair of foot tendon 4.36 5.72 3.46 0.71 10.79 8.53

090 28210............... .............. A

Repair/graft of foot

6.34 7.12 4.19 0.93 14.39 11.46

090 tendon. 28220............... .............. A

Release of foot

4.52 5.56 3.56 0.76 10.84 8.84

090 tendon. 28222............... .............. A

Release of foot

5.61 5.95 4.23 0.93 12.49 10.77

090 tendons. 28225............... .............. A

Release of foot

3.65 5.26 3.07 0.60 9.51 7.32

090 tendon. 28226............... .............. A

Release of foot

4.52 5.61 3.85 0.75 10.88 9.12

090 tendons. 28230............... .............. A

Incision of foot

4.23 5.62 3.81 0.71 10.56 8.75

090 tendon(s). 28232............... .............. A

Incision of toe

3.38 5.66 3.44 0.58 9.62 7.40

090 tendon. 28234............... .............. A

Incision of foot

3.36 5.81 3.47 0.55 9.72 7.38

090 tendon. 28238............... .............. A

Revision of foot

7.72 7.97 5.07 1.30 16.99 14.09

090 tendon. 28240............... .............. A

Release of big toe... 4.35 5.59 3.63 0.74 10.68 8.72

090 28250............... .............. A

Revision of foot

5.91 6.53 4.25 0.98 13.42 11.14

090 fascia. 28260............... .............. A

Release of midfoot

7.95 7.09 5.14 1.30 16.34 14.39

090 joint. 28261............... .............. A

Revision of foot

11.71 8.91 7.34 2.00 22.62 21.05

090 tendon. 28262............... .............. A

Revision of foot and 15.81 14.32 11.44 2.68 32.81 29.93

090 ankle. 28264............... .............. A

Release of midfoot

10.33 8.51 7.82 1.76 20.60 19.91

090 joint. 28270............... .............. A

Release of foot

4.75 5.90 4.19 0.81 11.46 9.75

090 contracture. 28272............... .............. A

Release of toe joint, 3.79 5.14 3.04 0.63 9.56 7.46

090 each. 28280............... .............. A

Fusion of toes....... 5.18 7.25 4.52 0.87 13.30 10.57

090 28285............... .............. A

Repair of hammertoe.. 4.58 5.96 3.85 0.77 11.31 9.20

090 28286............... .............. A

Repair of hammertoe.. 4.55 5.74 3.67 0.77 11.06 8.99

090 28288............... .............. A

Partial removal of

4.73 6.69 5.30 0.78 12.20 10.81

090 foot bone. 28289............... .............. A

Repair hallux rigidus 7.03 8.97 6.21 1.16 17.16 14.40

090 28290............... .............. A

Correction of bunion. 5.65 7.02 5.28 0.95 13.62 11.88

090 28292............... .............. A

Correction of bunion. 7.03 7.80 5.75 1.18 16.01 13.96

090 28293............... .............. A

Correction of bunion. 9.14 10.84 6.01 1.54 21.52 16.69

090 28294............... .............. A

Correction of bunion. 8.55 7.64 5.08 1.40 17.59 15.03

090 28296............... .............. A

Correction of bunion. 9.17 8.14 5.80 1.54 18.85 16.51

090 28297............... .............. A

Correction of bunion. 9.17 9.11 6.74 1.58 19.86 17.49

090 28298............... .............. A

Correction of bunion. 7.93 7.31 5.40 1.35 16.59 14.68

090 28299............... .............. A

Correction of bunion. 10.56 8.71 6.41 1.50 20.77 18.47

090 28300............... .............. A

Incision of heel bone 9.53 13.10 7.07 1.58 24.21 18.18

090 28302............... .............. A

Incision of ankle

9.54 13.11 6.95 1.39 24.04 17.88

090 bone. 28304............... .............. A

Incision of midfoot

9.15 8.16 5.80 1.21 18.52 16.16

090 bones. 28305............... .............. A

Incise/graft midfoot 10.48 10.90 6.80 0.66 22.04 17.94

090 bones. 28306............... .............. A

Incision of

5.85 7.19 4.25 0.98 14.02 11.08

090 metatarsal. 28307............... .............. A

Incision of

6.32 11.59 5.33 0.86 18.77 12.51

090 metatarsal. 28308............... .............. A

Incision of

5.28 6.07 3.76 0.89 12.24 9.93

090 metatarsal. 28309............... .............. A

Incision of

12.76

NA 8.05 1.98

NA 22.79

090 metatarsals. 28310............... .............. A

Revision of big toe.. 5.42 6.24 3.96 0.92 12.58 10.30

090 28312............... .............. A

Revision of toe...... 4.54 5.98 4.11 0.75 11.27 9.40

090 28313............... .............. A

Repair deformity of

5.00 6.43 5.45 0.82 12.25 11.27

090 toe. 28315............... .............. A

Removal of sesamoid

4.85 5.82 3.67 0.80 11.47 9.32

090 bone. 28320............... .............. A

Repair of foot bones. 9.17

NA 6.76 1.53

NA 17.46

090 28322............... .............. A

Repair of metatarsals 8.33 10.13 6.33 1.41 19.87 16.07

090 28340............... .............. A

Resect enlarged toe

6.97 7.06 4.41 1.18 15.21 12.56

090 tissue. 28341............... .............. A

Resect enlarged toe.. 8.40 7.23 4.95 1.42 17.05 14.77

090 28344............... .............. A

Repair extra toe(s).. 4.25 6.78 3.69 0.72 11.75 8.66

090 28345............... .............. A

Repair webbed toe(s). 5.91 6.99 4.79 1.01 13.91 11.71

090 28360............... .............. A

Reconstruct cleft

13.32

NA 10.50 2.27

NA 26.09

090 foot. 28400............... .............. A

Treatment of heel

2.16 4.28 2.98 0.35 6.79 5.49

090 fracture.

[[Page 1142]]

28405............... .............. A

Treatment of heel

4.56 5.51 4.53 0.76 10.83 9.85

090 fracture. 28406............... .............. A

Treatment of heel

6.30

NA 6.80 1.05

NA 14.15

090 fracture. 28415............... .............. A

Treat heel fracture.. 15.95

NA 13.24 2.70

NA 31.89

090 28420............... .............. A

Treat/graft heel

16.62

NA 12.97 2.76

NA 32.35

090 fracture. 28430............... .............. A

Treatment of ankle

2.09 4.07 2.61 0.33 6.49 5.03

090 fracture. 28435............... .............. A

Treatment of ankle

3.39 4.49 3.63 0.57 8.45 7.59

090 fracture. 28436............... .............. A

Treatment of ankle

4.70

NA 5.90 0.80

NA 11.40

090 fracture. 28445............... .............. A

Treat ankle fracture. 15.60

NA 11.02 1.56

NA 28.18

090 28450............... .............. A

Treat midfoot

1.90 4.07 2.52 0.30 6.27 4.72

090 fracture, each. 28455............... .............. A

Treat midfoot

3.09 3.97 3.41 0.52 7.58 7.02

090 fracture, each. 28456............... .............. A

Treat midfoot

2.68

NA 4.21 0.43

NA 7.32

090 fracture. 28465............... .............. A

Treat midfoot

7.00

NA 6.37 1.05

NA 14.42

090 fracture, each. 28470............... .............. A

Treat metatarsal

1.99 3.87 2.48 0.31 6.17 4.78

090 fracture. 28475............... .............. A

Treat metatarsal

2.97 4.05 3.19 0.49 7.51 6.65

090 fracture. 28476............... .............. A

Treat metatarsal

3.37

NA 4.99 0.55

NA 8.91

090 fracture. 28485............... .............. A

Treat metatarsal

5.70

NA 5.55 0.96

NA 12.21

090 fracture. 28490............... .............. A

Treat big toe

1.09 2.21 1.73 0.16 3.46 2.98

090 fracture. 28495............... .............. A

Treat big toe

1.58 2.50 2.06 0.23 4.31 3.87

090 fracture. 28496............... .............. A

Treat big toe

2.33 9.72 3.63 0.39 12.44 6.35

090 fracture. 28505............... .............. A

Treat big toe

3.80 9.71 4.70 0.60 14.11 9.10

090 fracture. 28510............... .............. A

Treatment of toe

1.09 1.98 1.69 0.16 3.23 2.94

090 fracture. 28515............... .............. A

Treatment of toe

1.46 2.33 1.99 0.21 4.00 3.66

090 fracture. 28525............... .............. A

Treat toe fracture... 3.32 9.30 4.25 0.53 13.15 8.10

090 28530............... .............. A

Treat sesamoid bone

1.06 2.08 1.46 0.16 3.30 2.68

090 fracture. 28531............... .............. A

Treat sesamoid bone

2.35 8.98 2.51 0.40 11.73 5.26

090 fracture. 28540............... .............. A

Treat foot

2.04 2.87 2.67 0.29 5.20 5.00

090 dislocation. 28545............... .............. A

Treat foot

2.45 2.86 2.86 0.40 5.71 5.71

090 dislocation. 28546............... .............. A

Treat foot

3.20 7.89 4.84 0.55 11.64 8.59

090 dislocation. 28555............... .............. A

Repair foot

6.29 11.49 6.54 1.06 18.84 13.89

090 dislocation. 28570............... .............. A

Treat foot

1.66 2.89 2.29 0.27 4.82 4.22

090 dislocation. 28575............... .............. A

Treat foot

3.31 4.37 4.03 0.54 8.22 7.88

090 dislocation. 28576............... .............. A

Treat foot

4.16 10.15 5.51 0.68 14.99 10.35

090 dislocation. 28585............... .............. A

Repair foot

7.98 8.14 6.53 1.36 17.48 15.87

090 dislocation. 28600............... .............. A

Treat foot

1.89 3.29 2.66 0.29 5.47 4.84

090 dislocation. 28605............... .............. A

Treat foot

2.71 3.74 3.61 0.42 6.87 6.74

090 dislocation. 28606............... .............. A

Treat foot

4.89 16.02 6.01 0.82 21.73 11.72

090 dislocation. 28615............... .............. A

Repair foot

7.76

NA 7.98 1.31

NA 17.05

090 dislocation. 28630............... .............. A

Treat toe dislocation 1.70 1.22 1.12 0.21 3.13 3.03

010 28635............... .............. A

Treat toe dislocation 1.91 1.66 1.49 0.29 3.86 3.69

010 28636............... .............. A

Treat toe dislocation 2.77 6.14 3.07 0.47 9.38 6.31

010 28645............... .............. A

Repair toe

4.21 5.66 3.50 0.70 10.57 8.41

090 dislocation. 28660............... .............. A

Treat toe dislocation 1.23 1.61 1.16 0.13 2.97 2.52

010 28665............... .............. A

Treat toe dislocation 1.92 1.65 1.63 0.29 3.86 3.84

010 28666............... .............. A

Treat toe dislocation 2.66 5.93 2.24 0.46 9.05 5.36

010 28675............... .............. A

Repair of toe

2.92 8.81 3.77 0.49 12.22 7.18

090 dislocation. 28705............... .............. A

Fusion of foot bones. 18.77

NA 12.43 2.57

NA 33.77

090 28715............... .............. A

Fusion of foot bones. 13.08

NA 9.74 2.22

NA 25.04

090 28725............... .............. A

Fusion of foot bones. 11.59

NA 8.30 1.97

NA 21.86

090 28730............... .............. A

Fusion of foot bones. 10.74

NA 8.47 1.82

NA 21.03

090 28735............... .............. A

Fusion of foot bones. 10.83

NA 7.86 1.82

NA 20.51

090 28737............... .............. A

Revision of foot

9.63

NA 6.87 1.64

NA 18.14

090 bones. 28740............... .............. A

Fusion of foot bones. 8.01 11.59 6.43 1.36 20.96 15.80

090 28750............... .............. A

Fusion of big toe

7.29 12.97 6.59 1.24 21.50 15.12

090 joint. 28755............... .............. A

Fusion of big toe

4.73 6.83 3.86 0.80 12.36 9.39

090 joint. 28760............... .............. A

Fusion of big toe

7.74 8.04 5.62 1.29 17.07 14.65

090 joint. 28800............... .............. A

Amputation of midfoot 8.20

NA 6.04 1.18

NA 15.42

090 28805............... .............. A

Amputation thru

8.38

NA 5.90 1.17

NA 15.45

090 metatarsal. 28810............... .............. A

Amputation toe &

6.20

NA 4.76 0.84

NA 11.80

090 metatarsal. 28820............... .............. A

Amputation of toe.... 4.40 8.50 4.10 0.62 13.52 9.12

090 28825............... .............. A

Partial amputation of 3.58 7.91 3.79 0.52 12.01 7.89

090 toe. 28899............... .............. C

Foot/toes surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 29000............... .............. A

Application of body

2.25 3.09 1.72 0.36 5.70 4.33

000 cast. 29010............... .............. A

Application of body

2.06 3.30 1.73 0.33 5.69 4.12

000 cast. 29015............... .............. A

Application of body

2.41 3.01 1.58 0.25 5.67 4.24

000 cast. 29020............... .............. A

Application of body

2.11 3.30 1.41 0.19 5.60 3.71

000 cast. 29025............... .............. A

Application of body

2.40 3.22 1.83 0.31 5.93 4.54

000 cast. 29035............... .............. A

Application of body

1.77 3.45 1.54 0.29 5.51 3.60

000 cast. 29040............... .............. A

Application of body

2.22 2.57 1.51 0.42 5.21 4.15

000 cast. 29044............... .............. A

Application of body

2.12 3.80 1.85 0.35 6.27 4.32

000 cast. 29046............... .............. A

Application of body

2.41 3.27 2.02 0.41 6.09 4.84

000 cast. 29049............... .............. A

Application of figure 0.89 1.24 0.54 0.14 2.27 1.57

000 eight. 29055............... .............. A

Application of

1.78 2.81 1.43 0.29 4.88 3.50

000 shoulder cast. 29058............... .............. A

Application of

1.31 1.50 0.73 0.17 2.98 2.21

000 shoulder cast. 29065............... .............. A

Application of long

0.87 1.26 0.74 0.14 2.27 1.75

000 arm cast. 29075............... .............. A

Application of

0.77 1.20 0.67 0.13 2.10 1.57

000 forearm cast.

[[Page 1143]]

29085............... .............. A

Apply hand/wrist cast 0.87 1.23 0.63 0.13 2.23 1.63

000 29086............... .............. A

Apply finger cast.... 0.62 0.93 0.51 0.07 1.62 1.20

000 29105............... .............. A

Apply long arm splint 0.87 1.18 0.52 0.13 2.18 1.52

000 29125............... .............. A

Apply forearm splint. 0.59 0.99 0.40 0.07 1.65 1.06

000 29126............... .............. A

Apply forearm splint. 0.77 1.19 0.46 0.07 2.03 1.30

000 29130............... .............. A

Application of finger 0.50 0.45 0.17 0.06 1.01 0.73

000 splint. 29131............... .............. A

Application of finger 0.55 0.73 0.24 0.04 1.32 0.83

000 splint. 29200............... .............. A

Strapping of chest... 0.65 0.75 0.36 0.05 1.45 1.06

000 29220............... .............. A

Strapping of low back 0.64 0.72 0.39 0.08 1.44 1.11

000 29240............... .............. A

Strapping of shoulder 0.71 0.86 0.37 0.06 1.63 1.14

000 29260............... .............. A

Strapping of elbow or 0.55 0.75 0.34 0.05 1.35 0.94

000 wrist. 29280............... .............. A

Strapping of hand or

0.51 0.81 0.34 0.05 1.37 0.90

000 finger. 29305............... .............. A

Application of hip

2.03 3.19 1.71 0.35 5.57 4.09

000 cast. 29325............... .............. A

Application of hip

2.32 3.37 1.89 0.37 6.06 4.58

000 casts. 29345............... .............. A

Application of long

1.40 1.69 1.04 0.23 3.32 2.67

000 leg cast. 29355............... .............. A

Application of long

1.53 1.65 1.10 0.24 3.42 2.87

000 leg cast. 29358............... .............. A

Apply long leg cast

1.43 1.96 1.07 0.23 3.62 2.73

000 brace. 29365............... .............. A

Application of long

1.18 1.58 0.93 0.21 2.97 2.32

000 leg cast. 29405............... .............. A

Apply short leg cast. 0.86 1.17 0.70 0.14 2.17 1.70

000 29425............... .............. A

Apply short leg cast. 1.01 1.18 0.72 0.17 2.36 1.90

000 29435............... .............. A

Apply short leg cast. 1.18 1.49 0.91 0.21 2.88 2.30

000 29440............... .............. A

Addition of walker to 0.57 0.67 0.28 0.08 1.32 0.93

000 cast. 29445............... .............. A

Apply rigid leg cast. 1.78 1.75 0.96 0.29 3.82 3.03

000 29450............... .............. A

Application of leg

2.08 1.45 1.10 0.16 3.69 3.34

000 cast. 29505............... .............. A

Application, long leg 0.69 1.15 0.46 0.07 1.91 1.22

000 splint. 29515............... .............. A

Application lower leg 0.73 0.85 0.47 0.08 1.66 1.28

000 splint. 29520............... .............. A

Strapping of hip..... 0.54 0.87 0.45 0.02 1.43 1.01

000 29530............... .............. A

Strapping of knee.... 0.57 0.80 0.35 0.05 1.42 0.97

000 29540............... .............. A

Strapping of ankle

0.51 0.41 0.32 0.05 0.97 0.88

000 and/or ft. 29550............... .............. A

Strapping of toes.... 0.47 0.41 0.28 0.06 0.94 0.81

000 29580............... .............. A

Application of paste

0.57 0.65 0.36 0.06 1.28 0.99

000 boot. 29590............... .............. A

Application of foot

0.76 0.50 0.30 0.07 1.33 1.13

000 splint. 29700............... .............. A

Removal/revision of

0.57 0.88 0.28 0.08 1.53 0.93

000 cast. 29705............... .............. A

Removal/revision of

0.76 0.79 0.38 0.12 1.67 1.26

000 cast. 29710............... .............. A

Removal/revision of

1.34 1.49 0.70 0.21 3.04 2.25

000 cast. 29715............... .............. A

Removal/revision of

0.94 1.14 0.40 0.10 2.18 1.44

000 cast. 29720............... .............. A

Repair of body cast.. 0.68 1.10 0.38 0.12 1.90 1.18

000 29730............... .............. A

Windowing of cast.... 0.75 0.78 0.36 0.12 1.65 1.23

000 29740............... .............. A

Wedging of cast...... 1.12 1.12 0.49 0.18 2.42 1.79

000 29750............... .............. A

Wedging of clubfoot

1.26 1.04 0.58 0.19 2.49 2.03

000 cast. 29799............... .............. C

Casting/strapping

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 29800............... .............. A

Jaw arthroscopy/

6.42

NA 7.12 1.01

NA 14.55

090 surgery. 29804............... .............. A

Jaw arthroscopy/

8.13

NA 8.41 0.80

NA 17.34

090 surgery. 29805............... .............. A

Shoulder arthroscopy, 5.88

NA 5.65 1.01

NA 12.54

090 dx. 29806............... .............. A

Shoulder arthroscopy/ 14.35

NA 10.94 2.41

NA 27.70

090 surgery. 29807............... .............. A

Shoulder arthroscopy/ 13.88

NA 10.78 2.34

NA 27.00

090 surgery. 29819............... .............. A

Shoulder arthroscopy/ 7.61

NA 6.66 1.29

NA 15.56

090 surgery. 29820............... .............. A

Shoulder arthroscopy/ 7.06

NA 6.12 1.19

NA 14.37

090 surgery. 29821............... .............. A

Shoulder arthroscopy/ 7.71

NA 6.68 1.30

NA 15.69

090 surgery. 29822............... .............. A

Shoulder arthroscopy/ 7.42

NA 6.56 1.25

NA 15.23

090 surgery. 29823............... .............. A

Shoulder arthroscopy/ 8.16

NA 7.09 1.39

NA 16.64

090 surgery. 29824............... .............. A

Shoulder arthroscopy/ 8.24

NA 7.33 1.39

NA 16.96

090 surgery. 29825............... .............. A

Shoulder arthroscopy/ 7.61

NA 6.64 1.28

NA 15.53

090 surgery. 29826............... .............. A

Shoulder arthroscopy/ 8.98

NA 7.41 1.52

NA 17.91

090 surgery. 29827............... .............. A

Arthroscop rotator

15.34

NA 11.32 2.24

NA 28.90

090 cuff repr. 29830............... .............. A

Elbow arthroscopy.... 5.75

NA 5.25 0.95

NA 11.95

090 29834............... .............. A

Elbow arthroscopy/

6.27

NA 5.72 1.04

NA 13.03

090 surgery. 29835............... .............. A

Elbow arthroscopy/

6.47

NA 5.77 1.06

NA 13.30

090 surgery. 29836............... .............. A

Elbow arthroscopy/

7.54

NA 6.66 1.28

NA 15.48

090 surgery. 29837............... .............. A

Elbow arthroscopy/

6.86

NA 6.02 1.16

NA 14.04

090 surgery. 29838............... .............. A

Elbow arthroscopy/

7.70

NA 6.76 1.29

NA 15.75

090 surgery. 29840............... .............. A

Wrist arthroscopy.... 5.53

NA 5.24 0.83

NA 11.60

090 29843............... .............. A

Wrist arthroscopy/

6.00

NA 5.54 0.99

NA 12.53

090 surgery. 29844............... .............. A

Wrist arthroscopy/

6.36

NA 5.71 1.04

NA 13.11

090 surgery. 29845............... .............. A

Wrist arthroscopy/

7.51

NA 6.38 1.01

NA 14.90

090 surgery. 29846............... .............. A

Wrist arthroscopy/

6.74

NA 5.95 1.07

NA 13.76

090 surgery. 29847............... .............. A

Wrist arthroscopy/

7.07

NA 6.10 1.10

NA 14.27

090 surgery. 29848............... .............. A

Wrist endoscopy/

5.43

NA 5.49 0.87

NA 11.79

090 surgery. 29850............... .............. A

Knee arthroscopy/

8.18

NA 5.04 0.89

NA 14.11

090 surgery. 29851............... .............. A

Knee arthroscopy/

13.08

NA 9.66 2.18

NA 24.92

090 surgery. 29855............... .............. A

Tibial arthroscopy/

10.60

NA 8.60 1.81

NA 21.01

090 surgery. 29856............... .............. A

Tibial arthroscopy/

14.12

NA 10.51 2.41

NA 27.04

090 surgery. 29860............... .............. A

Hip arthroscopy, dx.. 8.04

NA 6.82 1.37

NA 16.23

090 29861............... .............. A

Hip arthroscopy/

9.14

NA 7.22 1.56

NA 17.92

090 surgery. 29862............... .............. A

Hip arthroscopy/

9.89

NA 8.39 1.68

NA 19.96

090 surgery.

[[Page 1144]]

29863............... .............. A

Hip arthroscopy/

9.89

NA 8.34 1.69

NA 19.92

090 surgery. 29870............... .............. A

Knee arthroscopy, dx. 5.06

NA 4.80 0.81

NA 10.67

090 29871............... .............. A

Knee arthroscopy/

6.54

NA 5.76 1.06

NA 13.36

090 drainage. 29873............... .............. A

Knee arthroscopy/

5.99

NA 6.37 0.88

NA 13.24

090 surgery. 29874............... .............. A

Knee arthroscopy/

7.04

NA 5.97 1.05

NA 14.06

090 surgery. 29875............... .............. A

Knee arthroscopy/

6.30

NA 5.74 1.06

NA 13.10

090 surgery. 29876............... .............. A

Knee arthroscopy/

7.91

NA 6.88 1.34

NA 16.13

090 surgery. 29877............... .............. A

Knee arthroscopy/

7.34

NA 6.59 1.24

NA 15.17

090 surgery. 29879............... .............. A

Knee arthroscopy/

8.03

NA 6.97 1.36

NA 16.36

090 surgery. 29880............... .............. A

Knee arthroscopy/

8.49

NA 7.21 1.44

NA 17.14

090 surgery. 29881............... .............. A

Knee arthroscopy/

7.75

NA 6.82 1.31

NA 15.88

090 surgery. 29882............... .............. A

Knee arthroscopy/

8.64

NA 7.10 1.31

NA 17.05

090 surgery. 29883............... .............. A

Knee arthroscopy/

11.03

NA 8.90 1.60

NA 21.53

090 surgery. 29884............... .............. A

Knee arthroscopy/

7.32

NA 6.55 1.24

NA 15.11

090 surgery. 29885............... .............. A

Knee arthroscopy/

9.08

NA 7.81 1.53

NA 18.42

090 surgery. 29886............... .............. A

Knee arthroscopy/

7.53

NA 6.70 1.28

NA 15.51

090 surgery. 29887............... .............. A

Knee arthroscopy/

9.03

NA 7.78 1.53

NA 18.34

090 surgery. 29888............... .............. A

Knee arthroscopy/

13.88

NA 10.09 2.35

NA 26.32

090 surgery. 29889............... .............. A

Knee arthroscopy/

15.98

NA 12.23 2.54

NA 30.75

090 surgery. 29891............... .............. A

Ankle arthroscopy/

8.39

NA 7.35 1.41

NA 17.15

090 surgery. 29892............... .............. A

Ankle arthroscopy/

8.99

NA 7.59 1.52

NA 18.10

090 surgery. 29893............... .............. A

Scope, plantar

5.21 6.14 3.92 0.89 12.24 10.02

090 fasciotomy. 29894............... .............. A

Ankle arthroscopy/

7.20

NA 5.39 1.22

NA 13.81

090 surgery. 29895............... .............. A

Ankle arthroscopy/

6.98

NA 5.39 1.17

NA 13.54

090 surgery. 29897............... .............. A

Ankle arthroscopy/

7.17

NA 5.78 1.22

NA 14.17

090 surgery. 29898............... .............. A

Ankle arthroscopy/

8.31

NA 6.11 1.37

NA 15.79

090 surgery. 29899............... .............. A

Ankle arthroscopy/

13.89

NA 9.84 2.35

NA 26.08

090 surgery. 29900............... .............. A

Mcp joint

5.41

NA 5.69 0.90

NA 12.00

090 arthroscopy, dx. 29901............... .............. A

Mcp joint

6.12

NA 6.09 1.03

NA 13.24

090 arthroscopy, surg. 29902............... .............. A

Mcp joint

6.69

NA 6.37 1.12

NA 14.18

090 arthroscopy, surg. 29999............... .............. C

Arthroscopy of joint. 0.00 0.00 0.00 0.00 0.00 0.00

YYY 30000............... .............. A

Drainage of nose

1.43 4.19 1.41 0.12 5.74 2.96

010 lesion. 30020............... .............. A

Drainage of nose

1.43 3.35 1.48 0.10 4.88 3.01

010 lesion. 30100............... .............. A

Intranasal biopsy.... 0.94 2.05 0.82 0.07 3.06 1.83

000 30110............... .............. A

Removal of nose

1.63 3.36 1.58 0.14 5.13 3.35

010 polyp(s). 30115............... .............. A

Removal of nose

4.34

NA 4.02 0.37

NA 8.73

090 polyp(s). 30117............... .............. A

Removal of intranasal 3.16 4.38 3.28 0.27 7.81 6.71

090 lesion. 30118............... .............. A

Removal of intranasal 9.68

NA 7.27 0.80

NA 17.75

090 lesion. 30120............... .............. A

Revision of nose..... 5.26 5.53 5.48 0.49 11.28 11.23

090 30124............... .............. A

Removal of nose

3.10

NA 3.03 0.24

NA 6.37

090 lesion. 30125............... .............. A

Removal of nose

7.15

NA 5.92 0.65

NA 13.72

090 lesion. 30130............... .............. A

Removal of turbinate

3.37

NA 3.51 0.27

NA 7.15

090 bones. 30140............... .............. A

Removal of turbinate

3.42

NA 3.97 0.29

NA 7.68

090 bones. 30150............... .............. A

Partial removal of

9.13

NA 7.66 0.92

NA 17.71

090 nose. 30160............... .............. A

Removal of nose...... 9.57

NA 7.65 0.94

NA 18.16

090 30200............... .............. A

Injection treatment

0.78 1.70 0.77 0.07 2.55 1.62

000 of nose. 30210............... .............. A

Nasal sinus therapy.. 1.08 2.17 1.32 0.10 3.35 2.50

010 30220............... .............. A

Insert nasal septal

1.54 4.50 1.54 0.13 6.17 3.21

010 button. 30300............... .............. A

Remove nasal foreign

1.04 4.84 1.96 0.08 5.96 3.08

010 body. 30310............... .............. A

Remove nasal foreign

1.96

NA 3.20 0.17

NA 5.33

010 body. 30320............... .............. A

Remove nasal foreign

4.51

NA 4.49 0.43

NA 9.43

090 body. 30400............... .............. R

Reconstruction of

9.82

NA 9.16 0.96

NA 19.94

090 nose. 30410............... .............. R

Reconstruction of

12.96

NA 10.94 1.30

NA 25.20

090 nose. 30420............... .............. R

Reconstruction of

15.86

NA 12.42 1.50

NA 29.78

090 nose. 30430............... .............. R

Revision of nose..... 7.20

NA 8.10 0.75

NA 16.05

090 30435............... .............. R

Revision of nose..... 11.69

NA 10.62 1.33

NA 23.64

090 30450............... .............. R

Revision of nose..... 18.62

NA 14.10 1.85

NA 34.57

090 30460............... .............. A

Revision of nose..... 9.95

NA 7.75 1.03

NA 18.73

090 30462............... .............. A

Revision of nose..... 19.54

NA 13.67 2.32

NA 35.53

090 30465............... .............. A

Repair nasal stenosis 11.62

NA 7.67 1.17

NA 20.46

090 30520............... .............. A

Repair of nasal

5.69

NA 5.15 0.49

NA 11.33

090 septum. 30540............... .............. A

Repair nasal defect.. 7.74

NA 5.62 0.64

NA 14.00

090 30545............... .............. A

Repair nasal defect.. 11.36

NA 8.64 0.96

NA 20.96

090 30560............... .............. A

Release of nasal

1.26 4.92 2.16 0.11 6.29 3.53

010 adhesions. 30580............... .............. A

Repair upper jaw

6.68 7.17 6.12 0.60 14.45 13.40

090 fistula. 30600............... .............. A

Repair mouth/nose

6.01 6.32 5.52 0.84 13.17 12.37

090 fistula. 30620............... .............. A

Intranasal

5.96

NA 5.78 0.54

NA 12.28

090 reconstruction. 30630............... .............. A

Repair nasal septum

7.11

NA 6.18 0.62

NA 13.91

090 defect. 30801............... .............. A

Cauterization, inner

1.09 2.17 2.07 0.10 3.36 3.26

010 nose. 30802............... .............. A

Cauterization, inner

2.03 2.71 2.58 0.18 4.92 4.79

010 nose. 30901............... .............. A

Control of nosebleed. 1.21 1.36 0.33 0.11 2.68 1.65

000 30903............... .............. A

Control of nosebleed. 1.54 2.80 0.50 0.14 4.48 2.18

000 30905............... .............. A

Control of nosebleed. 1.97 3.57 0.76 0.18 5.72 2.91

000 30906............... .............. A

Repeat control of

2.45 3.96 1.20 0.21 6.62 3.86

000 nosebleed. 30915............... .............. A

Ligation, nasal sinus 7.19

NA 5.82 0.60

NA 13.61

090 artery.

[[Page 1145]]

30920............... .............. A

Ligation, upper jaw

9.82

NA 7.49 0.83

NA 18.14

090 artery. 30930............... .............. A

Therapy, fracture of

1.26

NA 1.65 0.11

NA 3.02

010 nose. 30999............... .............. C

Nasal surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 31000............... .............. A

Irrigation, maxillary 1.15 2.91 1.41 0.10 4.16 2.66

010 sinus. 31002............... .............. A

Irrigation, sphenoid

1.91

NA 3.29 0.17

NA 5.37

010 sinus. 31020............... .............. A

Exploration,

2.94 4.12 3.51 0.24 7.30 6.69

090 maxillary sinus. 31030............... .............. A

Exploration,

5.91 5.64 4.81 0.51 12.06 11.23

090 maxillary sinus. 31032............... .............. A

Explore sinus, remove 6.56

NA 5.60 0.57

NA 12.73

090 polyps. 31040............... .............. A

Exploration behind

9.41

NA 6.27 0.86

NA 16.54

090 upper jaw. 31050............... .............. A

Exploration, sphenoid 5.27

NA 4.50 0.47

NA 10.24

090 sinus. 31051............... .............. A

Sphenoid sinus

7.10

NA 5.86 0.66

NA 13.62

090 surgery. 31070............... .............. A

Exploration of

4.27

NA 4.20 0.36

NA 8.83

090 frontal sinus. 31075............... .............. A

Exploration of

9.15

NA 7.21 0.77

NA 17.13

090 frontal sinus. 31080............... .............. A

Removal of frontal

11.40

NA 8.44 0.94

NA 20.78

090 sinus. 31081............... .............. A

Removal of frontal

12.73

NA 9.46 2.22

NA 24.41

090 sinus. 31084............... .............. A

Removal of frontal

13.49

NA 10.04 1.16

NA 24.69

090 sinus. 31085............... .............. A

Removal of frontal

14.18

NA 10.41 1.42

NA 26.01

090 sinus. 31086............... .............. A

Removal of frontal

12.84

NA 9.86 1.09

NA 23.79

090 sinus. 31087............... .............. A

Removal of frontal

13.08

NA 9.79 1.39

NA 24.26

090 sinus. 31090............... .............. A

Exploration of

9.52

NA 8.59 0.80

NA 18.91

090 sinuses. 31200............... .............. A

Removal of ethmoid

4.96

NA 5.02 0.30

NA 10.28

090 sinus. 31201............... .............. A

Removal of ethmoid

8.36

NA 6.82 0.70

NA 15.88

090 sinus. 31205............... .............. A

Removal of ethmoid

10.22

NA 7.63 0.70

NA 18.55

090 sinus. 31225............... .............. A

Removal of upper jaw. 19.20

NA 13.74 1.66

NA 34.60

090 31230............... .............. A

Removal of upper jaw. 21.91

NA 15.12 1.89

NA 38.92

090 31231............... .............. A

Nasal endoscopy, dx.. 1.10 3.55 0.92 0.10 4.75 2.12

000 31233............... .............. A

Nasal/sinus

2.18 4.49 1.51 0.19 6.86 3.88

000 endoscopy, dx. 31235............... .............. A

Nasal/sinus

2.64 5.10 1.76 0.22 7.96 4.62

000 endoscopy, dx. 31237............... .............. A

Nasal/sinus

2.98 5.40 1.91 0.25 8.63 5.14

000 endoscopy, surg. 31238............... .............. A

Nasal/sinus

3.26 5.45 2.12 0.28 8.99 5.66

000 endoscopy, surg. 31239............... .............. A

Nasal/sinus

8.69

NA 8.28 0.55

NA 17.52

010 endoscopy, surg. 31240............... .............. A

Nasal/sinus

2.61

NA 1.76 0.22

NA 4.59

000 endoscopy, surg. 31254............... .............. A

Revision of ethmoid

4.64

NA 2.89 0.39

NA 7.92

000 sinus. 31255............... .............. A

Removal of ethmoid

6.95

NA 4.15 0.59

NA 11.69

000 sinus. 31256............... .............. A

Exploration maxillary 3.29

NA 2.14 0.28

NA 5.71

000 sinus. 31267............... .............. A

Endoscopy, maxillary

5.45

NA 3.34 0.46

NA 9.25

000 sinus. 31276............... .............. A

Sinus endoscopy,

8.84

NA 5.17 0.75

NA 14.76

000 surgical. 31287............... .............. A

Nasal/sinus

3.91

NA 2.49 0.33

NA 6.73

000 endoscopy, surg. 31288............... .............. A

Nasal/sinus

4.57

NA 2.85 0.39

NA 7.81

000 endoscopy, surg. 31290............... .............. A

Nasal/sinus

17.21

NA 12.15 1.45

NA 30.81

010 endoscopy, surg. 31291............... .............. A

Nasal/sinus

18.16

NA 12.55 2.09

NA 32.80

010 endoscopy, surg. 31292............... .............. A

Nasal/sinus

14.74

NA 10.71 1.19

NA 26.64

010 endoscopy, surg. 31293............... .............. A

Nasal/sinus

16.19

NA 11.52 1.17

NA 28.88

010 endoscopy, surg. 31294............... .............. A

Nasal/sinus

19.03

NA 13.00 1.25

NA 33.28

010 endoscopy, surg. 31299............... .............. C

Sinus surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 31300............... .............. A

Removal of larynx

14.27

NA 12.03 1.19

NA 27.49

090 lesion. 31320............... .............. A

Diagnostic incision,

5.25

NA 7.24 0.48

NA 12.97

090 larynx. 31360............... .............. A

Removal of larynx.... 17.05

NA 13.95 1.45

NA 32.45

090 31365............... .............. A

Removal of larynx.... 24.12

NA 17.63 2.07

NA 43.82

090 31367............... .............. A

Partial removal of

21.83

NA 17.41 1.89

NA 41.13

090 larynx. 31368............... .............. A

Partial removal of

27.05

NA 21.00 2.29

NA 50.34

090 larynx. 31370............... .............. A

Partial removal of

21.35

NA 17.05 1.82

NA 40.22

090 larynx. 31375............... .............. A

Partial removal of

20.18

NA 15.35 1.72

NA 37.25

090 larynx. 31380............... .............. A

Partial removal of

20.18

NA 15.31 1.69

NA 37.18

090 larynx. 31382............... .............. A

Partial removal of

20.49

NA 16.56 1.74

NA 38.79

090 larynx. 31390............... .............. A

Removal of larynx &

27.49

NA 21.24 2.35

NA 51.08

090 pharynx. 31395............... .............. A

Reconstruct larynx & 31.04

NA 25.13 2.74

NA 58.91

090 pharynx. 31400............... .............. A

Revision of larynx... 10.29

NA 10.00 0.87

NA 21.16

090 31420............... .............. A

Removal of epiglottis 10.20

NA 9.80 0.86

NA 20.86

090 31500............... .............. A

Insert emergency

2.33

NA 0.55 0.18

NA 3.06

000 airway. 31502............... .............. A

Change of windpipe

0.65 1.49 0.26 0.05 2.19 0.96

000 airway. 31505............... .............. A

Diagnostic

0.61 1.57 0.64 0.05 2.23 1.30

000 laryngoscopy. 31510............... .............. A

Laryngoscopy with

1.92 3.42 1.28 0.18 5.52 3.38

000 biopsy. 31511............... .............. A

Remove foreign body,

2.16 3.25 1.11 0.19 5.60 3.46

000 larynx. 31512............... .............. A

Removal of larynx

2.07 3.34 1.39 0.19 5.60 3.65

000 lesion. 31513............... .............. A

Injection into vocal

2.10

NA 1.49 0.18

NA 3.77

000 cord. 31515............... .............. A

Laryngoscopy for

1.80 3.71 1.10 0.14 5.65 3.04

000 aspiration. 31520............... .............. A

Diagnostic

2.56

NA 1.60 0.21

NA 4.37

000 laryngoscopy. 31525............... .............. A

Diagnostic

2.63 3.86 1.70 0.22 6.71 4.55

000 laryngoscopy. 31526............... .............. A

Diagnostic

2.57

NA 1.75 0.22

NA 4.54

000 laryngoscopy. 31527............... .............. A

Laryngoscopy for

3.27

NA 1.90 0.25

NA 5.42

000 treatment. 31528............... .............. A

Laryngoscopy and

2.37

NA 1.45 0.19

NA 4.01

000 dilation. 31529............... .............. A

Laryngoscopy and

2.68

NA 1.72 0.22

NA 4.62

000 dilation. 31530............... .............. A

Operative

3.38

NA 1.98 0.29

NA 5.65

000 laryngoscopy. 31531............... .............. A

Operative

3.58

NA 2.31 0.30

NA 6.19

000 laryngoscopy.

[[Page 1146]]

31535............... .............. A

Operative

3.16

NA 2.02 0.27

NA 5.45

000 laryngoscopy. 31536............... .............. A

Operative

3.55

NA 2.29 0.30

NA 6.14

000 laryngoscopy. 31540............... .............. A

Operative

4.12

NA 2.59 0.35

NA 7.06

000 laryngoscopy. 31541............... .............. A

Operative

4.52

NA 2.81 0.39

NA 7.72

000 laryngoscopy. 31560............... .............. A

Operative

5.45

NA 3.17 0.46

NA 9.08

000 laryngoscopy. 31561............... .............. A

Operative

5.99

NA 3.38 0.51

NA 9.88

000 laryngoscopy. 31570............... .............. A

Laryngoscopy with

3.86 5.74 2.42 0.29 9.89 6.57

000 injection. 31571............... .............. A

Laryngoscopy with

4.26

NA 2.63 0.36

NA 7.25

000 injection. 31575............... .............. A

Diagnostic

1.10 1.88 0.91 0.10 3.08 2.11

000 laryngoscopy. 31576............... .............. A

Laryngoscopy with

1.97 3.62 1.31 0.16 5.75 3.44

000 biopsy. 31577............... .............. A

Remove foreign body,

2.47 3.74 1.57 0.21 6.42 4.25

000 larynx. 31578............... .............. A

Removal of larynx

2.84 4.25 1.56 0.24 7.33 4.64

000 lesion. 31579............... .............. A

Diagnostic

2.26 3.80 1.52 0.19 6.25 3.97

000 laryngoscopy. 31580............... .............. A

Revision of larynx... 12.36

NA 11.12 1.05

NA 24.53

090 31582............... .............. A

Revision of larynx... 21.59

NA 17.42 1.83

NA 40.84

090 31584............... .............. A

Treat larynx fracture 19.61

NA 14.58 1.71

NA 35.90

090 31585............... .............. A

Treat larynx fracture 4.63

NA 5.59 0.36

NA 10.58

090 31586............... .............. A

Treat larynx fracture 8.02

NA 8.36 0.68

NA 17.06

090 31587............... .............. A

Revision of larynx... 11.97

NA 10.05 1.06

NA 23.08

090 31588............... .............. A

Revision of larynx... 13.09

NA 13.10 1.11

NA 27.30

090 31590............... .............. A

Reinnervate larynx... 6.96

NA 8.81 0.60

NA 16.37

090 31595............... .............. A

Larynx nerve surgery. 8.33

NA 7.65 0.75

NA 16.73

090 31599............... .............. C

Larynx surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 31600............... .............. A

Incision of windpipe. 7.17

NA 3.20 0.41

NA 10.78

000 31601............... .............. A

Incision of windpipe. 4.44

NA 2.41 0.47

NA 7.32

000 31603............... .............. A

Incision of windpipe. 4.14

NA 1.72 0.42

NA 6.28

000 31605............... .............. A

Incision of windpipe. 3.57

NA 1.19 0.40

NA 5.16

000 31610............... .............. A

Incision of windpipe. 8.75

NA 7.45 0.83

NA 17.03

090 31611............... .............. A

Surgery/speech

5.63

NA 5.95 0.48

NA 12.06

090 prosthesis. 31612............... .............. A

Puncture/clear

0.91 1.12 0.36 0.07 2.10 1.34

000 windpipe. 31613............... .............. A

Repair windpipe

4.58

NA 5.42 0.45

NA 10.45

090 opening. 31614............... .............. A

Repair windpipe

7.11

NA 7.81 0.62

NA 15.54

090 opening. 31615............... .............. A

Visualization of

2.09 2.63 1.20 0.17 4.89 3.46

000 windpipe. 31622............... .............. A

Dx bronchoscope/wash. 2.78 4.17 0.89 0.17 7.12 3.84

000 31623............... .............. A

Dx bronchoscope/brush 2.88 5.05 0.89 0.17 8.10 3.94

000 31624............... .............. A

Dx bronchoscope/

2.88 4.28 0.90 0.16 7.32 3.94

000 lavage. 31625............... .............. A

Bronchoscopy w/

3.36 5.37 1.26 0.19 8.92 4.81

000 biopsy(s). 31628............... .............. A

Bronchoscopy/lung bx, 3.80 5.53 1.34 0.17 9.50 5.31

000 each. 31629............... .............. A

Bronchoscopy/needle

3.36

NA 1.22 0.16

NA 4.74

000 bx, each. 31630............... .............. A

Bronchoscopy dilate/

3.81

NA 2.00 0.36

NA 6.17

000 fx repr. 31631............... .............. A

Bronchoscopy, dilate

4.36

NA 2.02 0.37

NA 6.75

000 w/stent. 31632............... .............. A

Bronchoscopy/lung bx, 1.03 0.76 0.32 0.17 1.96 1.52

ZZZ add'l. 31633............... .............. A

Bronchoscopy/needle

1.32 0.91 0.40 0.17 2.40 1.89

ZZZ bx add'l. 31635............... .............. A

Bronchoscopy w/fb

3.67

NA 1.67 0.25

NA 5.59

000 removal. 31640............... .............. A

Bronchoscopy w/tumor

4.93

NA 2.35 0.45

NA 7.73

000 excise. 31641............... .............. A

Bronchoscopy, treat

5.02

NA 2.12 0.36

NA 7.50

000 blockage. 31643............... .............. A

Diag bronchoscope/

3.49

NA 1.31 0.18

NA 4.98

000 catheter. 31645............... .............. A

Bronchoscopy, clear

3.16

NA 1.20 0.16

NA 4.52

000 airways. 31646............... .............. A

Bronchoscopy, reclear 2.72

NA 1.08 0.14

NA 3.94

000 airway. 31656............... .............. A

Bronchoscopy, inj for 2.17

NA 0.93 0.12

NA 3.22

000 x-ray. 31700............... .............. A

Insertion of airway

1.34 2.05 0.69 0.08 3.47 2.11

000 catheter. 31708............... .............. A

Instill airway

1.41

NA 0.58 0.07

NA 2.06

000 contrast dye. 31710............... .............. A

Insertion of airway

1.30

NA 0.71 0.07

NA 2.08

000 catheter. 31715............... .............. A

Injection for

1.11

NA 0.59 0.07

NA 1.77

000 bronchus x-ray. 31717............... .............. A

Bronchial brush

2.12 2.96 0.87 0.11 5.19 3.10

000 biopsy. 31720............... .............. A

Clearance of airways. 1.06 1.45 0.33 0.07 2.58 1.46

000 31725............... .............. A

Clearance of airways. 1.96 1.87 0.58 0.12 3.95 2.66

000 31730............... .............. A

Intro, windpipe wire/ 2.85 2.22 1.09 0.18 5.25 4.12

000 tube. 31750............... .............. A

Repair of windpipe... 13.00

NA 11.57 1.23

NA 25.80

090 31755............... .............. A

Repair of windpipe... 15.91

NA 14.20 1.39

NA 31.50

090 31760............... .............. A

Repair of windpipe... 22.32

NA 10.82 1.79

NA 34.93

090 31766............... .............. A

Reconstruction of

30.38

NA 13.76 3.81

NA 47.95

090 windpipe. 31770............... .............. A

Repair/graft of

22.48

NA 10.34 2.74

NA 35.56

090 bronchus. 31775............... .............. A

Reconstruct bronchus. 23.50

NA 11.89 3.51

NA 38.90

090 31780............... .............. A

Reconstruct windpipe. 17.69

NA 11.14 1.87

NA 30.70

090 31781............... .............. A

Reconstruct windpipe. 23.49

NA 12.22 2.46

NA 38.17

090 31785............... .............. A

Remove windpipe

17.20

NA 10.26 1.64

NA 29.10

090 lesion. 31786............... .............. A

Remove windpipe

23.94

NA 13.20 2.65

NA 39.79

090 lesion. 31800............... .............. A

Repair of windpipe

7.42

NA 4.88 0.81

NA 13.11

090 injury. 31805............... .............. A

Repair of windpipe

13.11

NA 7.29 1.75

NA 22.15

090 injury. 31820............... .............. A

Closure of windpipe

4.48 5.52 4.93 0.42 10.42 9.83

090 lesion. 31825............... .............. A

Repair of windpipe

6.80 7.61 7.06 0.60 15.01 14.46

090 defect. 31830............... .............. A

Revise windpipe scar. 4.49 5.68 5.30 0.43 10.60 10.22

090 31899............... .............. C

Airways surgical

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 32000............... .............. A

Drainage of chest.... 1.54 3.13 0.48 0.08 4.75 2.10

000

[[Page 1147]]

32002............... .............. A

Treatment of

2.19 3.32 0.84 0.13 5.64 3.16

000 collapsed lung. 32005............... .............. A

Treat lung lining

2.19 6.58 0.70 0.21 8.98 3.10

000 chemically. 32020............... .............. A

Insertion of chest

3.97

NA 1.45 0.43

NA 5.85

000 tube. 32035............... .............. A

Exploration of chest. 8.66

NA 5.91 1.23

NA 15.80

090 32036............... .............. A

Exploration of chest. 9.67

NA 6.49 1.45

NA 17.61

090 32095............... .............. A

Biopsy through chest

8.35

NA 5.42 1.19

NA 14.96

090 wall. 32100............... .............. A

Exploration/biopsy of 15.22

NA 7.88 1.75

NA 24.85

090 chest. 32110............... .............. A

Explore/repair chest. 22.97

NA 10.81 1.97

NA 35.75

090 32120............... .............. A

Re-exploration of

11.52

NA 7.13 1.71

NA 20.36

090 chest. 32124............... .............. A

Explore chest free

12.70

NA 7.27 1.82

NA 21.79

090 adhesions. 32140............... .............. A

Removal of lung

13.91

NA 7.75 2.03

NA 23.69

090 lesion(s). 32141............... .............. A

Remove/treat lung

13.98

NA 7.62 2.07

NA 23.67

090 lesions. 32150............... .............. A

Removal of lung

14.13

NA 7.68 1.93

NA 23.74

090 lesion(s). 32151............... .............. A

Remove lung foreign

14.19

NA 8.07 1.80

NA 24.06

090 body. 32160............... .............. A

Open chest heart

9.29

NA 5.32 1.22

NA 15.83

090 massage. 32200............... .............. A

Drain, open, lung

15.27

NA 8.66 1.76

NA 25.69

090 lesion. 32201............... .............. A

Drain, percut, lung

3.99

NA 1.30 0.22

NA 5.51

000 lesion. 32215............... .............. A

Treat chest lining... 11.31

NA 6.96 1.62

NA 19.89

090 32220............... .............. A

Release of lung...... 23.96

NA 13.02 2.88

NA 39.86

090 32225............... .............. A

Partial release of

13.94

NA 7.72 2.05

NA 23.71

090 lung. 32310............... .............. A

Removal of chest

13.42

NA 7.46 1.99

NA 22.87

090 lining. 32320............... .............. A

Free/remove chest

23.96

NA 12.22 3.02

NA 39.20

090 lining. 32400............... .............. A

Needle biopsy chest

1.76 1.70 0.55 0.08 3.54 2.39

000 lining. 32402............... .............. A

Open biopsy chest

7.55

NA 5.17 1.10

NA 13.82

090 lining. 32405............... .............. A

Biopsy, lung or

1.93 2.14 0.63 0.11 4.18 2.67

000 mediastinum. 32420............... .............. A

Puncture/clear lung.. 2.18

NA 0.83 0.13

NA 3.14

000 32440............... .............. A

Removal of lung...... 24.96

NA 12.96 3.09

NA 41.01

090 32442............... .............. A

Sleeve pneumonectomy. 26.20

NA 14.82 3.76

NA 44.78

090 32445............... .............. A

Removal of lung...... 25.05

NA 14.13 3.75

NA 42.93

090 32480............... .............. A

Partial removal of

23.71

NA 12.12 2.70

NA 38.53

090 lung. 32482............... .............. A

Bilobectomy.......... 24.96

NA 12.97 2.83

NA 40.76

090 32484............... .............. A

Segmentectomy........ 20.66

NA 11.44 3.06

NA 35.16

090 32486............... .............. A

Sleeve lobectomy..... 23.88

NA 13.30 3.62

NA 40.80

090 32488............... .............. A

Completion

25.67

NA 13.84 3.84

NA 43.35

090 pneumonectomy. 32491............... .............. R

Lung volume reduction 21.22

NA 12.68 3.21

NA 37.11

090 32500............... .............. A

Partial removal of

21.97

NA 12.40 2.13

NA 36.50

090 lung. 32501............... .............. A

Repair bronchus add-

4.68

NA 1.54 0.68

NA 6.90

ZZZ on. 32520............... .............. A

Remove lung & revise 21.65

NA 11.36 3.27

NA 36.28

090 chest. 32522............... .............. A

Remove lung & revise 24.16

NA 12.17 3.43

NA 39.76

090 chest. 32525............... .............. A

Remove lung & revise 26.46

NA 12.86 3.92

NA 43.24

090 chest. 32540............... .............. A

Removal of lung

14.62

NA 9.68 2.22

NA 26.52

090 lesion. 32601............... .............. A

Thoracoscopy,

5.45

NA 2.42 0.76

NA 8.63

000 diagnostic. 32602............... .............. A

Thoracoscopy,

5.95

NA 2.58 0.84

NA 9.37

000 diagnostic. 32603............... .............. A

Thoracoscopy,

7.80

NA 3.09 0.92

NA 11.81

000 diagnostic. 32604............... .............. A

Thoracoscopy,

8.77

NA 3.53 1.17

NA 13.47

000 diagnostic. 32605............... .............. A

Thoracoscopy,

6.92

NA 2.97 1.04

NA 10.93

000 diagnostic. 32606............... .............. A

Thoracoscopy,

8.39

NA 3.39 1.19

NA 12.97

000 diagnostic. 32650............... .............. A

Thoracoscopy,

10.73

NA 6.80 1.51

NA 19.04

090 surgical. 32651............... .............. A

Thoracoscopy,

12.89

NA 7.26 1.81

NA 21.96

090 surgical. 32652............... .............. A

Thoracoscopy,

18.63

NA 10.19 2.77

NA 31.59

090 surgical. 32653............... .............. A

Thoracoscopy,

12.85

NA 7.01 1.87

NA 21.73

090 surgical. 32654............... .............. A

Thoracoscopy,

12.42

NA 7.57 1.82

NA 21.81

090 surgical. 32655............... .............. A

Thoracoscopy,

13.08

NA 7.27 1.85

NA 22.20

090 surgical. 32656............... .............. A

Thoracoscopy,

12.89

NA 7.97 1.94

NA 22.80

090 surgical. 32657............... .............. A

Thoracoscopy,

13.63

NA 7.72 1.98

NA 23.33

090 surgical. 32658............... .............. A

Thoracoscopy,

11.61

NA 7.38 1.77

NA 20.76

090 surgical. 32659............... .............. A

Thoracoscopy,

11.57

NA 7.49 1.68

NA 20.74

090 surgical. 32660............... .............. A

Thoracoscopy,

17.40

NA 9.52 2.52

NA 29.44

090 surgical. 32661............... .............. A

Thoracoscopy,

13.23

NA 7.83 2.00

NA 23.06

090 surgical. 32662............... .............. A

Thoracoscopy,

16.42

NA 8.85 2.42

NA 27.69

090 surgical. 32663............... .............. A

Thoracoscopy,

18.44

NA 10.81 2.75

NA 32.00

090 surgical. 32664............... .............. A

Thoracoscopy,

14.18

NA 7.67 2.05

NA 23.90

090 surgical. 32665............... .............. A

Thoracoscopy,

15.52

NA 8.17 2.16

NA 25.85

090 surgical. 32800............... .............. A

Repair lung hernia... 13.67

NA 7.49 1.82

NA 22.98

090 32810............... .............. A

Close chest after

13.03

NA 7.59 1.87

NA 22.49

090 drainage. 32815............... .............. A

Close bronchial

23.12

NA 11.04 3.43

NA 37.59

090 fistula. 32820............... .............. A

Reconstruct injured

21.45

NA 12.29 2.79

NA 36.53

090 chest. 32850............... .............. X

Donor pneumonectomy.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 32851............... .............. A

Lung transplant,

38.57

NA 27.97 5.91

NA 72.45

090 single. 32852............... .............. A

Lung transplant with 41.74

NA 33.35 6.24

NA 81.33

090 bypass. 32853............... .............. A

Lung transplant,

47.74

NA 31.96 7.39

NA 87.09

090 double. 32854............... .............. A

Lung transplant with 50.90

NA 34.97 7.73

NA 93.60

090 bypass. 32900............... .............. A

Removal of rib(s).... 20.24

NA 9.95 2.92

NA 33.11

090 32905............... .............. A

Revise & repair chest 20.72

NA 10.19 3.06

NA 33.97

090 wall. 32906............... .............. A

Revise & repair chest 26.73

NA 12.14 3.98

NA 42.85

090 wall.

[[Page 1148]]

32940............... .............. A

Revision of lung..... 19.40

NA 9.53 2.98

NA 31.91

090 32960............... .............. A

Therapeutic

1.84 1.76 0.57 0.14 3.74 2.55

000 pneumothorax. 32997............... .............. A

Total lung lavage.... 5.99

NA 1.91 0.66

NA 8.56

000 32999............... .............. C

Chest surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 33010............... .............. A

Drainage of heart sac 2.24

NA 0.96 0.16

NA 3.36

000 33011............... .............. A

Repeat drainage of

2.24

NA 1.00 0.16

NA 3.40

000 heart sac. 33015............... .............. A

Incision of heart sac 6.79

NA 4.98 0.77

NA 12.54

090 33020............... .............. A

Incision of heart sac 12.59

NA 6.84 1.81

NA 21.24

090 33025............... .............. A

Incision of heart sac 12.07

NA 6.39 1.81

NA 20.27

090 33030............... .............. A

Partial removal of

18.68

NA 9.59 2.89

NA 31.16

090 heart sac. 33031............... .............. A

Partial removal of

21.76

NA 10.10 3.35

NA 35.21

090 heart sac. 33050............... .............. A

Removal of heart sac 14.34

NA 7.90 2.09

NA 24.33

090 lesion. 33120............... .............. A

Removal of heart

24.52

NA 11.68 3.69

NA 39.89

090 lesion. 33130............... .............. A

Removal of heart

21.36

NA 10.18 3.03

NA 34.57

090 lesion. 33140............... .............. A

Heart revascularize

19.97

NA 10.94 2.74

NA 33.65

090 (tmr). 33141............... .............. A

Heart tmr w/other

4.83

NA 1.59 0.66

NA 7.08

ZZZ procedure. 33200............... .............. A

Insertion of heart

12.46

NA 6.98 1.41

NA 20.85

090 pacemaker. 33201............... .............. A

Insertion of heart

10.16

NA 6.73 1.46

NA 18.35

090 pacemaker. 33206............... .............. A

Insertion of heart

6.66

NA 4.57 0.60

NA 11.83

090 pacemaker. 33207............... .............. A

Insertion of heart

8.03

NA 4.76 0.69

NA 13.48

090 pacemaker. 33208............... .............. A

Insertion of heart

8.12

NA 4.86 0.65

NA 13.63

090 pacemaker. 33210............... .............. A

Insertion of heart

3.30

NA 1.25 0.21

NA 4.76

000 electrode. 33211............... .............. A

Insertion of heart

3.39

NA 1.32 0.21

NA 4.92

000 electrode. 33212............... .............. A

Insertion of pulse

5.51

NA 3.42 0.53

NA 9.46

090 generator. 33213............... .............. A

Insertion of pulse

6.36

NA 3.78 0.55

NA 10.69

090 generator. 33214............... .............. A

Upgrade of pacemaker

7.74

NA 4.99 0.63

NA 13.36

090 system. 33215............... .............. A

Reposition pacing-

4.75

NA 3.18 0.43

NA 8.36

090 defib lead. 33216............... .............. A

Insert lead pace-

5.77

NA 4.30 0.43

NA 10.50

090 defib, one. 33217............... .............. A

Insert lead pace-

5.74

NA 4.33 0.43

NA 10.50

090 defib, dual. 33218............... .............. A

Repair lead pace-

5.43

NA 4.37 0.48

NA 10.28

090 defib, one. 33220............... .............. A

Repair lead pace-

5.51

NA 4.34 0.47

NA 10.32

090 defib, dual. 33222............... .............. A

Revise pocket,

4.95

NA 4.36 0.47

NA 9.78

090 pacemaker. 33223............... .............. A

Revise pocket, pacing- 6.45

NA 4.64 0.53

NA 11.62

090 defib. 33224............... .............. A

Insert pacing lead &

9.04

NA 4.02 0.43

NA 13.49

000 connect. 33225............... .............. A

L ventric pacing lead 8.33

NA 3.23 0.43

NA 11.99

ZZZ add-on. 33226............... .............. A

Reposition l ventric

8.68

NA 3.88 0.43

NA 12.99

000 lead. 33233............... .............. A

Removal of pacemaker

3.29

NA 3.31 0.27

NA 6.87

090 system. 33234............... .............. A

Removal of pacemaker

7.81

NA 4.95 0.68

NA 13.44

090 system. 33235............... .............. A

Removal pacemaker

9.39

NA 6.86 0.82

NA 17.07

090 electrode. 33236............... .............. A

Remove electrode/

12.58

NA 7.48 1.80

NA 21.86

090 thoracotomy. 33237............... .............. A

Remove electrode/

13.69

NA 7.84 1.89

NA 23.42

090 thoracotomy. 33238............... .............. A

Remove electrode/

15.20

NA 8.26 1.88

NA 25.34

090 thoracotomy. 33240............... .............. A

Insert pulse

7.59

NA 4.66 0.64

NA 12.89

090 generator. 33241............... .............. A

Remove pulse

3.24

NA 2.99 0.25

NA 6.48

090 generator. 33243............... .............. A

Remove eltrd/

22.61

NA 11.50 3.05

NA 37.16

090 thoracotomy. 33244............... .............. A

Remove eltrd,

13.74

NA 8.96 1.27

NA 23.97

090 transven. 33245............... .............. A

Insert epic eltrd

14.28

NA 8.03 1.54

NA 23.85

090 pace-defib. 33246............... .............. A

Insert epic eltrd/

20.68

NA 10.41 2.68

NA 33.77

090 generator. 33249............... .............. A

Eltrd/insert pace-

14.21

NA 8.49 0.96

NA 23.66

090 defib. 33250............... .............. A

Ablate heart

21.82

NA 11.13 1.22

NA 34.17

090 dysrhythm focus. 33251............... .............. A

Ablate heart

24.84

NA 11.74 2.91

NA 39.49

090 dysrhythm focus. 33253............... .............. A

Reconstruct atria.... 31.01

NA 13.91 4.44

NA 49.36

090 33261............... .............. A

Ablate heart

24.84

NA 11.85 3.40

NA 40.09

090 dysrhythm focus. 33282............... .............. A

Implant pat-active ht 4.16

NA 4.11 0.47

NA 8.74

090 record. 33284............... .............. A

Remove pat-active ht

2.50

NA 3.58 0.28

NA 6.36

090 record. 33300............... .............. A

Repair of heart wound 17.89

NA 9.31 2.30

NA 29.50

090 33305............... .............. A

Repair of heart wound 21.41

NA 10.70 3.23

NA 35.34

090 33310............... .............. A

Exploratory heart

18.48

NA 9.65 2.73

NA 30.86

090 surgery. 33315............... .............. A

Exploratory heart

22.34

NA 10.95 3.50

NA 36.79

090 surgery. 33320............... .............. A

Repair major blood

16.76

NA 8.30 2.00

NA 27.06

090 vessel(s). 33321............... .............. A

Repair major vessel.. 20.17

NA 9.86 3.26

NA 33.29

090 33322............... .............. A

Repair major blood

20.59

NA 10.44 3.03

NA 34.06

090 vessel(s). 33330............... .............. A

Insert major vessel

21.40

NA 10.35 3.00

NA 34.75

090 graft. 33332............... .............. A

Insert major vessel

23.92

NA 10.59 2.95

NA 37.46

090 graft. 33335............... .............. A

Insert major vessel

29.96

NA 13.42 4.57

NA 47.95

090 graft. 33400............... .............. A

Repair of aortic

28.46

NA 15.73 3.73

NA 47.92

090 valve. 33401............... .............. A

Valvuloplasty, open.. 23.87

NA 13.57 3.27

NA 40.71

090 33403............... .............. A

Valvuloplasty, w/cp

24.85

NA 14.37 2.99

NA 42.21

090 bypass. 33404............... .............. A

Prepare heart-aorta

28.50

NA 14.58 3.99

NA 47.07

090 conduit. 33405............... .............. A

Replacement of aortic 34.95

NA 18.36 4.66

NA 57.97

090 valve. 33406............... .............. A

Replacement of aortic 37.44

NA 19.20 4.91

NA 61.55

090 valve. 33410............... .............. A

Replacement of aortic 32.41

NA 16.66 4.96

NA 54.03

090 valve. 33411............... .............. A

Replacement of aortic 36.20

NA 18.83 5.02

NA 60.05

090 valve. 33412............... .............. A

Replacement of aortic 41.94

NA 20.50 5.62

NA 68.06

090 valve. 33413............... .............. A

Replacement of aortic 43.43

NA 20.91 5.14

NA 69.48

090 valve.

[[Page 1149]]

33414............... .............. A

Repair of aortic

30.30

NA 14.23 4.57

NA 49.10

090 valve. 33415............... .............. A

Revision, subvalvular 27.11

NA 12.11 3.92

NA 43.14

090 tissue. 33416............... .............. A

Revise ventricle

30.30

NA 13.59 4.64

NA 48.53

090 muscle. 33417............... .............. A

Repair of aortic

28.49

NA 13.71 4.32

NA 46.52

090 valve. 33420............... .............. A

Revision of mitral

22.67

NA 9.66 1.79

NA 34.12

090 valve. 33422............... .............. A

Revision of mitral

25.90

NA 13.71 3.98

NA 43.59

090 valve. 33425............... .............. A

Repair of mitral

26.96

NA 13.10 3.62

NA 43.68

090 valve. 33426............... .............. A

Repair of mitral

32.95

NA 17.21 4.67

NA 54.83

090 valve. 33427............... .............. A

Repair of mitral

39.94

NA 19.44 5.19

NA 64.57

090 valve. 33430............... .............. A

Replacement of mitral 33.45

NA 17.37 4.76

NA 55.58

090 valve. 33460............... .............. A

Revision of tricuspid 23.56

NA 11.38 3.64

NA 38.58

090 valve. 33463............... .............. A

Valvuloplasty,

25.58

NA 12.99 3.82

NA 42.39

090 tricuspid. 33464............... .............. A

Valvuloplasty,

27.29

NA 13.60 4.19

NA 45.08

090 tricuspid. 33465............... .............. A

Replace tricuspid

28.75

NA 13.05 4.35

NA 46.15

090 valve. 33468............... .............. A

Revision of tricuspid 30.07

NA 13.76 4.82

NA 48.65

090 valve. 33470............... .............. A

Revision of pulmonary 20.78

NA 10.78 3.39

NA 34.95

090 valve. 33471............... .............. A

Valvotomy, pulmonary 22.22

NA 9.82 3.62

NA 35.66

090 valve. 33472............... .............. A

Revision of pulmonary 22.22

NA 11.97 3.52

NA 37.71

090 valve. 33474............... .............. A

Revision of pulmonary 23.01

NA 10.95 3.43

NA 37.39

090 valve. 33475............... .............. A

Replacement,

32.95

NA 15.48 3.18

NA 51.61

090 pulmonary valve. 33476............... .............. A

Revision of heart

25.73

NA 12.03 2.89

NA 40.65

090 chamber. 33478............... .............. A

Revision of heart

26.70

NA 13.13 4.29

NA 44.12

090 chamber. 33496............... .............. A

Repair, prosth valve 27.21

NA 12.83 4.15

NA 44.19

090 clot. 33500............... .............. A

Repair heart vessel

25.51

NA 11.54 3.38

NA 40.43

090 fistula. 33501............... .............. A

Repair heart vessel

17.75

NA 8.34 2.47

NA 28.56

090 fistula. 33502............... .............. A

Coronary artery

21.01

NA 11.15 3.03

NA 35.19

090 correction. 33503............... .............. A

Coronary artery graft 21.75

NA 9.83 1.71

NA 33.29

090 33504............... .............. A

Coronary artery graft 24.62

NA 11.91 3.67

NA 40.20

090 33505............... .............. A

Repair artery w/

26.80

NA 13.02 1.83

NA 41.65

090 tunnel. 33506............... .............. A

Repair artery,

35.45

NA 14.66 3.85

NA 53.96

090 translocation. 33508............... .............. A

Endoscopic vein

0.31

NA 0.10 0.04

NA 0.45

ZZZ harvest. 33510............... .............. A

CABG, vein, single... 28.96

NA 16.41 3.78

NA 49.15

090 33511............... .............. A

CABG, vein, two...... 29.96

NA 17.15 4.03

NA 51.14

090 33512............... .............. A

CABG, vein, three.... 31.75

NA 17.68 4.46

NA 53.89

090 33513............... .............. A

CABG, vein, four..... 31.95

NA 17.86 4.81

NA 54.62

090 33514............... .............. A

CABG, vein, five..... 32.70

NA 18.14 5.27

NA 56.11

090 33516............... .............. A

Cabg, vein, six or

34.95

NA 18.88 5.57

NA 59.40

090 more. 33517............... .............. A

CABG, artery-vein,

2.57

NA 0.84 0.39

NA 3.80

ZZZ single. 33518............... .............. A

CABG, artery-vein,

4.84

NA 1.59 0.74

NA 7.17

ZZZ two. 33519............... .............. A

CABG, artery-vein,

7.11

NA 2.33 1.07

NA 10.51

ZZZ three. 33521............... .............. A

CABG, artery-vein,

9.39

NA 3.08 1.42

NA 13.89

ZZZ four. 33522............... .............. A

CABG, artery-vein,

11.65

NA 3.82 1.79

NA 17.26

ZZZ five. 33523............... .............. A

Cabg, art-vein, six

13.93

NA 4.55 2.15

NA 20.63

ZZZ or more. 33530............... .............. A

Coronary artery,

5.85

NA 1.91 0.88

NA 8.64

ZZZ bypass/reop. 33533............... .............. A

CABG, arterial,

29.96

NA 16.54 3.91

NA 50.41

090 single. 33534............... .............. A

CABG, arterial, two.. 32.15

NA 17.79 4.38

NA 54.32

090 33535............... .............. A

CABG, arterial, three 34.45

NA 18.22 4.79

NA 57.46

090 33536............... .............. A

Cabg, arterial, four 37.44

NA 18.38 3.97

NA 59.79

090 or more. 33542............... .............. A

Removal of heart

28.81

NA 13.08 4.35

NA 46.24

090 lesion. 33545............... .............. A

Repair of heart

36.72

NA 15.73 5.31

NA 57.76

090 damage. 33572............... .............. A

Open coronary

4.44

NA 1.46 0.66

NA 6.56

ZZZ endarterectomy. 33600............... .............. A

Closure of valve..... 29.47

NA 12.62 2.77

NA 44.86

090 33602............... .............. A

Closure of valve..... 28.50

NA 12.54 3.50

NA 44.54

090 33606............... .............. A

Anastomosis/artery-

30.69

NA 13.75 4.33

NA 48.77

090 aorta. 33608............... .............. A

Repair anomaly w/

31.04

NA 14.19 5.03

NA 50.26

090 conduit. 33610............... .............. A

Repair by enlargement 30.56

NA 14.20 4.85

NA 49.61

090 33611............... .............. A

Repair double

33.95

NA 14.23 3.96

NA 52.14

090 ventricle. 33612............... .............. A

Repair double

34.95

NA 15.25 5.36

NA 55.56

090 ventricle. 33615............... .............. A

Repair, modified

33.95

NA 15.14 3.80

NA 52.89

090 fontan. 33617............... .............. A

Repair single

36.94

NA 16.11 4.93

NA 57.98

090 ventricle. 33619............... .............. A

Repair single

44.93

NA 20.94 5.68

NA 71.55

090 ventricle. 33641............... .............. A

Repair heart septum

21.36

NA 9.64 3.22

NA 34.22

090 defect. 33645............... .............. A

Revision of heart

24.78

NA 11.84 3.94

NA 40.56

090 veins. 33647............... .............. A

Repair heart septum

28.69

NA 13.86 4.06

NA 46.61

090 defects. 33660............... .............. A

Repair of heart

29.96

NA 13.58 3.40

NA 46.94

090 defects. 33665............... .............. A

Repair of heart

28.56

NA 13.91 4.60

NA 47.07

090 defects. 33670............... .............. A

Repair of heart

34.95

NA 13.39 2.63

NA 50.97

090 chambers. 33681............... .............. A

Repair heart septum

30.56

NA 14.77 4.26

NA 49.59

090 defect. 33684............... .............. A

Repair heart septum

29.61

NA 13.71 4.55

NA 47.87

090 defect. 33688............... .............. A

Repair heart septum

30.57

NA 10.58 4.69

NA 45.84

090 defect. 33690............... .............. A

Reinforce pulmonary

19.52

NA 10.32 3.09

NA 32.93

090 artery. 33692............... .............. A

Repair of heart

30.70

NA 14.02 4.55

NA 49.27

090 defects. 33694............... .............. A

Repair of heart

33.95

NA 14.32 5.15

NA 53.42

090 defects. 33697............... .............. A

Repair of heart

35.95

NA 14.95 5.48

NA 56.38

090 defects. 33702............... .............. A

Repair of heart

26.50

NA 12.65 4.16

NA 43.31

090 defects.

[[Page 1150]]

33710............... .............. A

Repair of heart

29.67

NA 14.08 4.64

NA 48.39

090 defects. 33720............... .............. A

Repair of heart

26.52

NA 12.36 3.87

NA 42.75

090 defect. 33722............... .............. A

Repair of heart

28.37

NA 13.94 4.58

NA 46.89

090 defect. 33730............... .............. A

Repair heart-vein

34.20

NA 14.23 3.44

NA 51.87

090 defect(s). 33732............... .............. A

Repair heart-vein

28.12

NA 13.50 3.35

NA 44.97

090 defect. 33735............... .............. A

Revision of heart

21.36

NA 10.08 1.35

NA 32.79

090 chamber. 33736............... .............. A

Revision of heart

23.48

NA 11.95 3.26

NA 38.69

090 chamber. 33737............... .............. A

Revision of heart

21.73

NA 11.02 3.53

NA 36.28

090 chamber. 33750............... .............. A

Major vessel shunt... 21.38

NA 10.31 2.10

NA 33.79

090 33755............... .............. A

Major vessel shunt... 21.76

NA 8.86 3.53

NA 34.15

090 33762............... .............. A

Major vessel shunt... 21.76

NA 10.24 1.92

NA 33.92

090 33764............... .............. A

Major vessel shunt & 21.76

NA 10.31 2.33

NA 34.40

090 graft. 33766............... .............. A

Major vessel shunt... 22.73

NA 11.73 3.67

NA 38.13

090 33767............... .............. A

Major vessel shunt... 24.46

NA 11.81 3.79

NA 40.06

090 33770............... .............. A

Repair great vessels 36.94

NA 14.77 5.42

NA 57.13

090 defect. 33771............... .............. A

Repair great vessels 34.60

NA 12.48 5.63

NA 52.71

090 defect. 33774............... .............. A

Repair great vessels 30.93

NA 14.23 5.04

NA 50.20

090 defect. 33775............... .............. A

Repair great vessels 32.15

NA 14.28 5.23

NA 51.66

090 defect. 33776............... .............. A

Repair great vessels 33.99

NA 15.88 5.52

NA 55.39

090 defect. 33777............... .............. A

Repair great vessels 33.41

NA 14.95 5.44

NA 53.80

090 defect. 33778............... .............. A

Repair great vessels 39.94

NA 16.98 5.83

NA 62.75

090 defect. 33779............... .............. A

Repair great vessels 36.16

NA 15.49 2.89

NA 54.54

090 defect. 33780............... .............. A

Repair great vessels 41.69

NA 19.13 6.28

NA 67.10

090 defect. 33781............... .............. A

Repair great vessels 36.40

NA 13.56 5.92

NA 55.88

090 defect. 33786............... .............. A

Repair arterial trunk 38.94

NA 16.79 5.66

NA 61.39

090 33788............... .............. A

Revision of pulmonary 26.58

NA 12.03 4.00

NA 42.61

090 artery. 33800............... .............. A

Aortic suspension.... 16.22

NA 8.21 1.34

NA 25.77

090 33802............... .............. A

Repair vessel defect. 17.63

NA 9.30 1.88

NA 28.81

090 33803............... .............. A

Repair vessel defect. 19.57

NA 9.84 3.17

NA 32.58

090 33813............... .............. A

Repair septal defect. 20.62

NA 10.99 3.35

NA 34.96

090 33814............... .............. A

Repair septal defect. 25.73

NA 12.73 3.04

NA 41.50

090 33820............... .............. A

Revise major vessel.. 16.27

NA 8.39 2.53

NA 27.19

090 33822............... .............. A

Revise major vessel.. 17.29

NA 9.03 2.81

NA 29.13

090 33824............... .............. A

Revise major vessel.. 19.49

NA 10.06 3.15

NA 32.70

090 33840............... .............. A

Remove aorta

20.60

NA 10.36 2.85

NA 33.81

090 constriction. 33845............... .............. A

Remove aorta

22.09

NA 11.42 3.50

NA 37.01

090 constriction. 33851............... .............. A

Remove aorta

21.24

NA 10.78 3.45

NA 35.47

090 constriction. 33852............... .............. A

Repair septal defect. 23.67

NA 11.45 3.85

NA 38.97

090 33853............... .............. A

Repair septal defect. 31.67

NA 14.92 5.10

NA 51.69

090 33860............... .............. A

Ascending aortic

37.94

NA 16.55 5.19

NA 59.68

090 graft. 33861............... .............. A

Ascending aortic

41.94

NA 17.81 5.11

NA 64.86

090 graft. 33863............... .............. A

Ascending aortic

44.93

NA 18.80 5.55

NA 69.28

090 graft. 33870............... .............. A

Transverse aortic

43.93

NA 18.49 6.14

NA 68.56

090 arch graft. 33875............... .............. A

Thoracic aortic graft 33.01

NA 14.18 4.92

NA 52.11

090 33877............... .............. A

Thoracoabdominal

42.54

NA 16.43 6.11

NA 65.08

090 graft. 33910............... .............. A

Remove lung artery

24.55

NA 11.52 3.69

NA 39.76

090 emboli. 33915............... .............. A

Remove lung artery

20.99

NA 9.68 1.45

NA 32.12

090 emboli. 33916............... .............. A

Surgery of great

25.79

NA 11.43 3.67

NA 40.89

090 vessel. 33917............... .............. A

Repair pulmonary

24.46

NA 12.27 3.82

NA 40.55

090 artery. 33918............... .............. A

Repair pulmonary

26.41

NA 12.19 4.12

NA 42.72

090 atresia. 33919............... .............. A

Repair pulmonary

39.94

NA 17.62 4.20

NA 61.76

090 atresia. 33920............... .............. A

Repair pulmonary

31.90

NA 13.92 4.35

NA 50.17

090 atresia. 33922............... .............. A

Transect pulmonary

23.48

NA 10.98 2.77

NA 37.23

090 artery. 33924............... .............. A

Remove pulmonary

5.49

NA 1.85 0.89

NA 8.23

ZZZ shunt. 33930............... .............. X

Removal of donor

0.00 0.00 0.00 0.00 0.00 0.00

XXX heart/lung. 33935............... .............. R

Transplantation,

60.87

NA 29.07 9.83

NA 99.77

090 heart/lung. 33940............... .............. X

Removal of donor

0.00 0.00 0.00 0.00 0.00 0.00

XXX heart. 33945............... .............. R

Transplantation of

42.04

NA 21.66 6.54

NA 70.24

090 heart. 33960............... .............. A

External circulation 19.33

NA 4.93 2.58

NA 26.84

000 assist. 33961............... .............. A

External circulation 10.91

NA 3.63 1.77

NA 16.31

ZZZ assist. 33967............... .............. A

Insert ia percut

4.84

NA 1.85 0.34

NA 7.03

000 device. 33968............... .............. A

Remove aortic assist

0.64

NA 0.23 0.08

NA 0.95

000 device. 33970............... .............. A

Aortic circulation

6.74

NA 2.29 0.84

NA 9.87

000 assist. 33971............... .............. A

Aortic circulation

9.68

NA 6.07 1.17

NA 16.92

090 assist. 33973............... .............. A

Insert balloon device 9.75

NA 3.32 1.22

NA 14.29

000 33974............... .............. A

Remove intra-aortic

14.39

NA 7.95 1.79

NA 24.13

090 balloon. 33975............... .............. A

Implant ventricular

20.97

NA 6.31 2.07

NA 29.35

XXX device. 33976............... .............. A

Implant ventricular

22.97

NA 7.58 3.40

NA 33.95

XXX device. 33977............... .............. A

Remove ventricular

19.26

NA 11.13 2.94

NA 33.33

090 device. 33978............... .............. A

Remove ventricular

21.70

NA 11.80 3.21

NA 36.71

090 device. 33979............... .............. A

Insert intracorporeal 45.93

NA 14.97 4.80

NA 65.70

XXX device. 33980............... .............. A

Remove intracorporeal 56.17

NA 25.52 5.55

NA 87.24

090 device. 33999............... .............. C

Cardiac surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 34001............... .............. A

Removal of artery

12.89

NA 6.75 1.76

NA 21.40

090 clot. 34051............... .............. A

Removal of artery

15.19

NA 7.82 2.29

NA 25.30

090 clot.

[[Page 1151]]

34101............... .............. A

Removal of artery

9.99

NA 5.38 1.34

NA 16.71

090 clot. 34111............... .............. A

Removal of arm artery 9.99

NA 5.38 1.03

NA 16.40

090 clot. 34151............... .............. A

Removal of artery

24.96

NA 10.45 2.22

NA 37.63

090 clot. 34201............... .............. A

Removal of artery

10.01

NA 5.45 1.23

NA 16.69

090 clot. 34203............... .............. A

Removal of leg artery 16.48

NA 8.09 1.65

NA 26.22

090 clot. 34401............... .............. A

Removal of vein clot. 24.96

NA 10.72 1.45

NA 37.13

090 34421............... .............. A

Removal of vein clot. 11.98

NA 6.33 1.15

NA 19.46

090 34451............... .............. A

Removal of vein clot. 26.96

NA 11.49 1.92

NA 40.37

090 34471............... .............. A

Removal of vein clot. 10.16

NA 5.35 1.09

NA 16.60

090 34490............... .............. A

Removal of vein clot. 9.85

NA 5.46 0.88

NA 16.19

090 34501............... .............. A

Repair valve, femoral 15.98

NA 8.55 1.65

NA 26.18

090 vein. 34502............... .............. A

Reconstruct vena cava 26.91

NA 12.34 3.61

NA 42.86

090 34510............... .............. A

Transposition of vein 18.92

NA 9.48 1.93

NA 30.33

090 valve. 34520............... .............. A

Cross-over vein graft 17.92

NA 8.72 1.70

NA 28.34

090 34530............... .............. A

Leg vein fusion...... 16.62

NA 8.65 2.48

NA 27.75

090 34800............... .............. A

Endovasc abdo repair 20.72

NA 9.21 1.80

NA 31.73

090 w/tube. 34802............... .............. A

Endovasc abdo repr w/ 22.97

NA 9.83 1.99

NA 34.79

090 device. 34804............... .............. A

Endovasc abdo repr w/ 22.97

NA 9.84 1.99

NA 34.80

090 device. 34805............... .............. A

Endovasc abdo repair 21.85

NA 9.46 1.99

NA 33.30

090 w/pros. 34808............... .............. A

Endovasc abdo occlud

4.12

NA 1.38 0.35

NA 5.85

ZZZ device. 34812............... .............. A

Xpose for endoprosth, 6.74

NA 2.24 0.59

NA 9.57

000 femorl. 34813............... .............. A

Femoral endovas graft 4.79

NA 1.58 0.41

NA 6.78

ZZZ add-on. 34820............... .............. A

Xpose for endoprosth, 9.74

NA 3.25 0.84

NA 13.83

000 iliac. 34825............... .............. A

Endovasc extend

11.98

NA 6.17 1.04

NA 19.19

090 prosth, init. 34826............... .............. A

Endovasc exten

4.12

NA 1.38 0.35

NA 5.85

ZZZ prosth, add'l. 34830............... .............. A

Open aortic tube

32.54

NA 13.76 2.82

NA 49.12

090 prosth repr. 34831............... .............. A

Open aortoiliac

35.29

NA 11.80 3.05

NA 50.14

090 prosth repr. 34832............... .............. A

Open aortofemor

35.29

NA 14.68 3.05

NA 53.02

090 prosth repr. 34833............... .............. A

Xpose for endoprosth, 11.98

NA 4.51 0.84

NA 17.33

000 iliac. 34834............... .............. A

Xpose, endoprosth,

5.34

NA 2.23 0.59

NA 8.16

000 brachial. 34900............... .............. A

Endovasc iliac repr w/ 16.36

NA 7.82 1.80

NA 25.98

090 graft. 35001............... .............. A

Repair defect of

19.61

NA 9.59 2.94

NA 32.14

090 artery. 35002............... .............. A

Repair artery

20.97

NA 9.74 2.20

NA 32.91

090 rupture, neck. 35005............... .............. A

Repair defect of

18.09

NA 8.89 1.63

NA 28.61

090 artery. 35011............... .............. A

Repair defect of

17.97

NA 8.02 1.57

NA 27.56

090 artery. 35013............... .............. A

Repair artery

21.97

NA 9.73 2.30

NA 34.00

090 rupture, arm. 35021............... .............. A

Repair defect of

19.62

NA 9.50 2.33

NA 31.45

090 artery. 35022............... .............. A

Repair artery

23.15

NA 10.10 2.40

NA 35.65

090 rupture, chest. 35045............... .............. A

Repair defect of arm 17.54

NA 7.58 1.51

NA 26.63

090 artery. 35081............... .............. A

Repair defect of

27.97

NA 11.51 3.86

NA 43.34

090 artery. 35082............... .............. A

Repair artery

38.44

NA 15.35 4.91

NA 58.70

090 rupture, aorta. 35091............... .............. A

Repair defect of

35.35

NA 13.63 4.93

NA 53.91

090 artery. 35092............... .............. A

Repair artery

44.93

NA 17.70 5.20

NA 67.83

090 rupture, aorta. 35102............... .............. A

Repair defect of

30.71

NA 12.41 4.15

NA 47.27

090 artery. 35103............... .............. A

Repair artery

40.44

NA 15.92 4.57

NA 60.93

090 rupture, groin. 35111............... .............. A

Repair defect of

24.96

NA 10.51 2.18

NA 37.65

090 artery. 35112............... .............. A

Repair artery

29.96

NA 12.01 2.35

NA 44.32

090 rupture,spleen. 35121............... .............. A

Repair defect of

29.96

NA 12.42 3.53

NA 45.91

090 artery. 35122............... .............. A

Repair artery

34.95

NA 13.86 4.27

NA 53.08

090 rupture, belly. 35131............... .............. A

Repair defect of

24.96

NA 10.80 2.54

NA 38.30

090 artery. 35132............... .............. A

Repair artery

29.96

NA 12.42 2.99

NA 45.37

090 rupture, groin. 35141............... .............. A

Repair defect of

19.97

NA 8.95 1.99

NA 30.91

090 artery. 35142............... .............. A

Repair artery

23.27

NA 10.40 2.11

NA 35.78

090 rupture, thigh. 35151............... .............. A

Repair defect of

22.61

NA 10.04 2.33

NA 34.98

090 artery. 35152............... .............. A

Repair artery

25.58

NA 11.43 2.33

NA 39.34

090 rupture, knee. 35161............... .............. A

Repair defect of

18.73

NA 9.19 2.67

NA 30.59

090 artery. 35162............... .............. A

Repair artery rupture 19.75

NA 9.61 2.67

NA 32.03

090 35180............... .............. A

Repair blood vessel

13.60

NA 6.98 1.74

NA 22.32

090 lesion. 35182............... .............. A

Repair blood vessel

29.96

NA 12.85 2.27

NA 45.08

090 lesion. 35184............... .............. A

Repair blood vessel

17.97

NA 8.34 1.62

NA 27.93

090 lesion. 35188............... .............. A

Repair blood vessel

14.26

NA 7.67 1.85

NA 23.78

090 lesion. 35189............... .............. A

Repair blood vessel

27.96

NA 12.00 2.56

NA 42.52

090 lesion. 35190............... .............. A

Repair blood vessel

12.73

NA 6.50 1.60

NA 20.83

090 lesion. 35201............... .............. A

Repair blood vessel

16.12

NA 8.02 1.41

NA 25.55

090 lesion. 35206............... .............. A

Repair blood vessel

13.23

NA 6.61 1.25

NA 21.09

090 lesion. 35207............... .............. A

Repair blood vessel

10.13

NA 7.51 1.39

NA 19.03

090 lesion. 35211............... .............. A

Repair blood vessel

22.09

NA 10.70 3.41

NA 36.20

090 lesion. 35216............... .............. A

Repair blood vessel

18.72

NA 9.04 2.62

NA 30.38

090 lesion. 35221............... .............. A

Repair blood vessel

24.35

NA 9.98 2.16

NA 36.49

090 lesion. 35226............... .............. A

Repair blood vessel

14.48

NA 7.52 1.01

NA 23.01

090 lesion. 35231............... .............. A

Repair blood vessel

19.97

NA 9.81 1.59

NA 31.37

090 lesion. 35236............... .............. A

Repair blood vessel

17.08

NA 7.95 1.44

NA 26.47

090 lesion. 35241............... .............. A

Repair blood vessel

23.09

NA 11.20 3.50

NA 37.79

090 lesion. 35246............... .............. A

Repair blood vessel

26.41

NA 11.51 2.68

NA 40.60

090 lesion. 35251............... .............. A

Repair blood vessel

30.15

NA 11.84 2.26

NA 44.25

090 lesion.

[[Page 1152]]

35256............... .............. A

Repair blood vessel

18.33

NA 8.43 1.59

NA 28.35

090 lesion. 35261............... .............. A

Repair blood vessel

17.77

NA 8.05 1.62

NA 27.44

090 lesion. 35266............... .............. A

Repair blood vessel

14.89

NA 7.06 1.40

NA 23.35

090 lesion. 35271............... .............. A

Repair blood vessel

22.09

NA 10.59 3.34

NA 36.02

090 lesion. 35276............... .............. A

Repair blood vessel

24.21

NA 11.28 2.86

NA 38.35

090 lesion. 35281............... .............. A

Repair blood vessel

27.96

NA 11.75 2.20

NA 41.91

090 lesion. 35286............... .............. A

Repair blood vessel

16.14

NA 8.12 1.64

NA 25.90

090 lesion. 35301............... .............. A

Rechanneling of

18.67

NA 8.50 2.69

NA 29.86

090 artery. 35311............... .............. A

Rechanneling of

26.96

NA 11.79 3.32

NA 42.07

090 artery. 35321............... .............. A

Rechanneling of

15.98

NA 7.41 1.64

NA 25.03

090 artery. 35331............... .............. A

Rechanneling of

26.16

NA 11.28 3.27

NA 40.71

090 artery. 35341............... .............. A

Rechanneling of

25.07

NA 10.91 3.46

NA 39.44

090 artery. 35351............... .............. A

Rechanneling of

22.97

NA 9.64 2.76

NA 35.37

090 artery. 35355............... .............. A

Rechanneling of

18.47

NA 8.12 2.17

NA 28.76

090 artery. 35361............... .............. A

Rechanneling of

28.16

NA 11.75 3.21

NA 43.12

090 artery. 35363............... .............. A

Rechanneling of

30.15

NA 12.63 3.34

NA 46.12

090 artery. 35371............... .............. A

Rechanneling of

14.70

NA 6.99 1.59

NA 23.28

090 artery. 35372............... .............. A

Rechanneling of

17.97

NA 8.08 1.85

NA 27.90

090 artery. 35381............... .............. A

Rechanneling of

15.79

NA 7.85 2.17

NA 25.81

090 artery. 35390............... .............. A

Reoperation, carotid

3.19

NA 1.07 0.46

NA 4.72

ZZZ add-on. 35400............... .............. A

Angioscopy........... 3.00

NA 1.12 0.41

NA 4.53

ZZZ 35450............... .............. A

Repair arterial

10.05

NA 4.04 1.01

NA 15.10

000 blockage. 35452............... .............. A

Repair arterial

6.90

NA 3.17 0.92

NA 10.99

000 blockage. 35454............... .............. A

Repair arterial

6.03

NA 2.84 0.81

NA 9.68

000 blockage. 35456............... .............. A

Repair arterial

7.34

NA 3.29 0.99

NA 11.62

000 blockage. 35458............... .............. A

Repair arterial

9.48

NA 4.01 1.31

NA 14.80

000 blockage. 35459............... .............. A

Repair arterial

8.62

NA 3.64 1.16

NA 13.42

000 blockage. 35460............... .............. A

Repair venous

6.03

NA 2.68 0.80

NA 9.51

000 blockage. 35470............... .............. A

Repair arterial

8.62

NA 3.85 0.60

NA 13.07

000 blockage. 35471............... .............. A

Repair arterial

10.05

NA 4.45 0.60

NA 15.10

000 blockage. 35472............... .............. A

Repair arterial

6.90

NA 3.24 0.47

NA 10.61

000 blockage. 35473............... .............. A

Repair arterial

6.03

NA 2.92 0.41

NA 9.36

000 blockage. 35474............... .............. A

Repair arterial

7.35

NA 2.88 0.48

NA 10.71

000 blockage. 35475............... .............. R

Repair arterial

9.48

NA 4.06 0.57

NA 14.11

000 blockage. 35476............... .............. A

Repair venous

6.03

NA 2.85 0.33

NA 9.21

000 blockage. 35480............... .............. A

Atherectomy, open.... 11.06

NA 4.51 1.36

NA 16.93

000 35481............... .............. A

Atherectomy, open.... 7.60

NA 3.48 1.01

NA 12.09

000 35482............... .............. A

Atherectomy, open.... 6.64

NA 3.09 0.90

NA 10.63

000 35483............... .............. A

Atherectomy, open.... 8.09

NA 3.54 0.98

NA 12.61

000 35484............... .............. A

Atherectomy, open.... 10.42

NA 4.23 1.36

NA 16.01

000 35485............... .............. A

Atherectomy, open.... 9.48

NA 4.06 1.28

NA 14.82

000 35490............... .............. A

Atherectomy,

11.06

NA 4.71 0.66

NA 16.43

000 percutaneous. 35491............... .............. A

Atherectomy,

7.60

NA 3.30 0.59

NA 11.49

000 percutaneous. 35492............... .............. A

Atherectomy,

6.64

NA 3.19 0.52

NA 10.35

000 percutaneous. 35493............... .............. A

Atherectomy,

8.09

NA 3.81 0.57

NA 12.47

000 percutaneous. 35494............... .............. A

Atherectomy,

10.42

NA 4.40 0.58

NA 15.40

000 percutaneous. 35495............... .............. A

Atherectomy,

9.48

NA 4.39 0.62

NA 14.49

000 percutaneous. 35500............... .............. A

Harvest vein for

6.44

NA 2.03 0.76

NA 9.23

ZZZ bypass. 35501............... .............. A

Artery bypass graft.. 19.16

NA 8.51 2.81

NA 30.48

090 35506............... .............. A

Artery bypass graft.. 19.64

NA 9.51 2.81

NA 31.96

090 35507............... .............. A

Artery bypass graft.. 19.64

NA 9.46 2.74

NA 31.84

090 35508............... .............. A

Artery bypass graft.. 18.62

NA 9.48 2.82

NA 30.92

090 35509............... .............. A

Artery bypass graft.. 18.04

NA 8.80 2.56

NA 29.40

090 35510............... .............. A

Artery bypass graft.. 22.97

NA 10.17 2.10

NA 35.24

090 35511............... .............. A

Artery bypass graft.. 21.17

NA 9.39 2.10

NA 32.66

090 35512............... .............. A

Artery bypass graft.. 22.47

NA 10.00 2.10

NA 34.57

090 35515............... .............. A

Artery bypass graft.. 18.62

NA 9.33 2.73

NA 30.68

090 35516............... .............. A

Artery bypass graft.. 16.30

NA 6.84 2.27

NA 25.41

090 35518............... .............. A

Artery bypass graft.. 21.17

NA 9.02 2.15

NA 32.34

090 35521............... .............. A

Artery bypass graft.. 22.17

NA 9.87 2.20

NA 34.24

090 35522............... .............. A

Artery bypass graft.. 21.73

NA 9.74 2.10

NA 33.57

090 35525............... .............. A

Artery bypass graft.. 20.60

NA 9.35 2.10

NA 32.05

090 35526............... .............. A

Artery bypass graft.. 29.91

NA 12.56 2.63

NA 45.10

090 35531............... .............. A

Artery bypass graft.. 36.15

NA 14.54 3.51

NA 54.20

090 35533............... .............. A

Artery bypass graft.. 27.96

NA 11.77 2.83

NA 42.56

090 35536............... .............. A

Artery bypass graft.. 31.65

NA 13.00 3.16

NA 47.81

090 35541............... .............. A

Artery bypass graft.. 25.76

NA 11.25 3.30

NA 40.31

090 35546............... .............. A

Artery bypass graft.. 25.50

NA 10.91 3.43

NA 39.84

090 35548............... .............. A

Artery bypass graft.. 21.54

NA 9.46 2.95

NA 33.95

090 35549............... .............. A

Artery bypass graft.. 23.31

NA 10.42 3.34

NA 37.07

090 35551............... .............. A

Artery bypass graft.. 26.63

NA 11.56 3.85

NA 42.04

090 35556............... .............. A

Artery bypass graft.. 21.73

NA 9.77 2.99

NA 34.49

090 35558............... .............. A

Artery bypass graft.. 21.17

NA 9.59 1.91

NA 32.67

090 35560............... .............. A

Artery bypass graft.. 31.95

NA 13.37 3.29

NA 48.61

090 35563............... .............. A

Artery bypass graft.. 24.16

NA 10.57 2.03

NA 36.76

090

[[Page 1153]]

35565............... .............. A

Artery bypass graft.. 23.17

NA 10.17 2.06

NA 35.40

090 35566............... .............. A

Artery bypass graft.. 26.88

NA 11.45 3.64

NA 41.97

090 35571............... .............. A

Artery bypass graft.. 24.02

NA 10.91 2.58

NA 37.51

090 35572............... .............. A

Harvest

6.81

NA 2.34 0.76

NA 9.91

ZZZ femoropopliteal vein. 35582............... .............. A

Vein bypass graft.... 27.09

NA 11.62 3.75

NA 42.46

090 35583............... .............. A

Vein bypass graft.... 22.34

NA 10.21 3.05

NA 35.60

090 35585............... .............. A

Vein bypass graft.... 28.35

NA 12.32 3.87

NA 44.54

090 35587............... .............. A

Vein bypass graft.... 24.71

NA 11.54 2.62

NA 38.87

090 35600............... .............. A

Harvest artery for

4.94

NA 1.63 0.72

NA 7.29

ZZZ cabg. 35601............... .............. A

Artery bypass graft.. 17.47

NA 8.66 2.51

NA 28.64

090 35606............... .............. A

Artery bypass graft.. 18.68

NA 9.06 2.62

NA 30.36

090 35612............... .............. A

Artery bypass graft.. 15.74

NA 7.92 2.07

NA 25.73

090 35616............... .............. A

Artery bypass graft.. 15.68

NA 8.14 2.22

NA 26.04

090 35621............... .............. A

Artery bypass graft.. 19.97

NA 8.71 2.03

NA 30.71

090 35623............... .............. A

Bypass graft, not

23.96

NA 10.54 2.30

NA 36.80

090 vein. 35626............... .............. A

Artery bypass graft.. 27.71

NA 12.03 3.49

NA 43.23

090 35631............... .............. A

Artery bypass graft.. 33.95

NA 13.88 3.41

NA 51.24

090 35636............... .............. A

Artery bypass graft.. 29.46

NA 12.35 2.86

NA 44.67

090 35641............... .............. A

Artery bypass graft.. 24.53

NA 11.11 3.41

NA 39.05

090 35642............... .............. A

Artery bypass graft.. 17.95

NA 8.72 2.22

NA 28.89

090 35645............... .............. A

Artery bypass graft.. 17.44

NA 8.31 2.30

NA 28.05

090 35646............... .............. A

Artery bypass graft.. 30.95

NA 13.15 4.38

NA 48.48

090 35647............... .............. A

Artery bypass graft.. 27.96

NA 11.82 3.96

NA 43.74

090 35650............... .............. A

Artery bypass graft.. 18.97

NA 8.40 1.98

NA 29.35

090 35651............... .............. A

Artery bypass graft.. 25.00

NA 10.89 3.05

NA 38.94

090 35654............... .............. A

Artery bypass graft.. 24.96

NA 10.70 2.53

NA 38.19

090 35656............... .............. A

Artery bypass graft.. 19.50

NA 8.64 2.67

NA 30.81

090 35661............... .............. A

Artery bypass graft.. 18.97

NA 8.96 1.81

NA 29.74

090 35663............... .............. A

Artery bypass graft.. 21.97

NA 10.02 1.87

NA 33.86

090 35665............... .............. A

Artery bypass graft.. 20.97

NA 9.48 2.12

NA 32.57

090 35666............... .............. A

Artery bypass graft.. 22.16

NA 10.72 2.64

NA 35.52

090 35671............... .............. A

Artery bypass graft.. 19.30

NA 9.43 2.03

NA 30.76

090 35681............... .............. A

Composite bypass

1.60

NA 0.53 0.22

NA 2.35

ZZZ graft. 35682............... .............. A

Composite bypass

7.19

NA 2.40 1.00

NA 10.59

ZZZ graft. 35683............... .............. A

Composite bypass

8.49

NA 2.83 1.18

NA 12.50

ZZZ graft. 35685............... .............. A

Bypass graft patency/ 4.04

NA 1.35 0.30

NA 5.69

ZZZ patch. 35686............... .............. A

Bypass graft/av fist

3.34

NA 1.13 0.25

NA 4.72

ZZZ patency. 35691............... .............. A

Arterial

18.02

NA 8.45 2.48

NA 28.95

090 transposition. 35693............... .............. A

Arterial

15.34

NA 7.76 2.17

NA 25.27

090 transposition. 35694............... .............. A

Arterial

19.13

NA 8.64 2.57

NA 30.34

090 transposition. 35695............... .............. A

Arterial

19.13

NA 8.60 2.64

NA 30.37

090 transposition. 35697............... .............. A

Reimplant artery each 3.00

NA 1.03 0.41

NA 4.44

ZZZ 35700............... .............. A

Reoperation, bypass

3.08

NA 1.03 0.43

NA 4.54

ZZZ graft. 35701............... .............. A

Exploration, carotid

8.49

NA 5.18 0.77

NA 14.44

090 artery. 35721............... .............. A

Exploration, femoral

7.17

NA 4.48 0.71

NA 12.36

090 artery. 35741............... .............. A

Exploration popliteal 7.99

NA 4.71 0.72

NA 13.42

090 artery. 35761............... .............. A

Exploration of artery/ 5.36

NA 4.07 0.72

NA 10.15

090 vein. 35800............... .............. A

Explore neck vessels. 7.01

NA 4.68 0.95

NA 12.64

090 35820............... .............. A

Explore chest vessels 12.86

NA 7.20 1.94

NA 22.00

090 35840............... .............. A

Explore abdominal

9.76

NA 5.31 1.28

NA 16.35

090 vessels. 35860............... .............. A

Explore limb vessels. 5.54

NA 4.06 0.76

NA 10.36

090 35870............... .............. A

Repair vessel graft

22.14

NA 9.81 2.98

NA 34.93

090 defect. 35875............... .............. A

Removal of clot in

10.11

NA 5.24 1.17

NA 16.52

090 graft. 35876............... .............. A

Removal of clot in

16.97

NA 7.59 2.27

NA 26.83

090 graft. 35879............... .............. A

Revise graft w/vein.. 15.98

NA 7.75 1.63

NA 25.36

090 35881............... .............. A

Revise graft w/vein.. 17.97

NA 8.75 1.74

NA 28.46

090 35901............... .............. A

Excision, graft, neck 8.18

NA 5.36 1.09

NA 14.63

090 35903............... .............. A

Excision, graft,

9.38

NA 6.01 1.24

NA 16.63

090 extremity. 35905............... .............. A

Excision, graft,

31.20

NA 13.26 2.59

NA 47.05

090 thorax. 35907............... .............. A

Excision, graft,

34.95

NA 14.11 2.62

NA 51.68

090 abdomen. 36000............... .............. A

Place needle in vein. 0.18 0.60 0.05 0.01 0.79 0.24

XXX 36002............... .............. A

Pseudoaneurysm

1.96 2.91 0.99 0.12 4.99 3.07

000 injection trt. 36005............... .............. A

Injection ext

0.95 8.47 0.32 0.05 9.47 1.32

000 venography. 36010............... .............. A

Place catheter in

2.43

NA 0.79 0.19

NA 3.41

XXX vein. 36011............... .............. A

Place catheter in

3.14

NA 1.03 0.21

NA 4.38

XXX vein. 36012............... .............. A

Place catheter in

3.51

NA 1.15 0.21

NA 4.87

XXX vein. 36013............... .............. A

Place catheter in

2.52

NA 0.66 0.21

NA 3.39

XXX artery. 36014............... .............. A

Place catheter in

3.02

NA 0.99 0.17

NA 4.18

XXX artery. 36015............... .............. A

Place catheter in

3.51

NA 1.15 0.19

NA 4.85

XXX artery. 36100............... .............. A

Establish access to

3.02

NA 1.10 0.22

NA 4.34

XXX artery. 36120............... .............. A

Establish access to

2.01

NA 0.65 0.13

NA 2.79

XXX artery. 36140............... .............. A

Establish access to

2.01

NA 0.64 0.14

NA 2.79

XXX artery. 36145............... .............. A

Artery to vein shunt. 2.01

NA 0.66 0.12

NA 2.79

XXX 36160............... .............. A

Establish access to

2.52

NA 0.85 0.24

NA 3.61

XXX aorta. 36200............... .............. A

Place catheter in

3.02

NA 1.02 0.18

NA 4.22

XXX aorta.

[[Page 1154]]

36215............... .............. A

Place catheter in

4.67

NA 1.58 0.27

NA 6.52

XXX artery. 36216............... .............. A

Place catheter in

5.27

NA 1.76 0.29

NA 7.32

XXX artery. 36217............... .............. A

Place catheter in

6.29

NA 2.14 0.39

NA 8.82

XXX artery. 36218............... .............. A

Place catheter in

1.01

NA 0.35 0.06

NA 1.42

ZZZ artery. 36245............... .............. A

Place catheter in

4.67

NA 1.65 0.28

NA 6.60

XXX artery. 36246............... .............. A

Place catheter in

5.27

NA 1.79 0.31

NA 7.37

XXX artery. 36247............... .............. A

Place catheter in

6.29

NA 2.10 0.39

NA 8.78

XXX artery. 36248............... .............. A

Place catheter in

1.01

NA 0.35 0.07

NA 1.43

ZZZ artery. 36260............... .............. A

Insertion of infusion 9.70

NA 4.90 1.21

NA 15.81

090 pump. 36261............... .............. A

Revision of infusion

5.44

NA 3.66 0.60

NA 9.70

090 pump. 36262............... .............. A

Removal of infusion

4.01

NA 2.77 0.52

NA 7.30

090 pump. 36299............... .............. C

Vessel injection

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 36400............... .............. A

Bl draw 3 yrs. 36415............... .............. I

Routine venipuncture. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 36416............... .............. I

Capillary blood draw. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 36420............... .............. A

Vein access cutdown 1 yr. 36430............... .............. A

Blood transfusion

0.00 1.01

NA 0.06 1.07

NA

XXX service. 36440............... .............. A

Bl push transfuse, 2

1.03

NA 0.30 0.10

NA 1.43

XXX yr or 5 yr. 49507............... .............. A

Prp i/hern init

9.56

NA 4.54 1.00

NA 15.10

090 block5 yr. 49520............... .............. A

Rerepair ing hernia,

9.62

NA 4.49 1.01

NA 15.12

090 reduce. 49521............... .............. A

Rerepair ing hernia, 11.95

NA 5.28 1.25

NA 18.48

090 blocked. 49525............... .............. A

Repair ing hernia,

8.56

NA 4.13 0.89

NA 13.58

090 sliding. 49540............... .............. A

Repair lumbar hernia. 10.37

NA 4.81 1.09

NA 16.27

090 49550............... .............. A

Rpr rem hernia, init, 8.62

NA 4.16 0.90

NA 13.68

090 reduce. 49553............... .............. A

Rpr fem hernia, init

9.43

NA 4.46 1.00

NA 14.89

090 blocked. 49555............... .............. A

Rerepair fem hernia,

9.02

NA 4.32 0.95

NA 14.29

090 reduce. 49557............... .............. A

Rerepair fem hernia, 11.13

NA 5.03 1.17

NA 17.33

090 blocked. 49560............... .............. A

Rpr ventral hern

11.55

NA 5.21 1.21

NA 17.97

090 init, reduc. 49561............... .............. A

Rpr ventral hern

14.23

NA 6.11 1.48

NA 21.82

090 init, block. 49565............... .............. A

Rerepair ventrl hern, 11.55

NA 5.28 1.21

NA 18.04

090 reduce. 49566............... .............. A

Rerepair ventrl hern, 14.38

NA 6.18 1.50

NA 22.06

090 block. 49568............... .............. A

Hernia repair w/mesh. 4.88

NA 1.68 0.60

NA 7.16

ZZZ 49570............... .............. A

Rpr epigastric hern,

5.68

NA 3.20 0.60

NA 9.48

090 reduce. 49572............... .............. A

Rpr epigastric hern,

6.72

NA 3.50 0.70

NA 10.92

090 blocked. 49580............... .............. A

Rpr umbil hern, reduc 4.10

NA 2.64 0.41

NA 7.15

090 5 yr. 49587............... .............. A

Rpr umbil hern, block 7.55

NA 3.78 0.78

NA 12.11

090 5 yr. 49590............... .............. A

Repair spigilian

8.53

NA 4.13 0.89

NA 13.55

090 hernia. 49600............... .............. A

Repair umbilical

10.94

NA 5.39 1.36

NA 17.69

090 lesion. 49605............... .............. A

Repair umbilical

75.89

NA 28.65 3.10

NA 107.64

090 lesion. 49606............... .............. A

Repair umbilical

18.57

NA 7.77 2.68

NA 29.02

090 lesion. 49610............... .............. A

Repair umbilical

10.48

NA 5.26 0.93

NA 16.67

090 lesion. 49611............... .............. A

Repair umbilical

8.91

NA 7.25 0.78

NA 16.94

090 lesion. 49650............... .............. A

Laparo hernia repair

6.26

NA 3.23 0.77

NA 10.26

090 initial. 49651............... .............. A

Laparo hernia repair

8.23

NA 4.09 1.01

NA 13.33

090 recur. 49659............... .............. C

Laparo proc, hernia

0.00 0.00 0.00 0.00 0.00 0.00

YYY repair. 49900............... .............. A

Repair of abdominal

12.26

NA 6.28 1.48

NA 20.02

090 wall. 49904............... .............. A

Omental flap, extra- 19.97

NA 15.52 2.30

NA 37.79

090 abdom. 49905............... .............. A

Omental flap, intra-

6.54

NA 2.30 0.74

NA 9.58

ZZZ abdom. 49906............... .............. C

Free omental flap,

0.00 0.00 0.00 0.00 0.00 0.00

090 microvasc. 49999............... .............. C

Abdomen surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 50010............... .............. A

Exploration of kidney 10.96

NA 5.42 0.95

NA 17.33

090 50020............... .............. A

Renal abscess, open

14.64

NA 8.81 0.96

NA 24.41

090 drain. 50021............... .............. A

Renal abscess, percut 3.37

NA 1.11 0.18

NA 4.66

000 drain. 50040............... .............. A

Drainage of kidney... 14.92

NA 8.42 0.99

NA 24.33

090 50045............... .............. A

Exploration of kidney 15.44

NA 6.80 1.28

NA 23.52

090 50060............... .............. A

Removal of kidney

19.27

NA 8.03 1.37

NA 28.67

090 stone. 50065............... .............. A

Incision of kidney... 20.76

NA 6.24 1.36

NA 28.36

090 50070............... .............. A

Incision of kidney... 20.29

NA 8.42 1.45

NA 30.16

090 50075............... .............. A

Removal of kidney

25.30

NA 10.19 1.82

NA 37.31

090 stone. 50080............... .............. A

Removal of kidney

14.69

NA 7.85 1.04

NA 23.58

090 stone. 50081............... .............. A

Removal of kidney

21.77

NA 10.35 1.57

NA 33.69

090 stone. 50100............... .............. A

Revise kidney blood

16.07

NA 7.99 1.98

NA 26.04

090 vessels. 50120............... .............. A

Exploration of kidney 15.89

NA 6.97 1.25

NA 24.11

090 50125............... .............. A

Explore and drain

16.50

NA 7.12 1.29

NA 24.91

090 kidney. 50130............... .............. A

Removal of kidney

17.26

NA 7.38 1.25

NA 25.89

090 stone. 50135............... .............. A

Exploration of kidney 19.15

NA 7.98 1.42

NA 28.55

090 50200............... .............. A

Biopsy of kidney..... 2.63

NA 0.90 0.14

NA 3.67

000 50205............... .............. A

Biopsy of kidney..... 11.29

NA 5.24 1.13

NA 17.66

090 50220............... .............. A

Remove kidney, open.. 17.12

NA 7.44 1.40

NA 25.96

090 50225............... .............. A

Removal kidney open, 20.20

NA 8.36 1.52

NA 30.08

090 complex. 50230............... .............. A

Removal kidney open, 22.04

NA 8.83 1.63

NA 32.50

090 radical. 50234............... .............. A

Removal of kidney &

22.37

NA 9.04 1.65

NA 33.06

090 ureter. 50236............... .............. A

Removal of kidney &

24.82

NA 11.41 1.81

NA 38.04

090 ureter. 50240............... .............. A

Partial removal of

21.97

NA 10.50 1.64

NA 34.11

090 kidney. 50280............... .............. A

Removal of kidney

15.65

NA 6.89 1.19

NA 23.73

090 lesion. 50290............... .............. A

Removal of kidney

14.71

NA 6.65 1.34

NA 22.70

090 lesion. 50300............... .............. X

Removal of donor

0.00 0.00 0.00 0.00 0.00 0.00

XXX kidney. 50320............... .............. A

Removal of donor

22.18

NA 9.96 2.15

NA 34.29

090 kidney. 50340............... .............. A

Removal of kidney.... 12.13

NA 6.93 1.39

NA 20.45

090 50360............... .............. A

Transplantation of

31.48

NA 15.76 3.58

NA 50.82

090 kidney. 50365............... .............. A

Transplantation of

36.75

NA 18.55 4.23

NA 59.53

090 kidney. 50370............... .............. A

Remove transplanted

13.70

NA 7.52 1.52

NA 22.74

090 kidney.

[[Page 1168]]

50380............... .............. A

Reimplantation of

20.73

NA 13.26 2.17

NA 36.16

090 kidney. 50390............... .............. A

Drainage of kidney

1.96

NA 0.64 0.11

NA 2.71

000 lesion. 50392............... .............. A

Insert kidney drain.. 3.37

NA 1.11 0.18

NA 4.66

000 50393............... .............. A

Insert ureteral tube. 4.15

NA 1.35 0.22

NA 5.72

000 50394............... .............. A

Injection for kidney

0.76 2.54 0.25 0.05 3.35 1.06

000 x-ray. 50395............... .............. A

Create passage to

3.37

NA 1.10 0.19

NA 4.66

000 kidney. 50396............... .............. A

Measure kidney

2.09

NA 0.86 0.12

NA 3.07

000 pressure. 50398............... .............. A

Change kidney tube... 1.46 1.19 0.47 0.08 2.73 2.01

000 50400............... .............. A

Revision of kidney/

19.47

NA 7.72 1.46

NA 28.65

090 ureter. 50405............... .............. A

Revision of kidney/

23.89

NA 10.41 1.75

NA 36.05

090 ureter. 50500............... .............. A

Repair of kidney

19.54

NA 8.77 1.75

NA 30.06

090 wound. 50520............... .............. A

Close kidney-skin

17.20

NA 8.75 1.52

NA 27.47

090 fistula. 50525............... .............. A

Repair renal-abdomen 22.24

NA 10.16 1.82

NA 34.22

090 fistula. 50526............... .............. A

Repair renal-abdomen 23.98

NA 10.88 1.95

NA 36.81

090 fistula. 50540............... .............. A

Revision of horseshoe 19.90

NA 8.55 1.54

NA 29.99

090 kidney. 50541............... .............. A

Laparo ablate renal

15.98

NA 6.41 1.19

NA 23.58

090 cyst. 50542............... .............. A

Laparo ablate renal

19.97

NA 8.13 1.64

NA 29.74

090 mass. 50543............... .............. A

Laparo partial

25.46

NA 10.27 1.64

NA 37.37

090 nephrectomy. 50544............... .............. A

Laparoscopy,

22.37

NA 8.47 1.70

NA 32.54

090 pyeloplasty. 50545............... .............. A

Laparo radical

23.96

NA 9.12 1.85

NA 34.93

090 nephrectomy. 50546............... .............. A

Laparoscopic

20.45

NA 8.30 1.65

NA 30.40

090 nephrectomy. 50547............... .............. A

Laparo removal donor 25.46

NA 10.44 2.46

NA 38.36

090 kidney. 50548............... .............. A

Laparo remove w/

24.36

NA 9.11 1.80

NA 35.27

090 ureter. 50549............... .............. C

Laparoscope proc,

0.00 0.00 0.00 0.00 0.00 0.00

YYY renal. 50551............... .............. A

Kidney endoscopy..... 5.59 4.92 1.80 0.40 10.91 7.79

000 50553............... .............. A

Kidney endoscopy..... 5.98 18.59 1.95 0.42 24.99 8.35

000 50555............... .............. A

Kidney endoscopy &

6.52 19.17 2.11 0.46 26.15 9.09

000 biopsy. 50557............... .............. A

Kidney endoscopy &

6.61 20.04 2.12 0.47 27.12 9.20

000 treatment. 50559............... .............. A

Renal endoscopy/

6.77

NA 2.19 0.33

NA 9.29

000 radiotracer. 50561............... .............. A

Kidney endoscopy &

7.58 17.69 2.44 0.53 25.80 10.55

000 treatment. 50562............... .............. A

Renal scope w/tumor

10.90

NA 3.84 1.01

NA 15.75

090 resect. 50570............... .............. A

Kidney endoscopy..... 9.53

NA 3.06 0.68

NA 13.27

000 50572............... .............. A

Kidney endoscopy..... 10.33

NA 3.33 0.77

NA 14.43

000 50574............... .............. A

Kidney endoscopy &

11.00

NA 3.57 0.78

NA 15.35

000 biopsy. 50575............... .............. A

Kidney endoscopy..... 13.96

NA 4.48 1.01

NA 19.45

000 50576............... .............. A

Kidney endoscopy &

10.97

NA 3.51 0.80

NA 15.28

000 treatment. 50578............... .............. A

Renal endoscopy/

11.33

NA 3.64 0.81

NA 15.78

000 radiotracer. 50580............... .............. A

Kidney endoscopy &

11.84

NA 3.80 0.84

NA 16.48

000 treatment. 50590............... .............. A

Fragmenting of kidney 9.08 10.77 5.03 0.65 20.50 14.76

090 stone. 50600............... .............. A

Exploration of ureter 15.82

NA 6.99 1.19

NA 24.00

090 50605............... .............. A

Insert ureteral

15.44

NA 7.00 1.36

NA 23.80

090 support. 50610............... .............. A

Removal of ureter

15.90

NA 7.24 1.30

NA 24.44

090 stone. 50620............... .............. A

Removal of ureter

15.14

NA 6.62 1.10

NA 22.86

090 stone. 50630............... .............. A

Removal of ureter

14.92

NA 6.56 1.09

NA 22.57

090 stone. 50650............... .............. A

Removal of ureter.... 17.38

NA 7.50 1.29

NA 26.17

090 50660............... .............. A

Removal of ureter.... 19.52

NA 8.24 1.44

NA 29.20

090 50684............... .............. A

Injection for ureter

0.76 15.38 0.25 0.05 16.19 1.06

000 x-ray. 50686............... .............. A

Measure ureter

1.51 4.56 0.65 0.11 6.18 2.27

000 pressure. 50688............... .............. A

Change of ureter tube 1.17

NA 1.75 0.07

NA 2.99

010 50690............... .............. A

Injection for ureter

1.16 15.84 0.37 0.07 17.07 1.60

000 x-ray. 50700............... .............. A

Revision of ureter... 15.19

NA 7.30 1.04

NA 23.53

090 50715............... .............. A

Release of ureter.... 18.87

NA 9.03 2.03

NA 29.93

090 50722............... .............. A

Release of ureter.... 16.33

NA 8.03 1.70

NA 26.06

090 50725............... .............. A

Release/revise ureter 18.46

NA 8.31 1.74

NA 28.51

090 50727............... .............. A

Revise ureter........ 8.17

NA 5.20 0.62

NA 13.99

090 50728............... .............. A

Revise ureter........ 12.00

NA 6.72 1.06

NA 19.78

090 50740............... .............. A

Fusion of ureter &

18.39

NA 7.96 1.80

NA 28.15

090 kidney. 50750............... .............. A

Fusion of ureter &

19.48

NA 8.27 1.50

NA 29.25

090 kidney. 50760............... .............. A

Fusion of ureters.... 18.39

NA 7.95 1.51

NA 27.85

090 50770............... .............. A

Splicing of ureters.. 19.48

NA 8.25 1.51

NA 29.24

090 50780............... .............. A

Reimplant ureter in

18.33

NA 7.86 1.45

NA 27.64

090 bladder. 50782............... .............. A

Reimplant ureter in

19.51

NA 9.83 1.36

NA 30.70

090 bladder. 50783............... .............. A

Reimplant ureter in

20.52

NA 9.35 1.63

NA 31.50

090 bladder. 50785............... .............. A

Reimplant ureter in

20.49

NA 8.58 1.57

NA 30.64

090 bladder. 50800............... .............. A

Implant ureter in

14.50

NA 6.99 1.11

NA 22.60

090 bowel. 50810............... .............. A

Fusion of ureter &

20.02

NA 9.57 2.15

NA 31.74

090 bowel. 50815............... .............. A

Urine shunt to

19.90

NA 8.93 1.58

NA 30.41

090 intestine. 50820............... .............. A

Construct bowel

21.86

NA 9.14 1.66

NA 32.66

090 bladder. 50825............... .............. A

Construct bowel

28.14

NA 11.65 2.18

NA 41.97

090 bladder. 50830............... .............. A

Revise urine flow.... 31.23

NA 12.66 2.65

NA 46.54

090 50840............... .............. A

Replace ureter by

19.97

NA 8.93 1.52

NA 30.42

090 bowel. 50845............... .............. A

Appendico-vesicostomy 20.86

NA 8.87 1.52

NA 31.25

090 50860............... .............. A

Transplant ureter to 15.34

NA 6.89 1.22

NA 23.45

090 skin. 50900............... .............. A

Repair of ureter..... 13.60

NA 6.36 1.18

NA 21.14

090 50920............... .............. A

Closure ureter/skin

14.31

NA 6.79 1.01

NA 22.11

090 fistula.

[[Page 1169]]

50930............... .............. A

Closure ureter/bowel 18.69

NA 8.19 1.89

NA 28.77

090 fistula. 50940............... .............. A

Release of ureter.... 14.49

NA 6.63 1.25

NA 22.37

090 50945............... .............. A

Laparoscopy

16.97

NA 6.96 1.39

NA 25.32

090 ureterolithotomy. 50947............... .............. A

Laparo new ureter/

24.46

NA 9.66 2.40

NA 36.52

090 bladder. 50948............... .............. A

Laparo new ureter/

22.47

NA 8.62 2.21

NA 33.30

090 bladder. 50949............... .............. C

Laparoscope proc,

0.00 0.00 0.00 0.00 0.00 0.00

YYY ureter. 50951............... .............. A

Endoscopy of ureter.. 5.83 5.34 1.87 0.42 11.59 8.12

000 50953............... .............. A

Endoscopy of ureter.. 6.23 18.61 2.00 0.45 25.29 8.68

000 50955............... .............. A

Ureter endoscopy &

6.74 20.51 2.22 0.46 27.71 9.42

000 biopsy. 50957............... .............. A

Ureter endoscopy &

6.78 18.26 2.18 0.48 25.52 9.44

000 treatment. 50959............... .............. A

Ureter endoscopy &

4.39

NA 1.37 0.22

NA 5.98

000 tracer. 50961............... .............. A

Ureter endoscopy &

6.04 25.47 1.94 0.42 31.93 8.40

000 treatment. 50970............... .............. A

Ureter endoscopy..... 7.13

NA 2.30 0.52

NA 9.95

000 50972............... .............. A

Ureter endoscopy &

6.88

NA 2.27 0.47

NA 9.62

000 catheter. 50974............... .............. A

Ureter endoscopy &

9.16

NA 2.93 0.64

NA 12.73

000 biopsy. 50976............... .............. A

Ureter endoscopy &

9.03

NA 2.91 0.64

NA 12.58

000 treatment. 50978............... .............. A

Ureter endoscopy &

5.09

NA 1.67 0.36

NA 7.12

000 tracer. 50980............... .............. A

Ureter endoscopy &

6.84

NA 2.20 0.49

NA 9.53

000 treatment. 51000............... .............. A

Drainage of bladder.. 0.78 1.98 0.24 0.06 2.82 1.08

000 51005............... .............. A

Drainage of bladder.. 1.02 4.80 0.34 0.10 5.92 1.46

000 51010............... .............. A

Drainage of bladder.. 3.52 5.74 1.89 0.28 9.54 5.69

010 51020............... .............. A

Incise & treat

6.70

NA 3.98 0.51

NA 11.19

090 bladder. 51030............... .............. A

Incise & treat

6.76

NA 4.09 0.51

NA 11.36

090 bladder. 51040............... .............. A

Incise & drain

4.39

NA 2.87 0.33

NA 7.59

090 bladder. 51045............... .............. A

Incise bladder/drain

6.76

NA 4.06 0.57

NA 11.39

090 ureter. 51050............... .............. A

Removal of bladder

6.91

NA 3.75 0.51

NA 11.17

090 stone. 51060............... .............. A

Removal of ureter

8.84

NA 4.62 0.65

NA 14.11

090 stone. 51065............... .............. A

Remove ureter

8.84

NA 4.47 0.64

NA 13.95

090 calculus. 51080............... .............. A

Drainage of bladder

5.95

NA 3.66 0.42

NA 10.03

090 abscess. 51500............... .............. A

Removal of bladder

10.12

NA 5.08 1.06

NA 16.26

090 cyst. 51520............... .............. A

Removal of bladder

9.28

NA 4.79 0.70

NA 14.77

090 lesion. 51525............... .............. A

Removal of bladder

13.95

NA 6.25 1.03

NA 21.23

090 lesion. 51530............... .............. A

Removal of bladder

12.36

NA 5.87 0.99

NA 19.22

090 lesion. 51535............... .............. A

Repair of ureter

12.55

NA 6.23 1.09

NA 19.87

090 lesion. 51550............... .............. A

Partial removal of

15.64

NA 6.86 1.27

NA 23.77

090 bladder. 51555............... .............. A

Partial removal of

21.20

NA 8.81 1.65

NA 31.66

090 bladder. 51565............... .............. A

Revise bladder &

21.59

NA 9.12 1.69

NA 32.40

090 ureter(s). 51570............... .............. A

Removal of bladder... 24.20

NA 9.94 1.92

NA 36.06

090 51575............... .............. A

Removal of bladder & 30.40

NA 12.26 2.27

NA 44.93

090 nodes. 51580............... .............. A

Remove bladder/revise 31.03

NA 12.73 2.34

NA 46.10

090 tract. 51585............... .............. A

Removal of bladder & 35.18

NA 13.93 2.63

NA 51.74

090 nodes. 51590............... .............. A

Remove bladder/revise 32.61

NA 12.84 2.42

NA 47.87

090 tract. 51595............... .............. A

Remove bladder/revise 37.08

NA 14.36 2.69

NA 54.13

090 tract. 51596............... .............. A

Remove bladder/create 39.46

NA 15.47 2.88

NA 57.81

090 pouch. 51597............... .............. A

Removal of pelvic

38.29

NA 15.07 3.00

NA 56.36

090 structures. 51600............... .............. A

Injection for bladder 0.88 5.85 0.29 0.05 6.78 1.22

000 x-ray. 51605............... .............. A

Preparation for

0.64 10.80 0.35 0.05 11.49 1.04

000 bladder xray. 51610............... .............. A

Injection for bladder 1.05 1.72 0.60 0.06 2.83 1.71

000 x-ray. 51700............... .............. A

Irrigation of bladder 0.88 1.65 0.28 0.06 2.59 1.22

000 51701............... .............. A

Insert bladder

0.50 1.64 0.19 0.04 2.18 0.73

000 catheter. 51702............... .............. A

Insert temp bladder

0.50 2.34 0.26 0.04 2.88 0.80

000 cath. 51703............... .............. A

Insert bladder cath,

1.47 3.05 0.57 0.11 4.63 2.15

000 complex. 51705............... .............. A

Change of bladder

1.02 2.34 0.61 0.07 3.43 1.70

010 tube. 51710............... .............. A

Change of bladder

1.49 3.43 0.77 0.11 5.03 2.37

010 tube. 51715............... .............. A

Endoscopic injection/ 3.73 4.01 1.35 0.29 8.03 5.37

000 implant. 51720............... .............. A

Treatment of bladder

1.96 1.79 0.71 0.14 3.89 2.81

000 lesion. 51725............... .............. A

Simple cystometrogram 1.51 5.77

NA 0.16 7.44

NA

000 51725............... 26............ A

Simple cystometrogram 1.51 0.49 0.49 0.12 2.12 2.12

000 51725............... TC............ A

Simple cystometrogram 0.00 5.28

NA 0.04 5.32

NA

000 51726............... .............. A

Complex

1.71 7.84

NA 0.18 9.73

NA

000 cystometrogram. 51726............... 26............ A

Complex

1.71 0.56 0.56 0.13 2.40 2.40

000 cystometrogram. 51726............... TC............ A

Complex

0.00 7.28

NA 0.05 7.33

NA

000 cystometrogram. 51736............... .............. A

Urine flow

0.61 0.58

NA 0.06 1.25

NA

000 measurement. 51736............... 26............ A

Urine flow

0.61 0.20 0.20 0.05 0.86 0.86

000 measurement. 51736............... TC............ A

Urine flow

0.00 0.38

NA 0.01 0.39

NA

000 measurement. 51741............... .............. A

Electro-uroflowmetry, 1.14 0.80

NA 0.10 2.04

NA

000 first. 51741............... 26............ A

Electro-uroflowmetry, 1.14 0.37 0.37 0.08 1.59 1.59

000 first. 51741............... TC............ A

Electro-uroflowmetry, 0.00 0.43

NA 0.02 0.45

NA

000 first. 51772............... .............. A

Urethra pressure

1.61 5.78

NA 0.19 7.58

NA

000 profile. 51772............... 26............ A

Urethra pressure

1.61 0.55 0.55 0.14 2.30 2.30

000 profile. 51772............... TC............ A

Urethra pressure

0.00 5.23

NA 0.05 5.28

NA

000 profile. 51784............... .............. A

Anal/urinary muscle

1.53 4.11

NA 0.16 5.80

NA

000 study. 51784............... 26............ A

Anal/urinary muscle

1.53 0.50 0.50 0.12 2.15 2.15

000 study. 51784............... TC............ A

Anal/urinary muscle

0.00 3.61

NA 0.04 3.65

NA

000 study. 51785............... .............. A

Anal/urinary muscle

1.53 4.62

NA 0.15 6.30

NA

000 study.

[[Page 1170]]

51785............... 26............ A

Anal/urinary muscle

1.53 0.50 0.50 0.11 2.14 2.14

000 study. 51785............... TC............ A

Anal/urinary muscle

0.00 4.12

NA 0.04 4.16

NA

000 study. 51792............... .............. A

Urinary reflex study. 1.10 5.98

NA 0.24 7.32

NA

000 51792............... 26............ A

Urinary reflex study. 1.10 0.41 0.41 0.11 1.62 1.62

000 51792............... TC............ A

Urinary reflex study. 0.00 5.57

NA 0.13 5.70

NA

000 51795............... .............. A

Urine voiding

1.53 7.62

NA 0.22 9.37

NA

000 pressure study. 51795............... 26............ A

Urine voiding

1.53 0.50 0.50 0.12 2.15 2.15

000 pressure study. 51795............... TC............ A

Urine voiding

0.00 7.12

NA 0.10 7.22

NA

000 pressure study. 51797............... .............. A

Intraabdominal

1.60 5.95

NA 0.17 7.72

NA

000 pressure test. 51797............... 26............ A

Intraabdominal

1.60 0.52 0.52 0.12 2.24 2.24

000 pressure test. 51797............... TC............ A

Intraabdominal

0.00 5.43

NA 0.05 5.48

NA

000 pressure test. 51798............... .............. A

Us urine capacity

0.00 0.36

NA 0.08 0.44

NA

XXX measure. 51800............... .............. A

Revision of bladder/ 17.39

NA 7.69 1.41

NA 26.49

090 urethra. 51820............... .............. A

Revision of urinary

17.86

NA 8.46 1.75

NA 28.07

090 tract. 51840............... .............. A

Attach bladder/

10.69

NA 5.57 1.05

NA 17.31

090 urethra. 51841............... .............. A

Attach bladder/

13.01

NA 6.37 1.25

NA 20.63

090 urethra. 51845............... .............. A

Repair bladder neck.. 9.72

NA 4.87 0.75

NA 15.34

090 51860............... .............. A

Repair of bladder

12.00

NA 5.90 1.07

NA 18.97

090 wound. 51865............... .............. A

Repair of bladder

15.02

NA 6.83 1.22

NA 23.07

090 wound. 51880............... .............. A

Repair of bladder

7.65

NA 4.07 0.65

NA 12.37

090 opening. 51900............... .............. A

Repair bladder/vagina 12.95

NA 6.22 1.05

NA 20.22

090 lesion. 51920............... .............. A

Close bladder-uterus 11.79

NA 5.75 1.04

NA 18.58

090 fistula. 51925............... .............. A

Hysterectomy/bladder 15.56

NA 8.62 1.79

NA 25.97

090 repair. 51940............... .............. A

Correction of bladder 28.39

NA 12.36 2.38

NA 43.13

090 defect. 51960............... .............. A

Revision of bladder & 22.98

NA 9.87 1.70

NA 34.55

090 bowel. 51980............... .............. A

Construct bladder

11.34

NA 5.49 0.89

NA 17.72

090 opening. 51990............... .............. A

Laparo urethral

12.48

NA 6.18 1.23

NA 19.89

090 suspension. 51992............... .............. A

Laparo sling

13.99

NA 6.24 1.12

NA 21.35

090 operation. 52000............... .............. A

Cystoscopy........... 2.01 3.38 0.76 0.14 5.53 2.91

000 52001............... .............. A

Cystoscopy, removal

5.44 5.18 1.87 0.39 11.01 7.70

000 of clots. 52005............... .............. A

Cystoscopy & ureter

2.37 5.98 0.90 0.18 8.53 3.45

000 catheter. 52007............... .............. A

Cystoscopy and biopsy 3.02

NA 1.15 0.22

NA 4.39

000 52010............... .............. A

Cystoscopy & duct

3.02

NA 1.13 0.22

NA 4.37

000 catheter. 52204............... .............. A

Cystoscopy........... 2.37 3.63 0.91 0.18 6.18 3.46

000 52214............... .............. A

Cystoscopy and

3.70

NA 1.33 0.27

NA 5.30

000 treatment. 52224............... .............. A

Cystoscopy and

3.14

NA 1.15 0.22

NA 4.51

000 treatment. 52234............... .............. A

Cystoscopy and

4.62

NA 1.63 0.33

NA 6.58

000 treatment. 52235............... .............. A

Cystoscopy and

5.44

NA 1.90 0.39

NA 7.73

000 treatment. 52240............... .............. A

Cystoscopy and

9.71

NA 3.30 0.70

NA 13.71

000 treatment. 52250............... .............. A

Cystoscopy and

4.49

NA 1.66 0.33

NA 6.48

000 radiotracer. 52260............... .............. A

Cystoscopy and

3.91

NA 1.43 0.28

NA 5.62

000 treatment. 52265............... .............. A

Cystoscopy and

2.94 3.75 1.12 0.22 6.91 4.28

000 treatment. 52270............... .............. A

Cystoscopy & revise

3.36

NA 1.25 0.24

NA 4.85

000 urethra. 52275............... .............. A

Cystoscopy & revise

4.69

NA 1.67 0.34

NA 6.70

000 urethra. 52276............... .............. A

Cystoscopy and

4.99

NA 1.79 0.36

NA 7.14

000 treatment. 52277............... .............. A

Cystoscopy and

6.16

NA 2.26 0.46

NA 8.88

000 treatment. 52281............... .............. A

Cystoscopy and

2.80 7.43 1.08 0.21 10.44 4.09

000 treatment. 52282............... .............. A

Cystoscopy, implant

6.39

NA 2.24 0.46

NA 9.09

000 stent. 52283............... .............. A

Cystoscopy and

3.73 4.03 1.39 0.27 8.03 5.39

000 treatment. 52285............... .............. A

Cystoscopy and

3.60 4.10 1.34 0.27 7.97 5.21

000 treatment. 52290............... .............. A

Cystoscopy and

4.58

NA 1.66 0.33

NA 6.57

000 treatment. 52300............... .............. A

Cystoscopy and

5.30

NA 1.91 0.39

NA 7.60

000 treatment. 52301............... .............. A

Cystoscopy and

5.50

NA 2.00 0.47

NA 7.97

000 treatment. 52305............... .............. A

Cystoscopy and

5.30

NA 1.86 0.37

NA 7.53

000 treatment. 52310............... .............. A

Cystoscopy and

2.81 3.53 1.04 0.21 6.55 4.06

000 treatment. 52315............... .............. A

Cystoscopy and

5.20

NA 1.84 0.37

NA 7.41

000 treatment. 52317............... .............. A

Remove bladder stone. 6.71

NA 2.28 0.48

NA 9.47

000 52318............... .............. A

Remove bladder stone. 9.18

NA 3.10 0.65

NA 12.93

000 52320............... .............. A

Cystoscopy and

4.69

NA 1.64 0.34

NA 6.67

000 treatment. 52325............... .............. A

Cystoscopy, stone

6.15

NA 2.11 0.45

NA 8.71

000 removal. 52327............... .............. A

Cystoscopy, inject

5.18

NA 1.83 0.39

NA 7.40

000 material. 52330............... .............. A

Cystoscopy and

5.03

NA 1.76 0.36

NA 7.15

000 treatment. 52332............... .............. A

Cystoscopy and

2.83

NA 1.06 0.21

NA 4.10

000 treatment. 52334............... .............. A

Create passage to

4.82

NA 1.76 0.34

NA 6.92

000 kidney. 52341............... .............. A

Cysto w/ureter

5.99

NA 2.22 0.45

NA 8.66

000 stricture tx. 52342............... .............. A

Cysto w/up stricture

6.49

NA 2.35 0.48

NA 9.32

000 tx. 52343............... .............. A

Cysto w/renal

7.19

NA 2.59 0.53

NA 10.31

000 stricture tx. 52344............... .............. A

Cysto/uretero, stone

7.69

NA 2.80 0.57

NA 11.06

000 remove. 52345............... .............. A

Cysto/uretero w/up

8.19

NA 2.96 0.60

NA 11.75

000 stricture. 52346............... .............. A

Cystouretero w/renal

9.22

NA 3.29 0.69

NA 13.20

000 strict. 52347............... .............. A

Cystoscopy, resect

5.27

NA 1.71 0.40

NA 7.38

000 ducts. 52351............... .............. A

Cystouretero & or

5.85

NA 2.14 0.43

NA 8.42

000 pyeloscope. 52352............... .............. A

Cystouretero w/stone

6.87

NA 2.51 0.51

NA 9.89

000 remove. 52353............... .............. A

Cystouretero w/

7.96

NA 2.86 0.59

NA 11.41

000 lithotripsy. 52354............... .............. A

Cystouretero w/biopsy 7.33

NA 2.67 0.54

NA 10.54

000

[[Page 1171]]

52355............... .............. A

Cystouretero w/excise 8.81

NA 3.15 0.66

NA 12.62

000 tumor. 52400............... .............. A

Cystouretero w/congen 9.67

NA 3.78 0.72

NA 14.17

090 repr. 52450............... .............. A

Incision of prostate. 7.63

NA 3.71 0.55

NA 11.89

090 52500............... .............. A

Revision of bladder

8.46

NA 3.96 0.60

NA 13.02

090 neck. 52510............... .............. A

Dilation prostatic

6.71

NA 3.14 0.48

NA 10.33

090 urethra. 52601............... .............. A

Prostatectomy (TURP). 12.35

NA 5.15 0.89

NA 18.39

090 52606............... .............. A

Control postop

8.12

NA 3.58 0.59

NA 12.29

090 bleeding. 52612............... .............. A

Prostatectomy, first

7.97

NA 3.77 0.58

NA 12.32

090 stage. 52614............... .............. A

Prostatectomy, second 6.83

NA 3.38 0.49

NA 10.70

090 stage. 52620............... .............. A

Remove residual

6.60

NA 3.01 0.47

NA 10.08

090 prostate. 52630............... .............. A

Remove prostate

7.25

NA 3.22 0.52

NA 10.99

090 regrowth. 52640............... .............. A

Relieve bladder

6.61

NA 2.98 0.47

NA 10.06

090 contracture. 52647............... .............. A

Laser surgery of

10.34 76.71 4.57 0.74 87.79 15.65

090 prostate. 52648............... .............. A

Laser surgery of

11.19

NA 4.84 0.80

NA 16.83

090 prostate. 52700............... .............. A

Drainage of prostate

6.79

NA 3.21 0.49

NA 10.49

090 abscess. 53000............... .............. A

Incision of urethra.. 2.28

NA 1.57 0.16

NA 4.01

010 53010............... .............. A

Incision of urethra.. 3.63

NA 3.02 0.24

NA 6.89

090 53020............... .............. A

Incision of urethra.. 1.77 3.10 0.67 0.13 5.00 2.57

000 53025............... .............. A

Incision of urethra.. 1.13 3.87 0.51 0.08 5.08 1.72

000 53040............... .............. A

Drainage of urethra

6.39 11.28 6.33 0.49 18.16 13.21

090 abscess. 53060............... .............. A

Drainage of urethra

2.63

NA 1.45 0.28

NA 4.36

010 abscess. 53080............... .............. A

Drainage of urinary

6.28

NA 6.17 0.51

NA 12.96

090 leakage. 53085............... .............. A

Drainage of urinary

10.25

NA 7.63 0.81

NA 18.69

090 leakage. 53200............... .............. A

Biopsy of urethra.... 2.59 4.29 0.98 0.21 7.09 3.78

000 53210............... .............. A

Removal of urethra... 12.55

NA 5.98 0.98

NA 19.51

090 53215............... .............. A

Removal of urethra... 15.56

NA 6.77 1.12

NA 23.45

090 53220............... .............. A

Treatment of urethra

6.99

NA 3.84 0.53

NA 11.36

090 lesion. 53230............... .............. A

Removal of urethra

9.57

NA 4.84 0.72

NA 15.13

090 lesion. 53235............... .............. A

Removal of urethra

10.12

NA 5.02 0.72

NA 15.86

090 lesion. 53240............... .............. A

Surgery for urethra

6.44

NA 3.64 0.51

NA 10.59

090 pouch. 53250............... .............. A

Removal of urethra

5.88

NA 3.38 0.42

NA 9.68

090 gland. 53260............... .............. A

Treatment of urethra

2.98 3.28 1.80 0.28 6.54 5.06

010 lesion. 53265............... .............. A

Treatment of urethra

3.12

NA 1.84 0.24

NA 5.20

010 lesion. 53270............... .............. A

Removal of urethra

3.09

NA 1.87 0.25

NA 5.21

010 gland. 53275............... .............. A

Repair of urethra

4.52

NA 2.28 0.34

NA 7.14

010 defect. 53400............... .............. A

Revise urethra, stage 12.75

NA 6.10 1.03

NA 19.88

090 1. 53405............... .............. A

Revise urethra, stage 14.46

NA 6.45 1.10

NA 22.01

090 2. 53410............... .............. A

Reconstruction of

16.42

NA 7.20 1.19

NA 24.81

090 urethra. 53415............... .............. A

Reconstruction of

19.38

NA 7.47 1.40

NA 28.25

090 urethra. 53420............... .............. A

Reconstruct urethra, 14.06

NA 6.45 1.09

NA 21.60

090 stage 1. 53425............... .............. A

Reconstruct urethra, 15.96

NA 7.05 1.17

NA 24.18

090 stage 2. 53430............... .............. A

Reconstruction of

16.32

NA 7.13 1.22

NA 24.67

090 urethra. 53431............... .............. A

Reconstruct urethra/ 19.86

NA 8.17 1.57

NA 29.60

090 bladder. 53440............... .............. A

Male sling procedure. 13.60

NA 6.04 0.88

NA 20.52

090 53442............... .............. A

Remove/revise male

11.55

NA 5.51 0.66

NA 17.72

090 sling. 53444............... .............. A

Insert tandem cuff... 13.38

NA 5.91 1.06

NA 20.35

090 53445............... .............. A

Insert uro/ves nck

14.04

NA 7.26 1.01

NA 22.31

090 sphincter. 53446............... .............. A

Remove uro sphincter. 10.21

NA 5.27 0.81

NA 16.29

090 53447............... .............. A

Remove/replace ur

13.47

NA 6.48 0.95

NA 20.90

090 sphincter. 53448............... .............. A

Remov/replc ur

21.12

NA 9.13 1.68

NA 31.93

090 sphinctr comp. 53449............... .............. A

Repair uro sphincter. 9.69

NA 4.85 0.69

NA 15.23

090 53450............... .............. A

Revision of urethra.. 6.13

NA 3.40 0.45

NA 9.98

090 53460............... .............. A

Revision of urethra.. 7.11

NA 3.82 0.52

NA 11.45

090 53500............... .............. A

Urethrlys, transvag w/ 12.19

NA 6.19 0.89

NA 19.27

090 scope. 53502............... .............. A

Repair of urethra

7.62

NA 4.11 0.60

NA 12.33

090 injury. 53505............... .............. A

Repair of urethra

7.62

NA 3.99 0.55

NA 12.16

090 injury. 53510............... .............. A

Repair of urethra

10.09

NA 5.29 0.72

NA 16.10

090 injury. 53515............... .............. A

Repair of urethra

13.29

NA 6.05 1.00

NA 20.34

090 injury. 53520............... .............. A

Repair of urethra

8.67

NA 4.60 0.64

NA 13.91

090 defect. 53600............... .............. A

Dilate urethra

1.21 1.17 0.43 0.08 2.46 1.72

000 stricture. 53601............... .............. A

Dilate urethra

0.98 1.30 0.38 0.07 2.35 1.43

000 stricture. 53605............... .............. A

Dilate urethra

1.28

NA 0.41 0.10

NA 1.79

000 stricture. 53620............... .............. A

Dilate urethra

1.62 2.04 0.60 0.12 3.78 2.34

000 stricture. 53621............... .............. A

Dilate urethra

1.35 2.13 0.50 0.10 3.58 1.95

000 stricture. 53660............... .............. A

Dilation of urethra.. 0.71 1.34 0.33 0.05 2.10 1.09

000 53661............... .............. A

Dilation of urethra.. 0.72 1.34 0.30 0.05 2.11 1.07

000 53665............... .............. A

Dilation of urethra.. 0.76

NA 0.26 0.06

NA 1.08

000 53850............... .............. A

Prostatic microwave

9.44 97.84 4.30 0.68 107.96 14.42

090 thermotx. 53852............... .............. A

Prostatic rf thermotx 9.87 93.04 4.69 0.70 103.61 15.26

090 53853............... .............. A

Prostatic water

5.23 57.88 3.18 0.33 63.44 8.74

090 thermother. 53899............... .............. C

Urology surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 54000............... .............. A

Slitting of prepuce.. 1.54

NA 1.33 0.12

NA 2.99

010 54001............... .............. A

Slitting of prepuce.. 2.19 4.30 1.51 0.17 6.66 3.87

010 54015............... .............. A

Drain penis lesion... 5.31

NA 2.59 0.40

NA 8.30

010 54050............... .............. A

Destruction, penis

1.24 1.69 1.05 0.08 3.01 2.37

010 lesion(s).

[[Page 1172]]

54055............... .............. A

Destruction, penis

1.22 1.60 0.80 0.08 2.90 2.10

010 lesion(s). 54056............... .............. A

Cryosurgery, penis

1.24 2.48 1.35 0.07 3.79 2.66

010 lesion(s). 54057............... .............. A

Laser surg, penis

1.24

NA 0.87 0.10

NA 2.21

010 lesion(s). 54060............... .............. A

Excision of penis

1.93 3.88 1.45 0.14 5.95 3.52

010 lesion(s). 54065............... .............. A

Destruction, penis

2.42

NA 1.72 0.16

NA 4.30

010 lesion(s). 54100............... .............. A

Biopsy of penis...... 1.90 2.87 0.82 0.12 4.89 2.84

000 54105............... .............. A

Biopsy of penis...... 3.49

NA 1.96 0.25

NA 5.70

010 54110............... .............. A

Treatment of penis

10.11

NA 5.64 0.72

NA 16.47

090 lesion. 54111............... .............. A

Treat penis lesion,

13.55

NA 6.69 0.95

NA 21.19

090 graft. 54112............... .............. A

Treat penis lesion,

15.84

NA 7.69 1.13

NA 24.66

090 graft. 54115............... .............. A

Treatment of penis

6.14 8.53 4.47 0.47 15.14 11.08

090 lesion. 54120............... .............. A

Partial removal of

9.96

NA 5.60 0.72

NA 16.28

090 penis. 54125............... .............. A

Removal of penis..... 13.51

NA 6.75 0.98

NA 21.24

090 54130............... .............. A

Remove penis & nodes. 20.11

NA 9.10 1.44

NA 30.65

090 54135............... .............. A

Remove penis & nodes. 26.32

NA 11.10 1.91

NA 39.33

090 54150............... .............. A

Circumcision......... 1.81

NA 0.97 0.21

NA 2.99

010 54152............... .............. A

Circumcision......... 2.31

NA 1.20 0.19

NA 3.70

010 54160............... .............. A

Circumcision......... 2.48

NA 1.11 0.19

NA 3.78

010 54161............... .............. A

Circumcision......... 3.27

NA 1.57 0.24

NA 5.08

010 54162............... .............. A

Lysis penil circumic

3.00

NA 2.00 0.24

NA 5.24

010 lesion. 54163............... .............. A

Repair of

3.00

NA 2.01 0.24

NA 5.25

010 circumcision. 54164............... .............. A

Frenulotomy of penis. 2.50

NA 1.85 0.19

NA 4.54

010 54200............... .............. A

Treatment of penis

1.06 1.85 0.99 0.07 2.98 2.12

010 lesion. 54205............... .............. A

Treatment of penis

7.92

NA 4.83 0.57

NA 13.32

090 lesion. 54220............... .............. A

Treatment of penis

2.42 3.94 0.96 0.18 6.54 3.56

000 lesion. 54230............... .............. A

Prepare penis study.. 1.34 1.12 0.62 0.10 2.56 2.06

000 54231............... .............. A

Dynamic

2.04 1.40 0.87 0.17 3.61 3.08

000 cavernosometry. 54235............... .............. A

Penile injection..... 1.19 0.98 0.58 0.08 2.25 1.85

000 54240............... .............. A

Penis study.......... 1.31 1.01

NA 0.16 2.48

NA

000 54240............... 26............ A

Penis study.......... 1.31 0.42 0.42 0.10 1.83 1.83

000 54240............... TC............ A

Penis study.......... 0.00 0.59

NA 0.06 0.65

NA

000 54250............... .............. A

Penis study.......... 2.22 0.93

NA 0.19 3.34

NA

000 54250............... 26............ A

Penis study.......... 2.22 0.71 0.71 0.17 3.10 3.10

000 54250............... TC............ A

Penis study.......... 0.00 0.22

NA 0.02 0.24

NA

000 54300............... .............. A

Revision of penis.... 10.39

NA 5.75 0.77

NA 16.91

090 54304............... .............. A

Revision of penis.... 12.47

NA 6.54 0.89

NA 19.90

090 54308............... .............. A

Reconstruction of

11.81

NA 6.17 0.84

NA 18.82

090 urethra. 54312............... .............. A

Reconstruction of

13.55

NA 7.20 0.98

NA 21.73

090 urethra. 54316............... .............. A

Reconstruction of

16.79

NA 8.15 1.21

NA 26.15

090 urethra. 54318............... .............. A

Reconstruction of

11.23

NA 6.00 1.39

NA 18.62

090 urethra. 54322............... .............. A

Reconstruction of

12.99

NA 6.63 0.93

NA 20.55

090 urethra. 54324............... .............. A

Reconstruction of

16.29

NA 8.22 1.24

NA 25.75

090 urethra. 54326............... .............. A

Reconstruction of

15.70

NA 8.00 1.12

NA 24.82

090 urethra. 54328............... .............. A

Revise penis/urethra. 15.63

NA 7.45 1.11

NA 24.19

090 54332............... .............. A

Revise penis/urethra. 17.05

NA 7.93 1.22

NA 26.20

090 54336............... .............. A

Revise penis/urethra. 20.01

NA 10.71 2.29

NA 33.01

090 54340............... .............. A

Secondary urethral

8.90

NA 5.25 0.87

NA 15.02

090 surgery. 54344............... .............. A

Secondary urethral

15.92

NA 7.97 1.33

NA 25.22

090 surgery. 54348............... .............. A

Secondary urethral

17.12

NA 8.60 1.23

NA 26.95

090 surgery. 54352............... .............. A

Reconstruct urethra/ 24.70

NA 11.50 1.95

NA 38.15

090 penis. 54360............... .............. A

Penis plastic surgery 11.91

NA 6.19 0.87

NA 18.97

090 54380............... .............. A

Repair penis......... 13.16

NA 6.83 1.40

NA 21.39

090 54385............... .............. A

Repair penis......... 15.37

NA 8.49 0.86

NA 24.72

090 54390............... .............. A

Repair penis and

21.58

NA 9.61 1.54

NA 32.73

090 bladder. 54400............... .............. A

Insert semi-rigid

8.98

NA 4.47 0.64

NA 14.09

090 prosthesis. 54401............... .............. A

Insert self-contd

10.26

NA 5.83 0.74

NA 16.83

090 prosthesis. 54405............... .............. A

Insert multi-comp

13.41

NA 6.06 0.96

NA 20.43

090 penis pros. 54406............... .............. A

Remove muti-comp

12.08

NA 5.46 0.90

NA 18.44

090 penis pros. 54408............... .............. A

Repair multi-comp

12.73

NA 5.77 0.95

NA 19.45

090 penis pros. 54410............... .............. A

Remove/replace penis 15.48

NA 6.66 1.16

NA 23.30

090 prosth. 54411............... .............. A

Remov/replc penis

15.98

NA 7.09 0.96

NA 24.03

090 pros, comp. 54415............... .............. A

Remove self-contd

8.19

NA 4.22 0.65

NA 13.06

090 penis pros. 54416............... .............. A

Remv/repl penis

10.85

NA 5.41 0.66

NA 16.92

090 contain pros. 54417............... .............. A

Remv/replc penis

14.17

NA 6.21 0.66

NA 21.04

090 pros, compl. 54420............... .............. A

Revision of penis.... 11.40

NA 5.71 0.87

NA 17.98

090 54430............... .............. A

Revision of penis.... 10.13

NA 5.25 0.72

NA 16.10

090 54435............... .............. A

Revision of penis.... 6.11

NA 3.73 0.43

NA 10.27

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 1.11 0.47 0.08 2.31 1.67

000 54500............... .............. A

Biopsy of testis..... 1.31 0.61 0.56 0.10 2.02 1.97

000 54505............... .............. A

Biopsy of testis..... 3.45

NA 1.93 0.25

NA 5.63

010 54512............... .............. A

Excise lesion testis. 8.57

NA 4.15 0.68

NA 13.40

090 54520............... .............. A

Removal of testis.... 5.22

NA 2.85 0.40

NA 8.47

090 54522............... .............. A

Orchiectomy, partial. 9.49

NA 4.91 0.75

NA 15.15

090 54530............... .............. A

Removal of testis.... 8.57

NA 4.31 0.64

NA 13.52

090

[[Page 1173]]

54535............... .............. A

Extensive testis

12.14

NA 5.66 1.00

NA 18.80

090 surgery. 54550............... .............. A

Exploration for

7.77

NA 3.90 0.59

NA 12.26

090 testis. 54560............... .............. A

Exploration for

11.11

NA 5.28 0.95

NA 17.34

090 testis. 54600............... .............. A

Reduce testis torsion 7.00

NA 3.61 0.54

NA 11.15

090 54620............... .............. A

Suspension of testis. 4.89

NA 2.47 0.37

NA 7.73

010 54640............... .............. A

Suspension of testis. 6.89

NA 3.80 0.59

NA 11.28

090 54650............... .............. A

Orchiopexy (Fowler-

11.43

NA 5.52 0.98

NA 17.93

090 Stephens). 54660............... .............. A

Revision of testis... 5.10

NA 3.05 0.42

NA 8.57

090 54670............... .............. A

Repair testis injury. 6.40

NA 3.61 0.49

NA 10.50

090 54680............... .............. A

Relocation of

12.63

NA 6.29 1.13

NA 20.05

090 testis(es). 54690............... .............. A

Laparoscopy,

10.94

NA 5.06 1.19

NA 17.19

090 orchiectomy. 54692............... .............. A

Laparoscopy,

12.86

NA 5.45 1.05

NA 19.36

090 orchiopexy. 54699............... .............. C

Laparoscope proc,

0.00 0.00 0.00 0.00 0.00 0.00

YYY testis. 54700............... .............. A

Drainage of scrotum.. 3.42

NA 1.95 0.28

NA 5.65

010 54800............... .............. A

Biopsy of epididymis. 2.33 0.95 0.90 0.17 3.45 3.40

000 54820............... .............. A

Exploration of

5.13

NA 3.00 0.40

NA 8.53

090 epididymis. 54830............... .............. A

Remove epididymis

5.37

NA 3.08 0.41

NA 8.86

090 lesion. 54840............... .............. A

Remove epididymis

5.19

NA 2.84 0.37

NA 8.40

090 lesion. 54860............... .............. A

Removal of epididymis 6.31

NA 3.37 0.46

NA 10.14

090 54861............... .............. A

Removal of epididymis 8.89

NA 4.38 0.63

NA 13.90

090 54900............... .............. A

Fusion of spermatic

13.18

NA 5.86 1.62

NA 20.66

090 ducts. 54901............... .............. A

Fusion of spermatic

17.91

NA 7.56 2.21

NA 27.68

090 ducts. 55000............... .............. A

Drainage of hydrocele 1.43 2.11 0.65 0.12 3.66 2.20

000 55040............... .............. A

Removal of hydrocele. 5.35

NA 2.96 0.42

NA 8.73

090 55041............... .............. A

Removal of hydroceles 7.73

NA 4.04 0.60

NA 12.37

090 55060............... .............. A

Repair of hydrocele.. 5.51

NA 3.13 0.45

NA 9.09

090 55100............... .............. A

Drainage of scrotum

2.13 3.77 1.59 0.18 6.08 3.90

010 abscess. 55110............... .............. A

Explore scrotum...... 5.69

NA 3.18 0.43

NA 9.30

090 55120............... .............. A

Removal of scrotum

5.08 5.76 2.98 0.40 11.24 8.46

090 lesion. 55150............... .............. A

Removal of scrotum... 7.21

NA 3.96 0.57

NA 11.74

090 55175............... .............. A

Revision of scrotum.. 5.23

NA 3.06 0.40

NA 8.69

090 55180............... .............. A

Revision of scrotum.. 10.70

NA 5.46 0.87

NA 17.03

090 55200............... .............. A

Incision of sperm

4.23 5.53 2.41 0.30 10.06 6.94

090 duct. 55250............... .............. A

Removal of sperm

3.29 9.07 2.78 0.25 12.61 6.32

090 duct(s). 55300............... .............. A

Prepare, sperm duct x- 3.50

NA 1.31 0.24

NA 5.05

000 ray. 55400............... .............. A

Repair of sperm duct. 8.48

NA 4.17 0.60

NA 13.25

090 55450............... .............. A

Ligation of sperm

4.11 7.21 1.87 0.29 11.61 6.27

010 duct. 55500............... .............. A

Removal of hydrocele. 5.58

NA 3.15 0.52

NA 9.25

090 55520............... .............. A

Removal of sperm cord 6.02

NA 3.31 0.68

NA 10.01

090 lesion. 55530............... .............. A

Revise spermatic cord 5.65

NA 3.07 0.43

NA 9.15

090 veins. 55535............... .............. A

Revise spermatic cord 6.55

NA 3.45 0.51

NA 10.51

090 veins. 55540............... .............. A

Revise hernia & sperm 7.66

NA 3.86 0.89

NA 12.41

090 veins. 55550............... .............. A

Laparo ligate

6.56

NA 3.32 0.57

NA 10.45

090 spermatic vein. 55559............... .............. C

Laparo proc,

0.00 0.00 0.00 0.00 0.00 0.00

YYY spermatic cord. 55600............... .............. A

Incise sperm duct

6.37

NA 3.39 0.46

NA 10.22

090 pouch. 55605............... .............. A

Incise sperm duct

7.95

NA 4.36 0.65

NA 12.96

090 pouch. 55650............... .............. A

Remove sperm duct

11.78

NA 5.35 0.87

NA 18.00

090 pouch. 55680............... .............. A

Remove sperm pouch

5.18

NA 3.03 0.37

NA 8.58

090 lesion. 55700............... .............. A

Biopsy of prostate... 1.57 4.33 0.71 0.12 6.02 2.40

000 55705............... .............. A

Biopsy of prostate... 4.56

NA 2.32 0.31

NA 7.19

010 55720............... .............. A

Drainage of prostate

7.63

NA 3.95 0.53

NA 12.11

090 abscess. 55725............... .............. A

Drainage of prostate

8.67

NA 4.62 0.62

NA 13.91

090 abscess. 55801............... .............. A

Removal of prostate.. 17.77

NA 7.38 1.30

NA 26.45

090 55810............... .............. A

Extensive prostate

22.55

NA 8.71 1.63

NA 32.89

090 surgery. 55812............... .............. A

Extensive prostate

27.47

NA 11.14 2.04

NA 40.65

090 surgery. 55815............... .............. A

Extensive prostate

30.41

NA 12.07 2.22

NA 44.70

090 surgery. 55821............... .............. A

Removal of prostate.. 14.23

NA 6.32 1.03

NA 21.58

090 55831............... .............. A

Removal of prostate.. 15.60

NA 6.77 1.13

NA 23.50

090 55840............... .............. A

Extensive prostate

22.66

NA 9.44 1.65

NA 33.75

090 surgery. 55842............... .............. A

Extensive prostate

24.34

NA 10.01 1.79

NA 36.14

090 surgery. 55845............... .............. A

Extensive prostate

28.51

NA 11.11 2.06

NA 41.68

090 surgery. 55859............... .............. A

Percut/needle insert, 12.50

NA 5.91 0.89

NA 19.30

090 pros. 55860............... .............. A

Surgical exposure,

14.43

NA 6.44 0.99

NA 21.86

090 prostate. 55862............... .............. A

Extensive prostate

18.36

NA 7.96 1.37

NA 27.69

090 surgery. 55865............... .............. A

Extensive prostate

22.84

NA 9.38 1.65

NA 33.87

090 surgery. 55866............... .............. A

Laparo radical

30.69

NA 11.81 1.65

NA 44.15

090 prostatectomy. 55870............... .............. A

Electroejaculation... 2.58 1.54 1.09 0.17 4.29 3.84

000 55873............... .............. A

Cryoablate prostate.. 19.44

NA 9.02 1.23

NA 29.69

090 55899............... .............. C

Genital surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 55970............... .............. N

Sex transformation, M 0.00 0.00 0.00 0.00 0.00 0.00

XXX to F. 55980............... .............. N

Sex transformation, F 0.00 0.00 0.00 0.00 0.00 0.00

XXX to M. 56405............... .............. A

I & D of vulva/

1.44 1.33 1.15 0.17 2.94 2.76

010 perineum. 56420............... .............. A

Drainage of gland

1.39 2.29 1.09 0.16 3.84 2.64

010 abscess. 56440............... .............. A

Surgery for vulva

2.84

NA 1.71 0.34

NA 4.89

010 lesion. 56441............... .............. A

Lysis of labial

1.97 1.83 1.42 0.21 4.01 3.60

010 lesion(s).

[[Page 1174]]

56501............... .............. A

Destroy, vulva

1.53 1.79 1.25 0.18 3.50 2.96

010 lesions, sim. 56515............... .............. A

Destroy vulva lesion/ 2.76 2.55 1.81 0.22 5.53 4.79

010 s compl. 56605............... .............. A

Biopsy of vulva/

1.10 1.09 0.46 0.13 2.32 1.69

000 perineum. 56606............... .............. A

Biopsy of vulva/

0.55 0.49 0.22 0.07 1.11 0.84

ZZZ perineum. 56620............... .............. A

Partial removal of

7.46

NA 4.84 0.92

NA 13.22

090 vulva. 56625............... .............. A

Complete removal of

8.39

NA 5.39 1.01

NA 14.79

090 vulva. 56630............... .............. A

Extensive vulva

12.34

NA 6.96 1.48

NA 20.78

090 surgery. 56631............... .............. A

Extensive vulva

16.18

NA 8.96 1.97

NA 27.11

090 surgery. 56632............... .............. A

Extensive vulva

20.26

NA 9.62 2.45

NA 32.33

090 surgery. 56633............... .............. A

Extensive vulva

16.45

NA 8.70 2.00

NA 27.15

090 surgery. 56634............... .............. A

Extensive vulva

17.85

NA 9.59 2.15

NA 29.59

090 surgery. 56637............... .............. A

Extensive vulva

21.94

NA 11.23 2.63

NA 35.80

090 surgery. 56640............... .............. A

Extensive vulva

22.14

NA 10.80 2.73

NA 35.67

090 surgery. 56700............... .............. A

Partial removal of

2.52

NA 1.73 0.29

NA 4.54

010 hymen. 56720............... .............. A

Incision of hymen.... 0.68

NA 0.39 0.08

NA 1.15

000 56740............... .............. A

Remove vagina gland

4.56

NA 2.47 0.45

NA 7.48

010 lesion. 56800............... .............. A

Repair of vagina..... 3.88

NA 2.19 0.45

NA 6.52

010 56805............... .............. A

Repair clitoris...... 18.83

NA 9.43 2.20

NA 30.46

090 56810............... .............. A

Repair of perineum... 4.12

NA 2.30 0.49

NA 6.91

010 56820............... .............. A

Exam of vulva w/scope 1.50 1.34 0.63 0.12 2.96 2.25

000 56821............... .............. A

Exam/biopsy of vulva

2.05 1.78 0.90 0.16 3.99 3.11

000 w/scope. 57000............... .............. A

Exploration of vagina 2.97

NA 1.73 0.34

NA 5.04

010 57010............... .............. A

Drainage of pelvic

6.02

NA 3.85 0.69

NA 10.56

090 abscess. 57020............... .............. A

Drainage of pelvic

1.50 0.95 0.59 0.18 2.63 2.27

000 fluid. 57022............... .............. A

I & d vaginal

2.56

NA 1.50 0.29

NA 4.35

010 hematoma, pp. 57023............... .............. A

I & d vag hematoma,

4.74

NA 2.59 0.29

NA 7.62

010 non-ob. 57061............... .............. A

Destroy vag lesions,

1.25 1.66 1.12 0.16 3.07 2.53

010 simple. 57065............... .............. A

Destroy vag lesions,

2.61 2.30 1.68 0.31 5.22 4.60

010 complex. 57100............... .............. A

Biopsy of vagina..... 1.20 1.10 0.48 0.12 2.42 1.80

000 57105............... .............. A

Biopsy of vagina..... 1.69 1.93 1.32 0.21 3.83 3.22

010 57106............... .............. A

Remove vagina wall,

6.35

NA 4.20 0.70

NA 11.25

090 partial. 57107............... .............. A

Remove vagina tissue, 22.97

NA 10.50 2.62

NA 36.09

090 part. 57109............... .............. A

Vaginectomy partial w/ 26.96

NA 11.34 2.38

NA 40.68

090 nodes. 57110............... .............. A

Remove vagina wall,

14.27

NA 7.31 1.72

NA 23.30

090 complete. 57111............... .............. A

Remove vagina tissue, 26.96

NA 12.64 3.27

NA 42.87

090 compl. 57112............... .............. A

Vaginectomy w/nodes, 28.96

NA 12.19 2.64

NA 43.79

090 compl. 57120............... .............. A

Closure of vagina.... 7.40

NA 4.64 0.90

NA 12.94

090 57130............... .............. A

Remove vagina lesion. 2.43 2.17 1.55 0.28 4.88 4.26

010 57135............... .............. A

Remove vagina lesion. 2.67 2.27 1.66 0.31 5.25 4.64

010 57150............... .............. A

Treat vagina

0.55 1.11 0.22 0.07 1.73 0.84

000 infection. 57155............... .............. A

Insert uteri tandems/ 6.26

NA 4.17 0.71

NA 11.14

090 ovoids. 57160............... .............. A

Insert pessary/other

0.89 1.09 0.38 0.11 2.09 1.38

000 device. 57170............... .............. A

Fitting of diaphragm/ 0.91 1.49 0.34 0.11 2.51 1.36

000 cap. 57180............... .............. A

Treat vaginal

1.58 2.18 1.29 0.19 3.95 3.06

010 bleeding. 57200............... .............. A

Repair of vagina..... 3.93

NA 2.91 0.46

NA 7.30

090 57210............... .............. A

Repair vagina/

5.16

NA 3.44 0.60

NA 9.20

090 perineum. 57220............... .............. A

Revision of urethra.. 4.30

NA 3.12 0.51

NA 7.93

090 57230............... .............. A

Repair of urethral

5.63

NA 3.42 0.60

NA 9.65

090 lesion. 57240............... .............. A

Repair bladder &

6.06

NA 3.84 0.64

NA 10.54

090 vagina. 57250............... .............. A

Repair rectum &

5.52

NA 3.59 0.65

NA 9.76

090 vagina. 57260............... .............. A

Repair of vagina..... 8.26

NA 4.86 1.00

NA 14.12

090 57265............... .............. A

Extensive repair of

11.32

NA 6.06 1.37

NA 18.75

090 vagina. 57268............... .............. A

Repair of bowel bulge 6.75

NA 4.21 0.80

NA 11.76

090 57270............... .............. A

Repair of bowel pouch 12.09

NA 6.28 1.41

NA 19.78

090 57280............... .............. A

Suspension of vagina. 15.02

NA 7.39 1.74

NA 24.15

090 57282............... .............. A

Repair of vaginal

8.85

NA 5.32 1.04

NA 15.21

090 prolapse. 57284............... .............. A

Repair paravaginal

12.68

NA 7.17 1.41

NA 21.26

090 defect. 57287............... .............. A

Revise/remove sling

10.69

NA 5.52 0.89

NA 17.10

090 repair. 57288............... .............. A

Repair bladder defect 13.00

NA 5.95 1.04

NA 19.99

090 57289............... .............. A

Repair bladder &

11.56

NA 6.07 1.15

NA 18.78

090 vagina. 57291............... .............. A

Construction of

7.94

NA 4.96 0.94

NA 13.84

090 vagina. 57292............... .............. A

Construct vagina with 13.07

NA 6.98 1.56

NA 21.61

090 graft. 57300............... .............. A

Repair rectum-vagina

7.60

NA 4.30 0.84

NA 12.74

090 fistula. 57305............... .............. A

Repair rectum-vagina 13.75

NA 6.30 1.60

NA 21.65

090 fistula. 57307............... .............. A

Fistula repair &

15.91

NA 7.07 1.92

NA 24.90

090 colostomy. 57308............... .............. A

Fistula repair,

9.93

NA 5.15 1.10

NA 16.18

090 transperine. 57310............... .............. A

Repair urethrovaginal 6.77

NA 3.90 0.54

NA 11.21

090 lesion. 57311............... .............. A

Repair urethrovaginal 7.97

NA 4.18 0.62

NA 12.77

090 lesion. 57320............... .............. A

Repair bladder-vagina 8.00

NA 4.43 0.72

NA 13.15

090 lesion. 57330............... .............. A

Repair bladder-vagina 12.33

NA 5.78 1.04

NA 19.15

090 lesion. 57335............... .............. A

Repair vagina........ 18.70

NA 9.10 2.00

NA 29.80

090 57400............... .............. A

Dilation of vagina... 2.27

NA 1.13 0.27

NA 3.67

000 57410............... .............. A

Pelvic examination... 1.75 2.02 0.89 0.17 3.94 2.81

000 57415............... .............. A

Remove vaginal

2.17

NA 1.43 0.23

NA 3.83

010 foreign body. 57420............... .............. A

Exam of vagina w/

1.60 1.38 0.67 0.12 3.10 2.39

000 scope.

[[Page 1175]]

57421............... .............. A

Exam/biopsy of vag w/ 2.20 1.87 0.96 0.16 4.23 3.32

000 scope. 57425............... .............. A

Laparoscopy, surg,

15.73

NA 6.69 1.74

NA 24.16

090 colpopexy. 57452............... .............. A

Exam of cervix w/

1.50 1.40 0.63 0.12 3.02 2.25

000 scope. 57454............... .............. A

Bx/curett of cervix w/ 2.33 1.76 1.00 0.16 4.25 3.49

000 scope. 57455............... .............. A

Biopsy of cervix w/

1.99 1.75 0.87 0.16 3.90 3.02

000 scope. 57456............... .............. A

Endocerv curettage w/ 1.85 1.68 0.82 0.16 3.69 2.83

000 scope. 57460............... .............. A

Bx of cervix w/scope, 2.83 6.03 1.22 0.34 9.20 4.39

000 leep. 57461............... .............. A

Conz of cervix w/

3.43 6.30 1.41 0.34 10.07 5.18

000 scope, leep. 57500............... .............. A

Biopsy of cervix..... 0.97 2.66 0.47 0.12 3.75 1.56

000 57505............... .............. A

Endocervical

1.14 1.47 1.10 0.14 2.75 2.38

010 curettage. 57510............... .............. A

Cauterization of

1.90 1.57 1.05 0.22 3.69 3.17

010 cervix. 57511............... .............. A

Cryocautery of cervix 1.90 1.84 1.38 0.22 3.96 3.50

010 57513............... .............. A

Laser surgery of

1.90 1.87 1.41 0.23 4.00 3.54

010 cervix. 57520............... .............. A

Conization of cervix. 4.03 4.88 2.77 0.49 9.40 7.29

090 57522............... .............. A

Conization of cervix. 3.35 4.35 2.67 0.41 8.11 6.43

090 57530............... .............. A

Removal of cervix.... 4.78

NA 3.43 0.58

NA 8.79

090 57531............... .............. A

Removal of cervix,

27.96

NA 13.23 2.97

NA 44.16

090 radical. 57540............... .............. A

Removal of residual

12.20

NA 6.27 1.46

NA 19.93

090 cervix. 57545............... .............. A

Remove cervix/repair 13.01

NA 6.70 1.57

NA 21.28

090 pelvis. 57550............... .............. A

Removal of residual

5.52

NA 3.86 0.66

NA 10.04

090 cervix. 57555............... .............. A

Remove cervix/repair

8.94

NA 5.14 1.07

NA 15.15

090 vagina. 57556............... .............. A

Remove cervix, repair 8.36

NA 4.88 0.96

NA 14.20

090 bowel. 57700............... .............. A

Revision of cervix... 3.54

NA 3.10 0.40

NA 7.04

090 57720............... .............. A

Revision of cervix... 4.12

NA 3.15 0.49

NA 7.76

090 57800............... .............. A

Dilation of cervical

0.77 0.76 0.47 0.10 1.63 1.34

000 canal. 57820............... .............. A

D & c of residual

1.67 1.49 1.14 0.21 3.37 3.02

010 cervix. 58100............... .............. A

Biopsy of uterus

1.53 1.33 0.72 0.08 2.94 2.33

000 lining. 58120............... .............. A

Dilation and

3.27 2.31 1.87 0.40 5.98 5.54

010 curettage. 58140............... .............. A

Myomectomy abdom

14.58

NA 7.13 1.76

NA 23.47

090 method. 58145............... .............. A

Myomectomy vag method 8.03

NA 4.84 0.96

NA 13.83

090 58146............... .............. A

Myomectomy abdom

18.97

NA 8.79 1.76

NA 29.52

090 complex. 58150............... .............. A

Total hysterectomy... 15.22

NA 7.52 1.89

NA 24.63

090 58152............... .............. A

Total hysterectomy... 20.57

NA 9.89 1.83

NA 32.29

090 58180............... .............. A

Partial hysterectomy. 15.27

NA 7.49 1.86

NA 24.62

090 58200............... .............. A

Extensive

21.56

NA 10.05 2.59

NA 34.20

090 hysterectomy. 58210............... .............. A

Extensive

28.81

NA 13.27 3.51

NA 45.59

090 hysterectomy. 58240............... .............. A

Removal of pelvis

38.33

NA 17.72 4.53

NA 60.58

090 contents. 58260............... .............. A

Vaginal hysterectomy. 12.96

NA 6.72 1.48

NA 21.16

090 58262............... .............. A

Vag hyst including t/ 14.75

NA 7.40 1.71

NA 23.86

090 o. 58263............... .............. A

Vag hyst w/t/o & vag 16.04

NA 7.90 1.87

NA 25.81

090 repair. 58267............... .............. A

Vag hyst w/urinary

17.01

NA 8.42 1.82

NA 27.25

090 repair. 58270............... .............. A

Vag hyst w/enterocele 14.24

NA 7.10 1.65

NA 22.99

090 repair. 58275............... .............. A

Hysterectomy/revise

15.74

NA 7.80 1.82

NA 25.36

090 vagina. 58280............... .............. A

Hysterectomy/revise

16.98

NA 8.28 1.86

NA 27.12

090 vagina. 58285............... .............. A

Extensive

22.23

NA 10.02 2.27

NA 34.52

090 hysterectomy. 58290............... .............. A

Vag hyst complex..... 18.97

NA 8.92 1.48

NA 29.37

090 58291............... .............. A

Vag hyst incl t/o,

20.76

NA 9.89 1.71

NA 32.36

090 complex. 58292............... .............. A

Vag hyst t/o &

22.05

NA 10.40 1.87

NA 34.32

090 repair, compl. 58293............... .............. A

Vag hyst w/uro

23.03

NA 10.91 1.82

NA 35.76

090 repair, compl. 58294............... .............. A

Vag hyst w/

20.25

NA 9.68 1.65

NA 31.58

090 enterocele, compl. 58300............... .............. N

Insert intrauterine

+1.01 1.42 0.38 0.12 2.55 1.51

XXX device. 58301............... .............. A

Remove intrauterine

1.27 1.33 0.48 0.16 2.76 1.91

000 device. 58321............... .............. A

Artificial

0.92 1.15 0.37 0.12 2.19 1.41

000 insemination. 58322............... .............. A

Artificial

1.10 1.21 0.41 0.13 2.44 1.64

000 insemination. 58323............... .............. A

Sperm washing........ 0.23 0.24 0.09 0.02 0.49 0.34

000 58340............... .............. A

Catheter for

0.88 6.08 0.65 0.10 7.06 1.63

000 hysterography. 58345............... .............. A

Reopen fallopian tube 4.65

NA 2.44 0.43

NA 7.52

010 58346............... .............. A

Insert heyman uteri

6.74

NA 3.93 0.77

NA 11.44

090 capsule. 58350............... .............. A

Reopen fallopian tube 1.01 1.50 0.93 0.12 2.63 2.06

010 58353............... .............. A

Endometr ablate,

3.55 36.26 2.05 0.45 40.26 6.05

010 thermal. 58400............... .............. A

Suspension of uterus. 6.35

NA 3.97 0.75

NA 11.07

090 58410............... .............. A

Suspension of uterus. 12.71

NA 6.48 1.31

NA 20.50

090 58520............... .............. A

Repair of ruptured

11.90

NA 6.07 1.41

NA 19.38

090 uterus. 58540............... .............. A

Revision of uterus... 14.62

NA 6.98 1.54

NA 23.14

090 58545............... .............. A

Laparoscopic

14.58

NA 7.19 1.75

NA 23.52

090 myomectomy. 58546............... .............. A

Laparo-myomectomy,

18.97

NA 8.98 1.75

NA 29.70

090 complex. 58550............... .............. A

Laparo-asst vag

14.17

NA 7.31 1.74

NA 23.22

090 hysterectomy. 58552............... .............. A

Laparo-vag hyst incl 15.98

NA 8.02 1.74

NA 25.74

090 t/o. 58553............... .............. A

Laparo-vag hyst,

18.97

NA 8.97 1.48

NA 29.42

090 complex. 58554............... .............. A

Laparo-vag hyst w/t/ 21.97

NA 10.46 1.48

NA 33.91

090 o, compl. 58555............... .............. A

Hysteroscopy, dx, sep 3.33 2.10 1.46 0.41 5.84 5.20

000 proc. 58558............... .............. A

Hysteroscopy, biopsy. 4.74

NA 2.06 0.59

NA 7.39

000 58559............... .............. A

Hysteroscopy, lysis.. 6.16

NA 2.62 0.75

NA 9.53

000 58560............... .............. A

Hysteroscopy, resect

6.99

NA 2.97 0.86

NA 10.82

000 septum. 58561............... .............. A

Hysteroscopy, remove

9.99

NA 4.18 1.23

NA 15.40

000 myoma.

[[Page 1176]]

58562............... .............. A

Hysteroscopy, remove

5.20

NA 2.21 0.63

NA 8.04

000 fb. 58563............... .............. A

Hysteroscopy,

6.16

NA 2.63 0.75

NA 9.54

000 ablation. 58578............... .............. C

Laparo proc, uterus.. 0.00 0.00 0.00 0.00 0.00 0.00

YYY 58579............... .............. C

Hysteroscope

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 58600............... .............. A

Division of fallopian 5.59

NA 3.36 0.47

NA 9.42

090 tube. 58605............... .............. A

Division of fallopian 4.99

NA 3.15 0.40

NA 8.54

090 tube. 58611............... .............. A

Ligate oviduct(s) add- 1.45

NA 0.57 0.08

NA 2.10

ZZZ on. 58615............... .............. A

Occlude fallopian

3.89

NA 2.72 0.48

NA 7.09

010 tube(s). 58660............... .............. A

Laparoscopy, lysis... 11.27

NA 5.28 1.37

NA 17.92

090 58661............... .............. A

Laparoscopy, remove

11.03

NA 5.14 1.35

NA 17.52

010 adnexa. 58662............... .............. A

Laparoscopy, excise

11.77

NA 5.80 1.42

NA 18.99

090 lesions. 58670............... .............. A

Laparoscopy, tubal

5.59

NA 3.28 0.66

NA 9.53

090 cautery. 58671............... .............. A

Laparoscopy, tubal

5.59

NA 3.30 0.68

NA 9.57

090 block. 58672............... .............. A

Laparoscopy,

12.86

NA 6.23 1.47

NA 20.56

090 fimbrioplasty. 58673............... .............. A

Laparoscopy,

13.72

NA 6.63 1.69

NA 22.04

090 salpingostomy. 58679............... .............. C

Laparo proc, oviduct- 0.00 0.00 0.00 0.00 0.00 0.00

YYY ovary. 58700............... .............. A

Removal of fallopian 12.03

NA 6.01 0.77

NA 18.81

090 tube. 58720............... .............. A

Removal of ovary/

11.34

NA 5.81 1.37

NA 18.52

090 tube(s). 58740............... .............. A

Revise fallopian

13.98

NA 7.16 0.71

NA 21.85

090 tube(s). 58750............... .............. A

Repair oviduct....... 14.82

NA 7.41 1.83

NA 24.06

090 58752............... .............. A

Revise ovarian

14.82

NA 6.99 1.82

NA 23.63

090 tube(s). 58760............... .............. A

Remove tubal

13.11

NA 6.75 1.62

NA 21.48

090 obstruction. 58770............... .............. A

Create new tubal

13.95

NA 6.95 1.71

NA 22.61

090 opening. 58800............... .............. A

Drainage of ovarian

4.13 4.49 2.99 0.43 9.05 7.55

090 cyst(s). 58805............... .............. A

Drainage of ovarian

5.87

NA 3.55 0.68

NA 10.10

090 cyst(s). 58820............... .............. A

Drain ovary abscess,

4.21

NA 3.34 0.35

NA 7.90

090 open. 58822............... .............. A

Drain ovary abscess, 10.11

NA 5.24 1.11

NA 16.46

090 percut. 58823............... .............. A

Drain pelvic abscess, 3.37

NA 1.12 0.22

NA 4.71

000 percut. 58825............... .............. A

Transposition,

10.96

NA 5.82 0.75

NA 17.53

090 ovary(s). 58900............... .............. A

Biopsy of ovary(s)... 5.98

NA 3.61 0.68

NA 10.27

090 58920............... .............. A

Partial removal of

11.34

NA 5.62 0.82

NA 17.78

090 ovary(s). 58925............... .............. A

Removal of ovarian

11.34

NA 5.71 1.37

NA 18.42

090 cyst(s). 58940............... .............. A

Removal of ovary(s).. 7.28

NA 4.13 0.88

NA 12.29

090 58943............... .............. A

Removal of ovary(s).. 18.40

NA 8.75 2.24

NA 29.39

090 58950............... .............. A

Resect ovarian

16.90

NA 8.50 1.87

NA 27.27

090 malignancy. 58951............... .............. A

Resect ovarian

22.35

NA 10.55 2.65

NA 35.55

090 malignancy. 58952............... .............. A

Resect ovarian

24.97

NA 11.85 3.10

NA 39.92

090 malignancy. 58953............... .............. A

Tah, rad dissect for 31.95

NA 14.61 3.98

NA 50.54

090 debulk. 58954............... .............. A

Tah rad debulk/lymph 34.95

NA 15.77 4.29

NA 55.01

090 remove. 58960............... .............. A

Exploration of

14.63

NA 7.45 1.77

NA 23.85

090 abdomen. 58970............... .............. A

Retrieval of oocyte.. 3.52 2.32 1.50 0.43 6.27 5.45

000 58974............... .............. C

Transfer of embryo... 0.00 0.00 0.00 0.00 0.00 0.00

000 58976............... .............. A

Transfer of embryo... 3.82 2.64 1.83 0.47 6.93 6.12

000 58999............... .............. C

Genital surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 59000............... .............. A

Amniocentesis,

1.30 2.10 0.69 0.28 3.68 2.27

000 diagnostic. 59001............... .............. A

Amniocentesis,

3.00

NA 1.41 0.28

NA 4.69

000 therapeutic. 59012............... .............. A

Fetal cord

3.44

NA 1.56 0.75

NA 5.75

000 puncture,prenatal. 59015............... .............. A

Chorion biopsy....... 2.20 1.57 1.06 0.48 4.25 3.74

000 59020............... .............. A

Fetal contract stress 0.66 0.79

NA 0.24 1.69

NA

000 test. 59020............... 26............ A

Fetal contract stress 0.66 0.27 0.27 0.14 1.07 1.07

000 test. 59020............... TC............ A

Fetal contract stress 0.00 0.52

NA 0.10 0.62

NA

000 test. 59025............... .............. A

Fetal non-stress test 0.53 0.45

NA 0.14 1.12

NA

000 59025............... 26............ A

Fetal non-stress test 0.53 0.21 0.21 0.12 0.86 0.86

000 59025............... TC............ A

Fetal non-stress test 0.00 0.24

NA 0.02 0.26

NA

000 59030............... .............. A

Fetal scalp blood

1.99

NA 1.05 0.43

NA 3.47

000 sample. 59050............... .............. A

Fetal monitor w/

0.89

NA 0.36 0.19

NA 1.44

XXX report. 59051............... .............. A

Fetal monitor/

0.74

NA 0.30 0.17

NA 1.21

XXX interpret only. 59070............... .............. A

Transabdom amnioinfus 5.24 5.12 2.41 0.28 10.64 7.93

000 w/ us. 59072............... .............. A

Umbilical cord occlud 8.99

NA 3.13 0.68

NA 12.80

000 w/ us. 59074............... .............. A

Fetal fluid drainage

5.24 4.61 2.41 0.28 10.13 7.93

000 w/ us. 59076............... .............. A

Fetal shunt

8.99

NA 3.13 0.68

NA 12.80

000 placement, w/ us. 59100............... .............. A

Remove uterus lesion. 12.33

NA 6.48 2.67

NA 21.48

090 59120............... .............. A

Treat ectopic

11.47

NA 6.27 2.48

NA 20.22

090 pregnancy. 59121............... .............. A

Treat ectopic

11.65

NA 6.35 2.52

NA 20.52

090 pregnancy. 59130............... .............. A

Treat ectopic

14.20

NA 4.99 3.06

NA 22.25

090 pregnancy. 59135............... .............. A

Treat ectopic

13.86

NA 7.25 3.00

NA 24.11

090 pregnancy. 59136............... .............. A

Treat ectopic

13.16

NA 6.64 2.85

NA 22.65

090 pregnancy. 59140............... .............. A

Treat ectopic

5.45 5.20 3.59 1.18 11.83 10.22

090 pregnancy. 59150............... .............. A

Treat ectopic

11.65

NA 6.05 1.48

NA 19.18

090 pregnancy. 59151............... .............. A

Treat ectopic

11.47

NA 6.09 1.70

NA 19.26

090 pregnancy. 59160............... .............. A

D & c after delivery. 2.71 3.27 2.11 0.59 6.57 5.41

010 59200............... .............. A

Insert cervical

0.79 1.20 0.31 0.18 2.17 1.28

000 dilator. 59300............... .............. A

Episiotomy or vaginal 2.41 2.16 0.96 0.52 5.09 3.89

000 repair. 59320............... .............. A

Revision of cervix... 2.48

NA 1.26 0.54

NA 4.28

000 59325............... .............. A

Revision of cervix... 4.06

NA 1.92 0.88

NA 6.86

000

[[Page 1177]]

59350............... .............. A

Repair of uterus..... 4.94

NA 1.95 1.06

NA 7.95

000 59400............... .............. A

Obstetrical care..... 23.03

NA 15.48 4.99

NA 43.50

MMM 59409............... .............. A

Obstetrical care..... 13.48

NA 5.32 2.92

NA 21.72

MMM 59410............... .............. A

Obstetrical care..... 14.76

NA 6.33 3.20

NA 24.29

MMM 59412............... .............. A

Antepartum

1.71

NA 0.81 0.37

NA 2.89

MMM manipulation. 59414............... .............. A

Deliver placenta..... 1.61

NA 0.63 0.35

NA 2.59

MMM 59425............... .............. A

Antepartum care only. 4.80 4.26 1.87 1.04 10.10 7.71

MMM 59426............... .............. A

Antepartum care only. 8.27 7.65 3.23 1.80 17.72 13.30

MMM 59430............... .............. A

Care after delivery.. 2.13 1.24 0.94 0.46 3.83 3.53

MMM 59510............... .............. A

Cesarean delivery.... 26.18

NA 17.43 5.67

NA 49.28

MMM 59514............... .............. A

Cesarean delivery

15.95

NA 6.23 3.45

NA 25.63

MMM only. 59515............... .............. A

Cesarean delivery.... 17.34

NA 7.87 3.76

NA 28.97

MMM 59525............... .............. A

Remove uterus after

8.53

NA 3.32 1.85

NA 13.70

ZZZ cesarean. 59610............... .............. A

Vbac delivery........ 24.58

NA 16.03 5.32

NA 45.93

MMM 59612............... .............. A

Vbac delivery only... 15.04

NA 6.07 3.26

NA 24.37

MMM 59614............... .............. A

Vbac care after

16.32

NA 6.96 3.53

NA 26.81

MMM delivery. 59618............... .............. A

Attempted vbac

27.74

NA 18.43 6.01

NA 52.18

MMM delivery. 59620............... .............. A

Attempted vbac

17.50

NA 6.78 3.80

NA 28.08

MMM delivery only. 59622............... .............. A

Attempted vbac after 18.90

NA 8.67 4.09

NA 31.66

MMM care. 59812............... .............. A

Treatment of

4.00

NA 2.56 0.70

NA 7.26

090 miscarriage. 59820............... .............. A

Care of miscarriage.. 4.00

NA 3.52 0.87

NA 8.39

090 59821............... .............. A

Treatment of

4.46

NA 3.45 0.96

NA 8.87

090 miscarriage. 59830............... .............. A

Treat uterus

6.10

NA 4.01 1.33

NA 11.44

090 infection. 59840............... .............. R

Abortion............. 3.01

NA 2.13 0.65

NA 5.79

010 59841............... .............. R

Abortion............. 5.23 2.58 2.58 1.13 8.94 8.94

010 59850............... .............. R

Abortion............. 5.90

NA 3.27 1.28

NA 10.45

090 59851............... .............. R

Abortion............. 5.92

NA 3.74 1.28

NA 10.94

090 59852............... .............. R

Abortion............. 8.23

NA 5.06 1.79

NA 15.08

090 59855............... .............. R

Abortion............. 6.11

NA 3.56 1.33

NA 11.00

090 59856............... .............. R

Abortion............. 7.47

NA 4.07 1.62

NA 13.16

090 59857............... .............. R

Abortion............. 9.28

NA 4.59 2.00

NA 15.87

090 59866............... .............. R

Abortion (mpr)....... 3.99

NA 1.83 0.87

NA 6.69

000 59870............... .............. A

Evacuate mole of

6.00

NA 4.43 0.93

NA 11.36

090 uterus. 59871............... .............. A

Remove cerclage

2.13 1.76 1.13 0.46 4.35 3.72

000 suture. 59897............... .............. C

Fetal invas px w/ us. 0.00 0.00 0.00 0.00 0.00 0.00

YYY 59898............... .............. C

Laparo proc, ob care/ 0.00 0.00 0.00 0.00 0.00 0.00

YYY deliver. 59899............... .............. C

Maternity care

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 60000............... .............. A

Drain thyroid/tongue

1.76 2.16 2.04 0.17 4.09 3.97

010 cyst. 60001............... .............. A

Aspirate/inject

0.97 1.49 0.34 0.07 2.53 1.38

000 thyriod cyst. 60100............... .............. A

Biopsy of thyroid.... 1.56 1.42 0.53 0.06 3.04 2.15

000 60200............... .............. A

Remove thyroid lesion 9.54

NA 6.14 1.01

NA 16.69

090 60210............... .............. A

Partial thyroid

10.86

NA 5.78 1.22

NA 17.86

090 excision. 60212............... .............. A

Partial thyroid

16.01

NA 7.82 1.82

NA 25.65

090 excision. 60220............... .............. A

Partial removal of

11.88

NA 6.30 1.17

NA 19.35

090 thyroid. 60225............... .............. A

Partial removal of

14.17

NA 7.55 1.58

NA 23.30

090 thyroid. 60240............... .............. A

Removal of thyroid... 16.04

NA 7.75 1.81

NA 25.60

090 60252............... .............. A

Removal of thyroid... 20.54

NA 10.29 1.97

NA 32.80

090 60254............... .............. A

Extensive thyroid

26.95

NA 14.38 2.36

NA 43.69

090 surgery. 60260............... .............. A

Repeat thyroid

17.44

NA 8.85 1.68

NA 27.97

090 surgery. 60270............... .............. A

Removal of thyroid... 20.24

NA 10.66 2.15

NA 33.05

090 60271............... .............. A

Removal of thyroid... 16.80

NA 8.78 1.63

NA 27.21

090 60280............... .............. A

Remove thyroid duct

5.86

NA 4.83 0.54

NA 11.23

090 lesion. 60281............... .............. A

Remove thyroid duct

8.52

NA 5.99 0.81

NA 15.32

090 lesion. 60500............... .............. A

Explore parathyroid

16.21

NA 7.53 1.94

NA 25.68

090 glands. 60502............... .............. A

Re-explore

20.32

NA 9.49 2.41

NA 32.22

090 parathyroids. 60505............... .............. A

Explore parathyroid

21.46

NA 11.12 2.58

NA 35.16

090 glands. 60512............... .............. A

Autotransplant

4.44

NA 1.63 0.53

NA 6.60

ZZZ parathyroid. 60520............... .............. A

Removal of thymus

16.78

NA 8.38 2.22

NA 27.38

090 gland. 60521............... .............. A

Removal of thymus

18.84

NA 9.63 2.82

NA 31.29

090 gland. 60522............... .............. A

Removal of thymus

23.06

NA 11.35 3.41

NA 37.82

090 gland. 60540............... .............. A

Explore adrenal gland 17.00

NA 7.65 1.71

NA 26.36

090 60545............... .............. A

Explore adrenal gland 19.85

NA 8.61 2.11

NA 30.57

090 60600............... .............. A

Remove carotid body

17.90

NA 10.90 2.26

NA 31.06

090 lesion. 60605............... .............. A

Remove carotid body

20.21

NA 12.79 2.75

NA 35.75

090 lesion. 60650............... .............. A

Laparoscopy

19.97

NA 7.99 2.39

NA 30.35

090 adrenalectomy. 60659............... .............. C

Laparo proc,

0.00 0.00 0.00 0.00 0.00 0.00

YYY endocrine. 60699............... .............. C

Endocrine surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 61000............... .............. A

Remove cranial cavity 1.58

NA 0.96 0.16

NA 2.70

000 fluid. 61001............... .............. A

Remove cranial cavity 1.49

NA 1.06 0.18

NA 2.73

000 fluid. 61020............... .............. A

Remove brain cavity

1.51

NA 1.35 0.31

NA 3.17

000 fluid. 61026............... .............. A

Injection into brain

1.69

NA 1.41 0.25

NA 3.35

000 canal. 61050............... .............. A

Remove brain canal

1.51

NA 1.26 0.16

NA 2.93

000 fluid. 61055............... .............. A

Injection into brain

2.10

NA 1.42 0.16

NA 3.68

000 canal. 61070............... .............. A

Brain canal shunt

0.89

NA 1.03 0.11

NA 2.03

000 procedure. 61105............... .............. A

Twist drill hole..... 5.13

NA 3.95 1.27

NA 10.35

090

[[Page 1178]]

61107............... .............. A

Drill skull for

4.99

NA 3.32 1.23

NA 9.54

000 implantation. 61108............... .............. A

Drill skull for

10.17

NA 7.14 2.46

NA 19.77

090 drainage. 61120............... .............. A

Burr hole for

8.75

NA 6.00 2.18

NA 16.93

090 puncture. 61140............... .............. A

Pierce skull for

15.88

NA 9.91 3.80

NA 29.59

090 biopsy. 61150............... .............. A

Pierce skull for

17.54

NA 10.41 4.25

NA 32.20

090 drainage. 61151............... .............. A

Pierce skull for

12.40

NA 7.85 2.95

NA 23.20

090 drainage. 61154............... .............. A

Pierce skull & remove 14.97

NA 9.50 3.68

NA 28.15

090 clot. 61156............... .............. A

Pierce skull for

16.30

NA 9.86 4.12

NA 30.28

090 drainage. 61210............... .............. A

Pierce skull, implant 5.83

NA 3.71 1.40

NA 10.94

000 device. 61215............... .............. A

Insert brain-fluid

4.88

NA 4.02 1.19

NA 10.09

090 device. 61250............... .............. A

Pierce skull &

10.40

NA 6.87 2.44

NA 19.71

090 explore. 61253............... .............. A

Pierce skull &

12.34

NA 7.74 2.73

NA 22.81

090 explore. 61304............... .............. A

Open skull for

21.93

NA 12.88 5.22

NA 40.03

090 exploration. 61305............... .............. A

Open skull for

26.57

NA 15.37 6.33

NA 48.27

090 exploration. 61312............... .............. A

Open skull for

24.53

NA 15.08 6.02

NA 45.63

090 drainage. 61313............... .............. A

Open skull for

24.89

NA 14.85 6.11

NA 45.85

090 drainage. 61314............... .............. A

Open skull for

24.19

NA 13.08 4.82

NA 42.09

090 drainage. 61315............... .............. A

Open skull for

27.64

NA 16.07 6.78

NA 50.49

090 drainage. 61316............... .............. A

Implt cran bone flap

1.39

NA 0.57 0.52

NA 2.48

ZZZ to abdo. 61320............... .............. A

Open skull for

25.58

NA 14.80 6.27

NA 46.65

090 drainage. 61321............... .............. A

Open skull for

28.46

NA 16.18 6.45

NA 51.09

090 drainage. 61322............... .............. A

Decompressive

29.46

NA 14.45 6.02

NA 49.93

090 craniotomy. 61323............... .............. A

Decompressive

30.95

NA 14.64 6.02

NA 51.61

090 lobectomy. 61330............... .............. A

Decompress eye socket 23.29

NA 13.80 3.11

NA 40.20

090 61332............... .............. A

Explore/biopsy eye

27.24

NA 15.66 5.01

NA 47.91

090 socket. 61333............... .............. A

Explore orbit/remove 27.91

NA 15.66 2.70

NA 46.27

090 lesion. 61334............... .............. A

Explore orbit/remove 18.24

NA 10.70 3.64

NA 32.58

090 object. 61340............... .............. A

Subtemporal

18.63

NA 11.16 4.41

NA 34.20

090 decompression. 61343............... .............. A

Incise skull (press

29.73

NA 16.88 7.28

NA 53.89

090 relief). 61345............... .............. A

Relieve cranial

27.16

NA 15.47 6.31

NA 48.94

090 pressure. 61440............... .............. A

Incise skull for

26.59

NA 14.28 6.72

NA 47.59

090 surgery. 61450............... .............. A

Incise skull for

25.91

NA 14.35 6.16

NA 46.42

090 surgery. 61458............... .............. A

Incise skull for

27.25

NA 15.58 6.37

NA 49.20

090 brain wound. 61460............... .............. A

Incise skull for

28.35

NA 16.49 6.19

NA 51.03

090 surgery. 61470............... .............. A

Incise skull for

26.02

NA 13.91 5.61

NA 45.54

090 surgery. 61480............... .............. A

Incise skull for

26.45

NA 15.34 6.68

NA 48.47

090 surgery. 61490............... .............. A

Incise skull for

25.62

NA 14.39 6.48

NA 46.49

090 surgery. 61500............... .............. A

Removal of skull

17.89

NA 10.85 3.93

NA 32.67

090 lesion. 61501............... .............. A

Remove infected skull 14.82

NA 9.25 3.17

NA 27.24

090 bone. 61510............... .............. A

Removal of brain

28.41

NA 16.76 6.96

NA 52.13

090 lesion. 61512............... .............. A

Remove brain lining

35.04

NA 19.76 8.61

NA 63.41

090 lesion. 61514............... .............. A

Removal of brain

25.22

NA 14.50 6.18

NA 45.90

090 abscess. 61516............... .............. A

Removal of brain

24.57

NA 14.33 5.96

NA 44.86

090 lesion. 61517............... .............. A

Implt brain chemotx

1.38

NA 0.57 0.10

NA 2.05

ZZZ add-on. 61518............... .............. A

Removal of brain

37.26

NA 21.20 9.08

NA 67.54

090 lesion. 61519............... .............. A

Remove brain lining

41.33

NA 22.75 9.83

NA 73.91

090 lesion. 61520............... .............. A

Removal of brain

54.76

NA 30.46 12.18

NA 97.40

090 lesion. 61521............... .............. A

Removal of brain

44.41

NA 24.33 10.67

NA 79.41

090 lesion. 61522............... .............. A

Removal of brain

29.41

NA 16.49 6.39

NA 52.29

090 abscess. 61524............... .............. A

Removal of brain

27.82

NA 15.74 6.04

NA 49.60

090 lesion. 61526............... .............. A

Removal of brain

52.09

NA 29.62 8.10

NA 89.81

090 lesion. 61530............... .............. A

Removal of brain

43.79

NA 25.19 7.44

NA 76.42

090 lesion. 61531............... .............. A

Implant brain

14.61

NA 9.17 3.43

NA 27.21

090 electrodes. 61533............... .............. A

Implant brain

19.68

NA 11.59 4.58

NA 35.85

090 electrodes. 61534............... .............. A

Removal of brain

20.94

NA 12.15 5.01

NA 38.10

090 lesion. 61535............... .............. A

Remove brain

11.61

NA 7.46 2.76

NA 21.83

090 electrodes. 61536............... .............. A

Removal of brain

35.47

NA 19.87 8.06

NA 63.40

090 lesion. 61537............... .............. A

Removal of brain

24.96

NA 14.45 6.49

NA 45.90

090 tissue. 61538............... .............. A

Removal of brain

26.77

NA 15.38 6.49

NA 48.64

090 tissue. 61539............... .............. A

Removal of brain

32.03

NA 17.85 7.98

NA 57.86

090 tissue. 61540............... .............. A

Removal of brain

29.96

NA 17.48 7.98

NA 55.42

090 tissue. 61541............... .............. A

Incision of brain

28.81

NA 16.28 6.63

NA 51.72

090 tissue. 61542............... .............. A

Removal of brain

30.97

NA 17.91 7.83

NA 56.71

090 tissue. 61543............... .............. A

Removal of brain

29.18

NA 16.46 7.37

NA 53.01

090 tissue. 61544............... .............. A

Remove & treat brain 25.46

NA 13.90 5.92

NA 45.28

090 lesion. 61545............... .............. A

Excision of brain

43.73

NA 24.33 10.71

NA 78.77

090 tumor. 61546............... .............. A

Removal of pituitary 31.25

NA 17.58 7.31

NA 56.14

090 gland. 61548............... .............. A

Removal of pituitary 21.50

NA 12.85 4.38

NA 38.73

090 gland. 61550............... .............. A

Release of skull

14.63

NA 7.01 1.37

NA 23.01

090 seams. 61552............... .............. A

Release of skull

19.53

NA 9.20 1.06

NA 29.79

090 seams. 61556............... .............. A

Incise skull/sutures. 22.23

NA 11.42 4.31

NA 37.96

090 61557............... .............. A

Incise skull/sutures. 22.35

NA 13.68 5.64

NA 41.67

090 61558............... .............. A

Excision of skull/

25.54

NA 14.25 3.15

NA 42.94

090 sutures. 61559............... .............. A

Excision of skull/

32.74

NA 19.39 8.27

NA 60.40

090 sutures. 61563............... .............. A

Excision of skull

26.79

NA 15.33 5.38

NA 47.50

090 tumor.

[[Page 1179]]

61564............... .............. A

Excision of skull

33.78

NA 18.37 8.54

NA 60.69

090 tumor. 61566............... .............. A

Removal of brain

30.95

NA 17.42 6.49

NA 54.86

090 tissue. 61567............... .............. A

Incision of brain

35.45

NA 20.73 6.49

NA 62.67

090 tissue. 61570............... .............. A

Remove foreign body, 24.56

NA 13.97 5.55

NA 44.08

090 brain. 61571............... .............. A

Incise skull for

26.35

NA 15.21 6.31

NA 47.87

090 brain wound. 61575............... .............. A

Skull base/brainstem 34.31

NA 19.74 6.05

NA 60.10

090 surgery. 61576............... .............. A

Skull base/brainstem 52.35

NA 29.68 5.64

NA 87.67

090 surgery. 61580............... .............. A

Craniofacial

30.30

NA 25.49 3.32

NA 59.11

090 approach, skull. 61581............... .............. A

Craniofacial

34.55

NA 23.05 4.06

NA 61.66

090 approach, skull. 61582............... .............. A

Craniofacial

31.61

NA 26.99 7.60

NA 66.20

090 approach, skull. 61583............... .............. A

Craniofacial

36.16

NA 25.01 8.37

NA 69.54

090 approach, skull. 61584............... .............. A

Orbitocranial

34.60

NA 24.41 7.88

NA 66.89

090 approach/skull. 61585............... .............. A

Orbitocranial

38.55

NA 26.46 7.47

NA 72.48

090 approach/skull. 61586............... .............. A

Resect nasopharynx,

25.06

NA 22.35 4.25

NA 51.66

090 skull. 61590............... .............. A

Infratemporal

41.72

NA 28.81 5.16

NA 75.69

090 approach/skull. 61591............... .............. A

Infratemporal

43.61

NA 29.71 6.34

NA 79.66

090 approach/skull. 61592............... .............. A

Orbitocranial

39.58

NA 26.60 9.11

NA 75.29

090 approach/skull. 61595............... .............. A

Transtemporal

29.53

NA 22.51 3.68

NA 55.72

090 approach/skull. 61596............... .............. A

Transcochlear

35.58

NA 24.59 5.13

NA 65.30

090 approach/skull. 61597............... .............. A

Transcondylar

37.90

NA 23.05 8.02

NA 68.97

090 approach/skull. 61598............... .............. A

Transpetrosal

33.36

NA 23.35 5.55

NA 62.26

090 approach/skull. 61600............... .............. A

Resect/excise cranial 25.81

NA 19.88 3.76

NA 49.45

090 lesion. 61601............... .............. A

Resect/excise cranial 27.85

NA 20.56 6.38

NA 54.79

090 lesion. 61605............... .............. A

Resect/excise cranial 29.29

NA 22.16 3.03

NA 54.48

090 lesion. 61606............... .............. A

Resect/excise cranial 38.77

NA 25.23 8.21

NA 72.21

090 lesion. 61607............... .............. A

Resect/excise cranial 36.22

NA 23.88 6.86

NA 66.96

090 lesion. 61608............... .............. A

Resect/excise cranial 42.04

NA 26.67 10.02

NA 78.73

090 lesion. 61609............... .............. A

Transect artery,

9.88

NA 4.87 2.50

NA 17.25

ZZZ sinus. 61610............... .............. A

Transect artery,

29.63

NA 13.19 4.25

NA 47.07

ZZZ sinus. 61611............... .............. A

Transect artery,

7.41

NA 3.84 1.87

NA 13.12

ZZZ sinus. 61612............... .............. A

Transect artery,

27.84

NA 13.36 4.28

NA 45.48

ZZZ sinus. 61613............... .............. A

Remove aneurysm,

40.80

NA 26.34 10.03

NA 77.17

090 sinus. 61615............... .............. A

Resect/excise lesion, 32.02

NA 22.82 5.60

NA 60.44

090 skull. 61616............... .............. A

Resect/excise lesion, 43.27

NA 28.77 8.47

NA 80.51

090 skull. 61618............... .............. A

Repair dura.......... 16.96

NA 10.51 3.52

NA 30.99

090 61619............... .............. A

Repair dura.......... 20.68

NA 12.31 4.12

NA 37.11

090 61623............... .............. A

Endovasc tempory

9.95

NA 4.23 0.60

NA 14.78

000 vessel occl. 61624............... .............. A

Transcath occlusion, 20.12

NA 6.93 1.39

NA 28.44

000 cns. 61626............... .............. A

Transcath occlusion, 16.60

NA 5.54 1.01

NA 23.15

000 non-cns. 61680............... .............. A

Intracranial vessel

30.66

NA 17.52 7.28

NA 55.46

090 surgery. 61682............... .............. A

Intracranial vessel

61.48

NA 32.37 15.31

NA 109.16

090 surgery. 61684............... .............. A

Intracranial vessel

39.75

NA 22.10 9.49

NA 71.34

090 surgery. 61686............... .............. A

Intracranial vessel

64.39

NA 34.88 15.92

NA 115.19

090 surgery. 61690............... .............. A

Intracranial vessel

29.27

NA 16.80 6.65

NA 52.72

090 surgery. 61692............... .............. A

Intracranial vessel

51.79

NA 27.61 12.27

NA 91.67

090 surgery. 61697............... .............. A

Brain aneurysm repr, 50.44

NA 28.13 12.43

NA 91.00

090 complx. 61698............... .............. A

Brain aneurysm repr, 48.34

NA 26.80 12.05

NA 87.19

090 complx. 61700............... .............. A

Brain aneurysm repr, 50.44

NA 27.93 12.28

NA 90.65

090 simple. 61702............... .............. A

Inner skull vessel

48.34

NA 26.15 11.76

NA 86.25

090 surgery. 61703............... .............. A

Clamp neck artery.... 17.44

NA 10.52 4.37

NA 32.33

090 61705............... .............. A

Revise circulation to 36.15

NA 19.34 8.04

NA 63.53

090 head. 61708............... .............. A

Revise circulation to 35.25

NA 15.20 2.63

NA 53.08

090 head. 61710............... .............. A

Revise circulation to 29.63

NA 13.66 2.92

NA 46.21

090 head. 61711............... .............. A

Fusion of skull

36.28

NA 19.90 8.91

NA 65.09

090 arteries. 61720............... .............. A

Incise skull/brain

16.74

NA 10.03 4.23

NA 31.00

090 surgery. 61735............... .............. A

Incise skull/brain

20.40

NA 12.22 5.02

NA 37.64

090 surgery. 61750............... .............. A

Incise skull/brain

18.17

NA 10.67 4.47

NA 33.31

090 biopsy. 61751............... .............. A

Brain biopsy w/ct/mr 17.59

NA 10.86 4.31

NA 32.76

090 guide. 61760............... .............. A

Implant brain

22.24

NA 8.77 5.54

NA 36.55

090 electrodes. 61770............... .............. A

Incise skull for

21.41

NA 12.31 4.93

NA 38.65

090 treatment. 61790............... .............. A

Treat trigeminal

10.84

NA 5.95 2.20

NA 18.99

090 nerve. 61791............... .............. A

Treat trigeminal

14.59

NA 8.96 3.65

NA 27.20

090 tract. 61793............... .............. A

Focus radiation beam. 17.21

NA 10.16 4.23

NA 31.60

090 61795............... .............. A

Brain surgery using

4.03

NA 2.04 0.98

NA 7.05

ZZZ computer. 61850............... .............. A

Implant

12.37

NA 7.71 2.69

NA 22.77

090 neuroelectrodes. 61860............... .............. A

Implant

20.84

NA 12.13 4.87

NA 37.84

090 neuroelectrodes. 61862............... .............. D

Implant neurostimul,

0.00 0.00 0.00 0.00 0.00 0.00

090 subcort. 61863............... .............. A

Implant

18.97

NA 9.21 4.79

NA 32.97

090 neuroelectrode. 61864............... .............. A

Implant

4.49

NA 2.29 1.13

NA 7.91

ZZZ neuroelectrde, add'l. 61867............... .............. A

Implant

31.29

NA 13.81 4.79

NA 49.89

090 neuroelectrode. 61868............... .............. A

Implant

7.91

NA 4.03 1.21

NA 13.15

ZZZ neuroelectrde, add'l. 61870............... .............. A

Implant

14.92

NA 9.82 2.05

NA 26.79

090 neuroelectrodes. 61875............... .............. A

Implant

15.04

NA 8.61 2.92

NA 26.57

090 neuroelectrodes. 61880............... .............. A

Revise/remove

6.28

NA 4.60 1.58

NA 12.46

090 neuroelectrode. 61885............... .............. A

Implant neurostim one 5.84

NA 5.32 1.47

NA 12.63

090 array.

[[Page 1180]]

61886............... .............. A

Implant neurostim

7.99

NA 6.36 1.98

NA 16.33

090 arrays. 61888............... .............. A

Revise/remove

5.06

NA 3.88 1.25

NA 10.19

010 neuroreceiver. 62000............... .............. A

Treat skull fracture. 12.51

NA 5.55 1.05

NA 19.11

090 62005............... .............. A

Treat skull fracture. 16.15

NA 8.83 2.81

NA 27.79

090 62010............... .............. A

Treatment of head

19.78

NA 11.75 4.88

NA 36.41

090 injury. 62100............... .............. A

Repair brain fluid

22.00

NA 12.85 4.91

NA 39.76

090 leakage. 62115............... .............. A

Reduction of skull

21.63

NA 11.69 5.46

NA 38.78

090 defect. 62116............... .............. A

Reduction of skull

23.55

NA 13.42 5.85

NA 42.82

090 defect. 62117............... .............. A

Reduction of skull

26.56

NA 15.44 6.71

NA 48.71

090 defect. 62120............... .............. A

Repair skull cavity

23.31

NA 14.33 3.70

NA 41.34

090 lesion. 62121............... .............. A

Incise skull repair.. 21.55

NA 12.75 2.98

NA 37.28

090 62140............... .............. A

Repair of skull

13.49

NA 8.36 3.14

NA 24.99

090 defect. 62141............... .............. A

Repair of skull

14.89

NA 9.10 3.44

NA 27.43

090 defect. 62142............... .............. A

Remove skull plate/

10.77

NA 7.03 2.53

NA 20.33

090 flap. 62143............... .............. A

Replace skull plate/ 13.03

NA 8.08 3.08

NA 24.19

090 flap. 62145............... .............. A

Repair of skull &

18.79

NA 10.95 4.60

NA 34.34

090 brain. 62146............... .............. A

Repair of skull with 16.10

NA 9.68 3.55

NA 29.33

090 graft. 62147............... .............. A

Repair of skull with 19.31

NA 11.38 4.39

NA 35.08

090 graft. 62148............... .............. A

Retr bone flap to fix 2.00

NA 0.82 0.52

NA 3.34

ZZZ skull. 62160............... .............. A

Neuroendoscopy add-on 3.00

NA 1.14 0.63

NA 4.77

ZZZ 62161............... .............. A

Dissect brain w/scope 19.97

NA 9.56 4.46

NA 33.99

090 62162............... .............. A

Remove colloid cyst w/ 25.21

NA 11.69 6.96

NA 43.86

090 scope. 62163............... .............. A

Neuroendoscopy w/fb

15.48

NA 7.85 4.46

NA 27.79

090 removal. 62164............... .............. A

Remove brain tumor w/ 27.46

NA 12.90 6.96

NA 47.32

090 scope. 62165............... .............. A

Remove pituit tumor w/ 21.97

NA 10.51 4.38

NA 36.86

090 scope. 62180............... .............. A

Establish brain

21.03

NA 12.34 5.21

NA 38.58

090 cavity shunt. 62190............... .............. A

Establish brain

11.05

NA 7.11 2.63

NA 20.79

090 cavity shunt. 62192............... .............. A

Establish brain

12.23

NA 7.66 2.97

NA 22.86

090 cavity shunt. 62194............... .............. A

Replace/irrigate

5.02

NA 2.79 0.60

NA 8.41

010 catheter. 62200............... .............. A

Establish brain

18.29

NA 10.89 4.46

NA 33.64

090 cavity shunt. 62201............... .............. A

Brain cavity shunt w/ 14.84

NA 9.49 3.04

NA 27.37

090 scope. 62220............... .............. A

Establish brain

12.98

NA 8.02 3.05

NA 24.05

090 cavity shunt. 62223............... .............. A

Establish brain

12.85

NA 8.28 3.11

NA 24.24

090 cavity shunt. 62225............... .............. A

Replace/irrigate

5.40

NA 4.11 1.31

NA 10.82

090 catheter. 62230............... .............. A

Replace/revise brain 10.52

NA 6.51 2.53

NA 19.56

090 shunt. 62252............... .............. A

Csf shunt reprogram.. 0.74 1.48

NA 0.21 2.43

NA

XXX 62252............... 26............ A

Csf shunt reprogram.. 0.74 0.37 0.37 0.19 1.30 1.30

XXX 62252............... TC............ A

Csf shunt reprogram.. 0.00 1.11

NA 0.02 1.13

NA

XXX 62256............... .............. A

Remove brain cavity

6.59

NA 4.72 1.62

NA 12.93

090 shunt. 62258............... .............. A

Replace brain cavity 14.52

NA 8.74 3.51

NA 26.77

090 shunt. 62263............... .............. A

Epidural lysis mult

6.13 11.87 2.39 0.51 18.51 9.03

010 sessions. 62264............... .............. A

Epidural lysis on

4.42 7.66 1.40 0.36 12.44 6.18

010 single day. 62268............... .............. A

Drain spinal cord

4.73 10.58 2.18 0.35 15.66 7.26

000 cyst. 62269............... .............. A

Needle biopsy, spinal 5.01 12.80 2.01 0.35 18.16 7.37

000 cord. 62270............... .............. A

Spinal fluid tap,

1.13 3.08 0.49 0.07 4.28 1.69

000 diagnostic. 62272............... .............. A

Drain cerebro spinal

1.35 3.68 0.64 0.16 5.19 2.15

000 fluid. 62273............... .............. A

Treat epidural spine

2.15 2.73 0.57 0.17 5.05 2.89

000 lesion. 62280............... .............. A

Treat spinal cord

2.63 6.59 0.88 0.21 9.43 3.72

010 lesion. 62281............... .............. A

Treat spinal cord

2.66 5.76 0.77 0.19 8.61 3.62

010 lesion. 62282............... .............. A

Treat spinal canal

2.33 8.20 0.79 0.17 10.70 3.29

010 lesion. 62284............... .............. A

Injection for

1.54 4.88 0.60 0.12 6.54 2.26

000 myelogram. 62287............... .............. A

Percutaneous

8.07

NA 5.52 0.80

NA 14.39

090 diskectomy. 62290............... .............. A

Inject for spine disk 3.00 6.81 1.28 0.24 10.05 4.52

000 x-ray. 62291............... .............. A

Inject for spine disk 2.91 5.69 1.13 0.21 8.81 4.25

000 x-ray. 62292............... .............. A

Injection into disk

7.85

NA 4.50 0.78

NA 13.13

090 lesion. 62294............... .............. A

Injection into spinal 11.81

NA 5.62 1.03

NA 18.46

090 artery. 62310............... .............. A

Inject spine c/t..... 1.91 4.83 0.50 0.13 6.87 2.54

000 62311............... .............. A

Inject spine l/s (cd) 1.54 4.91 0.45 0.11 6.56 2.10

000 62318............... .............. A

Inject spine w/cath,

2.04 5.51 0.51 0.14 7.69 2.69

000 c/t. 62319............... .............. A

Inject spine w/cath l/ 1.87 4.82 0.47 0.13 6.82 2.47

000 s (cd). 62350............... .............. A

Implant spinal canal

6.86

NA 3.99 0.77

NA 11.62

090 cath. 62351............... .............. A

Implant spinal canal

9.99

NA 7.10 2.16

NA 19.25

090 cath. 62355............... .............. A

Remove spinal canal

5.44

NA 3.20 0.57

NA 9.21

090 catheter. 62360............... .............. A

Insert spine infusion 2.62

NA 2.71 0.25

NA 5.58

090 device. 62361............... .............. A

Implant spine

5.41

NA 3.91 0.60

NA 9.92

090 infusion pump. 62362............... .............. A

Implant spine

7.03

NA 4.38 1.04

NA 12.45

090 infusion pump. 62365............... .............. A

Remove spine infusion 5.41

NA 3.60 0.70

NA 9.71

090 device. 62367............... .............. C

Analyze spine

0.00 0.00 0.00 0.00 0.00 0.00

XXX infusion pump. 62367............... 26............ A

Analyze spine

0.48 0.13 0.13 0.04 0.65 0.65

XXX infusion pump. 62367............... TC............ C

Analyze spine

0.00 0.00 0.00 0.00 0.00 0.00

XXX infusion pump. 62368............... .............. C

Analyze spine

0.00 0.00 0.00 0.00 0.00 0.00

XXX infusion pump. 62368............... 26............ A

Analyze spine

0.75 0.19 0.19 0.06 1.00 1.00

XXX infusion pump. 62368............... TC............ C

Analyze spine

0.00 0.00 0.00 0.00 0.00 0.00

XXX infusion pump. 63001............... .............. A

Removal of spinal

15.80

NA 9.52 3.65

NA 28.97

090 lamina. 63003............... .............. A

Removal of spinal

15.93

NA 9.86 3.59

NA 29.38

090 lamina.

[[Page 1181]]

63005............... .............. A

Removal of spinal

14.90

NA 9.93 3.16

NA 27.99

090 lamina. 63011............... .............. A

Removal of spinal

14.50

NA 8.26 1.72

NA 24.48

090 lamina. 63012............... .............. A

Removal of spinal

15.38

NA 10.09 3.27

NA 28.74

090 lamina. 63015............... .............. A

Removal of spinal

19.32

NA 11.89 4.63

NA 35.84

090 lamina. 63016............... .............. A

Removal of spinal

19.17

NA 11.79 4.37

NA 35.33

090 lamina. 63017............... .............. A

Removal of spinal

15.92

NA 10.36 3.51

NA 29.79

090 lamina. 63020............... .............. A

Neck spine disk

14.79

NA 9.67 3.49

NA 27.95

090 surgery. 63030............... .............. A

Low back disk surgery 11.98

NA 8.39 2.67

NA 23.04

090 63035............... .............. A

Spinal disk surgery

3.15

NA 1.59 0.69

NA 5.43

ZZZ add-on. 63040............... .............. A

Laminotomy, single

18.78

NA 11.50 4.05

NA 34.33

090 cervical. 63042............... .............. A

Laminotomy, single

17.44

NA 11.30 3.75

NA 32.49

090 lumbar. 63043............... .............. C

Laminotomy, add'l

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ cervical. 63044............... .............. C

Laminotomy, add'l

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ lumbar. 63045............... .............. A

Removal of spinal

16.48

NA 10.35 3.85

NA 30.68

090 lamina. 63046............... .............. A

Removal of spinal

15.78

NA 10.16 3.49

NA 29.43

090 lamina. 63047............... .............. A

Removal of spinal

14.59

NA 9.85 3.15

NA 27.59

090 lamina. 63048............... .............. A

Remove spinal lamina

3.26

NA 1.67 0.70

NA 5.63

ZZZ add-on. 63055............... .............. A

Decompress spinal

21.96

NA 13.14 4.93

NA 40.03

090 cord. 63056............... .............. A

Decompress spinal

20.33

NA 12.54 4.03

NA 36.90

090 cord. 63057............... .............. A

Decompress spine cord 5.25

NA 2.64 0.98

NA 8.87

ZZZ add-on. 63064............... .............. A

Decompress spinal

24.57

NA 14.45 5.69

NA 44.71

090 cord. 63066............... .............. A

Decompress spine cord 3.26

NA 1.67 0.76

NA 5.69

ZZZ add-on. 63075............... .............. A

Neck spine disk

19.38

NA 12.08 4.50

NA 35.96

090 surgery. 63076............... .............. A

Neck spine disk

4.04

NA 2.06 0.94

NA 7.04

ZZZ surgery. 63077............... .............. A

Spine disk surgery,

21.41

NA 12.76 4.15

NA 38.32

090 thorax. 63078............... .............. A

Spine disk surgery,

3.28

NA 1.64 0.60

NA 5.52

ZZZ thorax. 63081............... .............. A

Removal of vertebral 23.69

NA 14.33 5.38

NA 43.40

090 body. 63082............... .............. A

Remove vertebral body 4.36

NA 2.23 0.99

NA 7.58

ZZZ add-on. 63085............... .............. A

Removal of vertebral 26.88

NA 15.47 5.67

NA 48.02

090 body. 63086............... .............. A

Remove vertebral body 3.19

NA 1.60 0.66

NA 5.45

ZZZ add-on. 63087............... .............. A

Removal of vertebral 35.52

NA 19.45 7.08

NA 62.05

090 body. 63088............... .............. A

Remove vertebral body 4.32

NA 2.18 0.93

NA 7.43

ZZZ add-on. 63090............... .............. A

Removal of vertebral 28.12

NA 16.01 5.15

NA 49.28

090 body. 63091............... .............. A

Remove vertebral body 3.03

NA 1.46 0.54

NA 5.03

ZZZ add-on. 63101............... .............. A

Removal of vertebral 31.95

NA 19.34 5.69

NA 56.98

090 body. 63102............... .............. A

Removal of vertebral 31.95

NA 19.34 5.69

NA 56.98

090 body. 63103............... .............. A

Remove vertebral body 3.89

NA 2.01 0.76

NA 6.66

ZZZ add-on. 63170............... .............. A

Incise spinal cord

19.80

NA 12.06 4.69

NA 36.55

090 tract(s). 63172............... .............. A

Drainage of spinal

17.63

NA 10.85 4.17

NA 32.65

090 cyst. 63173............... .............. A

Drainage of spinal

21.96

NA 13.03 4.99

NA 39.98

090 cyst. 63180............... .............. A

Revise spinal cord

18.24

NA 11.21 4.62

NA 34.07

090 ligaments. 63182............... .............. A

Revise spinal cord

20.47

NA 11.18 4.20

NA 35.85

090 ligaments. 63185............... .............. A

Incise spinal column/ 15.02

NA 8.25 2.51

NA 25.78

090 nerves. 63190............... .............. A

Incise spinal column/ 17.42

NA 10.31 3.47

NA 31.20

090 nerves. 63191............... .............. A

Incise spinal column/ 17.51

NA 10.68 4.22

NA 32.41

090 nerves. 63194............... .............. A

Incise spinal column 19.16

NA 11.89 4.84

NA 35.89

090 & cord. 63195............... .............. A

Incise spinal column 18.81

NA 11.24 4.15

NA 34.20

090 & cord. 63196............... .............. A

Incise spinal column 22.27

NA 13.58 5.62

NA 41.47

090 & cord. 63197............... .............. A

Incise spinal column 21.08

NA 12.39 5.33

NA 38.80

090 & cord. 63198............... .............. A

Incise spinal column 25.34

NA 8.63 6.40

NA 40.37

090 & cord. 63199............... .............. A

Incise spinal column 26.85

NA 15.24 6.78

NA 48.87

090 & cord. 63200............... .............. A

Release of spinal

19.15

NA 11.48 4.35

NA 34.98

090 cord. 63250............... .............. A

Revise spinal cord

40.70

NA 20.03 9.23

NA 69.96

090 vessels. 63251............... .............. A

Revise spinal cord

41.14

NA 22.69 9.62

NA 73.45

090 vessels. 63252............... .............. A

Revise spinal cord

41.13

NA 22.33 9.35

NA 72.81

090 vessels. 63265............... .............. A

Excise intraspinal

21.53

NA 12.81 5.17

NA 39.51

090 lesion. 63266............... .............. A

Excise intraspinal

22.27

NA 13.22 5.39

NA 40.88

090 lesion. 63267............... .............. A

Excise intraspinal

17.92

NA 11.09 4.22

NA 33.23

090 lesion. 63268............... .............. A

Excise intraspinal

18.49

NA 10.42 3.84

NA 32.75

090 lesion. 63270............... .............. A

Excise intraspinal

26.76

NA 15.52 6.53

NA 48.81

090 lesion. 63271............... .............. A

Excise intraspinal

26.88

NA 15.63 6.71

NA 49.22

090 lesion. 63272............... .............. A

Excise intraspinal

25.28

NA 14.73 6.11

NA 46.12

090 lesion. 63273............... .............. A

Excise intraspinal

24.25

NA 14.39 6.13

NA 44.77

090 lesion. 63275............... .............. A

Biopsy/excise spinal 23.64

NA 13.83 5.64

NA 43.11

090 tumor. 63276............... .............. A

Biopsy/excise spinal 23.41

NA 13.72 5.58

NA 42.71

090 tumor. 63277............... .............. A

Biopsy/excise spinal 20.80

NA 12.54 4.86

NA 38.20

090 tumor. 63278............... .............. A

Biopsy/excise spinal 20.53

NA 12.39 4.85

NA 37.77

090 tumor. 63280............... .............. A

Biopsy/excise spinal 28.31

NA 16.37 7.00

NA 51.68

090 tumor. 63281............... .............. A

Biopsy/excise spinal 28.01

NA 16.22 6.84

NA 51.07

090 tumor. 63282............... .............. A

Biopsy/excise spinal 26.35

NA 15.38 6.43

NA 48.16

090 tumor. 63283............... .............. A

Biopsy/excise spinal 24.96

NA 14.71 6.18

NA 45.85

090 tumor. 63285............... .............. A

Biopsy/excise spinal 35.95

NA 20.01 8.82

NA 64.78

090 tumor. 63286............... .............. A

Biopsy/excise spinal 35.58

NA 19.97 8.53

NA 64.08

090 tumor. 63287............... .............. A

Biopsy/excise spinal 36.64

NA 20.53 9.02

NA 66.19

090 tumor. 63290............... .............. A

Biopsy/excise spinal 37.32

NA 20.66 9.23

NA 67.21

090 tumor.

[[Page 1182]]

63300............... .............. A

Removal of vertebral 24.39

NA 14.34 5.77

NA 44.50

090 body. 63301............... .............. A

Removal of vertebral 27.56

NA 15.58 6.07

NA 49.21

090 body. 63302............... .............. A

Removal of vertebral 27.77

NA 15.88 6.33

NA 49.98

090 body. 63303............... .............. A

Removal of vertebral 30.45

NA 16.92 6.28

NA 53.65

090 body. 63304............... .............. A

Removal of vertebral 30.28

NA 17.34 5.69

NA 53.31

090 body. 63305............... .............. A

Removal of vertebral 31.98

NA 18.06 6.50

NA 56.54

090 body. 63306............... .............. A

Removal of vertebral 32.17

NA 17.84 2.88

NA 52.89

090 body. 63307............... .............. A

Removal of vertebral 31.58

NA 16.82 5.10

NA 53.50

090 body. 63308............... .............. A

Remove vertebral body 5.24

NA 2.62 1.22

NA 9.08

ZZZ add-on. 63600............... .............. A

Remove spinal cord

14.00

NA 5.44 1.47

NA 20.91

090 lesion. 63610............... .............. A

Stimulation of spinal 8.72 55.66 2.30 0.52 64.90 11.54

000 cord. 63615............... .............. A

Remove lesion of

16.26

NA 9.41 3.44

NA 29.11

090 spinal cord. 63650............... .............. A

Implant

6.73

NA 3.22 0.58

NA 10.53

090 neuroelectrodes. 63655............... .............. A

Implant

10.27

NA 6.90 2.23

NA 19.40

090 neuroelectrodes. 63660............... .............. A

Revise/remove

6.15

NA 3.63 0.78

NA 10.56

090 neuroelectrode. 63685............... .............. A

Implant neuroreceiver 7.03

NA 4.16 1.16

NA 12.35

090 63688............... .............. A

Revise/remove

5.38

NA 3.57 0.84

NA 9.79

090 neuroreceiver. 63700............... .............. A

Repair of spinal

16.51

NA 10.27 3.24

NA 30.02

090 herniation. 63702............... .............. A

Repair of spinal

18.45

NA 10.84 1.64

NA 30.93

090 herniation. 63704............... .............. A

Repair of spinal

21.15

NA 12.89 4.63

NA 38.67

090 herniation. 63706............... .............. A

Repair of spinal

24.07

NA 13.61 5.70

NA 43.38

090 herniation. 63707............... .............. A

Repair spinal fluid

11.24

NA 7.68 2.36

NA 21.28

090 leakage. 63709............... .............. A

Repair spinal fluid

14.30

NA 9.36 3.00

NA 26.66

090 leakage. 63710............... .............. A

Graft repair of spine 14.05

NA 9.05 3.15

NA 26.25

090 defect. 63740............... .............. A

Install spinal shunt. 11.34

NA 7.38 2.59

NA 21.31

090 63741............... .............. A

Install spinal shunt. 8.24

NA 4.78 1.27

NA 14.29

090 63744............... .............. A

Revision of spinal

8.09

NA 5.28 1.82

NA 15.19

090 shunt. 63746............... .............. A

Removal of spinal

6.42

NA 3.80 1.39

NA 11.61

090 shunt. 64400............... .............. A

N block inj,

1.11 2.01 0.37 0.07 3.19 1.55

000 trigeminal. 64402............... .............. A

N block inj, facial.. 1.25 1.74 0.53 0.08 3.07 1.86

000 64405............... .............. A

N block inj,

1.32 1.52 0.39 0.10 2.94 1.81

000 occipital. 64408............... .............. A

N block inj, vagus... 1.41 1.58 0.66 0.11 3.10 2.18

000 64410............... .............. A

N block inj, phrenic. 1.43 2.56 0.39 0.10 4.09 1.92

000 64412............... .............. A

N block inj, spinal

1.18 2.71 0.37 0.10 3.99 1.65

000 accessor. 64413............... .............. A

N block inj, cervical 1.40 1.88 0.43 0.11 3.39 1.94

000 plexus. 64415............... .............. A

N block inj, brachial 1.48 2.84 0.39 0.10 4.42 1.97

000 plexus. 64416............... .............. A

N block cont infuse,

3.49

NA 0.72 0.10

NA 4.31

010 b plex. 64417............... .............. A

N block inj, axillary 1.44 3.09 0.42 0.11 4.64 1.97

000 64418............... .............. A

N block inj,

1.32 2.65 0.37 0.08 4.05 1.77

000 suprascapular. 64420............... .............. A

N block inj,

1.18 3.53 0.36 0.08 4.79 1.62

000 intercost, sng. 64421............... .............. A

N block inj,

1.68 5.39 0.45 0.12 7.19 2.25

000 intercost, mlt. 64425............... .............. A

N block inj ilio-ing/ 1.75 1.70 0.47 0.13 3.58 2.35

000 hypogi. 64430............... .............. A

N block inj, pudendal 1.46 2.59 0.49 0.13 4.18 2.08

000 64435............... .............. A

N block inj,

1.45 2.58 0.63 0.18 4.21 2.26

000 paracervical. 64445............... .............. A

N block inj, sciatic, 1.48 2.69 0.37 0.10 4.27 1.95

000 sng. 64446............... .............. A

N blk inj, sciatic,

3.25

NA 1.18 0.10

NA 4.53

010 cont inf. 64447............... .............. A

N block inj fem,

1.50

NA 0.51 0.10

NA 2.11

000 single. 64448............... .............. A

N block inj fem, cont 3.00

NA 1.03 0.10

NA 4.13

010 inf. 64449............... .............. A

N block inj, lumbar

3.00

NA 0.97 0.10

NA 4.07

010 plexus. 64450............... .............. A

N block, other

1.27 1.26 0.41 0.10 2.63 1.78

000 peripheral. 64470............... .............. A

Inj paravertebral c/t 1.85 4.86 0.56 0.14 6.85 2.55

000 64472............... .............. A

Inj paravertebral c/t 1.29 1.94 0.31 0.11 3.34 1.71

ZZZ add-on. 64475............... .............. A

Inj paravertebral l/s 1.41 4.56 0.47 0.11 6.08 1.99

000 64476............... .............. A

Inj paravertebral l/s 0.98 1.82 0.25 0.07 2.87 1.30

ZZZ add-on. 64479............... .............. A

Inj foramen epidural

2.20 7.05 0.72 0.17 9.42 3.09

000 c/t. 64480............... .............. A

Inj foramen epidural

1.54 2.41 0.46 0.11 4.06 2.11

ZZZ add-on. 64483............... .............. A

Inj foramen epidural

1.90 7.53 0.66 0.14 9.57 2.70

000 l/s. 64484............... .............. A

Inj foramen epidural

1.33 2.80 0.37 0.10 4.23 1.80

ZZZ add-on. 64505............... .............. A

N block,

1.36 1.22 0.47 0.10 2.68 1.93

000 spenopalatine gangl. 64508............... .............. A

N block, carotid

1.12 2.96 0.51 0.07 4.15 1.70

000 sinus s/p. 64510............... .............. A

N block, stellate

1.22 3.20 0.37 0.08 4.50 1.67

000 ganglion. 64517............... .............. A

N block inj, hypogas

2.20 2.70 0.87 0.13 5.03 3.20

000 plxs. 64520............... .............. A

N block, lumbar/

1.35 4.56 0.41 0.10 6.01 1.86

000 thoracic. 64530............... .............. A

N block inj, celiac

1.58 3.94 0.47 0.11 5.63 2.16

000 pelus. 64550............... .............. A

Apply neurostimulator 0.18 0.30 0.05 0.01 0.49 0.24

000 64553............... .............. A

Implant

2.31 2.70 1.86 0.21 5.22 4.38

010 neuroelectrodes. 64555............... .............. A

Implant

2.27 3.09 1.20 0.13 5.49 3.60

010 neuroelectrodes. 64560............... .............. A

Implant

2.36 2.64 1.30 0.21 5.21 3.87

010 neuroelectrodes. 64561............... .............. A

Implant

6.73

NA 3.16 0.13

NA 10.02

010 neuroelectrodes. 64565............... .............. A

Implant

1.76 3.35 1.26 0.10 5.21 3.12

010 neuroelectrodes. 64573............... .............. A

Implant

7.49

NA 5.23 1.79

NA 14.51

090 neuroelectrodes. 64575............... .............. A

Implant

4.34

NA 2.70 0.45

NA 7.49

090 neuroelectrodes. 64577............... .............. A

Implant

4.61

NA 3.32 0.60

NA 8.53

090 neuroelectrodes. 64580............... .............. A

Implant

4.11

NA 3.55 0.25

NA 7.91

090 neuroelectrodes. 64581............... .............. A

Implant

13.48

NA 5.41 0.45

NA 19.34

090 neuroelectrodes.

[[Continued on page 1183]]

From the Federal Register Online via GPO Access [wais.access.gpo.gov] ]

[[pp. 1183-1232]] Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004

[[Continued from page 1182]]

[[Page 1183]]

64585............... .............. A

Revise/remove

2.06 11.57 1.71 0.35 13.98 4.12

010 neuroelectrode. 64590............... .............. A

Implant neuroreceiver 2.40 7.26 1.90 0.48 10.14 4.78

010 64595............... .............. A

Revise/remove

1.73 10.69 1.49 0.27 12.69 3.49

010 neuroreceiver. 64600............... .............. A

Injection treatment

3.44 8.45 1.57 0.34 12.23 5.35

010 of nerve. 64605............... .............. A

Injection treatment

5.60 8.59 2.05 0.64 14.83 8.29

010 of nerve. 64610............... .............. A

Injection treatment

7.15 7.89 3.58 1.35 16.39 12.08

010 of nerve. 64612............... .............. A

Destroy nerve, face

1.96 2.62 1.08 0.11 4.69 3.15

010 muscle. 64613............... .............. A

Destroy nerve, spine

1.96 2.97 0.99 0.12 5.05 3.07

010 muscle. 64614............... .............. A

Destroy nerve, extrem 2.20 3.24 1.12 0.11 5.55 3.43

010 musc. 64620............... .............. A

Injection treatment

2.84 4.60 1.18 0.21 7.65 4.23

010 of nerve. 64622............... .............. A

Destr paravertebrl

3.00 7.62 1.23 0.21 10.83 4.44

010 nerve l/s. 64623............... .............. A

Destr paravertebral n 0.99 2.42 0.23 0.07 3.48 1.29

ZZZ add-on. 64626............... .............. A

Destr paravertebrl

3.28 6.67 1.85 0.27 10.22 5.40

010 nerve c/t. 64627............... .............. A

Destr paravertebral n 1.16 2.61 0.27 0.10 3.87 1.53

ZZZ add-on. 64630............... .............. A

Injection treatment

3.00 2.73 1.28 0.19 5.92 4.47

010 of nerve. 64640............... .............. A

Injection treatment

2.76 4.24 1.67 0.13 7.13 4.56

010 of nerve. 64680............... .............. A

Injection treatment

2.62 5.97 1.28 0.18 8.77 4.08

010 of nerve. 64681............... .............. A

Injection treatment

3.54 8.71 2.10 0.18 12.43 5.82

010 of nerve. 64702............... .............. A

Revise finger/toe

4.22

NA 3.82 0.62

NA 8.66

090 nerve. 64704............... .............. A

Revise hand/foot

4.56

NA 3.28 0.71

NA 8.55

090 nerve. 64708............... .............. A

Revise arm/leg nerve. 6.11

NA 4.83 0.99

NA 11.93

090 64712............... .............. A

Revision of sciatic

7.74

NA 4.99 0.65

NA 13.38

090 nerve. 64713............... .............. A

Revision of arm

10.98

NA 5.90 1.22

NA 18.10

090 nerve(s). 64714............... .............. A

Revise low back

10.31

NA 4.24 0.77

NA 15.32

090 nerve(s). 64716............... .............. A

Revision of cranial

6.30

NA 5.26 0.71

NA 12.27

090 nerve. 64718............... .............. A

Revise ulnar nerve at 5.98

NA 5.87 1.05

NA 12.90

090 elbow. 64719............... .............. A

Revise ulnar nerve at 4.84

NA 4.46 0.76

NA 10.06

090 wrist. 64721............... .............. A

Carpal tunnel surgery 4.28 4.95 4.95 0.71 9.94 9.94

090 64722............... .............. A

Relieve pressure on

4.69

NA 3.06 0.39

NA 8.14

090 nerve(s). 64726............... .............. A

Release foot/toe

4.17

NA 2.76 0.69

NA 7.62

090 nerve. 64727............... .............. A

Internal nerve

3.10

NA 1.51 0.48

NA 5.09

ZZZ revision. 64732............... .............. A

Incision of brow

4.40

NA 3.53 0.93

NA 8.86

090 nerve. 64734............... .............. A

Incision of cheek

4.91

NA 4.06 1.00

NA 9.97

090 nerve. 64736............... .............. A

Incision of chin

4.59

NA 4.03 0.86

NA 9.48

090 nerve. 64738............... .............. A

Incision of jaw nerve 5.72

NA 4.62 1.01

NA 11.35

090 64740............... .............. A

Incision of tongue

5.58

NA 4.39 0.52

NA 10.49

090 nerve. 64742............... .............. A

Incision of facial

6.21

NA 4.74 0.83

NA 11.78

090 nerve. 64744............... .............. A

Incise nerve, back of 5.23

NA 3.79 1.18

NA 10.20

090 head. 64746............... .............. A

Incise diaphragm

5.92

NA 4.53 0.90

NA 11.35

090 nerve. 64752............... .............. A

Incision of vagus

7.05

NA 4.31 1.00

NA 12.36

090 nerve. 64755............... .............. A

Incision of stomach

13.50

NA 5.68 1.40

NA 20.58

090 nerves. 64760............... .............. A

Incision of vagus

6.95

NA 3.52 0.62

NA 11.09

090 nerve. 64761............... .............. A

Incision of pelvis

6.40

NA 3.56 0.31

NA 10.27

090 nerve. 64763............... .............. A

Incise hip/thigh

6.92

NA 5.24 0.93

NA 13.09

090 nerve. 64766............... .............. A

Incise hip/thigh

8.66

NA 5.26 1.19

NA 15.11

090 nerve. 64771............... .............. A

Sever cranial nerve.. 7.34

NA 5.58 1.59

NA 14.51

090 64772............... .............. A

Incision of spinal

7.20

NA 4.93 1.45

NA 13.58

090 nerve. 64774............... .............. A

Remove skin nerve

5.16

NA 3.81 0.72

NA 9.69

090 lesion. 64776............... .............. A

Remove digit nerve

5.11

NA 3.67 0.76

NA 9.54

090 lesion. 64778............... .............. A

Digit nerve surgery

3.11

NA 1.50 0.46

NA 5.07

ZZZ add-on. 64782............... .............. A

Remove limb nerve

6.22

NA 3.75 0.95

NA 10.92

090 lesion. 64783............... .............. A

Limb nerve surgery

3.71

NA 1.85 0.58

NA 6.14

ZZZ add-on. 64784............... .............. A

Remove nerve lesion.. 9.81

NA 6.57 1.41

NA 17.79

090 64786............... .............. A

Remove sciatic nerve 15.44

NA 9.84 2.68

NA 27.96

090 lesion. 64787............... .............. A

Implant nerve end.... 4.29

NA 2.13 0.68

NA 7.10

ZZZ 64788............... .............. A

Remove skin nerve

4.60

NA 3.47 0.65

NA 8.72

090 lesion. 64790............... .............. A

Removal of nerve

11.29

NA 7.19 2.03

NA 20.51

090 lesion. 64792............... .............. A

Removal of nerve

14.90

NA 8.84 2.27

NA 26.01

090 lesion. 64795............... .............. A

Biopsy of nerve...... 3.01

NA 1.59 0.48

NA 5.08

000 64802............... .............. A

Remove sympathetic

9.14

NA 5.17 1.05

NA 15.36

090 nerves. 64804............... .............. A

Remove sympathetic

14.62

NA 7.20 2.16

NA 23.98

090 nerves. 64809............... .............. A

Remove sympathetic

13.65

NA 5.80 1.16

NA 20.61

090 nerves. 64818............... .............. A

Remove sympathetic

10.28

NA 5.33 1.30

NA 16.91

090 nerves. 64820............... .............. A

Remove sympathetic

10.35

NA 7.11 1.41

NA 18.87

090 nerves. 64821............... .............. A

Remove sympathetic

8.74

NA 7.35 1.19

NA 17.28

090 nerves. 64822............... .............. A

Remove sympathetic

8.74

NA 7.27 1.19

NA 17.20

090 nerves. 64823............... .............. A

Remove sympathetic

10.35

NA 8.18 1.41

NA 19.94

090 nerves. 64831............... .............. A

Repair of digit nerve 9.43

NA 7.05 1.37

NA 17.85

090 64832............... .............. A

Repair nerve add-on.. 5.65

NA 2.95 0.82

NA 9.42

ZZZ 64834............... .............. A

Repair of hand or

10.17

NA 7.08 1.48

NA 18.73

090 foot nerve. 64835............... .............. A

Repair of hand or

10.92

NA 7.67 1.64

NA 20.23

090 foot nerve. 64836............... .............. A

Repair of hand or

10.92

NA 7.65 1.59

NA 20.16

090 foot nerve. 64837............... .............. A

Repair nerve add-on.. 6.25

NA 3.25 0.96

NA 10.46

ZZZ 64840............... .............. A

Repair of leg nerve.. 13.00

NA 8.28 1.04

NA 22.32

090 64856............... .............. A

Repair/transpose

13.78

NA 9.17 2.06

NA 25.01

090 nerve.

[[Page 1184]]

64857............... .............. A

Repair arm/leg nerve. 14.47

NA 9.62 2.12

NA 26.21

090 64858............... .............. A

Repair sciatic nerve. 16.47

NA 10.74 3.35

NA 30.56

090 64859............... .............. A

Nerve surgery........ 4.25

NA 2.20 0.60

NA 7.05

ZZZ 64861............... .............. A

Repair of arm nerves. 19.21

NA 11.83 2.95

NA 33.99

090 64862............... .............. A

Repair of low back

19.41

NA 11.96 2.98

NA 34.35

090 nerves. 64864............... .............. A

Repair of facial

12.53

NA 8.10 1.36

NA 21.99

090 nerve. 64865............... .............. A

Repair of facial

15.22

NA 9.87 1.65

NA 26.74

090 nerve. 64866............... .............. A

Fusion of facial/

15.72

NA 9.71 1.28

NA 26.71

090 other nerve. 64868............... .............. A

Fusion of facial/

14.02

NA 8.87 1.69

NA 24.58

090 other nerve. 64870............... .............. A

Fusion of facial/

15.97

NA 8.75 1.30

NA 26.02

090 other nerve. 64872............... .............. A

Subsequent repair of

1.99

NA 1.09 0.29

NA 3.37

ZZZ nerve. 64874............... .............. A

Repair & revise nerve 2.98

NA 1.54 0.41

NA 4.93

ZZZ add-on. 64876............... .............. A

Repair nerve/shorten

3.37

NA 1.28 0.47

NA 5.12

ZZZ bone. 64885............... .............. A

Nerve graft, head or 17.50

NA 10.91 1.82

NA 30.23

090 neck. 64886............... .............. A

Nerve graft, head or 20.72

NA 12.75 2.09

NA 35.56

090 neck. 64890............... .............. A

Nerve graft, hand or 15.13

NA 9.99 2.10

NA 27.22

090 foot. 64891............... .............. A

Nerve graft, hand or 16.12

NA 7.63 1.66

NA 25.41

090 foot. 64892............... .............. A

Nerve graft, arm or

14.63

NA 8.86 1.99

NA 25.48

090 leg. 64893............... .............. A

Nerve graft, arm or

15.58

NA 9.89 2.13

NA 27.60

090 leg. 64895............... .............. A

Nerve graft, hand or 19.22

NA 9.67 2.46

NA 31.35

090 foot. 64896............... .............. A

Nerve graft, hand or 20.46

NA 11.01 2.23

NA 33.70

090 foot. 64897............... .............. A

Nerve graft, arm or

18.21

NA 10.72 3.18

NA 32.11

090 leg. 64898............... .............. A

Nerve graft, arm or

19.47

NA 11.81 3.27

NA 34.55

090 leg. 64901............... .............. A

Nerve graft add-on... 10.20

NA 5.29 1.19

NA 16.68

ZZZ 64902............... .............. A

Nerve graft add-on... 11.81

NA 5.99 1.33

NA 19.13

ZZZ 64905............... .............. A

Nerve pedicle

14.00

NA 8.56 1.83

NA 24.39

090 transfer. 64907............... .............. A

Nerve pedicle

18.80

NA 12.50 2.16

NA 33.46

090 transfer. 64999............... .............. C

Nervous system

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 65091............... .............. A

Revise eye........... 6.45

NA 9.73 0.31

NA 16.49

090 65093............... .............. A

Revise eye with

6.86

NA 10.09 0.34

NA 17.29

090 implant. 65101............... .............. A

Removal of eye....... 7.02

NA 10.68 0.34

NA 18.04

090 65103............... .............. A

Remove eye/insert

7.56

NA 10.87 0.36

NA 18.79

090 implant. 65105............... .............. A

Remove eye/attach

8.48

NA 11.52 0.41

NA 20.41

090 implant. 65110............... .............. A

Removal of eye....... 13.93

NA 14.61 0.82

NA 29.36

090 65112............... .............. A

Remove eye/revise

16.36

NA 16.88 1.16

NA 34.40

090 socket. 65114............... .............. A

Remove eye/revise

17.50

NA 17.10 1.13

NA 35.73

090 socket. 65125............... .............. A

Revise ocular implant 3.12 9.23 2.96 0.18 12.53 6.26

090 65130............... .............. A

Insert ocular implant 7.14

NA 10.24 0.34

NA 17.72

090 65135............... .............. A

Insert ocular implant 7.32

NA 10.42 0.35

NA 18.09

090 65140............... .............. A

Attach ocular implant 8.01

NA 10.87 0.37

NA 19.25

090 65150............... .............. A

Revise ocular implant 6.25

NA 9.29 0.30

NA 15.84

090 65155............... .............. A

Reinsert ocular

8.65

NA 11.59 0.48

NA 20.72

090 implant. 65175............... .............. A

Removal of ocular

6.27

NA 9.65 0.31

NA 16.23

090 implant. 65205............... .............. A

Remove foreign body

0.71 0.60 0.19 0.04 1.35 0.94

000 from eye. 65210............... .............. A

Remove foreign body

0.84 0.74 0.30 0.04 1.62 1.18

000 from eye. 65220............... .............. A

Remove foreign body

0.71 0.60 0.18 0.06 1.37 0.95

000 from eye. 65222............... .............. A

Remove foreign body

0.93 0.76 0.27 0.05 1.74 1.25

000 from eye. 65235............... .............. A

Remove foreign body

7.56

NA 7.26 0.36

NA 15.18

090 from eye. 65260............... .............. A

Remove foreign body

10.94

NA 11.43 0.52

NA 22.89

090 from eye. 65265............... .............. A

Remove foreign body

12.57

NA 12.67 0.60

NA 25.84

090 from eye. 65270............... .............. A

Repair of eye wound.. 1.90 3.83 2.24 0.10 5.83 4.24

010 65272............... .............. A

Repair of eye wound.. 3.81 5.78 5.21 0.19 9.78 9.21

090 65273............... .............. A

Repair of eye wound.. 4.35

NA 5.63 0.21

NA 10.19

090 65275............... .............. A

Repair of eye wound.. 5.33 5.66 5.66 0.33 11.32 11.32

090 65280............... .............. A

Repair of eye wound.. 7.65

NA 8.17 0.36

NA 16.18

090 65285............... .............. A

Repair of eye wound.. 12.88

NA 12.38 0.62

NA 25.88

090 65286............... .............. A

Repair of eye wound.. 5.50 8.42 7.52 0.25 14.17 13.27

090 65290............... .............. A

Repair of eye socket

5.40

NA 6.47 0.31

NA 12.18

090 wound. 65400............... .............. A

Removal of eye lesion 6.05 8.63 7.47 0.29 14.97 13.81

090 65410............... .............. A

Biopsy of cornea..... 1.47 1.72 0.65 0.07 3.26 2.19

000 65420............... .............. A

Removal of eye lesion 4.16 7.53 6.74 0.21 11.90 11.11

090 65426............... .............. A

Removal of eye lesion 5.24 7.49 6.54 0.24 12.97 12.02

090 65430............... .............. A

Corneal smear........ 1.47 4.95 0.66 0.07 6.49 2.20

000 65435............... .............. A

Curette/treat cornea. 0.92 1.32 0.39 0.05 2.29 1.36

000 65436............... .............. A

Curette/treat cornea. 4.18 5.85 5.22 0.21 10.24 9.61

090 65450............... .............. A

Treatment of corneal

3.27 7.22 6.33 0.16 10.65 9.76

090 lesion. 65600............... .............. A

Revision of cornea... 3.39 5.63 3.11 0.17 9.19 6.67

090 65710............... .............. A

Corneal transplant... 12.33

NA 12.33 0.59

NA 25.25

090 65730............... .............. A

Corneal transplant... 14.23

NA 11.86 0.68

NA 26.77

090 65750............... .............. A

Corneal transplant... 14.98

NA 13.35 0.71

NA 29.04

090 65755............... .............. A

Corneal transplant... 14.87

NA 13.26 0.70

NA 28.83

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

0.00 0.00 0.00 0.00 0.00 0.00

XXX transplant. 65770............... .............. A

Revise cornea with

17.53

NA 14.31 0.83

NA 32.67

090 implant.

[[Page 1185]]

65771............... .............. N

Radial keratotomy.... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 65772............... .............. A

Correction of

4.28 7.15 6.46 0.21 11.64 10.95

090 astigmatism. 65775............... .............. A

Correction of

5.78

NA 7.35 0.27

NA 13.40

090 astigmatism. 65780............... .............. A

Ocular reconst,

10.23

NA 9.94 0.35

NA 20.52

090 transplant. 65781............... .............. A

Ocular reconst,

17.64

NA 13.31 0.35

NA 31.30

090 transplant. 65782............... .............. A

Ocular reconst,

14.98

NA 11.66 0.35

NA 26.99

090 transplant. 65800............... .............. A

Drainage of eye...... 1.91 2.27 1.17 0.10 4.28 3.18

000 65805............... .............. A

Drainage of eye...... 1.91 2.27 1.18 0.10 4.28 3.19

000 65810............... .............. A

Drainage of eye...... 4.86

NA 8.05 0.23

NA 13.14

090 65815............... .............. A

Drainage of eye...... 5.04 8.37 7.49 0.24 13.65 12.77

090 65820............... .............. A

Relieve inner eye

8.12

NA 10.65 0.39

NA 19.16

090 pressure. 65850............... .............. A

Incision of eye...... 10.50

NA 9.38 0.49

NA 20.37

090 65855............... .............. A

Laser surgery of eye. 3.84 5.20 4.05 0.21 9.25 8.10

010 65860............... .............. A

Incise inner eye

3.54 3.90 3.26 0.17 7.61 6.97

090 adhesions. 65865............... .............. A

Incise inner eye

5.59

NA 6.48 0.27

NA 12.34

090 adhesions. 65870............... .............. A

Incise inner eye

6.26

NA 7.14 0.29

NA 13.69

090 adhesions. 65875............... .............. A

Incise inner eye

6.53

NA 7.44 0.30

NA 14.27

090 adhesions. 65880............... .............. A

Incise inner eye

7.08

NA 7.69 0.34

NA 15.11

090 adhesions. 65900............... .............. A

Remove eye lesion.... 10.91

NA 11.51 0.55

NA 22.97

090 65920............... .............. A

Remove implant of eye 8.39

NA 8.70 0.40

NA 17.49

090 65930............... .............. A

Remove blood clot

7.43

NA 7.74 0.35

NA 15.52

090 from eye. 66020............... .............. A

Injection treatment

1.59 2.37 1.58 0.08 4.04 3.25

010 of eye. 66030............... .............. A

Injection treatment

1.25 2.21 1.42 0.06 3.52 2.73

010 of eye. 66130............... .............. A

Remove eye lesion.... 7.68 7.48 6.92 0.37 15.53 14.97

090 66150............... .............. A

Glaucoma surgery..... 8.29

NA 9.86 0.40

NA 18.55

090 66155............... .............. A

Glaucoma surgery..... 8.28

NA 9.80 0.39

NA 18.47

090 66160............... .............. A

Glaucoma surgery..... 10.15

NA 10.65 0.49

NA 21.29

090 66165............... .............. A

Glaucoma surgery..... 8.00

NA 9.69 0.37

NA 18.06

090 66170............... .............. A

Glaucoma surgery..... 12.14

NA 12.45 0.58

NA 25.17

090 66172............... .............. A

Incision of eye...... 15.02

NA 15.12 0.71

NA 30.85

090 66180............... .............. A

Implant eye shunt.... 14.53

NA 11.56 0.69

NA 26.78

090 66185............... .............. A

Revise eye shunt..... 8.13

NA 8.19 0.39

NA 16.71

090 66220............... .............. A

Repair eye lesion.... 7.76

NA 8.73 0.39

NA 16.88

090 66225............... .............. A

Repair/graft eye

11.03

NA 9.32 0.53

NA 20.88

090 lesion. 66250............... .............. A

Follow-up surgery of

5.97 7.67 6.50 0.28 13.92 12.75

090 eye. 66500............... .............. A

Incision of iris..... 3.70

NA 5.10 0.18

NA 8.98

090 66505............... .............. A

Incision of iris..... 4.07

NA 5.38 0.21

NA 9.66

090 66600............... .............. A

Remove iris and

8.67

NA 8.91 0.41

NA 17.99

090 lesion. 66605............... .............. A

Removal of iris...... 12.77

NA 11.26 0.74

NA 24.77

090 66625............... .............. A

Removal of iris...... 5.12 7.02 6.30 0.24 12.38 11.66

090 66630............... .............. A

Removal of iris...... 6.15

NA 7.42 0.29

NA 13.86

090 66635............... .............. A

Removal of iris...... 6.24

NA 6.64 0.29

NA 13.17

090 66680............... .............. A

Repair iris & ciliary 5.43

NA 6.04 0.25

NA 11.72

090 body. 66682............... .............. A

Repair iris & ciliary 6.20

NA 7.43 0.29

NA 13.92

090 body. 66700............... .............. A

Destruction, ciliary

4.77 5.34 4.05 0.23 10.34 9.05

090 body. 66710............... .............. A

Destruction, ciliary

4.77 5.22 3.85 0.22 10.21 8.84

090 body. 66720............... .............. A

Destruction, ciliary

4.77 5.68 4.60 0.23 10.68 9.60

090 body. 66740............... .............. A

Destruction, ciliary

4.77 5.38 4.21 0.22 10.37 9.20

090 body. 66761............... .............. A

Revision of iris..... 4.06 5.55 4.23 0.19 9.80 8.48

090 66762............... .............. A

Revision of iris..... 4.57 5.62 4.22 0.22 10.41 9.01

090 66770............... .............. A

Removal of inner eye

5.17 6.05 4.73 0.24 11.46 10.14

090 lesion. 66820............... .............. A

Incision, secondary

3.88

NA 7.10 0.19

NA 11.17

090 cataract. 66821............... .............. A

After cataract laser

2.35 3.98 3.88 0.12 6.45 6.35

090 surgery. 66825............... .............. A

Reposition

8.22

NA 10.08 0.39

NA 18.69

090 intraocular lens. 66830............... .............. A

Removal of lens

8.19

NA 7.08 0.39

NA 15.66

090 lesion. 66840............... .............. A

Removal of lens

7.90

NA 6.99 0.37

NA 15.26

090 material. 66850............... .............. A

Removal of lens

9.10

NA 7.75 0.43

NA 17.28

090 material. 66852............... .............. A

Removal of lens

9.96

NA 8.20 0.47

NA 18.63

090 material. 66920............... .............. A

Extraction of lens... 8.85

NA 7.43 0.42

NA 16.70

090 66930............... .............. A

Extraction of lens... 10.16

NA 8.57 0.49

NA 19.22

090 66940............... .............. A

Extraction of lens... 8.92

NA 8.01 0.42

NA 17.35

090 66982............... .............. A

Cataract surgery,

13.48

NA 9.92 0.68

NA 24.08

090 complex. 66983............... .............. A

Cataract surg w/iol,

8.98

NA 6.20 0.45

NA 15.63

090 1 stage. 66984............... .............. A

Cataract surg w/iol, 10.21

NA 7.63 0.49

NA 18.33

090 1 stage. 66985............... .............. A

Insert lens

8.38

NA 7.47 0.40

NA 16.25

090 prosthesis. 66986............... .............. A

Exchange lens

12.26

NA 9.22 0.59

NA 22.07

090 prosthesis. 66990............... .............. A

Ophthalmic endoscope

1.51

NA 0.69 0.07

NA 2.27

ZZZ add-on. 66999............... .............. C

Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00

YYY 67005............... .............. A

Partial removal of

5.69

NA 4.38 0.27

NA 10.34

090 eye fluid. 67010............... .............. A

Partial removal of

6.86

NA 4.93 0.33

NA 12.12

090 eye fluid. 67015............... .............. A

Release of eye fluid. 6.91

NA 7.73 0.33

NA 14.97

090 67025............... .............. A

Replace eye fluid.... 6.83 14.23 7.51 0.33 21.39 14.67

090 67027............... .............. A

Implant eye drug

10.83 12.78 8.79 0.55 24.16 20.17

090 system. 67028............... .............. A

Injection eye drug... 2.52 6.50 1.13 0.13 9.15 3.78

000 67030............... .............. A

Incise inner eye

4.83

NA 6.81 0.23

NA 11.87

090 strands.

[[Page 1186]]

67031............... .............. A

Laser surgery, eye

3.66 4.74 4.09 0.18 8.58 7.93

090 strands. 67036............... .............. A

Removal of inner eye 11.87

NA 9.35 0.57

NA 21.79

090 fluid. 67038............... .............. A

Strip retinal

21.21

NA 15.83 1.01

NA 38.05

090 membrane. 67039............... .............. A

Laser treatment of

14.50

NA 12.54 0.69

NA 27.73

090 retina. 67040............... .............. A

Laser treatment of

17.20

NA 14.02 0.82

NA 32.04

090 retina. 67101............... .............. A

Repair detached

7.52 9.85 8.11 0.35 17.72 15.98

090 retina. 67105............... .............. A

Repair detached

7.40 7.99 6.23 0.35 15.74 13.98

090 retina. 67107............... .............. A

Repair detached

14.82

NA 12.82 0.70

NA 28.34

090 retina. 67108............... .............. A

Repair detached

20.79

NA 17.02 0.99

NA 38.80

090 retina. 67110............... .............. A

Repair detached

8.80 15.37 9.23 0.42 24.59 18.45

090 retina. 67112............... .............. A

Rerepair detached

16.83

NA 14.59 0.80

NA 32.22

090 retina. 67115............... .............. A

Release encircling

4.98

NA 7.09 0.23

NA 12.30

090 material. 67120............... .............. A

Remove eye implant

5.97 12.30 6.93 0.28 18.55 13.18

090 material. 67121............... .............. A

Remove eye implant

10.65

NA 11.17 0.51

NA 22.33

090 material. 67141............... .............. A

Treatment of retina.. 5.19 7.24 6.49 0.24 12.67 11.92

090 67145............... .............. A

Treatment of retina.. 5.36 5.76 4.94 0.25 11.37 10.55

090 67208............... .............. A

Treatment of retinal

6.69 5.95 5.38 0.31 12.95 12.38

090 lesion. 67210............... .............. A

Treatment of retinal

8.81 6.25 5.79 0.42 15.48 15.02

090 lesion. 67218............... .............. A

Treatment of retinal 18.50

NA 14.13 0.64

NA 33.27

090 lesion. 67220............... .............. A

Treatment of choroid 13.11 9.84 8.83 0.62 23.57 22.56

090 lesion. 67221............... .............. R

Ocular photodynamic

4.00 4.69 1.81 0.19 8.88 6.00

000 ther. 67225............... .............. A

Eye photodynamic ther 0.47 0.26 0.22 0.01 0.74 0.70

ZZZ add-on. 67227............... .............. A

Treatment of retinal

6.57 6.38 5.39 0.31 13.26 12.27

090 lesion. 67228............... .............. A

Treatment of retinal 12.72 10.83 8.42 0.60 24.15 21.74

090 lesion. 67250............... .............. A

Reinforce eye wall... 8.65

NA 10.37 0.43

NA 19.45

090 67255............... .............. A

Reinforce/graft eye

8.89

NA 10.95 0.42

NA 20.26

090 wall. 67299............... .............. C

Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00

YYY 67311............... .............. A

Revise eye muscle.... 6.64

NA 6.42 0.33

NA 13.39

090 67312............... .............. A

Revise two eye

8.53

NA 7.55 0.42

NA 16.50

090 muscles. 67314............... .............. A

Revise eye muscle.... 7.51

NA 7.26 0.36

NA 15.13

090 67316............... .............. A

Revise two eye

9.65

NA 8.22 0.48

NA 18.35

090 muscles. 67318............... .............. A

Revise eye muscle(s). 7.84

NA 7.64 0.37

NA 15.85

090 67320............... .............. A

Revise eye muscle(s)

4.32

NA 1.96 0.21

NA 6.49

ZZZ add-on. 67331............... .............. A

Eye surgery follow-up 4.05

NA 1.91 0.21

NA 6.17

ZZZ add-on. 67332............... .............. A

Rerevise eye muscles

4.48

NA 2.03 0.22

NA 6.73

ZZZ add-on. 67334............... .............. A

Revise eye muscle w/

3.97

NA 1.81 0.19

NA 5.97

ZZZ suture. 67335............... .............. A

Eye suture during

2.49

NA 1.12 0.12

NA 3.73

ZZZ surgery. 67340............... .............. A

Revise eye muscle add- 4.92

NA 2.23 0.23

NA 7.38

ZZZ on. 67343............... .............. A

Release eye tissue... 7.34

NA 7.34 0.36

NA 15.04

090 67345............... .............. A

Destroy nerve of eye

2.96 4.36 1.37 0.16 7.48 4.49

010 muscle. 67350............... .............. A

Biopsy eye muscle.... 2.87

NA 1.87 0.16

NA 4.90

000 67399............... .............. C

Eye muscle surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 67400............... .............. A

Explore/biopsy eye

9.75

NA 12.51 0.52

NA 22.78

090 socket. 67405............... .............. A

Explore/drain eye

7.92

NA 11.09 0.43

NA 19.44

090 socket. 67412............... .............. A

Explore/treat eye

9.49

NA 12.99 0.49

NA 22.97

090 socket. 67413............... .............. A

Explore/treat eye

9.99

NA 12.14 0.52

NA 22.65

090 socket. 67414............... .............. A

Explr/decompress eye 11.11

NA 14.01 0.58

NA 25.70

090 socket. 67415............... .............. A

Aspiration, orbital

1.76

NA 0.77 0.11

NA 2.64

000 contents. 67420............... .............. A

Explore/treat eye

20.03

NA 18.77 1.01

NA 39.81

090 socket. 67430............... .............. A

Explore/treat eye

13.37

NA 15.83 1.17

NA 30.37

090 socket. 67440............... .............. A

Explore/drain eye

13.07

NA 15.47 0.70

NA 29.24

090 socket. 67445............... .............. A

Explr/decompress eye 14.40

NA 15.70 0.76

NA 30.86

090 socket. 67450............... .............. A

Explore/biopsy eye

13.49

NA 15.82 0.68

NA 29.99

090 socket. 67500............... .............. A

Inject/treat eye

0.79 0.82 0.19 0.05 1.66 1.03

000 socket. 67505............... .............. A

Inject/treat eye

0.82 0.92 0.21 0.05 1.79 1.08

000 socket. 67515............... .............. A

Inject/treat eye

0.61 0.82 0.28 0.02 1.45 0.91

000 socket. 67550............... .............. A

Insert eye socket

10.17

NA 12.28 0.60

NA 23.05

090 implant. 67560............... .............. A

Revise eye socket

10.58

NA 12.33 0.57

NA 23.48

090 implant. 67570............... .............. A

Decompress optic

13.56

NA 15.33 0.83

NA 29.72

090 nerve. 67599............... .............. C

Orbit surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 67700............... .............. A

Drainage of eyelid

1.35 4.84 0.62 0.07 6.26 2.04

010 abscess. 67710............... .............. A

Incision of eyelid... 1.02 4.99 0.53 0.05 6.06 1.60

010 67715............... .............. A

Incision of eyelid

1.22 4.58 0.62 0.06 5.86 1.90

010 fold. 67800............... .............. A

Remove eyelid lesion. 1.38 2.50 0.69 0.07 3.95 2.14

010 67801............... .............. A

Remove eyelid lesions 1.88 5.34 0.92 0.10 7.32 2.90

010 67805............... .............. A

Remove eyelid lesions 2.22 5.49 1.08 0.11 7.82 3.41

010 67808............... .............. A

Remove eyelid

3.79

NA 5.23 0.21

NA 9.23

090 lesion(s). 67810............... .............. A

Biopsy of eyelid..... 1.48 3.65 0.68 0.07 5.20 2.23

000 67820............... .............. A

Revise eyelashes..... 0.89 1.11 0.37 0.05 2.05 1.31

000 67825............... .............. A

Revise eyelashes..... 1.38 1.58 1.08 0.07 3.03 2.53

010 67830............... .............. A

Revise eyelashes..... 1.70 7.48 1.95 0.08 9.26 3.73

010 67835............... .............. A

Revise eyelashes..... 5.55

NA 5.00 0.27

NA 10.82

090 67840............... .............. A

Remove eyelid lesion. 2.04 5.32 1.00 0.10 7.46 3.14

010 67850............... .............. A

Treat eyelid lesion.. 1.69 6.06 1.89 0.08 7.83 3.66

010 67875............... .............. A

Closure of eyelid by

1.35 7.05 0.62 0.07 8.47 2.04

000 suture.

[[Page 1187]]

67880............... .............. A

Revision of eyelid... 3.79 9.66 4.29 0.19 13.64 8.27

090 67882............... .............. A

Revision of eyelid... 5.06 11.01 5.50 0.25 16.32 10.81

090 67900............... .............. A

Repair brow defect... 6.13 10.53 6.32 0.36 17.02 12.81

090 67901............... .............. A

Repair eyelid defect. 6.96

NA 6.41 0.39

NA 13.76

090 67902............... .............. A

Repair eyelid defect. 7.02

NA 6.47 0.41

NA 13.90

090 67903............... .............. A

Repair eyelid defect. 6.36 11.28 6.70 0.47 18.11 13.53

090 67904............... .............. A

Repair eyelid defect. 6.25 12.49 7.17 0.31 19.05 13.73

090 67906............... .............. A

Repair eyelid defect. 6.78 9.11 6.01 0.51 16.40 13.30

090 67908............... .............. A

Repair eyelid defect. 5.12 8.83 5.68 0.24 14.19 11.04

090 67909............... .............. A

Revise eyelid defect. 5.39 9.36 6.09 0.30 15.05 11.78

090 67911............... .............. A

Revise eyelid defect. 5.26

NA 6.04 0.28

NA 11.58

090 67912............... .............. A

Correction eyelid w/

5.67 20.38 5.27 0.28 26.33 11.22

090 implant. 67914............... .............. A

Repair eyelid defect. 3.67 9.30 3.95 0.19 13.16 7.81

090 67915............... .............. A

Repair eyelid defect. 3.18 7.90 2.58 0.16 11.24 5.92

090 67916............... .............. A

Repair eyelid defect. 5.30 11.78 5.69 0.27 17.35 11.26

090 67917............... .............. A

Repair eyelid defect. 6.01 9.71 6.15 0.30 16.02 12.46

090 67921............... .............. A

Repair eyelid defect. 3.39 9.11 3.75 0.17 12.67 7.31

090 67922............... .............. A

Repair eyelid defect. 3.06 7.86 3.49 0.16 11.08 6.71

090 67923............... .............. A

Repair eyelid defect. 5.87 11.35 5.90 0.29 17.51 12.06

090 67924............... .............. A

Repair eyelid defect. 5.78 9.10 5.65 0.28 15.16 11.71

090 67930............... .............. A

Repair eyelid wound.. 3.60 8.42 2.95 0.21 12.23 6.76

010 67935............... .............. A

Repair eyelid wound.. 6.21 11.36 5.95 0.35 17.92 12.51

090 67938............... .............. A

Remove eyelid foreign 1.33 5.81 0.56 0.07 7.21 1.96

010 body. 67950............... .............. A

Revision of eyelid... 5.81 8.25 6.57 0.36 14.42 12.74

090 67961............... .............. A

Revision of eyelid... 5.68 10.20 5.70 0.31 16.19 11.69

090 67966............... .............. A

Revision of eyelid... 6.56 8.33 5.66 0.40 15.29 12.62

090 67971............... .............. A

Reconstruction of

9.78

NA 7.27 0.51

NA 17.56

090 eyelid. 67973............... .............. A

Reconstruction of

12.85

NA 9.24 0.71

NA 22.80

090 eyelid. 67974............... .............. A

Reconstruction of

12.82

NA 9.16 0.65

NA 22.63

090 eyelid. 67975............... .............. A

Reconstruction of

9.12

NA 6.95 0.46

NA 16.53

090 eyelid. 67999............... .............. C

Revision of eyelid... 0.00 0.00 0.00 0.00 0.00 0.00

YYY 68020............... .............. A

Incise/drain eyelid

1.37 5.69 0.68 0.07 7.13 2.12

010 lining. 68040............... .............. A

Treatment of eyelid

0.85 4.82 0.37 0.04 5.71 1.26

000 lesions. 68100............... .............. A

Biopsy of eyelid

1.35 5.01 0.61 0.07 6.43 2.03

000 lining. 68110............... .............. A

Remove eyelid lining

1.77 6.06 1.40 0.08 7.91 3.25

010 lesion. 68115............... .............. A

Remove eyelid lining

2.36 5.56 1.13 0.12 8.04 3.61

010 lesion. 68130............... .............. A

Remove eyelid lining

4.92 8.14 4.28 0.23 13.29 9.43

090 lesion. 68135............... .............. A

Remove eyelid lining

1.84 5.32 0.90 0.08 7.24 2.82

010 lesion. 68200............... .............. A

Treat eyelid by

0.49 0.72 0.23 0.02 1.23 0.74

000 injection. 68320............... .............. A

Revise/graft eyelid

5.36 6.56 5.41 0.25 12.17 11.02

090 lining. 68325............... .............. A

Revise/graft eyelid

7.35

NA 6.39 0.36

NA 14.10

090 lining. 68326............... .............. A

Revise/graft eyelid

7.14

NA 6.28 0.36

NA 13.78

090 lining. 68328............... .............. A

Revise/graft eyelid

8.17

NA 7.03 0.48

NA 15.68

090 lining. 68330............... .............. A

Revise eyelid lining. 4.82 7.24 6.05 0.23 12.29 11.10

090 68335............... .............. A

Revise/graft eyelid

7.18

NA 6.79 0.35

NA 14.32

090 lining. 68340............... .............. A

Separate eyelid

4.16 10.80 4.77 0.21 15.17 9.14

090 adhesions. 68360............... .............. A

Revise eyelid lining. 4.36 6.60 5.58 0.21 11.17 10.15

090 68362............... .............. A

Revise eyelid lining. 7.33

NA 7.72 0.35

NA 15.40

090 68371............... .............. A

Harvest eye tissue,

4.89

NA 4.62 0.21

NA 9.72

010 alograft. 68399............... .............. C

Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.00

YYY 68400............... .............. A

Incise/drain tear

1.69 7.61 2.04 0.08 9.38 3.81

010 gland. 68420............... .............. A

Incise/drain tear sac 2.30 7.92 2.33 0.12 10.34 4.75

010 68440............... .............. A

Incise tear duct

0.94 4.93 0.49 0.05 5.92 1.48

010 opening. 68500............... .............. A

Removal of tear gland 11.00

NA 10.16 0.72

NA 21.88

090 68505............... .............. A

Partial removal, tear 10.92

NA 11.17 0.69

NA 22.78

090 gland. 68510............... .............. A

Biopsy of tear gland. 4.60 8.42 2.10 0.23 13.25 6.93

000 68520............... .............. A

Removal of tear sac.. 7.50

NA 7.78 0.40

NA 15.68

090 68525............... .............. A

Biopsy of tear sac... 4.42

NA 2.02 0.22

NA 6.66

000 68530............... .............. A

Clearance of tear

3.65 9.45 2.85 0.19 13.29 6.69

010 duct. 68540............... .............. A

Remove tear gland

10.58

NA 9.78 0.55

NA 20.91

090 lesion. 68550............... .............. A

Remove tear gland

13.24

NA 11.75 0.80

NA 25.79

090 lesion. 68700............... .............. A

Repair tear ducts.... 6.59

NA 7.29 0.33

NA 14.21

090 68705............... .............. A

Revise tear duct

2.06 5.45 1.01 0.10 7.61 3.17

010 opening. 68720............... .............. A

Create tear sac drain 8.95

NA 8.26 0.46

NA 17.67

090 68745............... .............. A

Create tear duct

8.62

NA 8.22 0.46

NA 17.30

090 drain. 68750............... .............. A

Create tear duct

8.65

NA 8.69 0.45

NA 17.79

090 drain. 68760............... .............. A

Close tear duct

1.73 3.99 1.23 0.08 5.80 3.04

010 opening. 68761............... .............. A

Close tear duct

1.36 3.42 0.98 0.07 4.85 2.41

010 opening. 68770............... .............. A

Close tear system

7.01 12.75 6.78 0.34 20.10 14.13

090 fistula. 68801............... .............. A

Dilate tear duct

0.94 0.94 0.60 0.05 1.93 1.59

010 opening. 68810............... .............. A

Probe nasolacrimal

1.90 2.32 0.92 0.10 4.32 2.92

010 duct. 68811............... .............. A

Probe nasolacrimal

2.35

NA 2.36 0.12

NA 4.83

010 duct. 68815............... .............. A

Probe nasolacrimal

3.20 8.16 2.68 0.17 11.53 6.05

010 duct. 68840............... .............. A

Explore/irrigate tear 1.25 1.64 0.96 0.06 2.95 2.27

010 ducts. 68850............... .............. A

Injection for tear

0.80 16.32 0.30 0.04 17.16 1.14

000 sac x-ray.

[[Page 1188]]

68899............... .............. C

Tear duct system

0.00 0.00 0.00 0.00 0.00 0.00

YYY surgery. 69000............... .............. A

Drain external ear

1.45 2.95 1.39 0.12 4.52 2.96

010 lesion. 69005............... .............. A

Drain external ear

2.11 2.96 1.85 0.19 5.26 4.15

010 lesion. 69020............... .............. A

Drain outer ear canal 1.48 3.92 2.03 0.13 5.53 3.64

010 lesion. 69090............... .............. N

Pierce earlobes...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 69100............... .............. A

Biopsy of external

0.81 1.74 0.39 0.05 2.60 1.25

000 ear. 69105............... .............. A

Biopsy of external

0.85 2.31 0.77 0.07 3.23 1.69

000 ear canal. 69110............... .............. A

Remove external ear,

3.43 4.07 3.03 0.29 7.79 6.75

090 partial. 69120............... .............. A

Removal of external

4.04

NA 3.96 0.37

NA 8.37

090 ear. 69140............... .............. A

Remove ear canal

7.96

NA 6.69 0.68

NA 15.33

090 lesion(s). 69145............... .............. A

Remove ear canal

2.62 3.57 2.60 0.22 6.41 5.44

090 lesion(s). 69150............... .............. A

Extensive ear canal

13.41

NA 9.90 1.29

NA 24.60

090 surgery. 69155............... .............. A

Extensive ear/neck

20.77

NA 14.47 1.82

NA 37.06

090 surgery. 69200............... .............. A

Clear outer ear canal 0.77 2.33 0.58 0.06 3.16 1.41

000 69205............... .............. A

Clear outer ear canal 1.20

NA 1.35 0.11

NA 2.66

010 69210............... .............. A

Remove impacted ear

0.61 0.63 0.24 0.05 1.29 0.90

000 wax. 69220............... .............. A

Clean out mastoid

0.83 2.31 0.74 0.07 3.21 1.64

000 cavity. 69222............... .............. A

Clean out mastoid

1.40 3.78 2.02 0.12 5.30 3.54

010 cavity. 69300............... .............. R

Revise external ear.. 6.35

NA 4.23 0.52

NA 11.10

YYY 69310............... .............. A

Rebuild outer ear

10.77

NA 8.37 0.93

NA 20.07

090 canal. 69320............... .............. A

Rebuild outer ear

16.93

NA 12.09 1.41

NA 30.43

090 canal. 69399............... .............. C

Outer ear surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 69400............... .............. A

Inflate middle ear

0.83 2.33 0.67 0.07 3.23 1.57

000 canal. 69401............... .............. A

Inflate middle ear

0.63 1.30 0.65 0.05 1.98 1.33

000 canal. 69405............... .............. A

Catheterize middle

2.63 3.48 2.29 0.22 6.33 5.14

010 ear canal. 69410............... .............. A

Inset middle ear

0.33 2.05 0.48 0.02 2.40 0.83

000 (baffle). 69420............... .............. A

Incision of eardrum.. 1.33 3.08 1.58 0.12 4.53 3.03

010 69421............... .............. A

Incision of eardrum.. 1.73

NA 2.09 0.16

NA 3.98

010 69424............... .............. A

Remove ventilating

0.85 2.14 0.68 0.07 3.06 1.60

000 tube. 69433............... .............. A

Create eardrum

1.52 3.09 1.66 0.13 4.74 3.31

010 opening. 69436............... .............. A

Create eardrum

1.96

NA 2.22 0.17

NA 4.35

010 opening. 69440............... .............. A

Exploration of middle 7.56

NA 6.28 0.64

NA 14.48

090 ear. 69450............... .............. A

Eardrum revision..... 5.56

NA 5.02 0.47

NA 11.05

090 69501............... .............. A

Mastoidectomy........ 9.06

NA 7.06 0.78

NA 16.90

090 69502............... .............. A

Mastoidectomy........ 12.36

NA 9.26 1.04

NA 22.66

090 69505............... .............. A

Remove mastoid

12.97

NA 9.51 1.11

NA 23.59

090 structures. 69511............... .............. A

Extensive mastoid

13.50

NA 9.85 1.16

NA 24.51

090 surgery. 69530............... .............. A

Extensive mastoid

19.16

NA 13.01 1.59

NA 33.76

090 surgery. 69535............... .............. A

Remove part of

36.09

NA 22.36 3.12

NA 61.57

090 temporal bone. 69540............... .............. A

Remove ear lesion.... 1.20 3.68 1.93 0.11 4.99 3.24

010 69550............... .............. A

Remove ear lesion.... 10.97

NA 8.31 0.96

NA 20.24

090 69552............... .............. A

Remove ear lesion.... 19.43

NA 12.92 1.64

NA 33.99

090 69554............... .............. A

Remove ear lesion.... 33.11

NA 20.88 2.80

NA 56.79

090 69601............... .............. A

Mastoid surgery

13.22

NA 10.01 1.11

NA 24.34

090 revision. 69602............... .............. A

Mastoid surgery

13.56

NA 9.95 1.13

NA 24.64

090 revision. 69603............... .............. A

Mastoid surgery

14.00

NA 10.16 1.21

NA 25.37

090 revision. 69604............... .............. A

Mastoid surgery

14.00

NA 10.14 1.18

NA 25.32

090 revision. 69605............... .............. A

Mastoid surgery

18.46

NA 12.80 1.56

NA 32.82

090 revision. 69610............... .............. A

Repair of eardrum.... 4.42 5.39 3.27 0.37 10.18 8.06

010 69620............... .............. A

Repair of eardrum.... 5.88 6.13 4.51 0.48 12.49 10.87

090 69631............... .............. A

Repair eardrum

9.85

NA 7.85 0.83

NA 18.53

090 structures. 69632............... .............. A

Rebuild eardrum

12.73

NA 9.72 1.07

NA 23.52

090 structures. 69633............... .............. A

Rebuild eardrum

12.08

NA 9.38 1.01

NA 22.47

090 structures. 69635............... .............. A

Repair eardrum

13.31

NA 9.38 1.05

NA 23.74

090 structures. 69636............... .............. A

Rebuild eardrum

15.20

NA 11.15 1.29

NA 27.64

090 structures. 69637............... .............. A

Rebuild eardrum

15.09

NA 11.09 1.28

NA 27.46

090 structures. 69641............... .............. A

Revise middle ear &

12.69

NA 9.47 1.07

NA 23.23

090 mastoid. 69642............... .............. A

Revise middle ear &

16.81

NA 12.11 1.42

NA 30.34

090 mastoid. 69643............... .............. A

Revise middle ear &

15.30

NA 11.15 1.30

NA 27.75

090 mastoid. 69644............... .............. A

Revise middle ear &

16.94

NA 12.06 1.44

NA 30.44

090 mastoid. 69645............... .............. A

Revise middle ear &

16.36

NA 11.70 1.40

NA 29.46

090 mastoid. 69646............... .............. A

Revise middle ear &

17.96

NA 12.63 1.52

NA 32.11

090 mastoid. 69650............... .............. A

Release middle ear

9.65

NA 7.40 0.82

NA 17.87

090 bone. 69660............... .............. A

Revise middle ear

11.88

NA 8.60 1.01

NA 21.49

090 bone. 69661............... .............. A

Revise middle ear

15.72

NA 11.07 1.33

NA 28.12

090 bone. 69662............... .............. A

Revise middle ear

15.42

NA 10.79 1.30

NA 27.51

090 bone. 69666............... .............. A

Repair middle ear

9.74

NA 7.48 0.82

NA 18.04

090 structures. 69667............... .............. A

Repair middle ear

9.75

NA 7.46 0.87

NA 18.08

090 structures. 69670............... .............. A

Remove mastoid air

11.49

NA 8.63 0.94

NA 21.06

090 cells. 69676............... .............. A

Remove middle ear

9.51

NA 7.60 0.83

NA 17.94

090 nerve. 69700............... .............. A

Close mastoid fistula 8.22

NA 5.87 0.66

NA 14.75

090 69710............... .............. N

Implant/replace

0.00 0.00 0.00 0.00 0.00 0.00

XXX hearing aid. 69711............... .............. A

Remove/repair hearing 10.42

NA 8.06 0.75

NA 19.23

090 aid. 69714............... .............. A

Implant temple bone w/ 13.98

NA 9.89 1.22

NA 25.09

090 stimul. 69715............... .............. A

Temple bne implnt w/ 18.22

NA 12.37 1.59

NA 32.18

090 stimulat.

[[Page 1189]]

69717............... .............. A

Temple bone implant

14.96

NA 9.55 1.30

NA 25.81

090 revision. 69718............... .............. A

Revise temple bone

18.47

NA 12.27 1.62

NA 32.36

090 implant. 69720............... .............. A

Release facial nerve. 14.36

NA 10.74 1.24

NA 26.34

090 69725............... .............. A

Release facial nerve. 25.34

NA 16.83 2.15

NA 44.32

090 69740............... .............. A

Repair facial nerve.. 15.94

NA 10.35 1.36

NA 27.65

090 69745............... .............. A

Repair facial nerve.. 16.66

NA 11.34 1.21

NA 29.21

090 69799............... .............. C

Middle ear surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 69801............... .............. A

Incise inner ear..... 8.55

NA 6.81 0.72

NA 16.08

090 69802............... .............. A

Incise inner ear..... 13.08

NA 9.59 1.10

NA 23.77

090 69805............... .............. A

Explore inner ear.... 13.80

NA 10.04 1.17

NA 25.01

090 69806............... .............. A

Explore inner ear.... 12.33

NA 9.17 1.04

NA 22.54

090 69820............... .............. A

Establish inner ear

10.32

NA 7.83 0.80

NA 18.95

090 window. 69840............... .............. A

Revise inner ear

10.24

NA 6.91 0.77

NA 17.92

090 window. 69905............... .............. A

Remove inner ear..... 11.08

NA 8.30 0.93

NA 20.31

090 69910............... .............. A

Remove inner ear &

13.61

NA 9.70 1.13

NA 24.44

090 mastoid. 69915............... .............. A

Incise inner ear

21.20

NA 14.15 1.86

NA 37.21

090 nerve. 69930............... .............. A

Implant cochlear

16.78

NA 11.81 1.44

NA 30.03

090 device. 69949............... .............. C

Inner ear surgery

0.00 0.00 0.00 0.00 0.00 0.00

YYY procedure. 69950............... .............. A

Incise inner ear

25.60

NA 16.04 3.50

NA 45.14

090 nerve. 69955............... .............. A

Release facial nerve. 27.00

NA 17.57 2.28

NA 46.85

090 69960............... .............. A

Release inner ear

27.00

NA 17.04 2.93

NA 46.97

090 canal. 69970............... .............. A

Remove inner ear

29.99

NA 18.32 2.82

NA 51.13

090 lesion. 69979............... .............. C

Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.00

YYY 69990............... .............. R

Microsurgery add-on.. 3.46

NA 1.80 0.68

NA 5.94

ZZZ 70010............... .............. A

Contrast x-ray of

1.19 4.73

NA 0.29 6.21

NA

XXX brain. 70010............... 26............ A

Contrast x-ray of

1.19 0.39 0.39 0.07 1.65 1.65

XXX brain. 70010............... TC............ A

Contrast x-ray of

0.00 4.34

NA 0.22 4.56

NA

XXX brain. 70015............... .............. A

Contrast x-ray of

1.19 1.75

NA 0.14 3.08

NA

XXX brain. 70015............... 26............ A

Contrast x-ray of

1.19 0.39 0.39 0.06 1.64 1.64

XXX brain. 70015............... TC............ A

Contrast x-ray of

0.00 1.36

NA 0.08 1.44

NA

XXX brain. 70030............... .............. A

X-ray eye for foreign 0.17 0.47

NA 0.03 0.67

NA

XXX body. 70030............... 26............ A

X-ray eye for foreign 0.17 0.06 0.06 0.01 0.24 0.24

XXX body. 70030............... TC............ A

X-ray eye for foreign 0.00 0.41

NA 0.02 0.43

NA

XXX body. 70100............... .............. A

X-ray exam of jaw.... 0.18 0.58

NA 0.03 0.79

NA

XXX 70100............... 26............ A

X-ray exam of jaw.... 0.18 0.06 0.06 0.01 0.25 0.25

XXX 70100............... TC............ A

X-ray exam of jaw.... 0.00 0.52

NA 0.02 0.54

NA

XXX 70110............... .............. A

X-ray exam of jaw.... 0.25 0.70

NA 0.05 1.00

NA

XXX 70110............... 26............ A

X-ray exam of jaw.... 0.25 0.08 0.08 0.01 0.34 0.34

XXX 70110............... TC............ A

X-ray exam of jaw.... 0.00 0.62

NA 0.04 0.66

NA

XXX 70120............... .............. A

X-ray exam of

0.18 0.68

NA 0.05 0.91

NA

XXX mastoids. 70120............... 26............ A

X-ray exam of

0.18 0.06 0.06 0.01 0.25 0.25

XXX mastoids. 70120............... TC............ A

X-ray exam of

0.00 0.62

NA 0.04 0.66

NA

XXX mastoids. 70130............... .............. A

X-ray exam of

0.34 0.90

NA 0.06 1.30

NA

XXX mastoids. 70130............... 26............ A

X-ray exam of

0.34 0.11 0.11 0.01 0.46 0.46

XXX mastoids. 70130............... TC............ A

X-ray exam of

0.00 0.79

NA 0.05 0.84

NA

XXX mastoids. 70134............... .............. A

X-ray exam of middle

0.34 0.85

NA 0.06 1.25

NA

XXX ear. 70134............... 26............ A

X-ray exam of middle

0.34 0.11 0.11 0.01 0.46 0.46

XXX ear. 70134............... TC............ A

X-ray exam of middle

0.00 0.74

NA 0.05 0.79

NA

XXX ear. 70140............... .............. A

X-ray exam of facial

0.19 0.68

NA 0.05 0.92

NA

XXX bones. 70140............... 26............ A

X-ray exam of facial

0.19 0.06 0.06 0.01 0.26 0.26

XXX bones. 70140............... TC............ A

X-ray exam of facial

0.00 0.62

NA 0.04 0.66

NA

XXX bones. 70150............... .............. A

X-ray exam of facial

0.26 0.88

NA 0.06 1.20

NA

XXX bones. 70150............... 26............ A

X-ray exam of facial

0.26 0.09 0.09 0.01 0.36 0.36

XXX bones. 70150............... TC............ A

X-ray exam of facial

0.00 0.79

NA 0.05 0.84

NA

XXX bones. 70160............... .............. A

X-ray exam of nasal

0.17 0.58

NA 0.03 0.78

NA

XXX bones. 70160............... 26............ A

X-ray exam of nasal

0.17 0.06 0.06 0.01 0.24 0.24

XXX bones. 70160............... TC............ A

X-ray exam of nasal

0.00 0.52

NA 0.02 0.54

NA

XXX bones. 70170............... .............. A

X-ray exam of tear

0.30 1.05

NA 0.07 1.42

NA

XXX duct. 70170............... 26............ A

X-ray exam of tear

0.30 0.10 0.10 0.01 0.41 0.41

XXX duct. 70170............... TC............ A

X-ray exam of tear

0.00 0.95

NA 0.06 1.01

NA

XXX duct. 70190............... .............. A

X-ray exam of eye

0.21 0.69

NA 0.05 0.95

NA

XXX sockets. 70190............... 26............ A

X-ray exam of eye

0.21 0.07 0.07 0.01 0.29 0.29

XXX sockets. 70190............... TC............ A

X-ray exam of eye

0.00 0.62

NA 0.04 0.66

NA

XXX sockets. 70200............... .............. A

X-ray exam of eye

0.28 0.88

NA 0.06 1.22

NA

XXX sockets. 70200............... 26............ A

X-ray exam of eye

0.28 0.09 0.09 0.01 0.38 0.38

XXX sockets. 70200............... TC............ A

X-ray exam of eye

0.00 0.79

NA 0.05 0.84

NA

XXX sockets. 70210............... .............. A

X-ray exam of sinuses 0.17 0.68

NA 0.05 0.90

NA

XXX 70210............... 26............ A

X-ray exam of sinuses 0.17 0.06 0.06 0.01 0.24 0.24

XXX 70210............... TC............ A

X-ray exam of sinuses 0.00 0.62

NA 0.04 0.66

NA

XXX 70220............... .............. A

X-ray exam of sinuses 0.25 0.87

NA 0.06 1.18

NA

XXX 70220............... 26............ A

X-ray exam of sinuses 0.25 0.08 0.08 0.01 0.34 0.34

XXX 70220............... TC............ A

X-ray exam of sinuses 0.00 0.79

NA 0.05 0.84

NA

XXX 70240............... .............. A

X-ray exam, pituitary 0.19 0.47

NA 0.03 0.69

NA

XXX saddle. 70240............... 26............ A

X-ray exam, pituitary 0.19 0.06 0.06 0.01 0.26 0.26

XXX saddle. 70240............... TC............ A

X-ray exam, pituitary 0.00 0.41

NA 0.02 0.43

NA

XXX saddle.

[[Page 1190]]

70250............... .............. A

X-ray exam of skull.. 0.24 0.70

NA 0.05 0.99

NA

XXX 70250............... 26............ A

X-ray exam of skull.. 0.24 0.08 0.08 0.01 0.33 0.33

XXX 70250............... TC............ A

X-ray exam of skull.. 0.00 0.62

NA 0.04 0.66

NA

XXX 70260............... .............. A

X-ray exam of skull.. 0.34 1.00

NA 0.07 1.41

NA

XXX 70260............... 26............ A

X-ray exam of skull.. 0.34 0.11 0.11 0.01 0.46 0.46

XXX 70260............... TC............ A

X-ray exam of skull.. 0.00 0.89

NA 0.06 0.95

NA

XXX 70300............... .............. A

X-ray exam of teeth.. 0.10 0.32

NA 0.03 0.45

NA

XXX 70300............... 26............ A

X-ray exam of teeth.. 0.10 0.05 0.05 0.01 0.16 0.16

XXX 70300............... TC............ A

X-ray exam of teeth.. 0.00 0.27

NA 0.02 0.29

NA

XXX 70310............... .............. A

X-ray exam of teeth.. 0.16 0.49

NA 0.03 0.68

NA

XXX 70310............... 26............ A

X-ray exam of teeth.. 0.16 0.08 0.08 0.01 0.25 0.25

XXX 70310............... TC............ A

X-ray exam of teeth.. 0.00 0.41

NA 0.02 0.43

NA

XXX 70320............... .............. A

Full mouth x-ray of

0.22 0.87

NA 0.06 1.15

NA

XXX teeth. 70320............... 26............ A

Full mouth x-ray of

0.22 0.08 0.08 0.01 0.31 0.31

XXX teeth. 70320............... TC............ A

Full mouth x-ray of

0.00 0.79

NA 0.05 0.84

NA

XXX teeth. 70328............... .............. A

X-ray exam of jaw

0.18 0.55

NA 0.03 0.76

NA

XXX joint. 70328............... 26............ A

X-ray exam of jaw

0.18 0.06 0.06 0.01 0.25 0.25

XXX joint. 70328............... TC............ A

X-ray exam of jaw

0.00 0.49

NA 0.02 0.51

NA

XXX joint. 70330............... .............. A

X-ray exam of jaw

0.24 0.93

NA 0.06 1.23

NA

XXX joints. 70330............... 26............ A

X-ray exam of jaw

0.24 0.08 0.08 0.01 0.33 0.33

XXX joints. 70330............... TC............ A

X-ray exam of jaw

0.00 0.85

NA 0.05 0.90

NA

XXX joints. 70332............... .............. A

X-ray exam of jaw

0.54 2.30

NA 0.14 2.98

NA

XXX joint. 70332............... 26............ A

X-ray exam of jaw

0.54 0.20 0.20 0.02 0.76 0.76

XXX joint. 70332............... TC............ A

X-ray exam of jaw

0.00 2.10

NA 0.12 2.22

NA

XXX joint. 70336............... .............. A

Magnetic image, jaw

1.48 11.72

NA 0.67 13.87

NA

XXX joint. 70336............... 26............ A

Magnetic image, jaw

1.48 0.48 0.48 0.08 2.04 2.04

XXX joint. 70336............... TC............ A

Magnetic image, jaw

0.00 11.24

NA 0.59 11.83

NA

XXX joint. 70350............... .............. A

X-ray head for

0.17 0.44

NA 0.03 0.64

NA

XXX orthodontia. 70350............... 26............ A

X-ray head for

0.17 0.07 0.07 0.01 0.25 0.25

XXX orthodontia. 70350............... TC............ A

X-ray head for

0.00 0.37

NA 0.02 0.39

NA

XXX orthodontia. 70355............... .............. A

Panoramic x-ray of

0.20 0.65

NA 0.05 0.90

NA

XXX jaws. 70355............... 26............ A

Panoramic x-ray of

0.20 0.08 0.08 0.01 0.29 0.29

XXX jaws. 70355............... TC............ A

Panoramic x-ray of

0.00 0.57

NA 0.04 0.61

NA

XXX jaws. 70360............... .............. A

X-ray exam of neck... 0.17 0.47

NA 0.03 0.67

NA

XXX 70360............... 26............ A

X-ray exam of neck... 0.17 0.06 0.06 0.01 0.24 0.24

XXX 70360............... TC............ A

X-ray exam of neck... 0.00 0.41

NA 0.02 0.43

NA

XXX 70370............... .............. A

Throat x-ray &

0.32 1.42

NA 0.08 1.82

NA

XXX fluoroscopy. 70370............... 26............ A

Throat x-ray &

0.32 0.11 0.11 0.01 0.44 0.44

XXX fluoroscopy. 70370............... TC............ A

Throat x-ray &

0.00 1.31

NA 0.07 1.38

NA

XXX fluoroscopy. 70371............... .............. A

Speech evaluation,

0.84 2.38

NA 0.17 3.39

NA

XXX complex. 70371............... 26............ A

Speech evaluation,

0.84 0.28 0.28 0.05 1.17 1.17

XXX complex. 70371............... TC............ A

Speech evaluation,

0.00 2.10

NA 0.12 2.22

NA

XXX complex. 70373............... .............. A

Contrast x-ray of

0.44 1.94

NA 0.13 2.51

NA

XXX larynx. 70373............... 26............ A

Contrast x-ray of

0.44 0.15 0.15 0.02 0.61 0.61

XXX larynx. 70373............... TC............ A

Contrast x-ray of

0.00 1.79

NA 0.11 1.90

NA

XXX larynx. 70380............... .............. A

X-ray exam of

0.17 0.73

NA 0.05 0.95

NA

XXX salivary gland. 70380............... 26............ A

X-ray exam of

0.17 0.06 0.06 0.01 0.24 0.24

XXX salivary gland. 70380............... TC............ A

X-ray exam of

0.00 0.67

NA 0.04 0.71

NA

XXX salivary gland. 70390............... .............. A

X-ray exam of

0.38 1.92

NA 0.13 2.43

NA

XXX salivary duct. 70390............... 26............ A

X-ray exam of

0.38 0.13 0.13 0.02 0.53 0.53

XXX salivary duct. 70390............... TC............ A

X-ray exam of

0.00 1.79

NA 0.11 1.90

NA

XXX salivary duct. 70450............... .............. A

Ct head/brain w/o dye 0.85 5.02

NA 0.30 6.17

NA

XXX 70450............... 26............ A

Ct head/brain w/o dye 0.85 0.28 0.28 0.05 1.18 1.18

XXX 70450............... TC............ A

Ct head/brain w/o dye 0.00 4.74

NA 0.25 4.99

NA

XXX 70460............... .............. A

Ct head/brain w/dye.. 1.13 6.04

NA 0.36 7.53

NA

XXX 70460............... 26............ A

Ct head/brain w/dye.. 1.13 0.37 0.37 0.06 1.56 1.56

XXX 70460............... TC............ A

Ct head/brain w/dye.. 0.00 5.67

NA 0.30 5.97

NA

XXX 70470............... .............. A

Ct head/brain w/o & w/ 1.27 7.51

NA 0.44 9.22

NA

XXX dye. 70470............... 26............ A

Ct head/brain w/o & w/ 1.27 0.41 0.41 0.07 1.75 1.75

XXX dye. 70470............... TC............ A

Ct head/brain w/o & w/ 0.00 7.10

NA 0.37 7.47

NA

XXX dye. 70480............... .............. A

Ct orbit/ear/fossa w/ 1.28 5.16

NA 0.32 6.76

NA

XXX o dye. 70480............... 26............ A

Ct orbit/ear/fossa w/ 1.28 0.42 0.42 0.07 1.77 1.77

XXX o dye. 70480............... TC............ A

Ct orbit/ear/fossa w/ 0.00 4.74

NA 0.25 4.99

NA

XXX o dye. 70481............... .............. A

Ct orbit/ear/fossa w/ 1.38 6.12

NA 0.37 7.87

NA

XXX dye. 70481............... 26............ A

Ct orbit/ear/fossa w/ 1.38 0.45 0.45 0.07 1.90 1.90

XXX dye. 70481............... TC............ A

Ct orbit/ear/fossa w/ 0.00 5.67

NA 0.30 5.97

NA

XXX dye. 70482............... .............. A

Ct orbit/ear/fossa w/ 1.45 7.57

NA 0.44 9.46

NA

XXX o&w dye. 70482............... 26............ A

Ct orbit/ear/fossa w/ 1.45 0.47 0.47 0.07 1.99 1.99

XXX o&w dye. 70482............... TC............ A

Ct orbit/ear/fossa w/ 0.00 7.10

NA 0.37 7.47

NA

XXX o&w dye. 70486............... .............. A

Ct maxillofacial w/o

1.14 5.11

NA 0.31 6.56

NA

XXX dye. 70486............... 26............ A

Ct maxillofacial w/o

1.14 0.37 0.37 0.06 1.57 1.57

XXX dye. 70486............... TC............ A

Ct maxillofacial w/o

0.00 4.74

NA 0.25 4.99

NA

XXX dye. 70487............... .............. A

Ct maxillofacial w/

1.30 6.09

NA 0.37 7.76

NA

XXX dye. 70487............... 26............ A

Ct maxillofacial w/

1.30 0.42 0.42 0.07 1.79 1.79

XXX dye. 70487............... TC............ A

Ct maxillofacial w/

0.00 5.67

NA 0.30 5.97

NA

XXX dye.

[[Page 1191]]

70488............... .............. A

Ct maxillofacial w/o

1.42 7.56

NA 0.44 9.42

NA

XXX & w dye. 70488............... 26............ A

Ct maxillofacial w/o

1.42 0.46 0.46 0.07 1.95 1.95

XXX & w dye. 70488............... TC............ A

Ct maxillofacial w/o

0.00 7.10

NA 0.37 7.47

NA

XXX & w dye. 70490............... .............. A

Ct soft tissue neck w/ 1.28 5.16

NA 0.32 6.76

NA

XXX o dye. 70490............... 26............ A

Ct soft tissue neck w/ 1.28 0.42 0.42 0.07 1.77 1.77

XXX o dye. 70490............... TC............ A

Ct soft tissue neck w/ 0.00 4.74

NA 0.25 4.99

NA

XXX o dye. 70491............... .............. A

Ct soft tissue neck w/ 1.38 6.12

NA 0.37 7.87

NA

XXX dye. 70491............... 26............ A

Ct soft tissue neck w/ 1.38 0.45 0.45 0.07 1.90 1.90

XXX dye. 70491............... TC............ A

Ct soft tissue neck w/ 0.00 5.67

NA 0.30 5.97

NA

XXX dye. 70492............... .............. A

Ct sft tsue nck w/o & 1.45 7.57

NA 0.44 9.46

NA

XXX w/dye. 70492............... 26............ A

Ct sft tsue nck w/o & 1.45 0.47 0.47 0.07 1.99 1.99

XXX w/dye. 70492............... TC............ A

Ct sft tsue nck w/o & 0.00 7.10

NA 0.37 7.47

NA

XXX w/dye. 70496............... .............. A

Ct angiography, head. 1.75 11.22

NA 0.68 13.65

NA

XXX 70496............... 26............ A

Ct angiography, head. 1.75 0.57 0.57 0.10 2.42 2.42

XXX 70496............... TC............ A

Ct angiography, head. 0.00 10.65

NA 0.58 11.23

NA

XXX 70498............... .............. A

Ct angiography, neck. 1.75 11.22

NA 0.68 13.65

NA

XXX 70498............... 26............ A

Ct angiography, neck. 1.75 0.57 0.57 0.10 2.42 2.42

XXX 70498............... TC............ A

Ct angiography, neck. 0.00 10.65

NA 0.58 11.23

NA

XXX 70540............... .............. A

Mri orbit/face/neck w/ 1.35 11.68

NA 0.44 13.47

NA

XXX o dye. 70540............... 26............ A

Mri orbit/face/neck w/ 1.35 0.44 0.44 0.05 1.84 1.84

XXX o dye. 70540............... TC............ A

Mri orbit/face/neck w/ 0.00 11.24

NA 0.39 11.63

NA

XXX o dye. 70542............... .............. A

Mri orbit/face/neck w/ 1.62 14.02

NA 0.53 16.17

NA

XXX dye. 70542............... 26............ A

Mri orbit/face/neck w/ 1.62 0.53 0.53 0.06 2.21 2.21

XXX dye. 70542............... TC............ A

Mri orbit/face/neck w/ 0.00 13.49

NA 0.47 13.96

NA

XXX dye. 70543............... .............. A

Mri orbt/fac/nck w/o

2.15 25.69

NA 0.92 28.76

NA

XXX & w dye. 70543............... 26............ A

Mri orbt/fac/nck w/o

2.15 0.71 0.71 0.08 2.94 2.94

XXX & w dye. 70543............... TC............ A

Mri orbt/fac/nck w/o

0.00 24.98

NA 0.84 25.82

NA

XXX & w dye. 70544............... .............. A

Mr angiography head w/ 1.20 11.63

NA 0.65 13.48

NA

XXX o dye. 70544............... 26............ A

Mr angiography head w/ 1.20 0.39 0.39 0.06 1.65 1.65

XXX o dye. 70544............... TC............ A

Mr angiography head w/ 0.00 11.24

NA 0.59 11.83

NA

XXX o dye. 70545............... .............. A

Mr angiography head w/ 1.20 11.63

NA 0.65 13.48

NA

XXX dye. 70545............... 26............ A

Mr angiography head w/ 1.20 0.39 0.39 0.06 1.65 1.65

XXX dye. 70545............... TC............ A

Mr angiography head w/ 0.00 11.24

NA 0.59 11.83

NA

XXX dye. 70546............... .............. A

Mr angiograph head w/ 1.80 23.08

NA 0.69 25.57

NA

XXX o&w dye. 70546............... 26............ A

Mr angiograph head w/ 1.80 0.59 0.59 0.10 2.49 2.49

XXX o&w dye. 70546............... TC............ A

Mr angiograph head w/ 0.00 22.49

NA 0.59 23.08

NA

XXX o&w dye. 70547............... .............. A

Mr angiography neck w/ 1.20 11.63

NA 0.65 13.48

NA

XXX o dye. 70547............... 26............ A

Mr angiography neck w/ 1.20 0.39 0.39 0.06 1.65 1.65

XXX o dye. 70547............... TC............ A

Mr angiography neck w/ 0.00 11.24

NA 0.59 11.83

NA

XXX o dye. 70548............... .............. A

Mr angiography neck w/ 1.20 11.63

NA 0.65 13.48

NA

XXX dye. 70548............... 26............ A

Mr angiography neck w/ 1.20 0.39 0.39 0.06 1.65 1.65

XXX dye. 70548............... TC............ A

Mr angiography neck w/ 0.00 11.24

NA 0.59 11.83

NA

XXX dye. 70549............... .............. A

Mr angiograph neck w/ 1.80 23.08

NA 0.69 25.57

NA

XXX o&w dye. 70549............... 26............ A

Mr angiograph neck w/ 1.80 0.59 0.59 0.10 2.49 2.49

XXX o&w dye. 70549............... TC............ A

Mr angiograph neck w/ 0.00 22.49

NA 0.59 23.08

NA

XXX o&w dye. 70551............... .............. A

Mri brain w/o dye.... 1.48 11.73

NA 0.67 13.88

NA

XXX 70551............... 26............ A

Mri brain w/o dye.... 1.48 0.49 0.49 0.08 2.05 2.05

XXX 70551............... TC............ A

Mri brain w/o dye.... 0.00 11.24

NA 0.59 11.83

NA

XXX 70552............... .............. A

Mri brain w/ dye..... 1.78 14.08

NA 0.80 16.66

NA

XXX 70552............... 26............ A

Mri brain w/ dye..... 1.78 0.59 0.59 0.10 2.47 2.47

XXX 70552............... TC............ A

Mri brain w/ dye..... 0.00 13.49

NA 0.70 14.19

NA

XXX 70553............... .............. A

Mri brain w/o & w/

2.36 25.76

NA 1.43 29.55

NA

XXX dye. 70553............... 26............ A

Mri brain w/o & w/

2.36 0.78 0.78 0.12 3.26 3.26

XXX dye. 70553............... TC............ A

Mri brain w/o & w/

0.00 24.98

NA 1.31 26.29

NA

XXX dye. 70557............... .............. C

Mri brain w/o dye.... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 70557............... 26............ A

Mri brain w/o dye.... 2.90 0.98 0.98 0.08 3.96 3.96

XXX 70557............... TC............ C

Mri brain w/o dye.... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 70558............... .............. C

Mri brain w/ dye..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 70558............... 26............ A

Mri brain w/ dye..... 3.20 1.08 1.08 0.10 4.38 4.38

XXX 70558............... TC............ C

Mri brain w/ dye..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 70559............... .............. C

Mri brain w/o & w/

0.00 0.00 0.00 0.00 0.00 0.00

XXX dye. 70559............... 26............ A

Mri brain w/o & w/

3.20 1.08 1.08 0.12 4.40 4.40

XXX dye. 70559............... TC............ C

Mri brain w/o & w/

0.00 0.00 0.00 0.00 0.00 0.00

XXX dye. 71010............... .............. A

Chest x-ray.......... 0.18 0.53

NA 0.03 0.74

NA

XXX 71010............... 26............ A

Chest x-ray.......... 0.18 0.06 0.06 0.01 0.25 0.25

XXX 71010............... TC............ A

Chest x-ray.......... 0.00 0.47

NA 0.02 0.49

NA

XXX 71015............... .............. A

Chest x-ray.......... 0.21 0.59

NA 0.03 0.83

NA

XXX 71015............... 26............ A

Chest x-ray.......... 0.21 0.07 0.07 0.01 0.29 0.29

XXX 71015............... TC............ A

Chest x-ray.......... 0.00 0.52

NA 0.02 0.54

NA

XXX 71020............... .............. A

Chest x-ray.......... 0.22 0.69

NA 0.05 0.96

NA

XXX 71020............... 26............ A

Chest x-ray.......... 0.22 0.07 0.07 0.01 0.30 0.30

XXX 71020............... TC............ A

Chest x-ray.......... 0.00 0.62

NA 0.04 0.66

NA

XXX 71021............... .............. A

Chest x-ray.......... 0.27 0.83

NA 0.06 1.16

NA

XXX 71021............... 26............ A

Chest x-ray.......... 0.27 0.09 0.09 0.01 0.37 0.37

XXX 71021............... TC............ A

Chest x-ray.......... 0.00 0.74

NA 0.05 0.79

NA

XXX

[[Page 1192]]

71022............... .............. A

Chest x-ray.......... 0.31 0.84

NA 0.07 1.22

NA

XXX 71022............... 26............ A

Chest x-ray.......... 0.31 0.10 0.10 0.02 0.43 0.43

XXX 71022............... TC............ A

Chest x-ray.......... 0.00 0.74

NA 0.05 0.79

NA

XXX 71023............... .............. A

Chest x-ray and

0.38 0.92

NA 0.07 1.37

NA

XXX fluoroscopy. 71023............... 26............ A

Chest x-ray and

0.38 0.13 0.13 0.02 0.53 0.53

XXX fluoroscopy. 71023............... TC............ A

Chest x-ray and

0.00 0.79

NA 0.05 0.84

NA

XXX fluoroscopy. 71030............... .............. A

Chest x-ray.......... 0.31 0.89

NA 0.06 1.26

NA

XXX 71030............... 26............ A

Chest x-ray.......... 0.31 0.10 0.10 0.01 0.42 0.42

XXX 71030............... TC............ A

Chest x-ray.......... 0.00 0.79

NA 0.05 0.84

NA

XXX 71034............... .............. A

Chest x-ray and

0.46 1.60

NA 0.10 2.16

NA

XXX fluoroscopy. 71034............... 26............ A

Chest x-ray and

0.46 0.16 0.16 0.02 0.64 0.64

XXX fluoroscopy. 71034............... TC............ A

Chest x-ray and

0.00 1.44

NA 0.08 1.52

NA

XXX fluoroscopy. 71035............... .............. A

Chest x-ray.......... 0.18 0.58

NA 0.03 0.79

NA

XXX 71035............... 26............ A

Chest x-ray.......... 0.18 0.06 0.06 0.01 0.25 0.25

XXX 71035............... TC............ A

Chest x-ray.......... 0.00 0.52

NA 0.02 0.54

NA

XXX 71040............... .............. A

Contrast x-ray of

0.58 1.65

NA 0.12 2.35

NA

XXX bronchi. 71040............... 26............ A

Contrast x-ray of

0.58 0.19 0.19 0.04 0.81 0.81

XXX bronchi. 71040............... TC............ A

Contrast x-ray of

0.00 1.46

NA 0.08 1.54

NA

XXX bronchi. 71060............... .............. A

Contrast x-ray of

0.74 2.46

NA 0.17 3.37

NA

XXX bronchi. 71060............... 26............ A

Contrast x-ray of

0.74 0.25 0.25 0.04 1.03 1.03

XXX bronchi. 71060............... TC............ A

Contrast x-ray of

0.00 2.21

NA 0.13 2.34

NA

XXX bronchi. 71090............... .............. A

X-ray & pacemaker

0.54 1.90

NA 0.13 2.57

NA

XXX insertion. 71090............... 26............ A

X-ray & pacemaker

0.54 0.21 0.21 0.02 0.77 0.77

XXX insertion. 71090............... TC............ A

X-ray & pacemaker

0.00 1.69

NA 0.11 1.80

NA

XXX insertion. 71100............... .............. A

X-ray exam of ribs... 0.22 0.64

NA 0.05 0.91

NA

XXX 71100............... 26............ A

X-ray exam of ribs... 0.22 0.07 0.07 0.01 0.30 0.30

XXX 71100............... TC............ A

X-ray exam of ribs... 0.00 0.57

NA 0.04 0.61

NA

XXX 71101............... .............. A

X-ray exam of ribs/

0.27 0.76

NA 0.05 1.08

NA

XXX chest. 71101............... 26............ A

X-ray exam of ribs/

0.27 0.09 0.09 0.01 0.37 0.37

XXX chest. 71101............... TC............ A

X-ray exam of ribs/

0.00 0.67

NA 0.04 0.71

NA

XXX chest. 71110............... .............. A

X-ray exam of ribs... 0.27 0.88

NA 0.06 1.21

NA

XXX 71110............... 26............ A

X-ray exam of ribs... 0.27 0.09 0.09 0.01 0.37 0.37

XXX 71110............... TC............ A

X-ray exam of ribs... 0.00 0.79

NA 0.05 0.84

NA

XXX 71111............... .............. A

X-ray exam of ribs/

0.32 1.00

NA 0.07 1.39

NA

XXX chest. 71111............... 26............ A

X-ray exam of ribs/

0.32 0.11 0.11 0.01 0.44 0.44

XXX chest. 71111............... TC............ A

X-ray exam of ribs/

0.00 0.89

NA 0.06 0.95

NA

XXX chest. 71120............... .............. A

X-ray exam of

0.20 0.72

NA 0.05 0.97

NA

XXX breastbone. 71120............... 26............ A

X-ray exam of

0.20 0.07 0.07 0.01 0.28 0.28

XXX breastbone. 71120............... TC............ A

X-ray exam of

0.00 0.65

NA 0.04 0.69

NA

XXX breastbone. 71130............... .............. A

X-ray exam of

0.22 0.78

NA 0.05 1.05

NA

XXX breastbone. 71130............... 26............ A

X-ray exam of

0.22 0.07 0.07 0.01 0.30 0.30

XXX breastbone. 71130............... TC............ A

X-ray exam of

0.00 0.71

NA 0.04 0.75

NA

XXX breastbone. 71250............... .............. A

Ct thorax w/o dye.... 1.16 6.31

NA 0.37 7.84

NA

XXX 71250............... 26............ A

Ct thorax w/o dye.... 1.16 0.38 0.38 0.06 1.60 1.60

XXX 71250............... TC............ A

Ct thorax w/o dye.... 0.00 5.93

NA 0.31 6.24

NA

XXX 71260............... .............. A

Ct thorax w/dye...... 1.24 7.50

NA 0.43 9.17

NA

XXX 71260............... 26............ A

Ct thorax w/dye...... 1.24 0.40 0.40 0.06 1.70 1.70

XXX 71260............... TC............ A

Ct thorax w/dye...... 0.00 7.10

NA 0.37 7.47

NA

XXX 71270............... .............. A

Ct thorax w/o & w/

1.38 9.33

NA 0.53 11.24

NA

XXX dye. 71270............... 26............ A

Ct thorax w/o & w/

1.38 0.45 0.45 0.07 1.90 1.90

XXX dye. 71270............... TC............ A

Ct thorax w/o & w/

0.00 8.88

NA 0.46 9.34

NA

XXX dye. 71275............... .............. A

Ct angiography, chest 1.92 13.05

NA 0.46 15.43

NA

XXX 71275............... 26............ A

Ct angiography, chest 1.92 0.63 0.63 0.07 2.62 2.62

XXX 71275............... TC............ A

Ct angiography, chest 0.00 12.42

NA 0.39 12.81

NA

XXX 71550............... .............. A

Mri chest w/o dye.... 1.46 11.72

NA 0.50 13.68

NA

XXX 71550............... 26............ A

Mri chest w/o dye.... 1.46 0.48 0.48 0.05 1.99 1.99

XXX 71550............... TC............ A

Mri chest w/o dye.... 0.00 11.24

NA 0.45 11.69

NA

XXX 71551............... .............. A

Mri chest w/dye...... 1.73 14.06

NA 0.59 16.38

NA

XXX 71551............... 26............ A

Mri chest w/dye...... 1.73 0.57 0.57 0.07 2.37 2.37

XXX 71551............... TC............ A

Mri chest w/dye...... 0.00 13.49

NA 0.52 14.01

NA

XXX 71552............... .............. A

Mri chest w/o & w/dye 2.26 25.72

NA 0.78 28.76

NA

XXX 71552............... 26............ A

Mri chest w/o & w/dye 2.26 0.74 0.74 0.10 3.10 3.10

XXX 71552............... TC............ A

Mri chest w/o & w/dye 0.00 24.98

NA 0.68 25.66

NA

XXX 71555............... .............. R

Mri angio chest w or

1.81 11.84

NA 0.69 14.34

NA

XXX w/o dye. 71555............... 26............ R

Mri angio chest w or

1.81 0.60 0.60 0.10 2.51 2.51

XXX w/o dye. 71555............... TC............ R

Mri angio chest w or

0.00 11.24

NA 0.59 11.83

NA

XXX w/o dye. 72010............... .............. A

X-ray exam of spine.. 0.45 1.18

NA 0.10 1.73

NA

XXX 72010............... 26............ A

X-ray exam of spine.. 0.45 0.15 0.15 0.04 0.64 0.64

XXX 72010............... TC............ A

X-ray exam of spine.. 0.00 1.03

NA 0.06 1.09

NA

XXX 72020............... .............. A

X-ray exam of spine.. 0.15 0.46

NA 0.03 0.64

NA

XXX 72020............... 26............ A

X-ray exam of spine.. 0.15 0.05 0.05 0.01 0.21 0.21

XXX 72020............... TC............ A

X-ray exam of spine.. 0.00 0.41

NA 0.02 0.43

NA

XXX 72040............... .............. A

X-ray exam of neck

0.22 0.67

NA 0.05 0.94

NA

XXX spine. 72040............... 26............ A

X-ray exam of neck

0.22 0.07 0.07 0.01 0.30 0.30

XXX spine. 72040............... TC............ A

X-ray exam of neck

0.00 0.60

NA 0.04 0.64

NA

XXX spine.

[[Page 1193]]

72050............... .............. A

X-ray exam of neck

0.31 0.99

NA 0.08 1.38

NA

XXX spine. 72050............... 26............ A

X-ray exam of neck

0.31 0.10 0.10 0.02 0.43 0.43

XXX spine. 72050............... TC............ A

X-ray exam of neck

0.00 0.89

NA 0.06 0.95

NA

XXX spine. 72052............... .............. A

X-ray exam of neck

0.36 1.25

NA 0.08 1.69

NA

XXX spine. 72052............... 26............ A

X-ray exam of neck

0.36 0.12 0.12 0.02 0.50 0.50

XXX spine. 72052............... TC............ A

X-ray exam of neck

0.00 1.13

NA 0.06 1.19

NA

XXX spine. 72069............... .............. A

X-ray exam of trunk

0.22 0.57

NA 0.04 0.83

NA

XXX spine. 72069............... 26............ A

X-ray exam of trunk

0.22 0.08 0.08 0.02 0.32 0.32

XXX spine. 72069............... TC............ A

X-ray exam of trunk

0.00 0.49

NA 0.02 0.51

NA

XXX spine. 72070............... .............. A

X-ray exam of

0.22 0.72

NA 0.05 0.99

NA

XXX thoracic spine. 72070............... 26............ A

X-ray exam of

0.22 0.07 0.07 0.01 0.30 0.30

XXX thoracic spine. 72070............... TC............ A

X-ray exam of

0.00 0.65

NA 0.04 0.69

NA

XXX thoracic spine. 72072............... .............. A

X-ray exam of

0.22 0.81

NA 0.06 1.09

NA

XXX thoracic spine. 72072............... 26............ A

X-ray exam of

0.22 0.07 0.07 0.01 0.30 0.30

XXX thoracic spine. 72072............... TC............ A

X-ray exam of

0.00 0.74

NA 0.05 0.79

NA

XXX thoracic spine. 72074............... .............. A

X-ray exam of

0.22 0.98

NA 0.07 1.27

NA

XXX thoracic spine. 72074............... 26............ A

X-ray exam of

0.22 0.07 0.07 0.01 0.30 0.30

XXX thoracic spine. 72074............... TC............ A

X-ray exam of

0.00 0.91

NA 0.06 0.97

NA

XXX thoracic spine. 72080............... .............. A

X-ray exam of trunk

0.22 0.74

NA 0.06 1.02

NA

XXX spine. 72080............... 26............ A

X-ray exam of trunk

0.22 0.07 0.07 0.02 0.31 0.31

XXX spine. 72080............... TC............ A

X-ray exam of trunk

0.00 0.67

NA 0.04 0.71

NA

XXX spine. 72090............... .............. A

X-ray exam of trunk

0.28 0.76

NA 0.06 1.10

NA

XXX spine. 72090............... 26............ A

X-ray exam of trunk

0.28 0.09 0.09 0.02 0.39 0.39

XXX spine. 72090............... TC............ A

X-ray exam of trunk

0.00 0.67

NA 0.04 0.71

NA

XXX spine. 72100............... .............. A

X-ray exam of lower

0.22 0.74

NA 0.06 1.02

NA

XXX spine. 72100............... 26............ A

X-ray exam of lower

0.22 0.07 0.07 0.02 0.31 0.31

XXX spine. 72100............... TC............ A

X-ray exam of lower

0.00 0.67

NA 0.04 0.71

NA

XXX spine. 72110............... .............. A

X-ray exam of lower

0.31 1.01

NA 0.08 1.40

NA

XXX spine. 72110............... 26............ A

X-ray exam of lower

0.31 0.10 0.10 0.02 0.43 0.43

XXX spine. 72110............... TC............ A

X-ray exam of lower

0.00 0.91

NA 0.06 0.97

NA

XXX spine. 72114............... .............. A

X-ray exam of lower

0.36 1.31

NA 0.10 1.77

NA

XXX spine. 72114............... 26............ A

X-ray exam of lower

0.36 0.12 0.12 0.04 0.52 0.52

XXX spine. 72114............... TC............ A

X-ray exam of lower

0.00 1.19

NA 0.06 1.25

NA

XXX spine. 72120............... .............. A

X-ray exam of lower

0.22 0.96

NA 0.08 1.26

NA

XXX spine. 72120............... 26............ A

X-ray exam of lower

0.22 0.07 0.07 0.02 0.31 0.31

XXX spine. 72120............... TC............ A

X-ray exam of lower

0.00 0.89

NA 0.06 0.95

NA

XXX spine. 72125............... .............. A

Ct neck spine w/o dye 1.16 6.31

NA 0.37 7.84

NA

XXX 72125............... 26............ A

Ct neck spine w/o dye 1.16 0.38 0.38 0.06 1.60 1.60

XXX 72125............... TC............ A

Ct neck spine w/o dye 0.00 5.93

NA 0.31 6.24

NA

XXX 72126............... .............. A

Ct neck spine w/dye.. 1.22 7.49

NA 0.43 9.14

NA

XXX 72126............... 26............ A

Ct neck spine w/dye.. 1.22 0.39 0.39 0.06 1.67 1.67

XXX 72126............... TC............ A

Ct neck spine w/dye.. 0.00 7.10

NA 0.37 7.47

NA

XXX 72127............... .............. A

Ct neck spine w/o & w/ 1.27 9.29

NA 0.53 11.09

NA

XXX dye. 72127............... 26............ A

Ct neck spine w/o & w/ 1.27 0.41 0.41 0.07 1.75 1.75

XXX dye. 72127............... TC............ A

Ct neck spine w/o & w/ 0.00 8.88

NA 0.46 9.34

NA

XXX dye. 72128............... .............. A

Ct chest spine w/o

1.16 6.31

NA 0.37 7.84

NA

XXX dye. 72128............... 26............ A

Ct chest spine w/o

1.16 0.38 0.38 0.06 1.60 1.60

XXX dye. 72128............... TC............ A

Ct chest spine w/o

0.00 5.93

NA 0.31 6.24

NA

XXX dye. 72129............... .............. A

Ct chest spine w/dye. 1.22 7.49

NA 0.43 9.14

NA

XXX 72129............... 26............ A

Ct chest spine w/dye. 1.22 0.39 0.39 0.06 1.67 1.67

XXX 72129............... TC............ A

Ct chest spine w/dye. 0.00 7.10

NA 0.37 7.47

NA

XXX 72130............... .............. A

Ct chest spine w/o &

1.27 9.29

NA 0.53 11.09

NA

XXX w/dye. 72130............... 26............ A

Ct chest spine w/o &

1.27 0.41 0.41 0.07 1.75 1.75

XXX w/dye. 72130............... TC............ A

Ct chest spine w/o &

0.00 8.88

NA 0.46 9.34

NA

XXX w/dye. 72131............... .............. A

Ct lumbar spine w/o

1.16 6.31

NA 0.37 7.84

NA

XXX dye. 72131............... 26............ A

Ct lumbar spine w/o

1.16 0.38 0.38 0.06 1.60 1.60

XXX dye. 72131............... TC............ A

Ct lumbar spine w/o

0.00 5.93

NA 0.31 6.24

NA

XXX dye. 72132............... .............. A

Ct lumbar spine w/dye 1.22 7.50

NA 0.44 9.16

NA

XXX 72132............... 26............ A

Ct lumbar spine w/dye 1.22 0.40 0.40 0.07 1.69 1.69

XXX 72132............... TC............ A

Ct lumbar spine w/dye 0.00 7.10

NA 0.37 7.47

NA

XXX 72133............... .............. A

Ct lumbar spine w/o & 1.27 9.30

NA 0.53 11.10

NA

XXX w/dye. 72133............... 26............ A

Ct lumbar spine w/o & 1.27 0.42 0.42 0.07 1.76 1.76

XXX w/dye. 72133............... TC............ A

Ct lumbar spine w/o & 0.00 8.88

NA 0.46 9.34

NA

XXX w/dye. 72141............... .............. A

Mri neck spine w/o

1.60 11.77

NA 0.67 14.04

NA

XXX dye. 72141............... 26............ A

Mri neck spine w/o

1.60 0.53 0.53 0.08 2.21 2.21

XXX dye. 72141............... TC............ A

Mri neck spine w/o

0.00 11.24

NA 0.59 11.83

NA

XXX dye. 72142............... .............. A

Mri neck spine w/dye. 1.92 14.14

NA 0.81 16.87

NA

XXX 72142............... 26............ A

Mri neck spine w/dye. 1.92 0.65 0.65 0.11 2.68 2.68

XXX 72142............... TC............ A

Mri neck spine w/dye. 0.00 13.49

NA 0.70 14.19

NA

XXX 72146............... .............. A

Mri chest spine w/o

1.60 13.00

NA 0.72 15.32

NA

XXX dye. 72146............... 26............ A

Mri chest spine w/o

1.60 0.52 0.52 0.08 2.20 2.20

XXX dye. 72146............... TC............ A

Mri chest spine w/o

0.00 12.48

NA 0.64 13.12

NA

XXX dye. 72147............... .............. A

Mri chest spine w/dye 1.92 14.13

NA 0.81 16.86

NA

XXX 72147............... 26............ A

Mri chest spine w/dye 1.92 0.64 0.64 0.11 2.67 2.67

XXX 72147............... TC............ A

Mri chest spine w/dye 0.00 13.49

NA 0.70 14.19

NA

XXX

[[Page 1194]]

72148............... .............. A

Mri lumbar spine w/o

1.48 12.97

NA 0.72 15.17

NA

XXX dye. 72148............... 26............ A

Mri lumbar spine w/o

1.48 0.49 0.49 0.08 2.05 2.05

XXX dye. 72148............... TC............ A

Mri lumbar spine w/o

0.00 12.48

NA 0.64 13.12

NA

XXX dye. 72149............... .............. A

Mri lumbar spine w/

1.78 14.09

NA 0.81 16.68

NA

XXX dye. 72149............... 26............ A

Mri lumbar spine w/

1.78 0.60 0.60 0.11 2.49 2.49

XXX dye. 72149............... TC............ A

Mri lumbar spine w/

0.00 13.49

NA 0.70 14.19

NA

XXX dye. 72156............... .............. A

Mri neck spine w/o &

2.57 25.83

NA 1.44 29.84

NA

XXX w/dye. 72156............... 26............ A

Mri neck spine w/o &

2.57 0.85 0.85 0.13 3.55 3.55

XXX w/dye. 72156............... TC............ A

Mri neck spine w/o &

0.00 24.98

NA 1.31 26.29

NA

XXX w/dye. 72157............... .............. A

Mri chest spine w/o & 2.57 25.83

NA 1.44 29.84

NA

XXX w/dye. 72157............... 26............ A

Mri chest spine w/o & 2.57 0.85 0.85 0.13 3.55 3.55

XXX w/dye. 72157............... TC............ A

Mri chest spine w/o & 0.00 24.98

NA 1.31 26.29

NA

XXX w/dye. 72158............... .............. A

Mri lumbar spine w/o

2.36 25.76

NA 1.44 29.56

NA

XXX & w/dye. 72158............... 26............ A

Mri lumbar spine w/o

2.36 0.78 0.78 0.13 3.27 3.27

XXX & w/dye. 72158............... TC............ A

Mri lumbar spine w/o

0.00 24.98

NA 1.31 26.29

NA

XXX & w/dye. 72159............... .............. N

Mr angio spine w/o&w/ +1.80 12.92 12.92 0.74 15.46 15.46

XXX dye. 72159............... 26............ N

Mr angio spine w/o&w/ +1.80 0.69 0.69 0.10 2.59 2.59

XXX dye. 72159............... TC............ N

Mr angio spine w/o&w/ +0.00 12.23 12.23 0.64 12.87 12.87

XXX dye. 72170............... .............. A

X-ray exam of pelvis. 0.17 0.58

NA 0.03 0.78

NA

XXX 72170............... 26............ A

X-ray exam of pelvis. 0.17 0.06 0.06 0.01 0.24 0.24

XXX 72170............... TC............ A

X-ray exam of pelvis. 0.00 0.52

NA 0.02 0.54

NA

XXX 72190............... .............. A

X-ray exam of pelvis. 0.21 0.74

NA 0.05 1.00

NA

XXX 72190............... 26............ A

X-ray exam of pelvis. 0.21 0.07 0.07 0.01 0.29 0.29

XXX 72190............... TC............ A

X-ray exam of pelvis. 0.00 0.67

NA 0.04 0.71

NA

XXX 72191............... .............. A

Ct angiograph pelv w/ 1.81 12.67

NA 0.46 14.94

NA

XXX o&w/dye. 72191............... 26............ A

Ct angiograph pelv w/ 1.81 0.60 0.60 0.07 2.48 2.48

XXX o&w/dye. 72191............... TC............ A

Ct angiograph pelv w/ 0.00 12.07

NA 0.39 12.46

NA

XXX o&w/dye. 72192............... .............. A

Ct pelvis w/o dye.... 1.09 6.29

NA 0.37 7.75

NA

XXX 72192............... 26............ A

Ct pelvis w/o dye.... 1.09 0.36 0.36 0.06 1.51 1.51

XXX 72192............... TC............ A

Ct pelvis w/o dye.... 0.00 5.93

NA 0.31 6.24

NA

XXX 72193............... .............. A

Ct pelvis w/dye...... 1.16 7.25

NA 0.42 8.83

NA

XXX 72193............... 26............ A

Ct pelvis w/dye...... 1.16 0.38 0.38 0.06 1.60 1.60

XXX 72193............... TC............ A

Ct pelvis w/dye...... 0.00 6.87

NA 0.36 7.23

NA

XXX 72194............... .............. A

Ct pelvis w/o & w/dye 1.22 8.92

NA 0.49 10.63

NA

XXX 72194............... 26............ A

Ct pelvis w/o & w/dye 1.22 0.40 0.40 0.06 1.68 1.68

XXX 72194............... TC............ A

Ct pelvis w/o & w/dye 0.00 8.52

NA 0.43 8.95

NA

XXX 72195............... .............. A

Mri pelvis w/o dye... 1.46 11.72

NA 0.51 13.69

NA

XXX 72195............... 26............ A

Mri pelvis w/o dye... 1.46 0.48 0.48 0.06 2.00 2.00

XXX 72195............... TC............ A

Mri pelvis w/o dye... 0.00 11.24

NA 0.45 11.69

NA

XXX 72196............... .............. A

Mri pelvis w/dye..... 1.73 14.06

NA 0.58 16.37

NA

XXX 72196............... 26............ A

Mri pelvis w/dye..... 1.73 0.57 0.57 0.06 2.36 2.36

XXX 72196............... TC............ A

Mri pelvis w/dye..... 0.00 13.49

NA 0.52 14.01

NA

XXX 72197............... .............. A

Mri pelvis w/o & w/

2.26 25.72

NA 1.02 29.00

NA

XXX dye. 72197............... 26............ A

Mri pelvis w/o & w/

2.26 0.74 0.74 0.10 3.10 3.10

XXX dye. 72197............... TC............ A

Mri pelvis w/o & w/

0.00 24.98

NA 0.92 25.90

NA

XXX dye. 72198............... .............. A

Mr angio pelvis w/o & 1.80 11.92

NA 0.69 14.41

NA

XXX w/dye. 72198............... 26............ A

Mr angio pelvis w/o & 1.80 0.68 0.68 0.10 2.58 2.58

XXX w/dye. 72198............... TC............ A

Mr angio pelvis w/o & 0.00 11.24

NA 0.59 11.83

NA

XXX w/dye. 72200............... .............. A

X-ray exam sacroiliac 0.17 0.58

NA 0.03 0.78

NA

XXX joints. 72200............... 26............ A

X-ray exam sacroiliac 0.17 0.06 0.06 0.01 0.24 0.24

XXX joints. 72200............... TC............ A

X-ray exam sacroiliac 0.00 0.52

NA 0.02 0.54

NA

XXX joints. 72202............... .............. A

X-ray exam sacroiliac 0.19 0.68

NA 0.05 0.92

NA

XXX joints. 72202............... 26............ A

X-ray exam sacroiliac 0.19 0.06 0.06 0.01 0.26 0.26

XXX joints. 72202............... TC............ A

X-ray exam sacroiliac 0.00 0.62

NA 0.04 0.66

NA

XXX joints. 72220............... .............. A

X-ray exam of

0.17 0.63

NA 0.05 0.85

NA

XXX tailbone. 72220............... 26............ A

X-ray exam of

0.17 0.06 0.06 0.01 0.24 0.24

XXX tailbone. 72220............... TC............ A

X-ray exam of

0.00 0.57

NA 0.04 0.61

NA

XXX tailbone. 72240............... .............. A

Contrast x-ray of

0.91 5.06

NA 0.30 6.27

NA

XXX neck spine. 72240............... 26............ A

Contrast x-ray of

0.91 0.29 0.29 0.05 1.25 1.25

XXX neck spine. 72240............... TC............ A

Contrast x-ray of

0.00 4.77

NA 0.25 5.02

NA

XXX neck spine. 72255............... .............. A

Contrast x-ray,

0.91 4.62

NA 0.27 5.80

NA

XXX thorax spine. 72255............... 26............ A

Contrast x-ray,

0.91 0.28 0.28 0.05 1.24 1.24

XXX thorax spine. 72255............... TC............ A

Contrast x-ray,

0.00 4.34

NA 0.22 4.56

NA

XXX thorax spine. 72265............... .............. A

Contrast x-ray, lower 0.83 4.35

NA 0.27 5.45

NA

XXX spine. 72265............... 26............ A

Contrast x-ray, lower 0.83 0.26 0.26 0.05 1.14 1.14

XXX spine. 72265............... TC............ A

Contrast x-ray, lower 0.00 4.09

NA 0.22 4.31

NA

XXX spine. 72270............... .............. A

Contrast x-ray, spine 1.33 6.53

NA 0.41 8.27

NA

XXX 72270............... 26............ A

Contrast x-ray, spine 1.33 0.41 0.41 0.08 1.82 1.82

XXX 72270............... TC............ A

Contrast x-ray, spine 0.00 6.12

NA 0.33 6.45

NA

XXX 72275............... .............. A

Epidurography........ 0.76 2.30

NA 0.26 3.32

NA

XXX 72275............... 26............ A

Epidurography........ 0.76 0.20 0.20 0.04 1.00 1.00

XXX 72275............... TC............ A

Epidurography........ 0.00 2.10

NA 0.22 2.32

NA

XXX 72285............... .............. A

X-ray c/t spine disk. 1.16 8.77

NA 0.50 10.43

NA

XXX 72285............... 26............ A

X-ray c/t spine disk. 1.16 0.36 0.36 0.07 1.59 1.59

XXX 72285............... TC............ A

X-ray c/t spine disk. 0.00 8.41

NA 0.43 8.84

NA

XXX

[[Page 1195]]

72295............... .............. A

X-ray of lower spine

0.83 8.15

NA 0.45 9.43

NA

XXX disk. 72295............... 26............ A

X-ray of lower spine

0.83 0.27 0.27 0.05 1.15 1.15

XXX disk. 72295............... TC............ A

X-ray of lower spine

0.00 7.88

NA 0.40 8.28

NA

XXX disk. 73000............... .............. A

X-ray exam of collar

0.16 0.57

NA 0.03 0.76

NA

XXX bone. 73000............... 26............ A

X-ray exam of collar

0.16 0.05 0.05 0.01 0.22 0.22

XXX bone. 73000............... TC............ A

X-ray exam of collar

0.00 0.52

NA 0.02 0.54

NA

XXX bone. 73010............... .............. A

X-ray exam of

0.17 0.58

NA 0.03 0.78

NA

XXX shoulder blade. 73010............... 26............ A

X-ray exam of

0.17 0.06 0.06 0.01 0.24 0.24

XXX shoulder blade. 73010............... TC............ A

X-ray exam of

0.00 0.52

NA 0.02 0.54

NA

XXX shoulder blade. 73020............... .............. A

X-ray exam of

0.15 0.52

NA 0.03 0.70

NA

XXX shoulder. 73020............... 26............ A

X-ray exam of

0.15 0.05 0.05 0.01 0.21 0.21

XXX shoulder. 73020............... TC............ A

X-ray exam of

0.00 0.47

NA 0.02 0.49

NA

XXX shoulder. 73030............... .............. A

X-ray exam of

0.18 0.63

NA 0.05 0.86

NA

XXX shoulder. 73030............... 26............ A

X-ray exam of

0.18 0.06 0.06 0.01 0.25 0.25

XXX shoulder. 73030............... TC............ A

X-ray exam of

0.00 0.57

NA 0.04 0.61

NA

XXX shoulder. 73040............... .............. A

Contrast x-ray of

0.54 2.28

NA 0.16 2.98

NA

XXX shoulder. 73040............... 26............ A

Contrast x-ray of

0.54 0.18 0.18 0.04 0.76 0.76

XXX shoulder. 73040............... TC............ A

Contrast x-ray of

0.00 2.10

NA 0.12 2.22

NA

XXX shoulder. 73050............... .............. A

X-ray exam of

0.20 0.74

NA 0.06 1.00

NA

XXX shoulders. 73050............... 26............ A

X-ray exam of

0.20 0.07 0.07 0.02 0.29 0.29

XXX shoulders. 73050............... TC............ A

X-ray exam of

0.00 0.67

NA 0.04 0.71

NA

XXX shoulders. 73060............... .............. A

X-ray exam of humerus 0.17 0.63

NA 0.05 0.85

NA

XXX 73060............... 26............ A

X-ray exam of humerus 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73060............... TC............ A

X-ray exam of humerus 0.00 0.57

NA 0.04 0.61

NA

XXX 73070............... .............. A

X-ray exam of elbow.. 0.15 0.57

NA 0.03 0.75

NA

XXX 73070............... 26............ A

X-ray exam of elbow.. 0.15 0.05 0.05 0.01 0.21 0.21

XXX 73070............... TC............ A

X-ray exam of elbow.. 0.00 0.52

NA 0.02 0.54

NA

XXX 73080............... .............. A

X-ray exam of elbow.. 0.17 0.63

NA 0.05 0.85

NA

XXX 73080............... 26............ A

X-ray exam of elbow.. 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73080............... TC............ A

X-ray exam of elbow.. 0.00 0.57

NA 0.04 0.61

NA

XXX 73085............... .............. A

Contrast x-ray of

0.54 2.29

NA 0.16 2.99

NA

XXX elbow. 73085............... 26............ A

Contrast x-ray of

0.54 0.19 0.19 0.04 0.77 0.77

XXX elbow. 73085............... TC............ A

Contrast x-ray of

0.00 2.10

NA 0.12 2.22

NA

XXX elbow. 73090............... .............. A

X-ray exam of forearm 0.16 0.57

NA 0.03 0.76

NA

XXX 73090............... 26............ A

X-ray exam of forearm 0.16 0.05 0.05 0.01 0.22 0.22

XXX 73090............... TC............ A

X-ray exam of forearm 0.00 0.52

NA 0.02 0.54

NA

XXX 73092............... .............. A

X-ray exam of arm,

0.16 0.54

NA 0.03 0.73

NA

XXX infant. 73092............... 26............ A

X-ray exam of arm,

0.16 0.05 0.05 0.01 0.22 0.22

XXX infant. 73092............... TC............ A

X-ray exam of arm,

0.00 0.49

NA 0.02 0.51

NA

XXX infant. 73100............... .............. A

X-ray exam of wrist.. 0.16 0.55

NA 0.04 0.75

NA

XXX 73100............... 26............ A

X-ray exam of wrist.. 0.16 0.06 0.06 0.02 0.24 0.24

XXX 73100............... TC............ A

X-ray exam of wrist.. 0.00 0.49

NA 0.02 0.51

NA

XXX 73110............... .............. A

X-ray exam of wrist.. 0.17 0.59

NA 0.03 0.79

NA

XXX 73110............... 26............ A

X-ray exam of wrist.. 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73110............... TC............ A

X-ray exam of wrist.. 0.00 0.53

NA 0.02 0.55

NA

XXX 73115............... .............. A

Contrast x-ray of

0.54 1.77

NA 0.14 2.45

NA

XXX wrist. 73115............... 26............ A

Contrast x-ray of

0.54 0.19 0.19 0.04 0.77 0.77

XXX wrist. 73115............... TC............ A

Contrast x-ray of

0.00 1.58

NA 0.10 1.68

NA

XXX wrist. 73120............... .............. A

X-ray exam of hand... 0.16 0.54

NA 0.03 0.73

NA

XXX 73120............... 26............ A

X-ray exam of hand... 0.16 0.05 0.05 0.01 0.22 0.22

XXX 73120............... TC............ A

X-ray exam of hand... 0.00 0.49

NA 0.02 0.51

NA

XXX 73130............... .............. A

X-ray exam of hand... 0.17 0.59

NA 0.03 0.79

NA

XXX 73130............... 26............ A

X-ray exam of hand... 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73130............... TC............ A

X-ray exam of hand... 0.00 0.53

NA 0.02 0.55

NA

XXX 73140............... .............. A

X-ray exam of

0.13 0.45

NA 0.03 0.61

NA

XXX finger(s). 73140............... 26............ A

X-ray exam of

0.13 0.04 0.04 0.01 0.18 0.18

XXX finger(s). 73140............... TC............ A

X-ray exam of

0.00 0.41

NA 0.02 0.43

NA

XXX finger(s). 73200............... .............. A

Ct upper extremity w/ 1.09 5.33

NA 0.31 6.73

NA

XXX o dye. 73200............... 26............ A

Ct upper extremity w/ 1.09 0.36 0.36 0.06 1.51 1.51

XXX o dye. 73200............... TC............ A

Ct upper extremity w/ 0.00 4.97

NA 0.25 5.22

NA

XXX o dye. 73201............... .............. A

Ct upper extremity w/ 1.16 6.31

NA 0.37 7.84

NA

XXX dye. 73201............... 26............ A

Ct upper extremity w/ 1.16 0.38 0.38 0.06 1.60 1.60

XXX dye. 73201............... TC............ A

Ct upper extremity w/ 0.00 5.93

NA 0.31 6.24

NA

XXX dye. 73202............... .............. A

Ct uppr extremity w/

1.22 7.85

NA 0.46 9.53

NA

XXX o&w/dye. 73202............... 26............ A

Ct uppr extremity w/

1.22 0.40 0.40 0.07 1.69 1.69

XXX o&w/dye. 73202............... TC............ A

Ct uppr extremity w/

0.00 7.45

NA 0.39 7.84

NA

XXX o&w/dye. 73206............... .............. A

Ct angio upr extrm w/ 1.81 11.59

NA 0.46 13.86

NA

XXX o&w/dye. 73206............... 26............ A

Ct angio upr extrm w/ 1.81 0.59 0.59 0.07 2.47 2.47

XXX o&w/dye. 73206............... TC............ A

Ct angio upr extrm w/ 0.00 11.00

NA 0.39 11.39

NA

XXX o&w/dye. 73218............... .............. A

Mri upper extremity w/ 1.35 11.68

NA 0.44 13.47

NA

XXX o dye. 73218............... 26............ A

Mri upper extremity w/ 1.35 0.44 0.44 0.05 1.84 1.84

XXX o dye. 73218............... TC............ A

Mri upper extremity w/ 0.00 11.24

NA 0.39 11.63

NA

XXX o dye. 73219............... .............. A

Mri upper extremity w/ 1.62 14.02

NA 0.53 16.17

NA

XXX dye. 73219............... 26............ A

Mri upper extremity w/ 1.62 0.53 0.53 0.06 2.21 2.21

XXX dye. 73219............... TC............ A

Mri upper extremity w/ 0.00 13.49

NA 0.47 13.96

NA

XXX dye.

[[Page 1196]]

73220............... .............. A

Mri uppr extremity w/ 2.15 25.69

NA 0.94 28.78

NA

XXX o&w/dye. 73220............... 26............ A

Mri uppr extremity w/ 2.15 0.71 0.71 0.10 2.96 2.96

XXX o&w/dye. 73220............... TC............ A

Mri uppr extremity w/ 0.00 24.98

NA 0.84 25.82

NA

XXX o&w/dye. 73221............... .............. A

Mri joint upr extrem

1.35 11.68

NA 0.44 13.47

NA

XXX w/o dye. 73221............... 26............ A

Mri joint upr extrem

1.35 0.44 0.44 0.05 1.84 1.84

XXX w/o dye. 73221............... TC............ A

Mri joint upr extrem

0.00 11.24

NA 0.39 11.63

NA

XXX w/o dye. 73222............... .............. A

Mri joint upr extrem

1.62 14.02

NA 0.53 16.17

NA

XXX w/dye. 73222............... 26............ A

Mri joint upr extrem

1.62 0.53 0.53 0.06 2.21 2.21

XXX w/dye. 73222............... TC............ A

Mri joint upr extrem

0.00 13.49

NA 0.47 13.96

NA

XXX w/dye. 73223............... .............. A

Mri joint upr extr w/ 2.15 25.69

NA 0.92 28.76

NA

XXX o&w/dye. 73223............... 26............ A

Mri joint upr extr w/ 2.15 0.71 0.71 0.08 2.94 2.94

XXX o&w/dye. 73223............... TC............ A

Mri joint upr extr w/ 0.00 24.98

NA 0.84 25.82

NA

XXX o&w/dye. 73225............... .............. N

Mr angio upr extr w/ +1.73 11.68 11.68 0.69 14.10 14.10

XXX o&w/dye. 73225............... 26............ N

Mr angio upr extr w/ +1.73 0.67 0.67 0.10 2.50 2.50

XXX o&w/dye. 73225............... TC............ N

Mr angio upr extr w/ +0.00 11.01 11.01 0.59 11.60 11.60

XXX o&w/dye. 73500............... .............. A

X-ray exam of hip.... 0.17 0.53

NA 0.03 0.73

NA

XXX 73500............... 26............ A

X-ray exam of hip.... 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73500............... TC............ A

X-ray exam of hip.... 0.00 0.47

NA 0.02 0.49

NA

XXX 73510............... .............. A

X-ray exam of hip.... 0.21 0.64

NA 0.06 0.91

NA

XXX 73510............... 26............ A

X-ray exam of hip.... 0.21 0.07 0.07 0.02 0.30 0.30

XXX 73510............... TC............ A

X-ray exam of hip.... 0.00 0.57

NA 0.04 0.61

NA

XXX 73520............... .............. A

X-ray exam of hips... 0.26 0.76

NA 0.06 1.08

NA

XXX 73520............... 26............ A

X-ray exam of hips... 0.26 0.09 0.09 0.02 0.37 0.37

XXX 73520............... TC............ A

X-ray exam of hips... 0.00 0.67

NA 0.04 0.71

NA

XXX 73525............... .............. A

Contrast x-ray of hip 0.54 2.28

NA 0.16 2.98

NA

XXX 73525............... 26............ A

Contrast x-ray of hip 0.54 0.18 0.18 0.04 0.76 0.76

XXX 73525............... TC............ A

Contrast x-ray of hip 0.00 2.10

NA 0.12 2.22

NA

XXX 73530............... .............. A

X-ray exam of hip.... 0.29 0.62

NA 0.03 0.94

NA

XXX 73530............... 26............ A

X-ray exam of hip.... 0.29 0.10 0.10 0.01 0.40 0.40

XXX 73530............... TC............ A

X-ray exam of hip.... 0.00 0.52

NA 0.02 0.54

NA

XXX 73540............... .............. A

X-ray exam of pelvis

0.20 0.64

NA 0.06 0.90

NA

XXX & hips. 73540............... 26............ A

X-ray exam of pelvis

0.20 0.07 0.07 0.02 0.29 0.29

XXX & hips. 73540............... TC............ A

X-ray exam of pelvis

0.00 0.57

NA 0.04 0.61

NA

XXX & hips. 73542............... .............. A

X-ray exam,

0.59 2.26

NA 0.16 3.01

NA

XXX sacroiliac joint. 73542............... 26............ A

X-ray exam,

0.59 0.16 0.16 0.04 0.79 0.79

XXX sacroiliac joint. 73542............... TC............ A

X-ray exam,

0.00 2.10

NA 0.12 2.22

NA

XXX sacroiliac joint. 73550............... .............. A

X-ray exam of thigh.. 0.17 0.63

NA 0.05 0.85

NA

XXX 73550............... 26............ A

X-ray exam of thigh.. 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73550............... TC............ A

X-ray exam of thigh.. 0.00 0.57

NA 0.04 0.61

NA

XXX 73560............... .............. A

X-ray exam of knee, 1 0.17 0.58

NA 0.04 0.79

NA

XXX or 2. 73560............... 26............ A

X-ray exam of knee, 1 0.17 0.06 0.06 0.02 0.25 0.25

XXX or 2. 73560............... TC............ A

X-ray exam of knee, 1 0.00 0.52

NA 0.02 0.54

NA

XXX or 2. 73562............... .............. A

X-ray exam of knee, 3 0.18 0.63

NA 0.06 0.87

NA

XXX 73562............... 26............ A

X-ray exam of knee, 3 0.18 0.06 0.06 0.02 0.26 0.26

XXX 73562............... TC............ A

X-ray exam of knee, 3 0.00 0.57

NA 0.04 0.61

NA

XXX 73564............... .............. A

X-ray exam, knee, 4

0.22 0.70

NA 0.06 0.98

NA

XXX or more. 73564............... 26............ A

X-ray exam, knee, 4

0.22 0.08 0.08 0.02 0.32 0.32

XXX or more. 73564............... TC............ A

X-ray exam, knee, 4

0.00 0.62

NA 0.04 0.66

NA

XXX or more. 73565............... .............. A

X-ray exam of knees.. 0.17 0.55

NA 0.04 0.76

NA

XXX 73565............... 26............ A

X-ray exam of knees.. 0.17 0.06 0.06 0.02 0.25 0.25

XXX 73565............... TC............ A

X-ray exam of knees.. 0.00 0.49

NA 0.02 0.51

NA

XXX 73580............... .............. A

Contrast x-ray of

0.54 2.80

NA 0.18 3.52

NA

XXX knee joint. 73580............... 26............ A

Contrast x-ray of

0.54 0.18 0.18 0.04 0.76 0.76

XXX knee joint. 73580............... TC............ A

Contrast x-ray of

0.00 2.62

NA 0.14 2.76

NA

XXX knee joint. 73590............... .............. A

X-ray exam of lower

0.17 0.58

NA 0.03 0.78

NA

XXX leg. 73590............... 26............ A

X-ray exam of lower

0.17 0.06 0.06 0.01 0.24 0.24

XXX leg. 73590............... TC............ A

X-ray exam of lower

0.00 0.52

NA 0.02 0.54

NA

XXX leg. 73592............... .............. A

X-ray exam of leg,

0.16 0.55

NA 0.03 0.74

NA

XXX infant. 73592............... 26............ A

X-ray exam of leg,

0.16 0.06 0.06 0.01 0.23 0.23

XXX infant. 73592............... TC............ A

X-ray exam of leg,

0.00 0.49

NA 0.02 0.51

NA

XXX infant. 73600............... .............. A

X-ray exam of ankle.. 0.16 0.54

NA 0.03 0.73

NA

XXX 73600............... 26............ A

X-ray exam of ankle.. 0.16 0.05 0.05 0.01 0.22 0.22

XXX 73600............... TC............ A

X-ray exam of ankle.. 0.00 0.49

NA 0.02 0.51

NA

XXX 73610............... .............. A

X-ray exam of ankle.. 0.17 0.59

NA 0.03 0.79

NA

XXX 73610............... 26............ A

X-ray exam of ankle.. 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73610............... TC............ A

X-ray exam of ankle.. 0.00 0.53

NA 0.02 0.55

NA

XXX 73615............... .............. A

Contrast x-ray of

0.54 2.29

NA 0.16 2.99

NA

XXX ankle. 73615............... 26............ A

Contrast x-ray of

0.54 0.19 0.19 0.04 0.77 0.77

XXX ankle. 73615............... TC............ A

Contrast x-ray of

0.00 2.10

NA 0.12 2.22

NA

XXX ankle. 73620............... .............. A

X-ray exam of foot... 0.16 0.54

NA 0.03 0.73

NA

XXX 73620............... 26............ A

X-ray exam of foot... 0.16 0.05 0.05 0.01 0.22 0.22

XXX 73620............... TC............ A

X-ray exam of foot... 0.00 0.49

NA 0.02 0.51

NA

XXX 73630............... .............. A

X-ray exam of foot... 0.17 0.59

NA 0.03 0.79

NA

XXX 73630............... 26............ A

X-ray exam of foot... 0.17 0.06 0.06 0.01 0.24 0.24

XXX 73630............... TC............ A

X-ray exam of foot... 0.00 0.53

NA 0.02 0.55

NA

XXX

[[Page 1197]]

73650............... .............. A

X-ray exam of heel... 0.16 0.52

NA 0.03 0.71

NA

XXX 73650............... 26............ A

X-ray exam of heel... 0.16 0.05 0.05 0.01 0.22 0.22

XXX 73650............... TC............ A

X-ray exam of heel... 0.00 0.47

NA 0.02 0.49

NA

XXX 73660............... .............. A

X-ray exam of toe(s). 0.13 0.45

NA 0.03 0.61

NA

XXX 73660............... 26............ A

X-ray exam of toe(s). 0.13 0.04 0.04 0.01 0.18 0.18

XXX 73660............... TC............ A

X-ray exam of toe(s). 0.00 0.41

NA 0.02 0.43

NA

XXX 73700............... .............. A

Ct lower extremity w/ 1.09 5.33

NA 0.31 6.73

NA

XXX o dye. 73700............... 26............ A

Ct lower extremity w/ 1.09 0.36 0.36 0.06 1.51 1.51

XXX o dye. 73700............... TC............ A

Ct lower extremity w/ 0.00 4.97

NA 0.25 5.22

NA

XXX o dye. 73701............... .............. A

Ct lower extremity w/ 1.16 6.31

NA 0.37 7.84

NA

XXX dye. 73701............... 26............ A

Ct lower extremity w/ 1.16 0.38 0.38 0.06 1.60 1.60

XXX dye. 73701............... TC............ A

Ct lower extremity w/ 0.00 5.93

NA 0.31 6.24

NA

XXX dye. 73702............... .............. A

Ct lwr extremity w/

1.22 7.85

NA 0.45 9.52

NA

XXX o&w/dye. 73702............... 26............ A

Ct lwr extremity w/

1.22 0.40 0.40 0.06 1.68 1.68

XXX o&w/dye. 73702............... TC............ A

Ct lwr extremity w/

0.00 7.45

NA 0.39 7.84

NA

XXX o&w/dye. 73706............... .............. A

Ct angio lwr extr w/

1.90 11.62

NA 0.46 13.98

NA

XXX o&w/dye. 73706............... 26............ A

Ct angio lwr extr w/

1.90 0.62 0.62 0.07 2.59 2.59

XXX o&w/dye. 73706............... TC............ A

Ct angio lwr extr w/

0.00 11.00

NA 0.39 11.39

NA

XXX o&w/dye. 73718............... .............. A

Mri lower extremity w/ 1.35 11.68

NA 0.44 13.47

NA

XXX o dye. 73718............... 26............ A

Mri lower extremity w/ 1.35 0.44 0.44 0.05 1.84 1.84

XXX o dye. 73718............... TC............ A

Mri lower extremity w/ 0.00 11.24

NA 0.39 11.63

NA

XXX o dye. 73719............... .............. A

Mri lower extremity w/ 1.62 14.02

NA 0.53 16.17

NA

XXX dye. 73719............... 26............ A

Mri lower extremity w/ 1.62 0.53 0.53 0.06 2.21 2.21

XXX dye. 73719............... TC............ A

Mri lower extremity w/ 0.00 13.49

NA 0.47 13.96

NA

XXX dye. 73720............... .............. A

Mri lwr extremity w/

2.15 25.69

NA 0.94 28.78

NA

XXX o&w/dye. 73720............... 26............ A

Mri lwr extremity w/

2.15 0.71 0.71 0.10 2.96 2.96

XXX o&w/dye. 73720............... TC............ A

Mri lwr extremity w/

0.00 24.98

NA 0.84 25.82

NA

XXX o&w/dye. 73721............... .............. A

Mri jnt of lwr extre

1.35 11.68

NA 0.44 13.47

NA

XXX w/o dye. 73721............... 26............ A

Mri jnt of lwr extre

1.35 0.44 0.44 0.05 1.84 1.84

XXX w/o dye. 73721............... TC............ A

Mri jnt of lwr extre

0.00 11.24

NA 0.39 11.63

NA

XXX w/o dye. 73722............... .............. A

Mri joint of lwr extr 1.62 14.02

NA 0.54 16.18

NA

XXX w/dye. 73722............... 26............ A

Mri joint of lwr extr 1.62 0.53 0.53 0.07 2.22 2.22

XXX w/dye. 73722............... TC............ A

Mri joint of lwr extr 0.00 13.49

NA 0.47 13.96

NA

XXX w/dye. 73723............... .............. A

Mri joint lwr extr w/ 2.15 25.69

NA 0.92 28.76

NA

XXX o&w/dye. 73723............... 26............ A

Mri joint lwr extr w/ 2.15 0.71 0.71 0.08 2.94 2.94

XXX o&w/dye. 73723............... TC............ A

Mri joint lwr extr w/ 0.00 24.98

NA 0.84 25.82

NA

XXX o&w/dye. 73725............... .............. R

Mr ang lwr ext w or w/ 1.82 11.84

NA 0.69 14.35

NA

XXX o dye. 73725............... 26............ R

Mr ang lwr ext w or w/ 1.82 0.60 0.60 0.10 2.52 2.52

XXX o dye. 73725............... TC............ R

Mr ang lwr ext w or w/ 0.00 11.24

NA 0.59 11.83

NA

XXX o dye. 74000............... .............. A

X-ray exam of abdomen 0.18 0.58

NA 0.03 0.79

NA

XXX 74000............... 26............ A

X-ray exam of abdomen 0.18 0.06 0.06 0.01 0.25 0.25

XXX 74000............... TC............ A

X-ray exam of abdomen 0.00 0.52

NA 0.02 0.54

NA

XXX 74010............... .............. A

X-ray exam of abdomen 0.23 0.65

NA 0.05 0.93

NA

XXX 74010............... 26............ A

X-ray exam of abdomen 0.23 0.08 0.08 0.01 0.32 0.32

XXX 74010............... TC............ A

X-ray exam of abdomen 0.00 0.57

NA 0.04 0.61

NA

XXX 74020............... .............. A

X-ray exam of abdomen 0.27 0.71

NA 0.05 1.03

NA

XXX 74020............... 26............ A

X-ray exam of abdomen 0.27 0.09 0.09 0.01 0.37 0.37

XXX 74020............... TC............ A

X-ray exam of abdomen 0.00 0.62

NA 0.04 0.66

NA

XXX 74022............... .............. A

X-ray exam series,

0.32 0.85

NA 0.06 1.23

NA

XXX abdomen. 74022............... 26............ A

X-ray exam series,

0.32 0.11 0.11 0.01 0.44 0.44

XXX abdomen. 74022............... TC............ A

X-ray exam series,

0.00 0.74

NA 0.05 0.79

NA

XXX abdomen. 74150............... .............. A

Ct abdomen w/o dye... 1.19 6.06

NA 0.36 7.61

NA

XXX 74150............... 26............ A

Ct abdomen w/o dye... 1.19 0.39 0.39 0.06 1.64 1.64

XXX 74150............... TC............ A

Ct abdomen w/o dye... 0.00 5.67

NA 0.30 5.97

NA

XXX 74160............... .............. A

Ct abdomen w/dye..... 1.27 7.28

NA 0.43 8.98

NA

XXX 74160............... 26............ A

Ct abdomen w/dye..... 1.27 0.41 0.41 0.07 1.75 1.75

XXX 74160............... TC............ A

Ct abdomen w/dye..... 0.00 6.87

NA 0.36 7.23

NA

XXX 74170............... .............. A

Ct abdomen w/o &w /

1.40 8.97

NA 0.50 10.87

NA

XXX dye. 74170............... 26............ A

Ct abdomen w/o &w /

1.40 0.45 0.45 0.07 1.92 1.92

XXX dye. 74170............... TC............ A

Ct abdomen w/o &w /

0.00 8.52

NA 0.43 8.95

NA

XXX dye. 74175............... .............. A

Ct angio abdom w/o &

1.90 12.69

NA 0.46 15.05

NA

XXX w/dye. 74175............... 26............ A

Ct angio abdom w/o &

1.90 0.62 0.62 0.07 2.59 2.59

XXX w/dye. 74175............... TC............ A

Ct angio abdom w/o &

0.00 12.07

NA 0.39 12.46

NA

XXX w/dye. 74181............... .............. A

Mri abdomen w/o dye.. 1.46 11.72

NA 0.52 13.70

NA

XXX 74181............... 26............ A

Mri abdomen w/o dye.. 1.46 0.48 0.48 0.07 2.01 2.01

XXX 74181............... TC............ A

Mri abdomen w/o dye.. 0.00 11.24

NA 0.45 11.69

NA

XXX 74182............... .............. A

Mri abdomen w/dye.... 1.73 14.05

NA 0.59 16.37

NA

XXX 74182............... 26............ A

Mri abdomen w/dye.... 1.73 0.56 0.56 0.07 2.36 2.36

XXX 74182............... TC............ A

Mri abdomen w/dye.... 0.00 13.49

NA 0.52 14.01

NA

XXX 74183............... .............. A

Mri abdomen w/o & w/

2.26 25.72

NA 1.02 29.00

NA

XXX dye. 74183............... 26............ A

Mri abdomen w/o & w/

2.26 0.74 0.74 0.10 3.10 3.10

XXX dye. 74183............... TC............ A

Mri abdomen w/o & w/

0.00 24.98

NA 0.92 25.90

NA

XXX dye. 74185............... .............. R

Mri angio, abdom w

1.80 11.83

NA 0.69 14.32

NA

XXX orw/o dye. 74185............... 26............ R

Mri angio, abdom w

1.80 0.59 0.59 0.10 2.49 2.49

XXX orw/o dye. 74185............... TC............ R

Mri angio, abdom w

0.00 11.24

NA 0.59 11.83

NA

XXX orw/o dye.

[[Page 1198]]

74190............... .............. A

X-ray exam of

0.48 1.47

NA 0.09 2.04

NA

XXX peritoneum. 74190............... 26............ A

X-ray exam of

0.48 0.16 0.16 0.02 0.66 0.66

XXX peritoneum. 74190............... TC............ A

X-ray exam of

0.00 1.31

NA 0.07 1.38

NA

XXX peritoneum. 74210............... .............. A

Contrst x-ray exam of 0.36 1.31

NA 0.08 1.75

NA

XXX throat. 74210............... 26............ A

Contrst x-ray exam of 0.36 0.12 0.12 0.02 0.50 0.50

XXX throat. 74210............... TC............ A

Contrst x-ray exam of 0.00 1.19

NA 0.06 1.25

NA

XXX throat. 74220............... .............. A

Contrast x-ray,

0.46 1.34

NA 0.08 1.88

NA

XXX esophagus. 74220............... 26............ A

Contrast x-ray,

0.46 0.15 0.15 0.02 0.63 0.63

XXX esophagus. 74220............... TC............ A

Contrast x-ray,

0.00 1.19

NA 0.06 1.25

NA

XXX esophagus. 74230............... .............. A

Cine/vid x-ray,

0.53 1.49

NA 0.09 2.11

NA

XXX throat/esoph. 74230............... 26............ A

Cine/vid x-ray,

0.53 0.18 0.18 0.02 0.73 0.73

XXX throat/esoph. 74230............... TC............ A

Cine/vid x-ray,

0.00 1.31

NA 0.07 1.38

NA

XXX throat/esoph. 74235............... .............. A

Remove esophagus

1.19 3.01

NA 0.20 4.40

NA

XXX obstruction. 74235............... 26............ A

Remove esophagus

1.19 0.39 0.39 0.06 1.64 1.64

XXX obstruction. 74235............... TC............ A

Remove esophagus

0.00 2.62

NA 0.14 2.76

NA

XXX obstruction. 74240............... .............. A

X-ray exam, upper gi

0.69 1.69

NA 0.12 2.50

NA

XXX tract. 74240............... 26............ A

X-ray exam, upper gi

0.69 0.23 0.23 0.04 0.96 0.96

XXX tract. 74240............... TC............ A

X-ray exam, upper gi

0.00 1.46

NA 0.08 1.54

NA

XXX tract. 74241............... .............. A

X-ray exam, upper gi

0.69 1.72

NA 0.12 2.53

NA

XXX tract. 74241............... 26............ A

X-ray exam, upper gi

0.69 0.23 0.23 0.04 0.96 0.96

XXX tract. 74241............... TC............ A

X-ray exam, upper gi

0.00 1.49

NA 0.08 1.57

NA

XXX tract. 74245............... .............. A

X-ray exam, upper gi

0.91 2.69

NA 0.18 3.78

NA

XXX tract. 74245............... 26............ A

X-ray exam, upper gi

0.91 0.30 0.30 0.05 1.26 1.26

XXX tract. 74245............... TC............ A

X-ray exam, upper gi

0.00 2.39

NA 0.13 2.52

NA

XXX tract. 74246............... .............. A

Contrst x-ray uppr gi 0.69 1.88

NA 0.14 2.71

NA

XXX tract. 74246............... 26............ A

Contrst x-ray uppr gi 0.69 0.23 0.23 0.04 0.96 0.96

XXX tract. 74246............... TC............ A

Contrst x-ray uppr gi 0.00 1.65

NA 0.10 1.75

NA

XXX tract. 74247............... .............. A

Contrst x-ray uppr gi 0.69 1.92

NA 0.15 2.76

NA

XXX tract. 74247............... 26............ A

Contrst x-ray uppr gi 0.69 0.23 0.23 0.04 0.96 0.96

XXX tract. 74247............... TC............ A

Contrst x-ray uppr gi 0.00 1.69

NA 0.11 1.80

NA

XXX tract. 74249............... .............. A

Contrst x-ray uppr gi 0.91 2.89

NA 0.19 3.99

NA

XXX tract. 74249............... 26............ A

Contrst x-ray uppr gi 0.91 0.30 0.30 0.05 1.26 1.26

XXX tract. 74249............... TC............ A

Contrst x-ray uppr gi 0.00 2.59

NA 0.14 2.73

NA

XXX tract. 74250............... .............. A

X-ray exam of small

0.47 1.47

NA 0.09 2.03

NA

XXX bowel. 74250............... 26............ A

X-ray exam of small

0.47 0.16 0.16 0.02 0.65 0.65

XXX bowel. 74250............... TC............ A

X-ray exam of small

0.00 1.31

NA 0.07 1.38

NA

XXX bowel. 74251............... .............. A

X-ray exam of small

0.69 1.54

NA 0.11 2.34

NA

XXX bowel. 74251............... 26............ A

X-ray exam of small

0.69 0.23 0.23 0.04 0.96 0.96

XXX bowel. 74251............... TC............ A

X-ray exam of small

0.00 1.31

NA 0.07 1.38

NA

XXX bowel. 74260............... .............. A

X-ray exam of small

0.50 1.66

NA 0.10 2.26

NA

XXX bowel. 74260............... 26............ A

X-ray exam of small

0.50 0.17 0.17 0.02 0.69 0.69

XXX bowel. 74260............... TC............ A

X-ray exam of small

0.00 1.49

NA 0.08 1.57

NA

XXX bowel. 74270............... .............. A

Contrast x-ray exam

0.69 1.94

NA 0.15 2.78

NA

XXX of colon. 74270............... 26............ A

Contrast x-ray exam

0.69 0.23 0.23 0.04 0.96 0.96

XXX of colon. 74270............... TC............ A

Contrast x-ray exam

0.00 1.71

NA 0.11 1.82

NA

XXX of colon. 74280............... .............. A

Contrast x-ray exam

0.99 2.57

NA 0.18 3.74

NA

XXX of colon. 74280............... 26............ A

Contrast x-ray exam

0.99 0.33 0.33 0.05 1.37 1.37

XXX of colon. 74280............... TC............ A

Contrast x-ray exam

0.00 2.24

NA 0.13 2.37

NA

XXX of colon. 74283............... .............. A

Contrast x-ray exam

2.02 3.24

NA 0.25 5.51

NA

XXX of colon. 74283............... 26............ A

Contrast x-ray exam

2.02 0.66 0.66 0.11 2.79 2.79

XXX of colon. 74283............... TC............ A

Contrast x-ray exam

0.00 2.58

NA 0.14 2.72

NA

XXX of colon. 74290............... .............. A

Contrast x-ray,

0.32 0.85

NA 0.06 1.23

NA

XXX gallbladder. 74290............... 26............ A

Contrast x-ray,

0.32 0.11 0.11 0.01 0.44 0.44

XXX gallbladder. 74290............... TC............ A

Contrast x-ray,

0.00 0.74

NA 0.05 0.79

NA

XXX gallbladder. 74291............... .............. A

Contrast x-rays,

0.20 0.48

NA 0.03 0.71

NA

XXX gallbladder. 74291............... 26............ A

Contrast x-rays,

0.20 0.07 0.07 0.01 0.28 0.28

XXX gallbladder. 74291............... TC............ A

Contrast x-rays,

0.00 0.41

NA 0.02 0.43

NA

XXX gallbladder. 74300............... .............. C

X-ray bile ducts/

0.00 0.00 0.00 0.00 0.00 0.00

XXX pancreas. 74300............... 26............ A

X-ray bile ducts/

0.36 0.12 0.12 0.02 0.50 0.50

XXX pancreas. 74300............... TC............ C

X-ray bile ducts/

0.00 0.00 0.00 0.00 0.00 0.00

XXX pancreas. 74301............... .............. C

X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00

ZZZ on. 74301............... 26............ A

X-rays at surgery add- 0.21 0.07 0.07 0.01 0.29 0.29

ZZZ on. 74301............... TC............ C

X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00

ZZZ on. 74305............... .............. A

X-ray bile ducts/

0.42 0.93

NA 0.07 1.42

NA

XXX pancreas. 74305............... 26............ A

X-ray bile ducts/

0.42 0.14 0.14 0.02 0.58 0.58

XXX pancreas. 74305............... TC............ A

X-ray bile ducts/

0.00 0.79

NA 0.05 0.84

NA

XXX pancreas. 74320............... .............. A

Contrast x-ray of

0.54 3.35

NA 0.19 4.08

NA

XXX bile ducts. 74320............... 26............ A

Contrast x-ray of

0.54 0.18 0.18 0.02 0.74 0.74

XXX bile ducts. 74320............... TC............ A

Contrast x-ray of

0.00 3.17

NA 0.17 3.34

NA

XXX bile ducts. 74327............... .............. A

X-ray bile stone

0.70 2.00

NA 0.15 2.85

NA

XXX removal. 74327............... 26............ A

X-ray bile stone

0.70 0.23 0.23 0.04 0.97 0.97

XXX removal. 74327............... TC............ A

X-ray bile stone

0.00 1.77

NA 0.11 1.88

NA

XXX removal. 74328............... .............. A

X-ray bile duct

0.70 3.40

NA 0.21 4.31

NA

XXX endoscopy. 74328............... 26............ A

X-ray bile duct

0.70 0.23 0.23 0.04 0.97 0.97

XXX endoscopy. 74328............... TC............ A

X-ray bile duct

0.00 3.17

NA 0.17 3.34

NA

XXX endoscopy.

[[Page 1199]]

74329............... .............. A

X-ray for pancreas

0.70 3.40

NA 0.21 4.31

NA

XXX endoscopy. 74329............... 26............ A

X-ray for pancreas

0.70 0.23 0.23 0.04 0.97 0.97

XXX endoscopy. 74329............... TC............ A

X-ray for pancreas

0.00 3.17

NA 0.17 3.34

NA

XXX endoscopy. 74330............... .............. A

X-ray bile/panc

0.90 3.47

NA 0.22 4.59

NA

XXX endoscopy. 74330............... 26............ A

X-ray bile/panc

0.90 0.30 0.30 0.05 1.25 1.25

XXX endoscopy. 74330............... TC............ A

X-ray bile/panc

0.00 3.17

NA 0.17 3.34

NA

XXX endoscopy. 74340............... .............. A

X-ray guide for GI

0.54 2.80

NA 0.16 3.50

NA

XXX tube. 74340............... 26............ A

X-ray guide for GI

0.54 0.18 0.18 0.02 0.74 0.74

XXX tube. 74340............... TC............ A

X-ray guide for GI

0.00 2.62

NA 0.14 2.76

NA

XXX tube. 74350............... .............. A

X-ray guide, stomach

0.76 3.42

NA 0.21 4.39

NA

XXX tube. 74350............... 26............ A

X-ray guide, stomach

0.76 0.25 0.25 0.04 1.05 1.05

XXX tube. 74350............... TC............ A

X-ray guide, stomach

0.00 3.17

NA 0.17 3.34

NA

XXX tube. 74355............... .............. A

X-ray guide,

0.76 2.87

NA 0.18 3.81

NA

XXX intestinal tube. 74355............... 26............ A

X-ray guide,

0.76 0.25 0.25 0.04 1.05 1.05

XXX intestinal tube. 74355............... TC............ A

X-ray guide,

0.00 2.62

NA 0.14 2.76

NA

XXX intestinal tube. 74360............... .............. A

X-ray guide, GI

0.54 3.36

NA 0.19 4.09

NA

XXX dilation. 74360............... 26............ A

X-ray guide, GI

0.54 0.19 0.19 0.02 0.75 0.75

XXX dilation. 74360............... TC............ A

X-ray guide, GI

0.00 3.17

NA 0.17 3.34

NA

XXX dilation. 74363............... .............. A

X-ray, bile duct

0.88 6.41

NA 0.38 7.67

NA

XXX dilation. 74363............... 26............ A

X-ray, bile duct

0.88 0.29 0.29 0.05 1.22 1.22

XXX dilation. 74363............... TC............ A

X-ray, bile duct

0.00 6.12

NA 0.33 6.45

NA

XXX dilation. 74400............... .............. A

Contrst x-ray,

0.49 1.85

NA 0.13 2.47

NA

XXX urinary tract. 74400............... 26............ A

Contrst x-ray,

0.49 0.16 0.16 0.02 0.67 0.67

XXX urinary tract. 74400............... TC............ A

Contrst x-ray,

0.00 1.69

NA 0.11 1.80

NA

XXX urinary tract. 74410............... .............. A

Contrst x-ray,

0.49 2.12

NA 0.13 2.74

NA

XXX urinary tract. 74410............... 26............ A

Contrst x-ray,

0.49 0.16 0.16 0.02 0.67 0.67

XXX urinary tract. 74410............... TC............ A

Contrst x-ray,

0.00 1.96

NA 0.11 2.07

NA

XXX urinary tract. 74415............... .............. A

Contrst x-ray,

0.49 2.28

NA 0.14 2.91

NA

XXX urinary tract. 74415............... 26............ A

Contrst x-ray,

0.49 0.16 0.16 0.02 0.67 0.67

XXX urinary tract. 74415............... TC............ A

Contrst x-ray,

0.00 2.12

NA 0.12 2.24

NA

XXX urinary tract. 74420............... .............. A

Contrst x-ray,

0.36 2.74

NA 0.16 3.26

NA

XXX urinary tract. 74420............... 26............ A

Contrst x-ray,

0.36 0.12 0.12 0.02 0.50 0.50

XXX urinary tract. 74420............... TC............ A

Contrst x-ray,

0.00 2.62

NA 0.14 2.76

NA

XXX urinary tract. 74425............... .............. A

Contrst x-ray,

0.36 1.43

NA 0.09 1.88

NA

XXX urinary tract. 74425............... 26............ A

Contrst x-ray,

0.36 0.12 0.12 0.02 0.50 0.50

XXX urinary tract. 74425............... TC............ A

Contrst x-ray,

0.00 1.31

NA 0.07 1.38

NA

XXX urinary tract. 74430............... .............. A

Contrast x-ray,

0.32 1.17

NA 0.08 1.57

NA

XXX bladder. 74430............... 26............ A

Contrast x-ray,

0.32 0.11 0.11 0.02 0.45 0.45

XXX bladder. 74430............... TC............ A

Contrast x-ray,

0.00 1.06

NA 0.06 1.12

NA

XXX bladder. 74440............... .............. A

X-ray, male genital

0.38 1.25

NA 0.08 1.71

NA

XXX tract. 74440............... 26............ A

X-ray, male genital

0.38 0.12 0.12 0.02 0.52 0.52

XXX tract. 74440............... TC............ A

X-ray, male genital

0.00 1.13

NA 0.06 1.19

NA

XXX tract. 74445............... .............. A

X-ray exam of penis.. 1.14 1.50

NA 0.12 2.76

NA

XXX 74445............... 26............ A

X-ray exam of penis.. 1.14 0.37 0.37 0.06 1.57 1.57

XXX 74445............... TC............ A

X-ray exam of penis.. 0.00 1.13

NA 0.06 1.19

NA

XXX 74450............... .............. A

X-ray, urethra/

0.33 1.57

NA 0.10 2.00

NA

XXX bladder. 74450............... 26............ A

X-ray, urethra/

0.33 0.11 0.11 0.02 0.46 0.46

XXX bladder. 74450............... TC............ A

X-ray, urethra/

0.00 1.46

NA 0.08 1.54

NA

XXX bladder. 74455............... .............. A

X-ray, urethra/

0.33 1.69

NA 0.12 2.14

NA

XXX bladder. 74455............... 26............ A

X-ray, urethra/

0.33 0.11 0.11 0.02 0.46 0.46

XXX bladder. 74455............... TC............ A

X-ray, urethra/

0.00 1.58

NA 0.10 1.68

NA

XXX bladder. 74470............... .............. A

X-ray exam of kidney

0.54 1.43

NA 0.09 2.06

NA

XXX lesion. 74470............... 26............ A

X-ray exam of kidney

0.54 0.18 0.18 0.02 0.74 0.74

XXX lesion. 74470............... TC............ A

X-ray exam of kidney

0.00 1.25

NA 0.07 1.32

NA

XXX lesion. 74475............... .............. A

X-ray control, cath

0.54 4.27

NA 0.24 5.05

NA

XXX insert. 74475............... 26............ A

X-ray control, cath

0.54 0.18 0.18 0.02 0.74 0.74

XXX insert. 74475............... TC............ A

X-ray control, cath

0.00 4.09

NA 0.22 4.31

NA

XXX insert. 74480............... .............. A

X-ray control, cath

0.54 4.27

NA 0.24 5.05

NA

XXX insert. 74480............... 26............ A

X-ray control, cath

0.54 0.18 0.18 0.02 0.74 0.74

XXX insert. 74480............... TC............ A

X-ray control, cath

0.00 4.09

NA 0.22 4.31

NA

XXX insert. 74485............... .............. A

X-ray guide, GU

0.54 3.35

NA 0.21 4.10

NA

XXX dilation. 74485............... 26............ A

X-ray guide, GU

0.54 0.18 0.18 0.04 0.76 0.76

XXX dilation. 74485............... TC............ A

X-ray guide, GU

0.00 3.17

NA 0.17 3.34

NA

XXX dilation. 74710............... .............. A

X-ray measurement of

0.34 1.17

NA 0.08 1.59

NA

XXX pelvis. 74710............... 26............ A

X-ray measurement of

0.34 0.11 0.11 0.02 0.47 0.47

XXX pelvis. 74710............... TC............ A

X-ray measurement of

0.00 1.06

NA 0.06 1.12

NA

XXX pelvis. 74740............... .............. A

X-ray, female genital 0.38 1.44

NA 0.09 1.91

NA

XXX tract. 74740............... 26............ A

X-ray, female genital 0.38 0.13 0.13 0.02 0.53 0.53

XXX tract. 74740............... TC............ A

X-ray, female genital 0.00 1.31

NA 0.07 1.38

NA

XXX tract. 74742............... .............. A

X-ray, fallopian tube 0.61 3.37

NA 0.19 4.17

NA

XXX 74742............... 26............ A

X-ray, fallopian tube 0.61 0.20 0.20 0.02 0.83 0.83

XXX 74742............... TC............ A

X-ray, fallopian tube 0.00 3.17

NA 0.17 3.34

NA

XXX 74775............... .............. A

X-ray exam of

0.62 1.67

NA 0.12 2.41

NA

XXX perineum. 74775............... 26............ A

X-ray exam of

0.62 0.21 0.21 0.04 0.87 0.87

XXX perineum. 74775............... TC............ A

X-ray exam of

0.00 1.46

NA 0.08 1.54

NA

XXX perineum.

[[Page 1200]]

75552............... .............. A

Heart mri for morph w/ 1.60 11.77

NA 0.67 14.04

NA

XXX o dye. 75552............... 26............ A

Heart mri for morph w/ 1.60 0.53 0.53 0.08 2.21 2.21

XXX o dye. 75552............... TC............ A

Heart mri for morph w/ 0.00 11.24

NA 0.59 11.83

NA

XXX o dye. 75553............... .............. A

Heart mri for morph w/ 2.00 11.89

NA 0.70 14.59

NA

XXX dye. 75553............... 26............ A

Heart mri for morph w/ 2.00 0.65 0.65 0.11 2.76 2.76

XXX dye. 75553............... TC............ A

Heart mri for morph w/ 0.00 11.24

NA 0.59 11.83

NA

XXX dye. 75554............... .............. A

Cardiac MRI/function. 1.83 11.88

NA 0.67 14.38

NA

XXX 75554............... 26............ A

Cardiac MRI/function. 1.83 0.64 0.64 0.08 2.55 2.55

XXX 75554............... TC............ A

Cardiac MRI/function. 0.00 11.24

NA 0.59 11.83

NA

XXX 75555............... .............. A

Cardiac MRI/limited

1.74 11.88

NA 0.67 14.29

NA

XXX study. 75555............... 26............ A

Cardiac MRI/limited

1.74 0.64 0.64 0.08 2.46 2.46

XXX study. 75555............... TC............ A

Cardiac MRI/limited

0.00 11.24

NA 0.59 11.83

NA

XXX study. 75556............... .............. N

Cardiac MRI/flow

0.00 0.00 0.00 0.00 0.00 0.00

XXX mapping. 75600............... .............. A

Contrast x-ray exam

0.49 12.83

NA 0.67 13.99

NA

XXX of aorta. 75600............... 26............ A

Contrast x-ray exam

0.49 0.19 0.19 0.02 0.70 0.70

XXX of aorta. 75600............... TC............ A

Contrast x-ray exam

0.00 12.64

NA 0.65 13.29

NA

XXX of aorta. 75605............... .............. A

Contrast x-ray exam

1.14 13.03

NA 0.71 14.88

NA

XXX of aorta. 75605............... 26............ A

Contrast x-ray exam

1.14 0.39 0.39 0.06 1.59 1.59

XXX of aorta. 75605............... TC............ A

Contrast x-ray exam

0.00 12.64

NA 0.65 13.29

NA

XXX of aorta. 75625............... .............. A

Contrast x-ray exam

1.14 13.02

NA 0.71 14.87

NA

XXX of aorta. 75625............... 26............ A

Contrast x-ray exam

1.14 0.38 0.38 0.06 1.58 1.58

XXX of aorta. 75625............... TC............ A

Contrast x-ray exam

0.00 12.64

NA 0.65 13.29

NA

XXX of aorta. 75630............... .............. A

X-ray aorta, leg

1.79 13.78

NA 0.79 16.36

NA

XXX arteries. 75630............... 26............ A

X-ray aorta, leg

1.79 0.61 0.61 0.10 2.50 2.50

XXX arteries. 75630............... TC............ A

X-ray aorta, leg

0.00 13.17

NA 0.69 13.86

NA

XXX arteries. 75635............... .............. A

Ct angio abdominal

2.40 16.77

NA 0.50 19.67

NA

XXX arteries. 75635............... 26............ A

Ct angio abdominal

2.40 0.80 0.80 0.11 3.31 3.31

XXX arteries. 75635............... TC............ A

Ct angio abdominal

0.00 15.97

NA 0.39 16.36

NA

XXX arteries. 75650............... .............. A

Artery x-rays, head & 1.49 13.13

NA 0.73 15.35

NA

XXX neck. 75650............... 26............ A

Artery x-rays, head & 1.49 0.49 0.49 0.08 2.06 2.06

XXX neck. 75650............... TC............ A

Artery x-rays, head & 0.00 12.64

NA 0.65 13.29

NA

XXX neck. 75658............... .............. A

Artery x-rays, arm... 1.31 13.11

NA 0.72 15.14

NA

XXX 75658............... 26............ A

Artery x-rays, arm... 1.31 0.47 0.47 0.07 1.85 1.85

XXX 75658............... TC............ A

Artery x-rays, arm... 0.00 12.64

NA 0.65 13.29

NA

XXX 75660............... .............. A

Artery x-rays, head & 1.31 13.08

NA 0.72 15.11

NA

XXX neck. 75660............... 26............ A

Artery x-rays, head & 1.31 0.44 0.44 0.07 1.82 1.82

XXX neck. 75660............... TC............ A

Artery x-rays, head & 0.00 12.64

NA 0.65 13.29

NA

XXX neck. 75662............... .............. A

Artery x-rays, head & 1.66 13.23

NA 0.75 15.64

NA

XXX neck. 75662............... 26............ A

Artery x-rays, head & 1.66 0.59 0.59 0.10 2.35 2.35

XXX neck. 75662............... TC............ A

Artery x-rays, head & 0.00 12.64

NA 0.65 13.29

NA

XXX neck. 75665............... .............. A

Artery x-rays, head & 1.31 13.07

NA 0.73 15.11

NA

XXX neck. 75665............... 26............ A

Artery x-rays, head & 1.31 0.43 0.43 0.08 1.82 1.82

XXX neck. 75665............... TC............ A

Artery x-rays, head & 0.00 12.64

NA 0.65 13.29

NA

XXX neck. 75671............... .............. A

Artery x-rays, head & 1.66 13.19

NA 0.75 15.60

NA

XXX neck. 75671............... 26............ A

Artery x-rays, head & 1.66 0.55 0.55 0.10 2.31 2.31

XXX neck. 75671............... TC............ A

Artery x-rays, head & 0.00 12.64

NA 0.65 13.29

NA

XXX neck. 75676............... .............. A

Artery x-rays, neck.. 1.31 13.08

NA 0.73 15.12

NA

XXX 75676............... 26............ A

Artery x-rays, neck.. 1.31 0.44 0.44 0.08 1.83 1.83

XXX 75676............... TC............ A

Artery x-rays, neck.. 0.00 12.64

NA 0.65 13.29

NA

XXX 75680............... .............. A

Artery x-rays, neck.. 1.66 13.19

NA 0.75 15.60

NA

XXX 75680............... 26............ A

Artery x-rays, neck.. 1.66 0.55 0.55 0.10 2.31 2.31

XXX 75680............... TC............ A

Artery x-rays, neck.. 0.00 12.64

NA 0.65 13.29

NA

XXX 75685............... .............. A

Artery x-rays, spine. 1.31 13.07

NA 0.72 15.10

NA

XXX 75685............... 26............ A

Artery x-rays, spine. 1.31 0.43 0.43 0.07 1.81 1.81

XXX 75685............... TC............ A

Artery x-rays, spine. 0.00 12.64

NA 0.65 13.29

NA

XXX 75705............... .............. A

Artery x-rays, spine. 2.18 13.37

NA 0.78 16.33

NA

XXX 75705............... 26............ A

Artery x-rays, spine. 2.18 0.73 0.73 0.13 3.04 3.04

XXX 75705............... TC............ A

Artery x-rays, spine. 0.00 12.64

NA 0.65 13.29

NA

XXX 75710............... .............. A

Artery x-rays, arm/

1.14 13.02

NA 0.72 14.88

NA

XXX leg. 75710............... 26............ A

Artery x-rays, arm/

1.14 0.38 0.38 0.07 1.59 1.59

XXX leg. 75710............... TC............ A

Artery x-rays, arm/

0.00 12.64

NA 0.65 13.29

NA

XXX leg. 75716............... .............. A

Artery x-rays, arms/

1.31 13.07

NA 0.72 15.10

NA

XXX legs. 75716............... 26............ A

Artery x-rays, arms/

1.31 0.43 0.43 0.07 1.81 1.81

XXX legs. 75716............... TC............ A

Artery x-rays, arms/

0.00 12.64

NA 0.65 13.29

NA

XXX legs. 75722............... .............. A

Artery x-rays, kidney 1.14 13.04

NA 0.71 14.89

NA

XXX 75722............... 26............ A

Artery x-rays, kidney 1.14 0.40 0.40 0.06 1.60 1.60

XXX 75722............... TC............ A

Artery x-rays, kidney 0.00 12.64

NA 0.65 13.29

NA

XXX 75724............... .............. A

Artery x-rays,

1.49 13.20

NA 0.71 15.40

NA

XXX kidneys. 75724............... 26............ A

Artery x-rays,

1.49 0.56 0.56 0.06 2.11 2.11

XXX kidneys. 75724............... TC............ A

Artery x-rays,

0.00 12.64

NA 0.65 13.29

NA

XXX kidneys. 75726............... .............. A

Artery x-rays,

1.14 13.01

NA 0.71 14.86

NA

XXX abdomen. 75726............... 26............ A

Artery x-rays,

1.14 0.37 0.37 0.06 1.57 1.57

XXX abdomen. 75726............... TC............ A

Artery x-rays,

0.00 12.64

NA 0.65 13.29

NA

XXX abdomen. 75731............... .............. A

Artery x-rays,

1.14 13.01

NA 0.71 14.86

NA

XXX adrenal gland. 75731............... 26............ A

Artery x-rays,

1.14 0.37 0.37 0.06 1.57 1.57

XXX adrenal gland.

[[Page 1201]]

75731............... TC............ A

Artery x-rays,

0.00 12.64

NA 0.65 13.29

NA

XXX adrenal gland. 75733............... .............. A

Artery x-rays,

1.31 13.07

NA 0.72 15.10

NA

XXX adrenals. 75733............... 26............ A

Artery x-rays,

1.31 0.43 0.43 0.07 1.81 1.81

XXX adrenals. 75733............... TC............ A

Artery x-rays,

0.00 12.64

NA 0.65 13.29

NA

XXX adrenals. 75736............... .............. A

Artery x-rays, pelvis 1.14 13.01

NA 0.71 14.86

NA

XXX 75736............... 26............ A

Artery x-rays, pelvis 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75736............... TC............ A

Artery x-rays, pelvis 0.00 12.64

NA 0.65 13.29

NA

XXX 75741............... .............. A

Artery x-rays, lung.. 1.31 13.07

NA 0.72 15.10

NA

XXX 75741............... 26............ A

Artery x-rays, lung.. 1.31 0.43 0.43 0.07 1.81 1.81

XXX 75741............... TC............ A

Artery x-rays, lung.. 0.00 12.64

NA 0.65 13.29

NA

XXX 75743............... .............. A

Artery x-rays, lungs. 1.66 13.18

NA 0.73 15.57

NA

XXX 75743............... 26............ A

Artery x-rays, lungs. 1.66 0.54 0.54 0.08 2.28 2.28

XXX 75743............... TC............ A

Artery x-rays, lungs. 0.00 12.64

NA 0.65 13.29

NA

XXX 75746............... .............. A

Artery x-rays, lung.. 1.14 13.01

NA 0.71 14.86

NA

XXX 75746............... 26............ A

Artery x-rays, lung.. 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75746............... TC............ A

Artery x-rays, lung.. 0.00 12.64

NA 0.65 13.29

NA

XXX 75756............... .............. A

Artery x-rays, chest. 1.14 13.08

NA 0.70 14.92

NA

XXX 75756............... 26............ A

Artery x-rays, chest. 1.14 0.44 0.44 0.05 1.63 1.63

XXX 75756............... TC............ A

Artery x-rays, chest. 0.00 12.64

NA 0.65 13.29

NA

XXX 75774............... .............. A

Artery x-ray, each

0.36 12.77

NA 0.67 13.80

NA

ZZZ vessel. 75774............... 26............ A

Artery x-ray, each

0.36 0.13 0.13 0.02 0.51 0.51

ZZZ vessel. 75774............... TC............ A

Artery x-ray, each

0.00 12.64

NA 0.65 13.29

NA

ZZZ vessel. 75790............... .............. A

Visualize A-V shunt.. 1.84 1.96

NA 0.19 3.99

NA

XXX 75790............... 26............ A

Visualize A-V shunt.. 1.84 0.60 0.60 0.11 2.55 2.55

XXX 75790............... TC............ A

Visualize A-V shunt.. 0.00 1.36

NA 0.08 1.44

NA

XXX 75801............... .............. A

Lymph vessel x-ray,

0.81 5.71

NA 0.35 6.87

NA

XXX arm/leg. 75801............... 26............ A

Lymph vessel x-ray,

0.81 0.27 0.27 0.06 1.14 1.14

XXX arm/leg. 75801............... TC............ A

Lymph vessel x-ray,

0.00 5.44

NA 0.29 5.73

NA

XXX arm/leg. 75803............... .............. A

Lymph vessel x-

1.17 5.82

NA 0.35 7.34

NA

XXX ray,arms/legs. 75803............... 26............ A

Lymph vessel x-

1.17 0.38 0.38 0.06 1.61 1.61

XXX ray,arms/legs. 75803............... TC............ A

Lymph vessel x-

0.00 5.44

NA 0.29 5.73

NA

XXX ray,arms/legs. 75805............... .............. A

Lymph vessel x-ray,

0.81 6.39

NA 0.38 7.58

NA

XXX trunk. 75805............... 26............ A

Lymph vessel x-ray,

0.81 0.27 0.27 0.05 1.13 1.13

XXX trunk. 75805............... TC............ A

Lymph vessel x-ray,

0.00 6.12

NA 0.33 6.45

NA

XXX trunk. 75807............... .............. A

Lymph vessel x-ray,

1.17 6.50

NA 0.39 8.06

NA

XXX trunk. 75807............... 26............ A

Lymph vessel x-ray,

1.17 0.38 0.38 0.06 1.61 1.61

XXX trunk. 75807............... TC............ A

Lymph vessel x-ray,

0.00 6.12

NA 0.33 6.45

NA

XXX trunk. 75809............... .............. A

Nonvascular shunt, x- 0.47 0.95

NA 0.07 1.49

NA

XXX ray. 75809............... 26............ A

Nonvascular shunt, x- 0.47 0.16 0.16 0.02 0.65 0.65

XXX ray. 75809............... TC............ A

Nonvascular shunt, x- 0.00 0.79

NA 0.05 0.84

NA

XXX ray. 75810............... .............. A

Vein x-ray, spleen/

1.14 13.01

NA 0.72 14.87

NA

XXX liver. 75810............... 26............ A

Vein x-ray, spleen/

1.14 0.37 0.37 0.07 1.58 1.58

XXX liver. 75810............... TC............ A

Vein x-ray, spleen/

0.00 12.64

NA 0.65 13.29

NA

XXX liver. 75820............... .............. A

Vein x-ray, arm/leg.. 0.70 1.18

NA 0.10 1.98

NA

XXX 75820............... 26............ A

Vein x-ray, arm/leg.. 0.70 0.23 0.23 0.04 0.97 0.97

XXX 75820............... TC............ A

Vein x-ray, arm/leg.. 0.00 0.95

NA 0.06 1.01

NA

XXX 75822............... .............. A

Vein x-ray, arms/legs 1.06 1.83

NA 0.14 3.03

NA

XXX 75822............... 26............ A

Vein x-ray, arms/legs 1.06 0.35 0.35 0.06 1.47 1.47

XXX 75822............... TC............ A

Vein x-ray, arms/legs 0.00 1.48

NA 0.08 1.56

NA

XXX 75825............... .............. A

Vein x-ray, trunk.... 1.14 13.01

NA 0.72 14.87

NA

XXX 75825............... 26............ A

Vein x-ray, trunk.... 1.14 0.37 0.37 0.07 1.58 1.58

XXX 75825............... TC............ A

Vein x-ray, trunk.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75827............... .............. A

Vein x-ray, chest.... 1.14 13.01

NA 0.71 14.86

NA

XXX 75827............... 26............ A

Vein x-ray, chest.... 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75827............... TC............ A

Vein x-ray, chest.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75831............... .............. A

Vein x-ray, kidney... 1.14 13.01

NA 0.71 14.86

NA

XXX 75831............... 26............ A

Vein x-ray, kidney... 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75831............... TC............ A

Vein x-ray, kidney... 0.00 12.64

NA 0.65 13.29

NA

XXX 75833............... .............. A

Vein x-ray, kidneys.. 1.49 13.13

NA 0.73 15.35

NA

XXX 75833............... 26............ A

Vein x-ray, kidneys.. 1.49 0.49 0.49 0.08 2.06 2.06

XXX 75833............... TC............ A

Vein x-ray, kidneys.. 0.00 12.64

NA 0.65 13.29

NA

XXX 75840............... .............. A

Vein x-ray, adrenal

1.14 13.01

NA 0.73 14.88

NA

XXX gland. 75840............... 26............ A

Vein x-ray, adrenal

1.14 0.37 0.37 0.08 1.59 1.59

XXX gland. 75840............... TC............ A

Vein x-ray, adrenal

0.00 12.64

NA 0.65 13.29

NA

XXX gland. 75842............... .............. A

Vein x-ray, adrenal

1.49 13.12

NA 0.73 15.34

NA

XXX glands. 75842............... 26............ A

Vein x-ray, adrenal

1.49 0.48 0.48 0.08 2.05 2.05

XXX glands. 75842............... TC............ A

Vein x-ray, adrenal

0.00 12.64

NA 0.65 13.29

NA

XXX glands. 75860............... .............. A

Vein x-ray, neck..... 1.14 13.03

NA 0.72 14.89

NA

XXX 75860............... 26............ A

Vein x-ray, neck..... 1.14 0.39 0.39 0.07 1.60 1.60

XXX 75860............... TC............ A

Vein x-ray, neck..... 0.00 12.64

NA 0.65 13.29

NA

XXX 75870............... .............. A

Vein x-ray, skull.... 1.14 13.03

NA 0.72 14.89

NA

XXX 75870............... 26............ A

Vein x-ray, skull.... 1.14 0.39 0.39 0.07 1.60 1.60

XXX 75870............... TC............ A

Vein x-ray, skull.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75872............... .............. A

Vein x-ray, skull.... 1.14 13.01

NA 0.71 14.86

NA

XXX 75872............... 26............ A

Vein x-ray, skull.... 1.14 0.37 0.37 0.06 1.57 1.57

XXX

[[Page 1202]]

75872............... TC............ A

Vein x-ray, skull.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75880............... .............. A

Vein x-ray, eye

0.70 1.18

NA 0.10 1.98

NA

XXX socket. 75880............... 26............ A

Vein x-ray, eye

0.70 0.23 0.23 0.04 0.97 0.97

XXX socket. 75880............... TC............ A

Vein x-ray, eye

0.00 0.95

NA 0.06 1.01

NA

XXX socket. 75885............... .............. A

Vein x-ray, liver.... 1.44 13.11

NA 0.72 15.27

NA

XXX 75885............... 26............ A

Vein x-ray, liver.... 1.44 0.47 0.47 0.07 1.98 1.98

XXX 75885............... TC............ A

Vein x-ray, liver.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75887............... .............. A

Vein x-ray, liver.... 1.44 13.11

NA 0.72 15.27

NA

XXX 75887............... 26............ A

Vein x-ray, liver.... 1.44 0.47 0.47 0.07 1.98 1.98

XXX 75887............... TC............ A

Vein x-ray, liver.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75889............... .............. A

Vein x-ray, liver.... 1.14 13.01

NA 0.71 14.86

NA

XXX 75889............... 26............ A

Vein x-ray, liver.... 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75889............... TC............ A

Vein x-ray, liver.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75891............... .............. A

Vein x-ray, liver.... 1.14 13.01

NA 0.71 14.86

NA

XXX 75891............... 26............ A

Vein x-ray, liver.... 1.14 0.37 0.37 0.06 1.57 1.57

XXX 75891............... TC............ A

Vein x-ray, liver.... 0.00 12.64

NA 0.65 13.29

NA

XXX 75893............... .............. A

Venous sampling by

0.54 12.82

NA 0.67 14.03

NA

XXX catheter. 75893............... 26............ A

Venous sampling by

0.54 0.18 0.18 0.02 0.74 0.74

XXX catheter. 75893............... TC............ A

Venous sampling by

0.00 12.64

NA 0.65 13.29

NA

XXX catheter. 75894............... .............. A

X-rays, transcath

1.31 24.65

NA 1.35 27.31

NA

XXX therapy. 75894............... 26............ A

X-rays, transcath

1.31 0.43 0.43 0.08 1.82 1.82

XXX therapy. 75894............... TC............ A

X-rays, transcath

0.00 24.22

NA 1.27 25.49

NA

XXX therapy. 75896............... .............. A

X-rays, transcath

1.31 21.51

NA 1.17 23.99

NA

XXX therapy. 75896............... 26............ A

X-rays, transcath

1.31 0.45 0.45 0.07 1.83 1.83

XXX therapy. 75896............... TC............ A

X-rays, transcath

0.00 21.06

NA 1.10 22.16

NA

XXX therapy. 75898............... .............. A

Follow-up angiography 1.65 1.61

NA 0.14 3.40

NA

XXX 75898............... 26............ A

Follow-up angiography 1.65 0.55 0.55 0.08 2.28 2.28

XXX 75898............... TC............ A

Follow-up angiography 0.00 1.06

NA 0.06 1.12

NA

XXX 75900............... .............. A

Arterial catheter

0.49 21.20

NA 1.13 22.82

NA

XXX exchange. 75900............... 26............ A

Arterial catheter

0.49 0.16 0.16 0.02 0.67 0.67

XXX exchange. 75900............... TC............ A

Arterial catheter

0.00 21.04

NA 1.11 22.15

NA

XXX exchange. 75901............... .............. A

Remove cva device

0.49 1.47

NA 0.85 2.81

NA

XXX obstruct. 75901............... 26............ A

Remove cva device

0.49 0.16 0.16 0.02 0.67 0.67

XXX obstruct. 75901............... TC............ A

Remove cva device

0.00 1.31

NA 0.83 2.14

NA

XXX obstruct. 75902............... .............. A

Remove cva lumen

0.39 1.44

NA 0.85 2.68

NA

XXX obstruct. 75902............... 26............ A

Remove cva lumen

0.39 0.13 0.13 0.02 0.54 0.54

XXX obstruct. 75902............... TC............ A

Remove cva lumen

0.00 1.31

NA 0.83 2.14

NA

XXX obstruct. 75940............... .............. A

X-ray placement, vein 0.54 12.82

NA 0.69 14.05

NA

XXX filter. 75940............... 26............ A

X-ray placement, vein 0.54 0.18 0.18 0.04 0.76 0.76

XXX filter. 75940............... TC............ A

X-ray placement, vein 0.00 12.64

NA 0.65 13.29

NA

XXX filter. 75945............... .............. A

Intravascular us..... 0.40 4.72

NA 0.28 5.40

NA

XXX 75945............... 26............ A

Intravascular us..... 0.40 0.14 0.14 0.04 0.58 0.58

XXX 75945............... TC............ A

Intravascular us..... 0.00 4.58

NA 0.24 4.82

NA

XXX 75946............... .............. A

Intravascular us add- 0.40 2.44

NA 0.17 3.01

NA

ZZZ on. 75946............... 26............ A

Intravascular us add- 0.40 0.14 0.14 0.04 0.58 0.58

ZZZ on. 75946............... TC............ A

Intravascular us add- 0.00 2.30

NA 0.13 2.43

NA

ZZZ on. 75952............... .............. C

Endovasc repair abdom 0.00 0.00 0.00 0.00 0.00 0.00

XXX aorta. 75952............... 26............ A

Endovasc repair abdom 4.49 1.50 1.50 0.82 6.81 6.81

XXX aorta. 75952............... TC............ C

Endovasc repair abdom 0.00 0.00 0.00 0.00 0.00 0.00

XXX aorta. 75953............... .............. C

Abdom aneurysm

0.00 0.00 0.00 0.00 0.00 0.00

XXX endovas rpr. 75953............... 26............ A

Abdom aneurysm

1.36 0.45 0.45 0.82 2.63 2.63

XXX endovas rpr. 75953............... TC............ C

Abdom aneurysm

0.00 0.00 0.00 0.00 0.00 0.00

XXX endovas rpr. 75954............... .............. C

Iliac aneurysm

0.00 0.00 0.00 0.00 0.00 0.00

XXX endovas rpr. 75954............... 26............ A

Iliac aneurysm

2.25 0.47 0.47 0.82 3.54 3.54

XXX endovas rpr. 75954............... TC............ C

Iliac aneurysm

0.00 0.00 0.00 0.00 0.00 0.00

XXX endovas rpr. 75960............... .............. A

Transcatheter intro,

0.82 15.24

NA 0.82 16.88

NA

XXX stent. 75960............... 26............ A

Transcatheter intro,

0.82 0.29 0.29 0.05 1.16 1.16

XXX stent. 75960............... TC............ A

Transcatheter intro,

0.00 14.95

NA 0.77 15.72

NA

XXX stent. 75961............... .............. A

Retrieval, broken

4.24 11.94

NA 0.77 16.95

NA

XXX catheter. 75961............... 26............ A

Retrieval, broken

4.24 1.40 1.40 0.22 5.86 5.86

XXX catheter. 75961............... TC............ A

Retrieval, broken

0.00 10.54

NA 0.55 11.09

NA

XXX catheter. 75962............... .............. A

Repair arterial

0.54 15.99

NA 0.87 17.40

NA

XXX blockage. 75962............... 26............ A

Repair arterial

0.54 0.19 0.19 0.04 0.77 0.77

XXX blockage. 75962............... TC............ A

Repair arterial

0.00 15.80

NA 0.83 16.63

NA

XXX blockage. 75964............... .............. A

Repair artery

0.36 8.54

NA 0.45 9.35

NA

ZZZ blockage, each. 75964............... 26............ A

Repair artery

0.36 0.12 0.12 0.02 0.50 0.50

ZZZ blockage, each. 75964............... TC............ A

Repair artery

0.00 8.42

NA 0.43 8.85

NA

ZZZ blockage, each. 75966............... .............. A

Repair arterial

1.31 16.26

NA 0.90 18.47

NA

XXX blockage. 75966............... 26............ A

Repair arterial

1.31 0.46 0.46 0.07 1.84 1.84

XXX blockage. 75966............... TC............ A

Repair arterial

0.00 15.80

NA 0.83 16.63

NA

XXX blockage. 75968............... .............. A

Repair artery

0.36 8.55

NA 0.44 9.35

NA

ZZZ blockage, each. 75968............... 26............ A

Repair artery

0.36 0.13 0.13 0.01 0.50 0.50

ZZZ blockage, each. 75968............... TC............ A

Repair artery

0.00 8.42

NA 0.43 8.85

NA

ZZZ blockage, each. 75970............... .............. A

Vascular biopsy...... 0.83 11.88

NA 0.65 13.36

NA

XXX 75970............... 26............ A

Vascular biopsy...... 0.83 0.29 0.29 0.05 1.17 1.17

XXX

[[Page 1203]]

75970............... TC............ A

Vascular biopsy...... 0.00 11.59

NA 0.60 12.19

NA

XXX 75978............... .............. A

Repair venous

0.54 15.98

NA 0.85 17.37

NA

XXX blockage. 75978............... 26............ A

Repair venous

0.54 0.18 0.18 0.02 0.74 0.74

XXX blockage. 75978............... TC............ A

Repair venous

0.00 15.80

NA 0.83 16.63

NA

XXX blockage. 75980............... .............. A

Contrast xray exam

1.44 5.91

NA 0.36 7.71

NA

XXX bile duct. 75980............... 26............ A

Contrast xray exam

1.44 0.47 0.47 0.07 1.98 1.98

XXX bile duct. 75980............... TC............ A

Contrast xray exam

0.00 5.44

NA 0.29 5.73

NA

XXX bile duct. 75982............... .............. A

Contrast xray exam

1.44 6.58

NA 0.40 8.42

NA

XXX bile duct. 75982............... 26............ A

Contrast xray exam

1.44 0.46 0.46 0.07 1.97 1.97

XXX bile duct. 75982............... TC............ A

Contrast xray exam

0.00 6.12

NA 0.33 6.45

NA

XXX bile duct. 75984............... .............. A

Xray control catheter 0.72 2.20

NA 0.15 3.07

NA

XXX change. 75984............... 26............ A

Xray control catheter 0.72 0.24 0.24 0.04 1.00 1.00

XXX change. 75984............... TC............ A

Xray control catheter 0.00 1.96

NA 0.11 2.07

NA

XXX change. 75989............... .............. A

Abscess drainage

1.19 3.55

NA 0.23 4.97

NA

XXX under x-ray. 75989............... 26............ A

Abscess drainage

1.19 0.38 0.38 0.06 1.63 1.63

XXX under x-ray. 75989............... TC............ A

Abscess drainage

0.00 3.17

NA 0.17 3.34

NA

XXX under x-ray. 75992............... .............. A

Atherectomy, x-ray

0.54 15.99

NA 0.85 17.38

NA

XXX exam. 75992............... 26............ A

Atherectomy, x-ray

0.54 0.19 0.19 0.02 0.75 0.75

XXX exam. 75992............... TC............ A

Atherectomy, x-ray

0.00 15.80

NA 0.83 16.63

NA

XXX exam. 75993............... .............. A

Atherectomy, x-ray

0.36 8.56

NA 0.44 9.36

NA

ZZZ exam. 75993............... 26............ A

Atherectomy, x-ray

0.36 0.14 0.14 0.01 0.51 0.51

ZZZ exam. 75993............... TC............ A

Atherectomy, x-ray

0.00 8.42

NA 0.43 8.85

NA

ZZZ exam. 75994............... .............. A

Atherectomy, x-ray

1.31 16.26

NA 0.90 18.47

NA

XXX exam. 75994............... 26............ A

Atherectomy, x-ray

1.31 0.46 0.46 0.07 1.84 1.84

XXX exam. 75994............... TC............ A

Atherectomy, x-ray

0.00 15.80

NA 0.83 16.63

NA

XXX exam. 75995............... .............. A

Atherectomy, x-ray

1.31 16.27

NA 0.90 18.48

NA

XXX exam. 75995............... 26............ A

Atherectomy, x-ray

1.31 0.47 0.47 0.07 1.85 1.85

XXX exam. 75995............... TC............ A

Atherectomy, x-ray

0.00 15.80

NA 0.83 16.63

NA

XXX exam. 75996............... .............. A

Atherectomy, x-ray

0.36 8.54

NA 0.44 9.34

NA

ZZZ exam. 75996............... 26............ A

Atherectomy, x-ray

0.36 0.12 0.12 0.01 0.49 0.49

ZZZ exam. 75996............... TC............ A

Atherectomy, x-ray

0.00 8.42

NA 0.43 8.85

NA

ZZZ exam. 75998............... .............. A

Fluoroguide for vein

0.38 1.44

NA 0.15 1.97

NA

ZZZ device. 75998............... 26............ A

Fluoroguide for vein

0.38 0.13 0.13 0.05 0.56 0.56

ZZZ device. 75998............... TC............ A

Fluoroguide for vein

0.00 1.31

NA 0.10 1.41

NA

ZZZ device. 76000............... .............. A

Fluoroscope

0.17 1.36

NA 0.08 1.61

NA

XXX examination. 76000............... 26............ A

Fluoroscope

0.17 0.05 0.05 0.01 0.23 0.23

XXX examination. 76000............... TC............ A

Fluoroscope

0.00 1.31

NA 0.07 1.38

NA

XXX examination. 76001............... .............. A

Fluoroscope exam,

0.67 2.84

NA 0.18 3.69

NA

XXX extensive. 76001............... 26............ A

Fluoroscope exam,

0.67 0.22 0.22 0.04 0.93 0.93

XXX extensive. 76001............... TC............ A

Fluoroscope exam,

0.00 2.62

NA 0.14 2.76

NA

XXX extensive. 76003............... .............. A

Needle localization

0.54 1.48

NA 0.11 2.13

NA

XXX by x-ray. 76003............... 26............ A

Needle localization

0.54 0.17 0.17 0.04 0.75 0.75

XXX by x-ray. 76003............... TC............ A

Needle localization

0.00 1.31

NA 0.07 1.38

NA

XXX by x-ray. 76005............... .............. A

Fluoroguide for spine 0.60 1.47

NA 0.11 2.18

NA

XXX inject. 76005............... 26............ A

Fluoroguide for spine 0.60 0.16 0.16 0.04 0.80 0.80

XXX inject. 76005............... TC............ A

Fluoroguide for spine 0.00 1.31

NA 0.07 1.38

NA

XXX inject. 76006............... .............. A

X-ray stress view.... 0.41 0.19 0.19 0.05 0.65 0.65

XXX 76010............... .............. A

X-ray, nose to rectum 0.18 0.58

NA 0.03 0.79

NA

XXX 76010............... 26............ A

X-ray, nose to rectum 0.18 0.06 0.06 0.01 0.25 0.25

XXX 76010............... TC............ A

X-ray, nose to rectum 0.00 0.52

NA 0.02 0.54

NA

XXX 76012............... .............. C

Percut vertebroplasty 0.00 0.00 0.00 0.00 0.00 0.00

XXX fluor. 76012............... 26............ A

Percut vertebroplasty 1.31 0.46 0.46 0.28 2.05 2.05

XXX fluor. 76012............... TC............ C

Percut vertebroplasty 0.00 0.00 0.00 0.00 0.00 0.00

XXX fluor. 76013............... .............. C

Percut

0.00 0.00 0.00 0.00 0.00 0.00

XXX vertebroplasty, ct. 76013............... 26............ A

Percut

1.38 0.47 0.47 0.58 2.43 2.43

XXX vertebroplasty, ct. 76013............... TC............ C

Percut

0.00 0.00 0.00 0.00 0.00 0.00

XXX vertebroplasty, ct. 76020............... .............. A

X-rays for bone age.. 0.19 0.58

NA 0.03 0.80

NA

XXX 76020............... 26............ A

X-rays for bone age.. 0.19 0.06 0.06 0.01 0.26 0.26

XXX 76020............... TC............ A

X-rays for bone age.. 0.00 0.52

NA 0.02 0.54

NA

XXX 76040............... .............. A

X-rays, bone

0.27 0.88

NA 0.09 1.24

NA

XXX evaluation. 76040............... 26............ A

X-rays, bone

0.27 0.09 0.09 0.04 0.40 0.40

XXX evaluation. 76040............... TC............ A

X-rays, bone

0.00 0.79

NA 0.05 0.84

NA

XXX evaluation. 76061............... .............. A

X-rays, bone survey.. 0.45 1.15

NA 0.08 1.68

NA

XXX 76061............... 26............ A

X-rays, bone survey.. 0.45 0.15 0.15 0.02 0.62 0.62

XXX 76061............... TC............ A

X-rays, bone survey.. 0.00 1.00

NA 0.06 1.06

NA

XXX 76062............... .............. A

X-rays, bone survey.. 0.54 1.62

NA 0.10 2.26

NA

XXX 76062............... 26............ A

X-rays, bone survey.. 0.54 0.18 0.18 0.02 0.74 0.74

XXX 76062............... TC............ A

X-rays, bone survey.. 0.00 1.44

NA 0.08 1.52

NA

XXX 76065............... .............. A

X-rays, bone

0.70 0.98

NA 0.06 1.74

NA

XXX evaluation. 76065............... 26............ A

X-rays, bone

0.70 0.24 0.24 0.01 0.95 0.95

XXX evaluation. 76065............... TC............ A

X-rays, bone

0.00 0.74

NA 0.05 0.79

NA

XXX evaluation. 76066............... .............. A

Joint survey, single

0.31 1.23

NA 0.08 1.62

NA

XXX view. 76066............... 26............ A

Joint survey, single

0.31 0.11 0.11 0.02 0.44 0.44

XXX view. 76066............... TC............ A

Joint survey, single

0.00 1.12

NA 0.06 1.18

NA

XXX view. 76070............... .............. A

Ct bone density,

0.25 3.04

NA 0.17 3.46

NA

XXX axial.

[[Page 1204]]

76070............... 26............ A

Ct bone density,

0.25 0.08 0.08 0.01 0.34 0.34

XXX axial. 76070............... TC............ A

Ct bone density,

0.00 2.96

NA 0.16 3.12

NA

XXX axial. 76071............... .............. A

Ct bone density,

0.22 3.03

NA 0.06 3.31

NA

XXX peripheral. 76071............... 26............ A

Ct bone density,

0.22 0.07 0.07 0.01 0.30 0.30

XXX peripheral. 76071............... TC............ A

Ct bone density,

0.00 2.96

NA 0.05 3.01

NA

XXX peripheral. 76075............... .............. A

Dexa, axial skeleton

0.30 3.21

NA 0.18 3.69

NA

XXX study. 76075............... 26............ A

Dexa, axial skeleton

0.30 0.10 0.10 0.01 0.41 0.41

XXX study. 76075............... TC............ A

Dexa, axial skeleton

0.00 3.11

NA 0.17 3.28

NA

XXX study. 76076............... .............. A

Dexa, peripheral

0.22 0.84

NA 0.06 1.12

NA

XXX study. 76076............... 26............ A

Dexa, peripheral

0.22 0.08 0.08 0.01 0.31 0.31

XXX study. 76076............... TC............ A

Dexa, peripheral

0.00 0.76

NA 0.05 0.81

NA

XXX study. 76078............... .............. A

Radiographic

0.20 0.83

NA 0.06 1.09

NA

XXX absorptiometry. 76078............... 26............ A

Radiographic

0.20 0.07 0.07 0.01 0.28 0.28

XXX absorptiometry. 76078............... TC............ A

Radiographic

0.00 0.76

NA 0.05 0.81

NA

XXX absorptiometry. 76080............... .............. A

X-ray exam of fistula 0.54 1.24

NA 0.08 1.86

NA

XXX 76080............... 26............ A

X-ray exam of fistula 0.54 0.18 0.18 0.02 0.74 0.74

XXX 76080............... TC............ A

X-ray exam of fistula 0.00 1.06

NA 0.06 1.12

NA

XXX 76082............... .............. A

Computer mammogram

0.06 0.43

NA 0.02 0.51

NA

ZZZ add-on. 76082............... 26............ A

Computer mammogram

0.06 0.02 0.02 0.01 0.09 0.09

ZZZ add-on. 76082............... TC............ A

Computer mammogram

0.00 0.41

NA 0.01 0.42

NA

ZZZ add-on. 76083............... .............. A

Computer mammogram

0.06 0.43

NA 0.02 0.51

NA

ZZZ add-on. 76083............... 26............ A

Computer mammogram

0.06 0.02 0.02 0.01 0.09 0.09

ZZZ add-on. 76083............... TC............ A

Computer mammogram

0.00 0.41

NA 0.01 0.42

NA

ZZZ add-on. 76085............... .............. F

Computer mammogram

+0.00 0.00 0.00 0.00 0.00 0.00

ZZZ add-on. 76085............... 26............ F

Computer mammogram

+0.00 0.00 0.00 0.00 0.00 0.00

ZZZ add-on. 76085............... TC............ F

Computer mammogram

+0.00 0.00 0.00 0.00 0.00 0.00

ZZZ add-on. 76086............... .............. A

X-ray of mammary duct 0.36 2.74

NA 0.16 3.26

NA

XXX 76086............... 26............ A

X-ray of mammary duct 0.36 0.12 0.12 0.02 0.50 0.50

XXX 76086............... TC............ A

X-ray of mammary duct 0.00 2.62

NA 0.14 2.76

NA

XXX 76088............... .............. A

X-ray of mammary

0.45 3.83

NA 0.21 4.49

NA

XXX ducts. 76088............... 26............ A

X-ray of mammary

0.45 0.15 0.15 0.02 0.62 0.62

XXX ducts. 76088............... TC............ A

X-ray of mammary

0.00 3.68

NA 0.19 3.87

NA

XXX ducts. 76090............... .............. A

Mammogram, one breast 0.70 1.29

NA 0.10 2.09

NA

XXX 76090............... 26............ A

Mammogram, one breast 0.70 0.23 0.23 0.04 0.97 0.97

XXX 76090............... TC............ A

Mammogram, one breast 0.00 1.06

NA 0.06 1.12

NA

XXX 76091............... .............. A

Mammogram, both

0.87 1.60

NA 0.11 2.58

NA

XXX breasts. 76091............... 26............ A

Mammogram, both

0.87 0.29 0.29 0.04 1.20 1.20

XXX breasts. 76091............... TC............ A

Mammogram, both

0.00 1.31

NA 0.07 1.38

NA

XXX breasts. 76092............... .............. A

Mammogram, screening. 0.70 1.46

NA 0.11 2.27

NA

XXX 76092............... 26............ A

Mammogram, screening. 0.70 0.23 0.23 0.04 0.97 0.97

XXX 76092............... TC............ A

Mammogram, screening. 0.00 1.23

NA 0.07 1.30

NA

XXX 76093............... .............. A

Magnetic image,

1.63 18.21

NA 1.00 20.84

NA

XXX breast. 76093............... 26............ A

Magnetic image,

1.63 0.53 0.53 0.08 2.24 2.24

XXX breast. 76093............... TC............ A

Magnetic image,

0.00 17.68

NA 0.92 18.60

NA

XXX breast. 76094............... .............. A

Magnetic image, both

1.63 24.52

NA 1.32 27.47

NA

XXX breasts. 76094............... 26............ A

Magnetic image, both

1.63 0.53 0.53 0.08 2.24 2.24

XXX breasts. 76094............... TC............ A

Magnetic image, both

0.00 23.99

NA 1.24 25.23

NA

XXX breasts. 76095............... .............. A

Stereotactic breast

1.59 7.71

NA 0.48 9.78

NA

XXX biopsy. 76095............... 26............ A

Stereotactic breast

1.59 0.52 0.52 0.11 2.22 2.22

XXX biopsy. 76095............... TC............ A

Stereotactic breast

0.00 7.19

NA 0.37 7.56

NA

XXX biopsy. 76096............... .............. A

X-ray of needle wire, 0.56 1.50

NA 0.11 2.17

NA

XXX breast. 76096............... 26............ A

X-ray of needle wire, 0.56 0.19 0.19 0.04 0.79 0.79

XXX breast. 76096............... TC............ A

X-ray of needle wire, 0.00 1.31

NA 0.07 1.38

NA

XXX breast. 76098............... .............. A

X-ray exam, breast

0.16 0.46

NA 0.03 0.65

NA

XXX specimen. 76098............... 26............ A

X-ray exam, breast

0.16 0.05 0.05 0.01 0.22 0.22

XXX specimen. 76098............... TC............ A

X-ray exam, breast

0.00 0.41

NA 0.02 0.43

NA

XXX specimen. 76100............... .............. A

X-ray exam of body

0.58 1.44

NA 0.11 2.13

NA

XXX section. 76100............... 26............ A

X-ray exam of body

0.58 0.19 0.19 0.04 0.81 0.81

XXX section. 76100............... TC............ A

X-ray exam of body

0.00 1.25

NA 0.07 1.32

NA

XXX section. 76101............... .............. A

Complex body section

0.58 1.62

NA 0.12 2.32

NA

XXX x-ray. 76101............... 26............ A

Complex body section

0.58 0.19 0.19 0.04 0.81 0.81

XXX x-ray. 76101............... TC............ A

Complex body section

0.00 1.43

NA 0.08 1.51

NA

XXX x-ray. 76102............... .............. A

Complex body section

0.58 1.94

NA 0.15 2.67

NA

XXX x-rays. 76102............... 26............ A

Complex body section

0.58 0.20 0.20 0.04 0.82 0.82

XXX x-rays. 76102............... TC............ A

Complex body section

0.00 1.74

NA 0.11 1.85

NA

XXX x-rays. 76120............... .............. A

Cine/video x-rays.... 0.38 1.19

NA 0.08 1.65

NA

XXX 76120............... 26............ A

Cine/video x-rays.... 0.38 0.13 0.13 0.02 0.53 0.53

XXX 76120............... TC............ A

Cine/video x-rays.... 0.00 1.06

NA 0.06 1.12

NA

XXX 76125............... .............. A

Cine/video x-rays add- 0.27 0.88

NA 0.06 1.21

NA

ZZZ on. 76125............... 26............ A

Cine/video x-rays add- 0.27 0.09 0.09 0.01 0.37 0.37

ZZZ on. 76125............... TC............ A

Cine/video x-rays add- 0.00 0.79

NA 0.05 0.84

NA

ZZZ on. 76140............... .............. I

X-ray consultation... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76150............... .............. A

X-ray exam, dry

0.00 0.41

NA 0.02 0.43

NA

XXX process. 76350............... .............. C

Special x-ray

0.00 0.00 0.00 0.00 0.00 0.00

XXX contrast study. 76355............... .............. A

Ct scan for

1.21 8.69

NA 0.49 10.39

NA

XXX localization.

[[Page 1205]]

76355............... 26............ A

Ct scan for

1.21 0.40 0.40 0.07 1.68 1.68

XXX localization. 76355............... TC............ A

Ct scan for

0.00 8.29

NA 0.42 8.71

NA

XXX localization. 76360............... .............. A

Ct scan for needle

1.16 8.66

NA 0.48 10.30

NA

XXX biopsy. 76360............... 26............ A

Ct scan for needle

1.16 0.37 0.37 0.06 1.59 1.59

XXX biopsy. 76360............... TC............ A

Ct scan for needle

0.00 8.29

NA 0.42 8.71

NA

XXX biopsy. 76362............... .............. A

Ct guide for tissue

3.99 9.59

NA 1.68 15.26

NA

XXX ablation. 76362............... 26............ A

Ct guide for tissue

3.99 1.30 1.30 0.22 5.51 5.51

XXX ablation. 76362............... TC............ A

Ct guide for tissue

0.00 8.29

NA 1.46 9.75

NA

XXX ablation. 76370............... .............. A

Ct scan for therapy

0.85 3.24

NA 0.21 4.30

NA

XXX guide. 76370............... 26............ A

Ct scan for therapy

0.85 0.28 0.28 0.05 1.18 1.18

XXX guide. 76370............... TC............ A

Ct scan for therapy

0.00 2.96

NA 0.16 3.12

NA

XXX guide. 76375............... .............. A

3d/holograph reconstr 0.16 3.60

NA 0.19 3.95

NA

XXX add-on. 76375............... 26............ A

3d/holograph reconstr 0.16 0.05 0.05 0.01 0.22 0.22

XXX add-on. 76375............... TC............ A

3d/holograph reconstr 0.00 3.55

NA 0.18 3.73

NA

XXX add-on. 76380............... .............. A

CAT scan follow-up

0.98 3.84

NA 0.23 5.05

NA

XXX study. 76380............... 26............ A

CAT scan follow-up

0.98 0.33 0.33 0.05 1.36 1.36

XXX study. 76380............... TC............ A

CAT scan follow-up

0.00 3.51

NA 0.18 3.69

NA

XXX study. 76390............... .............. N

Mr spectroscopy...... +1.40 11.48 11.48 0.66 13.54 13.54

XXX 76390............... 26............ N

Mr spectroscopy...... +1.40 0.47 0.47 0.07 1.94 1.94

XXX 76390............... TC............ N

Mr spectroscopy...... +0.00 11.01 11.01 0.59 11.60 11.60

XXX 76393............... .............. A

Mr guidance for

1.50 11.74

NA 0.63 13.87

NA

XXX needle place. 76393............... 26............ A

Mr guidance for

1.50 0.50 0.50 0.08 2.08 2.08

XXX needle place. 76393............... TC............ A

Mr guidance for

0.00 11.24

NA 0.55 11.79

NA

XXX needle place. 76394............... .............. A

Mri for tissue

4.24 12.63

NA 1.79 18.66

NA

XXX ablation. 76394............... 26............ A

Mri for tissue

4.24 1.39 1.39 0.23 5.86 5.86

XXX ablation. 76394............... TC............ A

Mri for tissue

0.00 11.24

NA 1.56 12.80

NA

XXX ablation. 76400............... .............. A

Magnetic image, bone

1.60 11.76

NA 0.67 14.03

NA

XXX marrow. 76400............... 26............ A

Magnetic image, bone

1.60 0.52 0.52 0.08 2.20 2.20

XXX marrow. 76400............... TC............ A

Magnetic image, bone

0.00 11.24

NA 0.59 11.83

NA

XXX marrow. 76490............... .............. D

Us for tissue

0.00 0.00 0.00 0.00 0.00 0.00

XXX ablation. 76490............... 26............ D

Us for tissue

0.00 0.00 0.00 0.00 0.00 0.00

XXX ablation. 76490............... TC............ D

Us for tissue

0.00 0.00 0.00 0.00 0.00 0.00

XXX ablation. 76496............... .............. C

Fluoroscopic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76496............... 26............ C

Fluoroscopic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76496............... TC............ C

Fluoroscopic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76497............... .............. C

Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76497............... 26............ C

Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76497............... TC............ C

Ct procedure......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76498............... .............. C

Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76498............... 26............ C

Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76498............... TC............ C

Mri procedure........ 0.00 0.00 0.00 0.00 0.00 0.00

XXX 76499............... .............. C

Radiographic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76499............... 26............ C

Radiographic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76499............... TC............ C

Radiographic

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76506............... .............. A

Echo exam of head.... 0.63 1.68

NA 0.12 2.43

NA

XXX 76506............... 26............ A

Echo exam of head.... 0.63 0.25 0.25 0.04 0.92 0.92

XXX 76506............... TC............ A

Echo exam of head.... 0.00 1.43

NA 0.08 1.51

NA

XXX 76511............... .............. A

Echo exam of eye..... 0.94 1.09

NA 0.09 2.12

NA

XXX 76511............... 26............ A

Echo exam of eye..... 0.94 0.40 0.40 0.02 1.36 1.36

XXX 76511............... TC............ A

Echo exam of eye..... 0.00 0.69

NA 0.07 0.76

NA

XXX 76512............... .............. A

Echo exam of eye..... 0.66 1.02

NA 0.11 1.79

NA

XXX 76512............... 26............ A

Echo exam of eye..... 0.66 0.30 0.30 0.01 0.97 0.97

XXX 76512............... TC............ A

Echo exam of eye..... 0.00 0.72

NA 0.10 0.82

NA

XXX 76513............... .............. A

Echo exam of eye,

0.66 1.10

NA 0.11 1.87

NA

XXX water bath. 76513............... 26............ A

Echo exam of eye,

0.66 0.30 0.30 0.01 0.97 0.97

XXX water bath. 76513............... TC............ A

Echo exam of eye,

0.00 0.80

NA 0.10 0.90

NA

XXX water bath. 76514............... .............. A

Echo exam of eye,

0.17 0.14

NA 0.02 0.33

NA

XXX thickness. 76514............... 26............ A

Echo exam of eye,

0.17 0.08 0.08 0.01 0.26 0.26

XXX thickness. 76514............... TC............ A

Echo exam of eye,

0.00 0.06

NA 0.01 0.07

NA

XXX thickness. 76516............... .............. A

Echo exam of eye..... 0.54 0.73

NA 0.08 1.35

NA

XXX 76516............... 26............ A

Echo exam of eye..... 0.54 0.25 0.25 0.01 0.80 0.80

XXX 76516............... TC............ A

Echo exam of eye..... 0.00 0.48

NA 0.07 0.55

NA

XXX 76519............... .............. A

Echo exam of eye..... 0.54 0.81

NA 0.08 1.43

NA

XXX 76519............... 26............ A

Echo exam of eye..... 0.54 0.25 0.25 0.01 0.80 0.80

XXX 76519............... TC............ A

Echo exam of eye..... 0.00 0.56

NA 0.07 0.63

NA

XXX 76529............... .............. A

Echo exam of eye..... 0.57 0.77

NA 0.09 1.43

NA

XXX 76529............... 26............ A

Echo exam of eye..... 0.57 0.25 0.25 0.01 0.83 0.83

XXX 76529............... TC............ A

Echo exam of eye..... 0.00 0.52

NA 0.08 0.60

NA

XXX 76536............... .............. A

Us exam of head and

0.56 1.62

NA 0.10 2.28

NA

XXX neck. 76536............... 26............ A

Us exam of head and

0.56 0.19 0.19 0.02 0.77 0.77

XXX neck. 76536............... TC............ A

Us exam of head and

0.00 1.43

NA 0.08 1.51

NA

XXX neck. 76604............... .............. A

Us exam, chest, b-

0.55 1.49

NA 0.09 2.13

NA

XXX scan. 76604............... 26............ A

Us exam, chest, b-

0.55 0.18 0.18 0.02 0.75 0.75

XXX scan. 76604............... TC............ A

Us exam, chest, b-

0.00 1.31

NA 0.07 1.38

NA

XXX scan. 76645............... .............. A

Us exam, breast(s)... 0.54 1.24

NA 0.10 1.88

NA

XXX

[[Page 1206]]

76645............... 26............ A

Us exam, breast(s)... 0.54 0.18 0.18 0.04 0.76 0.76

XXX 76645............... TC............ A

Us exam, breast(s)... 0.00 1.06

NA 0.06 1.12

NA

XXX 76700............... .............. A

Us exam, abdom,

0.81 2.25

NA 0.16 3.22

NA

XXX complete. 76700............... 26............ A

Us exam, abdom,

0.81 0.27 0.27 0.05 1.13 1.13

XXX complete. 76700............... TC............ A

Us exam, abdom,

0.00 1.98

NA 0.11 2.09

NA

XXX complete. 76705............... .............. A

Echo exam of abdomen. 0.59 1.63

NA 0.12 2.34

NA

XXX 76705............... 26............ A

Echo exam of abdomen. 0.59 0.20 0.20 0.04 0.83 0.83

XXX 76705............... TC............ A

Echo exam of abdomen. 0.00 1.43

NA 0.08 1.51

NA

XXX 76770............... .............. A

Us exam abdo back

0.74 2.23

NA 0.15 3.12

NA

XXX wall, comp. 76770............... 26............ A

Us exam abdo back

0.74 0.25 0.25 0.04 1.03 1.03

XXX wall, comp. 76770............... TC............ A

Us exam abdo back

0.00 1.98

NA 0.11 2.09

NA

XXX wall, comp. 76775............... .............. A

Us exam abdo back

0.58 1.62

NA 0.12 2.32

NA

XXX wall, lim. 76775............... 26............ A

Us exam abdo back

0.58 0.19 0.19 0.04 0.81 0.81

XXX wall, lim. 76775............... TC............ A

Us exam abdo back

0.00 1.43

NA 0.08 1.51

NA

XXX wall, lim. 76778............... .............. A

Us exam kidney

0.74 2.23

NA 0.15 3.12

NA

XXX transplant. 76778............... 26............ A

Us exam kidney

0.74 0.25 0.25 0.04 1.03 1.03

XXX transplant. 76778............... TC............ A

Us exam kidney

0.00 1.98

NA 0.11 2.09

NA

XXX transplant. 76800............... .............. A

Us exam, spinal canal 1.13 1.78

NA 0.13 3.04

NA

XXX 76800............... 26............ A

Us exam, spinal canal 1.13 0.35 0.35 0.05 1.53 1.53

XXX 76800............... TC............ A

Us exam, spinal canal 0.00 1.43

NA 0.08 1.51

NA

XXX 76801............... .............. A

Ob us /=

0.99 2.45

NA 0.17 3.61

NA

XXX 14 wks, sngl fetus. 76805............... 26............ A

Ob us /=

0.99 0.35 0.35 0.05 1.39 1.39

XXX 14 wks, sngl fetus. 76805............... TC............ A

Ob us /=

0.00 2.10

NA 0.12 2.22

NA

XXX 14 wks, sngl fetus. 76810............... .............. A

Ob us /=

0.98 1.41

NA 0.30 2.69

NA

ZZZ 14 wks, addl fetus. 76810............... 26............ A

Ob us /=

0.98 0.35 0.35 0.08 1.41 1.41

ZZZ 14 wks, addl fetus. 76810............... TC............ A

Ob us /=

0.00 1.06

NA 0.22 1.28

NA

ZZZ 14 wks, addl fetus. 76811............... .............. A

Ob us, detailed, sngl 1.90 4.20

NA 0.61 6.71

NA

XXX fetus. 76811............... 26............ A

Ob us, detailed, sngl 1.90 0.66 0.66 0.18 2.74 2.74

XXX fetus. 76811............... TC............ A

Ob us, detailed, sngl 0.00 3.54

NA 0.43 3.97

NA

XXX fetus. 76812............... .............. A

Ob us, detailed, addl 1.78 1.69

NA 0.55 4.02

NA

ZZZ fetus. 76812............... 26............ A

Ob us, detailed, addl 1.78 0.63 0.63 0.14 2.55 2.55

ZZZ fetus. 76812............... TC............ A

Ob us, detailed, addl 0.00 1.06

NA 0.41 1.47

NA

ZZZ fetus. 76815............... .............. A

Ob us, limited,

0.65 1.66

NA 0.10 2.41

NA

XXX fetus(s). 76815............... 26............ A

Ob us, limited,

0.65 0.23 0.23 0.02 0.90 0.90

XXX fetus(s). 76815............... TC............ A

Ob us, limited,

0.00 1.43

NA 0.08 1.51

NA

XXX fetus(s). 76816............... .............. A

Ob us, follow-up, per 0.85 1.44

NA 0.08 2.37

NA

XXX fetus. 76816............... 26............ A

Ob us, follow-up, per 0.85 0.32 0.32 0.02 1.19 1.19

XXX fetus. 76816............... TC............ A

Ob us, follow-up, per 0.00 1.12

NA 0.06 1.18

NA

XXX fetus. 76817............... .............. A

Transvaginal us,

0.75 1.80

NA 0.08 2.63

NA

XXX obstetric. 76817............... 26............ A

Transvaginal us,

0.75 0.28 0.28 0.02 1.05 1.05

XXX obstetric. 76817............... TC............ A

Transvaginal us,

0.00 1.52

NA 0.06 1.58

NA

XXX obstetric. 76818............... .............. A

Fetal biophys profile 1.05 2.00

NA 0.15 3.20

NA

XXX w/nst. 76818............... 26............ A

Fetal biophys profile 1.05 0.38 0.38 0.05 1.48 1.48

XXX w/nst. 76818............... TC............ A

Fetal biophys profile 0.00 1.62

NA 0.10 1.72

NA

XXX w/nst. 76819............... .............. A

Fetal biophys profil

0.77 1.90

NA 0.12 2.79

NA

XXX w/o nst. 76819............... 26............ A

Fetal biophys profil

0.77 0.28 0.28 0.02 1.07 1.07

XXX w/o nst. 76819............... TC............ A

Fetal biophys profil

0.00 1.62

NA 0.10 1.72

NA

XXX w/o nst. 76825............... .............. A

Echo exam of fetal

1.67 2.58

NA 0.18 4.43

NA

XXX heart. 76825............... 26............ A

Echo exam of fetal

1.67 0.60 0.60 0.07 2.34 2.34

XXX heart. 76825............... TC............ A

Echo exam of fetal

0.00 1.98

NA 0.11 2.09

NA

XXX heart. 76826............... .............. A

Echo exam of fetal

0.83 1.00

NA 0.09 1.92

NA

XXX heart. 76826............... 26............ A

Echo exam of fetal

0.83 0.29 0.29 0.04 1.16 1.16

XXX heart. 76826............... TC............ A

Echo exam of fetal

0.00 0.71

NA 0.05 0.76

NA

XXX heart. 76827............... .............. A

Echo exam of fetal

0.58 1.95

NA 0.14 2.67

NA

XXX heart. 76827............... 26............ A

Echo exam of fetal

0.58 0.22 0.22 0.02 0.82 0.82

XXX heart. 76827............... TC............ A

Echo exam of fetal

0.00 1.73

NA 0.12 1.85

NA

XXX heart. 76828............... .............. A

Echo exam of fetal

0.56 1.34

NA 0.10 2.00

NA

XXX heart. 76828............... 26............ A

Echo exam of fetal

0.56 0.22 0.22 0.02 0.80 0.80

XXX heart. 76828............... TC............ A

Echo exam of fetal

0.00 1.12

NA 0.08 1.20

NA

XXX heart. 76830............... .............. A

Transvaginal us, non- 0.69 1.75

NA 0.14 2.58

NA

XXX ob. 76830............... 26............ A

Transvaginal us, non- 0.69 0.23 0.23 0.04 0.96 0.96

XXX ob. 76830............... TC............ A

Transvaginal us, non- 0.00 1.52

NA 0.10 1.62

NA

XXX ob. 76831............... .............. A

Echo exam, uterus.... 0.72 1.78

NA 0.12 2.62

NA

XXX 76831............... 26............ A

Echo exam, uterus.... 0.72 0.26 0.26 0.02 1.00 1.00

XXX 76831............... TC............ A

Echo exam, uterus.... 0.00 1.52

NA 0.10 1.62

NA

XXX 76856............... .............. A

Us exam, pelvic,

0.69 1.75

NA 0.14 2.58

NA

XXX complete. 76856............... 26............ A

Us exam, pelvic,

0.69 0.23 0.23 0.04 0.96 0.96

XXX complete. 76856............... TC............ A

Us exam, pelvic,

0.00 1.52

NA 0.10 1.62

NA

XXX complete. 76857............... .............. A

Us exam, pelvic,

0.38 1.70

NA 0.08 2.16

NA

XXX limited.

[[Page 1207]]

76857............... 26............ A

Us exam, pelvic,

0.38 0.13 0.13 0.02 0.53 0.53

XXX limited. 76857............... TC............ A

Us exam, pelvic,

0.00 1.57

NA 0.06 1.63

NA

XXX limited. 76870............... .............. A

Us exam, scrotum..... 0.64 1.73

NA 0.14 2.51

NA

XXX 76870............... 26............ A

Us exam, scrotum..... 0.64 0.21 0.21 0.04 0.89 0.89

XXX 76870............... TC............ A

Us exam, scrotum..... 0.00 1.52

NA 0.10 1.62

NA

XXX 76872............... .............. A

Us, transrectal...... 0.69 2.09

NA 0.15 2.93

NA

XXX 76872............... 26............ A

Us, transrectal...... 0.69 0.23 0.23 0.05 0.97 0.97

XXX 76872............... TC............ A

Us, transrectal...... 0.00 1.86

NA 0.10 1.96

NA

XXX 76873............... .............. A

Echograp trans r,

1.55 2.59

NA 0.26 4.40

NA

XXX pros study. 76873............... 26............ A

Echograp trans r,

1.55 0.49 0.49 0.10 2.14 2.14

XXX pros study. 76873............... TC............ A

Echograp trans r,

0.00 2.10

NA 0.16 2.26

NA

XXX pros study. 76880............... .............. A

Us exam, extremity... 0.59 1.63

NA 0.12 2.34

NA

XXX 76880............... 26............ A

Us exam, extremity... 0.59 0.20 0.20 0.04 0.83 0.83

XXX 76880............... TC............ A

Us exam, extremity... 0.00 1.43

NA 0.08 1.51

NA

XXX 76885............... .............. A

Us exam infant hips,

0.74 1.77

NA 0.14 2.65

NA

XXX dynamic. 76885............... 26............ A

Us exam infant hips,

0.74 0.25 0.25 0.04 1.03 1.03

XXX dynamic. 76885............... TC............ A

Us exam infant hips,

0.00 1.52

NA 0.10 1.62

NA

XXX dynamic. 76886............... .............. A

Us exam infant hips,

0.62 1.64

NA 0.12 2.38

NA

XXX static. 76886............... 26............ A

Us exam infant hips,

0.62 0.21 0.21 0.04 0.87 0.87

XXX static. 76886............... TC............ A

Us exam infant hips,

0.00 1.43

NA 0.08 1.51

NA

XXX static. 76930............... .............. A

Echo guide,

0.67 1.78

NA 0.12 2.57

NA

XXX cardiocentesis. 76930............... 26............ A

Echo guide,

0.67 0.26 0.26 0.02 0.95 0.95

XXX cardiocentesis. 76930............... TC............ A

Echo guide,

0.00 1.52

NA 0.10 1.62

NA

XXX cardiocentesis. 76932............... .............. A

Echo guide for heart

0.67 1.78

NA 0.12 2.57

NA

XXX biopsy. 76932............... 26............ A

Echo guide for heart

0.67 0.26 0.26 0.02 0.95 0.95

XXX biopsy. 76932............... TC............ A

Echo guide for heart

0.00 1.52

NA 0.10 1.62

NA

XXX biopsy. 76936............... .............. A

Echo guide for artery 1.99 6.98

NA 0.47 9.44

NA

XXX repair. 76936............... 26............ A

Echo guide for artery 1.99 0.66 0.66 0.13 2.78 2.78

XXX repair. 76936............... TC............ A

Echo guide for artery 0.00 6.32

NA 0.34 6.66

NA

XXX repair. 76937............... .............. A

Us guide, vascular

0.30 0.47

NA 0.15 0.92

NA

ZZZ access. 76937............... 26............ A

Us guide, vascular

0.30 0.10 0.10 0.05 0.45 0.45

ZZZ access. 76937............... TC............ A

Us guide, vascular

0.00 0.37

NA 0.10 0.47

NA

ZZZ access. 76940............... .............. A

Us guide, tissue

2.00 2.17

NA 0.42 4.59

NA

XXX ablation. 76940............... 26............ A

Us guide, tissue

2.00 0.65 0.65 0.13 2.78 2.78

XXX ablation. 76940............... TC............ A

Us guide, tissue

0.00 1.52

NA 0.29 1.81

NA

XXX ablation. 76941............... .............. A

Echo guide for

1.34 2.00

NA 0.15 3.49

NA

XXX transfusion. 76941............... 26............ A

Echo guide for

1.34 0.47 0.47 0.07 1.88 1.88

XXX transfusion. 76941............... TC............ A

Echo guide for

0.00 1.53

NA 0.08 1.61

NA

XXX transfusion. 76942............... .............. A

Echo guide for biopsy 0.67 2.76

NA 0.15 3.58

NA

XXX 76942............... 26............ A

Echo guide for biopsy 0.67 0.22 0.22 0.05 0.94 0.94

XXX 76942............... TC............ A

Echo guide for biopsy 0.00 2.54

NA 0.10 2.64

NA

XXX 76945............... .............. A

Echo guide, villus

0.67 1.76

NA 0.12 2.55

NA

XXX sampling. 76945............... 26............ A

Echo guide, villus

0.67 0.23 0.23 0.04 0.94 0.94

XXX sampling. 76945............... TC............ A

Echo guide, villus

0.00 1.53

NA 0.08 1.61

NA

XXX sampling. 76946............... .............. A

Echo guide for

0.38 1.66

NA 0.11 2.15

NA

XXX amniocentesis. 76946............... 26............ A

Echo guide for

0.38 0.14 0.14 0.01 0.53 0.53

XXX amniocentesis. 76946............... TC............ A

Echo guide for

0.00 1.52

NA 0.10 1.62

NA

XXX amniocentesis. 76948............... .............. A

Echo guide, ova

0.38 1.65

NA 0.12 2.15

NA

XXX aspiration. 76948............... 26............ A

Echo guide, ova

0.38 0.13 0.13 0.02 0.53 0.53

XXX aspiration. 76948............... TC............ A

Echo guide, ova

0.00 1.52

NA 0.10 1.62

NA

XXX aspiration. 76950............... .............. A

Echo guidance

0.58 1.50

NA 0.11 2.19

NA

XXX radiotherapy. 76950............... 26............ A

Echo guidance

0.58 0.19 0.19 0.04 0.81 0.81

XXX radiotherapy. 76950............... TC............ A

Echo guidance

0.00 1.31

NA 0.07 1.38

NA

XXX radiotherapy. 76965............... .............. A

Echo guidance

1.34 6.01

NA 0.37 7.72

NA

XXX radiotherapy. 76965............... 26............ A

Echo guidance

1.34 0.42 0.42 0.08 1.84 1.84

XXX radiotherapy. 76965............... TC............ A

Echo guidance

0.00 5.59

NA 0.29 5.88

NA

XXX radiotherapy. 76970............... .............. A

Ultrasound exam

0.40 1.19

NA 0.08 1.67

NA

XXX follow-up. 76970............... 26............ A

Ultrasound exam

0.40 0.13 0.13 0.02 0.55 0.55

XXX follow-up. 76970............... TC............ A

Ultrasound exam

0.00 1.06

NA 0.06 1.12

NA

XXX follow-up. 76975............... .............. A

GI endoscopic

0.81 1.80

NA 0.14 2.75

NA

XXX ultrasound. 76975............... 26............ A

GI endoscopic

0.81 0.28 0.28 0.04 1.13 1.13

XXX ultrasound. 76975............... TC............ A

GI endoscopic

0.00 1.52

NA 0.10 1.62

NA

XXX ultrasound. 76977............... .............. A

Us bone density

0.05 0.85

NA 0.06 0.96

NA

XXX measure. 76977............... 26............ A

Us bone density

0.05 0.02 0.02 0.01 0.08 0.08

XXX measure. 76977............... TC............ A

Us bone density

0.00 0.83

NA 0.05 0.88

NA

XXX measure. 76986............... .............. A

Ultrasound guide

1.20 3.02

NA 0.22 4.44

NA

XXX intraoper. 76986............... 26............ A

Ultrasound guide

1.20 0.40 0.40 0.08 1.68 1.68

XXX intraoper. 76986............... TC............ A

Ultrasound guide

0.00 2.62

NA 0.14 2.76

NA

XXX intraoper. 76999............... .............. C

Echo examination

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76999............... 26............ C

Echo examination

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 76999............... TC............ C

Echo examination

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 77261............... .............. A

Radiation therapy

1.39 0.51 0.51 0.07 1.97 1.97

XXX planning. 77262............... .............. A

Radiation therapy

2.11 0.75 0.75 0.11 2.97 2.97

XXX planning. 77263............... .............. A

Radiation therapy

3.14 1.12 1.12 0.16 4.42 4.42

XXX planning. 77280............... .............. A

Set radiation therapy 0.70 3.70

NA 0.22 4.62

NA

XXX field.

[[Page 1208]]

77280............... 26............ A

Set radiation therapy 0.70 0.22 0.22 0.04 0.96 0.96

XXX field. 77280............... TC............ A

Set radiation therapy 0.00 3.48

NA 0.18 3.66

NA

XXX field. 77285............... .............. A

Set radiation therapy 1.05 5.93

NA 0.35 7.33

NA

XXX field. 77285............... 26............ A

Set radiation therapy 1.05 0.34 0.34 0.05 1.44 1.44

XXX field. 77285............... TC............ A

Set radiation therapy 0.00 5.59

NA 0.30 5.89

NA

XXX field. 77290............... .............. A

Set radiation therapy 1.56 7.02

NA 0.42 9.00

NA

XXX field. 77290............... 26............ A

Set radiation therapy 1.56 0.49 0.49 0.07 2.12 2.12

XXX field. 77290............... TC............ A

Set radiation therapy 0.00 6.53

NA 0.35 6.88

NA

XXX field. 77295............... .............. A

Set radiation therapy 4.56 29.48

NA 1.70 35.74

NA

XXX field. 77295............... 26............ A

Set radiation therapy 4.56 1.45 1.45 0.22 6.23 6.23

XXX field. 77295............... TC............ A

Set radiation therapy 0.00 28.03

NA 1.48 29.51

NA

XXX field. 77299............... .............. C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX planning. 77299............... 26............ C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX planning. 77299............... TC............ C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX planning. 77300............... .............. A

Radiation therapy

0.62 1.55

NA 0.11 2.28

NA

XXX dose plan. 77300............... 26............ A

Radiation therapy

0.62 0.20 0.20 0.04 0.86 0.86

XXX dose plan. 77300............... TC............ A

Radiation therapy

0.00 1.35

NA 0.07 1.42

NA

XXX dose plan. 77301............... .............. A

Radiotherapy dose

7.99 30.57

NA 1.70 40.26

NA

XXX plan, imrt. 77301............... 26............ A

Radiotherapy dose

7.99 2.54 2.54 0.22 10.75 10.75

XXX plan, imrt. 77301............... TC............ A

Radiotherapy dose

0.00 28.03

NA 1.48 29.51

NA

XXX plan, imrt. 77305............... .............. A

Teletx isodose plan

0.70 2.10

NA 0.15 2.95

NA

XXX simple. 77305............... 26............ A

Teletx isodose plan

0.70 0.23 0.23 0.04 0.97 0.97

XXX simple. 77305............... TC............ A

Teletx isodose plan

0.00 1.87

NA 0.11 1.98

NA

XXX simple. 77310............... .............. A

Teletx isodose plan

1.05 2.68

NA 0.18 3.91

NA

XXX intermed. 77310............... 26............ A

Teletx isodose plan

1.05 0.34 0.34 0.05 1.44 1.44

XXX intermed. 77310............... TC............ A

Teletx isodose plan

0.00 2.34

NA 0.13 2.47

NA

XXX intermed. 77315............... .............. A

Teletx isodose plan

1.56 3.15

NA 0.21 4.92

NA

XXX complex. 77315............... 26............ A

Teletx isodose plan

1.56 0.49 0.49 0.07 2.12 2.12

XXX complex. 77315............... TC............ A

Teletx isodose plan

0.00 2.66

NA 0.14 2.80

NA

XXX complex. 77321............... .............. A

Special teletx port

0.95 4.37

NA 0.26 5.58

NA

XXX plan. 77321............... 26............ A

Special teletx port

0.95 0.31 0.31 0.05 1.31 1.31

XXX plan. 77321............... TC............ A

Special teletx port

0.00 4.06

NA 0.21 4.27

NA

XXX plan. 77326............... .............. A

Brachytx isodose calc 0.93 2.67

NA 0.18 3.78

NA

XXX simp. 77326............... 26............ A

Brachytx isodose calc 0.93 0.30 0.30 0.05 1.28 1.28

XXX simp. 77326............... TC............ A

Brachytx isodose calc 0.00 2.37

NA 0.13 2.50

NA

XXX simp. 77327............... .............. A

Brachytx isodose calc 1.39 3.92

NA 0.25 5.56

NA

XXX interm. 77327............... 26............ A

Brachytx isodose calc 1.39 0.44 0.44 0.07 1.90 1.90

XXX interm. 77327............... TC............ A

Brachytx isodose calc 0.00 3.48

NA 0.18 3.66

NA

XXX interm. 77328............... .............. A

Brachytx isodose plan 2.09 5.63

NA 0.36 8.08

NA

XXX compl. 77328............... 26............ A

Brachytx isodose plan 2.09 0.66 0.66 0.11 2.86 2.86

XXX compl. 77328............... TC............ A

Brachytx isodose plan 0.00 4.97

NA 0.25 5.22

NA

XXX compl. 77331............... .............. A

Special radiation

0.87 0.78

NA 0.07 1.72

NA

XXX dosimetry. 77331............... 26............ A

Special radiation

0.87 0.28 0.28 0.05 1.20 1.20

XXX dosimetry. 77331............... TC............ A

Special radiation

0.00 0.50

NA 0.02 0.52

NA

XXX dosimetry. 77332............... .............. A

Radiation treatment

0.54 1.52

NA 0.09 2.15

NA

XXX aid(s). 77332............... 26............ A

Radiation treatment

0.54 0.17 0.17 0.02 0.73 0.73

XXX aid(s). 77332............... TC............ A

Radiation treatment

0.00 1.35

NA 0.07 1.42

NA

XXX aid(s). 77333............... .............. A

Radiation treatment

0.84 2.17

NA 0.16 3.17

NA

XXX aid(s). 77333............... 26............ A

Radiation treatment

0.84 0.27 0.27 0.05 1.16 1.16

XXX aid(s). 77333............... TC............ A

Radiation treatment

0.00 1.90

NA 0.11 2.01

NA

XXX aid(s). 77334............... .............. A

Radiation treatment

1.24 3.65

NA 0.23 5.12

NA

XXX aid(s). 77334............... 26............ A

Radiation treatment

1.24 0.39 0.39 0.06 1.69 1.69

XXX aid(s). 77334............... TC............ A

Radiation treatment

0.00 3.26

NA 0.17 3.43

NA

XXX aid(s). 77336............... .............. A

Radiation physics

0.00 2.99

NA 0.16 3.15

NA

XXX consult. 77370............... .............. A

Radiation physics

0.00 3.50

NA 0.18 3.68

NA

XXX consult. 77399............... .............. C

External radiation

0.00 0.00 0.00 0.00 0.00 0.00

XXX dosimetry. 77399............... 26............ C

External radiation

0.00 0.00 0.00 0.00 0.00 0.00

XXX dosimetry. 77399............... TC............ C

External radiation

0.00 0.00 0.00 0.00 0.00 0.00

XXX dosimetry. 77401............... .............. A

Radiation treatment

0.00 1.78

NA 0.11 1.89

NA

XXX delivery. 77402............... .............. A

Radiation treatment

0.00 1.78

NA 0.11 1.89

NA

XXX delivery. 77403............... .............. A

Radiation treatment

0.00 1.78

NA 0.11 1.89

NA

XXX delivery. 77404............... .............. A

Radiation treatment

0.00 1.78

NA 0.11 1.89

NA

XXX delivery. 77406............... .............. A

Radiation treatment

0.00 1.78

NA 0.11 1.89

NA

XXX delivery. 77407............... .............. A

Radiation treatment

0.00 2.09

NA 0.12 2.21

NA

XXX delivery. 77408............... .............. A

Radiation treatment

0.00 2.09

NA 0.12 2.21

NA

XXX delivery. 77409............... .............. A

Radiation treatment

0.00 2.09

NA 0.12 2.21

NA

XXX delivery. 77411............... .............. A

Radiation treatment

0.00 2.09

NA 0.12 2.21

NA

XXX delivery. 77412............... .............. A

Radiation treatment

0.00 2.34

NA 0.13 2.47

NA

XXX delivery. 77413............... .............. A

Radiation treatment

0.00 2.34

NA 0.13 2.47

NA

XXX delivery. 77414............... .............. A

Radiation treatment

0.00 2.34

NA 0.13 2.47

NA

XXX delivery. 77416............... .............. A

Radiation treatment

0.00 2.34

NA 0.13 2.47

NA

XXX delivery. 77417............... .............. A

Radiology port

0.00 0.59

NA 0.04 0.63

NA

XXX film(s). 77418............... .............. A

Radiation tx

0.00 18.05

NA 0.13 18.18

NA

XXX delivery, imrt. 77427............... .............. A

Radiation tx

3.31 1.05 1.05 0.17 4.53 4.53

XXX management, x5. 77431............... .............. A

Radiation therapy

1.81 0.68 0.68 0.08 2.57 2.57

XXX management.

[[Page 1209]]

77432............... .............. A

Stereotactic

7.92 2.91 2.91 0.40 11.23 11.23

XXX radiation trmt. 77470............... .............. A

Special radiation

2.09 11.85

NA 0.70 14.64

NA

XXX treatment. 77470............... 26............ A

Special radiation

2.09 0.66 0.66 0.11 2.86 2.86

XXX treatment. 77470............... TC............ A

Special radiation

0.00 11.19

NA 0.59 11.78

NA

XXX treatment. 77499............... .............. C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX management. 77499............... 26............ C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX management. 77499............... TC............ C

Radiation therapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX management. 77520............... .............. C

Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX o comp. 77522............... .............. C

Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX comp. 77523............... .............. C

Proton trmt,

0.00 0.00 0.00 0.00 0.00 0.00

XXX intermediate. 77525............... .............. C

Proton treatment,

0.00 0.00 0.00 0.00 0.00 0.00

XXX complex. 77600............... .............. R

Hyperthermia

1.56 3.55

NA 0.26 5.37

NA

XXX treatment. 77600............... 26............ R

Hyperthermia

1.56 0.49 0.49 0.10 2.15 2.15

XXX treatment. 77600............... TC............ R

Hyperthermia

0.00 3.06

NA 0.16 3.22

NA

XXX treatment. 77605............... .............. R

Hyperthermia

2.09 4.74

NA 0.38 7.21

NA

XXX treatment. 77605............... 26............ R

Hyperthermia

2.09 0.66 0.66 0.16 2.91 2.91

XXX treatment. 77605............... TC............ R

Hyperthermia

0.00 4.08

NA 0.22 4.30

NA

XXX treatment. 77610............... .............. R

Hyperthermia

1.56 3.56

NA 0.24 5.36

NA

XXX treatment. 77610............... 26............ R

Hyperthermia

1.56 0.50 0.50 0.08 2.14 2.14

XXX treatment. 77610............... TC............ R

Hyperthermia

0.00 3.06

NA 0.16 3.22

NA

XXX treatment. 77615............... .............. R

Hyperthermia

2.09 4.74

NA 0.33 7.16

NA

XXX treatment. 77615............... 26............ R

Hyperthermia

2.09 0.66 0.66 0.11 2.86 2.86

XXX treatment. 77615............... TC............ R

Hyperthermia

0.00 4.08

NA 0.22 4.30

NA

XXX treatment. 77620............... .............. R

Hyperthermia

1.56 3.57

NA 0.23 5.36

NA

XXX treatment. 77620............... 26............ R

Hyperthermia

1.56 0.51 0.51 0.07 2.14 2.14

XXX treatment. 77620............... TC............ R

Hyperthermia

0.00 3.06

NA 0.16 3.22

NA

XXX treatment. 77750............... .............. A

Infuse radioactive

4.90 2.91

NA 0.28 8.09

NA

090 materials. 77750............... 26............ A

Infuse radioactive

4.90 1.57 1.57 0.21 6.68 6.68

090 materials. 77750............... TC............ A

Infuse radioactive

0.00 1.34

NA 0.07 1.41

NA

090 materials. 77761............... .............. A

Apply intrcav radiat

3.80 3.62

NA 0.33 7.75

NA

090 simple. 77761............... 26............ A

Apply intrcav radiat

3.80 1.10 1.10 0.19 5.09 5.09

090 simple. 77761............... TC............ A

Apply intrcav radiat

0.00 2.52

NA 0.14 2.66

NA

090 simple. 77762............... .............. A

Apply intrcav radiat

5.71 5.45

NA 0.46 11.62

NA

090 interm. 77762............... 26............ A

Apply intrcav radiat

5.71 1.83 1.83 0.27 7.81 7.81

090 interm. 77762............... TC............ A

Apply intrcav radiat

0.00 3.62

NA 0.19 3.81

NA

090 interm. 77763............... .............. A

Apply intrcav radiat

8.56 7.22

NA 0.64 16.42

NA

090 compl. 77763............... 26............ A

Apply intrcav radiat

8.56 2.72 2.72 0.41 11.69 11.69

090 compl. 77763............... TC............ A

Apply intrcav radiat

0.00 4.50

NA 0.23 4.73

NA

090 compl. 77776............... .............. A

Apply interstit

4.65 3.14

NA 0.42 8.21

NA

090 radiat simpl. 77776............... 26............ A

Apply interstit

4.65 0.96 0.96 0.29 5.90 5.90

090 radiat simpl. 77776............... TC............ A

Apply interstit

0.00 2.18

NA 0.13 2.31

NA

090 radiat simpl. 77777............... .............. A

Apply interstit

7.47 6.61

NA 0.61 14.69

NA

090 radiat inter. 77777............... 26............ A

Apply interstit

7.47 2.36 2.36 0.39 10.22 10.22

090 radiat inter. 77777............... TC............ A

Apply interstit

0.00 4.25

NA 0.22 4.47

NA

090 radiat inter. 77778............... .............. A

Apply interstit

11.17 8.69

NA 0.84 20.70

NA

090 radiat compl. 77778............... 26............ A

Apply interstit

11.17 3.54 3.54 0.57 15.28 15.28

090 radiat compl. 77778............... TC............ A

Apply interstit

0.00 5.15

NA 0.27 5.42

NA

090 radiat compl. 77781............... .............. A

High intensity

1.66 20.91

NA 1.14 23.71

NA

090 brachytherapy. 77781............... 26............ A

High intensity

1.66 0.53 0.53 0.08 2.27 2.27

090 brachytherapy. 77781............... TC............ A

High intensity

0.00 20.38

NA 1.06 21.44

NA

090 brachytherapy. 77782............... .............. A

High intensity

2.49 21.18

NA 1.18 24.85

NA

090 brachytherapy. 77782............... 26............ A

High intensity

2.49 0.80 0.80 0.12 3.41 3.41

090 brachytherapy. 77782............... TC............ A

High intensity

0.00 20.38

NA 1.06 21.44

NA

090 brachytherapy. 77783............... .............. A

High intensity

3.72 21.56

NA 1.24 26.52

NA

090 brachytherapy. 77783............... 26............ A

High intensity

3.72 1.18 1.18 0.18 5.08 5.08

090 brachytherapy. 77783............... TC............ A

High intensity

0.00 20.38

NA 1.06 21.44

NA

090 brachytherapy. 77784............... .............. A

High intensity

5.60 22.16

NA 1.33 29.09

NA

090 brachytherapy. 77784............... 26............ A

High intensity

5.60 1.78 1.78 0.27 7.65 7.65

090 brachytherapy. 77784............... TC............ A

High intensity

0.00 20.38

NA 1.06 21.44

NA

090 brachytherapy. 77789............... .............. A

Apply surface

1.12 0.82

NA 0.06 2.00

NA

000 radiation. 77789............... 26............ A

Apply surface

1.12 0.37 0.37 0.04 1.53 1.53

000 radiation. 77789............... TC............ A

Apply surface

0.00 0.45

NA 0.02 0.47

NA

000 radiation. 77790............... .............. A

Radiation handling... 1.05 0.84

NA 0.07 1.96

NA

XXX 77790............... 26............ A

Radiation handling... 1.05 0.34 0.34 0.05 1.44 1.44

XXX 77790............... TC............ A

Radiation handling... 0.00 0.50

NA 0.02 0.52

NA

XXX 77799............... .............. C

Radium/radioisotope

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 77799............... 26............ C

Radium/radioisotope

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 77799............... TC............ C

Radium/radioisotope

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 78000............... .............. A

Thyroid, single

0.19 1.04

NA 0.07 1.30

NA

XXX uptake. 78000............... 26............ A

Thyroid, single

0.19 0.07 0.07 0.01 0.27 0.27

XXX uptake. 78000............... TC............ A

Thyroid, single

0.00 0.97

NA 0.06 1.03

NA

XXX uptake. 78001............... .............. A

Thyroid, multiple

0.26 1.40

NA 0.08 1.74

NA

XXX uptakes. 78001............... 26............ A

Thyroid, multiple

0.26 0.09 0.09 0.01 0.36 0.36

XXX uptakes. 78001............... TC............ A

Thyroid, multiple

0.00 1.31

NA 0.07 1.38

NA

XXX uptakes. 78003............... .............. A

Thyroid suppress/

0.33 1.08

NA 0.07 1.48

NA

XXX stimul.

[[Page 1210]]

78003............... 26............ A

Thyroid suppress/

0.33 0.11 0.11 0.01 0.45 0.45

XXX stimul. 78003............... TC............ A

Thyroid suppress/

0.00 0.97

NA 0.06 1.03

NA

XXX stimul. 78006............... .............. A

Thyroid imaging with

0.49 2.56

NA 0.15 3.20

NA

XXX uptake. 78006............... 26............ A

Thyroid imaging with

0.49 0.17 0.17 0.02 0.68 0.68

XXX uptake. 78006............... TC............ A

Thyroid imaging with

0.00 2.39

NA 0.13 2.52

NA

XXX uptake. 78007............... .............. A

Thyroid image, mult

0.50 2.76

NA 0.16 3.42

NA

XXX uptakes. 78007............... 26............ A

Thyroid image, mult

0.50 0.17 0.17 0.02 0.69 0.69

XXX uptakes. 78007............... TC............ A

Thyroid image, mult

0.00 2.59

NA 0.14 2.73

NA

XXX uptakes. 78010............... .............. A

Thyroid imaging...... 0.39 1.96

NA 0.13 2.48

NA

XXX 78010............... 26............ A

Thyroid imaging...... 0.39 0.13 0.13 0.02 0.54 0.54

XXX 78010............... TC............ A

Thyroid imaging...... 0.00 1.83

NA 0.11 1.94

NA

XXX 78011............... .............. A

Thyroid imaging with

0.45 2.57

NA 0.15 3.17

NA

XXX flow. 78011............... 26............ A

Thyroid imaging with

0.45 0.15 0.15 0.02 0.62 0.62

XXX flow. 78011............... TC............ A

Thyroid imaging with

0.00 2.42

NA 0.13 2.55

NA

XXX flow. 78015............... .............. A

Thyroid met imaging.. 0.67 2.82

NA 0.18 3.67

NA

XXX 78015............... 26............ A

Thyroid met imaging.. 0.67 0.23 0.23 0.04 0.94 0.94

XXX 78015............... TC............ A

Thyroid met imaging.. 0.00 2.59

NA 0.14 2.73

NA

XXX 78016............... .............. A

Thyroid met imaging/

0.82 3.78

NA 0.22 4.82

NA

XXX studies. 78016............... 26............ A

Thyroid met imaging/

0.82 0.29 0.29 0.04 1.15 1.15

XXX studies. 78016............... TC............ A

Thyroid met imaging/

0.00 3.49

NA 0.18 3.67

NA

XXX studies. 78018............... .............. A

Thyroid met imaging,

0.86 5.75

NA 0.33 6.94

NA

XXX body. 78018............... 26............ A

Thyroid met imaging,

0.86 0.30 0.30 0.04 1.20 1.20

XXX body. 78018............... TC............ A

Thyroid met imaging,

0.00 5.45

NA 0.29 5.74

NA

XXX body. 78020............... .............. A

Thyroid met uptake... 0.60 1.52

NA 0.16 2.28

NA

ZZZ 78020............... 26............ A

Thyroid met uptake... 0.60 0.21 0.21 0.02 0.83 0.83

ZZZ 78020............... TC............ A

Thyroid met uptake... 0.00 1.31

NA 0.14 1.45

NA

ZZZ 78070............... .............. A

Parathyroid nuclear

0.82 2.11

NA 0.15 3.08

NA

XXX imaging. 78070............... 26............ A

Parathyroid nuclear

0.82 0.28 0.28 0.04 1.14 1.14

XXX imaging. 78070............... TC............ A

Parathyroid nuclear

0.00 1.83

NA 0.11 1.94

NA

XXX imaging. 78075............... .............. A

Adrenal nuclear

0.74 5.72

NA 0.33 6.79

NA

XXX imaging. 78075............... 26............ A

Adrenal nuclear

0.74 0.27 0.27 0.04 1.05 1.05

XXX imaging. 78075............... TC............ A

Adrenal nuclear

0.00 5.45

NA 0.29 5.74

NA

XXX imaging. 78099............... .............. C

Endocrine nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 78099............... 26............ C

Endocrine nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 78099............... TC............ C

Endocrine nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 78102............... .............. A

Bone marrow imaging,

0.55 2.24

NA 0.14 2.93

NA

XXX ltd. 78102............... 26............ A

Bone marrow imaging,

0.55 0.20 0.20 0.02 0.77 0.77

XXX ltd. 78102............... TC............ A

Bone marrow imaging,

0.00 2.04

NA 0.12 2.16

NA

XXX ltd. 78103............... .............. A

Bone marrow imaging,

0.75 3.44

NA 0.21 4.40

NA

XXX mult. 78103............... 26............ A

Bone marrow imaging,

0.75 0.26 0.26 0.04 1.05 1.05

XXX mult. 78103............... TC............ A

Bone marrow imaging,

0.00 3.18

NA 0.17 3.35

NA

XXX mult. 78104............... .............. A

Bone marrow imaging,

0.80 4.36

NA 0.26 5.42

NA

XXX body. 78104............... 26............ A

Bone marrow imaging,

0.80 0.27 0.27 0.04 1.11 1.11

XXX body. 78104............... TC............ A

Bone marrow imaging,

0.00 4.09

NA 0.22 4.31

NA

XXX body. 78110............... .............. A

Plasma volume, single 0.19 1.02

NA 0.07 1.28

NA

XXX 78110............... 26............ A

Plasma volume, single 0.19 0.07 0.07 0.01 0.27 0.27

XXX 78110............... TC............ A

Plasma volume, single 0.00 0.95

NA 0.06 1.01

NA

XXX 78111............... .............. A

Plasma volume,

0.22 2.67

NA 0.15 3.04

NA

XXX multiple. 78111............... 26............ A

Plasma volume,

0.22 0.08 0.08 0.01 0.31 0.31

XXX multiple. 78111............... TC............ A

Plasma volume,

0.00 2.59

NA 0.14 2.73

NA

XXX multiple. 78120............... .............. A

Red cell mass, single 0.23 1.82

NA 0.12 2.17

NA

XXX 78120............... 26............ A

Red cell mass, single 0.23 0.08 0.08 0.01 0.32 0.32

XXX 78120............... TC............ A

Red cell mass, single 0.00 1.74

NA 0.11 1.85

NA

XXX 78121............... .............. A

Red cell mass,

0.32 3.03

NA 0.15 3.50

NA

XXX multiple. 78121............... 26............ A

Red cell mass,

0.32 0.11 0.11 0.01 0.44 0.44

XXX multiple. 78121............... TC............ A

Red cell mass,

0.00 2.92

NA 0.14 3.06

NA

XXX multiple. 78122............... .............. A

Blood volume......... 0.45 4.78

NA 0.26 5.49

NA

XXX 78122............... 26............ A

Blood volume......... 0.45 0.16 0.16 0.02 0.63 0.63

XXX 78122............... TC............ A

Blood volume......... 0.00 4.62

NA 0.24 4.86

NA

XXX 78130............... .............. A

Red cell survival

0.61 3.07

NA 0.18 3.86

NA

XXX study. 78130............... 26............ A

Red cell survival

0.61 0.21 0.21 0.04 0.86 0.86

XXX study. 78130............... TC............ A

Red cell survival

0.00 2.86

NA 0.14 3.00

NA

XXX study. 78135............... .............. A

Red cell survival

0.64 5.11

NA 0.29 6.04

NA

XXX kinetics. 78135............... 26............ A

Red cell survival

0.64 0.22 0.22 0.04 0.90 0.90

XXX kinetics. 78135............... TC............ A

Red cell survival

0.00 4.89

NA 0.25 5.14

NA

XXX kinetics. 78140............... .............. A

Red cell

0.61 4.15

NA 0.25 5.01

NA

XXX sequestration. 78140............... 26............ A

Red cell

0.61 0.20 0.20 0.04 0.85 0.85

XXX sequestration. 78140............... TC............ A

Red cell

0.00 3.95

NA 0.21 4.16

NA

XXX sequestration. 78160............... .............. A

Plasma iron turnover. 0.33 3.80

NA 0.23 4.36

NA

XXX 78160............... 26............ A

Plasma iron turnover. 0.33 0.12 0.12 0.04 0.49 0.49

XXX 78160............... TC............ A

Plasma iron turnover. 0.00 3.68

NA 0.19 3.87

NA

XXX 78162............... .............. A

Radioiron absorption

0.45 3.40

NA 0.18 4.03

NA

XXX exam. 78162............... 26............ A

Radioiron absorption

0.45 0.19 0.19 0.01 0.65 0.65

XXX exam. 78162............... TC............ A

Radioiron absorption

0.00 3.21

NA 0.17 3.38

NA

XXX exam. 78170............... .............. A

Red cell iron

0.41 5.47

NA 0.33 6.21

NA

XXX utilization.

[[Page 1211]]

78170............... 26............ A

Red cell iron

0.41 0.14 0.14 0.05 0.60 0.60

XXX utilization. 78170............... TC............ A

Red cell iron

0.00 5.33

NA 0.28 5.61

NA

XXX utilization. 78172............... .............. C

Total body iron

0.00 0.00 0.00 0.00 0.00 0.00

XXX estimation. 78172............... 26............ A

Total body iron

0.53 0.18 0.18 0.02 0.73 0.73

XXX estimation. 78172............... TC............ C

Total body iron

0.00 0.00 0.00 0.00 0.00 0.00

XXX estimation. 78185............... .............. A

Spleen imaging....... 0.40 2.51

NA 0.15 3.06

NA

XXX 78185............... 26............ A

Spleen imaging....... 0.40 0.14 0.14 0.02 0.56 0.56

XXX 78185............... TC............ A

Spleen imaging....... 0.00 2.37

NA 0.13 2.50

NA

XXX 78190............... .............. A

Platelet survival,

1.09 6.12

NA 0.37 7.58

NA

XXX kinetics. 78190............... 26............ A

Platelet survival,

1.09 0.39 0.39 0.07 1.55 1.55

XXX kinetics. 78190............... TC............ A

Platelet survival,

0.00 5.73

NA 0.30 6.03

NA

XXX kinetics. 78191............... .............. A

Platelet survival.... 0.61 7.56

NA 0.41 8.58

NA

XXX 78191............... 26............ A

Platelet survival.... 0.61 0.20 0.20 0.04 0.85 0.85

XXX 78191............... TC............ A

Platelet survival.... 0.00 7.36

NA 0.37 7.73

NA

XXX 78195............... .............. A

Lymph system imaging. 1.20 4.50

NA 0.28 5.98

NA

XXX 78195............... 26............ A

Lymph system imaging. 1.20 0.41 0.41 0.06 1.67 1.67

XXX 78195............... TC............ A

Lymph system imaging. 0.00 4.09

NA 0.22 4.31

NA

XXX 78199............... .............. C

Blood/lymph nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78199............... 26............ C

Blood/lymph nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78199............... TC............ C

Blood/lymph nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78201............... .............. A

Liver imaging........ 0.44 2.52

NA 0.15 3.11

NA

XXX 78201............... 26............ A

Liver imaging........ 0.44 0.15 0.15 0.02 0.61 0.61

XXX 78201............... TC............ A

Liver imaging........ 0.00 2.37

NA 0.13 2.50

NA

XXX 78202............... .............. A

Liver imaging with

0.51 3.07

NA 0.16 3.74

NA

XXX flow. 78202............... 26............ A

Liver imaging with

0.51 0.18 0.18 0.02 0.71 0.71

XXX flow. 78202............... TC............ A

Liver imaging with

0.00 2.89

NA 0.14 3.03

NA

XXX flow. 78205............... .............. A

Liver imaging (3D)... 0.71 6.18

NA 0.35 7.24

NA

XXX 78205............... 26............ A

Liver imaging (3D)... 0.71 0.25 0.25 0.04 1.00 1.00

XXX 78205............... TC............ A

Liver imaging (3D)... 0.00 5.93

NA 0.31 6.24

NA

XXX 78206............... .............. A

Liver image (3d) with 0.96 6.27

NA 0.16 7.39

NA

XXX flow. 78206............... 26............ A

Liver image (3d) with 0.96 0.34 0.34 0.05 1.35 1.35

XXX flow. 78206............... TC............ A

Liver image (3d) with 0.00 5.93

NA 0.11 6.04

NA

XXX flow. 78215............... .............. A

Liver and spleen

0.49 3.12

NA 0.16 3.77

NA

XXX imaging. 78215............... 26............ A

Liver and spleen

0.49 0.17 0.17 0.02 0.68 0.68

XXX imaging. 78215............... TC............ A

Liver and spleen

0.00 2.95

NA 0.14 3.09

NA

XXX imaging. 78216............... .............. A

Liver & spleen image/ 0.57 3.69

NA 0.20 4.46

NA

XXX flow. 78216............... 26............ A

Liver & spleen image/ 0.57 0.20 0.20 0.02 0.79 0.79

XXX flow. 78216............... TC............ A

Liver & spleen image/ 0.00 3.49

NA 0.18 3.67

NA

XXX flow. 78220............... .............. A

Liver function study. 0.49 3.91

NA 0.21 4.61

NA

XXX 78220............... 26............ A

Liver function study. 0.49 0.17 0.17 0.02 0.68 0.68

XXX 78220............... TC............ A

Liver function study. 0.00 3.74

NA 0.19 3.93

NA

XXX 78223............... .............. A

Hepatobiliary imaging 0.84 3.96

NA 0.24 5.04

NA

XXX 78223............... 26............ A

Hepatobiliary imaging 0.84 0.28 0.28 0.05 1.17 1.17

XXX 78223............... TC............ A

Hepatobiliary imaging 0.00 3.68

NA 0.19 3.87

NA

XXX 78230............... .............. A

Salivary gland

0.45 2.33

NA 0.15 2.93

NA

XXX imaging. 78230............... 26............ A

Salivary gland

0.45 0.15 0.15 0.02 0.62 0.62

XXX imaging. 78230............... TC............ A

Salivary gland

0.00 2.18

NA 0.13 2.31

NA

XXX imaging. 78231............... .............. A

Serial salivary

0.52 3.37

NA 0.19 4.08

NA

XXX imaging. 78231............... 26............ A

Serial salivary

0.52 0.19 0.19 0.02 0.73 0.73

XXX imaging. 78231............... TC............ A

Serial salivary

0.00 3.18

NA 0.17 3.35

NA

XXX imaging. 78232............... .............. A

Salivary gland

0.47 3.72

NA 0.19 4.38

NA

XXX function exam. 78232............... 26............ A

Salivary gland

0.47 0.17 0.17 0.01 0.65 0.65

XXX function exam. 78232............... TC............ A

Salivary gland

0.00 3.55

NA 0.18 3.73

NA

XXX function exam. 78258............... .............. A

Esophageal motility

0.74 3.14

NA 0.18 4.06

NA

XXX study. 78258............... 26............ A

Esophageal motility

0.74 0.25 0.25 0.04 1.03 1.03

XXX study. 78258............... TC............ A

Esophageal motility

0.00 2.89

NA 0.14 3.03

NA

XXX study. 78261............... .............. A

Gastric mucosa

0.69 4.36

NA 0.26 5.31

NA

XXX imaging. 78261............... 26............ A

Gastric mucosa

0.69 0.25 0.25 0.04 0.98 0.98

XXX imaging. 78261............... TC............ A

Gastric mucosa

0.00 4.11

NA 0.22 4.33

NA

XXX imaging. 78262............... .............. A

Gastroesophageal

0.68 4.51

NA 0.26 5.45

NA

XXX reflux exam. 78262............... 26............ A

Gastroesophageal

0.68 0.24 0.24 0.04 0.96 0.96

XXX reflux exam. 78262............... TC............ A

Gastroesophageal

0.00 4.27

NA 0.22 4.49

NA

XXX reflux exam. 78264............... .............. A

Gastric emptying

0.78 4.41

NA 0.26 5.45

NA

XXX study. 78264............... 26............ A

Gastric emptying

0.78 0.27 0.27 0.04 1.09 1.09

XXX study. 78264............... TC............ A

Gastric emptying

0.00 4.14

NA 0.22 4.36

NA

XXX study. 78267............... .............. X

Breath tst attain/

0.00 0.00 0.00 0.00 0.00 0.00

XXX anal c-14. 78268............... .............. X

Breath test analysis, 0.00 0.00 0.00 0.00 0.00 0.00

XXX c-14. 78270............... .............. A

Vit B-12 absorption

0.20 1.62

NA 0.11 1.93

NA

XXX exam. 78270............... 26............ A

Vit B-12 absorption

0.20 0.07 0.07 0.01 0.28 0.28

XXX exam. 78270............... TC............ A

Vit B-12 absorption

0.00 1.55

NA 0.10 1.65

NA

XXX exam. 78271............... .............. A

Vit b-12 absrp exam,

0.20 1.72

NA 0.11 2.03

NA

XXX int fac. 78271............... 26............ A

Vit b-12 absrp exam,

0.20 0.07 0.07 0.01 0.28 0.28

XXX int fac. 78271............... TC............ A

Vit b-12 absrp exam,

0.00 1.65

NA 0.10 1.75

NA

XXX int fac. 78272............... .............. A

Vit B-12 absorp,

0.27 2.43

NA 0.14 2.84

NA

XXX combined. 78272............... 26............ A

Vit B-12 absorp,

0.27 0.10 0.10 0.01 0.38 0.38

XXX combined.

[[Page 1212]]

78272............... TC............ A

Vit B-12 absorp,

0.00 2.33

NA 0.13 2.46

NA

XXX combined. 78278............... .............. A

Acute GI blood loss

0.99 5.23

NA 0.30 6.52

NA

XXX imaging. 78278............... 26............ A

Acute GI blood loss

0.99 0.34 0.34 0.05 1.38 1.38

XXX imaging. 78278............... TC............ A

Acute GI blood loss

0.00 4.89

NA 0.25 5.14

NA

XXX imaging. 78282............... .............. C

GI protein loss exam. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78282............... 26............ A

GI protein loss exam. 0.38 0.13 0.13 0.02 0.53 0.53

XXX 78282............... TC............ C

GI protein loss exam. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78290............... .............. A

Meckel's divert exam. 0.68 3.29

NA 0.20 4.17

NA

XXX 78290............... 26............ A

Meckel's divert exam. 0.68 0.23 0.23 0.04 0.95 0.95

XXX 78290............... TC............ A

Meckel's divert exam. 0.00 3.06

NA 0.16 3.22

NA

XXX 78291............... .............. A

Leveen/shunt patency

0.88 3.38

NA 0.21 4.47

NA

XXX exam. 78291............... 26............ A

Leveen/shunt patency

0.88 0.30 0.30 0.05 1.23 1.23

XXX exam. 78291............... TC............ A

Leveen/shunt patency

0.00 3.08

NA 0.16 3.24

NA

XXX exam. 78299............... .............. C

GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78299............... 26............ C

GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78299............... TC............ C

GI nuclear procedure. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78300............... .............. A

Bone imaging, limited 0.62 2.71

NA 0.18 3.51

NA

XXX area. 78300............... 26............ A

Bone imaging, limited 0.62 0.21 0.21 0.04 0.87 0.87

XXX area. 78300............... TC............ A

Bone imaging, limited 0.00 2.50

NA 0.14 2.64

NA

XXX area. 78305............... .............. A

Bone imaging,

0.83 3.96

NA 0.23 5.02

NA

XXX multiple areas. 78305............... 26............ A

Bone imaging,

0.83 0.28 0.28 0.04 1.15 1.15

XXX multiple areas. 78305............... TC............ A

Bone imaging,

0.00 3.68

NA 0.19 3.87

NA

XXX multiple areas. 78306............... .............. A

Bone imaging, whole

0.86 4.58

NA 0.27 5.71

NA

XXX body. 78306............... 26............ A

Bone imaging, whole

0.86 0.29 0.29 0.05 1.20 1.20

XXX body. 78306............... TC............ A

Bone imaging, whole

0.00 4.29

NA 0.22 4.51

NA

XXX body. 78315............... .............. A

Bone imaging, 3 phase 1.02 5.15

NA 0.30 6.47

NA

XXX 78315............... 26............ A

Bone imaging, 3 phase 1.02 0.35 0.35 0.05 1.42 1.42

XXX 78315............... TC............ A

Bone imaging, 3 phase 0.00 4.80

NA 0.25 5.05

NA

XXX 78320............... .............. A

Bone imaging (3D).... 1.04 6.30

NA 0.36 7.70

NA

XXX 78320............... 26............ A

Bone imaging (3D).... 1.04 0.37 0.37 0.05 1.46 1.46

XXX 78320............... TC............ A

Bone imaging (3D).... 0.00 5.93

NA 0.31 6.24

NA

XXX 78350............... .............. A

Bone mineral, single

0.22 0.83

NA 0.06 1.11

NA

XXX photon. 78350............... 26............ A

Bone mineral, single

0.22 0.07 0.07 0.01 0.30 0.30

XXX photon. 78350............... TC............ A

Bone mineral, single

0.00 0.76

NA 0.05 0.81

NA

XXX photon. 78351............... .............. N

Bone mineral, dual

+0.30 1.72 0.12 0.01 2.03 0.43

XXX photon. 78399............... .............. C

Musculoskeletal

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78399............... 26............ C

Musculoskeletal

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78399............... TC............ C

Musculoskeletal

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78414............... .............. C

Non-imaging heart

0.00 0.00 0.00 0.00 0.00 0.00

XXX function. 78414............... 26............ A

Non-imaging heart

0.45 0.16 0.16 0.02 0.63 0.63

XXX function. 78414............... TC............ C

Non-imaging heart

0.00 0.00 0.00 0.00 0.00 0.00

XXX function. 78428............... .............. A

Cardiac shunt imaging 0.78 2.56

NA 0.17 3.51

NA

XXX 78428............... 26............ A

Cardiac shunt imaging 0.78 0.30 0.30 0.04 1.12 1.12

XXX 78428............... TC............ A

Cardiac shunt imaging 0.00 2.26

NA 0.13 2.39

NA

XXX 78445............... .............. A

Vascular flow imaging 0.49 2.04

NA 0.13 2.66

NA

XXX 78445............... 26............ A

Vascular flow imaging 0.49 0.17 0.17 0.02 0.68 0.68

XXX 78445............... TC............ A

Vascular flow imaging 0.00 1.87

NA 0.11 1.98

NA

XXX 78455............... .............. A

Venous thrombosis

0.73 4.25

NA 0.25 5.23

NA

XXX study. 78455............... 26............ A

Venous thrombosis

0.73 0.25 0.25 0.04 1.02 1.02

XXX study. 78455............... TC............ A

Venous thrombosis

0.00 4.00

NA 0.21 4.21

NA

XXX study. 78456............... .............. A

Acute venous thrombus 1.00 4.35

NA 0.34 5.69

NA

XXX image. 78456............... 26............ A

Acute venous thrombus 1.00 0.35 0.35 0.05 1.40 1.40

XXX image. 78456............... TC............ A

Acute venous thrombus 0.00 4.00

NA 0.29 4.29

NA

XXX image. 78457............... .............. A

Venous thrombosis

0.77 2.92

NA 0.18 3.87

NA

XXX imaging. 78457............... 26............ A

Venous thrombosis

0.77 0.26 0.26 0.04 1.07 1.07

XXX imaging. 78457............... TC............ A

Venous thrombosis

0.00 2.66

NA 0.14 2.80

NA

XXX imaging. 78458............... .............. A

Ven thrombosis

0.90 4.37

NA 0.25 5.52

NA

XXX images, bilat. 78458............... 26............ A

Ven thrombosis

0.90 0.33 0.33 0.04 1.27 1.27

XXX images, bilat. 78458............... TC............ A

Ven thrombosis

0.00 4.04

NA 0.21 4.25

NA

XXX images, bilat. 78459............... .............. C

Heart muscle imaging

0.00 0.00 0.00 0.00 0.00 0.00

XXX (PET). 78459............... 26............ R

Heart muscle imaging

1.50 0.57 0.57 0.05 2.12 2.12

XXX (PET). 78459............... TC............ C

Heart muscle imaging

0.00 0.00 0.00 0.00 0.00 0.00

XXX (PET). 78460............... .............. A

Heart muscle blood,

0.86 2.67

NA 0.17 3.70

NA

XXX single. 78460............... 26............ A

Heart muscle blood,

0.86 0.30 0.30 0.04 1.20 1.20

XXX single. 78460............... TC............ A

Heart muscle blood,

0.00 2.37

NA 0.13 2.50

NA

XXX single. 78461............... .............. A

Heart muscle blood,

1.23 5.17

NA 0.31 6.71

NA

XXX multiple. 78461............... 26............ A

Heart muscle blood,

1.23 0.43 0.43 0.06 1.72 1.72

XXX multiple. 78461............... TC............ A

Heart muscle blood,

0.00 4.74

NA 0.25 4.99

NA

XXX multiple. 78464............... .............. A

Heart image (3d),

1.09 7.48

NA 0.42 8.99

NA

XXX single. 78464............... 26............ A

Heart image (3d),

1.09 0.38 0.38 0.05 1.52 1.52

XXX single. 78464............... TC............ A

Heart image (3d),

0.00 7.10

NA 0.37 7.47

NA

XXX single. 78465............... .............. A

Heart image (3d),

1.46 12.35

NA 0.68 14.49

NA

XXX multiple. 78465............... 26............ A

Heart image (3d),

1.46 0.52 0.52 0.06 2.04 2.04

XXX multiple. 78465............... TC............ A

Heart image (3d),

0.00 11.83

NA 0.62 12.45

NA

XXX multiple. 78466............... .............. A

Heart infarct image.. 0.69 2.87

NA 0.18 3.74

NA

XXX

[[Page 1213]]

78466............... 26............ A

Heart infarct image.. 0.69 0.25 0.25 0.04 0.98 0.98

XXX 78466............... TC............ A

Heart infarct image.. 0.00 2.62

NA 0.14 2.76

NA

XXX 78468............... .............. A

Heart infarct image

0.80 3.96

NA 0.23 4.99

NA

XXX (ef). 78468............... 26............ A

Heart infarct image

0.80 0.28 0.28 0.04 1.12 1.12

XXX (ef). 78468............... TC............ A

Heart infarct image

0.00 3.68

NA 0.19 3.87

NA

XXX (ef). 78469............... .............. A

Heart infarct image

0.92 5.56

NA 0.32 6.80

NA

XXX (3D). 78469............... 26............ A

Heart infarct image

0.92 0.32 0.32 0.04 1.28 1.28

XXX (3D). 78469............... TC............ A

Heart infarct image

0.00 5.24

NA 0.28 5.52

NA

XXX (3D). 78472............... .............. A

Gated heart, planar,

0.98 5.88

NA 0.35 7.21

NA

XXX single. 78472............... 26............ A

Gated heart, planar,

0.98 0.35 0.35 0.05 1.38 1.38

XXX single. 78472............... TC............ A

Gated heart, planar,

0.00 5.53

NA 0.30 5.83

NA

XXX single. 78473............... .............. A

Gated heart, multiple 1.47 8.80

NA 0.48 10.75

NA

XXX 78473............... 26............ A

Gated heart, multiple 1.47 0.51 0.51 0.06 2.04 2.04

XXX 78473............... TC............ A

Gated heart, multiple 0.00 8.29

NA 0.42 8.71

NA

XXX 78478............... .............. A

Heart wall motion add- 0.62 1.79

NA 0.12 2.53

NA

XXX on. 78478............... 26............ A

Heart wall motion add- 0.62 0.23 0.23 0.02 0.87 0.87

XXX on. 78478............... TC............ A

Heart wall motion add- 0.00 1.56

NA 0.10 1.66

NA

XXX on. 78480............... .............. A

Heart function add-on 0.62 1.79

NA 0.12 2.53

NA

XXX 78480............... 26............ A

Heart function add-on 0.62 0.23 0.23 0.02 0.87 0.87

XXX 78480............... TC............ A

Heart function add-on 0.00 1.56

NA 0.10 1.66

NA

XXX 78481............... .............. A

Heart first pass,

0.98 5.61

NA 0.32 6.91

NA

XXX single. 78481............... 26............ A

Heart first pass,

0.98 0.37 0.37 0.04 1.39 1.39

XXX single. 78481............... TC............ A

Heart first pass,

0.00 5.24

NA 0.28 5.52

NA

XXX single. 78483............... .............. A

Heart first pass,

1.47 8.43

NA 0.47 10.37

NA

XXX multiple. 78483............... 26............ A

Heart first pass,

1.47 0.54 0.54 0.06 2.07 2.07

XXX multiple. 78483............... TC............ A

Heart first pass,

0.00 7.89

NA 0.41 8.30

NA

XXX multiple. 78491............... .............. I

Heart image (pet),

0.00 0.00 0.00 0.00 0.00 0.00

XXX single. 78491............... 26............ I

Heart image (pet),

+1.50 0.59 0.59 0.06 2.15 2.15

XXX single. 78491............... TC............ I

Heart image (pet),

0.00 0.00 0.00 0.00 0.00 0.00

XXX single. 78492............... .............. I

Heart image (pet),

0.00 0.00 0.00 0.00 0.00 0.00

XXX multiple. 78492............... 26............ I

Heart image (pet),

+1.87 0.74 0.74 0.07 2.68 2.68

XXX multiple. 78492............... TC............ I

Heart image (pet),

0.00 0.00 0.00 0.00 0.00 0.00

XXX multiple. 78494............... .............. A

Heart image, spect... 1.19 7.51

NA 0.35 9.05

NA

XXX 78494............... 26............ A

Heart image, spect... 1.19 0.41 0.41 0.05 1.65 1.65

XXX 78494............... TC............ A

Heart image, spect... 0.00 7.10

NA 0.30 7.40

NA

XXX 78496............... .............. A

Heart first pass add- 0.50 7.28

NA 0.32 8.10

NA

ZZZ on. 78496............... 26............ A

Heart first pass add- 0.50 0.18 0.18 0.02 0.70 0.70

ZZZ on. 78496............... TC............ A

Heart first pass add- 0.00 7.10

NA 0.30 7.40

NA

ZZZ on. 78499............... .............. C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78499............... 26............ C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78499............... TC............ C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78580............... .............. A

Lung perfusion

0.74 3.69

NA 0.22 4.65

NA

XXX imaging. 78580............... 26............ A

Lung perfusion

0.74 0.25 0.25 0.04 1.03 1.03

XXX imaging. 78580............... TC............ A

Lung perfusion

0.00 3.44

NA 0.18 3.62

NA

XXX imaging. 78584............... .............. A

Lung V/Q image single 0.99 3.54

NA 0.22 4.75

NA

XXX breath. 78584............... 26............ A

Lung V/Q image single 0.99 0.33 0.33 0.05 1.37 1.37

XXX breath. 78584............... TC............ A

Lung V/Q image single 0.00 3.21

NA 0.17 3.38

NA

XXX breath. 78585............... .............. A

Lung V/Q imaging..... 1.09 6.02

NA 0.36 7.47

NA

XXX 78585............... 26............ A

Lung V/Q imaging..... 1.09 0.37 0.37 0.06 1.52 1.52

XXX 78585............... TC............ A

Lung V/Q imaging..... 0.00 5.65

NA 0.30 5.95

NA

XXX 78586............... .............. A

Aerosol lung image,

0.40 2.73

NA 0.16 3.29

NA

XXX single. 78586............... 26............ A

Aerosol lung image,

0.40 0.13 0.13 0.02 0.55 0.55

XXX single. 78586............... TC............ A

Aerosol lung image,

0.00 2.60

NA 0.14 2.74

NA

XXX single. 78587............... .............. A

Aerosol lung image,

0.49 2.98

NA 0.16 3.63

NA

XXX multiple. 78587............... 26............ A

Aerosol lung image,

0.49 0.17 0.17 0.02 0.68 0.68

XXX multiple. 78587............... TC............ A

Aerosol lung image,

0.00 2.81

NA 0.14 2.95

NA

XXX multiple. 78588............... .............. A

Perfusion lung image. 1.09 3.58

NA 0.24 4.91

NA

XXX 78588............... 26............ A

Perfusion lung image. 1.09 0.37 0.37 0.06 1.52 1.52

XXX 78588............... TC............ A

Perfusion lung image. 0.00 3.21

NA 0.18 3.39

NA

XXX 78591............... .............. A

Vent image, 1 breath, 0.40 3.00

NA 0.16 3.56

NA

XXX 1 proj. 78591............... 26............ A

Vent image, 1 breath, 0.40 0.14 0.14 0.02 0.56 0.56

XXX 1 proj. 78591............... TC............ A

Vent image, 1 breath, 0.00 2.86

NA 0.14 3.00

NA

XXX 1 proj. 78593............... .............. A

Vent image, 1 proj,

0.49 3.63

NA 0.20 4.32

NA

XXX gas. 78593............... 26............ A

Vent image, 1 proj,

0.49 0.17 0.17 0.02 0.68 0.68

XXX gas. 78593............... TC............ A

Vent image, 1 proj,

0.00 3.46

NA 0.18 3.64

NA

XXX gas. 78594............... .............. A

Vent image, mult

0.53 5.17

NA 0.27 5.97

NA

XXX proj, gas. 78594............... 26............ A

Vent image, mult

0.53 0.18 0.18 0.02 0.73 0.73

XXX proj, gas. 78594............... TC............ A

Vent image, mult

0.00 4.99

NA 0.25 5.24

NA

XXX proj, gas. 78596............... .............. A

Lung differential

1.27 7.52

NA 0.43 9.22

NA

XXX function. 78596............... 26............ A

Lung differential

1.27 0.42 0.42 0.06 1.75 1.75

XXX function. 78596............... TC............ A

Lung differential

0.00 7.10

NA 0.37 7.47

NA

XXX function. 78599............... .............. C

Respiratory nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78599............... 26............ C

Respiratory nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78599............... TC............ C

Respiratory nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78600............... .............. A

Brain imaging, ltd

0.44 3.04

NA 0.16 3.64

NA

XXX static.

[[Page 1214]]

78600............... 26............ A

Brain imaging, ltd

0.44 0.15 0.15 0.02 0.61 0.61

XXX static. 78600............... TC............ A

Brain imaging, ltd

0.00 2.89

NA 0.14 3.03

NA

XXX static. 78601............... .............. A

Brain imaging, ltd w/ 0.51 3.58

NA 0.20 4.29

NA

XXX flow. 78601............... 26............ A

Brain imaging, ltd w/ 0.51 0.17 0.17 0.02 0.70 0.70

XXX flow. 78601............... TC............ A

Brain imaging, ltd w/ 0.00 3.41

NA 0.18 3.59

NA

XXX flow. 78605............... .............. A

Brain imaging,

0.53 3.60

NA 0.20 4.33

NA

XXX complete. 78605............... 26............ A

Brain imaging,

0.53 0.19 0.19 0.02 0.74 0.74

XXX complete. 78605............... TC............ A

Brain imaging,

0.00 3.41

NA 0.18 3.59

NA

XXX complete. 78606............... .............. A

Brain imaging, compl

0.64 4.10

NA 0.25 4.99

NA

XXX w/flow. 78606............... 26............ A

Brain imaging, compl

0.64 0.22 0.22 0.04 0.90 0.90

XXX w/flow. 78606............... TC............ A

Brain imaging, compl

0.00 3.88

NA 0.21 4.09

NA

XXX w/flow. 78607............... .............. A

Brain imaging (3D)... 1.23 7.01

NA 0.41 8.65

NA

XXX 78607............... 26............ A

Brain imaging (3D)... 1.23 0.43 0.43 0.06 1.72 1.72

XXX 78607............... TC............ A

Brain imaging (3D)... 0.00 6.58

NA 0.35 6.93

NA

XXX 78608............... .............. N

Brain imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78609............... .............. N

Brain imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78610............... .............. A

Brain flow imaging

0.30 1.69

NA 0.11 2.10

NA

XXX only. 78610............... 26............ A

Brain flow imaging

0.30 0.11 0.11 0.01 0.42 0.42

XXX only. 78610............... TC............ A

Brain flow imaging

0.00 1.58

NA 0.10 1.68

NA

XXX only. 78615............... .............. A

Cerebral vascular

0.42 4.02

NA 0.23 4.67

NA

XXX flow image. 78615............... 26............ A

Cerebral vascular

0.42 0.16 0.16 0.02 0.60 0.60

XXX flow image. 78615............... TC............ A

Cerebral vascular

0.00 3.86

NA 0.21 4.07

NA

XXX flow image. 78630............... .............. A

Cerebrospinal fluid

0.68 5.28

NA 0.31 6.27

NA

XXX scan. 78630............... 26............ A

Cerebrospinal fluid

0.68 0.23 0.23 0.04 0.95 0.95

XXX scan. 78630............... TC............ A

Cerebrospinal fluid

0.00 5.05

NA 0.27 5.32

NA

XXX scan. 78635............... .............. A

CSF ventriculography. 0.61 2.80

NA 0.16 3.57

NA

XXX 78635............... 26............ A

CSF ventriculography. 0.61 0.24 0.24 0.02 0.87 0.87

XXX 78635............... TC............ A

CSF ventriculography. 0.00 2.56

NA 0.14 2.70

NA

XXX 78645............... .............. A

CSF shunt evaluation. 0.57 3.64

NA 0.20 4.41

NA

XXX 78645............... 26............ A

CSF shunt evaluation. 0.57 0.20 0.20 0.02 0.79 0.79

XXX 78645............... TC............ A

CSF shunt evaluation. 0.00 3.44

NA 0.18 3.62

NA

XXX 78647............... .............. A

Cerebrospinal fluid

0.90 6.25

NA 0.35 7.50

NA

XXX scan. 78647............... 26............ A

Cerebrospinal fluid

0.90 0.32 0.32 0.04 1.26 1.26

XXX scan. 78647............... TC............ A

Cerebrospinal fluid

0.00 5.93

NA 0.31 6.24

NA

XXX scan. 78650............... .............. A

CSF leakage imaging.. 0.61 4.87

NA 0.26 5.74

NA

XXX 78650............... 26............ A

CSF leakage imaging.. 0.61 0.21 0.21 0.02 0.84 0.84

XXX 78650............... TC............ A

CSF leakage imaging.. 0.00 4.66

NA 0.24 4.90

NA

XXX 78660............... .............. A

Nuclear exam of tear

0.53 2.30

NA 0.14 2.97

NA

XXX flow. 78660............... 26............ A

Nuclear exam of tear

0.53 0.18 0.18 0.02 0.73 0.73

XXX flow. 78660............... TC............ A

Nuclear exam of tear

0.00 2.12

NA 0.12 2.24

NA

XXX flow. 78699............... .............. C

Nervous system

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78699............... 26............ C

Nervous system

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78699............... TC............ C

Nervous system

0.00 0.00 0.00 0.00 0.00 0.00

XXX nuclear exam. 78700............... .............. A

Kidney imaging,

0.45 3.21

NA 0.18 3.84

NA

XXX static. 78700............... 26............ A

Kidney imaging,

0.45 0.15 0.15 0.02 0.62 0.62

XXX static. 78700............... TC............ A

Kidney imaging,

0.00 3.06

NA 0.16 3.22

NA

XXX static. 78701............... .............. A

Kidney imaging with

0.49 3.74

NA 0.20 4.43

NA

XXX flow. 78701............... 26............ A

Kidney imaging with

0.49 0.17 0.17 0.02 0.68 0.68

XXX flow. 78701............... TC............ A

Kidney imaging with

0.00 3.57

NA 0.18 3.75

NA

XXX flow. 78704............... .............. A

Imaging renogram..... 0.74 4.22

NA 0.25 5.21

NA

XXX 78704............... 26............ A

Imaging renogram..... 0.74 0.25 0.25 0.04 1.03 1.03

XXX 78704............... TC............ A

Imaging renogram..... 0.00 3.97

NA 0.21 4.18

NA

XXX 78707............... .............. A

Kidney flow/function

0.96 4.81

NA 0.28 6.05

NA

XXX image. 78707............... 26............ A

Kidney flow/function

0.96 0.33 0.33 0.05 1.34 1.34

XXX image. 78707............... TC............ A

Kidney flow/function

0.00 4.48

NA 0.23 4.71

NA

XXX image. 78708............... .............. A

Kidney flow/function

1.21 4.89

NA 0.29 6.39

NA

XXX image. 78708............... 26............ A

Kidney flow/function

1.21 0.41 0.41 0.06 1.68 1.68

XXX image. 78708............... TC............ A

Kidney flow/function

0.00 4.48

NA 0.23 4.71

NA

XXX image. 78709............... .............. A

Kidney flow/function

1.41 4.95

NA 0.30 6.66

NA

XXX image. 78709............... 26............ A

Kidney flow/function

1.41 0.47 0.47 0.07 1.95 1.95

XXX image. 78709............... TC............ A

Kidney flow/function

0.00 4.48

NA 0.23 4.71

NA

XXX image. 78710............... .............. A

Kidney imaging (3D).. 0.66 6.15

NA 0.35 7.16

NA

XXX 78710............... 26............ A

Kidney imaging (3D).. 0.66 0.22 0.22 0.04 0.92 0.92

XXX 78710............... TC............ A

Kidney imaging (3D).. 0.00 5.93

NA 0.31 6.24

NA

XXX 78715............... .............. A

Renal vascular flow

0.30 1.69

NA 0.11 2.10

NA

XXX exam. 78715............... 26............ A

Renal vascular flow

0.30 0.11 0.11 0.01 0.42 0.42

XXX exam. 78715............... TC............ A

Renal vascular flow

0.00 1.58

NA 0.10 1.68

NA

XXX exam. 78725............... .............. A

Kidney function study 0.38 1.92

NA 0.12 2.42

NA

XXX 78725............... 26............ A

Kidney function study 0.38 0.13 0.13 0.01 0.52 0.52

XXX 78725............... TC............ A

Kidney function study 0.00 1.79

NA 0.11 1.90

NA

XXX 78730............... .............. A

Urinary bladder

0.36 1.59

NA 0.10 2.05

NA

XXX retention. 78730............... 26............ A

Urinary bladder

0.36 0.13 0.13 0.02 0.51 0.51

XXX retention. 78730............... TC............ A

Urinary bladder

0.00 1.46

NA 0.08 1.54

NA

XXX retention. 78740............... .............. A

Ureteral reflux study 0.57 2.31

NA 0.14 3.02

NA

XXX 78740............... 26............ A

Ureteral reflux study 0.57 0.19 0.19 0.02 0.78 0.78

XXX

[[Page 1215]]

78740............... TC............ A

Ureteral reflux study 0.00 2.12

NA 0.12 2.24

NA

XXX 78760............... .............. A

Testicular imaging... 0.66 2.90

NA 0.18 3.74

NA

XXX 78760............... 26............ A

Testicular imaging... 0.66 0.22 0.22 0.04 0.92 0.92

XXX 78760............... TC............ A

Testicular imaging... 0.00 2.68

NA 0.14 2.82

NA

XXX 78761............... .............. A

Testicular imaging/

0.71 3.45

NA 0.21 4.37

NA

XXX flow. 78761............... 26............ A

Testicular imaging/

0.71 0.24 0.24 0.04 0.99 0.99

XXX flow. 78761............... TC............ A

Testicular imaging/

0.00 3.21

NA 0.17 3.38

NA

XXX flow. 78799............... .............. C

Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78799............... 26............ C

Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78799............... TC............ C

Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78800............... .............. A

Tumor imaging,

0.66 3.63

NA 0.22 4.51

NA

XXX limited area. 78800............... 26............ A

Tumor imaging,

0.66 0.22 0.22 0.04 0.92 0.92

XXX limited area. 78800............... TC............ A

Tumor imaging,

0.00 3.41

NA 0.18 3.59

NA

XXX limited area. 78801............... .............. A

Tumor imaging, mult

0.79 4.51

NA 0.26 5.56

NA

XXX areas. 78801............... 26............ A

Tumor imaging, mult

0.79 0.27 0.27 0.04 1.10 1.10

XXX areas. 78801............... TC............ A

Tumor imaging, mult

0.00 4.24

NA 0.22 4.46

NA

XXX areas. 78802............... .............. A

Tumor imaging, whole

0.86 5.85

NA 0.34 7.05

NA

XXX body. 78802............... 26............ A

Tumor imaging, whole

0.86 0.30 0.30 0.04 1.20 1.20

XXX body. 78802............... TC............ A

Tumor imaging, whole

0.00 5.55

NA 0.30 5.85

NA

XXX body. 78803............... .............. A

Tumor imaging (3D)... 1.09 6.96

NA 0.40 8.45

NA

XXX 78803............... 26............ A

Tumor imaging (3D)... 1.09 0.38 0.38 0.05 1.52 1.52

XXX 78803............... TC............ A

Tumor imaging (3D)... 0.00 6.58

NA 0.35 6.93

NA

XXX 78804............... .............. A

Tumor imaging, whole

1.07 4.66

NA 0.34 6.07

NA

XXX body. 78804............... 26............ A

Tumor imaging, whole

1.07 0.37 0.37 0.04 1.48 1.48

XXX body. 78804............... TC............ A

Tumor imaging, whole

0.00 4.29

NA 0.30 4.59

NA

XXX body. 78805............... .............. A

Abscess imaging, ltd

0.73 3.66

NA 0.22 4.61

NA

XXX area. 78805............... 26............ A

Abscess imaging, ltd

0.73 0.25 0.25 0.04 1.02 1.02

XXX area. 78805............... TC............ A

Abscess imaging, ltd

0.00 3.41

NA 0.18 3.59

NA

XXX area. 78806............... .............. A

Abscess imaging,

0.86 6.75

NA 0.39 8.00

NA

XXX whole body. 78806............... 26............ A

Abscess imaging,

0.86 0.30 0.30 0.04 1.20 1.20

XXX whole body. 78806............... TC............ A

Abscess imaging,

0.00 6.45

NA 0.35 6.80

NA

XXX whole body. 78807............... .............. A

Nuclear localization/ 1.09 6.97

NA 0.40 8.46

NA

XXX abscess. 78807............... 26............ A

Nuclear localization/ 1.09 0.39 0.39 0.05 1.53 1.53

XXX abscess. 78807............... TC............ A

Nuclear localization/ 0.00 6.58

NA 0.35 6.93

NA

XXX abscess. 78810............... .............. N

Tumor imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78810............... 26............ N

Tumor imaging (PET).. +1.93 0.74 0.74 0.11 2.78 2.78

XXX 78810............... TC............ N

Tumor imaging (PET).. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 78890............... .............. B

Nuclear medicine data +0.05 1.33

NA 0.07 1.45

NA

XXX proc. 78890............... 26............ B

Nuclear medicine data +0.05 0.02 0.02 0.01 0.08 0.08

XXX proc. 78890............... TC............ B

Nuclear medicine data +0.00 1.31

NA 0.06 1.37

NA

XXX proc. 78891............... .............. B

Nuclear med data proc +0.10 2.66

NA 0.14 2.90

NA

XXX 78891............... 26............ B

Nuclear med data proc +0.10 0.04 0.04 0.01 0.15 0.15

XXX 78891............... TC............ B

Nuclear med data proc +0.00 2.62

NA 0.13 2.75

NA

XXX 78990............... .............. I

Provide diag

0.00 0.00 0.00 0.00 0.00 0.00

XXX radionuclide(s). 78999............... .............. C

Nuclear diagnostic

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78999............... 26............ C

Nuclear diagnostic

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 78999............... TC............ C

Nuclear diagnostic

0.00 0.00 0.00 0.00 0.00 0.00

XXX exam. 79000............... .............. A

Init hyperthyroid

1.80 3.22

NA 0.22 5.24

NA

XXX therapy. 79000............... 26............ A

Init hyperthyroid

1.80 0.60 0.60 0.08 2.48 2.48

XXX therapy. 79000............... TC............ A

Init hyperthyroid

0.00 2.62

NA 0.14 2.76

NA

XXX therapy. 79001............... .............. A

Repeat hyperthyroid

1.05 1.67

NA 0.12 2.84

NA

XXX therapy. 79001............... 26............ A

Repeat hyperthyroid

1.05 0.36 0.36 0.05 1.46 1.46

XXX therapy. 79001............... TC............ A

Repeat hyperthyroid

0.00 1.31

NA 0.07 1.38

NA

XXX therapy. 79020............... .............. A

Thyroid ablation..... 1.81 3.22

NA 0.22 5.25

NA

XXX 79020............... 26............ A

Thyroid ablation..... 1.81 0.60 0.60 0.08 2.49 2.49

XXX 79020............... TC............ A

Thyroid ablation..... 0.00 2.62

NA 0.14 2.76

NA

XXX 79030............... .............. A

Thyroid ablation,

2.10 3.33

NA 0.24 5.67

NA

XXX carcinoma. 79030............... 26............ A

Thyroid ablation,

2.10 0.71 0.71 0.10 2.91 2.91

XXX carcinoma. 79030............... TC............ A

Thyroid ablation,

0.00 2.62

NA 0.14 2.76

NA

XXX carcinoma. 79035............... .............. A

Thyroid metastatic

2.52 3.50

NA 0.25 6.27

NA

XXX therapy. 79035............... 26............ A

Thyroid metastatic

2.52 0.88 0.88 0.11 3.51 3.51

XXX therapy. 79035............... TC............ A

Thyroid metastatic

0.00 2.62

NA 0.14 2.76

NA

XXX therapy. 79100............... .............. A

Hematopoetic nuclear

1.32 3.08

NA 0.20 4.60

NA

XXX therapy. 79100............... 26............ A

Hematopoetic nuclear

1.32 0.46 0.46 0.06 1.84 1.84

XXX therapy. 79100............... TC............ A

Hematopoetic nuclear

0.00 2.62

NA 0.14 2.76

NA

XXX therapy. 79200............... .............. A

Intracavitary nuclear 1.99 3.31

NA 0.22 5.52

NA

XXX trmt. 79200............... 26............ A

Intracavitary nuclear 1.99 0.69 0.69 0.08 2.76 2.76

XXX trmt. 79200............... TC............ A

Intracavitary nuclear 0.00 2.62

NA 0.14 2.76

NA

XXX trmt. 79300............... .............. C

Interstitial nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 79300............... 26............ A

Interstitial nuclear

1.60 0.56 0.56 0.08 2.24 2.24

XXX therapy. 79300............... TC............ C

Interstitial nuclear

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 79400............... .............. A

Nonhemato nuclear

1.96 3.29

NA 0.24 5.49

NA

XXX therapy. 79400............... 26............ A

Nonhemato nuclear

1.96 0.67 0.67 0.10 2.73 2.73

XXX therapy. 79400............... TC............ A

Nonhemato nuclear

0.00 2.62

NA 0.14 2.76

NA

XXX therapy. 79403............... .............. A

Hematopoetic nuclear

2.25 5.19

NA 0.24 7.68

NA

XXX therapy.

[[Page 1216]]

79403............... 26............ A

Hematopoetic nuclear

2.25 0.90 0.90 0.10 3.25 3.25

XXX therapy. 79403............... TC............ A

Hematopoetic nuclear

0.00 4.29

NA 0.14 4.43

NA

XXX therapy. 79420............... .............. C

Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00

XXX ther. 79420............... 26............ A

Intravascular nuclear 1.51 0.49 0.49 0.07 2.07 2.07

XXX ther. 79420............... TC............ C

Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00

XXX ther. 79440............... .............. A

Nuclear joint therapy 1.99 3.34

NA 0.24 5.57

NA

XXX 79440............... 26............ A

Nuclear joint therapy 1.99 0.72 0.72 0.10 2.81 2.81

XXX 79440............... TC............ A

Nuclear joint therapy 0.00 2.62

NA 0.14 2.76

NA

XXX 79900............... .............. C

Provide ther

0.00 0.00 0.00 0.00 0.00 0.00

XXX radiopharm(s). 79999............... .............. C

Nuclear medicine

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 79999............... 26............ C

Nuclear medicine

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 79999............... TC............ C

Nuclear medicine

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 80500............... .............. A

Lab pathology

0.37 0.22 0.16 0.01 0.60 0.54

XXX consultation. 80502............... .............. A

Lab pathology

1.33 0.62 0.58 0.06 2.01 1.97

XXX consultation. 83020............... 26............ A

Hemoglobin

0.37 0.16 0.16 0.01 0.54 0.54

XXX electrophoresis. 83912............... 26............ A

Genetic examination.. 0.37 0.15 0.15 0.01 0.53 0.53

XXX 84165............... 26............ A

Electrophoreisis of

0.37 0.16 0.16 0.01 0.54 0.54

XXX proteins. 84181............... 26............ A

Western blot test.... 0.37 0.14 0.14 0.01 0.52 0.52

XXX 84182............... 26............ A

Protein, western blot 0.37 0.17 0.16 0.01 0.55 0.54

XXX test. 85060............... .............. A

Blood smear

0.45 0.20 0.20 0.02 0.67 0.67

XXX interpretation. 85097............... .............. A

Bone marrow

0.94 1.75 0.41 0.04 2.73 1.39

XXX interpretation. 85390............... 26............ A

Fibrinolysins screen. 0.37 0.15 0.15 0.01 0.53 0.53

XXX 85396............... .............. A

Clotting assay, whole 0.37

NA 0.17 0.04

NA 0.58

XXX blood. 85576............... 26............ A

Blood platelet

0.37 0.17 0.16 0.01 0.55 0.54

XXX aggregation. 86077............... .............. A

Physician blood bank

0.94 0.46 0.41 0.04 1.44 1.39

XXX service. 86078............... .............. A

Physician blood bank

0.94 0.49 0.40 0.04 1.47 1.38

XXX service. 86079............... .............. A

Physician blood bank

0.94 0.49 0.41 0.04 1.47 1.39

XXX service. 86255............... 26............ A

Fluorescent antibody, 0.37 0.17 0.16 0.01 0.55 0.54

XXX screen. 86256............... 26............ A

Fluorescent antibody, 0.37 0.16 0.16 0.01 0.54 0.54

XXX titer. 86320............... 26............ A

Serum

0.37 0.16 0.16 0.01 0.54 0.54

XXX immunoelectrophoresi s. 86325............... 26............ A

Other

0.37 0.16 0.16 0.01 0.54 0.54

XXX immunoelectrophoresi s. 86327............... 26............ A

Immunoelectrophoresis 0.42 0.19 0.19 0.01 0.62 0.62

XXX assay. 86334............... 26............ A

Immunofixation

0.37 0.16 0.16 0.01 0.54 0.54

XXX procedure. 86485............... .............. C

Skin test, candida... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 86490............... .............. A

Coccidioidomycosis

0.00 0.29

NA 0.02 0.31

NA

XXX skin test. 86510............... .............. A

Histoplasmosis skin

0.00 0.32

NA 0.02 0.34

NA

XXX test. 86580............... .............. A

TB intradermal test.. 0.00 0.26

NA 0.02 0.28

NA

XXX 86585............... .............. A

TB tine test......... 0.00 0.21

NA 0.01 0.22

NA

XXX 86586............... .............. C

Skin test, unlisted.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 87164............... 26............ A

Dark field

0.37 0.12 0.12 0.01 0.50 0.50

XXX examination. 87207............... 26............ A

Smear, special stain. 0.37 0.17 0.16 0.01 0.55 0.54

XXX 88104............... .............. A

Cytopathology, fluids 0.56 0.75

NA 0.04 1.35

NA

XXX 88104............... 26............ A

Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83

XXX 88104............... TC............ A

Cytopathology, fluids 0.00 0.50

NA 0.02 0.52

NA

XXX 88106............... .............. A

Cytopathology, fluids 0.56 0.62

NA 0.04 1.22

NA

XXX 88106............... 26............ A

Cytopathology, fluids 0.56 0.25 0.25 0.02 0.83 0.83

XXX 88106............... TC............ A

Cytopathology, fluids 0.00 0.37

NA 0.02 0.39

NA

XXX 88107............... .............. A

Cytopathology, fluids 0.76 0.98

NA 0.06 1.80

NA

XXX 88107............... 26............ A

Cytopathology, fluids 0.76 0.34 0.34 0.04 1.14 1.14

XXX 88107............... TC............ A

Cytopathology, fluids 0.00 0.64

NA 0.02 0.66

NA

XXX 88108............... .............. A

Cytopath, concentrate 0.56 0.81

NA 0.04 1.41

NA

XXX tech. 88108............... 26............ A

Cytopath, concentrate 0.56 0.25 0.25 0.02 0.83 0.83

XXX tech. 88108............... TC............ A

Cytopath, concentrate 0.00 0.56

NA 0.02 0.58

NA

XXX tech. 88112............... .............. A

Cytopath, cell

1.18 1.98

NA 0.08 3.24

NA

XXX enhance tech. 88112............... 26............ A

Cytopath, cell

1.18 0.51 0.51 0.06 1.75 1.75

XXX enhance tech. 88112............... TC............ A

Cytopath, cell

0.00 1.47

NA 0.02 1.49

NA

XXX enhance tech. 88125............... .............. A

Forensic

0.26 0.26

NA 0.02 0.54

NA

XXX cytopathology. 88125............... 26............ A

Forensic

0.26 0.12 0.12 0.01 0.39 0.39

XXX cytopathology. 88125............... TC............ A

Forensic

0.00 0.14

NA 0.01 0.15

NA

XXX cytopathology. 88141............... .............. A

Cytopath, c/v,

0.42 0.18 0.18 0.01 0.61 0.61

XXX interpret. 88160............... .............. A

Cytopath smear, other 0.50 0.92

NA 0.04 1.46

NA

XXX source. 88160............... 26............ A

Cytopath smear, other 0.50 0.22 0.22 0.02 0.74 0.74

XXX source. 88160............... TC............ A

Cytopath smear, other 0.00 0.70

NA 0.02 0.72

NA

XXX source. 88161............... .............. A

Cytopath smear, other 0.50 0.88

NA 0.04 1.42

NA

XXX source. 88161............... 26............ A

Cytopath smear, other 0.50 0.22 0.22 0.02 0.74 0.74

XXX source. 88161............... TC............ A

Cytopath smear, other 0.00 0.66

NA 0.02 0.68

NA

XXX source. 88162............... .............. A

Cytopath smear, other 0.76 0.68

NA 0.06 1.50

NA

XXX source. 88162............... 26............ A

Cytopath smear, other 0.76 0.34 0.34 0.04 1.14 1.14

XXX source. 88162............... TC............ A

Cytopath smear, other 0.00 0.34

NA 0.02 0.36

NA

XXX source. 88172............... .............. A

Cytopathology eval of 0.60 0.66

NA 0.04 1.30

NA

XXX fna. 88172............... 26............ A

Cytopathology eval of 0.60 0.27 0.27 0.02 0.89 0.89

XXX fna. 88172............... TC............ A

Cytopathology eval of 0.00 0.39

NA 0.02 0.41

NA

XXX fna. 88173............... .............. A

Cytopath eval, fna,

1.39 1.75

NA 0.08 3.22

NA

XXX report. 88173............... 26............ A

Cytopath eval, fna,

1.39 0.60 0.60 0.06 2.05 2.05

XXX report. 88173............... TC............ A

Cytopath eval, fna,

0.00 1.15

NA 0.02 1.17

NA

XXX report.

[[Page 1217]]

88180............... .............. A

Cell marker study.... 0.36 1.43

NA 0.03 1.82

NA

XXX 88180............... 26............ A

Cell marker study.... 0.36 0.16 0.16 0.01 0.53 0.53

XXX 88180............... TC............ A

Cell marker study.... 0.00 1.27

NA 0.02 1.29

NA

XXX 88182............... .............. A

Cell marker study.... 0.77 1.59

NA 0.08 2.44

NA

XXX 88182............... 26............ A

Cell marker study.... 0.77 0.34 0.34 0.04 1.15 1.15

XXX 88182............... TC............ A

Cell marker study.... 0.00 1.25

NA 0.04 1.29

NA

XXX 88199............... .............. C

Cytopathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 88199............... 26............ C

Cytopathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 88199............... TC............ C

Cytopathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 88291............... .............. A

Cyto/molecular report 0.52 0.28 0.28 0.02 0.82 0.82

XXX 88299............... .............. C

Cytogenetic study.... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 88300............... .............. A

Surgical path, gross. 0.08 0.28

NA 0.02 0.38

NA

XXX 88300............... 26............ A

Surgical path, gross. 0.08 0.04 0.04 0.01 0.13 0.13

XXX 88300............... TC............ A

Surgical path, gross. 0.00 0.24

NA 0.01 0.25

NA

XXX 88302............... .............. A

Tissue exam by

0.13 0.69

NA 0.03 0.85

NA

XXX pathologist. 88302............... 26............ A

Tissue exam by

0.13 0.06 0.06 0.01 0.20 0.20

XXX pathologist. 88302............... TC............ A

Tissue exam by

0.00 0.63

NA 0.02 0.65

NA

XXX pathologist. 88304............... .............. A

Tissue exam by

0.22 0.87

NA 0.03 1.12

NA

XXX pathologist. 88304............... 26............ A

Tissue exam by

0.22 0.10 0.10 0.01 0.33 0.33

XXX pathologist. 88304............... TC............ A

Tissue exam by

0.00 0.77

NA 0.02 0.79

NA

XXX pathologist. 88305............... .............. A

Tissue exam by

0.75 1.74

NA 0.06 2.55

NA

XXX pathologist. 88305............... 26............ A

Tissue exam by

0.75 0.34 0.34 0.02 1.11 1.11

XXX pathologist. 88305............... TC............ A

Tissue exam by

0.00 1.40

NA 0.04 1.44

NA

XXX pathologist. 88307............... .............. A

Tissue exam by

1.59 2.65

NA 0.13 4.37

NA

XXX pathologist. 88307............... 26............ A

Tissue exam by

1.59 0.69 0.69 0.07 2.35 2.35

XXX pathologist. 88307............... TC............ A

Tissue exam by

0.00 1.96

NA 0.06 2.02

NA

XXX pathologist. 88309............... .............. A

Tissue exam by

2.28 3.25

NA 0.16 5.69

NA

XXX pathologist. 88309............... 26............ A

Tissue exam by

2.28 1.00 1.00 0.10 3.38 3.38

XXX pathologist. 88309............... TC............ A

Tissue exam by

0.00 2.25

NA 0.06 2.31

NA

XXX pathologist. 88311............... .............. A

Decalcify tissue..... 0.24 0.20

NA 0.02 0.46

NA

XXX 88311............... 26............ A

Decalcify tissue..... 0.24 0.11 0.11 0.01 0.36 0.36

XXX 88311............... TC............ A

Decalcify tissue..... 0.00 0.09

NA 0.01 0.10

NA

XXX 88312............... .............. A

Special stains....... 0.54 1.35

NA 0.03 1.92

NA

XXX 88312............... 26............ A

Special stains....... 0.54 0.24 0.24 0.02 0.80 0.80

XXX 88312............... TC............ A

Special stains....... 0.00 1.11

NA 0.01 1.12

NA

XXX 88313............... .............. A

Special stains....... 0.24 1.09

NA 0.02 1.35

NA

XXX 88313............... 26............ A

Special stains....... 0.24 0.11 0.11 0.01 0.36 0.36

XXX 88313............... TC............ A

Special stains....... 0.00 0.98

NA 0.01 0.99

NA

XXX 88314............... .............. A

Histochemical stain.. 0.45 0.89

NA 0.04 1.38

NA

XXX 88314............... 26............ A

Histochemical stain.. 0.45 0.20 0.20 0.02 0.67 0.67

XXX 88314............... TC............ A

Histochemical stain.. 0.00 0.69

NA 0.02 0.71

NA

XXX 88318............... .............. A

Chemical

0.42 0.80

NA 0.02 1.24

NA

XXX histochemistry. 88318............... 26............ A

Chemical

0.42 0.19 0.19 0.01 0.62 0.62

XXX histochemistry. 88318............... TC............ A

Chemical

0.00 0.61

NA 0.01 0.62

NA

XXX histochemistry. 88319............... .............. A

Enzyme histochemistry 0.53 1.89

NA 0.04 2.46

NA

XXX 88319............... 26............ A

Enzyme histochemistry 0.53 0.23 0.23 0.02 0.78 0.78

XXX 88319............... TC............ A

Enzyme histochemistry 0.00 1.66

NA 0.02 1.68

NA

XXX 88321............... .............. A

Microslide

1.30 0.82 0.56 0.05 2.17 1.91

XXX consultation. 88323............... .............. A

Microslide

1.35 1.44

NA 0.08 2.87

NA

XXX consultation. 88323............... 26............ A

Microslide

1.35 0.59 0.59 0.06 2.00 2.00

XXX consultation. 88323............... TC............ A

Microslide

0.00 0.85

NA 0.02 0.87

NA

XXX consultation. 88325............... .............. A

Comprehensive review

2.22 2.90 0.97 0.10 5.22 3.29

XXX of data. 88329............... .............. A

Path consult introp.. 0.67 0.63 0.30 0.02 1.32 0.99

XXX 88331............... .............. A

Path consult intraop, 1.19 0.98

NA 0.09 2.26

NA

XXX 1 bloc. 88331............... 26............ A

Path consult intraop, 1.19 0.52 0.52 0.05 1.76 1.76

XXX 1 bloc. 88331............... TC............ A

Path consult intraop, 0.00 0.46

NA 0.04 0.50

NA

XXX 1 bloc. 88332............... .............. A

Path consult intraop, 0.59 0.50

NA 0.04 1.13

NA

XXX add'l. 88332............... 26............ A

Path consult intraop, 0.59 0.26 0.26 0.02 0.87 0.87

XXX add'l. 88332............... TC............ A

Path consult intraop, 0.00 0.24

NA 0.02 0.26

NA

XXX add'l. 88342............... .............. A

Immunohistochemistry. 0.85 1.35

NA 0.06 2.26

NA

XXX 88342............... 26............ A

Immunohistochemistry. 0.85 0.37 0.37 0.04 1.26 1.26

XXX 88342............... TC............ A

Immunohistochemistry. 0.00 0.98

NA 0.02 1.00

NA

XXX 88346............... .............. A

Immunofluorescent

0.86 1.44

NA 0.06 2.36

NA

XXX study. 88346............... 26............ A

Immunofluorescent

0.86 0.37 0.37 0.04 1.27 1.27

XXX study. 88346............... TC............ A

Immunofluorescent

0.00 1.07

NA 0.02 1.09

NA

XXX study. 88347............... .............. A

Immunofluorescent

0.86 1.76

NA 0.06 2.68

NA

XXX study. 88347............... 26............ A

Immunofluorescent

0.86 0.36 0.36 0.04 1.26 1.26

XXX study. 88347............... TC............ A

Immunofluorescent

0.00 1.40

NA 0.02 1.42

NA

XXX study. 88348............... .............. A

Electron microscopy.. 1.51 8.47

NA 0.13 10.11

NA

XXX 88348............... 26............ A

Electron microscopy.. 1.51 0.65 0.65 0.06 2.22 2.22

XXX 88348............... TC............ A

Electron microscopy.. 0.00 7.82

NA 0.07 7.89

NA

XXX 88349............... .............. A

Scanning electron

0.76 9.99

NA 0.10 10.85

NA

XXX microscopy. 88349............... 26............ A

Scanning electron

0.76 0.34 0.34 0.04 1.14 1.14

XXX microscopy. 88349............... TC............ A

Scanning electron

0.00 9.65

NA 0.06 9.71

NA

XXX microscopy. 88355............... .............. A

Analysis, skeletal

1.85 2.60

NA 0.14 4.59

NA

XXX muscle.

[[Page 1218]]

88355............... 26............ A

Analysis, skeletal

1.85 0.80 0.80 0.08 2.73 2.73

XXX muscle. 88355............... TC............ A

Analysis, skeletal

0.00 1.80

NA 0.06 1.86

NA

XXX muscle. 88356............... .............. A

Analysis, nerve...... 3.02 2.87

NA 0.19 6.08

NA

XXX 88356............... 26............ A

Analysis, nerve...... 3.02 1.27 1.27 0.12 4.41 4.41

XXX 88356............... TC............ A

Analysis, nerve...... 0.00 1.60

NA 0.07 1.67

NA

XXX 88358............... .............. A

Analysis, tumor...... 0.95 1.38

NA 0.19 2.52

NA

XXX 88358............... 26............ A

Analysis, tumor...... 0.95 1.23 1.23 0.12 2.30 2.30

XXX 88358............... TC............ A

Analysis, tumor...... 0.00 0.15

NA 0.07 0.22

NA

XXX 88361............... .............. A

Immunohistochemistry, 0.94 2.59

NA 0.19 3.72

NA

XXX tumor. 88361............... 26............ A

Immunohistochemistry, 0.94 0.41 0.41 0.12 1.47 1.47

XXX tumor. 88361............... TC............ A

Immunohistochemistry, 0.00 2.18

NA 0.07 2.25

NA

XXX tumor. 88362............... .............. A

Nerve teasing

2.17 4.40

NA 0.14 6.71

NA

XXX preparations. 88362............... 26............ A

Nerve teasing

2.17 0.93 0.93 0.08 3.18 3.18

XXX preparations. 88362............... TC............ A

Nerve teasing

0.00 3.47

NA 0.06 3.53

NA

XXX preparations. 88365............... .............. A

Tissue hybridization. 0.93 2.21

NA 0.06 3.20

NA

XXX 88365............... 26............ A

Tissue hybridization. 0.93 0.41 0.41 0.04 1.38 1.38

XXX 88365............... TC............ A

Tissue hybridization. 0.00 1.80

NA 0.02 1.82

NA

XXX 88371............... 26............ A

Protein, western blot 0.37 0.13 0.13 0.01 0.51 0.51

XXX tissue. 88372............... 26............ A

Protein analysis w/

0.37 0.17 0.17 0.01 0.55 0.55

XXX probe. 88380............... .............. C

Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 88380............... 26............ C

Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 88380............... TC............ C

Microdissection...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 88399............... .............. C

Surgical pathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 88399............... 26............ C

Surgical pathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 88399............... TC............ C

Surgical pathology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 89060............... 26............ A

Exam,synovial fluid

0.37 0.17 0.16 0.01 0.55 0.54

XXX crystals. 89100............... .............. A

Sample intestinal

0.60 1.60 0.22 0.02 2.22 0.84

XXX contents. 89105............... .............. A

Sample intestinal

0.50 2.24 0.17 0.02 2.76 0.69

XXX contents. 89130............... .............. A

Sample stomach

0.45 1.74 0.13 0.02 2.21 0.60

XXX contents. 89132............... .............. A

Sample stomach

0.19 1.48 0.06 0.01 1.68 0.26

XXX contents. 89135............... .............. A

Sample stomach

0.79 1.59 0.25 0.04 2.42 1.08

XXX contents. 89136............... .............. A

Sample stomach

0.21 1.60 0.09 0.01 1.82 0.31

XXX contents. 89140............... .............. A

Sample stomach

0.94 2.06 0.28 0.04 3.04 1.26

XXX contents. 89141............... .............. A

Sample stomach

0.85 2.72 0.34 0.04 3.61 1.23

XXX contents. 90281............... .............. I

Human ig, im......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90283............... .............. I

Human ig, iv......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90287............... .............. I

Botulinum antitoxin.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90288............... .............. I

Botulism ig, iv...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90291............... .............. I

Cmv ig, iv........... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90296............... .............. E

Diphtheria antitoxin. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90371............... .............. E

Hep b ig, im......... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90375............... .............. E

Rabies ig, im/sc..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90376............... .............. E

Rabies ig, heat

0.00 0.00 0.00 0.00 0.00 0.00

XXX treated. 90378............... .............. X

Rsv ig, im, 50mg..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90379............... .............. I

Rsv ig, iv........... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90384............... .............. I

Rh ig, full-dose, im. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90385............... .............. E

Rh ig, minidose, im.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90386............... .............. I

Rh ig, iv............ 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90389............... .............. I

Tetanus ig, im....... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90393............... .............. E

Vaccina ig, im....... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90396............... .............. E

Varicella-zoster ig,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90399............... .............. I

Immune globulin...... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90471............... .............. A

Immunization admin... 0.00 0.21

NA 0.01 0.22

NA

XXX 90472............... .............. A

Immunization admin,

0.00 0.14

NA 0.01 0.15

NA

ZZZ each add. 90473............... .............. N

Immune admin oral/

0.00 0.00 0.00 0.00 0.00 0.00

XXX nasal. 90474............... .............. N

Immune admin oral/

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ nasal addl. 90476............... .............. E

Adenovirus vaccine,

0.00 0.00 0.00 0.00 0.00 0.00

XXX type 4. 90477............... .............. E

Adenovirus vaccine,

0.00 0.00 0.00 0.00 0.00 0.00

XXX type 7. 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,

0.00 0.00 0.00 0.00 0.00 0.00

XXX intravesical. 90632............... .............. E

Hep a vaccine, adult

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90633............... .............. E

Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00

XXX 2 dose. 90634............... .............. E

Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00

XXX 3 dose. 90636............... .............. E

Hep a/hep b vacc,

0.00 0.00 0.00 0.00 0.00 0.00

XXX adult im. 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,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90647............... .............. E

Hib vaccine, prp-omp, 0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90648............... .............. E

Hib vaccine, prp-t,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90655............... .............. X

Flu vaccine, 6-35 mo, 0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90657............... .............. X

Flu vaccine, 6-35 mo, 0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90658............... .............. X

Flu vaccine, 3 yrs,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90659............... .............. D

Flu vaccine, whole,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90660............... .............. X

Flu vaccine, nasal... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90665............... .............. E

Lyme disease vaccine, 0.00 0.00 0.00 0.00 0.00 0.00

XXX im.

[[Page 1219]]

90669............... .............. N

Pneumococcal vacc,

0.00 0.00 0.00 0.00 0.00 0.00

XXX ped 7 im. 90716............... .............. E

Chicken pox vaccine,

0.00 0.00 0.00 0.00 0.00 0.00

XXX sc. 90717............... .............. E

Yellow fever vaccine, 0.00 0.00 0.00 0.00 0.00 0.00

XXX sc. 90718............... .............. E

Td vaccine 7, im. 90719............... .............. E

Diphtheria vaccine,

0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90720............... .............. E

Dtp/hib vaccine, im.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90721............... .............. E

Dtap/hib vaccine, im. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90723............... .............. I

Dtap-hep b-ipv

0.00 0.00 0.00 0.00 0.00 0.00

XXX vaccine, im. 90725............... .............. E

Cholera vaccine,

0.00 0.00 0.00 0.00 0.00 0.00

XXX injectable. 90727............... .............. E

Plague vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90732............... .............. X

Pneumococcal vaccine. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90733............... .............. E

Meningococcal

0.00 0.00 0.00 0.00 0.00 0.00

XXX vaccine, sc. 90734............... .............. E

Meningococcal

0.00 0.00 0.00 0.00 0.00 0.00

XXX vaccine, im. 90735............... .............. E

Encephalitis vaccine, 0.00 0.00 0.00 0.00 0.00 0.00

XXX sc. 90740............... .............. X

Hepb vacc, ill pat 3

0.00 0.00 0.00 0.00 0.00 0.00

XXX dose im. 90743............... .............. X

Hep b vacc, adol, 2

0.00 0.00 0.00 0.00 0.00 0.00

XXX dose, im. 90744............... .............. X

Hepb vacc ped/adol 3

0.00 0.00 0.00 0.00 0.00 0.00

XXX dose im. 90746............... .............. X

Hep b vaccine, adult, 0.00 0.00 0.00 0.00 0.00 0.00

XXX im. 90747............... .............. X

Hepb vacc, ill pat 4

0.00 0.00 0.00 0.00 0.00 0.00

XXX dose im. 90748............... .............. I

Hep b/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90749............... .............. E

Vaccine toxoid....... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90780............... .............. A

IV infusion therapy,

0.17 2.15

NA 0.07 2.39

NA

XXX 1 hour. 90781............... .............. A

IV infusion,

0.17 0.46

NA 0.04 0.67

NA

ZZZ additional hour. 90782............... .............. T

Injection, sc/im..... 0.17 0.32

NA 0.01 0.50

NA

XXX 90783............... .............. T

Injection, ia........ 0.17 0.32

NA 0.02 0.51

NA

XXX 90784............... .............. T

Injection, iv........ 0.17 0.80

NA 0.04 1.01

NA

XXX 90788............... .............. T

Injection of

0.17 0.27

NA 0.01 0.45

NA

XXX antibiotic. 90799............... .............. C

Ther/prophylactic/dx

0.00 0.00 0.00 0.00 0.00 0.00

XXX inject. 90801............... .............. A

Psy dx interview..... 2.80 1.17 0.94 0.07 4.04 3.81

XXX 90802............... .............. A

Intac psy dx

3.01 1.20 0.98 0.08 4.29 4.07

XXX interview. 90804............... .............. A

Psytx, office, 20-30

1.21 0.49 0.38 0.04 1.74 1.63

XXX min. 90805............... .............. A

Psytx, off, 20-30 min 1.37 0.50 0.42 0.04 1.91 1.83

XXX w/e&m. 90806............... .............. A

Psytx, off, 45-50 min 1.86 0.70 0.60 0.05 2.61 2.51

XXX 90807............... .............. A

Psytx, off, 45-50 min 2.02 0.70 0.63 0.06 2.78 2.71

XXX w/e&m. 90808............... .............. A

Psytx, office, 75-80

2.79 1.03 0.91 0.08 3.90 3.78

XXX min. 90809............... .............. A

Psytx, off, 75-80, w/ 2.95 1.00 0.92 0.08 4.03 3.95

XXX e&m. 90810............... .............. A

Intac psytx, off, 20- 1.32 0.50 0.42 0.04 1.86 1.78

XXX 30 min. 90811............... .............. A

Intac psytx, 20-30, w/ 1.48 0.57 0.46 0.04 2.09 1.98

XXX e&m. 90812............... .............. A

Intac psytx, off, 45- 1.97 0.79 0.64 0.06 2.82 2.67

XXX 50 min. 90813............... .............. A

Intac psytx, 45-50

2.13 0.77 0.67 0.06 2.96 2.86

XXX min w/e&m. 90814............... .............. A

Intac psytx, off, 75- 2.90 1.11 0.99 0.08 4.09 3.97

XXX 80 min. 90815............... .............. A

Intac psytx, 75-80 w/ 3.06 1.05 0.95 0.08 4.19 4.09

XXX e&m. 90816............... .............. A

Psytx, hosp, 20-30

1.25

NA 0.46 0.04

NA 1.75

XXX min. 90817............... .............. A

Psytx, hosp, 20-30

1.41

NA 0.45 0.04

NA 1.90

XXX min w/e&m. 90818............... .............. A

Psytx, hosp, 45-50

1.89

NA 0.69 0.05

NA 2.63

XXX min. 90819............... .............. A

Psytx, hosp, 45-50

2.05

NA 0.65 0.06

NA 2.76

XXX min w/e&m. 90821............... .............. A

Psytx, hosp, 75-80

2.83

NA 1.01 0.07

NA 3.91

XXX min. 90822............... .............. A

Psytx, hosp, 75-80

2.99

NA 0.95 0.08

NA 4.02

XXX min w/e&m. 90823............... .............. A

Intac psytx, hosp, 20- 1.36

NA 0.48 0.04

NA 1.88

XXX 30 min. 90824............... .............. A

Intac psytx, hsp 20-

1.52

NA 0.49 0.04

NA 2.05

XXX 30 w/e&m. 90826............... .............. A

Intac psytx, hosp, 45- 2.01

NA 0.73 0.05

NA 2.79

XXX 50 min. 90827............... .............. A

Intac psytx, hsp 45-

2.16

NA 0.69 0.06

NA 2.91

XXX 50 w/e&m. 90828............... .............. A

Intac psytx, hosp, 75- 2.94

NA 1.07 0.08

NA 4.09

XXX 80 min. 90829............... .............. A

Intac psytx, hsp 75-

3.10

NA 0.99 0.08

NA 4.17

XXX 80 w/e&m.

[[Page 1220]]

90845............... .............. A

Psychoanalysis....... 1.79 0.58 0.55 0.05 2.42 2.39

XXX 90846............... .............. R

Family psytx w/o

1.83 0.65 0.65 0.05 2.53 2.53

XXX patient. 90847............... .............. R

Family psytx w/

2.21 0.82 0.76 0.06 3.09 3.03

XXX patient. 90849............... .............. R

Multiple family group 0.59 0.27 0.24 0.01 0.87 0.84

XXX psytx. 90853............... .............. A

Group psychotherapy.. 0.59 0.25 0.23 0.01 0.85 0.83

XXX 90857............... .............. A

Intac group psytx.... 0.63 0.30 0.26 0.02 0.95 0.91

XXX 90862............... .............. A

Medication management 0.95 0.40 0.32 0.02 1.37 1.29

XXX 90865............... .............. A

Narcosynthesis....... 2.84 1.59 0.89 0.08 4.51 3.81

XXX 90870............... .............. A

Electroconvulsive

1.88 0.79 0.79 0.05 2.72 2.72

000 therapy. 90871............... .............. N

Electroconvulsive

+2.72 1.07 1.07 0.07 3.86 3.86

000 therapy. 90875............... .............. N

Psychophysiological

+1.20 0.90 0.46 0.04 2.14 1.70

XXX therapy. 90876............... .............. N

Psychophysiological

+1.90 1.16 0.73 0.05 3.11 2.68

XXX therapy. 90880............... .............. A

Hypnotherapy......... 2.19 1.04 0.69 0.06 3.29 2.94

XXX 90882............... .............. N

Environmental

0.00 0.00 0.00 0.00 0.00 0.00

XXX manipulation. 90885............... .............. B

Psy evaluation of

+0.97 0.37 0.37 0.02 1.36 1.36

XXX records. 90887............... .............. B

Consultation with

+1.48 0.82 0.56 0.04 2.34 2.08

XXX family. 90889............... .............. B

Preparation of report 0.00 0.00 0.00 0.00 0.00 0.00

XXX 90899............... .............. C

Psychiatric service/

0.00 0.00 0.00 0.00 0.00 0.00

XXX therapy. 90901............... .............. A

Biofeedback train,

0.41 0.66 0.14 0.02 1.09 0.57

000 any meth. 90911............... .............. A

Biofeedback peri/uro/ 0.89 1.61 0.31 0.05 2.55 1.25

000 rectal. 90918............... .............. I

ESRD related

+11.16 7.34 7.34 0.36 18.86 18.86

XXX services, month. 90919............... .............. I

ESRD related

+8.53 4.07 4.07 0.29 12.89 12.89

XXX services, month. 90920............... .............. I

ESRD related

+7.26 3.81 3.81 0.23 11.30 11.30

XXX services, month. 90921............... .............. I

ESRD related

+4.46 2.48 2.48 0.14 7.08 7.08

XXX services, month. 90922............... .............. I

ESRD related

+0.37 0.22 0.22 0.01 0.60 0.60

XXX services, day. 90923............... .............. I

Esrd related

+0.28 0.13 0.13 0.01 0.42 0.42

XXX services, day. 90924............... .............. I

Esrd related

+0.24 0.12 0.12 0.01 0.37 0.37

XXX services, day. 90925............... .............. I

Esrd related

+0.15 0.08 0.08 0.01 0.24 0.24

XXX services, day. 90935............... .............. A

Hemodialysis, one

1.22

NA 0.67 0.04

NA 1.93

000 evaluation. 90937............... .............. A

Hemodialysis,

2.11

NA 0.98 0.07

NA 3.16

000 repeated eval. 90939............... .............. X

Hemodialysis study,

0.00 0.00 0.00 0.00 0.00 0.00

XXX transcut. 90940............... .............. X

Hemodialysis access

0.00 0.00 0.00 0.00 0.00 0.00

XXX study. 90945............... .............. A

Dialysis, one

1.28

NA 0.70 0.05

NA 2.03

000 evaluation. 90947............... .............. A

Dialysis, repeated

2.16

NA 1.01 0.07

NA 3.24

000 eval. 90989............... .............. X

Dialysis training,

0.00 0.00 0.00 0.00 0.00 0.00

XXX complete. 90993............... .............. X

Dialysis training,

0.00 0.00 0.00 0.00 0.00 0.00

XXX incompl. 90997............... .............. A

Hemoperfusion........ 1.84

NA 1.41 0.06

NA 3.31

000 90999............... .............. C

Dialysis procedure... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 91000............... .............. A

Esophageal intubation 0.73 0.33

NA 0.05 1.11

NA

000 91000............... 26............ A

Esophageal intubation 0.73 0.25 0.25 0.04 1.02 1.02

000 91000............... TC............ A

Esophageal intubation 0.00 0.08

NA 0.01 0.09

NA

000 91010............... .............. A

Esophagus motility

1.25 2.71

NA 0.12 4.08

NA

000 study. 91010............... 26............ A

Esophagus motility

1.25 0.43 0.43 0.06 1.74 1.74

000 study. 91010............... TC............ A

Esophagus motility

0.00 2.28

NA 0.06 2.34

NA

000 study. 91011............... .............. A

Esophagus motility

1.50 3.20

NA 0.12 4.82

NA

000 study. 91011............... 26............ A

Esophagus motility

1.50 0.53 0.53 0.06 2.09 2.09

000 study. 91011............... TC............ A

Esophagus motility

0.00 2.67

NA 0.06 2.73

NA

000 study. 91012............... .............. A

Esophagus motility

1.46 3.34

NA 0.14 4.94

NA

000 study. 91012............... 26............ A

Esophagus motility

1.46 0.51 0.51 0.07 2.04 2.04

000 study. 91012............... TC............ A

Esophagus motility

0.00 2.83

NA 0.07 2.90

NA

000 study. 91020............... .............. A

Gastric motility..... 1.44 2.93

NA 0.13 4.50

NA

000 91020............... 26............ A

Gastric motility..... 1.44 0.48 0.48 0.07 1.99 1.99

000 91020............... TC............ A

Gastric motility..... 0.00 2.45

NA 0.06 2.51

NA

000 91030............... .............. A

Acid perfusion of

0.91 2.40

NA 0.06 3.37

NA

000 esophagus. 91030............... 26............ A

Acid perfusion of

0.91 0.33 0.33 0.04 1.28 1.28

000 esophagus. 91030............... TC............ A

Acid perfusion of

0.00 2.07

NA 0.02 2.09

NA

000 esophagus. 91032............... .............. A

Esophagus, acid

1.21 4.10

NA 0.12 5.43

NA

000 reflux test. 91032............... 26............ A

Esophagus, acid

1.21 0.41 0.41 0.06 1.68 1.68

000 reflux test. 91032............... TC............ A

Esophagus, acid

0.00 3.69

NA 0.06 3.75

NA

000 reflux test. 91033............... .............. A

Prolonged acid reflux 1.30 4.16

NA 0.17 5.63

NA

000 test. 91033............... 26............ A

Prolonged acid reflux 1.30 0.45 0.45 0.06 1.81 1.81

000 test. 91033............... TC............ A

Prolonged acid reflux 0.00 3.71

NA 0.11 3.82

NA

000 test. 91052............... .............. A

Gastric analysis test 0.79 2.19

NA 0.06 3.04

NA

000 91052............... 26............ A

Gastric analysis test 0.79 0.28 0.28 0.04 1.11 1.11

000 91052............... TC............ A

Gastric analysis test 0.00 1.91

NA 0.02 1.93

NA

000 91055............... .............. A

Gastric intubation

0.94 2.37

NA 0.07 3.38

NA

000 for smear. 91055............... 26............ A

Gastric intubation

0.94 0.27 0.27 0.05 1.26 1.26

000 for smear. 91055............... TC............ A

Gastric intubation

0.00 2.10

NA 0.02 2.12

NA

000 for smear. 91060............... .............. A

Gastric saline load

0.45 0.30

NA 0.04 0.79

NA

000 test. 91060............... 26............ A

Gastric saline load

0.45 0.14 0.14 0.02 0.61 0.61

000 test. 91060............... TC............ A

Gastric saline load

0.00 0.16

NA 0.02 0.18

NA

000 test. 91065............... .............. A

Breath hydrogen test. 0.20 1.96

NA 0.03 2.19

NA

000 91065............... 26............ A

Breath hydrogen test. 0.20 0.07 0.07 0.01 0.28 0.28

000 91065............... TC............ A

Breath hydrogen test. 0.00 1.89

NA 0.02 1.91

NA

000 91100............... .............. A

Pass intestine

1.08

NA 0.29 0.07

NA 1.44

000 bleeding tube.

[[Page 1221]]

91105............... .............. A

Gastric intubation

0.37

NA 0.09 0.02

NA 0.48

000 treatment. 91110............... .............. A

Gi tract capsule

3.64 21.13

NA 0.09 24.86

NA

XXX endoscopy. 91110............... 26............ A

Gi tract capsule

3.64 1.30 1.30 0.02 4.96 4.96

XXX endoscopy. 91110............... TC............ A

Gi tract capsule

0.00 19.83

NA 0.07 19.90

NA

XXX endoscopy. 91122............... .............. A

Anal pressure record. 1.77 6.06

NA 0.20 8.03

NA

000 91122............... 26............ A

Anal pressure record. 1.77 0.60 0.60 0.12 2.49 2.49

000 91122............... TC............ A

Anal pressure record. 0.00 5.46

NA 0.08 5.54

NA

000 91123............... .............. B

Irrigate fecal

0.00 0.00 0.00 0.00 0.00 0.00

XXX impaction. 91132............... .............. C

Electrogastrography.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 91132............... 26............ A

Electrogastrography.. 0.52 0.19 0.19 0.04 0.75 0.75

XXX 91132............... TC............ C

Electrogastrography.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 91133............... .............. C

Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX test. 91133............... 26............ A

Electrogastrography w/ 0.66 0.24 0.24 0.04 0.94 0.94

XXX test. 91133............... TC............ C

Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX test. 91299............... .............. C

Gastroenterology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 91299............... 26............ C

Gastroenterology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 91299............... TC............ C

Gastroenterology

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 92002............... .............. A

Eye exam, new patient 0.88 0.96 0.35 0.02 1.86 1.25

XXX 92004............... .............. A

Eye exam, new patient 1.67 1.68 0.68 0.04 3.39 2.39

XXX 92012............... .............. A

Eye exam established

0.67 1.02 0.29 0.01 1.70 0.97

XXX pat. 92014............... .............. A

Eye exam & treatment. 1.10 1.38 0.46 0.02 2.50 1.58

XXX 92015............... .............. N

Refraction........... +0.38 1.49 0.15 0.01 1.88 0.54

XXX 92018............... .............. A

New eye exam &

2.50

NA 1.08 0.04

NA 3.62

XXX treatment. 92019............... .............. A

Eye exam & treatment. 1.31

NA 0.56 0.04

NA 1.91

XXX 92020............... .............. A

Special eye

0.37 0.33 0.16 0.01 0.71 0.54

XXX evaluation. 92060............... .............. A

Special eye

0.69 0.72

NA 0.02 1.43

NA

XXX evaluation. 92060............... 26............ A

Special eye

0.69 0.29 0.29 0.01 0.99 0.99

XXX evaluation. 92060............... TC............ A

Special eye

0.00 0.43

NA 0.01 0.44

NA

XXX evaluation. 92065............... .............. A

Orthoptic/pleoptic

0.37 0.54

NA 0.02 0.93

NA

XXX training. 92065............... 26............ A

Orthoptic/pleoptic

0.37 0.15 0.15 0.01 0.53 0.53

XXX training. 92065............... TC............ A

Orthoptic/pleoptic

0.00 0.39

NA 0.01 0.40

NA

XXX training. 92070............... .............. A

Fitting of contact

0.70 1.08 0.32 0.01 1.79 1.03

XXX lens. 92081............... .............. A

Visual field

0.36 0.85

NA 0.02 1.23

NA

XXX examination(s). 92081............... 26............ A

Visual field

0.36 0.15 0.15 0.01 0.52 0.52

XXX examination(s). 92081............... TC............ A

Visual field

0.00 0.70

NA 0.01 0.71

NA

XXX examination(s). 92082............... .............. A

Visual field

0.44 1.15

NA 0.02 1.61

NA

XXX examination(s). 92082............... 26............ A

Visual field

0.44 0.19 0.19 0.01 0.64 0.64

XXX examination(s). 92082............... TC............ A

Visual field

0.00 0.96

NA 0.01 0.97

NA

XXX examination(s). 92083............... .............. A

Visual field

0.50 1.33

NA 0.02 1.85

NA

XXX examination(s). 92083............... 26............ A

Visual field

0.50 0.22 0.22 0.01 0.73 0.73

XXX examination(s). 92083............... TC............ A

Visual field

0.00 1.11

NA 0.01 1.12

NA

XXX examination(s). 92100............... .............. A

Serial tonometry

0.92 1.26 0.37 0.02 2.20 1.31

XXX exam(s). 92120............... .............. A

Tonography & eye

0.81 1.04 0.32 0.02 1.87 1.15

XXX evaluation. 92130............... .............. A

Water provocation

0.81 1.23 0.37 0.02 2.06 1.20

XXX tonography. 92135............... .............. A

Opthalmic dx imaging. 0.35 0.78

NA 0.02 1.15

NA

XXX 92135............... 26............ A

Opthalmic dx imaging. 0.35 0.16 0.16 0.01 0.52 0.52

XXX 92135............... TC............ A

Opthalmic dx imaging. 0.00 0.62

NA 0.01 0.63

NA

XXX 92136............... .............. A

Ophthalmic biometry.. 0.54 1.75

NA 0.08 2.37

NA

XXX 92136............... 26............ A

Ophthalmic biometry.. 0.54 0.25 0.25 0.01 0.80 0.80

XXX 92136............... TC............ A

Ophthalmic biometry.. 0.00 1.50

NA 0.07 1.57

NA

XXX 92140............... .............. A

Glaucoma provocative

0.50 0.94 0.21 0.01 1.45 0.72

XXX tests. 92225............... .............. A

Special eye exam,

0.38 0.22 0.16 0.01 0.61 0.55

XXX initial. 92226............... .............. A

Special eye exam,

0.33 0.21 0.15 0.01 0.55 0.49

XXX subsequent. 92230............... .............. A

Eye exam with photos. 0.60 1.67 0.20 0.02 2.29 0.82

XXX 92235............... .............. A

Eye exam with photos. 0.81 2.93

NA 0.08 3.82

NA

XXX 92235............... 26............ A

Eye exam with photos. 0.81 0.37 0.37 0.02 1.20 1.20

XXX 92235............... TC............ A

Eye exam with photos. 0.00 2.56

NA 0.06 2.62

NA

XXX 92240............... .............. A

Icg angiography...... 1.10 7.03

NA 0.08 8.21

NA

XXX 92240............... 26............ A

Icg angiography...... 1.10 0.49 0.49 0.02 1.61 1.61

XXX 92240............... TC............ A

Icg angiography...... 0.00 6.54

NA 0.06 6.60

NA

XXX 92250............... .............. A

Eye exam with photos. 0.44 1.73

NA 0.02 2.19

NA

XXX 92250............... 26............ A

Eye exam with photos. 0.44 0.20 0.20 0.01 0.65 0.65

XXX 92250............... TC............ A

Eye exam with photos. 0.00 1.53

NA 0.01 1.54

NA

XXX 92260............... .............. A

Ophthalmoscopy/

0.20 0.29 0.09 0.01 0.50 0.30

XXX dynamometry. 92265............... .............. A

Eye muscle evaluation 0.81 1.88

NA 0.04 2.73

NA

XXX 92265............... 26............ A

Eye muscle evaluation 0.81 0.28 0.28 0.02 1.11 1.11

XXX 92265............... TC............ A

Eye muscle evaluation 0.00 1.60

NA 0.02 1.62

NA

XXX 92270............... .............. A

Electro-oculography.. 0.81 1.56

NA 0.06 2.43

NA

XXX 92270............... 26............ A

Electro-oculography.. 0.81 0.34 0.34 0.04 1.19 1.19

XXX 92270............... TC............ A

Electro-oculography.. 0.00 1.22

NA 0.02 1.24

NA

XXX 92275............... .............. A

Electroretinography.. 1.01 1.93

NA 0.04 2.98

NA

XXX 92275............... 26............ A

Electroretinography.. 1.01 0.42 0.42 0.02 1.45 1.45

XXX 92275............... TC............ A

Electroretinography.. 0.00 1.51

NA 0.02 1.53

NA

XXX 92283............... .............. A

Color vision

0.17 0.83

NA 0.02 1.02

NA

XXX examination. 92283............... 26............ A

Color vision

0.17 0.07 0.07 0.01 0.25 0.25

XXX examination.

[[Page 1222]]

92283............... TC............ A

Color vision

0.00 0.76

NA 0.01 0.77

NA

XXX examination. 92284............... .............. A

Dark adaptation eye

0.24 2.31

NA 0.02 2.57

NA

XXX exam. 92284............... 26............ A

Dark adaptation eye

0.24 0.09 0.09 0.01 0.34 0.34

XXX exam. 92284............... TC............ A

Dark adaptation eye

0.00 2.22

NA 0.01 2.23

NA

XXX exam. 92285............... .............. A

Eye photography...... 0.20 1.07

NA 0.02 1.29

NA

XXX 92285............... 26............ A

Eye photography...... 0.20 0.09 0.09 0.01 0.30 0.30

XXX 92285............... TC............ A

Eye photography...... 0.00 0.98

NA 0.01 0.99

NA

XXX 92286............... .............. A

Internal eye

0.66 3.37

NA 0.03 4.06

NA

XXX photography. 92286............... 26............ A

Internal eye

0.66 0.30 0.30 0.01 0.97 0.97

XXX photography. 92286............... TC............ A

Internal eye

0.00 3.07

NA 0.02 3.09

NA

XXX photography. 92287............... .............. A

Internal eye

0.81 2.69 0.31 0.02 3.52 1.14

XXX photography. 92310............... .............. N

Contact lens fitting. +1.17 1.12 0.45 0.04 2.33 1.66

XXX 92311............... .............. A

Contact lens fitting. 1.08 1.18 0.35 0.04 2.30 1.47

XXX 92312............... .............. A

Contact lens fitting. 1.26 1.16 0.49 0.04 2.46 1.79

XXX 92313............... .............. A

Contact lens fitting. 0.92 1.16 0.29 0.02 2.10 1.23

XXX 92314............... .............. N

Prescription of

+0.69 0.94 0.27 0.01 1.64 0.97

XXX contact lens. 92315............... .............. A

Prescription of

0.45 0.95 0.16 0.01 1.41 0.62

XXX contact lens. 92316............... .............. A

Prescription of

0.68 1.00 0.30 0.01 1.69 0.99

XXX contact lens. 92317............... .............. A

Prescription of

0.45 1.05 0.15 0.01 1.51 0.61

XXX contact lens. 92325............... .............. A

Modification of

0.00 0.39

NA 0.01 0.40

NA

XXX contact lens. 92326............... .............. A

Replacement of

0.00 1.64

NA 0.06 1.70

NA

XXX contact lens. 92330............... .............. A

Fitting of artificial 1.08 1.08 0.33 0.05 2.21 1.46

XXX eye. 92335............... .............. A

Fitting of artificial 0.45 1.01 0.17 0.01 1.47 0.63

XXX eye. 92340............... .............. N

Fitting of spectacles +0.37 0.70 0.14 0.01 1.08 0.52

XXX 92341............... .............. N

Fitting of spectacles +0.47 0.74 0.18 0.01 1.22 0.66

XXX 92342............... .............. N

Fitting of spectacles +0.53 0.76 0.21 0.01 1.30 0.75

XXX 92352............... .............. B

Special spectacles

+0.37 0.73 0.14 0.01 1.11 0.52

XXX fitting. 92353............... .............. B

Special spectacles

+0.50 0.78 0.19 0.02 1.30 0.71

XXX fitting. 92354............... .............. B

Special spectacles

+0.00 8.89

NA 0.10 8.99

NA

XXX fitting. 92355............... .............. B

Special spectacles

+0.00 4.34

NA 0.01 4.35

NA

XXX fitting. 92358............... .............. B

Eye prosthesis

+0.00 0.97

NA 0.05 1.02

NA

XXX service. 92370............... .............. N

Repair & adjust

+0.32 0.55 0.13 0.02 0.89 0.47

XXX spectacles. 92371............... .............. B

Repair & adjust

+0.00 0.62

NA 0.02 0.64

NA

XXX spectacles. 92390............... .............. N

Supply of spectacles. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 92391............... .............. N

Supply of contact

0.00 0.00 0.00 0.00 0.00 0.00

XXX lenses. 92392............... .............. I

Supply of low vision +0.00 3.79 3.79 0.02 3.81 3.81

XXX aids. 92393............... .............. I

Supply of artificial +0.00 11.76 11.76 0.57 12.33 12.33

XXX eye. 92395............... .............. I

Supply of spectacles. +0.00 1.28 1.28 0.10 1.38 1.38

XXX 92396............... .............. I

Supply of contact

+0.00 2.16 2.16 0.07 2.23 2.23

XXX lenses. 92499............... .............. C

Eye service or

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 92499............... 26............ C

Eye service or

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 92499............... TC............ C

Eye service or

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 92502............... .............. A

Ear and throat

1.51

NA 1.13 0.07

NA 2.71

000 examination. 92504............... .............. A

Ear microscopy

0.18 0.49 0.09 0.01 0.68 0.28

XXX examination. 92506............... .............. A

Speech/hearing

0.86 2.61 0.40 0.05 3.52 1.31

XXX evaluation. 92507............... .............. A

Speech/hearing

0.52 1.13 0.24 0.02 1.67 0.78

XXX therapy. 92508............... .............. A

Speech/hearing

0.26 0.52 0.12 0.01 0.79 0.39

XXX therapy. 92510............... .............. I

Rehab for ear implant +1.50 2.08 0.82 0.07 3.65 2.39

XXX 92511............... .............. A

Nasopharyngoscopy.... 0.84 3.14 0.79 0.04 4.02 1.67

000 92512............... .............. A

Nasal function

0.55 1.08 0.18 0.02 1.65 0.75

XXX studies. 92516............... .............. A

Facial nerve function 0.43 0.89 0.22 0.02 1.34 0.67

XXX test. 92520............... .............. A

Laryngeal function

0.76 0.50 0.38 0.04 1.30 1.18

XXX studies. 92526............... .............. A

Oral function therapy 0.55 1.66 0.20 0.02 2.23 0.77

XXX 92531............... .............. B

Spontaneous nystagmus 0.00 0.00 0.00 0.00 0.00 0.00

XXX study. 92532............... .............. B

Positional nystagmus

0.00 0.00 0.00 0.00 0.00 0.00

XXX test. 92533............... .............. B

Caloric vestibular

0.00 0.00 0.00 0.00 0.00 0.00

XXX test. 92534............... .............. B

Optokinetic nystagmus 0.00 0.00 0.00 0.00 0.00 0.00

XXX test. 92541............... .............. A

Spontaneous nystagmus 0.40 0.97

NA 0.04 1.41

NA

XXX test. 92541............... 26............ A

Spontaneous nystagmus 0.40 0.19 0.19 0.02 0.61 0.61

XXX test. 92541............... TC............ A

Spontaneous nystagmus 0.00 0.78

NA 0.02 0.80

NA

XXX test. 92542............... .............. A

Positional nystagmus

0.33 1.06

NA 0.03 1.42

NA

XXX test. 92542............... 26............ A

Positional nystagmus

0.33 0.16 0.16 0.01 0.50 0.50

XXX test. 92542............... TC............ A

Positional nystagmus

0.00 0.90

NA 0.02 0.92

NA

XXX test. 92543............... .............. A

Caloric vestibular

0.10 0.53

NA 0.02 0.65

NA

XXX test. 92543............... 26............ A

Caloric vestibular

0.10 0.05 0.05 0.01 0.16 0.16

XXX test. 92543............... TC............ A

Caloric vestibular

0.00 0.48

NA 0.01 0.49

NA

XXX test. 92544............... .............. A

Optokinetic nystagmus 0.26 0.84

NA 0.03 1.13

NA

XXX test. 92544............... 26............ A

Optokinetic nystagmus 0.26 0.12 0.12 0.01 0.39 0.39

XXX test. 92544............... TC............ A

Optokinetic nystagmus 0.00 0.72

NA 0.02 0.74

NA

XXX test. 92545............... .............. A

Oscillating tracking

0.23 0.79

NA 0.03 1.05

NA

XXX test. 92545............... 26............ A

Oscillating tracking

0.23 0.11 0.11 0.01 0.35 0.35

XXX test. 92545............... TC............ A

Oscillating tracking

0.00 0.68

NA 0.02 0.70

NA

XXX test. 92546............... .............. A

Sinusoidal rotational 0.29 1.80

NA 0.03 2.12

NA

XXX test. 92546............... 26............ A

Sinusoidal rotational 0.29 0.13 0.13 0.01 0.43 0.43

XXX test. 92546............... TC............ A

Sinusoidal rotational 0.00 1.67

NA 0.02 1.69

NA

XXX test.

[[Page 1223]]

92547............... .............. A

Supplemental

0.00 1.15

NA 0.06 1.21

NA

ZZZ electrical test. 92548............... .............. A

Posturography........ 0.50 3.19

NA 0.15 3.84

NA

XXX 92548............... 26............ A

Posturography........ 0.50 0.26 0.26 0.02 0.78 0.78

XXX 92548............... TC............ A

Posturography........ 0.00 2.93

NA 0.13 3.06

NA

XXX 92551............... .............. N

Pure tone hearing

0.00 0.00 0.00 0.00 0.00 0.00

XXX test, air. 92552............... .............. A

Pure tone audiometry, 0.00 0.44

NA 0.04 0.48

NA

XXX air. 92553............... .............. A

Audiometry, air &

0.00 0.66

NA 0.06 0.72

NA

XXX bone. 92555............... .............. A

Speech threshold

0.00 0.37

NA 0.04 0.41

NA

XXX audiometry. 92556............... .............. A

Speech audiometry,

0.00 0.57

NA 0.06 0.63

NA

XXX complete. 92557............... .............. A

Comprehensive hearing 0.00 1.19

NA 0.12 1.31

NA

XXX test. 92559............... .............. N

Group audiometric

0.00 0.00 0.00 0.00 0.00 0.00

XXX testing. 92560............... .............. N

Bekesy audiometry,

0.00 0.00 0.00 0.00 0.00 0.00

XXX screen. 92561............... .............. A

Bekesy audiometry,

0.00 0.72

NA 0.06 0.78

NA

XXX diagnosis. 92562............... .............. A

Loudness balance test 0.00 0.40

NA 0.04 0.44

NA

XXX 92563............... .............. A

Tone decay hearing

0.00 0.37

NA 0.04 0.41

NA

XXX test. 92564............... .............. A

Sisi hearing test.... 0.00 0.47

NA 0.05 0.52

NA

XXX 92565............... .............. A

Stenger test, pure

0.00 0.39

NA 0.04 0.43

NA

XXX tone. 92567............... .............. A

Tympanometry......... 0.00 0.52

NA 0.06 0.58

NA

XXX 92568............... .............. A

Acoustic reflex

0.00 0.37

NA 0.04 0.41

NA

XXX testing. 92569............... .............. A

Acoustic reflex decay 0.00 0.40

NA 0.04 0.44

NA

XXX test. 92571............... .............. A

Filtered speech

0.00 0.38

NA 0.04 0.42

NA

XXX hearing test. 92572............... .............. A

Staggered spondaic

0.00 0.09

NA 0.01 0.10

NA

XXX word test. 92573............... .............. A

Lombard test......... 0.00 0.35

NA 0.04 0.39

NA

XXX 92575............... .............. A

Sensorineural acuity

0.00 0.30

NA 0.02 0.32

NA

XXX test. 92576............... .............. A

Synthetic sentence

0.00 0.44

NA 0.05 0.49

NA

XXX test. 92577............... .............. A

Stenger test, speech. 0.00 0.72

NA 0.07 0.79

NA

XXX 92579............... .............. A

Visual audiometry

0.00 0.73

NA 0.06 0.79

NA

XXX (vra). 92582............... .............. A

Conditioning play

0.00 0.73

NA 0.06 0.79

NA

XXX audiometry. 92583............... .............. A

Select picture

0.00 0.89

NA 0.08 0.97

NA

XXX audiometry. 92584............... .............. A

Electrocochleography. 0.00 2.49

NA 0.21 2.70

NA

XXX 92585............... .............. A

Auditor evoke potent, 0.50 2.08

NA 0.16 2.74

NA

XXX compre. 92585............... 26............ A

Auditor evoke potent, 0.50 0.22 0.22 0.02 0.74 0.74

XXX compre. 92585............... TC............ A

Auditor evoke potent, 0.00 1.86

NA 0.14 2.00

NA

XXX compre. 92586............... .............. A

Auditor evoke potent, 0.00 1.86

NA 0.14 2.00

NA

XXX limit. 92587............... .............. A

Evoked auditory test. 0.13 1.38

NA 0.12 1.63

NA

XXX 92587............... 26............ A

Evoked auditory test. 0.13 0.07 0.07 0.01 0.21 0.21

XXX 92587............... TC............ A

Evoked auditory test. 0.00 1.31

NA 0.11 1.42

NA

XXX 92588............... .............. A

Evoked auditory test. 0.36 1.64

NA 0.14 2.14

NA

XXX 92588............... 26............ A

Evoked auditory test. 0.36 0.17 0.17 0.01 0.54 0.54

XXX 92588............... TC............ A

Evoked auditory test. 0.00 1.47

NA 0.13 1.60

NA

XXX 92589............... .............. A

Auditory function

0.00 0.53

NA 0.06 0.59

NA

XXX test(s). 92590............... .............. N

Hearing aid exam, one 0.00 0.00 0.00 0.00 0.00 0.00

XXX ear. 92591............... .............. N

Hearing aid exam,

0.00 0.00 0.00 0.00 0.00 0.00

XXX both ears. 92592............... .............. N

Hearing aid check,

0.00 0.00 0.00 0.00 0.00 0.00

XXX one ear. 92593............... .............. N

Hearing aid check,

0.00 0.00 0.00 0.00 0.00 0.00

XXX both ears. 92594............... .............. N

Electro hearng aid

0.00 0.00 0.00 0.00 0.00 0.00

XXX test, one. 92595............... .............. N

Electro hearng aid

0.00 0.00 0.00 0.00 0.00 0.00

XXX tst, both. 92596............... .............. A

Ear protector

0.00 0.59

NA 0.06 0.65

NA

XXX evaluation. 92597............... .............. A

Oral speech device

0.86 1.69 0.45 0.05 2.60 1.36

XXX eval. 92601............... .............. A

Cochlear implt f/up

0.00 3.41

NA 0.07 3.48

NA

XXX exam . 92604............... .............. A

Reprogram cochlear

0.00 1.47

NA 0.07 1.54

NA

XXX implt 7 . 92605............... .............. B

Eval for nonspeech

0.00 0.00 0.00 0.00 0.00 0.00

XXX device rx. 92606............... .............. B

Non-speech device

0.00 0.00 0.00 0.00 0.00 0.00

XXX service. 92607............... .............. A

Ex for speech device

0.00 3.22

NA 0.05 3.27

NA

XXX rx, 1hr. 92608............... .............. A

Ex for speech device

0.00 0.67

NA 0.05 0.72

NA

XXX rx addl. 92609............... .............. A

Use of speech device

0.00 1.60

NA 0.04 1.64

NA

XXX service. 92610............... .............. A

Evaluate swallowing

0.00 3.44

NA 0.08 3.52

NA

XXX function. 92611............... .............. A

Motion fluoroscopy/

0.00 3.44

NA 0.08 3.52

NA

XXX swallow. 92612............... .............. A

Endoscopy swallow tst 1.27 2.71 0.67 0.08 4.06 2.02

XXX (fees). 92613............... .............. A

Endoscopy swallow tst 0.71 0.39 0.39 0.05 1.15 1.15

XXX (fees). 92614............... .............. A

Laryngoscopic sensory 1.27 2.41 0.61 0.08 3.76 1.96

XXX test. 92615............... .............. A

Eval laryngoscopy

0.63 0.36 0.36 0.05 1.04 1.04

XXX sense tst. 92616............... .............. A

Fees w/laryngeal

1.88 3.29 0.97 0.08 5.25 2.93

XXX sense test. 92617............... .............. A

Interprt fees/

0.79 0.44 0.44 0.05 1.28 1.28

XXX laryngeal test. 92700............... .............. C

Ent procedure/service 0.00 0.00 0.00 0.00 0.00 0.00

XXX 92950............... .............. A

Heart/lung

3.79

NA 0.98 0.25

NA 5.02

000 resuscitation cpr. 92953............... .............. A

Temporary external

0.23

NA 0.23 0.01

NA 0.47

000 pacing. 92960............... .............. A

Cardioversion

2.25 6.66 1.17 0.10 9.01 3.52

000 electric, ext. 92961............... .............. A

Cardioversion,

4.59

NA 2.09 0.21

NA 6.89

000 electric, int. 92970............... .............. A

Cardioassist,

3.51

NA 1.07 0.21

NA 4.79

000 internal. 92971............... .............. A

Cardioassist,

1.77

NA 0.85 0.07

NA 2.69

000 external. 92973............... .............. A

Percut coronary

3.28

NA 1.29 0.14

NA 4.71

ZZZ thrombectomy. 92974............... .............. A

Cath place, cardio

3.00

NA 1.18 0.17

NA 4.35

ZZZ brachytx.

[[Page 1224]]

92975............... .............. A

Dissolve clot, heart

7.24

NA 2.81 0.27

NA 10.32

000 vessel. 92977............... .............. A

Dissolve clot, heart

0.00 8.08

NA 0.46 8.54

NA

XXX vessel. 92978............... .............. A

Intravasc us, heart

1.80 5.29

NA 0.31 7.40

NA

ZZZ add-on. 92978............... 26............ A

Intravasc us, heart

1.80 0.71 0.71 0.07 2.58 2.58

ZZZ add-on. 92978............... TC............ A

Intravasc us, heart

0.00 4.58

NA 0.24 4.82

NA

ZZZ add-on. 92979............... .............. A

Intravasc us, heart

1.44 2.86

NA 0.18 4.48

NA

ZZZ add-on. 92979............... 26............ A

Intravasc us, heart

1.44 0.56 0.56 0.05 2.05 2.05

ZZZ add-on. 92979............... TC............ A

Intravasc us, heart

0.00 2.30

NA 0.13 2.43

NA

ZZZ add-on. 92980............... .............. A

Insert intracoronary 14.82

NA 6.07 0.86

NA 21.75

000 stent. 92981............... .............. A

Insert intracoronary

4.16

NA 1.64 0.24

NA 6.04

ZZZ stent. 92982............... .............. A

Coronary artery

10.96

NA 4.55 0.63

NA 16.14

000 dilation. 92984............... .............. A

Coronary artery

2.97

NA 1.16 0.17

NA 4.30

ZZZ dilation. 92986............... .............. A

Revision of aortic

21.77

NA 11.62 1.37

NA 34.76

090 valve. 92987............... .............. A

Revision of mitral

22.67

NA 12.01 1.42

NA 36.10

090 valve. 92990............... .............. A

Revision of pulmonary 17.31

NA 9.63 1.09

NA 28.03

090 valve. 92992............... .............. C

Revision of heart

0.00 0.00 0.00 0.00 0.00 0.00

090 chamber. 92993............... .............. C

Revision of heart

0.00 0.00 0.00 0.00 0.00 0.00

090 chamber. 92995............... .............. A

Coronary atherectomy. 12.07

NA 4.98 0.70

NA 17.75

000 92996............... .............. A

Coronary atherectomy

3.26

NA 1.28 0.19

NA 4.73

ZZZ add-on. 92997............... .............. A

Pul art balloon repr, 11.98

NA 4.85 0.76

NA 17.59

000 percut. 92998............... .............. A

Pul art balloon repr, 5.99

NA 2.21 0.37

NA 8.57

ZZZ percut. 93000............... .............. A

Electrocardiogram,

0.17 0.51

NA 0.03 0.71

NA

XXX complete. 93005............... .............. A

Electrocardiogram,

0.00 0.45

NA 0.02 0.47

NA

XXX tracing. 93010............... .............. A

Electrocardiogram

0.17 0.06 0.06 0.01 0.24 0.24

XXX report. 93012............... .............. A

Transmission of ecg.. 0.00 6.04

NA 0.18 6.22

NA

XXX 93014............... .............. A

Report on transmitted 0.52 0.19 0.19 0.02 0.73 0.73

XXX ecg. 93015............... .............. A

Cardiovascular stress 0.75 1.98

NA 0.13 2.86

NA

XXX test. 93016............... .............. A

Cardiovascular stress 0.45 0.17 0.17 0.01 0.63 0.63

XXX test. 93017............... .............. A

Cardiovascular stress 0.00 1.69

NA 0.11 1.80

NA

XXX test. 93018............... .............. A

Cardiovascular stress 0.30 0.12 0.12 0.01 0.43 0.43

XXX test. 93024............... .............. A

Cardiac drug stress

1.17 1.57

NA 0.13 2.87

NA

XXX test. 93024............... 26............ A

Cardiac drug stress

1.17 0.45 0.45 0.05 1.67 1.67

XXX test. 93024............... TC............ A

Cardiac drug stress

0.00 1.12

NA 0.08 1.20

NA

XXX test. 93025............... .............. A

Microvolt t-wave

0.75 8.18

NA 0.13 9.06

NA

XXX assess. 93025............... 26............ A

Microvolt t-wave

0.75 0.29 0.29 0.02 1.06 1.06

XXX assess. 93025............... TC............ A

Microvolt t-wave

0.00 7.89

NA 0.11 8.00

NA

XXX assess. 93040............... .............. A

Rhythm ECG with

0.16 0.20

NA 0.02 0.38

NA

XXX report. 93041............... .............. A

Rhythm ECG, tracing.. 0.00 0.15

NA 0.01 0.16

NA

XXX 93042............... .............. A

Rhythm ECG, report... 0.16 0.05 0.05 0.01 0.22 0.22

XXX 93224............... .............. A

ECG monitor/report,

0.52 3.63

NA 0.24 4.39

NA

XXX 24 hrs. 93225............... .............. A

ECG monitor/record,

0.00 1.24

NA 0.08 1.32

NA

XXX 24 hrs. 93226............... .............. A

ECG monitor/report,

0.00 2.19

NA 0.14 2.33

NA

XXX 24 hrs. 93227............... .............. A

ECG monitor/review,

0.52 0.20 0.20 0.02 0.74 0.74

XXX 24 hrs. 93230............... .............. A

ECG monitor/report,

0.52 3.90

NA 0.26 4.68

NA

XXX 24 hrs. 93231............... .............. A

Ecg monitor/record,

0.00 1.52

NA 0.11 1.63

NA

XXX 24 hrs. 93232............... .............. A

ECG monitor/report,

0.00 2.18

NA 0.13 2.31

NA

XXX 24 hrs. 93233............... .............. A

ECG monitor/review,

0.52 0.20 0.20 0.02 0.74 0.74

XXX 24 hrs. 93235............... .............. A

ECG monitor/report,

0.45 2.79

NA 0.15 3.39

NA

XXX 24 hrs. 93236............... .............. A

ECG monitor/report,

0.00 2.62

NA 0.14 2.76

NA

XXX 24 hrs. 93237............... .............. A

ECG monitor/review,

0.45 0.17 0.17 0.01 0.63 0.63

XXX 24 hrs. 93268............... .............. A

ECG record/review.... 0.52 7.47

NA 0.28 8.27

NA

XXX 93270............... .............. A

ECG recording........ 0.00 1.24

NA 0.08 1.32

NA

XXX 93271............... .............. A

Ecg/monitoring and

0.00 6.04

NA 0.18 6.22

NA

XXX analysis. 93272............... .............. A

Ecg/review, interpret 0.52 0.19 0.19 0.02 0.73 0.73

XXX only. 93278............... .............. A

ECG/signal-averaged.. 0.25 1.25

NA 0.12 1.62

NA

XXX 93278............... 26............ A

ECG/signal-averaged.. 0.25 0.10 0.10 0.01 0.36 0.36

XXX 93278............... TC............ A

ECG/signal-averaged.. 0.00 1.15

NA 0.11 1.26

NA

XXX 93303............... .............. A

Echo transthoracic... 1.30 4.35

NA 0.28 5.93

NA

XXX 93303............... 26............ A

Echo transthoracic... 1.30 0.48 0.48 0.05 1.83 1.83

XXX 93303............... TC............ A

Echo transthoracic... 0.00 3.87

NA 0.23 4.10

NA

XXX 93304............... .............. A

Echo transthoracic... 0.75 2.23

NA 0.15 3.13

NA

XXX 93304............... 26............ A

Echo transthoracic... 0.75 0.28 0.28 0.02 1.05 1.05

XXX 93304............... TC............ A

Echo transthoracic... 0.00 1.95

NA 0.13 2.08

NA

XXX 93307............... .............. A

Echo exam of heart... 0.92 4.23

NA 0.27 5.42

NA

XXX 93307............... 26............ A

Echo exam of heart... 0.92 0.36 0.36 0.04 1.32 1.32

XXX 93307............... TC............ A

Echo exam of heart... 0.00 3.87

NA 0.23 4.10

NA

XXX 93308............... .............. A

Echo exam of heart... 0.53 2.16

NA 0.15 2.84

NA

XXX 93308............... 26............ A

Echo exam of heart... 0.53 0.21 0.21 0.02 0.76 0.76

XXX 93308............... TC............ A

Echo exam of heart... 0.00 1.95

NA 0.13 2.08

NA

XXX 93312............... .............. A

Echo transesophageal. 2.20 4.58

NA 0.39 7.17

NA

XXX 93312............... 26............ A

Echo transesophageal. 2.20 0.79 0.79 0.10 3.09 3.09

XXX 93312............... TC............ A

Echo transesophageal. 0.00 3.79

NA 0.29 4.08

NA

XXX 93313............... .............. A

Echo transesophageal. 0.95

NA 0.21 0.06

NA 1.22

XXX 93314............... .............. A

Echo transesophageal. 1.25 4.26

NA 0.34 5.85

NA

XXX 93314............... 26............ A

Echo transesophageal. 1.25 0.47 0.47 0.05 1.77 1.77

XXX

[[Page 1225]]

93314............... TC............ A

Echo transesophageal. 0.00 3.79

NA 0.29 4.08

NA

XXX 93315............... .............. C

Echo transesophageal. 0.00 0.00

NA 0.00 0.00

NA

XXX 93315............... 26............ A

Echo transesophageal. 2.78 1.02 1.02 0.12 3.92 3.92

XXX 93315............... TC............ C

Echo transesophageal. 0.00 0.00

NA 0.00 0.00

NA

XXX 93316............... .............. A

Echo transesophageal. 0.95

NA 0.24 0.06

NA 1.25

XXX 93317............... .............. C

Echo transesophageal. 0.00 0.00

NA 0.00 0.00

NA

XXX 93317............... 26............ A

Echo transesophageal. 1.83 0.67 0.67 0.07 2.57 2.57

XXX 93317............... TC............ C

Echo transesophageal. 0.00 0.00

NA 0.00 0.00

NA

XXX 93318............... .............. C

Echo transesophageal

0.00 0.00 0.00 0.00 0.00 0.00

XXX intraop. 93318............... 26............ A

Echo transesophageal

2.20 0.47 0.47 0.07 2.74 2.74

XXX intraop. 93318............... TC............ C

Echo transesophageal

0.00 0.00 0.00 0.00 0.00 0.00

XXX intraop. 93320............... .............. A

Doppler echo exam,

0.38 1.87

NA 0.13 2.38

NA

ZZZ heart. 93320............... 26............ A

Doppler echo exam,

0.38 0.15 0.15 0.01 0.54 0.54

ZZZ heart. 93320............... TC............ A

Doppler echo exam,

0.00 1.72

NA 0.12 1.84

NA

ZZZ heart. 93321............... .............. A

Doppler echo exam,

0.15 1.18

NA 0.09 1.42

NA

ZZZ heart. 93321............... 26............ A

Doppler echo exam,

0.15 0.06 0.06 0.01 0.22 0.22

ZZZ heart. 93321............... TC............ A

Doppler echo exam,

0.00 1.12

NA 0.08 1.20

NA

ZZZ heart. 93325............... .............. A

Doppler color flow

0.07 2.94

NA 0.22 3.23

NA

ZZZ add-on. 93325............... 26............ A

Doppler color flow

0.07 0.03 0.03 0.01 0.11 0.11

ZZZ add-on. 93325............... TC............ A

Doppler color flow

0.00 2.91

NA 0.21 3.12

NA

ZZZ add-on. 93350............... .............. A

Echo transthoracic... 1.48 2.34

NA 0.15 3.97

NA

XXX 93350............... 26............ A

Echo transthoracic... 1.48 0.57 0.57 0.02 2.07 2.07

XXX 93350............... TC............ A

Echo transthoracic... 0.00 1.77

NA 0.13 1.90

NA

XXX 93501............... .............. A

Right heart

3.02 18.11

NA 1.24 22.37

NA

000 catheterization. 93501............... 26............ A

Right heart

3.02 1.15 1.15 0.19 4.36 4.36

000 catheterization. 93501............... TC............ A

Right heart

0.00 16.96

NA 1.05 18.01

NA

000 catheterization. 93503............... .............. A

Insert/place heart

2.91

NA 0.68 0.19

NA 3.78

000 catheter. 93505............... .............. A

Biopsy of heart

4.37 3.68

NA 0.44 8.49

NA

000 lining. 93505............... 26............ A

Biopsy of heart

4.37 1.69 1.69 0.28 6.34 6.34

000 lining. 93505............... TC............ A

Biopsy of heart

0.00 1.99

NA 0.16 2.15

NA

000 lining. 93508............... .............. A

Cath placement,

4.09 14.73

NA 0.90 19.72

NA

000 angiography. 93508............... 26............ A

Cath placement,

4.09 2.09 2.09 0.25 6.43 6.43

000 angiography. 93508............... TC............ A

Cath placement,

0.00 12.64

NA 0.65 13.29

NA

000 angiography. 93510............... .............. A

Left heart

4.32 39.26

NA 2.57 46.15

NA

000 catheterization. 93510............... 26............ A

Left heart

4.32 2.18 2.18 0.27 6.77 6.77

000 catheterization. 93510............... TC............ A

Left heart

0.00 37.08

NA 2.30 39.38

NA

000 catheterization. 93511............... .............. A

Left heart

5.02 38.55

NA 2.54 46.11

NA

000 catheterization. 93511............... 26............ A

Left heart

5.02 2.45 2.45 0.31 7.78 7.78

000 catheterization. 93511............... TC............ A

Left heart

0.00 36.10

NA 2.23 38.33

NA

000 catheterization. 93514............... .............. A

Left heart

7.04 39.24

NA 2.68 48.96

NA

000 catheterization. 93514............... 26............ A

Left heart

7.04 3.14 3.14 0.45 10.63 10.63

000 catheterization. 93514............... TC............ A

Left heart

0.00 36.10

NA 2.23 38.33

NA

000 catheterization. 93524............... .............. A

Left heart

6.94 50.36

NA 3.36 60.66

NA

000 catheterization. 93524............... 26............ A

Left heart

6.94 3.19 3.19 0.43 10.56 10.56

000 catheterization. 93524............... TC............ A

Left heart

0.00 47.17

NA 2.93 50.10

NA

000 catheterization. 93526............... .............. A

Rt & Lt heart

5.98 51.28

NA 3.39 60.65

NA

000 catheters. 93526............... 26............ A

Rt & Lt heart

5.98 2.82 2.82 0.37 9.17 9.17

000 catheters. 93526............... TC............ A

Rt & Lt heart

0.00 48.46

NA 3.02 51.48

NA

000 catheters. 93527............... .............. A

Rt & Lt heart

7.27 50.50

NA 3.39 61.16

NA

000 catheters. 93527............... 26............ A

Rt & Lt heart

7.27 3.33 3.33 0.46 11.06 11.06

000 catheters. 93527............... TC............ A

Rt & Lt heart

0.00 47.17

NA 2.93 50.10

NA

000 catheters. 93528............... .............. A

Rt & Lt heart

8.99 51.22

NA 3.50 63.71

NA

000 catheters. 93528............... 26............ A

Rt & Lt heart

8.99 4.05 4.05 0.57 13.61 13.61

000 catheters. 93528............... TC............ A

Rt & Lt heart

0.00 47.17

NA 2.93 50.10

NA

000 catheters. 93529............... .............. A

Rt, lt heart

4.79 49.46

NA 3.23 57.48

NA

000 catheterization. 93529............... 26............ A

Rt, lt heart

4.79 2.29 2.29 0.30 7.38 7.38

000 catheterization. 93529............... TC............ A

Rt, lt heart

0.00 47.17

NA 2.93 50.10

NA

000 catheterization. 93530............... .............. A

Rt heart cath,

4.22 18.90

NA 1.34 24.46

NA

000 congenital. 93530............... 26............ A

Rt heart cath,

4.22 1.94 1.94 0.29 6.45 6.45

000 congenital. 93530............... TC............ A

Rt heart cath,

0.00 16.96

NA 1.05 18.01

NA

000 congenital. 93531............... .............. A

R & l heart cath,

8.34 52.05

NA 3.57 63.96

NA

000 congenital. 93531............... 26............ A

R & l heart cath,

8.34 3.59 3.59 0.55 12.48 12.48

000 congenital. 93531............... TC............ A

R & l heart cath,

0.00 48.46

NA 3.02 51.48

NA

000 congenital. 93532............... .............. A

R & l heart cath,

9.99 51.44

NA 3.56 64.99

NA

000 congenital. 93532............... 26............ A

R & l heart cath,

9.99 4.27 4.27 0.63 14.89 14.89

000 congenital. 93532............... TC............ A

R & l heart cath,

0.00 47.17

NA 2.93 50.10

NA

000 congenital. 93533............... .............. A

R & l heart cath,

6.69 49.98

NA 3.45 60.12

NA

000 congenital. 93533............... 26............ A

R & l heart cath,

6.69 2.81 2.81 0.52 10.02 10.02

000 congenital. 93533............... TC............ A

R & l heart cath,

0.00 47.17

NA 2.93 50.10

NA

000 congenital. 93539............... .............. A

Injection, cardiac

0.40

NA 0.16 0.01

NA 0.57

000 cath. 93540............... .............. A

Injection, cardiac

0.43

NA 0.17 0.01

NA 0.61

000 cath. 93541............... .............. A

Injection for lung

0.29

NA 0.11 0.01

NA 0.41

000 angiogram. 93542............... .............. A

Injection for heart x- 0.29

NA 0.11 0.01

NA 0.41

000 rays. 93543............... .............. A

Injection for heart x- 0.29

NA 0.12 0.01

NA 0.42

000 rays. 93544............... .............. A

Injection for

0.25

NA 0.10 0.01

NA 0.36

000 aortography.

[[Page 1226]]

93545............... .............. A

Inject for coronary x- 0.40

NA 0.16 0.01

NA 0.57

000 rays. 93555............... .............. A

Imaging, cardiac cath 0.81 6.62

NA 0.38 7.81

NA

XXX 93555............... 26............ A

Imaging, cardiac cath 0.81 0.32 0.32 0.04 1.17 1.17

XXX 93555............... TC............ A

Imaging, cardiac cath 0.00 6.30

NA 0.34 6.64

NA

XXX 93556............... .............. A

Imaging, cardiac cath 0.83 10.26

NA 0.55 11.64

NA

XXX 93556............... 26............ A

Imaging, cardiac cath 0.83 0.33 0.33 0.04 1.20 1.20

XXX 93556............... TC............ A

Imaging, cardiac cath 0.00 9.93

NA 0.51 10.44

NA

XXX 93561............... .............. A

Cardiac output

0.50 0.68

NA 0.08 1.26

NA

000 measurement. 93561............... 26............ A

Cardiac output

0.50 0.16 0.16 0.02 0.68 0.68

000 measurement. 93561............... TC............ A

Cardiac output

0.00 0.52

NA 0.06 0.58

NA

000 measurement. 93562............... .............. A

Cardiac output

0.16 0.37

NA 0.05 0.58

NA

000 measurement. 93562............... 26............ A

Cardiac output

0.16 0.05 0.05 0.01 0.22 0.22

000 measurement. 93562............... TC............ A

Cardiac output

0.00 0.32

NA 0.04 0.36

NA

000 measurement. 93571............... .............. A

Heart flow reserve

1.80 5.26

NA 0.37 7.43

NA

ZZZ measure. 93571............... 26............ A

Heart flow reserve

1.80 0.68 0.68 0.13 2.61 2.61

ZZZ measure. 93571............... TC............ A

Heart flow reserve

0.00 4.58

NA 0.24 4.82

NA

ZZZ measure. 93572............... .............. A

Heart flow reserve

1.44 2.80

NA 0.34 4.58

NA

ZZZ measure. 93572............... 26............ A

Heart flow reserve

1.44 0.50 0.50 0.21 2.15 2.15

ZZZ measure. 93572............... TC............ A

Heart flow reserve

0.00 2.30

NA 0.13 2.43

NA

ZZZ measure. 93580............... .............. A

Transcath closure of 17.97

NA 7.21 1.37

NA 26.55

000 asd. 93581............... .............. A

Transcath closure of 24.39

NA 9.66 1.37

NA 35.42

000 vsd. 93600............... .............. A

Bundle of His

2.12 2.79

NA 0.26 5.17

NA

000 recording. 93600............... 26............ A

Bundle of His

2.12 0.83 0.83 0.13 3.08 3.08

000 recording. 93600............... TC............ A

Bundle of His

0.00 1.96

NA 0.13 2.09

NA

000 recording. 93602............... .............. A

Intra-atrial

2.12 1.95

NA 0.21 4.28

NA

000 recording. 93602............... 26............ A

Intra-atrial

2.12 0.83 0.83 0.14 3.09 3.09

000 recording. 93602............... TC............ A

Intra-atrial

0.00 1.12

NA 0.07 1.19

NA

000 recording. 93603............... .............. A

Right ventricular

2.12 2.51

NA 0.24 4.87

NA

000 recording. 93603............... 26............ A

Right ventricular

2.12 0.82 0.82 0.13 3.07 3.07

000 recording. 93603............... TC............ A

Right ventricular

0.00 1.69

NA 0.11 1.80

NA

000 recording. 93609............... .............. A

Map tachycardia, add- 4.99 4.67

NA 0.80 10.46

NA

ZZZ on. 93609............... 26............ A

Map tachycardia, add- 4.99 1.95 1.95 0.63 7.57 7.57

ZZZ on. 93609............... TC............ A

Map tachycardia, add- 0.00 2.72

NA 0.17 2.89

NA

ZZZ on. 93610............... .............. A

Intra-atrial pacing.. 3.02 2.52

NA 0.31 5.85

NA

000 93610............... 26............ A

Intra-atrial pacing.. 3.02 1.16 1.16 0.21 4.39 4.39

000 93610............... TC............ A

Intra-atrial pacing.. 0.00 1.36

NA 0.10 1.46

NA

000 93612............... .............. A

Intraventricular

3.02 2.78

NA 0.32 6.12

NA

000 pacing. 93612............... 26............ A

Intraventricular

3.02 1.16 1.16 0.21 4.39 4.39

000 pacing. 93612............... TC............ A

Intraventricular

0.00 1.62

NA 0.11 1.73

NA

000 pacing. 93613............... .............. A

Electrophys map 3d,

6.99

NA 2.76 0.63

NA 10.38

ZZZ add-on. 93615............... .............. A

Esophageal recording. 0.99 0.59

NA 0.06 1.64

NA

000 93615............... 26............ A

Esophageal recording. 0.99 0.27 0.27 0.04 1.30 1.30

000 93615............... TC............ A

Esophageal recording. 0.00 0.32

NA 0.02 0.34

NA

000 93616............... .............. A

Esophageal recording. 1.49 0.74

NA 0.09 2.32

NA

000 93616............... 26............ A

Esophageal recording. 1.49 0.42 0.42 0.07 1.98 1.98

000 93616............... TC............ A

Esophageal recording. 0.00 0.32

NA 0.02 0.34

NA

000 93618............... .............. A

Heart rhythm pacing.. 4.25 5.66

NA 0.51 10.42

NA

000 93618............... 26............ A

Heart rhythm pacing.. 4.25 1.68 1.68 0.27 6.20 6.20

000 93618............... TC............ A

Heart rhythm pacing.. 0.00 3.98

NA 0.24 4.22

NA

000 93619............... .............. A

Electrophysiology

7.31 10.94

NA 0.93 19.18

NA

000 evaluation. 93619............... 26............ A

Electrophysiology

7.31 3.20 3.20 0.46 10.97 10.97

000 evaluation. 93619............... TC............ A

Electrophysiology

0.00 7.74

NA 0.47 8.21

NA

000 evaluation. 93620............... .............. C

Electrophysiology

0.00 0.00

NA 0.00 0.00

NA

000 evaluation. 93620............... 26............ A

Electrophysiology

11.57 4.86 4.86 0.72 17.15 17.15

000 evaluation. 93620............... TC............ C

Electrophysiology

0.00 0.00

NA 0.00 0.00

NA

000 evaluation. 93621............... .............. C

Electrophysiology

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ evaluation. 93621............... 26............ A

Electrophysiology

2.10 0.82 0.82 0.18 3.10 3.10

ZZZ evaluation. 93621............... TC............ C

Electrophysiology

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ evaluation. 93622............... .............. C

Electrophysiology

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ evaluation. 93622............... 26............ A

Electrophysiology

3.10 1.21 1.21 0.81 5.12 5.12

ZZZ evaluation. 93622............... TC............ C

Electrophysiology

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ evaluation. 93623............... .............. C

Stimulation, pacing

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ heart. 93623............... 26............ A

Stimulation, pacing

2.85 1.12 1.12 0.18 4.15 4.15

ZZZ heart. 93623............... TC............ C

Stimulation, pacing

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ heart. 93624............... .............. A

Electrophysiologic

4.80 4.19

NA 0.43 9.42

NA

000 study. 93624............... 26............ A

Electrophysiologic

4.80 2.20 2.20 0.30 7.30 7.30

000 study. 93624............... TC............ A

Electrophysiologic

0.00 1.99

NA 0.13 2.12

NA

000 study. 93631............... .............. A

Heart pacing, mapping 7.59 8.95

NA 1.42 17.96

NA

000 93631............... 26............ A

Heart pacing, mapping 7.59 2.78 2.78 0.80 11.17 11.17

000 93631............... TC............ A

Heart pacing, mapping 0.00 6.17

NA 0.62 6.79

NA

000 93640............... .............. A

Evaluation heart

3.51 8.56

NA 0.64 12.71

NA

000 device. 93640............... 26............ A

Evaluation heart

3.51 1.36 1.36 0.22 5.09 5.09

000 device. 93640............... TC............ A

Evaluation heart

0.00 7.20

NA 0.42 7.62

NA

000 device. 93641............... .............. A

Electrophysiology

5.92 9.52

NA 0.79 16.23

NA

000 evaluation. 93641............... 26............ A

Electrophysiology

5.92 2.32 2.32 0.37 8.61 8.61

000 evaluation.

[[Page 1227]]

93641............... TC............ A

Electrophysiology

0.00 7.20

NA 0.42 7.62

NA

000 evaluation. 93642............... .............. A

Electrophysiology

4.88 9.42

NA 0.61 14.91

NA

000 evaluation. 93642............... 26............ A

Electrophysiology

4.88 2.22 2.22 0.19 7.29 7.29

000 evaluation. 93642............... TC............ A

Electrophysiology

0.00 7.20

NA 0.42 7.62

NA

000 evaluation. 93650............... .............. A

Ablate heart

10.49

NA 4.45 0.66

NA 15.60

000 dysrhythm focus. 93651............... .............. A

Ablate heart

16.23

NA 6.35 1.03

NA 23.61

000 dysrhythm focus. 93652............... .............. A

Ablate heart

17.65

NA 6.91 1.11

NA 25.67

000 dysrhythm focus. 93660............... .............. A

Tilt table evaluation 1.89 2.43

NA 0.09 4.41

NA

000 93660............... 26............ A

Tilt table evaluation 1.89 0.74 0.74 0.07 2.70 2.70

000 93660............... TC............ A

Tilt table evaluation 0.00 1.69

NA 0.02 1.71

NA

000 93662............... .............. C

Intracardiac ecg

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ (ice). 93662............... 26............ A

Intracardiac ecg

2.80 1.11 1.11 0.49 4.40 4.40

ZZZ (ice). 93662............... TC............ C

Intracardiac ecg

0.00 0.00

NA 0.00 0.00

NA

ZZZ (ice). 93668............... .............. N

Peripheral vascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX rehab. 93701............... .............. A

Bioimpedance,

0.17 1.02

NA 0.02 1.21

NA

XXX thoracic. 93701............... 26............ A

Bioimpedance,

0.17 0.07 0.07 0.01 0.25 0.25

XXX thoracic. 93701............... TC............ A

Bioimpedance,

0.00 0.95

NA 0.01 0.96

NA

XXX thoracic. 93720............... .............. A

Total body

0.17 0.76

NA 0.07 1.00

NA

XXX plethysmography. 93721............... .............. A

Plethysmography

0.00 0.71

NA 0.06 0.77

NA

XXX tracing. 93722............... .............. A

Plethysmography

0.17 0.05 0.05 0.01 0.23 0.23

XXX report. 93724............... .............. A

Analyze pacemaker

4.88 5.90

NA 0.46 11.24

NA

000 system. 93724............... 26............ A

Analyze pacemaker

4.88 1.92 1.92 0.22 7.02 7.02

000 system. 93724............... TC............ A

Analyze pacemaker

0.00 3.98

NA 0.24 4.22

NA

000 system. 93727............... .............. A

Analyze ilr system... 0.52 0.20 0.20 0.06 0.78 0.78

XXX 93731............... .............. A

Analyze pacemaker

0.45 0.67

NA 0.06 1.18

NA

XXX system. 93731............... 26............ A

Analyze pacemaker

0.45 0.18 0.18 0.02 0.65 0.65

XXX system. 93731............... TC............ A

Analyze pacemaker

0.00 0.49

NA 0.04 0.53

NA

XXX system. 93732............... .............. A

Analyze pacemaker

0.92 0.87

NA 0.08 1.87

NA

XXX system. 93732............... 26............ A

Analyze pacemaker

0.92 0.36 0.36 0.04 1.32 1.32

XXX system. 93732............... TC............ A

Analyze pacemaker

0.00 0.51

NA 0.04 0.55

NA

XXX system. 93733............... .............. A

Telephone analy,

0.17 0.80

NA 0.07 1.04

NA

XXX pacemaker. 93733............... 26............ A

Telephone analy,

0.17 0.07 0.07 0.01 0.25 0.25

XXX pacemaker. 93733............... TC............ A

Telephone analy,

0.00 0.73

NA 0.06 0.79

NA

XXX pacemaker. 93734............... .............. A

Analyze pacemaker

0.38 0.50

NA 0.03 0.91

NA

XXX system. 93734............... 26............ A

Analyze pacemaker

0.38 0.15 0.15 0.01 0.54 0.54

XXX system. 93734............... TC............ A

Analyze pacemaker

0.00 0.35

NA 0.02 0.37

NA

XXX system. 93735............... .............. A

Analyze pacemaker

0.74 0.73

NA 0.08 1.55

NA

XXX system. 93735............... 26............ A

Analyze pacemaker

0.74 0.29 0.29 0.04 1.07 1.07

XXX system. 93735............... TC............ A

Analyze pacemaker

0.00 0.44

NA 0.04 0.48

NA

XXX system. 93736............... .............. A

Telephonic analy,

0.15 0.69

NA 0.07 0.91

NA

XXX pacemaker. 93736............... 26............ A

Telephonic analy,

0.15 0.06 0.06 0.01 0.22 0.22

XXX pacemaker. 93736............... TC............ A

Telephonic analy,

0.00 0.63

NA 0.06 0.69

NA

XXX pacemaker. 93740............... .............. B

Temperature gradient +0.16 0.20

NA 0.02 0.38

NA

XXX studies. 93740............... 26............ B

Temperature gradient +0.16 0.04 0.04 0.01 0.21 0.21

XXX studies. 93740............... TC............ B

Temperature gradient +0.00 0.16

NA 0.01 0.17

NA

XXX studies. 93741............... .............. A

Analyze ht pace

0.80 0.99

NA 0.06 1.85

NA

XXX device sngl. 93741............... 26............ A

Analyze ht pace

0.80 0.32 0.32 0.02 1.14 1.14

XXX device sngl. 93741............... TC............ A

Analyze ht pace

0.00 0.67

NA 0.04 0.71

NA

XXX device sngl. 93742............... .............. A

Analyze ht pace

0.91 1.03

NA 0.06 2.00

NA

XXX device sngl. 93742............... 26............ A

Analyze ht pace

0.91 0.36 0.36 0.02 1.29 1.29

XXX device sngl. 93742............... TC............ A

Analyze ht pace

0.00 0.67

NA 0.04 0.71

NA

XXX device sngl. 93743............... .............. A

Analyze ht pace

1.03 1.14

NA 0.08 2.25

NA

XXX device dual. 93743............... 26............ A

Analyze ht pace

1.03 0.40 0.40 0.04 1.47 1.47

XXX device dual. 93743............... TC............ A

Analyze ht pace

0.00 0.74

NA 0.04 0.78

NA

XXX device dual. 93744............... .............. A

Analyze ht pace

1.18 1.13

NA 0.08 2.39

NA

XXX device dual. 93744............... 26............ A

Analyze ht pace

1.18 0.46 0.46 0.04 1.68 1.68

XXX device dual. 93744............... TC............ A

Analyze ht pace

0.00 0.67

NA 0.04 0.71

NA

XXX device dual. 93760............... .............. N

Cephalic thermogram.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 93762............... .............. N

Peripheral thermogram 0.00 0.00 0.00 0.00 0.00 0.00

XXX 93770............... .............. B

Measure venous

+0.16 0.08

NA 0.02 0.26

NA

XXX pressure. 93770............... 26............ B

Measure venous

+0.16 0.05 0.05 0.01 0.22 0.22

XXX pressure. 93770............... TC............ B

Measure venous

+0.00 0.03

NA 0.01 0.04

NA

XXX pressure. 93784............... .............. A

Ambulatory BP

0.38 1.55

NA 0.03 1.96

NA

XXX monitoring. 93786............... .............. A

Ambulatory BP

0.00 0.91

NA 0.01 0.92

NA

XXX recording. 93788............... .............. A

Ambulatory BP

0.00 0.51

NA 0.01 0.52

NA

XXX analysis. 93790............... .............. A

Review/report BP

0.38 0.13 0.13 0.01 0.52 0.52

XXX recording. 93797............... .............. A

Cardiac rehab........ 0.18 0.37 0.07 0.01 0.56 0.26

000 93798............... .............. A

Cardiac rehab/monitor 0.28 0.49 0.11 0.01 0.78 0.40

000 93799............... .............. C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 93799............... 26............ C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 93799............... TC............ C

Cardiovascular

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 93875............... .............. A

Extracranial study... 0.22 1.66

NA 0.12 2.00

NA

XXX 93875............... 26............ A

Extracranial study... 0.22 0.08 0.08 0.01 0.31 0.31

XXX 93875............... TC............ A

Extracranial study... 0.00 1.58

NA 0.11 1.69

NA

XXX 93880............... .............. A

Extracranial study... 0.60 4.18

NA 0.40 5.18

NA

XXX

[[Page 1228]]

93880............... 26............ A

Extracranial study... 0.60 0.21 0.21 0.05 0.86 0.86

XXX 93880............... TC............ A

Extracranial study... 0.00 3.97

NA 0.35 4.32

NA

XXX 93882............... .............. A

Extracranial study... 0.40 3.01

NA 0.27 3.68

NA

XXX 93882............... 26............ A

Extracranial study... 0.40 0.14 0.14 0.05 0.59 0.59

XXX 93882............... TC............ A

Extracranial study... 0.00 2.87

NA 0.22 3.09

NA

XXX 93886............... .............. A

Intracranial study... 0.94 4.47

NA 0.45 5.86

NA

XXX 93886............... 26............ A

Intracranial study... 0.94 0.37 0.37 0.06 1.37 1.37

XXX 93886............... TC............ A

Intracranial study... 0.00 4.10

NA 0.39 4.49

NA

XXX 93888............... .............. A

Intracranial study... 0.62 3.02

NA 0.32 3.96

NA

XXX 93888............... 26............ A

Intracranial study... 0.62 0.23 0.23 0.05 0.90 0.90

XXX 93888............... TC............ A

Intracranial study... 0.00 2.79

NA 0.27 3.06

NA

XXX 93922............... .............. A

Extremity study...... 0.25 1.93

NA 0.15 2.33

NA

XXX 93922............... 26............ A

Extremity study...... 0.25 0.09 0.09 0.02 0.36 0.36

XXX 93922............... TC............ A

Extremity study...... 0.00 1.84

NA 0.13 1.97

NA

XXX 93923............... .............. A

Extremity study...... 0.45 3.00

NA 0.27 3.72

NA

XXX 93923............... 26............ A

Extremity study...... 0.45 0.15 0.15 0.05 0.65 0.65

XXX 93923............... TC............ A

Extremity study...... 0.00 2.85

NA 0.22 3.07

NA

XXX 93924............... .............. A

Extremity study...... 0.50 3.76

NA 0.31 4.57

NA

XXX 93924............... 26............ A

Extremity study...... 0.50 0.17 0.17 0.06 0.73 0.73

XXX 93924............... TC............ A

Extremity study...... 0.00 3.59

NA 0.25 3.84

NA

XXX 93925............... .............. A

Lower extremity study 0.58 4.87

NA 0.40 5.85

NA

XXX 93925............... 26............ A

Lower extremity study 0.58 0.20 0.20 0.05 0.83 0.83

XXX 93925............... TC............ A

Lower extremity study 0.00 4.67

NA 0.35 5.02

NA

XXX 93926............... .............. A

Lower extremity study 0.39 3.49

NA 0.27 4.15

NA

XXX 93926............... 26............ A

Lower extremity study 0.39 0.13 0.13 0.04 0.56 0.56

XXX 93926............... TC............ A

Lower extremity study 0.00 3.36

NA 0.23 3.59

NA

XXX 93930............... .............. A

Upper extremity study 0.46 3.85

NA 0.41 4.72

NA

XXX 93930............... 26............ A

Upper extremity study 0.46 0.16 0.16 0.04 0.66 0.66

XXX 93930............... TC............ A

Upper extremity study 0.00 3.69

NA 0.37 4.06

NA

XXX 93931............... .............. A

Upper extremity study 0.31 2.82

NA 0.26 3.39

NA

XXX 93931............... 26............ A

Upper extremity study 0.31 0.11 0.11 0.02 0.44 0.44

XXX 93931............... TC............ A

Upper extremity study 0.00 2.71

NA 0.24 2.95

NA

XXX 93965............... .............. A

Extremity study...... 0.35 1.86

NA 0.14 2.35

NA

XXX 93965............... 26............ A

Extremity study...... 0.35 0.12 0.12 0.02 0.49 0.49

XXX 93965............... TC............ A

Extremity study...... 0.00 1.74

NA 0.12 1.86

NA

XXX 93970............... .............. A

Extremity study...... 0.68 3.97

NA 0.46 5.11

NA

XXX 93970............... 26............ A

Extremity study...... 0.68 0.23 0.23 0.06 0.97 0.97

XXX 93970............... TC............ A

Extremity study...... 0.00 3.74

NA 0.40 4.14

NA

XXX 93971............... .............. A

Extremity study...... 0.45 2.86

NA 0.31 3.62

NA

XXX 93971............... 26............ A

Extremity study...... 0.45 0.15 0.15 0.04 0.64 0.64

XXX 93971............... TC............ A

Extremity study...... 0.00 2.71

NA 0.27 2.98

NA

XXX 93975............... .............. A

Vascular study....... 1.80 5.82

NA 0.56 8.18

NA

XXX 93975............... 26............ A

Vascular study....... 1.80 0.60 0.60 0.13 2.53 2.53

XXX 93975............... TC............ A

Vascular study....... 0.00 5.22

NA 0.43 5.65

NA

XXX 93976............... .............. A

Vascular study....... 1.21 3.46

NA 0.37 5.04

NA

XXX 93976............... 26............ A

Vascular study....... 1.21 0.40 0.40 0.07 1.68 1.68

XXX 93976............... TC............ A

Vascular study....... 0.00 3.06

NA 0.30 3.36

NA

XXX 93978............... .............. A

Vascular study....... 0.65 3.58

NA 0.43 4.66

NA

XXX 93978............... 26............ A

Vascular study....... 0.65 0.22 0.22 0.06 0.93 0.93

XXX 93978............... TC............ A

Vascular study....... 0.00 3.36

NA 0.37 3.73

NA

XXX 93979............... .............. A

Vascular study....... 0.44 2.65

NA 0.29 3.38

NA

XXX 93979............... 26............ A

Vascular study....... 0.44 0.15 0.15 0.05 0.64 0.64

XXX 93979............... TC............ A

Vascular study....... 0.00 2.50

NA 0.24 2.74

NA

XXX 93980............... .............. A

Penile vascular study 1.25 4.78

NA 0.42 6.45

NA

XXX 93980............... 26............ A

Penile vascular study 1.25 0.41 0.41 0.08 1.74 1.74

XXX 93980............... TC............ A

Penile vascular study 0.00 4.37

NA 0.34 4.71

NA

XXX 93981............... .............. A

Penile vascular study 0.44 4.61

NA 0.33 5.38

NA

XXX 93981............... 26............ A

Penile vascular study 0.44 0.15 0.15 0.02 0.61 0.61

XXX 93981............... TC............ A

Penile vascular study 0.00 4.46

NA 0.31 4.77

NA

XXX 93990............... .............. A

Doppler flow testing. 0.25 3.42

NA 0.25 3.92

NA

XXX 93990............... 26............ A

Doppler flow testing. 0.25 0.09 0.09 0.02 0.36 0.36

XXX 93990............... TC............ A

Doppler flow testing. 0.00 3.33

NA 0.23 3.56

NA

XXX 94010............... .............. A

Breathing capacity

0.17 0.67

NA 0.03 0.87

NA

XXX test. 94010............... 26............ A

Breathing capacity

0.17 0.05 0.05 0.01 0.23 0.23

XXX test. 94010............... TC............ A

Breathing capacity

0.00 0.62

NA 0.02 0.64

NA

XXX test. 94014............... .............. A

Patient recorded

0.52 0.77

NA 0.03 1.32

NA

XXX spirometry. 94015............... .............. A

Patient recorded

0.00 0.60

NA 0.01 0.61

NA

XXX spirometry. 94016............... .............. A

Review patient

0.52 0.17 0.17 0.02 0.71 0.71

XXX spirometry. 94060............... .............. A

Evaluation of

0.31 1.12

NA 0.07 1.50

NA

XXX wheezing. 94060............... 26............ A

Evaluation of

0.31 0.10 0.10 0.01 0.42 0.42

XXX wheezing. 94060............... TC............ A

Evaluation of

0.00 1.02

NA 0.06 1.08

NA

XXX wheezing. 94070............... .............. A

Evaluation of

0.60 2.99

NA 0.12 3.71

NA

XXX wheezing. 94070............... 26............ A

Evaluation of

0.60 0.19 0.19 0.02 0.81 0.81

XXX wheezing. 94070............... TC............ A

Evaluation of

0.00 2.80

NA 0.10 2.90

NA

XXX wheezing. 94150............... .............. B

Vital capacity test.. +0.07 0.48

NA 0.02 0.57

NA

XXX

[[Page 1229]]

94150............... 26............ B

Vital capacity test.. +0.07 0.03 0.03 0.01 0.11 0.11

XXX 94150............... TC............ B

Vital capacity test.. +0.00 0.45

NA 0.01 0.46

NA

XXX 94200............... .............. A

Lung function test

0.11 0.44

NA 0.03 0.58

NA

XXX (MBC/MVV). 94200............... 26............ A

Lung function test

0.11 0.03 0.03 0.01 0.15 0.15

XXX (MBC/MVV). 94200............... TC............ A

Lung function test

0.00 0.41

NA 0.02 0.43

NA

XXX (MBC/MVV). 94240............... .............. A

Residual lung

0.26 0.65

NA 0.06 0.97

NA

XXX capacity. 94240............... 26............ A

Residual lung

0.26 0.08 0.08 0.01 0.35 0.35

XXX capacity. 94240............... TC............ A

Residual lung

0.00 0.57

NA 0.05 0.62

NA

XXX capacity. 94250............... .............. A

Expired gas

0.11 0.65

NA 0.02 0.78

NA

XXX collection. 94250............... 26............ A

Expired gas

0.11 0.03 0.03 0.01 0.15 0.15

XXX collection. 94250............... TC............ A

Expired gas

0.00 0.62

NA 0.01 0.63

NA

XXX collection. 94260............... .............. A

Thoracic gas volume.. 0.13 0.57

NA 0.05 0.75

NA

XXX 94260............... 26............ A

Thoracic gas volume.. 0.13 0.04 0.04 0.01 0.18 0.18

XXX 94260............... TC............ A

Thoracic gas volume.. 0.00 0.53

NA 0.04 0.57

NA

XXX 94350............... .............. A

Lung nitrogen washout 0.26 0.75

NA 0.05 1.06

NA

XXX curve. 94350............... 26............ A

Lung nitrogen washout 0.26 0.08 0.08 0.01 0.35 0.35

XXX curve. 94350............... TC............ A

Lung nitrogen washout 0.00 0.67

NA 0.04 0.71

NA

XXX curve. 94360............... .............. A

Measure airflow

0.26 0.69

NA 0.07 1.02

NA

XXX resistance. 94360............... 26............ A

Measure airflow

0.26 0.08 0.08 0.01 0.35 0.35

XXX resistance. 94360............... TC............ A

Measure airflow

0.00 0.61

NA 0.06 0.67

NA

XXX resistance. 94370............... .............. A

Breath airway closing 0.26 0.72

NA 0.03 1.01

NA

XXX volume. 94370............... 26............ A

Breath airway closing 0.26 0.08 0.08 0.01 0.35 0.35

XXX volume. 94370............... TC............ A

Breath airway closing 0.00 0.64

NA 0.02 0.66

NA

XXX volume. 94375............... .............. A

Respiratory flow

0.31 0.61

NA 0.03 0.95

NA

XXX volume loop. 94375............... 26............ A

Respiratory flow

0.31 0.10 0.10 0.01 0.42 0.42

XXX volume loop. 94375............... TC............ A

Respiratory flow

0.00 0.51

NA 0.02 0.53

NA

XXX volume loop. 94400............... .............. A

CO2 breathing

0.40 0.84

NA 0.07 1.31

NA

XXX response curve. 94400............... 26............ A

CO2 breathing

0.40 0.12 0.12 0.01 0.53 0.53

XXX response curve. 94400............... TC............ A

CO2 breathing

0.00 0.72

NA 0.06 0.78

NA

XXX response curve. 94450............... .............. A

Hypoxia response

0.40 0.68

NA 0.04 1.12

NA

XXX curve. 94450............... 26............ A

Hypoxia response

0.40 0.12 0.12 0.02 0.54 0.54

XXX curve. 94450............... TC............ A

Hypoxia response

0.00 0.56

NA 0.02 0.58

NA

XXX curve. 94620............... .............. A

Pulmonary stress test/ 0.64 2.42

NA 0.12 3.18

NA

XXX simple. 94620............... 26............ A

Pulmonary stress test/ 0.64 0.20 0.20 0.02 0.86 0.86

XXX simple. 94620............... TC............ A

Pulmonary stress test/ 0.00 2.22

NA 0.10 2.32

NA

XXX simple. 94621............... .............. A

Pulm stress test/

1.42 2.06

NA 0.16 3.64

NA

XXX complex. 94621............... 26............ A

Pulm stress test/

1.42 0.43 0.43 0.06 1.91 1.91

XXX complex. 94621............... TC............ A

Pulm stress test/

0.00 1.63

NA 0.10 1.73

NA

XXX complex. 94640............... .............. A

Airway inhalation

0.00 0.32

NA 0.02 0.34

NA

XXX treatment. 94642............... .............. C

Aerosol inhalation

0.00 0.00 0.00 0.00 0.00 0.00

XXX treatment. 94656............... .............. A

Initial ventilator

1.22 1.18 0.32 0.07 2.47 1.61

XXX mgmt. 94657............... .............. A

Continued ventilator

0.83 1.00 0.25 0.04 1.87 1.12

XXX mgmt. 94660............... .............. A

Pos airway pressure,

0.76 0.66 0.24 0.04 1.46 1.04

XXX CPAP. 94662............... .............. A

Neg press

0.76

NA 0.24 0.02

NA 1.02

XXX ventilation, cnp. 94664............... .............. A

Evaluate pt use of

0.00 0.32

NA 0.04 0.36

NA

XXX inhaler. 94667............... .............. A

Chest wall

0.00 0.54

NA 0.05 0.59

NA

XXX manipulation. 94668............... .............. A

Chest wall

0.00 0.46

NA 0.02 0.48

NA

XXX manipulation. 94680............... .............. A

Exhaled air analysis, 0.26 1.89

NA 0.07 2.22

NA

XXX o2. 94680............... 26............ A

Exhaled air analysis, 0.26 0.08 0.08 0.01 0.35 0.35

XXX o2. 94680............... TC............ A

Exhaled air analysis, 0.00 1.81

NA 0.06 1.87

NA

XXX o2. 94681............... .............. A

Exhaled air analysis, 0.20 2.62

NA 0.13 2.95

NA

XXX o2/co2. 94681............... 26............ A

Exhaled air analysis, 0.20 0.07 0.07 0.01 0.28 0.28

XXX o2/co2. 94681............... TC............ A

Exhaled air analysis, 0.00 2.55

NA 0.12 2.67

NA

XXX o2/co2. 94690............... .............. A

Exhaled air analysis. 0.07 1.97

NA 0.05 2.09

NA

XXX 94690............... 26............ A

Exhaled air analysis. 0.07 0.02 0.02 0.01 0.10 0.10

XXX 94690............... TC............ A

Exhaled air analysis. 0.00 1.95

NA 0.04 1.99

NA

XXX 94720............... .............. A

Monoxide diffusing

0.26 1.00

NA 0.07 1.33

NA

XXX capacity. 94720............... 26............ A

Monoxide diffusing

0.26 0.08 0.08 0.01 0.35 0.35

XXX capacity. 94720............... TC............ A

Monoxide diffusing

0.00 0.92

NA 0.06 0.98

NA

XXX capacity. 94725............... .............. A

Membrane diffusion

0.26 2.92

NA 0.13 3.31

NA

XXX capacity. 94725............... 26............ A

Membrane diffusion

0.26 0.08 0.08 0.01 0.35 0.35

XXX capacity. 94725............... TC............ A

Membrane diffusion

0.00 2.84

NA 0.12 2.96

NA

XXX capacity. 94750............... .............. A

Pulmonary compliance

0.23 1.35

NA 0.05 1.63

NA

XXX study. 94750............... 26............ A

Pulmonary compliance

0.23 0.07 0.07 0.01 0.31 0.31

XXX study. 94750............... TC............ A

Pulmonary compliance

0.00 1.28

NA 0.04 1.32

NA

XXX study. 94760............... .............. T

Measure blood oxygen

0.00 0.04

NA 0.02 0.06

NA

XXX level. 94761............... .............. T

Measure blood oxygen

0.00 0.07

NA 0.06 0.13

NA

XXX level. 94762............... .............. A

Measure blood oxygen

0.00 0.40

NA 0.10 0.50

NA

XXX level. 94770............... .............. A

Exhaled carbon

0.15 1.67

NA 0.08 1.90

NA

XXX dioxide test. 94770............... 26............ A

Exhaled carbon

0.15 0.04 0.04 0.01 0.20 0.20

XXX dioxide test. 94770............... TC............ A

Exhaled carbon

0.00 1.63

NA 0.07 1.70

NA

XXX dioxide test. 94772............... .............. C

Breath recording,

0.00 0.00 0.00 0.00 0.00 0.00

XXX infant. 94772............... 26............ C

Breath recording,

0.00 0.00 0.00 0.00 0.00 0.00

XXX infant. 94772............... TC............ C

Breath recording,

0.00 0.00 0.00 0.00 0.00 0.00

XXX infant. 94799............... .............. C

Pulmonary service/

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure.

[[Page 1230]]

94799............... 26............ C

Pulmonary service/

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 94799............... TC............ C

Pulmonary service/

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 95004............... .............. A

Percut allergy skin

0.00 0.10

NA 0.01 0.11

NA

XXX tests. 95010............... .............. A

Percut allergy

0.15 0.33 0.06 0.01 0.49 0.22

XXX titrate test. 95015............... .............. A

Id allergy titrate-

0.15 0.15 0.06 0.01 0.31 0.22

XXX drug/bug. 95024............... .............. A

Id allergy test, drug/ 0.00 0.15

NA 0.01 0.16

NA

XXX bug. 95027............... .............. A

Id allergy titrate-

0.00 0.15

NA 0.01 0.16

NA

XXX airborne. 95028............... .............. A

Id allergy test-

0.00 0.24

NA 0.01 0.25

NA

XXX delayed type. 95044............... .............. A

Allergy patch tests.. 0.00 0.21

NA 0.01 0.22

NA

XXX 95052............... .............. A

Photo patch test..... 0.00 0.26

NA 0.01 0.27

NA

XXX 95056............... .............. A

Photosensitivity

0.00 0.18

NA 0.01 0.19

NA

XXX tests. 95060............... .............. A

Eye allergy tests.... 0.00 0.35

NA 0.02 0.37

NA

XXX 95065............... .............. A

Nose allergy test.... 0.00 0.21

NA 0.01 0.22

NA

XXX 95070............... .............. A

Bronchial allergy

0.00 2.29

NA 0.02 2.31

NA

XXX tests. 95071............... .............. A

Bronchial allergy

0.00 2.93

NA 0.02 2.95

NA

XXX tests. 95075............... .............. A

Ingestion challenge

0.95 0.83 0.38 0.04 1.82 1.37

XXX test. 95078............... .............. A

Provocative testing.. 0.00 0.26

NA 0.02 0.28

NA

XXX 95115............... .............. A

Immunotherapy, one

0.00 0.38

NA 0.02 0.40

NA

000 injection. 95117............... .............. A

Immunotherapy

0.00 0.50

NA 0.02 0.52

NA

000 injections. 95120............... .............. I

Immunotherapy, one

0.00 0.00 0.00 0.00 0.00 0.00

XXX injection. 95125............... .............. I

Immunotherapy, many

0.00 0.00 0.00 0.00 0.00 0.00

XXX antigens. 95130............... .............. I

Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00

XXX venom. 95131............... .............. I

Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00

XXX venoms. 95132............... .............. I

Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00

XXX venoms. 95133............... .............. I

Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00

XXX venoms. 95134............... .............. I

Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00

XXX venoms. 95144............... .............. A

Antigen therapy

0.06 0.15 0.02 0.01 0.22 0.09

000 services. 95145............... .............. A

Antigen therapy

0.06 0.33 0.02 0.01 0.40 0.09

000 services. 95146............... .............. A

Antigen therapy

0.06 0.44 0.03 0.01 0.51 0.10

000 services. 95147............... .............. A

Antigen therapy

0.06 0.42 0.02 0.01 0.49 0.09

000 services. 95148............... .............. A

Antigen therapy

0.06 0.58 0.03 0.01 0.65 0.10

000 services. 95149............... .............. A

Antigen therapy

0.06 0.81 0.03 0.01 0.88 0.10

000 services. 95165............... .............. A

Antigen therapy

0.06 0.20 0.02 0.01 0.27 0.09

000 services. 95170............... .............. A

Antigen therapy

0.06 0.14 0.02 0.01 0.21 0.09

000 services. 95180............... .............. A

Rapid desensitization 2.01 1.52 0.82 0.05 3.58 2.88

000 95199............... .............. C

Allergy immunology

0.00 0.00 0.00 0.00 0.00 0.00

000 services. 95250............... .............. A

Glucose monitoring,

0.00 3.82

NA 0.01 3.83

NA

XXX cont. 95805............... .............. A

Multiple sleep

1.88 16.26

NA 0.41 18.55

NA

XXX latency test. 95805............... 26............ A

Multiple sleep

1.88 0.66 0.66 0.07 2.61 2.61

XXX latency test. 95805............... TC............ A

Multiple sleep

0.00 15.60

NA 0.34 15.94

NA

XXX latency test. 95806............... .............. A

Sleep study,

1.66 3.81

NA 0.38 5.85

NA

XXX unattended. 95806............... 26............ A

Sleep study,

1.66 0.53 0.53 0.07 2.26 2.26

XXX unattended. 95806............... TC............ A

Sleep study,

0.00 3.28

NA 0.31 3.59

NA

XXX unattended. 95807............... .............. A

Sleep study, attended 1.66 11.67

NA 0.48 13.81

NA

XXX 95807............... 26............ A

Sleep study, attended 1.66 0.53 0.53 0.06 2.25 2.25

XXX 95807............... TC............ A

Sleep study, attended 0.00 11.14

NA 0.42 11.56

NA

XXX 95808............... .............. A

Polysomnography, 1-3. 2.65 12.91

NA 0.53 16.09

NA

XXX 95808............... 26............ A

Polysomnography, 1-3. 2.65 0.93 0.93 0.11 3.69 3.69

XXX 95808............... TC............ A

Polysomnography, 1-3. 0.00 11.98

NA 0.42 12.40

NA

XXX 95810............... .............. A

Polysomnography, 4 or 3.52 17.02

NA 0.56 21.10

NA

XXX more. 95810............... 26............ A

Polysomnography, 4 or 3.52 1.18 1.18 0.14 4.84 4.84

XXX more. 95810............... TC............ A

Polysomnography, 4 or 0.00 15.84

NA 0.42 16.26

NA

XXX more. 95811............... .............. A

Polysomnography w/

3.79 18.45

NA 0.59 22.83

NA

XXX cpap. 95811............... 26............ A

Polysomnography w/

3.79 1.27 1.27 0.16 5.22 5.22

XXX cpap. 95811............... TC............ A

Polysomnography w/

0.00 17.18

NA 0.43 17.61

NA

XXX cpap. 95812............... .............. A

Eeg, 41-60 minutes... 1.08 3.91

NA 0.16 5.15

NA

XXX 95812............... 26............ A

Eeg, 41-60 minutes... 1.08 0.45 0.45 0.05 1.58 1.58

XXX 95812............... TC............ A

Eeg, 41-60 minutes... 0.00 3.46

NA 0.11 3.57

NA

XXX 95813............... .............. A

Eeg, over 1 hour..... 1.73 4.93

NA 0.18 6.84

NA

XXX 95813............... 26............ A

Eeg, over 1 hour..... 1.73 0.70 0.70 0.07 2.50 2.50

XXX 95813............... TC............ A

Eeg, over 1 hour..... 0.00 4.23

NA 0.11 4.34

NA

XXX 95816............... .............. A

Eeg, awake and drowsy 1.08 3.14

NA 0.15 4.37

NA

XXX 95816............... 26............ A

Eeg, awake and drowsy 1.08 0.46 0.46 0.05 1.59 1.59

XXX 95816............... TC............ A

Eeg, awake and drowsy 0.00 2.68

NA 0.10 2.78

NA

XXX 95819............... .............. A

Eeg, awake and asleep 1.08 3.69

NA 0.15 4.92

NA

XXX 95819............... 26............ A

Eeg, awake and asleep 1.08 0.46 0.46 0.05 1.59 1.59

XXX 95819............... TC............ A

Eeg, awake and asleep 0.00 3.23

NA 0.10 3.33

NA

XXX 95822............... .............. A

Eeg, coma or sleep

1.08 4.35

NA 0.18 5.61

NA

XXX only. 95822............... 26............ A

Eeg, coma or sleep

1.08 0.45 0.45 0.05 1.58 1.58

XXX only. 95822............... TC............ A

Eeg, coma or sleep

0.00 3.90

NA 0.13 4.03

NA

XXX only. 95824............... .............. C

Eeg, cerebral death

0.00 0.00 0.00 0.00 0.00 0.00

XXX only. 95824............... 26............ A

Eeg, cerebral death

0.74 0.32 0.32 0.06 1.12 1.12

XXX only. 95824............... TC............ C

Eeg, cerebral death

0.00 0.00

NA 0.00 0.00

NA

XXX only. 95827............... .............. A

Eeg, all night

1.08 2.70

NA 0.18 3.96

NA

XXX recording. 95827............... 26............ A

Eeg, all night

1.08 0.40 0.40 0.04 1.52 1.52

XXX recording.

[[Page 1231]]

95827............... TC............ A

Eeg, all night

0.00 2.30

NA 0.14 2.44

NA

XXX recording. 95829............... .............. A

Surgery

6.20 31.30

NA 0.39 37.89

NA

XXX electrocorticogram. 95829............... 26............ A

Surgery

6.20 2.33 2.33 0.37 8.90 8.90

XXX electrocorticogram. 95829............... TC............ A

Surgery

0.00 28.97

NA 0.02 28.99

NA

XXX electrocorticogram. 95830............... .............. A

Insert electrodes for 1.70 3.37 0.73 0.08 5.15 2.51

XXX EEG. 95831............... .............. A

Limb muscle testing,

0.28 0.34 0.13 0.01 0.63 0.42

XXX manual. 95832............... .............. A

Hand muscle testing,

0.29 0.25 0.12 0.01 0.55 0.42

XXX manual. 95833............... .............. A

Body muscle testing,

0.47 0.45 0.23 0.01 0.93 0.71

XXX manual. 95834............... .............. A

Body muscle testing,

0.60 0.50 0.28 0.02 1.12 0.90

XXX manual. 95851............... .............. A

Range of motion

0.16 0.37 0.08 0.01 0.54 0.25

XXX measurements. 95852............... .............. A

Range of motion

0.11 0.26 0.05 0.01 0.38 0.17

XXX measurements. 95857............... .............. A

Tensilon test........ 0.53 0.61 0.23 0.02 1.16 0.78

XXX 95858............... .............. A

Tensilon test &

1.56 1.06

NA 0.09 2.71

NA

XXX myogram. 95858............... 26............ A

Tensilon test &

1.56 0.67 0.67 0.05 2.28 2.28

XXX myogram. 95858............... TC............ A

Tensilon test &

0.00 0.39

NA 0.04 0.43

NA

XXX myogram. 95860............... .............. A

Muscle test, one limb 0.96 1.45

NA 0.06 2.47

NA

XXX 95860............... 26............ A

Muscle test, one limb 0.96 0.42 0.42 0.04 1.42 1.42

XXX 95860............... TC............ A

Muscle test, one limb 0.00 1.03

NA 0.02 1.05

NA

XXX 95861............... .............. A

Muscle test, 2 limbs. 1.54 1.42

NA 0.12 3.08

NA

XXX 95861............... 26............ A

Muscle test, 2 limbs. 1.54 0.68 0.68 0.06 2.28 2.28

XXX 95861............... TC............ A

Muscle test, 2 limbs. 0.00 0.74

NA 0.06 0.80

NA

XXX 95863............... .............. A

Muscle test, 3 limbs. 1.87 1.75

NA 0.13 3.75

NA

XXX 95863............... 26............ A

Muscle test, 3 limbs. 1.87 0.81 0.81 0.07 2.75 2.75

XXX 95863............... TC............ A

Muscle test, 3 limbs. 0.00 0.94

NA 0.06 1.00

NA

XXX 95864............... .............. A

Muscle test, 4 limbs. 1.99 2.66

NA 0.19 4.84

NA

XXX 95864............... 26............ A

Muscle test, 4 limbs. 1.99 0.87 0.87 0.07 2.93 2.93

XXX 95864............... TC............ A

Muscle test, 4 limbs. 0.00 1.79

NA 0.12 1.91

NA

XXX 95867............... .............. A

Muscle test cran nerv 0.79 0.93

NA 0.08 1.80

NA

XXX unilat. 95867............... 26............ A

Muscle test cran nerv 0.79 0.35 0.35 0.04 1.18 1.18

XXX unilat. 95867............... TC............ A

Muscle test cran nerv 0.00 0.58

NA 0.04 0.62

NA

XXX unilat. 95868............... .............. A

Muscle test cran

1.18 1.21

NA 0.10 2.49

NA

XXX nerve bilat. 95868............... 26............ A

Muscle test cran

1.18 0.51 0.51 0.05 1.74 1.74

XXX nerve bilat. 95868............... TC............ A

Muscle test cran

0.00 0.70

NA 0.05 0.75

NA

XXX nerve bilat. 95869............... .............. A

Muscle test, thor

0.37 0.38

NA 0.03 0.78

NA

XXX paraspinal. 95869............... 26............ A

Muscle test, thor

0.37 0.16 0.16 0.01 0.54 0.54

XXX paraspinal. 95869............... TC............ A

Muscle test, thor

0.00 0.22

NA 0.02 0.24

NA

XXX paraspinal. 95870............... .............. A

Muscle test,

0.37 0.38

NA 0.03 0.78

NA

XXX nonparaspinal. 95870............... 26............ A

Muscle test,

0.37 0.16 0.16 0.01 0.54 0.54

XXX nonparaspinal. 95870............... TC............ A

Muscle test,

0.00 0.22

NA 0.02 0.24

NA

XXX nonparaspinal. 95872............... .............. A

Muscle test, one

1.50 1.23

NA 0.10 2.83

NA

XXX fiber. 95872............... 26............ A

Muscle test, one

1.50 0.63 0.63 0.05 2.18 2.18

XXX fiber. 95872............... TC............ A

Muscle test, one

0.00 0.60

NA 0.05 0.65

NA

XXX fiber. 95875............... .............. A

Limb exercise test... 1.10 1.46

NA 0.11 2.67

NA

XXX 95875............... 26............ A

Limb exercise test... 1.10 0.46 0.46 0.05 1.61 1.61

XXX 95875............... TC............ A

Limb exercise test... 0.00 1.00

NA 0.06 1.06

NA

XXX 95900............... .............. A

Motor nerve

0.42 1.29

NA 0.03 1.74

NA

XXX conduction test. 95900............... 26............ A

Motor nerve

0.42 0.19 0.19 0.01 0.62 0.62

XXX conduction test. 95900............... TC............ A

Motor nerve

0.00 1.10

NA 0.02 1.12

NA

XXX conduction test. 95903............... .............. A

Motor nerve

0.60 1.21

NA 0.04 1.85

NA

XXX conduction test. 95903............... 26............ A

Motor nerve

0.60 0.26 0.26 0.02 0.88 0.88

XXX conduction test. 95903............... TC............ A

Motor nerve

0.00 0.95

NA 0.02 0.97

NA

XXX conduction test. 95904............... .............. A

Sense nerve

0.34 1.11

NA 0.03 1.48

NA

XXX conduction test. 95904............... 26............ A

Sense nerve

0.34 0.15 0.15 0.01 0.50 0.50

XXX conduction test. 95904............... TC............ A

Sense nerve

0.00 0.96

NA 0.02 0.98

NA

XXX conduction test. 95920............... .............. A

Intraop nerve test

2.11 2.25

NA 0.24 4.60

NA

ZZZ add-on. 95920............... 26............ A

Intraop nerve test

2.11 0.94 0.94 0.17 3.22 3.22

ZZZ add-on. 95920............... TC............ A

Intraop nerve test

0.00 1.31

NA 0.07 1.38

NA

ZZZ add-on. 95921............... .............. A

Autonomic nerv

0.90 0.70

NA 0.06 1.66

NA

XXX function test. 95921............... 26............ A

Autonomic nerv

0.90 0.33 0.33 0.04 1.27 1.27

XXX function test. 95921............... TC............ A

Autonomic nerv

0.00 0.37

NA 0.02 0.39

NA

XXX function test. 95922............... .............. A

Autonomic nerv

0.96 0.77

NA 0.06 1.79

NA

XXX function test. 95922............... 26............ A

Autonomic nerv

0.96 0.40 0.40 0.04 1.40 1.40

XXX function test. 95922............... TC............ A

Autonomic nerv

0.00 0.37

NA 0.02 0.39

NA

XXX function test. 95923............... .............. A

Autonomic nerv

0.90 2.08

NA 0.06 3.04

NA

XXX function test. 95923............... 26............ A

Autonomic nerv

0.90 0.37 0.37 0.04 1.31 1.31

XXX function test. 95923............... TC............ A

Autonomic nerv

0.00 1.71

NA 0.02 1.73

NA

XXX function test. 95925............... .............. A

Somatosensory testing 0.54 1.14

NA 0.08 1.76

NA

XXX 95925............... 26............ A

Somatosensory testing 0.54 0.23 0.23 0.02 0.79 0.79

XXX 95925............... TC............ A

Somatosensory testing 0.00 0.91

NA 0.06 0.97

NA

XXX 95926............... .............. A

Somatosensory testing 0.54 1.15

NA 0.08 1.77

NA

XXX 95926............... 26............ A

Somatosensory testing 0.54 0.24 0.24 0.02 0.80 0.80

XXX 95926............... TC............ A

Somatosensory testing 0.00 0.91

NA 0.06 0.97

NA

XXX 95927............... .............. A

Somatosensory testing 0.54 1.16

NA 0.10 1.80

NA

XXX 95927............... 26............ A

Somatosensory testing 0.54 0.25 0.25 0.04 0.83 0.83

XXX 95927............... TC............ A

Somatosensory testing 0.00 0.91

NA 0.06 0.97

NA

XXX

[[Page 1232]]

95930............... .............. A

Visual evoked

0.35 1.43

NA 0.02 1.80

NA

XXX potential test. 95930............... 26............ A

Visual evoked

0.35 0.15 0.15 0.01 0.51 0.51

XXX potential test. 95930............... TC............ A

Visual evoked

0.00 1.28

NA 0.01 1.29

NA

XXX potential test. 95933............... .............. A

Blink reflex test.... 0.59 1.03

NA 0.08 1.70

NA

XXX 95933............... 26............ A

Blink reflex test.... 0.59 0.24 0.24 0.02 0.85 0.85

XXX 95933............... TC............ A

Blink reflex test.... 0.00 0.79

NA 0.06 0.85

NA

XXX 95934............... .............. A

H-reflex test........ 0.51 0.44

NA 0.04 0.99

NA

XXX 95934............... 26............ A

H-reflex test........ 0.51 0.22 0.22 0.02 0.75 0.75

XXX 95934............... TC............ A

H-reflex test........ 0.00 0.22

NA 0.02 0.24

NA

XXX 95936............... .............. A

H-reflex test........ 0.55 0.46

NA 0.04 1.05

NA

XXX 95936............... 26............ A

H-reflex test........ 0.55 0.24 0.24 0.02 0.81 0.81

XXX 95936............... TC............ A

H-reflex test........ 0.00 0.22

NA 0.02 0.24

NA

XXX 95937............... .............. A

Neuromuscular

0.65 0.61

NA 0.04 1.30

NA

XXX junction test. 95937............... 26............ A

Neuromuscular

0.65 0.27 0.27 0.02 0.94 0.94

XXX junction test. 95937............... TC............ A

Neuromuscular

0.00 0.34

NA 0.02 0.36

NA

XXX junction test. 95950............... .............. A

Ambulatory eeg

1.51 4.47

NA 0.53 6.51

NA

XXX monitoring. 95950............... 26............ A

Ambulatory eeg

1.51 0.64 0.64 0.10 2.25 2.25

XXX monitoring. 95950............... TC............ A

Ambulatory eeg

0.00 3.83

NA 0.43 4.26

NA

XXX monitoring. 95951............... .............. C

EEG monitoring/

0.00 0.00

NA 0.00 0.00

NA

XXX videorecord. 95951............... 26............ A

EEG monitoring/

5.99 2.57 2.57 0.24 8.80 8.80

XXX videorecord. 95951............... TC............ C

EEG monitoring/

0.00 0.00

NA 0.00 0.00

NA

XXX videorecord. 95953............... .............. A

EEG monitoring/

3.08 7.64

NA 0.55 11.27

NA

XXX computer. 95953............... 26............ A

EEG monitoring/

3.08 1.29 1.29 0.12 4.49 4.49

XXX computer. 95953............... TC............ A

EEG monitoring/

0.00 6.35

NA 0.43 6.78

NA

XXX computer. 95954............... .............. A

EEG monitoring/giving 2.45 4.29

NA 0.18 6.92

NA

XXX drugs. 95954............... 26............ A

EEG monitoring/giving 2.45 1.05 1.05 0.12 3.62 3.62

XXX drugs. 95954............... TC............ A

EEG monitoring/giving 0.00 3.24

NA 0.06 3.30

NA

XXX drugs. 95955............... .............. A

EEG during surgery... 1.01 2.33

NA 0.23 3.57

NA

XXX 95955............... 26............ A

EEG during surgery... 1.01 0.36 0.36 0.06 1.43 1.43

XXX 95955............... TC............ A

EEG during surgery... 0.00 1.97

NA 0.17 2.14

NA

XXX 95956............... .............. A

Eeg monitoring, cable/ 3.08 14.14

NA 0.56 17.78

NA

XXX radio. 95956............... 26............ A

Eeg monitoring, cable/ 3.08 1.30 1.30 0.13 4.51 4.51

XXX radio. 95956............... TC............ A

Eeg monitoring, cable/ 0.00 12.84

NA 0.43 13.27

NA

XXX radio. 95957............... .............. A

EEG digital analysis. 1.98 2.56

NA 0.20 4.74

NA

XXX 95957............... 26............ A

EEG digital analysis. 1.98 0.85 0.85 0.08 2.91 2.91

XXX 95957............... TC............ A

EEG digital analysis. 0.00 1.71

NA 0.12 1.83

NA

XXX 95958............... .............. A

EEG monitoring/

4.24 3.50

NA 0.35 8.09

NA

XXX function test. 95958............... 26............ A

EEG monitoring/

4.24 1.75 1.75 0.22 6.21 6.21

XXX function test. 95958............... TC............ A

EEG monitoring/

0.00 1.75

NA 0.13 1.88

NA

XXX function test. 95961............... .............. A

Electrode

2.97 2.63

NA 0.29 5.89

NA

XXX stimulation, brain. 95961............... 26............ A

Electrode

2.97 1.32 1.32 0.22 4.51 4.51

XXX stimulation, brain. 95961............... TC............ A

Electrode

0.00 1.31

NA 0.07 1.38

NA

XXX stimulation, brain. 95962............... .............. A

Electrode stim, brain 3.21 2.70

NA 0.28 6.19

NA

ZZZ add-on. 95962............... 26............ A

Electrode stim, brain 3.21 1.39 1.39 0.21 4.81 4.81

ZZZ add-on. 95962............... TC............ A

Electrode stim, brain 0.00 1.31

NA 0.07 1.38

NA

ZZZ add-on. 95965............... .............. C

Meg, spontaneous..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 95965............... 26............ A

Meg, spontaneous..... 7.99 3.42 3.42 0.37 11.78 11.78

XXX 95965............... TC............ C

Meg, spontaneous..... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 95966............... .............. C

Meg, evoked, single.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 95966............... 26............ A

Meg, evoked, single.. 3.99 1.73 1.73 0.18 5.90 5.90

XXX 95966............... TC............ C

Meg, evoked, single.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 95967............... .............. C

Meg, evoked, each

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ add'l. 95967............... 26............ A

Meg, evoked, each

3.49 1.33 1.33 0.16 4.98 4.98

ZZZ add'l. 95967............... TC............ C

Meg, evoked, each

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ add'l. 95970............... .............. A

Analyze neurostim, no 0.45 0.17 0.15 0.04 0.66 0.64

XXX prog. 95971............... .............. A

Analyze neurostim,

0.78 0.28 0.23 0.07 1.13 1.08

XXX simple. 95972............... .............. A

Analyze neurostim,

1.50 0.59 0.49 0.21 2.30 2.20

XXX complex. 95973............... .............. A

Analyze neurostim,

0.92 0.39 0.35 0.08 1.39 1.35

ZZZ complex. 95974............... .............. A

Cranial neurostim,

3.00 1.29 1.29 0.18 4.47 4.47

XXX complex. 95975............... .............. A

Cranial neurostim,

1.70 0.73 0.73 0.08 2.51 2.51

ZZZ complex. 95990............... .............. A

Spin/brain pump refil 0.00 1.50

NA 0.06 1.56

NA

XXX & main. 95991............... .............. A

Spin/brain pump refil 0.77 1.43 0.19 0.06 2.26 1.02

XXX & main. 95999............... .............. C

Neurological

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 96000............... .............. A

Motion analysis,

1.80

NA 0.55 0.02

NA 2.37

XXX video/3d. 96001............... .............. A

Motion test w/ft

2.15

NA 0.66 0.02

NA 2.83

XXX press meas. 96002............... .............. A

Dynamic surface emg.. 0.41

NA 0.15 0.02

NA 0.58

XXX 96003............... .............. A

Dynamic fine wire emg 0.37

NA 0.14 0.04

NA 0.55

XXX 96004............... .............. A

Phys review of motion 2.14 0.95 0.95 0.10 3.19 3.19

XXX tests. 96100............... .............. A

Psychological testing 0.00 1.77

NA 0.18 1.95

NA

XXX 96105............... .............. A

Assessment of aphasia 0.00 1.77

NA 0.18 1.95

NA

XXX 96110............... .............. A

Developmental test,

0.00 0.19

NA 0.18 0.37

NA

XXX lim. 96111............... .............. A

Developmental test,

2.60 1.07

NA 0.18 3.85

NA

XXX extend. 96115............... .............. A

Neurobehavior status

0.00 1.77

NA 0.18 1.95

NA

XXX exam. 96117............... .............. A

Neuropsych test

0.00 1.77

NA 0.18 1.95

NA

XXX battery. 96150............... .............. A

Assess lth/behave,

0.50 0.19 0.18 0.02 0.71 0.70

XXX init.

[[Continued on page 1233]]

From the Federal Register Online via GPO Access [wais.access.gpo.gov] ]

[[pp. 1233-1267]] Medicare Program; Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004

[[Continued from page 1232]]

[[Page 1233]]

96151............... .............. A

Assess hlth/behave,

0.48 0.18 0.17 0.02 0.68 0.67

XXX subseq. 96152............... .............. A

Intervene hlth/

0.46 0.17 0.16 0.02 0.65 0.64

XXX behave, indiv. 96153............... .............. A

Intervene hlth/

0.10 0.04 0.04 0.01 0.15 0.15

XXX behave, group. 96154............... .............. A

Interv hlth/behav,

0.45 0.17 0.16 0.02 0.64 0.63

XXX fam w/pt. 96155............... .............. N

Interv hlth/behav fam +0.44 0.18 0.17 0.02 0.64 0.63

XXX no pt. 96400............... .............. A

Chemotherapy, sc/im.. 0.17 1.12

NA 0.01 1.30

NA

XXX 96405............... .............. A

Intralesional chemo

0.52 2.35 0.24 0.02 2.89 0.78

000 admin. 96406............... .............. A

Intralesional chemo

0.80 3.10 0.30 0.02 3.92 1.12

000 admin. 96408............... .............. A

Chemotherapy, push

0.17 2.91

NA 0.06 3.14

NA

XXX technique. 96410............... .............. A

Chemotherapy,infusion 0.17 4.16

NA 0.08 4.41

NA

XXX method. 96412............... .............. A

Chemo, infuse method

0.17 0.74

NA 0.07 0.98

NA

ZZZ add-on. 96414............... .............. A

Chemo, infuse method

0.17 5.22

NA 0.08 5.47

NA

XXX add-on. 96420............... .............. A

Chemotherapy, push

0.17 2.81

NA 0.08 3.06

NA

XXX technique. 96422............... .............. A

Chemotherapy,infusion 0.17 5.19

NA 0.08 5.44

NA

XXX method. 96423............... .............. A

Chemo, infuse method

0.17 1.96

NA 0.02 2.15

NA

ZZZ add-on. 96425............... .............. A

Chemotherapy,infusion 0.17 4.73

NA 0.08 4.98

NA

XXX method. 96440............... .............. A

Chemotherapy,

2.37 8.42 1.24 0.14 10.93 3.75

000 intracavitary. 96445............... .............. A

Chemotherapy,

2.20 8.54 1.19 0.08 10.82 3.47

000 intracavitary. 96450............... .............. A

Chemotherapy, into

1.89 7.32 1.10 0.07 9.28 3.06

000 CNS. 96520............... .............. A

Port pump refill &

0.17 3.94

NA 0.06 4.17

NA

XXX main. 96530............... .............. A

Syst pump refill &

0.17 2.86

NA 0.06 3.09

NA

XXX main. 96542............... .............. A

Chemotherapy

1.42 4.43 0.66 0.06 5.91 2.14

XXX injection. 96545............... .............. B

Provide chemotherapy

0.00 0.00 0.00 0.00 0.00 0.00

XXX agent. 96549............... .............. C

Chemotherapy,

0.00 0.00 0.00 0.00 0.00 0.00

XXX unspecified. 96567............... .............. A

Photodynamic tx, skin 0.00 0.98

NA 0.04 1.02

NA

XXX 96570............... .............. A

Photodynamic tx, 30

1.10

NA 0.37 0.05

NA 1.52

ZZZ min. 96571............... .............. A

Photodynamic tx, addl 0.55

NA 0.20 0.02

NA 0.77

ZZZ 15 min. 96900............... .............. A

Ultraviolet light

0.00 0.48

NA 0.02 0.50

NA

XXX therapy. 96902............... .............. B

Trichogram........... +0.41 0.25 0.16 0.01 0.67 0.58

XXX 96910............... .............. A

Photochemotherapy

0.00 1.07

NA 0.04 1.11

NA

XXX with UV-B. 96912............... .............. A

Photochemotherapy

0.00 1.34

NA 0.05 1.39

NA

XXX with UV-A. 96913............... .............. A

Photochemotherapy, UV- 0.00 1.78

NA 0.10 1.88

NA

XXX A or B. 96920............... .............. A

Laser tx, skin 500 sq cm. 96999............... .............. C

Dermatological

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 97001............... .............. A

Pt evaluation........ 1.20 0.73 0.45 0.06 1.99 1.71

XXX 97002............... .............. A

Pt re-evaluation..... 0.60 0.43 0.24 0.02 1.05 0.86

XXX 97003............... .............. A

Ot evaluation........ 1.20 0.86 0.40 0.06 2.12 1.66

XXX 97004............... .............. A

Ot re-evaluation..... 0.60 0.60 0.20 0.02 1.22 0.82

XXX 97005............... .............. I

Athletic train eval.. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 97006............... .............. I

Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.00

XXX 97010............... .............. B

Hot or cold packs

+0.06 0.05

NA 0.01 0.12

NA

XXX therapy. 97012............... .............. A

Mechanical traction

0.25 0.14

NA 0.01 0.40

NA

XXX therapy. 97014............... .............. I

Electric stimulation +0.18 0.19 0.19 0.01 0.38 0.38

XXX therapy. 97016............... .............. A

Vasopneumatic device

0.18 0.19

NA 0.01 0.38

NA

XXX therapy. 97018............... .............. A

Paraffin bath therapy 0.06 0.11

NA 0.01 0.18

NA

XXX 97020............... .............. A

Microwave therapy.... 0.06 0.06

NA 0.01 0.13

NA

XXX 97022............... .............. A

Whirlpool therapy.... 0.17 0.22

NA 0.01 0.40

NA

XXX 97024............... .............. A

Diathermy treatment.. 0.06 0.09

NA 0.01 0.16

NA

XXX 97026............... .............. A

Infrared therapy..... 0.06 0.06

NA 0.01 0.13

NA

XXX 97028............... .............. A

Ultraviolet therapy.. 0.08 0.07

NA 0.01 0.16

NA

XXX 97032............... .............. A

Electrical

0.25 0.16

NA 0.01 0.42

NA

XXX stimulation. 97033............... .............. A

Electric current

0.26 0.28

NA 0.02 0.56

NA

XXX therapy. 97034............... .............. A

Contrast bath therapy 0.21 0.16

NA 0.01 0.38

NA

XXX 97035............... .............. A

Ultrasound therapy... 0.21 0.11

NA 0.01 0.33

NA

XXX 97036............... .............. A

Hydrotherapy......... 0.28 0.33

NA 0.01 0.62

NA

XXX 97039............... .............. A

Physical therapy

0.20 0.10

NA 0.01 0.31

NA

XXX treatment. 97110............... .............. A

Therapeutic exercises 0.45 0.28

NA 0.04 0.77

NA

XXX 97112............... .............. A

Neuromuscular

0.45 0.30

NA 0.02 0.77

NA

XXX reeducation. 97113............... .............. A

Aquatic therapy/

0.44 0.40

NA 0.04 0.88

NA

XXX exercises. 97116............... .............. A

Gait training therapy 0.40 0.24

NA 0.02 0.66

NA

XXX 97124............... .............. A

Massage therapy...... 0.35 0.23

NA 0.01 0.59

NA

XXX 97139............... .............. A

Physical medicine

0.21 0.20

NA 0.01 0.42

NA

XXX procedure. 97140............... .............. A

Manual therapy....... 0.43 0.26

NA 0.02 0.71

NA

XXX 97150............... .............. A

Group therapeutic

0.27 0.18

NA 0.02 0.47

NA

XXX procedures. 97504............... .............. A

Orthotic training.... 0.45 0.33

NA 0.04 0.82

NA

XXX 97520............... .............. A

Prosthetic training.. 0.45 0.28

NA 0.02 0.75

NA

XXX 97530............... .............. A

Therapeutic

0.44 0.32

NA 0.02 0.78

NA

XXX activities. 97532............... .............. A

Cognitive skills

0.44 0.21

NA 0.01 0.66

NA

XXX development. 97533............... .............. A

Sensory integration.. 0.44 0.24

NA 0.01 0.69

NA

XXX 97535............... .............. A

Self care mngment

0.45 0.33

NA 0.02 0.80

NA

XXX training. 97537............... .............. A

Community/work

0.45 0.27

NA 0.01 0.73

NA

XXX reintegration. 97542............... .............. A

Wheelchair mngment

0.45 0.28

NA 0.01 0.74

NA

XXX training. 97545............... .............. R

Work hardening....... 0.00 0.00 0.00 0.00 0.00 0.00

XXX

[[Page 1234]]

97546............... .............. R

Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.00

ZZZ 97601............... .............. A

Wound(s) care,

0.50 0.49

NA 0.05 1.04

NA

XXX selective. 97602............... .............. B

Wound(s) care non-

0.00 0.00 0.00 0.00 0.00 0.00

XXX selective. 97703............... .............. A

Prosthetic checkout.. 0.25 0.41

NA 0.02 0.68

NA

XXX 97750............... .............. A

Physical performance

0.45 0.30

NA 0.02 0.77

NA

XXX test. 97755............... .............. A

Assistive technology

0.62 0.29

NA 0.02 0.93

NA

XXX assess. 97780............... .............. N

Acupuncture w/o

0.00 0.00 0.00 0.00 0.00 0.00

XXX stimul. 97781............... .............. N

Acupuncture w/stimul. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 97799............... .............. C

Physical medicine

0.00 0.00 0.00 0.00 0.00 0.00

XXX procedure. 97802............... .............. A

Medical nutrition,

0.00 0.47

NA 0.01 0.48

NA

XXX indiv, in. 97803............... .............. A

Med nutrition, indiv, 0.00 0.47

NA 0.01 0.48

NA

XXX subseq. 97804............... .............. A

Medical nutrition,

0.00 0.19

NA 0.01 0.20

NA

XXX group. 98925............... .............. A

Osteopathic

0.45 0.33 0.14 0.01 0.79 0.60

000 manipulation. 98926............... .............. A

Osteopathic

0.65 0.42 0.25 0.02 1.09 0.92

000 manipulation. 98927............... .............. A

Osteopathic

0.87 0.51 0.30 0.04 1.42 1.21

000 manipulation. 98928............... .............. A

Osteopathic

1.03 0.60 0.35 0.04 1.67 1.42

000 manipulation. 98929............... .............. A

Osteopathic

1.19 0.68 0.37 0.05 1.92 1.61

000 manipulation. 98940............... .............. A

Chiropractic

0.45 0.24 0.12 0.01 0.70 0.58

000 manipulation. 98941............... .............. A

Chiropractic

0.65 0.30 0.18 0.02 0.97 0.85

000 manipulation. 98942............... .............. A

Chiropractic

0.87 0.36 0.24 0.04 1.27 1.15

000 manipulation. 98943............... .............. N

Chiropractic

+0.40 0.24 0.16 0.01 0.65 0.57

XXX manipulation. 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

0.00 0.00 0.00 0.00 0.00 0.00

XXX visit. 99025............... .............. F

Initial surgical

0.00 0.00 0.00 0.00 0.00 0.00

XXX evaluation. 99026............... .............. N

In-hospital on call

0.00 0.00 0.00 0.00 0.00 0.00

XXX service. 99027............... .............. N

Out-of-hosp on call

0.00 0.00 0.00 0.00 0.00 0.00

XXX service. 99050............... .............. B

Medical services

0.00 0.00 0.00 0.00 0.00 0.00

XXX after hrs. 99052............... .............. B

Medical services at

0.00 0.00 0.00 0.00 0.00 0.00

XXX night. 99054............... .............. B

Medical servcs,

0.00 0.00 0.00 0.00 0.00 0.00

XXX unusual hrs. 99056............... .............. B

Non-office medical

0.00 0.00 0.00 0.00 0.00 0.00

XXX services. 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

0.00 0.00 0.00 0.00 0.00 0.00

XXX materials. 99075............... .............. N

Medical testimony.... 0.00 0.00 0.00 0.00 0.00 0.00

XXX 99078............... .............. B

Group health

0.00 0.00 0.00 0.00 0.00 0.00

XXX education. 99080............... .............. B

Special reports or

0.00 0.00 0.00 0.00 0.00 0.00

XXX forms. 99082............... .............. C

Unusual physician

0.00 0.00 0.00 0.00 0.00 0.00

XXX travel. 99090............... .............. B

Computer data

0.00 0.00 0.00 0.00 0.00 0.00

XXX analysis. 99091............... .............. B

Collect/review data

0.00 0.00 0.00 0.00 0.00 0.00

XXX from pt. 99100............... .............. B

Special anesthesia

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ service. 99116............... .............. B

Anesthesia with

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ hypothermia. 99135............... .............. B

Special anesthesia

0.00 0.00 0.00 0.00 0.00 0.00

ZZZ procedure. 99140............... .............. B

Emergency anesthesia. 0.00 0.00 0.00 0.00 0.00 0.00

ZZZ 99141............... .............. B

Sedation, iv/im or

+0.80 1.92 0.38 0.05 2.77 1.23

XXX inhalant. 99142............... .............. B

Sedation, oral/rectal/ +0.60 0.99 0.31 0.04 1.63 0.95

XXX nasal. 99170............... .............. A

Anogenital exam,

1.75 1.72 0.52 0.08 3.55 2.35

000 child. 99172............... .............. N

Ocular function

0.00 0.00 0.00 0.00 0.00 0.00

XXX screen. 99173............... .............. N

Visual acuity screen. 0.00 0.00 0.00 0.00 0.00 0.00

XXX 99175............... .............. A

Induction of vomiting 0.00 1.40

NA 0.10 1.50

NA

XXX 99183............... .............. A

Hyperbaric oxygen

2.34 4.75 0.72 0.14 7.23 3.20

XXX therapy. 99185............... .............. A

Regional hypothermia. 0.00 0.64

NA 0.04 0.68

NA

XXX 99186............... .............. A

Total body

0.00 1.79

NA 0.45 2.24

NA

XXX hypothermia. 99190............... .............. X

Special pump services 0.00 0.00 0.00 0.00 0.00 0.00

XXX 99191............... .............. X

Special pump services 0.00 0.00 0.00 0.00 0.00 0.00

XXX 99192............... .............. X

Special pump services 0.00 0.00 0.00 0.00 0.00 0.00

XXX 99195............... .............. A

Phlebotomy........... 0.00 0.44

NA 0.02 0.46

NA

XXX 99199............... .............. C

Special service/proc/ 0.00 0.00 0.00 0.00 0.00 0.00

XXX report. 99201............... .............. A

Office/outpatient

0.45 0.50 0.16 0.02 0.97 0.63

XXX visit, new. 99202............... .............. A

Office/outpatient

0.88 0.79 0.32 0.06 1.73 1.26

XXX visit, new. 99203............... .............. A

Office/outpatient

1.34 1.13 0.48 0.10 2.57 1.92

XXX visit, new. 99204............... .............. A

Office/outpatient

2.00 1.51 0.71 0.12 3.63 2.83

XXX visit, new. 99205............... .............. A

Office/outpatient

2.67 1.80 0.95 0.14 4.61 3.76

XXX visit, new. 99211............... .............. A

Office/outpatient

0.17 0.39 0.06 0.01 0.57 0.24

XXX visit, est. 99212............... .............. A

Office/outpatient

0.45 0.54 0.16 0.02 1.01 0.63

XXX visit, est. 99213............... .............. A

Office/outpatient

0.67 0.70 0.24 0.04 1.41 0.95

XXX visit, est. 99214............... .............. A

Office/outpatient

1.10 1.05 0.40 0.05 2.20 1.55

XXX visit, est. 99215............... .............. A

Office/outpatient

1.77 1.34 0.65 0.08 3.19 2.50

XXX visit, est. 99217............... .............. A

Observation care

1.28

NA 0.53 0.06

NA 1.87

XXX discharge. 99218............... .............. A

Observation care..... 1.28

NA 0.43 0.06

NA 1.77

XXX 99219............... .............. A

Observation care..... 2.14

NA 0.72 0.10

NA 2.96

XXX 99220............... .............. A

Observation care..... 2.99

NA 1.03 0.13

NA 4.15

XXX 99221............... .............. A

Initial hospital care 1.28

NA 0.45 0.06

NA 1.79

XXX 99222............... .............. A

Initial hospital care 2.14

NA 0.74 0.10

NA 2.98

XXX

[[Page 1235]]

99223............... .............. A

Initial hospital care 2.99

NA 1.04 0.12

NA 4.15

XXX 99231............... .............. A

Subsequent hospital

0.64

NA 0.23 0.02

NA 0.89

XXX care. 99232............... .............. A

Subsequent hospital

1.06

NA 0.37 0.04

NA 1.47

XXX care. 99233............... .............. A

Subsequent hospital

1.51

NA 0.52 0.06

NA 2.09

XXX care. 99234............... .............. A

Observ/hosp same date 2.56

NA 1.00 0.13

NA 3.69

XXX 99235............... .............. A

Observ/hosp same date 3.41

NA 1.29 0.16

NA 4.86

XXX 99236............... .............. A

Observ/hosp same date 4.26

NA 1.59 0.21

NA 6.06

XXX 99238............... .............. A

Hospital discharge

1.28

NA 0.54 0.05

NA 1.87

XXX day. 99239............... .............. A

Hospital discharge

1.75

NA 0.74 0.06

NA 2.55

XXX day. 99241............... .............. A

Office consultation.. 0.64 0.65 0.22 0.05 1.34 0.91

XXX 99242............... .............. A

Office consultation.. 1.29 1.05 0.46 0.11 2.45 1.86

XXX 99243............... .............. A

Office consultation.. 1.72 1.39 0.63 0.12 3.23 2.47

XXX 99244............... .............. A

Office consultation.. 2.58 1.83 0.92 0.16 4.57 3.66

XXX 99245............... .............. A

Office consultation.. 3.42 2.29 1.24 0.19 5.90 4.85

XXX 99251............... .............. A

Initial inpatient

0.66

NA 0.25 0.05

NA 0.96

XXX consult. 99252............... .............. A

Initial inpatient

1.32

NA 0.50 0.10

NA 1.92

XXX consult. 99253............... .............. A

Initial inpatient

1.82

NA 0.68 0.11

NA 2.61

XXX consult. 99254............... .............. A

Initial inpatient

2.64

NA 0.99 0.13

NA 3.76

XXX consult. 99255............... .............. A

Initial inpatient

3.64

NA 1.35 0.18

NA 5.17

XXX consult. 99261............... .............. A

Follow-up inpatient

0.42

NA 0.16 0.02

NA 0.60

XXX consult. 99262............... .............. A

Follow-up inpatient

0.85

NA 0.31 0.04

NA 1.20

XXX consult. 99263............... .............. A

Follow-up inpatient

1.27

NA 0.45 0.05

NA 1.77

XXX consult. 99271............... .............. A

Confirmatory

0.45 0.55 0.16 0.04 1.04 0.65

XXX consultation. 99272............... .............. A

Confirmatory

0.84 0.82 0.31 0.07 1.73 1.22

XXX consultation. 99273............... .............. A

Confirmatory

1.19 1.10 0.44 0.08 2.37 1.71

XXX consultation. 99274............... .............. A

Confirmatory

1.73 1.36 0.64 0.11 3.20 2.48

XXX consultation. 99275............... .............. A

Confirmatory

2.31 1.64 0.84 0.12 4.07 3.27

XXX consultation. 99281............... .............. A

Emergency dept visit. 0.33

NA 0.09 0.02

NA 0.44

XXX 99282............... .............. A

Emergency dept visit. 0.55

NA 0.15 0.04

NA 0.74

XXX 99283............... .............. A

Emergency dept visit. 1.24

NA 0.31 0.10

NA 1.65

XXX 99284............... .............. A

Emergency dept visit. 1.95

NA 0.47 0.14

NA 2.56

XXX 99285............... .............. A

Emergency dept visit. 3.06

NA 0.72 0.23

NA 4.01

XXX 99288............... .............. B

Direct advanced life

0.00 0.00 0.00 0.00 0.00 0.00

XXX support. 99289............... .............. A

Ped crit care

4.79

NA 1.91 0.17

NA 6.87

XXX transport. 99290............... .............. A

Ped crit care

2.40

NA 0.83 0.08

NA 3.31

ZZZ transport addl. 99291............... .............. A

Critical care, first

3.99 2.34 1.28 0.17 6.50 5.44

XXX hour. 99292............... .............. A

Critical care, add'l

2.00 0.81 0.64 0.08 2.89 2.72

ZZZ 30 min. 99293............... .............. A

Ped critical care,

15.98

NA 4.96 0.84

NA 21.78

XXX initial. 99294............... .............. A

Ped critical care,

7.99

NA 2.49 0.28

NA 10.76

XXX subseq. 99295............... .............. A

Neonate crit care,

18.46

NA 5.39 0.84

NA 24.69

XXX initial. 99296............... .............. A

Neonate critical care 7.99

NA 2.55 0.28

NA 10.82

XXX subseq. 99298............... .............. A

Ic for lbw infant 4.0 cm. 11420............... .............. A

Exc h-f-nk-sp b9+marg 0.98 1.77 0.94 0.10 2.85 2.02

010 0.5 4 cm. 11440............... .............. A

Exc face-mm b9+marg

1.06 2.28 1.33 0.10 3.44 2.49

010 0.5 4 cm. 11600............... .............. A

Exc tr-ext mlg+marg

1.31 2.65 0.98 0.11 4.07 2.40

010 0.5 4 cm. 11620............... .............. A

Exc h-f-nk-sp

1.19 2.62 0.96 0.11 3.92 2.26

010 mlg+marg 0.5 4 cm. 11640............... .............. A

Exc face-mm

1.35 2.69 1.12 0.12 4.16 2.59

010 malig+marg 0.5 4 cm. 20982............... .............. A

Ablate, bone tumor(s) 7.27 105.35 2.99 0.69 113.31 10.95

000 perq. 21030............... .............. A

Excise max/zygoma b9

4.49 6.84 4.31 0.72 12.05 9.52

090 tumor. 21040............... .............. A

Excise mandible

4.49 6.87 4.14 0.23 11.59 8.86

090 lesion. 21685............... .............. A

Hyoid myotomy &

12.98

NA 10.09 1.52

NA 24.59

090 suspension. 21742............... .............. C

Repair stern/nuss w/o 0.00 0.00 0.00 0.00 0.00 0.00

090 scope. 21743............... .............. C

Repair sternum/nuss w/ 0.00 0.00 0.00 0.00 0.00 0.00

090 scope. 22532............... .............. A

Lat thorax spine

23.96

NA 14.82 4.56

NA 43.34

090 fusion. 22533............... .............. A

Lat lumbar spine

23.09

NA 13.48 3.84

NA 40.41

090 fusion. 22534............... .............. A

Lat thor/lumb, add'l

5.99

NA 3.04 1.18

NA 10.21

ZZZ seg.

[[Page 1243]]

31622............... .............. A

Dx bronchoscope/wash. 2.78 4.17 0.89 0.17 7.12 3.84

000 31623............... .............. A

Dx bronchoscope/brush 2.88 5.05 0.89 0.17 8.10 3.94

000 31624............... .............. A

Dx bronchoscope/

2.88 4.28 0.90 0.16 7.32 3.94

000 lavage. 31625............... .............. A

Bronchoscopy w/

3.36 5.37 1.26 0.19 8.92 4.81

000 biopsy(s). 31628............... .............. A

Bronchoscopy/lung bx, 3.80 5.53 1.34 0.17 9.50 5.31

000 each. 31629............... .............. A

Bronchoscopy/needle

3.36

NA 1.22 0.16

NA 4.74

000 bx, each. 31630............... .............. A

Bronchoscopy dilate/

3.81

NA 2.00 0.36

NA 6.17

000 fx repr. 31631............... .............. A

Bronchoscopy, dilate

4.36

NA 2.02 0.37

NA 6.75

000 w/stent. 31632............... .............. A

Bronchoscopy/lung bx, 1.03 0.76 0.32 0.17 1.96 1.52

ZZZ add'l. 31633............... .............. A

Bronchoscopy/needle

1.32 0.91 0.40 0.17 2.40 1.89

ZZZ bx add'l. 31635............... .............. A

Bronchoscopy w/fb

3.67

NA 1.67 0.25

NA 5.59

000 removal. 31640............... .............. A

Bronchoscopy w/tumor

4.93

NA 2.35 0.45

NA 7.73

000 excise. 33310............... .............. A

Exploratory heart

18.48

NA 9.65 2.73

NA 30.86

090 surgery. 33315............... .............. A

Exploratory heart

22.34

NA 10.95 3.50

NA 36.79

090 surgery. 34805............... .............. A

Endovasc abdo repair 21.85

NA 9.46 1.99

NA 33.30

090 w/pros. 35510............... .............. A

Artery bypass graft.. 22.97

NA 10.17 2.10

NA 35.24

090 35512............... .............. A

Artery bypass graft.. 22.47

NA 10.00 2.10

NA 34.57

090 35522............... .............. A

Artery bypass graft.. 21.73

NA 9.74 2.10

NA 33.57

090 35525............... .............. A

Artery bypass graft.. 20.60

NA 9.35 2.10

NA 32.05

090 35697............... .............. A

Reimplant artery each 3.00

NA 1.03 0.41

NA 4.44

ZZZ 36511............... .............. A

Apheresis wbc........ 1.74

NA 0.71 0.07

NA 2.52

000 36512............... .............. A

Apheresis rbc........ 1.74

NA 0.71 0.07

NA 2.52

000 36513............... .............. A

Apheresis platelets.. 1.74

NA 0.71 0.07

NA 2.52

000 36514............... .............. A

Apheresis plasma..... 1.74

NA 0.71 0.07

NA 2.52

000 36515............... .............. A

Apheresis, adsorp/

1.74

NA 0.73 0.07

NA 2.54

000 reinfuse. 36516............... .............. A

Apheresis, selective. 1.22

NA 0.51 0.07

NA 1.80

000 36555............... .............. A

Insert non-tunnel cv

2.68 6.00 0.82 0.21 8.89 3.71

000 cath. 36556............... .............. A

Insert non-tunnel cv

2.50 5.85 0.74 0.10 8.45 3.34

000 cath. 36557............... .............. A

Insert tunneled cv

5.09 13.56 2.58 0.59 19.24 8.26

010 cath. 36558............... .............. A

Insert tunneled cv

4.79 13.45 2.47 0.59 18.83 7.85

010 cath. 36560............... .............. A

Insert tunneled cv

6.24 29.19 2.96 0.59 36.02 9.79

010 cath. 36561............... .............. A

Insert tunneled cv

5.99 29.11 2.87 0.59 35.69 9.45

010 cath. 36563............... .............. A

Insert tunneled cv

6.19 38.09 2.98 0.68 44.96 9.85

010 cath. 36565............... .............. A

Insert tunneled cv

5.99 22.15 2.87 0.59 28.73 9.45

010 cath. 36566............... .............. A

Insert tunneled cv

6.49 22.95 3.04 0.59 30.03 10.12

010 cath. 36568............... .............. A

Insert tunneled cv

1.92 8.19 0.59 0.21 10.32 2.72

000 cath. 36569............... .............. A

Insert tunneled cv

1.82 7.39 0.57 0.16 9.37 2.55

000 cath. 36570............... .............. A

Insert tunneled cv

5.31 40.27 2.64 0.59 46.17 8.54

010 cath. 36571............... .............. A

Insert tunneled cv

5.29 35.64 2.63 0.59 41.52 8.51

010 cath. 36575............... .............. A

Repair tunneled cv

0.67 3.35 0.26 0.59 4.61 1.52

000 cath. 36576............... .............. A

Repair tunneled cv

3.19 7.71 1.76 0.59 11.49 5.54

010 cath. 36578............... .............. A

Replace tunneled cv

3.49 10.54 2.20 0.59 14.62 6.28

010 cath. 36580............... .............. A

Replace tunneled cv

1.31 6.76 0.41 0.16 8.23 1.88

000 cath. 36581............... .............. A

Replace tunneled cv

3.43 13.27 1.84 0.59 17.29 5.86

010 cath. 36582............... .............. A

Replace tunneled cv

5.19 26.63 2.76 0.59 32.41 8.54

010 cath. 36583............... .............. A

Replace tunneled cv

5.24 13.13 2.77 0.59 18.96 8.60

010 cath. 36584............... .............. A

Replace tunneled cv

1.20 7.23 0.54 0.16 8.59 1.90

000 cath. 36585............... .............. A

Replace tunneled cv

4.79 35.46 2.62 0.59 40.84 8.00

010 cath. 36589............... .............. A

Removal tunneled cv

2.27 2.20 1.41 0.25 4.72 3.93

010 cath. 36590............... .............. A

Removal tunneled cv

3.30 6.41 1.64 0.41 10.12 5.35

010 cath. 36595............... .............. A

Mech remov tunneled

3.59 19.71 1.46 0.28 23.58 5.33

000 cv cath. 36596............... .............. A

Mech remov tunneled

0.75 4.39 0.49 0.05 5.19 1.29

000 cv cath. 36597............... .............. A

Reposition venous

1.21 3.18 0.43 0.07 4.46 1.71

000 catheter. 36838............... .............. A

Dist revas ligation, 20.60

NA 9.36 2.99

NA 32.95

090 hemo. 37765............... .............. A

Phleb veins - extrem - 7.34

NA 4.55 0.48

NA 12.37

090 to 20. 37766............... .............. A

Phleb veins - extrem

9.29

NA 5.26 0.48

NA 15.03

090 20+. 37785............... .............. A

Ligate/divide/excise

3.83 5.14 2.64 0.49 9.46 6.96

090 vein. 38207............... .............. I

Cryopreserve stem

0.00 0.00 0.00 0.00 0.00 0.00

XXX cells. 38208............... .............. I

Thaw preserved stem

0.00 0.00 0.00 0.00 0.00 0.00

XXX cells. 38209............... .............. I

Wash harvest stem

0.00 0.00 0.00 0.00 0.00 0.00

XXX cells. 38210............... .............. I

T-cell depletion of

0.00 0.00 0.00 0.00 0.00 0.00

XXX harvest. 38211............... .............. I

Tumor cell deplete of 0.00 0.00 0.00 0.00 0.00 0.00

XXX harvst. 38212............... .............. I

Rbc depletion of

0.00 0.00 0.00 0.00 0.00 0.00

XXX harvest. 38213............... .............. I

Platelet deplete of

0.00 0.00 0.00 0.00 0.00 0.00

XXX harvest. 38214............... .............. I

Volume deplete of

0.00 0.00 0.00 0.00 0.00 0.00

XXX harvest. 38215............... .............. I

Harvest stem cell

0.00 0.00 0.00 0.00 0.00 0.00

XXX concentrte. 43235............... .............. A

Uppr gi endoscopy,

2.39 5.04 1.07 0.16 7.59 3.62

000 diagnosis. 43237............... .............. A

Endoscopic us exam,

3.98

NA 1.61 0.27

NA 5.86

000 esoph. 43238............... .............. A

Uppr gi endoscopy w/

5.02

NA 1.97 0.27

NA 7.26

000 us fn bx. 43242............... .............. A

Uppr gi endoscopy w/

7.30

NA 2.78 0.35

NA 10.43

000 us fn bx. 43259............... .............. A

Endoscopic ultrasound 5.19

NA 2.04 0.27

NA 7.50

000 exam. 43752............... .............. A

Nasal/orogastric w/

0.68 0.26 0.26 0.02 0.96 0.96

000 stent. 47133............... .............. C

Removal of donor

0.00 0.00 0.00 0.00 0.00 0.00

XXX liver. 47140............... .............. A

Partial removal,

54.92

NA 22.74 4.80

NA 82.46

090 donor liver. 47141............... .............. A

Partial removal,

67.40

NA 27.39 4.80

NA 99.59

090 donor liver.

[[Page 1244]]

47142............... .............. A

Partial removal,

74.89

NA 29.97 4.80

NA 109.66

090 donor liver. 53500............... .............. A

Urethrlys, transvag w/ 12.19

NA 6.19 0.89

NA 19.27

090 scope. 57425............... .............. A

Laparoscopy, surg,

15.73

NA 6.69 1.74

NA 24.16

090 colpopexy. 58545............... .............. A

Laparoscopic

14.58

NA 7.19 1.75

NA 23.52

090 myomectomy. 58546............... .............. A

Laparo-myomectomy,

18.97

NA 8.98 1.75

NA 29.70

090 complex. 58550............... .............. A

Laparo-asst vag

14.17

NA 7.31 1.74

NA 23.22

090 hysterectomy. 58552............... .............. A

Laparo-vag hyst incl 15.98

NA 8.02 1.74

NA 25.74

090 t/o. 58553............... .............. A

Laparo-vag hyst,

18.97

NA 8.97 1.48

NA 29.42

090 complex. 58554............... .............. A

Laparo-vag hyst w/t/ 21.97

NA 10.46 1.48

NA 33.91

090 o, compl. 59070............... .............. A

Transabdom amnioinfus 5.24 5.12 2.41 0.28 10.64 7.93

000 w/ us. 59072............... .............. A

Umbilical cord occlud 8.99

NA 3.13 0.68

NA 12.80

000 w/ us. 59074............... .............. A

Fetal fluid drainage

5.24 4.61 2.41 0.28 10.13 7.93

000 w/ us. 59076............... .............. A

Fetal shunt

8.99

NA 3.13 0.68

NA 12.80

000 placement, w/ us. 59897............... .............. C

Fetal invas px w/ us. 0.00 0.00 0.00 0.00 0.00 0.00

YYY 61537............... .............. A

Removal of brain

24.96

NA 14.45 6.49

NA 45.90

090 tissue. 61538............... .............. A

Removal of brain

26.77

NA 15.38 6.49

NA 48.64

090 tissue. 61539............... .............. A

Removal of brain

32.03

NA 17.85 7.98

NA 57.86

090 tissue. 61540............... .............. A

Removal of brain

29.96

NA 17.48 7.98

NA 55.42

090 tissue. 61543............... .............. A

Removal of brain

29.18

NA 16.46 7.37

NA 53.01

090 tissue. 61566............... .............. A

Removal of brain

30.95

NA 17.42 6.49

NA 54.86

090 tissue. 61567............... .............. A

Incision of brain

35.45

NA 20.73 6.49

NA 62.67

090 tissue. 61863............... .............. A

Implant

18.97

NA 9.21 4.79

NA 32.97

090 neuroelectrode. 61864............... .............. A

Implant

4.49

NA 2.29 1.13

NA 7.91

ZZZ neuroelectrde, add'l. 61867............... .............. A

Implant

31.29

NA 13.81 4.79

NA 49.89

090 neuroelectrode. 61868............... .............. A

Implant

7.91

NA 4.03 1.21

NA 13.15

ZZZ neuroelectrde, add'l. 63101............... .............. A

Removal of vertebral 31.95

NA 19.34 5.69

NA 56.98

090 body. 63102............... .............. A

Removal of vertebral 31.95

NA 19.34 5.69

NA 56.98

090 body. 63103............... .............. A

Remove vertebral body 3.89

NA 2.01 0.76

NA 6.66

ZZZ add-on. 64449............... .............. A

N block inj, lumbar

3.00

NA 0.97 0.10

NA 4.07

010 plexus. 64517............... .............. A

N block inj, hypogas

2.20 2.70 0.87 0.13 5.03 3.20

000 plxs. 64680............... .............. A

Injection treatment

2.62 5.97 1.28 0.18 8.77 4.08

010 of nerve. 64681............... .............. A

Injection treatment

3.54 8.71 2.10 0.18 12.43 5.82

010 of nerve. 65780............... .............. A

Ocular reconst,

10.23

NA 9.94 0.35

NA 20.52

090 transplant. 65781............... .............. A

Ocular reconst,

17.64

NA 13.31 0.35

NA 31.30

090 transplant. 65782............... .............. A

Ocular reconst,

14.98

NA 11.66 0.35

NA 26.99

090 transplant. 67912............... .............. A

Correction eyelid w/

5.67 20.38 5.27 0.28 26.33 11.22

090 implant. 68371............... .............. A

Harvest eye tissue,

4.89

NA 4.62 0.21

NA 9.72

010 alograft. 70557............... 26............ A

Mri brain w/o dye.... 2.90 0.98 0.98 0.08 3.96 3.96

XXX 70558............... 26............ A

Mri brain w/ dye..... 3.20 1.08 1.08 0.10 4.38 4.38

XXX 70559............... 26............ A

Mri brain w/o & w/

3.20 1.08 1.08 0.12 4.40 4.40

XXX dye. 75901............... 26............ A

Remove cva device

0.49 0.16 0.16 0.02 0.67 0.67

XXX obstruct. 75902............... 26............ A

Remove cva lumen

0.39 0.13 0.13 0.02 0.54 0.54

XXX obstruct. 75998............... 26............ A

Fluoroguide for vein

0.38 0.13 0.13 0.05 0.56 0.56

ZZZ device. 76082............... 26............ A

Computer mammogram

0.06 0.02 0.02 0.01 0.09 0.09

ZZZ add-on. 76083............... 26............ A

Computer mammogram

0.06 0.02 0.02 0.01 0.09 0.09

ZZZ add-on. 76514............... 26............ A

Echo exam of eye,

0.17 0.08 0.08 0.01 0.26 0.26

XXX thickness. 76937............... 26............ A

Us guide, vascular

0.30 0.10 0.10 0.05 0.45 0.45

ZZZ access. 78800............... 26............ A

Tumor imaging,

0.66 0.22 0.22 0.04 0.92 0.92

XXX limited area. 78801............... 26............ A

Tumor imaging, mult

0.79 0.27 0.27 0.04 1.10 1.10

XXX areas. 78802............... 26............ A

Tumor imaging, whole

0.86 0.30 0.30 0.04 1.20 1.20

XXX body. 78803............... 26............ A

Tumor imaging (3D)... 1.09 0.38 0.38 0.05 1.52 1.52

XXX 78804............... 26............ A

Tumor imaging, whole

1.07 0.37 0.37 0.04 1.48 1.48

XXX body. 79100............... 26............ A

Hematopoetic nuclear

1.32 0.46 0.46 0.06 1.84 1.84

XXX therapy. 79400............... 26............ A

Nonhemato nuclear

1.96 0.67 0.67 0.10 2.73 2.73

XXX therapy. 79403............... 26............ A

Hematopoetic nuclear

2.25 0.90 0.90 0.10 3.25 3.25

XXX therapy. 85396............... .............. A

Clotting assay, whole 0.37

NA 0.17 0.04

NA 0.58

XXX blood. 88112............... 26............ A

Cytopath, cell

1.18 0.51 0.51 0.06 1.75 1.75

XXX enhance tech. 88342............... 26............ A

Immunohistochemistry. 0.85 0.37 0.37 0.04 1.26 1.26

XXX 88358............... 26............ A

Analysis, tumor...... 0.95 1.23 1.23 0.12 2.30 2.30

XXX 88361............... 26............ A

Immunohistochemistry, 0.94 0.41 0.41 0.12 1.47 1.47

XXX tumor. 91110............... 26............ A

Gi tract capsule

3.64 1.30 1.30 0.02 4.96 4.96

XXX endoscopy. 93784............... .............. A

Ambulatory BP

0.38 1.55

NA 0.03 1.96

NA

XXX monitoring. 93786............... .............. A

Ambulatory BP

0.00 0.91

NA 0.01 0.92

NA

XXX recording. 93788............... .............. A

Ambulatory BP

0.00 0.51

NA 0.01 0.52

NA

XXX analysis. 93790............... .............. A

Review/report BP

0.38 0.13 0.13 0.01 0.52 0.52

XXX recording. 95990............... .............. A

Spin/brain pump refil 0.00 1.50

NA 0.06 1.56

NA

XXX & main. 95991............... .............. A

Spin/brain pump refil 0.77 1.43 0.19 0.06 2.26 1.02

XXX & main. 96110............... .............. A

Developmental test,

0.00 0.19

NA 0.18 0.37

NA

XXX lim. 96111............... .............. A

Developmental test,

2.60 1.07

NA 0.18 3.85

NA

XXX extend. 97537............... .............. A

Community/work

0.45 0.27

NA 0.01 0.73

NA

XXX reintegration. 97755............... .............. A

Assistive technology

0.62 0.29

NA 0.02 0.93

NA

XXX assess. G0308............... .............. A

ESRD related svc

12.74 8.54 8.54 0.42 21.70 21.70

XXX 4+mo