[Federal Register Volume 60, Number 1 (Tuesday, January 3, 1995)]
[Rules and Regulations]
[Pages 46-54]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-32286]



=======================================================================
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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

42 CFR Parts 410 and 414

[BPD-789-CN]
RIN 0938-AG52


Medicare Program; Refinements to Geographic Adjustment Factor 
Values, Revisions to Payment Policies, Adjustments to the Relative 
Value Units (RVUs) Under the Physician Fee Schedule for Calendar Year 
1995, and the 5-Year Refinement of RVUs

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Correction of final rule with comment period.

-----------------------------------------------------------------------

SUMMARY: This document corrects technical errors that appeared in the 
final rule with comment period published in the Federal Register on 
December 8, 1994 (59 FR 63410) entitled ``Medicare Program; Refinements 
to Geographic Adjustment Factor Values, Revisions to Payment Policies, 
Adjustments to the Relative Value Units (RVUs) Under the Physician Fee 
Schedule for Calendar Year 1995, and the 5-Year Refinement of RVUs.''

EFFECTIVE DATE: January 1, 1995.

FOR FURTHER INFORMATION CONTACT: Elizabeth Holland, (410) 966-1309.

SUPPLEMENTARY INFORMATION:

Background

    In the Federal Register Document [94-29916] dated December 8, 1994 
beginning on page 63410, there were a number of technical and 
typographical errors in the preamble, in one section of the regulations 
text, and in two of the addenda. The corrections appear later in this 
document, under the heading ``Correction of Errors.''
    In Table 6, Anesthesia Codes and Imputed RVUs, beginning on page 
63456, we omitted the entry for HCPCS code 00534 and should not have 
included HCPCS code 00806. Also in Table 6, due to a transcription 
error, the ``descriptions'' were incorrect for HCPCS codes 00540 
through 00802.
    In the regulations text, Sec. 414.39, appearing at page 63463, the 
text does not agree with the preamble description of it on page 63418 
relating to payment of physician oversight services.
    In Addendum B, Relative Value Units (RVUs) and Related Information, 
on page 63497, for HCPCS code 33247, the incorrect work RVUs (9.36) and 
incorrect total RVUs (25.06) were printed. The correct work RVUs for 
HCPCS code 33247 are 9.76 and the correct total RVUs are 25.36.
    In Addendum G, Reference Set with 1995 Work RVUs, we inadvertently 
included some codes and omitted other codes. Thus, we are reprinting a 
corrected Addendum G in its entirety. The codes that were incorrectly 
included are listed below.

                                       Codes To Be Deleted From Addendum G                                      
----------------------------------------------------------------------------------------------------------------
      HCPCS\1\                                         Description                                     Work RVU 
----------------------------------------------------------------------------------------------------------------
10040...............  Acne surgery.................................................................         1.34
10080...............  Drainage of pilonidal cyst...................................................         1.62
11042...............  Cleansing of skin/tissue.....................................................         1.12
11050...............  Trim skin lesion.............................................................         0.43
11051...............  Trim 2 to 4 skin lesions.....................................................         0.66
14041...............   Skin tissue rearrangement...................................................        10.74
14061...............   Skin tissue rearrangement...................................................        11.42
15732...............   Muscle-skin graft, head/neck................................................        12.10
15822...............   Revision of upper eyelid....................................................         4.27
15851...............   Removal of sutures..........................................................         0.86
16000...............   Initial treatment of burn(s)................................................         0.89
16025...............   Treatment of burn(s)........................................................         1.85
22505...............   Manipulation of spine.......................................................         1.77
26990...............   Drainage of pelvis lesion...................................................         6.76
27125...............   Partial hip replacement.....................................................        13.21
28450...............   Treat midfoot fracture, each................................................         1.77
28515...............   Treatment of toe fracture...................................................         1.36
31579...............   Diagnostic laryngoscopy.....................................................         2.26
32005...............   Treat lung lining chemically................................................         2.19
32095...............   Biopsy through chest wall...................................................         7.13
33249...............   Insert/replace leads/gener..................................................        12.83
33510...............   Cabg, vein, single..........................................................        23.29
35381...............   Rechanneling of artery......................................................        14.50
43226...............   Esophagus endoscopy, dilation...............................................         2.34
43640...............   Vagotomy & pylorus repair...................................................        13.28
43820...............   Fusion of stomach and bowel.................................................        10.43
44110...............   Excision of bowel lesion(s).................................................         9.01
44130...............   Bowel to bowel fusion.......................................................        11.09
44141...............   Partial removal of colon....................................................        17.36
45383...............   Colonoscopy, lesion removal.................................................         5.87
45915...............   Remove rectal obstruction...................................................         2.09
46080...............   Incision of anal sphincter..................................................         2.35
47100...............   Wedge biopsy of liver.......................................................         6.75
47510...............   Insert catheter, bile duct..................................................         7.39
48100...............   Biopsy of pancreas..........................................................        10.19
49002...............   Reopening of abdomen........................................................         9.40
49421...............   Insert abdominal drain......................................................         4.89
50360...............   Transplantation of kidney...................................................        27.05
50398...............   Change kidney tube..........................................................         1.46
52005...............   Cystoscopy & ureter catheter................................................        2.37 
[[Page 47]]                                                                                                     
                                                                                                                
52320...............   Cystoscopy and treatment....................................................         4.70
52330...............   Cystoscopy and treatment....................................................         5.04
52340...............   Cystoscopy and treatment....................................................         7.76
52630...............   Remove prostate regrowth....................................................         6.55
54001...............   Slitting of prepuce.........................................................         2.14
54161...............   Circumcision................................................................         3.22
55040...............   Removal of hydrocele........................................................         5.15
55520...............   Removal of sperm cord lesion................................................         5.72
57511...............   Cryocautery of cervix.......................................................         1.85
57800...............   Dilation of cervical canal..................................................         0.77
58210...............   Extensive hysterectomy......................................................        23.97
58720...............   Removal of ovary/tube(s)....................................................         6.20
60220...............   Partial removal of thyroid..................................................         9.86
62272...............   Drain spinal fluid..........................................................         1.35
64640...............   Injection treatment of nerve................................................         2.49
67311...............   Revise eye muscle...........................................................         6.30
67903...............   Repair eyelid defect........................................................         6.22
67908...............   Repair eyelid defect........................................................         4.95
90911...............   Anorectal biofeedback.......................................................         2.15
92975...............   Dissolve clot, heart vessel.................................................         7.25
93501...............   Right heart catheterization.................................................         3.02
93505...............   Biopsy of heart lining......................................................         4.56
93511...............   Left heart catheterization..................................................         5.03
93536...............   Insert circulation assist...................................................         4.85
93619...............   Electrophysiology evaluation................................................         7.32
93624...............   Electrophysiologic study....................................................         4.81
99217...............   Observation care discharge..................................................        1.09 
----------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                           

    The codes that are to be added are listed below.

                                         Codes To Be Added To Addendum G                                        
----------------------------------------------------------------------------------------------------------------
      HCPCS\1\                                         Description                                     Work RVU 
----------------------------------------------------------------------------------------------------------------
10060...............  Drainage of skin abscess.....................................................         1.12
11043...............  Cleansing of tissue/muscle...................................................         1.83
11100...............  Biopsy of skin lesion........................................................         0.81
14060...............  Skin tissue rearrangement....................................................         8.05
15260...............  Skin full graft procedure....................................................         9.56
15823...............  Revision of upper eyelid.....................................................         6.65
15946...............  Removal of pressure sore.....................................................        19.81
17000...............  Destroy benign/premal lesion.................................................         0.64
19240...............  Removal of breast............................................................        14.71
22554...............  Neck spine fusion............................................................        18.14
26531...............  Revise knuckle with implant..................................................         7.57
27006...............  Incision of hip tendons......................................................         9.50
28485...............  Repair metatarsal fracture...................................................         5.31
31584...............  Repair of larynx fracture....................................................        18.50
32020...............  Insertion of chest tube......................................................         3.98
33405...............  Replacement of aortic valve..................................................        28.47
33430...............  Replacement of mitral valve..................................................        29.42
33500...............  Repair heart vessel fistula..................................................        23.91
35454...............  Repair arterial blockage.....................................................         6.04
43235...............  Upper GI endoscopy, diagnosis................................................         2.39
43750...............  Place gastrostomy tube.......................................................         5.71
44120...............  Removal of small intestine...................................................        13.15
44140...............  Partial removal of colon.....................................................        16.97
45385...............  Colonoscopy, lesion removal..................................................         5.31
46050...............  Incision of anal abscess.....................................................         1.14
46600...............  Diagnostic anoscopy..........................................................         0.50
47130...............  Partial removal of liver.....................................................        31.56
48150...............  Partial removal of pancreas..................................................        40.25
49000...............  Exploration of abdomen.......................................................         8.99
49505...............  Repair inguinal hernia.......................................................         6.17
50392...............  Insert kidney drain..........................................................         5.59
50393...............  Insert ureteral tube.........................................................         6.88
50780...............  Reimplant ureter in bladder..................................................        17.12
51860...............  Repair of bladder wound......................................................        11.17
52000...............  Cystoscopy...................................................................         2.01
52325...............  Cystoscopy, stone removal....................................................        6.16 
[[Page 48]]                                                                                                     
                                                                                                                
52601...............  Prostatectomy (TURP).........................................................        11.51
54150...............  Circumcision.................................................................         1.78
55250...............  Removal of sperm duct(s).....................................................         3.21
57520...............  Conization of cervix.........................................................         3.96
58260...............  Vaginal hysterectomy.........................................................        11.39
59400...............  Obstetrical care.............................................................        20.99
59515...............  Cesarean delivery............................................................        16.55
62270...............  Spinal fluid tap, diagnostic.................................................         1.13
63075...............  Neck spine disk surgery......................................................        19.77
63690...............  Analysis of neuroreceiver....................................................         0.45
63691...............  Analysis of neuroreceiver....................................................         0.65
64595...............  Revise/remove neuroreceiver..................................................         1.68
67228...............  Treatment of retinal lesion..................................................        12.39
67904...............  Repair eyelid defect.........................................................         5.96
92950...............  Heart/lung resuscitation (cpr)...............................................         3.80
92982...............  Coronary artery dilation.....................................................        10.98
93510...............  Left heart catheterization...................................................         4.33
93526...............  Rt & Lt heart catheters......................................................         5.99
93620...............  Electrophysiology evaluation.................................................        11.59
99295...............  Neonatal critical care.......................................................       16.03 
----------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                           

Correction of Errors

    In FR Doc. 94-29916 of December 8, 1994 (59 FR 63410) make the 
following corrections:

A. Page 63456, Table 6

    On page 63456, the following code is added in numerical order to 
read:


--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                               Imputed  
             HCPCS\1\                                                Description                                    Base unit    Time unit    work RVUs 
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                        
                         *                *                *                *                *                *                *                        
00534............................  Anesth, Cardioverter/defib....................................................            7         9.65         4.49
                                                                                                                                                        
                         *                *                *                *                *                *                *                        
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                                                                   


B. Pages 63456 and 63457, Table 6

    1. On pages 63456 and 63457, the HCPCS codes starting with 00540 
through 00802 are corrected to read as follows:


----------------------------------------------------------------------------------------------------------------
                                                                                                       Imputed  
      HCPCS\1\                            Description                       Base unit    Time unit    work RVUS 
----------------------------------------------------------------------------------------------------------------
00540...............  Anesth, chest surgery..............................           13        12.99         7.01
00542...............  Anesth, release of lung............................           15        13.32         7.64
00544...............  Anesth, chest lining removal.......................           15        14.00         7.83
00546...............  Anesth, lung, chest wall surg......................           15        15.59         8.26
00548...............  Anesth, trachea, bronchi surg......................           15        14.86         8.06
00560...............  Anesth, open heart surgery.........................           15        10.89         6.99
00562...............  Anesth, open heart surgery.........................           20        22.27        11.41
00580...............  Anesth, heart/lung transplant......................           20        27.01        12.69
00600...............  Anesth, spine, cord surgery........................           10        14.31         6.56
00604...............  Anesth, surgery of vertebra........................           13        13.44         7.14
00620...............  Anesth, spine, cord surgery........................           10        15.34         6.84
00622...............  Anesth, removal of nerves..........................           13        10.08         6.23
00630...............  Anesth, spine, cord surgery........................            8        11.30         5.21
00632...............  Anesth, removal of nerves..........................            7         7.95         4.03
00634...............  Anesth for chemonucleolysis........................           10         1.92         3.22
00670...............  Anesth, spine, cord surgery........................           13        21.82         9.40
00700...............  Anesth, abdominal wall surg........................            3         5.99         2.43
00702...............  Anesth, for liver biopsy...........................            4         7.67         3.15
00730...............  Anesth, abdominal wall surg........................            5         6.94         3.22
00740...............  Anesth, gi visualization...........................            5         3.29         2.24
00750...............  Anesth, repair of hernia...........................            4         6.62         2.87
00752...............  Anesth, repair of hernia...........................            6         7.45         3.63
00754...............  Anesth, repair of hernia...........................            7         9.12         4.35
00756...............  Anesth, repair of hernia...........................            7        11.55        5.01 
[[Page 49]]                                                                                                     
                                                                                                                
00770...............  Anesth, blood vessel repair........................           15        18.01         8.91
00790...............  Anesth, surg upper abdomen.........................            7         9.88         4.56
00792...............  Anesth, part liver removal.........................           13        19.03         8.64
00794...............  Anesth, pancreas removal...........................            8        23.85         8.60
00796...............  Anesth, for liver transplant.......................           30        41.76        19.37
00800...............  Anesth, abdominal wall surg........................            3         5.88         2.40
00802...............  Anesth, fat layer removal..........................            5        10.47         4.18
                                                                                                                
        *                  *                  *                  *                  *                  *        
                                                        *                                                       
----------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                           

    2. On page 63457, HCPCS code 00806 in Table 6 is removed.

C. Page 63463

    In column 2, in Sec. 414.39(b)(2), line 8, the words ``HHA or'' are 
removed.

D. Page 63497

    On page 63497, Addendum B, HCPCS code 33247 is corrected to read as 
follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                Practice                                                
    HCPCS\1\          MOD      Status                  Description                    Work       expense   Malpractice     Total      Global     Update 
                                                                                     RVUs\2\     RVUs\3\       RVUs                   period            
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                                                        
                   *                  *                  *                  *                  *                  *                 *                   
33247...........  ..........  A         Insert/replace leads.....................        9.76       13.24         2.36       25.36         090  N       
                                                                                                                                                        
                   *                  *                  *                  *                  *                  *                 *                   
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                                                                   
\2\# Indicates RVUs are not used for Medicare payment.                                                                                                  
\3\Indicates reduction of Practice Expense RVUs as a result of OBRA 1993.                                                                               

E. Pages 63633 through 63635

    On pages 63633 through 63635, Addendum G is corrected to read as 
follows:

                                 Addendum G.--Reference Set With 1995 Work RVUs                                 
----------------------------------------------------------------------------------------------------------------
      HCPCS\1\                                         Description                                     Work RVU 
----------------------------------------------------------------------------------------------------------------
10060...............  Drainage of skin abscess.....................................................         1.12
10120...............  Remove foreign body..........................................................         1.19
11040...............  Surgical cleansing, abrasion.................................................         0.50
11043...............  Cleansing of tissue/muscle...................................................         1.83
11100...............  Biopsy of skin lesion........................................................         0.81
11400...............  Removal of skin lesion.......................................................         0.86
11406...............  Removal of skin lesion.......................................................         2.71
11441...............  Removal of skin lesion.......................................................         1.56
11603...............  Removal of skin lesion.......................................................         2.30
11642...............  Removal of skin lesion.......................................................         2.88
11762...............  Reconstruction of nail bed...................................................         2.84
12002...............  Repair superficial wound(s)..................................................         1.81
14060...............  Skin tissue rearrangement....................................................         8.05
15100...............  Skin split graft procedure...................................................         8.05
15240...............  Skin full graft procedure....................................................         8.30
15260...............  Skin full graft procedure....................................................         9.56
15734...............  Muscle-skin graft, trunk.....................................................        16.52
15755...............  Microvascular flap graft.....................................................        28.33
15823...............  Revision of upper eyelid.....................................................         6.65
15937...............  Remove sacrum pressure sore..................................................        12.98
15946...............  Removal of pressure sore.....................................................        19.81
17000...............  Destroy benign/premal lesion.................................................         0.64
17100...............  Destruction of skin lesion...................................................         0.53
19240...............  Removal of breast............................................................        14.71
19318...............  Reduction of large breast....................................................        11.08
19364...............  Breast reconstruction........................................................        27.60
19367...............  Breast reconstruction........................................................        24.73
20610...............  Drain/inject joint/bursa.....................................................         0.79
21267...............  Revise eye sockets...........................................................        17.66
21395...............  Repair eye socket fracture...................................................        11.85
21433...............  Repair craniofacial fracture.................................................        23.69
22554...............  Neck spine fusion............................................................       18.14 
[[Page 50]]                                                                                                     
                                                                                                                
22595...............  Neck spinal fusion...........................................................        19.24
23412...............  Repair of tendon(s)..........................................................        12.69
25611...............  Repair fracture radius/ulna..................................................         7.11
26040...............  Release palm contracture.....................................................         3.09
26045...............  Release palm contracture.....................................................         5.27
26055...............  Incise finger tendon sheath..................................................         2.56
26123...............  Release palm contracture.....................................................         8.64
26356...............  Repair finger/hand tendon....................................................         7.05
26531...............  Revise knuckle with implant..................................................         7.57
26615...............  Repair metacarpal fracture...................................................         5.18
27006...............  Incision of hip tendons......................................................         9.50
27165...............  Incision/fixation of femur...................................................        16.20
27170...............  Repair/graft femur head/neck.................................................        14.90
27418...............  Repair degenerated kneecap...................................................         9.82
27635...............  Remove lower leg bone lesion.................................................         7.29
27792...............  Repair of ankle fracture.....................................................         7.04
28285...............  Repair of hammertoe..........................................................         4.41
28485...............  Repair metatarsal fracture...................................................         5.31
29881...............  Knee arthroscopy/surgery.....................................................         7.46
30520...............  Repair of nasal septum.......................................................         5.55
31575...............  Diagnostic laryngoscopy......................................................         1.10
31584...............  Repair of larynx fracture....................................................        18.50
31600...............  Incision of windpipe.........................................................         3.62
31622...............  Diagnostic bronchoscopy......................................................         2.80
32000...............  Drainage of chest............................................................         1.54
32020...............  Insertion of chest tube......................................................         3.98
32100...............  Exploration/biopsy of chest..................................................        10.07
32440...............  Removal of lung..............................................................        19.15
32480...............  Partial removal of lung......................................................        16.84
32500...............  Partial removal of lung......................................................        13.10
32602...............  Thoracoscopy, diagnostic.....................................................         5.96
33208...............  Insertion of heart pacemaker.................................................         7.28
33405...............  Replacement of aortic valve..................................................        28.47
33426...............  Repair of mitral valve.......................................................        26.07
33430...............  Replacement of mitral valve..................................................        29.42
33500...............  Repair heart vessel fistula..................................................        23.91
33512...............  CABG, vein, three............................................................        27.84
33513...............  CABG, vein, four.............................................................        30.12
33533...............  CABG, arterial, single.......................................................        24.00
33870...............  Transverse aortic arch graft.................................................        37.74
34201...............  Removal of artery clot.......................................................         8.04
35081...............  Repair defect of artery......................................................        22.15
35082...............  Repair artery rupture, aorta.................................................        28.82
35091...............  Repair defect of artery......................................................        28.10
35207...............  Repair blood vessel lesion...................................................         9.06
35221...............  Repair blood vessel lesion...................................................        15.11
35301...............  Rechanneling of artery.......................................................        15.95
35454...............  Repair arterial blockage.....................................................         6.04
35473...............  Repair arterial blockage.....................................................         6.04
35474...............  Repair arterial blockage.....................................................         7.36
35556...............  Artery bypass graft..........................................................        15.47
35646...............  Artery bypass graft..........................................................        24.00
35654...............  Artery bypass graft..........................................................        17.62
35656...............  Artery bypass graft..........................................................        13.86
36140...............  Establish access to artery...................................................         2.01
36200...............  Place catheter in aorta......................................................         3.02
36215...............  Place catheter in artery.....................................................         4.47
36216...............  Place catheter in artery.....................................................         5.28
36245...............  Place catheter in artery.....................................................         5.07
36471...............  Injection therapy of veins...................................................         1.49
36489...............  Insertion of catheter, vein..................................................         1.22
36533...............  Insertion of access port.....................................................         3.82
36620...............  Insertion catheter, artery...................................................         1.15
37140...............  Revision of circulation......................................................        22.15
38720...............  Removal of lymph nodes, neck.................................................        12.29
39400...............  Visualization of chest.......................................................         5.11
40701...............  Repair cleft lip/nasal.......................................................        15.10
42200...............  Reconstruct cleft palate.....................................................         9.48
42415...............  Excise parotid gland/lesion..................................................        16.12
42440...............  Excision submaxillary gland..................................................         6.61
42809...............  Remove pharynx foreign body..................................................         1.76
42820...............  Remove tonsils and adenoids..................................................        3.59 
[[Page 51]]                                                                                                     
                                                                                                                
43235...............  Upper GI endoscopy, diagnosis................................................         2.39
43239...............  Upper GI endoscopy, biopsy...................................................         2.69
43260...............  Endoscopy, bile duct/pancreas................................................         5.96
43268...............  Endoscopy, bile duct/pancreas................................................         7.39
43312...............  Repair esophagus and fistula.................................................        27.26
43331...............  Repair of esophagus..........................................................        14.73
43420...............  Repair esophagus opening.....................................................        10.19
43610...............  Excision of stomach lesion...................................................        10.11
43750...............  Place gastrostomy tube.......................................................         5.71
44120...............  Removal of small intestine...................................................        13.15
44140...............  Partial removal of colon.....................................................        16.97
44152...............  Removal of colon/ileostomy...................................................        22.98
44160...............  Removal of colon.............................................................        14.09
44950...............  Appendectomy.................................................................         6.06
45110...............  Removal of rectum............................................................        21.68
45300...............  Proctosigmoidoscopy..........................................................         0.70
45330...............  Sigmoidoscopy, diagnostic....................................................         0.96
45331...............  Sigmoidoscopy and biopsy.....................................................         1.26
45378...............  Diagnostic colonoscopy.......................................................         3.70
45380...............  Colonoscopy and biopsy.......................................................         4.01
45385...............  Colonoscopy, lesion removal..................................................         5.31
46050...............  Incision of anal abscess.....................................................         1.14
46221...............  Ligation of hemorrhoid(s)....................................................         1.38
46255...............  Hemorrhoidectomy.............................................................         4.95
46260...............  Hemorrhoidectomy.............................................................         6.70
46500...............  Injection into hemorrhoids...................................................         1.53
46600...............  Diagnostic anoscopy..........................................................         0.50
47000...............  Needle biopsy of liver.......................................................         1.90
47130...............  Partial removal of liver.....................................................        31.56
47556...............  Biliary endoscopy, thru skin.................................................         8.56
47605...............  Removal of gallbladder.......................................................        11.53
48150...............  Partial removal of pancreas..................................................        40.25
49000...............  Exploration of abdomen.......................................................         8.99
49505...............  Repair inguinal hernia.......................................................         6.17
50080...............  Removal of kidney stone......................................................        13.98
50230...............  Removal of kidney............................................................        20.56
50392...............  Insert kidney drain..........................................................         5.59
50393...............  Insert ureteral tube.........................................................         6.88
50780...............  Reimplant ureter in bladder..................................................        17.12
51050...............  Removal of bladder stone.....................................................         6.04
51596...............  Remove bladder, create pouch.................................................        36.27
51845...............  Repair bladder neck..........................................................         9.06
51860...............  Repair of bladder wound......................................................        11.17
52000...............  Cystoscopy...................................................................         2.01
52325...............  Cystoscopy, stone removal....................................................         6.16
52601...............  Prostatectomy (TURP).........................................................        11.51
54150...............  Circumcision.................................................................         1.78
54520...............  Removal of testis............................................................         4.93
54640...............  Suspension of testis.........................................................         6.55
55250...............  Removal of sperm duct(s).....................................................         3.21
55530...............  Revise spermatic cord veins..................................................         5.45
55700...............  Biopsy of prostate...........................................................         1.57
55845...............  Extensive prostate surgery...................................................        26.73
56340...............  Laparoscopic cholecystectomy.................................................        10.68
56360...............  Peritoneoscopy...............................................................         4.04
57100...............  Biopsy of vagina.............................................................         0.97
57300...............  Repair rectum-vagina fistula.................................................         6.81
57520...............  Conization of cervix.........................................................         3.96
58100...............  Biopsy of uterus lining......................................................         0.71
58150...............  Total hysterectomy...........................................................        13.00
58260...............  Vaginal hysterectomy.........................................................        11.39
58950...............  Resect ovarian malignancy....................................................        14.10
59160...............  D&C after delivery...........................................................         2.66
59400...............  Obstetrical care.............................................................        20.99
59515...............  Cesarean delivery............................................................        16.55
60240...............  Removal of thyroid...........................................................        15.66
61154...............  Pierce skull, remove clot....................................................        13.67
61312...............  Open skull for drainage......................................................        20.54
61510...............  Removal of brain lesion......................................................        23.39
61518...............  Removal of brain lesion......................................................        32.27
61520...............  Removal of brain lesion......................................................        38.35
61526...............  Removal of brain lesion......................................................       29.71 
[[Page 52]]                                                                                                     
                                                                                                                
61530...............  Removal of brain lesion......................................................        42.35
61700...............  Inner skull vessel surgery...................................................        34.83
62223...............  Establish brain cavity shunt.................................................        12.81
62270...............  Spinal fluid tap, diagnostic.................................................         1.13
62279...............  Inject spinal anesthetic.....................................................         1.58
62284...............  Injection for myelogram......................................................         1.54
62289...............  Injection into spinal canal..................................................         1.64
63012...............  Removal of spinal lamina.....................................................        14.21
63017...............  Removal of spinal lamina.....................................................        15.85
63030...............  Low back disk surgery........................................................        12.11
63047...............  Removal of spinal lamina.....................................................        12.76
63075...............  Neck spine disk surgery......................................................        19.77
63650...............  Implant neuroelectrodes......................................................         5.99
63660...............  Revise/remove neuroelectrode.................................................         5.54
63685...............  Implant neuroreceiver........................................................         6.29
63688...............  Revise/remove neuroreceiver..................................................         4.77
63690...............  Analysis of neuroreceiver....................................................         0.45
63691...............  Analysis of neuroreceiver....................................................         0.65
63750...............  Insert spinal canal catheter.................................................         7.23
63780...............  Insert spinal canal catheter.................................................         6.22
64442...............  Injection for nerve block....................................................         1.41
64590...............  Implant neuroreceiver........................................................         2.35
64595...............  Revise/remove neuroreceiver..................................................         1.68
64721...............  Carpal tunnel surgery........................................................         3.99
66984...............  Remove cataract, insert lens.................................................         9.89
67010...............  Partial removal of eye fluid.................................................         6.67
67107...............  Repair detached retina.......................................................        13.99
67145...............  Treatment of retina..........................................................         5.07
67228...............  Treatment of retinal lesion..................................................        12.39
67904...............  Repair eyelid defect.........................................................         5.96
69631...............  Repair eardrum structures....................................................         9.55
70220...............  X-ray exam of sinuses........................................................         0.25
70450...............  CAT scan of head or brain....................................................         0.85
70470...............  Contrast CAT scans of head...................................................         1.27
70541...............  Magnetic image, head (MRA)...................................................         1.81
70553...............  Magnetic image, brain........................................................         2.36
71020...............  Chest x-ray..................................................................         0.22
72050...............  X-ray exam of neck spine.....................................................         0.31
72100...............  X-ray exam of lower spine....................................................         0.22
72131...............  CAT scan of lower spine......................................................         1.16
72148...............  Magnetic image, lumbar spine.................................................         1.48
72170...............  X-ray exam of pelvis.........................................................         0.17
73560...............  X-ray exam of knee...........................................................         0.17
74000...............  X-ray exam of abdomen........................................................         0.18
74020...............  X-ray exam of abdomen........................................................         0.27
74160...............  Contrast CAT scan of abdomen.................................................         1.27
74280...............  Contrast x-ray exam of colon.................................................         0.99
74400...............  Contrast x-ray urinary tract.................................................         0.49
74455...............  X-ray exam urethra/bladder...................................................         0.33
75650...............  Artery x-rays, head & neck...................................................         1.49
75962...............  Repair arterial blockage.....................................................         0.54
76091...............  Mammogram, both breasts......................................................         0.41
76519...............  Echo exam of eye.............................................................         0.54
76645...............  Echo exam of breast..........................................................         0.54
76700...............  Echo exam of abdomen.........................................................         0.81
76805...............  Echo exam of pregnant uterus.................................................         0.99
76872...............  Echo exam, transrectal.......................................................         0.69
77263...............  Radiation therapy planning...................................................         3.14
77290...............  Set radiation therapy field..................................................         1.56
77430...............  Weekly radiation therapy.....................................................         3.60
77762...............  Radioelement application.....................................................         5.35
77777...............  Radioelement application.....................................................         6.99
78006...............  Thyroid, imaging with uptake.................................................         0.49
78223...............  Hepatobiliary imaging........................................................         0.84
78306...............  Bone imaging, whole body.....................................................         0.86
78461...............  Heart muscle blood multiple..................................................         1.23
78465...............  Heart image (3D) multiple....................................................         1.46
78472...............  Gated heart, resting.........................................................         0.98
78585...............  Lung V/Q imaging.............................................................         1.09
79000...............  Intial hyperthyroid therapy..................................................         1.80
80500...............  Lab pathology consultation...................................................         0.37
85060...............  Blood smear interpretation...................................................        0.45 
[[Page 53]]                                                                                                     
                                                                                                                
85095...............  Bone marrow aspiration.......................................................         1.08
85102...............  Bone marrow biopsy...........................................................         1.37
86078...............  Physician blood bank service.................................................         0.94
88104...............  Microscopic exam of cells....................................................         0.56
88302...............  Tissue exam by pathologist...................................................         0.13
88304...............  Tissue exam by pathologist...................................................         0.22
88305...............  Tissue exam by pathologist...................................................         0.75
88307...............  Tissue exam by pathologist...................................................         1.59
88309...............  Tissue exam by pathologist...................................................         2.28
88325...............  Comprehensive review of data.................................................         2.22
88331...............  Pathology consult in surgery.................................................         1.19
90801...............  Psychiatric interview........................................................         2.19
90843...............  Psychotherapy 20-30 min......................................................         1.10
90844...............  Psychotherapy 45-50 min......................................................         1.72
90853...............  Special group therapy........................................................         0.43
90862...............  Medication management........................................................         0.95
90870...............  Electroconvulsive therapy....................................................         1.88
90935...............  Hemodialysis, one evaluation.................................................         1.22
90937...............  Hemodialysis, repeated eval..................................................         2.11
90945...............  Dialysis, one evaluation.....................................................         1.28
92004...............  Eye exam, new patient........................................................         1.61
92012...............  Eye exam established pt......................................................         0.82
92014...............  Eye exam & treatment.........................................................         1.06
92083...............  Visual field examination(s)..................................................         0.50
92250...............  Eye exam with photos.........................................................         0.44
92950...............  Heart/lung resuscitation (cpr)...............................................         3.80
92960...............  Heart electroconversion......................................................         2.25
92982...............  Coronary artery dilation.....................................................        10.98
93010...............  Electrocardiogram report.....................................................         0.17
93015...............  Cardiovascular stress test...................................................         0.75
93224...............  ECG monitor/report, 24 hrs...................................................         0.52
93307...............  Echo exam of heart...........................................................         0.78
93320...............  Doppler echo exam, heart.....................................................         0.38
93510...............  Left heart catheterization...................................................         4.33
93526...............  Rt & Lt heart catheters......................................................         5.99
93620...............  Electrophysiology evaluation.................................................        11.59
93651...............  Ablate heart dysrhythm focus.................................................        16.25
93732...............  Analyze pacemaker system.....................................................         0.92
93736...............  Telephone analysis, pacemaker................................................         0.15
93880...............  Extracranial study...........................................................         0.60
94010...............  Breathing capacity test......................................................         0.17
94060...............  Evaluation of wheezing.......................................................         0.31
94160...............  Vital capacity screening.....................................................         0.18
94656...............  Initial ventilator mgmt......................................................         1.22
94657...............  Cont. ventilator.............................................................         0.83
95819...............  Electroencephalogram (EEG)...................................................         1.08
95860...............  Muscle test, one limb........................................................         0.96
95861...............  Muscle test, two limbs.......................................................         1.54
95900...............  Motor nerve conduction test..................................................         0.42
95904...............  Sense nerve conduction test..................................................         0.34
95935...............  ``H'' or ``F'' reflex study..................................................         0.59
97110...............  Therapeutic exercises........................................................         0.45
99201...............  Office/outpatient visit, new.................................................         0.38
99202...............  Office/outpatient visit, new.................................................         0.75
99203...............  Office/outpatient visit, new.................................................         1.14
99204...............  Office/outpatient visit, new.................................................         1.71
99205...............  Office/outpatient visit, new.................................................         2.28
99211...............  Office/outpatient visit, est.................................................         0.17
99212...............  Office/outpatient visit, est.................................................         0.38
99213...............  Office/outpatient visit, est.................................................         0.55
99214...............  Office/outpatient visit, est.................................................         0.94
99215...............  Office/outpatient visit, est.................................................         1.51
99222...............  Initial hospital care........................................................         1.84
99223...............  Initial hospital care........................................................         2.57
99231...............  Subsequent hospital care.....................................................         0.51
99232...............  Subsequent hospital care.....................................................         0.88
99233...............  Subsequent hospital care.....................................................         1.25
99238...............  Hospital discharge day.......................................................         1.06
99241...............  Office consultation..........................................................         0.54
99242...............  Office consultation..........................................................         1.11
99243...............  Office consultation..........................................................         1.47
99244...............  Office consultation..........................................................        2.23 
[[Page 54]]                                                                                                     
                                                                                                                
99245...............  Office consultation..........................................................         2.96
99252...............  Initial inpatient consult....................................................         1.13
99253...............  Initial inpatient consult....................................................         1.56
99254...............  Initial inpatient consult....................................................         2.27
99255...............  Initial inpatient consult....................................................         3.14
99263...............  Follow-up inpatient consult..................................................         1.16
99282...............  Emergency dept visit.........................................................         0.47
99283...............  Emergency dept visit.........................................................         1.07
99284...............  Emergency dept visit.........................................................         1.68
99285...............  Emergency dept visit.........................................................         2.63
99291...............  Critical care, first hour....................................................         3.64
99292...............  Critical care, addl 30 min...................................................         1.84
99295...............  Neonatal critical care.......................................................        16.03
99296...............  Neonatal critical care.......................................................         7.40
99297...............  Neonatal critical care.......................................................         3.84
99302...............  Nursing facility care........................................................         1.67
99311...............  Nursing facility care, subseq................................................         0.54
99353...............  Home visit, estab patient....................................................         1.48
99381...............  Preventive visit, new, infant................................................         1.19
99382...............  Preventive visit, new, age 1-4...............................................         1.36
99383...............  Preventive visit, new, age 5-11..............................................         1.36
99384...............  Preventive visit, new, 12-17.................................................         1.53
99385...............  Preventive visit, new, 18-39.................................................         1.53
99386...............  Preventive visit, new, 40-64.................................................         1.88
99387...............  Preventive visit, new, 65 & over.............................................         2.06
99391...............  Preventive visit, est, infant................................................         1.02
99392...............  Preventive visit, est, age 1-4...............................................         1.19
99393...............  Preventive visit, est, age 5-11..............................................         1.19
99394...............  Preventive visit, est, 12-17.................................................         1.36
99431...............  Initial care, normal newborn.................................................         1.17
99433...............  Normal newborn care, hospital................................................         0.62
99440...............  Newborn resuscitation........................................................        2.93 
----------------------------------------------------------------------------------------------------------------
\1\All numeric CPT HCPCS Copyright 1994 American Medical Association.                                           

(Section 1848 of the Social Security Act (42 U.S.C. 1395w-4))

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

    Dated: December 22, 1994.
Neil J. Stillman,
Deputy Assistant Secretary for Information Resources Management.
[FR Doc. 94-32286 Filed 12-29-94; 8:45 am]
BILLING CODE 4120-01-P